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    Thomas Smith • Leerink Partners

    Thomas Smith's questions to Madrigal Pharmaceuticals Inc (MDGL) leadership

    Thomas Smith's questions to Madrigal Pharmaceuticals Inc (MDGL) leadership • Q2 2025

    Question

    Thomas J. Smith of Leerink Partners inquired about the gross-to-net and inventory dynamics during the quarter, asking for clarification on the apparent improvement in net pricing versus Q1 and the outlook for the remainder of the year.

    Answer

    CFO Mardi Dier explained that the quarter's results were driven by strong demand and reiterated that gross-to-net will be choppy early in the launch. She noted that while contracting began in April, the more significant impact is expected in the second half of the year, keeping the metric within the typical specialty pharma range. CEO Bill Sibold added that the company takes a long-term, disciplined view on gross-to-net to preserve value.

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    Thomas Smith's questions to Madrigal Pharmaceuticals Inc (MDGL) leadership • Q4 2024

    Question

    Thomas Smith of Leerink Partners inquired about the Rezdiffra launch momentum in early 2025, asking for commentary on new patient additions, any changes in cadence, and the impact of Q1 insurance dynamics. He also sought color on Q1 and full-year 2025 performance relative to successful specialty drug launch analogs.

    Answer

    CEO William Sibold confirmed that the strong momentum from 2024 has continued into 2025 with steady patient and prescriber growth, while acknowledging the typical 'Q1 dynamic' that the company is managing well. CFO Mardi Dier added that while not providing specific guidance, they expect the Q1 2025 consensus to narrow and increase, and that the launch continues to track well against their basket of top specialty launch analogs.

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    Thomas Smith's questions to Madrigal Pharmaceuticals Inc (MDGL) leadership • Q3 2024

    Question

    Thomas Smith inquired about early visibility into patient persistence and refill rates for Rezdiffra, and also asked about the company's business development strategy for building a pipeline beyond Rezdiffra.

    Answer

    CEO William Sibold responded that it is too early to quantify persistence but that early indicators are optimistic. On business development, he affirmed Madrigal's goal to be the leading NASH company by building a pipeline. He noted the company is evaluating opportunities across all stages and is receiving inbound interest due to its leadership position, with a focus on finding the right assets to add to the portfolio.

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    Thomas Smith's questions to Viking Therapeutics Inc (VKTX) leadership

    Thomas Smith's questions to Viking Therapeutics Inc (VKTX) leadership • Q1 2025

    Question

    Thomas Smith asked about the baseline patient characteristics in the Phase II VENTURE oral study and how they compare to the prior injectable study. He also inquired about the need for additional manufacturing capacity or redundancy beyond the CordenPharma agreement.

    Answer

    Brian Lian, President and CEO, stated he had not yet reviewed the demographic data for the oral study but expected it to be similar to past trials. He confirmed that Viking does plan to establish redundancy across its entire supply chain to ensure capacity and mitigate risks.

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    Thomas Smith's questions to Viking Therapeutics Inc (VKTX) leadership • Q3 2024

    Question

    Thomas Smith asked for an update on the review of the 100mg oral VK2735 cohort data, whether higher doses might be explored, what additional analyses for VK2809 in NASH could be expected at the upcoming AASLD meeting, and the current strategy for partnering the NASH program.

    Answer

    Executive Brian Lian deferred detailed comments on the 100mg cohort until the ObesityWeek data release but noted nothing precluded dosing higher. For VK2809, he said to expect more granular data on histologic changes at AASLD. He reiterated that the company's strategy for the NASH program remains to advance it in collaboration with a larger pharmaceutical partner.

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    Thomas Smith's questions to argenx SE (ARGX) leadership

    Thomas Smith's questions to argenx SE (ARGX) leadership • Q4 2024

    Question

    Thomas Smith asked about the lupus nephritis (LN) proof-of-concept study, inquiring about the baseline characteristics of the patients enrolled in China by Zai Lab and the company's bar for success.

    Answer

    CEO Tim Van Hauwermeiren praised partner Zai Lab and explained the trial is a true proof-of-concept designed to answer the primary question of whether the IgG-lowering mechanism works in LN patients. He stated that if the data is positive, argenx will advance to a global Phase III trial designed to account for different global treatment regimens.

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    Thomas Smith's questions to Aclaris Therapeutics Inc (ACRS) leadership

    Thomas Smith's questions to Aclaris Therapeutics Inc (ACRS) leadership • Q1 2024

    Question

    Thomas Smith asked about any preclinical data comparing ATI-2138 to upadacitinib (a JAK1 inhibitor), the rationale for an open-label versus placebo-controlled trial design, and the expected timeline for top-line data.

    Answer

    Interim CEO Neal Walker stated he was unaware of direct comparisons to a pure JAK1 inhibitor but emphasized the hypothesis that the dual ITK/JAK3 mechanism should yield an additive effect. He defended the open-label design as more cost-efficient and faster for enrollment, which is ideal for signal-finding in a well-understood indication like atopic dermatitis. Regarding timing, Walker declined to give specific guidance but indicated data would be available within a year.

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