核心观点 - Biomea Fusion在2025年欧洲糖尿病研究协会年会上公布其研究性menin抑制剂icovamenib与semaglutide联合疗法的临床前数据 显示该组合在2型糖尿病动物模型中显著改善血糖控制和体重减轻 同时保留瘦体重[1][2][3] - 公司计划在2025年下半年启动icovamenib与GLP-1疗法联合的II期临床研究 并已获得下一代口服GLP-1受体激动剂BMF-650的新药研究申请批准 预计2026年上半年公布28天减肥数据[5][6][8] 临床前研究结果 - 在ZDF大鼠模型中 icovamenib(200 mg/kg 每日口服)与低剂量semaglutide(0.02 mg/kg 每日皮下注射)联合治疗28天 相比单独使用semaglutide表现更优:空腹血糖降低60% 口服葡萄糖耐量试验血糖曲线下面积降低50% 糖化血红蛋白在第28天降低超过1%[7] - 联合治疗使体重多减少约10%(-12.5% vs -3.4%) 且完全由脂肪减少驱动 瘦体重得到完全保留 同时胰岛素抵抗指标HOMA-IR降低75% β细胞功能显著改善[7] 产品管线进展 - icovamenib作为口服生物可利用的强效选择性menin共价抑制剂 通过促进β细胞增殖、保存和再活化 有望成为首个改变1型和2型糖尿病疾病进程的疗法[11] - BMF-650作为研究性口服GLP-1受体激动剂 已获得FDA新药研究申请批准 肥胖适应症的I期临床试验按计划进行中[6][8] 糖尿病市场背景 - 美国约有3700万糖尿病患者(占总人口11%) 9600万成年人处于糖尿病前期 糖尿病医疗支出占美国医疗总费用的四分之一[10] - 功能性β细胞质量和功能丧失是糖尿病核心病理特征 menin抑制可能通过解除对β细胞更新的抑制 实现正常健康β细胞的再生[9] 公司定位 - Biomea Fusion为临床阶段糖尿病和肥胖药物公司 专注于开发口服小分子药物icovamenib和BMF-650 旨在显著改善糖尿病、肥胖和代谢疾病患者生活[12]

药物疗效数据 - 每周一次2.4mg cagrilintide单药治疗68周后实现平均体重降低11.8% 显著优于安慰剂组的2.3% [1][4] - 31.6%用药组患者达到≥15%体重减轻 显著高于安慰剂组的4.7% [1][2] - 按治疗政策估计量分析显示 cagrilintide组平均减重11.5% 安慰剂组减重3.0% [1] 安全性特征 - 药物耐受性良好 主要不良反应为胃肠道事件（恶心、呕吐、腹泻、便秘）且多为暂时性轻中度 [1][4] - 因恶心导致永久停药率为1.0% 安慰剂组为0.1% [1] 研发进展 - 三期RENEW专项临床计划将于2025年第四季度启动 专注于超重或肥胖人群 [1][3] - REDEFINE 1试验为双盲安慰剂对照研究 共纳入3,417名BMI≥27kg/m²伴有合并症的非糖尿病患者 [3][5] 药物机制特点 - cagrilintide是长效胰淀素类似物 作用机制区别于当前已批准的GLP-1类减肥药物 [1][2] - 此为全球首个公布三期临床数据的 investigational长效胰淀素类似物单药疗法 [1] 战略意义 - 公司强调需要多种治疗选择满足不同肥胖患者需求 该药物代表下一代胰淀素疗法突破 [2] - 临床数据显示cagrilintide以独特方式实现显著减重 有望提供替代治疗选择 [1][2]

股价表现 - 公司股价年初至今下跌21.1% 而同期行业指数上涨5.2% 且表现逊于板块和标普500指数[1] - 股价在6月5日触及52周低点476.49美元后有所反弹 但年初至今回报仍为负值[1] 核心产品Eylea表现 - 旗舰产品Eylea销售因罗氏Vabysmo竞争而持续承压 该药物是公司最大的收入贡献者[5] - Eylea HD在美国市场第二季度销售额因需求增长而环比增长29%[6] - FDA将Eylea HD两项监管申请的目标行动日期推迟至2025年第四季度[7][9][10] 合作产品Dupixent表现 - 公司与赛诺菲合作的Dupixent销售强劲 用于特应性皮炎、哮喘等适应症[12] - 2025年4月Dupixent标签扩大至慢性自发性荨麻疹治疗 近期获FDA批准用于大疱性类天疱疮成人患者[13] - 欧盟和日本监管申请正在审评中 强劲需求趋势和持续标签扩展推动销售增长[13] 肿瘤学产品线进展 - 肿瘤产品Libtayo上半年销售额达6.616亿美元 同比增长18%[14] - FDA接受Libtayo用于辅助治疗皮肤鳞状细胞癌的优先审评申请 目标行动日期为2025年10月[15] - 近期FDA加速批准Lynozyfic用于复发/难治性多发性骨髓瘤治疗[16] - Ordspono获批准用于滤泡性淋巴瘤和弥漫性大B细胞淋巴瘤治疗[17] 研发管线与战略拓展 - 公司正通过授权引进HS-20094（GLP-1/GIP受体激动剂）拓展临床阶段肥胖症产品线[19] - 肥胖症候选药物包括trevogrumab 成功开发任何肥胖治疗药物将极大推动公司发展[19] - 两款first-in-class过敏原阻断抗体在III期研究中达到主要和关键次要终点[20] 财务估值指标 - 公司股票当前远期市盈率为17.87倍 低于其均值18.71倍但高于大型制药行业14.79倍的水平[21] - 2025年每股收益预期在过去60天内上调2.22美元至38.71美元 2026年预期上调0.63美元[22] - 第二季度每股收益预期从60天前的10.81美元下调至9.07美元 降幅达16.10%[24] 管线研发挫折 - FDA就odronextamab的BLA发出完整回复函 该申请受到Catalent Indiana LLC生产基地检查的影响[17] - 公司与赛诺菲合作的itepekimab在慢性阻塞性肺病治疗的两项晚期研究中结果不一 AERIFY-2研究未达到主要终点[26]

核心观点 - 礼来公司股价年初至今的疲软是短期问题 公司拥有多款重磅药物 在肥胖症 糖尿病和阿尔茨海默病治疗领域处于领先地位 未来收入增长潜力巨大 [1][2][8] 主要增长领域 - 肥胖症药物Zepbound第二季度在美国销售额达33.8亿美元 同比增长172% 是美国成人肥胖率40.3%背景下的重要增长动力 [5][6] - 糖尿病药物Mounjaro第二季度全球收入52亿美元 同比增长68% 其中美国市场收入33亿美元 同比增长37% [3] - 乳腺癌药物Verzenio第二季度全球销售额14.9亿美元 同比增长12% 其中国际市场收入5.603亿美元 同比增长19% [6] - 新获批的阿尔茨海默病药物Donanemab针对美国超过700万患者群体 为公司提供新的增长机会 [7] 财务表现 - 2023和2024财年收入分别增长19.5%和32% 净利润在2024财年接近翻倍达到106亿美元 [9] - 2025年第二季度收入155.6亿美元 同比增长38% 净利润56.6亿美元 同比增长91% 每股收益6.29美元 同比增长92% [9] 未来展望 - 2025年每股收益指引为20.85-22.10美元 对应前瞻市盈率36倍 低于当前49倍的追踪市盈率 [12] - 研发管线包括肥胖症药物Orforglipron和糖尿病/心脏病复合药物Mounjaro SURPASS-CVOT [11] - 美国十分之一人口患有糖尿病 全球肥胖症市场庞大 为公司提供持续增长空间 [10]

公司近期重大事件 - 公司将于2025年12月11日在伦敦举办资本市场日活动 [1] - 活动将包括管理层和外部肥胖领域专家的演讲 [1] - 届时将提供现场网络直播和回放 [4] 公司战略定位与愿景 - 公司致力于成为未来肥胖管理领域的关键参与者 [2] - 公司认为肥胖是当今时代最大的医疗挑战之一 减肥疗法市场处于快速发展的早期阶段 [2] - 公司凭借差异化的产品管线、强大的合作伙伴关系和稳固的财务基础 处于有利地位 [2] 研发管线与催化剂 - 公司拥有针对肥胖及相关并发症的差异化产品管线 [2] - 公司即将进入一个催化剂丰富的阶段 [3] - 资本市场日将为petrelintide的二期临床数据和survodutide的三期临床数据发布做铺垫 [3] - 公司将分享推动下一波创新浪潮的战略见解 [3] 公司业务背景 - 公司是一家专注于发现和开发肽类药物的生物技术公司 [5] - 公司已有超过10个自研候选药物进入临床开发阶段 其中2个已上市 3个处于后期开发阶段 [5] - 公司与多家制药公司建立了开发合作伙伴关系 并就其上市产品建立了商业合作伙伴关系 [5] - 公司成立于1998年 总部位于丹麦哥本哈根 在美国设有分支机构 [6]

股价表现与市场反应 - 诺和诺德股价盘前一度上涨4% 但随后回吐涨幅[1] - 公司股价较2024年6月历史高点下跌超过60%[1] - 市场对裁员消息反应积极但短暂 股价从上涨转为基本持平[2][3] 裁员与重组计划 - 公司宣布裁员9000人 占员工总数超过11%[1] - 此次裁员是7月上任CEO推行的快速重组措施[4] - 过去5年员工人数增长约80% 此次裁员旨在降低复杂度和费用[2][4] 战略调整与资金配置 - 裁员节省的资金将重新分配给研发部门[2] - 公司被认为在研发方面落后 需要追赶竞争对手[2] - 重组目的是保持满足市场需求的能力[5] 行业竞争格局 - 礼来公司相对表现更好 虽然也从高点下跌但跌幅较小[3] - 市场认为礼来在新产品功效方面具有优势[3] - 行业从稀缺性故事转变为竞争加剧格局[4] 机构观点与估值 - 伯恩斯坦将公司评级上调至跑赢大盘[2] - 目标价显示超过50%的上涨空间[2] - 机构认为肥胖症增长引擎目前被市场低估[2] 公司历史表现 - 股价已回落至三年前水平 完全回吐了之前的涨幅[3] - 多年来公司一直无法完全满足市场需求[5] - 公司在丹麦贸易和经济中占据重要份额[5]

重组计划与财务影响 - 公司宣布重大重组计划，旨在精简运营、提高决策速度并将资源重新部署到糖尿病和肥胖症核心增长领域，该计划涉及立即在全球裁员约9000人，其中丹麦5000人，约占员工总数的11% [1] - 管理层预计此次转型将在2026年前产生约80亿丹麦克朗的年化节约，这些资金将重新投资于研发、商业执行和制造扩产 [1] - 重组将产生一次性净费用约80亿丹麦克朗，其中约90亿丹麦克朗支出计入2025年第三季度，第四季度约10亿丹麦克朗的节约将部分抵消影响 [3] - 公司将2025年营业利润增长预期（按固定汇率计算）下调至4%-10%，较此前10%-16%的预测下调了6个百分点 [3] 业务运营与市场挑战 - 此次重组源于公司在7月下调2025年销售和利润展望，原因是其司美格鲁肽药物Wegovy和Ozempic的增长势头低于预期 [2] - 尽管FDA结束了复合宽限期，但美国肥胖症市场因假冒销售问题而增长受阻，公司正采取法律和监管行动 [2] - Wegovy在自费支付和保险渠道的采用均显滞后，国际推广进展不均，同时面临来自礼来替尔泊肽药物Mounjaro和Zepbound的激烈竞争，这些药物快速抢占需求和市场份额 [2] - 公司股票年内下跌36.9%，同期行业指数下跌0.8%，表现逊于行业、板块和标普500指数 [15] 核心产品与研发管线 - 司美格鲁肽系列药物（Ozempic、Rybelsus、Wegovy）仍是公司主要的营收驱动力，2025年上半年Wegovy销售额达54.1亿美元（369亿丹麦克朗），同比增长78% [5][6] - 公司正通过新适应症扩大司美格鲁肽的覆盖范围，Wegovy已获批用于降低主要心血管事件、缓解HFpEF症状和肥胖相关的膝关节骨关节炎疼痛，Ozempic的标签包括用于患有心血管和肾脏疾病的糖尿病患者 [7] - 一项真实世界研究数据显示，在患有心血管疾病的肥胖患者中，Wegovy在降低心血管风险方面显著优于礼来的替尔泊肽，巩固了其作为该人群唯一具有经证实心脏保护作用的GLP-1疗法地位 [7] - FDA正在审查公司25毫克口服司美格鲁肽用于肥胖症的申请，预计年底前做出决定，若获批将使公司成为上市口服肥胖药片的唯一生产商 [8] - 公司研发管线中的下一代肥胖候选药物包括计划在2026年提交监管申请的CagriSema、处于中期研究的小分子口服CB1反向激动剂monlunabant，以及计划在2026年第一季度启动III期项目的Amycretin [11][12] 行业竞争格局 - 肥胖症市场预计到2030年将扩大至1000亿美元，目前由礼来和诺和诺德主导 [13] - 安进和Viking Therapeutics等其他公司在GLP-1候选药物研发上进展迅速，安进已启动其双重GIPR/GLP-1受体激动剂MariTide的大型III期项目，Viking Therapeutics也开始评估其研究性肥胖药物VK2735皮下制剂的两项晚期研究 [14] 公司估值与预期 - 公司股票当前远期市盈率为13.56倍，低于行业的14.71倍，也远低于其五年均值29.25倍 [18] - 过去60天内，2025年每股收益预估从3.94美元恶化至3.85美元，2026年每股收益预估从4.59美元下降至4.07美元 [21]

公司及行业 * Altimmune公司 专注于开发治疗严重肝脏疾病的药物 主要候选药物为pemvidutide 一种GLP-1/glucagon双重受体激动剂[3] * 行业涉及非酒精性脂肪性肝炎（NASH）、酒精使用障碍（AUD）、酒精性肝病（ALD）和肥胖症的治疗领域[3][31][34] 核心观点与论据 **Pemvidutide的机制与优势** * Pemvidutide被合理设计为兼具肝脏直接作用（通过glucagon）和代谢益处（通过GLP-1实现体重减轻）[3] * 治疗NASH的最佳方式是同时治疗肝脏并去除致病的原始损伤（即肥胖）约80%的NASH患者超重或患有肥胖症[4] * 该药物在减少肝脏脂肪、肝脏炎症和肝纤维化方面有非常显著的效果 同时还能减轻体重[4] * 其高度差异化的药代动力学（PK）特征改善了耐受性 且无需剂量滴定（titration）即可给药[4][6][16] **NASH项目临床数据（24周）** * IMPACT 2b期试验设计：212名患者 48周治疗期 设安慰剂组、1.2 mg和1.8 mg pemvidutide组 无剂量滴定[6] * 24周活检主要终点显示类领先的NASH缓解（NASH resolution）其抗炎方面非常强劲 超过其他化合物在48周和72周时观察到的效果[7] * 在所有非侵入性测试（NITs）中均表现类领先 包括ALT水平、MRI-PDFF（肝脏脂肪含量）和cT1（肝脏炎症）[7][8] * 通过计算机AI算法读取达到了纤维化改善终点 但病理学家手动读取未达到 欧洲已接受该计算机标准 美国FDA预计在第四季度对此进行审议[8] * 试验中几乎没有因不良事件而停药的情况 耐受性极佳[15][16][17] **NASH项目未来计划与预期** * 48周数据预计在2024年第四季度读出[5] * 计划在2024年第四季度与FDA举行2期结束会议 并为2026年启动3期试验做准备[5] * 期望与FDA就试验设计达成一致 将终点从基于活检转换为基于非侵入性测试（NITs） 这将使试验规模更小、执行更快、成本更低[10][11] * 讨论将包括剂量选择（曾使用的2.4 mg剂量体重减轻效果比1.8 mg高40%）和研究规模（典型NASH项目需1800名患者 公司希望基于其在肥胖症中600名患者的数据缩小规模）[12][13][14] * 计划与FDA讨论将F4阶段（肝硬化）患者纳入未来研究 并认为基于现有数据成功概率很高[22] **肥胖症项目** * 已完成成功的2期结束FDA会议 就3期注册试验设计达成一致[26] * 在2期研究中 2.4 mg剂量在48周时实现了15.6%的体重减轻 且曲线轨迹显示还有更多减轻潜力 若延长至68周（tirzepatide）或72周（semaglutide）时间点 减重效果将极具竞争力[26] * 保持了血糖控制 未出现显著心脏不良事件或心律失常 心率总体增幅极小 与任何其他GLP-1药物相当[26] * FDA同意项目中无安全信号 无需进行心脏结局试验（某些竞争对手被要求进行）[27] * 计划进行四项名为VELOCITY的3期试验 其中一项关注对基线LDL胆固醇升高人群的降低作用（降低超过20% 即使服用他汀类药物者亦然）FDA看好其与他汀类药物的协同作用及提高依从性的潜力[30] **差异化优势：瘦体重保留** * Pemvidutide的瘦体重损失比率（lean loss ratio）为21.9% 显著优于semaglutide的约40%和retatrutide的38% 甚至优于自然减肥的约25%[28][29] * 这对于NASH患者（常伴有少肌症）和老年人（骨折和跌倒风险高）尤为重要 semaglutide处方信息中已有关于老年人和女性骨折风险更高的警告[28][29] **酒精使用障碍（AUD）与酒精性肝病（ALD）项目** * AUD和ALD是存在巨大未满足需求的领域 肥胖会恶化AUD和ALD的结局[34] * GLP-1对酒精渴望和摄入的影响已有文献记载 公司自身动物模型数据显示pemvidutide能显著减少酒精摄入[35] * AUD的2期研究已于2024年5月启动 预计2026年下半年读出结果[35] * ALD的病理与NASH几乎相同（脂肪驱动的炎症→纤维化→肝硬化）pemvidutide的GLP-1成分可减少渴望 glucagon成分可修复肝损伤[36] * ALD试验已于2024年7月启动[36] * 已获FDA同意在ALD试验中使用非侵入性测试VCTE（FibroScan）作为主要终点评估肝损伤[37] * AUD项目近期已获得快速通道资格（Fast Track designation）[39] **商业发展策略** * 公司意图在肥胖症3期试验前为pemvidutide寻求合作伙伴[40] * 战略重点不是主攻单纯的肥胖症市场（因预计将面临巨大的定价压力）而是专注于治疗由肥胖引起的严重肝脏疾病（如NASH、AUD、ALD）认为这能提供完全不同的价值主张[31][40] * 合作伙伴可以选择追求肥胖症适应症[40] 其他重要信息 **行业动态与监管环境** * NASH领域药物批准刚刚开始 目前有两种药物：Resdiffa（肝脏直接作用剂）和semaglutide（通过代谢成分/减重起作用）[23] * FDA近期对使用非侵入性测试（NITs）评估NASH患者表现出极大兴趣 约一周前接受了EchoSense公司关于使用FibroScan（VCTE）作为替代终点的意向书 这在之前从未发生过[9] * 这一监管转变可能使未来的NASH试验更小、更快、成本更低[10] **临床实践洞察** * 肝病学家面对新批准的semaglutide 对其缓慢的剂量滴定（可能需要一年到一年半才能达到2.4 mg的有效剂量）不感兴趣 许多患者在此过程中停药[15][16] * 相比之下 pemvidutide因耐受性好 无需滴定即可从第一天起给予治疗NASH所需的剂量[16] * IMPACT试验是迄今为止入组速度最快的NASH试验之一 患者和医生对该药物的接受度很高[18]

[角色] 你是一名拥有10年投资银行从业经验的资深研究分析师，专门负责上市公司、行业研究。你擅长解读公司财报、行业动态、宏观市场，发现潜在的投资机会和风险。 [任务] 你需要仔细研读一份上市公司或者行业研究的电话会议记录，请阅读全文，一步一步思考，总结全文列出关键要点，不要错过任何信息，包括： * 纪要涉及的行业或者公司 * 纪要提到的核心观点和论据 * 其他重要但是可能被忽略的内容 如果没有相关内容，请跳过这一部分，进行其他的部分。 总结时要全面、详细、尽可能覆盖全部的内容、不遗漏重点,并根据上述方面对内容进行分组。 要引用原文数字数据和百分比变化,注意单位换算(billion=十亿,million=百万,thousand=千)。 [注意事项] 1) 使用中文,不要出现句号 2) 采用markdown格式 3) 不使用第一人称,以"公司"、"行业"代替 4) 只输出关于公司和行业的内容 5) 在每一个关键点后用[序号]形式引用原文档id 6) 一个[序号]只应该包含一个数字，不能包含多个，如果多个就用[序号][序号]分开写，不要写成 [序号-序号] 7) 每个关键要点后边的 [序号] 不要超过 3 个 Content: --------- <doc id='1'>Company Participants Adam Steensberg - President & CEO Prakhar Agrawal - Managing Director Adam Steensberg People dropping off the GLP-1s. And we think we have with PetriniType an alternative product that can give patients the weight loss they're looking for, but in a more pleasant weight loss experience. And we really think that, you know, the dynamics we're looking at today will only be exaggerated further as we see alternatives coming out because then the conversations will change from can you tolerate a therapy to will you accept it? If there is an alternative, what will patients accept? And we at least speculate that even more patients will not accept being on a GLP-one with all the side effects you often see with these molecules.</doc> <doc id='2'>Prakhar Agrawal Got it, and obviously we've seen a lot of activity in the amylin space recently, so there was cabrizema data at ADA, Lilly presented some data for their amylin drug which is with a cabrizema, it's a little bit early stage, Metsarah has an Amylin. So with all those competition coming in, which everyone probably predicted would happen, how do you sort of highlight some of petrolinitis differentiation in this increasing incompetent space? Space?</doc> <doc id='3'>Adam Steensberg Yeah. It is really good to start to see more clinical data readouts in this space of the amylin. And I would say with all the data that we have seen coming out this year, that confirms to us that we have what still looks to be the best in class opportunity. When you look at the totality of data, it is still important when you look at these molecules that you do not only focus on, let's say, efficacy and then disregard safety at the same. So you need to balance always what is what is the efficacy you're looking for and what is the safety profile that is our tolerability profile that comes along that efficacy.</doc> <doc id='4'>And when we look at the totality of of that experience, we still think that the Treinside by far looks to have the strongest profile among these clinical assets. If you take the quinolantide, which is of course the one that is furthest developed, where Novo's main focus so far has been Carcurisema, that's a combination product. That's not an alternative. And then but what we were excited about, considering that data set from their phase three program was actually the arm where they also tested monotherapy of cadrelioside, where they actually showed 12% weight loss with almost placebo like side effects. And we think we have a product that will give more weight loss due to the specific features of our molecules that really reconfirm our belief that Petrides has the potential to really lead in this new category and also that the category can actually become the largest category</doc> <doc id='5'>Prakhar Agrawal Okay. And maybe can you help us understand the specific differentiation versus gagrelentide? Is it the half life, potency or something else that you can do with petrolentide? Adam Steensberg Yeah. So a lot of these there's of course a lot lot of, you can say, scientific rigor behind choosing these molecules. And if you think about coagrelin type by Novo Nordisk and then petraintide by us, the way it interacts with the amylin receptors and the calitronin receptors, we believe are quite similar. And that's why it's really reassuring not only the efficacy signal from cadherin type, but also the safety signal from cadherin type. So we have a very balanced approach and we use also human amylin as the backbone.</doc> <doc id='6'>Other companies have chosen different paths and I think we are starting to see now that maybe some of those decisions will then carry out carry some side effects and maybe even some quite significant safety signals, which so far it looks like we have avoided with the decisions we have made. Compared to caquilinide, we have a significant upside in the fact that we our molecule is stable and neutral pH, and what we believe that translate into is that we don't see the same degree of injection site reactions as has seen with ekaglutide, we have not seen</doc> <doc id='7'>the same degree of immunogenicity. And then we have a much higher bioavailability, so we get more drug to the receptor when we inject.</doc> <doc id='8'>Prakhar Agrawal Okay, got it. And you announced a deal with Roche earlier in the year. I thought it was great economics. But maybe strategically, why did you feel Roche was the right partner to maximize the value of Betterment Day? Adam Steensberg Yes.</doc> <doc id='9'>So we after we got our Phase 1b data last summer last year, we started a very kind of structured process to identify the right pharma partner for us to realize our vision of becoming a key player in obesity, which was extremely important for us, this was a very competitive process. I had been on quite a few last cap CEOs to ultimately choose us. What was extremely important for us was the strong commitment they have made to actually become a leader in this space. We didn't just wanna team up with somebody who just thought it would be hard to have an obesity asset. We actually, it's a big effort to go in and lead in this space and that was with with us.</doc> <doc id='10'>We found a company who convinced us that they wanna lead in this. We were impressed with how they presented their manufacturing plans because ultimately, you cannot just tap into existing manufacturing capacity. Yes, you can do that, but then you will not get the most efficient. And they convinced us that the plans they have by building new fit for purpose manufacturing capacity would be a huge edge for us as we launch these molecules together. And then of course, lastly, we actually managed to get 50% shared economics on also the combination products with their c c d three eighty eight, which is a GLP one GLP molecule.</doc> <doc id='11'>So of course, that added to the value opportunity. So so, yes, we are now sharing the the profit fifty fifty with us, but we actually also got a new value opportunity in, and at the same time, a lot of good economics. So those were probably the three main reasons.</doc> <doc id='12'>Prakhar Agrawal Yes. And on the manufacturing investments, we saw some announcements from Roche as well. I think 700,000,000 investment in the North Carolina plant. Like how much of that capacity is going to be focused on petrolinta, if you can speak about that? Adam Steensberg Yes, I cannot share the specifics, but just I can share that we feel very confident that HUS is making the right investments in this investments needed to support the launch without any, you can say, shortage. And it's perhaps also an aspect of this agreement which has been overlooked a little bit that while we will share all development cost and also the future profit, we, Zealand, do not have to finance any manufacturing investments. That would be us that is responsible for financing all these investments, which is of course also a lot of dollars short term at least for us that we save.</doc> <doc id='13'>Prakhar Agrawal Got it. And when you were running the process and like what was attractive, what better than tied to Roche, what were the some of the two or three attributes that was really interesting? Was it a differentiated mechanism? Was it on the safety tolerability side? If you can just lay out the reasons that Roche will tolerate, we have to be involved in the ambulance space.</doc> <doc id='14'>Adam Steensberg Yes. I think they will, of course, have to speak for themselves either ultimately were so excited as I would say most of their peers in the industry was as well. So but I would but for me, it's a logical consequence of looking at the current market dynamics. With the GLP-1s, where we have two established brands, of course, it's going to be hugely difficult to come in with another GLP-one and start to lead if you already have very established brands. You're You're going to have high rebate walls, you're going to have a lot of prescribing experience with</doc> <doc id='15'>existing molecules, and you're also going to fight against ten, twenty years of data. So but coming in with a new modality, coming in with an alternative, then suddenly you have an opportunity to lead in a new category instead of trying to eat your way into something that is very established.</doc> <doc id='16'>That is a much more attractive value proposition. Also, you think about the launch years, it's it's a much more compelling opportunity to launch with a new category because you will be you can say the first alternative for people who do not know where else to go, if you launch and with a similar mode of action, then you will have to convince somebody why you should take that molecule rather than a new in a in a very existing and well known molecular entity. So this opportunity to lead in a new category, I think, is what was appealing to many of the companies we spoke to.</doc> <doc id='17'>Prakhar Agrawal Got it. Makes sense. Maybe onto the some of the clinical data, you have the ongoing Phase 2b that will read out the forty two weeks will read out next year. Just clear on what are you hoping to see maybe starting with efficacy? Adam Steensberg Yes. So what we hope to see is a molecule that can provide patients with a GLP-one like weight loss, and that is in the mid teens, so fifteen percent to twenty percent what we have seen. And then with a much more benign tolerability profile, we are already very confident in the tolerability profile because we have sixteen week data. We have also data from Novo Nordisk, which shows that it's almost placebo like experience that you have when you get a patrinetide as compared to when you get the GLP-1s. So and on the efficacy side, we achieved 8.6% weight loss over sixteen weeks.</doc> <doc id='18'>And those models would suggest that we can easily achieve the weight loss we're looking for. What I think is super important as we continue to mature our view on the future BT market is to maybe that go a little bit of that, what is the number? This is about a profile of a drug. Most patients, if you ask them, are looking for a 10% to 20% weight loss. And we and and thus, we we have to get away from this weight loss Olympics.</doc> <doc id='19'>We need to get into talking about what is the profile of the drug, which drugs can give patients that weight loss they're looking for, but in a more pleasant experience. And then importantly, which is the big big big miss of the current therapies is how do we manage to get patients to stay in therapy. The reason that we have so low volumes of patients on treatment is because they stopped taking the GLP-1s far, far too early today. And we think we can change that with enamelin.</doc> <doc id='20'>Prakhar Agrawal Yes. And I think that's an important point because I think people under appreciate the duration of therapy for Alnylam drug. So like what are you based on your research, what's the sort of the state time for GLP-1s and how much further can you improve with an amylin therapy even as monotherapy option? Adam Steensberg Yes, but I think it has actually not changed a lot this daytime on a GLP-1s. And we know, I mean, from the launch years, I mean that within the one already in one once we have thirty percent who drops off and probably within a year is less than than fifty percent who are still on on therapy. By those who leaves, the majority are actually people who say it's because I cannot tolerate the drug. Of course, there are other reasons as well, but the major极是 because they cannot tolerate it. And there's actually a big dilemma here because if you only achieve a weight loss and you don't manage to maintain it, we actually you could actually be worse off.</doc> <doc id='21'>So it is so important we start to think about how do we get people to stay on therapy. And we all know that an obese person is very motivated to lose weight. Once you have achieved the weight loss, you become less motivated, and that also means that you will accept less side effects. And that's where we think amylin will come in and be something you can actually have that you can also enjoy being on when you have achieved your 极是 loss because it has this feature of making people feel full faster rather than losing their appetite. So it's actually also beyond the classical tolerability issues</doc> <doc id='22'>Prakhar Agrawal</doc> <极是 id='23'>And on the safety tolerability side, obviously, we have been comparing it with semaglutide, but don't you think the market is moving now more closer to tirzepatide, which has really good safety tolerability as well, so how would you compare ambulance versus let's say dual agonist, like Adam Steensberg a GLP, GLP agonist which has good safety? Yeah, but I politely probably have to disagree with your statement there. In my book, think the safety and tolerability profiles between Vigovi and and and Zepbound are quite similar. You may data at least suggest that you could get a higher weight loss on on Zepbound, but again, as we discussed before, if you balance things net net, you still have all the side effects with the GLP one TIP class that we have also seen with the GLP one class. I think another kind of fact underscoring this is that while the clinical data we always discuss for these molecules are data generated with the highest doses,极是 what was the weight loss you achieved with, let's say, fifteen milligrams of of of of Z bound, then the real world evidence suggests that very, few patients ever get to these doses.</doc> <doc id='24'>They end at much lower doses. I actually believe that the average dose being used real world for Zepbound is around seven and a half milligram, which is a very low dose. So they don't actually experience the weight loss that the clinical data suggest they can do. And then you might ask yourself, why is that? Why do they not get to those numbers? And we think a lot of that has to do with the tolerability profile. We used to talk a lot about just vomiting and nausea, but I think we need to discuss diarrhea in particular because these are side effects that tend to stick and not be able to titrate yourself out, especially when we start to think about the new classes of all GLP-1极是 where in my book, at least looks to be even worse.</doc> <doc id='25'>Prakhar Agrawal Got it. And you disclosed some pooled baselines during the last earnings call. But maybe just a broader question on obesity trials. We are seeing a lot of discontinuations in the obesity trials, especially in the placebo arm as well. We saw this with Lilly's orfagriplone data. Viking had a little readout that had极是 lot of disc conditions as well. What are you doing to mitigate this risk? Because this is a forty two week trial as well.</doc> <doc id='26'>Adam Steensberg Yes. But I mean, we, of course, don't have the data yet, but but I also hear other companies who have not seen the same issue. So I I don't know. Before we see the actual data, it's it's actually difficult to say what the real reasons are behind those discontinuations. Of course, there is this observation that if people don't achieve a weight loss in a placebo group, they could be less motivated to stay in the study.</极是> <doc id='27'>That could also, again, coming back to ofroglipin, why you had more discontinuations than average on on even on active drug because people did not achieve the weight loss they were looking for. So I think we need to see the individual data before we can start to draw conclusions.</doc> <doc id='28'>Prakhar Agrawal Anything you can comment on the pool discrimination rates in the ongoing trial? Adam Steensberg No. I mean, again, we try to keep a high level of data integrity on our clinical studies and not be too, you can say, to introduce any risks. So we like to keep things blinded until we have the data.</doc> <doc id='29'>Prakhar Agrawal Okay. And once you have the forty two weeks, I know there will be an interim readout this year to progress for to start the regulatory discussions around the Phase III plan. But what could a Phase III development plan look like? And a follow-up to that, like does Roche plan to run a CV outcomes trial for Amlens? Adam Steens

公司及行业 * Zealand Pharma及其合作伙伴Roche专注于开发新一代肥胖治疗药物 特别是基于amylin（胰淀素）机制的petrelintide（彼得林肽）[1][2][3] * 行业竞争激烈 主要参与者包括Novo Nordisk（诺和诺德）和Eli Lilly（礼来） 其GLP-1类药物（如semaglutide司美格鲁肽和tirzepatide替尔泊肽）主导当前市场[12][20][38] * 行业关注焦点从单纯追求减肥疗效转向平衡疗效与安全耐受性 并重视患者对治疗的长期坚持[2][16][18] 核心产品：petrelintide (彼得林肽) **差异化优势与科学依据** * 公司认为petrelintide是同类最佳（best-in-class）的amylin受体激动剂 拥有最强的综合（疗效与安全性）表现[2][3] * 与Novo Nordisk的amylin候选药物cagrilintide（卡格列肽）相比：两者作用机制相似 均以人胰淀素为骨架 但petrelintide在稳定性、生物利用度和安全性方面更具优势[4][5] * petrelintide分子在中性pH下稳定 这转化为更少的注射部位反应、更低的免疫原性以及更高的生物利用度（意味着更多药物能到达受体）[5] * 引用cagrilintide单药治疗数据显示了12%的减重效果和近乎安慰剂般的副作用 公司相信petrelintide能凭借其分子特性实现更优的减重效果[3] **临床开发与预期** * 正在进行Phase 2b试验 42周数据预计明年读出 此前16周数据已显示8.6%的减重效果 模型预测最终能达到15%-20%的GLP-1类中段减重效果[14][15] * 安全性是核心优势 现有16周数据和Novo的数据均支持其拥有近乎安慰剂般的耐受性体验[14] * Phase 3临床试验计划将采用经典的肥胖项目设计 包括心血管结局（CVOT）试验 以支持其成为基础疗法的愿景[27][28] **市场定位与愿景** * 目标不是与现有GLP-1药物直接争夺用户 而是为因副作用停药或无法耐受的患者提供一个更优的替代方案 并旨在成为一线疗法[12][28][29] * 核心价值主张：提供患者寻求的（10%-20%）减重效果 但拥有更良好的治疗体验 从而解决当前GLP-1疗法患者停药率高（一年内超50%停药 主要因无法耐受）的痛点[15][16][17][18] * 认为amylin类别有潜力成为最大的肥胖治疗药物类别[3] 合作伙伴关系：Roche（罗氏） **合作逻辑与战略价值** * 选择Roche作为合作伙伴因其承诺成为肥胖领域的领导者 而非仅仅拥有一个资产[8] * Roche计划投资建设新的、专用于此的制造产能（提及7亿美元投资北卡罗来纳州工厂） 这将为产品上市提供巨大优势 避免出现短缺[9][11] * Zealand无需承担任何制造投资成本 由Roche负责融资 为Zealand节省了大量短期资金[11] * 合作经济条款优厚：Zealand获得美国及欧洲市场50%的利润分成 并且对与Roche的GLP-1/GIP双靶点药物CT388组成的联合疗法也享有50%的经济收益[9][10][30] **商业化规划** * 这是一项真正的合作伙伴关系 Zealand拥有平等话语权并计划参与关键市场（如美国）的商业化推广 最高可承担50%的推广工作[30][31] * 具体参与程度将与Roche讨论后决定 公司具有最大灵活性[31][32] 竞争格局与市场观点 **对现有GLP-1类药物的看法** * 认为GLP-1类药物（包括tirzepatide）普遍存在耐受性问题（如呕吐、恶心、特别是腹泻） 这些副作用持久且难以通过剂量滴定消除 导致患者实际使用剂量远低于临床试验中的最高剂量（如Zepbound平均剂量约7.5mg） 因此实际减重效果低于临床数据[20][21] * 强调市场需要从“减重竞赛”转向讨论药物的综合 profile：哪些药能在提供所需减重效果的同时 带来更愉悦的体验[15][16] **对新进入者的看法** * 认为凭借新的作用机制（amylin）开创一个新类别 比以相同机制（如GLP-1）去挑战已建立强大品牌和市场地位（高返利墙、多年处方经验和数据）的巨头更具吸引力[12][13] * 预测除非具有真正的临床差异化优势 否则再推出含GLP-1机制的药物将极其困难[43] 其他重要管线资产 **cerdulatinib (由Boehringer Ingelheim开发)** * 一种GLP-1/glucagon（胰高血糖素）双靶点激动剂 Phase II数据显现在减重效果和耐受性上与GLP-1/GIP类药物相似 但在管理NASH（非酒精性脂肪性肝炎）方面潜力突出[38][39][40] * Boehringer正在开展一项规模巨大的Phase 3 NASH项目（涉及3500名患者 包括肝硬化患者） 显示其对该产品前景的信心[40] * 有望凭借在NASH领域的显著疗效 将其定位在独特的市场空间 避免陷入GLP-1类的价格战[42][43] **dapiglutide** * 一种差异化的GLP-1分子 同时具有GLP-2活性 可能更好地控制炎症[44] * 开发策略将聚焦于超越减重 重点开发针对肥胖且伴有特定炎症相关共病的患者群体 计划今年启动Phase II研究[44][45] 公司战略与展望 * 公司资本状况强劲 雄心勃勃 目标是利用其在肥胖管理领域25年的经验、领先的下一代分子和资本优势 推动公司进入下一个加速成长阶段[47][48] * 计划于12月11日举办R&D日活动 分享对未来创新的思考 并介绍新的科学官 为未来半年密集的催化剂（包括cerdulatinib的Phase 3数据和petrelintide的Phase 2数据）设定预期[46]