Amputation is a looming threat for some patients with prosthetic joint infections, but a new partnership between Cytophage Technologies and the Orthopaedic Innovation Centre (OIC) aims to offer a cutting-edge alternative: phage therapy. This collaboration seeks to combat antibiotic-resistant infections, offering hope to patients for whom traditional treatments have failed.
The partnership will initially focus on prosthetic joint infections (PJIs), a serious complication of joint replacement surgeries. The infection rate is usually two per cent or less, depending on the joint. Hips are less prone to infection than knees. These infections often necessitate prolonged treatment, multiple revision surgeries, or even amputation. By combining Cytophage’s expertise in bacteriophage development with OIC’s leadership in orthopaedic research, the initiative aims to integrate phage therapy into mainstream medical practice.
Addressing Antibiotic Resistance
"The fact that we don’t yet possess medications to effectively fight resistant bacteria is very concerning. There’s very few options left at that point," said Trevor Gascoyne, chief executive of the Orthopaedic Innovation Centre. Antibiotics resistance is increasing at an alarming rate. Phage therapy offers a potential solution to this growing problem.
How Phage Therapy Works
Phages are viruses that kill specific bacteria by binding to them and inserting their own genetic information. Cytophage modifies phages to target specific bacteria strains. Patients receive phage treatments through IV or direct injection, depending on the doctor's prescription.
Clinical Trial and Approval Process
Cytophage is developing phage therapy tailored to the specific bacterial infection of a Manitoba patient. Once completed, the data will be submitted to Health Canada for approval. Both Cytophage and the OIC are optimistic about receiving approval and aim to begin treatment in February. Doctors will monitor the patient for any recurrence of the infection in the following months.
Expansion and Future Goals
The OIC aims to support Cytophage in expanding its treatment across the country, potentially revolutionizing the approach to antibiotic resistance. Cytophage plans to test its phage fixes on patients with different bacterial infections. The ultimate goal is to create a "phage cocktail," a drug capable of treating a spectrum of prosthetic joint infections.
Financial and Logistical Challenges
Despite the promise of phage therapy, Cytophage, with its small team of 16 staff, faces funding and logistical challenges. The company became publicly traded in February and produces phage products for animals as antibiotic replacements. Both Cytophage and the OIC are absorbing costs to treat the Manitoba patient, underscoring their commitment to advancing this therapy.
The Economic Impact
A review in the New England Journal of Medicine reported the lifetime cost of a hip prosthetic joint infection is US$391,000 (CAD$553,851), and annual hospital costs for these hip and knee infections will reach nearly US$2 billion (CAD$2.83 billion) by 2030. Phage therapy offers a cost-effective alternative to traditional treatments.
Next Steps for Cytophage and OIC
Cytophage and OIC will prioritize identifying and recruiting patients with prosthetic joint infections resistant to traditional antibiotic therapies. These initial cases will be treated under compassionate use/N=1 protocols, allowing patients to benefit from this treatment while generating valuable safety data. This data will form the foundation of an Investigational New Drug (IND) application, a precondition for launching Phase 1 clinical trials. Cytophage will then scale its efforts to include up to five more clinical centers across Canada.
