Gregory Glenn
Analyst · Jefferies
Thank you, Stan, and maybe we can turn to Slide 4. This really has been a remarkable year. Over the past 12 months, we’ve moved rapidly to respond to the COVID-19 pandemic. We first identified a stabilized recombinant fully protein Novavax CoV2373, which I'll call it 2373 for short, as our vaccine candidate. We identified this within one month of the SARS CoV sequence being published. We also demonstrated the key role of our Matrix-M adjuvant for induction of potent immune responses when formulated together showed that these component elicited highly protective immunity in animal challenge models. As you will see below, we've moved rapidly through clinical development and now demonstrated the same high-level of efficacy in humans. Our scientists are committed to transparency and publication in high-quality peer-reviewed journals and we know with satisfaction, we've met this goal through multiple manuscripts, a few, what you see here published in prestigious scientific journals, including the New England Journal of Medicine Science and Nature. So moving to Slide 5, our recombinant protein subunit-based vaccine 2373 offers the range of practical benefits, which we expect will optimize and expedite its global distribution. First, our candidate recombinant spike protein was designed to ensure stability and as a result can be stored at typical refrigeration temperatures, enabling distribution through standard coal supply chains. Additionally, it's ready to use liquid formulation of both the protein and the adjuvant markedly facilitate the administration of the vaccine. The adjuvant Matrix-M is a critical feature of the 2373 vaccine, which has both an immune enhancing and dose varying effect, allowing us to produce more doses of 2373 with less antigen required per dose, while reducing immunity that exceed that seen from a COVID-19 infection. This greatly augments our global capacity for vaccine manufacturing and distribution. On Slide 6, we provide an overview of our COVID-related clinical trials. The Phase 1/2 safety and immunogenicity trials demonstrated the key role the adjuvant dose bearing and the immune responses, they were all well in excess of convalescent sera. The data suggests the hallmark of our vaccine is the introduction of high levels of functional immunity and has an excellent safety profile. In addition, this study confirmed the 5-microgram dose for the antigen. I want to note that there are several other immunogenicity trials that have already or will be starting soon in India, the Czech Republic and Japan that will help to extend the global access to our vaccine. For day I'm - for today, I'm going to focus on the results of our efficacy studies. During their conduct, the dramatic evolution, the virus occurred and we are first to demonstrate FC against all three major circulating strains. This has led to vital insight for public health and a unique opportunity to demonstrate the utility of our technology in the face of the evolving COVID-19 virus. Let's begin by talking about our Phase 3 trial in the UK on Slide 7. After initiating our trial in September 2020 with the support of UK Vaccines Task Force in the NIHR registry, we were able to rapidly enroll over 15,000 participants, 27% of whom were over the age of 65. Our top line interim analysis showed an overall efficacy of 89%. However, during the conduct of this trial, the virus evolved and against the original COVID strain similar to the virus as seen in the mRNA trials, we demonstrated best-in-class efficacy of 96% with the B-117 variant strain that appeared during the trial, we observed an 86% vaccine efficacy. This latter strain is growing in the prominence in the U.S. and it's worth noting that the UK data suggests that 2373 will perform well in the U.S. amid rapid viral evolution that's trending heavily in this direction. All of the primary endpoint has been met, additional cases have been collected and a final analysis will be available in the coming weeks. Considering the pathway to authorization, we initiated a rolling submission with non-clinical data with MHRA in the UK. We plan to file for authorization by early second quarter after we have gathered sufficient data from our UK trial and completed CMC requirements. Moving now to our Phase 2b trial in South Africa on Slide 8, we enrolled diverse study population of about 4,400 participants including 245 medically stable HIV-positive adults. We achieved our primary efficacy endpoint in the overall population, demonstrating a significant level of efficacy at 49% including all participants. It's important to note the 2373 also demonstrated 60% efficacy in the population that was HIV negative, representing 94% of the volunteers. During the conduct of the trials, I mentioned earlier, the virus evolved and during surveillance, the South African B1.351 variant was widely circulated during our trial accounting for 93% of sequence cases. Although one-third of the study participants were seropositive baseline, these antibodies did not seem to prevent infection with 131 - 1351 again suggesting that prior COVID-19 infection did not protect against subsequent with the B1.531 variant. However 2373 did offer significant protection, even though the vaccine was derived from the original COVID-19 strain. This is not unexpected as a qualitatively better and broader response here reflects the lessons learned from the matrix and adjuvant NanoFlu vaccine that shows in the face of evolution, we have these appropriate responses. I would like now to direct your attention to Slide 9. We are pleased with the progress we've observed to date with our Phase 3 efficacy trial in the U.S. and in Mexico, which we conducted in partnership with the NIH and the corona virus prevention network. Briefly the study design is a 2-to-1 randomized trial enrolling over 30,000 subjects. You can see, the primary endpoint is aligned with our previous trials and interim analysis will be done with 72 cases and 144 final events. Finally, we are encouraged to discover highly motivated participant population during the enrollment process, and we believe the 2-to-1 randomized study, as well as the expectation of a crossover elders played a major role in expediting recruitment. If you look at Slide 10, we can complete the enrollment within two months of initiating this event-driven trial in December of 2020. And now we are happy to report we have a diverse study population of 30,000 participants, which is comprised of 20% Latin American, 12% African-American, 6% Native American, 5% Asian-American with approximately 13% of the individuals 65 and older. We expect to announce this interim data from the trial in the second quarter depending of course on the overall attack rate. As of today, we are working to implement, I blinded crossover for both our UK Phase 3 and PREVENT-19 trials. In these blinded crossovers, participants will receive active or placebo opposite to what placebos the participants initially received while still remained in blinded. This design ensures the integrity of the blinded studies and enable us to continue following participate for the duration of efficacy and safety. For PREVENT-19, our blinded crossover protocol has been submitted to the FDA and the updated protocol including the details of the crossover have been posted on our website under resources. So moving ahead to Slide 11. Regarding our regulatory pathway in the U.S., we are in ongoing discussions with the FDA to align on the data required for initiation of the EUA and continue to provide information to our opening IND application. At this time, we expect to complete our EUA filing in the second quarter. Overall, we are very busy on the regulatory front and we've also began the rolling submission process with multiple other regulatory authorities including the European Medicines Agency, Health Canada, the Australian Therapeutic Goods Administration and New Zealand's Medsafe. We will continue to engage in dialog with respect to regulators as we complete our pivotal Phase 3 clinical trials in the UK and U.S. ensuring that we fully address all safety, efficacy and quality elements required for authorization. As we look to the future for our 2373 clinical program, we would like to highlight two areas of focus in the coming months. Our six month boosting protocol taking place in our Phase 1/2 trial in the U.S. and Australia and the development of a variant stain in candidates. On Slide 12, you see our Phase 1/2 trial in the U.S. and Australia initiated in May 2020 provided positive data on 2373 immunogenicity and safety. The trial is continuing to offer valuable clinical insights with some participants now receiving a six-month boost dose to examine the production of functional immune response. Our technical - technology is suitable for boosting and agile enough to enable the rapid development of a bivalent vaccine approach that can address an evolving virus. On Slide 13 as I mentioned, then we have also made significant strides in addressing the mutations of the COVID-19 arising around the globe, including exploring variant strain vaccines as stand-alone and bivalent candidates. We are evaluating these candidates in ongoing human primate studies and plan to initiate clinical evaluation in these candidates in mid-2021. We are leveraging the adaptability of both our vaccine technology and the manufacturing processes to evolve our strategy alongside the evolution of the virus. So inclusion on Slide 14, we now have two independent trials demonstrating 2373's high level of efficacies at levels similar to that seen in the best results against the original virus strain and efficacy against two variant strains coming out of the viral evolution. We also see an encouraging safety profile. We are proud of the clinical team as Stan mentioned, that has achieved these milestones with 2373 to date and look forward to additional data in the coming months including data from the PRVENT-19. Ad with that, I'd like to turn it over to John Trizzino.