Brian Lian
Analyst · Chardan Capital Markets. Please go ahead
Thanks, Greg. I’ll now provide an update on our recent development activities, beginning with our lead program, VK2809 for the treatment of NASH. As a reminder, VK2809 is an orally available small molecule agonists of the thyroid hormone receptor that possesses selectivity for liver tissue, as well as the beta receptor subtype, suggesting promising therapeutic potential in a range of metabolic disorders, including NASH. As we previously discussed, in a 12-week Phase 2 trial in patients with hypercholesterolemia and non-alcoholic fatty liver disease, VK2809 produced statistically significant reductions in liver fat content, as well as improvements in LDL cholesterol, meeting the study’s primary and secondary efficacy endpoints. On exploratory efficacy measures evaluating other plasma lipids such as triglycerides, apolipoprotein B and lipoprotein (a) treatment with VK2809 also resulted in significant reductions. Importantly, the study showed VK2809 to possess an encouraging safety and tolerability profile, with no serious adverse events reported among patients receiving VK2809 or placebo. The initial data from this study were highlighted at the annual meeting of the American Association for the Study of Liver Diseases or AASLD in 2018. Additional data, including efficacy at the low dose of 5 milligrams daily were presented at the International Liver Conference or EASL in 2019. As we indicated on our last quarterly call, further results from this study have been selected for oral presentation at the upcoming 2020 EASL meeting, which will be held in a virtual format from August 27th through August 29th. The VK2809 presentation will occur on Friday, August 28th. In our view, the data obtained thus far suggests that VK2809 possesses several differentiating characteristics relative to the current NASH development landscape. In addition to the potent reductions observed in liver fat, which we believe suggest promise for improvement in other histologic features, VK2809’s broader efficacy on lipid measures suggests additional potential cardiometabolic benefits for patients with NASH. The compounds oral route of administration, liver targeted mode of action and encouraging safety and tolerability to-date, combined to place it among the most promising development programs in the NASH landscape today. Given the encouraging findings from the 12-week Phase 2 study, last year we initiated the 52-week Phase 2b study to evaluate the safety and efficacy of VK2809 in patients with biopsy confirmed NASH and fibrosis. This study which we’ve called the VOYAGE study is a randomized, double blind, placebo controlled multicenter trial designed to assess the efficacy, safety and tolerability of VK2809 in the setting of NASH. The study is targeting enrollment of approximately 340 patients across five treatment arms, including 1 milligram daily, 2.5 milligrams daily, 5 milligrams every other day, 10 milligrams every other day and placebo. The target population includes patients with F2 and F3 fibrosis, as well as up to 25% with F1 fibrosis. F1 patients must possess additional risk factors to be eligible for enrollment. The primary endpoint of the study will evaluate the relative change in liver fat content, as assessed by magnetic resonance imaging, proton density fat fraction from baseline to week 12 in subjects treated with VK2809, as compared to subjects receiving placebo. Secondary objectives include evaluation of histologic changes assessed by hepatic biopsy after 52 weeks of therapy. We are currently enrolling patients in this study in the United States and we remain on track to open sites outside the U.S. later this quarter. As we reported in our last quarterly update, we continue to closely monitor site activities in the context of the ongoing Coronavirus pandemic. To reiterate an important comment from our last update, we have never pause enrollment in this study or indicated to our sites that we plan to defer any activities required for trial execution. Since our last update, we’re encouraged that sites continued to loosen many of the restrictions put in place earlier in the pandemic. We have more sites open for in-person and virtual payment -- patient engagement today than in prior months and anticipate further expansion of site activities in the coming months. In addition, we’re pleased to report that dosing in this study has now exceeded six months and we look forward the completion of the plan 52-week treatment window that will enable the evaluation of VK2809 safety and efficacy on histologic endpoints in NASH. With respect to further expansion of clinical sites, we remain on track to open sites outside the U.S. later this year, in both the third and fourth quarters, and continue to target over 80 sites globally. As we’ve previously indicated, we continue to anticipate completion of enrollment in VOYAGE in the first half of next year. I would now like provide an update on our VK0214 program. Like VK2809, VK0214 is an orally available small molecule thyroid hormone receptor agonist that possesses selectivity for the beta receptor subtype. We’re developing VK0214 as a potential treatment for X-linked adrenoleukodystrophy or X-ALD. X-ALD is a serious degenerative neuromuscular disease for which no pharmacologic treatment exists. The disease is caused by a defect in the proximal transporter called ABCD1. This defect can result in increase plasma and tissue levels of very long chain fatty acids, which are believed to contribute to the cerebral and motor neuron toxicities that are characteristic of the disease. The thyroid beta receptor is an important potential target for therapeutic intervention in X-ALD because it is believed to play a role in very long chain fatty acid metabolism. Data from in vivo models have demonstrated that treatment with VK0214 produces reduction in very long chain fatty acids in both plasma and tissue. These encouraging findings suggest potential benefit in the setting of X-ALD and we’re eager to move VK0214 into the clinic. To this end, we are pleased to report that we recently filed an IND for VK0214 to initiate the clinical development of this important program. Following clearance of the IND, we plan to initiate the first in human studies of VK0214, to be followed by initiation of a proof-of-concept study in patients with X-ALD. We will provide more details on trial design upon study initiation. As we advanced both VK2809 and VK0214, we continue to carefully manage our cash resources and maintain a strong financial position. As Greg stated earlier, we ended the second quarter with approximately $263 million in cash, which we currently expect will provide sufficient runway to achieve a number of the key clinical milestones that we believe will drive value creation in the future. In conclusion, we continue to make exciting progress with both our VK2809 and VK0214 programs. With respect to our Phase 2b VOYAGE trial evaluating VK2809 in patients with biopsy confirmed NASH and fibrosis, we’ve increased the number of sites that are open and actively enrolling and look forward to adding new sites both within and outside the U.S. in the coming months. We’re also happy to report that we passed the six-month dosing milestone and continue to treat subjects for the plan 52-week trial duration. We currently anticipate completion of enrollment in the first half of 2021. With respect to VK0214 for the treatment of X-linked adrenoleukodystrophy, we recently filed an IND for this program and we expect to initiate clinical development in the third quarter. Finally, during the second quarter, we continued to carefully manage our cash to ensure that we have the resources to optimally advance our key programs through the critical milestones. This concludes our prepared comments for today. Thanks again for joining us and now we’ll open the call for questions. Operator?