Definium Therapeutics, Inc. (DFTX)
NASDAQ: DFTX · Real-Time Price · USD
22.48
-0.78 (-3.35%)
At close: Apr 24, 2026, 4:00 PM EDT
22.47
-0.01 (-0.03%)
After-hours: Apr 24, 2026, 7:59 PM EDT
← View all transcripts

Earnings Call: Q3 2022

Nov 10, 2022

Operator

Good day, and welcome to the Mind Medicine third quarter 2022 financial results and corporate update conference call. At this time, all participants are in a listen-only mode. A brief question and answer session will follow the formal presentation. You may press star one at any time during the call if you'd like to ask a question. As a reminder, this conference call is being recorded. It is now my pleasure to introduce your host, Robert Barrow, Chief Executive Officer and Director at Mind Medicine. Mr. Barrow, you may begin your conference.

Robert Barrow
CEO and Director, MindMed Inc.

Thank you, operator, and good morning, everyone. Welcome to MindMed's third quarter 2022 financial results and corporate update conference call. Prior to market open today, we issued a press release with a summary of our results for the third quarter of 2022. The press release reporting our financial results is available in the Investors and Media section of MindMed's website. Our quarterly report on Form 10-Q for the quarter ended September 30th, 2022, is planned to be filed today with the Securities and Exchange Commission. Joining me today is Schond Greenway, our Chief Financial Officer, Dr. Dan Karlin, our Chief Medical Officer, and Dr. Miri Halperin Wernli, our Executive President. During the course of today's call, I will provide an overview and update on our business. Then Schond will review financial results for the quarter ended September 30th, 2022, followed by Q&A.

Before we begin, let me remind you that during this conference call, we will be making forward-looking statements. The company's actual results may differ materially from those expressed in or indicated by such forward-looking statements. For a description of risks, please refer to our recent filings with the Securities and Exchange Commission. During the course of the third quarter, we continued to make significant progress across our business. Beginning with MM-120 or LSD D-tartrate. In the third quarter, we dosed the first patient in our phase II-B dose optimization study of MM-120 for the treatment of generalized anxiety disorder. Study enrollment has continued to progress according to plan. We remain on target for a top-line readout in late 2023.

In September, results from the LSD-Assist Study, which is a phase II placebo-controlled, investigator-initiated clinical trial of LSD in the treatment of anxiety disorders, that was conducted by our collaborators at University Hospital Basel, was published in the peer-reviewed scientific journal, Biological Psychiatry. Top-line results in 46 patients with clinically significant anxiety demonstrated the significant, rapid, durable, and beneficial effects of LSD and its potential to mitigate symptoms of anxiety and depression. Enrollment in our phase II proof of concept trial of low repeated administration of MM-120 in ADHD has also continued to progress and remains on track for a top-line readout in late 2023. With respect to our MM-402 or R-MDMA program, we continue to progress preclinical R&D efforts in preparation for the initiation of a phase I clinical trial in 2023.

Additionally, through our collaboration with University Hospital Basel, in the third quarter, we initiated a phase I pharmacokinetic and pharmacodynamic investigator-initiated trial of R, S, and racemic MDMA in healthy volunteers. This study seeks to assess two dose levels of R-MDMA and one dose level each of racemic and S-MDMA, and we expect will provide valuable insights into the clinical activity of MM-402 as we progress our sponsored development program targeting core symptoms of autism spectrum disorder. Additionally, our external collaborations and early R&D activities have continued to progress, including the investigator-initiated study of LSD in the treatment of major depressive disorder being conducted at UHB.

Our collaboration with the Liechti Lab at UHB continues to offer the opportunity to generate modern, high-quality data demonstrating LSD's clinical activity in brain health disorders and continues to provide useful insights to inform the potential future directions in MM-120's development. We've continued the efforts disclosed in our second quarter earnings call to further streamline our operational and financial efficiency, and we continue to prioritize and focus our current development efforts and resources on MM-120 and psychiatric indications in MM-402. I would also like to take a moment to discuss our intellectual property position and strategy. As we are all aware, LSD in its freebase form was discovered in the 1930s by Sandoz chemist Albert Hofmann. Accordingly, IP is not available on LSD freebase.

However, we believe we have made meaningful improvements and innovations on the original form of LSD and the development of our proprietary product candidate, MM-120. This includes advancements both on the active pharmaceutical ingredient, LSD tartrate, and dosage forms of LSD tartrate that we believe are optimized to meet modern pharmaceutical standards. In the third quarter of 2022, we converted several non-provisional patent applications, which we believe could play a central role in the protection of MM-120. Should the claims in those applications be granted, their first expiry date would be in 2042. We continue to retain all rights to our intellectual property, clinical data, and manufacturing rights that we have filed on our product candidates and will continue to aggressively protect and expand our IP portfolio, seeking to maximize the protection of our product candidates should they eventually be approved for marketing.

I'll now turn to our platform of digital medicine products, which is strategically aligned with our drug development programs and we believe has the potential to facilitate broad and diverse access to our product candidates. Under our MindMed Session Monitoring System or MSMS platform, we've continued to advance our clinical studies and regulatory engagement in the pursuit of eventual approval for elements of MSMS as a software as a medical device product. We look forward to providing further updates as we continue to progress our digital medicine strategy over the months ahead. We're incredibly pleased with the progress in our pipeline, and as we approach the end of 2022, we remain highly focused on the execution of our long-term plan and to reaching key value-driving milestones which are anticipated in the upcoming year.

I will now turn the call over to Schond Greenway, our CFO, who will discuss our financial results.

Schond Greenway
CFO, MindMed Inc.

Thanks, Rob, and thank you all for joining us today. We will now turn to our financial results for the third quarter ended September 30, 2022. As of September 30, 2022, cash and cash equivalents were $154.5 million compared to $133.5 million at December 31, 2021. During the quarter, the company regained compliance with Nasdaq listing requirements as well as completed financings through the use of our ATM facility and a public offering which brought in an aggregate of approximately $60 million in gross proceeds.

We believe these transactions not only brought in large life science institutional investors into the shareholder register, which displays their confidence in both our clear plan for value creation as well as our management team, but also enhanced and strengthened the financial position of the company away from the vagaries of the macroeconomic risks of the current equity markets. We believe that our cash and cash equivalents on hand positions us to accelerate and advance our proprietary pipeline into later stages of clinical development and will be sufficient to meet our operating requirements into the first half of 2025. Our net cash used in operating activities was $37.3 million for the nine months ended September 30, 2022, compared to $38 million for the same period in 2021.

Research and development expenses for the third quarter of 2022 were $7.8 million compared to $9 million for the third quarter of 2021. The decrease was primarily due to external costs related to MM-110 research program and a decrease in preclinical activities, which was offset by an increase in internal personnel costs as we continue to expand in-house research and development capabilities. General and administrative expenses were $9.2 million for the third quarter of 2022 compared to $8.2 million for the same period in 2021. The increase was primarily related to issuance costs related to the company's public offering, which closed during the quarter.

The net loss for the third quarter of 2022 was $16.5 million compared to $17.2 million for the same period in 2021. Lastly, I wish to reiterate that we believe we are continuing to execute on a very efficient operation in terms of quarterly cash burn and compared to our largest peers in the space. As we have previously highlighted during our second quarter of 2022 business update call, we intend to continue to conserve our cash, look for operational efficiencies, in particular our discretionary spending where we can, while also focusing and prioritizing our support to our most precious research and development activities directed towards our key value drivers. I will now turn the call back to Rob, who will provide some closing comments.

Robert Barrow
CEO and Director, MindMed Inc.

Thank you, Sean. As we have demonstrated, the third quarter was marked by steady progress across our development pipeline. We have a highly talented and deeply committed team here at MindMed who have continued to execute on our mission to be a leader in the advancement of novel treatments for brain health disorders. This concludes our prepared remarks, and I would now like to ask the operator to open the line for questions.

Operator

If you would like to ask a question, please press star one on your telephone keypad now, and you will be placed in the queue in the order received. Please be prepared to ask your question when prompted. Once again, if you would like to ask a question, please press star one on your phone now. Our first question comes from Charles Duncan from Cantor Fitzgerald. Please go ahead, Charles.

Charles Duncan
Managing Director and Senior Biotechnology Research Analyst, Cantor Fitzgerald

Yeah. Hi. Good morning, Rob, Sean. Thanks for taking our questions, and congratulations on a good quarter of progress. I had a couple of questions. The first series on MM-120 and the second on R-MDMA. I guess in terms of MM-120, thanks for the update, but I'm wondering if you could provide any additional color with regard to enrollment patterns, either in terms of patients beyond the first one or few, and then the number of sites. If you could help us understand whether or not there's good investigator interest in this study.

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Thanks so much, Charles, and thanks for being here this morning with the questions. We haven't provided, and we're not in a position to provide specific guidance on the number of patients that have been enrolled to date, but enrollment has progressed well beyond the initial patient dosing that we announced in the third quarter. Additionally, sites coming online have continued to progress as well. We have a very clear path and, you know, I believe we will be in a position where all of our sites will be online in the very near term.

In terms of investor engagement, we have very frequent engagement with our investigative sites, with the session monitors who are actually conducting the delivery sessions of our MM-120 treatment sessions or the investigational drug treatment sessions, I should say. We've seen an enormous amount of investigator enthusiasm for this study. We are really optimistic about the enrollment and continually we will be on track to hit our readout in this late part of 2023.

Charles Duncan
Managing Director and Senior Biotechnology Research Analyst, Cantor Fitzgerald

That's helpful, Rob. If I could ask one follow-up on 120, and that is, in this investigator feedback that you referred to, have you heard any interest in other generalized anxiety disorder adjacency indications that you might consider looking at in the future that have even higher unmet need, if you will?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. We've certainly heard both from our investigators and also from key opinion leaders in our scientific advisory board who we just met with them this week. You know, an extraordinary level of engagement and excitement about the potential in a broad range of psychiatric indications. While we are certainly very keenly focused on getting to a GAD approval first, the comorbidity with depression is something that is top of mind for all investigators and all of the CNS researchers and professionals that have been working in this area.

We also, as you all know, we have additional studies ongoing with University Hospital Basel, including a study of LSD in major depressive disorder, which we anticipate we'll have clarity on in terms of timeline results in the coming months. We're very excited to see the continued progress across other indications and to certainly look at the opportunity. We believe the historical data supports the potential beyond just generalized anxiety disorder. There is certainly a massive need in GAD, but also in other therapeutic areas where we believe there's a possibility of pursuing that indication at a later date.

Charles Duncan
Managing Director and Senior Biotechnology Research Analyst, Cantor Fitzgerald

That makes sense to me. If I could hop over to 402 or R-MDMA just quickly. I'm wondering if you could provide some of your perspective on the mechanistic rationale that may differentiate R versus S or racemic MDMA. Then just a little more granularity on timing. I think that you said phase I could be in 2023, which is, you know, a big range. I'm wondering if you think first half or second half.

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Dan Karlin, our Chief Medical Officer, to comment on mechanistically, and I'm happy to add onto that. Dan, do you wanna comment?

Dan Karlin
CMO, MindMed Inc.

Yeah, sure. Happy to, and it's an excellent question. When we look at the differential activity of R/S -MDMA, and of course, racemic just being a mixture of the two, S-MDMA has attribution for dopaminergic effects of racemic MDMA. It seems like the S is largely driving both amphetamine-like activity via dopamine, excuse me, and some of the toxicity like hyperthermia and hyperactivity. That's been demonstrated repeatedly in animal studies. The R-MDMA enantiomer seems to be largely the serotonergic enantiomer of MDMA and responsible for the prosocial and social perception and social communication effects of racemic MDMA.

Given that the core symptoms of ASD that we're targeting really relate to social cognition and social communication, it seems clear to us that the R enantiomer is the right one to target those symptoms. The other thing that's worth pointing out is that the development paradigms currently foR-MDMA relate to its use as an adjunct for psychotherapy, right? An enhancer of the process of psychotherapy. We see our R -MDMA program as being a different mechanistic action.

Rather than enhancing psychotherapy for folks with autism spectrum disorder, we see the R-MDMA program as being more about the on-drug effects in the real world for folks with ASD, so that on R-MDMA, they'll be better able to engage in social behavior, social communication, and have better social perception. It really is a different kind of an entirely different target and different paradigm, different dosing schedule and things like this.

Charles Duncan
Managing Director and Senior Biotechnology Research Analyst, Cantor Fitzgerald

Very, very good. Thanks.

Robert Barrow
CEO and Director, MindMed Inc.

Rob, you wanna comment on-

Charles Duncan
Managing Director and Senior Biotechnology Research Analyst, Cantor Fitzgerald

Any timing?

Robert Barrow
CEO and Director, MindMed Inc.

You covered it well, Dan. Thanks. Yeah, Charles, to your question about timing, you know, at this stage, you know, We have the ongoing study with University Hospital Basel. We do have plans, and we plan to initiate the study in 2023. We would like to see some preliminary results and see if that alters our design or any of the outcome measures that we would want to add or amend in our planned phase I study. We are going to be further refining those timelines and plans. We'll certainly communicate those in the not-distant future once the more precise timelines are available.

Operator

Our next question comes from François Brisebois from Oppenheimer. Please go ahead, François .

Speaker 9

Hi. Thanks for taking the question. This is Dan on for Frank. I had a question just on the R-MDMA program. I'm sorry if I missed this, but could you talk about I think you mentioned one dose each of R and S and two doses of R and S. Could you just talk about the dosing strategy there? Any color there?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah, absolutely. This is a random order, placebo-controlled, double-blind crossover study. There are five treatment arms, including the placebo. Testing doses of 125 mg of racemic MDMA and S-MDMA, and 125 mg and 250 mg of R-MDMA. It's 24 participants. These five different investigational drugs or drug levels will be administered in a randomly ordered sequence in the same patient. We'll get intrapatient responses both in terms of PK and PD between the enantiomers and the racemic mixture.

Speaker 9

Great. Thanks. In your R-MDMA study, are you sharing at this time what core symptoms of ASD you're gonna be looking at, like the ones in the past, social anxiety or any color there?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Social anxiety is certainly the core feature of ASD that we believe would be most aligned mechanistically with MM-402 program and also, you know, the one where we are focused based on the regulatory precedent and the history of research in this area. That is our current expectation, that we would be using similar endpoints as have been used in the past for some breakthrough programs that unfortunately, those programs didn't progress beyond clinical studies. We certainly believe mechanistically, R-MDMA represents a unique pharmacology and opportunity to advance in this population. We look at this historical endpoint and the historical indication language as our primary target for treating core symptoms.

That being principally social anxiety, which is the core targetable innate set of characteristics in ASD that we'd be targeting with this indication.

Speaker 9

Great. Thanks. Finally, just in terms of the digital medicine products that you talked about, are you gonna be using any of these products with the ongoing trials? Are we gonna see any preliminary data, in terms of patient journey or any of that?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Great question. We have ongoing studies. The digital medicine products, the SaMD products in particular that we are developing are not in use in our phase II-B study of MM-120. We do have ongoing studies with our digital medicine products, both looking at a number of molecules, including ketamine and LSD. That's where our collaboration with University Hospital Basel continues to be particularly important because given all the ongoing research, we're able to include those digital medicine assets in some of those ongoing studies in University Hospital Basel. It really gives us a unique opportunity to study both the effects of LSD and various indications and for its mechanistic activity, but also to generate robust data sets for our digital medicine products.

We've seen a really positive engagement with regulatory agencies that would put us in a position to really advance the SaMD approach.

Speaker 9

Thank you. Thanks for taking my questions and congrats on all the progress.

Robert Barrow
CEO and Director, MindMed Inc.

Thanks.

Operator

Our next question comes from Elemer Piros from Roth Capital Partners. Please go ahead, Elemer.

Elemer Piros
Managing Director and Senior Biotechnology Analyst, Roth Capital Partners

Yes, good morning. Rob or Dan, would you please help us to understand what is your IP strategy with R-MDMA, or broadly speaking, if you cannot be any more specific?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Absolutely. Elemer, it's a great question. I think, you know, a lot of the discussion around intellectual property is fairly consistent across any of these molecules that have been researched in the past. There's certainly some basic. You know, R-MDMA is not a molecule that we discovered clearly, right? MDMA has been studied for a long time. The two enantiomers have been looked at individually historically. That said, methods of using R-MDMA in indications, we have data that we have generated that, you know, certainly gives us excitement about our IP approach, both in terms of those methods of use, but also, in terms of things such as for formulation, intersection with our digital medicine intellectual property.

As with most of these molecules and as with outside of the psychedelic drug class, and inside it, when there's a molecule that has been studied historically and there's not composition of matter on the baseline API, we build sort of a multilayered fortress approach to protecting our market share, and that would rely on marketing exclusivity from FDA, having patents that we believe are differentiated both in terms of the delivery, the formulation, and the methods of use.

You know, getting those patents Orange Book-listed and utilizing the mechanisms available to us to get stays for any potential generic entrants and ultimately exercise any of the IP protection mechanisms both inside and mediated by FDA and extra FDA IP protections that are afforded to us through the courts and the ability to take action against any potential entrants at a later date.

Elemer Piros
Managing Director and Senior Biotechnology Analyst, Roth Capital Partners

Okay. Would you be a little bit more specific of what, sort of information would come out from the PK/PD trial conducted in Switzerland that would help you to design the phase I? What is your hypothesis there?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah, absolutely. As was asked before, the core focus of treating core symptoms in autism spectrum disorder is social anxiety, and this is something where we see the prosocial effects of R-MDMA in preclinical models. We know, you know, racemic MDMA, as it's studied in the clinic, is described as an empathogen and enhances prosocial engagement. Our expectation or our hypothesis here would be that R-MDMA would demonstrate that sort of prosocial effect in healthy volunteers.

This is really important to highlight that, while, autism spectrum disorder is clearly an indication where there's a great unmet need or no available therapies for the treatment of core symptoms of ASD, you know, it is one where it is not a disease so to speak like you would think of a, you know, underlying physiological condition that is totally distinct in terms of its physiology from healthy volunteers. I know that that's it certainly is an indication, a disorder that is again, clinically relevant, has a major impact on patient lives. I wanna be clear that we certainly respect all of the implications of an ASD diagnosis.

Unlike some indications such as, you know, an oncology indication where you couldn't understand the activity of an oncology drug in a healthy volunteer for its pharmacodynamic activity, we believe that in the healthy volunteers, by looking at those prosocial effects and by targeting the social communication skills, which are, again, the core focus of an ASD indication, that we would be able to potentially see those exact kind of pharmacodynamic effects in healthy volunteers.

We believe that based on this disorder in particular, there's a reasonable likelihood of sort of read-through effect that we could glean from a phase I study in healthy volunteers that would both inform the design and also potentially give us some positive preliminary signs of optimism at a minimum for the potential effects in treating social communication in ASD.

Elemer Piros
Managing Director and Senior Biotechnology Analyst, Roth Capital Partners

Do you believe that you might be able to, based on the results from Basel, enter into a trial in autism patients with your IND in the U.S.?

Robert Barrow
CEO and Director, MindMed Inc.

Certainly at some stage. Some of that's going to depend on regulatory discussions that we have with the regulatory authorities in the countries where we would potentially conduct our phase I study. You know, there's sometimes the ability to go into phase I studies in patient populations. That is not something that we have guided to or you know set plans to definitively. Certainly we're looking to generate early signs of efficacy across indications as quickly as we possibly can.

The ability to get phase I data and get PK/PD data in healthy volunteers with R-MDMA at 2 different doses should be quite informative in terms of how we design our phase I program and the population we're targeting and as you mentioned, going into the ASD population by phase II.

Elemer Piros
Managing Director and Senior Biotechnology Analyst, Roth Capital Partners

Yes. Thank you so much, Rob.

Operator

Our next question comes from Patrick Trucchio from H.C. Wainwright. Please go ahead, Patrick.

Patrick Trucchio
Managing Director of Equity Research, H.C. Wainwright & Co.

Thanks. Good morning. Just a couple of follow-up questions on the MM120 program. First, I'm wondering if you can discuss some of the similarities and differences between the recently published phase II placebo-controlled investigator-initiated trial with LSD and anxiety as compared to the MindMed sponsored phase II-B trial with MM120 for treatment of generalized anxiety disorder, and how much of a read-through could we expect from this investigator-initiated study to the phase II-B trial?

Robert Barrow
CEO and Director, MindMed Inc.

Absolutely. Thanks so much, Patrick. Thanks for the question. I'll ask Dan to comment. I'll give you initial response. In terms of read-through effect, I think one thing that's really critically important to sort of understand here is that, you know, the aggregate of clinical information is particularly important, right? As you look back to the last roughly 80 years of research on LSD, we've seen consistent responses in anxiety, depression, and neurotic illness. This is in hundreds of patients in over 20 studies and we see a consistent response. When we then see modern, high quality, well conducted and well controlled investigator-initiated study that confirms those historical effects, it gives us a high degree of confidence and optimism.

One of the differences in terms of the phase, the IIT conducted by Dr. Liechti at University Hospital Basel and our phase II-B study, the number of elements are a bit different, but one of the central ones is the endpoint that's used. In their study, they used the State-Trait Anxiety Inventory, which is something that we believe from the literature is quite relevant in terms of demonstrating that we are seeing reduction in anxiety symptoms. The difference there is that it is not a regulatory endpoint, and so its utility in terms of being the basis for a regulatory application or approval is just frankly not there.

We've had very productive discussions with FDA about where this would fit in the overall development and evidence base. There's sort of this tension between what we know can see clinically and the observations from investigator-initiated studies, such as the one you mentioned by Dr. Liechti, and what's required by FDA. FDA is gonna require us to use the Hamilton Anxiety Scale, which is the scale that's been used historically for all anxiolytics, and that's what we are using in our phase II-B study. Dr. Liechti's study, again, using the STAI or the STAI-G as the endpoint. From the literature, we also know there's a high degree of response consistency.

While that gives us an incredible amount of internal comfort and optimism about the likelihood of success for phase II-B clinical trial, it really is an important point to emphasize that the nuance here is what is required by FDA and what that means in terms of the evidence base that we have today in their eyes. The other aspect I would touch on briefly is that we are conducting you know from a design and statistical standpoint what is a very patient- and subject-number-efficient clinical trial design that allows us to have 40 patients per arm across five arms, four different levels of LSD or excuse me, MM-120.

That, again, gives us an extraordinary opportunity to see the dose response in a patient population. Now we have seen historically, you know, we've seen dose response in healthy volunteers in terms of the pharmacodynamic response, the PK response. This is one of the interesting things about a PD response. When we measure it by, you know, the overall drug effect or the Mystical Experience Questionnaire is that, you know, we're asking patients to, or excuse me, in this case, we're asking healthy volunteers to quantify something that is supposedly ineffable, which is sort of a paradoxical thing. While it's also really important to emphasize the positive results we observed at a high dose level, the highest dose we're testing is 200 micrograms, and that was the dose used in Dr.

Liechti's study. What we saw at the highest dose we're testing, a clinical response, is critically important that we define the response on a regulatory endpoint in the population of interest in patients with generalized anxiety disorder. That's what we're robustly doing in phase II-B trial. It really builds on the historical phase I and phase II investigator-initiated studies that we have exclusive access to through Dr. Liechti and our collaboration with UHB. It really ties this all together in our phase II-B study with endpoints that would meet regulatory requirements, we believe, with a design that gives us a very efficient look at how we demonstrate clinical activity in the population of interest.

Ultimately with a clear path and a design that we believe will be leveraged into a pivotal program. We have designed phase II-B study with the phase III study in mind and believe that the evidence generation in this study would give us a very strong argument data set and a clear pathway to have negotiations with the FDA about a pivotal program.

Patrick Trucchio
Managing Director of Equity Research, H.C. Wainwright & Co.

Yeah. That, that's really helpful. Just as a point of clarification, just the decision to move ahead with phase II-B study instead of moving directly into a phase III pivotal program, can you just talk about, you know, how those discussions with the FDA have been ongoing, why the program wouldn't have been able to kind of progress directly to a phase III pivotal, you know, following that investigator-initiated trial?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Many of the points that I just mentioned are sort of the obvious factual basis. I think, you know, certainly we've had very productive regulatory engagements. We have great regulatory expertise. I've had the good fortune of engaging with FDA and Division of Psychiatry on numerous occasions, right, in terms of developing the psychedelic drug class. That has given us very, you know, clarity in terms of what is expected. You know, I think you could also look at one of our peer companies, Compass Pathways. Obviously, they had phase II-B study, and they're still conducting two pivotal phase III studies. You know, while in some disease areas, you might be able to jump right into a pivotal study.

I've had those discussions directly with senior leadership in the division of psychiatry at FDA about what's gonna be expected. They've given this field a nice opportunity to go straight into phase II studies. It's important to remember most of the times with drug development, you have to go into a preclinical package. You have to go to phase I, and then you go to phase II, and you do a few phase II studies, and then you're able to go to a pivotal study. They've allowed us to go directly into phase II without doing some of that historical work. They've made it very clear that they expect a comprehensive data package at the time of NDA submission.

Just at face, you know, it's not realistic, and it's really sort of a naive thought that, you know, a program's first clinical trial could be one of the pivotal studies. This is not something that we believe is a realistic pathway for any molecule that's going to be used in a broad population in an indication that is highly prevalent, that's gonna have a lot of exposure in the real world.

Patrick Trucchio
Managing Director of Equity Research, H.C. Wainwright & Co.

Yeah. That makes sense. I had a follow-up, actually, just the last one on this, on the one you were alluding to earlier, just around the COMP360 program. It's a different drug, different mechanism and indication, TRD. Here, we're looking at anxiety. I'm curious what the read-through has been from those discussions there and with the pivotal program now getting underway. As well, just in terms of the number of patients that are having to be enrolled there in both phase II-B as well as the phase III program. Presumably this is as well to build up a substantial safety database as well.

I'm just curious on your thoughts on kinda how the FDA is thinking about kind of pivotal programs with classic psychedelics. What read-through is there from COMP360 and the number of patients that are gonna be needed to build out that safety database.

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Another great question, Patrick. We always try to rely on regulatory precedent. Regulatory precedent is something that's particularly important in our field because FDA has, to an extent, or certainly has broad leeway in terms of their discretion to determine the adequacy of a package and ultimately the approval of a marketing application. We think psychiatry has done a really nice job at balancing the ability to both enable research to progress at a good pace, but also require a robust data set.

It's something that Dan Karlin and I came into MindMed beginning of 2021, something that from day one and from the first pre-IND engagement we had with FDA, which actually pre-dated my employment, which was conducted in December of 2020 that I worked on closely with Dr. Halperin Wernli. From that very first engagement, our approach has been to plan for a comprehensive research and development program. We believe that builds credibility both for our organization and builds our profile of both MindMed and the program with FDA and broadly with the entire community of stakeholders. Our expectation is that we're gonna be doing a comprehensive pivotal program.

Now one of the things that is certainly you know important to emphasize is that strategy and geographic focus and the number of countries in which a trial has been conducted and ultimately seeks marketing application and the sequencing of that also has an implication in terms of patient sizing the design of clinical trials. While we've gotten you know a read-through of and clarity on what the phase III program is, we don't have the regulatory minutes or knowledge of the discussions that have been had with FDA or other competent authorities for instance in European Union that would potentially inform how COMPASS Pathways for instance was thinking about their clinical program. Certainly we anticipate to conduct two pivotal clinical trials of MM-120 in generalized anxiety disorder.

We again had productive regulatory discussions. I believe we have a good degree of clarity in terms of the overall expectations. Those will be firmed up as we complete phase II-B study. Based on the evidence we generate there and based on our continued regulatory negotiations, we will in the phase II meeting certainly try to have greater clarity in exactly what our pivotal program would be. You know, whenever there's a precedent established, we certainly pay very close attention in trying to unpack the rationale.

I think we would approach a few things a little differently, and we believe that MM-120 is going to have a multi-month effect, and we wanna demonstrate what happens over the acute course and over that longer duration. We've seen from the UHB study many months of reduction in anxiety symptoms, and so we're highly confident in that, you know, many months response level, and that's gonna inform how we think about the core pivotal trials and how we think about other trials that may be required either as part of the phase III package or as a post-approval clinical trial that would inform what happens on retreatment and the ability to maintain or retreatment a potential relapse.

'Cause these agents certainly are not gonna be curative in all patients, and that would be an unreasonable expectation. We need to develop a strategy for the long term, how we can safely and effectively both treat the acute situation, but also maintain that effect over a period of time.

Patrick Trucchio
Managing Director of Equity Research, H.C. Wainwright & Co.

Yep. That, that's really helpful. Thank you so much.

Robert Barrow
CEO and Director, MindMed Inc.

Thanks, Patrick.

Operator

Our next question comes from Sepehr Manochehri from Eight Capital. Please go ahead, Sepehr.

Sepehr Manochehri
Partner and Principal Analyst, Eight Capital

Thanks, and good morning. Thanks for taking my question. I noticed you mentioned some of the studies ongoing on the SAMD side of things and want to get your thoughts on how that will wrap around into whether it's ahead of your phase III program or if that's something that's gonna basically be in the package to then submit for potential REMS. Just trying to understand when that data and those studies kind of add value to the programs and how you think about the readouts there.

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. It's really important that it's emphasized that there are two discrete pathways by which products are approved. Thanks so much, Sepehr, for the question, I should say first. You know, we obviously engage CDER and the division of psychiatry for the development of our drug product candidates. For our digital SaMD products, we're engaged with CDRH and at least those that are being developed as SaMD products. We're engaged with CDRH, which is the device division that reviews including any devices, including SaMD products.

We've had the really productive engagement, including with joint meetings with CDRH and CDER, which have informed our overall development strategy, both in terms of the digital medicine products independently, but also our longer term thoughts and strategy about how these digital SaMD products could be integrated and married up with our drug products, in particular MM-120. We have not, you know, gotten to a point in those negotiations or regulatory discussions where we can say that there's a precise moment in time where we would include those two or try to have them labeled together from a regulatory standpoint.

Certainly we are making rapid progress on the SaMD device, side of the equation, and certainly have a view to include those and integrate those with our drug development strategy as we enter our pivotal study. The sequencing of how those could be used, whether it's, you know, together labeled separately but used together in a real-world delivery setting, subject to both of those products being ultimately approved for marketing, or whether it's, you know, a sequence approach to getting them co-labeled. That's something that sequencing is what is top of mind and top of our regulatory discussions at this point. Something that we absolutely intend to do in the long term is to have our digital products directly integrated with the delivery of our drug products.

In so doing, trying to address some of the key gaps in the delivery of psychedelic drug class. Things such as the high labor intensity that is required in clinical trials for the delivery or dosing session, the scalability and, you know, we saw a recent article from Bertha Madras commenting on the results from COMPASS Pathways. One of the things we felt was a particular opportunity when we think about scalability. Dr. Madras mentioned, you know, in the real world, how tightly controlled clinical delivery, both in terms of psychotherapy and the labor-intensive observation, is very hard to scale. We agree with that view.

We don't agree with some of the other points made, but we would certainly agree with the view that that is something that needs to be addressed. We believe the right approach to address that is by adding tools that can innovate and can allow the more efficient delivery of the drug. If we were to say, you know, we're going to just try to scale a multi-hour, highly degreed two individuals with medical degrees sitting in a room with a patient, that's gonna be very difficult.

If we can come up with ways to safely make that process more efficient, make observation more efficient, make time of observation in a clinic more efficient and more personalized, these would be meaningful improvements that we believe would substantially enhance the drug uptake and would be, you know, really unlock the potential to deliver the psychedelic drug class and what we believe is our aim with our SaMD products.

Sepehr Manochehri
Partner and Principal Analyst, Eight Capital

Got it. That's kind of on top of mind in terms of pinning down the sequence there. In terms of the anticipated results around those, like I know the QPEPS program's in use, is that something that you anticipate in the coming year? Any of these in-use studies or the beta studies getting some data as to kind of the applications? Hello?

Robert Barrow
CEO and Director, MindMed Inc.

Oh, apologies. We certainly anticipate that across the digital programs we have, and in particular the MSMS platform studies, that we would be making announcements as we progress those programs. While we haven't given a precise or quarterly guidance when those data announcements would be, we will have certainly more to announce in the near term and are very excited to do so.

I think when we make that announcement, it will be with a lot more, you know, with a lot of clarity in terms of, the scope of the potential, the data we've been generating and exactly how that dovetails both with our product candidates and with other substances that have perceptual effects, that have been approved by FDA and that, you know, require an observation period. So we believe our clinical research and some of the things we'll be announcing over the coming months would be very clear how it leverages current research with approved psychiatric therapies and how that could be a great analogy for how we can scale this into the utilization with our MM120 product candidate in particular.

Sepehr Manochehri
Partner and Principal Analyst, Eight Capital

Oh, I look forward to that. Just on the MM120, I know you've talked about some of the wraparound, whether it's some of the digital health assets or, things that you guys can do to differentiate your offering. I want to ask about TripSitter. I know ketanserin was, I guess, in an investigator-initiated trial in the past that was completed. Is that something that could be paired with the kind of delivery that you guys think about, whether it's for the REMS program down the line or whether data for that could help in your, in filing eventually down the line? Like how do I think about that and how that folds into the MM120 program?

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. At this point, we don't have an intent to have, you know, a co-labeled product with a serotonin 2A receptor antagonist. Here in the U.S., ketanserin is not approved, pimavanserin is, and by Acadia Pharmaceuticals. You know, there's certainly, you know, a potential that we could at some point in the future pursue further research there. It's mechanistically quite interesting and important to understand if there is an ability to abruptly terminate the effects or the perceptual effects of MM120 or other psychedelics that are serotonin agonists.

That would require in order to have that as a directly targeted for that use, it would require clinical research and a label expansion or an initial labeling in the case of marketing application in the case of ketanserin. At this point, that's not something we're pursuing. We're always, as we get more data, we you know, obviously develop our strategy and research development plans accordingly. As we have continued progress in the clinic and we get more data, that can certainly inform future direction. At this stage, it is an interesting research study, but not something that we have in the product candidate we are actively developing.

Sepehr Manochehri
Partner and Principal Analyst, Eight Capital

Okay. Well, thanks for the insight there and congrats on the continued development progress. Appreciate the level of detail here.

Robert Barrow
CEO and Director, MindMed Inc.

Yeah. Thanks so much, Todd.

Operator

This concludes the question and answer portion of the call. I'll now turn the call back over to MindMed's CEO, Rob Barrow, for closing remarks. Rob?

Robert Barrow
CEO and Director, MindMed Inc.

Yes. Thank you, operator, and really thank you to everyone who joined us today and to all the analysts for the great questions. I'd also like to thank our entire team. As I said, we have a highly talented and dedicated team here at MindMed, and we're you know very grateful for their incredible efforts to advance our research and development programs. I wanna thank our investors and all the people who have been supportive to MindMed along the way and continue to be supportive as we execute on our strategy to provide meaningful impact in the development of novel treatments for brain health disorders. I also wanna thank the investigators and study participants and their families. This is a you know a.

We're doing research in populations that have significant impact. There's a massive unmet medical need, and we believe we can have a meaningful impact in these populations, and it can't be done without the dedicated researchers and the patients who volunteer their time and go through all of the extensive work in a clinical trial to conduct these studies. A very direct thank you to all of them. We're very excited to continue our study. We're very excited for the year ahead. Thank you all for being here today, and we look forward to providing further updates soon.

Operator

This concludes today's conference call. Thank you for attending.

Powered by