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Bacteriophages or “phages” have a powerful and highly differentiated mechanism of action that enables binding to and killing specific bacteria, in contrast to traditional broad-spectrum antibiotics.
−Removed: believe that phages represent a promising means to treat bacterial infections, especially those that have developed resistance to current standard of care therapies, including the so-called multidrug-resistant or “superbug” strains of bacteria.
−Removed: We are a leading developer of phage therapeutics that are uniquely positioned to address the growing worldwide threat of antibiotic-resistant bacterial infections.
−Removed: We are combining our proprietary approach and expertise in identifying, characterizing and developing both naturally-occurring and engineered (synthetic) bacteriophages with our proprietary phage-specific current good manufacturing practice regulations (“cGMP”) compliant manufacturing capabilities to advance a broad pipeline of high-quality bacteriophage product candidates.
−Removed: We believe that synthetic phage, engineered using advances in sequencing and synthetic biology techniques, represent a promising means to advance phage therapy, including phage-based diagnostics and improving upon the ability of natural phage to treat bacterial infections, especially those that have developed resistance to current antibiotic therapies, including the multidrug-resistant or “superbug” bacterial pathogens.
−Removed: We are developing and advancing our lead clinical phage candidate for Pseudomonas aeruginosa (“ P.
−Removed: aeruginosa ”), AP-PA02.
−Removed: On October 14, 2020, we received the approval to proceed from the FDA for our Investigational New Drug application for AP-PA02.
+Added: We believe that phages represent a promising means to treat bacterial infections, especially those that have developed resistance to current standard of care therapies, including the so-called multidrug-resistant or “superbug” strains of bacteria.
+Added: We are a leading developer of phage therapeutics which are uniquely positioned to address the growing worldwide threat of antibiotic-resistant bacterial infections .
+Added: We are combining our proprietary approach and expertise in identifying, characterizing and developing both naturally-occurring and engineered (synthetic) bacteriophages with our proprietary phage-specific current good manufacturing practice regulation (“cGMP”) manufacturing capabilities to advance a broad pipeline of high-quality bacteriophage product candidates.
+Added: We believe that synthetic phage, engineered using advances in sequencing and synthetic biology techniques, represent a promising means to advance phage therapy, including improving upon the ability of natural phage to treat bacterial infections, especially those that have developed resistance to current antibiotic therapies, including the multidrug-resistant or “superbug” bacterial pathogens.
+Added: We are developing and advancing our lead clinical phage candidate for Pseudomonas aeruginosa .
+Added: On October 14, 2020, Armata received the approval to proceed from the U.S.
+Added: Food and Drug Administration (“FDA”) for its Investigational New Drug application for AP-PA02.
We plan to continue to advance the “SWARM- P.a.
−Removed: ” study – a Phase 1b/2a, multicenter, double-blind, randomized, placebo-controlled, single ascending dose (SAD) and multiple ascending dose (MAD) clinical trial to evaluate the safety and tolerability of inhaled AP-PA02 in subjects with cystic fibrosis (“CF”) and chronic pulmonary P.
−Removed: aeruginosa infection, provided that the impacts of COVID-19 do not impede our ability to enroll subjects in this clinical trial.
−Removed: This study is supported by the Cystic Fibrosis Foundation (“CFF”), which granted us a Therapeutics Development Award of up to $5.0 million (“CFF Award”).
−Removed: We are also developing a phage product candidate for Staphylococcus aureus (“ S.
−Removed: aureus ”) for the treatment of S.
−Removed: aureus bacteremia, AP-SA02.
−Removed: On June 15, 2020, we entered into an agreement (the “MTEC Agreement”) with the Medical Technology Enterprise Consortium (“MTEC”), pursuant to which we will receive a $15.0 million grant and entered into a three-year program administered by the DoD through MTEC with funding from the Defense Health Agency and Joint Warfighter Medical Research Program.
−Removed: We expect to use the grant to partially fund a Phase 1/2, multi-center, randomized, double-blind, placebo- controlled dose escalation study that will assess the safety, tolerability, and efficacy of AP-SA02 for the treatment of adults with complicated S.
−Removed: aureus bacteremia in 2021.
−Removed: However, the COVID-19 outbreak may delay or prohibit the enrollment of patients in our clinical trials.
−Removed: In partnership with Merck & Co., known as Merck Sharp & Dohme outside of the United States and Canada (“Merck”), we are developing proprietary synthetic phage candidates to target undisclosed infectious disease agents.
+Added: ” study – a Phase 1b/2a, multicenter, double-blind, randomized, placebo-controlled, single ascending dose (“SAD”) and multiple ascending dose (“MAD”) clinical trial to evaluate the safety and tolerability of inhaled AP-PA02 in subjects with CF and chronic pulmonary P.
+Added: aeruginosa infection, provided that the impacts of COVID-19 do not further impede our ability to enroll subjects in this clinical trial.
+Added: This study is supported by the CFF, which granted us a Therapeutics Development Award of up to $5.0 million.
+Added: As discussed in more detail below, in October 2021, we issued and sold 909,091 shares of newly issued commons stock to CFF at a per share price of $3.30 pursuant to a private placement transaction.
+Added: We are also developing a phage product candidate for Staphylococcus aureus for the treatment of S.
+Added: aureus bacteremia.
+Added: On June 15, 2020, we entered into an agreement (the “MTEC Agreement”) with the Medical Technology Enterprise Consortium (“MTEC”), pursuant to which we expect to receive a $15.0 million grant and entered into a three-year program administered by the U.S Department of Defense (“DoD”) through MTEC with funding from the Defense Health Agency and Joint Warfighter Medical Research Program.
+Added: We expect to use the grant to partially fund a Phase 1b/2a, multi-center, randomized, double-blind, placebo-controlled dose escalation study (“diSArm” study), that will assess the safety, tolerability, and efficacy of AP-SA02, a phage-based candidate for the treatment of adults with S.
+Added: aureus bacteremia .
+Added: On November 17, 2021, Armata announced that it had received the approval to proceed from the FDA for its Investigational New Drug application for AP-SA02.
+Added: We plan to initiate the “diSArm” study provided that the impacts of COVID-19 do not impede our ability to enroll subjects in this clinical trial.
+Added: In addition to our more advanced pipeline programs, we have phage development efforts underway to target other indications including non-cystic fibrosis bronchiectasis (“NCFB”), prosthetic joint infections (“PJI”) and hospitalized pneumonia.
Our proprietary phage engineering platform serves to enhance the clinical and commercial prospects of phage therapy.
−Removed: These attributes include expanded host range, improved potency which is a fundamental drug property that can translate into improved clinical efficacy, and importantly, biofilm disruption, which is a critical aspect of serious infections that needs to be addressed.
−Removed: In addition to our more advanced pipeline programs, we have phage discovery efforts underway to target other major pathogens of infectious disease (including Enterococcus faecium , S.
−Removed: aureus , Klebsiella pneumoniae , Acinetobacter baumannii , P.
−Removed: aeruginosa , and Enterobacter species , or “ESKAPE pathogens”) and preventable infectious disease of the microbiome.
−Removed: We are committed to conducting randomized controlled clinical trials required for FDA approval in order to move toward commercialization of alternatives to traditional antibiotics and provide a potential method of treating patients suffering from drug-resistant bacterial infections.
+Added: We are committed to conducting randomized controlled clinical trials required for FDA approval in order to move toward commercialization of alternatives to traditional antibiotics and provide a potential method of treating patients suffering from drug-resistant and difficult-to-treat bacterial infections.
Corporate History and Reorganization
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Business Update Regarding COVID-19
−Removed: On January 30, 2020, the World Health Organization (“WHO”) announced a global health emergency because of a new strain of coronavirus originating in Wuhan, China (the “COVID-19 outbreak”) and the risks to the international community as the virus spreads globally beyond its point of origin.
−Removed: In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally.
+Added: In March 2020, the World Health Organization (“WHO”) declared COVID-19 a global pandemic and the United States declared a national emergency with respect to COVID-19.
The COVID-19 pandemic has directly and indirectly impacted our business, results of operations and financial condition and is expected to continue to impact our business.
For example, the COVID-19 pandemic has resulted in delays in our clinical trials due to the implementation of COVID-19 protocols at investigator sites, which resulted in longer than anticipated site identification and initiation activities.
−Removed: In addition, while we currently do not anticipate any interruptions in our supply chain, it is possible that the COVID-19 pandemic and response efforts may have a future impact on our third-party suppliers and partners.
−Removed: It is possible that due to the increasing emphasis on the development of vaccines for COVID-19, certain basic supply chain materials such as resins, vessels, vials and stoppers may be in high demand by the pharmaceutical companies developing vaccines and our ability to obtain these materials for our development activities could be negatively impacted.
−Removed: We have experienced some delays of this nature in the fourth quarter of 2020 and in early 2021.
−Removed: The full extent of the COVID-19 pandemic impact will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19, the actions taken to contain it or treat its impact, the development and distribution of vaccines and the economic impact on local, regional, national and international markets.
+Added: In addition, while we currently do not anticipate any interruptions in our supply chain, it is possible that the COVID-19 pandemic and the continuing response efforts may have a future impact on our third-party suppliers and partners.
+Added: It is possible that due to the continued development and manufacturing of vaccines for COVID-19, certain basic supply chain materials such as resins, vessels, vials and stoppers may be in high demand by the pharmaceutical companies developing and manufacturing vaccines and our ability to obtain these materials for our development activities could be negatively impacted.
+Added: Although we have experienced some delays of this nature during 2021, such delays have not had a material adverse impact on our business, results of operations or financial condition .
+Added: The full extent of the COVID-19 pandemic impact continues to depend on future developments that remain highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19, the actions taken to contain it or treat its impact, the identification and spread of COVID-19 variants such as the Delta and the Omicron variants, the distribution of vaccines, the acceptance of vaccines and the implementation of vaccine mandates, and the economic impact on local, regional, national and international markets.
Management continues to actively monitor the developments regarding the pandemic and the impact that the pandemic could have on our financial condition, liquidity, ability to enroll patients in our contemplated clinical trials, manufacturing and research and development operations, suppliers to our operations and suppliers to our outside clinical trial organizations, biotech industry overall, and importantly the health and safety of our workforce.
−Removed: Given the continuing evolution of the COVID-19 outbreak and the global responses to curb its spread, we are not able to estimate the effects of the COVID-19 outbreak on our results of operations, financial condition, or liquidity for fiscal year 2021 or 2022.
−Removed: Any recovery from negative impacts to our business and related economic impact due to the COVID-19 outbreak may also be slowed or reversed by a number of factors, including but not limited to multiple variants of the COVID-19 virus, a resurgence in COVID-19 infections, and the seasonal flu.
+Added: Given the continued volatility of the COVID-19 pandemic and the global responses to curb its spread, we are not able to estimate the effects of the COVID-19 pandemic on our results of operations, financial condition, or liquidity for 2022.
+Added: Any recovery from negative impacts to our business and related economic impact due to the COVID-19 pandemic may also be slowed or reversed by a number of factors, including the current widespread resurgence in COVID-19 infections attributable to the Omicron variant, combined with the seasonal flu.
Recent Developments
−Removed: On January 26, 2021, we entered into a securities purchase agreement (the “2021 Securities Purchase Agreement”) with Innoviva Strategic Opportunities LLC, a wholly-owned subsidiary of Innoviva, Inc.
−Removed: INVA) (collectively, “Innoviva”), pursuant to which we agreed to issue and sell to Innoviva, in a private placement, up to 6,153,847 newly issued shares (the “Shares”) of our common stock, par value $0.01 per share (“common stock”) and warrants (the “Common Warrants”) to purchase up to 6,153,847 shares of common stock, with an exercise price per share of $3.25 (the “2021 Private Placement”).
−Removed: Each Share was sold together with one Common Warrant, and the per-unit purchase price is $3.25.
−Removed: The 2021 Private Placement occurred in two tranches.
−Removed: On January 26, 2021 and concurrently with entering into the 2021 Securities Purchase Agreement, we completed the first tranche (the “First Closing”) of the 2021 Private Placement.
−Removed: At the First Closing, Innoviva purchased 1,867,912 Shares and Common Warrants to purchase 1,867,912 shares of common stock, in compliance with any and all applicable laws and without the requirement for the prior receipt of the stockholders’ approval under the listing requirements of the NYSE American, for an aggregate purchase price of approximately $6.1 million.
−Removed: We received shareholder approval for the second closing (“Second Closing”) on March 16, 2021, and the Second Closing was completed on March 17, 2021, when Innoviva purchased 4,286,935 shares of Shares and Common Warrants for an aggregate purchase price of $13.9 million.
−Removed: We received aggregate gross proceeds from the 2021 Private Placement of approximately $20.0 million, before deducting transaction expenses, and excluding proceeds (if any) received in connection with the exercise of any warrants.
−Removed: As part of the First Closing, we entered into an amended and restated investor rights agreement (the “A&R IRA”), which amended and restated in its entirety that certain Investor Rights Agreement, dated February 12, 2020, with Innoviva, Inc.
−Removed: Pursuant to the A&R IRA, for so long as Innoviva and its affiliates hold at least 12.5% of the outstanding shares of common stock on a fully-diluted basis, Innoviva shall have the right to designate two (2) directors to our board of directors and for so long as Innoviva and its affiliates hold at least 8%, but less than 12.5%, of the outstanding shares of common stock on a fully-diluted basis, Innoviva shall have the right to designate one (1) director, subject to certain conditions and qualifications set forth in the A&R IRA.
−Removed: The A&R IRA also provides Innoviva with certain subscription rights in the event of any new issuances.
−Removed: As part of the First Closing, we also entered into a registration rights agreement (the “Registration Rights Agreement”) with Innoviva.
−Removed: Pursuant to the Registration Rights Agreement, we must file a registration statement on Form S-1 or Form S-3 (the “Shelf Registration Statement”) covering the resale of the securities issued and sold pursuant to the 2021 Securities Purchase Agreement with the U.S.
−Removed: Securities and Exchange Commission (the “Commission”) on a continuous basis pursuant to Rule 415 promulgated under the Securities Act of 1933, as amended (the “Securities Act”), or if Rule 415 is not available for offers and sales of such securities, by such other means of distribution of such securities as Innoviva may reasonably specify.
−Removed: We must use commercially reasonable efforts to cause the Shelf Registration Statement to be declared effective under the Securities Act as promptly as possible after the filing thereof, but in any event (i) no later than the fifteenth (15th) day following the filing of the Shelf Registration Statement in the event of no “review” by the Commission, (ii) no later than the sixtieth (60th) day following the filing of the Shelf Registration Statement in the event of “limited review” by the Commission, or (iii) in the event of a “review” by the Commission, the one hundred and twentieth (120th) day following the filing of the Shelf Registration Statement, subject to certain exceptions.
−Removed: We also entered into a Voting Agreement with Innoviva (the “Voting Agreement”), pursuant to which Innoviva agreed not to vote or take any action by written consent with respect to shares of common stock held by Innoviva or any of its subsidiaries which represent, in the aggregate, more than 49.5% of the total number of shares of common stock issued and outstanding as of any given record date for voting (such shares, the “Excess Shares”) on the matters related to the election of directors or removal of directors from our board of directors (“Board Matters”) presented at any meeting of the our stockholders (or any adjournment or postponement thereof) or for their action by written consent, in each case, unless the board of directors authorizes Innoviva to vote such Excess Shares with respect to Board Matters.
+Added: NCFB Investigational New Drug (“IND”) Approval
+Added: On February 22, 2022, we announced that the U.S.
+Added: FDA has cleared Armata's IND application to initiate a clinical trial of its optimized lead therapeutic candidate, AP-PA02, in a second indication, NCFB.
+Added: The company plans to initiate a Phase 2 trial in 2022.
+Added: February 2022 Private Placement
+Added: On February 9, 2022, we entered into a securities purchase agreement to sell our common stock and warrants to Innoviva Strategic Opportunities LLC, a wholly ‐ owned subsidiary of Innoviva, Inc.
+Added: INVA) (collectively, "Innoviva"), our largest shareholder.
+Added: The gross proceeds from the transaction are expected to be $45 million, before deducting estimated offering expenses.
+Added: Pursuant and subject to the terms and conditions of the securities purchase agreement and related agreements, Innoviva will purchase 9,000,000 newly issued shares of our common stock, at a price of $5.00 per share, and warrants to purchase up to 4,500,000 additional shares of our common stock, with an exercise price of $5.00 per share.
+Added: The stock purchases are expected to occur in two tranches.
+Added: Upon execution, Innoviva purchased 3,614,792 shares of common stock and warrants to purchase 1,807,396 shares of common stock for an aggregate purchase price of $18.1 million.
+Added: At the closing of the second tranche, upon our stockholders voting in favor of the transaction, Innoviva will purchase 5,385,208 shares of common stock and warrants to purchase 2,692,604 shares of common stock for an aggregate purchase price of $26.9 million.
+Added: Subject to the satisfaction of certain closing conditions, including the approval of our stockholders, the second closing contemplated by the securities purchase agreement is expected to occur near the end of the first quarter of 2022.
+Added: October 2021 Private Placements
+Added: On October 28, 2021, we entered into a securities purchase agreement (the “October 2021 Securities Purchase Agreement”) with the Cystic Fibrosis Foundation, a Delaware corporation (“CFF”), our partner for the lead Phase 1b/2a clinical development program, and Innoviva for the private placement of newly issued shares of our common stock, par value $0.01 per share (“Common Stock”).
+Added: Pursuant to the October 2021 Securities Purchase Agreement, we issued and sold 909,091 shares to CFF and 1,212,122 shares to Innoviva, each at a per share price of $3.30 (the “October 2021 Private Placements”).
+Added: We received aggregate gross proceeds from the October 2021 Private Placements of approximately $7.0 million, before deducting transaction expenses.
+Added: 2021 Lease Agreement
+Added: On October 28, 2021, we entered into a lease for office and research and development space under a non-cancellable lease in Los Angeles, CA (the “2021 Lease”).
+Added: The leased space comprises approximately 56,000 square feet.
+Added: The 2021 Lease payment start date is May 1, 2022 and the total lease term is for 16 years and runs through 2038.
+Added: Monthly rent for 2022 and 2023 will be fully or partially abated while we and the lessor complete planned tenant improvements to the facility.
+Added: Base monthly rent will be approximately $0.25 million in 2024.
+Added: We are entitled to receive an allowance for tenant improvements of up to $7.3 million.
The following chart summarizes the status of our phage product candidate development programs and partners.
−Removed: Our strategy is to demonstrate safety, tolerability and efficacy of multiple phage products in randomized controlled clinical trials required for FDA approval and to support commercialization in multiple indications of high unmet medical need, including bacterial infections caused by multidrug-resistant and difficult-to-treat pathogens.
−Removed: Our fully integrated product development capabilities from bench to clinic enables discovery of optimal product candidates, efficient process development and manufacturing, rigorous clinical trials.
+Added: Our strategy is to demonstrate the safety, tolerability and efficacy of multiple phage products in randomized controlled clinical trials required for FDA approval and to support commercialization in multiple indications of high unmet medical need, including bacterial infections caused by multidrug-resistant and difficult-to-treat pathogens.
+Added: Our fully integrated product development capabilities from bench to clinic enable the discovery of optimal product candidates, efficient process development and manufacturing, and rigorous clinical trials.
Our microbiological surveillance and synthetic biology capabilities drive long-term product life cycle management.
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aeruginosa infections such as non-cystic fibrosis bronchiectasis (“NCFB”) and hospitalized pneumonia.
−Removed: ● Initiate and advance clinical trials of AP-SA02 in patients with complicated S.
+Added: ● Initiate and advance clinical trials of AP-SA02 in patients with S.
aureus bacteremia.
● Develop AP-SA02 for the treatment of other antibiotic-resistant and difficult-to-treat S.
−Removed: aureus infections such as periprosthetic joint infections.
−Removed: Because a study in PJI may use a different route of administration from the bacteremia study, it is possible, pending FDA concurrence, that we could initiate a study in this indication prior to obtaining safety data from the AP-SA02 bacteremia study.
−Removed: ● Advance our partnership with Merck to develop synthetic phage utilizing our phage engineering platform to improve natural phage characteristics, such as host range, biofilm disruption and antimicrobial activity.
−Removed: ● Develop phage-based diagnostics to drive clinical success and market adoption.
+Added: aureus infections such as periprosthetic joint infections (“PJI”).
The Need for New Anti-Infective Therapies
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aureus (“MRSA”), in the United States occurred in 1968.
−Removed: A void in the discovery of new classes of antibiotics lasting approximately 30 years drove the emergence and spread of antibiotic-resistant bacteria, including vancomycin-resistant enterococci (VRE), and pandrug-resistant strains of Acinetobacter baumannii , P.
+Added: A void in the discovery of new classes of antibiotics lasting approximately 30 years drove the emergence and spread of antibiotic-resistant bacteria, including
+Added: vancomycin-resistant enterococci (“VRE”), and pandrug-resistant strains of Acinetobacter baumannii , P.
aeruginosa , Escherichia coli and Klebsiella pneumoniae .
−Removed: The dramatic and continuous emergence of antibiotic-resistant bacteria, and the lack of new antibiotics in the pipeline, has prompted calls to action from many of the world’s major health bodies such as The Centers for Disease Control and Prevention (the “CDC”), and the WHO, who warn of an “antibiotic cliff” and a “post-antibiotic era.” A growing list of infections – such as pneumonia, tuberculosis, bacteremia/septicemia, gonorrhea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.
−Removed: In 2009, the European Antimicrobial Resistance Surveillance System concluded that “the loss of effective antimicrobial therapy increasingly threatens the delivery of crucial health services in hospitals and in the community.” This conclusion was reinforced by The Antimicrobial Availability Task Force of the Infectious Diseases Society of America (the “IDSA”), and the European Centre for Disease Prevention and Control in conjunction with the EMA.
−Removed: The IDSA and WHO regard antimicrobial resistance as one of the greatest threats to human health worldwide.
+Added: The dramatic and continuous emergence of antibiotic-resistant bacteria, and the lack of new antibiotics in the pipeline, has prompted calls to action from many of the world’s major health bodies such as the U.S.
+Added: Centers for Disease Control and Prevention (the “CDC”), and the World Health Organization (the “WHO”), who warn of an “antibiotic cliff” and a “post-antibiotic era.” A growing list of infections – such as pneumonia, tuberculosis, bacteremia/septicemia, gonorrhea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.
+Added: In 2009, the European Antimicrobial Resistance Surveillance System concluded that “the loss of effective antimicrobial therapy increasingly threatens the delivery of crucial health services in hospitals and in the community.” This conclusion was reinforced by The Antimicrobial Availability Task Force of the Infectious Diseases Society of America (the “IDSA”), and the European Centre for Disease Prevention and Control in conjunction with the European Medicines Agency (the “EMA”).
+Added: The IDSA and the WHO regard antimicrobial resistance as one of the greatest threats to human health worldwide.
The Review on Antimicrobial Resistance, a global project commissioned by the British government and the Wellcome Trust, reports that at least 700,000 people die each year of drug resistance in illnesses that include bacterial infections.
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The market opportunity for antibiotics is large, with the market estimated to exceed $58 billion in annual sales globally by 2027.
−Removed: Almost one in every five deaths worldwide occurs as a result of infection and, according to the WHO, many bacterial infections will become difficult or impossible to cure as the efficacy of current standard-of-care antibiotics wanes.
+Added: Almost one in every five deaths worldwide occurs as a result of infection and, according to the WHO, many bacterial infections will become difficult or impossible to cure as the efficacy of current standard-of-care
+Added: antibiotics wanes.
Despite the advances in antimicrobial and vaccine development, infectious diseases still remain the third-leading cause of death in the United States and the second-leading cause of death worldwide.
The number of new antibiotics approved by the FDA, and other global regulatory authorities has declined consistently over the last two decades.
−Removed: According to an April 2020 report from PEW Charitable Trusts, only 41 new antibiotics (all small molecules that act systemically) with the potential to treat serious or life-threatening bacterial infections are in global clinical development.
+Added: According to a March 2021 report from PEW Charitable Trusts, only 41 new antibiotics (all small molecules that act systemically) with the potential to treat serious or life-threatening bacterial infections are in global clinical development.
This is compared with more than 1,100 new product candidates in the drug pipeline for cancer.
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There are hundreds of cases published in the scientific and medical literature describing the use of phage therapy in human medicine over more than 90 years, mostly in the former Soviet Union and Eastern Europe.
−Removed: Phage therapy is still commonly used today in Russia, Poland and Georgia, with numerous reports of success in treating infectious diseases
−Removed: caused by many pathogenic bacterial species.
+Added: Phage therapy is still commonly used today in Russia, Poland and Georgia, with numerous reports of success in treating infectious diseases caused by many pathogenic bacterial species.
However, the safety and effectiveness of these therapies have not been conclusively established due to the lack of randomized controlled clinical studies.
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aeruginosa otitis treated with a cocktail of six natural phages.
−Removed: Since 2016, there have been a number of Compassionate Use cases in which patients suffering from various serious or life-threatening infections have been treated with phage therapy under physician-sponsored Emergency Investigational New Drug (“Emergency IND”) Applications with high rates of success and no adverse effects attributable to the therapy.
+Added: Since 2016, there have been a number of “compassionate use” cases in which patients suffering from various serious or life-threatening infections have been treated with phage therapy under physician-sponsored Emergency Investigational New Drug (“EIND”) Applications with high rates of success and no adverse effects attributable to the therapy.
Most notable was the well-documented case in 2016 of Tom Patterson, whose disseminated multidrug-resistant Acinetobacter baumannii infection was successfully treated with phage-based therapeutic cocktails administered intravenously and intraperitoneally.
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NCFB patients frequently become chronically colonized with multidrug-resistant strains of P.
−Removed: aeruginosa because of the need for repeated courses of antibiotic treatment.
−Removed: There are currently no approved antibiotics to manage chronic P.
−Removed: aeruginosa infection in NCFB patients.
+Added: aeruginosa because of the need for repeated courses of
+Added: antibiotic treatment.
+Added: There are currently no approved inhaled antibiotics for the treatment of NCFB patients with chronic P.
+Added: aeruginosa respiratory infections.
Hospitalized Pneumonia
Hospital-acquired pneumonia and ventilated-associated pneumonia is one of the most common causes of death among all hospital‐acquired infections, with approximately 300,000 hospitalization each year in the United States due to Pseudomonas .
−Removed: Infection with Pseudomonas results in mortality rates ranging as high as 35‐50%, drives considerable healthcare costs (excess of $40,000 per patient), and accounts for around 50% of all intensive care unit antibiotics.
+Added: Infection with Pseudomonas results in mortality rates ranging as high as 35‐50%, drives considerable healthcare costs (in excess of $40,000 per patient), and accounts for around 50% of all intensive care unit antibiotics.
Staphylococcus aureus Infections
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develop bacteremia each year.
−Removed: aureus is the most commonly identified pathogen in both hospital- and community-acquired blood stream infections.
+Added: aureus is the most commonly identified pathogen in both hospital- and community-acquired bloodstream infections.
Annually in the U.S.
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aureus bacteremia (“SAB”).
−Removed: Despite conventional antibiotics, mortality in SAB results in death of up to 40% of all cases and 57% of patients over the age of 85.
+Added: Despite conventional antibiotics, mortality in SAB results in the death of up to 40% of all cases and 57% of patients over the age of 85.
Patients with comorbidities such as alcoholism, malignancy, diabetes, end-stage renal disease requiring hemodialysis, and immunosuppression are at even higher risk for death when SAB develops.
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The total number of prosthetic joint infection (“PJI”)-related revision surgeries is expected to more than double from 70,000 in 2020 to 144,000 in 2040 in the United States and European Union Five (France, Germany, Italy, Spain, United Kingdom), at an annual growth rate of 5.6% due to a growing elderly population.
−Removed: The United States is the largest market for PJI, accounting for 61% of PJI-related revision surgery in 2020 (71% by 2040) each estimated to cost $150,000.
+Added: The United States is the largest market for PJI, accounting for 61% of PJI-related revision surgery in 2020 (estimated to be 71% by 2040) each estimated to cost $150,000.
aureus PJI infections are among the most commonly observed, accounting for up to 47% of all infections.
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These powerful natural phages can be purposely engineered to be more efficient killers.
−Removed: The use of synthetic biology tools enables us to precisely engineer natural phages in ways that further improve their pharmacological properties and antimicrobial activity, with the potential to create supercharged synthetic phages that, once marketing authorization is obtained, can be deployed in the clinic as highly effective weapons in the fight against multidrug-resistant bacterial infections.
+Added: The use of synthetic
+Added: biology tools enables us to precisely engineer natural phages in ways that further improve their pharmacological properties and antimicrobial activity, with the potential to create supercharged synthetic phages that, once marketing authorization is obtained, can be deployed in the clinic as highly effective weapons in the fight against multidrug-resistant bacterial infections.
Engineering natural phages may broaden their host range, minimize resistance and improve efficacy through the expression of beneficial moieties such as biofilm-degrading enzymes and antimicrobial peptides.
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We are committed to developing novel phage therapies, with drug development expertise and product development capabilities that span bench to clinic, including in-house phage-specific cGMP manufacturing.
−Removed: Our phage discovery
−Removed: platform in which we screen panels of clinically-relevant isolates against our extensive phage library utilizing proprietary methods that identify phage combinations with superior attributes, together with our phage-specific cGMP compliant manufacturing facilities, uniquely enables us to efficiently identify optimal product candidates.
+Added: Our phage discovery platform in which we screen panels of clinically-relevant isolates against our extensive phage library utilizing proprietary methods that identify phage combinations with superior attributes, together with our phage-specific cGMP compliant manufacturing facilities, uniquely enables us to efficiently identify optimal product candidates.
Our microbiological surveillance and synthetic biology capabilities drive long-term product life cycle management.
−Removed: Our therapeutic phage candidates aim to address areas of significant unmet medical need, by targeting key drug-resistant bacteria, including those on the World Health Organization’s global priority pathogens list, and the priority pathogens list issued by the Centers for Disease Control and Prevention.
+Added: Our therapeutic phage candidates aim to address areas of significant unmet medical need, by targeting key drug-resistant bacteria, including those on the WHO’s global priority pathogens list, and the priority pathogens list issued by the CDC.
The long-term potential for phage therapy is broad reaching, including potential use as front-line therapy.
6 unchanged sentences
aeruginosa , with its mucoid and multidrug-resistant strains, is a dominant culprit in chronic respiratory infections in CF and NCFB patients as well as acute pneumonias in hospitalized patients;
−Removed: aureus , with its heteroresistant and methicillin-resistant S.
−Removed: aureus (MRSA) strains, has been implicated in systemic (e.g., bacteremia) as well as prosthetic-related infections.
+Added: aureus , with its heteroresistant and MRSA strains, has been implicated in systemic (e.g., bacteremia) as well as prosthetic-related
By advancing randomized controlled clinical trials using P.
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Historical Background
−Removed: AP-PA02 is being developed as a replacement for its predecessor AP-PA01 (previously known as AB-PA01).
+Added: AP-PA02 is being developed as a next-generation replacement for AP-PA01 (previously known as AB-PA01).
A total of 10 patients with serious or life-threatening P.
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Another success with AP-PA01, used to treat a 77-year-old with ventilated-associated pneumonia and empyema, was published in November 2019, in the American Journal of Respiratory and Critical Care Medicine.
−Removed: We no longer offer AP-SA01 through any expanded access program.
+Added: We no longer offer AP-PA01 through any expanded access program.
In August 2018, we held a Type B pre-IND meeting with the U.S.
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Feedback from the pre-IND meeting has been insightful for the regulatory path required for phage therapeutics in general, and specifically for a phage product candidate intended for respiratory infection.
−Removed: We therefore have leveraged our experiences with AP-PA01 to derive a development plan for AP-PA02.
+Added: We, therefore, have leveraged our experiences with AP-PA01 to derive a development plan for the next-generation product candidate, AP-PA02.
Preclinical Development of AP-PA02
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aeruginosa phage product candidate, AP-PA01.
−Removed: A series of selection criteria and different methods were deployed, including bioinformatics and comparative genomics, in order to identify optimal attributes for a product candidate.
−Removed: We have engaged in preclinical studies to determine pharmacological and toxicological parameters to confirm therapeutic potential in the clinic.
+Added: The phages that comprise AP-PA02 were selected with desired attributes for a product candidate targeting P.
+Added: aeruginosa lung infections.
+Added: Different methods were deployed, including microbiological, bioinformatics and comparative genomics, in order to identify optimal attributes for the product candidate.
+Added: Susceptibility, killing kinetics, and biofilm eradication, was assessed using P.
+Added: aeruginosa isolates from CF patients to determine antimicrobial activity and potency of AP-PA02.
+Added: Viability in relevant biological fluids, and compatibility with current standard of care therapies for CF patients was verified to confirm suitability of AP-PA02 for clinical use in this patient population.
+Added: Immune stimulation was assessed to assure the lack of inflammatory impact by AP-PA02.
+Added: Animal studies were conducted to provide insight into safe and efficacious dose levels that would support the expectation of pharmacological activity (i.e.
+Added: antimicrobial potential of phage) in the lung compartment following an inhaled route of administration.
In parallel, we initiated manufacturing feasibility and process optimization efforts with the goal of achieving high-quality phage product free of endotoxin and host cell proteins whilst maintaining adequate phage titers.
AP-PA02 is comprised of a cocktail of natural P.
−Removed: aeruginosa phages originating from distinct families and subfamilies, targeting multiple receptor classes, functioning with compatibility (i.e., the phages don’t interfere with one another) and cooperativity (i.e., the phages work together for a better outcome), and further characterized by being highly potent and having a broad host range and overlap.
−Removed: AP-PA02 demonstrates broad coverage against approximately 90% of tested clinical isolates.
+Added: aeruginosa phages originating from distinct families and subfamilies, targeting multiple receptor classes, functioning with compatibility (i.e., the phages don’t interfere with one
+Added: another) and cooperativity (i.e., the phages work together for a better outcome), and further characterized by being highly potent and having a broad host range and overlap.
+Added: Prior to initiating the SWARM- P.a.
+Added: trial (described below), our clinical isolate screening and phage collections yielded a three-phage AP-PA02 cocktail with compelling host-range coverage.
+Added: We subsequently modified AP-PA02 to include additional phage genera that increase potency and broaden coverage of strains of P.
+Added: aeruginosa found in CF patients.
+Added: The optimized five-phage AP-PA02 cocktail provides coverage against at least 90% of tested CF clinical isolates and has shown superior in vitro potency as well as improved efficacy in an animal model of infection.
+Added: The improvements in AP-PA02 reflect our core strategy of utilizing clinical isolate surveillance data to drive enhancement of product composition.
Preclinical highlights of AP-PA02 include:
● Significantly reduced P.
−Removed: aeruginosa biofilm mass in vitro within 4 hours of a low-dose application;
−Removed: ● Persisted in the lung after intranasal instillation;
−Removed: ● Systemic exposure after intranasal instillation is limited;
+Added: aeruginosa biofilm mass in vitro ;
+Added: ● Persistence of active phage particles in the lung;
+Added: ● Limited systemic and off-target organ distribution;
● Significantly decreased mortality in a murine model of acute P.
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● Components maintain activity in the presence of other CF therapies.
−Removed: We have developed AP-PA02 as a sterile liquid formulation, suitable for delivery by inhalation and intravenous administration.
−Removed: Clinical trial material of AP-PA02 is manufactured under cGMP at our production facility in Marina del Rey, California, to support the required regulatory filing(s) for clinical entry in the United States.
−Removed: Potency of drug substance currently supports doses up to approximately 1x10 11 PFU (plaque forming units) per mL, and endotoxin levels are well within specifications for an intravenous product.
+Added: We have developed AP-PA02 as a sterile liquid formulation, suitable for delivery by inhalation.
+Added: Clinical trial material of AP-PA02 is currently manufactured under cGMP at our production facility in Marina del Rey, California.
Clinical Development of AP-PA02 in Cystic Fibrosis
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On October 14, 2020, Armata received approval for the study to proceed from the FDA for its Investigational New Drug (“IND”) to initiate the “SWARM- P.a.
−Removed: ” study – a Phase 1b/2a, multi-center, double-blind, randomized, placebo-controlled, single ascending dose (“SAD”) and multiple ascending dose (“MAD”) clinical trial to evaluate the safety and tolerability of inhaled AP-PA02 in subjects with CF and chronic pulmonary P.
−Removed: aeruginosa infection.
+Added: ” study – a Phase 1b/2a, double-blind, randomized, placebo-controlled, single ascending dose (“SAD”) and multiple ascending dose (“MAD”) clinical trial to evaluate the safety, tolerability and phage recovery profile of AP-PA02 administered by inhalation in subjects with cystic fibrosis and chronic pulmonary Pseudomonas aeruginosa infection.
Primary Endpoints (SAD and MAD) will include incidence and severity of treatment-emergent, adverse events.
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We will look at clinical parameters as a part of exploratory endpoints for the SAD and MAD cohorts.
−Removed: The study is designed to include a total of approximately 48 subjects in multiple U.S.-based sites.
−Removed: We anticipate generating topline data from the MAD portion of the study in 2022.
+Added: The enhanced five-phage AP-PA02 cocktail (described
+Added: above) was advanced through manufacturing and regulatory review for introduction into the MAD component of the SWARM- P.a.
The SWARM- P.a.
+Added: study is designed to include a total of approximately 32 subjects in multiple U.S.-based sites.
+Added: We anticipate generating topline data from the SWARM- P.a.
+Added: study in 2022.
+Added: The SWARM- P.a.
study is supported by the CFF, which in March 2020 granted us a Therapeutics Development Award of up to $5.0 million.
With positive outcomes from this first study, SWARM- P.a.
−Removed: , we plan to initiate follow-on studies that will investigate the efficacy of AP-PA02 in chronically-infected patients and patients with primary/early intermittent infections.
+Added: , we plan to initiate follow-on studies that will investigate the efficacy of AP-PA02 in chronically-infected patients and potentially other CF patient populations.
Our ultimate goal is to bring AP-PA02 to the CF community at large as a new FDA-approved novel therapy to treat airway P.
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aeruginosa Phage Product Candidates
−Removed: In addition to pursuing lung infections in CF patients, we have begun charting the appropriate clinical and regulatory paths for other respiratory infections with high unmet clinical need, such as in NCFB patients as well as acute pneumonias in hospitalized patients.
−Removed: We intend to optimize P.
−Removed: aeruginosa phage product candidates for the treatment of each of these indications.
−Removed: Our clinical candidate for pneumonia, AP-PA03, took advantage of our collection of relevant P.
−Removed: aeruginosa clinical isolates and our expanded phage library.
−Removed: AP-PA03 is comprised of a cocktail of natural P.
−Removed: aeruginosa phages originating from distinct genera, targeting multiple receptor classes, functioning with compatibility and cooperativity, and further characterized by being highly potent and having a broad host coverage against approximately 90% of tested clinical isolates.
−Removed: We expect AP-PA03 to enter process development in the first half of 2021.
−Removed: We do not anticipate clinical development of AP-PA02 for NCFB until such time that we can evaluate the results of the CF SWARM- P.a.
−Removed: We plan to obtain regulatory approval to initiate clinical studies for NCFB and/or for pneumonia in 2021 or 2022.
+Added: In addition to pursuing lung infections in CF patients, we have begun charting the appropriate clinical and regulatory paths for other respiratory infections with high unmet clinical need, such as in NCFB patients as well as acute cases of pneumonia in hospitalized patients.
+Added: aeruginosa isolates from people diagnosed with NCFB revealed that the five-phage AP-PA02 cocktail offers broad coverage and robust potency in this indication as well.
+Added: In 2022, we received regulatory approval to a initiate Phase 2 clinical trial for NCFB using AP-PA02.
+Added: The Company plans to initiate a Phase 2 trial during 2022.
+Added: Conversely and representing the different physiology of acute pneumonia lung infections as compared to chronic CF and NCFB respiratory infections, a novel cocktail is in development for the clinical indication of acute hospitalized pneumonia.
+Added: We have deployed our extensive clinical isolate collection and phage library to identify a candidate phage cocktail, AP-PA03, that is entering manufacturing with a regulatory filing expected in 2022 or 2023.
Staphylococcus aureus Phage Product Candidate, AP-SA02
Historical Background
−Removed: AP-SA02 is being developed as a more advanced version of its predicate AP-SA01 (previously known as AB-SA01).
+Added: AP-SA02 is being developed as a more advanced version of AP-SA01 (previously known as AB-SA01).
The therapeutic potential of AP-SA01 has been demonstrated through:
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We no longer offer AP-SA01 through any expanded access program.
−Removed: Human exposure through treatment of single patients with AP-SA01 under the expanded access program has been helpful in demonstrating the promise of phage therapy and warrants further study to support safety and efficacy through randomized controlled trials required to support registration.
+Added: Human exposure through treatment of single patients with AP-SA01 under the expanded access program has been helpful in demonstrating the promise of phage therapy and warrants further study to support safety and efficacy through
+Added: randomized controlled trials required to support registration.
Feedback from a Type B pre-IND meeting with the FDA in August 2018 has been insightful for the regulatory path required for phage therapeutics in general, and specifically for a phage product candidate intended for systemic delivery.
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Development of AP-SA02
−Removed: AP-SA02 is a novel biologic product candidate comprising natural lytic phages that target the problematic pathogen, S.
+Added: AP-SA02 is a novel biologic product candidate comprised of a cocktail of natural lytic phages that target the problematic pathogen, S.
Preclinical highlights of AP-SA02 include:
−Removed: ● Coverage of more than 90% of clinical isolates tested, including against drug-resistant isolates (MRSA:
+Added: ● Potent antimicrobial activity against approximately 95% of S.
+Added: aureus clinical isolates tested, including drug-resistant isolates (MRSA:
methicillin-resistant S.
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vancomycin-resistant S.
−Removed: ● Efficiency of plating and plaque morphology reflect strongly potent component phages.
−Removed: Potency further demonstrated by the failure of attempts to obtain phage-resistant bacteria;
−Removed: ● Component phages are stable and retain infectivity after exposure to relevant biological fluids (blood and plasma);
−Removed: ● Penetrates pre-existing biofilms;
−Removed: ● Additive, indifferent, or synergistic effects in combination with vancomycin;
−Removed: no antagonistic effects noted;
−Removed: ● Maintains activity in the presence of current standard-of-care anti-staphylococcal antibiotics.
+Added: ● Unique mechanism of action offers synergistic or additive benefit with standard of care antibiotics;
+Added: ● Component phages are stable and retain infectivity after exposure to relevant biological fluids;
+Added: ● Penetrates pre-existing S.
+Added: aureus biofilms.
We have developed AP-SA02 as a sterile solution, suitable for delivery by intravenous administration.
−Removed: Feasibility batches of AP-SA02 have been completed meeting all intended specifications.
−Removed: Verification batches are advancing with quality control data expected to support regulatory filings.
−Removed: Potency of drug substance supports doses up to at least 1x10 9 PFU (plaque forming units) per phage, and endotoxin levels are well within specifications for an intravenous product.
−Removed: Clinical trial material of AP-SA02 will be manufactured under cGMP at our production facility in Marina del Rey, California, to support the required regulatory filing(s) for clinical entry in the United States and ex-U.S.
+Added: Clinical trial material of AP-SA02 is currently manufactured under cGMP at our production facility in Marina del Rey, California to support the required regulatory filing(s) for clinical entry in the United States and ex-U.S.
Clinical Development of AP-SA02 in Bacteremia
−Removed: We plan to file an IND application with the FDA in 2021, and, upon regulatory clearance, initiate a first-in-man Phase 1b/2a, multicenter, randomized, double-blind, placebo-controlled, multiple-ascending dose escalation study of the safety, tolerability, and efficacy of intravenous AP-SA02 as an adjunct to best available antibiotic therapy compared to best available antibiotic therapy alone for the treatment of adults with complicated bacteremia due to S.
+Added: On November 17, 2021, Armata received approval for the study to proceed from the FDA for its Investigational New Drug (“IND”) to initiate the “diSArm” study – a Phase 1b/2a, randomized, double‐blind, placebo‐controlled, multiple ascending dose escalation study of the safety, tolerability, and efficacy of intravenous AP‐SA02 as an adjunct to best available antibiotic therapy compared to best available antibiotic therapy alone for the treatment of adults with bacteremia due to Staphylococcus aureus .
The objectives of this study are to:
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(ii) evaluate optimal dosing through safety, pharmacokinetics and microbial efficacy;
−Removed: and (iii) explore efficacy through
−Removed: evaluation of key meaningful endpoints.
−Removed: We anticipate conducting the study at sites in the United States and also at sites abroad.
+Added: and (iii) explore efficacy through evaluation of key meaningful endpoints.
+Added: The study will be conducted at sites in the United States and also at sites abroad.
The Phase 1b/2a study will be partially funded by a $15.0 million award from the DoD through the Medical Technology Enterprise Consortium (“MTEC”) with funding from the Defense Health Agency and Joint Warfighter Medical Research Program.
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aureus (“MRSA").
−Removed: Merck Partnered Program
−Removed: Proprietary synthetic phage candidates designed to target an undisclosed infectious disease agent are being developed in partnership with Merck, a collaboration that reflects the pharmaceutical industry’s growing interest in phage therapy.
−Removed: Pursuant to the terms of the Amended and Restated Research Collaboration and Option to License Agreement between Armata and Merck (the “Research and Option Agreement”) we are engaged in the research and development of engineered phage, or a combination of two or more engineered phages, that infect specific bacteria, pursuant to the criteria set forth in the research plan.
−Removed: We intend for the phage to be engineered for a wide host range, and to express anti-biofilm and antimicrobial payloads.
−Removed: We will be entitled to milestone payments tied to the achievement of product development and regulatory milestones, and royalty payments based on net sales of products developed pursuant to the Research and Option Agreement.
−Removed: We are responsible for our costs and expenses in connection with the research program.
−Removed: Unless the Research and Option Agreement is terminated by Merck, it will continue in full force and effect until one or more products developed thereunder has received marketing authorization and, thereafter, until expiration of all royalty obligations thereunder.
−Removed: Upon expiration of the Research and Option Agreement, Merck’s licenses pursuant to the Research and Option Agreement will become fully paid-up, perpetual licenses.
−Removed: An amendment to the Research and Option Agreement with a revised research plan was agreed to by the parties in December 2019.
−Removed: Engineered Phage-Based Diagnostic
−Removed: We are developing a diagnostic test that, once fully developed, will help us to rapidly and accurately identify patients for future clinical trials and we believe will be useful in the commercialization of our phage product candidates.
−Removed: These tests are deigned to drive early use of our therapeutic phage in a treatment paradigm by identifying patients who are most likely to benefit.
−Removed: For example, those patients who are infected with a bacterial isolate that is sensitive to our particular therapeutic phage, and to monitor response to treatment with our particular therapeutic phage.
−Removed: The test is designed to be highly sensitive and to identify colonized patients even before a diagnosis of infection has been given by the treating physician .
+Added: A regulatory filing for AP-SA02 in this indication is expected in 2022.
Discovery Research
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Klebsiella pneumoniae phage, for example, is a potentially important addition to treatment options for serious lung infections.
−Removed: An outbreak of ventilator-associated pneumonia caused by a new emerging hypervirulent K.
−Removed: pneumoniae strain led to the death of five patients in the intensive care unit of a hospital in China (Lancet Infect.
−Removed: Volume 18:1, Jan 2018).
−Removed: Furthermore, our team of microbiologists and synthetic biologists hunt for natural phages and evaluate the suitability of these phages for engineering using our proprietary synthetic phage platform.
−Removed: We continue to make advancements in the engineering of super fit phage, incorporating the best attributes from a phage family to expand host range and increase burst size, and improving bactericidal and biofilm activity through the expression of heterologous proteins.
+Added: Furthermore, our team of microbiologists and synthetic biologists hunt for natural phages and evaluate the suitability of these natural phages for engineering using our proprietary synthetic phage platform.
+Added: These powerful natural phages can be purposely engineered to be more efficient killers.
+Added: The use of synthetic biology tools enables us to precisely engineer natural phages in ways that further improve their pharmacological properties and antimicrobial activity, with the potential to create supercharged synthetic phages that can be deployed in the clinic as highly effective weapons in the fight against multidrug-resistant bacterial infections.
+Added: Attributes of engineered phages can include expanded host range, improved potency which is a fundamental drug property that can translate into improved clinical efficacy, and importantly, biofilm disruption, which is a critical aspect of serious infections that needs to be addressed.
+Added: On our own, and in partnership, we are developing proprietary synthetic phage candidates designed to target pathogens such as Pseudomonas aeruginosa , as well as undisclosed infectious disease agents.
Manufacturing
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This facility, which serves as our headquarters, has approximately 35,500 square feet of laboratory and office space, including 5,600 square feet of cGMP laboratory space, designed to produce clinical quantities of each of our product candidates and to perform in-house Quality Control testing.
−Removed: We operate in-house process development activities through to production, purification, formulation, and release of our therapeutic phage cocktails for use in human clinical trials.
+Added: We operate in-house process development activities through to the production, purification, formulation, and release of our therapeutic phage cocktails for use in human clinical trials.
Our facility is licensed by the California Department of Public Health (“CDPH”) for drug manufacturing and is subject to periodic, unannounced inspections for compliance with cGMP and other state and federal laws and regulations.
1 unchanged sentence
Our facility is staffed with an independent Quality Unit and Manufacturing and Facilities personnel trained under cGMPs.
−Removed: We believe this facility will be sufficient to meet our manufacturing needs through our Phase 3 clinical trials.
Our current formulations for our P.
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We also rely on trademarks, trade secrets, know-how, continuing technological innovation and in-licensing opportunities to develop and maintain our proprietary position.
−Removed: We also depend upon the skills, knowledge, experience
−Removed: and know-how of our management and research and development personnel, as well as that of our advisors, consultants and other contractors.
+Added: We also depend upon the skills, knowledge, experience and know-how of our management and research and development personnel, as well as that of our advisors, consultants and other contractors.
To help protect our proprietary processes and know-how, which is not patentable, and for inventions for which patents may be difficult to enforce, we currently and will in the future rely on trade secret protection and contractual obligations with third parties to protect our interests and to develop and maintain our competitive position.
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Bacteriophage Patent Portfolio
−Removed: As of January 14, 2021, we owned or had exclusive license rights to a total of 121 patents and applications:
+Added: As of December 31, 2021, we owned or had exclusive license rights to a total of 131 patents and applications:
patents, 10 U.S.
−Removed: non-provisional patent applications, 2 U.S.
−Removed: provisional applications, 62 foreign patents, and 39 foreign patent applications, with nominal expiration on various dates between 2024 and 2041.
+Added: patent applications, 65 foreign patents, and 45 foreign patent applications, with nominal expiration on various dates between 2024 and 2041.
Patent term adjustments or patent term extensions could result in later expiration dates.
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There are a handful of small biotechnology companies developing bacteriophage products to treat human diseases.
−Removed: To our knowledge, several biotechnology companies in the United States and Europe, including Adaptive Phage Therapeutics, Pherecydes Pharma, BiomX Inc., Intralytix, Inc., Locus Biosciences, Inc., PhagoMed Biopharma GmbH, TechnoPhage, SA, Felix Biotechnology, as well as academic institutions, have discovery stage or clinical programs utilizing naturally occurring phages or synthetic biology approaches to genetically modify bacteriophages to remove or input genes to improve therapeutic properties such as increases to the bacterial host range to infect a larger number of bacterial strains and decrease the need for using multiple phages in a product.
+Added: To our knowledge, several biotechnology companies in the United States and Europe, including Adaptive Phage Therapeutics, Pherecydes Pharma, BiomX Inc., Intralytix, Inc., Locus Biosciences, Inc., TechnoPhage, SA, Felix Biotechnology, as well as academic institutions, have discovery stage or clinical programs utilizing naturally occurring phages or synthetic biology approaches to genetically modify bacteriophages to remove or input genes to improve therapeutic properties such as increases to the bacterial host range to infect a larger number of bacterial strains and decrease the need for using multiple phages in a product.
Our bacteriophage programs may compete with or be synergistic with currently approved antibiotics, and experimental approaches such as novel antibiotics, antimicrobial peptides, antimicrobial vaccines, metals, antisense, monoclonal antibodies and possibly microbiome manipulation.
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We have not yet established a sales, marketing or product distribution infrastructure because our lead candidates are still in early clinical development.
−Removed: Subject to receiving marketing approvals, or earlier we intend to either partner the commercial rights to our products with existing companies that have the wherewithal and resources to commercialize explore building the necessary marketing and sales infrastructure to market and sell our current product candidates.
+Added: Subject to receiving marketing approvals, or earlier we intend to either partner the commercial rights to our products with existing companies that have the wherewithal and resources to commercialize
+Added: explore building the necessary marketing and sales infrastructure to market and sell our current product candidates.
We also intend to explore the use of a variety of distribution agreements and commercial partnerships in those territories where we do not establish a sales force for any of our product candidates that obtain marketing approval.
Material Agreements
−Removed: License Agreements
−Removed: Amended and Restated Research Collaboration and Option to License Agreement with Merck
−Removed: Pursuant to the terms of the Research and Option Agreement, we are engaged in generating broad host range synthetic bacteriophage candidate(s) targeting an undisclosed infectious disease agent(s), pursuant to the criteria set forth in the research plan.
−Removed: We granted to Merck an exclusive, worldwide license in our patent rights, and our interest in any joint patent rights, with the right to grant and authorize sublicenses, for any and all uses of any product candidates, or products, developed through the research plans set forth in the Research and Option Agreement in a specific field of use.
−Removed: Further, we granted
−Removed: to Merck an exclusive, worldwide license, with the right to grant and authorize sublicenses, in our background intellectual property and know-how, solely to make, have made, use, import, offer to sell and sell (but not genetically modify) the product candidates, or products, developed through the research plans set forth in the Research and Option Agreement in the specific field of use.
−Removed: We will be entitled to milestone payments tied to the achievement of product development and regulatory milestones, and royalty payments based on net sales of products developed pursuant to the Research and Option Agreement.
−Removed: Each party to the Research and Option Agreement is responsible for its costs and expenses in connection with the research program.
−Removed: Unless the Research and Option Agreement is terminated by Merck, it will continue in full force and effect until one or more products developed thereunder has received marketing authorization and, thereafter, until expiration of all royalty obligations thereunder.
−Removed: Upon termination of the Research and Option Agreement, Merck’s licenses pursuant to the Research and Option Agreement will become fully paid-up, perpetual licenses.
−Removed: License Agreement with United Kingdom Secretary of State for the Department of Health
−Removed: In January 2011, upon completion of our acquisition of Biocontrol Ltd., we assumed a license agreement entered into in March 2007 between Biocontrol Ltd.
−Removed: and the Health Protection Agency, Centre for Emergency Preparedness and Response, to use certain intellectual property rights to develop treatments for bacterial biofilm infections.
−Removed: The agreement was subsequently assigned to the United Kingdom Secretary of State for the Department of Health (“DoH”).
−Removed: Under the license agreement, we have obtained exclusive rights to a patent portfolio related to the use of bacteriophages combined with biofilm-disrupting agents in treating biofilm infections.
−Removed: In consideration for the exclusive license, we may be required to pay to the DoH certain milestone payments in the aggregate of up to £10,000 per product, as well as single digit percentage royalty on net sales of products incorporating licensed intellectual property.
−Removed: The license agreement will remain in effect until the expiration of the last patent exclusively licensed under the license agreement.
−Removed: If we default on any milestone or royalty payments, or upon breach by us of certain other terms of the license agreement, the DoH may either terminate the license agreement immediately upon written notice or modify the license to be non-exclusive upon 30 days’ written notice.
Strategic Alliances and Research Agreements
On June 15, 2020, we entered into a Research Project Award agreement (the “MTEC Agreement”) with the Medical Technology Enterprise Consortium (“MTEC”), pursuant to which we will receive a $15.0 million grant and entered into a three-year program administered by the DoD through MTEC with funding from the Defense Health Agency and Joint Warfighter Medical Research Program.
−Removed: We plan to use the grant to partially fund a Phase 1b/2, randomized, double-blind, placebo-controlled, dose escalation clinical study of Armata's therapeutic phage-based candidate, AP-SA02, for the treatment of complicated S.
+Added: We plan to use the grant to partially fund a Phase 1b/2a, randomized, double-blind, placebo-controlled, dose-escalation clinical study of Armata's therapeutic phage-based candidate, AP-SA02, for the treatment of S.
aureus bacteremia infections.
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CFF Therapeutics Development Award
−Removed: On March 13, 2020, we entered into an award agreement (the “Agreement”) with CFF, pursuant to which we received a Therapeutics Development Award of up to $5.0 million (the “Award”).
−Removed: The Award will be used to fund a portion of our Phase 1b/2 clinical trial of the P.
+Added: On March 13, 2020, we entered into an award agreement (the “Agreement”) with the CFF, pursuant to which we received a Therapeutics Development Award of up to $5.0 million (the “Award”).
+Added: The Award will be used to fund a portion of our Phase 1b/2a clinical trial of the P.
aeruginosa phage candidate, AP-PA02, as a treatment for P.
1 unchanged sentence
The first payment under the Agreement, in the amount of $1.0 million, became due upon signing the Agreement and was received in April 2020.
−Removed: The remainder of the Award will be paid to us incrementally in installments upon the achievement of certain milestones related to the development program and progress of the Phase 1b/2 clinical trial of AP-PA02, as set forth in the Agreement.
+Added: The remainder of the Award will be paid to us incrementally in installments upon the achievement of certain milestones related to the development program and progress of the Phase 1b/2a clinical trial of AP-PA02, as set forth in the Agreement.
If we cease to use commercially reasonable efforts directed to the development of AP-PA02, or any other Product (as defined in the Agreement), for a period of 360 days (an “Interruption”) and fails to resume the development of the Product after receiving from CFF notice of an Interruption, then we must either repay the amount of the Award actually received by the Company, plus interest, or grant to CFF (1) an exclusive (even as to Armata), worldwide, perpetual, sublicensable license under technology developed under the Agreement that covers the Product for use in treating infections in CF patients (the “CF Field”), and (2) a non-exclusive, worldwide, perpetual, sublicensable license under certain background intellectual property covering the Product, to the extent necessary to commercialize the Product in the CF Field.
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Our payment obligations survive the termination of the Agreement.
+Added: License Agreements
+Added: Amended and Restated Research Collaboration and Option to License Agreement with Merck
+Added: Pursuant to the terms of the Research and Option Agreement, we are engaged in generating broad host range synthetic bacteriophage candidate(s) targeting an undisclosed infectious disease agent(s), pursuant to the criteria set forth in the research plan.
+Added: We granted to Merck an exclusive, worldwide license in our patent rights, and our interest in any joint patent rights, with the right to grant and authorize sublicenses, for any and all uses of any product candidates, or products, developed through the research plans set forth in the Research and Option Agreement in a specific field of use.
+Added: Further, we granted to Merck an exclusive, worldwide license, with the right to grant and authorize sublicenses, in our background intellectual property and know-how, solely to make, have made, use, import, offer to sell and sell (but not genetically modify) the product candidates, or products, developed through the research plans set forth in the Research and Option Agreement in the specific field of use.
+Added: We will be entitled to milestone payments tied to the achievement of product development and regulatory milestones, and royalty payments based on net sales of products developed pursuant to the Research and Option Agreement.
+Added: Each party to the Research and Option Agreement is responsible for its costs and expenses in connection with the research program.
+Added: Unless the Research and Option Agreement is terminated by Merck, it will continue in full force and effect until one or more products developed thereunder has received marketing authorization and, thereafter, until expiration of all royalty obligations thereunder.
+Added: Upon termination of the Research and Option Agreement, Merck’s licenses pursuant to the Research and Option Agreement will become fully paid-up, perpetual licenses.
+Added: License Agreement with United Kingdom Secretary of State for the Department of Health
+Added: In January 2011, upon completion of our acquisition of Biocontrol Ltd., we assumed a license agreement entered into in March 2007 between Biocontrol Ltd.
+Added: and the Health Protection Agency, Centre for Emergency Preparedness and Response, to use certain intellectual property rights to develop treatments for bacterial biofilm infections.
+Added: The agreement was subsequently assigned to the United Kingdom Secretary of State for the Department of Health (“DoH”).
+Added: Under the license agreement, we have obtained exclusive rights to a patent portfolio related to the use of bacteriophages combined with biofilm-disrupting agents in treating biofilm infections.
+Added: In consideration for the exclusive license, we may be required to pay to the DoH certain milestone payments in the aggregate of up to £10,000 per product, as well as single digit percentage royalty on net sales of products incorporating licensed intellectual property.
+Added: The license agreement will remain in effect until the expiration of the last patent exclusively licensed under the license agreement.
+Added: If we default on any milestone or royalty payments, or upon breach by us of certain other terms of the license agreement, the DoH may either terminate the license agreement immediately upon written notice or modify the license to be non-exclusive upon 30 days’ written notice.
Our corporate headquarters are located in Marina del Rey, California, where we currently lease 35,500 square feet of laboratory and office space.
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Armata’s facility is subject to periodic inspections by the City of Los Angeles and Los Angeles County for fire hazard and waste management and is in compliance with all applicable regulations.
+Added: On October 28, 2021, we entered into a lease for office and research and development space under a non-cancellable lease in Los Angeles, CA (the “2021 Lease”).
+Added: The 2021 Lease payment start date is May 1, 2022, and the total lease term is for 16 years and runs through 2038.
+Added: Monthly rent for 2022 and 2023 will be fully or partially abated while we and the lessor complete planned tenant improvements to the facility, which is planned to be completed in the second half of 2022.
+Added: Base monthly rent will be approximately $0.25 million in 2024.
+Added: We are entitled to receive an allowance for tenant improvements of up to $7.3 million.
In addition, we lease a 5,000 square foot facility located in Sydney, Australia.
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The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local and foreign statutes and regulations require the expenditure of substantial time and financial resources.
−Removed: Failure to comply with the applicable FDA requirements at any time during the product development process or approval process, or after approval, may subject an applicant to administrative or judicial sanctions.
+Added: Failure to comply
+Added: with the applicable FDA requirements at any time during the product development process or approval process, or after approval, may subject an applicant to administrative or judicial sanctions.
FDA sanctions could include refusal to approve pending applications, withdrawal of an approval, a clinical hold, warning letters, product recalls, product seizures, total or partial suspension of production or distribution injunctions, fines, refusals of government contracts, restitution, disgorgement or civil or criminal penalties.
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● Submission to the FDA of a Biologics License Application (“BLA”) for a new biological product;
−Removed: ● Satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities where the biological product is produced to assess compliance with the FDA’s cGMP regulations, to assure that the
−Removed: facilities, methods and controls are adequate to preserve the biological product’s identity, strength, quality and purity;
+Added: ● Satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities where the biological product is produced to assess compliance with the FDA’s cGMP regulations, to assure that the facilities, methods and controls are adequate to preserve the biological product’s identity, strength, quality and purity;
● Potential FDA inspection of the nonclinical study sites and clinical trial sites that generated the data in support of the BLA;
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Further, each clinical trial must be reviewed and approved by an independent institutional review board (“IRB”) or ethics committee if conducted outside of the United States, at or servicing each institution at which the clinical trial will be conducted.
−Removed: An IRB or ethics committee is charged with protecting the welfare and rights of trial participants and considers such items as whether the
−Removed: risks to individuals participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits.
+Added: An IRB or ethics committee is charged with protecting the welfare and rights of trial participants and considers such items as whether the risks to individuals participating in the clinical trials are minimized and are reasonable in relation to anticipated benefits.
The IRB or ethics committee also approves the informed consent form that must be provided to each clinical trial subject or his or her legal representative and must monitor the clinical trial until completed.
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FDA Review and Approval Processes
−Removed: In order to obtain approval to market a biological product in the United States, a BLA that provides data establishing to the FDA’s satisfaction the safety and effectiveness of the investigational product candidate for the proposed indication
−Removed: must be submitted to the FDA.
+Added: In order to obtain approval to market a biological product in the United States, a BLA that provides data establishing to the FDA’s satisfaction the safety and effectiveness of the investigational product candidate for the proposed indication must be submitted to the FDA.
The application includes all data available from nonclinical studies and clinical trials, including negative or ambiguous results as well as positive findings, together with detailed information relating to the product’s manufacture and composition, and proposed labeling, among other things.
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The FDA will not approve the product unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements and adequate to assure consistent production of the product within required specifications.
−Removed: The FDA also may audit data from clinical trials to ensure compliance with GCP requirements.
+Added: The FDA also may audit data from clinical
+Added: trials to ensure compliance with GCP requirements.
Additionally, the FDA may refer applications for novel product candidates or those that present difficult questions of safety or efficacy to an advisory committee, typically a panel that includes clinicians and other experts, for review, evaluation and a recommendation as to whether the application should be approved and, if so, under what conditions.
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If a product that has orphan designation subsequently receives the first FDA approval for the rare disease or condition for which it has such designation, the product is entitled to orphan drug exclusivity, which means that the FDA may not approve any other applications to market the same drug for the same indication for seven years from the date of such approval.
−Removed: Additionally, the sponsor can benefit from certain financial incentives, including opportunities for grant
−Removed: funding towards clinical trial costs, research and development tax credits, and user fee waivers.
+Added: Additionally, the sponsor can benefit from certain financial incentives, including opportunities for grant funding towards clinical trial costs, research and development tax credits, and user fee waivers.
If the same drug has already been approved, the proposed drug needs to demonstrate clinical superiority to obtain orphan exclusivity for the same indication, such as by means of greater effectiveness, greater safety or providing a major contribution to patient care, or in instances of drug supply issues.
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The FDA and the sponsor must reach an agreement on the PSP.
−Removed: A sponsor can submit amendments to an agreed-upon initial PSP at any time if changes to the pediatric plan need to be considered based on data collected from preclinical studies, early phase clinical trials and/or other clinical development programs.
+Added: A sponsor can submit amendments to an agreed-upon initial PSP at any time if
+Added: changes to the pediatric plan need to be considered based on data collected from preclinical studies, early phase clinical trials and/or other clinical development programs.
Special FDA Expedited Review and Approval Programs
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Additionally, a product may be eligible for accelerated approval.
−Removed: Drug or biological products studied for their safety and effectiveness in treating serious or life-threatening illnesses and that provide meaningful therapeutic benefit over existing treatments may receive accelerated approval, which means that they may be approved on the basis of adequate and well-controlled clinical trials establishing that the product has an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit, or on the basis of an effect on a clinical endpoint other than survival or irreversible morbidity or mortality, that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity or prevalence of the condition and the availability or lack of alternative treatments.
−Removed: The limited population pathway for antibacterial and antifungal drugs or biologics (LPAD) may enable streamlined development of safe and effective medicines that overcome the unmet needs of a limited population of patients with serious bacterial infections.
+Added: Drug or biological products studied for their safety and effectiveness in treating serious or life-threatening illnesses and that provide meaningful therapeutic benefit over existing treatments may receive accelerated approval, which means that they may be approved on the basis of adequate and well-controlled clinical trials establishing that the product has an effect on a surrogate endpoint that is reasonably likely to predict a clinical benefit, or on the basis of an effect on a clinical endpoint other than survival or irreversible morbidity or mortality or other clinical benefits, that is reasonably likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity or prevalence of the condition and the availability or lack of alternative treatments.
+Added: The limited population pathway for antibacterial and antifungal drugs or biologics (“LPAD”) may enable the streamlined development of safe and effective medicines that overcome the unmet needs of a limited population of patients with serious bacterial infections.
As a condition of approval, the FDA may require a sponsor of a drug or biological product receiving accelerated approval to perform post-marketing studies to verify and describe the predicted effect on irreversible morbidity or mortality or other clinical endpoint, and the drug or biological product may be subject to accelerated withdrawal procedures.
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Biological product manufacturers and other entities involved in the manufacture and distribution of approved products are required to register their facilities with the FDA and certain state agencies and are subject to periodic unannounced inspections by the FDA and certain state agencies for compliance with cGMPs and other laws.
−Removed: In addition, changes to the manufacturing process or facility generally require prior FDA approval before being implemented and other types of changes to the approved product, such as adding new indications and additional labeling claims, are also subject to further FDA review and approval.
+Added: changes to the manufacturing process or facility generally require prior FDA approval before being implemented and other types of changes to the approved product, such as adding new indications and additional labeling claims, are also subject to further FDA review and approval.
Labeling, Marketing and Promotion
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The term of individual patents depends upon the legal term of the patents in the countries in which they are obtained.
−Removed: In most countries in which we file, including the United States, the base term is 20 years from the filing date of the earliest-filed non-provisional patent application from which the patent claims priority.
+Added: In most countries in which we file, including the United States (“U.S.”), the base term is 20 years from the filing date of the earliest-filed non-provisional patent application from which the patent claims priority.
The term of a U.S.
patent can be lengthened by patent term adjustment, which compensates the owner of the patent for administrative delays at the U.S.
+Added: Patent and Trademark Office (“PTO”).
Depending upon the timing, duration and specifics of FDA approval of our drugs, some of our U.S.
−Removed: patents may be eligible for limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of
−Removed: 1984, referred to as the Hatch-Waxman Amendments.
+Added: patents may be eligible for limited patent term extension under the Drug Price Competition and Patent Term Restoration Act of 1984, referred to as the Hatch-Waxman Amendments.
The Hatch-Waxman Amendments permit a patent restoration term of up to five years as compensation for patent term lost during product development and the FDA regulatory review process.
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and (3) one or more clinical trials to demonstrate safety, purity and potency in one or more appropriate conditions of use for which the reference product is approved.
−Removed: In addition, the applicant must show that the biosimilar and reference products have the same mechanism of action for the conditions of use on the label, route of administration, dosage and strength, and the production facility must meet standards designed to assure product safety, purity and potency.
+Added: In addition, the applicant must show that the biosimilar and reference products
+Added: have the same mechanism of action for the conditions of use on the label, route of administration, dosage and strength, and the production facility must meet standards designed to assure product safety, purity and potency.
An application for a biosimilar product may not be submitted until four years after the date on which the reference product was first approved.
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or monitor response to treatment with a particular therapeutic product for the purpose of adjusting treatment to achieve improved safety or effectiveness.
−Removed: Companion diagnostics are regulated as
−Removed: medical devices by the FDA and, as such, require either clearance or approval prior to commercialization.
+Added: Companion diagnostics are regulated as medical devices by the FDA and, as such, require either clearance or approval prior to commercialization.
The level of risk combined with available controls to mitigate risk determines whether a companion diagnostic device requires Premarket Approval Application (“PMA”) approval or is cleared through the 510(k) premarket notification process.
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● federal civil and criminal false claims laws and civil monetary penalties laws, such as the federal False Claims Act, which impose criminal and civil penalties and authorize civil whistleblower or qui tam actions, against individuals or entities for, among other things:
−Removed: knowingly presenting, or causing to be presented, to the federal government, claims for payment that are false or fraudulent; making, using or causing to be made or used, a false statement or record material to a false or fraudulent claim or obligation to pay or transmit money or property to the federal government; or knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay money to the federal government;
+Added: knowingly presenting, or causing to be presented, to the federal
+Added: government, claims for payment that are false or fraudulent; making, using or causing to be made or used, a false statement or record material to a false or fraudulent claim or obligation to pay or transmit money or property to the federal government; or knowingly concealing or knowingly and improperly avoiding or decreasing an obligation to pay money to the federal government;
● the anti-inducement law, which prohibits, among other things, the offering or giving of remuneration, which includes, without limitation, any transfer of items or services for free or for less than fair market value (with limited exceptions), to a Medicare or Medicaid beneficiary that the person knows or should know is likely to influence the beneficiary’s selection of a particular supplier of items or services reimbursable by a federal or state governmental program;
−Removed: ● HIPAA, which created new federal criminal statutes that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program, regardless of the payor (e.g., public or private) and knowingly and willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially false statements in connection with the delivery of, or payment for, healthcare benefits, items or services relating to healthcare matters; similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation;
−Removed: ● HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009, and their respective implementing regulations, which impose requirements on certain covered healthcare providers, health plans, and healthcare clearinghouses as well as their respective business associates that perform services
−Removed: for them that involve the use, or disclosure of, individually identifiable health information, relating to the privacy, security and transmission of individually identifiable health information;
+Added: ● The Health Insurance Portability and Accountability (“HIPAA”), which created new federal criminal statutes that prohibit knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program or obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any healthcare benefit program, regardless of the payor (e.g., public or private) and knowingly and willfully falsifying, concealing or covering up by any trick or device a material fact or making any materially false statements in connection with the delivery of, or payment for, healthcare benefits, items or services relating to healthcare matters; similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a violation;
+Added: ● HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act of 2009, and their respective implementing regulations, which impose requirements on certain covered healthcare providers, health plans, and healthcare clearinghouses as well as their respective business associates that perform services for them that involve the use, or disclosure of, individually identifiable health information, relating to the privacy, security and transmission of individually identifiable health information;
● the federal transparency requirements under the Affordable Care Act, including the provision commonly referred to as the Physician Payments Sunshine Act, which requires manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health Insurance Program to report annually to the U.S.
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There are ambiguities as to what is required to comply with these state requirements, and if we fail to comply with an applicable state law requirement, we could be subject to penalties.
−Removed: Finally, there are state and foreign laws governing the privacy and security of health information, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
+Added: Finally, there are state and foreign laws governing the privacy and security of health
+Added: information, many of which differ from each other in significant ways and often are not preempted by HIPAA, thus complicating compliance efforts.
Because of the breadth of these laws and the narrowness of the statutory exceptions and safe harbors available, it is possible that some of our business activities could be subject to challenge under one or more of such laws.
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healthcare industry and elsewhere is cost containment.
−Removed: Government authorities and other third-party payors have attempted to control costs by limiting coverage and the amount of reimbursement for particular medical products.
−Removed: For example, in March 2010, the Affordable Care Act was enacted, which, among other things, increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug Rebate Program;
+Added: Government authorities and other third-party payors have attempted to control costs by limiting coverage and the amount of reimbursement for
+Added: particular medical products.
+Added: For example, in March 2010, the Affordable Care Act (“ACA”) was enacted, which, among other things, increased the minimum Medicaid rebates owed by most manufacturers under the Medicaid Drug Rebate Program;
introduced a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, implanted or injected;
4 unchanged sentences
created a new Patient Centered Outcomes Research Institute to oversee, identify priorities in and conduct comparative clinical effectiveness research, along with funding for such research;
−Removed: and established the Center for Medicare Innovation at the CMS to test innovative payment and service delivery models to lower Medicare and Medicaid spending.
−Removed: Since its enactment, there have been a number of significant changes to the Affordable Care Act (the “ACA”).
+Added: and established the Center for Medicare Innovation at the Centers for Medicare and Medicaid (“CMM”) to test innovative payment and service delivery models to lower Medicare and Medicaid spending.
+Added: Since its enactment, there have been a number of significant changes to the ACA.
On October 13, 2017, President Trump signed an Executive Order terminating the cost-sharing subsidies that reimburse insurers under the Affordable Care Act.
Several state Attorneys General filed suit to stop the administration from terminating the subsidies, but their request for a restraining order was denied by a federal judge in California on October 25, 2017.
−Removed: In addition, CMS has recently proposed regulations that would give states greater flexibility in setting benchmarks for insurers in the individual and small group marketplaces, which may have the effect of relaxing the essential health benefits required under the Affordable Care Act for plans sold through such marketplaces.
+Added: In addition, CMS has recently proposed regulations that would give states greater flexibility in setting benchmarks for insurers in the individual and small group marketplaces, which may have the effect of relaxing the essential health benefits required under the ACA for plans sold through such marketplaces.
In January 2017, President Trump signed an Executive Order directing federal agencies with authorities and responsibilities under the Affordable Care Act to waive, defer, grant exemptions from, or delay the implementation of any provision of the Affordable Care Act that would impose a fiscal or regulatory burden on states, individuals, healthcare providers, health insurers, or manufacturers of pharmaceuticals or medical devices.
−Removed: The Tax Cuts and Jobs Act of 2017 (“TCJA”), includes a provision repealing, effective January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals who fail to maintain qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” Additionally, on January 22,
−Removed: 2018, President Trump signed a continuing resolution on appropriations for fiscal year 2018 that delayed the implementation of certain ACA-mandated fees, including the so-called “Cadillac” tax on certain high cost employer sponsored insurance plan, the annual fee imposed on certain health insurance providers based on market share, and the medical device exercise tax on non-exempt medical devices.
+Added: The Tax Cuts and Jobs Act of 2017 (“TCJA”), includes a provision repealing, effective January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals who fail to maintain qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” Additionally, on January 22, 2018, President Trump signed a continuing resolution on appropriations for fiscal year 2018 that delayed the implementation of certain ACA-mandated fees, including the so-called “Cadillac” tax on certain high cost employer sponsored insurance plan, the annual fee imposed on certain health insurance providers based on market share, and the medical device exercise tax on non-exempt medical devices.
Further, the Bipartisan Budget Act of 2018, among other things, amends the ACA, effective January 1, 2019, to reduce the coverage gap in most Medicare drug plans, commonly referred to as the “donut hole.” Congress will likely consider other legislation to replace or modify elements of the Affordable Care Act.
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Certain countries outside of the United States have a regulatory process similar to the U.S.
−Removed: process that requires the submission of a CTA much like the IND prior to the commencement of human clinical trials.
+Added: process that requires the submission of a clinical trial application (“CTA”) much like the IND prior to the commencement of human clinical trials.
In the European Union, for example, CTA must be submitted for each clinical trial to the national health authority and an independent ethics committee in each country in which the trial is to be conducted, much like the FDA and an IRB, respectively.
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That procedure is available for all medicinal products unless they fall into the mandatory scope of the centralized procedure.
−Removed: In practice, it is used for OTC, not highly innovative products, generic products and, increasingly, for biosimilars.
+Added: In practice, it is used for over-the-counter, not highly innovative products, generic products and, increasingly, for biosimilars.
The centralized procedure provides for the grant of a single marketing authorization by the European Commission that is valid for all European Union member states.
−Removed: The centralized procedure is compulsory for certain medicinal products, including for medicinal products produced by certain biotechnological processes, products designated as orphan medicinal products, advanced therapy medicinal products (“ATMPs”) and products with a new active substance and indicated for the treatment of certain diseases.
+Added: The centralized procedure is compulsory for certain medicinal products, including for medicinal products produced by certain biotechnological processes, products designated as
+Added: orphan medicinal products, advanced therapy medicinal products (“ATMPs”) and products with a new active substance and indicated for the treatment of certain diseases.
For products with a new active substance and indicated for the treatment of other diseases, products that are highly innovative or for which a centralized process is in the interest of patients, the centralized procedure is optional.
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To this end, the marketing authorization holder must provide the EMA or the competent authority with a consolidated version of the file in respect of quality, safety and efficacy, including all variations introduced since the marketing authorization was granted, at least six months before the marketing authorization ceases to be valid.
−Removed: Once renewed, the marketing authorization is valid for an unlimited period, unless the European
−Removed: Commission or the national competent authority decides, on justified grounds relating to pharmacovigilance, to proceed with one additional renewal.
+Added: Once renewed, the marketing authorization is valid for an unlimited period, unless the European Commission or the national competent authority decides, on justified grounds relating to pharmacovigilance, to proceed with one additional renewal.
Any authorization which is not followed by the actual placing of the medicinal product on the European Union market (in case of centralized procedure) or on the market of the authorizing member state within three years after authorization ceases to be valid (the so-called sunset clause).
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In the European Union, orphan drug designation entitles the sponsor to financial incentives such as reduction of fees or fee waivers and to ten years of market exclusivity granted following medicinal product approval.
−Removed: Market exclusivity precludes the EMA or a national regulatory authority from validating another MAA, and the European Commission or a national regulatory authority from granting another marketing authorization, for a same or similar medicinal product and a same therapeutic indication, for that time period.
+Added: Market exclusivity
+Added: precludes the EMA or a national regulatory authority from validating another MAA, and the European Commission or a national regulatory authority from granting another marketing authorization, for the same or similar medicinal product and the same therapeutic indication, for that time period.
This 10-year period may be reduced to six years if the orphan drug designation criteria are no longer met, including where it is shown that the product is sufficiently profitable not to justify maintenance of market exclusivity.
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PRIME status enables early dialogue with the relevant EMA scientific committees and, possibly, some payors and thus reinforces the EMA’s scientific and regulatory support.
−Removed: It also opens accelerated assessment of the MAA as PRIME status, is normally reserved for medicinal products that may benefit from accelerated assessment, i.e., medicines of major interest from a public health perspective, in particular from a therapeutic innovation perspective.
−Removed: Finally, all medicinal products (i.e.
−Removed: decentralized and centralized procedures) may benefit from an MA “under exceptional circumstances.” This marketing authorization is close to the conditional marketing authorization as it is reserved to medicinal products to be approved for severe diseases or unmet medical needs and the applicant does not hold the complete data set legally required for the grant of a marketing authorization.
+Added: It also opens accelerated assessment of the MAA as PRIME
+Added: status, is normally reserved for medicinal products that may benefit from accelerated assessment, i.e., medicines of major interest from a public health perspective, in particular from a therapeutic innovation perspective.
+Added: Finally, all medicinal products (i.e., decentralized and centralized procedures) may benefit from an MAA “under exceptional circumstances.” This marketing authorization is close to the conditional marketing authorization as it is reserved to medicinal products to be approved for severe diseases or unmet medical needs and the applicant does not hold the complete data set legally required for the grant of a marketing authorization.
However, unlike the conditional marketing authorization, the applicant does not have to provide the missing data and will never have to.
The risk/benefit of the medicinal product is reviewed annually.
−Removed: As a result, although the MA “under exceptional circumstances” is granted definitively, the risk/benefit balance of the medicinal product is reviewed annually and the marketing authorization is withdrawn in case the risk/benefit ratio is no longer favorable.
+Added: As a result, although the MAA “under exceptional circumstances” is granted definitively, the risk/benefit balance of the medicinal product is reviewed annually and the marketing authorization is withdrawn in case the risk/benefit ratio is no longer favorable.
Mandatory testing in the pediatric population is required in more and more jurisdictions.
The European Union has enacted a complex and very stringent system that has inspired other jurisdictions, including the United States and Switzerland.
−Removed: Any application for approval of (i) a medicinal product containing a new active substance or (ii) a new therapeutic indication, pharmaceutical form or route of administration of an already authorized medicinal product which contains an active substance still protected by a supplementary protection certificate (“SPC”) or a patent that qualifies for an SPC, must include pediatric data.
+Added: Any application for approval of (i) a medicinal product containing a new active substance or (ii) a new therapeutic indication, pharmaceutical form or route of administration of an already authorized medicinal product that contains an active substance still protected by a supplementary protection certificate (“SPC”) or a patent that qualifies for an SPC, must include pediatric data.
Otherwise, the application is not validated by the competent regulatory authority.
−Removed: The submission of pediatric data is mandatory in those cases, even if the application concerns an adult use.
+Added: The submission of pediatric data is mandatory in those cases, even if the application concerns adult use.
Submission of pediatric data is not required or fully required if the EMA granted, respectively, a full or partial waiver to pediatric development.
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The EMA may agree to modify the PIP at the company’s request.
−Removed: The scope of the PIP is the adult therapeutic indication or the condition of which the adult application is part or even the
−Removed: mechanism of action of the active substance, at the EMA’s quasi-discretion.
+Added: The scope of the PIP is the adult therapeutic indication or the condition of which the adult application is part or even the mechanism of action of the active substance, at the EMA’s quasi-discretion.
This very broad discretion enables the EMA to require companies to develop children indications that are different from the adult indications.
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Furthermore, authorized drugs and biologics may benefit from regulatory exclusivities (in additional to patent protection resulting from patents).
−Removed: In the European Union, Regulation (EC) 469/2009 institutes SPCs.
+Added: In the European Union, Regulation (EC) 469/2009 institutes a supplementary protection certificate (“SPC”).
An SPC is an extension of the term of a patent that compensates for the patent protection lost because of the legal requirements to conduct safety and efficacy tests and to obtain a marketing authorization before placing a medicinal product on the market.
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Data exclusivity prevents other companies from referring to the non-clinical and clinical data in marketing authorization dossier of the reference medicinal product for submission of generic MAA purposes, and market protection prevents other companies from placing generics on the market.
−Removed: Pursuant to the concept of global marketing authorization, any further development of that medicinal product (e.g., new indication, new form, change to the active substance) by the marketing authorization holder does not trigger any new or
−Removed: additional protection.
+Added: Pursuant to the concept of global marketing authorization, any further development of that medicinal product (e.g., new indication, new form, change to the active substance) by the marketing authorization holder does not trigger any new or additional protection.
The authorization of any new development is considered as “falling” into the initial marketing authorization with regard to regulatory protection;
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Pediatric reward is another regulatory exclusivity.
−Removed: Completion of a PIP renders the company eligible for a pediatric reward, which can be six-month extension of the term of the SPC or, in the cases of orphan medicinal products, two additional years of market exclusivity (see above).
+Added: Completion of a PIP renders the company eligible for a pediatric reward, which can be six-month extension of the term of the SPC or, in the cases of orphan medicinal products, two
+Added: additional years of market exclusivity (see above).
In case a PIP is completed on a voluntary basis, i.e., for an approved medicinal product that is not or no longer protected by an SPC or a basic patent, the pediatric reward takes the form of a “pediatric use marketing authorization” (“PUMA”).
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Although none of our product candidates has been commercialized for any indication, if they are approved for marketing, commercial success of our product candidates will depend, in part, upon the availability of third-party reimbursement from payors at the federal, state and private levels.
−Removed: Third-party payors include government healthcare
−Removed: programs, such as Medicare and Medicaid, private health insurers and managed-care plans.
+Added: Third-party payors include government healthcare programs, such as Medicare and Medicaid, private health insurers and managed-care plans.
We anticipate third-party payors will provide reimbursement for our products.
13 unchanged sentences
Employees and Human Capital
−Removed: As of March 1, 2021, we had 59 full-time employees and three part-time employees.
+Added: As of March 1, 2022, we had 69 full-time employees and two part-time employees.
Of the 69 full-time employees, 62 were engaged in research and development activities and seven employees were engaged in finance, legal, human resources, facilities and general management.
11 unchanged sentences
We believe that we must offer and maintain market competitive compensation and benefit programs for our employees in order to attract and retain qualified personnel.
−Removed: In addition to cash compensation, we provide equity
−Removed: compensation, healthcare and insurance benefits, health savings and flexible spending accounts, paid time off, family leave, and employee assistance programs.
+Added: In addition to cash compensation, we provide equity compensation, healthcare and insurance benefits, health savings and flexible spending accounts, paid time off, family leave, and employee assistance programs.
Corporate History and Reorganization
10 unchanged sentences
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.