Dr. Kathy Rickard: Bronchodilators have not failed per se. As was mentioned, there are no approved drugs for non-CF bronchiectasis. Bronchiectasis had some similar things that we see that are similar to COPD, for example, infections, they have widening of the airways and they have destruction in the airways and increased mucus. So many of the things that they — we see in bronchiectasis, we see effects from ensifentrine and COPD. So for example, bronchodilation may help clear out the mucus better. It doesn’t necessarily work like you would see in somebody with asthma where you’re actually looking to actually bronchodilate the airway, but you’re looking for increasing, getting rid of the mucus and all those sitting in the airways because that’s what’s causing all the underlying infections when you have stuff sitting there if it gets infected and then you lead to exacerbations.
So do we use them? Yes, we use them. We use everything we have because we don’t have anything else to use. So we’re going to use bronchodilators, or you can use steroids for you, whatever we have available because that’s what we have to use to treat bronchiectasis. I think we also think from ensifentrine perspective, both on the non-steroidal anti-inflammatory effect and its ability to increase mucociliary clearance will help clear mucus out of the airways and help prevent and decrease exacerbations that we may see with patients with bronchiectasis.
Operator: [Operator Instructions] Our next question comes from Dipesh Patel with H.C. Wainwright.
Dipesh Patel: This is Dipesh, covering for Boobalan, H.C. Wainwright. In one of the HCP-focused market research slides that you presented last month, we see that ensifentrine’s twice-a-day dosing schedule was the least preferred attribute among 7 others. So the score was not that bad. Thinking long term, how do you expect the twice-a-day regimen to potentially impact ensifentrine’s market adoption?
Dr. David Zaccardelli: Great. Chris, do you want to speak to it?
Chris Martin: Yes. Thanks, Dave, and I appreciate the question, Dipesh. I think you’re referring to the slide on the attributes of drugs. Attribute to ensifentrine and how physicians rated that. I think it’s really important to just ground ourselves on how impressive the response was from physicians on the profile of ensifentrine. As you mentioned, that was the lowest score, but it’s still well above the median. But for every attribute that’s listed from least important, the most important, ensifentrine score is extraordinarily high within a physician’s mindset. And I think that plays based on what we’ve heard in qualitative and KOL interactions to the unmet need that still exists in the marketplace. As we discussed earlier, 50% of these patients are having persistent symptoms.
So the physicians are looking for drugs that have the potential to have an effect on their patient lives that potentially ensifentrine could have. We talk specifically to doctors about BID dosing, one of the things that’s interesting is what we hear from them is that many patients struggle, and Kathy can talk about this, but many patients struggle when they wake up in the morning because single or once-a-day drugs tend to lose their effect over time. So in their mind, sometimes the BID dosing is very beneficial for the patient because they get that evening dose that allows them to wake up in a better place than maybe they would have with a single once-a-day type product. So when we look at overall adoption and how physicians look at the profile, we don’t believe that a BID dose is a hindrance at all.
And you can see that on the second part of that slide, which basically says that 90% of the HCPs believe that they’ll be adopting ensifentrine within the first year of launch. And that’s a remarkably high adoption rate. And it, again, speaks to the unmet need and the overall differentiated profile that ensifentrine has.
Dipesh Patel: Great. I have a couple of more questions. You may have touched on this in some of the prior questions, but can you discuss the challenges you anticipate solving as you work on testing the combinability of ensifentrine plus LAMA in a single nebulizer formulation. And I think you had noted earlier on, just to confirm that you’re going to be expecting the clinical trial to begin second half of ’24 on that?
