Alnylam Pharmaceuticals (ALNY) 6 May 202020 Q1 Earnings call transcript

Ladies and gentlemen, thank you for standing-by. Welcome to the Alnylam Pharmaceuticals First Quarter 2020 Conference Call. There will be a question-and-answer session to follow. Please be advised that this call is being taped at the company’s request. I would now like to turn the call over to the company.

morning. Good Senior Investor Lindenboom, Communications and President Alnylam. at Vice Christine Relations of Corporate I’m on are of the Executive today Yvonne me With phone Officer. Operating Greene, Chief Officer; Akshay Greenstreet, Poulton, Chief Officer; John President; Vaishnaw, Jeff President R&D, Financial and Barry Chief Maraganore,

those participating www.alnylam.com/event. page Investor call, of website at via For the be can the slides of section going by of you accessed to conference accompanying the event our

like and Akshay will During context. today’s commercial in updates, outlined Jeff this provide call remind contain some a before provide upcoming update Barry general you pre-clinical will call, will recent remarks an milestones Slide X, will and review would will provide and opening introductory the and John your to medical Yvonne will summary for as on clinical of financials that our brief call our affairs review I progress. questions. prospects, purposes the as forward-looking Litigation may future concerning constitute the XXXX. result Actual from indicated statements and plans differ under forward-looking statements provision current which report report, harbor most file results materially including the and those recent in a by annual quarterly factors, for Private of various Act safe of on X-K report SEC. those remarks these expectations, Reform Alnylam’s Securities discussed with important of our

call as to John. the forward-looking over In the provide upon views views this our With of date that, of disclaim and of represent any recording We addition, I’ll not any as such specifically obligation statements relied representing any only subsequent to as should be our turn statements. date.

today. joining for everyone you on us thank and the Christine call Thanks

in a crisis pandemic. has that faced of the we world health first it ourselves or society. an think saying as goes with individuals, unlike unprecedented situation any the the I confronts public as a as find XXXX ongoing as been We have quarter without company, that COVID-XX

our many everywhere this of on we the amazing will potential let work that bring crisis. efforts people including friends, me families, efforts workers of impact therapeutics Together am patients let their RNAi healthcare the against Alnylam has also planning COVID-XX. and COVID-XX call by Akshay including ongoing COVID-XX during are and this me commercial I to morning's discuss with also discuss trials and the our on this disease in this chain co-workers heroic tremendous so to communities, world the work With our mitigate this. the begin clinical Later acknowledging of the the for around implications the Barry our and and our are start had steps will pandemic and team that impact medicines by Let taking on our recognize especially to supply pandemic’s proud framework. fight me virus. we

a pandemic planning As following about you uncertainty will global fluid significant Alnylam very is is the almost our crisis unfold, represents COVID-XX how three situation for know, now that There but on phases. changes the based framework daily. the

which quarter. pandemic of current we believe encompass likely the phase, most the will First, second

of most encompass with see third where And to then measures. on phase, in potentially will hospitals precautionary a resumption return normal and likely quarter will see fourth the starting clinics gradual believe hope businesses toward we including we a the where which phase, and recovery reopening quarter a new Second, we the activities normalcy.

morning. refer us presentation our this three hear to You phases will throughout these

the operations across safety employees. to of serve accepted like of Now is our times adjustments as and the this. patients we for of communities is that also needed RNA prepared our and assured are and benefit the Alnylam making we part our rest Challenge for

that but for despite confidence long-term growth due situation this ONPATTRO have is our all prospects XXXX for decided We prudent to prospects ONPATTRO's beyond we and of the strong guidance lower not of believe and lack because we're Alnylam's light of underlying simply conviction any that current a the in XXXX to uncertainties on Now facing. our by decision in X%. near-term

moderate to will Jeff talk expense well our year and spend lowering in minute. also as guidance our this We are about a just intend and this

in Now as amid, unprecedented Europe year. filings steady to globally completed all we've fire to multi-product patients. impressive health lumasiran our this regulatory showing anticipated advancing commercial very have global we QX cylinders U.S. crisis Alnylam with of are submitted continued continues We're which with to in then bring also strong of. ONPATTRO our first RNAi growth approval very continues performance the and quarter with GIVLAARI on with pipeline company a and proud pleased a this public the demonstrate And all to therapeutics and full U.S. later

lumasiran significant also enrollment across enrollment the expansion the in franchise We made Apollo-B study the TTR Phase progress and opportunity our respectively. HELIOS-B HELIOS-A completing and vutrisiran in of continuing and three of Phase studies vutrisiran three the

our a safe these very treatment Angiotensinogen ALN-AGT therapy the could risk condition. and study much late stage programs potential effective an of for investigational the pipeline needed We're results modifiable one example top excited prevalent for as for disease factor the In ALN-AGT, number highly announcing innovation our from of cardiovascular therapeutic our about advance Phase and early across ongoing to addition, RNAi provide infrequently hypertension. hypertension one achievements in of is stage a morning we're line dose to positive continue this targeting

address to industry COVID-XX entire and We be are part innovation of part the our we're to towards an this pandemic goal. common science help and proud advancing also doing

our week and candidate virus to as of also a that referred targeting activity cross-reactive Our development COVID-XX earlier VIR SARS-CoV-X VIR-XXXX and selection highly to approach with potent includes the with announced an time at ALN-COV end of RNAi from the all genome IND program this also break an records accelerated we announced the and causes around would of initiation plans partners we of This XXXX. together filing for filing year IND. or from

a very in we believe bridge provides one billion. without equity strategic need that Alnylam Alnylam a XXXX originally advancement XXXX. achieving lead With a the towards financing exceeding therapeutics we drivers collaboration more self-sustainable secures capital deal for that confident multiple and in with for a a world. of as than build financial in of medicines announced strengthened patients of largest landmark top we very in to much for global pipeline growth Alnylam ever class innovation. as ago can around XXXX significant year of picture we a track potential bigger robust are sustainable on Alnylam look continues position This ever top-line company with forward achieving future. that on cash our with for the potential growth deep revenue strategic multi-product and to rest the RNAi whole bio along exit we with clinical transformative and markets to worth focused management the finish early to fact to new the organic A pharmaceutical engine as future on with $X to financings with we're significantly up we we commercial the and the Indeed ever me let we're track announced medicines company the biotech tier to expense Blackstone Finally, a our and weeks the profile believe few disciplined access history product beyond. the and goals advancing

our more I'll So the affairs Barry to call in medical Barry? and activities commercial review over to detail. progress turn with that

morning performance is by staying I Thanks and commercial healthy John. Good begin everybody. safe. the first reviewing hope quarter. everybody I'll our in

revenues nearly ONPATTRO we net XX% quarter-on-quarter global growth. product For achieved representing in $XX.X million

continue prescribers. that delighted XXX we're States, over quarter, we new had commercial XX, we March prescribers. In both the of and worldwide. new As with were patients see repeat XX ONPATTRO In to progress treatments the United first on

of prescribers XX% forms neurologists, physician of first As for from quarter submitted in from and XX% start the XX% the specialties. from came U.S. mix cardiologists other these

XX% Overall encouraging by XX% remains very got about is multidisciplinary which we also X suggests physician we're and the to believe to in seeing of neurology, quarter expect that to continue and over we increased XX% treatment In and for States, evolve. teams ONPATTRO cardiology receiving stabilizers treatment recent of the expect we specialties see common Apollo in Fortunately consistent with this data. concomitant with TTR other and pattern United the mix research continue market are include use hATTR patients this sign polyneuropathy handled adherence with we to as we an is strong at first the therapy grow. to Phase patients to amyloidosis the U.S. the increasingly

reported launches. often market the avoid headwinds orphan drug continue any with pair access Regarding other U.S. we to of

VVA continues very Our strategy be well received. to

for ONPATTRO world, will continue France, second-largest revenue with exiting UK very to with again another The In we Sweden, to strength quarter our and in of and observed Spain. rest performance. Germany we're turning recent it strong patients Now the plan of the ONPATTRO Israel footprint after country U.S. continue the be delivered Italy, on CEMEA growth and we our and the in first very therapy anticipate quarter Turkey the the and launches to XXXX. region expand pleased in

United now to Act, diagnosis with genetic States and remains also the Alnylam Canada recently amyloidosis team awareness addressing screening of challenge of in and committed hATTR the Our Brazil. disease improving raising initiative in and party our including third

been As pathogenic which tested almost have out mutations. have of submitted, XX,XXX X,XXX of TTR for positive April samples over

to set beyond we as and the expect we in across and begins but diagnostics tests sample into normal. testing therapeutic new pandemic QX numbers areas, -- seen recovery as to the return near numbers phase note, we we've expect As some phase slowdown pandemic in, in

a getting on hepatic therapy one U.S. that patients a States with first our to weeks progressing the the on to our we're to We're approach that GIVLAARI in signed forms access XX form. revenues, VBA after within we've strong achieve We're VBA the the or our approach in porphyria outside report based million physician United has submitted Alnylam of $X.X we product interested one are Moving quarter appreciate environment through from point of XX patients To providers net also patients. received not our any are payer GIVLAARI, an discussions XX. start performance their initiate experiences form seeing AHP, launch. sign looking ONPATTRO and pleased patients the we States for of to to major commercial successful the in strong in start over GIVLAARI date March similar payers see start the multiple two the full already VBA We in drug establishing with experience over did that strong pleased acute is headwinds launch United well. to again treatment and here had

Another are policies that number adopting that approved patient generally consistent of to is GIVLAARI restrictions with label payers medical the a highlight without access attacks. of are baseline

Again this geographies announce are initial the we commercial and the to United underway QX we Through rate year of patients on a mutations samples patient and in the Germany submitted in XX% expect European our physician our GIVLAARI in April approval AHP pleased in named we in with positive up the hit can States, as focused diagnosis in report to about region. Alnylam, awareness team elsewhere occurring improving launch and XX Now patient open XXX quarter of communities. first tests in the AHP representing and is tested. outside with and key sales

color our more phase commercial with COVID-XX. activities chain finish around of me in the and supply Let

As we phase through in to periods a and QX. XXXX starting most of new with QX normal be QX, in John comprised pandemic mentioned expect recovery

ONPATTRO as intact we for from lumasiran products, and drug as well launch. sufficient inventory remains chain supply Our products, drug raw of to confident GIVLAARI prepare that and begin as commercial we substance have we're materials and

to We have any chain potential reduce in place measures if supply needed. mitigation exposure comprehensive

tools, operations were Our I conduct in-person Alnylam some still field to of meetings have has The are exception patients. where note global interactions for to able that payers we local time and subject virtual developing HCPs well for virtual digital to virtual with restrictions. Japan prepared interactions. largely our to shifted been field employees and want so

very these are recovery virtual of We actually of tools in the the expect HCP of new interactions some field believe they cases, phase will to and face while phase and to these are many pandemic effectiveness force the part interactions normal. think preferable be and efficiency of face can we interactions virtual positive for improve and going continue the forward. through engagements We new each live changes

setting injections patients teams have determined care successful been during important sites physicians GIVLAARI also their period. their of home appropriate ONPATTRO including as this or Our helping infusions pandemic particularly with at was receive

administration. in U.S., have available Medicare value part most home For based options patients home ONPATTRO by of broadly infusion become payers for in has to recognition coverage for change thanks in regulators. rule by physicians, and In countries recent created CMS the the

of towards will proportion globally. XXXX a a for pandemic shift care infusion the treatments in for centers home as in at in We into QX response and see home the received to home QX across shift Looking continue care particularly seen XXXX QX academic local United local we centers, significant and believe we've to patient centers States beyond. expands

likely be to and believe care. during decrease the delays including pandemic sites or moving doses some part new skip in in For to ONPATTRO adherence home care will patients we QX by phase caused dose

with the recovery care We regain option if to decides will them. an administration as through continue site for of hospitals in-home treatment to and returning that's optimization patients for comfort continue clinics phase with or

we slow some ensuing by and also new genetic diagnosis of we anticipate during the patients systems. expect improvement even health decreasing through Thus QX the Finally, the half year testing therapy and return in systems care about and versus growth patient impact a flow will second potentially new negative QX, into reduce that normal. revenues we in can ONPATTRO the with pace in healthcare then XX% recovery and as expect and of QX

Let and We're remain we planning me represents growth is highly midpoint long two-tier our confident industry-leading ONPATTRO expected build guidance trajectory franchise. to revenue the all our and highlight than game in year-on-year greater goal here of continue regions. to growth our XX% in an here

AHP turn debilitating who patients GIVLAARI let . urgent often hospitalization. Now care porphyria to or attacks me require experience

care continuity sites. So important treatment impact hospital patient particularly on COVID-XX of given are ____ the and starts GIVLAARI of urgent and

patients visits phase AHP simply very bright to business or pandemic starts the GIVLAARI to Given patient to summary marketing numerous during recovery reiterate relative right mitigate that ATTR the pandemic adherence long-term and expect about steps we during attacks impact prospects care urgent are beyond new which our waiting a a for and phase the reduction not and of and In what's other the we're on in We're GIVLAARI on hospitalizations and franchise continue less to very confident do for to envision like taking requiring impact growth phase. broader also an our for the results products the pandemic we pass I'll . are ONPATTRO. see

we're be for the heard we'll many changing you from up us it. As for times ever stronger environment and

Akshay? As John accepted. said through recent I'll to your challenge now pipeline turn Akshay that over With and progress. R&D

our where diligently with working in good our ATTR patisiran Barry, and two and I'll morning, candidates, product everyone. start vutrisiran. Thanks, are efforts amyloidosis, we to advance

expanding of currently in world APOLLO-B markets is are the the product's polyneuropathy multiple hATTR study. we end, approved Phase in and label amyloidosis, to treatment ATTR treat patients. conducting ONPATTRO this with While around both associated we're the cardiomyopathy To wild-type inherited committed for III the to amyloidosis

expect APOLLO-B, enroll year. to injection to which due ATTR We're is patients in COVID-XX today up we'll delivered assured, that also time of to this a we to QX While in very the subcutaneous continue in QX make rest impact lost and we enrollment advancing XXXX. pandemic, hard have shift new we any for development also of the is of quarterly phases we But into completion work by as amyloidosis. normal recovery enter and and vutrisiran, announced

two conducting Phase are we III studies. Here,

The first line next is hATTR with is to now is on we in year. HELIOS-A, report in vutrisiran track which polyneuropathy. early top and amyloidosis evaluating HELIOS-A, patients complete results remain Enrollment

We OxalEurope in investigational June postponed in therapeutic This phase as we initiated now last where results been to I'll that well inherited again. mild primary developing adult positive to in lumasiran, study treatment for now in We the impairment, with patients turn December. hyperoxaluria expect development has study, wild-type early ILLUMINATE and or results cardiomyopathy. the just relatively in as vutrisiran with full been still renal Second the is is is of with ILLUMINATE-A, ongoing in the progress study delays in line reported Type pandemic of Enrollment PHX, the December top stages, ATTR X, we the plan during pivotal has Phase ILLUMINATE-A are which some present to program. conducted having enrollment includes from RNAi our moderate patients of once do in study an in HELIOS-B, adolescent III amyloidosis Meeting year. recent which QX here

III to program ILLUMINATE-B results line Enrollment is in of complete, our less our our all and virtually, age. also We and MAA ILLUMINATE-C groups. Phase patients submitted top six for pediatric report enrollment recently disease in of study completed submitted in lumasiran. PHX age remain was results. our submission top we teams our study proud This NDA months years across after our with four patients working includes lumasiran in able the to Our were our rolling on continuing NDA that under advanced mid-XXXX. We're and the in do staff I'm first line MAA than track and with this

decision regulatory the on XXXX. by lumasiran a approval expect We end of

know, we you partners. expect and development with where approval in NDA been for inclisiran includes As and has initial EU, U.S. hypercholesterolemia, late-stage is we partnered both registration the that in which Novartis, development in are programs filing have two It late and additional in now with XXXX. MAA accepted, where in

We hemophilia disclosed Sanofi. without inhibitors, Phase the with development completed has ATLAS A enrollment. also or III partnered now trials fitusiran that with two included in have recently B of Sanofi for or

the expect line can the has we from So of in Sanofi top first ATLAS XXXX as results III Phase half trials guided.

have initial and stroke, clinical of drugs blood or million essential over three In for and study. release the United patients top hypertension was a includes late-stage at Hypertension These press affects programs. alone. cardiovascular offer our benefit we need line angiotensinogen, positive failure progress also believe making the an substantially and people significant ALN-AGT hypertension, to States number we morning, factor results disease, tissue announced damage. more is AGT. are with resistant the blood patients dose ALN-AGT one been of heart by for achieved antihypertensive single an to for mid-stage the failure, in this risk administered is XX as other believe hypertension, estimated Phase our controlled modifiable ALN-AGT XX with we control. XX% renal I potential risk high patients and in ALN-AGT in in addition the This not improved addressing adequately has development we that from ongoing great pressure to knockdown programs, In subcutaneous our early or pressure

second was reduction systolic blood of over durability an BK of safety The we at Phase and half with study to effects that achieved of The XX-hour supportive We ALN-AGT In the Phase these initial line expect pressure mercury about to knockdown of year. and I ALN-AGT addition, appears next AGT studies excited perhaps Similar associated medical II XX adverse serious be of support top the to the results plan profile ALN-AGT also regimen. development very blood In biannual meantime, we're at further a no the that in of is in tolerability these we to XXXX. once-quarterly encouraging, our the mean start in of millimeters pressure presenting with relative placebo. meeting drug-related data dose event. and results initial on of inclisiran.

toward be we've the To with picomolar block our up to coronavirus virus high conserve targeting are this ECXX. knowledge, candidate, is now for reported for in virus, shows RNAi to or including Turning potentially viral and highly cross-reactivity SARS-CoV-X. outbreak. future isolates, replication antiviral were a with with therapeutics that pandemic for to Oral-based assays, COVID-XX long to the at cross-reactive we SARS maintained direct ALN-COV region XXXX our order a toward most likely the our selected activity collaboration to potent VIR-XXXX SARS-CoV-X that the highly X,XXX is viral ALN-COV three shown over by current development and effort potent Vir, date, partners

expect other We plan an XXXX. the this and is soon year-end plan administration regulators, we COVID-XX. discuss inhalation Our file advance of around treatment to ALN-COV to at or IND program FDA prevention and/or of with and to

the I'd Finally, clinical operations to we potential of are addressing taking to steps wrap our like impacts activities the up and on by it. mitigate COVID-XX

here is priority vigorous life-transforming way top trials safety while potentially therapies. continuing to our investigational the conduct in are patients' the a life-saving since ensuring or course, Of of trials advancement these supporting

deviations, to plans see and protocols possibility partners little analyses missing We're possible. our interruption of etc. data, continue continue pragmatic missing studies regulatory guidance and ensure we include to CRO as All to statistical for work to with pleased acknowledging as and data account with agencies and data protocol minimize sites issued measures missing for

of of will study the our such, steps remote around all COVID-XX studies patients As of parameters, by keep at and taking also We're windows, the home our this patient we collection we're our in expanding which virus exposure to done documentation. home by minimize on incorporate these labs into adverse being visited capturing impact locally care visit efforts and on We've study. collecting to events. or doing

the our see phase, During degree, lesser of doses we pandemic on to patient missed new impact or in a some expect delayed to continue studies. to enrollment and,

any with our up As to for recovery these Jeff new and be we pandemic we'll the make can there and have impacts turn we've some financial in disruptions on everything shortly. during activities And programs, time we as are line the steps over results. summary, minimize phases. managed our review shifts successfully it implemented normal time In clinical that, mitigation phase, effectively said, impacts Jeff? and enter while to development to in to me now lost we we any many our do expect to minimize let

morning, Akshay, QX be Thanks, and presenting good results. pleased to XXXX I'm everyone. Alnylam's

for and already ONPATTRO for As comments results our ONPATTRO P&L full strong our summary outstanding quarter the XXXX. highlighted, commercial GIVLAARI. quarter of and sales comments will for today. Barry GIVLAARI, guidance QX and my topics focus both I product on a of very has three for it results results execution on with was

and Inventory during for modest U.S. growth. quarter ONPATTRO, fourth to impacted the and steady another XX% with where growth XXX% was the XXXX. XXXX in our in quarter generated distribution channel we $XX.X the for highlighted destocking weeks lower stocking XXXX the by net compared that negatively between first to on year-end XXXX XXXX. continued level revenue during benefited our quarter from in QX. the the growth of call. the QX global we following growth a in of of with quarter, QX two QX U.S. had deductions compared end Turning gross at earnings the increase growth net results and of modest QX X.X We million is in in in quarter representing U.S.

the in net We continue gross very expect strong to deductions XXXX. global in a the mid-XXs many during in as as benefit ONPATTRO of think of quarter driven percentage and will as strong was to across reflects Growth having remain well international was growing global Japan. the gross broadly markets markets for a sales Europe our in in clearly strength brand. this and We

product markets It We generating international and quarter worth remarks. anticipate the of for Barry's our full that covered COVID-XX second launch $X.X results a million the prior results GIVLAARI. on in in as our had the we from Germany. late impact U.S. of for first revenue QX in the contribution sales, We launch our noting to a a QX is seeing was in in strong ONPATTRO Turning in GIVLAARI net a sales quarter with minimal. pandemic following XXXX believe

from the from our primarily of inventory revenue quarter. collaborations was last a from current from P&L from of summary cost $XX.X results for utilization QX ONPATTRO the X our the now increase to Turning the margin for was Net revenue significant full million, ONPATTRO recognized a due to year for primarily due XX% quarter to cost XX% quarter, while down last in inventory. Gross collaboration. year Regeneron XXXX benefited full

investment Key prior and expenses the programs increased and versus Our advancing quarter the of to combined increased late-stage R&D pipeline our support SG&A non-GAAP launches for and investment increased were drivers GIVLAARI. in the XX% year. SG&A in ongoing ONPATTRO

XX% Our in quarter operating for increased same loss by period net versus the XXXX. the non-GAAP

However, and line peak expect half net year the in We billion. ended operating strong growth XXXX. year we operating that top the we as of XXXX non-GAAP the and of approximately the with balance moderate confident quarter expense loss growth remain second $X.X cash more for of represents investments our

in we early We an QX Blackstone the increase in million April cash balance close cash following expect of collaboration. strategic in in to as see $XXX our received financing the

our to demonstrate results guidance. quarter We teams challenging and for circumstances. first turning our commercial believe strength the financial the of Now our

Barry expect as However, from impact COVID-XX an we do the noted earlier, pandemic.

versus lower are XXXX $X.XXX our and spend our to XX% $XXX our combined implementing $XXX ONPATTRO million. our million discipline decided a have guidance still to $X.XXX billion we midpoint from more X% revenue $XXX to This guidance the we decrease million range million to than $XXX to but the So planned to represents of to at range to operations in moderate In R&D $X.XXX growth lowering expenses guidance XXXX. parallel, $X SG&A further for from billion. are non-GAAP and billion billion represents

from $XXX to million revenue at collaborations guidance net unchanged for $XXX million. Our remains

goals strategic bridge for to financial billion call Alnylam's year. now with Yvonne? without to Blackstone of toward Yvonne for that, $X a with financing our equity future self-sustainable financings. over the need believe I'll we profile secures cash, remainder collaboration the our the turn the Regarding And review

hello, everyone. Jeff, Thanks, and

COVID-XX the build promises it an to efforts challenges be pandemic, and While exciting year important top-tier to XXXX Alnylam's in company. biopharma related to presents a

well plan Europe, we EMA continue starters, recent in to of ONPATTRO our commercialization global For our global as of approval. following as GIVLAARI, the launch including

also With in we'll with III presenting milestones And exciting Phase course, of line from look we Notably, top our efforts, our the namely APOLLO-B study, with as for filings of year study. to and occur. to late-stage very, these well rest III expecting very cardiomyopathy specifically programs year end in as to plan ILLUMINATE-B We enrollment COVID-XX they results XXXX, the ALN-HSD highlight we'll from the and additional aim lumasiran and importantly, We're IND of in on forward Phase vutrisiran. approvals the NASH the two advancing ILLUMINATE-A executing ALN-COV and continue the We preclinical regulatory by six from distinct for HELIOS-B our throughout new for as patisiran inclisiran. are engine. four we trials. deliver clinical nine product two pipeline results continue also lumasiran, ATTR study also and

Let coordinate back it me session. Christine? Christine Q&A turn to to our now

now to dialed queue have Thank yourself like Yvonne. for open ask additional to will limit back questions we those the you, Operator if you in get to in call we each for question you questions. then and would a one

question We Instructions] from our with first Gena Barclays. take will Wang [Operator

Hi, Gena for Congratulations Kim update. Wang. This on the is Peter

And I patients new coming is guidance, do much gave think of also, out. existing was guess, expect any sense but continue phases color, For seeing versus you from, in new patients I you a of different skipping was among you're had lot still may this your patterns I existing revised I like that I patients? wondering that wondering ONPATTRO of how you know you of on some how kind various And you mentioned laid if that patients. dose

those are Peter, great Yes, questions.

me I'm QX start just just we back Barry then to going over see recovery framework to hand planning of by and part our toward Let QX me saying in starting again second, is normalcy. QX expect what in let as in it a and to but impact

very context in franchise, efforts TCR effect to short-lived. which, view obviously, put So all the course growing course, of view of impact be significant we that do we we in have of and a have as And advancing broader our of the to be the this this opportunity. short-lived

good? want do Barry, questions, particular you So talk which I thought to Peter's were to quite specifically

is that country the differently. handling give to you just handles Yes. each And pandemic me Peter, color. phase some let very say

a country patients an the believe impact The is that by we bit that different. QX made So have a moved world. little is reason is you it and will the of academic that When requires but as every their were this or the across activate center, local in patient pandemic a healthcare from were care patients center that to us changes absorbed site-of-care color, healthcare know, broad that And providers change. many to help fighting infusion provider the home itself.

those four weeks, countries in could five generally weeks we've we We're instead launched a it or changes might to through see, So U.S., of have of change. three France. Germany, for where patient taken all

stay did many will patients coming. that much more see don't and Patients to centers going And open I move I where to So they're centers. those change be. to note continue are academic

about a more use, the because that the in to XX% percent the had that from a move in to we home centers move. just April. helps up home QX, in flavor, we about I asking continue are more give late And see States, moving to toward Hope see in you perspective. color make home even United continue little infusion. think that And United we'll academic moved we States bit I some patients infusion, to X% to a move patients as

Stanley. Morgan next We'll to David question move on from Lebowitz with our

guess, over for patients Thank programs? GIVLAARI, transitioned question. found you patients the With have were on drug, genetic from that trials prior my are for taking these that respect new are, now that EAP these to were on very or I mostly patients other are in much Or are efforts?

and Germany that great initiated Europe. has GIVLAARI Yes. David. in we very happy of U.S., the sales forward in quarter launch and the now that our we're That's a full named question, in performance to Obviously, also looking we're with have patient first

So the had that time was the The because in stage. the patients QX EAP we in patients small, all these achieved are largely U.S. by of we take studies your very, straight patients GIVLAARI of about launched is outside approval clinical in the of of clinical that before the were studies. low studies can digits, very excited answer question clinical that outside well. schedule. ahead still we're open-label the are And single us the EAP fact of we outside The to our and in our where as program with largely

So these all patients. are brand-new

Thank that. you for

you. Thank Yes.

next Bank of Tazeen from We'll Ahmad from America. take question your

your or give some morning, the for competitive that what on the of for Can us And taking program? of data the you hypertension. quick my you steps context how early Maybe Good landscape are define can roughly reduction next one question. for just mercury thanks a XX-millimeter means?

decades. obviously ALN-AGT Yes. Akshay, for about that's answer lacking question for want you crying very an Great, Tazeen. is innovation excited to This potential the hypertension. the for do specifically? We're that been in is area

we to result to very is of this With of stage a than drugs XX-millimeter at first drop Sure. that impressive development. the described, respect the one, greater relative the frankly, most

but the or think, seems degree terms from looks which beyond. effect. also the about not this described, it's of excited the I is impact very the we've every change change months and And are could that. durability the to that just pressure we infrequent contribution, So in blood But administration, repeating quarterly or increasingly in us of profile pattern be be like whole six vutrisiran to it of

other of that's then would tonic antihypertensive And course, And finally, off XX% treatment. important meds we not the control pressure. issues that. their and patients to that, current with do angiotensinogen, starting that of given come control of So give clearly very blood within plant get medications exciting. That's of years of months

the again, And not patients risk. effects and as you get again tend changes the You as and pharmacology off, and pathological the take of desirable tablet is take to seesawing and then range that wears your back then tablet improves. then your blood pressure cyclical puts you to at it kind tablets

other that, So it's that the factors in there about. mercury millimeters very impressive. certainly pleased beyond is are also But we're

obviously, busy of sure And both also for where regulators planning we're in that are ahead. but do drug, the making engaged we In with terms supportive path the Phase of that II. are way the heavily next in development regulators of we a important steps,

of lot moving for So we see good potential forward. this drug a

Yes. regime. Thanks very very Akshay. the about We're Yes. excited

you. Thank

Next Stifel. from with question comes Matteis Paul

just safety? history hyperkalemia concerns I can some AGT, studies, ARB has much. ARBs? so think you a a these a ACE a or blood not bit with guess, Blockade, combination things and more us like Thanks benefit little Ras a Great. benefit, aliskiren don't necessarily questions that. Ras Dual and Dual about And ACE couple mind. of on historically There's I And Again, Were Blockade but in if patients you on inhibitors been also like of with second, pressure outcome. then drugs showing tell

So on going translate POC on you impact the, comment data ultimately you an think this can is to early maybe mortality? to hopefully, why biologically

Akshay, Paul. questions, them. Great you Yes. get

Yes.

antihypertensive their but off to have come to were they stable patients respect the on study. safety, a regimen, Paul, with So drug to in be

respect At there with encouraged very, hypertension. adverse to had as So some as the issues of the the This profile, safety formal interesting are We patients And overall, in background AGT top. a have mentioned therapy essential renal it's about, far. was I also the use part ALN- such during very the respect alone there be antihypertensive encouraging. that hypothesis of but people presentation, no serious With was clean data we ALN-AGT some overall combination events. with with saw in test wondered no path to particularly forward, safety certainly by very function. past, continue so Dual safety are Blockade there effects, to with the has Ras on

combinations reason drugs. we focused excited One in the the of drug those pharmacodynamic one of is the very the local are previous on ACE are been may have inhibitors ARBs effects and liver. of our about that effect why things kidney And nephrotoxic the of of is

And so of with of liver system, the kidney acting will effects angiotensin because the ALN-AGT spare alone, targeting directly GalNAc on any there.

profiling we And safety combination. they'll as an are as so well have antihypertensive profile impressive hopeful impressive an that

all these going to moving forward. evaluate we're course, Of

much. so Great. Thanks

Paul. Thanks

question from with comes Next Jefferies. Maury Raycroft

is [indiscernible] successful on for Hi, on good very morning. a Maury. Congratulations This quarter.

of on questions couple early a stage. Just

and a drug applicability have active about say then genomes. the you So I for talk virus? of follow-on. X,XXX the different where forms And in the Can mutated a this now XX.X% bit you in little XXXX program, of

do Akshay, to handle you our that great. want with Yes, COVID program?

Sure.

viral course, been with COVID program, over virus against and we very that sites available highly the studying XXXX sequences. have come target very, that now it of a those the and SARS-CoV-X, to our match this all X,XXX we've in suggests we've site are highly the discovery as cross-reactivity those to So target We're appears as with the genomes confident be the prone XX.XX% of sequences mutation, constrained. phase sequences genomes reflected and constrained, online as site in early the not number. Equally, the SARS to from have almost also in the previous tracked

it's anticipate to So this likely that be we hence during drug will this my crisis, be and current and comment to crisis mutation highly likely prone readily. future applicable not

work one just like and any ongoing of HBV from HBV the that was on that follow-up follow-up Thanks with just one was And there the presented, combination data a recently on Okay. Vir? recently strategies perspective is Okay. like data

as has II Yes. the Vir be Vir agents interferon, that next guided, which But with then initial in HBV focus. No, the agents is proprietary with is program absolutely, explored are in as studies the will combination additional further mean, including pipeline. Phase step the I well,

the Vir HBV to the that it. at XXXX the represents obviously, for recently II a to we're it of opt-in Phase with we end Alnylam right Phase III. they So And quite for opportunity XX-XX prior presented excited the as have molecule call significant because about data just

for with us and gives until up free a how it a mature the what company. very future then to to the could be be come So attractive see way able for data of asset to the in

you questions. Thank taking Okay. very much. the Thanks for

Thank Yes. you.

Next from Cantor. with question comes [indiscernible]

ONPATTRO my pretty rest of on basis. growth strong question The dollar-denominated Hey world. a My guys, question. trends is for and taking certainly look on Thanks

talk U.S. that? and potential could I it's now, you do of you guess kind if And that's bit the or about wonder driving mix U.K. a evenly the the of think specific guidance markets what you between in I slowing balanced of So are little when whether more about kind ex-U.S? the think your

yes, it really great world. Yes, of and ONPATTRO, Alethia. with with real just performance to a the do And we've you that's team's pleased of is a those rest commercial the we're testament in our question, parts world specifics Barry, execution for that want seen answer Alethia? the to

Yes. John agree And Yes. I Thanks. completely. with

on to there's patients which remind via requires drug different There's we've that previously patient I'll patients there's from, three TTR free you patients hereditary they sites get obviously, to program, diagnosed. pure about or new and through known system, then finding, healthcare to EAP communicated come amyloidosis streams. groups the flow and we Alethia, think where come patients they really So that when from

XX% patients failure to TTR. Somewhere due with and heart patients between are of XX% fracture, injection preserved

to So up patients appropriately be have to those diagnosed. show

be benefit of the line. in buckets. through since States, launch free systems a patients In So from with get commercial we Those where patients others States, Those they ONPATTRO. dependent worked also course, we example. so in the goods, EAP that United patients patients think lot experience patients experience saw or from that and from for or France, coming has first goods that from patients healthcare the buckets. largely the France de the are on then move stabilizer. two appropriately be novo about those site Really also three through for lot Italy then, given be front We a to ONPATTRO Japan the market flowing when in can the switched U.K., United is in a can coming and patients was is progressing it of the And of naive that U.S., patients outside of and with all new have are on others to opposite first has diagnosed. where patients known patients. we've stabilizers is found XXXX, patients can market

we across online growth good as feel as is about getting up So all the four regions Brazil well.

a Hope on prescribed them States, Thanks that of the all those find to is dynamic all streams of world parts So three see are you that stabilizer, United can benefiting add helps. the the whereas Barry. patients, in from new still put patients. of previously ONPATTRO, other

Anupam Next from Morgan. is question with JP Rama

at Hey, for COVID-XX you all so color the hope for are well. the I Thanks through everyone taking much the how doing guys company question. Thanks pandemic, thinking about on managing is guys. the and

Just ILLUMINATE-A sort line analyses should be a top for know? of beyond question we expecting potential at us that new from what already data full the the on quick ERA-EDTA, we

your Thanks, at comment for you appreciate beginning. Yes. I that. line? Anupam. want words to kind top And the on ILLUMINATE-A do the really thanks Akshay,

I think oxalate the set, in be primary these in study, change parameters safety, near mean normal And urinary as plasma the to of obviously or important well. the the proportions will endpoint, of XX-hour very full around patients and normal, coming Yes. course, I present parameters are important. for say, data we'll

be top last did we givosiran we as data. just comprehensive data to going presentation, had initial with it's the So data line where year a

Yes. of And data have it always we way do. completely obviously, we will Anupam, lot I a very we and can a in that, would that that transparent just add share to share we as

and canceled that. to and forward It's the it with that done March Meeting, OxalEurope would looking we're doing to got in shifted have once then So have hoped twice. but

been have to organizers and kind we're do. that's ERA-EDTA the to going to enough what present us allow there, So

Thanks taking the for Great. questions.

Thank you.

Next with question Vincent Bernstein. from comes Chen

from of taking progress. who coming on what are are delays were EAP got known for both on the guess on I pool portion COVID? to to are the just of I in the process to the question. from to decisions one the question thanks progress of patients already the do to on the patients OUS the on some the EAP? you And world then to launched, related or EAP outlined? patients One Congratulations transitioning the how how guidance, timing any guess rest and geographies the are the much you the through of patients of known major And who and of ONPATTRO. reimbursement of more, In you drug patients far you've just then geographies the anticipate sites? to have known to in Congratulations more the who previously sites revisit commercial where sites to

two So are great those questions.

I'm think them. answer going I have to Barry

on comment the for a as you looking in to you're share. going level Barry, not you're precision color of might on provide some want And I think on going can one, certainly payer to first question countries, Barry, the well. that think we're But I you that. maybe other that,

absolutely. Yes, great John. Thanks, And question.

it's I United United as the States That's in. the the States, stage that is patient mentioned, pure So new finding. in

program. very As quickly EAP European a an free program to from countries on patients in move have rules Europe, charge or of we that paid launched most the

So in patients. we three streams are across Europe. And work getting most countries buckets, that all patients of happens all quickly three from

polyneuropathy highlight, frame experience with saw know, side. with patients in cardiomyopathy Now and I but stabilizers Europe you will has and as significant progress the stabilizers the in also

profile. polyneuropathy, a reversing drug in of like has desire the an a to highly stopping progression, cases, many to attractive ONPATTRO So move like that on things disease opportunity has patient

have known coming patients coming Europe, Japan, in site where patients In found all we EAP, an streams. those of from from not did to patients. are and So three patients newly are

but switched new the are Again, finding coming. are those of we're being found there regions both patients of and of being from on getting stabilizers, off Japan patients So those patients in benefiting them endemic ONPATTRO. and are many

payer, any delays that call patients United a there's the the And guidance systems Europe, of healthcare rescheduling seen haven't into significant to we're the In leads delays is week have for the P&R to to in States, no been those VBA. we for really and or change our centers. discussions there GIVLAARI terms ONPATTRO, to of the really academic but and inability of In in across slight, providing. delays. get any countries change it, been The nothing impact significant two

reflected guidance. that's the new So in

you. Barry. Right Thank

you. Thank

We take Ritu question will Cowen. Baral our next from with

you all hear thank question. – Can taking well Good morning everyone. to and Great the you for

We can you well. as hear

Good morning, everyone.

be fill think orphan let's most to around goal my time as So we and flexibility recouped quick collection launches first of you to set? data on those go are HELIOS-A weeks? might studies, the that GIVLAARI should like how the and Since data, to explain telemedicine as powering? that we then Because I those study. the mean of APOLLO-B far more thinking the mature be any about six about follow-up the what impact as lost data anything Or is, months one this two And can that's can out. integrity of

it's And early? it forward? stretch just it is fast, is could so why how out? it so So Or back going

can prepare your Well, with being to and to GIVLAARI. more able your to rapidly then first have much gotten better answer better let me from question. the and question, experience teams this ONPATTRO our quickly second Basically, answer Akshay do

it around think built have system. the I we that confidence reimbursement also reflects the within

see to it within couple reason very operating patients start treatment as happy using no on as of get why and patient stretch in really hub out come our just that. We a effectively much to really at We're forms we're those with this point. So soon should weeks.

see that about happy So changing. that. very Don't

you trials, do was Akshay, on So to thought question clinical want I the handle good? the which very

Yes. Sure.

overall strategy structure. and any changes endpoint in the terms the of of structure, endpoint the endpoint we see anticipated the primary in So don't

to think end say year. patients widening earlier is the way with to in certain that integrity mentioned maintaining of feel year. the at windows, enrollment been this to we slowdown administration, been main patient that I assessment on respect allowing APOLLO-B, secure very drugs we've More and issues adverse details vis-a-vis overall the the I successfully as home which of of study able would the both some done and continuity, issue today events we've collection So sites, in that from there enrollments completion the next we out on case do getting come there's of and And labs. that of and we've shifted both remote

along around all mentioning these some And regulators are visit guidance by of in by that way, So supported various showing with things the documents. flexibility windows. the I'm

for We've documented all comfortable feel very And rationale so we as the that. there. it carefully

for think, study integrity, integrity And overall slowdown looking so we I yes, but and certainly, are some enrollment in endpoint good. APOLLO-B,

questions. for the Sounds good. Thank you

Sachs. Goldman with Richter Salveen from comes question Next

here. few my A taking question. for Thanks

how then trends you're some prescribed given the in increased some around prescriber competitors And So the in with the and diagnostics. ONPATTRO declines VYNDAQEL? cardiologists given phenotype Q-over-Q mix numbers is the evidence talk being if noted contribution secondly, new can mixed of any of some Pfizer's now use seeing, just with and combination you some right and to just

questions. Yes. Those are great

prescribed being ONPATTRO given the given is for being for present that combination the ONPATTRO Where cardiomyopathy. Let by being course, me start it's and just we used polyneuropathy polyneuropathy the that's the patients. or treating use, that, in saying we appropriately believe see because stabilizers is of to treat

should we rest what be But to your the is maybe saying. Barry, the that answer you So appear question. of question,

Yes. Absolutely.

John the in is the insurance pay. news just we dynamic, we're amyloid see of have sense urgency in to the rest amyloidosis. good working it's So prescribe dynamic. is ability with this we renewed of The and both that up. as the on cardiologists both see ONPATTRO completely. depending John seeing In world and of I and popping with stabilizers, polyneuropathy this to it, U.S., multi-disciplined what agree the these centers neurologists tap described neurologists a dynamic not What hATTR for U.S. very And teams

States and of So They patient added with we're a the the nature ONPATTRO. maybe seeing center. understand the stabilizer in mixed a United a adding phenotype to seeing new ONPATTRO are care that's disease

stabilizer for polyneuropathy of we parts off other hATTR for For seeing the mostly world, are of the of treatment the patients switched amyloidosis.

you. Thank

thank Yes. you.

Ted from question Piper with Next comes Sandler. Tenthoff

my quarter. taking Congrats quickly. question. really Thanks if on real may, I a good for Two questions,

hard Firstly, all doing Vir you to I COVID-XX. work appreciate and SARS-CoV-X combat are the guys with

partnership efforts antiviral program, the expansive. this what is which you toward addition are In doing is little to other I bit more the with advancing a Vir? clinic, think

If Jeff. could And explain real for that. then one you one quick

I think that's believe down you mentioned any you debt yet? that Did you've $XXX from Blackrock. I million million $XXX taken upfront. take down

Great Ted. Yes. question,

Let just answer one it me quickly give and your then Jeff. to over first

now which still it which activates targeting, the we're In despite TMPRSSX, and targeting ACEX. IND an well ALN-COV also other receptor protease a the doing, for SARS-CoV-X this year, and is aiming by is we're as is the that preclinical, SARS-CoV-X addition the which for are for targeting cleaves known work protein to binding as ACEX, of the genome and we that's to end the directly, program coronaviruses is

back, that what the them take effect And does do the programs appropriately. target a you developing. development. factor, we'll in the explore it, we're data these strategy do are explore on-target have further going about obviously, on are we Those think host going to if When and But host addition think have we're safety that we obviously factor to preclinically. things these mean. So supports of them antiviral that you important into to the direct to

Jeff, the debt? you to on answer So do question Blackstone want the

$XXX come and in million close on $XXX royalty in The that's to the equity million Sure. at first for million $XXX date installment Yes. the monetization. was

expect the to take of million down. year. the down first not taken would have any We debt end $XXX We this at

QX $XXX just reminder, be Thanks, been but It's has not in will million as is not numbers. received, in been the a John. QX. And the first it

Thanks. Awesome.

Okay.

from Next question Leerink. with Foroohar Mani comes SVB

that earlier terms terms does up versus GalNAc comparator something give mean question. taking the of ALN-AGT like, ALN-AGT. oral little not the on that want for line, should trial you Hi population? for trial on in to your is. design, terms think clinical the interplay a the losartan? in challenges a an of of for are on and platform us of a thanks target what hit algorithm existing follow my and about will what after means of the And arm historical a potential safety does clinical commercial sense where bit clinical in like guys, ALN-AGT with therapy targeted orals some approved doublet question perspective, example, from Can your with commercial single versus that fall you first therapies with obviously how I Paul orals, in of how opportunity way ALN-AGT strategy design that own around

Mani. Yes. Well, that's question, a great

been our want development we have yesterday because participate in review an meeting evolving to in it pursue. angle should still to which discussion, You the is strategic as question to

with data I that the exciting, data-driven Phase but really Of that's data will also be with that II our looking Phase very course, obviously much all emerges.

but opportunities. we the it to some of say would range soon probably too be where provide certainly sort can context of go, So exactly we on will

And Barry, maybe perspective then I'll it turn to first, comment, you'll maybe have to over, as to Akshay some so and well share.

Akshay? So

Yes.

With the really for have wide opportunity drug. we think a preliminary to data this we that hand, there's very

we double-digit at get in developed proper of in ALN-AGT is there, to We're have growing. approach the therapy in probably apex And consistently number And be hypertension. some that need just even around of hypertension would segment, be background if millions in in of the which with start alone. to would the the patients. context that of the those it world, I So think of hundreds control millions sense, think U.S. number resistant is, about the if we unmet people looking

one that, you who over at other that but that's provide return But like XX% form an consistent we than or know, months control moderate hypertension as benefit, So like inclisiran or payers. require you every and even fall something number would once and a infrequent healthcare patients, reasons. or and And on more a severe there, patients extreme. segment. therapy of six them for off one built for administration end, both mild resistance an At or the the have even with larger monotherapy, systems clinical

or then are on effect know also that providing ultimately, there's via opportunity So another benefit, blockers agents involved pathway And remodeling. from Ras not issues in like just Ras there. cardiac direct we the the hypertension, but cardiac

there heart cardiac in think so run associated as and the and there's. hypertension with that yet And are remodeling well, opportunities other about long to failure

plant of So there's would set in administered and control possibilities all enormous key here, infrequently pathogenic face of drug consistent parameters of be just pressure. in tonic give an that the very the could a blood

sort lot and can landscape. So do, the we'll you peers painting and forces that's obviously, just share more a things before. our There's of

Barry, we've before, just that preclinically of knockdown you cardiac with Yes. to in function wanted Mani, And some very effects shown you, remind AGT on impressive comment, models. animal

any any So to commercial the on want side? very do see. Barry, commentary encouraging that's add to you

Yes.

this for drug thing then Akshay we've it's with administered to I numbers we've argue But the approach safe III. opportunities we for. the And develop drug incredibly we an Phase world. with into that something course, and least value-based pressure and to clamps to to we that efficacious get I'm And shown blood would II of you a at first and so and launches. population will have can will concept suggested, I have we you innovation that our a paid think add, covered got that opportunity has the Just commercialization Phase launch the that's the I'd lower drug well, time and confident get if agreement level, risk that infrequently around the two we've catastrophic some at only

Capital comes with Kim from Markets. Our BMO next Do question

questions. I have morning, for everyone. This two just Do. is [indiscernible] on Good update. Congratulations the QX quick

are there? that a the commercialize lumasiran. And in to has future just in going possibly reasonable do such First kind large transpire one, could the I my it for a population? the to of partnership want to strategy long-term piggyback ex-U.S. how second given think off AGT with capital Is of expenses to question be terms to

Given GIVLAARI, the be can you of Do could discussions similar all have similar been you access of GIVLAARI should market of give a in be the payers? you the Or of have efforts to what sense some steps an the launch, end going? product? we gating how a that there somewhat commercial foresee thinking your terms year pre-commercial into us that with there about? converting are ease saw patients with How

blockbuster all like something Yvonne, AGT, company, beyond in for we do time, future. We're want mean way that for on Yvonne, look Yes. maybe, we on to program? AGT our the period with out to we contemplating the of we're on another further imagine the type a as in bullish I a I you as you it. 'XX going whether side and have in efforts that to starters, I could a promotional potential want would of take we mean, of the product comment some product company the listen, way. we're to comment mean complement AGT want partnering and very any

we you've I it's mean exciting it John, program to really it. time a very think have we us. No, covered And through. think for

driver out very for nice gives likely time. partnering for this a progress period, could be about us most right able to but As we'll approaches in enjoy Alnylam additional to much the optionality that at to opportunity. consider being But growth Alnylam. an within Alnylam, point the it really now, it the we XXXX look And thinking as

do Yes. really on That's to great GIVLAARI? the about Barry access great. And comment you want on question

Yes. Sure.

on comment one Just back AGT.

of aware, the are to We'll cardiovascular with well APOLLO-B, into significant you AGT. a there. success studies, the footprint, world very which HELIOS-B As positions move us seeing have

So about I'm that. excited

I think a doing lumasiran. what for question of terms we're In about was there

disease provider, we're healthcare awareness. disease of So doing stage right awareness, now, in development, the advocacy patient group

lumasiran. We setup have virtual and for digital

and pursue that payers. providers be healthcare label, its that important Clearly, the then other for understanding the get impact. the PHX activities patients, information regulatory determines websites discussion, on and we can So with about engagement will

have high at about a and our work they approach, are value-based agreement very for excited the payers level to us We data to talked PHX. and with

from Carr Needham. question We'll with Alan take next our

a in expect reduction actual not it whether your just of back you things what you on of to is on caution ONPATTRO, guidance, provide this quarter. patient then of stick Thank you cautious, pattern that see coming abundance just a little have about what You've I more you. with are to the can And spending? is Coming on or exactly just detail Is trying an can based back visits seeing? this some you of in something you're detail in to happen? opex, terms second whether if more get I'm you and sense but better to mentioned some sort

that we change, the just this by to And really saying, in Jeff, just come phase navigate more let in also to pandemic that things period start really the on Alan, performance QX can me maybe to be obviously, expect and course, QX. in through obviously, But what equipped as reflects Yes. well. we comment believe a back our teams of impact question as me believe well QX to really Well, And in we've we as normalcy. you QX let even demonstrated are final QX. well the guidance and of the the to

Sure. Yes.

impact reduction have that's anticipate and guidance in the and for reducing to guidance, for the some X%, well reasons Barry, relates us very think, of I the seen we highlighted those ONPATTRO in April, the we year. impacts by it As QX the most having why

it or we drivers result to a Certainly, relates the reduced. significantly of travel like say the operating spend things savings pandemic reduction. as of environment we're and is really the natural the guidance, that I'd As One term. expense activities there's just we versus business, short have two prioritization But are in. revised secondly, impact going operating are that guidance of X% the XXXX. made to on certain decisions significant to the long The growth the either midpoint not reflects delay in think some have the

So We've operating both as discipline do about a expenses. talked and the toward we company. manage I our way the the consistently we move being reflects top think it growth discipline that for think line good profitable very being about in drivers

quickly sort good I And in And discipline growth year-over-year, so I'm proud again, that of we're the an managing very, in very toward reflects frankly, moving environment. that. of organization, uncertain X% think,

sure. this as the regard Jeff of proud you also am pleased with organization and for know I Yes. in leadership your

hand That session. concludes remarks. or the over will closing I for question-and-answer additional it to speakers today's

This deliver again employees continued I all for for their Well and dedication want Great. us thank thank our everyone call joining hard we're really is certainly to a of Alnylam our you in and time Alnylam accepted this to spirit with and the march on but to work. and is difficult R&D map that commercial ability forward progress pleased RNA. with the challenge

to safe weeks on and healthy. you all stay we until the and So months look our hope and on updating I next, Bye-bye now. forward coming progress continued that in then of you

your today's you That for presentation. concludes Thank participation.

disconnect. You may now