Christopher Anzalone
Analyst · RBC Capital Markets. Your line is now open
Thanks, Vince. Good afternoon, everyone. Thank you for joining us today. This is our first earnings call as Arrowhead Pharmaceuticals, and I wanted to take a moment to talk about our name change. While we remain a company rooted in research and world-class science, our top priority is advancing products through clinical development to bring innovative new medicines to patients. The name Arrowhead Research was simply no longer an accurate representation of the Company. Arrowhead Pharmaceuticals reflects the progress we're making on our growing pipeline of RNAi-based therapeutics. We have quickly become a company with multiple clinical stage products, and we plan on having additional products enter clinical trials over the next year and beyond. This is an and move rather than an or. While we expand our focus to include clinical and eventually commercial development, we remain fiercely innovative and continue to drive big science. Our proprietary and constantly evolving technologies give us a robust and versatile drug discovery and development platform. This allows us to continually build on successes from each program and develop effective new therapies rapidly, cost-effectively, and potentially with lower risk relative to traditional approaches. This is reflected in the speed at which we've gone from one clinical candidate to our current pipeline of six programs targeting a broad range of disease areas. It is also reflected in the confidence we have in ARC-AAT and ARC-521, for instance. We now know that ARC-520 does exactly what it was designed to do: it consistently and deeply reduces expression of HBV cccDNA. We also know that it does this in a well-tolerated manner. ARC-520 has been given to over 150 people, and we continue to see a favorable safety profile. This high activity and emerging safety profile should read on ARC-AAT and ARC-521, because both use the exact same DPC delivery technology as ARC-520. It is uncommon in the pharmaceutical industry to have this carry-over safety and activity understanding as new drugs come to the clinic, and this is a substantial value driver. We've made a great deal of progress across all of our programs as well as the underlying platforms during the FY16 second quarter and the period since our last conference call. I'll discuss a few of them now and provide some context. Later in the call, Bruce Given will give some more detail and provide a status update on our clinical studies. I mentioned ARC-520, and let's talk a bit about that. During the quarter we continued to execute quite well, and there are now seven ARC-520 clinical studies actively enrolling patients. As a reminder, the following is a list of current studies: 1002 is a single dose study in healthy volunteers testing faster infusion rates of ARC-520. 2002 is a placebo controlled, three-month study of ARC-520 plus NUCs in NUC-experienced e-negative patients. 2003 is the same as 2002, but in e-positive NUC-experienced patients. 2007 is an open label nine-month extension for patients in 2002 and 2003 who achieve a 0.5 log or greater reduction in circulating s-antigen, providing a full year of therapy for eligible patients. 2004 is our US only placebo-controlled three-month study of ARC-520 plus NUCs in e-positive patients. 2001 extension is an open label study of one year of ARC-520 treatment on top of NUCs in patients from the single-dose 2001 study; 54 of the 58 patients from 2001 are eligible to participate. MONARCH is our open label study that includes arms with ARC-520 alone and triple therapy with ARC-520 plus NUCs plus interferon. We intend to open additional arms as combinations with new compounds become available. These are a lot of studies, and we will enroll a large number of patients. And given the diversity of disease factors, they will be required to gain a more complete understanding of ARC-520 and how it works. These studies will span various HBV genotypes, NUC experience, and e-antigen status. We go into these studies as clear intellectual leaders in HBV. Between our long-term study in chronically infected chimps and our ARC-520 studies to date, we have moved the HBV field forward, and I expect to retain this leadership position this year and beyond. We clearly have a comprehensive clinical program. The data continue to indicate that ARC-520 is highly active against cccDNA-derived mRNA transcripts and thus can reduce the production of HBV proteins. Keep in mind, the virus hijacks patients' hepatocytes to make only five proteins and pre-genomic RNA. That is all this virus does, and our data suggest that we silence every one of them. Several, and possibly all, of these proteins are believed to contribute to immune suppression and, therefore, chronicity of HBV infection as the body is unable to control the virus. Many believe that dramatically reducing both circulating and intrahepatic proteins will make it increasingly difficult for the virus to continue to evade immune control. In theory, this mode of action should be a powerful tool against the virus. It is difficult to imagine that the virus could continue its normal lifecycle while everything it is capable of making is silenced. Of course, we are testing that theory now. In addition to what ARC-520 can do on its own, it could be a powerful backbone therapy that is complementary to other therapeutic mechanisms, and we are eager to interrogate this possibility with various agents in our MONARCH study. We continue to see ARC-520 as a key to enabling functional cures in patients with chronic HBV infection. As we have said previously, ARC-520 appears to be maximally active in patients with higher relative levels of HBV cccDNA versus HBV that has integrated into the host DNA. During the quarter, we presented additional data at the EASL International Liver Congress in e-antigen positive treatment naive patients from cohort 7 of the 2001 study. This patient group is predicted to have higher relative levels of cccDNA. These data show how powerful ARC-520 is against cccDNA-derived transcripts and how deeply we can knockdown HBV proteins. We saw a max knockdown of s-antigen of almost 2 logs, or 99%, and a dramatic duration of effect. We had previously reported the former, but the latter represented new data. In this group of patients s-antigen was still reduced by 83% two months after a single dose and 75% after three months, which is the final time point of the study. In fact, one of the six patients demonstrated approximately 1 log, or 90% reduction, of circulating s-antigen 85 days after a single dose of ARC-520. These are important data because there has simply never been a reliable report that approaches this depth and duration, particularly after a single dose of a therapeutic. In addition, serum HBV DNA reductions of up to 5.5 logs were observed. These were exciting data for us and for the HBV community, and give us great confidence in our ongoing multiple dose and combination studies. In addition to ARC-520, we also recently announced that we filed for regulatory clearance to begin a Phase 1/2 study of ARC-521, our second pipeline candidate targeting chronic HBV. We think having both ARC-520, which has been very active in patients with higher cccDNA, and ARC-521, which may be optimal for those with lower cccDNA, should provide us with greater potential to treat all HBV patients. We have an aggressive plan for the development of ARC-521 that includes an accelerated first-in-man Phase 1/2 design intended to allow rapid transition into multi-dose patient cohorts. Our plan was to file regulatory submissions toward the end of this quarter, so we are already a couple months ahead of schedule. We will provide more details about the design when we initiate the study, so stay tuned. We have moved very fast with this program, and we think ARC-521 increases our leadership position in the HBV space and the race to a functional cure. Turning to ARC-AAT, we continue to accrue our Phase 1 single-ascending dose study that consists of Part A in healthy volunteers and Part B in patients with AATD. We remain on schedule to complete enrollment and release top line results from both the expanded Part A and Part B this year, and report full data at relevant medical meetings. We are currently preparing a pilot Phase 2a multiple-dose study of ARC-AAT that we intend to begin this year. During the quarter we also presented new data on our three disclosed preclinical programs: ARC-F12, ARC-HIF2, and ARC-LPA. These programs represent not only our expanding pipeline of RNAi therapeutics against a wide range of diseases, but also progress we are making on our underlying technology platforms. I will quickly go over these one by one. First, ARC-F12 is designed to inhibit the production of Factor 12. In an edema model in rats, ARC-F12 led to a significant reduction in swelling. In animal models of thrombosis, ARC-F12 reduce the risk of blood clot formation without the undesirable bleeding risk caused by anticoagulants. These support our belief that ARC-F12 has the potential to treat both hereditary angioedema, or HAE, and to prevent thrombosis. These are very different patient populations, and we have both subcutaneous and intravenous formats for this program, so we are currently assessing what the best clinical path will be for this product. We plan on discussing this more in the future. ARC-HIF2 is the first candidate to use a DPC vehicle designed for extra-hepatic delivery. ARC-HIF2 targets HIF-2alpha for the treatment of renal cell carcinoma. We presented preclinical data showing proof of concept for the delivery vehicle, and that ARC-HIF2 could inhibit tumor growth and promote tumor cell death in multiple RCC mouse models. This represents both an exciting new candidate and expansion of our DPC platform. Lastly, ARC-LPA is the first RNAi therapeutic to use Arrowhead's new delivery vehicles designed for subcutaneous administration. This preclinical candidate is targeting lipoprotein(a), or Lp(a), for the treatment of cardiovascular disease. High levels of Lp(a) are associated with an increased risk of cardiovascular disease independent of cholesterol and LDL, and there is currently no good way to deeply reduce circulating levels of Lp(a). Data we recently presented show that ARC-LPA can achieve up to 98% reduction of Lp(a) in mice, and 85% to 90% in primates with significant reductions through at least six weeks. We think this is a very attractive candidate on its own, and we are excited about our new subcutaneous platform that may create additional opportunities to address diseases that require chronic treatment and where the subcutaneous route may be preferable to patients and physicians. So as you've heard, this has been another highly productive quarter for us at Arrowhead. We're confident that novel medicines like the ones we're developing at Arrowhead that treat intractable diseases will in the end always have a great value. We are committed to pushing our pipeline forward and unlocking that value. With that overview, I would now like to turn the call over to Dr. Bruce Given, our COO and head of R&D. Bruce?