Gregory Glenn
Analyst · Citi. Your line is open
Why not continue and we'll make into the key slides, or make sure we have. So, we're going to continue, Slide 5 and discuss the primary and secondary objectives of the trial. The primary objectives were to evaluate the incidents, symptomatic respiratory illnesses due to RSV, in community-living older adults, who have been treated with placebo examine the amplitude and duration of the anti-F IgG antibody responses in patients receiving the vaccine and to evaluate the safety and tolerability of the vaccine. Secondary objective, including evaluating the amplitude and duration of the Palivizumab competing the antibody responses and microneutralization antibodies to both RSV-A and RSV-B viruses. In Slide 6, we have additional exploratory at Ad-Hoc evaluations, this included estimating the efficacy of our RSV vaccines and all symptomatic RSV illnesses, and all symptomatic RSV lower tract infections. We’re also in this trial looking to define the clinical syndrome associated with RSV illness, to look for relationship between the new measures and protection and describe the spectrum of other pathogens associated with symptomatic illness. Finally and importantly, we evaluate that the amplitude of vaccine with regard to symptomatic RSV lower tract infections and looked at the vaccine efficacy in the context of symptoms that would be associated with difficulty breathing. So Slide 7, we look at the demographics briefly. Overall, the trial arms are well balanced. The slide also provides the number of patients including for safety identity and for protocol analysis. So in safety population, in the vaccine, we have 798, in the placebo 801, and the per-protocol in the placebo. These are mostly -- the balance between male is 42% and mean age is around 70%. We did recruit a significant number of patients over 75 as around 17% and you can see the ratio right down at the bottom. So turning to Slide 8, this shows some high level of results here. This is the attack rate, the attack rate we saw, observed here was 4.9% for symptomatic RSV disease. The symptoms we measured included pharyngitis, nasal congestion, cough, wheezing, shortness of breath and increased sputum production. Of these subjects, 95% have lower respiratory tract infection which included cough, wheezing, shortness of breath or increased sputum production. On Slide 9, we show the key efficacy results. Overall, our vaccine demonstrated statistically significantly level of efficacy and prevention of all symptomatic RSV disease at 44% and prevented symptomatic RSV lower respiratory tract infections at a level of 46%. This slide provides relative risk and efficacy estimates on a protocol basis for both all symptomatic RSV and RSV with lower respiratory tract infection. And from this slide you can see that the relative risk analysis clearly favors the vaccine. So let’s move to Slide 10, we also looked at Ad Hoc analysis of lower respiratory tract infection associated with symptoms and signs that would be associated with difficulty breathing. There were significant decrease rates of symptomatic RSV illness associated with at least three to four symptoms at least to one of which indicates difficulty breathing, which would include shortness of breath, wheezing or tachypnea. You can see the vaccine efficacy here with 64% for three or more symptoms, a significant effect is indicated by the confidence intervals. Consistent with the greater vaccine effect for more severe disease when compared against the Cluster 4 symptoms with vaccine FC continue to decrease to 75% compared to 64% for three symptoms. If you go to the next slide and look at the capital marker of Slide 11, they show the early and continued divergence of the vaccine effect from placebo, and a robust durability of protection RSV season, and with a significant difference here in this analysis as well, the key value 0.39. Now moving to Slide 12, we show the anti-F IgG antibody response rapidly peak by day 14 and then remained elevated through day 56. Importantly we demonstrated 4.8 fold increase in titer as well as 93% zero response rate. On Slide 13, turning to the palivizumab-competing antibody response we saw again a rapid response remained elevated through day 56 with the 96% zero response rate and a 5.24 rate which all closely follow the anti-F IgG response. On Slide 14, we show the microneutralizing antibodies to RCA and V there were significant shifts in both measure although the baseline antibody titers as measured by this assay were quite high. For the technical folks, the amount of new antibody is measured from a zero baseline, will be about a lot 27 decrease. To put these results in context, we have Slide 15, to show the efficacy of other respiratory licensed respiratory vaccines in older adults. Based on these results, the government agencies recommend flu and pneumococcal vaccination for this population and about 60% to 70% of that population currently received anti flu vaccine. As you can see, anti-flu vaccine effectiveness can range from 0% to 43% in older adults and the efficacy for the pneumococcal, conjugated pneumococcal vaccine in the same population was 46% as demonstrated in the recent large randomized clinical trial. Based on our Phase 2 results our vaccine has the potential to demonstrate similar or better protection compared to these vaccines. So to summarize, we are quite pleased with the data Slide 16, shows a summary of the conclusions. Overall, we see a 4.9% rate of symptomatic RSV in these adults and 95% of these illnesses are associated with lower respiratory tract infection, that tracks well with Dr. Ann Falsey's medical journal paper showing a high rate symptomatic RSV infections when detected. We also saw a significant reduction in symptomatic RSV lower respiratory tract infection using our vaccine. And when we look at more severity on this is a 64% reduction in more severe illnesses. There is also durable protection for the entire RSV season which is important as we expect this to be an annual seasonal vaccine. And just again to point out, this is the first study to demonstrate an effective RSV immunization. So with that, I’m going to turn this back over to Stan, and let him take it from here.