My professional life has involved finding solutions to problems, so I was intrigued to come across, in SPL, a company that had a solution, and was looking for problems. Jackie had acquired her virucidal dendrimer and decided that BV was a good target for elimination. At first trials things looked promising but faded after treatment stopped, being almost the same outcome as placebo at 16 weeks. Later, less intense dosing fared better, but it showed alleviation of symptoms, rather than elimination. The vaginal biome is complex, and, while Vivagel knocked down Gardererella and its malign cohort, it also knocked back Lactobacilus. In the post treatment rush to recolonise Lactobacilus does not always win, so regular use of Vivagel is needed, to keep symptoms under control. JF rejected a probiotic approach. A pity. Remarkable results in a small study of 5 women with RBV were recently reported by Lev-Sagie et al with vaginal microbiome transfer (VMT) from healthy female donors directly into the vagina, leading to prolonged symptom free relief.
After Vivagel came the condoms, then the eye drops, and finally, c/o Covid, the nasal spray, all problems for which the dendrimer seemed an answer. Great aims, hopeless marketing, little money,The cancer treatments have great potential but trials never seem to end. At one stage I thought Jackie was channeling Zeno, of the paradox. We shareholders are Achilles and the trial outcomes are the tortoise. Just as we approach a deadline, the parameters shift - the trial cohort grows bigger, etc. Jackie kicks the tortoise down the road. We never reach our targets.
The jostle for new treatments is a difficult ecosystem in which to create a clear market advantage. Doctors are conservative and there are so many competing possibilities. It needs skilled sales techniques, just what SPL lacks. I have kept a small parcel, just to watch this fascinating tragedy.
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