Jay Luly
Analyst · JMP Securities.
Sure. So, thanks, Liisa. So, the LDL receptor is an interesting story. We and others, obviously, have thought about FXR in the context of lipids. Intercept saw LDL elevation in their study, and so we wanted to understand whether or not that would be an observation we'd have to worry about and think about how to handle going forward. So, we looked at lipids. We did a lot of interrogation preclinically and, ultimately, in our Phase I study. Preclinically, animal models are a little bit tricky. They all seem to deal with lipid regulation in different ways or at least in some of these animal models that are – it's hard to come up with perfect models in that regard. That said, when we look down at expression levels, looking at RNA and protein and then ultimately function, we did see that EDP-305 differentially versus OCA had an up-regulation of LDL receptor preferentially by EDP-305. So, for those of you who don't know, the LDL receptor is one of the proteins that's substantially responsible for reducing circulating LDL levels. So, if you have LDL receptor expression go up, you see circulating LDL go down. And that would be viewed as a good thing. So, when we saw differentially an up-regulation of LDL receptor by 305 versus OCA, we thought that was an interesting observation, but it certainly needed to be borne out clinically. Under steatotic conditions, not to make it more confusing, but under steatotic conditions, we saw no change in LDL receptor levels, but we saw that OCA reduced LDL receptor levels. So, the relative differences were preserved. So, when we went into the clinic, we looked at lipids very carefully not only in healthy volunteers across our entire dose range, but also in presumed NAFLD subjects and we didn't see any dose-related increases in LDL at all even at the highest dose of 20 mg, which we know gave better than linear pharmacokinetics, so there was a very, very large exposure in those subjects at the 20-mg dose. So, those were the observations. We saw at least – had a clinical rationale that we found preclinically. And then, at least in Phase I so far, it's borne out.