Roger G. M. Mills
Analyst · JMP Securities
Thank you, Tom, good afternoon. Following the successful outcome of the -020 Study, this remains an exciting and busy time for our team as we continue to advance our Phase III PDP program. I'm pleased to report that we've now completed our analysis of the full -020 data set, and have continued to see consistent and robust data aligned with the top line efficacy results. The -020 shows highly significant improvements on both the primary and secondary antipsychotic efficacy endpoints. Significant improvements were also demonstrated on nighttime sleep and daytime wakefulness and on caregiver burden. In addition, the key secondary endpoint of motoric tolerability was met, and the overall safety profile of pimavanserin continued to appear benign. An initial presentation of the -020 data to the scientific community is scheduled to occur at the American Academy of Neurology Annual Meeting on March 20. At the Emerging Science Session at this meeting, Dr. Jeffrey Cummings, who is the Director of the Cleveland Clinic Lou Ruvo Center for Brain Health and an internationally renowned clinician, will make a brief oral and subsequent post the presentation. We are also planning additional presentations of the -020 data at subsequent clinical meetings during the year, including the annual meeting of the Movement Disorder Society in June. With the significant and consistent results seen in -020, we are now planning for our confirmatory pivotal Phase III trial, the -021 Study, using the same trial design. Let me take a moment to highlight the -021 Study design, which is based on our recently completed -020 Study. -021 will be a randomized, multicenter, double-blind placebo-controlled study designed to evaluate the efficacy, tolerability and safety of pimavanserin in about 200 patients with PDP. Once again, we plan to conduct this study exclusively in North America and use a small centralized group of highly trained, independent raters to conduct blinded assessments of the primary endpoint at all study sites. In the 2-week period between screening and randomization, patients will participate in a brief psychosocial therapy program designed to help patients adapt to a clinical trial setting and to pull initial placebo responses ahead of the baseline assessment. To participate in the study, patients will be required to have moderate to severe psychosis as measured by the Neuropsychiatric Inventory scale, or NPI, at screening and the Scale to the Assessment of Positive Symptoms, or SAPS, at the time of the baseline assessment. Primary endpoint of the study will, once again, be antipsychotic efficacy as measured using the SAPS-PD scale which consists of 9 items in the hallucinations and delusions domain of SAPS that best reflect the expression of psychosis in patients with Parkinson's disease. Motoric tolerability will be a key secondary endpoint in the trial and measured using Parts 2 and 3 of the Unified Parkinson's Disease Rating Scale, or UPDRS. We are now in the process of finalizing preparations for the -021 Study. We plan to leverage the existing infrastructure from the recent trial, including a core base of clinical sites to enable us to startup and run the -021 Study in an efficient manner. We expect to initiate the -021 Study in April. Let me now turn to another ongoing trial in our PDP program, our Phase III open-label safety extension study, referred to as the -015 Study. This important trial involves patients who completed the -020 Study, as well as patients from earlier trials and who, in the opinion of the treating physician, may benefit from continued treatment with pimavanserin. This study, along with a similar extension study from our early earlier Phase II trial, has allowed us to generate a large amount of valuable long-term safety data regarding the use of pimavanserin in patients with PDP. Importantly, we have far exceeded ICH guidelines for required 1 year exposures with well over 200 patients having been treated for 1 year or longer. We also have well over 100 patients that have been treated with pimavanserin for at least 2 years and our longest single-patient exposure is over 7 years. Our experience to date suggests that the long-term administration of pimavanserin continues to be generally safe and well-tolerated and is often fragile in elderly patient population. We believe that the favorable safety profile observed to date provides support for the potential of pimavanserin to offer significant advantages relative to current antipsychotics used off-label for the treatment of PDP. In addition to our confirmatory pivotal trial and long-term safety extension trials, we are planning for NDA-enabling studies, including drug-drug interaction studies and supporting CMC development as part of advancing our Phase III PDP program towards registration. I'll now turn the call over to Uli.