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4/30/2026
Thank you for standing by, and welcome to CourseUp Therapeutics first quarter, 2026 earnings conference call. Currently, all participants are in a listen-only mode. After the speaker's presentation, there will be a question-and-answer session. To ask a question during the session, you will need to press star-1-1 on your telephone. To remove yourself from the queue, you may press star-1-1 again. I would now like to hand the call over to Adubak Makari, CFO. Please, go ahead. Hello, everyone.
Good afternoon, and thank you for joining us. Today, we issued a press release announcing our financial results for the first quarter and providing a corporate update. Copy is available at coursehub.com. Our complete financial results will be available when we file our Form 10-Q with the SEC. Today's call is being recorded. It will be available at the Investors Pass Events tab of our website. Statements during this call, other than statements of historical fact, are forward-looking statements based on our plans and expectations that are subject to risks and uncertainties which might cause actual results to be materially different from those such statements express or imply. The risks and uncertainties that may affect our forward-looking statements are described in our annual report on Form 10-K and our quarterly reports on Form 10-Q, which are available at the SEC's website. Please refer to those documents for more information. We disclaim any intention or duty to update forward-looking statements. Our revenue in the first quarter of 2026 was $164.9 million, compared to $157.2 million in the prior year period. We have increased our 2026 revenue guidance to $950 million to $1.05 billion. Net loss was $31.8 million in the first quarter of 2026 compared to net income of $20.5 million in the first quarter of last year. Our cash and investments on March 31st were $515 million. I will now turn the call over to Sean Madduke, President of our Endocrinology Division. Sean?
Thanks, Ottobock. Demand for our medications continues to increase. We ended the first quarter with a record number of new prescriptions written from a record number of prescribers, which translated to an all-time high for the number of patients receiving our medications. Importantly, we set a record for new patients starts in March and again in April. These figures are outstanding. They give me great confidence in the current and future health of our hypercortisolism business. But full impact is not reflected in our revenue for three reasons. First, revenue often dips in the first quarter, as it does for many rare disease medications, because insurance companies impose onerous reauthorization procedures at the start of each year that interrupt patient coverage for a month or two. We provide patients with free drug to bridge the gap, but our revenue suffers. Second, new patients, whom we are adding at a rapid clip, provide much less revenue when they start treatment then they will later, after payer coverage has been secured and they have titrated to their optimum dose. The full revenue impact of patients added this quarter will grow substantially over the next few quarters. Finally, our specialty pharmacy vendor has done an excellent job onboarding the thousands of patients transferred from our former vendor and getting them the medicine they've been prescribed. They have also excelled at servicing new prescriptions written for our medications, the new patient starts I just described. The task that remains is grinding through the insurance prior authorization backlog that accumulated as patients transition to the new pharmacy. This is painstaking work, but it yields steady dividends that will be reflected in our revenue over the coming months. Our new pharmacy vendors' ability to handle large numbers of new patients skillfully is important because I expect demand to increase substantially as physicians adapt their practices to the landmark findings of our catalyst and momentum trials. Catalysts showed that 24% of patients with resistant diabetes had hypercortisolism, and that treatment with corallum led to substantial reductions in hemoglobin A1C, weight, and waist circumference compared to placebo. Catalyst results were published in the field's prominent journal, Diabetes Care, in December of 2025, and were referenced in the March 2026 American Association of Clinical Endocrinology, or ACE, guidance document for the management of diabetes. This is an important step towards increasing the awareness of hypercortisolism by the broader physician community. The recently reported results of our Momentum study showed that 27% of patients with resistant hypertension had hypercortisolism. Momentum's results were featured in an oral presentation at the annual conference of the American College of Cardiology, or ACC, last month. Catalyst and Momentum will transform the practice of medicine. They provide consistent, complementary evidence that hypercortisolism is the underlying cause of many patients difficult to treat diabetes and hypertension. Physicians have begun responding to these findings, but a change of this magnitude takes some time to be fully absorbed and implemented in clinical practice. As medical practices adapt, screening for and treatment of Cushing syndrome will increase, and so will the number of patients receiving our medications. We expect our current Cushing syndrome business to grow to at least $2 billion in annual revenue by the end of this decade. When Relacorlin is available, growth will accelerate further. I will now turn the call over to Roberto Vieira, President of our Oncology Division. Roberto?
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