ANA Therapeutics Begins Phase 2/3 Clinical Trial of Proprietary Oral Niclosamide Formulation to Treat COVID-19
“ANA Therapeutics refocused its business with the emergence of COVID-19 to utilize our expertise in niclosamide and drug formulation,” said Akash Bakshi, Co-Founder and CEO of ANA Therapeutics. “We have moved quickly to bring niclosamide into clinical trials and expect to accelerate development further through partnerships to deliver this product as an important new therapeutic option for COVID-19 patients.”
“There is a great need for additional therapeutic options to reduce the impact of COVID-19 on patients,” said Nadja Mannowetz, PhD, ANA’s Chief Scientific Officer. “Niclosamide has demonstrated antiviral as well as immune-modulating activities in preclinical studies. This trial provides the first opportunity to evaluate its safety and potential to improve clinical outcomes and reduce hospital stay by reducing viral load, inflammation linked to cytokine dysregulation, acute respiratory distress syndrome, and disease related blood coagulation.”
Niclosamide, which is not currently available in the U.S., has been used for more than 50 years to treat millions of people worldwide, with its primary indication being the treatment of tapeworm infections. The drug recently emerged as a promising candidate for treating SARS-CoV-2. In pre-clinical research by an independent academic group published in Antimicrobial Agents and Chemotherapy, niclosamide inhibited viral replication in vitro and was more potent than remdesivir in the same assay.
The mechanism of action for niclosamide’s inhibition of SARS-CoV-2 is believed to be through SKP2-inhibition. In a preprint, an independent academic group reported niclosamide prevents SARS-CoV-2 replication via SKP2-inhibition. The same group previously reported in Nature Communications that niclosamide prevents the replication of Middle East respiratory syndrome (MERS-CoV), a coronavirus closely related to SARS-CoV-2, by the same mechanism.
In addition to its antiviral properties, niclosamide has shown anti-inflammatory activity through NF-κB and STAT3, transcription factors that induce the expression of molecules that drive inflammation. In vitro experiments reported in Cancer Research and ACS Medicinal Chemistry Letters, respectively, demonstrated that niclosamide inhibited both NF-κB and STAT3 transcription.
“The original niclosamide product was designed to work in the gut, where tapeworms reside, and not enter the bloodstream,” said Andrew Bartynski, PhD, ANA’s Co-Founder and COO. “We have developed a proprietary formulation intended to enable the drug to readily enter the bloodstream at levels sufficient to stop the virus from replicating.”
The Phase 2/3 trial is a randomized, placebo-controlled study that will be conducted in two parts at a total of 20 clinical sites in the U.S. In both study parts, hospitalized patients with moderate COVID-19 (patients not requiring ventilators) will be administered a seven-day course of niclosamide capsules in addition to standard of care. The primary objective of the first part of the trial is assess safety and tolerability; secondary objectives include measurement of efficacy (median time to discharge) and pharmacokinetics.
The trial’s second part will enroll several hundred patients, with the primary objectives of assessing niclosamide’s efficacy (median time to hospital discharge), safety and tolerability. Secondary objectives relate to clinical improvement and the need and duration for rescue therapy.
About ANA Therapeutics
ANA Therapeutics is a Silicon Valley-based biotech start-up developing a proprietary niclosamide formulation as a widely accessible antiviral treatment for patients with COVID-19. ANA Therapeutics is the first Y Combinator portfolio company to initiate a Phase 2 clinical trial. For more information, please visit https://anatherapeutics.com/.
Source: ANA Therapeutics