Kristen Buck
Analyst · Brookline Capital
Thank you, James and good afternoon everyone. I'm excited to join you today on my first Caladrius quarterly conference call and look forward to engaging with all of you in person in the months and years ahead. My focus throughout the first months at the company has been spent on evaluating and refining development strategies for existing programs in order to maximize the probability of clinical and commercial success, all while minimizing the capital outlay needed to achieve the next developmental milestone in each program. In addition, I've been immersed in the company's search for new assets to add to our development portfolio, both to diversify development risk and to increase development opportunity. As most of you know, Caladrius is focused on the development of autologous cellular therapies that are designed to both treat and/or reverse disease. We have clinical programs underway based on a large database of human clinical data. To date, our therapies have shown strong signs of efficacy and durability with an excellent safety profile, unlike many allogeneic therapies. Importantly, we believe that curative cell therapy products, when applied to the right indication and at the right price, can restore human health and improve quality of life with a single administration of the therapy, rather than a treatment that requires frequent re-administration. Our CD34+ cell therapy technology has led to the development of therapeutic product candidates designed to address diseases and conditions caused by ischemia, a condition in which the supply of oxygenated blood to healthy tissue is restricted. Previously published preclinical and human clinical studies have demonstrated that administration of CD34+ cells induces angiogenesis of the microvasculature. That is these cells prompt the development of new blood capillaries, thereby contributing to the prevention of tissue death by facilitating blood flow to the area of ischemic insult. We believe that several conditions caused by underlying ischemic injury can be improved through the application of our CD34 cell technology, including, but not limited to, critical limb ischemia we call CLI and Buerger’s disease, coronary microvascular dysfunction or CMD, and diabetic kidney disease known as DKD. That said, I will now expand on each of our clinical programs in numerical order kicking off with CLBS12 HONEDRA in Japan, our product candidate for the treatment of CLI and Buerger’s disease. HONEDRA was awarded a SAKIGAKE Designation from the Japanese regulatory authorities for the treatment of CLI in Buerger’s disease an orphan size subset of CLI. The SAKIGAKE Designation is akin to an RMAT Designation in the United States and affords the recipient prioritized regulatory consultation, a dedicated review system to support the development and review process, including the option of a rolling registration submission, as well as reduced review time of six months for the registration application once filed. Additionally, under Japan's regenerative medicine guidelines, products such as HONEDRA are eligible for early conditional approval and possibly full approval in Japan based on the assessment by the regulatory authorities over the data from the trial or trials designed in direct collaboration with the Japanese PMDA. Note the conditional approval of SAKIGAKE product only requires the demonstration of a trend towards therapeutic effect together with acceptable safety. Now as you might expect, the SAKIGAKE Designation is a highly sought regulatory classification in Japan. And we hope that this, coupled with positively trending data from our trial will make HONEDRA, an attractive product for partnering to a Japanese pharmaceutical company. The company study of HONEDRA in Japan for the treatment of CLI and Buerger’s disease has shown positive results to date. The initial response is observed in the subjects who have reached an end point in this study, are consistent with a therapeutic effect and safety profile previously reported in published clinical trials in both Japan and the United States. However, as discussed in prior quarters, the multiple states of emergency declared by the Japanese Government over the last 18 months due to the COVID-19 pandemic have made incremental enrolment exceedingly challenging. While the trial is demonstrating positive trends in both efficacy and safety, which are the key criteria for consideration of conditional approval in Japan under the SAKIGAKE Designation, we have concluded that is in the company’s and our shareholders best interest to suspend our enrolment efforts with the objective of minimizing the operational and financial burden that we have and continue to incur due to enrolment delays and the lack of visibility on time to completion. Our near-term focus in Japan will be on securing a partner to complete the study by enrolling the four remaining, no option critical limb ischemia subjects if deemed necessary and or to explore the possibility of submitting the existing data to the Japanese regulatory authorities under the SAKIGAKE Designation. Now earlier this year, we reported that the United States Food and Drug Administration, the FDA, granted Orphan Designation to CLBS12 as a treatment for Buerger’s disease. We've very recently received a response from the FDA regarding our briefing document and questions about our potential CLBS12 development program in the United States for Buerger’s disease. The FDA's response has led us to believe that a clinical program of some size and cost would be required for U.S. approval. Especially since they felt that the existing data out of Japan would not be representative of the Buerger’s disease patients in the United States. Based on that guidance from FDA, we have decided not to pursue the development of CLBS12 in Buerger’s disease in the U.S. at this time. Turning now to XOWNA, CLBS16, for the treatment of coronary microvascular disease, CMD. CMD is a disease that continues to be under diagnosed and potentially afflicts millions annually, a vast majority of whom are female with no current treatment options. The company is committed to raising awareness of this growing women's health crisis and finding an effective treatment. In May of 2020, Caladrius announced the full data results from the ESCaPE-CMD trial at the Society for Cardiovascular Angiography and Interventions 2020 Scientific Sessions Virtual Conference, showing a highly statistically significant improvement in coronary flow reserve correlating with symptom relief for patients with CMD after a single intracoronary injection of XOWNA. Subsequently earlier this year the company initiated and is currently treating patients in a rigorous Phase 2b clinical trial known as the FREEDOM trial, which to our knowledge is the first controlled regenerative medicine trial in CMD in the United States. The FREEDOM trial is a double-blind, randomized, placebo-controlled trial designed to assess the efficacy and safety of delivering autologous CD34 cells, our XOWNA product to key subjects with CMD and without obstructive coronary artery disease. Investigator and potential subject response to the FREEDOM trial has been favourable and while early enrolment in the trial proceeded as planned with the first patient treated in January of 2021, the impact of the COVID-19 pandemic in the United States has contributed to the general slowing of enrolment to date. In an effort to accelerate enrolment, the company has expanded the number of participating investigational sites and modified the study protocol to broaden the array of available techniques acceptable for diagnosing CMD and thereby opening trial participation to a much larger number of sites throughout the U. S. This and other protocol amendments intended to facilitate enrolment were implemented in the latter part of the quarter, after agreement with the FDA and we will assess the impact of the protocol changes on enrolment in the coming months at which time we expect to provide an update on enrolment feasibility and completion with final data expected approximately six months after last patient last visit in the study. Lastly and most recently, proposed development program for CLBS201 for the treatment of diabetic kidney disease, DKD. The company plans to initiate a Phase 1 open label, proof-of-concept trial evaluating CLBS201, a CD34+ regenerative cell therapy for intra renal artery administration in patients with DKD. Although still pre-dialysis, these patients exhibit rapidly progressing stage 3b disease. Progressive kidney failure is associated with attrition of the microcirculation of the kidney and pre-clinical studies in kidney disease and injury models have demonstrated that protection or replenishment of the micro circulation results in improved kidney function. The protocol pending final approval from the Institutional Review Board calls for an open label, staggered, sequentially dosed cohort of 6 patients overseen by an independent Data Safety Monitoring Board. A key read out of the data will occur at the six months follow up visit for all patients. The company projects enrolment of this study to begin in the first quarter of 2022 with data from all subjects expected by the first quarter of 2023. Finally, as I mentioned previously, we are in the midst of a concerted effort to identify and secure an additional development asset or assets to complement our current portfolio of product development candidates. Based on the quality and breadth of available opportunities, as well the continued advancement of our existing development portfolio, I am excited about our prospects and see a bright future ahead of us for Caladrius and I look forward to discussing specifics with you in the future. With that I will now turn the call over to Dave.