Michael Rowe
Analyst · Ladenburg Thalmann. Please proceed with your question
Thank you, Sean. As you mentioned, the Eyenovia teams have been very busy working on demonstrating the value of our technology and preparing for future commercial scale manufacturing across the product line. One of those value drivers is potentially improving ocular surface safety and comfort due to our microdose array print technology. As you may know, the vast majority of topical ophthalmic medications contain preservatives to help ensure the sterility of the product and to increase its shelf life. However, many patients on chronic treatments, such as for glaucoma or dry eye, often experience adverse effects and ocular stress in the long-term due to the toxicity from overexposure to these preservatives. With the Optejet, we have demonstrated something that, to our knowledge, no other delivery technology has achieved, namely to limit the negative impact of ocular preservatives and to transform a preserved formulation into a non-preserved therapeutic profile without any reformulation. The evidence of this comes from a study we recently conducted in collaboration with Dr. Pedro Hamara at Tufts Medical Center. The purpose of the study was to compare the impact of the most commonly prescribed preserved glaucoma medication delivered by the Optejet versus the same medication delivered in the traditional eye drop. We also compared ourselves versus non-preserved medication delivered by eye drop. We looked at the impact of these medications on human conjunctiva cells to assess toxicity and metabolic impact. The results of this study demonstrated that human conjunctival epithelial cells tolerated preserved drug treatment administered by Optejet spray better than the same drug administered by a standard eye drop and similar to a non-preserved drug-treated cell line and a control with respect to cell viability, cytotoxicity, apoptosis and metabolic activity. Why is this important? Because all else being equal, non-preserved topical ophthalmic medication is the preference as it is better for the long-term health of the eye. However, today’s non-preserved medications are often provided either an inconvenience and difficult-to-use unit dose vials or in clumsy bottle-like devices that filter out the preservative. The ability of the Optejet to provide the same benefit as these non-preserved options, but in a dispenser that makes administration of the drug easier, more comfortable and without inducing the ocular stress is a big win and opens the door to products with superior profiles for use in chronic disease states, such as glaucoma. Another study we conducted to further demonstrate the value of our technology was called SPEED, and we will be presenting data from this study at the American Society of Cataract and Refractive Surgery Conference in Washington DC next month. In short, SPEED demonstrated that the efficacy seen with a single Optejet mist was not significantly different when you added a second spray, establishing yet again and even though our dose is just one-fifth out of an eye drop that all you need to achieve similar clinical effect is one spray. Moving on to MicroLine, as you may recall, MicroLine is our proprietary microdose array print pilocarpine therapy for the temporary improvement in near vision associated with presbyopia or otherwise for the treatment of presbyopia, a market representing over 18 million people in the United States between the ages of 40 and 55 who otherwise never work glasses. MicroLine is unique in that it is designed to be used on demand, the way most people would like to use this type of treatment. Recall that VISION-1 demonstrated positive efficacy with a very low rate of brow acre headache as compared to pilocarpine eye drop formulations. We hope to replicate these same positive results in VISION-2, which is ongoing. VISION-2 is a Phase 3 registrational, double-masked, placebo-controlled superiority trial of 2% multi-array print pilocarpine versus placebo. We aim to enroll about 140 patients into the study and anticipate top line data around midyear. Enrollment is tracking according to plan. We believe MicroLine, if approved, will be a great step forward in the treatment of presbyopia. It will be highly differentiated from other myopic presbyopia formulations. For one, horizontal on-demand delivery is a game changer for patients that are struggling with legacy eyedropper technology. In addition, microdosing is able to do something not readily achieved with the standard eye dropper, delivering a therapeutic profile with potential tolerability benefits. Conventional pilocarpine eye drops, such as the one recently approved can cause headache in 15% to 20% of patients. With the Optejet, we saw this rate reduced to less than 3% in our VISION-1 trial. Also, as mentioned earlier, the study of ocular surface toxicity with preserved microdose formulation shows equivalence to preserve the free macro dose. This potentially means a healthier ocular surface with long-term use. Presbyopia with its multibillion-dollar market opportunity has one of the largest addressable markets of any ophthalmic condition. Allergan recently launched the product, VUITY, which uses the same active ingredient as MicroLine, and has a broad direct-to-consumer advertising campaign to raise awareness of the product and the fact that there is a pharmacologic treatment for presbyopia available. Over the last 2 years, we have compiled a significant body of market research indicating strong consumer and prescriber preference for the Optejet dispenser. So while we are pleased that Allergan is creating a market for pilocarpine-based presbyopia treatment, we ultimately believe that MicroLine, if approved, will better address what patients and prescribers actually want and a product for this indication. We remain very bullish on MicroLine and believe it has the potential to be a significant long-term value driver for Eyenovia as well as our Chinese and Korean licensing – licensee, Arctic Vision. Combined with the positive clinical data generated to date, our upcoming results for VISION-2 and the significant benefits of Optejet, we believe MicroLine could be transformational ophthalmic therapy upon its approval. We had previously discussed changes that were being contemplated at the centers for Medicare and Medicaid services regarding potential reimbursement for remote therapeutic monitoring or RTM. RTM gained widespread acceptance during the peak of the COVID pandemic. And as a result, new reimbursement codes were approved for RTM beginning in January of 2022, one of which we believe is applicable for ophthalmology. Such remote monitoring allows training physicians to gather compliance and adherence data in real time, ultimately leading to better patient care between office visits and/or avoiding unnecessary office visits. Our Optejet dispenser is purpose-built for such remote monitoring and therefore has the potential to become a go-to option for the remote therapeutic monitoring associated with topical ophthalmic drug adherence and compliance. Combined with the potential benefits to the ocular surface that we just discussed from the TUF study, the reduced systemic impact of drugs seen in our published studies and the ease of use versus standard eye droppers, we believe we have the potential to partner with companies who want to leapfrog ahead in chronic disease management. Remote therapeutic monitoring can open a new pathway for smarter, more personalized eye care with real-world benefits for patients with chronic diseases such as glaucoma while also potentially enabling doctors to get compensated for their patient management. We look forward to providing further updates on our progress on future calls. Turning now to manufacturing, in preparation for the commercialization of MydCombi and MicroLine, if approved, we are finishing validation of our fill-and-finish drug facility in Redwood City, California. And they are preparing to install equipment that will allow us to have better control over the logistics and costs for device production in Reno, Nevada. The same equipment would also help us efficiently supply our partners, Arctic Vision in China and Korea and Bausch in the U.S. and Canada, as they continue their clinical programs. I would now like to turn the call over to our Chief Financial Officer, John Gandolfo, to provide a financial update. John?