NASDAQ:ALT Altimmune Q2 2025 Earnings Report $3.68 -0.06 (-1.60%) Closing price 04:00 PM EasternExtended Trading$3.70 +0.02 (+0.54%) As of 05:02 PM Eastern Extended trading is trading that happens on electronic markets outside of regular trading hours. This is a fair market value extended hours price provided by Polygon.io. Learn more. ProfileEarnings HistoryForecast Altimmune EPS ResultsActual EPS-$0.27Consensus EPS -$0.32Beat/MissBeat by +$0.05One Year Ago EPSN/AAltimmune Revenue ResultsActual Revenue$0.01 millionExpected Revenue$0.00 millionBeat/MissBeat by +$4.00 thousandYoY Revenue GrowthN/AAltimmune Announcement DetailsQuarterQ2 2025Date8/12/2025TimeBefore Market OpensConference Call DateTuesday, August 12, 2025Conference Call Time8:30AM ETConference Call ResourcesConference Call AudioConference Call TranscriptPress Release (8-K)Quarterly Report (10-Q)SEC FilingEarnings HistoryCompany ProfilePowered by Altimmune Q2 2025 Earnings Call TranscriptProvided by QuartrAugust 12, 2025 ShareLink copied to clipboard.Key Takeaways Positive Sentiment: Pemvidutide met the primary endpoint of NASH resolution at 24 weeks with statistically significant improvements in inflammation, fibrosis markers, liver fat, weight loss, and showed best-in-class tolerability without dose titration. Positive Sentiment: Phase II trials for alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) are now underway, targeting areas with high unmet needs and leveraging pemvidutide’s dual metabolic and liver-directed activity. Positive Sentiment: Altimmune ended Q2 with $183.1M in cash and equivalents, bolstered by a $100M debt facility, providing runway to advance Phase III development and key upcoming milestones. Positive Sentiment: Appointment of industry veteran Jerry Durso as Board Chair, reflecting strengthened leadership with proven commercial and corporate-development expertise ahead of Phase III and commercialization. Neutral Sentiment: Altimmune plans an end-of-Phase II meeting with the FDA in Q4 to align on Phase III trial design—potentially incorporating non-invasive tests—alongside reporting full 48-week IMPACT data. AI Generated. May Contain Errors.Conference Call Audio Live Call not available Earnings Conference CallAltimmune Q2 202500:00 / 00:00Speed:1x1.25x1.5x2xThere are 14 speakers on the call. Operator00:00:00Good morning, ladies and gentlemen, and welcome to the Altimmune Second Quarter twenty twenty five Financial Results Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. A reminder, this call is being recorded. I'll now introduce your host for today's conference call, Lee Roth, President of Burns McClellan, Investor Relations Adviser to Altimmune. Operator00:00:33Lee, you may begin. Speaker 100:00:35Thanks, Olivia. Good morning, everyone. Once again, thank you for joining us for the Altimmune second quarter twenty twenty five financial results and business update conference call. On today's call, you'll hear from Doctor. Vipin Garg, our Chief Executive Officer Doctor. Speaker 100:00:49Scott Harris, our Chief Medical Officer and Greg Weaver, our Chief Financial Officer. Doctor. Scott Roberts, our Chief Scientific Officer and Ray Jort, our Chief Business Officer will join us for the Q and A. Our second quarter twenty twenty five financial results and corporate update press release was issued earlier this morning and it can be found on the Investor Relations section of the Ultimmune website. Before we begin, I'd like to remind everyone that remarks made about future expectations, plans and prospects constitute forward looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Speaker 100:01:25Altimmune cautions that these forward looking statements are subject to risks and uncertainties, and these could cause our actual results to differ materially from those indicated. For a full review of the risk factors that could affect the company's future results and operations, we refer you to the company's filings with the SEC. I also direct you to read the forward looking statement disclaimer in our press release issued this morning, is available on our website. Any statements made on this call speak only as of today's date, 08/12/2025, and the company does not undertake any obligation to update any forward looking statements to reflect events or circumstances that occur on or after today's date. As a reminder, this call is being recorded and will be available for audio replay on the Altimmune website. Speaker 100:02:09With that, it's my pleasure to turn the call over to Doctor. Vipin Garg, President and Chief Executive Officer of Altimmune. Vipin? Speaker 200:02:16Thank you, Lee. Good morning, everyone, and thank you for joining us today for our second quarter financial results and corporate update. As many of you know, we presented the twenty four week top line data from the IMPACT trial at the June. As we shared, pembiguate achieved statistical significance in the primary endpoint of NASH resolution and across multiple objective measures of efficacy at twenty four weeks of treatment. These included all noninvasive markers of inflammation and fibrosis, liver fat reduction, and weight loss, along with best in class safety and tolerability without the need for dose titration. Speaker 200:03:01These data will serve as the foundation of the package that we take to the FDA for our end of phase two meeting in the fourth quarter, and will inform the design of our Phase III program. In addition to the advancement of our NASH program, our Phase II trials in AUD and ALD, RECLAIM and RESTORE, are now underway. Alcohol use disorder and alcohol associated liver diseases are two indications with significant unmet needs and few to no treatment options, for which we believe famidutide may be particularly well suited. As we announced yesterday, our board has appointed Jerry Durso as Chairman of the Board, succeeding Doctor. Mitch Sayer, who has served in this role for the past seven years and will remain with us as a nonexecutive director. Speaker 200:03:54This change reflects our planned advancement to Phase III development of pembidutide in NASH. Jerry has a wealth of commercial and corporate development experience, including the building of a successful liver franchise as CEO of Intercept prior to its acquisition. We are excited to continue moving forward under Jerry's leadership and look forward to Mitch's ongoing contribution. With $183,100,000 in cash and cash equivalent, we have considerably strengthened our balance sheet as we work to continue to advance the development of pembidutide and look forward to reaching additional milestones, including the full forty eight week impact data as the year progresses. With that, I'll now turn the call over to Doctor. Speaker 200:04:45Scott Harris, our Chief Medical Officer, to provide a clinical development update. Scott? Speaker 300:04:52Thank you, Vipin. Those of you on the call with us are likely familiar with the INPCT top line data that we reported about six weeks ago. I'd like to expand upon a few of the key highlights of this positive and important dataset. First, we achieved MATCH resolution up to 59.1% of subjects, a highly statistically significant result after twenty four weeks of treatment. On the other measure of fibrosis improvement, we did not reach statistical significance, but clear evidence of anti fibrotic activity was observed that was supported by additional objective measures of fibrosis improvement. Speaker 300:05:35As Vipin noted, multiple measures of efficacy that were assessed at the twenty four week time point achieved statistical significance. We demonstrated impressive results in all of the noninvasive tests of liver fibrosis, including enhanced liver fibrosis and vibration control transient elastography. In addition, the pathway based analysis of the biopsies showed a statistically significant improvement in liver fibrosis in a supplemental analysis. We recently completed our analysis of another important noninvasive test of fibro inflammation, corrected T1 imaging or CT1, where a class leading effect for pemvedutide was observed at the twenty four week time point. CT1 is a reproducible MRI based liver imaging method that has been correlated with changes in liver inflammation and fibrosis in clinical studies. Speaker 300:06:40Decreases in CT1 relaxation time of eighty milliseconds or greater have been correlated with improvements in liver inflammation and fibrosis in clinical studies. At twenty four weeks, mean decreases from baseline and CT1 relaxation time were one hundred and forty five point zero and one hundred forty seven point nine milliseconds in the one point two and one point eight milligram pemvigutide treatment arms, respectively, compared with a decrease of twenty seven point five milliseconds in placebo, representing a p value of less than 0.001 for both doses. These new data add additional depth to the data demonstrating that strong anti inflammatory and anti fibrotic activity of pemvedutide treatment. In addition to these impressive effects on the liver, pemvedutide was associated with a greater than 6% decrease in body weight at twenty four weeks of treatment, with a weight loss trajectory indicating that further weight loss was likely. Decreases in body weight are important in NASH patients as they succumb to the complications of obesity at greater rates than the complications of liver disease until cirrhosis actually develops. Speaker 300:08:06In the aggregate, the impact top line data compare very favorably to other NASH therapies, including those that have read out at much later time points. Now moving to safety, pemphigutide demonstrated potentially class leading results in that important area. Through twenty four weeks, pempidutide was remarkably well tolerated with only a single adverse event related discontinuation across the two pempidutide treatment arms versus two adverse event related discontinuations in the placebo group. It is worth noting that this excellent tolerability was achieved in the absence of dose titration, which is unique for GLP-one based agents. The ability to start patients in a dose that is both effective and tolerable will be highly attractive to prescribers and will be another key differentiator for our therapy. Speaker 300:09:10We're continuing to analyze the twenty four week data and look forward to providing updates as the results become available. The team is preparing for our fourth quarter end of Phase II meeting with FDA that will further guide our Phase III plans. We will also be reporting the full forty eight week data in the fourth quarter. This data will include the noninvasive tests that were reported at the twenty four week readout, weight loss and safety. In addition to our MATCH program, we've made progress in the development of pembidutide in two additional indications, AUD and ALD, with the initiation of Phase II trials in these indications in May and July. Speaker 300:09:55AUD and ALD are serious and highly prevalent conditions, recurrent treatment approaches are inadequate and innovation has been limited. We claim our AUD trial is a twenty four week trial evaluating weekly two point four milligram pempidutide versus placebo. The primary endpoint is the change in the number of heavy drinking days with key secondary endpoints, including other measures of alcohol intake and weight loss, including the World Health Organization risk drinking level, which has recently been accepted by FDA as an additional basis of approval in this indication. RESTORE, the Phase II trial in ALD, started enrolling in July. It is a forty eight week trial evaluating the two point four milligram weekly dose of pemphidutide versus placebo with a primary endpoint of change in liver stiffness measurement at twenty four weeks. Speaker 300:10:56Liver stiffness is a non invasive measure of liver inflammation and fibrosis that characterizes the prognosis and severity of ALD. Key secondary endpoints include an assessment of liver stiffness at 48, as well as changes in eLF score, alcohol consumption, and body weight at both twenty four and forty eight weeks. And with that, I'll turn it out now over to Greg Weaver, who will review our second quarter financial results. Speaker 400:11:29Greg? Thanks, Scott. Beginning with the balance sheet. We finished the second quarter with total cash of 183,100,000.0 That's an increase of approximately 40% over our cash position at the start of this year. We've raised $88,000,000 in gross equity capital this year, while adding the flexibility of $100,000,000 Hercules debt facility, which we announced in the second quarter, and drew down $15,000,000 from that facility at signing. Speaker 400:12:02These strategic financial moves are part of our ongoing efforts to ensure that our balance sheet is able to support the continuing clinical development of PEMV. We are committed to staying focused on driving value as we work to position PEMV to benefit Match patients. Now to briefly comment on the Q2 financial results. First, R and D expenses, which were $17,200,000 for the three months ended June 30, as compared to $21,000,000 in the same period of 2024. And this amount includes $11,200,000 of direct costs related to pembidutide development. Speaker 400:12:40Breaking that down further, approximately $5,500,000 for the IMPACT Phase 2B trial, dollars 2,600,000.0 for AUD and ALD startup Phase two costs, and $1,000,000 for our pempadutide oral formulation preclinical development. G and A expenses were consistent period over period at $5,700,000 and $5,600,000 for the quarters ended 06/30/2524. Really nothing noteworthy to call out in our G and A. Net loss for the 2025 was $22,100,000 or $0.27 a share compared to a net loss of $24,600,000 or zero three five dollars a share in the second quarter of the prior year. With that, I'll turn the call back to Vipin for closing remarks. Speaker 200:13:31Thank you, Greg. The 2025 will be an exciting period for Altimmune as we report the forty eight week impact data and prepare for our end of Phase II meeting, while continuing to enroll the Phase II trials in AUD and ARD. This concludes our formal remarks, and we would now like to open the line to take questions. Operator? Operator00:13:54Thank you. Our first question coming from the line of Annabel Samimy with Stifel. Your line is now open. Speaker 500:14:23Hi. This is Jayed on for Hanabel. Thanks for taking our question. I have two. The first one related to the mass development plan. Speaker 500:14:34You've had some time to digest the data. And we did see VIBERSA improvement not reached that SIG, but to what extent could you still leverage the other improvements in this and the path AI analysis at week 24? How does the FDA view these new measures? And could you potentially get it into the label by including those endpoints in a phase three? Speaker 300:15:03Hi, Jed. This is Scott and thank you for the question. There's more and more emphasis being placed on noninvasive tests. And the overall feeling among experts in the areas that we will be moving to a noninvasive test or nit based improvement at some point in the future. I think the FDA is warm to that. Speaker 300:15:30We actually haven't seen that happen at this point. I want to remind you that we achieved highly statistically significant effects on e. F. And VCTE, sometimes called FibroScan, which are considered the best noninvasive tests for assessing fibrosis. And also the PathAI I should remind you that PathAI analyses have been accepted in Europe as the basis of approval and that FDA is now reviewing that proposal and we should have some news on that in the near future. Speaker 300:16:13So we think that based on these highly recognized and validated measures of fibrosis improvement, that we not only have excellent evidence that fibrosis improvement is occurring, we're actually meeting what could be FDA and EMA expectations for approval in both of these areas. So as we've said before, there is a great deal of evidence that we have very potent anti fibrotic effects. We're very confident about our ability to be able to hit these effects in Phase III. Speaker 200:16:57Yeah, I just wanted to add that, just to remind everybody that this readout was at twenty four week. At forty eight week or beyond, which is where really the phase three program will be designed for, we believe that we will hit the statistical significance in the fibrosis endpoint. With longer trials and larger trials, that would reduce the placebo noise, that's really the reason we didn't hit the endpoint in this twenty four week study. So we feel very good about going into a Phase III program, in spite whether the nits are allowed or not, even without that, we should hit the fibrosis endpoint in a longer Phase III trial. Speaker 500:17:41Thank you. I had one more question. It's related to the AUALD trial. I could be wrong about this, but I do recall you guys mentioning that you would test different doses like one point two, one point eight, two point four with titration. It looks like you're only testing the two point four milligrams in these trials. Speaker 500:18:03Is there a particular reason for that? Speaker 300:18:06Yes, Jay, I mean, we think that for Phase two trial, it's appropriate to only test one dose. We were testing the most efficacious dose and then we'll have that conversation with FDA and other regulatory agencies going forward. And there's always the opportunity to expand that and to analyze different doses in a Phase three program. But we think that we're going in with what will be our most efficacious dose and then we can re examine other doses as the program unfolds. Speaker 500:18:39Great, thank you. Operator00:18:41Thank you. And our next question coming from the line of Ellie Moore with UBS. Your line is now open. Speaker 600:18:51Hey, this is Jasmine on for Ellie. Thank you for taking our question. So, on your end of Phase II meeting, can you talk about what you're hoping to discuss with the FDA and align with them on? Are you planning to discuss the possibility of an NIP based Phase III design with them? And will we get an update after this meeting? Speaker 600:19:11Thank you. Speaker 300:19:12Hey, Jasmine, thanks for the question. I think that we really can't provide a lot of details about the meeting and our proposals until we actually have the meeting and there'll be a lot of topics to discuss. Opinions of the FDA on this are shifting right now and we're keeping our ears very close to the ground on this. So we expect to be able to have a very rich conversation with the FDA along multiple lines of approaching this and have an update for you after the end of the Phase II meeting. Speaker 600:19:50Okay, awesome. Thank you. Operator00:19:54Thank you. And our next question coming from the line of Yasmeen Rahimi with Piper Sandler. Your line is now open. Speaker 700:20:03Hi, this is Dominic on for Yasmeen Rahimi. Congrats on a great quarter and thank you for taking our question. So we just had a few questions. The first one, was there any measures on alcohol alcoholic consumption in the impact study that could derisk reclaim and restore? And then kind of going with that, what is the timing for those readouts? Speaker 700:20:24And what do you need to see to advance in the Phase three? Speaker 300:20:29Right. So, are continuing to analyze the data sets from the IMPACT trial, and we'll have an update on any alcohol measures as we continue to provide data. As you know, we're continuing to analyze the results of the trial and we'll provide on that information as we further analyze the data. We think we have a great deal of evidence for the effects of pempadutide on AUD and ALD. As you're aware, we have a very impressive animal study showing that an 80% drop in alcohol consumption in animals who were given free choice, as well there's a huge literature on the effects of GLP-one agents in alcohol consumption, both observational trials and at least one randomized trial. Speaker 300:21:25And as you know, with ALD, the pathophysiologic basis of that is fat induced liver inflammation very similar to NASH. So we feel very confident of our ability to hit the endpoints in both the AUD and ALD trial. And in terms of the Phase III development program in those indications, we'll meet with the FDA after the Phase II results and get agreement on what that program looks like. Speaker 700:21:58Thank you. Operator00:22:00Thank you. And our next question coming from the line of Raju Song with Jefferies. Your line is now open. Speaker 800:22:08Great. Congrats for the progress and thank you for taking our question. Maybe just also on the end of phase meeting, how much more work you need to do before you cannot request the meeting? My understanding you have not requested the meeting. How much data from this forty eight week readout is needed to finalize the Phase III design proposal? Speaker 800:22:29And then I have a follow-up question. Thank you. Speaker 300:22:32Yeah, Roger, we feel very good about having that meeting by the end of the year. And we'll have the results of that meeting and share it with The Street. Other companies have met with twenty four weeks of data. And I want to remind you that we have a lot of information on forty eight weeks of data and dosing from our obesity momentum study. So consequently, we feel confident that we'll have the data to go in and we'll have that meeting. Speaker 300:23:03We should have it sometime in the fourth quarter and we'll inform the Street on what the results of that Speaker 800:23:15Got it, thank you. And then my follow-up question is, with the new chairman appointment, so how will the corporate strategy evolve regarding the partnership for phase three and commercialization? It seems you're more focused on the commercialization now. Thank you. Speaker 200:23:34Yes, that's, as you can imagine, that's part of the natural evolution. The board is continuously evaluating the skill set at the Board level. Given that we're now moving into Phase III, the Board felt that addition of bringing Jerry as Chairman would be an added advantage for the, for the management team to, to move forward. So his experience in domain area in, in liver, building a liver disease company, and ultimately being part of that M and A transaction would be important as we move forward. Got it. Speaker 200:24:17Thank you. Operator00:24:19Thank you. Our next question coming from the line of Catherine O'Klakone with Citizens. Your line is now open. Speaker 900:24:29Hi. This is Catherine on for John. I just have a quick question about the T1 responses and how the results from impact compared to other programs. I know that you said kind of best in class, but if you could kind of give us some kind of ranges from the other competitor programs. Thanks. Speaker 300:24:47Yeah, Kathryn, so as you're aware, the results that we have were in the range of a reduction of about 145 to 140. That was seen in this trial, but it was also seen in a prior trial or Phase 1b trial in patients with fatty liver. And based on the public data, we're seeing readouts of approximately 50 to 60 for Resmitteram and up to about 107 for Tirzepatide. So you can see that these results that we're getting, 147 versus a range of 50 to 107, are clearly superior to other compounds, at least those that are reported in the public domain. And that given the association of CT1 with reduction of both, mesh activity and fibrosis that this is one other measure among many measures showing the potent anti inflammatory and anti fibrotic activity of the compound. Speaker 900:25:56Great, thank you. Operator00:26:00Thank you. Our next question coming from the line of Patrick Tuchio with H. C. Wainwright. Your line is now open. Speaker 1000:26:10Hi, good morning, and congrats on all the progress. I just have a couple of follow-up questions on expectations around the Phase III program then as well just maybe looking further ahead to potential commercialization and the product profile that's emerging. I guess the first part of the question is just around kind of updated thoughts on dosing strategy, one point two milligram, one point eight milligram and then the higher dose and how you're thinking about the dose selection for the Phase three. And then as well, you know, primary endpoints, how are you thinking about primary endpoint, co primary endpoint? You know, would mass resolution as primary with fibrosis improvement? Speaker 1000:26:55Or would there be a co primary design? And I guess, how would you power for both? And then just as it relates to just the commercial potential, just based on, I mean, there's a lot of data and I think there's a lot of points of differentiation here. So, if the Phase three were to reproduce the impact efficacy and tolerability, I guess, how do you see the positioning in NASH if there's an eventual approval? Speaker 300:27:23Patrick, I'll take the first part of the question for the commercial potential. I'll turn it over to Vipin. So, as you are aware, we studied the one point two and the one point eight milligram doses and impact. And even at the one point eight milligram dose, which is not our most potent dose for weight loss, we still achieve 6.2% weight loss at only twenty four weeks. And the trajectory of the weight loss indicated there was a lot more weight loss to be had. Speaker 300:27:57So we think it's going to be very attractive to put the two point four milligram dose into Phase three. Would not only give more weight loss to the extent that it could problem us even more provide even more efficacy, we find that very attractive. Regarding the other two doses, that's currently being looked at very critically and we'll discuss that with the agency and have an update for the Street after we have our end of Phase II meeting. As you're aware, there are two endpoints in NASH, NASH resolution and fibrosis improvement. In the IMPACT study, we had a dual endpoint, meaning that we either had a hit, MAH resolution or fibrosis improvement for the trial to be successful and consequently, IMPACT was a successful trial. Speaker 300:28:43We could go into Phase III with a similar strategy of dual endpoints. There's also the possibility of co endpoints when you have to hit both, etcetera. And then in the background, you have endpoints based on noninvasive tests, which we feel are very exciting. And by the way, EMA has approved the use of a PathAI methodology for actually reading out mesh resolution and fibrosis improvement using computerized algorithms assisted by the pathologist but driven predominantly by the computer, which we think is going to reduce greatly the noise that we're seeing in the trial and probably help us control the placebo response and really express the anti fibrotic potential of the compound. So we think there's a lot of things that play here in terms of the discussion with the FDA. Speaker 300:29:34It's going to be a very exciting and important end of Phase II meeting. And as soon as we have further information, we'll update the street. So with that, I'm going to turn the commercial discussion over to Vipin. Vipin? Speaker 200:29:46Yeah, I just want to emphasize one other thing with regards to the FDA discussion. You know, one thing I want to remind everybody is that we have a very large safety database that we have already accumulated on pembidutide. So part of our discussion would be how do we leverage that? Do we think there is an opportunity to reduce the number of exposures in terms of the safety database. So we'll certainly be having that dialogue with the FDA, as Scott said, among many other things that we'll be discussing with the FDA. Speaker 200:30:15So looking forward to that. Patrick, in terms of commercial potential of pemigutide, as we have said all along and as you pointed out, there are multiple points of differentiation. First and foremost, we are combining two mechanisms: direct action in the liver, a direct acting agent in the liver with a metabolic agent with weight loss. So really think of it, we're treating NASH with obesity. And when you look at the NASH landscape, everybody's talking about the benefit of adding weight loss on top of liver directed effect. Speaker 200:30:51We're bringing that in single molecule, we're combining these two mechanisms. So we're treating NASH, but on top of that people are losing weight. Sixty to eighty percent of patients with NASH are obese or overweight, so they would benefit from losing weight. So that's number one, which we believe is a very big advantage or differentiating factor for pembidutide. You know, in our, in our work, our market research, it's clear that physicians are looking for a drug where people will not only improve their liver health, but will also lose weight. Speaker 200:31:24Secondly, safety and tolerability is going to be very, very important. And as you can see from our data, we are seeing class leading tolerability profile. We think that can be leveraged. Patients like that, doctors like that, lack of dose titration is going to be a major plus when we go, when we commercialize pembituride. So it's really the benefit of combining the two mechanisms, and on top of that, having a very clean safety and tolerability profile that we think is going to speak well in terms of the commercial success of the product. Speaker 1000:32:02Great. Thanks so much. Operator00:32:04Thank you. Our next question coming from the line of Mayank Mamtani with B. Riley Securities. Your line is now open. Speaker 700:32:15Hi. Thanks for taking our questions. This is William on for Mayank today. Two from us. Maybe I'll start with the first. Speaker 700:32:23So now that we know that Lilly has gotten positive FDA buy in on pursuing high risk MAZZOID trial for their Reta and Tirzepatide. They're using NITs for patient screening and then foregoing biopsies completely for primary efficacy endpoint. And it looks like even in the trial, looking more of an outcomes type trial. How do you see this as an opportunity for Pembina to execute on a capital efficient Phase III trial? And is your understanding that this still only biopsies are a way to secure Subpart H accelerated approval? Speaker 700:33:00And then I have a follow-up. Speaker 300:33:03Well, thanks, William. Yeah, think it's really exciting. I think it creates a real opportunity for us in noninvasive tests and we're taking a very careful look at that. We think that there's real opportunity for us here and we'll certainly have that discussion with the FDA. Speaker 800:33:24As we Speaker 200:33:25said, will look at every potential opportunity to come up with an innovative trial design and incorporate all of these things that are now becoming clear that the FDA is reviewing. So we'll certainly have all of those discussions. We can't get into the specifics right now, but we'll definitely talk about it once we've had the end of phase two meeting. Speaker 300:33:45Yeah, let add to that, William, that there are a lot of exciting things happening here, the development of NITS, the movement toward AI based reading in Europe and we think there's a good chance that FDA will pick that up and you saw that we had very positive results from the AI based analyses that really reduce the noise from the manual pathologist readout. So there other developments here that are going to increase our probabilities of success in Phase three. We're very interested in those and share your excitement and plan to have that discussion with the FDA this fourth quarter. Speaker 700:34:30Got it. And then also, again, also sort of thinking of crosstown peer. Merck has their Afinopegutide readout coming out shortly, and they're looking at biopsy results at forty eight weeks. Slightly different glucagon ratio here, but what could their data mean in terms of your forty eight week data potentially in Phase three or obviously your just your net data coming up at the end of the year? And what may you be specifically looking for to bring confidence phase three going forward and what will help guide you in the development of that phase three? Speaker 300:35:05Right, well, as you noted, William, the reading added forty eight weeks. And another glucagon compound is read out at forty eight weeks, and these have lesser ratios of glucagon. As Vipin mentioned, we read out at only twenty four weeks. So we think that our readouts at forty eight weeks, had we done the biopsy week forty eight weeks, would have been as good if not better than the other compounds. That's certainly supported by the very potent non invasive test results we're seeing at week twenty four. Speaker 300:35:37I want to remind you that there hasn't been an incretin, let alone a glucagon containing incretin that is read out at week twenty four. And at week twenty four, our MATCH resolution was comparable to or superior to other compounds at week twenty four and better than compounds reading out at later time points in forty eight to seventy two weeks. So we think that afinipegatide readout will be further confirmation of the efficacy of the compound. Now, as you know, we don't have a biopsy at week forty eight, but we have the noninvasive tests. And we expect to be able to use the noninvasive test to model and to predict what we would have seen a week of 48 had we done the week biopsy, forty eight week biopsy. Speaker 300:36:26So we think that data will be very supportive of our mechanism and our efficacy. Speaker 700:36:33Got it. Thanks for that color. I'll hop back in the queue. Operator00:36:37Thank you. Our next question coming from the line of Corinne Johnson with Goldman Sachs. Your line is now open. Speaker 1100:36:45Good morning. Maybe just one from us. How should we think about the cadence of research and development spend from here as these AUD and ALD studies kind of get up and further running and enrollment increases? Thanks. Speaker 400:37:01Thanks, I appreciate the call. This is Greg and in terms of the R and D spend investment in AUD and ALD, these are phase two trials. They're baked into our budget for this year, they're incorporated in our cash runway. These are relatively modest in size, and we're on it. Don't anticipate anything unusual in our burn rate going forward in the near term as related to AUD ALD. Speaker 200:37:31Okay, thanks. Thank Operator00:37:35you. Our next question coming from the line of Andy Hsieh with William Blair. Your line is now open. Speaker 1200:37:44Thanks for taking the question. Just a quick one. Very interested in the oral program that you are advancing. So I'm curious, maybe from a technological perspective, we think about it as a gastric absorption enhancer. And also just curious if you can tell us a little bit more about how you would position this formulation in the grand scheme of things. Speaker 1200:38:09Thank you. Speaker 1000:38:11Yes. Thanks for the question. Speaker 1300:38:14We've been at this for a little while here and I'm excited to share that we've had a big breakthrough in the activity. From the very beginning, we focused on two elements that really differentiate an oral formulation of the peptide from others that are out there, Rybelsus for example. The first is to get away from the food restriction. You mentioned gastric absorption. That's exactly what we're trying to get away from. Speaker 1300:38:42And we've done that from the beginning and focused on that because when it's absorbed in the gut or in stomach, then it's really about very tight food restrictions that you're aware of for the Rybelsus indication. So that's one of the things we wanted to do. And the secondary feature was to make sure that it really made sense from a cost of goods standpoint. As you know, the oral absorption is always inefficient compared to subcutaneous injection, but to make it work, we had a fairly high threshold for what we would be interested in. So I think that things are looking very good in that respect. Speaker 1300:39:24I think this breakthrough that we had was mechanism based that it went just the way we expect and we're looking forward to translating that into a preclinical development and nomination there. So as far as the impact to the commercial situation, I'll let Vipin speak to that. Speaker 200:39:43Yes. I mean, our strategy with the oral program is very similar to what you would expect with what's being done with other products. Really a life cycle management question. As this field grows, there would be attractiveness to the oral program. As Scott mentioned, oral delivery is never going to be as efficient as subcutaneous injections. Speaker 200:40:04So we believe that both of these formulations would be important in terms of developing commercially the value proposition around pemidutide. Speaker 1200:40:15Wonderful, thank you. Operator00:40:19Thank you. And there are no further questions in the queue at this time. I will now turn the call back over to Doctor. Bipengarg for any closing remarks. Speaker 200:40:28Thank you all for joining our call today. As always, we appreciate your continued support and look forward to keeping you updated in the months ahead. Have a wonderful rest of the day. Operator00:40:41This concludes today's conference call. Thank you for your participation, and you may now disconnect.Read morePowered by Earnings DocumentsPress Release(8-K)Quarterly report(10-Q) Altimmune Earnings HeadlinesAltimmune, Inc. Sued for Securities Law Violations – Investors Should Contact Levi & Korsinsky for More Information – ALT1 hour ago | globenewswire.comThe Gross Law Firm Notifies Altimmune, Inc. ...August 14 at 9:18 AM | gurufocus.comBREAKING: The House just passed 3 pro-crypto bills!THREE pro-crypto bills just passed the House! Now, experts believe altcoin season is officially here. August 14 at 2:00 AM | Crypto 101 Media (Ad)The Gross Law Firm Notifies Altimmune, Inc. Investors of a Class Action Lawsuit and Upcoming Deadline - ALTAugust 14 at 8:45 AM | prnewswire.comAltimmune (NASDAQ:ALT) Receives Buy Rating from HC WainwrightAugust 14 at 3:21 AM | americanbankingnews.comRosen Law Firm Urges Altimmune, Inc. (NASDAQ: ALT) Stockholders to Contact the Firm for Information About Their RightsAugust 13 at 5:30 PM | prnewswire.comSee More Altimmune Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Altimmune? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Altimmune and other key companies, straight to your email. Email Address About AltimmuneAltimmune (NASDAQ:ALT), a clinical stage biopharmaceutical company, focuses on developing treatments for obesity and liver diseases. The company's lead product candidate, pemvidutide, a GLP-1/glucagon dual receptor agonist that is in Phase 2 trial for the treatment of obesity and metabolic dysfunction-associated steatohepatitis. It is also developing HepTcell, an immunotherapeutic product candidate, which is in Phase 2 clinical trial for patients chronically infected with the hepatitis B virus. The company was formerly known as Vaxin Inc. and changed its name to Altimmune, Inc. in September 2015. 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There are 14 speakers on the call. Operator00:00:00Good morning, ladies and gentlemen, and welcome to the Altimmune Second Quarter twenty twenty five Financial Results Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. A reminder, this call is being recorded. I'll now introduce your host for today's conference call, Lee Roth, President of Burns McClellan, Investor Relations Adviser to Altimmune. Operator00:00:33Lee, you may begin. Speaker 100:00:35Thanks, Olivia. Good morning, everyone. Once again, thank you for joining us for the Altimmune second quarter twenty twenty five financial results and business update conference call. On today's call, you'll hear from Doctor. Vipin Garg, our Chief Executive Officer Doctor. Speaker 100:00:49Scott Harris, our Chief Medical Officer and Greg Weaver, our Chief Financial Officer. Doctor. Scott Roberts, our Chief Scientific Officer and Ray Jort, our Chief Business Officer will join us for the Q and A. Our second quarter twenty twenty five financial results and corporate update press release was issued earlier this morning and it can be found on the Investor Relations section of the Ultimmune website. Before we begin, I'd like to remind everyone that remarks made about future expectations, plans and prospects constitute forward looking statements for purposes of the safe harbor provisions under the Private Securities Litigation Reform Act of 1995. Speaker 100:01:25Altimmune cautions that these forward looking statements are subject to risks and uncertainties, and these could cause our actual results to differ materially from those indicated. For a full review of the risk factors that could affect the company's future results and operations, we refer you to the company's filings with the SEC. I also direct you to read the forward looking statement disclaimer in our press release issued this morning, is available on our website. Any statements made on this call speak only as of today's date, 08/12/2025, and the company does not undertake any obligation to update any forward looking statements to reflect events or circumstances that occur on or after today's date. As a reminder, this call is being recorded and will be available for audio replay on the Altimmune website. Speaker 100:02:09With that, it's my pleasure to turn the call over to Doctor. Vipin Garg, President and Chief Executive Officer of Altimmune. Vipin? Speaker 200:02:16Thank you, Lee. Good morning, everyone, and thank you for joining us today for our second quarter financial results and corporate update. As many of you know, we presented the twenty four week top line data from the IMPACT trial at the June. As we shared, pembiguate achieved statistical significance in the primary endpoint of NASH resolution and across multiple objective measures of efficacy at twenty four weeks of treatment. These included all noninvasive markers of inflammation and fibrosis, liver fat reduction, and weight loss, along with best in class safety and tolerability without the need for dose titration. Speaker 200:03:01These data will serve as the foundation of the package that we take to the FDA for our end of phase two meeting in the fourth quarter, and will inform the design of our Phase III program. In addition to the advancement of our NASH program, our Phase II trials in AUD and ALD, RECLAIM and RESTORE, are now underway. Alcohol use disorder and alcohol associated liver diseases are two indications with significant unmet needs and few to no treatment options, for which we believe famidutide may be particularly well suited. As we announced yesterday, our board has appointed Jerry Durso as Chairman of the Board, succeeding Doctor. Mitch Sayer, who has served in this role for the past seven years and will remain with us as a nonexecutive director. Speaker 200:03:54This change reflects our planned advancement to Phase III development of pembidutide in NASH. Jerry has a wealth of commercial and corporate development experience, including the building of a successful liver franchise as CEO of Intercept prior to its acquisition. We are excited to continue moving forward under Jerry's leadership and look forward to Mitch's ongoing contribution. With $183,100,000 in cash and cash equivalent, we have considerably strengthened our balance sheet as we work to continue to advance the development of pembidutide and look forward to reaching additional milestones, including the full forty eight week impact data as the year progresses. With that, I'll now turn the call over to Doctor. Speaker 200:04:45Scott Harris, our Chief Medical Officer, to provide a clinical development update. Scott? Speaker 300:04:52Thank you, Vipin. Those of you on the call with us are likely familiar with the INPCT top line data that we reported about six weeks ago. I'd like to expand upon a few of the key highlights of this positive and important dataset. First, we achieved MATCH resolution up to 59.1% of subjects, a highly statistically significant result after twenty four weeks of treatment. On the other measure of fibrosis improvement, we did not reach statistical significance, but clear evidence of anti fibrotic activity was observed that was supported by additional objective measures of fibrosis improvement. Speaker 300:05:35As Vipin noted, multiple measures of efficacy that were assessed at the twenty four week time point achieved statistical significance. We demonstrated impressive results in all of the noninvasive tests of liver fibrosis, including enhanced liver fibrosis and vibration control transient elastography. In addition, the pathway based analysis of the biopsies showed a statistically significant improvement in liver fibrosis in a supplemental analysis. We recently completed our analysis of another important noninvasive test of fibro inflammation, corrected T1 imaging or CT1, where a class leading effect for pemvedutide was observed at the twenty four week time point. CT1 is a reproducible MRI based liver imaging method that has been correlated with changes in liver inflammation and fibrosis in clinical studies. Speaker 300:06:40Decreases in CT1 relaxation time of eighty milliseconds or greater have been correlated with improvements in liver inflammation and fibrosis in clinical studies. At twenty four weeks, mean decreases from baseline and CT1 relaxation time were one hundred and forty five point zero and one hundred forty seven point nine milliseconds in the one point two and one point eight milligram pemvigutide treatment arms, respectively, compared with a decrease of twenty seven point five milliseconds in placebo, representing a p value of less than 0.001 for both doses. These new data add additional depth to the data demonstrating that strong anti inflammatory and anti fibrotic activity of pemvedutide treatment. In addition to these impressive effects on the liver, pemvedutide was associated with a greater than 6% decrease in body weight at twenty four weeks of treatment, with a weight loss trajectory indicating that further weight loss was likely. Decreases in body weight are important in NASH patients as they succumb to the complications of obesity at greater rates than the complications of liver disease until cirrhosis actually develops. Speaker 300:08:06In the aggregate, the impact top line data compare very favorably to other NASH therapies, including those that have read out at much later time points. Now moving to safety, pemphigutide demonstrated potentially class leading results in that important area. Through twenty four weeks, pempidutide was remarkably well tolerated with only a single adverse event related discontinuation across the two pempidutide treatment arms versus two adverse event related discontinuations in the placebo group. It is worth noting that this excellent tolerability was achieved in the absence of dose titration, which is unique for GLP-one based agents. The ability to start patients in a dose that is both effective and tolerable will be highly attractive to prescribers and will be another key differentiator for our therapy. Speaker 300:09:10We're continuing to analyze the twenty four week data and look forward to providing updates as the results become available. The team is preparing for our fourth quarter end of Phase II meeting with FDA that will further guide our Phase III plans. We will also be reporting the full forty eight week data in the fourth quarter. This data will include the noninvasive tests that were reported at the twenty four week readout, weight loss and safety. In addition to our MATCH program, we've made progress in the development of pembidutide in two additional indications, AUD and ALD, with the initiation of Phase II trials in these indications in May and July. Speaker 300:09:55AUD and ALD are serious and highly prevalent conditions, recurrent treatment approaches are inadequate and innovation has been limited. We claim our AUD trial is a twenty four week trial evaluating weekly two point four milligram pempidutide versus placebo. The primary endpoint is the change in the number of heavy drinking days with key secondary endpoints, including other measures of alcohol intake and weight loss, including the World Health Organization risk drinking level, which has recently been accepted by FDA as an additional basis of approval in this indication. RESTORE, the Phase II trial in ALD, started enrolling in July. It is a forty eight week trial evaluating the two point four milligram weekly dose of pemphidutide versus placebo with a primary endpoint of change in liver stiffness measurement at twenty four weeks. Speaker 300:10:56Liver stiffness is a non invasive measure of liver inflammation and fibrosis that characterizes the prognosis and severity of ALD. Key secondary endpoints include an assessment of liver stiffness at 48, as well as changes in eLF score, alcohol consumption, and body weight at both twenty four and forty eight weeks. And with that, I'll turn it out now over to Greg Weaver, who will review our second quarter financial results. Speaker 400:11:29Greg? Thanks, Scott. Beginning with the balance sheet. We finished the second quarter with total cash of 183,100,000.0 That's an increase of approximately 40% over our cash position at the start of this year. We've raised $88,000,000 in gross equity capital this year, while adding the flexibility of $100,000,000 Hercules debt facility, which we announced in the second quarter, and drew down $15,000,000 from that facility at signing. Speaker 400:12:02These strategic financial moves are part of our ongoing efforts to ensure that our balance sheet is able to support the continuing clinical development of PEMV. We are committed to staying focused on driving value as we work to position PEMV to benefit Match patients. Now to briefly comment on the Q2 financial results. First, R and D expenses, which were $17,200,000 for the three months ended June 30, as compared to $21,000,000 in the same period of 2024. And this amount includes $11,200,000 of direct costs related to pembidutide development. Speaker 400:12:40Breaking that down further, approximately $5,500,000 for the IMPACT Phase 2B trial, dollars 2,600,000.0 for AUD and ALD startup Phase two costs, and $1,000,000 for our pempadutide oral formulation preclinical development. G and A expenses were consistent period over period at $5,700,000 and $5,600,000 for the quarters ended 06/30/2524. Really nothing noteworthy to call out in our G and A. Net loss for the 2025 was $22,100,000 or $0.27 a share compared to a net loss of $24,600,000 or zero three five dollars a share in the second quarter of the prior year. With that, I'll turn the call back to Vipin for closing remarks. Speaker 200:13:31Thank you, Greg. The 2025 will be an exciting period for Altimmune as we report the forty eight week impact data and prepare for our end of Phase II meeting, while continuing to enroll the Phase II trials in AUD and ARD. This concludes our formal remarks, and we would now like to open the line to take questions. Operator? Operator00:13:54Thank you. Our first question coming from the line of Annabel Samimy with Stifel. Your line is now open. Speaker 500:14:23Hi. This is Jayed on for Hanabel. Thanks for taking our question. I have two. The first one related to the mass development plan. Speaker 500:14:34You've had some time to digest the data. And we did see VIBERSA improvement not reached that SIG, but to what extent could you still leverage the other improvements in this and the path AI analysis at week 24? How does the FDA view these new measures? And could you potentially get it into the label by including those endpoints in a phase three? Speaker 300:15:03Hi, Jed. This is Scott and thank you for the question. There's more and more emphasis being placed on noninvasive tests. And the overall feeling among experts in the areas that we will be moving to a noninvasive test or nit based improvement at some point in the future. I think the FDA is warm to that. Speaker 300:15:30We actually haven't seen that happen at this point. I want to remind you that we achieved highly statistically significant effects on e. F. And VCTE, sometimes called FibroScan, which are considered the best noninvasive tests for assessing fibrosis. And also the PathAI I should remind you that PathAI analyses have been accepted in Europe as the basis of approval and that FDA is now reviewing that proposal and we should have some news on that in the near future. Speaker 300:16:13So we think that based on these highly recognized and validated measures of fibrosis improvement, that we not only have excellent evidence that fibrosis improvement is occurring, we're actually meeting what could be FDA and EMA expectations for approval in both of these areas. So as we've said before, there is a great deal of evidence that we have very potent anti fibrotic effects. We're very confident about our ability to be able to hit these effects in Phase III. Speaker 200:16:57Yeah, I just wanted to add that, just to remind everybody that this readout was at twenty four week. At forty eight week or beyond, which is where really the phase three program will be designed for, we believe that we will hit the statistical significance in the fibrosis endpoint. With longer trials and larger trials, that would reduce the placebo noise, that's really the reason we didn't hit the endpoint in this twenty four week study. So we feel very good about going into a Phase III program, in spite whether the nits are allowed or not, even without that, we should hit the fibrosis endpoint in a longer Phase III trial. Speaker 500:17:41Thank you. I had one more question. It's related to the AUALD trial. I could be wrong about this, but I do recall you guys mentioning that you would test different doses like one point two, one point eight, two point four with titration. It looks like you're only testing the two point four milligrams in these trials. Speaker 500:18:03Is there a particular reason for that? Speaker 300:18:06Yes, Jay, I mean, we think that for Phase two trial, it's appropriate to only test one dose. We were testing the most efficacious dose and then we'll have that conversation with FDA and other regulatory agencies going forward. And there's always the opportunity to expand that and to analyze different doses in a Phase three program. But we think that we're going in with what will be our most efficacious dose and then we can re examine other doses as the program unfolds. Speaker 500:18:39Great, thank you. Operator00:18:41Thank you. And our next question coming from the line of Ellie Moore with UBS. Your line is now open. Speaker 600:18:51Hey, this is Jasmine on for Ellie. Thank you for taking our question. So, on your end of Phase II meeting, can you talk about what you're hoping to discuss with the FDA and align with them on? Are you planning to discuss the possibility of an NIP based Phase III design with them? And will we get an update after this meeting? Speaker 600:19:11Thank you. Speaker 300:19:12Hey, Jasmine, thanks for the question. I think that we really can't provide a lot of details about the meeting and our proposals until we actually have the meeting and there'll be a lot of topics to discuss. Opinions of the FDA on this are shifting right now and we're keeping our ears very close to the ground on this. So we expect to be able to have a very rich conversation with the FDA along multiple lines of approaching this and have an update for you after the end of the Phase II meeting. Speaker 600:19:50Okay, awesome. Thank you. Operator00:19:54Thank you. And our next question coming from the line of Yasmeen Rahimi with Piper Sandler. Your line is now open. Speaker 700:20:03Hi, this is Dominic on for Yasmeen Rahimi. Congrats on a great quarter and thank you for taking our question. So we just had a few questions. The first one, was there any measures on alcohol alcoholic consumption in the impact study that could derisk reclaim and restore? And then kind of going with that, what is the timing for those readouts? Speaker 700:20:24And what do you need to see to advance in the Phase three? Speaker 300:20:29Right. So, are continuing to analyze the data sets from the IMPACT trial, and we'll have an update on any alcohol measures as we continue to provide data. As you know, we're continuing to analyze the results of the trial and we'll provide on that information as we further analyze the data. We think we have a great deal of evidence for the effects of pempadutide on AUD and ALD. As you're aware, we have a very impressive animal study showing that an 80% drop in alcohol consumption in animals who were given free choice, as well there's a huge literature on the effects of GLP-one agents in alcohol consumption, both observational trials and at least one randomized trial. Speaker 300:21:25And as you know, with ALD, the pathophysiologic basis of that is fat induced liver inflammation very similar to NASH. So we feel very confident of our ability to hit the endpoints in both the AUD and ALD trial. And in terms of the Phase III development program in those indications, we'll meet with the FDA after the Phase II results and get agreement on what that program looks like. Speaker 700:21:58Thank you. Operator00:22:00Thank you. And our next question coming from the line of Raju Song with Jefferies. Your line is now open. Speaker 800:22:08Great. Congrats for the progress and thank you for taking our question. Maybe just also on the end of phase meeting, how much more work you need to do before you cannot request the meeting? My understanding you have not requested the meeting. How much data from this forty eight week readout is needed to finalize the Phase III design proposal? Speaker 800:22:29And then I have a follow-up question. Thank you. Speaker 300:22:32Yeah, Roger, we feel very good about having that meeting by the end of the year. And we'll have the results of that meeting and share it with The Street. Other companies have met with twenty four weeks of data. And I want to remind you that we have a lot of information on forty eight weeks of data and dosing from our obesity momentum study. So consequently, we feel confident that we'll have the data to go in and we'll have that meeting. Speaker 300:23:03We should have it sometime in the fourth quarter and we'll inform the Street on what the results of that Speaker 800:23:15Got it, thank you. And then my follow-up question is, with the new chairman appointment, so how will the corporate strategy evolve regarding the partnership for phase three and commercialization? It seems you're more focused on the commercialization now. Thank you. Speaker 200:23:34Yes, that's, as you can imagine, that's part of the natural evolution. The board is continuously evaluating the skill set at the Board level. Given that we're now moving into Phase III, the Board felt that addition of bringing Jerry as Chairman would be an added advantage for the, for the management team to, to move forward. So his experience in domain area in, in liver, building a liver disease company, and ultimately being part of that M and A transaction would be important as we move forward. Got it. Speaker 200:24:17Thank you. Operator00:24:19Thank you. Our next question coming from the line of Catherine O'Klakone with Citizens. Your line is now open. Speaker 900:24:29Hi. This is Catherine on for John. I just have a quick question about the T1 responses and how the results from impact compared to other programs. I know that you said kind of best in class, but if you could kind of give us some kind of ranges from the other competitor programs. Thanks. Speaker 300:24:47Yeah, Kathryn, so as you're aware, the results that we have were in the range of a reduction of about 145 to 140. That was seen in this trial, but it was also seen in a prior trial or Phase 1b trial in patients with fatty liver. And based on the public data, we're seeing readouts of approximately 50 to 60 for Resmitteram and up to about 107 for Tirzepatide. So you can see that these results that we're getting, 147 versus a range of 50 to 107, are clearly superior to other compounds, at least those that are reported in the public domain. And that given the association of CT1 with reduction of both, mesh activity and fibrosis that this is one other measure among many measures showing the potent anti inflammatory and anti fibrotic activity of the compound. Speaker 900:25:56Great, thank you. Operator00:26:00Thank you. Our next question coming from the line of Patrick Tuchio with H. C. Wainwright. Your line is now open. Speaker 1000:26:10Hi, good morning, and congrats on all the progress. I just have a couple of follow-up questions on expectations around the Phase III program then as well just maybe looking further ahead to potential commercialization and the product profile that's emerging. I guess the first part of the question is just around kind of updated thoughts on dosing strategy, one point two milligram, one point eight milligram and then the higher dose and how you're thinking about the dose selection for the Phase three. And then as well, you know, primary endpoints, how are you thinking about primary endpoint, co primary endpoint? You know, would mass resolution as primary with fibrosis improvement? Speaker 1000:26:55Or would there be a co primary design? And I guess, how would you power for both? And then just as it relates to just the commercial potential, just based on, I mean, there's a lot of data and I think there's a lot of points of differentiation here. So, if the Phase three were to reproduce the impact efficacy and tolerability, I guess, how do you see the positioning in NASH if there's an eventual approval? Speaker 300:27:23Patrick, I'll take the first part of the question for the commercial potential. I'll turn it over to Vipin. So, as you are aware, we studied the one point two and the one point eight milligram doses and impact. And even at the one point eight milligram dose, which is not our most potent dose for weight loss, we still achieve 6.2% weight loss at only twenty four weeks. And the trajectory of the weight loss indicated there was a lot more weight loss to be had. Speaker 300:27:57So we think it's going to be very attractive to put the two point four milligram dose into Phase three. Would not only give more weight loss to the extent that it could problem us even more provide even more efficacy, we find that very attractive. Regarding the other two doses, that's currently being looked at very critically and we'll discuss that with the agency and have an update for the Street after we have our end of Phase II meeting. As you're aware, there are two endpoints in NASH, NASH resolution and fibrosis improvement. In the IMPACT study, we had a dual endpoint, meaning that we either had a hit, MAH resolution or fibrosis improvement for the trial to be successful and consequently, IMPACT was a successful trial. Speaker 300:28:43We could go into Phase III with a similar strategy of dual endpoints. There's also the possibility of co endpoints when you have to hit both, etcetera. And then in the background, you have endpoints based on noninvasive tests, which we feel are very exciting. And by the way, EMA has approved the use of a PathAI methodology for actually reading out mesh resolution and fibrosis improvement using computerized algorithms assisted by the pathologist but driven predominantly by the computer, which we think is going to reduce greatly the noise that we're seeing in the trial and probably help us control the placebo response and really express the anti fibrotic potential of the compound. So we think there's a lot of things that play here in terms of the discussion with the FDA. Speaker 300:29:34It's going to be a very exciting and important end of Phase II meeting. And as soon as we have further information, we'll update the street. So with that, I'm going to turn the commercial discussion over to Vipin. Vipin? Speaker 200:29:46Yeah, I just want to emphasize one other thing with regards to the FDA discussion. You know, one thing I want to remind everybody is that we have a very large safety database that we have already accumulated on pembidutide. So part of our discussion would be how do we leverage that? Do we think there is an opportunity to reduce the number of exposures in terms of the safety database. So we'll certainly be having that dialogue with the FDA, as Scott said, among many other things that we'll be discussing with the FDA. Speaker 200:30:15So looking forward to that. Patrick, in terms of commercial potential of pemigutide, as we have said all along and as you pointed out, there are multiple points of differentiation. First and foremost, we are combining two mechanisms: direct action in the liver, a direct acting agent in the liver with a metabolic agent with weight loss. So really think of it, we're treating NASH with obesity. And when you look at the NASH landscape, everybody's talking about the benefit of adding weight loss on top of liver directed effect. Speaker 200:30:51We're bringing that in single molecule, we're combining these two mechanisms. So we're treating NASH, but on top of that people are losing weight. Sixty to eighty percent of patients with NASH are obese or overweight, so they would benefit from losing weight. So that's number one, which we believe is a very big advantage or differentiating factor for pembidutide. You know, in our, in our work, our market research, it's clear that physicians are looking for a drug where people will not only improve their liver health, but will also lose weight. Speaker 200:31:24Secondly, safety and tolerability is going to be very, very important. And as you can see from our data, we are seeing class leading tolerability profile. We think that can be leveraged. Patients like that, doctors like that, lack of dose titration is going to be a major plus when we go, when we commercialize pembituride. So it's really the benefit of combining the two mechanisms, and on top of that, having a very clean safety and tolerability profile that we think is going to speak well in terms of the commercial success of the product. Speaker 1000:32:02Great. Thanks so much. Operator00:32:04Thank you. Our next question coming from the line of Mayank Mamtani with B. Riley Securities. Your line is now open. Speaker 700:32:15Hi. Thanks for taking our questions. This is William on for Mayank today. Two from us. Maybe I'll start with the first. Speaker 700:32:23So now that we know that Lilly has gotten positive FDA buy in on pursuing high risk MAZZOID trial for their Reta and Tirzepatide. They're using NITs for patient screening and then foregoing biopsies completely for primary efficacy endpoint. And it looks like even in the trial, looking more of an outcomes type trial. How do you see this as an opportunity for Pembina to execute on a capital efficient Phase III trial? And is your understanding that this still only biopsies are a way to secure Subpart H accelerated approval? Speaker 700:33:00And then I have a follow-up. Speaker 300:33:03Well, thanks, William. Yeah, think it's really exciting. I think it creates a real opportunity for us in noninvasive tests and we're taking a very careful look at that. We think that there's real opportunity for us here and we'll certainly have that discussion with the FDA. Speaker 800:33:24As we Speaker 200:33:25said, will look at every potential opportunity to come up with an innovative trial design and incorporate all of these things that are now becoming clear that the FDA is reviewing. So we'll certainly have all of those discussions. We can't get into the specifics right now, but we'll definitely talk about it once we've had the end of phase two meeting. Speaker 300:33:45Yeah, let add to that, William, that there are a lot of exciting things happening here, the development of NITS, the movement toward AI based reading in Europe and we think there's a good chance that FDA will pick that up and you saw that we had very positive results from the AI based analyses that really reduce the noise from the manual pathologist readout. So there other developments here that are going to increase our probabilities of success in Phase three. We're very interested in those and share your excitement and plan to have that discussion with the FDA this fourth quarter. Speaker 700:34:30Got it. And then also, again, also sort of thinking of crosstown peer. Merck has their Afinopegutide readout coming out shortly, and they're looking at biopsy results at forty eight weeks. Slightly different glucagon ratio here, but what could their data mean in terms of your forty eight week data potentially in Phase three or obviously your just your net data coming up at the end of the year? And what may you be specifically looking for to bring confidence phase three going forward and what will help guide you in the development of that phase three? Speaker 300:35:05Right, well, as you noted, William, the reading added forty eight weeks. And another glucagon compound is read out at forty eight weeks, and these have lesser ratios of glucagon. As Vipin mentioned, we read out at only twenty four weeks. So we think that our readouts at forty eight weeks, had we done the biopsy week forty eight weeks, would have been as good if not better than the other compounds. That's certainly supported by the very potent non invasive test results we're seeing at week twenty four. Speaker 300:35:37I want to remind you that there hasn't been an incretin, let alone a glucagon containing incretin that is read out at week twenty four. And at week twenty four, our MATCH resolution was comparable to or superior to other compounds at week twenty four and better than compounds reading out at later time points in forty eight to seventy two weeks. So we think that afinipegatide readout will be further confirmation of the efficacy of the compound. Now, as you know, we don't have a biopsy at week forty eight, but we have the noninvasive tests. And we expect to be able to use the noninvasive test to model and to predict what we would have seen a week of 48 had we done the week biopsy, forty eight week biopsy. Speaker 300:36:26So we think that data will be very supportive of our mechanism and our efficacy. Speaker 700:36:33Got it. Thanks for that color. I'll hop back in the queue. Operator00:36:37Thank you. Our next question coming from the line of Corinne Johnson with Goldman Sachs. Your line is now open. Speaker 1100:36:45Good morning. Maybe just one from us. How should we think about the cadence of research and development spend from here as these AUD and ALD studies kind of get up and further running and enrollment increases? Thanks. Speaker 400:37:01Thanks, I appreciate the call. This is Greg and in terms of the R and D spend investment in AUD and ALD, these are phase two trials. They're baked into our budget for this year, they're incorporated in our cash runway. These are relatively modest in size, and we're on it. Don't anticipate anything unusual in our burn rate going forward in the near term as related to AUD ALD. Speaker 200:37:31Okay, thanks. Thank Operator00:37:35you. Our next question coming from the line of Andy Hsieh with William Blair. Your line is now open. Speaker 1200:37:44Thanks for taking the question. Just a quick one. Very interested in the oral program that you are advancing. So I'm curious, maybe from a technological perspective, we think about it as a gastric absorption enhancer. And also just curious if you can tell us a little bit more about how you would position this formulation in the grand scheme of things. Speaker 1200:38:09Thank you. Speaker 1000:38:11Yes. Thanks for the question. Speaker 1300:38:14We've been at this for a little while here and I'm excited to share that we've had a big breakthrough in the activity. From the very beginning, we focused on two elements that really differentiate an oral formulation of the peptide from others that are out there, Rybelsus for example. The first is to get away from the food restriction. You mentioned gastric absorption. That's exactly what we're trying to get away from. Speaker 1300:38:42And we've done that from the beginning and focused on that because when it's absorbed in the gut or in stomach, then it's really about very tight food restrictions that you're aware of for the Rybelsus indication. So that's one of the things we wanted to do. And the secondary feature was to make sure that it really made sense from a cost of goods standpoint. As you know, the oral absorption is always inefficient compared to subcutaneous injection, but to make it work, we had a fairly high threshold for what we would be interested in. So I think that things are looking very good in that respect. Speaker 1300:39:24I think this breakthrough that we had was mechanism based that it went just the way we expect and we're looking forward to translating that into a preclinical development and nomination there. So as far as the impact to the commercial situation, I'll let Vipin speak to that. Speaker 200:39:43Yes. I mean, our strategy with the oral program is very similar to what you would expect with what's being done with other products. Really a life cycle management question. As this field grows, there would be attractiveness to the oral program. As Scott mentioned, oral delivery is never going to be as efficient as subcutaneous injections. Speaker 200:40:04So we believe that both of these formulations would be important in terms of developing commercially the value proposition around pemidutide. Speaker 1200:40:15Wonderful, thank you. Operator00:40:19Thank you. And there are no further questions in the queue at this time. I will now turn the call back over to Doctor. Bipengarg for any closing remarks. Speaker 200:40:28Thank you all for joining our call today. As always, we appreciate your continued support and look forward to keeping you updated in the months ahead. Have a wonderful rest of the day. Operator00:40:41This concludes today's conference call. 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