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Altimmune Corporate Overview November 2025 Our Mission: To Revolutionize the Standard of Care for Serious Liver Diseases
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Forward Looking Statements 2 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, but not limited to, statements relating to future financial or business performance, conditions, plans, prospects, trends, or strategies and other financial and business matters, including without limitation, the timing of key milestones for our clinical assets, the performance of our drug candidates in ongoing and future clinical trials including the ongoing IMPACT, RECLAIM and RESTORE trials evaluating pemvidutide in patients with MASH, AUD and ALD, respectively, and the prospects for regulatory approval, commercializing, market size, market potential, competitive landscape, or selling any product or drug candidates. In addition, when or if used in this press release, the words “may,” “could,” “should,” “anticipate,” “believe,” “estimate,” “expect,” “intend,” “plan,” “predict,” “potential”, “suggest” 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 such as delays in regulatory review, manufacturing and supply chain interruptions, access to clinical sites, enrollment, adverse effects on healthcare systems and disruption of the global economy; subject baseline characteristics which may vary and impact the success of future trials; the reliability of the results of studies relating to human safety and possible adverse effects resulting from the administration of the Company’s product candidates; the Company’s ability to manufacture clinical trial materials on the timelines anticipated; and the success of future product advancements, including the success of current and future clinical trials. 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 the U.S. Securities and Exchange Commission, including under the heading “Risk Factors” in the Company’s latest annual report on Form 10-K, quarterly report on Form 10-Q and our other filings with the SEC, which are available atwww.sec.gov.
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Leadership Team 3 Vipin K. Garg, PhD President & CEO Christophe Arbet-Engels, MD, PhD Chief Medical Officer Scot Roberts, PhD Chief Scientific Officer Greg Weaver Chief Financial Officer Raymond Jordt Chief Business Officer Linda Richardson Chief Commercial Officer Robin E. Abrams, JD Chief Legal Officer & Corporate Secretary
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Differentiated 1:1 glucagon/GLP-1 ratio enables optimal therapeutic profile by directly targeting liver and metabolic components Proprietary EuPort domain provides differentiated PK profile with improved tolerability Therapeutic applicability in a variety of steatotic liver diseases Pemvidutide: The Molecule Matters Favorable tolerability, a critical driver of prescribing practice Tolerability Glucagon Provides Direct Liver Effects GLP-1 Treats Metabolic Issues Significant and continuing weight loss at 24 weeks treats underlying cause of MASH Potential Class-Leading Phase 2b MASH results with proven direct liver benefit at 24 weeks 4 MASH = Metabolic Dysfunction-Associated Steatohepatitis.
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Pemvidutide: The Molecule Matters 5 Maximize Liver Benefits and Treat Underlying Cause of MASH EuPort ↓ Delayed Tmax with Lower Cmax ↓ Better Tolerability EuPort Domain Glucagon specificity Direct impact on the liver and metabolism GLP-1 specificity Direct impact on GI and CNS COOH (CH2)nPemvidutide
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Our Priority Programs in Liver Diseases Phase of Development Pemvidutide Pre-clinical Phase 1 Phase 2 Phase 3 Key Catalysts MASH (FDA Fast Track Designation) IMPACT Phase 2b 24w data 4Q25: IMPACT Phase 2b 48w data 4Q25: End of Phase 2 FDA Meeting AUD (FDA Fast Track Designation) 4Q25: RECLAIM Phase 2 trial enrollment complete ALD 3Q25: RESTORE Phase 2 trial initiated 6
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MASH and ALD are Related and Progressive Liver Diseases Characterized by Common Comorbidities 1. Younossi et al. (2016) North America Prevalence. Hepatology 64(1):73 Supplement (onlinelibrary.wiley.com/doi/10.1002/hep.28431/suppinfo). 80% Overweight / Obese 83% Dyslipidemia 77% Hypertension Steatosis Inflammation Fibrosis Cirrhosis Disease Progression MASH comorbidities that may be addressable with pemvidutide Normal Liver 7 MASH ALD AUD Obesity
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The “Must Have” Attributes of a MASH Drug That May Drive Prescriber / Payor / Patient Adoption “Must Have” Attributes Pemvidutide Other GLP-1/GCGs GLP-1 THR-β FGF21 Liver Directed Glucagon Weight Loss GLP-1 Tolerability EuPort Domain 8
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IMPACT Phase 2b MASH Trial Design 1. Liver fat content. 2. MASH Resolution without worsening of fibrosis or Fibrosis Improvement without worsening of MASH. 1.2 mg weekly 1.8 mg weekly Placebo (PBO) weekly Week 48 NITs Weight Loss Week 24 Liver Biopsy NITs Weight Loss Key Eligibility Criteria MASH (F2/F3) LFC(1) ≥ 8% BMI ≥ 27.0 kg/m2 HbA1c < 9.5% Key Endpoints Primary MASH resolution or fibrosis improvement(2) Secondary MASH resolution and fibrosis improvement Non-invasive tests (NITs) Weight Loss Screening/Randomization 9 n = 212 subjects randomized 2:1:2 No dose titration
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MASH Resolution without Worsening of Fibrosis: Best-in-Class Potential **** indicates p<0.0001 vs. placebo (Chi-Square Test). No head-to-head studies of pemvidutide to other MASH products or product candidates have been conducted; the data regarding other MASH products and product candidates is based on published data. Bec ause of differences in patient populations, study designs, and numerous other factors, cross-trial comparisons must be interpreted with caution and no conclusions can be drawn. Actual results may materially differ. Note: 1. For ITT Analysis, patients without a biopsy at 24 weeks, or those who did not complete treatment, are treated as non-responders. 2. Pegozafermin data generated with multiple imputations. 3. Calculated efimosfermin. 10 Proportion of subjects (%) ITT analyses(1) 24 weeks ≥ 48 weeks (2) Pemvidutide (3) efruxifermin (FGF21) 24 Weeks Phase 2b pegozafermin (FGF21) 24 Weeks Phase 2b efimosfermin (FGF21) 24 Weeks Phase 2b resmetirom (THR-β) 52 Weeks Phase 3 survodutide (GLP-1/GCG) 48 Weeks Phase 2 semaglutide (GLP-1) 72 Weeks Phase 3 pemvidutide (GLP-1/GCG) 24 Weeks Phase 2b
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Rapid Reduction in Liver Fat Content Drives Early MASH Resolution 11 *** indicates p<0.001 vs. placebo (ANCOVA) in Liver Fat Content. **** indicates p<0.0001 vs. placebo (CMH) in Liver Fat Conte nt Responder. Reduction in Liver Fat Content LS mean relative reduction from baseline (% ± SE) Liver Fat Content Responder Proportion of subjects (%) PBO (N=76) 1.2mg (N=39) 1.8mg (N=79) Pemvidutide 30% reduction 50% reduction Normalization (<5% LFC)
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*** indicates p<0.001 vs. placebo (ANCOVA) for Altimmune. No head-to-head studies of pemvidutide to other MASH products or product candidates have been conducted; the data regarding othe r MASH products and product candidates is based on published data Corrected T1 (cT1) Imaging – A Marker of Liver Inflammation that Correlates with MASH Resolution Absolute change from baseline (ms) cT1 Change from Baseline pemvidutide QW (GLP-1/GCG) 24 Weeks Phase 2b pegozafermin QW (FGF21) 24 Weeks Phase 2b resmetirom QW (THR-β) 36 Weeks Phase 2 tirzepatide QW (GLP-1/GIP) 52 Weeks Phase 2b 12
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Fibrosis Improvement at 24 Weeks No head-to-head studies of pemvidutide to other MASH products or product candidates have been conducted; the data regarding othe r MASH products and product candidates is based on published data. Because of differences in patient populations, study desig ns, and numerous other factors, cross-trial comparisons must be interpreted with caution and no conclusions can be drawn. Actual results may materially differ. Note: 1. For ITT Analysis, patients without a biopsy at 24 weeks, or those who did not complete treatment, are treated as non -responders. 2. Pegozafermin data generated with multiple imputations. 3. Calculated efimosfermin. 13 Proportion of subjects (%) ITT analyses(1) 24 weeks ≥ 48 weeks (2) (3) pemvidutide (GLP-1/GCG) 24 Weeks Phase 2b efruxifermin (FGF21) 24 Weeks Phase 2b pegozafermin (FGF21) 24 Weeks Phase 2b efimosfermin (FGF21) 24 Weeks Phase 2b resmetirom (THR-β) 52 Weeks Phase 3 survodutide (GLP-1/GCG) 48 Weeks Phase 2 semaglutide (GLP-1) 72 Weeks Phase 3 Pemvidutide
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Proportion of Patients with Both MASH Resolution AND Fibrosis Improvement 1. Chi-Square Test. For ITT Analysis, patients without a biopsy at 24 weeks, or those who did not complete treatment, are treated as non -responders 14 MASH Resolution and Fibrosis Improvement ITT Analysis(1) LS Mean Proportion of Subjects (%) Pemvidutide PBO (N=86) 1.2mg (N=41) 1.8mg (N=85)
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* indicates p<0.05 | *** indicates p<0.001 vs. placebo (CMH). 1. Changes corrected for reductions in liver fat. For ITT Analysis, patients without a biopsy at 24 weeks, or those who did not complete treatment, are treated as non -responders 15 Significant Changes in Area of Fibrosis(1) ITT Analysis Proportion of subjects (%) 30% reduction 40% reduction 50% reduction 60% reduction PBO (N=86) 1.2mg (N=41) 1.8mg (N=85) Pemvidutide Significant Reductions in Fibrosis at 24 Weeks by AI-Based Analysis
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Significant Changes in Non-invasive Tests of Fibrosis at 24 Weeks 25% LSM Reduction + >0.5 ELF Reduction ITT Analysis Proportion of Subjects (%) PBO N=70 1.2 mg N=37 1.8 mg N=73 ELF(2) LS Mean Absolute Reduction from Baseline (± SE) PBO N=74 1.2 mg N=39 1.8mg N=76 Pemvidutide LSM(1) LS Mean Absolute Reduction from Baseline (kPa ± SE) PBO N=76 1.2 mg N=37 1.8 mg N=78 Pemvidutide Pemvidutide 16 1. Liver Stiffness Measurement. 2. Enhanced Liver Fibrosis. * p<0.05 | *** p<0.001 vs. placebo (ANCOVA) For ITT Analysis, patients without a biopsy at 24 weeks, or those who did not complete treatment, are treated as non -responders * p<0.05 | **** p<0.0001 vs. placebo (CMH)
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IMPACT Data Show Significant and Continuing Weight Loss at 24 Weeks Addressing An Underlying Cause of MASH * p<0.05 | ** p<0.005 | *** indicates p<0.001 vs. placebo (MMRM). 17 PBO (N=86) 1.2mg (N=41) 1.8mg (N=85) Weight loss likely to improve MASH response and clinical outcomes Weight loss continuing at week 24 with no plateauing Reduction in waist circumference reflects decreases in visceral adiposity Pemvidutide Weight Loss LS Mean Relative Reduction from Baseline (% ± SE) Waist Circumference LS Mean Relative Reduction from Baseline (% ± SE)
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Improved Quality of Weight Loss with Pemvidutide 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) 18 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. MOMENTUM Obesity Phase 2 Class-Leading Lean Mass Preservation Lean Loss Ratio (%) = (Lean Loss (kg)/Total Loss (kg)
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Favorable Safety Profile Placebo (n = 86) 1.2 mg (n = 41) 1.8 mg (n = 85) Serious AEs 3 (3.5%) 1 (2.4%) 3 (3.5%) Serious AEs related to study med 0 (0.0%) 0 (0.0%) 0 (0.0%) AEs of Special Interest 0 (0.0%) 0 (0.0%) 0 (0.0%) 19 No AEs of Special Interest No reported serious AEs related to pemvidutide Majority of AEs mild in severity No heart rate increases or imbalances in cardiac AEs versus placebo
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Pemvidutide Demonstrated a Favorable Tolerability Profile with No Dose Titration Placebo (n = 86) 1.2 mg (n = 41) 1.8 mg (n = 85) AEs leading to treatment discontinuation 2 (2.3%) 0 (0.0%) 1 (1.2%) Nausea 12 (14.0%) 9 (22.0%) 35 (41.2%) Vomiting 2 (2.3%) 2 (4.9%) 7 (8.2%) Diarrhea 7 (8.1%) 4 (9.8%) 18 (21.2%) Constipation 8 (9.3%) 5 (12.2%) 11 (12.9%) 20
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Our Priority Programs in Liver Diseases Phase of Development Pemvidutide Pre-clinical Phase 1 Phase 2 Phase 3 Key Catalysts MASH (FDA Fast Track Designation) IMPACT Phase 2b 24w data 4Q25: IMPACT Phase 2b 48w data 4Q25: End of Phase 2 FDA Meeting AUD (FDA Fast Track Designation) 4Q25: RECLAIM Phase 2 trial enrollment complete ALD 3Q25: RESTORE Phase 2 trial initiated 21
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Related Conditions with Significant Unmet Needs 22 AUD ALD Only 3 approved medications, which are decades old Small effect size with current treatment options Poor treatment compliance with current therapies Patients at high-risk to develop ALD 90% will develop steatosis1 66% of AUD patients have obesity or overweight2 Similar to MASH - disease begins with liver steatosis, which may lead to fibrosis, and ultimately cirrhosis No approved treatments; few in development Obesity significantly accelerates disease progression 66% of ALD patients have obesity or overweight3 45% have dyslipidemia4 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. Singh, A. et al. American Journal of Gastroenterology 2016 (Abstract 837). Increased Prevalence of Obesity and Metabolic Syndrome in Patients With Alcoholic Fatty Liver Disease. 4. 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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AUD: One of the Largest Known Healthcare Treatment Gaps(1) 23 Pemvidutide • Reduce alcohol cravings and number of heavy drinking days • Improve liver health metrics • Reduce body weight • Improve liver fat and serum lipids Opportunity to substantially increase today’s 697,000 drug-treated population Total AUD Population Drug-treated 28M 1.US Data: SAMHSA, CBHSQ. 2023 National Survey on Drug Use and Health Tables 5.3A, 5.2A, 5.21A Increase to Millions with Pemvidutide 552K today Mod/Severe AUD Population ~12M
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ALD: Alcohol Poses Significant Incremental Risk of Progression 1. Desalegn et al. Impact of alcohol use on liver disease outcomes. Clin Liver Dis. 2024;23:e0192. 2. Metabolic and Alcohol -Associated Liver Disease. 5-Year Liver Disease Progression for MASH, Met-ALD and ALD (F3/F4)(1) ALD patients are ~3X more likely to have liver- related disease progression as compared to patients with MASH MASH 5-15% Met-ALD(2) 10-30% ALD 15-50% 24
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AUD & ALD: Pemvidutide Differentiation 25 Pemvidutide Semaglutide Disulfiram, Acamprosate, Naltrexone Reduction in Alcohol Consumption / Heavy Drinking Days Rapid Reduction of Liver Inflammation Weight Loss No head-to-head studies of pemvidutide to other products or product candidates have been conducted; the data regarding other pro ducts and product candidates is based on published literature.
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Pemvidutide Profile Well Suited to Address Unmet Medical Needs in AUD and ALD Ongoing Ph2 Studies in AUD and ALD Primary endpoint: Change in heavy drinking days on a weekly basis Screening/ Randomization Week 24 placebo weekly (N~50) 1.2mg 4 Weeks 1.8mg 4 Weeks 1.2 mg 1.8 mg 2.4 mg weekly (N~50) Randomized, double-blind, placebo-controlled trial of ~100 subjects with obesity and moderate to severe AUD according to DSM-5 2.4 mg weekly (N~50)Screening/ Randomization placebo weekly (N~50) 1.2 mg 4 Weeks 1.8mg 4 Weeks Randomized, double-blind, placebo-controlled trial of ~100 subjects with obesity and ALD Week48Week24 AUDALD Primary Endpoint: Change in Liver Stiffness Measurement (LSM) (24 weeks) 2.4 mg weekly (N~50) 26
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Near Term Catalysts and Financial Position 27 IMPACT MASH 48- week data readout 4Q 2025 End-of-Phase 2 Meeting with FDA scheduled 4Q 2025 AUD Phase 2 Readout 2026 Preparing for MASH Phase 3 trial 2026 Financials $211 million total cash as of September 30, 2025 Access to $125 million credit facility 9 months YTD OPEX of $54.5 million