Summary

Indications

We focus on therapeutic areas where the conditions are acute or chronic, and where there is a well-defined medical need. Below a short description of the conditions that Savara seeks to treat by inhalation of Vancomycin, GM-CSF and FVIIa respectively.

cystic-fibrosis-CF-1024x1024

Frontal chest radiograph in patient with cystic fibrosis

There are approximately 30,000 people living with cystic fibrosis in the U.S. Cystic fibrosis is a life-shortening genetic disease characterized by thick, sticky mucus in the lungs and chronic lung infections resulting in gradual loss of lung function. The most prevalent lung pathogen in cystic fibrosis patients is Pseudomonas aeruginosa, which is commonly treated using inhaled antibiotics. In recent years, methicillin-resistant Staphylococcus aureus (MRSA), a bacterium that is resistant to conventional antibiotics (1), has become increasingly common, with a prevalence of almost 30% of the U.S. cystic fibrosis patient population. Recent publications indicate that cystic fibrosis patients with chronic MRSA infection have more hospitalizations, faster decline in lung function, and reduced life expectancy. (2,3,4)

[1] Gorwitz RJ et al. Journal of Infectious Diseases. 2008:197:1226-34. [2] Prevalence and impact on FEV1 decline of chronic methicillin-resistant Staphylococcus aureus (MRSA) coloniation in patients with Cystic Fibrosis: A single-center case control study of 165 patients. Vanderhelst E, De Meirleir L, Verbanck S. et al. s.l. : J Cystic Fibrosis, 2012, Vol. 11, pp. 2-7. [3] Persistent Methicillin-resistant Staphylococcus aureus and Rate of FEV1 Decline in Cystic Fibrosis. Dasenbrook EC, Merlo CA, Diener-West M, et. al. s.l. : Am J Respir Crit Care Med, 2008, Vol. 178, pp. 814-821. [4] Elliott C. Dasenbrook; William Checkley; Christian A. Merlo; Michael W. Konstan; Noah Lechtzin; Michael P. Boyle. Association Between Respiratory Tract Methicillin-Resistant Staphylococcus aureus and Survival in Cystic Fibrosis. JAMA, 2010; 303 (23): 2386-2392.

Thorax scan of patient with PAP

Thorax scan of patient with PAP

Pulmonary Alveolar Proteinosis (PAP) is a rare lung disease, which affects approximately 7 persons in a million people. It is characterised by the build-up of grainy material in the air sacs (alveoli) in the lungs. The grainy material consists of proteins and lipids from lung surfactant – an important substance that coats the inside of the air sacs to prevent the lungs from collapsing. The air sacs need to be inflated for the lungs to absorb the oxygen that the patient breathes and transfer it to the blood circulation. The body continuously produces new active surfactant. In healthy lungs the old, inactivated surfactant is digested by immune cells called alveolar macrophages. They are the dustmen or garbage collectors of the body and they have a very important task of keeping the alveoli clean. In PAP lungs, however, the macrophages fail to clean the air sacs.

pap-folder-patients

Read PAP information brochure

Consequently, the old surfactant material builds up gradually in the lungs and eventually fills the alveoli causing the patient to feel breathless. Scientific research shows that the macrophages need to be stimulated by the GM-CSF protein in order to function. In PAP lungs, however, the GM-CSF protein is either inactivated or defective, rendering the macrophages or dustmen unable to perform their cleaning tasks. The patient is commonly a man in early middle age who experiences increasing breathing difficulty, first with exertion, later at rest while developing a cough. There may be episodes of fever, chest pain, or coughing blood, especially if secondary lung infection develops.

The best available treatment today is periodic whole lung lavage (WLL), i.e. washing out the lungs under general anesthesia. This requires admission to intensive care, which is an invasive and inconvenient procedure that can only be conducted effectively and safely by highly experienced physicians at a few specialist sites. In many patients WLL only provides temporary symptomatic relief[1] [2]. The lungs may well clutter up again and WLL will have to be repeated.

[1]Morgan et al, 2004, The benefits of whole lung lavage in PAP. [2] Griese et al, 2011, Long-term follow-up and treatment of congenital alveolar proteinosis.

 

Diffuse-alveolar-hemorrhage-DAH-1024x768

Thorax scan of patient with diffuse alveolar hemorrhage (DAH)

DAH is persistent or recurrent pulmonary hemorrhage. Bleeding into the alveolar spaces characterizes the syndrome and is due to disruption of the alveolar-capillary basement membrane. There are numerous causes[1] [2] [3] [4], including autoimmune diseases, hematopoietic stem cell transplantation (HSTC), lung cancer and acute respiratory distress syndrome (ARDS). If the bleeding is severe, death will follow in minutes or hours. In-hospital mortality ranges from 20 to 100%. Another (numerically minor) cause, blast lung injury (BLI), is a sporadic, unpredictable event of special relevance to military and homeland security agencies, requiring an assessment that goes beyond the scope of the present clinical development. At present, there is no drug available aimed specifically at local hemostasis in the lung. The acute medical need is evident considering the elevated and often rapid mortality. Patients who survive DAH spontaneously are often be hospitalized for longer periods of time in the intensive care unit, generating high treatment costs.

[1] Ioachimescu et al, 2008, Diffuse alveolar hemorrhage: diagnosing it and finding the cause. [2] Orphanet report series, Prevalence of rare diseases, November 2012, Volume 1.[3] Nichols et al, 2012, Causes of death of patients with lung cancer.[4] Tzouvelekis et al, 2012, Idiopathic pulmonary hemosiderosis in adults: a case report and review of the literature

Back to Top