Praxis Precision Medicines Q2 2026 Earnings Call Transcript

Quartr
Provided by Quartr
August 6, 2026

Key Takeaways

  • Positive Sentiment: Ulixacaltamide and relutrigine remain on track for potential FDA decisions, with target dates around January 2027 and December 27, 2026, respectively. Praxis said neither program is expected to require an advisory committee meeting, and FDA mid-cycle reviews identified no significant efficacy issues.
  • Positive Sentiment: Praxis has substantially advanced its commercial preparations, including hiring and training the relutrigine field team, building the ulixacaltamide sales force, establishing distribution and supply networks, and developing patient-support programs. Management expects to be launch-ready ahead of the anticipated approvals.
  • Positive Sentiment: Enrollment in the EMERALD broad developmental and epileptic encephalopathy study exceeded its target at approximately 200 patients across more than 50 genetic etiologies. If positive, the company expects the data could support a supplemental filing for relutrigine in 2027.
  • Negative Sentiment: Vormatrigine’s POWER1 study failed its primary endpoint in highly refractory focal-onset seizures, although it met a key responder secondary endpoint. Praxis plans to amend POWER2 and POWER3 based on learnings about dose, treatment duration, and patient selection, with both studies expected to restart by the fourth quarter.
  • Neutral Sentiment: Second-quarter operating expenses increased to $96.9 million and operating cash usage rose to $78 million, reflecting greater development and commercial spending. Praxis ended the quarter with $1.4 billion in cash and marketable securities, which management believes funds operations into 2028.
AI Generated. May Contain Errors.
Earnings Conference Call
Praxis Precision Medicines Q2 2026
00:00 / 00:00

Transcript Sections

Skip to Participants
Operator

Good day. Thank you for standing by. Welcome to the Praxis Precision Medicines second quarter 2026 financial results conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question, you will need to press star one one on your phone. You will then hear an automated message advising that your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to our first speaker today, Daniel Ferry, Managing Director of LifeSci Advisors. Daniel, please go ahead.

Daniel Ferry
Managing Director at LifeSci Advisors

Good morning. Welcome to the Praxis Precision Medicines Second Quarter 2026 Financial Results and Business Update Conference Call. This call is being webcast live and can be accessed on the Investors section of Praxis' website at www.praxismedicines.com. Please note that remarks made during this call may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These may include statements about the company's future expectations and plans, clinical development timelines, and financial projections. While these forward-looking statements represent Praxis' views as of today, they should not be relied upon as representing the company's views in the future. Praxis may update these statements in the future but is not taking on an obligation to do so. Please refer to Praxis' most recent filings with the Securities and Exchange Commission for a discussion of certain risks and uncertainties associated with the company's business.

Daniel Ferry
Managing Director at LifeSci Advisors

Joining us on today's call are Marcio Souza, President and Chief Executive Officer of Praxis, and Tim Kelly, our Chief Financial Officer. After providing updates on our key programs, we'll move to a brief Q&A session where Marcio and Tim will be joined by Steve Petrou, President of Research and Development, and Megan Sniecinski, Chief Operating Officer. With that, it's my pleasure to turn the call over to Marcio. Marcio?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thank you, Dan. Good morning, everyone. Thank you for joining Praxis Second Quarter 2026 Conference Call. Three months ago, I told you this would be the year Praxis become a commercial company. This quarter is the one where that stopped being a plan and it started materializing into the organization. We have two NDAs in late-stage review with the FDA, with both approvals expected in about six months. It's extremely exciting to bring both ulixacaltamide to ET patients and relutrigine to SCN2A and SCN8A patients. We have commercial leadership in place, a field force for the first launch hired and trained, and a distribution network established and inventory being built. I want to spend most of my time today on some key regulatory developments and what we have been building. Let me start with ulixacaltamide.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Essential tremor affects over 7 million Americans, and there is still no FDA-approved therapy developed specifically to treat the condition. With the potential approval coming up by January next year, ulixacaltamide is poised to change that. Speaking about the NDA review, the FDA completed its mid-cycle communications with us and are very pleased with the progress and discussions with the agency. In that meeting, the agency identified no efficacy-related significant issues and stated that it does not plan to request an advisory committee meeting. I would characterize the discussion as expected and very forward-looking. On the commercial build itself, leadership is in place, and all core capabilities are where we expect it to be at this stage. We will be ready ahead of PDUFA to launch ulixacaltamide for ET patients.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We are set up for a very successful launch and continue to think many years in the future as we intend to continue to serve patients with ET and other neurological conditions. As part of that, you should expect updates from us in the near future about lifecycle opportunities for T-type calcium channel inhibitors. One of those steps is the collaboration we just announced with Remagine Labs, which would extend the reach of ulixa further. That work is about expanding the value for patients and Praxis way beyond the initial launch year. Turning to relutrigine. SCN2A and SCN8A are amongst the most severe epilepsies we know of. Seizure onset in infancy, profound developmental delays, and no approved treatment. The addressable population is roughly 10,000 patients in the United States.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

As we disclosed last quarter, we submitted additional sensitive analysis of existing clinical data, and the FDA deemed that submission a major amendment, and the review period was extended with a new PDUFA target now of December 27 this year. In the mid-cycle meeting for relutrigine, very similarly to ulixacaltamide, as I just discussed, the agency also confirmed they do not intend to hold an advisory committee meeting. If approved, relutrigine would be the first therapy for SCN2A and SCN8A DEE and would be eligible for a pediatric review voucher. Just like for ulixa, launch preparation here is further along than the calendar might suggest. Commercial and medical teams are fully hired, the supply chain is established, and we have built a comprehensive patient support program, all pointing to a very structured and successful launch. The broader opportunity keeps getting clearer.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Enrollment in EMERALD, our study in broad DEEs, exceeded its target, with approximately 200 patients enrolled spanning more than 50 distinct genetically defined etiologies, amongst many others not genetically defined. That is a trial population that did not exist as a cohort even five years ago. Assuming the study will be positive, and the initial review for relutrigine in SCN2A/SCN8A also positive, EMERALD would serve as the base for a supplemental NDA approval in 2027. It is also worth mentioning a quick regulatory update that spans both programs. During the quarter, the FDA conducted a BIMO inspection of Praxis as a sponsor for both ulixacaltamide and relutrigine applications. The scope was very comprehensive, including corporate and clinical operations, safety, reporting, data integrity, statistical analysis, and the interim analysis for both programs, amongst other areas of the BIMO program.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We're incredibly pleased that the inspections concluded without any findings, and therefore, no Form 483 was issued. Considering how complex both programs are with multiple studies and the first of its kind, the centralized study for ET, as well as the interim analysis, we're extremely pleased with the outcome of the inspections. One note on how we communicate from now on. Given the stage of discussions on both applications, we do not intend to provide further regulatory updates until the expected action dates. I would ask you to read our silence between now and January as discipline rather than a signal of any kind. Let me turn to vormatrigine. In June, we reported top-line results from POWER1 in a highly refractory focal onset seizure population. As you know, the study did not meet its primary endpoints of reduction in monthly focal seizures frequency from baseline to week 12.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

It did meet a key secondary endpoint with a significantly greater proportion of patients on vormatrigine achieving at least 50% reduction in seizure frequency. That result tells you something specific, and we have spent the last several weeks making sure we took the right lessons from it rather than the comfortable one. The responder finding says the drug is doing something real in a population where very little works. The primary endpoint miss say our dose and a few elements of our design were not matched to the question we're asking. Those are design problems, and therefore fixable. We're finalizing the plans to amend and revamp both POWER2 and POWER3, informed directly by what POWER1 taught us about the dose and entry criteria, and we intend to have both studies up and running by the fourth quarter of this year.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We will further describe the amendments and impact on the design once they are final in the very near future. Switching gears to elsunersen. In June, the FDA granted us BTD designation for elsunersen for seizures associated with SCN2A DE caused by gain-of-function variant based on the results of the EMBRAVE Part A study. That's our third breakthrough designation since July last year. Three designations across three different assets on two different platforms. It's basically unheard of for a company like Praxis. We're taking advantage of the access to the FDA that the designation give us and discussing a comprehensive plan with the agency in the near future. Parallel to that, EMBRAVE3 continues to enroll well, with top-line results expected next year. We're incredibly pleased with all the progress made in all fronts this quarter, and we look forward for a successful rest of the year.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Let me now turn the call to our CFO, Tim Kelly. Tim?

Tim Kelly
Tim Kelly
CFO at Praxis Precision Medicines

Thank you, Marcio, and good morning, everybody. Thank you for joining today's call, where you've heard about the good updates that we have going on. I'll provide a quick summary of our second quarter financials. In Q2, our operating expenses were $96.9 million, with $69.4 million of that for R&D, and the remaining $27.5 million for G&A, which compares to $76 million in operating expenses for the Q2 period in 2025. During the second quarter, Praxis spent $78 million in operating cash, compared to $55 million in the second quarter of 2025, with the increase reflecting greater spend in both R&D and G&A. We expect G&A will pick up more in the second half of this year to support our planned upcoming launches.

Tim Kelly
Tim Kelly
CFO at Praxis Precision Medicines

This will be driven by adding two teams of commercial field-facing headcount, rolling out disease state awareness campaigns, building sufficient inventory, and ensuring solid business systems and infrastructure. We ended the second quarter with $1.4 billion in cash equivalents, and marketable securities. Compared to $926 million as of December 31st, 2025. We maintain that this is adequate to support our runway into 2028. With that, I will hand the call back over to Marcio.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thank you, Tim. Really appreciate it, the updates. Now we're going to move into Q&A. Operator?

Operator

Thank you. At this time, we will conduct the question-and-answer session. As a reminder, to ask a question, you will need to press star one one on your phone and wait for your name to be announced. To withdraw your question, please press star one one again. Please limit one question per analyst and hop back into the queue for further questions. Please stand by while we compile the Q&A roster. Our first question comes from Yasmeen Rahimi from Piper Sandler. Your line is open.

Yasmeen Rahimi
Yasmeen Rahimi
Analyst at Piper Sandler

Good morning, team. Congrats to an incredible update that I think was very timely and important to us, especially as some bears have been creating some noise around AdCom. Thank you for letting us know that you had a successful mid-cycle review along with inspection. Given now that that is behind us, maybe help us understand sort of with the sales team that is being hired for relutrigine, what is the phenotype of the sales force that you have in place? What is the size of it, and how do you see the cadence of hiring for ulixacaltamide? Tim, that was really helpful, but if you could dig a little bit deeper around some of the matrix and if you also envision sort of patients have been warehoused as we're getting very close to launch early next year. Appreciate your coloring. Congrats again.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thanks, Yas. Absolutely share the sentiment that you just expressed there. Incredibly complex programs as we discussed on the remarks to actually check all the boxes. Collaboration with the FDA has been exceptional. The real questions we got throughout have really been, I would say, very straightforward and really very similar to what we've been discussed before publicly. Checked that box quite nicely as well. Of course, the cherry on top, it's always good to get the FDA in the house checking everything, making sure that they agree. We always knew we were doing everything correctly, but that they agree with our assessments that from data integrity, documentation, communications, procedures, safety of subjects in these studies, everything was checked there.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We turn a page to talk about what we're really talking about, that the millions and millions of Americans that are not served currently in the U.S. We've been very diligent hiring a world-class sales, marketing, market access, medical, of course, Tim, at Praxis. I can say this is probably an opportunity of a lifetime if you are in one of those positions to launch these drugs to transform patients' lives. I'll hand over to Megan to discuss a little bit the phenotype and what we are seeing at the stage we are.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

Thanks, Marcio. As Marcio is sharing, not unexpectedly, these are hot launches upcoming. They each represent the first targeted therapies for indications with huge unmet needs. It's allowed us from a hiring perspective to be very selective, and we're incredibly pleased with the caliber of the talent. Certainly from the phenotype individuals with multiple launch experience, the rare neuro space, the hunters that are going to go out there and really do a phenomenal job for us. In the case of relutrigine, now we've got the team hired and trained. We have the next few months to really be active in doing the account profiling, which will set us up quite well from a launch readiness perspective. Then the ulixacaltamide field force buildout's well underway and also on track for where we'll be from a launch perspective.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thanks, Megan. Thanks, Yas, for the question.

Operator

Thank you. Our next question comes from Ritu Baral of TD Cowen. Your line is open.

Ritu Baral
Ritu Baral
Analyst at TD Cowen

Good morning, guys. Thanks for taking the question. Marcio, I wanted to dig down into your comment about the mid-cycle, the ulixacaltamide mid-cycle review meeting, if you'll let me. You mentioned the word forward-looking. I guess first, could you comment on if there were any surprises during the meeting, any new topics that were unexpected? Two, I guess, how do you define what you're calling forward-looking? Have you been able to discuss what we spoke of previously, which is the potential inclusion of alternate titration regimens to improve the ulixacaltamide experience? If I could ask a quick follow-up to that last point, the ulixacaltamide experience, what aspects of commercial launch prep are you preparing to optimize that commercial experience to optimize compliance? Thanks.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah, absolutely. I appreciate the vagueness of what forward-looking might be there. I'll take that one. It was not meant to be vague. It was really meant to be what you're looking for here in the context of this application, right? We are late stage now, approval, labeling, promotion, making sure these patients have access. I think that that's what I meant by that in the conversation. I would say, Ritu, the conversation itself in the room, it's a rare type of feeling when you are in a discussion with the FDA, at least in my view, where you actually feel very peaceful. That's the way I would describe how I felt on that discussion. Where they know for a fact that they're being incredibly transparent, like collaborations being incredibly high.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Really all the elements that are necessary to make a decision have been on the table. On your sub-question about surprise, I would say none, really. Maybe my surprise on the meeting is just how much of the discussion is turned into proper use. I was going to call of the drug. By proper use is when you discuss labeling and things like that, normally later in the process, all you're really trying to do is proper use. Right? When you are actually marching towards proper use in conversations like this, I consider exceptionally positive the discussions, the level of collaboration and integration and the understanding of the application, the depth and the breadth of the discussion, the number of people in the meeting, the presence of leadership and the support from leadership, all of that.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

What I meant is, it is an application that matters for them as much as it matters for us. It was good to see that overall. The topic of titration did come up, to your point, as completely expected, right? It's something we proposed to have. Once again, I was positively surprised by how much further along our alignment is in that regard. While I cannot and should not predict what's going to end up saying on a label, I can tell you right now unequivocally that studies have very good understanding that when patients start ulixacaltamide, they will sometimes, in about 30% of the case have some tolerability issues that does not transfer to safety issues. If they stay on that goes away, and they have this quite phenomenal, in my view, right, efficacy that is just not there for any other compound.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Any reasonable person, and I think the FDA is incredibly reasonable and certainly we believe we are, will look into that as an opportunity to maximize the suffering on this incredibly difficult indication by figuring out a way for patients to get there. I think we're really, really close to figuring that out. How this translates to commercial, and I'm going to hand back to Megan on this as well, right? You can imagine that 70% of the patients on $7 million or even $2 million or $3 million at launch, anyone would say plenty. We want every patient to have the best possible experience, and we want to make sure every patient stay on drug if they desire to and if their physicians believe they should. Maybe Megan can talk a little bit about what we are doing there.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

Sure. Thanks, Marcio. Maybe just to recap again, the focus out of the gates for the launch will absolutely be on ensuring the high-quality first experience so that we build the physician confidence and ensure that we have that durable patient persistence. I think in the context from the provider's perspective and as we've been doing advisory boards and also engaging with the physicians, I think it starts with them setting up that first conversation with clear expectations. As they see the ulixacaltamide data, right? The ability to tell a patient there's going to be a rapid onset of effect, right? With a meaningful change and that there might be some tolerability issues which as we hear from the neurologists, they're very comfortable with managing the patients through that.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

In terms of some patient programs and services that we're building, Tim mentioned in his remarks, we're well underway in establishing the infrastructure we need to support this. We're basically building a hub of the future, which is fully integrated from the front end to receive the prescription all the way, pulling through the channel to ensure that we have line of sight to where we are with fulfilling that first Rx. Also having certain programs and services on the SP, the pharmacy side with our integrated network to ensure that we're able to deliver the support to the patient to get them started on treatment as quick as possible and then titrate through those early weeks. It's absolutely a priority for us, Ritu, and we're feeling really good about where we are with that build.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

The excitement and enthusiasm from the physicians is there to get as many patients started on this therapy.

Ritu Baral
Ritu Baral
Analyst at TD Cowen

Thank you.

Operator

Thank you. Our next question comes from François Brisebois from LifeSci Capital. Your line is open.

François Brisebois
François Brisebois
Analyst at LifeSci Capital

All right. Thanks for the question. Just on relutrigine, I was just wondering, I think you mentioned that there's about 50 separate genetic etiologies involved here. Would you say that the study population is relatively enhanced for indications which either have a history of sensitivity to sodium channel blockers or what not?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah. Thanks, François, for that. I'll hand over to you, to Steve, to discuss a little bit.

Steve Petrou
Steve Petrou
President of Research and Development at Praxis Precision Medicines

Yes. Looking at the size of the trial, that spread of etiologies is precisely what you would think to get when you look at the distribution of prevalence in that group of patients. The precise mix of people that we fully anticipate would be pharmacosensitive to a sodium channel mechanism is represented in that cohort.

François Brisebois
François Brisebois
Analyst at LifeSci Capital

Okay, great. Can you mention at all, can you comment on the powering of EMERALD here? I think based on the study number, is there a placebo kind of level or median percent change that you're looking for stat sig?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

With the caveat, François, that a true multi, both genetically diverse and non-genetically diverse, DEE study has not been run so far. There are many that we can borrow from. When you go through that analysis, I think what we know is there are kind of three levels here. The first, when you look into the overall response, and let's define whatever, 50%, that benchmark is very clear. It's very small for placebo. These patients are so severe. I'll give you a number. The median baseline countable seizures in EMERALD is over 50 for 28 days. Imagine that kind of burden and just how little it is, the possibility that these patients are going to naturally regress. The second is, as we move upwards the ladder, like 75% response, 90% response, those numbers become very, very ridiculously small for placebo.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

As we are looking into a distribution, it was very simple, I would say, to model from a power perspective. I would say very straightforward, the expectations. As you can imagine, as you heard from me, before you hear from Steve now, we're very pleased not only with the a priori powering, but quite importantly, the a posteriori mix of patients that are pharmacosensitive to the mechanism. Stay tuned. Soon to come up, the results, but I think we should be as bullish as we are on what we're going to see on the other end.

François Brisebois
François Brisebois
Analyst at LifeSci Capital

Great. Thank you very much.

Operator

Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

You bet.

Operator

Our next question comes from Kevin Strang of Goldman Sachs. Your line is open.

Kevin Strang
Kevin Strang
Analyst at Goldman Sachs

Good morning. I wanted to ask on vormatrigine. You alluded to the design being more important versus the drug itself. Do you mind walking us through sort of some of the specific learnings from POWER1 on dose or design that gave you confidence to restart the program? Thanks.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah, absolutely. We're going to reserve it, and I hope you don't see this as hedging because it's not. Since we're going to be discussing this a little bit more in the future. A couple things that as we look into in a very detail, and at the same time, keeping ourselves from seeing things that are not there. It's a really disciplined approach to what we're going to do next, right? Looking about the value right now, at least external value for the company, one could argue four-fifth of the value is ulixacaltamide and relutrigine. Of course, there's a huge potential for upside and huge residual value for vormatrigine. Who really wants to measure that? It's one of the reasons why we're not focused today, call on vormatrigine. Dose clearly played a role. Duration at the dose clearly played a role. We sometimes say dose.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

It looks like it was only the 20 or the 30, but actually six weeks and six weeks play a role, and I would say a pretty significant role on that. I think a few other things that we're going to be hearing further, including the number of failures that was extremely high to prior medications that could be tightened up, and a few things here and there. Every single parameter, maybe that's the matter I'm going to leave you with, that we looked into are very easy to adjust and to fix. Once we do, without overstretching, without drinking the Kool-Aid, without seeing things that are not supposed to be seen there, the effects on the other side for POWER2, and of course, eventually POWER3, are at or higher than what I would expect for this drug on those populations.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Great way to look into this. We're finalizing a few things internally and with our key advisors. You're going to see an update, a fulsome update about that in the near future, and we're starting up the study.

Operator

Thank you. Our next question comes from Tiago Fauth of Raymond James. Your line is open.

Tiago Fauth
Tiago Fauth
Analyst at Raymond James

Great. Thanks for taking the question. Just on EMERALD, right? For Dravet, conventional sodium channel blockers are counter-indicated. Sometimes they can make seizures worse. Yet you had really strong preclinical data in Dravet models, right? What does that example tell you about the mechanism relative to conventional sodium channel blockers? What does that imply about the potential to work across other DEEs? We've been getting a lot of questions on the enrichment criteria that you have on seizure burden being enough to offset some of the unknowns or risks From non-ion channel DEEs that can be in the mix of EMERALD. How should we think about that overall?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah. Absolutely. I will start with, and then hand over to Steve here, Tiago. The first is, I find a little ironic, I am going to say, to be the classical me in calls like this, that no one asks about how many serotonergic mutations are when this is being discussed, the serotonergic one. It is very easy to say sodium channels for us. Maybe one must revisit their own understanding of neurobiology. Having said that, I will hand over to the person who really knows neurobiology here. That is not me. That is Steve. Steve.

Steve Petrou
Steve Petrou
President of Research and Development at Praxis Precision Medicines

Thanks, Marcio. I think when you look at the role of sodium channels in determining the behavior of neurons normally and in epilepsy, clearly they are the gatekeepers of excitability in a neuron. Because of that role, if the sodium channels themselves are altered in their behavior as a result of mutations as we saw in the INVOLVE study, they are a clear target. Beyond that, they are also the most downstream element in the etiology of other disorders that result in DEEs, whether it is other genetic mutations or acquired conditions. Because of that very unique role, they are also targets where a lot of the physiology converges. We have got a lot of confidence that it does not really matter what the etiology is.

Steve Petrou
Steve Petrou
President of Research and Development at Praxis Precision Medicines

Even in the cases of loss of function, and there is always a lot of chatter about that, clearly, even though we have lost sodium channel function as the primary mutation, we still have excitability issues, and the way to control excitability is through modulation of sodium channels. When these loss of function mutations occur, that can result in the upregulation of other elements in the neuron. We are confident of that. Our preclinical data shows that. This is all because sodium channels are concentrated in a very specific part of the neuron where the axon emerges, called the axon initial segment. It is a pretty much crystalline structure of sodium channels and other elements. That is the little part of the neuron that decides, from my experience, from everything that is upstream, what am I going to do? How am I going to respond to that input?

Steve Petrou
Steve Petrou
President of Research and Development at Praxis Precision Medicines

We know that program is modulated a lot by sodium channel modulation. One other thing I want to say about sodium channels is the manner in which the sodium channel modulator interacts with the actual sodium channels themselves is very important. We know, we have talked about this a lot, that the mechanism of action and the profile of relutrigine distinguishes itself from any other agent in the market now. That was the initial therapeutic hypothesis we started with relutrigine, and we are following that through the trials right now.

Tiago Fauth
Tiago Fauth
Analyst at Raymond James

Yeah. Honestly, very helpful. Appreciate it.

Operator

Thank you. Our next question comes from Douglas Tsao of H.C. Wainwright. Your line is open.

Douglas Tsao
Douglas Tsao
Analyst at H.C. Wainwright

Hi. Good morning. Thanks for taking the questions and congrats on the progress. I guess, Marcio, I just want to maybe start with vormatrigine for a minute because it was interesting that you sort of are going to be restarting both POWER2 as well as POWER3. I'm just curious, do you think that those two studies would be enough to support a potential filing, just given the fact that they are going to be very different studies in terms of their design and what they're trying to demonstrate? Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

No, thanks, Doug. Yeah, we do. That's maybe the short answer to that there are steps between now and then to have conversations with the agency and to discuss exactly which label potentially that would result. The bottom line is both from a historical perspective and most importantly from a policy perspective, as it forms up right now and even considering the progressive nature of the division that all epilepsy falls within right now as just restructured a couple of weeks ago, I think we feel incredibly bullish about it. To be seen.

Douglas Tsao
Douglas Tsao
Analyst at H.C. Wainwright

Okay. If I can ask a follow-up in terms of relutrigine. I'm just curious because obviously, that program or in particular with EMERALD, is enrolling and there's obviously the besifloxacin program ongoing as well, and I'm just curious if you have heard any feedback from clinicians if there's any kind of pattern in terms of what types of patients they're referring to each particular study. Meaning, is there any kind of subconscious enrichment perhaps ongoing, in terms of picking a study in which they think a patient might be best to respond to, just given the different MOAs of the drugs? Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

No, I get it. I would say we always have to take with a grain of salt anecdotal conversations we have with one or two physicians here and there. It is not unexpected, right, that you would say, Let's say we will start with serotonergics here. There are drugs approved. There are a lot of stuff that's being done on that space, hand-to-hand combat with multiple drugs for Dravet and LGS. If we're going to try another drug, let's try on the ones that I would humbly say that that may be okay for a trial execution. It's a terrible strategy once you get to the market, but I'll leave it there. I think likewise for us, the EMERALD, as we said, about 200 patients finished randomization a while back.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

It is kind of obvious by what Steve just mentioned, that when you look into the final mix, that either by chance or not, that this seems to be some of the most potentially active on this mechanism historically. Whether or not there was a conscious or unconscious kind of segmentation when there were sites that were enrolling both studies, it happens naturally. You fast-forward a few years from now, both mechanisms work, right? I think we know that. On a market with anywhere between 200,000 and 400,000 patients, the discussion is bringing on 10 other mechanisms, right? This is number 1, should be a dream for anyone on this space. It's an ability to help incredibly sick kids and young adults, to control seizures. Any one of us that thinks that one mechanism is going to do this should be institutionalized.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I think it is more than reasonable to expect that multiple mechanisms are going to be I keep going back to the same thematic. You heard me saying this 1,000 times, I'm going to do 1,001. The zero-sum game idea in diseases and epilepsy is purely serving to people who don't want patients to get drugs. Has nothing to do with either drug developments or market potential. If anything else, I'm going to say, I'm going to be cheering every day for Lundbeck to be incredibly successful, just like you're going to be, so we all can help patients with these conditions.

Douglas Tsao
Douglas Tsao
Analyst at H.C. Wainwright

Okay, great. Thank you so much, Marcio.

Operator

Our next question comes from Andrew Tsai of Jefferies. Your line is open.

Andrew Tsai
Andrew Tsai
Analyst at Jefferies

Hey, team. Good morning. Thanks for all the great set of updates. Back to essential tremor. There really, to me at least, seems to be a chance maybe ET could be approved earlier than expected, especially if this mid-cycle review is done, inspections are done. Is it the right thinking that you will be entering final labeling discussions soon? If not, can you just remind us what the key steps generally are from here? Then how prepared would you guys be to launch in Q4 if there was an early approval? Thank you. I appreciate you might not be able to share too much, but just thought I'd ask. Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

These are appreciated. The next forward steps here are the quick late cycle discussion. I will tell you that's in the books. Label negotiations, that's in the books. The reason why we mentioned in my prepared remarks is that we're not going to be giving updates because you can imagine that this discussion as we move forward is very dynamic, right? There's a lot of back and forth. There's a lot of really cool discussions there. We set the goal to be ready for launch way ahead of PDUFA for multiple reasons. One, it's the right thing to do. Two, thanks to a lot of you listening to this call, we have the capital to do it.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Three, I would challenge absolutely everyone in this call to name one market with millions of Americans that don't have a treatment right now, that are getting every single day requests from physicians and patients to when is this drug going to be available. It's just a responsible thing to do. We'll be ready. We are basically ready. We're going to continue to be ready to maximize in the case of the great fortune that the agents finish the review earlier and we are blessed with that approval earlier than the PDUFA.

Andrew Tsai
Andrew Tsai
Analyst at Jefferies

Thank you. Fingers crossed. Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Exactly. Thank you. To us as well.

Operator

Our next question comes from Yatin Suneja of Guggenheim. Your line is now open.

Yatin Suneja
Yatin Suneja
Analyst at Guggenheim

Hey, guys. Thank you for taking my questions. Again, excellent updates today. Just staying with the essential tremor, could you maybe talk a little bit about the payer work you have done? Marcio, in the past, I have talked about pricing. Love to get the feedback that you are hearing from the payer perspective. In terms of the step edit, how should we think about it? Most people are on generic stuff, there should not be much. Love to sort of understand all of those dynamics. In terms of the commercial build-out, could you maybe outline for us when is that plan in terms of how big of a sales force you would need, all of that stuff? Thank you so much.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Absolutely. From a payer perspective, very active. We did a lot of pre-work to shape our general understanding. Of course, that is a lot of analytical work that can be done with Dan that is benchmarking work. We moved on the last several weeks to a different phase, right? Where both proactively we want to talk to some of those plan administrators, but I would say the latest wave is that they want to talk to us. I would say there was a lot of those interactions. I would even argue I was positively surprised with one, their understanding that absolutely there is a need here and that they are not going to put a lot of stuff, not a lot of blocks in the way.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

The second is just like they want to be right at day one, just like we want to be right at day one. That is good news. Our planning assumptions includes step adds through propranolol. Not at all, by the way, what we are hearing across the board is going to happen. It is just a prudent thing to do or look into this. Now we know we did extensive work here from a medical perspective and claims and so on, that a lot of these patients, they are just super cardiac or something else, that it prevents them from ever going into our beta blockers. About half of the market cannot magically take propranolol. One can call that low-hanging fruits, but I guess to call 1 million patients low-hanging fruits a little bit oxymoronic, I am not going to do that. That is a very clear part of the market.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I think the other parts they just had exposed to that. I will remind everyone on the stratified, predefined use of propranolol on the Essential3 study, showing that on top of propranolol, ulixacaltamide is incredibly efficacious, right? There is really no restrictions here one way or another. Welcome. Do we believe that in the long run, that is going to be needed to stay involved? No, but that is a belief. We welcome all the patients at day one here, and physicians are incredibly excited about hearing that, which is normally what payers actually want to hear. A lot of work is being done on the payer space. I know you asked about pricing. I think the more we talk to payers, the more we realize that our initial pricing assumptions are very well, I would say grounded.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We talked about a little bit over maybe $50,000-$100,000 per year. There was a lot, as you know, from clients of yours and from people we talk to, a little bit of pushback on do you actually go that high. I think right now, while we're not going to disclose the price specifically, I think we're actually very confident that that's the right range to operate in general.

Operator

Thank you for your question. Our next question comes from Kambiz Yazdi of US Bancorp BTIG. Your line is open.

Kambiz Yazdi
Analyst at US Bancorp BTIG

Morning team. Thank you for the question. How are you thinking about the relutrigine efficacy in EMERALD relative to what was observed in EMBOLD? From a biological level, how should we think about relutrigine performance in broader DEEs compared to the SCN2A/8A population? Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah. Thanks, Kambiz. Good to hear from you. I would start with the what is necessary and then what is possible. I think those are two completely different things here, right? I mentioned earlier in the call on the background of seizure burden for these patients, right? It is absolutely insane. I cannot even imagine as a parent to have to deal with something like that. These patients tried, and these parents tried everything they could possibly imagine on those. Logically, no matter what we want to believe, reducing consistently a part of those seizures and therefore statistical significance when you think about a study, that should be a bar, right? The bar here is significance on this study. Of course, we want to go above much, much higher than the bar, right? Bar for success, no doubts whatsoever.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Physicians, patients are saying, "Help me control a little bit better. Let me give a little bit more hours without being on top of these kids nonstop, afraid of complications, SUDEP," you name it. That would be a big win. Biologically, though, by what Steven just discussed, there are reasons to believe that it could be similar, if not better than what he's saying on EMBOLD. I think it's hard to imagine, right, being better than EMBOLD, but we need to stay true to the science and to what we are seeing so far. We're going to discuss a lot more about this in the near future as well, but again, going to have to stay true to what is possible. Not necessary, but we'll love nothing more than help these patients to an extreme.

Kambiz Yazdi
Analyst at US Bancorp BTIG

Thank you so much.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

You bet.

Operator

Our next question comes from Jay Olson of Oppenheimer. Your line is now open.

Jay Olson
Jay Olson
Analyst at Oppenheimer

Hey, congrats on all the progress, thanks for taking our questions. We have another relutrigine question, just wanted to follow up on something that you've commented on in the past, Marcio, that you've seen in the pooled mask data from EMERALD, that you've observed dynamics that are profoundly different from what a meta-analysis of historic DEE placebo groups could accommodate. Can you talk about the most important factor behind this observation, and how would you compare the information in proportion of patients with a 50% reduction versus 75% reduction versus 100% freedom from seizures? Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thank you very much. I think that all those parameters you mentioned, these continuous of response, 50%, 70%, 75%, 90%, 95%, whatever you want, 100%, are incredibly important. We've been tracking and we've been, I would say, quite pleased about the entire distribution. Maybe one point here that we haven't discussed as much, it is quite interesting as well to see what happens when they transition to the open label. Right? Studies been going on for a bit, and we rose relatively fast. There is a very large proportion of patients that have multiple months now in the open label. When you put all of that together, the initial response with the double blinds, the information we're able to get from the open label, I would say they depart a lot from what historical expectations would be.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Hey, who here hasn't been burned by blinded data from the first rock? I'm not saying this is completely proof of any possibilities of not being a misread, but it is just very hard to believe that we would read this incorrectly, considering how severe this disease is and how high the seizure burden is. Very happy across the boards, but we're going to stay vigilant until the end of this study.

Jay Olson
Jay Olson
Analyst at Oppenheimer

Super helpful. Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

You bet.

Operator

Our next question comes from Ami Fadia of Needham & Company.

Ami Fadia
Ami Fadia
Analyst at Needham & Company

Hi, good afternoon. Thank you for taking my question, and congrats on all the positive updates this morning. I had one question on ulixacaltamide and one follow-up on EMERALD. As you think about the uptake of ulixacaltamide, can you talk about the mix of patients that you expect across maybe the commercial Medicare, Medicaid setting, and where do you see the initial patients coming from? Is it sort of older patients that have been suffering with ET for a very long time, or do you also expect younger patients to start to take ulixacaltamide earlier in the launch? Then with regards to the EMERALD study, across the 50 etiologies that you talked about, from a mechanistic perspective, is there a reason to believe that the response rates would be similar, or could it be varied across the different etiologies? Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah, no. Absolutely, Ami. This launch is going to likely have several stages. I believe we're being quite responsible defining the addressable population at time of launch around 2 million patients. That is mostly, I would say three quarters or so of those patients would be the Medicare Advantage, arguably slightly older patients there. Maybe the phenomena that we are seeing more and more is the family members. Right? The interests of those patients. So I would say for the phase II, very likely what we're going to see is a migration continue to increase these patients on the 65+, but also a lot of the 40s to 65 patients there. Of course, there's a different payer mix, there's different dynamic on those patients.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Maybe the part we don't talk as much about, we kept this number static, but it's not static. Right. The population demographics in the U.S., and globally, but particularly in the U.S., is shifting quite a lot. When you look into the prevalence of essential tremor in the overall population, it's a little bit about 2.5%. When you get to 60s, that is about 2.5 times the overall prevalence. Then about every 10 years after that, it doubles. We haven't discussed, but you're going to hear us discussing a lot more, is actually the completely organic growth of these markets that is about double digits. We just don't have drug launches on multi-million patient markets growing organically as a market, double digits moving forward. That changed a little bit, the mix.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I know you had an EMERALD question there as well.

Tim Kelly
Tim Kelly
CFO at Praxis Precision Medicines

The efficacy across the etiologies.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

The efficacy across etiologies. Thanks, Tim.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Of course, it's not going to be the same. I think my math teacher would remove my diplomas if I say it's going to be the same on an heterogeneous population. We do expect that would be consistently positive. I think that that's what we should be expecting at this point in time.

Operator

Thank you.

Ami Fadia
Ami Fadia
Analyst at Needham & Company

Thank you.

Operator

Our next question comes from Brian Skorney of Baird. Your line is open.

Brian Skorney
Brian Skorney
Analyst at Baird

Hey, good morning, guys. Thanks for taking the question. Maybe if I could just ask you to characterize some of the areas of the focus for the agency in the mid-cycle review meeting for you. Who took the most time on the side of the FDA? Was it the clinical review team, the stats group, the safety group? Is it mostly handed by the lead reviewer, like are Emily Frelik and Teresa Buracchio in the meeting? I don't know if this is something that comes across in the context of a mid-cycle review meeting, but any insight into FDA's thinking about whether or not they're going to look for DEA scheduling here?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I would say those meetings are comprehensive, right? This is not exactly like, oh, they stayed quiet for several months and they come and dump a meeting on us. Quite the opposite, right? There's been dialogue. Overall, it's an opportunity. As you might recall, when Senate, with heavy lobby from the industry, requested mid-cycle meetings to be implemented as part of a appeal for reauthorization, was to actually give us, as the applicants, an opportunity to have that discussion on how things are going. I would say very little on areas that are of, I would say, interest for people that don't have an interest on this drug getting to the markets, like some of your clients. A lot of the interest here was actually how to actually get this drug to help patients.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

All the areas were represented, that you named there, as normally the case. Of course, senior leadership was represented since this is not only an important application, but it's one with a Breakthrough Designation. No drug approved mechanistically for essential tremor ever, only one approved. You would imagine that fits exactly the agenda for the FDA from a public health perspective in the United States. What I would say is, and as we said on the prepared remarks, which by the way, we're legally obliged to be complete, as you know. I find some of the questions, to be honest, a little bit annoying, is that there was no major comments here or there. We see this as overall incredibly positive that we are. It's not over yet. It's never over. One must take the stage we are, right?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

The questions before this call were what happens in the mid-cycle? Is the FDA going to have an Advisory Committee? Is this and that? Maybe it's time to flip the page towards how large of an opportunity essential tremor is and burn the ships, as one say in Carthage, and start moving forwards towards conquering new worlds.

Brian Skorney
Brian Skorney
Analyst at Baird

Thanks, Marcio.

Operator

Our next question, Danielle Brill of Truist. Your line is open.

Analyst at Truist

Hey, guys. This is Alex on for Danielle. Thanks for taking the question. Just given that you had these two mid-cycle reviews in close proximity, any noticeable differences in the tenor, pushback, body language, et cetera, between the FDA reviews for ulixacaltamide versus relutrigine? Thanks so much.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I would say no on the body language. That is a very collegial discussion throughout the group at the agents and ourselves, and exemplified by the fact that we are really the only company that probably know every person on that room by name, and actually have a trust and rapport with each one of them because there are multiple INDs and multiple NDAs under review. Much larger, right? As you can imagine, the application for ulixacaltamide hydrochloride is so much larger, so there's a lot more people involved on that. If anything, I'm a paranoid by nature person, so I never expect people to be very happy on meetings like this. I would venture to say that I think it's very calm, as I said, it's very peaceful and body language is incredibly positive across the board.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

It reflects the collaboration throughout the review, as one would expect.

Analyst at Truist

Thank you so much.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Yeah.

Operator

Our next question comes from David Hoang of Deutsche Bank. Your line is open.

David Hoang
David Hoang
Analyst at Deutsche Bank

Hi there. Thanks for the updates and taking my questions. I wanted to go back to ulixacaltamide's potential commercial launch. Could you talk a little bit about the prescriber base for the drug and remind us if this will be primarily neuros writing for it? Or would a primary care doc, let's say, feel comfortable to write for this drug? What size of sales force would you need to support a successful launch? Then if you could just remind us of your latest assumptions on peak sales for ulixacaltamide. Thank you.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Sounds good. We start with the last part, then hand over to Megan. The big sales here, I think we've been very conservative on when you look into the size of the opportunity. In general, from number of patients, from not really having anything else. The growth we just mentioned that had not been adding in general feedback from physicians. You name it, we set that floor into around 10 billion for. I would say the more we move forward, I think the more we feel comfortable that's really a fairly conservative number. Let me hand over to Megan to discuss the other topics.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

Yep, absolutely. Thanks, David, for the question. From a target perspective, you are right. Neurologists are our focus coming out for the launch, with us targeting them primarily because of their strong ET influence and just the patient volume. With a call target sizing in the 13,000-15,000 range, that puts us in a place of having a field force around 300. As I shared earlier, at the start of the Q&A, we are well underway with our hiring.

Megan Sniecinski
Megan Sniecinski
COO at Praxis Precision Medicines

Context we are heading into with the first targeted therapy, huge unmet need, and just the opportunity to have the most successful launch here in neurology. We are definitely attracting top-caliber talent that want to be a part of this. The focus for the build-out will allow us to be out in the field doing the account profiling, so we are very well-prepared upon PDUFA.

Operator

Thank you. Our next question comes from Leonid Timashev of RBCCM. Your line is open.

Analyst at RBCCM

Hey, guys. Josh on for Leo. Thanks for taking my question. For the initial patient population that you will be targeting for relutrigine, are you planning on going after the most severe patients, or do you think you will go more broadly earlier? How might that play with how clinicians typically may use a novel seizure agent? Thanks.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I would say to call any patient with this condition non-severe, it's probably something I'm never going to be able to do it. The population is the population here, right? We are still represented us into the SCN2A Familie Foundation meeting last week. We had several updates after that in discussions with them. Many clinicians gave us the feedback based on how they are waiting for this. Some of these hospitals in America, centers of excellence, have very large, either the largest or second-largest cohorts of DEEs they have. Suffering is suffering, and we shouldn't compare. When you look into other DEEs that there are three or four companies going after, they are way, way less severe, and the majority of the patients are being treated there.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

We don't see a segmentation per se here, but really careful use. I don't think we would want for everyone to just start right away without doing the proper assessments of these patients, without making sure their background medications are optimized before getting into relutrigine. That is what's going to dictate the launch. I think our medical education exchange discussions are going to focus on proper use because proper use is what leads to maximum penetration and maximum retention and, of course, maximum benefit for patients. The other parts that we're all interested is maximum revenues that can return to all of us and get more drugs to the market. That is the strategy here. I couldn't be more pleased to the feedback we're getting from physicians and patient groups.

Operator

Thank you. Our next question comes from Rudy Li of Wolfe Research. Your line is open.

Rudy Li
Rudy Li
Analyst at Wolfe Research

Thanks for taking my question. For Ulix, what gives you confidence that titration can help improve discontinuation in practice? What data evidence you have to support your titration proposal, and how should we think about discontinuation rates in the real world? Thanks.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

No, that is a fantastic question and one that we spent a lot of time ourselves and, of course, discussing with the FDA. That is why I can't possibly go through every line of evidence here. One thing that is quite key that we haven't, and I'll take full responsibility for not actually discussing this properly publicly before, is if the patients stay, the odds of staying on drug and responding, if you just stay a day or two more after arising a tolerability are disproportionate, right? That evidence and the mathematical evidence is very, very clear, right? Imagine a study, when we conducted these studies, we wanted to make sure we're not biasing these patients. When a patient goes to an office to discuss with their physician, it's very different conversations like this is the possible benefits, and this is the possible risks, right?

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

The benefit question is there. In a clinical study, the benefit question is not there. That is a key driver. We have a fair bit of data showing that if patients stay on the drug, and if they stay a little bit longer, not a lot longer, they're going to be able to tolerate and get fantastic, in my words, benefits on the other side of that. Our proposal in the label, notwithstanding the fact that label has to be approved by the FDA and so on and so forth, is that physicians are instructed to, if they have concerns because they know their patients. There are patients that chronically don't respond so well in terms of tolerability. They can keep the patients for a little bit longer, right? It is important because they're going to see 70% of the patients doing really well.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Their desire is going to turn into like, "I want to get all my patients to do really well." That's the bridge we want to. What Megan mentioned before about the hub of the future, right? It is really, and we're going to be talking about in our commercial day coming up soon, going to be announcing. It is really a state-of-the-art way to help the practice manage the patients and getting all the tools to maximize tolerability. We could be here saying, why do we care about those patients, right? It's completely irrelevant from a big revenue perspective. It's not, because we know this drug works, and we want to make sure it's there with each one of those patients. I really appreciate it. It is something very close to our hearts.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Our team worked incredibly hard to make sure every percent point is not only a percent point in revenue, it's a lot more patients that are being able to get benefits that they cannot get any other way.

Rudy Li
Rudy Li
Analyst at Wolfe Research

Very helpful. Thanks for the color.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Of course.

Operator

Our next question comes from Ben Burnett of Wells Fargo. Your line is open.

Analyst at Wells Fargo

Hi. Good morning, team. This is Orfia joining for Ben. Congrats on over-enrolling EMERALD. I had one question on RELU and one on your cash runway. First on RELU, are you able to share what proportion of EMERALD patients are on XCOPRI or another sodium blocker at baseline? And what are your expectations for incremental efficacy in patients who are already on cenobamate? Secondly, on your cash runway, given that both RELU and ELSU are eligible for pediatric vouchers, are your current plans to monetize those on approval, and is that contemplated in your cash runway? Thank you very much.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

I think we got a very representative distribution of what the background meds are here. Very happy. I'll tell you, discontinuation, for example, it is a good surrogate there, being extremely low on this study, tolerability is being very good. We know, unfortunately, a lot of these patients failed pretty much everything. You name a drug, I'm going to tell you they failed or they are on it. We're confident on not only on the effect, which is important, but on the safety as well to get to a positive benefit risk. I'll leave the last question to Tim, who's been anxiously waiting for a financial question for the call.

Tim Kelly
Tim Kelly
CFO at Praxis Precision Medicines

Thanks for the question about the runway. I think part of what we talked about with the runway is it gives us this great flexibility and ability to launch into these launches that the way we're investing with field force and all the activities that Marcio and Megan have taken us through. With respect to the PRV, because we do anticipate an approval for relutrigine for SCN2A and SCN8A, where we do have orphan designation and are eligible for a PRV, we would expect to receive that as well. It is not a meaningful impact to our runway, but it does ensure that we can continue to invest in these launches. You're right also about elsunersen down the road because that also has orphan designation. We believe that would be our second product that could be eligible for a PRV. Thank you for the question.

Analyst at Wells Fargo

Got it. Thank you. Congrats again.

Operator

Thank you. This concludes the question-and-answer session. I would now like to turn it back to Marcio for closing remarks.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Thank you so much. I appreciate. I hope you see we tried to be very comprehensive today, giving updates on. It's just absolutely amazing, palpable energy that we get every single day here in the office with all the now sales team as well, and being there and talking to physicians, giving us a lot more information. I would say, as we move this phase towards a commercial, a lot of you helped us along the way to make a successful clinical development for these drugs, as we're going to discuss less and less the clinical and regulatory. Just want to take a moment to thank all of you who are certainly my biggest critics and my biggest supporters when we got into certain conversations. I appreciate every feedback being given to the company made us to where we are right now.

Marcio Souza
Marcio Souza
President and CEO at Praxis Precision Medicines

Couldn't be prouder on behalf of patients. When we get these stories every single day, trust me, we got them every single day from the patients who transition on EMBOLD to the open label or the ones who are on BOLT or the ones who are on an emergency access of one of our medicines, or particularly these days, for the ones wanting to be on ulixacaltamide. That's what keeps us going. Thanks enormously for your support and really looking forward to the conversations later today and in the near future.

Operator

Thank you for your participation in today's conference. This does conclude the program, and you may now disconnect.

Executives
    • Marcio Souza
      Marcio Souza
      President and CEO
    • Tim Kelly
      Tim Kelly
      CFO
    • Megan Sniecinski
      Megan Sniecinski
      COO
    • Steve Petrou
      Steve Petrou
      President of Research and Development
Analysts
Powered by Quartr