Ian Mortimer
Analyst · Stifel
Thanks, Sherry. Good afternoon, everyone. Thanks for joining our call. Today, I will provide a high level update on our partnered and proprietary programs and then I will turn the call over to Chris Kenney, who will provide additional color around our plans for XEN1101 moving forward. Sherry will conclude our call by briefly summarizing our financial results and anticipated key milestone events ahead. Chris Von Seggern is also on the call to provide his perspective during the Q&A. Overall, when we look back on 2021, we are proud of the significant progress we made across our proprietary drug development pipeline and partnered programs, including the transformational event of the positive readout of strong efficacy data from our XEN1101 Phase 2b X-TOLE clinical trial. We enter 2022 with incredible momentum with multiple mid to late-stage clinical programs and important milestone opportunities throughout the year, which we will discuss today. I will start by briefly touching on our partnered programs. In November, Pacira Biosciences completed its acquisition of Flexion Therapeutics, along with the rights to develop and commercialize XEN402, a Nav1.7 inhibitor. XEN402 has been formulated for extended-release from a thermosensitive hydrogel and is now known as PCRX301. Pacira has indicated that they expect data in the second quarter of this year from a Phase 1b proof-of-concept trial that is evaluating the safety and tolerability of PCRX301 administered as a single dose in patients undergoing bunionectomy. In addition, I am pleased to report that our partnered programs with Neurocrine Biosciences also continue to advance through development. In January, we received a $15 million regulatory milestone under our collaboration and Neurocrine now has two separate Phase 2 trials underway, evaluating NBI-921352 in adult patients with focal onset seizures and pediatric patients with SCN8A related epilepsy. We look forward to keeping you updated as these partnered programs reach important milestones. Within our proprietary pipeline, we continue to enroll patients in our pediatric XEN496 Phase 3 EPIC clinical trial. This Phase 3 randomized, double-blind, placebo-controlled parallel group global multi-center clinical trial is evaluating the efficacy, safety and tolerability of XEN496 in approximately 40 pediatric patients aged 1 month to less than 6 years with KCNQ2-DEE. Based on published physician case studies with ezogabine and its Kv7 mechanism of action, we believe that XEN496 has the potential to address an important unmet medical need for these young patients. As the EPIC trial continues to expand through the onboarding of new sites and new geographical jurisdictions, our clinical team is anticipating the study completion in the first half of 2023. We also continue to make meaningful progress within our XEN1101 program and have spent considerable time from our X-TOLE top line data in October 2021, analyzing and presenting additional subgroup analyses, building out a robust PK/PD model, evaluating interim safety data in the X-TOLE open-label extension study and completing our planning for our Phase 3 program. This is all in preparation for our anticipated end-of-Phase 2 meeting with FDA in Q2 of this year and expected initiation of our Phase 3 program in the second half of the year. Before passing the call to Chris, we have had some questions recently from investors on the Biohaven KCNQ preclinical Kv deal. We haven’t discussed the XEN1101 preclinical data in some time, but we are happy to provide our perspective as these questions have come up. The first question we have received is the activity of XEN1101 on GABAA. XEN1101 has no activity on GABAA at 10 micromolar. These experiments on XEN1101 have been conducted at established CRO labs and are also included in our regulatory filings supporting our clinical studies. And just to put this into context, 10 micromolar is approximately 50-fold higher than the concentrations we reached clinically, so we have no reason to believe that XEN1101 has any GABA activity in a human contributing to either the efficacy or the tolerability of XEN1101. The second question we have received is around in vivo pharmacology and therapeutic index. Comparison across experiments are always challenging and the data presented on their Kv compound BVH7000 is in a different preclinical species and with different toxological measures than the data they showed for XEN1101 or ezogabine. We have chosen to use a much broader number of preclinical efficacy models and we focused on data generated in the mouse MES model as the EC50s in this model predicts well the concentrations required to see efficacy in human clinical trials. And this has now been validated with both ezogabine and XEN1101. The BVH7000 efficacy data presented is in the rat MES model. Rats are known to show efficacy in this model at significantly lower concentrations for the Kv mechanism in the mouse. We see roughly a fourfold leftward shift in our EC50s in the rat MES model for the Kv mechanism. So bottom line, data generated using different pre-clinical species and different experimental endpoints cannot be compared. But now moving back to our XEN1101 clinical program, in summary, we have considerable data supporting the role that XEN1101 could play in treating adult patients with focal epilepsy. The XPO clinical results demonstrated substantial efficacy in a difficult-to-treat patient population with even more impressive efficacy in subgroup analyses of patients with less severe disease. A tolerability profile consistent with an active CNS drug, additional clearly differentiating attributes, including an only-in-class mechanism, dosing of one pill once a day with no titration required. Feedback from KOLs and from our proprietary market research supports our belief that XEN1101 has the potential to significantly improve the current standard of care for patients with residual seizure burden, and if approved, would represent a meaningful advancement in the therapeutic armamentarium for this disease. On that note, I’d like to turn the call over to Chris Kenney, who can provide an update on where we are with our Phase 3 plans for XEN1101 and also on our other Phase 2 proof-of-concept studies running in parallel. Chris?