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Operations Started research operations (10 FTEs) in September 2011 Redx Anti-Infectives launched in Alderley Park in April 2013 Currently 55 scientists Focus Antibiotics for serious, drug-resistant Gram-negative and Grampositive infections Antiviral therapies for indications of high unmet need (e.g. Influenza & hepatitis B) Novel therapeutics targeting bacterial resistance mechanisms GSK (1995-2001) - 70 HTS (260,000-530,000 compounds) - Mainly enzyme based - 16 HTS screens gave hits - 5 translated into leads - 7% success rate (4-5 fold lower vs non-AB targets) - Each screen estimated $1 million Pfizer - 6.5% success rate • HTS screening sets not geared to binding AB targets • Challenges of crossing bacterial membranes • Lack of druggability Leverage Structural Based Drug Discovery 1 Scaffold hopping 2 Explore uncharted potential binding opportunities 3 Execution of 21st century synthetic methodology 4 Knowledge based SAR Known Chemotype - lack classic FQ COOH function - 4 points of SAR tractable diversity - balanced dual inhibitors - low frequency of resistance < 10-10 - not cytotoxic (HepG2) - low activity vs human Topo (II) Novel Core - target MRSA Strain key: S. aureus ATCC 29213: wild-type S. aureus NRS1: GyrA S84L; GrlA S80F S. aureus NRS482: GyrA S84L; GrlA S80Y S. aureus CIP1-SP25*: GrlA E84G *Ciprofloxacin-resistant mutant generated in-house by serial passage RedxA Whole-cell susceptibility data indicate that RedxA retains potent activity against quinolone-resistant strains Mouse PK - low clearance (18% LBF) - high oral bioavailability (70%) - oral efficacy S. aureus induced septicaemia model (50 mg/kg) *** RedxA *** Cipro O Vehicle ***P<0.0001 No change in bodyweight or temperature Lead Optimisation ongoing - key focus on ADMET Inhibitor RedxA RedxB RedxC S. aureus ATCC 29213 ug/mL 0.015 0.5 0.5 Free AUC/MIC @ po 5 mg/kg 3.9 1.8 9.9 Neutropenic murine MRSA induced thigh infection model on going with RedxC Funded by Royal Liverpool & Broadgreen University Hospital Trusts - ground breaking collaboration between industry & NHS - complete human PoC studies - 3 points of SAR tractable diversity - low frequency of resistance < 10-9 - not cytotoxic (HepG2) - low activity vs human Topo (II) - no significant cross resistance with FQ resistant strains Known Chemotype Adapted Novel Core Gram+ve Organism MIC (µg/mL) RedxD RedxE RedxF Acinetobacter baumannii NCTC 13420 32 2 0.5 Enterobacter cloacae NCTC 13406 64 8 2 Escherichia coli ATCC 25922 4 0.5 0.06 Haemophilus influenzae ATCC 49247 16 4 1 Klebsiella pneumoniae ATCC 700603 128 16 8 Pseudomonas aeruginosa ATCC 27853 >128 8 4 Staphylococcus aureus ATCC 29213 1 1 0.25 Streptococcus pneumoniae ATCC 49619 1 2 2 Single digit activity against several of the ESKAPE pathogens 10 MIC (µg/mL) Strain RedxD RedxE RedxF Cipro E. coli MG1655 (Wild-type) 8 0.5 0.25 0.008 E. coli MG1655 S83L 8 0.5 0.12 0.12 E. coli MG1655 D87G 16 1 0.5 0.06 15x No significant cross resistance with FQ resistant strains Extended to clinical isolates 11 Hit to lead phase Funded in part through European Gram Negative Antibacterial Engine (ENABLE) Project infrastructure moving from an internal base to one of working partnerships with consortium partners - Med Chem (Redx & Upsalla); Microbiology (Upsalla) etc 12