Arrowhead Pharmaceuticals - Q1 2026

Transcript

Operator (participant)

Ladies and gentlemen, welcome to the Arrowhead Pharmaceuticals conference call. Throughout today's recorded presentation, all participants will be in a listen-only mode. After the presentation, there will be an opportunity to ask questions. I want to hand the conference over to Vince Anzalone, Vice President of Investor Relations for Arrowhead. Please go ahead, Vince.

Vince Anzalone (VP of Investor Relations)

Thank you, Victor. Good afternoon, and thank you for joining us today to discuss Arrowhead's results for its fiscal 2026 first quarter, ended December 31, 2025. With us today from management, our President and CEO, Dr. Chris Anzalone, who will provide an overview. Andy Davis, Senior Vice President and Head of the Global Cardiometabolic Franchise, who will provide an update on commercialization activities. Dr. James Hamilton, Chief Medical Officer and Head of R&D, who will discuss our development programs, and Dan Apel, Chief Financial Officer, who will give over a review of the financials. Following management's prepared remarks, we will open the call to questions.

Before we begin, I would like to remind you that comments made during today's call contain certain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934. All statements other than statements of historical fact are forward-looking statements and are subject to numerous risks and uncertainties that could cause actual results to differ materially from those expressed in any forward-looking statements. For further details concerning these risks and uncertainties, please refer to our SEC filings, including our most recent annual report on Form 10-K and our quarterly reports on Form 10-Q. I'd now like to turn the call over to Chris Anzalone, President and CEO of the company. Chris?

Chris Anzalone (President and CEO)

Thanks, Vince. Good afternoon, everyone, and thank you for joining us today. We had another quarter of strong execution across all areas of our business, and we are well-positioned to build on this progress throughout 2026 and beyond. In fact, the recent months have included some of the more significant achievements in Arrowhead's history. Let's talk about some of these. First, on November 18, 2025, Arrowhead received its first regulatory approval and began the next phase of growth as a commercial company marketing its own medicines. The FDA approved REDEMPLO as an adjunct to diet to reduce triglycerides in adults with familial chylomicronemia syndrome, or FCS.

FCS is a severe, rare disease with an estimated 6,500 people in the U.S. living with genetic or clinical FCS, characterized by TG levels that can be 10-100 times higher than normal, leading to a substantially higher risk of developing acute, recurrent, and potentially fatal pancreatitis. This approval was supported by clinical data from the phase III PALISADE study in adults with either clinically diagnosed or genetically confirmed FCS. The PALISADE study demonstrated deep and durable reductions in TGs with a median reduction of 80% from baseline and a lower numerical incidence of acute pancreatitis events compared to placebo. Arrowhead launched REDEMPLO independently in the U.S. with a one REDEMPLO pricing model that creates one consistent price across current and potential future indications. This is important.

We're committed to sustainable innovation, and this requires rational drug pricing according to the value a medicine offers to patients and healthcare systems. REDEMPLO is a pancreatitis drug, and when we think about pricing, we look to those patient populations at greatest risk of acute TG-related pancreatitis. We've only had drug in channel for about 10 weeks, which included Thanksgiving, Christmas, and New Year's holidays, so it is difficult to infer too much about launch. However, initial trends in prescriptions, payer interactions, and shipments have been encouraging. To date, over 100 prescriptions for REDEMPLO have been received from a diverse prescriber base, with geographically balanced uptake across the U.S. Early patient starts fall into three categories: patients transitioning from our expanded access program, patients naive to the APOC3 class, and patients switching from olezarsen.

In addition, REDEMPLO shipments are being made for patients with clinically diagnosed and genetically confirmed FCS. In addition to FDA approval, we announced in January 2026 that REDEMPLO also received approval for the treatment of FCS from Health Canada and from the Chinese National Medical Products Administration. REDEMPLO will be available later this year in Canada, and we anticipate it will be marketed independently by Arrowhead. Pending regulatory review and approval, we expect to potentially launch REDEMPLO later this year in select EU countries and in the U.K. In Greater China, REDEMPLO will be marketed by Sanofi. Our cardiometabolic pipeline is off to a good start with REDEMPLO and the ongoing phase III study of zodasiran in homozygous familial hypercholesterolemia, or HoFH. We are actively expanding this pipeline with a number of discovery programs and importantly, three clinical programs.

ARO-INHBE and ARO-ALK7, being developed as potential treatments for obesity, are in phase I and II studies. We also recently initiated a phase I/II study of ARO-DimerPA in patients with mixed hyperlipidemia. For our initial obesity candidates, we recently announced some early interim clinical data. ARO-INHBE enhanced weight loss and fat reduction versus tirzepatide alone in obese patients with Type II diabetes. More specifically, two administrations of ARO-INHBE at the 400 mg dose in combination with tirzepatide achieved approximately twofold better weight loss at week 16 than tirzepatide alone. This appears to be high-quality weight loss, as we saw an approximately threefold reduction in each of total fat, visceral fat, and liver fat measures based on week 12 MRI versus tirzepatide alone in these patients. The ARO-ALK7 phase I/II study is approximately two quarters behind the ARO-INHBE study, but early data are encouraging.

We believe this is the first RNAi therapeutic to show adipocyte gene target silencing in a clinical trial, and we've seen dose-dependent reductions in adipose ALK7 mRNA, with a mean reduction of -88% at the 200 mg dose at week eight, and a maximum reduction of -94%. While these are very intriguing data, they are early and incomplete, so we have substantial work ahead of us before we get too excited about how these candidates could eventually be used. We will continue to run both phase one and two studies. We are expanding existing cohorts to increase power, and we are adding new cohorts to better understand these candidates and underlying biology. We intend to report additional results later in 2026.

ARO-DimerPA is being developed as a potential treatment for atherosclerotic cardiovascular disease, or ASCVD, due to mixed hyperlipidemia, where both LDL cholesterol and triglycerides are elevated. We believe there are approximately 20 million people in the U.S. with mixed hyperlipidemia, and this is a patient population without adequate treatment options. We recently announced that we dosed the first patients in the phase I/II clinical trial of ARO-DimerPA, which is a dual functional RNAi therapeutic designed to silence expression of the PCSK9 and APOC3 genes, thus designed to reduce both LDL cholesterol and TGs. This represents an important step forward for the RNAi field, as we believe it is the first clinical candidate to target two genes simultaneously in one molecule, and an important step forward for preventative cardiology, as both LDL and TGs have epidemiologic support as being important drivers for ASCVD risk.

We expect to have interim data for ARO-DimerPA in the second half of 2026. If we see good LDL and TG reduction in a well-tolerated manner, we may have something truly special for a very large and currently underserved patient population. Outside of cardiometabolic, we made important advances in our CNS portfolio, specifically in programs that utilize a new proprietary delivery system designed to achieve blood-brain barrier, or BBB, penetration, utilizing subcutaneous administration. In non-clinical studies across multiple animal models, we saw deep target gene knockdown across the CNS, including deep brain regions. This underscores Arrowhead's leadership in the delivery of siRNA to multiple tissues and cell types throughout the body, utilizing the proprietary TRiM Platform. Our first wholly-owned program using the BBB platform is ARO-MAPT, being developed as a potential treatment for tauopathies, including Alzheimer's disease.

During the last quarter, we announced that we dosed the first subjects in a phase I/II clinical trial that will include healthy volunteers and Alzheimer's patients. ARO-MAPT targets the tau protein in the brain, which has good biological validation as a potential driver of pathology and has emerged as a promising target for Alzheimer's Disease and additional tauopathies. We anticipate interim clinical data from the healthy volunteer portion of the study should be available in 2026, with data from the Alzheimer's patients to follow in 2027. This is a very exciting program for us. The second program to use our BBB delivery system is SRP-1005, formerly called ARO-HTT, for the treatment of Huntington's Disease. This program is partnered with Sarepta, which recently announced the submission of its CTA for study SRP-1005-101, also known as INSIGHT, in approximately 24 participants.

While our cardiometabolic and CNS work by no means encompasses everything we are doing, they are areas of substantial focus and potential value drivers in the near, mid-, and long term. Within these areas, we are addressing three of the greatest public health challenges of our time: obesity, cardiovascular disease, and neurodegenerative conditions. Now I'd like to move on to some key events during the recent period that have dramatically strengthened our balance sheet and give us the necessary resources to push multiple programs toward commercialization. We anticipate being funded through multiple potential independent and partner launches. These meaningfully increase revenue opportunities for the company and push us toward becoming cash flow positive and self-sustaining from commercial sales. Since our last reporting period, we have completed transactions with gross proceeds of $1.33 billion. Let's break that down.

First, we completed a global licensing and collaboration agreement with Novartis for ARO-SNCA, Arrowhead's preclinical-stage siRNA therapy against Alpha-synuclein for the treatment of synucleinopathies, such as Parkinson's Disease. The collaboration includes a limited number of additional targets outside our pipeline that will utilize Arrowhead's proprietary TRiM Platform. Arrowhead received a $200 million upfront payment and is also eligible to receive development, regulatory, and sales milestone payments of up to $2 billion. Arrowhead is further eligible to receive tiered royalties on commercial sales up to low double digits. Second, we earned $200 million milestone payment from Sarepta following a drug safety committee review and subsequent authorization to dose escalate and achievement of the second pre-specified patient enrollment target for ARO-DM1.

Third, we closed concurrent public offerings of $700 million aggregate principal amount of 0% coupon convertible senior notes and $230 million of common stock. Both offerings were several times oversubscribed and priced at company-friendly terms. As I mentioned at the beginning of the call, we demonstrated strong execution across all areas of our business. We received regulatory approval in three different countries. We launched our first commercial product. We continued to grow our cardiometabolic portfolio. We had encouraging early results from our obesity programs. We advanced our TRiM platform and CNS pipeline, and we meaningfully improved our financial position to push these and other programs forward. It has been a productive last few months at Arrowhead, with so much potential to continue this strong progress in 2026 and beyond.

With that overview, I'd now like to turn the call over to Andy Davis. Andy?

Andy Davis (SVP and Head of Global Cardiometabolic Franchise)

Thank you, Chris, and good afternoon, everyone. It has been just over two months since the approval of REDEMPLO on November 18, 2025, and we are very pleased with the progress we are seeing. I'd like to share some early insights across healthcare provider engagement, patient dynamics, and payer developments. I'll start with healthcare provider engagement. As a reminder, we are targeting approximately 5,000 healthcare professionals through personal promotion, complemented by a much broader omni-channel effort. Early prescribing has been led by preventive cardiologists and endocrinologists, who together account for approximately 70% of total prescriptions, with the remainder coming from internal medicine physicians focused on lipid disorders. In addition, advanced practice providers, including nurse practitioners and physician associates, working within multidisciplinary care teams, are playing a meaningful role in patient identification and treatment decisions.

Turning to patient dynamics, as Chris mentioned, over 100 prescriptions for REDEMPLO have been received to date. We see this as a very strong start that exceeded our expectations for the early months of the launch. We are also seeing geographically balanced uptake across the United States. Early patient starts fall into three categories: patients transitioning from our expanded access program, patients naive to the APOC3 class, and patients switching from olezarsen. Class-naive patients represent the overwhelming majority of starts, with expanded access and switch patients contributing evenly to the remainder. Patients receiving REDEMPLO include both clinically diagnosed and genetically confirmed FCS, with the majority not required to submit genetic testing to gain access. Importantly, a high proportion of patients are enrolling in the Rely on REDEMPLO patient support program, and in the fiscal first quarter, patients eligible for co-pay assistance paid $0 out of pocket.

Next, I'll touch on payer developments. While it is still early, we remain encouraged by positive payer feedback on both the clinical profile of REDEMPLO and our unified one REDEMPLO pricing approach. We are actively engaged with the largest payers, and discussions to date reflect a willingness to cover REDEMPLO to label, including access based on either genetic or clinical diagnosis of FCS. I'd like to conclude with a brief comment on execution. Within days of FDA approval, we had product available in the channel for FCS patients. Our REDEMPLO care coordinators, rare disease specialists, and field reimbursement navigators were deployed on day one to support prescribers and patients, and our payer account team continues to work closely with customers to minimize access barriers. The teams are off to a great start, and our teams are highly encouraged by early stakeholder feedback.

This feedback further reinforces the key differentiating attributes of REDEMPLO. As a reminder, in the PALISADE study, REDEMPLO reduced triglycerides by 80% from baseline as early as month one and maintained this reduction with minimal variability through 12 months of treatment. In addition, the numerical incidence of acute pancreatitis was lower in REDEMPLO-treated patients than in placebo. The U.S.-approved prescribing information includes no contraindications, no warnings, and no precautions. REDEMPLO can be self-administered at home once every three months, just four injections per year. With that, I'll turn the call over to James Hamilton to discuss the R&D portfolio.

James Hamilton (Chief Medical Officer and Head of R&D)

Thank you, Andy. I'd like to start with a review of the REDEMPLO FDA approval and information in the label and contained in the package insert. REDEMPLO is approved as an adjunct to diet to reduce triglycerides in adults with FCS. The recommended dose of REDEMPLO is 25 mg, and it can be self-administered at home by subcutaneous injection once every three months. REDEMPLO has no contraindications, warnings, or precautions in the U.S. FDA-approved label. The most common adverse reaction includes hyperglycemia, headache, nausea, and injection site reactions. REDEMPLO was studied in patients with both genetic FCS and clinically diagnosed FCS in the phase III PALISADE study. Patients achieved deep and durable reductions in median triglycerides of around 80% from baseline, with reductions largely maintained below the guideline-directed threshold of 500 mg/dL throughout the year of treatment.

Importantly, patients with genetic FCS versus clinical FCS showed similar reductions from baseline. We see the clinical FCS population as having the same high unmet need as the genetic FCS group, and as such, we think it's crucial to have shown that both patient populations showed similar large reduction from baseline in triglycerides. In PALISADE, treated patients also had a reduced rate of adjudicated acute pancreatitis events, a very welcome finding for FCS patients and their caregivers, and an important validation that reduction in triglycerides can in fact lead to reductions in pancreatitis. In addition to FCS, we are also investigating plozasiran in patients with severe hypertriglyceridemia or SHTG. We announced last quarter that the FDA granted breakthrough therapy designation to investigational plozasiran as an adjunct to diet to reduce triglycerides in adults with SHTG.

Breakthrough therapy designation is a process designed to expedite the development and review of drugs that are intended to treat a serious condition and where preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapies on clinically significant endpoints. This is another important step for the program. The global phase III studies of plozasiran designed to support the supplemental NDA filing to expand the label beyond genetic and clinical FCS are the SHASTA-3 and SHASTA-4 studies, which enrolled approximately 750 patients, and MUIR-3, which enrolled 1,400 patients. We're also enrolling patients in SHASTA-5 to directly assess the the ability of plozasiran to reduce the risk of acute pancreatitis as the primary endpoint. We remain on schedule to complete the blinded portion of the SHASTA-3, SHASTA-4, and MUIR-3 phase III clinical studies in mid-2026.

We expect top line data to be available in the third quarter of 2026, with planned sNDA submission for SHTG before the end of the year. We presented the study design and baseline characteristics of the SHASTA-3 and SHASTA-4 studies at the 23rd World Congress on Insulin Resistance, Diabetes, and Cardiovascular Disease in December of 2025. I'd like to spend a moment to go over a few key parts of that poster. The primary endpoint of the SHASTA studies and the accepted regulatory endpoint is TG lowering versus placebo. Plozasiran has been highly active in all patient populations studied, so these studies are overpowered to show TG lowering. One of the additional objectives and key secondary endpoints of SHASTA-3 and SHASTA-4 studies includes the assessment of acute pancreatitis rates. To be clear, the study was not designed or prospectively powered to demonstrate AP rate reduction after just a year of treatment.

However, there are a meaningful number of SHTG patients enrolled that would be considered at high risk for AP. Specifically, among the two studies, which will be pooled for AP event assessment, 37% of enrolled patients reported TGs greater than 880 mg/dL, accepted high risk threshold for AP. In addition, 20% of enrolled patients had a prior medical history of pancreatitis. Lastly, we are seeing AP events in the studies. We are, of course, still blinded and have about another 4 months before the last patient reaches the end of the blinded period, but overall, the studies are progressing as planned. Chris mentioned the interim obesity results from our ARO-INHBE and ARO-ALK7 programs earlier, but I'd like to add some color and talk about what we are adding to these programs. First, these early results were very encouraging.

The next steps would be to investigate whether and where there is a therapeutic benefit, and in the patient segments and treatment settings where it may be applicable. To review, the interim clinical trial results represent the first demonstration in humans that the Activin E ALK7 pathway, a genetically validated pathway that regulates adipose fat storage, may potentially be harnessed therapeutically to improve body composition and enhance weight loss versus tirzepatide treatment alone in obese patients with type 2 diabetes mellitus. This patient population typically experiences less weight loss with increased therapy. They're less likely to reach weight loss targets and need more effective, effective treatment options. Importantly, ARO-INHBE, in combination with tirzepatide, achieved approximately twofold weight loss and approximately threefold reduction in visceral fat, total fat, and liver fat versus tirzepatide alone in obese diabetics.

We saw signals that the pathway was active in the non-diabetics as well, but based on early data, the diabetic signal, particularly in combination with tirzepatide, appeared to be the clearest. We are already in the planning and execution stage of the following next steps: increasing numbers of patients in the phase I diabetic cohorts, including longer follow-up to better understand drug durability and activity out to one year, and initiating monotherapy cohorts in obese diabetic patients. We expect to have more data later in 2026 from these programs as we see data from the new expanded scope of the phase I/II studies. I will now turn the call over to Dan Apel.

Dan Apel (CFO)

Thank you, James, and good afternoon, everyone. I'll provide a brief outline of our financial picture. As we reported today, net income for the quarter ended December 31, 2025, was $30.8 million, for an income of $0.22 per share based on 140.7 million fully diluted weighted average shares outstanding. This compares to a net loss of $173.1 million, or loss of $1.39 per share for the quarter ended December 31, 2024, based on 124.8 million fully diluted weighted average shares outstanding at that time. Revenue for the quarter totaled $264 million, driven primarily by our licensing collaborations agreements with Sarepta and Novartis.

Of this amount, approximately $229 million related to the Sarepta collaboration, and this included $181 million from the achievement of the second DM1 milestone, $32 million from the ongoing recognition of the initial Sarepta consideration, and $17 million related to reimbursement of incurred collaboration program costs. In addition, we re-recognized thirty-four million of the $200 million upfront payment we received from Novartis under our global licensing and collaboration agreement with them. The remainder of that $200 million will be deferred over time as we fulfill our preclinical collaboration obligations. Finally, on revenue, we also recorded our first commercial sale of plozasiran in FCS. As both Chris and Andy have mentioned, we are very encouraged with the feedback and uptake we are seeing with patients and providers.

For now, we are not disclosing specific sales numbers until such time as they become a meaningful driver to our financials. Turning to expenses, total operating expenses for the quarter were approximately $223 million, compared to $164 million in the prior year quarter, representing an increase of $59 million year-over-year. This increase was driven by $40 million of higher R&D expenses and $19 million of higher SG&A expenses. To break that down, the increase in R&D expense was primarily attributable to, as planned, higher clinical costs associated with our phase III registrational studies for plozasiran in SHTG, as well as increased clinical supply chain costs. Nearly half of our clinical trial spend in the quarter was associated with our three registrational SHTG studies, namely SHASTA-3, SHASTA-4, and MUIR, which again should read out in the summer.

SG&A expenses increased year-over-year compared to the prior year's fiscal first quarter, primarily driven by investments to support the commercialization of REDEMPLO. As previously discussed, in advance of the U.S. launch, we built robust commercial capabilities to fully support FCS, and importantly, capabilities that were intentionally designed to be highly leverageable downstream should we obtain approval for plozasiran in SHTG and zodasiran in HoFH. Turning now to the balance sheet. Cash and investments totaled $917 million as of December 31, 2025. Common shares outstanding at quarter end were 137.4 million. To be clear, the reported cash balance does not include the $200 million that we earned for the ARO-DM1 second milestone, which was received in January, nor does it include the $50 million anniversary payment that we expect to receive from Sarepta on or before February 10.

Finally, and importantly, the cash balance of about $917 million also does not include the financing transaction announced in early January, consisting of a concurrent offering of convertible senior notes and common stock, along with associated capped call transactions. As Chris mentioned, these were on company-friendly terms in the sense that the convertible was 0% coupon and the initial conversion premium was 35%. Said another way, the 0% coupon means the notes will not bear regular interest, and the principal amount of the notes will not accrete. The initial conversion price represents a significant premium of approximately 35% over the public offering price per share of common stock in the common stock offering.

Moreover, the private capped calls will prevent any dilution to existing shareholders up to an 85% of the premium over the offering price, or roughly $119. We estimate that the total cost of capital of that convertible at any share price below that $119 to be very attractively below 1.5%. All that is to say that we have very significantly and efficiently strengthened our balance sheet, which provides additional flexibility to support ongoing clinical development, current and future commercialization activities, and other long-term strategic priorities. With that brief overview, I will now turn the call back to Chris.

Chris Anzalone (President and CEO)

Thanks, Dan. This is indeed an exciting time to be an Arrowhead or an Arrowhead shareholder. We're coming off an historic period for the company, where we executed extremely well, and all the hard work of the last several years is starting to pay off. While 2025 was productive, we look to the remainder of 2026 and the years ahead to be even more transformational. Let's look at some key 2026 events that we anticipate could be important value-creating events for the company and our shareholders. Commercial sales progress for REDEMPLO. Q3 2026 readout of phase III, SHASTA-3 and SHASTA-4 studies of Plozasiran in patients with SHTG, which we believe has the potential to be a $3 billion-$4 billion commercial opportunity.

Second half 2026 readout for ARO-DimerPA, targeting PCSK9 and APOC3 for LDL and TG lowering, which may address mixed hyperlipidemia, a population of potentially 20 million patients in the U.S. Additional ARO-INHBE and ARO-ALK7 data presented in 2026 that may build on the already encouraging early data for this novel non-incretin strategy and early ARO-MAPT data in 2026, potentially providing validation for this drug candidate and our emerging CNS pipeline with systemic delivery via subcutaneous administration. These are just a few potentially important events in 2026 alone. If you fast-forward one to three years, we expect many more opportunities in our pipeline to build value and potential, commercial launches, both independently and with partners. Thank you for joining us today, I would now like to open the call to your questions. Operator?

Operator (participant)

Thank you. To ask a question, you want to press star one one on your phone and wait for your name to be announced. To withdraw your question, please press star one one again. Please limit to one question in the interest of time. Any additional questions, you can go back into the queue. Please stand by the Q&A roster for a moment for our first question.

Our first question will come from the line of Mike Ulz from Morgan Stanley. Your line is open.

Mike Ulz (Executive Director)

Good afternoon, and thanks for taking the question. Maybe just one on REDEMPLO. Can you just give a little bit more color on the breakdown between the different categories of patients transitioning from expanded access, naive, and switch? And then maybe on the latter, in terms of switch, just any key reasons you're seeing a switch, and does it have anything to do with, you know, coverage and pricing? Thanks.

Andy Davis (SVP and Head of Global Cardiometabolic Franchise)

Thanks, Mike. This is Andy. Yeah, I can comment that the vast majority of patient origination is from APOC3 naive segment, with the remaining balance split roughly 50/50 between those that are coming from switch and those that are transitioning off of the expanded access program. As it relates to switch, we're seeing switch patients that are coming both from efficacy, but also from safety, as the two principal drivers for why physicians might be considering REDEMPLO as an alternative. I hope that helps.

Operator (participant)

Thank you. One moment for our next question. Our next question will come from the line of Maury Raycroft from Jefferies. Your line is open.

Maury Raycroft (Equity Research Analyst)

Hi, congrats on the progress, and thanks for taking my question. I'll ask one on obesity. Just wondering if, if you've had discussions with FDA about the development path, or when would it make sense to do this? And what could timelines for your phase II start look like? And do you need to have all the data, including combo data, in hand before you can determine next steps for the development path?

James Hamilton (Chief Medical Officer and Head of R&D)

Yeah, sure, Maury. I, I can take that. This is James. Probably middle of the year, we would be having some of those discussions with FDA. I, I don't think we need all of the data from all of the cohorts. As I mentioned in the prepared remarks, we had expanded some of these cohorts, so they'll be going on, some of them, for a longer period of time. And so, you know, FDA conversations probably middle of, around middle of the year, and then we'd be looking to file an IND shortly thereafter.

Operator (participant)

Thank you. One moment for our next question. Our next question will come from the line of Andrea Newkirk from Goldman Sachs. Your line is open.

Andrea Newkirk (SVP of Biotechnology Equity Research)

Hi, guys. Good afternoon. Thanks for taking the question. Maybe I can ask you one here on the ARO-DimerPA asset. Just as we think about the data sets that's coming later this year, just curious if you might be willing to speculate or share what you are looking for, or how you've defined a TPP, what level of reduction in LDL-C and trigs you're hoping to see, and then how that might inform a go, no-go decision for advancing the asset forward, and what extent of reduction would give you confidence that you could then see that translation to a benefit on MACE? Thanks so much.

James Hamilton (Chief Medical Officer and Head of R&D)

Yeah, sure. We'll, we'll see. I think, you know, we probably don't have to reach the level of reduction in terms of APOC3 and triglycerides that we're seeing with volanesorsen, for example, as something less than that, with the combination of the LDL cholesterol reductions would, probably be sufficient. So you know, I think if you look at some of the monkey data that we presented, in the dyslipidemic monkeys, we were seeing reductions in, in LDL and in triglycerides of around 40%-50%. So, I mean, so I think something like that, if you could do both of those, that would, you know, that'd be really encouraging. But we'll see what the data show later this year.

Operator (participant)

Thank you. One moment for our next question. Our next question comes from the line of Luca Issi from RBC Capital Markets. Your line is open.

Speaker 16

Well, thanks so much. Hi, team. This is Cassie on for Luca. Congrats on strong REDEMPLO launch and progress. A question also on ARO-INHBE and ARO-ALK7, since we just talked about the regulatory path. And I appreciate early days, but how are you thinking about potential pricing for ARO-INHBE and ARO-ALK7? I mean, Lilly now offers their Zepbound via LillyDirect at $300 a month, and the compounders announced today that you can get oral Wegovy basically at the same monthly price as the Ozempic. So what is your latest thinking on pricing, and how should we think about costs for ARO-INHBE and ARO-ALK7? Thanks so much.

James Hamilton (Chief Medical Officer and Head of R&D)

Thanks. It is as you expected. It's way too early for us to think about that. You know, we're inheriting the biology here to see how these drug candidates could potentially, you know, work in various patient populations. Until we have a better understanding of that, you know, it's really too early to speculate on potential pricing.

Operator (participant)

Thank you. One moment for our next question. Our next question comes from the line of Prakhar Agrawal from Cantor. Your line is open.

Prakhar Agrawal (Senior Biotech Analyst)

Hi, thank you for taking my questions, and congrats on the quarter and the progress. So I think, James, you mentioned that, about the pancreatitis event rates in the ongoing phase III/4 trials. Maybe if you can talk about the blinded AP events that you're seeing in those trials and whether it's in the same, ballpark of what Ionis saw? And just a follow-up to that, would you expect the placebo event rate on AP reduction to perform similarly to olezarsen core trials, given the population looks similar, or are there any, nuances that we should be aware of? Thank you so much.

James Hamilton (Chief Medical Officer and Head of R&D)

Yes, so on the first one, we're not gonna give any additional details on event rates, or the number of events that we've seen, other than to say that we are seeing events. On the second question, I mean, I think it's rational to look at in the cohort two placebo rate, that the population was similar to ours. So they are obviously different studies, but the population was similar.

Operator (participant)

Thank you. One moment for our next question. Our next question comes from the line of Jason Gerberry from Bank of America. Your line is open.

Jason Gerberry (Managing Director)

Hey, guys. Thanks for taking my question. You mentioned payer feedback for REDEMPLO. I believe that was in the context of FCS. But I'm curious if in those discussions, SHTG came up at all, and whether that price point that you guys have for FCS is appropriate for a market the size of SHTG and the likely benefits that APOC3 would provide. It seems pretty de-risked at this point, but just kind of curious if those discussions came up and how the view was on the $60,000 price point. Thanks.

Andy Davis (SVP and Head of Global Cardiometabolic Franchise)

Thanks, Jason. This is Andy. Appreciate the question. I won't get into the details of any specific payer discussions, only to say that our team is laser focused on ensuring we can gain coverage and access for those patients that have FCS, either genetically confirmed or clinically diagnosed. I would just add that the payers with whom we're discussing represent over 90% of U.S. lives, and both the clinical teams and the economic teams recognize the clinical value and the economic value of REDEMPLO at the one REDEMPLO price that we've previously announced.

Jason Gerberry (Managing Director)

Thanks.

Andy Davis (SVP and Head of Global Cardiometabolic Franchise)

You mentioned, you know, the size of the SHTG market. You know, we think there are, you know, somewhere around 3.5 million people with triglycerides above 500, but that market is not all created equal. You know, when we look at our at least initial target market there, and we look at how we price REDEMPLO, it is really focused on those very high-risk individuals, those maybe 750,000 to maybe 1 million people who have triglycerides above 880, you know, or a history of pancreatitis. You know, that's, at least initially, that is the real core market. That's, you know, those are the patients who really need this new medicine.

So, again, don't, you know, don't get lost in the 3-4 million people with trigs above 500. Really focus on the high risk group. That's who we're focusing on, at least initially.

Operator (participant)

Thank you. One moment for our next question. Our next question will come from the line of Patrick Trucchio from H.C. Wainwright. Your line is open.

Patrick Trucchio (Managing Director)

Thanks. My question is on ARO-MAPT. I'm just curious, with the interim data from the healthy volunteer portion, and then with the patient data to follow, I'm wondering what specific elements of the healthy volunteer data, safety, CSF, tau knockdown or downstream biomarkers, would most likely increase your confidence in this program, and as well, the data we should look for in patients to follow? And if you could also just talk about, you know, just the, the confidence this would give in the, in the CNS targeting and, and platform overall, and how we should expect, you know, the CNS platform to develop from here.

James Hamilton (Chief Medical Officer and Head of R&D)

Yeah, I can, I can take that, Patrick. This is James. So maybe I'll take the, the second question first. You know, we don't have any data in, in the clinic yet, any data from humans. But we do have data using the platform with multiple different targets in, multiple different monkey studies, and they're pretty consistent in terms of the drug concentration that we get in various CNS regions and the, and the knockdown we're able to achieve, in, even in the, the deep brain. So that, that is helpful and certainly, enhances our confidence. But, of, of course, the, the large leap in confidence will come once we see the clinical data.

To your first question, I think the key data that we anticipate being confidence building, of course, safety, and then the CSF knockdown will be key in the healthy volunteers. There's not a lot of other downstream biomarkers to measure in the healthy volunteers, but then going forward into the patient cohorts, we can measure some of the phospho-tau varieties in the blood, also in the CSF, and then, of course, we can look at tau PET. Although those readouts will take a while to see the tau PET signals in the patients, I think seeing a reduction in tau PET signal will be really very encouraging.

Operator (participant)

Thank you. One moment for our next question. The next question will come from the line of Edward Tenthoff from Piper Sandler. Your line is open.

Edward Tenthoff (Managing Director)

Great. Thank you very much. So thanks for all the detail. I'm really excited to see the pipeline advancing. I'm wondering when it comes to the recognition of revenues, at this point, are you guys anticipating breaking out a cost of goods sold line? I'm sure a lot of the manufacturing expenses have already been expensed to R&D, but I'm just trying to think about how you're planning on reporting COGS going forward. And will you break out REDEMPLO product sales in the future too? Thanks.

Dan Apel (CFO)

.Yeah. Thanks, Ted. Thanks for the question. Yeah, so as you pointed out, the cost of goods sold, you know, part of, part of the launch are gonna be in the R&D, and that's the majority of what we're gonna see in the short term. You know, we said in the prepared remarks, we're not, we're not gonna disclose this, you know, actively until such time as there are meaningful drivers. So we will at some point, not gonna hazard a guess as to when that will be. But then you would at that point, you would normally see then sort of that traditional product growth and product cost sense.

Operator (participant)

Thank you. One moment for our next question. Our next question comes from the line of Joseph Thome from TD Cowen. Your line is open.

Joseph Thome (Managing Director)

Hi there. Good afternoon, thank you for taking my question. Maybe just based on the differential biology of activin E and ALK7, can you talk a little bit about your expectation to see monotherapy weight loss in obese, non-diabetic patients with the ALK7 program? And then a point of clarification, when you talk about the expansions of the studies in terms of, you know, including that, monotherapy diabetic population and expanding the overall size, was that for the activin E and ALK7 programs already, both of them? Thank you.

James Hamilton (Chief Medical Officer and Head of R&D)

Yeah, I think, well, we don't really have expectations in terms of monotherapy weight loss. We'll see what happens. I think we've said just a few times that we view these studies as hypothesis generating. So we'd like to see if there's an early signal and then potentially expand cohorts to confirm that signal. So can't really predict ahead of time what we're going to see. Then on your second question, the addition of the monotherapy cohort, we did add that in the Activin E study, that we will likely add that in the ALK7 study as well.

Operator (participant)

Thank you. One moment for our next question. Our next question comes from the line of Mani Foroohar from Leerink Partners. Your line is open.

Mani Foroohar (Managing Director)

Hey, guys. Thanks for taking the question. I had a little bit of technical issue there earlier, so not sure if this was asked earlier, but could you give us a breakdown of the EAP versus non-EAP patients out of the 100+ prescriptions? And how should we think about the total pool of EAP patients rolling on to commercial drug? Is that, is there a tail of that remaining? And I have a follow-up question.

Andy Davis (SVP and Head of Global Cardiometabolic Franchise)

Thanks for your question, Mani. This is Andy. At this time, we're not gonna provide any further details aside from the previous remarks, which, you know, the vast majority of patients are APOC3 naive. That gives us a lot of optimism about our ability to identify and diagnose both genetically confirmed and clinically diagnosed FCS patients. And again, with respect to the balance, we do see that fairly evenly split between those patients transitioning off of the expanded access program and those that are coming via switch.

Mani Foroohar (Managing Director)

Okay, that's helpful. And as a separate question, what are the expectations we should have over the next 12-18 months around potential datasets, or admittedly, perhaps early on novel tissue types and further expansion of the platform?

James Hamilton (Chief Medical Officer and Head of R&D)

That's a good question, Mani. We've not given any guidance on that at this point. I think we have enough exciting stuff, you know, with more INHBE ALK7 data, you know, with initial MAPT data, with initial dimer data, with cohorts three and four reading out, you know, and with sample sizes, you know, that we feel pretty good about those things. But, you know, you know us, Mani, we are always developing the platform, and we are always expanding the insights, and so I can't. It's possible that you may, you may hear, you know, something about where we're going with the platform, as well as maybe new, new candidates within the existing platform.

I just can't give you any guidance on when that might be. I apologize.

Operator (participant)

Thank you. One moment for our next question. Our next question will come from the line of Madison El-Saadi from B. Riley. Your line is open.

Madison El-Saadi (Healthcare Research Analyst)

Hi, guys. Thanks for taking our question. On the more prescriptions you mentioned, I'm curious, how many of those do you expect to be converted to paid drug? And how long does it take to get from prescription to drug in body? And then relatedly, how should we think about the pace of both patient onboarding and competitive switching? Is this kind of a leading indicator for SHTG dynamic? Thanks.

James Hamilton (Chief Medical Officer and Head of R&D)

Thanks, Madison. Happy to comment. What we're seeing are really high-quality prescriptions in the sense that we believe these prescriptions truly represent either genetically confirmed or clinically diagnosed FCS patients. So we do have high confidence that a significant proportion of those prescriptions will, in time, translate into, you know, drug shipments and drug in patients. As far as the time it takes from prescription to drug shipment, again, that does vary by patient, by insurance, and by prior authorization. But I would say in general, we're able to do that within just a couple of weeks from prescription to patient receiving drug. So I've been incredibly pleased with the patient identification, including both genetic and clinically diagnosed, and incredibly pleased with the operational execution from the team in converting prescriptions to shipped medicine.

And also just broadly, you know, be careful about reading too much into where we are right now. We've only been actively in market for 10 weeks now. So we're still working with payers. We're still working with, you know, with physicians to get comfortable prescribing this. We're still, you know, informing and educating patients and prescribers about the medicine. So we have a long way to go. You know, let's see where we are more towards the end of the year. We have a pretty small sample set at this point.

Operator (participant)

Thank you. I'm not showing any further questions in the queue. I would now like to turn it back over to Chris for any closing remarks.

Chris Anzalone (President and CEO)

Thanks, everyone, for joining us today. We look forward to speaking with you next quarter.

Operator (participant)

Thank you for your participation in today's conference. This does conclude the program. You may now disconnect. Everyone, have a great day.