Vishwas Seshadri
Analyst · H.C. Wainwright
Thanks, Madhav. With ZEVASKYN providing our commercial foundation, we have also been considering how to build on our capabilities and broaden our opportunities for value inflection. Through ZEVASKYN and our prior advancement of the program, which resulted in the approval of FAYUVI, we have built experience in late-stage clinical development, regulatory execution and commercialization. Our goal is to create a diversified revenue-generating company with multiple opportunities for durable growth. ABO-801 is well aligned with that strategy. It is a Phase III-ready orphan drug with robust clinical data and a uniquely differentiated profile that can translate into a substantial peak annual revenue potential of greater than $750 million in a disease of growing prevalence. Just as importantly, we believe that our prior experiences in late-stage development position us to move the Phase III program forward without distracting our commercialization and manufacturing teams from the ZEVASKYN launch focus. Eosinophilic esophagitis, or EoE, is a growing disease with increasing unmet need with approximately 360,000 diagnosed patients in the U.S. today. It is a chronic lifelong inflammatory disease of the esophagus that can significantly affect swallowing and food intake. Over time, persistent inflammation can also lead to structural damage to the esophagus and exacerbate the condition. Because of that, EoE requires lifelong disease management. The goal is not simply to manage symptoms, but also to control the underlying inflammation, restore and maintain normal structure of the esophagus while limiting adverse events of therapy. ABO-801 is a once-daily oral disintegrating tablet, or ODT, formulation of fluticasone propionate taken at bedtime. It is designed to deliver topical corticosteroid therapy directly across the esophagus. The tablet dissolves in the mouth in less than 30 seconds without water and acts both in proximal and distal esophagus with little to no systemic absorption. We think that this profile is important in a chronically managed disease like EoE. The treatment landscape of FDA-approved therapies comprises an oral corticosteroid, EOHILIA, and an injectable biologic, DUPIXENT. While there are several injectable biologics in development, there is dearth of effective, safe and convenient oral therapies. We believe that the combination of targeted topical delivery, limited systemic exposure and convenient once-daily bedtime orally disintegrating tablet, or ODT, could offer a uniquely differentiated treatment option for patients with EoE. Importantly, ABO-801 has already been evaluated in 2 Phase III studies, giving us a substantial body of clinical experience to build on. Let me walk through those results, which are important not only in characterizing the activity and differentiated profile of the drug, but also in optimizing the design of the subsequent Phase III study. The 2 completed Phase III studies evaluated more than 350 patients combined. Due to low systemic absorption of less than 1% for ABO-801, corticosteroid-associated AEs like adrenal suppression have not been observed. The efficacy data showed strong activity across physician-reported measures like histology, which is an FDA-required co-primary endpoint and endoscopic measurements of esophageal structure. On the right, you can see a representative example where rings and furrows, which are characteristic of EoE seen at baseline were corrected by week 12 and sustained at week 52. In addition, the studies also showed improvements in patient-reported symptoms. We believe the totality of these findings provides important evidence that ABO-801 is active in EoE. Gastroenterologists place particular emphasis on endoscopic findings in EoE, including features such as edema, rings, exudates and furrows, known as EREFS. ABO-801 showed significant improvements in overall EREFS response at week 12 in FLUTE 2 and week 24 in FLUTE 3 studies. These findings indicate that ABO-801 had an effect not only on inflammation, but also on structural features of the disease in these trials. We also saw encouraging evidence of symptomatic improvement in both trials. While neither study individually met the co-primary patient-reported symptom endpoint, a post-hoc exploratory analysis pooling week 12 data from both trials showed a significant improvement in complete symptom response with ABO-801 compared with placebo with a p-value of 0.004. Complete response was defined as patients reporting no episode of dysphagia in the final 14-day window of the 12 weeks. Importantly, the completed studies also gave us insight into why, despite the strong histologic and EREFS results, the individual studies missed the symptom endpoint. The DSQ, or dysphagia symptom questionnaire, the industry standard patient-reported outcome tool that has been validated and used in the studies of FDA-approved EoE therapies was not available to Ellodi at the time of the studies. So Ellodi developed a proprietary PRO tool called PROSE, which was used in FLUTE 2 and FLUTE 3. PROSE did not distinguish between solid, soft or liquid foods. Instead, patients rated their swallowing difficulty on a 0 to 10 scale with limited guidance on how to assign a score. This may have introduced variability in how patients reported their symptoms, making it more difficult to distinguish treatment effect from background noise. In contrast, the DSQ first asks whether patients consume solid food. If the answer is no, the assessment does not proceed for that session. The DSQ then asks more objective questions about what patients did in response to swallowing difficulties using a defined numerical scale tied to those actions. A post-hoc analysis mapping the DSQ to the FLUTE 3 study data showed that had the DSQ been used in the study, there would have been a high probability of meeting the symptom endpoint. We have described these data in greater detail in a clinical deck included on our 8-K filing and available on our corporate website. Importantly, the DSQ is now available to us, and we plan to use it as a symptom assessment tool in our next Phase III study. These learnings are informing our plans for the Phase III study. We currently envision enrolling approximately 400 patients to evaluate 3 mg of ABO-801 once daily versus placebo with co-primary endpoints assessing symptoms using the DSQ and histologic response at week 12 and secondary endpoints at week 24 to assess durability of activity. We plan to discuss the study design with the FDA at a Type C meeting and currently anticipate initiating the study in mid-2027. While the timing of top line results will depend on study initiation and enrollment, we currently anticipate results around end of 2028. With that, I'll turn the call over to Joe to review our third quarter financial results and provide additional detail on the transaction and financing. Joe?