Norbert W. Bischofberger
Analyst · JPMorgan
Thank you, Kevin. Just last week, we had a significant scientific presence at the European Liver Disease Conference EASL. This meeting has grown considerably over the years. And this year, there were more than 9,000 health care professionals and scientists in attendance. More than 30 presentations covered Gilead programs and products. And new data were presented on GS-7977, our nucleotide analog for HCV infection; GS 5885, our NS5A inhibitor; and GS-9669, our novel NS5B inhibitor. Also presented were very important data on Viread for the treatment of hepatitis B. The very first presentation at the EASL conference reported on an arm in the ATOMIC study, which evaluated a regimen of GS-7977 with pegylated interferon ribavirin for 12 weeks in genotype 1 infected patients. This data indicated that this regimen resulted in 90% to 94% cure rates without the need for response-guided therapy algorithms. The addition of GS-7977 to pegylated interferon ribavirin did not result in additional side effects. And thus, this 12-week regimen could be an important advancement for the field. Data from the ELECTRON study were also presented, and in addition, we chose to include data from the QUANTUM study of last week's press release. Both data sets were from study arms evaluating GS-7977 with ribavirin for 12 weeks in genotype 1 treatment-naïve HCV-infected patients. The studies are ongoing and only SVR4 data were available at the time of the EASL Conference. The SVR4 rates in ELECTRON were 88% and in QUANTUM 59%. These are exciting results and indicate that it is possible the genotype 1 patient to be cured with a 12-week course of GS-7977 and ribavirin. Bristol-Myers Squibb presented data from their study, utilizing GS-7977 in combination with their NS5A inhibitor, daclatasvir, with or without ribavirin in genotype 1 infected patients. After 24 weeks of treatment, 100% of genotype 1 HCV treatment groups achieved SVR4. BMS has also initiated and is enrolling a 12-week study evaluating GS-7977 in daclatasvir with or without ribavirin, and data from that cohort is anticipated to be available in the fourth quarter of this year. We also presented data on the antiviral activity, resistance profile and persistence of drug resistance mutations for NS5A inhibitor, GS 5885. Three days of monotherapy with 5885 resulted in median maximal HCV RNA reductions of greater than 3 logs at all doses 3 milligrams or higher. GS 5885 showed picomolar activity in genotypes 1, 4 and 6 and nanomolar activity in genotypes 2 and 3. Another poster described the antiviral activity of GS-9669, a novel NS5B non-nucleoside polymerase inhibitor in genotype 1 infected patients. GS-9669 when dosed for 3 days at the 500 milligram dose once daily resulted in median maximal viral load reductions of 3.5 logs in both genotype 1a and 1b. These data indicate that GS-9669 is one of the most potent non-nucleoside NS5B inhibitors described to date and has the potential to be co-formulated with GS-7977 into a single-tablet regimen. Based on Phase II data in genotype 2/3 patients, which were disclosed previously, we have advanced GS-7977 into 2 Phase III studies called FISSION and POSITRON. Both studies will reevaluate the 12-week treatment course of GS-7977 with ribavirin in genotype 2/3 infected patients. FISSION is conducted in 500 treatment-naïve patients and uses a pegylated interferon ribavirin standard-of-care week -- 24-week control arm. That study should be fully enrolled by the end of this month. POSITRON evaluates GS-7977 ribavirin in 240 interferon ineligible or intolerant patients and utilizes a 12-week placebo arm as the control. That study should be fully enrolled at the end of May. Thus with these 2 studies, we should be able to file for approval for GS-7977 for the treatment of genotype 2/3 infected patients by mid-2013. A GS-7977 and GS 5885 drug interaction study has been completed, indicating that no dose adjustments are necessary when the 2 agents are used together. This, along with our safety database that includes over 800 patients dosed with GS 5885, will allow us to advance this combination of GS-7977 and 5885 into a Phase II study as an arm in ELECTRON in genotype 1 null responders and also into other clinical studies. There are several paths we could pursue that could accelerate our entry in the market in genotype 1 patients. But until we complete the dialogue with regulators, and this path is crystallized, we will not project what that could look like at this time. At EASL, there were also a number of presentations that highlighted the use of Viread for the treatment of chronic hepatitis B infection. The study showed that Viread results in high virological suppression and is safe in patients with baseline renal disease. Now turning to HIV. I would like to provide a quick update on ongoing studies further exploring the use of Quad. We've initiated 2 48-week Phase IIIb studies to evaluate switching of virologic suppressed patients on an NNRTI plus Truvada regimen to Quad and from a protease plus Truvada regimen to Quad, respectively. Both studies are approximately 20% enrolled. We've also initiated a 50-patient 12-week switch study from raltegravir plus Truvada to Quad, and this study is approximately half enrolled. In January, we announced the initiation of a Phase II clinical trial evaluating GS-7340 for the treatment of HIV infection in treatment-naïve adults. We have now completed screening for this 150-patient Phase II study that compares GS-7340 as part of a once daily co-formulated single-tablet regimen that also contains cobicistat, elvitegravir and emtricitabine to our Quad single-tablet regimen. We have recently completed the co-formulation of the first protease inhibitor containing single-tablet regimen, consisting of GS-7340, emtricitabine, darunavir and cobicistat. And just this month, we began screening patients in a Phase II study comparing this single tablet regimen to Truvada, darunavir and cobicistat. With respect to Complera, we fully enrolled the single tablet Phase IIIb head-to-head study versus Atripla and anticipate data in the fourth quarter of this year. As you may recall, the Phase III studies that supported the approval of Complera were blinded studies, utilizing Rilpivirine, efavirenz and Truvada as single pills, given multiple times per day rather than a single-tablet regimen administered once daily. This design could have led to the data that underestimate the true benefit of single-tablet regimens. As a final R&D highlight, 3 Phase III studies will be initiated in patients with relapsed or refractory chronic lymphocytic leukemia, or CLL, which is 1101 in combination with rituximab, with bendamustine/rituximab or with ofatumumab. The first 2 of these studies are anticipated to begin enrollment -- enrolling patients this quarter and the third study will begin in the second half of this year. All in all, I'm very excited about our pipeline, and we very much look forward to advancing these programs to the commercial stage. I will now turn over the call to John Milligan. John?