On May 8, 2023 DURECT Corporation (Nasdaq: DRRX) reported financial results for the three months ended March 31, 2023 and provided a corporate update (Press release, DURECT, MAY 8, 2023, View Source [SID1234631137]).
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"We are rapidly approaching the completion of enrollment in our Phase 2b AHFIRM trial later this quarter and remain on track to report topline data in the second half of 2023. We are preparing to file an NDA for larsucosterol in alcohol-associated hepatitis (AH) if the AHFIRM trial outcome is positive and are in the early stages of commercial launch planning in the U.S.," stated James E. Brown, D.V.M., President and CEO of DURECT. "If approved, larsucosterol would be the first FDA-approved treatment for AH. We also are pleased that an article describing our Phase 2a data in AH has been published online in The American Journal of Gastroenterology. This peer-reviewed publication provides further insight into the efficacy and safety of larsucosterol in AH and underscores the insufficiency of current treatment approaches for this highly lethal disease."
Recent Business Highlights:
• AHFIRM approaching completion – DURECT has enrolled more than 285 patients in the AHFIRM trial to date,
which exceeds 95% of the target enrollment for the 300-patient trial. We have enrolled patients at leading hospitals in the U.S., Australia, E.U. and U.K., including prominent transplant centers. We continue to expect to complete enrollment in the AHFIRM trial in the second quarter of 2023, which should enable topline data to be reported in the second half of 2023.
• Peer-reviewed publication of Phase 2a trial of larsucosterol in AH – Additional data from our previously
completed Phase 2a trial evaluating larsucosterol in AH was recently published online by The American Journal of Gastroenterology. In addition to previously reported safety and efficacy data from the 19-patient, open label Phase 2a trial, the publication includes individual patient data and additional liver biomarker data as well as cross-study comparisons of severe AH patients from the Phase 2a trial with two matching comparison arms from a contemporaneous study conducted by the DASH (Defeat Alcoholic Steatohepatitis) Consortium.
• Upcoming AH Key Opinion Leader (KOL) Event – DURECT announced that it will be hosting a KOL event for
investors on May 16, 2023 at 12 p.m. ET in New York City. The event will include presentations by Dr. Paul Gaglio and Dr. Brett Fortune, as well as members of our senior leadership team.
Financial Highlights for Q1 2023:
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Total revenues were $2.1 million and net loss was $12.0 million for the three months ended March 31, 2023 compared to total revenues of $1.9 million and net loss of $10.8 million for the three months ended March 31, 2022.
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At March 31, 2023, cash, cash equivalents and investments were $44.4 million, compared to $43.6 million at December 31, 2022. Debt at March 31, 2023 was $21.3 million, compared to $21.2 million at December 31, 2022.
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In February 2023, we completed a registered direct offering of common stock and warrants with a leading institutional healthcare investor and an existing institutional investor. The offering raised net proceeds from the financing of approximately $8.8 million.
Earnings Conference Call
We will host a conference call today at 4:30 p.m. Eastern Time/1:30 p.m. Pacific Time to discuss first quarter 2023 results and provide a corporate update:
Monday, May 8 @ 4:30 p.m. Eastern Time / 1:30 p.m. Pacific Time
Toll Free: 1-877-869-3847
International: 201-689-8261
Conference ID: 13738577
Webcast: View Source
A live audio webcast of the presentation will be also available by accessing DURECT’s homepage at www.durect.com and clicking "Investors." If you are unable to participate during the live webcast, the call will be archived on DURECT’s website under "Event Calendar" in the "Investors" section.
About the AHFIRM Trial
Enrollment is ongoing in our Phase 2b randomized, double-blind, placebo-controlled, international, multi-center study in subjects with severe acute alcohol-associated hepatitis (AH) to evaluate saFety and effIcacy of laRsucosterol treatMent (AHFIRM). The study is comprised of three arms targeting enrollment of 300 total patients, with approximately 100 patients in each arm: (1) Placebo plus supportive care, with or without methylprednisolone capsules at the investigators’ discretion; (2) larsucosterol (30 mg); and (3) larsucosterol (90 mg). Patients in the larsucosterol arms receive the same supportive care without steroids. In order to maintain blinding, patients in the two active arms receive matching placebo capsules if the investigator prescribes steroids. The primary outcome measure will be the 90-Day incidence of mortality or liver transplantation for patients treated with larsucosterol compared to those treated with placebo. The Company has enrolled patients at clinical trial sites across the U.S., EU, U.K., and Australia. Reflecting the life-threatening nature of AH and the lack of therapeutic options, the U.S. Food and Drug Administration (FDA) has granted larsucosterol Fast Track Designation for the treatment of AH. We believe a positive outcome in the AHFIRM trial could support a New Drug Application filing. For more information, refer to ClinicalTrials.gov Identifier: NCT04563026.
About Alcohol-associated Hepatitis (AH)
AH is an acute form of alcohol-associated liver disease (ALD), associated with long-term heavy intake of alcohol and often occurs after a recent period of increased alcohol consumption (i.e., a binge). AH is typically characterized by severe inflammation and destruction of liver tissue (i.e., necrosis), potentially leading to life-threatening complications including liver failure, acute kidney injury and multi-organ failure. There are no FDA approved therapies for AH and a retrospective analysis of 77 studies published between 1971 and 2016, which included data from a total of 8,184 patients, showed the overall mortality from AH was 26% at 28 days, 29% at 90 days and 44% at 180 days. A subsequent global study published in December 2021, which included 85 tertiary centers in 11 countries across 3 continents, prospectively enrolled 2,581 AH patients with a median Model of End-Stage Liver Disease (MELD) score of 23.5, reported mortality at 28 and 90 days of approximately 20% and 31%, respectively. Stopping alcohol consumption is necessary, but frequently not sufficient for recovery in many moderate (defined as MELD scores of 11-20) and severe (defined as MELD scores >20) patients and the use of treatments to reduce liver inflammation, such as corticosteroids, are limited by contraindications and have not been shown to improve survival at 90 days or one year, and have demonstrated an increased risk of infection. While liver transplantation is becoming more common for ALD patients, including AH patients, the total number of such transplants is still relatively small. Average charges for a liver transplant exceed $875,000, and patients require lifelong immunosuppressive therapy to prevent organ rejection.
About Larsucosterol
Larsucosterol is an endogenous sulfated oxysterol and an epigenetic modulator. Epigenetic regulators are compounds that regulate patterns of gene expression without modifying the DNA sequence. DNA hypermethylation, an example of epigenetic dysregulation, results in transcriptomic reprogramming and cellular dysfunction, and has been found to be associated with many acute (e.g., AH) or chronic diseases (e.g., NASH). As an inhibitor of DNA methyltransferases (DNMT1, DNMT3a and 3b), larsucosterol inhibits DNA methylation, which subsequently modulates expression of genes that are involved in cell signaling pathways associated with stress responses, cell death and survival, and lipid biosynthesis. This may ultimately lead to improved cell survival, reduced inflammation, and decreased lipotoxicity. As an epigenetic modulator, the proposed mechanism of action provides further scientific rationale for developing larsucosterol for the treatment of acute organ injury and certain chronic diseases.