Cubist Pharmaceuticals, Inc. / Trius Therapeutics Inc.

Acute Bacterial Skin and Skin Structure Infections (ABSSSI)

870K US cases/yr

Disease Overview

ABSSSI are bacterial infections of the skin and underlying tissues, frequently caused by Staphylococcus aureus including community- and hospital-acquired MRSA. They drive a large share of US hospitalizations and ambulatory infectious-disease visits, and the rise of MRSA has made simple skin infections harder to treat empirically.

Competitive Landscape

The ABSSSI / Gram-positive antibiotic landscape in 2013 was anchored by Pfizer's Zyvox (linezolid), the first-generation oxazolidinone and reference comparator, alongside Cubist's own Cubicin (daptomycin) IV lipopeptide and generic vancomycin. Newer entrants targeted shorter dosing and oral/IV switches: Durata's Dalvance (dalbavancin) and The Medicines Company's Orbactiv (oritavancin) — both long-acting lipoglycopeptides — were in late-stage development, and Theravance's Vibativ (telavancin) was already approved. Tedizolid (Sivextro) was positioned as a second-generation oxazolidinone with 4–16x greater potency vs. linezolid against staphylococci/enterococci, once-daily dosing, and a six-day course versus Zyvox's twice-daily, 10-day regimen. For Cubist, the Trius deal layered tedizolid on top of Cubicin's daptomycin franchise, giving the company an oral/IV oxazolidinone to bracket the MRSA market and replace Cubicin's eroding exclusivity. The asset later won FDA approval in June 2014 as Sivextro under the GAIN Act, validating the deal thesis.