Scott Harris
Analyst · Piper Sandler. Please proceed with your question
Thank you, Scot, and good morning everyone. As Vipin said at the outset of the call, this is a very important year for Altimmune from a clinical perspective, with five of our pipeline candidates now advancing into clinical development and meaningful data readouts anticipated throughout the year. That said we are pleased to announce the initiation of our AdCOVID Phase 1 clinical trial today, given the known and potential advantages of an intranasal vaccine approach. There is considerable interest in our AdCOVID program. To briefly recap the Phase 1 trial will evaluate the safety and immunogenicity of AdCOVID in up to 180 healthy adult volunteers between the ages of 18 and 55. Volunteers will receive AdCOVID at one of three dose levels administered as a nasal spray. While the experience from our influenza vaccine platform in preclinical experiments from the University of Alabama at Birmingham indicates that AdCOVID should be effective after a single dose. We plan to study the effects of both prime and prime boost in this study. In addition to the primary study endpoint of safety and tolerability, the immunogenicity of AdCOVID will be evaluated by serum IgG binding and neutralizing antibody titers, mucosal IgA antibody from nasal samples, and T cell responses. We anticipate a full data read out from this Phase 1 trial in the second quarter of 2021. We continue to explore additional development opportunities for AdCOVID, including as Scott mentioned, designing studies to address the efficacy of AdCOVID against variant straints use in a heterologous prime boost regimen and use in a pediatric setting. As the understanding of the pandemic constantly shifts we remain nimble and will continue to adopt our development path to address these evolving needs and opportunities, most importantly visibility into the Phase 1 clinical data, which we expect to have in the second quarter, will guide these opportunities. Moving on our Phase 1/2 clinical trial where T-COVID has made solid progress. We have completed dosing in the first and second study cohorts, which are predominantly safety cohorts and will soon commence enrollment, and the third and final study cohort – the cohort focused on both safety and efficacy. Cohort 3 includes patients at higher risk for severe COVID-19 infection, such as those 65 years of age or older, or those with one or more risk factors for severe COVID-19 complications. The study is being overseen by an independent data monitoring committee and no significant safety signals have been observed to-date. The demographics hospitalization rates and death rates with COVID-19 have evolved over the past year. And this has required changes to the protocol to optimizing the chances of a meaningful trial readout. To ensure that a sufficient number of higher risk patients are enrolled to maximize the quality of the data readout, the study protocol was modified to require that a minimum number of patients meet one or more of these criteria in this final cohort and further modifications are being evaluated thanks to cohort 3. Based on the protocol modification and the anticipated rate of enrollment we now expect that the data readout from this study will occur in the second quarter of 2021. We feel confident about these protocol changes because while the timeline has been extended, we do expect them to enhance the probability of a meaningful trial outcome. As a reminder, this trial was designed to evaluate the potential protective effects of T-COVID in preventing clinical worsening in patients with early COVID-19 symptoms. We expect to enroll up to 100 patients who are being randomized one-to-one to receive intranasal T-COVID or placebo administered in a non-hospitalized setting shortly after the onset of symptoms. The primary efficacy endpoint is the proportion of patients with clinical worsening, defined as a 4% decrease in pulse oxygen saturation, or the need for hospitalization. Shifting gears now, let me provide an update on our liver programs. Last year was an important year for the ALT-801 program as we achieved a major milestone initiating the first-in-human study of this compound. The Phase 1 trial, which commenced in December in Australia, will enroll approximately 100 subjects in 86-week single ascending dose in six-week multiple ascending dose study. The primary pharmacodynamic endpoints are weight loss and reduction in liver fat, and we expect to have six-week data readouts and weight loss and liver fat reduction in the second quarter of 2021. These outcomes in particular have been associated with NASH resolution and fibrosis improvement in advanced clinical trials. We recently amended the study protocol to continue our clinical trial in Australia and plan now to incorporate the 12-week study in patients with non-alcoholic fatty liver disease or NAFLD into this study. We believe that by incorporating the 12-week extension into this study, we can avoid any potential impact of COVID-19 and maintain study timelines. The 12-week data on weight loss liver fat reduction in noninvasive markers of inflammation are expected in the third quarter of 2021. If the data from this study are positive we expected transition rapidly to a full Phase 2 biopsy based trial on NASH endpoints in early 2022. The market opportunity for balanced dual-agonist GLP-1/glucagon candidate is substantial. Also remains a significant unmet need for NASH therapeutic, potentially such as like ALT-801 with a pre-K profile that permits once weekly dosing as well as improved GI tolerability. As the evolving clinical data for tirzepatide illustrate improvements in weight loss can be achieved over GLP-1 monotherapy with a dual agonist strategy, such as ALT-801. However, while the safety profile of tirzepatide was generally similar to that of the well-established GLP-1 receptor class clinical benefit was realized only with a protracted 20 week incremental dose titration schedule and a significant number of dropouts due to GI side effects still occurred. Clearly there is room for improvement in this class. Based on our dose modeling with ALT-801, we have reasons to anticipate robust weight loss and an acceptable safety and tolerability profile without the need to dose titrate. Keep in mind as well the preclinical data for ALT-801 demonstrated superiority to semaglutide and overall weight loss reduction in liver fat, NASH improvement and effects in liver fibrosis. If these results can be substantiated in the clinic, we believe that ALT-801 will present a significant opportunity in the metabolic disease space. Moving on to our HepTcell program, we achieved another important milestone in 2020 convincing our Phase 2 development program. The Phase 2 trial was designed to evaluate the antiviral activity of HepTcell in chronically infected Hepatitis B patients and is an important milestone in our mission to develop a functional cure for this disease. The unmet medical need in chronic Hepatitis B remains high as currently approved therapies to achieve minimal rates of functional cures. Similar to ALT-801 we protect HepTcell to be multi-billion dollar opportunity of successful. The Phase 2 trial was expected for enroll up to 80 patients with chronic Hepatitis B. HepTcell will be administered intramuscularly once monthly for a total of six doses. The primary end point is virologic response with secondary end points of safety, immunologic criteria, and other assessments of neurologic response. We participate having a data readout from this study in the first half of 2022. Finally, before we wrap-up we completed dosing in our Phase 1b clinical trial of NasoShield for anthrax last year. The data readout from this trial was projected to be available in the coming weeks. As we're developing NasoShield under a contract with BARDA, if NasoShield is shown to be safe and sufficiently immunogenicity. We could be eligible to receive the remaining options under our $133.7 million contract with BARDA. We could be awarded the fund Phase 2 clinical testing followed by the stockpile if NasoShield in the strategic national stockpile. And with that, I will now turn the call over to Will Brown, our Chief Financial Officer. Will?