Pharis Mohideen
Analyst · JMP Securities. Please go ahead
Thanks, Daniel. Let's start on slide number three, with the pathway for toddlers. Just to remind you, the Viaskin Peanut program in toddlers ages one to three uses the original square Viaskin Peanut patch. Efficacy in this age group was fully supported by our Phase 3 study known as EPITOPE, which was completed in June 2022. Recapping those results, Viaskin Peanut demonstrated a statistically significant treatment effect with a p-value of less than 0.001 with a 67% of subjects in Viaskin Peanut arm meeting the treatment responder criteria after 12 months, that's double compared to 33.5% of subjects in the placebo arm. The predefined endpoint was achieved with the lower bound of the 95% confidence interval in 22.4%, which was well above the pre-specified 15% mark. We were, of course, delighted that the results from EPITOPE were published in the New England Journal of Medicine in May. The publication also featured an accompanying editorial entitled good news for toddlers with food allergies. This past April, we received pre-BLA written responses from the FDA regarding the next steps for the Viaskin Peanut Toddler program. As we have previously announced, the agency confirmed that our Phase 3 EPITOPE study met the pre specified criteria for success for the primary endpoint and therefore did not request an additional efficacy study. But FDA did ask that we conduct a supplemental safety study using the original square Viaskin Peanut patch to support and complement the efficacy and safety results collected from EPITOPE. This study is intended to bring the safety database in this age group to approximately 600 total subjects on active treatment, which is consistent with FDA's position in support of the company's dossier in four to seven year olds, as previously announced in December 2022. Let me add a little more detail around that. The FDA has not raised any specific safety concerns with respect to the Viaskin Peanut development program, which includes toddlers and children. Thus, we are not looking for or being asked to assess any specific safety signal in particular. The FDA has been consistent in their communications with us, dating back to the original BLA in 2019, in wanting exposure numbers on active treatment to be approximately 600 subjects in total. Let's move now to slide number four, and the four to seven year old indication in children, which is evaluating Viaskin Peanut using the modified circular patch. Efficacy will be supported by our pivotal Phase 3 study, VITESSE, which was modeled on EPIT, our Phase 3 study in four to eleven year olds. We initiated enrollment in VITESSE in March, and we are making good progress. As with toddlers, we also plan to initiate a supplemental safety study in approximately 270 additional peanut allergic children ages four to seven years. When added to the safety data generated by VITESSE, the supplemental safety study in children will bring our safety database to approximately 600 children on active therapy in this age group. Recall that in December of last year, the FDA agreed that the supplemental study in four to seven year olds would be six months of treatment duration. Now let's discuss the progress that we have made with our Viaskin Peanut supplemental safety study following receipt of Type C Meeting Written Responses from the FDA. The meeting had two main objectives. One, to discuss key study design elements, and two, to agree that a six month study would be adequate in toddlers. Let me summarize where we are, both safety studies, toddlers and children, will be six months in duration. They will be double-blind, placebo-controlled studies. No food challenges will be required for participation for either study. As I just mentioned, with the four to seven year old children safety study will include about 270 subjects. The Toddler safety study will include about 400 subjects in total. Both studies will have 3:1 randomization of active:placebo. Both supplemental safety studies will also generate patch adhesion data in the same manner previously agreed to with the FDA for the VITESSE Phase 3 study. Now that we have received this feedback, we will finalize the protocols and submit them to the FDA for their formal 90 day review. Viaskin Peanut is a novel complex product for which there is no analog, and we believe that taking a best practice approach with the formal FDA review process serves us and the FDA very well. As they said, a picture is worth a thousand words. So, here's a picture of the two patches. Both have the same foam ring and 250 microgram dose of peanut protein. The only difference is the shape and the size of the overlay. The safety studies will be named COMFORT Toddlers in one to three year olds, and COMFORT Children in four to seven year olds. COMFORT stands for characterization of the optimal management of food allergy, relief, and treatment. At this point, I'll turn the call back over to Daniel, to review the financial results. Daniel?
Daniel Tassé: Thank you, Pharis. Now, let's briefly review financial highlights of the first half 2023. Move to slide number eight. Cash, cash equivalents were $174 million as of June 30th compared to a position of $209.2 million as of December 31, which is a net decrease of $35.2 million. $46.4 million of cash were used in operating activities, which the biotech company was mostly driven by clinical R&D, the initiation of VITESSE Phase 3 trial being the biggest component here. Cash used for operation in the six months ended on June 30, 2023, increased by 34.7 million compared to the six months ended June 30, 2022. Now in 2022, the company received 24.8 million euros during the six months ending June 30 2022 for reimbursement of 2019, 2020, and 2021, French research tax credits. We’ve raised $7.8 million proceeds from the issuance and sale of new ordinary shares in form of American Depositary Shares, ADSs, which took place on June 16, 2023, pursuant to our At-The-Market, ATM program which was established in May 2022. In closing, we continue to maximize the efficiency of our spend to make sure we are highly disciplined in our cash management. We have a lot of clinical work to do by next year. We anticipate to have about 1,400 subjects enrolled in Viaskin Peanut Phase 3 studies, which is the bulk of our focus in our broadcast sheets. So let me summarize the fact we've covered quite a bit of information today. So let me recap. Our four to seven year old efficacy study, VITESSE, opened with first subject screened in March of this year, and we are pleased with the ongoing progress of that trial. We are also actively finalizing the two supplement COMFORT safety study protocols in toddlers and children. We expect to initiate these studies once we have final FDA review of the protocols in parallel, we are diligently working on appropriate study start up activities for both supplement safety studies, and the things such as site feasibility, site selection contract with many sites that can be done very effectively in parallel. We believe that the successful completion of the supplemental COMFORT Toddlers safety study would be an important step towards filing a BLA, seeking marketing approval of this potential novel breakthrough technology for peanut allergic toddlers and their families. I want to thank everyone on the phone and webcast for joining us today. I'll ask Pharis and our Chief Financial Officer at Sébastien, to join me for a Q&A. Operator, let's open the line for questions, please.