NASDAQ:NKTR Nektar Therapeutics Q4 2023 Earnings Report $0.64 +0.03 (+4.88%) Closing price 04:00 PM EasternExtended Trading$0.62 -0.01 (-1.79%) As of 04:48 PM Eastern Extended trading is trading that happens on electronic markets outside of regular trading hours. This is a fair market value extended hours price provided by Polygon.io. Learn more. Earnings HistoryForecast Nektar Therapeutics EPS ResultsActual EPS-$0.22Consensus EPS -$0.21Beat/MissMissed by -$0.01One Year Ago EPS-$0.32Nektar Therapeutics Revenue ResultsActual Revenue$23.89 millionExpected Revenue$17.09 millionBeat/MissBeat by +$6.80 millionYoY Revenue GrowthN/ANektar Therapeutics Announcement DetailsQuarterQ4 2023Date3/4/2024TimeAfter Market ClosesConference Call DateMonday, March 4, 2024Conference Call Time5:00PM ETUpcoming EarningsNektar Therapeutics' Q1 2025 earnings is scheduled for Thursday, May 8, 2025, with a conference call scheduled at 5:00 PM ET. Check back for transcripts, audio, and key financial metrics as they become available.Q1 2025 Earnings ReportConference Call ResourcesConference Call AudioConference Call TranscriptPress Release (8-K)Annual Report (10-K)Earnings HistoryCompany ProfilePowered by Nektar Therapeutics Q4 2023 Earnings Call TranscriptProvided by QuartrMarch 4, 2024 ShareLink copied to clipboard.There are 10 speakers on the call. Operator00:00:00Good day and thank you for standing by. Welcome to the Nektar Therapeutics 4th Quarter 2023 Financial Results Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. Operator00:00:31I would now like to hand the conference over to your speaker today, Vivian Wu. Please go ahead. Speaker 100:00:37Thank you, Crystal, and good afternoon, everyone. Thanks for joining us today. With us on the call are Howard Robin, our President and CEO Doctor. Jonathan Zlotsky, our Chief of Research and Development Doctor. Mary Tagliaferri, our Chief Medical Officer Sandra Gardner, our Chief Financial Officer and Jennifer Radek, our Chief Business Officer. Speaker 100:00:57On today's call, we expect to make forward looking statements regarding our business, including statements regarding the therapeutic potential of and future development plans for drug candidates and research programs the timing of the initiation of clinical studies and the availability of clinical data for drug candidates the timing and plans for our future clinical data presentation the formation, future development plans or success of our collection agreements, expectations following our corporate restructuring and reorganization, financial guidance and certain other statements regarding the future of our business. Because forward looking statements relate to the future, they are subject to uncertainties and risks that are difficult to predict, many of which are outside of our control. Our actual results may differ materially from these statements. Important risks and uncertainties are set forth in our Form 10 Q that was filed on November 8, 2023, which is available atsec.gov. We undertake no obligation to update any forward looking statements whether as a result of new information, future developments, or otherwise. Speaker 100:01:59A webcast of this call will be available on the IR page of Connector's website atnetor.com. With that said, I would like to hand the call over to our President, CEO, Robin. Howard? Speaker 200:02:13Thank you, Vivian, and thank you for all joining us today. 2023 was a pivotal year for Nektar. We refocused the company's development pipeline on immunology and inflammation with our primary near term goal to advance Respegg to meaningful data catalysts in the first half of twenty twenty five. Respegg is poised to be highly disruptive in the biologic treatment landscape for atopic dermatitis by offering a novel agonistic mechanism. Respegg is designed to both dampen the inflammatory response and simultaneously restore immune balance by directly expanding functional Treg cells and engaging multiple immunoregulatory pathways in patients with atopic dermatitis and other autoimmune disorders. Speaker 200:03:04Through its unique mechanism, Respek also has the potential to provide patients with superior efficacy as well as more favorable infrequent dosing. There are over 30,000,000 people in the U. S. Alone battling this chronic skin condition and it can greatly impact quality of life and mental health for these patients. We made significant advancements in 2023 with respect to our Respegg program. Speaker 200:03:31Most notably, we regained the full rights to Respegg from Eli Lilly and now own the program 100% with no encumbrances. We moved to quickly design a Phase 2b study in atopic dermatitis based on the promising results from the Phase 1b placebo controlled randomized study of ResBag, which showed an 83% drop in eczema skin scores after just 12 weeks of treatment. Our Phase 2b global study in this indication was launched in October of 2023 and enrollment is on track for data readout in the first half of twenty twenty five. In late 2023, we also began work designing a Phase IIb study in alopecia areata, another area of high unmet need. The study is starting this month. Speaker 200:04:23There are approximately 7,000,000 patients in the United States and 160,000,000 people worldwide who have alopecia areata. JAK inhibitors are the primary treatment option for patients with alopecia, but have a significant rebound effect with treatment cessation and several black box warnings. Based on the data we generated to date on ResVeg in the skin related autoimmune condition of atopic dermatitis, psoriasis and in patients with cutaneous manifestations of lupus, we believe Respegg has strong scientific rationale in the setting of alopecia and could have the potential to be a highly differentiated treatment option with a similar remitiv effect for this unserved patient population. As I stated earlier, we look forward to the Phase IIb data for our atopic dermatitis study and for our alopecia study in the first half of twenty twenty five. These will be highly meaningful data catalysts for Nektar. Speaker 200:05:26In addition to Respegg, we have another important immunology program that we're moving toward the clinic. This is a 1st in class differentiated mechanism in immunology, a TNFR2 agonist antibody NKTR-one hundred and sixty five. TNFR2 has been shown to potentiate the suppressive effects and overall functional properties of Tregs and the program is built on what we've learned through our deep experience with Respeg and the Treg field and represents a promising mechanism for treatment of autoimmune disease, including multiple sclerosis and ulcerative colitis. We're currently conducting IND enabling studies with the goal of targeting an IND submission in the first half of next year. In line with our objectives to advance our immunology pipeline, today we announced a $30,000,000 financing that further bolsters Nektar's financial position as we head into transformative data catalysts. Speaker 200:06:23Importantly, we're pleased to bring on a new high quality long term investor, TCG Crossover, who clearly shares our belief in the potential of ResBank. At a price of $1.20 per share, the transaction represents a premium of over 80% to Nektar's 30 day VYB. This puts us in a strong financial position and extends our cash runway from our previous guidance, which was the middle of 2026 to now well into the Q3 of 2026. And with that, I'll hand the call over to J. Z. Speaker 200:06:57For an R and D discussion. J. Z? Speaker 300:07:01Thank you, Howard. Let's begin today with Respegg, which is the most advanced IL-two based Treg mechanism in the field. Across the Respegg studies that have been conducted to date, we have observed a consistent and highly predictable clinical pharmacology profile with respect to target engagement as well as the peak and duration of Treg mobilization. It has demonstrated a well tolerated safety profile and clear clinical efficacy in atopic dermatitis and also psoriasis and in patients with cutaneous manifestations of lupus. Our deep experience with Respegg to date across the totality of this clinical program gives us conviction in our ongoing Phase 2b studies in atopic dermatitis and alopecia areata. Speaker 300:07:54Specifically in atopic dermatitis, there are 3 important issues that patients with this disease continue to face. First, there is a need for great efficacy, specifically a deeper magnitude of response and rapid onset of treatment. 2nd, patients lack durable responses and therapy free remission. Once current therapies are discontinued, patients rebound rapidly. And 3rd, treatments with favorable safety profiles are lacking. Speaker 300:08:26This is especially important given the chronic nature of the disease and the need for continuous dosing. We believe there are major opportunities in this disease state that the differentiated profile of Respek could potentially address. Diving into our Phase Ib data in atopic dermatitis. Through the 12 week induction period, ResTag demonstrated dose dependent efficacy across both physician assessed and patient reported efficacy measurement, reaching statistical significant across many of these measures. At the highest dose level, ResPag demonstrated a very rapid onset of response with over 40% of patients achieving EASD75 by week 3 after only 2 doses of Respegg. Speaker 300:09:11This rapid onset of action rivals that of JAK inhibitors, which have outperformed tepilumab at this parameter. At the end of the induction period of 12 weeks, we observed a profound magnitude of efficacy, an 83% reduction in percent change from baseline EASI score with the highest dose tested. This is the largest magnitude of change that we've seen for a biologic and outside of one JAK inhibitor. Importantly, we are encouraged by the extended durability seen for ResVax. Long after the completion of the 12 week induction period, many patients maintain durable disease control for an additional 36 weeks after the end of dosing. Speaker 300:09:55And this type of extended disease control after the end of dosing is not observed tepilumab or for JAK inhibitors. Durability of the EZ75 response was observed with approximately 70% of VZ-seventy five responders maintaining that response for 36 weeks after the end of the 12 week induction period. This is a very exciting result and suggests that ResVag has the potential to be the 1st remitted therapy for atopic dermatitis. For both patient reported outcomes and physician assessed endpoints, we observed the same trend, rapid onset of effect, dose dependence and long durability of control. Additionally, Respegg was well tolerated and treatment with Respegg did not induce antidrug antibodies in patients, which has been reported with some examples of the IL-two mutine class. Speaker 300:10:48These promising data have us and KOLs very enthusiastic about the potential for long lasting responses and infrequent maintenance dosing with ResPag in the setting of atopic dermatitis. In October 2023, we initiated the Phase 2b study of ResPag in biologic naive atopic dermatitis patients and enrollment is well underway. Our goal is to enroll roughly 400 patients with 3 different regimens of ResVag versus placebo evaluated over a 16 week induction period. After the induction period, patients that meet a threshold to advance from induction to maintenance will be re randomized into 1 of 2 maintenance regimens at different dosages at either once a month or once every 3 month dosing and that schedule will continue for another 28 weeks. Our enrollment for this study is on track and we expect data in the first half of twenty twenty five. Speaker 300:11:47Moving to alopecia areata, we believe ResBag has strong scientific rationale in this indication. Alopecia areata is also a disease of the skin where your immune system starts to attack the hair follicle, thereby weakening the ability of stem cells to grow hair. With prolonged immune attack, this eventually causes the hair follicle to release the hair altogether, leading to patchy hair loss and as the disease progresses to baldness. Biologically speaking, ResVag through its central pathway of Treg rescue is uniquely poised to address the diversity of immunopathology, providing broad potential for targeting multiple dermal diseases, including alopecia. For example, in alopecia, there are almost no immune cells in normal hair follicles, meaning the hair follicle is an immune privileged tissue. Speaker 300:12:43Tregs are very important in maintaining that immune privilege and people with alopecia areata develop a breakdown of that immune privileged state. We think the Treg mechanism of Respeg can restore immune privilege and could provide durable disease control, which we believe would be game changing in this indication. JAK inhibitors are the only agents approved in alopecia and they do not provide disease durability after a patient discontinues treatment. With JAK inhibitors, it can take a patient anywhere from 9 to 18 months to grow hair. And once a patient stops taking a JAK inhibitor, which may happen for a variety of reasons, including toxicity, their hair falls out again rapidly. Speaker 300:13:30There is a high unmet need in this patient population for tolerable treatment options that provide durable responses. And we believe that restoration of immune privilege is key to obtain durability. For these reasons, we believe there is an opportunity for Respegg to become a novel biologic therapy in alopecia areata. We are initiating a Phase 2b study of Respegg in alopecia this month. The Phase 2b study plans to recruit roughly 80 patients with severe to very severe alopecia, who will be randomized to Respegs or placebo. Speaker 300:14:06Patients will be treated for a period of 36 weeks and observed up to 60 weeks in total. Our primary endpoint for this study is mean percent improvement in SALT or the severity of alopecia tool at week 36, which is the validated outcome measure used for regulatory approval. We will also be looking at a number of other secondary endpoints, including proportion of patients who saw a reduction in salt. Now turning to NKTR-one hundred and sixty five, our TNFR2 agonist antibody. TNFR2 is highly expressed on Tregs, myeloid suppressor cells, regulatory B cells, neuronal cells and others, and TNFr2 agonism has been shown to potentiate the suppressive effect in overall functional properties of Tregs and these other suppressive cell populations. Speaker 300:14:59If TNFR2 is absent, it is associated with autoimmunity and other genetic conditions that resemble FOXP3 loss of function. In contrast, its presence has been associated with immunoregulatory function and protective effects from multiple cell populations and tissues in the body. This TNFR2 agonist program in our pipeline is built upon many years of Treg experience gained from ResMed. For example, we know that central Tregs such as thymic Tregs require a substantial JAK STAT signal that is physiologically provided by the IL-two receptor pathway. And this is a central theme in the mechanism of action of Respek. Speaker 300:15:44In contrast, Tregs that leave the central compartment and infiltrate the distal organs and tissues, they are less dependent on the JAK STAT pathway and instead shift their reliance on to NF kappa V pathway engagement for their maintenance of suppressor function. TNFR2 is the most abundant TNF superfamily member expressed on Tregs and the key driver of NF kappa V signaling in those cells. And consequently, a bona fide TNFr2 agonist would be an incredibly exciting addition to our pipeline. Examples of indications that could be addressed by TNFr2 agonism include multiple sclerosis, mucosal immunology conditions such as ulcerative colitis of the GI or other oral mucosal diseases and even dermal autoimmune diseases like vitiligo. We have identified several lead CNFR2 antibody programs from an artificial intelligence based antibody discovering campaign with our partner Biologic Design. Speaker 300:16:46The lead antibody is called NKTR-one hundred and sixty five and it has highly desirable properties including exquisite R2 cell activity, TNF R2 agonism in primary human cells, activity in multiple preclinical efficacy models and a very well tolerated profile in early non GLP toxicology study. We have developed a manufacturing cell line for the lead and are conducting upstream and downstream process development with the aim to enter the clinic for this program in the first half of twenty twenty five. Later this year, we plan to present the 1st preclinical data for NKTR-one hundred and sixty five at an upcoming medical conference. As we move forward with our IND enabling studies, there is growing interest for a novel selective TNFR2 agonist like NKTR-one hundred and sixty five and thus we remain open to the opportunity of working with companies that have interested in these areas to strategize on the best path forward. Now let's switch gears to our IL-fifteen based oncology program NKTR-two fifty five. Speaker 300:17:50NKTR-two fifty five is IL-fifteen based mechanism of action, holds a great promise as a combination agent with cell therapies and other mechanisms such as checkpoint inhibitors and we are exploring the best partnering paths for continued development for this drug candidate. Our Nektar sponsored trial combining NKTR-two fifty five with the approved CD19 CAR Ts, Brianca and Yescarta, for treatment of patients with a large B cell lymphoma has enrolled 15 patients in the dose escalation portion of the study. The combination of NKTR-two fifty five and BRYANZEY is also being studied in the separate investigator sponsored trial at Fred Hutch. We are targeting the potential submission of data from these studies at medical meetings in the second half of this year. A clinical trial in non small cell lung cancer sponsored and funded by ablzeta, which evaluates the combination of ablzeta's tumor infiltrating lymphocyte cell therapy plus NKTR-two fifty five and checkpoint inhibitor is also ongoing and enrolling patients. Speaker 300:18:56And with our partner Merck KGaA, we have also been evaluating NKTR-two fifty five in combination with Bavencio versus single agent Bavencio in the Phase 2 JAVELIN bladder medley study. And that study is on track to potentially report interim PFS data later this year. And with that, I will turn the call over to Sandy for a review of our financial guidance. Sandy? Speaker 400:19:21Thank you, J. Z, and good afternoon, everyone. We ended the year in a very strong financial position with $329,400,000 in cash and investments and with no debt on our balance sheet. As Howard stated earlier, today's announcement of a $30,000,000 financing further strengthens our cash position. Our revenue was $23,900,000 for the Q4 of 2023 $90,100,000 for the full year of 2023. Speaker 400:19:55Our operating costs and expenses for the Q4 of 2023 were $57,400,000 $353,800,000 for the full year 2023. Our non operating expenses for the Q4 of 2023 were $8,600,000 $12,600,000 for the full year 2023. Q4 2023 included a non cash charge of $6,100,000 or $0.03 per share for the reclassification of the foreign currency translation adjustment to income related to the wind down of our India legal entity. As a reminder, our India facility was sold in December 2022 for approximately $12,000,000 with the wind down of the entity occurring in 2023. Our net loss for the Q4 of 2023 was $42,100,000 or $0.22 per share. Speaker 400:21:00For the full year of 2023, our net loss was $276,100,000 or $1.45 per share. Excluding $111,800,000 in noncash goodwill and other impairment charges, net loss on a non GAAP basis for the full year 2023 was $164,300,000 or $0.86 basic and diluted loss per share. Looking forward to 2024 and beyond, our financial position remains strong, in part reflecting the cost savings initiatives we undertook last year. We plan to end 2024 with $200,000,000 to $225,000,000 in cash and investments. In addition to the $30,000,000 pipe we announced this morning, our 2024 cash guidance also includes $15,000,000 resulting from an amendment executed today on a former 2020 agreement with certain entities of healthcare royalty. Speaker 400:22:07Our cash runway now extends well into the Q3 of 2026, which will take us through key value generating milestones, including Phase II Respegg data in atopic dermatitis and alopecia areata. Our revenue for the full year of 2024 is expected to be between $75,000,000 $85,000,000 which includes $55,000,000 to $65,000,000 in noncash royalties and $20,000,000 to $25,000,000 in product sales. We anticipate full year R and D expense will range between $120,000,000 $130,000,000 This includes approximately $5,000,000 to $10,000,000 of non cash depreciation and stock based compensation expense. The increase in R and D spend for 2024 over 2023 represents an increased investment in 2 RetiFEG Phase 2b studies in atopic dermatitis and alopecia areata as well as IND enabling studies for our antibody program, NKTR-one hundred and sixty five. This increase is partially offset by decreased spending on NKTR-two fifty five clinical studies in cell therapy, which are completing in 2024. Speaker 400:23:30The remaining ongoing clinical studies for NKTR-two fifty five are primarily funded by our external partners. We expect G and A expense for the full year of 2024 to be between $70,000,000 $75,000,000 which includes $5,000,000 to $10,000,000 of non cash depreciation and stock based compensation expense. Our full year non cash interest expense is expected to be between $20,000,000 $25,000,000 As I stated earlier, we expect to end this year with $200,000,000 to $225,000,000 in cash and investments. And with that, we will now open the call for questions. Crystal? Speaker 500:24:14Thank Operator00:24:40And our first question will come from Jay Olson from Opco. Your line is open. Speaker 600:24:47Hey, this is Chung on the line for Jay. Thank you for taking the question and congrats on the progress. Maybe just on ResPACK 80 study, wondering if you can talk about the initial feedback from doctors and patients participating in the study, especially in the context that there are many other competing trials out there. Also, if you also could comment on the recruitment progress thus far versus your internal expectation, that will be great. And I have a quick follow-up question after that. Speaker 600:25:22Thank you. Speaker 200:25:24Mary, you want to take that question? Speaker 500:25:26Yes, sure, Howard. Thank you. Hi, Joe. This is Mary Taliaselli. When we look at the aggregate of data from site activation, screening activities and enrollment, we are on track to have our top line induction data from the AD study in the first half of twenty twenty five. Speaker 500:25:46And in terms of the feedback, we're really pleased with the type of screening we're seeing. And we believe this is driven by the data that was presented by Jonathan Silverberg at EADV 2023. The doctors really do see that, 1, Respegg has a very rapid onset of action. Number 2, the depth of response that was seen with being percent change and easy after only 12 weeks of treatment. When most studies look at an induction period of 16 weeks, the doctors have been very impressed with that. Speaker 500:26:24And then certainly for the benefit of their patients, they really love the durability that we saw when patients were off treatment for 9 consecutive months. And they were able to maintain that very deep response and easy. This is all very, very attractive for recruiting patients to the study. So we're doing very well. I have heard, that other states are pleased with enrollment and we're not experiencing that. Speaker 600:26:52Got it. Thank you. And just a quick follow-up. Just wondering to what extent you can leverage the clinical sites for the AD study for the upcoming alopecia areata initiation? So can you just use the same sites or just another layer of work you need to do? Speaker 500:27:11Yes. So we are going to use 12 sites that are participating in the AD study and our alopecia study. And those physicians are very excited to have an opportunity for a second skin disease to evaluate Respeg in alopecia orata. And again, they're really eager to see a durability of response because, of course, when they treat their patients with JAK inhibitors and they grow back, immediately they start to lose their hair once they discontinue treatment with the JAK inhibitors. So the promise of an agent to have a durability and restore immune privilege is definitely really encouraging and exciting to teams I've been speaking to. Speaker 600:27:58Okay. Thank you so much. Operator00:28:02Thank you. And our next question will come from Roger Song from Jefferies. Your line is open. Speaker 700:28:10Hi, Tane. This is Tommy on for Roger. Maybe just following up on the alopecia areata study. How many total clinical sites will you be enrolling? And what's kind of the geographic distribution of those sites? Speaker 700:28:22And then what are some key baseline characteristics for the patients in these studies will be most of them be JAK inhibitor refractory? Any detail there would be appreciated. Speaker 500:28:35Sure. Yes. Mary, you want to say again? Yes. Thanks, Howard. Speaker 500:28:39We'll have, slightly over 30 sites. We're going to be in Canada, in the United States and in Poland. As you may imagine, when you're in Poland, they definitely have an access issue and it also takes a very long time for those patients to get in to see a dermatologist. So it's actually a very favorable environment to enroll patients. These patients are going to be JAK inhibitor naive patients. Speaker 500:29:13And then our key inclusion criteria is the severe to very severe alopecia. So these patients all have to have a salt greater than or equal to 50. And of course, this is the same patient population, where baricitinib and Lilly JAK and Pfizer's JAK inhibitor at the same eligibility criteria for their pivotal trial. Speaker 700:29:40Great. Thank you. Thank you. Our next question will Operator00:29:47come from Jessica Fye from JPMorgan. Your line is open. Speaker 100:29:53Hey, thanks for taking my question. For the Phase 2b atopic derm trial, what's the threshold patients need to meet to be considered a responder and be rerandomized at least 16? And then also curious what's your latest thinking on whether the AD or the alopecia trial will read out first and why? Speaker 500:30:12Yes. Hi, Jessica, it's Mary. So, to be re randomized, the patient has to have EZ50 or above when they are re randomized to the maintenance dose of once a month or once every 3 months, they will be on the same dose that they were randomized to in the induction period. And do you have a second question? Speaker 100:30:41Just the timing of alopecia versus AD data? Speaker 500:30:45Yes. So, we expect the AD trial to read out first. Speaker 100:30:53Thank you. Speaker 500:30:55Thank you. Speaker 700:30:57Thank you. Our next question Operator00:30:59will come from Julian Harrison from BTIG. Your line is open. Speaker 800:31:05Hi, congrats on the progress and thank you for taking my questions. I'm curious if you could remind us how you're thinking about efficacy beyond 12 weeks of dosing with BRESPEG in atopic derm. Do you expect to plateau at some point? Or do you expect response rates to maybe be progressive through 44 weeks of dosing? And then with regards to the Lilly litigation, sorry if I missed it, I'm wondering if you could comment on its current status and timing of next steps? Speaker 200:31:33Mary, why don't you take the first part and I'll take the second part. Speaker 500:31:38Yes. I definitely think that as we extend our induction period from 12 weeks to 16 weeks, we're going to see a greater number of patients experience a deeper response. So I very much look forward to seeing what the mean percent change is. As you know, our easy mean percent change from baseline to 12 weeks was 83%. And as such, that was greater than any of the biologic agents. Speaker 500:32:11If you look at DUPI or ODDDRI or lebri or NEEMO or ROKA, we definitely saw the deepest response. But I do believe that we'll probably see more patients who experience a EZ75 and even a EZ90 as we go out additional 4 weeks in the induction period. Speaker 200:32:32With regard to Lilly, Lilly after we filed our complaint in federal courts, Lilly tried to convince the federal court judge to dismiss the case, as you know. And last week, the federal judge refused Lilly's request, and the judge agreed to allow Nektar's primary claims to move forward and we expect the judge to settle trial date in 2025. The court also ordered the parties to engage in mediation within the next 3 months to try to resolve the issue. And so we're very, very happy the case is moving forward. The judge did not dismiss the case and we look forward to vindicating ourselves through the litigation process. Speaker 800:33:20Excellent. Thanks very much. Speaker 700:33:24Thank you. Operator00:33:32And our next question will come from Andy Hsieh from William Blair. Your line is open. Speaker 900:33:39Great. Thanks for taking our questions. Two quick ones for us. One is, can you talk about this ebb and flow dynamic associated with hair loss in alopecia? Would enrolling kind of severe and really severe patients kind of mitigate that variability? Speaker 900:34:00And the second question has to do with the TNF receptor 165 program. We know that the receptor family is a trimer. So I guess to maximally agonize this receptor, you might have to have like a trimer design. I'm just curious if that's kind of a part of the design that goes into 165. And downstream from that, there's also kind of clustering. Speaker 900:34:28So is that also a part of the design of the molecule? Thanks. Speaker 700:34:39Mary, do you want to take the hair loss? Yes. And then JV can take the peanuts on Speaker 500:34:42Yes. So, hi, Andy, it's Mary. So you're exactly right. Once patients go into the severe and the very severe, generally speaking, there is not a regrowth of the hair and that's you're exactly right that that's why the eligibility criteria and even the threshold for approval by the FDA is this patient population. It does patients do start out with experiencing the patchy hair loss. Speaker 500:35:15But as the disease progresses, certainly the hair loss becomes more extreme and even towards baldness. But once a patient loses their hair, it's very usual for them to have regrowth of their hair without some sort of medical intervention. And then I'll pass over the second question to J. C. Speaker 300:35:39Yes. Thanks, Mary, and thanks, Andy, for your question. So you're right. So TNF proteins are trimers. But as we've learned more and more about the biophysics of the receptors and the way the plant domains, right, which are the cysteine rich domains that hold together the receptor subunits. Speaker 300:35:59They actually work to create dimers for receptors. And then a trimer comes along and clusters 6 receptors or 3 pairs of dimers. So and then you can get additional clustering and some of this ultra structure has been published and some structural studies have been done. What we've come to understand, A, through learning about the cell biology of these receptors, the way these divers need to multimerize and the way the epitopes for binding to the receptors need to work is that the epitope is actually fundamentally important. One of the things we discovered with NKTR-one hundred and sixty five is that it's an epitope that has its own unique properties and it can signal in a completely cluster independent fashion. Speaker 300:36:48For example, it doesn't need Fc, it doesn't even need Valence. That's one of the things that's really unique and highly differentiated, about the antibodies that we've created. And keeping in mind, all of these ultrastructural forms of the receptor and then the different states that the receptor can occupy is obviously one of the key things that's important for developing a successful agonist. Thanks for the question. Speaker 700:37:18Thank you. And I Operator00:37:21am showing no further questions from the phone lines. I'd now like to turn the conference back over to Howard Robin for any closing remarks. Speaker 200:37:28Well, thank you everyone for joining us today. And as we stated on our call, we really remain focused on executing the development of Respeg and our immunology focused research programs. I'd like to thank all of our employees for their very hard work and thank all of our shareholders, new and existing, for their continued support. And we look forward to providing you with updates on our progress. So stay tuned. Speaker 200:37:50Thanks for joining us again. Operator00:37:53Thank you. This concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone have a wonderful day.Read morePowered by Conference Call Audio Live Call not available Earnings Conference CallNektar Therapeutics Q4 202300:00 / 00:00Speed:1x1.25x1.5x2x Earnings DocumentsPress Release(8-K)Annual report(10-K) Nektar Therapeutics Earnings HeadlinesStockNews.com Begins Coverage on Nektar Therapeutics (NASDAQ:NKTR)April 16 at 2:11 AM | americanbankingnews.comNektar management to meet virtually with B. RileyApril 12, 2025 | markets.businessinsider.comTrump Treasure April 19Thanks to President Trump… A $900 investment across5 specific cryptos… Could gain 12,000% so quickly that, just 12 months later…April 17, 2025 | Paradigm Press (Ad)Nektar Therapeutics (NKTR) Shares Surge on Jefferies UpgradeApril 12, 2025 | gurufocus.comNektar upgraded to Buy from Hold at JefferiesApril 11, 2025 | markets.businessinsider.comJefferies Upgrades Nektar Therapeutics to Buy, Doubles Price Target to $2.00April 11, 2025 | gurufocus.comSee More Nektar Therapeutics Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Nektar Therapeutics? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Nektar Therapeutics and other key companies, straight to your email. Email Address About Nektar TherapeuticsNektar Therapeutics (NASDAQ:NKTR), a biopharmaceutical company, focuses on discovering and developing medicines in the field of immunotherapy in the United States and internationally. The company is developing rezpegaldesleukin, a cytokine Treg stimulant that is in phase 2 clinical trial for the treatment of systemic lupus erythematosus and ulcerative colitis, as well as phase 2b clinical trial to treat atopic dermatitis and psoriasis; and NKTR-255, an IL-15 receptor agonist, which is in phase 1 clinical trial to boost the immune system's natural ability to fight cancer. It has collaboration agreements with Takeda Pharmaceutical Company Ltd.; AstraZeneca AB; UCB Pharma S.A.; F. Hoffmann-La Roche Ltd; Bausch Health Companies Inc.; Pfizer Inc.; Amgen Inc.; UCB Pharma (Biogen); Bristol-Myers Squibb Company; Merck KGaA; and SFJ Pharmaceuticals, Inc. The company was incorporated in 1990 and is headquartered in San Francisco, California.View Nektar Therapeutics ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Earnings By Country U.S. Earnings Reports Canadian Earnings Reports U.K. Earnings Reports Latest Articles 3 Reasons to Like the Look of Amazon Ahead of EarningsTesla Stock Eyes Breakout With Earnings on DeckJohnson & Johnson Earnings Were More Good Than Bad—Time to Buy? 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There are 10 speakers on the call. Operator00:00:00Good day and thank you for standing by. Welcome to the Nektar Therapeutics 4th Quarter 2023 Financial Results Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. Please be advised that today's conference is being recorded. Operator00:00:31I would now like to hand the conference over to your speaker today, Vivian Wu. Please go ahead. Speaker 100:00:37Thank you, Crystal, and good afternoon, everyone. Thanks for joining us today. With us on the call are Howard Robin, our President and CEO Doctor. Jonathan Zlotsky, our Chief of Research and Development Doctor. Mary Tagliaferri, our Chief Medical Officer Sandra Gardner, our Chief Financial Officer and Jennifer Radek, our Chief Business Officer. Speaker 100:00:57On today's call, we expect to make forward looking statements regarding our business, including statements regarding the therapeutic potential of and future development plans for drug candidates and research programs the timing of the initiation of clinical studies and the availability of clinical data for drug candidates the timing and plans for our future clinical data presentation the formation, future development plans or success of our collection agreements, expectations following our corporate restructuring and reorganization, financial guidance and certain other statements regarding the future of our business. Because forward looking statements relate to the future, they are subject to uncertainties and risks that are difficult to predict, many of which are outside of our control. Our actual results may differ materially from these statements. Important risks and uncertainties are set forth in our Form 10 Q that was filed on November 8, 2023, which is available atsec.gov. We undertake no obligation to update any forward looking statements whether as a result of new information, future developments, or otherwise. Speaker 100:01:59A webcast of this call will be available on the IR page of Connector's website atnetor.com. With that said, I would like to hand the call over to our President, CEO, Robin. Howard? Speaker 200:02:13Thank you, Vivian, and thank you for all joining us today. 2023 was a pivotal year for Nektar. We refocused the company's development pipeline on immunology and inflammation with our primary near term goal to advance Respegg to meaningful data catalysts in the first half of twenty twenty five. Respegg is poised to be highly disruptive in the biologic treatment landscape for atopic dermatitis by offering a novel agonistic mechanism. Respegg is designed to both dampen the inflammatory response and simultaneously restore immune balance by directly expanding functional Treg cells and engaging multiple immunoregulatory pathways in patients with atopic dermatitis and other autoimmune disorders. Speaker 200:03:04Through its unique mechanism, Respek also has the potential to provide patients with superior efficacy as well as more favorable infrequent dosing. There are over 30,000,000 people in the U. S. Alone battling this chronic skin condition and it can greatly impact quality of life and mental health for these patients. We made significant advancements in 2023 with respect to our Respegg program. Speaker 200:03:31Most notably, we regained the full rights to Respegg from Eli Lilly and now own the program 100% with no encumbrances. We moved to quickly design a Phase 2b study in atopic dermatitis based on the promising results from the Phase 1b placebo controlled randomized study of ResBag, which showed an 83% drop in eczema skin scores after just 12 weeks of treatment. Our Phase 2b global study in this indication was launched in October of 2023 and enrollment is on track for data readout in the first half of twenty twenty five. In late 2023, we also began work designing a Phase IIb study in alopecia areata, another area of high unmet need. The study is starting this month. Speaker 200:04:23There are approximately 7,000,000 patients in the United States and 160,000,000 people worldwide who have alopecia areata. JAK inhibitors are the primary treatment option for patients with alopecia, but have a significant rebound effect with treatment cessation and several black box warnings. Based on the data we generated to date on ResVeg in the skin related autoimmune condition of atopic dermatitis, psoriasis and in patients with cutaneous manifestations of lupus, we believe Respegg has strong scientific rationale in the setting of alopecia and could have the potential to be a highly differentiated treatment option with a similar remitiv effect for this unserved patient population. As I stated earlier, we look forward to the Phase IIb data for our atopic dermatitis study and for our alopecia study in the first half of twenty twenty five. These will be highly meaningful data catalysts for Nektar. Speaker 200:05:26In addition to Respegg, we have another important immunology program that we're moving toward the clinic. This is a 1st in class differentiated mechanism in immunology, a TNFR2 agonist antibody NKTR-one hundred and sixty five. TNFR2 has been shown to potentiate the suppressive effects and overall functional properties of Tregs and the program is built on what we've learned through our deep experience with Respeg and the Treg field and represents a promising mechanism for treatment of autoimmune disease, including multiple sclerosis and ulcerative colitis. We're currently conducting IND enabling studies with the goal of targeting an IND submission in the first half of next year. In line with our objectives to advance our immunology pipeline, today we announced a $30,000,000 financing that further bolsters Nektar's financial position as we head into transformative data catalysts. Speaker 200:06:23Importantly, we're pleased to bring on a new high quality long term investor, TCG Crossover, who clearly shares our belief in the potential of ResBank. At a price of $1.20 per share, the transaction represents a premium of over 80% to Nektar's 30 day VYB. This puts us in a strong financial position and extends our cash runway from our previous guidance, which was the middle of 2026 to now well into the Q3 of 2026. And with that, I'll hand the call over to J. Z. Speaker 200:06:57For an R and D discussion. J. Z? Speaker 300:07:01Thank you, Howard. Let's begin today with Respegg, which is the most advanced IL-two based Treg mechanism in the field. Across the Respegg studies that have been conducted to date, we have observed a consistent and highly predictable clinical pharmacology profile with respect to target engagement as well as the peak and duration of Treg mobilization. It has demonstrated a well tolerated safety profile and clear clinical efficacy in atopic dermatitis and also psoriasis and in patients with cutaneous manifestations of lupus. Our deep experience with Respegg to date across the totality of this clinical program gives us conviction in our ongoing Phase 2b studies in atopic dermatitis and alopecia areata. Speaker 300:07:54Specifically in atopic dermatitis, there are 3 important issues that patients with this disease continue to face. First, there is a need for great efficacy, specifically a deeper magnitude of response and rapid onset of treatment. 2nd, patients lack durable responses and therapy free remission. Once current therapies are discontinued, patients rebound rapidly. And 3rd, treatments with favorable safety profiles are lacking. Speaker 300:08:26This is especially important given the chronic nature of the disease and the need for continuous dosing. We believe there are major opportunities in this disease state that the differentiated profile of Respek could potentially address. Diving into our Phase Ib data in atopic dermatitis. Through the 12 week induction period, ResTag demonstrated dose dependent efficacy across both physician assessed and patient reported efficacy measurement, reaching statistical significant across many of these measures. At the highest dose level, ResPag demonstrated a very rapid onset of response with over 40% of patients achieving EASD75 by week 3 after only 2 doses of Respegg. Speaker 300:09:11This rapid onset of action rivals that of JAK inhibitors, which have outperformed tepilumab at this parameter. At the end of the induction period of 12 weeks, we observed a profound magnitude of efficacy, an 83% reduction in percent change from baseline EASI score with the highest dose tested. This is the largest magnitude of change that we've seen for a biologic and outside of one JAK inhibitor. Importantly, we are encouraged by the extended durability seen for ResVax. Long after the completion of the 12 week induction period, many patients maintain durable disease control for an additional 36 weeks after the end of dosing. Speaker 300:09:55And this type of extended disease control after the end of dosing is not observed tepilumab or for JAK inhibitors. Durability of the EZ75 response was observed with approximately 70% of VZ-seventy five responders maintaining that response for 36 weeks after the end of the 12 week induction period. This is a very exciting result and suggests that ResVag has the potential to be the 1st remitted therapy for atopic dermatitis. For both patient reported outcomes and physician assessed endpoints, we observed the same trend, rapid onset of effect, dose dependence and long durability of control. Additionally, Respegg was well tolerated and treatment with Respegg did not induce antidrug antibodies in patients, which has been reported with some examples of the IL-two mutine class. Speaker 300:10:48These promising data have us and KOLs very enthusiastic about the potential for long lasting responses and infrequent maintenance dosing with ResPag in the setting of atopic dermatitis. In October 2023, we initiated the Phase 2b study of ResPag in biologic naive atopic dermatitis patients and enrollment is well underway. Our goal is to enroll roughly 400 patients with 3 different regimens of ResVag versus placebo evaluated over a 16 week induction period. After the induction period, patients that meet a threshold to advance from induction to maintenance will be re randomized into 1 of 2 maintenance regimens at different dosages at either once a month or once every 3 month dosing and that schedule will continue for another 28 weeks. Our enrollment for this study is on track and we expect data in the first half of twenty twenty five. Speaker 300:11:47Moving to alopecia areata, we believe ResBag has strong scientific rationale in this indication. Alopecia areata is also a disease of the skin where your immune system starts to attack the hair follicle, thereby weakening the ability of stem cells to grow hair. With prolonged immune attack, this eventually causes the hair follicle to release the hair altogether, leading to patchy hair loss and as the disease progresses to baldness. Biologically speaking, ResVag through its central pathway of Treg rescue is uniquely poised to address the diversity of immunopathology, providing broad potential for targeting multiple dermal diseases, including alopecia. For example, in alopecia, there are almost no immune cells in normal hair follicles, meaning the hair follicle is an immune privileged tissue. Speaker 300:12:43Tregs are very important in maintaining that immune privilege and people with alopecia areata develop a breakdown of that immune privileged state. We think the Treg mechanism of Respeg can restore immune privilege and could provide durable disease control, which we believe would be game changing in this indication. JAK inhibitors are the only agents approved in alopecia and they do not provide disease durability after a patient discontinues treatment. With JAK inhibitors, it can take a patient anywhere from 9 to 18 months to grow hair. And once a patient stops taking a JAK inhibitor, which may happen for a variety of reasons, including toxicity, their hair falls out again rapidly. Speaker 300:13:30There is a high unmet need in this patient population for tolerable treatment options that provide durable responses. And we believe that restoration of immune privilege is key to obtain durability. For these reasons, we believe there is an opportunity for Respegg to become a novel biologic therapy in alopecia areata. We are initiating a Phase 2b study of Respegg in alopecia this month. The Phase 2b study plans to recruit roughly 80 patients with severe to very severe alopecia, who will be randomized to Respegs or placebo. Speaker 300:14:06Patients will be treated for a period of 36 weeks and observed up to 60 weeks in total. Our primary endpoint for this study is mean percent improvement in SALT or the severity of alopecia tool at week 36, which is the validated outcome measure used for regulatory approval. We will also be looking at a number of other secondary endpoints, including proportion of patients who saw a reduction in salt. Now turning to NKTR-one hundred and sixty five, our TNFR2 agonist antibody. TNFR2 is highly expressed on Tregs, myeloid suppressor cells, regulatory B cells, neuronal cells and others, and TNFr2 agonism has been shown to potentiate the suppressive effect in overall functional properties of Tregs and these other suppressive cell populations. Speaker 300:14:59If TNFR2 is absent, it is associated with autoimmunity and other genetic conditions that resemble FOXP3 loss of function. In contrast, its presence has been associated with immunoregulatory function and protective effects from multiple cell populations and tissues in the body. This TNFR2 agonist program in our pipeline is built upon many years of Treg experience gained from ResMed. For example, we know that central Tregs such as thymic Tregs require a substantial JAK STAT signal that is physiologically provided by the IL-two receptor pathway. And this is a central theme in the mechanism of action of Respek. Speaker 300:15:44In contrast, Tregs that leave the central compartment and infiltrate the distal organs and tissues, they are less dependent on the JAK STAT pathway and instead shift their reliance on to NF kappa V pathway engagement for their maintenance of suppressor function. TNFR2 is the most abundant TNF superfamily member expressed on Tregs and the key driver of NF kappa V signaling in those cells. And consequently, a bona fide TNFr2 agonist would be an incredibly exciting addition to our pipeline. Examples of indications that could be addressed by TNFr2 agonism include multiple sclerosis, mucosal immunology conditions such as ulcerative colitis of the GI or other oral mucosal diseases and even dermal autoimmune diseases like vitiligo. We have identified several lead CNFR2 antibody programs from an artificial intelligence based antibody discovering campaign with our partner Biologic Design. Speaker 300:16:46The lead antibody is called NKTR-one hundred and sixty five and it has highly desirable properties including exquisite R2 cell activity, TNF R2 agonism in primary human cells, activity in multiple preclinical efficacy models and a very well tolerated profile in early non GLP toxicology study. We have developed a manufacturing cell line for the lead and are conducting upstream and downstream process development with the aim to enter the clinic for this program in the first half of twenty twenty five. Later this year, we plan to present the 1st preclinical data for NKTR-one hundred and sixty five at an upcoming medical conference. As we move forward with our IND enabling studies, there is growing interest for a novel selective TNFR2 agonist like NKTR-one hundred and sixty five and thus we remain open to the opportunity of working with companies that have interested in these areas to strategize on the best path forward. Now let's switch gears to our IL-fifteen based oncology program NKTR-two fifty five. Speaker 300:17:50NKTR-two fifty five is IL-fifteen based mechanism of action, holds a great promise as a combination agent with cell therapies and other mechanisms such as checkpoint inhibitors and we are exploring the best partnering paths for continued development for this drug candidate. Our Nektar sponsored trial combining NKTR-two fifty five with the approved CD19 CAR Ts, Brianca and Yescarta, for treatment of patients with a large B cell lymphoma has enrolled 15 patients in the dose escalation portion of the study. The combination of NKTR-two fifty five and BRYANZEY is also being studied in the separate investigator sponsored trial at Fred Hutch. We are targeting the potential submission of data from these studies at medical meetings in the second half of this year. A clinical trial in non small cell lung cancer sponsored and funded by ablzeta, which evaluates the combination of ablzeta's tumor infiltrating lymphocyte cell therapy plus NKTR-two fifty five and checkpoint inhibitor is also ongoing and enrolling patients. Speaker 300:18:56And with our partner Merck KGaA, we have also been evaluating NKTR-two fifty five in combination with Bavencio versus single agent Bavencio in the Phase 2 JAVELIN bladder medley study. And that study is on track to potentially report interim PFS data later this year. And with that, I will turn the call over to Sandy for a review of our financial guidance. Sandy? Speaker 400:19:21Thank you, J. Z, and good afternoon, everyone. We ended the year in a very strong financial position with $329,400,000 in cash and investments and with no debt on our balance sheet. As Howard stated earlier, today's announcement of a $30,000,000 financing further strengthens our cash position. Our revenue was $23,900,000 for the Q4 of 2023 $90,100,000 for the full year of 2023. Speaker 400:19:55Our operating costs and expenses for the Q4 of 2023 were $57,400,000 $353,800,000 for the full year 2023. Our non operating expenses for the Q4 of 2023 were $8,600,000 $12,600,000 for the full year 2023. Q4 2023 included a non cash charge of $6,100,000 or $0.03 per share for the reclassification of the foreign currency translation adjustment to income related to the wind down of our India legal entity. As a reminder, our India facility was sold in December 2022 for approximately $12,000,000 with the wind down of the entity occurring in 2023. Our net loss for the Q4 of 2023 was $42,100,000 or $0.22 per share. Speaker 400:21:00For the full year of 2023, our net loss was $276,100,000 or $1.45 per share. Excluding $111,800,000 in noncash goodwill and other impairment charges, net loss on a non GAAP basis for the full year 2023 was $164,300,000 or $0.86 basic and diluted loss per share. Looking forward to 2024 and beyond, our financial position remains strong, in part reflecting the cost savings initiatives we undertook last year. We plan to end 2024 with $200,000,000 to $225,000,000 in cash and investments. In addition to the $30,000,000 pipe we announced this morning, our 2024 cash guidance also includes $15,000,000 resulting from an amendment executed today on a former 2020 agreement with certain entities of healthcare royalty. Speaker 400:22:07Our cash runway now extends well into the Q3 of 2026, which will take us through key value generating milestones, including Phase II Respegg data in atopic dermatitis and alopecia areata. Our revenue for the full year of 2024 is expected to be between $75,000,000 $85,000,000 which includes $55,000,000 to $65,000,000 in noncash royalties and $20,000,000 to $25,000,000 in product sales. We anticipate full year R and D expense will range between $120,000,000 $130,000,000 This includes approximately $5,000,000 to $10,000,000 of non cash depreciation and stock based compensation expense. The increase in R and D spend for 2024 over 2023 represents an increased investment in 2 RetiFEG Phase 2b studies in atopic dermatitis and alopecia areata as well as IND enabling studies for our antibody program, NKTR-one hundred and sixty five. This increase is partially offset by decreased spending on NKTR-two fifty five clinical studies in cell therapy, which are completing in 2024. Speaker 400:23:30The remaining ongoing clinical studies for NKTR-two fifty five are primarily funded by our external partners. We expect G and A expense for the full year of 2024 to be between $70,000,000 $75,000,000 which includes $5,000,000 to $10,000,000 of non cash depreciation and stock based compensation expense. Our full year non cash interest expense is expected to be between $20,000,000 $25,000,000 As I stated earlier, we expect to end this year with $200,000,000 to $225,000,000 in cash and investments. And with that, we will now open the call for questions. Crystal? Speaker 500:24:14Thank Operator00:24:40And our first question will come from Jay Olson from Opco. Your line is open. Speaker 600:24:47Hey, this is Chung on the line for Jay. Thank you for taking the question and congrats on the progress. Maybe just on ResPACK 80 study, wondering if you can talk about the initial feedback from doctors and patients participating in the study, especially in the context that there are many other competing trials out there. Also, if you also could comment on the recruitment progress thus far versus your internal expectation, that will be great. And I have a quick follow-up question after that. Speaker 600:25:22Thank you. Speaker 200:25:24Mary, you want to take that question? Speaker 500:25:26Yes, sure, Howard. Thank you. Hi, Joe. This is Mary Taliaselli. When we look at the aggregate of data from site activation, screening activities and enrollment, we are on track to have our top line induction data from the AD study in the first half of twenty twenty five. Speaker 500:25:46And in terms of the feedback, we're really pleased with the type of screening we're seeing. And we believe this is driven by the data that was presented by Jonathan Silverberg at EADV 2023. The doctors really do see that, 1, Respegg has a very rapid onset of action. Number 2, the depth of response that was seen with being percent change and easy after only 12 weeks of treatment. When most studies look at an induction period of 16 weeks, the doctors have been very impressed with that. Speaker 500:26:24And then certainly for the benefit of their patients, they really love the durability that we saw when patients were off treatment for 9 consecutive months. And they were able to maintain that very deep response and easy. This is all very, very attractive for recruiting patients to the study. So we're doing very well. I have heard, that other states are pleased with enrollment and we're not experiencing that. Speaker 600:26:52Got it. Thank you. And just a quick follow-up. Just wondering to what extent you can leverage the clinical sites for the AD study for the upcoming alopecia areata initiation? So can you just use the same sites or just another layer of work you need to do? Speaker 500:27:11Yes. So we are going to use 12 sites that are participating in the AD study and our alopecia study. And those physicians are very excited to have an opportunity for a second skin disease to evaluate Respeg in alopecia orata. And again, they're really eager to see a durability of response because, of course, when they treat their patients with JAK inhibitors and they grow back, immediately they start to lose their hair once they discontinue treatment with the JAK inhibitors. So the promise of an agent to have a durability and restore immune privilege is definitely really encouraging and exciting to teams I've been speaking to. Speaker 600:27:58Okay. Thank you so much. Operator00:28:02Thank you. And our next question will come from Roger Song from Jefferies. Your line is open. Speaker 700:28:10Hi, Tane. This is Tommy on for Roger. Maybe just following up on the alopecia areata study. How many total clinical sites will you be enrolling? And what's kind of the geographic distribution of those sites? Speaker 700:28:22And then what are some key baseline characteristics for the patients in these studies will be most of them be JAK inhibitor refractory? Any detail there would be appreciated. Speaker 500:28:35Sure. Yes. Mary, you want to say again? Yes. Thanks, Howard. Speaker 500:28:39We'll have, slightly over 30 sites. We're going to be in Canada, in the United States and in Poland. As you may imagine, when you're in Poland, they definitely have an access issue and it also takes a very long time for those patients to get in to see a dermatologist. So it's actually a very favorable environment to enroll patients. These patients are going to be JAK inhibitor naive patients. Speaker 500:29:13And then our key inclusion criteria is the severe to very severe alopecia. So these patients all have to have a salt greater than or equal to 50. And of course, this is the same patient population, where baricitinib and Lilly JAK and Pfizer's JAK inhibitor at the same eligibility criteria for their pivotal trial. Speaker 700:29:40Great. Thank you. Thank you. Our next question will Operator00:29:47come from Jessica Fye from JPMorgan. Your line is open. Speaker 100:29:53Hey, thanks for taking my question. For the Phase 2b atopic derm trial, what's the threshold patients need to meet to be considered a responder and be rerandomized at least 16? And then also curious what's your latest thinking on whether the AD or the alopecia trial will read out first and why? Speaker 500:30:12Yes. Hi, Jessica, it's Mary. So, to be re randomized, the patient has to have EZ50 or above when they are re randomized to the maintenance dose of once a month or once every 3 months, they will be on the same dose that they were randomized to in the induction period. And do you have a second question? Speaker 100:30:41Just the timing of alopecia versus AD data? Speaker 500:30:45Yes. So, we expect the AD trial to read out first. Speaker 100:30:53Thank you. Speaker 500:30:55Thank you. Speaker 700:30:57Thank you. Our next question Operator00:30:59will come from Julian Harrison from BTIG. Your line is open. Speaker 800:31:05Hi, congrats on the progress and thank you for taking my questions. I'm curious if you could remind us how you're thinking about efficacy beyond 12 weeks of dosing with BRESPEG in atopic derm. Do you expect to plateau at some point? Or do you expect response rates to maybe be progressive through 44 weeks of dosing? And then with regards to the Lilly litigation, sorry if I missed it, I'm wondering if you could comment on its current status and timing of next steps? Speaker 200:31:33Mary, why don't you take the first part and I'll take the second part. Speaker 500:31:38Yes. I definitely think that as we extend our induction period from 12 weeks to 16 weeks, we're going to see a greater number of patients experience a deeper response. So I very much look forward to seeing what the mean percent change is. As you know, our easy mean percent change from baseline to 12 weeks was 83%. And as such, that was greater than any of the biologic agents. Speaker 500:32:11If you look at DUPI or ODDDRI or lebri or NEEMO or ROKA, we definitely saw the deepest response. But I do believe that we'll probably see more patients who experience a EZ75 and even a EZ90 as we go out additional 4 weeks in the induction period. Speaker 200:32:32With regard to Lilly, Lilly after we filed our complaint in federal courts, Lilly tried to convince the federal court judge to dismiss the case, as you know. And last week, the federal judge refused Lilly's request, and the judge agreed to allow Nektar's primary claims to move forward and we expect the judge to settle trial date in 2025. The court also ordered the parties to engage in mediation within the next 3 months to try to resolve the issue. And so we're very, very happy the case is moving forward. The judge did not dismiss the case and we look forward to vindicating ourselves through the litigation process. Speaker 800:33:20Excellent. Thanks very much. Speaker 700:33:24Thank you. Operator00:33:32And our next question will come from Andy Hsieh from William Blair. Your line is open. Speaker 900:33:39Great. Thanks for taking our questions. Two quick ones for us. One is, can you talk about this ebb and flow dynamic associated with hair loss in alopecia? Would enrolling kind of severe and really severe patients kind of mitigate that variability? Speaker 900:34:00And the second question has to do with the TNF receptor 165 program. We know that the receptor family is a trimer. So I guess to maximally agonize this receptor, you might have to have like a trimer design. I'm just curious if that's kind of a part of the design that goes into 165. And downstream from that, there's also kind of clustering. Speaker 900:34:28So is that also a part of the design of the molecule? Thanks. Speaker 700:34:39Mary, do you want to take the hair loss? Yes. And then JV can take the peanuts on Speaker 500:34:42Yes. So, hi, Andy, it's Mary. So you're exactly right. Once patients go into the severe and the very severe, generally speaking, there is not a regrowth of the hair and that's you're exactly right that that's why the eligibility criteria and even the threshold for approval by the FDA is this patient population. It does patients do start out with experiencing the patchy hair loss. Speaker 500:35:15But as the disease progresses, certainly the hair loss becomes more extreme and even towards baldness. But once a patient loses their hair, it's very usual for them to have regrowth of their hair without some sort of medical intervention. And then I'll pass over the second question to J. C. Speaker 300:35:39Yes. Thanks, Mary, and thanks, Andy, for your question. So you're right. So TNF proteins are trimers. But as we've learned more and more about the biophysics of the receptors and the way the plant domains, right, which are the cysteine rich domains that hold together the receptor subunits. Speaker 300:35:59They actually work to create dimers for receptors. And then a trimer comes along and clusters 6 receptors or 3 pairs of dimers. So and then you can get additional clustering and some of this ultra structure has been published and some structural studies have been done. What we've come to understand, A, through learning about the cell biology of these receptors, the way these divers need to multimerize and the way the epitopes for binding to the receptors need to work is that the epitope is actually fundamentally important. One of the things we discovered with NKTR-one hundred and sixty five is that it's an epitope that has its own unique properties and it can signal in a completely cluster independent fashion. Speaker 300:36:48For example, it doesn't need Fc, it doesn't even need Valence. That's one of the things that's really unique and highly differentiated, about the antibodies that we've created. And keeping in mind, all of these ultrastructural forms of the receptor and then the different states that the receptor can occupy is obviously one of the key things that's important for developing a successful agonist. Thanks for the question. Speaker 700:37:18Thank you. And I Operator00:37:21am showing no further questions from the phone lines. I'd now like to turn the conference back over to Howard Robin for any closing remarks. Speaker 200:37:28Well, thank you everyone for joining us today. And as we stated on our call, we really remain focused on executing the development of Respeg and our immunology focused research programs. I'd like to thank all of our employees for their very hard work and thank all of our shareholders, new and existing, for their continued support. And we look forward to providing you with updates on our progress. So stay tuned. Speaker 200:37:50Thanks for joining us again. Operator00:37:53Thank you. This concludes today's conference call. Thank you for your participation. You may now disconnect. Everyone have a wonderful day.Read morePowered by