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Precision Endocrine Peptides Company Overview November 2025
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2 Disclaimer This presentation includes forward looking statements. All statements other than statements of historical facts contained in this presentation, including statements regarding our product candidates, preclinical study and/or clinical trial timelines, including projected data announcements, future results of operations and financial position, strategy and plans, industry environment, potential growth opportunities, and our expectations for future operations, are forward looking statements The words “ believe,” “ may,” “will,” “ estimate,” “ continue,” “ anticipate,” “ design,” “ “ expect,” “ could,” “ plan,” “ potential,” “ predict,” “ seek,” “ should,” “would,” or the negative version of these words and similar expressions are intended to identify forward looking statements. We have based these forward-looking statements on our current expectations and projections about future events and trends that we believe may affect our financial condition, results of operations, strategy, short- and long-term business operations and objectives, and financial needs. These forward-looking statements are subject to a number of risks, uncertainties and assumptions, including but not limited to, our ability to develop and advance our programs and product candidates, our regulatory approvals and filings, and other risks, uncertainties and assumptions identified in our filings with the Securities and Exchange Commission. Moreover, we operate in a very competitive and rapidly changing environment. New risks emerge from time to time, and it is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed in this presentation may not occur and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. You should not rely upon forward looking statements as predictions of future events. Although we believe that the expectations reflected in the forward-looking statements are reasonable, we cannot guarantee that the future results, levels of activity, performance or events and circumstances reflected in the forward-looking statements will be achieved or occur. Moreover, except as required by law, neither we nor any other person assumes responsibility for the accuracy and completeness of the forward-looking statements. We undertake no obligation to update publicly any forward-looking statements for any reason after the date of this presentation to conform these statements to actual results or to changes in our expectations, unless required by law. This presentation contains estimates and other information concerning our industry, our business and the markets for our product candidates. Information that is based on estimates, market research or similar methodologies, including prevalence studies which are extrapolated to broader populations, is inherently subject to uncertainties, and actual events or circumstances may differ materially from events and circumstances that are assumed in this information. Unless otherwise expressly stated, we obtained this industry, business, market and other data from our own internal estimates and research as well as from reports, research surveys, studies and similar data prepared by market research firms and other third parties, industry, medical and general publications, government data and similar sources. Industry publications and surveys generally state that the information contained therein has been obtained from sources believed to be reliable. Although we believe the industry and market data to be reliable as of the date of this presentation, this information could prove to be inaccurate. Industry and market data could be wrong because of the method by which sources obtained their data and because information cannot always be verified with complete certainty due to the limits on the availability and reliability of raw data, the voluntary nature of the data gathering process and other limitations and uncertainties. While we are responsible for the accuracy of such information and believe our internal company research as to such matters is reliable and the market definitions are appropriate, neither such research nor these definitions have been verified by any independent source.
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3 Three clinical-stage programs, each designed to overtake multibillion dollar markets Pioneering Precision Peptides for Endocrine and Metabolic Diseases Canvuparatide demonstrates potential best-in-class profile in chronic hypoparathyroidism Catalyst-rich 2026 with substantial value inflection opportunities across all three programs Clinically validated PEP platform unlocks vast potential of peptide therapeutics Well capitalized for long-term growth with cash runway into 2029 • Extended duration of action, consistent drug exposures, less frequent dosing • Convenient weekly dosing vs. daily injectable, high responder rates, well tolerated • Phase 3 trial preparations and pre-commercial activities underway • Canvuparatide – One-year data (Q2), Phase 3 trial initiation (Q3) • MBX 4291 – 12-week MAD results in obesity (Q4) • Imapextide – Phase 2a data in post-bariatric hypoglycemia (Q2)
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4 World-Class Leadership Team Andreas Moraitis, MD SENIOR VICE PRESIDENT CLINICAL DEVELOPMENT Kent Hawryluk PRESIDENT & CEO Sam Azoulay, MD CHIEF MEDICAL OFFICER Rick Bartram, CPA CHIEF FINANCIAL OFFICER Michelle Graham CHIEF HUMAN RESOURCES OFFICER Chatan Charan, PhD SENIOR VICE PRESIDENT PHARMACEUTICAL DEVELOPMENT & CMC Mike Dorato, PhD SENIOR VICE PRESIDENT DISCOVERY & NONCLINCAL DEVELOPMENT Mark Hope SENIOR VICE PRESIDENT REGULATORY & QUALITY
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5 Candidate MOA Indication Discovery IND Enabling Phase 1 Phase 2 Phase 3 Anticipated Milestones Canvuparatide (MBX 2109) PTH Prodrug Hypo- parathyroidism Q1 ‘26: End of P2 meeting Q2 ’26: Avail data at medical meeting Q2 ‘26: One-year OLE data Q3 ‘26: P3 initiation MBX 4291 GLP-1/GIP Co-agonist Prodrug Obesity & co-morbidities Q4 ‘26: P1 12-week MAD results Imapextide (MBX 1416) GLP-1 Receptor Antagonist Post-bariatric Hypoglycemia Q2 ‘26: P2a results Three Clinical-Stage Programs Addressing Significant Unmet Needs MBX retains global commercial rights to all programs GLP-1=glucagon-like peptide-1; GIP=glucose-dependent insulinotropic polypeptide; PTH=parathyroid hormone Robust obesity discovery pipeline with multiple programs in the lead optimization stage of development
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Canvuparatide Investigational Once-Weekly PTH Replacement Therapy for Hypoparathyroidism
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7 Canvuparatide: Potential Best-in-Class Profile for Hypoparathyroidism • Chronic hypoparathyroidism is a serious endocrine disease with high unmet need • Data from Phase 2 Avail trial of canvuparatide demonstrate strong clinical proof of concept with once-weekly dosing • Well-tolerated with no treatment-related serious adverse events or discontinuations during 12-week trial • New physician market research highlights potential best-in-class profile • Phase 3 trial preparations underway, commercial readiness preparation ongoing • Significant value inflection points upcoming, including one-year follow-up data • MBX retains global commercial rights, patent protection to 2041 and beyond
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8 Canvuparatide: Prodrug Chemically Converts to Active Drug at a Precisely Controlled Rate Under Physiologic Conditions PTH=parathyroid hormone Biologically active peptide analog is converted and inactive metabolite eliminated CANVUPARATIDE (MBX 2109) PRODRUG Dipeptide ACTIVE DRUG Fatty acids (FA) facilitate binding to albumin PTH Receptor FA Albumin FA facilitates extended time action Active drug binds to and activates the PTH receptor A B C
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9 Once-Weekly Canvuparatide Trial Design and Endpoints QW, once weekly. ClinicalTrials.gov Identifier: NCT06465108, NCT06531941 Key Endpoints from Phase 2 Avail and OLE Screening & Optimization Period Treatment Period: 12 weeks 4- Week Fixed Dose Treatment Period 8-Week Dose Adjustment Period 800 μg QW (n=16) N=64 600 μg QW (n=16) 400 μg QW (n=16) QW Placebo (n=16) Titrate Canvuparatide (up to 1600 μg) Titrate Canvuparatide (up to 1400 μg) Titrate Canvuparatide (up to 1200 μg) Titrate Placebo R 12-Week Trial and 2-Year Open-Label Extension Study Design Open-Label Extension: 2 years Placebo crossover: Start at 400 μg QW Canvuparatide, Titrate (n=15) Continuation of QW Canvuparatide, Titrate (n=45) N=60 Primary Composite Endpoint (Week 12) Proportion of patients (% Responders) meeting all three criteria: • Normal albumin-adjusted serum calcium (8.2 mg/dL to 10.6 mg/dL) • Independence from active vitamin D • Calcium supplements (<600 mg/day) Select Secondary and Exploratory Endpoints • % Responders of each starting dose at Week 12 • % Meeting each individual component of composite criteria • % Responders at 6 months • Change from baseline in 24h urine calcium excretion • Change from baseline in bone turnover biomarkers • Safety and tolerability
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10 • 63% of patients receiving once-weekly canvuparatide achieved the primary endpoint at Week 12 vs 31% on placebo (p < 0.05) • All patients completed Avail & 94% entered the Open-Label Extension (OLE) • Responder status increased to 79% at 6 months in the OLE • At Week 12, urine calcium excretion was reduced in canvuparatide-treated patients with elevated baseline values • Bone biomarkers increased in canvuparatide-treated patients at Week 12 and continued to improve at 6 months • Once-weekly canvuparatide was well-tolerated, with no treatment related serious adverse events or discontinuations during the 12-week trial Once-Weekly Canvuparatide Achieved Primary Endpoint at Week 12; 79% Responder Rate at 6 Months in Open-Label Extension Results support development for once-weekly dosing and progression into Phase 3
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11 63% of Patients Treated with Once-Weekly Canvuparatide Met the Primary Composite Endpoint with Zero PRN use at Week 12 AdjCa, albumin-adjusted calcium. Parameter, n (%) Canvuparatide (Pooled) (n = 48) Placebo (n = 16) P Value vs Placebo* Proportion of Patients Meeting Primary Endpoint Criteria at Week 12 (Responders) 30 (63%) 5 (31%) 0.0427 Proportion of Patients Meeting Each Component of Composite Criteria, (n, %) Independence from active vitamin D 47 (98%) 10 (63%) 0.0004 Independence from oral calcium (≤600 mg/day) 36 (75%) 5 (31%) 0.0026 Serum AdjCa within normal range (8.2−10.6 mg/dL) 39 (81%) 7 (44%) 0.0062 *Strata-adjusted differences in proportions and p-value are obtained from Cochran-Mantel-Haenszel test after adjusting for randomization strata (history of surgically-induced hypoparathyroidsim (yes/no) and urine calcium excretion of <250 mg/day or >250 mg/day. PRN rescue therapy defined as use of any calcium or vitamin D supplements in addition to the daily prescribed dose on any day during the week of primary endpoint evaluation (week 12)
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12 Responder Rates Increased to 79% at 6 Months in OLE 96% of responders at Week 12 remained responders at 6 months* *Based on patients with available data (23 out of 24) aAnalysis based on patients with available data for each component of the composite criteria at 6 months.Canvuparatide (pooled) cohort at month 6 includes patients initially randomized to canvuparatide (n=41) and placebo (n=15) for 12 weeks in the Avail study. bPercentages based on 58 patients Parameter, n (%) Week 12 6 Months Canvuparatide (Pooled) (n = 48) All Treated (n = 56)a Proportion of Patients Achieving Responder Status 30 (63%) 44 (79%) Proportion of Patients Meeting Each Component of Responder Criteria, (n, %) Independence from active vitamin D 47 (98%) 52 (90%)b Independence from oral calcium (≤600 mg/day) 36 (75%) 47 (81%)b Serum AdjCa within normal range (8.2−10.6 mg/dL) 39 (81%) 53 (95%)
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13 Once-Weekly Canvuparatide: Meaningful Reduction in 24h Urine Calcium While Maintaining Serum Calcium within Normal Range ULN, upper limit of normal. AdjCa, albumin-adjusted calcium. 427 353 224 236 0 50 100 150 200 250 300 350 400 450 500 Canvuparatide (Pooled) Placebo Mean (SE) 24-Hour Urine Calcium Levels, mg/day Participants With Elevated Urine Calcium at Baseline ULN (Men) ULN (Women) 7n = 21 721 −203 (31)* −117 (95)* *Mean (SE) difference 7.5 8.0 8.5 9.0 9.5 10.0 0 1 2 3 4 5 6 7 8 9 10 11 12 Weeks Canvuparatide (Pooled; n = 48) Placebo (n = 16) Mean (SE) Serum AdjCa Levels, mg/dL Canvuparatide: Baseline Week 12 Placebo: Baseline Week 12 Serum Calcium Over 12 weeks - All Participants
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14 6.0 7.0 8.0 9.0 10.0 11.0 12.0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Mean (SE) Serum AdjCa Levels, mg/dL Weeks Once-Weekly Canvuparatide Treated Patients Maintained Mean Serum AdjCa Levels Within Normal Range Over 6 Months AdjCa, albumin-adjusted calcium; OLE, open-label extension. OLE Avail Study 0a Canvuparatide (Pooled; n = 45) Placebo (n = 15) Placebo switched in OLE (n = 15)
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15 Bone Turnover Markers Increased Over 12 Weeks and Continued Over 6 Months aThe canvuparatide (pooled) cohort at M6 includes patients initially randomized to canvuparatide or placebo for W12 in the Avail study. BSAP, bone-specific alkaline phosphatase; CTx, C-terminal telopeptide of type I collagen; M, month; OLE, open-label extension; P1NP, procollagen 1 intact N-terminal propeptide; W, week. 0 50 100 150 200 250 Mean (SE) P1NP Levels, μg/L P1NP W0 W12 M6aW4 Avail Study OLE 0 200 400 600 800 1000 1200 Mean (SE) CTx Levels, ng/L M6a CTx W0 W12W4 Avail Study OLE Canvuparatide (Pooled) Placebo
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16 Canvuparatide Placebo (n = 16)TEAE, n (%) 400 μg (n = 16) 600 μg (n = 16) 800 μg (n = 16) Pooled (n = 48) TEAE 12 (75.0) 10 (62.5) 13 (81.3) 35 (72.9) 10 (62.5) Mild 10 (62.5) 5 (31.3) 7 (43.8) 22 (45.8) 9 (56.3) Moderate 2 (12.5) 3 (18.8) 6 (37.5) 11 (22.9) 1 (6.3) Severe 0 2a,b (12.5) 0 2 (4.2) 0 Treatment-related TEAE 7 (43.8) 8 (50.0) 10 (62.5) 25 (52.1) 6 (37.5) SAE 0 1a (6.3) 0 1 (2.1) 0 Treatment-related SAEs 0 0 0 0 0 TEAE leading to discontinuation Of study drug 0 0 0 0 0 Of study 0 0 0 0 0 Deaths 0 0 0 0 0 Once-Weekly Canvuparatide Was Well-Tolerated with No Treatment-Related Serious Adverse Events or Discontinuations aOne patient with Bell’s palsy was reported as not treatment related, and resolved without sequelae. bOne patient with abdominal pain was reported as possibly treatment related. SAE, serious treatment-emergent adverse events; TEAE, treatment-emergent adverse event.
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17 Phase 2 Treatment-Emergent AESIs Inform Phase 3 Starting Dose Selection AESI, treatment-emergent of special interest; TEAE, treatment-emergent adverse event. Canvuparatide Placebo (n = 16)TEAE, n (%) 400 μg (n = 16) 600 μg (n = 16) 800 μg (n = 16) Pooled (n = 48) Metabolism and nutrition disorders Hypercalcemia 2 (12.5) 2 (12.5) 5 (31.3) 9 (18.8) 1 (6.3) Urgent care visit 0 0 1 (6.3) 1 (2.1) 0 Required hospitalization 0 0 0 0 0 Hypocalcemia 1 (6.3) 1 (6.3) 2 (12.5) 4 (8.3) 3 (18.8) Urgent care visit 0 0 0 0 1 (6.3) Required hospitalization 0 0 0 0 0 General disorders and administration site conditions Injection site TEAEs (grouped terms) 3 (18.8) 2 (12.5) 4 (25.0) 9 (18.8) 2 (12.5) • Three patients in the 400 μg and 600 μg experienced hypercalcemia prior to first dose of canvuparatide • Hypercalcemic events occurred during the titration period while still on conventional therapy (i.e. either active vitamin D or calcium supplements or both)
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18 Once-Weekly Canvuparatide Demonstrated Competitive Responder Rates in Phase 2 Avail and OLE Studies Note: These data are derived from different clinical trials at different points in time, with differences in trial design, including endpoints, and patient populations. As a result, cross-trial comparisons cannot be made, it is only provided for illustrative purposes, and no head- to-head clinical trials have been conducted. Achieved primary endpoint with statistical significance at Week 12 Data sourced from (1)“PaTH Forward: A Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial of TransCon PTH in Adult Hypoparathyroidism”, https://pmc.ncbi.nlm.nih.gov/articles/PMC8684498/; (2) palopegteriparatide prescribing information Did not achieve primary endpoint with statistical significance at Week 4 Achieved primary endpoint with statistical significance at Week 26 12 Week Tx 12 Week Placebo 6 Month Tx 4 Week Tx 4 Week Placebo 6 Month Tx 6 Month Placebo 63% 31% 79% 71% 27% 50% 69% 5% Once-Weekly Canvuparatide Phase 2 Responder Rates Once-Daily Injectable Phase 2 Responder Rates1 Once-Daily Injectable FDA- Approved Label Responder Rates2
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Canvuparatide: A Significant Treatment Opportunity
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20 Source: Mannstadt. Nat Rev Dis Primers. 2017; Vadiveloo. J Bone Miner Res. 2017; Clarke. J Clin Endocrinol Metab. 2016; Powers. J Bone Miner Res. 2013; Underbjerg. J Bone Miner Res. 2013; Soibelman. Clin Otolaryngol. 2025; Cianferotti. Calcif Tissue Int. 2018; Swartling. J Clin Endocrinol Metab. 2022. • U.S. and Europe have >250 K diagnosed prevalent patients • Majority of patients are insufficiently managed on conventional therapy (i.e., large doses of calcium and active vitamin D) • Insufficiently managed patients may experience: – Fatigue – Seizures – Anxiety or depression 10% 50% 40% Hypoparathyroidism Diagnosed Prevalence (2025) >250 K Chronic hypoparathyroidism (HP) is a serious endocrine disease affecting greater than 250,000 patients in the U.S. and Europe
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21 HP: Hypoparathyroidism; SC: Subcutaneous. Source: Physician Interviews. Conventional Therapy (i.e., calcium and active Vitamin D) PTH Replacement Therapy Low cost High pill burden Risk of renal damage, poor bone health Addresses physiologic cause of HP Established benefits in renal health Requires daily SC injections vs. Physicians wish to prescribe PTH replacement therapy in the majority of their moderate-to-severe HP patients, but daily injections are a key downside of recently marketed therapies Recently Marketed PTH Replacement Therapy Represents Advance in Treatment, But Daily Injections Remain a Barrier
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22 Once-Weekly Canvuparatide: Potential to Become Preferred Treatment for Hypoparathyroidism Once-Weekly Canvuparatide Daily Injectable 7 / week 52 / year 365 / year 1 / week
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23 Source: Physician interviews commissioned by the company and conducted by ClearView Healthcare Partners, fielded October 2025: HCPs (n = 27), Payers (n = 14). Quotations are regarding a target product profile consistent with Phase 2 data, and are speculative based on assumed efficacy and approval of canvuparatide. Comparable efficacy and weekly dosing has the potential to drive switch from once-daily in experienced patients and preference for canvuparatide in new patients if approved Interest in Potential Canvuparatide Product Profile “I expect to use PTH replacement therapy in most of my patients with chronic hypoparathyroidism.” – UK Endocrinologist “This product has sustained release of PTH, which is critical for calcium stability of patients.” – U.S. Endocrinologist KOL “Comparable efficacy to Yorvipath but weekly dosing would be enough for me to recommend patients switch to [canvuparatide].” – U.S. Endocrinologist “I don’t see any reason why all of my patients wouldn’t switch from Yorvipath for the weekly dosing.” – U.S. Endocrinologist “For a new patient, I would absolutely recommend [canvuparatide] first, because all patients would prefer four injections per month.” – DE Endocrinologist KOL “The data is impressive. It’s just as good as Yorvipath but much more convenient.” – U.S. Endocrinologist Market Research Shows Endocrinologist Enthusiasm
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24 • PTH replacement therapies positioned as standard of care for moderate-to-severe hypoparathyroidism patients • Phase 2 Avail data demonstrates strong clinical proof of concept with once-weekly dosing • Category-leading market share potential driven by significant advantages vs. current treatments • Phase 3 trial preparations underway with initiation anticipated in Q3 2026 • Commercial readiness preparation ongoing, including development of go-to-market strategies • Significant value inflection points upcoming with presentation of Phase 2 Avail data at major medical meeting and one-year OLE data in Q2 2026 Canvuparatide: Potential for a New Standard of Care in Hypoparathyroidism
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Obesity Portfolio
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26 MBX 4291: Long-acting GLP-1/GIP Receptor Co-agonist Prodrug in Development for Obesity 1 Press Release: Dec. 4, 2024: Lilly's Zepbound® (tirzepatide) superior to Wegovy® (semaglutide) in head-to-head trial showing an average weight loss of 20.2% vs. 13.7% • Dual-agonism results in statistically and clinically meaningful greater weight loss relative to mono-agonism1 • Designed as a high potency GLP-1/GIP receptor co-agonist utilizing PEP technology • Potential for improved GI tolerability, once-monthly administration, and increased maximal weight loss • Phase 1 trial initiated in Q3 2025; topline results anticipated Q4 2026 MBX scientific founder, Richard DiMarchi, PhD
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27 MBX 4291 Infusion-like Profile Demonstrated in Once-weekly Repeat Administration in NHPs NHP = non-human primates 1 2 3 4 5 6 7 8 0.001 0.01 0.1 1 22 23 24 25 26 27 28 29 Time (Days) Concentration (μM) 0.065 μmol/kg (0.4323 mg/kg) MBX 4291 (Active) - Sex Combined 0.2 μmol/kg (1.33 mg/kg) MBX 4291 (Active) - Sex Combined 0.65 μmol/kg (4.33 mg/kg) MBX 4291 (Active) - Sex Combined 2 μmol/kg (13.3 mg/kg) MBX 4291 (Active) - Sex Combined Week 1 Week 4
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28 MBX 4291 Demonstrated Significant Weight Loss vs. Baseline in NHPs 8 15 22 29 36 43 50 -20 -10 0 10 NHP Body Weight Change (Combined Sexes) Study Day Percent Change (%) from Day -1 0 μmol/kg (0 mg/kg) MBX 4291 0.065 μmol/kg (0.4323 mg/kg) MBX 4291 0.2 μmol/kg (1.33 mg/kg) MBX 4291 0.65 μmol/kg (4.33 mg/kg) MBX 4291 2 μmol/kg (13.3 mg/kg) MBX 4291 Recovery Phase 1 NHP = non-human primates
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29 MonthlyTrial Design SAD (“Part A”) MAD (“Part B”) MAD (“Part C”) Participants BMI > 30 Design N=40 N=24 N=30 5 Cohorts 3 Cohorts 1 Cohort1 X X X Single dose (15 mg to 120 mg) 4 weekly doses (X mg to 4X mg) Weekly dosing followed by once monthly dosing for 12 weeks 1. May add a second cohort to evaluate additional doses/dosing regimens MBX 4291 Phase 1 Trial Primary: • Establish safety and tolerability focusing on competitive gastrointestinal tolerability and streamlined dose titration Secondary: • Determine pharmacokinetics suitable for monthly injection schedule • Demonstrate pharmacodynamics (i.e., weight loss) • Identify doses and titration regimen for Phase 2 Endpoints MBX 4291 Placebo N=6 N=2 N=6 N=2 N=20 N=10
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Imapextide (MBX 1416) Long-Acting GLP-1 Receptor Antagonist for Post-bariatric Hypoglycemia
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31 Post-bariatric Hypoglycemia (PBH): a Rare, Serious and Chronic Complication of Bariatric Surgery 1. Fischer et al Surg Obes Relat Dis. 2021, 2. Michaels et al Obes Surg. 2017, 3. Lee et al Obesity 2015, 4. Internal Estimates Estimated >125,000 patients in U.S.1,2,3,4 Severe Hypoglycemia Neuroglycopenia symptoms including seizures, loss of consciousness, confusion, weakness, dizziness and blurred vision Rapid transit of nutrients into intestines stimulates excess GLP-1 and insulin secretion; occurs after a meal PBH presents six months to years after roux-en-Y gastric bypass and sleeve gastrectomy Unpredictable timing and frequency Social isolation Diminished quality of life, including disability Glucagon injection may be required CAUSE1,2 SYMPTOMS PATIENT IMPACT
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32 Managing PBH: No Currently Approved Pharmacotherapies 1. Suhl E et al Surg Obes Relat Dis 2017, 2. Salehi M et al JCEM 2018 Includes restricted diet, off-label medications and surgery Once-daily PBH investigational therapy Once-weekly PBH investigational therapy STANDARD OF CARE1,2 Frequent, small meals and avoid/limit high glycemic index foods • Limited efficacy and long- term adherence challenges Off-label use of acarbose, diazoxide and octreotide • Limited clinical data • Side effect profiles and cost may limit patient adherence avexitide • GLP-1 receptor antagonist in Phase 3 development Designed to: • Provide daily and nightly prevention of severe hypoglycemia and associated risks • Offer convenient weekly dosing • Improve QoL • Eliminate need for rescue therapy (glucagon) and surgical intervention IN DEVELOPMENT IMAPEXTIDE (MBX 1416)
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33 • Imapextide was generally well tolerated with a favorable safety profile • No imapextide dose-related serious adverse events observed; mild or moderate injection site reactions • PK profile supportive of weekly administration: • In the MAD, imapextide mean half-life was approximately 90 hours • Median Tmax of imapextide at steady state was between 36 and 48 hours post-dose • In mixed meal tolerance tests, imapextide appeared to increase GLP-1 within 60 mins suggesting a PD effect in healthy volunteers that may translate into a therapeutic benefit in PBH patients Imapextide (MBX 1416) Phase 1 Trial Results Single and Multiple Ascending Doses of MBX 1416 in healthy adult subjects1 1.ClinicalTrials.gov Identifier: NCT06036784; TEAE = treatment emergent adverse event; ISR = injection site reaction; SAD = single ascending dose; MAD = multiple ascending dose; DDI = drug-drug interaction Tmax = time to reach maximum concentration
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34 Imapextide Phase 2a Study Design Overview SC=subcutaneously; ClincalTrials.gov ID: NCT07029412 10 Adult Participants w/ PBH Baseline the Day 1 MMTT Treatment period 1 Day 7 Imapextide 7mg Day 9 MMTT Washout Day 16 Safety follow-up Day 23 Imapextide 45mg Day 25 MMTT Follow-up Day 32 Safety follow-up Day 39 End of study Treatment period 2 ≤28-Day screening period Trial Design Primary: • Assess efficacy in increasing post-prandial glucose nadir (referring to the lowest point in blood glucose levels that occurs after a meal) during a standardized mixed meal tolerance test (MMTT) Secondary: • Assess efficacy on reducing post-prandial insulin and C-peptide peaks. • Evaluate safety and tolerability • Evaluate pharmacokinetic parameters Endpoints
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35 Clinically Validated Precision Endocrine Peptide (PEP ) Platform Created by MBX Scientific Founder Richard DiMarchi, PhD INNOVATIVE PEPTIDE DESIGN Designed to precisely time chemical conversion of prodrug to active drug to reduce peak-to- trough ratios and improve clinical outcomes With a goal to provide: • Enhanced physical properties including stability and solubility • Increased potency • Multiple mechanisms of action in a single peptide PROGRAMMABLE PRODRUG FATTY ACYLATION Aims to provide: • Increased duration of action (convenient dosing regimen) • Compatibility with non- injectable formulations (e.g. oral)
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36 Program Milestone Anticipated Timing Canvuparatide (MBX 2109) Avail Phase 2: Topline Results End of Phase 2 FDA Meeting Q1 2026 Avail Phase 2: Presentation at Medical Meeting Q2 2026 Phase 2: One-year Follow-Up Data Q2 2026 Phase 3: Initiation Q3 2026 MBX 4291 Phase 1: Initiation Phase 1: 12-week MAD Results Q4 2026 Imapextide (MBX 1416) STEADI Phase 2a: Initiation STEADI Phase 2a: Results Q2 2026 Substantial Near-Term Value Inflection Opportunities ~$392 million in cash as September 30, 2025; expected to support operations into 20291 1. Unaudited cash, cash equivalents and marketable securities as of September 30, 2025
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