Investor Presentation - genkyotex.com · Investor Presentation Page 8 Immuno-oncology therapies not...

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Investor Presentation January 2019 Inhibiting NOX enzymes to treat multiple diseases with high medical need Euronext: GKTX

Transcript of Investor Presentation - genkyotex.com · Investor Presentation Page 8 Immuno-oncology therapies not...

Page 1: Investor Presentation - genkyotex.com · Investor Presentation Page 8 Immuno-oncology therapies not as effective in highly fibrotic tumors Cancer associated fibroblasts (CAFs) oppose

Investor Presentation

January 2019

Inhibiting NOX enzymes to treat multiple diseases with high medical need

Euronext: GKTX

Page 2: Investor Presentation - genkyotex.com · Investor Presentation Page 8 Immuno-oncology therapies not as effective in highly fibrotic tumors Cancer associated fibroblasts (CAFs) oppose

Disclaimer

This document has been prepared by Genkyotex (the "Company") and is for information and background purposes only.

While the information contained herein has been prepared in good faith, neither the Company, nor its shareholders, directors, officers, agents, employees, or advisors give, havegiven or have authority to give, any representations or warranties (express or implied) as to, or in relation to, the fairness, accuracy, reliability or completeness of the informationin this document, or any revision thereof, or of any other written or oral information made or to be made available to any interested party or its advisers, including financialinformation (all such information being referred to as “Information”), and liability therefor is expressly disclaimed. Accordingly, neither the Company nor any of its shareholders,directors, officers, agents, employees, affiliates, representatives or advisers take any responsibility for, or will accept any liability whether direct or indirect express or implied,contractual, tortuous, statutory or otherwise, in respect of the accuracy or completeness of the Information or for any of the opinions contained herein or for any errors, omissionsor misstatements or for any loss, howsoever arising from this document.

The information and opinions contained in this document are provided as of the date of this document only and may be updated, supplemented, revised, verified or amended,and thus such information may be subject to significant changes. The Company is not under any obligation to update the information or opinions contained herein which aresubject to change without prior notice.

The information contained in this document has not been subject to independent verification and are qualified in their entirety by the business, financial and other informationthat the Company is required to publish in accordance with the rules, regulations and practices applicable to companies listed on the regulated market of Euronext in Paris,including in particular the risk factors and other information in the Company’s Document de référence (Registration Document) registered by the French Autorité des marchésfinanciers (Financial Markets Authority) (the “AMF”) on April 27, 2018 under no. R. 18-037, and in any other periodic report, which are available free of charge on the websites ofthe Company (www.genkyotex.com) and the AMF (www.amf-france.org).

No representation, warranty or undertaking, express or implied, is made as to the accuracy, completeness or appropriateness of the information and opinions contained in thisdocument. The Company, its subsidiaries, its advisors and representatives accept no responsibility for and shall not be held liable for any loss or damage that may arise from theuse of this document or the information or opinions contained herein.

This document contains information on the Company’s markets and competitive position, and more specifically, on the size of its markets. This information has been drawn fromvarious sources or from the Company’s own estimates which may not be accurate and thus no reliance should be placed on such information. Any prospective investors mustmake their own investigation and assessments and consult with their own advisers concerning any evaluation of the Company and its prospects, and this document, or any part ofit, may not form the basis of or be relied on in connection with any investment decision.

This document contains certain forward-looking statements. These statements are not guarantees of the Company's future performance. These forward-looking statements relateto the Company's future prospects, developments and marketing strategy and are based on analyses of earnings forecasts and estimates of amounts not yet determinable.Forward-looking statements are subject to a variety of risks and uncertainties as they relate to future events and are dependent on circumstances that may or may not materializein the future. Forward-looking statements cannot, under any circumstance, be construed as a guarantee of the Company's future performance and the Company’s actual financialposition, results and cash flow, as well as the trends in the sector in which the Company operates, may differ materially from those proposed or reflected in the forward-lookingstatements contained in this document. Even if the Company’s financial position, results, cash-flows and developments in the sector in which the Company operates were toconform to the forward-looking statements contained in this document, such results or developments cannot be construed as a reliable indication of the Company's future resultsor developments. The Company does not undertake any obligation to update or to confirm projections or estimates made by analysts or to make public any correction to anyprospective information in order to reflect an event or circumstance that may occur after the date of this document.

By reading or otherwise accessing this document, you agree to be bound by the foregoing limitations.

Page 2Investor Presentation

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Positive PBC interim efficacy data released on November 5 2018 - Full data expected in Spring 2019

Genkyotex: Establishing NOX inhibition as a new therapeutic class

Page 3

We discover and develop oral small molecule NOX inhibitors

— NOX enzymes are important since they control multiple stress responses pathways simultaneously

— Activation of NOX enzymes is key in many multifactorial diseases

Lead asset GKT831: a potent anti fibrotic oral small molecule currently in Phase 2 testing

— Two Phase 2 trials ongoing in liver fibrosis (PBC) and kidney fibrosis (DKD)

— NIH sponsored Phase 2 trial in idiopathic pulmonary fibrosis (IPF) to be launched in H1 2019

— Further potential in NASH and immuno-oncology

PBC trial: Positive interim efficacy results released November 5th, final results expected in Spring 2019 – over 75% of patients have completed the full 24 week treatment

Partnership with Serum Institute of India Private Ltd (SIIPL) valued at up to €150 million plus royalties

Trading on Euronext Paris & Brussels: GKTX - founded in 2006 in Geneva, Switzerland

— Cash and cash equivalents of €12.8 million as of September 30 2018, cash runway to end Q1 2020

Investor Presentation

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Seasoned management team with international life sciences experience

Page 4Investor Presentation

Elias Papatheodorou

Chief Executive Officer

25 years of experience in biotechnology and multinational companies

Ex- Philip Morris International, The Coca Cola Company, Novosom AG, MedigeneAG and Covagen AG

Covagen was acquired by Janssen Pharmaceuticals, a J&J Company.

Strong track record in fundraising, business and corporate development andlicensing transactions

Philippe Wiesel

Chief Medical Officer & EVP

Lead clinical research programs at Serono’s EU and US offices, including the phase3 program (ex-US) for Raptiva in psoriasis, leading to the first EMA approval of abiologic agent for psoriasis

Conducted basic research in the laboratories of Professor Edgar Haber at HarvardMedical School, and of Professor Hans Brunner at the Division of Hypertension inLausanne

Alexandre Grassin

VP Finance & Administration

Diverse experiences in Finance with Novartis from 2007-2010 and Alexion from2010 to 2012

Financial Auditor with KPMG

Investor Presentation

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Discovery platform delivers broad pipeline in diseases with high medical needPositive PBC interim efficacy data released on November 5th 2018 - Full data in Spring 2019

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GKT831 - Liver Fibrosis(NOX1/4 inhibitor)

Primary Biliary Cholangitis (PBC)(Positive interim efficacy data released November 5th 2018)

GKT831 - Kidney Fibrosis(NOX1/4 inhibitor)

Diabetic Kidney Disease (DKD) in T1D(IIT1 funded by JDRF2 - Trial launched in H2 2017)

GKT831 - Lung Fibrosis(NOX1/4 inhibitor)

Idiopathic Pulmonary Fibrosis (IPF)(IIT funded by US NIH3 - Trial launch H1 2019)

GKT771(NOX1 inhibitor)

Preclinical

Novel NOX inhibitor

VaxiclasePertussis vaccine (Licensed to SIIPL)

Preclinical Phase 1 Phase 2 Phase 3Program

Discovery

1Investigator initiated trial2 Juvenile Diabetes Research Foundation3 National Institutes of Health

Investor Presentation

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NOX inhibitors: pathway based medicine addressing validated disease targets

NOX stands for a group of enzymes called NADPH Oxidases

NOX NOX1 NOX2 NOX3 NOX4 NOX5 DUOX1 DUOX2

VALIDATED DISEASE

PATHWAYS

DISEASE PROCESSES

Inflammation Angiogenesis Fibrosis Proliferation

A family of 7 enzymes that amplify multiple signaling pathways

VEGF PI3K TRPV1 NF-kB

NMDA(CNS)

TRPV1 (hearing loss)

TGFb RAS RANKL TLR4 NA Thyroid hormone iodination

Page 6Investor Presentation

We focus on fibrotic diseases by targeting NOX1 and NOX4 with GKT831

Investor Presentation

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NOX 1 & 4 are major drivers of fibrogenesis in multiple organsNOXs act upstream of targets such as TGF-b, MCP-1 and ASK1

*Sources: Brenner DA, Hepatology 2012, Brenner DA, PLoS One, 2015, Torok N, Free Radic Biol Med, 2012. Torok N, Gastroenterology, 2015; Thannickal V, Science Trans Med, 2014; Gray SP, Circulation, 2013

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Quiescentfibroblast

LIVER INJURY

NOX/ROS

Proliferation

Contractility

Fibrogenesis

Matrix degradationMMP-2

Chemotaxis

Retinoid loss

WBC chemoattraction

FIBROSIS

Pathways amplified by NOX1/4

Activated myofibroblast

SteatosisCholestasis

Hep C/HepBAlcohol

FIBROGENIC PATHWAYS

GKT831 downregulates the activation of multiple clinically validated fibrogenic and apoptotic pathways*

LUNG INJURYSmoking

Toxic chemicalsInflammation

RENAL INJURYHyperglycemia

High blood pressureInflammation

LIVER

FIBROSIS

KIDNEY

FIBROSIS

LUNG

Investor Presentation

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We focus on key fibrosis markets with GKT831

Fibrosis: ~45% of all deaths in the developed world1

Source 1: The Journal of Clinical Investigation; Common and unique mechanisms regulate fibrosis in various fibroproliferative diseases; March 2007. Source 2: The global impact of hepatic fibrosis and end-stage liver disease ; Lim YS1,Kim WR.ClinLiver Dis.2008 Nov;12(4):733-46, vii. doi: 10.1016/j.cld.2008.07.007. Source 3: Nalysnyk L., et al. Incidence and Prevalence of Idiopathic Pulmonary Fibrosis: Review of the Literature. Eur Respir Rev. 2012;21(126):355-361. Source 4: HovindP, Tarnow L, Rossing K, et al. Diabetes care 2003;26:1258-64. Source 5: Groop PH, Thomas MC, Moran JL, et al. Diabetes 2009;58:1651-8. Source 6: Diabetes Care, American Diabetes Association, 2014 Jan;37 Suppl 1:S14-80. doi: 10.2337/dc14-S014.

GKT831

Liver fibrosis impacts 300 to 700 million people worldwide2

Primary Biliary Cholangitis (PBC)│Orphan disease Non-alcoholic steatohepatitis (NASH) Primary biliary sclerosis (PSC) │Orphan disease Viral hepatitis Alcoholic steatohepatitis

Idiopathic Pulmonary Fibrosis (IPF) affects 3 million people

worldwide3

Idiopathic Pulmonary Fibrosis│Orphan disease Cystic fibrosis│ Orphan disease Multiple sclerosis│ Orphan disease Refractory asthma and Chronic Obstructive

Pulmonary Disease (COPD)

Diabetic Kidney Disease develops in 20% to 40% of all

diabetics6

Page 8Investor Presentation

Immuno-oncology therapies not as effective in highly

fibrotic tumors

Cancer associated fibroblasts (CAFs) oppose immunotherapies by shielding tumors from T-cells

Targeting CAFs with GKT831 restores response to immunotherapies

Investor Presentation

Diabetic Kidney Disease (DKD) is the leading cause of end-stage renal disease4

Affects 14% to 31% of people with type 1 diabetes after 20 years of diabetes5

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GKT831 – A Phase 2 asset with therapeutic potential in multiple fibrotic diseases

Page 9

Orally available small molecule (NCE) with nanomolar potency

— NOX1 and NOX4 Ki ~ 100nM in membrane based assays

— 10-12 hour half life in humans

— Solid patent protection in key countries till 2028/2029 without any extension

Favorable clinical safety profile in healthy subjects and susceptible patients

— No safety signal and no dose limiting toxicity in 4 Phase 1 clinical studies

— No safety signal in patients with long-term type 2 diabetes and multiple diabetic complications

— SMB of the ongoing Phase 2 trial in PBC reviewed 110 patients, of whom 87 have reached 6 weeks of treatment, 69 who have reached Week 12, and 41 who had completed the full 24-week treatment

— To date, 100% of patients have completed at least 12 weeks of treatment while over 75% have completed the full 24-week treatment period of the PBC trial – no pruritus drop outs reported to date

— Over 240 subjects exposed to GKT831

Broad therapeutic potential in fibrotic disorders and immuno-oncology

— Efficacy in multiple models of fibrotic and inflammatory diseases and in immuno-oncology

— Two Phase 2 trials ongoing in liver (PBC) and kidney fibrosis (DKD)

— Lung fibrosis (IPF) IIT to be initiated in H1 2019

Investor Presentation

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PBC: A gateway to the large fibrosis market

Primary Biliary Cholangitis (PBC):an orphan disease in the large liver fibrosis area

A quicker proof of concept (PoC) in smaller and shorter trial

Page 10Investor Presentation

Source 1 : In Europe, USA and Japan. Boonstra K. et al. Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis: a systematic review. J Hepatol. 2012 May;56(5):1181-8

Description

— Chronic autoimmune liver disease leading to the progressive destruction of the bile ducts

— Bile, a fluid produced in the liver, plays a role in digesting food but is toxic when it accumulates in the bile ducts and liver cells

Prevalence

— Prevalence of between 2 - 40 cases per hundred thousand-population 1

— Women make up about 90% of PBC cases

The disease most often develops during middle age and is usually diagnosed in people between the ages of about 30 to 60 years

There appears to be a genetic component to developing PBC

Current treatments

— Current medications only slow disease progression and manage symptoms

GKT831

Primary Biliary Cholangitis

Inflammed Bile DuctsNormal Bile Ducts

Investor Presentation

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Phase 2 trial of GKT831 in patients with PBC – Interim analysis results

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International liver fibrosis Phase 2 trial in primary biliary cholangitis

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GKT831

111 PBC patients Confirmed PBC

UDCA non responder

Baseline ALP & GGT ≥1.5ULN

Normal bilirubin

Randomized, double blind, placebo controlled, parallel group

24-week treatment with interim analysis on week 6 data

UDCA plus placebo or one of 2 doses of GKT831 (400 mg once-daily (OD) and 400 mg twice daily (BID)) – randomization ratio 1:1:1

Trial Patients Design

Markers of liver fibrosis (ELF score, collagen fragments, transient elastography)

Markers of cholestasis (ALP, bilirubin)

Markers of liver injury (AST, ALT, CK-18)

Markers of inflammation (hsCRP, fibrinogen, IL-6)

Quality of life and itching (PBC40 questionnaire and VAS score)

Phase 2

Secondary endpoint

A marker of liver injury (Change in serum Gamma Glutamyl Transferase - GGT)

Primary endpoint

Positive interim analysis conducted when 92 patients completed their week 6 visit and published on November 5th 2018

Sources: 1ALP: alkaline phosphatase; AST: aspartate aminotransferase; ALT: alanine aminotransferase; CK-18: cytokeratin-18; hsCRP: high sensitivity C-reactive protein; IL-6: interleukin-6)

Investor Presentation

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Patient enrollment exceeded target - interim efficacy analysis completed

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Global network of investigational centers

— 62 centers in Canada, USA, Belgium, Italy, Germany, Greece, Spain, United Kingdom, & Israel

Enrollment target of 102 patients exceeded with 111 patients randomized

— Patient enrollment completed on September 25, 2018

— Patients are all UDCA non-responders, a refractory and difficult to treat population

Interim efficacy analysis conducted as per protocol when 92 patients completed week 6

— Primary interim efficacy endpoint:

Change in GGT, a marker of liver and bile duct injury, at week 6 compared to baseline

— Secondary interim efficacy endpoints:

Marker of bile duct injury: ALP

Markers of liver injury: ALT, AST, GGT, total and conjugated bilirubin

Marker of inflammation: hsCRP

Final results at week 24 will include additional endpoints assessing quality of life (fatigue & pruritus) and fibrosis

Positive recommendation at each of the 3 Safety Monitoring board meetings

— No patient drop outs due to pruritus while over 75% of patients have completed the 24 week treatment period to date

GKT831

Investor Presentation

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Phase 2 trial of GKT831 in PBC: Baseline patient characteristics

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GKT831

Baseline characteristics in line with the targeted population of active PBC patients

PlaceboGKT831

400mg OD1GKT831

400mg BID2 ALL

N 31 31 30 92

Age (years) 56 (10) 56 (10) 55 (9) 56 (9)

Females (%) 97 84 93 91

ALP (IU/L) 304 (151) 282 (89) 350 (177) 312 (145)

GGT (IU/L) 224 (212) 215 (154) 237 (193) 225 (187)

ALT (IU/L) 44 (18) 44 (22) 55 (34) 47 (26)

AST (IU/L) 44 (19) 43 (20) 50 (33) 46 (24)

Total bilirubin (mmol/L) 11 (5) 11 (5) 10 (4) 11 (4)

hsCRP (mg/L) 5.0 (4.9) 5.8 (5.7) 4.7 (5.1) 5.2 (5.2)

Values expressed as mean (SD). Baseline: Day 1 1 Once daily; 2 Twice daily

Investor Presentation

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Dose dependent and statistically significant reductions in GGT

Page 15

GKT831

p<0.01

p=0.52

Pe

rce

nt

chan

ge in

GG

T fr

om

Bas

elin

e

-7%

-12%

-23%

-30

-25

-20

-15

-10

-5

0

0 1 2 3 4 5 6

Mean ± SEM

Placebo

GKT831 400mg OD

GKT831 400mg BIDTreatment duration (week)

-7%

-12%

-23%

The progressive reductions from baseline to week 2 and to week 6 suggest that further improvements can be achieved with continued treatment

Investor Presentation

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Greater GGT reductions in patients with higher baseline GGT (≥2.5XULN, n=68)

Page 16

GKT831

Placebo

400mgOD

400mgBID

GKT831

Mean ± SEM

Pe

rce

nt

chan

ge in

GG

T fr

om

B

ase

line

to

We

ek

6-8%

-11%

-29%

These results suggest that GKT831 may also benefit patients with more advanced disease

-40

-35

-30

-25

-20

-15

-10

-5

0

p=0.64

p<0.01

-29%

-11%

-8%

Investor Presentation

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GKT831 also achieves statistically significant reductions in ALP GKT831

PlaceboGKT831

400mg ODGKT831

400mg BID

Proportion of patients with ≥15%reduction in ALP at Week 6

16.1% 25.8% 53.3%

Page 17

p<0.001

p=0.06

-2%

-2%

-17%

-25

-20

-15

-10

-5

0

5

0 1 2 3 4 5 6

Pe

rce

nt

chan

ge in

ALP

fro

m B

ase

line

Mean ± SEM

Placebo

GKT831 400mg OD

GKT831 400mg BID

Treatment duration (week)

-8%

Investor Presentation

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Dose dependent reductions in liver transaminases at week 6

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GKT831

-12

-10

-8

-6

-4

-2

0

-12

-10

-8

-6

-4

-2

0

Placebo

400mgOD

400mgBID

GKT831

Change in AST Change in ALT

Placebo

400mgOD

400mgBID

GKT831

Me

dia

n %

ch

ange

in A

ST

fro

m B

ase

line

to

We

ek

6

Me

dia

n %

ch

ange

in A

LT f

rom

B

ase

line

to

We

ek

6

Although enrolled patients had relatively low levels of liver transaminases, dose dependent reductions were observed

Investor Presentation

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Changes in inflammatory marker hsCRP at week 6

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GKT831

-30

-25

-20

-15

-10

-5

0

5M

ed

ian

% c

han

ge in

hsC

RP

fr

om

Bas

elin

e t

o W

ee

k 6

Change in hsCRP

Placebo

400mgOD

400mgBID

GKT831

Although enrolled patients had relatively low levels of high sensitivity C-reactive protein, dose dependent reductions were observed

Investor Presentation

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Dose dependent reductions in FIB-4 and APRI

Page 20

-25

-20

-15

-10

-5

0

5

-25

-20

-15

-10

-5

0

5

Placebo

400mgOD

400mgBID

GKT831

FIB-4 score APRI score

Me

dia

n %

ch

ange

in F

IB-4

sco

re

fro

m B

ase

line

to

We

ek

6

Me

dia

n %

ch

ange

in A

PR

I sco

re

fro

m B

ase

line

to

We

ek

6

Placebo

400mgOD

400mgBID

GKT831

At weeks 12 and 24, assessments of liver fibrosis will include collagen fragments (e.g. Pro-C3), the Enhanced Liver Fibrosis (ELF) score. Transient elastography (i.e. Fibroscan®) will be done at week 24

GKT831

Investor Presentation

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The good safety profile of GKT831 appears to be confirmed in PBC patients

Page 21

Positive recommendation at each of the 3 Safety Monitoring board meetings

— Third SMB meeting held October 25th 2018 to review data from 110 patients:

87 had completed week 6 and 41 had completed week 24

— SMB recommended to continue trial as per protocol

Safety profile continues to be very favorable

— All patients have completed at least 12 weeks of treatment

— Over 75% of patients have completed 24 weeks of treatment

— No drop-outs and no treatment interruptions due to pruritus

GKT831

Investor Presentation

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Conclusions – Interim analysis results

Page 22

GKT831

These results allow us to accelerate & expand our clinical programs with GKT831

— Prepare PBC Phase 3 program

— Further investigate options in NASH and PSC

— Consider acceleration and/or expansion of investigator initiated trials in DKD & IPF

Continue research work on novel NOX inhibitors

Investor Presentation

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Other Pipeline and Conclusions

Page 23Investor Presentation

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Phase 2 trial in type 1 diabetes-induced kidney disease (DKD)

Page 24Investor Presentation

GKT831

142 T1D DKD patients

48-week treatment in up to 15 centers in Australia. Trials conducted by Baker Heart and Diabetes Institute in Melbourne

GKT831 200mg BID against matching placebo, twice daily

Trial # patients Design

Renal function: estimated glomerular filtration rate (eGFR), and cystatin C

Renal injury: NGAL, KIM-1

Inflammation: hsCRP, fibrinogen, IL-6

Metabolomics and lipidomics profiles

Exploratory epigenetics and transcriptomics studies

Phase 2

Secondary endpoint

Change in urinary albumin to creatinine ratio (UACR), adjusted for baseline

Primary endpoint

The IIT DKD phase 2 trial funded by JDRF was initiated in H2 2017

Sources 1NGAL: neutrophil gelatinase-associated lipocalin; KIM-1: kidney injury marker 1; hsCRP: high sensitivity C-reactive protein; IL-6: interleukin-6; T1D: type 1 diabetes

Investor Presentation

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Solid IP portfolio with potential of term extensions in the US, Europe and Japan

Solid patent protection in key countries

Page 25Investor Presentation

GKT831 (per se) and its derivatives in treating NADPH related disorders

GKT831

Country Application No. Patent No. Anticipated expiry Type of protection

USA 12/532,336 8,389,518 12.04.2028 Pharmaceutical formulations/use

USA 13/734,205 9,073,919 20.03.2028 Pharmaceutical formulations/use

Europe 08718102.0 2139477 20.03.2028 Pharmaceutical formulations/use

Europe 12187254.3 2545918 20.03.2028 Pharmaceutical formulations/use

Japan 2009-554036 5715340 20.03.2028 Pharmaceutical formulations/use

Japan 2015-050104 6047189 20.03.2028 Pharmaceutical formulations/use

Country Application No. Patent No. Anticipated expiry Type of protection

USA 13/120,440 9,096,588 22.09.2029 NCE/use

USA 14/750,019 Pending - NCE/use

Europe 9787271.7 2344492 22.09.2029 NCE/use

Europe 14190340.1 Pending - NCE/use

Japan 2011-527466 5700837 22.09.2029 NCE/use

Japan 2014-254651 5932008 22.09.2029 NCE/use

GKT831 (generically) and its derivatives in treating NADPH related disorders

Investor Presentation

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A selective NOX1 inhibitor with broad therapeutic potential

GKT771: potential to address multiple pain processing , inflammatory, and angiogenic pathways

Page 26Investor Presentation

GKT771

Analgesic

Anti-inflammatory

Anti-angiogenic

Potent, highly selective NOX1 inhibitor

NOX1 plays key roles in angiogenesis, inflammation, and inflammatory pain

GKT771 targets the NGF / TrkA / TRPV1 pain processing pathway: a clinically validated target for pain therapies

GKT771 blocks angiogenesis through the VEGF1 pathway, a clinically validated anti-angiogenic target

GKT771 shows potent activity in vitro and in vivo models of angiogenesis and inflammatory pain

Combined mechanism of action (MoA) consistent with therapeutic potential in inflammatory pain and chronic inflammatory diseases

Further therapeutic potential in eye diseases and itching

Excellent ADME2 profile

IP protection with NCE3/use patent running until 2035

GKT771

1. VGEF: Vascular endothelial growth factor 2. ADME: Absorption, distribution, metabolism, and excretion3. NCE: New chemical entity

Investor Presentation

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Stock information

Page 27Investor Presentation

Stock market information

– Markets: Euronext Paris and Euronext Brussels

– Number of shares: 79,347,621 (as of Dec. 2018)

Cash Position

– €12.8m in Cash & Cash equivalent (30 Sept. 2018)

– Cash runway to Q1.2020

– €5m gross financing in form of convertible notes with warrants (Aug. 2018)

Stock codes

– Name: GENKYOTEX

– Mnemonic: GKTX

– ISIN code: FR0011790542

Contacts Genkyotex

– Elias Papatheodorou – CEO

– Alexandre Grassin – VP Finance and Administration

Tel.: +33 4 80 16 06 07

E-mail: [email protected]

Website: www.genkyotex.com

Shareholding structure (as at April 27, 2018):

Investor Presentation

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Appendix – Additional Analysis on Phase 2 PBC Interim Results

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Pharmacokinetics analysis indicates good exposure and a dose effect

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Drug levels were measured at weeks 2 (n=44), 12 (n=29), and 18 (n=17)

The main findings are:

— All patients allocated to GKT831 had detectable drug levels indicating good compliance

— As expected, patients receiving GKT831 400mg BID had higher plasma levels compared to patients

receiving 400mg OD

— As anticipated in PBC patients with cholestasis and reduced biliary elimination, drug levels were

higher than in healthy subjects or diabetic patients

GKT831

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Appendix – Additional Information on Genkyotex

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Preclinical studies: over 50 publications in leading peer-reviewed journals

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GKT831

“Inhibition of NOX4 by GKT831 improves inflammation and fibrosis in fast food diet-fed mice. […]”

Hepatocyte NADPH Oxidase 4 Regulates Stress Signaling, Fibrosis, and Insulin Sensitivity During Development of Steatohepatitis in MiceGastroenterology. 2015 Aug;149(2):468-80

“GKT831 treatment led to a reversal of age-associated persistent fibrosis and reduced mortality. […]” in an IPF model

Reversal of Persistent Fibrosis in Aging by Targeting Nox4-Nrf2 Redox ImbalanceSci Transl Med. 2014 Apr 9;6(231):231ra47

“[…] our results demonstrate the potential of the NOX1 and NOX4 inhibitor GKT831, which is currently in phase 2human clinical trials, as an NLRP3 inflammasome inhibitor […]”

NOX4-dependent fatty acid oxidation promotes NLRP3 inflammasome activation in macrophages Nat Med. 2016 Sep;22(9):1002-12

“GKT831 treatment prevented skeletal muscle oxidation and nitrosylation of RyR1, restored calstabin1 binding andimproved EDL muscle–specific force. […]”

Excess TGF-b mediates muscle weakness associated with bone metastases in miceNat Med. 2015 Nov;21(11):1262-1271

Investor Presentation

“[…] pharmacological inhibition of NOX4 may have broad applicability for stromal targeting across cancer types. […]”

Targeting the Myofibroblastic Cancer-Associated Fibroblast Phenotype Through Inhibition of NOX4 J Natl Cancer Inst. 2018 Jan 1;110(1)

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GKT831 markedly reduces fibrosis and inflammation in diet-induced NASH modelRobust anti-fibrotic activity despite sustained steatosis

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Reduced inflammation and fibrosis despite sustained steatosis

Fast food diet model of NASH

831 831

831 831

Source: Torok N et al, Gastroenterology 2015

GKT831

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Source: Victor Thannickal et al., University of Alabama. Science Translational Medicine, 2014

GKT831 reverses fibrosis & improves survival in a model of irreversible lung fibrosisThe bleomycin model conducted in aged mice induces irreversible lung fibrosis

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n = 21-23/group

Start of treatment

Weeks post injury

Bo

dy

we

igh

t (g

)

Days post injury

p = 0.043

6 weeks post injury

Hyd

roxy

pro

line

(mg/

lun

g)

Pe

rce

nt

surv

ival

Control Vehicle GKT831

GKTVehicle

GKT

Vehicle

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Four Phase 1 studies: very good safety and pharmacodynamics (PD) profile

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No dose limiting toxicity

No safety signal

Dose proportional PK up to 900mg/day

GKT831 is rapidly absorbed after oral dosing(median tmax ~ 1h)

Mean half-life of parent compound is 8-15 hours

Minimal renal elimination (<2%)

Multiple dosing does not affect PK parameters

Very low probability of DDI* through CYP3A4

Low variability in PK parameters when taken with meals

GKT831

Pharmacodynamics

0

2

4

6

8

10

Placebo 100mg OD2

300mg OD

400mg BID3

GKT831

900mg OD

Med

ian

ch

ange

in M

inim

a Er

yth

ema

Do

se (

mJ/

cm2)

RO

S (r

elat

ive

flu

ore

sce

nce

)

Time after UV (minutes)

UV + GKT831 2 uM

UV + GKT831 0.2 uM

UV + GKT831 20 uM

No UV

UV + vehicle

UV + Trolox

UV + DPI

120000

100000

80000

60000

40000

20000

0 10 20 30 40 50 60 700

GKT831 reduces ROS production induced by UVB4 in vitro1

GKT831 is pharmacologically active in healthy subjects

Safety and PK

Single and multiple doses of GKT831 were well-tolerated and pharmacologically active in healthy subjects

• Drug-drug interactions studies

• Sources: 1 In vitro studies conducted at StratiCELL for Genkyotex, unpublished; 2 Once-daily; 3 Twice a day; 4Ultra-violet

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Initial phase 2 results in diabetic kidney disease (DKD)

Excellent safety profile up to 200mg BID for 12 weeks

— Well tolerated with fewer adverse events than placebo : moderate

to severe AEs 57 vs 15 (p<0.001) n=68/arm

Primary endpoint: no significant difference on renal

outcomes

— Possible reasons:

Duration of treatment: 12 weeks sufficient for drugs acting on intra-renal

hemodynamics, but not to demonstrate direct anti-inflammatory or anti-

fibrotic effects

Dose

Secondary endpoints: pharmacological activity

demonstrated

— Statistically significant reduction in liver enzymes – GGT (p<0.05)

— Strong trend for reduction in triglycerides (p=0.066)

— Statistically significant reduction in inflammation - hsCRP (p<0.05)

— Strong trend for reduction in additional inflammatory markers –

serum amyloid protein A (p<0.08), IL-6 (p=0.2)

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GKT831

GKT831 significantly reduces the incidence of adverse events

Adverse events

Severity Placebo GKT831 Diff.

All 119 69 -42%

Mild 62 54 -12%

Moderate 44 14 -68%

Severe 13 1 -93%

p < 0.001 (CMH analysis)

GKT831 significantly improved multiple predefined secondary efficacy endpoints of liver inflammation and injury. Importantly, the study confirmed the favourable safety profile of GKT831.

Investor Presentation