Dr. Michael Goldstein
Analyst · Piper Sandler. Your line is now open
Thanks, Anthony. Let me begin with an update of our back-of-the-eye program, OTX-TKI. OTX-TKI is a bioresorbable, hydrogel implant containing axitinib, which has anti-angiogenic properties and is delivered by intravitreal injection. It is being developed to treat patients with wet age-related macular degeneration and other retinal diseases, such as diabetic macular edema and retinal vein occlusion. We continue to dose subjects in a multicenter open label Phase 1 clinical trial in Australia that is designed to assess the safety and tolerability of OTX-TKI, as well as to assess preliminary biological activities by measuring anatomical and functional changes. As Anthony mentioned, we recently reported encouraging interim data from the ongoing Phase 1 trial in March. In April, Robert Avery, a member of the Data Safety Monitoring Committee, overseeing the Phase 1 trial presented interim data on OTX-TKI at the Annual Vit Buckle Society Meeting. These data included an update on the first two fully enrolled cohorts and demonstrated that OTX-TKI in both cohorts was generally observed to be well-tolerated with a favorable safety profile with no ocular serious adverse events. Regarding biological activity, in the interim look in this small data set, there seems to be a dose response with greater clinical response in the higher dose cohort compared to the lower dose cohort. In the higher dose cohort two, OTX-TKI treated subjects showed a decrease in retinal fluid as measured by decreases in intraretinal and/or subretinal fluid with the longest treated subjects with age-related wet macular degeneration now out to be on 4.5 months. Additionally, some patients in cohort 1 who had required frequent anti-VEGF dosing prior to enrollment in the study were shown to potentially not need rescue therapy for as long as 10 months after being treated with OTX-TKI. While the drug product profile is still emerging, we are pleased with the interim data that shows intravitreal injection of a TKI can reduce intraretinal and/or subretinal fluid. There are a number of questions that still need to be addressed as we continue to study the durability of the response, and we have recently amended the current protocol to allow for an even higher dose for the next cohort to be enrolled. Moving to our glaucoma program, OTX-TIC is a bioresorbable travoprost containing hydrogel implant delivered via intracameral injection designed to deliver extended duration of IOP reduction. We continue to enroll subjects with primary open angle glaucoma or ocular hypertension in a Phase 1 prospective, multicenter open-label dose escalation clinical trial in the United States to evaluate the safety, biological activity, durability and tolerability of OTX-TIC. In February, we presented interim data at the Glaucoma 360 Conference that took place in San Francisco. Data from the first two fully-enrolled cohorts, five subjects in cohort 1 and four subjects in cohort 2 showed decreased IOP in patients receiving the OTX-TIC that was comparable to current standard of care. Topical travoprost placed in the non-study eye throughout the six-month period. The data also showed that the IOP remained consistently decreased for an extended duration of 6 to 9 months in many subjects with a single implant. We also have seen one subject with well-controlled IOP for over 20 months for the single implant. The hydrogel biodegraded in approximately 5 to 7 months in most subjects and we continue to observe that the product is well-tolerated and has a favorable safety profile. From a safety perspective, we have seen no clinically meaningful changes in corneal endothelial cells as measured by slit lamp pachymetry and direct imaging of the endothelial cells. We have now completed enrollment in cohort 2 and cohort 3, the same dose of travoprost as cohort 1 and more rapidly degrading hydrogel implant and are currently enrolling cohort 4, smaller implant with a lower dose. Enrollment has recently been slowed slightly by COVID-19 but we believe this will pick up as ophthalmic offices open back up for non-emergent patients. Once this trial is complete, we intend to advance the most promising formulations into Phase 2 clinical trials. In the area of ocular surface diseases, which includes our work in allergic conjunctivitis and dry eye, we've recently announced positive top-line results for our Phase 3 clinical trial for DEXTENZA in the treatment of ocular itching associated with allergic conjunctivitis. The Phase 3 randomized double-masked parallel arm, placebo-controlled clinical trial enrolled 96 subjects and was conducted across 6 sites in the United States, using Ora’s modified Conjunctival Allergen Challenge models. The primary efficacy measure for this trial was ocular itching on day 8 at 3 minutes, 5 minutes and 7 minutes post challenge and included subjects with seasonal and perennial allergens. DEXTENZA treated subjects demonstrated a statistically significant difference in ocular itching scores, p value less than 0.0001, compared to vehicle-treated subjects at all three pre-specified time points. An assessment of the secondary endpoint of ocular itching at all other visits, day seven, day eight in the morning, day eight in the afternoon and 10 minutes following exposure, day 14 and day 15 in the morning and afternoon also showed that DEXTENZA-treated subjects had lower itching scores than vehicle-treated subjects at 3 minutes, 5 minutes, 7 minutes and 10 minutes, post-CAC, p value less than point 0.05 for all 21 time points, except day 7 at 3 minutes. DEXTENZA was observed to have a favorable safety profile and be well-tolerated with no serious adverse events observed, ocular or non-ocular. No subjects required rescue medication and no subjects experienced elevated intraocular pressure. Overall, the data highlights the compelling product profile,, targeting a large market that could potentially change the current standard of care for the one-time, long-acting hands-free therapy for the treatment of allergic conjunctivitis. Importantly, as Anthony stated in his comments, this sNDA, if approved, would represent our first in-office indication and expands significantly the versatility and potential for DEXTENZA. In terms of next steps, we plan to complete our review of the full data set in this Phase 3 study, discuss our findings and regulatory pathway with the FDA and target submission of an sNDA by the end of this year. The largest potential opportunity in the treatment of ocular surface diseases is dry eye disease. We have two programs in dry eye disease, OTX-CSI with an intracanalicular insert which includes the punctum and releases cyclosporine for approximately three months for patients with dry eye disease. And DEXTENZA has potential benefit for patients with episodic dry eye disease. For OTX-CSI, we’ve recently initiated a Phase 1 open-label, single-center clinical trial in the United States to evaluate the safety, efficacy durability and tolerability of OTX-CSI. We expect to dose the first subjects in the near future. We're very excited about the potential for this hands-free option in helping dry eye disease patients receive the benefits of cyclosporine with the potentially greater tolerability and more rapid clinical benefits compared to therapies currently on the market. There continues to be significant interest in studying DEXTENZA in many areas of unmet need with over 70 investigator initiated trial requests submitted including many seeking to evaluate DEXTENZA in the treatment of dry eye disease patients. We currently have 9 IIT studies that are active including the one that has completed enrollment. I would now like to turn the call back over to Donald, who’ll review our fourth (sic) [first] quarter and yearend financial results.