Thank you very much. It's not, I changed name, it's we changed presenter. My name is Mads Bjerregaard. I'm the Chief Business Officer. Okay, no problem. We're going to do this in English simply because my Swedish is really, really bad, and I think I will lose a lot of it by speaking Danish. SynAct Pharma, we are changing gears now. We are solely focused on developing new pharmaceutical agents that deals with diseases of the immune system. These are our forward-looking statements. I'm not going to read that out loud. The field really is what we call pro-resolution immunology or pro-resolution therapies. I'll get a little bit back to what we mean about that and what that can do, but it really addresses chronic and acute inflammatory conditions. If you have an autoimmune disease, arthritis, for example, or even acute inflammation diseases like a COVID-19 or an influenza virus where you basically need to go to hospital, this is the remit where we will address these therapies or these diseases. Resolution therapy is really something that could be a paradigm shift compared to everything else that is used today. Everything that you use today, or most what is used today to treat these diseases have immunosuppressive features. Meaning that they are closing or closing some of the systems in your immune system that is overreactive. By closing that, you're basically dealing with the problem, but you'll also have a lot of side effects with that because your immune system will not function as well as it should be. There's a lot of issues. There's a lot of pros, a lot of issues, this is what we're trying to deal with in what we call pro-resolution. We are targeting specific immune cells that we can modulate with our medicine, that will give the effect. Our lead compound is what is called in the middle of the slide here, is what's called resomelagon or AP1189. It is a potential first-in-class mechanism. It is a non-suppressive therapy, meaning we have not seen anything yet that suggests that it will have immunosuppressant features. It is different from everything else that is out there, and that's very important. It is a once daily oral therapy, so basically a tablet that you take once daily. Many therapies in this category are injectables or even infusion therapies. A very different concept and you can work with that differently. We're focusing on a couple of different therapies, I'm going to talk a lot about one of them today, which is our lead asset. Our lead program, which is in rheumatoid arthritis, which is one of these autoimmune diseases where you have the disease, is basically a kind of recurring inflammatory scale. We have a phase II-B program, which is the program that comes before the big phase III program, in rheumatoid arthritis. We have a readout in June. This is the major factor why we're standing here today, and a lot of attention to the company is the data from that trial. We also have other trials than that. We're a company, we've been around for a while. We established in 2012. We've been listed on the Nasdaq Stock Exchange here in Stockholm, main market since 2022 and since 2016. We're a very small team. We can use this technology to deal with many diseases. I'll speed up a little bit. This is what we think pro-resolution or resolution immunology is all about. On the left-hand side of this slide, you see kind of a picture of immune response. You basically have normal response. You have an infection, the immune system reacts, you deal with it. Then there's the mechanisms that basically turn on and say, "Okay, let's stop the immune cascade and let's initiate the part of the system that kind of heals the cells and clears out the leftovers." That's your normal response. In many of these diseases, that response is kind of crooked. In rheumatoid arthritis, this is a disease where this response basically just goes up and up and up and up and continues. What you do is that you try to block that cascade. That's what we've been doing so far with immunosuppressive therapies. That works pretty well, but it comes with a lot of baggage. That's why you have to be careful about that, but it's a kind of a choice between two evils if you're a physician for that. What pro-resolution does, it doesn't stop anything. It puts a lid on the left-hand side of the immune response. Then it increases kind of the healing aspects of your immune system. That balance is, at least in theory, is creating a different approach that will create much less side effects. We're having effect directly on specific immune cells, specifically what's called macrophages, which are part of these key immune cells that are doing all these responses. We already have addressed these cells across multiple organs in the body. These cells are abundant obviously in joints, but also in heart tissue, in kidneys, in lungs, in the skin, and so forth. You can apply these concepts very, very broadly. On the right-hand side, we have made a table of all the indications or some of the indications where we have tested out the mechanism for a compound like this in RA, that's rheumatoid arthritis, but you also have osteoarthritis or gout disease. A lot of these arthritis-like diseases, and also into more respiratory viral infections and more exotic infections like dengue virus and so forth, which all has this immune response that you interact to. Many of these, we have animal models suggesting that this could have an effect. We have clinical programs running in several of these. I'm going to speak to the first one, the rheumatoid arthritis one. This is our pipeline of various development programs to really put this field forward in as many organs as possible, but you need to establish proof of concept in one of them first. Then you move from there. That's a part of what we're doing right now. In rheumatoid arthritis, this is a picture of a joint that is inflamed in rheumatoid arthritis. Just beneath you can see all the red. That is the inflammation in the tissue, in the synovial tissue between the bones, so really in the joint. A part of that cascade is these activated macrophages that creates a lot of damage or a lot of issues, a lot of trouble. What you see is that in patients with high disease of rheumatoid arthritis, you see these, you can actually measure the abundance of these activated macrophages. If you're developing medicine, that's a clear target to do something about those activated macrophages, and that is exactly what resomelagon does. It changes the activated macrophages to what's called a pro-resolving macrophage, and you can modulate that by addressing what's called melanocortin receptors. The therapies that are currently used in rheumatoid arthritis today, from the top and down, general NSAIDs, which is for pain and for anti-inflammatory effect. You use a lot of steroids in this disease. Once you're not satisfied with those, you go into what is called disease-modifying antirheumatic drugs or DMARDs. The first DMARD you're going to use is what's called methotrexate. That was invented, I believe, back in the 1970s. It is still widely used today and is the first line of therapy for people with moderate to severe rheumatoid arthritis. It also comes with a lot of baggage. It has immunosuppressive features to it, but works well for many patients. The problem is for those where it doesn't work adequately and fast enough, then you have to move on to biologic agents. That is your TNF blockers. This is your HUMIRA of the world, one of the biggest agents in the world. You move from there. There are different strategies of how to deal with that with more and more potency in these drugs. They are all coming with immunosuppressive features. Really this target around dealing with macrophages and doing something that is not immunosuppressive, that is something that is needed in a market like this. Looking at the U.S., we're very much talking for the U.S. market in this. You have roughly 1.3 million people living that are being treated for their rheumatoid arthritis. Around 500,000 of those are not responding well to the first-line agents. They will move into the biologic therapies, which are priced much, much higher than what you have on first-line therapies. You can basically dissect and say, well, patients that have a lot of high response measured on what's called CRP levels, well, they are more likely to be going into the biologics because they need more therapy. There's a lot of tolerability issues, so you need to change drugs along the way. There's a lot of steroid use, which is not good for a chronic disorder and so forth. There's really need for something new. This is a picture of how we see rheumatoid arthritis being treated today and where we can fit in. On the left-hand side of the picture, you have the newly diagnosed patients. Well, they get diagnosed, they start on methotrexate, and you try that for three to six months to see, have you adequate results. If you can't tolerate that, you use something else and so forth, and you can also combine that with steroid therapy. After three to six months, you have to evaluate, do you have enough effects from that therapy? If not, then you have to move on, and you need to move on fast because you need to stop the disease, otherwise you will have damage. A lot of patients go into the biologics and so forth, and then you start a progressive use of various therapies. That is roughly 30%-40% of all patients that ends up in that cascade. This is where the pharmaceutical companies are focusing right now, or the last 25 years, because that is where TNF, JAK- inhibitors, and so forth, this is the realm where they are. These are expensive therapies. What we think is that by addressing macrophages, doing something different, non-immunosuppressant, that means a more safe drug that can address patients early on, that basically put on first-line therapies and try to get patients to not progress into the biologics or at least prolong that process as far as possible. That's what we're going for with resomelagon. We do that because we think it's safe, meaningful, and so forth. We have some results from previous trials. We have been in clinic in the past six years doing this. Here is an overview of what we've seen in over four weeks of trials or 12 weeks of trials, is the usual for phase II trial, and basically reaching a clinical meaningful effect in 80% of patients. That will translate into prolonged clinical effect. This is why we're doing this in a trial that we've been conducting the last two years. We expect top-line results of that in June. The next couple of weeks, we will have the data and report that. We're very eager to do that because that will basically tell whether this picture, what we've seen in the past, is that solid. If it's solid, that means that we have adequate clinical results without suppressing the immune system. That means that this can be applied as a safe therapy early on, and that means also that we can move into discussion with authorities and basically combine that with a phase III package. More importantly as well is that that will also lead us into talking with pharmaceutical companies that will take this on as a license to really develop this moving forward. This is what's hopefully going to happen over the next couple of weeks with data and then initiate all this partnering discussion over the next 6-12 months, something like that. That's typically what it takes to move this forward. We have a very experienced team doing this that has been making companies with new assets before, sold them, and so forth. We're very confident with the team that we have that can execute on this plan. Just last but not least, please remember, we are addressing a potentially huge market with something new that could be a paradigm shift. Just in rheumatoid arthritis and some of the viral indications that we're looking at right now, well, that's a $26 billion, $30 billion market. If we can have just a slight piece of that will be very, very attractive for most companies around the world to work with. It's a first-in-class mechanism, which also means that if you're a big pharmaceutical company that wants something new because you need that in your pipeline, we'll be a good candidate to talk with. We'll have data suggesting whether that is the case. We'll have that very, very soon. We can use this if we're positive in suggesting that this product actually works and it's a safe product. We can use this for a lot of different other organs and addressing a lot of different other diseases across the immune space. By that, I will open the floor for questions. Any questions from the audience? From you? I think I will do for the questions. Thank you so much for that presentation. You mentioned that you're just days or perhaps weeks away from this top-line data in your ADVANCE study. What type of effect do you need to see in order to view this as clinically and commercially relevant? Yeah, sure. First, backing up a little bit, we're dealing with something novel here. Yeah. Right. It's always hard to say exactly what that is. Clinical meaningful results in a phase II trial is can you show that you are having enough clinical effect measured on what's called ACR 20 levels— Right. — or DAS 28, which is measures of clinical difference or clinical effects in rheumatoid arthritis. Can you do that in a patient population that are adequate and do that in a safe manner? That would be the target here. We've done this before, and looking at the results before, we can get something similar, we will be very happy. All right. If you get positive data on this study, what will you do? What is the next step? Will you conduct an even bigger study or where are you? We're a call it a virtual biotech company, meaning that we are less than 10 people in the organization. We work with clinical research organizations and consultants to the army. Our priority one, two, and three, that is finding the right partner to work with, that is a pharmaceutical company that loves this as much as we do, and will be able to conduct a phase III trial and bring this to market successfully. All right. phase III? Yes. That's the next step. Yes You can go broader commercially. Yes. All right. Besides this, you also have a broader pipeline. Yeah. How should you, as an investor, view this? Do you think that the company is solely dependent on ADVANCE, or are there any more values in here? Again, looking back at some of the application of this mechanism, because it works across a lot of our different organs, there's a lot of opportunities in trying this product out. Obviously, what we have with the ADVANCE trial in rheumatoid arthritis, that is the first sign that this product works. Yeah. Right? Right after we have what's called the RESPIRE trial and the RESOVIR-2 trial. Those are in respiratory viral infections and in dengue virus. Especially the respiratory viral infections, that is influenza, COVID-19, RSV viruses. Yep. When people go to hospital, they need oxygen therapy, and you can actually provide this, maybe alongside with an antiviral medicine, and get people out of hospital faster. That is an application that we are investigating right now, and we could probably come up with 10 or 20 more that will work. Obviously, the world would be so much easier if we show that rheumatoid arthritis, it works there, then the logical conclusion is that it will also work in a lot of these other indications. Yeah. We are doing trials in these other indications as we speak. We'll have the results of that to support the total body of evidence. Interesting. The financing market for biotech company has been, well, rough, to say, at least in the last, well, five years, I think. What are your views on your capital need currently? We were good, lucky, or fortunate enough to raise capital earlier this year. Right. We are actually funded to beyond the results of the ADVANCE study. We are funded for a time being that we have time to make a deal on this. Obviously, that being said, that it depends on how much other activities do we want to do. If we want to do more, obviously we would have to find more capital as well. Our priority one, two, and three is to find the right partner that loves this just as much as we do and to move this forward in a phase III program. That will solve a lot of the downstream things for us. You will not conduct the phase III study on your own? As it looks right now, we will not. We actually have the capabilities of doing so. Right One of the largest owners of the company is a CRO that conducts these kind of trials. I think the best opportunity is to find the right partner that has products on the market and knows how to do that, and really position a drug like resomelagon in a phase III trial for success. That is the best opportunity for this, and that's what we're going for. Yeah, right. I think that is all good final words. Excellent. Thank you so much for this. Thank you very much.
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