Q2 2022 Achieve Life Sciences Inc Earnings Call
star zero on your telephone keypad to reach a live operator. At this time, it is my pleasure to turn the floor over to your host, Nicole Jones. Nicole, the floor is yours. Thank you, operator, and thank you to everyone for joining the call. Today on the call from Achieve, we have John Bensich, Chief Executive Officer, Dr. Cindy Jacobs, President and Chief Medical Officer, and Jerry Wan, Principal Accounting Officer.0000 career interview
Achieve Management will be available for Q&A after the prepared remarks. I'd like to remind everyone that today's conference call contains forward-looking statements based on current expectations. These statements are only predictions and actual results may vary materially from those projected. Please refer to Achieve documents available on the website and filed with the FCC concerning factors that could affect the company. I'll now turn the call over to John .
Thank you, Nicole. And thanks to everyone for joining us today. The second quarter of 2022 has been one of the most exciting yet for Achieve.
Not only did we announce successful efficacy and safety results from our Phase III ORCA II trial in April , but we also received grant funding from the NIH allowing us to proceed with the initiation of the Phase II ORCA V1 trial in adult users of e-cigarettes.
These were two major milestones for us to reach in the first half of the year, and we are pleased to continue delivering on our commitments.
As you likely have heard or read recently, there is great attention and debate surrounding smoking and nicotine e-cigarettes in the US political arena.
Tobacco use continues to be the leading cause of preventable disease and death, resulting in more than 480,000 American lives lost each year.
We are in agreement that action must be taken to save lives, to improve the health of smokers, and to reverse the increasing youth nicotine addiction trend.
The potential restrictions to increase regulation over nicotine products, such as lowering nicotine content and restricting flavors such as menthol, are controversial and will likely take many years to be implemented if they end up proceeding at all.
while they may limit access to an increased scrutiny of available products, they do not solve the nicotine addiction problem at hand.
With the recent FDA actions on e-cigarette products, including Juul, we have already seen reports of e-cigarette users considering a move back to combustible cigarettes.
Smokers and e-cigarette users need solutions to help them overcome their nicotine addiction.
That is why it's more important than ever for us to continue advancing our mission of bringing Cytosinocline to the US market as soon as possible.
If approved by the FDA, Cytosinocline would be the first non-nicotine prescription treatment for smoking cessation approved in nearly two decades.
offering hope to the millions of smokers who want to quit for good.
And we believe the heightened focus by FDA on nicotine regulation provides a nice tailwind as we look to move cytosinocline forward through the agency to market in the near future.
As announced in April , we are one step closer to accomplishing our goal with the first phase 3 trial result in hand.
The ORCA II trial evaluated the efficacy and safety of 3 milligrams cytosinocline dosed three times daily compared to placebo in 810 adult cigarette smokers in the US.
The study evaluated both six and 12-week treatment duration of cytosinocline, and all participants received standard behavioral support throughout the trial.
The ORCA II results were overwhelmingly positive indicating that smokers who received cytosinocline were six to eight times more likely to quit smoking compared to smokers who received placebo.
The safety profile of cytosinocline was once again very impressive, with single-digit rates of adverse events observed.
we were able to validate the excellent tolerability profile for both the six and 12-week durations of therapy for cytothenically in this study.
The results of our CATU trial will be submitted for journal publication this year, and we look forward to presenting additional datasets from the trial at future medical conferences.
We will provide updates as additional data are released.
We continue to believe that the tolerability profile of cytosinocline will be a key point of differentiation as smokers and their doctors consider using cytosinocline once available.
Smoking cessation prescription therapies historically have had black box warnings and high rates of troublesome side effects such as abnormal dreams, insomnia, nausea, and vomiting.
which increases treatment discontinuation and limits the overall utilization of current products.
Quitting smoking is difficult enough due to withdrawal symptoms without the treatment making you feel even worse.
We think offering a more tolerable product should help maintain strong treatment compliance leading ultimately to better outcomes for smokers looking to quit.
As we look ahead to the next milestone for the Smoking Cessation Program, we continue to anticipate enrollment completion for our second confirmatory Phase III trial to occur by the end of the third quarter this year.
ORCA III aims to enroll 750 smokers across 20 clinical trial locations in the US.
The design of the trap is similar to Orca2 in that it will evaluate six and twelve weeks of cytosantacline treatment versus placebo in smokers using the same dosing schedule and endpoints for evaluation.
This trial was initiated in the first quarter of this year and is currently enrolling smokers.
We look forward to the next update on ORCA III, which we expect will be when enrollment has completed in the coming months.
we continue to anticipate top-line results to be available in the first half of next year.
Moving on to the potential for cytosinocline in users of nicotine e-cigarettes or vapes.
In June , we initiated our Phase II ORCA V1 trial, thanks to the continued funding from the NIH and NIDA, which awarded us the next $2.5 million in grant funding to conduct this trial.
ORCA V1 aims to enroll approximately 150 adult nicotine e-cigarette users in the U.S. and is led by our ORCA II PI Dr. Nancy Rigatti, professor of medicine at Harvard Medical School and director of the Tobacco Research and Treatment Center at Massachusetts General Hospital.
ORCA V1 has two treatment arms evaluating the safety and efficacy of 3 milligrams cytosinocline dosed three times a day for 12 weeks compared to placebo.
As with the other ORCA trials, all participants will receive behavioral support.
The primary objective of the study will be to evaluate for successful nicotine vaping cessation.
Vaping cessation is defined as weekly nicotine vaping abstinence for the last four weeks of treatment from weeks 9 to 12.
Other timing for weekly vaping abstinence will also be assessed as secondary outcomes.
For example, between weeks three to six, as well as any reduction in nicotine vaping during the 12-week period. The broader answer to those mistakes is best distribution rates for younger people over
There's great enthusiasm and interest in ORCA V1 and we are encouraged by what we are seeing thus far in terms of patient recruitment for this trial.
We expect enrollment to be completed in the fourth quarter of 2022 and top line results in the first half of next year.
There are currently no FDA-approved treatments indicated specifically for users of nicotine e-cigarettes or vapes.
The CDC reported that there were nearly 11 million adult e-cigarette users in the US alone in 2019.
While it is believed that non-combustible forms of nicotine present lower health consequences than traditional cigarettes, complete abstinence from nicotine is ultimately the goal for many.
In a survey conducted by Achieve of vape and e-cigarette users, approximately 73% of participants stated they intended to quit vaping in the next 3-12 months.
an overwhelming majority would be interested in trying a new natural prescription treatment to help them do so.
We believe cytosinocline has great potential to meet the needs of this population who are ready to quit nicotine for good.
With that, I will now turn the call over to Jerry for our financial update.
Thank you, John . I would like to provide an update on our cash position as of June 30, 2022, as well as review our operating expenses for the second quarter.
As of June 30, 2022, the company's cash, cash equivalents, short-term investments, and restricted cash were $29.4 million.
compared to $43 million as of December 31st, 2021.
We believe we have sufficient cash to bring us into 2023.
Our cash forecast
includes the recently awarded 2.5 million grant funding received from the NIH to initiate the Phase 2 ORCA V1 trial to evaluate the use of cytosilicate as a treatment for cessation of nicotine e-cigarette use.
As a reminder, approximately half of the costs from the ORCA V1 trial are funded through the grant from the NIH.
With respect to our statement of operations,
Net loss decreased to $10.4 million for the quarter ended June 30, 2022.
compared to $11.3 million for the same quarter of 2021.
That loss for the six months ended June 30, 2022.
It increased to 18 million.
COVID-19.3 million for the same period of 2021.
Operating expenses decreased before the quarter ended June 30, 2022. The lower cost associated with the completion of the ORCA II trial.
This was partially offset with the initiation of the ORCA III trial in January 2022 and the initiation of the ORCA V1 trial in June 2022.
We expect our quarterly operating expenses will increase as we progress forward with both the ORCA3 and ORCAV1 trials.
I will now turn the call back over to John .
Thanks, Jerry.
We continue to make tremendous progress with the cytosinic lean development program, especially with the announcement of positive phase 3 ORCA2 results and the initiation of both our ORCA3 and ORCA V1 trials.
We remain committed to moving these trials forward and ultimately bringing a new treatment option to the market for nicotine addiction.
With a compelling efficacy and safety profile and a shortened treatment regimen, Cytosinocline has the potential to make a strong impact in a market that has lacked innovation and new treatments in over 15 years.
The most successful prescription smoking cessation product was Chantix, which had peak global sales of $1.1 billion before it was withdrawn in 2021 for safety concerns.
There are currently only two non-nicotine prescription products available to the 30 million plus smokers in the US, Generic Chantix and Generic Zyban.
Despite being tainted with its historical black box warning and disruptive side effects, generic Chantix is anticipated to reach approximately $300 million in US sales over the coming year.
We believe that Cytosinoclean's product profile, including robust efficacy, high tolerability, and shorter duration of treatment has potential to resonate in this underserved market.
We look forward to moving Cytosanacline to market and providing smokers and their physicians a compelling new treatment option.
We look forward to sharing with you our continued progress in the back end of this year, including completion of enrollment in our ORCA III and ORCA V1 studies, as well as potential for publication of the ORCA II results.
At this time, I'd like to turn the call over to the operator and take any questions you might have. Operator....
Thank you. The floor is now open for questions. If you do have a question, you may press star 1 on your telephone keypad at this time. If your question has been answered, you can remove yourself from the queue by pressing 1. Again, ladies and gentlemen, it's star 1. And our first question comes from Thomas Fatten from Lake Street Capital. Go ahead, Thomas.
Thomas, you may be muted. Okay.
Your line is live.
C Fund
I think you dropped out.
Next in line is Michael Higgins from Landberg-Thalman. Go ahead, Michael.
Thanks, guys. Thanks for taking the questions. Congrats on continued results. Looking forward to seeing the results coming up in the spring of next year. A couple questions for you as we look out to 23, if I could. What your thoughts are for the timing of the NDA filing, specifically if there's any additional studies or CMC work that needs to be completed, let's say by mid-year of next year.
Any comments on the timing for that filing? Thanks. Hi Michael, thanks for the questions. I'm going to hand it over to Cindy for this one.
Sure, we're looking at the timing for the NDA. The latter half of next year, there are two studies that we need to finish up. One is a study, a PK study with renal impairment and then a standard kind of like TQT study that we will be finishing up by early part of next year. As far as...
additional CMC. I'll let John kind of go over that, but that's kind of on the same timeframe for coming together by the end of next year.
Yeah, I think the clinical pieces are in motion as Cindy mentioned, then on the CMC side, we're working with so pharma, our partner on this to get the validation batches up and running later this year. So we can be in a position for that NDA filing in the back half of 2020 three.
Thanks. And then just to follow up on the validation batches, how many patients' worth of supply do you think you'll have ready, say, by the time the drug is approved? Here we go again. Thanks. Thanks.
Thank you.
Yeah, on the validation batch side, so what we've been focusing on is really stockpiling product in advance of commercial launch. We look to be on track to have between two and three years of launch quantity by the end of 2022. We expect that to increase as we continue to progress in 2023 and 2024. I think as we get into next year more fully, we'll refine further kind of the batches that will be out there and ready for launch.
The partnering front, obviously we can't comment on any, you know, ongoing discussions that may be occurring. I will say that there has been continued interest in the program and we expect that would likely continue as we move the program forward and I would expect more interest the closer we bring this towards FDA approval and commercial launch. I think we continue to stay focused in running that in parallel to our own commercial planning exercises.
That's great. I've got a few more questions. I'll jump back to the queue. Thanks, guys.
Yep, thanks Michael.
This question comes from Francois Berth-Bose from Oppenheimer. Go ahead.
Alright thanks for taking the question. Sorry if this was mentioned it's breaking out a little on my end but going forward with the effects here on the R&D side I was just wondering any comments of what to expect maybe in 2023 or second half of 2022?
Yeah, so as Jerry mentioned on the call, in terms of expenses, we would expect those to be elevated, especially in the third quarter now that we're up and running on both ORCA 3 as well as ORCA V1. As we get to full enrollment on those and patients start to roll off of study, which will kind of progress into the early parts of 2023, we would expect those R&D expenses to taper off quite significantly. So, we expect those to be elevated. We expect those to be elevated.
But as Cindy mentioned, we do have a couple of other trials in terms of TQT and renal impairment that will be running in parallel with those trials as well. But that's kind of how we see the expenses shaping up.
Okay, great. So, I heard that I think you guys mentioned the cash should be sufficient to get into 2023, but just wondering, I think data from ORCA III is first half 23. Do you guys comment on whether or not the cash is sufficient to get the data readout?
I think at the moment we're focused on getting ORCA 3 enrollment complete. I think once we have that in hand, we'll be able to clarify further kind of where that puts us in terms of where we might expect top line results. I think as we move forward we'll be able to narrow in on the timing of that.
Okay, great. And just lastly, you talked about potentially a publication of ORCA II. I was just wondering, any, you talked about a medical conference, any conferences to, in this space to kind of think about that would be, that would make sense for you guys.
Yeah, so on the medical conference front, I think historically one of the core forms for us has been SR&T, or the Society for Research on Nicotine and Tobacco. The biggest of those events is the annual US conference, which is typically in late first quarter of the year. There is European conferences in the fall. So I think we're looking at what makes sense, but I would stay tuned especially for that annual US conference.
think the most interesting would be a single global partner as opposed to you know dividing this up into multiple regions around the globe.
All right, thank you.
Thanks, Greg.
And our next question comes from John VanderMoseman from SACS. Go ahead.
Good afternoon. I had a couple questions on just how the vaping trial had started and how it's going. I assume that you started enrolling the first patient in July . Is that right? And you had all five sites open at that point? Yes.
Yeah, so we initiated right at the end of June . So over the last month and a half or so, we've really been getting everything up and running. We do have patients that have been randomized or subjects being randomized on that trial. As we mentioned on the call, we're quite encouraged with what we're seeing so far in terms of interests on the recruitment side. So I think we look forward to further updates on that one as we kind of get into the back end of the year here.
Okay, sounds good. I guess after doing two of them so far, two are the ones you're learning how to efficiently enroll those. Question on, kind of a general question on medical consensus about low nicotine cigarettes. I mean, maybe that's a little bit outside of the kind of what you're looking at, but I've had some questions from investors on that and wondering if you had heard of any research that shows that that's effective at all. Okay, thank you.
Yeah, good question. I think there has been some data particular around another product that's out in the market that just launched earlier this year that is a low nicotine cigarette. I think what we have seen is that that data set may not be the most robust in terms of how it relates directly to real world circumstances. But I think, yeah, clearly if you remove nicotine or lower them considerably, you're probably going to get people either smoking less or smoking them more.
several years out before any potential disruption. And I think the beauty is that that stage will likely be on the market and be there ready for smokers if the cigarettes that they're used to smoking is disrupted.
And the last one for me is just on the trend in generic Verunaclean. I was able to find some of the data in Endo's report. Looks like they've been doing pretty well there. But I was wondering if you had seen any other data, maybe in terms of scripts and sequential growth there, if you had any color on that at all.
Yeah, I think the only thing I would note, so we did mention that it looks like a run rate, probably north of 300 million at the moment in terms of where they're at. But I think the big piece there is that is only roughly half of the Chantix unit sales before it was withdrawn from the market last year. So they just launched last September , so it's still early days in terms of them being out in the marketplace and replicating that historic Chantix.
from H.C. Wainwright. Go ahead Vernon.
Hey John , thanks for taking my question.
So you mentioned in June that ACHIEV initiated the ORCA V1 clinical trial across five trial locations. Just wondering if you started dosing in all of those five trial locations and when might we see data from the ORCA V1 trial?
Yeah, thanks for the question Vernon. So on the vaping trial, we've got four out of five of the sites that are fully activated at this point. So we've got one that's in process at the moment, so they should all be up and running here shortly. But yeah, excited to see what has come through thus far. I think just a reminder, we've got Nancy Rigatti from Harvard Mass General as the PI. She was also the PI on our Orca too.
guiding likely the first half of next year. Obviously a big range will be triggered off of enrollment. So we'll see you in the first half of next year for top line results.
Do you anticipate most of the enrollment will be in that one site?
because we've got there's five total sites in ORCA V1 trial. And so I think we would look to have that, evenly spread as we can across those study centers.
And that's in 150 e-cigarette users or vapors.
Okay, I was just trying to get some visibility. Thanks for taking my questions. I'm looking forward to the further progress.
Thank you.
Thanks, Vernon.
Again, ladies and gentlemen, it's star one to ask a question on the phone. And our next question comes from Michael Higgins from Lattenberg,
Thanks again, operator. Thanks guys, just some follow-ups here if I could.
There was a study in JAMA not long ago on cytosinecline against reticline, NRT, and placebo. I'm wondering if you're aware of any other ongoing investigator-initiated studies. These seem to be more and more popular. Just trying to get a sense as to what's coming. Thanks. Okay.
Yeah, thanks Michael. Yeah, there is continued interest for cytosinic clean around the globe. I think we are aware of some other smaller trials being run across Europe , as well as I'm thinking to Asia or Mongolia, some work being done. None of it's really as I think analogous to what we put together here in the US, typically on the Eastern European dose and administration.
But I think as some of those come out, if they're interesting data points, then we'll be sure to share that with everyone.
Just a follow up on that one.
Do you know of any of these that have come around yet to your dosing regimen with TAD?
Yeah, none that we've seen.
Not yet anyway, okay. And then this fall, it doesn't sound like you have anything at ESRNT. Just want to clarify that and then thinking ahead to next spring, what might we see? Maybe ORCA II. I don't think you'll have a chance then.
I'm just thinking of the timing of it to have even late breakers at SRT, but if you could let us know and those would be great.
Yeah, so I think I, you know, barring any major disruptions, we would anticipate having some data sets at the annual USSRNT conference in the spring of next year. Between now and then, you know, we've been focused on working with the investigators on ORCA II, including Dr. Ragatti on getting the ORCA II results published. And we're going to focus that on high quality journals. But that's the focus, is to get that published first.
and then move forward with additional data sets that we'll be able to share with everyone.
and then move forward with additional data sets that we'll be able to share with everyone. Makes sense, appreciate it. Thanks, John .
Thanks, Michael.
And our next question comes from Jim Malloy from Alliance Global Partners. Go ahead.
Hi, thank you. Thanks for taking my questions. And John , kind of a bigger picture question on the manufacturing. How goes the plants to try to chemically manufacture cytosynically inverse the current growing and getting it from the trees? And how goes expanding, broadening, diversifying the risk of the planting sites to other locales?
Yeah, Jim, thanks for the question. On the synthetic side, this has continued to be an area that we're poking around on. Someone's going to crack a way to make this synthetically, we want it to be us so we can protect that administration or that way of producing it. So far that's proven very difficult. Our focus here in real time has been more on stockpile, as I mentioned earlier, getting three to four years of launch material in hand, at the time of.
clean right here in North America. So yeah, lots going on there but you know we'll have additional updates as some of that progresses over time.
Understood. And I just touched on that earlier, but with every way to characterize the market, the environment for bringing in partners, we say the buyers sellers market to talk a little bit about the level of interest that you're seeing for partnerships.
Yeah, I mean, I think, you know, not just here at post-Orca II data, but I think overall historically, we have seen continued interest around cytosinocline. I think as I mentioned earlier, you know, historically, it's probably been overweight to Asia, but we have seen folks that have global scale as well as strong capabilities in Europe . So, I think it really is quite broad. You know, I think in terms of appetite, you know, I think until these things move ahead to the point where, you know, we start to get...
Thanks everyone for joining us today and for your continued interest in the company. We look forward to sharing additional information with you in the coming months. Thanks again for joining us. Take care.
Thank you. This does conclude today's conference. We thank you for your participation. You may disconnect your lines at this time and have a wonderful day.