Earnings Labs

Theravance Biopharma, Inc. (TBPH)

Q2 2018 Earnings Call· Wed, Aug 1, 2018

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Transcript

Operator

Operator

Ladies and gentlemen, good morning. At this time, I’d like to welcome everyone to the Theravance Biopharma Conference Call. During the presentation all participants will be in a listen-only mode. A question-and-answer session will follow the company’s formal remarks. [Operator Instructions]. Today’s conference call is being recorded. And now I would like to turn the call over to Alex Dobbin, Head of Investor Relations. Please go ahead.

Alex Dobbin

Analyst · Needham & Company. Your line is now open

Thanks Candice. Good morning, everyone. Thank you for joining our conference call and webcast to discuss our Second Quarter 2018 Financial Results. With me on the call today are Rick Winningham, Chief Executive Officer; Renee Gala, Chief Financial Officer; and Brett Haumann, Chief Medical Officer. Following our prepared remarks, we’ll open the call for questions. A copy of the press release is associated with today’s call and slides accompanying this call can be downloaded from our website, or you can call Investor Relations at (650) 808-4045, and we’ll be happy to assist you. Before we begin, I’d like to direct your attention to Slide 2 of the deck and to remind you that this conference call will contain forward-looking statements which involve certain risks and uncertainties, including statements about our product pipeline; expected benefits of our products; the anticipated timing of trial results and regulatory filings; and expected financial results. Information concerning factors that could cause results to differ materially from our forward-looking statements is described further in the company’s filings made with the Securities and Exchange Commission. And with that, I’ll call your attention to slide 3, and hand the call over to Rick Winningham.

Rick Winningham

Analyst · Leerink. Your line is now open

Thanks, Alex. Good morning everyone and thank you for joining us. 2018 in unfolding as a year of great progress with Theravance Biopharma, as we focus on strategic priorities for the company. Those programs where we think there is the greatest opportunity to create transformational medicines. Today we are pleased to report updates on two of those strategic priorities with positive results from both the phase 2 trial of TD-9855 in neurogenic orthostatic hypotension and from the phase 1b trial of TD-1473 in ulcerative colitis which complement the data previously reported. With both programs we’ve also completed exhaustive and extensive regulatory discussions to inform the progression of these programs in the pivotal registrational studies. Starting with 9855, our goals in the phase 2 study were to demonstrate a positive therapeutic impact on blood pressure and symptoms of nOH and to show durability of effect as well as safety and tolerability. We believe that the topline four week data detailed today in a separate release, strongly support advancing TD-9855 in to a phase 3 registrational program. In a few minutes Brett will provide additional perspective on the phase 2 data, but we’re pleased with these results and especially gratified by the responses from key opinion leaders in neurology with whom we’ve discussed the dataset. These clinicians support the view that these data are clinically meaningful and highly encouraging and that 9855 has the potential to be a transformational treatment for this debilitating condition in need of new options. We concluded our discussions with FDA on the design of the pivotal phase 3 registrational program and we plan to initiative the program in late 2018 or early 2019. Earlier this year, we announced a global collaboration with Janssen for the development and commercialization of 1473 in inflammatory intestinal diseases and plans to…

Brett Haumann

Analyst · Leerink. Your line is now open

Thanks Rick. I’ll begin on slide 4 and discuss the phase 2 trial of 9855 in norepinephrine and serotonin reuptake inhibitor in patients with neurogenic orthostatic hypotension or nOH. nOH is a rare autonomic disorder which presents in a proportion of patients with Parkinson’s disease as well as the majority of patience with multiple systems atrophy and pure autonomic failure. The phase 2 study of 9855 consisted of three parts; Part A was a single ascending dose from 1 milligram up to 20 milligrams, designed to evaluate the impact on blood pressure and standing time for 9855. Part B was a double blind single dose study designed to evaluate the impact on blood pressure for 9855 as compared to placebo. Following emergence of encouraging improvements in patients in Part A and in response to patients request to continue taking therapy, the study was amended to include Part C. This part of the study focused specifically on evaluating improvements in both blood pressure and symptoms in nOH and to repeat dose conditions. The primary assessment in the study was measured after four weeks, although patients can continue to receive medication for up to five months. Before I describe the data, I’ll take a moment to explain what we mean by OHSA question one and the symptom measurement scale used in nOH. OSHA stands for Orthostatic Hypertension Symptom Assessment, and it’s a validated scale assessing the presence of a range of symptoms in nOH including dizziness, weakness, problems with vision, fatigue, trouble concentrating and head and neck discomfort. It’s based on a scale from zero with no symptoms to 10, which is the worst possible to very serious symptom with reductions in OHSA indicating symptom improvements. OHSA question one specifically measures patients dizziness, light headedness, feeling things or feeling that they might…

Renee Gala

Analyst · Leerink. Your line is now open

Thank you Brett. Starting on slide 9, revenue for the second quarter of 2018 was $23.5 million comprised of revenues from collaborative arrangements at 18.1 million and product sales of Vibativ of 5.4 million. Revenue in the second quarter represents an increase of approximately $20 million over the same period in 2017. The increase is primarily related to revenue recognized from both the Alfasigma opt-in payment for Velusetrag and the Janssen upfront payment for 1473. As we’ve stated previously, we expect to recognize a $100 million Janssen upfront payment over the course of the 1473 phase 2 program. R&D expenses for the second quarter of 2018 were $48.6 million compared to 42.9 million in the same period in 2017. The increase is primarily due to higher share based compensation, external related and other allocated expenses. Second quarter R&D expenses include non-cash share based compensation of $6.9 million. SG&A expenses for the second quarter of 2018 were $25 million compared to 24.3 million in the same period in 2017. Second quarter SG&A expenses include non-cash share based compensation of $7 million. We remain in a well-capitalized position with approximately $371 million in cash, cash equivalents and marketable securities as of June 30. Our 2018 financial guidance remains unchanged. For the full year of 2018, we expect our operating loss excluding non-cash share based compensation to be in the range of $180 million to $200 million. As a reminder, our guidance does not include income related to our economic interest in Trelegy Ellipta, as we recognize this income below the operating line, as other income related to our equity interest in Theravance Respiratory Company or TRC. I’ll close on slide 10, with an update on our economic interest in Trelegy, the first and only once daily single inhaler triple therapy. Trelegy continues…

Rick Winningham

Analyst · Leerink. Your line is now open

Thanks Renee. Moving to slide 11, we’ve made exciting progress across our portfolio. Positive data from the 1473 1b study in ulcerative colitis and 9855 phase 2 study in nOH provides strong clinical rationale for the progression in the registrational programs. With regulatory dialogs recently completed, each program now has a clear path to late stage studies. For Yupelri, our brand name for Revefenacin, we and our partner Mylan are finalizing launch readiness activities in anticipation of a potential FDA approval later this year. In our early stage pipeline, we’re preparing to advance TD-8236 our novel inhaled JAK inhibitor for serious respiratory diseases in to the clinic. These recent pipeline advancements along with a strong balance sheet and emerging cash flows from Trelegy position us to continue to delever growth across our businesses from research to commercial to drive value for shareholders and maximize the impact we can make on patients’ lives. Our anticipated upcoming milestones are; for 1473 initiation of a phase 2 induction study in Crohn’s disease in the third quarter and a phase 2b/3 induction and maintenance study in ulcerative colitis in the fourth quarter, plus full results from the phase 1b study in ulcerative colitis at a future medical meeting. For 9855, the initiation of a registrational phase 3 program in nOH later this year or in early 2019, additionally presentation of pre-clinical 9855 data at the Movement Disorders Congress in October. For Yupelri, COPD exacerbation data from the phase 3 clinical program will be shared in an oral presentation at ERS 2018 in September in Paris and a potential regulatory approval and commercial launch in the fourth quarter. For TD-8236, our novel inhaled JAK inhibitor and a compound that leverages our unique and powerful institutional knowledge regarding both the lung and JAK inhibition, progression in to the first inhuman studies in late 2018. For Trelegy Ellipta, potential label expansion in the EU supported by submission of the impact study to the EMA, potential regulatory approval in Japan and an early 2019 expected completion of the phase 3 CAPTAIN study in asthma patients. And finally, we look forward to R&D day in December focusing on research in the next generation of clinical programs which represent the insight in innovation at the heart of our company. And now I’d like to turn the call over to the operator for questions.

Operator

Operator

[Operator Instructions] And our first question comes from Jeffrey Borges of Leerink. Your line is now open.

Jeffrey Borges

Analyst · Leerink. Your line is now open

First question on 9855, Brett could you help me understand the flow of patients from Part A to Part B and Part C. I just wanted to know which patient was selected on the basis of their responses before progressing to the subsequent stages to understand the context of the placebo comparison. That was a little bit confusing. And then secondly, could you talk a little bit about what the individual patient blood pressure excursions have been? Have you had any patients with systolic blood pressure getting say above 160 or 180? And then lastly could you give us a sense of what you’re seeing in the extended follow-up after the four-week dosing period? At times as though I think you said 76% of patients are continuing, but are they continuing to get the same level of response or is the response eroding? And then just quickly for Rick, Trelegy you’re clearly breaking it out as a separate asset for the company, so why you’re not operationally involved at this stage. At what point do you feel a sufficient confidence in the outlook for the product and the value of that royalty stream that you might contemplate realizing that value in some other way? And then Renee, could you just comment on the trajectory of R&D spend, because it sounds as though you got to really be wrapping up with pivotal trials for 9855 and then the phase 2b/3 trial for 1473 which you are funding. So could you give us a sense of how much of a step up we should be expecting in our R&D forecast for the next few quarters?

Brett Haumann

Analyst · Leerink. Your line is now open

This is Brett. On to your first three questions, you are asking about the flow of patients. I’ll actually combine that with an answer on the extended phase because we’ll speak about the flow and then you asked about blood pressure excursion as well. So just to explain how we set the study up, the initial design of the study for only for two parts, Part A and Part B, and we had 34 patients coming in to Part A. They were test by their physicians, the treating investigators who were experienced clinicians in treating patients with nOH and 27 of those 34 were deemed to have a clinical response either on blood pressure change and/or a standing client improvement at one of the doses that was assessed, and that dose was different for different patients but on average settled around the 10 milligram dose. So 27 patients were eligible to continue beyond Part A. The first 10 of those patients were considered for Part B and they were in fact randomized to either active or to placebo and their blood pressure was assessed in the double blind phase that I shared the data for. But while we were conducting Part B, we acknowledged and recognized that there was several of these 27 patients requesting extension on their therapy. And so alongside Part B we designed Part C and allowed patients to move in to this ongoing maintenance portion. That took us a little while to get up and running and sadly during that time, there were patients that became ineligible from Part A to go in to Part C. Of the 27 that could have been considered, 21 went in to the extension study sadly because of the progressive nature of this disease. There were some patients who were…

Rick Winningham

Analyst · Leerink. Your line is now open

Yeah Trelegy, while Jeff we continue to be favorably impressed with the progression of the product in the US because that’s where you have the most granular information. But I think the European Trelegy sales and success are just getting started, and then as GSK rolls it our across the world I highlighted the Japanese submission in my comments. So I think we’re in the early stage of sort of the sales evolution of the product and clearly it would be accelerated with positive results from the asthma study early next year. We do look at this as a strategic asset; we do look at it as a potential source of funds either directly or through debt instrument of some kind. But we’re really – early on in the evolution of the sales cycle, when we would expect based on everything GSK has said and how the product is performing for the sales and therefor the economic benefit that accrues to us to continue it to improve quite significantly over the next 18 months.

Renee Gala

Analyst · Leerink. Your line is now open

And Jeff you had asked about the trajectory of R&D spend, given the studies that we’ll be initiating. And yes, you’re correct; we’ll be paying for the current study to be in the ulcerative colitis program as well as the 9855 study. As you know, we don’t generally provide quarterly guidance, but I would reiterate that we are on track with our financial guidance for the full year of $180 million to $200 million in [op] loss excluding stock based compensation. And if you look at where we are year-to-date with about 86 million on that metric including roughly $10 million received from [Alfasigma] you’ll see that we’re on track there. With respect to 2019 guidance, I would expect we’ll provide that earlier in 2019 as we normally would. So stay tune there, but we are pretty comfortable with where we are relative to our full year guidance.

Operator

Operator

Your next question comes from Tyler Van Buren of Piper Jaffray. Your line is now open.

Tyler Van Buren

Analyst · Piper Jaffray. Your line is now open

The first question would be, as we think about the results that were reported for 9855 and comparing it to the historical (inaudible) data, I guess it’s a little bit difficult because we don’t have mean baselines. But as you look at the earlier time points perhaps at one week and then as you’ll also look at the data at four weeks, is it possible to give us any sort of a sense of the percent reduction in the OHSA item 1 score or perhaps the placebo adjusted percent reduction and how we should look at comparing that to the (inaudible) data.

Brett Haumann

Analyst · Piper Jaffray. Your line is now open

This is Brett. As you know Part C lacked the placebo and that by design, these were patients who were requesting ongoing active therapy. So we haven’t got a perfect colors to answer your question. And in terms of comparing to the placebo controlled responses that we’ve with droxidopa, but I think we can provide some measure of overlap with what was reported before. With the droxidopa pivotal study and in fact particularly the study 306b that was reported in support of their approval. They were able to demonstrate a change from base line on active of around 2.3 points, and this was in patients who had to have some symptoms at baseline. When we apply the same threshold and by the way that change of 2.3 was seen at one week. That was the deepest response they got, and actually saw less response when they continued to track patients at two, four and eight weeks. The treatment delta or a change from baseline drifted back up towards two points. But if we apply the same criteria at baseline, it’s those 13 of 16 patients I am referring to who were symptomatic at baseline coming in to Part C. In those patients, we see a change from baseline of 3.8 points. So the treatment difference that we’re able to overlay on droxidopa would suggest that in patients who were symptomatic at baseline and these are the patients we’ll recruit in phase 3, we should see treatment differences that are at least as good as droxi for longer. But if we are able to maintain these effects, we should see greater treatment differences than we’re seeing with droxidopa, assuming of course that the placebo response is comfortable to what they had in their own studies and we had no reason to believe that it would be different. Does that answer your question Tyler?

Tyler Van Buren

Analyst · Piper Jaffray. Your line is now open

Yes, that’s very helpful and I’m starring at OHSA item 1 score graph in the label. So is it safe to say and that’s how from the magnitude of week one, but is it safe to say that these patients didn’t have that rebound from week one to week two as we saw, as that graph shows in the droxidopa label?

Rick Winningham

Analyst · Piper Jaffray. Your line is now open

So in our own program we’ve evaluated the treatment effects on weekly interval throughout the four weeks, and the durability that we described here is because we’re seeing that degree of change that magnitude of effects in each of the weekly assessments. So our improvements we believe are more durable because we’ve seeing greater magnitude of defects not only at four weeks but throughout the four weeks dosing interval.

Tyler Van Buren

Analyst · Piper Jaffray. Your line is now open

And I believe you all were measuring low reduction levels at baseline or throughout the study. Was there any correlation there to response and what do you think about it as using as a potential biomarker moving forward?

Rick Winningham

Analyst · Piper Jaffray. Your line is now open

So it’s a great question Tyler and in fact some of what we’ll be disclosing at future scientific meetings will give a lot more insights including correlation with underlying disease state as well as baseline norepinephrine levels. Today we’ve obviously focused on the topline results, but we said and will be bringing that material, those data to future scientific meetings.

Tyler Van Buren

Analyst · Piper Jaffray. Your line is now open

And just finally, if the pivotal study has started around year-end or early next year, what you all think is the approximate timeline to approval and market launch?

Rick Winningham

Analyst · Piper Jaffray. Your line is now open

We’re always a little bit hesitant to perfectly predict on our involvement grades. I think it’s fair to say that right now having just completed our regulatory discussions, we’re finalizing our sample size for the entire program and that will obviously drive recruitment grades. But we’re advanced discussions with investigators in scaling up for this program. So really all eyes now are on initiating this program before the end of this year or very early next year.

Brett Haumann

Analyst · Piper Jaffray. Your line is now open

Once we get the study up and going, we’ll be able to provide more context and anticipated timing.

Tyler Van Buren

Analyst · Piper Jaffray. Your line is now open

I was just saying and I know it’s - may be not a fair proxy, but could you just remind us how long the (inaudible) pivotal trial took from start to beta?

Rick Winningham

Analyst · Piper Jaffray. Your line is now open

They had several attempts as you may recall Tyler in getting successful approval, there were two separate findings and they had to run further studies after a series of failed studies. So I’m not sure that their program would necessarily be a reasonable proxy for what we’re hoping to achieve. I think our intention here is obviously to seek an expedited path with doing a program as possible. So I’m not sure that the droxi analog would necessarily be one that we draw reference to.

Operator

Operator

And our next question comes from Josh Schimmer of Evercore ISI. Your line is now open.

Josh Schimmer

Analyst · Evercore ISI. Your line is now open

First on 9855, how is the dose determined for Part B and how do you assess whether any individual patient is dose optimized?

Brett Haumann

Analyst · Evercore ISI. Your line is now open

This is Brett. So in fact in the early part of the study, we didn’t have a perfect answer to that. We were curious as to whether there may be very different doses required for different patients in order to titrate. But really the observations that we had in the single ascending dose, we reaffirmed in Part C where patients could change their doses if they needed to base on symptoms or blood pressure. What became evident is that the majority of patients were really gravitating around the 10 milligram dose and that was producing really the most consistent response. So even though we’d allowed for titration in the early parts, our view on the basis of this data is that the 10 milligram dose would be a central dose for phase 3. It would be the dose we would focus on.

Rick Winningham

Analyst · Evercore ISI. Your line is now open

I think other point I would add is, we’ve published some data on 9855 with regard to central [nap] occupancy based on cat scans that we’ve done with the compound and clearly if you look at the occupancy measures, it would also guide, it would provide additional support to what we actually found in the chronic 10 milligrams.

Josh Schimmer

Analyst · Evercore ISI. Your line is now open

And is the 20 milligram not give incremental benefit or it doesn’t lead to excessively high blood pressure?

Brett Haumann

Analyst · Evercore ISI. Your line is now open

So it doesn’t lead to excessively high blood pressure Josh, but when given the opportunity to increase the dose, physicians didn’t feel that it was needed or warranted, because the patients were getting adequate responses clinically of the 10 milligram dose.

Josh Schimmer

Analyst · Evercore ISI. Your line is now open

And for the 30 millimeter mercury benefit at four hours, seems like it was split fairly evenly between a gain in the treatment earning a lot and a reduction in blood pressure and then placebo arm. How do we think about what a typical placebo responses in these trials might be or what for this specific trial design the placebo response might have been, since it looks like it’s a little bit hard to get a hand on how the placebo arm performed on blood pressure at least in the droxidopa studies?

Brett Haumann

Analyst · Evercore ISI. Your line is now open

So I think that one difference in certainly Part B of this study is that we track this blood pressure over a 24 hour duration. We were really interested in seeing what the profile would look like. The placebo response was very much as we might expect it to be. Patients starting with a low base line, a low blood pressure – never mind these are patients with nOH, their blood pressure even early morning can sit at somewhere between 50 and 70 millimeters of mercury as opposed to where all of us operate at around a 120. So it’s a low baseline to begin with, and then as patients become active in the absence of therapy their blood pressure drops. Interestingly their blood pressure also drops after meals, because blood directed away from the brain and actually we circulate it to the guts in order to facilitate absorption. So patients often will have further decline in their blood pressure after meals, and indeed we see this profile in the placebo response. You’re right that’s part of the difference. The increases that we saw with the active therapy taking us around 15 millimeters of mercury above their baseline is actually quite reassuring to us, it’s an evidence of the pressure effects. You can [cross away] from droxidopa, I think in the label they quote improvements of around between 6 and 12 millimeters of mercury based on or depending on the study. In the placebo rounds of those studies, on average they see a slight increase around 4 millimeters of mercury, but I think it’s probably not fair to compare it directly because those are often spot blood pressure as opposed to profile since we’ve generated in the study. But I think we’ll continue to monitor for blood pressure obviously through the remainder of the phase 3 program as we accrue more patients. It will probably be easier and certainly once we’ve got balanced numbers of active and placebo in later studies, we’ll be able to create a useful frame of reference. So one last thing I will say on blood pressure is that although it’s an important precursor to improving blood pressure in this condition, it isn’t an end point that regulators are interested in. And in fact even physicians will tell us that blood pressure is an important enabler, but it’s the symptoms that are critically important. In fact above a certain blood pressure improvement, symptoms will completely disappear. And the reason for that is, that above a certain threshold on blood pressure the brain is adequately profuse to prevent or to ablate dizziness. So you don’t have to see a perfect correlation between blood pressure and symptoms, and symptoms has emerged really under the experience of droxidopa as the sentinel measure of benefits and that would be the key focus in phase 3. That’s why I would just say Question one is of central importance to us.

Josh Schimmer

Analyst · Evercore ISI. Your line is now open

Maybe just one follow-up to that and while there are questions, I guess given that commentary about, it sounds like blood pressure is kind of a proxy for the therapeutic effect, it looks like that the benefits sustained for seven maybe nine hours, but by 12 hours at least blood pressure the effect versus placebo is diminished. What is the optimal duration of benefit for a patient? Isn’t 12 hours a little short from what they might want to be to kind of make it through a full day and early evening or is that the charter profile. And then a quick one on 1473, you had mentioned that the highest dose had greatest efficacy, was the difference between a high dose and a middle dose meaningful, and do you have any plans to explore higher dose given it sounds like you’re seeing a dose response.

Brett Haumann

Analyst · Evercore ISI. Your line is now open

Just on your question about 9855, the first one that we’re describing on the blood pressure we believe to be really very much in line with what we would like to see. We don’t need these patients to have high blood pressures when they are lying down at night. In fact we did during droxidopa carried box warning for the risk of supine hypertension in the evening. Both therapies need to be administered at least three hours before patients lie down to prevent the risk of over shooting on blood pressure. And in contrast to our product, those once daily we think in the morning producing this sort of profile would really be ideal, because patients don’t need that elevated blood pressure when they’re lying down. In fact we want to mitigate against the risk of supine hypertension. So this profile is very much in keeping with what we would like. Symptoms of course remain the key measure, and OHSA 1 ultimately in our phase 3 program, we’ll be looking on a chronic basis at improving symptoms regardless at the time of day. The recall period for that instrument is seven days. So it really looks back over the last week. On 1473 you were asking about whether there were any meaningful difference between the top two doses. We said and we will be sharing more information on each of the various responses on a number of our clinical end points including partial and full. I think it’s fair to say that’s both the 80 and 270 milligram dose were giving us confidence that those are within a therapeutic range. And it’s on that basis that the 80 and 200 milligram doses going forward remain central both for Crohn’s and ulcerative colitis. Based on our [patient] concentration data, we are not convinced that there is any additional benefit above 200, which is why we have pulled that as the top dose for the next range of studies as oppose to 270. But the 80 and 200 remain of significant interest to us, and I think 20 milligrams although we’ve evaluated in this program was beginning to suggest that that maybe sub-optimal, not ineffective but suboptimal. You’ll see that it appears in our ulcerative colitis program and the reason for that is purposeful, just as we did with the Revefenacin program its important still to anchor pivotal registrational studies on what we deem to be a sub-effective dose and that’s the reason for the inclusion of the 20 milligram dose in ulcerative colitis pivotal programs going forward.

Operator

Operator

And our next question comes from Alan Carr of Needham & Company. Your line is now open.

Alan Carr

Analyst · Needham & Company. Your line is now open

It’s sounds like you’re hesitant to give the mean baseline number, but I’m sure if you can at least tell us if its meaningfully different from the approximately 5 that was in the [Procera] trial. I was wondering also can you tell us whether there were other metrics, other component of OHQ that were accessed in the 9855 trial and any patterns there. And then lastly around 9855, OHSA 1 is obviously importantly from a regulatory perspective, but I’m wondering if you can comment on duration, is this going to be for the phase 3 trial check plan. Is there any reason to believe that it’s going to be different from the 8 to 12 week range that we’ve seen for some of these other trials in the past?

Brett Haumann

Analyst · Needham & Company. Your line is now open

So no sensitivity in sharing baseline, actually you’re right, the droxidopa average baseline certainly in their pivotal registration study was 5.1. In this study, the extension study, the average baseline for our patients, for all patients 16 of them coming in was 6.6. So slightly more severe in terms of their baseline OHSA than what was reported, but within a range that we think was still significant. And bear in mind three of those 16 patients actually didn’t have symptoms to begin with. So you can get a sense around the severity of their baseline dizziness. And you were asking about associated changes in other measures, although we are looking in to all the detail of the study today, we will be sharing that in the future. I think it’s fair to say that looking at the umbrella terms we tend to focus very much on OHSA Question one. It’s viewed by clinicians as being the least confounded of the measure. As you would appreciate measures such as fatigue or activity in the context of the patients with Parkinson’s disease, there may be reasons why they’re fatigued or not active unrelated to orthostatic hypotension, but still related to Parkinson’s. But nevertheless we still measure them and we saw consistent changes at the overall level with reductions on the OHQ, the Orthostatic Hypotension Questionnaire as well as the subdomains looking at OHSA, the symptom assessment as well as OHDAS, that the daily activity symptom. And we will be reporting more detail on that at our coming scientific conferences. And your last question I think related to duration of studies, is that right? And forgive me; was that in relation to 1473 or 9855?

Alan Carr

Analyst · Needham & Company. Your line is now open

I am thinking more of 9855, the FDA ad comps for (inaudible) and then a focus on a 12 weeks wondering if your proposed design with the FDA is meaningfully different from it?

Brett Haumann

Analyst · Needham & Company. Your line is now open

So again we’ll be sharing more details around the studies at future business updates. I think it’s fair to say though that we’ve got real clarity from the agency, and the endpoints that we’re looking at are conventional endpoints. OHSA Question one remains really important in terms of assessing the efficacy. And then consistent with droxidopa, the agency is also looking for confidence of durability of response. And so the designs that we’re really now finalizing will reflect that. But we look forward to updating you on those designs really as we begin to initiate these programs. We’ll provide more details on what those are.

Alan Carr

Analyst · Needham & Company. Your line is now open

I wondered if you could comment a bit more about the baseline of 6.6 or actually it would be even higher for the 13 patients that had, I guess their average response 3.8 of those 13, and to have a baseline it’s going to be well over 6.6. Can you comment on and why is this a – why do you think you had such a different baseline population here versus some of the other trials, the [choice] you had and then is that something that can be easily replicated under phase 3 whilst you have enrollment challenges or greater enrollment challenges with higher baseline and can you talk about that a bit?

Brett Haumann

Analyst · Needham & Company. Your line is now open

So just to be clear Alan, although there are numerical differences here, I’d be careful not to over interpret them just because they are very different size of studies. The droxidopa program had almost 300 patients; we are talking about a much smaller denominator here, but notwithstanding that, allowing all chemist to come into our program. I think what we were satisfied with is that we weren’t getting patients with really zero symptoms. We feel confident that interpreting this magnitude of change in dizziness comes of a baseline that was significant to begin with. You raised a very good point about the eligibility in phase 3 and really what we’re focused on is ensuring that we enroll the right patients coming in to the program that are able to demonstrate improvements to a meaningful treatment, and in that respect we’re putting not only criteria around a minimum threshold for OHSA, and I mentioned that we’re going to use that threshold of 4 points or more coming in to the program. But we’ll also be really rigorous in ensuring that these are patients who are able to report those symptoms with accuracy. So we’re putting a lot investment in to ensuring that these patients are properly screened including with two table assessments coming in to the next portion of the study. Tyler asked earlier about threshold for norepinephrine and again that’s a plan in the program is to use thresholds to ensure that the patients who are coming in could respond to this mechanism. Bear in mind that in contrast to droxidopa and midodrine, this compound 9855 doesn’t add extra exogenous (inaudible) in to the system, it really prevents the breakdown of what’s already in the body. And that’s in contrast to these other two mechanisms. So we’re going to be those sorts of criteria to ensure that we have recruited the right patients. And we are confident having done feasibility with sites that treat these patients, we are confident we’ll be able to identify them.

Alan Carr

Analyst · Needham & Company. Your line is now open

I’ve a question, what percentage of these patients and did you disclose what percent of these patients were Parkinson’s versus pure autonomic failure or MSA. Can you tell us that if you haven’t disclosed it?

Brett Haumann

Analyst · Needham & Company. Your line is now open

We haven’t disclosed this but plan to at a future scientific congress. So we’ll provide the details around that in a scientific forum.

Alan Carr

Analyst · Needham & Company. Your line is now open

Can you say whether it was distributed across and what percentage?

Brett Haumann

Analyst · Needham & Company. Your line is now open

Again I think we’re going to hold that for the scientific congress just out of respect for the fact that today was a topline review. Let’s hope it was representative of the population.

Rick Winningham

Analyst · Needham & Company. Your line is now open

Representation of the population both MSA and Parkinson’s disease patients were in the study.

Alex Dobbin

Analyst · Needham & Company. Your line is now open

Operator we are just about up. Just about up on the hour operator if there is another question in the queue, we have another minute or two.

Operator

Operator

And our final question comes from the line of Louise Chen of Cantor Fitzgerald. Your line is now open.

Louise Chen

Analyst · Cantor Fitzgerald. Your line is now open

Last question I have is based on the latest data for 9855, do you still believe you can get an expedited development pathway for this product, and then I just had a question on your TD-8236 product, where is market landscape here and what supports proof of concept for the opportunities for you?

Brett Haumann

Analyst · Cantor Fitzgerald. Your line is now open

Plans continue to be for an expedited program. We are working with a rare condition here, and so certainly this is aligned with the program that we’ve agreed with the agency. The purpose is very much to continue in expedited development. You had asked about how inhaled JAK and I’ll ask Rick to comment too, but certainly I think we’ll provide more details in terms of clinical development strategy as we get very closer to the clinic should I say. But let me pass over to Rick to comment on the Inhaled JAK.

Rick Winningham

Analyst · Cantor Fitzgerald. Your line is now open

Sure, I think clearly there continues to exists an unmet medical need in the broad (inaudible) population in severe asthma. So the patients that are uncontrolled on current therapy and compliant to current therapy, these mix between maybe tradition TH2 and non-TH2 patients. I think even with the advent of some improved medicines out there such as [IO4] [I13] product. I think that the market continues to be quite significant. And the beauty of an inhaled medicine and our objective with all localized therapies is that you can deliver the medicine directly in to the lung without overlapping toxicity of a systemic therapy. Therefore for the potentially first time, for those very serious patients being able to execute a combination therapy without overlapping toxicity. But we’ll be talking and providing more market data and so forth through the rest of the year on 8236 and the opportunity that exists there.

Operator

Operator

Thank you. It appears we have no further question on the phone. I’d now like to turn the conference back over to Mr. Winningham. Please go ahead sir.

Rick Winningham

Analyst · Leerink. Your line is now open

Thank you very much operator. I’d like to thank everyone for joining us today and listening to our business update. Have a good day.

Operator

Operator

Ladies and gentlemen, thank you for participating in today’s conference. This does conclude the program and you may now disconnect. Everyone have a great day.