Earnings Labs

NRx Pharmaceuticals, Inc. (NRXP)

Q2 2023 Earnings Call· Mon, Aug 14, 2023

$2.96

-2.31%

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Transcript

Operator

Operator

Good day and welcome to the NRX Pharmaceuticals Incorporated Second Quarter 2023 Earnings Conference Call. [Operator Instructions]. I would now like to turn the conference over to Mr. Matthew Duffy, the company's Chief Business Officer. Please go ahead, sir.

Matthew Duffy

Analyst

Thank you, Joe. Before we proceed with the call, I would like to remind everyone that certain statements made during this call are forward-looking statements under US federal securities laws. These statements are subject to risks and uncertainties that could cause actual results to differ materially from historical experience or present expectations. Additional information concerning factors that could cause actual results to differ from statements made on this call is contained in our periodic reports filed with the SEC. The forward-looking statements made during this call speak only as of the date hereof and the company undertakes no obligation to update or revise the forward-looking statements. Information presented on this call is contained in the press release issued earlier today and the company's Form 10-Q filed today, which may be accessed from the Investor page of the NRX Pharmaceuticals, Inc. website. Joining me on the call are Stephen Willard, our Chief Executive Officer; Jonathan Javitt, our Chief Scientist; and Seth Voorhees, our Chief Financial Officer and Treasurer. Stephen and Jonathan will provide a summary of the company's progress. Seth will review the company's financial results, and then Stephen will review upcoming milestones before making closing comments. Following their prepared remarks, we will address investor questions. I'll now turn the call over to Stephen.

Steve Willard

Analyst

Thank you, Matt. Good afternoon, everyone, and thank you for joining us. Our second quarter reflects an important inflection point for the company as we advance our novel NMDA platform. This expansion of our pipeline is driven by our signed partnership agreement with Alvogen and Lotus Pharmaceuticals related to the use of NRX-101, our breakthrough investigational medicine in bipolar depression with suicidality. The milestones and commitments within that partnership, as disclosed in our filings and described in the press release, provide the extensive financial resources needed to fund Phase 3 and commercialization of NRX-101 in this indication without additional dilution to our shareholders, should we deliver a statistically significant data readout. When we met with FDA last January, and FDA guided us to broaden our clinical indication and to develop a 1,500 person safety database, investors asked how we were going to fund this program. The Alvogen deal answers this question. In our previous calls, we have explained the urgent unmet need for a medicine to treat this group of patients who have a 50% lifetime risk of suicide attempts and who have been excluded from trials of all previous antidepressants. The urgent need is detailed on our website and validated by FDA and an award of breakthrough therapy designation and a special protocol agreement. As further validation of the life-saving applications of this therapy, this week, we published the previously announced results of STABIL-B in the International Journal of Bipolar Disorders, a peer-reviewed, high-impact journal published by Springer Nature. The lead author is Professor Andrew Nierenberg who leads bipolar research at Mass General Hospital. The article documents a nearly 8-point difference on the MADRS depression scale when NRX is tested against lurasidone, a difference approximately twofold greater than the difference seen when typical antidepressants are tested against placebo. Moreover,…

Jonathan Javitt

Analyst

Thank you, Steve. So as Steve shared with all of you on the phone, our near term priority remains the delivery of data for NRX-101 in bipolar depression with suicidality, sufficient to trigger the first $10 million milestone payment in our partnership agreement. As you know, we're the first pharmaceutical company to enroll patients with suicidal bipolar depression in a clinical trial of a potentially life-saving oral medicine. These are patients who have been excluded from the clinical trials of all previous anti-depressant drugs. The high-risk nature of this population has required us to take a high level of caution in recruiting, selecting, and monitoring the care of these vulnerable patients. In March, we advised you that the Independent Data Safety Monitoring Board identified no safety concerns and no futility. And now we're pleased to share with you that no unexpected serious adverse events have occurred in this high-risk population since that time. More importantly, clinical trials in psychiatry succeed or fail based on patient compliance with study medicine and the consistency with which depression and other key endpoints are measured from one study to another. And that the things I'm about to talk about are scientifically complex. We've posted a paper to the free-print service, which are free to read and reflect on what I'm about to say. So the quality metrics we're seeing in terms of study retention, safety, medication compliance, and rating reliability give us added confidence that the trial in which we are engaged has the potential to be submitted for drug registration should we prove efficacy. In other words, we don't know that the drug is going to work, but we do have increased confidence that we're measuring the results of the trial in such a way that we will be able to identify efficacy…

Seth Voorhees

Analyst

Thank you, Jonathan, and good afternoon, everyone. I will now review the highlights from our second-quarter 2023 financial results. In June, the company raised $6.3 million in a registered direct offering and negotiated an amendment with Streeterville Capital, the company's current debt holder, to address the company's current debt facility to best support the ongoing needs of the clinical trial. The amendment targets reduced monthly redemptions of the loan to $400,000 per month through year-end 2023. For the three months ended June 30, 2023, NRX recorded $3.9 million of R&D expenses compared to $3 million for the three months ended June 30, 2022. The increase is related primarily to an increased clinical trial enrollment in our ongoing Phase 2b/3 trial. For the same three-month period, we recorded a 38% reduction in general and administrative expenses from $6.6 million in the second quarter of 2022 to $4.1 million for the three months ended June 30, 2023. The decrease of $2.5 million is related primarily to decrease in legal, insurance, and accounting costs. The six-month period from January through June of 2023 similarly shows decreased expenditures as reflected in our financial statement compared to the prior year. As of June 30, 2023, we had $15 million in cash and cash equivalents. These working capital assets are expected to fund the company's operations through the fourth quarter of this year, which is the expected delivery of data for our Phase 2b/3 trial. Additionally, we are evaluating operational efficiencies to extend this runway. With that, I'll turn it back to Steve for closing remarks. Steve?

Steve Willard

Analyst

Thanks, Seth. 2023 has been incredibly productive so far and we look forward to advancing our NMDA platform in general and specifically our NRX-101 program in suicidal bipolar depression with our partners at Alvogen, as well as our very exciting chronic pain program all in the near term. We believe that NRX-101 is a potentially life-saving medicine that could change the treatment paradigm for a wide range of serious and life-threatening conditions, which is the driving force behind our mission of meeting the needs of these underserved patients. With the shared commitment of our investors, our team, and our researchers, we aim to bring hope to life for the millions of patients who may benefit from our unique products. Operator, we are ready to take questions from the audience.

Operator

Operator

[Operator Instructions].

Matthew Duffy

Analyst

Operator, we've received a couple of written questions that I'll proceed with now. This one is for the company. How is the partnership with Alvogen going so far?

Steve Willard

Analyst

I think it is going very well. We had a joint executive meeting in person last week. The teams are melding well. I think it's going very well.

Matthew Duffy

Analyst

Thanks. This one is for Dr. Javitt. How potent do you believe D-cycloserine in NRX-101 may be in treatment of chronic pain?

Jonathan Javitt

Analyst

Please let me hear the question again. I didn't read the second word.

Matthew Duffy

Analyst

Sorry. How potent do you believe D-cycloserine in NRX-101 may be in chronic pain?

Jonathan Javitt

Analyst

Well, if you look at the 2016 publication by Schnitzer and of carrying on their coworkers, the reduction seen in treating chronic pain was certainly deemed clinically meaningful. It's a reduction that is probably larger than what you can obtain from non-opioid pain medicine and may even be comparable to what you can obtain from safe doses of opioid medicines. We're going to know an awful lot more when the DOD trial reads out because that's a couple of hundred patients treated over 12 weeks. But there's reason to hope that NMDA antagonist drug may be quite potent. And in fact, anesthesiologists already treat chronic pain with IV ketamine. But of course, recognize that to get IV ketamine, you've got to be in a hospital environment. It's not a simple process. But there's no question that an NMDA antagonist drug block the pain pathway at each step. There are three nerve cells that go between your fingertip and your frontal cortex. And at each step, the connection between nerve cells is regulated by the NMDA receptor.

Matthew Duffy

Analyst

Another question. Can you talk a little bit about the patients who are going into the Phase 3 study? How they're doing? And are they continuing through the trial and how that's going sort of in the big picture?

Jonathan Javitt

Analyst

Well, I think we shared just about everything we can in the context of a randomized double-blind trial. We're steadily enrolling patients. We're doing it with a great degree of caution. So for instance, a study site will identify if patient is potentially eligible. They'll review the eligibility criteria with us ahead of enrolling the patient. And then they'll submit the audio files of the MADRS score, rating session, the suicidality rating sessions. And our in-house master raters will validate those floors before somebody gets into the clinical trial. So I think we're being as careful as we can possibly be about who gets them and how the primary and secondary endpoints are ascertained once they're in the trial.

Matthew Duffy

Analyst

Very good. Last written question that we've received. Can you talk about the genesis of the Department of Defense study in their -- with D-cycloserine and the genesis of a larger trial, the bigger picture around that?

Jonathan Javitt

Analyst

Well, we had nothing to do with the Department of Defense study. So Dan Javitt, the Co-Founder of this company, began engaging with D-cycloserine as a potential anti-depressant drug around 2004, professor of carrying and his coworkers, similarly, began studying the potential for D-cycloserine to be used to treat chronic pain. They've developed a substantial basic science base, which is cited in the review paper that we've posted for you. And they perform that first 40 person trial, which yielded the positive results. The trial itself was not deemed to have met its primary endpoint because they studied patients at 50 milligrams, 100 milligrams, 200 milligrams, and 400 milligrams of D-cycloserine, and they didn't see a benefit across all of those doses. They saw statistically significant benefit only at the highest dose. They reported that out in 2016. And they applied to the Department of Defense who responded with a $5 million grant to do a larger confirmatory trial. And we don't know any more about that trial. It's available to the public; you can read about it on clinicaltrials.gov. But we do know that data collection is complete and the study is anticipating a readout this year. So we're very excited that the study happened. And we're making plans to initiate registration study should that study yield a positive readout.

Matthew Duffy

Analyst

Thank you.

Operator

Operator

The next question will come from Ed Woo with Ascendiant Capital.

Ed Woo

Analyst

Yeah. Congratulations on the progress. My question is on the partnership that you guys found recently with Lotus and Alvogen. A lot of this obviously very strong in Asia. How much efforts are you going to be doing to expand these drugs into Asia? Or is it pretty much just focused on US approval first before you move into Asia? Thank you.

Steve Willard

Analyst

Thanks for that question, Ed. I think it's significant that Lotus is a full partner in this because they are very strong on in Asia. I think as we go through into the Phase 3 trial and get closer to commercialization, some of those decisions will be made. But I know that, for example, in our meetings on the commercial side, Lotus is always present at the table. And I think that bodes well for a major effort in Asia as well as in the US. That said, of course, the US is a much larger market for the product.

Ed Woo

Analyst

Great. Well, thank you for answering my questions, and I wish you guys good luck. Thank you.

Steve Willard

Analyst

Thank you.

Operator

Operator

[Operator Instructions]. This concludes our question-and-answer session. I would like to turn the conference back over to Mr. Steve Willard for any closing remarks. Please go ahead, sir.

Steve Willard

Analyst

Thank you very much and we very much appreciate your interest in NRX Pharmaceuticals. We thank you for listening to our presentation on this very exciting quarter. And we hope that you will follow us closely in the weeks and months to come. Thank you very much.

Operator

Operator

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.