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:XRTX : ANUA Xanthine Oxidase Reducing Technology T argeting Gout and Progressive Kidney Disease February 2026
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2 Forward-Looking Statements Certain information included in this Presentation constitutes “forward-looking information” or “forward-looking statements” within the meaning of applicable securities laws (“forward-looking statements”). These statements relate to future events or future performance of XORTX Therapeutics Inc. (the ”Company”). Forward-looking statements are statements that are not historical facts and are often, but not always, identified using words or phrases such as “can”, “continue”, “develop”, “expect”, “forecast”, “future”, “may”, “milestone”, “plan”, “potential”, “proposed”, “will” and other similar expressions. In particular, but without limiting the foregoing, this Presentation contains forward-looking statements pertaining to, among other things: the industry and market in which Company operates, including the size and value thereof; strategic plans, including the timing thereof; the Company’s operations, including with respect to accelerated approval processes, “licencing” deals, patent filings and clinical trials, including the timing and results thereof; the effects of end-stage renal disease and onset delay of end-stage renal disease; timing and occurrence of certain milestones, including the success of preclinical studies and clinical trials; and the Company’s products, services and assets, including the benefits thereof. In addition, this Presentation may contain forward-looking statements attributed to third party industry sources. By their nature, forward-looking statements involve known and unknown risks, uncertainties, and other factors that may cause actual results or events to differ materially from those anticipated. Such forward- looking statements are provided for the purpose of providing information about management’s current expectations and plans relating to the future. Readers are cautioned that reliance on such statements may not be appropriate for other purposes, such as making investment decisions. These factors and risks include, without limitation: incorrect assessments of the value of acquisitions, licenses and development programs; technical, manufacturing and processing problems; actions by governmental authorities, including increases in taxes; the availability of capital on acceptable terms; fluctuations in foreign exchange, currency, or interest rates and stock market volatility; failure to realize the anticipated benefits from licenses or acquisitions; and potential labour unrest. This list is not exhaustive of the factors that may affect any of the Company’s forward-looking statements. Some of the important risks and uncertainties that could affect forward-looking statements are described further under the heading “Key Information - Risk Factors” in the Company’s annual report on Form 20-F filed with the Securities and Exchange Commission and under the heading “Risks Related to the Business” in its Management’s Discussion and Analysis section, filed as an Exhibit to its annual report on Form 20-F, which annual report is available on www.sec.gov. With respect to forward-looking statements in this Presentation, the Company has made assumptions regarding, among other things: the availability of capital to fund planned expenditures; prevailing regulatory, tax and environmental laws and regulations; the ability to secure necessary personnel, equipment, supplies and services; the Company’s ability to manage its growth effectively; the absence of material adverse changes in the Company’s industry or the global economy; trends in the Company’s industry and markets; the Company’s ability to maintain good business relationships with the Company’s strategic partners; the Company’s ability to comply with current and future regulatory standards; the Company’s ability to protect its intellectual property rights; the Company’s continued compliance with third-party license terms and the non-infringement of third-party intellectual property rights; the Company’s ability to manage and integrate acquisitions; and the Company’s ability to raise sufficient debt or equity financing to support its continued growth. Although the Company believes that the expectations reflected in such forward-looking statements are reasonable, such statements are not guarantees of future performance and actual results may differ materially from those in forward-looking statements. Undue reliance should not be placed on forward-looking statements because the Company can give no assurance that such expectations will prove to be correct and such statements are based on the beliefs, estimates and opinions of the Company’s management on the date such statements are made. Many factors could cause the Company’s actual results, performance or achievements to vary from those described herein. Should one or more of these risks or uncertainties materialize, or should assumptions underlying forward-looking statements prove incorrect, actual results may differ materially from those described in this Presentation as intended, planned, anticipated, believed, estimated or expected. The forward-looking statements included in this Presentation are expressly qualified in their entirety by this cautionary statement. The Company cautions that the foregoing lists of assumptions, risks and uncertainties are not exhaustive. The forward-looking statements contained in this Presentation are made as of the date hereof and the Company undertakes no obligation to update publicly or revise any forward-looking statements, whether as a result of new information, future events or otherwise, unless required by applicable securities laws.
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XRx-026 for gout targeted for NDA submission by H1 2027 3 *All $ in this presentation are USD SHORT TIMELINE PIPELINE TEAM LARGE MARKET LIMITED RISK XORTX’s team have a strong history of company building: Cynapsus Therapeutics acquired for $624M* Trillium Therapeutics acquired for $2.2B* XRx-008 for ADPKD† to begin registration trials with accelerated approval and orphan designation in >$5B* market >$0.7B peak sales opportunity created by a marketed allopurinol alternative receiving a Black Box Warning Safe and effective in over 700 patients † autosomal dominant polycystic kidney disease Investment Highlights G O U T
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4 Gout Overview Caused by a Build-Up of Uric Acid in tissues Causes Severe Pain and Discomfort - particularly joints, classic ‘big toe pain’ Multiple associated-disease conditions Prevalence has doubled in the last 20 years - 7 million gout patients diagnosed in the US Patients prescribed meds to manage pain and reduce serum Uric Acid concentrations 3-5% of patients are intolerant to allopurinol, the standard of care Common Symptoms of Gout Pain in big toe Pain in ankle Pain in fingers Pain in knee Pain in wrist Kidney stones Pain that rapidly worsens Tenderness Warm, red skin Strange lumps around joints Pain in wrist
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5 Gout - Estimated Addressable U.S. Market 47 Million People with elevated Uric Acid levels 7 Million Patients diagnosed with gout 280,000 Allopurinol-intolerant gout patients $6-8,000 Projected annual drug price per patient $2 Billion Size of the allopurinol intolerant market $0.5 – 1.0 Billion Targeted peak sales of XRx-026, XORTX’s gout drug Febuxostat reached peak annual sales of ~$0.5B in the US
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6 Market Opportunity: Febuxostat • 2008 - Febuxostat entered the US gout market targeting allopurinol intolerance (~3-5% of patients) • 2019 - Received a black box warning; prescriptions dropped • 2024 – Febuxostat sales were less than $30M 2025 - No drug currently fills this gap in the gout market N/A* N/A*N/A*N/A* * Estimated decline rate ‘GAP’
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• Over 750 allopurinol-intolerant patients have been successfully treated with oxypurinol. • Oxypurinol has been proven safe and effective in typical gout and in allopurinol-intolerant gout patients. • Oxypurinol offers gout patients who don’t respond well to treatment with allopurinol an alternative they don’t currently have. • Oxypurinol is an active metabolite of allopurinol without the same negative effect profile. 7 Oxypurinol Safety in Allopurinol Intolerant Patients * Patients enrolled in this clinical trial were all ‘allopurinol-intolerant’ Side Effect Incidence OXPL–213 study* Allopurinol Oxypurinol Skin Side Effects 80% 26% Liver Side Effects 9% 4% Overall Side Effects 100% 31% 70% of Allopurinol-intolerant patients get relief from gout symptoms and attacks.
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DRUG STATUS XRx-026 (xanthine oxidase inhibitor) XORTX Therapeutics Inc. PRE-NDA READY Allopurinol (xanthine oxidase inhibitor) Generic FDA APPROVED Febuxostat (xanthine oxidase inhibitor) Takeda, various generics FDA APPROVED (Black Box Warning – acute cardiac death and other side effects) Uricosuric Agents (probenecid etc.) (reduce reabsorption of uric acid by the kidneys ) Various FDA APPROVED (Increased risk of kidney stone development) 8 Gout - Competitive Landscape
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NDA Review Targeting NDA filing in H1 2027 9 NDA Filing Marketing/ Revenue Gout (XRx-026): Regulatory and Clinical Development Plan Type “B” Meeting 2027 Q1 Q2 Q3 Q4 2026 Q1 Q2 Q3 Q4 2025 Q1 Q2 Q3 Q4 CM&C Validation and Commercial Batch Production Stability PK Study IND Filing PRODUCT SUPPLY CLINICAL REGULATORY
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Formulation enables maximum drug uptake. Pipeline-in-a-product patented technology Proprietary and highly scalable CMC approach; Once daily oral dosing Robust published data supports the therapeutic benefit in gout as well as in other indications. Multiple successful trials in >700 patients have demonstrated safety and efficacy. Over 90% Inhibition of the Xanthine Oxidase (XOI) enzyme 10 Oxypurinol - the most effective Uric Acid Lowering Agent available Xanthine Oxidase Proprietary Oxypurinol Formulation for Gout IP Formulated to Optimize Absorption and Protection Reduced Uric Acid Levels
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11 Pipeline - ADPKD Overview Causes liver cysts, pain and discomfort Leads to decreased kidney function and ultimately to end-stage kidney disease Associated with increased incidence of neurologic aneurisms, cardiovascular disease 160,000 patients in the US - Treatments are limited – Tolvapten ($156,000 annual treatment cost) has a black-box warning for liver toxicity Common Symptoms of ADPKD
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Cost of Dialysis/yr ~$90,000 Cost of Tolvaptan/yr ~$156,000 U.S. ADPKD Population Diagnosed ~160,000 % of ADPKD Population Stage 2, 3, 4 ~96,000 % of ADPKD with hyperuricemia ~38% (~36,500) U.S. Population ~337,000,000 12 ADPKD - Estimated Addressable U.S. Market Future net sales revenue: Estimate U.S. Peak Sales $1 - 6B/yr (7-year Orphan Designation)Est. Cost of XORLO/yr ~$178,000
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13 Renal Fibrosis Accelerates Decline of Kidney Function Chronic kidney disease (CKD) affects an estimated 14% (1 in 7) of adults globally, ~ 35–37 million individuals in the United States. Rare kidney diseases such as autosomal dominant polycystic kidney disease (ADPKD) and lupus nephritis also manifest fibrosis. Additionally, acute kidney injury can lead to accelerated Renal fibrosis - a failed wound-healing process - resulting in progressive chronic kidney disease and end stage renal failure. VB4-P5 – An anti-fibrotic agent - aligns with our strategic focus on developing innovative therapies for progressive kidney disease. (Vectus Acquisition) No approved therapies specifically target or reverse kidney fibrosis Renal Fibrosis Anti-Fibrotic Therapies may slow Kidney Disease Progression
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14 Milestones & Comparables IND submission: gout – H1 2026 PK study results: gout – H2 2026 Completion of CM&C validation: gout – H2 2026 Stability studies initiated: gout – H1 2026 NDA submission: gout – H1 2027 • 2020: Sobi acquires SEL-212 for refractory gout from Selecta Biosciences - up to $1.6B million. • 2025: Novartis acquires Regulus for farabursen, an ADPKD drug entering phase II development - up to $1.7B.
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Allen W. Davidoff, Ph.D. , Chief Executive Officer Dr. Davidoff has 20 years of drug development experience and is the founder and CEO of XORTX. Allen has a broad range of clinical and regulatory experience and senior management experience in pharmaceutical R&D. Previously, Allen was co-founder, CSO at Stem Cell Therapeutics Corp. which merged with Trillium and thereafter was acquired by Pfizer. Prior to his role at Stem Cell, Allen was Senior Scientist/Head of Pharmacology at Cardiome Pharma Corp. Allen earned his PhD in Cardiovascular Physiology and Biophysics at University of Calgary. Stephen Haworth , M.D., Chief Medical Officer Dr. Haworth has >25 years of successful global drug development and senior leadership in both “start-up“ and Fortune 500 pharmaceutical firms in both the US and Europe. Stephen has a broad clinical and regulatory experience that ranges from nephrology, cardiovascular, and infectious disease. He has extensive regulatory experience with FDA and EMA submissions, as well as licensing and M&A transactions. Stephen holds a MD from University College Hospital Medical School, University of London, having graduated with Honors. Taryn Boivin, Ph.D., Head Chemistry, Manufacturing and Controls (CMC) Dr. Boivin is a pharmaceutical veteran with >30 years of experience leading all aspects of CMC and related disciplines. Her experience includes multiple worldwide drug submissions, post approval support activities, and commercial supply chain operations. Early in her career, Taryn was among a key group of leaders who established the Glaxo Canada (later GSK) pharmaceutical development organization, and was a pivotal contributor to this world-class research, development, and manufacturing facility. Dr. Boivin has held numerous Senior VP positions in large and small biopharma. Michael Bumby, DVM, MBA, Chief Financial Office r Dr. Bumby was recently appointed as the Company’s Chief Financial Officer. He has extensive experience in the biotech/pharmaceutical industry from the scientific, regulatory and financial perspectives having worked in multiple Canadian-based publicly traded life sciences companies as well as holding multiple financial roles at Eli Lilly & Company in Canada, the US and in Europe. Stacy Evans, M.D., MBA, Chief Business Officer (Consultant) Dr. Evans has >20 years of commercial development and business development experience, including 12 years at Pfizer where he was last responsible for leading transactions across all TAs. Stacy has been consulting at an executive level for small to mid-size private and public biopharma companies for the past 7 years including as part-time Chief Business Officer for Avillion, LLP, a Blackstone-backed late-stage financing and co-development company. Stacy holds a MD from McGill University and an Executive MBA from Columbia University. 15 T eam - Management
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Anthony Giovinazzo – Chairman 43 years of total work experience, is an internationally recognized expert in intellectual property, drug development and commercialization, including numerous licensing agreements, with more than 25 years’ experience in Central Nervous System diseases. Co-inventor, Chief Executive Officer and Director of Cynapsus Therapeutics, led a NASDAQ listed specialty pharmaceutical company that developed the first successful sublingual apomorphine thin film strip for Parkinson’s disease and led a highly successful exit of Cynapsus by way of a 120% premium to market of an $841 MM all cash M&A deal. Mr. Giovinazzo is currently Executive Chairman of Kalgene, and director of Titan Medical Inc. Paul Van Damme Held senior positions with a number of Canadian and U.S. public companies. His experience focused on the biotech industry in Toronto when he joined GlycoDesign, a private biotech company. While at Allelix Pharmaceuticals Inc., he participated in the sale of that company to NPS Pharmaceuticals, Inc. Allen W. Davidoff Ph.D. – President and CEO Raymond Pratt, M.D. Raymond Pratt is an accomplished Physician Executive in clinical medicine, Nephrology, drug development, and the pharmaceutic al industry. He has extensive experience troubleshooting issues concerning regulatory approval of drugs and devices and providing development strategies for global pharmaceutical com panies. Krysta Foss Ms. Davies Foss is an experienced, biotechnology executive with more than 25 years of expertise advising pharmaceutical and b iotechnology companies on development strategy, commercialization, and market preparedness across a broad range of therapeutic areas. She currently serves as Chief Executive Officer of Triad Strategic Services, a leading pharma and biotech strategy consulting firm . 16 Board of Directors
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17 XORTX Cap T able Capitalization as of February 24, 2026 # of Shares % of Fully Diluted Common Shares Outstanding (Insiders): 139,166 1.3% Common Shares Outstanding (Other): 6,823,052 65.0% Total Common Shares Outstanding 6,962,218 66.3% WarrantsOutstanding: 3,309,880 32.2% Options Outstanding: 149,761 1.5% Fully Diluted Shares : 10,421,859 100%
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XRx-026 for gout targeted for NDA submission by H1 2027 18 *All $ in this presentation are USD SHORT TIMELINE PIPELINE TEAM LARGE MARKET LIMITED RISK >$0.7B peak sales opportunity created by a marketed allopurinol alternative receiving a Black Box Warning Safe and effective in over 700 patients † autosomal dominant polycystic kidney disease Summary G O U T XRx-008 for ADPKD† to begin registration trials with accelerated approval and orphan designation in >$5B market XORTX’s team have a strong history of company building: Cynapsus Therapeutics acquired for $624M* Trillium Therapeutics acquired for $2.2B*
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XORTX Therapeutics Inc. 3710 33rd St NW Calgary, Alberta T2L 2M1 (403) 455-7727 info@xortx.com / www.xortx.com 19 :XRTX : ANUA