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TRVI

Trevi TherapeuticsD
Nasdaq / Pharmaceuticals, Biotechnology & Life Sciences
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2026-06-02
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2026-05-07
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Earnings documents stored for TRVI.

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Investor releaseQuarter not tagged2026-05-07

Trevi Therapeutics, Inc. Q1 2026 Earnings Call Summary

Moby

Management is pivoting to a multi-indication strategy, leveraging synergies between IPF and non-IPF-ILD programs as both patient populations are treated by the same pulmonologists at identical care centers. The company secured FDA alignment on the IPF-related chronic cough Phase III program, focusing on global site identification for two pivotal studies starting in the first and second halves of 2026. Strategic focus remains on patients with established lung fibrosis and chronic cough, where management believes their central and peripheral mechanism of action provides a competitive advantage over peripheral-only treatments. Intellectual property strategy has shifted toward 'label enablement' patents, targeting specific titration schedules and dosing adjustments to extend protection potentially through 2046. The refractory chronic cough (RCC) program is positioned as a high-value 'third leg of the stool,' targeting the most refractory patients who may not respond to other modalities. Operational scaling since receiving Phase IIb results has included a 10-person headcount increase to manage the simultaneous execution of three major clinical programs without compromising quality. Cash runway is now extended into 2030 following a $162 million offering, intended to fund the IPF program through potential FDA approval and top-line data for ILD and RCC programs. A critical Sample Size Reestimation (SSRE) for the RCC Phase IIb trial is expected in the fourth quarter of 2026 to confirm powering assumptions at the 50% enrollment mark. Management intends to propose an adaptive Phase II/III study design for non-IPF-ILD to the FDA, aiming to streamline the path to approval by rolling dose confirmation directly into a pivotal study. The company expects to initiate a Phase IIb parallel arm dose-ranging trial for refractory chronic cough (RCC) this quarter and plans to initiate a non-IPF-ILD trial in the second half of the year. Guidance for major top-line data readouts is currently set for the second half of 2027, though management notes high investigator interest could influence enrollment timelines. The April 2026 common stock offering added $162 million in net proceeds, removing 'financial overhang' during upcoming high-value clinical readouts. Current cash guidance excludes expenses related to the actual commercial launch of Haduvio or any trials beyond those explicitly...

Investor releaseQuarter not tagged2026-05-06

Trevi Therapeutics Q1 Earnings Call Highlights

MarketBeat

Trevi plans near-term trial starts across its chronic cough programs: the first of two IPF-related Phase 3 trials is expected to start this quarter with the second in H2 2026, an adaptive Phase 2/3 for non‑IPF ILD is planned pending FDA alignment (target H2 2026), and a RCC Phase 2b dose‑ranging study is slated to begin this quarter with a sample‑size re‑estimation readout in Q4 2026. The company significantly bolstered its balance sheet with an April equity offering (ended Q1 cash ~$172M plus ~$162M net proceeds), which management says extends Trevi’s cash runway into 2030 and funds planned Phase 2/3 programs and pre‑commercial activities. Trevi strengthened its intellectual property position—its core method‑of‑treatment patent was issued in Europe and the U.S. covering use through 2039, with additional U.S. filings that could extend protection toward 2046 and further patents planned around dosing/titration strategies. Interested in Trevi Therapeutics, Inc.? Here are five stocks we like better. MarketBeat’s Top 5 Rated Small-Cap Stocks Trevi Therapeutics (NASDAQ:TRVI) management used the company’s first-quarter 2026 earnings call to outline upcoming clinical milestones for its chronic cough programs and to highlight an expanded cash runway following an April equity offering. President and CEO Jennifer Good said 2026 is “an important year of execution,” and noted the company is preparing to advance multiple studies across idiopathic pulmonary fibrosis (IPF)-related chronic cough, non-IPF interstitial lung disease (ILD)-related chronic cough, and refractory chronic cough (RCC). → Roblox Stock Slides to New Low as Safety Changes Weigh on Outlook Following what Good described as a positive FDA meeting in the first quarter to align on the company’s IPF-related chronic cough program, Trevi finalized protocols for two Phase 3 trials and has been identifying global trial sites. Good said the company expects to initiate the first of the two Phase 3 studies in the current quarter, with the second slated to begin in the second half of 2026. For non-IPF ILD-related chronic cough, Good said the company plans to request another FDA meeting and submit a protocol to discuss an adaptive Phase 2/3 study design. The company intends to use the Phase 2 portion to confirm dose and assumptions before transitioning into a single pivotal Phase 3 study intended to support approval....

Investor releaseQuarter not tagged2026-05-06

Trevi Therapeutics Reports First Quarter 2026 Financial Results and Provides Business Updates

GlobeNewswire

Completed follow-on common stock offering with net proceeds of ~$162 million, extending expected cash runway into 2030 through potential FDA approval of Haduvio in IPF-related chronic cough and continued pipeline advancement Clinical development plans remain on track across all chronic cough indications Management to host a conference call and webcast today at 4:30 p.m. ET NEW HAVEN, Conn., May 05, 2026 (GLOBE NEWSWIRE) -- Trevi Therapeutics, Inc. (Nasdaq: TRVI), a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine ER) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC), today announced financial results for the quarter ended March 31, 2026, and provided business updates. “We are entering an important phase of execution for Trevi, with study initiations anticipated across our chronic cough programs,” said Jennifer Good, President and CEO of Trevi Therapeutics. “Following a very productive End-of-Phase 2 meeting with the FDA on our lead program in IPF-related chronic cough, we are excited to initiate multiple clinical trials this quarter, including our first Phase 3 in IPF-related chronic cough and our Phase 2b in RCC. With an expected cash runway into 2030, we are well-positioned to execute on our development strategy and advance towards a potential FDA submission in IPF-related chronic cough. We believe successful execution of our strategy would establish Trevi as the leader in providing best-in-class therapy in chronic cough indications with significant unmet needs and no FDA-approved therapies.” Recent Business Highlights IPF-Related Chronic Cough Completed an End-of-Phase 2 meeting with the FDA and gained overall alignment on the clinical development plan for the treatment of IPF-related chronic cough. Execution plans remain on track to conduct two Phase 3 trials in parallel with the first trial expected to initiate in the second quarter of 2026 and the second trial in the second half of 2026. The Company expects to have topline results from the first Phase 3 trial in the first half of 2028 and from the second Phase 3 trial in the second half of 2027. The Company received a notice to grant a European patent covering nalbuphine ER for the treatment of IPF-related chronic cough, with...

TranscriptFY2026 Q12026-05-05

FY2026 Q1 earnings call transcript

Earnings source - 85 paragraphs
Operator

Good afternoon, welcome to the Trevi Therapeutics first quarter 2026 earnings conference call. At this time, all participants are in a listen-only mode. After today's presentation, there will be an opportunity to ask questions. To ask a question during the session, you will need to press star one one on your telephone. You will hear an automated message advising your hand is raised. To withdraw your question, please press star one one again. Please be advised that today's conference is being recorded. Various remarks that management makes during this conference call about the company's future expectations, plans, and prospects constitute forward-looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995.

Operator

Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the Risk Factors section of the company's most recent annual report on Form 10-K, which the company filed with the SEC on March 17, 2026, as updated by our subsequent filings. In addition, any forward-looking statements represent the company's views only as of today and should not be relied upon as representing the company's views as of any subsequent date. While the company may elect to update these forward-looking statements at some point in the future, the company specifically disclaims any obligation to do so even if its views change. I would now like to turn the conference call over to Jennifer Good, Trevi's President and CEO. Please go ahead.

Jennifer Good

Good afternoon. Thank you for joining us for our first quarter 2026 earnings call and business update. Joining me today on this call are my colleagues, Dr. James Cassella, our Chief Development Officer, Farrell Simon, our Chief Commercial Officer, and David Hastings, our Chief Financial Officer. Dave and I will make some initial comments but are going to keep them brief as we have a robust presentation this Thursday at our Investor and Analyst Day. After our comments on the quarter, the team is happy to answer any questions you may have. 2026 is an important year of execution for the company, and the team is focused on delivering.

Jennifer Good

Following our positive FDA meeting in the first quarter to align on our IPF-related chronic cough program, the team has finalized the study protocols for our phase III trials and has been busy identifying global sites for both pivotal studies. We expect to initiate the first of those two studies this quarter, followed by the second study in the second half of this year. After gaining alignment with the FDA in our end-of-phase II meeting, we now intend to submit a meeting request and protocol to the FDA to discuss our non-IPF interstitial lung disease or non-IPF ILD-related chronic cough program. We intend to propose an adaptive phase II/III study to confirm dose and powering assumptions in the phase II study prior to rolling into one pivotal phase III study for approval.

Jennifer Good

If all goes as proposed to the FDA, we expect to initiate this trial in the second half of the year. This non-IPF ILD population will mimic the patient profile of patients in our IPF trial as it will include patients who have established lung fibrosis and chronic cough. There are a lot of synergies with our IPF studies as these patients with non-IPF ILD are seen in the same care centers by the same pulmonologist. As we negotiate CDAs, contracts, and budgets for the initiation of our IPF-related chronic cough trials, we have this trial in the scope so that we can act quickly once we have alignment with the FDA on the protocol. Finally, for refractory chronic cough, we also expect to initiate a phase II-B parallel arm dose-ranging trial with three doses and placebo this quarter as well.

Jennifer Good

The protocol is finalized and has been submitted to regulatory authorities. We are actively qualifying sites for this trial. This trial includes a sample size re-estimation or SSRE, which will read out when 50% of the patients complete the trial and is in place to confirm powering assumptions and adjust the sample size if necessary. We expect the SSRE readout in the fourth quarter of this year. One final update I would like to give is on the advancement of our intellectual property portfolio. We own the worldwide rights for our drug and are acutely focused on prosecuting incremental patent coverage in addition to the patents that have already been issued. This quarter, we had our core method of treatment patent issued for IPF-related chronic cough in Europe as well. This patent had already been issued in the U.S. and provides protection through 2039.

Jennifer Good

We filed additional applications this year in the U.S. which, if issued, would extend the patent coverage through 2046. We will keep you updated as incremental IP evolves. Before I close, I want to note there are two important meetings this month where we hope to see many of you. The first is our Investor and Analyst Day this Thursday, May 7th, from 10:00 A.M. to 12:00 P.M. Eastern Time, followed by an optional lunch in New York City. At this event, we plan to lay out details for the next clinical trials, the projected timelines for each of our chronic cough programs, and discuss incremental data we have developed as we continue to analyze our existing clinical trial data. We also will share commercial learnings based on recent market research and hear from KOLs on their perspective. It should be an informative event.

Jennifer Good

We will post the webcast and slides after the event for those of you that are unable to join us. Second, we will also be very active at the American Thoracic Society or ATS meeting this year, with all six of our submissions being accepted for either presentations or posters. We will also be holding an investor analyst event at ATS, where Jim and Dr. Philip Molyneaux, the lead investigator on our CORAL trial, will summarize and share the various data being presented at the conference. This event will be a lunch meeting being held on Monday, May eighteenth. If you plan to attend ATS, please reach out to us as we would love to have you join.

Jennifer Good

In closing, we are focused on executing against our plan of becoming the leader in chronic cough, providing therapy for these patients where there are no good options, and in the process, creating meaningful value for patients and our shareholders. I will now turn it over to Dave for his remarks, and then we are happy to answer your questions. Dave?

David Hastings

Thanks, Jennifer, and good afternoon, everybody. My brief remarks today will focus on our most important financial metric, which is our cash position and the runway it provides. We ended the 1st quarter of 2026 with approximately $172 million in cash equivalents and marketable securities. This balance does not include the $162 million in net proceeds from our underwritten common stock offering completed in April 2026. The offering was well-received. We appreciated the strong support and participation we got from our current shareholders, and we are grateful that we were able to attract new investors to Trevi. Additionally, with the completion of this offering, we accomplished two major objectives. One. We removed any financial overhang when we reach critical high-value clinical endpoints. Two. We extended our cash runway into 2030.

David Hastings

Included in this runway guidance is the funding of our development program in patients with IPF-related chronic cough, potentially through FDA approval. We also expect these cash resources will enable the company to fund and report top-line data from the planned phase II-B clinical trial and potentially a subsequent phase III trial for the treatment of patients with non-IPF ILD-related chronic cough. It funds the planned phase II-B trial for the treatment of patients with RCC. The planned spending of these resources also include pre-commercial activities but does not include any expenses related to the commercial launch of Haduvio or any other clinical trials. With that, I believe we are now well-positioned to execute our clinical trials with funding through critical value inflection points. Operator, we can now open the call for questions.

Operator

Thank you. We will now conduct the question and answer session. As a reminder, to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. At this time, we will pause momentarily to assemble our roster. Our first question comes from the line of Roanna Ruiz of Leerink Partners. Your line is now open.

Roanna Ruiz

Great. Afternoon, everyone. A couple from me. First one, I was curious, what are your goals for the upcoming meeting with the FDA to talk about the protocol for your phase II-B in non-IPF ILD chronic cough? If you could elaborate, like, anything you expect that might be up for discussion with the FDA versus more straightforward questions.

James Cassella

Hey, Roanna. This is Jim. Thanks for the question. Basically, that meeting is designed to discuss our intention for the ILD program. We will be submitting the full phase II-B/III protocol with that for discussion and really talk about our intentions on using that in an sNDA strategy so that we would support approval with that adaptive phase II/III design. There's going to be details about our patient population, how we're going to use the phase II for our dose selection confirmation and defining the dose for going into phase III and then pulling up the, you know, the results from the phase II part of that study with the interim analysis to confirm our power assumptions and for the phase III component.

Roanna Ruiz

Makes sense. A quick follow-up. Thinking about RCC phase II-B potentially ramping up as well, and moving forward in a non-IPF ILD, can you talk a bit about how you plan to balance resources and prioritize things, as you have many really interesting things going on and, moving forward?

James Cassella

Yeah. We don't like a lot of sleep. We have things under control. You know, this is not my first time running multiple programs with a small team. You know, we use our internal expertise. We have leveraged very experienced CRO, one that I've worked with from my last NDA, have a lot of years of experience with them. It's a really tight team. Our vendors that we've selected are really here to support us across all of our programs. I think we're in a good position to be able to do these things. I have no questions that we have the capabilities and the intellectual horsepower to get these things done. I've been working with small companies for almost 40 years now.

James Cassella

We know how to manage the resources to get these things done.

Jennifer Good

I would add, too, Jim, Roanna, we have added probably 10 people since getting our phase II-B results. We added a really experienced pulmonologist. We've added several clinical people. You know, 10 people for us is a lot of hiring. We have tried to scale appropriately to address the busyness of these trials.

Roanna Ruiz

Yeah. Yep. Sounds good. Thanks a lot.

Jennifer Good

Thank you for the question.

Operator

Thank you. Our next question comes from the line of Judah Frommer of Morgan Stanley. Your line is now open.

Judah Frommer

Yeah. Hi, guys. Thanks for the update, and thanks for taking the questions. Two for us. I guess just from a competitive standpoint in RCC, we have a P2X3 readout coming mid-year. Just curious how you think the landscape evolves for Haduvio if kind of along the spectrum of possible outcomes for that P2X3 readout. I guess if results are unexpectedly strong, what does that do for your opportunity in RCC? What does it do maybe for enrollment in the RCC trial? Thanks.

Jennifer Good

Farrell, why don't you answer the competitive landscape, and Jim can talk about enrollment.

Farrell Simon

Judah, thank you for the question. You know, when we look at the competitive landscape, especially camlipixant, which will be reading out soon in the next couple of weeks, you know, we're hoping that they are successful here, right? This is a large unmet need patient population with no approved therapies and definitely a category that can support multiple modalities. We have strong differentiation with our central and peripheral mechanism of action, and I think what we'll take you through on Thursday in the Investor Day is exactly how that positions us for success. I'll turn it over.

Farrell Simon

You know, I'll just say on the flip side if camlipixant is unsuccessful within that space, I think we'll have to take a look at, you know, what is our competitive positioning. We have a really strong efficacy and see what the phase II-B results say and see what the commercial opportunity lies ahead. It's still a large unmet need. patients are waiting for us. I'll turn it to Jim.

James Cassella

Yeah. I mean, on the enrollment side, you know, we have our investigators signed up for that study. There's a lot of excitement. There's a lot of patients available to us. Regardless of what happens in that environment, we're strongly supported by the investigators that we have for the study who really talk about a lot of patients being available and interested in being in our study. I think our different mechanism, the data that we've shown, the strength of the data that we have out there, still is really the absolute driving force for the interest in being in our study.

Jennifer Good

Our phase II-B will be done by the time they ever got approval.

Judah Frommer

Yeah.

Jennifer Good

It might be a phase III issue.

Judah Frommer

Yeah

Jennifer Good

to deal with. Yeah, thanks for the question.

Judah Frommer

Great. Just maybe more high level philosophical just on the ILDs. With kind of more inhaled formulation drugs kind of entering or late stage in kind of the IPF and PPF space, right, a common AE in a lot of those trials is cough. Just curious how you think, you know, the opportunity for Haduvio could be impacted by maybe more inhaled therapeutics in the PF space. Thanks.

Jennifer Good

Judah, we get this question a lot. I think obviously we're treating more of a chronic cough that's more systemic. Whether the hypersensitization's intertwined with them taking these inhaled products and you might be able to settle that down, that's something that's gonna have to be learned over time. I do think, you know, these different therapies are helpful. They'll define the market. They create options. We can lay alongside all of these. That's why Jim's been busy doing these DDI studies. Whether we can sort of help with the cough due to their delivery system, I think that'll have to be discovered.

Judah Frommer

Thanks.

Jennifer Good

Yeah. Thank you.

Operator

Thank you. Our next question comes from the line of Alexa Deemer of Cantor Fitzgerald. Your line is now open.

Alexa Deemer

Hi, guys. Thanks for taking my question, and congrats on the great quarter. For the guidance for the data readouts for the upcoming program, this begins in the second half of 2027. I just wanted to ask if there are any other data updates planned that we can expect before that. Thanks.

Jennifer Good

I mean, we have the SSRE, the sample size re-estimation at the halfway point of the RCC trial. We should get that in by the fourth quarter of this year. We'll have to see how enrollment unfolds, that's what we're working towards. That's a pretty insightful readout on the RCC trial, I think. Otherwise, our current plan is second half of 2027. I wanna echo what Jim said. I've been going to a lot of these investigator meetings as well. There's a lot of interest and attention on our programs. The team is, I think, setting us up for success here. We'll continue to update you guys as we move through the trials, we are definitely moving along nicely.

Alexa Deemer

Awesome. Thank you.

Jennifer Good

Thanks, Alexa.

Operator

Thank you. Our next question comes from the line of Serge Belanger of Needham & Company. Your line is now open.

John Todaro

Hi. Good afternoon. This is John on for Serge today. Thanks for taking our questions. Just a couple from us. First, I might be jumping the gun here a little bit, on the SSRE and RCC coming up later this year, curious what some of the key checkpoints will be that you're looking for during this analysis. I would imagine it might look somewhat similar to the IPF one done during the phase II. In the event of requiring additional patients, just curious how you might expect that to look. Secondly, on the IP front, I believe you have patents issued through 2039. Curious if and where you'd look to expand that portfolio ahead of the potential commercialization of Haduvio. Thanks.

Jennifer Good

Yeah. Jim, you wanna do the SSRE?

James Cassella

Yeah. The SSRE is exactly what we did with CORAL. It'll be at the halfway point, looking for conditional power of 80%. If the numbers are below that, if the conditional power at that point is below 80%, we will upsize proportionately and, like we had in the CORAL design, if there's, you know, futility, you know, it will be recognized too. That's gonna be down in that 30%-40% range. I think, you know, conditional power. It's really what you expected from CORAL is gonna be carried over to here and we'll be reporting whether or not we have to stay the same or upsize.

Jennifer Good

Yeah. Your second question, John, about IP. We are in an interesting position now. We've got the base core patents issued in IPF, and now we have a good view of what our label's gonna look like. Now we are starting to prosecute the different sort of label enablement patents. Things that we're zeroing in on the label, like the final titration schedule, like how you dose adjust it with food or hepatic impairment. Jim's running a lot of different phase I studies. Those tend to be quite rich for IP. Our goal at this point, now that we've got a nice broad sort of method of treatment patent around treating cough and these indications, now we'll start building around the label.

Jennifer Good

We'll keep patents, applications open, so as we complete development work and learn new things, we're able to file incremental IP around them. Our goal would be when this drug actually launches, that we've got multiple patents around the original base patent.

John Todaro

Great. Thanks so much for the color.

Jennifer Good

Thank you.

Operator

Thank you. Our next question comes from the line of Ryan Deschner of Raymond James. Your line is now open.

Ryan Deschner

Thanks for the question. You have some very interesting dyspnea data coming up at ATS later this month in Orlando. How impactful do you think dyspnea is as a quality of life metric for IPF chronic cough patients, and how relevant is potential modulation of dyspnea for the RCC and non-IPF ILD indications? We'll follow up.

Farrell Simon

Yeah, Ryan, this is Farrell. Thank you for the question. We've actually done a lot of research with physicians and with payers around this point. You know, when you look at the top 3 most common complaints from these patients, whether it's IPF or ILD, dyspnea is in that top 3. It's cough, dyspnea, and fatigue at the top 3. It, it doesn't change our commercial thesis, but what it can do is definitely complement the speed of uptake of the product and also I think just the adoption from patients 'cause it's gonna be helping them across more than one of the experiences that they have and impacts.

Jennifer Good

Payer conversations, right?

Farrell Simon

Payer conversations. It will help in payer conversations. It'll help justify additional value.

Ryan Deschner

Got it. How do you plan to try to minimize placebo in the RCC clinical program? Is high potential placebo as much of a concern in the IPF chronic cough and non-IPF ILD indications?

James Cassella

Hey, Ryan, it's Jim. You know, I think, you know, we have solid data from our CORAL study in the IPF population. You know, came in with under 20% placebo response. I think that was expected. I also think that that's probably in the world of chronic cough, that's probably one of the more well-behaved populations and expect to see something like that going forward. I think there's precedent here in the RCC world that the placebo response could be a little bit more variable and a little bit more ranging. We are doing everything in this trial to really control for things that can contribute to a placebo response. I think a lot of it is having an extremely well-controlled trial, so we're doing our best there.

James Cassella

I think, you know, we are incorporating, at the advice of some of the experts in the RCC space, you know, a placebo run-in period to try to mitigate any of the response there. The idea there is to look for, you know, stability around lower end of cough response. You know, we are incorporating those things and, of course, just sort of the rules of thumbs that I'm bringing in from my CNS background where placebo response is always a big concern, is really about, you know, trial conduct and making sure that you don't set false expectations, that you don't overpromise and things like that can help contribute to the overall placebo response.

Ryan Deschner

Thank you very much.

Operator

Thank you. Our next question comes from the line of Debanjana Chatterjee of JonesTrading. Your line is now open.

Debanjana Chatterjee

Hi. Thanks for taking my question. Congrats on all the progress. Looking forward to ATS, what are some of the most exciting developments we should look forward to? I have a quick follow-up.

Jennifer Good

Jim and I will both be there. We're looking at each other. Jim, you go ahead. You're the author on a bunch of them.

James Cassella

Hi, Deb. It's I think we have some exciting updates in the oral presentation that'll be given by Dr. Philip Molyneaux. I mean, that's gonna be some new sub-analyses from our CORAL study. I think there's also gonna be some interesting presentations and posters on cough bouts, our analysis of the cough bouts for both CORAL and RIVER. It was brought up earlier, but I think our breathlessness data, you know, being presented by Donald Mahler, who is really one of the key experts in this space, is really gonna be exciting poster to get out that initial analysis that really shows some benefit here on the breathlessness piece of things.

James Cassella

I think, you know, those are highlights, I think that really add some new information into the data flow for us.

Debanjana Chatterjee

Appreciate the color. Just a quick follow-up. I know, of course, FVC is not an endpoint that you are pursuing, but, like, given that you'll be following the IPF patients, like 52 weeks, at least, right, in the phase III program, do you expect to see some trends there? Even if that's kind of like a safety endpoint?

James Cassella

We are following FVC. We have it at baseline. We have it throughout the 52-week time period. We will be able to look to see what's there. Our ends are very different than what you expect from an IPF trial because FVC is highly variable, and I think that drives the size of those trials. All I can promise you is that we will see what we see and report it out.

Debanjana Chatterjee

Thank you.

Operator

Thank you. Our next question comes from the line of William Wood, B. Riley Securities. Your line is now open.

William Wood

Thanks for taking our questions, and congrats on a nice quarter. Just curious more thinking about the peers P2X3 readout coming up. I was curious if there's anything specific that you might be looking for in that trial, regardless of whether it's positive or negative, in terms of, you know, taking forward to the FDA that you think, you know, they could really improve your learnings on your own trials.

Jennifer Good

I mean, I'm just gonna jump in, Jim, you add any color. Thanks for the question, William. I don't think so. You know, P2X3s have had to kind of chase this path of the highest level of coughers and placebo run-ins and highly adjudicate the indication. You know, we've shown data that our drug works broadly in IPF chronic cough and refractory chronic cough across different cough counts. I think that we have to be a lot less fussy with who goes into the trial and how we get results. We'll obviously be interested in the placebo effect and how they've controlled that, those trials were upsized. The bigger trial was upsized twice, that's always tricky, I think. They're also managing a much tighter response. We'll look at it. We're interested. I agree with Farrell.

Jennifer Good

I hope they see some results for patients. They are guiding towards about a 15%-20% placebo-adjusted change in their calls. We would expect much better performance of our drug. We really are looking to be best in class in the most refractory patients for our drug. You know, it's more, as Farrell mentioned, just how we position the drug and where we go. I would say nothing that really impacts our program. We'll learn more from our phase II-B than we'll probably learn from their phase III data.

William Wood

Got it.

Jennifer Good

Yep.

William Wood

That's helpful. One brief, quick add-on. Just in terms of, you know, sort of setting our expectations for your KOL event coming up, as well as at ATS, you know, is there anything specific that the FDA may be looking for in terms of guiding for your non-IPF ILD-related chronic cough trials that you may be highlighting at these that really sort of bolster moving into this and/or certain subsets of populations as you, as you look to meet with them in the second half? Thank you for taking our questions.

Jennifer Good

We are having an ILD expert in the U.S., Dr. Toby Maher, who runs a big ILD center. He's gonna speak there. He's gotta join us by Zoom 'cause he has clinic. One of the topics we've asked him to cover is why, in his judgment, an IPF and an ILD patient is the same or not the same as it relates to cough. You'll hear straight from one of the experts here. Toby's been involved in our program from the beginning. He knows our drug quite well. He actually sat on our FDA call with us. You'll get some independent insights from really one of the leading voices in the ILD space on Thursday.

William Wood

That's helpful. Thank you.

Jennifer Good

Yeah. Thank you, William.

Operator

Thank you. Again, if you have questions, please press star one one. Our next question comes from the line of Kaveri Pohlman of Clear Street.

Kaveri Pohlman

Okay. Yes, good evening. Thanks for taking my questions. Just to like a follow-up on the previous comments you made on the phase II-B RCC trial design. I was wondering how you were thinking about enrolling a truly addressable patient population to fully de-risk the program, particularly given the expectations that many patients may be P2X3 antagonist experience in real world. For broadly, just like on a high level, there appears to be an increasing focus on the development progress in IPF and non-IPF ILD, obviously alongside continued efforts in RCC. How do you think about, you know, the relative opportunity across these indications in the context of the evolving treatment landscape? What key challenges in RCC will need to be addressed to fully realize its potential? Thank you.

Jennifer Good

There were a lot of questions there to disentangle. I'll just kind of start from a strategy perspective. Trevi has always been led as an IPF sort of and then adding an ILD-led strategy, primarily because of our commercial strategy. Specialty, high pricing, specialty sales force. That was always our focus. I think as the RCC competitive landscape sort of fell away and really there wasn't much left, some of the experts came to us asking us to please try our drug in RCC. We did and got very strong data. I think definitely a commitment to RCC, but it is sort of the third leg of the stool here. With regard to the variability in the program and P2X3 responders, anything, Jim, on that?

James Cassella

I think are you asking, there's gonna be people who have experience with P2X3 that may be entering in our trial? I mean, I think, you know, the key there is if they meet the eligibility requirements and they've been off their P2X3 for an appropriate period of time, they still have, you know, the requirements to get into the study, you know, they're fair game for coming in. I mean, we want people with various experiences. We know, you know, this is a refractory condition, and people have tried a lot of different things and they may or may not have succeeded on a P2X3, but if they meet our entry criteria, they'll be coming into the trial. I don't think it really differentiates from any other type of therapy that they've tried in the past.

James Cassella

They will meet the eligibility requirements for being off of the P2X3 for a certain amount of time.

Kaveri Pohlman

Got it. Thank you.

Jennifer Good

Thank you, Kaveri.

Operator

Thank you. I am showing no further questions at this time. This concludes our question and answer session. I would now like to turn the conference back to Jennifer Good for closing remarks.

Jennifer Good

We appreciate you joining us for today's call and look forward to hopefully seeing many of you later this week and this month. Thank you.

Operator

This concludes today's conference call. Thank you for attending. You may now disconnect.

Investor releaseQuarter not tagged2026-04-29

Trevi Therapeutics to Report First Quarter 2026 Financial Results and Provide a Corporate Update on May 5, 2026

GlobeNewswire

Conference call and webcast to be held at 4:30 p.m. ET NEW HAVEN, Conn., April 28, 2026 (GLOBE NEWSWIRE) -- Trevi Therapeutics, Inc. (Nasdaq: TRVI), a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine ER) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC), today announced that senior management will host a conference call and live audio webcast on Tuesday, May 5, 2026, at 4:30 p.m. ET, to provide a corporate update and review the Company's financial results for the quarter ended March 31, 2026. Conference Call and Webcast To register for the live conference call and webcast, please visit the ‘Investors & News’ section of the Company’s website or access directly at ir.trevitherapeutics.com/news-events/events. Please note for phone participants: Once registered, you will receive an email with unique call-in details. An archived replay of the webcast will also be available for 30 days on the Company's website following the event. About Trevi Therapeutics, Inc. Trevi Therapeutics, Inc. is a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine extended-release) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC). Haduvio is the first and only investigational therapy to show a statistically-significant reduction in cough frequency in clinical trials across both patients with IPF chronic cough and in patients with RCC. Haduvio acts on the cough reflex arc both centrally and peripherally as a kappa agonist and a mu antagonist (KAMA), targeting opioid receptors that play a key role in controlling chronic cough. Nalbuphine is not currently scheduled by the U.S. Drug Enforcement Agency. Chronic cough in patients with IPF and non-IPF ILD is a condition with high unmet need and no FDA-approved therapies. There are ~140,000 U.S. patients with IPF, and two-thirds of these patients are faced with uncontrolled chronic cough. Additionally, there are ~228,000 U.S. patients with non-IPF ILD, with 50-60% having uncontrolled chronic cough. The impact of chronic cough is significant, with patients coughing up to 1,500 times per day. Th...

Investor releaseQuarter not tagged2026-04-17

Exchange-Traded Funds, Equity Futures Higher Pre-Bell Friday as Investors Take Positions Amid Corporate Earnings

MT Newswires

The broad market exchange-traded fund SPDR S&P 500 ETF Trust (SPY) was up 0.3% and the actively trad

Investor releaseQuarter not tagged2026-03-18

Trevi Therapeutics Inc (TRVI) Q4 2025 Earnings Call Highlights: Strategic Advances and ...

GuruFocus.com

This article first appeared on GuruFocus. Cash and Cash Equivalents: Approximately $188 million at the end of 2025. Cash Runway: Expected to extend into 2028. Release Date: March 17, 2026 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Trevi Therapeutics Inc (NASDAQ:TRVI) reported positive data readouts from the CORAL and RIVER trials, which have driven growth and capital raising. The company had a successful end of Phase II meeting with the FDA for its IPF-related chronic cough program, gaining alignment on the path to NDA. Trevi Therapeutics Inc (NASDAQ:TRVI) plans to initiate two pivotal Phase III clinical trials for IPF-related chronic cough, with clear timelines and trial designs. The company has a strong cash position with $188 million, providing a runway into 2028 to support key clinical milestones. Trevi Therapeutics Inc (NASDAQ:TRVI) is expanding its clinical footprint into the U.S. and has received positive feedback from physicians and patient advocates, indicating strong interest in its trials. The requirement for 52 weeks of controlled safety data in the IPF trial means the 24-week endpoint cannot be read out until the end, potentially delaying data availability. There is uncertainty around the placebo effect in the longer 24-week IPF trial, which could impact trial outcomes. The company faces potential competition from other IPF drugs that may be approved by the time its trials are completed. Trevi Therapeutics Inc (NASDAQ:TRVI) may need to conduct additional drug-drug interaction studies if new IPF drugs are approved during its trial period. The company is still finalizing plans for the non-IPF ILD trial, which could affect timelines and resource allocation. Warning! GuruFocus has detected 1 Warning Sign with TRVI. Is TRVI fairly valued? Test your thesis with our free DCF calculator. Q: Could you elaborate on the remaining Phase I studies discussed with the FDA and their purpose? A: James Cassella, Chief Development Officer: These studies are label-informative, focusing on potential drug-drug interactions and the mechanism of drug metabolism. They are not rate-limiting and can be conducted in parallel with the Phase III trials. Q: Regarding the non-IPF ILD trial design, what are the key features you want to align with the FDA? A: James Cassella, Chief Development Officer: We plan to use learn...

Investor releaseQuarter not tagged2026-03-18

Trevi Therapeutics Reports Fourth Quarter and Year End 2025 Financial Results and Provides Business Updates

GlobeNewswire

Following the End-of-Phase 2 meeting with the FDA, the Company gained alignment on its Phase 3 program for the treatment of patients with idiopathic pulmonary fibrosis-related chronic cough On track to initiate a Phase 2b clinical trial for the treatment of patients with refractory chronic cough in the second quarter of 2026 Company ended 2025 with $188.3 million in cash, cash equivalents and marketable securities, with expected cash runway into 2028 Management to host a conference call and webcast today at 4:30 p.m. ET NEW HAVEN, Conn., March 17, 2026 (GLOBE NEWSWIRE) -- Trevi Therapeutics, Inc. (Nasdaq: TRVI), a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine ER) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC), today announced financial results for the fourth quarter and year ended December 31, 2025, and provided business updates. "Our progress in 2025 marked a major inflection point for Trevi’s growth trajectory, driven by positive Phase 2 data across our chronic cough programs," said Jennifer Good, President and CEO of Trevi Therapeutics. "These results provide a strong foundation as we pursue our goal of becoming a leader in treating chronic cough. We’ve carried this momentum into 2026 as we gained overall alignment with the FDA during our End-of-Phase 2 meeting for patients with IPF-related chronic cough. We are now focused on initiating the first of our two pivotal Phase 3 IPF-related chronic cough trials, as well as our Phase 2b RCC trial in the second quarter of this year. Looking ahead, Trevi is well positioned to execute on its clinical programs and help address the high unmet need for patients who are burdened by chronic cough in our target indications, where there are no FDA-approved therapies." Recent Business Highlights IPF-Related Chronic Cough The Company had its End-of-Phase 2 meeting with the FDA and gained overall alignment on the plan for the remaining development program of nalbuphine ER (NAL ER) for the treatment of IPF-related chronic cough. The Company plans to conduct two pivotal Phase 3 clinical trials and obtained agreement on the remaining Phase 1 clinical studies that the Company expects to conduct to support a New Drug Application (NDA) submission....

TranscriptFY2025 Q42026-03-17

FY2025 Q4 earnings call transcript

Earnings source - 68 paragraphs
Operator

Good afternoon, and welcome to the Trevi Therapeutics Fourth Quarter and Year-End 2025 Earnings Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded. Various remarks that management makes during this conference call about the company's future expectations, plans and prospects constitute forward-looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Actual results may differ materially from those indicated by these forward-looking statements as a result of various important factors, including those discussed in the Risk Factors section of the company's most recent annual report on Form 10-K, which the company filed with the SEC this afternoon. In addition, any forward-looking statements represent the company's views only as of today and should not be relied upon as representing the company's views as of any subsequent date. While the company may elect to update these forward-looking statements at some point in the future, the company specifically disclaims any obligation to do so even if its views change. I would now like to turn the conference call over to Jennifer Good, Trevi's President and CEO. Please go ahead.

Jennifer Good

Good afternoon, and thank you for joining us for our fourth quarter 2025 earnings call and business update. Joining me today on this call are my colleagues, Dr. James Cassella, our Chief Development Officer; Farrell Simon, our Chief Commercial Officer; and David Hastings, our Chief Financial Officer. I want to welcome Dave to his first official earnings call with Trevi. His experience has already been felt in the company, and we feel very fortunate that we are able to add him to our leadership team at this important time of execution and growth. So welcome, Dave. I will make some comments on the business, and Dave will make some brief financial remarks. Then the team is happy to answer any questions you may have. 2025 was a major inflection point for growth at Trevi, driven by our positive data readouts in both the CORAL trial in patients with idiopathic pulmonary fibrosis or IPF related chronic cough and the RIVER trial in patients with refractory chronic cough or RCC. As a result of these data, we were able to raise capital, setting us up nicely for the next round of trials for each of our indications. That momentum has carried into the early part of this year as we have been preparing to initiate the next set of clinical trials. This work recently culminated in a positive End-of-Phase 2 meeting with the FDA for our IPF-related cough program. We believe the path forward for our registration trials is clear, and the team at Trevi has been moving aggressively to initiate our Phase III program. Let me provide you with an update on where we stand in each of our chronic cough indications. Beginning with our lead indication of Haduvio for the treatment of IPF-related chronic cough, at our recently held End-of-Phase 2 meeting with the FDA, we believe we gained overall alignment on the plan for the remaining development program and pathway to NDA. First, I want to share that the meeting was very collaborative and we were appreciative of the preparation and comments from the FDA, especially with all of the changes going on at the agency. We had constructive dialogue around each of our questions and left with a good understanding of the path forward. During our interaction, we confirmed the primary endpoint using the objective cough monitor and discussed the proposed key secondary endpoints and the evaluation of these endpoints. Based on the FDA's input, the company plans to conduct 2 pivotal Phase III clinical trials and obtained agreement on the remaining Phase I clinical studies to support an NDA submission. The company plans to conduct these 2 Phase III trials in parallel and is on track to initiate the clinical program. We plan to initiate the first trial in the second quarter of this year. This trial will be a global 52-week trial with a primary efficacy endpoint following 24 weeks of fixed dosing. We have planned for the trial to include approximately 300 patients. The second confirmatory Phase III trial, which we expect to initiate in the second half of this year will also be a global trial with a primary efficacy endpoint at 12 weeks and is estimated to enroll approximately 130 patients. The 2 studies are almost identical in design, except for the different duration for the primary efficacy endpoints and sample sizes. The reason for these differences is the FDA interest in a 24-week readout to support durability of effect in at least 1 of the trials. As for the end of the trials, the 52-week trial with the 24-week endpoint is powered for all of the key secondary endpoints that we would hope to include in the label and supports an adequate safety database. The second Phase III trial is studying a 12-week endpoint to confirm the primary efficacy outcomes along with providing additional safety through 12 weeks of dosing. IPF-related chronic cough is a new indication for the FDA, and we believe this pivotal program provides robust safety and efficacy data for a potential NDA submission. In the U.S., there are approximately 150,000 IPF patients, 2/3 of which have uncontrolled chronic cough. These cough patients have a high unmet need with no FDA-approved therapies. With our distinct mechanism of action and known safety and tolerability profile, we believe we are well positioned to have potentially the first therapy for the treatment of IPF-related chronic cough. Also a quick comment on the remaining Phase I studies. These are all standard label-enabling studies, which we had already been planning for in our development program, and we're aligned with what we had submitted to the FDA in our briefing document. Jim can give more color in Q&A if you are interested. Following alignment with the FDA on our IPF-related chronic cough program, we now intend to submit a meeting request and protocol to the FDA to request our non-IPF interstitial lung disease or non-IPF ILD-related chronic cough program. We intend to propose an adaptive Phase IIb trial to confirm dose and powering assumptions prior to rolling into 1 pivotal Phase III trial for approval. We are planning to file a supplemental NDA for this indication. We are planning to have this meeting in the third quarter of this year, and if all goes as planned with the FDA, initiate that trial by year-end. This population will include non-IPF ILD patients who suffer from lung fibrosis and chronic cough. We estimate there are approximately 228,000 non-IPF ILD patients with 50% to 60% having uncontrolled cough. This more than doubles the market opportunity of IPF chronic cough, and these patients are primarily seen by the same pulmonologists that see IPF patients. This keeps our clinical and commercial efforts efficient and creates synergies. Finally, for refractory chronic cough. We are planning to conduct a Phase IIb parallel arm dose-ranging trial with 3 doses and placebo. The protocol is drafted and being submitted to regulatory authorities, and we have selected sites to conduct this trial. This trial is interesting scientifically as we explore whether dosing in RCC patients is lower or equivalent to doses we are testing in the IPF chronic cough trial. We plan to initiate this trial in the second quarter of this year as well and have included a sample size reestimation readout when 50% of the patients complete the trial. It has been a busy time at Trevi preparing to launch this next round of clinical trials. Jim and his team have been working very hard to leverage the important learnings and relationships we have already built as well as to expand our clinical footprint into the U.S. We are excited to initiate these trials and begin enrolling patients. Before I close, I want to note there will be 2 important meetings we are preparing for in the second quarter where we hope to see many of you. The first is an in-person Investor and Analyst Day on May 7 from 10:00 a.m. to 12:00 p.m. followed by an optional lunch in New York City to discuss the company's clinical and commercial strategy. We will be joined by both IPF and RCC KOLs. At this event, we plan to lay out clinical trials and time lines in more detail, share recent commercial learnings as Farrell has been busy at work on based on our recent data, hear from KOLs on their perspective, and I also plan to discuss our active efforts around obtaining additional intellectual property. So it should be an informative event. We will also webcast the event live for those of you that can't join us in person. Second, we will also be very active at the American Thoracic Society, or ATS meeting this year with all of our submissions being accepted for either presentations or posters. We will be sharing some new data from our various trials at this meeting. We are planning on holding an investor event at ATS, where Jim and Dr. Philip Molyneaux, the lead investigator on our CORAL trial, will summarize and share the various data being presented at the conference. This meeting is being held in Orlando from May 17 to 19, with our ATS investor event being held on Monday, May 18. If you plan to attend ATS, please reach out to us as we would love to have you join us. So in closing, Trevi is well positioned to execute against our plan of becoming the leader in chronic cough, providing therapy for these patients where there are not good options and in the process, creating meaningful value for our shareholders. I will now turn it over to Dave for his remarks, and then we are happy to answer your questions. Dave?

David Hastings

Thanks, Jennifer, and good afternoon, everybody. First, I just want to say I'm thrilled to be participating in my first earnings call as CFO of Trevi. And before moving to the financial results, I want to take a moment to talk about why I took this role. The company has impressive clinical data in indications of high unmet medical need that offer a significant commercial opportunity. Importantly, given their specialty nature, we can commercially launch our indications effectively. In addition, the company has a proven track record of using its capital efficiently as it progresses with its key clinical programs. Also, after meeting the team, I felt confident in their ability to execute and I'm excited about the opportunity to contribute. Now turning to our key financial metrics, which are cash runway and what that runway funds. We ended 2025 with approximately $188 million in cash, cash equivalents and marketable securities, which gives us an expected runway into 2028. This runway allows us to provide top line data in our key clinical trials. This includes our Phase IIb clinical trial in RCC, our Phase IIb clinical trial in non-IPF related chronic cough and importantly, top line data in our 12-week pivotal Phase III clinical trial in IPF-related chronic cough. So while we're well positioned from a cash runway perspective to reach key clinical milestones, it is important to ensure that Trevi is always appropriately capitalized given the key inflection points and significant clinical trial data readouts the company has in front of us. So with that, I'll now turn the call back over to the operator to open the call for Q&A. Operator?

Operator

[Operator Instructions] And our first question comes from Roanna Ruiz with Leerink Partners.

Roanna Clarissa Ruiz

A couple for me. I wanted to check on the remaining Phase I studies that you talked about with the FDA at the End-of-Phase 2 meeting. Could you elaborate a bit on what questions they're meant to answer and how efficiently you think you can complete them in the near term?

James Cassella

Hi Roanna, this is Jim. Thanks for the question. So these are pretty much label informative studies. So specifically, the FDA has asked us to look at nerandomilast as a newly approved antifibrotic agent to see if there's any drug-drug interaction with that, we had previously done that with pirfenidone and nintedanib. So we were kind of expecting this one is going to be coming along. The idea there is to make sure that there's no PK drug interaction that could affect the PK levels of either nerandomilast or vice versa, the PK of nalbuphine ER. So that's the first one. That was kind of expected given that we just completed those other ones. The other 1 was related to our mechanism of drug metabolism. We are metabolized in part by cytochrome P450 liver enzymes, specifically, were metabolized by cytochromes P450, the 2C9 and 2C19 isoforms, we had planned on doing an inhibitor study to look at drugs that inhibit the enzymes to see if the effect -- if it affects RPK, the FDA wanted to just step more -- step further and look at inducers of those enzymes. So again, it's kind of routine, we'll be able to inform on the physicians through the label and what happens when we do that. Now what we had also proposed and was accepted was standard label-enabling studies on renal impairment, hepatic impairment, food effect and things like that. So we're in a good place there. I think we have a very good idea of what we're required to do for the pathway to the NDA. These are not rate limiting in any way. They can be done in parallel with the Phase III, and we'll be performing those as we go along.

Roanna Clarissa Ruiz

Great. That's helpful. And a separate question on non-IPF ILD and talking about the -- going in front of the FDA about that trial design as well. Any design features that you particularly want to align with the FDA most? And is there anything that you expect maybe some questions or things you may have to have more of a discussion about with the FDA on?

James Cassella

Yes, great question. I think the beauty of our timing here is that we're coming off of a very positive End-of-Phase 2 meeting in IPF. And you know IPF is a form of ILD, interstitial lung disease. So we're really looking at the other part of that ILD population. So I think a lot of the learnings that we have from the End-of-Phase 2 meeting directly relate to what we're looking to do in the non-IPF ILD. So everything we learned in the End-of-Phase 2 meeting in terms of study design, what the FDA is looking at for study duration, even our endpoints really will carry over. So what we want to do with that meeting is really introduce them to the concept that we're interested in this other part of the population. We are looking at doing this in terms of a Phase II, Phase III adaptive design, as Jen mentioned. The Phase II part is really -- this is a slightly different population. There will be other comorbidities associated with this non-IPF ILD population. So we're going to do some dose ranging in the Phase II part. The idea of the adaptive design is that we were able to pick our doses, determine what our effect size is, look at the variability in this population, immediately translate that into the Phase III study. There will be a data readout in between there. So we're basically going to lay out that concept with them in the Type C meeting that we plan on having with them.

Operator

Our next question comes from Judah Frommer with Morgan Stanley.

Judah Frommer

Congrats on the progress. Dave, congrats on joining the team. I guess maybe just first from us on non-IPF ILD. Was there any conversation in the End-of-Phase 2 about potentially adding an arm in the pivotal program for IPF that could include non-IPF patients if not, did you feel that it just wasn't the right format. And also in the End-of-Phase 2, can you help us with any color on discussion of 1 trial versus 2? I know you had always assumed that you'd be doing 2 trials here. But was there any discussion around that?

James Cassella

Yes. So in terms of non-IPF ILD -- we -- the IPF program is our lead program. It has a very clear directive. It's a very distinct population. It's what we had actually talked about when we filed our IND. So we really kept it to the IPF part of the ILD population. The idea was that we would take the learnings from that meeting and then apply it to the ILD. So we did not have any direct conversations about that. I'll let Jen chime in on the second part.

Jennifer Good

Yes. The 1 versus 2, Judah, I think we got good comments from the agency and had good dialogue with them in the meeting. As you know, there's sort of this in between phase now where there's this New England Journal article floating around that hasn't really translated down into FDA guidance. I think that causes a little bit of wondering what to do with that at FDA, especially for us because it's a brand-new indication, a chronic cough drug has not been approved, and this will be our first indication approved. So as our management team stepped away from everything we heard, we made the decision that it was best to really lean in on our lead indication here and conduct a robust trial so that we didn't get caught sort of in any kind of changes around view there. So it was really a decision we made as a company. There's a lot of confidence that we can run a successful study and these are not big trials because of our drug effect size. So I would say it was sort of room to move, probably either way there and we opted to protect our lead program and move forward with 2 studies.

Judah Frommer

That makes sense. And then just 1 on refractory chronic cough. It sounds like you have a plan there. Just curious, I guess, on any read-through you'll be looking for in the P2X3 readout kind of around midyear and if that could impact the program?

Jennifer Good

So it's interesting. That should read out in the third quarter. Obviously, important for patients. I do think our strategy is a bit different. We're going after treatment failure patients. The only read through there, I think probably particularly Jim will be interested in is kind of what did their placebo effect look like. I think we hope the trial works, sort of work or not work. I don't think it really impacts what we're doing. We will look at some of the trial details. I don't know that those will all be available in the third quarter. It may come later as they publish the data. But that's probably the most interesting thing. I don't know, Farrell, Jim, anything you'd add? No.

James Cassella

No, I think that's right.

Operator

Next question comes from Annabel Samimy with Stifel.

Jayed Momin

This is Jayed on for Annabel. Congrats on the progress. I had 2 questions. The first 1 is just related to cash runway. It is sufficient for Phase IIb in RCC, the Phase IIb in non-IPF and a 12-week readout of IPFCC. Does that mean 24-week data, it doesn't cover 24-week IPFCC readout?

David Hastings

Yes. So that's correct. This will get us through, obviously, those key clinical milestones you outlined. And as I mentioned, look, it's important that the company is always appropriately capitalized and we'll make sure that the funding will be there for all our key clinical studies.

Jennifer Good

And Dave, can I just add 1 thing, history because I've been around this. I think what changed here fundamentally from our FDA meeting is that the FDA wants 52 weeks of controlled safety. So we have to keep our placebo arm on and placebo for 52 weeks, which means we can't readout that 24-week endpoint, until the end. So that's been a little bit of shift in the requirement. If we could read it out at 24 weeks, we would be able to cover all this. But now that we've got to leave that study blinded and go all the way to the end, that's where a little bit of this gap shows up. Having said all that, we're still nailing down exactly the non-IPF ILD plan and all that.

David Hastings

Yes. Also, I'd just like to add, I mean, strategically, we could deploy the cash differently, right? But I think expanding the indications is important as well. So that's why getting the non-IPF ILD study going and getting data there is also very important.

Jayed Momin

My other question was regarding secondary endpoints in the IPF pivotal trial. What are you guys thinking? Or is there any color you can give there?

James Cassella

Sure. This is Jim. So it's very important in this program that we get the patient perspective. The primary endpoint is objective cough monitor. Of course, we use the same thing in the CORAL study. But also some of the PROs that we developed and used in the CORAL study, we'll be bringing forward into the Phase III program. These are primarily centered around patient perception of cough frequency, cough severity. We also have some very interesting data that came out of the CORAL study in terms of potential impact on subject perception of breathlessness, and so we are moving that up into a key secondary category because we have some very interesting findings there. And of course, it's a very important measure because patients do feel breathless after these coughing periods. So we think that's a very important endpoint. It's something that the patients are very concerned about.

Jennifer Good

And Jim, that's one of the things we'll share at ATS.

James Cassella

Yes, we have some great data to share at ATS. So I'm spilling the beans a little bit.

Jennifer Good

Just only...

James Cassella

Only a little bit.

Operator

Our next question comes from Alexa Deemer with Cantor Fitzgerald.

Alexa Deemer

Congrats on the great year. This is Alexa on for Josh. So 2 quick questions from me. The first being, do you expect the label dose in RCC to be the same as in IPF? And if not, do you expect to procure additional IP for dosing in RCC. And then the last question I have is, do you plan on sharing data from the RCC study this year?

Jennifer Good

Yes. So I'll take that. Alexa, hi, by the way. So the label dose, that's part of what Jim's mission is. He's going to go off and figure that out. When you look at the crossover data, it appears that, that whole effect is there at the lowest dose, very early. And by 1 week, the first time we measured it. I think there's sort of a mechanistic reason of why that may be true that you need less drug. And so Jim is going to be really exploring the lower end of that dose range along with the QD dose we're going to look at actually. So we've sort of told Jim, once he figures out what's the appropriate dose, we'll figure out the strategy. And if we do end up below this dose range we're in now, there will be additional IP because there will probably be some new formulation work that needs to be done, which we're actually working on in parallel. So that was good. Your second question, I'm sorry, what was that?

Alexa Deemer

Just if you plan on sharing data from the RCC study?

Jennifer Good

Yes. Sorry, I didn't -- I only wrote the S part of that, and then I couldn't remember what that meant. Yes. So we have built in the sample size reestimation. We won't get all the way to the end of the RCC trial this year. We are targeting getting to that sample size reestimation readout by later this year. So we will hope to do that. When we initiate the study formally, we'll lay out guidance for both -- for that milestone as well as the full trial readout.

Operator

Our next question comes from Serge Belanger with Needham.

Serge Belanger

So a follow-up regarding the secondary endpoints. I think in your prepared comments, you mentioned the larger of the Phase III studies was powered to further with secondary endpoints to be included in the label. Just curious if that was an FDA request or it's a strategic decision by the company. And second question, just whether there was any discussion at the End-of-Phase 2 meeting regarding orphan drug designation or that's a conversation that takes place separately at a later time.

Jennifer Good

Go ahead, Jim.

James Cassella

I'll take the first part of that question. So it's really a strategic question, Serge, because the FDA is looking for 52 weeks of controlled data, safety data. And in that study because it has to run longer, it's most efficient that we sort of build in a little bit more into that study. So obviously, that's a study that contains our 24-week primary endpoint of fixed dosing. And also because we have -- we will meet our -- basically our safety database requirement for the 52 weeks on drug, it was easier and more efficient to build in all of our key secondary endpoints. Remember, I mentioned these are PROs. So they're not quite as clean a signal. They have a little bit more variability, add a little bit more end to the study. It was most efficient to build all that into the larger Phase III study. And then the second study is really just confirmatory with the 12-week endpoint. So it's really a matter of efficiency and strategy that we did it that way.

Jennifer Good

Jim, we proposed that, FDA didn't make us do it, right? This is our proposal search, and they agreed with it. As far as the orphan drug question, it's a good question. We are going to file this year an application for orphan drug. As you've heard me say before, I'm skeptical whether we'll be able to get it because we're -- while IPF is orphan, we are looking at chronic cough in IPF, which is largely viewed as 1 of the most difficult chronic cough conditions. So they're probably going to look at that and realize that if it works in IPF chronic cough, it could work more broadly, but that's a question we want to answer. I don't want to assume that. So we will file. We'll ask the question. We wanted to get aligned with the FDA on our program first. So now that we've done that, we'll work to submit that application and get an answer to that question.

Operator

[Operator Instructions] Our next question comes from Ryan Deschner with Raymond James.

Ryan Deschner

You had any recent feedback since your big 2025 data readouts from either patients or physicians suggesting increased awareness of Haduvio or your programs in general, which might be able to inform on expectations for enrollment demand for the IPF chronic cough pivotal study and then I have 1 more question.

Farrell Simon

Yes, Ryan, this is Farrell. So we've been doing a lot of work over the summer in terms of just understanding physicians' behaviors and key drivers of just liking. And what really comes up to the top of the list is the efficacy that was shown. So we've seen an increase in physician understanding. We've also been really active with the patient advocacy groups in the U.S. and ex U.S. environment, so that we understand how we can work with them to better support patients. This all nicely flows into the work that Jim and his team are doing in terms of clinical trial awareness and our team have our sights set on that. But we'll give a lot more details on the insights in the Investor and Analyst Day come May.

Jennifer Good

Yes. I would say, as you know, Ryan, we are going to be entering the U.S. with these trials. And we've been staying close to that group. And while we've hosted receptions, we have a lot of these physicians show up in lobby. Jim and myself are getting entry into the trial. We've had good response time, right, on all our sites. So there's good awareness of our drug, our program, the unmet need. I think I'm excited about the enrollment curves here. I think we can do a good job.

Farrell Simon

There's a lot of excitement as we reach out to the sites in the U.S. Clearly, very high interest in participating in this drug trial.

Ryan Deschner

And then maybe quickly from a more general perspective. Are you anticipating meaningful read through your programs regarding the relatively new developments to FDA related to plausible mechanism, increased emphasis on Bayesian trial design or even recent turnover at the department.

Jennifer Good

I would say no. I mean, that's what the beauty of this, Jim, you chime in. But the End-of-Phase 2 meeting, we have a very clear path forward, and that's the playbook we're going to execute against. I think fortunately, the division -- or the acting Division Director was very active in our meeting. So we know she's bought in and solid with that. There's going to be a lot of churn -- or there is churn going on in the leadership roles, we're not sort of under that branch. So I don't foresee that really affecting what we do because we're going to have our heads down for the next 2 years, executing the plan that was agreed to. So I don't know, Jim, anything you want to add?

James Cassella

No. Other than that, I think you hit the nail on the head. We work with the division. The division was very clear on what the expectations are for the approval of a drug for cough, which they were very enthusiastic about. They see the Division Director really talked about the need here and the burden on the patients. So I think that was very clear. We have clear line of sight with this division on what needs to get done. I think that's the most important step that we're going to work towards.

Operator

Our next question comes from Brandon Folkes with H.C. Wainwright.

Brandon Folkes

Congrats on all the progress. Maybe just 2 for me, if that's all right. How do you think about moving forward into a Phase III in RCC in terms of timing post the Phase IIb? Do you expect to make a decision just in terms of sort of the second indication to market, where perhaps post that Phase IIb in RCC, we could see a bigger focus on the non-IPF-ILD as the second indication to market given the commercial overlap and then also the fact that you're probably going to get off-label use in RCC.

Jennifer Good

So that's not the motivation. I would say, obviously, our lead indication is IPF. And I would say our second indication is ILD because they're attached at the hip. I do think, though, ILD, the non-IPF ILD and RCC are both going to be sNDAs. So they would be fast follow-on. So when IPF got approved, we would look to be in a position to file both of those really very closely together. I think if there was ever a resource issue on time, ILD would get prioritized because we'll be launching into those centers, and it makes a lot of sense with IPF. So yes, I think we think about the priorities internally, it's IPF, ILD, it's sort of close cousin. RCC, we will move along urgently, though. That is a big unmet need. I think our drug has shown good data there. And there's no reason we can't have that ready to go as soon as our IPF drug gets approved. We believe there's only going to be one Phase III trial to run on the heels of our IIb. So we'll be prepared to keep this moving.

Brandon Folkes

Great. And then secondly, coming back to the Phase III in IPF chronic cough, can you just remind us or help us think about what's your thinking on the placebo effect in the longer 24-week duration?

James Cassella

That's a great question. Really that question. I think we -- our CORAL study gave us a really good indication of the placebo response. We had about a 17% placebo response in terms of objective cough. We saw the response in our subjects come in within the first couple of weeks. And then it was a pretty steady response over that time for the active drug. Placebo was sort of bouncing around that range. It's a slightly smaller study. I don't think we think about it any differently going forward. I think that we are something that we need to figure out. I think we're sufficiently powered to find out what the effect is but it really is an unknown at this point, and we're going to find that out both in the 12-week trial and then in the longer trial. So I think it's a stay tuned. I think we're well powered to handle any perturbations around what that placebo response is. I think our primary endpoint -- our trial is powered over 90% for the primary and the key secondary endpoint. So we built in some safety net there as you would for a Phase III trial. But I think we're going to all find out together.

Operator

Our next question comes from Debanjana Chatterjee with Jones.

Debanjana Chatterjee

So sorry if I missed this and you've already clarified, but could you comment on the internal expectations around pace of recruitment and enrollment completion in the Phase III IPF cough trial? And I have a follow-up.

James Cassella

Yes. We have good solid data from our CORAL study to lay out some expectations for recruitment. Given the size of the first Phase III, the larger one, we're expecting that enrollment should be about a year to enroll the trial. We're anticipating something between 80 and 100 sites. So I think with those kinds of parameters, the vast majority of those centers will be focused in the U.S., which I think offers all these PFF excellent care centers, where there are large numbers of patients. So I think the 1-year expectation is reasonable for a trial like that.

Debanjana Chatterjee

So are you assuming for 1 year to recruit and then you have to follow patients for 52 weeks for safety reasons. So by the time, this is potentially approved, there could be other IPF drugs such as United Therapeutics' Tyvaso or BMS' admilparant that's potentially out there. Will you need to do additional, like Phase I drug-drug interaction studies to file?

James Cassella

Depends on when those drugs get approved, theoretically, we would probably have to do a DDI study to make sure there's no effects on the PK. We do know from the mechanisms, whether or not we expect to see some kind of drug-drug interaction there. I think it will be a matter of timing. If we're done with our recruitment phase, then we're continuing the running of the study, then obviously, we won't need to bring in any more patients. So I think it's a matter of timing, Deb, and we'll see what happens. But it's not a big deal to do a Phase I study, DDI study. So I wouldn't see that as a barrier.

Operator

Our next question comes from William Wood with B. Riley Securities.

William Wood

So 2 for me, 1 upfront. So just thinking about in terms of your ILD study, you've mentioned that you're going to do an adaptive design. And I believe in the past, you've mentioned that you're going to stay away from sarcoidosis. But apart from that, how should we think about how your inclusion criteria could look? And should we really expect that to look into all sort of ILDs, including differential forms of pneumonia, just sort of discuss how we should think about that, if you would. And then I have a follow-up.

James Cassella

Yes. We actually had a very insightful meeting with a group of KOLs last year. And it comes down to that -- the commonality that all these patients have, even though they may have different comorbid diseases is that they all have interstitial lung disease to a varying degree. They have a certain amount of scarring, that scarring can get worse over time, and they all have cough, whatever percentage that is. So what we came to was that there wouldn't be any basket-type trial where we're picking them based on the diagnosis that they have. We're going to base it on amount of fibrosis that they have and the amount of cough that they have. So I think it really minimizes it to the core essentials, and we think that the fibrosis is probably leading to the cough anyway. So it really does get to the fundamental issues. Now that doesn't mean we won't have to deal with comorbid conditions and conmeds and things like that. We'll work out those details, but I think that's the essence of the trial.

William Wood

Makes sense. And then in terms of -- the FDA is sort of continually evolving. And so I was just curious if there's been any viewpoint change on how they're seeing nalbuphine potentially scheduling or not scheduling and just sort of if there's been any updates and interpretation there?

Jennifer Good

I would say, William, we provided our human abuse potential study. We provided our data from our respiratory safety study, we had a consult on the meeting from controlled substance staff. It was a very constructive meeting. I would say, I think all of our interpretation is. FDA is less focused on the molecule because that's already unscheduled and focused on our formulation and whether there is anything unique about it that could change the profile around that. Our data has not showed that. Jim did a really nice job of doing a cut around their various terms. They'll look at the end of the study and there just isn't much there. So I've been living this ride from the beginning. And I would say I just continue to have stronger and stronger conviction that this drug will stay unscheduled. So nothing in the End-of-Phase 2 to change that. I would say very relaxed tenor around that generally and clear guidance about what they're interested, which quite honestly, was more around dependence than it was addiction. So I don't know, Jim, anything you want to add?

James Cassella

Yes. No, but that's a good point. I think we laid out for them to plan on how we would pull together the data to support the conversation at the NDA time. So there's clearly very good datasets that need to be generated with the guidance of VA and CSS, where they put out these terms for adverse events that are related to these abuse terms. But as Jen said, there was a lot of discussion or meaningful discussion around observing whether or not there's physical dependence and withdrawal. Just for a point of reference, that's a label issue, not a scheduling issue. So again, there's 2 different aspects of this that they're interested in. So not that we expect to see any of that but that would be label as opposed to scheduling.

Operator

Our next question comes from Kaveri Pohlman with Clear Street.

Unknown Analyst

This is Christian. I'm on for Kaveri today. So you've mentioned that the 1-year IPF Phase III safety data set could start to teach you about things like dyspnea, exacerbations, hospitalizations and maybe even lung function trends over time. Will any of those be prespecified analyses? And what data would actually change how you think about the label or launch strategy?

James Cassella

Yes. So there's a lot of things that we're going to be tracking. We are seeking approval for cough. I think that's first and foremost, we have to support that label. I think the 1 thing that we mentioned previously is that cough patients really do have concerns about shortness of breath. So we are moving breathlessness into the key secondary endpoint, that's clearly related. We are clearly going to be capturing data that would relate to these other things that you're referring to. So we do FVCs, we do other things, we'll look at hospitalizations. These are going to be patients living with their disease is a terminal condition. So we'll be tracking those things as well over the course of the year.

Unknown Analyst

Got it. I appreciate the color. And I just have 1 more regarding Phase III IPF population. You've previously mentioned that you would be -- you would like the population to be as real world as possible and that it would be like the Phase IIb population, but with some broadening efforts. Could you possibly talk about which parts of the patient population you're intentionally broadening into versus the Phase II CORAL study?

James Cassella

So there's a lot of carryover from the CORAL study. The CORAL study was really a great study in setting us up for this, not only in terms of dose ranging, but in terms of understanding the patient population. So we are broadening that. We're making as real world as possible, which is clearly what the FDA wants. There will be patients who are on background antifibrotic medications. That was true in CORAL. This is going to be true here. We don't have a cough count requirement coming into the trial. That was true in CORAL. That is true here. The FDA actually mentioned that nobody expects to find cough monitors in doctors' offices when the patients are going there. We actually have some more data that will be coming out at ATS that looks at minimum cough levels, and there was an arbitrary cutoff around 10 coughs per hour. There was some concern about maybe capping those. We are going to cap the number of coughs coming in under 10 coughs per hour. That came out of the CORAL study. So we're learning the CORAL study, but really it's a very similar population to that study.

Operator

Thank you. I'm showing no further questions at this time. This concludes our question-and-answer session. I would now like to turn the conference back to Jennifer Good for any closing remarks.

Jennifer Good

We appreciate you joining us for today's call. I know for all of you guys, this is getting to the end of your earnings season, so you're tired. We look forward to sharing our continued progress in the second quarter as we initiate clinical trials as well as at our Investor and Analyst Day in May as well as ATS. Thank you.

Operator

Thank you. This concludes today's conference call. Thank you for attending. You may now disconnect.

Investor releaseQuarter not tagged2026-03-11

Trevi Therapeutics to Report Fourth Quarter and Year End 2025 Financial Results and Provide Business Updates on March 17, 2026

GlobeNewswire

Conference call and webcast to be held at 4:30 p.m. ET NEW HAVEN, Conn., March 10, 2026 (GLOBE NEWSWIRE) -- Trevi Therapeutics, Inc. (Nasdaq: TRVI), a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine ER) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC), today announced that senior management will host a conference call and live audio webcast on Tuesday, March 17, 2026, at 4:30 p.m. ET, to provide business updates and review the Company's financial results for the fourth quarter and year ended December 31, 2025. Conference Call and Webcast To register for the live conference call and webcast, please visit the ‘Investors & News’ section of the Company’s website or access directly at ir.trevitherapeutics.com/news-events/events. Please note for phone participants: Once registered, you will receive an email with unique call-in details. An archived replay of the webcast will also be available for 30 days on the Company's website following the event. About Trevi Therapeutics, Inc. Trevi Therapeutics, Inc. is a clinical-stage biopharmaceutical company developing the investigational therapy Haduvio™ (oral nalbuphine extended-release) for the treatment of chronic cough in patients with idiopathic pulmonary fibrosis (IPF), non-IPF interstitial lung disease (non-IPF ILD), and refractory chronic cough (RCC). Haduvio is the first and only investigational therapy to show a statistically-significant reduction in cough frequency in clinical trials across both patients with IPF chronic cough and in patients with RCC. Haduvio acts on the cough reflex arc both centrally and peripherally as a kappa agonist and a mu antagonist (KAMA), targeting opioid receptors that play a key role in controlling chronic cough. Nalbuphine is not currently scheduled by the U.S. Drug Enforcement Agency. Chronic cough in patients with IPF and non-IPF ILD is a condition with high unmet need and no FDA-approved therapies. There are ~150,000 U.S. patients with IPF, and two-thirds of these patients are faced with uncontrolled chronic cough. Additionally, there are ~228,000 U.S. patients with non-IPF ILD, with 50-60% having uncontrolled chronic cough. The impact of chronic cough is significant, with patients coughing up to 1,5...

Investor releaseQuarter not tagged2026-01-23

Trevi Therapeutics Reports Positive Results on Treatment for Chronic Cough; Shares Rise

MT Newswires

Trevi Therapeutics (TRVI) reported positive results from the Phase 2b trial of oral nalbuphine ER fo

Investor releaseQuarter not tagged2025-11-14

Trevi Therapeutics Inc (TRVI) Q3 2025 Earnings Call Highlights: Strategic Advances Amid ...

GuruFocus.com

This article first appeared on GuruFocus. Net Loss: $11.8 million for Q3 2025, compared to $13.2 million in Q3 2024. R&D Expenses: Decreased to $10.1 million in Q3 2025 from $11.2 million in Q3 2024. G&A Expenses: Increased to $3.8 million in Q3 2025 from $2.9 million in Q3 2024. Cash and Investments: Approximately $195 million as of September 30, 2025. Cash Runway: Expected to extend into 2028. Warning! GuruFocus has detected 2 Warning Sign with TRVI. Is TRVI fairly valued? Test your thesis with our free DCF calculator. Release Date: November 13, 2025 For the complete transcript of the earnings call, please refer to the full earnings call transcript. Trevi Therapeutics Inc (NASDAQ:TRVI) reported positive data readouts from both the coral trial for chronic cough in IPF patients and the river trial for RCC patients. The company successfully raised approximately $115 million in June, providing a cash runway into 2028. Recent phase one studies showed no clinically meaningful changes in pharmacokinetics when nalbuphine was co-administered with standard IPF treatments. An external safety review committee found no safety signals in the respiratory function study, allowing the completion of enrollment. Trevi Therapeutics Inc (NASDAQ:TRVI) is financially strong, with cash and investments totaling approximately $195 million as of September 30, 2025. Trevi Therapeutics Inc (NASDAQ:TRVI) reported a net loss of $11.8 million for the third quarter of 2025. R&D expenses decreased due to reduced clinical trial work, but G&A expenses increased due to higher professional fees and personnel costs. The company anticipates needing to conduct additional drug-drug interaction studies based on the mechanism of drug metabolism. The FDA requested a specific respiratory safety study despite existing data from 200 IPF patients, indicating regulatory hurdles. The company faces the challenge of aligning with the FDA on the phase 3 program design and other parameters for chronic cough in IPF patients. Q: Have you narrowed down the inclusion and exclusion criteria for the non-IPF ILD study, particularly regarding what constitutes chronic cough, and will any ILDs be excluded from the initial study? A: James Cassella, Chief Development Officer, explained that the criteria will be similar to those for IPF, focusing on the amount of cough and lung fibrosis. They are not planning to exclude an...

As of 2026-05-18 • Updated weeklySource: Earnings sourceIngestion runbook