Craig Granowitz
Analyst · Citi. Please go ahead
Thank you, Jeff. As we discussed during our last quarterly call, the primary endpoint of the RELIEF-DPN-1 study was achieved with a statistically significant reduction in the average daily pain score or ADPS, at week six compared to placebo in the low-dose arm. There was an absolute reduction in ADPS from baseline of 1.39 points with a p-value of 0.007 compared to placebo. The high-dose arm achieved a reduction from baseline of 1.27 points with a p-value of 0.03 compared to placebo, narrowly missing the significant threshold of 0.028 but showing consistent effects. As announced at the 16th Annual Pain Therapeutics Summit in Washington, D.C. this past November, not only did LX9211 achieved the primary objective of the study by reducing patients’ average daily pain score, but the final data demonstrated significant positive effects of LX9211 on measures that are meaningful to patients suffering from diabetic peripheral neuropathic pain, including burning pain and sleep interference, which have a direct impact on patient quality of life, as is shown in the attached slides. We also noted during the blinded five-week placebo runoff period in the study, there was a gradual tapering of efficacy in both treatment arms with no evidence of rebound pain or withdrawal symptoms. There were no observed differences in treatment-emergent adverse events between the treatment and placebo arms during the runoff period and no drug-related serious adverse events or deaths were reported in the trial. Now turning to the results of our second Phase 2 proof-of-concept study in postherpetic neuralgia, RELIEF-PHN-1. As we announced in December during our call, reporting the top-line results from the trial, LX9211 achieved a reduction in average daily pain score of 2.42 points from baseline at week six and compared to a reduction of 1.62 points in the placebo arm with a placebo-adjusted difference of 0.8 points and a p-value of $0.12. Although these results did not achieve significance on the primary endpoint of the study, overall study results demonstrated clear evidence of effect and achieved our goal for this small 79-patient study that further support the further development of LX9211 in another neuropathic pain condition. As Lonnel mentioned, when reviewing the data of both the RELIEF-DPN-1, and RELIEF-PHN-1 studies, we noted a remarkable consistency across the study results. When placing the graphs from the two studies side-by-side, the separation from placebo and mean change from baseline create similarly shaped curves. In addition to the timing and the magnitude of clinical benefit, we observed an adverse event profile that was consistent across both trials. To summarize, treatment-emergent adverse events were generally mild-to-moderate. There were no drug-related serious adverse events in either study. Finally, dizziness was the most commonly reported treatment-emergent adverse event. What we did not observe in the safety profile of LX9211 were some of the limitations of current therapies for neuropathic pain, such as peripheral edema, increased appetite, blurred vision or dry mouth. The adverse events tended to occur early in treatment, suggesting the possibility that might be associated with the loading dose. And given the rapid onset of effect on ADPS, offering potential for further optimizing dosing for both tolerability and efficacy effects that we are currently exploring. In conclusion, we have now completed two Phase 2 proof-of-concept studies of LX9211 that support AAK1 inhibition as a potential new mechanism of action for treating neuropathic pain. We believe that LX9211 has the potential to overcome many of the shortcomings of current therapies and could become a welcome new innovation for those suffering from neuropathic pain on a daily basis. This is a large and growing market with high unmet medical need. As a result, we are pursuing the rapid advancement of LX9211 into Phase 3 development for the treatment of neuropathic pain. We are continuing the work to identify and optimize the proper dosing regimens, and we are preparing to engage in the dialogue with the FDA in the first half of this year on how best to advance the program into Phase 3 development as quickly and efficiently as possible. As we have shared previously, we believe this program would benefit from a partnership that offers the right strategic fit for our organization and stakeholders, and we are engaged in discussions in this regard, which we believe will yield a positive outcome. In the meantime, we are proceeding with our plans for further development without cause. I’d like to now turn the call back to Jeff to take us through the financial results for the fourth quarter of 2022.