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Acadia Pharmaceuticals Inc (ACAD) Q3 2021 Earnings Call Transcript
By Motley Fool Transcribers – Nov 9, 2021 at 1:30AM
NASDAQ: ACAD
Acadia Pharmaceuticals
(0.05%) $0.01
ACAD earnings call for the period ending November 8, 2021.
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Acadia Pharmaceuticals Inc (ACAD 0.05%)
Q3 2021 Earnings Call
Nov 8, 2021, 4:30 p.m. ET
Prepared Remarks
Call Participants
Good day, ladies and gentlemen, and welcome to the Acadia Pharmaceuticals Third Quarter 2021 Financial Results Conference Call. My name is Gigi, and I'll be your coordinator for today.
I would now like to turn the presentation over to Mark Johnson, Vice President of Investor Relations at Acadia. Please proceed.
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Mark Johnson -- Vice President, Investor Relations
[Technical Issues] today's call to discuss Acadia's third quarter 2021 financial results. Joining me on the call today from Acadia are Steve Davis, our Chief Executive Officer, who'll provide an overview of our Q3 2021 financial performance and a review of our business operation. Also joining us today is Brendan Teehan, our Chief Operating Officer and Head of Commercial, who'll provide updates on our commercial performance. Dr. Serge Stankovic, our President will discuss our pipeline progress; and our Interim Chief Financial Officer, Mark Schneyer will then discuss our financial results in more detail before turning it back to Steve for final remarks and opening the call for your question. I would also like to point out that we are using supplemental slides, which are available on the Events and Presentation section of our website.
Before we proceed, I would first like to remind you that during our call today, we'll be making a number of forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements including goals, expectations, plans, prospects, growth potential, timing of events or future results are based on current information, assumptions and expectations that are inherently subject to change and involve a number of risks and uncertainties that may cause actual results to differ materially. These factors and other risks associated with our business can be found in our filings made with the SEC. You are cautioned not to place undue reliance on these forward-looking statements, which are made only as of today's date.
I'll now turn the call over to Steve.
Stephen R. Davis -- Chief Executive Officer
Thank you, Mark. Good afternoon, everyone and thank you for joining us today. I'd like to start with a quick recap of our commercial performance followed by regulatory update for pimavanserin and a preview of our upcoming catalysts.
Please turn to Slide 4. First, I'd like to take a moment to remind everyone of our announcement last week that Brendan Teehan has been promoted to the position of Chief Operating Officer and Head of Commercial. Brendan has been a tremendous leader for our team, and I'm very excited to be able to further leverage his deep experience and strong capabilities. While Brendan will take you through our commercial update in greater detail in a minute, let me just say that on a macro level, the Parkinson's disease market continues to be significantly impacted as a result of the pandemic.
Despite these challenges, NUPLAZID has outperformed branded drugs in the space and for the third quarter of 2021, NUPLAZID achieved $131.6 million in net sales. This represents a 9% year-over-year increase with sequential and year-over-year volume growth. As shown in the graph on the left, our team has continued to execute with year-over-year and sequential growth each quarter since the beginning of the year. To be more precise, NUPLAZID has outperformed the market basket of top prescribed brands in Neurology and Parkinson's disease in the office-based setting. Similarly, NUPLAZID continued its strong outperformance in the long-term care channel.
Our strong relative performance underscores our team's ability to adapt and find ways to grow our brand. This includes our recently launched branded campaign targeting healthcare providers, which promotes NUPLAZID's unique safety profile specifically as it relates to the Parkinson's community. On the patient and caregiver front, we're in the process of launching a new DTC campaign aimed at solving one of our biggest COVID-related challenges, which is physicians not seeing as many PDP patients in-person. As such, this DTC campaign is aimed at patients and caregivers who are at home and is designed to activate them to have a conversation with their doctor about their symptoms of psychosis and potential treatment with NUPLAZID. Our growth initiatives, new leadership and strong relative performance give us confidence that we'll further accelerate the growth of NUPLAZID into 2022.
Now let's move to our regulatory update regarding our sNDA for pimavanserin on Slide 5. As you recall at our Type A End of Review Meeting, the FDA made it clear that today they are looking at individual subgroups of dementia rather than DRP as a single group. Accordingly, they stated that they believe our best path forward is to conduct an additional study in each subgroup where we seek approval. However, at that meeting, the FDA also stated based on additional analyses [Phonetic] we've shared with them that they are open to having another meeting to discuss whether there is a potential path to resubmission without an additional clinical study in any of the subgroups. This meeting is now scheduled and we expect to be able to report on the results of the meeting around year-end.
When we look at our dementia subgroup data, it is very clear that we have the most data for Alzheimer's disease, which represent somewhere between 60% and 80% of all dementia patients in the U.S. Our database includes two independent clinical studies providing evidence of pimavanserin antipsychotic efficacy in Alzheimer's disease psychosis, Study -019 and the HARMONY Study. Together, these studies demonstrate improvement in psychotic symptoms and reduction of risk of relapse of psychosis in ADP patients. At our upcoming meeting with the FDA, we look forward to sharing additional analyses we've done in response to feedback from the last meeting.
Serge will provide more details on this opportunity in his section. As we look ahead, I'd like to highlight some important near-term catalysts as shown on Slide 6. First, as I've noted, we look forward to providing an update from our meeting with the FDA around year-end. Second, we expect to announce top-line results from LAVENDER, our pivotal Phase 3 study for trofinetide in Rett syndrome later this quarter. And third, we expect to announce top-line results from a Phase 2 proof-of-concept study evaluating ACP-044 in postoperative pain following bunionectomy surgery in the first quarter of 2022. Finally, our Company is well poised for further expansion. We have a healthy balance sheet, a growing revenue base and best-in-class in-house R&D and commercial teams. Business development continues to be a key priority of our strategy and we continue to be very active on that front.
I would now like to turn the call over to Brendan to discuss our commercial performance.
Brendan Teehan -- Executive Vice President, Chief Operating Officer, Head of Commercial
Thank you, Steve. Today, I'd like to review our third quarter performance for NUPLAZID in Parkinson's disease psychosis, please turn to Slide 8. In the quarter, we delivered net sales of $131.6 million. This quarterly performance represents sequential demand growth fueled by new patient starts and continuing patients with strong adherence and compliance rates. I'd like to start with a further dive into the current macroenvironment that we're operating in.
As we've stated previously, the pandemic has disproportionately affected the Parkinson's disease patient population, significantly impacting the market. As shown on the slide, PD office visits and occupancy rates at long-term care facilities are still down significantly from pre-pandemic levels. Despite this, NUPLAZID has continued to grow meaningfully throughout the period with strong relative performance as compared to the overall Parkinson's disease and broader Neurology markets. More specifically, when we compare recent quarterly performance with pre-pandemic performance of 2019, we see the following, in the office-based setting, Carbidopa and Levodopa are down 4% and the top 10 Parkinson's brands on average are down 7% over that time period. And while the top 15 marketed Neurology products are up 15%, NUPLAZID is up fully 28% for that same time period.
Similarly, in the long-term care channel, Carbidopa and Levodopa are down 12% and the top 15 LTC brands are down on average 22%, while NUPLAZID has grown 8%. Perhaps the most important of all of these data points is the Carbidopa and Levodopa total prescription trend. These are the fundamental PD movement disorder medications and they have trended down during the pandemic. This decline clearly signifies just how challenged the PD market has been over the past two years. However, against the backdrop of this environment, NUPLAZID has continued to grow in both channels giving us confidence in our future growth.
We've had to adapt and utilizing novel analytics and thoughtful implementation of our tactics have found new opportunities to grow new patient starts. Our strong relative performance and continued growth across all channels underscores our commercial execution and gives us confidence that our tactics are working and will continue resonating in months ahead. Furthermore, our team is not simply waiting around for the macroenvironment to improve. We are buckling down and working even harder to ensure that we are interacting with in educating physicians, patients and their caregivers on PD psychosis and treatment with NUPLAZID.
Let's turn to Slide 9 to continue the discussion on what we are doing to further grow the brand. To continue to drive brand choice and growth in the second half of the year, we have introduced two new important campaigns, one focused principally on the healthcare provider or HCP audience and the other focused on engaging patients and caregivers. On this slide, I'd like to discuss our new HCP focused messaging platform that educates the treating community on the unique safety profile of NUPLAZID, specifically as it relates to the Parkinson's community. Our campaign is amplified across all promotional channels, including our field teams and is resonating well with HCPs. This messaging incorporates market research insights focused on HCP's treatment goals for Parkinson's patients experiencing psychosis and specifically on NUPLAZID's safety and tolerability profile in light of other important medical consideration. The most notable being the desire to avoid impacting motor function. Our messaging demonstrates a deep understanding of our clinicians' treatment goals by leveraging important clinical data to better educate physicians on NUPLAZID's safety and efficacy profile. While early in the roll-out of this campaign, this messaging is resonating with physicians and we see the opportunity to further increase diagnosis and capture a higher percentage of new PDP patients for NUPLAZID moving forward.
Slide 10 highlights our new direct-to-consumer campaign, which is intended to reach patients and caregivers at home and drive them to their physicians to have conversations about their symptoms of psychosis and treatment with NUPLAZID. This campaign should help solve one of our biggest COVID-related challenges, patients staying at home and not seeing their physicians in-person and therefore not adequately discussing their symptoms or new treatment options. Our campaign has been on air since mid-October. It tells an important patient caregiver-centered story about the impact of PD psychosis. The ad introduces NUPLAZID and its potential treatment benefits to both patients and their families. The ad also includes a critical component of disease awareness to help patients understand and recognize the signs and symptoms and prevalence of psychosis in patients living with Parkinson's disease. With the work our commercial team has been doing executing on the new message platform on the HCP side, this is the perfect time to introduce a new patient-centric campaign, drive new patients to their newly educated doctors and grow the NUPLAZID brand.
Of course, while we expect to see traction in the fourth quarter, the full benefit of these complementary campaigns will be mostly realized in next year's growth. The bottom-line, patients and caregivers are in need of better treatment options such as NUPLAZID and patients and caregivers need to recognize the symptoms of psychosis and its connection to Parkinson's disease. We are confident our campaigns will accomplish this.
I will now turn it over to Serge.
Serge Stankovic -- President
Thank you, Brendan, and good afternoon, everyone. As Steve mentioned, we have had a constructive dialog with the FDA and are looking forward to our upcoming meeting. While we continue to believe that evaluating pimavanserin as a treatment for the broad dementia-related psychosis indication is most appropriate, we understand the FDA's position and are preparing additional analysis [Phonetic] to support pimavanserin as a potential treatment by dementia subgroup.
Let's start the discussion on Slide 12 with an overview of our HARMONY data, specifically looking at the Alzheimer's disease subgroup, which as Steve mentioned is the most prevalent form of dementia. On the left side of the slide is an overview of pimavanserin antipsychotic efficacy observed overall and in the Alzheimer's [Phonetic] disease subgroup in the open-label portion of the HARMONY study, as well as the primary efficacy outcome in the double-blind portion. As we previously noted, HARMONY was not powered to show statistical significance by dementia subgroup. However, we did prospectively plan exploratory efficacy analysis of dementia subgroups. In the Alzheimer's disease subgroups, we see that Alzheimer's disease subjects who remain of pimavanserin were about 40% less likely to experience a relapse of psychotic symptoms compared with those on placebo has shown with hazard ratio of 0.62. Post-hoc analysis of the pimavanserin 34 milligram dose group, the dose currently approved for treating PDP patients showed about 50% risk reduction with a hazard ratio of 0.47.
For context, this magnitude of effect is in line with what has been observed in numerous relapse prevention studies of comparable design for approved drugs in various psychiatric indications such as schizophrenia or depression. In addition, this benefit is further supported by a number of complementary analysis, some examples of which are listed on the right hand side of the slide. These analysis consistently show the antipsychotic efficacy across different endpoints within the Alzheimer's disease subgroup, which clearly support the overall conclusion of the clinically meaningful benefit that pimavanserin demonstrated in the treatment of psychosis in Alzheimer's patients. Furthermore, these additional analysis also demonstrate and confirm pimavanserin's observed antipsychotic treatment effect across all dementia subgroups and thus provide further supportive evidence for the benefit of pimavanserin in Alzheimer's disease psychosis.
Please turn to Slide 13. In the upcoming meeting, we will also discuss with the FDA our positive -019 Study, a randomized, placebo-controlled study of pimavanserin for the treatment of symptoms of psychosis in Alzheimer's disease patients. The primary efficacy outcome was positive with p-value equal to 0.045. In a pre-specified analysis of Alzheimer's disease subjects with more severe psychotic symptoms, the magnitude of efficacy more than doubled with a p-value equal to 0.011.
In response to issues raised in the Complete Response Letter, Acadia has conducted multiple sensitivity and responder analysis that support the primary efficacy conclusion. Note that the responder analysis shown on the right of the slide also demonstrate that pimavanserin had even greater efficacy in those patients with a higher severity of psychosis. To recap, pimavanserin has been evaluated in ADP patients across two independent clinical studies, and in addition to positive and clinically meaningful efficacy has been well tolerated and importantly has not shown negative impact on cognition or motor function. In our next meeting with the FDA, we will share several analysis and a substantial data set demonstrating the potential utility of pimavanserin in the treatment of ADP in order to further examine the potential for resubmission without conducting additional clinical studies.
Now I would like to discuss our pivotal Phase 3 study evaluating trofinetide as a potential treatment for Rett syndrome on Slide 14. LAVENDER is a randomized, double-blind placebo-controlled study in approximately 180 young females age 5 to 20 with Rett syndrome, patients are evaluated for 12 weeks. The co-primary endpoints are Rett Syndrome Behavioral Questionnaire or RSBQ, a caregiver assessment tool and the Clinical Global Impression of Improvement or CGI-I, which is a physician assessment. We are currently on track to announce top-line results by year-end. And importantly, we have agreement with the FDA that positive results from LAVENDER in addition to supportive efficacy data from the previous Phase 2 study and the safety database we are collecting could be sufficient to support a new drug application.
Finally, let me remind you that there is nothing approved for the treatment of Rett syndrome. Rett is a devastating and burdensome disease for both the patients and their caregivers often requiring around-the-clock support. We have had several discussions with the key opinion leaders and experts in the field. They inform us that even a modest improvement of symptoms could make a significant and very meaningful difference in the ability to care for the patients and for their overall functioning. We look forward to announcing the results of this study in the near future.
Slide 15 shows a summary of our Phase 3 program evaluating pimavanserin for the treatment of the negative symptoms of schizophrenia, which includes two pivotal studies, our positive ADVANCE-1 Study and ADVANCE-2 which we initiated in the third quarter of last year. Please turn to Slide 16 for an update on our ACP-044 program. Our ongoing Phase 2 study evaluating ACP-044 for the treatment of postoperative pain following bunionectomy surgery is nearing enrollment completion. However, we now expect the results in the first quarter of 2022. This slight delay is due to slower than expected enrollment with the postponement of many elective surgeries during the summer COVID-19 Delta variant surge. In addition, as a reminder, earlier this year we initiated a Phase 2 study for patients suffering from pain associated with osteoarthritis and plan to provide an update on this study next year.
Slide 17 highlights a brief summary of our ACP-319 M1 PAM program for the potential treatment of schizophrenia and cognitive impairment in Alzheimer's disease. We recently initiated a multiple ascending dose study as our Phase 1 work continues for this program. Turning to Slide 18, at Acadia, we're committed to investing in therapies to address high unmet needs in CNS. Our clinical development pipeline has two late stage Phase 3 programs, as well as multiple early stage program. This year we have initiated multiple clinical studies, including ACP-044 in acute pain in Q1, ACP-044 in chronic pain in Q2, and most recently the ACP-319 multiple ascending dose study.
With that, I'll turn the call over to Mark.
Mark Schneyer -- Senior Vice President, Business Development, Chief Business and Interim Chief Financial Officer
Thank you, Serge. Today, I'll discuss our third quarter 2021 results, please turn to Slide 20. In the third quarter of 2021, we recorded $131.6 million in net sales, an increase of approximately 9% compared to $120.6 million of net sales in Q3 of 2020. Our net sales increase in Q3 2021 represents 3% volume growth year-over-year. The gross to net adjustment for Q3 2021 was 15.2%. Weeks of inventory in the channel at the end of the third quarter was slightly down. As a result, sequential demand growth of approximately 3% was slightly higher than sequential selling growth of approximately 1%.
Moving down the P&L, GAAP R&D expenses decreased to $58.6 million in the quarter compared to $120.1 million in Q3 2020. Recall last year, GAAP R&D expense included the $52.8 million upfront consideration and transaction costs related to our acquisition of CerSci Therapeutics. GAAP SG&A expenses were relatively flat at $81.7 million in the third quarter compared to $81.6 million in the third quarter of last year. Non-cash stock-based compensation expense during the quarter was $15.5 million compared to $21.4 million for the same period in 2020. Our cash balance at the end of the quarter was $540.3 million.
I'll now provide some additional color on our financial expectations and guidance ranges for the remainder of the year, please turn to Slide 21. As we mentioned previously, our commercial team is continuing to execute well and deliver quarter-over-quarter growth with strong relative performance in both channels. As a reminder, in the fourth quarter, we expect a much higher impact from gross to net as a result of accruing for the donut hole obligation associated with year-end inventory in the channel.
In addition, recall that last quarter we guided to gross to net being somewhere around 20% for the full-year. As we get closer to the end of the year, we have narrowed the top end of our full-year 2021 net sales guidance range to $480 million to $500 million from the previous range of $480 million to $515 million. Our net sales guidance assumes that inventory levels remain relatively flat in the channel as we approach the end of the year.
I'd like to provide a little bit more commentary on our net sales guidance. As we saw on Slide 8 of Brendan's presentation, our leading indicators of PD office visits and LTC occupancy rates has started to improve in the first half of the year. However, in the third quarter, they seem to have leveled off or declined. This is a reflection of the COVID-19 Delta variant surge we experienced in the summer. Our net sales guidance range factors and scenarios that depends on how long our leading indicators remain relatively flat versus how quickly they return to grow.
Moving on to the expense side for 2021, we have lowered our GAAP R&D guidance to be between $230 million and $245 million for the full-year from our previous range of $250 million to $270 million. And finally, we have slightly narrowed the top end of our GAAP SG&A full-year guidance range to be between $385 million to $405 million from $385 million to $415 million.
And with that, I'll turn the call back over to Steve.
Thank you, Mark. Please turn to Slide 23. In closing, I'd like to remark on how proud I'm of our teams for their execution this year. Our commercial team has worked tirelessly all year on delivering pimavanserin to more Parkinson's patients and their families who are suffering from the symptoms of psychosis. They've achieved more with less and continue to push through the pandemic conditions. Our R&D team has executed during a time when patient enrollment is difficult. We're now poised to report out on two key clinical studies, Phase 3 results from LAVENDER, our trofinetide study in Rett syndrome and Phase 2 results from our ACP-044 study in postoperative pain. And, of course, we look forward to providing additional clarity regarding ADP around year-end. Finally, I would like to thank all of our employees for their commitment to our mission to elevate life.
I'll now open up the call for questions. Operator?
[Operator Instructions] Please standby while we compile the Q&A roster. Our first question comes from the line of Neena Bitritto-Garg from Citi. Your line is now open.
Neena Bitritto-Garg -- Citi -- Analyst
Hey guys, thanks for taking my question and congrats on the quarter. So just a question about the commercial performance of NUPLAZID. I guess, can you comment at all on the pace of new starts during the quarter versus Q2? And then also just on Q4, just from -- from Mark's commentary just now, it sounds like we should expect a higher gross to net and kind of similar patient dynamics quarter-over-quarter, I guess, should -- is it kind of safe for us to assume that Q4 could actually be kind of a down quarter? Thanks.
Yeah, thanks for the questions, Neena. I'm going to ask Brendan answer the first question and Mark, the second.
Neena, thanks for the question. The question regarding new patient starts in the third quarter, we are seeing new patient starts that are approaching the pre-pandemic levels, so largely comparable in between the quarters. As we head into the fourth quarter with DTC and our increased -- and our efforts with our HCP campaign, we would expect to continue growth moving into 2022.
Thanks, Brendan. Mark?
Yeah, Neena, thanks for the question. I think with the range of scenario -- of guidance that we put out for net sales, there's -- I think what I want to point out is, there is volume growth across that full range. But yes we are with an expected higher gross to net adjustment for the fourth quarter at the lower end of that range, the implication for fourth quarter net sales has got -- reported net sales at the bottom end of the range would be lower than the third quarter reported net sales.
Got it. Thanks, guys. I appreciate it.
Thank you. Our next question comes from the line of Cory Kasimov from JPMorgan. Your line is now open.
Gavin Scott -- JPMorgan -- Analyst
Hi, this is Gavin on for Cory. We had a question actually on DRP regulatory review, Carano [Phonetic] is expected to invest their drug candidate for DRP, but are now planning to launch a Phase 3 next year in ADP specifically, have you had any feedback from the agency about how they're broadly thinking about the DRP setting relative to the independent components as this development would seem to -- to help your case?
Gavin, I didn't hear the second part of that question, could you repeat that part?
I just said that this development would seem to help your case?
Got it, OK, thanks. Well look, we can't obviously comment on what other people's interactions are with the FDA. I would just simply say that the FDA has made it clear to us that they think the correct way to assess this population based upon reviewing our data is on a subgroup by subgroup basis. So that's what we're focused on, that's what we'll be focused on at the next meeting.
Thank you. Our next question comes from the line of Ritu Baral from Cowen. Your line is now open.
Ritu Baral -- Cowen -- Analyst
Hi, guys. Thanks for taking the question. I did want to follow up on that last question, I guess, I was going to ask it a slightly different way. As you approach this meeting and come out on the far side, if the FDA does prove immovable, is an ADP specific trial sort of the best next option, and so far as you clearly have treatment effect, it would just take a well powered study to address as you mentioned 60% to 80% of the overall DRP population? And then further as you plan to discuss -019, can you remind us -- I believe the FDA sort of changed its mind on whether they considered -019 a well-controlled study and I think that was around sort of like the whole quote-unquote, administrative single center aspect of it. Can you remind us of what their interpretation of well-controlled was versus Acadia's conduct of the study? Thanks.
Yeah, thanks for the question, Ritu. I'm going to take the first part, I'm going to ask Serge to answer the -019 portion of the question. Serge, if you have any other comments regarding the HARMONY, please chime in as well. So just to recap very briefly, we received a CRL in April, and through that process and our Type A meeting, the FDA made it clear that they are looking at dementia-related psychosis on a subgroup by subgroup basis as I mentioned a second ago.
At our Type A meeting, we presented data to the -- that was intended to demonstrate both a consistency of response on drug-treated patients versus placebo-controlled patients or placebo-treated patients. And also cluster analyses that broke down the individual components of the SAPS-H+D scale, which was used throughout the study, it's used for enrollment entry criteria, it was used during the 12-week response period and then during the six-month randomized portion of the study.
And when we broke that down on individual components, what we saw again was a very consistency of response irrespective of underlying subgroups. So across each of those elements, patients looked pretty much the same when they came into the study, they looked -- they responded in a very similar way during the 12-week open-label period and then they responded -- those on drug that has responded in a very similar way during the randomized portion of the study.
The one area where we did see difference was in the placebo group on patients that have both comorbid Parkinson's disease and trench [Phonetic] dementia. And in that group, we saw a more rapid relapse in that group relative to patients sub -- placebo patients in other subgroups, and we attribute that to the fact that these patients were taking dopaminergic therapies for their motor function and that is known to, can exacerbate psychotic symptoms.
So at the conclusion of that meeting, the FDA said we get your points, we think you made some valid points, we want to reiterate we think the best way to study this population is on a subgroup by subgroup basis, and we think your best path forward is to run an additional study in each of the subgroups that you were seeking approval, however, didn't get to complete the conversation. It's a one-hour meeting, of course, through dialog back and forth before the meeting, and they said, we would be very open to having another meeting with you if you like to further discuss the potential for resubmitting without an additional clinical study.
And so what we're telling you today is, we think the subgroup where that is -- where there's the greatest potential of doing that is in Alzheimer's disease psychosis. That's the group that was about 70% of the population in our HARMONY study, also epidemiologically it represents about 70% of dementia patients and we also have our Study -019 that Serge will speak to in a second, where we had a very positive result in the Alzheimer's dementia psychosis population. And so for all those reasons, as we said, we're very focused now on this next meeting in taking new analyses that we've done since the last meeting that focuses on the Alzheimer's disease psychosis population. So we look forward to having that meeting, obviously, that's the next step we need to have a meeting, and as soon as we have, we'll be able to give further guidance about next steps. Serge, do you want to address the -019 Study.
Yes, thank you. In respect to -019 Study, just a reminder, our Alzheimer's disease psychosis study that was conducted in the care homes, in a number of care homes in the UK, FDA raised certain issues that in the Complete Response Letter, they expressed concern that makes it difficult for them to consider this study adequate and well-controlled study. These issues by the FDA can be roughly categorized into two buckets, one is related to the design of the study and the others are related to conduct of the study or the protocol deviations that were recorded and reported in the study.
In respect to design, two specific issues were emphasized, one that this is a single center study, and the second is that the secondary outcome measures, there was no Type 1 error control for the secondary outcomes. We believe that we can and intend to address these concerns, particularly from the perspective that in our understanding none of these are requirements for the adequate and well-controlled study. Just as a reminder as I said, this study is done under coordination of a single investigator in the UK, but it was done in a number of care homes or nursing homes throughout the broader UK, London area.
From the perspective of the conduct, we also intend to address not only in detail the, specifically the protocol deviations that are reported, and by the way, they are reported in the study report from very beginning and we discussed them, but we will further elaborate on the specifics and timing and their ability to impact the study per se and the interpretation of the results, but also we will provide a number of additional sensitivity analysis that are intended to demonstrate that these protocol deviations did not impact the overall conclusions of the study in anyway.
So in short, we are -- from the data perspective, we have a level of comfort that we can address these concerns raised by the FDA and that is exactly what we intend to do in the -- in our meeting, as well as in -- eventually in the resubmission. And we believe that following that, this study can and should be considered adequate and well-controlled study and supportive in the overall as an independent evidence of efficacy of pimavanserin in the Alzheimer's disease psychosis.
Got it, thanks.
Thank you. Our next question comes from the line of Charles Duncan from Cantor Fitzgerald. Your line is now open.
Charles Duncan -- Cantor Fitzgerald -- Analyst
Yes, hi, good afternoon, Steve and team. First of all, thanks for taking our question and congrats on a solid quarter. I wanted to ask you one commercial question and then one pipeline question. Regarding the commercial question, I guess I'm thinking about the two new campaigns for HCPs and direct-to-consumer, and I think Brendan suggested that higher percentage of PDP diagnosis would be the goal. I guess I'm wondering if you could provide us some color on where you're at today and where you'd like to be in say 12 months?
Sure. Brendan, go ahead.
Excuse me, Charles, thank you very much for the question. First I'd say, we're excited about both campaigns. The HCP campaign is focused on drawing attention to the ability to improve psychosis while not impacting motor function. We know that our patients are going to see their HCPs principally because of their Parkinson's disease and we need to weave in the story about Parkinson's disease psychosis and the need to treat. We've done market research on the campaign. HCPs are responding very favorably to it. They demonstrate an interest, a higher interest in prescribing NUPLAZID as a function of telling the story that way.
The second campaign more focused on patients and caregivers, you can see in the DTC story, which is to, first of all, highlight NUPLAZID as the solution to Parkinson's disease psychosis, but every bit is importantly to make sure that those patients and caregivers understand that this is a normal part of their Parkinson's disease experience, and thus it's important to bring that situation to their HCP's attention. So we are using those in a complementary fashion. We've been very proud of the DTC campaigns up to now and how that has engaged patients and caregivers with their treaters in that conversation and we're very confident that, that will happen again here.
Okay. And then second question is for Serge on the pipeline, perhaps you just answered this in addressing Ritu's question, but I'm wondering if you could provide us a little bit more color on the new analyses that have been conducted, are they primarily around efficacy or they -- are they around safety? I mean, Brendan just mentioned a lack of impact on motor function and it would seem to me that would be important, as well as cognition in the ADP population. So what kind of analyses have you conducted? And then secondarily, when would you be able to update this, would the meeting happen by the end of the year or would you be in a position to update by the end of this year or so?
Yeah, Serge, please go ahead.
Yes, thanks, Charles. Let me just get one by one. In regard to new analyses, I'll start first of all by stating something that we previously also stated that questions raised in the Complete Response Letter were related to the way of how the efficacy evidence in the patient population should be derived, and the -- as Steve said, what is the appropriate way of evaluating efficacy in dementia patients with psychosis whether as a group or as by dementia subtype.
So as you can imagine, most of the discussion that we have is around that evidence efficacy in patient population. And in this specific case, we are preparing a number of analyses that are specifically designed to whether it's natural to start with a subgroup that is the largest subgroup of Alzheimer's disease psychosis, whether we are providing a broader additional analyses, and I'll comment on that just in a second. But also I don't want to address your question about safety, and that is there were issues related to safety, because the pimavanserin safety profile is unchanged and all the additional data that we have provided in the supplemental NDA did not open any new questions in regard to the safety of pimavanserin.
That calls as well for the certain safety benefit that we see with pimavanserin and that is related to the motor function and specifically in this patient population with dementia to lack of negative impact in -- in cognition -- in cognitive functioning. And, of course, that is a part, it was a part of our supplemental NDA submission, it's also a part of this discussion where we certainly are providing the information in that respect. In regard to specifically Alzheimer's disease psychosis and the additional evidence that, that can be looked at in three -- grouped in three different groups. One is related to the primary and secondary outcome, and that is of the reduction in relapse, as well as reduction in the upper clause [Phonetic] discontinuation in this specific group, where we are providing variety of ways of looking into that analyses and demonstrating the benefit that is clinically meaningful and substantive.
As I mentioned in the prepared remarks, between 40% and 50% reduction, where we're also providing not only the overall in the Alzheimer's group, but also specifically in the larger group of patients that received 34 milligram, which is a dose we -- recommended dose and the approved dose in PDP and recommended dose in DRP or Alzheimer's disease psychosis. Second group analyses is following the -- different ways of measuring severity of psychotic symptoms in all of the patients following randomization either to continue active treatment with pimavanserin or to discontinue pimavanserin and switch to placebo or to placebo. We are following over time, the severity of symptoms in these two groups of patients both on the scale for psychotic symptoms for hallucinations and delusions, as well as in the Clinical Global Impression of Change and Improvement, where we are looking at and demonstrating that patients that remaining on treatment continue -- overall continue with the benefit of pimavanserin in terms of control of psychotic symptoms.
We are also looking on the relationship of the dose and drug exposure, pharmacokinetic exposure and the efficacy of the drug as another way of looking of the -- that the effects that we're seeing and benefit that we're seeing in patients that are receiving pimavanserin is real true effect and not spurious finding. And the third group of evidence is really related to the broader overview of the response across different dementia subtypes and characterization of psychotic symptoms prior to treatment, following the treatment with one purpose, and that is to demonstrate the benefits that we're seeing across the subgroup is another supportive evidence that what we're seeing in Alzheimer's disease psychosis subgroup is a real effect. And finally, I would just mention that we're also looking at categorical presentation of response across different categories of patients, specifically in the Alzheimer's disease psychosis and confirming again both overall and in the 34 milligram group, the substantive evidence of benefit in treating patients with pimavanserin. So I hope this helps on the -- on a broader scale.
Definitely. Look forward to hearing the response from the agency, hopefully, they allocate more than an hour to you and forget about the timing of the response, we'll just hear when we hear it.
Yeah, well, I'm sorry, I will address that, I just slipped my mind. We are saying that we -- meeting is scheduled, we will have the meeting and anticipate that we will receive minutes from that meeting around year-end. Just because we're talking about year-end holidays, it's a little bit difficult for us to confidently say that, that whether we will receive the minutes before the end of the year or maybe just after the end year and therefore, we are characterizing that around year-end.
Very good. Thanks for the added color, Serge.
Thank you. Our next question comes from the line of Yatin Suneja from Guggenheim Partners. Your line is now open.
Yatin Suneja -- Guggenheim Partners -- Analyst
Thank you. Hey, guys, thank you for taking my question. Just a few question on trofinetide. So you guys are looking at two or a co-primary endpoint, could you comment on what sort of agreements you have with the FDA if you hit on one and what exactly you are aiming to show both on RSBQ and CGI-I? And the second question I have is that could you also confirm to us or let us know if all patients have entered the OLE portion of the study or are there any patients who decided to enter -- to not enter the OLE after the 12-week treatment period?
Yeah, thanks much for the question. Serge, do you want to take both of those?
Yeah, thanks, Yatin. First in terms of the co-primary measure, as we have disclosed to actually having the actual data from the study, I think I would hesitate to speculate on different scenarios that may occur, obviously, what we are focused on is obtaining a positive result and statistical separation of both the Rett Syndrome Behavioral Questionnaire Scale and on the Clinician Scale. Rest assured, we are certainly preparing for all different scenarios in the background, but I don't think it would serve any good purpose for us to speculate what would be -- what would happen if it happens.
From the -- on the second point, vast majority of patients -- we, of course, don't provide again the specific numbers, but I can say that vast majority of patients have rolled over into the open-label extension of the study. And therefore, I think that's -- that hasn't been an issue from the perspective of the further safety exposures on the patient -- for the patients in this program.
Got it. Just one more clarifying question on the timeline, could you just maybe let us know how long it might take for you to analyze the data once the trial is completing, just trying to get a sense that if these data could sort of get pushed to January?
I can just say that we are on track to report top-line results from this study before the end year, there hasn't been a change in that respect.
Got it. Good luck with that. Thank you.
Thank you. Our next question comes from the line of Marc Goodman from SVB Leerink. Your line is now open.
Marc Goodman -- SVB Leerink -- Analyst
Serge, you explained nicely what new data you're going to be given to the FDA when you do the meeting, but I'm just curious there were a couple of slides that you went over with us today, has the FDA even seen that data, that subgroup data of Alzheimer's?
Yes, Marc, thanks for the question. We have in the previous meeting discussed some of this, so they have seen some of the data, discussion in the general terms of what we should be providing have been discussed, but some of the output on some of this analyses hasn't. So it's sort of a mixture in that regard. But they have -- we have provided them with a good general idea what direction we are moving in that respect, and we'll be providing much more color in the next meeting in terms of the output and specific data.
Right, OK. And then just separately commercial question, can you just give us a sense of how the reps in the office has just changed relative to second quarter and how -- in the third quarter and then how fourth quarter has changed, just give us a sense of the past four months how that's changed?
Yeah, thanks for the question, Marc. Brendan, do you want to take that?
Sure. Marc, thanks for the question. We have seen improved access rates for our representatives both in the community and LTC setting. So I think we previously reported very much in line with what we've seen in the industry. We're up around 70% of visits being face to face, it varies a little bit between community and LTC, but we are encouraged by what we're seeing so far in the early fourth quarter.
And where were we three months ago?
So we would -- we were reporting in the 60%, 65% range, so it's continuing to arc up.
Maybe just to again say a little bit more, it's very low at the beginning of the year for us and everyone else. And what we've seen in the industry is month by month from the beginning of this year, those numbers were really going up on a very continual and meaningful basis [Technical Issues]. With the Delta variant, you saw that slowdown quite a bit. So where we stand today is, as Brendan mentioned about 70% of our details are in-person, about 30% are virtual. And I think as we see the impact of the Delta variant kind of pull all the way through and you guys are all seeing the same press that we are, I think we're probably approaching that point now, we'll see the impact of the Delta variant pass as well.
Thank you. Our next question comes from the line of Gregory Renza from RBC Capital Markets. Your line is now open.
Gregory Renza -- RBC Capital Markets -- Analyst
Hey, good afternoon, Steve and team. My congratulations on the quarter and thanks for taking my question. Steve, just to follow up on the regulatory update that -- that's expected and as you proceed with engaging the FDA, I know you -- in the past, you have characterized that the stance as more of an agree to disagree position with respect to the totality of DRP versus the subgroups, and I'm just curious, if you can comment quickly on how that's evolved if that changes you're going into the subgroup meeting or the meeting on the subgroup with respect to starting with Alzheimer's disease, and just your level of enthusiasm that that's the right way to proceed with the DRP indication going forward? Thank you very much.
Let me take -- thanks for the question, Greg. Let me take a little bit of running start at it. There is no drug approved to treat dementia-related psychosis, there is no drug approved to treat Alzheimer's disease psychosis, so we're breaking ground. We today have undoubtedly the largest safety database in dementia-related psychosis patients or Alzheimer's disease psychosis patients. In addition, we've done really groundbreaking work in terms of trying to determine how to treat these patients.
Our view has not changed. We still believe that the best way to study this population is looking at dementia-related psychosis as a whole, reasons for that described very thoroughly before.The underlying etiology is relevant as it relates to the dementia itself, but as it relates to psychosis, the symptoms are very similar, they respond in a very similar way, and we think that is the best way to study population. However, in this groundbreaking area, where there is very little data to go on, we understand that reasonable minds [Phonetic] can differ and the FDA does not share that view.
Their view is that we should be looking at things and they should be looking at things on a subgroup by subgroup basis. So recognizing that, we have pivoted to focus on that for the next meeting, describe the history of the CRL dialog we've had, and I would just simply say at this point in time that FDA, this includes the Division of Psychiatry, as well as the Office of Neuroscience have been very engaged. It's a very important topic to them, of course, it's a very important topic to us as well. And together, we expect that this next meeting to come to a conclusion. We are eager to make a decision and move forward. And if they remain engaged in the way that they have been up to this point, I think the prospects are very good. But I'll simply say, again, this is a new area where there's a lot of virgin territory that has not been encountered before. Having said that, when we look at our data in ADP, that is Alzheimer's disease psychosis, we think that data represents a strong case for the utility of pimavanserin from both an efficacy, as well as a safety and tolerability perspective for utility in those -- in that patient population. We need to have that meeting with FDA to see if we can find alignment around that.
Thanks, Steve. I appreciate the color.
Thank you. Our next question comes from the line of Ami Fadia from Needham. Your line is now open.
Ami Fadia -- Needham -- Analyst
Great, thanks for taking my question. I had a follow-up on DRP and want to ask the question in a slightly different way, is the point of contention with the FDA around whether or not there is adequate data in the Alzheimer's disease sub population or whether or not the Phase 2 study can be viewed as acceptable as part of registrational package, if you could give us your best sort of view on that? And then I have a different question.
Well, I'll try to give you a little bit of additional color and then Serge feel free to jump in if anything else you want to add. I think when we designed our Phase 3 program and we aligned with the FDA about how to pursue that program, we and the FDA aligned around a design that was not to study Alzheimer's disease psychosis or dementia with Lewy body psychosis or Parkinson's dementia psychosis, it was to study all of these subgroups as one single group, and so that's the Phase 3 program we ran.
Today, as I've just described, the FDA has a perspective that we should be looking at things or they are looking at things on a subgroup by subgroup basis. And so from that perspective, we're in a situation that is a little bit atypical because we're talking about now a group that was not -- where we did not design the study to show statistically significant data on a subgroup basis, but we have very clinically meaningful results in that subgroup. And Serge described I think very thoroughly, we've looked at things from a multitude of cross-sectional perspectives to see if we have consistency in that data and we do.
We also have our -019 study that was focused on just Alzheimer's disease psychosis patients, we have a positive study there, as Serge has described, we need to have further dialog with FDA around the perspective of that being an adequate and well-controlled study. So that's where the pieces on the chessboard are. We're very eager to have the next meeting with FDA to see if we can align around the data to the data that we have.
Yeah, if I just may add, I think it's very important to remember that with everything that Steve said that we did not set out to study Alzheimer's disease psychosis subgroup or any other subgroup specifically, but more as a group that now that we are aligning out the evidence for benefit in that specific subgroup, this has to be taken in the context of actually us having two positive studies. One positive study is -019 study and the second positive study is DRP study, and looking at the subgroup of Alzheimer's disease psychosis is in the context of the robustly positive overall evidence or efficacy. This is a very different situation that if you would look on the study that failed on its primary analyses and then you're looking at a subgroup and seeing whether there is a benefit in the subgroup, completely different, and from that perspective, much more persuasive and convincing in terms of evidence. So we believe that there is independent evidence to two separate studies demonstrating benefit in this particular subgroup of dementia.
Great, that was very helpful. My second question is on trofinetide, and you answered a question earlier about the co-primary endpoints and the clinical meaningfulness of those, I understand that any type of improvement would be welcome in this patient population, however, as we think about the chronic nature of treatment and the possible requirements of other supportive care for these patients, how would you think about pricing the drug should it get approved?
Yeah, thanks much for the question. I think as much as I'd like to answer the question, I think it would just be premature and imprudent for us to comment on pricing at this juncture. The next step, of course, in that program is to open the envelope, determine the results and if they're -- if we have results that support an application, we'll file it and look forward to moving forward. I would just simply say that as is the case with NUPLAZID, we would seek to price the drug based on the value that we're delivering. It is in the Rett syndrome population, it's a very, very unfortunate situation, where it's -- the extraordinarily high disease burden, and if we can help improve the lives of those patients and their caregivers, we think that'd be very important from a medical perspective.
Got it. I appreciate that. Thank you.
Thank you. Our next question comes from the line of Paul Matteis from Stifel. Your line is now open.
Paul Matteis -- Stifel -- Analyst
Hey, thanks so much. I had a couple of questions on the refiling strategy and just the DRP data in general. I guess one is just kind of related to reconciling one thing we've had trouble wrapping our heads around and that is you speak to patients with DRP presenting similarly and responding similarly, but just going back to the forest plot, the hazard ratio in Parkinson's is around 0.1 and it's a lot higher in other subgroups except for Lewy body. So I was just kind of curious how you explain that and if that is not driven by biological differences and disease in your view?
And then second on the ADP subgroup, can you just speak to statistics or anything around that, that can kind of quantitatively bolster your case. I know you talked about a 40% relapse reduction, but the hazard ratio upper bounds is almost 1.5. So how do you think FDA will view that quantitatively speaking or if there is any sort of p-value that's tied to it? Thanks so much.
Yeah, thanks much for the question. Serge, do you want to take those?
Yes. Let me address first question. Paul you characterized, well, the principal question about the difference that we see in the observed hazard ratio in Parkinson's disease psychosis versus the other subgroups of dementia, like Alzheimer's. And what I think the question is, is that really a reason for the biological difference in the response or there is something else going on here that we could point out to and think of, I will, first of all, say, when you just look to the relapse rates in patients on pimavanserin versus relapse rates in patients on placebo after randomization, what we see actually that relapse rates among dementia subtypes are very similar for the groups on pimavanserin, where the difference really is striking is in placebo where patients are randomized to discontinuation of treatment, it turns out that the Parkinson's disease patients relapse much faster at a faster rate than all other patients from group.
So we thought about that why is that happening, because it's on the active treatment, the relapse rates are fairly similar among different subtypes, and thought about what is unique about Parkinson's disease patients that is not present in other subtype. One thing that is unique is actually dopaminergic therapy, it is dopamine stimulating therapy or replacement therapy that these patients are on, all of them are on that, there is virtually just in the whole sample we have just one that wasn't. And when you look at and what is happening is that there additional sort of a stimulus that while the psychotic symptoms are controlled once you discontinue antipsychotic treatment in these patients, they relapse faster because they have this additional kind of promoting element in their concomitant therapy.
So we have presented -- when we intent to present some additional data to FDA in that regard, because we look this -- there are small samples, obviously, there is very few other patients that are not Parkinson's that are on dopamine stimulating therapy, but we can look at that and look at the patterns, and it seems that there is some confirmation of this hypothesis that we are -- so what we see in our data, it's not about biological difference, it is about confounding related to the concomitant therapy effects that we are seeing in this subgroup. So I hope that helps a little bit with your conundrum and reconciling these different hazard ratios.
And now, I'll ask you in regard to the second part of your question, it escaped my mind, while I was thinking and talking about this. So if you can remind me please?
Yeah, no worries, Serge, and thank you for the thoughts there, that was super interesting. As it relates to the ADP subgroup right, I mean, we see the 40% relapse reduction, but we also see the hazard ratio for the 95% confidence interval, the upper bounds almost 1.5, which would suggest this is really far away from statistical significance or at least there is -- it's telling you there is a ton of, I guess just sample size issue in the data and I'd be kind of curious how you think about that?
Well, the -- as Steve said, the study is not designed to test statistically separation in the subgroups, because we needed to have more patients in each of the subgroups in order to see that as a reasonable power. So confidence intervals that you're seeing are actually simply a consequence of the sample size that we have, smaller the sample size, larger the confidence intervals that you are talking about.
But what we are presenting the body of evidence related to Alzheimer's disease psychosis is a number of different analysis, some of them reached statis -- nominal statistical significance, some doesn't, but what is important point is consistency of that effect. The question is, is the 40% or 50% risk reduction that we are seeing, nobody argued, it's clinically meaningful and robust. The question is, is that a spurious finding or it is a real true effect.
And one way to demonstrate that, if you look to consistency of different analytical approaches, different outcome measures, different time points and point out to that consistency. And, let's say, sometimes it's not significant, sometimes it's significant nominally, because these are -- some of these are post-hoc analysis or not controlled for Type 1 error. But the point is, if you see something consistently, you start to be convinced that it is actually a true effect and true benefit rather than some spurious chance findings.
All right. Thank you so much, Serge.
Thank you. We have time for one more question. Our next question comes from the line of Jeff Hung from Morgan Stanley. Your line is now open.
Jeffrey Hung -- Morgan Stanley -- Analyst
Thanks for taking the question. For ACP-044, can you provide more granularity on when you expect to complete enrollment and when in the first quarter the data might readout? I guess when would you need to have the enrollment completed for the data in January versus data in March, just appreciate any color you can provide. Thanks.
Yeah, thanks so much for the question, Jeff. Serge, do you want to take that?
Yes, happy to. Thanks, Jeff. What I will say is that we -- as I said, we are experiencing some headwinds, but it's a slight delay. We anticipate that we should be completing enrollment before the end of the year, by the end of the year, and therefore by sometimes within the first quarter or toward the end of first quarter, we should have top -line results. That's again as I'm saying is in the context of dependency, particularly sensitivity of this type of elective surgeries and enrollment there is always a certain level of uncertainty, but we are -- that's generally our expectation.
All right. Thank you.
Thank you. At this time, I'm showing no further questions. I would like to turn the call back over to Steve Davis for closing remarks.
Great, thanks much, operator. Thanks again everyone for joining us today. We look forward to updating you on our progress next quarter.
[Operator Closing Remarks]
Call participants:
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Graham Lee works at Facebook, where he helps people make better tests so they can help people make better software. In the past he worked with some other people, and has written books and blogs so he can work with people he hasn't met too. His blog is at sicpers.info.
Mike Lee is an American engineer living in Amsterdam. He has worked with some interesting and even historic project teams, including such titles and company names as Delicious Monster, Tap Tap Revenge, Appsterdam, Obama '08, Black Pixel, Lemurs Chemistry, and Apple. He is currently studying terraforming.
Stay tuned for more announcements and for the call for papers.
Life has been really busy for Chris, Peter, Matt and Max. So busy that the future of UIKonf was uncertain for a while. However, a new team has been found to continue their project.
We are honored and excited to organize the UIKonf 2015. In the last weeks we have been collecting new ideas to make the conference even greater and even confirmed the first speakers. More informations will follow soon.
UIKonf is not just about expanding your skill set. It is also about meeting interesting people and making new connections. Because its participants greatly contribute to the experience of UIKonf, we want you to be able to shape the conference as well. Therefore, we are asking for your feedback.
What did you like about the last two UIKonfs? What could be done better?
Which topics would you like to have covered this time?
And who would you really like to see on stage as a speaker?
Help us make UIKonf awesome and fill out this really short (we promise!) survey.
After our previous post, we heard back from you. Thanks!
We are very excited to announce that three people from the local community will take over UIKonf, and they have already started planning lots of things for the 2015 edition. We can't think of any better team to take UIKonf to the next level than Engin, Maxim and Sabine. All three are passionate developers, and great at organizing things.
As we've built up quite some experience in what works (and more importantly, what doesn't), we'll be there for any advice that they need. Hereby, we hand over all the virtual keys, and are really looking forward to 2015. All of us are very much looking forward to being at next year's edition, and it'll be great to enjoy the conference from the other side of the stage. Here's to Engin, Maxim and Sabine!
Is there going to be a UIKonf 2015?
It's hard to believe that UIKonf happened just a few months ago. Thinking back to it, we're still thrilled. However, the summer break is over now and it's time to look ahead. When we started talking about plans for next year one thing became increasingly obvious: Each of us will have plenty on their plates. So much so, that we don't think we will find the time to run another full-blown UIKonf in 2015. In order to make it live up to our standards, we all would need to invest more time than we have during the next nine or ten months.
UIKonf started as a side project that brought the three of us together: We wanted to see an iOS conference for Europe - a place for the whole community to gather - and at the time there wasn't really one. Now there are a few great options out there. While we did manage to put UIKonf on a stable financial basis, needless to say we didn't run this as a business in a sense that would allow anyone of us to replace our "real" jobs.
To name just a few things that have been keeping us - and will continue to keep us - busy: Matt has become the Director of Engineering of Berlin-based startup Tape.tv, a more-than-full time role. Chris has launched Deckset and is writing a book. Peter runs ThingsCon, curates NEXT Berlin, publishes a magazine. Two out of three also take on client work on the side.
We're mentally prepared to sunset UIKonf. But it would be nicer if the fantastic community could keep going. Which brings us to Option 2: Handing over UIKonf to another team. If you are, or know of, an organization that might want to continue to run and grow UIKonf, we'd like to hear from you. Please send us an email and introduce yourself. For a short time, all options are on the table - let us know what your ideas are!
It's been an incredible journey. (Yes, yes, we hear you say, but bear with us.) We have really enjoyed these last two years of UIKonf, and getting to know all of you. Now we'd like to make sure that this energetic community will keep to have a great place to grow and foster even when we cannot run it ourselves. Help us build it.
Thank you & talk soon.


1932 STUDEBAKER ROCKNE MODEL 75 One of only five 4p coupes known, two in museums. Garaged entire 87 year life. Second owner 36 years. 100% original Colorado car zero rust. Body professionally restored. Complete car less front bumper. NO TEXTING!
1925 STUDEBAKER 2 DR COUPE 100% mohair interior. Flat head 6 cylinder engine. Good condition.
1941 STUDEBAKER 2-DOOR COUPE V-8 engine, automatic transmission, GM subframe with power steering and power disc brakes, performance upgrades, chrome accessories, 10-bolt rear, aftermarket tach and gauges, tilt steering, staggered 15" aluminum Weld wheels.
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1946 STUDEBAKER TRUCK Lot# 0057: 350, auto, 350 Turbo, A/C, PS, PW, complete restoration.
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A Fan-Filled Friday at C2E2 (Chicago Comic & Entertainment Expo)!
This year the Chicago Comic & Entertainment Expo (C2E2) arrived a month early but, so far as we fans were concerned, not a moment too soon! In my humble opinion, this is the best comic fan expo the Windy City has to offer and one that my entire family pines for. That's not surprising as it caters to all facets of fandom; comics, horror, science fiction, and so much more! It also attracts some amazing cosplay and I was so happy that my daughter, Jade, was there all weekend to assist with picture taking. Despite thousands of people showing up, it's organized so well that it runs like a well-oiled machine which means less griping and more shopping. In previous years I've always attended Saturdays only but 2016 would have me showing up on it's opening Friday evening. Ideally, you should devote multiple days to C2E2 as each day has its pros and cons (which I'll delve more into later). I wasn't sure what to expect when we arrived at the McCormick Place at 3:30pm and eagerly made our way inside.
STAR WARS (though always popular in the geek realm) was really riding high this year due to the $uccess of The Force Awakens. As soon as we made it to the expo we encountered the 501st Legion, an international group of fans who wear screen accurate STAR WARS costumes. Here they had their own section complete with a really cool tauntaun bust. Members were there to answer any questions while also illustrating how STAR WARS fandom is a family affair (so writes the man with a son named Luke and daughter named Leia). In this world it's not unusual to see dads dressed as storm troopers, moms as Jedis, and the kids prancing around as Jawas. They also had full-sized LEGO versions of Keylo Ren, Rey and BB-8.
Since this wasn't our first C2E2 experience we knew that the wisest thing to do was get our passes well in advance and to pre-pay for parking. This way we didn't waste any time getting inside the immense main hall. The one big advantage of doing Friday was that there a lot less people and it's easier to navigate. Of course that's a Catch-22 since less people also means less cosplay and many celebrities don't show up till Saturday anyway.
Lots of memories of these guys!
"Five Nights at Freddy's" one of my kids' favorites!
Eventually we needed to give our tired legs a break so we sat a table (another luxury you're hard-pressed to find on a Saturday) and ate a dinner I packed (another smart C2E2 tip). The reason we made a point of showing up on Friday was due to the presence of the talented two sisters from The Hillywood Show; Hilly and Hannah Hindi. They had their own panel scheduled this night and there was no way we were going to miss it! But before that, we wanted to meet them!
Coming Up…The Hillywood Show's C2E2 Panel & the Power of Parody!
This entry was posted in Comics & Superheroes, Convention & Expos, Cosplay and tagged C2E2, Cosplay, STAR WARS. Bookmark the permalink.
← Svengoolie and that Wacky Wrestling Fundraiser!
Thanks for the report and all of the great photos Dave. Next best thing to being there. One of these years I will make it down there. What is the character of the giant "wooden" guy your daughter is posing in front of?
Thanks for the info. I checked them out and I think the Funko Pop version looks better than the one in the movie. Now if we could only get a production Funko Pop Svengoolie like he showed Saturday night.
Yeah, that was great! I'm always amazed by the creativity of his fans.


Hey my Tan Lines Bikini Babes! I have a really fun blog post/photo diary to share with you today with my one of my favorite companies, Ete Swimwear. I also made a video for this collaboration and you can watch that at the end of the blog post, Yay!
Été Swimwear's newest collection is the perfect bohemian, yet beachy mix. The light pastel colors, ruffles, and lace detailing is so beautiful! The pieces of this collection honestly make me wish I was laying on a pure white, sandy beach with a light blue ocean in front of me!
I fell in love with Ete Swimwear a couple years ago and it was always a company that I dreamed of one day working with. Their attention to detail on all of the little things really add up to make these gorgeous pieces of swimwear.
I have worked with Ete two times this year and every time I do, its just so enjoyable! The two collections I have worked with were and are both so amazing and I truly love them!
My personal fave set, as well as something I know I am going to wear often is the, Siena Reversible Bottoms and the Ciara Reversible top. I love the simplistic and seamless design of these two pieces!
I hope you babes enjoyed this blog post & don't forget to watch the youtube video below! Please, Please, Please subscribe! It'll mean the world to me! Thanks for stopping by!
Sep 20 Are you buying cheap swimwear? How to know.


text:
Playing "Hawks' Hockey" key to Nipawin's quest to take final step
By Dave Leaderhouse
Could this be the year for the Nipawin Hawks?
The Hawks advanced to the semi-finals in each of the last two Saskatchewan Junior Hockey League seasons only to be sidelined by the eventual Canalta Cup champion Melfort Mustangs. Two years ago the series was over in five games while last spring Nipawin pushed the Mustangs to the limit before bowing out with a 5-4 setback in the decisive contest.
"The goal every year is to get a championship," says Nipawin head coach and general manager Doug Johnson. "We will have to take it day by day."
The Hawks, who were 38-17-3-2 in the regular season last year, will have to try and improve on those numbers with a bunch of new faces as the club graduated a number of players to the college level.
Gone from last year's line-up are Evan Mignault (Lakehead University), Jayden Piattelli (Simon Fraser), Blake Fournier (Minot State), Ian Wolkowicz (Milwaukee School of Engineering), Gordon Campbell (Selkirk College) and Eric Bolden and Patrick Schmelzinger, both to Elmira College. Also moving on is leading scorer Garrett Dunlop (31-49-80) who was undecided about his hockey future, but is unavailable this year due to age.
The Hawks also traded winger Zach McNeill to Grand Prairie in the off-season and assistant coach Devin Windle left the club to assume the head coaching and general manager duties with the Melville Millionaires.
That's a pretty sizeable turnover, but Johnson is happy with what he has seen at camp and is confident the Hawks will be a threat once again.
"I thought we had a lot of options," said Johnson in assessing the talent pool from camp. "There is a lot of work to do to get them on the same page and to get them ready to play Hawks' hockey."
"It is going to take all 20 players on the ice, and those in the stands, to be ready to play," added Johnson, who will have TJ Millar assisting him this year in place of Windle.
The only area on the team that returns intact is in goal. Kristian Stead was a workhorse for the Hawks last year appearing in 45 games and posting a very respectable 2.51 goals-against average and .912 save percentage. Michael Barabash was a more than capable back-up seeing duty in 18 games and registering a 3.55 GAA.
"Between the pipes better not be an issue – I have to find a piece of wood to knock on," lamented Johnson.
"The defence will be by committee and the offence will be by committee," added Johnson. "It is going to be a total team effort this year and not relying on two or three guys like last year or in past seasons."
Chase Thudium and Keegan Kjargaard are two veteran forwards expected to be back for a third season with the Hawks while Nicholas Reimer, last year's winner of the Roger Neilson Memorial Award, will also return for a third year and should be the anchor on the blueline.
Johnson says Michael Grant, a 19-year-old forward acquired in the Zach McNeill trade with Grand Prairie, is also someone to watch this year in the Hawks' line-up. Nipawin also picked up Tanner Thompson from the Kindersley Klippers in another off-season deal and Johnson is excited to have him in the fold.
It is a fresh start for everyone at this time of the year and if the Hawks can come together as a unit they should be able to challenge once again for a league title. Some mid-season inner turmoil set the Hawks back a bit last year, but Johnson will undoubtedly eliminate any possibility of that recurring again and Nipawin could quite possibly take that next step in their quest for their first championship in over a quarter century.
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Since the Mercy Center Guidelines of the early 1990's, claims have been cut before or near 12 visits per patient. Even though these guidelines were mainly for low back pain, IMEs have continued to use these guidelines inappropriately by applying these guidelines to multiple other health and spinal conditions. This has caused many DCs to implement cash practice programs to minimize interference by 3rd party payers with care recommendations.
USA State Boards and Canadian Provincial Boards are beginning to bring DCs up on charges of over utilization for extended care programs and for the use of x-ray as a diagnostic tool for evaluating presence and amount of subluxation. These ACA proposed and directed local guidelines are often contrary to existing State or Provincial practice laws or are merely Board rulings. Because Health Care Boards have powers above what the Constitution intended, one must often go through a humiliating Board hearing before being able to appeal any Board decisions to the Court system.
In some instances, States have ruled that prepay programs are essentially the same as the provider acting as an insurance company. As Boards begin to evaluate DCs on an "Evidence Based" concept, they are applying literature used in the Mercy Center Guidelines and similar recent published papers to "prove" that a certain number of visits for a certain condition is beyond the "Standard". At this time in January 2002, there are no published trials supporting 6 month programs of care or 1-year programs of care. This creates a very difficult situation for any DC going before his/her Board for utilizing long term care programs.
From this list, one realizes that the 6 presently completed CBP® Non-randomized Control Trials are the 2nd highest type of evidence.
Five CBP® Case studies are in press at JMPT, while the six CBP® Clinical Control Trials are published/accepted/in review at JMPT (2), Archives of Physical Medicine and Rehabilitation (2), the (USA Veterans Administration journal) Journal of Rehabilitation Research and Development, and the European Spine Journal. By anyone ignoring this evidence for long-term care, it can only be considered as a deliberate bias against CBP® in particular and long-term structural care in general.
Curvature be Closely Approximated by an Ellipse? J Orthop Res 1998; 16(6):766-70.
80 Asymptomatic Subjects. J Spinal Disord Tech 2002; 15(3): 213-220.
Neck Pain Subjects. Spine 2004; in press.
These CBP® spinal models are of two types: ideals and averages. The average models have normal values for segmental and global measurements, are based on real live subjects, and have predictive validity (are able to discriminate between pain groups and normal subjects). There has been some backhanded criticism of these studies by persons stating that the Harrisons are too close to their own work, i.e., we must have cheated some how on the data to get in such prestigious journals. This attitude towards CBP® research is an insult to the whole CBP® Research Team, which, besides the Harrisons, includes Rene Cailliet, MD (world's most renown physiatrist), Burt Holland, PhD (Professor of Statistics at Temple Univ.), Tony S. Keller, PhD (Professor of Mechanical Engineering at Univ. Vermont), Bill Jones, PhD (Professor of Mechanical Engineering at Mississippi State Univ.), Tad Janik, PhD (Research Scientist for a Defense Contractor and former Professor at Univ. Alabama in Huntsville), and Stacy F. Harmon, DC, MD (Emergency Medicine, Marion Medical Center in California).
We will use the reported average results of the 6 CBP® Clinical Control Trials as estimates of the need for long-term care.
Clinical Control Trial. Archives Phys Med Rehabil 2002; 83(4): 447-453.
Trial. Archives Phys Med Rehabil 2002; 83(11): 1585-1591.
List (Lateral Translations of the Thoracic Cage). J Rehab Res Devel 2004; in press.
6. Harrison DE, Cailliet R, Betz JW, Haas JW, Harrison DD, Janik TJ, Holland B.
Cage: A Non-randomized clinical Control Trial. Euro Spine J 2004; in review.
Using Table 1, we may hypothesize what it might take to get a typical/average patient to near normal in his/her cervical or lumbar lordosis. For example, if a patient's initial lumbar curve ARA was -18°, then two average programs of CBP® lumbar traction of 38 visits in 3 months, = 76 visits in 6 months, would hypothetically result in two increments of the average improvement of –11.3°, or 2 x (-11.3°) = -22.6° + -18° = -40.6°, which is near the ideal normal lumbar ARA value of -40°. Table 3 gives some average data values applied to multiples of the 5 CBP® published/in review programs. Also Table 3 gives average data for what it might take to reduce trunk list on the AP lumbar view as measured by horizontal displacement of T12 compared to a vertical line up from S2 tubercle.
Curvature be Closely Approximated by an Ellipse? J Orthop Res 1998; 16(6): 766-770.
Evidence. J Manipulative Physiol Ther 2000; 23: 623-644.
Are Posture and X-ray positioning Repeatable?
It is often claimed by IMEs for different insurance companies that posture and x-ray positioning are not repeatable. These IMEs claim that posture and x-ray displacements cannot be used for clinical outcomes. This is in opposition to the Index Medicus literature.
Groups. J Manipulative Physiol Ther 2003; 26(2): 87-98.
head posture. Arch Phys Med Rehabil 1991; 72:877-880.
the head. Surg Rad Anat 1986; 8:169-73.
New Zealand: Spinal Publications, Ltd, 1990.
clinical setting. JOSPT 1993; 17(3):155-160.
17. Lundstrom F, Lundstrom A. Natural head position as a basis for cephalometric analysis.
Am J Orthod Dentofac Orthod 1992;101:244-247.
subjects. Spine 1995; 20(11): 1245-51.
position of the mandible. JOSPT 1984;8(4):179-183.
Vol 1, Spine 3rd ed. Minnesota: Educational Opportunities, 1993.
23. Beck A, Killus J. Normal posture of spine determined by mathematical and statistical methods.
measurements). J Radiol Electrol Med Nucl 1975; 56(suppl 2):402-403.
25. Goff CW. Orthograms of posture. J Bone Joint Surg 1952;34A:115-122.
Can 1 Year Programs be Extrapolated From This Data?
Yes, one could add/augment 4 visits/month for one month, 2 visits per month for 2 months, and/or 1 visit per month for the remaining months to total 6 additional months (to arrive at a 1 Year program).
What If the Patient Has More or Less Initial ARA Compared to Values in Table 3?
a) If the patient's curve ARA measurement is below (in absolute value) the average initial ARA in Tables 1 and 2, then it would be possible to extrapolate the need for 3 programs of 3 months each. For example, if the patient had a kyphotic cervical curve ARA measuring +2°, then 3 programs of 3 months each of CBP® 2-way traction might be needed on average, i.e., +2° + 3(-14.2°) = -40.6°, which is near to the normal of –43°.
b) If the patient's curve ARA measurement is above (in absolute value) the average initial ARA in Tables 1 and 3, then one would be hard pressed to show the need for 2 programs of 3 months each. For example, if the patient had a cervical ARA = -29°, then only one program of 3 months of CBP® 2-way traction would hypothetically get him/her to –43°, i.e., -29° + average improvement of -14.2° in 3 months = -43.2°.
What Technique Must I Practice to Use these Arguments to Support my Care?
Obviously these two Tables are based on CBP® Traction studies. You must be utilizing CBP® Mirror Image® adjusting methods and one of our traction methods to use this data to support your care recommendations.
Our critics have often claimed that (1) x-ray line drawing is not reliable, (2) we are over-utilizing x-ray, and (3) unnecessarily exposing our patients to ionizing radiation. These are all false statements.
and AP Modified Risser-Ferguson. J Manipulative Physiol Ther 2002; 25: 93-98.
These studies not only show high reliability, but our reference sections in each publication indicate that previous studies show high reliability for geometric line drawing on radiographs.
Secondly, in our CBP® Protocol of Care, it is recommended that the Doctor obtain Posture and Radiographic measurements. These measurements are necessary to determine the type of care needed. The frequency suggested for radiography is initial and then follow-up views-measurements at 36 visit intervals. From our 6 published CBP® Clinical Control Trials, the average patients needs 6 months of intensive care to achieve a near normal spinal and postural alignment. This would result in one initial set of x-rays and two follow-up sets. This is a very minimal frequency compared to orthopedic surgeons who often take initial, pre-operative, immediate post-operative, one week, one month, 6 months, and long-term follow-up radiographs for surgery cases. As CBP® protocols are evaluating and monitoring structural spinal changes, so are these orthopedists. Several of the CBP® Research Team (Rene Cailliet, MD, Deed E. Harrison, DC, Donald D. Harrison, PhD, DC, and Tony S. Keller, PhD, &Christopher J. Colloca, DC is being considered in 2004) are members of the International Society for the Study of the Lumbar Spine (ISSLS), of whose members, 2/3 out of 250 world wide, are orthopedic surgeons. These surgeons report at our annual ISSLS meetings that approximately 4-6 radiographs and 1-2 CATSCANs or MRIs are obtained of each patient (before, during, and follow-ups on surgery cases). Their medical radiologists read their films and do not chastise them for obtaining structural information regarding spinal alignment changes.
Lastly, medical x-rays are of very minimal health risks. From Butler [Butler G. Inflight Occupational Exposures to Cosmis Radiation and Magnetic Fields. Air Line Pilot 2000; Jan: 30], one can calculate the routine exposure of airplane passengers and crew. For example, based on 0.60 mSv (= 0.6 x 0.1 rem) per 100 block hours (the mean for a flight between New York City and Athens, Greece), a pilot flying 700 block hours per year would receive an annual occupational exposure of 4.2 mSv (= 0.42 rem). In contrast, a pilot flying 700 block hours on a Chicago-to-San Francisco route (0.41 mSv/100 block hours) would receive an annual dose of approximately 2.8 mSv (= 0.28 rem).
This Chicago-San Francisco dose is 0.28 rem/yr = 280 mrem/yr = 5.4 mrem/wk, while according to Cohen and Lee (Cohen BL, Lee IS. A Catalog of risks. Health Physics 1979; 36(Jun): 707-722.) "smoking a cigarette has the risk equivalent of 7 mrem of radiation , and an overweight person eating a pie a-la-mode runs a risk equal to that of 35 mrem".
It now becomes obvious why our Federal government and Airplane companies (such as Delta) do not tell pilots to stop flying after one year. If a pilot reduces his desserts, he cancels out his equivalent radiation risks!! The government on its website states that a flight from LA to NY and back is approximately worth one chest x-ray due to being in the upper atmosphere. Thus pilots that fly two round trips from LA to NY per week get 2 chest x-rays per week or about 100 per year!! After 10 years, a Delta pilot has 1,000!!
Continuing with risk from x-ray exposure, claims of over-exposure are complete fabrication and personal opinion, which we do not share. The risks of medical x-ray views are so minimal that it is more hazardous to be overweight or drink a soft dink. These facts were put in perspective recently by the late Edward Maurer, DC, DACBR. We reprint his article from Dynamic Chiropractic (http://www.chiroweb.com/archives/08/14/11.html) for the reader's education.
by Edward L. Maurer, D.C., D.A.C.B.R.
Environmental pollution, cholesterol, steroids, drugs, iatrogenic disease, radiation effects, and others, have all been highly visible in the media over the past few years. Near daily announcements are made of items which are purported to be carcinogenic. One begins to wonder if it would be easier to list the things that do not cause cancer.
Radiation health and safety are being discussed at social gatherings, and people are generally more aware of associated risks. Many still have visions of Nagasaki, Hiroshima, Chernobyl, and Three Mile Island whenever radiation is mentioned. Little wonder then that patients frequently ask questions related to the necessity and safety of radiographic procedures. At times simple reassurance will suffice, but often we must attempt to help put things in perspective.
Authorities agree that while no radiation dose level is risk-free, the level used in diagnostic radiology provides low-dose risk and is considered as acceptable to the average individual. According to the 1949 National Council on Radiation Protection and Measurements (NCRP), the definition of permissible dose is: "Permissible dose may then be defined as the dose of ionizing radiation that, in light of present knowledge, is not expected to cause appreciable bodily injury to a person at any time during his lifetime." Since this NCRP statement, the trend in science has been away from the "permissible or acceptable" dose concept to the current "risk" concept. In either approach, the end result is similar, e.g., for the information gained with diagnostic radiology, the radiation risk is minimal.
An interesting article by Cohen and Lee entitled, "A Catalog of Risks," published in Health Physics, provides a look at radiation risk levels, along with other examples of risks associated with various activities and how they translate into loss of life expectancy. It provides the likely results of both general patterns of behavior and one-time occurrences. According to the study: The drinking of one diet soft drink per day reduces life expectancy by two days; ingesting 100 calories per day by drinking regular soft drinks increases body weight by 7 pounds and reduces life expectancy by 210 days. If you are 30 percent overweight you lose 1,300 days; 20 percent overweight 900 days. Unmarried males lose 3,500 days, smokers 2,250.
While accidents in an average job cause 74 days of life loss, a job with radiation exposure carries only a 40 day loss. An average person who receives a lifetime of medical (diagnostic) x-rays, results in a life expectancy loss of six days. Radiation to workers in the nuclear industry lose 0.02 days. Single, individual acts and their associated risks were also reviewed. Smoking one cigarette reduces life expectancy by 10 minutes, eating a calorie-rich dessert by 50 minutes; and the missing of an annual PAP test will cost the average woman 6,000 minutes. One millirem of radiation reduces life expectancy by 1.5 minutes.
This study and many others point out that risks are associated with nearly all activities of daily living. Some can be guarded against, for example, wearing a seat belt, losing weight, stopping smoking, etc., but even these measures will not eliminate all risk. Minimal risk in everything we do during the human experience is near-inherent. While we must constantly work towards the reduction of risk, in all endeavors, we must accept a minimal level as normal. Diagnostic radiology does present risk; but the radiation dose when compared to the benefits of useful information gained, necessary for appropriate treatment selection, is indeed an acceptable trade-off when put into perspective.
In summary, logic must prevail and the use of radiography in chiropractic given the respect that is deserved. Clinical x-rays are of minimal exposure (health risk) and provide the necessary information for doctors interested in structural outcomes.
When Does CBP® Suggest Starting Exercises and Traction?
The care program is 6 months, i.e. from Table 3, the average patient has need of two 3 month programs. If only one 3 month program is needed because the patient has only slight loss of lordosis, and then another 3 months of 2 visits per month can be augmented to arrive at 6 months. This basic "3 month program" could be modified from 3 visits per week for 12 weeks = 36 visits to 4 visits per week for 9 weeks = 36 visits.
i)  Did you find my problem?
ii) Can you fix ME?
iii) How long will it take?
iv) How much will it cost?


Brugada syndrome is an electrical abnormality of the heart that can increase the risk of developing abnormal and potentially dangerous heart rhythms.
Brugada syndrome is an electrical abnormality of the heart that can increase the risk of developing abnormal and potentially dangerous heart rhythms. The condition gets its name from the three Brugada brothers who described the condition in 1992. Characteristic changes can be seen on an electrical recording of the heart (ECG).
Brugada syndrome affects at least 1 in 2000 of the population. It is one of the commonest cause of sudden death in young men in South East Asia (where it is know as Lai Tai).
Most people with Brugada syndrome have no symptoms but palpitation and blackouts can occur. Brugada syndrome is a recognised cause of sudden cardiac death in young adults.
You will need a cardiac ultrasound (echocardiogram) to check your heart structure and function. Sometimes a gene test is required to identify a genetic cause. Some patients require a test where an infusion of a drug (such as ajmaline) is given to identify more subtle changes in the ECG.
If you have Brugada syndrome and features that suggest you are an increased risk such as a history of collapse or you have family member who has died from the condition, then you may be offered an implantable cardioverter defibrillator (ICD).
Brugada syndrome can be inherited from either your mother or father. For that reason we recommend that your immediately family including any brothers and sisters you have be screened for the condition.
It can do, although many people with Brugada syndrome can lead an entirely normal life.
If you have been diagnosed with the Brugada syndrome then a consultation can be offered to you with a local heart rhythm specialist to discuss any further tests or treatment.


Check our guide to measuring your wall. If you have an unusually shaped wall that isn't listed below, get in touch and we'll help.
Measure the full width of your wall from edge to edge and measure the height of both the right and left sides of your wall. We recommend that you measure both sides as the heights of the two sides can often differ. If one side is shorter than the other, select the greater of the two heights.
Measure the width and height of the greatest lengths on your wall only, ignoring any slopes. The mural will be supplied as a full rectangle mural and the slope should be cut away during installation.
If there are any obstacles on your wall, simply measure the entire wall as you would for a full standard wall and cut away the obstacle during hanging.
Measure the diameter, then the size is the diameter*diameter. The mural will be supplied as a squire mural and the extra parts should be cut away during installation.
We recommend that you add an extra 5cm or 2 inches to the height and width of your mural to accommodate any variations in the height and width. Any excess can be trimmed when you hang your mural.
Double your measurements again! If you are in any doubt, add a little extra. It's easy to trim your mural.
Ideally, use a tape measure that is long enough to measure the entire wall.
If you don't want to fill your entire wall, you can order a wall mural to cover only part of it.
If you have any questions, just contact us and we will be happy to help you.


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