Dr. Richard Glickman
Analyst · Ed Arce with H. C. Wainwright. Please proceed
Well, thank you, Glenn. And thank you all for joining us today as we review our fourth quarter and year-end 2018 financial results and provide a general business update. This past year has truly been extraordinary year for the team here at Aurinia with significant progress made on a number of fronts. As the quick level-set, I think it's important to bring everyone up to speed on the progress made and what we are looking forward to during the year to come. Aurinia has three programs ongoing in parallel that highlight the potential of our pipeline and a drug for our lead candidate voclosporin. First and foremost, we are evaluating voclosporin in a Phase 3 trial for lupus nephritis. In addition, oral voclosporin is being tested in FSGS or focal segmental glomerulosclerosis. And lastly, VOS, our ophthalmic solution being tested in the treatment of dry eye syndrome. Reflecting on this past year, our most significant milestone was in September where we announced the early completion of enrollment in the AURORA Phase 3 clinical trial for the treatment of lupus nephritis. The target enrolment of 324 patients was surpassed due to the high patient demand with 358 lupus nephritis patients randomized at sites across 27 countries. We would like to thank all our trial patients, the physicians, our CROs, the advocacy group and especially the team at Aurinia for their extraordinary efforts, which led to this result. We are related by the significant interest in this trial and it reinforces the need for new treatment options for patients living with lupus nephritis. I continue to be impressed by the level of dedication exhibited by our team to execute this trial with great diligence and expediency but without compromising quality. As you’ll recall, the AURORA clinical trial is a global double-blinded placebo-controlled study to evaluate whether voclosporin when added to background therapy of mycophenolate mofetil or CellCept, can increase speed and overall renal response rates in the presence of low dose steroids. The primary endpoint of the study is complete renal response at 52 weeks, and we look forward to sharing these trial results towards the end of the year which is positive forming the basis of the regulatory filing. As you know, LN is a debilitating disease and our team is extremely motivated and working diligently to potentially provide the first FDA approved therapy for patients who are in desperate need of new treatment options. We believe the totality of the data from both the AURORA and AURA clinical studies will serve as a basis for a new drug application submission with the FDA following a successful completion of the AURORA clinical study. Under voclosporin’s Fast Track destination, we are also utilizing the rolling NDA process, which will allow us to begin the submission process following a positive pre-NDA meeting with the FDA, which we anticipate to occur in the first quarter of 2020. To that end, we are actively preparing the non-clinical and CMC modules required for the NDA submission. Our current plan is to complete the NDA submission, including the clinical module in the second quarter of 2020, in line with our previously disclosed regulatory timelines. With respect to intellectual property, we recently announced that we received notification from the US Patent Office after extensive interaction with the US PTO, that our patent which covers how we treat patients and how they are managed during the initial titration period have been allowed and should be granted shortly. This method of this patent is integrally tied into the label we seek to obtain for voclosporin, which relates to dose adjustment used in both the AURA and AURORA studies. The patent provides potential coverage until December of 2037 for not only the treatment of lupus nephritis but also other proteinuric kidney diseases that could be treated with voclosporin, representing on additional potential for 10 years of additional patent protection. So really excited about this development. That brings us to an update on FSGS program with voclosporin. According to NephCure, approximately 5,400 new patients are diagnosed with FSGS each year accounting for the largest segment of almost 30% of patients with Nephrotic Syndrome. FSGS is a rare disease that attacks the kidney filtering units, the glomeruli, causing serious scarring which leads to permanent kidney damage and even failure. Similar to lupus nephritis an early clinical response can be measured by the reduction of proteinuria which appears to correlate with improved long-term outcome. Voclosporin also appears to play a key role in maintaining podocyte structure and functional integrity which is thought to be critical for long-term kidney health. While guidelines exist for the treatment of this disease there are no currently approved therapies for FSGS in the United States or in European Union. Our ongoing open label proof-of-concept study is to evaluate up to 20 treatment naïve patients with FSGS. The goal of this study is to assess potential voclosporin as first line treatment option for these patients before other interventions such steroid immunosuppressants are utilized. As we are essentially enrolling newly diagnosed treatment naïve patients with this rare disease, enrollment remains slow. We are opening up additional sites to enhance enrollment. We look forward to providing additional update later in this year. Finally, I am very excited to present the data generated in our Phase 2a study with VOS in the treatment of dry eye syndrome. As you’ll recall in July of 2018, we initiated the dry eye program with a new patented topical formulation of voclosporin called VOS. This novel formulation of voclosporin is a unique patented aqueous, preservative-free, nanomicellar solution containing 0.2% of voclosporin. And from previous disclosers, voclosporin has been shown to be several times more potent than cyclosporine, the active ingredient used in RESTASIS. Dry eye syndrome is a chronic disease in which a lack of moisture and lubrication in the eye’s surface results in irritation and inflammation of the eyes. Dry eye is a multifactorial heterogeneous disease estimated to affect greater than 20 million people in the United States alone. While the FDA approved products do exist for the treatment of dry eye, two of which are CNIs and there are plenty of opportunity for potential improvements in efficacy, tolerability including onset of action and alleviating the need for repetitive dosing. We believe the calcineurin inhibitors will remain a mainstay for treatment of dry eye and VOS has the potential to be a best-in-class calcineurin inhibitor within this $1 billion market. We initiated an exploratory Phase 2 head-to-head study of voclosporin ophthalmic solution versus RESTASIS for the treatment of moderate to severe dry eye in July of 2018. The four-week study enrolled 100 patients. And in January 2019, we announced results of the study. The study evaluated and compared the efficacy, safety and tolerability of VOS and RESTASIS. The primary endpoint we used evaluated drop discomfort at one minute post drop installation looking to see whether there's a difference between the two treatment arms. What we learned did surprise us and apparently the market, both VOS and RESTASIS showed low levels of one minute drug discomfort. RESTASIS demonstrated less than anticipated drug discomfort. However, the secondary outcome measures on efficacy, namely in the Schirmer Tear Test and the Fluorescein Corneal Staining, VOS achieved statistically superior results to RESTASIS. We were surprised that after only four weeks of treatment that VOS showed statistical superiority to RESTASIS and FDA accepted objective science of dry eye syndrome with 42.9% of VOS patients versus 18.4% of RESTASIS subjects achieving greater than 10 millimeter improvement in the Schirmer Tear Test at week four, with a P value of less than 0.005. VOS also demonstrated statistical superiority to RESTASIS in Fluorescein Corneal Staining with a P value of less than 0.0003. The primary endpoint of drop discomfort at one minute on the first day of therapy showed no statistical difference between the treatment groups, as both groups as I mentioned exhibited low drop discomfort scores. Again, as a first exploratory Phase 2 study which evaluated VOS against RESTASIS, the results observed just after 28 days of treatment is very striking and beyond our expectations. Currently we're developing a roadmap assessing different protocols and regulatory strategies with a goal to rapidly advance VOS into its next phase of clinical development. We look forward to providing updates as we invest in the dry eye indication. I also want to mention that today on our call is Dr. Neil Solomons our Chief Medical Officer; and Mike Martin, our Chief Operating Officer who will answer questions related to both intellectual property and the VOS 2a -- our Phase 2a program today. So Aurinia is in a substantial growth phase and has transitioned from an early stage clinical company with one indication to a late stage clinical company with multiple indications and we are diligently preparing for commercialization. The past two years have been a critical time in our company's growth, driven by the potential of voclosporin to transform the LN treatment landscape, and thereby our belief in its ability to enhance the management of dry eye syndrome. In 2018 our team focused on a number of essential goals and objectives and I believe we have successfully completed all of them. The most important being the diligent execution of our Phase 3 clinical trial of voclosporin. We also expanded our intellectual property footprint for voclosporin. We advanced an additional renal indication for voclosporin in FSGS and we developed an additional standalone product for the treatment of dry eye. And we did so while maintaining a robust balance sheet to provide appropriate financial runway for the company. With that I will turn the call over to Dennis Bourgeault our CFO to view the Q4 and year-end 2018 financial results with you. Dennis?