Iterum Therapeutics plc

Q2 2024 Earnings Conference Call

8/14/2024

speaker
Operator
Welcome to Eterin Therapeutic Second Quarter 2024 Financial Results and Business Update. My name is Kiki, and I will be your conference operator today. During the presentation, you will have the opportunity to ask a question by pressing star followed by one on your telephone keypad. If you change your mind, please press star followed by two. I will now hand you over to your host, Louise Barrett, Senior Vice President legal affairs to begin. Louise, please go ahead.
speaker
Louise Barrett
Thank you, Kiki. Good morning and welcome to Iterum Therapeutics' second quarter 2024 financial results and business update conference call. A press release with our second quarter results was issued earlier this morning and can be found on our website. We are joined this morning by our Chief Executive Officer, Corey Fishman, and our Chief Financial Officer, Judy Matthews. Corey will provide some opening remarks Judy will provide details on our financial results, and then we will open the lines for Q&A. Before I begin, I'd like to remind you that some of the information presented on this conference call will contain forward-looking statements concerning our plans, strategies, and prospects for our business. These include statements regarding the topics that will be covered at the upcoming advisory committee meeting in relation to our resubmitted NDA for Oral Sulipenem, the date by which the FDA will take action regarding our NDA, the expected use of proceeds from our recently completed rights offering, the planned extraordinary general meeting of shareholders to consider the disapplication of preemption rights, the sufficiency of ITERM's cash resources to fund its operating expenses into 2025, and our strategic process to sell, license, or otherwise dispose of our rights to Sulipenem to maximize stakeholder value. Actual results may differ materially from those indicated by these forward-looking statements as a result of various factors outside of a control, including uncertainties inherent in the design, initiation and conduct of clinical and non-clinical development, changes in regulatory requirements or decisions of regulatory authorities, the likelihood of regulatory filings and approvals, changes in public policy or legislation, commercialisation plans and timelines of oral sulipenem as approved, the accuracy of our expectations regarding how far into the future our cash-in-hand will fund our ongoing operations, the sufficiency of our cash resources and our ability to continue as a going concern, our ability to regain compliance and maintain our listing on the NASDAQ capital market, and risks and uncertainties concerning the outcome, impact, effects and results of our pursuit of strategic alternatives. And those other factors discussed under the caption risk factors in our quarterly report on Form 10Q filed with the SEC this morning. In addition, any forward-looking statements represent our views only as of the date of this call and should not be relied upon as representing our views as of any subsequent date. We specifically disclaim any obligation to update such statements. We will also be referencing non-GAAP financial measures during the call. We've provided reconciliation of GAAP reported to non-GAAP adjusted information in the press release issued this morning. With that all said, I'll turn it over to you now, Corey, for your opening remarks.
speaker
Corey
Thanks, Louise. Welcome, and thanks for joining us today. It continues to be a very busy and productive time for ITERM, and I'm pleased to share the following updates. We were pleased to have recently closed our rights offering, which generated $5.8 million of net proceeds after taking into account fees and expenses. This additional capital will allow us to continue to pursue our business plan and strategy, including funding our ongoing strategic process to maximize the value of sulopenem for our stakeholders. Now, turning to upcoming milestones. On September 9th, ITERM will meet with the FDA's Antimicrobial Drugs Advisory Committee to discuss our resubmitted new drug application for oral sulopenem for the treatment of uncomplicated urinary tract infections in adult women. The general function of the Antimicrobial Drugs Advisory Committee is to provide advice and recommendations to FDA on regulatory issues. We have been working diligently to prepare materials for this upcoming meeting and are looking forward to the discussion. Another important date is October 25th. That is the PDUFA action date assigned by FDA to ITERM's resubmitted new drug application for oral sulopenem. We continue to work with the FDA during their review process. If the FDA completes its review within their general timeframe, on or about this date, we should receive a decision regarding the approvability of oral sulopenem for the treatment of uncomplicated urinary tract infections in adult women. If approved, oral psilopenem would be the first oral penem approved in the United States. We continue to expand our intellectual property estate. Most recently, we announced that two pending U.S. patent applications and one pending Canadian patent application were recently allowed. One allowed U.S. patent application is directed to the method of use of oral psilopenem in treating uncomplicated urinary tract infections, while the other allowed U.S. patent application is directed to the method of use of sulopenem exodroxyl, probenicid, and valproic acid in treating multiple diseases. The allowed Canadian patent application is directed to the bilayered tablet of oral sulopenem and its related preparations and or uses. Once these new patents issue, in addition to in-license patents, we will have owned patents in the U.S., Japan, Australia, Korea, and Canada with patent applications pending in Europe, China, and other key territories. As we look at our cash, as of June 30th, we had $11.7 million in cash and cash equivalents. Based on our current operating plan, we believe that the current cash, cash equivalents and short-term investments, plus the newly raised cash from the rights offering, provides a runway into 2025, including through the expected PDUFA date in late October of this year. Looking to future capital requirements, we are once again seeking approval of our shareholders at an upcoming extraordinary general meeting of shareholders to disapply the statutory preemption rights applicable to the increase in authorized share capital that was approved by our shareholders at our 2023 annual general meeting. This will enable us to quickly take advantage of opportunities to raise capital through share issuances for cash which in turn allow us to fund the continued execution of our business plans and strategies further into 2025, including funding our ongoing strategic process and repayment of $14.7 million of principal and interest due in January 2025 on the outstanding 6.5% exchangeable senior subordinated note. The granting of the preemption opt-out authority eliminates the competitive disadvantage we are placed at compared to non-Irish NASDAQ-listed public companies and the risks associated with seeking transaction-specific shareholder approvals or having to first offer those shares that we propose to issue for cash to all our existing shareholders in a time-consuming and costly manner. As an example, our recently completed rights offering was both time-consuming and costly, taking approximately three and a half months to implement, with total costs in excess of $1.6 million, including dealer manager fees. Our Board of Directors continues to view this proposal as being in the best interest of the company and our shareholders and recommends a vote in favor thereof. Now I'll turn the call over to Judy Matthews for an update on our financial performance.
speaker
Judy Matthews
Thanks, Corey. Total operating expenses were $4 million in the second quarter of 2024 and compared to $10.8 million in the second quarter of 2023. Operating expenses include research and development expenses and general and administrative expenses. R&D costs were $2.1 million for the second quarter, compared to $9 million for the same period in 2023. The primary driver of the $6.9 million decrease in R&D expense for the second quarter was primarily due to higher costs incurred in 2023 to support a reassured trial, which began enrollment in October 2022 and completed enrollment in October 2023. G&A costs were $1.9 million for the second quarter of 2024, which is flat to G&A costs of $1.9 million in the second quarter of 2023. Our net loss on a U.S. GAAP basis was $5 million for the second quarter of 2024 compared to $12.2 million for the same period in 2023. On a non-GAAP basis, which excludes certain non-cash adjustments, our net loss of $3.8 million in the second quarter of 2024 compared compared to our non-GAAP net loss of $10 million in the second quarter of 2023. The $6.2 million decrease in our non-GAAP net loss for the second quarter was primarily a result of lower R&D expenses related to our REASSURE trial, as enrollment in the Phase III trial was completed in October 2023. At the end of June, we had cash, cash equivalents, and short-term investments of $11.7 million in And earlier this month, we completed the rights offering, resulting in aggregate net proceeds of $5.8 million, which, based on our current operating plan, will provide cash runway into 2025, including through potential FDA approval on October 25, 2024. We currently have approximately 22.7 million ordinary shares outstanding, which includes the shares issued in the recently completed rights offering. Also, we currently have approximately $11.1 million of exchangeable notes outstanding, which can be exchanged at the option of the note holder for approximately 1.9 million shares. If the notes are not exchanged, we will be obligated to pay the note holders $14.7 million, which includes accrued interest. in January, 2025. Now we will open the line for questions.
speaker
Operator
Thank you. If you would like to ask a question, please press star followed by one on your telephone keypad. If you change your mind, please press star followed by two. Please ensure your mic is muted and muted locally when you ask the question. The first question is from Ed Arcee from H.C. Wainwright. The line is now open. Please go ahead.
speaker
Ed Arcee
Hi, good morning, everyone. This is Thomas asking a couple of questions for Ed. Thank you for the kind of questions. So first question, Can you discuss your perspectives on the two stated objectives of the ATCOM by the FDA? So you said the agency is very concerned about antibiotic resistance. It refers to oral pandem, which is so pandem is. Do you say the agency is somewhat reluctant in considering its approval?
speaker
Corey
Thanks for the question, Thomas. I don't think they're reluctant to approve it. I think what they are thinking about is because it would be the first oral penum to be approved is making sure that it is getting to the right patients for this indication, which of course is consistent with what we would want and of course what we would do in terms of any promotion would be only for our approved indications. And so I don't think they're reluctant to approve it. I think this is just a little bit of an area they haven't had to address recently. And therefore, I think they're just being mindful of the opportunity to have a drug like an oral penum available, which is extremely efficacious and very safe. and not being more widely used than would be natural given the approval that we might get.
speaker
Ed Arcee
Got it. And to that end, can you outline some topics of debate that you would expect at the ad comp?
speaker
Corey
I'm sorry, I didn't catch that question, Thomas.
speaker
Ed Arcee
What we would like to know is can you outline some topics of debate that you anticipate will be raised at the adcom?
speaker
Corey
Yeah. When the FDA sent us our note, and we have obviously talked about this publicly, they did talk about two specific things they would like to talk with us and the adcom about, which is stewardship, And that, again, goes to what we just talked about, which is making sure that the product is being used appropriately in an appropriate way for the appropriate patient. And the second topic that they mentioned was, what is the appropriate patient population? And obviously, we have done our study based on uncomplicated UTI in adult women, and that in and of itself could be the appropriate population I think they're trying to just get a sense from the advisory committee as to that conversation and talking through that because, again, I think this is a little bit of new ground for the FDA, not so much on whether it should be approved or not. Obviously, they'll make their own decision on that, but who uses this and how they use it. So those are the two topics that they specifically mentioned in their correspondence to us. with regard to what topics they would like to talk with the advisory committee about.
speaker
Ed Arcee
Got it. And then perhaps one more question from us. To provide evidence of independent safety, Are you allowed to include safety data from studies outside of UTI patients, specifically the reissue study? Are you allowed to include other completed studies as well?
speaker
Corey
Yeah, not only are you allowed to, I think it's probably, I don't want to say required, but certainly we've done four Phase III studies, and we will have a comprehensive safety database across all of those patients. And as you know, the good news is, from a safety perspective, Sulipenem has presented a very clean safety profile. So, yes, that will be part of the data that gets presented as well.
speaker
Ed Arcee
Thank you, Steve. Thank you again for the kind of questions. We look forward to the outcome.
speaker
Corey
Thanks, Thomas.
speaker
Operator
Thank you. The next question is from Jason Metcotti from Medicine Group. The line is now open. Please go ahead.
speaker
Jason Metcotti
Hi, Corey. This is kind of an impossible question without the briefing documents for the ICOM, but do you think because I can appreciate why it's new, it's a first oral penum, and they want to go through the stewardship discussion, but considering they want to talk about stewardship and then look for the most appropriate patient population, do you think they're trying to maybe narrow down the label and indication and thus the commercial opportunity to maybe patients who are failing on Augmentin or Cipro or something else and, you know, having to go through that process to get to Sulo?
speaker
Corey
Yeah, thanks for the question, Jason. It's a really good one. I don't know the answer to that other than what I can tell you is we have studied the, you know, the populations have been what we've studied. And so to your point, I think it might be a little difficult to try to narrow that label without having evidence of having studied that particular subgroup. So having said that, you know, I, I, again, I don't know what the FDA is going to do ultimately, of course, and I don't know where they're going. I just think that, um, it would be a little bit more challenging, and that could potentially be why they want to talk with the advisory committee to pick a subgroup and say, well, you know, you have to go through this and this and this in order to get psilopenta. That's not what we studied. So it would be very difficult, I think, for the FDA to kind of put those guideposts up if that's not the population we've studied. Certainly, we're going to work with the FDA and the advisory committee to try to come to some understanding. Clearly, getting the drug approved from our standpoint is going to be the paramount thing. Then, of course, what does the label say is next in the conversation. given the patient populations we've studied, you know, we just don't know how that would happen. And that's not to say that the FDA won't come up with something, because, of course, that's their prerogative. But, you know, certainly it isn't in our study material to say, you know, you have to have had a prior infection or have had failed on something else. We just didn't study it that way.
speaker
Jason Metcotti
Got it. And do you think, and I know these are the two major topics, and maybe it'll be in the briefing documents. Do you think there'll be some discussion around the reassured data? Because while it was non-inferior in meeting that primary endpoint, there was statistical superiority, and there was also those cases, right, in the prior SURE-1 trial with CIPRO where you were statistically superior in different cuts of the data. Do you think a superiority case aspect to this can wind up in the label, which would be great?
speaker
Corey
It's another good question. I don't know if that would be something that they would put in the label. It's certainly something that is a conversation piece for discussion with the FDA. The real question, I think, becomes the strength of the data And I think, you know, we feel very good that given the reassured data of not only, as you said, the non-inferiority plus superiority, you know, you've got some really compelling data there. So it'll be interesting to see if, you know, if we get to that stage with the agency, you know, where their heads are at with regard to the conversation around what does the label say? Is it kind of your standard label, your approved for uncomplicated UTI, or is it something more you know, more broad that says not only are you approved, but you've shown superiority, you know, to these other agents and, you know, will that show up somewhere in the label? It's possible.
speaker
Ed Arcee
Got it. Thanks, Corey. Great. Thank you, Jason.
speaker
Operator
Thank you. As we currently have no further questions, I would like to turn the conference back over to Corey Fishman, Chief Executive Officer, for closing remarks.
speaker
Corey
Thank you, Kiki. Thanks again for joining us today. We are very excited about our upcoming interactions with the FDA's Antimicrobial Advisory Committee and the FDA as part of the continued review of our resubmitted new drug application and are looking forward to potentially bringing sulopenem an important treatment option to physicians and patients in the underserved market of uncomplicated urinary tract infections. Thanks again, and have a good day.
speaker
Operator
This concludes today's conference call. You may now disconnect your lines. Thank you.
Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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