Operator: The next question comes from Myles Minter with William Blair.
Myles Minter : Just on Biogen’s claims that SPINRAZA is going to return to growth, and they’re citing the only 20% of adults, presumably type 3 patients are actually treated with disease-modifying therapy. What’s the sort of cadence, I guess, of return to growth that we can sort of expect? It doesn’t seem that it’s going to happen this year. And it seems as if for the SPINRAZA franchise that you really like to back this up with clinical data. And I think the type 3 patients, particularly the adult is probably where there’s a lack of SPINRAZA efficacy data. So can we expand some expect some clinical studies to be launched by Biogen to support that thesis.
Brett Monia: Beth, on the return metrics, the return to growth?
Beth Hougen: Sure, absolutely. So thanks for the question, Myles. I think you’re already starting to see what we had really anticipated that this return to growth is starting in the United States with stabilization and even really a little bit of increase year-over-year and quarter-over-quarter Q3, Q4. And that’s what you would expect because that was the first launch for both SPINRAZA as well as for the competitor products. We would anticipate that, that will continue to — we’d see those same dynamics across other geographies, similar to the cadence of the various launches across various geographies. So that would be our anticipation of the cadence. And I think it’s really important to focus on the fact that the teens and adults are where SPINRAZA has already a very strong efficacy and safety profile, but it’s particularly strong in those teens and adults.
And it’s particularly in comparison to the competitor products, which really don’t adequately address those patients or in fact, in the case of Zolgensma isn’t really even approved for those older patients, right? So you would expect that’s a great place for SPINRAZA to see growth. And in fact, that’s the largest prevalent population. There’s about 60% of the prevalent population is made up of these teens and adults. So it gives tremendous opportunity for growth, not only in the U.S. but in other markets across the world. Biogen is particularly focused on expanding in Asia as well as in other geographies around the world, Latin America, Eastern Europe, some other geographies as well. So I think all of those things are going to be factors in SPINRAZA’s return to growth.
Brett Monia: And the post-marketing studies, Myles, the other part of your question, we think will only contribute to and further enhance the potential to run to significant growth for SPINRAZA. And those studies are going really well. Two studies are examining higher doses of SPINRAZA, the DEVOTE study, some of that data — some data was shared last year. Looking at higher doses of SPINRAZA has showed even greater efficacy in SMA patients. The ASCEND study in patients that their disease progresses on risdi. We’re also — big is also looking at a higher dose in those patients to show that patients will do better and will benefit. And then the RESPONSE study, looking at the commercial dose of SPINRAZA today in patients that — whose disease progresses that are on gene therapy is also going well.
Biogen hasn’t laid out timing or expectations on timing to share data, but the study is going well, and the purpose of those studies is to further enhance the market performance for SPINRAZA. And so far, everything is going on track.
