Slides
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Altimmune Corporate Presentation May 2025
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Forward-looking Statements Safe-Harbor Statement This presentation has been prepared by Altimmune, Inc. ("we, " "us, " "our, " "Altimmune" or the "Company") and includes certain “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, including statements regarding the timing of clinical development and funding milestones for our clinical assets, the timing of the IMPACT trial data readout, as well as statements relating to future financial or business performance, conditions, plans, prospects, trends, or strategies and other financial and business matters, and the prospects for commercializing or selling any product or drug candidates. In addition, when or if used in this presentation, the words “may, ” “could, ” “should, ” “anticipate, ” “believe, ” “estimate, ” “expect, ” “intend, ” “plan, ” “predict” and similar expressions and their variants, as they relate to the Company may identify forward-looking statements. The Company cautions that these forward-looking statements are subject to numerous assumptions, risks, and uncertainties, which change over time. Important factors that may cause actual results to differ materially from the results discussed in the forward- looking statements or historical experience include risks and uncertainties, including risks relating to: the potential impact of pemvidutide in the indications of MASH, Alcohol Use Disorder ("AUD") and Alcohol Liver Disease ("ALD") and associated treatment needs and development plans, potential impacts such as delays in clinical trials; regulatory applications, review and approvals; manufacturing and supply chain interruptions; adverse effects on healthcare systems and disruption of the global economy; the timing and reliability of the results of the studies relating to human safety and possible adverse effects; our lack of financial resources and access to capital; the commercialization of proposed product candidates (such as marketing, regulatory, product liability, supply, competition, dependence on third parties and other risks) including in the new indications of AUD and ALD; and, the protection afforded by regulatory exclusivity and intellectual property. Further information on the factors and risks that could affect the Company's business, financial conditions and results of operations are contained in the Company’s filings with theU.S. Securities and Exchange Commission, including under the heading “Risk Factors” in the Company’s annual reports on Form 10-K and quarterly reports on Form 10-Q filed with the SEC, which are available at www.sec.gov. The statements made herein speak only as of the date stated, and any forward-looking statements are based on assumptions that the Company believes to be reasonable as of this date. The Company undertakes no obligation to update these statements as result of new information or future events. 2
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Pemvidutide Vision: A Transformational Therapy Across Related Diseases 3 Designed to cover the spectrum of steatotic liver disease and its primary causes MASH ALD AUDObesity $150 million cash, cash equivalents and short-term investments as of 3/31/25 provides runway into 3Q 2026
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Seasoned Management Team Vipin K. Garg, PhD President & CEO Scott Harris, MD Chief Medical Officer Scot Roberts, PhD Chief Scientific Officer Bertrand Georges, PhD Chief Technology Officer Greg Weaver, MBA Chief Financial Officer Raymond Jordt, MBA Chief Business Officer 4
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Pursuing Multiple Indications with Key Milestones STATUS / UPCOMING MILESTONES** Completed successful EOP2 meeting IMPACT Phase 2b topline data 2Q 25 Phase 2 trial initiation 2Q 25 Phase 2 trial initiation 3Q 25 PRECLINICAL PHASE 1 PHASE 2 PHASE 3 5 Obesity MASH* AUD ALD **expected dates*FDA has granted Fast Track Designation for pemvidutide in MASH
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1:1 POTENCY OF GLP -1 AND GLUCAGON GLP-1 Direct Effects on GI & Brain Appetite Cravings Inflammation Compelling clinical data to-date support continued development in multiple indications Clinically meaningful weight loss Class-leading lean mass preservation Rapid and robust liver fat reduction Significant reductions in serum lipids Pemvidutide: Novel GLP-1/Glucagon Dual Receptor Agonist 6 Energy expenditure Lipolysis Mobilization of liver fat Glucagon Direct effects on Liver Lipolysis Mobilization of Fat Energy Expenditure
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7 >15% Weight Loss >75% Liver Fat Reduction 15-20% LDL-C Reduction Pemvidutide: Designed to Address Major CV Risk Factors
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58-75% MASLD3,4,5 15-36% MASH3,4,6 66-70% Dyslipidemia1,2 45-55% Hypertension1,7 Most Significant Comorbidities Relate to Lipid and Liver Fat Disorders Managing Comorbidities is Essential to Treating Obesity 8 1.Bays, Harold, et. al. (2013) Obesity, adiposity, and dyslipidemia: A consensus statement from the National Lipid Association. Journal of Clinical Lipidology 7(4):304–383 2.Lim Y, Boster J. Obesity and Comorbid Conditions. [Updated 2023 Feb 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; https://www.ncbi.nlm.nih.gov/books/NBK574535/ 3.Quek, Jingxuan, et. al. (2023) Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population:. The Lancet Gastroenterology & Hepatology 8(1):20-30. 4.Vernon, G, et. al. (2011) Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 34:274–285. 5.Le, Michael, et. al. (2022) 2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology 2022;20:2809–2817 6.Dufour, Jean-François, et. al. (2021) The global epidemiology of nonalcoholic steatohepatitis (NASH) and associated risk factors–A targeted literature review. Endocrine and Metabolic Science 3. 7.Pantalone KM, et al. Prevalence and recognition of obesity and its associated comorbidities. BMJ Open 2017;7:e017583. doi:10.1136/ bmjopen-2017-017583
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Pemvidutide: MOMENTUM Phase 2 Clinical Data Summary
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Weight Loss of 15.6% Continuing at Week 48 on 2.4 mg MMRM, mixed model for repeated measures Relative Weight Loss (%) *** p < 0.001 vs. placebo (MMRM) Relative Weight Loss Curves (%) MMRM, mixed model for repeated measures 10
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Drug Study Study Duration Lean Loss Ratio Pemvidutide MOMENTUM Phase 2 48 weeks 21.9% 1 Semaglutide* STEP-1 Phase 3 68 weeks 39.9% 2 Tirzepatide* SURMOUNT 1 Phase 3 72 weeks 26.0% 3 Retatrutide* Obesity Phase 2 36 weeks 37.7% 4 Lean Loss Ratio = Lean Loss (kg)/Total Loss (kg) Pemvidutide: Improved Quality of Weight Loss Class-leading Lean Mass Preservation Preferential Loss of Visceral Fat Subcutaneous Fat Visceral Fat -40 -30 -20 -10 0 -28.3% -15.6% -20.4% -8.8% LS Mean Change from Baseline (% ± SE) ** * placebo N=17 1.2 mg N=18 1.8 mg N=15 2.4 mg N=17 pemvidutide -40 -30 -20 -10 0 -19.5% -13.0% -11.5% -4.7% LS Mean Change from Baseline (% ± SE) placebo N=17 1.2 mg N=18 1.8 mg N=15 2.4 mg N=17 pemvidutide ** * p < 0.05 | ** p < 0.005 vs. placebo (analysis of covariance; ANCOVA) Visceral fat is a CV risk factor 1. Pemvidutide data from MRI MOMENTUM sub-study 2. Wilding JPH. N Engl J Med. 2021 Mar 18;384(11):989-1002 3. Look M. Diabetes Obes Metab. 2025 May;27(5):2720-2729 4. Harris C, Obesity Week 2023 *Data derived from published results; not from head-to-head studies 11
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Enhanced Lipid Reductions in Subjects with Elevated Baseline Levels Triglycerides > 150 mg/dL at Baseline Total Cholesterol > 200 mg/dL at Baseline LDL > 130 mg/dL at Baseline * p < 0.05 | ** p < 0.005 | *** p < 0.001 vs. placebo (ANCOVA) -80 -70 -60 -50 -40 -30 -20 -10 0 -55.8% -33.1% -36.3% -13.1% LS Mean Change from Baseline (% ± SE) * * *** placebo N=17 1.2 mg N=22 1.8 mg N=19 2.4 mg N=21 pemvidutide -30 -20 -10 0 -20.0% -18.5% -14.8% -4.4% ** *** *** placebo N=23 1.2 mg N=35 1.8 mg N=27 2.4 mg N=25 pemvidutide -40 -30 -20 -10 0 ** * placebo N=15 1.2 mg N=22 1.8 mg N=21 2.4 mg N=17 pemvidutide -2.4% -12.1% -21.8% -17.4% 12
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Overview of Adverse Events Characteristic Treatment Placebo (N=97) 1.2 mg (N=98) 1.8 mg (N=99) 2.4 mg (N=97) SAEs related to study drug N (%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (1.0%) Drug-related AEs leading to discontinuation N (%) 2 (2.1%) 4 (4.1%) 16 (16.2%) 15 (15.5%) Gastrointestinal (GI) AEs—mainly mild to moderate Nausea N (%) 11 (11.3%) 25 (25.5%) 59 (59.6%) 50 (51.5%) Vomiting N (%) 3 (3.1%) 6 (6.1%) 27 (27.3%) 27 (27.8%) Diarrhea N (%) 5 (5.2%) 8 (8.2%) 10 (10.1%) 18 (18.6%) Constipation N (%) 8 (8.2%) 17 (17.3%) 13 (13.1%) 22 (22.7%) Major Adverse Cardiac Events (MACE) N (%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) Cardiac AEs, including arrhythmias N (%) 4 (4.1%) 3 (3.1%) 4 (4.0%) 3 (3.1%) • No MACE events • No imbalances in cardiac arrythmias across treatment groups Results observed with no or minimal dose titration, and no dose reduction 13
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Pemvidutide in MASH: Combining direct liver effects with clinically meaningful weight loss to optimize MASH treatment
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The Rising Prevalence of MASH 1. Estes C, et. al. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018 Jan;67(1):123-133. doi: 10.1002/hep.29466 16.5M 27.5M 0 5 10 15 20 25 30 2015 2030 Prevalence (M) 63% increase Projected MASH Prevalence in the US (2030)1 Projected MASH US Prevalence by Stage (2030)1 3.9M 9.0M 6.1M 4.5M 3.5M 15 F0 F1 F2 F3 F4
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1 Significant Comorbidities Associated with MASH Addressing Comorbidities Essential for Comprehensive MASH Treatment 1 161.Younossi et al. (2016) North America Prevalence. Hepatology 64(1):73 Supplement (http://onlinelibrary.wiley.com/doi/10.1002/hep.28431/suppinfo)
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Pemvidutide: MASLD Phase 1b Clinical Data Summary
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0 10 20 30 40 50 60 70 80 90 100 0% 30.8% 53.8% 45.5% 0% 61.5% 84.6% 72.7% 5.6% 76.9% 92.3% Proportion of Subjects (%) 0.0% placebo N=18 1.2 mg N=14 1.8 mg N=13 2.4 mg N=11 pemvidutide 0.0% 100.0% placebo N=18 1.2 mg N=14 1.8 mg N=13 2.4 mg N=11 pemvidutide placebo N=18 1.2 mg N=14 1.8 mg N=13 2.4 mg N=11 pemvidutide **** **** **** *** **** **** *** ** * Up to 76.4% Reduction of Liver Fat in Phase 1b MASLD Trial Relative Reduction at Week 24 (N=56) Responder Analyses at Week 24 (N=56) *** p < 0.001 vs. placebo (ANCOVA) * p < 0.05 | ** p < 0.005 | *** p < 0.001 | **** p < 0.0001 vs. placebo (Cochran-Mantel-Haenszel; CMH) 50% Reduction Normalization (≤5% LFC) 30% Reduction 0 10 20 30 40 50 60 70 80 90 14.0% 56.3% 75.2% 76.4% LS Mean Change from Baseline (% ± SE) *** *** *** placebo N=18 1.2 mg N=14 1.8 mg N=13 2.4 mg N=11 pemvidutide 18
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Magnitude of Liver Fat Reduction Correlates with MASH Resolution & Fibrosis Improvement > 50% reduction > 30% reduction < 30% reduction >75% liver fat reduction at week 24 Pemvidutide MASH Resolution Fibrosis Improvement 0 10 20 30 40 50 60 70 Liver Fat Reduction Drives MASH Improvement1 Response Rate (%) Liver Fat Reduction 191.Adapted from Loomba, European Association for the Study of the Liver, International Liver Conference, 2020, analysis of Phase 2 resmetirom study (Harrison SA, Lancet 2019)
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Class-Leading Liver Fat Reduction among MASH Agents Pbo 28 mg 50 mg Pbo 30 mg (QW) 44 mg (Q2W) Pbo 4.8 mg 6.0 mg Pbo 2.5 mg (QD) 10 mg (QOD) Pbo 80 mg 100 mg Pbo 1.2 mg 1.8 mg 2.4 mg Sema 1 mg 10 mg Pemvidutide QW (GLP-1/GCG) 24wk Phase 1b Efruxifermin QW (FGF21) 24wk Phase 2b Efinopegdutide QW (GLP-1/GCG) 24wk Phase 2a Survodutide QW (GLP-1/GCG) 48wk Phase 2 Semaglutide QD* (GLP-1) 48wk Phase 1 Resmetirom QW (THR-β) 52wk Phase 3 Pegozafermin QW & Q2W (FGF21) 24wk Phase 2b VK2809 QD & QOD (THR-β) 52wk Phase 2b Pbo 0.4 mg* 20 Tirzepatide QW (GLP-1/GIP) 52wk Phase 2 Pbo 10 mg 15 mg Note: These data are derived from published results in different clinical trials at different points in time, with differences in trial design and patient populations. As a result, cross-trial comparisons cannot be made, and no head-to-head clinical trials have been conducted (see appendix for sources).
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PEMVIDUTIDE 1.8 mg 95% relative reduction in liver fat in a patient with high liver fat (normalization within 24 weeks) Baseline 32.3% Week 24 1.7% MASLD Ph1b Case Example: Near Complete De-Fatting of Liver with Pemvidutide 21 PDFF %
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Pemvidutide: IMPACT Phase 2b MASH Trial
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23 Key endpoints Primary MASH resolution or fibrosis improvement Secondary Weight Loss (WL) Noninvasive tests (NITs) Week48 WL/NITs IMPACT Phase 2B Biopsy-driven F2/F3 MASH Trial Topline Data 2Q 2025 Week24 Liver Biopsy/WL/NITs Screening/Randomization 1.8 mg weekly (N~76) 1.2 mg weekly (N~38) Placebo weekly (N~76)
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IMPACT Phase 2b Trial: Designed for Success 24 24 Large Sample Size Greater Liver Fat Reduction Biopsy Re-Reads and the use of 3 Readers Increased Study Power Greater Biopsy Responses Minimize the Placebo Response
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Pemvidutide has the Potential to be a Complete Solution for MASH Liver Effect Weight Loss Pemvidutide 1:1 GLP-1/Glucagon Rapid liver effects, significant weight loss GLP-1/GIP THR-β FGF21 25 Significant weight loss, modest liver effect Insignificant weight loss, modest liver effect Rapid liver effects, insignificant weight loss
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Leveraging Pemvidutide’s Novel MoA to Open New Opportunities Addressing large, under-served patient populations in AUD and ALD
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Pemvidutide Treatment Could Halt Progression of AUD to ALD Up to 28.1M patients have AUD1 AUD5+/day Designed to address alcohol misuse and liver inflammation, with added promise of weight loss Pemvidutide: Positioned to Address Significant Unmet Needs in AUD & ALD 27 Up to 6.6M patients have ALD2 ALD 1. SAMHSA 2023 NSDUH Survey 2. Calculated based on Amonker S, et. al. Hepatol Commun. 2023;7:e0133. https://doi.org/10.1097/HC9.0000000000000133
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Surgeon General Advisory January 2025 AUD: Significant Societal Burden 7th Leading cause of death and disability globally due to alcohol1 $249B Total cost of alcohol misuse in the US in 20102 28 Alcohol is 3rd leading cause of preventable cancer after tobacco and obesity 1. GBD 2016 Alcohol Collaborators. Lancet 2018; 392: 1015–35 2. https://www.hhs.gov/surgeongeneral/reports-and-publications/alcohol-cancer/index.html
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0 5 10 15 20 25 30 Prevalence (M) Only 2.0% of patients drug-treated AUD Population Treated Drug-treated 28.1M 552K2.2M AUD: One of the Largest Known Healthcare Treatment Gaps 1 291. SAMHSA 2023 NSDUH Survey
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In addition to managing underlying alcohol misuse, patients with AUD require therapies to address comorbidities Cardiometabolic Comorbidities 66% are overweight or have obesity2 90% will develop liver steatosis 1 45% have hypertension 3 23% have hyperlipidemia 3 AUD Patients Typically Have Significant Comorbidities 30 1. Osna et al. Alcoholic Liver Disease: Pathogenesis and Current Management. Alcohol Research Current Reviews 2. Raza et al. Burden of high-risk phenotype of heavy alcohol consumption among obese US population: results from NHANES 1999-2020. Lancet Vol 23, July, 2023 3. AshaRani PV, et.al. Prevalence and Correlates of Physical Comorbidities in Alcohol Use Disorder (AUD): a Pilot Study in Treatment-Seeking Population. Int J Ment Health Addict. 2022 Jan 23:1-18
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Pemvidutide Suppresses Alcohol Intake in Preclinical Model vehicle Hamster Free-Choice Model 0 2 4 6 8 10 12 14 16 18 20 0 10 20 30 40 50 60 70 80 90 100 Day % Alcohol Intake per Day (Alcohol/Total Volume) pemvidutide 10 nmol/kg 31Water and 15% ethanol solution
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Pemvidutide: Phase 2 AUD Trial Design Randomized, double-blind, placebo-controlled trial of ~ 100 subjects with obesity and moderate to severe AUD according to DSM-5 32 Screening/Randomization Key endpoints Primary Change in heavy drinking days Week 24 Secondary Change in biomarkers of alcohol consumption Weight loss placebo weekly (N~50) Week 1 4 Weeks 4 Weeks 1.2 mg 1.8 mg 2.4 mg weekly (N~50)
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Critical Need for Drugs that Improve Liver Health and Reduce Alcohol Consumption Alcohol Liver Disease Company Confidential Result of chronic, excessive alcohol use Similar to MASH, disease progression begins with liver steatosis, which may lead to fibrosis, and ultimately cirrhosis Up to 6.6 million Americans affected by ALD No approved treatments; few in development Obesity significantly accelerates disease progression and leads to worse outcomes 33
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Obesity Potentiates Alcohol-Related Liver Mortality 1 0 2 4 6 8 10 12 14 16 18 20 Baseline (B) B + Obesity (O) B + O + Alcohol Interaction Relative Risk 17.3 10 1.91 For heavy drinkers, increasing BMI increases all-cause disease mortality Baseline Risk Excess Obesity Risk Excess Alcohol Risk Excess Interaction Risk Obesity Significantly Increases Risk of Poor Alcohol- Related Liver Outcomes 341. Patra et al. Impact of body mass and alcohol consumption on all-cause and liver mortality in 240,000 adults in the United States. Drug and Alcohol Review (September 2021), 40, 1061–1070
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Pemvidutide: Phase 2 ALD Trial Design 35 Screening/Randomization Other Key Endpoints Weight loss Change in alcohol consumption 4 Weeks 4 Weeks Randomized, double-blind, placebo-controlled trial of ~ 100 subjects with obesity and ALD Week48Week24 Key eligibility Primary Endpoints Change in LSM Additional Endpoints Change in LSM Weight loss Change in alcohol consumption • Liver Stiffness Measurement (LSM) (10 to ≥ 18.5 kPa) • BMI ≥ 25 kg/m2 • Heavy alcohol consumption placebo weekly (N~50) 1.2 mg 1.8 mg 2.4 mg weekly (N~50)
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Clinical and Regulatory Milestones & Near-Term Catalysts Q2Q1 INDs in AUD and ALD Cleared by FDA Q2 Q4Q3 2025 Initiate Phase 2 AUD trial IMPACT Phase 2b 24-week topline data Initiate Phase 2 ALD trial FDA EOP2 meeting for MASH 36 2026 Q1 Initiate MASH Phase 3 Trial
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A Complete Solution MASH AUD ALD Pemvidutide Vision: Transformational Therapy Across Multiple Indications 37 Treating the Comorbidities OBESITY Major Cause of Liver Damage No Approved Therapies
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Thank You
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Appendix Slide 20 Data Sources: • Pemvidutide: Phase 1b NAFLD Study Topline Results Extension • Efinopegdutide: EASL Congress 2023, Manuel Romero-Gomez Presentation • Efruxifermin: Harrison et al. “Safety and efficacy of once-weekly efruxifermin versus placebo in non-alcoholic steatohepatitis (HARMONY): a multicentre, randomised, double-blind, placebo-controlled, phase 2b trial. ” The lancet. Gastroenterology & hepatology vol. 8,12 (2023): 1080-1093. doi:10.1016/S2468-1253(23)00272-8 • Survodutide: Sanyal, Arun J et al. “A Phase 2 Randomized Trial of Survodutide in MASH and Fibrosis. ” The New England journal of medicine vol. 391,4 (2024): 311-319. doi:10.1056/NEJMoa2401755 • Tirzepatide: Loomba et al. “Tirzepatide for Metabolic Dysfunction-Associated Steatohepatitis with Liver Fibrosis. ” The New England journal of medicine vol. 391,4 (2024): 299-310. doi:10.1056/NEJMoa2401943 • Semaglutide: Flint et al. “Randomised clinical trial: semaglutide versus placebo reduced liver steatosis but not liver stiffness in subjects with non-alcoholic fatty liver disease assessed by magnetic resonance imaging. ” Alimentary pharmacology & therapeutics vol. 54,9 (2021): 1150-1161. doi:10.1111/apt.16608 • VK2809: Company Release June 3, 2024 • Pegozafermin: Corporate Presentation March 2025 • Resmetirom: Harrison et al. “A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis. ” The New England journal of medicine vol. 390,6 (2024): 497-509. doi:10.1056/NEJMoa2309000 39