To welcome Lisa Conte, Founder, President, and Chief Executive Officer of Jaguar Health, which trades on Nasdaq under the symbol JAGX. Welcome back, Lisa. Thanks so much, Lily. It's a pleasure to be here. Thank you for welcoming me, and thank you all who have joined and are listening. Hopefully, there are some people that are coming back to learn how Jaguar has progressed. If there are some new people, I'm going to give a short introduction about what the company does. We are a public company, I will dispense with the forward-looking statements here and jump right into it. As you heard, I'm the Founder, President, and CEO of Jaguar Health. We have a wholly owned subsidiary, Napo Pharmaceuticals, I may use the names Jaguar and Napo interchangeably. What we do is all drug discovery from plants used traditionally in tropical areas to seek new ways of treating and potentially curing primarily gastrointestinal diseases and disorders with plant-based medicines, prescription medicines. We are pursuing prescription medicines. This has been a year-- We've been in business for couple of decades now. This is a year where the themes and the presentation themes are transformation, focused, and near-term catalyst. That's what I'm going to be talking about during this presentation. We have taken a product all the way from a tree growing in the rainforest to a first-in-class, FDA-approved anti-secretory agent known as crofelemer. The brand name is Mytesi, and you see it right there on the slide, and that is approved for AIDS-related diarrhea. There is also a version of crofelemer that is approved by the Center for Veterinary Medicine of the FDA called Canalevia-CA1. It's a conditional approval for chemotherapy-induced diarrhea. These products are plant-based, they're natural, they're organic, they are sustainably harvested, and they are FDA-approved drugs, and they are the only oral drugs approved by the FDA under botanical guidance. Under botanical guidance, there is no practical pathway to bring a generic to market. Even though we have a very robust IP patent strategy, just like any other pharmaceutical company, and you'll see that later on, we have over 150 patents issued. We essentially have exclusivity to infinity and beyond, which is very powerful when doing terminal value calculations with, for example, potential commercial partners. You don't have that patent cliff that you often hear about with other companies. The really powerful thing about crofelemer and its first-in-class, novel, paradigm-shifting mechanism of action is that it's a pipeline within a product with multiple follow-on indications. It's approved for the first specialty indication, as I mentioned, HIV-related diarrhea, which is a relatively small market. The estimates are about anywhere from $50 million to less than $100 million a year in the United States. Multiple follow-on indications, most of which we have proof of concept, phase II, in some case, even pivotal data. The real transformative moment in this company happened in the beginning of this year, 2026, where we closed an out-license deal, a commercial out-license deal for Mytesi and Canalevia-CA1, Mytesi for the human HIV indication. That deal resulted in an $18 million upfront payment, essentially an access fee, non-dilutive dollars, $16 million of which we got upon closing, $2 million which we'll be getting very shortly for some post-closing conditions, and an additional $20 million in milestone and other future payments, several million of which we have already received. Through this deal, Jaguar continues to be the manufacturer of crofelemer, which is important as a natural product and the manufacturing process, there is great economy of scale, and because of the multiple follow-on indications, we want to control that manufacturing process, and we do supply it to Future Pak at a profit. The focus now, and the near-term catalysts come from our rare disease program, where we're pursuing crofelemer for intestinal failure. Two indications, Sjögren-Larsson syndrome and MVID, which we're going to hear a lot about in a moment. We already have proof of concept, groundbreaking clinical results in hand, including a presentation that's happening as we speak, at ESPGHAN, the European Society of Paediatric and Gastroenterology, where I will be going in the next couple of days. You'll be hearing about that presentation. A market opportunity for intestinal failure that third-party estimates put at over $8 billion when you include MVID and SBS. These are both rare diseases, orphan indications, but follow the business models of high morbidity, high mortality, high expense in taking care of these patients, strong family patient support groups. Very, very valuable for companies to pursue and life changing for the patients themselves. Just to put this in perspective, the out-license to Future Pak, $18 million up front for a market that is maybe $50 million-$80 million in the United States. What are we looking for in potential partners for rare disease indications that have a market that is estimated to be multi-billion? The product for these intestinal failure is crofelemer, but it's not the Mytesi formulation. The Mytesi formulation is a pill. With intestinal failure, a pill would just go right through the patient in high throughput, high transit times, it would land in the toilet bowl. This is a highly concentrated liquid formulation that is medically and clinically relevant for the patient, and therefore is a different product and has a whole different business model that's being pursued. We're going to talk right now about intestinal failure from microvillus inclusion disease. I'm going to refer to that as MVID. That's a product for which we expect to have final clinical data by the end of this year, 2026, in support of a new drug application in mid-2027. Then that is a stepping stone for intestinal failure. The same clinical failure indication, intestinal failure in short bowel syndrome patients, for which we have a blinded phase II study going on right now, which will be completed at about the same time that we're filing the NDA for MVID. What is MVID in intestinal failure? Intestinal failure is a situation where the patient can't absorb the nutrients of life, protein, carbs, vitamins, et cetera. With MVID, this is a congenital diarrheal disease, so the patient is born and has massive diarrhea, not able to absorb the nutrients of life. If the patient, the baby, is not diagnosed immediately, the patient dies. If the patient is diagnosed, they will then, for the rest of their life, be on TPN, total parenteral nutrition, PS, parenteral support, often up to 20 hours a day, seven days a week. This treatment is a lethal natural history. The patients typically don't live beyond their early teens, in part because TPN itself is quite toxic. Quite toxic to the liver, to the kidney, cognitive functioning. The patients never really end up on a normal growth curve. There is no other drug in development or available, or any intervention for these patients other than standard of care, which is TPN, which is necessary to keep them alive, but as I said, is a lethal treatment. The key that you would be looking for, the key that we're looking for in treating these patients with an intervention, is the reduction in the amount of time that they are on parenteral support. That can have the greatest impact on the comorbidities that are life-shortening for these patients, high mortality and high morbidity. The presentation that we'll be making at ESPGHAN this week is a continuation of a presentation and treatment of patients that was made at NASPGHAN, North American Pediatric Gastroenterology Society meeting last year. In that presentation, these are patients that were on investigator-initiated treatment or early patient access treatment. This was not a blinded trial, which I'll be talking about in a moment. We were able to show reduction of parenteral support of up to 37% in intestinal failure with MVID patients, and some pediatric short bowel syndrome patients, parenteral support reduction of about 16%. These patients have now continued to be treated for over a year, no safety issues, and we'll hear the update, which it's under embargo at the moment, the presentation will be Saturday. You'll hear the update at ESPGHAN. This is absolutely groundbreaking and huge. A clinical relevant impact would've been a 10% reduction. What was also really powerful in these patients, after they were treated for about three months, they were taken off crofelemer and immediately relapsed and were put back on crofelemer, and now they will be on crofelemer for the rest of their lives. We simultaneously have a blinded clinical trial going on in MVID. The blinded portion of that trial has completed, and we have spoken with the FDA and have their agreement and acknowledgement to go into a treatment-only extension phase. The first patients have entered that treatment-only extension. With the patients from the treatment-only extension and the early patient access and the IIT, we're talking about the opportunity to file for a new drug application with essentially a single-digit number of patients. Drugs get approved based on benefit risk. We've had no safety issue with crofelemer for thousands of patients treated with HIV and other indications, and now with intestinal failure, with multiple clinical trials going on. When you're seeing the level of benefit that we have and no risk, the opportunity is essentially infinity. Timeframe. We're looking to complete enough patients in the treatment-only blinded trial in the fourth quarter to file for breakthrough designation in the United States, which would give us the opportunity to have a review of perhaps four months after we file the NDA. The data, the complete data package, clinical package to file the NDA by the end of 2026, putting the NDA for the new drug formulation in place in the first half of 2027, and with breakthrough designation, could have the product approved in the United States by the end of 2027, and in Europe and the rest of the world in 2028. This is a global trial that is going on on three different continents right now. Intestinal failure in MVID is the same situation as intestinal failure in short bowel syndrome. In this situation, patients are not able to absorb the appropriate nutrients of life because they literally have a short bowel. A normal intestine is about 20 ft-25 ft. A short bowel syndrome intestine may be 5 ft or less. There's not enough surface area for the patient to absorb the nutrients of life. Therefore, once again, they end up on parenteral nutrition, parenteral support, again, often up to 20 hours a day, seven days a week. Catastrophic for the patient, and all the same comorbidities associated with that. This is the market. Again, orphan designation. We do have orphan designation for each of these intestinal failure diseases. Third parties put this market at over $8 billion. There is a product approved for short bowel syndrome, and it's a GLP-2, not a GLP-1. GLP-2 approach was essentially a growth hormone. What it does is it tends to grow the intestine a bit, such that there's more surface area, so that parenteral support, the key primary endpoint, can be reduced by 10%-15%. It's not standard of care. There are many, many side effects with GLP-2, including as a growth hormone, the product can't be used in cancer patients, for example, or any situation where you have abnormal hyperproliferation. You wouldn't want to give a cancer patient a growth hormone, which, by the way, is about a third of the short bowel syndrome patients. Nevertheless, it establishes a business model. This GLP-2 is reimbursed at the rate of about a $0.5 million a year in the United States, a couple of hundred thousand dollars a year per patient in Europe. That is the basis of the estimate of the market being about an $8 billion market with the opportunity to reduce parenteral nutrition. We are seeking to become standard of care. GLP-2s are used in about 5%-7% of the patients and can't really be used on a lifelong chronic basis, where crofelemer can. crofelemer could be used with a GLP-2 approach. Really transformative and paradigm-shifting for an opportunity to return quality of life, morbidity, and even extend patients' life, and particularly with those with congenital diarrheal diseases. Oops. There we go. The convergence with our focus is completely on the clinical side now, completely on the clinical and regulatory side on intestinal failure. The near-term catalysts are actually live, happening right now in the next 12 months. This slide was actually made several months ago. Our one-year proof of concept data and nine-month data from our expanded access program is being presented live, as I mentioned, this week in France in Lille. Our first MVID patients from the blinded trial have entered the treatment-only extension phase. All these patients will now be on crofelemer for the rest of their lives. We'll be seeking breakthrough designation in probably the fourth quarter of this year as enough patients complete three months on treatment only. All the blinded data will be in by the end of 2026, and that will be in support of our targeted new drug application in the first half of 2027. This is all for MVID. Simultaneously, we are near the end of enrollment for a blinded phase II clinical trial for short bowel syndrome intestinal failure. The approval of intestinal failure of MVID is the stepping stone for the very same product, the very same formulation that will then get into an even larger market into the short bowel syndrome patient population. Other activities going on in the company. That is +90% of what we do. Mytesi is out licensed for commercial purposes. We do manufacture the product. MVID is the 100% focused, sharp strategic focus of the clinical and regulatory human activities going on in the company. We have completed a filing for an extension of the approval of Canalevia-CA1 for chemotherapy-induced diarrhea in doggies. Conditional approval is sort of like orphan designation on the human side. It was the opportunity to get the product out without a full data package because of the unmet medical need for chemotherapy-induced diarrhea in dogs, which, by the way, is a remarkably predictive model of the same situation in humans. We've now completed the study, statistically significant results to make that a full approval, and that was just submitted this week. We just announced that it was submitted this week to the Center for Veterinary Medicine and provides the opportunity for the ongoing sustainable approval for chemotherapy-induced diarrhea in dogs. We are also pulling together an extension of a small non-prescription product line that we have with the same paradigm-shifting mechanism of action, anti-secretory mechanism of action. This product line is called Neonorm. We have Neonorm Calf, we have Neonorm Foal, and we are looking to put out Neonorm Dog, which would be for all watery diarrheas, all secretory diarrheas in dogs, not limited to the prescription opportunity for Canalevia. One other program that we participate in is a joint venture that we participate in called Magdalena Biosciences. We have about 2,300 plants that we have collected over the 30-year experience in this company, firsthand field investigation in the rainforest, looking at plants that are treating different signs and symptoms. About 20% of those plants are for mental health and CNS-related symptoms. With the great interest and emergence in funding and breakthrough opportunity with psychedelics, we started to look at what do we have in the library that is different than what's out there now, not psilocybin, not MDMA, not ketamines, but new ways to potentially treat and potentially cure mental health disorders with the same botanical pathway that we successfully pursued with crofelemer, Mytesi, Canalevia, and now our intestinal failure program. We were able to mobilize that library, 20% of the 2,300 plants, without any expense from us at all, in a joint venture with a company called Filament Health that does the chemistry. We supply the plant material and the IP. It came with an outside venture capital investment from the Peterffy family called One Small Planet, was the name of the venture fund. We own 40% of Magdalena at a post-money valuation of $5 million. We have three candidates within Magdalena right now that are looking at [audio distortion] Thank you for your patience. We're having a technical issue that we're working on getting Lisa reconnected. [audio distortion] Thank you for your continued patience while we waited to reconnect with Lisa. [audio distortion] Hi there, Lisa. You're reconnected again. If you want to continue on, please do so. When did it die out? It's been about six or seven minutes. Nobody heard the answers to the questions? Correct. You were not fully connected. If you wanted to redo that part, that would be great. Oh, gosh. I have two minutes though, right? Yeah. Okay. Well, I apologize. I don't know what happened there. I have up the investment highlights from the end of the year. The questions that I answered were, I'll do it quickly now because I only have two minutes. What are the key clinical and regulatory milestones over the next 12- 18 months in the congenital GI disorder indications that you believe the market is still underestimating? I do strongly believe that. The first one, of course, is this Saturday, where we have the ESPGHAN presentation of the investigator-initiated and early patient access. This is a continuation of benefit and safety that was presented last year in the North American Conference. By the fourth quarter, we will have enough patients in the treatment-only extension to file for breakthrough designation in the United States, which shortens the regulatory process when we file. By the end of the year, the 2026, we will have all data from the blinded trial, treatment-only extension, and investigator-initiated early patient access to support the clinical support for a regulatory filing for a new drug application in the first half of 2027, coincident with the completion of the blinded phase II study for intestinal failure in short bowel syndrome patients. Another question was, how do you see Jaguar's positioning? Are you becoming primarily a rare disease GI company? Absolutely. We are 100% sharp strategic focus on the rare disease program right now. Anything that is an extension, a line extension, a supplemental NDA for Mytesi formulation, which are very large clinical trials, much greater expense and regulatory time than you have in the business model of rare disease, that would only be done with outside funding from a corporate partner. Beyond CID in dogs, chemotherapy-induced diarrhea in dogs, how should we think about the broader companion animal gut health strategy, including the plan to expand the Neonorm Dog OTC franchise later this year? Once again, our R&D and our dollars are very precious giving our valuation and those non-dilutive dollars that we got from Mytesi out-license are very, very precious. All the R&D work For the most part, is going into the rare disease human program. The clinical work was already done to expand the indication for chemotherapy-induced diarrhea, and the Neonorm extension is essentially the same formulation and benefiting from the clinical endpoint and clinical work that we have seen in dogs. To give an opportunity for a dog on a non-prescription basis to be able to treat all watery secretory diarrheas, not just limited to the prescription Canalevia. Given your leadership's European rare disease experience, should we think of Europe as an equally important or even primary value driver for the IF franchise? We do have a subsidiary, Napo Therapeutics, that is based in Italy, which facilitates our opportunity to do clinical work in Europe, and we have a lot of clinical work for rare diseases going on on a global basis, including Germany, Italy, and then also another continent, in the UAE as well. The European opportunity is very important, and typically, because of the reimbursement process, about six months behind what we have planned for the United States. I think I've run out of time there, I will stop at this point. If you wanted a little extra time, Lisa, feel free to do so to address all the questions, or you can just end it now. Okay. Well, I have another very interesting question. "You now have visibility at NASPGHAN. How are you leveraging those societies and KOLs to build early demand and guideline support for crofelemer-based regimens?" I love this question. We are engaged with a patient advocacy group in particular for MVID. It's a very close-knit community. For population right now, that's about 200 patients, as best as can be estimated for MVID around the world. That's because it is a lethal natural history. By extending life, we hope that the prevalence goes up as the incidence will stay the same. We have many patients, many out of a population of 200, that have been identified to us because there is a very close-knit, small group of KOLs who treat MVID, congenital diarrheal disorders, and pediatric intestinal failure. It's a very important group for the patients, for what we're doing, the mission of what we're doing to provide the education about the importance of getting rapid access and approval and reimbursement of these products to regulatory agencies like the FDA. They do hear from patient groups, that's a very important component of what we also are doing at ESPGHAN this week and have been doing throughout our development program in MVID. I will end at this point. Now I'm four minutes over.
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