Brian Leuthner
Analyst · Leerink Partners. Your line is now open
Thank you, Greg. Good morning and thanks for joining us today. Edge has made significant progress on multiple fronts since our last call. Our clinical progress is highlighted by the initiation of our Phase 3 study of EG-1962 in aneurysmal subarachnoid hemorrhage. And then on the financial side, we recently announced the closing of a $20 million debt facility. At the same time, we continue to build out our management team with the necessary experience and leadership to help us advance our promising therapies to the patients in need. So, let's get started with the progress of our clinical efforts here at Edge. As most of you know, our top priority is advancing our lead clinical program EG-1962 in aneurysmal subarachnoid hemorrhage. Aneurysmal subarachnoid hemorrhage is also known as ruptured brain aneurysms are the sudden and catastrophic medical emergencies that have particularly poor outcome and limited treatment options for patients to-date. In fact, if you look around the world, over 600,000 people suffer a life-threatening ruptured brain aneurysm each year. In the U.S., over 35,000 patients annually make it to the hospital after aneurysmal subarachnoid hemorrhage and nearly all of these patients receive a medicine called Nimodipine. Now despite this treatment and doctor's best effort, 75% of patients that suffer an aneurysmal subarachnoid hemorrhage will be permanently brain damaged or worse within 30 days. While oral Nimodipine has been the standard-of-care for almost 30 years to prevent delayed neurological deterioration in the days and weeks following this ruptured brain aneurysm, its primary limitation is that it cannot be administered in sufficiently -- in sufficient doses to be more effective due to dose-limiting side effects namely hypotension or lowering of blood pressure. What we're attempting to do here at Edge is to address this significant unmet medical need with EG-1962. And some of you may recall, EG-1962 is a biodegradable polymer micro-particle and it contains Nimodipine that is delivered through an existing external ventricular drain, we call them EVDs. Now, an EVD is a catheter that's placed into the patient's brain to relieve this increased brain pressure that they have -- that some the patients after a ruptured aneurysm. So, EG-1962 is being studied to prevent these delayed neurological deterioration or complications that typically occur in many of these patients in the days to weeks following a ruptured brain aneurysm. EG-1962 is designed to provide high localized concentrations of Nimodipine in the brain while maintaining safe systemic exposure thereby avoiding these dose-limiting side effects namely hypotension and ideally [Indiscernible] the brain in Nimodipine. So, I'm extremely pleased and proud to say that we delivered on our goals to initiate the Phase 3 NEWTON 2 Study of EG-1962 in mid-2016. So, as we recently announced the treatment of our first patient in this study late last week. Now, this is a significant milestone for the program. It’s a huge accomplishment for the Edge team that's been working so hard to get this done and obviously, it's an important step in our goal to improve outcomes for these vulnerable patients. So, we believe that the NEWTON 2 Study if positive can serve as the confirmatory study to support our Marketing Application for Approval of EG-1962 in the initial indication of improving the outcomes after aneurysmal subarachnoid hemorrhage. So, now, I'm going to spend a little bit of time talking about the design of our Phase III study. We determined the overall design and the key elements of the Phase III study based on our successful Phase II NEWTON study and also on the end of the Phase II feedback that we received from FDA and the European and Canadian regulatory authorities. Now we minimized the changes between the NEWTON study and the Phase III NEWTON II study. So the key difference between the two studies is that the Phase III study is a blinded study, while the phase II study was an open label design. So we’ve designed the Phase III study to be consistent with our Phase II study in terms of the same patient population that’s WFNS 2 – 4 with a catheter, the same comparator versus oral Nimodipine and the same primary clinical endpoint that’s the Glasgow Outcome Score Extended. So we believe that by employing the Phase III study design that's almost identical to that of our successful Phase II study, it gives us the best chance of generating similar positive efficacy and safety results that we saw in the NEWTON study. So the Phase III NEWTON II study is a global, multicenter, randomized, double-blind, placebo-controlled study that will compare the efficacy and safety of EG-1962 to standard-of-care oral Nimodipine. So in this study the patients will be randomized one to one to receive treatment with 600 mg of EG-1962 via the external ventricular drain, or standard-of-care oral Nimodipine. The primary endpoint will be the proportion of patients showing a GOSE score of 6 – 8, which we deem as a favorable outcome at day 90. This endpoint has been agreed upon by the health authorities from the U.S., Europe and also Canada. The study is recruiting up to 374 patients across approximately 65 to 70 centers in North America, Europe, Israel and Australasia. Now we’ve designed it with an interim analysis when 210 patients had been treated. So where if the results are sufficiently positive that means that there is a greater than a 20% absolute difference in the proportion of favorable outcomes amongst the EG-1962 treated patients versus oral Nimodipine treated patients, then the study could be stopped. So in this case we would then meet with the FDA and the other health authorities to discuss submission of a Marketing Application at that time. Now, if this level of efficacy does not materialize, the study will continue to enroll either a sample size of 300 patients or its target enrollment of 374 patients with the full data seeking to achieve at least a 15% absolute difference in the proportion of favorable outcome with EG-1962 versus the proportion of favorable outcomes with oral Nimodipine. So I know I’ve given a lot of data here, but as a point of reference, our North American Phase II study for EG-1962 showed a 32% absolute difference between the two groups in the proportion of favorable outcome across all the tolerated doses of EG-1962. So that’s the study design. So let’s talk about some timing. So turning to the expected milestone for the Phase III NEWTON II study. We currently anticipate that it will take about 24 months to enroll 374 patients. Now, as I previously mentioned, we built in this interim analysis for a potential early efficacy stop at 210 patients. So we anticipate that this will take approximately 18 months to get to this stopping point, potentially. So, now, for more information on the NEWTON 2 including details about the study, its status, sites that are participating, we refer you to clinicaltrial.gov. So, this is the location where Edge will provide information about the study and we then plan to update the registry from time-to-time. So, some of the other things that we just reported on -- also with EG-1962 that were notable were the fact that we received or EG-1962 received the FDA Fast Track designation for the treatment of subarachnoid hemorrhage. This designation reflects a significant unmet medical need in subarachnoid hemorrhage. In fact its Fast Track designation could help expedite EG-1962 development and also allow for FDA rolling submission of the completed sections of the new drug application before the complete application is submitted and may vest in the overall NDA submission time to save some time. So, with the Fast Track and also previously reported that we have the orphan drug designation with EG-1962, we believe that's obviously going to be eligible for FDA priority review status which is granted upon submission of the application. So, the priority review status means that once the NDA is filed, the FDA PDUFA goal is set at six months as compared to the 10 months for the standard review. So, that's our EG-1962 program focused on EVD. We're also focused on expanding -- or further expanding the potential for EG-1962 to help patients that suffered a ruptured brain aneurysm. So, to this end, we're initiating a study to evaluate intracisternal administration of EG-1962 for patients that do not require an EVD. Now, this route of delivery could potentially lead to EG-1962 addressing a portion of that remaining 50% of the patients that do not currently receive an external ventricular drain. So, we anticipate initiating the cisternal study later this year and expect that data readout from this study in 2017. So, in addition, to all of this clinical progress that we just talked about, we recently announced the closing of this $20 million debt facility with Hercules Capital. This increases our cash position and we believe will enable us to continue to execute our growth strategy. So Andy is going to provide more details on this debt facility in his comments coming up. So, and lastly, in other corporate progress, we continue to build out our management team and we recently appointed Dr. Harry Sacks as our Vice President of Clinical Development. So, in this role, Harry will be working with Herb and Loch and also working with the rest of the clinical team on the global strategy, planning, and the execution of our clinical study. For those of you that don't know Harry, he has got a track record of successfully leading clinical development strategy, also study execution at several pharmaceutical companies and biotechnology companies and he brings approximately 20 years of clinical development experience to Edge. And again this experience includes directing clinical program oversight from early stages through development and then beyond marketing approval. So, his expertise will be of tremendous value as we progress our pivotal NEWTON 2 study of EG-1962 and also expand our pipeline. So, we're very pleased to welcome Harry to our team. So, now I'll turn it over to Andy for the financial review.