Good morning, and welcome to day one of the Wells Fargo Healthcare Conference. My name is Eva Fortea-Verdejo . I'm a biotech analyst here at Wells, and to kick off our conference, we have the Kiniksa team with us. So we have Ross Moat , Chief Commercial Officer, and John Paolini, Chief Medical Officer. Nice to see you guys.
Nice to see you, Eva.
So for those who are not familiar with the story, perhaps we could start with, you know, a quick overview of the company, and then we can dive into some questions.
Okay. Thank you very much, Eva, and thank you for the invite from you and Wells Fargo for the invite to the conference. Just to note at the beginning that we'll be making forward-looking statements that are subject to risks and uncertainties, and full details of those risks and uncertainties can be seen on our SEC filings. So John and I, I think, will kind of chair the session today and look forward to your questions. Maybe just to start off, Kiniksa is a commercial stage biopharmaceutical company. We launched our first commercial drug three and a half years ago now. And we also have a pipeline of immune-modulating assets that we're happy to go through throughout the course of the session.
Awesome. So maybe we can start with your commercial asset, ARCALYST. Can you provide an overview of the launch so far, and kind of like, how do you see the recurrent pericarditis market evolving over time?
Thank you. So maybe I'll take that, and John-
Sure, go for it.
Can chime in as needed as well. So yeah, so we launched around three and a half years ago, in April 2021. Just as a note, ARCALYST is the first and only approved therapy for recurrent pericarditis, which is a debilitating autoinflammatory condition of inflammation around the pericardium. There are many patients that suffer from pericarditis in the U.S., around a hundred and sixty thousand patients in any given year. And a subsection of those patients, around 30%, unfortunately, go on to suffer from multiple recurrences of this disease, which can be incredibly debilitating for the patients.
And ARCALYST was studied as an interleukin-1 alpha beta inhibitor, which ultimately is the root cause of recurrent pericarditis, and was approved by the FDA with a very broad label, which is for recurrent pericarditis, in April of 2021. Since then, the market has been evolving, and the work that we've undertaken is to increase the education and the awareness of recurrent pericarditis as a disease, how to diagnose it, and distinguish it from acute episodes of pericarditis. So really focusing on the 14,000 patient population that suffer from multiple recurrences, that being two or more recurrences. There's also an additional group of patients that are on their first recurrence as well.
That's another 26,000 patients, so 40,000 in total, that fall into the label, the broad label of ARCALYST, and the design of the study was to really focus on both the treatment and the prevention of recurrences for those patients. So being the first and only approved therapy in this market space, ARCALYST has really gone through quite a steady progressive growth since the time of our launch. Every quarter, we've seen growth in the net revenue, growth in the number of patients that are on ARCALYST therapy, growth in the number of physicians that have been prescribing, so we've really, I think, made quite good progress since the time of our launch.
But I think the thing for us is that we're also more enthusiastic about what we have left for the future and the number of patients that we can reach and really penetrate into that market opportunity. As of the end of Q2, we announced that we were around 11% penetrated into the 14,000-patient population, which is... I think shows, on one hand, really good progress to date, but on the other hand, as well, shows the opportunity that we still have ahead to continue educating physicians on the disease and on ARCALYST as a treatment. Continue to work with patients around self-advocacy for treatments as well, and really continue, you know, the growth that we've seen over the last few years.
You mentioned educating physicians and patients. What are the key steps that you've taken here to ensure, you know, they're aware of the drug and kind of, like, know how to use it?
So we've been very focused on just education per se overall, both with healthcare professionals and with patients since the time of launch. I think previously, obviously there was no approved therapies for treating recurrent pericarditis, so there was also not the impetus for necessarily distinguishing recurrent pericarditis from the initial episode or the index episode of pericarditis. So, a lot of that education around diagnosis has been incredibly important, for us and for patients to get a timely diagnosis. What we hear from many of the patients that are on ARCALYST treatment is that they've had a very elongated journey through to a diagnosis of recurrent pericarditis in the first place.
And in fact, the market research that we've done, patients received an average of two point seven misdiagnoses before getting an accurate diagnosis of pericarditis, of recurrent pericarditis. So we know that the journey, as with many rare diseases, and this is a rare flaring cardiovascular disease, can be elongated, and they can visit multiple physicians to try to get the right diagnosis. So our focus, both from our commercial teams, in the field, the digital marketing work that we do, from home office, as well as on the medical side as well, educating on the disease has been incredibly important. That continues to be very important. You know, we have two and a half, so 2,000 ...
more than 2,300 prescribers of ARCALYST so far, so, and that's been growing at quite some clip. So, you can see that the awareness is certainly growing, and people are getting, you know, a more accurate, timely diagnosis. But also, you know, we're focused on just continuing to evolve that over time through all the different routes and channels that we have open to us, acknowledging that there are still many patients that are going untreated and misdiagnosed.
Have you started to see already, you know, ARCALYST has been on the market now for a few years, but not that long. Have you started to see a change in how doctors are diagnosing or how patients are being diagnosed earlier?
Yeah. So I think we are starting to see an evolution of that. One thing that we have said is that out of all the patients that are treated with ARCALYST, the vast majority of those patients are within the 14,000 patient population, which is really our target population, from a kind of a field commercial targeting perspective. Because they are the people that have two or more recurrences, they're the people that most closely match the entry criteria to RHAPSODY, our phase three pivotal study. So that's been very important. But we've also seen, to a smaller degree, patients being treated earlier on in the disease.
So patients that are maybe just on their first recurrence, which is obviously still within the label of ARCALYST, but it's maybe just outside of really how we kind of set up as our target population with our, with our field resources. So I think that's, that shows that there's, you know, there's kind of a growing sentiment to identify and treat patients earlier. And the fact that we've seen a significant growth in the prescriber numbers quarter on quarter since the time of launch, as I say, most recently, more than 2,300, which was a growth of more than 300 versus Q1. And also on the repeat prescriber side as well, we've got around 550 physicians that have prescribed for two or more recurrent pericarditis patients.
So again, that's something that's been growing quarter on quarter, and I think it's just, you know, more information that the physicians are understanding the disease, more patients are advocating for treatment. And that's about 10% of the total cardiologists across the U.S. So as we kind of widen that net and continue to widen education, there's more chance that more patients diagnosed with recurrent pericarditis will go through those physicians that are already educated and aware of both the disease and how to prescribe the drug.
You mentioned 10% of cardiologists. Are you seeing rheumatologists prescribe the drug? Are you seeing a higher proportion of rheumatologists now that the drug has been in the market for a little bit longer? And also, are you starting to see more usage, perhaps on, like, more community centers versus, like, academic centers at this point in the launch?
Yeah. So to address your last point first, we're really agnostic into where physicians are based, whether it's community, academic centers or anything else. We spent a lot of time prior to launch and also post-launch as well, to really understand where patients are presenting to physicians. And we do that through triangulating sources from obviously claims data, but also a lot of market research that we've done, to really understand the patient pathway and set up our targeting strategy aligned with that. So we focus on where we believe the highest population of patients are, agnostic to the setting of where those patients are presenting into. And to go back to the first part of your question, mainly it's cardiologists in terms of people who are really looking after this disease.
When patients first suffer their index pericarditis episode, they often go to the emergency department. The symptomatology is incredibly severe; it feels like a myocardial infarction, and when eventually, you know, pericarditis or subsequently recurrent pericarditis is diagnosed, often by that stage, they have contact with cardiologists, and they'll often go back to a cardiologist upon subsequent flares, so we see that the majority of physicians looking after this disease is cardiologists. About 70% of all the ARCALYST prescribing is with cardiologists. The remainder is with rheumatologists, who also have some experience with this disease. They also have experience with prescribing biologics, as well, as well as also trying to rule out any other underlying etiology.
So sometimes, cardiologists will refer on to rheumatologists to rule out underlying etiology of other autoimmune diseases that patients may be suffering from, which may be the causation of the recurrent pericarditis. So to that level, there is some rheumatologists, but it's predominantly a cardiology-based treatment disease.
Okay. Very helpful, and perhaps now, we can move on and discuss a little bit the RESONANCE study and, like, kind of what you've seen so far in terms of, like, IL-1 inhibition usage and switches to ARCALYST there.
Sure. Maybe I can help a little bit with that one. So RESONANCE is a real-world registry. It's been going since 2021. The aim is to enroll 500 patients. We're about two-thirds, three-quarters of the way through the enrollment, so actually a fairly large and substantial patient database. And what's interesting about this is that it's being run in about over 20 centers across the United States. And so these are centers where there are cardiologists that are focused on pericarditis management. And so what this really does is it represents kind of a tip of the spear, people who are really focused on the disease.
It's useful to look at the data from how these physicians are managing disease, you know, to see kind of the uptake of in terms of management. It's also helpful for other cardiologists and other practitioners to see, because it provides the example of how the experts are treating disease. We've been reporting data from the registry since early 2023. You know, the first data that we showed in early 2023 showed that amongst these expert cardiologists, the share of use, if you will, in terms of patient years of IL-1 pathway inhibition, driven primarily by rilonacept by ARCALYST, was about 40%.
The more recent data that we've been showing now then started to look at the trends of use over time and how the arrival of ARCALYST, if you will, in recurrent pericarditis, really heralded a change in patient management, and some of the data that we showed at this most recent ACC as well as, in fact, at the European Society of Cardiology meetings just last week in London. What it showed was that prior to ARCALYST availability, the way patients were managed was, of course, according to the 2015 ESC guidelines, and so what that did is it said NSAIDs and colchicine first, followed by corticosteroids, and then advanced immunomodulators, you know, after that.
In fact, our data showed that 80% of those patients that were failing colchicine were in fact being treated with corticosteroids. The interesting thing in the U.S. is that after the availability of rilonacept, what we've seen is a year-on-year growth of increasing use of IL-1 pathway inhibition, predominantly driven by ARCALYST, and a reducing share in terms of how these patients were managed with steroids. Such that now in 2023, which is the last year for which we had complete data, about two-thirds of patients were being treated with ARCALYST, whereas it was a much smaller proportion. What that's showing is a real paradigm shift in how patients are being managed by experts to a more steroid-sparing paradigm.
Taking patients who have been on steroids and getting them off steroids, or even obviating the need to go onto steroids altogether by taking them after they're failing colchicine and putting them directly on IL-1 pathway inhibition. And of course, in the U.S., ARCALYST is the only, you know, approved therapy for recurrent pericarditis.
Okay, thanks. Yeah, no, this was very helpful. So perhaps moving on to, like, the growth from here, right? Like, what would you say are the bucket, the buckets of growth, you know, within the recurrent pericarditis market, for ARCALYST in the next, like, twelve to eighteen months?
Yeah, so maybe I'll take that back . So the key areas for the growth continue to be really what we've been focused on since the time of launch. Acknowledging that, we're still relatively nascent within this disease space, as we've seen good growth so far. But yeah, we're around 11% penetration into the 14,000 patient population. Obviously, that tells you that there's significant headroom left ahead for us to really get into. And that's only focusing on the 14,000 patients, not the further upside of the 26,000 patients as well, which we say we have some, you know, limited use in so far or some smaller use in. So yeah, we feel good about that.
The key things are just continuing to increase the awareness, increase the patient identification. One thing around this disease area is that patients are quite widely dispersed across the US. So, that means that we've got to go out and educate a high number of physicians, and it can be tricky knowing exactly where those patients are gonna kind of present into over time. So we need to kind of cast that net quite wide, as we mentioned earlier on, with the growing number of physicians that have experience and are treating this disease, but also there's work going on with a lot of interested parties around building more specialist centers for treating pericardial diseases.
And we've seen some work through the American Heart Association in addressing recurrent pericarditis to try to set up more maybe expert centers and a collaboration from expert centers to really share information and collaborate on how to diagnose and treat this disease. So that's, you know, other, I think, helpful areas within this disease space that help to get the message out and broaden the education. So patient identification will remain very important for the future as well as other metrics around, you know, patient stops and restarts. This is kind of a dynamic disease space, if you like. We know that this disease is a multi-year disease for the vast majority of patients.
Patients that suffer for two or more recurrences have a median duration of disease with the natural history of three years. And a third of the patients are still suffering from the disease at five years. A quarter of the patients are still suffering from the disease at eight years. So we know that for many this is a chronic multi-year disease. So, you know, the other drivers for future growth are duration of treatment, thinking about the restart rates. You know, we've seen around a 45% restart rate of all patients that have stopped therapy, that have gone back onto ARCALYST treatments. And continuing to educate physicians around the natural history of the disease and the appropriate time to treat patients for is incredibly important.
Historically, as John was alluding to as well, physicians would treat this disease for as short a time period as possible, and often that was driven from the necessity of the drugs that were available. If you're using corticosteroids to try to treat this disease because there was nothing else available, you would try to do that for as short a time period as possible due to the toxicity, and it's well documented around you trying to, you know, really like prolonging the disease and being very difficult to get patients off without suffering symptomology again, so you try to treat for as short a time period as possible. With ARCALYST, this has really been designed to be treated throughout the duration of the disease, through the natural history of the disease.
So there's a big educational part there to try to really change that treatment paradigm and to get physicians to think this as treatment throughout the duration. And I think you see from the duration figures that we've shared on our earnings calls, that we're making good progress around that. We see a total average duration of treatments of around 26 months, meaning around 15 months for the initial treatment. We're seeing around a 45% restart rate, and then obviously the duration of kind of subsequent restarts so far is around 26 months in totality. So that's grown over time, which I think speaks to the evolving mindset and awareness of physicians on how to treat the disease. But that's gonna continue to be important over time.
Cool. So let's unpack there. So perhaps we can start with, like, the patient, like, stops and restarts. Like, I guess, how are physicians deciding when to stop a patient, and like, what's triggering the restart again, right?
Yeah, this is a very interesting question, and Ross, you know, laid out for you that, you know, median duration of disease is three years. And so when you look at the clinical trials, you know, there's really good evidence there that also kind of speaks to the idea that, you know, long-term treatment is needed. So in the long-term extension, where patients were treated for, you know, an average of two years, there was a decision milestone at eighteen months. And there, you know, there was an assessment of the patient at that time to make a decision about whether to continue therapy, whether to discontinue therapy, or to suspend therapy for observation. And this is actually represents almost like a classic in-office situation that a cardiologist would do, say, looking at these patients.
And what you see is that while these patients were on continuous therapy, you know, their level of pain was low, you know, less than two on the NRS scale. Their C-reactive protein had normalized. And in fact, for many of these patients that had MRI scans, their MRI scans had... While they might have had a lot of late gadolinium enhancement, which is evidence of inflammatory vessels growing in the pericardium, that had even resolved by the 18-month time point. So we're looking at a patient who is asymptomatic, you know, at that point, and by all, you know, intents and purposes, looks quite normal. And so the question is: How do you know whether this patient still has underlying disease that's continuing or whether the disease may have resolved?
The point is that we learned is that it's very difficult to figure that out. What we know in terms of the odds of that, if you will, is that in these difficult to manage patients, the odds are that the disease continues to progress even at that time point, and we have two pieces of evidence there. One was at that 18-month decision milestone, where the patients that chose to suspend therapy, 75% of them had a recurrence.
We have more data that we showed at the just in fact this past week at the European Society of Cardiology meetings, where there was a group of the Italian patients who were followed for 28 months, and then when they reached the end of the long-term extension and stopped treatment, again over 80% of those patients had a pericarditis recurrence as well within about eight weeks. So what that tells us is that it's very difficult to tell. But on the other hand, what it also showed us is that patients were reliably having an increase in symptoms at a rate, if you will, that was proportionate to how the drug washes off. One of the unique attributes of ARCALYST is that it's a once-weekly drug, and so it washes off very slowly and self-tapers itself down.
And so what we also saw is that as patients in the main part of the trial, before patients, you know, as patients washed off, the couple of weeks before they had a flare, they started to have increasing symptoms. And so that combination of factors really provides some guidance that while it's difficult to assess when to stop, per se, other than looking at baseline characteristics and saying, "With that complexity of disease, we anticipate your disease may last three years, or five years, or eight years." But at the point in time that there's a decision to stop, it's actually very simple, where the trials show that cessation of therapy, a gradual wash off, and expected observation, looking for a prodrome of increased symptoms, identifies those patients who require, you know, continued therapy.
And so, again, the trials show that therapy can be reinitiated, and then at that point, all of the patients that reinitiated therapy, their disease went back under control. And so in that way, it provides a useful gauge, if you will, for physicians to figure out who needs additional treatment. And sadly, for these, you know, for this disease, the vast majority of these patients, even at these later time points, still require continued treatment.
Yeah. And John, maybe to add to that as well, is that obviously our work is to try to educate physicians to treat throughout the duration of the natural history of the disease. But the good news is that when patients stop therapy, if there is still underlying autoinflammation.
Mm-hmm
... going on, as we've seen in the clinical trial setting, as John outlined, in the commercial setting, it's also generally very easy for patients to restart therapy. Just from a practical, operational perspective, often there's a payer approval that's already in place, sometimes there's drug on hand already, and we've seen that patients, you know, there's 45% who restart. Generally, they restart pretty easily, and just to go back on, onto drug. Obviously, we don't want that to happen. We want patients to just be treated throughout the course, but it's a good safety net for patients to restart if needed, and I guess the other point I wanted to make is that all of the dynamics that we've been talking around, patient starts, patient stops, patient restarts, all go into our revenue guidance that we provided.
And externally, the guidance we provided, which we increased at the end of Q2, in our earnings call, is $405-$415 million for 2024, taking into account all of those dynamics.
How is treatment duration taken into account here? Because you said the natural history of the disease is around three years, but you're not there yet in terms of treatment duration. Do you expect this to, like, continue to increase up to three years? And how long do you think that's gonna take?
Yeah, it's a great, great question and a great point, and I don't think we have a satisfying response to it right now, because we would just have to see how it evolves in the real-world setting, and how prescribing behavior continues to evolve over time. We have seen since the time of our launch, that the duration of therapy has grown quite substantially through to the 26 months. As you say, there is a median duration in recurrences of two or more, but it's at three years. So, will it continue to increase? We just don't know. There are many different dynamics that are at play there.
... when patients actually get diagnosed. So if you could take into account the median duration is three years, you know, if patients have been getting misdiagnosed along the way and been suffering from the disease, and, you know, maybe they've had a pathway which is six months, a year before they get diagnosed or treated with ARCALYST, obviously, that needs to be taken into account for the duration of treatment, as well. So I think there are a lot of different variables, and we have to see how it evolves just as more patients continue on therapy for longer periods of time. And, you know, we've provided updates in our quarterly earnings calls, since the time of launch.
We'll continue to look and think through what are the most helpful metrics to provide externally as these datasets continue to evolve. Of note, I think it's important to say that we will also see patients that have really stayed on therapy without any stops for quite some time as well. You know, out of all the patients that started in the very first quarter of our launch in Q2 of 2021 , we still have 15%-20% of those patients that are on therapy now, without having any stops or restarts, just continuation of therapy throughout. So really kind of reinforcing the message that we know this is a chronic, long-term disease in many patients. Many patients may just stay on therapy, others will kind of trial a cessation and restart if needed, as John has described.
So in terms of payers, how does this affect, you know, as you get, like, to longer treatment durations, right? Like, are you getting, you know, payer approval for, like, 12 months? Are you getting for longer duration now? Do you have to, like, resubmit after a year?
Yeah, this is a great question, so usually what happens is, payers will approve for generally 12 months worth of treatment, which I think is generally the longest that a payer generally approves any, you know, chronic drug for as well, before doing a reapproval, particularly in a rare specialty disease space, so there is some variability, but, you know, the majority of payers are approving for a year. Generally, when you get to the end of that 12-month time period, many payers just ask for an attestation from the physician, that the patient is continuing to see benefits as a result of being on the drug and needs to continue to be on the drug, in order to get the reapproval.
So I think we see it as a relatively low bar. And they're generally not asking for biomarkers or any other type of evidence to back that up. So it's a relatively low bar for the reapproval rates, and I think that stems from an understanding, generally from payers, that this is a chronic disease and it's an incredibly debilitating disease for many patients, and that they need to be treated throughout the course of the natural history.
Perhaps last question on ARCALYST. We mentioned, you know, at the beginning of our chat, we're talking a little bit about, you know, these patients in first recurrence, and how, you know, as of right now, this is not your target. But how big would the opportunity be here, and what's it gonna take for you to, you know, increase your market penetration in this patient population?
Yeah, so I think as Eva said, we do cover some of that population now. Yeah, we have a field team of around 85 sales representatives going into the start of this year. We're covering about 85% of the recurrent pericarditis population. So many of those are within the first recurrence as well. That enables us to cover around 11,000 physicians across the U.S. So we've got quite a good coverage with the team that we have in place.
I think one thing to bear in mind with patients on the first recurrence is, as much as we see as an upside, and you know, thankfully, having the benefit of a very broad label to help those patients, the natural history also show the patients that are just on the first recurrence often have a shorter duration of disease as well, but we have, you know, we have some use within that patient group, and it's really up to physicians to decide whether they want to treat patients within that group or not, and we really help patients throughout the course.
Okay, so perhaps now switching gears a little bit to abiprubart. You know, this is CD40, CD40 ligand. We've seen quite a bit of data from other, you know, therapies, other drugs, within this sharing the same mechanism. So can you just, like, give us a brief overview on how abiprubart is differentiated and, you know, how de-risked it is in Sjögren's?
Sure. Yeah, thanks, thanks for the question. We agree that there's been a lot of external validation, external proof of concept of this mechanism in a range of autoimmune diseases. And that actually is a good thing, in the sense that it de-risks many of the different, disease mechanisms as we consider, the path forward for abiprubart. And in terms of, you know, the differentiating features, you know, as we look at some of these different, assets that are already, you know, that are already working their way through, you know, none of which are, yet approved. In terms of certain limitations, some of them are IV only, or if they're subcutaneously administered, they might require relatively frequent dosing.
And so as we thought about the abiprubart development program, we looked into what were the fundamental attributes that would distinguish abiprubart from the others. And so we set out from the beginning to focus on subcutaneous dosing. We did that even in our phase one study. And then from a formulation perspective, we focused on developing a high concentration liquid formulation that would enable us to deliver enough drug subcutaneously, such that less frequent dosing might be possible. So that's what we studied in our phase two study in rheumatoid arthritis, where we tested weekly, biweekly, and even monthly administration of abiprubart at a 400 milligram, you know, maximum dose, 5 milligrams per kilo or 400 milligrams.
And what we found was that relatively similar efficacy, if you will, across those three dosing intervals, thus really kind of setting the stage for the fact that it is possible, to test, abiprubart with monthly dosing subcutaneously, you know, going forward. And so thinking about that, that's then how we moved forward into the Sjögren's study, that we initiated recently. World Sjögren's Day was, in fact, just last month. And in that study, what we're doing is we're testing, you know, biweekly dosing, but also monthly dosing of abiprubart in that study.
In a sense, as a fast follower with a differentiated profile, that we were able to kind of learn a lot from the world ahead, but at the same time, put a flag in the ground of why we think abiprubart has the potential to be differentiated in the space where there are no approved therapies.
So in terms of the Sjögren's study, you're studying the ESSDAI population right now. What are you hoping to learn from this study that could be used, you know, to move forward to registration and trials? And can you provide any updates on, like, how enrollment is going?
Yeah. So, you know, the trials, back to the last part of your question, the trial is posted on ClinicalTrials.gov. And so, you know, enrollment updates, you know, kind of, or study updates come through that pathway, you know, as usual. But, what we can, you know, say is that we've started enrollment in the trial. In terms of the specifics of the trial, yes, we're taking patients with, using this composite endpoint called the ESSDAI, which measures systemic, if you will, systemic manifestations of disease as well as certain patient symptoms, as assessed by the clinician. And so that is a fairly standardized approach to studying the disease.
At this point, there's no established regulatory endpoint for approval, but it seems to be a useful benchmark, if you will, for studying patients. You know, I think what we've been able to do is refine our study of the endpoint to make sure that there's sufficient dynamic range in the experiment, such that the parts of the ESSDAI score that are the most modulatable by a treatment over, you know, a relatively brief period of time, if you will, 24 weeks, allows us to study that endpoint in great detail. Where we go from there, you know, clearly there is a range of endpoints that are being studied.
There are also studies of, you know, patient symptomatology, especially around the sicca symptoms, you know, the dryness in the eyes and the mouth. Some of that information is collected in this clinical trial. That'll give us, you know, additional insights into that aspect of the disease. Going forward, I think that sets the stage for registrational trials that could follow, you know, assuming that abiprubart, you know, performs as we would hope.
In terms of, you know, with the last couple of minutes, in terms of indication selection for abiprubart and kind of like, how are you gonna move forward with this program? Are you gonna wait to see the Sjögren's data before you announce new indications, or should we be expecting, you know, new announcements anytime soon?
Right. So, you know, clearly, as you mentioned in the first part of your remarks, this mechanism has been essentially validated across a range of autoimmune diseases. And from our perspective, abiprubart has been de-risked, if you will, from the perspective of target engagement already with the rheumatoid arthritis study. And so while we've announced that, Sjögren's disease is where, you know, we are now, and that's the study that we've started, you know, we're aware of the fact that there is a broad potential, you know, for this drug going forward. And so, you know, we don't necessarily need to wait for the Sjögren's result to do additional work. We're obviously always looking for, you know, potential opportunities.
But given the results of the RA study, I think we have the information that we need, in terms of understanding dose response, which is a critical element of, you know, picking the right, doses to take into subsequent clinical trials.
Awesome. I mean, these were all my questions. Thank you so much for joining us today.
Thank you for having us.
Thank you, Eva.