Michael Rowe
Analyst · Ladenburg
Thank you, Eric, and welcome, everyone, to our first quarter 2024 financial results conference call. During the first quarter, we took several meaningful steps to strengthen the inherent value of our company, which currently includes Eyenovia Optejet dispensing technology, two FDA-approved products, MidCap and clobetasol and a third MicroPine in late Phase III development. Together, these products address the U.S. market worth more than $3.3 billion annually. By being able to address a broad range of patient needs with a portfolio of novel technologies and products, we believe we are building a solid foundation upon which to drive accelerating sales growth in 2025 and beyond. Our main focus is on the successful commercialization of MydCombi and clobetasol and the expedited development of MicroPine. We are in the process of establishing a solid foundation for our portfolio with a second FDA-approved product to be launched by our sales force in the next few months and a potential blockbuster MicroPine in the next couple of years. At the same time, our finance and business development teams are diligently executing on an overall strategy to ensure that Eyenovia is well positioned for success beyond the immediate near term and through these challenging times in the capital markets for small cap life sciences companies. Now, let's take some time to provide an update on our MicroPine program, which is our Phase III candidate for progressive myopia. Pediatric progressive myopia has been called an epidemic in the United States and China, where we have licensed the rights to MicroPine to our partner, Arctic Vision. In the U.S. alone, approximately 5 million children are at higher risk of losing functional vision due to this disease in which the eye elongates and can result in separation of the retinal tissues from the back of the eye. Third-party sources have estimated the value of this market, which currently has no FDA-approved drug treatment options at $1.8 billion annually with a similar opportunity in China. The present standard of care involves glasses and contact lenses, which can reduce progression but does not stop it, and these are often not appropriate or well tolerated by the youngest children who are most at risk. And this is where MicroPine can make a significant difference addressing this unmet medical need. As a reminder, MicroPine is our investigational 8 microliter ophthalmic spray of atropine delivered by the Optejet currently being evaluated as a potential treatment for pediatric progressive myopia in the CHAPERONE study. If the results of this study are positive, the FDA has agreed that the single 40-year evaluation could be sufficient for an NDA filing and approval. This is based upon several prior atropine studies in children in Asia, which demonstrated efficacy in slowing myopia progression by as much as 60%. MicroPine may also offer benefits far beyond what would be obtained with an eye drop. With the Optejet technology, children in our clinical study as young as six years old, are dosing themselves every evening without parental involvement. They can do this because the Optejet doesn't require any head tilting or manipulation of eyedropper bottles and makes aiming easier with a built-in mirror so that children can see exactly where they are spraying. The side effects of atropine, which have overwhelmingly been mild and transient in our study have been consistent with what we have come to expect with our advanced device. In its commercial form, we plan to have MicroPine equipped with our Opticare system which can notify patients and their parents when to administer their spray dose as well as communicate important compliance and adherence information for the treating physician. We are continuing to advance the Phase III CHAPERONE study and our clinical team is exploring a potential protocol amendment that could greatly expedite the study time lines and registration of MicroPine. This protocol amendment would include a planned limited review of the CHAPERONE data by an independent data safety monitoring committee later in the fourth quarter of this year when approximately 2/3 of CHAPERONE patients will have reached the study efficacy endpoint. If recommended by the committee, we could potentially be looking at a substantially derisked program, enabling a potential NDA submission as soon as late 2025 or early 2026. As you can imagine, we believe this program would then be a very attractive opportunity for commercialization by us or a larger partner. We are eager to reach that milestone as MicroPine, if approved, would anchor our commercial portfolio and perfectly complement both Mydcombi and clobetasol, providing significant value to eye doctors, patients and payers by addressing a broad spectrum of unmet needs. Now, let's talk about clobetasol propionate ophthalmic suspension 0.05%, the U.S. rights to which we acquired from Taiwan based Formosa Pharmaceuticals last August. Clobetasol was approved by the FDA on March 4 and in rapid succession, the New Drug Application, or NDA, was transferred to us from Formosa. There have been no new ophthalmic steroids approved in the U.S. in over 15 years. The last one was Durezol by Alcon, which for many years, was selling well over $100 million annually. Clobetasol addresses many of the unmet needs for an ophthalmic steroid with a highly differentiated clinical and pharmacologic profile, including twice-a-day dosing and from a safety standpoint, fewer than 1% of patients experiencing seven eye pressure increases that may be more common with other steroids. Intraocular inflammation and eye pressure spikes are the two main safety issues that eye surgeons want to avoid and are paying particular attention to as they can lead to significant clinical consequences, complications and non-reimbursable costs to the providers. We believe that clobetasol has the potential to become the leading option in the postsurgical space. Unlike conventional steroid drugs, clobetasol was developed using a breakthrough innovation in ophthalmic formulation and active ingredient development. This unique postocular surgery steroid is the first product developed using Formosa's proprietary APNT nanoparticle formulation platform which reduces an active pharmaceutical ingredients critical size with high uniformity and impurity, thereby allowing penetration to relevant compartments in the eye and ultimately enhancing bioavailability. The nanotechnology is so effective that it essentially makes the suspension act like a solution. In fact, patients don't even have to shake the product prior to use, and this is just one of the unique elements of our approved label. And while this might not seem like a big deal, it does point to the difference between clobetasol and other ophthalmic steroids. Clobetasol's efficacy and previously discussed safety profile is another point of differentiation. In clinical studies, nearly nine out of 10 patients achieved complete absence of postsurgical pain and six out of that achieved complete absence of inflammation within 15 days post ocular surgery. And the incidence of all side effects was below 2%. Moreover, twice a day dosing without titration is a benefit all patients can understand, especially versus other treatments, which require dosing up to 4x a day. This is particularly important thus eye surgery patients were often on multiple drugs during recovery. So, any advancement which simplifies the treatment regimen would be welcomed by eye doctors and patients alike. It is estimated that there are more than 7 million ocular surgeries in the U.S. each year with topical ocular steroids and steroid combinations currently totaling $1.3 billion in sales. So, this is a very significant market opportunity for us and one that we think we can capture a mid-single-digit market share over the next three to four years. We continue to prepare for a robust commercial launch of clobetasol later in the summer. And longer term, we see a potential opportunity to develop a formulation of clobetasol for our Optejet dispenser as a treatment for acute dry eye. To that end, we plan to engage with the FDA in the coming months to discuss the path forward in that indication. Lastly, some of you have asked me about the brand name for clobetasol. That trade name is currently being reviewed by the FDA, and we expect the decision from the agency later in June for our launch. Staying on the topic of dry eye for a moment, in late February, we entered into a collaboration agreement with SGN Nanopharma, an innovation-led clinical-stage nanopharmaceutical company, focusing on creating impactful best-in-class nanotherapeutics, targeting large unmet medical needs. As we aim for proprietary micellar nanoparticle platform, the MNP platform allows for the distribution of an active pharmaceutical ingredient into three or more phases, thereby improving its bioavailability, biodistribution and pharmacokinetics. For the terms of the agreement, Eyenovia will conduct feasibility and process manufacturing testing with SGN's Phase III-ready ophthalmic cyclosporin formulation, SGN-101, in combination with the Gen 2 Optejet device as a potential treatment for chronic dry eye. Dry eye is a very significant market opportunity with some external sources valuing it at $3.6 billion annually in the U.S., a combination of a faster working cyclosporin and the Optejet could be a powerful addition into this large and underserved market. For the SGN collaboration, we may have a Phase III-ready asset next year in chronic dry eye. As part of our collaboration, SGN will seek independent funding towards advancing the development of this candidate. I'll now provide an update on Mydcombi, first and only FDA-approved fixed combination of two popular pupil dilation drugs, tropicamide and phenylephrine and the first approved ophthalmic spray using the Optejet platform. We are midway through the hiring and training of our 12-person sales force, and we have satisfied state licensing requirements in states covering over 2/3 of the U.S. population for the distribution strategy to reach offices in those states where we do not yet have a license. The sales force has been out for five weeks now since their training and are making inroads into this market. The sales process requires demonstrating and training the office staff on the use of Mydcombi, which is not difficult, but it's important to make sure that these offices have a great initial experience and realize all of the benefits of the technology. To date, they have trained and converted about 50 offices, many of whom you'll see in our social media stream as they talk about their experience with the product. We have also partnered with these offices in a waiting room promotional campaign showing how they use Mydcombi because they care about their patients. And we plan on collecting market research information from these same offices so that they can bolster their own practice satisfaction scores. There are a number of reasons why offices and institutions like the University of California and Premier buying groups like Vision Source have turned to Mydcombi. With Mydcombi, the dilation process is needed since the spray amount is a fraction of what's in an eye drop. It's comfortable with virtually no stinging reported in clinical studies. It's hygienic with no protruding tips that could accidentally touch one patient and then another when using the same bottle and it works reliably and quickly. To further demonstrate the potential benefits of Mydcombi, we recently completed a Phase IV study to characterize the lowest effective dose to achieve mydriasis. For certain eye care patients, the current standard of care mydriasis eyedrops could present safety and tolerability risks, including potential systemic cardiovascular side effects in older patients, particularly those with high blood pressure. In this Phase IV study, 29 subjects were treated with a half dose of Mydcombi or 8 microliters per eye. We won't recap all of the positive results again, but 2/3 of subjects at treated clinically relevant pupil dilation within 30 minutes post-dose, and 83% achieved relevant pupil dilation at 60 minutes post dose. Importantly, the lower dose of Mydcombi was safer well tolerated with only three subjects reporting mild installation site pain and one with mild dry eye upon installation. And interestingly enough, most patients return to a functional pupil size as soon as 3.5 hours after the drug was used. The duration of pupil dilation is sometimes an issue for patients, especially those that may need to get back to work. So, this finding should help eye doctors determine what might be best for an individual patient. Turning now to our overall sales and marketing initiatives to complement the efforts of our sales team. We entered into a co-promotion agreement with NovaBay Pharmaceuticals to cross promote clobetasol to hundreds of eye care professionals through its telephone-based sales force. At the same time, our field sales force will promote their prescription, Avenova Antimicrobial Lid & Lash Solution to our doctors who can include this product in their suite of pre and postsurgical offerings. In addition to the benefit of the promotion and potential sales for both sides, each party will also get a percentage of the sales that they generate. This is an extremely cost-effective way to boost our commercial sales reach, and we believe this agreement will be very beneficial to both parties. This agreement with NovaBay complements our recent announcement with Vision Source, that Vision Source has added Mydcombi as an approved product for its membership of more than 3,000 locally owned optometry offices. So, while our own sales force is targeted, this agreement allows us to significantly expand our commercial reach, particularly in more rural areas where we may not be providing direct sales coverage currently. We are already seeing sales have been coming to Vision Source member offices. Before turning the call over to Bren to provide a manufacturing update, I will conclude with a recap of recent national ophthalmology medical meetings that we participated in. The first was the American Society of Cataract & Refractive Surgery Annual Meeting, or ASCRS in Boston. During ASCRS, we featured our entire suite of commercial products, Mydcombi, clobetasol and Avenova. Both our sales and medical affairs teams were present to demonstrate the products review data, answer questions and provide attendees for the opportunity to purchase these products on site. We also attended Vision Source Exchange in Orlando. Vision Source Exchange is the country's largest gathering of private practice optometrists with more than 1,000 of the most successful ODs in the nation. The event featured continuing education keynote speakers exchange-only pricing for more than 100 vendors and opportunities to network with colleagues who were on hand to demonstrate and sell Mydcombi there as well. And just recently, we delivered the presentation at the Association for Research in Vision and Ophthalmology 2024 Annual Meeting or RVO. The presentation detailed results from a study demonstrating that Formosa's APN technology on which the development of clobetasolid base, improves the solubility and bioavailability of topical ophthalmic medications. APMT much like our Optejet Dispenser, represents an exciting new attain technology, and we are thrilled to feature both in our product portfolio. Our presence at national medical and commercial meetings like these are key to raising awareness of the breadth of our product portfolio and are a critical component of our commercialization strategy. We plan to attend more such meetings later this year. At this point, I'd like to turn the call over to our Chief Operating Officer, Bren Kern, for our manufacturing update. Bren?