First Wave BioPharma Announces Final Patient Dosed in Phase 2 SPAN Clinical Trial of Enhanced Adrulipase Formulation


First Wave BioPharma, Inc. recently announced the final patient was dosed in the Phase 2 SPAN clinical trial investigating an enhanced enteric microgranule delivery formulation of adrulipase for the treatment of exocrine pancreatic insufficiency (EPI) in patients with cystic fibrosis (CF).

The Phase 2 multi-center clinical trial (NCT05719311) is designed to investigate the safety, tolerability and efficacy of an enteric microgranule delivery formulation for adrulipase in a titrated dose-escalation study involving thirteen (13) patients. The primary efficacy endpoint is the coefficient of fat absorption (CFA), with secondary endpoints of stool weight, signs and symptoms of malabsorption and coefficient of nitrogen absorption (CNA). Topline results from the study are anticipated by mid-2023.

“Dosing the final patient is a key milestone in the Phase 2 SPAN clinical trial investigating our enhanced enteric microgranule delivery formulation of adrulipase for the treatment of EPI in CF patients,” said James Sapirstein, President and CEO of First Wave BioPharma. “We remain positioned to report topline data in July, which is expected to provide an initial indication of the new formulation’s ability to release adrulipase in the small intestine where the drug is designed to mix with food and deliver its therapeutic benefit. Ultimately our goal is to provide patients with a safe and effective therapy that allows individuals with CF to gain control over EPI, while diminishing the daily pill burden required with porcine-derived pancreatic enzyme replacement therapy (PERT).”

The Phase 2b SPAN trial is designed to investigate the safety, tolerability, and efficacy of a new enteric microgranulation formulation of adrulipase. The SPAN trial is an open-label study that will be conducted at three sites in the US. A total of 13 cystic fibrosis patients, all 18 years or older have been enrolled. The trial design employs a dose titration strategy. Patients will be screened at baseline to ensure they have a coefficient of fat absorption (CFA) of at least 80%. Eligible patients will then be switched from their commercial enzyme product to adrulipase. Each patient will be started on a low dose of adrulipase. If the patient is not clinically controlled, the patient will be switched to a medium dose, and if not controlled on this dose, the patient will be advanced to a high dose. The titrations will be carried out over a 3-week period, after which a CFA will be obtained. End-of-study CFAs will be compared to the baseline CFAs in a descriptive fashion. A post-treatment safety visit will be conducted one week after completing the treatment period.

Adrulipase is a recombinant lipase enzyme administered as an oral, non-systemic biologic capsule for the treatment of exocrine pancreatic insufficiency (EPI) associated with cystic fibrosis (CF) and chronic pancreatitis (CP). Adrulipase is derived from the Yarrowia lipolytica yeast lipase and is designed to break up fat molecules in the digestive tract of EPI patients so that they can be absorbed as nutrients. EPI is a condition characterized by deficiency of the exocrine pancreatic enzymes, resulting in a patient’s inability to digest food properly, or maldigestion. The deficiency in this enzyme can be responsible for greasy diarrhea, fecal urge, and weight loss. There are approximately 40,000 patients in the US with EPI caused by cystic fibrosis according to the Cystic Fibrosis Foundation and approximately 95,000 patients in the U.S. with EPI caused by chronic pancreatitis according to the National Pancreas Foundation.

First Wave BioPharma is a clinical-stage biopharmaceutical company specializing in the development of targeted, non-systemic therapies for gastrointestinal (GI) diseases. The company is currently advancing a therapeutic development pipeline with multiple clinical stage programs built around its two proprietary technologies – the biologic adrulipase, a recombinant lipase enzyme designed to enable the digestion of fats and other nutrients, and niclosamide, an oral small molecule with anti-inflammatory properties. First Wave is advancing two Phase 2 clinical programs built around adrulipase for the treatment of exocrine pancreatic insufficiency (FW-EPI) in patients with cystic fibrosis (CF) and chronic pancreatitis (CP). In developing adrulipase, First Wave is seeking to provide CF and CP patients with a safe and effective therapy to control EPI that is non-animal derived and offers the potential to dramatically reduce their daily pill burden. The company is also advancing multiple programs involving niclosamide, including FW-UP for ulcerative proctitis and ulcerative proctosigmoiditis, FW-UC for ulcerative colitis, and FW-CD for Crohn’s disease. First Wave BioPharma is headquartered in Boca Raton, Florida. For more information, visit www.firstwavebio.com.