Doug Ingram
Analyst · Bank of America. Your line is open
Thank you, Mary. Good afternoon and thank you all for joining us for Sarepta Therapeutics second quarter 2020 investor conference call. As I have mentioned in the past, on March 13 of this year, all but the small contingent of our workforce transitioned it to a virtual work environment. Notwithstanding this unusual approach, we are not merely remaining productive, but have arguably become even more efficient and effective as we advanced our multi program, multi-platform genetic medicine ambitions. As you will hear this afternoon, we have continued to serve the patient community with our approved therapies, have already achieved or remain on track or many planned 2020 milestones expanded our three-pronged approach to building our enduring gene therapy engine. And as we have generated additional evidence in 2020, continued to build confidence in our unique approach to gene therapy is proving successful and highly differentiated. With that, let us review our performance. As we continue to serve our patient community, while endeavoring to keep them safe in this pandemic, I am pleased to report that our second quarter net sales stand at $111.3 million, an 18% increase over the same quarter last year. As I mentioned in our last quarterly conference call, we withdrew our 2020 guidance in light of the potential impact of COVID-19 on clinic visits. As you can see, that impact has thus far been modest. Given the uncertainties of the external environment, we are not ready yet to set full year guidance. However, consistent with what we have seen thus far in 2020, we anticipate that any continuing impact from COVID-19 will remain modest. Moving to our development programs, let me begin by commenting on our RNA franchise. In the second quarter, we completed our NDA submission for casimersen. Our RNA therapy built on our PMO platform and designed to treat the 8% of the Duchenne community who are exon 45 amenable. The PDUFA date for casimersen should be in the first quarter of 2021. If we are successful in obtaining this approval, casimersen will be our third FDA approved therapy, bringing the percentage of Duchenne community with available PMO therapies to nearly 30%. With a successful casimersen approval, we will have more than doubled the size of the treatable patient population since eteplirsen was first approved. As successful as our PMO platform has been, we are not satisfied with the status quo. We have been working on our next generation of the PMO, which if successful, they profoundly improve the efficacy and convenience of our RNA technology. We are in our multi-ascending dose study called the MOMENTUM study for a peptide-conjugated PMO or PPMO and that is candidate 5051. Here we are using a proprietary positively charged peptide to increase penetration. In animal models, we have shown that if we can safely achieve appropriate dose levels, the PPMO greatly increases tissue exposure in turn greatly increasing exon-skipping and thus dystrophin production. Treating Duchenne is all about increasing the production of the structural shock absorber dystrophin. So if the PPMO candidates are able to increase exon-skipping and dystrophin production, we could see a profoundly more efficacious RNA platform. And at monthly dosing versus the PMO weekly dosing, we would have a far more convenient therapy as well. In the second half of this year, we will have completed and we’ll release our safety tissue exposure, PK/PD and comparative exon-skipping for our PPMO 5051 candidate at 20 mg per kg. This will be an important proof of concept for that therapy, not only within DMD, but more broadly as a potential RNA platform to treat diseases where our steric blocking RNA technology could provide therapeutic benefit. Let’s move now to our gene therapy engine. There are three pillars upon which we are building our gene therapy engine. First, our pipeline, second manufacturing capacity and manufacturing expertise, and third advancing and improving the science and effectiveness of gene therapy itself. Over the course of 2020, we have not only stayed on track, but having successfully dosed a significant number of DMD and LGMD patients. And with the additional data we have generated already this year, we continue to build confidence that our unique approach to gene therapy research and development is first-in-class and replicable. Consider the additional confirmatory data on our gene therapy platform that has been generated already this year. One of the most significant challenges with full body neuromuscular gene therapy is safely delivering the proper number of genome copies to cell nuclei. In this regard, Sarepta’s programs have shown good tolerability and exceptional expression at reasonable doses. Now you will recall that in 2018, we announced the results of study 101, our first four DMD patients on SRP-9001, reporting a mean of 3.3 genome copies per nucleus, protein expression approaching normal as measured by western blot, IF positive fibers and IF intensity and that all patients improved significantly on each and every functional endpoint measured. On that basis, we commenced a placebo-controlled trial for SRP-9001 in the fourth quarter of 2018 using clinical material. Then in 2019, we announced the results from our three patient low dose cohort for SRP-903 to treat LGMD2E. This is important for our platform because SRP-9001 and SRP-9003 share much in common within the design approach under the guidance of Dr. Louise Rodino-Klapac, the same viral vector, AAVrh74 and the same promoter the heavy chain MHCK7. We were pleased to report that even at a quarter of our SRP-900 dose, we had exceptional expression. As an example, over 50% of beta-sarcoglycan positive fibers were achieved. Every child improved significantly on every functional measure at nine months. In 2020, we have generated additional consistent data and gained more experience with our constructs. In the second quarter, the one year results for Study 101 in Duchenne were published in JAMA Neurology, showing that every boy in the study improved significantly on each and every function line point at one year. In the same month, we announced the results of our second three patient cohort treated with SRP-9003 for LGMD2E, using the same dose that we have used for SRP-9001 for Duchenne. We were very pleased to announce that with the increased dose, we yet, again confirm the ability of our construct to safely deliver gene therapy robustly. The children in the study had 4.2 genome copies per nucleus on average. There was a significant dose dependent increase in expression with children achieving 62% of normal on western blot, 72% of protein positive fibers, and 73% on intensity. Additionally, in our 41 patient placebo-controlled Study 102 using SRP-9001 for DMD, we dosed all children for the main analysis and are dosing children on crossover as well. By now between our two studies for SRP-9001 and our study for SRP-9003, we have dosed over 35 patients with active therapy, far more than any similar clinical programs in the studies are proceeding at pace. The second pillar of our gene therapy engine is our manufacturing expertise. And there we have built impressively over the last two years. We have among the greatest capacity available for gene therapy in biotech in just two years between our dedicated suites at Catalent and our dedicated site in Lexington with Thermo Fisher. At the same time, we have built out our centralized gene therapy, manufacturing expertise within Sarepta. It is this group that drives the analytical and process development approaches across our programs and with our partners. Across Burlington and over Cambridge and our gene therapy center of excellence in Columbus, we now have some 270 professionals dedicated to technical operations, manufacturing and quality. For SRP-9001, we have completed process development and analytical development and have completed GMP runs for the material with land views, both for our next clinical trial and commercially. For SRP-9003, we’re in GMP runs now. The third pillar of our gene therapy engine is bringing together the technology and tools necessary to improve and advance the science and effectiveness of gene therapy. We are a science driven company, and I am pleased to note that COVID-19 has done nothing to slow our progress in this endeavor. Having built out one of the deepest and most valuable gene therapy pipelines commencing in 2017, and then spending an enormous effort in the last two plus years on building out our manufacturing process, commencing in 2019, we began to aggressively look for opportunities to advance the science of gene therapy to compliment our internal program development. In this quarter alone, we have added four new approaches to our armamentarium. In May, we announced our partnership with Dyno Therapeutics for the use of their AI and machine learning approach to develop improved capsids. From there, we entered into a partnership with Selecta Biosciences to use their ImmTOR technology in an effort to empower re-dosing. And then we entered into a partnership with Hansa Biopharma to access imlifidase with the goal of using it to ablate pre-existing neutralizing antibodies and to open gene therapy to patients that would otherwise be left behind. And then from there, we entered into a relationship with Codiak BioSciences to explore the use of exosomes across gene therapy, gene editing and RNA. Now looking forward, we have important gene therapy engine milestones across the remainder of 2020. First with respect to SRP-9001, we have two major efforts ongoing. We must complete Study 101, our blinded placebo-controlled trial using clinical material. That trial is on track to have last patient last visit by the end of this year and to read out in the first quarter of 2021. Secondly, with GMP in the commercial material now in hand, our goal is to start our next trial in the second half of this year, our remaining gating items there are the following; first, engaging sites and obtaining IRB approvals. The pandemic has certainly created some challenges here, but the team is working through them and things are going quite well, and second, gaining alignment with the FDA on the initiation using the GMP material, which will occur this quarter. With respect to SRP-9003, our goal is to start our pivotal trial in 2021. Our two gating items here are these; first, completing assay development and obtaining the release of our GMP runs, and second, completing a dialogue with the agency on the appropriate regulatory and development pathway for SRP-9003. Now this is an important dialogue, it will not only inform the development for SRP-9003, but we believe, it will provide insight into the development pathway for our other five LGMD candidates. We will provide an update on the LGMD discussions and our GMP material for SRP-9003 in early 2021. If you will indulge me on a personal note, the second quarter marked my three year anniversary at Sarepta. In three years, we have made an enormous amount of progress toward our goal of bringing a better, longer life to those living with and too often dying from their disease. And we have done so by building and articulating an ambitious vision to become the leader in rare disease genetic medicine, with a robust and productive RNA platform and an enduring gene therapy engine. By gathering the resources and talent to make that a reality, and by then ruthlessly executing with a rapidity that to the extent possible matches the urgency of the very patients that we serve, patients who have their movement and their lives stolen from them bit by bit daily and hourly. In the last three years, we have built a pipeline with over 40 programs, are now in 10 clinical trials advancing multiple therapies. Have made enormous progress in building from ideation to reality, our three pillar gene therapy engine and are seeing consistent and confirming results thus far. As I reflect on our progress, the credit should go to three groups, the sophisticated, dedicated and hardworking professionals that make up our over 1000 strong workforce at Sarepta. Our external partners, in my opinion, the best and brightest in genetic medicine around the world. And of course, our patient community, a community that not only relies upon us, but also informs us and guides us and often pushes us. So we are clear now is not yet the time for a victory lap or premature celebration. We are encouraged by our success so far, but we have much to do over the course of the next 15 months and still much more to prove. But you can count on this team, stay on mission, to address and remove obstacles that appear here in front of us and to execute for patients waiting for our therapies. And with that, I’ll now turn the call over to Bo for a commercial update. Bo?