Jerome Jabbour
Analyst · BTIG
Thank you, Peter. Good morning, everyone, and thank you for taking the time to join us today as we provide a business update and discuss our 2020 third quarter results. Overall, we made great progress across our entire business during the third quarter, which was marked by several very important accomplishments.
First, as everyone is aware, in July, we commenced Part 2 of the EnACT study with MAT2203 dosing in the first cohort of 10 patients. Taking all necessary steps and precautions to initiate dosing, following a temporary pause due to COVID-19, was a key objective for the company in the third quarter.
More recently, we completed this portion of the study, and in October, the independent Data and Safety Monitoring Board, or DSMB, reviewed the first cohort data and unanimously recommended progression into the second patient cohort. This was a significant milestone for the company and provides great optimism as the EnACT study moves forward.
Our enthusiasm is not only focused on the development of MAT2203 as the potential gold standard for the treatment of invasive fungal infections, but also extends to our overall LNC platform and the potential broad therapeutic applications that are available for medicines that can be orally administered with less systemic toxicity and with targeted intracellular delivery.
I will go into more detail on EnACT and our LNC platform shortly. But we believe that the market has yet to fully appreciate the differentiating characteristics of our LNC platform and the significant challenges that it may be poised to solve. Challenges that lipid nanoparticles and viral vectors have unfortunately not been able to overcome despite widespread adoption.
Second, we completed enrollment in the ENHANCE-IT study, a second head-to-head comparative study of MAT9001 versus Vascepa. We continue to be on track to report top line data from this study in the first quarter of 2021.
Lastly, we had a very successful end-of-Phase II meeting with the FDA and are fully aligned with them on the key elements of our Phase III development program for MAT9001, which we expect to initiate in the first half of 2021. I will go into more detail on our MAT9001 program and recent FDA interaction later in the call.
Let's begin with MAT2203, our lipid nano-crystal or LNC, formulation of the highly potent broad spectrum antifungal drug, amphotericin B, currently in Phase II development in the EnACT study, which explores the use of MAT2203 for both induction and maintenance treatment of cryptococcal meningitis in HIV-infected patients in Uganda.
The EnACT study, which is financially supported by the National Institutes of Health, has 2 distinct parts. The first part focused on safety and was completed late last year and demonstrated that MAT2203 was well tolerated and safe in subjects infected with HIV, but whom did not have an active cryptococcal meningitis infection.
Coming out of the first part, we identified the highest possible tolerated dose to then bring forward into the second part of EnACT, which is designed to assess both safety and efficacy of MAT2203 in HIV patients with an active cryptococcal meningitis infection. This second part of EnACT is divided into 4 distinct patient cohorts with sequential adjustments to the timing of MAT2203 and the duration of exposure to IV amphotericin B, the existing standard of care for patients with cryptococcal meningitis.
Cohort 1 of the EnACT study got underway early in the third quarter of this year and included 10 patients on active treatment, who initially received 5 days of IV amphotericin, followed by 9 days of MAT2203 to complete the normal 14-day induction period. Thereafter, patients continued MAT2203 as maintenance therapy for an additional 4 weeks.
In October, the EnACT DSMB reviewed both safety and efficacy data from the first cohort of patients and unanimously recommended moving forward into the second cohort of 40 active treatment patients. Based on our discussions with the principal investigator and given the vulnerability of this patient population, we believe that the DSMB would need to see a combination of favorable safety and efficacy data in order to advance the study to the next cohort.
We are very optimistic as we head into cohort 2, where patients will receive only 2 days of IV amphotericin before transitioning to 12 days of MAT 2203, again, followed by 4 weeks of maintenance therapy on MAT2203.
We believe cohort 2 will provide even more insight on the potential for MAT2203 in this deadly disease. Enrollment in cohort 2 is expected to begin shortly following local IRB approval and the DSMB evaluation of data from completed cohort 2 is anticipated to occur by the middle of 2021. We believe that as we consider the broader implications for EnACT on both the development of MAT2203, as well as for the future of our LNC platform, it is important to provide some context on how an oral, less toxic and well tolerated amphotericin B could provide substantial value to both patients and providers.
First, I would like to comment on the overwhelming preference patients have indicated for oral MAT2203 versus IV amphotericin so far in EnACT. The results of the first phase of EnACT were published in the Journal of Antimicrobial Agents and Chemotherapy in September, and highlighted that 96% of subjects preferred taking MAT2203 as compared to IV amphotericin. Anecdotal feedback from the first cohort of patients in Part 2 of EnACT suggests a similar preference.
Second, an orally administered, less toxic and better tolerated formulation of amphotericin B would provide much more flexibility for treatment and can decrease the cost and complexity of care through reduced hospital stays, fewer hospital-acquired infections, and most importantly, fewer amphotericin related side effects with less treatment limiting toxicities.
A 2014 study reported that up to 85% of the cost of IV amphotericin associated hospitalizations for invasive fungal infections arose from managing side effects of this drug. A better tolerated oral option could dramatically improve the patient experience, could provide more options for treating disseminated fungal infections and could substantially reduce the cost of care associated with treating these deadly infections.
Cohort progression in the EnACT study is not only an important milestone for the development of MAT2203, but also yet another critical step forward in validating the enormous clinical potential of our LNC platform. The DSMB's unanimous recommendation to move forward is a promising sign that our LNC formulation of amphotericin B is both safe and potentially capable of crossing the blood-brain barrier to deliver drug to an active infection in the brain.
This has important, positive, broader implications as we consider extending this technology to target other diseases and conditions where highly effective therapies may have significant drug delivery challenges and/or treatment limiting toxicities.
Our LNC formulation of amphotericin B represents a true gateway opportunity for both advancing the standard of care of patients with life-threatening fungal infections and as a tangible demonstration of the potential significant and far-reaching capabilities of our LNC platform.
With our recent cohort progression in EnACT and the anticipated DSMB evaluation in the middle of 2021, we are very close to delivering data, which could represent a transformational opportunity for Matinas.
Turning next to MAT2501, which uses our LNC platform to orally deliver the broad spectrum and potent aminoglycoside drug amikacin, which is commonly used to treat both chronic and acute bacterial infections. We remain particularly enthusiastic about MAT2501 given its favorable profile and the significant unmet medical needs it potentially addresses.
For example, an oral, less toxic and well tolerated aminoglycoside would allow physicians to treat gram-negative infections quickly and effectively without the need for lengthy hospital stays, repeated infusions and debilitating side effects. In fact, MAT2501, if approved, would become the first oral aminoglycoside available to physicians and patients.
MAT2501 has been positioned for an initial indication for the treatment of nontuberculous mycobacterial lung disease or NTM. NTM infections have emerged in recent years as an increasing problem to individuals with cystic fibrosis and other pulmonary diseases, and they are increasingly resistant to most available antibiotics and becoming extremely difficult to treat.
Moreover, achieving adequate levels of drug in lung tissues can be very challenging, especially in patients with cystic fibrosis. Current therapies are limited and can be highly toxic to patients. MAT2501 is formulated to address these limitations and provides a therapy which is well tolerated, orally bioavailable and demonstrates efficient intracellular delivery.
We believe that once delivered into a cell MAT2501 is transported by cells directly into the lung at the site of infection, resulting in efficient delivery and less toxicity than observed with other treatments. This profile is exactly what initially attracted the interest of the Cystic Fibrosis Foundation, with whom we have been working since 2016.
As previously guided, we applied to the Cystic Fibrosis Foundation earlier this year to help support the continued development of MAT2501, and we expect a decision imminently. In the interim, we have reformulated and potentially improved MAT2501 from its first iteration and stand ready to commence a series of preclinical toxicology studies and a single ascending dose Phase I study with this promising new formulation. With the continued support from the Cystic Fibrosis Foundation, we plan to be in position to begin Phase II in 2022.
We draw confidence from the clinical and commercial success of Insmed's ARIKAYCE as we determine both the viability and large market opportunity for MAT2501. ARIKAYCE, which administers amikacin through an inhaler, was approved under FDA's new LPAD pathway, but has significant limitations in its indicated use, including not being able to be used in cystic fibrosis patients.
Further, it is accompanied by a comprehensive black box warning related to toxicity and the potential for serious adverse events in patients. We believe that MAT2501, if approved, would represent a significant improvement over ARIKAYCE and other treatments for chronic pulmonary infections, giving patients and physicians an effective oral alternative in the fight against NTM. And unlike ARIKAYCE, MAT2501 would also potentially be able to treat more acute bacterial infections like gram-negative bacterial infections, which generally occur outside of the lungs.
Before moving to a discussion of MAT9001, we would like to provide brief commentary on our broader ongoing LNC platform collaborations, where we continue to make good progress despite the impact that COVID-19 has had on the short-term strategic priorities of some of our collaborators.
We continue to work very closely with Genentech in developing formulations of multiple molecules per our existing agreement. We are encouraged by the limited data we have seen, although we are precluded from commenting further under the terms of that agreement. However, Genentech recently approached us and extended our agreement for at least another year, which we believe is indicative of progress to-date and the continued enthusiasm shared by both organizations for the potential benefit our LNC platform technology can provide.
We continue to aggressively explore opportunities through the National Institute of Allergy and Infectious Disease to utilize our LNC platform in the fight against COVID-19 and remain optimistic that we will be a meaningful participant soon.
Finally, as we advance MAT2203 and MAT2501 and generate important clinical data, we continue to receive increased interest from potential partners on those assets as well as other potential applications of our LNC platform delivery technology, both inside and outside the United States.
We believe that establishing collaborations and licensing relationships on these assets, especially outside the United States, could be a significant opportunity for Matinas in the coming quarters. These discussions and relationships, obviously, take time to develop and formalize, but we are very pleased with the interest expressed to-date and the quality of the potential partners.
Now, I will turn to MAT9001. As I mentioned at the beginning of the call, there are 2 very important milestones for our MAT9001 program during the third quarter that are worth mentioning. First, we completed enrollment in ENHANCE-IT, our second head-to-head crossover comparative study of MAT9001, our next-generation prescription omega-3 therapy versus Vascepa.
This clinical trial will directly compare MAT9001 and Vascepa's effectiveness in reducing triglycerides and their effect on other important direct and indirect lipid markers such as PCSK9 as well as blood levels of eicosapentaenoic acid, or EPA, and other omega-3 fatty acids.
Despite the challenges presented by COVID-19, we continue to expect top line data from this trial in the first quarter of 2021. Given the complexity of the continually evolving omega-3 market, the ability to show differentiation and potential head-to-head superiority versus Vascepa is extremely important. We believe we are in the final stages of exactly the right study at exactly the right time to again demonstrate the overall superior profile of MAT9001 to Vascepa and any other prescription only omega 3, including generic copies of those drugs.
Second, following an end-of-Phase II meeting and review of the official minutes, we believe we are aligned with the FDA on key next steps for MAT9001 Phase III development program and the 505(b)(2) registration pathway for an initial indication to treat severe hypertriglyceridemia, which is patients with triglyceride levels at 500 or above.
The main agreed upon elements of a Phase III program to support an NDA filing include: one, approval to go directly into a Phase III study without any additional clinical work; Two, the requirement for a single 12-week study to support efficacy in severe hypertriglyceridemia; and Three, flexibility in the totality of patient safety data needed to meet regulatory requirements for NDA submission.
We continue to evaluate several ways to both meet these requirements and to potentially provide additional data, clinically differentiating MAT9001 from other prescription omega-3 drugs, and we remain on track to initiate our Phase III program for MAT9001 in the first half of 2021.
As Amarin recently restated its commitment to continue to educate physicians on the benefit of EPA and to expand the market for Vascepa and branded omega-3s in the face of generic competition, we continue to view MAT9001 as the potential best-in-class prescription omega-3.
MAT9001 was designed with the goal of clear differentiation in pharmacokinetics and impact on direct and indirect lipid markers, such as triglyceride and PCSK9. And we believe that ENHANCE-IT provides an important and near-term opportunity to validate the results from our first head-to-head study and separate MAT9001 from the rest of the omega-3 class.
I would now like to turn the call over to Keith Kucinski, our Chief Financial Officer, who will discuss our financial results for the third quarter.