Yaqrit, through its newly formed subsidiary Amalive Limited, is advancing the development of L-ornithine phenylacetate (OPA), a promising ammonia scavenger therapy, into Phase 3 clinical trials for acute hepatic encephalopathy. The company acquired global rights to OPA from Mallinckrodt Pharmaceuticals in late 2024, including FDA and EMA orphan drug designations and FDA fast track status.
Strategic Development Plans
The intravenous formulation of OPA is scheduled to enter Phase 3 trials in 2025, with trial design optimization incorporating previous clinical experience and AI-driven patient selection methods. Simultaneously, Amalive is developing an oral formulation for Phase 2b trials targeting outpatient prevention of hepatic encephalopathy recurrence, along with an oral liquid formulation for hyperammonaemia in urea cycle enzyme disorders.
"OPA is a key asset for Yaqrit, a potentially great molecule both clinically and commercially, and the creation of subsidiary dedicated to its development will ensure its full potential is realized," stated Troels Jordansen, Chief Executive Officer of Yaqrit.
Clinical Significance and Market Impact
Hepatic encephalopathy represents a substantial burden in advanced liver disease, affecting up to 40% of patients with decompensated cirrhosis. The condition results in approximately 200,000 hospitalizations annually in the United States, with 40-50% of patients experiencing a second episode within a year of their initial event.
Professor Rajiv Jalan, Founder and Chief Medical Officer of Yaqrit, emphasized the therapeutic potential: "OPA addresses ammonia toxicity, a frequent, high-mortality event in vulnerable, advanced liver disease patients. Not only can OPA directly impact the prospects of millions of patients with late-stage liver disease, but it also opens a window for additional interventions in this severely underserved population."
Scientific Foundation and Clinical Evidence
The drug's development history traces back to its discovery at the University College London's Liver Failure Group. Previous clinical studies conducted through Ocera Therapeutics demonstrated OPA's superior efficacy in reducing toxic ammonia levels compared to standard care treatments. This rapid ammonia reduction capability positions OPA as a potential breakthrough in managing hepatic encephalopathy and reducing the risk of mortality and multi-organ failure.
Disease Burden and Treatment Landscape
Decompensated cirrhosis affects over 10 million patients worldwide annually, with median survival dropping dramatically from 12+ years in compensated cirrhosis to approximately two years in decompensated cases. For patients developing multi-organ failure, survival rates plummet to less than three months, highlighting the critical need for effective interventions like OPA.
The development agreement includes milestone payments to Mallinckrodt Pharmaceuticals for late-stage achievements, plus royalties on future sales, structuring a partnership that aligns incentives for successful commercialization of this potentially life-saving treatment.
