PowerPoint Presentation - Jefferies - The Global … presentation contains "forward-looking"...

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June 2016 1

Transcript of PowerPoint Presentation - Jefferies - The Global … presentation contains "forward-looking"...

  • June 2016

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    Forward Looking Statement

    This presentation contains "forward-looking" statements within the meaning of Section27A of the Securities Act of 1933, as amended, and Section 21E of the SecuritiesExchange Act of 1934, as amended, that involve risks and uncertainties. These forward-looking statements include statements about our business outlook and strategy, andstatements about historical results that may suggest trends for our business. You canidentify these statements by the use of terminology such as guidance , believe ,expect, will, or similar forward-looking terms. You should not rely on these forward-looking statements as they involve risks and uncertainties and may cause actual results tovary materially from the forward-looking statements. Factors that might contribute to suchdifferences include, among others, economic downturns and the general state of theeconomy, our ability to retain and hire necessary employees; our ability to develop on atimely basis our clinical program; unforeseen changes in expense levels; and competition,which could lead to pricing pressure. For more information regarding the risks anduncertainties that could cause actual results to differ materially from those expressed orimplied in these forward-looking statements, as well as risks relating to our business ingeneral, we refer you to the Risk Factors sections of the companys SEC filings, whichare available on the Securities and Exchange Commissions Web site at www.sec.gov.These forward-looking statements are based on current expectations and the companyassumes no obligation to update this information.

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  • Right Patient, Right Therapy

    Novel treatment of IgA Nephropathy

    Ending the burden of enzyme replacement therapy

    Systemic Lupus Erythematosus

    IgA Nephropathy

    EPI due to Cystic Fibrosis

    Capsule and Powder for Oral Solution

    Subcutaneous

    Subcutaneous

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  • Late Stage Clinical Pipeline

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    Pipeline

    Phase 1Phase 2Phase 3NDA Submission

    Exocrine Pancreatic Insufficiency

    Severe Lupus (SLE)

    IgA Nephropathy

  • Sollpura: Billion $ Market Opportunity Worldwide

    5

    $659

    60%

    20122011

    $628

    Ex-US (Creon)

    56%

    40%

    $735

    2013

    44%

    54%

    46%

    US (Creon)

    47%

    53%

    $864

    2014

    Source: Citibank Historical and projected WW Drug Sales, Creon and Zenpep; EvaluatePharma. AbbVie 2014 Form 10-K on Annual Report, p. 40. Aptalis Pharma Inc. Annual Information, Year ended Sep. 30, 2012, p. 78*Assumption that Creon has ~70% of the WW market is based on ratio of Zenpep/Creon pts by age and dose; Lilly PERT Market Analysis (IMS; 2011); and Aquest EU physician interviews

    Worldwide PERT Revenue by Brand($MM)

    Creon Revenue by Geography($MM)

    2011 2012 2013 2014

    $1,234

    $941

    $1,050

    +11.2%

    $897

    Creon

    Zenpep

    Other PERTs

    70%

    70%

    70%70%

    13%

    8%13%

    15%

    17%

    22%17%

    15%

    2015 US sales: $682

  • ~26k Patients Account for Nearly Half of PERT Revenue

    1.Sikkens ECM et al. Best Pract Res Clin Gastroenterol. 2010:24;337-347.2.Dominguez-Munoz JE. Curr Gastroenterol Rep. 2007;9(2):116-122.3.Dominguez-Munoz JE. Gastroenterol Hepatol. 2011;7(6):401-403.4. Lilly PERT Market Analysis June 17, 2011

    US PERT Patients4(-162K patients)

    49%16%84%

    Small patient

    size, yet

    accounts for

    49% of US PERT

    revenue

    Chronic Pancreatitis/Other Cystic Fibrosis

  • Current PERT Therapy is Suboptimal

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    Porcine Derived

    Enteric Coating

    Burdensome

    13.6 14.115.1

    17.018.8

    20.1

    23.4

    20.6

    6.7

    0-3 4-6 7-9 10-12 13-15 16-18 19-21 22-64 65+

    Age

    Average Daily Pill Consumption by Age

    SOURCE: IMS Rx Database

  • Biotech Derived Stable in Low pHDry Powder Sachet and Capsule Convenient

    10,000 units

    40,000 units

    Porcine PERT

    Lipase (Fat)crystallized and cross-linked to

    increase low pH stability

    Protease (Protein)crystallized to prevent proteolysis

    over product shelf life

    Amylase (Carbohydrate)stable at a low pH

    Sollpura: Optimizing PERT Treatment

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  • **

    **

    0

    20

    40

    60

    80

    100

    control washout Creon Liprotamase

    mea

    n CF

    A (

    %)

    %CFA in EPI Pigs*

    ** p

  • Phase 3 (726) Fixed Dose: Significant Improvement

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    21.2

    13.8

    7.76.0

    3.2-0.9

    -5

    5

    15

    25

    CFA

  • Sollpura: Safe and Well Tolerated (767)

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    Sollpura vs. CFF Registry

    SOURCE: Internal data on file

    In a global Phase 3 trial (767), Sollpura was equivalent to historical control in the prevention of weight loss.

  • Phase 3 Registration Study Enrolling

    your proposed trial design constitutes an adequate and well-controlled trial, which, if successful, will support approval of the NDA.

    Deputy Director, FDA

    Creon/Zenpep(maintain current PERT)

    Dose Optimization

    Cystic Fibrosis

    CFTR Potentiators OK

    N126

    7 years old

    CFA 80%

    Treatment

    8 weeks

    Pancreaze

    BaselineCoefficient of fat absorption (CFA)

    Primary endpointCoefficient of fat absorption (CFA)

    12 week extension

    period

    Weight, BMI, safety

    Screening

    3 weeks

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    92% Power

    Non-inferiority margin: 15%

    Standard deviation: 18%

  • Sachet Study: Pediatric CF Patients

    Evaluate efficacy, safety and ease-of-use of optimized Sollpura; data for pediatric approval for patients

  • Initiate Enrollment Q1 16 (EU) Q2 16

    Complete Enrollment Q4 16 Q4 16

    Topline Data Q4 16 / Q1 17 Q4 16 / Q1 17

    Near-term, large commercial opportunity ($1 billion+ market)

    Novel, non-porcine, stable and soluble PERT

    126 patient FDA approved registration study, enrolling

    54 patient pediatric study with sachet

    Two non-enterically coated formulations capsule and sachet

    Highlights

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  • Late Stage Clinical Pipeline

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    Pipeline

    Phase 1Phase 2Phase 3NDA Submission

    Exocrine Pancreatic Insufficiency

    Severe Lupus (SLE)

    IgA Nephropathy

  • 16Company estimates"Belimumab (Benlysta): A Breakthrough Therapy for Systemic Lupus Erythematosus." Pharmacy and Therapeutics

    Positioning for Success in Severe Lupus Patients

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    MILD55,000

    MODERATE65,000

    SEVERE30,000

    30,000 40,000Patients

    Marina

    Alopecia

    Proteinuria

    32mg prednisone / day

    SELENA-SLEDAI: 23

    Patient 1:

    Annual Cost of Treatment: $35k/patient

    150k-300k Patients

  • Blisibimod: Best-in-Class BAFF Inhibitor

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    Peptibody, with high affinity for human BAFF

    Blisibimod KD = 1 pM

    Belimumab KD = 250-350 pM

    4 BAFF binding domains versus belimumabs two

    Binds both soluble and membrane-bound BAFF

    Lower molecular weight provides more drug per 200mg weekly dose

    64 kD vs 147 kD (belimumab)

    2012 Hsu A novel modality of BAFF-specific inhibitor AMG623 peptibody reduces B-cell number and improves outcomes in murine models of autoimmune disease

  • Benlysta Sales Strong and Show Continued Increase

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    $8

    $45

    $69 $79

    $101

    $120 $132

    $153 $166

    $185

    1H 11 2H 11 1H 12 2H 12 1H 13 2H 13 1H 14 2H 14 1H 15 2H 15

    +41%CAGR

    Benlysta Historical WW Sales ($MM) ~95% US

    HGSI/GSK quarterly reports (GBP = 1.6 average $USD)

  • 11.8%P

  • PEARL-SC Phase 2: Demonstrated SRI-6 Response

    In the PEARL-SC trial to identify an effective and safe dose for future phase 3 studies and explore key inclusion criteria and clinical endpoints, Blisibimod showed

    strong benefit over placebo and by Week 24, there was a 15.9% improvement.

    SOURCE: Internal data on file

    N=48N=47

    14.9

    21.3

    27.7

    31.9 31.9

    38.3

    12

    31.3

    37.5

    41.7

    52.154.2

    Week 4 Week 8 Week 12 Week 16 Week 20 Week 24

    Placebo Blisibimod 200mg QW

    SRI-6 in SS>10 + steroids

  • PEARL-SC Phase 2: Positive Patient Reported Outcomes

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    Patients randomized to blisibimod reported significantly better FACIT-fatigue scores compared with placebo.

    3.1

    *6*6.5 6.2 6.7

    6.9*7.5

    8.6 9

    11.6

    0

    2

    4

    6

    8

    10

    12

    0 4 8 12 16 20 24 28 32 36 40 44 48 52

    Mea

    n ch

    ange

    fro

    m b

    asel

    ine

    Study Week

    placebo pooled blisibimod pooledblisibimod 200mg QW minimally important diff

    Study Week 4 8 12 16 20 24 28 36 44 52

    Number of subjects

    Placebo Pooled 258 245 240 236 232 229 189 142 73 37

    Blisibimod Pooled 267 254 246 246 240 239 191 132 70 44

    Blisibimod 200QW 87 85 83 81 79 80 64 45 25 14

  • *Systemic Lupus Responder Index (SRI) is a composite endpoint comprised of a >6 point improvement in the SELENA-SLEDAI clinical assessment instrument AND no new BILAG 1A or 2B organ domain flares AND no worsening in Physicians Global Assessment (PGA) (< 0.3 increase)Study used imbalanced randomization (approximately 5:4 Active:Placebo) to maximize collection of safety data.

    52 Weeks Treatment

    Severe Lupus PatientsN=442

    (~260 patients met

    criteria)

    84% Powerp

  • *Systemic Lupus Responder Index (SRI) is a composite endpoint comprised of a >6 point improvement in the SELENA-SLEDAI clinical assessment instrument AND no new BILAG 1A or 2B organ domain flares AND no worsening in Physicians Global Assessment (PGA) (< 0.3 increase)Study used imbalanced randomization (approximately 5:4 Active:Placebo) to maximize collection of safety data.

    52 Weeks Treatment

    Enriched Lupus PatientsN300

    85% Power

    p

  • $1 billion market opportunity in patients with SLE

    Best-in-Class BAFF inhibitor

    Enriched patient population with increased likelihood of response to BAFF inhibition

    Highlights

    Company estimates

    Initiate Enrollment Complete Q2 16

    Complete Enrollment Q3 15 Q4 17

    Topline Data Q3 16 Q1 19

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  • Late Stage Clinical Pipeline

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    Pipeline

    Phase 1Phase 2Phase 3NDA Submission

    Exocrine Pancreatic Insufficiency

    Severe Lupus (SLE)

    IgA Nephropathy

  • Most common cause of primary glomerulonephritis

    High unmet medical need 15-50% progress to ESRD in 10-

    20 years

    No approved Rx therapy

    Accelerated development path (proteinuria endpoint)

    Pursuing orphan indication in the US

    IgA Nephropathy: Accelerated Development Pathway

    26Moriyama T, Tanaka K, Iwasaki C, Oshima Y, Ochi A, et al. (2014) Prognosis in IgA Nephropathy: 30-Year Analysis of 1,012 Patients at a Single Center in Japan. PLoS ONE 9(3): e91756. doi:10.1371/journal.pone.0091756

  • Serum BAFF Correlates with Severity of IgA Nephropathy

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    healthy control

    Seru

    m B

    AFF

    (ng

    /ml)

    0

    2

    4

    6

    8

    10

    12

    14

    Mild Moderate

    N=55 N=26 N=127

    p

  • Decreased Proteinuria Improves Survival in IgAN

    28KDIGO Kidney Disease: Improving Global Outcomes

    Reich 2007

    Effect of Proteinuria on Renal Survival in IgA Nephropathy

    Surv

    ival

    from

    rena

    l fai

    lure

    Years

    3 g/day

    1.0

    0.9

    0.8

    0.7

    0.6

    0.5

    0.4

    0.3

    0.2

    0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

    Reduction in proteinuria corresponds to KDIGO* treatment goal associated with favorable long-term prognosis.

  • PEARL-SC Phase 2: Blisibimod Reduced Proteinuria

    * p

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    8-Week InductionMaintenance up to 96 weeks or Elective DiscontinuationIgA

    NephropathyN=57

    Biopsy Proven

    18 65 years

    Proteinuria 1-6g/24h

    >90 days ACE/ARB

    Blood Pressure 150/90

    eGFR>30(*40)

    Complete Response

  • Phase 2 Proof-of-Concept Study for the Treatment of IgAN

    Primary Endpoint Partial & Complete Response

    Secondary Endpoints Change in Proteinuria Serum creatinine total B cells (CD19+/CD20+) Activated B cells (CD19+/CD38+/CD138-) Plasma cells Immunoglobulin A, G, M (IgA, IgG,IgM), Complement C3 and C4

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  • Interim Analysis Complete

    Initial Data(Urinary protein response rates) Q2 16

    Final Data(eGFR) Q4 16

    First potential disease-modifying therapy for IgAN

    High unmet medical need with no currently approved therapies

    Orphan approval opportunity

    Accelerated development path (proteinuria endpoint)

    Insight into biomarkers associated with SLE

    Highlights

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    Capital Structure and Financial Statistics

    Exchange NASDAQ: ANTH

    Market Capitalization ~$148mm

    Shares Outstanding ~40mm

    Cash as of March 31st, 2016 $36.9mm

    Total Outstanding Debt $0

    As of June 1st, stock price of $3.62 per share

    Financial Overview

  • Significant market potential Completed enrollment data in H2 2016 Enrolled severe and responsive patient population Responder population defined by 5 randomized controlled

    trials with BAFF inhibitors cohort provides data in H2 2016 First potential disease modifying approach Completed interim futility analysis Orphan market in US, large global market

    Large commercial opportunity Phase 3 and pediatric programs completing Q4 16 / Q1 17 Small registration trial (n = 126) Soluble, stable, fewer pills Convenient sachet and capsule formulation

    Well Positioned for Market Success

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    Slide Number 1Forward Looking StatementSlide Number 3Late Stage Clinical PipelineSollpura: Billion $ Market Opportunity Worldwide~26k Patients Account for Nearly Half of PERT RevenueCurrent PERT Therapy is SuboptimalSollpura: Optimizing PERT TreatmentSollpura: Comparable Efficacy to Creon in PigsPhase 3 (726) Fixed Dose: Significant ImprovementSollpura: Safe and Well Tolerated (767)Slide Number 12Slide Number 13Slide Number 14Late Stage Clinical Pipeline Positioning for Success in Severe Lupus PatientsBlisibimod: Best-in-Class BAFF InhibitorBenlysta Sales Strong and Show Continued IncreasePatient Selection Translates to Greater Treatment EffectPEARL-SC Phase 2: Demonstrated SRI-6 ResponsePEARL-SC Phase 2: Positive Patient Reported OutcomesChablis-SC1: Right Therapy for the Right PatientChablis 7.5: Enhanced Patient SelectionSlide Number 24Late Stage Clinical PipelineIgA Nephropathy: Accelerated Development PathwaySerum BAFF Correlates with Severity of IgA NephropathyDecreased Proteinuria Improves Survival in IgANPEARL-SC Phase 2: Blisibimod Reduced ProteinuriaPhase 2 Proof-of-Concept Study for the Treatment of IgANPhase 2 Proof-of-Concept Study for the Treatment of IgANSlide Number 32Financial OverviewWell Positioned for Market SuccessSlide Number 35