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A multicenter, double-blind Phase I/II trial evaluating safety and efficacy of a fixed phage cocktail vs. placebo + DAIR in treating S. aureus prosthetic joint infections.

Objective

PHAGE4DAIR: Phage therapy for Arthroplasty infections using Local and Conservative surgery (DAIR)

PHAGE4DAIR is a multicenter, randomized, double-blind, placebo-controlled, adaptive Phase I/II clinical trial evaluating the safety and preliminary efficacy of a GMP-manufactured 5-phage cocktail targeting Staphylococcus aureus in prosthetic joint infections (PJI) treated using DAIR (Debridement, Antibiotics, and Implant Retention). Acute S. aureus PJI represents approximately 23% of prosthetic hip and knee infections, with DAIR performed in over 40% of acute cases . Despite its conservative advantages, DAIR is associated with high failure rates, especially in antibiotic-resistant infections, underscoring the urgent need for novel adjunctive therapeutics.

This Horizon Europe trial integrates a seamless Bayesian adaptive design to evaluate dose, route, and treatment efficacy over time. The investigational phage cocktail is already under IND in the United States for related indications, facilitating transatlantic regulatory alignment. Patients will be enrolled based on confirmed S. aureus infection undergoing DAIR, with phages administered intraoperatively and intravenously alongside standard-of-care antibiotics. Co-primary endpoints include safety and clinical cure 3 months post-antibiotic completion.

PHAGE4DAIR will generate high-quality clinical, PK/PD, immunological, and microbiological data to support regulatory decision-making. The consortium includes leaders in GMP manufacturing, clinical trials, and regulatory science. A robust dissemination, exploitation, and regulatory strategy ensures a clear pathway to EMA Scientific Advice, stakeholder engagement, and future Phase III readiness. The project directly supports Horizon Europe’s goal to accelerate phage-based solutions for antimicrobial resistance and foster biotech innovation for difficult-to-treat infections.

Fields of science (EuroSciVoc)

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Keywords

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Programme(s)

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Topic(s)

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Funding Scheme

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HORIZON-RIA - HORIZON Research and Innovation Actions

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Call for proposal

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(opens in new window) HORIZON-HLTH-2025-01

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Coordinator

QEEN BIOTECHNOLOGIES INC.
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 4 374 508,37
Address
669 Auguste-Mondoux, Local 1
J9J 3K3 Gatineau
Canada

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SME

The organization defined itself as SME (small and medium-sized enterprise) at the time the Grant Agreement was signed.

Yes
Activity type
Private for-profit entities (excluding Higher or Secondary Education Establishments)
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Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

No data

Participants (20)

Partners (4)

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