Earnings Labs

Amicus Therapeutics, Inc. (FOLD)

Q4 2012 Earnings Call· Tue, Mar 12, 2013

$14.49

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Transcript

Operator

Operator

Good day, ladies and gentlemen. And welcome to the Amicus Therapeutics full year 2012 results conference call. At this time, all participants are in a listen-only mode. Later, we will conduct a question-and-answer session, and instructions will follow at that time. (Operator instructions) As a reminder, this conference call is being recorded. I would now like to introduce your host for today’s conference, Sara Pellegrino. Ma'am, you may begin.

Sara Pellegrino

Management

Good evening and thank you for joining our conference call to discuss our full year 2012 financial results. Speaking on today's call we have John Crowley, Chairman and Chief Executive Officer; and Chip Baird, our Chief Financial Officer. Bradley Campbell, our Chief Business Officer and David Lockhart, our Chief Scientific Officer are also on today's call and available to participate in the Q&A session. Today’s remarks coincide with the slide presentation that is now available on our corporate website at www.amicusrx.com. The slides are located in the Investors section under Events and Presentations right below the webcast link to today’s call. On slide two, you will find a reference to our safe harbor statement. This conference call contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 relating to business, operations and financial conditions of Amicus, including, but not limited to, preclinical and clinical development of Amicus’ candidate drug products, the timing and reporting of results from clinical trials evaluating Amicus’ candidate drug products. Words such as but not limited to, look forward, to, believe, expect, anticipate, estimate, intend, plan, would, should and could, and similar expressions or words identify forward-looking statements. Although Amicus believes the expectations reflected in such forward-looking statements are based upon reasonable assumptions, there can be no assurance that this expectation will be realized. Actual results could differ materially from those projected in Amicus’ forward-looking statements, due to numerous known and unknown risks and uncertainties including the risk factors described in our annual report on Form 10-K for the year ended December 31, 2012. All forward-looking statements are qualified in their entirety by this cautionary statement and Amicus undertakes no obligation to revise or update this presentation to reflect events or circumstances after the date hereof. At this time, it is my pleasure to turn the call over to John Crowley, Chairman and Chief Executive Officer of Amicus.

John Crowley

Management

Great. Thank you, Sara and good evening everybody. It’s a pleasure as always. We will recap where we were in 2012 and much of my discussion here before I turn it over to Chip for the financial overview will be focused on where we are today and what we see as some of the key milestones as we head forward into 2013 which as we have indicated through a number of investor meetings with many of you over the last several weeks will be an incredibly important year where I really believe we are finally going to realize in the clinic the true potential of these drugs being developed Again, for a number of years, what we have sought to do is to use these pharmacological chaperone technology to make medicines, to build drugs that can fundamentally change peoples lives. As we ended 2012, we have the first glimpse into the most significant of the clinical studies we have ever done in Fabry disease and of course that’s Migalastat [for our] [ph] monotherapy. So if you look in on the agenda slide here on slide three, you will see I will begin with Migalastat monotherapy for Fabry, an overview, give you the current state of that program and what to expect as we head into this year. I will also then highlight the new CHART, our Chaperone Advanced Replacement Therapy platform technology our proprietary platform and where that stands in now multiple programs including the clinical data as well and then of course turn it over to Chip for financial results in fiscal year 2012 and also for a guidance on fiscal year '13. And of course my full team will be here and happy as always to take any questions. So as we started to do last year, we…

Chip Baird

Management

Great. Thanks, John and good afternoon everyone. I will start today's financial discussion with a few comments on our current cash position and guidance and I am on slide seven. As previously announced at the JPMorgan conference in January, we began 2013 in a strong balance sheet position with $99.1 million of cash as compared to $55.7 million in the beginning of 2012. For the full-year 2012, net operating expenses were $40.7 million. This amount was net of cash reimbursed by GSK for shared global development of Migalastat and I am pleased to report that was within our guidance range of $37 million to $43 million. Looking ahead, we continued to estimate full-year 2013 net cash spend of between $52 million to $58 million. Again, that’s net of anticipated cost-sharing under the GSK collaboration. As a reminder, GSK is responsible for 60% of the global development cost for Migalastat in 2013 and beyond. Our current cash position along with these anticipated GSK reimbursements is projected to fund our operating plan in this second half of 2014. Turning over to slide eight, you will find snapshot of our full year financial results which also appear in tables one, two of today's press release which we put out after market close. Additional details can be found in our annual report on Form 10-K which will be filed later this evening. For the 12 months ended December 31, 2012, total revenue was $18.4 million. That compares to $21.4 million in the year ago period. The slight year-over-year decrease is attributed to change in revenue recognition accounting under the expanded GSK collaboration. This accounting change does not impact cash and we will explain more detail on this on the following slides. Operating expenses for full-year 2012 totaled $71.3 million compared to $72.3 million in…

John Crowley

Management

Great. Thanks, Chip. So I will go ahead and end here on slide number 10 which is our milestones for 2013. Again these are the clinical milestones. We are going to focus on the company and we look to make a difference for people with these diseases which we look forward to as well as of course building significant shareholder value. We see these, the three key drivers of value, hopefully this year. Again the first being the Migalastat monotherapy program for Fabry disease. We have already delivered the full Study 011 interim data in science platform presentation of WORLD. Again now guiding for third quarter 2013 for the topline Study 011 12 month data or the Stage 2 data. That will be very important. Again we are moving that to Q3, I think, to give us the time to continue to work with the FDA. We are fortunate that the study was designed that we have an interim look at the data. It's told us much about how the drug is working. It also now gives us an opportunity to potentially make yet further changes to the statistical analysis plan which I think will be important to understand the full effect of the safety and efficacy of the medicine and also to realizing that the FDA has already guided that they will look to the entirety of the data from both of those stages. So we think that’s very encouraging and we are glad that we have a little bit extra time to complete those regulatory discussions as well as then to analyze the data once its underlined to us in the third quarter. And of course we will be able to topline release that very quickly after we look at it and digest the data. We still plan…

Operator

Operator

(Operator Instructions) Our first question comes from Ritu Baral of Canaccord. Your line is now open.

Ritu Baral - Canaccord

Analyst

Thank you for taking the question. I just wanted to drill down further on the 12 month data that could come out, especially the potential changes to the statistical analysis plan that you discussed. What are some of those potential changes? Is filtering by baseline inclusion numbers one of them? Whatever you guys decide and decide prospectively to analyze the data? How you prospectively decide to analyze the data would you run it by FDA even before the Q3 12 months data?

John Crowley

Management

Yes. The short answer is yes, Ritu. If you remember, if you look back historically over the last year, in this program, we had that type-C meeting last summer and that was the first time the FDA had indicated that we consider safety and efficacy of both six and 12 months. In fact referring to six-months as Stage 1 and 12 months as Stage 2. Through the fall of last year in 2012, we then worked with the FDA. We proposed three additional prespecified statistical comparison. We have gone through this before. Happy to review those again. But that’s already agreed to for the 12 month data set. What we are looking at now is based on the six-month data as we know it. Can there be or should there be any other changes to the statistical analysis plan or different statistical comparisons, I do not want to comment specifically on what we are discussing with FDA. I want to preserve the integrity of those conversations. So I will leave it at that, but once we have that guidance we will be able to release it outward.

Ritu Baral - Canaccord

Analyst

Just as a follow-up. Because of the change at the six months point, the conversion of placebo patients to active, will we have hazard ratios for certain measures even if we don’t have P values and how historically has FDA looked at hazard ratios from small orphan trials?

John Crowley

Management

I am not as familiar with that, Ritu. David, if you want to comment or we can certainly follow-up.

David Lockhart

Analyst

Yes, this is David. So we are still doing statistics. Sometimes people use the word descriptive statistics and it sounds like it is a less than rigorous comparison. But that’s now what we mean here. There is still direct comparisons. There is still calculations of means and medians. I think with the hazard ratio, comparable as to say, the 95% confidence interval. So standard [airs] [ph], confidence intervals and those sorts of things can be calculated. The sensitivity is just to calculating a formal P value as technically that means there was a formal hypothesis testing. So if anything it's post hoc. There is sensitivity to calling it a hypothesis testing with the P value but essentially the same information comes from analyses with the confidence intervals.

John Crowley

Management

Again, I think it is important, Ritu, to remember that what we are seeking here is that conditional approval. So looking for conditional approval based on a surrogate marker or markers likely to predict clinical benefit. We think GL3 is an excellent one and certainly the cell types in the tissues that we are looking at in the kidney are the very relevant ones that we think will be likely to predict a clinical benefit. We just want to make sure that as we look at the entirety of that data that we are able to pre-specify as many of those statistical comparisons as we can.

David Lockhart

Analyst

And I think there are two things that are important to be reminded of. One is that there is a lot more data when we have the 12 months collection. Because at that point the patients who were on drug for the first six months stay on drug. So we have will have data for of those patients for 12 full months. Then also the patients who were originally on placebo crossover to drug. So in effect you nearly twice as many patients. We will have data for nearly twice as many patients on drug for at least six months. It gives us two things. One is data for nearly twice as many patients and it gives us data not only for a six-months treatment period but also a 12 month treatment period. As we saw in the Phase 2 studies there was an effect at six-months but that effect was larger at 12 months. That’s also what is seen with ERT. So there is reason to believe that the effect could be even larger for the patients who have been on drug for 12 months not just six. So we can do that direct comparison. In addition, we have nearly twice as many patients with at least a six-month treatment period.

Operator

Operator

Our next question comes from Anupam Rama of JPMorgan. Your line is now open.

Anupam Rama - JPMorgan

Analyst

Thanks for taking the question. Just on the repeat dose study for Pompe which is expected to start in 3Q, what sort of preclinical work or next steps need to be completed before the start of that study.

John Crowley

Management

The manufacturing, we have to do the formulation work, moving from the oral formulation to the IV formulation. That’s completed. The GMP manufacture is completed. The aseptic fill finish is completed for the drug material. Then its just in the last of its toxicology studies. Brad you want to?

Bradley Campbell

Analyst

No, I think that’s a fair characterization. Of course the other elements of starting up a study are on the clinical operational side. So working with the sites which we have already identified, getting protocols approved, going through IRBs, Those kinds of things. So its really more in the clinical operations mode.

John Crowley

Management

Yes. It is actually exciting to see that program now. I mean we were all here about two months ago when the contract manufacture had a live video feed from their aseptic fill finish facility and that was just an idea about 10 months ago at the company that it would be best to deliver this is an IV formulation for a host of reasons and the enormous amount of work here internally at Amicus to make that happen. Again, remember of course as you know. Anupam, this is an un-partnered program. So we are doing all of this with our internal resources and our key vendors. So it is exciting to see this move forward. And now we are only a quarter or two away from this going into patients in a repeat dose study. Obviously very, very excited to see the data coming out of that open label study.

Operator

Operator

Thank you. Our next question comes from Kim Lee with Janney Capital. Your line is now open.

Kim Lee - Janney Capital

Analyst · Janney Capital. Your line is now open.

Good afternoon. A quick question for you. What was the thinking that was behind the pushing out of the lead out for the Stage 2 of the trial? Is it some discussions with the FDA? If so, what has been that feedback? Thanks.

John Crowley

Management

Again, we had been guiding to late Q2, early Q3. We think its prudent now that we say its Q3. Its really with all the data that we have, Kim, at six months, all the internal analysis that we have done, working with the pathologists to make sure that we have all the right types and numbers of pathology reads, together with the ongoing discussions with FDA and under Type C guidance, because there are timelines that are in two months or so period. So that will take some time to complete that. So again I consider it very much a positive. Obviously we would love to have all the data sooner rather than later but the fact that six months data really look so encouraging, especially as we have dug deeper in to it on areas like looking at the overall GL3 level on that continuous variable. Just making sure that we do everything possible and take a little bit extra time so that we can analyze that data as comprehensively as possible and to set up as diligent a briefing package as we can into the FDA for the pre-NDA meeting.

Bradley Campbell

Analyst · Janney Capital. Your line is now open.

Yes, the only other thing I would add, John, is from an operational perspective. Remember we have collected all those biopsies. Those were collected by the end of December last year. We are still blinded to the data. I know John mentioned both of those things. But as John said it is not an operational issue, more its just making sure that we get it right and we have the appropriate discussions and that we prepare appropriately.

John Crowley

Management

Yes, to me, this was a strategic decision to take those extra couple of weeks and I think it is actually quite positive that we are engaging the FDA in this interim period between the six and the 12 months data. So I think it is very positive. Hopefully it will set us up even better.

Kim Lee - Janney Capital

Analyst · Janney Capital. Your line is now open.

And what --

John Crowley

Management

Go ahead, Kim. I am sorry.

Kim Lee - Janney Capital

Analyst · Janney Capital. Your line is now open.

Oh, no. That’s okay. So you are in discussions with the FDA currently and can you help us understand what kind of guidance they are providing for you between now and your readout in Q3? Thanks.

John Crowley

Management

I can't comment on specific items from the agency and the nature of the discussions. Only to state that we are sharing the data. We are proposing ideas for potential changes to not take away from but to add to the prespecified statistical comparisons. So that when we look and we describe what is the entirety of the data, we understand, the regulators understand, investors, physicians, really all the interested parties understand just how well we hope this drug is working and therefore how convincing of a package we can put together for that pre-NDA meeting. But I think its time well spent. Thankfully, we have got good data to look at.

Operator

Operator

Thank you. Our next question comes from Joseph Schwartz of Leerink Swann. Your line is now open.

John Crowley

Management

Joe?

Joseph Schwartz - Leerink Swann

Analyst

Oh, hi. Sorry, I was on mute. Thanks. So, when will the FDA see 12 month data and how do you anticipate updating investors once they have seen and then that meeting has taken place and you are able to share with us whatever clarity you can at the end of that interaction.

John Crowley

Management

Sure. So I think, Joe, in the third quarter, we will expect to be able to topline that data. As before, the full data that would be presented at a science conference most likely in the early part of the fall, I would suspect. Then in terms of the FDA, we intend to move once we analyze that data very, very quickly into the pre-NDA discussions with FDA. So you think about the monotherapy program. There is really three gates this year that we have to go through. It's going to be the 12 month data in Q3. It is going to be the pre-NDA discussion after that. Then we are still on track and all the other work that we need to do is on track assuming that the 12 month data looks where need it to be, to file the NDA by the end of the fourth quarter. So those are the three gates that we will need to get through to continue to de-risk that program.

Joseph Schwartz - Leerink Swann

Analyst

Okay, great. Then can I ask one quick follow-up on the IV AT2220 study in combination with the marker ERTs. I was curious, I think you said it was going to run for around 12 to 24 weeks. How many patients do you anticipate enrolling and how long do you think it will take to do that? Then what kind of immune response test do you anticipate you will be able to analyze? Will there be a ERT monotherapy arm as a control?

John Crowley

Management

All right. So that’s four questions. Let me make sure I got them. So it’s the number of patients. Again we are still developing the protocols but I think it is fair to say this is probably going to be about 18 to 24 patients. Again, some on ERT, some naïve to ERT. We do expect afterwards that there will be an extension arm. I think your second question was the time to enrollment. We expect this to enroll very, very quickly. We are not asking anybody to come off of their ERT. We are only adding an investigational medicine to explore whether we can change the PK profile, enhance the tissue uptake and potentially affect the immune profile of the ERT in a positive way. So we think there will be significant interest. I could tell you we are talking to the key opinion leaders in the world, all of whom were investigators for the Myozyme pivotal studies. We are very excited about the data that we have seen including the clinical data. If you remember too. for Study 010, even though it was basically a Phase 2a PK study and it included multiple muscle biopsies, no chance to take the medicine our chaperone more than once, we enrolled that study very, very rapidly. In fact we had to turn some patients away. The people living with Pompe disease are really, really eager for next-generation therapies that can either enhance the efficacy or safety of their current medicine potentially lead to the development of next-generation ERTs. I know at the end of the night, I don’t worry about enrollment of this study. We will do it in a rigorous fashion but we will enroll the study in a very, very expedited manner. You had a question too also about immunogenetic. I was just scribbling down your questions quick. I apologize but immunogenicity was your third question, Joe?

Joseph Schwartz - Leerink Swann

Analyst

Yes, thanks. Sorry to include so many but the immunogenicity aspect is obviously important and then we have ERT monotherapy as a control?

John Crowley

Management

That’s not clear that we will need a monotherapy control right now but we are looking at that. Again, we will final protocols in the next short while here. But again since we are looking at ERT experienced patients, and remember of course, in Pompe you have a 100% pure conversion. So everybody develops antibodies. That’s known to the ERT. We will have many of those patients in the study. We will look on a number of different parameters, including T-cell response antibodies to see if the addition of the chaperone and coadministration has any impact. We need to investigate that. Then we will also look at ERT naïve patient. If the medicine is coadministered with the ERT, chaperone with the ERT, what impact, if any, does that have on the immune response. So we will look at all the multiple parameters to measure the immunologic response. I would stop there.

Joseph Schwartz - Leerink Swann

Analyst

I think that was a, thanks very much, extremely helpful.

Operator

Operator

Thank you. Our next question comes from Greg Wade of Wedbush. Your line is now open.

Greg Wade - Wedbush

Analyst

Thanks for taking my questions as well.

John Crowley

Management

Hey, Greg, how are you?

Greg Wade - Wedbush

Analyst

Hi, I am good, John. Good to hear your voice. The results of the 12-months study are complicated. You have got patients who had responded which could either continue to respond or fail, patients who had failed to respond who could respond or continue to fail. Then the same in the placebo group. So there is potential outcomes per group that you have already, responders and nonresponders. So I am curious, what you would prospectively define as a successful enough result at this 12 month time point to continue the program forward. Then secondly, if I just might squeeze another one in. Your amenable mutation assessment hasn’t really been predictive of response at this point. I am just curious as to what the company is doing in order to create a sufficiently robust commercial test that would allow you to identify those patients whom, if you do go forward with the program might best be treated with Migalastat. Thanks.

John Crowley

Management

Yes, let me address that last question first and I will ask David and Bradley to add any color that’s necessary. Actually we think it's one of the most powerful aspects of the technology is a very personalized medicine aspect of the monotherapy where, if you recall, we had develop the constructs of every known mutations that can cause Fabry disease, over 500 and even in the course of enrolling this study discovered several dozen new mutations that can cause Fabry. We are actually very confident that we can predict with nearly 100% certainty who is appropriate to this medicine based on that GLP assay. So the amenable versus nonamenable is critically important to us. We think we have very good evidence. I think it indicated that we didn’t see evidence before. I am a little confused about that. Because if you look at our Phase 2 data that was presented at the American Society of Nephrology back in the fall, we actually had patients who had nonamenable mutations, and they actually showed an overall increase in their GL3 level compared to a 78% median reduction in the GL3 in people with amenable mutations. So I don’t think that’s quite right but maybe I missed something. So David or Bradley, if you want to add any color on that point and then I will come back to your first part, Greg. I am sorry. So there is nothing there. So let me guess.

Bradley Campbell

Analyst

So actually, John's correct that from the Phase 2, we do have evidence that the in vitro study mutation by mutation does appear to be meaningful in terms of the response in vivo in patients with different mutations get the drug. We will have similar data from Phase 3. We haven’t shared the patient by patient data yet but we do have patients in the Phase 3 study who have mutations that based on the GLP pharmacogenetics assay are nonamenable. So we are able to compare those with the preidentified nonamenable mutations versus those that are amenable and when we share the patient by patient data we will be able to compare those two groups and see whether there is good predictive power with the pharmacogenetics work. Is that what you were asking, Greg?

Greg Wade - Wedbush

Analyst

Well, everyone in the Phase 2 study was identified as having amenable mutation but last month it wasn’t 100%. So I am a little confused.

Bradley Campbell

Analyst

The confusion comes from the fact that when we were enrolled in that study, we had and R&D assay that was the basis of the inclusion. We tried to be inclusive. So there are patients who went into that study who then, when the full set of 531 assays were transferred to CRO so that could be done under GLP conditions. So every single one of the 531 were rechecked. There were some that had previously scored as amenable that were now determined to be not amenable. We agree with the assessment of the CRO done under the GLP conditions. So those are, by the criteria we defined before the study started, they do not meet the amenable status criteria. So they were let in because of the R&D assay but with the GLP assay they are nonamenable. So that’s why they were in there. It was just a matter of time and the switching of the assay to a GLP setting outside of Amicus. So they will effectively serve as the control for the ability to predict based on that assay.

John Crowley

Management

So let me just be clear, the vast majority of the patients in the study do have amenable mutations and that small number who don’t but we are still analyzing but I think, may be if I can just get to the first part of your question, I think it is very important, Greg, and a very good question around what to expect at 12 months and how do we know that’s going to support approval of this drug. We know the drug worked. It has been patients now more than 200 years of patient data. Some people more than seven years on the drug. We think the compliance rate, the fact that the 57 of 59 people who agreed to go in the extension study in December before the six-month data was released, every one of them has continued on in the study. So there is really three things we need to show at 12 month advancing from six months. First we need to show that the effect of the medicine is persistence and durable. So for instance, a lot of different ways and perhaps off-line, we can go through it in more detailed comparison but what we need to show is for people who were on the drug for six month, when you add another six-month of treatment, is that persistent and durable? Does it continue? Is it even greater in effect? If it is consistent with our Phase 2 data, it should be. Again, for people who were on placebo, when they switch you start to see a change in the trend and the primary endpoint the six-month data, we look at peer responder analysis. As you saw with the post hoc analysis, it made sense that a cut of 0.3 and above, I think that explains that unexpected placebo response but much more importantly for 12 months we need to show that this entirety of the data on this biochemical endpoint supports that we see a persistent and durable change first. Secondly that the change and the magnitude of the change we are showing is meaningful. We think it is actually quite encouraging at six months of the Migalastat treated group, it was already at a 41% median reduction. We think, in talking to all the experts in the field, that if that were to continue that would indeed be a meaningful changes likely to predict clinical benefit. Of course, thirdly, we need to show that the drug continues to have strong safety profile, which thankfully it really does. When we put all that together we were hoping that all of that data will lead to a strong package for FDA seeking conditional approval.

Operator

Operator

Thank you. Our next question comes from Ritu Baral of Canaccord. Your line is now open.

Ritu Baral - Canaccord

Analyst

Thanks for taking the follow-up, guys. One thing that’s not in your upcoming catalysts is a plan to take Migalastat, a sole Migalastat formulation for Migalastat alone into potential combo use. Can you take us through the strategy around that decision? Why bring it forward to the combo only as co-formulation.

John Crowley

Management

Because we think it will be a better option for patients for number one. Number two, our co-formulation has essentially co-formulation program. It is eventually caught up with coadministration. So we think the 013 study was excellent proof of concept, again, showing of course we can change the PK profile, the tissue uptake of both Fabrazyme and Replagal and we did that in all patients for whom it was tested. Over the last two months we have work with GSK we have had many long meetings assessing whether we should move that into a pivotal study for coadministration and given how advanced the ERT and how well the ERT co-formulated product looks preclinically to be performing and how well the manufacturing is going, it doesn’t make sense to run those programs in parallel given that the next generation ERT for people with these nonamenable mutations will still need to the ERT. It should be and we think it has significant potential to be a better therapeutic outcome than just the coadministered chaperone with other ERTs. So we think it’s very important then to bifurcate the program. Migalastat monotherapy for Fabry disease for 30% to 50% of the patient population with anyone of these amenable mutations. Then the other half or more of the population we will have an IND we intend by the end of this year with a next-generation ERT. So I hope that makes sense.

Operator

Operator

Thank you, and at this time. I am not showing any further questions. So I would like to turn the call back to management for any further remarks.

John Crowley

Management

No, that’s all we have, operator. Everybody, thanks for listening and always available to speak as needed. Have a great evening.

Operator

Operator

Ladies and gentlemen, thank you for participating in today's conference. This does conclude today's program. You may all disconnect. Everyone, have a great day.

John Crowley

Management

Thank you.

Operator

Operator

You are welcome.