Revelation Reaches FDA Approval Pathway Agreement for Gemini in Acute Kidney Injury Treatment
Revelation Biosciences has reached agreement with the FDA on an approval pathway for Gemini as a treatment for Acute Kidney Injury. The two key agreements were a clinically relevant and objective composite endpoint comprising death and/or need for dialysis, and positive data from a single well-controlled Phase 2/3 adaptive design clinical study, comprising approximately 300 patients, would be sufficient for submission of a new drug application. Revelation reached agreement with FDA on a single adaptive clinical study design with a clearly defined and achievable patient-centered endpoint. The advantage of an adaptive design Phase 2/3 study is the ability to transition rapidly from Phase 2 to Phase 3, with an opportunity to sufficiently power the Phase 3 portion of the study. The planned adaptive Phase 2/3 design will be a randomized, double-blind, placebo-controlled study, and will be comprised of two parts. Part 1 will evaluate different dosing regimens vs placebo and part 2 will be conducted as a Phase 3 study using the safest dosing regimen identified in part 1. Data from both part 1 and part 2 can be used in the primary and secondary endpoint analyses. The primary endpoint will be a composite of measures including death and/or the need for dialysis. Over the course of 2026, Revelation will continue to build the infrastructure required to successfully conduct this clinical study, including engagement of a top-tier clinical research organization specializing in hospital-based renal studies, establishing an expert panel of scientific advisors, and completing the manufacture of clinical drug supply. Revelation is working expeditiously toward initiating the Phase 2/3 study.
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Revelation Biosciences Executes Third Reverse Stock Split in a Year
- Frequent Reverse Splits: Revelation Biosciences announced a 1-for-4 reverse stock split effective January 28, 2026, marking its third reverse split in a year aimed at boosting share price to meet Nasdaq's minimum bid requirements.
- Financing Plan: Last week, the company agreed to exercise outstanding warrants to purchase up to 13.1 million shares at a discounted price of $0.86 per share, expecting gross proceeds of $11 million, which enhances its liquidity position.
- FDA Approval Pathway: Revelation reached an agreement with the U.S. FDA on an approval pathway for Gemini as a treatment for acute kidney injury, planning a well-controlled adaptive Phase 2/3 clinical study involving about 300 patients to support a new drug application.
- Market Sentiment Analysis: Despite a more than 10% drop in stock price on the announcement day, retail sentiment on Stocktwits remained in the 'extremely bullish' territory, indicating confidence in the company's future prospects.
Revelation Biosciences (REVB) Secures FDA Agreement for Gemini Drug's Clinical Trial Pathway
- Regulatory Clarity: REVB has reached an agreement with the FDA that a single Phase 2/3 adaptive study will support a future NDA for treating acute kidney injury, marking a significant advancement in addressing a major unmet medical need.
- Clinical Trial Design: The planned randomized, double-blind, placebo-controlled trial will enroll approximately 300 patients and utilize an adaptive design for rapid dose selection, directly impacting patient survival rates by evaluating the safest and most effective treatment options in Phase 3.
- Significant Market Potential: With an estimated 6.8 million U.S. hospital admissions involving AKI annually and Medicare spending exceeding $10 billion on related care, Gemini's first-in-class therapy could fill a critical market gap and significantly improve patient outcomes.
- Future Plans: REVB aims to finalize the infrastructure for the pivotal study in 2026, including engaging a top-tier CRO, establishing a scientific advisory panel, and completing the manufacturing of clinical-grade Gemini drug supply to ensure a smooth study initiation.
