The following is excerpted from the question-and-answer section of the transcript.
(Questions from industry analysts are provided in full, but answers are omitted - download the transcript to see the full question-and-answer session)
Question: Mayank Mamtani - B. Riley Securities Holdings Inc - Analyst
: Good good morning team. Thanks for taking our questions and I appreciate all the detail provided today. First for Dr. Kaufmann. In REDWOOD,
we see a 1.6 point improvement on the HSA composite, as you highlighted and in CYPRESS, there's a target 1 point change. If you could
maybe talk to subcomponents that you highlighted in forest plot that tend to have maybe more variability than less and perhaps less
plausibility with the NET inhibition mechanism.
Question: Mayank Mamtani - B. Riley Securities Holdings Inc - Analyst
: In the forest plot in the different subcomponents that you have in the forest plot within OHSA, I was just curious, are there subcomponents
that have more variability than less in general as you assess these evaluation metrics?
And then with the NET inhibition mechanism specifically, is there short versus long-standing, for example, like is there a possibility of certain
metrics that is more related to the mechanism versus not, if you could talk to that?
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DECEMBER 08, 2025 / 3:30PM, TBPH.OQ - Theravance Biopharma Inc To Host Virtual KOL Investor Event
Question: Mayank Mamtani - B. Riley Securities Holdings Inc - Analyst
: Yes, thank you. That durability comment was helpful. And then maybe for the company, on the CYPRESS execution details to the extent
you're able to share, would love to hear what proportion of patients have progressed from the initial open label to the randomized withdrawal
section? Were there any differences versus REDWOOD?
And I guess a commercial question, how does the initial screening rate in CYPRESS provide insight into both the sort of the epidemiology
of MSA, nOH and kind of the diagnosis trends that you're seeing that can inform commercial uptake?
Question: Mayank Mamtani - B. Riley Securities Holdings Inc - Analyst
: And then on the commercial question, any learnings from the trial that inform the epidemiology or diagnosis trends that might be changing?
Question: Debanjana Chatterjee - Jonestrading Institutional Services LLC - Analyst
: Hi, thanks for taking my question and congrats on the excellent presentation. So I have a couple. The first one is regarding the potential for
off-label use. Given the like high unmet need in neurogenic orthostatic hypotension, do you see any potential for off-label use of ampreloxetine
in broader population beyond MSA?
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Question: Debanjana Chatterjee - Jonestrading Institutional Services LLC - Analyst
: Thanks, and do you see any potential for payers implementing step edits if ampreloxetine is approved and commercially available given its
premium price?
Question: Debanjana Chatterjee - Jonestrading Institutional Services LLC - Analyst
: Sure. And the last one, what gross donate discount assumptions are you modeling for ampleloxetine at launch and what factors like peer
makes, Medicare, like, drives these estimates?
Question: Andrew Kassin - BTIG LLC - Analyst
: Hi, thanks everyone for this great event. Just a quick question on the OHSA composite score. Could you put the MCID for this composite
score in context for us? Do you expect payers are aligned on the expectation for efficacy considering no other safe alternatives exist?
Question: Andrew Kassin - BTIG LLC - Analyst
: And then just one more on the commercial side. I know we -- you discussed the centers of excellence as a focus. What percentage of
patients or proportion of patients would be treated by community neurologists that could be available?
Rhonda Farnum - Theravance Biopharma Inc - Senior Vice President - Commercial and Medical Affairs, Chief Business Officer
I would still say when I want to make sure we're aligned on when we say community neurologists, there are still specialists within the
neurology specialty. So taking that qualification, I would expect about 80% of our targets are in that realm and the 20% are in the COEs or
academia.
Question: Trevor Allred - Oppenheimer & Co Inc - Analyst
: And so just along as a follow-up. When you think about potential for some disease-modifying therapies that are in development, your
perspective would be that they are likely not to address the nOH symptoms and there would continue to likely be still a need for ampreloxetine?
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Question: Trevor Allred - Oppenheimer & Co Inc - Analyst
: Hey, thanks for taking my question and thanks for this great event.My first question is for Dr. Kaufmann and it kind of goes along the same
line as Doug's question. Can you expound a bit on how, say, a 1- to 2-point OHSA improvement correlates to clinical benefit? What's the
change in the patient's daily experience?
Question: Trevor Allred - Oppenheimer & Co Inc - Analyst
:
Question: Ellen Horste, Ph.D. - Cowen and Company LLC - Analyst
: Hi guys. Thanks for this presentation. It's been super helpful in helping us frame expectations and understanding the launch a little bit better.
I guess if I could just ask a question that's a little more launch focused.
I'm wondering, assuming the trial hits, assuming approval, I understand this should be modeled kind of like a rare disease launch, but do
you have any expectation that there should be a bolus of patients? Is there kind of a pent-up demand leading up to the approval based on
the concentration of physicians and patients? Just wondering kind of how we can get more granular on modeling this launch. Thank you.
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