Protara Therapeutics, Inc. annual report, FY2016

Protara Therapeutics, Inc. (identified in this filing as Proteon Therapeutics, Inc.) — FY 2016 Form 10-K

Reporting period: Fiscal year ended December 31, 2016; filed March 16, 2017. This is an annual report, not a standalone 2016 fourth-quarter filing. The company-name difference between the request and the filing should be verified.

Business context and reporting period

Proteon was a development-stage biopharmaceutical company focused primarily on vonapanitase, an investigational recombinant human elastase intended to improve vascular access outcomes in patients with chronic kidney disease undergoing creation of a fistula for hemodialysis. The company had no approved products or product sales. It reported 19 full-time employees as of March 10, 2017.

Financial performance and liquidity

MetricFY 2016FY 2015
Revenue$0$0
Research and development expense$18.9 million$12.4 million
General and administrative expense$9.8 million$8.5 million
Total operating expenses / operating loss$28.7 million / $(28.7) million$20.9 million / $(20.9) million
Net loss$(28.5) million$(21.4) million
Basic and diluted loss per share$(1.72)$(1.30)
Net cash used in operating activities$(23.7) million$(17.6) million

Revenue in 2014 included a one-time $2.9 million recognition related to the expiration of rights under a 2009 agreement; no revenue was reported in 2015 or 2016. With no product revenue, operating margins are not meaningful.

At year-end 2016, cash, cash equivalents and available-for-sale investments totaled $41.3 million, down from $65.3 million a year earlier. Working capital was $37.7 million; total assets were $43.5 million and total liabilities were $5.1 million. The balance sheet reported no debt. Cash and investments were expected to fund operations into the third quarter of 2018, but not through the expected PATENCY-2 top-line results.

Investing activities provided $19.9 million in 2016, mainly reflecting investment maturities net of purchases; financing activities provided $0.2 million. The company had a $40 million at-the-market equity offering facility, but had not commenced sales under it by December 31, 2016. Contractual obligations included CHF 7.6 million payable to Lonza for manufacturing work and $252,000 in lease payments.

Material changes versus the prior comparable period

  • Net loss increased by $7.1 million year over year as operating expenses rose $7.8 million.
  • R&D expense rose $6.5 million, mainly from manufacturing pre-validation and ongoing Phase 3 trial costs; G&A rose $1.3 million.
  • Operating cash use increased $6.1 million. Cash and investments fell by approximately $24.0 million.
  • The first Phase 3 trial, PATENCY-1, did not meet its primary endpoint, prompting a redesign and increased enrollment target for PATENCY-2.

Outlook, management commentary, risks and unusual items

PATENCY-1 missed its primary endpoint of improved primary unassisted patency (p=0.254). Other results favored vonapanitase: secondary patency loss risk was reduced 34% (p=0.048), and the proportion of patients using the fistula for hemodialysis was 64% versus 44% (p=0.006). Adverse-event rates were described as comparable to placebo; one fistula thrombosis in the vonapanitase arm was considered related to study drug.

Following FDA discussions, Proteon amended PATENCY-2 to make secondary patency and fistula use co-primary endpoints and increased planned enrollment from 300 to 500. As of February 28, 2017, 315 patients had been enrolled. Management expected enrollment completion in Q4 2017 and top-line data in Q4 2018; if successful, it expected to submit a BLA in 2019. These are forward-looking expectations, not assured outcomes.

The company also initiated two Phase 1 PAD studies in 2016. It expected to enroll at least 24 patients in the below-the-knee angioplasty adjunct study during 2017, while pausing enrollment in the above-the-knee monotherapy study under its current operating plan. Further indications and European development were contingent on clinical results and available funding.

  • Financing risk: ongoing losses, no product revenue and projected cash needs beyond the stated runway create a need for additional capital; financing may be unavailable or dilutive.
  • Clinical and regulatory risk: PATENCY-2 must meet both co-primary endpoints at statistical significance for management’s contemplated single-pivotal-study BLA path; FDA may still require more evidence.
  • Manufacturing concentration: API supply depended on Lonza. The filing also disclosed a prior FDA Warning Letter to finished-product supplier Jubilant HollisterStier, while stating the FDA had said it did not affect the Phase 3 batch then in use.
  • Commercial and reimbursement risk: the company had no commercial infrastructure; expected reimbursement, market adoption and the proposed U.S. sales-force plan were not established.
  • Other exposures: foreign-exchange risk from Swiss-franc obligations; patent and third-party IP uncertainty; and dilution risk from future equity issuance. Forward currency contracts were settled by year-end 2016.

Management reported effective disclosure controls and internal control over financial reporting as of December 31, 2016. The independent auditor gave an unqualified opinion on the financial statements; it did not provide an attestation opinion on internal controls.

Most important facts for investors to verify

  • Confirm the issuer identity: the supplied filing is for Proteon Therapeutics, Inc., despite the request naming Protara Therapeutics, Inc.
  • Review PATENCY-1’s missed primary endpoint and full analysis, and monitor whether PATENCY-2 achieves statistical significance on both co-primary endpoints.
  • Check subsequent cash balances, operating spend, financing activity and whether capital is available to fund the trial through its expected readout.
  • Verify the status of the BLA plan, FDA feedback, manufacturing validation and supplier readiness; the single-pivotal-study route was management’s understanding, not an approval commitment.
  • Assess potential dilution from the ATM facility and other financing needs, plus the effect of the CHF 7.6 million Lonza commitment.