RedHill Biopharma Ltd., an Israeli biopharmaceutical company, announced additional supportive data from the first phase III study with RHB-105 for eradication of H. pylori (the ERADICATE Hp Study). Results from the subsequent open-label treatment of patients in the placebo arm with standard-of-care (SoC) therapy for persistent H. pylori infection demonstrated a 63 per cent eradication rate with SoC, compared to the previously reported 89.4 per cent eradication rate demonstrated in the RHB-105 arm of the controlled study.

These results further support the potential superior efficacy of RHB-105 over SoC and validate the use of the historical SoC efficacy threshold of 70 per cent implemented in the ERADICATE Hp study as the control for the study’s primary endpoint. RedHill announced in June 2015 positive top-line results from the ERADICATE Hp phase III study for the treatment of H. pylori bacterial infection. The top-line results demonstrated 89.4 per cent efficacy in eradicating H. pylori infection with RHB-105. The study successfully met its primary endpoint of superiority over historical SoC eradication rate levels of 70 per cent, with high statistical significance (p<0.001). No serious adverse events related to the drug product, new or unexpected safety issues were identified in the study.

David Graham, M.D., M.A.C.G., of the Baylor College of Medicine, a key opinion leader in the field of gastric cancer and H. pyloriinfection and principal investigator of the ERADICATE Hp Study, said, “The study’s results of 63 per cent eradication rate of H. pylori infection with standard-of-care (SoC) are in-line with recent literature and clinical experience and are indicative of the increasing and alarming rates of resistance of H. pylori bacteria to SoC treatment. Furthermore, it strengthens the RHB-105 phase III study’s primary endpoint results, and supports the potential superior efficacy of RHB-105 over SoC, with an 89.4 per cent eradication rate. H. pylori is a leading cause of gastric cancer, peptic ulcer disease and MALT lymphoma, and the falling cure rates of SoC therapies represent a significant concern for healthcare authorities worldwide. Despite existing therapies becoming increasingly ineffective in eradicating H. pylori, no new therapies have been approved for this indication in the last decade.”

Gilead Raday, RedHill's senior VP corporate and product development, added, “The positive top-line results from the first phase III study with RHB-105 and the new SoC data lead us to believe that RHB-105 can potentially be positioned as a best-in-class, first-line therapy for eradication of H. pylori. We plan to meet with the FDA during the fourth quarter of 2015 or the first quarter of 2016 to discuss the future development plan of RHB-105 and the path to marketing approval of this important drug candidate in the US.”

The randomized, placebo-controlled, ERADICATE Hp phase III study was intended to evaluate the safety and efficacy of RHB-105 as a first-line treatment for confirmed H. pylori bacterial infection. A total of 118 non-investigated dyspepsia patients with confirmed H. pylori infection were enrolled and treated in the study, which was conducted in the US. Subjects were randomized in a 2:1 ratio to receive either RHB-105 or a placebo for a period of 14 days and assessed for the eradication of H. pylori infection. Subsequent to completion of the treatment period and the un-blinding of the study, subjects enrolled in the placebo arm were entitled to receive SoC therapy as prescribed by the treating physician in an open-label setting, and were assessed for the eradication of H. pylori infection 28-35 days after completion of treatment.

RedHill recently entered into an agreement with Recipham AB, a leading CMO (Contract Manufacturing Organisation) for the manufacture of RHB-105. Under the terms of the agreement, Recipharm will be responsible for manufacturing RHB-105 for the planned second phase III study and for future potential commercial supply of RHB-105. In order to support the manufacturing of RHB-105, Recipharm will invest approximately 13 million SEK (approximately $1.55 million) in manufacturing capabilities. Recipharm operates development and manufacturing facilities with approximately 2,200 employees in Sweden, France, the UK, Germany, Spain, Italy and Portugal and is headquartered in Jordbro, Sweden.

The 2015 global and U.S. market potential for H. pylori eradication therapies, at current branded prices, were recently estimated at approximately $4.83 billion and $1.45 billion, respectively, and could potentially grow with increasing awareness of the health risks associated with H. pylori infection and the benefits of its eradication.

Top-line and other results from the ERADICATE Hp phase III study, demonstrating achievement of primary endpoint, were provided to RedHill by an independent third party following an independent analysis and remain subject to completion of the independent review and analysis of the underlying data, including all safety, secondary and other outcome measures. Completion of the clinical study report (CSR) is expected in the fourth quarter of 2015.

RHB-105 is a new and proprietary fixed-dose oral combination therapy of two antibiotics and a proton pump inhibitor (PPI) in an all-in-one oral capsule with a planned indication for the treatment of H. pylori infection. H. pylori bacterial infection is a major cause of chronic gastritis, peptic ulcer disease, gastric cancer and mucosa associated lymphoid tissue (MALT) lymphoma. A first phase III study with RHB-105 is ongoing in the US with positive top-line results (the ERADICATE Hp study). The study demonstrated an overall success rate of 89.4 per cent in eradicating H. pylori, and met its protocol-defined primary endpoint of superiority in eradication of H. pylori infection over historical standard of care efficacy levels of 70 per cent, with high statistical significance (p<0.001). RedHill plans to conduct a second phase III study. Additional studies may be required, subject to FDA feedback. RHB-105 has been granted Qualifying Infectious Disease Product (QIDP) designation by the FDA, providing a Fast-Track development pathway, as well as Priority Review status, potentially leading to a shorter review time by the FDA of an NDA, if filed. If approved, RHB-105 will also receive an additional five years of US market exclusivity, in addition to the standard exclusivity period, for a total of 8 years of market exclusivity.