Christopher Missling
President
So it's important to point out that there is a requirement for clinically meaningfulness and that's been recently published in our paper 2024, which we also pointed out or cited in one of the last press releases on the efficacy data on the open-label as well as the paper publication on JPAD and that threshold is a 2 point score or more delta of ADAS-Cog and we demonstrated in our trials a ADAS-Cog13 of 2.03 for the entire population, all participants. That means we are clearly clinically meaningful because that means that patient -- a participant can identify these changes himself, herself but also the caregiver can identify these changes as well as the physician can identify these changes. And every score less than that would be not identifiable. And to put this in perspective, our ADAS-Cog13 over 48 weeks reach that level of 2 point or more. And in comparison Kisunla or donanemab from Lilly reach for the ADAS-Cog13 exactly a same score, a score only of 1.35 delta to placebo and that would not meet the clinically meaningful threshold of 2 point or more, and it was also reached after a much longer period of time, this 1.35. So, we are better and earlier in identifying improvement compared to placebo with blarcamesine. And that comes on top of the advantage of an oral once-daily administration, which is mechanistically probably closer to the complexity or origination of the disease, which is ahead or earlier than a better in (ph) tau aggregation and inflammation and other dysfunctions, which are within this disease than other drugs, including the monoclonal antibodies, which are targeting further downstream limited pathways, for example, the -- a better pathway, which has recently gotten in a bit of critique because of the focus on this and the support, which was criticized in some media recently as well. But there is no doubt that we are happy to consider blarcamesine as a potentially complementary to existing treatments that includes the antibodies, but also existing treatments, which is donepezil and memantine, which was demonstrated in our trial to be on -- the data was on top of blarcamesine, on top of donepezil and memantine. So our effect is basically on top of standard of care available at the time of the trial. But again, the key thing is that the scalability, the ecosystem of the healthcare would be better suited with oral once daily. And given its ability not to cause serious deaths is the antibodies are doing and that's why they have a black box warning, that means, you can die from this drug in case of the antibodies. And you need to have a physician, which has to be very courageous to prescribe this drug. And given that it has to monitor the effect on the patient very carefully and requires a mandatory MRI every three weeks and this requires a contrast medium. It's not a trivial task also to find appointment for an MRI. And MRI centers are not widely spread out in the Midwest, you hardly find any. And that is probably also the contribution of the slow uptake of the antibodies and the limited ability to expand this into a broader patient population with diverse background and location. And that would be overcome with oral once daily small molecule like blarcamesine, of course.