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Glenmark Pharma and SaNOtize announce results of its phase-III clinical trials on SaNOtize’s Nitric Oxide nasal spray

The trial administered to adult COVID-19 patients in India met the key endpoints and demonstrated reductions of viral load of 94 per cent in 24 hours and 99 per cent in 48 hours

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Glenmark Pharma and SaNOtize Research and Development yesterday announced that The Lancet Regional Health Southeast Asia (TLRHSEA) – peer reviewed, high impact journal published the phase-III clinical trial results of SaNOtize’s Nitric Oxide Nasal Spray (NONS) study titled: “SARS-CoV-2 accelerated clearance using a novel nitric oxide nasal spray (NONS) treatment: A randomised trial.”

“We are excited to publish the study of the novel Nitric Oxide Nasal Spray, which positively impacts the lives of people, in The Lancet group of journals. The robust double-blind trial demonstrated significant efficacy and remarkable safety of NONS. This therapy has the potential to make a crucial contribution to COVID-19 management, with its ease of use in the current highly transmissible phase of pandemic”, said Dr Monika Tandon, Senior VP & Head – Clinical Development, Glenmark Pharma, said in the statement.

It also informed that the study demonstrated that patients who received NONS had significant reduction in viral load within 24 hours, which was sustained over seven days of treatment. Viral load was reduced by 93.7 per cent within 24 hours and by 99 per cent within 48 hours of treatment with NONS. The average change from baseline in log viral RNA load through the entire treatment duration was statistically superior with NONS compared to placebo. Similar results were observed in vaccinated and unvaccinated populations. The study was conducted during the delta and omicron surges. The key secondary endpoints including clinical improvement assessed by WHO Clinical Progression Scale Score and extent/rapidity of virologic recovery was demonstrated in patients using NONS. The median time to virological cure was three days in the NONS group and seven days in the placebo group after start of treatment (four days sooner). The exploratory evaluation of the proportion of immediate contacts having a positive COVID-19 test or becoming symptomatic, remained nearly the same in the NONS group while it numerically increased in the placebo group over the treatment.

“The phase study results strongly support the safety and efficacy of NONS in the treatment of COVID-19 and its known variants,” said Gilly Regev, PhDCo-Founder and CEO, SaNOtize, also said in the statement, “Nitric oxide blocks entry into the nasal passage, kills the virus, and stops its replication, which is why viral load is reduced so rapidly with NONS. Viral load has been linked to infectivity, poorer health outcomes, and complications from long COVID. The evidence is mounting that NONS represents an effective, well-tolerated antiviral treatment that significantly shortens the course of COVID-19.”

The statement noted that the study was conducted by Glenmark in 306 vaccinated and non-vaccinated adults of symptomatic mild COVID-19 across 20 clinical sites in India. This randomised, double-blind phase-III clinical trial evaluated a seven-day treatment of NONS plus standard of care versus placebo nasal spray plus standard care in patients with symptomatic COVID-19. The primary outcome measure of nasal SARSCoV-2 RNA accelerated clearance was used to assess the efficacy of this transformational NONS in high-risk patients (unvaccinated, or 45 years of age, or had one or more comorbidities) after seven days of treatment. Exploratory evaluation of NONS in prevention of infection in immediate contacts of these COVID-19 patients was also evaluated. NONS treatment was found to be well tolerated, establishing an advantage of locally acting nasal therapy. None of the patients reported any moderate or severe adverse events. There were no clinically significant changes from baseline observed in methemoglobin suggesting lack of systemic availability of nitric oxide from nasal spray. Additionally, neither nasal vasodilation symptoms nor systemic vasodilation signs were observed in either treatment.

In July 2021, Glenmark entered into an exclusive long-term strategic partnership with Canadian biotech firm SaNOtize, to manufacture, market and distribute its breakthrough Nitric Oxide Nasal Spray for COVID-19 treatment in India and other Asian markets including Singapore, Malaysia, Hong Kong, Taiwan, Nepal, Brunei, Cambodia, Laos, Myanmar, Sri Lanka, Timor-Leste and Vietnam, the statement further added.

Glenmark launched NONS under the brand name FabiSprayin in February 2022, after receiving manufacturing and marketing approval from the Drugs Controller General of India (DCGI) as part of the accelerated approval process. NONS has already received a CE mark in Europe, which is an equivalent of marketing authorisation in case of a medical device. By virtue of the CE mark, SaNOtize has permission to launch NONS in the EU. NONS is also approved and being sold in Singapore, Hong Kong, Israel, Thailand, Indonesia and Bahrain, under the name enovid or VirX. Outside of India, NONS has also been approved globally for protection against viruses, including SARS COV-2, the statement concluded.

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