Operator
Operator
Welcome to the Lexicon Pharmaceuticals' First Quarter 2012 Conference Call. At this time, all participants are in a listen-only mode. There will be a question-and-answer session to follow. Please be advised that this call is being recorded at Lexicon’s request. At this time, I would like to introduce your host for today’s call, Wade Walke, Senior Director of Communications and Investor Relations. Please go ahead, Dr. Walke. Wade Walke – Senior Director, Communications and Investor Relations: Good morning and welcome to the Lexicon Pharmaceuticals' first quarter 2012 conference call. I am Wade Walke and with me today are Dr. Arthur Sands, Lexicon’s President and Chief Executive Officer; Dr. Brian Zambrowicz, Lexicon’s Executive Vice President and Chief Scientific Officer; Dr. Pablo Lapuerta, Lexicon’s Senior Vice President of Clinical Development and Chief Medical Officer; .and Jeff Wade, Lexicon’s Executive Vice President of Corporate Development and Chief Financial Officer. We expect that you have seen a copy of our earnings press release that was distributed this morning. During this call, we will review the information provided in the release, provide an update on our clinical programs, and then use the remainder of our time to answer your questions. The call will begin with Dr. Sands who will give an update on the status of our programs; Dr. Lapuerta will then provide additional information on our lead clinical programs; and Mr. Wade will review our financial results for the first quarter of 2012 and discuss our financial guidance for 2012. We will then open the call to your questions. If you would like to view the slides for today’s call, please access the Lexicon website at www.lexpharma.com. You will see a link on the homepage for today’s webcast. Before we begin, I would like to state that we will be making forward-looking statements, including statements relating to Lexicon’s research and development of LX4211, LX1033, LX2931, LX7101, and telotristat etiprate also known as LX1032 and the potential therapeutic and commercial potential of those drug candidates. This call may also contain forward-looking statements relating to Lexicon's future operating results, financial arrangements, cash and investments, discovery and development of products, strategic alliances, and intellectual property. Various risks may cause Lexicon’s actual results to differ materially from those expressed or implied in such forward-looking statements, including uncertainties related to the timing of results of clinical trials and preclinical studies of our drug candidates, our dependence upon strategic alliances and ability to enter into additional collaboration and license agreements, the success and productivity of our drug discovery efforts, our ability to obtain patent protection for our discoveries, limitations imposed by patents owned or controlled by third-parties and the requirements of substantial funding to conduct our drug discovery and development activities. For a list and a description of the risks and uncertainties that we face, please see the reports we have filed with the Securities and Exchange Commission. I will now turn the call over to Dr. Sands. Dr. Arthur Sands – President and Chief Executive Officer: Thank you Wade and good morning everyone. We are off to a strong start here in Q1 of 2012. And this morning, we'll be updating you as to the progress of our pipeline. On the call, we'll spend most of our time on LX4211 and diabetes. We have had some new news regarding that which we released this morning and additional indication will be setting now in addition to type 2 diabetes will be type 1 diabetes in a proof-of-concept trial which I will discuss, and then we'll move on to discuss telotristat etiprate and carcinoid syndrome and our current thinking regarding the Phase 3 program for that compound. At the end of the call, I will be summarizing the timing regarding milestones affecting all the drugs in the pipeline and I will be giving very brief updates then on LX1033 for IBS; LX2931 for rheumatoid arthritis; and LX7101 in glaucoma. So, what I can say about all the programs currently as we are here at the end of the first quarter is that they are all on track. In fact, a few are running somewhat ahead of schedule and so we are pleased with the progress of the pipeline in its entirety. So, with that brief introduction, I'd like to turn to a discussion of a new opportunity we have in front of us in type 1 diabetes or juvenile diabetes. This is the type diabetes, of course, is by definition insulin-dependent diabetes. The cause of type 1 diabetes is loss of functions of the pancreatic beta cells are typically affecting people initially in their use and then establishing itself as a lifelong disease condition. Now, there is approximately $3 million in the world with type 1 diabetes are estimated $1.3 million in the United States and maintaining control of the blood glucose because of the lack of functioning beta cells. They are entirely insulin-dependent for maintain that control. So, insulin has a low established drug for glycemic control has certain issues that make it challenging for the type 1 diabetic and also the non-compliance with injections can be a problem where 80% of type 1 diabetes are on three or more insulin injections per day, well another 20% in the United States are on insulin pumps. But there is issues regarding serum hypoglycemia, which is one of the most common side effects of the insulin therapy and this can lead to deviations from compliance with the insulin therapy. In addition, long-term poor glycemic control can produce kidney disease and retinal damage and long-term cardiovascular disease as well. So, we see the opportunity for LX4211 here a very unique of course, it's all oral agents, which is unique in the sales as there are no currently approved oral therapies for type 1 diabetes. And what we know about LX4211 mechanism has led us to believe that we can enhance glycemic control significantly while reducing insulin needs and we think this will address a significant unmet medical need in the population. We have seen LX4211 performed well and animal models of type 1 diabetes and the potential benefits and could not only more consistent glycemic control and addition to insulin therapy – in combination with insulin therapy of course, but also there are benefits by reducing the potential dose of insulin, which would include less hypoglycemia, a greater ability to reach hemoglobin A1c target and therefore reduced the long-term consequences of toxic levels of glucose. And then there is a lifestyle factor also we'd like to consider here which is the elimination potentially a one or more insulin doses in some patients. And then finally insulin use itself is also associated with weight gain and we think that by reducing the dose of – total dose of insulin used that can reduce our side effect of course, we've also seen a favorable effects on body weight with LX4211 therapy. So, I'd like to describe briefly now the type 1 diabetes proof-of-concept study that we have outlined and received funding for. We'll begin this program with multi-center, randomized, placebo-controlled study, double-blind study and patients with an adequately controlled type 1 diabetes. That will be in subjects that are 18 or 55 years of age with established type 1 diabetes and they can be either on the continuous subcutaneous insulin infusion, which is the insulin pump or on multiple dose injection, which should be some combination of short-acting insulin at mealtime with long-acting insulin for the basal dose. We anticipate approximately 25 subjects overall. We think we can achieve a proof-of-concept goal within a four-week treatment period. So, this is a fairly short treatment period and which time we can derive a significant amount of information. The dose we are targeting here is a 600 milligrams total daily dose of LX4211, the initial dosing being 400 milligrams just before breakfast where we are seeing excellent control in both healthy normal and type 2 diabetics over a postprandial glucose at breakfast to lunch and then 200 milligrams just before dinner and of course it will be all compared to placebo. The end points will be looking at in the study are listed on this slide. The primary objective and I think the most qualitative endpoint for the short-term study is the reduction in the total daily amount of (exhaustion) as insulin required. Our patients are also on LX4211. So, we anticipate there being a reduction in insulin required once LX4211 is added and of course we'll compare that to the placebo group. There are secondary objectives as well, which are very important and the first one there is to further define LX4211's effects in terms of reducing the dose of insulin required between the mealtime insulin or the bolus insulin requirements and the basal insulin, which is the longer acting as one of the baseline requirements that they have. So, these will be studied independently as a secondary endpoint. In addition to this, then there are endpoints we can measure in the short-term study that revolve around improvements in glycemic control and the one of the most qualitative one will be the effects on the fasting plasma glucose overtime and postprandial glucose again what we've seen significant effects in previous studies with LX4211. And then we'll also be measuring through our continuous glucose monitor, which gives us a measure of glucose – blood glucose concentration essentially every five minutes through a device. We'll do measuring the time spent in the normal glucose range or new glycemic range and this will speak to ability of LX4211 to enhance glucose control overall and also importantly reduced the amount of time spent either hypoglycemic that was with low blood sugar or hyperglycemic that is with high blood sugar. Now longer term studies are possible after this and in those kind of studies we'd anticipate end points including hemoglobin A1c, a long-term measure that glycemic control, which we would hope would improved. So, that's a brief outline of our study in type 1 diabetes. We think again it offers a new opportunity for the drive to expand its potential indication in addition to our type 2 effort, which we will be updating you on now as I turned the call over to Pablo Lapuerta. Pablo? Dr. Pablo Lapuerta – Senior Vice President, Clinical Development and Chief Medical Officer: Thank you, Arthur. In type 2 diabetes, one of the updates that we have is that we have initiated a study in renal impairment. The study of renal impairment in type 2 diabetes is attractive for something even. One is that the population is very large up to 40% of patients with type 2 diabetes eventually will suffer from some degree of renal failure. Another is that the population has a high unmet need. Metformin is contraindicated in this population by (indiscernible) are contraindicated, many of the so-called ureas are contraindicated. Using insulin can be difficult in this population, so we have a very unmet need. But another reason is that we believe that LX4211 can differentiate in renal impairment and this is a good opportunity for us. SGLT2 selective inhibitors have been shown to be less effective in patients with renal impairment. But LX4211 provides an addition to SGLT2 inhibition, the SGLT1 inhibition in the gastrointestinal tract and that could provide benefit by reducing glucose absorption and enhancing a GLP-1 and PYY. So, with that in mind, we put together a small study. We plan to enroll 20 patients that will give us some initial data in the setting of renal impairments. These patients have type 2 diabetes and moderate-to-severe renal impairments will be treated with LX4211 at the 400 mg dose of placebo for seven days and we'll have assessments of postprandial glucose at the end of the (indiscernible). We expect to have results in the second half of 2012 and results in 2012 will help us prepare for a large renal impairment study that we anticipate would be part of our Phase 3 program. One of the update relates to our ongoing study, our Phase 2b study, and type 2 diabetes. We've mentioned the study at several calls. At this call, we can update that we completed randomizing all 299 patients. We've also completed dosing for all of those patients. We have good participation in the study approximately 90% of patients completed the study with no serious adverse events related to the study drug. The overall safety is blinded, but we are seeing a pattern that’s consistent with the non-tolerability profile of LX4211. So, in June 2012, we expect to have data on the study with information on reductions in hemoglobin A1c as we top our primary endpoints. But we also have other data on achievement of hemoglobin A1c less than 7% fasting plasma glucose, weight, blood pressure and triglycerides that this kind of profile of LX4211. So, in addition to nearing completion with its Phase 2b study, we are busy preparing for Phase 3 and one of the activities that we undertook in the past few months is to meet with several European Union regulatory agencies. We met with agencies in Germany, Austria and United Kingdom in order to get feedback on our proposed Phase 3 program. We are very aware of the importance of moving forward into Phase 3 effectively and that’s why we've been proactive in seeking regulatory input. With regard to telotristat etiprate, we’ve undergone our Phase 3 planning and that’s been marked by another Phase 2 meeting that was completed with the Food and Drug Administration and was a positive interaction and has led to our current Phase 3 plan. We believe we can move forward with a single pivotal study for an indication in carcinoid syndrome for telotristat etiprate. That single pivotal study will have 12 weeks of blinded treatment period that's placebo controlled. We are trying to move forward with two doses 250 milligrams three times daily, 500 milligrams three times daily, and placebo. The sample size will be approximately 100 patients and our focus will be on the reduction in the number of bowel movement frequency in carcinoid syndrome patients with diarrhea. We’re also proceeding with European Medicines Agency and seeking protocol assistance, that's scientific advice on our proposed Phase 3 program and its scientific advice for an orphan drug. We are on track to initiate this study in the second half of 2012. I also have an update on the telotristat etiprate Phase 2 study and ulcerative colitis. This is a proof-of-concept study and it also be providing important safety information for patients with ulcerative colitis and they have the potential to expand the target population for telotristat etiprate. The name of the study is called (indiscernible), it's a Phase 2 study of the relationship between serotonin and efficacy in ulcerative colitis. We hope to have about 60 patients with mild-to-moderate ulcerative colitis, randomized to placebo on two different doses on telotristat etiprate to an 8-week study with efficacy measures that are common in ulcerative colitis studies. So, we initiated the study effectively. Enrollment is progressing. Randomization is a bit ahead of schedule. Those are the key updates. And with that, I would like to turn the call over to Jeff Wade. Jeff Wade – Executive Vice President, Corporate Development and Chief Financial Officer: Thank you, Pablo. I will provide a brief financial update. As indicated in our press release today, we had revenues for the three months ended March 31, 2012 at $0.3 million, a decrease of 50% from $0.6 million in the prior year period. Our research and development expenses for the 2012 first quarter decreased 4% to $23 million from $23.9 million in the prior year period. The decrease was primarily attributable to decreases in facility and personnel cost partially offset by an increase in external manufacturing clinical research and development costs. In connection with our acquisition of Symphony Icon, we made an initial estimate of the fair value of our liability for the base and contingent payments. Changes in this liability, based on the development of the programs and the time until the payments are expected to be made are recorded in our consolidated statements of operations. The associated increase in fair value of Symphony Icon purchase liability was $2.1 million in the three months ended March 31, 2012. Our general and administrative expenses for the 2012 first quarter were $4.6 million, a decrease of 4% from $4.8 million in the prior year period. The decrease was primarily attributable to decreases in personnel and facility costs. Our net loss for the 2012 first quarter was $29.9 million or $0.06 per share compared to a net loss of $29.6 million or $0.09 per share in the prior year period. For the three months ended March 31, 2012. Our net loss included non-cash, stock-based compensation expense of $1.7 million, compared to $1.5 million in the corresponding period in 2011. Let me now turn to our cash and investments. As of March 31, 2012, we had $253.7 million in cash and investments as compared to $281.7 million as of December 31, 2011. Now, let's look to our forward-looking guidance for 2012. We expect contractual revenues from existing agreements in 2012 of around $1 million. Consistent with our past practice while we are in conversations with pharmaceutical companies about potential collaborations and alliances, we are not including forecasted revenue from these potential arrangements in our guidance. That said we believe our productive pipeline will provide Lexicon with attractive opportunities for future alliances. We expect operating expenses in 2012 to be in the range of $110 million to $120 million, which is unchanged from our prior forecast. Non-cash expenses are expected to be approximately $19 million of that total; including $9 million of increase in fair value of Symphony Icon purchase liability, $6 million in stock-based compensation and $4 million in depreciation and amortization. Taking into account, cash received under existing contractual relationships only, we expect our 2012 net cash used and operations to be in the range of $93 million to $98 million, which is consistent with our previous guidance. I will now turn the call back to, Arthur. Dr. Arthur Sands – President and Chief Executive Officer: Thank you, Jeff. And as we look over the next 12 months, you can see on this slide we have a number of key milestones coming up all involving reporting of important results from a number of programs? And then on the bottom of the timeline you can see our anticipated timing of launching of our Phase 3 effort in carcinoid syndrome in 2012 and then look before to the 2013, the proximal timing of our launch of LX4211. So, if we look at the key results coming up just in front of us, Pablo updated you with respect to LX4211 and the Phase 2b results which is on track. Then shortly thereafter, in early Q3, we expect to have results from LX2931, our S1P lyase inhibitor, which is currently being studied in the dose escalation protocol in patients with rheumatoid arthritis. That has preceded well through the various dose levels and so we look forward to those results. Later that quarter, our trial in glaucoma with our new agent LX7101 is actually progressing ahead of schedule and so we see results for that hopefully in the – nearing the end of the third quarter. Enrollments going well and to remind you that is a new kinase inhibitor that we have developed within the eye drop formulations is being tested in approximately 60 patients with glaucoma. The endpoints of there being not only safety but also intraocular pressure, which is of course the most important endpoint. And then as we go into Q4, we – in the end of Q3 or beginning of Q4, we are anticipating getting results from our European open-label study and carcinoid syndrome. That study is important, because that is the study on which we've had a treatment period of 12 weeks. And as you recall, the US-placebo controlled study was a four-week treatment period, so we'll be looking at an extended treatment period with that result. And so that again will be anticipated around the early Q4. Moving into 2013, LX1033 results in IBS that is the trial that is also enrolling very well, somewhat ahead of schedule. That’s a trial of our locally acting tryptophan hydroxylase inhibitor and 360 patients with IBSD, and then shortly thereafter, our results from telotristat etiprate and ulcerative colitis. So, very dense 12 months coming up here with respect to clinical results and we’ll be keeping you updated. So, I’m sure by now you may have formulated some questions and I'd like to open it up to Q&A.