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Positive Results Support Travelan progress to Phase 3 Clinical Trials in the US Highlights: Immuron proceeding to Phase 3 registration strategy with the FDA Travelan topline clinical trial results demonstrate protective

Key Takeaway: Positive Results Support Travelan progress to Phase 3 Clinical Trials in the US Melbourne, Australia, March 7, 2024: Immuron Limited (ASX: IMC; NASDAQ: IMRN), an Australian based and globally integrated biopharmaceutical company is pleased to announce the interim topline resu

Full Press Release Details

Positive Results Support Travelan
progress to Phase 3 Clinical Trials in the US
Melbourne, Australia, March 7, 2024: Immuron
Limited (ASX: IMC; NASDAQ: IMRN), an Australian based and globally integrated biopharmaceutical company is pleased to announce the interim
topline results confirming that a single daily dose of Travelan is effective in prevention of moderate to severe
diarrhea following challenge with enterotoxigenic Escherichia coli (ETEC).
AU $4.8 (USD $3.43) million funding by the U.S. Department of Defense (ASX Announcement 12 January 2022) to perform a randomized double-blind
placebo-controlled phase 2 controlled human infection model (CHIM) study to assist with evaluating a dosing regimen that is most suited
to deployed US troops visiting developing countries. Healthy volunteers were recruited and randomly assigned to receive a single daily
oral dose of 1200 mg of Travelan or placebo. Dosing commenced 2 days prior to challenge with ETEC strain H10407 and continued
for 7 days. ClinicalTrials.gov Identifier: NCT05933525.
This interim analysis summarizes the data for
a total of 60 subjects who have completed the inpatient challenge component of this current clinical study. Last patients last visits
are anticipated to commence in April this year and final clinical study report will be completed in H2 2024.
Having demonstrated protective efficacy in two
published clinical studies (Otto et al., 2011), this Phase 2 study was designed to compare the preventative effects of once daily dosing
to the current standard recommended treatment of three times daily dosing. To learn more about Phase 2 study design, read: U.S. Food and
Drug Administration Step 3: Clinical Research
IMM-124E (Travelan ) will be the
first product developed with Immuron's platform technology to proceed into Phase 3 clinical trials. The underlying nature of Immuron's
platform technology enables the development of medicines across a large range of infectious diseases. The platform can be used to block
viruses or bacteria at mucosal surfaces such as the Gastrointestinal tract and neutralize the toxins they produce. More information on
Immuron's platform technology can be found below.
Travelan demonstrated clinical
efficacy in preventing ETEC-attributable diarrhea in two previous CHIM studies. These studies showed dosing 400 mg three times daily,
resulted in 76.7% (p=0.007) to 90.9% (p=0.0005) protection (Otto et al., 2011).
This trial demonstrated protective efficacy* with
once daily dosing even though the attack rate for this study was much lower than planned. The intended attack rate (percentage of subjects
with ETEC-induced moderate- severe diarrhea) for this study was approximately 70%. The attack rate for the Placebo group of this study
was only 37% (Table 2). Given the lower than planned attack rate, this current study is underpowered to appropriately detect a significant
difference in moderate to severe ETEC attributed diarrhea in the Placebo group compared to the Treatment group. This makes the demonstration
of protective efficacy and reduction in adverse events and diarrheal symptoms particularly noteworthy.
The company will now proceed to hold an end of
Phase 2 meeting with the U.S Food and Drug Administration to discuss the pivotal Phase 3 registration strategy and planned clinical trials
including recommended dosing to support a Biologics License Application (BLA) for Travelan as a prophylactic medicine
for Travelers' Diarrhea. A preventative treatment that defends against infectious enteric diseases is a high priority objective
for the U.S. Military.
Immuron is in the process of exploring non-dilutive funding opportunities
for these Phase 3 clinical trials.
Travelan , a first-in-class, oral
antibody therapy, dosed once daily resulted in a reduction ETEC-induced moderate-severe diarrhea compared to placebo.
Studies using the CHIM for a variety of different
enteric pathogens suggest the greatest protection may be against more severe disease and in studies where the disease appears to be predominately
mild, which appears to be the case in this study, the efficacy estimates can be lower than anticipated.
Table 2: Comparison of clinical study data
Event post challenge Otto 3 Study 1 Placebo n = 15 n (%) Otto 3 Study 2 Placebo n = 14 n (%) Current Travelan Study n = 30 n (%)
Number (n) of subjects with ETEC-induced moderate- severe diarrhea 11 (73%) 12 (86%) 11 (37%)
Immuron is investigating the impact of the lower than expected attack
Immuron has filed a provisional patent application with the U.S. Patent
Office including results from this trial.
Table 1: Summary of current clinical study
Event post challenge Travelan n = 30 n (%) Placebo n = 30 n (%) Reduction in AEs or Symptoms (%) P value
Primary Endpoint
Number (n) of subjects with ETEC-induced moderate- severe diarrhea 7 (23.3%) 11 (36.7%) NA 0.399
Protective efficacy [%] 1 95% 2-sided Confidence Interval 2 36.4%* (-79.8%, 79.1%)
Secondary Endpoints - Safety and tolerability
Number of subjects with an adverse event (AE) 95% 2-sided Confidence Interval 2 4 (13.3%) (-3.8%, 37.1%) 9 (30.0%) 55.6% 0.1172
Number of subjects with (AEs) fever, nausea, anorexia, or abdominal pain/cramps rated as moderate to severe 95% 2-sided Confidence Interval 2 3 (10.0%) (-5.2%, 31.9%) 7 (23.3%) 57.1% 0.1659
Secondary Endpoints - Degree to which a participant experiences diarrheal symptoms
Number of subjects who experienced severe diarrhea 95% 2-sided Confidence Interval 2 1 (3.3%) (-5.8%, 19.2%) 3 (10.0%) 66.7% 0.3006
Number of subjects requiring early antibiotic treatment 95% 2-sided Confidence Interval 2 1 (3.3%) (1.0%, 32.4%) 6 (20.0%) 83.3% 0.0444
Number of subjects requiring IV fluids 95% 2-sided Confidence Interval 2 0 (-0.7%, 20.7%) 3 (10.0%) 100.0% 0.0756
1 Fishers exact test and binomial
AE = Adverse event associated with the ETEC challenge
* Intent-to-treat analysis set defined as randomized
subjects who received study medication and were challenged
This release has been authorized by the directors
Immuron Limited (ASX:
IMC, NASDAQ: IMRN), is an Australian biopharmaceutical company focused on developing and commercializing orally delivered targeted polyclonal
antibodies for the treatment of infectious diseases.
About Phase 2 Clinical Trials
researchers administer the drug to a group of patients with the disease or condition for which the drug is being developed. Typically
involving a few hundred patients, these studies aren't large enough to show whether the drug will be beneficial. Instead, Phase 2 studies
provide researchers with additional safety data. Researchers use these data to refine research questions, develop research methods, and
is an orally administered passive immunotherapy that prophylactically reduces the likelihood of contracting travelers' diarrhea,
a digestive tract disorder that is commonly caused by pathogenic bacteria and the toxins they produce.
Travelan is a highly purified tabletized preparation of hyper immune bovine antibodies and other factors, which when
taken with meals bind to diarrhea-causing bacteria and prevent colonization and the pathology associated with travelers' diarrhea.
In Australia, Travelan is a listed medicine on the Australian Register for Therapeutic Goods (AUST L 106709) and is indicated
to reduce the risk of Travelers' Diarrhea, reduce the risk of minor gastro-intestinal disorders and is antimicrobial. In Canada,
Travelan is a licensed natural health product (NPN 80046016) and is indicated to reduce the risk of Travelers'
Diarrhea. In the U.S., Travelan is sold as a dietary supplement for digestive tract protection.
TD is generally defined
as the passage of 3 unformed stools per 24 hours plus at least one additional symptom (such as nausea, vomiting, abdominal cramps,
fever, blood/mucus in the stools, or fecal urgency) that develop while abroad or within 10 days of returning from any resource-limited
destinations (Leung et al., 2006). Diarrhea continues to be the most frequent health problem among travelers to destinations in lower-
and middle-income regions (Steffen, 2017). Deployed US military personnel, essentially representing a long-term traveller population,
are particularly affected given their population dynamics and the context in which they seek care and treatment (Connor et al., 2012).
Diarrhea is the leading infectious disease threat to the overall health and preparedness of deployed US armed forces, with diarrheagenic
E. coli, Campylobacter spp., and Shigella spp. among the most commonly reported etiologies (Riddle et al., 2006).
Immuron Platform Technology
Immuron's proprietary
technology is based on polyclonal immunoglobulins (IgG) derived from engineered hyper-immune bovine colostrum. Immuron has the capability
of producing highly specific immunoglobulins to any enteric pathogen and our products are orally active. Bovine IgG can withstand the
acidic environment of the stomach and is resistant to proteolysis by the digestive enzymes found in the Gastrointestinal (GI) tract. Bovine
IgG also possesses this unique ability to remain active in the human GI tract delivering its full benefits directly to the bacteria found
there. The underlying nature of Immuron's platform technology enables the development of medicines across a large range of infectious
diseases. The platform can be used to block viruses or bacteria at mucosal surfaces such as the Gastrointestinal tract and neutralize
the toxins they produce.
IMM-124E was developed
using Immuron's platform technology. IMM-124E is produced from the colostrum of birthing cattle that have been immunised during
pregnancy with a vaccine containing the outer antigens of multiple human derived ETEC. A total of 13 ETEC strains are used in the vaccine
to produce high levels of antibodies against selected surface antigens from the most common strains of ETEC.
The resultant hyperimmune
colostrum IMM-124E from ETEC vaccinated cows contains significant levels of polyclonal antibodies specific for ETEC antigens LPS, CFA-I
and Flagellin (Sears et al., 2017).
The antibodies produced
in IMM-124E have been found to have a stronger binding and neutralizing activity (than the antibodies of unvaccinated cattle) against
a wide range of LPS antigens including both the variable O-polysaccharide region and the preserved oligosaccharide core R'
region of LPS from the 13 serotypes used in the ETEC vaccine.
Last updated: Mar 7, 2024