PowerPoint Presentation - Jefferies - The Global … presentation contains "forward-looking"...
Transcript of PowerPoint Presentation - Jefferies - The Global … presentation contains "forward-looking"...
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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
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Sollpura: Billion $ Market Opportunity Worldwide
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$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
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~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
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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
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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
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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
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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.
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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%
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Sachet Study: Pediatric CF Patients
Evaluate efficacy, safety and ease-of-use of optimized Sollpura; data for pediatric approval for patients
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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
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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
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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
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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)
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11.8%P
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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
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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
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*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
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*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
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$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
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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
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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
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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.
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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
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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
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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