Brian Lian
Analyst · Raymond James. You may now go ahead
Thanks, Greg. During the second quarter, we continue to advance our clinical pipeline focused on the development of best-in-class or first-in-class treatments for serious metabolic diseases. Our lead compounds VK2809 for NASH and fibrosis, and our new program evaluating VK2735 for metabolic diseases, both advanced according to plan during the quarter. In addition, we recently announced the removal of a clinical hold on our study evaluating VK0214 in patients with X-linked adrenoleukodystrophy. I will begin with an update on our lead compound VK2809. VK2809 is an orally available small molecule agonist of the thyroid hormone receptor that is selected for liver tissue as well as the beta isoform of the receptor. This currently being evaluated in our Phase 2b VOYAGE study in patients with NASH and fibrosis. Data generated to-date suggests VK2809 has the potential to be a best-in-class treatment for NASH and fibrosis. We have previously announced data from a 12-week Phase 2a trial of VK2809 in patients with hypercholesterolemia and non-alcoholic fatty liver disease. This trial successfully achieved both its primary and secondary endpoints, and demonstrated significant reductions in liver fat and plasma lipids. The results from the Phase 2a trial included data showing that dosing cohorts treated with VK2809 experienced up to 60% mean relative reductions in liver fat content and that 88% of patients receiving VK2809 experienced at least a 30% reduction in liver fat content, including all patients receiving five milligrams per day, the lowest dose in the study. In addition, patients receiving VK2809 experienced improvements in plasma lipids such as LDL cholesterol, triglycerides and atherogenic proteins. These results have are of particular importance as VK2809 lipid lowering effects suggests a potential cardiovascular benefit. This key feature represents a significant point of differentiation when compared to other drugs and mechanisms in development that have been shown to increase plasma lipids and potentially cardiovascular risk. Patients treated with VK2809 in the 12-week study also experienced durable reductions in liver fat, with the majority of patients remaining responders four weeks after completion of dosing. Finally, the study demonstrated the promising safety and tolerability profile of VK2809. No serious adverse events were reported and the rate of GI disturbances such as nausea and diarrhea was lower among the VK2809 treated versus placebo patients. Based on these promising results, we initiated the VOYAGE study a Phase 2b study designed to evaluate VK2809 in patients with NASH and fibrosis. VOYAGE is a randomized, double blind placebo controlled multicenter trial designed to assess the efficacy, safety and tolerability of VK2809 in patients with biopsy confirmed NASH and fibrosis. The target population includes patients with at least 8% liver fat content, as measured by magnetic resonance imaging proton density fat fraction, as well as F2 and F3 fibrosis. Up to 25% of patients may have F1 fibrosis provided that they also possess at least one additional risk factor. The primary endpoint of the study will evaluate the change in liver fat content from baseline to week 12 in patients treated with VK2809 as compared to patients receiving placebo. Secondary objectives include the evaluation of histologic changes assessed by hepatic biopsy after 52 weeks of treatment. During the second quarter, enrollment in VOYAGE continued at both U.S. and ex-U.S. studies, and we remain on track to complete enrollment in the second half of this year. Moving to our dual agonist program, earlier this year, we announced the initiation of a Phase 1 trial of our newest pipeline compounds VK2735. VK2735, which was developed internally at Viking is a dual agonist of the Glucagon Like Peptide-1 or GLP-1 receptor and the Glucose Dependent Insulinotropic Polypeptide or GIP receptors. Based on data to date, we are excited about this program and the potential for this mechanism to be applicable across a range of metabolic disorders. Initial data from our dual agonist program were presented last November in two posters at ObesityWeek, the annual meeting of the obesity society. These posters highlighted the improvements in metabolic profile observed among diet induced obese mice treated with our compounds as compared to control cohorts. Specifically, weight loss, glucose control and insulin sensitivity were all enhanced following treatment with our dual agonists, compared to the effects observed following treatment with the GLP-1 mono-agonist semaglutide. When administered at the same dose for the same period of time. We observed reductions in liver fat content were generally larger among animals treated with our compounds relative to the liver fat reductions observed among animals treated with semaglutide. These results suggested that the addition of GIP receptor activity improved upon the effects achieved through activation of the GLP-1 receptor alone. In January of this year, we announced the initiation of a Phase 1 clinical trial of VK2735. The Phase 1 trial is a randomized double blind placebo controlled single ascending and multiple ascending dose study. The single ascending dose portion of the study will enroll healthy adults, while the multiple ascending dose portion of the study will enroll healthy adults with a minimum body mass index of 30 kilograms per meter squared. The primary objectives of the study include an evaluation of the safety and tolerability of single and multiple doses of VK2735 delivered subcutaneously as well as the identification of doses suitable for further clinical development. The trial will also evaluate the pharmacokinetics of VK2735 following single and multiple doses. Exploratory pharmacodynamic assessments include evaluations of changes in body weights and liver fat content after four weeks of once weekly administration. During the quarter enrollment continued in both the SAD and MAD portions of the study and we expect to report the initial data from this study in the fourth quarter. I will wrap up with an update on VK0214 Viking’s second orally available small molecule thyroid hormone receptor beta agonist and clinical development. We believe VK0214 has the potential to be a first-in-class treatment for X-linked adrenoleukodystrophy or X-ALD. X-ALD is a rare and often fatal metabolic disorder characterized by a breakdown in the protective barriers surrounding brain and nerve cells. The disease is caused by genetic mutations that impact the function of a proximal transporter a very long chain fatty acids. As a result of the mutations, transporter function is impaired, and patients are unable to efficiently metabolize very long chain fatty acids. The resulting accumulation of these compounds is believed to contribute to the onset and progression of clinical signs and symptoms in patients with X-ALD. Our rationale for advancing VK0214 into the clinic was based on the observation that the thyroid hormone beta receptor plays an important role in regulating the expression of very long chain fatty acid transporters. Multiple models have shown that improved and potentially normalized very long chain fatty acid metabolism can be achieved through increased expression of compensatory transporters. Because VK0214 is a potent agonist of the thyroid hormone beta receptor, we believe it may provide therapeutic benefit in the treatment of X-ALD. Early data from nonclinical studies have supported this rationale with VK0214 demonstrating the ability to stimulate the expression of the key compensatory transporter, very long chain fatty acids and reduced plasma levels very long chain fatty acids in an in an animal model. Last year, we reported the results of a randomized double blind placebo controlled single ascending and multiple ascending dose Phase 1 study of VK0214 a healthy volunteers. The study was successful with VK0214 demonstrating dose dependent exposures, no evidence of accumulation and half life consistent with anticipated once daily dosing. After 14-days for treatment subjects who received VK0214 also experienced reductions in LDL cholesterol, triglycerides, apolipoprotein B, and lipoprotein A. Many of these lipid reductions achieved statistical significance though the study was not powered to demonstrate statistical significance on lipid assessments. VK0214 also demonstrated encouraging safety and tolerability in this study, among than more than 100 subjects enrolled, no serious adverse events were reported, and no treatment or dose related signals were observed for vital signs or cardiovascular measures. No gastrointestinal disturbances such as diarrhea or nausea were reported even at doses of 125 milligrams daily, the highest dose evaluated and study. Shortly after the inclusion of the Phase 1 study, we initiated the Phase 1b study of VK0214. In patients with the Adrenal Myelin Neuropathy or AMN form of X-ALD. AMN is the most common form of X-ALD, affecting approximately 50% of those with the disease. Clinical manifestations include progressive leg weakness, incontinence and sexual dysfunction. The Phase 1b trial is randomized, double blind, placebo controlled multicenter study in adult male patients with AMN. The primary objectives of the study are to evaluate the safety and tolerability of VK0214, administered orally once daily for 28-days. The study also includes an evaluation of the pharmacokinetics of VK0214 in AMN patients, as well as an exploratory assessment of changes in plasma levels of very long chain fatty acids. Pending unblinded review of preliminary safety tolerability and pharmacokinetic data, additional dosing cohorts may be pursued. In January of this year, we announced this trial had been placed on clinical hold by the FDA. The agency requested completion of an additional preclinical study prior to the continued dosing of patients. This request was not due to any findings from ongoing or previously completed studies. Rather, the FDA informed us that it considered the trial to be a Phase 2 trial rather than a Phase 1b. As such regulatory guidance required that rodent genotoxicity study to be completed prior to initiation. During the second quarter, we successfully completed the requested study and submitted the results to the agency. Following the review, we received an authorization to resume the study as planned. And we are in the process of doing so now. We expect to report the results from this trial in the first half of 2023. Finally, as we expand and advance our clinical pipeline, we continue to carefully manage our financial resources. We entered the second quarter with approximately 170 million in cash, which we believe provides the runway to advance each of our clinical programs in the later stage development. In conclusion, as we look to the next 12-months, we anticipate multiple important catalysts from our clinical pipeline. Between now and year-end, we expect to announce the initial data from the Phase 1 study of our newest clinical compound VK2735, our internally developed program targeting dual activation of the GLP-1 and GIP receptors with potential applications in a range of metabolic disorders. We also expect to announce completion of enrollment in the voyage phase to be study evaluating VK2809 in patients with NASH and fibrosis, and we remain on track to announce in the first half of 2023 the results from our Phase 1b study evaluating VK0214 for the treatment of X-ALD. By any measure next year will be a pivotal year for Viking. As we highlighted on our year-end call in February, Viking has transformed over the past several quarters from a company with one clinical program to a company with three active clinical programs across a range of indications with important data from each now expected within the next 12-months. The breadth and depth of our clinical and preclinical pipeline represent an important evolution from a single program company into a diversified biopharmaceutical company with programs across multiple important indications. In our view, the data we expect to report in the upcoming quarters will serve to strengthen Viking’s position as a leader in the development of novel class leading therapeutics for the treatment of metabolic disorders. This concludes our prepared comments for today. Thanks again for joining us. And we will now open the call for questions. Operator?