On May 4, 2022 Horizon Therapeutics plc (Nasdaq: HZNP) reported first-quarter 2022 financial results and maintained its full-year 2022 net sales and adjusted EBITDA guidance (Press release, Horizon Pharma, MAY 4, 2022, View Source [SID1234613475]).
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"Our first quarter financial and operational performance established a strong start to the year, with meaningful progress on our strategic priorities and positioning us well for another year of top-tier growth," said Tim Walbert, chairman, president and chief executive officer, Horizon. "We advanced our pipeline with the initiation of two clinical trials, drove strong performance of our key growth drivers, TEPEZZA, KRYSTEXXA and UPLIZNA, and continued our international expansion. In addition, the FDA granted priority review of our sBLA to expand the KRYSTEXXA label to include co-treatment of KRYSTEXXA plus methotrexate, marking an important milestone in our journey to help more uncontrolled gout patients benefit from the medicine."
First-quarter 2021 results were negatively impacted by a short-term TEPEZZA supply disruption due to U.S. government-mandated COVID 19-vaccine orders.
First Quarter and Recent Company Highlights
FDA Granted Priority Review of sBLA for Co-Treatment of KRYSTEXXA Plus Methotrexate: In March, the U.S. Food and Drug Administration (FDA) granted priority review of the Company’s sBLA to expand the label for KRYSTEXXA to include co-treatment with methotrexate. The Company submitted an sBLA in January based on results from the MIRROR Phase 4 randomized placebo-controlled trial which demonstrated that 71% of patients receiving KRYSTEXXA plus methotrexate achieved a complete response, a more than 30 percentage-point improvement compared to patients who were randomized to receive KRYSTEXXA plus placebo (p<0.0001). An updated label would allow the Company’s commercial team to promote KRYSTEXXA plus methotrexate to physicians. The Prescription Drug User Fee Act (PDUFA) action date is July 7, 2022.
UPLIZNA Approved in Europe and China for NMOSD: In April, the European Commission approved UPLIZNA for the treatment of adult patients with neuromyelitis optica spectrum disorder (NMOSD) who are Anti-Aquaporin-4 Immunoglobulin G Seropositive (AQP4-IgG+). Germany is expected to be the first country where the Company initiates promotional and commercialization efforts in the EU. In March, the Company’s strategic partner Hansoh Pharmaceutical Group Company Limited received approval of UPLIZNA for the treatment of NMOSD from the National Medical Products Administration of the People’s Republic of China.
Advancing the Company’s Global Expansion with TEPEZZA and UPLIZNA Launch Preparations in Brazil: The Company initiated its build-out of primary infrastructure in Brazil to support the potential approvals of TEPEZZA for thyroid eye disease (TED) and UPLIZNA for NMOSD. There are no on-label treatments that are commercially available for TED or NMOSD in Brazil. Brazil marks the newest market that the company is pursuing as part of its global expansion strategy.
Initiated Enrollment in Two Clinical Trials:
In January, the first patient enrolled in a pivotal Phase 2b trial to evaluate HZN-825 in patients with idiopathic pulmonary fibrosis (IPF), the most common form of interstitial lung disease. IPF is a rare, progressive lung disease caused by inflammation and fibrosis, or scarring, of the lungs.
In February, the first patient enrolled in a Phase 3 trial in Japan to evaluate TEPEZZA in patients with moderate-to-severe active TED, a serious, progressive and potentially vision-threatening rare autoimmune disease. TEPEZZA has not been approved for commercial use in Japan.
Announced Positive Topline Proof-of-Concept Data from Dazodalibep Rheumatoid Arthritis Trial: In May, the Company announced positive topline results from the Phase 2 randomized placebo-controlled trial of dazodalibep in patients with RA. The primary endpoint of the trial was met across all doses, a statistically significant change from baseline in DAS28-CRP, a standardized measure of disease activity in RA trials, at Day 113. In addition, dazodalibep was well tolerated across all doses. The impact observed after various doses will inform the dosing regimen for other studies with dazodalibep.
Presented New UPLIZNA Data at Key Medical Meetings: In April, multiple new data were presented at the American Academy of Neurology (AAN) 2022 Annual Meeting, including new data from the Phase 3 trial showing no significant differences in attacks or Expanded Disability Status Scale (EDSS) worsening between NMOSD patients treated with UPLIZNA with one pre-study attack and those with two or more pre-study attacks. A separate new analysis of the Phase 3 trial showed long-term treatment with UPLIZNA improved pain and quality of life outcomes for at least three years. Additionally, new data from the Phase 3 trial were presented at the 48th Annual Meeting of the North American Neuro-Ophthalmology Society (NANOS 2022) in February, showing that treatment with UPLIZNA effectively reduced the severity of attacks in patients with NMOSD.
Presented New TEPEZZA Data at Key Medical Meeting: In February, multiple new data were presented at NANOS 2022, including new data from a post-marketing safety analysis of hearing-related events associated with TEPEZZA. Among the thousands of patients included in the analysis, approximately 10% of all cases reported to the safety database included a hearing-related event. This rate was similar to the rate in the Company’s initial trials. The majority of hearing-related adverse events in the pivotal trials and post-approval have been mild to moderate and reversible. No new safety concerns were observed in the post-marketing safety analysis.
New TEPEZZA Chronic TED Data Published: In January, new data from an independent physician case study of six chronic TED patients who showed benefit after treatment with TEPEZZA were published in Eye, the official journal for the Royal College of Ophthalmologists. The case study adds to the growing body of evidence supporting the use of TEPEZZA in chronic TED patients, with nearly 60 chronic TED patients across multiple case studies who have demonstrated benefit.
Expanding East Coast R&D and Technical Operations Hub: In January, the Company announced it entered into an agreement to lease a new 192,000-square-foot, state-of-the-art facility under construction in Rockville, Maryland that will serve as the Company’s primary East Coast research and development and technical operations hub. The Company is significantly expanding and consolidating its East Coast footprint with the new facility, nearly quadrupling its current Maryland footprint acquired in the 2021 acquisition of Viela. The Company anticipates adding key R&D talent to support its growing research and development capabilities and expanded pipeline.
Received Multiple Best Workplace Awards: In April, the Company was named one of Fortune’s "100 Best Companies to Work For" for the second consecutive year, retaining the highest ranked position in the biotechnology/pharmaceutical category. In March, Great Place to Work Ireland recognized Horizon as one of the "Best Workplaces in Ireland 2022" for the third consecutive year. These recognitions add to the many workplace awards the Company has received, reflecting the high level of engagement of its employees.
New President, Global Commercial Operations: The Company announced today that Jacopo Leonardi will join Horizon as president, global commercial operations, reporting to Tim Walbert, chairman, president and chief executive officer, effective May 16, 2022. Leonardi is an accomplished life sciences executive with more than two decades of commercial experience, which includes commercial launch, R&D new product planning as well as accelerating growth for high performing businesses in rare disease and immunology. Leonardi will oversee the U.S. and international commercial organizations, commercial development (life-cycle management) and global medical affairs.
Key Clinical Development Programs
Daxdilimab (HZN-7734), an anti-ILT7 human monoclonal antibody that depletes certain dendritic cells. Depleting these cells may interrupt the cycle of inflammation that causes tissue damage in diseases such as lupus, and a variety of other autoimmune conditions.
Systemic Lupus Erythematosus (SLE) Trial: Phase 2 randomized placebo-controlled trial underway to evaluate daxdilimab in patients with SLE, a disease in which the body’s immune system attacks its own tissues and organs.
Alopecia Areata Trial: Phase 2 trial to evaluate daxdilimab in patients with alopecia areata, an autoimmune disorder characterized by nonscarring hair loss, expected to initiate in the second quarter of 2022.
Discoid Lupus Erythematosus (DLE) Trial: Phase 2 trial to evaluate daxdilimab in patients with DLE, a rare, chronic, inflammatory skin condition characterized by lesions that result in scarring, expected to initiate by mid-year 2022.
Lupus Nephritis Trial: Phase 2 trial to evaluate daxdilimab in patients with lupus nephritis, a rare, autoimmune and inflammatory condition of the kidney, expected to initiate in the third quarter of 2022.
Dermatomyositis Trial: Phase 2 trial to evaluate daxdilimab in patients with dermatomyositis, a rare, autoimmune disorder characterized by rashes, debilitating muscle weakness and interstitial lung disease, expected to initiate in the fourth quarter of 2022.
Dazodalibep (HZN-4920), a CD40 ligand antagonist that blocks T-cell interaction with CD40-expressing B-cells, disrupting the overactivation of the CD40 ligand co-stimulatory pathway. Several autoimmune diseases are associated with the overactivation of this pathway.
Sjögren’s Syndrome Trial: Phase 2 randomized placebo-controlled trial underway to evaluate dazodalibep in patients with Sjögren’s syndrome, a chronic, systemic autoimmune condition that impacts exocrine glands, including the salivary and tear glands. The trial completed enrollment in April 2022.
Rheumatoid Arthritis Trial: Phase 2 randomized placebo-controlled trial to evaluate dazodalibep in patients with RA. Topline results were announced in May 2022. The trial met the primary endpoint and dazodalibep was well tolerated.
Kidney Transplant Rejection Trial: Phase 2 open-label trial underway to evaluate dazodalibep in kidney transplant rejection patients.
Focal Segmental Glomerulosclerosis (FSGS) Trial: Phase 2 trial to evaluate dazodalibep in patients with FSGS, a rare kidney disorder characterized by scarring of glomeruli, expected to initiate in the fourth quarter of 2022.
HZN-825, an oral lysophosphatidic acid receptor 1 (LPAR1) antagonist designed to prevent gene activation.
Diffuse Cutaneous Systemic Sclerosis Trial: Pivotal Phase 2b trial underway to evaluate HZN-825 in diffuse cutaneous systemic sclerosis.
Idiopathic Pulmonary Fibrosis Trial: Pivotal Phase 2b trial initiated in January 2022 to evaluate HZN-825 in idiopathic pulmonary fibrosis, the most common form of interstitial lung disease.
UPLIZNA, an anti-CD19 humanized monoclonal antibody that depletes B-cells, including the pathogenic cells that produce autoantibodies.
Myasthenia Gravis Trial: Phase 3 randomized placebo-controlled trial underway to evaluate UPLIZNA in patients with myasthenia gravis, a chronic, rare, autoimmune neuromuscular disease that affects voluntary muscles, especially those that control the eyes, mouth, throat and limbs.
IgG4-Related Disease Trial: Phase 3 randomized placebo-controlled trial underway to evaluate UPLIZNA in patients with IgG4-related disease, which is a group of disorders marked by tumor-like swelling and fibrosis of affected organs, such as the pancreas, salivary glands and kidneys.
TEPEZZA, an insulin-like growth factor type 1 receptor (IGF-1R) antagonist monoclonal antibody.
Chronic TED Trial: Phase 4 randomized placebo-controlled trial underway to evaluate TEPEZZA in chronic TED.
TED in Japan (OPTIC-J) Trial: Phase 3 randomized placebo-controlled trial in Japan initiated in February 2022 to evaluate TEPEZZA in patients with moderate-to-severe active TED.
Subcutaneous (SC) Administration Trial: Phase 1b trial to explore the pharmacokinetics, safety, tolerability, efficacy and immunogenicity of subcutaneous administration of TEPEZZA in patients with TED, expected to initiate by mid-year 2022.
Diffuse Cutaneous Systemic Sclerosis Exploratory Trial: Phase 1 exploratory trial underway to evaluate TEPEZZA in diffuse cutaneous systemic sclerosis.
KRYSTEXXA, a recombinant uricase enzyme that converts urate into a water-soluble liquid, allantoin, that can be easily excreted from the body.
Shorter Infusion Duration Trial: Phase 4 open-label trial underway to evaluate the impact of administering KRYSTEXXA plus methotrexate over a shorter infusion duration in patients with uncontrolled gout.
Monthly Dosing Trial: Phase 4 open-label trial underway to evaluate monthly dosing of KRYSTEXXA plus methotrexate in patients with uncontrolled gout.
Retreatment Trial: Phase 4 open-label trial underway to evaluate KRYSTEXXA plus methotrexate in patients who were not complete responders to KRYSTEXXA monotherapy.
HZN-1116, a fully human monoclonal antibody designed to bind and neutralize the function of the FLT3-ligand, thereby reducing both conventional and plasmacytoid dendritic cells.
Autoimmune Disease Trial: Phase 1 trial underway to evaluate HZN-1116 in patients with autoimmune diseases.
First-Quarter Financial Results
Note: For additional detail and reconciliation of non-GAAP financial measures to the most directly comparable GAAP financial measures, please refer to the tables at the end of this release.
Net Sales: First-quarter 2022 net sales were $885.2 million, an increase of 159% compared to the first quarter of 2021. First-quarter 2021 results were negatively impacted by a short-term TEPEZZA supply disruption due to U.S. government-mandated COVID 19-vaccine orders.
Gross Profit: Under U.S. GAAP, the first-quarter 2022 gross profit ratio was 75.7% compared to 70.7% in the first quarter of 2021. The non-GAAP gross profit ratio in the first quarter of 2022 was 88.9% compared to 90.9% in the first quarter of 2021.
Operating Expenses: R&D expenses were 11.7% of net sales and SG&A expenses were 42.1% of net sales in the first quarter of 2022. First-quarter non-GAAP R&D expenses were 10.4% of net sales and non-GAAP SG&A expenses were 37.1% of net sales.
Income Tax Expense (Benefit): On a GAAP basis in the first quarter of 2022, income tax benefit was $31.5 million. First-quarter non-GAAP income tax expense was $35.7 million.
Net Income: In the first-quarter of 2022, net income on a GAAP and non-GAAP basis was $204.3 million and $315.8 million, respectively.
Earnings (Loss) per Share: On a GAAP basis, diluted earnings (loss) per share in the first quarter of 2022 and 2021 were $0.87 and $(0.55). Non-GAAP diluted earnings per share in the first quarter of 2022 and 2021 were $1.34 and $0.02, respectively. Weighted average shares outstanding used for calculating GAAP and non-GAAP diluted earnings per share in the first quarter of 2022 were 236.0 million.
First-Quarter Segment Results
Management uses net sales and segment operating income to evaluate the performance of the Company’s two segments, the orphan segment and the inflammation segment. While segment operating income contains certain adjustments to the directly comparable GAAP figures in the Company’s consolidated financial results, such as the exclusion of upfront and milestone payments related to license and collaboration agreements, it is considered to be prepared in accordance with GAAP for purposes of presenting the Company’s segment operating results.
Orphan Segment Operating Income
First-quarter 2021 results were negatively impacted by a short-term TEPEZZA supply disruption due to U.S. government-mandated COVID 19-vaccine orders.
UPLIZNA was acquired on March 15, 2021. First-quarter 2022 UPLIZNA net sales included $5.2 million in revenue and milestone payments from the Company’s international partners.
First-quarter 2022 net sales of the orphan segment, the Company’s strategic growth segment, were $834.4 million, driven by the strong performance of TEPEZZA, KRYSTEXXA, RAVICTI, PROCYSBI, ACTIMMUNE and UPLIZNA. First-quarter 2022 orphan segment operating income was $351.5 million.
Inflammation Segment Operating Income
On Aug. 4, 2021, Alkem Laboratories, Inc. initiated an at-risk launch of generic DUEXIS in the United States.
First-quarter 2022 net sales of the inflammation segment were $50.9 million and segment operating income was $15.3 million.
Cash Flow Statement and Balance Sheet Highlights
First-quarter 2022 operating cash flow on a GAAP and non-GAAP basis was $215.8 million and $222.6 million, respectively.
As of March 31, 2022, the Company had cash and cash equivalents of $1.64 billion.
As of March 31, 2022, the total principal amount of debt outstanding was $2.60 billion.
2022 Guidance
The Company continues to expect full-year 2022 net sales to range between $3.9 billion and $4.0 billion, representing 22% growth at the midpoint. The Company continues to expect TEPEZZA full-year 2022 net sales percentage growth in the mid-30s and KRYSTEXXA full-year 2022 net sales growth of more than 20%. The Company continues to expect full-year 2022 adjusted EBITDA to range between $1.63 billion and $1.70 billion, representing 30% growth and 230 basis points of margin expansion at the midpoint.
Webcast
At 8 a.m. EDT / 1 p.m. IST today, the Company will host a live webcast to review its financial and operating results and provide a general business update. The live webcast and a replay may be accessed at View Source Please connect to the Company’s website at least 15 minutes prior to the live webcast to ensure adequate time for any software download that may be needed to access the webcast. A replay of the webcast will be available approximately two hours after the live webcast.