Daniel Barber
Analyst · Leerink Partners
Good morning, and thank you for joining us today. In the last 62 days since our earnings call, we have progressed the company significantly. For Anaphylm dibutepinephrine sublingual film, we have completed our Type A face-to-face meeting with the FDA, completed a teleconference with the U.K. regulatory body known as MHRA, submitted our pediatric investigational plan to the European Medicines Agency and submitted our human factors protocol for review by the FDA. In addition, we have closed on a new debt facility with a leading life sciences debt provider and completed our Phase I safety study in humans for our pipeline program, AQST-108. We are also on track to attend over 40 conferences and submit over 20 publications this year. It is a testament to the Aquestive team that they were able to complete so much important work in such a brief period of time. The question, of course, is where does this work take us and how do we expect the coming months to unfold. Today, I am providing guidance that we currently expect to have our human factors data and potentially our pharmacokinetic data for Anaphylm available in time for our August earnings call. Now the completion of this data is dependent on the FDA providing responses to our human factors protocol on time and the responses being within expectations, including with respect to the scope and content of that feedback. With these assumptions in mind, we continue to guide to a third quarter resubmission to the FDA, recognizing this timing remains subject to FDA feedback and ongoing review processes. As we've stated in the past, we currently expect our resubmission of the NDA for Anaphylm to be classified as a type 2 submission with a 6-month review, although final classification is determined by the FDA. We will request an expedited review upon our submission and we'll do everything we can to communicate with the FDA and support their review process, recognizing that any decision on review timing rests solely with the FDA. We believe the comments by FDA's leadership on the need for the agency to provide more timely feedback and review points to a broader agency focus and in this case, may create the possibility of aligning with the FDA on a faster process. This, of course, cannot be guaranteed. Our commercial preparations continue to progress. Importantly, we were pleased to enter into a $150 million debt facility with Oaktree, a leading life sciences debt provider. While Ernie will talk about this in more detail; at a global level, this agreement unlocks several important things for Aquestive. One, we have improved the interest rate terms on our existing debt and principal payments will not begin for several years. Two, this completes the pre-approval requirements for the RTW funding; and three, we have the ability to access $20 million in additional capital if Anaphylm is approved by the FDA. Taken together with our existing cash and the RTW deal, we currently project that we will have greater than $150 million in cash at launch, and this is before considering ex U.S. Anaphylm and U.S. Libervant out-licensing deals. We plan on using this cash to focus on building intense awareness and access within the allergy community for Anaphylm. We have already shared our plans for launch of Anaphylm with you, if approved by the FDA, including a strong medical affairs presence, a 75-person sales force and a focused marketing effort. We have also been watching and learning from the launch of a nasal spray product in the market. Our research within the allergy community indicate that building clarity, trust and support for allergists is key to unlocking prescriptions. This may seem obvious, but just think of the daily pressures allergists face in running their practices. Fitting into their world in a meaningful and credible way in furtherance of patient access to Anaphylm is task #1, 2 and 3 for us. While the U.S. market is incredibly important to us, we can't forget that 96% of the world's population does not live in the U.S. I truly believe Anaphylm is a product that will save lives, and we want as many people as possible on this planet to ultimately have access to it. Our lead ex U.S. strategy continues to be Canada and Europe, and we have made significant progress. As I mentioned before, we recently completed a comprehensive and positive interaction with MHRA, the U.K.'s regulatory body. I'm pleased to say we received confirmation that we do not need to conduct additional studies before submitting our application to MHRA in the U.K. We also recently submitted our pediatric investigational plan to the European Medicines Agency, or EMA, for the European Union. Aligning with EMA on this plan is essential to submitting our application. We now know that we can submit applications in the EU, U.K. and Canada without conducting further clinical studies. Between the U.S., Canada, the U.K. and the European Union, our product, if approved in each of these regions, could eventually be available to almost 1 billion people in the next several years. Now let's talk about our product pipeline. Given the excitement around Anaphylm, people often forget that we are utilizing our epinephrine prodrug platform, AdrenaVerse, to advance treatment in other indications. Our lead asset is AQST-108, and we recently completed a Phase I safety study in men with androgenic areata. I am pleased to say that there were no drug-related adverse events observed in the study, and we also saw no appreciable signs of systemic absorption of our epinephrine prodrug or of epinephrine itself. We did, however, see something intriguing. Now keep in mind, this is very early Phase I study data. Our Chief Development Officer, Dr. Matthew Davis, added biomarker assays to the study to see if we could detect changes in key proteins associated with both alopecia areata and androgenic areata, along with other dermatological conditions, such as atopic dermatitis. While this information is not statistically powered and should be viewed as directional only, we were pleased to see in subjects with alopecia that the cytokine TSLP appeared to be impacted by AQST-108. This was not the case when subjects were given placebo. This is very exciting as the signaling pathway for TSLP involves the activation of JAK1 and of JAK2. We have included preliminary data on this work in our supplemental material available under the Presentations section of the Investor page on our website. We will talk more about the next studies for AQST-108 in the coming months once we have resubmitted our Anaphylm application in the U.S. Our business development efforts and base business continue to move forward. Our business development team is currently in active negotiations on multiple programs for Europe, the U.S. and South America. We have also had outreach from additional regions of the world, including China and Australia. We are prioritizing this work based on the territory and program involved. We expect to have more to say on this topic in the months to come. In summary, we expect to provide a significant data update in August, assuming the FDA keeps to its review time line and provides constructive comments to our human factor study protocol. We continue to drive awareness in the epilepsy community ahead of a potential product launch of Anaphylm if approved by the FDA. Our international filing efforts continue to be a priority, and our AQST-108 program continues to show promise for expansion into potential multiple indications. With that, I will turn the call over to Ernie.