MONSIELiving with RDEBJefferies 2019 Healthcare Conference
June 5, 2019
Safe Harbor Statement
This presentation contains certain statements that may be forward-looking within the meaning of Section 27a of theSecurities Act of 1933, as amended, including statements relating to the product portfolio and pipeline and clinicalprograms of the company, the market opportunities for all of the company’s products and product candidates, and thecompany’s goals and objectives. These statements are subject to numerous risks and uncertainties, including butnot limited to the risks detailed in the Company’s Annual Report on Form 10-K for the year ended December 31, 2018,and other reports filed by the company with the Securities and Exchange Commission.
This presentation does not constitute an offer or invitation for the sale or purchase of securities or to engage in anyother transaction with Abeona Therapeutics or its affiliates. The information in this presentation is not targeted at theresidents of any particular country or jurisdiction and is not intended for distribution to, or use by, any person in anyjurisdiction or country where such distribution or use would be contrary to local laws or regulations. The Companyundertakes no obligations to make any revisions to the forward-looking statements contained in this presentation or toupdate them to reflect events or circumstances occurring after the date of this presentation, whether as a result ofnew information, future developments or otherwise.
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Abeona: a fully-Integrated gene & cell therapy company
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Key Milestones
• Pivotal Phase 3 for Recessive Dystrophic Epidermolysis Bullosa (RDEB) – start mid 2019
• Updates on enrollment and clinical data for Phase 1/2 study in MPS IIIA and MPS IIIB – 2H2019
• CLN1/Infantile Batten disease - IND “may proceed” received May 2019
• Abeona GMP gene and cell therapy facility established in Cleveland
- Seamless transition from concept-to-commercial across multiple modalities
- EB-101 manufacturing for upcoming Phase 3 study and commercialization
- Quality systems and staff in place to support EB and AAV programs
Robust Pipeline
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RDEB Clinical ProgramEB-101
Orphan Drug Designation (FDA)✓
Orphan Drug Designation (EU)✓
Rare Pediatric Disease Designation (FDA)✓
Breakthrough Therapy Designation (FDA)✓
Regenerative Medicine Advanced Therapy Designation (FDA)
✓
Group of devastating inherited connective tissue diseases; characterized by skin blisters and erosions
• Recessive Dystrophic Epidermolysis Bullosa (RDEB): Absence of the COL7A1 gene (encodes type VII collagen to anchor skin to the underlying stroma)
No FDA-approved therapy
Phase 1/2 clinical trial completed• Conducted at Stanford University School of Medicine• Primary endpoint: Safety, wound healing vs. baseline• Secondary endpoint: Expression of type VII collagen, pain, itching,
quality-of-life
Preparing for pivotal Phase 3
Supportive Natural History Study helps shape clinical program• Average duration of untreated chronic wounds >7 years• 128 RDEB Subjects - clinical trial readiness
EB-101: Breakthrough Therapy for Severe Form of EB
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UNTREATED CHRONIC WOUND: ARMBASELINE 3 MONTHS 6 MONTHS
Recurrent Wounds Over Time (N=25)
Chronic Wounds Over Time (N=25)
Time to heal (6 weeks)Time to re-blister (3 weeks)
baseline 2 months 5 months
baseline 2 months 3 months
RDEB Wounds Can Have Distinct Time CoursesChronic
Recurrent
≤ 19 cm2
20-39cm2
≥ 40 cm2
RecurrentWounds 39% 4% 57%
Chronic OpenWounds 33% 13% 55%
0%
10%
20%
30%
40%
50%
60%
Perc
ent o
f Wou
nds
Stanford Natural History Study: Size Distribution Of Wounds
N = 120
N = 104
These large wounds are the most urgent to treat as they carry the greatest burden:• Pain• Pruritis• Risk of infection
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EB-101: 26-days post growth
EB-101: ready for patients
EB-101: Ex-Vivo Autologous Gene-Corrected Cell Therapy
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Site Location Descript Estimated duration 3m 6m 12m 24m
A R lateral hand Erosion 3-5 yrs
B R medialhandScar tissue 3-5 yrs
C L ventral footErosion and scar 3-5 yrs
D L hand Scar tissue 3-5 yrs
E R foot Erosion and scar 3-5 yrs
Z L ventralfootInduced wound New
≥75% healed 50-70% healed < 50% healed
Baseline 3 months 6 months 12 months
Phase 1/2 Study: EB-101 restored collagen VII that forms anchoring fibrils
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Anti-COl7A1 NC2 MabHoechst 33342
Pre-Grafting 3 Month 6 Month 9 Month 12 Month
Pain at wound site (% reported yes) 58% 0% 17% 20% 0%
Itch at wound site (% reported yes) 67% 5% 17% 50% 25%
Lack of durability at wound site(% reported yes) 90% 0% 0% 0% 0%
Ease of blistering at wound site (% reported yes) 83% 0% 0% 0% 0%
EB-101 significantly improved patient-reported outcomes
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Phase 1/2 results: EB-101 provides durable healing of chronic wounds
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2 years 5 years
A R distal forearm >5 B L forearm >5C R proximal forearm >5D R shoulder >5 E L arm 5 B L shoulder >5C R forearm 5-MarD R posterior shoulder >5E Lower back >5 Z R upper chest InducedA R lateral hand 5-MarB R medial hand 5-MarC L ventral foot 5-MarD L hand 5-MarE R foot 5-MarZ L ventral foot InducedA L distal forearm >5 B L medial forearm >5 C L proximal forearm >5 D R lateral forearm >5E R distal forearm >5 Z R medial forearm InducedA L upper arm 16B L upper arm 16
5 C R upper arm 16D R upper arm 16E R upper arm 16F R upper arm 16A R lateral back upper 20B R middle back upper 20
6 C R medial back upper 20D R lateral. back lower 20E R middle back lower 20F R medial back lower 20A R back corner 20
7 B R lateral outer leg 20C R Back central 20D R Back medial 20E R foot front anterior 20F Back upper corner 20
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12 months 3 years 4 years
1
2
3 months 6 months
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Participant Site Location Wound Age (years)
R&D Day 2018
PatientSiteLocationDescription at BaselineWound Age1 month23 months6 months12 months3 years4 years
2 years5 years
RDEB Wound Healing
1AR distal forearmErosion>5 yrs>75%
BL forearmErosion>5 yrs>50%-75%
CR proximal forearmErosion>5 yrs5 yrs
EL armNew blister1 wk
ZR armInduced woundNew
2ACentral chestErosion>5 yrs
BL shoulderErosion and scar>5 yrs
CR forearmErosion and scar3-5 yrs
DR posterior shoulderInflamed erosion>5 yrs
ELower backErosion>5 yrs
ZR upper chestInduced woundNew
3AR lateral handErosion3-5 yrs
BR medial handScar tissue3-5 yrs
CL ventral footErosion and scar3-5 yrs
DL handScar tissue3-5 yrs
ER footErosion and scar3-5 yrs
ZL ventral foot Induced woundNewUnable to assess
4AL distal forearmInflamed erosion>5 yrs
BL medial forearmInflamed erosion>5 yrs
CL proximal forearmInflamed erosion>5 yrs
DR lateral forearmInflamed erosion>5 yrs
ER distal forearmInflamed erosion>5 yrs
ZR medial forearmInduced woundNew
AL upper armErosion16 yrs
BL upper armErosion16 yrs
5CR upper armErosion16 yrs
DR upper armErosion16 yrs
ER upper armErosion16 yrs
FR upper armErosion16 yrs
AR back axilla (lateral), upper rowErosion20 yrs
BR back axilla (middle), upper rowErosion20 yrs
6CR back axilla (medial) upper rawErosion20 yrs
DR back axilla (lateral) lower rowErosion20 yrs
ER back axilla (middle), lower rowErosion20 yrs
FR back axilla (medial) lower rowErosion20 yrs
AR back cornerErosion20 yrs
7BR lateral outer legErosion20 yrs
CR Back centralErosion20 yrs
DR Back medialErosion20 yrs
ER foot front anteriorErosion20 yrs
F Back upper cornerErosion20 yrs
ASGCT 2018
PatientPatientSiteLocationDescription at BaselineWound Age1 month3 months6 months12 months2 years
GT 011AR distal forearmRecurrent wound>5 yrs
BL forearmRecurrent wound>5 yrs
CR proximal forearmRecurrent wound>5 yrs
DR shoulderOpen wound>5 yrs
EL armNew blister1 wk
ZR armInduced woundNew
GT 032ACentral chestOpen wound>5 yrs
BL shoulderRecurrent wound>5 yrs
CR forearmRecurrent wound3-5 yrs
DR posterior shoulderOpen wound>5 yrs
ELower backOpen wound>5 yrs
ZR upper chestInduced woundNew
GT 043AR lateral handOpen wound3-5 yrs
BR medial handOpen wound3-5 yrs
CL ventral footRecurrent wound3-5 yrs
DL handRecurrent wound3-5 yrs
ER footRecurrent wound3-5 yrs
ZL ventral footInduced woundNew
GT054AL distal forearmOpen wound>5 yrs
BL medial forearmOpen wound>5 yrs
CL proximal forearmOpen wound>5 yrs
DR lateral forearmOpen wound>5 yrs
ER distal forearmOpen wound>5 yrs
ZR medial forearmInduced woundNew
Chronic untreatedR elbowOpen wound >5yrs
Chronic untreatedL elbowOpen wound>5yrs
GT075AL upper armOpen wound16 yrs
BL upper armOpen wound16 yrs
CR upper armOpen wound16 yrs
DR upper armOpen wound16 yrs
ER upper armOpen wound16 yrs
FR upper armOpen wound16 yrs
Chronic untreated Antecubital fossaOpen wound16 yrs
GT 086AR back axilla (lateral), upperOpen wound20 yrs
BR back axilla (middle), upperOpen wound20 yrs
CR back axilla (medial) upperOpen wound20 yrs
DR back axilla (lateral) lowerOpen wound20 yrs
ER back axilla (middle), lowerOpen wound20 yrs
FR back axilla (medial) lowerOpen wound20 yrs
Chronic untreated Lower back (5 matched wounds)Open wound20 yrs
GT097AR back cornerOpen wound20 yrs
BR lateral outer legRecurrent wound20 yrs
CR Back centralOpen wound20 yrs
DR Back medialOpen wound20 yrs
ER foot front anteriorRecurrent wound20 yrs
FBack upper cornerRecurrent wound20 yrs
Chronic untreated R dorsal foot (small)Recurrent wound20 yrs
Chronic untreatedL dorsal foot (small)Recurrent wound20 yrs
EB-101 summary and next steps
• Successful Phase 1/2 • Favorable safety profile with no product-related SAEs to date• Significant and durable wound healing, with up to 5 years of follow-up• Continuous type VII collagen expression 2+ years post treatment
• Established GMP manufacturing capability at Abeona• Manufacture both clinical and commercial product in Cleveland• Scalable capacity to support commercial launch
• VITAL: Phase 3 Trial• Final stages of regulatory CMC review near completion• First patient expected to enroll mid-2019
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MPS III Clinical ProgramABO-102* ABO-101
Orphan Drug Designation (FDA)✓Orphan Drug Designation (EU)✓Rare Pediatric Disease Designation (FDA)✓
Fast Track Designation (FDA)✓Regenerative Medicine Advanced Therapy Designation* (FDA)
✓
Inherited monogenic disorders causing lysosomal enzyme deficiency
• Two most common forms categorized by deficient enzymes:
• MPS IIIA (SGSH), MPS IIIB (NAGLU)
• Abnormal accumulation of glycosaminoglycans (GAGs; heparan sulfate (HS))
• Loss of speech/language, cognitive decline, behavioral abnormalities, seizures,
sleep disturbances
• 70% of children with MPS III do not reach age 18 years
Estimated incidence of 1 in 70,000 births
Two ongoing global clinical trials
• ABO-102 (AAV-SGSH) for MPS IIIA: USA, EU, Australia clinical sites
• ABO-101 (AAV-NAGLU) for MPS IIIB: USA and EU clinical sites
No approved treatments available
Cell withlysosome deficiency
Normal cell
Ongoing Phase 1/2 clinical trials for Sanfilippo Syndrome (MPS III)
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MPS IIIA Natural History: Cognitive & Developmental Assessments
Chronological Age (mo)
Cog
nitiv
e A
ge E
quiv
alen
t (m
o)
Shapiro et al. 2016
0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69 72 75 78 81 84 87 90 93 96 99 102
105
108
111
114
0
3
6
9
12
15
18
21
24
27
30
33
36
39
42
45
Chronological Age (Month)
p
g (
)
DQ 1
00
Chronological Age (mo)
Dev
elop
men
tal A
ge (m
o)
Truxal, K.V. et al. 2016)
36m age equivalent
36m age equivalent
A Phase 1/2 Clinical Trial (ABT-001) for MPS IIIA with AAV9-SGSH
Intravenous Dosing
• Cohort 1: 5 x 1012 vg/kg (n=3)
• Cohort 2: 1 x 1013 vg/kg (n=3)
• Cohort 3: 3 x 1013 vg/kg (9-12) 8 subjects treated
Primary Endpoint
• Safety
Secondary Endpoints
• Cerebrospinal Fluid (CSF) and/or urinary HS and/or GAGs• CSF and serum SGSH enzyme activity• Liver, spleen and brain volume by MRI• Neurocognitive function as measured by Leiter International Performance Scale and the Mullen
Scales of Early Learning
• Adaptive functioning, by Vineland Adaptive Behavior Scale (caregiver report)
2-Year, Open-label, dose-escalation clinical trial
ClinicalTrials.gov: NCT02716246; Study Sponsor Abeona Therapeutics Inc
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Reductions in CSF and Urine Heparan Sulfate Post Treatment
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Lower Limit Quantitation
Normal Liver Volume
Reduction in Liver Volume Post Treatment vs Natural History
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1. (Truxal et. al., 2016, Mol. Genet. Metab.)
*Gray lines indicate natural history study patients1
Change in Mullen Developmental Age Post Treatment vs. Natural History
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1. (Truxal et. al., 2016, Mol. Genet. Metab.)
*Gray lines indicate natural history study patients1DQ= Developmental Quotient
* DQ100 Approximate typical development trajectory (Eapen et al. BMC Pediatrics 2013)
Summary of MPS IIIA ABO-102 Phase 1/2 Study Data
• N=14 as of November 2018- Length of follow up in cohort 3: 6 months (N=6 of 8 total), 12 months (N=3 of 8 total)
• Clear dose-response, and sustained improvement in biomarkers (HS CSF, Liver Volume)• Encouraging neurocognitive signals seen in younger, higher functioning patients in cohort 3
- Caregiver observations include:- Reports of improved attention, interaction with siblings/schoolmates/environment
- Improved sleep
- Improved speech in young patients
• Enrolled at age 2.3 years: “putting adjectives and adverbs into complete sentences”
• Safety: ABO-102 has been well tolerated to date- No serious drug related adverse events
- SGSH ELISpot negative
- Length of Follow up as of November 2018:• Cohort 1: 27-30 months; Cohort 2: 19-21 months; Cohort 3: 1-16 months
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2-year, Open-label, dose-escalation global clinical trial
IntravenousDosing
• Cohort 1: 2 x 1013 vg/kg (n=2 subjects*) 2 patients treated
• Cohort 2: 5 x 1013 vg/kg (n=3-6 subjects planned) 1 patient treated
Primary Endpoint • Safety
Secondary Endpoints
• CSF and/or urinary HS and/or GAG• CSF and serum NAGLU enzyme activity levels• Liver, spleen and brain volume (MRI)• Neurocognitive function as measured by Leiter International Performance Scale and the Mullen
Scales of Early Learning
• Adaptive functioning, by Vineland Adaptive Behavior Scale (caregiver report)
A Phase 1/2 Clinical Trial (ABT-002) for MPS IIIB with AAV9-NAGLU
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*Clinical study protocol states 3 subjects in Cohort 1; however, due to exceptional circumstances and following robust safety profile and positive review from DSMB, trial was cleared in Europe to advance to Cohort 2 dose
https://clinicaltrials.gov/ct2/show/NCT03315182?term=abeona&cond=MPS+IIIB&rank=1
Liver Volume CSF and Urine HS
Reduction in Liver Volume, CSF and Urine Heparan Sulfate Post Treatment vs. Natural History
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1. (Truxal et. al., 2016, Mol. Genet. Metab.)
*Gray lines indicate natural history study patients1
Change in Mullen Developmental Age Post Treatment vs. Natural History
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1. (Whitley et al., 2018)
*Gray lines indicate natural history study patients1
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CLN1 (Infantile Batten) DiseaseABO-202
Orphan Drug Designation (FDA)✓Orphan Drug Designation (EU)✓Rare Pediatric Disease Designation (FDA)✓
ABO-202: scAAV9 for Treatment of Infantile Batten Disease – CLN1
• Infantile Neuronal Ceroid Lipofuscinosis (INCL): - Severe neurodegenerative lysosomal storage disease, with no approved treatment- Caused by mutations in the CLN1 gene, encoding the soluble lysosomal enzyme palmitoyl-protein
thioesterase-1 (PPT1)
• Exclusive, worldwide license secured for AAV9 for treatment of CLN1
• Onset of symptoms between 6 to 24 months of age - Progressive visual failure, cognitive decline, loss of fine and gross motor skills develop by 2-3 years- By 5 years of age there is loss of light perception, complete loss of motor skills and social interaction;
myoclonus and seizures can appear eventually
- Death usually occurs by 7 years of age
• Therapeutic approach is a scAAV9 vector with codon-optimized CLN1 transgene
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ABO-202 Therapeutic Approach: combination IV & IT dosing
• Demonstrated efficacy in CLN1 mice support rationale for clinical dosing by both intrathecal (IT) and intravenous (IV) simultaneously
• IT: Intrathecal (lumbar puncture)
• IV: Intravenous (tail vein)
• Potential Benefits of IT/IV dosing include:
• Combination dosing with both a high intrathecal and high intravenous doses showed significant efficacy in CLN1 mice
• Combination dosing overcomes IT dose limitations due to volume constraints and bolsters IV doses, especially in older patients
• “Double exposure” to the CNS enables broad and distributed coverage
Steven Gray, Ph.D. - Batten Researcher
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ABO-202: Phase 1/2 clinical trial readiness
• IND-enabling toxicology and efficacy studies completed ⎻ Strong safety, with no significant toxicology findings in the combination dose escalation study⎻ Data demonstrated normalized survival, muscle function and cognition, especially with early treatment
• FDA IND clearance received Q2 2019
• Potential Benefits of IT/IV dosing include:- Overcoming IT dose limitations due to volume constraints and bolsters IV doses, especially in older patients- “Double exposure” to the CNS enables broad and distributed coverage
• Trial outcomes supported by large, multi-year Natural History Study
• World-leading investigators and clinical sites for CLN1⎻ University of Rochester and University of Hamburg
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Next Generation AIMTM AAV Platform
AIM™: Next Generation AAV Vector Platform
• AIM™ Vector Platform: AAV viral vector platform selected to target CNS, lung, skin, muscle, liver and other tissues
• Key Advantages of AIM™• First generation demonstrated increased gene delivery efficiency
to specific tissues• Second and third generations have increased tissue tropisms
• Over 100 capsids under evaluation
• Potential for redosing previously treated AAV subjects
• Cystic Fibrosis and Ocular programs demonstrate proof-of-concept to support pre-clinical studies
DNASAL FRAGMENTATION
ASSEMBLY AND AMPLIFICATION
CHIMERIC CAPSID LIBRARY
WILD TYPE AAVS
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AAV GMP MANUFACTURING
Abeona’s Gene Therapy Manufacturing and Quality Capabilities
Advantages of internal cGMP manufacturing• Control of supply chain, including timelines and cost• Internal Abeona quality systems and personnel
Multi-use production platform yields flexibility & risk reduction• Manufacturing suspension and adherent upstream mammalian and insect platforms• High quality, high titer material supporting clinical development & commercial scalability
Abeona’s large-scale cGMP capacity and deep expertise• 26,000 sq. ft facility in Cleveland– stage 1of 2 completed, stage 2 underway• State-of-the-art laboratories to support CMC development for process and analytics
Commercial readiness of Abeona’s facility• Designed for seamless transition from concept-to-commercial• Conversion of GMP to commercial scalability
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• FDA Division of Manufacturing and Product Quality (DMPQ) supports clinical or single use commercial facility
• 46 highly trained staff members in instrumentation and equipment Quality, technical operations, process development, assay development, management of contract manufacturing
• AAV processing GMP facility supportive of clinical translation• Separate Upstream and Downstream Suites• Capable of Clinical and Commercial Production
• Cell processing facility• Commercially viable GMP suites• Dedicated to the production of EB-101• Capacity for Commercial launch and scalability
Abeona’s Gene Therapy Manufacturing and Quality Capabilities
Hyperstacks18,000 cm2
Eppendorf BiobluScalable to 40L
CellSTACKS6,320 cm2
iCellis Nano40,000 cm2
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João Siffert, M.D. Chief Executive Officer, Head of R&D, Chief Medical Officer
Timothy J. Miller, Ph.D.President, Chief Scientific Officer
Christine SilversteinChief Financial Officer
Management Team
Max ColaoChief Commercial Officer, Head of Business Development
Edward CarrChief Accounting Officer
Maria Escolar, M.D. Pittsburgh Children’s Hospital
John Cooper, Ph.D.University of California, San Diego
Scientific AdvisorsJonathan Mink, M.D., Ph.D. University of Rochester
Erika Augustine, M.D.University of Rochester
Steven Gray, Ph.D.University of Texas Southwestern
Kevin Flanigan, M.D.Nationwide Children’s Hospital
Juan Ruiz, MD, Ph.D.Head of European Medical Affairs
Neena Patil, J.D.SVP, General Counsel
Jay BircherSVP, Quality & Technical Operations
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Slide Number 1Safe Harbor Statement Abeona: a fully-Integrated gene & cell therapy companyRobust PipelineSlide Number 5EB-101: Breakthrough Therapy for Severe Form of EBRDEB Wounds Can Have Distinct Time CoursesStanford Natural History Study: Size Distribution Of WoundsEB-101: Ex-Vivo Autologous Gene-Corrected Cell TherapyPhase 1/2 Study: EB-101 restored collagen VII that forms anchoring fibrils EB-101 significantly improved patient-reported outcomesPhase 1/2 results: EB-101 provides durable healing of chronic woundsEB-101 summary and next stepsSlide Number 15Ongoing Phase 1/2 clinical trials for Sanfilippo Syndrome (MPS III) MPS IIIA Natural History: Cognitive & Developmental AssessmentsA Phase 1/2 Clinical Trial (ABT-001) for MPS IIIA with AAV9-SGSHReductions in CSF and Urine Heparan Sulfate Post TreatmentReduction in Liver Volume Post Treatment vs Natural HistoryChange in Mullen Developmental Age Post Treatment vs. Natural HistorySummary of MPS IIIA ABO-102 Phase 1/2 Study DataA Phase 1/2 Clinical Trial (ABT-002) for MPS IIIB with AAV9-NAGLU Reduction in Liver Volume, CSF and Urine Heparan Sulfate Post Treatment vs. Natural HistoryChange in Mullen Developmental Age Post Treatment vs. Natural History Slide Number 26ABO-202: scAAV9 for Treatment of Infantile Batten Disease – CLN1 ABO-202 Therapeutic Approach: combination IV & IT dosingABO-202: Phase 1/2 clinical trial readinessSlide Number 30AIM™: Next Generation AAV Vector PlatformSlide Number 32Abeona’s Gene Therapy Manufacturing and Quality CapabilitiesSlide Number 34Slide Number 35