TfR1

SOUTH SAN FRANCISCO, Calif., Feb. 27, 2024 (GLOBE NEWSWIRE) -- Denali Therapeutics Inc. (Nasdaq: DNLI), a biopharmaceutical company developing a broad portfolio of product candidates engineered to cross the blood-brain barrier (BBB) for the treatment of neurodegenerative diseases and lysosomal storage diseases, today reported financial results for the fourth quarter and year ended December 31, 2023, and provided business highlights. "2023 was a year of significant progress across our broad therapeutic portfolio and further clinical validation of our BBB-crossing Transport Vehicle (TV) platform," said Ryan Watts, Ph.D., Chief Executive Officer of Denali. "In 2024, we expect to complete enrollment of our late-stage trials in MPS II and ALS as we establish commercial readiness for our product candidates in our first peak of programs. In addition, we are well positioned to expand our TV-enabled portfolio to address large neurodegenerative diseases with TV-enabled enzymes, antibodies, and oligonucleotides. We recognize the urgent needs of patients and families living with neurodegenerative and lysosomal storage diseases and we will continue to push for the fastest path to approval of effective medicines." Fourth Quarter 2023 and Recent Program Updates: Late-stage and mid-stage clinical programs Tividenofusp alfa (DNL310): Enzyme Transport Vehicle (ETV)-enabled, iduronate-2-sulfatase (IDS) replacement therapy in development for MPS II (Hunter syndrome) Presented additional interim data from the open-label, single-arm Phase 1/2 study of DNL310 at the 2024 WORLDSymposium™. Data out to 104 weeks showed additional improvement and stabilization in multiple measures of clinical outcomes, including those of adaptive behavior, cognition, hearing, and growth trajectory. In addition, robust and sustained responses in biomarkers of neuronal health (e.g., CSF heparan sulfate, neurofilament light (NfL)) and peripheral activity (e.g., urine heparan sulfate and dermatan sulfate) were observed. DNL310 continued to be generally well tolerated. Participated in the Reagan-Udall Foundation for the Food and Drug Administration (FDA) workshop that brought together FDA representatives, patient advocates, clinical and basic science researchers, and industry to explore a case study of CSF heparan sulfate as a relevant substrate biomarker to support accelerated approval in neuronopathic mucopolysaccharidoses (MPS). Enrollment continues in the global Phase 2/3 COMPASS study and is expected to be completed in 2024. DNL343: eIF2B activator in development for the treatment of amyotrophic lateral sclerosis (ALS) Enrollment continues in Regimen G (DNL343) of the Phase 2/3 HEALEY ALS Platform Trial and is expected to be completed in 2024. SAR443820/DNL788: CNS-penetrant RIPK1 inhibitor in development for the treatment of multiple sclerosis (MS) As previously announced, Sanofi informed Denali that the Phase 2 HIMALAYA study evaluating SAR443820/DNL788 in participants with ALS did not meet the primary endpoint of change in ALS Functional Rating Scale-Revised (ALSFRS-R). Sanofi intends to present the detailed efficacy and safety results of the ALS Phase 2 HIMALAYA study at a future scientific forum. Sanofi is evaluating SAR443820/DNL788 in another Phase 2 clinical trial in participants with MS, and the outcome of HIMALAYA study has no impact on the ongoing MS study. BIIB122/DNL151: LRRK2 inhibitor in development for the treatment of Parkinson’s disease (PD) Today Denali also announced the execution of a Collaboration and Development Funding Agreement in January 2024 with a third party related to a global Phase 2a study of BIIB122/DNL151, which Denali plans to solely operationalize to evaluate safety and biomarkers associated with BIIB122 in participants with Parkinson’s disease and confirmed pathogenic variants of LRRK2. This agreement includes committed funding of $75.0 million, of which $12.5 million was received in January 2024, and the remainder will be triggered based on time and operational milestones in the study. Biogen will continue to conduct the ongoing global Phase 2b LUMA study in early-stage Parkinson’s disease. Denali and Biogen will co-commercialize BIIB122/DNL151 assuming regulatory approval. The third party will be eligible to receive low single-digit royalties from Denali on annual worldwide net sales of LRRK2 inhibitors for the treatment of Parkinson’s disease, with royalty amounts varying based on the scope of the label. Eclitasertib (SAR443122/DNL758): Peripheral RIPK1 inhibitor in development for the treatment of ulcerative colitis (UC) Sanofi is conducting the Phase 2 trial of SAR443122/DNL758 in UC. Early-stage clinical and preclinical programs DNL126: ETV-enabled N-sulfoglucosamine sulfohydrolase (SGSH) replacement therapy in development for the treatment of MPS IIIA (Sanfilippo syndrome Type A) Initiated dosing in the Phase 1/2 study of DNL126 in MPS IIIA; biomarker proof of concept and safety data are expected by the end of 2024. Presented preclinical data at WORLDSymposium™ demonstrating that DNL126 improves lysosomal and microglial morphology, neurodegeneration, and cognitive function in adult MPS IIIA mice. TAK-594/DNL593: Protein Transport Vehicle (PTV)-enabled progranulin (PGRN) replacement therapy in development for the treatment of frontotemporal dementia-granulin (FTD-GRN) Announced Part B has been voluntarily paused in the DNL593 Phase 1/2 study in participants with FTD-GRN to implement protocol modifications, and is expected to resume this year. Oligonucleotide Transport Vehicle (OTV) platform Announced two lead OTV programs in the investigational new drug (IND)-enabling stage of development: OTV:MAPT targeting tau for Alzheimer’s disease and OTV:SNCA targeting alpha-synuclein for Parkinson’s disease. Antibody Transport Vehicle Amyloid beta (ATV:Abeta) program ATV:Abeta using Denali's TfR-targeting TV technology is licensed by Biogen and is in the IND-enabling stage of development. Presented preclinical data showing superior amyloid plaque binding and reduction with ATV:Abeta compared to a conventional Abeta antibody and the potential for ATV:Abeta to reduce the risk of amyloid-related imaging abnormalities (ARIA) associated with the treatment of Alzheimer’s disease. Discovery programs Denali continues to use deep scientific expertise in neurodegeneration biology and the BBB to discover and develop medicines and platforms with the focus on programs enabled by the TV technology and targeting neurodegenerative disease, including Alzheimer’s and Parkinson’s, and lysosomal storage diseases. Announced the second TV platform, which targets CD98 heavy chain (CD98hc), an amino acid transporter expressed at the BBB. The CD98hc-targeting TV platform, having distinct properties from Denali's TfR-targeting TV platform, may enable selection of the optimal platform for a given drug target. Corporate Updates Announced entering into a securities purchase agreement with certain existing accredited investors to issue and sell an aggregate of 3,244,689 shares of Denali's common stock at a price of $17.07 per share and pre-funded warrants to purchase an aggregate of 26,046,065 shares of Denali's common stock at a purchase price of $17.06 per pre-funded warrant, through a private investment in public equity (PIPE) financing. Denali anticipates the gross proceeds from the PIPE to be approximately $500 million. Announced the intention to spin out the company's preclinical small molecule portfolio. Denali will maintain ownership of and continue to advance its current portfolio of clinical stage small molecule programs. The decision was made based on clinical validation and prioritization of Denali’s TV-enabled platforms for brain delivery of large molecules. 2024 Guidance on Operating Expenses: Cash, cash equivalents, and marketable securities were approximately $1.03 billion as of December 31, 2023. For the full year 2024, Denali anticipates its operating expenses will be less than or equal to those in 2023 based on prioritization of its portfolio. With the anticipated proceeds from the PIPE financing, Denali expects the company’s cash runway to extend into 2028. Participation in Upcoming Investor Conferences: Cowen 44th Annual Health Care Conference, March 4-6 Leerink Global Biopharma Conference, March 11-13 Jefferies Biotech on the Bay Summit, March 12-13 Stifel 2023 CNS Days, March 19-20 Fourth Quarter 2023 Financial Results Net losses were $119.5 million and $145.2 million for the quarter and year ended December 31, 2023, compared to net losses of $98.7 million and $326.0 million for the quarter and year ended December 31, 2022, respectively. There was no collaboration revenue for the quarter ended December 31, 2023, compared to $10.3 million for the quarter ended December 31, 2022. Collaboration revenue was $330.5 million for the year ended December 31, 2023, compared to $108.5 million for the year ended December 31, 2022. The decrease in collaboration revenue of $10.3 million for the quarter ended December 31, 2023, compared to the comparative period in the prior quarter was primarily due to a decrease of revenue earned under the Sanofi Collaboration of $10.0 million for a milestone triggered in December 2022 upon first patient dosed in a Phase 2 study of SAR443122/DNL758 in individuals with UC. The increase in collaboration revenue of $222.0 million for the year ended December 31, 2023 compared to the previous year was primarily due to $293.9 million in revenue recognized in April 2023 under the Biogen Collaboration Agreement as a result of Biogen exercising its option to license our ATV:Abeta program, partially offset by a decrease of $41.9 million in revenue earned under the Takeda Collaboration Agreement, as well as a decrease of $28.4 million in milestone revenue earned under the Sanofi Collaboration Agreement. The decreases in revenues from the Sanofi and Takeda Collaboration Agreements are due to the timing of underlying activities and achievement of milestones under the collaboration agreements. Total research and development expenses were $107.8 million and $423.9 million for the quarter and year ended December 31, 2023, compared to $92.1 million and $358.7 million for the quarter and year ended December 31, 2022, respectively. The increases of approximately $15.7 million and $65.2 million for the quarter and year ended December 31, 2023 compared to the comparative period in the prior year were primarily attributable to increases in ETV:IDS and eIF2B program external expenses reflecting the continued progress of these programs in clinical trials; and an increase in personnel-related expenses mainly driven by increased salary costs as a result of higher headcount. Furthermore, net cost sharing with collaboration partners shifted from reimbursements to payments due to decreased reimbursements from Takeda and increased payments to Biogen. These expense increases were partially offset by decreases in TV platform and other program external expenses, PTV:PGRN program external expenses and other external research and development expenses due to the timing of significant external research and manufacturing related activities period over period, and LRRK2 program external expenses due to the transition of LRRK2 clinical activities to Biogen. Further, for the quarter ended December 31, 2023, there was also a decrease in other unallocated research and development expenses as a result of reduced facility costs. General and administrative expenses were $24.8 million and $103.4 million for the quarter and year ended December 31, 2023, compared to $23.5 million and $90.5 million for the quarter and year ended December 31, 2022, respectively. The increases of approximately $1.3 million and $12.9 million for the quarter and year ended December 31, 2023, respectively, were primarily attributable to an increase in personnel-related expenses, including employee compensation and stock-based compensation expenses, driven by higher headcount and equity award grants. Additionally, there was an increase in facility and other corporate costs for the year ended December 31, 2023 associated with the new Salt Lake City manufacturing facility. Cash, cash equivalents, and marketable securities were approximately $1.03 billion as of December 31, 2023. About Denali Therapeutics Denali Therapeutics is a biopharmaceutical company developing a broad portfolio of product candidates engineered to cross the blood-brain barrier (BBB) for the treatment of neurodegenerative diseases and lysosomal storage diseases. Denali pursues new treatments by rigorously assessing genetically validated targets, engineering delivery across the BBB, and guiding development through biomarkers that demonstrate target and pathway engagement. Denali is based in South San Francisco. For additional information, please visit . Cautionary Note Regarding Forward-Looking Statements This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements expressed or implied in this press release include, but are not limited to, statements regarding expectations regarding Denali’s TV technology platform; statements made by Denali’s Chief Executive Officer; plans, timelines, and expectations regarding DNL310 and the ongoing Phase 2/3 COMPASS and Phase 1/2 studies as well as the timing of approval; plans and timelines regarding DNL343, including enrollment for Regimen G of the Phase 2/3 HEALEY ALS Platform Trial; plans, timelines, and expectations of both Denali and Sanofi regarding DNL788, including the Phase 2 study in MS and the timing of data in the Phase 2 study in ALS; plans, timelines, and expectations regarding DNL151, including with respect to the ongoing LUMA study as well as enrollment and timing of the proposed Phase 2a study in PD patients with LRRK2 mutations, the potential for commercialization, and the achievement of milestones under the third-party agreement; expectations regarding DNL758, including the ongoing Phase 2 study in patients with UC; plans, timelines, and expectations related to DNL126, including the timing and availability of data in the ongoing Phase 1/2 study; plans, timelines, and expectations of both Denali and Takeda regarding DNL593 and the ongoing Phase 1/2 study, including the implementation of protocol modifications and timing of continuation of the study; plans, timelines, and expectations regarding the advancement of OTV candidates towards clinical development; plans, timelines, and expectations of both Denali and Biogen regarding the ATV:Abeta; plans and expectations for Denali's preclinical programs and the CD98hc-targeting TV platform; Denali's future operating expenses and anticipated cash runway; Denali's PIPE financing, including the number of shares and warrants and the anticipated proceeds; and Denali's participation in upcoming investor conferences. Actual results are subject to risks and uncertainties and may differ materially from those indicated by these forward-looking statements as a result of these risks and uncertainties, including but not limited to, risks related to: any and all risks to Denali’s business and operations caused by adverse economic conditions; risk of the occurrence of any event, change, or other circumstance that could give rise to the termination of Denali’s agreements with Sanofi, Takeda, or Biogen, or any of Denali’s other collaboration agreements; Denali’s transition to a late-stage clinical drug development company; Denali’s and its collaborators’ ability to complete the development and, if approved, commercialization of its product candidates; Denali’s and its collaborators’ ability to enroll patients in its ongoing and future clinical trials; Denali’s reliance on third parties for the manufacture and supply of its product candidates for clinical trials; Denali’s dependence on successful development of its blood-brain barrier platform technology and its programs and product candidates; Denali’s and its collaborators' ability to conduct or complete clinical trials on expected timelines; the risk that preclinical profiles of Denali’s product candidates may not translate in clinical trials; the potential for clinical trials to differ from preclinical, early clinical, preliminary or expected results; the risk of significant adverse events, toxicities or other undesirable side effects; the uncertainty that product candidates will receive regulatory approval necessary to be commercialized; Denali’s ability to continue to create a pipeline of product candidates or develop commercially successful products; developments relating to Denali's competitors and its industry, including competing product candidates and therapies; Denali’s ability to obtain, maintain, or protect intellectual property rights related to its product candidates; implementation of Denali’s strategic plans for its business, product candidates, and blood-brain barrier platform technology; Denali's ability to obtain additional capital to finance its operations, as needed; Denali's ability to accurately forecast future financial results in the current environment; and other risks and uncertainties, including those described in Denali's most recent Annual and Quarterly Reports on Forms 10-K and 10-Q filed with the Securities and Exchange Commission (SEC) on February 27, 2023 and November 7, 2023, respectively, and Denali’s future reports to be filed with the SEC. Denali does not undertake any obligation to update or revise any forward-looking statements, to conform these statements to actual results, or to make changes in Denali’s expectations, except as required by law. Denali Therapeutics Inc. Condensed Consolidated Statements of Operations (Unaudited) (In thousands, except share and per share amounts) Three Months Ended December 31, Twelve Months Ended December 31, 2023 2022 2023 2022 Collaboration revenue: Collaboration revenue from customers(1) $ — $ 10,260 $ 330,531 $ 105,065 Other collaboration revenue — 23 — 3,398 Total collaboration revenue — 10,283 330,531 108,463 Operating expenses: Research and development(2) 107,803 92,111 423,876 358,732 General and administrative 24,769 23,516 103,354 90,475 Total operating expenses 132,572 115,627 527,230 449,207 Loss from operations (132,572 ) (105,344 ) (196,699 ) (340,744 ) Interest and other income, net 13,129 6,660 51,505 14,774 Loss before income taxes (119,443 ) (98,684 ) (145,194 ) (325,970 ) Income tax benefit (expense) (30 ) 6 (30 ) (21 ) Net loss $ (119,473 ) $ (98,678 ) $ (145,224 ) $ (325,991 ) Net loss per share, basic and diluted $ (0.86 ) $ (0.75 ) $ (1.06 ) $ (2.60 ) Weighted average number of shares outstanding, basic and diluted 138,245,382 132,877,411 137,370,897 125,530,703 __________________________________________________ (1) Includes related-party collaboration revenue from customers of $0.3 million for the quarter ended December 31, 2022, and $295.5 million and $3.2 million for the year ended December 31, 2023 and 2022, respectively. There is no related-party collaboration revenue from customers for quarter ended December 31, 2023 (2) Includes expenses for cost sharing payments due to a related party of $3.2 million and $17.7 million for the quarter end year ended December 31, 2023, respectively, and $4.4 million and $8.2 million for the quarter and year ended December 31, 2022. Denali Therapeutics Inc. Condensed Consolidated Balance Sheets (Unaudited) (In thousands) December 31, 2023 December 31, 2022 Assets Current assets: Cash and cash equivalents $ 127,106 $ 218,044 Short-term marketable securities 907,405 1,118,171 Prepaid expenses and other current assets 29,626 36,104 Total current assets 1,064,137 1,372,319 Property and equipment, net 45,589 44,087 Operating lease right-of-use asset 26,048 30,437 Other non-current assets 18,143 13,399 Total assets $ 1,153,917 $ 1,460,242 Liabilities and stockholders' equity Current liabilities: Accounts payable $ 9,483 $ 2,790 Cost sharing payments due to related party — 4,388 Accrued expenses and other current liabilities 68,499 66,691 Related-party contract liability, current — 290,053 Total current liabilities 77,982 363,922 Related-party contract liability, less current portion — 479 Operating lease liability, less current portion 44,981 53,032 Other non-current liabilities — 379 Total liabilities 122,963 417,812 Total stockholders' equity 1,030,954 1,042,430 Total liabilities and stockholders’ equity $ 1,153,917 $ 1,460,242 Investor and Media Contact: Laura Hansen, Ph.D. Vice President, Investor Relations (650) 452-2747 hansen@dnli.com

- Presentations Highlight Potential Benefits of Therapies Incorporating J-Brain Cargo®, JCR’s Proprietary, Blood-Brain Barrier-Penetrating Technology - HYOGO, Japan--(BUSINESS WIRE)-- JCR Pharmaceuticals Co., Ltd. (TSE 4552; Chairman and President: Shin Ashida; “JCR”) today announced the presentation of several datasets demonstrating the potential benefits of its investigational therapies for lysosomal storage disorders (LSDs). In a series of oral and poster presentations at the 20th Annual WORLDSymposium™ in San Diego, Calif., JCR highlighted several programs that rely on J-Brain Cargo®, a proprietary technology developed by JCR, to deliver medicines across the blood-brain barrier (BBB). “Lysosomal storage disorders present a lifelong burden for patients because of the somatic, and most importantly, the progressive neurological signs and symptoms associated with these devastating and life-threatening diseases for which there are inadequate treatment options or no approved therapies available. JCR is dedicated to address the unmet medical needs for this community,” said Shin Ashida, President and CEO of JCR Pharmaceuticals. “The clinical data presented at the WORLDSymposium™ demonstrate the safety and efficacy of JR-141 in individuals with MPS II and the potential of our proprietary J-Brain Cargo® technology across multiple lysosomal storage disorders. In addition, we’re excited to present preclinical data focused on retinal function and bone abnormalities.” There are three JR-141 presentations, including one presentation focused on the long-term safety and efficacy and behavioral effects of JR-141 (pabinafusp alfa) for mucopolysaccharidosis type II (MPS II, or Hunter syndrome). JR-141 is a recombinant iduronate-2-sulfatase (I2S) enzyme replacement therapy (ERT) that was approved in March 2021 by the Ministry of Health, Labour and Welfare (MHLW) in Japan, where it is marketed as IZCARGO® for the treatment of patients with MPS II. The second JR-141 presentation details the global phase III clinical trial study. Finally, the third JR-141 presentation is pre-clinical and highlights the recovery of retinal function in mice with MPS II. “We are pleased to be able to offer IZCARGO® to patients with MPS II in Japan,” said Yoshikatsu Eto, M.D., Ph.D., Institute of Neurological Disorders, Advanced Clinical Research Center, Kanagawa, Japan. “As we continue gathering new data from the Japanese and Brazilian long-term efficacy study and from the ongoing phase III global JR-141 clinical study, currently in recruitment, we look forward to providing updates as appropriate. These data sets will make it more certain that JR-141 can treat not only the somatic symptoms of MPS II, but also the neurocognitive symptoms of this devastating and life-threatening disease.” In addition to the three JR-141 presentations, the WORLDSymposium™ 2024 scientific program featured presentations focusing on: 52-week interim data from the JR-171 phase I/II clinical trial (Hurler syndrome, Hurler-Scheie syndrome or Scheie syndrome); pre-clinical data on an ERT with JR-171 preventing bone deformities in a mouse model of MPS I; JR-441 global clinical trial study design (Sanfilippo syndrome type A). JR-141 MPS II Datasets The following poster presentation provides additional evidence and context for the use of JR-141 in the treatment of MPS II: Integrated long-term efficacy and safety data on enzyme replacement therapy with pabinafusp alfa for neuronopathic mucopolysaccharidosis II (MPS-II): updated clinical data from Japan and Brazil (Abstract 81) Presenter: Yoshikatsu Eto, M.D., Ph.D. (Institute of Neurological Disorders, Advanced Clinical Research Center, Kanagawa, Japan) This abstract analyzes the long-term efficacy and safety data on pabinafusp alfa for the treatment of individuals with MPS II. This study analyzed 104 patients over 260 weeks. In terms of safety, the data include four pabinafusp alfa-related serious adverse events (consciousness disturbance, hypotension, pyrexia and facial palour) in one individual, but all four were managed and resolved. Infusion-associated reactions were noted to gradually decrease in frequency as the length of exposure to pabinafusp alfa increased. The Kyoto Scale of Psychological Development, Bayley Scale for Infant Development, Kaufman Assessment Battery for Children, and Vineland Adaptive Behavioral Scale were used to evaluate the efficacy of pabinafusp alfa against neurocognitive impairment. A developmental quotient (DQ) of >70 was identified as the best predictor of treatment response in achieving age-equivalent neurodevelopment. Another predictor was age at initiation of treatment, with initiation before 36 months of age associated with the most favorable response in subjects with severe MPS II. Analysis of adaptive behavior showed a trend to overall improvement in most individuals with the attenuated subtype, and some improvement in those with the severe subtype and a DQ of >70, while changes, as expected, were limited in those with a DQ of <70. Notable sustained efficacy was seen in terms of liver and spleen volumes, joint range of motion, and left ventricular mass index. These outcomes of ERT with pabinafusp alfa for more than five years provide good evidence of its safety as well as peripheral efficacy, with preliminary data of central efficacy particularly in certain patients with attenuated form of the disease. Post-marketing studies will last for a total of 10 years and provide long-term evidence of pabinafusp alfa’s safety and efficacy. The following poster presentation provides an overview of the global phase III clinical trial study design for JR-141 in the treatment of MPS II: A global phase III study of pabinafusp alfa (JR-141) for neuronopathic mucopolysaccharidosis type II: updated study design (Abstract 154) Presenter: Toshiaki Ikeda (JCR Pharmaceuticals) This abstract provides an overview of the ongoing global phase III clinical trial of pabinafusp alfa (JR-141) for neuronopathic MPS II. The trial began in February 2022 and spans 10 countries as of now. The study consists of two cohorts with a total of 80 patients with MPS II. Cohort A includes individuals with the severe (neuronopathic) subtype aged 30 to 71 months, who are randomized into a treatment arm given a weekly administration of JR-141 at 2.0 mg/kg, and a control arm receiving ERT idursulfase; the total study duration is 24 months, and the purpose is to demonstrate that the efficacy of JR-141 in patients with neuronopathic MPS II is superior to that of conventional ERT. Cohort B consists of attenuated patients aged 6 years and older, randomized into two arms in the same manner as above; the study duration is 12 months, and the purpose is to evaluate the efficacy of JR-141 in patients with somatic symptoms in comparison with that of idursulfase. Primary efficacy endpoints are assessed on the basis of HS levels in the CSF and neurocognitive test (BSID-III) results. Key secondary outcome measures include liver and spleen volumes and further neurological outcomes. The study thus designed is expected to establish the efficacy of JR-141 against both the central nervous system (CNS) and peripheral/somatic symptoms. Details of other outcome measures and study design components will be presented at the symposium. The following poster presentation showcases preclinical data on retinal function for the use of JR-141 in the treatment of MPS II: Recovery of retinal function in MPS II mice by treatment with pabinafusp alfa (Abstract 155) Presenter: Atsushi Imakiire (JCR Pharmaceuticals) This abstract explains how pabinafusp alfa addresses one of the difficult-to-treat complications of MPS II: Retinal disorders in individuals with MPS II are known to be resistant to conventional intravenous ERT due to the presence of the blood-retinal barrier (BRB), which interferes with drug transport into the eye. The retinal function assessed by electroretinography (ERG) was found to worsen with age in a murine model of MPS II (hTfR knock-in/Ids knock-out mice). The presented study demonstrates that pabinafusp alfa crosses the BRB and reaches the retina in MPS II mice. Repeated intravenous dose of pabinafusp alfa started at an early age decreased HS deposition in the retina, optic nerve, and visual cortex and preserved or improved ERG response in MPS II mice. Retinal degeneration was also ameliorated by pabinafusp alfa. Recombinant non-fused I2S did not enter the retina and minimally affected the retinal disease. These results substantiate the postulate that pabinafusp alfa penetrates the BRB and exerts beneficial effects on retinal dysfunction in MPS II. JR-171 MPS I Datasets The following poster presentation focuses on the use of JR-171 in the treatment MPS I: Efficacy and safety data (52-week) from a phase 1/2 trial and extension study of JR-171 (lepunafusp alfa) used in enzyme replacement therapy for patients with MPS I (Abstract 113) Presenter: Roberto Giugliani, M.D., Ph.D. (Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil) This abstract reports the 52-week safety and efficacy data from the first-in-human, open-label, multicenter phase I/II trial and an extension study of JR-171 used to treat 14 individuals with MPS I. The 14 individuals had a broad spectrum of disease severity. 12 of them had received treatment with laronidase prior to enrollment, one was treated with laronidase after hematopoietic stem cell transplantation, and the other individual was treatment-naïve. The most common adverse drug reactions were infusion-associated reactions, all manageable without requiring discontinuation of the test drug. Ability to target the neuronopathy was evaluated by measuring HS levels in the CSF from baseline through weeks 13, 26, and 52, all of which were significantly reduced in all subjects. Also, in several individuals with the severe subtype whose treatment started early, neurocognitive data suggested some stabilization of neurodevelopmental decline in comparison with the natural history data. Liver and spleen volumes were stabilized in most of the patients. Other somatic signs and symptoms, including urine and serum HS/DS concentrations, were well-controlled in the subjects switched from laronidase, while they decreased significantly and then remained stable in the naïve patients. These data provide further evidence that JR-171 is delivered across the BBB to address the CNS manifestations of MPS I as well as the somatic/peripheral symptoms while maintaining an appropriate safety profile. A pivotal phase III clinical trial is planned to establish the efficacy and safety of the drug. The following poster presentation highlights preclinical data on bone deformities for the use of JR-171 in the treatment of MPS I: Enzyme replacement therapy with a blood-brain barrier-penetrating antibody-fused a-L-iduronidase prevents bone deformities in a mouse model of mucopolysaccharidosis I (Abstract 229) Presenter: Hiroki Morioka (JCR Pharmaceuticals) This abstract reports on the effect of JR-171 on the CNS and bone abnormalities in hTfR knock-in/Idua knock-out mice, an animal model of MPS I. JR-171 was intravenously administered to the mice once a week at 2.0 and 4.0 mg/kg for 24 weeks. The long-term intravenous treatment with JR-171 markedly reduced HS and DS concentrations and improved histopathological changes in the peripheral and CNS tissues. In addition, using micro-computed tomography, MPS I mice were found to have skeletal abnormalities such as increased bone mass and density. The treatment with JR-171 prevented or improved the skeletal abnormalities observed in MPS I mice. These results suggest the potential efficacy of JR-171 against neurodegeneration and neurological impairments, and demonstrate the beneficial effects on bone deformities characteristic of MPS I. The following late-breaking abstract discloses patient experiences upon treatment with JR-171: The impact of lepunafusp alfa (JR 171) on the disease burden in MPS I: Patient reported outcomes (Abstract LB-39) Presenter: Ana Maria Martins (Reference Center in Inborn Errors of Metabolism, Federal University of Sao Paulo, Brazil) This late-breaking abstract presents data on patient reported outcomes of individuals treated in an ongoing phase I/II study with lepunafusp alfa, a fusion protein consisting of a transferrin-receptor binding domain and α-L-iduronidase, the enzyme missing or malfunctioning in MPS I. JR-441 MPS IIIA Dataset The following poster presentation showcases the company’s pipeline of innovative, BBB-penetrating ERT products for the treatment of MPS IIIA: A phase I/II clinical trial of JR-441 for treatment of Sanfilippo syndrome type A (MPS IIIA) (Abstract 234): Presenter: Nicole Muschol, M.D. (University Medical Center Hamburg-Eppendorf, International Center for Lysosomal Disorders (ICLD), Hamburg, Germany) This abstract reports the Phase I/II clinical trial study design of JR-441 as a first-in-human, open-label, single-center trial to evaluate the optimal dose, safety/tolerability, pharmacokinetics and exploratory efficacy in individuals with MPS IIIA aged ≥1 year to ≤18 years. This study consists of a treatment period (52-week), a drug holiday period (6-week), and an extension period (202-week). After confirming the tolerability in the first 6 individuals with MPS IIIA in a dose escalating manner, a total of 12 individuals are then treated with JR-441 for approximately 5 years. During the drug holiday period, potential rebound effects due to withholding JR-441 are evaluated. Following dose escalation, all individuals are randomized to 2 treatment doses until an optimal dose is determined, which is applied thereafter to all of the enrolled subjects. A broad range of assessments are performed including substrate levels in the CSF, blood and urine, MRI of the brain, liver and spleen, neurodevelopmental function tests, adaptive behavior tests, quality-of-life questionnaires, and life-habit-related questionnaires regarding sleeping, eating and stool to identify and validate suitable endpoints to inform the design of a future global registrational trial. About Pabinafusp Alfa (JR-141) Pabinafusp alfa is a recombinant fusion protein of an antibody against the human transferrin receptor and idursulfase, the enzyme missing or malfunctioning in subjects with Hunter syndrome. It utilizes J-Brain Cargo®, JCR’s proprietary blood-brain barrier (BBB)-penetrating technology, to cross the BBB via transferrin receptor-mediated transcytosis. Uptake into cells is mediated through the mannose-6-phosphate receptor or the transferrin receptor. This novel mechanism of action is expected to make IZCARGO® effective against the CNS symptoms of Hunter syndrome. In pre-clinical studies, JCR has confirmed both high-affinity binding of pabinafusp alfa to transferrin receptors and passage across the BBB into neuronal cells. In addition, JCR has confirmed enzyme uptake in various brain tissues. The company has also confirmed a reduction of substrate accumulation in the CNS and peripheral organs in an animal model of Hunter syndrome.1,2 In several clinical trials with pabinafusp alfa, JCR obtained evidence of reducing heparan sulfate (HS) concentrations in the CSF, a biomarker that is believed to reflect substrate reduction in the brain and changes in CNS function. These results were consistent with those obtained in pre-clinical studies. Clinical studies have also demonstrated positive effects of pabinafusp alfa on CNS symptoms.3,4,5,6 Pabinafusp alfa was approved by the Ministry of Health, Labour and Welfare in Japan and marketed since May 2021 under the brand name “IZCARGO® I.V. Infusion 10mg.” In September 2021, JCR and Takeda announced a collaboration and license agreement to commercialize JR-141. Under the agreement, Takeda will exclusively commercialize JR-141 outside of the United States, including Canada, Europe, and other regions (excluding Japan and certain other Asia-Pacific countries). Takeda also received an option for an exclusive license to commercialize JR-141 in the U.S. upon completion of the phase III program. Important Safety Information INDICATION: IZCARGO® is indicated for the treatment of mucopolysaccharidosis type II (MPS II), which is also known as Hunter syndrome. IZCARGO® is approved in Japan only. CONTRAINDICATION: IZCARGO® is contraindicated in patients with a history of anaphylactic shock to any of its components. WARNINGS AND PRECAUTIONS: Warnings Since serious anaphylaxis and shock may occur with the use of IZCARGO®, adequate emergency measures should be made ready for application before initiation of administration, and the patient should be closely monitored during and after the administration. If a serious infusion associated reaction (IAR) occurs, administration of IZCARGO® should be discontinued, and appropriate actions should be taken. When IZCARGO® is administered to patients with severe respiratory failure or acute respiratory disease, an IAR may lead to acute exacerbation of symptoms. The patient’s condition should be closely monitored, and appropriate actions should be taken as needed. Precautions for Use IZCARGO® is a protein medicinal product and may cause anaphylactic shock, for which close monitoring is required. If any signs of anaphylaxis are noted, discontinue the infusion, and take appropriate actions. Considering the onset of such symptoms, emergency measures should be made ready for application. IZCARGO® may cause IARs such as headache, chills, syncope, fatigue, dizziness, pyrexia, rash, erythema, urticaria, or other symptoms. If an IAR occurs, reduce the rate or temporarily discontinue the infusion, and initiate appropriate drug treatment (e.g., corticosteroids, antihistamines, antipyretic analgesics, anti-inflammatory drugs) or emergency procedures (e.g., oxygen administration, securing of airway, adrenaline administration). Premedication with antihistamines, corticosteroids, etc. should be considered for the subsequent infusion of IZCARGO®. ADVERSE REACTIONS: The most commonly reported adverse reactions were pyrexia and urticaria. About the J-Brain Cargo® Platform Technology JCR Pharmaceuticals has developed a proprietary BBB-penetrating technology J-Brain Cargo®, to bring biotherapeutics into the CNS. The first drug developed based on this technology and approved in Japan for the treatment of MPS II (mucopolysaccharidosis type II) is IZGARGO® (INN: pabinafusp alfa). Based on the same platform technology, JR-171 (INN:lepunafusp alfa) and JR-441 are advancing into global clinical stage. JCR intends to start clinical trials on four additional programs from its LSD pipeline by FY2028. About Mucopolysaccharidosis II (Hunter Syndrome) Mucopolysaccharidosis II (Hunter syndrome) is an X-linked recessive LSD caused by a deficiency of iduronate-2-sulfatase, an enzyme that breaks down complex carbohydrates called glycosaminoglycans (GAGs, also known as mucopolysaccharides) in the body. Hunter syndrome, which affects an estimated 7,800 individuals worldwide (according to JCR research), gives rise to a wide range of somatic and neurological symptoms. The current standard of care for Hunter syndrome is ERT. CNS symptoms related MPS II have been unmet medical needs so far. About Mucopolysaccharidosis I (Hurler, Hurler-Scheie, Scheie syndrome) MPS I is an autosomal recessive lysosomal storage disorders (“LSD”) caused by a deficiency of α-L-iduronidase, an enzyme that breaks down glycosaminoglycans (mucopolysaccharides) in the body. The current worldwide prevalence of MPS I is estimated to be approximately 3,000 (according to JCR internal research). MPS I gives rise to a wide range of somatic and neurological symptoms. A major limitation of current ERT is that it does not address CNS symptoms because of the enzyme’s inability cross the BBB. MPS I is the only LSD in which hematopoietic stem cell transplantation (“HSCT”) is part of the standard of case for the severe form of the disease. Significant unmet medical need persists in all forms of MPS I. About Sanfilippo Syndrome (MPS III) Sanfilippo syndrome is an autosomal recessive disease caused by a deficiency of the enzymes that metabolize mucopolysaccharides within the body. The disease is classified into four subtypes (A, B, C, and D) according to the respective deficient enzymes. Symptoms include accumulation of heparan sulfate in tissues throughout the body. Notably, the rapidly progressive form of the disease frequently affects neurologic development, which peaks around two or three years of age, before subsequently deteriorating, resulting in a complete loss of speech by the age of seven or eight. Progression further gives rise to symptoms such as sleep disorders, hepatosplenomegaly, seizures, and neurobehavioral abnormalities. About JCR Pharmaceuticals Co., Ltd. JCR Pharmaceuticals Co., Ltd. (TSE 4552) is a global specialty pharmaceuticals company that is redefining expectations and expanding possibilities for people with rare and genetic diseases worldwide. We continue to build upon our 49-year legacy in Japan while expanding our global footprint into the US, Europe, and Latin America. We improve patients’ lives by applying our scientific expertise and unique technologies to research, develop, and deliver next-generation therapies. Our approved products in Japan include therapies for the treatment of growth disorder, Fabry disease, MPS II (Hunter syndrome), acute graft-versus host disease, and renal anemia. Our investigational products in development worldwide are aimed at treating rare diseases including MPS I (Hurler, Hurler-Scheie and Scheie syndrome), Hunter syndrome, Pompe disease, and more. JCR strives to expand the possibilities for patients while accelerating medical advancement at a global level. Our core values – reliability, confidence, and persistence – benefit all our stakeholders, including employees, partners, and patients. Together we soar. For more information, please visit . Cautionary Statement Regarding Forward-Looking Statements This document contains forward-looking statements that are subject to known and unknown risks and uncertainties, many of which are outside our control. Forward-looking statements often contain words such as “believe,” “estimate,” “anticipate,” “intend,” “plan,” “will,” “would,” “target” and similar references to future periods. All forward-looking statements regarding our plans, outlook, strategy and future business, financial performance and financial condition are based on judgments derived from the information available to us at this time. Factors or events that could cause our actual results to be materially different from those expressed in our forward-looking statements include, but are not limited to, a deterioration of economic conditions, a change in the legal or governmental system, a delay in launching a new product, impact on competitors’ pricing and product strategies, a decline in marketing capabilities relating to our products, manufacturing difficulties or delays, an infringement of our intellectual property rights, an adverse court decision in a significant lawsuit and regulatory actions. This document involves information on pharmaceutical products (including those under development). However, it is not intended for advertising or providing medical advice. Furthermore, it is intended to provide information on our company and businesses and not to solicit investment in securities we issue. Except as required by law, we assume no obligation to update these forward-looking statements publicly or to update the factors that could cause actual results to differ materially, even if new information becomes available in the future. References 1: Sonoda, et al. A blood-brain-barrier-penetrating anti-human transferrin receptor antibody fusion protein for neuronopathic mucopolysaccharidosis II. Mol. Ther. 2018; 26(5):1366-1374. 2: Morimoto, et al. Clearance of heparin sulfate in the brain prevents neurodegeneration and neurocognitive impairment in MPS II mice. Mol. Ther. 2021; 29(5): 1853-1861. 3: Okuyama, et al. Iduronate-2-sulfatase with Anti-human Transferrin Receptor Antibody for Neuropathic Mucopolysaccharidosis II: A Phase 1/2 Trial. Mol Ther. 2020; 27(2): 456-464. 4: Okuyama, et al. A Phase 2/3 Trial of Pabinafusp Alfa, IDS Fused with Anti-Human Transferrin Receptor Antibody, Targeting Neurodegeneration in MPS-II. Mol Ther. 2021; 29(2): 671-679. 5: Giugliani, et al. Iduronate-2-sulfatase fused with anti-human transferrin receptor antibody, pabinafusp alfa, for treatment of neuronopathic and non-neuronopathic mucopolysaccharidosis II: Report of a phase 2 trial in Brazil. Mol Ther. 2021; 29(7): 2378-2386. 6: Giugliani, et al. Enzyme Replacement Therapy with Pabinafusp Alfa for Neuronopathic　Mucopolysaccharidosis II; an Integrated Analysis of Preclinical and Clinical Data. Int. J. Mol. Sci. 2021, Volume 22, Issue 20, 10938.

PHILADELPHIA--(BUSINESS WIRE)-- Aro Biotherapeutics, a clinical stage biotechnology company pioneering the development of tissue-targeted genetic medicines, today announced upcoming data presentations highlighting the therapeutic potential of its proprietary CD71 Centyrin – Gys1 siRNA conjugate ABX1100, for the treatment of Pompe Disease. The presentations will take place at the WORLD Symposium 2024 in San Diego, CA, from February 4-6, 2024. In the upcoming presentations, Bartholomew Pederson, PhD, Aro collaborator and Professor of Medical Education at Ball State University, will present new data in the Pompe Disease mouse model that demonstrates potent and specific reduction of Gys1 mRNA, glycogen synthase activity and glycogen in muscle tissues, and improved impaired treadmill performance in male mice. “We are excited for the opportunity to share our promising data with the Lysosomal Storage Disease and Pompe communities,” said Steven Nadler, Ph.D., Senior Vice President of Translation Research of Aro Biotherapeutics. “Dr. Pederson is a leading expert in the field of glycogen biology, and working with him affords us the ability to better understand the mechanism of action and the potential disease-modifying impact of our CD71 Centyrin - Gys1 siRNA conjugate for treatment of Pompe disease.” Dr. Nadler will also present data from non-human primate studies, detailing the preclinical development work supporting progression of ABX1100 into first in human studies, which are now ongoing. Following are additional details about the conferences and presentations: Title: A novel Centyrin - siRNA targeting and delivery platform inhibits glycogen synthesis and reduces glycogen levels in skeletal and cardiac muscle in a mouse model of Pompe Disease Presentation Type: Oral Presenter: Bartholomew Pederson, Ph.D., Professor of Medical Education at Ball State University Date: February 6th, 2024 at 10:30am PST Title: A novel Centyrin - siRNA targeting and delivery platform inhibits glycogen synthesis and reduces glycogen levels in skeletal and cardiac muscle in a mouse model of Pompe Disease Presentation Type: Poster Presenter: Bartholomew Pederson, Ph.D., Professor of Medical Education at Ball State University Date: February 6th, 2024 at 3:00pm PST Title: Nonclinical studies in non-human primates on ABX1100: A Centyrin – siRNA conjugate for the treatment of Pompe disease Presentation Type: Poster Presenter: Steven Nadler, PhD, SVP Translational Research at Aro Biotherapeutics Date: February 6th, 2024 at 3:00pm PST About ABX1100 ABX1100, a novel potential treatment for Pompe Disease, is comprised of a CD71 receptor binding Centyrin conjugated to a small interfering RNA (siRNA) which specifically interferes with expression of Gys1 mRNA, thereby reducing levels and overall activity of the Gys1 enzyme in muscle tissues. ABX1100 demonstrated a favorable safety pro GLP toxicology studies, with durable reductions in Gys1 mRNA in muscles supporting the potential for monthly or quarterly dosing. ABX1100 has received Orphan Drug Designation and Rare Pediatric Disease status from the United States Food and Drug Administration. About Aro Biotherapeutics Based in Philadelphia, Aro Biotherapeutics is a biotechnology company pioneering the development of tissue-targeted genetic medicines with a platform based on a proprietary protein technology called Centyrins. The company is developing a wholly owned pipeline of Centyrin-based therapeutic candidates for tissue-specific targeting of therapeutics for a diverse set of diseases. For more information, visit .