NASDAQ:TRVI Trevi Therapeutics Q1 2024 Earnings Report $14.20 -0.46 (-3.12%) As of 10:07 AM Eastern This is a fair market value price provided by Massive. Learn more. ProfileEarnings HistoryForecast Trevi Therapeutics EPS ResultsActual EPS-$0.11Consensus EPS -$0.09Beat/MissMissed by -$0.02One Year Ago EPSN/ATrevi Therapeutics Revenue ResultsActual RevenueN/AExpected RevenueN/ABeat/MissN/AYoY Revenue GrowthN/ATrevi Therapeutics Announcement DetailsQuarterQ1 2024Date5/7/2024TimeN/AConference Call DateTuesday, May 7, 2024Conference Call Time4:30PM ETConference Call ResourcesConference Call AudioConference Call TranscriptPress Release (8-K)Quarterly Report (10-Q)Earnings HistoryCompany ProfilePowered by Trevi Therapeutics Q1 2024 Earnings Call TranscriptProvided by QuartrMay 7, 2024 ShareLink copied to clipboard.Key Takeaways Trevi’s Phase 2a RIVER trial in refractory chronic cough has all 14 sites activated, with enrollment progressing and readout of top-line data expected in H2 2024. The Phase 2b CORAL study in IPF chronic cough is on track with ~160 patients and ~60 sites activated by end-June; a sample size re-estimation will be completed in H2 2024 and full readout is anticipated in H1 2025. The human abuse potential (HAP) study for oral nalbuphine ER is ~75% enrolled, on pace for completion this summer, with top-line data expected in H2 2024 and the goal of maintaining an unscheduled status. As of March 31, 2024, Trevi held $72.8 million in cash, cash equivalents and marketable securities—providing a runway into 2026 at an expected burn of $9–12 million per quarter. An IND for a respiratory physiology study in IPF cough was cleared by the FDA, with trial initiation planned in Q3 2024 in the U.S. and U.K. to inform Phase 3 patient selection. AI Generated. May Contain Errors.Conference Call Audio Live Call not available Earnings Conference CallTrevi Therapeutics Q1 202400:00 / 00:00Speed:1x1.25x1.5x2xTranscript SectionsPresentationParticipantsPresentationSkip to Participants Operator00:00:00Good afternoon and welcome to the Trevi Therapeutics first quarter 2024 earnings conference call. At this time, all participants will be in a listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by 0. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then 1 on your phone. To withdraw your question, please press star then 2. Please note this event is being recorded. Various remarks that management makes during this conference call about the company's future expectations, plans, and prospects constitute forward-looking statements for purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. Operator00:00:49Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the risk factors section of the company's most recent quarterly report on Form 10-Q, which the company filed with the SEC this afternoon. In addition, any forward-looking statements represent the company's views only as of today and should not be relied upon as representing the company's views as of any subsequent date. While the company may elect to update these forward-looking statements at some point in the future, the company specifically disclaims any obligation to do so, even if its views change. I would now like to turn the conference over to Jennifer Good, Trevi's President and CEO. Please go ahead. Jennifer GoodCEO at Trevi Therapeutics00:01:38Good afternoon, and thank you for joining us for our first quarter 2024 earnings call and business update. Joining me today on this call are my colleagues Lisa Delfini, Trevi's Chief Financial Officer, and Dr. David Clark, Trevi's Chief Medical Officer. We reported Q4 earnings just six weeks ago, so Lisa and I will give a brief update, then the three of us are happy to answer any questions. This is a busy time at Trevi advancing our clinical development plans for both refractory chronic cough, or RCC, as well as cough and idiopathic pulmonary fibrosis, or IPF. Let me provide a brief update on our various trials, beginning with our phase II-A trial in RCC, which is expected to read out later this year. Jennifer GoodCEO at Trevi Therapeutics00:02:23Refractory chronic cough, or RCC, is a debilitating disease that affects up to 10% of the adult population and is defined as a persistent cough lasting greater than eight weeks despite treatment for the underlying condition. With a lack of any approved therapies for RCC in the U.S., there continues to be a significant, unmet, and urgent need for new potential therapies. The key point of differentiation for Haduvio in refractory chronic cough is the mechanism of action, which works synergistically both centrally in the brain and peripherally in the lungs. We believe Haduvio's mechanism has the potential to work in more patients and potentially have a stronger effect across a broader range of baseline cough counts than peripheral-only mechanisms like the P2X3 inhibitors. Our RCC trial, RIVER, is a phase II-A double-blind randomized placebo-controlled two-period crossover study evaluating the reduction of cough in approximately 60 patients. Jennifer GoodCEO at Trevi Therapeutics00:03:23This design is similar to other phase II-A cough trials run to date but does incorporate a meaningful difference. These patients will be randomized with a 1-to-1 stratification between those with 10-19 coughs per hour and those with greater than 20 coughs per hour. Each treatment period will last 3 weeks, separated by a 3-week washout period. Patients on Haduvio will have the dose titrated weekly from 27 milligrams up to 108 milligrams twice daily across the dosing period. The primary efficacy endpoint is the relative change in the 24-hour cough frequency as measured by an objective cough monitor. The study will also explore secondary endpoints, including patient-reported outcome measures for cough and quality of life. Jennifer GoodCEO at Trevi Therapeutics00:04:12We now have all 14 sites activated for this trial and see almost an even split in the enrolled subjects between each arm, the 10-19 and greater than 20 cough counts in the study. Enrollment is progressing, and we continue to expect top-line data from this study in the second half of this year. Next, an update on our lead program in IPF chronic cough. IPF is a serious end-of-life disease. Chronic cough is reported by approximately 85% of patients suffering from IPF and has similar significant physical, psychological, and social impacts to that of RCC but may also be a risk factor that plays a role in the progression of the underlying disease of IPF. The constant lung injury, micro-tears, and potential inflammation caused by persistent coughing may lead to worse health outcomes for patients, such as increased respiratory hospitalizations, mortality, or need for transplant. Jennifer GoodCEO at Trevi Therapeutics00:05:10With no currently approved treatment options for chronic cough in IPF, patients and providers have an urgent need for new therapies. While there are a lot of ongoing development programs in IPF, current and in-development therapies have not shown an impact on chronic cough, which is one of the most difficult aspects of IPF, elevating the unmet need. Our trial, CORAL, is a phase II-B parallel-arm dose-ranging study that will study three active doses of Haduvio and placebo. The study is a six-week trial in approximately 160 patients. We are conducting this study in multiple countries and sites to be able to complete enrollment in a timely manner. We expect to have the majority of our planned 60 sites activated by the end of June. Enrollment is progressing, and we are working with our sites to ensure our study is top of mind. Jennifer GoodCEO at Trevi Therapeutics00:06:04We reaffirm our guidance for this study, in which we expect to read out the results from our sample-size reestimation analysis in the second half of this year, and we continue to expect top-line data for the full study in the first half of 2025. As a reminder, the SSRE is conducted when 50% of the subjects complete the study. We intend to share the SSRE results once it is complete, which will either confirm our current study sizing assumptions, recommend upsizing within a pre-specified range, or indicate futility. We have also made good enrollment progress on our human abuse potential study, or HAP, this year. This study is now approximately 75% enrolled, and we expect to complete enrollment this summer. The objective of this study is to determine the abuse potential of oral nalbuphine relative to butorphanol and placebo and was designed and agreed upon with FDA input. Jennifer GoodCEO at Trevi Therapeutics00:07:02Recall that parenteral nalbuphine is unscheduled by the DEA and was recently re-reviewed by the DEA and left unscheduled. It's also important to note that the two parts of nalbuphine's mechanism are also unscheduled, whether it be kappa agonists such as Korsuva or mu antagonists in products such as naloxone and naltrexone. This study will be submitted with our NDA as part of an eight-factor plan, which includes all the preclinical work done to date, the mechanistic rationale for why this drug is unscheduled, our clinical data generated in our development programs, the results of this HAP study, as well as a public health rationale. Our goal is to have oral nalbuphine remain unscheduled, as the parenteral form has been all these years. We continue to expect top-line data from this study in the second half of this year as well. Jennifer GoodCEO at Trevi Therapeutics00:07:54Finally, our IND for IPF cough was cleared by the FDA, and we expect to initiate our respiratory physiology study in the third quarter of 2024. We anticipate this study being conducted in the U.S. and in the U.K. The goal of this study is to systematically measure the impact of nalbuphine on respiratory depression in varying levels of disease severity and IPF to determine our phase III patient population. Today, we have excluded sleep-disordered breathing patients in our studies, and we want to better characterize the safety in this group as we move forward. As you can see, it is a busy time clinically for Trevi, and we believe the data from these trials will be important to inform the development path forward for Haduvio across chronic cough conditions. We are excited to begin completing these studies in the second half of this year and reporting the data. Jennifer GoodCEO at Trevi Therapeutics00:08:49On a final note, our management team will be attending several medical conferences over the next few months, including the American Thoracic Society meeting in San Diego in a couple of weeks, the London Cough Conference in July, and the European Respiratory Society meeting in Austria in September. Please let us know if you plan to attend, as we would love to meet with you. I will now turn it over to Lisa to review our financial results, then we will open it up for any questions. Lisa DelfiniCFO at Trevi Therapeutics00:09:16Thank you, Jennifer, and good afternoon, everyone. The full financial results for the three months ended March 31st, 2024, can be found in our press release issued ahead of this call and our 10-Q, which was filed with the SEC today after the market closed. The first quarter of 2024 was a quiet quarter for finance, as the rest of the company is operationally focused on the enrollment and execution of our four trials that Jennifer discussed today. For the first quarter of 2024, we reported a net loss of $10.9 million compared to a net loss of $6.4 million for the same quarter in 2023. R&D expenses were $8.8 million during the first quarter of 2024 compared to $5 million in the same quarter of 2023, primarily due to increased clinical development expenses for our phase II-B CORAL trial, our phase II-A RIVER trial, and our HAP trial. Lisa DelfiniCFO at Trevi Therapeutics00:10:08These increases were partially offset by decreased clinical development expenses for our phase II-B/III PRISM trial. G&A expenses were $3.1 million during the first quarter of 2024 compared to $2.6 million in the same period of 2023, primarily due to increases in information technology and finance staffing and activities, as well as professional fees. Other income, net was $1 million in the first quarter of 2024 compared to $1.2 million in the same period of 2023. As of March 31st, 2024, our cash, cash equivalents, and marketable securities totaled $72.8 million compared to $83 million as of December 31st, 2023. We used about $10.9 million in cash in Q1 2024, offset by about $700,000 of interest received. This is within the range of our expected cash burn for the year of $9 million-$12 million per quarter. Lisa DelfiniCFO at Trevi Therapeutics00:11:04Our cash runway guidance remains unchanged, and we have cash, cash equivalents, and marketable securities into 2026. This concludes our prepared remarks, and I will now turn the call back over to the operator for Q&A. Jennifer GoodCEO at Trevi Therapeutics00:11:19Thank you. We will now begin the question and answer session. To ask a question, you may press star, then 1 on your touch-tone phone. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star, then 2. The first question comes from Leland Gershell from Oppenheimer. Please go ahead. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:11:44Hi, good afternoon. Thanks for taking our questions. Just two from us. First, in terms of the upcoming ATS meeting, we look forward to. I believe we'll be hearing a cough bout analysis from CANAL by Dr. Jacky Smith from the UK. As we look forward to those data, if you could maybe, Jennifer, kind of discuss what the formal definition of a cough bout would be, at least in this setting, and to what extent do cough bouts impact patients with IPF? And then I have a second question. Thanks. Jennifer GoodCEO at Trevi Therapeutics00:12:20Yeah, sounds good. I'll kind of tee it up, and I'm going to let David give you the specifics because he was deep into the paper. The reality is this whole concept of cough bouts, it reminds me a lot of itch, in that when we talk about average cough, that's sort of averaged over time, but there's a belief that when people have these severe bouts, that's what's doing a lot of the damage. People are starting to get interested in looking at what that looks like. Unfortunately, there's no agreement in the field as to how you define a cough bout, so that is sort of part of the debate. There's two very leading KOLs who have taken our data and done the analysis. Dr. Smith will present that, and I'll let David speak exactly to sort of her methodology at this meeting. Jennifer GoodCEO at Trevi Therapeutics00:13:02Then I think in the fall, one of the other KOLs is going to present it sort of using a different methodology. But David, can you explain sort of Jacky's methodology and how that'll be presented? David ClarkCMO at Trevi Therapeutics00:13:13Absolutely, I can. So the methodology that Dr. Smith prefers is a cough bout is defined by two coughs, a minimum of two coughs, and then you have to have an off period. And the off period is so that a bout is if you have a cough, and typically if the off period is a two-second duration, so if you have a cough within two seconds, that bout is ongoing. Now, in an exploratory way, she likes to look at cough bout off periods of one second up to 10 seconds. So what you'll see in the paper is looking at the definition of this cough bout. So that's a cough within this duration that varies between one and 10 seconds. And that sort of cough bout definition, as Jennifer Good said, there's not complete consensus in the field, but the methodology that Dr. David ClarkCMO at Trevi Therapeutics00:14:09Smith uses is probably among the commoner of the cough bout definitions. And then we have, as we say, we have this other methodology will be presented later in the year. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:14:22Okay. Thanks, David. Jennifer GoodCEO at Trevi Therapeutics00:14:22Thank you, David. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:14:23And then just wanted to ask, with respect to the HAP study, I know you're looking at a few different doses there, and it's obviously encouraging to hear recent support for lack of scheduling for nalbuphine from the FDA. If we were to see significant liking at, I guess, any of those dose levels, would that be incremental concern that we could see some form of DEA scheduling? What would be kind of the sensitivity if you have that in any sort of way that you can quantify for us to the risk of scheduling based on the HAP study? Thanks. Jennifer GoodCEO at Trevi Therapeutics00:15:02Yeah. So the scheduling decision will be made. It'll be a reviewed decision first by the division that gets deferred to the DEA. They do look at sort of the gestalt, if you will, of the eight-factor plan. So the mechanism of the drug, what they know about it from epidemiology, what you saw in your own clinical trials. There's sort of a whole big picture they look at. Now, the HAP is not in the preclinical data is also quite important, which has all been done, and that's all clean. The HAP, though, is not insignificant, I think. It's not that you can't see anything in your data. It's all going to be, in theory, you're going to be a little more likable than placebo. I think if you're significantly more likable than butorphanol, it opens up the conversation. I think it'll just depend. Jennifer GoodCEO at Trevi Therapeutics00:15:47We'll have to look at that data sort of in context of everything else. I will tell you, though, when I sat through the original discussions of what the FDA focuses on, it's not that you can't have sort of any signs of this. What they really get worried about is a dose response to likability. So if you have some likability, it'll call your low dose, and that doubles and then triples with sort of your high dose. That's where you get into issues because they obviously worry people take 10 of your tablets, and that's a problem. So it's a hard question to answer, Leland, and internally, we've been grappling with. I think when we have the data, we'll put it out as clear as we can and have an expert join the call so that people can interrogate the data themselves and ask the questions. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:16:31Fair enough. Thank you for the incremental color. Jennifer GoodCEO at Trevi Therapeutics00:16:34Yes, thank you. And we'll see you at ATS. Jennifer GoodCEO at Trevi Therapeutics00:16:39The next question comes from Jack Padovano from Stifel. Please go ahead. Jack PadovanoAnalyst at Stifel00:16:45Hi, this is Jack on for Annabel. Thanks for taking our questions. So when you arrive at this sample size reestimation for IPF, what might the chances be that the study has already hit statistical significance at that point? And if that occurs, would you just continue as planned until final readout, or could you potentially halt the trial early in that case? And then kind of to follow up on that, just recalling the magnitude of effect that we've seen in IPF already, if those kinds of effects persist in upcoming trials, are there any opportunities for you to move straight from POC into phase III? Jennifer GoodCEO at Trevi Therapeutics00:17:26So David, I'll let you answer both of those. David ClarkCMO at Trevi Therapeutics00:17:30Yes. So with the SSRE we are utilizing, it is not acceptable with regulators, particularly the FDA, to use a success criteria such as you've outlined. So you've got 80 subjects completed the primary time point, and you've separated with several doses from placebo. The FDA will not allow you to build that sort of success criteria into this sort of a standard SRE. So there's the answer to the first question. It really just, in a closed-loop system, you say, "Is your variance and your effect size sufficient for your assumptions going in?" So your sample size cannot fall below 160. And what was your second question? I'm sorry. Jennifer GoodCEO at Trevi Therapeutics00:18:16The second question, I can jump in, David, and then you can add color. He wanted to know if the magnitude of effect is strong. Can we go straight from POC to pivotal? I think in IPF, we're doing a phase II-B to select dose, and the intent is to roll into our pivotal program. I think with RIVER, the phase II-A, the internal consensus is, and David, this is where you can add some color, is we are planning for a phase II-B that is structured to look like a pivotal. So we still are probably going to need to do some dose ranging work to make sure we're clear in that patient group, but we will try to structure it to look like a pivotal study, and then depending on the data, can hopefully have discussions. David, any color you want to add on that? David ClarkCMO at Trevi Therapeutics00:18:58No, I think that addresses it very well. Thanks, Jennifer. Jack PadovanoAnalyst at Stifel00:19:04Great. Thank you. Jennifer GoodCEO at Trevi Therapeutics00:19:06Thank you, Jack. Jennifer GoodCEO at Trevi Therapeutics00:19:08The next question comes from Tom Smith from Leerink Partners. Please go ahead. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:19:14Hi, this is Roanna Ruiz for Tom Smith. We have a couple of questions on the RIVER study. First, what's the rationale for choosing 21-day duration while the other late-stage trials look at endpoints at 12 or 24 weeks? And I have a follow-up. Jennifer GoodCEO at Trevi Therapeutics00:19:31Yeah, I mean, the rationale is all phase II-As. I mean, for the compounds you currently see in development, they all ran this phase II-A crossover design as a proof of concept, sort of to show that your drug is working. It takes away some variability. As you exit the proof of concept, that's when you get into the longer trials. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:19:51Got it. And what's your expectation on the data expected in 2024? Do you anticipate to see different levels of efficacy in patients with moderate versus severe cough frequency as you look at rate of change in cough frequency rather than the absolute changes? Jennifer GoodCEO at Trevi Therapeutics00:20:07Yeah, David, do you want to talk a little bit about sort of the hypothesis around the study and what we're trying to show with the different cough levels and things? David ClarkCMO at Trevi Therapeutics00:20:15I'd be happy to do that, Jennifer. So the information we have so far, and it is, as you know, it's only from the CANAL study in IPF chronic cough population, is that baseline cough frequency did not influence the efficacy signal. It was as robust in the subjects independent of that cough frequency. So that's the only information we have going into this. And as you're aware, there has been difficulty with peripheral-based mechanisms of action getting the signal in that moderate population. But our information going into the study is that based on the IPF chronic cough, we didn't see any evidence of a difference, a change based on baseline cough frequency. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:21:06Got it. Do you plan to include efficacy endpoints that can capture, for example, a cough cluster or cough episode which appears to burden patients with RCC? David ClarkCMO at Trevi Therapeutics00:21:18I'm sorry. Can you repeat that question? Jennifer GoodCEO at Trevi Therapeutics00:21:21Is that the cough clustering you're asking about, and are we capturing some of that data? Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:21:26Yes. Jennifer GoodCEO at Trevi Therapeutics00:21:28Yeah. And David, I think we have an ability to go back and do that analysis, correct? David ClarkCMO at Trevi Therapeutics00:21:33We do. Actually, we have that pre-specified as analysis, which we will be conducting. Because, as we have mentioned before, we think the primary endpoint for cough programs, we believe, will stay the same as it is right now, using 24-hour cough frequency. But there's clinical relevance to these cough bouts by these different definitions. So we really want to study them in all of our studies moving forward so we understand what sort of effects we're having there, in addition to what we believe will be the registration endpoint. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:22:11Got it. Thank you so much. Jennifer GoodCEO at Trevi Therapeutics00:22:13Thank you. Jennifer GoodCEO at Trevi Therapeutics00:22:15As a reminder, if you have a question, please press star one. The next question comes from Mayank Mamtani from B. Riley Securities. Please go ahead. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:22:26Yes. Good afternoon, Jen. Thanks for taking your questions, and congrats on the progress. So just maybe on the SSRE for the CORAL trial, if you could just maybe clarify the statistical assumptions for placebo as well as, I guess, the top dose you're looking to show separation against. Just maybe how many patients, what sort of effect size and p-value. And also, are there any baseline characteristics that could be different between CORAL than CANAL that we should be aware of? And then I have a quick follow-up. Jennifer GoodCEO at Trevi Therapeutics00:23:04David, do you want to take that? David ClarkCMO at Trevi Therapeutics00:23:06I'm happy to do that, Jennifer. So in terms of the inclusion criteria, we did not change them. So the way we are selecting the IPF chronic cough population is the same as we utilized in CANAL. I mean, the main difference, as you know, is it's a global program. So there is the potential for some differences there. We will see in the study. So the assumptions we made for the SSRE, the N of 160, so that's 40 per group, that is based on an effect size of active drug above placebo, on top of the placebo effect. So the separation on top of placebo effect of 36%. We've got more than 80% power going into the study with the N of 160, 40 per group. The top end of the sample size that we are allowed to go to, we set at 160. David ClarkCMO at Trevi Therapeutics00:23:59We can go up to 400. That's if we either have a variance which is higher than we expected or the effect size is smaller. For example, if the effect size, increasing it to the top sample size of 400, that's 100 per group, if that is necessary, that would allow us to detect a clinically relevant effect size of 25% on top of placebo. That's how we framed the SSRE characteristics. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:24:30Super helpful. And then on the phase II RIVER study, moderate versus severe cohorts, are they equally split in terms of enrollment? And would you be looking to present data in second half in both of those cohorts, or you'd do sort of a total pooled analysis? And then lastly, what's the forum for this HAP study presentation? Obviously, great to see the 75% enrollment achieved, but it does have a relatively short follow-up. So just curious if that would be a press release or an event, a KOL event, if you could clarify that. Thanks again for taking your questions. Jennifer GoodCEO at Trevi Therapeutics00:25:12Yeah. Thank you, Mayank. So far, so good on the enrollment in RIVER. We're seeing sort of equal numbers in both moderate and severe. Obviously, we won't finish the study till we get everybody in. We do plan to report that out as part of our top-line data. So that won't come later. That'll be part of our top-line data reported out. As far as the forum for human abuse potential, we're sort of working through that, but I think what we're working towards is a press release and then also doing a call with probably an expert or two on the phone that works in this area regularly. So we'll present the data on our end, but then also open up the call to folks like you to be able to ask whatever questions you'd like around the data. Jennifer GoodCEO at Trevi Therapeutics00:25:58I mean, hopefully, it's clear and sort of not a lot to discuss, but that's also encouraging and allows you guys the opportunity to sort of confirm that yourself. That's the current plan that we are working against. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:26:11Understood. Looking forward to it. Thank you. Jennifer GoodCEO at Trevi Therapeutics00:26:13Good. Thank you. Operator00:26:18I am not showing any further questions. This concludes our question-and-answer session. I would like to turn the conference back over to Jennifer Good for closing remarks. Jennifer GoodCEO at Trevi Therapeutics00:26:29Thank you. We are expecting a data-rich year with regards to our clinical trials for Haduvio. We see an exciting road ahead for Trevi and we are locked down on executing good-quality trials on time. We will be participating in several investor conferences over the next couple of months as listed in our press release and look forward to seeing many of you there. Thank you for joining today's call, and we are available after the call for any follow-up questions you may have. Operator00:26:59The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.Read moreParticipantsExecutivesDavid ClarkCMOJennifer GoodCEOLisa DelfiniCFOAnalystsJack PadovanoAnalyst at StifelLeland GershellManaging Director and Senior Analyst at OppenheimerMayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.Roanna RuizManaging Director and Senior Analyst at Leerink PartnersPowered by Earnings DocumentsPress Release(8-K)Quarterly report(10-Q) Trevi Therapeutics Earnings HeadlinesTrevi Therapeutics, Inc. (TRVI) Q1 2026 Earnings Call Transcript3 hours ago | seekingalpha.comTrevi Therapeutics Reports First Quarter 2026 Financial Results and Provides Business UpdatesMay 5 at 4:05 PM | globenewswire.comLouis Navellier: My #1 AI stock for 2026 (name & ticker inside)Louis Navellier's Stock Grader system helped him flag Nvidia before its 82,000% run and has identified the top S&P 500 stock for 12 years running—and today, he's giving away his #1 AI stock pick for 2026, free. This company's sales are up 28% year over year, it holds over 30,000 patents in wireless and video technology, and it just earned an A-rating in his proprietary Stock Grader system that has cost him $9 million to build and maintain.May 6 at 1:00 AM | InvestorPlace (Ad)Trevi Therapeutics Announces Oral Presentation and Multiple Posters Accepted at the American Thoracic Society (ATS) 2026 International ConferenceApril 30, 2026 | globenewswire.comTrevi Therapeutics to Report First Quarter 2026 Financial Results and Provide a Corporate Update on May 5, 2026April 28, 2026 | globenewswire.comDid Trevi’s US$173 Million Raise and Share Expansion Just Reshape Trevi Therapeutics' (TRVI) Investment Narrative?April 24, 2026 | finance.yahoo.comSee More Trevi Therapeutics Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Trevi Therapeutics? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Trevi Therapeutics and other key companies, straight to your email. Email Address About Trevi TherapeuticsTrevi Therapeutics (NASDAQ:TRVI) is a clinical-stage biopharmaceutical company focused on the development of novel non-opioid therapies for the management of chronic and acute pain. The company leverages proprietary drug delivery platforms and targeted molecular approaches to address high unmet needs in cancer-related pain, chemotherapy-induced neuropathy and other severe pain conditions. Its lead product candidate is a proprietary formulation of tetrodotoxin (TTX), a sodium-channel blocking agent being evaluated in early-stage clinical trials for moderate-to-severe pain associated with advanced cancer and peripheral neuropathy. In addition to its TTX program, Trevi maintains a pipeline of preclinical and discovery-stage assets aimed at broadening treatment options for patients with refractory pain syndromes. Headquartered in San Diego, California, Trevi Therapeutics conducts research and development activities at its U.S. facilities and collaborates with academic institutions and contract research organizations to advance its clinical candidates. The company’s leadership team combines expertise in pharmaceutical development, regulatory affairs and commercialization strategy to guide its growth as a specialty biopharmaceutical innovator.View Trevi Therapeutics ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Latest Articles Just How Big a Problem Could Amazon’s Cash Burn Rate Be?BlackBerry Rewrites Its Own Operating SystemGrab Holdings Faces Hurdles, But Upside Potential Is Hard to IgnorePalantir Drops After a Blowout Q1—What Investors Should KnowShopify’s Valuation Crisis Creates Opportunity in 2026onsemi Stock Dips After Earnings: Why the Dip Is BuyableTSLA: 3 Reasons the Stock Could Hit $400 in May Upcoming Earnings Coinbase Global (5/7/2026)Airbnb (5/7/2026)Datadog (5/7/2026)Ferrovial (5/7/2026)Gilead Sciences (5/7/2026)Microchip Technology (5/7/2026)MercadoLibre (5/7/2026)Monster Beverage (5/7/2026)Canadian Natural Resources (5/7/2026)W.W. 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PresentationSkip to Participants Operator00:00:00Good afternoon and welcome to the Trevi Therapeutics first quarter 2024 earnings conference call. At this time, all participants will be in a listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by 0. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then 1 on your phone. To withdraw your question, please press star then 2. Please note this event is being recorded. Various remarks that management makes during this conference call about the company's future expectations, plans, and prospects constitute forward-looking statements for purposes of the Safe Harbor provisions under the Private Securities Litigation Reform Act of 1995. Operator00:00:49Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the risk factors section of the company's most recent quarterly report on Form 10-Q, which the company filed with the SEC this afternoon. In addition, any forward-looking statements represent the company's views only as of today and should not be relied upon as representing the company's views as of any subsequent date. While the company may elect to update these forward-looking statements at some point in the future, the company specifically disclaims any obligation to do so, even if its views change. I would now like to turn the conference over to Jennifer Good, Trevi's President and CEO. Please go ahead. Jennifer GoodCEO at Trevi Therapeutics00:01:38Good afternoon, and thank you for joining us for our first quarter 2024 earnings call and business update. Joining me today on this call are my colleagues Lisa Delfini, Trevi's Chief Financial Officer, and Dr. David Clark, Trevi's Chief Medical Officer. We reported Q4 earnings just six weeks ago, so Lisa and I will give a brief update, then the three of us are happy to answer any questions. This is a busy time at Trevi advancing our clinical development plans for both refractory chronic cough, or RCC, as well as cough and idiopathic pulmonary fibrosis, or IPF. Let me provide a brief update on our various trials, beginning with our phase II-A trial in RCC, which is expected to read out later this year. Jennifer GoodCEO at Trevi Therapeutics00:02:23Refractory chronic cough, or RCC, is a debilitating disease that affects up to 10% of the adult population and is defined as a persistent cough lasting greater than eight weeks despite treatment for the underlying condition. With a lack of any approved therapies for RCC in the U.S., there continues to be a significant, unmet, and urgent need for new potential therapies. The key point of differentiation for Haduvio in refractory chronic cough is the mechanism of action, which works synergistically both centrally in the brain and peripherally in the lungs. We believe Haduvio's mechanism has the potential to work in more patients and potentially have a stronger effect across a broader range of baseline cough counts than peripheral-only mechanisms like the P2X3 inhibitors. Our RCC trial, RIVER, is a phase II-A double-blind randomized placebo-controlled two-period crossover study evaluating the reduction of cough in approximately 60 patients. Jennifer GoodCEO at Trevi Therapeutics00:03:23This design is similar to other phase II-A cough trials run to date but does incorporate a meaningful difference. These patients will be randomized with a 1-to-1 stratification between those with 10-19 coughs per hour and those with greater than 20 coughs per hour. Each treatment period will last 3 weeks, separated by a 3-week washout period. Patients on Haduvio will have the dose titrated weekly from 27 milligrams up to 108 milligrams twice daily across the dosing period. The primary efficacy endpoint is the relative change in the 24-hour cough frequency as measured by an objective cough monitor. The study will also explore secondary endpoints, including patient-reported outcome measures for cough and quality of life. Jennifer GoodCEO at Trevi Therapeutics00:04:12We now have all 14 sites activated for this trial and see almost an even split in the enrolled subjects between each arm, the 10-19 and greater than 20 cough counts in the study. Enrollment is progressing, and we continue to expect top-line data from this study in the second half of this year. Next, an update on our lead program in IPF chronic cough. IPF is a serious end-of-life disease. Chronic cough is reported by approximately 85% of patients suffering from IPF and has similar significant physical, psychological, and social impacts to that of RCC but may also be a risk factor that plays a role in the progression of the underlying disease of IPF. The constant lung injury, micro-tears, and potential inflammation caused by persistent coughing may lead to worse health outcomes for patients, such as increased respiratory hospitalizations, mortality, or need for transplant. Jennifer GoodCEO at Trevi Therapeutics00:05:10With no currently approved treatment options for chronic cough in IPF, patients and providers have an urgent need for new therapies. While there are a lot of ongoing development programs in IPF, current and in-development therapies have not shown an impact on chronic cough, which is one of the most difficult aspects of IPF, elevating the unmet need. Our trial, CORAL, is a phase II-B parallel-arm dose-ranging study that will study three active doses of Haduvio and placebo. The study is a six-week trial in approximately 160 patients. We are conducting this study in multiple countries and sites to be able to complete enrollment in a timely manner. We expect to have the majority of our planned 60 sites activated by the end of June. Enrollment is progressing, and we are working with our sites to ensure our study is top of mind. Jennifer GoodCEO at Trevi Therapeutics00:06:04We reaffirm our guidance for this study, in which we expect to read out the results from our sample-size reestimation analysis in the second half of this year, and we continue to expect top-line data for the full study in the first half of 2025. As a reminder, the SSRE is conducted when 50% of the subjects complete the study. We intend to share the SSRE results once it is complete, which will either confirm our current study sizing assumptions, recommend upsizing within a pre-specified range, or indicate futility. We have also made good enrollment progress on our human abuse potential study, or HAP, this year. This study is now approximately 75% enrolled, and we expect to complete enrollment this summer. The objective of this study is to determine the abuse potential of oral nalbuphine relative to butorphanol and placebo and was designed and agreed upon with FDA input. Jennifer GoodCEO at Trevi Therapeutics00:07:02Recall that parenteral nalbuphine is unscheduled by the DEA and was recently re-reviewed by the DEA and left unscheduled. It's also important to note that the two parts of nalbuphine's mechanism are also unscheduled, whether it be kappa agonists such as Korsuva or mu antagonists in products such as naloxone and naltrexone. This study will be submitted with our NDA as part of an eight-factor plan, which includes all the preclinical work done to date, the mechanistic rationale for why this drug is unscheduled, our clinical data generated in our development programs, the results of this HAP study, as well as a public health rationale. Our goal is to have oral nalbuphine remain unscheduled, as the parenteral form has been all these years. We continue to expect top-line data from this study in the second half of this year as well. Jennifer GoodCEO at Trevi Therapeutics00:07:54Finally, our IND for IPF cough was cleared by the FDA, and we expect to initiate our respiratory physiology study in the third quarter of 2024. We anticipate this study being conducted in the U.S. and in the U.K. The goal of this study is to systematically measure the impact of nalbuphine on respiratory depression in varying levels of disease severity and IPF to determine our phase III patient population. Today, we have excluded sleep-disordered breathing patients in our studies, and we want to better characterize the safety in this group as we move forward. As you can see, it is a busy time clinically for Trevi, and we believe the data from these trials will be important to inform the development path forward for Haduvio across chronic cough conditions. We are excited to begin completing these studies in the second half of this year and reporting the data. Jennifer GoodCEO at Trevi Therapeutics00:08:49On a final note, our management team will be attending several medical conferences over the next few months, including the American Thoracic Society meeting in San Diego in a couple of weeks, the London Cough Conference in July, and the European Respiratory Society meeting in Austria in September. Please let us know if you plan to attend, as we would love to meet with you. I will now turn it over to Lisa to review our financial results, then we will open it up for any questions. Lisa DelfiniCFO at Trevi Therapeutics00:09:16Thank you, Jennifer, and good afternoon, everyone. The full financial results for the three months ended March 31st, 2024, can be found in our press release issued ahead of this call and our 10-Q, which was filed with the SEC today after the market closed. The first quarter of 2024 was a quiet quarter for finance, as the rest of the company is operationally focused on the enrollment and execution of our four trials that Jennifer discussed today. For the first quarter of 2024, we reported a net loss of $10.9 million compared to a net loss of $6.4 million for the same quarter in 2023. R&D expenses were $8.8 million during the first quarter of 2024 compared to $5 million in the same quarter of 2023, primarily due to increased clinical development expenses for our phase II-B CORAL trial, our phase II-A RIVER trial, and our HAP trial. Lisa DelfiniCFO at Trevi Therapeutics00:10:08These increases were partially offset by decreased clinical development expenses for our phase II-B/III PRISM trial. G&A expenses were $3.1 million during the first quarter of 2024 compared to $2.6 million in the same period of 2023, primarily due to increases in information technology and finance staffing and activities, as well as professional fees. Other income, net was $1 million in the first quarter of 2024 compared to $1.2 million in the same period of 2023. As of March 31st, 2024, our cash, cash equivalents, and marketable securities totaled $72.8 million compared to $83 million as of December 31st, 2023. We used about $10.9 million in cash in Q1 2024, offset by about $700,000 of interest received. This is within the range of our expected cash burn for the year of $9 million-$12 million per quarter. Lisa DelfiniCFO at Trevi Therapeutics00:11:04Our cash runway guidance remains unchanged, and we have cash, cash equivalents, and marketable securities into 2026. This concludes our prepared remarks, and I will now turn the call back over to the operator for Q&A. Jennifer GoodCEO at Trevi Therapeutics00:11:19Thank you. We will now begin the question and answer session. To ask a question, you may press star, then 1 on your touch-tone phone. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star, then 2. The first question comes from Leland Gershell from Oppenheimer. Please go ahead. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:11:44Hi, good afternoon. Thanks for taking our questions. Just two from us. First, in terms of the upcoming ATS meeting, we look forward to. I believe we'll be hearing a cough bout analysis from CANAL by Dr. Jacky Smith from the UK. As we look forward to those data, if you could maybe, Jennifer, kind of discuss what the formal definition of a cough bout would be, at least in this setting, and to what extent do cough bouts impact patients with IPF? And then I have a second question. Thanks. Jennifer GoodCEO at Trevi Therapeutics00:12:20Yeah, sounds good. I'll kind of tee it up, and I'm going to let David give you the specifics because he was deep into the paper. The reality is this whole concept of cough bouts, it reminds me a lot of itch, in that when we talk about average cough, that's sort of averaged over time, but there's a belief that when people have these severe bouts, that's what's doing a lot of the damage. People are starting to get interested in looking at what that looks like. Unfortunately, there's no agreement in the field as to how you define a cough bout, so that is sort of part of the debate. There's two very leading KOLs who have taken our data and done the analysis. Dr. Smith will present that, and I'll let David speak exactly to sort of her methodology at this meeting. Jennifer GoodCEO at Trevi Therapeutics00:13:02Then I think in the fall, one of the other KOLs is going to present it sort of using a different methodology. But David, can you explain sort of Jacky's methodology and how that'll be presented? David ClarkCMO at Trevi Therapeutics00:13:13Absolutely, I can. So the methodology that Dr. Smith prefers is a cough bout is defined by two coughs, a minimum of two coughs, and then you have to have an off period. And the off period is so that a bout is if you have a cough, and typically if the off period is a two-second duration, so if you have a cough within two seconds, that bout is ongoing. Now, in an exploratory way, she likes to look at cough bout off periods of one second up to 10 seconds. So what you'll see in the paper is looking at the definition of this cough bout. So that's a cough within this duration that varies between one and 10 seconds. And that sort of cough bout definition, as Jennifer Good said, there's not complete consensus in the field, but the methodology that Dr. David ClarkCMO at Trevi Therapeutics00:14:09Smith uses is probably among the commoner of the cough bout definitions. And then we have, as we say, we have this other methodology will be presented later in the year. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:14:22Okay. Thanks, David. Jennifer GoodCEO at Trevi Therapeutics00:14:22Thank you, David. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:14:23And then just wanted to ask, with respect to the HAP study, I know you're looking at a few different doses there, and it's obviously encouraging to hear recent support for lack of scheduling for nalbuphine from the FDA. If we were to see significant liking at, I guess, any of those dose levels, would that be incremental concern that we could see some form of DEA scheduling? What would be kind of the sensitivity if you have that in any sort of way that you can quantify for us to the risk of scheduling based on the HAP study? Thanks. Jennifer GoodCEO at Trevi Therapeutics00:15:02Yeah. So the scheduling decision will be made. It'll be a reviewed decision first by the division that gets deferred to the DEA. They do look at sort of the gestalt, if you will, of the eight-factor plan. So the mechanism of the drug, what they know about it from epidemiology, what you saw in your own clinical trials. There's sort of a whole big picture they look at. Now, the HAP is not in the preclinical data is also quite important, which has all been done, and that's all clean. The HAP, though, is not insignificant, I think. It's not that you can't see anything in your data. It's all going to be, in theory, you're going to be a little more likable than placebo. I think if you're significantly more likable than butorphanol, it opens up the conversation. I think it'll just depend. Jennifer GoodCEO at Trevi Therapeutics00:15:47We'll have to look at that data sort of in context of everything else. I will tell you, though, when I sat through the original discussions of what the FDA focuses on, it's not that you can't have sort of any signs of this. What they really get worried about is a dose response to likability. So if you have some likability, it'll call your low dose, and that doubles and then triples with sort of your high dose. That's where you get into issues because they obviously worry people take 10 of your tablets, and that's a problem. So it's a hard question to answer, Leland, and internally, we've been grappling with. I think when we have the data, we'll put it out as clear as we can and have an expert join the call so that people can interrogate the data themselves and ask the questions. Leland GershellManaging Director and Senior Analyst at Oppenheimer00:16:31Fair enough. Thank you for the incremental color. Jennifer GoodCEO at Trevi Therapeutics00:16:34Yes, thank you. And we'll see you at ATS. Jennifer GoodCEO at Trevi Therapeutics00:16:39The next question comes from Jack Padovano from Stifel. Please go ahead. Jack PadovanoAnalyst at Stifel00:16:45Hi, this is Jack on for Annabel. Thanks for taking our questions. So when you arrive at this sample size reestimation for IPF, what might the chances be that the study has already hit statistical significance at that point? And if that occurs, would you just continue as planned until final readout, or could you potentially halt the trial early in that case? And then kind of to follow up on that, just recalling the magnitude of effect that we've seen in IPF already, if those kinds of effects persist in upcoming trials, are there any opportunities for you to move straight from POC into phase III? Jennifer GoodCEO at Trevi Therapeutics00:17:26So David, I'll let you answer both of those. David ClarkCMO at Trevi Therapeutics00:17:30Yes. So with the SSRE we are utilizing, it is not acceptable with regulators, particularly the FDA, to use a success criteria such as you've outlined. So you've got 80 subjects completed the primary time point, and you've separated with several doses from placebo. The FDA will not allow you to build that sort of success criteria into this sort of a standard SRE. So there's the answer to the first question. It really just, in a closed-loop system, you say, "Is your variance and your effect size sufficient for your assumptions going in?" So your sample size cannot fall below 160. And what was your second question? I'm sorry. Jennifer GoodCEO at Trevi Therapeutics00:18:16The second question, I can jump in, David, and then you can add color. He wanted to know if the magnitude of effect is strong. Can we go straight from POC to pivotal? I think in IPF, we're doing a phase II-B to select dose, and the intent is to roll into our pivotal program. I think with RIVER, the phase II-A, the internal consensus is, and David, this is where you can add some color, is we are planning for a phase II-B that is structured to look like a pivotal. So we still are probably going to need to do some dose ranging work to make sure we're clear in that patient group, but we will try to structure it to look like a pivotal study, and then depending on the data, can hopefully have discussions. David, any color you want to add on that? David ClarkCMO at Trevi Therapeutics00:18:58No, I think that addresses it very well. Thanks, Jennifer. Jack PadovanoAnalyst at Stifel00:19:04Great. Thank you. Jennifer GoodCEO at Trevi Therapeutics00:19:06Thank you, Jack. Jennifer GoodCEO at Trevi Therapeutics00:19:08The next question comes from Tom Smith from Leerink Partners. Please go ahead. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:19:14Hi, this is Roanna Ruiz for Tom Smith. We have a couple of questions on the RIVER study. First, what's the rationale for choosing 21-day duration while the other late-stage trials look at endpoints at 12 or 24 weeks? And I have a follow-up. Jennifer GoodCEO at Trevi Therapeutics00:19:31Yeah, I mean, the rationale is all phase II-As. I mean, for the compounds you currently see in development, they all ran this phase II-A crossover design as a proof of concept, sort of to show that your drug is working. It takes away some variability. As you exit the proof of concept, that's when you get into the longer trials. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:19:51Got it. And what's your expectation on the data expected in 2024? Do you anticipate to see different levels of efficacy in patients with moderate versus severe cough frequency as you look at rate of change in cough frequency rather than the absolute changes? Jennifer GoodCEO at Trevi Therapeutics00:20:07Yeah, David, do you want to talk a little bit about sort of the hypothesis around the study and what we're trying to show with the different cough levels and things? David ClarkCMO at Trevi Therapeutics00:20:15I'd be happy to do that, Jennifer. So the information we have so far, and it is, as you know, it's only from the CANAL study in IPF chronic cough population, is that baseline cough frequency did not influence the efficacy signal. It was as robust in the subjects independent of that cough frequency. So that's the only information we have going into this. And as you're aware, there has been difficulty with peripheral-based mechanisms of action getting the signal in that moderate population. But our information going into the study is that based on the IPF chronic cough, we didn't see any evidence of a difference, a change based on baseline cough frequency. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:21:06Got it. Do you plan to include efficacy endpoints that can capture, for example, a cough cluster or cough episode which appears to burden patients with RCC? David ClarkCMO at Trevi Therapeutics00:21:18I'm sorry. Can you repeat that question? Jennifer GoodCEO at Trevi Therapeutics00:21:21Is that the cough clustering you're asking about, and are we capturing some of that data? Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:21:26Yes. Jennifer GoodCEO at Trevi Therapeutics00:21:28Yeah. And David, I think we have an ability to go back and do that analysis, correct? David ClarkCMO at Trevi Therapeutics00:21:33We do. Actually, we have that pre-specified as analysis, which we will be conducting. Because, as we have mentioned before, we think the primary endpoint for cough programs, we believe, will stay the same as it is right now, using 24-hour cough frequency. But there's clinical relevance to these cough bouts by these different definitions. So we really want to study them in all of our studies moving forward so we understand what sort of effects we're having there, in addition to what we believe will be the registration endpoint. Roanna RuizManaging Director and Senior Analyst at Leerink Partners00:22:11Got it. Thank you so much. Jennifer GoodCEO at Trevi Therapeutics00:22:13Thank you. Jennifer GoodCEO at Trevi Therapeutics00:22:15As a reminder, if you have a question, please press star one. The next question comes from Mayank Mamtani from B. Riley Securities. Please go ahead. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:22:26Yes. Good afternoon, Jen. Thanks for taking your questions, and congrats on the progress. So just maybe on the SSRE for the CORAL trial, if you could just maybe clarify the statistical assumptions for placebo as well as, I guess, the top dose you're looking to show separation against. Just maybe how many patients, what sort of effect size and p-value. And also, are there any baseline characteristics that could be different between CORAL than CANAL that we should be aware of? And then I have a quick follow-up. Jennifer GoodCEO at Trevi Therapeutics00:23:04David, do you want to take that? David ClarkCMO at Trevi Therapeutics00:23:06I'm happy to do that, Jennifer. So in terms of the inclusion criteria, we did not change them. So the way we are selecting the IPF chronic cough population is the same as we utilized in CANAL. I mean, the main difference, as you know, is it's a global program. So there is the potential for some differences there. We will see in the study. So the assumptions we made for the SSRE, the N of 160, so that's 40 per group, that is based on an effect size of active drug above placebo, on top of the placebo effect. So the separation on top of placebo effect of 36%. We've got more than 80% power going into the study with the N of 160, 40 per group. The top end of the sample size that we are allowed to go to, we set at 160. David ClarkCMO at Trevi Therapeutics00:23:59We can go up to 400. That's if we either have a variance which is higher than we expected or the effect size is smaller. For example, if the effect size, increasing it to the top sample size of 400, that's 100 per group, if that is necessary, that would allow us to detect a clinically relevant effect size of 25% on top of placebo. That's how we framed the SSRE characteristics. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:24:30Super helpful. And then on the phase II RIVER study, moderate versus severe cohorts, are they equally split in terms of enrollment? And would you be looking to present data in second half in both of those cohorts, or you'd do sort of a total pooled analysis? And then lastly, what's the forum for this HAP study presentation? Obviously, great to see the 75% enrollment achieved, but it does have a relatively short follow-up. So just curious if that would be a press release or an event, a KOL event, if you could clarify that. Thanks again for taking your questions. Jennifer GoodCEO at Trevi Therapeutics00:25:12Yeah. Thank you, Mayank. So far, so good on the enrollment in RIVER. We're seeing sort of equal numbers in both moderate and severe. Obviously, we won't finish the study till we get everybody in. We do plan to report that out as part of our top-line data. So that won't come later. That'll be part of our top-line data reported out. As far as the forum for human abuse potential, we're sort of working through that, but I think what we're working towards is a press release and then also doing a call with probably an expert or two on the phone that works in this area regularly. So we'll present the data on our end, but then also open up the call to folks like you to be able to ask whatever questions you'd like around the data. Jennifer GoodCEO at Trevi Therapeutics00:25:58I mean, hopefully, it's clear and sort of not a lot to discuss, but that's also encouraging and allows you guys the opportunity to sort of confirm that yourself. That's the current plan that we are working against. Mayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.00:26:11Understood. Looking forward to it. Thank you. Jennifer GoodCEO at Trevi Therapeutics00:26:13Good. Thank you. Operator00:26:18I am not showing any further questions. This concludes our question-and-answer session. I would like to turn the conference back over to Jennifer Good for closing remarks. Jennifer GoodCEO at Trevi Therapeutics00:26:29Thank you. We are expecting a data-rich year with regards to our clinical trials for Haduvio. We see an exciting road ahead for Trevi and we are locked down on executing good-quality trials on time. We will be participating in several investor conferences over the next couple of months as listed in our press release and look forward to seeing many of you there. Thank you for joining today's call, and we are available after the call for any follow-up questions you may have. Operator00:26:59The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.Read moreParticipantsExecutivesDavid ClarkCMOJennifer GoodCEOLisa DelfiniCFOAnalystsJack PadovanoAnalyst at StifelLeland GershellManaging Director and Senior Analyst at OppenheimerMayank MamtaniManaging Director and Senior Analyst at B. Riley Securities.Roanna RuizManaging Director and Senior Analyst at Leerink PartnersPowered by