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The Lancet Infectious Diseases Publishes Results from Paratek’s Phase 3 Oral only Dosing Study of NUZYRA® (omadacycline) for Skin Infections
NUZYRA is a modernized tetracycline that is a once-daily intravenous (IV) and oral formulation for the treatment of community-acquired bacterial pneumonia (CABP) and ABSSSI. NUZYRA was approved by the
“The incidence of skin infections that require hospitalization has substantially increased due, in part, to the emergence of community-acquired MRSA. These infections are estimated to cause almost 900,000 hospital admissions and 3.4 million emergency department visits each year and place a significant financial burden on the healthcare system,” said
One of three pivotal, Phase 3 clinical studies demonstrating the efficacy and safety of NUZYRA in skin infections and pneumonia, OASIS-2 (Omadacycline in Acute Skin Structure Infections Study), evaluated the efficacy and safety of once-daily, oral-only NUZYRA compared to twice-daily oral-only linezolid in 735 adults with ABSSSI. OASIS-2 demonstrated that NUZYRA was non-inferior to linezolid for treating ABSSSI, with a similar safety profile. Efficacy was consistent across study populations, type of skin infection and causative pathogen including methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MRSA) infections. These account for nearly half of all ABSSSI isolates in
In the modified intent-to-treat population (mITT), NUZYRA (n=360) met the
Additionally, NUZYRA met statistical NI compared to linezolid for the EMA-specified co-primary endpoints at the post therapy evaluation (PTE), 7 to 14 days after completion of therapy in the mITT and the Clinically Evaluable (CE) populations. Clinical success rates at PTE in the mITT population for the NUZYRA and linezolid arms were 84.2% vs. 80.8%, respectively; and in the CE population were 97.9% vs. 95.5%, respectively.
Efficacy observed in OASIS-2 was consistent and similar to results from the OASIS-1 study, which evaluated the efficacy and safety of an IV to oral once-daily NUZYRA against twice-daily linezolid.
In the OASIS-2 study, there was a low rate of study treatment discontinuation for both omadacycline and linezolid patients at 10.9% vs. 14.2%, respectively. Less than 2% of patients discontinued treatment due to adverse events in both treatment groups. No deaths occurred in the NUZYRA treatment arm.
The most common treatment emergent adverse events (TEAEs) in NUZYRA- and linezolid-treated patients were nausea (30.2% vs. 7.6%, respectively) and vomiting (16.8% vs. 3.0%, respectively). Seventy-five percent of the nausea in the NUZYRA treated group was classified as mild with none reported as severe, and only one NUZYRA patient discontinued treatment for gastrointestinal events. Onset of nausea or vomiting in NUZYRA patients occurred more frequently during the loading-dose phase on days one or two (25.3% and 12.5% respectively), compared to nausea or vomiting rates of </=5% after day two. The median duration of these episodes was two days.
Additional TEAEs, occurring in > 3% of NUZYRA patients were wound infection (6.0%), increased alanine aminotransferase (ALT; 5.2%), increased aspartate aminotransferase (AST; 4.6%), diarrhea (4.1%), headache (3.5%) and cellulitis (3.3%), which were generally comparable between treatment arms. No subject in either treatment group developed Clostridium difficile infection.
“Results from OASIS-2 demonstrate that once-daily, oral-only NUZYRA is an effective, well-tolerated monotherapy across multiple types of skin infections and bacterial pathogens—including resistant pathogens such as MRSA,” said
Paratek has submitted a marketing authorization application of omadacycline in the European Union. Paratek has entered into a collaboration agreement with Zai Lab for the development and commercialization of omadacycline in the greater China region and retains all remaining global rights.
Under a research agreement with the U.S. Department of Defense, omadacycline also is being studied against pathogenic agents causing infectious diseases of public health and biodefense importance, including plague and anthrax.
SEYSARA™ (sarecycline) is an FDA-approved product with respect to which we have exclusively licensed certain rights in the United States to Almirall, LLC, or Almirall. SEYSARA is currently being marketed by Almirall in the U.S. as a new once-daily oral therapy for the treatment of moderate to severe acne vulgaris. Paratek retains development and commercialization rights with respect to sarecycline in the rest of the world.
Recognizing the serious threat of bacterial infections, Paratek is dedicated to providing solutions that enable positive outcomes and lead to better patient stories. For more information, visit www.ParatekPharma.com or follow @ParatekPharma on Twitter.
NUZYRA (omadacycline) is a novel antibiotic with both once-daily intravenous (IV) and oral formulations for the treatment of community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin structure infections (ABSSSI). A modernized tetracycline, NUZYRA is specifically designed to overcome tetracycline resistance and exhibits activity across a spectrum of bacteria, including Gram-positive, Gram-negative, atypicals, and other drug-resistant strains.
Indications and Usage
NUZYRA is a tetracycline class antibiotic indicated for the treatment of adult patients with the following infections caused by susceptible microorganisms:
Community-Acquired Bacterial Pneumonia (CABP) caused by the following:
Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible isolates), Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae.
Acute Bacterial Skin and Skin Structure Infections (ABSSSI) caused by the following:
Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Staphylococcus lugdunensis, Streptococcus pyogenes, Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Enterococcus faecalis, Enterobacter cloacae, and Klebsiella pneumoniae.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of NUZYRA and other antibacterial drugs, NUZYRA should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.
Important Safety Information
NUZYRA is contraindicated in patients with known hypersensitivity to omadacycline or tetracycline class antibacterial drugs, or to any of the excipients.
Warnings and Precautions
Mortality imbalance was observed in the CABP clinical trial with eight deaths (2%) occurring in patients treated with NUZYRA compared to four deaths (1%) in patients treated with moxifloxacin. The cause of the mortality imbalance has not been established. All deaths, in both treatment arms, occurred in patients >65 years of age; most patients had multiple comorbidities. The causes of death varied and included worsening and/or complications of infection and underlying conditions. Closely monitor clinical response to therapy in CABP patients, particularly in those at higher risk for mortality.
The use of NUZYRA during tooth development (last half of pregnancy, infancy and childhood to the age of 8 years) may cause permanent discoloration of the teeth (yellow-gray-brown) and enamel hypoplasia.
The use of NUZYRA during the second or third trimester of pregnancy, infancy and childhood up to the age of 8 years may cause irreversible inhibition of bone growth.
Hypersensitivity reactions have been reported with NUZYRA. Life-threatening hypersensitivity (anaphylactic) reactions have been reported with other tetracycline-class antibacterial drugs.
NUZYRA is structurally similar to other tetracycline-class antibacterial drugs and is contraindicated in patients with known hypersensitivity to tetracycline-class antibacterial drugs.
Discontinue NUZYRA if an allergic reaction occurs.
Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents and may range in severity from mild diarrhea to fatal colitis. Evaluate if diarrhea occurs.
NUZYRA is structurally similar to tetracycline-class of antibacterial drugs and may have similar adverse reactions. Adverse reactions including photosensitivity, pseudotumor cerebri, and anti-anabolic action which has led to increased BUN, azotemia, acidosis, hyperphosphatemia, pancreatitis, and abnormal liver function tests, have been reported for other tetracycline-class antibacterial drugs, and may occur with NUZYRA. Discontinue NUZYRA if any of these adverse reactions are suspected.
Prescribing NUZYRA in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
The most common adverse reactions (incidence ≥ 2%) are nausea, vomiting, infusion site reactions, alanine aminotransferase increased, aspartate aminotransferase increased, gamma-glutamyl transferase increased, hypertension, headache, diarrhea, insomnia, and constipation.
Patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage while taking NUZYRA.
Absorption of tetracyclines, including NUZYRA is impaired by antacids containing aluminum, calcium, or magnesium, bismuth subsalicylate and iron containing preparations.
Use in Specific Populations
Lactation: Breastfeeding is not recommended during treatment with NUZYRA
To report SUSPECTED ADVERSE REACTIONS, contact
Please see full Prescribing Information for NUZYRA at www.NUZYRA.com.
Forward Looking Statements
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Source: Paratek Pharmaceuticals