Steve Rubin
Analyst · Jefferies
Thanks, Phil. Good afternoon, everyone. And thank you for joining us today. As Phil indicated, it’s been an eventful quarter. We achieved progress across multiple programs and reached important milestones, particularly on the somatrogon project. We were very pleased with results in our global Phase 3 trial evaluating somatrogon dosed once weekly in pre-pubertal children with growth hormone deficiency. The trial successfully met its primary endpoint of non-inferiority to GENOTROPIN injected daily with respect to height velocity after 12 months. Various sensitivity analyses show that weekly somatrogon was consistently higher and non-inferior to daily GENOTROPIN with respect to height velocity. Key secondary endpoints were also achieved. Change in height standard deviation scores or SDS at six and 12 months were higher in somatrogon compared to GENOTROPIN. At six months, change in height velocity was also higher with somatrogon compared to GENOTROPIN. These common measures of growth are employed in the clinical setting to measure the potential level of catchup growth that children may experience relative to height per age and gender match peers. Finally, as to safety, somatrogon was generally well-tolerated and comfortable to GENOTROPIN dosed daily with respect to the type, number and severity of adverse events. We are concluding immunogenicity testing and analysis of additional data and we look forward to presentation of the full results of the study at our future scientific meeting. Recall that we have over four years of safety and efficacy data in growth hormone deficiency, pediatric patients from our Phase 2 extension study, in children with growth hormone deficiency. 48 children with growth hormone deficiencies that completed the main Phase 2 study continued an open label expansion or OLE Phase 2 study. 40 subjects are still continuing in the OLE study with the GLP, the pen device using the same dose 0.66 milligrams per kg per week as used in the Phase 3 study. Safety and tolerability data from the OLE study remain comparable to those obtained with the early growth hormone treatment. Mean annualized height velocity over three years in the OLE study shows that long-term somatrogon treatment resulted in sustained growth. Height SDS value showed height normalization over time. Important to note IGF-1 and IGF binding protein 3 levels remained within the normal range with the ongoing Somatrogon therapy. No other long-acting growth hormone therapy under development has safety and the efficacy data for as long as we have with somatrogon. I also would like to highlight that our Phase 3 trial was global with over 80 clinical sites across more than 20 countries including parts of Asia and Latin America. The global enrolment including our separate ongoing study in Japan is part of a strategy that provides Pfizer the ability to seek global approval and global commercialization of somatrogon. It is important to note that the purpose of growth hormone replacing therapy for pediatric growth hormone deficiency is to provide a level of growth hormones to children similar to the level that would have occurred naturally, had they not had growth hormone deficiency. We developed our once weekly somatrogon with that concept in mind, to mimic the activity of the growth hormone therapies that have been safely and effectively used on a daily basis in children for over 24 years. We believe we have demonstrated that objective through our Phase 3 trial which compared our once weekly somatrogon to once a day GENOTROPIN. If you give a child greater levels of growth hormone, they may grow taller, but that could also result in higher than normal levels of IGF-1 with its attendant potential safety issues. For this reason, with long-acting formulations administered once weekly, IGF-1 SDS is used as a biomarker to evaluate efficacy and safety of hGH replacement and mean IGF-1 SDS level are used to guide clinical decisions making on dosing. Patients with sustained mean IGF-1 SDS levels of greater than 2 may require a dose reduction. In the previous Phase 2 pediatric trial, somatrogon demonstrated that mean IGF-1 SDS levels occurred at 96 hours post dose in pediatric GHD patients and that less than 2% of the patients had IGF-1 SGS levels greater than 2. In our Phase 3 study, we observed similar results with somatrogon when mean IGF-1 SD levels were estimated using a pharmacokinetic-pharamcodynamic model. These data suggest that weekly somatrogon dosing results in patients maintaining IGF-1 SDS levels within a normal range over the 12-month three treatment period. And in-depth analysis of the IGF-1 SDS levels and other study outcome data is expected to be submitted for presentation at the Endocrinology Conference in March of 2020. Based on these results, we anticipate that Pfizer will submit the biologics license application to the FDA and a marketing authorization application in Europe for somatrogon in the second half of 2020. The pediatric registration study in Japan comparing our weekly somatrogon to daily GENOTROPIN continues to progress with over 65% of subjects already having completed 12 months of treatment and entered the open-label extension. We expect top line data readout for that study in the second half of next year. Touching briefly on our other therapeutics pipeline projects, we also expect to advance our long-acting rare disease platform, moving several compounds designed to offer advantages over existing medicines into the clinic. These include our long-acting GLP-2 compound for short bowel syndrome, our hGH antagonist CTP for acromegaly and our IGF-1 CTP for growth failure associated with severe primary insulin-like growth factor deficiency. A briefly update on our SARM or OPK88004. In previous studies, our SARM was showed to increase lean body mass and physical function without altering PSA levels in aging males. In collaboration with Dr. Shalender Bhasin and his colleagues at Harvard Medical School with support from the NIH, we have just completed a six-month Phase 2 trial with approximately 114 patients. This trial is examining the efficacy and safety of our SARM, given improving patients symptoms of androgen deficiencies such as sexual function, lean body mass and physical strength and dysfunction endemic prostate cancer we have undergone radical prostatectomy. In this study, to-date, we have not observed any safety issues related to treatment with our SARM, such as increased PSA or liver enzyme levels. We expect top-line efficacy data by the end of this year. The safety data with our SARM has been compelling. And with this new data, we are considering a late stage clinical trial evaluating our SARM for the treatment of sarcopenia associated physical strength dysfunction in end-stage renal disease patients on dialysis. Turning now to our pharmaceutical business. Let me start the RAYALDEE. From a commercial perspective, RAYALDEE numbers for the quarter break down as follows. Total prescriptions of RAYALDEE in Q3 as reported by IQVIA increased 83% compared with Q3 2018 and show continual sequential growth with a 14% increase compared with Q2 of this year. New patient starts increased 9% in Q3 versus Q2. Since launch, there has been a total of approximately 13,600 patients on RAYALDEE. As of Q3, over 2,400 patients have written a prescription for RAYALDEE of which 229 or nearly 10% were new prescribers in Q3. We ended Q3 2019 with approximately 83% of patients having access to RAYALDEE without prior authorization or other restrictions. After assistance, most patients pay a nominal amount out of pocket for RAYALDEE. Turning now to our clinical development programs, starting with renal. Last September, we initiated a global Phase 2 trial with a higher strength RAYALDEE in patients with the stage five, chronic kidney disease and vitamin D insufficiency, who require regular dialysis. The study is progressing well and is proceeding the two successive cohorts. The first cohort of approximately 44 patients is being treated for 26 weeks in a randomized open label fashion with either RAYALDEE or placebo to identify the appropriate dosing to be studied in the second, larger cohort. Treatment of the first cohort is expected to be completed in mid-2020. An interim data readout for this first cohort is expected in Q1 2020. Final data will be available in the second half of 2020. Costs of this study are being shared with Vifor Fresenius Japan Tobacco. Other ongoing and upcoming clinical studies for RAYALDEE include, an ongoing 80-patient open label Phase 4 study designed to demonstrate that RAYALDEE is superior to commonly used competitive therapies, namely paricalcitol or Zemplar, immediate release calcifediol or Hidroferol and high dose cholecalciferol or vitamin D3. The enrollment is more than 60% complete and full enrollment is expected near the end of 2019 or in early 2020. Initial top-line data are anticipated in Q2 of 2020. And we also have a Phase 3 study with RAYALDEE in pediatric patients as part of a post-marketing requirement, which is expected to start in Q1 2020. The final protocol for this study was approved by the FDA in Q2 of 2019. With that overview, let me turn the call over to Jon Cohen for discussion of our diagnostic business. Jon?