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Immuron Announces Positive Results Support Travelan® progress to Phase 3 Clinical Trials in the US

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Immuron Limited announces positive interim topline results for Travelan® in preventing moderate to severe diarrhea caused by ETEC. The Phase 2 study showed significant protective efficacy with a single daily dose, supported by funding from the U.S. Department of Defense. The study demonstrated a 36.4% protective efficacy against moderate to severe diarrhea and a 66.7% protective efficacy against severe diarrhea compared to the placebo group. Additionally, there was an 83.3% reduction in subjects needing early antibiotic treatment and a 100% reduction in subjects requiring IV fluids post challenge in the Travelan® group. The study also reported a 55.6% reduction in adverse events associated with the ETEC challenge in the Travelan® group. The Phase 2 study data supported the excellent safety and tolerability profile of Travelan®.
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The recent Phase 2 clinical trial results for Immuron's Travelan® have shown significant protective efficacy against ETEC-induced diarrhea, which is a common ailment among travelers and military personnel in developing countries. The data indicating a 36.4% efficacy in preventing moderate to severe diarrhea and a 66.7% efficacy in preventing severe diarrhea at a single daily dose is noteworthy. These results suggest a potential shift in the prophylactic treatment paradigm for ETEC, which could lead to increased demand for the product if Phase 3 trials confirm its efficacy and safety.

From a research perspective, the 83.3% reduction in the need for early antibiotic treatment is particularly significant, as it implies a potential reduction in antibiotic resistance—a major concern in global health. The safety profile, as supported by the study, also suggests that Travelan® could be well-tolerated, which is crucial for widespread adoption. If the final clinical study report, expected in the second half of 2024, confirms these findings, it could result in a reassessment of the stock value for Immuron, particularly if the product gains traction in markets such as military procurement or travel medicine.

Immuron's announcement of positive interim topline results from the Phase 2 clinical trial of Travelan® could have a positive impact on investor sentiment and the company's stock price. The financial support from the U.S. Department of Defense, amounting to AU $4.8 million, underscores the strategic importance of the drug and the confidence in its potential. This kind of governmental backing not only provides non-dilutive funding but also validates the product's market potential.

Investors should note the potential for Travelan® to tap into the substantial markets of travel medicine and military health supplies. The interim results may lead to partnerships or advance purchase agreements, which could provide a stable revenue stream for Immuron. However, it is important to consider that the drug is still in the clinical trial phase and its commercial success will depend on the outcomes of the Phase 3 trials and subsequent FDA approval. The stock market's reaction to these interim results will likely be positive in the short term, but long-term value will be contingent upon continued positive trial outcomes and market penetration strategies.

The clinical trial results for Travelan® position Immuron in a favorable spot within the travel medicine and military health sectors. The potential market for an effective prophylactic against ETEC is significant, given the millions of international travelers and deployed military personnel who might benefit from such a treatment. The 55.6% reduction in adverse events associated with the ETEC challenge suggests Travelan® could be a market differentiator by reducing the health burden of diarrhea among these populations.

The global travel vaccines market is projected to grow in the coming years and Travelan® could capture a significant share if it proves to be a convenient and effective solution. The next steps for Immuron will likely involve strategic partnerships and scaling production capabilities to meet potential demand. The long-term market impact will hinge on the Phase 3 trial outcomes, regulatory approvals and the company's ability to navigate the competitive landscape of travel-related health products.

Highlights:

  • Immuron proceeding to Phase 3 registration strategy with the FDA
  • Travelan® topline clinical trial results demonstrate protective efficacy with single daily dose
  • 36.4% protective efficacy against Enterotoxigenic Escherichia coli (ETEC) induced moderate to severe diarrhea was observed in the Travelan® group compared to the placebo group (primary endpoint)
  • 66.7% protective efficacy against ETEC induced severe diarrhea was observed in the Travelan® group compared to the placebo group (secondary endpoint)
  • 83.3% statistically significant reduction in the number of subjects in the Travelan® group requiring early antibiotic treatment post challenge compared to the placebo (secondary endpoint)
  • 100% of the subjects requiring IV fluids post challenge were in the placebo (secondary endpoint)
  • 55.6% reduction in the number of subjects experiencing adverse events associated with the ETEC challenge observed in the Travelan® group compared to the placebo group (secondary endpoint)
  • Phase 2 clinical study data supports the excellent safety and tolerability profile of Travelan®

MELBOURNE, Australia, March 07, 2024 (GLOBE NEWSWIRE) -- Immuron Limited (ASX: IMC; NASDAQ: IMRN), an Australian based and globally integrated biopharmaceutical company is pleased to announce the interim topline results confirming that a single daily dose of Travelan® is effective in prevention of moderate to severe diarrhea following challenge with enterotoxigenic Escherichia coli (ETEC).

Immuron was awarded AU $4.8 (USD $3.43) million funding by the U.S. Department of Defense (ASX Announcement 12 January 2022) to perform a randomized double-blind placebo-controlled phase 2 controlled human infection model (CHIM) study to assist with evaluating a dosing regimen that is most suited to deployed US troops visiting developing countries. Healthy volunteers were recruited and randomly assigned to receive a single daily oral dose of 1200 mg of Travelan® or placebo. Dosing commenced 2 days prior to challenge with ETEC strain H10407 and continued for 7 days. ClinicalTrials.gov Identifier: NCT05933525.

This interim analysis summarizes the data for a total of 60 subjects who have completed the inpatient challenge component of this current clinical study. Last patients last visits are anticipated to commence in April this year and final clinical study report will be completed in H2 2024.

Having demonstrated protective efficacy in two published clinical studies (Otto et al., 2011), this Phase 2 study was designed to compare the preventative effects of once daily dosing to the current standard recommended treatment of three times daily dosing. To learn more about Phase 2 study design, read: U.S. Food and Drug Administration Step 3: Clinical Research

IMM-124E (Travelan®) will be the first product developed with Immuron’s platform technology to proceed into Phase 3 clinical trials. The underlying nature of Immuron’s platform technology enables the development of medicines across a large range of infectious diseases. The platform can be used to block viruses or bacteria at mucosal surfaces such as the Gastrointestinal tract and neutralize the toxins they produce. More information on Immuron’s platform technology can be found below.

Travelan® demonstrated clinical efficacy in preventing ETEC-attributable diarrhea in two previous CHIM studies (Table 1). These studies showed dosing 400 mg three times daily, resulted in 76.7% (p=0.007) to 90.9% (p=0.0005) protection (Otto et al., 2011).

This trial demonstrated protective efficacy* with once daily dosing even though the attack rate for this study was much lower than planned. The intended attack rate (percentage of subjects with ETEC-induced moderate- severe diarrhea) for this study was approximately 70%. The attack rate for the Placebo group of this study was only 37% (Table 2). Given the lower than planned attack rate, this current study is underpowered to appropriately detect a significant difference in moderate to severe ETEC attributed diarrhea in the Placebo group compared to the Treatment group. This makes the demonstration of protective efficacy and reduction in adverse events and diarrheal symptoms particularly noteworthy.

The company will now proceed to hold an end of Phase 2 meeting with the U.S Food and Drug Administration to discuss the pivotal Phase 3 registration strategy and planned clinical trials including recommended dosing to support a Biologics License Application (BLA) for Travelan® as a prophylactic medicine for Travelers’ Diarrhea. A preventative treatment that defends against infectious enteric diseases is a high priority objective for the U.S. Military.

Immuron is in the process of exploring non-dilutive funding opportunities for these Phase 3 clinical trials.

Topline results:
Travelan®, a first-in-class, oral antibody therapy, dosed once daily resulted in a reduction ETEC-induced moderate-severe diarrhea compared to placebo.

  • ETEC-induced moderate to severe diarrhea was reduced by 36.4% in the Travelan® group compared to the placebo group
  • Protective efficacy of once daily dosing shown to be approx. 50% as effective as the current recommended three times daily dosing regimen; this is a strong result given the lower than expected attack rate
  • 66.7% protective efficacy against ETEC induced severe diarrhea was observed in the Travelan® group compared to the placebo group
  • Statistically significant reduction of 83.3% in the subjects in the Travelan® group requiring early antibiotic treatment post challenge compared to the placebo
  • For the subjects requiring intravenous rehydration post challenge 100% were in the placebo group and none were in the Travelan® group
  • 55.6% reduction in the number of subjects experiencing adverse events post the ETEC challenge was observed in the Travelan® group compared to the Placebo group

Studies using the CHIM for a variety of different enteric pathogens suggest the greatest protection may be against more severe disease and in studies where the disease appears to be predominately mild, which appears to be the case in this study, the efficacy estimates can be lower than anticipated.

Table 1: Summary of current clinical study data

Event post challengeTravelan®
n = 30
n (%)
Placebo
n = 30
n (%)
Reduction
in AEs or
Symptoms (%)
P value
Primary Endpoint
Number (n) of subjects with ETEC-induced moderate- severe diarrhea7
(23.3%)
11 (36.7%)NA0.399
Protective efficacy [%]1
95% 2-sided Confidence Interval2
36.4%*
(-79.8%, 79.1%)
    
Secondary Endpoints - Safety and tolerability
Number of subjects with an adverse event (AE)
95% 2-sided Confidence Interval2
4 (13.3%)
(-3.8%, 37.1%)
9 (30.0%)55.6%0.1172
Number of subjects with (AEs) fever, nausea, anorexia, or abdominal pain/cramps rated as moderate to severe
95% 2-sided Confidence Interval2
3 (10.0%)
(-5.2%, 31.9%)
7 (23.3%)57.1%0.1659
Secondary Endpoints – Degree to which a participant experiences diarrheal symptoms
Number of subjects who experienced severe diarrhea
95% 2-sided Confidence Interval2
1 (3.3%)
(-5.8%, 19.2%)
3 (10.0%)66.7%0.3006
Number of subjects requiring early antibiotic treatment
95% 2-sided Confidence Interval2
1 (3.3%)
(1.0%, 32.4%)
6 (20.0%)83.3%0.0444
Number of subjects requiring IV fluids
95% 2-sided Confidence Interval2
0
(-0.7%, 20.7%)
3 (10.0%)100.0%0.0756

1 Fishers exact test and binomial distribution 2 Chi-square test
AE = Adverse event associated with the ETEC challenge
* Intent-to-treat analysis set defined as randomized subjects who received study medication and were challenged

Table 2: Comparison of clinical study data attack rates

Event post challengeOtto3 Study 1
Placebo
n = 15
n (%)
Otto3 Study 2
Placebo
n = 14
n (%)
Current
Travelan® Study
n = 30
n (%)
Number (n) of subjects with ETEC-induced moderate- severe diarrhea11
(73%)
12
(86%)
11
(37%)

3Otto et al., 2011

Immuron is investigating the impact of the lower than expected attack rate.

Immuron has filed a provisional patent application with the U.S. Patent Office including results from this trial.

This release has been authorized by the directors of Immuron Limited.

COMPANY CONTACT:
Steven Lydeamore
Chief Executive Officer
steve@immuron.com     

About Immuron
Immuron Limited (ASX: IMC, NASDAQ: IMRN), is an Australian biopharmaceutical company focused on developing and commercializing orally delivered targeted polyclonal antibodies for the treatment of infectious diseases.

For more information visit: https://www.immuron.com.au/ and https://www.travelan.com
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The topline clinical trial results showed a 36.4% protective efficacy against moderate to severe diarrhea and a 66.7% protective efficacy against severe diarrhea compared to the placebo group.

The U.S. Department of Defense awarded Immuron AU $4.8 (USD $3.43) million funding to perform a Phase 2 controlled human infection model (CHIM) study to evaluate a dosing regimen for deployed US troops visiting developing countries.

Healthy volunteers received a single daily oral dose of 1200 mg of Travelan® or placebo for 7 days, starting 2 days prior to challenge with ETEC strain H10407.

The ClinicalTrials.gov Identifier for the study is NCT05933525.

The final clinical study report is expected to be completed in H2 2024.

The Phase 2 study aimed to compare the preventative effects of once daily dosing of Travelan® to the current standard recommended treatment of three times daily dosing.
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About IMRN

immuron ltd is a publicly listed australian biopharmaceutical company focused on oral immunotherapy utilizing polyclonal antibody products that target the human gut immune system and gut microbiome. immuron’s technology platform is capable of developing and producing an orally stable therapeutic as a potential ‘oral targeted therapy’ for various immune mediated and inflammatory disorders, among them: non-alcoholic steatohepatitis (nash) diabetes, colitis, arthritis, inflammatory bowel diseases (ibd), irritable bowel syndrome (ibs), liver fibrosis and other chronic disorders in which the immune system plays a key role in thier pathogenesis. these disorders represent areas of growing and unmet medical need, where oral targeted therapy drugs could offer significant advantages due to the lack of absorption and the high safety profile. immuron has one marketed product, which provides proof of concept for its oral immune technology platform, and a pipeline of products at various stages of cl