Kevin Gorman
Analyst · Piper Jaffray. Please go ahead
Thank you very much, Tim. I couldn’t agree with Tim more that this is the transformational year for Neurocrine, as described in his comments about turning the Company from being solely an R&D-based company over to now a fully integrated commercial company. What I’d like to do now is to turn the call over to Chris. And so, Chris can give you his thoughts and views on the recent release by AbbVie and also an update on all of our R&D programs. Chris?
Chris O’Brien: Thanks, Kevin. And thanks to the participants who are joining the call. I’m going to talk about four programs, elagolix, tardive dyskinesia, Tourette syndrome, essential tremor, and also CAH, so will cover the full spectrum. With elagolix, the press release yesterday I think said it all, really positive results. And I want to put this in perspective. If you think about what’s happened in the field of women’s health over the last decade or more, there have been very few breakthroughs that have approached some of the unmet medical needs in women’s health. And when you think about the fact that we have both the Violet Petal study and the Solstice study as two very large, more than 800 women each, clinical trials with positive results in the form of statistically significant and clinically meaningful benefit for both co-primary endpoints, both doses, and both time points at month 3 and month 6. This is big news. And it’s gratifying to see such an important outcome in women’s health. It’s very complementary of AbbVie for releasing some additional detail around data from this trial in this most recent press release. And when you look back at these results and then the prior Phase 3 pivotal trial results, and then even before that the Phase 2b Daisy Petal study run by Neurocrine, these results all angst together. They show efficacy for dysmenorrhea and non-menstrual pelvic pain. They show what appears to be a very reasonable safety and tolerability profile. And this is no small feat. I mean when you think about endometriosis-associated pain, while we’re dealing with a women’s health issue and an endocrine target, we’re really talking about chronic pain studies. And they’re not easy. I mean we’re very familiar with how challenging it is to deal with neuropathic pain, for example. And, in fact while dysmenorrhea is more akin to acute pain that is pain with menses, non-menstrual pelvic pain occurs the rest of the time outside of the menstrual period and is much more like neuropathic or chronic pain syndrome. So, to see this kind of separation of responders with elagolix from the placebo group with such robust and statistically significant result is really quite remarkable. So, we are pleased with that. The other point that I think is worth noting is that AbbVie has shown some of the preliminary bone mineral density data. And, again, consistent from our Petal study, the 603 study that Neurocrine had run, we were looking at 150 milligram dosing for six months and then the current Solstice and Violet Petal studies, we see a very nice profile that angst together showing minimal impact on bone at this dose. And, as AbbVie has said, there is dose related suppression of estradiol or hormones with the higher 200 milligram bid dosing, and you see a corresponding impact on BMD. So, very good results. They are going to be presenting in much more detail around this at scientific meetings. I think the next planned presentation is at the American Society of Reproductive Medicine, the ASRM meeting coming up in the fall. And I’m sure that this will be an opportunity to dig into this a little more. And we’re very excited that they’re planning on the targeted NDA submission on elagolix for the treatment of endometriosis associated pain in 2017. So, really congratulations to AbbVie and the teams there, and good news for women’s health overall. So, let’s move now to valbenazine. We’ll talk about both tardive dyskinesia and Tourette syndrome. I think the last time we had our conference call, we had an opportunity to talk about the Kinect 3result. And, as we had a very good efficacy results from that trial. The primary endpoint was a reduction in dyskinesia as measured by the Abnormal Involuntary Movement Scale, and we saw very robust reduction in dyskinesia, highly statistically significant and a very nice responder rate. That data has been shared with the FDA and we are currently in the process of winding down the extension phase of the Kinect 3study. As you may recall, after the placebo controlled treatment period, subjects continued in the extension period on either 40 or 80 milligrams of valbenazine. And that study is winding down over the next couple of months. At the same time, we have continued with the Kinect 4 study. And this is the open label one-year safety trial with 40 and 80 milligrams of valbenazine. We’re just in the process of winding down enrollment now as we speak. And this study is going well. We have approximately 60 sites in North America running this trial. We’ve been very pleased overall with the general safety and tolerability to-date. And we will continue to collect long-term safety data of this trial. We are also taking advantage of the fact that we still have our independent data safety monitoring board, a group of expert consultants who continue to look at our safety data from our Phase 3 trial and keep us informed of their impression about this safety and tolerability of the drug. And their last meeting just recently again encouraged us to carry on with the program as is. And as we mentioned before, with the wealth of data that we now have from Kinect 3 and also data that we have from prior studies, Kinect 2 for example, we have been delving into additional analyses and multiple ways of looking at the data, understanding how to translate this into meaningful information for clinicians. And we have submitted or are in the process of submitting multiple abstracts and manuscripts for these analyses. And we will be planning on presenting detailed data at upcoming meetings, such as the neurology and psychiatry meetings in the first half of this year. And all of these meetings have their own kind of embargoes on when the details of that can be released. So, I can’t really say anything about it until the time comes. But we look forward to sharing the details of our programs at upcoming meetings. I think we also talked recently about the Tourette syndrome program. We had the T-Force study, which was the Phase 1b trial in children with Tourette syndrome. We were very pleased with that outcome, as you’ll recall. Our main purpose was safety, tolerability and PK. We got what we needed from that and allowed us to proceed into the next placebo controlled Phase 2 trial. And we were also pleased that the pharmacodynamic assessment of tic and tic severity for Tourette syndrome in those in open label trial showed us what we would anticipate a nice reduction in tic severity even after just two weeks of treatment and a fairly robust percentage of responders, more than half of the kids in Phase 1b study would be considered a responder in a normal controlled trial. So, with that good data behind us, we got approval to go ahead and start the Phase 2 studies. The T-Force study is the adult Tourette trial, placebo controlled trial. Currently recruiting patients and the T-Force GREEN study is the pediatric placebo-controlled trial. We had a successful investigator meeting to kick off the start of this study a couple weeks ago, and screening is this month, and dosing shortly thereafter. So, these trials are up and running. I think as Kevin has said from the podium before, we’d like to see data from these trials turn of the year -- end of this year, turn of the year. It’s hard for me to know yet which one is first, but if I were to bet, I would bet on the pediatric one being a little easier to recruit since 80% of Tourette patients are children and 20% are adults. So, it’s a little easier to recruit for Tourette syndrome trial. And frankly, the interest level from parents and families on the Tourette syndrome association is very strong for new and well-tolerated treatment option for children. So, those are going well. That’s the valbenazine program. Next to talk about is the essential tremor program. We have successfully completed the first couple of cohorts of our single ascending dose trial and that will finish up shortly. The way you’ll know that we’re happy with those results is when we tell you about starting the multiple ascending dose trial, which we would anticipate after successful completion of the single ascending dose trial. So, that is going well so far. Obviously early days, but we’re excited to have a new molecule with a new mechanism of action in the clinic and for a very large unmet medical need. There is something like 8 million people with essential tremor in the U.S., which is 10 times the number of people with Parkinson’s disease. And last up then is our CAH program. As we’ve discussed before, our initial compound which we numbered as 860, had a nice signal in our early pilot study. But then we have finding in a juvenile toxicology study, which we felt important to conduct before we had gone into children. And because of that we decided to take 860 out of clinical development and move in one of our backup compounds. We have several to choose from. The one that we’re -- we plan on having one open as a new IND within the next year, hopefully later this year and that compound would then be moved into CAH trials. So, that program suffered a setback with 860, but that’s the nature of drug discovery and development. While we have extensive experience with that compound in toxicology studies, standard toxicology studies, no one had ever done a preclinical juvenile tox study. And as we mentioned earlier in our press releases and phone calls that really with abundance of caution we want to be sure we’re very comfortable with what we take into the clinic with young children with this orphan disease. And so we’re very excited to move this backup compound along. It’s cleared its hurdle of juvenile tox and now we are embarking on things we need to open the IND to get into the next set of clinical studies. So, I think I’ll pause there, turn it back to Kevin, and I look forward to your questions.