IDWeek 2019 — Exebacase adjunct bests standard-of-care alone for MRSA bacteremia


  • Marielle Fares, Pharm.D.
  • Conference Reports
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Takeaway 

  • Exebacase added to standard-of-care (SOC) antibiotics yielded a higher clinical responder rate than antibiotics alone in a subgroup of patients with methicillin-resistant staphylococcus aureus (MRSA) bacteremia.
  • Exebacase reduced length of stay, 30-day readmissions in this phase 2 study.
  • Results support phase 3 trial.

Why this matters

  • MRSA has high social and economic costs.
  • Lysins like exebacase are first in class and synergistic with conventional antibiotics, with a low propensity for resistance.

Study design

  • Randomized, double blind, placebo-controlled, superiority design phase 2 study in adults with MRSA bacteremia, including endocarditis.
  • Study compared exebacase plus SOC antibiotics with antibiotics alone in the modified intention-to-treat population (71 patients on exebacase+SOC vs 45 patients on antibiotics alone).
  • Primary endpoint: clinical responder rate at day 14.

Key results

  • In the prespecified MRSA subgroup, exebacase (n=27) resulted in a 42.8% higher responder rate at day 14 vs antibiotics alone (n=16).
  • Exebacase was associated with reduced hospital length of stay by 4 days (median stay, 6 days for exebacase vs 10 for antibiotics) and reduced readmissions. 
  • Exebacase was safe and well-tolerated.

Limitations

  • Presented without peer review at a conference.