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NVC-422 topical gel for the treatment of impetigo
Susan M Iovino1, Kenneth D Krantz, Daisy M Blanco
1NovaBay Pharmaceuticals Inc., Emeryville, CA 94605, USA.
Abstract:
Impetigo is a highly contagious bacterial skin infection affecting children worldwide that is caused by the Gram-positive bacteria Staphylococcus aureus, Streptococcus pyogenes, or both. Staphylococcus species can quickly develop drug resistance rendering mupirocin, fusidic acid, and erythromycin ineffective. Preclinical and clinical studies demonstrated that NVC-422 (N, N-dichloro-2, 2-dimethyltaurine) rapidly kills pathogens without the development of drug resistance. 129 patients with clinically diagnosed impetigo were randomized to three dose groups (0.1, 0.5, or 1.5% NVC-422 topical gel) in a study conducted at 2 centers; 125 patients (97%) had microbiologically confirmed infection. Treatment was administered three times a day (TID) for 7 days to all randomized subjects. Response was measured at the completion of treatment (Day 8) and 1 week post treatment (Day 15) by the Skin Infection Rating Scale (SIRS) and by microbiological response. A total of 120 subjects (96%) completed all 7 days of treatment and were assessed at end of treatment (EOT). Clinical response rate at EOT in the PPC population was excellent in each of the dose groups (84.6%, 87.2%, and 92.3% in the 0.1%, 0.5% and 1.5% dose groups respectively). The majority of the infections were caused by S. aureus, alone (106/125, 85%) of which approximately 10% were MRSA. There were no clinical recurrences in any treatment groups. Treatment-emergent adverse events were seen in 5.4% of the subjects (7/129) and were mild to moderate and resolved. NVC-422 topical gel administered TID was well tolerated, with high rates of clinical and microbiological responses for treating impetigo.
Insights
NVC-422 topical gel shows high efficacy and tolerability in treating impetigo, a common bacterial skin infection. This novel treatment rapidly kills pathogens like Staphylococcus aureus without causing drug resistance.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Impetigo is a contagious bacterial skin infection prevalent in children globally.
- Common causative agents include Staphylococcus aureus and Streptococcus pyogenes.
- Increasing antibiotic resistance to mupirocin, fusidic acid, and erythromycin poses a treatment challenge.
Purpose of the Study:
- To evaluate the efficacy and safety of NVC-422 (N, N-dichloro-2, 2-dimethyltaurine) topical gel for treating impetigo.
- To assess the impact of different NVC-422 concentrations on treatment outcomes.
Main Methods:
- A randomized study involving 129 patients with clinically diagnosed impetigo.
- Patients received NVC-422 topical gel at 0.1%, 0.5%, or 1.5% three times daily for 7 days.
- Clinical and microbiological responses were assessed using the Skin Infection Rating Scale (SIRS) and pathogen identification.
Main Results:
- High clinical response rates were observed across all dose groups at end of treatment (84.6% to 92.3%).
- The majority of infections were caused by Staphylococcus aureus, including some Methicillin-resistant Staphylococcus aureus (MRSA) strains.
- NVC-422 was well-tolerated, with mild to moderate adverse events reported in only 5.4% of subjects.
Conclusions:
- NVC-422 topical gel is a well-tolerated and effective treatment for impetigo.
- The study demonstrates high clinical and microbiological response rates, suggesting NVC-422 as a promising alternative for impetigo treatment.
- NVC-422's ability to overcome existing drug resistance mechanisms warrants further investigation.
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