Dr Christopher Burns
President and CEO, Venatorx Pharmaceuticals
Dr Joseph Larsen
Vice President, Strategic Portfolio Development, Venatorx Pharmaceuticals
Two years ago, the outlook for viable antibiotics looked bleak. Now policymakers have realised the scope of the problem, while a number of new innovations are in the pipeline.
Bacteria are clever, says Dr Christopher Burns, President and CEO of Pennsylvania-based pharma company, Venatorx Pharmaceuticals.
You can put them under pressure with an antibiotic, but eventually they’ll find a way to wear it down and decrease its effectiveness. They always do, and always will.
“There’s an inevitability to antimicrobial resistance (AMR),” notes Dr Burns. “It’s unavoidable, which is why every 15 – 20 years the world needs a new wave of antibiotics.” Without them, infections will become harder, or even impossible, to treat.
Worryingly, in recent times, pharma companies and policymakers have taken a head-in-the-sand mentality to antibiotic-resistant infections.
When one antibiotic has lost its effectiveness — or even stopped working altogether — the medical establishment has simply ditched it and moved on to the next. But the repercussions are potentially dire.
Creating new antibiotics that are safe and effective
To address the next wave of AMR, Dr Burns believes that new broad-spectrum antimicrobials — which have the potential to affect both gram-positive and gram-negative bacteria — are needed.
“It makes more sense to develop broad-spectrum agents,” he says. “Physicians don’t have the luxury of waiting for lab results (which narrow-spectrum agents would require) and want to treat infections as broadly and as quickly as they can with something that’s safe and dependable.”
That, however, is harder than it sounds because many pharma companies have been reluctant to get involved in antibiotic development.
Not surprisingly, they dislike being exposed to significant costs and risk for an uncertain return.
Therefore, an improved economic model is needed — one that incentivises and supports antibiotic innovation and ensures that medicines are available when needed and new drugs are constantly in the pipeline.
The pandemic is increasing the need for antibiotics
Thankfully, in the United States, two pieces of legislation — the Developing an Innovative Strategy for Antimicrobial Resistant Microorganisms (DISARM) Act of 2019 and the Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act — may provide the incentives pharma companies need.
“It’s early days, but at the very least there is now explicit acknowledgement that the marketplace for these drugs is broken,” says Dr Joseph Larsen, Vice President, Strategic Portfolio Development at Venatorx Pharmaceuticals.
“I think the discussion among policymakers has shifted from ‘is there a problem?’ to ‘there is a problem — so what kinds of initiatives should we roll out to solve it?’
DISARM and PASTEUR may provide a step towards transformational change in the market that will allow companies like ours to thrive, grow and continue making new and novel antimicrobial agents.”
COVID-19 has increased demand for new antibiotics, because a significant percentage of people with the virus progress to a secondary bacterial infection.
“COVID-19 is another reason why we’re going to need new drugs,” stresses Dr Burns. “But these drugs don’t drop from the heavens. Someone has to produce them.”
Two years ago, pessimism about the future of new antibiotic production was palpable, admits Dr Burns. Now a number of interesting developments give cause for optimism.
For example, Venatorx Pharmaceuticals has an innovative intravenous asset (one which uniquely addresses both serine- and metallo-beta-lactamases resistance) in phase 3 trials, which has prompted partnerships with The Global Antibiotic Research and Development Partnership (GARDP), Everest Medicines, and Biomedical Advanced Research and Development Authority (BARDA). In addition, the company also has a best-in-class oral agent in phase 1 trials.
“It’s not just us,” says Dr Burns. “Our friends and competitors are doing some interesting work, while big pharma is seeing the value of being productive players in this space. Plus, there are some serious policy initiatives underway. So, I’m optimistic that things are changing.”