Laks Hanbury-Brown
Analyst, William Blair
Replay available
Uniqure (NASDAQ:QURE) reported Q3 2026 results on this call. Replay available.

Automated transcript · Written by software from the replay's audio. It can mishear names and figures; the replay is the record.
0:00 Hello and thank you for standing by. My name is John and I will be your conference operator today. At this time, I would like to welcome everyone to the Unique Year 3rd Quarter 2026 earnings call. All lines have been placed on view to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star followed by the number 1 on your telephone keypad. If you would like to withdraw your question, press star 1 again. Thank you. I would like to turn the call over to Chiara Russo, Senior Director of Investor Relations.
0:37 Thank you. Good morning, and thank you for joining us for Unicare's third quarter of 2026 earnings call. Earlier this morning, Unicare released its financial results for the third quarter of 2026, and our press release is available on the Investors and Media section of our website at unicare.com. Our 10-Q was also filed with the SEC earlier today. Joining me on the call this morning are Matt Kapusta, Chief Executive Officer, Dr. Walid Abi-Saab, Chief Medical Officer, Kylie O'Keefe, Chief Customer and Strategy Officer, and Christian Klemt, Chief Financial Officer. After our formal remarks, we'll open up for an analyst Q&A. Before we begin, Please know that we will be making forward-looking statements during this investor call. All statements, other than statements of historical fact, are forward-looking statements. They are based on management's beliefs and assumptions and on information available to management only as of the date of this conference call.
1:37 Our actual results could differ materially from those anticipated in these forward-looking statements for many reasons, including without limitation the factors described in Unicure's most recent SEC filings. Given these risks, we should not place undue reliance on these forward-looking statements, and we assume no obligation to update these statements, even if information becomes available in the future. Now, let me introduce Matt Kapusta, Unicare's CEO.
2:03 Thanks, Chiara. Good morning, and thank you for joining us on today's call. For the families who avoid degeneration for treatment for Huntington's disease, this quarter brought meaningful progress. As we announced Monday, The FDA has accepted our biologics license application for AM2130 and granted priority review with a target PDUFA date of May 1, 2027. In the United Kingdom, the MHRA has also validated our marketing authorization application. These are the first such marketing applications for disease-modifying therapy for Huntington's disease, and it brings patients and families one step closer to a treatment option. We greatly appreciate the engagement of both the FDA and the MHRA and their focus on the critical need for new therapies and Huntington's disease.
2:52 I also want to acknowledge the commitment of our clinical, regulatory, and CMC teams who prepared and submitted both applications in record time. And to every HD patient, family member, and investigator who has trusted us with their hope, thank you. In September, we shared additional data from our ongoing Phase 1-2 studies including updated 36-month data from all 27 valuable patients across the low- and high-dose cohorts and, for the first time, 48 months of follow-up after a single administration of AMT130. These data continue to show meaningful dose-dependent slowing of disease progression and reinforce our strong belief that AMT130 has the potential to deliver treatment benefit to patients.
3:38 We are also pleased to have aligned with the FDA on the key elements of the confirmatory study design, and we are making significant progress getting the trial up and running. We are fully committed to the timely execution of this study, and our priority is to have it well underway at the time of an approval decision. Walid will provide more detail on the confirmatory study later in the call. Regarding commercial preparations, we are making excellent progress ahead of potential US launch in 2027. We continue to build out our field, medical, market access, and strategic account teams in a disciplined way, and our financial strength provides the runway needed to execute this build-out. Kylie and Christian will provide more details on our commercial readiness and financial position later on the call.
4:26 Beyond AMT-130, we continue to advance our broader pipeline. We've completed enrollment in the second-dose cohort of our Phase I two-way study of AMT-260 and refractory, Mesial Temporal Lobe Epilepsy, and have resumed enrollment in the Phase 1-2 study of AMT191 and Fabry disease. For both programs, we expect to present new and updated data in the first half of 2027. In summary, we are heading into the end of 2026 with strong momentum. Our priorities are clear. Working closely with regulators as the application reviews proceed, executing our confirmatory study, advancing our pipeline, and building the organization to prepare for the planned launch of AMT-130. With that, I will turn the call over to Walid to provide additional detail on AMT-130 in our pipeline. Walid?
5:19 Thank you, Matt. Good morning and good afternoon, everyone. I'll start with AMT-130 and Huntington's disease, or HD. As Matt noted, the BLA is under priority review with the PDUFA date of May 1, 2027, and the MAA has been validated by the MHRA. Both submissions are based on the 36-month analysis we presented in September 2025. In that analysis, the high dose of ANT130 showed a 75% slowing of disease progression on the composite unified Huntington's disease rating scale, or C-ratio RS, and a 60% slowing on total functional capacity, or TFC, compared with the propensity score matched external control.
6:04 Both results were statistically significant. With the BLA now accepted and under active review, going forward, we will not be commenting on specific information requests made by the FDA, including questions regarding a potential outcome. The FDA indicated that they are tentatively planning to discuss our application and an outcome. As you're aware, scheduling an outcome is within the sole discretion of the agency. In September 2026, We presented detailed analyses from a recent data cutoff. I will not repeat that today. Instead, I would like to focus on the progress we've made towards initiating the confirmatory study. Earlier this year, we reached alignment with the FDA on key elements of the design.
6:51 Specifically, this will be a randomized study with a 2 to 1 ratio of AMT130 high dose to standard of care. It will include approximately 200 patients. The primary endpoint is TFC at 36 months. After 36 months, all standard of care participants will be offered AMT-130 in a separate open-label study. Unicure is fully committed to completing the study in a timely manner. Preparations started at the beginning of this year and have accelerated following alignment with the FDA. This will be a global study with sites across North America, Europe, and Latin America. The protocol has already been submitted to institutional review boards, or IRBs, in the US, and we expect to begin patient screening by the end of this year.
7:44 I would like to take a moment to talk about TFC, the primary endpoint in the confirmatory study. This is a critical endpoint that is very important, not only for regulators, but also for people living with HD. Why is TFC important? TFC captures whether a person can keep working Manage their finances, handle household responsibilities, take care of themselves day-to-day, and live without full-time care. For patients and families, these are not abstract measures. They are the difference between maintaining and losing independence, and they are directly related to quality of life. This is what patients and families care about. In fact, it is what we heard from HD specialists at the two most recent scientific meetings we attended, the International Parkinson and Movement Disorder Society meeting in Seoul, and the European Huntington's Disease Network meeting in Krakow.
8:41 These specialists described TFC as the endpoint they find most meaningful when talking with patients. Across our Phase I-II studies, TFC declined by less than a tenth of a point per year in patients who received a high dose of AMT-130. This remarkably slow decline was consistent across all analyses and maintained through four years following treatment. Although these results come from a relatively small number of patients, they have never been seen before in HD. Moving on to our other clinical programs, starting with AMT260 for refractory mesial temporal lobe epilepsy. Following the initial six-month data of the first low-dose cohort of six patients, which was presented in June, Earlier this quarter, we completed enrollment of the second cohort of seven higher-dose patients.
9:36 We expect to present updated results from both cohorts in the Phase I-II-A study in the first half of 2027. Turning to AMT191 for Fabry disease. In August, enrollment resumed in the mid- and high-dose cohorts. As a reminder, dosing has been paused per protocol in these two cohorts after asymptomatic liver enzyme elevation, which fully resolved following a course of immunosuppression. We presented updated results in June from a March 15th cutoff, and we expect to share updated results from all three dosing cohorts in the first half of 2027. Now, I will turn the call over to Kylie to discuss our recent patient advocacy work.
10:21 Kylie?
10:24 Thanks, Walid. With a known PDUFA date ahead of us, the question for our customer-facing team is no longer when, it's how. How do we make sure every piece of this patient journey is in place and well-supported by the PDUFA date, so if approval is granted, we are ready to launch? For AMT 130, that journey runs from identifying an eligible patient through evaluation, surgery, follow-up, and reimbursement. It involves many critical stakeholders. Our job is to ensure a smooth process for patients, families, and the clinicians who care for them. For many of these families, the patient journey already runs through a familiar place, a specialty HD clinic they have relied on for years.
11:13 That is an important feature of this market as HD care is concentrated. A large share of diagnosed patients are seen at a number of specialty centers many of them HTSA Centers of Excellence. That concentration will allow for a focused launch footprint. We continue to see strong enthusiasm from the physician and patient community. This quarter, our team spent significant time with the Huntington's Disease Clinical and Patient Communities. That included the International Congress of Parkinson's Disease and Movement Disorders, or MDS, and the EHDN Clinical Research Congress. These meetings came shortly after we submitted our BLA and UK MAA and shared our recent data.
12:00 That gave us a timely chance to hear directly from the physicians who care for HC patients every day. Our ongoing interactions tell us that physicians and families place great weight on preserving function and independence. And that is why the total functional capacity data Walid described resonates so strongly. We expect uptake to be shaped mainly by treatment center capacity in the early launch period, not by demand. That's why center readiness is our top operational priority and preparing to allow them to be operational as quickly as possible after a potential approval. Moving on to identifying treatment centers. AMT130 is a one-time administered therapy through a neurosurgical procedure.
12:48 Each treatment center therefore needs three capabilities working together. HD neurology expertise to identify and evaluate patients, neurosurgical teams experienced in image-guided delivery, and the ancillary infrastructure to support the procedure and product handling. We have identified priority centers in the US and the UK. Our readiness work at these centers covers three key areas. First, neurosurgical training and procedural support. Second, product handling. And third, patient evaluation and Referral Pathways. Our goal is for a meaningful number of centers to be ready to treat eligible patients soon after a potential approval.
13:33 Finally, access and our ongoing work with payers. We have been engaging with access stakeholders through appropriate pre-approval information exchange. These initial conversations cover the burden of Huntington's disease, the clinical data package and the economic profile of a one-time therapy. From early discussions, payers recognized the high in that need in HD and the lack of any approved disease modifying therapies. And there is a strong interest in learning more about AMT 130. In the UK, we have begun engaging with NICE, NHS England, and are planning for health technology assessments so that access can follow as closely as possible after any potential MHRA decision. Finally, we continue to build the team that will make this launch a success.
14:22 We expect to have our core team fully in place by early next year, ahead of the producer date. We're hiring with care, bringing in people with deep experience in rare disease, gene therapy, and neurology launches. To summarize, we are preparing with urgency and discipline. Our goal is that if AMT 130 is approved, patients can move from referral to treatment as efficiently as possible. With that, I'll turn the call over to Christian for a financial update. Christian?
14:53 Thank you, Carly. I'll now be sharing the financial highlights of the third quarter of 2026. Please refer to the earnings press release issued this morning and our quarterly filings with the SEC for additional detail. Revenue for the three months ended September 30, 2026, was $5.2 million, compared to $3.7 million in the same period in 2025. The increase of $1.5 million is due to an increase in license revenue compared to the prior period. Research and development expenses were $35.5 million when the three months ended, September 30, 2026, compared to $34.4 million during the same period in 2025. The $1.1 million increase primarily driven by $3.6 million increase in employee-contractor-related expenses, including share-based compensation, which was partially offset by a $2.3 million decrease in direct research and development expenses.
15:57 The decrease in direct research and development expenses resulted from a $4.1 million reduction in process validation expenses related to AMT-130, a $1.5 million increase in expenses related to NT260 and a $1.7 million increase in expenses related to preclinical activities and technology innovation projects. Selling, general, and administrative expenses were $23.9 million for the three months ended September 30, 2026, compared to $19.4 million during the same period, 2025. The $4.5 million increase was primarily related to a $3 million increase in employee and contractor-related expenses including share-based compensation, mainly as a result of the recruitment efforts over the last 12 to 15 months, a $0.7 million increase in professional fees, and a $0.7 million increase in information technology costs to support the potential commercial launches of ANT 130.
17:04 Cash, cash equivalents and investment securities totaled $768.4 million as of September 30, 2026, compared to $622.5 million as of December 31, 2025. We believe that Unicure continues to be well-positioned to execute on its clinical and operational priorities. Expect that cash, cash equivalents, and investment securities will be sufficient to fund operations into 2030. I now turn the call back over to Matt.
17:40 Thank you, Christian. As you've heard today, the third quarter of 2026 was an important one for Unicure and for people impacted by Huntington's disease. We believe that AMT 130 has demonstrated a meaningful slowing of disease progression and has the potential to provide treatment benefit for people living with Huntington's disease. We now look forward to working with the regulatory agencies to bring AMT 130 to patients as soon as possible. With that, operator, please go ahead and open the call for questions. Thank you. We will now begin the question and answer session. If you're dialed in and would like to ask a question, simply press star then the number one on your telephone keypad to raise your hand and enter the queue.
18:27 Okay, so our first question comes from the line of the G Chattopadhyay with Guggenheim Securities. Your line is now open.
18:39 Hey, good morning and thank you for taking my questions. I have a couple. First on AMT 130, If it becomes commercially available in the U.S. next year, how are you modeling potential dropouts from the standard of care cohort in the confirmatory study? And number two, are you evaluating any alternative delivery approaches to potentially expedite the procedure times? Thank you so much.
19:07 Hey, Devjit. It's Matt here. Walid, do you want to take the first question on the confirmatory study?
19:13 Sure. I'd love to. This is going to be a global clinical study. Early on, we're going to be prioritizing recruitment in the U.S. to get us up and running and be meaningfully recruited, but the reach will be global such that during the conduct of the study, we will go to places where we will not be having AMT-130 on the market during the conduct of the study, and that will reduce this.
19:43 In addition to this, we are
19:45 We're doing a number of simulations, and we have adjusted our sample size to match this eventuality as well, as well as analysis plans to deal with dropouts whenever they happen in the SOC. I turn it over to you, Matt.
20:08 Yeah, Debjit, on the second question, there is actually a significant amount of work that's going on now looking at procedural adaptations. And, you know, these would be things that would potentially be implemented post-approval. But a number of these things have the potential to meaningfully reduce procedural time and complexity.
20:40 Got it, thank you, and looking forward to the outcome next year. Congrats. Thank you. Okay, next question comes from the line of Paul Matisse with Stifel. Your line is now open.
20:57 Hi, this is Matthew on for Paul. Thank you so much for taking our question and congrats on the progress. I guess maybe a question for Kylie, you know, how quickly would you anticipate patients would be able to get therapy assuming the positive outcome from the MAPE-DUFA and what would be the gating factor there? Would it be access? And then another quick follow-up for the confirmatory study, would the eligibility criteria be similar to the phase one, two, including the stage of the disease and maybe the striatal volume requirements? Thank you so much.
21:36 Thank you very much for the first question. So with regards to what could potentially be gating factors, I think there's two elements to this. Access is, of course, one of them, as well as ensuring that we have P&T approvals in the individual institutions to ensure that patients can get access to the therapy and that the institutions can get paid for that. However, what I would say, while these are traditional gating factors, the team is working very hard Thank you so much for joining us. The team is also working with payers on educating across both the unmet need and Huntington's disease, as well as the AMT-130 data package to ensure that we're able to move it to a possible post-launch.
22:49 So regarding the eligibility for the confirmatory study, that will be similar to what we did for the Phase 1-2, including the stridal volume as well.
23:01 Thank you. Thank you. Next question comes from the line of Joel Schwartz with Learing Partners.
23:15 Thanks. Congrats on all the progress. Given the FDA expects the confirmatory study to be well underway and potentially fully enrolled at the time of accelerated approval and screening starts by year end and the decision date is about four months later on May 1st, we were wondering how many patients Do you expect to have randomized or dosed by then? And then for the advisory committee, how do you keep the discussion on the 36-month analysis, which the FDA agreed supports the BLA rather than re-arguing the 48-month primary analysis?
23:53 And then any sense yet of timing or which committee? Thanks.
24:02 Joe, thanks for the questions. Walid, do you want to take them one by one?
24:09 Sure, happy to. So the FDA's fundamental intent for the confirmatory studies based on their January 25th guidance is to make sure that they can be completed in a timely manner after approval. and we are confident we can demonstrate that. We started to prepare for the study before we engaged fully with the FDA and after we aligned with them, we accelerated that. Our goal is to run the study globally, as I indicated, across the US, Canada, North America, Latin America and Europe. and we intend also to run it in places where there will not be access during the trial so that there will be lower risk of dropout which is when the agency is to a great extent worried about it if we cannot complete the study.
25:00 So with all of these elements in place and making sure that we demonstrate to the agency the full engagement and all these sites across the world that we've engaged with and the momentum for enrollment, we believe that we can present a credible path that would satisfy the agency. Regarding the outcome and 48 versus 36 months, it's premature for us to position this. We will be ready to discuss any action, but to a great extent that will be depending on The agency's briefing book. As you know, in preparation for the adcom, we will be preparing for any possible scenario.
25:48 And we will have to gauge this based on what our specific questions are going to be raising for the adcom and the briefing book supporting that. So we will get a chance to adjust in due course. and regarding the committee, I do not have any more information on this, definitely not from the FDA, but I would imagine it will be the typical committee that reviews cell and gene therapy and advanced therapies. Thank you. Thank you. Next question comes from the line of Luca Issy with With RMBC Capital Markets, your line is now open.
26:30 Great. Thanks so much for taking my question. Congrats on the progress. Maybe, Walid, can you confirm that you have yet to receive the Day 74 letter? And then maybe bigger picture, can you just maybe educate us on what is usually included in that letter? Do you think the FDA will share some of their preliminary concern in the context of the letter? I guess what I'm trying to ask here is whether there could be anything material in the letter that you need to disclose to the street as well or not. And then maybe super quickly, SG&A obviously went up a little bit versus last year. You're obviously preparing for the launch. How should we think about the line item going forward, maybe before and after the PDUFA? Thanks so much.
27:14 Yeah, thanks Luca. Look, as we have indicated that since now we are an active review process, we will not be providing any updates based on requests for information or any other communication with the FDA. Of course, we will respond to them in due course, but unless things are material, we will not be communicating externally. in terms of usually comes at day 74. That would be one example if the agency has, they list their areas of concern and areas that they're focused on. That's usually part of that day 74.
27:57 Christian, you want to answer the SG&A question?
28:00 Sure. Happy to. Look, as you know, we don't give specific guidance. Shouldn't be surprised that SG&A will go up, but we'll maintain our disciplined approach. And it's all built into the runway guidance that we're capable of funding all our products into 2030. Got it. Thanks so much. Next question comes from the line of June Lee with UBS. Your line is now open.
28:37 Hi, thanks for taking our questions. Upon approval in May, how many patients would you be ready to dose in the U.S. and U.K., depending on the approval in U.K., obviously? And what is your manufacturing capacity? And last question, in the unlikely scenario where the FDA does not end up approving AMP-130, are you still obligated to complete the confirmatory trial? Thank you. Kylie, do you want to answer the first question on launch?
29:10 Yeah, absolutely. I think across the board, from a patient perspective, it's a bit premature to provide specific patient estimates. I think what the team is working on extensively is ensuring that we're able to understand what the capacity is at each of the different centers, both in the U.S. and in the U.K., to understand what we think is a reasonable number of centers that need to be operationalized at launch. to be able to try and meet the demand as quickly as possible. So the team is working on that at the moment, and we're targeting a number of institutions that have both HDSA centers of excellence as well as ClearPoint in the same institution to ensure that patients are able to be evaluated, moved to surgery, and then back to neurology very seamlessly.
29:57 And that is the work that's been ongoing. So while we're not quite there yet to give specific patient estimates, I think a reasonable analog is other gene therapies that have launched recently.
30:12 Yeah, and maybe I'll answer the next two questions. On manufacturing capacity, we do not expect that to be a constraint. Remember, these are relatively small volumes that we're administering in a targeted and precise way. Per infusion, this is approximately 500 microliters. So the yields that we get in terms of number of patients that can be treated per batch is meaningfully higher than an IV-administered medicine. On the third question regarding the confirmatory study, obviously, if we're not approved at the PDUFA date, we have to understand the reasons why and what our next steps are going to be.
31:05 If you're asking more about the obligations related to the confirmatory study, I mean, I certainly think we have a commitment to this patient community and there would be an ethical obligation to continue with that study. I don't know if it's a legal obligation, but we're absolutely committed to the HD community. and completing that study whether or not the drug is approved and it's a confirmatory study or if it's a phase three registrational study. Thank you.
31:42 Thank you. Next question comes from the line of Peyton Bonsack with TDCO and your line is now open.
31:51 Hi, this is Peyton. I'm for Joe. Thanks for taking our questions. I guess, can you talk a little bit about the phase three protocol or trial design and anything that's included to decrease any variability in the TFC measure or make sure that there is a high chance to detect a difference between the two groups?
32:07 Thanks. Sure. I assume you meant the confirmatory study, but, Walid, why don't you answer that
32:15 one? Yeah, thanks, Matt. Yeah, I assume it was in the confirmatory study. So look, we take very good care to try and train the sites and do regular training to make sure that the measurement is really accurate. We're collaborating with HSG where they are trying to standardize also the administration of the question for TFC TFC tends to be a bit less noisy because this is not subjective as much in terms of to what degree you have an abnormal movement in various parts of your body, like TMS, which has been shown to be excessively variable.
33:04 TFC talks about, like, really crude measures. Can you work full-time? Can you work part-time? Can you take care of yourself? And those tend to be, you know, a bit much more consistent, you know, I should say. And so we will be doing this. Was there another part of the question that I'm missing? No.
33:29 I think you asked about, yep.
33:32 Yeah, and oh, I wanted to mention also in powering the study, we also were careful, of course, we don't want to be skating too close to the edge. We base it on information that we have from our ongoing study and took the necessary precautions to make sure that we will have enough power also considering potential dropout in the center of care patients in the event that happens.
33:59 Great, thank you. Thank you. Next question comes from the line of Salvin Richter with Goldman Sachs. Your line is now open.
34:11 Good morning. Thanks for taking my question. On the launch here, how many certified neurosurgical centers do you expect to be fully trained and operationally prepared to dose commercial patients at approval and what is the target throughput capacity here? and then if you could just also just speak to how you're thinking about the label and whether it'll reflect the broad, you know, phase one to inclusion criteria or whether it's restricted to specific striatal volume thresholds.
34:45 Absolutely. So starting with the first question on number of neurosurgical centers and capacity, I think one of the things that is important to note is neurosurgical capacity differs quite dramatically from center to center. And so again, this has been a lot of the work that the team has been doing to understand how many functional neurosurgeons would be able to perform the procedure, how many operating rooms are in place that could be used, and then calculating capacity based on those discussion with the centers. And so you see sometimes something from two a week to one a month and it varies center to center. So the team has been really thinking through what is the capacity at each institution and as you look across the institutions, how does that scale up on a national level?
35:31 We're still working through the number that we think will be available at launch. We're certainly going to be north of 15 centers. Could it be 30? Could it be 25? We're still working through that to understand what that could look like and how quickly we can operationalize these centers. But we're looking at centers with the highest potential capacity initially and then also adding additional centers from there. With regards to the second part of the question associated with the label, I think it's a bit premature for us to comment on that. We're not at the stage of discussing the label with the FDA. However, the way we've thought about the addressable market is assuming straight or volume requirements. And then obviously, if that's not the case, then we would adjust that accordingly.
36:31 Okay, moving on to our next question. comes from the line of Yanan Zhu with Wells Fargo. Your line is now open. People are scrambling to find where actually they're asking us. And I have my team checking as well.
36:48 Yeah. Okay. Yeah, but sorry.
36:51 What's big in your conference for us?
36:53 Huh?
36:54 What's big in your conference for us? Oh, for us it's Beijing or B1 Medicine.
37:02 B1 Medicine. I think we should go to the next question, operator. Okay. Thank you. Next question comes from the line of Ellie Merle with Barclays. Your line is now open.
37:16 Hey, guys. Thank you so much for taking your question. Just follow up to the earlier question on the number of patients that you anticipate having dose in the confirmatory trial at the time of like potential approval. I guess do you have plans to submit additional safety data to the FDA prior to accelerated approval? after some of the patients in the confirmatory study have received the initial procedures. And then just a follow-up question on kind of like additional submissions to the FDA. I guess if the FDA asked for the four-year data, would that, you know, potentially warrant a major amendment as part of the review and how you're thinking about that as a potential scenario? Thanks so much.
38:00 Thanks, Ellie. Walid, do you want to answer those?
38:03 Sure. The number of patients, we are confident that we will be well underway by the time we reach PDUFA. And as I mentioned before, we have a lot of measures in place to be able to complete the study in a timely manner across the world. So pretty comfortable with that. In terms of the safety data, we will be providing a day 120 safety update, which is typical. in this situation. And of course, if there's any patients that have been dosed in the confirmatory trial by that cutoff date, those will be included, should be any patient available by that time. Regarding the four-year data, there's been no discussion with the FDA to date regarding the four-year data in terms of requesting it.
38:57 But as I mentioned before, if this were to happen during the course of the review, we will not be communicating on this because, you know, during the process, unless something is material, we will not be communicating on this. Now, as you mentioned, in the event they ask for it, we submit it, and they consider that a major amendment, and there will be a delay to PDUFA. Of course, that will become material, and we will be sharing that information with you. Thank you. Next question comes from the line of Patrick Lutea with HCE Wainwright. Your line is now open. Hello?
39:42 Hi, this is Luis Santos. Hey, Patrick. In for Patrick. Thank you for taking our questions. The question is focused on trying to understand a little bit what could happen in the UK and what steps need to happen assuming MHRA approval. And I would like to also ask a question on your epilepsy data coming up. And I was thinking if you could tell us a little bit more about how do you expect consistency in the patients that were treated with lower dose to inform the expectations for the higher dose. Thank you.
40:24 Thanks for the questions. Do you want to answer the first question, Kylie, on the UK?
40:29 Absolutely. Thanks, Matt. So with regards to your question around what happens from an access point of view to ensure that AMT 130 can be available for patients in the UK, what would happen is we would undergo a NICE review. And from there, assuming success, we would begin NHS commissioning. NHS England, NHS Wales and so on and so forth. We would be commissioning with each of the individual countries in the UK. So what we have done is begun engaging from an early scientific point of view with both NICE and NHS England to ensure that we're able to understand how they're viewing Huntington's disease, how they're viewing the AMT 130 package and then ultimately we'll be in a position next year to be submitting the dossier to ensure that we're starting that process immediately upon approval.
41:22 So for the AMT260 question on MTLE, you know, the really phase one studies are there to learn. You know, we dosed six patients in the low-dose cohort. We had, you know, great results in, you know, in probably half the patients and the others did not respond as well. Thank you very much. Then there would be one interpretation. If that's not the case, then we need to figure out what would be the next step. So those would be part of the evaluation that we will do, and we will be sharing that information with you in the first half of next year. Another element we do in the Phase 1 study is to look at safety.
42:27 and in the first cohort that profile was fairly good at this stage of development. So we were encouraged by that and that allowed us to go to the higher dose cohort. And again, we will be sharing with you the results in the first half of the year.
42:46 Thank you so much. Thank you. Next question comes from the line of Rudy Lee with Wolf Research. Your line is now open.
42:59 Hi, this is Devin on for Rudy. Just had a question on AMT260. Can you talk about the differentiation versus Neurona NRTX1001?
43:12 And what is the bar for a no-go versus a go decision for the ongoing study? Thank you. Walid, do you want to take that?
43:23 Sure. Again, we're early in development, so our goal right now is to evaluate the risk-benefit of this product and see whether there's clear evidence of activity. Our goal in the end would be to be best in class, and that will determine But that will be determined after an appropriately well-controlled trial that we can do. At this point, we're still in the signal detection mode. And as always, we are very careful in making go-no-go decisions. So we're still gathering that information. We will share with you an update early next year. And based on that, we will tell you which direction, based on these data, we will be going next.
44:16 Thank you. Next question comes from the line of Laxan Hanbury-Brown with William Blair, Chicago.
44:28 Hey, guys. Thanks for taking the question. I wanted to follow up on one of the prior questions about the confirmatory trial. You know, you mentioned FDA's guidance about having to be sort of well underway at the time of accelerated approval, but I feel like we've kind of seen them apply that standard a bit differently across programs, so I was just wondering if you'd like at any sort of explicit discussions with them on how they're thinking about that standard and what well underway means in this instance.
44:57 Yeah, I think I'll maybe just, I think it's really the same answer to the question that Walid has mentioned previously. The FDA does have wide discretion to determine what is meaningfully underway. The spirit of this, which applies to really all accelerated approvals, is that they want to ensure that the execution of confirmatory evidence generation is done in a timely manner. They obviously are aware that we just are starting the confirmatory study. We've shared with them approximate timelines as part of our communication. The progress that we're making in getting the study up and running is accelerating.
45:43 We will have an initial focus on enrolling patients in the United States in centers that are already up and running. And we plan to have numerous centers outside the United States, assuming the product is approved. So we're very confident and very committed to this study that we can complete it in a timely manner and then generate the data that is sufficient to support full approval. Thank you. Now our final question comes from the line of Sushaila Hernandez with VLK. Your line is now open.
46:26 Yes, thank you for taking my questions. So for the confirmatory study, could you expand on the primary analysis being assessed at 36 months? What is supporting this time point? And secondly, how many US centers do you expect could administrate AMT 130 in the first 12 months after approval? How do you look at this development during the initial launch period? Thank you.
46:49 Walid, do you want to take the first one and then Kylie, you can take the second?
46:53 Sure. Yeah, the primary analysis is, you know, essentially at 36 months, TFC comparing our treated subjects to the standard of care control. I'm not sure if there's any need to elaborate more. This would be, you know, an MMRM analysis, which is typical of these types of studies. Kylie?
47:19 Thanks, Walid. And with the second question, Across the US, there's more than 60 HTSA centers of excellence. And then when you layer over the top of that centers that also have ClearPoint capabilities, you get to north of 100. This is obviously not what we're targeting in the first 12 months, and as I said, Thank you very much. We're going to be having a certain number of capacity at launch, which, as I said, is going to be north of 15 centers, whether it's 25, whether it's 30.
48:11 That number has not been defined yet. And then we will build from there.
48:18 That's good. Thank you.
48:24 Thank you. So this concludes the question and answer session and our call today. Thank you all for joining. You may now disconnect.
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Analyst, William Blair
Analyst, Barclays
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Chief Financial Officer
Chief Customer and Strategy Officer
Analyst, Leerink Partners
Chief Executive Officer
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Analyst, VLK
Senior Director of Investor Relations
Analyst, H.C. Wainwright
Chief Medical Officer