Transcript of Video - What You
`Need to Know About Mavenclad
`
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`WORLDWIDE COURT REPORTING & LITIGATION TECHNOLOGY
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`Merck 2052
`TWi v Merck
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`
`Need to Know About Mavenclad
`
`Planet Depos
`Phone: 888-433-3767
`Fax: 888-503-3767
`Email: transcripts@planetdepos.com
`www.planetdepos.com
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`WORLDWIDE COURT REPORTING & LITIGATION TECHNOLOGY
`
`Merck 2052
`TWi v Merck
`IPR2023-00049
`
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`
` RECORDED VIDEO - WHAT YOU NEED TO KNOW ABOUT
` MAVENCLAD
`
`https://www.nationalmssociety.org/Treating-MS/Medications/Mavenclad
`
`Job No.: 514115
`Pages: 1 - 14
`Transcribed by: Lauren Bishop
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`Transcript of Video - What You Need to Know About Mavenclad
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`2
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` DR. AARON MILLER, MD: It's always exciting
`to have a new medication for the treatment of
`multiple sclerosis. In this case, we're going to be
`talking about a new medicine called Mavenclad. The
`scientific name for Mavenclad is Cladribine. And
`Cladribine has been used has been approved to be used
`in patients with relapsing, remitting multiple
`sclerosis and secondary progressive MS with activity.
`So nowadays, we classify multiple sclerosis into
`several different types. One is relapsing remitting
`MS. These are people who have clear cut relapses and
`then a relapse resolves often completely. Sometimes
`leaving some degree of neurological deficit behind
`until another relapse comes.
` At the very first episode of MS, a first
`attack of something that looks like MS, we may refer
`to that as a clinically isolated syndrome, meaning a
`person doesn't meet the criteria for definite MS yet.
`In some cases we may treat patients with CIS with
`certain medicines, but specifically Mavenclad has not
`been approved for the treatment of clinically
`isolated syndrome. Other forms of MS are progressive
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`Transcript of Video - What You Need to Know About Mavenclad
`
`3
`
`disease, and we have two types of progressive
`disease. Secondary progressive disease and primary
`progressive MS. Secondary progressive MS is diagnosed
`in a person who once upon a time had at least one
`relapse and then ultimately the disease course
`changes so that the person is little by little
`getting worse.
` Primary progressive MS refers to a patient
`who from the very beginning had a progressive course.
`Relapses are sometimes superimposed later on but the
`initial course was progressive.
` Nowadays, however, we apply modifiers to
`these Progressive courses depending on whether or not
`an individual has what we refer to as activity.
`Activity could either be clinical activity that is a
`relapse or it could be new lesions on MRI. So the FDA
`in approving Mavenclad for the very first time use
`the term secondary progressive MS with activity so
`that means a person who has been getting
`progressively worse, but in the recent past has had
`either new relapses or new lesions appearing on the
`MRI scan. Interestingly, the FDA did not apply a time
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`
`4
`
`frame for what they meant by activity. Usually
`clinicians will be thinking about activity in the
`relatively recent past. Let's say the past year or
`two, but the FDA specifically did not mention that in
`the prescribing information for Mavenclad.
` Mavenclad is a drug which interferes with
`the synthesis and repair of DNA in certain cells and
`by interfering with these processes, it kills certain
`cells. In particular, it's use in MS has come about
`because the substrate for Mavenclad is particularly
`concentrated in lymphocytes. And so the drug has a
`particularly strong effect in destroying lymphocytes.
`Lymphocytes are a form of immune cells that are
`involved in the MS process and lymphocytes come in
`two major varieties, T cells and B cells. And both of
`these are affected by Mavenclad.
` The treatment regimen for Mavenclad is
`rather unique. So Mavenclad is a -- a tablet. It
`comes as a 10-milligram tablet and the dose of
`Mavenclad is dependent on an individual's weight.
`This is the only MS medicine that we have that is not
`given in a fixed dose but rather the dose is
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`
`5
`
`determined by how much the individual weighs.
`Mavenclad is given in -- in courses so that the first
`course starts at the beginning and you get you get
`two cycles approximately a month apart. So at the
`very beginning, you take a number of tablets over 4
`to 5 days, exactly how many tablets again depending
`on the weight and then you wait between three and
`four weeks to get the -- the second part of that
`course, the second cycle in that treatment phase. And
`after that second course, so now you're roughly one
`month into treatment, then you have the rest of the
`year off and you come back at the beginning of the
`second year and you get another cycle. Again, another
`course rather of two cycles about a month apart with
`the same dose that you got at the beginning. After
`that you don't get any more medicine. Mavenclad by
`the FDA's recommendation is considered a second-line
`therapy. Meaning that the recommendation is that a
`person either have had breakthrough disease on a
`previous therapy or has not tolerated previous
`therapy before Mavenclad is used.
` So in order for a drug to be approved by
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`
`6
`
`the FDA, it has to go through phase 3 testing, the
`last stage of testing which is aimed at determining
`that a drug is effective as well as continuing to
`demonstrate a satisfactory safety profile that would
`allow the FDA to approve the drug.
` So the major phase three trial for -- for
`Mavenclad was known as the CLARITY trial and it
`involved over 1,300 patients. There were three arms
`in that trial. So close to 500 patients in each of
`the three arms. The primary endpoint of the trial was
`looking to see whether there would be a reduction in
`the annualized relapse rate. The number of relapses
`that an average individual had per year.
` So there was a roughly 58 percent
`reduction in the annualized relapse rate for -- for
`Mavenclad compared to Placebo. The investigations
`also looked at what we refer to as confirmed
`disability progression. That is a person who shows a
`worsening of their neurological examination to a
`certain degree specified by the protocol and then
`maintains that degree of worsening at least three
`months later. That's referred to as 3-month confirmed
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`
`7
`
`disease progression. And this was reduced by about 33
`percent in the patients taking Mavenclad. Also the
`use of Mavenclad was associated with an extremely
`robust reduction in MRI activity, both contrast
`enhancing lesions, which reflect active lesions or
`other types of lesions, which developed at some point
`in the period between the prior MRI and the -- and
`the new MRI.
` So this drug is quite -- is quite
`effective and certainly compares favorably with the
`other oral drugs in terms of efficacy. Whenever we
`prescribe a drug for MS, we have to balance the
`potential benefits of the drug. In this case the
`reduction in relapse rate, the far fewer MRI lesions,
`the lower rate of disability progression against what
`are the tolerability issues of the drug and the
`potential -- potentially serious adverse events or
`side effects. Mavenclad appears to be very well
`tolerated. There is a slightly increased rate of
`headache with the drug and there are some slight
`increases in the risks of minor infections and to a
`lesser extent, more severe infections. Other side
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`8
`
`effects that we are concerned about, we need to watch
`out for liver injury. We get baseline liver function
`tests and monitor liver function in patients who are
`on Mavenclad. And one of the infections that we’re
`concerned about is the possibility of shingles which
`is caused by the varicella virus, which is the virus
`that also causes chickenpox. So the incidence of
`shingles is somewhat elevated in patients taking
`Mavenclad.
` So one of the things we do before putting
`a person on this medication is check for their immune
`status to varicella. If they're not immune to
`varicella, we recommend the immunization with
`varicella vaccine and then that because it's a live
`virus vaccine should be given at least four to six
`weeks before one initiates treatment with Mavenclad.
`A rare thing that we need to consider is an entity
`called graft-versus-host disease. Graft-versus-host
`disease is a an unusual situation in which
`transplanted tissue of one type starts to attack the
`recipient’s own tissue. The concern with regard to
`Mavenclad is specifically relates to blood
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`
`9
`
`transfusions. So if a person on Mavenclad needs to
`get a blood transfusion, graft versus host disease
`can prevent -- be prevented fairly simply and readily
`by irradiating the blood that's going to be
`transfused. But that is an important thing to
`remember all be it a relatively unusual situation.
` One of the major concerns that the FDA had
`about the safety of Mavenclad regard -- regards a
`potentially increased risk of cancer. So that's an
`increased risk, but it's a very low increased risk.
`It's also important to note that the cancers that
`occurred with Mavenclad were all different types of
`cancers. We -- the warning about cancer is in a boxed
`warning in the prescribing information, but I think
`it's important that patients understand that this
`does appear to be a very low risk.
` Another concern about Mavenclad is that it
`would have potential risks to a fetus if a woman were
`taking Mavenclad during pregnancy, so we strongly
`advise women not to get pregnant while they're taking
`Mavenclad. They should use effective contraceptive
`means and especially during their active cycles of
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`
`10
`
`Mavenclad, they should use not only a hormonal
`contraceptive but also barrier methods. When the man
`is taking Mavenclad he should avoid impregnating a
`woman until six months after the dose and women
`should not attempt to get pregnant until six months
`after a course of Mavenclad.
` So the testing that we do before a patient
`goes on Mavenclad relate to some of these adverse
`events that we've been talking about. Mavenclad would
`have the risk of activating latent infections. So one
`of the infections that could be reactivated is
`tuberculosis. So we screen patients for tuberculosis.
`Another is hepatitis. So we recommend screening for
`Hepatitis B and Hepatitis C. Mavenclad should not be
`used in patients who are HIV positive. So we should
`screen for HIV prior to the use of Mavenclad. We also
`do routine blood counts and liver function testing.
`Again, we want to make sure that the lymphocyte count
`is at least a thousand prior to the first dose and at
`least 800 prior to the second dose of Mavenclad. And
`that I think pretty much encompasses the baseline
`testing that we want to do in a patient going on
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`
`11
`
`Mavenclad. Of course for a woman we want to make sure
`that she's not pregnant.
` One of our concerns with a number of drugs
`that we use in MS is the risk of a brain infection
`called PML which stands for Progressive Multifocal
`Leukoencephalopathy. That's a mouthful so we will
`stick with PML. PML is caused by a virus that many of
`us live with comfortably. It doesn't do any harm to
`people who are whose immune systems are not
`compromised. PML has not been reported with
`cladribine, with oral cladribine, but it is at least
`a theoretical risk because of the effect on the
`immune system that Mavenclad has. So patients before
`going on Mavenclad should have an MRI test not only
`to assess the status of their MS, but to look for any
`evidence that might exist for PML.
` Many people with MS start on a medication
`and then need to change medication at some point for
`one reason or another. Sometimes we need to do some
`advance planning or at least thinking about the
`timing in making a switch. And it depends not only on
`the drug to which you are switching, but also the
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`
`12
`
`drug that the patient has been on in the first place.
`Now in the case of Mavenclad that the main
`circumstance here would be that we need to have the
`lymphocyte count be up to 1,000. And some of the
`drugs that we -- that the person might have been on
`before Mavenclad may have suppressed the lymphocyte
`count. And so we may need to wait to get that
`lymphocyte count back into the safe range for
`Mavenclad. Mavenclad is generally not recommended as
`an initial therapy because of the safety concerns
`that it have been raised. It is on the market and
`available -- available for prescriptions.
`Unfortunately, like all of the other MS medications,
`it has an enormously high price tag.
` As providers, we only have access to
`average wholesale prices and what was listed for
`Mavenclad as I believe $99,000 so as with most other
`medications, we certainly don't expect that people
`with MS are going to be paying these kinds of prices
`for the drugs. Hopefully their insurer is going to
`cover the drug and the patient hopefully would have a
`relatively small copay. Even with that EMD Serono,
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`13
`
`the manufacturer of Mavenclad has a patient
`assistance program is available -- available. They
`offer co-pay assistance to many patients who are
`commercially insured.
` Decisions about what disease-modifying
`therapy to use are getting increasingly complex.
`That's actually good news because the reason they're
`complex is because we have so many good therapies and
`any therapy -- any choice of therapy entails and
`assessment of benefit versus risk. The benefits, of
`course in reducing MS activity and the risks variable
`depending on the particular medication.
` I think the best thing that a patient
`should do in is have a frank discussion with the
`healthcare provider. They should have an open
`discussion about what we know about the benefits of
`the drug and go over not only the serious risks, but
`any tolerability issues.
` (The recording was concluded.)
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`14
`
` CERTIFICATE OF TRANSCRIBER
` I, Lauren Bishop, do hereby certify that
`the transcript was prepared from the audio recording;
`that said transcript is a true and accurate
`transcription of the audio to the best of my
`knowledge, skills, and ability; and that I am neither
`counsel for, related to, nor employed by any of the
`parties to this case and have no interest, financial
`or otherwise, in its outcome.
`
`
`____________________________
`LAUREN BISHOP
`Planet Depos,
`November 14, 2023
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`Transcript of Video - What You Need to Know About Mavenclad
`
`A
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`Transcript of Video - What You Need to Know About Mavenclad
`
`chickenpox
`8:7choice
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`2:5, 2:6, 11:11
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`12:5, 12:20
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`9:19, 9:22
`E
`each
`6:9effect
`4:12, 11:12
`effective
`6:3, 7:10, 9:21
`effects
`7:18, 8:1
`efficacy
`7:11either
`3:15, 3:21,
`5:19elevated
`8:8emd
`12:22
`employed
`14:7encompasses
`10:21
`endpoint
`6:10enhancing
`7:5enormously
`12:14
`entails
`13:9
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`Transcript of Video - What You Need to Know About Mavenclad
`
`entity
`8:17episode
`2:15especially
`9:22even
`12:22
`events
`7:17, 10:9
`evidence
`11:16
`exactly
`5:6examination
`6:19exciting
`2:1exist
`11:16
`expect
`12:18
`extent
`7:22extremely
`7:3
`F
`fairly
`9:3far
`7:14favorably
`7:10fda
`3:16, 3:22,
`4:4, 6:1, 6:5,
`9:7fda's
`5:17fetus
`9:18fewer
`7:14financial
`14:8first
`2:15, 3:17,
`
`5:2, 10:19, 12:1
`fixed
`4:22form
`4:13forms
`2:22four
`5:8, 8:15
`frame
`4:1frank
`13:14
`function
`8:2, 8:3, 10:17
`G
`generally
`12:9getting
`3:7, 3:19, 13:6
`given
`4:22, 5:2, 8:15
`go
`6:1, 13:17
`goes
`10:8going
`2:3, 9:4,
`10:22, 11:14,
`12:19, 12:20
`good
`13:7, 13:8
`graft
`9:2graft-versus-host
`8:18
`H
`harm
`11:8headache
`7:20healthcare
`13:15
`hepatitis
`10:13, 10:14
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`12:3
`
`hereby
`14:2high
`12:14
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`10:15, 10:16
`hopefully
`12:20, 12:21
`hormonal
`10:1host
`9:2however
`3:12https
`1:10
`I
`immune
`4:13, 8:11,
`8:12, 11:9,
`11:13
`immunization
`8:13important
`9:5, 9:11, 9:15
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`10:3incidence
`8:7increased
`7:19, 9:9, 9:10
`increases
`7:21increasingly
`13:6individual
`3:14, 5:1, 6:13
`individual's
`4:20infection
`11:4infections
`7:21, 7:22,
`8:4, 10:10,
`10:11
`information
`4:5, 9:14
`
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`initial
`3:11, 12:10
`initiates
`8:16injury
`8:2insured
`13:4insurer
`12:20
`interest
`14:8interestingly
`3:22interferes
`4:6interfering
`4:8investigations
`6:16involved
`4:14, 6:8
`irradiating
`9:4isolated
`2:17, 2:22
`issues
`7:16, 13:18
`J
`job
`1:20
`kills
`4:8kinds
`12:19
`know
`1:7, 13:16
`knowledge
`14:6known
`6:7
`last
`6:2
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`K
`
`L
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`Transcript of Video - What You Need to Know About Mavenclad
`
`latent
`10:10
`later
`3:10, 6:22
`lauren
`1:22, 14:2,
`14:13
`least
`3:4, 6:21,
`8:15, 10:19,
`10:20, 11:11,
`11:20
`leaving
`2:13lesions
`3:16, 3:21,
`7:5, 7:6, 7:14
`lesser
`7:22let's
`4:3leukoencephalopa-
`thy
`11:6listed
`12:16
`little
`3:6live
`8:14, 11:8
`liver
`8:2, 8:3, 10:17
`look
`11:15
`looked
`6:17looking
`6:11looks
`2:16low
`9:10, 9:16
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`7:15lymphocyte
`10:18, 12:4,
`12:6, 12:8
`lymphocytes
`4:11, 4:12,
`
`4:13, 4:14
`M
`main
`12:2maintains
`6:21major
`4:15, 6:6, 9:7
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`10:18, 11:1
`making
`11:21
`man
`10:2manufacturer
`13:1many
`5:6, 11:7,
`11:17, 13:3,
`13:8market
`12:11
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`1:8, 1:10, 2:4,
`2:5, 2:20, 3:17,
`4:5, 4:6, 4:10,
`4:16, 4:17,
`4:18, 4:20, 5:2,
`5:16, 5:21, 6:7,
`6:16, 7:2, 7:3,
`7:18, 8:4, 8:9,
`8:16, 8:22, 9:1,
`9:8, 9:12, 9:17,
`9:19, 9:21,
`10:1, 10:3,
`10:6, 10:8,
`10:9, 10:14,
`10:16, 10:20,
`11:1, 11:13,
`11:14, 12:2,
`12:6, 12:9,
`12:17, 13:1
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`2:1meaning
`2:17, 5:18
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`3:19, 9:22
`
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`4:1medication
`2:2, 8:11,
`11:17, 11:18,
`13:12
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`1:10, 12:13,
`12:18
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`2:4, 4:21, 5:16
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`2:20meet
`2:18mention
`4:4methods
`10:2might
`11:16, 12:5
`miller
`2:1milligram
`4:19minor
`7:21modifiers
`3:12monitor
`8:3month
`5:4, 5:11, 5:14
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`6:22, 10:4,
`10:5more
`5:16, 7:22
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`12:17
`mouthful
`11:6mri
`3:16, 3:22,
`7:4, 7:7, 7:8,
`7:14, 11:14
`much
`5:1, 10:21
`
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`18
`
`multifocal
`11:5multiple
`2:3, 2:7, 2:9
`N
`name
`2:5nationalmssociety
`1:10need
`1:7, 8:1, 8:17,
`11:18, 11:19,
`12:3, 12:7
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`14:6neurological
`2:13, 6:19
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`2:2, 2:4, 3:16,
`3:21, 7:8
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`13:7note
`9:11november
`14:15
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`2:9, 3:12
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`5:5, 6:12, 11:3
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`2:10, 3:4,
`5:10, 8:4, 8:10,
`8:16, 8:20, 9:7,
`10:10, 11:3,
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`Transcript of Video - What You Need to Know About Mavenclad
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`11:19
`only
`4:21, 10:1,
`11:14, 11:21,
`12:15, 13:17
`open
`13:15
`oral
`7:11, 11:11
`order
`5:22org
`1:10other
`2:22, 7:6,
`7:11, 7:22,
`12:13, 12:17
`otherwise
`14:9out
`8:2outcome
`14:9over
`5:5, 6:8, 13:17
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`8:21
`pages
`1:21part
`5:8particular
`4:9, 13:12
`particularly
`4:10, 4:12
`parties
`14:8past
`3:20, 4:3
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`3:8, 10:7,
`10:22, 12:1,
`12:21, 13:1,
`13:13
`patients
`2:7, 2:19, 6:8,
`
`P
`
`6:9, 7:2, 8:3,
`8:8, 9:15,
`10:12, 10:15,
`11:13, 13:3
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`12:19
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`2:11, 11:9,
`11:17, 12:18
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`6:14, 7:2
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`2:18, 3:4, 3:6,
`3:19, 5:19,
`6:18, 8:11, 9:1,
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`5:9, 6:1, 6:6
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`14:14
`planning
`11:20
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`11:5, 11:7,
`11:10, 11:16
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`7:6, 11:18
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`10:15
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`8:5potential
`7:13, 7:17,
`9:18potentially
`7:17, 9:9
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`9:19pregnant
`9:20, 10:5,
`11:2prepared
`14:3
`
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`7:12prescribing
`4:5, 9:14
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`12:12
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`10:21
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`9:3previous
`5:20price
`12:14
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`12:16, 12:19
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`3:2, 3:8, 6:10
`prior
`7:7, 10:16,
`10:19, 10:20
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`4:14processes
`4:8profile
`6:4program
`13:2progression
`6:18, 7:1, 7:15
`progressive
`2:8, 2:22, 3:1,
`3:2, 3:3, 3:8,
`3:9, 3:11, 3:13,
`3:18, 11:5
`progressively
`3:20protocol
`6:20provider
`13:15
`providers
`12:15
`putting
`8:10
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`Q
`
`R
`
`quite
`7:9
`raised
`12:11
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`6:12, 6:15,
`7:14, 7:15, 7:19
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`4:18, 4:22,
`5:14reactivated
`10:11
`readily
`9:3reason
`11:19, 13:7
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`3:20, 4:3
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`8:21recommend
`8:13, 10:13
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`5:17, 5:18
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`12:9recorded
`1:7recording
`13:19, 14:3
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`13:11
`reduction
`6:11, 6:15,
`7:4, 7:14
`refer
`2:16, 3:14,
`6:17
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`Transcript of Video - What You Need to Know About Mavenclad
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`referred
`6:22refers
`3:8reflect
`7:5regard
`8:21, 9:8
`regards
`9:8regimen
`4:17relapse
`2:12, 2:14,
`3:5, 3:16, 6:12,
`6:15, 7:14
`relapses
`2:11, 3:10,
`3:21, 6:12
`relapsing
`2:7, 2:10
`relate
`10:8related
`14:7relates
`8:22relatively
`4:3, 9:6, 12:22
`remember
`9:6remitting
`2:7, 2:10
`repair
`4:7reported
`11:10
`resolves
`2:12rest
`5:11risk
`9:9, 9:10,
`9:16, 10:10,
`11:4, 11:12,
`13:10
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`7:21, 9:18,
`
`S
`
`13:11, 13:17
`robust
`7:4roughly
`5:10, 6:14
`routine
`10:17
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`12:8safety
`6:4, 9:8, 12:10
`said
`14:4same
`5:15satisfactory
`6:4say
`4:3scan
`3:22scientific
`2:5sclerosis
`2:3, 2:8, 2:9
`screen
`10:12, 10:16
`screening
`10:13
`second
`5:8, 5:9, 5:10,
`5:13, 10:20
`second-line
`5:17secondary
`2:8, 3:2, 3:3,
`3:18see
`6:11serious
`7:17, 13:17
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`12:22
`several
`2:10severe
`7:22
`
`shingles
`8:5, 8:8
`should
`8:15, 9:21,
`10:1, 10:3,
`10:5, 10:14,
`10:15, 11:14,
`13:14, 13:15
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`6:18side
`7:18, 7:22
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`14:11
`simply
`9:3situation
`8:19, 9:6
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`8:15, 10:4,
`10:5skills
`14:6slight
`7:20slightly
`7:19small
`12:22
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`11:18, 11:19,
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`2:16sometimes
`2:12, 3:10,
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`2:20, 4:4, 8:22
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`5:3, 8:20
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`8:12, 11:15
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`4:12strongly
`9:19substrate
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`3:10suppressed
`12:6sure
`10:18, 11:1
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`11:21
`switching
`11:22
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`2:17, 2:22
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`4:7system
`11:13
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`11:9
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`4:18, 4:19
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`5:5, 5:6
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`12:14
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`5:5taking
`7:2, 8:8, 9:19,
`9:20, 10:3
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`2:4, 10:9
`term
`3:18
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`Transcript of Video - What You Need to Know About Mavenclad
`
`terms
`7:11test
`11:14
`testing
`6:1, 6:2, 10:7,
`10:17, 10:22
`tests
`8:3theoretical
`11:12
`therapies
`13:8therapy
`5:18, 5:20,
`5:21, 12:10,
`13:6, 13:9
`thing
`8:17, 9:5,
`13:13
`things
`8:10think
`9:14, 10:21,
`13:13
`thinking
`4:2, 11:20
`thousand
`10:19
`three
`5:7, 6:6, 6:8,
`6:10, 6:21
`through
`6:1time
`3:4, 3:17, 3:22
`timing
`11:21
`tissue
`8:20, 8:21
`tolerability
`7:16, 13:18
`tolerated
`5:20, 7:19
`transcribed
`1:22transcriber
`14:1
`
`transcript
`14:3, 14:4
`transcription
`14:5transfused
`9:5transfusion
`9:2transfusions
`9:1transplanted
`8:20treat
`2:19treating-ms
`1:10treatment
`2:2, 2:21,
`4:17, 5:9, 5:11,
`8:16trial
`6:6, 6:7, 6:9,
`6:10true
`14:4tuberculosis
`10:12
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`5:4, 5:14
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`2:10, 3:1, 7:6,
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`3:5understand
`9:15unfortunately
`12:13
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`2:14, 10:4,
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`8:19, 9:6
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`3:17, 4:9, 7:3,
`9:21, 10:1,
`10:16, 11:4,
`13:6usually
`4:1
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`vaccine
`8:14, 8:15
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`13:11
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`8:6, 8:12,
`8:13, 8:14
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`4:15versus
`9:2, 13:10
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`1:7virus
`8:6, 8:15, 11:7
`W
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`5:7, 12:7
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`10:18, 10:22,
`11:1warning
`9:13, 9:14
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`8:1we're
`2:3we've
`10:9weeks
`5:8, 8:16
`weighs
`5:1weight
`4:20, 5:7
`we’re
`8:4
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`21
`
`1
`
`whenever
`7:11whether
`3:13, 6:11
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`12:16
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`9:18, 10:4,
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`9:20, 10:4
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`3:7, 3:20
`worsening
`6:19, 6:21
`www
`1:10
`Y
`year
`4:3, 5:12,
`5:13, 6:13
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`12:17
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`12:41,300
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`1:21, 14:15
`2
`2023
`14:15
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`6:2233
`7:1
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`6:9
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`3
`
`5
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`
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`Transcript of Video - What You Need to Know About Mavenclad
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`22
`
`514115
`1:2058
`6:14
`800
`10:20
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`8
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`PLANET DEPOS
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