Chris O'Brien
Analyst · Piper Jaffray. Please go ahead
Well, thanks Erik for the comments, thanks for the participants in the call this afternoon. As Kevin mentioned, I’ll provide some clinical updates on our pipeline specifically five programs, which are all moving along well. So let's start with the two valbenazine programs. First up tardive dyskinesia, you just heard about the commercial aspects of the INGREZZA launch from Erik, we are also very pleased with the engagement that our medical affairs team has been having with scientific leaders both in psychiatry and neurology. The medical affairs group has been successful with multiple manuscripts recently submitted for publication including the connect three long-term extension of data, which has been accepted and specific subtype patient analyses, psychiatric stability and other topics of clinical importance. We do anticipate sharing more data at upcoming scientific meetings including the American College of Psycho-Neuropsychopharmacology coming up later this year and a steady flow of data is planned in 2018. For Tourette Syndrome, we're very pleased that the FDA recently granted us orphan disease designation for valbenazine for pediatric patients with Tourettes. The clinical team is currently very busy with wrapping up the T-Force fusion study, which was that open label extension study, which followed T-Force screen. And the data from that fusion study is important because in conjunction with our exposure response modeling that we've got some T-Force screen study, we were able to come up with a sufficient set of data to design the T-Force GOLD study. So following the investigator meeting, which was held just in October, a couple weeks ago, the T-Force GOLD study is now enrolling pediatric patients. You can see it on clinicaltrials.gov. And as we noted in our press release last week, this new trial is a randomized double blind placebo controlled trial as one to one randomization of valbenazine and placebo. The controlled treatment period is for twelve weeks and it is being conducted all in the United States. The trial will randomize approximately 120 patients with Tourette syndrome and these are kids aged six through eighteen years of age. The design of the trial includes a dose optimization strategy and includes higher doses that were used in the prior Phase II study. Like our other trials, this also will offer an open label extension trial for those subjects, who complete the placebo controlled portion. We anticipate top-line data from the T-Force GOLD study in late 2018, obviously that's dependent on the rate of recruitment for that trial, so huge progress on that very excited about those patients beginning to enroll. Turning to Congenital Adrenal Hyperplasia. This Phase II clinical study with the molecule that we call NBI-74788 is about to begin. We are initiating sites as we speak and we expect top-line data in the first half of 2018. If you recall based on prior descriptions, our goal with this trial is to confirm proof-of-concept in adult patients with CAH. With that data in hand, we will then request a meeting with the FDA to discuss study design details for the pediatric study that we hope will follow. So we will have data readout in the – early in the first half of 2018 and keep you updated. And now turning to our opicapone program for Parkinson's disease, we requested and were granted a meeting with the FDA in January 2018 and this meeting is designed to confirm plans for the submission of the NDA of opicapone for the treatment of Parkinson's disease. As usual with these meetings, the FDA would then provide formal meeting minutes approximately one month after the face to face meeting. So we'll keep you updated on that. As Kevin mentioned, we are really happy with the progress with elagolix that has been made by our partners AbbVie. They have done a tremendous job in not only generating high quality data, but now beginning to share that data across a range of scientific meetings and publications. So after the really pivotal publication in The New England Journal of Medicine recently, they’re now rolling out additional long-term safety and efficacy data out through twelve months of treatment. And I won't go into all the details about the abstracts. You can read them for yourself from the American Society of Reproductive Medicine going on this week, but let me point out three key things that I take away when I look at these data. Number one, when you look at the efficacy of elagolix for the treatment of endometriosis in patients who have taken elagolix for a year, what you see is a remarkable persistence or maintenance of benefit such that with the primary endpoints of dysmenorrhea and non menstrual pelvic pain in these two large extension trials. It's remarkable to see this 70 to 80 – sorry 50% to 80% responder rate for both dysmenorrhea and non menstrual pelvic pain. That's remarkable. With a chronic pain syndrome that has been extremely difficult to treat often requiring surgeries, opiates and other forms of aggressive intervention to have this kind of responder rate is remarkable and this will resonate well with clinicians, who take care of these patients. As important or maybe more important is how patients feel and the tool used to assess this has been the patient global impression of change or the PGIC. After twelve months of treatment, the responder rates in these two long term trials range from 70% to 90% responders who described their responses as much improved or very much improved. So this is robust response as judged by the patients and really speaks to the potential impact that elagolix will have for women suffering with endometriosis. The flip side, the question that I was asked is what caused, what’s the safety profile and AbbVie has done a really good job talking about that. I would point out there are some very interesting data about bone mineral density in their presentations and if you look at for example Z-scores that are used to describe whether women’s bone mineral density is in the normal range or not, you see remarkable numbers and that women on chronic therapy with elagolix were up to a year are all in the normal range with their Z-scores. This is quite remarkable data very, very encouraging for the drug for the 200 milligram bid there – without add-back there is a slight widening of the confidence intervals around the Z-score that is suggesting that there are a few more patients with more measurable reduction in BMD on the higher dose. But in their follow up data after stopping drug, you see that the BMD tends to progressively return towards baseline in the post-treatment period for those high dose individuals. Lastly the only other comment I'd make is some remarkable data has been generated in the uterine fibroids studies. As you know there two replicate trials currently are being conducted with top-line data from those Phase III studies expected at the end of this year. The data presented by AbbVie at ASRM includes some really powerful data on the impact of elagolix on health related quality of life for women suffering with heavy menstrual bleeding and uterine fibroids. And again, the data here has really not been seen before in programs like this. This is a remarkable impact across all areas of the quality of life domains including activities, self-consciousness, sexual function, energy levels et cetera. So the kind of data that is important not just to physicians and patients, but also to payers. So congrats to our colleagues at AbbVie for such a outstanding work. So with that that’s an update on the five programs that are currently active in the clinic. I'll turn it back to Kevin and look forward to your questions.