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Thought Leaders Say Eravacycline Is No. 1 for Hospital-Acquired Pneumonia

Advantages include activity against multidrug-resistant pathogens (Apr. 24)

Decision Resources, a research and advisory firm located in Burlington, Mass., finds that, based on clinical data and the opinions of interviewed thought leaders, the intravenous and oral synthetic tetracycline derivative eravacycline (Tetraphase Pharmaceuticals) offers competitive advantages over currently marketed therapies for hospital-acquired pneumonia (HAP). These advantages include the drug’s delivery as well as its activity against multidrug-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase–producing Enterobacteriaceae.

Interviewed thought leaders also expect that ceftazidime/avibactam (Forest/AstraZeneca) and ceftolozane/tazobactam (Cubist) will offer improvements in activity against multidrug-resistant Pseudomonas aeruginosa compared with current HAP therapies.

Surveyed U.S. and European infectious disease specialists also agreed that clinical trial data demonstrating a clinical cure rate in clinically evaluable patients at the test-of-cure visit is a key driver of their prescribing decisions in HAP. Clinical data and the opinions of interviewed thought leaders indicate that the current therapies vancomycin and meropenem (Merrem/Meronem, AstraZeneca; and generics) are comparable on this attribute and have no advantage over sales-leading Zyvox (Pfizer).

In addition, increasing rates of antimicrobial resistance have made frequently used first-line therapies, such as piperacillin/tazobactam (Zosyn, Pfizer; and generics) and levofloxacin (Levaquin, Johnson & Johnson; Tavanic, Sanofi; and generics), less effective in clinically curing patients with HAP.

“Nearly all trials of antibiotics are powered to demonstrate non-inferiority between an emerging therapy and an active comparator, and it is unlikely that results from HAP clinical trials will show significantly better clinical cure rates for emerging drugs when compared with current therapies,” said analyst David Holman, PhD.

The report also finds that surveyed U.S. hospital pharmacy directors are generally willing to grant favorable formulary status to new HAP therapies with improved activity against multidrug-resistant HAP pathogens, particularly MRSA, multidrug-resistant P. aeruginosa, and extended-spectrum beta-lactamase–producing Enterobacteriaceae. Patients with HAP caused by these pathogens have significantly fewer treatment options and ultimately poorer clinical outcomes. Responses from surveyed hospital pharmacy directors revealed that therapies with improved activity against these pathogens could command price premiums compared with current treatments.

Source: Decision Resources; April 24, 2013.

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