Heron Therapeutics, Inc. · NASDAQ:HRTX
Heron Therapeutics — Technical Presentation (June 2018)
35 slides from Heron Therapeutics's technical presentation, Jun 21, 2018
Slide 1: HTX-011 Postoperative Pain Program Topline Results from Phase 2b Studies
HTX-011 Postoperative Pain Program Topline Results from Phase 2b Studies June 21, 2018 Exhibit 99.3
Slide 2: Forward-Looking Statements
Forward-Looking Statements This presentation contains "forward-looking statements" as defined by the Private Securities Litigation Reform Act of 1995. We caution investors that forward-looking statements are based on management’s expectations and assumptions as of the date of this presentation and i
Slide 3: Status of Product Portfolio
Preclinical Clinical NDA Approved SUSTOL® (granisetron) extended-release injection CINVANTI® (aprepitant) injectable emulsion HTX-011 bupivacaine + meloxicam ER Local Administration HTX-011 bupivacaine + meloxicam ER Nerve Block Approved by U.S. FDA for CINV Prevention Status of Product Portfolio Ap
Slide 4: HTX-011 Has Received Breakthrough Therapy Designation
HTX-011 for Postoperative Pain Management Has Received Breakthrough Therapy Designation Breakthrough Therapy designation designed to expedite development and review of drugs: Intended to treat serious conditions; and For which preliminary clinical evidence indicates substantial improvement over avai
Slide 5: Postoperative Opioids Are a Gateway to Addiction
Postoperative Opioids Are a Gateway to Addiction $ AS MANY AS 2.6 MILLION patients that take opioids to manage pain after surgery may become persistent opioid users each year . MORE THAN 40 MILLION patients undergoing surgical procedures are prescribed opioids for pain management in the United State
Slide 6: HTX-011 achieved statistically significant reductions in pain and the need for opioids
HTX-011 achieved statistically significant reductions in pain and the need for opioids Vs. Bupivacaine in every phase 2 study and both phase 3 studies
Slide 7: Seven Positive Controlled Studies to Be Included in HTX-011 NDA
Seven Positive Controlled Studies to Be Included in HTX-011 New Drug Application (NDA) Study Phase Surgical Model Tissue Type Significant for Pain Reduction vs. PBO Significant for Pain Reduction vs. BPV Significant Reduction in Opioid Use PK – PD Relation-ship 202 2 Hernia Repair Soft ü ü ü ü 203 2
Slide 8: Recently Completed Phase 2b Studies
Recently Completed Phase 2b Studies
Slide 9: 209: Phase 2b Total Knee Arthroplasty (TKA) Study Design
Study 209: Phase 2b Total Knee Arthroplasty (TKA) Study Design HTX-011 400 mg Instillation N=58 HTX-011 400 mg Instillation + Ropivacaine Injection N=56 Saline Placebo Injection N=53 Bupivacaine 125 mg Injection N=55 Cohort 1 HTX-011 200 mg Instillation N=20 HTX-011 200 mg Instillation + Injection N
Slide 10: 209: Subject Demographics (ITT)
Study 209: Subject Demographics (ITT) Saline Placebo (N=53) Bupivacaine Solution 125 mg (N=55) HTX-011 400 mg (N=114) Total (N=222) Age (years) – mean (SD) 61.5 (8.3) 61.4 (9.4) 62.8 (9.0) 62.1 (8.9) Sex – n (%) Female 25 (47.2%) 35 (63.6%) 53 (46.5%) 113 (50.9%) Male 28 (52.8%) 20 (36.4%) 61 (53.5%
Slide 11: 209: Phase 2b TKA Results Hierarchy
Study 209: Phase 2b TKA Results Hierarchy AUC0-48 HTX-011 400 mg vs. Placebo AUC0-72 HTX-011 400 mg + Ropivacaine vs. Placebo AUC0-48 HTX-011 400 mg + Ropivacaine vs. Placebo p < 0.0001 AUC0-72 HTX-011 400 mg vs. Placebo p = 0.0002 p < 0.0001 p = 0.0004 HTX-011 via instillation achieved primary and
Slide 12: 209: Pain Reduction from HTX-011 at Rest Approximately Double that of Bupivacaine
Study 209: Pain Reduction from HTX-011 at Rest Approximately Double that of Bupivacaine Windowed-worst observation carried-forward (wWOCF) for use of opioid rescue medication and last-observation carried-forward (LOCF) for missing pain data HTX-011 achieved primary endpoint for AUC0-48
Slide 13: 209: Both HTX-011 Arms Significantly Reduce Pain at Rest Compared to Placebo through 72 Hours
Study 209: Both HTX-011 Arms Significantly Reduce Pain at Rest Compared to Placebo through 72 Hours wWOCF for use of opioid rescue medication and LOCF for missing pain data
Slide 14: 209: Significant Separation between HTX-011 Arms and Placebo through 72 Hours
Study 209: Significant Separation between HTX-011 Arms and Placebo through 72 Hours wWOCF for use of opioid rescue medication and LOCF for missing pain data
Slide 15: 209: Both HTX-011 Arms Reduce Pain with Activity Significantly Better than Placebo and Bupivacaine
Study 209: Both HTX-011 Arms Reduce Pain with Activity Significantly Better than Placebo and Bupivacaine through 48 Hours wWOCF for use of opioid rescue medication and LOCF for missing pain data
Slide 16: 209: HTX-011 plus Ropivacaine Significantly Reduces Opioid Use vs. Placebo through 72 Hours
Study 209: HTX-011 plus Ropivacaine Significantly Reduces Opioid Use vs. Placebo through 72 Hours Opioid consumption is presented in mean milligrams of morphine equivalents
Slide 17: 209: Strong Correlation between Pain Reduction and Pharmacokinetics of HTX-011 in TKA
Study 209: Strong Correlation between Pain Reduction and Pharmacokinetics of HTX-011 in TKA HTX-011 400 mg Via Instillation
Slide 18: 209: HTX-011 Well Tolerated in TKA
Study 209: HTX-011 Well Tolerated in TKA HTX-011 was well tolerated, with a safety profile comparable to placebo and bupivacaine solution: No clinically meaningful differences in overall adverse events No difference in the incidence of serious adverse events No difference in premature discontinuatio
Slide 19: 209: TKA Summary
Study 209: TKA Summary HTX-011 achieved primary and key secondary endpoints Both HTX-011 arms achieved significant reductions in pain at rest vs. placebo through 48 hours Also significantly reduced pain at rest through 72 hours vs. placebo Both HTX-011 arms achieved significant reductions in pain wi
Slide 20: Study 211: Phase 2b Breast Augmentation Study Design
HTX-011 60 mg Nerve Block N=12 Saline Placebo Nerve Block N=6 Study 211: Phase 2b Breast Augmentation Study Design Cohort 1 Cohort 2 Interim Review Committee (IRC) Cohort 2 dose decision HTX-011 120 mg Nerve Block N=27 Saline Placebo Nerve Block N=12 Bupivacaine 50 mg Nerve Block N=11 HTX-011 240 mg
Slide 21: 211: Subject Demographics (ITT)
Study 211: Subject Demographics (ITT) Saline Placebo (N=41) Bupivacaine HCL 50 mg (N=41) HTX-011 (N=161) Total (N=243) Age (years) – mean (SD) 31.3 (9.0) 30.4 (7.8) 31.4 (7.8) 31.2 (8.0) Sex – n (%) Female 41 (100%) 41 (100%) 161 (100%) 243 (100%) Race – n (%) Asian 2 (4.9%) 2 (4.9%) 7 (4.3%) 11 (4.
Slide 22: 211: Pain Reduction from HTX-011 at Rest Approximately Triple that of Bupivacaine
Study 211: Pain Reduction from HTX-011 at Rest Approximately Triple that of Bupivacaine HTX-011 achieved primary endpoint for AUC0-24
Slide 23: 211: HTX-011 Instillation Shows Superior Reduction in Pain Intensity Early
Study 211: HTX-011 Instillation Shows Superior Reduction in Pain Intensity Early and HTX-011 Nerve Block Shows Durable Response Notes: Pain intensity collected at rest wWOCF, windowed-worst observation carried-forward for use of opioid rescue medication and LOCF for missing pain data
Slide 24: 211: Raw Pain Scores in All Arms Drop Quickly; Difficult to Discriminate between Arms
Study 211: Raw Pain Scores in All Arms Drop Quickly; Difficult to Discriminate between Arms after 24 Hours Notes: Raw pain intensity collected at rest Scores not adjusted for opioid use
Slide 25: 211: Both HTX-011 Arms Reduce Pain with Activity Significantly Better than Placebo
Study 211: Both HTX-011 Arms Reduce Pain with Activity Significantly Better than Placebo through 24 Hours
Slide 26: 211: Both HTX-011 Arms Significantly Reduce Opioid Use vs. Placebo through 24 Hours
Study 211: Both HTX-011 Arms Significantly Reduce Opioid Use vs. Placebo through 24 Hours Opioid consumption is presented in mean milligrams of morphine equivalents
Slide 27: 211: Strong Correlation between Pain Reduction and Pharmacokinetics in Breast Augmentation
Study 211: Strong Correlation between Pain Reduction and Pharmacokinetics of HTX-011 Instillation in Breast Augmentation
Slide 28: HTX-011 Well Tolerated in Breast Augmentation
HTX-011 Well Tolerated in Breast Augmentation HTX-011 was well tolerated, with a safety profile comparable to placebo and bupivacaine solution: No clinically meaningful differences in overall adverse events No difference in the incidence of serious adverse events No premature discontinuations due to
Slide 29: 211: Breast Augmentation Summary
Study 211: Breast Augmentation Summary HTX-011 achieved the primary endpoint Both HTX-011 arms achieved significant reductions in pain at rest vs. placebo through 24 hours Both HTX-011 arms achieved significant reductions in pain with activity (the most conservative assessment) vs. placebo through 2
Slide 30: Consistent Pharmacokinetics
Consistent Pharmacokinetics
Slide 31: HTX-011 Pharmacokinetics Across Diverse Surgical Models Are More Dose-Linear than Bupivacaine Solution
HTX-011 Pharmacokinetics Across 5 Diverse Surgical Models Are More Dose-Linear than Bupivacaine Solution Bupivacaine Cmax With HTX-011 Bupivacaine Cmax With Bupivacaine HCl
Slide 32: Phase 2b Conclusions
Phase 2b Conclusions HTX-011 plus ropivacaine was significantly superior to both placebo and bupivacaine in TKA HTX-011 demonstrated significant activity via both instillation and nerve block in breast augmentation Pharmacokinetics of HTX-011 remained consistent across 5 diverse surgical models with
Slide 33: Large US Market Opportunity
Large US Market Opportunity Target Market Opportunity Initial Targets Higher volume procedures across 4 major specialties ~6.5M Orthopedic procedures ~4.3M General Surgery procedures ~3.3 M OB/GYN procedures ~1.1M Plastic Surgery procedures Secondary Targets Higher volume procedures in non-core spec
Slide 34: HTX-011 Has Demonstrated Significant Clinical Benefit in Several High-Value Procedures
HTX-011 Has Demonstrated Significant Clinical Benefit in Several of the High-Value Procedures in Initial Target Market Completed studies Procedure Annual Volume (‘000s, US, 2015) Overall % Local Anesthetic Use HTX-011 Significantly Superior to Bupivacaine Claims Survey Ortho Surgery Knee arthroplast
Slide 35: Positive Response by Physicians and Pharmacists to HTX-011's Target Product Profile
Positive Response by Physicians and Pharmacists to HTX-011’s Target Product Profile HTX-011 Target Product Profile: Strengths N = 376 total (101 anesthesiologists, 51 general surgeons, 122 orthopedic surgeons, 50 plastic surgeons, 52 pharmacy directors) *Opioid AE’s are assumed to be reduced with si
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