Raul Rodriguez
Analyst · Jefferies. Your line is now open
Thank you Anne-Marie. I would like to spend a few minutes telling you why we think fostamatinib may be a very useful treatment in ITP. Fostamatinib is a unique oral sick inhibitor developed by Rigel's R&D efforts. SYK Kinase is a key player in the immune process that leads to platelet destruction in ITP. As such, fostamatinib may address the underlying disease process, the auto-immune destruction of platelets in ITP. Fostamatinib has a well-defined safety profile based on more than 5000 patient years of clinical experience across multiple auto-immune indications. It has a manageable safety profile which may make it suitable for long term maintenance, therapy and chronic ITP. ITP's a highly heterogeneous disease and as Anne-Marie said there is little certainty which treatment will work with these with which patients. Rigel's phase 2 study in ITP fostamatinib was shown to work in other phases where other treatments had previously failed including patients with failed steroids, rituximab, [indiscernible] and splenectomy. The phase 2 study also demonstrated 2 important things about fostamatinib. The ability to attain a rapid horizon platelets and a sustained response in platelet counts in patients with a subset of ITP patients. The rapid response provides early feedback as to whether fostamatinib may be a viable treatment for that patients ITP. For more than 7 years now, 2 patients from that phase 2 study have successful maintained attractive platelet counts by taking fostamatinib daily. We hope to add to that experience with our long term extension study that is part of phase 3 program. Fostamtinib is also a convenient oral formulation which may help patients adhere to the treatment regimen. We hope that by helping patients maintain a long term regimen we potentially create a sustained management of this disease. If the phase 3 results confirm what we think about fostamatinib, fostamatinib may likely be the treatment of choice for refractory ITP patients since they have very few or very limited options. We think it's an attractive medical and commercial opportunity for Rigel. With that in mind we are working at the best approach to building a commercial enterprise which will launch this product for ITP and subsequently for auto-immune hemolytic anemia. Approximately 900 heam and heamongs [ph] in the US treat most of the patients suffering from ITP. We believe we can build our own highly focused marketing and sales organization to address this audience. We estimate building a sales force of about 30 individuals as well as additional management and marketing staff. This organization will be focused exclusively on fostamatinib and ITP at launch and will provide the most comprehensive information about this product and he management of this disease. In addition, we will make significant efforts to engage with patients directly. To help them manage the disease and understand the treatment options. We will also work with patient support groups to further this engagement. We believe that fostamatinib opportunity is not limited to ITP. Its mechanism will lend itself to discussing other auto-immune diseases. We are conducting a proof of concept phase 2 in study in auto-immune hemolytic anemia with fostamatinib. Auto-immune hemolytic anemia is also a rare serious blood disorder where the immune system produces antibodies that result in the destruction of the body's own red blood cells. These patients are anemic and have symptoms such as fatigue, rapid heartbeat or enlarged spleen. Currently there are no treatment options approved for auto-immune hemolytic anemia. So, we believe that there is a major medical need in this area. I would expect results from our phase 2 study in early 2017. Up further point, we believe that auto-immune hemolytic anemia is highly synergistic with ITP in that the same physician specialist, heam and heamong [ph] treat ITP also treat patients with auto-immune hemolytic anemia. In addition, we are conducting a phase 2 study of fostamatinib in IgA Nephropathy. IgA Nephropathy is also an auto-immune disease and effects the functioning of the kidneys which many of these patients eventually require in dialysis or kidney transplant. We are conducting a placebo controlled 2 sequential dose covert study, looking at the proteinuria as the primary endpoint. We expect results from the first dose, the 100mg BIT dose from the study by year end. We expect a signal that we are in the right track with this readout. That the more robust readout will likely come from the second cohort, a 150mg BIT dose group which we are currently enrolling. Before closing, I would like to say a few words about our financials, partnerships and our next clinical candidate. As Ryan mentioned our financial position remains strong. Our current cash position is expected to carry us for 12 months after the phase 3 results have been reported. Our current primary system making excellent progress and we look forward to updating you on each of these as they events. For fostamatinib outside of the US, we will be seeking collaboration partners with significant presence in Europe or Asia with capabilities to capitalize on ITP, auto-immune hemolytic anemia and IgA Nephropathy opportunities. We are also seeking partners for some of our earlier clinical stage projects. And finally, we expect our next clinical candidate to come from our Iraq program. We are excited about this candidate because like fostamatinib it may offer multiple therapeutic opportunities in immunology and possibly oncology. I will close by saying we are clear of our focus in the coming months. With data from the phase 3 ITP program, we will first prepare the NDA submission, Rigel's first by the way for fostamatinib and ITP and subsequent regulatory process. Second, we will build a commercial organization for the potential launch of fostamatinib in the US in ITP and third, we will grow the pipeline beyond fostamatinib and ITP i.e. fostamatinib and auto-immune hemolytic anemia and IgA Nephropathy in our next clinical candidate from our Iraq program. Now let's open the call up for your questions.