Alnylam Pharmaceuticals, Inc. (ALNY) Earnings Call Transcript & Summary
June 15, 2021
Earnings Call Speaker Segments
Maurice Raycroft
analystHi, everyone. My name is Maury Raycroft. And I'm one of the biotech analysts at Jefferies. So it's great pleasure that I'd like to welcome Jeff Poulton, the CFO of Alnylam. Thanks for joining us today, Jeff.
Jeffrey Poulton
executiveThanks, Maurice. It's great to be here with you today.
Maurice Raycroft
analystAnd Alnylam is a very interesting company with RNAi therapeutics, cutting-edge technology I would say. Jeff, maybe to start off, if you want to provide a 1-minute intro to Alnylam.
Jeffrey Poulton
executiveGreat. I'll try and keep it to a minute. You're right. There's a lot of exciting things going on at Alnylam. We're the leader in RNAi therapeutics, pioneering a whole new class of medicines. And the profile of the company today is a fully integrated biotech. So we've got a commercial part of the business that's -- it was created over the last 3 years. We've got 4 marketed products today, 3 of which are wholly owned by Alnylam. I think we'll talk about those during the course of our discussion today. All of those are relatively new to the market. So very much in growth mode for the foreseeable future. On the pipeline side, we've got 12 programs in clinical development today, including a couple of key Phase III programs that we think will hopefully open up a much larger part of the TTR market for Alnylam in the future. Again, I think we'll have an opportunity to talk about that. Preclinically, we've got approximately 25 programs in our pipeline, both in rare and prevalent diseases, which is sort of a new focus for the company, is expanding beyond rare, and we're also targeting 4 different tissue types, liver, CNS, ocular and lung, and we're generating 2 to 4 new INDs per year, increasing to 4-plus by 2025. And lastly, we put out a new set of 5-year goals earlier this year, which are really about transitioning the company to becoming a top 5 biotech by 2025.
Maurice Raycroft
analystGreat. It's a really good summary. Maybe starting off on the commercial products. If you can reiterate what 2021 guidance is for each program, talk about metrics that go into the guidance, and is there anything you're seeing in the field in the second quarter so far that you can comment on that investors should be thinking about in respect to your 2Q update?
Jeffrey Poulton
executiveYes. Let me just, again, start with the commercial products that we've got in the market. So ONPATTRO, our sort of our lead product, it's been on the market since 2018. And this is for the treatment of polyneuropathy in the hereditary amyloidosis market opportunity. We've got GIVLAARI, which is on the market for acute hepatic porphyria. That's an ultra-orphan disease that launched start of last year. And then our newest product is OXLUMO, which is for primary hyperoxaluria type 1, again, another ultra-orphan opportunity. In Q1 of this year was the first quarter of launch. Last year, between ONPATTRO and GIVLAARI, we did about $360 million in revenue for the year. Our guidance for this year, and we've issued top line guidance that's combined product sales for those 3 products. So we didn't issue individual product guidance, which we think is appropriate for a company with this many commercial products. And hopefully, more to come. But the guidance range that we gave for product sales for this year was $610 million to $660 million. So the midpoint of that reflects 75% growth versus last year. So we're obviously in a very sort of high growth part of our commercial life cycle. We did comment that our guidance did consider the impact of COVID this year. And our assumptions were that there would be impact more, hopefully, early in the year, and then as the vaccine rollout progresses, we thought there would be less impact across the course of the year. So I think we still feel very good about that guidance. I think there's a few things, I think, that would be tailwinds to drive strong growth this year. One would be just COVID subsiding, right, and seeing more patient flow through the health care systems. I think with all of these diseases, they are rare diseases. And so there's a particular focus commercially on driving disease awareness. So a lot of our commercial efforts across all these diseases are focused on that to increase the suspicion of the disease and increase sort of diagnosis and treatment rates. I think specifically to ONPATTRO, I think growth drivers include more success in the mixed phenotype segment in the U.S., which could include combination use with a stabilizer. Outside the U.S., where we've got a stabilizer on the market in the same patient segment that we're in, we're seeing a lot of switching. And we think that will continue to be a driver of growth for ONPATTRO outside the U.S. And then for GIVLAARI and OXLUMO specific tailwinds would be geographic expansion for both. We're relatively early and expanding outside the U.S. We'll see more growth in terms of new market entry this year for both products. And then for GIVLAARI, tapping into the milder patient segment. I think long term, it's really going to determine how big of an opportunity this is. And for OXLUMO, it's tapping into the adult part of the market, also will ultimately decide, I think, how big a commercial opportunity this is. We think both those drugs are $500 million plus peak opportunities. And then headwinds for these products for this year as it relates to our guidance, I would say, largely related to COVID, if it persists longer than what we had anticipated when we established the guidance. And that could again just impact patient flows through the healthcare systems, could impact compliance on our therapies, which we saw back in Q2 of last year when the pandemic initially hit. We did see an impact on compliance, particularly in the U.S., which impacted growth in that quarter. And then lastly, it could also impact just the timing of pricing and reimbursement agreements outside the U.S. Again, hopefully, we're on a good path now with the vaccine rollout and the likelihood of those headwinds materializing becomes less and less over time.
Maurice Raycroft
analystGot it. That's really helpful. And for ONPATTRO, you talked a little bit about the opportunity, but maybe if you can provide some more specifics about the patients that you're currently treating and where you're at commercially with that program. And then this opportunity could be broadened, too. Can you talk about the strategy there?
Jeffrey Poulton
executiveYes. So today, based on the label that we have, which is for the treatment of polyneuropathy and the hereditary, sort of part of the market for patients with amyloidosis, the market opportunity globally, we think based on prevalence, and that would be appropriate, is about 50,000 patients with the hereditary form of the disease. And then we think of that 50,000, 20,000 to 30,000, so roughly half of those patients would be polyneuropathy patients. And today, we think about 10,000 of those patients are diagnosed. So there's still plenty of opportunity to grow the franchise based on just ONPATTRO in the market by continuing to drive disease awareness, increase diagnosis and treatment rates. I think in terms of growth opportunities, there's actually a couple of things that I think in the future, hopefully, they are going to develop that will create growth opportunities. The first would be approval of vutrisiran. Based on the HELIOS-A study, which read out previously, very strong data, and we have filed based on that data in the U.S. for approval. And we would expect a decision on that early next year. So that would ultimately likely get us into the market with a very similar label to ONPATTRO, similar patient population, but the benefit of that product is how it's dosed. So ONPATTRO is an every 3-week IV infusion. So pretty high burden on patients. Vutrisiran is a subcu product that would be dosed initially once a quarter, and we've got an ongoing study to look at every 6-month dosing. So significant advantage from a convenience perspective for patients. And we think that creates a growth opportunity for us in the current population that we're in. We think it will accelerate, putting patients on therapy, both in that mixed phenotype patient segment in the U.S. and then we think it will accelerate switching outside the U.S., again, just given the more convenient profile of the drug. So that's sort of step one to maybe creating more growth opportunity for the existing franchise, but the larger opportunity to expand the franchises is getting success in the cardiomyopathy setting, both in wild-type and hereditary patients. And we've got 2 ongoing Phase III studies right now that are critical to ultimately tapping into that opportunity. The first of which is APOLLO-B, our APOLLO-B Phase III study, which has completed enrollment earlier this year. And this is studying patisiran or ONPATTRO in that cardiomyopathy setting. And that's a study that has a 12-month endpoint that looks at 6-minute walk distance at 12-month change from baseline. So given that we've recently completed enrollment, we expect top line data on that next year. So if that's positive, that could be in 2023 that we'd be entering a much larger part of the market with ONPATTRO. And the opportunity there in the wild-type setting is we think [ 200,000 to 300,000 ] at minimum in terms of the size of the opportunity. So significantly larger than the part of the market that we're in today. And we're also studying vutrisiran, which I talked about earlier, being filed for polyneuropathy in the hereditary setting. We're also studying that in the cardiomyopathy setting today. We've got an ongoing study there called HELIOS-B that's currently enrolling. We've announced that we think we'll complete enrollment on that study by the end of this year, and that's an outcome study that looks at morbidity and mortality and recurrent CV events, a composite endpoint. And that's -- because it's an outcome study, that's a longer study. So it's a 30-month study. So we're really excited about that. We think given the profile of vutrisiran, again, which we talked about earlier, once a quarter, hopefully, once every 6-month dose profile, we think that from an efficacy perspective, this is a drug that hopefully will offer the opportunity to really sort of halt the progression of the disease, which we think would be meeting an unmet need currently in the market based on the opportunities that patients have. And so we think of this ultimately as a best-in-class type drug and are excited about the advancement of that program as well.
Maurice Raycroft
analystGot it. And I think if you've talked to me -- talked with me about ATTR about 5 or 6 years ago before I knew Alnylam, I wouldn't have known anything about this disease. But I think you guys have helped build awareness in this space, and this could actually be a pretty big market opportunity. Can you talk about the competitive landscape and some of the validation from other players in this space?
Jeffrey Poulton
executiveYes. You're right. I mean we just talked about the -- based on prevalence, it's a -- as we move into the cardiomyopathy part of the market, that's a much larger opportunity. And we think this would be Alnylam's first anchor sort of commercial franchise, significant commercial opportunity, significant opportunity to drive growth over the period. And if you look at consensus, consensus reflects that in terms of expectations of what we'll generate from a revenue standpoint. But it is a -- given the large opportunity as per the usual, that tracks a lot of competition, so there is a lot of ongoing development going on in the space, which could ultimately bring different agents, different mechanisms of action into this space over time. So in addition to RNAi, which is our platform, we've got ASOs in development, you've got stabilizers already in the market. You've got an additional stabilizer in late-stage development, you've got the possibility of antibodies coming into this space and affecting clearance, and you've got the possibility of gene editing, which is very early in development. But we think about this ultimately long term as a market growth story rather than a market share story, maybe akin to what you see in MS, which -- where there are multiple agents on the market, multiple mechanisms of action. And a number of successful sort of companies and agents. We think that this will be a similar kind of market. But I do think that we're confident, ultimately, in the profile if we're successful, particularly in HELIOS-B, given the potential for stabilization of disease, very attractive safety profile and extremely convenient dosing, which hopefully is twice a year, almost vaccine-like dosing, if you think about it that way. We think that we've got an opportunity to have a leadership in this space. And we're very focused on that, both from an R&D. And ultimately, we'll be focused on that from a commercial perspective, if we're successful in these late stage studies.
Maurice Raycroft
analystGot it. That's really helpful. And then maybe moving on to GIVLAARI. If you can talk more about that drug, the disease setting and the number of patients supporting the commercial opportunity.
Jeffrey Poulton
executiveYes. So this was our second product that we got to market, and this got approved. I think it was in late 2019, really launched the first quarter of 2020. So just before the onset of the pandemic, we launched this. So it's another RNAi therapeutic. And this one is for acute hepatic porphyria, which is an ultra-orphan disease. It's a disease that's characterized by unpredictable and very painful and debilitating attacks, often impacting the GI tract, typically impacts females, and this is sort of maybe into the 20s when these patients usually present. It's a typical rare disease in terms of a real sort of odyssey that these patients are typically on to get the correct diagnosis. It's the average time to diagnosis is more than 10 years. So these are patients that really struggle sort of in and out of a health care system, sometimes getting diagnosed with the wrong diseases, having surgeries that are unnecessary, until they get the right diagnosis. So as with any rare disease, there's a real focus here on educating the space about the disease and what you should look for to get this disease diagnosed correctly. In terms of the opportunity, we think there's about 3,000 diagnosed patients today with active disease between the U.S. and Europe. And we think 1,000 of those are patients that have fairly recurrent attacks. And sort of the definition that we use for that 1,000 and these are patients that are having 4 or more attacks per year. That would be the low-hanging fruit in the space, so the ones that are having more attacks. And GIVLAARI is a prophylaxis drug. So you get on the drug to prevent the attacks from recurring. I think I mentioned earlier in terms of the upside here, the opportunity to really grow this franchise will -- ultimately, I think, tapping into that segment that having less frequent attacks, and our belief is that all patients that are having attacks with this disease should be treated. And attack in this disease could be fatal as an example. So ultimately, that will determine just how large a commercial opportunity is [indiscernible] how successful we are, in sort of penetrating a broad spectrum of patients and sort of the frequency of the attacks that they have. But we're confident in this drug being a $500 million plus peak revenue opportunity. We're, again, still relatively early in commercializing that. We had $55 million in revenue last year. Q1, we did $25 million in revenue, which was 11% growth compared to Q4 of last year. We've got more than 225 patients on therapy today. We're really just getting started outside the U.S. We're selling in -- primarily in Germany and France today. We've recently gotten approval in Italy, and we're launching there now. We've got an approval in Switzerland. I would expect more approvals this year in Europe. We also expect an approval and a launch in the second half of the year in Japan. So geographic expansion over the next 12 to 18 months will also be a driver of growth here in this disease.
Maurice Raycroft
analystGot it. And for OXLUMO, that's a recent launch, what's the latest status of the launch? And can you talk about this opportunity and what expectations are for the rest of the year?
Jeffrey Poulton
executiveYes. So this is another ultra-orphan opportunity, and this was an approval that we got late last year and launched this year. So Q1 was really the first full quarter of commercial results that we had to report. And this disease is primary hyperoxaluria type 1. Similar size, I would say, to GIVLAARI in terms of the number of patients. We're talking low thousands of patients, ultimately, we think, is the opportunity. We think this is, again, another $500 million plus opportunity, little bit different disease. So this is oxalate, that gets over produced in the liver. Ultimately, gets sort of trapped or collects in the kidneys, sort of manifests itself then with recurrent kidney stones. Ultimately, creating risk to the kidneys can lead to end-stage renal disease. The unique aspect of this disease from the first 2 diseases that we've got products for, is this impacts pediatric patients, not only pediatrics, but adults, but it's the first product that we've brought to market that could potentially treat pediatric patients. The first quarter results were really quite strong. We announced $9 million of revenue for Q1 with approximately 50 patients on therapy. We've generated revenue in both the U.S. and Europe. Actually, Europe was really strong. In Q1, $7 million of the $9 million was from Europe. And I think the advantage that we had in Europe is we did have an early access program, that had double digit number of patients on therapy. The vast majority of those were in Europe. We had a very small number in the U.S. And so we're able to transition a number of patients out of the EAP on to commercial therapy fairly quickly. So that underpinned the strength that we saw in Europe in Q1. The other thing I think that we were encouraged about -- 2 things that we were encouraged about. And again, we're very early, one quarter of commercial experience. But we saw a nice distribution across pediatric and adult patients. And we certainly think that, that pediatric segment is probably the earlier, so maybe the low-hanging fruit with this disease opportunity. Again, but longer term to drive the size of the commercial opportunity, we're going to need to be successful in that adult segment. And in Q1, we saw really nice distribution across peds and adults. And we also saw a nice distribution across eGFR severity, which we think is also important for us to ultimately have commercial success. So a long way to go here. We've also got some very encouraging data that we're continuing to collect in terms of impact on the course of the disease, and we look forward to sharing more of that with the market as we collect more data over time.
Maurice Raycroft
analystGot it. Interesting. And I also wanted to ask about synergies that exist between your commercial programs and how you think about commercial strategies ex U.S.
Jeffrey Poulton
executiveYes. So I mean, in terms of synergies, these are all different diseases and different physician call points. So maybe not the traditional synergies from a sales standpoint, at least in the U.S., we've got different sales teams for each of these products, albeit fairly small numbers of sales reps. Outside the U.S., in some cases, actually, we are able to leverage the same sales team to sell all 3 products. But the synergies commercially really come from other areas. And the sort of the commonality is these are all rare diseases. And we can leverage things like our patient services hub, which interacts with patients that help with sort of benefits verification, which is obviously a challenge with these types of drugs and sort of navigating the insurance world. We also help patients get to the appropriate site of care to get the product because these are physician-administered drugs, can be administered in the home, but will help with that process. And so we leverage that same team across all 3 products. Certainly, from a market access perspective, we're using the same team to negotiate around the world, to get sort of pricing and reimbursement, things like market insights, all of that -- all those kinds of things are all sort of common across the drug. So that's really where we see synergies. The other thing is we're really focused on starting to generate some operating leverage from these 3 products that are, as I mentioned earlier, all on the market for 3 years or less. And Alnylam's approach when it initially started to build its commercial infrastructure to support the ONPATTRO launch was to go global, right? These are 3 rare disease products. And typically, with rare disease products to maximize the value of those, you do need to have global infrastructure to get access to these patients where you can to get reimbursement. So the company took that decision very consciously to build global infrastructure. And at launch, they really built not just for ONPATTRO, but for 3 products, which we knew were hopefully going to be coming in close succession, which is the way that's played out. So now that we've got those 3 products on the market, we're seeing that nice uplift on the top line, which we talked about earlier, and you're seeing more modest growth now in operating expenses to support that business because we built a lot of it early, and we should really see some nice operating leverage going forward from an SG&A perspective. And that's one of the things from a profile perspective that's going to help move the company towards profitability, which is one of our goals over the next 5 years is to get the profitability. So I think you'll see the benefits of that over time.
Maurice Raycroft
analystGot it. It seems like a good segue in the longer-term vision for Alnylam. You've talked about a plan, including your P5x25 goal road map. Can you talk about this road map and what goes into your assumptions?
Jeffrey Poulton
executiveYes. So we announced that in January of this year -- and Alnylam has a history of putting 5-year sets of goals out. So this will be the sort of the third version of 5-year goals that Alnylam has put into the market. And with the first 2 sets of 5-year goals, the company met or exceeded the goals that it put into the market. So this isn't -- these aren't aspirational goals where we hope to move towards these, but may not meet them. The expectation at Alnylam is when we put these types of goals out, we're going to achieve the goals. So that's important, number one. And the goals themselves were really all about moving Alnylam towards, again, a leading biotech profile. So we've -- part of this is getting to top-5 biotech status, over the next 5 years. That's sort of the peer group that we want to be in. And we have talked about a way to measure that will be market caps. So we'll keep an eye on that, over time. But the goals themselves that were established are 5 specific goals. I'll start with P, hence P into fifth by '25. First one being patients. We expect to have 500,000 or more patients on RNAi -- Alnylam RNAi therapeutics by the end of 2025. Now that includes our partner program, Leqvio, which is in Novartis' hands to commercialize, and we've got royalties on, likely will drive a bulk of that 500,000 patients on therapy, given that that's a prevalent disease hypercholesteremia and are just launching that now. Second P is products. We intend to have 6 or more marketed products in rare and prevalent diseases on the market by '25. And we've got 4 today, 3 of our own and one partner program. Pipeline, we expect to have over 20 clinical programs by 2025 with 10 or more of those in late stages and generating 4 more INDs per year. And so this really is a platform, an organic engine that we intend to continue to invest in [indiscernible] long-term growth of the company. And then we got a couple of financially oriented goals, which are new to Alnylam, relative to what we've seen in the last 2 sets of 5-year goals, but appropriate, given where we are now from a commercialization perspective. So first one being performance. The expectation is that top line growth across the 5-year period will -- CAGR will be 40% or greater. And that includes both product sales, generated revenue, as well as revenue from our collaborations and royalties that we'll be collecting over the 5-year period. And then last goal is around profitability. So the goal is to achieve sustainable non-GAAP profitability by the end of 2025. We haven't yet specified a specific year, when we expect that will happen, but the commitment at this point is that it will happen within the period. 2019 was our peak loss year. We've talked about that pretty consistently over the last couple of years, and we've been showing sequential improvement quarter-to-quarter, and that's the idea that as we're in this high-growth period with the assets that we have in the market, more moderate operating expense growth that, that profile quarter after quarter is what gets you to profitability.
Maurice Raycroft
analystGot it. That's really helpful. And you've got a program that a lot of investors are interested in, which is the ALN-AGT program. Can you talk a little bit about that one, the current status and the market size?
Jeffrey Poulton
executiveYes. We're really excited about this. This is one of the things that you'll see in our pipeline now is that we're starting to pivot towards investing not only in rare disease opportunities but more prevalent or common diseases. And that's what AGT represents. And I think our confidence to pursue this type of opportunity was really established with inclisiran, which we talked about earlier, is now in the hands of Novartis to commercialize. But that was an RNAi therapeutic that was discovered and initially developed at Alnylam. And I think with the success that they've had, they are in a very large set of clinical studies, not only around efficacy but safety also gives us the confidence now that this is a -- this technology can be successfully taken into more common diseases. So that's what this represents for us, could be a very similar kind of profile and opportunity, frankly, to inclisiran, but this one in hypertension. So the target here is angiotensinogen, which we've got a Phase I study where we've seen really good knockdown, greater than 90% knockdown of AGT in that Phase I study. And at 8 weeks, we've seen impact on blood pressure lowering at greater than 15 millimeters of mercury systolic. So the initial clinical data is very encouraging. We think the commercial opportunity is really around sort of 2 attributes of the drug. If you look at the existing drugs that are available in the market to treat hypertension, there's really 2 primary challenges, is you don't get that tonic control or that clamp pharmacology, where you get that consistency of effect, you get the sawtooth pharmacology sort of peaks and troughs with the oral drugs, including a lot of variability at night. And that variability in blood pressure is a risk factor for cardiovascular disease. And then secondly, you just don't get patients that are adherent, when they're on these oral meds, sometimes multiple oral meds a day. You see a lot of patients that drop off of therapy or are not consistently taking them on a daily basis. So the profile of our AGT program would be once a quarter or potentially a once every 6 months, conveniently subcu administered product. And again, we think it could address both of those issues. And so we're excited about the results that we've had in Phase I. We're moving into 2 Phase II studies this year. We'll have a monotherapy study that will look at different doses and different dose intervals. And then importantly, we'll have a combination study with current standard of care products in the market, and safety will be a real focus of that study. About 1,000 patients across these 2 studies and more to come from a commercial standpoint, significant opportunity. I think as we continue the development, we'll understand the size of that opportunity a little bit better, whether it's maybe a segment of the market, high-risk CV patients or whether or not this actually could be positioned as a first-line therapy. I think as we generate more data, we'll understand exactly how this drug to be positioned. But regardless almost, we think this is a multibillion-dollar opportunity for us commercially longer term. So lots of attention on this, which we understand, and we're excited about it, and we'll have more data here shortly.
Maurice Raycroft
analystGot it. Yes, I think that's -- it's definitely an exciting one. And I think inclisiran -- in our view, inclisiran is a great case study example of trying to understand AGT and the value behind that program.
Jeffrey Poulton
executiveWe agree with that, yes.
Maurice Raycroft
analystMaybe as we're almost out of time, you've got 20 preclinical programs in advancing commercial portfolio. How do you think about prioritization and investment for future growth? And what are your favorite pipeline programs you want to highlight?
Jeffrey Poulton
executiveYes. I mean, it's a really good question. I mean we touched on sort of prioritization a little bit earlier in terms of how we're thinking about the company financially over the next 5 years and getting to profitability. There's 2 levers that get you there. One is strong top line growth. That's the most important lever. We're off to a good start. Hopefully, that continues across the period. But the second lever that we have an opportunity to, frankly, fully control is disciplined investment in our operations. We talked about SG&A being an area where we expect to see leverage over the coming years as the top line grows. On the pipeline side, this is probably where it's, frankly, a little bit more challenging. We have sort of competing forces. On the one hand, this is a fantastic platform. We've delivered incredible success rates well above industry norms to date. And there's lots of opportunities in front of us. So there's a desire to continue to invest as much as possible, frankly, in R&D. The competing forces, we want to get to profitability, and we want to be a sustainable company, where we're not having to go outside the company and issue equity to fund our operations. So there is some balance here for us. But we've talked about the profile and expect -- in terms of what we expect to deliver from a pipeline perspective, over the next 5 years. So I think we're appropriately investing in R&D, even though there's a bit of a push and pull there, we think we've got the right mix. And ultimately, we think when we get to profitability, given the investment that we're making in the platform, we think that's a sustainable profile that we're going to have when we get there. It's hard to pick favorite assets in the pipeline with so many to choose from, but I do think the TTR assets, the late phase and nature of those, and given the importance of what we expect to deliver over the next 5 commercial -- next 5 years commercially, those are critical for us in terms of sort of creating that leadership position in TTR. And then the product that we just talked about AGT in terms of reimagining the treatment of hypertension and moving on our own into a more prevalent disease population is another favorite for me.
Maurice Raycroft
analystGot it. And maybe to close out, what are key catalysts or events that investors should be focused on in the near term and long-term for Alnylam?
Jeffrey Poulton
executiveYes, I'd probably focus on the near term just because, again, given the robustness of the pipeline, it probably makes sense to focus on the near term. So really through the end of '22, I think that starts with the TTR franchise. So we'll have 18-month data from HELIOS-A by the end of this year. And that's a study that was focused on polyneuropathy. But we do have exploratory endpoints in cardiomyopathy that we'll be reading out on at 18 months, biomarker echo data as well as PYP scan. And I think that will be an important readout for us, given the importance of the cardiomyopathy space. We will have the [ complement-mediated ] HELIOS-B study enrollment by the end of this year. That's an important milestone. HELIOS or APOLLO-B, we think, reads out -- given the completion of the enrollment in that study, just a short while ago, that will read out middle of next year. That's obviously a critical data point for us. So that -- those are sort of the focuses for TTR, in addition to one other being the approval, hopefully, vutrisiran in that polyneuropathy setting early next year. A couple of others over the next 2 years will lumasiran, we expect to initiate a Phase II study for recurrent renal stones late this year. And that Phase II study will be important for life cycle management for OXLUMO with the potential to significantly expand the overall opportunity. We talked about ALN-AGT entering Phase II, 2 studies later this year. Our first CNS opportunity, our program, ALN-APP. We think we will -- for CNS CTA this year, and we'll enter the clinic this year with a proof-of-concept next year. So needless to say, lots of catalysts out through the end of 2022.
Maurice Raycroft
analystVery good. Well, Jeff, thanks so much for joining us today, and it was great having you.
Jeffrey Poulton
executiveThanks a lot Maury, and I appreciate the opportunity to talk with you today.
Maurice Raycroft
analystThank you.
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