7/29/2026

speaker
Joy
Conference Operator

Hello, and thank you for standing by. My name is Joy, and I will be your conference operator today. At this time, I would like to welcome everyone to the Unicure second quarter 2026 earnings call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star, followed by the number one on your telephone keypad. If you would like to withdraw your question, press star one again. We kindly ask that you please limit your questions to one and one follow-up. Thank you. I would now like to turn the call over to Chiara Russo, Senior Director of Investor Relations. Please go ahead, ma'am.

speaker
Chiara Russo
Senior Director of Investor Relations

Good morning, and thank you for joining us for Unicure's second quarter of 2026 earnings call.

speaker
Chiara Russo
Senior Director of Investor Relations

Earlier this morning, Unicure released financial results for the second quarter of 2026, and our press release is available on the Investors in Media section of our website, at unicure.com. Our 10-Q was also filed with the SEC earlier today. Joining me on the call this morning are Matt Kapusta, Chief Executive Officer, Dr. Walid Abi-Saab, Chief Medical Officer, Kylie O'Keefe, Chief Customer and Strategy Officer, and Christian Klemt, our Chief Financial Officer. After our formal remarks, we'll open up the call for Q&A. Before we begin, please know that we will be making forward-looking statements during this investor call.

speaker
Kylie O'Keefe
Chief Customer and Strategy Officer

All statements other than statements of historical facts are forward-looking statements.

speaker
Chiara Russo
Senior Director of Investor Relations

They are based on management's beliefs and assumptions and on information available to management only as of the date of this conference call. Our actual results could differ materially from those anticipated in these forward-looking statements for many reasons, including without limitation the factors described in Unicure's most recent SEC filings. Given these risks, you should not place undue reliance on these forward-looking statements, and we assume no obligation to update these statements even if new information becomes available in the future. Now, let me introduce Matt Kapusta, Unicure's CEO.

speaker
Matt Kapusta
Chief Executive Officer

Thanks, Chiara. Good morning, and thank you for joining us this morning.

speaker
Matt Kapusta
Chief Executive Officer

The second quarter was an important one for Unicure. We received guidance from both the FDA and NHRA, our near-term regulatory pathways for AMT-130, announced promising early data from our Fabry disease and refractory temporal lobe epilepsy programs, and strengthened our balance sheet into 2030 through a follow-on offering. Taken together, these developments meaningfully advance our ability to deliver transformative therapies to patients with serious unmet needs. On today's call, I will provide a brief overview of the quarter before turning to Walid for an update on our clinical programs, Kylie on commercial readiness and Christian on the financials. I will then offer some closing remarks before opening the call to analyst questions. I want to start with AMT 130 and the progress we have made with our FDA interactions. In June, 2026, we held a Type B meeting with the FDA during which we reached alignment with the FDA that a BLA submission under the accelerated approval pathway for AMT 130 based on the three-year data is reasonable. This alignment was later confirmed in the final meeting minutes we recently received. The FDA asked to align The confirmatory study design prior to the BLA submission, including the consideration of a randomized standard of control design instead of a sham procedure. Additionally, consistent with the agency's January 2025 draft published guidance for accelerated approvals, the FDA stated that the confirmatory study should be feasible to conduct within a reasonable timeframe and be well underway and potentially fully enrolled at the time of accelerated approval. We are fully committed to initiating the confirmatory trial as soon as possible after alignment has been reached. The FDA recognizes that HD is a serious disease with a high-end met need for safe and effective therapies, and we are working collaboratively with them on a confirmatory study design. We are on track to submit the BLA this quarter, and Waleed will provide additional details later in the call. In parallel, after a successful pre-submission meeting with the Medicines and Healthcare Products Regulatory Agency, or MHRA, earlier this year, our UK regulatory submission is also on track as planned for the third quarter. Also in the third quarter, we expect to conduct our four-year AMT130 data analyses from the Phase 1-2 studies. We look forward to presenting the four-year data results in September. Beyond AMT130, we are encouraged by the progress across our broader pipeline. Early data from our Phase 1-2A study of AMT260 in refractory mesial temporal lobe epilepsy and Phase 1-2 study of AMT191 in Fabry disease continue to support the potential of both programs, and we look forward to sharing further updates in the first half of next year. As we prepare for potential commercialization of AMT130, our team has intensified its focus and execution. We are deeply engaged with the Huntington's Disease Centers of Excellence, payers, and the patient community, and we are working diligently to put in place the infrastructure to support what we hope will be a timely and successful product launch. In summary, we are entering the second half of the year with strong momentum, clear regulatory pathways for AMT 130 in the U.S. and the U.K., advancing pipeline programs, and a customer-focused commercial organization prepared to deliver. We are grateful to the FDA for their continued engagement and collaboration, to the MHRA for their constructive interactions, and above all, to the patients, families, investigators, and advocates in the Huntington's disease community whose resilience and trust continue to inspire us every day. With that, I will turn the call over to Walid to provide additional detail on AMT-130 and our broader pipeline. Walid?

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Thank you, Matt. Good morning and good afternoon, everyone. I'll start with AMT130 and Huntington's disease. As Matt noted, the Type B meeting with the FDA was a pivotal moment for this program and DHT community. At this meeting, the FDA communicated that our three-year Phase I-II data would be acceptable as the primary basis of a BLA for the accelerated approval of AMT130. The FDA also requested that we align on the design of the confirmatory trial to support accelerated approval prior to BLA submission. We're working with the FDA to finalize the design of the confirmatory study. However, the critical point is that the FDA agreed that a randomized study using sham control is no longer required. The agency recommended instead that we run a randomized standard of care controlled study with total functional capacity at 36 months as the primary endpoint. We are committed to conducting the global confirmatory study and will work diligently to ensure that the study is completed with a reasonable timeline. We remain on track for the quarter BNA submission and look forward to potentially bringing this therapy to patients. On the ex-US regulatory strategy, as Matt noted earlier, we are on track with our planned regulatory activities with the MHRA. With our near-term regulatory focus on the US and the UK, We expect to engage more fully with the European Medicines Agency in 2027 and remain committed to bringing ANT130 to patients across Europe in due course. Finally, turning to our clinical progress, I'm very pleased to report that the ANT130 clinical team is on track with data quality and database log activities based on the June 30th cut-off date for the four-year data, keeping us on schedule for the expected September update. We currently plan to disclose safety and tolerability data through four years of follow-up. The update will also include top-line data from 12 high and 12 low-dose patients at four years, with an additional three patients at the high dose for a total of 15 patients now with three years of follow-up. Clinical data will include series CRS and its components such as TFC, compared to a propensity score-matched natural history control derived from the EnrollHD database. We continue to believe EnrollHD provides a robust and contemporaneous competitor, and we are pleased that CHDI has afforded us the opportunity to incorporate the latest iteration of the EnrollHD database into the four-year analysis, which has been recently updated with approximately 6,000 additional HD participants for a total of approximately 26,000 participants to draw from. We also plan on providing CSF-NFL change from baseline at four years. Moving on to AMT-260 for refractory medial temporal lobe epilepsy, this quarter brought the first cohort-level readout from the Phase I-II study, which we presented at a medical conference in June. As of May 29, 2026, data cut off three of six patients in the first low-dose cohort achieved meaningful reductions in disabling seizures during months four through six. from 79% to 100% below baseline. The remaining three patients showed variable outcomes over the same period, ranging from a 33% decrease to a 36% increase from baseline. Variability and response at this early stage is not unexpected, and we believe longer-term follow-up and the higher dose score data will be important to understanding potential dose response and patient selection. On safety, As of the presentation date, there were no serious adverse events related to ANT260 or the surgical procedure. All adverse events in the low-dose cohort were mild or moderate, most commonly headache in two patients, and no immunosuppression was required. We viewed the celebratory profile combined with early signals of biological activity as supportive of continued evaluation at the higher dose. Enrollment in the second and the higher dose cohort is expected to complete imminently. Updated results for both cohorts are expected in the first half of 2027. Lastly, I will cover AMT191 for Fabry disease. In June of this year, we presented updated preliminary safety and exploratory efficacy data from the Phase 1-2 study with the March 15, 2026 cutoff date. Patient follow-up ranged from three months to more than 18 months. Consistent with our disclosure in February, dose-dependent elevations of alpha-gal-A activity were observed in all 11 patients across three dose levels. Plasma lyso-GB3 levels remained stable post-dose across all cohorts, regardless of enzyme replacement therapy or ERT status, and all 11 dose patients remained withdrawn from ERT. On safety, AMT191 continued to show a manageable safety profile at all dose levels. Per protocol, additional dosing in the mid- and high-dose cohorts remains paused pending agreement with the FDA and a monitoring and management plan following the Grade 3 liver enzyme innovations reported in two patients from the mid-dose cohort. These events were reviewed and confirmed as dose-limiting toxicity by the Independent Data Monitoring Committee. As of the end of May, 2026, These LFT elevations have all resolved following a course of immunosuppression. Now I will turn the call over to Kylie to discuss our ongoing effort with the HG community and our US and ex-US commercial efforts. Kylie?

speaker
Kylie O'Keefe
Chief Customer and Strategy Officer

Thank you, Walid. I want to begin, as always, by acknowledging the Huntington's disease community, the patients, the families, and the caregivers who live with this disease every day, the clinicians who care for them, and the advocates who have tirelessly pushed for regulatory flexibility and access. Your trust in us is what drives our sense of urgency, and our recent accomplishments are a direct reflection of the work we have all done together. The FDA's communication that our three-year Phase 1-2 data will be acceptable as the primary basis for a BLA submission represents the regulatory clarity our commercial team has been preparing for. With a BLA submission planned for the third quarter and an MAA submission to the UK MHRA on the same timeline, our commercial preparations have taken on renewed focus and urgency across three key priorities. First, treatments that are ready in us. We have maintained deep and ongoing engagement with Huntington's Disease Centres of Excellence across the United States and the United Kingdom. working closely with the multidisciplinary neurosurgical, neurology and care teams that we believe are critical to a successful launch. The feedback we continue to receive from the community on the AMT130 dataset and its potential to meaningfully slow disease progression has been consistently strong and continues to reinforce our convention to have a successful launch. Second, community engagement and education. Ensuring continuity across the care journey, understanding genetic testing and referral pathways, and scientific education and communications remains a core focus. We are actively working to ensure that potentially eligible patients and the providers who care for them remain informed as we continue our commercial preparations. Third, market access readiness. Pay engagement is advancing in both the U.S. and the U.K., underpinned by a robust health economics and outcomes research program that continues to build the evidence base for the potential long-term clinical and societal value of ANT130. Potential approval in either the U.S. or the U.K. would also unlock the potential for names, patient, and early access programs in additional geographies, including the Middle East, Latin America, and Central and Eastern Europe. Extending our potential reach to patients ahead of formal reimbursement decisions locally. Turning to AMC 260 in refractory temporal lobe epilepsy and AMC 191 in Fabry disease. Our teams continue to deepen center of excellence relationships, refine the patient and provider journey, and build the evidence base needed to support potential future development decisions in both indications. We remain energized by the only clinical signals from both programs and are laying the strategic groundwork in parallel with clinical development. I'll close by saying that we believe the opportunity to potentially deliver the first disease-modifying therapy to patients with Huntington's disease is closer than it has ever been. We are energized by the potential of AMT130, and as we continue to engage with treatment centers, build pathways for patients, and interact with payers, our organization will be ready. as the HD community has waited long enough. Now I will turn the call over to Christian for a financial update. Christian?

speaker
Christian Klemt
Chief Financial Officer

Thank you, Kylie. I'll be sharing financial highlights of the second quarter of 2026. Please refer to the earnings press release issued this morning and the quarterly filing with the SEC for additional details. Revenue for the three months ended June 30, 2026 was $5.8 million. and many more. The increase of $.5 million is due to an increase in license revenue compared to the prior period. Research and development expenses were $34 million for the three months ended June 30, 2026, compared to $35.4 million during the same period in 2025. The $1.4 million decrease was driven by a $3.2 million decrease in other research and development expenses, partially offset by a $1.8 million increase in direct research and development expenses. The decrease in other research and development expenses primarily reflected a $1.5 million decrease in facility expenses, a $1.3 million decrease in employee and contractor-related expenses, including share-based compensation and a $1 million decrease in fair value of contingent consideration, partially offset by a $0.5 million increase in information technology costs. The increase in direct research and development expenses reflected higher spend on the AMT-260, AMT-162, and AMT-191 programs, partially offset by lower spend on AMT-130 compared to the prior period. Selling general administrative expenses were $17.4 million for the three months ended June 30, 2026, compared to $13.5 million during the same period of 2025. The $3.9 million increase was primarily related to a $4.3 million increase in employee and contractor related expenses, including share based compensation. mainly as a result of a higher number of employees recruited in the second half of 2025 to support the potential commercial launches of AMT 130, a $0.7 million increase in intellectual property fees and a $0.7 million increase in information technology costs and other expenses. This was partially offset by a $1.8 million decrease in professional fees, primarily as a result of low costs incurred in support of the potential commercial launches of AMT 130 and many more. Cash equivalents and investment securities totaled $810.3 million as of June 30, 2026, compared to $622.5 million as of December 31, 2025. We believe that Unicrypt continues to be well-positioned to execute on its clinical and operational priorities through 2026. We expect that cash, cash equivalents, and investment securities will be sufficient to fund operations into 2030. I now turn the call back over to Matt.

speaker
Matt Kapusta
Chief Executive Officer

Thank you, Christian. To summarize, we entered the second half of 2026 with clarity on our regulatory pathway for AMT 130, both in the U.S. and U.K., With the submission of multiple license applications for AMT 130 and the anticipated release of four-year data, the coming months represent potentially transformational milestones for Unicure and for the HD community we are committed to serving. In parallel, we continue to execute across our pipeline with disciplined capital allocation supported by a strong balance sheet that we expect to fund operations into 2030. Before we open to questions, I want to note that with the June 30th data cutoff passed, we are in a quiet period on the AMT 130 four-year data and will not be providing further commentary ahead of our September readout. We very much look forward to sharing those results with you then. Finally, I want to take a minute to sincerely thank my leadership, regulatory, and clinical teams. I am truly motivated by their perseverance and unwavering commitment to the patients and families for whom we aim to deliver potentially life-changing therapies.

speaker
Matt Kapusta
Chief Executive Officer

With that, operator, please open up the call to questions. Thank you.

speaker
Joy
Conference Operator

We will now begin the questions and answers session. If you are dialed in and would like to ask a question, simply press star, then the number one on your telephone keypad to raise your hand and enter the queue. We kindly ask that you please limit your questions to one and one follow-up We'll pause for just a moment to compile the Q&A roster. Your first question comes from the line of Devjit Chattopadhyay with Guggenheim Securities.

speaker
Matt Kapusta
Chief Executive Officer

Hey, good morning, and thank you for taking my questions. Given the strength of the three-year data, what would you consider to be the best outcome for the four-year data, and what role do you think the four-year data are going to play in any potential outcome that one should expect for a first dental art therapy for Huntington's.

speaker
Matt Kapusta
Chief Executive Officer

Hey, Devjit. It's Matt.

speaker
Matt Kapusta
Chief Executive Officer

Thanks for the question. As I mentioned on the call, given that we're in a quiet period, we're not able to comment on the four-year data. Obviously, with respect to an adcom, that will be at the discretion of the FDA. The package that we're going to be submitting, if there's alignment, that that package is going to be based on the three-year data. The package is considered complete and self-contained. Of course, if the FDA requests the four-year data, we're delighted to provide that to them, whether it's the context of the review or the advisory committee.

speaker
Matt Kapusta
Chief Executive Officer

Got it. And just one more follow-up here. Given that the confirmatory study needs to be nearly fully enrolled at the time of any accelerated approval, How quickly can the team operationalize this? And any clarity on the number of patients you're likely to enroll in the study would be helpful. Thank you so much and good luck going forward.

speaker
Matt Kapusta
Chief Executive Officer

Hey, Matt, I'm not sure if you guys can hear me. Yeah, we got you. Do you want me to answer this?

speaker
Matt

Yeah, please go ahead, Walid.

speaker
Matt Kapusta
Chief Executive Officer

All right.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

So essentially, you know, it's our belief that the fundamental intent of the FDA is that for all confirmatory studies, you know, is to ensure that they are completely or completed in a timely manner after approval. And we are confident we can demonstrate that. You know, we talked about sample size. We haven't yet finalized this with the FDA, so it's kind of premature for us to do this. But suffice it to say that our team has been working on this and expecting a positive outcome from a discussion with the FDA. We started all of the preparatory activity for a global study that's going to be conducted. So the idea is that most of the recruitment post-approval will occur in countries before the drug becomes available in those countries such that we can complete the study on time. We are confident that we will be able to conduct the study and complete it in a timely manner. and we believe that the way we are taking this approach with a global trial gives us a credible path to get there. I'm not sure if there were a couple of other little things that you asked, Devjit, so I don't know if Matt or anybody wants to point me in the right direction or maybe I've answered all the questions so far.

speaker
Matt

I think that was it.

speaker
Matt Kapusta
Chief Executive Officer

All right, thank you.

speaker
Chiara Russo
Senior Director of Investor Relations

Your next question comes from the line of Joe Schwartz with LeRinc Partners.

speaker
Joe Schwartz

Thanks and congratulations on the impressive ascent here. In speaking with functional neurosurgeons, our takeaway is that AMT-130 delivery is very feasible at expert centers, but commercial uptake might depend less on surgeon Willingness and technical ability and more on institutional workflow. As you prepare for launch, what have you learned from trial sites about operational bottlenecks? What are you doing to help address them? And how should investors think about realistic year one throughput per activated center?

speaker
Matt Kapusta
Chief Executive Officer

Yeah, thanks, Joe. Kylie, you want to answer that one?

speaker
Kylie O'Keefe
Chief Customer and Strategy Officer

Yeah, absolutely. Thanks, Joe, for the question. I think one of the things that has been incredibly important while we move forward with regulatory discussions has been that the team has not stopped the preparation and discussions with treatment centers of excellence. And this has been incredibly important, as you said, to get them to understand these institutional disease that occur across the different hospitals. And one of the things that we have learned is that no hospital is the same. And so what we have been doing is mapping each process across each institution looking at neurology, neurosurgery and a number of other specialties that would be involved in a procedure like this. I will say that we don't see it as a bottleneck because we're doing everything that we can to work with these institutions ahead of a potential BLA approval to make sure that at the point of that BLA approval we're able to move forward as quickly as possible. There are a number of centers that are available to do this and we are working with what we think is the right number in the initial term and then we will continue to build from there. From a capacity point of view, it's very challenging to give you one number and we're still working through that because it depends on the number of neurosurgeons at a particular hospital, it depends on the number of intraoperative OR suites and other competing priorities but we're working through this and we will plan to share more details around that in the coming months.

speaker
Chiara Russo
Senior Director of Investor Relations

Your next question comes from the line of Paul Matisse with CIFL.

speaker
Matt Kapusta
Chief Executive Officer

Hi, this is Matthew for Paul. Thank you so much for taking our question and congrats on all the progress. I guess based on your interactions with the FDA so far, are you expecting an adcom meeting for this BLA submission? And then separately, I understand you had some studies on patients with most striatal volume and potentially shorter neurosurgical administration. What's the progress on those and when might we see data from those cohorts? Thank you so much.

speaker
Matt Kapusta
Chief Executive Officer

Thanks, Matthew.

speaker
Matt Kapusta
Chief Executive Officer

As I mentioned... Go ahead, Walid.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Okay. Sorry, Matt. So regarding the adcom, I think our expectations is that we most likely will have one. We welcome it and we are preparing for it. Regarding the low straddle volume cohort, that cohort has been fully recruited, but it's a bit early right now to share any of the efficacy data. We've recently shared some of the safety data. So this is, you know, moving forward, we will be updating you as the data mature. In terms of the shorter surgical, you know, there's no, we don't have an ongoing cohort focusing on that at this point. Although this is a key element for us that we're going to be thinking about, you know, acutely as we're moving forward.

speaker
Matt Kapusta
Chief Executive Officer

Thanks.

speaker
Chiara Russo
Senior Director of Investor Relations

Your next question comes from the line of Luca E.C.

speaker
Joy
Conference Operator

with RBC Capital Markets.

speaker
spk09

Hi, team. This is Shelby on for Luca, and thanks for taking the question. Maybe on the regulatory setup for Huntington's, appreciate different indications, but the recent FDA briefing documents ahead of adcoms for Capricor and Replimune did raise some pointed questions about the efficacy of both drugs. Does the tone of those documents give you any pause that the FDA could still push back on AMT-130, even with the three-year data agreed upon as the primary basis for the BLA? Any color there. Much appreciated. Thanks.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, thanks for the question.

speaker
Matt Kapusta
Chief Executive Officer

You know, I mean, obviously, we're aware of the ad cons going on this week and, you know, appreciate that those are serious diseases, but It's not appropriate for us to comment on those particular adcoms. From our perspective, each program is evaluated on its own merits, on its own data, and its own patient population. I think it's possible that the FDA may request an adcom. This would be the first disease-modifying treatment for Huntington's disease. We continue to feel like our interactions with the FDA have been constructive and productive. And in the end, you know, our view is that the data speaks for itself and, you know, we would very much look forward to the extent that there's an adcom in participating and having that discussion.

speaker
Joy
Conference Operator

Your next question comes from the line of Salveen Richter with Goldman Sachs.

speaker
Merle

Hi, good morning. This is Lydia on for Selveen. Thanks so much for taking our question. Just on the regulatory side, again, if you could provide any more kind of color on the ongoing discussions, particularly around the standard of care control arm and how that might impact recruitment and retention in the study, given the somewhat open label nature of that.

speaker
Matt Kapusta
Chief Executive Officer

Thanks so much.

speaker
Matt Kapusta
Chief Executive Officer

Hey, Walid, you want to answer that one?

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Sure. Thanks, Matt. Yeah, I think the study design is straightforward. So patients would be randomized to either receive treatment or be on the standard of care arm where they are allowed to receive whatever is the latest standard of care available to them in their geography. I think it's a fair question that you ask in terms of retention. We believe that in our case, there's going to be a couple of items that are going to be Paying attention to one is that people who would be randomized to standard of care will be eligible to receive AMT-130 after three years. They don't have to meet the inclusion criteria anymore. As long as it is safe to administer it to them, they will be able to receive it. Now, of course, if AMT-130 becomes available to them earlier because it's commercially available, that's going to also depend on our strategy, which I alluded to earlier. The earlier part of the study we will be prioritizing the U.S. recruitment, but later in the study we will be focusing on countries where AMT 130 would not be yet available by the time we complete the study so that we can minimize this. Last but not least, any long-term study will always have a risk of a dropout rate. and we will be using statistical techniques and in agreement with the agency about how we will deal with those dropouts. So overall, we do feel very confident that we will be able to recruit the study and execute it in such a way that we can draw conclusions on it. And I think this is bolstered by the fact that patients with Huntington disease actually are amazingly dedicated to to being part of studies and actually generating these data, not just for them, but also for their family and their community. Thank you.

speaker
Matt

Your next question comes from the line of Ellie Merle with Barclays.

speaker
Merle

Hi, this is Jasmine on for Ellie. Thank you for the question. So is your current expectation still that you will get priority review and just following up on this, can you give some more detail on the ways that you're preparing to move quickly to have the confirmatory trial well underway at the time of approval? And how long would you potentially expect enrollment in the confirmatory trial to take? Thank you.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, thanks, Jasmine.

speaker
Matt Kapusta
Chief Executive Officer

I'll take the first part of that question on the priority review and then hand it over to Waleed to talk about the confirmatory trial. So just as a reminder, AMT 130 has breakthrough therapy designation and RMAT designation and fast track designation. Normally the priority review would be requested at the time of the BLA submission and the FDA would grant that or not at the time of the acceptance. But given the unmet need here, we think that there's a reasonable chance that that would be accepted by the FDA, but ultimately that's to the FDA's discretion.

speaker
Matt Kapusta
Chief Executive Officer

On to you, Walid.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Thanks, Matt. So regarding confidence and the study conduct, I think we, you know, we prepared for this. We're working, you know, diligently within ClinOps to be able to do that. And, you know, I'm very confident that we'll be able to recruit it in time. In terms of the size, It's premature to talk about it. As I mentioned, we are still in discussion with the FDA in terms of finalizing the study design, and that will also have, of course, an implication about the sample size. And so once we do that, we will be able to communicate. We will be able to give you a better idea about the timeline it will take us to recruit this trial.

speaker
Joy
Conference Operator

Your next question comes from the line of Yui Er with Mizuho.

speaker
Yui Er

Hi, guys. Yeah, congrats on all the progress, and thanks for taking your questions. So I guess my first question, could you just clarify, I just want to make sure I'm understood correctly, whether the accelerated approval is dependent on completion of enrollment for the confirmatory study? If you don't complete, does that mean you don't get the accelerated The application won't be approved or will be held until it's completed. And the second question is, could you maybe just provide, walk us through the assumptions behind your 2030 cash way? What does that include exactly? Thanks.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, thanks for the questions. I'll handle the first question and then pass it over to Christian for the second question. So, I mean, just to understand, the FDA put out draft guidance in January of 2025. That draft guidance is for all accelerated approvals and addresses confirmatory studies. And the FDA's intent for all confirmatory studies is really to make sure that they can be completed in a timely manner post-approval. Accelerated approval is, you don't have to complete the study to get accelerated approval, but the FDA wants to ensure that the study can be completed in a timely manner. And I think as Walid said, you know, we feel very confident that we'll be able to do that. Number one, we feel confident we can operationalize the study very quickly. Number two, we believe that we'll be able to focus on the U.S. and preapproval and to ensure that we have representation from the U.S. Third, this is going to be a global study where we're going to have sites in a number of different countries where the products are not commercially available. So we feel very confident that we'll be able to complete this study in a timely manner to address the FDA's priorities as it relates to confirmatory studies. And with that, I will pass it on to Christian.

speaker
Christian Klemt
Chief Financial Officer

Thanks, Matt. Yeah, the guidance into 2030 includes a number of things. So first and foremost, enrolling the confirmatory trial, funding the confirmatory trial into 2030, funding commercial launches, as well as the ongoing clinical trials, as well as making potential investments to advance certain other pipeline candidates into late stage development.

speaker
Matt Kapusta
Chief Executive Officer

Okay, thank you.

speaker
Joy
Conference Operator

Your next question comes from the line of Joseph Thorne with TD Cowen.

speaker
Matt Kapusta
Chief Executive Officer

Hi there, good morning. Thank you for taking my question. Can you review with us maybe how the SAP for the three-year data has changed at all over the past year since we saw the September data from last year and your level of alignment with the FDA on that for the final submission? and then maybe relatedly with the June 30th cutoff date and the September data presentation for the four-year data, is that just how long it takes to lock and clean the database or is there any SAP alignment that's kind of gating for that readout as well? Thank you.

speaker
Matt Kapusta
Chief Executive Officer

Okay, yeah, I'll pass that on to Walid, but just to confirm your first question, you're talking about have there been any changes to the three-year SAP?

speaker
Matt Kapusta
Chief Executive Officer

Yes. Okay.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, so Walid, why don't you answer? I think the question was, have there been any adjustments to the three-year SAP? And then the second part is questions around the four-year analysis.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Yep, thanks. Yeah, so the three-year SAP has not changed since we submitted it to the FDA in July of 2025. Based on that SAP, we shared with you the data back in September of 2025. So that has not changed. Actually, there should be no reason to change it after the fact. With regard to the four-year analysis, the timelines are generally similar to what we've done for the last year. So we're on track to be able to share the results with you in September of this year.

speaker
Matt Kapusta
Chief Executive Officer

Great, thank you. Maybe just a related follow-up. I guess, has the FDA signed off on that SAP you used last year in the most recent meeting? I guess, what level of communication do they give you on, yes, this is the SAP we agree with, or do they not comment to that level? Thank you.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

So just to get back to the history a little bit, so we met with the FDA back in April of 2025, a month after we submitted the briefing book. for the SAP. And the FDA at the time provided comments to us, which we incorporated in the SAP that we ultimately finalized and submitted to the FDA in June of last year. There's been no formal communication with the FDA since on that SAP, and we would not expect it. And these are the data that form the basis of the analysis, and the FDA is aware of those data. and in recent discussion with the FDA in the recent Type B meeting, we aligned with them that the data from the three-year analysis, from the three-year data cut supports the DLA filings.

speaker
Matt Kapusta
Chief Executive Officer

So that is what we are moving forward with.

speaker
Chiara Russo
Senior Director of Investor Relations

Your next question comes from the line of Ian Enzu with Wells Fargo.

speaker
Matt Kapusta
Chief Executive Officer

Hi, this is Jeff Ahn for Jeannette, and thanks for taking our questions. So following the receipt of the Type B meeting minutes, how closely did the written feedback align with your interpretation of the discussions? Were there any areas of clarification or any points that differed from your initial takeaways? And separately, I believe I heard that total functional capacity at three years could serve as the primary endpoint for the confirmatory trial. Given that AM 2130 had about 60% slowing of PFC in the Phase 1-2 study at three years, could you talk about the efficacy bar for the confirmatory trial? Is there any magnitude of PFC benefit that you believe could be required to support full approval? Thanks.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, I'll take maybe the first question, and then, Walid, you can talk about the second question, understanding that we haven't completed the alignment around the The confirmatory study. But nevertheless, on the first question, yeah, we confirmed that we received the final meeting minutes. And I think really all I would say is that our disclosures in this press release are complete. And so, you know, there was no material differences in our interpretation from the disclosures that we've had today.

speaker
Matt Kapusta
Chief Executive Officer

On the second question, Walid, you can go ahead and answer that one.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Yeah, thank you. So in terms of the magnitude effect of TFC, you know, indeed, as you saw in our top line from the three-year data analysis last year, the TFC changes were 60%. In the confirmatory trial, we will be using that information. Actually, it will be complemented with the, you know, the updated four-year analysis, because if you recall, we have three more patients that would have reached the three years in that analysis. So we will have a total of 15 patients instead of the 12 that we reported on last year. And we will be using those to fine-tune the powering. There's been no discussion, as Matt indicated, with the FDA yet on the details of that study and the powering specifically. We had a proposal, but it's premature for us to be able to talk about it at this point before we reach agreement with the FDA.

speaker
Matt

Your next question comes from the line of Kristen Kluska with Kantor.

speaker
Kylie O'Keefe
Chief Customer and Strategy Officer

Hi, good morning. Just to follow up on that point, I'm curious why the FEA is considering TFC as the primary endpoint over CUHDRS and if that's going to influence how they're going to review the package coming up while recognizing that you also had positive benefits on that endpoint.

speaker
Matt Kapusta
Chief Executive Officer

Yeah, I think, I mean, this is not a surprise to us at all. And, you know, we disclosed back in 2024 that the FDA views the composite unified Huntington's disease rating scale as an intermediate clinical endpoint that is reasonably likely to predict efficacy. You know, our sense is that, you know, the FDA just philosophically, they look at composites as, You know, a number that in and of itself has value but it's not as valuable or as pure, for lack of better words, as a functional endpoint. Total functional capacity is a measure of independence. It has a lot of aspects that are quality of life associated and our sense is that in discussions that the FDA had with us as well as other sponsors that they tend to lean more towards total functional capacity as a primary endpoint for a confirmatory study. But in terms of an accelerated approval, the FDA is comfortable that the composite UHDRS is an intermediate clinical endpoint that is reasonably likely to predict

speaker
Joy
Conference Operator

Your next question comes from the line of Suzanne Van Vortusen with Kempin and Company.

speaker
Suzanne Van Vortusen

Hi, team. Thanks for taking my questions. Maybe assuming approval, looking at the commercial launch, It's a first of its kind, potentially. So can you elaborate a bit higher level on some key characteristics of this upcoming launch that you believe we should consider when thinking of proxies or example launches? Speaking of things like the features of the treatment modality, specifics of the indication, or the setup of care centers, et cetera. Thank you.

speaker
Matt Kapusta
Chief Executive Officer

Sure. Thanks for the question. Kylie, you want to go ahead?

speaker
Kylie O'Keefe
Chief Customer and Strategy Officer

Yeah, absolutely. Thank you very much for the question. So I think some of the characteristics that are going to be key launch criteria is on ensuring that we have the right number of treatment centers set up and ready to go and able to treat patients. I think this is obviously going to be one of the key criteria, which is why we've spent so much time engaging with the treatment centers, understanding the specialties that will be relevant within, and ensuring we understand the processes, as we were discussing earlier. I think this is something that will be a key priority leading up to launch and then obviously post-launch. I think in addition to that, making sure that we have the right engagement on a payer level, making sure they understand the unmet need in Huntington's and the value that AMT 130 can potentially bring and then also ensuring that we understand the patient care pathways, how they're referred and how they're managed and the patient journey in totality. Understanding these three components will be critical to how we see launch success. You asked a little bit about analogs and other ways that would be consistent from a modality point of view. I think as we think about a treatment that is completed through a hospital procedure, I think Zolgensma is a reasonable analog. Also, if you look at Elividis from a general understanding of capacity point of view, I think they're reasonable analogs, but I will caution that no analog is perfect. and I think every disease and every treatment space is a little bit different in the way the dynamics work and we're looking to really ensure that we have all of our I's dotted and our T's crossed when it comes to launch preparation to bring this therapy to Huntington's patients.

speaker
Suzanne Van Vortusen

Got it, thank you. And maybe just a small follow-up. I know that Huntington's is core focus but I'm wondering for epilepsy and Febre, you've reported some encouraging data for both this year. Can you shed some color on how you balance your prime focus versus how you go about decision making and resource allocation for the other pipeline programs? Thank you.

speaker
Matt Kapusta
Chief Executive Officer

Yeah.

speaker
Matt Kapusta
Chief Executive Officer

I think, you know, over the years, we really made it a priority to be very disciplined in how we invest and really to make data-driven decisions. You know, we don't view... and many more. We're talking about truth seeking and we try to run the experiments to answer questions and when the data supports moving the program forward and advancing it we want to do that and focus on Impeccable Execution. When data does not support moving the program forward, we're also happy to discontinue or deprioritize. We recently did that with our Sod 1 ALS program. We've done that in the past, and that's going to be how we continue to make capital allocation decisions going forward.

speaker
Chiara Russo
Senior Director of Investor Relations

Again, if you would like to ask a question, press star one on your telephone keypad. Your next question comes from the line of Patrick Truccio with HC Wainwright.

speaker
Joy
Conference Operator

Hi, thank you so much for taking the question. This is Arabella on for Patrick. I was just wondering, Should we expect a pre-specified interim analysis built into the confirmatory study? And if that was positive, say, at two years, could that support conversion to full approval prior to the three-year primary? And then also, do you have any other outstanding CMC items to work on before you can submit the BLA?

speaker
Matt Kapusta
Chief Executive Officer

Yeah, maybe I'll answer the first question and hand it over to Walid, understanding that we have not completed our discussions with the FDA on the confirmatory study. But on the CMC, we feel confident that we've completed the activities that are required for the BLA submission. Obviously, we need to complete Module 3 for the BLA submission, but the fundamental activities around PPQ, Validation of analytics and assays, that work we feel very comfortable that we've done what's required to be ready for the BLA submission.

speaker
Dr. Walid Abi-Saab
Chief Medical Officer

Okay, so regarding the pre-specified interim, you know, it's really premature to discuss this. We haven't gone to that level yet with the FDA. I think it's a consideration that we should, it should be part of it, but we haven't yet finalized it. So I really cannot discuss more. So hang tight, more to come once we have that clarified.

speaker
Chiara Russo
Senior Director of Investor Relations

Your next question comes from the line of Rudy Lai with Wolf Research.

speaker
Matt Kapusta
Chief Executive Officer

Thanks for taking my question. Given that you already reached agreement on the filing package, what do you think could be the key questions and the debates to be discussed at the upcoming ad comm meeting? Do you imagine any pushback from FDA? and secondly, it sounds like William is back in enrollment of the confirmatory study to be a key limiting factor to get approval, so just want to confirm, thanks.

speaker
Matt Kapusta
Chief Executive Officer

Sure, I didn't catch the last part of that, but just, yeah, and I mean, I wouldn't want to speculate on, you know, what's going to be the content or the FDA's position of an ADCOM meeting that hasn't yet been requested. So I don't know how helpful that would be there. And then can you just repeat the second part of the question?

speaker
Matt Kapusta
Chief Executive Officer

Yeah, the second part is really about do you expect enrollment of the confirmatory study to be a key limiting factor to get approval?

speaker
Matt Kapusta
Chief Executive Officer

Well, I think, you know, I'll repeat what I said before. I think the FDA, you know, accelerated approvals are conditional approvals. And, you know, I think the FDA considers that flexibility because of these critically high unmet needs for Huntington's disease and other indications. But the confirmatory studies are important. And as I said, you know, their fundamental focus is ensuring that they can be completed in a timely manner. And, you know, but the reality is they have, you know, they have wide discretion to do that. You know, I mean, this is not the first time that the FDA has contemplated a confirmatory study. And I think we feel very confident that we can operationalize the study expeditiously, that we can demonstrate to the FDA that it is well underway. and demonstrate to the FDA that we've got the infrastructure to complete it in a timely manner. So, you know, I think it'll be a factor, but I think we feel confident that we can get the FDA comfortable on those key elements.

speaker
Matt Kapusta
Chief Executive Officer

Thanks and congrats on the progress.

speaker
Matt Kapusta
Chief Executive Officer

Thank you.

speaker
Chiara Russo
Senior Director of Investor Relations

This concludes the questions and answers session and our call today.

speaker
Joy
Conference Operator

Thank you all for joining. You may now disconnect.

Disclaimer

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