Chris Garabedian
Analyst · Ted Tenthoff with Piper Jaffray
Thank you, Erin. Good afternoon, everyone, and thank you for joining us. I’m pleased to provide you with an update and overview of our activities and accomplishments since our last quarterly update along with our financial performance in the fourth quarter and for the full year of 2011.
We’ve continued to realize significant progress in our value driving programs, particularly in our rare disease program for the treatment of Duchenne muscular dystrophy and our antiviral programs for the treatment of the life-threatening hemorrhagic fever viruses of Ebola and Marburg.
There is a lot of information to cover on the call, so I will begin by providing a detailed update on our DMD program. We completed our placebo controlled portion of study 201, our Phase II B study of eteplirsen in Duchenne muscular dystrophy in February. I’m extremely pleased to announce that we are on track to have top line results of our placebo controlled 24-week data by the end of April. This is a seminal event for the company and that it will help us evaluate the potential disease modifying effects of our drug compared to an untreated placebo cohort.
Importantly, we were very careful to include enrollment criteria in that trial that enhances our ability to detect the treatment effect over a 24-week timeframe. We did this by establishing inclusion criteria that captures progressive disease. For example, we enrolled boys that were at least seven years of age at the time of enrollment and also required a certain walking distance on their six-minute walk test specifically between 200 and 400 meters walk that will be informative for predicting a progressive decline of ambulation and other muscle strength and performance endpoints.
While we were very encouraged by the biochemical evidence from our previous UK study as it showed that 10-milligram per kilogram and 20-milligram per kilograms dose once weekly by IV infusion produce increases in novel dystrophin in every patient as well as dose-dependent reduction in inflammatory T-cell infiltrate in the muscle biopsy. It is important to note that our current study 201 trial evaluated higher doses over longer duration of treatment than what we saw in the previous study.
As a reminder, 12 patients in Study 201 received once weekly intravenous infusions of either 50 milligrams per kilogram of Eteplirsen, 30 milligrams per kilogram of Eteplirsen or placebo. We had recently amended the Study 201 protocol to include four weeks of open label Eteplirsen which allowed the patients to receive uninterrupted continued dosing of Eteplirsen and immediate roller of our placebo patients to open label Eteplirsen. This amendment also gave us sufficient time to set up and train the local institutions that will be dosing these patients closer to their home town rather than to fly these families weekly to Columbus, Ohio where the placebo blinded portion of the study took place.
Study 202 which is our extension study to Study 201 and which will assess the long-term safety and efficacy of Eteplirsen received IRB approval and has already begun dosing the first few patients. These patients were initiated dosing this past week. We now have six patients on 30 mg/kg and 6 patients on 50 mg/kg and we will have 48 weeks safety and efficacy data in eight of these patients and 24 week data in four of the original placebo patients by the end of this year.
We have also requested an additional biopsy in Study 202 which will occur at 48 weeks in the original Study 201 treated patients and at 24 weeks the same time point in the original placebo patients. These biopsy data will be important to understand the steady state or potential plateau levels of dystrophin at the dose we tested at the 48-week time point in addition to adding to the earlier biopsy data sets at 12 weeks and 24 weeks. Finally, we will continue to capture clinical outcomes from these patients in study 202 during this open label phase at 36 weeks, 48 weeks, and every 12 weeks through the 108 weeks from the original study 201 initiation of dosing.
We also believe these additional biopsy results along with the additional longer term clinical outcomes and safety will be useful in our discussions with the FDA as we discuss the fastest path toward approval. Additionally, we have an update related to our long-term animal tox program and I’m pleased to say that we’ve completed dosing in our nine-month primate study, our six-month mouse study, and our 12-week juvenile rat study. We expect to have final data sets by the end of the second quarter for all of these studies. We will plan to put these study 201 Phase IIB results along with the long-term animal tox program results into a briefing document to request an end of Phase II meeting with the FDA in the third quarter of this year.
The purpose of that meeting with the FDA will be to discuss the design of our pivotal study including gaining feedback on the acceptable endpoints for approval. We are still planning to have a larger confirmatory study for eteplirsen ready to enroll by year end with dosing to begin in the first half of 2013. We have continued to make process improvement in our manufacturing of eteplirsen and are preparing our contract manufacturers to deliver drug supply for our pivotal study as well as our ongoing extension study.
Since our last earnings call, we also announced we are actively pursuing development of a product candidate that skips exon 45 through an IND-enabling collaborations with Children’s National Medical Center and Carolinas Medical Center. And we are also finalizing the terms of a second IND-enabling collaboration through NIH’s trend program, the treatment of rare and neglected diseases which was Francis Collins is brainstormed to assist in translating promising technology from the bench to the clinic and we were pleased to win support for the development of a product candidate that skips exon 50. We expect that these two additional exon skipping drugs will be ready for initial clinical trials by the end of 2013.
Furthermore, these two collaborations along with our Eteplirsen program formed a foundation of our larger pan exon development program and may serve as a lynchpin in the pursuit of a class approval of our backbone chemistry for DMD.
We believe a class approval is possible if we can demonstrate sequence dependent efficacy and sequence independent safety and pharmacokinetics at a standard dose and using the same manufacturing process to produce the same quality of products. Because of the breadth and diversity of genetic mutations across the DMD population, several dozen drugs would be required to treat every DMD patient with our technology. And a class approval would be the only feasible way to make more drugs available for the majority of exon skipping amenable DMD patients including those with less prevalent genetic mutations.
Related to our pipeline of follow on DMD drugs that target other exons, we had an important hearing with the European Patent Office in November of last year where we opposed what we considered an overly broad patent that had claims to 11 of the most prevalent exon skipping target, including our lead program targeting an exon 51.
We invalidated or amended claims to 9 of the 11 exon skipping targets and strengthened our freedom to operate in the European Union for our overall DMD development program. However, of the two exon skipping targets for which we did not prevail, one was for the target of our lead program, exon 51. Although the written decision of the opposition hearing has not yet been posted by the European Patent Office, we are preparing to submit an appeal later this year or within four months of the posting of the written decision.
We put this patent decision in the context of the world-wide market opportunity for our DMD program. On approval of just the top four or five exon skipping drugs would triple the US opportunity beyond Eteplirsen. And with the favorable patent decision on the top exon beyond exon 51 in Europe, the market opportunities for these top exons across US and Europe is more than six fold greater than the US only opportunity of our lead product Eteplirsen.
Overall, our DMD program has been a critical inflection point. And if the 24- week data from our Eteplirsen study is favorable and shows the benefit on clinical outcomes that we’re hoping for, we will be intent on exploring the fastest path toward approval of the drug with the FDA. We believe it is an exciting time to be developing therapies for rare diseases like Duchenne and it is the time where we are seeing an alignment of goals across industry, patient advocacy, the legislative agenda and the FDA. As evidence of this, today the FDA is hosting here first Rare Disease Patient Advocacy Day designed to connect patient advocacy groups like the National Organization of Rare Disease and the genetic alliance with the NIH and the FDA in the interest of increasing awareness and collaboration. And just yesterday the NIH hosted their fifth Annual Rare Disease Day in which AVI participated to show our solidarity with other rare disease company’s advocate and stakeholders.
Now I’ll turn attention to our government sponsored infectious disease program where we continue to advance our two drug candidates for the treatment of the light threatening Ebola and Marburg. We had our final drug and safety monitoring review up the completed phase I single ascending dose or SAD studies earlier this year. And the DSMB concluded that the druggist faith at the highest tested of 9 milligrams per kilogram.
This is an important finding that it demonstrates the safety of our morpholinos in the clinic with one of our next generation chemistries that we refer to as PMOplus. Specifically today this chemistry is a positively charged version of our morpholinos which has shown greater anti viral efficacy without drug related adverse event in human subjects.
We are now preparing for the multiple ascending dose or MAD study in healthy volunteers and we are looking forward to exploring multiple doses and potentially higher doses then 9 milligrams per kilogram which will help us understand and possibly widen the therapeutic window for not only our Ebola and Marburg drug candidate but for future applications against the merging viral and bacterial target utilizing the same backbone chemistry. These MAD studies are planned to start in the second half of this year.
In parallel to the safety studies for these two drugs we have also begun a series of studies in primates to establish the optimal drug component dose activity and pharmacokinetics to determine the appropriate design for our pivotal studies in primate to support approval of these drugs under the FDAs Animal Rule. We have completed the first of those studies to determine the most effective dose and drug component to proceed with our Marburg program.
Earlier this week at the ASM, The American Society of Microbiology, Biodefense and Emerging Infectious Disease Research meeting held in Washington DC, we announced data from a Marburg primate study where we showed that our drug candidate AVI-7288 achieved 100% survival at the end of treatment at 14 days and through the end of follow up at 14 days compared to 0% survival at this time point for the untreated controls.
Importantly, we have also demonstrated that AVI-7288 on a standalone basis was efficacious as a single agent at a dose of 15 milligrams per kilogram compared to the previous combination therapy that we had been testing against the Marburg virus. To this end, we have made an amendment to the current open IND to proceed with the active components of what was formally known as AVI-603 which will be now referred to as the single agent AVI-7288.
We are in the middle of a similar study for our Ebola drug candidate, while we are evaluating the acid components of the drug at single agents versus the combination drug AVI-6002 that had been previously tested. We should be able to announce top line results from this study in the coming months.
Last year, we had a modification to the contract with the Department of Defense which supported completion of our multiple ascending dose studies and all of the primate studies prior to our pivotal studies within our current contract module, the first of four which would come to fruition the first module in mid 2013. So, over the next year through the middle of 2013, we are on track to complete our multiple ascending dose studies and the additional primate studies which include PKPD studies in primates and the delayed time to treat studies in primates, all of which will also be looking at efficacy and survival endpoints.
While we are on the subject of our execution of the government-sponsored programs, I’d like take this time to provide an update on some organizational changes at the company, many of which have enhanced our ability to execute on the current government programs as well as support the potential award of future contracts with the department of defense and other government agencies that support research for medical counter measures and pandemic planning.
First we announced the higher of our Senior Vice President of Technical Operations, Jayant Aphale who had significant experience in scaling up drug production in anticipation of late-stage clinical trials and commercial approval.
Prior to joining AVI, Jayant was the VP of Manufacturing for GlaxoSmithKline where he was based in Belgium overseeing their vaccine production facility and capability. Priority to GSK, Jayant was at Enobia, helping that company prepare for late-stage clinical development and commercial scale for a fusion protein to be a flight in the area of rare disease. Both of these experiences and Jayant’s expertise and manufacturing operations in scale up are well suited for both our DMD program and our infectious disease applications with the government.
We’ve also made some additions at the Vice President and Senior Director Levels that will also strengthen our support team on the government in DMD programs. Specifically, we hired Diane Berry as our Vice President of Global Health Policy and Government Affairs.
Diane has spent most of the last 10 years working at various federal agencies on Capitol Hill and built an expertise and high level contacts across these organizations that are charged with developing the government’s programmatic legislative and funding priorities for medical countermeasures and executing to those priorities. She most recently was the Chief Scientist and Director of Threat Characterization and Countermeasures in the Office of Health Affairs at the Department of Homeland Security, where she served as a nexus between the Department of Homeland Security and the Department of Health and Human Services on medical countermeasure issues primarily through her role as the public health emergency medical countermeasure enterprise.
We also recently hired Teresa Moody as our Senior Director of Project Management to oversee all of the activities across our Ebola and Marburg programs. Teresa joined us from Quintiles where she spent the last 10 years working almost exclusively on government-sponsored infectious disease programs. Here, Teresa became an expert in complying with government regulations and guidelines in support of these programs in addition to becoming an expert in writing proposals for various agencies to ensure the best chance of contract awards.
Additionally, we hired Robin Wallace as our Senior Director of Clinical Operations to oversee and manage the clinical aspects of both our DMD and Ebola and Marburg programs. Robin brings with her more than 15 years of global clinical trial management at the CRO and pharmaceutical biotech side of the industry. She has been a successful trainer and mentor of clinical trial associates and managers and brings a high degree of professional excellence to our company.
Lastly, I regret to inform you that Effie Toshav, our General Counsel and a Senior Vice President of the company tendered her resignation effective last Friday, February 24, to pursue other opportunities. We are sad to see her leave and are thankful for her many contributions to the company during a critical time of transition over this past year.
Our staffing has changed quite a bit over the last year and accommodated in a reduction in force of about 30% of our full-time staff in December. We also reduced the non-essential activities and cut our reliance on a variety of contract workers and consultants. As we began 2012 with approximately $40 million in cash, we believe that this effort to focus on the most essential activities and staff required to execute our priority programs has made us a leaner, more efficiently run organization that is better equipped to manage our cash burn.
With that I would like to turn the call over to Mike Jacobsen, our Vice President of Finance and Principal Accounting Officer who will review the financial results for the quarter.