Replies to post #381729 on Innovation Pharmaceuticals Inc (IPIX)

[steelyeye]

Nice call-out on the apples-to-oranges comparison. I hope you get a response that is credible, but I doubt it.

As many here know, Brilacidin underwent two safety reviews before compassionate use was approved by the FDA for hospitalized patients.

Even so, some continued to "worry" about tingling in the extremities, falsely believing they were serious adverse effects (SAEs).

Looking forward to next week's TLD.

Isn't this a lot different from how IPIX conducted its trial?

[sunspotter]

"The NRx PR announcing the results does not say:

1. It was a double-blind study.
2. It followed the 29-day protocol expected of such studies."



The Zyesami study is an adaptive study, which is blinded, randomised and initialy placebo controlled, so, yes, this does give me "sufficient confidence that the admission process was unbiased".

It's also run by a proper pharmaceutical company with experienced employees and the study is supported by NIH and NHLBI, among a host of other respectable US institutions.

It has a follow up of 90 and 180 days, so is even more meaningful than the brilacidin study.

"This is a master protocol to evaluate the safety and efficacy of investigational agents aimed at improving outcomes for patients with acute respiratory failure related to COVID-19.

Trials within this protocol will be adaptive, randomized, blinded and initially placebo-controlled. Participants will receive standard of care (SOC) treatment as part of the protocol. If an investigational agent shows superiority over placebo, SOC for the study of future investigational agents may be modified accordingly.

The international trials within this protocol will be conducted in up to several hundred clinical sites. Participating sites are affiliated with networks funded by the United States National Institutes of Health (NIH) and the US Department of Veterans Affairs.

The protocol is for a phase III platform study that allows investigational drugs to be added and dropped during the course of the study. This allows for efficient testing of new drugs against control within the same trial infrastructure. When more than one agent is being tested concurrently, participants may be randomly allocated across agents (as well as between the agent and its placebo) so the same control group can be shared, when feasible. In some situations, a factorial design may be used to study multiple agents.

Participants will be followed for 90 days following randomization for the primary endpoint and most secondary endpoints. Selected secondary endpoints will be measured at 180 days.

This study is planned to provide 80% power to detect an odds ratio of 1.5 for improvement in recovery status at Day 90 for an investigational agent versus placebo with use of the ordinal outcome. The planned sample size is 640 participants (320 per group) for each investigational agent/placebo. Sample size may be re-estimated before enrollment is complete based on an assessment of whether the pooled proportions of the outcome are still consistent with adequate power for the hypothesized difference measured by the odds ratio.

Randomization will be stratified by study site pharmacy and by receipt of invasive mechanical ventilation, or ECMO at enrollment. Other agent-specific stratification factors may be considered.

Investigational agents suitable for testing in the inpatient setting will be prioritized based on in vitro data, preclinical data, phase I pharmacokinetic and safety data, and clinical data from completed and ongoing trials. In some cases, a vanguard cohort/initial pilot phase may be incorporated into the trial.

An independent Data and Safety Monitoring Board (DSMB) will review interim safety and efficacy data at least monthly. Pre-specified guidelines will be established to recommend early stopping of the trial for evidence of harm or substantial efficacy. The DSMB may recommend discontinuation of an investigational agent if the risks are judged to outweigh the benefits."

https://clinicaltrials.gov/ct2/show/NCT04843761

Anything else you'd like to ask?