GSK's Gepotidacin shows promise as new treatment for gonorrhoea amid rising resistance

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GSK plc unveiled encouraging results from its pivotal Eagle-1 phase 3 trial for gepotidacin, a potential breakthrough oral antibiotic for uncomplicated urogenital gonorrhoea (GC) in adolescents and adults.

These findings, set to be showcased at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global event in Barcelona on April 30, 2024, mark a significant advancement in combatting the escalating challenge of gonorrhoea, particularly concerning drug-resistant strains.

In the trial, gepotidacin demonstrated a robust microbiological success rate of 92.6%, showcasing its non-inferiority compared to the standard combination treatment regimen of intramuscular ceftriaxone plus oral azithromycin. These results underscore gepotidacin's potential as a frontline treatment option, especially in the face of mounting antimicrobial resistance.

Chris Corsico, GSK's senior vice president of development, emphasized the urgency for innovative solutions in addressing the escalating global burden of gonorrhoea.

He said: “These results highlight the potential of gepotidacin as a new oral treatment option given the rising incidence of gonorrhoea worldwide including drug resistant infections. The imperative for innovative treatments has never been clearer.”

Gonorrhoea, caused by the bacterium Neisseria gonorrhoeae, poses a significant public health concern globally, with an estimated 82 million new cases annually. In the United States alone, reported cases have surged by 118% from 2009 to 2021, with approximately half of these cases exhibiting resistance to at least one antibiotic. This concerning trend underscores the critical need for effective and novel treatment options.

Transforming gonorrhoea treatment

Gepotidacin's safety profile in the EAGLE-1 trial remained consistent with previous phase I and II studies, with gastrointestinal adverse events being the most commonly reported. Notably, all adverse events were mild or moderate, underscoring gepotidacin's favorable safety and tolerability.

Gonorrhoea, if left untreated or inadequately managed, can lead to serious complications, including infertility and increased susceptibility to HIV infection. As such, the development of effective treatments is crucial in curbing its spread and mitigating associated health risks.

GSK's pursuit of innovative antimicrobial therapies extends beyond gonorrhoea, with gepotidacin also being explored for its potential in treating uncomplicated urinary tract infections (uUTI). Positive phase 3 data from the Eagle-2 and Eagle-3 trials, presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) in April 2023, further underscore gepotidacin's versatility and promise in addressing critical unmet medical needs.

Gepotidacin's development has received funding support from the US Department of Health and Human Services and the Defense Threat Reduction Agency, reflecting its strategic importance in combating infectious diseases and antimicrobial resistance.

The Eagle phase 3 programme, comprising three trials, represents a significant milestone in advancing gepotidacin's clinical development. With these promising results, gepotidacin stands poised to emerge as a transformative therapy in the fight against gonorrhoea and other infectious diseases, offering hope for improved patient outcomes and enhanced global public health.