Bassil Dahiyat
Analyst · Michael Schmidt with Leerink Partners. Please go ahead
Sure, I guess, to start-off, the 5817 program has potential in a broad array of autoimmune diseases, because a broad array of autoimmune diseases have had B-Cell disregulation implicated. Lupus is one of those and so as we look at the program as a whole, we’ve always wanted to seek out the value in whichever opportunities we think we can address, preferably multiple opportunities. IgG4-Related Disease, which is the primary driver we believe in the near term of this program is a newly defined rare disorder that has some serobiological relevance for B-cell inhibition and we think can give relatively to many other diseases faster development timelines and a smaller development cost footprint for a company like Xencor. That said, Lupus, very much larger opportunity, clearly, a high unmet need. Therapies in general are not as effective as doctors and patients that want there are certainly side-effects. And so, for us, the Lupus opportunity is one to add as a supplement for 5871 and then hopefully, in the future, if these programs show promise, 5871 starts to mature, we can even add more potentially. But for now it’s focusing on the two, within the treatment landscape of Lupus, I’d say the unmet need is high. The use of a broad array of immuno-suppressed and steroids, biologics like Belimumab is still leaving a large unmet need. So I think, there is absolutely room for new agents, if you can demonstrate a meaningful increase in activity from what is being seen with these current agents. Now, that’s a very big kind of answer, because we are still at early stage in development. Now, when you go to the second page of your question, how do the Phase II program that we’ve selected, how does it hopefully overcomes some of the challenges that have been faced in Lupus development, I think the crux of it is, the observation by Joan Merrill at Oklahoma Medical Research Foundation that would draw the immunosuppressive medications that Lupus patients have typically taken can clear up some of the muddiness that happens when you try to run a clinical trials of investigation led by 5871. And so our study design expressly cools the patients down with intramuscular steroids, enrolls those who show that kind of reduction in disease activity, you would draw them from their background of immuno suppressants in these patients are typically on something agent 5, methotrexate and you don’t allow them to go back on those medications unless they show a relapse essentially or a significant increase in their disease activity. When you randomize at that initial point, when they’ve been pulled down in their immunosuppressive background has withdrawn you can compare now in a much cleaner way 5871 versus placebo. And so now how that plays into the future feeling in them, we don’t know, there is no existing enforced guidance in the FCO on Phase III programs, but we will certainly hopefully have some exciting data represents in a couple of years and we will engage in the dialogue for how to hopefully make Phase III studies more amenable for seeing clear results in Lupus maybe than the past.