Brett Haumann
Analyst · Guggenheim. Your question please
Thanks Rick. I will start with TD-1473, our oral pan-JAK Inhibitor specifically designed for targeted delivery to the gastrointestinal tract for the treatment of inflammatory bowel diseases including ulcerative colitis, a debilitating disease of the lining of the colon that affects roughly 700,000 patients in the U.S. each year. Our goal is to develop a treatment option for UC and other GI diseases with a highly favorable therapeutic index and a clinically meaningful benefit for this differentiated from currently approved and investigational therapy. These include injectable biologicals such as anti-TNF and integrin inhibitors as well as oral medications such as Tofacitinib and oral JAK inhibitor. These systemically active therapies have shown varying degrees of efficacy in UC, but carry the risk of systemic immune suppression, which can lead to serious side effects including infection and tumors that limit their long time use in patients. Our vision for 1473 was to create a drug candidate that could represent a radical change and approach to the treatment of inflammatory bowel disease such as UC not just an incremental improvement of the current approaches. 1473 was purposefully designed for targeted delivery to colonic enclosure where it can act to reduce disease activity at the relevant size of information without being released into the systemic circulation for any significant degree. This targeted approach is one we've employed for many years in the development of inhaled medications of the treatment of diseases of the lung. We designed 1473 to be an orally available small molecule that has an optimized solubility and permeability profile to ensure slow and limited absorption throughout the full length of the intestine. In addition, it has the right dynamics and kinetics to block the immune response at the site of inflammation in the colon with very little systemic exposure, so that the risk of systemic side effects can minimize. In June, we hosted a key opinion leader event for the investment community based on the current standard of care for UC and GI diseases, JAK inhibitor has a class and 1473 is differentiated product profile and potential utility as a targeted local therapeutic option. Preclinical in vitro and x-vivo data showed the 1473 is present in the colon including in the inflamed colonic wall and is having anti-inflammatory effect in the cells of interest. Our in vivo preclinical model have demonstrated the 1473 reducive disease activity to a level that it at least as good as Tofacitinib, but without the associated immuno-suppression. At this event, we reported results from our recently completed Phase 1 program showing that 1473 meta target PK profile with favorable safety and tolerability to support progression of 1473 to a Phase 1Ib trial in patients with UC. The totality of the data generated in the program to-date validate our strategy of targeting JAK inhibition in the affected tissue within the intestine tract in order to achieve designed therapeutic results. While at the same time, minimizing the risk of systemic effects such as immuno-suppression. We believe the 1473 represents a potential breakthrough approach to treating Ulcerative Colitis including the potential to be used in patients earlier in the cause of that disease ahead of injectable biological agents. Later this year, we plan to initiate our Phase 1b dose ranging trial, which will be the first time 1473 will be administered to Ulcerative Colitis patients. This study should yield important additional safety and disease activity data and we are excited to embark upon this important milestone in our efforts to develop a treatment for Ulcerative Colitis and other inflammatory bowel diseases. I would now like to turn to discuss our NIP inhibitor program where our goal is to develop a medicine that has [full of] [ph] potential to be combined with complementary mechanisms to treat chronic heart failure and other serious cardiac and renal diseases. TD-0714 is the most advanced compound in our NIP inhibitor program. Last quarter, we reported favorable safety, PK and biomarker data from the Phase 1 single ascending dose study of 714 in healthy volunteers. This study met our target product profile of sustained 24-hour target engagement based on elevated cyclic GMP, favorable safety and tolerability and non-renal clearance. The finding of non-renal clearance is especially important because a significant number of patients with cardiac and renal disease who may benefit from NIP inhibition, or could have compromised renal function and drugs that relisted such as NEP inhibitor in Entresto have the potential to accumulate increase in the risk of unwanted side effects and/or requiring dose adjustment. Our Phase 1 multiple ascending dose study of 714 in healthy volunteers is ongoing and is schedule to relaunch in the second half of this year. We believe that our NEP inhibitor program has the potential for broader applicability beyond chronic heart failure. But, as the potential to be combined with a range of other mechanisms that may offer advantages over Entresto including once daily dosing by a oral or intravenous root, sustained 24-hour target engagement and importantly non-renal clearance. Achieving non-renal clearance may enable our NEP inhibitor to treat chronic heart failure in a broad range of renally compromised patients without those adjustments as well as in patients with acute heart failure and chronic kidney disease including diabetic nephropathy. A product with this target profile could represent a major advance in treating these diseases. Now turning to our late stage pipeline, the Phase 3 program for Revefenacin our investigational nebulized once daily Long-Acting Muscarinic Antagonist or LAMA for the treatment of COPD has progressed rapidly. We completed enrollment across all three pivotal Phase 3 studies successfully enrolling more than 2,300 patients in just over 200 U.S. clinical sites over an eight month period. The next key milestone will be the rebound from our replicate Phase 3 efficacy studies anticipated early in the fourth quarter of 2016. This will be followed by relaunch of the 12-month safety study slated for completion in 2017. Assuming positive outcome from all three studies we plan to file an NDA for Revefenacin next year. We and our partner Mylan also working together in earnest on the detailed commercial planning for Revefenacin. We believe that there is a large commercial opportunity for Revefenacin as the first once daily nebulized bronchodilator for COPD with an opportunity to become a standard of care in this market segment. Patients who require or prefer nebulized therapy because they may not be able to receive adequate bronchodilation with a handheld device did not currently have any once daily therapeutic option. We believe this COPD patient population is large and underserved encompassing the 9% of COPD patients who use nebulizers for ongoing maintenance therapy and the approximately 41% of COPD patients who use nebulizers intermittently for bronchodilator therapy. We're especially interested and excited by the prospect of co-promoting Revefenacin with Mylan as it aligns well with our commercial focus, capabilities and expertise in the acute care market segments where our sales reps are experienced in calling on pulmonologist and respiratory care physicians for VIBATIV. There are about 800,000 patients admitted each year to U.S. hospitals for worsening of their COPD, about half of these patients leave the hospital with the prescription for nebulized therapy. This is important because having an established commercial presence in and around acute care centers gives us the opportunity to target large and addressable patient populations at pivotal time starting in the hospital and expanding into the outpatient treatment setting. Now, I'd like to turn the call back to Rick.