Good morning. My name is Josh, and I'll be your conference operator today. At this time, I would like to welcome everyone to the EyePoint Pharmaceuticals Q1 2022 Financial Results and Recent Corporate Developments conference call. There will be a question and answer session to follow at the completion of the prepared remarks. Please be advised that this call is being recorded at the company's request. I would now like to turn the call over to George Elston, Chief Financial Officer of EyePoint Pharmaceuticals.
Thank you, Josh, and thank you all for joining us on today's conference call to discuss EyePoint Pharmaceuticals' Q1 2022 financial results and recent corporate developments. With me today are Nancy Lurker, President and Chief Executive Officer, Dr. Jay Duker, Chief Operating Officer, and Scott Jones, Chief Commercial Officer. Nancy will begin with a review of recent corporate updates. Dr. Duker will then discuss clinical plans for EYP-1901, and Scott will comment on our Q1 2022 commercial performance. I will close with commentary on Q1 financial results, and then we'll open up the call for your questions. Earlier this morning, we issued a press release detailing our financial results as well as commercial and operational developments. A copy of the release can be found in the Investor Relations tab on the company website, www.eyepointpharma.com.
Before we begin our formal comments, I'll remind you that various remarks we will make today constitute forward-looking statements for the purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. These include statements about our future expectations, clinical developments and regulatory matters and timelines, the potential success of our products and product candidates, financial projections, and our plans and prospects. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the Risk Factors section of our most recent annual report on Form 10-K, which is on file with the SEC, and other filings that we may make with the SEC in the future. Any forward-looking statements represent our views as of today only.
While we may elect to update those forward-looking statements at some point in the future, we specifically disclaim any obligation to do so, even if our views change. Therefore, you should not rely on these forward-looking statements as representing our views as of any date subsequent to today. I'll now turn the call over to Nancy Lurker, President and Chief Executive Officer of EyePoint Pharmaceuticals.
Thank you, George, and apologies for my hoarse voice. I'm still getting over a cold. Good morning, and I do want to thank you for joining us to discuss the very solid progress EyePoint made in Q1 of 2022. Our team has maintained the positive momentum we had in 2021 and now into 2022, and the company continues to be well-positioned to create long-term value for our shareholders, particularly should subsequent clinical trials for EYP-1901 report out positively. We are keenly focused to execute on our goal of becoming the leader in ocular drug delivery. In Q1 , EyePoint presented additional validating clinical results of our ongoing phase I trial for our lead pipeline program, EYP-1901, while simultaneously advancing two strategic corporate initiatives, refinancing our debt and our just-announced enhanced agreement with Betta Pharmaceuticals.
We also made important leadership hires that position the company for long-term successful growth that encompasses our overarching mission of improving the lives of patients with serious eye disorders and bringing our innovative products to patients in the United States and around the world. Prior to turning the call over to my colleagues, I'd like to highlight a few of our achievements in 2022 so far. I'm incredibly pleased with the team's consistent execution of our phase I DAVIO clinical trial for our lead pipeline asset, EYP-1901, in wet AMD. As many of you know, wet AMD is a serious and potentially devastating eye disorder, accounting for approximately 90% of all AMD-related blindness. Despite these safe and effective FDA-approved medications on the market, treatment adherence remains an ongoing challenge for patients and physicians.
Currently, most patients with wet AMD are treated every month or every other month with eye injections. EYP-1901, which is a combination of the small molecule TKI vorolanib and our proprietary bioerodible drug delivery technology, Durasert, has the potential to transform the currently burdensome treatment paradigm for many wet AMD patients. EYP-1901 may be able to provide the substantial benefit of a longer duration between physician office visits and eye injections of up to six months while maintaining stable visual acuity and macular anatomy. We believe, based on our interim Phase I DAVIO clinical trial results, that a majority of patients can potentially be maintained with EYP-1901 for up to six months with no supplemental therapy after an initial induction period with traditional anti-VEGF drugs. Under this treat to maintain treatment paradigm, EYP-1901 provides a number of potential benefits.
A new mechanism of action using vorolanib, an anti-VEGF tyrosine kinase inhibitor, zero-order kinetics delivery that provides consistent, stable release of vorolanib, and the potential ability to sustain a majority of patients up to 6 months while potentially significantly reducing the treatment burden for patients with wet AMD. As Jay will discuss in more detail later in the call, we continue to be pleased with the ongoing phase I DAVIO trial results, which showed positive safety data with no significant inflammation, as well as promising efficacy data at the 6- and now 8-month follow-up so far. We look forward to announcing our 12-month phase I DAVIO data at ASRS in July of this year. Looking ahead, we expect to initiate our phase II clinical trial for EYP-1901 in wet AMD in Q3 of 2022, and we anticipate interim 6-month results in H2 of 2023.
I'd like to thank the entire EyePoint team for their tireless work focused on bringing this innovative technology to as many patients as quickly as possible. We look forward to sharing additional updates this year on EYP-1901's exciting progress. In addition to advancing the phase two clinical trial of EYP-1901 for wet AMD, we are preparing to expand this innovative treatment to additional indications with a phase two study of EYP-1901 for non-proliferative diabetic retinopathy, or NPDR, beginning in the second half of this year. Along with our focus on development of EYP-1901 in the U.S., we continue to consider our options for partnering outside of North America. This quarter, we entered into an agreement to develop and commercialize EYP-1901 in China and other selected Asian territories with Betta Pharmaceuticals.
This extension of our current partnership was already contemplated as part of our 2020 agreement with Betta, where we secured vorolanib, a critical component of EYP-1901. In addition, we expanded our rights to local delivery of vorolanib for all of ophthalmology, including DME. We look forward to continuing our work with Betta, and we also look to additional partnering opportunities outside of North America at the appropriate time. Regarding our commercial products, we had a strong Q1 with $9 million in net product revenues, an increase of 32% from Q1 of last year, along with strong customer demand for both YUTIQ and DEXYCU. This strong start to 2022 supports our strategy for the commercial business franchise to achieve breakeven status this year.
Additionally, we wanted to share an update on our phase III trial of YUTIQ 50, a potential six-month sustained delivery for posterior segment of the eye. The FDA has recently updated the regulatory requirements for ophthalmic drug and device combination products such as YUTIQ. These regulatory changes now require EyePoint to complete an additional clinical trial for YUTIQ 50 beyond what was originally communicated for the planned post-approval NDA supplement, resulting in a significant increase in the program's anticipated cost. As a result, we've made the decision to pause enrollment for this study until we can reassess and determine if there's a path forward. I would like to emphasize that this decision is driven by financial considerations only. We still believe in the safety of YUTIQ 50 and its potential clinical utility, given the proven track record of YUTIQ 180.
Despite this, as an organization, we recognize that we must take a disciplined approach to our pipeline investments and continue to focus our resources on EYP-1901's clinical development. I'd also like to add that we remain committed to serving the posterior segment uveitis patient community with YUTIQ 180 and learning more about this serious eye disorder to improve patient outcomes through our ongoing YUTIQ CALM registry study, which is the first and only registry trial for posterior uveitis, and our YUTIQ phase 4 SYNCHRONICITY study, which is a prospective open-label, uncontrolled, 2-year follow-up study designed to evaluate the safety and efficacy of the YUTIQ 180 intravitreal implant for posterior segment uveitis. We plan to update the scientific and patient community on these important studies in the months to come.
As you'll hear from George later on, we remain well-capitalized to execute on our pipeline, and we remain focused on EyePoint's financial health and cash runway. This included a debt refinancing in Q1 with Silicon Valley Bank, which provided the company with a significant interest rate improvement, resulting in approximately $2.8 million of annual interest savings. Finally, we made important leadership appointments in the first quarter, building out our growing team with 2 new industry veterans. Earlier this year, we were very pleased to announce the appointment of Michael C. Pine as Chief Corporate Development and Strategy Officer. He brings more than 20 years of business development and strategy experience to EyePoint Pharmaceuticals, and we are thrilled to have him on board during this exciting time in the company's evolution. Recently, EyePoint also appointed Isabelle Lefebvre as Chief Regulatory Officer. Ms.
Lefebvre brings over thirty years of global regulatory affairs experience across all phases of drug development, especially in ophthalmic conditions, and we look forward to receiving her guidance on FDA-related matters and global regulatory strategies. I'd like to thank the talented EyePoint team for our company's clinical, operational, and financial success to date. As we advance the future of sustained ocular drug delivery, we look forward to executing on multiple near-term clinical catalysts so that we can deliver improved ocular treatment and ultimately create a better future for patients living with serious eye disorders. I'll now turn the call over to Dr. Jay Duker, our Chief Operating Officer, to provide an update on our lead program, EYP-1901, as well as other pipeline initiatives. Jay?
Thank you, Nancy, and good morning, everyone. Before I begin, I want to reiterate what an exciting time this is as our team is poised to execute on multiple clinical catalysts this year as we advance our pipeline. As Nancy stated earlier, we are quite pleased with the results of our Phase I DAVIO clinical trial for our lead pipeline program, EYP-1901, an investigational sustained release delivery treatment for wet age-related macular degeneration, being studied as a maintenance therapy following induction therapy with an anti-VEGF. A therapeutic approach which we refer to as Treat to Maintain. The largest unmet need in the wet AMD landscape is longevity of action of anti-VEGFs.
Our goal is to sustain the majority of wet AMD patients' treatment interval up to six months or longer after a single injection of EYP-1901, allowing patients and practitioners the flexibility to safely reduce the number of visits to their retina specialist through controlled and sustained intravitreal delivery of an anti-VEGF drug. The recent positive eight-month safety data and efficacy results give us increased confidence that EYP-1901 may have a differentiated profile for safety, efficacy and tolerability in wet AMD. Before we review the data, I'd like to touch on EYP-1901's use of the Durasert delivery technology and its differentiation from alternatives in the retinal drug delivery landscape. bio-erodible Durasert allows for true sustained release of drug with zero-order kinetics after an initial beneficial burst of medication. In its non-erodible formulation, Durasert has best in class track record of proven safety, tolerability, and consistent medication delivery.
Durasert has been safely administered to thousands of patients across four U.S. FDA-approved products, and the safety and efficacy results we have seen so far with the bio-erodible formulation used in the DAVIO trial bolster our confidence in this differentiated drug delivery system. EYP-1901 combines a bio-erodible formulation of the Durasert sustained release technology I just described with vorolanib, a small molecule tyrosine kinase inhibitor. Vorolanib binds to the VEGF receptors, blocking all isoforms of VEGF as well as PDGF. This is different from the antibody fragment and trap molecules that are the current anti-VEGFs on the market today. These molecules bind VEGF. This differentiated anti-VEGF mechanism of action, coupled with our bio-erodible Durasert zero-order kinetics technology, could potentially change the treatment paradigm to a much less burdensome approach with EYP-1901, which we have coined Treat to Maintain. Turning now to our DAVIO study.
DAVIO is a phase I open-label dose escalation trial that enrolled 17 patients across 4 dose cohorts. All enrolled patients were previously treated with standard of care anti-VEGF therapy. No re-injection with the study drug was performed during the study, and typical criteria for supplementation with a standard of care anti-VEGF was employed. Following a positive 6-month data readout in October of last year, we reported positive interim 8-month safety and efficacy data of the DAVIO trial in February at the Angiogenesis, Exudation, and Degeneration 2022 virtual meeting. We're quite pleased with the interim results we have observed so far. Importantly, we've seen impressive efficacy and durability with over 50% of patients supplemental anti-VEGF-free up to 6 months and 41% up to 9 months, as well as significant reduction in treatment burden for patients 79% at 6 months and 75% at 8 months.
Additionally, we observed stable visual acuity and central subfield thickness as measured by optical coherence tomography, with the updated 8-month data showing change in best corrected visual acuity of -3 ETDRS letters and central subfield thickness change of +13 microns. In addition, the 8-month data highlighted positive safety with no ocular serious adverse events and no drug-related systemic SAEs. Furthermore, no dose-limiting toxicities, no retinal detachments, no cases of endophthalmitis, no occurrences of implant migration into the anterior chamber or any posterior segment ocular inflammation was reported. As Nancy mentioned, we plan to initiate a randomized controlled phase II study of EYP-1901 for previously treated wet AMD in Q3 2022. The wet AMD phase II trial is expected to enroll 144 patients randomly assigned to one of two doses of EYP-1901, approximately 2 milligrams or 3 milligrams, or aflibercept control.
The efficacy endpoints are change in best corrected visual acuity, change in central subfield thickness as measured by OCT, time to supplementation, and safety. Looking ahead, we anticipate sharing interim 6-month data for this phase II trial in H2 of 2023. We are also working to explore the paradigm-changing treatment potential of EYP-1901 in several other severe eye disorders, including diabetic retinopathy, diabetic macular edema, and retinal vein occlusion. In H2 of this year, we plan to initiate a phase II trial of EYP-1901 in non-proliferative diabetic retinopathy. In addition, we now expect our third phase II trial employing EYP-1901 in serious ocular disease will be for the indication of DME. Diabetic macular edema is the most common sight-threatening complication of diabetic retinopathy. We expect to initiate this phase II trial in Q1 of 2023.
We will continue to provide clinical updates on these additional indications throughout the year as our rapidly growing pipeline advances. I will now turn the call over to Scott Jones, Chief Commercial Officer, for the commercial update. Scott?
Thank you, Jay. We're excited to report a strong quarter for our commercial business with $9 million of net product revenue, an increase of 32% from Q1 of last year. Our Q1 net product revenue for YUTIQ and DEXYCU was $4.6 million and $4.4 million, respectively. Customer demand was approximately 14,800 units of DEXYCU and 650 units of YUTIQ, compared to approximately 13,800 units and 650 units, respectively, in Q4 2021. Customer demand for DEXYCU saw approximately a 7% growth from Q4 2021. Customer demand for DEXYCU stemmed from our strong commercial presence and our collaboration with our commercial alliance partner, ImprimisRx, who has assumed full responsibility for U.S. sales and marketing activity for DEXYCU as of January 1, 2022.
EyePoint retains the DEXYCU NDA, revenue recognition, manufacturing, and distribution responsibilities for all markets. ImprimisRx has been a strong partner, and we look forward to continued growth for that franchise. Customer demand for YUTIQ remains strong due to our ongoing expansion of YUTIQ sales efforts into the retina community for the treatment of posterior segment uveitis and from an increased siliconized needle that provides preferred procedural experience for physicians and patients. Although demand for YUTIQ was consistent with Q4 2021, it's important to note that historically, Q1 demand numbers usually turn down due to insurance deductible resets for these patients. We are incredibly pleased by the progress we've made with our commercial businesses and with the performance of our commercial teams.
Our mission is to continue to provide a unique sustained delivery system across all platforms that requires fewer visits to the doctor's office, a key attribute for each product's value proposition for both patients and doctors. We look forward to updating you on revenues and demand in the quarters to come. I would now like to turn the call over to George to review the financials. George?
Thank you, Scott. As the financial results for the three months ended March 31, 2022 were included in the press release issued this morning, my comments today will focus on a high-level review for the quarter. To begin, in Q1 , we continued our balance sheet focus and entered into a new loan agreement with Silicon Valley Bank to replace our existing CRG credit facility with improved economic terms. The new loan agreement with Silicon Valley Bank provides for senior secured credit facilities in the aggregate amount of $45 million and reduces the loan interest rate from 12.5% to a blended rate of approximately 5%, resulting in an estimated $2.8 million in annualized interest savings.
For Q1 ended March 31, 2022, total net revenue was $9.3 million, compared to $7.3 million in the quarter ended March 31, 2021. This includes net product revenue for Q1 of $9 million, compared to net product revenue for Q1 ended March 31, 2021 of $6.8 million, an increase of 32%. Net revenue from royalties and collaborations for Q1 ended March 31, 2022 totaled $0.3 million compared to $0.5 million in the corresponding period in 2021. Operating expenses for Q1 ended March 31, 2022 totaled $27.6 million versus $18.3 million in the prior year period, primarily driven by an increase in R&D spending, including clinical trial costs for EYP-1901 and investment in personnel across the organization, including non-cash stock-based comp.
Non-operating expense totaled $2.7 million, and net loss was $21 million or $0.56 per share, compared to a net loss of $12.3 million or $0.50 per share for the prior year period. Cash and investments at March 31, 2022 totaled $190.8 million compared to $211.6 million at December 31, 2021. We expect the cash and investments on hand at March 31, 2022, and expected net cash inflows from our product sales will enable us to fund our current and planned operations into H2 of 2024. In conclusion, we are pleased with EyePoint's progress in Q1 of 2022 and are well-capitalized to advance our product pipeline to key value inflection points.
Thank you all very much for listening this morning, and I'll now turn the call over to the operator for questions.
Thank you. As a reminder, to ask a question, you will need to press star one on your telephone. To withdraw your question, press the pound key. Our first question comes from Georgi Yordanov with Cowen. You may proceed with your question.
Hi, team. Thank you so much for taking our questions, and congratulations on all the progress. Maybe just a few on our end. Now that you have the full DAVIO data, appreciating the fact that it's still a limited number of patients, but has this data helped you better refine the commercial opportunity for 1901? Who do you think would be the most optimal patient for a maintenance product, like that? What percentage of the patient population do these patients represent? Secondly, given the efficacy we've seen from 1901 in DAVIO, what do you see as the main risks?
To a successful registrational trial. I guess related to that, what would be the most optimal trial design that could maximize your chances of success while still ensuring you get the durability you've demonstrated so far on the label?
Wow, that's quite a list. All right.
Good morning, Georgi.
Good morning.
Yeah. Let me see if I can't answer an overview, and then I'm gonna triage it out to the team here.
Thank you.
If we miss some of your questions, just reiterate them. I would say definitely as the data continues to come in, of course, it refines our approach because it informs exact better how long this is working. We remain really pleased with what we're seeing. I mean, we're out 9 months on, which we've reported on rescue, 8 months on overall safety and efficacy. We continue just to see really good sustainability of treatment. Now we're going to continue to keep this designed as a 6-month treatment just because we want to be able to capture a majority of patients. We still believe, obviously dependent on phase II results, that a majority of patients can be treated with EYP-1901. I want to just elaborate a bit on this treat to maintain approach that we're taking.
It's important to understand that we're not here to replace current anti-VEGF. They are very effective and safe. The problem, as we all know, is they're not as durable and long-acting as patients really need, particularly given the fact patients have to keep coming in all the time to doctor's offices to get their eyes injected, which is a real burden. The goal is to be able to first go ahead and induce your patients with an anti-VEGF, get the eye as cleared up as possible, and then you can put in EYP-1901. Maintain that patient, so Treat to Maintain for, we hope, a majority of patients up to six months.
For some patients, though, who may be particularly resistant to anti-VEGF therapy or they just can't get rid of all the fluid, you can supplement as needed with existing therapy. Again, because we have two different mechanisms of action on board, there is often a benefit, could be, I wanna put caveats, we don't know everything yet, to having two different mechanisms of action at work on the eye. We think there's a lot of benefits for patients. We continue to have a group headed up by Scott, and I'm going to let him comment just a bit. We just launched a new group for early commercial development, and Scott and his team's task is to begin to more fully understand the commercial opportunity and what we need to do to more appropriately develop that commercial opportunity.
Because it is a new treatment paradigm, so you need to change some of the current mindset. I'm now actually. We'll get back to the regulatory trials in just a moment. I'm going to ask Dr. Jay Duker to comment and then Scott on the commercial opportunity.
Yeah. Thanks, Nancy. I think you covered things well. I probably just add a few more thoughts based on the DAVIO results. Georgi Yordanov, you asked, you know, what percentage of wet AMD patients would benefit from this treatment. The way I would answer that is based strictly on the 17 patients from DAVIO, one would extrapolate that the market would be at least 85% of wet AMD. Now, though, what I mean by that is there was a clear-cut benefit to about 85% of the patients who enrolled in the trial. Either they didn't require any supplemental anti-VEGF, or if they did require supplemental anti-VEGF, it was at a very reduced rate compared to prior to enrollment.
Now, I think we can speculate in more of a broad spectrum of wet AMD patients, not the spectrum we enrolled in DAVIO, that the benefit might be greater than that. Again, that's speculation. That's why we're doing a phase II trial to see in a broader population of wet AMD patients than what we enrolled in DAVIO, what percentage is gonna benefit. We're optimistic that that benefit will be a majority of patients. Major risks. You know, major risks of any trial are safety and efficacy at a very high level. The good news is with N equals 17, we really had no safety issues. Of course, that's a small number.
We're confident, though, that safety will probably not bubble up to be a problem, and the confidence stems from the experience with Durasert in tens of thousands of patients, number one, and the safety of vorolanib, both preclinical and so far in patients. You know, I have to say that in our preclinical studies, we haven't been able to find a maximally tolerated dose in animals for EYP-1901, and I think that would be a safe thing to say at N=17 from the phase I, that we didn't find an MTD in humans either. So far it looks safe. Again, anything can happen as you expand these trials. From an efficacy perspective, you know, the risks, number one thing we're trying to hit here is non-inferior visual acuity compared to EYLEA.
It's the primary endpoint. Looking at the DAVIO trial, and again, trying to extrapolate over six months, we're optimistic that that's a value that we'll be able to statistically meet. But obviously, that's the big risk as well, that in this population or with whom you enroll, that you won't be able to achieve that. But certainly extrapolation would suggest that we have a very good chance. Our last question was around trial design. Once again, the trial design is an iterative process. When we get more data, and the data suggests that a trial should be designed in a specific way, that's the way we go. Now, our wet AMD phase II DAVIO 2 trial is, you know, really on target to start in Q3 of this year.
The protocol is set, and that protocol and inclusion, exclusion criteria was largely influenced by the patients that we saw who did well in DAVIO 1, and those who didn't. I think those inclusion, exclusion criteria will reflect that. I hope we covered everything. I think if there's any commercial comments, perhaps Scott can weigh in.
Scott, go ahead.
Sure. Thank you for the question. You know, as Jay said, I think we're still examining the exact percent of patients, but certainly a large percent of the currently treated patients we believe will be correct for our potential therapy. Just to take a step back, you know, to think about why there is such a need for this in the marketplace. You know, as you know, it's wet AMD, DME, DR. It's a very large market. If you think about what's going to occur in the next several years, you know, we have an aging population. We have an expansion of the number of patients with diabetes. We currently have, you know, a very undertreated diabetic retinopathy market, and the number of retina specialists isn't expanding appreciably to be able to meet those needs.
The demand for a more durable therapy, we think we're just meeting a need that is growing every day. We certainly think there is just an enormous opportunity for us to be able to bring a durable therapy to the marketplace. Again, as Jay said, you know, we're currently evaluating which patients we believe will be most appropriate as we move forward. I'm certain that we'll have more information to come in the coming years.
Hopefully we captured all the questions, Georgi.
Incredibly comprehensive. Thank you so much. Really appreciate it. Congratulations again on all of this.
Thank you.
Thank you. Our next question comes from Yatin Suneja with Guggenheim. You may proceed with your question.
Hey, guys, congrats on the results. Just a couple from me. First is on the EYP-1901 phase II study. Just I think one of the confusion out there is that I think we and investor community is used to thinking about EYLEA or other injection as a comparison. So just help us understand what is the right comp. To us, it seems like Port Delivery System that was run with Lucentis might be the right comp to think about how you are conducting the phase II study. Can you maybe comment on that? Is that the right way to look at it? Then obviously the study is gonna start in Q3. Can you talk about how long it might take for you to report the interim data?
Any ballpark you could give on the enrollment and data readout timeframe? That'd be very helpful. Thanks.
Sure. No problem on that. Jay, why don't you take those questions?
Sure. Yatin, thanks for the questions, and as usual, very insightful. The first is a comparison of our trial, and I would say at a high level, the primary endpoint of non-inferior visual acuity is what has been used in all the recent wet AMD trials. Once you have a standard of care, and the standard of care was Lucentis initially, that was what the comparison needed to be, and that's how the trials were designed. Non-inferior margins were determined by the prior studies, by the size of your study and the statistics involved. At a very high level, one could look at any of the recent studies that were non-inferior visual acuity. However, as you point out, we're looking at a different patient population.
The only previous trial that looked at a non-naive patient population for maintenance therapy was the Port Delivery System. In some ways, the Port Delivery System trials would, you know, be in some ways comparable to the patient population that we're enrolling. However, their control group was monthly Lucentis, and our control group is monthly EYLEA times three, and then EYLEA every other month after that. We have a bit of a different control group as well with a different treatment interval. I'd also like to point out that given that EYLEA will be dosed after the first three months as every other month, there's the potential for anti-VEGF supplemental in our control group, which I believe is a bit unique for any of these studies.
While there are comparisons to many of the previous wet AMD trials, I'd say given the patient population, the longevity of action of our drug, the rescue criteria, there are always gonna be some differentiation. At a very high level, what we're trying to do is inherently different than what some of our previous anti-VEGF molecules have been trying to do, which is, again, as Nancy pointed out at the beginning, we're not necessarily replacing EYLEA or Faricimab. We are working to maintain the gains that those drugs give patients initially over the long term because we're sustained release, which helps to account for patients who can't make it back for visits or extended intervals that have been extended beyond perhaps what might be safe.
Because we know in the real world, patients with these branded drugs still over the year or two into their disease lose much of the visual gain that they had. There's a definite unmet need out there for continuous treatment, and that's what we aim to provide.
Yeah. Let me just also add on to your last question, Akin, which was we expect that we will report out the phase II wet AMD results in H2 of 2023. We're on track with this. Of course, timing of all the patients to be enrolled is still a variable, but we're pulling out all the stops to enroll as quickly as possible. As we stated earlier, we're on track for Q3 of this year to enroll our first patient.
Got it. Just one more question, if I may. With regard to the update on the YUTIQ 50 that you're pausing the study, like what exactly can you just provide a little bit more detail on what exactly FDA asked us to do that may be driving the cost of this program?
Yeah, good question. As again, some people may know, but others may not, the FDA recently issued new guidance related to drug device combinations. This new guidance was as a result of a lawsuit that was filed by another company against the FDA on their particular product, and it's called the Janus decision that was handed down by an appellate court. As a result, the FDA issued new guidance, and as a result of that, for some products, they want more studies to be done. That's the case with YUTIQ 50. Instead of one study, they're requiring now two studies. We don't see any impact right now on EYP-1901 because we already are anticipating that we will be doing multiple phase III pivotal studies. We don't see any impact on YUTIQ -- excuse me, EYP-1901.
Unfortunately, we had planned for 1 study on YUTIQ 50, and the guidance is now that we have to do 2 studies. As you can imagine, YUTIQ is a nice, steady, consistent product, growing very nicely in revenues, but it's never going to be a huge drug, as I've often said. It is going to deliver some nice profits to the bottom line over an extended period of time because we don't have to put a lot of money into it. However, these are not large drugs. As a result, the cost of doing another phase III study for YUTIQ 50 may become problematic for us to see the ROI on YUTIQ 50.
Got it. Basically more of an ROI or NPV decision. It seems like two studies, but given that for EYP-1901, you will be required to do multiple study till it get approved, should not have any downside, right?
Yeah, exactly.
Okay.
Again, let me just reiterate, this was strictly a financial decision on YUTIQ 50. It has nothing to do with YUTIQ, nothing to do with what we believe the benefit of a six-month steroid delivery is, for uveitis. However, again, uveitis is not a large category. It's an orphan disease. You know, as we've always said, YUTIQ 180 will probably hit maximum revenues of $80 million-$100 million over time. YUTIQ 50 is a subcategory of that. So when you do the ROI, it's just very hard to do that with two pivotal phase III studies. Again, we see no impact on EYP-1901.
Very nice. Thank you so much.
Thank you. Our next question comes from Jennifer Kim with Cantor Fitzgerald. Please go ahead.
Hey, everyone. Congrats on all the good work this quarter. Nancy, I wish you a fast recovery from your cold.
Thank you. Thank you.
Yeah. I have a few questions here. Maybe to start off, I think you mentioned that you're going to present 12-month data at ASRS.
Yes.
Given the 6-month is the sweet spot, like you said, what kind of additional takeaways are you hoping to see in that 12-month data?
Yeah, that's a great question. Jay, why don't you take that?
Yeah. I'll start by saying, first of all, again, the phase I trial is primarily safety. We wanna make sure that there's no longer term safety issues, not that we expect any. Certainly if you have a problem that's injection related, you'd expect it early in the study. If you have a problem that's dose related, once again, because of the burst of vorolanib that we get in the first few weeks, we would have expected that early in the study. We didn't see either of those. While we wouldn't anticipate any new safety issues in the last three months of the study, we wanna make sure that none exist. That's number 1. Number 2 is we didn't reinject 1901 during this study.
Based on the preclinical and animal and in vitro data, we would expect the implants to release in humans for approximately nine months. We would expect in some patients to get that longevity of action that we saw with 41% supplemental anti-VEGF-free up to nine months. But as the implants run out, we would expect a reactivation of the disease and need for supplementation, although not necessarily immediately. Remember, when you give an EYLEA or a Lucentis shot, that drug might be out of the eye in weeks, but some patients can go two or even three months between injections. We would expect to see somewhat of the same as the drugs run out.
While from a safety perspective, we would you know very happy to see minimal, if any safety issues, really in the first few months. We wanna confirm that through the year. With respect to efficacy, again, as we've said, as I think you know, we're really anticipating going for a label of every six months in the pivotal trials. One could argue that you know the efficacy data beyond six months may not be useful, except I will again remind you that retina specialists are happy to allow patients to go longer than the label if they deem it safe.
While we may have a label of 6 months, in some patients, it was 41% in DAVIO, we were able to go 8, and up to 9 months without supplement. That data is important to clinicians. Even though they might be able to reinject at 6 months in certain patients, they may choose to extend that a little bit longer.
Okay, great. Maybe another question. On your license agreement with Betta, is there any color you can give on the exact terms of that deal? And on a related note with your amended agreement with Equinox, I guess, is the biggest takeaway there that you're now able to plan that phase II trial in DME? And are you still planning to look into the RVO opportunity, or has DME sort of taken the priority over that?
Yeah, let me answer that. As for Betta, we're very pleased to have the extension of our partnership with them. As you may recall, we struck that agreement in 2020 where we in-licensed vorolanib. What was always anticipated, and that was part of the original agreement, is that they would have the ability to negotiate for rights to China. That was all anticipated as well as part of the payments and milestones that we owe them. In exchange, of course, that was some reduced payments in exchange for them gaining rights to EYP-1901. We won't go into the details of that, but suffice it to say, it gives them now the formal rights to EYP-1901 in China.
Of course, there's your typical royalties and milestones that they will pay us for that as well. In addition, back to DME. Yes, it now gives us rights to all of ophthalmology indications delivered locally with vorolanib, around the world outside of China. We are now going to prioritize, as Jake may have mentioned, I believe in his comments, that DME will now be done first before retinal vein occlusion. We'll do wet AMD and then non-proliferative diabetic retinopathy, and the thinking now is we'll do DME as a third study that we'll initiate. We certainly would still think about RVO. We have to be careful obviously of our capital management.
The timing of RVO is yet to be determined, but we do expect that we should be able to initiate a DME trial sometime early next year.
Okay, great.
Yeah?
Yeah. No, that's perfect. One last quick question, just on YUTIQ 50. Is there anything. I know it was just sort of a small single trial, but is there anything that we should think about in terms of modeling costs now that the trial has been put on hold?
George, why don't you answer that?
Yeah. I think, you know, certainly the near-term benefit is we're probably going to reduce that spend over the next 12-18 months. We'll probably pick up $4 million-$5 million in anticipated spending that we won't spend. That does certainly help our cash runway in the near term. Even though our cash guidance is unchanged from last quarter, you know, which is into H2 of 2024, that also assumes that we're starting the phase II in DME in the first quarter of next year. It's a cash pickup near term, which is good news in this environment.
Nancy.
Okay.
May I add one more thing about it, which is there's some, you know, what I might deem minor indirect benefits, which is the clinical team, although these two studies weren't large studies, they were still studies we needed to track, and therefore, they can focus more on the EYP-1901 studies and as well as the manufacturing group.
Yeah. Yeah. Very good point. Great. Very helpful. Thanks, guys.
Thank you. Our next question comes from Yale Jen with Ladenburg Thalmann & Co. You may proceed with your question.
Good morning. Thanks for taking the questions, and add my congrats for your progress. Maybe this is just a little follow-up from the previous one. Just in terms of the reason that you guys placed the DME ahead of the retinal vein occlusion, was that economic or market assessment or other reasoning? Just curious.
Oh.
I have a follow-up.
DME is a much, much larger market with a higher unmet need. Not that RVO still has unmet need, but DME is just a substantially larger market than RVO. When you look at where to put your capital, obviously you have to look at where you can have the most impact for patients, the broadest number of patients, as well as on a return basis. It was a pretty easy decision to prioritize DME over RVO.
Okay, great. That's very helpful. Two quick ones. The first one is that, in terms of you guys gonna start those phase II study later this year and next year, was the manufacturing aspect of that already been done or is still in progress to prepare for the stock getting to the trial?
Nope. Our product's already to go for the trials.
Okay, great. Maybe the last question here is a housekeeping one that, for this quarter, you have extinguishment of debt. Is that a one-time event, or that will be continued for the remaining of the year?
George, you take that.
I'll take that. Yeah, what that is, it's a non-cash non-amortized discount that was associated with the CRG loan and with the-
Right.
It was just a non-cash accounting entry. It's a one-time and won't repeat.
Okay, great. Well, thank you all. I really appreciate it, and congrats for the progress.
Thank you.
Thank you.
Thank you. As a reminder, to ask a question, you'll need to press star one on your telephone. Our next question comes from Yi Chen with H.C. Wainwright. You may proceed with your question.
Thank you for taking my questions. First question, just to clarify, with respect to the new FDA regulations for a combination drug device, does it apply to the non-erodible Durasert technology as well as the erodible Durasert technology?
Yeah. Yi Chen, let me just reiterate a couple things. Yes, it. By the way, let me just reiterate, it applies to a number of ophthalmology and even non-ophthalmology products. This is not specific to just ophthalmology or even our products. It's a drug device combination, so regulation. Any time that you have a drug combined with a device, and the definition of a device is quite broad, I might add, the FDA is now has to acquire more data. But I want to again reiterate, the way that the regulations based on the ruling came out is that it doesn't add anything more to EYP-1901.
Because 1901 is delivered in an injector and obviously it's also in an implant, it qualifies under these regulations, but we always anticipated doing all the work that is being promulgated. The difference was, in this particular case with YUTIQ 50, they need more than just one study because the YUTIQ 50 had not previously been on the market, and we did not have a clinical study around it, so they need two clinical studies. Which, as I said, we always anticipated with the multiple indications on 1901 regardless.
Got it. Thank you. Just to confirm, there is no upfront payment for the Betta Pharmaceuticals licensing agreement, right?
That is correct.
Okay. Last question. For the upcoming NPDR phase II trial in H2 of the year, what would be the drug used in the control group?
Yeah, Jay, why don't you answer that?
At this point, the control group will consist of a sham EYP-1901 injection, so there will be no active control.
Okay. Do you think it will be necessary at a certain point in the future to evaluate the drug against an active control?
We really can't speculate on that at the current time. We believe from a regulatory perspective as of now, that's not necessary. That could change in the future. Our current belief in discussing this with regulatory advisors is that a sham non-active control is still permissible, and that's because while there are two FDA-approved products in this space for DR, usage of them is so minimal.
Okay, got it. Thank you.
Thank you. I'm showing no further questions in the queue at this time. Ladies and gentlemen, thank you for participating in today's conference. This does conclude your program, and you may now disconnect. Everyone, have a great day.
Thank you, everyone.