AdeniumBiotech
Corporate presentation December 2013
Antimicrobial peptides with novel mode of action
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Adenium Biotech - Background
• Spin-out from Novozymes, founded in 2011 • Seed investment from Novo Seeds and Sunstone Capital • Seed company with experienced management, industry experienced
Board of Directors, and top KOL scientific advisory board • ”First-in-Class” systemic Anti Microbial Peptide (AMP) with potent &
selective activity against multi-drug resistant Gram-negative bacteria– Clinical Candidate, AA139, nominated and strong back-up candidate available– Bactericidal, new MoA, 2 week tox in pigs/rodents and efficacy in vivo completed– First-in-Man Phase I studies to be initiated by end of 2014
• Clear development plan • Funding requirement:
EUR 8 M to progress AA139 through Phase IEUR 20 M to progress AA139 through Phase II
• Additional AMP programs targeting Gram-positive pathogens
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Adenium Biotech - Key People
Board of Directors
Chairman, Khalid Islam, GentiumAnker Lundemose, Bionor Ejner Bech Jensen, NovozymesAndreas Segerros, SunstoneStephan Christgau, Novo SeedsCasper Tind Hansen, Pcovery
Scientific Advisory Board
Dr Bruce Montgomery (USA)Prof. Brad Spellberg (USA)Prof. David Livermore (UK)Prof. Matt Cooper (AUS)Dr Frank Fildes (UK)
Tim Joslin, Defined Health. Commercial assessment
Management & Team
CEO, Peter Nordkild. Biotech entrepreneur. Previously CEO of Arts Biologics and Egalet, SVP at Ferring and Novo NordiskCSO, Sergio Lociuro. Previously director of Medicinal Chemistry and Int. Project Leader in GSK, Head of Peptide Epitope Mimetics in Polyphor Ltd and Head of Research in Arpida COO, Søren Neve. Previously project manager for the Arenicin-3 discovery activities in Novozymes CMC, Kim Hejnæs. Previously project director at CMC Biologics
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Bacterial Resistance - An escalating problem calling for new MoA antibiotics
• Resistance is increasing rapidly• Resistance is a high priority with US and EU authorities • Even Colistin, invented in the fifties and abandoned in the sixties due to neuro-
and nephrotoxicity, is increasingly used but resistance is growing
Carbapenem resistant enterobacteria
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Arenicin Program
• Most potent anti Gram-negative AMP identified by Novozymes through screening effort comprising more than 500 organisms
• Arenicin-3 is a 21 AA peptide from the lugworm Arenicola marina• New and dual MoA• Novozymes has tested ≈ 250.000 Arenicin variants• Adenium has subjected the 10 best to extensive characterization/
lead optimization and selected AA139 as the clinical candidate• GMP manufacture initiated October 2013
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Arenicin Program Targets Unmet Medical Need
GAIN legislation from 2012 grants priority review, fast track status and extend market exclusivity period with 5 years
Klebsiella Acinetobacter Pseudomonas E coliEnterobacter Staphylococcus
ESKAPE pathogens Adenium Targets Gram neg GAIN act pathogens
E coli Klebsiella Pseudomonas Acinetobacter
Urinary Tract Infection (UTI)
Pneumonia (HAP/VAP)
Intra Abdominal Infection (IAI)
Adenium Lead Indication
Possible 2’ Indications
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Novel mode of action Bactericidal Selective and specific Low frequency of resistance Active against GAIN pathogens Wide therapeutic window Drugable
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NTarget Product Profile for multidrug resistant broad spectrum Gram-negative antibiotic
Dual Mechanisms of Action – low spontaneous mutation frequencies
0 16 64 256 1024 40960
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10
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Arcolpip
Extracellular ATP after 10 min
x MIC
Fold
cha
nge
Arenicin (Ar), colistin (col), and piperacillin (pip) induced release of ATP from E. coli. Exponential cells were incubated with drug for 10 minutes and ATP measured. y-axis is fold change relative to untreated and x-axis is fold MIC applied.
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Arenicin also inhibits protein synthesis through inhibition of cytosolic processes
MlaC is a periplasmic binding protein maintaining phospholipid homeostasis
Arenicin has a completely novel MoA: Distortion of phospholipid synthesis by interaction with MlaC
Frequency of resistance <10-11
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Arenicin Clinical Candidate, AA139: Excellent PK properties and efficacy against Multi Drug Resistant GAIN Pathogens
• Arenicin efficacy likely driven by Cmax
• AA139 has highest Cmax and largest AUC of all Arenicin variants • Plasma half life of 4.3 hours• Limited effect of Survanta (mucin analogue) on activity• Protein binding 93%
strains AA139 Colistin Meropenem Ceftazidime Ciprofloxacin Gentamicin Tigecycline
N=325 MIC (µg/ml)
E.coli N=55 1 0.25 4 R R R 0.5
K.pneumonia N=75 4 R R R R R 4
P.aeruginosa N=75 8 2 R R R R ND
A.baumanii N=120 2 R R R R R 4
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MIC90 determinations (Clinical MDR isolates)
Arenicin Clinical Candidate, AA139: Low ED 50 against E. Coli and K. pneumonia in UTI
• Mice inoculated on day -3• Treatment, twice daily, on day 1 and 2. Sacrificed on day 3• Bladder analyzed for bacterial load
E. coli K. pneumoniaMIC: 0.5 µg/ml MIC: 1µg/ml
Euprotec 2013
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Arenicin Clinical Candidate, AA139: Potent efficacy in UTI against E coli at 5xED50 compared with Meropenem
• Mice inoculated on day -3• Treatment, twice daily, on day 1 and 2. Sacrificed on day 3• Tissues analyzed for bacterial load• Comparison with standard of care, Meropenem
E.coli DSA443Compound µg/ml
AA139 0.12Meropenem <0.06
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Arenicin Clinical Candidate, AA139: Excellent efficacy in pneumonia compared with Colistin after aerosol admin.
• Mice inoculated on day 1• Treatment, 3 ml aerosol for 10 min at 2, 12, 24 hour post infection• Lung harvest at 34 hour post infection • Compared with standard of care, Colistin
Euprotec 2013
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Klebsiella Pneumonia NCTC13442
Compound log reduction MICAA139 -3.89 1
Colistin -1.75 1
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NAA139 shows potent effect against MDR Gram negative bacteria in major animal models of infection
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Good bioload reduction on par with Meropenem against E.coli in mouse thigh model following IV dosing
E.coli DSA443Variant log reduction MIC (ug/ml)
NZ17139 -1.6 0.12Meropenem -1.6 <0.06
Good bioload reduction on par with Meropenem against E.coli in bladder following IV dosing
Potent bioload reduction superiour to Meropenem against E.coli in peritoneal fluid following IV dosing
Moderate bioload reduction against P.aeruginosa in pneumonia following IV dosing
Pseudomonas aeruginosa VL-98Variant log reduction MIC (ug/ml)
NZ17139 -1.12 1.0Meropenem -3.1 0.25
E.coli AID172Variant log reduction MIC (ug/ml)
NZ17139 -0.4 0.12Meropenem -0.4 0.12
E.coli AID172Variant log reduction MIC (ug/ml)
NZ17139 -3.8 0.12Meropenem -1.1 0.12
AA139
MTD iv (mg/kg) 25
E. coli ED50 Bladder (UTI) (mg/kg) 1
MTD/ED50 Bladder 25
Protein binding 93
Extensive Tox testing in rodents and mini pigs confirm safety
• Histamine release and reversible proximal tubular damage only adverse event• No hERG or other cardiovascular toxicity
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(7 days of multiple dosing in mice and mini-pigs)
Indications Meropenem Colistin AA139
Pneumonia +++ +++ +++Complicated urinary tract infections +++ +++ +++Coverage
MDR E.coli ++ +++ +++MDR P.aeruginosa - + ++MDR A.baumannii - - +++KPC K.pneumonia - - ++Colistin resistant G- Bacteria - - +++Administration
Oral no no noIV yes yes yesAerosol no yes yesSafety
Renal/Hepatic (yes) yes (no)Neurological no yes noHypersensitivity yes yes yesAction
Bactericidal yes yes yes
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Product profiles of Meropenem, Colistin and Arenicin
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Very few new MoA Gram negative antibiotics – most in clinical development targets PseudomonasCompound Company Develop-
ment TargetSpectrum
E.coli Klebsiella Pseudomonas Acinetobacter
Single pathogen
ACHN975 Achaogen PhI LpxC inhibitor ÷ ÷ ÷Pol 7080 Polyphor ltd PhI Membrane modulator ÷ ÷ ÷BioPhage PA BioControl Ph2 Bacteriophage
(Virus) ÷ ÷ ÷IC 43 Intercell AG
(Novartis)Ph2 Immunostimulant
(Vaccine) ÷ ÷ ÷KB001 KaloBios
(Sanofi)Ph2 PcrV antibody ÷ ÷ ÷
Broad Gram-NegativeAA139 Adenium Preclinical MlaC/protein
synthesis GP-4 Trius (Cubist) Preclinical GyrB/ParE RX04 Rib-X
(Sanofi)Preclinical 50S ribosomal subunit
SASPject™ PT3.X Phico Preclinical Inactivated bacterial DNA
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Tasks 2013 2014 2015 2016 2017 2018 2019 2020 CostMUSD
Lead candidate selection
API synthesis (20 g) 0.1
API Preclin/Phase I production (1.7 kg) 1.9
Pre-clinical tox/safety 1.3
CTA/IND 0.3
Phase I (SAD/MAD) 2.0
cGMP production for ph II and III (0.6 - 2.7 kg) 3.1
Fill and finish (phII, phIII) 0.7
SPA meeting 0.3
Phase II (a and b) cUTI 6.0
Phase III studies cUTI 30.0
NDA submission 0.3
Total / Year 0.1 2.8 2.2 3.6 5.0 17.0 15.0 0.3 46.0
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External activities and cost for development of AA139 in cUTI
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Additional programs target other GAIN pathogens
• The Arenicin platform provides opportunities for multiple clinical indications:
• AA139 in other clinical indications than cUTI (e.g. HAP/VAP, IAI)
• Other Arenicin variants for selected pathogens (i.e. variants with high activity against e.g. MDR N. Gonorrhoeae identified)
• The Plectasin platform provides opportunities for multiple MDR Gram positive clinical indications:
•AP114 is very potent against C. difficile (cGMP material is available/FIM studies to be initiated summer 2014)• AP138 will be developed against cardio/osteo implant
infections caused by MDR S. aureus 18
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Adenium Expands AMP platform
• Lead program, AA139, will be advanced through phase II by midle of 2017 • AP114 program will initiate phase I studies in H2 2014• AP138 program will initiate phase I studies in summer 2016• Additional Arenicin programs will be developed with external funding
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Compound Indication Discovery Development
In vitro In vivo Preclinical Phase I
Arenicin MDR N. gonorrhea
PartnerIn vitro In vivo Preclinical Phase I
DMID
MDR C. diff
MDR G- cUTI/HAP&VAPAA139
AP114
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AP138 MDR G+ implant infections
Plans for series A round
• Development cost of EUR 6 mio for AA139 through phase I • Development cost of EUR 2 mio for AP114 through phase I• G&A cost of EUR 2 mio• Company plans to raise a minimum of EUR 10 mio in a
series A round in H1 2014• Current investors (Sunstone Capital and Novo) will
participate in the series A round• Plan to attract 1 – 2 additional investors to the syndicate
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Key Value Drivers for Investment
• AA139, one of very few new MoA, broad spectrum MDR Gram-negative antibiotic
• First in class antibiotic with strong patenting through 2033• Increasing resistance problem spurs interest in new anti-
infectives • Regulatory guidelines (e.g. GAIN act) provides additional
incentives for anti-infective development• Recent deal activity (e.g. Cubist – acquisition of
Trius/Optimer; Roche – license of POL7080) confirms interest in antibiotics
• Additional opportunities for AA139 in other indications• AP114 program targets C. diff infection, a growing problem
with rapidly aging populations and a GAIN pathogen21
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