QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 |
(State or other jurisdiction of incorporation or organization) |
(I.R.S. Employer Identification No.) | |
(Address of principal executive offices) |
(Zip Code) |
Title of each class |
Trading symbol(s) |
Name o f each exchangeon which registered | ||
Large accelerated filer | ☐ | Accelerated filer | ☐ | |||
Non-accelerated filer |
☒ | Smaller reporting company | ||||
Emerging growth company |
Page |
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PART I |
3 |
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Item 1. |
3 |
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3 |
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4 |
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5 |
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6 |
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7 |
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Item 2. |
18 |
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Item 3. |
25 |
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Item 4. |
25 |
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PART II |
26 |
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Item 1. |
26 |
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Item 1A. |
26 |
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Item 6. |
50 |
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51 |
September 30, |
December 31, |
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2021 |
2020 |
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Assets |
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Current assets: |
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Cash and cash equivalents |
$ | $ | ||||||
Marketable securities |
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Accrued interest receivable |
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Prepaid research and development expenses |
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Other prepaid expenses and current assets |
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Total current assets |
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Property and equipment, net |
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Operating lease right-of-use |
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Other assets |
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Total assets |
$ | $ | ||||||
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Liabilities and stockholders’ equity |
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Current liabilities: |
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Accounts payable |
$ | $ | ||||||
Accrued research and development expenses |
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Other accrued liabilities |
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Total current liabilities |
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Development financing liability |
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Long-term portion of operating lease liability |
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Total liabilities |
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Commitments and contingencies |
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Stockholders’ equity: |
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Preferred stock, $ |
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Common stock, $ |
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Additional paid-in capital |
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Accumulated other comprehensive (loss) income |
( |
) | ||||||
Accumulated deficit |
( |
) | ( |
) | ||||
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Total stockholders’ equity |
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Total liabilities and stockholders’ equity |
$ | $ | ||||||
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Three Months Ended |
Nine Months Ended |
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September 30, |
September 30, |
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2021 |
2020 |
2021 |
2020 |
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Operating expenses: |
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Research and development |
$ | $ | $ | $ | ||||||||||||
General and administrative |
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Total operating expenses |
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Loss from operations |
( |
) | ( |
) | ( |
) | ( |
) | ||||||||
Other income (expense), net: |
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Interest income |
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Interest expense |
( |
) | ( |
) | ||||||||||||
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Total other income (expense), net |
( |
) | ( |
) | ||||||||||||
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Net loss |
$ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | ||||
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Other comprehensive (loss) income: |
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Unrealized (loss) gain on marketable securities |
( |
) | ( |
) | ( |
) | ||||||||||
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Total other comprehensive (loss) income |
( |
) | ( |
) | ( |
) | ||||||||||
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Comprehensive loss |
$ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | ||||
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Basic and diluted net loss per common share |
$ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | ||||
Weighted average common shares outstanding used to calculate basic and diluted net loss per common share |
Nine Months Ended |
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September 30, |
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2021 |
2020 |
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Operating activities |
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Net loss |
$ | ( |
) | $ | ( |
) | ||
Adjustments to reconcile net loss to net cash used in operating activities: |
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Depreciation and amortization |
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Stock-based compensation expense |
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Accretion of development financing liability |
— | |||||||
Write-off of deferred financing costs |
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Net accretion and amortization of investments in marketable securities |
( |
) | ||||||
Changes in assets and liabilities: |
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Interest receivable and other current assets |
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Prepaid expenses |
( |
) | ||||||
Other assets |
( |
) | ||||||
Accounts payable |
( |
) | ||||||
Accrued liabilities |
( |
) | ||||||
Net cash used in operating activities |
( |
) | ( |
) | ||||
Investing activities |
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Purchases of property and equipment |
( |
) | ( |
) | ||||
Purchases of marketable securities |
( |
) | ( |
) | ||||
Proceeds from maturities of marketable securities |
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Net cash provided by investing activities |
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Financing activities |
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Proceeds from issuance of common stock pursuant to equity award plans |
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Proceeds from development financing, net of transaction costs |
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Net cash provided by financing activities |
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Net increase in cash and cash equivalents |
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Cash and cash equivalents at beginning of period |
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Cash and cash equivalents at end of period |
$ | $ | ||||||
Supplemental disclosure |
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Cash paid for amounts included in the measurement of lease liabilities |
$ | $ | ||||||
Supplemental non-cash investing and financing activities |
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Accrued financing costs |
$ | $ |
Three and Nine Months Ended September 30, 2021 |
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Accumulated |
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Additional |
Other |
Total |
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Common Stock |
Paid-in |
Comprehensive |
Accumulated |
Stockholders’ |
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Shares |
Amount |
Capital |
Income (Loss) |
Deficit |
Equity |
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Balances as of December 31, 2020 |
$ | $ | $ | $ | ( |
) | $ | |||||||||||||||||
Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized loss on marketable securities |
— | — | — | ( |
) | — | ( |
) | ||||||||||||||||
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Balances as of March 31, 2021 |
$ | $ | $ | ( |
) | $ | ( |
) | $ | |||||||||||||||
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Issuance of common stock upon exercise of stock options |
— | — | — | |||||||||||||||||||||
Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized gain on marketable securities |
— | — | — | — | ||||||||||||||||||||
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Balances as of June 30, 2021 |
$ | $ | $ | $ | ( |
) | $ | |||||||||||||||||
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Issuance of common stock upon exercise of stock options |
— | — | — | |||||||||||||||||||||
Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized loss on marketable securities |
— | — | — | ( |
) | — | ( |
) | ||||||||||||||||
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Balances as of September 30, 2021 |
$ | $ | $ | ( |
) | $ | ( |
) | $ | |||||||||||||||
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Three and Nine Months Ended September 30, 2020 |
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Accumulated |
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Additional |
Other |
Total |
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Common Stock |
Paid-in |
Comprehensive |
Accumulated |
Stockholders’ |
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Shares |
Amount |
Capital |
Income (Loss) |
Deficit |
Equity |
|||||||||||||||||||
Balances as of December 31, 2019 |
$ | $ | $ | $ | ( |
) | $ | |||||||||||||||||
Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized loss on marketable securities |
— | — | — | ( |
) | — | ( |
) | ||||||||||||||||
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Balances as of March 31, 2020 |
$ | $ | $ | ( |
) | $ | ( |
) | $ | |||||||||||||||
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Issuance of common stock upon exercise of stock options |
— | — | — | |||||||||||||||||||||
Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized gain on marketable securities |
— | — | — | — | ||||||||||||||||||||
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Balances as of June 30, 2020 |
$ | $ | $ | $ | ( |
) | $ | |||||||||||||||||
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|
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Stock-based compensation expense |
— | — | — | — | ||||||||||||||||||||
Net loss |
— | — | — | — | ( |
) | ( |
) | ||||||||||||||||
Net unrealized loss on marketable securities |
— | — | — | ( |
) | — | ( |
) | ||||||||||||||||
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Balances as of September 30, 2020 |
$ | $ | |
$ | $ | ( |
) | $ | ||||||||||||||||
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As of September 30, 2021 |
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Level 1 |
Level 2 |
Level 3 |
Total |
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Assets: |
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Cash equivalents: |
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Money market funds |
$ | $ | — | $ | — | $ | ||||||||||
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|
|
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|
|
|
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Total cash equivalents |
— | — | ||||||||||||||
Marketable securities: |
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U.S. and foreign co m mercial paper |
— | — | ||||||||||||||
U.S. and foreign corporate debt securities |
— | — | ||||||||||||||
Asset-backed securities |
— | — | ||||||||||||||
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|
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Total marketable securities |
— | — | ||||||||||||||
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Total assets measured at fair value |
$ | $ | $ | — | $ | |||||||||||
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|
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|
|
|
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As of December 31, 2020 |
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Level 1 |
Level 2 |
Level 3 |
Total |
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Cash equivalents: |
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Money market funds |
$ | $ | — | $ | — | $ | ||||||||||
|
|
|
|
|
|
|
|
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Total cash equivalents |
— | — | ||||||||||||||
Marketable securities: |
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U.S. treasury securities |
— | — | ||||||||||||||
U.S. and foreign commercial paper |
— | — | ||||||||||||||
U.S. and foreign corporate debt securities |
— | — | ||||||||||||||
U.S. agency securities |
— | — | ||||||||||||||
Asset-backed securities |
— | — | ||||||||||||||
Supranational debt securities |
— | — | ||||||||||||||
|
|
|
|
|
|
|
|
|||||||||
Total marketable securities |
— | — | ||||||||||||||
|
|
|
|
|
|
|
|
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Total assets measured at fair value |
$ | $ | $ | — | $ | |||||||||||
|
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|
|
|
Three Months Ended |
Nine Months Ended |
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September 30, |
September 30, |
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2021 |
2020 |
2021 |
2020 |
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Numerator: |
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Net loss |
$ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) | ||||
Denominator: |
||||||||||||||||
Weighted average number of common stock shares outstanding |
||||||||||||||||
Net loss per share |
$ | ( |
) | $ | ( |
) | $ | ( |
) | $ | ( |
) |
Three Months Ended |
Nine Months Ended |
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September 30, |
September 30, |
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2021 |
2020 |
2021 |
2020 |
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Common stock options |
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Incentive awards |
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Total |
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September 30, |
December 31, |
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2021 |
2020 |
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Accrued compensation |
$ | $ | ||||||
Accrued professional fees and other |
||||||||
Current portion of operating lease liability |
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|
|
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Total other accrued liabilities |
$ | $ | ||||||
|
|
|
|
Three Months Ended |
Nine Months Ended |
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September 30, |
September 30, |
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2021 |
2020 |
2021 |
2020 |
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Research and development |
$ | $ | $ | $ | ||||||||||||
General and administrative |
||||||||||||||||
|
|
|
|
|
|
|
|
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Total stock-based compensation expense |
$ | $ | $ | $ | ||||||||||||
|
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• | primary biliary cholangitis (PBC), an autoimmune disease that causes progressive destruction of the bile ducts in the liver resulting in impaired bile flow (cholestasis) and inflammation; and |
• | nonalcoholic steatohepatitis (NASH), a prevalent and serious chronic liver disease caused by excessive fat accumulation in the liver that results in inflammation and cellular injury that can progress to fibrosis and cirrhosis, and potentially liver failure and death. |
• | Remote workforce operations |
• | Clinical trial and drug manufacturing operations COVID-19 related travel restrictions and reduced access to work facilities through the use of remote working technologies and other measures as they continue to progress toward completion of our clinical trials. However, as we continue to enroll clinical trials and look to complete the clinical development of seladelpar and initiate other programs, our research and development employees and contractors may not be able to sufficiently access their applicable work facilities as a result of continued facility closure orders and the possibility that governmental authorities might further modify such restrictions. Furthermore, with the emergence of COVID-19 variants, such as the Delta and Mu variants, further disruptions to clinical trial sites have been observed, in particular in portions of the United States, in the U.K. and in Europe. As a result, subjects we expect to enroll in our clinical trials may be reluctant to enroll or may be prevented or delayed in enrolling due to COVID-19, ongoing travel restrictions and/or facility access restrictions. Although we and our contractors continue to plan for and develop pandemic-related risk mitigation strategies, it is uncertain whether these plans will continue to be sufficient to fully offset the potential impact that COVID-19, including the emergence of COVID-19 variants, travel restrictions and/or facility access restrictions (or other unanticipated impediments) may have on our ability to execute our research and development activities in a timely and cost-effective manner. |
• | Drug regulator interactions COVID-19 related regulatory submission issues have created an impediment to clinical site activation in the U.K. |
• | Financial reporting and compliance |
Three Months Ended September 30, |
Change Q3 |
Nine Months Ended September 30, |
Change Q3 YTD |
|||||||||||||||||||||
($ in thousands) |
2021 |
2020 |
2021 vs 2020 |
2021 |
2020 |
2021 vs 2020 |
||||||||||||||||||
Operating expenses: |
||||||||||||||||||||||||
Research and development |
$ | 17,010 | $ | 7,743 | $ | 9,267 | $ | 46,137 | $ | 25,194 | $ | 20,943 | ||||||||||||
General and administrative |
5,179 | 3,907 | 1,272 | 16,936 | 11,535 | 5,401 | ||||||||||||||||||
|
|
|
|
|
|
|
|
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Total operating expenses |
22,189 | 11,650 | 10,539 | 63,073 | 36,729 | 26,344 | ||||||||||||||||||
|
|
|
|
|
|
|
|
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Loss from operations |
(22,189 | ) | (11,650 | ) | (10,539 | ) | (63,073 | ) | (36,729 | ) | (26,344 | ) | ||||||||||||
Other income (expense), net: |
||||||||||||||||||||||||
Interest income |
29 | 229 | (200 | ) | 140 | 1,494 | (1,354 | ) | ||||||||||||||||
Interest expense |
(522 | ) | — | (522 | ) | (522 | ) | — | (522 | ) | ||||||||||||||
|
|
|
|
|
|
|
|
|||||||||||||||||
Total other income (expense), net |
(493 | ) | 229 | (722 | ) | (382 | ) | 1,494 | (1,876 | ) | ||||||||||||||
|
|
|
|
|
|
|
|
|||||||||||||||||
Net loss |
$ | (22,682 | ) | $ | (11,421 | ) | $ | (11,261 | ) | $ | (63,455 | ) | $ | (35,235 | ) | $ | (28,220 | ) | ||||||
|
|
|
|
|
|
|
|
Three Months Ended September 30, |
Change Q3 |
Nine Months Ended September 30, |
Change Q3 YTD |
|||||||||||||||||||||
2021 |
2020 |
2021 vs 2020 |
2021 |
2020 |
2021 vs 2020 |
|||||||||||||||||||
Project costs: |
||||||||||||||||||||||||
Seladelpar PBC clinical studies |
$ | 10,180 | $ | 2,279 | $ | 7,901 | $ | 25,050 | $ | 11,005 | $ | 14,045 | ||||||||||||
Seladelpar NASH clinical studies |
(52 | ) | 138 | (190 | ) | (71 | ) | 1,607 | (1,678 | ) | ||||||||||||||
Seladelpar PSC clinical studies |
— | (36 | ) | 36 | — | 218 | (218 | ) | ||||||||||||||||
Seladelpar drug manufacturing & development |
1,530 | 630 | 900 | 3,675 | 1,010 | 2,665 | ||||||||||||||||||
Seladelpar other studies |
144 | 170 | (26 | ) | 303 | 520 | (217 | ) | ||||||||||||||||
Non-seladelpar studies |
279 | 854 | (575 | ) | 2,547 | 1,667 | 880 | |||||||||||||||||
|
|
|
|
|
|
|
|
|||||||||||||||||
Total project costs |
12,081 | 4,035 | 8,046 | 31,504 | 16,027 | 15,477 | ||||||||||||||||||
Internal research and development costs |
4,929 | 3,708 | 1,221 | 14,633 | 9,167 | 5,466 | ||||||||||||||||||
|
|
|
|
|
|
|
|
|||||||||||||||||
Total research and development |
$ | 17,010 | $ | 7,743 | $ | 9,267 | $ | 46,137 | $ | 25,194 | $ | 20,943 | ||||||||||||
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• | expenses incurred under agreements with contract research organizations and investigative sites that conduct our clinical trials and a substantial portion of our preclinical activities; |
• | the cost of acquiring materials and manufacturing drug product for use in clinical trial and other research activities; and |
• | other costs associated with development activities, including additional studies. |
Nine Months Ended September 30, |
||||||||
2021 |
2020 |
|||||||
Net cash used in operating activities |
$ | (55,188 | ) | $ | (29,909 | ) | ||
Net cash provided by investing activities |
72,666 | 52,306 | ||||||
Net cash provided by financing activities |
23,292 | 7 | ||||||
|
|
|
|
|||||
Net increase in cash and cash equivalents |
$ | 40,770 | $ | 22,404 | ||||
|
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|
|
Item 1. |
Legal Proceedings |
• | Our business may be adversely affected by the effects of the COVID-19 pandemic, particularly the emergence of COVID-19 variants such as the Delta and Mu variants, including those impacting our ability to enroll and conduct critical clinical trials such as RESPONSE, as well as impacts to our other development efforts, administrative personnel and third-party service providers. |
• | We have incurred significant net losses since our inception and anticipate that we will continue to incur significant losses for the foreseeable future. We may need to raise additional equity and/or debt capital to fund our continued operations, including clinical trials and other product development. In the event we do not successfully raise sufficient funds to finance our product development activities, we will curtail our product development activities commensurate with the magnitude of the shortfall or our product development activities may cease altogether. |
• | Failure to remain in compliance with our obligations under the development financing agreement with Abingworth could lead to reduced funding under the agreement and/or the acceleration of potentially significant payments to Abingworth. |
• | Our ability to generate future revenues from product sales is uncertain and depends upon our ability to successfully develop, obtain regulatory approval for, and commercialize product candidates, including most importantly, seladelpar. |
• | Raising additional capital may cause dilution to our existing stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates. |
• | Drug development and obtaining and maintaining regulatory approval for drug products is costly, time-consuming, and highly uncertain. |
• | Serious complications or side effects in connection with the use or development of our product candidates could lead to delay or discontinuation of development of our product candidates. |
• | Our manufacturing partners and other service providers, including CROs managing our clinical trials, may fail to perform adequately in their efforts to support the development, manufacture, and commercialization of our drug candidates and future products. |
• | We have never successfully commercialized a product. If any of our product candidates receive marketing approval, they may nonetheless be unable to gain sufficient market acceptance by physicians, patients, health care payors and others in the medical community. |
• | If we are unable to establish sales and marketing capabilities or enter into agreements with third parties to market and sell our product candidates, we may be unable to generate any revenue. |
• | The commercial success of our products is subject to significant competition from products or product candidates that may be superior to, or more cost effective than, our products or product candidates. |
• | We may not be able to protect the confidentiality of our trade secrets, and our patents or other means of defending our intellectual property may be insufficient to protect our proprietary rights. |
• | Patents or proprietary rights of others may restrict our development, manufacturing, and/or commercialization efforts and subject us to litigation and other proceedings that could find us liable for damages. |
• | Our business is dependent on our key personnel and will be harmed if we cannot recruit and retain leaders in our development, administrative, and commercial organizations. |
• | Significant disruptions of information technology systems or breaches of data security could adversely affect our business. |
• | Changes in and failures to comply with United States and foreign privacy and data protection laws, regulations and standards may adversely affect our business, operations and consolidated financial performance. |
• | Our stock price is extremely volatile. |
• | We are currently managing clinical trials in geographies that are affected by the COVID-19 pandemic, in particular in areas that have been impacted by the emergence of COVID-19 variants such as the Delta and Mu variants. While we have not experienced material impacts to our clinical activities through September 30, 2021, we are observing impacts due to COVID-19, including reluctance of subjects to enroll in clinical studies due to the ongoing pandemic, travel restrictions impacting trial enrollment and facility restrictions impacting trial enrollment. We believe that the COVID-19 pandemic, including the emergence of COVID-19 variants, will have a continuing impact on various aspects of our clinical activities in the future. For example, pandemic-related reluctance or restrictions, including stay-at-home in-person at the sites (as per standard practice) and may be required to delay, or alter, their approach to complete this work due to shortages of personnel or diversion of resources at clinical sites or continued government-imposed limitations on activities. Further, our employees and representatives from our contract manufacturing organizations may experience unanticipated challenges sourcing raw materials or producing and distributing sufficient quantities of clinical drug supplies for use in our clinical trials. |
• | We have limited access to our corporate office and requested that most of our personnel, including all of our administrative employees, work remotely, and restricted on-site staff to only those personnel and contractors who must perform essential activities that must be completed on-site. The COVID-19 pandemic could disrupt our ability to secure supplies for our operations. The safety, health and well-being of our workforce is of primary concern and we may need to enact further precautionary measures to help minimize the risk of our employees being exposed to the coronavirus. |
• | Our increased and continuing reliance on personnel working from home may negatively impact productivity, or disrupt, delay, or otherwise adversely impact our business. In addition, this could increase our cyber-security and data privacy risks, create data accessibility concerns, and make us more susceptible to communication disruptions, any of which could adversely impact our business operations, or delay necessary interactions with regulators, contract manufacturers, contract research organizations, clinical trial sites, and other important agencies and contractors, which could result in increased costs to us. |
• | Our employees and contractors involved in conducting our research and development activities may not be able to access their applicable work facilities for an extended period of time as a result of facility closure orders and the possibility that governmental authorities further modify such access restrictions. |
• | The United States Food and Drug Administration (FDA), comparable foreign regulatory agencies, and ethics boards may experience operational interruptions or delays, which could impact timelines for regulatory meetings, submissions, trial initiations, and regulatory approvals. |
• | the rate of progress and cost of our clinical studies; |
• | the need for additional or expanded clinical studies; |
• | the rate of progress and cost of our Chemistry, Manufacturing and Control development, registration, validation and commercial programs; |
• | the timing, economic and other terms of any licensing, collaboration or other similar arrangement into which we may enter; |
• | the costs and timing of seeking and obtaining FDA and other regulatory approvals; |
• | the extent of our other development activities; |
• | the costs of filing, prosecuting, defending and enforcing our patent claims and other intellectual property rights; and |
• | the effect of competing products and market developments. |
• | successful enrollment and completion of clinical trials, including, in the case of RESPONSE, enrollment of sufficient subjects willing to obtain a liver biopsy; |
• | receipt of marketing approvals from the FDA and regulatory authorities outside the United States for the product candidate; |
• | establishing commercial manufacturing capabilities by making arrangements with third-party manufacturers; |
• | launching commercial sales of the product, whether alone or in collaboration with others; |
• | acceptance of the product by patients, the medical community and third-party payors; |
• | effectively competing with other therapies; |
• | a continued acceptable safety profile of the product following marketing approval; and |
• | obtaining, maintaining, enforcing and defending intellectual property rights and claims. |
• | regulators or institutional review boards may not authorize us or our investigators to commence a clinical trial or conduct a clinical trial at a prospective trial site; |
• | the clinical study protocol may require one or more amendments delaying study completion; |
• | clinical trials of our product candidates may produce negative or inconclusive results, and we may decide, or regulators may require us, to conduct additional clinical trials or abandon product development programs; |
• | the number of subjects required for clinical trials of our product candidates may be larger than we anticipate, enrollment in these clinical trials may be insufficient or slower than we anticipate, we may have to compete with other clinical trials to enroll eligible subjects, or subjects may drop out of these clinical trials at a higher rate than we anticipate; |
• | the number of patients in our RESPONSE clinical trial that choose to have biopsies may be insufficient to satisfy regulatory requirements; |
• | clinical investigators or study subjects may fail to comply with clinical study protocols; |
• | trial conduct and data analysis errors may occur, including, but not limited to, data entry and/or labeling errors; |
• | our third-party contractors may fail to comply with regulatory requirements or meet their contractual obligations to us in a timely manner, or at all; |
• | we might have to suspend or terminate clinical trials of our product candidates for various reasons, including a finding that the subjects are being exposed to unacceptable health risks; |
• | regulators or institutional review boards may require that we or our investigators suspend or terminate clinical research for various reasons, including noncompliance with regulatory requirements; |
• | the cost of clinical trials of our product candidates may be greater than we anticipate; |
• | the supply or quality of our clinical trial materials or other materials necessary to conduct clinical trials of our product candidates may be insufficient or inadequate; and |
• | our product candidates may have undesirable side effects or other unexpected characteristics, causing us or our investigators to suspend or terminate the trials. |
• | reluctance of patients to enroll in our clinical trials due to the COVID-19 pandemic; |
• | competition for eligible patients from competing clinical trials; |
• | delays in obtaining regulatory approval to commence a trial; |
• | delays in reaching agreement with the FDA or other regulatory authorities on final trial design; |
• | imposition of a clinical hold following a reported safety event; |
• | an inspection of our clinical trial operations or trial sites by the FDA or other regulatory authorities; |
• | delays in reaching agreement on acceptable terms with prospective contract research organizations (CROs) and clinical trial sites; |
• | delays in obtaining required institutional review board (IRB) approval at each site; |
• | delays in recruiting suitable patients to participate in a trial; |
• | delays in having subjects complete participation in a trial or return for post-treatment follow-up; |
• | delays caused by the need to enroll additional subjects willing to have biopsies in the RESPONSE trial; |
• | delays caused by subjects dropping out of a trial due to side effects or otherwise; |
• | changes to treatment guidelines or the introduction of a new standard of care; |
• | delays caused by clinical sites dropping out of a trial; |
• | time required to add new clinical sites; |
• | delays by our contract manufacturers to produce and deliver sufficient supply of clinical trial materials; and |
• | delays in importing clinical trial materials into foreign countries where our clinical trials are being conducted. |
• | regulatory authorities may withdraw their approval of the product or impose restrictions on its distribution in a form of a risk evaluation and mitigation strategy (REMS) plan; |
• | regulatory authorities may require the addition of labeling statements, such as black box or other warnings or contraindications that could diminish the usage of the product or otherwise limit the commercial success of the affected product; |
• | we may be required to change the way the product is administered or to conduct additional clinical studies; |
• | we may choose to discontinue sale of the product; |
• | we could be sued and held liable for harm caused to patients; or |
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