John Butler
Analyst · Credit Suisse. Your line is now open
Thanks, Nikki, and good afternoon everyone and thank you all for joining us today to review our 2015 financial results and corporate progress. During today's call, I will review our major accomplishments over the past year. Jason Amello, our Chief Financial Officer, will then review our financials. I'll close with our outlook for 2016 before opening the call for questions. Joining us for Q&A will be; Dr. Brad Maroni, our Chief Medical Officer; Nikki Hadas, our General Counsel; Michel Dahan, our Chief Business Officer; and Dr. Ramin Farzaneh-Far, our Vice President of Medical Research. 2015 was a transformative year for Akebia, marked by significant clinical, regulatory, intellectual property and corporate progress. We successfully executed all of our key objectives and are well-positioned to build on this momentum in the coming year, as we advance our global development and commercialization strategy for vadadustat and further demonstrate the therapeutic potential of HIF stabilization. As many of you know, vadadustat is a novel small molecule inhibitor of hypoxia inducible factor-prolyl hydroxylase or HIF-PH in development for the treatment of anemia related to chronic kidney disease or CKD. Vadadustat enables normal physiologic levels of EPO to be restored, allowing for a gradual, stable and controlled hemoglobin response. We believe that managing anemia through this pathway has the potential to translate into an improved safety profile over today's standard-of-care injectable erythropoiesis stimulating agents or ESAs, which has been shown to clearly increase cardiovascular events in CKD patients. Further, we believe that vadadustat's mechanism of action provides a specific response in the same manner as naturally occurs with a moderate increase in altitude. This response provides an enhancement in the normal daily variation of EPO and relative to other HIF compounds we believe has the potential to yield a best-in-class product profile. The data that has emerged from our 15 completed clinical studies reinforces the advantages of our approach in both non-dialysis and dialysis CKD patients, and last year we had the opportunity to highlight our Phase 2 data at several high-profile medical meetings. Investigators for the Phase 2b study of vadadustat in non-dialysis patients, including Dr. Bruce Spinowitz of NewYork-Presbyterian Hospital, Dr. Pablo Pergola of Renal Associates of Texas, and Dr. Volker Haase Vanderbilt, presented data from that study at the leading kidney disease meetings last year, most recently at the American Society of Nephrology Kidney Week. They presented the data demonstrating that treatment with vadadustat controls hemoglobin levels in a sustained manner and in a clinically relevant range, producing a coordinated physiologic response to resolve anemia while avoiding the excessive fluctuations in hemoglobin levels which have been associated with increased cardiovascular risks. Also at the ASN meeting, Dr. Haase presented the data from our Phase 2 study in dialysis patients. In patients converting from ESA therapy, vadadustat maintained stable hemoglobin levels over 16 weeks of treatment, whether dosed once daily or three times weekly. Overall, the collective data from our vadadustat studies suggest an efficacy and tolerability profile that fits squarely within the goals of new anemia treatments, which is focused on tightly controlling hemoglobin levels, minimizing hemoglobin excursions above 13 g/dL and improving the safety profile. Our Phase 3 development program is designed to build on these positive results, support the registration in major markets worldwide and collect the data required to establish a new standard-of-care for CKD patients. In October, we announced that we had reached agreement with both the FDA and EMA on our Phase 3 program for vadadustat in non-dialysis-dependent CKD patients, known as the PRO2TECT program. We launched PRO2TECT at the end of last year. It includes two separate studies, a correction study and a conversion study. The correction study addresses anemia patients not currently being treated with recombinant ESAs. The conversion study includes patients currently receiving ESAs who will be converted to either vadadustat or the active control, darbepoetin, with the goal of maintaining their baseline hemoglobin levels. Both studies will include a 1-to-1 randomization and an open label, active-control, non-inferiority design and will collectively enroll approximately 3,000 patients across 500 sites globally. Primary endpoints include an efficacy assessment of the hemoglobin response and an assessment of cardiovascular safety measured by major adverse cardiovascular events or MACE. We're now actively enrolling patients in both the correction and conversion studies and expect the complete enrollment in late 2017. Now during our interactions with the regulatory authorities last year, we also discussed the parallel Phase 3 program for vadadustat in CKD patients undergoing dialysis, known as INNO2VATE. We're now in the process of presenting full results from our Phase 2 dialysis study to both agencies. We look forward to providing an update on our discussions with the regulatory authorities in the near-term, but importantly we remain on track to commence that program in the middle of this year. A critical element of our global commercialization and corporate financing strategy is centered on partnering vadadustat in key territories outside the U.S. A stated goal for 2015 was to secure Japanese partnership by year-end, and we were pleased to deliver a high-value collaboration with Mitsubishi Tanabe in December. Mitsubishi is widely recognized as one of the most successful companies in Japan with a large established sales force and a strategic focus on renal disease and diabetes that will serve to maximize the potential of this innovative product in this region. Under the terms of our agreement, Mitsubishi has exclusive rights to market and promote vadadustat in roughly two dozen Asian countries. The major markets include Japan, Taiwan, South Korea, Indonesia and India. In exchange, Akebia received a $40 million payment upfront and will receive an additional $60 million in payments for our global Phase 3 program, bringing in a total of $100 million in committed capital to support the development of vadadustat. We're also eligible to receive up to $250 million in additional milestone payments based on the achievement of certain development and sales milestones. In addition, Mitsubishi will make tiered royalty payments from the low teens up to 20% on sales of vadadustat in the covered territories. This transaction offers important validation for the vadadustat value proposition, and importantly, provides us with a partner who shares our vision for the development of vadadustat and significant funding for our global Phase 3 program. With respect to our European partnering activities, we're advancing discussions with multiple parties. Our goal is to secure partner with significant expertise who is aligned with our strategy and willing to make the financial commitment necessary to continue development and support potential commercialization of vadadustat. We succeeded in finding this with Mitsubishi and we're pleased with the progress we're making on this front in our European partnering discussions. In support of our commercial efforts for vadadustat, we've reported tangible progress on the IP front in order to preserve our access to key markets worldwide. We've successfully challenged the FibroGen anemia patent family and reported favorable outcomes with proceedings in both Japan and more recently Europe. Specifically, in January, we reported that the Japanese Patent Office had accepted amendments to the claims of the FibroGen '131 patent, significantly narrowing the scope of the patent. As a result, the '131 patent does not cover vadadustat or any pyridine carboxamide compounds. In Europe, just last week, we announced that we had prevailed in our efforts to challenge the FibroGen '823 patent. After two days of comprehensive review, the opposition division of the European Patent Office ruled that the patent as granted did not meet the requirements for patentability and revoked the patent in its entirety. We're pleased with this clear unambiguous decision by the EPO. While we expect the revocation will be appealed, we're very confident that the comprehensive and definitive ruling of the opposition division will be confirmed. This is the patent that has been rejected multiple times and has never been granted in the U.S., narrowed to exclude vadadustat without an appeal right in Japan and now is revoked in its entirety in Europe. Each of these objective rulings has confirmed our perspective of the invalidity of this patent. With these recent IP developments, we have preserved commercial access to all key markets worldwide and further strengthened our value proposition for vadadustat. We do not believe that there is any other valid IP granted that will negatively impact that access. Beyond vadadustat, we've been leveraging our HIF platform to deliver additional innovative candidates that address major unmet needs. We filed an IND late last year for our second clinical candidate, AKB-6899, a small molecule HIF stabilizer with potential therapeutic benefit in oncology, ophthalmology as well as other indications. In in-vitro studies, 6899 reduced VEGF levels in the presence of hypoxia and therefore has the potential to reduce VEGF in tumor cells specifically. In several preclinical models, 6899 reduced tumor growth and the development of metastases. As we reported in January, the IND is cleared and we're on track to initiate a Phase 1 clinical study for 6899 in oncology toward the middle of this year. As our pipeline matures, we have also continued to expand and strengthen our management team to build on our expertise in HIF biology and support our transition to the Company's next phase of growth. For example, in September we welcomed Dr. Ramin Farzaneh-Far as Vice President of Medical Research. Ramin previously served as Director of Cardiovascular Clinical Research at Gilead. His experience in designing and executing multicenter cardiovascular outcomes trials complements the key renal experience of our clinical team as we advance our Phase 3 program. In addition, his experience in translational medicine will be of great value as we work to expand our HIF-PH pipeline. 2015 was a year of significant progress on multiple fronts and I'm very proud of what the Akebia team has accomplished. In 2016, we're committed to maintaining our high level of execution as we advance our Phase 3 program for vadadustat, further drive our commercial strategy for this innovative product and initiate clinical studies for our second HIF candidate. And now, I'll turn the call over to Jason to review our financials.