RE: A risk worth taking26 Feb 2022 12:50
A failed P3 is not the end of the road if there is post hoc analysis that can show that given new protocols or end points , it would have shown efficacy .
Close to home is the P3 INTEREST trial that Faron did in 2017/18 ( 600 odd patients ) . It failed , but straight away they saw that the steroids were causing issues .
What followed were meetings with the FDA to explain this , and draw up a new study protocol to prove their thesis .
From a Faron RNS -
The FDA accepted Faron's proposed study protocol for the new Traumakine trial, which excludes the use of concomitant corticosteroids and which will be split in two steps. The first step will commence with INTEGRITY, a pilot randomised and placebo controlled study, which will serve as final adjustment for adequate statistical powering and sample size justification for the pivotal second step, CALIBER.
That was in 2019 , and was about to get underway , when Covid blew up . That put a spanner in the works for normal trials in 2020 , but Faron got involved in two platform trials , that were a waste of time , and hence then had further meetings with FDA and redesigned the trial again - to focus on Covid - called HIBISCUS . This would pitch their drug directly up against Dexamethasone in a small P2/3 trial again ( funded by the Department of Defence ) .
Anyway - the gist of this is that if there is good data in amongst SPRINTER , then the FDA will more than likely be willing take post hoc analysis into consideration .
This may result in a smaller trial to just prove the point ( 70-150 patients with new protocols ) , or consider it along with all the other trial data , and ACTIV2 P2 data to make further recommendations .
Also , with the increasing research being published on IFN B and Covid , further biomarkers / patient types may be discovered that also make the diagnosis of likely responders even more clear .
For example , Faron also have another drug they are trialing , and P2 data has thrown up 4 biomarkers which gives an AUC of 0.917 ( 91% accuracy of targeting a likely responsive patient before therapy )
All this kind of stuff can come out off the data analysis . Synairgen will have a huge set of data now , so no surprise we haven't had any update yet .