Stephen Yoo
Analyst · Morgan Stanley
Thank you, Ken. As a reminder, our lead product candidates are currently targeting the following indications: wet age-related macular degeneration, or wet AMD; homozygous family hypercholesterolemia, or Hooch; and mucopolysaccharidosis type I and type II, or MPS I and MPS II. I'll begin with RGX-314 for the treatment of wet AMD, a disease that results in diminished, distorted or even total vision loss and which, we believe, effects more than 2 million patients in the U.S., Europe and Japan. RGX-314 is administered with a one-time subretinal injection and is designed to overcome the limitations of current anti-VEGF therapies being used to treat wet AMD. These limitations include patients receiving frequent painful and inconvenient administrations of anti-VEGF therapy into the eye. Many patients trouble to comply with the recommended therapeutic regimen for current anti-VEGF therapies, and lack of compliance may lead to reduced therapeutic efficacy and ultimately loss of vision. Utilizing the NAV AAV8 vector, RGX-314 is designed to encode a gene for a monoclonal antibody fragment in the cells of the retina. The expressed antibody fragment is designed to neutralize VEGF activity, employing a similar mechanism as standard of care, but with just a single administration. The NAV AAV8 vector has been selected for this product candidate because it has demonstrated effective transduction of retinal cells in multiple preclinical animal models. In February, we were pleased to announce the completion of dosing of the third cohort in our Phase I clinical trial, evaluating RGX-314 for the treatment of wet AMD. The primary objective of the trial was to evaluate the safety of a one-time subretinal delivery of RGX-314 at 24 weeks. Additionally, we'll be evaluating several efficacy parameters, including best corrected visual acuity and retinal thickness as measured by optical coherence tomography, or OCT. The clinical trial currently has seven active sites, which are leading retinal surgery centers across the United States. We have now treated a total of 18 patients in the study. All three cohorts enrolled rapidly, which reflects the investigator and patient enthusiasm we observed for the study. We remain on track to present top line data from the Phase I clinical trial in late 2018, which will include both primary and secondary endpoint data. I'll now turn to our metabolic franchise and development of RGX-501 for the treatment of HoFH, a rare genetic disorder caused by mutations in the gene encoding the low-density lipoprotein or LDL receptor. The LDL receptor is responsible for removal of LDL cholesterol from the bloodstream. When mutations occur in both LDL receptor genes, LDL cholesterol accumulates in the bloodstream, often leading to coronary artery disease at a young age, a severe and ultimately fatal condition. Current standard of care therapies for HoFH are often insufficient to lower LDL cholesterol to normal levels, requiring many patients to receive regular apharesis, a treatment associated with significant burden for both patients and caregivers, yet one that does not ultimately correct the underlying cause of the disease. RGX-501 has the potential to address the underlying genetic defect responsible for HoFH by correcting the LDL receptor deficiency. As with all of our product candidates, RGX-501 is designed as a one-time therapeutic administration and approach that has potential to alleviate the treatment burden and address the urgent unmet need in HoFH. RGX-501 uses the NAV AAV8 vector, a vector that has demonstrated a highly efficient transduction of liver cells in both clinical and preclinical studies. We announced today that the third patient in the second cohort and sixth patient overall was dosed in the RGX-501 clinical trial. The primary objective of this Phase I/II dose escalation trial is to assess the safety of a one-time intravenously administered dose of RGX-501. We will also evaluate the preliminary efficacy as measured a change in LDL cholesterol from baseline. The trial has been conducted at the University of Pennsylvania with a number of US and international sites being utilized for patient recruitment and follow-up. We remain on track to present top line data from the RGX-501 Phase I/II clinical trial in late 2018, which will include primary and secondary endpoint data. I would now like to share an update on our neurodegenerative franchise, where we have 2 product candidates in development for diseases of the central nervous system, RGX-111 for the treatment of MPS I and RGX-121 for the treatment of MPS II. MPS I and II are lysosomal storage diseases caused by defects in the IDUA and IDS genes, respectively. In both diseases, the defective genes result in enzyme deficiencies that lead to an accumulation of intracellular waste products, which would normally be broken down by these missing enzymes. This accumulation leads to cell and tissue damage, causing a wide range of physical symptoms and in severe patients’ significant cognitive deficits. While there are approved and marketed enzyme replacement therapies to start the -- to treat the systemic symptoms of both MPS I and MPS II, treatments for the CNS symptoms of the disease are severely limited or nonexistent. Our programs are designed to address area of significant unmet need. Both RGX-111 and RGX-121 utilize the NAV AAV9 vector. As with all of our product candidates, we are employing a one-time administration approach. The therapy will be administered directly into the cerebrospinal fluid via an intracisternal administration. The route of the administration was selected to optimize the exposure of the target CNS cells to RGX-111 and 121. Site activation is continuing for both the RGX-111 and 121 clinical trials. We have received institutional review board approval at the initial site for each clinical trial and are finalizing the last few steps to activate these sites. With the start of patient recruitment, dosing on first patient in each trial is anticipated in mid-2018. In addition, we recently announced that we received Fast Track Designation from the FDA for the RGX-121 program. We're excited about the continued progress in all of our lead candidate programs and look forward to sharing more updates with you throughout the year. With that, I will turn the call back over to Ken to discuss additional progress on building our capabilities and in our licensee programs.