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In these countries, pricing negotiations with governmental authorities can take 12 to 24 months or longer after the receipt of regulatory approval and product launch.
−Removed: In order to obtain favorable
−Removed: reimbursement for the indications sought or pricing approval in some countries, we may be required to collect additional data, including conducting additional studies.
+Added: In order to obtain favorable reimbursement for the indications sought or pricing approval in some countries, we may be required to collect additional data, including conducting additional studies.
Furthermore, several European countries have implemented government measures to either freeze or reduce pricing of pharmaceutical products.
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In particular, in many foreign countries, it is required that a product receives pricing and reimbursement approval before the product can be distributed commercially.
−Removed: Many foreign countries undertake cost-containment measures that could affect pricing or reimbursement of our products.
+Added: Many foreign countries undertak e cost-containment measures that could affect pricing or reimbursement of our products .
This can result in substantial delays, and the price that is ultimately approved in some countries may be lower than the price for which we expect to offer our products .
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In addition to any patent protection, we rely on various forms of regulatory exclusivity to protect our products.
−Removed: During the development of our products, we anticipate regulatory exclusivities available upon approval of our products.
+Added: During the development of our products, we anticipate any one of regulatory exclusivities becoming available upon approval of our products.
Implementation and enforcement of regulatory exclusivity, which may consist of regulatory data protection and market protection, varies widely from country to country.
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Thus, we cannot guarantee that another company will not receive approval to market a product candidate that is granted orphan drug exclusivity for the same drug or similar drug and same orphan indication as any of our product candidates for which we plan to file an NDA, BLA or MAA.
−Removed: If that were to happen, our prior approved orphan products may face competition and any pending NDA, BLA or MAA for our product candidate for that indication may not be approved until the
−Removed: competing company’s period of exclusivity has expired in the U.S.
+Added: If that were to happen, our prior approved orphan products may face competition and any pending NDA, BLA or MAA for our product candidate for that indication may not be approved until the competing company’s period of exclusivity has expired in the U.S.
or the EU, as applicable.
For example, in January 2020, the FDA issued a draft guidance to clarify its position on when gene therapy products would be considered the “same” or “different” for purposes of orphan drug exclusivity.
−Removed: The draft guidance notes that if the gene therapy products differ in either the gene transferred by the products (“transgene”) or the vector used to deliver the transgene, then the two gene therapy products are different and could both be approved for same indication.
−Removed: If the transgene and the vector are the same, then the products are likely the “same,” such that the first product approved would gain regulatory exclusivity over the second product.
−Removed: If there are other, lesser differences in the products, FDA would make a case-by-case determination as how to apply orphan exclusivity to the competing product.
+Added: The draft guidance notes that if two gene therapy products differ in the genes expressed by the
+Added: products (“transgenes”) and the vectors used to deliver the transgenes are different, then the two gene therapy products are different and could both be approved for same indication.
+Added: However, there is considerable uncertainty as to the interpretation of these guidelines, if adopted to become final.
+Added: If there are other, lesser differences in the products, FDA would make a case-by-case determination as how to apply orphan exclusivity to the competing product, and it is unclear how such case-by-case determinations would be made.
As illustrated by this draft guidance, orphan drug exclusivity as applied to gene therapy products is an evolving area subject to change and interpretation by the FDA and therefore we cannot be certain as to how the FDA will apply those rules to our products.
−Removed: Even though we have obtained orphan drug designation for certain of our product candidates and even if we obtain orphan drug designation for these or our future product candidates, due to the uncertainties associated with developing biopharmaceutical products, we may not be the first to obtain marketing approval for any particular orphan indication, which means that we may not obtain orphan drug exclusivity and could also potentially be blocked from approval of certain product candidates until the competitor’s orphan drug exclusivity period on its product expires (e.g., seven years in the U.S.).
−Removed: Moreover, with respect to antisense oligonucleotides and gene therapies, it is uncertain how similarity between product candidates designed to treat the same rare disease or condition may be determined on a country-by-country basis and whether the orphan drug exclusivity of a previously approved product can block the approval of a chemically distinct product candidate under regulatory review.
−Removed: The patient population suffering from DMD, LGMDs, Pompe disease, CMT 1A and MPS IIIA is small and has not been established with precision.
+Added: The patient population suffering from DMD, LGMDs, CMT 1A and MPS IIIA is small and has not been established with precision.
If the actual number of patients is smaller than we estimate, our revenue and ability to achieve profitability may be adversely affected.
−Removed: DMD, LGMD, Pompe disease, CMT 1A and MPS IIIA are rare, fatal genetic disorders.
+Added: DMD, LGMD, CMT 1A and MPS IIIA are rare, fatal genetic disorders.
DMD affects an estimated one in approximately every 3,500 to 5,000 males born worldwide, of which up to 13% are estimated to be amenable to exon 51 skipping and up to 8% are estimated to be amenable to exon 53.
LGMDs as a class affect an estimated range of approximately one in every 14,500 to one in every 123,000 individuals.
−Removed: Pompe disease affects an estimated one in approximately every 40,000 individuals.
CMT is a group of peripheral nerve disorders affecting approximately one in every 2,500 individuals.
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For example, we face competition in the field of DMD by third parties who are developing or who had once developed:
−Removed: (i) exon skipping product candidates, such as Wave Life Sciences (notably for exons 51 and 53), Nippon Shinyaku (notably for exon 53), Daiichi Sankyo (notably for exon 45) and Audentes Therapeutics, Inc.
+Added: (i) exon skipping product candidates, such as Wave Life Sciences (notably for exons 53 and 44), Nippon Shinyaku (notably for exon 53), Daiichi Sankyo (notably for exon 45), Avidity pursuing antibody-oligo conjugates for exons 44, 45, and 51, and Audentes Therapeutics, Inc.
(acquired by Astellas Pharma) (notably for exons 2, 51 and 53);
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In addition, while Wave announced its intention to discontinue development of suvodirsen and suspend development of WVE-N531, continued development of one or both of these candidates is possible.
−Removed: In addition, we are aware of many pharmaceutical and biotechnology companies that are actively engaged in research and development using platform technologies that may be viewed as competing with ours beyond and including those companies mentioned immediately above, such as Alnylam Pharmaceuticals, Inc., Tekmira Pharmaceuticals Corp., Deciphera Pharmaceuticals, Ionis Pharmaceuticals, Inc., Roche Innovation Center Copenhagen (formerly Santaris Pharma A/S), Shire plc (now Takeda), Biogen, Moderna Therapeutics, Avidity, Dyne Therapeutics, Stoke Therapeutics and Sanofi.
−Removed: Additionally, several companies and institutions have entered into collaborations or other agreements for the development of product candidates, including mRNA, gene therapy and
−Removed: gene editing (CRIPSR and AAV, among others) and small molecule therapies that are potential competitors for therapies being developed in the muscular dystrophy, neuromuscular and rare disease space, including, but not limited to, Astellas Pharma, Biogen Inc., Ionis, Alexion Pharmaceuticals, Inc., Sanofi, Shire (now Takeda), Eli Lilly, Alnylam Pharmaceuticals, Inc., Moderna Therapeutics, Inc., Akashi, Catabasis, Capricor Therapeutics, Oxford University, Exonics Therapeutics (acquired by Vertex Pharmaceuticals), and Editas Medicine.
+Added: In addition, we are aware of many pharmaceutical and biotechnology companies that are actively engaged in research and development using platform technologies that may be viewed as competing with ours beyond and including those companies mentioned immediately above, such as Alnylam Pharmaceuticals, Inc., Tekmira Pharmaceuticals Corp., Deciphera Pharmaceuticals, Ionis Pharmaceuticals, Inc., Roche Innovation Center Copenhagen (formerly Santaris Pharma A/S), Shire plc (now Takeda), Biogen, Moderna Therapeutics, Avidity, Dyne Therapeutics, Stoke Therapeutics, Fulcrum Therapeutics and Sanofi.
+Added: Additionally, several companies and institutions have entered into collaborations or other agreements for the development of product candidates, including mRNA, gene therapy and gene editing (CRIPSR and AAV, among others) and small molecule therapies that are potential competitors for therapies being developed in the muscular dystrophy, neuromuscular and rare disease space, including, but not limited to, Astellas Pharma, Biogen Inc., Ionis, Alexion Pharmaceuticals, Inc., Sanofi, Shire (now Takeda), Eli Lilly, Alnylam Pharmaceuticals, Inc., Moderna Therapeutics, Inc., Akashi, Catabasis, Capricor Therapeutics, Oxford University, Exonics Therapeutics (acquired by Vertex Pharmaceuticals), and Editas Medicine.
If any of our competitors are successful in obtaining regulatory approval for any of their product candidates, it may limit our ability to enter into the market, gain market share or maintain market share in the DMD space or other diseases targeted by our platform technologies, products and product candidate pipeline.
−Removed: It is possible that our competitors will succeed in developing technologies that limit the market size for our products or product candidates, impact the regulatory approval and post-marketing process for our products and product candidates, are more effective than our products or product candidates or would render our technologies obsolete or noncompetitive.
+Added: It is possible that our competitors will succeed in developing technologies that limit the market size for our products or product candidates, impact the regulatory approval and post-marketing process for our products and product candidates , are more effective than our product s or product candidates or would render our technologies obsolete or noncompetitive.
Our competitors may, among other things:
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and foreign jurisdictions in which we or the operations or assets we seek to acquire carry on business.
−Removed: We have entered into multiple collaborations, including with Roche, Nationwide, Lysogene, Lacerta, Duke University, Genethon, StrideBio and University of Florida.
+Added: We have entered into multiple collaborations, including with Roche, Nationwide, Lysogene, Lacerta, Duke University, Genethon, StrideBio, University of Florida and Codiak BioSciences, Inc.
We may not realize the anticipated benefits of such collaborations, and the anticipated benefits of any future collaborations or acquisitions, each of which involves numerous risks, including:
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collaborators may not properly maintain or defend our intellectual property rights or may use our intellectual property or proprietary information in a way that gives rise to actual or threatened litigation that could jeopardize or invalidate our intellectual property or proprietary information or expose us to potential liability;
−Removed: disputes may arise between us and a collaborator that cause the delay or termination of the research, development or commercialization of our product s or product candidates, or that result in costly litigation or arbitration that diverts management attention and resources ;
+Added: disputes may arise between us and a collaborator that cause the delay or termination of the research, development or commercialization of our products or product candidates, or that result in costly litigation or arbitration that diverts management attention and resources;
collaborations may be terminated and, if terminated, may result in a need for additional capital to pursue further development or commercialization of the applicable product or product candidate;
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Even if we achieve the long-term benefits associated with strategic transactions, our expenses and short-term costs may increase materially and adversely affect our liquidity and short-term net income (loss).
−Removed: Future licenses or acquisitions could result in potentially dilutive issuances of equity securities, the incurrence of debt, the creation of contingent liabilities, impairment expenses related to goodwill, and impairment or amortization expenses related to other intangible assets, which could harm our financial condition.
+Added: Future licenses or acquisitions could result in potentially dilutive issuances of equity securities, the incurrence of debt, the creation of contingent liabilities, impairment of expenses related to goodwill, and impairment or amortization expenses related to other intangible assets, which could harm our financial condition.
For example, in February 2020, we issued and sold 2,522,227 shares of common stock to Roche Finance in connection with the entry into the collaboration agreement with Roche.
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Patient enrollment is affected by factors including:
−Removed: design of the study protocol;
+Added: design and complexity of the study protocol;
size of the patient population;
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In addition, the COVID-19 pandemic may impact patient ability and willingness to travel to clinical trial sites as a result of quarantines and other restrictions, which may negatively impact enrollment in our clinical trials.
−Removed: We may not be able to initiate or continue clinical trials if we cannot enroll a sufficient number of eligible patients to participate in the clinical trials required by the FDA or the EMA or other regulatory agencies.
+Added: We may not be able to initiate or continue clinical trials if we cannot enroll the required eligible patients per protocol to participate in the clinical trials required by the FDA or the EMA or other regulatory agencies.
Our ability to successfully initiate, enroll and complete a clinical trial in any foreign country is subject to numerous risks unique to conducting business in foreign countries, including:
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In addition, the impact of COVID-19 has caused, and may continue to cause, delays and disruptions in some of our clinical trials.
−Removed: The response to COVID-19 by healthcare providers can delay site initiation, slow down enrollment, and make the ongoing collection of data for patients enrolled in studies more difficult or intermittent.
+Added: The response to COVID-19 by healthcare providers can delay site initiation, delay the completion of post-marketing requirements and commitments, slow down enrollment, and make the ongoing collection of data for patients enrolled in studies more difficult or intermittent.
In addition, the pandemic may impact patient ability and willingness to travel to clinical trial sites as a result of quarantines and other restrictions, which may negatively impact the execution of clinical trials.
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In addition, manufacturing or formulation changes to our product candidates often require additional studies to demonstrate comparability of the modified product candidates to earlier versions.
−Removed: Clinical study delays also shorten any periods during which we may have the
−Removed: exclusive right to commercialize our product candidates or allow our competitors to bring products to market before we do, which impair s our ability to successfully commercialize our product candidates and harm s our business and results of operations.
+Added: Clinical study delays also shorten any periods during which we may have the exclusive right to commercialize our product candidates or allow our competitors to bring products to market before we do, which impairs our ability to successfully commercialize our product candidates and harms our business and results of operations.
Results from pre-clinical and early‑stage clinical trials may not be indicative of efficacy in late‑stage clinical trials, and pre-clinical and clinical trials may fail to demonstrate acceptable levels of safety, efficacy, and quality of our product candidates, which could prevent or significantly delay their regulatory approval.
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Some of our clinical trials were conducted with small patient populations and were not blinded or placebo-controlled, making it difficult to predict whether the favorable results that we observed in such trials will be repeated in larger and more advanced clinical trials.
−Removed: For example, on October 3, 2018, Nationwide presented positive results from a Phase 1/2a micro-dystrophin gene therapy clinical trial in four individuals with DMD enrolled in the trial and, on March 25, 2019, we presented nine-month functional and CK data from baseline from these four individuals, and twelve-month CK data from baseline from one of these individuals.
−Removed: In addition, on February 27, 2019, we announced positive expression and biomarker data from the first three-patient cohort dosed in the SRP-9003 gene therapy trial to treat LGMD type 2E, or beta-sarcoglycanopathy and, on October 4, 2019, we announced positive nine-month functional data from these three patients.
+Added: For example, in October 2018, Nationwide presented positive results from a Phase 1/2a micro-dystrophin gene therapy clinical trial in four individuals with DMD enrolled in the trial and, in March 2019, we presented
+Added: nine -month functional and CK data from baseline from these four individuals, and twelve -month CK data from baseline from one of these individuals.
+Added: In June 2020, we announced that functional, safety and tolerability data at twelve-months from baseline from these four individuals had been published in JAMA Neurology .
+Added: In addition, i n February 2019, we announced positive expression and biomarker data from the first three-patient low-dose cohort dosed in the SRP - 9003 gene therapy trial to treat LGMD type 2E, or beta-sarcoglycanopathy and , i n October 2019, we announced positive nine-month functional data from these three patients.
+Added: In June 2020, we announced safety and expression results from three clinical trial participants in the high-dose cohort measured at 60 days, and one-year functional data from three clinical trial participants in the low-dose cohort.
The data is based on small patient samples and therefore may not be predictive of future results.
In addition, we cannot assure that the results of additional data or data from any future trial will yield results that are consistent with the data presented, that we will be able to demonstrate the safety and efficacy of these product candidates, that later trial results will support further development, or even if such later results are favorable, that we will be able to successfully complete the development of, obtain accelerated, conditional or standard regulatory approval for, or successfully commercialize any of such product candidates.
−Removed: Similarly, we cannot provide assurances that data from our ongoing and planned studies with respect to our commercially approved products and product candidates will be positive and consistent or that the interpretation by regulators, such as the FDA or EMA, of the data we collect for our products or product candidates will be consistent with our interpretations.
+Added: Similarly, we cannot provide assurances that data from our ongoing and planned studies with respect to our commercially approved products and product candidates will be positive and consistent or that the interpretation by regulators, such as the FDA or EMA, of the data we collect for our product s or product candidates will be consistent with our interpretations .
Our product candidates may cause undesirable side effects or have other properties that could delay or prevent regulatory approval of product candidates, limit the commercial potential or result in significant negative consequences following any potential marketing approval.
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More restrictive regulations or claims that our product candidates are unsafe or pose a hazard could prevent us from commercializing any products.
−Removed: New government requirements may be
−Removed: established that could delay or prevent regulatory approval of our product candidates under development.
+Added: New government requirements may be established that could delay or prevent regulatory approval of our product candidates under development.
It is impossible to predict whether legislative changes will be enacted, regulations, policies or guidance changed, or interpretations by agencies or courts changed, or what the impact of such changes, if any, may be.
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Responding to requests from regulators and meeting requirements for clinical trials, submissions and approvals may require substantial personnel, financial or other resources, which, as a small biopharmaceutical company, we may not be able to obtain in a timely manner or at all.
−Removed: In addition, our ability to respond to requests from regulatory
−Removed: authorities that involve our agents, third party vendors and associates may be complicated by our own limitations and those of the parties we work with.
+Added: In addition, our ability to respond to requests from regulatory authorities that involve our agents, third party vendors and associates may be complicated by our own limitations and those of the parties we work with.
It may be difficult or impossible for us to conform to regulatory guidance or successfully execute our product development plans in response to regulatory guidance, including guidance related to clinical trial design with respect to any NDA, BLA or MAA submissions.
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Finally, regulatory agencies may not approve the labeling claims that are necessary or desirable for the successful commercialization of our treatment candidates.
−Removed: Even after approval and commercialization of a product candidate, we remain subject to ongoing regulatory compliance and oversight to maintain our approval.
+Added: Even after approval and commercialization of a product candidate, we remain subject to ongoing regulatory compliance and oversight to maintain our
Conducting our confirmatory studies could take years to complete, could yield negative or uninterpretable results or could result in an FDA determination that the studies do not provide the safety and efficacy requirements to maintain regulatory approval.
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Even if the FDA does find our success criteria to be sufficiently validated and clinically meaningful, we may not achieve the pre-specified endpoints to a degree of statistical significance.
−Removed: Different methodologies, assumptions and applications we utilize to assess particular safety or efficacy parameters may yield different statistical results.
+Added: Achieving appropriate statistical power may be challenging for some of the ultra-rare genetically defined diseases we are targeting in our programs, especially if the acceptance of descriptive data is not yet established.
+Added: In addition, different methodologies, assumptions and applications we utilize to assess particular safety or efficacy parameters may yield different statistical results.
Even if we believe the data collected from clinical trials of our product candidates are promising, these data may not be sufficient to support approval by the FDA or foreign regulatory authorities.
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We may not be able to successfully defend patents necessary to prevent competitors from commercializing competing product candidates.
−Removed: Our patent rights might be challenged, invalidated,
−Removed: circumvented or otherwise not provide any competitive advantage.
+Added: Our patent rights might be challenged, invalidated, circumvented or otherwise not provide any competitive advantage.
Defending our patent positions may require significant financial resources and could negatively impact other Company objectives.
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Due to the amount of intellectual property in our various fields of technology, we cannot be certain that we do not infringe intellectual property rights of competitors or other third parties or that we will not infringe intellectual property rights of competitors or other third parties granted or created in the future.
−Removed: Our competitors or other third parties might have obtained, or could obtain in the future, patents that limit, interfere with or eliminate our ability to make, use and sell our products, product candidates or platform technologies in important commercial markets.
+Added: Our competitors or other third parties might have obtained, or could obtain in the future, patents that threaten, limit, interfere with or eliminate our ability to make, use and sell our products, product candidates or platform technologies in important commercial markets.
In order to maintain or obtain freedom to operate for our products and product candidates, we may incur significant expenses, including those associated with entering into agreements with third parties that require milestone and royalty payments.
−Removed: Additionally, if we were to challenge the patent rights of our competitors, we could incur substantial costs and ultimately might not be successful.
+Added: Additionally, if we were to challenge the patent rights of our competitors or otherwise defend against allegations of infringement, misappropriation or related claims, we could incur substantial costs and ultimately might not be successful.
If our products, product candidates , or platform technologies are alleged to infringe or are determined to infringe enforceable proprietary rights of others, we could incur substantial costs and may have to:
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The impact of COVID-19 may also result in delays in processing reauthorizations and modifications to program benefits by insurers, making it difficult for patients to obtain or maintain favorable coverage decisions for our products.
+Added: In addition, the increase in unemployment due to the pandemic has resulted in decreased insurance coverage for many individuals.
These challenges may continue for the duration of the COVID-19 pandemic, which is uncertain, and are expected to reduce our revenue and cash flows.
Clinical trials:
−Removed: The impact of COVID-19 has caused, and may continue to cause, delays and disruptions to some of our clinical trials.
−Removed: The response to COVID-19 by healthcare providers is expected to delay site initiation, slow down enrollment, and make the ongoing collection of data for patients enrolled in studies more difficult or intermittent.
−Removed: addition, patients may be unable or unwilling to travel to clinical trial sites as a result of quarantines and other restrictions, which may negatively impact the execution of clinical trials.
+Added: The impact of COVID-19 has caused, and may continue to cause, delays and disruptions to some of our clinical trials and missing data could undermine data integrity and probability of success.
+Added: The response to COVID-19 by healthcare providers is expected to delay site initiation, delay the completion of post-marketing requirements and commitments, slow down enrollment, and make the ongoing collection of data for patients enrolled in studies more difficult or intermittent.
+Added: In addition, as COVID-19 continues to spread, some participants and clinical investigators may be unable or unwilling to comply with clinical trial protocols.
+Added: For example, quarantines or other travel limitations (whether voluntary or required) have been implemented in many countries, and may impede participant movement, affect sponsor access to study sites, or interrupt healthcare services, which may negatively impact the execution of clinical trials.
Significant delays or disruptions to our clinical trials could adversely affect our ability to timely initiate studies, conduct successful studies, obtain or maintain regulatory approvals, or commercialize our product candidates.
Manufacturing:
−Removed: A prolonged outbreak could lead to delays in the manufacturing of our products and product candidates.
+Added: A significant outbreak at one of our partner sites could lead to delays in the manufacturing of our products and product candidates.
On March 13, 2020, to protect the health of our employees and their families, and our communities, and in accordance with direction from state and local government authorities, we instituted mandatory work-from-home for all employees and contingent workers other than those who are facility-dependent.
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General protective measures put into place at various governmental levels, including quarantines, travel restrictions and business shutdowns, may also negatively affect our operations.
+Added: Further, if the spread of the COVID-19 pandemic continues and our operations are adversely impacted, including due to an outbreak in a facility, we risk a delay, default and/or nonperformance under existing agreements.
The extent and duration of the impact of the COVID-19 pandemic on our stock price is uncertain.
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As the requirements in this area are constantly evolving, we cannot be certain that our program will eliminate all areas of potential exposure.
−Removed: Although compliance programs can mitigate the risk of investigation and prosecution for violations of these laws, the risks cannot be entirely eliminated.
+Added: Although compliance programs can mitigate the risk of investigation and prosecution for
+Added: violations of these laws, the risks cannot be entirely eliminated.
If our operations are found to be in violation of any of the laws described above or any other laws, rules or regulations that apply to us, we will be subject to penalties, including civil and criminal penalties, damages, fines and the curtailment or restructuring of our operations.
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If we are unable to attract, assimilate or retain such key personnel, our ability to advance our programs would be adversely affected.
+Added: On June 26, 2020, Sandesh Mahatme informed the Company of his resignation from his positions as the Company’s Executive Vice President, Chief Financial Officer and Chief Business Officer, effective as of July 10, 2020.
+Added: We have begun a search for a Chief Financial Officer to replace Mr.
+Added: Leadership transitions can be inherently difficult to manage and may cause uncertainty or a disruption to our business or may increase the likelihood of turnover in other key officers and employees.
+Added: If we lose the services of one or more of our senior management or key employees, or if one or more of them decides to join a competitor or otherwise to compete with us, our business could be harmed.
We expect to expand our organization and may experience difficulties in managing this growth, which could disrupt our operations.
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companies and their representatives from paying, offering to pay, promising to pay or authorizing the payment of anything of value to any foreign government official, government staff member, political party or political candidate for the purpose of obtaining or retaining business or to otherwise obtain favorable treatment or influence a person working in an official capacity.
−Removed: In many countries, the health care professionals we regularly interact with may meet the FCPA's definition of a foreign
−Removed: government official.
+Added: In many countries, the health care professionals we regularly interact with may meet the FCPA's definition of a foreign government official.
Failure to comply with domestic or foreign laws could result in various adverse consequences, including:
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If any of these events were to occur or we otherwise fail to comply with applicable regulations, we could incur liability, face overly restrictive regulatory actions or incur other harm to our business.
−Removed: We or the third parties upon whom we depend may be adversely affected by natural disasters and/or terrorism attacks, and our business continuity and disaster recovery plans may not adequately protect us from a serious disaster.
+Added: We or the third parties upon whom we depend may be adversely affected by natural disasters and/or terrorism attack s , and our business continuity and disaster recovery plans may not adequately protect us from a serious disaster.
Natural disasters could severely disrupt our operations, and have a material adverse effect on our business, results of operations, financial condition and prospects.
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We have incurred operating losses since our inception and we may not achieve or sustain profitability.
−Removed: We incurred an operating loss of $118.0 million for the three months ended March 31, 2020.
−Removed: Our accumulated deficit was $2.3 billion as of March 31, 2020.
+Added: We incurred an operating loss of $256.4 million for the six months ended June 30, 2020.
+Added: Our accumulated deficit was $2.5 billion as of June 30, 2020.
Although we currently have two commercially approved products in the U.S., we believe that it will take us some time to attain profitability and positive cash flow from operations.
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Raising funds in the current economic environment may present additional challenges.
−Removed: Even if we believe we have sufficient funds for
−Removed: our current or future operating plans, we may seek additional capital if market conditions are favorable or in light of specific strategic considerations.
+Added: Even if we believe we have sufficient funds for our current or future operating plans, we may seek additional capital if market conditions are favorable or in light of specific strategic considerations.
Any additional fundraising efforts may divert our management from their day-to-day activities, which may adversely affect our ability to develop and commercialize our product candidates.
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Currently, our Amended and Restated Certificate of Incorporation authorizes the issuance of up to 198.0 million shares of common stock.
−Removed: As of March 31, 2020, there were approximately 78.0 million shares of common stock outstanding and outstanding awards to purchase 10.5 million shares of common stock under various incentive stock plans.
−Removed: Additionally, as of March 31 2020, there were approximately 1.8 million shares of common stock available for future issuance under our 2018 Equity Incentive Plan, approximately 0.5 million shares of common stock available for issuance under our Amended and Restated 2013 Employee Stock Purchase Plan, and approximately 1.6 million shares of common stock available for issuance under our 2014 Employment Commencement Incentive Plan.
+Added: As of June 30, 2020, there were approximately 78.4 million shares of common stock outstanding and outstanding awards to purchase 10.0 million shares of common stock under various incentive stock plans.
+Added: Additionally, as of June 30, 2020, there were approximately 5.6 million shares of common stock available for future issuance under our 2018 Equity Incentive Plan, approximately 0.5 million shares of common stock available for issuance under our Amended and Restated 2013 Employee Stock Purchase Plan, and approximately 1.5 million shares of common stock available for issuance under our 2014 Employment Commencement Incentive Plan.
We may issue additional shares to grant equity awards to our employees, officers, directors and consultants under our 2018 Equity Incentive Plan, our 2013 Employee Stock Purchase Plan or our 2014 Employment Commencement Incentive Plan.
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For example, in February 2020, we issued and sold 2,522,227 shares of common stock to Roche Finance in connection with the entry into the collaboration agreement with Roche.
−Removed: We will need to increase our authorized shares of common stock under our Amended and Restated Certificate of Incorporation to support these strategic goals.
−Removed: There can be no assurance that we will be able to obtain shareholder approval to increase the number of authorized shares.
The issuance of additional shares of common stock or warrants to purchase common stock and the perception that such issuances may occur or exercise of outstanding warrants or stock options may have a dilutive impact on other stockholders and could have a material negative effect on the market price of our common stock.
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This activity could also cause or avoid an increase or a decrease in the market price of our common stock or the Notes, which could affect the value of our common stock.
+Added: Unregistered Sales of Equity Securities and Use of Proceeds.
+Added: Defaults Upon Senior Securities.
+Added: Mine Safety Disclosures.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.