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Atriva Development Programs

Atriva Therapeutics researches and develops first-in-class host-targeting therapies to treat severe respiratory viral infections, including influenza, COVID-19, RSV, dengue and hanta.

Rationale: COVID-19

The COVID-19 death toll was driven by the viral infection, the derailment of the immune system such as the overwhelming cytokine storm in the infected organs, and pre-existing comorbidities.

Based on its mode of action, its broad-spectrum antiviral activity against many RNA viruses, and its safety profile, zapnometinib was evaluated by the company’s scientists as a drug candidate that might be effective against the coronavirus SARS-CoV-2 – the cause of the COVID-19 pandemic.

Given the urgent need for a therapeutic approach during the past pandemic, the company decided to investigate zapnometinib’s efficacy against the SARS-CoV-2 virus and conducted preclinical studies.

The results clearly demonstrated the dual benefit of zapnometinib’s mechanism of action: The host cell factor blocks RNA-virus replication and in parallel generates immuno-modulating effects:

  • Benefit 1: inhibition of the viral propagation by interference with host-cell kinase
  • Benefit 2: inhibition of cytokine response

These observations established the rationale to clinically investigate zapnometinib in COVID-19. On December 29th, 2020, Atriva Therapeutics obtained RESPIRE trial approval in COVID-19 patients from German authorities. In April 2021, the company announced the dosing of the first patient at Charité – Universitätsmedizin Berlin, Germany. The trial was ended in the third quarter of 2022 following the decreasing pandemic threat.

Clinical Phase II in COVID-19

RESPIRE [Randomized, Double-Blind, Placebo-Controlled, Multi-Center Clinical Trial to Evaluate the Safety and Efficacy of zapnometinib in Adult Hospitalized Patients with COVID-19] was a randomized, double-blind, placebo-controlled, international, multi-center Phase II clinical trial for 220 adult patients with moderate to severe COVID-19, requiring hospitalization, but not requiring ICU admission or ventilator support at the time of screening or randomization. On top of standard of care, half the patients would receive zapnometinib 900 mg, administered as tablets once daily on day 1, followed by zapnometinib 600 mg once daily on days 2 to 6. Patients in the control group would receive placebo in a matching scheme, on top of standard of care.

Primary objective of the study was to prove the efficacy of zapnometinib versus placebo in addition to standard of care; secondary endpoints included the reduction of duration of hospitalization, the measurement of changes in clinical signs and symptoms and other relevant clinical parameters, scores, and study events. Outcomes were assessed based on the clinical severity status on day 15, using a 7-point ordinal scale as suggested by the WHO COVID-19 Therapeutic Trial Synopsis. All enrolled patients were followed-up for 90 days. The study  also evaluated the pharmacokinetics of zapnometinib and was ended with promising results in September 2022. These results now form a solid foundation for Atriva`s Phase 2 development program in the treatment of patients hospitalized with a severe influenza infection.

Figure: RESPIRE clinical trial design.