Travis Mickle
Analyst · RBC. Your line is now open
Thank you, Dan, and thanks everyone for joining the call. As discussed on prior quarterly conference calls, KemPharm’s mission is to build a portfolio of prodrugs that are an improvement on currently approved drugs and address unmet medical needs in large, established markets, or in treatment indications that are significantly underserved. Our pipeline consists of multiple products at varying stages of development, targeting both large market and orphan indications that address patient populations where a prodrug can offer better treatment outcomes and alleviate unwanted or unintended side effects. The depth and diversity of our pipeline is uncommon for a company our size, and the progress we've made and expect to make should enable us to build both near-term and longer-range value. Our ADHD portfolio, let by KP415, exemplifies this strategy and the potential advantages that prodrug products can offer. The second quarter was highlighted by two key clinical advances with our KP415 program, which we believe continues to demonstrate the potential of our ADHD prodrug pipeline. On July 9, we announced topline data from the efficacy and safety trial of KP415. I will discuss the results in greater detail shortly, but in summary, KP415 was shown to be an effective treatment, with the overall data package suggesting an onset of action at 30 minutes and a duration of effect of 13 hours. We believe these properties represent important points of differentiation when compared to current methylphenidate-based treatments for ADHD. In addition, another highly differentiating property of KP415 was highlighted during the second quarter, with the announcement of topline data from the intravenous human abuse potential trial of our prodrug of d-methylphenidate that is found in both KP415 and KP484. Results from the IV HAP study were outstanding, indicating that SER dexmethylphenidate, the prodrug for both of these products, produces pharmacodynamic effects that were similar to placebo in comparison to active d-methylphenidate when injected. KP415 is our d-methylphenidate, or DMPH, prodrug product candidate we're developing to address a number of unmet needs with currently marketed methylphenidate products, including onset of action, duration, and consistency of their therapeutic effect, as well as the possibility of a lower abuse potential. Additionally, KP415's design utilizes a small capsule that allows for easier swallowing. The capsule can be opened and sprinkled on food or added to a drink if need be. All of these are significant issues in the minds of physicians and patients, and since KP415 can help address these needs, we believe that it represents the potential best-in-class stimulant treatment, if approved. As mentioned earlier, we reported topline data from the KP415 pivotal efficacy trial or the KP415.EO1 trial in July. Simply stated, we believe the data are supportive of a product that is not only approvable but also differentiated. The KP415. EO1 trial was a multi-center, randomized, parallel, double-blind, placebo-controlled, analog laboratory classroom clinical trial in 150 children aged six through twelve years old with a diagnosis of ADHD, designed to assess the efficacy and safety of KP415. This study is commonly referred to as a classroom style study. The primary efficacy endpoint of KP415 EO1 trial was the mean difference in change from baseline across all post- post-dose time points for the SKAMP-C score. The SKAMP is widely considered by FDA and ADHD experts to be one of the standard measures of efficacy for ADHD medications. As indicated on this slide, KP415 met the primary efficacy endpoint with a P value of less than 0.001. Statistically speaking, this is a convincing result, and based on this measure, KP415 meets the efficacy threshold of an approvable medication for the treatment of ADHD. We view this as a very important achievement and one that should not be overlooked. In designing the study, we elected to conduct the pre-dose baseline assessment on Visit 5, or Day 21 of the trial, due to concerns of a potential carryover effect related to the steady state pharmacokinetic profile of KP415, which we thought might negatively impact the data. Our rationale was on, that Visit 5, we could measure pre-dose baseline following a two-day washout period prior to patient randomization so that no patient would have any methylphenidate on board. No carryover effect was subsequently observed, but by Visit 6, or Day 28, the treatment group versus the placebo group pre-dose baseline scores had meaningfully shifted from the Visit 5 baseline scores. To correct for this occurrence, we also conducted a post hoc Visit 6 pre-dose baseline analysis, which is actually a more typical way to measure efficacy in a classroom-style ADHD efficacy study. The far right column of this table contains data from our post hoc analysis of the Visit 6 treatment differences. As you can see, the data demonstrates statistically significant efficacy at all measurement intervals from 30 minutes to 13 hours. We believe the Visit 6 results are the correct results to use in assessing the efficacy of KP415 in comparison to placebo. We also believe that these results are more reflective of the analytical approach that the FDA is most accustomed to for reviewing ADHD efficacy studies of this design. Supporting this analysis were the results from the permanent product measurement of performance, or PERMP scale, which is an objective map test that patients take while the SKAMP ratings are occurring. The first table details data from the PERMP-A, or questions attempted measure. As indicated, the PERMP-A data indicate a statistically significant difference between placebo at all time intervals from 30 minutes to 13 hours post-dose, whether using Visit 5 as baseline or Visit 6. On the next slide, this table shows data from PERMP-C or answers correct measure. The PERMP-C data also indicates a statistically significant difference versus placebo at all time intervals from 30 minutes to 13 hours post dose, whether using Visit 5 as the baseline or Visit 6. Although we believe that KP415.EO1 study clearly demonstrates that KP415 is safe and efficacious and shows that KP415 enables an onset of action at 30 minutes and a duration of effect of 13 hours, which is meaningfully differentiated from currently marketing methylphenidate products, as highlighted in this and previous slides, there is overwhelming evidence of the efficacy, duration, onset, and differentiation that KP415 can bring to the ADHD market. The FDA will be the ultimate arbiter for KP415, but we are confident that the data compiled in the KP415.EO1 study are supportive of an approvable product. Based on our prior interactions with the division, the opinion of our regulatory consultant and historical precedent, we believe it is very reasonable that the FDA should rely on the Visit 6 baseline analysis, as it reviews our KP415 clinical data. It fundamentally boils down to a simple analysis of whether one would believe that the FDA would make a decision about duration and onset based on a faulty hypothesis and a statistically problematic analysis, or use the overwhelmingly available evidence generated in the trial, the standard practice of a Visit 6 baseline, as well as nearly a 60 years history with methylphenidate, in order to make their determination. Supporting this viewpoint, Dr. Tom Laughlin [ph], the recently retired division director for the division of psychiatry products, Center for Drug Evaluation and Research at FDA, remarked on a KOL call hosted by RBC Capital Markets that Classroom Visit 6 would have been more typical than Visit 5, and that post-hoc analyses are appropriate and often utilized by FDA, especially when secondary endpoints such as PERMP corroborate the data in question. Dr. Laughlin also noted that, based on his examination of the overall KP415.EO1 data set, it is reasonable to conclude that KP415 likely has an onset at 30 minutes and a duration of 13 hours. In addition to the KP415 pivotal efficacy study results, during the second quarter, we reported results from the intravenous human abuse potential study of SER dexmethylphenidate, the prodrug in KP415 and KP484. The data from the study were very favorable and suggest that our prodrug produces pharmacodynamic effects that were similar to placebo in comparison to active d-methylphenidate when injected. In the intravenous HAP study trial, known as KP415.AO3, we assessed the abuse potential of SER dexmethylphenidate following intravenous injection in recreational stimulant users in comparison to an active control of IV dexmethylphenidate and IV placebo. The double-blind, randomized crossover design of this study included 30 subjects who received molar equivalent doses of SER dexmethylphenidate, d-methylphenidate, or placebo. Overall, the IV HAP results provided compelling evidence that SER dexmethylphenidate has little to no abuse potential when administered via an injection. Lower or less abuse potential is one of the key unmet needs for methylphenidate products, and KB415 is the only potential ADHD methylphenidate product with data suggesting the potential for less IV abuse. Looking ahead, we expect to report data from the oral and intranasal HAP studies of SER dexmethylphenidate between now and the end of the year. Upon completion of these studies, we expect to be in a position to file the new drug application for KP415 in the first quarter of 2019. In addition to KP415, the KP484 program is moving ahead with pivotal efficacy studies expected to initiate prior to year-end, which should allow us to progress along an expedited development timeline and towards a potential NDA in late 2019. While we're continuing to advance KP415 and KP484 in the clinic, we're also continuing to explore various business development pathways for each product, given the sizeable ADHD market opportunity. As well as KP415’s differentiated efficacy profile, along with the reduced abuse potential for both products, as well as their long patent life and their potential NCE status. We believe that all these attributes potentially represent a best-in-class methylphenidate, or even further, a best-in-class stimulant product in the large, approximately $13 billion ADHD market, where the branded product leader, Vyvanse, comes off patent in 2024. As presented earlier today, we have an active partnering process underway and expect to complete a partnership by year-end. With that, now let me turn the presentation over to LaDuane, who will discuss this quarter's financial results.