Michael Severino
Analyst · Goldman Sachs
Thank you, Rick. When we set out as an independent company, we knew that building a productive R&D engine was an essential part of our success. And we're proud of the progress we've made over the past seven years. We've built one of the strongest late-stage pipelines in our industry and brought to market six new assets; RINVOQ, SKYRIZI, IMBRUVICA, VENCLEXTA, MAVYRET and ORILISSA, which collectively delivered approximately $9 billion in sales in 2019. These assets are performing very well in their lead indications and will drive significant growth for AbbVie over the long-term as we continue to build the body of evidence supporting their differentiated clinical profiles. In immunology, both RINVOQ and SKYRIZI are off to a very strong start in rheumatoid arthritis and psoriasis respectively. And we continue to generate clinical data sets that set them apart from competitive offerings. For example we recently announced positive topline results from a Phase 3 head-to-head trial comparing SKYRIZI to COSENTYX in psoriasis. In this study, SKYRIZI demonstrated superiority to COSENTYX at week 52 with 87% of SKYRIZI patients achieving PASI 90 compared to 57% for COSENTYX. SKYRIZI also demonstrated superiority to COSENTYX on all ranked secondary end points including PASI 100, PASI 75, and sPGA clear or almost clear at week 52. These results underscore two critical components of SKYRIZI's profile; the ability to drive high levels of response and the durability of that response at long-term end points. In oncology, we will also continue to support our hem/onc franchise with important regulatory milestones and additional Phase 3 data readouts for our approved indications in 2020. We recently received a positive CHMP opinion for VENCLEXTA in previously untreated CLL. And we expect to receive an important label update for IMBRUVICA in the first half of this year based on results from ECOG study which demonstrated the superiority of IMBRUVICA to FCR in frontline fit patients with CLL. When we think about sources of growth beyond the current indications for our recently approved assets, it's important to consider two components of our late-stage pipeline. The first is a large number of programs that will allow us to drive our core assets into important new disease areas that represent large and attractive markets. And the second is a set of new assets that will help support additional growth in the future. If we look first at our opportunity to move into new disease areas with our existing therapies, we see a number of commercially attractive programs that have been de-risked based on strong data. For example we recently announced topline results from the second Phase 3 study for RINVOQ in psoriatic arthritis which compared RINVOQ to both placebo and HUMIRA in patients who had an inadequate response to at least one non-biologic DMARD. In this study, both doses of RINVOQ met all primary and key secondary end points, demonstrating a significant impact on both joint and skin end points as well as radiographic inhibition of damage to joint structure. RINVOQ also demonstrated superiority to HUMIRA on ACR20 response at week 12 with the high dose and non-inferiority with the low dose. These data followed the positive results from our first registrational trial reported late last year. Detailed data from both pivotal studies will be presented at an upcoming medical meeting and we expect to submit our regulatory applications for RINVOQ in psoriatic arthritis in the second quarter with commercialization expected in 2021. Following discussions with global regulators, our approval submissions in ankylosing spondylitis are planned for the second half of 2020 based on positive data already presented at ACR last November. In this study, RINVOQ demonstrated significantly greater improvements in signs and symptoms as well as physical function and imaging end points compared to placebo. Together, psoriatic arthritis and ankylosing spondylitis make up an important segment of the rheumatology market with global market sales of approximately $14 billion. The dermatology segment will also be an important area of growth for RINVOQ. Moderate-to-severe atopic dermatitis is a large market that we do not participate in today. And in the middle of this year, we expect to see Phase 3 data for RINVOQ in this indication. In our Phase 2b study, RINVOQ demonstrated a very strong effect on the easy composite end point and had a prominent impact on itch which is one of the most troublesome symptoms of this disease. Following the pivotal data readouts, we plan to submit global regulatory submissions later this year. We are also nearing completion of the registrational programs for SKYRIZI in several new disease areas. In the second half of this year, we expect to see data from Phase 3 studies in both psoriatic arthritis and Crohn's disease with regulatory submissions for both indications expected in 2021. The IBD segment, including both Crohn's disease and ulcerative colitis, represents a significant opportunity with global market sales of approximately $18 billion. IBD is a growing segment where there continues to be significant unmet need. And based on the efficacy demonstrated in our mid-stage studies, we believe both SKYRIZI and RINVOQ have the potential to drive higher levels of performance than other therapeutic alternatives. Together we expect SKYRIZI and RINVOQ to have full coverage across the major disease areas for which HUMIRA is currently approved plus new areas such as atopic dermatitis. With these two new medicines, AbbVie is well positioned to maintain its strong leadership in the $70 billion global immunology market. Another growth asset that we expect to expand into important new areas is VENCLEXTA. CANOVA our Phase 3 study in relapsed/refractory multiple myeloma patients with the t(11;14) genetic mutation is now well underway. And towards the end of this year, we plan to initiate a second Phase 3 study in the relapsed/refractory t(11;14) population.
21:49: The level of efficacy that we've seen suggests that t(11;14) patients may be particularly responsive to VENCLEXTA. This biomarker-defined population makes up approximately 20% of the $18 billion multiple myeloma market representing an important new opportunity for VENCLEXTA. In addition to multiple myeloma, we will begin Phase 3 studies in two additional Bcl-2-driven diseases in 2020. The first is AML. Building on our experience in the transplant-ineligible population, we are initiating a study in fit patients with AML who have received stem cell transplant, but remain at high risk for recurrence. The second is higher-risk Myelodysplastic Syndrome or MDS. MDS is a malignant disease of bone marrow stem cells that is associated with significant morbidity and mortality due to the risk of bleeding, infection and transformation to acute leukemia. Some patients with MDS undergo stem cell transplant, but many cannot. And these patients have very few treatment options. Preclinical and early clinical studies support a role for Bcl-2 inhibition in these patients and our Phase 3 studies with VENCLEXTA will begin later this year. The second component of value in our late-stage pipeline includes important new therapies that we expect to launch in 2021 and 2022 including; navitoclax, veliparib and ABBV-951. Navitoclax will be entering Phase 3 studies in the first half of this year in frontline and second-line myelofibrosis. Myelofibrosis is a malignant disease in which the bone marrow is replaced with fibrotic tissue leading to bone marrow failure. Currently, JAK2 inhibition is the only approved therapeutic option, but despite treatment many patients progress and experience significant morbidity and mortality. Navitoclax is a first-in-class Bcl-xL inhibitor with the potential to transform the treatment of myelofibrosis by deleting the clone that causes the disease. At ASH last year, we presented encouraging data from a Phase II study which demonstrated that up to 43% of patients who had failed JAK2 inhibition responded to navitoclax based on a 35% reduction in spleen volume. In addition, responses deepened over time and we continue to follow these patients. Navitoclax treated patients also showed reductions in the number of malignant cells and decreases in bone marrow fibrosis supporting the potential for disease modification. In the area of solid tumors, we've previously presented positive Phase 3 data from two veliparib studies in frontline ovarian cancer and BRCA breast cancer. Data from these two studies demonstrated significant prolongation of progression-free survival and support the use of PARP inhibition in combination with chemotherapy earlier in the course of treatment. In ovarian cancer, veliparib will be the only PARP inhibitor to combine with frontline chemotherapy and treat a broader population that is not restricted to biomarker status or chemo responsiveness. In BRCA-positive breast cancer veliparib will also be the only PARP inhibitor to combine with platinum-based chemotherapy giving these patients a valuable new treatment option. Based on feedback from global regulatory authorities, we plan to submit our applications for veliparib in the first half of this year. Veliparib will be an important new treatment option for women with ovarian cancer and BRCA breast cancer offering the potential to provide better outcomes. And in our late-stage neuroscience pipeline, we are making good progress with the Phase 3 program for ABBV-951, our innovative approach to delivering DUOPA like efficacy through a subcutaneous delivery system for advanced Parkinson's disease. This approach is enabled by novel levodopa and carbidopa prodrugs and would be a transformative improvement to current treatment options. With a less invasive non-surgical delivery system 951 has the potential to significantly expand the patient population currently addressed by DUOPA or other more invasive therapies for advanced Parkinson's such as deep brain stimulation. We'll see data from the pivotal program in 2021 with commercialization anticipated in 2022. In addition to advancing, our late-stage programs we've also made tremendous progress building our early-stage pipeline. Following several years of investment, we're beginning to see these efforts pay-off. And over the next three years, we're planning for proof-of-concept data readouts in approximately 30 programs. Our early pipeline is designed to include a mix of highly novel targets supported by strong underlying science and clinically validated targets where we think an opportunity exists to improve on current agents. In the area of immunology, I'll highlight our TNF steroid conjugate ABBV-3373, which is novel technology that delivers a proprietary high-potency steroid directly to activated immune cells by TNF-mediated uptake. We've shown in model systems that this approach has the potential to drive transformational efficacy. And our early clinical work has demonstrated that we can deliver 3373 at its anticipated therapeutic dose without systemic steroid effects. We will see efficacy data from this study later this year. If our clinical data reproduce what we have seen pre-clinically, our steroid conjugate technology has the potential to serve as a platform across a wide range of diseases including RA, IBD and lupus. We will also see proof-of-concept data this year from several other early-stage assets in our immunology portfolio including data for ABBV-599 our JAK-BTK program; and ABBV-323 our CD40 antagonist program, which are both targeting multiple pathogenic nodes that are thought to play important roles in diseases such as RA, IBD, lupus and scleroderma, allowing us to restate standard of care in our core disease areas and move into new ones where no effective therapy exists today. In oncology, we are building on what we have learned with venetoclax and navitoclax to advance a number of promising apoptosis programs. The most advanced of these are ABBV-155, which uses a B7-H3-targeting antibody to deliver a novel high-potency Bcl-xL warhead to solid tumors; and ABBV-621, which is designed to induce apoptosis by clustering TRAIL, an apoptosis-inducing ligand on the surface of cancer cells. We will see monotherapy data for ABBV-155 in 2020 and combination data in 2021. We expect to see proof-of-concept data for ABBV-621 in 2021 as well. In immuno-oncology, we have a number of very promising T cell-redirecting bispecifics in the clinic and several more in preclinical development. The most advanced of these are BCMA bispecifics in multiple myeloma TNB-338B [ph] and HPN-217. These programs allow us to explore different epitope specificities and binding affinities to optimize benefit/risk of our candidates in this very promising area. We are also pursuing several novel approaches designed to modify the tumor immunosuppressive environment. Here I would highlight ABBV-151, our monoclonal antibody targeting GARP. Through its effect on GARP ABBV-151 reduces TGF-beta-mediated signaling within tumors. TGF-beta is thought to be an important driver of tumor immune evasion and TGF-beta signaling is correlated with a lack of tumor immune infiltrate and PD-1 unresponsiveness. In addition, I would highlight our CD39 inhibitor, TTX-030. Recently emerging data suggest that CD39 plays an important role in tumor immune evasion by converting pro-inflammatory ATP to anti-inflammatory ADP and adenosine in the extracellular environment. TTX-030 is designed to restore this important pro-inflammatory signal and reduce tumor immunosuppression. Lastly in our early neuroscience pipeline we have several promising disease-modifying candidates in the clinic for Alzheimer's and Parkinson's disease. In addition to our tau-directed programs we have programs aimed at important regulators of the neuroinflammatory response TREM2 and CD33; as well as a core driver of pathology in Parkinson's disease alpha-synuclein. So in summary, we've continued to see significant evolution of our early- and late-stage development programs. We have a late-stage pipeline that includes more than 20 programs in registrational studies and have nearly 40 programs in early- to mid-stage development that will mature over the next few years. With that I'll turn the call over to Rob for additional comments on our 2019 performance and our 2020 guidance. Rob?