Mihael H. Polymeropoulos
Analyst
Thanks, Oren. I will take the vivid dream question first, the outcome second. The vivid dreams were about 2% of our patients, small number, and 0.5% in placebo. But we do believe that this is a true mechanistic effect that tasimelteon, through ejection of melatonin 1 and 1 receptors, produces. Now, just to characterize further, those few patients that have these vivid dreams, I would say half of them liked the dreams and half of them did not. And of course, we all suspect that content is unrelated to any drug, but rather a reflection of other things. So in the mechanistic side, we'd actually believe that vivid dreams is a reflection of the collection of tasimelteon on REM density. So what happens in a normal sleep cycle, REM periods tend to be more frequent with the density towards the end of the night. That REM density sequence is disrupted in people with circadian disorders. And we have published before in 2008, in Lancet, the confirmation that tasimelteon corrects this REM density. So as a result, if you wake up right after you had a dream, which is normally happening, you will tend to remember the dream. So it is more of a reflection of the correction rather than something that you mentioned in the field of parasomnias, of night terrors or other things that you have seen with the unrelated class of other hypnotics or sedatives. Now on the advisory committee composition, again, this will be the peripheral nervous system committee, which is a standing committee for the FDA. In fact, this committee met last May to examine suvorexant, the orexin antagonist by Merck for the treatment of insomnia. So this is a well-versed committee on these issues, drug development, regulatory-surrounding issues. But we do expect that the FDA will attempt to supplement these committees with experts in circadian biology. And as you mentioned, they can come from different fields. They can be experts in circadian systems, circadian sleep medicine, circadian endocrinology, and, of course, ophthalmologists that have played a significant role to elucidate the mechanism by which the light transmitted through the eye resets the clock in the suprachiasmatic nucleus. So we expect that the standing by-law may be supplemented with experts. But just to underscore that Vanda is very excited with the opportunity to present in front of an advisory panel, because we believe this will mark the beginning of the in-depth appreciation of a couple of things. One, the significance of the disorder, the impact that it has in patients’ lives, and then, the potential collective effects of tasimelteon as a circadian regulator; and indeed, the in-depth scientific effort that Vanda has undertaken over the years to bring forward the treatment.