Jay Luly
Analyst · Yasmeen Rahimi with Roth Capital Partners
Thank you, Jennifer. Good afternoon, everyone. I'd like to take a moment to acknowledge the extraordinary times we are experiencing during the COVID-19 pandemic. Our thoughts are with those who are directly affected. And we are grateful for the heroic efforts of caregivers, first responders and many others who are making great sacrifices for the common good, as we navigate through the worst weeks of this crisis. The safety and well-being of our employees is paramount and we will continue to prioritize it as we move forward. I want to thank our employees for their unwavering dedication to our mission during these last several weeks. In a period of great upheaval and uncertainty, their commitment has allowed us to maintain continuous business operations and momentum that will enable us to execute on our business plans and milestone goals to the best possible extent given the circumstances. This global healthcare crisis has strengthened our resolve to advance novel therapies for unmet needs. And our core expertise in both virology and respiratory diseases positions Enanta to be part of the solution for COVID-19, and other emerging viral threats. To that end, I'll start by highlighting the newest disease program in our respiratory virus pipeline, namely, COVID-19. As you know, in mid-March, we announced that we initiated a program to discover direct-acting antiviral drug candidates for the treatment of patients infected with COVID-19. Based on our proven track record in virology and our capabilities in respiratory diseases, we believe we can leverage our core competencies to discover a potential treatment for COVID-19. That said, we are leveraging our experience and taking a two-pronged approach for our COVID-19 Discovery efforts. Not only are we testing compounds from our antiviral compound library for potential activity against the virus, we are using our background and expertise in direct-acting antiviral mechanisms to discover new candidates to treat COVID-19. We mobilized our virologists and chemists to begin this discovery program, which involves finding leads and ultimately candidates. Among other mechanisms of interest, an initial focus for us are SARS-CoV-2 protease inhibitors. These are direct-acting antivirals. Not a simple endeavor, but this is what Enanta does and what it does well. We'll continue to update our COVID-19 efforts in the coming quarters. I will now turn to our lead respiratory virus program EDP-938 for respiratory syncytial virus or RSV. To remind everyone, RSV is a severe respiratory infection associated with significant morbidity and mortality in infants, the elderly and immune compromised adults, and a condition for which there is currently no safe and effective therapy. Each year in the United States, approximately 57,000 children below age five, and 177,000 older adults are hospitalized for RSV, and about 14,000 die from this respiratory infection. We have completed the RSV season in the United States and are on track with plans to move our Phase 2b study, known as RSVP into the Southern Hemisphere. Given uncertainty is created by the spread of COVID-19 in that region, we're also keeping our North American sites ready for reactivation in the fall and winter RSV season. We are planning to add substantial number of sites in Europe. If we can complete enrollment for this study in the Northern Hemisphere next winter, we would expect to have data in the third calendar quarter of 2021. As a reminder, RSVP is a randomized double-blind placebo-controlled study of EDP-938 designed to enroll approximately 70 subjects up to the age of 75 years, randomized to receive either 80 milligrams of EDP-938 or placebo for five days. The primary objective of this study is to evaluate the effect of EDP-938 on the progression of RSV infection by assessment of clinical symptoms measured over the course of the 14 days study observation period. Antiviral efficacy will be evaluated as a secondary endpoint. Obviously, COVID-19 pandemic currently has an impact on any respiratory disease study. And RSVP, we are in the process of modifying our protocol to do testing to exclude the presence of COVID-19 in any potentially eligible patient with RSV. We continue to collaborate with Cepheid is it's real-time PCR machines, which can now test for RSV, flu A, flu B and COVID-19. These are the machines that we've used at our North American testing sites. We're in the process of getting additional machines set out from the Southern hemisphere sites. We're also on track to initiate two additional Phase II studies, one in pediatric patients and one in adult transplant patients by the end of this year concurrent with the RSVP study. Fortunately, today, it appears the health effects of COVID-19 in children have not been as severe as on adults. And we anticipate parents will continue to take ill children to the doctor, even if the pandemic continues into the winter RSV season in the Northern Hemisphere. And given their immune suppressed condition, we would hope to transplant patients will be on high alert for respiratory illness and be willing to participate in a clinical study. However, we recognize there are potentially more challenges for the transplant study depending upon how the pandemic moves later in the fall. Regarding the third respiratory virus in our portfolio, we introduced our discovery program for human metapneumovirus, also known as hMPV at the beginning of the year. hMPV is a pathogen that causes upper and lower respiratory tract infections in young children and the elderly as well as in COPD, asthma and immunocompromised patients. In fact, it's the second most common cause of lower airway infection in children less than five years of age behind RSV that accounts for more than 20,000 hospitalizations in this age group each year. hMPV also presents a significant health challenge in the elderly and immunocompromised individuals with more than 100,000 hospitalizations annually. We continue to perform optimization of our current nanomolar hMPV inhibitor leads as we work toward identifying our first clinical candidate for this indication. I'll now move to our portfolio of products, focused on the treatment of liver-related conditions. First, let me update you on our clinical stage hepatitis B program with EDP-514, our novel class II HBV core inhibitor. Last month we announced that we are pausing further recruitment in part two of our Phase 1a/1b study of EDP-514 in nuc-suppressed HBV patients in North America, which initiated earlier in this quarter. Nuc-suppressed refers to patients with chronic HBV infection that is being suppressed with nucleoside reverse transcriptase treatment. The current standard of care. We plan to enroll a total of 24 subjects among three escalating dose cohorts with study drug dosed for 28 days. We're regularly evaluating the circumstances around this study and are hoping to resume enrollment within the next couple of months, depending upon whether enough of our clinical sites are able to open. Given FDA guidance on the conduct of clinical trials during the COVID-19 pandemic, and its emphasis regarding the safety of trial participants and integrity of clinical trial data conducting short term trials in patients with chronic disease during the pandemic is not practicable nor recommended. As such, we'll continue to follow regulatory guidance to determine when it is safe to resume the study. We're also pleased to be on track to initiate our Phase 1b study this quarter in HBV patients who are not on therapy and who have high levels of the virus in their blood, who are also referred to as viremic. We are optimistic about this study moving forward in viremic patients, given that our sites are in Hong Kong and Taiwan, those areas where COVID-19 appears to be under better control than in Western countries, and where there is a large unmet need for HPV treatment. As a reminder, this study will assess the impact of EDP-514 on viral load in patients not on other HBV therapies. We are excited about this study because we expect that will produce our next clinical data readout, which we are targeting for around year-end. I'll now move to EDP-305, our farnesoid X receptor or FXR agonist in development for both PBC and non-alcoholic steatohepatitis or NASH. But first, let me focus on our efforts in primary biliary cholangitis or PBC. Earlier today, we announced data from our Phase 2a INTREPID study. INTREPID was a 12-week, randomized, double-blind, placebo-controlled study evaluating the safety, tolerability, pharmacokinetics and efficacy of EDP-305 in subjects with PBC, with or without an inadequate response to ursodeoxycholic acid. The primary endpoint of the study was to evaluate the proportion of subjects with at least 20% reduction in ALP from pre-treatment value, or normalization of ALP, at week 12. In the intent-to-treat or ITT analysis, treatment with 1 milligrams and 2.5 milligrams of EDP-305 resulted in 45% and 46% ALP responses, respectively, compared to 11% in placebo. These response rates, while numerically higher than placebo were not statistically significant. However, in an analysis of the subjects who completed study treatment with no missing value at week 12. The proportions of ALP responders in the 1 milligram and 2.5 milligram arms showed statistically significant response rates of 50% and 62%, respectively, compared to 11% in placebo. Key secondary objectives were to evaluate the safety and tolerability of EDP-305 as well as changes from baseline in the liver enzymes ALT, AST or GGT. Data from the full ITT population showed statistically significant reductions in absolute amounts of these key biomarkers compared to placebo at 1 milligram and 2.5 milligrams of EDP-305. A statistically significant difference in the percent changes from baseline of these key biomarkers at week-12 was also observed in both EDP-305 arms compared to placebo. In terms of safety, EDP-305 was generally well tolerated in subjects with PBC, with the majority of treatment-emergent adverse events or TEAEs being mild to moderate. The most common TEAEs included pruritus, gastrointestinal-related symptoms, headache and insomnia. These TEAEs are consistent with the safety profile observed across more than 400 subjects exposed to EDP-305 for up to 12 weeks. The incidence of treatment discontinuation due to pruritus in INTREPID was approximately 3% for the 1 milligram EDP-305 treatment group, 18% for the 2.5 milligram treatment group and 0% for the placebo treatment group. While we did not meet the primary endpoint for PBC and the ITT analysis, we plan to use these data to help inform our development of EDP-305 for NASH. Specifically, we are encouraged that the lower dose of 1 milligram achieve better tolerability in terms of pruritus, without significantly reducing the number of ALP responders and while still having statistically significant effects on key biomarkers of target engagement. We see this is helpful information for the intermediate doses of 1.5 milligrams and 2 milligrams that we plan to use in our ARGON-2 study in NASH patients. We believe the dose of 1.5 milligrams or 2 milligrams in NASH could potentially achieve an efficacy and tolerability profile comparable to that of the 1.0 milligram dose in PBC. For more information on the INTREPID study, please see the slide deck that we will post on our website after this call. Rather than conducting further dose selection studies with EDP-305 in PBC, a disease for which there is already an approved second-line FXR agonist therapy, and for which generic fibrates are showing benefit and some studies. We intend to focus our future efforts with EDP-305 on NASH. We see NASH, as a disease where FXR agonists like EDP-305 have the potential to be important components of drug combinations designed to give maximum benefit to patients. At our NASH program, we remain focused on evaluating EDP-305 and ARGON-2, a Phase 2b randomized, double-blind, placebo-controlled 72-week study in approximately 340 subjects with biopsy-proven NASH. While we were ready to begin dosing ARGON-2 on schedule in March, we decided to pause recruitment and dosing in the study due to the ongoing COVID-19 pandemic. We did this having in mind the safety of our clinical trial participants as well as resource constraints to clinical trial sites. As a reminder, the primary endpoint of ARGON-2 will be improvement in fibrosis without worsening of NASH and/or NASH resolution without worsening of fibrosis. We plan to use doses of 1.5 milligrams and 2 milligrams, which we selected to provide strong target engagement and a balanced profile in terms of efficacy and tolerability. ARGON-2 will include a 12-week interim analysis to generate dose information more quickly for potential combinations with other mechanisms in NASH. We're hopeful that we'll be able to resume this trial within the next couple of months, depending upon whether enough of our clinical trial sites for this study are able to open up in the context of the COVID-19 pandemic. Also in our NASH program, we are developing in EDP-297, our follow-on FXR candidate. We're excited about the compelling preclinical data we have previously shared that demonstrate the high potency and tissue-targeting characteristics of EDP-297 compared to other FXR agonists in development. Subject to a determination that it is safe to initiate the healthy volunteer study at the trial site in Europe in the context of the COVID-19, we now plan to initiate a Phase I study of EDP-297 later in the third quarter, which would likely produce a readout in the second quarter of 2021. Beyond our pipeline, I would like to take a moment to comment on MAVYRET, our treatment for hepatitis C developed in collaboration with AbbVie. AbbVie recently announced that it is experiencing lower new patient volumes of hospital-based treatments in several international markets where hospitals are limiting access to non-emergency, non COVID-19 patients. If the COVID-19 pandemic continues for a prolonged period, we expect this to adversely affect AbbVie's MAVYRET sales during that period. However, we also expect that those sales will likely shift to subsequent periods, since there is no expectation that existing infections will decline materially other than by eventual treatment. We also note that AbbVie has now guided that it expects its calendar 2020 HCV sales to be approximately $2.3 billion. Also worth noting that the CDC guidelines issued in April 2020, now recommend that all adults ages 18 to 75 to be tested for hepatitis C virus. In closing, I'd like to point to a few key takeaways. Despite a challenging backdrop of COVID-19, which could have effects we don't currently expect, Enanta remains well positioned to execute on our business plans and advance our growing pipeline of novel therapies for respiratory viruses and the liver diseases. The unusual combination of our strong balance sheet and ongoing royalty revenue allows us to capitalize on the opportunities ahead and to advance our wholly-owned pipeline independent of capital market conditions. We are on-track with several milestones. First, our Phase 1b study of EDP-514 in viremic hepatitis B patients is slated to begin this quarter. Second, we are planning to initiate our first in human study of EDP-297 for NASH next quarter. Regarding our RSV program, our two Phase II studies in pediatric patients and adult transplant patients are still on track to begin in the fourth quarter. Finally, we are advancing our RSVP study in the Southern hemisphere, while also keeping our Northern American sites ready for reactivation for the upcoming fall and winter RSV season. And later this year, we are planning to add a substantial number of sites in Europe. Assuming we can complete the study in the next Northern Hemisphere season. We would expect to have RSVP top line data in the third calendar quarter of 2021. Overall, we are in a very solid position with several opportunities in place. With that, I will now turn the call over to Paul to discuss our financials for the quarter. Paul?