Akebia Therapeutics Reports Third Quarter 2024 Financial Results and Recent Business Highlights

    --  Vafseo® (vadadustat) on track for U.S. market availability expected in
        January 2025
    --  Over 300,000 patients, representing approximately 60% of dialysis
        patient lives in the U.S., now covered under dialysis provider contracts
        for Vafseo
    --  Vafseo granted TDAPA reimbursement and issued a Level II Healthcare
        Common Procedure Coding System code
    --  Akebia to Host Conference Call at 8:00 a.m. ET on November 7

CAMBRIDGE, Mass., Nov. 7, 2024 /PRNewswire/ -- Akebia Therapeutics®, Inc. (Nasdaq: AKBA), a biopharmaceutical company with the purpose to better the lives of people impacted by kidney disease, today reported financial results for the third quarter ended September 30, 2024, and recent business highlights. During the quarter, Akebia continued to execute on the commercial launch of Vafseo® (vadadustat) to prepare for U.S. market availability expected in January 2025.

"Our entire organization has been diligently executing across multiple fronts on launch readiness activities as we approach Vafseo U.S. market availability expected in January. Importantly, approximately 60 percent of patients on dialysis are now covered under dialysis organization and group purchasing organization contracts for Vafseo," said John P. Butler, Chief Executive Officer of Akebia. "We expect to enter into contracts with additional dialysis providers to increase coverage over the remainder of 2024 while continuing our efforts to drive demand for Vafseo from prescribers. We also recently partnered with U.S. Renal Care (USRC) to initiate a collaborative trial evaluating mortality and hospitalization outcomes for dialysis patients taking Vafseo to further add to Vafseo's body of clinical evidence, and separately presented six posters with Vafseo clinical data at the recent American Society of Nephrology (ASN) Kidney Week conference. Taken together, these initiatives are intended to continue to support a strong launch and move toward establishing Vafseo as the new oral standard of care for dialysis patients with anemia."

Progress on Key Vafseo Business Initiatives

    --  Akebia has entered into commercial supply contracts for Vafseo with
        dialysis organizations treating over 300,000 patients, which represents
        approximately 60% of dialysis patients in the U.S. Recent commercial
        supply contracts include agreements with one of the leading dialysis
        organizations serving more than 200,000 dialysis patients, USRC which
        serves more than 36,000 patients and Renal Purchasing Group, a specialty
        group purchasing organization that serves many of the independent and
        small dialysis organizations.
    --  In October 2024, the Center for Medicare & Medicaid Services determined
        that Vafseo met the criteria for Transitional Drug Add-On Payment
        Adjustment (TDAPA) reimbursement, which will begin on January 1, 2025.
        Akebia also received a Level II Healthcare Common Procedure Coding
        System code for Vafseo that will be utilized by dialysis organizations
        to help process health insurance claims for Medicare enrollees upon
        launch.
    --  In October 2024, Akebia had a strong presence at the ASN Kidney Week
        conference, hosting commercial and medical affairs booths, and a product
        theatre, as well as presenting seven scientific posters at the
        conference. The event was well-attended with significant participation
        from the nephrology community serving to help Akebia further educate the
        physician community and to drive prescriber demand in advance of Vafseo
        market availability.
    --  In September 2024, Akebia and USRC initiated the Vafseo Outcomes
        In-Center Experience (VOICE) trial. The trial will randomize patients to
        treatment with oral Vafseo 300 mg tablets administered three times per
        week or standard of care erythropoiesis-stimulating agents and will be
        powered to demonstrate non-inferiority for all-cause mortality and
        superiority for a 10% reduction in all-cause hospitalization.

Financial Results

    --  Revenues: Total revenues were $37.4 million in the third quarter of 2024
        compared to $42.0 million for the third quarter of 2023, comprised of
        the following components:
        --  Auryxia® (ferric citrate) net product revenues were $35.6 million
            in the third quarter of 2024 as compared to $40.1 million in the
            third quarter of 2023. This decrease was driven by a reduction in
            volume partially offset by price increases and execution of our
            contracting strategy with third party payors. Akebia continues to
            enter into commercial supply contracts for Auryxia, which is
            expected to be added to the bundled payment for dialysis services in
            January 2025.
        --  License, collaboration and other revenues were $1.8 million in the
            third quarter of 2024 compared to $1.9 million in the third quarter
            of 2023.
    --  Cost of Goods Sold: Cost of goods sold (COGS) was $14.2 million in the
        third quarter of 2024 compared to $18.0 million in the third quarter of
        2023. This decrease was driven by a $3.7 million benefit due to our
        ability to commercially sell inventory previously written-down as excess
        inventory, as well as lower year-over-year sales volume. Akebia
        continues to carry a non-cash intangible amortization charge of $9.0
        million per quarter in COGS through the fourth quarter of 2024.
    --  Research & Development Expenses: Research and development expenses were
        $8.5 million in the third quarter of 2024 compared to $13.3 million in
        the third quarter of 2023. This decrease was driven by the completion of
        activities related to certain clinical trials, lower headcount related
        costs and decreased professional service and consulting expense.
    --  Selling, General & Administrative Expenses: Selling, general and
        administrative expenses were $26.5 million in the third quarter of 2024
        compared to $22.7 million in the third quarter of 2023. This increase
        was driven by higher costs incurred in connection with preparatory
        activities related to Vafseo product availability in the U.S., which is
        expected in January 2025.
    --  Net Loss: Net loss was $20.0 million in the third quarter of 2024
        compared to $14.5 million in the third quarter of 2023. The increase in
        net loss included $4.4 million in non-cash interest expense related to
        the settlement royalty liability in connection with the Vifor
        Termination and Settlement Agreement that Akebia signed in July 2024.
    --  Cash Position: Cash and cash equivalents as of September 30, 2024 were
        approximately $34.0 million. Akebia expects its existing cash resources
        and cash from operations will be sufficient to fund its current
        operating plan, including the U.S. Vafseo launch, for at least two
        years.

Conference Call

Akebia will host a conference call on Thursday, November 7 at 8:00 a.m. Eastern Time to discuss third quarter 2024 earnings. To access the call, please register by clicking on this Registration Link, and you will be provided with dial in details. To avoid delays and ensure timely connection, we encourage dialing into the conference call 15 minutes ahead of the scheduled start time.

A live webcast of the conference call will be available via the "Investors" section of Akebia's website at: https://ir.akebia.com/. An online archive of the webcast can be accessed via the Investors section of Akebia's website at https://ir.akebia.com approximately two hours after the event.

About Akebia Therapeutics

Akebia Therapeutics, Inc. is a fully integrated biopharmaceutical company with the purpose to better the lives of people impacted by kidney disease. Akebia was founded in 2007 and is headquartered in Cambridge, Massachusetts. For more information, please visit our website at www.akebia.com, which does not form a part of this release.

About Vafseo® (vadadustat) tablets

Vafseo® (vadadustat) tablets is a once-daily oral hypoxia-inducible factor prolyl hydroxylase inhibitor that activates the physiologic response to hypoxia to stimulate endogenous production of erythropoietin, increasing hemoglobin and red blood cell production to manage anemia. Vafseo is approved for use in 37 countries.

INDICATION

VAFSEO is indicated for the treatment of anemia due to chronic kidney disease (CKD) in adults who have been receiving dialysis for at least three months.

Limitations of Use

    --  VAFSEO has not been shown to improve quality of life, fatigue, or
        patient well-being.
    --  VAFSEO is not indicated for use:
        --  As a substitute for red blood cell transfusions in patients who
            require immediate correction of anemia.
        --  In patients with anemia due to CKD not on dialysis.

IMPORTANT SAFETY INFORMATION about VAFSEO (vadadustat) tablets


                                                                                                                                                                                             
            
              WARNING: INCREASED RISK OF DEATH, MYOCARDIAL INFARCTION, STROKE, VENOUS THROMBOEMBOLISM, and THROMBOSIS OF VASCULAR ACCESS.



    VAFSEO increases the risk of thrombotic vascular events, including major adverse cardiovascular events (MACE).


              Targeting a hemoglobin level greater than 11 g/dL is expected to further increase the risk of death and arterial and venous thrombotic events, as occurs with erythropoietin stimulating agents (ESAs), which also increase erythropoietin levels.


              No trial has identified a hemoglobin target level, dose of VAFSEO, or dosing strategy that does not increase these risks.


              Use the lowest dose of VAFSEO sufficient to reduce the need for red blood cell transfusions.

CONTRAINDICATIONS

    --  Known hypersensitivity to VAFSEO or any of its components
    --  Uncontrolled hypertension

WARNINGS AND PRECAUTIONS

    --  Increased Risk of Death, Myocardial Infarction (MI), Stroke, Venous
        Thromboembolism, and Thrombosis of Vascular AccessA rise in hemoglobin
        (Hb) levels greater than 1 g/dL over 2 weeks can increase these risks.
        Avoid in patients with a history of MI, cerebrovascular event, or acute
        coronary syndrome within the 3 months prior to starting VAFSEO.
        Targeting a Hb level of greater than 11 g/dL is expected to further
        increase the risk of death and arterial and venous thrombotic events.
        Use the lowest effective dose to reduce the need for red blood cell
        (RBC) transfusions. Adhere to dosing and Hb monitoring recommendations
        to avoid excessive erythropoiesis.

    --  HepatotoxicityHepatocellular injury attributed to VAFSEO was reported in
        less than 1% of patients, including one severe case with jaundice.
        Elevated serum ALT, AST, and bilirubin levels were observed in 1.8%,
        1.8%, and 0.3% of CKD patients treated with VAFSEO, respectively.
        Measure ALT, AST, and bilirubin before treatment and monthly for the
        first 6 months, then as clinically indicated. Discontinue VAFSEO if ALT
        or AST is persistently elevated or accompanied by elevated bilirubin.
        Not recommended in patients with cirrhosis or active, acute liver
        disease.

    --  HypertensionWorsening of hypertension was reported in 14% of VAFSEO and
        17% of darbepoetin alfa patients. Serious worsening of hypertension was
        reported in 2.7% of VAFSEO and 3% of darbepoetin alfa patients. Cases of
        hypertensive crisis, including hypertensive encephalopathy and seizures,
        have also been reported in patients receiving VAFSEO. Monitor blood
        pressure. Adjust anti-hypertensive therapy as needed.

    --  Seizures Seizures occurred in 1.6% of VAFSEO and 1.6% of darbepoetin
        alfa patients. Monitor for new-onset seizures, premonitory symptoms, or
        change in seizure frequency.

    --  Gastrointestinal (GI) Erosion Gastric or esophageal erosions occurred in
        6.4% of VAFSEO and 5.3% of darbepoetin alfa patients. Serious GI
        erosions, including GI bleeding and the need for RBC transfusions, were
        reported in 3.4% of VAFSEO and 3.3% of darbepoetin alfa patients.
        Consider this risk in patients at increased risk of GI erosion. Advise
        patients about signs of erosions and GI bleeding and urge them to seek
        prompt medical care if present.

    --  Serious Adverse Reactions in Patients with Anemia Due to CKD and Not on
        Dialysis The safety of VAFSEO has not been established for the treatment
        of anemia due to CKD in adults not on dialysis and its use is not
        recommended in this setting. In large clinical trials in adults with
        anemia of CKD who were not on dialysis, an increased risk of mortality,
        stroke, MI, serious acute kidney injury, serious hepatic injury, and
        serious GI erosions was observed in patients treated with VAFSEO
        compared to darbepoetin alfa.

    --  MalignancyVAFSEO has not been studied and is not recommended in patients
        with active malignancies. Malignancies were observed in 2.2% of VAFSEO
        and 3.0% of darbepoetin alfa patients. No evidence of increased
        carcinogenicity was observed in animal studies.

ADVERSE REACTIONS

    --  The most common adverse reactions (occurring at >= 10%) were
        hypertension and diarrhea.

DRUG INTERACTIONS

    --  Iron supplements and iron-containing phosphate binders: Administer
        VAFSEO at least 1 hour before products containing iron.
    --  Non-iron-containing phosphate binders: Administer VAFSEO at least 1 hour
        before or 2 hours after non-iron-containing phosphate binders.
    --  BCRP substrates: Monitor for signs of substrate adverse reactions and
        consider dose reduction.
    --  Statins: Monitor for statin-related adverse reactions. Limit the daily
        dose of simvastatin to 20 mg and rosuvastatin to 5 mg.

USE IN SPECIFIC POPULATIONS

    --  Pregnancy: May cause fetal harm.
    --  Lactation: Breastfeeding not recommended until two days after the final
        dose.
    --  Hepatic Impairment: Not recommended in patients with cirrhosis or
        active, acute liver disease.

Please note that this information is not comprehensive. Please click here for the Full Prescribing Information, including BOXED WARNING and Medication Guide.

Forward-Looking Statements

Statements in this press release regarding Akebia Therapeutics, Inc.'s ("Akebia's") strategy, plans, prospects, expectations, beliefs, intentions and goals are forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995, as amended, and include, but are not limited to, statements regarding: Akebia's expectations as to the timing of the market availability of Vafseo; Akebia's plans with respect to its commercial launch of Vafseo, including Akebia's expectations to enter into contracts with additional dialysis providers to increase coverage over the remainder of 2024 and continue to drive demand for Vafseo from prescribers; Akebia's expectations regarding the trial with USRC to evaluate mortality and hospitalization outcomes for dialysis patients taking Vafseo, including the ability to further add to Vafseo's body of clinical evidence; Akebia's plans to establish Vafseo as the new oral standard of care for dialysis patients with anemia; Akebia's expectations regarding the VOICE trial, including the ability to demonstrate non-inferiority for all-cause mortality and superiority for a 10% reduction in all-cause hospitalization; Akebia's efforts to enter into commercial supply contracts for Auryxia and its expectations that Auryxia will be added to the bundled payment for dialysis services in January 2025; Akebia's expectations that its existing cash resources and cash from operations will be sufficient to fund its current operating plan, including the U.S. Vafseo launch, for at least two years; and Akebia's expectations about Auryxia revenue in 2024 and assumptions related thereto.

The terms "intend," "believe," "plan," "goal," "potential," "anticipate, "estimate," "expect," "future," "will," "continue," derivatives of these words, and similar references are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. Actual results, performance or experience may differ materially from those expressed or implied by any forward-looking statement as a result of various risks, uncertainties and other factors, including, but not limited to, risks associated with: whether Vafseo will be commercially available when expected; the potential demand and market potential and acceptance of, as well as coverage and reimbursement related to, Auryxia® and Vafseo, including estimates regarding the potential market opportunity; the competitive landscape for Auryxia and Vafseo, including potential generic entrants; the ability of Akebia to attract and retain qualified personnel; Akebia's ability to implement cost avoidance measures and reduce operating expenses; decisions made by health authorities, such as the FDA, with respect to regulatory filings; the potential therapeutic benefits, safety profile, and effectiveness of Vafseo; the results of preclinical and clinical research; the direct or indirect impact of the COVID-19 pandemic on the markets and communities in which Akebia and its partners, collaborators, vendors and customers operate; manufacturing, supply chain and quality matters and any recalls, write-downs, impairments or other related consequences or potential consequences; and early termination of any of Akebia's collaborations. Other risks and uncertainties include those identified under the heading "Risk Factors" in Akebia's Quarterly Report on Form 10-Q for the quarter ended September 30, 2024, and other filings that Akebia may make with the U.S. Securities and Exchange Commission in the future. These forward-looking statements (except as otherwise noted) speak only as of the date of this press release, and, except as required by law, Akebia does not undertake, and specifically disclaims, any obligation to update any forward-looking statements contained in this press release.

Akebia Therapeutics® and Vafseo® are registered trademarks of Akebia Therapeutics, Inc. and its affiliates.

Akebia Therapeutics Contact
Mercedes Carrasco
mcarrasco@akebia.com


                                                 
              
                AKEBIA THERAPEUTICS, INC.


                                 
              
                Unaudited Condensed Consolidated Statements of Operations




                                                                                                                               Three Months Ended September 30,



     
                (in thousands, except per share data)                                                                  2024                   2023



     
                Revenues



     Product revenue, net                                                                                             $35,592                $40,118



     License, collaboration and other revenue                                                                           1,836                  1,928



     Total revenues                                                                                                    37,428                 42,046



     
                Cost of goods sold



     Cost of product and other revenue                                                                                  5,150                  8,998



     Amortization of intangible asset                                                                                   9,011                  9,011



     Total cost of goods sold                                                                                          14,161                 18,009



     Operating expenses



     Research and development                                                                                           8,487                 13,330



     Selling, general and administrative                                                                               26,516                 22,710



     License                                                                                                              769                    864



     Restructuring                                                                                                          -                   169



     Total operating expenses                                                                                          35,772                 37,073



     
                Loss from operations                                                                               (12,505)              (13,036)



     Other expense, net                                                                                               (6,678)               (1,453)



     Change in fair value of warrant liability                                                                          (856)



     Loss on termination of lease                                                                                           -



     
                Net loss                                                                                          $(20,039)             $(14,489)





     Net loss per share - basic and diluted                                                                           $(0.10)               $(0.08)



     Weighted-average number of common shares - basic and diluted                                                 210,348,459            188,306,350


                                           
     
     Unaudited Selected Balance Sheet Data





     
                (in thousands)                                                    September 30, 2024 December 31, 2023



     Cash and cash equivalents                                                                 $34,019            $42,925



     Working capital                                                                           $34,411            $18,279



     Total assets                                                                             $207,142           $241,703



     Total stockholders' (deficit) equity                                                    $(50,402)         $(30,584)

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SOURCE Akebia Therapeutics, Inc.