ACELYRIN Inc (SLRN) 2024 Q3 法說會逐字稿

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  • Operator

  • Good afternoon and welcome to the ACELYRIN. third quarter, 2024 financial results and company update conference call.

  • This conference call is being recorded today.

  • November 13th, 2024.

  • I would now like to turn the call over to Tyler Marciniak, Vice President of Investor Relations and Corporate Affairs.

  • Tyler.

  • Tyler Marciniak - Vice President of Investor Relations and Corporate Affairs

  • Thanks Victor.

  • Good afternoon, everyone and thank you for joining us for a ACELYRIN in third quarter, 2024.

  • Conference call with me today are Mina Kim, Our Chief Executive Officer, Gil Labrucherie, Our Chief Financial Officer and Chief Business Officer and Shephard Mpofu, Our Chief Medical Officer.

  • We issued a news release earlier detailing our third quarter financial results and important corporate updates.

  • And before we begin today's call, I'd like to remind the audience that our remarks may contain forward-looking statements such as those related to the progress of our clinical trials, our future financial operating results and investments and our ability to commercialize our product candidates.

  • We urge you to review the risk factors section of our form 10-Q for the quarter ended September 30 2024 which was filed today with the SEC and which is also available on our website at a ACELYRIN.com along with today's press release, which identifies certain factors that could cause our actual results, performance and events to differ materially.

  • Finally, our statements are based on information available to us today, November 13, 2024.

  • And we undertake no obligation to update them as circumstances may change.

  • I would like to now turn the call over to Mina.

  • Mina Kim - Chief Executive Officer

  • Thanks Tyler and thanks everyone for joining us today.

  • The first nine months of 2024 were transformative for its sovereign and we're pleased with the progress we've made.

  • Refocusing our pipeline and corporate strategy in August.

  • We announced the strategic reprioritization of our pipeline to focus our efforts on developing our lead product candidate Magua map for which we are in late stage development as a treatment for thyroid eye disease or TD.

  • Today, we will review our progress with [ONAP] as well as our anticipated upcoming milestones for both that program and our ongoing phase 2b/3 trial of Izokibep and non-infectious non-interior, uveitis.

  • First, I'd like to review our progress on [onam] our subcutaneously delivered humanized IgG1 monoclonal antibody targeting IGF-1R which is the only approved mechanism of action for the treatment of TED.

  • TED is a vision threatening autoimmune disease in which there is both inflammation as well as expansion of the tissue behind the eye resulting in eye bulging known as proptosis and the subsequent inability to close the islands, double vision or diplopia can also occur as well as the potential for compression of the optic nerve which can lead to blindness.

  • TED is a progressive chronic inflammatory disease impacting more than 100,000 people in the US alone.

  • Earlier this year, we shared positive proof of concept data for a subcutaneously delivered [LGU AAB] in TED patients.

  • A first for the anti IGF-1R MOA demonstrating rapid improvements in proptosis and clinical activity scores within three weeks.

  • After the first dose.

  • Our adaptive phase two dose finding trial now continues with multiple cohorts to establish both a minimum effective dose and optimal dose level and dose regimen for the phase three registrational program.

  • In selecting a dose, we're focused on maintaining a narrow therapeutic window that stays above a certain semen to drive efficacy of the kind that we have observed with Lauda Math and which is in line with other anti IGF-1R agents and minimizes C max in an effort to mitigate the safety liabilities especially hearing related to events that are evident with the same agents.

  • We've now completed cohorts two and three through 12 weeks of dosing and 12 weeks of follow up as a reminder.

  • Cohort two included a loading dose of 50 mg followed by 25 mg weekly and cohort three tested 50 mg monthly with no loading dose.

  • We previously announced that we were adding 1/4 dosing cohort to our phase two trial that dosing cohort was expected to be 70 mg, either Q3 W or Q4 W.

  • We started this cohort at 70 mg Q4 W but have now shifted to 100 mg Q4 W.

  • We're using this cohort primarily to confirm PK.

  • We've used the model of loading dose.

  • For example, cohort two used a loading dose and that cohort demonstrated rapid achievement of steady state semen which we think could deliver faster patient benefit.

  • Cohort four is also the first cohort where we are using MRI assessment to measure proptosis.

  • In addition to hotel measurements, we think this early experience with MRI assessments will help ensure smooth execution in the phase three program.

  • We're continuing to enroll cohort four and this cohort may not be fully enrolled at the time that we announced the full results from the first three cohorts as well as detailed phase three program design and time lines.

  • Given this last cohort is really being used to confirm a loading dose.

  • We have now largely completed our dosing exploration with the first three cohorts and with FDA alignment on our dosing strategy.

  • We're confident in our ability to start our phase three program.

  • In the first quarter of 2025 the TED patient data presented so far for long to map it has been met with excitement from both the physician and patient communities.

  • And during the third quarter were presented at multiple International Medical Congresses including [Asop E Soper and A al] we're encouraged by the response from the CAS and patient communities and believe this response demonstrates the need for even better treatment options for TED patients which deliver the right risk benefit profile.

  • One that delivers the efficacy scene with IGF-!R

  • agents but also with a potentially improved safety profile.

  • This response also gives us confidence in our ability to enroll the phase three trials in a timely manner.

  • We also recently completed a positive end of phase two meeting with the FDA.

  • The goal of the meeting request was to achieve alignment on important elements of the phase three registrational program including design size, primary and secondary end points and proposed phase three dose.

  • We were pleased with the feedback received to and in alignment with our proposed differentiated approach to Developing Magua map and TED, we have also aligned with the agency on our approach to dosing patients beyond 24 weeks and out to 52 weeks in both active and inactive TED patients.

  • We look forward to sharing further details at our upcoming investor event in early 2025.

  • Finally, we recently established a scientific and patient advisory board that brings together world class clinicians and patient advocates to provide important strategic input, clinical expertise and patient perspectives as we prepare to [advance wut to ma] into phase three clinical development.

  • But before that milestone occurs, we also expect to announce top line results for our phase 2/3 trial of Isaac Hiab in UBI in December.

  • As with our earlier decision to discontinue internal development of ISA and HS and PSA, we will make a decision about the future development plans for UVIs.

  • After we see the data, the development path for UVIs as a standalone indication and not one tied to HS and PSA presents a very different opportunity.

  • Importantly, we are now thinking about UVIs as a potential orphan indication in a patient population with very high unmet need.

  • This materially changes the potential opportunity for UVIs, especially if our data demonstrate improved patient outcomes.

  • Compared to the currently approved treatments.

  • We look forward to providing the UVI topline data along with an update on the entire ISA program in December and with that, I'll turn it over to Shep to walk you through the UVI program in more details.

  • Shephard Mpofu - Chief Medical Officer

  • Thank you, Mina UVI it is a complex disease that is characterized by ocular inflammation.

  • It is heterogeneous and the pathophysiology varies greatly.

  • Although the exact cause of uveitis remains multifactorial aberrant immunic insults can cause ocular tissue damage and cytokine imbalances play a key role.

  • So it is not surprising that there are significant challenges in diagnosis and management of this disease.

  • Unfortunately, demographically, most at risk population in developing UVI is the working age group with ages 20 to 50 years.

  • These patients are at risk of retinal detachment, cataracts, glaucoma and macular edema loss of vision is a key concern and often leads to blindness in 5% to 20% of cases in developed countries.

  • As noted above, there is a high unmet need in both the diagnosis and treatment of uveitis.

  • In terms of treatments, patients really only have two approved options, corticosteroids and Adalimumab.

  • The well established first line treatment for uveitis consists of corticosteroids which cannot be maintained long term as it is associated with systemic side effects.

  • Adalimumab is the only approved biologic and approximately half of patients fail treatment on Adalimumab and half lose efficacy due to anti-drug antibodies.

  • Thus, there is an unmet medical need for the treatment of uveitis in thinking about future innovations for these patients.

  • There is an interesting scientific rationale for the potential role of interleukin 17A inhibition as a treatment for uveitis.

  • In previous clinical trials, Secukinumab Monoclonal Antibody Targeting IL-17A demonstrated proof of concept response in Uveitis with IV dosing of 10 mg/Kg and 30 mg/Kg showing a response rate that was approximately 15% better than Adalimumab.

  • However, when the trials were run using 300 mg of sin delivered subcutaneously, the signal was lost.

  • It is hypothesized that reduced drug exposures when moving from IV to subcutaneous.

  • Combined with the relatively large size of a monoclonal antibody contributed to this loss of efficacy.

  • A Izokibep on the other hand, is a small protein therapeutic designed to inhibit interleukin 17A with high potency and small molecular size, approximately 1/10 the size of a monoclonal antibody.

  • In pre-clinical study, we have shown Izokibep significantly more potent than cab.

  • And they have also shown that Izokibep can penetrate the blood retinal barrier in a dose dependent manner.

  • Further, we have shown that due to its higher potency and smaller size iso 100 and 60 mg delivered subcutaneously every week can deliver drug exposure similar to 10 week per kg every other week of IV.

  • In May, we completed enrollment of our phase 2/3 trial in uveitis with 96 patients randomized 1 to 1 active treatment versus placebo.

  • The trial primary endpoint is designed to be similar to the Adalimumab visual one study that is time to treatment failure.

  • In addition, as was done with visual one in our topline results, the treatment failure rates will be read out at a landmark endpoint of 24 weeks.

  • In visual one Adalimumab demonstrated a 20% benefit over placebo at 24 weeks.

  • As we look forward to our data readout, we will be looking for a clinical outcome that is superior to that of Adalimumab.

  • Should the upcoming phase 2/3 data be positive?

  • Our best guess is that one additional phase three trial of approximately 200,250 patients will be required for registration.

  • However, given the high unmet need and the FTS acknowledgment of Uveitis as an orphan disease with the associated potential for orphan drug like pricing.

  • We would certainly look to confer with the health authorities on any potential accelerated pathway to approval.

  • I hope that overview of Uveitis has been helpful and we look forward to sharing with you the top line results from our trial.

  • This December.

  • Now let me turn the call over to Gil for a review of our third quarter financial results.

  • Gil Labrucherie - Chief Financial Officer & Chief Business Officer

  • Great.

  • Thank you Shep.

  • Today we reported our financial results for the quarter ended September 30, 2024.

  • We remain in a very strong financial position and continue to execute on schedule with a pipeline prioritization plan we laid out in our August conference call.

  • We ended the third quarter with 562.4 million in cash research and development expenses were 31.6 million for the quarter as compared to 74.6 million for the same period.

  • In 2023.

  • The decrease was primarily a result of reduced clinical development activity as the phase three trials for [Aoy] in PSA and HS are substantially complete for the third quarter.

  • General and administrative expenses were 12.3 million compared to 19.9 million for the same period.

  • In 2023.

  • The decreases were primarily a result of lower stock based compensation expense.

  • As we recently reported in an amended form, 8K filed on November 5th.

  • We are very pleased to have fully resolved outstanding manufacturing commitments for Izokibep that we identified last quarter as part of our restructuring, our team was successful in transforming a significant contractual liability to a net expense of only 7.2 million.

  • This net expense consists of a payment to the manufacturer of 42.9 million.

  • Together with an accompanying 35.7 million credit voucher.

  • This credit voucher can be directly applied towards any future manufacturing services including on a good map supply where we are already actively working on the manufacturing front to advance this program into phase three development in Q1 2025 we expect to utilize this credit in 2025 in the first quarter of 2026 to directly offset what would otherwise have been cash outflows.

  • We are very pleased with this outcome and with this we have incurred substantially all of our expenses associated with the restructuring announced in August of this year.

  • In August, we guided to a 2024 year in cash position of 420 million to 450 million.

  • With the manufacturing commitments resolved, we are now updating year and cash guidance to 435million to 450 million this year in cash guidance includes the anticipated 31 million license option payment in Q4 to acquire all global rights to a lot of good mab from our licensing partner, as we stated last quarter, our current cash position gives us operational runway to at least mid 2027.

  • This runway projection includes the entire phase three development program for Lonigutamab including both development and manufacturing activities through to a potential filing but does not include any new investments in ISO including UVI.

  • While we are not changing our cash runway guidance.

  • At this time, the 35.7 million manufacturing credit voucher gives us even more flexibility to engage in selective pipeline expansion in 2025 which could also include further development of UVI.

  • Pending our review of the upcoming data, I wanted to make one administrative note for the quarter.

  • Like most biotechs who are eligible to do so today, we put in place an ATM facility as part of our corporate infrastructure to provide for future capital flexibility.

  • Our focus heading into 2025 will remain on disciplined capital allocation efficiency and high quality execution.

  • I will now turn the call back to Mina for closing remarks.

  • Mina Kim - Chief Executive Officer

  • Thanks Gil and thanks Shep.

  • We're proud of the progress we're continuing to make with both Lonigutamab and TED and Izokibep and UBI.

  • And I want to thank our entire team for their continued hard work.

  • We have a number of important updates to share in just the next few months and we continue to make disciplined and capital conscious decisions and to maintain a strong financial position from which to achieve our clinical and corporate goals.

  • For the remainder of this year and into 2027 we appreciate your continued support as we work to bring these potentially transformative new treatments to the patients who need them.

  • And with that, we're ready to take questions.

  • Operator

  • Thank you.

  • And to ask a question, you will need to press star 11 on your telephone and wait for your name to be announced.

  • To withdraw your question.

  • Please press star 11 again.

  • Please stand by while we compile the Q&A roster.

  • One moment for our first question.

  • Our first question will come from the line of Tyler Van Buren from TD Cowen.

  • Your line is open.

  • Tyler Van Buren - Analyst

  • Hey guys, good to see progress with the clinical programs and the decreased operating expenses and improved cost controls in particular.

  • I have a couple for you on a good So can you help us better understand what data the FDA saw during the end of phase two meeting?

  • Was it just data from the first three cohorts or did they see partial data from cohort four?

  • I guess I'm trying to understand how you could propose a dose for phase three if they didn't see the cohort four dose and or for, for data.

  • And the second question is just is it fair to say that the pivotal tetra will likely include a dose somewhere in the 70 to100 mg range being tested and cohort force?

  • Mina Kim - Chief Executive Officer

  • Yeah.

  • So, hey, Tyler, thanks for the questions.

  • Hey, so I wanted to just make sure I'm answering.

  • I think you had two questions in there.

  • One was, what did we show the FDA, you know, what was part of that end of phase two meeting?

  • And then the second was, what's the, the 70 that 100 the cohort four, right.

  • What's the kind of the purpose of that, or what role are they going to play?

  • Right in the program that up there?

  • Okay.

  • Yeah, so maybe on the end of phase two meeting, right?

  • I mean, we had the pretty typical end of phase two meeting with the FDA where we showed them what we had, right?

  • As you know, this is an open label trial with data that's maturing over time and you know what we've been testing really in those first three cohorts is doses from 25 to100 mg, right?

  • And that includes, sorry, that includes a cohort four with that 100 mg and with regimens that are weekly to monthly, right?

  • With data kind of maturing along the way.

  • So that's a pretty narrow band, right, in which to do dose ranging.

  • And we have a molecule that's very well behaved, right where the data frankly has been very consistent with our modeling.

  • And so that is helpful, right?

  • And is obviously a pretty important input here.

  • And so we've taken, you know, the da the totally the data that we had and we took that to the end of phase two meeting and we aligned with them on sort of an approach to dosing and how we're thinking about it.

  • And so, you know, so the totality of that informed that decision, like I just said in the script, the 70 and100 in the cohort board, we're really thinking about as a loading dose, right?

  • And, and again, that's just to, is there an opportunity for us to get to faster responses right?

  • To get to that narrow therapeutic window in a shorter period of time to try to prove provide patient benefit faster.

  • And so that's really how we're thinking about that cohort for dose.

  • And so it does have a fairly narrow role, right?

  • As we think about dosing.

  • Tyler Van Buren - Analyst

  • Thank you.

  • Operator

  • One moment for our next question.

  • Our next question off line of Akash Tewari from Jefferies.

  • Your line is open.

  • Akash Tewari - Analyst

  • Hey, this is Manoj on behalf of Akash.

  • We have thanks for taking our question.

  • Just one question.

  • What gives you that if you [KCU A is C max]driven?

  • If the molar exposure 160 mg IO comes, let's say slightly lower than six up 10 mg kilogram, let's say like 80%, 90% will that be enough to bring a significant clinical benefit?

  • And are you expecting to see a similar [KC two C 10] milligram per kilogram a week?

  • Thanks.

  • Mina Kim - Chief Executive Officer

  • Hey, thanks for the question.

  • Hey, I just want to make sure we're hearing the question and answering the right question, I think you're curious about, I guess the potency sort of equivalency to that, you can imagine.

  • How do we think about the 160 relative to other programs?

  • Okay.

  • Yeah.

  • And, and sort of, you know, what does that mean in terms of potential clinical benefit, right, that we could see in the UBTI program?

  • Yeah.

  • Okay.

  • I'm actually going to ask Shep to take that one.

  • Shephard Mpofu - Chief Medical Officer

  • Yeah.

  • No, thanks for the question.

  • So we have done a significant amount of work as we started the program on ISOD based on its potency.

  • And if you look at some of our presentations for arthritis and s we derived a very clear understanding of the exposure that is commensurate equipotent to SubQ.

  • So 10 mg/kg every two weeks of equates in all our modeling and some of our data sets across the autoimmune indications.

  • We have studied to 160 mg SubQ every week in Uveitis.

  • We are very fortunate that we have done primate studies with the various exposure SubQ that have enabled us to find the presence of AOY within vitreous humor.

  • So we know this is possible because it's 10 times smaller than seic.

  • So therefore, it's able to penetrate the blood retinal barrier.

  • So it gets into the eye and in terms of potential outcomes, in terms of the therapeutic impact in Uveitis, you ask a question, whether we expect to see the same data set.

  • We hope to see something much improved mainly because of the notion that a big monoclonal antibody like [cinis] abrogates inflammation peripherally systemically.

  • And we have the opportunity to do dual abrogation systemically and also locally given that we permeate the eye and are present there.

  • So we hope to see something better than what was demonstrated.

  • Akash Tewari - Analyst

  • Yeah, that's really helpful.

  • Thanks.

  • Operator

  • Thank you one moment for our next question.

  • Our next question line of Yasmeen Rahimi from Piper Sandler, your line is open.

  • Yasmeen Rahimi - Analyst

  • Hey, this is

  • [J I for YZ].

  • Thanks for taking our questions.

  • Given the base case for phase three study in Uveitis.

  • What would the capital commitment look like?

  • And secondly, how soon would you be able to kick off a pivotal study following top line data in December?

  • Gil Labrucherie - Chief Financial Officer & Chief Business Officer

  • Yeah, thanks.

  • Thanks for the question.

  • This isLabrucherie, I'll take the certainly take the 1st 1st piece of that question.

  • So as I mentioned in my prepared remarks, you know, with our runway out to mid 2027 we haven't given any specific estimates, you know, around the guys study.

  • We will probably do so until we have data in hand if we're if we decide to take that forward, but we do have significant flexibility within our runway to to further develop with THEIS if that, that's the right decision for us.

  • So we feel really good about where we are and the options that we have to take it forward with the existing resources on hand.

  • Mina Kim - Chief Executive Officer

  • Yeah.

  • And maybe I'll take the timing one.

  • I don't think we're ready to give any kind of guidance, specific guidance right around time lines.

  • But obviously it's a molecule in a program that we know really well.

  • And, you know, I think as chef said, our base case, right, is that we're going to need another trial with under 250 patients, right?

  • Something like that.

  • But we would certainly go and talk to the FDA about potential acceleration path if the data warrants that.

  • So, you know, I think it makes sense for us to take a look at the data, right?

  • Figure out what we think is the right path forward and then we'll update you guys on timing at the right time.

  • Yasmeen Rahimi - Analyst

  • Got it.

  • Yeah.

  • Thank you so much.

  • Operator

  • Thank you one moment for our next question.

  • Our next question will come the line of Derek Archila from Wells Fargo.

  • Your line is open.

  • Derek Archila - Analyst

  • Great.

  • Hey, team.

  • This is Adam on behalf of Derek.

  • Thanks for taking our questions this evening.

  • Maybe just one on Isab and Uveitis.

  • Can you remind us what constitutes a clinical meaningful benefit in this patient population?

  • And how are you currently thinking about the market opportunity there?

  • Given the entry of Humira biosimilars to market?

  • Mina Kim - Chief Executive Officer

  • Thank you.

  • Yeah, maybe I'll just start.

  • You know, we are thinking about if you're thinking about clinical benefit, there is high unmet need, right?

  • In Uveitis, it's steroids and then there's Adalimumab and we do think as chef noted right at the Adalimumab is not a perfect answer, many patients do fail.

  • So there is room for improvement there.

  • That said we are certainly going to look at a ofab as a primary reference point for us as we think about just the data, you know, is is it differentiated, is it going to offer patients increased benefit?

  • And so that will be the bar.

  • And as she said, we are going to look for a superior, you know, clinical profile compared to add a little.

  • Gil Labrucherie - Chief Financial Officer & Chief Business Officer

  • Map, maybe just to add on the market front.

  • You know, this is a very significant population.

  • And as me to just said that there's really an unmet need, there's not much here right now.

  • So when you, when we think about Isobe within the orphan pricing framework, you know, we see this as you know, a market with significant potential to have patient benefit and Aso and associated economics, you know, with that benefit.

  • Derek Archila - Analyst

  • Got it.

  • And then maybe just one on Google maps proposed phase three dosage I believe previously, you've disclosed that the go forward dose for phase three was going to be 70 mg.

  • Can you confirm that this is remains to be the case and any color on the dose regimen proposed if where you are on that.

  • Thank you.

  • Mina Kim - Chief Executive Officer

  • Yeah.

  • And so we have not announced the pivotal dose, right?

  • What we have said you know is that we have dosed in a range that's 25 to 100 mg, right?

  • And that 100 mg is new in that cohort four.

  • And again, really to test a potential loading dose and the regimens, we've tested our weekly to monthly.

  • So it will be in that kind of envelope, but we have not announced yet the pivot dose and we'll do that when we announce the data and provide details on the phase three program.

  • Derek Archila - Analyst

  • Got it.

  • Thank you.

  • Mina Kim - Chief Executive Officer

  • Thanks.

  • Operator

  • One moment for our next question.

  • Next question comes the line of Emily boar from AT win, right?

  • Your line is open.

  • Unidentified_1

  • Hi.

  • Thanks for taking the questions.

  • I guess for Labrucherie, you mentioned for the phase three, you're looking at 52 weeks instead of 24.

  • So maybe can you just talk about how you're thinking about durability of response and what you'd kind of hope to see beyond that 24 week time frame.

  • And then just to clarify for the phase three in the first quarter.

  • Are you planning to initiate phase three studies for chronic and active TED?

  • Thanks.

  • Mina Kim - Chief Executive Officer

  • Yeah.

  • And so maybe I'll start.

  • So we are we have alignment with the FDA on the ability to dose out to 52 weeks.

  • And we do think that that's a real differentiator for us.

  • Right.

  • It's a testament, I think to the dosing work that we've been doing in patients, right?

  • To show that, you know, these anti IGF-1 of our agents can be both effective but, you know, could potentially come with an improved safety profile at the same time.

  • And so we do think that gives us the ability to, to look at dosing out to 52 weeks in both the active and inactive TED populations.

  • And so that's how we're thinking about the the phase three trial design.

  • You know, like I said, I think, you know, we'll provide sort of a complete picture of what is that development program and timelines, right?

  • In early 25 right?

  • But that those are sort of the parameters that we're using to think about the development program.

  • Gil Labrucherie - Chief Financial Officer & Chief Business Officer

  • Maybe just to also add in keeping with the real world evidence on thyroid eye disease.

  • It's very clear that current therapies do not fully address the unmet need.

  • There's a high rate of recurrence and relapse of disease, post fixed dose treatment and given the potential safety considerations in the exposures we are having in these patients, as mina mentioned ranges of 25 to 100 mg, which we know are multiple for lower exposures than current therapies or including approved therapy.

  • We believe the FDA saw a very good rationale to really address what is currently a disregulated immune pathway in a chronic autoimmune disease in a way where patients might have enough exposure with a safe dose and be able to arrive at disease resolution if not modification over time.

  • Unidentified_1

  • Okay, thanks.

  • And just on the active and TED phase three are both expected in the first quarter.

  • Mina Kim - Chief Executive Officer

  • We haven't provided sort of that level of detail.

  • You know, like we said, we expect to we're going to be testing in both populations, right?

  • And we'll provide details about the phase three program design in the early 25.

  • Unidentified_1

  • Okay.

  • Got it.

  • Thank you.

  • Mina Kim - Chief Executive Officer

  • Thanks.

  • Operator

  • One moment for our next question.

  • Next question line of Vikram Perrot from Morgan Stanley.

  • Your line is open.

  • Unidentified_2

  • Great.

  • Good afternoon.

  • Thanks for taking our questions.

  • So we have first online and go to map apologies if this was asked and, and we missed it, but for the next data cut and then the eventual pivotal data as well, what would you consider a clinically meaningful hearing impairment benefit versus Tepezza in terms of the number of events and, and their severity?

  • And then secondly, on his AIV up in HS and PSA I know you previously mentioned that you would be open to finding a partner there.

  • So I just wanted to see if there's been any interesting BD discussions and, and if you feel like this is something that could be actioned in the, in the near to mid term.

  • Thanks.

  • Mina Kim - Chief Executive Officer

  • Okay.

  • Hey, thanks for the question.

  • Maybe we'll, let's start with, the BD question and I'll turn it over to Gil and then we can hit hearing.

  • Yeah.

  • Gil Labrucherie - Chief Financial Officer & Chief Business Officer

  • They're going to be out on the BD front on the program for IOC, but we're going to have the data in hand on Uveitis coming up here very shortly in December.

  • I think at that time, you know, we can provide a more fulsome update on the program.

  • I would just, I would just remind you that in my runway guidance that we talked about earlier, we have not included any assumptions around partnering or new investments in ISO.

  • Shephard Mpofu - Chief Medical Officer

  • Yeah.

  • And on the hearing, I think Mina alluded to how we have been really calibrating a dose which also mitigates you know, the over exposure that's associated with potential hearing impairment on this pathway.

  • So as you asked the question around percentages of what we are expecting, we will at our investor at our research day in early 25 be able to share with you how we are approaching hearing as you might be aware.

  • More and more.

  • All phase three studies currently are assessing patients audiogram at baseline to really quantify objectively whether patients are having sensor sensor neuro hearing impairment or just subjective changes that do not impact objective assessments.

  • And therefore we'll be able to share this with you how we are approaching this hearing and what we are expecting in different subpopulations.

  • Let's not forget that 40% to 50% of patients with thyroid eye disease also have issues pertaining to hearing, impairment of various nature.

  • So we will have to explore, you know, outcomes based on all those, you know, important considerations.

  • So more to come in early 25.

  • Unidentified_2

  • That's helpful.

  • Thank you.

  • Operator

  • Thank you one moment for our next question.

  • The next question will come from the line of Samantha Semenkow from citi.

  • Your line is open.

  • Samantha Semenkow - Analyst

  • Hi, good afternoon and thanks for taking the questions.

  • I'm just following on, on a prior question.

  • Is this the right way to think about it?

  • If the UVI data come sort of in line with Humira, does that make it less interesting for you to take forward?

  • Is the bar for success in your mind really, you know, better than Humira and I have a follow up, please.

  • Mina Kim - Chief Executive Officer

  • Yeah. let me, start.

  • I think it is right.

  • I mean, obviously look, you know, data is always tell the complicated story and you look at the whole package.

  • So we'll, you know, when we have the data in the same way that we did with HS and PSA, we'll look at the totality of that data to really think about what is the potential clinical sort of benefit, right?

  • And you know, is this something that patients need.

  • And so we will think about that, but like I said, I do think that at 11 map is the bar, right?

  • And so we would say in general, look for a profile that is better.

  • Samantha Semenkow - Analyst

  • Got it that's very helpful.

  • And then just thinking about the study design, I believe you're allowing patients that are biologic experience, meaning, you know, they've seen Humira previously into the study.

  • I'm just trying to think about how that could impact the data and and how that, you know, because biologically experienced patients and a lot of other indications that potentially do worse.

  • And when you look at the visual one study, obviously, those patients were biologic naive, I believe given there were no other approved biologics at that time.

  • So just trying to think through that dynamic and how that might impact your study results.

  • Thanks very much.

  • Mina Kim - Chief Executive Officer

  • For sure.

  • So let me start and then I'll turn it over to shop.

  • So you're correct, right?

  • So the Aimab trial that was not the case.

  • And we are different and it is a different patient population now, right?

  • Because Aimab that is now approved.

  • And so we do include some of those patients are in our trial.

  • And so let me start there and then I can turn it over to Shep for any further comments.

  • Shephard Mpofu - Chief Medical Officer

  • Yeah.

  • No, it's an important question and thank you for that.

  • And we have in our protocol made sure obviously at randomization, we stratify for these patients so that we have equal numbers on drug and placebo to be able to ascertain to your point and understanding of that subpopulation.

  • How are we doing versus the naive patients as you would expect in these trials where you have patients previously failing a TNF blocker like we have seen in PSA or HS, usually this is a small fraction of the overall population.

  • So for sure, we will take the data in consideration of what would have been a naive population result and also a total population, including those patients and be able to have an understanding of the impact of ESO on patients that have felt a mu as well in the study.

  • So more to come.

  • Operator

  • Thank you and with no more questions and I'll turn it over to Tyler for to conclude today's call.

  • Tyler Marciniak - Vice President of Investor Relations and Corporate Affairs

  • Thank you, Victor and thank you everyone for joining our call today.

  • As noted in our press release, we look forward to participating in one-on-one meetings with many of you in a fireside chat at the upcoming Jeffries conference in London as well as sharing with you the phase two B top 3-line results for Isaac and UVI Itis by the end of the year and hosting our Lana Guam investor event in early 2025.

  • Thank you for your continued interest in a seller.

  • And with that, we will conclude today's call.

  • Operator

  • Thank you for your participation in today's conference.

  • This does include the program.

  • You may now disconnect everyone.

  • Have a great day.