Jennifer L. Good
Good afternoon, and thank you for joining us for our second quarter 2025 earnings call and business update. Joining me today on this call are my colleagues, Lisa Delfini, Trevi's Chief Financial Officer; Dr. James Cassella, our Chief Development Officer; and Farrell Simon, our Chief Commercial Officer. Lisa and I will make some comments on the business and financial results, then the team is happy to answer any questions that you may have. The first half of this year has been a major inflection point for Trevi, with positive data readouts in both the CORAL trial for chronic cough in patients with idiopathic pulmonary fibrosis, or IPF, and the RIVER trial for patients with refractory chronic cough or RCC. As a result of this strong data, we were able to raise approximately $115 million in capital for total cash and investments at the end of June of approximately $204 million. This gives us strong runway to execute against several important clinical milestones in each of our programs. It is an exciting place to be in our journey, and we believe we are well positioned to execute our strategy and create value. Let me provide a brief update on what we have been up to this summer. As you all know, the top line results from our CORAL trial were announced in early June with Haduvio meeting the primary endpoint with a statistically significant reduction in 24-hour cough frequency across all dose groups studied. Since reporting our top line data, we have received the full data set from the trial and can confirm that the data across the secondary endpoints were consistent with the top line results. Importantly, the quality of life assessment in our patients using the Leicester Cough Questionnaire, or LCQ, showed marked improvement with a statistically significant reduction at both the 54 and 108-milligram BID doses. The LCQ is a 21-point scale with 3 different domains: physical, social and psychological, an increase in total score of 1.3 points is considered clinically meaningful. For the 54-milligram and 108 milligram BID doses, there was a statistically significant 3.7 and 3.4 point increase, respectively, p equal 0.01 for the total LCQ score at week 6. These are strong results for a 6-week study. The LCQ is meaningful in patients with IPF. In fact, the publication from the large U.S. Pulmonary Fibrosis Foundation Registry demonstrated that a worse quality of life as measured by the LCQ correlated with the risk of worse health outcomes such as respiratory hospitalizations and mortality. One of our key focuses at Trevi is remaining patient-centric as we plan for development and commercialization. In a recent patient advisory Board meeting, we reviewed the CORAL results to get patients' reactions. The 2 most important factors to patients when looking for a future cough treatment, we're seeing improvements in cough frequency and severity and quality of life, similar to what we've heard from physicians. Several patients remarked that with the kind of change in cough seen in CORAL, it would be incredibly impactful and positive in their day-to-day lives. I was struck by how much cough controls patients' daily activities and how they isolate or compensate to avoid the embarrassment of coughing out in public. Coming off this data, Jim and his team have been very busy preparing for the end of Phase II FDA meeting and the next set of trials. We will provide more detailed guidance when we initiate each trial. But let me give you a brief update on the priorities over the next few months. First, we are currently conducting a couple of important Phase I studies. We are working on completing our TIDAL study, which is studying the respiratory function and safety of Haduvio on IPF patients as well as conducting a drug-drug interaction study looking at any potential PK effects of nalbuphine when co-administered with pirfenidone and nintedanib, both antifibrotics that are taken by patients with IPF, and other progressive fibrotic diseases. We expect to have the data from both of these trials in time for our end of Phase II meeting with the FDA. As for the end of Phase II meeting, we expect to request that meeting in the fourth quarter of this year. The key points we are looking to discuss with the FDA are to gain alignment on the Phase III program for cough and IPF, as well as any other NDA-enabling work, which needs to be completed. In parallel, the team has been preparing to initiate the Phase III program in the first half of next year. We have also been preparing for a study in other non-IPF interstitial lung diseases. This population will include non-IPF patients that have lung fibrosis and cough. We estimate there are approximately 228,000 of these patients with 50% to 60% having uncontrolled cough. This more than doubles the market opportunity of IPF cough, and these patients are primarily seen by the same pulmonologists that see the IPF patients. This keeps our clinical and commercial efforts efficient and create synergies. We plan to request a meeting with the FDA this year to discuss our study design for non-IPF-ILD and the protocol for this indication. Once we have FDA input, we will be prepared to initiate this study. Finally, we have been working on the next study in refractory chronic cough. We expect that to be a Phase IIb parallel arm study design, looking at dose ranging and are planning to initiate that study in the first half of next year as well. So, as you can see, there is a lot of clinical development planning going on at Trevi as well as preparation work to align with the regulatory authorities. This takes time to ensure that we get these next set of trials right. We will provide updates on next steps as we gain alignment and have line of sight to study starts. I will now turn it over to Lisa to review our financial results, then we will open it up for any questions you may have.