Brian Culley
Analyst · Maxim. Please go ahead with your question
Thank you, Ioana. Good afternoon everyone and thank you for joining today’s call. With me today are Brandi Roberts, our Chief Financial Officer and Ed Parsley, our Chief Medical Officer. I’ll begin today with an update on our lead candidate Vepoloxamer for sickle cell disease. As you all know, Mast is conducting a 388 patient Phase 3 study called EPIC, which seeks to demonstrate that Vepoloxamer can reduce the duration of a vaso-occlusive crisis. We now have opened more than 75 sites in 12 counties with more than two thirds of the study sites located in the U.S. We recently opened sites in the United Kingdome and France and a few weeks ago our EPIC study surpassed the 80% enrolment mark. We are extremely proud that Mast has enrolled more patients in an interventional sickle cell disease study than any company in history. Thank you in part to an incredible effort by our clin-ops team and motivated investigators around globe. We are able to share some key demographic characteristics from the EPIC study. The average age of patients’ enrolled to-date is 15 years and 72% of EPIC patients are under the age of 18, a distribution which is in line with our objectives. About 80% of our clinical sites have enrolled more than one patient reflecting broad support for the study and more than 50% of patients’ enrolled to-date are coming from the U.S. That’s a finding which we expect will continue through completion of the study. Notably 61% of patients enrolled in EPIC are on hydroxyurea. As you may remember, in a Phase 3 study run by prior sponsor vepoloxamer showed a statistically significant reduction in the length of vaso-occlusive crisis in pediatric patients and patients who are on hydroxyurea. So as such, we believe the demographics I just shared are encouraging and give us added confidence about the potential for vepoloxamer to show a clinical benefit in sickle cell disease. In September, the Independent Data Safety Monitoring Board for the EPIC study held a meeting to review data from the first 250 patients enrolled in the trial. The SMB reported to Mast that no unexpected safety signals had been observed and that no further meetings of the DSMB would be necessary before completion of the study. Separately, as we discussed in detail at our Investor Day in early October, a blinded statistical analysis conducted on the first 250 patients concluded that the study’s actual performance was consistent with the statistical assumptions of which the study was designed, including as expected levels of variability in the primary efficacy outcome measurement across the U.S. and non-U.S. regions. Turning again to enrolment, as many of you saw in the Detailed Enrolment Graphic we shared publicly at our Investor Day, patient enrolment has tracked very closely with our projections. While we experienced slower than predicted enrolment in the last month we believe our service performance is an outlier and not a signal of a broader slowdown. In fact vendors enrollment is back in line with our original projections and specifically although we are only in the second week of November, we already enrolled more patients this month than we did in the entire month of October, which gives us confidence that we really only lost a few weeks. Now we don’t know why October was slower than expected, but we solicited feedback from our sites, including during investigated meetings which we conducted in the second half of October, at which approximately 90% of our U.S. sites were represented and based on their continued enthusiasm and support we continue to anticipate the enrolment of the final patient will occur in Q1, 2016. To be conservative however, we are now updating our timeline for announcing top-line EPIC data to Q2, 2016. This will provide us with sufficient time for post-studies activates required prior to announcing top-line data. For those who are unfamiliar with this process, I will just briefly explain that following the final patients enrolment and resolution of their crises ,we must wait for a 30 day observation period to pass, followed by weeks of blinded data review and quality control procedures, leading ultimately to data base lock and unblinding by the study statisticians. Once their work is complete, the statisticians can provide senior management with the top line data and that is when Mast executives will learn the outcome of the study and its top-line results, which we will announce promptly thereafter. In addition to our focus on enrolment, we have been working to enhance our vepoloxamer data set and support our NDA with additional clinical studies. You will recall that we previously announced positive results from a 60-patient thorough QT study and last month we dosed the first patient in our weekly dose study EPIC-E. EPIC-E will expand our already extensive safety data base with repeat exposures and provide physicians with new world experiences using vepoloxamer during a vaso-occlusive crisis. Third, we are in the process of staring a special population study in approximately 40 renally-impaired subjects to supplement dosing information in our eventual label. This may sound like a lot of clinical work for a rare disease program, but our objective is to deliver to the FDA a robust data package to help ensure vepoloxamer is improvable and utilized in the most appropriate way for each patient. Thus each of these clinical studies I just mentioned, along with the tissue oxygenation sub-study and bio market data being collective within EPIC is intended to enhance our NDA and provide the agency with supporting evidence to demonstrate vepoloxamer efficacy in improving the path of physiologic processes occurring during vaso-occlusive crisis. Because we believe vepoloxamer will demonstrate a clinical benefit in this study, we have already begun to prepare for an NDA submission, including building out an experienced regulatory team. Following the announcement of top-line results from EPIC in Q2, we will request a pre-NDA meeting with the FDA to discuss our submission and to gain their insight on our forthcoming application. We believe we will be invited to participate in an FDA Advisory Committee meeting and are planning for this event. Among other things, the Advisory Committee meeting will give the agency the opportunity here to refer some patients in advocacy groups about the need for a new therapy in this disease. If our NDA is approved, we would anticipate launching vepoloxamer in the second half of 2017 consistent with our prior guidance. From a commercialization perspective, we believe vepoloxamer is extremely well posted for success in the FCB market, as a novel therapy with a unique and relevant mechanism of action and which has the potential to be the first and only approved treatment to reduce the duration of an ongoing crisis. We would have a significant first-to-market advantage as we currently enjoy more than a two year head start on our closest interventional competitor and an even greater lead on prophylactic treatments which have only just begun in the long road of clinical testing. Certainly we’ve been extremely focused on conducting a rigorous Phase 3 study in sickle cell disease. I’d like to note that we also are excited about our other clinical programs, because we potentially can impact a far greater number of patients in diseases including heart failure and stroke. In particular, last month we initiated our Phase 2 study of vepoloxamer for the treatment of chronic heart failure. With Phase 2 study as a randomized double blind placebo control multicenter and global study utilizing a new formulation of vepoloxamer. Approximately 150 patients will be randomized equality into one of three studies arms and receive one of two dose levels of vepoloxamer or placebo control. Vepoloxamer will be administered in addition to standard medical therapy as a single intravenous infusion lasting just three hours in an out-patient setting or short stay in-patient unit. The purpose of this study is to evaluate whether vepoloxamer can provide a functional and/or biochemical benefit to damaged heart muscle cells, which will be evaluated by echocardiograms and blood based laboratory markers and to evaluate the safety and pharmacokinetics of vepoloxamer in chronic heart failure patients compared to placebo control. Notably, this Phase 2 study is testing a new formulation of vepoloxamer designed to be more suitable for heart failure patients and for which we recently filed a provisional patent application. We now have multiple pending patent applications, including a new formulation application and a new composition of matter application, which would provide multi-protection for vepoloxamer in the setting of heart failure. This new formulation is distinct from our sickle cell formulation, which we believe could provide us with important commercial advantages and/or business development opportunities. In addition, earlier this week non-clinical data of vepoloxamer in advanced heart failures was presented at the American Heart Association’s Scientific Sessions. The results from that study indicated that repeated administration of vepoloxamer in animals with severe heart failure elicited progressively sustained improvements in Left Ventricular Systolic Function, which is evident for at least six weeks. We were pleased with the AHAs recognition of this study and continue to believe the results support the development of vepoloxamer for the treatment of acute and chronic heart failure. We also continue to work with world leaders in the stroke filed, to develop a regulatory and clinical strategy for vepoloxamer in ischemic stroke with the goal of demonstrating that vepoloxamer can improve microvascular perfusion and reduce infarct sizes in patients. Depending on the outcome of our other programs, we would look to advance the stork program into the clinical in the second half of next year. Now, we usually spend the majority of our time talking about vepoloxamer, but I think it’s worth highlighting the progress we recently made with AIR001, our second pipeline product. We believe AIR001 maybe uniquely suited to address the serious unmet need of patients with heart failure with preserved ejection fraction of HFpEF and our pursuing development in that indication. In particular, we currently are supporting two institutional sponsored Phase 2a studies of AIR001 in patients with HFpEF. Initial observations from these ongoing Phase 2a studies are encouraging. In particular, this week at the American Heart Association a lead breaking clinical trial presentation suggested that organonitrates, which otherwise can compete with AIR001 were not a suitable treatment for HFpEF patients. But the medical expert from the main clinic who presented this work explained that inorganic nitrates might have been a better choice for this patient population, based upon biochemical issues with the bio activation of organonitrate that occur in diseased states such as HFpEF. We certainly agree with the suggestion and in fact data analyzed from the first six patients from one of these two studies is showing significant reductions in pulmonary arterial, pulmonary capillary and right atrial pressures. We recognized the sample size of six patients in the study thus far is small, but we nevertheless are encouraged by the fact we’re seeing a positive early signal for AIR001. In our second investigator sponsor study which is blinded and placebo controlled, there are still four patients left to enroll. So we will not see that data until after enrollment is complete, which we hope will turn before the end of the year. But if the results from these Phase 2 studies are positive, we would plan to begin a Phase 2b proof of concept study of AIR001 and HFpEF patients next year, either on our own or with a partner. Overall, I think it’s important to keep in mind that there are two Phase 2a heart failure studies yet to be reported by Mast, which may markedly elevate the value of our second asset. I have two additional items to mention to you today. We continue to be committed to raising awareness in the investment community of Mast’s work and our progress. We received substantial feedback which is positive from our Sickle Cell Conference in September and our Investor Day and Dr. Marty Emanuele, our Senior Vice President of Development will be representing Mast in upcoming events hosted by Maxim Group called Sickle Cell Disease, from science to the commercial opportunity and how the treatment paradigm is changing, which will be held on November 20 in New York City. Additionally and I think this is a great example of our last, but is not any least. We also recently announced the appointment of two new members to our Board of Directors, Peter Greenleaf and Matt Pauls. We are excited to welcome the contributions of these two highly respected and successful biotech executives and are pleased they want to be involved with our company’s growth. Peter Greenleaf is the CEO of Sucampo Pharmaceuticals and has a long track record of commercial and transactional success and similarly Matt Pauls is the CEO of Strongbridge Biopharma and brings us a wealth of experience, most notably in commercializing drugs for rare diseases. We believe their collected expertise in helping small and mid-sized companies transition into industry leaders will be vital as we approach the completion of our EPIC study and position for product commercialization. At the end of the day, we believe the best way to reward our shareholders for their patience and support is to complete the EPIC study as quickly as we can and with the highest quality data possible, in order to demonstrate vepoloxamer’s clinical value and to continue to build value across other indications, as well as with our AIR001 program. With that, I’d like to turn the call over to Brandi to go through our Q3 financials.