Douglas Edward Williams
Analyst · Michael Yee from RBC Capital Markets
Thank you, Francesco. During Q3, we made important advances on several aspects of our R&D programs, which highlight our novel science and continue to position the company for substantial future growth. As George mentioned, on Wednesday, we announced positive top line results from CONFIRM, the second Phase III study of BG-12 in relapsing MS. We have now successfully completed DEFINE and CONFIRM, 2 randomized, blinded, well-controlled Phase III studies in 2,600 patients with relapsing-remitting MS, with very comparable, very positive outcomes. While there's still ongoing analysis being done with the CONFIRM study results, we're now aggressively working on regulatory submissions for BG-12 to file with the FDA and EMA in the first half of next year. Very briefly, the CONFIRM study was a 2-year, multicenter, double-blind, placebo-controlled, dose-comparison study in over 1,400 relapsing-remitting MS patients, evaluating 2 doses of BG-12 in comparison to placebo for the reduction in annualized relapse rate or ARR at 2 years. The glatiramer acetate reference comparator arm was also evaluated versus placebo. Both the BID and TID doses of BG-12 met the study's primary and secondary relapse and MRI endpoints. With respect to reduction of ARR, the primary endpoint of the study, we saw 44% and 51% reduction for BID and TID doses of BG-12, respectively, and a 29% reduction for glatiramer acetate reference arm versus placebo. Data from CONFIRM also showed a favorable safety and tolerability profile, consistent with what was seen in DEFINE. Further detailed information from CONFIRM will be presented at an upcoming medical meeting. Last week, we also shared comprehensive data from DEFINE, the first registrational study of BG-12, at the ECTRIMS meeting in Amsterdam. Both doses of BG-12 demonstrated significant clinical effects compared to placebo in the proportion of patients relapsing at 2 years, annualized relapse rate, multiple MRI measures and disability progression. Incidence of infections and severe infections were similar across all treatment arms, and no opportunistic infections were observed in the BG-12 treatment arms. While the incidence of flushing and gastrointestinal symptoms was higher with BG-12, these events were primarily mild to moderate and decreased substantially after the first month of treatment. We're very impressed with the robustness of the positive BG-12 data from both DEFINE and CONFIRM studies, and plan to file with the FDA and EMA in the first half of 2012. The data shows that BG-12 has a very favorable benefit-risk profile, and we believe that if approved, it will provide an important treatment option for patients with relapsing-remitting MS. Turning to TYSABRI, 28 posters and presentations were presented at last week's ECTRIMS meeting in Amsterdam, highlighting the high standard of efficacy that TYSABRI has set in the MS market. Data from AFFIRM, a long-term outcome study, showed ARR and EDSS benefits seen with earlier treatment of TYSABRI over delayed treatment. Data was also presented from the TYSABRI observational study known as TOP. This study assessed long-term outcomes in almost 3,500 patients, and showed that mean ARRs in TYSABRI-treated patients were lowest in those that were treatment naïve at baseline and highest in patients who were previously treated with immunosuppressive agent or switched from another disease-modifying therapy, further supporting the benefits of early treatment with TYSABRI. Last week, we and our partner, Elan, announced that the FDA notified us of a 3-month extension to the PDUFA date for the TYSABRI sBLA, for updating the prescribing information for TYSABRI to include anti-JC virus antibody status to further help stratify the risk of PML. The FDA has indicated that this extension is needed to allow time for review of the changes being incorporated into the risk evaluation and mitigation strategies, also known as REMS, to be consistent with the anticipated prescribing information. We and Elan are working with the agency to facilitate a timely review of the REMS changes and the sBLA. And finally, for TYSABRI, we initiated patient enrollment in ASCEND, the Phase III trial of TYSABRI in secondary-progressive MS. This trial is expected to enroll 860 patients, and we'll investigate whether TYSABRI treatment slows the accumulation of disability not related to relapses and subjects with SPMS. Turning now to other important aspects of our MS pipeline, in a late breaker presentation at ECTRIMS, we and our partner, Abbott Labs, announced additional data from SELECT, our first registrational study of daclizumab in relapsing-remitting MS. SELECT showed significant reduction in annualized relapse rate at 1 year and met key secondary endpoints. The overall incidence of adverse events and treatment discontinuations were similar in all study arms. Serious infections, serious cutaneous events and liver function test abnormalities greater than 5x the upper limit of normal occurred more frequently in the DAC-treated patients. We placed additional monitoring and management measures in the ongoing clinical programs for the cutaneous and LFT events. These data further support investigation of DAC in the ongoing DECIDE study, which is a randomized, blinded study of 1,500 patients with a primary endpoint of ARR at 2 years. I'm pleased to say that we have received a positive decision from the European Commission for the AVONEX titration kit. The titration kit is designed to help mitigate flu-like symptoms at the start of therapy, making for better initial experience with AVONEX, one of the most trusted MS therapies available. Lastly, enrollment for ADVANCE, our Phase III trial of PEGylated Interferon for MS, is on track to be completed by year-end. The trial is being conducted under a Special Protocol Assessment with the FDA. With an annualized relapse rate at 1 year as its primary endpoint, we anticipate top line data to be available in early 2013. From AVONEX, with its 15 years of safety and efficacy experience, to TYSABRI, which sets the standard for high efficacy, and our anticipated introductions of BG-12 and daclizumab, we hope to offer MS patients a wide range of treatment options. Our portfolio of MS drugs is unrivaled in the industry and speaks to our commitment to the individual needs of different segments of the MS population. Turning to the rest of the neurology pipeline, patient enrollment in EMPOWER, the first global Phase III study of dexpramipexole for treatment of ALS or Lou Gehrig's disease, has been completed well ahead of schedule. This highlights the high unmet need for new and effective therapies for ALS. Recall that we've agreed with the FDA on a Special Protocol Assessment for the design of this study. We anticipate top line data readout in the second half of 2012. We expect to initiate the second Phase III study of dex in the first half of 2012. Dex is a novel oral compound that potentially has neuroprotective properties based on experimental and preclinical studies and may slow the loss of motor neuron function, which is the hallmark of this devastating disease. Moving on to our hemophilia programs, we continue to expect to complete the bulk of patient enrollment in both B-LONG and A-LONG studies in 2011, but there may be some carryover into the first half of next year. Recall that in the B-LONG study, there's a surgical arm which may take enrollment into next year. Data readout for both trials, however, remains on track for the second half of 2012. Along with substantial progress on our late-stage clinical programs, we've also taken steps to bolster our earlier-stage development pipeline. We announced yesterday an exclusive, worldwide collaboration with Portola Pharmaceuticals to develop and commercialize what we believe will be a potent, oral, highly-selective Syk inhibitor. Inhibition of Syk has the potential to provide effective, well-tolerated therapies for a variety of autoimmune diseases, including lupus, rheumatoid arthritis and atopic diseases. We're encouraged by the preclinical and Phase I clinical data to date and see an opportunity to develop a best-in-class, highly-selective, once-daily oral treatment for a broad range of autoimmune diseases. We expect to begin Phase IIa testing of the lead compound next year in RA. This program plays to our strengths and experience in immunology and strengthens our Phase I, II pipeline. I'm extremely pleased with the progress that the R&D organization has attained this quarter for our pipeline, which is one of the most enviable in the industry. I look forward to providing you with further updates on our progress in the coming quarters. With that, I'll now pass the call to Paul Clancy, our Executive Vice President of Finance and Chief Financial Officer.