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Disruptive Therapy for Burn Care
NexoBrid, a concentrate of proteolytic enzymes enriched in bromelain, is an easy to use, topically-applied product that removes eschar in four hours and does not harm the surrounding healthy tissues.
Eschar removal is a critical first step in the treatment of severe burns. Under existing standard of care, burn eschar may be removed either by surgical approach, primarily surgical excision, which is traumatic and may result in loss of blood and viable tissue or by non-surgical approach, employing certain existing topical agents that have been found to be minimally effective or that take a significantly longer period of time to work.
NexoBrid’s rapid and selective debridement alleviates the known risks associated with eschar, such as infection, eventual sepsis, wound deterioration and consequential scarring and it allows physicians to reach an informed decision on further treatment at an earlier stage by direct visual assessment of the actual burn depth. Furthermore, NexoBrid minimizes the burden associated with invasive surgical procedures, reduces the need for skin grafting and sacrifice of healthy tissue from donor sites on a patient’s body and generally results in a more favorable overall long-term patient outcome.
Severe burns require specialized care in hospitals or burn centers. Approximately 100,000 patients with severe burns are hospitalized every year in the United States and Europe. The severe burn patients are predominantly treated by specialists in approximately 250 burn centers in Europe and the United States, as well as at burn units of large hospitals.
NexoBrid development has been supported in whole or in part with federal funds from the U.S. Department of Health and Human Services; Administration for Strategic Preparedness and Response; Biomedical Advanced Research and Development Authority (BARDA), under contract HHSO100201500035C. This contract provided funding and technical support for the pivotal U.S. Phase 3 clinical study (DETECT), the randomized, controlled pivotal clinical trial for use in the pediatric population (CIDS), the marketing approval registration process for NexoBrid as well as its procurement and availability under the expanded access protocol (NEXT) in the U.S. Additional projects for evaluation of NexoBrid funded under the BARDA contract include establishment of a pre-emergency use data package and development of the health economic model to evaluate the cost savings impact to enable market adoption in the United States.
How to Use
NexoBrid removes the eschar and does not harm surrounding viable tissue, in the majority of cases, after only a single 4-hour topical application at the patients’ bedside. This early, non-surgical, successful eschar removal, allows the physician to diagnose the burn depth simply by direct visual assessment of the debrided clean wound bed and reach an informed decision on further treatment.
Furthermore, NexoBrid effective eschar removal significantly reduces the extent of surgery required, without sacrificing the surrounding healthy tissues. The application is easy-to use and can be applied by a physician or a nurse.
NexoBrid’s effective and selective activity is mediated by the proteolytic activity of the enzymes, which leads to degradation of denatured collagen.
The U.S. Food and Drug Administration (FDA) has recently approved a pediatric indication for NexoBrid®, allowing its use for eschar removal in pediatric patients from newborns to eighteen years old with deep partial- and/or full-thickness thermal burns. With this FDA approval, NexoBrid is now authorized for use in the U.S. across all age groups, aligning with its approvals in the European Union and Japan.
The NexoBrid temperature-stable formulation development for use as a non-surgical solution in field-care burn treatment for the U.S. Army is progressing as planned.
Positive results from the U.S. NexoBrid Expanded Access Protocol (NEXT) confirm NexoBrid’s proven safety and efficacy in eschar removal, significantly reducing the need for surgical procedures in burn patients.
Facts
Scientific Evidence
NexoBrid has been investigated in hundreds of patients across 22 countries and four continents in nine completed Phase 2 and Phase 3 and post-marketing clinical studies.
Our U.S. Phase 3 study (DETECT) evaluated the efficacy and safety of NexoBrid compared to Gel Vehicle and compared to SOC in 175 hospitalized patients with severe burns with twelve month and twenty four month safety follow-ups. The study met its primary endpoint with statistical significance. Patients treated with NexoBrid demonstrated a significantly higher incidence of complete eschar removal compared with patients treated with the Gel Vehicle. The study included secondary endpoints that were all met with statistical significance and provided further insight on several efficacy parameters:
(i) Patients treated with NexoBrid demonstrated shorter time to achieve complete eschar removal compared with patients treated with Standard of Care (SOC); (ii) Patients treated with NexoBrid demonstrated a significantly lower incidence of surgical eschar removal compared with patients treated with SOC; (iii) and Patients treated with NexoBrid incurred significantly lower blood loss during the eschar removal procedure compared with patients treated with SOC. In addition, Patients treated with NexoBrid had a non-inferior time to complete wound closure compared with patients treated with SOC. The overall safety profile of NexoBrid in the study is consistent with the safety data known from previous studies. The twelve- and twenty four-month patients’ follow-up safety data of cosmesis, function and quality of life were found to be comparable across all study arms, and no safety signals were observed.
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