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ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA.
PART IV

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K

(Mark One)    

ý

 

ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the fiscal year ended December 31, 2014

OR

o

 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from                  to                

Commission file number: 001-35726

Radius Health, Inc.
(Exact name of registrant as specified in its charter)

Delaware
(State or other jurisdiction of
incorporation or organization)

  80-0145732
(I.R.S. Employer
Identification No.)

950 Winter Street
Waltham, Massachusetts

(Address of principal executive offices)

 

02451
(Zip Code)

617-551-4000
(Registrant's telephone number, including area code)

         Securities issued pursuant to Section 12(b) of the Act: Common Stock

         Securities issued pursuant to Section 12(g) of the Act: None

Title of each class   Name of each exchange on which registered
Common Stock, par value $0.0001 per share   The NASDAQ Global Market

         Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes  ý     No  o

         Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes  o     No  ý

         Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes  ý     No  o

         Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes  ý     No  o

         Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to the best of registrant's knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K.  o

         Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting company. See the definitions of "large accelerated filer," "accelerated filer" and "smaller reporting company" in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer  o   Accelerated filer  ý   Non-accelerated filer  o
(Do not check if a
smaller reporting company)
  Smaller reporting company  o

         Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes  o     No  ý

         The aggregate market value of the registrant's common stock, $0.0001 par value per share ("Common Stock"), held by non-affiliates of the registrant, based on the last sale price of the Common Stock at the close of business on June 30, 2014 was $190.5 million. For the purpose of the foregoing calculation only, all directors and executive officers of the registrant are assumed to be affiliates of the registrant.

         Number of shares outstanding of the registrant's common stock, par value $0.0001 per share, as of March 5, 2015: 37,821,722

DOCUMENTS INCORPORATED BY REFERENCE

         Portions of the registrant's definitive proxy statement for its 2015 annual meeting of stockholders are incorporated by reference into Part III of this Form 10-K.

   


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Radius Health, Inc.

Annual Report on Form 10-K

For the Fiscal Year Ended December 31, 2014

INDEX

 

Special Note Regarding Forward-Looking Statements

    1  

 

Currency and Conversions

    2  

PART I

       

ITEM 1:

 

Business

    3  

ITEM 1A:

 

Risk Factors

    51  

ITEM 1B:

 

Unresolved Staff Comments

    77  

ITEM 2:

 

Properties

    77  

ITEM 3:

 

Legal Proceedings

    77  

ITEM 4:

 

Mine Safety Disclosures

    77  

PART II

       

ITEM 5:

 

Market for Registrant's Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

    78  

ITEM 6:

 

Selected Financial Data

    79  

ITEM 7:

 

Management's Discussion and Analysis of Financial Condition and Results of Operations

    80  

ITEM 7A:

 

Quantitative and Qualitative Disclosures About Market Risk

    104  

ITEM 8:

 

Financial Statements and Supplementary Data

    105  

ITEM 9:

 

Changes in and Disagreements With Accountants on Accounting and Financial Disclosure

    142  

ITEM 9A:

 

Controls and Procedures

    142  

ITEM 9B:

 

Other Information

    144  

PART III

       

ITEM 10:

 

Directors, Executive Officers and Corporate Governance

    145  

ITEM 11:

 

Executive Compensation

    148  

ITEM 12:

 

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

    148  

ITEM 13:

 

Certain Relationships and Related Transactions, and Director Independence

    149  

ITEM 14:

 

Principal Accountant Fees and Services

    149  

PART IV

       

ITEM 15:

 

Exhibits and Financial Statement Schedules

    150  

 

Signatures

    151  

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SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

         This report, including in the sections titled "Risk Factors," "Management's Discussion and Analysis of Financial Condition and Results of Operations" and "Business," contains, in addition to historical information, forward-looking statements. We may, in some cases, use words such as "project," "believe," "anticipate," "plan," "expect," "estimate," "intend," "continue," "should," "would," "could," "potentially," "will," "may" or similar words and expressions that convey uncertainty of future events or outcomes to identify these forward-looking statements. Forward-looking statements in this Annual Report on Form 10-K may include, among other things, statements about:

         The outcome of the events described in these forward-looking statements is subject to known and unknown risks, uncertainties and other important factors that could cause actual results to differ materially from the results anticipated by these forward-looking statements. These important factors include our financial performance, our ability to attract and retain customers, our development activities and those other factors we discuss in Item 1A of this Annual Report on Form 10-K under the caption "Risk Factors." You should read these factors and the other cautionary statements made in this report as being applicable to all related forward-looking statements wherever they appear in this report. These risk factors are not exhaustive and other sections of this report may include additional factors which could adversely impact our business and financial performance.

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CURRENCY AND CONVERSIONS

        In this report, references to "dollar" or "$" are to the legal currency of the United States, and references to "euro" or "€" are to the single currency introduced on January 1, 1999 at the start of the third stage of European Economic and Monetary Union, pursuant to the Treaty establishing the European Communities, as amended by the Treaty on European Union and the Treaty of Amsterdam. Unless otherwise indicated, the financial information in this report has been expressed in U.S. dollars. Unless otherwise stated, the U.S. dollar equivalent information translating euros into U.S. dollars has been made, for convenience purposes, on the basis of the noon buying rate published by the Board of Governors of the Federal Reserve as of December 31, 2014, which was €1.00 = $1.2101. Such translations should not be construed as a representation that the euro has been, could have been or could be converted into U.S. dollars at the rate indicated, any particular rate or at all.

        Trademarks appearing in this report are the property of their respective holders.

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PART I

ITEM 1.    BUSINESS.

         Unless otherwise provided in this report, all references in this report to "we," "us," "our company," "our," or the "Company" refer to Radius Health, Inc.

Overview

        We are a science-driven biopharmaceutical company focused on developing new therapeutics for patients with osteoporosis as well as other serious endocrine-mediated diseases. Our lead development candidate is the investigational drug abaloparatide (BA058), a bone anabolic for potential use in the reduction of fractures in postmenopausal osteoporosis delivered via subcutaneous injection, which we refer to as abaloparatide-SC. We announced the 18-month top-line data from our Phase 3 clinical trial, or ACTIVE trial, evaluating abaloparatide-SC for potential use in the reduction of fractures in postmenopausal osteoporosis in December 2014. Patients from the abaloparatide-SC and placebo groups from our Phase 3 clinical trial are eligible to continue in an extension study, or ACTIVExtend trial, in which they are receiving an approved alendronate therapy for osteoporosis management. We currently anticipate the first six months' results from the ACTIVExtend trial to be available in the second quarter of 2015. We plan to submit a new drug application, or NDA, in the United States, and a marketing authorization application, or MAA, in Europe, during the second half of 2015 which will include results from the 18-month ACTIVE trial along with the first six months' results from the ACTIVExtend trial. We hold worldwide commercialization rights to abaloparatide-SC, other than in Japan, and subject to a regulatory review and favorable regulatory outcome, we anticipate our first commercial sales of abaloparatide-SC will take place in 2016. We are leveraging our investment in abaloparatide-SC to develop a line extension that is designed to improve patient convenience by enabling administration of abaloparatide through an investigational short-wear-time transdermal patch, which we refer to as abaloparatide-TD. We hold worldwide commercialization rights for abaloparatide-TD.

        Our current clinical product portfolio also includes the investigational drug RAD1901, a selective estrogen receptor down-regulator/degrader, or SERD, and RAD140, a nonsteroidal selective androgen receptor modulator, or SARM. We are developing RAD1901 at higher doses for the potential treatment of metastatic breast cancer or other estrogen receptor mediated oncology applications, and intend to advance its development with the initiation of Phase 1 clinical trials, including a maximum tolerated dose study that has commenced patient dosing and a Phase 1 clinical trial in metastatic breast cancer patients, which commenced in late 2014. At lower doses, RAD1901 acts as a selective estrogen receptor modulator, or SERM. Low-dose RAD1901 has shown potential to be effective for the treatment of vasomotor symptoms such as hot flashes in a successful Phase 2 proof of concept study. We intend to commence a Phase 2b clinical trial in vasomotor symptoms in the second half of 2015. RAD140 resulted from an internal drug discovery program focused on the androgen receptor pathway, which is highly expressed in many breast cancers. Due to its receptor and tissue selectivity, potent oral activity and long duration half-life, RAD140 could have clinical potential in the treatment of breast cancer or possibly other conditions where androgen modulation may offer therapeutic benefit.

Abaloparatide

        Abaloparatide is a novel synthetic peptide analog of parathyroid hormone-related protein, or PTHrP, that we are developing as a bone anabolic treatment for potential use in the reduction of fractures in postmenopausal osteoporosis. Osteoporosis is a disease that affects nearly 10 million people, with an additional approximately 43 million people at increased risk for the disease, in the United States. It is characterized by low bone mass and structural deterioration of bone tissue, which leads to greater fragility and an increase in fracture risk. Anabolic agents, like Forteo (teriparatide), are

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used to increase bone mineral density, or BMD, and to reduce the risk of fracture. We believe abaloparatide has the potential to increase BMD and bone quality to a greater degree, at more sites, at a faster rate, and in more patients than other drugs that are approved for the treatment of osteoporosis. We are developing two formulations of abaloparatide:

    Abaloparatide-SC is an injectable subcutaneous formulation of abaloparatide. Our Phase 3 study of abaloparatide-SC is designed to evaluate whether abaloparatide-SC is superior to placebo for prevention of vertebral fracture. The study is also designed to evaluate whether abaloparatide-SC is superior to open-label teriparatide treatment for greater BMD improvement at major skeletal sites and for a lower occurrence of hypercalcemia, a condition in which the calcium level in a patient's blood is above normal. On December 21, 2014, we announced positive top-line data from the ACTIVE trial, evaluating the investigational drug abaloparatide-SC for potential use in the reduction of fractures in postmenopausal osteoporosis. In January 2015, based on comments on the draft Statistical Analysis Plan from the U.S. Food and Drug Administration, or FDA (or the Agency), we revised our statistical analysis of the Phase 3 top-line data. See "Abaloparatide—Abaloparatide-SC."

      Our Phase 3 study includes a 6-month extension period in order to obtain 24-months of fracture data, as requested by the FDA and the European Medicines Agency, or EMA. We currently anticipate the first six months' results from the ongoing ACTIVExtend trial to be available in the second quarter of 2015. We believe that the abaloparatide-SC program is on-track for submission of an NDA for abaloparatide-SC to the FDA and submission of an MAA to EMA each of which incorporates the 24-month fracture data, in the second half of 2015. We will remain blinded at the patient and site level until such time as six months of the alendronate extension study is completed.

      In July 2014, the FDA denied our request for breakthrough therapy designation for abaloparatide-SC, and indicated that, upon a new request, abaloparatide-SC would be considered for a breakthrough therapy designation if new clinical evidence demonstrates that patients dosed with abaloparatide-SC show substantial improvement in treatment of postmenopausal osteoporosis over existing therapies on one or more clinically significant endpoints. We believe that the recently completed analyses of the 18-month top-line results of our Phase 3 clinical trial and two abaloparatide Phase 2 clinical trials have shown potentially important clinical benefits relative to placebo and current anabolic therapies and that these data could support a breakthrough therapy designation. Once we have fully evaluated the 24-month results from the Phase 3 clinical trial, a decision will be made on whether to re-submit our request or to apply for one of the other FDA expedited review programs for new drugs that address unmet medical needs in the treatment of serious or life threatening conditions.

    Abaloparatide-TD is a line extension of abaloparatide-SC in the form of a convenient, short-wear-time transdermal patch. In January 2014, we reported that in the Phase 2 clinical trial, abaloparatide-TD showed a statistically significant mean percent increase from baseline in BMD. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving comparability to abaloparatide-SC. We hold worldwide commercialization rights to abaloparatide-TD technology.

        We also believe that, subject to further research and development, abaloparatide may have potential applications across a variety of skeletal or bone related diseases or medical conditions.

RAD1901

        RAD1901 is a SERD that we believe crosses the blood-brain barrier and that we are evaluating for the potential treatment of metastatic breast cancer and other estrogen receptor mediated oncology applications. In studies completed to date, RAD1901 has been shown to bind with good selectivity to

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the estrogen receptor and to have both estrogen-like and estrogen-antagonistic effects in different tissues. In many cancers, hormones, like estrogen, stimulate tumor growth and a desired therapeutic goal is to block this estrogen-dependent growth while inducing apoptosis of the cancer cells. SERDs are an emerging class of endocrine therapies that directly induce estrogen receptor, or ER, degradation, enabling them to remove the estrogen growth signal in ER-dependent tumors without allowing ligand-independent resistance to develop. There is currently only one SERD, Faslodex (fulvestrant), approved for the treatment of hormone-receptor positive metastatic breast cancer. In 2014, the worldwide market for Faslodex was $720.0 million. For ER-positive metastatic breast cancer patients with brain metastases, there are no approved targeted therapies that cross the blood-brain barrier with the potential to more effectively treat and potentially reduce both intracranial and extracranial metastatic breast cancer tumors.

        In December 2014, we commenced a Phase 1 clinical trial of RAD1901 in the United States for the treatment of metastatic breast cancer. The Phase 1 study is a multicenter, open-label, two-part, dose-escalation study of RAD1901 in postmenopausal women with advanced estrogen receptor positive and HER2-negative breast cancer that is designed to determine the recommended dose for a Phase 2 study and includes a preliminary evaluation of the potential anti-tumor effect of RAD1901. We expect to report progress on this study in the first half of 2015 and to initiate additional Phase 1 clinical trials in the European Union in 2015. In June 2014, we initiated a Phase 1 maximum tolerated dose, or MTD, study of RAD1901 in healthy volunteers. The study is designed to evaluate the tolerability, safety and pharmacokinetics of RAD1901, and also to use 18F-estradiol positron emission tomography, or FES-PET, imaging to provide a pharmacodynamic assessment of estrogen receptor turnover following administration of RAD1901. Levels of RAD1901 in cerebrospinal fluid samples taken from study subjects will be measured to confirm that RAD1901 has crossed the blood-brain barrier. Based upon initial study results, FES-PET imaging of RAD1901 has demonstrated potent SERD activity. As of December 31, 2014, 40 subjects had completed dose escalation in the ongoing MTD study, and FES-PET imaging had been completed in a total of five subjects across two different doses. Each of these five subjects demonstrated, based on FES-PET imaging, suppression of the FES-PET signal to background levels after six days of dosing. In addition, RAD1901, at the doses that showed suppression of the FES-PET signal, was well tolerated in these patients.

        In March 2014, we submitted to the FDA an application for orphan drug designation of RAD1901 for the treatment of breast cancer brain metastases. In June 2014, we received a response to our application from the FDA, requesting additional data with respect to our orphan drug designation application. We plan to meet with the FDA and are working to provide the Agency with the data requested to support orphan drug designation of RAD1901.

        We are also developing RAD1901 at lower doses as a SERM, for the potential treatment of vasomotor symptoms. Historically, hormone replacement therapy, or HRT, with estrogen or progesterone has been considered the most efficacious approach to relieving menopausal symptoms such as hot flashes. However, because of the concerns about the potential long-term risks and contraindications associated with HRT, we believe a significant need exists for new therapeutic treatment options to treat vasomotor symptoms. In a Phase 2 proof of concept study, RAD1901 at lower doses showed a reduction in the frequency and severity of moderate and severe hot flashes. We intend to commence a Phase 2b trial in vasomotor symptoms in the second half of 2015.

        Additional information regarding our clinical trials, their designs and the results of previously completed clinical trials is described in the section entitled "—Our Investigational Product Candidates." The U.S. National Institutes of Health also provides a database of human clinical trials, which can be found at www.clinicaltrials.gov. The information contained in, or that can be accessed through, this website is not part of, and is not incorporated into, this annual report.

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Our Opportunity

Osteoporosis

        Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, which leads to greater fragility and an increase in fracture risk. All bones become more fragile and susceptible to fracture as the disease progresses. People tend to be unaware that their bones are getting weaker, and a person with osteoporosis can fracture a bone from even a minor fall. The debilitating effects of osteoporosis have substantial costs. Loss of mobility, admission to nursing homes and dependence on caregivers are all common consequences of osteoporosis. The prevalence of osteoporosis is growing and, according to the National Osteoporosis Foundation, or NOF, is significantly under-recognized and under-treated in the population. While the aging of the population is a primary driver of an increase in cases, osteoporosis is also increasing from the use of drugs that induce bone loss, such as chronic use of glucocorticoids and aromatase inhibitors that are increasingly used for breast cancer and the hormone therapies used for prostate cancer.

        The NOF has estimated that 10 million people in the United States, composed of eight million women and two million men, already have osteoporosis, and another approximately 43 million have low bone mass placing them at increased risk for osteoporosis. In addition, the NOF has estimated that osteoporosis is responsible for more than two million fractures in the United States each year resulting in an estimated $19 billion in costs annually. The NOF expects that the number of fractures in the United States due to osteoporosis will rise to three million by 2025, resulting in an estimated $25.3 billion in costs each year. Worldwide, osteoporosis affects an estimated 200 million women according to the International Osteoporosis Foundation, or IOF, and causes more than 8.9 million fractures annually, which is equivalent to an osteoporotic fracture occurring approximately every three seconds. The IOF has estimated that 1.6 million hip fractures occur worldwide each year, and by 2050 this number could reach between 4.5 million and 6.3 million. The IOF estimates that in Europe alone, the annual cost of osteoporotic fractures could surpass €76 billion by 2050.

        There are two main types of osteoporosis drugs currently available in the United States, anti-resorptive agents and anabolic agents. Anti-resorptive agents act to prevent further bone loss by inhibiting the breakdown of bone, whereas anabolic agents stimulate bone formation to build new, high-quality bone. According to industry sources, sales of these drugs in the United States, Japan and the five major markets in Europe exceeded $6 billion in 2011. We believe there is a large unmet need in the market for osteoporosis treatment because existing therapies have been reported to have shortcomings in efficacy, tolerability and convenience. For example, one current standard of care, bisphosphonates, which are anti-resorptive agents, has been associated with infrequent but serious adverse events, such as osteonecrosis of the jaw and atypical fractures, especially of long bones. These side effects, although uncommon, reportedly have created increasing concern with physicians and patients. Many physicians are seeking alternatives to bisphosphonates. The two primary alternatives to bisphosphonates that are approved for the treatment of osteoporosis, Lilly's Forteo and Amgen's Prolia, had reported sales of approximately $1.3 billion and $1.0 billion, respectively, in 2014. Forteo, a 34 amino acid recombinant peptide of human parathyroid hormone, is the only anabolic drug approved in the United States for the treatment of osteoporosis. We believe there is a significant opportunity for an anabolic agent that has the potential to increase BMD to a greater degree and at a faster rate than other approved drugs for the treatment of osteoporosis with potential added advantages in convenience and safety.

    Our Investigational Drug—Abaloparatide

        Abaloparatide is a novel synthetic peptide analog of parathyroid hormone-related protein, or PTHrP, that we are developing as a bone anabolic treatment for potential use in the reduction of fractures in postmenopausal osteoporosis. PTHrP, unlike parathyroid hormone, or PTH, is critical in

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the formation of the skeleton, is involved in the regulation of bone formation and is able to rebuild bone with low associated risk of inducing the presence of too much calcium in the blood, known as hypercalcemia, as a side effect. We believe that abaloparatide is the most advanced PTHrP analog in clinical development for the treatment of osteoporosis and that, subject to regulatory review and approval, it could have the potential to provide the following advantages over other current standard of care treatments for osteoporosis:

    improved efficacy—greater bone build at hip and spine;

    faster benefit for building bone;

    shorter treatment duration; and

    less hypercalcemia.

        Abaloparatide-TD.     Abaloparatide-TD is a convenient, short-wear-time transdermal patch formulation of abaloparatide with Phase 2 clinical results suggesting efficacy, safety and tolerability in the treatment of osteoporosis. We believe that by offering an alternative to daily injections, abaloparatide-TD, if successfully developed and approved, could have the potential to further improve patient outcomes by increasing patient acceptance.

        During 2014, we made progress towards the development of an optimized, short-wear-time transdermal patch that may be capable of demonstrating comparability to abaloparatide-SC injection. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving comparability to abaloparatide-SC. If our clinical trials of abaloparatide-SC and abaloparatide-TD are successful, we expect to seek marketing approval of abaloparatide-TD as a line extension of abaloparatide-SC. The FDA approval of abaloparatide-TD, and the timing of any such approval, is dependent upon the approval of abaloparatide-SC.

Breast Cancer

        According to the World Health Organization, breast cancer is the second most common cancer in the world and the most prevalent cancer in women, accounting for 16% of all female cancers. The major cause of death from breast cancer is metastases, most commonly to the bone, liver, lung and brain. About 5% of patients have distant metastases at the time of diagnoses, and these patients have a five-year survival rate of only 25%, compared with a greater than 99% survival rate for patients with only local disease. Importantly, even patients without metastases at diagnosis are at risk for developing metastases over time.

        Approximately 70% of breast cancers express the ER and depend on estrogen signaling for growth and survival. There are three main classes of therapies for ER-positive tumors available: aromatase inhibitors, or AIs; SERMs; and SERDs. AIs, which block the generation of estrogen, and SERMs, which selectively inhibit an ER's ability to bind estrogen, both block ER-dependent signaling but leave functional ERs present on breast cancer cells. For this reason, although these classes of drugs are effective as adjuvants for breast cancer, patients' tumors often acquire resistance to them by developing the ability to signal through the ER in a ligand-independent manner. SERDs, in contrast, are an emerging class of endocrine therapies that directly induce ER degradation. Therefore, these agents should have the potential to be able to treat ER-dependent tumors without allowing ligand-independent resistance to develop, and to act on AI- and SERM-resistant ER-positive tumors.

        There is currently only one SERD approved for the treatment of ER-positive metastatic breast cancer, but there are no approved targeted therapies that cross the blood-brain barrier and can treat patients with ER-positive breast cancer brain metastases. We believe a significant opportunity exists for a SERD that can more effectively treat ER-positive metastatic breast cancer, as well as cross the blood-brain barrier, and potentially reduce both intracranial and extracranial metastatic breast cancer tumors.

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    Our Investigational Drug—RAD1901

        We are developing RAD1901 as a high-dose SERD in an oral formulation in Phase 1 clinical development for the potential treatment of metastatic breast cancer. RAD1901 has been shown to bind with good selectivity to the estrogen hormone receptor and to have both estrogen-like and estrogen-antagonist effects in different tissues. In cell culture, RAD1901 inhibits the proliferation of breast cancer cells, and antagonizes the stimulating effects of estrogen on cell proliferation. Furthermore, in breast cancer cell lines a dose dependent degradation of ER, has been observed. In a preclinical model of breast cancer in which human breast cancer cells are implanted in mice and allowed to establish tumors in response to estrogen treatment, we have shown that treatment with RAD1901 results in marked regression of estrogen stimulated tumor growth. In healthy volunteers, FES-PET imaging of RAD1901 has shown suppression of the FES-PET signal to background levels after six days of dosing.

        Studies with RAD1901 have established the pharmacokinetic profile, including demonstration of good oral bioavailability and the ability of RAD1901 to cross the blood-brain barrier. We believe that, subject to successful development, regulatory review and approval, RAD1901 could have the potential to offer the following advantages over other current standard of care treatments for ER-positive metastatic breast cancer:

    ability to suppress estrogen receptor turnover;

    favorable tolerability profile;

    ability to penetrate the blood-brain barrier;

    oral administration; and

    treatment of hormone-resistant breast cancers.

        In December 2014, we commenced a Phase 1 clinical trial of RAD1901 in the United States for the treatment of metastatic breast cancer. We expect to report progress on this study in the first half of 2015 and to initiate additional Phase 1 clinical trials in the European Union in 2015. In June 2014, we received a request from the FDA for additional data with respect to our March 2014 orphan drug designation application for RAD1901. We plan to meet with the FDA and are working to provide the Agency with the data requested to support designation of RAD1901 as an orphan drug.

    Our Investigational Drug—RAD140

        RAD140 is a nonsteroidal selective androgen receptor modulator, or SARM, that resulted from an internal drug discovery program focused on the androgen receptor pathway which is highly expressed in many breast cancers. Due to its receptor and tissue selectivity, potent oral activity and long duration half-life, RAD140 could have clinical potential in the treatment of breast cancer.

Vasomotor symptoms

        Vasomotor symptoms, such as hot flashes and night sweats, are common during menopause, with up to 85% of women experiencing them during the menopause transition, for a median duration of four years. In 2010, approximately 11.5 million women in the United States were in the 45 to 49 year age range upon entering perimenopause/menopause. In addition, most women receiving systemic therapy for breast cancer suffer hot flashes, often with more severe or prolonged symptoms than women experiencing natural menopause. These symptoms can disrupt sleep and interfere with quality of life. An estimated two million women go through menopause every year in the United States, with a total population of 50 million postmenopausal women.

        Historically HRT with estrogen and/or progesterone has been considered the most efficacious approach to relieving menopausal symptoms such as hot flashes. However, data from the Women's

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Health Initiative, or WHI, identified increased risks for malignancy and cardiovascular disease associated with estrogen therapy. Sales of HRT declined substantially after the release of the initial WHI data, but HRT remains the current standard of care for many women suffering from hot flashes. However, due to concerns about the potential long-term risks and contraindications associated with HRT, we believe that there is a significant need for new therapeutic options to treat vasomotor symptoms.

    Our Investigational Drug—RAD1901

        We are developing RAD1901 as a low-dose SERM in an oral formulation for the treatment of vasomotor symptoms. The results of our Phase 2 proof of concept study in healthy perimenopausal women showed that RAD1901 at low doses achieved a statistically significant reduction in the frequency of moderate and severe hot flashes both by linear trend test and by comparison to placebo and in overall hot flashes.

        We intend to commence a Phase 2b study during the second half of 2015 in perimenopausal women experiencing a high frequency of hot flashes at baseline.

Our Strategy

        Our goal is to become a leading provider of therapeutics for osteoporosis and other serious endocrine-mediated diseases. To achieve this goal we plan to:

    Advance the development and obtain regulatory approval of abaloparatide-SC.   We have completed a Phase 3 clinical trial of abaloparatide-SC and are preparing for the completion of the first six months of an extension trial for its potential use in the reduction of fractures in postmenopausal osteoporosis. We plan to submit an NDA for abaloparatide-SC in the United States, and an MAA in the European Union, during the second half of 2015.

    Advance the development of RAD1901 for the treatment of metastatic breast cancer and vasomotor symptoms.   We have commenced a Phase 1 MTD study of RAD1901 in healthy volunteers and a Phase 1 study in patients with metastatic breast cancer. We expect to report progress on the study in patients with metastatic breast cancer in the first half of 2015 and to initiate additional Phase 1 clinical trials in the European Union in 2015.

      In addition, we plan to commence a Phase 2b study of RAD1901 for the treatment of vasomotor symptoms during the second half of 2015.

    Extend the lifecycle of abaloparatide through the continued development of abaloparatide-TD.   We are developing abaloparatide-TD as a short-wear-time transdermal patch and we anticipate, pending successful development and a favorable regulatory outcome, commercial launch two to three years after the approval and first commercial sale of abaloparatide-SC. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving pharmacokinetic equivalence to abaloparatide-SC. If abaloparatide-SC is approved by the FDA, we believe that we will only need to conduct either a pharmacokinetic equivalence or a single non-inferiority Phase 3 clinical trial comparing the change in BMD for patients dosed with abaloparatide-TD as compared to patients dosed with abaloparatide-SC. If our clinical trials of abaloparatide-SC and abaloparatide-TD are successful, we expect to seek marketing approval of abaloparatide-TD as a line extension of abaloparatide-SC.

    Establish internal sales and marketing capabilities to commercialize our product candidates in the United States.   We currently plan to commercialize any of our product candidates that are approved by developing an internal sales force focused within the targeted indications on specialists in core strategic markets in the United States. We believe that we can effectively

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      target those markets using a sales force of approximately 150 representatives and that by doing so we can achieve a greater return on our product investment than if we license our products to third parties for sale. We plan to expand the use of our products within the targeted indications to primary care physicians through selective co-promotion partnerships. Our management team has experience commercializing products in these core strategic markets, and understands the relevant sales, marketing and reimbursement requirements.

    Selectively pursue collaborations to commercialize our product candidates outside the United States.   We intend to seek to enter into one or more collaborations for the commercialization of our approved product candidates in strategic markets in Europe and in other countries worldwide.

    Continue to expand our product portfolio.   We plan to leverage our drug development expertise to discover and develop additional investigational product candidates focused on serious endocrine-related diseases and conditions. We may also consider opportunistically expanding our product portfolio through in-licensing, acquisitions or partnerships.

Our Investigational Product Candidates

        The following table identifies the investigational product candidates in our current product portfolio, their proposed indication and stage of development:

GRAPHIC

Abaloparatide

Overview

        Abaloparatide is a novel synthetic PTHrP that we are developing as a bone anabolic treatment for potential use in the reduction of fractures in postmenopausal osteoporosis. PTHrP, unlike PTH, is critical in the formation of the skeleton, is involved in the regulation of bone formation and is able to rebuild bone with low associated risk of inducing hypercalcemia as a side effect. Human PTHrP (a protein of 139 to 173 amino acids) is different from PTH (a protein of 84 amino acids) in its structure

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and role. In 2009, the medical journal, Nature Chemical Biology, published the results of a study indicating that PTH (which primarily regulates calcium homeostasis and bone resorption) and PTHrP activate the same parathyroid hormone receptor, or PTHR1, but produce divergent effects in bone due to differences in receptor conformation selectivity, receptor localization and downstream cell signaling. Forteo is a 34 amino acid recombinant peptide of PTH. We believe that abaloparatide is the most advanced PTHrP analog in clinical development for the treatment of osteoporosis. We acquired and maintain exclusive worldwide rights, excluding Japan, to certain patents, data and technical information related to abaloparatide through a license agreement with an affiliate of Ipsen Pharma SAS, or Ipsen.

        We are developing abaloparatide for potential use in reduction of fractures in postmenopausal osteoporosis. Recognizing both the therapeutic potential of abaloparatide in this indication as well as the drawbacks inherent in self-injection therapies in this population, we are also developing abaloparatide-TD for transdermal administration of the product using a microneedle technology from 3M. We plan to develop and register abaloparatide-SC as our lead product, with abaloparatide-TD as a line extension that provides greater patient convenience. We believe the ability of abaloparatide-TD to capitalize on the more extensive fracture study data of abaloparatide-SC will allow the patch product to be accelerated through later-phase development without requiring its own fracture study. We also believe that, subject to further research and development, abaloparatide may have potential applications across a variety of skeletal or bone related diseases or medical conditions.

Abaloparatide-SC

        We are developing abaloparatide-SC as a once daily subcutaneous injection of abaloparatide for potential use in the reduction of fractures in postmenopausal osteoporosis. In April 2011, we commenced a Phase 3 clinical trial of abaloparatide-SC, which completed enrollment in March 2013 with 2,463 subjects. The trial was designed to enroll 2,400 subjects that would be randomized equally to receive daily doses of one of the following: 80 µg of abaloparatide, a matching placebo, or the approved dose of 20 µg of Forteo for 18 months. The trial was designed to test our belief that abaloparatide is superior to placebo for prevention of vertebral fracture and to open-label Forteo for greater BMD improvement at major skeletal sites and for a lower occurrence of hypercalcemia. We also believed that the trial would show that BMD gains for abaloparatide patients occur earlier than for open-label Forteo patients. On December 21, 2014, we announced positive top-line data from the ACTIVE trial, evaluating the investigational drug abaloparatide-SC for potential use in the reduction of fractures in postmenopausal osteoporosis. On the primary endpoint, abaloparatide-SC (n=690, fracture rate 0.72%) achieved a statistically significant 83% reduction of incident vertebral fractures (defined as new and worsening vertebral fractures) as compared to the placebo-treated group (n=711, fracture rate 4.36%) (p<0.0001). The ACTIVE trial included an open-label teriparatide [rDNA origin] injection treatment group (n=717, fracture rate 0.98%) that showed a statistically significant 78% reduction of incident vertebral fractures as compared to the placebo-treated group (p<0.0001). On the secondary endpoints, as compared to placebo, abaloparatide-SC achieved: a statistically significant fracture-rate reduction of 43% in the adjudicated non-vertebral fracture subset of patients; a statistically significant reduction of 45% in the adjudicated clinical fracture group, which includes both vertebral and non-vertebral fractures; and a statistically significant difference in the time to first incident of nonvertebral fracture in both the adjudicated non-vertebral fracture (p=0.0489) and the clinical fracture subset of patients (p=0.0112). The open-label teriparatide injection treatment group, as compared to placebo, achieved a fracture-rate reduction of 28% in the adjudicated non-vertebral fracture subset of patients and a reduction of 29% in the adjudicated clinical fracture group; these differences were not statistically significantly different as compared to the placebo group. The fracture-rate reduction observed in the abaloparatide-SC treatment group, as compared to open-label teriparatide, was not statistically significant.

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        In January 2015, the FDA provided us with comments on the draft SAP that was used for the analysis of the top-line data from the Phase 3 ACTIVE clinical trial. In its correspondence, the FDA recommended that the primary endpoint of incident vertebral fracture reduction be performed excluding worsening vertebral fractures and including only new vertebral fractures. Using the FDA-recommended analysis, on the primary endpoint of reduction of new vertebral fractures (excluding worsening), abaloparatide-SC (n=690, fracture rate 0.58%) achieved a statistically significant 86% reduction as compared to the placebo-treated group (n=711, fracture rate 4.22%) (p<0.0001). The open-label teriparatide injection treatment group (n=717, fracture rate 0.84%) showed a statistically significant 80% reduction of new vertebral fractures (excluding worsening) as compared to the placebo-treated group (p<0.0001). The FDA also recommended, for the secondary endpoint of non-vertebral fractures, that our definition was generally acceptable provided that sternal (breast bone) and patellar (knee cap) fractures were excluded. In the previously announced top-line data for the secondary endpoint of non-vertebral fracture reduction noted above, we had excluded sternum and patella fractures, and abaloparatide-SC (n=824, Kaplan-Meier estimated, or KM, fracture rate 2.7%) achieved a statistically significant reduction compared to the placebo-treated group (n=821, KM fracture rate 4.7%), and the hazard ratio for abaloparatide vs. placebo was 0.57 (p=0.0489); the open label teriparatide injection treatment group (n=818, KM fracture rate 3.3%) had a hazard ratio of 0.72 (p=NS) compared to the placebo-treated group. The FDA also recommended, for the secondary endpoint of BMD that we use an ANCOVA approach with the last observation carried forward for missing data. The MMRM method, which was used in the BMD secondary endpoint in the top-line data announced in December 2014, is to be applied for sensitivity analysis.

        We have also completed two Phase 2 clinical trials of abaloparatide-SC. We announced results from our first Phase 2 clinical trial in August 2009, which showed that Abaloparatide-SC produced faster and greater BMD increases at the spine and the hip with substantially less hypercalcemia than Forteo. Specifically, our study showed that total hip BMD showed a more than five-fold benefit with abaloparatide-SC at a dose of 80 µg over Forteo after 24 weeks. Abaloparatide-SC at 80 µg increased mean lumbar spine BMD by 6.7% at 24 weeks, compared to 5.5% with Forteo, and by 12.9% at 48 weeks, compared to 8.6% with Forteo. In January 2014, we reported positive data from a second Phase 2 clinical trial of abaloparatide. Consistent with our Phase 2 clinical trial of abaloparatide-SC completed in 2009, our second clinical trial showed that patients who received an 80 µg dose of abaloparatide-SC experienced increases in BMD from baseline in the lumbar spine (5.8% increase from baseline) and total hip (2.7% increase from baseline). In addition to the BMD results, these study results add to the safety data from the prior Phase 2 clinical study with abaloparatide-SC, which showed that abaloparatide is generally safe and well tolerated.

        In 2012 we participated in a Type A meeting with the Division of Reproductive and Urologic Products of the FDA and discussed the abaloparatide-SC single pivotal placebo-controlled, comparative Phase 3 fracture study. The FDA indicated that it wanted us to provide additional feedback on the design of our ongoing Phase 3 clinical trial so that the data would be adequate for submission of an NDA for the treatment of osteoporosis. Following this meeting, we amended our protocol to incorporate changes in response to our discussions with the FDA, which included the addition of data from the first six months of an extension study during which patients receive an approved alendronate therapy in order to obtain 24-month fracture data. The FDA determination of the approvability of any NDA is made based on their independent assessment of the totality of the data submitted. Based on our discussions with the FDA, we believe that a successful, single pivotal placebo-controlled, comparative Phase 3 fracture study will be sufficient to support approval of abaloparatide-SC for the reduction of fracture risk in postmenopausal women with severe osteoporosis in the United States. We believe that the use of a single pivotal placebo-controlled comparative Phase 3 fracture study is consistent with the approach taken with Forteo and Prolia, which were each approved by the FDA for the treatment of osteoporosis in the United States on the basis of a single pivotal placebo-controlled Phase 3 fracture study. We plan to submit the NDA with the 24-month fracture data. We will remain

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blinded at the patient and site level until such time as the first six months of the extension study is completed.

        On May 9, 2014, we submitted a request for breakthrough therapy designation request to the FDA for abaloparatide-SC for the treatment of postmenopausal osteoporosis. In July 2014, the FDA denied our request and indicated that, upon a new request, abaloparatide-SC would be considered for a breakthrough therapy designation if new clinical evidence demonstrates that patients dosed with abaloparatide-SC show substantial improvement in treatment of postmenopausal osteoporosis over existing therapies on one or more clinically significant endpoints. We believe that the recently completed analyses of the 18-month top-line results of our Phase 3 clinical trial and two abaloparatide Phase 2 clinical trials have shown potentially important clinical benefits relative to placebo and current anabolic therapies, including significant improvements in reducing the risk of osteoporotic fractures and in calcemic control. We believe these results could support a breakthrough therapy designation. Once we have evaluated the 24-month results from the Phase 3 clinical trial and the first six months of the extension study, we expect to make a decision as to whether to re-submit our request for breakthrough designation with a focus on the areas highlighted by the FDA or to apply for one of the other FDA expedited programs for new drugs that address unmet medical needs in the treatment of serious or life threatening conditions.

        We understand that Phase 3 clinical trials with similar size, design and endpoints as our Phase 3 clinical trial have been sufficient to support registration with the EMA for other bone anabolic drugs used to treat women with osteoporosis in the European Union, or the EU. In December 2012, we met with the Swedish Medical Products Agency, or the MPA, to review the design and the overall progress of the Phase 3 clinical trial. The MPA confirmed that the program, based on the current single pivotal trial design, could support the submission and potential approval of an MAA in the EU, depending on the results of the Phase 3 clinical trial.

Abaloparatide-TD

        We are developing abaloparatide-TD as a line extension of abaloparatide-SC in a short-wear-time transdermal patch formulation. In January 2014, we reported positive data from our Phase 2 clinical trial of abaloparatide-TD. The results showed that for each abaloparatide-TD dose there was a statistically significant mean percent increase from baseline in BMD at the lumbar spine, as compared to placebo. For the 100 µg and 150 µg abaloparatide-TD doses, there was also a statistically significant mean percent increase from baseline in BMD at the hip, as compared to placebo. The highest abaloparatide-TD dose of 150 µg produced increases in BMD from baseline in the lumbar spine and total hip of +2.9% and +1.5%, respectively, compared to changes in the placebo group of +0.04% and –0.02%, respectively. In addition, there was a consistent dose effect seen with increasing doses of abaloparatide-TD, with a statistically significant dosing trend seen for changes in both spine and total hip BMD. Further, the overall tolerability and safety profile was acceptable; there were no clinically significant signs of anti-abaloparatide antibodies; and patient ratings of patch adhesion and local skin response to the transdermal patch technology were also acceptable.

        In order to further enhance BMD efficacy, we currently plan to modify the pharmacokinetic profile of abaloparatide-TD to more closely resemble that of abaloparatide-SC. On December 21, 2014, we reported progress towards the development of an optimized, short-wear-time transdermal patch that may be capable of demonstrating comparability to abaloparatide-SC injection. In preliminary, nonhuman primate pharmacokinetic studies, prototype A7 achieved a desirable pharmacokinetic profile, with comparable AUC, Cmax, Tmax and T1/2 relative to abaloparatide-SC. We believe that these results support continued clinical development toward future global regulatory submissions as a potential post-approval line extension of the investigational drug abaloparatide-SC. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving comparability to abaloparatide-SC. If abaloparatide-SC is already approved by the

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FDA, we believe that we will only need to conduct either a pharmacokinetic equivalence or a single non-inferiority Phase 3 clinical trial comparing the change in lumbar spine BMD at 12 months for patients dosed with abaloparatide-TD to patients dosed with abaloparatide-SC to confirm that the effect of abaloparatide-TD treatment is comparable to that of abaloparatide-SC. If our clinical trials of abaloparatide-SC and abaloparatide-TD are successful, we expect to seek marketing approval of abaloparatide-TD as a line extension of abaloparatide-SC. The FDA's approval of abaloparatide-TD, and the timing of any such approval, is dependent upon the approval of abaloparatide-SC.

Clinical Development

Pivotal Phase 3 Clinical Trial of Abaloparatide-SC

        In April 2011, we commenced our Phase 3 trial, which completed enrollment in March 2013. The trial completed enrollment with 2,463 patients at 28 medical centers in 10 countries in the United States, Europe, Latin America and Asia. Patients in the trial were randomized equally to receive daily doses of one of the following for 18 months: 80 µg of abaloparatide; a matching placebo or the approved dose of 20 µg of Forteo.

        On February 15, 2012, we received a letter from the FDA stating that, after internal consideration, the Agency believes that a minimum of 24-month fracture data are necessary for approval of new products for the treatment of postmenopausal osteoporosis. Our ongoing abaloparatide-SC pivotal Phase 3 clinical trial is designed to produce fracture data based on an 18-month primary endpoint. The FDA's letter solicited a meeting to review the status of our Phase 3 clinical trial and discuss options for fulfilling the FDA's new request for 24-month fracture data in the context of the ongoing Phase 3 study. We subsequently met with the FDA on March 21, 2012 to discuss satisfying the 24-month data request while preserving the current 18- month primary endpoint. Based upon our discussion with the FDA, we believe that continued use of the 18-month primary endpoint will be acceptable, provided that our NDA includes the 24-month fracture data derived from a 6-month extension of the abaloparatide 80 µg and placebo groups in our Phase 3 study that will receive an approved alendronate (generic Fosamax) therapy for osteoporosis management. We intend to submit the NDA with the 24-month fracture data.

        Study population —The Phase 3 study enrolled otherwise healthy ambulatory women aged 50 to 85 (inclusive) who had been postmenopausal for at least five years, met the study entry criteria and had provided written informed consent. Osteoporosis is defined as when a patient's t-score is less than or equal to –2.5, meaning that the patient has a BMD that is two and one-half standard deviations below the mean BMD of an ethnically matched 30-year-old man or woman, as applicable. The women enrolled in the study have a BMD t- score £ –2.5 and >–5.0 at the lumbar spine or hip (femoral neck) as measured by dual energy x-ray absorptiometry, or DXA, and radiological evidence of two or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral or tibial fracture within the past five years. Postmenopausal women older than 65 who met the above fracture criteria but had a t-score of £ –2.0 and >–5.0 could also be enrolled. Women older than 65 who did not meet the fracture criteria could also be enrolled if their t- score was £ –3.0 and >–5.0. All patients were to be in good general health as determined by medical history, physical examination (including vital signs), and clinical laboratory testing. We believe this study population contains a patient population reflective of the type of severe osteoporosis patients that specialists will treat in their practices.

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Study design

GRAPHIC

        The 2,463 eligible patients were randomized equally to receive one of the following for 18 months:

    abaloparatide at a dose of 80 µg;

    a matching placebo; or

    Forteo at a dose of 20 µg.

        The study drug was blinded to patients and medical personnel until the randomization process was completed. Treatment with abaloparatide at a dose of 80 µg or placebo will remain blinded to all parties throughout the study. Forteo comes as a proprietary prefilled drug and device combination that cannot be repackaged. Therefore, its identity cannot be blinded to treating physicians and patients once use begins. Study medication is self-administered daily by subcutaneous injection for a maximum of 18 months. All enrolled patients also receive calcium and vitamin D supplementation from the time of enrollment until the end of the treatment period. It is recommended to patients that they also continue these supplements through the one month follow-up period.

        Primary efficacy endpoints —The primary efficacy endpoint is the number of patients treated with abaloparatide-SC that show new vertebral fractures at end-of-treatment when compared to placebo as evaluated by a blinded assessor according to a standardized graded scale of severity of the vertebral deformity. The sample size per treatment arm provides 90% power at a two-sided alpha to detect a superiority difference on vertebral fracture incidence between placebo patients and those who receive abaloparatide-SC at a dose of 80 µg.

        Secondary efficacy endpoints —Secondary efficacy parameters include reduction in the incidence of non-vertebral fractures to the wrist, hip and rib, for example, and reduction in moderate and severe vertebral fractures from baseline to end-of-treatment. Other secondary efficacy endpoints include changes in BMD of the spine, hip, femoral neck and wrist from baseline to end-of-treatment as assessed by DXA and as compared to Forteo, as well as the number of hypercalcemic events in abaloparatide-SC treated patients when compared to Forteo at end-of-treatment.

        Additional secondary endpoints include change in standing height and changes in serum bone formation markers across treatment, such as P1NP, osteocalcin and bone-specific alkaline phosphatase.

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    Extension study design.

        Each of the abaloparatide 80 µg and placebo groups in our Phase 3 study are eligible to continue in an extension study and will receive an approved alendronate (generic Fosamax) therapy for osteoporosis management. A key endpoint of the extension study is the reduction in new vertebral fractures at up to 24 months in all randomized patients, including abaloparatide-treated and placebo-treated patients who are treated with alendronate at the end of treatment.

GRAPHIC

        Safety outcomes —Safety evaluations performed include physical examinations, vital signs, 12-lead electrocardiograms, or ECGs, clinical laboratory tests and monitoring and recording of adverse events. Specific safety assessments include post-dose (four hours) determination of serum calcium, determination of creatinine clearance, post-dose ECG assessments at selected visits and assessments of postural hypotension (60 minutes post-dose) at selected clinic visits.

        Bone biopsy of the iliac crest were performed in a subset of patients receiving abaloparatide at a dose of 80 µg and placebo for assessment of bone quality and quantitative bone histomorphometry which is the quantitative study of the microscopic organization and structure of the bone tissue, and will be read blinded to treatment by an independent blinded assessor. Renal safety was further evaluated in a subset of approximately 100 patients in each treatment group by renal computed tomography, or CT, scan.

        Overall study safety is being monitored by an independent Data and Safety Monitoring Board.

        On December 21, 2014, we announced positive top-line data from the ACTIVE trial, evaluating the investigational drug abaloparatide-SC for potential use in the reduction of fractures in postmenopausal osteoporosis. On the primary endpoint, abaloparatide-SC (n=690, fracture rate 0.72%) achieved a statistically significant 83% reduction of incident vertebral fractures (defined as new and worsening vertebral fractures) as compared to the placebo-treated group (n=711, fracture rate 4.36%) (p<0.0001). The ACTIVE trial included an open-label teriparatide [rDNA origin] injection treatment group (n=717, fracture rate 0.98%) that showed a statistically significant 78% reduction of incident vertebral fractures as compared to the placebo-treated group (p<0.0001). On the secondary endpoints, as compared to placebo, abaloparatide-SC achieved: a statistically significant fracture-rate reduction of 43% in the adjudicated non-vertebral fracture subset of patients; a statistically significant reduction of 45% in the adjudicated clinical fracture group, which includes both vertebral and non-vertebral fractures; and a statistically significant difference in the time to first incident of nonvertebral fracture in both the adjudicated non-vertebral fracture (p=0.0489) and the clinical fracture subset of patients (p=0.0112). The open-label teriparatide injection treatment group, as compared to placebo, achieved a fracture-rate reduction of 28% in the adjudicated non-vertebral fracture subset of patients and a reduction of 29% in the adjudicated clinical fracture group; these differences were not statistically significantly different as compared to the placebo group. The fracture-rate reduction observed in the

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abaloparatide-SC treatment group, as compared to open-label teriparatide, was not statistically significant.

        In January 2015, the FDA provided us with comments on the draft SAP that was used for the analysis of the top-line data from the Phase 3 clinical trial. In its correspondence, the FDA recommended that the primary endpoint of incident vertebral fracture reduction be performed excluding worsening vertebral fractures and including only new vertebral fractures. Using the FDA-recommended analysis, on the primary endpoint of reduction of new vertebral fractures (excluding worsening), abaloparatide-SC (n=690, fracture rate 0.58%) achieved a statistically significant 86% reduction as compared to the placebo-treated group (n=711, fracture rate 4.22%) (p<0.0001). The open-label teriparatide injection treatment group (n=717, fracture rate 0.84%) showed a statistically significant 80% reduction of new vertebral fractures (excluding worsening) as compared to the placebo-treated group (p<0.0001). The FDA also recommended, for the secondary endpoint of non-vertebral fractures, that our definition was generally acceptable provided that sternal (breast bone) and patellar (knee cap) fractures were excluded. In the original top-line data announced for the secondary endpoint of non-vertebral fracture reduction noted above, we had excluded sternum and patella fractures, and abaloparatide-SC (n=824, Kaplan-Meier estimated, or KM, fracture rate 2.7%) achieved a statistically significant reduction compared to the placebo-treated group (n=821, KM fracture rate 4.7%), and the hazard ratio for abaloparatide vs. placebo was 0.57 (p=0.0489); the open label teriparatide injection treatment group (n=818, KM fracture rate 3.3%) had a hazard ratio of 0.72 (p=NS) compared to the placebo-treated group. The FDA also recommended, for the secondary endpoint of BMD that we use an ANCOVA approach with the last observation carried forward for missing data. The MMRM method, which was used in the BMD secondary endpoint in the top-line data announced in December 2014, is to be applied for sensitivity analysis.

        The top-line results announced in December 2014 included the following results of comparative analyses of abaloparatide-SC versus teriparatide using the MMRM method on these BMD secondary endpoints:


Mean Percent Change In Bone Mineral Density (BMD) From Baseline (MMRM approach)

 
  Lumbar Spine   Total Hip   Femoral Neck  
 
  6 mo   12 mo   18 mo   6 mo   12 mo   18 mo   6 mo   12 mo   18 mo  

Placebo

    0.60 %   0.45 %   0.63 %   0.31 %   0.09 %   –0.10 %   –0.13 %   –0.41 %   –0.43 %

abaloparatide-SC

    6.58% **   9.77% **   11.20% *   2.32% **   3.41% **   4.18% **   1.72% **   2.65% **   3.60% **

teriparatide

    5.25% *   8.28% *   10.49% *   1.44% *   2.29% *   3.26% *   0.87% *   1.54% *   2.66% *

** p<0.0001 vs. placebo and teriparatide

* p<0.0001 vs. placebo

        Applying the ANCOVA approach with the last observation carried forward that the FDA recommended in its January 8, 2015 correspondence results in the following comparative analysis of the BMD secondary endpoints:

        Mean Percent Change In Bone Mineral Density (BMD) From Baseline (ANCOVA approach)

 
  Lumbar Spine   Total Hip   Femoral Neck  
 
  6 mo   12 mo   18 mo   6 mo   12 mo   18 mo   6 mo   12 mo   18 mo  

Placebo

    0.55 %   0.39 %   0.48 %   0.29 %   0.10 %   –0.08 %   –0.12 %   –0.37 %   –0.44 %

abaloparatide-SC

    5.90% **   8.19% ***   9.20% *   2.07% **   2.87% **   3.44% ****   1.54% **   2.21% **   2.90% *****

Teriparatide

    4.84% *   7.40% *   9.12% *   1.33% *   2.03% *   2.81% *   0.80% *   1.41% *   2.26% *

* vs. placebo p<0.0001

** vs. teriparatide p<0.0001

*** vs. placebo p< 0.0001 and vs. teriparatide p=0.0087

**** vs. placebo p< 0.0001 and vs. teriparatide p=0.0003

***** vs. placebo p< 0.0001 and vs. teriparatide p=0.0016

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        The ACTIVE Trial also evaluated several potential safety measures, including blood calcium levels, orthostatic hypotension, nausea, dizziness and injection-site reactions. Among the most frequently reported adverse events, the following incidence rates were reported in the trial as part of the top-line 18-month results:

    back pain: placebo (n=820) (10.0%), abaloparatide (n=822) (8.6%), teriparatide (n=818) (7.2%)

    arthralgia: placebo (9.8%), abaloparatide (8.5%), teriparatide (8.6%)

    upper respiratory tract infection: placebo (8.9%), abaloparatide (9.0%), teriparatide (9.8%)

    hypercalciuria: placebo (8.9%), abaloparatide (10.9%), teriparatide (12.5%)

    dizziness: placebo (6.1%), abaloparatide (10.0%), teriparatide (7.3%)

        In December 2014, we reported hypercalcemia event rates using uncorrected serum calcium values of 1.2% for the placebo group (n=820), 6.0% for the abaloparatide-SC group (n=822) and 10.8% for the teriparatide group (n=818). The results for the primary analysis of the hypercalcemia event rate based on albumin corrected serum calcium are now available and are as follows: 0.37% for the placebo group (n=820), 3.41% for the abaloparatide-SC group (n=822) and 6.36% for the teriparatide group (n=818). Each of the abaloparatide group and teriparatide group had statistically significantly higher hypercalcemia event rates as compared to the placebo group, and the abaloparatide group had a statistically significant lower hypercalcemia event rate as compared to the teriparatide group (p=0.0055).

        As part of the top-line 18-month results of the ACTIVE trial, we reported the results for several exploratory endpoints. For clinical fractures, abaloparatide-SC (n=824, KM fracture rate 3.9%) statistically significantly reduced clinical fractures compared to placebo (n=821, KM fracture rate 8.3%) with a hazard ratio=0.55 (p=0.0112); teriparatide (n=818, KM fracture rate 4.8%) had a hazard ratio = 0.71 (p=NS) compared to the placebo treated group.

        For wrist fractures, abaloparatide-SC (n=824, KM fracture rate 0.5%) and teriparatide (n=818, KM fracture rate 2.0%) were not statistically significantly reduced compared to placebo (n=821, KM fracture rate 1.5%); wrist fractures were statistically significantly less for abaloparatide-SC than for the teriparatide treated group (p=0.0149).

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        The following table sets forth the Kaplan-Meier curve of time to first incident non-vertebral fractures by treatment group in the intent-to-treat population:


Kaplan Meier Curve of Time to First Incident Non-Vertebral Fractures (NVF) by Treatment Group
(ITT Population)

GRAPHIC

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        The following table sets forth the Kaplan-Meier curve of time to first incident clinical fractures by treatment group in the intent-to-treat population:


Kaplan Meier Curve of Time to First Incident Clinical Fracture by Treatment Group
(ITT Population)

GRAPHIC

        We anticipate the first results from the ACTIVExtend trial in the second quarter of 2015, and plan to submit a NDA to the FDA, and an MMA to the EMA, in the second half of 2015. The results from the ACTIVE trial and from the first six months of the ACTIVExtend trial, together with the entire data set from the abaloparatide development program, are subject to regulatory review. We hold worldwide commercialization rights to abaloparatide-SC, other than in Japan, and with a favorable regulatory outcome, we anticipate the first commercial sales of abaloparatide-SC will take place in 2016.

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    Abaloparatide-SC Phase 2 Clinical Trial

        We conducted a randomized, placebo-controlled, parallel group dose-finding Phase 2 study (Study BA058-05-002) in the United States, Argentina, India and the United Kingdom. A total of 270 patients (mean age: 65 years) entered the pretreatment period, 222 patients were randomized, and 221 patients received study treatment and were analyzed in the intent-to-treat, or ITT, population with 55 continuing into an additional 24 weeks of treatment. A total of 155 patients were included in the efficacy population (per protocol) in the initial 24 weeks of treatment. The purpose of the study was to evaluate the safety and efficacy of daily injections of abaloparatide-SC in women with osteoporosis. Postmenopausal women between the ages of 55 and 85 (inclusive) who had a BMD t-score £ –2.5 at the lumbar spine or hip (femoral neck) by DXA or a BMD t-score £ –2 and a prior low trauma fracture or an additional risk factor were candidates for this study. The study evaluated the effects of abaloparatide-SC at multiple doses (placebo, 20 m g, 40 m g and 80 m g) on recovery of BMD, a marker of fracture risk, and on biomarkers of anabolic and resorptive activity in bone. The study also included a Forteo treatment arm for reference. After the initial 24 weeks of treatment, eligible patients were offered a second 24 weeks of their assigned treatment. Safety was assessed throughout the study and reported on at both 24 weeks and 48 weeks. Abaloparatide-SC and placebo were self-administered using a prefilled cartridge in a pen-injector device. Forteo was self-administered as the marketed product at the approved dose of 20 µg per day by subcutaneous injection. Four weeks prior to start of treatment, patients began taking calcium and vitamin D supplements that continued throughout the study.

        Initial 24 weeks of treatment —The following tables depict the percent change in total BMD-spine and BMD-hip at 12 and 24 weeks for each of arm of the trial.

        In the ITT population, the mean percent change from baseline at week 12 in lumbar spine BMD (active treatment—placebo) for abaloparatide-SC 40 µg and 80 µg groups were statistically significant (p = 0.0013 and p < 0.001, respectively). The difference was not statistically significant in the abaloparatide-SC 20 µg group, in the placebo group or in the Forteo group (p = 0.055). At week 24, the mean percent change from baseline continued to increase and was statistically significantly proportional to dose (p < 0.001) as shown in Figure A below. Again, the mean gain in total spine BMD was statistically significant for abaloparatide-SC 40 µg (p < 0.001) and 80 µg (p < 0.001) groups. The mean BMD gain at week 24 was also statistically significant for the Forteo group (p < 0.001). The difference was not statistically significant in the abaloparatide-SC 20 µg group or in the placebo group. The response of lumbar spine BMD to abaloparatide-SC was dose dependent, and the 80 µg abaloparatide-SC dose produced a larger percentage increase in BMD at the lumbar spine than the approved 20 µg Forteo dose.

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Figure A—Mean Standard Error of the Mean (SEM) Percent Change from Baseline at weeks 12 and 24 in Total Spine BMD (ITT Population, N =221)

GRAPHIC

        An even greater proportional response in BMD was elicited in the hip region. By week 24, mean percent changes in total hip BMD were 0.4%, 1.4%, 2.0% and 2.6% for the placebo, abaloparatide at a dose of 20 µg, abaloparatide at a dose of 40 µg, and abaloparatide at a dose of 80 µg groups, respectively. Mean percent change in the Forteo (0.5%) group was similar to placebo as shown in Figure B below. The change in total hip BMD showed a dose response to abaloparatide-SC and a more than five-fold benefit of abaloparatide at a dose of 80 µg over Forteo. A similar relative benefit of abaloparatide at a dose of 80 µg over Forteo was seen in all regions of the hip.

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Figure B—Mean (SEM) Percent Change from Baseline at weeks 12 and 24 in Total Hip BMD (ITT Population, N=221)

GRAPHIC

        Abaloparatide-SC also induced a dose-dependent rise in major markers of bone anabolic activity, including P1NP, bone specific alkaline phosphatase, or BSAP, and osteocalcin. The response to Forteo was somewhat greater for anabolic markers and bone resorption markers (C-telopeptides of type I collagen crosslinks, or CTX, and N-telopeptides of type I collagen crosslinks, or NTX), consistent with published data, suggesting a close of the anabolic window and attenuation in the anabolic benefit of continued Forteo administration. While elevated over baseline, the abaloparatide-SC patient group maintained lower levels of resorption markers (CTX) throughout the study period as compared to Forteo. We believe abaloparatide may have the potential to demonstrate a lengthening of the anabolic window as compared to Forteo.

        Abaloparatide-SC was well tolerated at all doses and safety events were consistent with usual medical events in a study population of this age and gender. The safety profile was also similar to that of Forteo and there were no treatment-related serious adverse events, or SAE's. Adverse events were reported by 74% of patients in the first six months of treatment, with a similar incidence across all treatment groups. The majority of on-treatment events were mild-to-moderate in severity and there were no deaths reported. Treatment-related treatment-emergent adverse events were reported in approximately 30% of patients, with similar incidence across all treatment groups. Seven subjects discontinued due to adverse events: one in the abaloparatide 20 µg group, one in the abaloparatide 40 µg group, three in the abaloparatide 80 µg group and two in the Forteo group. Eight patients (four percent) experienced at least one SAE and the incidence of such events was similar across treatment groups. Five SAEs, unrelated to treatment, were reported in three patients. Local tolerance at the injection site was similar across treatment groups and fewer than 20% of subjects reported any symptoms, such as redness at the injection site across the many months of injections.

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        The level of calcium in the blood, known as serum calcium levels, were monitored throughout the study and clinically significant elevated levels (greater than or equal to 10.5 milligrams per deciliter, or mg/dL) were observed in 40% of the Forteo group while also observed in four percent, 12%, 19% and 18% of the placebo, and abaloparatide-SC 20 µg, 40 µg and 80 µg groups, respectively. Most elevations were noted at the four-hour post- injection time point.

        Blood pressure was assessed throughout the study for postural change. Postural changes in blood pressure (predetermined level of change in systolic or diastolic from lying to standing) were reported in seven patients, including 0%, 5%, 2%, 2% and 7% of patients in the placebo, abaloparatide-SC 20 µg, 40 µg, 80 µg and Forteo groups, respectively. Pre-dose postural changes in blood pressure were similar across treatment groups. There were no clinically meaningful differences in ECG parameters between the placebo and active treatment groups.

        Sixteen patients had low titer antibodies against abaloparatide after 24 weeks of treatment. Of these, five were in the abaloparatide 20 µg group, six were in the abaloparatide 40 µg group and five were in the abaloparatide 80 µg group. There were no associated safety events or attenuation of treatment efficacy. One antibody-positive patient in the abaloparatide-SC 40 µg group was found to have possible evidence of neutralizing activity using an in vitro assay at 24 weeks without evidence of attenuation of drug efficacy; the patient achieved a 9.3% gain in total spine BMD at the week 24 assessment.

        Extended 24 weeks of treatment —Patients who completed the initial 24 weeks of treatment and continued to meet eligibility criteria were offered participation in the 24-week extension study in which they would continue their assigned treatment. On completion of the regulatory process to approve the study extension, 69 patients remained eligible and 55 participated, including 13, 10, 7, 11 and 14 patients in abaloparatide-SC 20 m g, 40 m g, 80 m g, placebo and Forteo groups, respectively. Forty-eight patients completed the extended treatment period.

        BMD continued to increase during the extended 24 weeks of treatment, with the largest percent increases in total spine BMD, femoral neck BMD and total hip BMD observed in the abaloparatide-SC 80 µg group, as shown in Figure C below. By week 48, mean percent changes in spine BMD were 0.7%, 5.1%, 9.8% and 12.9% for the placebo and, abaloparatide-SC 20 µg, 40 µg and 80 µg groups, respectively, while mean percent change from baseline in the Forteo group was 8.6%. At week 48, the mean femoral neck BMD in the abaloparatide-SC 80 µg group gained 4.1% compared to the mean of the Forteo group at 2.2%. The total gain in hip BMD was 0.7%, 2.0%, 2.1% and 2.7% for the placebo and abaloparatide-SC 20 µg, 40 µg and 80 µg groups, respectively, compared to 1.3% for the Forteo group.

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Figure C—Mean (SEM) Percent Change from Baseline at weeks 12, 24 and 48 in Total Spine BMD (Extension Population, N=55)

GRAPHIC

        No treatment-related SAEs or deaths were reported during this time period. Two patients discontinued treatment, one for bilateral femoral hernias (abaloparatide-SC 80 µg) and one for moderate syncope (abaloparatide- SC 40 µg). Study-related adverse events occurred in a similar proportion of patients in each treatment group across the 52-week study period and the majority of events were mild or moderate in severity. The profile of events was not different during the second 24 weeks of study treatment.

    Non-Head-to-Head Comparison of Abaloparatide-SC and Amgen Anti-sclerostin Antibody Phase 2 Study Results

        Our abaloparatide-SC Phase 2 clinical study used substantially similar patient inclusion and exclusion criteria as a study completed by Amgen of the use of a human anti-sclerostin antibody, romosozumab or AMG 785, for the treatment of osteoporosis. A non-head to head, cross-study comparison of the 6-month and 12-month spine BMD results of the AMG 785 study at the 210 mg once-monthly subcutaneous dosing regimen, including both patients treated with AMG 785 and a control group of patients treated with Forteo, and our abaloparatide-SC study at the 80 µg single daily subcutaneous dose are set forth in the following table. Recognizing such cross-study comparisons cannot support potential labeling or promotional claims in the event that our investigational drug were to be approved, we believe the comparison is useful in evaluating the results of our Phase 2 clinical study of abaloparatide-SC. The abaloparatide-SC and AMG 785 studies were separate trials conducted at different sites in different patients, and we have not conducted a head-to-head comparison of the drugs in a clinical trial. Results of an actual head-to-head comparison study may differ significantly from those set forth in the following table. In addition, because the abaloparatide-SC and AMG 785 studies were separate studies and because the abaloparatide-SC Phase 2 clinical study involved a lesser

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number of patients, differences between the results of the two studies may not be statistically or clinically meaningful.

 
  Abaloparatide-SC Phase 2(1)   AMG 785 Phase 2(2)

Product

  Abaloparatide   Forteo   AMG 785   Forteo

Dose

  80 µg   20 µg   210 mg   20 µg

Dosing frequency

  Daily   Daily   Monthly   Daily

No. of Injections per dose

  1   1   3   1

Type of Injection

  Self   Self   Physician   Self

Spine Mean Percent BMD Change from Baseline—24 weeks / 6 months

  +6.7%   +5.5%   +8.2%   +4.8%

Spine Mean Percent BMD Change from Baseline—48 weeks / 12 months

  +12.9%   +8.6%   +11.3%   +7.1%

Femoral Neck Mean Percent BMD Change from Baseline—48 weeks / 12 months

  +4.1%   +2.2%   +3.7%   +1.1%

(1)
Abaloparatide-SC Study n=221 (24 weeks) and n=55 (48 weeks), 5 arms

(2)
AMG 785 Study n=419 (12 months), 9 arms

    Abaloparatide-SC Phase 1 Clinical Trials

        We have completed three Phase 1 clinical trials of abaloparatide-SC. Together with our Phase 2 clinical trials and ongoing Phase 3 clinical trial, over 1,300 patients have received the drug. The results of our Phase 1 clinical trials suggest that abaloparatide-SC is safe and well tolerated at doses of up to 100 m g administered once daily. These studies also showed that abaloparatide was 100% bioavailable, meaning it was absorbed completely, when administered subcutaneously, and that it was rapidly cleared from the circulation.

    Abaloparatide-TD Phase 2 Clinical Trials

        We conducted a randomized, double-blind, placebo-controlled, Phase 2 clinical trial of abaloparatide administered via a coated transdermal microarray delivery system in healthy postmenopausal women with osteoporosis. This study was conducted in nine centers in the United States, Denmark, Poland and Estonia. The primary objective of this study was to determine the clinical safety and efficacy of abaloparatide-TD as assessed by changes in BMD when compared to a transdermal placebo and abaloparatide-SC. Postmenopausal women between the ages of 55 and 85 (inclusive) who had a BMD t-score £ –2.5 at the lumbar spine or hip (femoral neck) by DXA or a BMD t-score £ –2 and a prior low trauma fracture or an additional risk factor were candidates for this study. Abaloparatide-TD was administered via a spring-loaded applicator and abaloparatide-SC was administered by a multi-use pen injector into which a multi-dose glass cartridge was inserted. Four weeks prior to the start of treatment, subjects began taking calcium and vitamin D supplements which were continued throughout the study. The study drug was to be administered once daily for a total of six months.

        A total of 372 subjects were screened and 250 were randomized to treatment in one of five treatment regimens: transdermal placebo, abaloparatide-TD at doses of 50 µg, 100 µg, and 150 µg or abaloparatide-SC at a dose of 80 µg. Two hundred and forty-nine subjects were included in the safety population and 231 subjects were included in the modified intent-to-treat, or mITT, population.

        In the mITT population, the mean percent change from baseline in total spine BMD after six months of treatment increased with abaloparatide-TD dose (0.04%, 1.87%, 2.33% and 2.95% in the placebo, abaloparatide 50 µg, 100 µg and 150 µg groups, respectively). The test for a dose response

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was statistically significant (p<0.0001). The mean differences (active treatment—placebo) of the percent change from baseline in total spine BMD at six months were 1.83%, 2.29% and 2.91% in the abaloparatide-TD 50 µg, 100 µg and 150 µg groups, respectively. The results for all abaloparatide-TD dose groups were statistically significantly better than placebo (p=0.0066, 0.0005, and <0.0001, respectively).

Figure D—Mean (SEM) Percent Change from Baseline at Six Months in Total Spine BMD

GRAPHIC

        Similar to the findings in the spine, the mean percent change from baseline in total hip BMD after six months of treatment also increased with abaloparatide-TD dose (–0.02% and 0.97%, 1.32% and 1.49% in the placebo, abaloparatide 50 µg, 100 µg and 150 µg groups). The mean differences (active treatment—placebo) of the percent change from baseline in total hip BMD at six months were 0.99%, 1.33% and 1.51% in the abaloparatide 50 µg, 100 µg, and 150 µg groups, respectively; the results for the 100 µg and 150 µg abaloparatide-TD dose groups were statistically significantly better than placebo (p=0.0056 and 0.0018, respectively).

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Figure E—Mean (SEM) Percent Change from Baseline at Six Months in Total Hip BMD

GRAPHIC

        Analysis of adverse events was performed on treatment-emergent adverse events, or TEAEs. There were no apparent differences between the TEAE profiles across the five treatment groups. Overall, nasopharyngitis, headache, and influenza were the most frequently reported TEAEs. There were nine serious TEAEs reported, one in the placebo group, two in the 100 µg group, two in the 150 µg group, and four in the abaloparatide-SC group. No subjects died during the course of this study. All of the events were consistent with medical events in women with postmenopausal osteoporosis, and none of the events were considered to be related to treatment with study medication.

        Assessment of local tolerance consisted of daily self-evaluation by the subject of any dermal reaction for two months during the course of the study using scales that ranged from 0 to 3 or 6, with 0 indicating no effect. In general, the types of symptoms reported were similar across the treatment groups, with dermal response and swelling being the effects most frequently reported. In an initial analysis, detectable antibodies against abaloparatide were noted in a subset of patients. However, these antibodies were of low titer, and there was no evidence of an effect on safety or attenuation of treatment efficacy.

    Abaloparatide-TD Phase 1 Clinical Trials

        We have completed three Phase 1 clinical trials that collectively evaluated the safety, pharmacokinetics, or PK, time course of delivery and dose ranging of abaloparatide-TD. Abaloparatide-TD was characterized by a rapid release of abaloparatide with a faster time to reach peak concentration as well as more rapid elimination in plasma compared to abaloparatide-SC. Peak transdermal drug levels were consistent with abaloparatide-SC. An optimal wear time of five minutes or less was identified as well as effective sites of application. Abaloparatide-TD showed an increase in the bone-formation marker P1NP in serum after seven days of exposure, consistent with bone-building activity, and was shown to be safe and well tolerated in all doses studied.

        In order to further enhance BMD efficacy for abaloparatide-TD, we currently plan to modify the pharmacokinetic profile of abaloparatide-TD to more closely resemble that of abaloparatide-SC. On December 21, 2014, we reported progress towards the development of an optimized, short-wear-time

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transdermal patch that may be capable of demonstrating therapeutic comparability to abaloparatide-SC injection. In preliminary, nonhuman primate pharmacokinetic studies, prototype A7 achieved a desirable pharmacokinetic profile, with comparable AUC, Cmax, Tmax and T1/2 relative to abaloparatide-SC. We believe that these results support continued clinical development toward future global regulatory submissions as a potential post-approval line extension of the investigational drug abaloparatide-SC. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving pharmacokinetic equivalence to abaloparatide-SC. If abaloparatide-SC is already approved by the FDA, we believe that we will only need to conduct either a pharmacokinetic equivalence or a single non-inferiority Phase 3 clinical trial comparing the change in lumbar spine BMD at 12 months for patients dosed with abaloparatide-TD to patients dosed with abaloparatide-SC to confirm that the effect of abaloparatide-TD treatment is comparable to that of abaloparatide-SC. If our clinical trials of abaloparatide-SC and abaloparatide-TD are successful, we expect to seek marketing approval of abaloparatide-TD as a line extension of abaloparatide-SC. The FDA approval of abaloparatide-TD, and the timing of any such approval, is dependent upon the approval of abaloparatide-SC.

    Preclinical Pharmacology of Abaloparatide

        We have completed several preclinical studies of abaloparatide, and the following has been shown:

    abaloparatide is a potent selective agonist of the human PTH type 1 receptor (PTHR1), with binding selectivity for the RG vs R0 receptor conformation compared to PTH(1-34) and greater selectivity than PTHrP(1-34);

    in models of calcium mobilization, abaloparatide has significantly less calcium mobilizing activity at higher doses than the native PTHrP(1-34), and less activity than PTH(1-34);

    abaloparatide-SC stimulates the formation of normal, well-organized bone and restores BMD in ovariectomized (OVX), osteopenic rats and primates. Mechanical testing of bones from OVX rats after treatment with abaloparatide-SC revealed a significant increase in femur and vertebral bone strength. Similar studies in rats with abaloparatide-TD show comparable restoration of bone;

    abaloparatide-SC was generally well tolerated over a wide range of doses in two species, rats and primates, for up to six months and nine months, respectively; and

    safety pharmacology studies showed no respiratory, gastroenterologic, hematologic, renal or central nervous system effects.

        A two-year subcutaneous injection carcinogenicity study of abaloparatide in Fischer 344 albino rats was conducted to assess the carcinogenic potential of abaloparatide. The study was conducted according to the provisions set forth in Guidance ICH-S1A, ICH-S1B and ICH-S1C(R2), and the design was accepted by the FDA on July 15, 2009. This study evaluated three abaloparatide dose levels. The doses were selected based upon findings and tolerance in completed long-term rat toxicology studies and the anticipated tolerance over a two-year dosing period. Furthermore, the doses represent an exposure multiple over maximum clinical doses. The study included a cohort of rats being dosed with a daily subcutaneous injection of PTH(1-34) as a positive control, as it was anticipated that osteosarcomas would be observed with this treatment, as previously published for both rhPTH(1-34) and rhPTH(1-84) in similar two-year rat carcinogenicity studies. The positive control served to provide confirmation of the sensitivity of the model. A preliminary unaudited analysis of histopathology data revealed osteosarcomas in our carcinogenicity study in both the abaloparatide and PTH(1-34) treated groups, with similar frequency between abaloparatide and PTH(1-34) when comparing comparable exposure multiples to the human therapeutic dose.

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        We have also conducted one preclinical bone quality study in OVX rats with 12 months of daily abaloparatide-SC dosing and a second preclinical bone quality study in adult OVX monkeys for 16 months. The primary objective of these studies was to determine the long-term treatment effects of abaloparatide-SC on bone quality. Effects on bone mass, both cortical bone and cancellous bone, were assessed by BMD and peripheral quantitative CT, and bone strength was determined by biomechanical testing. The mechanisms by which abaloparatide affects bone were assessed by evaluation of biomarkers of bone turnover and histomorphometric indices of bone turnover. Data from the 12-month rat study showed marked, dose dependent increases in BMD following abaloparatide treatment, increases in bone formation markers, but not bone resorption, and an increase in bone strength.

        Results from the 16-month monkey OVX study have also shown significant BMD gains, together with increases in bone strength.

RAD1901

        We exclusively licensed the worldwide rights to RAD1901 from Eisai Co. Ltd., or Eisai. We are developing RAD1901 as a SERD in Phase 1 clinical development for the potential treatment of metastatic breast cancer. We are also developing RAD1901, which at lower doses acts as a SERM, in an oral formulation as a potential treatment for vasomotor symptoms, commonly known as hot flashes or hot flushes.

Pharmacologic Characteristics

        RAD1901 has been shown to bind with good selectivity to the ER alpha, or ER a , and to have both estrogen-like and estrogen antagonist effects in different tissues. RAD1901 has also been shown to have estrogen-like behavioral effects in an animal model of partner preference and to reduce vasomotor signs in an animal model of menopausal hot flashes. In bone, RAD1901 protects against gonadectomy-induced bone loss. RAD1901 does not stimulate the endometrium, as shown in short- and long-term animal models, where changes in uterine weight, uterine epithelial thickness, and C3 gene expression are measured, all of which are sensitive indicators. In studies in which an estrogen is used to stimulate the endometrium, RAD1901 antagonizes this estrogen-mediated stimulation of the endometrium. In cell culture, RAD1901 does not stimulate replication of breast cancer cells, and antagonizes the stimulating effects of estrogen on cell proliferation. Furthermore, in breast cancer cell lines a dose dependent down regulation of ER a is observed, a process we have shown to involve proteosomal-mediated degradation pathway. In a model of breast cancer, in which human breast cancer cells are implanted in mice and allowed to establish tumors in response to estrogen treatment, we have shown that treatment with RAD1901 results in decreased tumor growth.

        We are currently advancing the development of RAD1901 for potential use in the treatment of metastatic breast cancer in two Phase 1 studies. In June 2014, we initiated a Phase 1 MTD, study of RAD1901 in healthy volunteers. The study is designed to evaluate the tolerability, safety and pharmacokinetics of RAD1901, and also to use FES-PET imaging to provide a pharmacodynamic assessment of estrogen receptor turnover following administration of RAD1901. Levels of RAD1901 in cerebrospinal fluid samples taken from study subjects will be measured to confirm that RAD1901 has crossed the blood-brain barrier. Based upon initial study results, FES-PET imaging of RAD1901 has showed potent SERD activity. As of December 31, 2014, 40 subjects had completed dose escalation in the ongoing MTD study, and FES-PET imaging had been completed in a total of five subjects across two different doses. Each of these five subjects showed, based on FES-PET imaging, suppression of the FES-PET signal to background levels after six days of dosing. In addition, RAD1901, at the doses that showed suppression of the FES-PET signal, was well tolerated in these patients.

        In December 2014, we commenced a Phase 1 clinical trial of RAD1901 in the United States for the treatment of metastatic breast cancer. The Phase 1 study is a multicenter, open-label, two-part, dose-escalation study of RAD1901 in postmenopausal women with advanced estrogen receptor positive

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and HER2-negative breast cancer that is designed to determine the recommended dose for a Phase 2 clinical trial and includes a preliminary evaluation of the potential anti-tumor effect of RAD1901. We expect to report progress on this study in the first half of 2015 and to initiate additional Phase 1 clinical trials in the European Union in 2015.

Clinical Development Program

    Phase 2 Study—Vasomotor Symptoms

        A Phase 2 proof of concept study was conducted in 100 healthy perimenopausal women using four doses of RAD1901 (10 mg, 25 mg, 50 mg and 100 mg) and placebo. The primary study outcome was reduction in the frequency and severity of moderate and severe hot flashes. While a classic dose-response effect was not demonstrated, efficacy was determined to occur at the 10 mg dose level which achieved a statistically significant reduction in the frequency of moderate and severe hot flashes both by linear trend test and by comparison to placebo and in overall (mild-moderate-severe) hot flashes at either the two-, three- or four-week time-points. A similar reduction in composite score (frequency × severity of hot flashes) was identified at all time-points, with a statistically significant difference from placebo achieved at the two-, three- or four-week time-points. Numerical reductions in mean severity and mean daily severity were observed, but did not reach statistical significance. We believe RAD1901 is an attractive candidate for advancement to Phase 3 development as a potential treatment for vasomotor symptoms.

        No SAEs were reported during the course of the study. Overall, 69% of patients had an adverse event, generally mild or moderate in severity, with some evidence of dose dependency, and events were most commonly gastrointestinal symptoms and headaches. Three severe adverse events occurred, one in a placebo patient, none of which were considered treatment related. Two patients discontinued treatment due to an adverse event, neither in relation to the 10 mg dose.

    Phase 1 Study—Vasomotor Symptoms

        We have conducted Phase 1 safety, PK and bioavailability studies of RAD1901 in 80 healthy postmenopausal women over a range of doses. Bioavailability was determined to be approximately 10%. Food effect was also investigated and the presence of food was determined to increase absorption and delay clearance of RAD1901. RAD1901 was generally well tolerated at all dose levels tested. All study-related adverse events were of mild intensity, with some increase in frequency at the higher doses in the multiple dose group, most commonly gastrointestinal symptoms and headaches. There were no SAEs observed.

RAD140

        RAD140 is a nonsteroidal selective androgen receptor modulator, or SARM, that resulted from an internal drug discovery program focused on the androgen receptor pathway which is highly expressed in many breast cancers. Due to its receptor and tissue selectivity, potent oral activity and long duration half-life, RAD140 could have clinical potential in the treatment of breast cancer or possibly other conditions where androgen modulation may offer therapeutic benefit. We may choose to advance the RAD140 program internally or to collaborate with third parties for its further development and commercialization. Therefore, the date of any FDA approval of RAD140, if ever, cannot be predicted at this time. As a result of the uncertainties around the development strategy for RAD140, we are unable to determine the duration and costs to complete current or future clinical stages of development, if any, for our RAD140 investigational product candidate.

Manufacturing

        We do not own or operate manufacturing facilities for the production of any of our investigational product candidates, nor do we have plans to develop our own manufacturing operations in the

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foreseeable future. The active pharmaceutical ingredient, or API, of abaloparatide is manufactured on a contract basis by Lonza Group Ltd., or Lonza, using a solid phase peptide synthesis assembly process, and purification by high pressure liquid chromatography. Abaloparatide-SC is supplied as a liquid in a multi-dose cartridge for use in a pen delivery device. The multi-dose cartridges are manufactured by Vetter Pharma Fertigung GmbH & Co. Abaloparatide-TD is manufactured by 3M based on their patented microneedle technology to administer drugs through the skin, as an alternative to subcutaneous injection. The API of RAD1901 is manufactured for us on a contract basis by Irix Pharmaceuticals, Inc.

        Manufacturing is subject to extensive regulations that impose various procedural and documentation requirements, which govern record keeping, manufacturing processes and controls, personnel, quality control and quality assurance, among others. Our contract manufacturing organizations are required to manufacture our investigational product candidates under current Good Manufacturing Practice, or cGMP, conditions. cGMP is a regulatory standard for the production of human pharmaceuticals that imposes extensive procedural, substantive and record keeping requirements on the manufacturing process and associated production and testing facilities.

Intellectual Property

        As of December 31, 2014, we owned or co-owned eight issued United States patents, as well as twelve pending U.S. patent applications and about 42 pending foreign patent applications in Europe and 15 other jurisdictions, and about 17 granted foreign patents. As of December 31, 2014, we had licenses to eight U.S. patents related to compositions and related uses thereof as well as numerous foreign counterparts to many of these patents and patent applications.

        We strive to protect the proprietary technology that we believe is important to our business, including seeking and maintaining patents intended to cover our investigational product candidates and compositions, their methods of use and processes for their manufacture and any other inventions that are commercially important to the development of our business. We also rely on trade secrets to protect aspects of our business that are not amenable to, or that we do not consider appropriate for, patent protection.

        Our success will significantly depend on our ability to obtain and maintain patent and other proprietary protection for commercially important technology and inventions and know-how related to our business, defend and enforce our patents, preserve the confidentiality of our trade secrets, and operate without infringing the valid and enforceable patents and proprietary rights of third parties. We also rely on know-how and continuing technological innovation to develop and maintain our proprietary position.

Abaloparatide

        We acquired and maintain exclusive worldwide rights, excluding Japan, to certain patents, data and technical information related to abaloparatide through a license agreement with an affiliate of Ipsen. Composition of matter of abaloparatide is claimed in the United States (U.S. Patent No. 5,969,095), Europe, Australia, Canada, China, Hong Kong, South Korea, New Zealand, Poland, Russia, Singapore, Mexico, Hungary, and Taiwan. These patents have an expiration date of 2016 absent any U.S. patent term extension under the Hatch-Waxman Act. European Patent No. 0847278, which was included in the license from Ipsen and claimed the composition of matter of abaloparatide, lapsed due to Ipsen's failure to pay annuities. We are pursuing restoration of those patent rights. To date, the patent rights in Finland, France, Germany, Portugal, Spain and United Kingdom have been restored. We believe that the data and market exclusivity provided in Europe for a new chemical entity, coupled with the need for a potential competitor to conduct clinical trials will likely provide a longer barrier to entry than the patent protection provided by the original European patent term, which would have expired in 2016, plus a five year maximum Supplemental Protection Certificate. The Phase 3 clinical dosage of

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abaloparatide by the subcutaneous route for potential use in treating osteoporosis is covered by Patent No. 7,803,770 until the statutory term expires October 3, 2027 which may be extended to March 26, 2028 (statutory term extended with 175 days of patent term adjustment due to delays in patent prosecution by the United States Patent and Trademark Office, or USPTO) in the United States (absent any patent term extension under the Hatch-Waxman Act). The intended therapeutic formulation for abaloparatide-SC is covered by Patent No. 8,148,333 until 2027 in the United States (absent any patent term extension under the Hatch-Waxman Act). Related patents granted in China, Australia, Singapore, Japan, Israel, Mexico, New Zealand, Russia, and Ukraine, and currently pending in Europe, Canada, Brazil, Singapore, South Korea, India, Norway, and Hong Kong will have a patent expiration date of 2027. Patent applications which cover various aspects of abaloparatide for microneedle application are pending in the United States, Australia, Brazil, Canada, China, Europe, Hong Kong, Israel, India, Japan, Korea, Mexico, New Zealand, Russia, Singapore, and Ukraine. Any patents that might issue from these applications will have an expiration date in 2032.

RAD1901

        We exclusively licensed the worldwide rights to RAD1901 from Eisai. US Patent No. 7,612,114 (statutory term expires December 25, 2023 and may be extended up to August 18, 2026 with 967 days of patent term adjustment absent any Hatch-Waxman patent term extensions) and US Patent No. 8,399,520 (statutory term expires 2023) cover RAD1901 as a composition of matter as well as the use of RAD1901 for treatment of estrogen-dependent osteoporosis or estrogen-dependent breast cancer. Corresponding patents issued in Australia, Canada and Europe and pending in India will have an expiration date in 2023. Patent applications covering methods of using RAD1901 for the treatment of vasomotor symptoms are pending in the United States (published as US 2010/0105733A1), and granted in Canada and Europe; any issued patents will have an expiration date in 2027. Patent applications covering a dosage form have been filed in the United States, Europe, Canada and Mexico, and any claims that might issue from these applications will have an expiration date in 2031.

RAD140

        The composition of matter of, and methods of using, RAD140 are covered by US Patent No. 8,067,448 (statutory term expires February 19, 2029, and may be extended to September 25, 2029, with 218 days of patent term adjustment due to delays by the USPTO) and U.S. Patent No. 8,268,872 (statutory term expires February 19, 2029 and may be extended to September 25, 2029 with patent term adjustment, subject to a terminal disclaimer of Patent No. 8,067,448). Related patents have been granted in Australia, Europe, Japan and Mexico and additional patent applications are pending in Brazil, Canada and India. Any patents issued from these filings will have an expiration in 2029.

        There can be no assurance that an issued patent will remain valid and enforceable in a court of law through the entire patent term. Should the validity of a patent be challenged, the legal process associated with defending the patent can be costly and time consuming. Issued patents can be subject to oppositions, interferences and other third party challenges that can result in the revocation of the patent or that can limit patent claims such that patent coverage lacks sufficient breadth to protect subject matter that is commercially relevant. Competitors may be able to circumvent our patents. Development and commercialization of pharmaceutical products can be subject to substantial delays and it is possible that at the time of commercialization any patent covering the product has expired or will be in force for only a short period of time following commercialization. We cannot predict with any certainty if any third party U.S. or foreign patent rights, or other proprietary rights, will be deemed infringed by the use of our technology. Nor can we predict with certainty which, if any, of these rights will or may be asserted against us by third parties. Should we need to defend ourselves and our partners against any such claims, substantial costs may be incurred. Furthermore, parties making such claims may be able to obtain injunctive or other equitable relief, which could effectively block our ability to develop or commercialize some or all of our products in the U.S. and abroad, and could

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result in the award of substantial damages. In the event of a claim of infringement, we or our partners may be required to obtain one or more licenses from a third party. There can be no assurance that we can obtain a license on a reasonable basis should we deem it necessary to obtain rights to an alternative technology that meets our needs. The failure to obtain a license may have a material adverse effect on our business, results of operations and financial condition.

        We also rely on trade secret protection for our confidential and proprietary information. No assurance can be given that we can meaningfully protect our trade secrets on a continuing basis. Others may independently develop substantially equivalent confidential and proprietary information or otherwise gain access to our trade secrets.

        It is our policy to require our employees and consultants, outside scientific collaborators, sponsored researchers and other advisors who receive confidential information from us to execute confidentiality agreements upon the commencement of employment or consulting relationships. These agreements provide that all confidential information developed or made known to these individuals during the course of the individual's relationship with the company is to be kept confidential and is not to be disclosed to third parties except in specific circumstances. The agreements provide that all inventions conceived by an employee shall be the property of the company. There can be no assurance, however, that these agreements will provide meaningful protection or adequate remedies for our trade secrets in the event of unauthorized use or disclosure of such information.

        Our success will depend in part on our ability to obtain and maintain patent protection, preserve trade secrets, prevent third parties from infringing upon our proprietary rights and operate without infringing upon the proprietary rights of others, both in the U.S. and other territories worldwide.

Competition

        The development and commercialization of new products to treat the targeted indications of our investigational product candidates is highly competitive, and our products, if approved, will face considerable competition from major pharmaceutical, biotechnology and specialty pharmaceutical companies, including Amgen, UCB, Merck & Co, Novartis, Lilly, Pfizer, Roche, Asahi Kasei, Corium and Zosano, that currently market and/or are seeking to develop products for similar indications. Many of our competitors have substantially more resources than we do, including financial, manufacturing, marketing, research and drug development resources. In addition, many of these companies have longer operating histories and more experience than us in preclinical and clinical development, manufacturing, regulatory and global commercialization.

        Within the osteoporosis market, Lilly launched Forteo in December 2002 as the first-to-market anabolic agent for the treatment of osteoporosis. In April 2012, UCB and Amgen started a Phase 3 clinical trial program for their anti-sclerostin antibody for the treatment of osteoporosis. We are also aware that Corium and Zosano are developing a transdermal form of PTH(1-34) that would compete with abaloparatide-TD.

        RAD1901 for the treatment of metastatic breast cancer will face competition from SERDs, CNS-penetrant anti-cancer agents and from chemotherapy derivatives. We are aware that Roche is developing an oral SERD that would compete with RAD1901. RAD1901 will also face competition from other therapeutics in development for the treatment of hot flashes. We cannot assure you that our current investigational product candidates, if successfully developed and approved, will be able to compete effectively against these, or any other competing therapeutics that may become available on the market.

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Collaborations and License Agreements

Nordic Bioscience

        Abaloparatide-SC Phase 3 Clinical Trial —We have entered into agreements with Nordic Bioscience Clinical Development VII A/S, or Nordic, to conduct our Phase 3 clinical trial of abaloparatide-SC, or the Phase 3 Clinical Trial. On March 29, 2011, we entered into a Clinical Trial Services Agreement, or the Clinical Trial Services Agreement, with Nordic.

        The Clinical Trial Services Agreement has a five-year term unless it is sooner terminated. The Clinical Trial Services Agreement or any work statement under the agreement, or Work Statement, may be terminated by mutual agreement of the parties at any time. Either party may also terminate any Work Statement upon a material breach by the other party with respect to such Work Statement unless such other party cures the breach within the notice period specified in the Clinical Trial Services Agreement or, if the breach cannot be cured within such period, the party in breach commences efforts to cure the breach and diligently proceeds to cure the breach. Termination of any Work Statement does not result in termination of the Clinical Trial Services Agreement or any other Work Statements, which remain in force until terminated. Either party may also terminate a Work Statement if force majeure conditions have prevented performance by the other party for more than a specified period of time. We may also terminate a Work Statement with notice to Nordic if authorization and approval to perform any clinical study that is the subject of such Work Statement is withdrawn by the FDA; other toxicological test results support termination of the clinical study relating to such Work Statement for reasons of safety; or if the emergence of any adverse event or side effect in the clinical study relating to a Work Statement is of such magnitude or incidence in our opinion as to support termination.

        The Clinical Trial Services Agreement contains customary risk allocation clauses with each party indemnifying the other in respect of third-party claims arising out of or resulting from: (1) the negligence or intentional misconduct of such party, its employees, agents or representatives in performing its obligations under the Clinical Trial Services Agreement or any Work Statement; and (2) any breach by such party of its representations and warranties under the Clinical Trial Services Agreement. We have agreed to indemnify Nordic in respect of third-party claims for product liability or personal injury arising from or relating to our products or our use of any deliverables. The Clinical Trial Services Agreement contains other customary clauses and terms as are common in similar agreements in the industry.

        On March 29, 2011, we also entered into Work Statement NB-1 under the Clinical Trial Services Agreement, as amended on December 9, 2011, June 18, 2012, March 28, 2014 May 19, 2014 and July 22, 2014, or the Work Statement NB-1. Pursuant to the Work Statement NB-1, we are required to make certain per patient payments denominated in both euros and U.S. dollars for each patient enrolled in the Phase 3 Clinical Trial, followed by monthly payments for the duration of the study and final payments in two equal euro-denominated installments and two equal U.S. dollar-denominated installments. In addition, Nordic is entitled to a performance incentive payment, or Performance Incentive Payment, of $500,000 for every 50 patients that, subsequent to March 28, 2014, complete all end-of-study procedures, up to a maximum aggregate amount of $5.0 million. The Work Statement NB-1 provides for a total of up to approximately €41.2 million ($49.8 million) of euro-denominated payments and a total of up to approximately $3.2 million of U.S. dollar-denominated payments over the course of the Phase 3 Clinical Trial, plus Performance Incentive Payments of up to $5.0 million. These payments may be adjusted based upon actual sites opened, work performed or number of patients enrolled. In addition, pursuant to indemnification letters with each investigative site, we have agreed to indemnify the investigative sites performing services pursuant to the Work Statement NB-1 in respect of third-party claims of injury, illness or adverse side effects to a patient in the study that is the subject of the Work Statement NB-1 that are attributable to the Radius study drug.

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        In connection with the Clinical Trial Services Agreement, we entered into a Stock Issuance Agreement on March 29, 2011, as amended and restated on May 16, 2011, and as further amended on February 21, 2013, March 28, 2014, and May 19, 2014, or the Stock Issuance Agreement. Pursuant to the Stock Issuance Agreement, Nordic purchased 6,443 shares of our Series A-5 preferred stock. In connection with the Work Statement NB-1, the shares of Series A-5 preferred stock held by Nordic were entitled to receive quarterly stock dividends payable in shares of our Series A-6 preferred stock, having an aggregate value of up to €36.8 million ($44.5 million). The Stock Issuance Agreement further provided that in the event an initial public offering of our common stock occurred prior to June 30, 2014, any payments owed by us to Nordic in relation to Work Statement NB-1 and Work Statement NB-3, discussed below, excluding Performance Incentive Payments, for all periods of time after 2014, would be changed from the right to receive stock to the right to receive a total cash payment from us of $4.3 million payable in ten equal monthly installments of $430,000 beginning on March 31, 2015. As we completed our initial public offering on June 11, 2014, payments owed to Nordic under the Stock Issuance Agreement have been paid in cash for periods after June 11, 2014.

        Abaloparatide-SC Phase 3 Clinical Extension Study —On February 21, 2013, we entered into a Work Statement NB-3, as amended on March 4, 2014, or the Work Statement NB-3, with Nordic. Pursuant to the Work Statement NB-3, Nordic will perform an extension study to evaluate six months of standard-of-care osteoporosis management following the completion of the Phase 3 Clinical Trial, and, upon completion of this initial six months, an additional period of 18 months of standard-of-care osteoporosis management ("the Extension Study"). Payments in cash to be made to Nordic under the Work Statement NB-3 are denominated in both euros and U.S. dollars and total up to €7.5 million ($9.1 million) and $1.1 million, respectively.

        In addition, in connection with the Work Statement NB-3, the Stock Issuance Agreement provided that, beginning with the quarter ended March 31, 2013, Nordic was entitled to receive quarterly stock dividends on its shares of Series A-5 preferred stock, payable in shares of our Series A-6 preferred stock, in connection with services performed under the Work Statement NB-3, having an aggregate value of up to €7.5 million ($9.1 million) and $0.8 million. The Stock Issuance Agreement further provided that in the event an initial public offering of our common stock occurred prior to June 30, 2014, any payments owed by us to Nordic in relation to Work Statement NB-1 and Work Statement NB-3, excluding Performance Incentive Payments, for all periods of time after 2014, would be changed from the right to receive stock to the right to receive a total cash payment from us of $4.3 million payable in ten equal monthly installments of $430,000 beginning on March 31, 2015. As we completed our initial public offering on June 11, 2014, payments owed to Nordic under the Stock Issuance Agreement have been paid in cash for periods after June 11, 2014.

        Abaloparatide-TD Phase 2 Clinical Trial —On July 26, 2012, we entered into a Letter of Intent, or the Phase 2 Letter of Intent with Nordic, which provided that we and Nordic would, subject to our compliance with certain requirements of our certificate of incorporation and applicable securities law, negotiate in good faith to enter into a Work Statement NB-2, or the Work Statement NB-2, and an amendment to the Amended and Restated Stock Issuance Agreement.

        On February 21, 2013, we entered into the Work Statement NB-2. Pursuant to the Work Statement NB-2, Nordic provided clinical trial services relating to the Phase 2 clinical trial for abaloparatide-TD. Payments in cash under the Work Statement NB-2 are denominated in both euros and U.S. dollars and total up to €3.6 million ($4.4 million) and $0.3 million, respectively. In addition, pursuant to the Stock Issuance Agreement, Nordic was entitled to shares of our Series A-6 preferred stock payable as dividends upon shares of Series A-5 preferred stock held by Nordic, having an aggregate value of up to $2.9 million. In December 2013, we issued Nordic 32,215 shares of our Series A-6 preferred stock, which constituted all shares of Series A-6 preferred stock due in connection with Work Statement NB-2.

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3M

        In December 2008, we entered into a Feasibility Agreement with 3M whereby 3M assessed the feasibility of developing an abaloparatide-TD product and supplying the product for preclinical studies in an animal model. Upon successful completion of the feasibility study, during June 2009, we entered into a Development and Clinical Supplies Agreement with 3M under which 3M is responsible for the development of an abaloparatide-TD product and the manufacture of clinical and toxicology supplies of the abaloparatide-TD product for preclinical, Phase 1 and Phase 2 studies on an exclusive basis during the term of the agreement. In December 2012, we entered into an amendment to the Development and Clinical Supplies Agreement in which 3M agreed to develop and manufacture clinical and toxicology supplies for the Phase 3 abaloparatide-TD clinical study. In addition, 3M agreed that it will not use jointly owned intellectual property developed during and resulting from its work with us on abaloparatide-TD in relation to any other PTH or PTHrP analogue or derivative. We hold exclusive worldwide rights to this use of the 3M transdermal technology.

        We pay 3M for services delivered pursuant to the Development and Clinical Supplies Agreement on a fee-for-service or a fee-for-deliverable basis as specified in the Development and Clinical Supplies Agreement. The Feasibility Agreement expired on or around September 2009. We have paid 3M approximately $15.3 million, in the aggregate, through December 31, 2014 in respect to services and deliverables delivered pursuant to the Feasibility Agreement and the Development and Clinical Supplies Agreement.

        The Development and Clinical Supplies Agreement, as amended, provides for services through December 31, 2017, unless it is sooner terminated. Either party may terminate the Development and Clinical Supplies Agreement upon a material breach by the other party unless such other party cures the alleged breach within the notice period specified in the Development and Clinical Supplies Agreement. The Development and Clinical Supplies Agreement contains customary risk allocation clauses with 3M indemnifying us in respect of third-party claims arising from any personal injury to the extent that such claim results from 3M's breach of warranty with respect to abaloparatide-TD meeting applicable specifications; and us indemnifying 3M in respect of third-party claims arising from our or our agent's use, testing or clinical studies of abaloparatide-TD. The Development and Clinical Supplies Agreement contains other customary clauses and terms as are common in similar agreements in the industry.

Ipsen Pharma

        In September 2005, we entered into a License Agreement with Ipsen, as amended in September 2007 and May 2011, under which we exclusively licensed certain Ipsen compound technology and related patents covering abaloparatide to research, develop, manufacture and commercialize certain compounds and related products in all countries, except Japan (where we do not hold commercialization rights) and France (where our commercialization rights are subject to certain co-marketing and co-promotion rights retained by Ipsen). Ipsen also granted us an exclusive right and license under the Ipsen compound technology and related patents to make and have made compounds or product in Japan. Ipsen also granted us an exclusive right and license under certain Ipsen formulation technology and related patents solely for purposes of enabling us to develop, manufacture and commercialize compounds and products covered by the compound technology license in all countries, except Japan (where we do not hold commercialization rights) and France (where our commercialization rights are subject to certain co-marketing and co-promotion rights retained by Ipsen). With respect to France, if Ipsen exercises its co-marketing and co-promotion rights, then Ipsen may elect to receive a percentage of the aggregate revenue from the sale of products by both parties in France (subject to a mid-double digit percentage cap), and Ipsen shall bear a corresponding percentage of the costs and expenses incurred by both parties with respect to such marketing and promotion efforts in France; Ipsen shall also pay us a mid-single digit royalty on Ipsen's allocable portion of aggregate revenue from the sale of products by both parties in France. Specifically, we licensed US

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Patent No. 5,969,095 (statutory term expires March 29, 2016), entitled "Analogs of Parathyroid Hormone," US Patent No. 6,544,949 (statutory term ends March 29, 2016), entitled "Analogs of Parathyroid Hormone," US Patent No. 6,544,949, (effective filing date March 29, 1996, statutory term ends March 29, 2016) entitled "Analogs of Parathyroid Hormone" and the corresponding foreign patents and continuing patent applications. European Patent No. 0847278, which was included in the license from Ipsen and claimed the composition of matter of abaloparatide, lapsed due to Ipsen's failure to pay annuities. We are pursuing restoration of those rights. To date, the patent rights in Finland, France, Germany, Portugal, Spain and United Kingdom have been restored. We believe that the data and market exclusivity provided in Europe for a new chemical entity, coupled with the need for a potential competitor to conduct clinical trials, will likely provide a longer barrier to entry than the patent protection provided by the original European patent term, which would have expired in 2016, plus a five year maximum Supplemental Protection Certificate.

        We also have rights to joint intellectual property related to abaloparatide, including rights to the jointly derived intellectual property contained in US Patent No. 7,803,770 (statutory term expires October 3, 2027 and may be extended to March 26, 2028 with 175 days of patent term adjustment due to delays in patent prosecution by the United States Patent and Trademark Office, or USPTO), US Patent No. 8,148,333 (statutory term expires October 3, 2027 and may be extended to November 8, 2027 with 36 days of patent term adjustment due to delays in patent prosecution by the USPTO) and related patents and patent applications both in the United States and worldwide that cover the method of treating osteoporosis using the Phase 3 Clinical Trial dosage strength and form. A corresponding European application is pending with claims to the intended therapeutic formulation for abaloparatide-SC. Examination has been requested, but substantive examination has not yet commenced. Upon grant, this patent could be validated in any designated contracting or extension states and potentially could be considered for a Supplemental Protection Certificate depending upon the timing of its grant. Related cases granted in China, Australia, Singapore, Japan, Israel, Mexico, New Zealand, Russia and Ukraine, and currently pending in Europe, Canada, Brazil, Singapore, South Korea, India, Norway, and Hong Kong will have a patent expiration date of 2027. Patent applications which cover various aspects of abaloparatide for microneedle application are pending in the United States, Australia, Brazil, Canada, China, Europe, Hong Kong, Israel, India, Japan, Korea, Mexico, New Zealand, Russia, Singapore, and Ukraine. Any patents that might issue from these applications will have an expiration date in 2032.

        In consideration for the rights to abaloparatide and in recognition of certain milestones having been met to date, we have paid to Ipsen an aggregate amount of $1.0 million. The license agreement further requires us to make payments upon the achievement of certain future clinical and regulatory milestones. The range of milestone payments that could be paid under the agreement is €10.0 million to €36.0 million ($12.1 million to $43.6 million). Should abaloparatide be approved and subsequently become commercialized, we or our sublicensees will be obligated to pay to Ipsen a fixed five percent royalty based on net sales of the product on a country by country basis until the later of the last to expire of the licensed patents or for a period of 10 years after the first commercial sale in such country. The date of the last to expire of the abaloparatide patents licensed from or co-owned with Ipsen, barring any extension thereof, is expected to be March 26, 2028. In the event that we sublicense abaloparatide to a third party, we are obligated to pay a percentage of certain payments received from such sublicensee (in lieu of milestone payments not achieved at the time of such sublicense). The applicable percentage is in the low double digit range. In addition, if we or our sublicensees commercialize a product that includes a compound discovered by us based on or derived from confidential Ipsen know-how, we will be obligated to pay to Ipsen a fixed low single digit royalty on net sales of such product on a country-by-country basis until the later of the last to expire of our patents that cover such product or for a period of 10 years after the first commercial sale of such product in such country. The license agreement contains other customary clauses and terms as are common in similar agreements in the industry.

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        The License Agreement expires on a country by country basis on the later of (1) the date the last remaining valid claim in the licensed patents expires, in that country; or (2) a period of 10 years after the first commercial sale of the licensed products in such country, unless it is sooner terminated.

        The License Agreement may be terminated by us with prior notice to Ipsen. The License Agreement may be terminated by Ipsen upon notice to us with immediate effect, if we, in any country of the world, bring an action or proceeding seeking to have any Ipsen patent right declared invalid or unenforceable. The License Agreement can also be terminated by Ipsen if we fail to use reasonable commercial efforts to develop the licensed product for sale and commercialization in those countries within the territory where it is commercially reasonable to do so as contemplated by the License Agreement, or fail to use reasonable commercial efforts to perform our obligations under the latest revised version of the development plan approved by the joint steering committee, or fail to use reasonable commercial efforts to launch and sell one licensed product in those countries within the territory where it is commercially reasonable to do so. Either party may also terminate the License Agreement upon a material breach by the other party unless such other party cures the alleged breach within the notice period specified in the License Agreement. Ipsen may terminate the License Agreement in the event that the License Agreement is assigned or sublicensed or in the event that a third party acquires us or in the event that we acquire control over a PTH or a PTHrP compound that is in clinical development or is commercially available in the territory and that, following such assignment, sublicense, acquisition, or acquisition of control by us, such assignee, sublicensee, acquirer or we fail to meet the timetable under the latest revised version of the development plan approved by the joint steering committee under the License Agreement. Any failure to meet such timetable for purposes of such termination clause is deemed a material breach by us.

        The License Agreement contains customary risk allocation clauses with each party indemnifying the other in respect of third-party claims arising out of or resulting from: (1) the gross negligence or willful misconduct of such party, its affiliates, licensees, distributors or contractors; (2) any breach by such party of its representations and warranties or any other provision of the License Agreement or any related agreement; (3) the manufacture on behalf of such party of any licensed product or compound; (4) (in the case of Ipsen) the use, development, handling or commercialization of any licensed compound, licensed product or the Ipsen formulation technology by or on behalf of Ipsen or any of its affiliates, licensees, distributors or contractors; and (5) (in our case) the making, use, development, handling or commercialization of any licensed compound or any licensed product by or on our behalf or any of our affiliates, licensees or contractors. The License Agreement contains other customary clauses and terms as are common in similar agreements in the industry. The License Agreement was amended on September 12, 2007 and May 11, 2011.

        Prior to executing the license agreement for abaloparatide with Radius, Ipsen licensed the Japanese rights for abaloparatide to Teijin Limited, or Teijin, a Japanese pharmaceutical company. It is our understanding that Teijin has fully enrolled a Phase 2 study of abaloparatide, which is expected to report results in mid-2015.

Eisai

        In June 2006, we exclusively licensed the worldwide (except Japan) rights to research, develop, manufacture and commercialize RAD1901 and related products from Eisai, or the Eisai Agreement. Specifically, we licensed the patent application that subsequently issued as US Patent No. 7,612,114 (statutory term expires December 25, 2023 and may be extended to August 18, 2026 with 967 days of patent term adjustment due to delays by the USPTO), entitled "Selective Estrogen Receptor Modulator," the corresponding foreign patent applications and continuing patent applications. As consideration for the rights to RAD1901, we paid Eisai an initial license fee of $0.5 million. In connection with the License Agreement, we have agreed to pay Eisai certain fees in the range of $1.0 million to $20.0 million (inclusive of the $0.5 million initial license fee), payable upon the achievement of certain clinical and regulatory milestones. In March 2015, we entered into an

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amendment to the Eisai Agreement, or the Eisai Amendment, to include Japan within the territory covered by the Eisai Agreement. In consideration for the rights to RAD1901 in Japan, we paid Eisai an initial license fee of $0.4 million upon execution of the Eisai Amendment. The Eisai Amendment also provides for additional payments, payable upon the achievement of certain clinical and regulatory milestones in Japan.

        Should a product covered by the licensed technology be commercialized, we will be obligated to pay to Eisai royalties in a variable mid-single digit range based on net sales of the product on a country-by-country basis until the later of the last to expire of the licensed patents or the expiration of data protection clauses covering such product in such country; the royalty rate shall then be subject to reduction and the royalty obligation will expire at such time as sales of lawful generic version of such product account for more than a specified minimum percentage of the total sales of all products that contain the licensed compound. The latest patent to expire, barring any extension thereof, is expected on August 18, 2026.

        We were also granted the right to sublicense with prior written approval from Eisai. If we sublicense the licensed technology to a third party, we will be obligated to pay Eisai, in addition to the milestone fees referenced above, a fixed low double digit percentage of certain fees we receive from such sublicensee and royalties in low single digit range based on net sales of the sublicensee. The license agreement expires on a country-by-country basis on the later of (1) the date the last remaining valid claim in the licensed patents expires, lapses or is invalidated in that country, the product is not covered by data protection clauses, and the sales of lawful generic version of the product account for more than a specified percentage of the total sales of all pharmaceutical products containing the licensed compound in that country; or (2) a period of 10 years after the first commercial sale of the licensed products in such country, unless it is sooner terminated.

        The license agreement may be terminated by us with respect to the entire territory with prior notice to Eisai if we reasonably determine that the medical/scientific, technical, regulatory or commercial profile of the licensed product does not justify continued development or marketing. The license agreement can also be terminated by Eisai on a country-by-country basis at any time prior to the date on which we have submitted for either an FDA NDA approval or an EMA marketing approval with respect to a licensed product, upon prior written notice to us if Eisai makes a good faith determination that we have not used commercially reasonable efforts to develop the licensed product in the territory having reference to prevailing principles and time scales associated with the development, clinical testing and government approval of products of a like nature to such licensed product, unless such default is cured within the period specified in the license agreement or if not capable of being cured within such period we commence efforts to cure and make diligent efforts to do so. Either party may also terminate the license agreement upon a material breach by the other party unless such other party cures the alleged breach within the notice period specified in the license agreement. Either party may also terminate the license agreement upon the bankruptcy or insolvency of the other party. Eisai may also terminate the license agreement with prior notice if we are acquired by, or if we transfer all of our pharmaceutical business assets (or an essential part of such assets) or more than 50% of our voting stock to, any third party person or organization, or otherwise come under the control of, such a person or organization, whether resulting from merger, acquisition, consolidation or otherwise in the event that Eisai reasonably determines that the person or organization assuming control of us is not able to perform the license agreement with the same degree of skill and diligence that we would use, such determination being made with reference to the following criteria with respect to the person or organization assuming control of us: (1) whether such person or organization has the financial resources to assume our obligations with respect to development and commercialization of products; (2) whether such person or organization has personnel with skill and experience adequate to assume our obligations with respect to development and commercialization of products at the stage of development and commercialization as of the date of such change; and (3) whether such person or organization expressly assumes all obligations imposed on us by the license agreement and agrees to

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dedicate personnel and financial resources to the development and commercialization of the licensed product that are at least as great as those provided by us. Eisai shall further have the right to terminate if the acquiring person or organization: (a) has any material and active litigations with Eisai; or (b) is a hostile takeover bidder against us which has not been approved by our board of directors as constituted immediately prior to such change of control.

        The license agreement contains customary risk allocation. We agreed to indemnify Eisai in respect of third-party claims arising out of or resulting from: (1) negligence, recklessness or intentional acts or omissions by us, our affiliates and licensees; (2) any breach by us of a representation, warranty or covenant; and (3) any personal injury arising out of the labeling, packaging, package insert, other materials or promotional claims with respect to any licensed product by us, our affiliates, licensees or distributors in the territory. Eisai agreed to indemnify us for (1) negligence, recklessness or intentional acts or omissions by Eisai or its affiliates and licensees and (2) any breach by Eisai of a representation, warranty or covenant. The license agreement contains other customary clauses and terms as are common in similar agreements in the industry.

Lonza

        In October 2007, we entered into a Development and Manufacturing Services Agreement with Lonza. We and Lonza have entered into a series of Work Orders pursuant to the Development and Manufacturing Services Agreement pursuant to which Lonza has performed pharmaceutical development and manufacturing services for our abaloparatide product. We pay Lonza for services rendered and deliverables delivered pursuant to these work orders on a fee for service basis as specified in the applicable work statement. The Development and Manufacturing Services Agreement will expire on December 31, 2015 unless it is sooner terminated, and is subject to renewal by us for successive multiple-year terms with notice to Lonza.

        The Development and Manufacturing Services Agreement or any Work Order may be terminated by either party upon a material breach by the other party with respect to the Development and Manufacturing Services Agreement unless such other party cures the alleged breach within the notice period specified in the Development and Manufacturing Services Agreement. Either party may also terminate a Work Order if force majeure conditions have prevented performance by the other party for more than a specified period of time with respect to such Work Order. Termination of any Work Order for force majeure shall not result in termination of the Development and Manufacturing Services Agreement or any other Work Orders, which shall remain in force until terminated. Either party may also terminate the Development and Manufacturing Services Agreement upon the bankruptcy or insolvency of the other party. We may also terminate the Development and Manufacturing Services Agreement or any Work Order with prior notice to Lonza for convenience. We may also terminate the Development and Manufacturing Services Agreement or any Work Order if we reasonably determine that Lonza is or will be unable to perform the applicable services in accordance with the agreed upon timeframe and budget set forth in the applicable Work Order, or if Lonza fails to obtain or maintain any material governmental licenses or approvals required in connection with such services.

        The Development and Manufacturing Services Agreement contains customary risk allocation clauses with each party indemnifying the other in respect of third- party claims arising out of or resulting from: (i) the negligence or willful misconduct of such party, its affiliates and their respective officers, directors, employees and agents in performing its obligations under the Developing and Manufacturing Services Agreement; and (ii) any breach by such party of its representations and warranties under the Development and Manufacturing Services Agreement. We have agreed to indemnify Lonza in respect of third-party claims arising from or relating to the use of our product.

        On December 23, 2011, we entered into Work Order No. 4, or Work Order No. 4, under that certain Development and Manufacturing Services Agreement with Lonza. Pursuant to Work Order No. 4, Lonza agreed to perform activities required for our submission of an NDA in the United States

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with the FDA and similar applications required by the EMA and other authorities, excluding authorities in Japan, for abaloparatide, including production of three validation batches. These activities will provide for full process qualification and all required documentation necessary for regulatory submissions of the NDA to the FDA and the NDA equivalents to such other authorities. The total compensation payable to Lonza from us for services performed under Work Order No. 4 is up to €363,500 plus up to €1.1 million ($440,000, plus up to $1.3 million), for the regulatory qualification and validation campaigns.

        On December 10, 2014, we entered into Work Order No. 5, or Work Order No. 5, under that certain Development and Manufacturing Services Agreement with Lonza. Pursuant to Work Order No. 5, Lonza agreed to manufacture a batch of active pharmaceutical ingredient. The total compensation payable to Lonza from us for services performed under Work Order No. 5 is up to €400,000 ($484,000).

        On December 22, 2014, we entered into Work Order No. 6, or Work Order No. 6, under that certain Development and Manufacturing Services Agreement with Lonza. Pursuant to Work Order No. 6, Lonza agreed to perform activities required for our submission of an NDA in the United States with the FDA and similar applications required by the EMA and other authorities, excluding authorities in Japan, for abaloparatide, including stability testing. The total compensation payable to Lonza from us for services performed under Work Order No. 6 is up to €60,400 ($73,100).

Government Regulation

United States—FDA Process

        The research, development, testing, manufacture, labeling, promotion, advertising, distribution and marketing, among other things, of our product candidates are extensively regulated by governmental authorities in the United States and other countries. In the United States, the FDA regulates drugs under the Federal Food, Drug, and Cosmetic Act, or the FDCA, and its implementing regulations. Failure to comply with the applicable United States requirements may subject us to administrative or judicial sanctions, such as FDA refusal to approve pending NDAs, warning letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, and/or criminal prosecution. We expect abaloparatide, RAD1901 and RAD140 will each be subject to review by the FDA as a drug pursuant to the NDA process, and we currently only have active IND applications in relation to abaloparatide and RAD1901 in the United States.

        Approval Process —None of our drugs may be marketed in the United States until the drug has received FDA approval of an NDA. The steps required to be completed before a drug may be marketed in the United States include, among others:

    preclinical laboratory tests, animal studies, and formulation studies, all performed in accordance with the FDA's Good Laboratory Practice, or GLP, regulations;

    submission to the FDA of an IND application for human clinical testing, which must become effective before human clinical trials may begin and must be updated annually;

    adequate and well-controlled human clinical trials to establish the safety and efficacy of the drug for each proposed indication to FDA's satisfaction;

    submission to the FDA of an NDA;

    satisfactory completion of an FDA pre-approval inspection of one or more clinical trial site(s) at which the drug was studied in a clinical trial(s) to assess compliance with Good Clinical Practices, or GCP, regulations;

    satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities at which the drug is produced to assess compliance with cGMP regulations; and

    FDA review and approval of the NDA.

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        Preclinical tests include laboratory evaluation of product chemistry, toxicity, and formulation, as well as animal studies. The conduct of the preclinical tests and formulation of the compounds for testing must comply with federal regulations and requirements. The results of the preclinical tests, together with manufacturing information and analytical data, are submitted to the FDA as part of an IND application, which must become effective before human clinical trials may begin. An IND application will automatically become effective 30 days after receipt by the FDA, unless before that time the FDA raises concerns or questions about issues such as the conduct of the trials as outlined in the IND application. In such a case, the IND application sponsor and the FDA must resolve any outstanding FDA concerns or questions before clinical trials can proceed. We cannot be sure that submission of an IND application will result in the FDA allowing clinical trials to begin.

        Clinical trials involve the administration of the investigational drug to human subjects under the supervision of qualified investigators. Clinical trials are conducted under GCP pursuant to protocols detailing the objectives of the study, the parameters to be used in monitoring safety, and the effectiveness criteria to be evaluated. Each protocol must be submitted to the FDA as part of the IND application.

        Clinical trials necessary for product approval are typically conducted in three sequential phases, but the Phases may overlap. The study protocol and informed consent information for study subjects in clinical trials must also be approved by an Institutional Review Board, or IRB, for each institution where the trials will be conducted, and each IRB must monitor the study until completion. Study subjects must provide informed consent and sign an informed consent form before participating in a clinical trial. Clinical testing also must satisfy the extensive GCP regulations and regulations for informed consent and privacy of individually identifiable information.

        Phase 1 usually involves the initial introduction of the investigational drug into people to evaluate its short-term safety, dosage tolerance, metabolism, pharmacokinetics and pharmacologic actions, and, if possible, to gain an early indication of its effectiveness. Phase 1 studies are usually conducted in healthy individuals and are not intended to treat disease or illness. However, Phase 1b studies are conducted in healthy volunteers or in patients diagnosed with the disease or condition for which the study drug is intended, who present some biomarker, surrogate, or possibly clinical outcome that could be considered for "proof of concept." Proof of concept in a Phase 1b study typically confirms the hypothesis that the current prediction of biomarker, or outcome benefit is compatible with the mechanism of action.

        Phase 2 usually involves trials in a limited patient population to: (1) evaluate dosage tolerance and appropriate dosage; (2) identify possible adverse effects and safety risks; and (3) evaluate preliminarily the efficacy of the drug for specific target indications. Several different doses of the drug may be looked at in Phase 2 to see which dose has the desired effects. Patients are monitored for side effects and for any improvement in their illness, symptoms, or both.

        Phase 3 trials usually further evaluate clinical efficacy and test further for safety by using the drug in its planned commercial form in an expanded patient population. A Phase 3 trial usually compares how well the study drug works compared with an inactive placebo and/or another approved medication. One group of patients may receive the investigational new drug being tested, while another group of patients may receive the comparator drug (already approved drug for the disease being studied), or placebo.

        There can be no assurance that Phase 1, Phase 2 or Phase 3 testing will be completed successfully within any specified period of time, if at all. Furthermore, we or the FDA or an IRB (with respect to a particular study site) may suspend clinical trials at any time on various grounds, including a finding that the subjects or patients are being exposed to an unacceptable health risk.

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        Assuming successful completion of the required clinical testing, the results of the preclinical studies and of the clinical studies, together with other detailed information, including information on the manufacture and composition of the drug, are submitted to the FDA in the form of an NDA requesting approval to market the product for one or more proposed indications. The testing and approval process requires substantial time, effort and financial resources. The FDA reviews the application and may deem it to be inadequate, and companies cannot be sure that any approval will be granted on a timely basis, if at all. The FDA may also refer the application to an appropriate advisory committee, typically a panel of clinicians, for review, evaluation and a recommendation as to whether the application should be approved. The FDA is not bound by the recommendations of the advisory committee, but the Agency historically has tended to follow such recommendations.

        The FDA has various programs, including fast track designation, breakthrough therapy designation, priority review and accelerated approval, which are intended to expedite or simplify the process for reviewing drugs and/or provide for approval on the basis of surrogate endpoints. Generally, drugs that may be eligible for one or more of these programs are those intended to treat serious or life-threatening diseases or conditions, those with the potential to address unmet medical needs for those disease or conditions, and those that provide meaningful benefit over existing treatments. For example, a sponsor may be granted FDA designation of a drug candidate as a "breakthrough therapy" if the drug candidate is intended, alone or in combination with one or more other drugs, to treat a serious or life-threatening disease or condition and preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development. If a drug is designated as breakthrough therapy, FDA will expedite the development and review of such drug. From time to time, we anticipate applying for such programs where we believe we meet the applicable FDA criteria. A company cannot be sure that any of its drugs will qualify for any of these programs, or even if a drug does qualify, that the review time will be reduced. On May 9, 2014, we submitted a request for breakthrough therapy designation to the FDA for abaloparatide-SC for the treatment of postmenopausal osteoporosis. In July 2014, the FDA denied our request and indicated that, upon a new request, abaloparatide-SC would be considered for a breakthrough therapy designation if new clinical evidence demonstrates that patients dosed with abaloparatide-SC show substantial improvement in treatment of postmenopausal osteoporosis over existing therapies on one or more clinically significant endpoints. We believe that the recently completed analyses of the 18-month top-line results of our Phase 3 clinical trial and two abaloparatide Phase 2 clinical trials have shown potentially important clinical benefits relative to placebo and current anabolic therapies, including significant improvements in reducing the risk of osteoporotic fractures and in calcemic control. We believe these results could support a breakthrough therapy designation. Once we have evaluated the 24-month results from the Phase 3 clinical trial, we expect to make a decision as to whether or not to re-submit our request for breakthrough designation with a focus on the areas highlighted by the FDA or to apply for one of the other FDA expedited programs for new drugs that address unmet medical needs in the treatment of serious or life threatening conditions.

        Before approving an NDA, the FDA usually will inspect the facility or the facilities at which the drug is manufactured and will not approve the product unless the manufacturing and production and testing facilities are in compliance with cGMP regulations. If the NDA and the manufacturing facilities are deemed acceptable by the FDA, it may issue an approval letter, or in some cases, a Complete Response Letter. An approval letter authorizes commercial marketing of the drug with specific prescribing information for a specific indication(s). A Complete Response Letter indicates that the review cycle of the application is complete and the application is not ready for approval. A Complete Response Letter may require additional clinical data and/or an additional pivotal Phase 3 clinical trial(s), and/or other significant, expensive and time-consuming requirements related to clinical trials, preclinical studies or manufacturing. Even if such additional information is submitted, the FDA may ultimately decide that the NDA does not satisfy the criteria for approval. The FDA could also require,

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as a condition of NDA approval, post- marketing testing and surveillance to monitor the drug's safety or efficacy, or impose other conditions. Approval may also be contingent on a Risk Evaluation and Mitigation Strategy, or REMS, that limits the labeling, distribution or promotion of a drug product. The FDA also may condition approval on, among other things, changes to proposed labeling, development of adequate controls and specifications, or a commitment to conduct one or more post-marketing studies or clinical trials. Once issued, the FDA may withdraw product approval if ongoing regulatory requirements are not met or if safety problems occur after the product reaches the market.

        After approval, certain changes to the approved product, such as adding new indications, making certain manufacturing changes or making certain additional labeling claims, are subject to further FDA review and approval. Before a company can market products for additional indications, it must obtain additional approvals from the FDA. Obtaining approval for a new indication generally requires that additional clinical studies be conducted. A company cannot be sure that any additional approval for new indications for any investigational product candidate will be approved on a timely basis, or at all.

        Post-Approval Requirements —Often times, even after a drug has been approved by the FDA for sale, the FDA may require that certain post- approval requirements be satisfied, including the conduct of additional clinical studies. If such post-approval conditions are not satisfied, the FDA may withdraw its approval of the drug. In addition, holders of an approved NDA are required to: (1) report certain adverse reactions to the FDA, (2) comply with certain requirements concerning advertising and promotional labeling for their products, and (3) continue to have quality control and manufacturing procedures conform to cGMP regulations after approval. The FDA periodically inspects the sponsor's records related to safety reporting and/or manufacturing facilities; this latter effort includes assessment of ongoing compliance with cGMP regulations. Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality control to maintain cGMP compliance. We have used and intend to continue to use third-party manufacturers to produce our products in clinical and commercial quantities, and future FDA inspections may identify compliance issues at the facilities of our contract manufacturers that may disrupt production or distribution, or require substantial resources to correct. In addition, discovery of problems with a product after approval may result in restrictions on a product, including recall or withdrawal of the product from the market.

        Hatch-Waxman Act —Under the Drug Price Competition and Patent Term Restoration Act of 1984, also known as the Hatch-Waxman Act, Congress created an abbreviated FDA review process for generic versions of pioneer (brand name) drug products. In considering whether to approve such a generic drug product, the FDA requires that an Abbreviated New Drug Application, or ANDA, applicant demonstrate, among other things, that the proposed generic drug product's active ingredient is the same as that of the reference product, that any impurities in the proposed product do not affect the product's safety or effectiveness, and that its manufacturing processes and methods ensure the consistent potency and purity of its proposed product.

        The Hatch-Waxman Act provides five years of data exclusivity for new chemical entities, which generally (except as discussed below) prevents the FDA from accepting ANDAs and 505(b)(2) applications containing the protected active ingredient during the five-year period. We expect to be eligible for five years of data exclusivity following any FDA approval of abaloparatide-SC.

        The Hatch-Waxman Act also provides three years of exclusivity for applications containing the results of new clinical investigations (other than bioavailability studies) essential to the FDA's approval of new uses of approved products, such as new indications, delivery mechanisms, dosage forms, strengths, or conditions of use. For example, if abaloparatide-SC is approved for commercialization and we are successful in performing a clinical trial of abaloparatide-TD that provides a new basis for approval (a different delivery mechanism), it is possible that we may become eligible for a three year period of market exclusivity which protects against the approval (but not the filing) of ANDAs and

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505(b)(2) applications for the protected use but will not prohibit the FDA from accepting or approving ANDAs or 505(b)(2) applications for other products containing the same active ingredient.

        The Hatch-Waxman Act requires NDA applicants and NDA holders to provide certain information about patents related to the drug for listing in the FDA's list of Approved Drug Products with Therapeutic Equivalence Evaluations (commonly known as the Orange Book). ANDA and 505(b)(2) applicants must then certify regarding each of the patents listed with the FDA for the reference product. A certification that a listed patent is invalid and/or will not be infringed by the marketing of the applicant's product is called a "Paragraph IV certification." If the ANDA or 505(b)(2) applicant provides such a notification of patent invalidity or non-infringement, then the FDA may accept the ANDA or 505(b)(2) application beginning four years after approval of the NDA. If an ANDA or 505(b)(2) application containing a Paragraph IV certification is submitted to the FDA and accepted as a reviewable filing by the Agency, the ANDA or 505(b)(2) applicant then must provide, within 20 days, notice to the NDA holder and patent owner stating that the application has been submitted and providing the factual and legal basis for the applicant's opinion that the patent is invalid and/or not infringed. The NDA holder or patent owner then may file suit against the ANDA or 505(b)(2) applicant for patent infringement. If this is done within 45 days of receiving notice of the Paragraph IV certification, a one-time 30-month stay of the FDA's ability to approve the ANDA or 505(b)(2) application is triggered. The 30-month stay begins at the end of the NDA holder's data exclusivity period, or, if data exclusivity has expired, on the date that the patent holder is notified of the submission of the ANDA. The FDA may approve the proposed product before the expiration of the 30-month stay if a court finds the patent invalid and/or not infringed or if the court shortens the period because the parties have failed to cooperate in expediting the litigation.

European Union—EMA Process

        In the EU, medicinal products are authorized following a similar demanding process as that required in the United States and applications are based on the ICH Common Technical Document. In the European Union, medicines can be authorized by using either the centralized authorization procedure or national authorization procedures.

        Centralized procedure —Under the centralized procedure, after the EMA issues an opinion, the European Commission issues a single marketing authorization valid across the EU, as well as Iceland, Liechtenstein and Norway. The centralized procedure is compulsory for human medicines that are: derived from biotechnology processes, such as genetic engineering, contain a new active substance indicated for the treatment of certain diseases, such as HIV/AIDS, cancer, diabetes, neurodegenerative disorders or autoimmune diseases and other immune dysfunctions, and officially designated orphan medicines. For medicines that do not fall within these categories, an applicant has the option of submitting an application for a centralized marketing authorization to the EMA, as long as the medicine concerned is a significant therapeutic, scientific or technical innovation, or if its authorization would be in the interest of public health.

        National authorization procedures —There are also two other possible routes to authorize medicinal products in several countries, which are available for products that fall outside the scope of the centralized procedure:

    Decentralized procedure.   Using the decentralized procedure, an applicant may apply for simultaneous authorization in more than one EU country of a medicinal product that has not yet been authorized in any EU country and that does not fall within the mandatory scope of the centralized procedure.

    Mutual recognition procedure.   In the mutual recognition procedure, a medicine is first authorized in one EU Member State, in accordance with the national procedures of that country. Thereafter, further marketing authorizations can be sought from other EU countries in a

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      procedure whereby the countries concerned agree to recognize the validity of the original, national marketing authorization.

        In light of the fact that there is no policy at the EU level governing pricing and reimbursement, the 28 EU Member States each have developed their own, often varying, approaches. In many EU Member States, pricing negotiations must take place between the holder of the marketing authorization and the competent national authorities before the product is sold in their market with the holder of the marketing authorization required to provide evidence demonstrating the pharmaco-economic superiority of its product in comparison with directly and indirectly competing products. We have reviewed our development program, proposed Phase 3 study design, and overall non-clinical and clinical data package and believe they support future regulatory approval of abaloparatide-SC in the EU. In December 2012 and November 2014, we met with the Swedish Medical Products Agency, or MPA, to review the design and the overall progress of the Phase 3 study. The MPA confirmed that the program, based on the current single pivotal trial design, could support the submission and potential approval of an MAA in the EU, depending on the results of the Phase 3 study.

        Good manufacturing practices —Like the FDA, the EMA, the competent authorities of the EU Member States and other regulatory agencies regulate and inspect equipment, facilities and processes used in the manufacturing of pharmaceutical and biologic products prior to approving a product. If, after receiving clearance from regulatory agencies, a company makes a material change in manufacturing equipment, location, or process, additional regulatory review and approval may be required. Once we or our partners commercialize products, we will be required to comply with cGMP, and product-specific regulations enforced by, the European Commission, the EMA and the competent authorities of EU Member States following product approval. Also like the FDA, the EMA, the competent authorities of the EU Member States and other regulatory agencies also conduct regular, periodic visits to re-inspect equipment, facilities, and processes following the initial approval of a product. If, as a result of these inspections, it is determined that our or our partners' equipment, facilities, or processes do not comply with applicable regulations and conditions of product approval, regulatory agencies may seek civil, criminal or administrative sanctions and/or remedies against us, including the suspension of our manufacturing operations or the withdrawal of our product from the market.

        Data and Market Exclusivity —Similar to the United States, there is a process for approval of generic versions of innovator drug products in the EU. Abridged applications for the authorization of generic versions of drugs authorized by EMA can be submitted to the EMA through a centralized procedure referencing the innovator's data and demonstrating bioequivalence to the reference product, among other things.

        New medicinal products in the EU can receive eight years of data exclusivity coupled with two years of market exclusivity, and a potential one year extension, if the marketing authorizations holder obtains an authorization for one or more new therapeutic indications that demonstrates "significant clinical benefit" in comparison with existing therapies; this system is usually referred to as "8+2+1". We expect to be eligible for at least ten years of exclusivity (8 years of data exclusivity + 2 years of market exclusivity) following any approval of abaloparatide-SC. At this time we do not believe that there are orphan or pediatric applications for abaloparatide that would be likely to result in a grant of exclusivity or supplemental protection certificate in the EU.

        Abridged applications cannot rely on an innovator's data until after expiry of the 8-year data exclusivity term; applications for a generic product can be submitted after that 8 th  year, but the product cannot be marketed until the end of the market exclusivity term.

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Other International Markets—Drug approval process

        In some international markets (e.g., China or Japan), although data generated in United States or EU trials may be submitted in support of a marketing authorization application, additional clinical trials conducted in the host territory, or studying people of the ethnicity of the host territory, may be required prior to the filing or approval of marketing applications within the country.

Pricing and Reimbursement

        In the United States and internationally, sales of products that we market in the future, and our ability to generate revenues on such sales, are dependent, in significant part, on the availability and level of reimbursement from third-party payers such as state and federal governments, managed care providers and private insurance plans. Private insurers, such as health maintenance organizations and managed care providers, have implemented cost-cutting and reimbursement initiatives and likely will continue to do so in the future. These include establishing formularies that govern the drugs and biologics that will be offered and also the out-of-pocket obligations of member patients for such products. In addition, particularly in the United States and increasingly in other countries, we may be required to provide discounts and pay rebates to state and federal governments and agencies in connection with purchases of our products that are reimbursed by such entities. It is possible that future legislation in the United States and other jurisdictions could be enacted which could potentially impact the reimbursement rates for the products we are developing and may develop in the future and also could further impact the levels of discounts and rebates paid to federal and state government entities. Any legislation that impacts these areas could impact, in a significant way, our ability to generate revenues from sales of products that, if successfully developed, we bring to market.

        There is no legislation at the EU level governing the pricing and reimbursement of medicinal products in the EU. As a result, the competent authorities of each of the 28 EU Member States have adopted individual strategies regulating the pricing and reimbursement of medicinal products in their territory. These strategies often vary widely in nature, scope and application. However, a major element that they have in common is an increased move towards reduction in the reimbursement price of medicinal products, a reduction in the number and type of products selected for reimbursement, and an increased preference for generic products over innovative products. These efforts have mostly been executed through these countries' existing price-control methodologies. The government of the UK announced the phase-out of its established Pharmaceutical Pricing Reimbursement Scheme approach in January 2014 and the adoption of a new value-based pricing approach, at least for new product introductions. Under this approach, in a complete departure from established methodologies, reimbursement levels of each drug will be explicitly based on an assessment of value, looking at the benefits for the patient, unmet need, therapeutic innovation, and benefit to society as a whole. It is increasingly common in many EU Member States for Marketing Authorization Holders to be required to demonstrate the pharmaco-economic superiority of their products as compared to products already subject to pricing and reimbursement in specific countries. In order for drugs to be evaluated positively under such criteria, pharmaceutical companies may need to re-examine, and consider altering, a number of traditional functions relating to the selection, study, and management of drugs, whether currently marketed, under development, or being evaluated as candidates for research and/or development.

        Future legislation, including the current versions being considered at the federal level in the United States and at the national level in EU Member States, or regulatory actions implementing recent or future legislation may have a significant effect on our business. Our ability to successfully commercialize products depends in part on the extent to which reimbursement for the costs of our products and related treatments will be available in the United States and worldwide from government health administration authorities, private health insurers and other organizations. Substantial

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uncertainty exists as to the reimbursement status of newly approved healthcare products by third-party payers.

Sales and Marketing

        The FDA regulates all advertising and promotion activities for products under its jurisdiction both prior to and after approval. A company can make only those claims relating to safety and efficacy that are approved by the FDA following review and approval of an NDA. Physicians may prescribe legally available drugs for uses that are not described in the drug's labeling and that differ from those tested by us and approved by the FDA. Such off-label uses are common across medical specialties, and often reflect a physician's belief that the off-label use is the best treatment for the patients. The FDA does not regulate the behavior of physicians in their choice of treatments, but FDA regulations do impose stringent restrictions on manufacturers' communications regarding off-label uses. Failure to comply with applicable FDA requirements may subject a company to adverse publicity, enforcement action by the FDA, corrective advertising, consent decrees and the full range of civil and criminal penalties available to the FDA.

        We may also be subject to various federal and state laws pertaining to healthcare "fraud and abuse," including anti-kickback laws and false claims laws. Anti-kickback laws make it illegal for a prescription drug manufacturer to solicit, offer, receive, or pay any remuneration in exchange for, or to induce, the referral of business, including the purchase or prescription of a particular drug. Due to the breadth of the statutory provisions and the absence of guidance in the form of regulations and very few court decisions addressing industry practices, it is possible that our practices might be challenged under anti-kickback or similar laws. Moreover, recent healthcare reform legislation has strengthened these laws. For example, the recently enacted Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or collectively, the PPACA, among other things, amends the intent requirement of the federal anti-kickback and criminal healthcare fraud statutes, so that a person or entity no longer needs to have actual knowledge of this statute or specific intent to violate it in order to have committed a violation. In addition, PPACA permits the government to assert that a claim that includes items or services resulting from a violation of the federal anti-kickback statute constitutes a false or fraudulent claim for purposes of the false claims statutes. False claims laws prohibit anyone from knowingly and willingly presenting, or causing to be presented for payment, to third-party payers (including Medicare and Medicaid) claims for reimbursed drugs or services that are false or fraudulent, claims for items or services not provided as claimed, or claims for medically unnecessary items or services. Our activities relating to the sale and marketing of our products, if approved, may be subject to scrutiny under these laws. Violations of fraud and abuse laws may be punishable by criminal and civil sanctions, including fines and civil monetary penalties, the possibility of exclusion from federal healthcare programs (including Medicare and Medicaid) and corporate integrity agreements, which impose, among other things, rigorous operational and monitoring requirements on companies. Similar sanctions and penalties also can be imposed upon executive officers and employees, including criminal sanctions against executive officers under the so-called "responsible corporate officer" doctrine, even in situations where the executive officer did not intend to violate the law and was unaware of any wrongdoing.

        Given the significant penalties and fines that can be imposed on companies and individuals if convicted, allegations of such violations often result in settlements even if the company or individual being investigated admits no wrongdoing. Settlements often include significant civil sanctions, including fines and civil monetary penalties, and corporate integrity agreements. If the government were to allege or convict us or our executive officers of violating these laws, our business could be harmed. In addition, private individuals have the ability to bring similar actions. The majority of states also have anti-kickback and false claims laws, which establish similar prohibitions and in some cases may apply to items or services reimbursed by any third-party payor, including commercial insurers. Our activities

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could be subject to challenge for the reasons discussed above and due to the broad scope of these laws and the increasing attention being given to them by law enforcement authorities.

        There has also been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare providers. The PPACA, among other things, imposes new reporting requirements on drug manufacturers for payments made by them to physicians and teaching hospitals, as well as ownership and investment interests held by physicians and their immediate family members. Failure to submit required information may result in civil monetary penalties of up to an aggregate of $150,000 per year (or up to an aggregate of $1 million per year for "knowing failures"), for all payments, transfers of value or ownership or investment interests that are not timely, accurately and completely reported in an annual submission. Drug manufacturers are required to submit reports to the government by the 90th day of each calendar year. Certain states also mandate implementation of compliance programs, impose restrictions on drug manufacturer marketing practices and/or require the tracking and reporting of gifts, compensation and other remuneration to physicians. Many of these laws contain ambiguities as to what is required to comply with the laws. Given the lack of clarity in laws and their implementation, our actions could be subject to the penalty provisions of the pertinent state authorities.

        Similar rigid restrictions are imposed on the promotion and marketing of medicinal products in the EU and other countries. Laws (including those governing promotion, marketing and anti-kickback provisions), industry regulations and professional codes of conduct often are strictly enforced. Even in those countries where we are not directly responsible for the promotion and marketing of our products, inappropriate activity by our international distribution partners can have adverse implications for us.

Other Laws and Regulatory Processes

        We are subject to a variety of financial disclosure and securities trading regulations as a public company in the United States, including laws relating to the oversight activities of the SEC and, if any or our capital stock becomes listed on a national securities exchange, we will be subject to the regulations of such exchange on which our shares are traded. In addition, the Financial Accounting Standards Board, or FASB, the SEC and other bodies that have jurisdiction over the form and content of our accounts, our financial statements and other public disclosure are constantly discussing and interpreting proposals and existing pronouncements designed to ensure that companies best display relevant and transparent information relating to their respective businesses.

        Our international operations are subject to compliance with the Foreign Corrupt Practices Act, or the FCPA, which prohibits corporations and individuals from paying, offering to pay, or authorizing the payment of anything of value to any foreign government official, government staff member, political party, or political candidate in an attempt to obtain or retain business or to otherwise influence a person working in an official capacity. We also may be implicated under the FCPA for activities by our partners, collaborators, CROs, vendors or other agents.

        Our present and future business has been and will continue to be subject to various other laws and regulations. Various laws, regulations and recommendations relating to safe working conditions, laboratory practices, the experimental use of animals, and the purchase, storage, movement, import and export and use and disposal of hazardous or potentially hazardous substances used in connection with our research work are or may be applicable to our activities. Certain agreements entered into by us involving exclusive license rights or acquisitions may be subject to national or supranational antitrust regulatory control, the effect of which cannot be predicted. The extent of government regulation, which might result from future legislation or administrative action, cannot accurately be predicted.

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Employees

        As of December 31, 2014, we employed 25 full-time employees and 1 part-time employee, 8 of whom held Ph.D. or M.D. degrees. Sixteen of our employees were engaged in research and development activities and 10 were engaged in support administration, including business development and finance. We intend to use CROs and other third parties to perform our clinical studies and manufacturing.

Corporate Information

        We were incorporated in the state of Delaware on February 4, 2008 under the name MPM Acquisition Corp. In May 2011, we entered into a reverse merger transaction, or the Merger, with our predecessor, Radius Health, Inc., a Delaware corporation formed on October 3, 2003, or the Former Operating Company, pursuant to which the Former Operating Company became a wholly-owned subsidiary of ours. Immediately following the merger transaction, the Former Operating Company was merged with and into us, or the Short-Form Merger, we assumed the business of the Former Operating Company and changed our name to Radius Health, Inc.

Legal Proceedings

        We are not currently involved in any material legal proceedings.

Investor Information

        Financial and other information about us is available on our website at www.radiuspharm.com. We make available on our website, free of charge, copies of our Annual Report on Form 10-K, Quarterly Reports on Form 10-Q, current reports on Form 8-K and amendments to those reports filed or furnished pursuant to Section 13(a) or 15(d) of the Exchange Act as soon as reasonably practicable after we electronically file such material with, or furnish it to, the U.S. Securities and Exchange Commission, or the SEC. In addition, we have previously filed registration statements and other documents with the SEC. Any document we file may be inspected, without charge, at the SEC's public reference room at 100 F Street NE, Washington, DC 20549, or at the SEC's internet address at www.sec.gov. These website addresses are not intended to function as hyperlinks, and the information contained in our website and in the SEC's website is not intended to be a part of this filing. Information related to the operation of the SEC's public reference room may be obtained by calling the SEC at 800-SEC-0330.

ITEM 1A.    RISK FACTORS.

         Our business faces significant risks and uncertainties. Certain important factors may have a material adverse effect on our business prospects, financial condition and results of operations, and you should carefully consider them. Accordingly, in evaluating our business, we encourage you to consider the following discussion of risk factors, in its entirety, in addition to other information contained in or incorporated by reference into this Annual Report on Form 10-K and our other public filings with the SEC.


Risks Related to Our Business

Risks Related to Our Financial Position and Need for Capital

We currently have no product revenues and we will need to raise additional capital, which may not be available on favorable terms, if at all, in order to continue operating our business.

        To date, we have generated no product revenues. Until, and unless, we receive approval from the U.S. Food and Drug Administration, or FDA, and other foreign regulatory authorities for our product candidates, we will not be permitted to sell our drugs and will not have product revenues. Currently,

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our only product candidates are abaloparatide-SC, abaloparatide-TD, RAD1901 and RAD140, and none of these product candidates is approved by the FDA or other foreign regulatory authorities for sale. Therefore, for the foreseeable future, we will have to fund our operations and capital expenditures with our existing cash and cash equivalents and marketable securities, or through strategic financing opportunities, future offerings of our equity, and/or the incurrence of debt. We believe that our existing resources will be sufficient to fund our planned operations into the fourth quarter of 2016. We have based this estimate on assumptions that may prove to be wrong, and we could use up our available capital resources sooner than we currently expect. If we fail to obtain additional capital, we may be unable to complete our planned preclinical and clinical trials and obtain approval of any product candidates from the FDA and other foreign regulatory authorities. In addition, we could be forced to discontinue product development, reduce or forego sales and marketing efforts for any product candidate that is approved, forego attractive business opportunities or discontinue our operations entirely. Any additional sources of financing may not be available or may not be available on favorable terms and will likely involve the issuance of additional equity securities, which will have a dilutive effect on stockholders. Our future capital requirements will depend on many factors, including the scope and progress made in our research and development activities and our clinical studies.

We are not currently profitable and may never become profitable.

        We have a history of net losses and expect to incur substantial losses and have negative operating cash flow for the foreseeable future, and may never achieve or maintain profitability. We had net losses of $62.5 million, $60.7 million, and $69.1 million for the years ended December 31, 2014, 2013, and 2012, respectively. As of December 31, 2014, we had an accumulated deficit of $344.2 million. Even if we succeed in developing and commercializing one or more of our product candidates, we expect to incur substantial losses for the foreseeable future and may never become profitable. We also expect to continue to incur significant operating and capital expenditures and anticipate that our expenses will increase substantially in the foreseeable future as we:

    continue to undertake preclinical development and clinical trials for product candidates;

    seek regulatory approvals for product candidates;

    implement additional internal systems and infrastructure; and

    hire additional personnel.

        We also expect to experience negative cash flow for the foreseeable future as we fund our operating losses and capital expenditures. As a result, we will need to generate significant revenues in order to achieve and maintain profitability. Accordingly, unless and until we generate revenues and become profitable, we will need to raise additional capital to continue to operate our business. Our failure to achieve or maintain profitability or to raise additional capital could negatively impact the value of our securities.

Our credit facility imposes significant restrictions on our business, and if we default on our obligations, the lenders would have a right to foreclose on substantially all our assets.

        In May 2014, we entered into our new $30.0 million credit facility with Solar Capital Ltd., as collateral agent and lender, and Oxford Finance LLC, as lender. We drew $21.0 million under our new credit facility on May 30, 2014, and used approximately $9.3 million to repay our existing credit facility. Pursuant to an amendment to the credit facility, we drew an additional $4.0 million on July 10, 2014. Our new credit facility contains a number of covenants that impose significant operating and financial restrictions on us, including covenants that limit our ability to:

    dispose of our business or certain assets;

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    change our business, management, ownership or business locations;

    incur additional debt or liens;

    make certain investments or declare dividends;

    acquire or merge with another entity;

    enter into licensing agreements;

    engage in transactions with affiliates; or

    encumber our intellectual property.

        Our credit facility may limit our ability to finance future operations or capital needs or to engage in, expand or pursue our business activities. It may also prevent us from engaging in activities that could be beneficial to our business and our stockholders unless we repay the outstanding debt, which may not be desirable or possible.

        We have pledged substantially all of our assets other than our intellectual property to secure our obligations under our credit facility. If we default on our obligations and are unable to obtain a waiver for such a default, the lenders would have a right to accelerate the debt and terminate all commitments under our credit facility. They would also have the right to foreclose on the pledged assets, including our cash and cash equivalents. Any such action on the part of lenders against us would significantly harm our business and our ability to operate.

Raising additional capital may cause dilution to our existing stockholders, restrict our operations or require us to relinquish rights to our technologies or product candidates.

        Until such time, if ever, as we can generate substantial product revenues, we expect to finance our cash needs through a combination of collaborations, strategic alliances, licensing arrangements, other marketing and distribution arrangements, equity offerings, and debt financings. We do not have any committed external source of funds. To the extent that we raise additional capital through the sale of equity or convertible debt securities, your ownership interest will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect your rights as a stockholder. Debt financing, if available, may involve agreements that include covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we raise additional funds through marketing and distribution arrangements or other collaborations, strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates, or we may need to grant licenses on terms that may not be favorable to us. If we are unable to raise additional funds through equity or debt financings when needed, we may be required to delay, limit, reduce or terminate our product development or commercialization efforts or grant rights to develop and market product candidates that we would otherwise prefer to develop and market ourselves.

We are a company with a limited operating history upon which to base an investment decision.

        We are a company with a limited operating history and have not demonstrated an ability to perform the functions necessary for the successful commercialization of any product candidates. The successful commercialization of any product candidates will require us to perform a variety of functions, including:

    continuing to undertake preclinical development and clinical trials;

    participating in regulatory approval processes;

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    formulating and manufacturing products; and

    conducting sales and marketing activities for products if approved.

        Our operations have been limited to organizing and staffing our company, acquiring, developing and securing our proprietary technology and undertaking preclinical and clinical trials of our product candidates. These operations provide a limited basis for you to assess our ability to commercialize our product candidates and the advisability of investing further in our securities.

Our financial results may fluctuate from quarter to quarter, which makes our results difficult to predict and could cause our results to fall short of expectations.

        Our financial results may fluctuate as a result of a number of factors, many of which are outside of our control. For these reasons, comparing our financial results on a period-to-period basis may not be meaningful, and you should not rely on our past results as an indication of our future performance. Our revenues, if any, may fluctuate from quarter to quarter and our future quarterly and annual expenses as a percentage of our revenues may be significantly different from those we have recorded in the past or which we expect for the future. Our financial results in some quarters may fall below expectations. Any of these events as well as the various risk factors listed in this "Risk Factors" section could adversely affect our financial results and cause our stock price to fall.

Risks Related to the Discovery, Development and Commercialization of Our Product Candidates

We are heavily dependent on the success of abaloparatide-SC which is under clinical development. We cannot be certain that abaloparatide-SC will receive regulatory approval or be successfully commercialized even if we receive regulatory approval.

        Abaloparatide-SC is our only product candidate in late-stage clinical development, and our business currently depends heavily on its successful development, regulatory approval and commercialization. We have no drug products for sale currently and may never be able to develop approved and marketable drug products. The research, testing, manufacturing, labeling, approval, sale, marketing and distribution of drug products are subject to extensive regulation by the FDA and other foreign regulatory authorities in the United States and other countries, which regulations differ from country to country. We are not permitted to market abaloparatide-SC in the United States unless and until we receive approval of a New Drug Application, or NDA, from the FDA, or in any foreign countries unless and until we receive the requisite approval from regulatory authorities in foreign countries. In addition, the approval of abaloparatide-TD as a line extension to abaloparatide-SC is dependent on the earlier approval of abaloparatide-SC. We have not submitted an NDA to the FDA or comparable applications to regulatory authorities in other countries. Obtaining approval of a product candidate is an extensive, lengthy, expensive and uncertain process, and any approval of abaloparatide-SC may be delayed, limited or denied for many reasons, including:

    we may not be able to demonstrate that abaloparatide is safe and effective as a treatment for reduction of fracture risk in postmenopausal women with severe osteoporosis to the satisfaction of the FDA or other foreign regulatory authorities;

    the results of our clinical studies may not meet the level of statistical or clinical significance required for marketing approval;

    the FDA or other foreign regulatory authorities may disagree with the number, design, size, conduct or implementation of our clinical studies;

    any clinical research organizations, or CROs, that we have retained or may in the future retain, to conduct clinical studies may take actions outside of our control that materially adversely impact our clinical studies;

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    the FDA or other foreign regulatory authorities may not find the data from preclinical studies and clinical studies sufficient to demonstrate that abaloparatide's clinical and other benefits outweigh its safety risks;

    the FDA or other foreign regulatory authorities may disagree with our interpretation of data from our preclinical studies and clinical studies or may require that we conduct additional studies;

    the FDA or other foreign regulatory authorities may not accept data generated at our clinical study sites;

    the FDA or other foreign regulatory authorities may not agree with our proposed labeling and may require labeling that undermines or otherwise significantly impairs the commercial value of the product if it were to be approved with such labeling;

    the FDA may require development of a Risk Evaluation and Mitigation Strategy, or REMS, as a condition of approval;

    if our NDA is reviewed by an advisory committee, the FDA may have difficulties scheduling an advisory committee meeting in a timely manner or the advisory committee may recommend against approval of our application or may recommend that the FDA require, as a condition of approval, additional preclinical studies or clinical studies, limitations on approved labeling or distribution and use restrictions; or

    the FDA or other foreign regulatory authorities may identify deficiencies in the manufacturing processes or facilities of our third-party manufacturers.

        In addition, the FDA or other foreign regulatory authorities may change its approval policies or adopt new regulations. For example, on February 15, 2012, we received a letter from the FDA stating that, after internal consideration, the FDA believes that a minimum of 24-month fracture data are necessary for approval of new products for the treatment of postmenopausal osteoporosis. Our abaloparatide-SC pivotal Phase 3 clinical trial is designed to produce fracture data based on an 18-month primary endpoint. Based on our discussions with the FDA, we believe that continued use of the 18-month primary endpoint will be acceptable, provided that our NDA includes the 24-month fracture data derived from the first six months extension of the abaloparatide 80 µg and placebo groups in our Phase 3 study, which groups will receive an approved alendronate (generic Fosamax) therapy for osteoporosis management. We plan to submit our NDA with the 24-month fracture data. We cannot be certain that the FDA will be supportive of this plan, will not change this approval policy again or will not adopt other approval policies or regulations that adversely affect any NDA that we may submit, the occurrence of any of which may further delay FDA approval.

        Before we submit an NDA to the FDA for abaloparatide-SC as a proposed treatment for osteoporosis, we must complete the first six months of the alendronate extension study of the abaloparatide and placebo groups from our Phase 3 clinical and submit 24-month fracture data to the FDA. We also must complete several additional studies, including, but not limited to, a thorough QT Phase 1 study and a Phase 1 pharmacokinetic study in renal patients. The results of these studies will have an important bearing on the approval of abaloparatide.

        We cannot assure you that we will receive the approvals necessary to commercialize any of our product candidates, including abaloparatide-SC, abaloparatide-TD, RAD1901 and RAD140, or any product candidate we may acquire or develop in the future. We will need FDA approval to commercialize our product candidates in the United States and approvals from the regulatory authorities in foreign jurisdictions to commercialize our product candidates in those jurisdictions. In order to obtain FDA approval of any product candidate, we must submit to the FDA an NDA demonstrating that the product candidate is safe for humans and effective for its indicated use. This

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demonstration requires significant research and animal tests, which are referred to as preclinical studies, as well as human tests, which are referred to as clinical trials. Satisfaction of the FDA's regulatory requirements typically takes many years, depends upon the type, complexity and novelty of the product candidate and requires substantial resources for research, development and testing. We cannot predict whether our research and clinical approaches will result in drugs that the FDA considers safe for humans and effective for proposed uses. The FDA has substantial discretion in the drug approval process and may require us to conduct additional preclinical and clinical testing or to perform post-marketing studies. The approval process may also be delayed by changes in government regulation, future legislation or administrative action or changes in FDA policy that occur prior to or during its regulatory review, such as the request we received from the FDA with respect to providing a minimum of 24-month fracture data for approval of abaloparatide. Delays in obtaining regulatory approvals may:

    delay commercialization of, and our ability to derive product revenues from, our product candidates;

    impose costly procedures on us; and

    diminish any competitive advantages that we may otherwise enjoy.

        Even if we comply with all FDA requests, the FDA may ultimately reject one or more of our NDAs. We may never obtain regulatory clearance for any of our product candidates. Failure to obtain FDA approval of any of our product candidates will severely undermine our business by leaving us without a saleable product, and therefore without any source of revenues, until another product candidate can be developed. There is no guarantee that we will ever be able to develop or acquire any product candidate.

        In foreign jurisdictions, we must receive approval from the appropriate regulatory authorities before we can commercialize any drugs. Foreign regulatory approval processes generally include all of the risks associated with the FDA approval procedures described above. We cannot assure you that we will receive the approvals necessary to commercialize any of our product candidates for sale outside the United States.

Clinical trials are very expensive, time-consuming and difficult to design and implement.

        Human clinical trials are very expensive and difficult to design and implement, in part because they are subject to rigorous regulatory requirements. A substantial portion of our abaloparatide development costs are denominated in euros and any adverse movement in the dollar/euro exchange rate will result in increased costs and require us to raise additional capital to complete the development of our products. The clinical trial process is also time consuming. Furthermore, failure can occur at any stage of the trials, and we could encounter problems that cause us to abandon or repeat clinical trials. The commencement and completion of clinical trials may be delayed by several factors, including:

    changes in government regulation, administrative action or changes in FDA or other foreign regulatory authority policy with respect to clinical trials that change the requirements for approval;

    unforeseen safety issues;

    determination of dosing issues;

    lack of effectiveness during clinical trials;

    slower than expected rates of patient recruitment and enrollment;

    failure of sites to comply with requirements for conducting clinical trials;

    inability to monitor patients adequately during or after treatment; and

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    inability or unwillingness of medical investigators to follow our clinical protocols.

        In addition, we, the FDA, or other equivalent regulatory authorities and ethics committees with jurisdiction over our studies may suspend our clinical trials at any time if it appears that we are exposing participants to unacceptable health risks or if the FDA or other foreign regulatory authorities find deficiencies in our regulatory submissions or the conduct of these trials. Therefore, we cannot predict with any certainty the schedule for existing or future clinical trials. Any such unexpected expenses or delays in our clinical trials could increase our need for additional capital, which may not be available on favorable terms or at all.

Most of our investigational product candidates are in early stages of clinical trials.

        Except for abaloparatide-SC and abaloparatide-TD, each of our other product candidates (i.e., RAD1901 and RAD140) is in the early stages of development and requires extensive preclinical and clinical testing. We cannot predict with any certainty if or when we might submit an NDA or equivalent application to foreign regulatory authorities for regulatory approval for any of our product candidates or whether any such NDA or equivalent application would be accepted for filing by FDA or other foreign regulatory authorities or approved if filed.

The results of clinical trials may not support our product candidate claims.

        Even if our clinical trials are completed as planned, we cannot be certain that the results will support regulatory approval of our product candidates. Success in preclinical testing and early clinical trials does not ensure that later clinical trials will be successful, and we cannot be sure that the results of later clinical trials will replicate the results of prior clinical trials and preclinical testing. The clinical trial process may fail to demonstrate that our product candidates are safe for humans and effective for proposed uses. This failure would cause us to abandon a product candidate and may delay development of other product candidates. Any delay in, or termination of, our clinical trials will delay the submission of our NDAs to the FDA or equivalent application to foreign regulatory authorities and, ultimately, our ability to commercialize our product candidates and generate product revenues. In addition, our clinical trials to date have involved small patient populations. Because of the small sample sizes, the results of these clinical trials may not be indicative of future results.

        In addition, third parties could conduct clinical trials using the product candidates we license. We would have no control over how these trials are conducted and the results could potentially contradict the results we have obtained, or will obtain from the clinical trials we conduct.

If serious adverse or undesirable side effects are identified during the development of our product candidates, we may need to abandon our development of some of our product candidates.

        All of our product candidates are still in preclinical or clinical development. Undesirable side effects caused by our product candidates could cause us or regulatory authorities to interrupt, delay or halt clinical trials and could result in a more restrictive label or the delay or denial of regulatory approval by the FDA or other comparable foreign authorities. It is impossible to predict when or if any of our product candidates will prove effective or safe in humans or will receive regulatory approval, if ever. If our product candidates result in undesirable side effects or have characteristics that are unexpected, we may need to abandon their development. Drug-related side effects could affect patient recruitment or the ability of enrolled patients to complete the trial or result in potential product liability claims. Any of these occurrences may harm our business, financial condition and prospects significantly.

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        Additionally if one or more of our product candidates receives marketing approval, and we or others later identify undesirable side effects caused by such products, a number of potentially significant negative consequences could result, including:

    regulatory authorities may withdraw approvals of such product;

    regulatory authorities may require additional warnings on the label;

    we may be required to create a medication guide outlining the risks of such side effects for distribution to patients;

    we could be sued and held liable for harm caused to patients; and

    our reputation may suffer.

        Any of these events could prevent us from achieving or maintaining market acceptance of the particular product candidate, if approved, and could significantly harm our business, results of operations and prospects.

Any product candidate for which we obtain marketing approval could be subject to restrictions or withdrawal from the market and we may be subject to penalties if we fail to comply with regulatory requirements or if we experience unanticipated problems with our products, when and if any of them are approved.

        Any product candidate for which we obtain marketing approval, along with the manufacturing processes, post-approval clinical studies, labeling, advertising and promotional activities for such product, will be subject to continual requirements of and review by the FDA and other foreign regulatory authorities. These requirements include submissions of safety and other post-marketing information and reports, registration and listing requirements, current good manufacturing practices, or cGMP, requirements relating to quality control, quality assurance and corresponding maintenance of records and documents, and requirements regarding the distribution of samples to physicians and recordkeeping. Even if we obtain marketing approval of a product candidate, the approval may be subject to limitations on the indicated uses for which the product may be marketed or to the conditions of approval, or contain requirements for costly post-marketing testing and surveillance to monitor the safety or efficacy of the product. The FDA closely regulates the post-approval marketing and promotion of drugs to ensure drugs are marketed only for the approved indications and in accordance with the provisions of the approved labeling. The FDA imposes stringent restrictions on manufacturers' communications regarding off-label use and, if we do not market our products for their approved indications, we may be subject to enforcement action for off-label marketing.

        In addition, later discovery of previously unknown problems with our products, manufacturers or manufacturing processes, or failure to comply with regulatory requirements, may yield various results, including:

    restrictions on such products, manufacturers or manufacturing processes;

    restrictions on the labeling or marketing of a product;

    restrictions on product distribution or use;

    requirements to conduct post-marketing clinical trials;

    warning or untitled letters;

    withdrawal of the products from the market;

    refusal to approve pending applications or supplements to approved applications that we submit;

    voluntary or mandatory recall of products and related publicity requirements;

    fines, restitution or disgorgement of profits or revenue;

    suspension or withdrawal of marketing approvals;

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    refusal to permit the import or export of our products;

    product seizure; or

    injunctions or the imposition of civil or criminal penalties.

        In addition, the FDA's policies may change and additional government regulations may be enacted that could prevent, limit, or delay regulatory approval of our product candidates. We cannot predict the likelihood, nature, or extent of government regulation that may arise from future legislation or administrative action, either in the United States or abroad. If we are slow or unable to adapt to changes in existing requirements or the adoption of new requirements or policies, or if we are not able to maintain regulatory compliance, we may lose any marketing approval that we may have obtained and we may not achieve or sustain profitability, which would adversely affect our business.

The commercial success of any product candidates that we may develop and that may be approved will depend upon the degree of market acceptance by regulators, key opinion leaders, physicians, patients, healthcare payers and others in the medical community.

        Even if the FDA or other foreign regulatory authority approves one or more of our product candidates, physicians and patients may not accept and use them. Acceptance and use of any of our products will depend upon a number of factors including:

    perceptions by members of the healthcare community, including physicians and key opinion leaders, about the safety and effectiveness of our drug;

    cost-effectiveness of our product relative to competing products;

    availability of coverage and reimbursement for our product from government or other healthcare payers; and

    effectiveness of marketing and distribution efforts by us and our licensees and distributors, if any.

        If any of our product candidates are commercialized and unexpected adverse events are reported in connection with the use of any of those products, physician and patient acceptance of the product could deteriorate and the commercial success of such product could be adversely affected. We are required to report to the FDA or similar bodies in other countries events associated with our products relating to death or serious injury. Adverse events could result in additional regulatory controls, such as for the imposition of costly post-approval clinical studies or revisions to approved labeling which could limit the indications or patient population for a product or could even lead to the withdrawal of a product from the market. Because we expect sales of our current product candidates, if approved, to generate substantially all of our product revenues for the foreseeable future, the failure of these drugs to gain market acceptance or, once gained, a decrease in market acceptance would harm our business and would require us to seek additional financing.

We may expend our limited resources to pursue a particular product candidate or indication and fail to capitalize on product candidates or indications that may be more profitable or for which there is a greater likelihood of success.

        Because we have limited financial and managerial resources, we narrowly focus on research programs and product candidates that we identify for specific indications. As a result, we may forego or delay pursuit of opportunities with other product candidates or for other indications that later prove to have greater commercial potential. Our resource allocation decisions may cause us to fail to capitalize on viable commercial products or profitable market opportunities. Our spending on current and future research and development programs and product candidates for specific indications may not yield any commercially viable products. If we do not accurately evaluate the commercial potential or target market for a particular product candidate, we may relinquish valuable rights to that product candidate

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through collaboration, licensing or other royalty arrangements in cases in which it would have been more advantageous for us to retain sole development and commercialization rights to such product candidate.

If we experience delays in the enrollment of patients in our clinical trials, our receipt of necessary regulatory approvals could be delayed or prevented.

        We may not be able to initiate or continue clinical trials for some of our product candidates if we are unable to locate and enroll a sufficient number of eligible patients to participate in these trials as required by the FDA or other foreign regulatory authorities. In addition, many of our competitors have ongoing clinical trials for product candidates that could be competitive with our product candidates, and patients who would otherwise be eligible for our clinical trials may instead enroll in clinical trials of our competitors' product candidates.

        Enrollment delays in our clinical trials may result in increased development costs for our product candidates, which would cause the value of the company to decline and limit our ability to obtain additional financing. Our inability to enroll a sufficient number of patients for any of our current or future clinical trials would result in significant delays or may require us to abandon one or more clinical trials altogether.

Risks Related to Our Dependence on Third Parties

Our drug development program depends upon third-party researchers, investigators and collaborators who are outside our control.

        We depend upon independent researchers, investigators and collaborators, to conduct our preclinical and clinical trials under agreements with us. These third parties are not our employees and we cannot control the amount or timing of resources that they devote to our programs. Nevertheless, we are responsible for ensuring that each of our studies is conducted in accordance with the applicable protocol, legal, regulatory and scientific standards and requirements, and our reliance on third parties does not relieve us of our regulatory responsibilities. We and our third party researchers, investigators and collaborators are required to comply with good clinical practice, or GCP, requirements, which are regulations and guidelines enforced by the FDA, the Competent Authorities of the Member States of the European Economic Area, or EEA, and comparable foreign regulatory authorities for all of our products in clinical development. Regulatory authorities enforce these GCPs through periodic inspections of trial sponsors, principal investigators and trial sites. If we or any of our CROs fail to comply with applicable GCPs, the clinical data generated in our clinical trials may be deemed unreliable and the FDA, EMA or other comparable foreign regulatory authorities may require us to perform additional clinical trials before approving our marketing applications. We cannot assure you that upon inspection by a given regulatory authority, such regulatory authority will determine that any of our clinical trials complies with GCP regulations. In addition, our clinical trials must be conducted with product produced under cGMP regulations. Our failure to comply with these regulations may require us to repeat clinical trials, which would delay the regulatory approval process. In addition, these third parties may not assign as great a priority to our programs or pursue them as diligently as we would if we were undertaking such programs ourselves. If outside collaborators fail to devote sufficient time and resources to our drug-development programs, or if their performance is substandard, the approval of our FDA or foreign regulatory authority applications, if any, and our introduction of new drugs, if any, will be delayed. These collaborators may also have relationships with other commercial entities, some of whom may compete with us. If our collaborators assist competitors at our expense, our competitive position would be harmed.

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If a regulatory or governmental authority determines that a financial interest in the outcome of the Phase 3 study of abaloparatide-SC by any of the entities managing our Phase 3 clinical trial affected the reliability of the data from the Phase 3 clinical trial, our ability to use the data for our planned regulatory submissions could be compromised, which could harm our business and the value of our common stock.

        The Phase 3 clinical trial and subsequent extension studies of abaloparatide-SC are being managed by Nordic at certain clinical sites operated by the Center for Clinical and Basic Research, or CCBR, a leading global CRO with extensive experience in global osteoporosis registration studies. Nordic controls, and holds an ownership interest in, the local CCBR clinical sites. The clinical trial investigators are employees of CCBR and may also hold an equity interest in the local CCBR clinical trials.

        In consideration of Nordic's management of our Phase 3 clinical trial and subsequent extension studies, we have agreed to make various cash payments to Nordic denominated in both euros and U.S. dollars over the course of the Phase 3 study equal to a total of up to approximately €48.6 million ($58.8 million) and a total of up to approximately $4.4 million plus up to an additional $5.0 million in aggregate performance incentive payments, payable in cash or stock depending on the timing of the closing of an underwritten offering of shares of our common stock. We also agreed to sell shares of capital stock to Nordic that were exchanged in the Merger for 6,443 shares of our series A-5 convertible preferred stock for proceeds of approximately $0.5 million. These shares of our series A-5 convertible preferred stock automatically converted into 28,258 shares of our common stock upon the listing of our common stock on the NASDAQ Global Market. Pursuant to the terms of our agreements with Nordic, we were required to issue to Nordic shares of stock with an aggregate value of up to approximately €44.3 million ($53.6 million) and $0.8 million in consideration of Nordic's management of the Phase 3 clinical trial. These shares of stock accrued at a quarterly rate based on the progress of the Phase 3 clinical trial and were issuable at a price per share equal to the greater of (1) the fair market value of our common stock as of the applicable accrual date or (2) $81.42 and rounding down the resulting quotient to the nearest whole number. On each of December 31, 2013 and March 31, 2014, our Board of Directors declared a stock dividend to pay all shares of stock that had accrued as of such dates and that were anticipated to accrue through December 31, 2014, representing an aggregate of 682,958 shares of our Series A-6 convertible preferred stock that automatically converted into 2,995,453 shares of our common stock upon the listing of our common stock on the NASDAQ Global Market. Following the completion of our initial public offering of shares of our common stock on June 11, 2014, or our initial public offering, all compensation remaining payable to Nordic in consideration of their management of our Phase 3 clinical trial became payable in cash.

        The fair market value of our common stock may be subject to wide fluctuations in response to various factors, many of which are beyond our control, including any negative outcome of the Phase 3 study. Accordingly, the shares of stock that we have issued to Nordic in consideration of Nordic's management of the Phase 3 clinical trial may be less than the full value originally anticipated under our agreements with Nordic, assuming Nordic did not expect the fair market value of our stock to fluctuate widely over the term of such agreements. As a result, the total consideration that Nordic will receive in cash and stock may be viewed to be below the market price paid by other companies for comparable clinical trial services.

        Because of the potential decrease in the value of the common stock issued to Nordic upon a negative outcome of the Phase 3 study, Nordic, CCBR and the clinical trial investigators may be viewed as having a financial interest in the outcome of the study. We have obtained written acknowledgments from the clinical trial investigators certifying that they have no financial interest in the outcome of the Phase 3 clinical trial. However, if the FDA, the EMA, or any other similar regulatory or governmental authority determines that Nordic, CCBR or the clinical trial investigators have a financial interest that affected the reliability of the data from the Phase 3 clinical trial, we could be subject to additional regulatory scrutiny and the utility of the Phase 3 clinical trial for purposes of our planned regulatory

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submissions could be compromised, which could have a material adverse effect on our business and the value of our common stock.

We will rely exclusively on third parties to formulate and manufacture our product candidates.

        We have no experience in drug formulation or manufacturing and do not intend to establish our own manufacturing facilities. We lack the resources and expertise to formulate or manufacture our own product candidates. We have entered into agreements with contract manufacturers to manufacture abaloparatide for use in clinical trial activities. These contract manufacturers are currently our only source for the production and formulation of abaloparatide. We may not have sufficient clinical supplies of abaloparatide but believe that our contract manufacturers will be able to produce sufficient supply of abaloparatide to complete all of the planned abaloparatide clinical studies. If our contract manufacturers are unable to produce, in a timely manner, adequate clinical supplies to meet the needs of our clinical studies, we would be required to seek new contract manufacturers that may require us to modify our finished product formulation and modify or terminate our clinical studies for abaloparatide. Any modification of our finished product or modification or termination of our clinical studies could adversely affect our ability to obtain necessary regulatory approvals and significantly delay or prevent the commercial launch of the product if it were to be approved, which would materially harm our business and impair our ability to raise capital. In addition, the facilities and processes and controls used by our contract manufacturers to manufacture our product candidates must be approved by the FDA pursuant to inspections that will be conducted after we submit our NDA to the FDA. We do not control the facilities or manufacturing process and controls of, and are completely dependent on, our contract manufacturing partners for compliance with the regulatory requirements, known as cGMPs, for manufacture of both active drug substances and finished drug products. If our contract manufacturers cannot successfully manufacture material that conforms to our specifications and the strict regulatory requirements of the FDA or others, they will not be able to secure and/or maintain regulatory approval for their manufacturing facilities. In addition, we have no control over the ability of our contract manufacturers to maintain adequate quality control, quality assurance and qualified personnel. If the FDA or a comparable foreign regulatory authority does not approve these for the manufacture of our product candidates or if it withdraws any such approval in the future, we may need to find alternative manufacturing facilities, which would significantly impact our ability to develop, obtain regulatory approval for or market our product candidates, if approved.

        We depend on a number of single source contract manufacturers to supply key components of abaloparatide. For example, we depend on Lonza Group Ltd., or Lonza, which produces supplies of bulk drug product of abaloparatide to support the abaloparatide-SC and abaloparatide-TD clinical studies and any potential commercial launch. We also depend on Vetter Pharma Fertigung GmbH & Co, or Vetter, and Ypsomed AG, or Ypsomed, for the production of finished supplies of abaloparatide-SC and we depend on 3M for the production of abaloparatide-TD. Because of our dependence on Vetter for the "fill and finish" part of the manufacturing process for abaloparatide-SC, we are subject to the risk that Vetter may not have the capacity from time to time to produce sufficient quantities of abaloparatide to meet the needs of our clinical studies or be able to scale to commercial production of abaloparatide. Because the manufacturing process for abaloparatide-TD requires the use of 3M's proprietary technology, 3M is our sole source for finished clinical trial supplies of abaloparatide-TD. To date, we have not entered into a commercial supply agreement with 3M. If we were not able to negotiate commercial supply terms with 3M, as we depend on 3M for production of abaloparatide-TD, we would be unable to commercialize this product if it were to be approved. Or, if we are forced to accept unfavorable terms for our future relationship with 3M, our business and financial condition would be materially harmed.

        While we are currently in discussions, to date, we have not entered into a long-term agreement with any of Lonza, Vetter or Ypsomed, each of whom currently produces abaloparatide or related components on a purchase order basis for us. Accordingly, Lonza, Vetter and Ypsomed could terminate

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their relationship with us at any time and for any reason. We may not be able to negotiate long-term agreements on acceptable terms, or at all. If our relationship with any of these contract manufacturers is terminated, or if they are unable to produce abaloparatide or related components in required quantities, on a timely basis or at all, or if we are forced to accept unfavorable terms for our future relationship, our business and financial condition would be materially harmed. If any of our current product candidates or any product candidates we may develop or acquire in the future receive FDA or foreign regulatory authority approval, we will rely on one or more third-party contractors to manufacture our drugs or related components. Our anticipated future reliance on a limited number of third-party manufacturers exposes us to the following risks:

    We may be unable to identify manufacturers on acceptable terms, or at all, because the number of potential manufacturers is limited and the FDA must approve any replacement contractor. This approval would require new testing and compliance inspections. In addition, a new manufacturer would have to be educated in, or develop substantially equivalent processes for, production of our products after receipt of FDA approval, if any.

    Our third-party manufacturers might be unable to formulate and manufacture our drugs or related components in the volume and of the quality required to meet our clinical needs and commercial needs, if any.

    Our future contract manufacturers may not perform as agreed or may not remain in the contract manufacturing business for the time required to supply our clinical trials or to successfully produce, store and distribute our products.

    Drug manufacturers are subject to ongoing periodic unannounced inspection by the FDA, the Drug Enforcement Administration, for any controlled substances, and corresponding state agencies to ensure strict compliance with cGMP, and other government regulations and corresponding foreign standards and failure to comply with cGMP or corresponding foreign standards can result in compliance actions that may limit a manufacturer's production or prohibit a manufacturer from producing some or all products at a facility. We do not have control over third-party manufacturers' compliance with these regulations and standards.

    If any third-party manufacturer makes improvements in the manufacturing process for our products, we may not own, or may have to share, the intellectual property rights to the innovation.

        Each of these risks could delay our clinical trials, the approval, if any, of our product candidates by the FDA or other foreign regulatory authority or the commercialization of our product candidates or result in higher costs or deprive us of potential product revenues

If we are not able to establish additional collaborations, we may have to alter our development plans.

        Our product development programs and the potential commercialization of our product candidates will require substantial additional cash to fund expenses. For some of our product candidates, we may decide to collaborate with pharmaceutical and biotechnology companies for the development and potential commercialization of those product candidates.

        We face significant competition in seeking appropriate collaborators. Collaborations are complex and time-consuming to negotiate and document. We may also be restricted under existing collaboration agreements from entering into agreements on certain terms with other potential collaborators. We may not be able to negotiate collaborations on acceptable terms, or at all. If that were to occur, we may have to curtail the development of a particular product candidate, reduce or delay its development program or one or more of our other development programs, delay its potential commercialization or reduce the scope of our sales or marketing activities, or increase our expenditures and undertake development or commercialization activities at our own expense. If we elect to increase our expenditures to fund development or commercialization activities on our own, we may need to obtain

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additional capital, which may not be available to us on acceptable terms or at all. If we do not have sufficient funds, we will not be able to bring our product candidates to market and generate product revenue.

Risks Related to Marketing and Sale of Our Products

We have no experience selling, marketing or distributing products and currently do not have the internal capability to do so.

        We currently have no sales, marketing or distribution capabilities. Our future success depends, in part, on our ability to enter into and maintain collaborative relationships for such capabilities, the collaborators' strategic interest in the products under development and such collaborators' ability to successfully market and sell any such products. We intend to build an internal sales force to market and sell our products to specialists within the target indications if approved and to pursue collaborative arrangements to market and sell our products to primary care physicians within the target indications if approved. To the extent that we depend on third parties for marketing and distribution, any revenues we receive will depend upon the efforts of such third parties, and we cannot assure you that their efforts will be successful. In addition, we cannot assure you that we will be able to establish or maintain relationships with such third party collaborators or that we would be able to market and sell our products in the United States or overseas through an in-house sales force in lieu of such relationships.

If we cannot compete successfully for market share against other drug companies, we may not achieve sufficient product revenues and our business will suffer.

        The market for our product candidates is characterized by intense competition and rapid technological advances. If any of our product candidates receives FDA or other foreign regulatory authority approval, it will compete with a number of existing and future drugs and therapies developed, manufactured and marketed by others. Existing or future competing products may provide greater therapeutic convenience or clinical or other benefits for a specific indication than our products, or may offer comparable performance at a lower cost. If our products fail to capture and maintain market share, we may not achieve sufficient product revenues and our business will suffer.

        We will compete against fully integrated pharmaceutical companies and smaller companies that are collaborating with larger pharmaceutical companies, academic institutions, government agencies and other public and private research organizations. Many of these competitors have compounds already approved or in development. In addition, many of these competitors, either alone or together with their collaborative partners, operate larger research and development programs or have substantially greater financial resources than we do, as well as significantly greater experience in:

    developing drugs;

    undertaking preclinical testing and human clinical trials;

    obtaining FDA and other regulatory approvals of drugs;

    formulating and manufacturing drugs; and

    launching, marketing and selling drugs.

Developments by competitors may render our products or technologies obsolete or non-competitive.

        The biotechnology and pharmaceutical industries are intensely competitive and subject to rapid and significant technological change. Some of the drugs that we are attempting to develop, such as abaloparatide-SC, abaloparatide-TD, RAD1901 and RAD140, will have to compete against existing therapies if they are approved. In addition, a large number of companies are pursuing the development of pharmaceuticals that target the same diseases and conditions that we are targeting. We face competition from pharmaceutical and biotechnology companies in the United States and abroad. In

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addition, companies doing business in different but related fields represent substantial competition. Many of these organizations competing with us have substantially greater capital resources, larger research and development staffs and facilities, longer drug development history in obtaining regulatory approvals, and greater manufacturing and marketing capabilities than we do. These organizations also compete with us to attract qualified personnel and parties for acquisitions, joint ventures or other collaborations, and therefore, we may not be able to hire or retain qualified personnel to run all facets of our business. These risks could render our products or technologies obsolete or non-competitive.

Our ability to generate product revenues will be diminished if our drugs sell for inadequate prices or patients are unable to obtain adequate levels of reimbursement.

        Our ability to commercialize our drugs, alone or with collaborators, will depend in large part on the extent to which coverage and reimbursement will be available from:

    government and health administration authorities;

    private health maintenance organizations and health insurers; and

    other healthcare payers.

        Significant uncertainty exists as to the reimbursement status of newly approved healthcare products. Healthcare payers, including Medicare, are challenging the prices charged for medical products and services. Government and other healthcare payers increasingly attempt to contain healthcare costs by limiting both coverage and the level of reimbursement for drugs. Even if one of our product candidates is approved by the FDA or other foreign regulatory authority, insurance coverage may not be available, and reimbursement levels may be inadequate, to cover the costs of our drug. If government and other healthcare payers do not provide adequate coverage and reimbursement levels for our product candidates, once approved, market acceptance of our products could be reduced.

We may incur substantial liabilities and may be required to limit commercialization of our products in response to product liability lawsuits.

        The testing and marketing of medical products entail an inherent risk of product liability. Even if one of our investigational product candidates is approved by the FDA or other foreign regulatory authority, if we cannot successfully defend ourselves against product liability claims, we may incur substantial liabilities or be required to limit commercialization of our products. Our inability to obtain sufficient product liability insurance at an acceptable cost to protect against potential product liability claims could prevent or inhibit the commercialization of pharmaceutical products we develop, alone or with collaborators.

Risks Related to Our Intellectual Property

If we fail to comply with our obligations in our intellectual property licenses with third parties, we could lose license rights that are important to our business.

        We are a party to a number of intellectual property license agreements with third parties and expect to enter into additional license agreements in the future. Our existing license agreements impose, and we expect that any future license agreements will impose, various diligence, milestone payment, royalty, insurance and other obligations on us. If we fail to comply with these obligations, our licensors may have the right to terminate these agreements, in which event we might not be able to develop and market any product that is covered by these agreements. Termination of these licenses or reduction or elimination of our licensed rights may result in our having to negotiate new or reinstated licenses with less favorable terms. The occurrence of such events could materially harm our business.

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If our efforts to protect our intellectual property related to abaloparatide-SC, abaloparatide-TD, RAD1901 and/or RAD140 fail to adequately protect these assets or if we are unable to secure all necessary intellectual property, we may lose the ability to license or successfully commercialize one or more of these candidates.

        Our commercial success is significantly dependent on intellectual property related to our product portfolio of product candidates. We are either the licensee or assignee of numerous issued and pending patent applications that cover various aspects of our assets, including abaloparatide-SC, abaloparatide-TD, RAD1901 and RAD140.

        Patents covering abaloparatide as a composition of matter have been issued in the United States (US Patent No. 5,969,095) and several additional countries. Because the abaloparatide composition of matter patent was filed in 1996, it is expected to have an expiration in 2016 in the United States (this date does not include the possibility of Hatch-Waxman patent term extension, which could extend the expiration in the United States into the first quarter of 2021 if an application for extension is made and the maximum extension is granted by the United States Patent and Trademark Office, USPTO), and additional countries where it has issued. European Patent No. 0847278, which was included in the license from Ipsen and claimed the composition of matter of abaloparatide, lapsed due to Ipsen's failure to pay annuities. We are pursuing restoration of those patent rights. To date, the patent rights in Finland, France, Germany, Portugal, Spain and United Kingdom have been restored. We believe that the data and market exclusivity provided in Europe for a new chemical entity, coupled with the need for a potential competitor to conduct clinical trials, will likely provide a longer barrier to entry than the patent protection provided by the original European patent term, which would have expired in 2016, plus a five year maximum Supplemental Protection Certificate.

        We and Ipsen are also co-assignees to US Patent No. 7,803,770 that we believe provides exclusivity until October 3, 2027 and may be extended to March 26, 2028 in the United States (absent any Hatch-Waxman patent term extension) for the method of treating osteoporosis with the intended therapeutic dose for abaloparatide-SC.

        We and Ipsen Pharma SAS, or Ipsen, are also co-assignees to US Patent No. 8,148,333 that we believe provides exclusivity until 2027 in the United States (absent any Hatch-Waxman patent term extension) for the intended therapeutic formulation for abaloparatide-SC.

        We and 3M are co-assignees to several foreign and corresponding U.S. patent applications with the earliest priority date of April 22, 2011, which cover various aspects of abaloparatide for microneedle application. Any issued patents resulting from these applications will expire in 2032. However, pending patent applications in the United States and elsewhere may not issue since the interpretation of the legal requirements of patentability in view of claimed inventions are not always predictable. Additional intellectual property covering abaloparatide-TD technology exists in the form of proprietary information protected as trade secrets. These can be accidentally disclosed to, independently derived by or misappropriated by competitors, possibly reducing or eliminating the exclusivity advantages of this form of intellectual property, thereby allowing those competitors more rapid entry into the marketplace with a competitive product thus reducing our advantage with abaloparatide-TD. In addition, trade secrets may in some instances become publicly available through required disclosures in regulatory files. Alternatively, competitors may sometimes reverse engineer a product once it becomes available on the market. Even where a competitor does not use an identical technology for the delivery of abaloparatide, it is possible that they could achieve an equivalent or even superior result using another technology. Such occurrences could lead to either one or more alternative competitor products becoming available on the market and/or one or more generic competitor products on the market gaining market share and causing a corresponding decrease in market share and/or price for abaloparatide-TD even if it were to be successfully developed and approved by FDA.

        Patents covering RAD1901 as a composition of matter, as well as the use of RAD1901 for the treatment of estrogen-dependent breast cancer, have been issued in the United States, Canada and

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Australia and are pending in Europe and India. The RAD1901 composition of matter patents in the United States expire in 2023 and 2026 (absent any Hatch-Waxman patent term extension). Additional patent applications relating to methods of treating vasomotor symptoms and clinical dosage strengths using RAD1901 have been filed. Pending patent applications in the United States and elsewhere may not issue since the interpretation of the legal requirements of patentability in view of any claimed invention before a patent office are not always predictable. As a result, we could encounter challenges or difficulties in building, maintaining and/or defending our intellectual property both in the United States and abroad.

        Patent applications covering RAD140 and other SARM compounds have been granted in the United States, Europe, Canada, Mexico, Japan and Australia, and are pending in the United States and elsewhere. The RAD140 composition of matter patents expire in 2029 in the United States (absent any Hatch-Waxman patent term extension) and additional countries if and when it issues.

        Since patents are technical legal documents that are frequently subject to intense litigation pressure, there is risk that even if one or more patents related to our products does issue and is asserted that the patent(s) will be found invalid, unenforceable and/or not infringed when subject to said litigation. Finally, the intellectual property laws and practices can vary considerably from one country to another and also can change with time. As a result, we could encounter challenges or difficulties in building, maintaining and defending our intellectual property both in the United States and abroad.

        We may become party to, or threatened with, future adversarial proceedings or litigation regarding intellectual property rights with respect to patents issued or licensed to us, including interference proceedings before the USPTO. Third parties also may assert infringement claims against us. If we are found to infringe a third party's intellectual property rights, we could be required to obtain a license from such third party to continue developing and marketing our products and technology. However, we may not be able to obtain any required license on commercially reasonable terms or at all. Even if we were able to obtain a license, it could be non-exclusive, thereby giving our competitors access to the same technologies licensed to us. We could be forced, including by court order, to cease commercializing the infringing technology or product. In addition, we could be found liable for monetary damages. A finding of infringement could prevent us from commercializing our product candidates or force us to cease some of our business operations, which could materially harm our business. Claims that we have misappropriated the confidential information or trade secrets of third parties could have a similar negative impact on our business. For example, we are aware of a provisional patent application recently filed with the USPTO that could be relevant to the use of RAD1901 to treat indications for which we are developing RAD1901. If a patent issues from this patent application with claims covering the use of RAD1901 to treat indications for which we are developing RAD1901, we may need to license the patent in order to commercialize RAD1901 specifically for the treatment of such indications even if RAD1901 were successfully developed and approved. We are evaluating whether to enter into negotiations for such license. We cannot assure you that we will be able to secure a license on reasonable terms, if at all. If we need a license of such patent in order to commercialize RAD1901 and are unable to secure one on reasonable terms, our business would be materially harmed.

If we are unable to obtain and maintain patent protection for our technology and products, or if our licensors are unable to obtain and maintain patent protection for the technology or products that we license from them, our competitors could develop and commercialize technology and products similar or identical to ours, and our ability to successfully commercialize our technology and products may be adversely affected.

        Our success depends in large part on our and our licensors' ability to obtain and maintain patent protection in the United States and other countries with respect to our proprietary technology and products. In some circumstances, we may not have the right to control the preparation, filing and

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prosecution of patent applications, or to maintain the patents, covering technology or products that we license from third parties. Therefore, we cannot be certain that these patents and applications will be prosecuted and enforced in a manner consistent with the best interests of our business. In addition, if third parties who license patents to us fail to maintain these patents, or lose rights to those patents, the rights we have licensed may be reduced or eliminated.

        The patent position of biotechnology and pharmaceutical companies generally is highly uncertain, involves complex legal and factual questions and has in recent years been the subject of much litigation. As a result, the issuance, scope, validity, enforceability and commercial value of our and our licensors' patent rights are highly uncertain. Our and our licensors' pending and future patent applications may not result in patents being issued that protect our technology or products or that effectively prevent others from commercializing competitive technologies and products. Changes in either the patent laws or interpretation of the patent laws in the United States and other countries may diminish the value of our patents or narrow the scope of our patent protection. The laws of foreign countries may not protect our rights to the same extent as the laws of the United States. Assuming the other requirements for patentability are met, in the United States, prior to March 16, 2013, the first to make the claimed invention was entitled to the patent (a "first-to-invent" system), while outside the United States, the first to file a patent application is entitled to the patent (a "first-to-file" system). With the implementation of the Leahy-Smith America Invents Act, the United States now has a first-to-file system for patent applications filed on or after March 16, 2013. We may become involved in opposition, interference or derivation proceedings challenging our patent rights or the patent rights of others. Publications of discoveries in the scientific literature often lag behind the actual discoveries, and patent applications in the United States and other jurisdictions are typically not published until 18 months after filing, or in some cases not at all. Therefore, we cannot be certain that we or our licensors were the first to make the inventions claimed in our owned and licensed patents or pending patent applications, or that we or our licensors were the first to file for patent protection of such inventions. An adverse determination in any such proceeding could reduce the scope of, or invalidate our patent rights, allow third parties to commercialize our technology or products and compete directly with us, without payment to us, or result in our inability to manufacture or commercialize products without infringing third-party patent rights.

        Even if our owned and licensed patent applications issue as patents, they may not issue in a form that will provide us with any meaningful protection, prevent competitors from competing with us or otherwise provide us with any competitive advantage. Our competitors may be able to circumvent our owned or licensed patents by developing similar or alternative technologies or products in a non-infringing manner. The issuance of a patent is not conclusive as to its scope, validity or enforceability, and our owned and licensed patents may be challenged in the courts or patent offices in the United States and abroad. Any challenges may result in patent claims being narrowed, invalidated or held unenforceable, which could limit our ability to stop or prevent us from stopping others from using or commercializing similar or identical technology and products, or limit the duration of the patent protection of our technology and products. Given the amount of time required for the development, testing and regulatory review of new product candidates, patents protecting such candidates might expire before or shortly after such candidates are commercialized. As a result, our owned and licensed patents may not provide us with sufficient rights to exclude others from commercializing products similar or identical to ours.

Payments, fees, submissions and various additional requirements must be met in order for pending patent applications to advance in prosecution and issued patents to be maintained. Rigorous compliance with these requirements is essential to procurement and maintenance of patents integral to our product portfolio.

        Periodic maintenance fees, renewal fees, annuity fees and various other governmental fees on patents and/or patent applications will come due for payment periodically throughout the lifecycle of

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patent applications and issued patents. In order to help ensure that we comply with any required fee payment, documentary and/or procedural requirements as they might relate to any patents for which we are an assignee or co-assignee, we employ competent legal help and related professionals as needed to comply with those requirements. Our outside patent counsel uses Computer Packages, Inc. for patent annuity payments. We depend on Eisai and/or Ipsen to comply with any required fee payment, documentary and/or procedural requirements as they might relate to any patents we have licensed. Failure to meet a required fee payment, document production or procedural requirement can result in the abandonment of a pending patent application or the lapse of an issued patent. In some instances the defect can be cured through late compliance but there are situations where the failure to meet the required event cannot be cured. Any failures could compromise the intellectual property protection around our preclinical or clinical candidates and possibly weaken or eliminate our ability to protect our eventual market share for that product.

If we are unable to protect the confidentiality of our trade secrets, our business and competitive position would be harmed.

        In addition to our patented technology and products, we rely on trade secrets, including unpatented know-how, technology and other proprietary information, to maintain our competitive position. We seek to protect these trade secrets, in part, by entering into non-disclosure and confidentiality agreements with parties that have access to our trade secrets, such as our corporate collaborators, outside scientific collaborators, sponsored researchers, contract manufacturers, consultants, advisors and other third parties. We also enter into confidentiality and invention or patent assignment agreements with our employees and consultants. However, any of these parties may breach the agreements and disclose our proprietary information, and we may not be able to obtain adequate remedies for any breaches. Enforcing a claim that a party illegally disclosed or misappropriated a trade secret is difficult, expensive and time-consuming, and the outcome is unpredictable. In addition, some courts inside and outside the United States are less willing or unwilling to protect trade secrets. If any of our trade secrets were to be lawfully obtained or independently developed by a competitor, we would have no right to prevent them from using that technology or information to compete with us. If any of our trade secrets were to be disclosed to, or independently developed by a competitor, our competitive position would be harmed.

If we infringe the rights of third parties, we could be prevented from selling products and could be forced to pay damages and defend against litigation.

        If our products, methods, processes and other technologies infringe the proprietary rights of other parties, we could incur substantial costs and may have to:

    obtain licenses, which may not be available on commercially reasonable terms, if at all;

    abandon an infringing drug candidate;

    redesign our products or processes to avoid infringement;

    stop using the subject matter claimed in the patents held by others;

    pay damages; or

    defend litigation or administrative proceedings which may be costly whether we win or lose, which could result in a substantial diversion of our financial and management resources.

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We may become involved in lawsuits to protect or enforce our patents, which could be expensive, time consuming and unsuccessful.

        Competitors may infringe our patents. To counter infringement or unauthorized use, we may be required to file infringement claims, which can be expensive and time consuming. In addition, in an infringement proceeding, a court may decide that a patent of ours is invalid and/or unenforceable, or may refuse to stop the other party from using the technology at issue on the grounds that our patents do not cover the technology in question. An adverse result in any litigation proceeding could put one or more of our patents at risk of being invalidated and/or interpreted narrowly. Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of our confidential information could be compromised by disclosure during this type of litigation. In addition, our licensors may have rights to file and prosecute these types of claims, and we may be reliant on them to do so.

We may be subject to claims that our employees have wrongfully used or disclosed alleged trade secrets of their former employers.

        Some of our employees were previously employed at universities or other biotechnology or pharmaceutical companies, including our competitors or potential competitors. Although we try to ensure that our employees do not use the proprietary information or know-how of others in their work for us, we may be subject to claims that we or these employees have used or disclosed intellectual property, including trade secrets or other proprietary information, of any such employee's former employer. Litigation may be necessary to defend against these claims. If we fail in defending any such claims, in addition to paying monetary damages, we may lose valuable intellectual property rights or personnel. Even if we are successful in defending against such claims, litigation could result in substantial costs and be a distraction to management.

Intellectual property litigation could cause us to spend substantial resources and distract our personnel from their normal responsibilities.

        Even if resolved in our favor, litigation or other legal proceedings relating to intellectual property claims may cause us to incur significant expenses, and could distract our technical and management personnel from their normal responsibilities, delaying the development of our product candidates. In addition, there could be public announcements of the results of hearings, motions or other interim proceedings or developments, and if securities analysts or investors perceive these results to be negative, it could have a substantial adverse effect on the price of our common stock. Litigation or other proceedings could substantially increase our operating losses and reduce our resources available for development activities. We may not have sufficient financial or other resources to adequately conduct any litigation or proceedings. Some of our competitors may be able to sustain the costs of any litigation or proceedings more effectively than we can because of their substantially greater financial resources. Uncertainties resulting from the initiation and continuation of patent litigation or other proceedings could have a material adverse effect on our ability to compete in the marketplace.

Risks Related to Legislation and Administrative Actions

Healthcare reform may have a material adverse effect on our industry and our results of operations.

        From time to time, legislation is implemented to reign in rising healthcare expenditures. In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or PPACA. PPACA includes a number of provisions affecting the pharmaceutical industry, including annual, non-deductible fees on any entity that manufactures or imports some types of branded prescription drugs and biologics and increases in Medicaid rebates owed by manufacturers under the Medicaid Drug Rebate Program. In addition,

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among other things, PPACA also establishes a new Patient-Centered Outcomes Research Institute to oversee, identify priorities and conduct comparative clinical effectiveness research. In addition, other legislative changes have been proposed and adopted since PPACA was enacted. Most recently, on August 2, 2011, President Obama signed into law the Budget Control Act of 2011, which may result in such changes as aggregate reductions to Medicare payments to providers of two percent per fiscal year, which went into effect in April 2013 and, due to subsequent legislative amendments to the statute, will remain in effect through 2024 unless additional Congressional action is taken. The full impact on our business of these new laws is uncertain. We cannot predict whether other legislative changes will be adopted, if any, or how such changes would affect the pharmaceutical industry generally or our business in particular.

We are subject to healthcare laws, regulation and enforcement, and our failure to comply with those laws could have a material adverse effect on our results of operations and financial conditions.

        We are subject to several healthcare regulations and enforcement by the federal government and the states and foreign governments in which we conduct our business. The laws that may affect our ability to operate include:

    the federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, as amended by the Health Information Technology for Economic and Clinical Health Act, which governs the conduct of various electronic healthcare transactions and protects the security and privacy of protected health information;

    the federal healthcare programs' Anti-Kickback Statute, which prohibits, among other things, persons from knowingly and willfully soliciting, receiving, offering or paying remuneration, directly or indirectly, in exchange for or to induce either the referral of an individual for, or the purchase, order or recommendation of, any good or service for which payment may be made under federal healthcare programs such as the Medicare and Medicaid programs. A person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to violate it to have committed a violation; in addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act;

    federal false claims laws, which prohibit, among other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from Medicare, Medicaid, or other third-party payers that are false or fraudulent;

    federal criminal laws that prohibit executing a scheme to defraud any healthcare benefit program or making false statements relating to healthcare matters. Similar to the federal Anti-Kickback Statute, a person or entity does not need to have actual knowledge of the federal Anti-Kickback Statute or specific intent to violate it to have committed a violation;

    the federal Physician Payment Sunshine Act, or the Sunshine Act, requires applicable manufacturers of covered drugs to report payments and other transfers of value to physicians and teaching hospitals, and ownership and investment interests held by physicians and their immediate family members. Data from the first reporting period, which began in August 2013, is now publicly available. Manufacturers will be required to submit subsequent reports to the government by the 90 th  day of each calendar year; and

    state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws which may apply to items or services reimbursed by any third-party payer, including commercial insurers; state laws that require pharmaceutical companies to comply with the industry's voluntary compliance guidelines and the applicable compliance guidance promulgated by the federal government or otherwise restrict payments that may be made to healthcare

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      providers and other potential referral sources; state laws that require drug manufacturers to report information related to payments and other transfers of value to physicians and other healthcare providers or marketing expenditures; and state laws governing the privacy and security of health information in certain circumstances, many of which differ from each other in significant ways and may not have the same effect, thus complicating compliance efforts.

        Our operations and commercial activities will be subject to comprehensive compliance obligations under state and federal fraud and abuse, false claims, physician payment transparency laws and government pricing regulations, as described above. If we are found to be in violation of these regulations, we may be subject to penalties, including civil and criminal penalties, damages, fines, the curtailment or restructuring of our operations, the exclusion from participation in federal and state healthcare programs and imprisonment, any of which could adversely affect our ability to operate our business and our financial results.

We may be exposed to liability claims associated with the use of hazardous materials and chemicals.

        Our research and development activities may involve the controlled use of hazardous materials and chemicals. Although we believe that our safety procedures for using, storing, handling and disposing of these materials comply with federal, state and local laws and regulations, we cannot completely eliminate the risk of accidental injury or contamination from these materials. In the event of such an accident, we could be held liable for any resulting damages and any liability could materially adversely affect our business, financial condition and results of operations. In addition, the federal, state and local laws and regulations governing the use, manufacture, storage, handling and disposal of hazardous or radioactive materials and waste products may require us to incur substantial compliance costs that could materially adversely affect our business, financial condition and results of operations.

Risks Related to Employee Matters and Managing Growth

As we evolve from a company primarily involved in drug discovery and development into one that is also involved in the commercialization of pharmaceutical products, we may have difficulty managing our growth and expanding our operations successfully.

        Our success will depend upon the expansion of our operations and the effective management of our growth, and if we are unable to manage this growth effectively, our business will be harmed. As we advance our product candidates through the development process, we will need to expand our development, regulatory, manufacturing, quality, distribution, sales and marketing capabilities or contract with other organizations to provide these capabilities for us. As our operations expand, we expect that we will need to manage additional relationships with various collaborators, suppliers and other organizations. Our ability to manage our operations and growth requires us to continue to improve our operational, financial and management controls, reporting systems and procedures. For example, some jurisdictions, such as the District of Columbia, have imposed licensing requirements for sales representatives. In addition, the District of Columbia and the Commonwealth of Massachusetts, as well as the federal government by way of the Sunshine Act, have established reporting requirements that would require public reporting of compensation and other "transfers of value" paid to health care professionals and teaching hospitals, as well as ownership and investment interests held by such professionals and their immediate family members. Because the reporting requirements vary in each jurisdiction, compliance will be complex and expensive and may create barriers to entering the commercialization phase. The need to build new systems as part of our growth could place a strain on our administrative and operational infrastructure. We may not be able to make improvements to our management information and control systems in an efficient or timely manner and may discover deficiencies in existing systems and controls. Such requirements may also impact our opportunities to collaborate with physicians at academic research centers as new restrictions on academic-industry relationships are put in place. In the past, collaborations between academia and industry have led to

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important new innovations, but the new laws may have an effect on these activities. While we cannot predict whether any legislative or regulatory changes will have negative or positive effects, they could have a material adverse effect on our business, financial condition and potential profitability.

We may enter into or seek to enter into business combinations and acquisitions which may be difficult to integrate, disrupt our business, divert management attention or dilute stockholder value.

        We may enter into business combinations and acquisitions. We have limited experience in making acquisitions, which are typically accompanied by a number of risks, including:

    the difficulty of integrating the operations and personnel of the acquired companies;

    the potential disruption of our ongoing business and distraction of management;

    the potential for unknown liabilities and expenses;

    the failure to achieve the expected benefits of the combination or acquisition;

    the maintenance of acceptable standards, controls, procedures and policies; and

    the impairment of relationships with employees as a result of any integration of new management and other personnel.

        If we are not successful in completing acquisitions that we may pursue in the future, we would be required to reevaluate our business strategy and we may have incurred substantial expenses and devoted significant management time and resources in seeking to complete the acquisitions. In addition, we could use substantial portions of our available cash as all or a portion of the purchase price, or we could issue additional securities as consideration for these acquisitions, which could cause our stockholders to suffer significant dilution.

We rely on key executive officers and scientific and medical advisors, and their knowledge of our business and technical expertise would be difficult to replace.

        We are highly dependent on our chief executive officer and our principal scientific, regulatory and medical advisors. We do not have "key person" life insurance policies for any of our officers. The loss of the technical knowledge and management and industry expertise of any of our key personnel could result in delays in product development, loss of customers and sales and diversion of management resources, which could adversely affect our operating results.

If we are unable to hire additional qualified personnel, our ability to grow our business may be harmed.

        We will need to hire additional qualified personnel with expertise in preclinical testing, clinical research and testing, government regulation, formulation and manufacturing and sales and marketing. We compete for qualified individuals with numerous biopharmaceutical companies, universities and other research institutions. Competition for such individuals is intense, and we cannot be certain that our search for such personnel will be successful. Attracting and retaining qualified personnel will be critical to our success.

Risks Relating to Our Securities

Our stock price may be volatile, and the value of an investment in our common stock may decline.

        The trading price of our common stock may be subject to wide fluctuations in response to various factors, some of which are beyond our control, including:

    results of clinical trials of our product candidates or those of our competitors;

    our operating performance and the operating performance of similar companies;

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    the success of competitive products;

    the overall performance of the equity markets;

    the number of shares of our common stock publicly owned and available for trading;

    threatened or actual litigation;

    changes in laws or regulations relating to our products, including changes in the structure of healthcare payment systems;

    any major change in our board of directors or management;

    publication of research reports about us or our industry or positive or negative recommendations or withdrawal of research coverage by securities analysts;

    large volumes of sales of our shares of common stock by existing stockholders;

    general political, economic and market conditions; and

    the other factors described in this "Risk factors" section.

        In addition, the stock market in general has experienced extreme price and volume fluctuations that have often been unrelated or disproportionate to the operating performance of the companies whose shares trade in the stock market. These fluctuations may be even more pronounced in the trading market for our stock shortly following the initial public offering. Securities class action litigation has often been instituted against companies following periods of volatility in the overall market and in the market price of a company's securities. Such litigation, if instituted against us, could result in very substantial costs, divert our management's attention and resources and harm our business, operating results and financial condition.

Because we do not anticipate paying any cash dividends on our common stock in the foreseeable future, capital appreciation, if any, will be your sole source of gain.

        We have never declared or paid cash dividends on our common stock. We currently intend to retain all of our future earnings, if any, to finance the growth and development of our business. In addition, the terms of our credit facility preclude us from paying cash dividends. As a result, capital appreciation, if any, of our common stock will be your sole source of gain for the foreseeable future.

We have incurred and will continue to incur increased costs as a result of operating as a public company, and our management is required to devote substantial time to new compliance initiatives.

        As a public company listed on the NASDAQ Global Market, we have incurred and will continue to incur significant legal, accounting and other expenses that we did not incur as a private company and prior to the listing of our common stock on the NASDAQ Global Market. In addition, the Sarbanes-Oxley Act of 2002 and rules subsequently implemented by the Securities and Exchange Commission, or the SEC, and NASDAQ have imposed various requirements on public companies, including establishment and maintenance of effective disclosure and financial controls and corporate governance practices. Our management and other personnel will need to devote a substantial amount of time to these compliance initiatives. Moreover, these rules and regulations have increased our legal and financial compliance costs and are making some activities more time-consuming and costly.

        Pursuant to Section 404 of the Sarbanes-Oxley Act of 2002, or Section 404, we are required to furnish a report by our management on our internal control over financial reporting, and are required to include an attestation report on internal control over financial reporting issued by our independent registered public accounting firm. If we are unable to maintain effective internal controls, we may not have adequate, accurate or timely financial information, and we may be unable to meet our reporting

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obligations as a publicly traded company or comply with the requirements of the SEC or Section 404. This could result in a restatement of our financial statements, the imposition of sanctions, including the inability of registered broker dealers to make a market in our common shares, or investigation by regulatory authorities. Any such action or other negative results caused by our inability to meet our reporting requirements or comply with legal and regulatory requirements or by disclosure of an accounting, reporting or control issue could adversely affect the trading price of our securities and our business. Material weaknesses in our internal control over financial reporting could also reduce our ability to obtain financing or could increase the cost of any financing we obtain.

Our directors and executive officers, together with their affiliates, have substantial influence over us and could delay or prevent a change in corporate control.

        Our directors and executive officers, together with their affiliates, beneficially own a significant portion of our outstanding common stock. As a result, these stockholders, acting together, would have the ability to significantly influence the outcome of matters submitted to our stockholders for approval, including the election of directors and any merger, consolidation or sale of all or substantially all of our assets. In addition, these stockholders, acting together, would have the ability to significantly influence the management and affairs of our company. Accordingly, this concentration of ownership might harm the market price of our common stock by:

    delaying, deferring or preventing a change in corporate control;

    impeding a merger, consolidation, takeover or other business combination involving us; or

    discouraging a potential acquirer from making a tender offer or otherwise attempting to obtain control of us.

Future sales and issuances of our common stock or rights to purchase common stock, including pursuant to our equity incentive plans, could result in additional dilution of the percentage ownership of our stockholders and could cause our stock price to fall.

        Additional capital will be needed in the future to continue our planned operations. To the extent we raise additional capital by issuing equity securities, our stockholders may experience substantial dilution. We may sell common stock, convertible securities or other equity securities in one or more transactions at prices and in a manner we determine from time to time. If we sell common stock, convertible securities or other equity securities in more than one transaction, investors may be materially diluted by subsequent sales. These sales may also result in material dilution to our existing stockholders, and new investors could gain rights superior to our existing stockholders.

        Pursuant to our equity incentive plans, our management is authorized to grant stock options and other equity-based awards to our employees, directors and consultants. We have reserved 4,559,510 shares of our common stock for issuance under our equity incentive plans as of December 31, 2014, which includes 3,220,380 shares of common stock issuable upon the exercise of options outstanding as of December 31, 2014, and will become eligible for sale in the public market in the future, subject to certain legal and contractual limitations. In addition, as of December 31, 2014, warrants to purchase 1,379,671 shares of our common stock were outstanding. Shares of our common stock issued upon exercise of these warrants may be sold in the public market, subject to prior registration, or under an exemption from registration. Furthermore, in connection with the public offering of our common stock in January 2015, our directors, officers and their affiliated entities entered into lock-up agreements under which they have agreed not to sell, transfer or dispose of, directly or indirectly, any shares of our common stock or any securities exercisable or exchangeable for shares of our common stock for a period of 90 days, subject to a possible extension under certain circumstances. After the expiration of the lock-up period, these shares may be sold in the public market, subject to prior registration or under an exemption from registration, including compliance with Rule 144. If any of these additional shares

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are sold, or if it is perceived that they will be sold, the price of our common stock could decline substantially.

If securities or industry analysts cease to publish research or publish inaccurate or unfavorable research about our business, our stock price and trading volume could decline.

        The trading market for our common stock depends in part on the research and reports that securities or industry analysts publish about us or our business. If one or more of the analysts who cover us downgrade our stock or publish inaccurate or unfavorable research about our business, our stock price would likely decline. If one or more of these analysts cease coverage of our company or fail to publish reports on us regularly, demand for our stock could decrease, which might cause our stock price and trading volume to decline.

Anti-takeover provisions contained in our restated certificate of incorporation and amended and restated bylaws, as well as provisions of Delaware law, could impair a takeover attempt.

        Our restated certificate of incorporation and our amended and restated bylaws contain provisions that could delay or prevent a change in control of our company. These provisions could also make it more difficult for stockholders to elect directors and take other corporate actions. These provisions include:

    a staggered board of directors;

    authorizing the board to issue, without stockholder approval, preferred stock with rights senior to those of our common stock;

    authorizing the board to amend our bylaws and to fill board vacancies until the next annual meeting of the stockholders;

    prohibiting stockholder action by written consent;

    limiting the liability of, and providing indemnification to, our directors and officers;

    eliminating the ability of our stockholders to call special meetings; and

    requiring advance notification of stockholder nominations and proposals.

        Section 203 of the Delaware General Corporation Law, or DGCL, prohibits, subject to some exceptions, "business combinations" between a Delaware corporation and an "interested stockholder," which is generally defined as a stockholder who becomes a beneficial owner of 15% or more of a Delaware corporation's voting stock, for a three-year period following the date that the stockholder became an interested stockholder.

        These and other provisions in our restated certificate of incorporation and our amended and restated bylaws under Delaware law could discourage potential takeover attempts, reduce the price that investors might be willing to pay in the future for shares of our common stock, and result in the market price of our common stock being lower than it would be without these provisions.

Our ability to utilize our net operating loss carryforwards and certain other tax attributes may be limited.

        As of December 31, 2014, we had $319.7 million of federal and $246.5 million of state net operating loss carryforwards available to offset future taxable income. Under Section 382 of the Internal Revenue Code of 1986, as amended, or the Code, if a corporation undergoes an "ownership change" (generally defined as a greater than 50% change (by value) in its equity ownership over a three year period), the corporation's ability to use its pre-change net operating loss carryforwards and other pre-change tax attributes to offset its post-change income may be limited. We have not performed a detailed analysis to determine whether an ownership change under Section 382 of the Code has

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previously occurred. As a result, if we earn net taxable income, our ability to use our pre-change net operating loss carryforwards to offset U.S. federal taxable income may become subject to limitations, which could potentially result in increased future tax liability to us.

ITEM 1B.    UNRESOLVED STAFF COMMENTS.

        None.

ITEM 2.    PROPERTIES.

        Our corporate headquarters are located in Waltham, Massachusetts. On May 14, 2014, we entered into a lease for our corporate offices with BP Bay Colony LLC for approximately 8,490 rentable square feet of space in the building located at 950 Winter Street, Waltham, Massachusetts 02451. We also lease an office suite in the building located at 55 Madison Avenue, Morristown, New Jersey 07960. The lease for the Morristown facility commenced in August 2014 and terminates in July 2015. We believe that our existing office space is adequate to meet current requirements but anticipate the need to lease additional or substitute space to accommodate our expansion plans which we anticipate will be available as needed.

ITEM 3.    LEGAL PROCEEDINGS.

        We are not currently involved in any material legal proceedings.

ITEM 4.    MINE SAFETY DISCLOSURES.

        Not applicable.

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PART II

ITEM 5.    MARKET FOR REGISTRANT'S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES

        Our common stock has been traded on the NASDAQ Global Market under the symbol "RDUS" since the initial public offering of our common stock on June 6, 2014. Prior to that time there was no public market for our common stock. The following table presents reported quarterly high and low per share sale prices of our common stock on The NASDAQ Global Market for the periods presented.

2014
  High   Low  

Quarter ended June 30, 2014 (beginning June 6, 2014)

  $ 14.60   $ 7.46  

Quarter ended September 30, 2014

    24.28     8.09  

Quarter ended December 31, 2014

    42.57     16.55  

        On March 5, 2015, the closing price of our common stock was $46.18 per share as reported on the NASDAQ Global Market.

Stock Performance Graph

        The graph set forth below compares the cumulative total stockholder return on our common stock between June 6, 2014 (the date of the initial public offering of our common stock) and December 31, 2014, with the cumulative total return of (a) the Nasdaq Biotechnology Index and (b) the Nasdaq Composite Index, over the same period. This graph assumes the investment of $100 on June 6, 2014 in our common stock, the Nasdaq Biotechnology Index and the Nasdaq Composite Index and assumes the reinvestment of dividends, if any. The graph assumes our closing sales price on June 6, 2014 of $8.01 per share as the initial value of our common stock and not the initial offering price to the public of $8.00 per share.

        The comparisons shown in the graph below are based upon historical data. We caution that the stock price performance shown in the graph below is not necessarily indicative of, nor is it intended to forecast, the potential future performance of our common stock. Information used in the graph was obtained from the Nasdaq Stock Market LLC, a financial data provider and a source believed to be reliable. The Nasdaq Stock Market LLC is not responsible for any errors or omissions in such information.


Comparison of Total Return*
Among Radius Health Inc., the NASDAQ Composite Index, and the
NASDAQ Biotechnology Index

GRAPHIC


*
$100 invested on June 6, 2014 in stock or index

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Holders

        As of March 5, 2015, there were 73 holders of record of our common stock. The actual number of stockholders is greater than this number of record holders, and includes stockholders who are beneficial owners, but whose shares are held in street name by brokers and other nominees. This number of holders of record also does not include stockholders whose shares may be held in trust by other entities.

Dividends

        We have not paid any cash dividends on our common stock since inception and do not anticipate paying cash dividends in the foreseeable future.

Recent Sales of Unregistered Securities

        We did not make any sales of unregistered securities during the fourth quarter of the fiscal year ended December 31, 2014.

Use of Proceeds from Public Offering of Common Stock

        On June 5, 2014, the Securities and Exchange Commission, or SEC, declared effective our Registration Statement on Form S-1 (File No. 333-194150), as amended, or Registration Statement, filed in connection with the initial public offering of our common stock. Pursuant to the Registration Statement, we registered the offer and sale of 7,475,000 shares of common stock with an aggregate offering price of approximately $59.8 million.

        There has been no material change in the expected use of the net proceeds from our initial public offering as described in our final prospectus, dated June 5, 2014, filed with the SEC pursuant to Rule 424(b) relating to our Registration Statement.

Purchases of Equity Securities by the Issuer or Affiliated Purchasers

        There were no repurchases of shares of common stock made during the fourth quarter of the fiscal year ended December 31, 2014.

ITEM 6.    SELECTED FINANCIAL DATA.

        You should read the following selected financial data together with our financial statements and the related notes contained in Item 8 of Part II of this Annual Report on Form 10-K. We have derived the statements of operations data for each of the three years ended December 31, 2012, 2013 and 2014 and the balance sheets data as of December 31, 2013 and 2014 from the audited financial statements contained in Item 8 of Part II of this Form 10-K. The selected balance sheet data as of December 31, 2010, 2011 and 2012 and the statement of operations data for the years ended December 31, 2010 and 2011 has been derived from the audited financial statements for such years not included in this Form 10-K.

        The financial information set forth below for the years ended December 31, 2010 and 2011 have been recast to reflect the adoption of Accounting Standards Update No. 2011-05, Presentation of Comprehensive Income .

        The historical financial information set forth below may not be indicative of our future performance and should be read together with "Management's Discussion and Analysis of Financial Condition and Results of Operations" and our historical financial statements and notes to those

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statements included in Item 7 of Part II and Item 8 of Part II, respectively, of this Annual Report on Form 10-K.

 
  Year Ended December 31,  
Statement of Operations and Comprehensive Loss Data
  2014   2013   2012   2011   2010  
 
  (in thousands)
 

Operating expenses:

                               

Research and development

  $ 45,719   $ 60,536   $ 54,961   $ 36,179   $ 11,692  

General and administrative

    13,674     6,829     9,469     5,330     3,630  

Restructuring

                    217  

Loss from operations

    (59,393 )   (67,365 )   (64,430 )   (41,509 )   (15,539 )

Other (expense) income:

   
 
   
 
   
 
   
 
   
 
 

Other (expense) income, net

    (713 )   9,085     (2,095 )   (236 )   824  

Interest (expense) income, net

    (2,373 )   (2,410 )   (2,603 )   (731 )   85  

Net loss

    (62,479 )   (60,690 )   (69,128 )   (42,476 )   (14,630 )

Other comprehensive loss, net of tax:

                               

Unrealized (loss) gain from available-for-sale securities

    (21 )       (5 )   8     (18 )

Comprehensive loss

  $ (62,500 ) $ (60,690 ) $ (69,133 ) $ (42,468 ) $ (14,648 )

Net (loss) earnings attributable to common stockholders

  $ (71,479 ) $ (78,161 ) $ (83,120 ) $ 113   $ (26,773 )

 

 
  As of December 31,  
Balance Sheet Data
  2014   2013   2012   2011   2010  
 
  (in thousands)
 

Cash and cash equivalents

  $ 28,518   $ 12,303   $ 18,653   $ 25,128   $ 10,582  

Marketable securities

    76,758         4,000     31,580     7,969  

Working capital

    86,774     (22,675 )   8,026     56,607     15,448  

Total assets

    108,417     12,758     25,300     63,637     18,969  

Long-term liabilities

    24,394     1,945     38,222     19,806      

Total liabilities

    44,953     37,257     55,312     26,589     3,385  

Total convertible preferred stock and redeemable convertible preferred stock

        252,802     170,649     156,658     143,836  

Total liabilities, convertible preferred stock, redeemable convertible preferred stock and stockholders' equity (deficit)

    108,417     12,758     25,300     63,637     18,969  

ITEM 7.    MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

         You should read the following discussions in conjunction with our consolidated financial statements and related notes included in this report. This discussion includes forward-looking statements that involve risk and uncertainties. As a result of many factors, such as those set forth under "Risk Factors," actual results may differ materially from those anticipated in these forward-looking statements.

Executive Overview

        We are a science-driven biopharmaceutical company focused on developing new therapeutics for patients with osteoporosis as well as other serious endocrine-mediated diseases. Our lead development candidate is the investigational drug abaloparatide (BA058), a bone anabolic for potential use in the

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reduction of fracture risk in postmenopausal women with severe osteoporosis delivered via subcutaneous injection, which we refer to as abaloparatide-SC. We announced the 18-month top-line data from our Phase 3 clinical trial evaluating abaloparatide-SC for potential use in the reduction of fracture risk in postmenopausal women with severe osteoporosis in December 2014. Patients from the abaloparatide and placebo groups from our Phase 3 clinical trial are eligible to continue in the ACTIVExtend trial, in which they are receiving an approved alendronate therapy for osteoporosis management. We currently anticipate the first results from the first six months of the ACTIVExtend trial to be available in the second quarter of 2015. Following completion of the first six months of the extension study, we plan to submit a new drug application, or NDA, in the United States, and a marketing authorization application, or MAA, in Europe, during the second half of 2015. We hold worldwide commercialization rights to abaloparatide-SC, other than in Japan, and subject to a regulatory review and favorable regulatory outcome, we anticipate our first commercial sales of abaloparatide-SC will take place in 2016. We are leveraging our investment in abaloparatide-SC to develop a line extension that is designed to improve patient convenience by enabling administration of abaloparatide through an investigational short-wear-time transdermal patch, which we refer to as abaloparatide-TD. We hold worldwide commercialization rights for abaloparatide-TD.

        Our current clinical product portfolio also includes the investigational drug RAD1901, a selective estrogen receptor down regulator/degrader, or SERD, and the investigational drug RAD140, a nonsteroidal selective androgen receptor modulator, or SARM. We are developing RAD1901 at higher doses for potential use in the treatment of metastatic breast cancer, and intend to advance its development with the initiation of Phase 1 clinical trials, including a maximum tolerated dose study that has commenced patient dosing and a Phase 1 clinical trial in metastatic breast cancer patients which commenced in late 2014. At lower doses, RAD1901 acts as a selective estrogen-receptor modulator, or SERM. Low-dose RAD1901 has shown potential to be effective for the treatment of vasomotor symptoms such as hot flashes in a successful Phase 2 proof of concept study. We intend to commence a Phase 2b clinical trial in vasomotor symptoms in the second half of 2015.

Abaloparatide

        Abaloparatide is a novel synthetic peptide analog of parathyroid hormone-related protein, or PTHrP, that we are developing as a bone anabolic treatment for potential use in the reduction of fracture risk in postmenopausal women with severe osteoporosis. Osteoporosis is a disease that affects nearly 10 million people, with an additional approximately 43 million people at increased risk for the disease, in the United States. It is characterized by low bone mass and structural deterioration of bone tissue, which leads to greater fragility and an increase in fracture risk. Anabolic agents, like Forteo (teriparatide), are used to increase bone mineral density, or BMD, and to reduce the risk of fracture. We believe abaloparatide has the potential to increase BMD and bone quality to a greater degree, at more sites, at a faster rate, and in more patients, than other approved drugs for the treatment of osteoporosis. We are developing two formulations of abaloparatide:

    Abaloparatide-SC is an injectable subcutaneous formulation of abaloparatide. Our Phase 3 study of abalopartatide-SC is designed to evaluate whether abaloparatide-SC is superior to placebo for prevention of vertebral fracture. The study is also designed to evaluate whether abaloparatide-SC is superior to open-label teriparatide for greater BMD improvement at major skeletal sites and for a lower occurrence of hypercalcemia, a condition in which the calcium level in a patient's blood is above normal. On December 21, 2014, we announced positive top-line data from the Phase 3 clinical trial (ACTIVE) of the investigational drug abaloparatide-SC, or the ACTIVE Trial, evaluating the investigational drug abaloparatide-SC for potential use in the reduction of fractures in postmenopausal osteoporosis. On the primary endpoint, abaloparatide-SC (n=690, fracture rate 0.72%) achieved a statistically significant 83% reduction of incident vertebral fractures (defined as new and worsening vertebral fractures) as compared

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      to the placebo-treated group (n=711, fracture rate 4.36%) (p<0.0001). The ACTIVE trial included an open-label teriparatide [rDNA origin] injection treatment group (n=717, fracture rate 0.98%) that showed a statistically significant 78% reduction of incident vertebral fractures as compared to the placebo-treated group (p<0.0001). On the secondary endpoints, as compared to placebo, abaloparatide-SC achieved: a statistically significant fracture-rate reduction of 43% in the adjudicated non-vertebral fracture subset of patients; a statistically significant reduction of 45% in the adjudicated clinical fracture group, which includes both vertebral and non-vertebral fractures; and a statistically significant difference in the time to first incident of nonvertebral fracture in both the adjudicated non-vertebral fracture (p=0.0489) and the clinical fracture subset of patients (p=0.0112). The open-label teriparatide injection treatment group, as compared to placebo, achieved a fracture-rate reduction of 28% in the adjudicated non-vertebral fracture subset of patients and a reduction of 29% in the adjudicated clinical fracture group; these differences were not statistically significantly different as compared to the placebo group. The fracture-rate reduction observed in the abaloparatide-SC treatment group, as compared to open-label teriparatide, was not statistically significant.

      In January 2015, the U.S. Food and Drug Administration, or FDA, provided us with comments on the draft Statistical Analysis Plan, or SAP, that was used for the analysis of the top-line data from the Phase 3 clinical trial. In its correspondence, the FDA recommended that the primary endpoint of incident vertebral fracture reduction be performed excluding worsening vertebral fractures and including only new vertebral fractures. Using the FDA-recommended analysis, on the primary endpoint of reduction of new vertebral fractures (excluding worsening), abaloparatide-SC (n=690, fracture rate 0.58%) achieved a statistically significant 86% reduction as compared to the placebo-treated group (n=711, fracture rate 4.22%) (p<0.0001). The open-label teriparatide injection treatment group (n=717, fracture rate 0.84%) showed a statistically significant 80% reduction of new vertebral fractures (excluding worsening) as compared to the placebo-treated group (p<0.0001). The FDA also recommended, for the secondary endpoint of non-vertebral fractures, that our definition was generally acceptable provided that sternal (breast bone) and patellar (knee cap) fractures were excluded. In the original top-line data announced for the secondary endpoint of non-vertebral fracture reduction noted above, we had excluded sternum and patella fractures, and abaloparatide-SC (n=824, Kaplan-Meier estimated, or KM, fracture rate 2.7%) achieved a statistically significant reduction compared to the placebo-treated group (n=821, KM fracture rate 4.7%), and the hazard ratio for abaloparatide vs. placebo was 0.57 (p=0.0489); the open label teriparatide injection treatment group (n=818, KM fracture rate 3.3%) had a hazard ratio of 0.72 (p=NS) compared to the placebo-treated group. The FDA also recommended, for the secondary endpoint of bone mineral density, or BMD, that we use an Analysis of Covariance, or ANCOVA, approach with the last observation carried forward for missing data. The Mixed-Effect Model For Repeated Measures, or MMRM, method, which was used in the BMD secondary endpoint in the top-line data announced in December 2014, is to be applied for sensitivity analysis.

      Our Phase 3 study includes a 6-month extension period in order to obtain 24-months of fracture data, as requested by the FDA. Patients from the abaloparatide and placebo groups from our Phase 3 clinical trial are eligible to continue in an extension study, in which they are receiving an approved alendronate therapy for osteoporosis management. We currently anticipate the first results from the first six months of the ACTIVExtend trial to be available in the second quarter of 2015. We believe that the abaloparatide-SC program is on-track for submission of an NDA for abaloparatide-SC to the FDA, and submission of an MAA to the European Medicines Agency, or EMA, each of which incorporates the 24-month fracture data, in the second half of 2015. We will remain blinded at the patient and site level until such time as the ACTIVExtend trial is completed.

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      On May 9, 2014, we submitted a request for a breakthrough therapy designation to the FDA for abaloparatide-SC for the treatment of postmenopausal osteoporosis. In July 2014, the FDA denied our request and indicated that, upon a new request, abaloparatide-SC would be considered for a breakthrough therapy designation if new clinical evidence demonstrates that patients dosed with abaloparatide-SC show substantial improvement in treatment of postmenopausal osteoporosis over existing therapies on one or more clinically significant endpoints. We believe that the recently completed analyses of the 18-month top-line results of our Phase 3 clinical trial and two abaloparatide Phase 2 clinical trials have shown potentially important clinical benefits relative to placebo and current anabolic therapies, including significant improvements in reducing the risk of osteoporotic fractures and in calcemic control. We believe these results could support a breakthrough therapy designation. Once we have evaluated the 24-month results from the Phase 3 clinical trial, we expect to make a decision as to whether to re-submit our request for breakthrough therapy designation with a focus on the areas highlighted by the FDA or to apply for one of the other FDA expedited programs for new drugs that address unmet medical needs in the treatment of serious or life threatening conditions.

    Abaloparatide-TD is a line extension of abaloparatide-SC in the form of a convenient, short-wear-time transdermal patch. In a recent Phase 2 clinical trial, abaloparatide-TD showed a statistically significant mean percent increase from baseline in BMD as compared to placebo at the lumbar spine and at the hip. These results demonstrated a clear proof of concept by achieving a dose dependent increase in BMD. During 2014, we reported progress towards the development of an optimized, short-wear-time transdermal patch that may be capable of demonstrating comparability to abaloparatide-SC injection. In preliminary, nonhuman primate pharmacokinetic studies, we achieved a desirable pharmacokinetic profile, with comparable AUC, Cmax, Tmax and T1/2 relative to abaloparatide-SC. We believe that these results support continued clinical development of abaloparatide-TD toward future global regulatory submissions as a potential post-approval line extension of the investigational drug abaloparatide-SC. We expect to initiate the clinical evaluation of the optimized abaloparatide-TD patch in the second half of 2015, with the goal of achieving comparability to abaloparatide-SC. We hold worldwide commercialization rights to abaloparatide-TD technology.

We also believe that, subject to further research and development, abaloparatide may have potential applications across a variety of skeletal or bone related diseases or medical conditions.

RAD1901

        RAD1901 is a SERD that we believe crosses the blood-brain barrier and that we are evaluating for potential use in the treatment of metastatic breast cancer and other estrogen receptor mediated oncology applications. RAD1901 has been shown to bind with good selectivity to the estrogen receptor and to have both estrogen-like and estrogen-antagonistic effects in different tissues. In many cancers, hormones, like estrogen, stimulate tumor growth and a desired therapeutic goal is to block this estrogen-dependent growth while inducing apoptosis of the cancer cells. SERDs are an emerging class of endocrine therapies that directly induce estrogen receptor, or ER, degradation, enabling them to remove the estrogen growth signal in ER-dependent tumors without allowing ligand-independent resistance to develop. There is currently only one SERD, Faslodex (fulvestrant), approved for the treatment of hormone-receptor positive metastatic breast cancer. In 2014, the worldwide market for Faslodex was $720.0 million. For patients with brain metastases, there are no approved targeted therapies that cross the blood-brain barrier.

        In December 2014, we commenced a Phase 1 clinical trial of RAD1901 in the United States for the treatment of metastatic breast cancer. The Phase 1 study is a multicenter, open-label, two-part, dose-escalation study of RAD1901 in postmenopausal women with advanced estrogen receptor positive

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and HER2-negative breast cancer that is designed to determine the recommended dose for a Phase 2 clinical trial and includes a preliminary evaluation of the potential anti-tumor effect of RAD1901. We expect to report progress on this study in the first half of 2015 and to initiate additional Phase 1 clinical trials in the European Union in 2015. In June 2014, we initiated a Phase 1 maximum tolerated dose, or MTD, study of RAD1901 in healthy volunteers. The study is designed to evaluate the tolerability, safety and pharmacokinetics of RAD1901, and also to use 18F-estradiol positron emission tomography, or FES-PET, imaging to provide a pharmacodynamic assessment of estrogen receptor turnover following administration of RAD1901. Levels of RAD1901 in cerebrospinal fluid samples taken from study subjects will be measured to confirm that RAD1901 has crossed the blood-brain barrier. Based upon initial study results, FES-PET imaging of RAD1901 has shown potent SERD activity. As of December 31, 2014, 40 subjects had completed dose escalation in the ongoing MTD study, and FES-PET imaging had been completed in a total of five subjects across two different doses. Each of these five subjects showed, based on FES-PET imaging, suppression of the FES-PET signal to background levels after six days of dosing. In addition, RAD1901, at the doses that showed suppression of the FES-PET signal, was well tolerated in these patients.

        In March 2014, we submitted to the FDA an application for orphan drug designation of RAD1901 for the treatment of breast cancer brain metastases. In June 2014, we received a response to our application from the FDA requesting additional data with respect to our orphan drug designation application. We plan to meet with the FDA and are working to provide them with the data requested to support orphan drug designation of RAD1901.

        We are also developing RAD1901 at lower doses as a SERM, for the potential treatment of vasomotor symptoms. Historically, hormone replacement therapy, or HRT, with estrogen or progesterone has been considered the most efficacious approach to relieving menopausal symptoms such as hot flashes. However, because of the concerns about the potential long-term risks and contraindications associated with HRT, we believe a significant need exists for new therapeutic treatment options to treat vasomotor symptoms. In a Phase 2 proof of concept study, RAD1901 at lower doses showed a reduction in the frequency and severity of moderate and severe hot flashes. We intend to commence a Phase 2b clinical trial in vasomotor symptoms in the second half of 2015.

        Our efforts and resources are focused primarily on developing abaloparatide-SC, abaloparatide-TD, RAD1901 and our other pharmaceutical investigational product candidates, raising capital and recruiting personnel. We have no product sales to date and we will not receive any revenue from product sales unless and until we receive regulatory approval for abaloparatide-SC from the FDA, or equivalent foreign regulatory authorities. However, developing pharmaceutical products is a lengthy and very expensive process. Accordingly, our success depends not only on demonstrating the safety and efficacy of abaloparatide, but also on our ability to finance the development of these product candidates, which will require substantial additional funding to complete development and submit applications seeking marketing approval. Our ability to raise this additional financing will depend on our ability to execute on the abaloparatide development plan, manage and coordinate, on a cost-effective basis, the required components of the NDA submission for abaloparatide-SC and scale-up abaloparatide-SC and abaloparatide-TD manufacturing capacity. In addition, we currently have no sales or distribution capabilities and thus our ability to market abaloparatide once approved may depend in part on our ability to enter into and maintain collaborative relationships, which will depend on the strength of our clinical data, our access to capital and other factors.

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Financial Overview

Research and Development Expenses

        Research and development expenses consist primarily of clinical testing costs, including payments in cash and stock made to contract research organizations, or CROs, salaries and related personnel costs, fees paid to consultants and outside service providers for regulatory and quality assurance support, licensing of drug compounds and other expenses relating to the manufacture, development, testing and enhancement of our investigational product candidates. We expense our research and development costs as they are incurred.

        None of the research and development expenses in relation to our investigational product candidates are currently borne by third parties. Our lead investigational product candidate is abaloparatide and it currently represents the largest portion of our research and development expenses for our investigational product candidates. We began tracking program expenses for abaloparatide-SC in 2005, and program expenses from inception to December 31, 2014 were approximately $176.0 million. We began tracking program expenses for abaloparatide-TD in 2007, and program expenses from inception to December 31, 2014 were approximately $31.1 million. We began tracking program expenses for RAD1901 in 2006, and program expenses from inception to December 31, 2014 were approximately $17.8 million. We began tracking program expenses for RAD140 in 2008, and program expenses from inception to December 31, 2014 were approximately $5.2 million. These expenses relate primarily to external costs associated with manufacturing, preclinical studies and clinical trial costs.

        Costs related to facilities, depreciation, stock-based compensation and research and development support services are not directly charged to programs as they benefit multiple research programs that share resources.

        We estimate that future development costs for abaloparatide-SC may exceed $52.0 million, including $18.0 million for clinical costs, $21.0 million for license and milestone payments and NDA submission fees, $10.0 million for manufacturing costs and $3.0 million for preclinical costs. For abaloparatide-TD, we estimate that future development costs may exceed $29.0 million, including $18.0 million for clinical costs, $7.0 million for manufacturing costs, and $4.0 million for preclinical costs and NDA submission fees.

        In late 2014, we commenced a Phase 1 clinical study of RAD1901 for potential use in the treatment of metastatic breast cancer. However, due to its early stage of development, we are not able to determine the possible marketing approval timeline or future development costs at this time. We intend to initiate a Phase 2b clinical study of RAD1901 for the potential treatment of vasomotor symptoms in the second half of 2015. We are currently designing the trial and have not finalized the full development plan. In addition, we are currently evaluating alternative development options for RAD140. Therefore, it is currently not possible to project the future development costs or possible marketing approval timelines at this time.

        The following table sets forth our research and development expenses related to abaloparatide-SC, abaloparatide-TD, RAD1901 and RAD140 for the years ended December 31, 2014, 2013 and 2012 (in thousands):

 
  Year Ended December 31,  
 
  2014   2013   2012  

Abaloparatide-SC

  $ 32,044   $ 45,977   $ 44,692  

Abaloparatide-TD

    1,493     11,459     6,040  

RAD1901

    2,250         59  

RAD140

            18  

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General and Administrative Expenses

        General and administrative expenses consist primarily of salaries and related expenses for executive, finance and other administrative personnel, professional fees, business insurance, rent, general legal activities, including the cost of maintaining our intellectual property portfolio, and other corporate expenses.

        Our results also include stock-based compensation expense as a result of the issuance of stock and stock option grants to employees, directors and consultants. The stock-based compensation expense is included in the respective categories of expense in the statement of operations (research and development and general and administrative expenses). We expect to record additional non-cash compensation expense in the future, which may be significant.

Interest Income and Interest Expense

        Interest income reflects interest earned on our cash, cash equivalents and marketable securities.

        Interest expense reflects interest due under our loan and security agreement, entered into on May 23, 2011 with General Electric Capital Corporation, or GECC, as agent and lender, and Oxford Finance, as a lender, or the Original Credit Facility, and our loan and security agreement entered into on May 30, 2014 with Solar Capital Ltd., or Solar, as agent and lender, and Oxford Finance, as lender, or the New Credit Facility. Under the Original Credit Facility, we drew $12.5 million under an initial and second term loan during the year ended December 31, 2011 and an additional $12.5 million under a third term loan during the year ended December 31, 2012. Under the New Credit Facility, we drew $21.0 million under an initial term loan on May 30, 2014 and $4.0 million under a second term loan on July 10, 2014.

        On May 30, 2014, we used approximately $9.3 million of the New Credit Facility to repay all the amounts owed under the Original Credit Facility.

Other Income (Expense)

        For the years ended December 31, 2014 and 2013, other income (expense) primarily reflects changes in the fair value of our warrant liability and the series A-6 convertible preferred stock liability and stock asset from the date of the initial accrual to the reporting date as discussed in note 8 to our financial statements included in this Annual Report.

Critical Accounting Policies and Estimates

        The preparation of our financial statements requires us to make certain estimates and assumptions that affect the reported amounts of assets and liabilities and expenses during the reported periods. We believe the following accounting policies are "critical" because they require us to make judgments and estimates about matters that are uncertain at the time we make the estimate, and different estimates, which would have been reasonable, could have been used, which would have resulted in different financial results.

Accrued Clinical Expenses

        When preparing our financial statements, we are required to estimate our accrued clinical expenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed on our behalf and estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of actual cost. Payments under some of the contracts we have with parties depend

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on factors such as successful enrollment of certain numbers of patients, site initiation and the completion of clinical trial milestones. Examples of estimated accrued clinical expenses include:

    fees paid to investigative sites and laboratories in connection with clinical studies;

    fees paid to CROs in connection with clinical studies, if CROs are used; and

    fees paid to contract manufacturers in connection with the production of clinical study materials.

        When accruing clinical expenses, we estimate the time period over which services will be performed and the level of effort to be expended in each period. If possible, we obtain information regarding unbilled services directly from our service providers. However, we may be required to estimate the cost of these services based only on information available to us. If we underestimate or overestimate the cost associated with a trial or service at a given point in time, adjustments to research and development expenses may be necessary in future periods. Historically, our estimated accrued clinical expenses have approximated actual expense incurred. Subsequent changes in estimates may result in a material change in our accruals.

Research and Development Expenses

        We account for research and development costs by expensing such costs to operations as incurred. Research and development costs primarily consist of personnel costs, outsourced research activities, laboratory supplies and consulting fees.

        Nonrefundable advance payments for goods or services to be received in the future for use in research and development activities are deferred and capitalized. The capitalized amounts are expensed as the related goods are delivered or the services are performed. If expectations change such that we do not expect we will need the goods to be delivered or the services to be rendered, capitalized nonrefundable advance payments would be charged to expense.

Stock-based Compensation

        We measure stock-based compensation cost at the accounting measurement date based on the fair value of the option, and recognize the expense on a straight-line basis over the requisite service period of the option, which is typically the vesting period. We estimate the fair value of each option using the Black-Scholes option pricing model that takes into account the fair value of our common stock, the exercise price, the expected life of the option, the expected volatility of our common stock, expected dividends on our common stock, and the risk-free interest rate over the expected life of the option. Due to the limited trading history of our common stock since our June 2014 initial public offering, we use the simplified method described in the SEC's Staff Accounting Bulletin No. 107, Share-Based Payment, to determine the expected life of the option grants. The estimate of expected volatility is based on a review of the historical volatility of similar publicly held companies in the biotechnology field over a period commensurate with the option's expected term. We have never declared or paid any cash dividends on our common stock and we do not expect to do so in the foreseeable future. Accordingly, we use an expected dividend yield of zero. The risk-free rate is based on the U.S. Treasury yield curve in effect at the time of grant valuation for a period commensurate with the option's expected term. These assumptions are highly subjective and changes in them could significantly impact the value of the option and hence the related compensation expense.

        We apply an estimated forfeiture rate to current period expense to recognize compensation expense only for those awards expected to vest. We estimate forfeitures based upon historical data, adjusted for known trends, and will adjust the estimate of forfeitures if actual forfeitures differ or are expected to differ from such estimates. Subsequent changes in estimated forfeitures are recognized through a cumulative adjustment in the period of change and also will impact the amount of stock-based compensation expense in future periods.

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        Stock-based compensation expense recognized for options granted to consultants is also based upon the fair value of the options issued, as determined by the Black-Scholes option pricing model. However, the unvested portion of such option grants is re-measured at each reporting period, until such time as the option is fully vested.

Fair Value Measurements

        We define fair value as the price that would be received to sell an asset or be paid to transfer a liability in an orderly transaction between market participants at the measurement date. We determine fair value based on the assumptions market participants use when pricing the asset or liability. We also use the fair value hierarchy that prioritizes the information used to develop these assumptions.

        The fair value hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets (Level 1) and the lowest priority to unobservable inputs (Level 3). Our financial assets and liabilities are classified within the fair value hierarchy based on the lowest level of input that is significant to the fair value measurement. The three levels of the fair value hierarchy, and its applicability to our financial assets, are described below:

    Level 1 —Unadjusted quoted prices in active markets that are accessible at the measurement date of identical, unrestricted assets.

    Level 2 —Quoted prices for similar assets, or inputs that are observable, either directly or indirectly, for substantially the full term through corroboration with observable market data. Level 2 includes investments valued at quoted prices adjusted for legal or contractual restrictions specific to the security.

    Level 3 —Pricing inputs are unobservable for the asset, that is, inputs that reflect the reporting entity's own assumptions about the assumptions market participants would use in pricing the asset. Level 3 includes private investments that are supported by little or no market activity.

        As of December 31, 2014, we held financial assets that were measured using Level 1 and Level 2 inputs. As of December 31, 2013, we held financial assets and liabilities that were measured using Level 1, Level 2 and Level 3 inputs. Assets measured using Level 1 inputs include money market funds, which are valued using quoted market prices with no valuation adjustments applied. Assets measured using Level 2 inputs include marketable securities that consist primarily of domestic corporate debt securities (direct issuance bonds, corporate bonds, etc.) and are valued using third-party pricing resources, which generally use interest rates and yield curves observable at commonly quoted intervals of similar assets as observable inputs for pricing. Prior to our initial public offering, assets and liabilities measured using Level 3 inputs included our stock asset, stock liability, other liability and warrant liability. The stock asset represented the prepaid balance and the stock liability represented the accrued balance of the research and development expense related to the stock dividends to be issued to Nordic in shares of our series A-6 convertible preferred stock (or in shares of common stock upon listing our common stock on a national exchange) which is being recognized ratably over the estimated per patient treatment period under the three work statements executed with Nordic, or the Nordic Work Statements. The other liability represented the liability to issue shares of our series A-6 convertible preferred stock for services rendered in connection with the Nordic Work Statements. The liability was calculated based upon the number of shares earned by Nordic through the performance of clinical trial services multiplied by the estimated fair value of our series A-6 convertible preferred stock at each reporting date. The fair values of the stock asset, stock liability and other liability were based upon the fair value of our series A-6 convertible preferred stock as determined using the probability-weighted expected return method, or PWERM. Upon completion of our initial public offering, any payments owed by us to Nordic in relation to the Nordic Work Statements were changed from the right to receive shares of Series A-6 to the right to receive a total cash payment of $4.3 million.

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        As of December 31, 2013, the warrant liability represented the liability for the warrants issued to the placement agent we engaged in connection with our series A-1 convertible preferred stock financing, to the investors in our series B convertible preferred stock financing in April and May 2013, and to the lenders in connection with our Credit Facility. The warrant liability was calculated using the Black-Scholes option pricing method. Upon completion of the our initial public offering, the outstanding warrants to purchase shares of A-1 convertible preferred stock were converted into the right to purchase shares of common stock and the Company's warrant liability was reclassified to equity.

        As of December 31, 2014, we held no Level 3 assets or liabilities.

Results of Operations

        The following discussion summarizes the key factors our management team believes are necessary for an understanding of our financial statements.

Years Ended December 31, 2014 and December 31, 2013

 
  Years Ended
December 31,
  Change  
 
  2014   2013   $   %  
 
  (in thousands)
 

Operating expenses:

                         

Research and development

  $ 45,719   $ 60,536   $ (14,817 )   –24 %

General and administrative

    13,674     6,829     6,845     100 %

Loss from operations

    (59,393 )   (67,365 )   (7,972 )   –12 %

Other (expense) income:

                         

Other (expense) income, net

    (510 )   9,085     9,595     106 %

Loss on retirement of note payable

    (203 )       203     100 %

Interest (expense) income, net

    (2,373 )   (2,410 )   (37 )   –2 %

Net loss

  $ (62,479 ) $ (60,690 ) $ 1,789     3 %

        Research and development expenses —For the year ended December 31, 2014, research and development expense was $45.7 million compared to $60.5 million for the year ended December 31, 2013, a decrease of $14.8 million, or 24%. This decrease is primarily a result of a decrease in the total professional contract service costs associated with the development of abaloparatide-SC and abaloparatide-TD, partially offset by an increase in professional contract services costs associated with the development of RAD1901. During the year ended December 31, 2014, we incurred professional contract service costs associated with the development of abaloparatide-SC, abaloparatide-TD and RAD1901 of $32.0 million, $1.5 million and $2.3 million, respectively, compared to $46.0 million, $11.5 million and zero, respectively, for the year ended December 31, 2013. The decrease in contract service costs associated with the development of abaloparatide-SC is primarily a result of the completion of the Phase 3 18-month fracture study in October 2014. Additionally, fewer patients were enrolled in the 6-month extension study as of December 31, 2014, as compared to the year ended December 31, 2013, as certain patients completed treatment. We expect that costs associated with the development of abaloparatide-SC will continue to decrease over the course of the clinical trial as patients complete treatment under the 18-month fracture study and first six months of the extension study. In addition, there will be variability from quarter to quarter in the costs for abaloparatide-SC, driven primarily by the euro/dollar exchange rate, which is more fully described below under "Research and Development Agreements." The decrease in contract service costs associated with the development of abaloparatide-TD is a result of the completion of the Phase 2 clinical trial (which began dosing patients in September 2012) in September 2013. The increase in contract service costs associated with

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the development of RAD1901 is a result of the initiation of various preclinical, clinical, and manufacturing activities in 2014.

        General and administrative expenses —For the year ended December 31, 2014, general and administrative expense was $13.7 million compared to $6.8 million for the year ended December 31, 2013, an increase of $6.8 million, or 100%. This increase was primarily due to an increase in compensation costs of $4.5 million, including an increase of $3.9 million in non-cash stock-based compensation expense as a result of the issuance of new option awards during 2014, as well as the acceleration of vesting for a portion of our Chief Executive Officer's outstanding option awards, in accordance with his employment agreement, upon completion of our initial public offering. This increase can also be attributed to higher legal fees and consulting support costs of approximately $1.7 million during the year ended December 31, 2014.

        Other (expense) income, net —For the year ended December 31, 2014, other expense, net of other income, was $0.5 million, as compared to other income, net of expense during the year ended December 31, 2013 of $9.1 million. Other expense, net of other income, primarily reflects changes in the fair value of the stock asset, stock liability, other liability and warrant liability as discussed in notes 8 and 10 to our financial statements included in this Annual Report on Form 10-K. The $0.5 million of other expense, net of income, for the year ended December 31, 2014 was primarily due to an increase in the fair value of our warrant liability as a result of an overall increase in the fair value of the underlying common stock from December 31, 2013 to June 6, 2014. Following our initial public offering on June 6, 2014, our warrant liability was reclassified to equity. The $9.1 million of other income, net of expense, as of December 31, 2013 was primarily due to a decrease in the fair value of our stock liability and other liability as a result of an overall decline in the fair value of the underlying convertible preferred stock from December 31, 2012 to December 31, 2013.

        Loss on retirement of note payable —For the year ended December 31, 2014, loss on retirement of note payable was $0.2 million. This loss was a result of the prepayment of our Original Credit Facility on May 30, 2014.

        Interest (expense) income —For the year ended December 31, 2014, interest expense, net of interest income, was $2.4 million, consistent with $2.4 million for the year ended December 31, 2013.

Years Ended December 31, 2013 and December 31, 2012

 
  Years Ended
December 31,
  Change  
 
  2013   2012   $   %  
 
  (in thousands)
 

Operating expenses:

                         

Research and development

  $ 60,536   $ 54,961   $ 5,575     10 %

General and administrative

    6,829     9,469     (2,640 )   –28 %

Loss from operations

    (67,365 )   (64,430 )   2,935     5 %

Other (expense) income:

                         

Other income (expense), net

    9,085     (2,095 )   (11,180 )   –534 %

Interest (expense) income, net

    (2,410 )   (2,603 )   (193 )   –7 %

Net loss

  $ (60,690 ) $ (69,128 ) $ (8,438 )   –12 %

        Research and development expenses —For the year ended December 31, 2013, research and development expense was $60.5 million compared to $55.0 million for the year ended December 31, 2012, an increase of $5.6 million, or 10%. During the year ended December 31, 2013, we incurred professional contract services associated with the development of abaloparatide-SC and

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abaloparatide-TD of $57.4 million, compared to $50.7 million for the year ended December 31, 2012. This increase was primarily the result of additional expenses incurred for the enrollment of patients in our Phase 3 clinical trial of abaloparatide-SC, which began dosing of patients in April 2011 and completed enrollment in March 2013, and for the enrollment of patients in our Phase 2 clinical trial of abaloparatide-TD, which began dosing patients in September 2012 and completed patient visits in August 2013.

        General and administrative expenses —For the year ended December 31, 2013, general and administrative expense was $6.8 million compared to $9.5 million for the year ended December 31, 2012, a decrease of $2.6 million, or 28%. This decrease was primarily the result of significant fees incurred during the year ended December 31, 2012 for consulting and legal costs associated with the compilation and review of our various filings with the Securities and Exchange Commission, including the filing of our first Form 10-K as a reporting company, and a one-time non-recurring consultation fee of approximately $0.3 million, as well as a decrease in the amount of franchise tax expense recognized during the year ended December 31, 2013, as compared to the year ended December 31, 2012.

        Other income (expense), net —For the year ended December 31, 2013, other income, net of other expense, was $9.1 million. Other income, net of other expense, primarily reflects changes in the fair value of the stock liability and other liability as discussed in notes 8 and 10 to our financial statements included in this Annual Report. The $9.1 million of other income, net of expense, as of December 31, 2013 was primarily due to a decrease in the fair value of our stock liability and other liability as a result of an overall decline in the fair value of the underlying convertible preferred stock from December 31, 2012 to December 31, 2013.

        Interest (expense) income, net —For the year ended December 31, 2013, interest expense, net of interest income, was $2.4 million compared to $2.6 million for the year ended December 31, 2012, a decrease of $0.2 million, or 7%. This decrease was primarily a result of lower average debt outstanding during the year ended December 31, 2013 as compared to the year ended December 31, 2012.

Liquidity and Capital Resources

        From inception to December 31, 2014, we have incurred an accumulated deficit of $344.2 million, primarily as a result of expenses incurred through a combination of research and development activities related to our various investigational product candidates and expenses supporting those activities. Our total cash, cash equivalents and marketable securities balance as of December 31, 2014 was $105.3 million. We have financed our operations since inception primarily through the public offerings of our common stock, private sale of preferred stock, borrowing under credit facilities and the receipt of $5.0 million in fees associated with an option agreement.

        We believe that the aggregate proceeds from the public offering of shares of our common stock that we completed in January 2015, together with our cash, cash equivalents and marketable securities as of December 31, 2014, will be sufficient to fund our operations into the fourth quarter of 2016. We expect to finance the future development costs of abaloparatide-SC, abaloparatide-TD and RAD1901 with our existing cash and cash equivalents and marketable securities, or through strategic financing opportunities that could include, but are not limited to, partnering or other collaboration agreements, or the completion of an additional public offering. However, there is no guarantee that any of these financing opportunities will be available to us on favorable terms, and some could be dilutive to existing stockholders. Our future capital requirements will depend on many factors, including the scope and progress made in our research and development and commercialization activities, the results of our clinical trials, and the potential approval of our products by the FDA and EMA. If we fail to obtain additional future capital, we may be unable to complete our planned preclinical and clinical trials and obtain approval of any investigational product candidates from the FDA and other foreign regulatory authorities.

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        The following table sets forth the major sources and uses of cash for each of the periods set forth below (in thousands):

 
  Years ended December 31,  
 
  2014   2013   2012  

Net cash (used in) provided by:

                   

Operating activities

  $ (48,345 ) $ (45,017 ) $ (43,158 )

Investing activities

    (78,065 )   3,971     27,435  

Financing activities

    142,625     34,696     9,248  

Net increase (decrease) in cash and cash equivalents

  $ 16,215   $ (6,350 ) $ (6,475 )

Cash Flows from Operating Activities

        Net cash used in operating activities during the year ended December 31, 2014 was $48.3 million, which was primarily the result of a net loss of $62.5 million, partially offset by $11.2 million of net non-cash adjustments to reconcile net loss to net cash used in operations and net changes in working capital of $3.0 million. The $62.5 million net loss was primarily due to expenses incurred in connection with our ongoing Phase 3 clinical trial of abaloparatide-SC. The $11.2 million net non-cash adjustments to reconcile net loss to net cash used in operations included stock-based compensation expense of $7.1 million, $2.7 million of research and development expenses settled in stock, and a $0.5 million increase in the fair value of our warrant liability and stock liability as a result of an increase in the fair value of the underlying convertible preferred stock and common stock from December 31, 2013 to June 6, 2014.

        Net cash used in operating activities for the year ended December 31, 2013 was $45.0 million, which was primarily the result of a net loss of $60.7 million, partially offset by net changes in working capital of $9.7 million and $6.0 million net non-cash adjustments to reconcile net loss to net cash used in operations. The $60.7 million net loss was primarily due to expenses incurred in connection with our ongoing Phase 3 clinical trial of abaloparatide-SC and our Phase 2 clinical study of abaloparatide-TD, which finished dosing patients during the three months ended September 30, 2013. The $6.0 million net non-cash adjustments to reconcile net loss to net cash used in operations included $13.1 million of research and development expenses settled in stock and stock-based compensation expense of $1.5 million, and was partially offset by a $9.1 million reduction in the fair value of our warrant liability, stock liability and other liability as a result of a decline in the fair value of the underlying convertible preferred stock from December 31, 2012 to December 31, 2013.

        Net cash used in operating activities for the year ended December 31, 2012 was $43.2 million, which was primarily the result of a net loss of $69.1 million, partially offset by changes in working capital of $6.4 million and $19.5 million of non-cash adjustments to reconcile net loss to net cash used in operations, including $15.1 million of research and development expenses settled in stock. The $69.1 million net loss and $15.1 million of research and development expenses settled in stock are primarily due to expenses incurred in connection with our Phase 3 clinical trial of abaloparatide-SC and our Phase 2 clinical study of abaloparatide-TD, which commenced during the third quarter of 2012.

Cash Flows from Investing Activities

        Net cash used in investing activities for the year ended December 31, 2014 was $78.1 million, as compared to net cash provided by investing activities of $4.0 million for the year ended December 31, 2013.

        The net cash used in investing activities during the year ended December 31, 2014 was primarily a result of $97.7 million in purchases of marketable securities and $0.9 million of purchases of property

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and equipment, partially offset by $20.5 million of net proceeds received from the sale or maturity of marketable securities. The net cash provided by investing activities during the year ended December 31, 2013 was primarily a result of $21.0 million net proceeds received from the sale or maturity of marketable securities, partially offset by $17.1 million in purchases of marketable securities. The net cash provided by investing activities during the year ended December 31, 2012 was primarily a result of a $46.5 million in net proceeds from the sale or maturity of marketable securities, partially offset by $19.0 million in purchases of marketable securities.

        Our investing cash flows will be impacted by the timing of purchases and sales of marketable securities. All of our marketable securities have contractual maturities of less than one year. Due to the short-term nature of our marketable securities, we would not expect our operational results or cash flows to be significantly affected by a change in market interest rates due to the short-term duration of our investments.

Cash Flows from Financing Activities

        Net cash provided by financing activities for the year ended December 31, 2014 was $142.6 million, as compared to $34.7 million of net cash provided by financing activities for the year ended December 31, 2013.

        Net cash provided by financing activities during the year ended December 31, 2014 consisted of $50.4 million of net proceeds from our initial public offering, $53.4 million of net proceeds from our additional public offering that closed October 7, 2014, $27.4 million of net proceeds from the issuance of our series B-2 convertible preferred stock in February and March of 2014, and $24.6 million of net proceeds from our New Credit Facility, partially offset by payments under our Original Credit Facility of $13.2 million.

        Net cash provided by financing activities for the year ended December 31, 2013 consisted of $42.9 million of net proceeds from the issuance of our series B convertible preferred stock in April and May of 2013, partially offset by payments under our Credit Facility of $8.2 million.

        Net cash provided by financing activities for the year ended December 31, 2012 consists of $12.5 million of proceeds from our Credit Facility and $0.3 million of net proceeds from stock option exercises, offset by $3.5 million of payments on our Credit Facility.

Financings

    Sales of Common Stock

        On June 11, 2014, we completed our initial public offering whereby we sold 6,500,000 shares of our common stock at a price of $8.00 per share. The shares began trading on the NASDAQ Global Market on June 6, 2014. In connection with the completion of the offering, all outstanding shares of our convertible preferred stock converted into 19,465,132 shares of common stock, and 2,862,654 shares of common stock were issued in satisfaction of accumulated dividends accrued on the preferred stock. In addition, all outstanding warrants to purchase shares of A-1 convertible preferred stock and warrants to purchase shares of series B-2 convertible preferred stock were converted into the right to purchase 149,452 shares of common stock and our warrant liability was reclassified to equity. On June 18, 2014 and June 25, 2014, the underwriters purchased an additional 512,744 shares in the aggregate by exercising a portion of the over-allotment option granted to them in connection with the initial public offering. As a result of the closing of the initial public offering and subsequent exercise of the over-allotment option, we received aggregate proceeds, net of underwriting discounts, commissions and offering costs, of approximately $50.4 million.

        On October 7, 2014, we completed an additional public offering whereby we sold 2,750,000 shares of common stock at a price of $18.25 per share, for aggregate proceeds, net of underwriting discounts,

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commissions and offering costs, of approximately $46.9 million. On October 7, 2014, the underwriters purchased an additional 378,524 shares in the aggregate by exercising a portion of the over-allotment option granted to them in connection with the offering. As a result of the public offering and subsequent exercise of the over-allotment option, we received aggregate proceeds, net of underwriting discounts, commissions and offering costs of approximately $53.4 million.

        On January 28, 2015, we completed a public offering of 4,000,000 shares of our common stock at a price of $36.75 per share, for aggregate estimated proceeds, net of underwriting discounts, commissions and offering costs, of approximately $137.8 million. On January 28, 2015, the underwriters purchased an additional 600,000 shares in the aggregate by exercising an option to purchase additional shares that was granted to them in connection with the offering. As a result of the public offering and subsequent exercise of the underwriters' option, we received aggregate proceeds, net of underwriting discounts, commissions and offering costs of approximately $158.6 million.

    Sales of Preferred Stock

        Through December 31, 2014, we have received aggregate net cash proceeds of $238.2 million from the sale of shares of our preferred stock as follows:

Issue
  Year   No. Shares   Net Proceeds
(in thousands)
 

Series B redeemable convertible preferred stock(1)

  2003, 2004, 2005     1,599,997   $ 23,775  

Series C redeemable convertible preferred stock(1)

  2006, 2007, 2008     10,146,629     82,096  

Series A-1 convertible preferred stock(1)

  2011     9,223,041     61,591  

Series A-5 convertible preferred stock(1)

  2011     64,430     525  

Series B convertible preferred stock

  2013     701,235     42,870  

Series B-2 convertible preferred stock

  2014     448,060     27,368  

Total

        22,183,392   $ 238,225  

(1)
Share amounts stated in pre-Merger shares, which converted into the rights to one-tenth of one share pursuant to the Merger.

        On February 14, 2014, we entered into a Series B-2 Convertible Preferred Stock and Warrant Purchase Agreement, or Purchase Agreement, pursuant to which we were able to raise up to approximately $40.2 million through the issuance of (1) up to 655,000 series B-2 Shares convertible preferred stock, or Series B-2, par value $.0001 per share, and (2) warrants to acquire up to 718,201 shares of our common stock, at an exercise price of $14.004 per share.

        Shares of our Series B-2 were convertible, in whole or in part, at the option of the holder at any time into shares of common stock, on an approximately 4.386-for-one basis at an initial effective conversion price of $14.004 per share. Shares of our Series B-2 were automatically convertible into shares of our common stock upon the closing of an initial public offering on or prior to June 30, 2014 at a conversion rate determined by dividing the initial purchase price of $61.42 per share by the lower of (1) $14.004 per share and (2) the initial public offering price, or upon listing of the common stock on a national securities exchange after June 30, 2014 at the then applicable conversion rate. Holders of shares of Series B-2 were entitled to receive dividends at a rate of 8% per annum, compounding annually, which accrue on a daily basis commencing on the date of issuance of the shares of Series B-2. Dividends were payable, as accrued, upon liquidation, event of sale, and conversion to common stock, including upon mandatory conversion of the Series B-2 upon the closing of our initial public offering on or prior to June 30, 2014 or upon listing of the common stock on a national securities exchange after June 30, 2014. The holders of shares of Series B-2 were also entitled to dividends declared or paid on any shares of common stock.

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        Shares of Series B-2 ranked senior in payment to any other dividends payable on any and all series of preferred stock and upon liquidation, or an event of sale, each share of Series B-2 ranked equally with each other share of Series B-2 and Series B, senior to all shares of Series A-1, Series A-2, Series A-3, Series A-4, Series A-5 and Series A-6 and senior to all shares of common stock. In the event of a liquidation, dissolution, or winding-up of the Company, the holders of the Series B-2 were entitled to be paid first out of the assets available for distribution, before any payment was made to the Series A-1, Series A-2, Series A-3, Series A-4, Series A-5 and Series A-6. Payment to the holders of Series B-2 was to consist of one and a half (1.5) times the original issuance price of $61.42, plus all accrued but unpaid dividends.

        On February 14, 2014, February 19, 2014, February 24, 2014, March 14, 2014 and March 28, 2014, we consummated closings under the Series B-2 Purchase Agreement, whereby, in exchange for aggregate proceeds to us of approximately $27.5 million, we issued an aggregate of 448,060 Series B-2 Shares and warrants to purchase up to a total of 491,293 shares of our common stock.

        Each share of Series B-2 had the right to that number of votes per share as is equal to the number shares of common stock into which such share of Series B-2 was then convertible.

        The warrants issuable pursuant to the Purchase Agreement are exercisable for a period of five years from issuance.

        The issuances in February and March 2014 of the Series B-2 and accompanying warrants under the Purchase Agreement resulted in an additional adjustment to the Conversion Price of the Series A-1, Series A-2 and Series A-3. As a result of the Anti-Dilution Adjustment, the effective conversion price of each share of Series A-1, Series A-2 and Series A-3 was reduced to $16.970. Accordingly, each share of Series A-1, Series A-2 and Series A-3 was convertible into approximately 4.798 shares of common stock.

        Upon completion of our initial public offering, all shares of Series B-2 were converted into shares of our common stock at a conversion rate of 7.678, which is equal to the initial purchase price, divided by the initial public offering price of $8.00 per share.

    Debt Borrowings

        On May 30, 2014, we entered into our New Credit Facility with Solar and Oxford Finance, pursuant to which Solar and Oxford agreed to make available to us $30.0 million in the aggregate subject to certain conditions to funding. An initial term loan was made on May 30, 2014 in an aggregate principal amount equal to $21.0 million, or the Initial Term Loan.

        We were originally required to make interest-only payments through June 1, 2015, and beginning on July 1, 2015, we were required to make payments of principal and accrued interest in equal monthly installments over a term of 36 months. However, as we were able to consummate public offerings of our common stock which resulted in the receipt of at least $65.0 million in aggregate net cash proceeds prior to May 31, 2015, as of December 31, 2014, we are permitted to make interest-only payments through December 1, 2015 rather than July 1, 2015, and beginning on January 1, 2016, we will be required to make principal and accrued interest payments in equal monthly installments over a term of 30 months.

        In addition to the Initial Term Loan, we would have been able to request an additional term loan in an aggregate principal amount of $9.0 million, or the Original Term B Loan, after the completion of this initial public offering if the net cash proceeds were at least $65.0 million subject to certain customary conditions to funding. Given the net proceeds from our initial public offering were less than $65.0 million, we were not able to request the Original Term B Loan. The Initial Term Loan bears interest per annum at 9.85% plus one-month LIBOR (customarily defined). All principal and accrued interest on the initial term loan is due on June 1, 2018.

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        As security for its obligations under the New Credit Facility, we granted a security interest in substantially all of our existing and after-acquired assets except for our intellectual property and certain other customary exclusions.

        On July 10, 2014, we entered into a first amendment to the New Credit Facility, or the First Amendment. Pursuant to the terms of the First Amendment, a second term loan of $4.0 million was drawn on July 10, 2014. The terms of the First Amendment, among other things,

    provide us with, subject to certain customary funding conditions, additional term loans in an aggregate principal amount of $4.0 million upon the closing of the First Amendment, or the Modified Term B Loan. All other terms applicable to the Original Term B Loan remain applicable to the Modified Term B Loan. The Original Term B Loan are replaced by the Modified Term B Loan. We borrowed the full amount of the Modified Term B Loan on July 10, 2014.

    provide us the ability to borrow additional term loans in an aggregate amount of $5.0 million, or the Term C Loan, at any time through December 31, 2014. In order to draw the Term C Loan, we had to, in addition to other customary conditions, either (a) close public or private stock offerings, equity raises or strategic partner arrangements resulting in $13.0 million in aggregate net proceeds after the closing of the First Amendment, or (b) as it relates specifically to RAD1901, complete both the maximum tolerable dose trial and enroll the first patient in the breast cancer brain metastasis trial. Although we closed a public offering resulting in over $13.0 million in aggregate net proceeds after the closing of the First Amendment, we did not exercise our right to draw the Term C Loan prior to December 31, 2014.

Future Financing Needs

        We expect to finance the future development costs of abaloparatide-SC, abaloparatide-TD and RAD1901 with our existing cash and cash equivalents and marketable securities, or through strategic financing opportunities, future offerings of our equity, or the incurrence of debt. We anticipate that we will make determinations as to which additional programs to pursue and how much funding to direct to each program on an ongoing basis in response to the scientific and clinical data of each investigational product candidate, progress on securing third-party collaborators, as well as ongoing assessments of such investigational product candidate's commercial potential and our ability to fund this product development.

        The successful development of our investigational product candidates is subject to numerous risks and uncertainties associated with developing drugs, including, but not limited to, the variables listed below. A change in the outcome of any of these variables with respect to the development of any of our investigational product candidates could mean a significant change in the cost and timing associated with the development of that investigational product candidate.

        Abaloparatide-SC is our only investigational product candidate in late stage development, and our business currently depends heavily on its successful development, regulatory approval and commercialization. We have not submitted an NDA to the FDA or comparable applications to foreign regulatory authorities. Obtaining approval of an investigational product candidate is an extensive, lengthy, expensive and uncertain process, and any approval of abaloparatide-SC may be delayed, limited or denied for many reasons, including:

    we may not be able to demonstrate that abaloparatide is safe and effective as a treatment for reduction of fracture risk in postmenopausal women with severe osteoporosis to the satisfaction of the FDA or other foreign regulatory authorities;

    the results of our clinical studies may not meet the level of statistical or clinical significance required for marketing approval;

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    the FDA or other foreign regulatory authorities may disagree with the number, design, size, conduct or implementation of our clinical studies;

    the CRO that we retain to conduct clinical studies may take actions outside of our control that materially adversely impact our clinical studies;

    the FDA or other foreign regulatory authorities may not find the data from preclinical studies and clinical studies sufficient to demonstrate that abaloparatide's clinical and other potential benefits outweigh its safety risks;

    the FDA or other foreign regulatory authorities may disagree with our interpretation of data from our preclinical studies and clinical studies or may require that we conduct additional studies;

    the FDA or other foreign regulatory authorities may not agree with our proposed labeling and may require labeling that undermines or otherwise significantly impairs the commercial value of the product if it were to be approved with such labeling;

    the FDA or other foreign regulatory authorities may not accept data generated at our clinical study sites;

    the FDA may require development of a Risk Evaluation and Mitigation Strategy, or REMS, as a condition of approval;

    if our NDA is reviewed by an advisory committee, the FDA may have difficulties scheduling an advisory committee meeting in a timely manner or the advisory committee may recommend against approval of our application or may recommend that the FDA require, as a condition of approval, additional preclinical studies or clinical studies, limitations on approved labeling or distribution and use restrictions; or

    the FDA or other foreign regulatory authorities may identify deficiencies in the manufacturing processes or facilities of our third-party manufacturers.

        In addition, the FDA or other foreign regulatory authorities may change their approval policies or adopt new regulations. For example, on February 15, 2012, we received a letter from the FDA stating that, after internal consideration, the Agency believes that a minimum of 24-months of fracture data is necessary for approval of new products for the treatment of postmenopausal osteoporosis, and our ongoing abaloparatide-SC pivotal Phase 3 clinical trial is designed to produce fracture data based on an 18-month primary endpoint. Based on our discussions with the FDA, we believe that continued use of the 18-month primary endpoint will be acceptable, provided that our NDA includes the 24-month fracture data derived from the first six months of an extension of the abaloparatide 80 µg and placebo groups in our Phase 3 clinical trial. In the extension study, patients are receiving an approved alendronate (generic Fosamax) therapy for osteoporosis management. We plan to submit the NDA with the 24-month fracture data. We cannot be certain that the FDA, or other regulatory authorities, will be supportive of this plan, will not change this approval policy again, or adopt other approval policies or regulations that adversely affect any NDA that we may submit.

Contractual Obligations and Commitments

        Contractual obligations represent future cash commitments and liabilities under agreements with third parties, and exclude contingent liabilities for which we cannot reasonably predict future payment. We enter into contracts in the normal course of business with CROs for preclinical and clinical research studies, research supplies and other services and products for operating purposes. These contracts generally provide for termination on notice, and therefore are cancelable contracts and not included in the table of contractual obligations and commitments. In addition, we have certain obligations to make future payments to third parties that become due and payable on the achievement of certain development, regulatory and commercial milestones (such as the start of a clinical trial, filing

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of an NDA, approval by the FDA or product launch). The table below excludes these potential payments we may be required to make under our agreements because the timing of payments and actual amounts paid under those agreements may be different depending on the timing of receipt of goods or services or changes to agreed-upon terms or amounts for some obligations, and those agreements are cancelable upon written notice by us and therefore, not long-term liabilities. Additionally, the expected timing of payment of the obligations presented below is estimated based on current information.

        Our contractual obligations result from property leases for office space and amounts due under our New Credit Facility. However, more information regarding significant contracts with CROs and our obligations to make future payments to third parties that become due and payable upon achievement of certain development, regulatory and commercial milestones can be found below under "Research and Development Agreements" and "License Agreement Obligations".

        The following table summarizes our contractual obligations at December 31, 2014:

 
  Total   Less than
1 Year
  1 to 3
Years
  3 to 5
Years
  More than
5 Years
 
 
  (in thousands)
 

Operating lease obligations

  $ 1,428   $ 328   $ 601   $ 499   $  

New Credit Facility

    25,000         20,000     5,000      

Total

  $ 26,428   $ 328   $ 20,601   $ 5,499   $  

Research and Development Agreements

        Abaloparatide-SC Phase 3 Clinical Trial —We have entered into agreements with Nordic to conduct our Phase 3 clinical trial of abaloparatide-SC, or the Phase 3 Clinical Trial. On March 29, 2011, we entered into a Clinical Trial Services Agreement, or the Clinical Trial Services Agreement. On the same date, we also entered into Work Statement NB-1, as amended on December 9, 2011, June 18, 2012, March 28, 2014, May 19, 2014 and July 22, 2014, or Work Statement NB-1, and the Stock Issuance Agreement, as amended and restated on May 16, 2011, and as further amended on February 21, 2013, March 28, 2014, and May 19, 2014, or the Stock Issuance Agreement.

        Pursuant to the Work Statement NB-1, we are required to make certain per patient payments denominated in both euros and U.S. dollars for each patient enrolled in the Phase 3 Clinical Trial followed by monthly payments for the duration of the study and final payments in two equal euro-denominated installments and two equal U.S. dollar-denominated installments. Changes to the Phase 3 Clinical Trial schedule may alter the timing, but not the aggregate amounts of the payments. In addition, Nordic is entitled to a performance incentive payment, or Performance Incentive Payment, of $500,000 for every 50 patients that, subsequent to March 28, 2014, complete all end-of-study procedures, up to a maximum aggregate amount of $5.0 million. The Work Statement NB-1, provides for a total of up to approximately €41.2 million ($49.8 million) of euro-denominated payments and a total of up to approximately $3.2 million of U.S. dollar-denominated payments over the course of the Phase 3 Clinical Trial, plus Performance Incentive Payments. These payments may be adjusted based upon actual sites opened, work performed or number of patients enrolled.

        Pursuant to the Stock Issuance Agreement, Nordic purchased 6,443 shares of our Series A-5 convertible preferred stock. In connection with the Work Statement NB-1, the shares of Series A-5 convertible preferred stock held by Nordic were entitled to receive quarterly stock dividends payable in shares of our Series A-6 convertible preferred stock, having an aggregate value of up to €36.8 million ($44.5 million), or the NB-1 Accruing Dividend. The Stock Issuance Agreement further provided that in the event an initial public offering of our common stock occurred prior to June 30, 2014, any payments owed by us to Nordic in relation to Work Statement NB-1 and Work Statement NB-3, as discussed below, excluding Performance Incentive Payments, for all periods of time after 2014 would

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change from the right to receive stock to the right to receive a total cash payment from us of $4.3 million payable in ten equal monthly installments of $430,000 beginning on March 31, 2015. As we completed our initial public offering on June 11, 2014, payments owed to Nordic under the Stock Issuance Agreement have been paid in cash for all periods after June 11, 2014.

        Prior to the issuance of shares of stock to Nordic in satisfaction of the NB-1 Accruing Dividend, the liability to issue shares of stock was accounted for as a liability on our balance sheet, based upon the fair value of the series A-6 convertible preferred stock as determined using PWERM. Changes in the fair value from the date of accrual to the date of issuance of shares of our series A-6 convertible preferred stock were recorded as a gain or loss in other (expense) income in the statement of operations.

        We recognize research and development expense for the amounts due to Nordic under the Work Statement NB-1 ratably over the estimated per patient treatment period beginning upon enrollment in the Phase 3 Clinical Trial, or a 20-month period, except for research and development expense for the amounts due under the fourth amendment to the Work Statement NB-1, which we recognize on a per patient basis when the end-of-study visit and all other required procedures are completed. We recorded $8.2 million, $31.6 million, and $30.8 million of research and development expense during the years ended December 31, 2014, 2013, and 2012, respectively, for per patient costs incurred for patients that had enrolled in the Phase 3 Clinical Trial.

        As of December 31, 2014, we had a liability of $5.6 million reflected in accrued expenses and other current liabilities on the balance sheet resulting from services provided by Nordic, which are payable in cash.

        Abaloparatide-SC Phase 3 Clinical Extension Study —On February 21, 2013, we entered into the Work Statement NB-3, as amended on March 4, 2014, or the Work Statement NB-3. Pursuant to the Work Statement NB-3, Nordic will perform an extension study to evaluate six months of standard-of-care osteoporosis management following the completion of the Phase 3 Clinical Trial, and, upon completion of this initial six months, an additional period of 18 months of standard-of-care osteoporosis management ("the Extension Study").

        Payments in cash to be made to Nordic under the Work Statement NB-3 are denominated in both euros and U.S. dollars and total up to €7.5 million ($9.1 million) and $1.1 million, respectively. In addition, the Stock Issuance Agreement provided that, beginning with the quarter ended March 31, 2013, Nordic was entitled to receive quarterly stock dividends on its shares of Series A-5 convertible preferred stock, payable in shares of our Series A-6 convertible preferred stock, having an aggregate value of up to €7.5 million ($9.1 million) and $0.8 million, or the NB-3 Accruing Dividend. The Stock Issuance Agreement further provided that in the event an initial public offering of our common stock occurred prior to June 30, 2014, any payments owed by us to Nordic in relation to Work Statement NB-1 and Work Statement NB-3, excluding Performance Incentive Payments, for all periods of time after 2014 would change from the right to receive stock to the right to receive a total cash payment from us of $4.3 million payable in ten equal monthly installments of $430,000 beginning on March 31, 2015. As we completed our initial public offering on June 11, 2014, payments owed to Nordic under the Stock Issuance Agreement have been paid in cash for all periods after June 11, 2014.

        Prior to the issuance of shares of stock to Nordic in satisfaction of the NB-3 Accruing Dividend, the liability to issue shares of stock was accounted for as a liability on our balance sheet, based upon the fair value of our series A-6 convertible preferred stock as determined using PWERM. Changes in the fair value from the date of accrual to the date of issuance of shares of our series A-6 convertible preferred stock are recorded as a gain or loss in other (expense) income in the statement of operations.

        We recognize research and development expense for the amounts due to Nordic under the Work Statement NB-3 ratably over the estimated per patient treatment periods beginning upon enrollment or over a nine-month and 19-month period, respectively. We recorded $9.6 million and $4.5 million of

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research and development expense during the year ended December 31, 2014 and 2013 for per patient costs incurred for patients that had enrolled in the Extension Study and Second Extension.

        As of December 31, 2014, we had a liability of $5.9 million reflected in accrued expenses and other current liabilities on the balance sheet resulting from services provided by Nordic, which are payable in cash.

        Abaloparatide-TD Phase 2 Clinical Trial —On July 26, 2012, we entered into a Letter of Intent, or the Phase 2 Letter of Intent with Nordic, which provided that we and Nordic would, subject to our compliance with certain requirements of our certificate of incorporation and applicable securities law, negotiate in good faith to enter into a Work Statement NB-2, or the Work Statement NB-2, and an amendment to the Amended and Restated Stock Issuance Agreement.

        On February 21, 2013, we entered into Work Statement NB-2. Pursuant to the Work Statement NB-2, Nordic provided clinical trial services relating to the Phase 2 clinical trial of abaloparatide-TD, or the Phase 2 Clinical Trial. Payments in cash under the Work Statement NB-2 are denominated in both euros and U.S. dollars and total up to €3.6 million ($4.4 million) and $0.3 million, respectively. In addition, pursuant to the Stock Issuance Agreement, Nordic was entitled to shares of our Series A-6 convertible preferred stock payable as dividends on the shares of Series A-5 convertible preferred stock held by Nordic, having an aggregate value of up to $2.9 million. In December 2013, we issued Nordic 32,215 shares of our Series A-6 convertible preferred stock, which constituted all shares of Series A-6 convertible preferred stock due in connection with Work Statement NB-2.

        We recognized research and development expense for the amounts due to Nordic under the Work Statement NB-2 ratably over the estimated per patient treatment period beginning upon enrollment in the Phase 2 Clinical Trial, or a nine-month period. We recorded nil, $4.1 million and $1.4 million of research and development expense during the years ended December 31, 2014, 2013, and 2012, respectively, for per patient costs incurred for patients that had enrolled in the Phase 2 Clinical Trial. Additionally, we recorded approximately $0.9 million of research and development expense associated with the costs incurred for preparatory and other start-up costs to initiate the Phase 2 Clinical Trial during the year ended December 31, 2012. As of December 31, 2014, all obligations due to Nordic under Work Statement NB-2 had been paid.

        We are also responsible for certain pass-through costs in connection with the Phase 3 Clinical Trial, Extension Study and Phase 2 Clinical Trial. Pass-through costs are expensed as incurred or upon delivery. We recognized research and development expense of $1.3 million, $3.9 million, and $6.0 million for pass through costs during years ended December 31, 2014, 2013, and 2012, respectively.

        We estimate that our future cash obligations to Nordic in relation to Work Statement NB-1 and Work Statement NB-3 will approximate the following as of December 31, 2014 (in thousands):

 
  TOTAL(1)   LESS THAN 1 YEAR(1)   1 - 3 YEARS(1)   4 - 5
YEARS
  MORE
THAN
5 YEARS
 
 
  EURO DENOMINATED
PAYMENTS
   
  EURO DENOMINATED
PAYMENTS
   
  EURO DENOMINATED
PAYMENTS
   
   
   
 
 
  EURO   USD
EQUIVALENT(2)
  USD
DENOMINATED
PAYMENTS
  EURO   USD
EQUIVALENT(2)
  USD
DENOMINATED
PAYMENTS
  EURO   USD
EQUIVALENT(2)
  USD
DENOMINATED
PAYMENTS
   
   
 

Work Statement NB-1

  4,351   $ 5,265   $ 248   4,351   $ 5,265   $ 248     $   $   $   $  

Work Statement NB-3

    4,440     5,373     4,300     3,165     3,830     4,300     1,275     1,543              

Total Payments

  8,791   $ 10,638   $ 4,548   7,516   $ 9,095   $ 4,548   1,275   $ 1,543   $   $   $  

(1)
The amounts above exclude pass-through costs and, in accordance with the respective work statements, may be adjusted from time to time and at the end of the study to reflect actual study activities completed by the study subjects. The future obligations under Work Statement NB-3 are based upon our current estimate of patient enrollment rates, which are based upon historical enrollment rates and estimated drop outs. These amounts may not be representative of the actual future enrollment rates which would have an impact on the amount and timing of our future cash payments to Nordic.

(2)
USD equivalent is based upon the noon buying rate published by the Board of Governors of the Federal Reserve on December 31, 2014.

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License Agreement Obligations

Abaloparatide

        In September 2005, we exclusively licensed the worldwide rights (except Japan) to abaloparatide and analogs from an affiliate of Ipsen Pharma SAS, or Ipsen, including US Patent No. 5,969,095 (statutory term expires March 29, 2016) entitled "Analogs of Parathyroid Hormone" that claims abaloparatide and US Patent No. 6,544,949, (statutory term expires March 29, 2016) entitled "Analogs of Parathyroid Hormone" that claims abaloparatide and US Patent No. 6,544,949, (effective filing date March 29, 1996, statutory term expires March 29, 2016), entitled "Analogs of Parathyroid Hormone" that claims methods of treating osteoporosis using abaloparatide and pharmaceutical compositions comprising abaloparatide, and the corresponding foreign patents and continuing patent applications. European Patent No. 0847278, which was included in the license from Ipsen and claimed the composition of matter of abaloparatide, lapsed due to Ipsen's failure to pay annuities. We are pursuing restoration of those rights. To date, the patent rights in Finland, France, Germany, Portugal, Spain and United Kingdom have been restored. We believe that the data and market exclusivity provided in Europe for a new chemical entity, coupled with the need for a potential competitor to conduct clinical trials will likely provide a longer barrier to entry than the patent protection provided by the original European patent term, which would have expired in 2016, plus a five year maximum Supplemental Protection Certificate.

        We also have rights to joint intellectual property related to abaloparatide, including rights to the jointly derived intellectual property contained in US Patent No. 7,803,770 (statutory term expires October 3, 2027, and may be extended to March 26, 2028 with 175 days of patent term adjustment due to delays in patent prosecution by the United States Patent and Trademark Office, or USPTO), US Patent No. 8,148,333 (statutory term expires October 3, 2027 and may be extended to November 8, 2027 with 36 days of patent term adjustment due to delays in patent prosecution by the USPTO) and related patents and patent applications both in the United States and worldwide that cover the method of treating osteoporosis using the Phase 3 Clinical Trial dosage strength and form. A corresponding European application is pending with claims to the intended therapeutic formulation for abaloparatide-SC. Examination has been requested, but substantive examination has not yet commenced. Upon grant, this patent could be validated in any designated contracting or extension states and potentially could be considered for a Supplemental Protection Certificate depending upon the timing of its grant. Related cases granted in China, Australia, Singapore, Japan, Israel, Mexico, New Zealand, Russia and Ukraine, and currently pending in Europe, Canada, Brazil, Singapore, South Korea, India, Norway, and Hong Kong will have a patent expiration date of 2027. Patent applications which cover various aspects of abaloparatide for microneedle application are pending in the United States, Australia, Brazil, Canada, China, Europe, Hong Kong, Israel, India, Japan, Korea, Mexico, New Zealand, Russia, Singapore, and Ukraine. Any patents that might issue from these applications will have an expiration date in 2032.

        In consideration for the rights to abaloparatide and in recognition of certain milestones having been met to date, we have paid to Ipsen an aggregate amount of $1.0 million. The license agreement further requires us to make payments upon the achievement of certain future clinical and regulatory milestones. The range of milestone payments that could be paid under the agreement is €10.0 million to €36.0 million ($12.1 million to $43.6 million). Should abaloparatide be approved and subsequently become commercialized, we or our sublicensees will be obligated to pay to Ipsen a fixed five percent royalty based on net sales of the product on a country-by-country basis until the later of the last to expire of the licensed patents or for a period of 10 years after the first commercial sale in such country. The date of the last to expire of the abaloparatide patents licensed from or co-owned with Ipsen, barring any extension thereof, is expected to be March 26, 2028. In the event that we sublicense abaloparatide to a third party, we are obligated to pay a percentage of certain payments received from such sublicensee (in lieu of milestone payments not achieved at the time of such sublicense). The

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applicable percentage is in the low double digit range. In addition, if we or our sublicensees commercialize a product that includes a compound discovered by us based on or derived from confidential Ipsen know-how, we will be obligated to pay to Ipsen a fixed low single digit royalty on net sales of such product on a country-by-country basis until the later of the last to expire of our patents that cover such product or for a period of 10 years after the first commercial sale of such product in such country. The license agreement contains other customary clauses and terms as are common in similar agreements in the industry.

        Prior to executing the license agreement for abaloparatide with Radius, Ipsen licensed the Japanese rights for abaloparatide to Teijin Limited, or Teijin, a Japanese pharmaceutical company. It is our understanding that Teijin has fully enrolled a Phase 2 study of abaloparatide, which is expected to report results in mid-2015.

RAD1901

        We exclusively licensed the worldwide rights to RAD1901 from Eisai Co. Ltd., or Eisai. In particular, we have licensed US Patent No. 7,612,114 (statutory term expires December 25, 2023 and may be extended to August 18, 2026 with 967 days of patent term adjustment due to delays by the USPTO) and US Patent No. 8,399,520 (statutory term expires December 25, 2023). In consideration for the rights to RAD1901 and in recognition of certain milestones having been met to date, we have paid to Eisai an aggregate amount of $1.5 million. The range of milestone payments that could be paid under the agreement is $1.0 million to $20.0 million. The license agreement further requires us to make payments upon the achievement of certain future clinical and regulatory milestones. Should RAD1901 be approved and subsequently become commercialized, we will be obligated to pay to Eisai a royalty in a variable mid-single digit range based on net sales of the product on a country-by-country basis for a period that expires on the later of (1) the date the last remaining valid claim in the licensed patents expires, lapses or is invalidated in that country, the product is not covered by data protection clauses, and the sales of lawful generic version of the product account for more than a specified percentage of the total sales of all pharmaceutical products containing the licensed compound in that country; or (2) a period of 10 years after the first commercial sale of the licensed products in such country, unless it is sooner terminated. The latest valid claim is expected to expire, barring any extension thereof, on August 18, 2026. The royalty rate shall then be subject to reduction and the royalty obligation will expire at such time as sales of lawful generic version of such product account for more than a specified minimum percentage of the total sales of all products that contain the licensed compound. We were also granted the right to sublicense with prior written approval from Eisai. If we sublicense RAD1901 to a third party, we will be obligated to pay Eisai, in addition to the milestones referenced above, a fixed low double digit percentage of certain fees we receive from such sublicensee and royalties in a variable mid-single digit range based on net sales of the sublicensee. The license agreement contains other customary clauses and terms as are common in similar agreements in the industry.

Net Operating Loss Carryforwards

        As of December 31, 2014, we had federal and state net operating loss carryforwards of approximately $319.7 million and $246.5 million, respectively, the use of which may be limited, as described below. If not utilized, the net operating loss carryforwards will expire at various dates through 2034.

        Under Section 382 of the Code, substantial changes in our ownership may limit the amount of net operating loss carryforwards that could be used annually in the future to offset taxable income. Specifically, this limitation may arise in the event of a cumulative change in ownership of our company of more than 50% within a three-year period. Any such annual limitation may significantly reduce the utilization of the net operating loss carryforwards before they expire. The private placements and other

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transactions that have occurred since our inception, may have triggered an ownership change pursuant to Section 382, which could limit the amount of net operating loss carryforwards that could be utilized annually in the future to offset taxable income, if any. Any such limitation, whether as the result of prior private placements, sales of common stock by our existing stockholders or additional sales of common stock by us, could have a material adverse effect on our results of operations in future years. We have not completed a study to assess whether an ownership change has occurred, or whether there have been multiple ownership changes since our inception, due to the significant costs and complexities associated with such study. In each period since our inception, we have recorded a valuation allowance for the full amount of our deferred tax asset, as the realization of the deferred tax asset is uncertain. As a result, we have not recorded any federal or state income tax benefit in our statement of operations.

Off-Balance Sheet Arrangements

        We do not have any off-balance sheet arrangements or any relationships with unconsolidated entities of financial partnerships, such as entities often referred to as structured finance or special purpose entities.

Recently Adopted Accounting Standards

        In July 2013, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, a Similar Tax Loss, or a Tax Credit Carryforward Exists ("ASU 2013-11"). ASU 2013-11 clarifies guidance and eliminates diversity in practice on the presentation of unrecognized tax benefits when a net operating loss carryforward, a similar tax loss, or a tax credit carryforward exists at the reporting date. The amendments under ASU 2013-11 were effective for interim and annual fiscal periods beginning after December 15, 2013, with early adoption permitted. We adopted ASU 2013-11 on January 1, 2014. Its adoption did not have a material impact on our results of operations, financial position, or cash flows.

        In December 2013, the FASB issued Accounting Standards Update No. 2013-12, Definition of a Public Business Entity ("ASU 2013-12"). ASU 2013-12 amends the Master Glossary of the FASB Accounting Standards Codification to include one definition of public business entity for future use in GAAP. ASU 2013-12 does not affect existing requirements but will be used in considering the scope of new financial guidance and will identify whether the guidance does or does not apply to public business entities. We adopted ASU 2013-12 on January 1, 2014. Its adoption did not have a material impact on our results of operations, financial position or cash flows.

New Accounting Standards

        In August 2014, the FASB issued Accounting Standards Update No. 2014-15, Disclosures of Uncertainties about an Entity's Ability to Continue as a Going Concern ("ASU 2014-15"). ASU 2014-15 provides guidance in GAAP about management's responsibility to evaluate whether there is substantial doubt about an entity's ability to continue as a going concern and to provide related footnote disclosures. The amendments under ASU 2014-15 are effective for interim and annual fiscal periods beginning after December 15, 2016, with early adoption permitted. We plan to adopt ASU 2013-12 on January 1, 2015. We do not expect the adoption to have a material impact on our results of operations, financial position or cash flows.

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ITEM 7A.    QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.

        We are exposed to market risk related to changes in interest rates. As of December 31, 2014 and 2013, we had cash, cash equivalents, and marketable securities of $105.3 million and $12.3 million, respectively, consisting of money market funds, domestic corporate debt securities, domestic corporate commercial paper, and cash equivalents. This exposure to market risk is interest rate sensitivity, which is affected by changes in the general level of U.S. interest rates, particularly because our investments are in short-term marketable securities. Due to the short-term duration of our investment portfolio and the low risk profile of our investments, an immediate 10 percent change in interest rates would not have a material effect on the fair market value of our portfolio. We generally have the ability to hold our short-investments until maturity, and therefore we would not expect our operating results or cash flows to be affected by any significant degree by the effect of a change in market interest rates on our investments. We carry our investments based on publicly available information. As of December 31, 2014 and 2013, we do not have any hard to value investment securities or securities for which a market is not readily available or active.

        On May 30, 2014, we entered into a Loan and Security Agreement with Solar Capital Ltd., as collateral agent and a lender, and Oxford Finance LLC, as a lender, pursuant to which Solar and Oxford agreed to make available to us $30.0 million in the aggregate subject to certain conditions to funding. An initial term loan was made on May 30, 2014 in an aggregate principal amount equal to $21.0 million, or the Initial Term Loan. A second term loan was made on July 10, 2014 in an aggregate principal amount equal to $4.0 million, or the Second Term Loan. The Initial Term Loan and Second Term Loan bear interest per annum at 9.85% plus one-month LIBOR (customarily defined) and mature on June 1, 2018. Changes in interest rates can cause interest charges to fluctuate under our Loan and Security Agreement, as amended. As of December 31, 2014, principal payable under the Initial Term Loan was $25.0 million. A 10 percent increase in current interest rates would have resulted in approximately $0.1 million in additional cash interest expense for the year ended December 31, 2014.

        We are not subject to significant credit risk as this risk does not have the potential to materially impact the value of assets and liabilities.

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ITEM 8.    FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA.

FINANCIAL STATEMENTS

Radius Health, Inc.

Index to Financial Statements

 
  PAGE  

Report of Independent Registered Public Accounting Firm

    106  

Balance Sheets as of December 31, 2014 and 2013

    107  

Statements of Operations and Comprehensive Loss for the years ended December 31, 2014, 2013 and 2012

    108  

Statements of Convertible Preferred Stock, Redeemable Convertible Preferred Stock and Stockholders' Equity (Deficit) for the years ended December 31, 2014, 2013 and 2012

    109  

Statements of Cash Flows for the years ended December 31, 2014, 2013 and 2012

    111  

Notes to Financial Statements

    112  

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Report of Independent Registered Public Accounting Firm

The Board of Directors and Shareholders of Radius Health, Inc.

        We have audited the accompanying balance sheets of Radius Health, Inc. as of December 31, 2014 and 2013, and the related statements of operations and comprehensive loss, convertible preferred stock, redeemable convertible preferred stock and stockholders' equity (deficit), and cash flows for each of the three years in the period ended December 31, 2014. These financial statements are the responsibility of the Company's management. Our responsibility is to express an opinion on these financial statements based on our audits.

        We conducted our audits in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation. We believe that our audits provide a reasonable basis for our opinion.

        In our opinion, the financial statements referred to above present fairly, in all material respects, the financial position of Radius Health, Inc. at December 31, 2014 and 2013, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2014, in conformity with U.S. generally accepted accounting principles.

        We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), Radius Health Inc.'s internal control over financial reporting as of December 31, 2014, based on criteria established in Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) and our report dated March 10, 2015 expressed an unqualified opinion thereon.

    /s/ Ernst & Young LLP

Boston, Massachusetts
March 10, 2015

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Radius Health, Inc.

Balance Sheets

(In thousands, except share and per share amounts)

 
  December 31,
2014
  December 31,
2013
 

ASSETS

             

Current assets:

             

Cash and cash equivalents

  $ 28,518   $ 12,303  

Marketable securities

    76,758      

Prepaid expenses and other current assets

    2,057     334  

Total current assets

    107,333     12,637  

Property and equipment, net

    842     76  

Other assets

    242     45  

Total assets

  $ 108,417   $ 12,758  

LIABILITIES, CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS' EQUITY (DEFICIT)

             

Current liabilities:

             

Accounts payable

  $ 2,292   $ 300  

Accrued expenses and other current liabilities

    18,267     22,007  

Current portion of note payable, net of discount

        13,005  

Total current liabilities

    20,559     35,312  

Note payable, net of current portion and discount

   
24,394
   
 

Warrant liability

        1,945  

Commitments and contingencies

   
 
   
 
 

Series B-2 Convertible Preferred Stock, $.0001 par value; no shares and 655,000 shares authorized, no shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

         

Series B Convertible Preferred Stock, $.0001 par value; no shares and 980,000 shares authorized, no shares and 701,235 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        43,892  

Series A-1 Convertible Preferred Stock, $.0001 par value; no shares and 1,000,000 shares authorized, no shares and 939,612 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        78,737  

Series A-2 Convertible Preferred Stock, $.0001 par value; no shares and 983,213 shares authorized, no shares and 983,208 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        93,977  

Series A-3 Convertible Preferred Stock, $.0001 par value; no shares and 142,230 shares authorized, no shares and 142,227 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        12,232  

Series A-4 Convertible Preferred Stock, $.0001 par value; no shares and 4,000 shares authorized, no shares and 3,998 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        271  

Series A-5 Convertible Preferred Stock, $.0001 par value; no shares and 7,000 shares authorized, no shares and 6,443 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        525  

Series A-6 Convertible Preferred Stock, $.0001 par value; no shares and 800,000 shares authorized, no shares and 496,111 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

        23,168  

Stockholders' equity (deficit):

             

Common stock, $.0001 par value; 200,000,000 shares and 100,000,000 shares authorized, 32,924,535 shares and 385,664 shares issued and outstanding at December 31, 2014 and December 31, 2013, respectively

   
3
   
 

Additional paid-in-capital

    407,720      

Accumulated other comprehensive loss

    (21 )    

Accumulated deficit

    (344,238 )   (277,301 )

Total stockholders' equity (deficit)

    63,464     (277,301 )

Total liabilities, convertible preferred stock and stockholders' equity (deficit)

  $ 108,417   $ 12,758  

   

See accompanying notes to financial statements.

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Radius Health, Inc.

Statements of Operations and Comprehensive Loss

(In thousands, except share and per share amounts)

 
  December 31,  
 
  2014   2013   2012  

OPERATING EXPENSES:

                   

Research and development

  $ 45,719   $ 60,536   $ 54,961  

General and administrative

    13,674     6,829     9,469  

Loss from operations

    (59,393 )   (67,365 )   (64,430 )

OTHER (EXPENSE) INCOME:

                   

Other (expense) income, net

    (510 )   9,085     (2,095 )

Loss on retirement of note payable

    (203 )        

Interest income

    94     30     64  

Interest expense

    (2,467 )   (2,440 )   (2,667 )

NET LOSS

  $ (62,479 ) $ (60,690 ) $ (69,128 )

OTHER COMPREHENSIVE LOSS, NET OF TAX:

                   

Unrealized loss from available-for-sale securities

    (21 )       (5 )

COMPREHENSIVE LOSS

  $ (62,500 ) $ (60,690 ) $ (69,133 )

LOSS ATTRIBUTABLE TO COMMON STOCKHOLDERS—BASIC AND DILUTED (Note 12)

  $ (71,479 ) $ (78,161 ) $ (83,120 )

LOSS PER SHARE:

                   

Basic and diluted

  $ (4.04 ) $ (203.91 ) $ (225.71 )

WEIGHTED AVERAGE SHARES:

                   

Basic and diluted

    17,699,487     383,310     368,261  

   

See accompanying notes to financial statements.

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Radius Health, Inc.
Statements of Convertible Preferred Stock, Redeemable Convertible
Preferred Stock and Stockholders' Equity (Deficit)
(In thousands, except share and per share amounts)

 
  Convertible Preferred Stock  
 
  Series B-2   Series B   Series A-1   Series A-2   Series A-3   Series A-4   Series A-5   Series A-6  
 
  Shares   Amount   Shares   Amount   Shares   Amount   Shares   Amount   Shares   Amount   Shares   Amount   Shares   Amount   Shares   Amount  

Balance at December 31, 2011

                    939,612   $ 65,675     983,208   $ 79,979     142,227   $ 10,208     3,998   $ 271     6,443   $ 525       $  

Net loss

                                                                                                 

Unrealized loss from available-for-sale securities

                                                                                                 

Stock options exercised

                                                                                                 

Issuance of preferred stock

                                                                                                 

Accretion of dividends on preferred stock

                                  6,282           6,735           974                                      

Stock-based compensation expense

                                                                                                 

Balance at December 31, 2012

                    939,612   $ 71,957     983,208   $ 86,714     142,227   $ 11,182     3,998   $ 271     6,443   $ 525       $  

Net loss

                                                                                                 

Stock options exercised

                                                                                                 

Issuance of preferred stock

                701,235     41,514                                                                 496,111     23,168  

Accretion of dividends on preferred stock

                      2,378           6,780           7,263           1,050                                      

Stock-based compensation expense

                                                                                                 

Balance at December 31, 2013

      $     701,235   $ 43,892     939,612   $ 78,737     983,208   $ 93,977     142,227   $ 12,232     3,998   $ 271     6,443   $ 525     496,111   $ 23,168  

Net loss

                                                                                                 

Unrealized loss from available-for-sale securities

                                                                                                 

Issuance of preferred stock

    448,060     26,152                                                                             186,847     10,109  

Accretion of dividends on preferred stock

          685           1,515           3,084           3,246           470                                      

Issuance of warrants

                                                                                                 

Exercise of warrants

                                                                                                 

Stock options exercised

                                                                                                 

Stock-based compensation expense

                                                                                                 

Issuance of common stock, net

                                                                                                 

Conversion of convertible preferred stock into common stock

    (448,060 )   (26,837 )   (701,235 )   (45,407 )   (939,612 )   (81,821 )   (983,208 )   (97,223 )   (142,227 )   (12,702 )   (3,998 )   (271 )   (6,443 )   (525 )   (682,958 )   (33,277 )

Reclassification of warrant liability to additional paid in capital

                                                                                                 

Balance at December 31, 2014

      $       $       $       $       $       $       $       $  

See accompanying notes to financial statements.

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Radius Health, Inc.
Statements of Convertible Preferred Stock, Redeemable Convertible
Preferred Stock and Stockholders' Equity (Deficit) (Continued)
(In thousands, except share and per share amounts)

 
  Stockholders' Equity (Deficit)  
 
  Common Stock   Additional
Paid-In-
Capital
  Accumulated Other
Comprehensive
Income (Loss)
  Accumulated
Deficit
  Total
Stockholders'
(Deficit) Equity
 
 
  Shares   Amount   Amount   Amount   Amount   Amount  

Balance at December 31, 2011

    283,047   $   $ 2,744   $ 5   $ (122,359 ) $ (119,610 )

Net loss

                            (69,128 )   (69,128 )

Unrealized loss from available-for-sale securities

                      (5 )         (5 )

Stock options exercised

    97,281           279                 279  

Issuance of preferred stock

                                     

Accretion of dividends on preferred stock

                (4,818 )         (9,174 )   (13,992 )

Stock-based compensation expense

                1,795                 1,795  

Balance at December 31, 2012

    380,328   $   $   $   $ (200,661 ) $ (200,661 )

Net loss

                            (60,690 )   (60,690 )

Stock options exercised

    5,336           13                 13  

Issuance of preferred stock

                                   

Accretion of dividends on preferred stock

                (1,521 )         (15,950 )   (17,471 )

Stock-based compensation expense

                1,508                 1,508  

Balance at December 31, 2013

    385,664   $   $   $   $ (277,301 ) $ (277,301 )

Net loss

                            (62,479 )   (62,479 )

Unrealized loss from available-for-sale securities

                      (21 )         (21 )

Issuance of preferred stock

                                   

Accretion of dividends on preferred stock

                (4,542 )         (4,458 )   (9,000 )

Issuance of warrants

                41                 41  

Exercise of warrants

    20,435                              

Stock options exercised

    49,382           170                 170  

Stock-based compensation expense

                7,070                 7,070  

Issuance of common stock, net

    10,141,268     1     103,803                 103,804  

Conversion of convertible preferred stock into common stock

    22,327,786     2     298,061                 298,063  

Reclassification of warrant liability to additional paid in capital

                3,117                 3,117  

Balance at December 31, 2014

    32,924,535   $ 3   $ 407,720   $ (21 ) $ (344,238 ) $ 63,464  

See accompanying notes to financial statements.

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Radius Health, Inc.

Statements of Cash Flows

(In thousands)

 
  Year Ended December 31,  
 
  2014   2013   2012  

CASH FLOWS USED IN OPERATING ACTIVITIES:

                   

Net loss

  $ (62,479 ) $ (60,690 ) $ (69,128 )

Adjustments to reconcile net loss to net cash used in operating activities:

                   

Depreciation and amortization

    77     27     44  

Amortization of premium on short-term investments, net

    429     27     101  

Stock-based compensation expense

    7,070     1,508     1,795  

Research and development expense settled in stock

    2,717     13,118     15,067  

Change in fair value of other current assets, warrant liability and other liability

    505     (9,087 )   2,069  

Non-cash interest

    295     387     449  

Loss on retirement of note payable

    57          

Changes in operating assets and liabilities:

                   

Prepaid expenses and other current assets

    (1,639 )   1,721     4,623  

Other long-term assets

    (105 )       35  

Accounts payable

    1,991     (250 )   237  

Accrued expenses and other current liabilities

    2,737     8,222     1,550  

Net cash used in operating activities

    (48,345 )   (45,017 )   (43,158 )

CASH FLOWS (USED IN) PROVIDED BY INVESTING ACTIVITIES:

                   

Purchases of property and equipment

    (857 )   (2 )   (40 )

Purchases of marketable securities

    (97,678 )   (17,070 )   (18,989 )

Sales and maturities of marketable securities

    20,470     21,043     46,464  

Net cash (used in) provided by investing activities

    (78,065 )   3,971     27,435  

CASH FLOWS PROVIDED BY FINANCING ACTIVITIES:

                   

Proceeds from exercise of stock options

    170     13     279  

Net proceeds from the issuance of preferred stock, net

    27,368     42,870      

Proceeds from note payable, net

    24,555         12,500  

Proceeds from issuance of common stock, net

    103,804          

Deferred financing costs

    (116 )       (31 )

Payments on note payable

    (13,156 )   (8,187 )   (3,500 )

Net cash provided by financing activities

    142,625     34,696     9,248  

NET INCREASE (DECREASE) IN CASH AND CASH EQUIVALENTS

    16,215     (6,350 )   (6,475 )

CASH AND CASH EQUIVALENTS AT BEGINNING OF YEAR

    12,303     18,653     25,128  

CASH AND CASH EQUIVALENTS AT END OF YEAR

  $ 28,518   $ 12,303   $ 18,653  

SUPPLEMENTAL DISCLOSURES:

                   

Cash paid for interest

  $ 1,971   $ 1,796   $ 1,801  

NON-CASH FINANCING ACTIVITIES:

                   

Accretion of dividends on preferred stock

  $ 9,000   $ 17,471   $ 13,992  

Reclassification of preferred stock to common stock

  $ 298,063   $   $  

Fair value of series A-6 convertible preferred stock issued as settlement of liability

  $ 10,109   $ 23,168   $  

Fair value of warrants issued

  $ 1,552   $ 1,356   $ 379  

   

See accompanying notes to financial statements.

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Radius Health, Inc.

Notes to Financial Statements

1. Nature of Business

        Radius Health, Inc. ("Radius" or the "Company") is a science-driven biopharmaceutical company focused on developing new therapeutics for patients with osteoporosis as well as other serious endocrine-mediated diseases. The Company's lead investigational product candidate is the investigational drug abaloparatide (BA058), a bone anabolic for potential use in the reduction of fracture risk in postmenopausal women with severe osteoporosis delivered via subcutaneous injection, which the Company refers to as abaloparatide-SC and is currently in Phase 3 development. The Company is leveraging its investment in abaloparatide-SC to develop a line extension that is designed to improve patient convenience by enabling administration of abaloparatide through an investigational short-wear-time patch, which the Company refers to as abaloparatide-TD. The Company has recently completed a successful Phase 2 proof of concept study of abaloparatide-TD. The Company also believes that, subject to further research and development, abaloparatide may have potential applications across a variety of skeletal or bone related diseases or medical conditions.

        The Company's current clinical product portfolio also includes the investigational drug RAD1901, a selective estrogen receptor down regulator/degrader ("SERD") and RAD140, a nonsteroidal selective androgen receptor modulator ("SARM"). The Company is developing RAD1901 at higher doses for potential use in the treatment of metastatic breast cancer and other estrogen receptor mediated oncology applications. At low doses, RAD1901 acts as a selective estrogen-receptor modulator ("SERM"). Low-dose RAD1901 has shown potential to be effective for the treatment of vasomotor symptoms such as hot flashes in a successful Phase 2 proof of concept study. RAD140 is a nonsteroidal selective androgen receptor modulator, or SARM, that resulted from an internal drug discovery program focused on the androgen receptor pathway which is highly expressed in many breast cancers. Due to its receptor and tissue selectivity, potent oral activity and long duration half-life, RAD140 could have clinical potential in the treatment of breast cancer or possibly other conditions where androgen modulation may offer therapeutic benefit.

        The Company is subject to the risks associated with emerging companies with a limited operating history, including dependence on key individuals, a developing business model, the necessity of securing regulatory approval to market its investigational product candidates, market acceptance of the Company's investigational product candidates, competition for its investigational product candidates, and the continued ability to obtain adequate financing to fund the Company's future operations. The Company has incurred losses and expects to continue to incur additional losses for the foreseeable future. As of December 31, 2014, the Company had an accumulated deficit of $344.2 million, and total cash, cash equivalents and marketable securities of $105.3 million. On January 28, 2015, the Company completed a public offering whereby the Company sold 4,600,000 shares of common stock at a price of $36.75 per share, for aggregate proceeds, net of underwriting discounts, commissions and offering costs, of approximately $158.6 million.

        The Company believes that the aggregate proceeds from the offering on January 28, 2015, together with its cash, cash equivalents and marketable securities as of December 31, 2014, will be sufficient to fund its operations into the fourth quarter of 2016. The Company expects to finance the future development costs of abaloparatide-SC, abaloparatide-TD and RAD1901 with its existing cash and cash equivalents and marketable securities, or through strategic financing opportunities, future offerings of our equity, or the incurrence of debt. However, there is no guarantee that any of these strategic or financing opportunities will be executed or executed on favorable terms, and some could be dilutive to existing stockholders. If the Company fails to obtain additional future capital, it may be unable to

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Radius Health, Inc.

Notes to Financial Statements (Continued)

1. Nature of Business (Continued)

complete its planned preclinical and clinical trials and obtain approval of certain investigational product candidates from the U.S. Food and Drug Administration or other foreign regulatory authorities.

2. Summary of Significant Accounting Policies

        Initial and Additional Public Offering —On June 11, 2014, the Company completed its initial public offering whereby the Company sold 6,500,000 shares of common stock at a price of $8.00 per share. The shares began trading on the NASDAQ Global Market on June 6, 2014. In connection with the offering, all outstanding shares of our convertible preferred stock converted into 19,465,132 shares of common stock and 2,862,654 shares of common stock were issued in satisfaction of accumulated dividends accrued on the preferred stock. In addition, all outstanding warrants to purchase shares of A-1 convertible preferred stock and warrants to purchase shares of series B-2 convertible preferred stock were converted into the right to purchase 149,452 shares of common stock and the Company's warrant liability was reclassified to equity.

        On June 18, 2014 and June 25, 2014, the underwriters purchased an additional 512,744 shares in the aggregate by exercising a portion of the over-allotment option granted to them in connection with the initial public offering. As a result of the closing of the initial public offering and subsequent exercise of the over-allotment option, the Company received aggregate proceeds, net of underwriting discounts, commissions and offering costs, of approximately $50.4 million.

        In connection with the completion of its initial public offering, the Company filed an amended and restated certificate of incorporation, which, among other things, changed the number of authorized shares of common stock to 200,000,000 shares.

        On October 7, 2014, the Company completed an additional public offering whereby it sold 2,750,000 shares of common stock at a price of $18.25 per share, for aggregate proceeds, net of underwriting discounts, commissions and offering costs, of approximately $46.9 million. On October 7, 2014, the underwriters purchased an additional 378,524 shares in the aggregate by exercising a portion of the over-allotment option granted to them in connection with the offering. As a result of the public offering and subsequent exercise of the over-allotment option, the Company received aggregate proceeds, net of underwriting discounts, commissions and offering costs of approximately $53.4 million.

        Reverse Stock Split —On April 24, 2014, the Company effected a reverse stock split of the Company's common stock. The number of authorized shares of the Company's common stock and the par value did not change. Pursuant to the stock split, every 2.28 shares of the Company's issued and outstanding common stock were automatically combined into one issued and outstanding share of the Company's common stock. All shares and per share amounts in the financial statements and accompanying notes have been retroactively adjusted to give effect to the reverse stock split.

        Use of Estimates —The preparation of financial statements in conformity with accounting principles generally accepted in the United States ("GAAP") requires the Company's management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. Actual results could differ from those estimates. The Company considers events or transactions that occur after the balance sheet date but before the financial statements are issued as additional evidence for certain estimates or to identify matters that require additional disclosure. Subsequent events have been evaluated up to the date of issuance of these financial statements.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

2. Summary of Significant Accounting Policies (Continued)

        Cash Equivalents —The Company considers all highly liquid investment instruments with an original maturity when purchased of three months or less to be cash equivalents. Cash equivalents at December 31, 2014 and 2013 are primarily comprised of money market funds.

        Marketable Securities —All investment instruments with an original maturity date, when purchased, in excess of three months have been classified as current marketable securities. The Company classifies securities that are available to fund current operations as current assets. These marketable securities are classified as available-for-sale and are carried at fair value. Unrealized gains and losses, if any, are included within other comprehensive (loss) income within stockholders' equity (deficit). The amortized cost of debt securities in this category is adjusted for amortization of premiums and accretion of discounts to maturity. Such amortization is included in interest income. Realized gains and losses on available-for-sale securities are included in interest income. The cost of securities sold is based on the specific identification method. The Company periodically reviews the portfolio of securities to determine whether an other-than-temporary impairment has occurred. No such losses have occurred to date. There were no realized gains or losses on the sale of securities for the years ended December 31, 2014 and 2013.

        Fair Value Measurements —The Company determines the fair market values of its financial instruments based on the fair value hierarchy, which requires an entity to maximize the use of observable inputs and minimize the use of unobservable inputs when measuring fair value. The following are three levels of inputs that may be used to measure fair value:

Level 1   Quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date.

Level 2

 

Observable inputs other than Level 1 prices such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.

Level 3

 

Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.

        Concentrations of Credit Risk and Off-Balance-Sheet Risk —Financial instruments that potentially subject the Company to credit risk primarily consist of cash and cash equivalents and available-for-sale marketable securities. The Company mitigates its risk with respect to cash and cash equivalents and marketable securities by maintaining its deposits and investments at high-quality financial institutions. The Company invests any excess cash in money market funds and other securities, and the management of these investments is not discretionary on the part of the financial institution. The Company's credit exposure on its marketable securities is limited by its diversification among United States government and agency debt securities. The Company has no significant off-balance-sheet risks such as foreign exchange contracts, option contracts, or other hedging arrangements.

        Property and Equipment —Property and equipment are recorded at cost and depreciated using the straight-line method over the estimated useful lives of the respective assets.

        Research and Development Costs —The Company accounts for research and development costs by expensing such costs to operations as incurred. Research and development costs primarily consist of

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Radius Health, Inc.

Notes to Financial Statements (Continued)

2. Summary of Significant Accounting Policies (Continued)

clinical testing costs, including payments in cash and stock made to contract research organizations, personnel costs, outsourced research activities, laboratory supplies, and license fees.

        Nonrefundable advance payments for goods or services to be received in the future for use in research and development activities are deferred and capitalized. The capitalized amounts are expensed as the related goods are delivered or the services are performed.

        Licensing Agreements —Costs associated with licensing early stage technology are expensed as incurred, and are included in research and development expenses.

        Impairment of Long-Lived Assets —The Company evaluates long-lived assets for potential impairment when there is evidence that events or changes in circumstances have occurred that indicate that the carrying amount of a long-lived asset may not be recovered. Recoverability of these assets is assessed based on the undiscounted expected future cash flows from the assets, considering a number of factors, including past operating results, budgets and economic projections, market trends, and product development cycles. Impairment in the carrying value of each asset is assessed when the undiscounted expected future cash flows derived from the asset are less than its carrying value.

        An impairment loss would be recognized in an amount equal to the excess of the carrying amount over the undiscounted expected future cash flows. No impairment charges have been recognized since the Company's inception.

        Segment Information —Operating segments are defined as components of an enterprise engaged in business activities for which discrete financial information is available and regularly reviewed by the chief decision maker in determining how to allocate resources and in assessing performance. The Company views its operations and manages its business as one operating segment and operates in one geographic area.

        Income Taxes —The Company recognizes deferred tax assets and liabilities for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis, as well as operating loss and tax credit carry forwards. The Company measures deferred tax assets and liabilities using enacted tax rates expected to apply to taxable income in the years in which those temporary differences and carryforwards are expected to be recovered or settled. Deferred tax assets are reduced by a valuation allowance to reflect the uncertainty associated with their ultimate realization. The effect on deferred tax assets and liabilities as a result of a change in tax rates is recognized as income in the period that includes the enactment date.

        The Company uses judgment to determine the recognition threshold and measurement attribute for financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. Any material interest and penalties related to unrecognized tax benefits are recognized in income tax expense.

        Due to uncertainty surrounding the realization of the favorable tax attributes in future tax returns the Company has recorded a full valuation allowance against otherwise realizable net deferred tax assets as of December 31, 2014 and 2013.

        Financial Instruments Indexed to and Potentially Settled in the Company's Common Stock —The Company evaluates all financial instruments issued in connection with its debt borrowings and equity

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Radius Health, Inc.

Notes to Financial Statements (Continued)

2. Summary of Significant Accounting Policies (Continued)

offerings when determining the proper accounting treatment for such instruments in the Company's financial statements. The Company considers a number of generally accepted accounting principles to determine such treatment and evaluates the features of the instrument to determine the appropriate accounting treatment. The Company utilizes the Black-Scholes method or other appropriate methods to determine the fair value of its derivative financial instruments. Key valuation factors in determining the fair value include, but are not limited to, the current stock price as of the date of measurement, the exercise price, the remaining contractual life, expected volatility for the instrument and the risk-free interest rate. For financial instruments that are determined to be classified as liabilities on the balance sheet, changes in fair value are recorded as a gain or loss in the Company's statement of operations, with the corresponding amount recorded as an adjustment to the liability on its balance sheet.

        Stock-Based Compensation —The Company measures stock-based compensation cost at the accounting measurement date based on the fair value of the option, and recognizes the expense related to awards to employees on a straight-line basis over the requisite service period of the option, which is typically the vesting period. The Company estimates the fair value of each option using a Black-Scholes option pricing model that takes into account the fair value of its common stock, the exercise price, the expected life of the option, the expected volatility of the Company's common stock, expected dividends on the Company's common stock, and the risk-free interest rate over the expected life of the option. Due to the limited trading history of the Company's common stock since its June 2014 initial public offering, the Company uses the simplified method described in the SEC's Staff Accounting Bulletin No. 107, Share-Based Payment, to determine the expected life of the option grants. The Company's estimate of expected volatility is based on a review of the historical volatility of similar publicly held companies in the biotechnology field over a period commensurate with the option's expected term. The Company has never declared or paid any cash dividends on its common stock and does not expect to do so in the foreseeable future. Accordingly, the Company utilizes an expected dividend yield of zero. The risk-free rate is based on the U.S. Treasury yield curve in effect at the time of grant valuation for a period commensurate with the option's expected term. These assumptions are highly subjective and changes in them could significantly impact the value of the option and hence the related compensation expense.

        The Company applies an estimated forfeiture rate to current period expense to recognize compensation expense only for those awards expected to vest. Estimated forfeitures are based upon historical data, adjusted for known trends, and will be adjusted if actual forfeitures differ or are expected to differ from such estimates. Subsequent changes in estimated forfeitures are recognized through a cumulative adjustment in the period of change and also will impact the amount of stock-based compensation expense in future periods.

        Stock-based compensation expense for options granted to consultants is also determined based upon the fair value of the options issued, as determined by the Black-Scholes option pricing model and recognized on an accelerated basis. However, the unvested portion of such option grants is re-measured at each reporting period, until such time as the award is fully vested.

        Net Loss Per Common Share —Net loss per common share is calculated using the two-class method, which is an earnings allocation formula that determines net loss per share for the holders of the Company's common shares and participating securities. Prior to the initial public offering, all of the Company's series of preferred stock contained participation rights in any dividend paid by the Company and were deemed to be participating securities. Net income available to common shareholders and

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Radius Health, Inc.

Notes to Financial Statements (Continued)

2. Summary of Significant Accounting Policies (Continued)

participating preferred shares was allocated to each share on an as-converted basis as if all of the earnings for the period had been distributed. The participating securities do not include a contractual obligation to share in losses of the Company and are not included in the calculation of net loss per share in the periods that have a net loss.

        Diluted net income per share is computed using the more dilutive of (a) the two-class method, or (b) the if-converted method. Prior to the initial public offering, the Company allocated net income first to preferred stockholders based on dividend rights and then to common and preferred stockholders based on ownership interests. The weighted-average number of common shares outstanding gives effect to all potentially dilutive common equivalent shares, including outstanding stock options, warrants, and, prior to the Company's initial public offering, potential issuance of stock upon the issuance of the Company's series A-6 convertible preferred stock ("Series A-6") as settlement of the liability to Nordic Bioscience ("Nordic"). Common equivalent shares are excluded from the computation of diluted net income per share if their effect is anti-dilutive.

        Comprehensive (Loss) Income —Comprehensive (loss) income refers to revenues, expenses, gains and losses that are excluded from net income, as these amounts are recorded directly as an adjustment to stockholders' deficit, net of tax. The Company's other comprehensive (loss) income is comprised of unrealized gains (losses) on its available-for-sale securities.

        Recently Adopted Accounting Standards —In July 2013, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, a Similar Tax Loss, or a Tax Credit Carryforward Exists ("ASU 2013-11"). ASU 2013-11 clarifies guidance and eliminates diversity in practice on the presentation of unrecognized tax benefits when a net operating loss carryforward, a similar tax loss, or a tax credit carryforward exists at the reporting date. The amendments under ASU 2013-11 are effective for interim and annual fiscal periods beginning after December 15, 2013, with early adoption permitted. The adoption of ASU 2013-11 did not have a material impact on the Company's results of operations, financial position, or cash flows.

        In December 2013, the FASB issued Accounting Standards Update No. 2013-12, Definition of a Public Business Entity ("ASU 2013-12"). ASU 2013-12 amends the Master Glossary of the FASB Accounting Standards Codification to include one definition of public business entity for future use in GAAP. ASU 2013-12 does not affect existing requirements but will be used in considering the scope of new financial guidance and will identify whether the guidance does or does not apply to public business entities. There is no actual effective date for the amendment in ASU 2013-12 but the amended definition of a public business entity is used in ASU 2014-01 and those that follow. The adoption of ASU 2013-12 did not have a material impact on the Company's results of operations, financial position or cash flows.

        Accounting Standards Updates —In August 2014, the FASB issued Accounting Standards Update No. 2014-15, Disclosures of Uncertainties about an Entity's Ability to Continue as a Going Concern ("ASU 2014-15"). ASU 2014-15 provides guidance in GAAP about management's responsibility to evaluate whether there is substantial doubt about an entity's ability to continue as a going concern and to provide related footnote disclosures. The amendments under ASU 2014-15 are effective for interim and annual fiscal periods beginning after December 15, 2016, with early adoption permitted. The Company plans to adopt ASU 2014-15 on January 1, 2015. The Company does not expect adoption of

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Radius Health, Inc.

Notes to Financial Statements (Continued)

2. Summary of Significant Accounting Policies (Continued)

ASU 2014-15 will have a material impact on the Company's results of operations, financial position or cash flows.

3. Marketable Securities

        Available-for-sale marketable securities and cash and cash equivalents consist of the following (in thousands):

 
  December 31, 2014  
 
  Amortized
Cost Value
  Gross
Unrealized
Gains
  Gross
Unrealized
Losses
  Fair Value  

Cash and cash equivalents:

                         

Cash

  $ 1,519   $   $   $ 1,519  

Money market funds

    23,994             23,994  

Domestic corporate debt securities

    3,005             3,005  

Total

  $ 28,518   $   $   $ 28,518  

Marketable securities:

                         

Domestic corporate debt securities

    69,542         (33 )   69,509  

Domestic corporate commercial paper

    7,237     12         7,249  

Total

  $ 76,779   $ 12   $ (33 ) $ 76,758  

        There were no debt securities that had been in an unrealized loss position for more than 12 months as of December 31, 2014. There were 34 debt securities in an unrealized loss position for less than 12 months at December 31, 2014. The aggregate unrealized loss on these securities as of December 31, 2014 was less than $34 thousand and the fair value was $68.9 million. As it was not more likely than not that the Company would be required to sell these securities before the recovery of their amortized cost basis, which may be maturity, the Company did not consider these investments to be other-than-temporarily impaired as of December 31, 2014.

        The contractual term to maturity of all marketable securities held by the Company as of December 31, 2014 is less than one year.

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Notes to Financial Statements (Continued)

4. Property and Equipment

        Property and equipment consists of the following (in thousands):

 
   
  December 31,  
 
  Estimated Useful
Life (In Years)
 
 
  2014   2013  

Furniture and fixtures

  5   $ 167   $ 68  

Computer equipment and software

  3     230     286  

Manufacturing equipment

  10     598      

Leasehold improvements

  Shorter of useful life or remaining lease term     16     505  

        1,011     859  

Less accumulated depreciation and amortization

        (169 )   (783 )

Property and equipment, net

      $ 842   $ 76  

        During the year ended December 31, 2014, the Company retired $0.7 million of property and equipment. The retirement was primarily due to the disposal of leasehold improvements and other property as a result of the Company's office relocation. All assets were fully depreciated prior to retirement.

5. Accrued Expenses and Other Current Liabilities

        Accrued expenses consist of the following (in thousands):

 
  December 31,  
 
  2014   2013  

Research costs—Nordic(1)

  $ 11,536   $ 17,998  

Research costs—other

    3,336     1,599  

Payroll and employee benefits

    1,659     1,005  

Professional fees

    1,304     426  

Accrued interest on notes payable

    234     852  

Other

    198     127  

Total accrued expenses and other current liabilties

  $ 18,267   $ 22,007  

(1)
Includes amounts accrued ratably over the estimated per patient treatment period under the Nordic Work Statement NB-1, Work Statement NB-2 and Work Statement NB-3. Amounts do not include pass-through costs which are expensed as incurred or upon delivery. See note 10 for additional information.

6. Loan and Security Agreement

        On May 23, 2011, the Company entered into a loan and security agreement (the "Loan and Security Agreement") with Oxford Finance LLC and General Electric Capital Corporation (collectively, the "Lender") pursuant to which the Lender agreed to lend the Company up to $25.0 million. Upon entering into the Loan and Security Agreement, the Company borrowed $6.3 million from the Lender

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Notes to Financial Statements (Continued)

6. Loan and Security Agreement (Continued)

on May 23, 2011("Term Loan A"), $6.3 million on November 21, 2011 ("Term Loan B") and an additional $12.5 million on May 29, 2012 ("Term Loan C"). The Company's obligations under the Loan and Security Agreement are secured by a first priority security interest in substantially all of the assets of the Company.

        Interest on the outstanding Term Loan A was payable on a monthly basis through and including December 1, 2011. Principal and interest payments on Term Loan A was payable in 36 equal monthly installments beginning December 1, 2011 through November 1, 2014, with a final balloon payment of $0.6 million due upon maturity on November 22, 2014. Interest was payable on Term Loan A at an annual interest rate of 10.16%. Interest on the outstanding Term Loan B was payable on a monthly basis through and including June 1, 2012. Principal and interest payments on Term Loan B was payable in 30 equal monthly installments beginning June 1, 2012, through November 1, 2014, with a final balloon payment of $0.6 million due upon maturity on November 22, 2014. Interest was payable on Term Loan B at an annual interest rate of 10%. Interest on Term Loan C was payable on a monthly basis through, and including, November 1, 2012. Principal and interest payments on Term Loan C was payable in 24 monthly installments beginning December 1, 2012, through November 1, 2014 with a final balloon payment of $1.3 million upon maturity on November 22, 2014. Interest is payable on Term Loan C at an annual interest rate of 10%.

        Per the Loan and Security Agreement, upon the last payment date of the amounts borrowed under the Loan and Security Agreement, whether on the maturity date of one of the Term Loans, on the date of any prepayment or on the date of acceleration in the event of a default, the Company would be required to pay the Lender a final payment fee equal to 3.5% of any of the Term Loans borrowed. In addition, if the Company repaid all or a portion of the Term Loans prior to maturity, it would pay the Lender a prepayment fee of three percent of the total amount prepaid if the prepayment occurs prior to the first anniversary of the funding of the relevant Term Loan, two percent of the total amount prepaid if the prepayment occurs between the first and second anniversary of the funding of the relevant Term Loan, and one percent of the total amount prepaid if the prepayment occurs on or after the second anniversary of the funding of the relevant Term Loan.

        In connection with each Term Loan, the Company issued warrants to the Lender to purchase 12,280 shares of the Company's Series A-1 convertible preferred stock (the "Warrants") at an exercise price per share of $81.42. The Warrants were initially classified as liabilities in the Company's balance sheet and were re-measured at their estimated fair value through completion of the Company's initial public offering. The changes in fair value are recorded as other (expense) income in the statement of operations. Upon the closing of its initial public offering and the automatic conversion of the Series A-1 convertible preferred stock into common stock, the Warrants became exercisable for up to 58,918 shares of common stock. Subsequent to the initial public offering, the Company's warrant liability was reclassified to equity.

        The Warrants are immediately exercisable in whole, or in part, and will expire ten years from their issuance.

        The initial fair value of the Warrants issued in connection with Term Loan A was $182.6 thousand and was recorded as a discount to Term Loan A. The Company also paid the Lender a facility fee of $250.0 thousand and reimbursed the Lender certain costs associated with the Loan and Security Agreement of approximately $117.0 thousand, both of which were also recorded as a discount to Term Loan A.

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Notes to Financial Statements (Continued)

6. Loan and Security Agreement (Continued)

        The initial fair value of the Warrants issued in connection with Term Loan B was $177.6 thousand and was recorded as a discount to Term Loan B. The Company also reimbursed the Lender for certain costs associated with Term Loan B of approximately $18.0 thousand, which was also recorded as a discount to Term Loan B.

        The initial fair value of the Warrants issued in connection with Term Loan C was $379.7 thousand and was recorded as a discount to Term Loan C. The Company also reimbursed the Lender for certain costs associated with the Loan and Security Agreement of approximately $31.0 thousand, which was also recorded as a discount to Term Loan C.

        On May 30, 2014, the Company entered into a Loan and Security Agreement (the "New Credit Facility), with Solar Capital Ltd. ("Solar"), as collateral agent and a lender, and Oxford Finance LLC ("Oxford"), as a lender (the "New Lenders"), pursuant to which Solar and Oxford agreed to make available to the Company $30.0 million in the aggregate subject to certain conditions to funding. An initial term loan was made on May 30, 2014 in an aggregate principal amount equal to $21.0 million ("Initial Term Loan"). The Company used approximately $9.3 million of the Initial Term Loan to repay all the amounts owed under its Loan and Security Agreement with General Electric Capital Corporation and Oxford.

        The Company was initially required to make interest-only payments through June 1, 2015, and beginning on July 1, 2015, it is required to make payments of principal and accrued interest in equal monthly installments over a term of 36 months. However, the Company consummated public stock offerings resulting in the receipt of at least $65.0 million in aggregate net cash proceeds prior to May 31, 2015. Therefore, it is permitted to make interest-only payments through December 1, 2015 rather than July 1, 2015, and beginning on January 1, 2016, the Company is required to make principal and accrued interest payments in equal monthly installments over a term of 30 months.

        In addition to the Initial Term Loan, the Company would have been able to request an additional term loan in an aggregate principal amount of $9.0 million (the "Original Term B Loan") after the completion of this initial public offering if the net cash proceeds were at least $65.0 million subject to certain customary conditions to funding. Given the net proceeds from the Company's initial public offering were less than $65.0 million, it was not able to request the Original Term B Loan. The Initial Term Loan and the Original Term B Loan bear interest per annum at 9.85% plus one-month LIBOR (customarily defined) and all principal and accrued interest is due on June 1, 2018.

        As security for its obligations under the New Credit Facility, the Company granted a security interest in substantially all of its existing and after-acquired assets except for our intellectual property and certain other customary exclusions.

        On July 10, 2014, the Company entered into a first amendment to the New Credit Facility ("First Amendment"). Pursuant to the terms of the First Amendment, a second term loan of $4.0 million was drawn on July 10, 2014. The terms of the First Amendment, among other things,

    provide the Company with, subject to certain customary funding conditions, additional term loans in an aggregate principal amount of $4.0 million upon the closing of the First Amendment (the "Modified Term B Loan"). All other terms applicable to the Original Term B Loan remain applicable to the Modified Term B Loan. The Original Term B Loan is replaced by the Modified Term B Loan. The Company borrowed the full amount of the Modified Term B Loan on July 10, 2014.

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Notes to Financial Statements (Continued)

6. Loan and Security Agreement (Continued)

    provide the Company the ability to borrow additional term loans in an aggregate amount of $5.0 million (the "Term C Loan") at any time through December 31, 2014. In order to draw the Term C Loan, the Company must, in addition to other customary conditions, either (a) close public or private stock offerings, equity raises or strategic partner arrangements resulting in $13.0 million in aggregate net proceeds after the closing of the First Amendment, or (b) as it relates specifically to RAD1901, complete both the maximum tolerable dose trial and enroll the first patient in the breast cancer brain metastasis trial.

        Although the Company closed a public offering resulting in over $13.0 million in aggregate net proceeds after the closing of the First Amendment, it did not exercise our right to draw the Term C Loan prior to December 31, 2014.

        The future principal payments under the New Credit Facility, as amended, are as follows, as of December 31, 2014 (in thousands):

Years ending December 31,
  Principal
Payments
 

2015

  $  

2016

    10,000  

2017

    10,000  

2018

    5,000  

  $ 25,000  

        On May 30, 2014, pursuant to the Loan and Security Agreement with Solar and Oxford, the Company issued to Solar and Oxford warrants to purchase an aggregate of up to 10,258 shares of its series B-2 convertible preferred stock ("Series B-2") at an exercise price equal to $61.42 per share. The warrants were initially classified as liabilities in the Company's balance sheet and were re-measured at their estimated fair value through completion of the Company's initial public offering. The changes in fair value are recorded as other (expense) income in the statement of operations. Upon the closing of its initial public offering at a price of $8.00 per share and the automatic conversion of the Series B-2 into common stock, these warrants became exercisable for up to 78,760 shares of common stock. Subsequent to the initial public offering, the Company's warrant liability was reclassified to equity. On July 10, 2014, pursuant to the First Amendment and closing of the Modified Term B Loan, the Company issued both Solar and Oxford warrants to purchase up to 4,706 shares of common stock, each at a price per share equal to $12.75.

        These warrants are immediately exercisable for cash or by net exercise and will expire five years from their issuance.

        The initial fair value of the warrants issued in connection with the Initial Term Loan was $0.3 million and was recorded as a discount to the Initial Term Loan. The initial fair value of the warrants issued in connection with the First Amendment was $41 thousand and was recorded as a discount to the Modified Term B Loan. The Company also paid Solar and Oxford a facility fee of $0.3 million and reimbursed certain costs associated with the Loan and Security Agreement of approximately $0.1 million, both of which were also recorded as a discount to the Initial Term Loan. The discount is being amortized to interest expense over the 48 month period that the Initial Term Loan is expected to be outstanding using the effective interest method.

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Notes to Financial Statements (Continued)

7. Convertible Preferred Stock

        Below is a summary of the rights, preferences, and privileges of the Series B convertible preferred stock ("Series B"), Series B-2 convertible preferred stock ("Series B-2), Series A-1 convertible preferred stock ("Series A-1"), Series A-2 convertible preferred stock ("Series A-2"), Series A-3 convertible preferred stock ("Series A-3"), Series A-4 convertible preferred stock ("Series A-4"), Series A-5 convertible preferred stock ("Series A-5") and Series A-6 convertible preferred stock ("Series A-6") (the Series A-1, Series A-2, Series A-3, Series A-4, Series A-5 and Series A-6, collectively, the "Series A Preferred Stock") prior to the conversion of all outstanding convertible preferred stock into common stock upon completion of the Company's initial public offering on June 11, 2014.

        On April 23, 2013, the Company entered into a Series B Convertible Preferred Stock and Warrant Purchase Agreement (the "Series B Purchase Agreement"), pursuant to which the Company could raise, at any time on or prior to May 10, 2013, up to approximately $60.0 million through the issuance of (1) up to 980,000 shares of its new Series B preferred stock (the "New Series B") and (2) warrants to acquire up to approximately 1,075,000 shares of its common stock with an exercise price of $14.004 per share. On April 23, 2013, the Company consummated a first closing under the Series B Purchase Agreement, whereby in exchange for aggregate proceeds of approximately $43.0 million, it issued 700,098 shares of New Series B and warrants to purchase up to a total of 767,651 shares of its common stock. On May 10, 2013, the Company consummated a second closing under the Series B Purchase Agreement, whereby in exchange for aggregate proceeds of approximately $0.1 million, it issued 1,137 shares of New Series B and warrants to purchase up to a total of 1,246 shares of its common stock. The warrants can be exercised at any time prior to the fifth anniversary of their issuance.

        On February 14, 2014, the Company entered into a Series B-2 Convertible Preferred Stock and Warrant Purchase Agreement (the "Series B-2 Purchase Agreement"), pursuant to which the Company was able to raise up to approximately $40.2 million through the issuance of (1) up to 655,000 shares of its Series B-2 and (2) warrants to acquire up to 718,201 shares of its common stock with an exercise price of $14.004 per share. In February and March 2014, the Company consummated closings under the Series B-2 Purchase Agreement, whereby, in exchange for aggregate gross proceeds to the Company of approximately $27.5 million, the Company issued an aggregate of 448,060 shares of Series B-2 and warrants to purchase up to a total of 491,293 shares of its common stock. The warrants can be exercised at any time prior to the fifth anniversary of their issuance.

        Conversion —Any holder of the Company's preferred stock had the right, at any time or from time to time, to convert any or all of its shares of preferred stock into fully paid and non-assessable shares of the Company's common stock for each share of preferred stock converted based upon the then in effect Conversion Price ("Conversion Feature"). If the Company issued or sold any shares of its Common Stock (as defined by the Company's certificate of incorporation) or options to purchase or other rights to subscribe for such convertible or exchangeable securities, in each case other than Excluded Stock (as defined by the Company's certificate of incorporation), for a consideration per share less than the then in effect conversion price ("Dilutive Issuance") of the Company's Series A-1, A-2, A-3, B, or B-2 preferred stock, respectively, the Conversion Price for such series in effect immediately prior to each such Dilutive Issuance would automatically be reduced in accordance with the provisions set forth in the Certificate of Designations. Upon issuance of each series of the Company's preferred stock, the respective Conversion Prices were greater than the fair value of the Company's common stock at the respective commitment dates. Therefore, the Conversion Feature was

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Notes to Financial Statements (Continued)

7. Convertible Preferred Stock (Continued)

not considered to be a beneficial conversion feature that would require the Company to record a deemed dividend on the preferred stock. Each holder of Series B and Series B-2 shares had the right, at their option at any time, to convert any such shares of preferred stock into such number of fully paid shares of common stock as determined by dividing the original purchase price of $61.42 by the conversion price ("Series B Optional Conversion"). The conversion price of the Series B and Series B-2 as of June 6, 2014 was $14.004 per share and $8.00 per share, respectively, (the "Series B Conversion Price"), which represented a conversion ratio of one share of Series B or Series B-2 into approximately 4.386 and 7.678 shares of common stock, respectively.

        Each holder of Series A-1, Series A-2 and Series A-3 had the right, at their option at any time, to convert any such shares of preferred stock into such number of fully paid shares of common stock as determined by dividing the original purchase price of $81.42 by the conversion price ("Optional Conversion"). The original conversion price of the Series A-1, Series A-2 and Series A-3 was $18.564 per share (the "Conversion Price"), which represented a conversion ratio of one share of Series A-1, Series A-2 or Series A-3 into approximately 4.386 shares of common stock. The issuance of the Series B in April and May of 2013 and the Series B-2 in February and March of 2014 resulted in an adjustment to the Conversion Price of the Series A-1, Series A-2 and Series A-3 (the "Anti-Dilution Adjustment"). As a result of the Anti-Dilution Adjustment, the conversion price of each share of Series A-1, Series A-2 and Series A-3 was reduced to $16.970, which represented a conversion ratio of one share of Series A-1, Series A-2 or Series A-3 into approximately 4.798 shares of common stock. This reduction of the Conversion Price did not create a beneficial conversion feature that would require the Company to record a deemed dividend on the Series A-1, Series A-2 or Series A-3 preferred stock.

        Each holder of Series A-4, Series A-5 and Series A-6 had the right, at their option at any time, to convert any such shares of preferred stock into such number of fully paid shares of common stock as determined by dividing the original purchase price of $81.42 by the conversion price. The Conversion Price of the Series A-4, Series A-5 and Series A-6 as of June 6, 2014 was $18.564 per share, which represented a conversion ratio of one share of Series A-4, Series A-5 or Series A-6 into approximately 4.386 shares of common stock.

        Upon an optional conversion, the holders of the converted Series B-2, Series B and Series A Preferred Stock were entitled to payment of all accrued, whether or not declared, but unpaid dividends in shares of the common stock of the Company at the then effective Conversion Price.

        Each share of the Series B, Series B-2 and Series A Preferred Stock was automatically convertible into fully paid and non-assessable shares of common stock at the applicable conversion price (as described above) in effect upon, in the case of the Series A and Series B Preferred Stock, upon (1) a vote of the holders of at least 70% of the outstanding shares of Series B, Series B-2, Series A-1, Series A-2 and Series A-3 to convert all shares of Series B, Series B-2 and Series A Preferred Stock or (2) the common stock becoming listed for trading on a national stock exchange, and in the case of the Series B-2 Preferred Stock, upon (1) a vote of the holders of at least 70% of the outstanding shares of Series B-2 to convert all shares of Series B-2 Preferred Stock, (2) the closing of a firm commitment underwritten public offering on or prior to June 30, 2014 or (3) after June 30, 2014, the common stock becoming listed for trading on a national stock exchange ("Special Mandatory Conversion"). Upon a Special Mandatory Conversion, all accrued, whether or not declared, but unpaid dividends were to be

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Notes to Financial Statements (Continued)

7. Convertible Preferred Stock (Continued)

paid in cash or shares of common stock (calculated based on the then effective conversion price) at the discretion of the Company's Board of Directors.

        In the event of a conversion upon the closing of a firm commitment underwritten public offering on or prior to June 30, 2014 in which the public offering price per share was less than the Series B-2 Conversion Price, then the Series B-2 Conversion Price was automatically reduced to the price equal to the public offering price.

        Redemption —Unless redemption was waived by a requisite stockholder vote or consent, the shares of Series B, Series B-2 and Series A Preferred Stock were automatically redeemable upon an event of sale of the Company. The shares of Series B, Series B-2 and Series A Preferred Stock were not redeemable at the option of the holder.

        Dividends —Holders of shares of Series B and Series B-2 were entitled to receive dividends at a rate of 8% per annum, compounding annually, which accrued on a daily basis commencing on the date of issuance of the shares of Series B and Series B-2. Dividends were payable, as accrued, upon liquidation, event of sale, and conversion to common stock, as described above. The holders of shares of Series B and Series B-2 were also entitled to dividends declared or paid on any shares of common stock.

        Following payment in full of required dividends to the holders of Series B and Series B-2, holders of shares of Series A-1 were entitled to receive dividends at a rate of 8% per annum, compounding annually, which accrued on a daily basis commencing on the date of issuance of the shares of Series A-1. Dividends were payable, as accrued, upon liquidation, event of sale, and conversion to common stock, as described above. The holders of shares of Series A-1 were also entitled to dividends declared or paid on any shares of common stock.

        Following payment in full of required dividends to the holders of Series B, Series B-2 and Series A-1, holders of Series A-2 were entitled to receive dividends at a rate of 8% per annum, compounding annually, which accrued on a daily basis commencing on the date of issuance of the shares of Series A-2. Dividends were payable, as accrued, upon liquidation, event of sale, and conversion to common stock, as described above. The holders of shares of Series A-2 were also entitled to dividends declared or paid on any shares of common stock.

        Following payment in full of required dividends to the holders of Series B, Series B-2, Series A-1 and Series A-2, holders of Series A-3 were entitled to receive dividends at a rate of 8% per annum, compounding annually, which accrued on a daily basis commencing on the date of issuance of the shares of Series A-3. Dividends were payable, as accrued, upon liquidation, event of sale and conversion to common stock, as described above. The holders of shares of Series A-3 were also entitled to dividends declared or paid on any shares of common stock.

        Without regard to the payment of required dividends to the holders of Series B, Series B-2, Series A-1, Series A-2 and Series A-3, holders of Series A-5 were entitled to receive the Series A-5 Special Accruing Dividend (as defined in the Company's certificate of incorporation) paid in shares of Series A-6 as described in note 10. Dividends were payable, as accrued, upon liquidation, event of sale and conversion to common stock, as described above. The holders of shares of Series A-5 were also entitled to dividends declared or paid on any shares of common stock.

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Notes to Financial Statements (Continued)

7. Convertible Preferred Stock (Continued)

        Following payment in full of required dividends to the holders of Series B, Series B-2, Series A-1, Series A-2, Series A-3 and Series A-5, holders of Series A-4 and Series A-6 were entitled to receive, when, if and as declared by the Board of Directors, dividends on any shares of Series A-4 Stock or Series A-6 Stock, as the case may be, out of funds legally available for that purpose, at a rate to be determined by the Board of Directors if and when they may so declare any dividend on the Series A-4 Stock or A-6 Stock, as the case may be. Dividends were payable, as accrued, upon liquidation, event of sale, and conversion to common stock, as described above. The holders of shares of Series A-4 and Series A-6 were also entitled to dividends declared or paid on any shares of common stock.

        As of June 6, 2014, the Company had accrued dividends of $3.9 million, $18.1 million, $21.2 million and $3.1 million on Series B, Series A-1, Series A-2 and Series A-3, respectively. As of June 11, 2014 the Company had accrued dividends of $0.7 million on Series B-2. Upon completion of the Company's initial public offering, all accrued dividends were paid in shares of common stock at the then effective Conversion Price.

        Voting —The holders of Series B, Series B-2 and Series A Preferred Stock were entitled to vote together with the holders of the common stock as one class on an as-if converted basis. In addition, as long as the shares of Series A-1 were outstanding, the holders of Series A-1, voting as a separate class, had the right to elect two members of the Company's Board of Directors.

        Liquidation —The shares of Series B and Series B-2 ranked equally to other shares of Series B and Series B-2, and ranked senior to the Series A-1 and all other classes of Series A Preferred Stock. The shares of Series A-1 ranked senior to all other classes of Series A Preferred Stock. Series A-2 ranked junior to Series A-1 and senior to Series A-3, Series A-4, Series A-5 and Series A-6. Series A-3, Series A-5 and Series A-6 ranked equally but junior to Series A-1 and Series A-2 and senior to Series A-4. Series A-4 ranked senior to the Company's common stock.

        In the event of a liquidation, dissolution, or winding-up of the Company, the holders of Series B and Series B-2 were entitled to be paid first out of the assets available for distribution, before any payment is made to the Series A Preferred Stock. Payment to the holders of Series B was to consist of two (2) times the original purchase price of $61.42, plus all accrued but unpaid dividends. Payment to the holders of Series B-2 was to consist of one and a half (1.5) times the original purchase price of $61.42, plus all accrued but unpaid dividends. After such distribution to the holders of Series B and Series B-2, the holders of Series A-1 would have been entitled to be paid out of the remaining assets available for distribution, before any payment is made to the Series A-2, Series A-3, Series A-4, Series A-5 and Series A-6. Payment to the holders of Series A-1 was to consist of the original purchase price of $81.42, plus all accrued but unpaid dividends. After the distribution to the holders of Series A-1, the holders of Series A-2 would have been entitled to receive an amount per share equal to the original purchase price per share of $81.42, plus any accrued but unpaid dividends. After the distribution to the holders Series A-1 and Series A-2, the holders of Series A-3, Series A-5 and Series A-6, would have been entitled to receive an amount per share equal to the original purchase price per share of $81.42, plus any accrued but unpaid or declared and unpaid dividends, as appropriate. After the distribution to the holders Series A-1, Series A-2, Series A-3, Series A-5 and Series A-6, the holders of Series A-4 would have been entitled to receive an amount per share equal to the original purchase price per share of $81.42, plus any declared and unpaid dividends. If the assets of the Company were insufficient to pay the full preferential amounts to the holders of Series B, the assets would have been distributed ratably among the holders of Series B in proportion to their

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Notes to Financial Statements (Continued)

7. Convertible Preferred Stock (Continued)

aggregate liquidation preference amounts. If the assets of the Company were insufficient to pay the full preferential amounts to the holders of Series A-1, the assets would have been distributed ratably among the holders of Series A-1 in proportion to their aggregate liquidation preference amounts. If the assets of the Company were insufficient to pay the full preferential amounts to the holders of Series A-2, the assets would have been distributed ratably among the holders of Series A-2 in proportion to their aggregate liquidation preference amounts. If the assets of the Company were insufficient to pay the full preferential amounts to the holders of Series A-3, Series A-5 and Series A-6, the assets would have been distributed ratably among the holders of Series A-3, Series A-5 and Series A-6 in proportion to their aggregate liquidation preference amounts. If the assets of the Company were insufficient to pay the full preferential amounts to the holders of Series A-4, the assets would have been distributed ratably among the holders of Series A-4 in proportion to their aggregate liquidation preference amounts. After all liquidation preference payments have been made to the holders of the Series B, Series B-2 and Series A Preferred Stock, the holders of the Series B, Series B-2 and Series A-1, Series A-2 and Series A-3 were to participate in the distribution of the remaining assets with the holders of the Company's common stock on an as-if converted basis.

        In the event of, and simultaneously with, the closing of an event of sale of the Company (as defined in the Company's Amended Certificate of Incorporation), the Company was to redeem all of the shares of Series B, Series B-2 and Series A Preferred Stock then outstanding at the Special Liquidation Price, as defined. If the event of sale involved consideration other than cash, the Special Liquidation Price could have been paid with such consideration having a value equal to the Special Liquidation Price. The Special Liquidation Price was to be equal to an amount per share, which would be received by each holder of the Preferred Stock if, in connection with the event of sale, all the consideration paid in exchange for the assets or the shares of capital stock of the Company was actually paid to and received by the Company, and the Company was immediately liquidated thereafter and its assets distributed pursuant to the liquidation terms above.

8. Fair Value Measurements

        The following tables summarize the financial assets and liabilities measured at fair value on a recurring basis in the accompanying balance sheets as of December 31, 2014 and 2013 (in thousands):

 
  As of December 31, 2014  
 
  Level 1   Level 2   Level 3   Total  

Assets

                         

Cash and cash equivalents:

                         

Cash

  $ 1,519   $   $   $ 1,519  

Money market funds(1)

    23,994             23,994  

Domestic corporate debt securities(2)

        3,005         3,005  

Total

  $ 25,513   $ 3,005   $   $ 28,518  

Marketable securities:

                         

Domestic corporate debt securities(2)

  $   $ 69,509   $   $ 69,509  

Domestic corporate commercial paper(2)

        7,249         7,249  

Total

  $   $ 76,758   $   $ 76,758  

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Notes to Financial Statements (Continued)

8. Fair Value Measurements (Continued)


 
  As of December 31, 2013  
 
  Level 1   Level 2   Level 3   Total  

Assets

                         

Cash and cash equivalents:

                         

Cash

  $ 2,710   $   $   $ 2,710  

Money market funds(1)

    9,593             9,593  

  $ 12,303   $   $   $ 12,303  

Liabilities

                         

Warrant liability(3)

  $   $   $ 1,945   $ 1,945  

Stock Liability(3)

            5,328     5,328  

  $   $   $ 7,273   $ 7,273  

(1)
Fair value is based upon quoted market prices.

(2)
Fair value is based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active and model-based valuation techniques for which all significant assumptions are observable in the market or can be corroborated by observable market data for substantially the full term of the assets. Inputs are obtained from various sources, including market participants, dealers and brokers.

(3)
Fair value is determined using the probability-weighted expected return model ("PWERM"), as discussed below. Changes in the fair value of the Level 3 assets and liabilities are recorded as other (expense) income in the statement of operations.

        The stock liability represents the accrued balance of the research and development expense related to the stock dividends that were issuable to Nordic Bioscience Clinical Development VII A/S ("Nordic") in shares of Series A-6 (or in shares of common stock upon listing the Company's common stock on a national exchange) as of December 31, 2013, for services rendered which is being recognized ratably over the estimated per patient treatment period under the three work statements executed with Nordic (the "Nordic Work Statements") (see note 10). The fair value of the stock liability was based upon the fair value of the Series A-6 as determined using PWERM, which considered the value of the Company's various classes of preferred stock. The fair value of the Company's various classes of preferred stock was determined through an analysis of the future values for equity assuming various future outcomes. Accordingly, share value was based upon the probability weighted present value of expected future net cash flows, considering each of the possible future events, discount rate as determined using the capital asset pricing model, as well as the rights and preferences of each share class. PWERM is complex as it requires numerous assumptions relating to potential future outcomes of equity. Accordingly, the valuation of the Company's stock liability was determined using Level 3 inputs. Upon completion of the Company's initial public offering, any payments owed by the Company to Nordic in relation to the Nordic Work Statements were changed from the right to receive shares of Series A-6 to the right to receive a total cash payment from the Company of $4.3 million.

        The warrant liability as of December 31, 2013, represents the liability for the warrants issued to the placement agent in connection with the Company's Series A-1 financing, to the investors in the Series B financing in April and May 2013, and to the lenders in connection with the Company's Loan and Security Agreement executed with Oxford and General Electric Capital Corporation in May 2011. The warrant liability was calculated using the Black-Scholes option pricing method. This method of

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Notes to Financial Statements (Continued)

8. Fair Value Measurements (Continued)

valuation includes using inputs such as the fair value of the Company's common stock or preferred stock, historical volatility, the term of the warrant and risk free interest rates. Prior to its initial public offering, the fair value of the Company's shares of common stock and preferred stock is estimated using PWERM, as described above. Accordingly, the valuation of the warrant liability at December 31, 2013, was determined using Level 3 inputs. Upon completion of the Company's initial public offering, the outstanding warrants to purchase shares of A-1 convertible preferred stock were converted into the right to purchase shares of common stock and the Company's warrant liability was reclassified to equity.

        The following table provides a roll forward of the fair value of the assets, where fair value is determined using Level 3 inputs (in thousands):

Balance at December 31, 2013

  $  

Issuance of shares of Series A-6—prepayment

    1,220  

Nordic amendment

    (1,220 )

Balance at December 31, 2014

  $  

        The following table provides a roll forward of the fair value of the liabilities, where fair value is determined using Level 3 inputs (in thousands):

Balance at December 31, 2013

  $ 7,273  

Issuance of shares of Series A-6

    (8,889 )

Additions—accrued shares of Series A-6

    2,717  

Additions—warrants

    1,511  

Change in fair value

    505  

Warrant liability reclassified to equity

    (3,117 )

Balance at December 31, 2014

  $  

        Additions represent the value of the asset or liability for additional accrued shares of stock that were issuable to Nordic for services rendered in connection with the Company's Phase 3 clinical trial of abaloparatide-SC (see note 10), as well as the value of any new warrants issued during the period. The issuance of shares of Series A-6 represents the release of the quarterly stock dividends of Series A-6 accrued under the Nordic Work Statements (see note 10). The Nordic amendment represents amounts that were originally payable in shares of Series A-6, but converted to the right to receive cash upon completion of the Company's initial public offering and no longer require fair value measurement at December 31, 2014 (see note 10).

        The fair value of the Company's note payable is determined using current applicable rates for similar instruments as of the balance sheet date. The carrying value of the Company's note payable approximated its fair value as of December 31, 2014, as the Company's interest rate is near current market rates. The fair value of the Company's notes payable was determined using Level 3 inputs.

9. License Agreements

        On September 27, 2005, the Company entered into a license agreement (the "Ipsen Agreement"), as amended, with SCRAS S.A.S, a French corporation on behalf of itself and its affiliates (collectively, "Ipsen"). Under the Ipsen Agreement, Ipsen granted to the Company an exclusive right and license

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Radius Health, Inc.

Notes to Financial Statements (Continued)

9. License Agreements (Continued)

under certain Ipsen compound technology and related patents to research, develop, manufacture and commercialize certain compounds and related products in all countries, except Japan and (subject to certain co-marketing and co-promotion rights retained by Ipsen) France. With respect to France, if Ipsen exercises its co-marketing and co-promotion rights, then Ipsen may elect to receive a percentage of the aggregate revenue from the sale of products by both parties in France (subject to a mid-double digit percentage cap) and Ipsen shall bear a corresponding percentage of the costs and expenses incurred by both parties with respect to such marketing and promotion efforts in France; Ipsen shall also pay Radius a mid-single digit royalty on Ipsen's allocable portion of aggregate revenue from the sale of products by both parties in France. Abaloparatide (the Company's investigational bone growth drug) is subject to the Ipsen Agreement. Ipsen also granted the Company an exclusive right and license under the Ipsen compound technology and related patents to make and have made compounds or product in Japan. Ipsen also granted the Company an exclusive right and license under certain Ipsen formulation technology and related patents solely for purposes of enabling the Company to develop, manufacture and commercialize compounds and products covered by the compound technology license in all countries, except Japan and (subject to certain co-marketing and co-promotion rights retained by Ipsen) France. In consideration for these licenses, the Company made a nonrefundable, non-creditable payment of $250.0 thousand to Ipsen, which was expensed during 2005. The Ipsen Agreement provides for further payments in the range of €10.0 million to €36.0 million ($12.1 million to $43.6 million) to Ipsen upon the achievement of certain development and commercialization milestones specified in the Ipsen Agreement, and for the payment of fixed 5% royalties on net sales of any product by the Company or our sublicensees on a country-by-country basis until the later of the last to expire of the licensed patents or for a period of 10 years after the first commercial sale in such country of any product that includes the compound licensed from Ipsen or any analog thereof.

        If the Company sublicenses the rights licensed from Ipsen, then the Company will also be required to pay Ipsen a percentage of certain payments received from such sublicensee (in lieu of milestone payments not achieved at the time of such sublicense). The applicable percentage is in the low double digit range. In addition, if the Company or its sublicensees commercialize a product that includes a compound discovered by it based on or derived from confidential Ipsen know-how, it will be obligated to pay to Ipsen a fixed low single digit royalty on net sales of such product on a country-by-country basis until the later of the last to expire of its patents that cover such product or for a period of 10 years after the first commercial sale of such product in such country. In connection with the Ipsen Agreement, the Company recorded approximately $0.5 million, $0.2 million and $0.7 million in research and developments costs in the years ended December 31, 2014, 2013 and 2012, respectively. The costs were incurred by Ipsen and charged to the Company for the manufacture of the clinical supply of the licensed compound.

        In June 2006, the Company entered into a license agreement (the "Eisai Agreement"), with Eisai Co. Ltd., ("Eisai"). Under the Eisai Agreement, Eisai granted to the Company an exclusive right and license to research, develop, manufacture and commercialize RAD1901 and related products from Eisai in all countries, except Japan. In consideration for the rights to RAD1901, the Company paid Eisai an initial license fee of $0.5 million, which was expensed during 2006. The Eisai Agreement provides for further payments in the range of $1.0 million to $20.0 million (inclusive of the $0.5 million initial license fee), payable upon the achievement of certain clinical and regulatory milestones.

        In addition, should a product covered by the licensed technology be commercialized, the Company will be obligated to pay to Eisai royalties in a variable mid-single digit range based on net sales of the

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Radius Health, Inc.

Notes to Financial Statements (Continued)

9. License Agreements (Continued)

product on a country-by-country basis until the later of the last to expire of the licensed patents or the expiration of data protection clauses covering such product in such country; the royalty rate shall then be subject to reduction and the royalty obligation will expire at such time as sales of lawful generic version of such product account for more than a specified minimum percentage of the total sales of all products that contain the licensed compound. The latest patent to expire, barring any extension thereof, is expected on August 18, 2026.

        The Eisai Agreement also grants the Company the right to sublicense with prior written approval from Eisai. If the Company sublicenses the licensed technology to a third party, the Company will be obligated to pay Eisai, in addition to the milestones referenced above, a fixed low double digit percentage of certain fees received from such sublicensee and royalties in low single digit range based on net sales of the sublicensee. The license agreement expires on a country-by-country basis on the later of (1) the date the last remaining valid claim in the licensed patents expires, lapses or is invalidated in that country, the product is not covered by data protection clauses, and the sales of lawful generic version of the product account for more than a specified percentage of the total sales of all pharmaceutical products containing the licensed compound in that country; or (2) a period of 10 years after the first commercial sale of the licensed products in such country, unless it is sooner terminated. During the years ended December 31, 2014, 2013 and 2012, the Company did not incur any expense related to the Eisai Agreement.

10. Research Agreements

        Abaloparatide-SC Phase 3 Clinical Trial —On March 29, 2011, the Company and Nordic entered into a Clinical Trial Services Agreement (the "Clinical Trial Services Agreement"), a Work Statement NB-1, as amended on December 9, 2011, June 18, 2012, March 28, 2014, May 19, 2014 and July 22, 2014 (the "Work Statement NB-1") and a Stock Issuance Agreement, as amended and restated on May 16, 2011, and as further amended on February 21, 2013, March 28, 2014, and May 19, 2014 (the "Stock Issuance Agreement"). Pursuant to the Work Statement NB-1, Nordic is managing the Phase 3 clinical trial of abaloparatide-SC (the "Phase 3 Clinical Trial").

        Pursuant to the Work Statement NB-1, the Company is required to make certain per patient payments denominated in both euros and U.S. dollars for each patient enrolled in the Phase 3 Clinical Trial followed by monthly payments for the duration of the study and final payments in two equal euro-denominated installments and two equal U.S. dollar-denominated installments. Changes to the clinical trial schedule may alter the timing, but not the aggregate amounts of the payments. In addition, the Company agreed to pay to Nordic an additional performance incentive (each a "Performance Incentive Payment") of $500,000 for every 50 patients that, subsequent to March 28, 2014, complete all end-of-study procedures, up to a maximum aggregate amount of additional payments equal to $5.0 million. The Work Statement NB-1, provides for a total of up to approximately €41.2 million ($49.8 million) of euro-denominated payments and a total of up to approximately $3.2 million of U.S. dollar-denominated payments over the course of the Phase 3 Clinical Trial, plus Performance Incentive Payments. These payments may be adjusted based upon actual sites opened, work performed or number of patients enrolled. In addition, payments are due to Nordic in connection with the Work Statement NB-1 pursuant to the Stock Issuance Agreement, as discussed below.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

10. Research Agreements (Continued)

        The Company recognizes research and development expense for the amounts due to Nordic under the Work Statement NB-1 ratably over the estimated per patient treatment period beginning upon enrollment in the Phase 3 Clinical Trial, or a twenty-month period. The Company recognizes research and development expense for the amounts due to Nordic under the fourth amendment to the Work Statement NB-1, which is recognized on a per patient basis when the end-of-study visit and all other required procedures are completed. The Company recorded $8.2 million, $31.6 million, and $30.8 million of research and development expense during the years ended December 31, 2014, 2013, and 2012, respectively, for per patient costs incurred for patients that had enrolled in the Phase 3 Clinical Trial.

        As of December 31, 2014, the Company had a liability of $5.6 million reflected in accrued expenses and other current liabilities on the balance sheet resulting from services provided by Nordic, which are payable in cash.

        Abaloparatide-SC Phase 3 Clinical Extension Study —On February 21, 2013, the Company entered into a Work Statement NB-3, as amended on March 4, 2014 (the "Work Statement NB-3"). Pursuant to the Work Statement NB-3, Nordic will perform an extension study to evaluate six months of standard-of-care osteoporosis management following the completion of the Phase 3 Clinical Trial, and, upon completion of this initial six months, an additional period of 18 months of standard-of-care osteoporosis management ("the Extension Study").

        Payments in cash to be made to Nordic under the Work Statement NB-3 are denominated in both euros and U.S. dollars and total up to €7.5 million ($9.1 million) and $1.1 million, respectively. In addition, payments are due to Nordic in connection with the Work Statement NB-3 pursuant to the Stock Issuance Agreement, as discussed below.

        The Company recognizes research and development expense for the amounts due to Nordic under the Work Statement NB-3 and Amendment ratably over the estimated per patient treatment periods beginning upon enrollment, or over a nine-month and nineteen-month period, respectively. The Company recorded $9.6 million and $4.5 million of research and development expense during the years ended December 31, 2014 and 2013, respectively, for per patient costs incurred for patients that had enrolled in the Extension Study and Second Extension.

        As of December 31, 2014, the Company had a liability of $5.9 million reflected in accrued expenses and other current liabilities on the balance sheet resulting from services provided by Nordic, which are payable in cash.

        Stock Issuance Agreement —Pursuant to the Stock Issuance Agreement, Nordic agreed to purchase 6,443 shares of the Company's Series A-5 and to receive quarterly stock dividends, payable in shares of the Company's Series A-6. In connection with the Work Statement NB-1, the Stock Issuance Agreement provided that Nordic was entitled to receive stock dividends, having an aggregate value of up to €36.8 million ($44.5 million) (the "NB-1 Accruing Dividend"). In connection with Work Statement NB-3, the Stock Issuance Agreement provided that, beginning with the quarter ended March 31, 2013, Nordic was entitled to receive stock dividends having an aggregate value of up to €7.5 million ($9.1 million) and $0.8 million (the "NB-3 Accruing Dividend" and together with the "NB-1 Accruing Dividend," the "Nordic Accruing Dividend"). On March 28, 2014, the Company entered into the second amendment to the Stock Issuance Agreement (the "Second Stock Issuance Agreement Amendment"). The Second Stock Issuance Agreement Amendment required that the

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Radius Health, Inc.

Notes to Financial Statements (Continued)

10. Research Agreements (Continued)

Company's Board of Directors declare, as soon as reasonably practical, a stock dividend of twenty-nine (29) shares of its Series A-6 for each share of the Company's then-outstanding Series A-5, all of which were held by Nordic, for a total of 186,847 shares of Series A-6, in full satisfaction of all stock dividends payable in 2014 under the terms of the Stock Issuance Agreement in connection with Work Statement NB-1 and Work Statement NB-3. In March 2014, Nordic requested that all 186,847 shares of Series A-6 be issued. Accordingly, the Company's Board of Directors declared and issued a dividend to Nordic of all 186,847 shares on March 31, 2014. The Second Stock Issuance Agreement Amendment further provided that in the event an initial public offering of the Company's common stock occurred prior to May 31, 2014, any payments owed by the Company to Nordic in relation to Work Statement NB-1 and Work Statement NB-3, excluding Performance Incentive Payments, for all periods of time after 2014, would be changed from the right to receive stock to the right to receive a total cash payment from the Company of $4.3 million payable in ten equal monthly installments of $430,000 beginning on March 31, 2015. On May 19, 2014, the Company entered into the third amendment to the Stock Issuance Agreement, which amended the date prior to which an initial public offering must occur to June 30, 2014. The Second Stock Issuance Agreement Amendment also stipulated that all consideration to be paid to Nordic pursuant to the Stock Issuance Agreement at any time after the consummation of an initial public offering be payable in cash. As the Company completed an initial public offering on June 11, 2014, Nordic no longer has the right to receive stock from the Company and has been paid in cash for all periods after June 11, 2014.

        Prior to the issuance of shares of stock to Nordic in satisfaction of the Nordic Accruing Dividend, the liability to issue shares of stock was being accounted for as a liability in the Company's balance sheet, based upon the fair value of the Series A-6 as determined using PWERM. Changes in the fair value from the date of accrual to the date of issuance of the Series A-6 shares were recorded as a gain or loss in other (expense) income in the statement of operations.

        Abaloparatide-TD Phase 2 Clinical Trial —On July 26, 2012, the Company entered into a Letter of Intent, (the "Phase 2 Letter of Intent with Nordic"), which provided that the Company and Nordic would, subject to the Company's compliance with certain requirements of the certificate of incorporation and applicable securities law, negotiate in good faith to enter into a Work Statement NB-2, (the "Work Statement NB-2"), and an amendment to the Amended and Restated Stock Issuance Agreement.

        On February 21, 2013, the Company entered into Work Statement NB-2. Pursuant to the Work Statement NB-2, Nordic provided clinical trial services relating to the Phase 2 clinical trial of abaloparatide-TD (the "Phase 2 Clinical Trial"). Payments in cash to be made by the Company to Nordic under the Work Statement NB-2 were denominated in both euros and U.S. dollars and totaled up to €3.6 million ($4.4 million) and $0.3 million, respectively. In addition, pursuant to the Stock Issuance Agreement, Nordic was entitled to shares of Series A-6 payable as dividends upon the shares of Series A-5 held by Nordic, having an aggregate value of up to $2.9 million.

        As of December 31, 2013, 32,215 shares of Series A-6 were due to Nordic under Work Statement NB-2. In December 2013, Nordic requested that all 32,215 shares of Series A-6 accrued as of December 31, 2013 under Work Statement NB-2 be issued. Accordingly, the Company's Board of Directors declared a dividend to Nordic of all 32,215 shares of Series A-6 accrued under Work Statement NB-2 on December 31, 2013, which constituted all shares of Series A-6 due under Work Statement NB-2.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

10. Research Agreements (Continued)

        The Company recognized research and development expense for the amounts due to Nordic under the Work Statement NB-2 ratably over the estimated per patient treatment period beginning upon enrollment in the Phase 2 Clinical Trial, or a nine-month period. The Company recorded nil, $4.1 million, and $1.4 million of research and development expense during the years ended December 31, 2014, 2013, and 2012, respectively, for per patient costs incurred for patients that had enrolled in the Phase 2 Clinical Study. Additionally, the Company recorded approximately $0.9 million of research and development expense associated with the costs incurred for preparatory and other start-up costs to initiate the Phase 2 Clinical Study during the year ended December 31, 2012. As of December 31, 2014, all obligations due to Nordic under Work Statement NB-2 had been paid.

        The Company is also responsible for certain pass-through costs in connection with the Phase 3 Clinical Trial, Extension Study and Phase 2 Clinical Study. Pass through costs are expensed as incurred or upon delivery. The Company recognized research and development expense of $1.3 million, $3.9 million, and $6.0 million for pass-through costs during the years ended December 31, 2014, 2013, and 2012, respectively.

11. Stock-based Compensation

        The Company has the following stock-based compensation plans as of December 31, 2014, under which equity awards have been granted to employees, directors and consultants:

    2003 Long-Term Incentive Plan; and

    2011 Equity Incentive Plan.

        The 2011 Equity Incentive Plan replaced the 2003 Long-Term Incentive Plan when the board of directors approved the new plan on November 7, 2011. As of December 31, 2014, an aggregate of approximately 4,560,000 shares have been authorized for issuance under the Company's stock-based compensation plans, with approximately 3,220,000 options outstanding. The number of common shares available for granting of future awards under these plans was approximately 981,000 at December 31, 2014.

        2003 Long-Term Incentive Plan —The Company's 2003 Long-Term Incentive Plan (the "Incentive Plan") provides for the granting of incentive stock options and nonqualified options to key employees, directors and consultants of the Company. The exercise price of the incentive stock options, as determined by the board of directors, must be at least 100% (110% in the case of incentive stock options granted to a stockholder owning in excess of 10% of the Company's common stock) of the common stock fair value as of the date of the grant. The provisions of the Incentive Plan limit the exercise of incentive stock options, but in no case may the exercise period extend beyond ten years from the date of grant (five years in the case of incentive stock options granted to a stockholder owning in excess of 10% of the Company's common stock). Stock options generally vest over a four-year period. Certain options contain explicit performance conditions. The Company authorized approximately 884,000 shares of common stock for issuance under the Incentive Plan.

        2011 Equity Incentive Plan —The Company's 2011 Equity Incentive Plan (the "Equity Plan") provides for the granting of incentive stock options and nonqualified options to key employees, directors and consultants of the Company. The exercise price of the incentive stock options, as determined by the board of directors, must be at least 100% (110% in the case of incentive stock

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Notes to Financial Statements (Continued)

11. Stock-based Compensation (Continued)

options granted to a stockholder owning in excess of 10% of the Company's common stock) of the common stock fair value as of the date of the grant. The provisions of the Equity Plan limit the exercise of incentive stock options, but in no case may the exercise period extend beyond ten years from the date of grant (five years in the case of incentive stock options granted to a stockholder owning in excess of 10% of the Company's common stock). Stock options generally vest over a four-year period. During 2014, the Company also issued stock options to certain members of its board of directors which vested immediately. Certain options contain explicit performance conditions. The Company has authorized approximately 3,676,000 shares of common stock for issuance under the Equity Plan. In addition, the shares remaining available for issuance under the Incentive Plan were assumed as shares authorized under the Equity Plan.

        The Company has historically granted stock options at exercise prices no less than the fair value of its common stock as determined by its board of directors, with input from management. Prior to the Company's initial public offering, the Company's board of directors has historically determined, with input from management, the estimated fair value of the Company's common stock on the date of grant based on a number of objective and subjective factors, including:

    the prices at which the Company sold shares of convertible preferred stock;

    the superior rights and preferences of securities senior to the Company's common stock at the time of each grant;

    the likelihood of achieving a liquidity event such as a public offering or sale of the Company;

    the Company's historical operating and financial performance and the status of its research and product development efforts; and

    achievement of enterprise milestones, including entering into collaboration and license agreements.

        Subsequent to the Company's initial public offering, exercise prices in the case of non-qualified and incentive stock options are not less than the fair value of the underlying common stock on the date of grant.

        The Company uses the Black-Scholes option-pricing model to estimate the grant date fair value of its employee stock options. The weighted-average grant-date fair value per share of options granted during 2014, 2013 and 2012 was $8.26, $4.67 and $5.38, respectively. The weighted-average assumptions used in the Black-Scholes option-pricing model were as follows:

 
  Years Ended
December 31,
 
 
  2014   2013   2012  

Expected term (years)

    6.06     6.25     6.25  

Volatility

    59 %   62 %   60 %

Expected dividend yield

    0 %   0 %   0 %

Risk-free interest rates

    2.06 %   2.45 %   1.10 %

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Notes to Financial Statements (Continued)

11. Stock-based Compensation (Continued)

        A summary of stock option activity for the year ended December 31, 2014 is as follows (in thousands, except for per share and weighted-average contractual life amounts):

 
  Shares   Weighted-
Average
Exercise
Price (in
dollars per
share)
  Weighted-
Average
Contractual
Life
(In Years)
  Aggregate
Intrinsic
Value
 

Options outstanding at December 31, 2013

    1,667   $ 7.05              

Granted

    2,785     15.20              

Exercised

    (49 )   3.45              

Cancelled

    (1,182 )   8.63              

Expired

    (1 )   3.42              

Options outstanding at December 31, 2014

    3,220   $ 13.58     8.57   $ 81,584  

Options exercisable at December 31, 2014

    1,323   $ 9.98     7.27   $ 38,266  

Options vested or expected to vest at December 31, 2014

    3,114   $ 13.49     8.54   $ 79,158  

        The aggregate intrinsic value of options exercised (i.e., the difference between the market price at exercise and the price paid by employees to exercise the option) during the years ended December 31, 2014 and 2013 was $0.7 million and $0.02 million, respectively.

        The following table summarizes stock-based compensation expense by financial statement line (in thousands):

 
  Years Ended December 31,  
 
  2014   2013   2012  

Research and development

  $ 1,953   $ 302   $ 338  

General and administrative

    5,117     1,206     1,457  

Share-based compensation expense included in operating expenses

  $ 7,070   $ 1,508   $ 1,795  

        As of December 31, 2014, there was approximately $16.0 million of total unrecognized compensation expense related to unvested share-based compensation arrangements, which is expected to be recognized over a weighted- average period of approximately 3 years.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

12. Net Loss Per Share

        Basic and diluted net loss per share is calculated as follows (in thousands, except share and per share amounts):

 
  Year Ended December 31,  
 
  2014   2013   2012  

Numerator:

                   

Net loss

  $ (62,479 ) $ (60,690 ) $ (69,128 )

Accretion of preferred stock

    (9,000 )   (17,471 )   (13,992 )

Loss attributable to common stockholders—basic

    (71,479 )   (78,161 )   (83,120 )

Effect of dilutive convertible preferred stock

             

Loss attributable to common stockholders—diluted

  $ (71,479 ) $ (78,161 ) $ (83,120 )

Denominator:

                   

Weighted-average number of common shares used in loss per share—diluted

    17,699,487     383,310     368,261  

Loss per share—basic and diluted

  $ (4.04 ) $ (203.91 ) $ (225.71 )

        The following potentially dilutive securities, prior to the use of the treasury stock method, have been excluded from the computation of diluted weighted-average shares outstanding, as they would be anti-dilutive. For the years ended December 31, 2014, 2013, and 2012, all convertible preferred stock, options to purchase common stock and warrants outstanding were assumed to be anti-dilutive as earnings attributable to common stockholders was in a loss position.

 
  Year Ended December 31  
 
  2014   2013   2012  

Convertible preferred stock

    3,857,664     6,617,686     3,412,898  

Options to purchase common stock

    2,466,492     1,743,890     1,706,539  

Warrants

    1,271,520     545,797     15,000  

13. Income Taxes

        As of December 31, 2014 the Company had federal and state net operating loss ("NOL") carryforwards of approximately $319.7 million and $246.5 million, respectively, which may be used to offset future taxable income. The Company also had federal and state tax credits of $4.5 million and $0.5 million, respectively, to offset future tax liabilities. The NOL and tax credit carryforwards will expire at various dates through 2034, and are subject to review and possible adjustment by federal and state tax authorities. The Internal Revenue Code contains provision that may limit the NOL and tax credit carryforwards available to be used in any given year in the event of certain changes in the ownership interests of significant stockholders under Section 382 of the Internal Revenue Code.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

13. Income Taxes (Continued)

        A reconciliation of income taxes computed using the U.S. federal statutory rate to that reflected in operations follows (in thousands):

 
  Year Ended December 31,  
 
  2014   2013   2012  

Income tax benefit using U.S. federal statutory rate

  $ (21,243 ) $ (20,635 ) $ (23,504 )

State income taxes, net of federal benefit

    (2,494 )   (2,255 )   (2,774 )

Stock-based compensation

    149     92     72  

Research and development tax credits

    (499 )   (1,277 )   (55 )

Change in the valuation allowance

    23,186     27,194     25,175  

Permanent items

    910     (3,085 )   709  

Other

    (9 )   (34 )   377  

  $   $   $  

        The Company is subject to Massachusetts net worth taxes, not based on income, which is largely offset by allowable tax credits and recorded as a component of operating expenses.

        The principal components of the Company's deferred tax assets are as follows (in thousands):

 
  December 31,  
 
  2014   2013  

Current assets:

             

Accrued expenses

  $ 671   $ 351  

Deferred rent

        9  

Gross current deferred tax assets

    671     360  

Valuation allowance

    (671 )   (360 )

Net current deferred tax assets

  $   $  

Non-current assets:

             

Net operating loss carryforwards

  $ 121,278   $ 100,284  

Capitalized research and development

    356     662  

Research and development credits

    4,844     4,345  

Depreciation and amortization

    (47 )   110  

Other

    3,158     1,313  

Gross non-current deferred tax assets

    129,589     106,714  

Valuation allowance

    (129,589 )   (106,714 )

Net non-current deferred tax assets

  $   $  

        The Company has recorded a valuation allowance against its deferred tax assets in each of the years ended December 31, 2014 and 2013, because the Company's management believes that it is more likely than not that these assets will not be realized. The increase in the valuation allowance in 2014 primarily relates to the net loss incurred by the Company.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

13. Income Taxes (Continued)

        As of December 31, 2014, the Company has no unrecognized tax benefits or related interest and penalties accrued. The Company has not, as yet, conducted a study of research and development credit carryforwards. In addition, the Company has not, as yet, conducted an Internal Revenue Code Section 382 study, which could impact its ability to utilize available NOL and tax credit carryforwards. These studies may result in adjustments to the Company's research and development credit carryforwards and NOL carryfowards; however, until a study is completed and any adjustment is known, no amounts are being presented as an uncertain tax position. A full valuation allowance has been provided against the Company's research and development credits and net operating loss carryforward and, if an adjustment is required, this adjustment would be offset by an adjustment to the valuation allowance. Thus, there would be no impact to the balance sheet or statement of operations if an adjustment were required. The Company would recognize both accrued interest and penalties related to unrecognized benefits in income tax expense. The Company has not recorded any interest or penalties on any unrecognized benefits since inception.

        The statute of limitations for assessment by the Internal Revenue Service ("IRS") and state tax authorities remains open for all tax years. The Company files income tax returns in the United States, Colorado, Connecticut, Florida, Pennsylvania, New Jersey, New York and Massachusetts. There are currently no federal or state audits in progress.

14. Commitments and Contingencies

        Litigation —The Company may be exposed to certain claims or assessments in the ordinary course of business. In the opinion of management, the outcome of these matters is not likely to have any material effect on the financial position, results of operations, or cash flows of the Company.

        Commitments —On July 15, 2011, the Company entered into an operating lease agreement for office space in Cambridge, Massachusetts. The term of the lease was August 1, 2011 through July 31, 2014.

        On May 14, 2014, the Company entered into an operating lease for office space in Waltham, Massachusetts. The term of the lease is August 1, 2014 through July 31, 2019. The Company has the option to extend the lease once for an additional 5-year period.

        On July 3, 2014, the Company entered into an operating lease for office space in Morristown, New Jersey. The term of the lease is August 1, 2014 through January 31, 2015. On October 31, 2014, the Company executed an agreement to extend the term of the rental agreement through July 31, 2015.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

14. Commitments and Contingencies (Continued)

        The Company is obligated to make monthly rent payments pursuant to these agreements as set forth below:

Years ended December 31,
  Future Lease
Commitments
 

2015

  $ 328  

2016

    296  

2017

    305  

2018

    313  

2019

    186  

Total minimum lease payments

  $ 1,428  

        Rent expense for the years ended December 31, 2014, 2013 and 2012 was $0.2 million, $0.2 million and $0.2 million, respectively.

15. Related Party Transactions

        On July 24, 2013, the Company entered into a Consulting Agreement with Morana Jovan-Embiricos, Ph.D. (the "Consulting Agreement"), a member of the Company's board of directors. Pursuant to the Consulting Agreement, Dr. Jovan-Embiricos agreed to provide financial and strategic consulting services as may be requested by the Company, and such other consulting services as may be reasonably requested by the Company, from time to time from July 1, 2013 until June 30, 2014. The Company agreed to pay Dr. Jovan-Embiricos an aggregate consulting fee in cash of $160,000, of which $80,000 was paid on July 30, 2013 and the remaining $80,000 was paid on October 2, 2013.

        On January 23, 2014, the Company entered into a consulting agreement with Orbit Advisors Limited (the "Orbit Agreement"), a Swiss company ("Orbit"), and Morana Jovan-Embiricos, Ph.D and an agreement terminating the Consulting Agreement dated July 24, 2013. The Orbit Agreement was effective as of January 22, 2014 and would continue in effect until December 31, 2014 or until the earlier termination thereof in accordance with its terms (the "Term"). Pursuant to the Orbit Agreement, Orbit had agreed to provide financial and strategic consulting services as may be requested by the Company, and such other consulting services as may have been reasonably requested by the Company, from time to time during the Term. The Company agreed to pay Orbit an aggregate consulting fee in cash of $400,000 in four equal installments of $100,000 on each of January 31, 2014, June 30, 2014, September 30, 2014 and December 31, 2014. The Orbit Agreement contained customary provisions, applicable to both Orbit and Dr. Jovan-Embiricos, as Orbit's representative under the Orbit Agreement, regarding the treatment of the Company's confidential information and assignment of inventions, as well as an obligation of Orbit and Dr. Jovan-Embiricos to not solicit, during the Term and for a period of one year thereafter, any person or entity engaged by the Company as an employee, customer or supplier of, or consultant or advisor to, the Company to terminate such party's relationship with the Company. On February 27, 2014, the Company entered into a letter agreement terminating the Orbit Agreement.

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Radius Health, Inc.

Notes to Financial Statements (Continued)

16. Selected Quarterly Financial Data (Unaudited)

        Selected quarterly financial data for the years ended December 31, 2014 and 2013 is as follows (in thousands, except for share and per share data):

 
  Three Months Ended  
 
  March 31,   June 30,   September 30,   December 31,  

2014:

                         

Net loss

  $ (14,488 ) $ (12,609 ) $ (17,420 ) $ (17,962 )

Net loss applicable to common stock

    (19,457 )   (16,640 )   (17,420 )   (17,962 )

Net loss per share—basic and diluted

    (50.45 )   (2.22 )   (0.59 )   (0.55 )

Weighted-average common shares outstanding—basic and diluted

    385,664     7,500,148     29,746,426     32,678,459  

2013:

   
 
   
 
   
 
   
 
 

Net loss

  $ (8,305 ) $ (19,512 ) $ (20,342 ) $ (12,531 )

Net loss applicable to common stock

    (11,887 )   (23,880 )   (25,090 )   (17,304 )

Net loss per share—basic and diluted

    (31.25 )   (62.59 )   (65.05 )   (44.87 )

Weighted-average common shares outstanding—basic and diluted

    380,352     381,525     385,688     385,688  

17. Subsequent Events

        On January 28, 2015, the Company completed a public offering of 4,000,000 shares of its common stock at a price of $36.75 per share, for aggregate proceeds, net of underwriting discounts, commissions and offering costs, of approximately $137.8 million. On January 28, 2015, the underwriters purchased an additional 600,000 shares by exercising an option to purchase additional shares that was granted to them in connection with the offering. As a result of the public offering and subsequent exercise of the underwriters' option, the Company received aggregate proceeds, net of underwriting discounts, commissions and offering costs of approximately $158.6 million.

        On March 9, 2015, the Company entered into an amendment to the Eisai Agreement (the "Eisai Amendment") in which Eisai granted to the Company an exclusive right and license to research, develop, manufacture and commercialize RAD1901 in Japan. In consideration for the rights to RAD1901 in Japan, the Company paid Eisai an initial license fee of $0.4 million upon execution of the contract. The Eisai Amendment also provides for additional payments, payable upon the achievement of certain clinical and regulatory milestones in Japan.

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ITEM 9.    CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE.

        None.

ITEM 9A.    CONTROLS AND PROCEDURES.

Limitations on Effectiveness of Controls and Procedures

        In designing and evaluating our disclosure controls and procedures and internal control over financial reporting, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives. In addition, the design of disclosure controls and procedures and internal control over financial reporting must reflect the fact that there are resource constraints and that management is required to apply judgment in evaluating the benefits of possible controls and procedures relative to their costs.

Evaluation of Disclosure Controls and Procedures

        Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, evaluated as of the end of the period covered by this Annual Report on Form 10-K, the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934, as amended, or the Exchange Act. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective at the reasonable assurance level as of December 31, 2014.

Management's Annual Report on Internal Control Over Financial Reporting

        Our management is responsible for establishing and maintaining adequate internal control over financial reporting, as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act. Our management, with the participation of our Chief Executive Officer and Chief Financial Officer, assessed the effectiveness of our internal control over financial reporting as of December 31, 2014, based on the criteria set forth in Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework). Based on that assessment, our management concluded that our internal control over financial reporting was effective as of December 31, 2014.

        The effectiveness of our internal control over financial reporting as of December 31, 2014 has been audited by Ernst & Young LLP, an independent registered public accounting firm, as stated in their report which is contained in Item 9A of this Annual Report on Form 10-K.

Changes in Internal Control Over Financial Reporting

        There was no change in our internal control over financial reporting during the quarter ended December 31, 2014 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting.

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Report of Independent Registered Public Accounting Firm

The Board of Directors and Shareholders of Radius Health, Inc.

        We have audited Radius Health, Inc.'s internal control over financial reporting as of December 31, 2014, based on criteria established in Internal Control—Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria). Radius Health, Inc.'s management is responsible for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting included in the accompanying Management's Annual Report on Internal Control over Financial Reporting. Our responsibility is to express an opinion on the company's internal control over financial reporting based on our audit.

        We conducted our audit in accordance with the standards of the Public Company Accounting Oversight Board (United States). Those standards require that we plan and perform the audit to obtain reasonable assurance about whether effective internal control over financial reporting was maintained in all material respects. Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, testing and evaluating the design and operating effectiveness of internal control based on the assessed risk, and performing such other procedures as we considered necessary in the circumstances. We believe that our audit provides a reasonable basis for our opinion.

        A company's internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company's internal control over financial reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company's assets that could have a material effect on the financial statements.

        Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

        In our opinion, Radius Health, Inc. maintained, in all material respects, effective internal control over financial reporting as of December 31, 2014, based on the COSO criteria.

        We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States), the consolidated balance sheets of Radius Health, Inc. as of December 31, 2014 and 2013, and the related consolidated statements of operations and comprehensive loss, convertible preferred stock, redeemable convertible preferred stock and stockholders' equity (deficit) and cash flows for each of the three years in the period ended December 31, 2014 of Radius Health, Inc. and our report dated March 10, 2015 expressed an unqualified opinion thereon.

 

/s/ Ernst & Young LLP

Boston, Massachusetts
March 10, 2015

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ITEM 9B.    OTHER INFORMATION.

        On March 9, 2015, we entered into an Amendment, effective as of February 26, 2015, or the Eisai Amendment, to the License Agreement, dated June 29, 2006, or the Eisai Agreement, between us and Eisai Co., Ltd., or Eisai. The Eisai Agreement granted a license to the Company for the right to research, develop, manufacture and commercialize the compound used in our investigational drug product candidate RAD1901, covering a worldwide territory excluding Japan. The Eisai Amendment amends the Eisai Agreement to include Japan in the territory covered by the license. In consideration for the rights to RAD1901 in Japan, we paid Eisai an upfront fee of $0.4 million upon execution of the Eisai Amendment. The Eisai Amendment also provides for additional payments, payable upon the achievement of certain clinical and regulatory milestones in Japan. The Eisai Agreement also obligated us to first negotiate with Eisai if we decided to sublicense the licensed technology to a collaborator in particular countries in Asia. The Eisai Amendment eliminates this obligation.

        None.

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PART III

ITEM 10.    DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE.

        The following table sets forth the name, age and position of each of our executive officers and directors:

Name
  Age   Position

Robert E. Ward

    57   President, Chief Executive Officer and Director

B. Nicholas Harvey

    54   Senior Vice President, Chief Financial Officer, Treasurer and Secretary

Gary Hattersley, Ph.D. 

    48   Senior Vice President, Chief Scientific Officer

Alan G. Harris, M.D., Ph.D

    63   Chief Medical Officer

Gregory Williams, Ph.D. 

    55   Chief Development Officer

Alan H. Auerbach(2)(3)

    45   Director

Willard H. Dere, M.D. 

    61   Director

Ansbert K. Gadicke, M.D.(2)(3)

    56   Director

Kurt C. Graves(2)(3)

    47   Chairman of the Board

Owen Hughes(1)

    40   Director

Martin Münchbach, Ph.D.(1)(3)

    44   Director

Anthony Rosenberg

    61   Director

Elizabeth Stoner, M.D.(1)

    64   Director

(1)
Member of the audit committee.

(2)
Member of the nominating and corporate governance committee.

(3)
Member of the compensation committee.

         Robert E. Ward has served as our President and Chief Executive Officer and as a member of our Board of Directors since December 2013. Prior to joining Radius, Mr. Ward was Vice President for Strategy and External Alliances for the New Opportunities iMed of AstraZeneca ("AZ"), a biopharmaceutical company, from 2011 to 2013. In addition, he served as Co-Chair of the Joint Development Committees in AZ's drug development partnerships with Alcon and Galderma. Prior to AstraZeneca, from 2010 to 2011, Mr. Ward was the Managing Director of Harriman Biopartners, LLC, a biopharmaceutical company, and from 2006 to 2010 he was the Vice President of Corporate Development for NPS Pharmaceuticals, a pharmaceutical company. Mr. Ward received a B.A. in Biology and a B.S. in Physiological Psychology, both from the University of California, Santa Barbara; an M.S. in Management from the New Jersey Institute of Technology; and an M.A. in Immunology from The Johns Hopkins University School of Medicine. We believe Mr. Ward is qualified to serve as a member of our Board of Directors because of his role with us and his extensive operational knowledge of, and executive level management experience in, the global biopharmaceutical industry.

         B. Nicholas Harvey has served as our Senior Vice President, Chief Financial Officer, Treasurer and Secretary since November 2010, and served as a member of our Board of Directors from November 2010 until the consummation of the Merger in May 2011. Mr. Harvey served as the Chief Financial Officer and Senior Vice President of the Former Operating Company from December 2006 until the Merger. Mr. Harvey received a Bachelor of Economics degree and a Bachelor of Laws degree with first-class honors from the Australian National University and an M.B.A. from the Harvard Business School.

        G ary Hattersley, Ph.D., served as our Senior Vice President of Preclinical Development from December 2011 to December 2013, and has served as Chief Scientific Officer since January 2014. He served as our Vice President of Biology from May 2011 to December 2011 and served in the same

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capacity at the Former Operating Company from April 2008 until the Merger. He also served in the Former Operating Company as Senior Director of Research from 2006 to 2008 and as Director of Disease Biology & Pharmacology from 2003 to 2006. Dr. Hattersley received a Ph.D. in Experimental Pathology from St. George's Hospital Medical School.

         Alan Harris, M.D., Ph.D., served as our Executive Medical Officer from February 2014 to May 2014, and has served as Chief Medical Officer since June 2014. Prior to joining Radius, from 2012 to 2013, Dr. Harris was the Chief Medical Officer of Morria/Celsus Biopharmaceuticals, a biopharmaceutical company. Prior to that, Dr. Harris was Consultant Chief Medical Officer of Immune Pharmaceuticals, a biopharmaceutical company, from 2011 to 2012. Before joining Immune Pharmaceuticals, Dr. Harris was Vice President of Drug Development, Regenerative Medicine and Regulatory Affairs at Neostem, Inc., a biopharmaceutical company, from 2009 to 2011. During 2008, Dr. Harris was the Senior Vice President of Research and Development and the Chief Medical Officer of NPS Pharmaceuticals, a pharmaceutical company. From 2004 to 2005, Dr. Harris was Therapeutic Head of Worldwide Medical Endocrine Care for Pfizer, Inc., a pharmaceutical company. Prior to his work at Pfizer, Dr. Harris worked for nine years at Schering Plough, a pharmaceutical company, in a number of positions related to scientific and medical affairs, including Vice President of Global Health Research and Outcomes. In 2012, Dr. Harris founded SomPharmaceuticals SA, a pharmaceutical company, where he currently serves as Chairman of the Board of Directors. Dr. Harris was an associate professor of medicine at the University of California, Los Angeles from 1992 to 1994 and has been an adjunct professor of medicine endocrinology at New York University since 2003. Dr. Harris received his medical degree from the Louis Pasteur Faculty of Medicine, University of Strasbourg, France, and his Ph.D. in endocrinology from Erasmus University, Rotterdam, The Netherlands.

         Gregory Williams, Ph.D., has served as our Chief Development Officer since January 2014. Prior to joining Radius, Dr. Williams was Vice President of Regulatory Affairs, Global Product and Clinical Development, and Program Management with The Medicines Company, a biopharmaceutical company, from 2006 to 2013. He was Vice President of Regulatory Affairs, Regulatory Compliance and Program Management for NPS Pharmaceuticals, a pharmaceutical company, from 2004 to 2006. Dr. Williams has a Ph.D. in Biopharmaceutics from Rutgers University and an M.B.A. from Cornell University.

         Alan H. Auerbach has served on our Board of Directors since May 2011 and served as a member of the Board of Directors of the Former Operating Company from October 2010 until the Merger. Mr. Auerbach is currently the Founder, Chief Executive Officer, President and Chairman of the Board of Puma Biotechnology, Inc., a company dedicated to in-licensing and developing drugs for the treatment of cancer and founded in 2010. Previously, Mr. Auerbach founded Cougar Biotechnology in May 2003 and served as the company's Chief Executive Officer, President and as a member of its Board of Directors until July 2009. From July 2009 until January 2010, Mr. Auerbach served as the Co-Chairman of the Integration Steering Committee at Cougar (as part of Johnson & Johnson). Mr. Auerbach received a B.S. in Biomedical Engineering from Boston University and an M.S. in Biomedical Engineering from the University of Southern California. We believe Mr. Auerbach is qualified to serve as a member of our Board of Directors because of his business and professional experience, including his leadership of Cougar Biotechnology in drug development, private and public financings and a successful sale of the business.

         Willard H. Dere, M.D. has served on our Board of Directors since November 2014. Dr. Dere has been Executive Director of Personalized Health at the University of Utah Health Sciences Center, and a Professor of Medicine in the School of Medicine since November 2014. Prior to that, he served as the Senior Vice President, Global Development from December 2004 to June 2007, and from April 2014 to October 2014, and as Chief Medical Officer from January 2007 to April 2014 at Amgen, Inc., a biopharmaceutical company, from December 2004 to October 2014. Before he joined Amgen in 2003, Dr. Dere served as Vice President of Endocrine, Bone and General Medicine Research and Development at Eli Lilly and Company, a biopharmaceutical company, where he also held various

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other roles in clinical pharmacology, regulatory affairs, and both early-stage translational, and late-stage clinical research. Dr. Dere received B.A. degrees in history and zoology and a M.D. degree from the University of California, Davis. We believe Mr. Dere is qualified to serve as a member of our Board of Directors because of his strong medical background and extensive experience in the pharmaceutical industry.

         Ansbert K. Gadicke, M.D. has served on our Board of Directors since May 2011 and served as a member of the board of directors of the Former Operating Company from November 2003 until the Merger. Dr. Gadicke has been the Co-Founder and Managing Director of MPM Capital, a venture capital firm, since August 1996. Dr. Gadicke received an M.D. from J.W. Goethe University in Frankfurt. Dr. Gadicke is a director of OSS Healthcare, Inc., Sideris Pharmaceuticals, Inc., RWHD, Inc. and Mitokyne, Inc. He served on the board of directors of Idenix Pharmaceuticals, Inc. from 1998 to 2005, BioMarin Pharmaceuticals, Inc. from 1997 to 2001, Verastem, Inc. from 2010 to 2012, Pharmasset, Inc. from 1999 to 2007 and PharmAthene, Inc. from 2004 to 2007. We believe Dr. Gadicke is qualified to serve as a member of our Board of Directors because of his business and professional experience, including his experience in the venture capital industry and his years of analyzing development opportunities in the life sciences sector.

         Kurt C. Graves has served on our Board of Directors since May 2011 and as Chairman of our Board of Directors since November 2011. Mr. Graves has been the Chairman, President and Chief Executive Officer of Intarcia Therapeutics, a biotechnology company, since April 2012. Mr. Graves served as Executive Chairman of Biolex Therapeutics, a biotechnology company, from November 2010 to March 2012, and served as Executive Chairman of Intarcia Therapeutics from August 2010 to April 2012. Previously, he served as Executive Vice President, Chief Commercial Officer and Head of Strategic Development at Vertex Pharmaceuticals Inc. from July 2007 to October 2009. Prior to joining Vertex, Mr. Graves held various leadership positions at Novartis pharmaceuticals from 1999 to June 2007. He was also the first Chief Marketing Officer for the Pharmaceuticals division from September 2003 to June 2007. He currently serves as a director of Intarcia Therapeutics, Pulmatrix Therapeutics and Achillion Pharmaceuticals. He served on the board of directors of Biolex Therapeutics and Springleaf Therapeutics from 2010 to 2012. Mr. Graves received a B.S. in Biology from Hillsdale College. We believe Mr. Graves is qualified to serve as a member of our Board of Directors because of his extensive experience in the life sciences industry, membership on various boards of directors and his leadership and management experience.

         Owen Hughes has served on our Board of Directors since April 2013. He has served as the Chief Business Officer and Head of Corporate Development at Intarcia Therapeutics, Inc. since 2013. Prior to Intarcia, he served as a Director at Brookside Capital, a hedge fund under the Bain Capital umbrella, managing public and private healthcare investments from 2008 to 2013. Mr. Hughes has served as a Senior Portfolio Manager at Pyramis Global Advisors from 2006 to 2008, co-founder and partner at Triathlon Fund Management from 2003 to 2006, an Investment Associate at Ziff Brothers Investments from 2001 to 2003, and an Assistant Vice President at Morgan Stanley/Merrill Lynch from 1998 to 2001. He earned a bachelor of arts from Dartmouth College. We believe Mr. Hughes is qualified to serve as a member of our Board of Directors because of his extensive business and professional experience, including his experience in the venture capital industry and years of analyzing development opportunities in the life sciences sector.

         Martin Münchbach, Ph.D. has served on our Board of Directors since May 2011. Dr. Münchbach has managed BB Biotech Ventures II, a venture capital fund, since he launched it in 2004. Dr. Münchbach received a Ph.D. in Protein Chemistry, a M.Sc. in Biochemistry and a Master in Industrial Engineering and Management from the Swiss Federal Institute of Technology (ETH). Dr. Münchbach currently serves on the board of directors of Atlas Genetics LTD, BioVascular Inc., Opsana Therapeutics Ltd, Sonetik AG and Tioga Pharmaceuticals Inc, and he served as a director of Optimer Pharmaceuticals, Inc. from 2005 to 2008. We believe Dr. Münchbach is qualified to serve on

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our Board of Directors because of his extensive business and professional experience, including his experience in the venture capital industry, membership on various other boards of directors and scientific background.

         Anthony Rosenberg has served on our Board of Directors since March 2015. From January 2013 to February 2015, Mr. Rosenberg served as Corporate Head of M&A and Licensing at Novartis International, a pharmaceutical company. From March 2005 to December 2012, he served as Global Head of Business Development and Licensing at Novartis Pharmaceuticals. Prior to that, Mr. Rosenberg was Global Head of the Transplant and Immunology Business Unit at Novartis Pharmaceuticals from 2000 to 2005. Mr. Rosenberg initially joined Sandoz, a predecessor to Novartis, in 1980. Mr. Rosenberg served as a director of Idenix Pharmaceuticals, Inc. from June 2009 to March 2012 and from December 2012 to March 2013. Mr. Rosenberg holds a B.Sc from the University of Leicester and an M.Sc in physiology from the University of London. We believe Mr. Rosenberg is qualified to serve as a member of our Board of Directors due to his extensive experience in mergers and acquisitions and licensing in the pharmaceutical sector.

         Elizabeth Stoner, M.D. has served on our Board of Directors since May 2011. Dr. Stoner has been a Managing Director at MPM Capital since October 2007, and the Chief Development Officer of Rhythm Pharmaceuticals, a biotechnology company, since 2010. Prior to joining MPM Capital, Dr. Stoner served in various roles, most recently as Senior Vice President of Global Clinical Development Operations at Merck Research Laboratories, since 1985. Dr. Stoner currently serves as a director of Momenta Pharmaceuticals Inc., and she served as a director of Metabasis Therapeutics, Inc. from 2009 to 2010. Dr. Stoner received an M.D. from Albert Einstein College of Medicine, an M.S. in Chemistry from the State University of New York at Stony Brook and a B.S. in Chemistry from Ottawa University, Kansas. We believe Dr. Stoner is qualified to serve on our Board of Directors because of her knowledge and expertise in the development of pharmaceutical products.

Code of Business Conduct and Ethics

        We have adopted a code of business conduct and ethics that applies to all of our employees, officers and directors, including those officers responsible for financial reporting. The code of business conduct and ethics is available on our website at www.radiuspharm.com. Any amendments to the code, or any waivers of its requirements, will be disclosed on our website. Information contained on or accessible through our website is not incorporated by reference into this report, and you should not consider information contained on or accessible through our website to be part of this report.

        The remainder of the response to this item is contained in our definitive Proxy Statement for our 2015 Annual Meeting of Stockholders and is incorporated herein by reference.

ITEM 11.    EXECUTIVE COMPENSATION.

        The information required to be disclosed by this item is contained in our definitive Proxy Statement for our 2015 Annual Meeting of Stockholders and is incorporated herein by reference.

ITEM 12.    SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS.

        The information required to be disclosed by this item is contained in our definitive Proxy Statement for our 2015 Annual Meeting of Stockholders and is incorporated herein by reference.

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ITEM 13.    CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE.

        The information required to be disclosed by this item is contained in our definitive Proxy Statement for our 2015 Annual Meeting of Stockholders and is incorporated herein by reference.

ITEM 14.    PRINCIPAL ACCOUNTANT FEES AND SERVICES.

        The information required to be disclosed by this item is contained in our definitive Proxy Statement for our 2015 Annual Meeting of Stockholders and is incorporated herein by reference.

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PART IV

ITEM 15.    EXHIBITS AND FINANCIAL STATEMENT SCHEDULES.

(a)   Financial Statements

        The following financial statements and supplementary data are included in Part II of Item 8 filed of this Annual Report on Form 10-K:

(b)   Financial Statement Schedules

        All financial statement schedules have been omitted because they are not applicable or are not required, or because the information required to be set forth therein is included in the consolidated financial statements or notes thereto.

(c)   Exhibits

        The Exhibit Index follows the signature pages hereof and is incorporated herein by reference.

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SIGNATURES

        Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this annual report to be signed on its behalf by the undersigned, thereunto duly authorized.

    RADIUS HEALTH, INC.

 

 

By:

 

/s/ ROBERT E. WARD

Robert E. Ward
President and Chief Executive Officer

Date: March 10, 2015


SIGNATURES AND POWER OF ATTORNEY

        Pursuant to the requirements of the Securities Exchange Act of 1934, this annual report has been signed by the following persons on behalf of the registrant in the capacities indicated.

Signature
 
Title
 
Date

 

 

 

 

 
/s/ ROBERT E. WARD

Robert E. Ward
  Chief Executive Officer and Director (Principal Executive Officer)   March 10, 2015

/s/ B. NICHOLAS HARVEY

B. Nicholas Harvey

 

Chief Financial Officer (Principal Accounting and Financial Officer)

 

March 10, 2015

/s/ ALAN H. AUERBACH

Alan H. Auerbach

 

Director

 

March 10, 2015

/s/ WILLARD H. DERE

Willard H. Dere

 

Director

 

March 10, 2015

/s/ ANSBERT K. GADICKE

Ansbert K. Gadicke

 

Director

 

March 10, 2015

/s/ KURT C. GRAVES

Kurt C. Graves

 

Director

 

March 10, 2015

/s/ OWEN HUGHES

Owen Hughes

 

Director

 

March 10, 2015

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Signature
 
Title
 
Date

 

 

 

 

 
/s/ MARTIN MÜNCHBACH

Martin Münchbach
  Director   March 10, 2015

/s/ ANTHONY ROSENBERG

Anthony Rosenberg

 

Director

 

March 10, 2015

/s/ ELIZABETH STONER

Elizabeth Stoner

 

Director

 

March 10, 2015

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EXHIBIT INDEX

Exhibit Number   Exhibit Description   Form   File No.   Exhibit   Filing Date   Filed/
Furnished
Herewith
  3.1   Restated Certificate of Incorporation, filed on June 11, 2014   8-K   001-35726   3.1   6/13/14    
                            
  3.2   Amended and Restated By-Laws   8-K   001-35726   3.2   6/13/14    
                            
  4.1   Fifth Amended and Restated Stockholders' Agreement, dated April 24, 2014, by and among the Company and the stockholders party thereto   S-1/A   333-194150   4.2   4/25/14    
                            
  10.1   Loan and Security Agreement, dated May 30, 2014, by and among the Company, Solar Capital Ltd. and Oxford Finance LLC   8-K   001-35726   10.1   6/2/14    
                            
  10.1(a ) First Amendment to Loan and Security Agreement, dated July 10, 2014, by and among Radius Health, Inc., Solar Capital Ltd., and Oxford Finance LLC   8-K   001-35726   10.3   7/11/14    
                            
  10.2   Form of Warrant to Purchase Shares of Common Stock in connection with the Series B Convertible Preferred Stock and Warrant Purchase Agreement, issued by the Company to certain investors and attached schedule with details   8-K   001-35726   10.2   4/25/13    
                            
  10.3   Form of Warrant to Purchase Shares of Common Stock in connection with the Series B-2 Convertible Preferred Stock and Warrant Purchase Agreement, issued by the Company to certain investors and attached schedule with details   8-K   001-35726   10.2   2/21/14    
                            
  10.4   Form of Warrant to Purchase Series A-1 Convertible Preferred Stock, issued by the Company, as successor to Radius Health, Inc., and Leerink Swann LLC                   *
                            
  10.5   Form of Warrant to Purchase Shares of Series A-1 Convertible Preferred Stock issued by the Company to GE Capital Equity Investments and Oxford Finance LLC                   *
                            
  10.6   Warrant to Purchase Stock, dated May 30, 2014, issued by the Company to Oxford Finance LLC   8-K   001-35726   10.2   6/2/14    
                            
  10.7   Warrant to Purchase Stock, dated May 30, 2014, issued by the Company to Oxford Finance LLC   8-K   001-35726   10.3   6/2/14    
 
                       

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Exhibit Number   Exhibit Description   Form   File No.   Exhibit   Filing Date   Filed/
Furnished
Herewith
  10.8   Warrant to Purchase Stock, dated July 10, 2014, issued by the Company to Oxford Finance LLC   8-K   001-35726   10.2   7/11/14    
                            
  10.9   Warrant to Purchase Stock, dated July, 10, 2014, issued by the Company to Solar Capital Ltd.   8-K   001-35726   10.1   7/11/14    
                            
  10.10 ^ Clinical Trial Services Agreement, dated March 29, 2011, by and between the Company, as successor to Radius Health, Inc., and Nordic BioScience Clinical Development VII A/S   8-K/A   000-53173   10.1   10/24/11    
                            
  10.11 ^ Work Statement NB-1, dated March 29, 2011, by and between the Company and Nordic Bioscience Clinical Development VII A/S, as amended on December 9, 2011, June 18, 2012, November 6, 2013, March 28, 2014, May 19, 2014 and July 22, 2014                   *
                            
  10.12 ^ Work Statement NB-2, dated February 21, 2013, by and between the Company and Nordic Bioscience Clinical Development VII/AS, as amended on November 6, 2013                   *
                            
  10.13 ^ Work Statement NB-3, dated February 21, 2013, by and between the Company and Nordic Bioscience Clinical Development VII/AS, as amended on February 28, 2014                   *
                            
  10.14   Amended and Restated Stock Issuance Agreement, dated May 16, 2011, by and between the Company, as successor to Radius Health, Inc., and Nordic BioScience Clinical Development VII A/S, as amended on February 21, 2013, March 28, 2014 and May 19, 2014                   *
                            
  10.15 ^ License Agreement, dated September 27, 2005, by and between the Company, as successor to Nuvios, Inc., and Ipsen Pharma SAS (f/k/a SCRAS S.A.S.) on behalf of itself and its affiliates, as amended on September 12, 2007 and May 11, 2011                   *
 
                       

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Exhibit Number   Exhibit Description   Form   File No.   Exhibit   Filing Date   Filed/
Furnished
Herewith
  10.16 ^ Pharmaceutical Development Agreement, dated January 2, 2006, by and between the Company, as successor to Radius Health, Inc., and Beaufour Ipsen Industrie SAS, as amended on January 1, 2007, January 1, 2009, June 16, 2010 and January 2, 2011                   *
                            
  10.17 ^ Development and Manufacturing Services Agreement, dated October 16, 2007, by and between the Company, as successor to Radius Health, Inc., and LONZA Sales Ltd., as amended on May 19, 2011 and January 30, 2014, and Work Orders thereunder through March 9, 2015                   *
                            
  10.18 ^ Development and Clinical Supplies Agreement, dated June 19, 2009, by and among the Company, as successor to Radius Health, Inc., and 3M Co. and 3M Innovative Properties Co., as amended on December 31, 2009, September 16, 2010, September 29, 2010, March 2, 2011 and November 30, 2012 and Change Order Forms thereunder through March 9, 2015                   *
                            
  10.19 ^ License Agreement, dated June 29, 2006, by and between the Company, as successor to Radius Health, Inc., and Eisai Co., Ltd.   8-K/A   000-53173   10.25   10/24/11    
                            
  10.20 Radius Health, Inc. (f/k/a Nuvios, Inc.) 2003 Long-Term Incentive Plan, assumed in the Merger (As Amended)                   *
                            
  10.21 Radius Health, Inc. (f/k/a Nuvios, Inc.) 2003 Long-Term Incentive Plan Form of Stock Option Agreement   8-K   000-53173   10.32   5/23/11    
                            
  10.22 Radius Health, Inc. 2011 Equity Incentive Plan (As Amended)   S-1/A   333-194150   10.84   4/21/14    
                            
  10.23 Form of Radius Health, Inc. 2011 Equity Incentive Plan Stock Option Agreement   S-1/A   333-175091   10.83   11/7/11    
                            
  10.24 Radius Health, Inc. Non-Employee Director Compensation Program                   *
                            
  10.25 Employment Letter Agreement, November 14, 2003, by and between the Company, as successor to Nuvios, Inc., and Gary Hattersley   8-K   000-53173   10.49   5/23/11    
 
                       

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Exhibit Number   Exhibit Description   Form   File No.   Exhibit   Filing Date   Filed/
Furnished
Herewith
  10.26 Employment Letter Agreement, dated November 15, 2006, by and between the Company, as successor to Radius Health, Inc., and B. Nicholas Harvey   8-K   000-53173   10.51   5/23/11    
                            
  10.27 Executive Employment Agreement, dated as of December 12, 2013, by and between the Company and Robert Ward   8-K   001-35726   10.1   12/17/13    
                            
  10.28 Employment Letter Agreement, dated January 3, 2014, by and between the Company and Greg Williams   S-1/A   333-194150   10.141   4/3/14    
                            
  10.29 Employment Letter Agreement, dated February 21, 2014, by and between the Company and Alan Harris   S-1/A   333-194150   10.142   4/3/14    
                            
  10.30 Form of Indemnification Agreement by and between the Company and the individuals listed on Schedule A thereto                   *
                            
  10.31   Lease, dated May 14, 2014, by and between the Company and BP Bay Colony LLC   8-K   001-35726   10.1   5/20/14    
                            
  23.1   Consent of Ernst & Young LLP, Independent Registered Public Accounting Firm                   *
                            
  31.1   Rule 13a-14(a)/15d-14(a) Certification of Chief Executive Officer                   *
                            
  31.2   Rule 13a-14(a)/15d-14(a) Certification of Chief Financial Officer                   *
                            
  32.1   Section 1350 Certification of Chief Executive Officer                   **
                            
  32.2   Section 1350 Certification of Chief Financial Officer                   **
                            
  101.INS   XBRL Instance Document                   *
                            
  101.SCH   XBRL Taxonomy Extension Schema Document                   *
                            
  101.CAL   XBRL Taxonomy Extension Calculation Linkbase Document                   *
                            
  101.LAB   XBRL Taxonomy Extension Label Linkbase Document                   *
                            
  101.PRE   XBRL Taxonomy Extension Presentation Linkbase Document                   *
 
                       

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Exhibit Number   Exhibit Description   Form   File No.   Exhibit   Filing Date   Filed/
Furnished
Herewith
  101.DEF   XBRL Taxonomy Extension Definition Linkbase Document                   *

^
Confidential treatment has been granted with respect to redacted portions of this exhibit. Redacted portions of this exhibit have been filed separately with the SEC.

A management contract or compensatory plan or arrangement required to be filed as an exhibit pursuant to Item 15(a)(3) of Form 10-K.

*
Filed herewith.

**
Furnished herewith.

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Exhibit 10.4

 

THIS WARRANT AND THE SHARES ISSUABLE HEREUNDER HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR ANY STATE SECURITIES LAWS, AND MAY NOT BE SOLD, PLEDGED, OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT AND LAWS OR PURSUANT TO RULE 144 AND EXEMPTIONS UNDER APPLICABLE STATE SECURITIES LAWS, OR, SUBJECT TO SECTION 5.3 HEREOF, AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE COMPANY AND ITS COUNSEL, THAT SUCH REGISTRATION IS NOT REQUIRED.

 

WARRANT TO PURCHASE SERIES A-1 CONVERTIBLE PREFERRED STOCK

 

Issuer:  Radius Health, Inc.
Number of Shares:  
Class of Stock: Series A-1 Convertible Preferred Stock, par value $0.01 per share
Exercise Price:  $8.142 per share, subject to adjustment
Issue Date: 
Expiration Date:

 

FOR THE AGREED UPON VALUE of $1.00, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, this Warrant is issued to LEERINK SWANN LLC (together with its successors and permitted assigns, “ Holder ”) by RADIUS, INC., a Delaware corporation (the “ Company ”).

 

Subject to the terms and conditions hereinafter set forth, the Holder is entitled upon surrender of this Warrant and a duly executed Notice of Exercise in substantially the form attached hereto as Appendix 1 (the “ Notice of Exercise ”), at the principal office of the Company, 201 Broadway, 6 th  Floor, Cambridge, Massachusetts 02139, or such other office as the Company shall notify the Holder of in writing, to purchase from the Company up to                                    of fully paid and non-assessable shares (the “ Shares ”) of the Company’s Series A-1 Convertible Preferred Stock, $.01 par value per share (the “ Class ”), at a purchase price per Share of eight dollars and 142/100 ($8.142) (the “ Exercise Price ”).  Subject to the terms and conditions hereinafter set forth, this Warrant may be exercised in whole or in part at any time and from time to time until 5:00 PM, Eastern time, on the Expiration Date set forth above, and shall be void thereafter.  Until such time as this Warrant is exercised in full or expires, the Exercise Price and the number of Shares are subject to adjustment from time to time as hereinafter provided.  This Warrant is issued in connection with that certain letter agreement dated September 24, 2010 by and between the Company and the Holder (the “ Agreement ”).  Capitalized terms used and not otherwise defined herein shall have the respective meanings set forth in the Agreement.

 

Notwithstanding the foregoing definition of Class, upon and after the automatic or voluntary conversion, redemption or retirement of all (but not less than all) of the outstanding

 



 

shares of such Class, including without limitation the Company’s initial registered underwritten public offering and sale of its securities (“ IPO ”), then from and after the date upon which all such outstanding shares have been so converted, redeemed or retired, “Class” shall mean the Company’s common stock, $.01 par value per share (“ Common Stock ”), and this Warrant shall be exercisable for such number of shares of Common Stock as shall equal the number of shares of Common Stock into which the Shares would have been converted pursuant to the Company’s Amended and Restated Certificate of Incorporation, as amended from time to time, including without limitation the Certificate of Designation, if any, applicable to the same class or series of preferred stock as the Shares (the “ Certificate ”) had the Shares been issued and outstanding immediately prior to such conversion, redemption or retirement, and the Exercise Price shall be the Common Stock conversion price as determined pursuant to the Certificate immediately prior to such conversion, redemption or retirement (all subject to further adjustment as provided herein).

 

ARTICLE 1.  EXERCISE .

 

1.1          Method of Exercise .  The Holder may exercise this Warrant by delivering this Warrant together with a duly executed Notice of Exercise to the principal office of the Company.  Unless the Holder is exercising the conversion right set forth in Section 1.2 , the Holder shall also deliver to the Company a check for the aggregate Exercise Price for the Shares being purchased.

 

1.2          Conversion Right .  In lieu of exercising this Warrant as specified in Section 1.1 , the Holder may from time to time convert this Warrant, in whole or in part, into a number of Shares determined as follows:

 

X = Y (A-B)/A

 

where:

 

X = the number of Shares to be issued to the Holder.

 

Y = the number of Shares with respect to which this Warrant is being exercised.

 

A = the Fair Market Value (as determined pursuant to Section 1.3 below) of one Share.

 

B = the Exercise Price.

 

1.3          Fair Market Value .

 

1.3.1       If the Company’s Common Stock is traded in a public market on a nationally recognized securities exchange or over the counter market and the Shares are Common Stock, the fair market value of each Share shall be the closing price of a Share reported for the business day immediately preceding the date of Holder’s Notice of Exercise to the

 

2



 

Company (or in the instance where the Warrant is exercised immediately prior to the effectiveness of the Company’s initial public offering, the “price to public” per share price specified in the final prospectus relating to such offering).  If the Company’s Common Stock is traded in a public market on a nationally recognized securities exchange or over the counter market and the Shares are preferred stock, the fair market value of a Share shall be the closing price of a share of the Company’s Common Stock reported for the business day immediately preceding the date of Holder’s Notice of Exercise to the Company (or in the instance where the Warrant is exercised immediately prior to the effectiveness of the Company’s initial public offering, the initial “price to public” per share price specified in a final prospectus relating to such offering), in both cases, multiplied by the number of shares of the Company’s Common Stock into which a Share is convertible.

 

1.3.2       If shares of the Class (or shares of the Company’s stock into which shares of the Class are convertible or exchangeable) are not traded on a nationally recognized securities exchange or over the counter market, the Board of Directors of the Company shall determine fair market value in its reasonable good faith judgment.

 

1.4          Delivery of Certificate and New Warrant .  Promptly after Holder exercises or converts this Warrant, the Company at its sole expense shall promptly deliver to Holder (i) certificates for the Shares acquired upon such exercise, and (ii) if this Warrant has not been fully exercised or converted and has not expired, a new warrant of like tenor representing the Shares for which this Warrant is still exercisable.

 

1.5          Replacement of Warrants .  On receipt of evidence reasonably satisfactory to the Company of the loss, theft, destruction or mutilation of this Warrant and, in the case of loss, theft or destruction, on delivery of an indemnity agreement reasonably satisfactory in form and amount to the Company or, in the case of mutilation, on surrender and cancellation of this Warrant, the Company at its expense shall execute and deliver, in lieu of this Warrant, a new warrant of like tenor.

 

1.6          Assumption/Repurchase on Sale, Merger, or Consolidation of the Company .

 

1.6.1       “Acquisition” .  For the purpose of this Warrant, “Acquisition” means any sale, assignment, transfer, exclusive license, or other disposition of all or substantially all of the assets of the Company, or any acquisition, reorganization, consolidation, or merger of the Company where the holders of the Company’s outstanding voting equity securities immediately prior to the transaction (i) receive cash, stock, securities or other property in respect of or in exchange for such voting equity securities pursuant to any of the transactions referred to in the foregoing provisions of this Section 1.6.1 , and (ii) in the event that such transaction consists of any acquisition, reorganization, consolidation or merger of the Company, beneficially own less than a majority of the outstanding voting equity securities of the surviving or successor entity immediately following the transaction.

 

1.6.2       Assumption of Warrant .  Upon the closing of any Acquisition (other than an Acquisition in which the consideration received by the Company’s stockholders consists

 

3



 

solely of cash, debt securities or a combination of cash and debt securities), and as a condition precedent thereto, the successor or surviving entity shall assume the obligations of this Warrant, and this Warrant shall be exercisable for the same securities and property as would be payable for the Shares issuable upon exercise of the unexercised portion of this Warrant as if such Shares were outstanding on the record date for the Acquisition and subsequent closing.  The Exercise Price shall be adjusted accordingly, and the Exercise Price and number and class of Shares shall continue to be subject to adjustment from time to time in accordance with the provisions hereof.

 

1.6.3       Purchase Right .  Notwithstanding the foregoing, upon the closing of any Acquisition in which the consideration paid to the Company or stockholders is cash or cash equivalents, at the election of Holder, the Company shall purchase the unexercised portion of this Warrant for cash for an amount equal to (a) the fair market value of any consideration that would have been received by Holder in consideration for the Shares had Holder exercised the unexercised portion of this Warrant immediately before the record date for determining the shareholders entitled to participate in the proceeds of the Acquisition, less (b) the aggregate Exercise Price of the Shares, but in no event less than zero.

 

ARTICLE 2.  ADJUSTMENTS TO THE SHARES .

 

2.1          Dividends, Splits, Etc .   If the Company declares or pays a dividend on the outstanding shares of the Class, payable in Common Stock, other securities or any type of property, or subdivides the outstanding shares of the Class into a greater number of shares of the Class, or subdivides the shares of the Class in a transaction that increases the amount of Common Stock into which such shares are convertible, then upon exercise of this Warrant, for each Share acquired, Holder shall receive, without additional cost to Holder, the total number and kind of securities or property to which Holder would have been entitled had Holder owned the Shares of record as of the date the dividend or subdivision occurred.

 

2.2          Reclassification, Exchange or Substitution .  Upon any reclassification, exchange, substitution, reorganization or other event that results in a change of the number and/or class of the securities issuable upon exercise or conversion of this Warrant, Holder shall be entitled to receive, upon exercise or conversion of this Warrant, the number and kind of securities and property that Holder would have received for the Shares if this Warrant had been exercised immediately before such reclassification, exchange, substitution, reorganization or other event.  The Company or its successor shall promptly issue to Holder a new warrant of like tenor for such new securities or other property.  The new warrant shall provide for adjustments which shall be as nearly equivalent as may be practicable to the adjustments provided for in this Article 2 including, without limitation, adjustments to the Exercise Price and to the number of securities or property issuable upon exercise of the new warrant.  The provisions of this Section 2.2 shall similarly apply to successive reclassifications, exchanges, substitutions, reorganizations or other events.

 

2.3          Adjustments for Combinations, Etc .  If the outstanding shares of the Class are combined or consolidated, by reclassification or otherwise, into a lesser number of shares, the

 

4



 

Exercise Price shall be proportionately increased and the number of Shares issuable upon exercise or conversion of this Warrant shall be proportionately decreased.

 

2.4          No Impairment .  The Company shall not, by amendment of the Certificate or its by-laws or through a reorganization, transfer of assets, consolidation, merger, dissolution, issue, or sale of securities or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms to be observed or performed under this Warrant by the Company, but shall at all times in good faith assist in carrying out of all the provisions of this Article 2 and in taking all such action as may be necessary or appropriate to protect Holder’s rights under this Article against impairment.

 

2.5          Adjustments for Dilutive Issuances .  The Conversion Price (as defined in the Certificate) with respect to the Class is subject to adjustment for Dilutive Issuances (as defined in the Certificate) in accordance with Section 7(e)(i) of Part A of Article III of the Certificate.

 

2.6          Fractional Shares .  No fractional Shares shall be issuable upon exercise or conversion of the Warrant and the number of Shares to be issued shall be rounded down to the nearest whole Share.  If a fractional Share interest arises upon any exercise or conversion of this Warrant, the Company shall eliminate such fractional Share interest by paying Holder an amount computed by multiplying such fractional interest by the Fair Market Value (determined in accordance with Section 1.3 above) of one Share.

 

2.7          Certificate as to Adjustments .  Upon each adjustment of the Exercise Price, number or class of Shares or number of shares of Common Stock or other securities for which the Shares are convertible or exchangeable, the Company at its expense shall promptly compute such adjustment, and furnish Holder with a certificate of its chief financial officer setting forth such adjustment and the facts upon which such adjustment is based.  The Company shall at any time and from time to time, upon written request, furnish Holder with a certificate setting forth the Exercise Price, number and class of Shares and conversion ratio in effect upon the date thereof and the series of adjustments leading to such Exercise Price, number and class of Shares and conversion ratio.

 

ARTICLE 3.  COVENANTS OF THE COMPANY .

 

3.1          Notice of Certain Events .  If the Company proposes at any time (a) to declare any dividend or distribution upon any of its capital stock, whether in cash, property, stock, or other securities and whether or not a regular cash dividend; (b) to offer for subscription pro rata to the holders of any class or series of its stock any additional shares of stock of any class or series or other rights; (c) to effect any reclassification or recapitalization of any of its securities; (d) to merge or consolidate with or into any other corporation, or sell, lease, license, or convey all or substantially all of its assets, or to liquidate, dissolve or wind up; or (e) offer holders of registration rights the opportunity to participate in an underwritten public offering of the Company’s securities for cash, then, in connection with each such event, the Company shall give Holder (1) at least 20 days prior written notice of the date on which a record will be taken for such dividend, distribution, or subscription rights (and specifying the date on which the holders

 

5



 

of securities of the Company shall be entitled to receive such dividend, distribution or rights) or for determining rights to vote, if any, in respect of the matters referred to in (c) and (d) above; (2) in the case of the matters referred to in (c) and (d) above at least 20 days prior written notice of the date when the same will take place (and specifying the date on which the holders of securities of the Company will be entitled to exchange their securities of the Company for securities or other property deliverable upon the occurrence of such event); and (3) in the case of the matter referred to in (e) above, the same notice as is given to the holders of such registration rights.

 

ARTICLE 4.  REPRESENTATIONS OF THE COMPANY

 

4.1          Purchase for Investment .  The Holder represents and warrants that it is acquiring the Warrant, and upon exercise will hold the Shares, solely for its account for investment and not with a view to or for sale or distribution of said Warrant or Shares in violation of the Securities Act.  The Holder also represents that the entire legal and beneficial interests of the Warrant and Shares the Holder is acquiring is being acquired for, and will be held for, its account only.

 

4.2          Securities Not Registered .  The Holder understands that the Warrant has not been registered under the Securities Act on the basis that no distribution or public offering of the stock of the Company is to be effected.  The Holder realizes that the basis for the exemption may not be present if, notwithstanding its representations, it has in mind merely acquiring the securities for a fixed or determinable period in the future, or for a market rise, or for sale if the market does not rise.  The Holder has no such intention.

 

4.3          Securities to be Held Indefinitely .  The Holder recognizes that the Warrant and Shares being acquired by it must be held indefinitely unless they are subsequently registered under the Securities Act or an exemption from such registration is available.  The Holder recognizes that except as expressly set forth herein, the Company has no obligation to register the Warrant or to comply with any exemption from such registration.

 

4.4          Rule 144 .  The Holder is aware that neither the Warrant nor the Shares may be sold pursuant to Rule 144 adopted under the Securities Act unless certain conditions are met and until the Holder has held the Shares for at least one year.

 

ARTICLE 5.  MISCELLANEOUS .

 

5.1          Automatic Conversion upon Expiration .  In the event that, upon the Expiration Date, the Fair Market Value of one Share (or other security issuable upon the exercise hereof) as determined in accordance with Section 1.3 above is greater than the Exercise Price in effect on such date, then this Warrant shall automatically be deemed on and as of such date to be converted pursuant to Section 1.2 above as to all Shares (or such other securities) for which it shall not previously have been exercised or converted, and the Company shall promptly deliver a certificate representing the Shares (or such other securities) issued upon such conversion to the Holder.

 

6



 

5.2          Legends .  This Warrant and the Shares (and the securities issuable, directly or indirectly, upon conversion of the Shares, if any) shall be imprinted with a legend in substantially the following form:

 

THIS SECURITY HAS NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED, OR ANY STATE SECURITIES LAWS, AND MAY NOT BE SOLD, PLEDGED OR OTHERWISE TRANSFERRED WITHOUT AN EFFECTIVE REGISTRATION THEREOF UNDER SUCH ACT AND LAWS OR PURSUANT TO RULE 144 AND EXEMPTIONS UNDER APPLICABLE STATE SECURITIES LAW, OR, SUBJECT TO SECTION 5.3 OF THAT CERTAIN WARRANT TO PURCHASE STOCK ISSUED BY THE COMPANY TO LEERINK SWAN LLC DATED AS OF MAY 17, 2011, AN OPINION OF COUNSEL REASONABLY SATISFACTORY TO THE COMPANY AND ITS COUNSEL THAT SUCH REGISTRATION IS NOT REQUIRED.

 

5.3          Compliance with Securities Laws on Transfer .  This Warrant and the Shares (and the securities, if any, issued and issuable, upon conversion of the Shares, if any) may not be transferred or assigned in whole or in part without compliance with applicable federal and state securities laws by the transferor and the transferee (including, without limitation, the delivery of investment representation letters and legal opinions reasonably satisfactory to the Company, as reasonably requested by the Company).  The Company shall not require Holder to provide an opinion of counsel if the transfer is to an affiliate of Holder, or if (a) there is no material question as to the availability of current information as referenced in Rule 144(c), (b) Holder represents that it has complied with Rule 144(d) and (e) in reasonable detail, (c) the selling broker represents that it has complied with Rule 144(f), and (d) the Company is provided with a copy of Holder’s notice of proposed sale.

 

5.4          Transfer Procedure .  Following its receipt of this executed Warrant, Holder may, subject to Section 5.3 above, transfer all or part of this Warrant and/or the Shares (or the securities, if any, issued and issuable upon conversion of the Shares) at any time and from time to time by giving the Company notice of the portion of the Warrant and/or Shares (or the securities, if any, issued and issuable upon conversion of the Shares) being transferred setting forth the name, address and taxpayer identification number of the transferee and surrendering this Warrant to the Company for reissuance to the transferee(s) (and Holder if applicable); provided , that at all times prior to the Company’s IPO, Holder shall not, without the prior written consent of the Company, transfer this Warrant (or any part hereof), any Shares, or any securities issued or issuable upon conversion of the Shares, to any person who directly competes with the Company, unless such transfer is in connection with an Acquisition of the Company by any such person or the stock of the transferee is publicly traded.

 

5.5          Effect of Violation of Transfer Restrictions; Preventive Measures .  Any offer, sale, assignment, transfer, endorsement, pledge, mortgage, hypothecation, or other conveyance or disposition of all or any portion of this Warrant or any Shares issued from time to time upon

 

7



 

exercise of this Warrant, or of any interest in this Warrant or any of such Shares, in violation of this Section 5 shall be null and void.  The Company may make a notation on its records or give instructions to any of its transfer agents in order to implement the restrictions on transfer set forth in this Section 5 .

 

5.6          Warrant Binding Upon Assignee or Successor .  The terms and conditions of this Warrant shall be binding upon any permitted assignee and successor of the Holder.  Any such successor or assignee shall be obligated to and shall immediately execute an instrument which provides that such party is bound under the terms of this Warrant.  Any transfer, assignment or other disposition without such execution by the proposed transferee, assignee or successor shall be null and void.

 

5.7          No Rights as Stockholder .  The Holder shall not be entitled to vote or to receive dividends or to be deemed the holder of shares of the Company’s capital stock that may at any time be issuable upon exercise of this Warrant for any purpose whatsoever, nor shall anything contained herein be construed to confer upon the Holder any of the rights of a stockholder of the Company or any right to vote for the election of directors or upon any matter submitted to stockholders at any meeting thereof, or to give or withhold consent to any corporate action (whether upon any recapitalization, issuance or reclassification of stock, change of par value or change of stock to no par value, consolidation, merger or conveyance or otherwise), or to receive notice of meetings, or to receive dividends or subscription rights, until the Holder shall have exercised the Warrant and shall have been issued Shares in accordance with the provisions hereof.

 

5.8          Notices .  All notices and other communications from the Company to the Holder, or vice versa, shall be deemed delivered and effective when given personally, or mailed by first-class registered or certified mail, postage prepaid, or sent via reputable overnight courier service, fee prepaid, at such address as may have been furnished to the Company or the Holder, as the case may be, in writing by the Company or such holder from time to time, but in all cases, unless instructed in writing otherwise, the Company shall deliver a copy of all notices to Holder to Leerink Swann LLC, One Federal Street, 37th Floor, Boston, Massachusetts 02110, Attention Donald D. Notman, Jr.

 

5.9          Waiver .  This Warrant and any term hereof may be changed, waived, discharged or terminated only by an instrument in writing signed by the party against which enforcement of such change, waiver, discharge or termination is sought.

 

5.10        Attorneys Fees .  In the event of any dispute between the parties concerning the terms and provisions of this Warrant, the party prevailing in such dispute shall be entitled to collect from the other party all costs incurred in such dispute, including reasonable attorneys’ fees.

 

5.11        Survival of Representations, Warranties and Agreements .  All representations and warranties of the Company contained herein shall survive the date of this Warrant, the exercise or conversion of this Warrant (or any part hereof) and/or the termination or expiration of rights

 

8



 

hereunder.  All agreements of the Company contained herein shall survive indefinitely until, by their respective terms, they are no longer operative.  The obligations of the Holder (and/or of any transferee of the Warrant or any Shares issued from time to time upon exercise of this Warrant) shall, with respect to any Shares issued upon exercise of this Warrant, survive the exercise, expiration or other termination, or transfer, of this Warrant indefinitely.

 

5.12        Counterparts .  This Warrant may be executed in counterparts, all of which together shall constitute one and the same agreement.

 

5.13        Governing Law .  This Warrant shall be governed by and construed in accordance with the laws of The Commonwealth of Massachusetts, without giving effect to its principles regarding conflicts of law.

 

[REMAINDER OF PAGE LEFT BLANK INTENTIONALLY]

 

9



 

IN WITNESS WHEREOF, the Company has caused this Warrant to Purchase Series A-1 Convertible Preferred Stock to be executed as an instrument under seal by its duly authorized representative as of the date first above written.

 

 

“COMPANY”

 

 

 

RADIUS HEALTH, INC.

 

 

 

 

 

By:

 

 

 

 

Name:

 

 

 

 

Title:

 

 

S-1



 

APPENDIX 1

 

NOTICE OF EXERCISE

 

1.             The undersigned hereby elects to purchase               shares of the                          stock of                                      pursuant to Section 1.1 of the attached Warrant, and tenders herewith payment of the Exercise Price of such shares in full.

 

1.             The undersigned hereby elects to convert the attached Warrant into Shares in the manner specified in Section 1.2 of the attached Warrant.  This conversion is exercised with respect to                          of shares of the                                                  Stock of                                       .

 

[Strike paragraph that does not apply.]

 

2.             Please issue a certificate or certificates representing said Shares in the name of the undersigned or in such other name as is specified below:

 

 

 

 

 

(Name)

 

 

 

 

 

 

 

 

 

 

 

(Address)

 

 

3.             The undersigned represents it is acquiring the Shares solely for its own account and not as a nominee for any other party and not with a view toward the resale or distribution thereof except in compliance with applicable securities laws.

 

 

 

 

 

 

(Signature)

 

 

 

 

(Date)

 

 




Exhibit 10.5

 

Execution Version

 

NEITHER THIS WARRANT NOR THE SECURITIES ISSUABLE UPON EXERCISE OF THIS WARRANT HAVE BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED.  SUBJECT TO SECTION 6 BELOW, NO SALE OR DISPOSITION MAY BE EFFECTED EXCEPT IN COMPLIANCE WITH RULE 144 UNDER SAID ACT OR WITHOUT AN EFFECTIVE REGISTRATION STATEMENT RELATED THERETO OR AN OPINION OF COUNSEL FOR HOLDER, SATISFACTORY TO COMPANY, THAT SUCH REGISTRATION IS NOT REQUIRED UNDER THE ACT OR RECEIPT OF A NO-ACTION LETTER FROM THE SECURITIES AND EXCHANGE COMMISSION.

 

WARRANT TO PURCHASE SHARES OF SERIES A-1 CONVERTIBLE PREFERRED STOCK

 

 

THIS CERTIFIES THAT , for value received,                                                            (“Holder”) is entitled to subscribe for and purchase up to such number of fully paid and nonassessable shares of Series A-1 Convertible Preferred Stock of Radius Health, Inc., a Delaware corporation (the “Company”), as is equal to the Warrant Share Amount  (as hereinafter defined) at the Warrant Price (as hereinafter defined), subject to the provisions and upon the terms and conditions hereinafter set forth.  As used herein, the term “Preferred Stock” shall mean Company’s presently authorized Series A-1 Convertible Preferred Stock, $0.01 par value per share, and/or any stock into which such Preferred Stock may hereafter be converted or exchanged pursuant to Section 7 hereof or otherwise, and the term “Warrant Shares” shall mean the shares of Preferred Stock which Holder may acquire pursuant to this Warrant and/or any other shares of stock into which such shares of Preferred Stock may hereafter be converted or exchanged pursuant to Section 7 hereof or otherwise.

 

1.             Warrant Share Amount and Warrant Price .  The “Warrant Share Amount” means such whole number (with any fractions rounded down) as is equal to the quotient of (a) the product of (i) the Initial Term Loan (as defined in the Loan and Security Agreement dated May 23, 2011 among General Electric Capital Corporation (“GECC”), the Lenders (as defined therein), and the Company (the “Loan Agreement”)) made pursuant to the terms of the Loan Agreement, multiplied by (ii) four percent (4%), multiplied by (iii) 0.5, divided by (b) the Warrant Price.  The “Warrant Price” shall initially be $81.42 per share, subject to adjustment as provided in Section 7 below.

 

2.             Conditions to Exercise .  The purchase right represented by this Warrant may be exercised at any time, or from time to time, in whole or in part during the term commencing on the date hereof and ending at 5:00 P.M. Pacific time on the tenth anniversary of the date of this Warrant (the “Expiration Date”).

 

3.             Method of Exercise or Conversion; Payment; Issuance of Shares; Issuance of New Warrant.

 

(a)           Cash Exercise .  Subject to Section 2 hereof, the purchase right represented by this Warrant may be exercised by Holder hereof, in whole or in part, by the surrender of the original of this Warrant (together with a duly executed Notice of Exercise in substantially the form attached hereto) at the principal office of Company (as set forth in Section 18 below) and by payment to Company, by certified or bank check, or wire transfer of immediately available funds, of an amount equal to the then applicable Warrant Price multiplied by the number of Warrant Shares then being purchased.  In the event of any exercise of the rights represented by this Warrant, certificates for the shares of stock so purchased shall be in the name of, and delivered to, Holder hereof, or as such Holder may direct

 



 

(subject to the terms of transfer contained herein and upon payment by such Holder hereof of any applicable transfer taxes).  Such delivery shall be made within 30 days after exercise of this Warrant and at Company’s expense and, unless this Warrant has been fully exercised or expired, a new Warrant having terms and conditions substantially identical to this Warrant and representing the portion of the Warrant Shares, if any, with respect to which this Warrant shall not have been exercised, shall also be issued to Holder hereof within 30 days after exercise of this Warrant.

 

(b)           Conversion .   In lieu of exercising this Warrant as specified in Section 3(a), Holder may from time to time convert this Warrant, in whole or in part, into Warrant Shares by surrender of the original of this Warrant (together with a duly executed Notice of Exercise in substantially the form attached hereto) at the principal office of Company, in which event Company shall issue to Holder the number of Warrant Shares computed using the following formula:

 

X = Y (A-B)

A

 

Where:

 

X = the number of Warrant Shares to be issued to Holder.

 

Y = the number of Warrant Shares purchasable under this Warrant (at the date of such calculation).

 

A = the Fair Market Value of one share of Company’s Preferred Stock (at the date of such calculation).

 

B = Warrant Price (as adjusted to the date of such calculation).

 

(c)           Fair Market Value .  For purposes of this Section 3, Fair Market Value of one share of Company’s Preferred Stock shall mean:

 

(i)            In the event of an exercise concurrently with the closing of an initial public offering of the Company’s common stock (“Common Stock”), the per share Fair Market Value for the Preferred Stock shall be the offering price at which the underwriters initially sell Common Stock to the public multiplied by the number of shares of Common Stock into which each share of Preferred Stock is then convertible, provided , however , that if, at the time of the closing of such initial public offering, this Warrant is then exercisable for Common Stock by virtue of any adjustment or adjustments pursuant to Section 7 hereof or otherwise, whether such adjustment or adjustments have occurred prior to such initial public offering or are occurring concurrently with such initial public offering, then, solely for purposes of this Section 3(c)(i), the per share Fair Market Value for such Common Stock shall be the offering price at which the underwriters initially sell Common Stock to the public; or

 

(ii)           The average of the closing bid and asked prices of Common Stock quoted in the Over-The-Counter Market Summary, the last reported sale price quoted on the Nasdaq Stock Market or on any other exchange on which the Common Stock is listed, whichever is applicable, as published in the Western Edition of the Wall Street Journal for the three (3) trading days prior to the date of determination of Fair Market Value, multiplied by the number of shares of Common Stock into which each share of Preferred Stock is then convertible, provided , however , that if, at the time of any determination of Fair Market Value under this Section 3(c)(ii), this Warrant is then exercisable for Common Stock by virtue of any adjustment or adjustments pursuant to Section 7 hereof or otherwise, whether such adjustment or adjustments have occurred prior to such determination or are occurring concurrently with such determination, then, solely for purposes of this Section 3(c)(ii), the per share Fair Market

 



 

Value for such Common Stock shall be the average of the closing bid and asked prices of Common Stock quoted in the Over-The-Counter Market Summary, the last reported sale price quoted on the Nasdaq Stock Market or on any other exchange on which the Common Stock is listed, whichever is applicable, as published in the Western Edition of the Wall Street Journal for the three (3) trading days prior to the date of any such determination of Fair Market Value; or

 

(iii)          In the event of an exercise in connection with a merger, acquisition or other consolidation in which Company is not the surviving entity, the per share Fair Market Value for the Preferred Stock shall be the value to be received per share of Preferred Stock by all holders of the Preferred Stock in such transaction as determined in the reasonable good faith judgment of Company’s Board of Directors; or

 

(iv)          In any other instance, the per share Fair Market Value for the Preferred Stock shall be as determined in the reasonable good faith judgment of Company’s Board of Directors.

 

In the event of 3(c)(iii) or 3(c)(iv), above, Company’s Board of Directors shall prepare a certificate, to be signed by an authorized officer of Company, setting forth in reasonable detail the basis for and method of determination of the per share Fair Market Value of the Preferred Stock.  The Board of Directors will also certify to Holder that this per share Fair Market Value will be applicable to all holders of Company’s Preferred Stock.  Such certification must be made to Holder at least ten (10) business days prior to the proposed effective date of the merger, consolidation, sale, or other triggering event as defined in 3(c)(iii) or 3(c)(iv).

 

(d)           Automatic Exercise .  To the extent this Warrant is not previously exercised, it shall be deemed to have been automatically converted in accordance with Sections 3(b) and 3(c) hereof (even if not surrendered) as of immediately before its expiration, involuntary termination or cancellation if the then-Fair Market Value of a Warrant Share exceeds the then-Warrant Price, unless Holder notifies Company in writing to the contrary prior to such automatic exercise.

 

(e)           Treatment of Warrant Upon Acquisition of Company .

 

(i)            Certain Definitions .  For the purpose of this Warrant: “Acquisition” means any sale, assignment, or other disposition of all or substantially all of the assets of Company, or any reorganization, consolidation, or merger of Company, or sale of outstanding Company securities by holders thereof, where the holders of Company’s securities as of immediately before the transaction beneficially own less than a majority of the outstanding voting securities of the successor or surviving entity as of immediately after such transaction or, if such Company shareholders beneficially own a majority of the outstanding voting securities of the successor or surviving entity as of immediately after the transaction, such successor or surviving entity is not the Company; and “Marketable Securities” means securities meeting all of the following requirements: (i) the issuer thereof is then subject to the reporting requirements of Section 13 or Section 15(d) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and is then current in its filing of all required reports and other information under the Act and the Exchange Act; (ii) the class and series of shares or other security of the issuer that would be received by Holder in connection with the Acquisition were Holder to exercise or convert this Warrant on or prior to the closing thereof is then traded on a national securities exchange or over-the-counter market, and (iii) Holder would not be restricted by contract or by applicable federal and state securities laws from  publicly re-selling, within six (6) months and one day following the closing of such Acquisition, all of the issuer’s shares and/or other securities that would be received by Holder

 



 

in such Acquisition were Holder to exercise or convert this Warrant in full on or prior to the closing of such Acquisition.

 

 

(ii)           Acquisition for Cash and/or Marketable Securities .  Holder agrees that, in the event of an Acquisition in which the sole consideration is cash and/or Marketable Securities, this Warrant shall terminate on and as of the closing of such Acquisition to the extent not previously exercised.  The Company shall provide Holder with written notice of any proposed Acquisition not later than ten (10) business days prior to the closing thereof setting forth the material terms and conditions thereof, and shall provide Holder with copies of the draft transaction agreements and other documents in connection therewith and with such other information respecting such proposed Acquisition as may reasonably be requested by Holder.

 

(iii)          Assumption of Warrant .  Upon the closing of any Acquisition other than as particularly described in subsection 3(e)(ii) above, the Company shall cause the surviving or successor entity to assume this Warrant and the obligations of the Company hereunder, and this Warrant shall, from and after such closing, be exercisable for the same class, number and kind of securities, cash and other property as would have been paid for or in respect of the shares issuable (as of immediately prior to such closing) upon exercise in full hereof as if such shares had been issued and outstanding on and as of such closing, at an aggregate Warrant Price equal to the aggregate Warrant Price in effect as of immediately prior to such closing; and subject to further adjustment thereafter from time to time in accordance with the provisions of this Warrant.

 

4.             Representations and Warranties of Holder and Company.

 

(a)           Representations and Warranties by Holder .  Holder represents and warrants to Company with respect to this purchase as follows:

 

(i)            Evaluation .  Holder has substantial experience in evaluating and investing in private placement transactions of securities of companies similar to Company so that Holder is capable of evaluating the merits and risks of its investment in Company and has the capacity to protect its interests.

 

(ii)           Resale .  Except for transfers to an affiliate of Holder, Holder is acquiring this Warrant and the Warrant Shares issuable upon exercise of this Warrant (collectively the “Securities”) for investment for its own account and not with a view to, or for resale in connection with, any distribution thereof.  Holder understands that the Securities have not been registered under the Securities Act of 1933, as amended (the “Act”) by reason of a specific exemption from the registration provisions of the Act which depends upon, among other things, the bona fide nature of the investment intent as expressed herein.

 

(iii)          Rule 144 .  Holder acknowledges that the Securities must be held indefinitely unless subsequently registered under the Act or an exemption from such registration is available.  Holder is aware of the provisions of Rule 144 promulgated under the Act.

 

(iv)          Accredited Investor .  Holder is an “accredited investor” within the meaning of Regulation D promulgated under the Act.

 

(v)           Opportunity To Discuss .  Holder has had an opportunity to discuss Company’s business, management and financial affairs with its management and an opportunity to review Company’s facilities.  Holder understands that such discussions, as well as the written information issued by Company, were intended to describe the aspects of Company’s business

 



 

and prospects which Company believes to be material but were not necessarily a thorough or exhaustive description.

 

(b)           Representations and Warranties by Company .   Company hereby represents and warrants to Holder that the statements in the following paragraphs of this Section 4(b) are true and correct (a) as of the date hereof and (b) except where any such representation and warranty relates specifically to an earlier date, as of the date of any exercise of this Warrant.

 

(i)            Corporate Organization and Authority .  Company (a) is a corporation duly organized, validly existing, and in good standing in its jurisdiction of incorporation, (b) has the corporate power and authority to own and operate its properties and to carry on its business as now conducted and as proposed to be conducted; and (c) is qualified as a foreign corporation in all jurisdictions where such qualification is required, except where the failure to be so qualified as a foreign corporation would not have a material adverse effect on the Company.

 

(ii)           Corporate Power .  Company has all requisite legal and corporate power and authority to execute, issue and deliver this Warrant, to issue the Warrant Shares issuable upon exercise or conversion of this Warrant, and to carry out and perform its obligations under this Warrant and any related agreements.

 

(iii)          Authorization; Enforceability .  All corporate action on the part of Company, its officers, directors and shareholders necessary for the authorization, execution, delivery and performance of its obligations under this Warrant and for the authorization, issuance and delivery of this Warrant and the Warrant Shares issuable upon exercise of this Warrant has been taken and this Warrant constitutes the legally binding and valid obligation of Company enforceable in accordance with its terms.

 

(iv)          Valid Issuance of Warrant and Warrant Shares .  This Warrant has been validly issued and is free of restrictions on transfer other than restrictions on transfer set forth herein and under applicable state and federal securities laws. The Warrant Shares issuable upon conversion of this Warrant, when issued, sold and delivered in accordance with the terms of this Warrant for the consideration expressed herein, will be duly and validly issued, fully paid and nonassessable, and will be free of restrictions on transfer other than restrictions on transfer under this Warrant and under applicable state and federal securities laws.  Subject to applicable restrictions on transfer, the issuance and delivery of this Warrant and the Warrant Shares issuable upon exercise or conversion of this Warrant are not subject to any preemptive or other similar rights or any liens or encumbrances except as specifically set forth in Company’s Certificate of Incorporation or this Warrant.  The offer, sale and issuance of the Warrant Shares, as contemplated by this Warrant, are exempt from the prospectus and registration requirements of applicable United States federal and state security laws, and neither Company nor any authorized agent acting on its behalf has or will take any action hereafter that would cause the loss of such exemption.

 

(v)           No Conflict.   The execution, delivery, and performance of this Warrant will not result in (a) any violation of, be in conflict with, or constitute a default under, with or without the passage of time or the giving of notice (1) any provision of Company’s Certificate of Incorporation or by-laws; (2) any provision of any judgment, decree, or order to which Company is a party, by which it is bound, or to which any of its material assets are subject; (3) any contract, obligation, or commitment to which Company is a party or by which it is bound; or (4) any statute, rule, or governmental regulation applicable to Company, or (b) the creation of any lien, charge or encumbrance upon any assets of Company.

 


 

(vi)          Capitalization .  The capitalization table of Company attached hereto as Annex A is complete and accurate as of the date hereof (after giving effect to the issuance of this Warrant) and reflects (a) all outstanding capital stock of Company and (b) all outstanding warrants, options, conversion privileges, preemptive rights or other rights or agreements to purchase or otherwise acquire or issue any equity securities or convertible securities of Company.  Company has reserved 1535 shares of Common Stock for issuance upon conversion of the Preferred Stock.

 

(vii)         Warrant Price .  As of the date hereof, the Warrant Price is no greater than the lowest price (as adjusted to reflect stock splits, stock combinations and like occurrences) at which Company has issued Series A-1 Convertible Preferred Stock.  The Warrant Price is, and will be, no greater than the lowest price (as adjusted to reflect stock splits, stock combinations and like occurrences) at which the Company issues Series A-1 Convertible Preferred Stock pursuant to that certain Series A-1 Convertible Stock Purchase Agreement, dated April 25, 2011, by and among the Company and the persons listed on Schedule I thereto, as amended from time to time.

 

5.              Legends .

 

(a)           Legend .  Each certificate representing the Warrant Shares shall be endorsed with substantially the following legend:

 

THESE SECURITIES HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933 AND MAY NOT BE TRANSFERRED (UNLESS SUCH TRANSFER IS TO AN AFFILIATE OF HOLDER) UNLESS COVERED BY AN EFFECTIVE REGISTRATION STATEMENT UNDER SAID ACT, A “NO ACTION” LETTER FROM THE SECURITIES AND EXCHANGE COMMISSION WITH RESPECT TO SUCH TRANSFER, A TRANSFER MEETING THE REQUIREMENTS OF RULE 144 OF THE SECURITIES AND EXCHANGE COMMISSION, OR (IF REASONABLY REQUIRED BY COMPANY) AN OPINION OF COUNSEL SATISFACTORY TO THE ISSUER TO THE EFFECT THAT ANY SUCH TRANSFER IS EXEMPT FROM SUCH REGISTRATION.

 

Company need not enter into its stock records a transfer of Warrant Shares unless the conditions specified in the foregoing legend are satisfied.  Company may also instruct its transfer agent not to allow the transfer of any of the Warrant Shares unless the conditions specified in the foregoing legend are satisfied.

 

(b)           Removal of Legend and Transfer Restrictions .  The legend relating to the Act endorsed on a certificate pursuant to paragraph 5(a) of this Warrant shall be removed and Company shall issue a certificate without such legend to Holder if (i) the Securities are issued by the Company pursuant to a registration statement filed under the Act and a prospectus meeting the requirements of Section 10 of the Act is available or (ii) Holder provides to Company an opinion of counsel for Holder reasonably satisfactory to Company, a no-action letter or interpretive opinion of the staff of the Securities and Exchange Commission (“SEC”) reasonably satisfactory to Company, or other evidence reasonably satisfactory to Company, to the effect that public sale, transfer or assignment of the Securities may be made without registration and without compliance with any restriction such as Rule 144.

 

6.             Transfers of Warrant .  In connection with any transfer by Holder of this Warrant, the Company may require the transferee to provide the Company with written representations and warranties substantially similar to Holder’s representations and warranties set forth in Section 4(a) above, and may require Holder to provide a legal opinion, in form and substance satisfactory to Company and its counsel, that such transfer is exempt from the registration and prospectus delivery requirements of the Act; provided , that the Company

 



 

shall not require Holder to provide an opinion of counsel if the transfer is to an affiliate of Holder, provided that such affiliate is an “accredited investor” as defined in Regulation D promulgated under the Act.  Any transferee (including, without limitation, any affiliate of Holder) shall take this Warrant subject to all of the terms and conditions thereof and such transferee’s rights under this Warrant shall be subject to such transferee’s compliance with all of the terms and conditions of this Warrant that are applicable to Holder.  Following any transfer of this Warrant, at the request of either the Company or the transferee, the transferee shall surrender this Warrant to the Company in exchange for a new warrant of like tenor and date, executed by Company.  Subject to the foregoing, this Warrant is transferable on the books of the Company at its principal office by the registered Holder hereof upon surrender of this Warrant properly endorsed.  Upon any partial transfer, Company will execute and deliver to Holder a new warrant of like tenor with respect to the portion of this Warrant not so transferred.  Holder shall not have any right to transfer any portion of this Warrant to any direct competitor of Company.

 

7.             Adjustment for Certain Events . The number and kind of securities purchasable upon the exercise of this Warrant and the Warrant Price shall be subject to adjustment from time to time upon the occurrence of certain events, as follows:

 

(a)           Reclassification, Recapitalization, Reorganization, Conversion or Merger .  In case of (i) any reclassification, recapitalization, reorganization, conversion or other change of securities of the class issuable upon exercise of this Warrant (other than a change in par value, or from par value to no par value, or from no par value to par value, or as a result of a subdivision or combination), (ii) any merger of Company with or into another corporation (other than a merger with another corporation in which Company is the acquiring and the surviving corporation and which does not result in any reclassification, recapitalization, reorganization, conversion or other change of outstanding securities issuable upon exercise of this Warrant and other than a merger with respect to which the provisions of Section 3(e)(ii) are applicable), or (iii) any sale of all or substantially all of the assets of Company (other than any such sale with respect to which the provisions of Section 3(e)(ii) are applicable), Company, or such successor or purchasing corporation, as the case may be, shall duly execute and deliver to Holder a new Warrant (in form and substance satisfactory to Holder of this Warrant), or Company shall make appropriate provision without the issuance of a new Warrant, so that Holder shall have the right to receive, at a total purchase price not to exceed that payable upon the exercise of the unexercised portion of this Warrant, and in lieu of the Warrant Shares theretofore issuable upon exercise or conversion of this Warrant, the kind and amount of shares of stock, other securities, money and property receivable upon such reclassification, recapitalization, reorganization, conversion, other change, merger or sale by a holder of the number of shares of Preferred Stock (or any other class or series of stock) then purchasable under this Warrant.  Any new Warrant shall provide for adjustments that shall be as nearly equivalent as may be practicable to the adjustments provided for in this Section 7.  The provisions of this subparagraph (a) shall similarly apply to successive reclassifications, changes, mergers and transfers.

 

(b)           Subdivision or Combination of Shares .  If Company at any time while this Warrant remains outstanding and unexpired shall subdivide or combine its outstanding shares of Preferred Stock (or of any other class or series of stock then purchasable under this Warrant), the Warrant Price shall be proportionately decreased and the number of Warrant Shares issuable hereunder shall be proportionately increased in the case of a subdivision and the Warrant Price shall be proportionately increased and the number of Warrant Shares issuable hereunder shall be proportionately decreased in the case of a combination.

 

(c)           Stock Dividends and Other Distributions .  If Company at any time while this Warrant is outstanding and unexpired shall (i) pay a dividend with respect to Preferred Stock (or with respect to any other class or series of stock then purchasable under this Warrant) payable in Preferred Stock (or

 



 

shares of such other class or series of stock, if applicable), then the Warrant Price shall be adjusted, from and after the date of determination of shareholders entitled to receive such dividend or distribution, to that price determined by multiplying the Warrant Price in effect immediately prior to such date of determination by a fraction (A) the numerator of which shall be the total number of shares of Preferred Stock (or such other class or series of stock then purchasable under this Warrant) outstanding immediately prior to such dividend or distribution, and (B) the denominator of which shall be the total number of shares of Preferred Stock (or such other class or series of stock then purchasable under this Warrant) outstanding immediately after such dividend or distribution; or (ii) make any other distribution with respect to Preferred Stock or with respect to any other class or series of stock then purchasable under this Warrant (except any distribution specifically provided for in Sections 7(a) and 7(b)), then, in each such case, provision shall be made by Company such that Holder shall receive upon exercise of this Warrant a proportionate share of any such dividend or distribution as though it were Holder of the Warrant Shares as of the record date fixed for the determination of the shareholders of Company entitled to receive such dividend or distribution.

 

(d)           Adjustment for Dilutive Issuance .  The number of shares of Common Stock issuable upon conversion of any shares of Series A-1 Convertible Preferred Stock that are issuable upon exercise of this Warrant shall be subject to adjustment, from time to time in the manner set forth in Company’s Certificate of Incorporation as if such shares of Series A-1 Convertible Preferred Stock were issued and outstanding on and as of the date of any such required adjustment.  The provisions set forth for the Warrant Shares in Company’s Certificate of Incorporation relating to the above in effect as of the date hereof may not be amended, modified or waived, without the prior written consent of Holder, unless such amendment, modification or waiver affects the rights associated with the Warrant Shares in the same manner as such amendment, modification or waiver affects the rights associated with all other shares of the same series and class as the Warrant Shares.

 

(f)            Adjustment for Pay-to-Play Transaction .  In the event that Company’s Certificate of Incorporation provides, or is amended to so provide, for the amendment or modification of the rights, preferences or privileges of the Preferred Stock, or the reclassification, conversion or exchange of the Preferred Stock, in the event that a holder thereof fails to participate in an equity financing transaction (a “Pay-to-Play Provision”), and in the event that such Pay-to-Play Provision becomes operative, this Warrant shall automatically and without any action required become exercisable for that number and type of shares of equity securities as would have been issued or exchanged, or would have remained outstanding, in respect of the Warrant Shares issuable hereunder had this Warrant been exercised in full prior to such event, and the Holder elected to participate in the equity financing or elected not to participate in the equity financing, as the case may be.

 

8.             Notice of Adjustments .  Whenever any Warrant Price or the kind or number of securities issuable under this Warrant shall be adjusted pursuant to Section 7 hereof, Company shall prepare a certificate signed by an officer of Company setting forth, in reasonable detail, the event requiring the adjustment, the amount of the adjustment, the method by which such adjustment was calculated, and the Warrant Price and number or kind of shares issuable upon exercise of this Warrant after giving effect to such adjustment, and shall cause copies of such certificate to be mailed (by certified or registered mail, return receipt required, postage prepaid) within thirty (30) days of such adjustment to Holder as set forth in Section 19 hereof.

 

9.             Financial and Other Reports .  From time to time up to the earlier of the Expiration Date or the complete exercise of this Warrant, Company shall furnish to Holder, if Company is a private company, (a) unaudited consolidated and, if available, consolidating balance sheets, statements of operations and cash flow statements within 30 days of each calendar quarter end, in a form reasonably acceptable to Holder and certified by Company’s president or chief financial officer, and (b) Company’s complete annual audited consolidated and, if available, consolidating balance sheets, statements of operations and cash flow

 



 

statements certified by an independent certified public accountant selected by Company within 120 days of the fiscal year end or, if sooner, within thirty (30) days after the Company’s Board of Directors receives the audit in final form.  All such statements are to be prepared using GAAP and, if Company is a publicly held company, are to be in compliance with SEC requirements.    At the time of Company’s delivery of quarterly financial statements in accordance with this Section 9, Company shall also deliver to Holder an updated capitalization table of Company in the form attached hereto as Annex A, provided that the Company shall have an obligation to deliver such updated capitalization table only if the Company is not a public company at that time.

 

10.          Registration Rights.   The Company agrees that the shares of Common Stock issued and issuable upon conversion of the shares of Preferred Stock issued and issuable upon exercise or conversion of this Warrant (and the shares of Common Stock issued and issuable upon exercise or conversion of this Warrant at all times, if any, when the Warrant Shares shall be Common Stock), shall have all registration rights pursuant to and as set forth in the Company’s Amended and Restated Stockholders’ Agreement, as amended and in effect from time to time (the “Stockholders Agreement”), on a pari passu basis with the investor parties thereto holding shares of Preferred Stock.  The foregoing referenced registration rights are subject to and conditioned upon the Holder, at the time of exercise of this Warrant, becoming a party to the Stockholders’ Agreement by executing and delivering to the Company an Instrument of adherence thereto and such registration rights will be governed by the terms of the Shareholders’ Agreement.

 

11.          No Fractional Shares .  No fractional share of Preferred Stock will be issued in connection with any exercise or conversion hereunder, but in lieu of such fractional share Company shall make a cash payment therefor upon the basis of the Warrant Price then in effect.

 

12.          Charges, Taxes and Expenses .  Issuance of certificates for shares of Preferred Stock upon the exercise or conversion of this Warrant shall be made without charge to Holder for any United States or state of the United States documentary stamp tax or other incidental expense with respect to the issuance of such certificate, all of which taxes and expenses shall be paid by Company, and such certificates shall be issued in the name of Holder.

 

13.          No Shareholder Rights Until Exercise .  Except as expressly provided herein, this Warrant does not entitle Holder to any voting rights or other rights as a shareholder of Company prior to the exercise hereof.

 

14.          Registry of Warrant .  Company shall maintain a registry showing the name and address of the registered Holder of this Warrant.  This Warrant may be surrendered for exchange or exercise, in accordance with its terms, at such office or agency of Company, and Company and Holder shall be entitled to rely in all respects, prior to written notice to the contrary, upon such registry.

 

15.          Loss, Theft, Destruction or Mutilation of Warrant .  Upon receipt by Company of evidence reasonably satisfactory to it of the loss, theft, destruction or mutilation of this Warrant, and, in the case of loss, theft, or destruction, of indemnity reasonably satisfactory to it, and, if mutilated, upon surrender and cancellation of this Warrant, Company will execute and deliver a new Warrant, having terms and conditions substantially identical to this Warrant, in lieu hereof.

 

16.          Miscellaneous .

 

(a)           Issue Date .  The provisions of this Warrant shall be construed and shall be given effect in all respect as if it had been issued and delivered by Company on the date hereof.

 

(b)           Successors .  This Warrant shall be binding upon any successors or assigns of Company.

 

(c)           Headings .  The headings used in this Warrant are used for convenience only and are not to be

 



 

considered in construing or interpreting this Warrant.

 

(d)           Saturdays, Sundays, Holidays .  If the last or appointed day for the taking of any action or the expiration of any right required or granted herein shall be a Saturday or a Sunday or shall be a legal holiday in the State of New York, then such action may be taken or such right may be exercised on the next succeeding day not a legal holiday.

 

(e)           Attorney’s Fees .   In the event of any dispute between the parties concerning the terms and provisions of this Warrant, the party prevailing in such dispute shall be entitled to collect from the other party all costs incurred in such dispute, including reasonable attorney’s fees.

 

17.          No Impairment .  Company will not, by amendment of its Certificate of Incorporation or any other voluntary action, avoid or seek to avoid the observance or performance of any of the terms of this Warrant, but will at all times in good faith assist in the carrying out of all such terms and in the taking of all such action as may be necessary or appropriate in order to protect the rights of Holder hereof against impairment.

 

18.          Addresses .  Any notice required or permitted hereunder shall be in writing and shall be mailed by overnight courier, registered or certified mail, return receipt requested, and postage prepaid, or otherwise delivered by hand or by messenger, addressed as set forth below, or at such other address as Company or Holder hereof shall have furnished to the other party in accordance with the delivery instructions set forth in this Section 18.

 

If to Company:

 

Radius Health, Inc.

 

 

201 Broadway, 6th floor

 

 

Cambridge, Massachusetts 02139

 

 

Attn:  Chief Financial Officer

 

 

 

If to Holder:

 

 

 

 

 

With copies to:

 

 

 

If mailed by registered or certified mail, return receipt requested, and postage prepaid, notice shall be deemed to be given five (5) days after being sent, and if sent by overnight courier, by hand or by messenger, notice shall be deemed to be given when delivered (if on a business day, and if not, on the next business day).

 

19.          WAIVER OF JURY TRIAL .  EACH OF THE PARTIES HERETO HEREBY WAIVES TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, ANY RIGHT IT MAY HAVE TO A TRIAL BY JURY IN RESPECT OF ANY LITIGATION DIRECTLY OR INDIRECTLY ARISING OUT OF, UNDER OR IN CONNECTION WITH THIS WARRANT OR THE WARRANT SHARES.

 

20.          GOVERNING LAW .  THIS WARRANT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK.

 



 

[Remainder of page intentionally left blank]

 



 

Execution Version

 

IN WITNESS WHEREOF, Company has caused this Warrant to be executed by its officer thereunto duly authorized.

 

RADIUS HEALTH, INC.

 

By:

 

 

Name:

 

 

Title:

 

 

Dated as of                         .

 



 

NOTICE OF EXERCISE

 

To:

Radius Health, Inc.

201 Broadway, 6th floor

Cambridge, Massachusetts 02139

Attn: Chief Financial Officer

 

1.                                       The undersigned Warrantholder (“Holder”) elects to acquire shares of the Series A-1 Convertible Preferred Stock (the “Preferred Stock”) of Radius Health, Inc. (the “Company”), pursuant to the terms of the Stock Purchase Warrant dated May         , 2011 (the “Warrant”).

 

2.                                       Holder exercises its rights under the Warrant as set forth below:

 

(           )                           Holder elects to purchase                            shares of Preferred Stock as provided in Section 3(a) and tenders herewith a check in the amount of $                       as payment of the purchase price.

 

(         )                           Holder elects to convert the purchase rights into shares of Preferred Stock as provided in Section 3(b) of the Warrant.

 

3.                                       Holder surrenders the Warrant with this Notice of Exercise.

 

Holder represents that it is acquiring the aforesaid shares of Preferred Stock for investment and not with a view to or for resale in connection with distribution and that Holder has no present intention of distributing or reselling the shares.

 

Please issue a certificate representing the shares of the Preferred Stock in the name of Holder or in such other name as is specified below:

 

 

Name:

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

Taxpayer I.D.:

 

 

 

 

 

 

 

 

 

 

 

 

[NAME OF HOLDER]

 

 

 

 

 

 

 

 

 

 

By:

 

 

 

 

 

 

Name:

 

 

 

 

 

 

Title:

 

 

 

 

 

 

 

 

 

 

 

Date:

                     , 200  

 

 


 

Execution Version

 

ANNEX A

 

CAPITALIZATION TABLE

 

RADIUS

 

 

 

POST MERGER CAPITALIZATION AFTER 1ST SERIES A-1, A-5, IPSEN EQUITY CLOSING, 1ST DEBT CLOSING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Series A-1

 

 

 

 

 

Post

 

%

 

Post

 

%

 

 

 

Series A-1

 

Series A-2

 

Series A-3

 

Series A-4

 

Series A-5

 

 

 

Warrants

 

Common

 

Common

 

As Converted

 

Shares

 

Fully Diluted

 

Fully

 

 

 

Convert 1:10

 

Convert 1:10

 

Convert 1:10

 

Convert 1:10

 

Convert 1:10

 

Common

 

Convert 1:10

 

Warrants

 

Options

 

Shares Out

 

Out

 

Shares

 

Diluted

 

Preferred Holders

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MPM Bioventures III Funds

 

8,222

 

12,194

 

2,985

 

 

 

 

 

 

 

 

 

 

 

 

234,010

 

1.46

%

234,010

 

1.32

%

MPM Bioventures III-QP, L.P.

 

122,290

 

181,364

 

44,395

 

 

 

 

 

 

 

 

 

 

 

 

3,480,490

 

21.69

%

3,480,490

 

19.64

%

MPM Bioventures III GMBH & Co.

 

10,335

 

15,327

 

3,752

 

 

 

 

 

 

 

 

 

 

 

 

294,140

 

1.83

%

294,140

 

1.66

%

MPM Bioventures III Parallel Fund, L.P.

 

3,693

 

5,477

 

1,340

 

 

 

 

 

 

 

 

 

 

 

 

105,100

 

0.65

%

105,100

 

0.59

%

MPM Asset Management Investors 2003

 

2,368

 

3,511

 

859

 

 

 

 

 

 

 

 

 

 

 

 

67,380

 

0.42

%

67,380

 

0.38

%

MPM Bio IV NVS Strategic Fund

 

54,001

 

184,242

 

 

 

 

 

 

 

 

 

 

 

 

 

2,382,430

 

14.85

%

2,382,430

 

13.44

%

Wellcome Trust

 

25,522

 

210,325

 

 

 

 

 

 

 

 

 

 

 

 

 

2,358,470

 

14.70

%

2,358,470

 

13.31

%

HealthCare Ventures VII

 

19,651

 

98,278

 

63,663

 

 

 

 

 

83,113

 

 

 

 

 

 

 

1,899,033

 

11.83

%

1,899,033

 

10.72

%

Saints Capital (OBP IV Holdings)

 

16,213

 

108,628

 

24,983

 

 

 

 

 

15,173

 

 

 

 

 

 

 

1,513,413

 

9.43

%

1,513,413

 

8.54

%

Saints Capital (mRNA Fund II Holdings)

 

162

 

1,090

 

250

 

 

 

 

 

151

 

 

 

 

 

 

 

15,171

 

0.09

%

15,171

 

0.09

%

BB Biotech Ventures II

 

43,596

 

105,162

 

 

 

 

 

 

 

 

 

 

 

 

 

1,487,580

 

9.27

%

1,487,580

 

8.39

%

Scottish Widows

 

6,805

 

56,086

 

 

 

 

 

 

 

 

 

 

 

 

 

628,910

 

3.92

%

628,910

 

3.55

%

Raymond F. Schinazi

 

757

 

1,524

 

 

414

 

 

 

 

 

 

 

 

 

 

26,950

 

0.17

%

26,950

 

0.15

%

David E. Thompson Revocable Trust

 

196

 

 

 

 

 

1,619

 

 

 

 

 

 

 

 

 

 

18,150

 

0.11

%

18,150

 

0.10

%

Hostetler Family Trust

 

 

 

 

 

 

 

 

 

3,071

 

 

 

 

 

 

 

3,071

 

0.02

%

3,071

 

0.02

%

H.Watt Gregory, III

 

132

 

 

 

 

 

1,095

 

 

 

 

 

 

 

 

 

 

12,270

 

0.08

%

12,270

 

0.07

%

The Richman Trust

 

65

 

 

 

 

 

535

 

 

 

 

 

 

 

 

 

 

6,000

 

0.04

%

6,000

 

0.03

%

Breining Family Trust

 

40

 

 

 

 

 

335

 

 

 

 

 

 

 

 

 

 

3,750

 

0.02

%

3,750

 

0.02

%

Dr. Dennis A. Carson

 

 

 

 

 

 

 

 

 

533

 

 

 

 

 

 

 

533

 

0.00

%

533

 

0.00

%

B Van Wyck

 

 

 

 

 

 

 

 

 

363

 

 

 

 

 

 

 

363

 

0.00

%

363

 

0.00

%

Jonnie K. Westbrook

 

 

 

 

 

 

 

 

 

363

 

 

 

 

 

 

 

363

 

0.00

%

363

 

0.00

%

Nordic Bioscience

 

 

 

 

 

 

 

 

6,443

 

 

 

 

 

 

 

 

 

64,430

 

0.40

%

64,430

 

0.36

%

Brookside

 

40,940

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

409,400

 

2.55

%

409,400

 

2.31

%

BB Biotech AG

 

40,940

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

409,400

 

2.55

%

409,400

 

2.31

%

Ipsen

 

17,326

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

173,260

 

1.08

%

173,260

 

0.98

%

GE Capital Equity Investments

 

 

 

 

 

 

 

 

 

 

 

 

 

1,535

 

 

 

 

 

 

0.00

%

15,350

 

0.09

%

Oxford Finance LLC

 

 

 

 

 

 

 

 

 

 

 

 

 

1,535

 

 

 

 

 

 

0.00

%

15,350

 

0.09

%

Leerink

 

 

 

 

 

 

 

 

 

 

 

 

 

818

 

 

 

 

 

 

0.00

%

8,180

 

0.05

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common (Shares, Options, Warrants)

 

 

 

 

 

 

 

 

 

 

 

452,827

 

 

 

266

 

1,634,860

 

452,827

 

2.82

%

2,087,953

 

11.78

%

Total

 

413,254

 

983,208

 

142,227

 

3,998

 

6,443

 

555,594

 

3,888

 

266

 

1,634,860

 

16,046,894

 

100.00

%

17,720,900

 

100.00

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Per Share

 

$

8.1420

 

 

 

$

8.1420

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Post-money $

 

$

130,653,811

 

 

 

$

144,283,568

 

 

 

 




Exhibit 10.11

 

Work Statement NB-1

 

WORK STATEMENT

 

This Work Statement NB-1 is entered into pursuant to Section 2.1 of the Clinical Trial Services Agreement dated as of March 29, 2011, by and between Radius Health, Inc. (“ Radius ”) and Nordic Bioscience Clinical Development VII A/S (“ NB ”) (the “ Agreement ”).  Capitalized terms used in this Work Statement NB-1 and not defined in this Work Statement NB-1 are used with the meanings ascribed to them in the Agreement.  This Work Statement NB-1 is attached to and becomes, upon execution by both parties below but subject to the consummation by Radius of an equity financing pursuant to which it shall have issued and sold shares of its Series A-1 Convertible Preferred Stock, par value $0.01 per share, to existing and/or new investors resulting in aggregate gross proceeds being received by Radius in an amount equal to approximately sixty million U.S. Dollars (US$60,000,000) (unless waived by Radius), a part of the Agreement, and sets forth the specific terms and conditions relating to the Services and Deliverables described herein.

 

In consideration of the mutual promises contained in the Agreement and for other good and valuable consideration the receipt and adequacy of which each of the parties does hereby acknowledge, the parties hereby agree to the terms of this Work Statement NB-1 entitled “A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture” .

 

This Work Statement NB-1 contains the following Attachments, each of which is made a part hereof:

 

Attachment A — Specifications/Key Assumptions/Services/Division of

Responsibilities/Timeline Specifications

Attachment B — Budgets, Fees, Pass-through Costs, and Payment Schedule

Attachment C — Materials Provided by Either Party

Attachment D — Core Team Members/Key Personnel

Attachment E — Protocol or Protocol Summary

Attachment F — Reports and Information Management/Regular Meetings

Attachment G — Special Insurance

Attachment H - Transfer of Obligation

 

IN WITNESS WHEREOF the parties have executed this Work Statement NB-1 intending it to take effect as an instrument under seal as part of the Agreement as of March 29, 2011.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

 

 

 

 

 

 

 

By:

/s/ C. Richard Lyttle

 

By:

/s/ Claus Christiansen

Name:

C. Richard Lyttle

 

Name:

 

Title:

CEO and President

 

Title:

CEO

Date:

 

 

Date:

 

 

 

Acknowledged and Agreed:

 

 

 

 

 

 

 

xxxxxxx, Project Leader

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

Work Statement NB-1

Attachment A

 

Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

 

Study Assumptions

 

Radius Health, Inc.

 

Protocol:  BA058-05-003, “A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture”

 

Protocol Number

 

BA058-05-003

Number of Sites:

 

11

Denmark

 

3

Estonia

 

1

Lithuania

 

1

Romania

 

1

Poland

 

1

Czech Republic

 

2

Brazil

 

1

Hong Kong

 

1

Number of Patients to be Screened

 

20,000

Number of Patients to Enroll:

 

2,400

Enrollment Period:

 

6 months from last approval of the Protocol by applicable Regulatory Authorities

Treatment Period:

 

18 months

Safety Follow up Period

 

1 month

Visits per Completed Subject:

 

10

 

Clinical Trial Timeline

 

BA058-05-003 Milestones

 

Duration in Months

 

Estimated
Timeline

Regulatory Submissions

 

All Complete

 

1 Jan 2011

First Regulatory Approval

 

 

 

15 Feb 2011

Last Regulatory Approval

 

8 months (Brazil)

 

1 July 2011

IMP ready at site

 

 

 

30 March 2011

First Patient Randomized

 

 

 

31 March 2011

Enrollment Complete

 

6 months (after last Regulatory Approval)

 

1 March 2012

Treatment Period

 

18 months

 

1 Sep 2013

Last Patient Last Study Visit

 

1 month

 

1 October 2013

Database Lock

 

1.5 months

 

15 November 2013

Locked Database Transfer to Sponsor

 

 

 

16 November 2013

Site Close-out Visits

 

1.5 months

 

31 Dec 2013

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment A-1



 

Work Statement NB-1

Attachment B

 

Budgets, Fees, Pass-through Costs, and Payment Schedule*

 

BA058-05-003 Draft Protocol Version 3.0 10 August 2010 Cost Proposal Version 2 September 2010

 

Sponsor:

 

Radius Health, Inc.

 

 

Protocol ID:

 

BA058-05-003

 

 

Development Phase:

 

III

 

 

Disease:

 

Osteoporosis

 

 

Total # of Randomized Subjects (CCBR):

 

2,400

 

Less 15% due to Drop Out= 2,040

PK/PD Study; *samples for BA058 on 600 subjects, samples for s-calcium on 2,400 subjects:

 

All

 

Adjusted for Drop Out

ECG pre-and 60 minutes post dose:

 

All

 

Adjusted for Drop Out

Bone Biopsy:

 

200

 

 

Expected Date of FPFV:

 

Q1 2011

 

 

Expected Length of Recruitment (months):

 

 

 

 

Treatment Duration (months):

 

18

 

 

Number of visits:

 

10

 

 

Number of CCBR Clinics:

 

11

 

Assumes only CCBR sites

Number of potential study subjects to be prescreened:

 

20,000

 

 

 

Total Budget

 

EURO

 

 

Pre-screening/Advertisement

 

[*]

 

Only spine DEXA

35 % screen failure

 

[*]

 

Assumes 35% Screen Failure rate after PIC has been signed

Clinic Activities (randomized and completed)

 

[*]

 

Adjusted for Drop Out

BA058 PK Study; sample collection and clinic stay

 

[*]

 

No BA058 analysis, adjusted for Drop-out

CRO Activities

 

[*]

 

50% source data verification and adjusted for Drop Out

Central Lab Fee

 

[*]

 

Adjusted for Drop Out Includes sample shipment. Bone markers on 600 subjects Local hematology (=less shipment cost)

Bone Biopsy (200 biopsies)

 

[*]

 

200 biopsies

CT-scan (payment to X-ray departments) (300 subjects)

 

[*]

 

300 Subjects end of study

Calcium and Vitamin D supplement

 

[*]

 

 

Sub Total budget (EURO)

 

[*]

 

 

Discount

 

[*]

 

 

Sub Total budget (EURO)

 

35,553,732

 

 

Sub Total budget (USD)

 

46,219,852

 

Assumes 1 EURO = 1.30 USD

Central Imaging Reading (USD)

 

[*]

 

All hip and spine DEXA central reading Local reading for eligibility. Wrist DEXA central read on 900 subjects (300 per arm)

Central Imaging Pass Through (USD)

 

[*]

 

 

Total Budget (USD)

 

48,825,737

 

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment B-1



 

The pricing specified in this Budget is calculated based upon 2,400 subjects randomized and entered into the clinical study and assumes a 35% screen-failure rate after the Patient Informed Consent has been signed and a 15% drop-out rate, the Budget will be adjusted as the study proceeds to reflect the actual screen-failure rate and the actual drop-out rate and all pricing will be adjusted in a pro rata fashion to reflect the actual study activities completed by the study subjects.

 

Pass through Cost

 

EURO

Submission Fee to ERC

 

Included

Containers for 24-h urine collection

 

Included

Local Hematology Test’s

 

Included

Advertisement

 

Included

Monitoring Travel Expenses & Accommodations / other travels

 

Included

Shipments of imaging and labs

 

Included

Translation

 

Included

Investigator Meeting

 

Included

Data Monitoring Committee

 

Not Included

Patient insurance

 

Not included

Annual reports to the FDA

 

Not included

External advisory Board

 

Not included

Statistical Data analysis and Clinical Study Report

 

Not included

Purchase of Forteo

 

Not included( 1)

 


(1) It is understood and agreed that Radius shall as part of the “Purchase of Forteo” obligations cause the supplier of the Forteo product (Pharmarama International Limited) to enter into a purchase agreement with NB that includes delivery by Pharmarama DDP to the Aptuit Ltd. facility in Oxford United Kingdom (“ UK ”) for packaging,  [*].

 

Payment Schedule

 

(a)  A portion of the purchase price for the Services shall be paid in cash and the balance shall be paid by issuance to NB of shares of Radius Series A-6 Convertible Preferred Stock, $0.01 par value, at a price of $0.01 per share.  The cash payment portion of the purchase price shall be subject to this Work Statement NB-1 and the Agreement; the stock issuance portion of the purchase price shall be made pursuant to a Stock Issuance Agreement (the “ Stock Issuance Agreement ”).

 

(2)  The cash payment portion of the purchase price is comprised of a portion denominated in EURO and a portion denominated in U.S. Dollars as noted in the cost proposal set forth above.  The EURO portion is €35,553,732  and the U.S. Dollar portion is $2,605,885.  This pricing is based upon 2,400 study subjects randomized and a 35% screen-failure rate after the Patient Informed Consent has been signed and a 15% drop-out rate and a pro rata adjustment to pricing based upon the actual number of study subjects that are not the subject of screen-failure and the actual clinical study activities that are completed prior to drop-out for study subjects that drop-out.  Radius shall pay the EURO denominated portion of the purchase price and the U.S. Dollar portion of the purchase price separately in the applicable currency as set forth in Paragraphs (3)-(9).

 

(3)  Radius has entered into a Letter of Intent dated September 3, 2010 with NB pursuant to which Radius has funded an aggregate $1,500,000.00 of Radius’ aggregate cash payment obligations to NB in respect of the clinical study that is the subject of Work Statement NB-1.  On the Effective Date, Radius will pay NB a non-refundable cash fee of €5,649,144.20, representing 15.889% of Radius’ aggregate cash payment obligation to NB for the EURO denominated portion of the clinical study, which amount shall be reduced by the aggregate $2,250,000.00 payment previously provided by Radius under the Letter of Intent and the two extensions to such Letter of Intent described below, using the exchange rate for buying EUROs with U.S. Dollars set forth in the Wall Street Journal (Online Edition) Market Data Center at http://online.wsj.com/mdc/public/page/marketsdata.html on the date(s) each portion of such aggregate $2,250,000.00 payment

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment B-2



 

was made.  The initial $500,000 portion was paid September 8, 2010 and the credit for such payment will use the exchange rate for that date (0.7865) to convert U.S. Dollars to EUROS; the second $500,000 portion was paid October 19, 2010 and the credit for such payment will use the exchange rate for that date (0.7283) to convert U.S. Dollars to EUROS.  Radius and NB entered into an extension of the Letter of Intent on December 15, 2010 pursuant to which Radius paid an additional $500,000 on December 19, 2010 and the credit for such payment will use the exchange rate for December 17 (0.7584) to convert U.S. Dollars to EUROS.  Radius and NB entered into a second extension of the Letter of Intent on January 31, 2011 pursuant to which Radius paid an additional $750,000 on February 3, 2011 and the credit for such payment will use the exchange rate for February 3 (0.7334) to convert U.S. Dollars to EUROS.

 

In addition, on the Effective Date, Radius shall also pay NB or its designee a non-refundable cash fee of $260,589 representing 10% of Radius’ aggregate cash obligation to NB for the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1.

 

(4)  Thereafter, Radius will pay NB on a calendar monthly basis commencing with the month in which the first subject is enrolled in the clinical study and ending the month that an aggregate 2,400 subjects have been enrolled in the clinical study (“ First Monthly Amount ”) at the rate of €[*] per randomized subject enrolled in the clinical study that is the subject of Work Statement NB-1 for the EURO denominated portion of the clinical study and at the rate of $[*] per randomized subject enrolled in the clinical study that is the subject of Work Statement NB-1 for the U.S. Dollar denominated portion of the clinical study.  These amounts represent 33.752% of Radius’ aggregate cash payment obligation to NB in respect of the EURO denominated portion of the clinical study that is the subject of Work Statement NB-1 and 7% of the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1.

 

(5)  Radius will thereafter pay NB €[*] per month for the first [*] ([*]) months after patient randomization is completed (“ Second Monthly Amount ”) and €[*] per month for the next [*] ([*]) months after patient randomization is completed (“ Third Monthly Amount ”) for the EURO denominated portion of the clinical study that is the subject of Work Statement NB-1. Radius shall also thereafter pay NB or its designee in respect of the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1 a Second Monthly Amount equal to $[*] per month and a Third Monthly Amount equal to $[*] per month during the periods when the Second Monthly Amount and the Third Monthly Amount, as applicable, is payable.

 

Payment of each installment of the Second Monthly Amount and the Third Monthly Amount shall be calculated based upon the estimated time that will be required to complete the clinical study (following enrollment of the first study subject) and lock the study database and transfer the study database to Radius.  The parties, acting through the Project Committee will evaluate the study timeline and adjust the Second Monthly Amounts and the Third Monthly Amounts to account for delays or accelerations in the performance of the clinical study.

 

(6)   Each Second Monthly Amount and Third Monthly Amount payment due NB shall be determined by subtracting payments (if any) previously made pursuant to the Second Monthly Amount and the Third Monthly Amount from €[*] (in the case of the EURO denominated portion of the clinical study) or from $[*] (in the case of the U.S. Dollar denominated portion of the clinical study) and then dividing that number by the number of months the Project Committee then determines it will take to complete the clinical study that is the subject of this Work Statement NB-1 and lock the study database and transfer the study database to Radius.

 

(7)  On a monthly basis, beginning with the month in which the last subject is enrolled in the clinical study that is the subject of this Work Statement NB-1, Radius shall request an update from the Project Committee with respect to the projected timeline of the clinical study that is the subject to Work Statement NB-1 and based upon the update provided by the Project Committee, Radius shall calculate the payment due NB using the formula set forth in Paragraph (6) and make payment to NB in accordance with Section 4.3 of the Agreement.

 

(8)  The Second Monthly Amount and the Third Monthly Amount represent, respectively, 16.876% of Radius’ aggregate cash payment obligation to NB in respect of the EURO denominated portion of the  clinical study that is the subject of Work Statement NB-1 and, respectively, 16% and 40% of the U.S. Dollar denominated portion of the  clinical study that is the subject of Work Statement NB-1.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment B-3



 

(9)  The balance of Radius’ aggregate cash payment obligation to NB in respect of the Euro denominated portion of the clinical study that is the subject of Work Statement NB-1, (€[*] based on 2,400 patients randomized and a 35% screen-failure rate after the Patient Informed Consent has been signed and a 15% drop-out rate and a pro rata adjustment to pricing based upon the actual number of study subjects that are not the subject of screen-failure and  the actual clinical study activities that are completed prior to drop-out for study subjects that drop-out) shall be paid in two equal installments of €[*]. The balance of Radius’ aggregate cash payment obligation to NB in respect of the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1, ($[*] based on 2,400 patients randomized and a 35% screen-failure rate after the Patient Informed Consent has been signed and a 15% drop-out rate and a pro rata adjustment to pricing based upon the actual number of study subjects that are not the subject of screen-failure and the actual clinical study activities that are completed prior to drop-out for study subjects that drop-out) shall be paid in two equal installments of $[*].  The  first installment of each payment will be due and payable to NB when the study database for the clinical study that is the subject of Work Statement NB-1 is locked and transferred to Radius; the second installment is due and payable upon the earlier of:  (i) acceptance of the Final Tables Listings and Figures for the clinical study that is the subject of Work Statement NB-1; or (ii) eight weeks after the database has been locked and delivered to Radius; provided that Radius shall not be required to accept the Final Tables Listings and Figures if they do not conform to the specifications set forth in the Protocol for Work Statement NB-1 or embody data that is scientifically inconsistent and merit, in Radius’ reasonable opinion, a review of clinical study site records for such clinical study purposes of confirming certain aspects of the underlying clinical study data and results as reported to the clinical study database (each, a “ Nonconformity ”).  If Radius identifies a Nonconformity prior to the expiration of the 8-week period specified in Paragraph (f)(ii), Radius shall deliver notice to NB of such Nonconformity specifying the steps that Radius believes are necessary to resolve such Nonconformity and bring the Final Tables Listings and Figures into conformity.  Upon receipt of such notice, NB shall take appropriate steps to investigate and resolve the Nonconformity and the 8-week period shall be extended day-for-day while NB investigates the Nonconformity and either updates the clinical study database and redelivers it to Radius or provides Radius with a report detailing the results of NB’s investigation of the Nonconformity and indicating why the Nonconformity does not require that the clinical study database be updated.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment B-4


 

Work Statement NB-1

Attachment C

Materials Provided by Either Party

 

Trial Activities & Delegation of Responsibilities

 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

 

Sponsor & Service provider Governance

 

 

 

 

 

 

CCBR - Radius Governance Committee

 

ü

 

ü

 

Sponsor and Service provider will responsible for creating an Executive Governance Committee to oversee program strategy and implementation.

Clinical Trial Joint Development Team

 

ü

 

ü

 

Sponsor and Service provider will appoint members of the clinical trial joint development team to implement the clinical study.

 

 

 

 

 

 

 

Regulatory

 

 

 

 

 

 

IND/CTA Preparation

 

R

 

ü

 

Sponsor will be responsible to create all IND and CTA submission documents. Service provider will be responsible for any required translations for the CTA.

FDA IND Submission & Updates

 

 

 

ü

 

Sponsor will be responsible for all FDA submissions.

CTA Submissions & Updates

 

ü

 

A

 

Service provider will be responsible for all CTA submissions. Sponsor approval of the submissions is required prior to submission.

Health Authority, EC, IRB Queries & Response

 

ü

 

ü

 

Sponsor and Service provider will be responsible to provide responses to Health Authority, Ethics Committee, and IRB queries, if necessary.

EUDRACT Registration

 

ü

 

ü

 

Sponsor will be responsible to register the clinical study to obtain an EUDRACT number and service provider will create the XML file for submission.

Investigator’s Brochure

 

 

 

ü

 

Sponsor will be responsible to create the Investigator Brochure and any updates.

Clinical Study Protocol

 

R

 

ü

 

Sponsor will be responsible to create the study protocol, and any amendments, if necessary. Service provider will be responsible to review the study protocol and any amendments, if necessary.

Clinical Study Extension Protocol

 

R

 

ü

 

Sponsor will be responsible to create the Extension study protocol, and any amendments, if necessary. Service provider will be responsible to review the Extension study protocol and any amendments, if necessary.

Informed Consent Form (ICF, PIS)

 

ü

 

R

 

Service provider will be responsible to create the Informed Consent Documents and/or Patient Information Sheets. Sponsor will be responsible to review the ICF or PIS.

 

Attachment 2, Attachment C-1



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

Ethics Committees/IRB Submissions & Updates

 

ü

 

 

 

Service Provider will be responsible for all country and site Ethics Committees and/or local IRBs submissions.

FDA SAE Submission & Follow Up(s)

 

 

 

ü

 

Sponsor will be responsible for FDA SAE submissions. See Health Authority reporting in Safety and Pharmacovigilance

Health Authority SAE Submissions & Follow Up(s)

 

ü

 

A

 

Service provider will be responsible for all Health Authority SAE submissions except FDA. Sponsor will be responsible for approving the HA submissions. See Health Authority reporting in Safety and Pharmacovigilance

Legal representative (if required)

 

ü

 

 

 

Service provider will be responsible to provide Legal Representative services, on behalf of the sponsor, if required by local regulation.

Regulatory & Study Documents translations

 

ü

 

 

 

Service provider will be responsible to provide all necessary document translations for regulatory and study documents.

Clinicaltrials.gov registration & management

 

 

 

ü

 

Sponsor will be responsible to register the clinical study on clinicaltrials.gov and manage the status of the study as required by regulation.

Clinical Trial Materials

 

 

 

 

 

 

BD Pen II Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture to BD Pen injection device

BA058 80 mcg Cartridge Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture the BA058 80 mcg cartridges.

BA058 Placebo Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture the BA058 placebo cartridges.

Qualified Person for Drug Release

 

 

 

ü

 

Sponsor will be responsible to provide a Qualified Person (QP) for drug release in the EU, if necessary.

Study Drug Shipping

 

 

 

ü

 

Sponsor will be responsible for shipping study drug to the study centers.

Forteo procurement

 

ü

 

ü

 

Service provider will be responsible to procure the Forteo clinical trial material from Pharmarama International Limited (“Pharmarama”) under terms that include delivery by Pharmarama DDP to the Aptuit Ltd. facility in Oxford England for packaging. Sponsor, however, shall be responsible for the logistics and costs of such clinical trial material.

Package Clinical Trial Materials

 

 

 

ü

 

Sponsor will be responsible to package the clinical trial material, including payment of any third party costs related to packaging.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment C-2



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

Vitamin D & Calcium

 

ü

 

 

 

Service provider will be responsible to procure the Vitamin D & Calcium required to be taken concomitantly during the study.

Country specific labels

 

ü

 

ü

 

Sponsor will be required for labeling the study drug kits. Service provider will be responsible to provide label translation and review label prior to packaging.

Instructions for Use - BA058 BD Pen & Forteo

 

R

 

ü

 

Sponsor will be responsible to create and provide an Instructions for Use for the BA058 BD Pen and Forteo User’s Manual in English. Service provider will be responsible for translating the Instructions for Use and Forteo User Manual, as required by local regulations.

BD 31g 8mm Needles

 

 

 

ü

 

Sponsor will be responsible to procure and supply the BD 31g 8 mm needles for use with the BA058 cartridges and Forteo pens.

Sharps containers

 

ü

 

 

 

Service provider will be responsible to provide each patient with a sharps container for disposal of study needles.

Alcohol Swabs

 

ü

 

 

 

Service provider will be responsible to provide each patient with alcohol swabs.

Tote Bags/Coolers

 

ü

 

 

 

Service provider will be responsible to provide each patient with tote bags and coolers.

Study Drug Release & Distribution (IVRS)

 

 

 

ü

 

Sponsor will be responsible to release study drug and distribute to clinical study sites. The sponsor will be responsible to contract an IVRS vendor.

Study Drug Reconciliation — Patient, Site, & Study

 

ü

 

R

 

Service provider will be responsible to perform drug accountability during the clinical study. Each study cartridge and Forteo pen and vitamin D and calcium tablet will need to be accounted for during and at the end of the study for each patient at every clinical site. The patient and site drug reconciliation documentation will be sent to the sponsor for review on a regular basis.

Study Drug Destruction

 

 

 

ü

 

Sponsor will be responsible for final study drug destruction.

Study Drug: Import Broker, License & Requirements

 

 

 

ü

 

Sponsor will be responsible to provide all information necessary to import the study drug and clinical trial materials, as needed. Sponsor will be responsible to contract with a local customs or import broker to facilitate the import of clinical trial materials, if necessary.

Proforma Invoice

 

 

 

ü

 

Sponsor will be responsible to create the proforma invoices for importing study

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment C-3



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

drug. Sponsor will be responsible to provide necessary information to complete the proforma invoice.

Clinical Trial Conduct

 

 

 

 

 

 

Data Safety Monitoring Board

 

 

 

ü

 

Sponsor will be responsible to create a Data Safety Monitoring Board for the clinical study.

Clinical Trial Project Plan

 

ü

 

A

 

Service provider will be responsible for developing a Clinical Trial Project Plan to identify the goals, objectives, timelines, milestones, organization chart, vendor list (including roles & responsibilities), and budget forecast and tracking for the clinical study. The Sponsor will be required to approve the clinical trial project plan prior to screening.

Clinical Trial Budget Forecasting & Tracking

 

ü

 

R

 

Service provider will be responsible for forecasting and tracking the trial expense and reporting to the Sponsor on a monthly basis.

Clinical Trial Insurance

 

 

 

ü

 

Sponsor will be responsible for obtaining and maintaining insurance for the clinical trial. Sponsor will be responsible to provide proof of insurance to the Service provider, as required.

Medical Monitoring

 

ü

 

R

 

Service provider will be responsible for medical monitoring. Sponsor will review Service provider’s performance and may request adjustments.

Vendor Management - Labs, X-ray, Dexa, Renal, Imaging, ECG

 

ü

 

 

 

Service provider will be responsible for qualifying, contracting, payment for services, data collection, and quality and compliance for any service contracted out by the Service provider

Vendor Management - PK, Antibody, Drug Manufacture/Package, IVRS

 

 

 

ü

 

Sponsor will be responsible for the vendor management of the PK sampling, Antibody testing, and Study drug manufacture, packaging, and/or procurement.

Vendor Payments

 

ü

 

ü

 

Sponsor and Service provider will be responsible to pay third party vendors to whom they have contracted required study services.

Patient Recruitment, Screening, Enrollment

 

ü

 

R

 

Service provider will be responsible for patient recruitment, screening, and enrollment. Service provider will provide, until enrollment completes, the Sponsor with a weekly update of cumulative number of patients recruited, cumulative number screened, number screened within the reporting week, number screened but not enrolled, number failed screening, and number enrolled.

 

Attachment 2, Attachment C-4



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

Site Selection

 

ü

 

A

 

Service provider will be responsible for site identification and selection for participation in the clinical study. Sponsor will be responsible for approving the list of sites identified by the Service provider.

Site Management

 

ü

 

 

 

Service provider will be responsible for site management activities.

Site Confidentiality Agreements

 

ü

 

R

 

Service Provider will be responsible to collect Site Confidentiality agreements prior to communicating any study specific information. A copy of the CDA will be sent to the Sponsor upon execution of the document..

Site Contract/Agreement

 

 

 

 

 

Service Provider will be responsible to create and manage the Site Contracts. A copy of the Site Agreement will be sent to the Sponsor upon execution of the document..

Clinical Trial Monitoring & Plan

 

ü

 

A

 

Service provider will be responsible to create a clinical trial monitoring plan as per the Service provider’s SOP for Clinical Monitoring and monitor the clinical study conduct at the sites. The Sponsor is responsible for approving the monitoring plan prior to study start.

Clinical Trial Monitoring Reports

 

ü

 

R

 

Service provider will be responsible to create clinical trial monitoring reports that document the clinical trial monitoring visit. The clinical trial monitoring report will be generated using the format identified in the Service provider’s SOP. The monitoring reports will be made available to the Sponsor for review within 10-20 days of the monitoring visit.

Clinical Trial Monitors

 

ü

 

A

 

Service provider will be responsible to provide qualified clinical trial monitors to perform required monitoring duties. Sponsor will be required to approve the Service provider’s selection of monitors.

Monitor Travel Expense

 

ü

 

 

 

Service provider will be responsible for monitoring expenses.

CRA Meetings

 

ü

 

R

 

Service provider will be responsible for scheduling, conducting, and creating meeting minutes for CRA meetings. The Service provider will include the Sponsor as a participant to the CRA meetings.

Sponsor Meetings

 

ü

 

ü

 

Sponsor and Service provider will be responsible for scheduling Sponsor Meetings on a weekly basis during enrollment and monthly after enrollment completes. Meetings can also happen on

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment C-5


 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

an ad-hoc basis as required by the Sponsor or Service provider.

Sponsor Meeting Minutes

 

ü

 

A

 

Service provider will be responsible to create the meeting minutes for the Sponsor meetings and circulate a draft within 24 hours. Sponsor will review and provide comment within 24 hours. Meeting minutes will be required to be final within 72 hours.

Trial Staff Training

 

ü

 

R

 

Service provider will be responsible for training of all trial staff as well as documenting the training for new trial staff members. The training records will be made available for the Sponsor’s review.

Investigator Meeting & Training

 

ü

 

ü

 

Service provider will be responsible for planning and conducting the study investigator meetings. Sponsor will be responsible to assist in the preparation and approval of investigator meeting training materials.

Central Imaging Analysis (Fracture, BMD, Renal)

 

ü

 

 

 

Service provider will be responsible to provide central imaging services to assess the protocol required measures for fracture, bone mineral density, and renal tissue mineralization and function.

Fracture Adjudication

 

ü

 

R

 

Service provider will be responsible to assess all radiographs by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fracture will be assessed according to the severity scale of Genant (1993). Assessment will be done according to the procedure set forth in the Protocol.

Protocol Deviation & Waiver

 

ü

 

A

 

Service provider will be responsible to identify and/or collect all protocol deviations. For prospective deviations, the Sponsor Medical Monitor will need to approve prior to the deviation occurring. For deviations identified retrospectively, the Service provider will send all protocol deviations and corrective and preventative actions to the Sponsor and will maintain a log of the deviations and actions. In the event a site requests a protocol waiver, the Service provider will communicate the request and data to the Sponsor for approval.

Sponsor Project Update Reports

 

ü

 

 

 

Service provider will be responsible to create monthly study status update reports.

Trial Master File

 

ü

 

 

 

Service provider will be responsible to

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment C-6



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

create, maintain, and reconcile the trial master file including all required Essential Documents. At the end of the study, the trial master file will be sent to the Sponsor. The Sponsor will be responsible for archiving the trial master file.

Site Trial File

 

ü

 

 

 

Service provider will be responsible to insure the site trial file is complete at all times during the study. The Service provider will be responsible to reconcile the site file against the trial master file site file.

Investigator Site Payments

 

ü

 

 

 

Service provider will be responsible for all site payments.

Essential Document Collection

 

ü

 

 

 

Service provider will be responsible to collect and file all required GCP Essential Documents. The Essential Documents will be part of the trial master file.

Printing Study Documents

 

ü

 

 

 

Service provider will be responsible to print or contract printing services for all study documents for sites and patients.

Labs

 

 

 

 

 

 

Central or Local Safety Labs

 

ü

 

 

 

Service provider will be responsible for the central and safety lab vendor contracting, management, payments, sampling of patient samples, and reporting of sample results.

Central/Safety/Bone Marker Labs Data Reporting (SI Units)

 

ü

 

 

 

Service provider will be responsible for the transfer specification and transfer of lab data from the central labs. Service provider will be responsible for validating the transfer and reconciling the lab data with the study database.

Abnormal lab value flags

 

ü

 

A

 

Service provider will be responsible for creating flags for abnormal lab values. Sponsor will be responsible for the approval of the lab value flags.

Lab Specimen Management, Shipping & Reconciliation

 

ü

 

 

 

Service provider will be responsible for lab sample management, shipping, storage, and reconciliation.

Lab Manual

 

ü

 

A

 

Service provider will be responsible to develop a lab manual with lab collection, handling, and shipping instructions for distribution to the site. The Sponsor will be responsible to approve the lab manual prior to study start.

Lab Kits & Supplies

 

ü

 

 

 

Service provider will be responsible to provide the lab kits and supplies to the study sites.

Lab Sample Storage

 

ü

 

 

 

Service provider will be responsible for storage of lab samples until all lab data are final and reported.

 

Attachment 2, Attachment C-7



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

Lab Sample Destruction

 

ü

 

A

 

Service provider will be responsible for destroying lab samples. Sponsor approval is required prior to destroying any lab samples.

Bone Marker Analysis & Data Reporting

 

ü

 

 

 

Service provider is responsible for the bone marker sample analysis and data reporting. The data transfer will be validated and reconciled with the study database.

PK & PK Data Reporting

 

 

 

ü

 

Sponsor will be responsible for PK sampling and data reporting.

Antibody (including NAbs) analysis & Data Reporting

 

 

 

ü

 

Sponsor will be responsible for Anti-drug antibody and neutralizing antibody sampling and data reporting.

Data Management

 

 

 

 

 

 

Data management & handling plan

 

ü

 

A

 

Service provider will be responsible to create the Data Management and Data Handling Plan for the study upon approval of the CRF. Sponsor will be required to approve the plans.

Annotated Case Report Form

 

ü

 

A

 

Service provider will be responsible to create the Annotated Case Report Forms based on CDISC SDTM. Sponsor will be required to approve the annotated CRF.

CRF

 

ü

 

A

 

Service provider will be responsible to create the Case Report Forms for data entry. Sponsor will be required to approve the CRF.

CRF Completion Instructions

 

ü

 

R

 

Service provider will be responsible to create the CRF completion instructions and distribute to the study sites. Sponsor will be required to approve the CRF completion instructions prior to site distribution.

Data validation checks

 

ü

 

R

 

Service provider will be responsible to create the data entry data validation checks. The data validation checks will be provided for Sponsor review.

Database Development, Testing, and Validation

 

ü

 

 

 

Service provider will be responsible for database development, testing, and validation in compliance with 21 CFR Part 11.

Data Cleaning & Query Management

 

ü

 

 

 

Service provider will be responsible to manage the study data collection, data cleaning, and query management process.

Double Data Entry

 

ü

 

 

 

For paper-based CRFs, Service provider will be responsible to double data enter the CRF data into the study database.

Data Transfers Specifications

 

ü

 

R

 

Service provider will be responsible to create the data transfer specifications for all data collected outside the study database from third party vendors. The data transfer specification will be provided

 

Attachment 2, Attachment C-8



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

for Sponsor review.

Data Transfers & Merge

 

ü

 

 

 

Service provider will be responsible to collect and validate the external data transfer and merge the datasets into the study database. The data transfer specification will be provided for Sponsor review.

DSMB Data Preparation & Transfer

 

ü

 

A

 

Service provider will be responsible to prepare for a DSMB meeting to clean the data and manage the queries and prepare a database transfer to the Sponsor’s statistician. The database transfer specification will be provided to the Sponsor for approval prior to the first data transfer.

Data Listings for Medical & Sponsor Review

 

ü

 

R

 

Service provider will be responsible to generate data listings for Medical and Sponsor Review during the study. The data listings will include: Reasons for Enrollment Failure (during screening), Baseline Demographics (during screening), Adverse Events (monthly), Concomitant Medications (monthly), Study Drug Administration (monthly), Patient Vertebral and Non Vertebral Fractures (monthly), Patient BMD all sites (monthly), Abnormal Labs (monthly), Elevated Calcium (monthly)

Data Coding (MeDRA, WHO Drug)

 

ü

 

A

 

Service provider will be responsible to code all Adverse Events, Medical History and Concomitant Medications with MeDRA and WHO Drug. Sponsor will be responsible to approve the events and medications are coded appropriately.

eCRF and Query Tracking

 

ü

 

 

 

Service provider will be responsible to manage and track site compliance with data entry by tracking CRFs and queries.

SAE Database Reconciliation

 

ü

 

ü

 

Sponsor and Service provider will be responsible to perform a reconciliation of the events in the safety and trial database. Service provider will perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock. The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Local Tolerance Diary

 

ü

 

A

 

The Service provider will be responsible to create the Local Tolerance Diary. The Sponsor will be responsible for approving the Local Tolerance Diary prior to the

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment C-9



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve
R = Review

 

Nordic
Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

document’s submissions.

Drug Compliance Diary

 

ü

 

A

 

The Service provider will be responsible to create the Drug Compliance Diary. The Sponsor will be responsible for approving the Drug Compliance Diary prior to the document’s submissions.

Patient CRFs for CSR (SAE or AE Discontinued)

 

ü

 

 

 

Service provider will be responsible to generate copies of the entire individual patient case report forms for all patients who had a serious adverse event or discontinued due to adverse event.

Investigator Signoff of Patient eCRF

 

ü

 

 

 

Service provider will be responsible to insure that the investigator has signed off on the patient case report forms that the data are reviewed and accurate.

Blinded Data Review Meeting with Sponsor

 

ü

 

A

 

Service provider will be responsible to provide the Sponsor with a completed database for blinded data review prior to database lock. Sponsor will be required to review and approve the database and data prior to database lock.

Database Lock

 

ü

 

A

 

Service provider will be responsible to lock the study database. Sponsor will be required to review and approve all changes or queries generated during the blinded study review meeting have been resolved and the database can be locked.

Data Transfer to Sponsor

 

ü

 

 

 

Service provider will be responsible to transfer the study data and database to the sponsor.

Data Archiving & PDF

 

ü

 

 

 

Service provider will be responsible to generate data and PDF for archiving. Service provider will be responsible to provide each study center a data archive for the sites’ patients.

Safety & Pharmacovigilance

 

 

 

 

 

 

Safety Monitor

 

ü

 

 

 

Service provider will be responsible to provide a Safety Monitor Medical Director to oversee and report on any serious adverse event.

Safety Plan

 

ü

 

A

 

Service provider will be responsible to develop a safety plan that documents the safety reporting process and health authority submission responsibilities.

Safety Reporting Database

 

ü

 

ü

 

Service provider will be responsible to enter serious adverse events data in a validated 21 CFR Part 11 compliant database provided by Sponsor.

SAE Site Reporting Form

 

ü

 

A

 

Service provider will be responsible to provide an SAE reporting form at the start of the study. This form will capture all the necessary reporting information requiring

 

Attachment 2, Attachment C-10


 

ü  = Owner

 

Activity Responsible

 

 

A = Approve

 

Nordic

 

 

 

 

R = Review

 

Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

for submitting a CIOMS form to the Health Authorities.  Sponsor will be responsible to approve the SAE reporting form.

ICSR CIOMS Initial & Follow up Forms

 

ü

 

A

 

Service provider will be responsible to complete the CIOMS form for all initial and follow up Suspected Unexpected Serious Adverse Event

ICSR Tracking of Health Authority filings

 

ü

 

R

 

Service provider will be responsible to create a tracking tool for all reported serious adverse events and report status (i.e., initial, follow up, dates of submission).

Serious Adverse Event Narrative

 

ü

 

ü

 

Sponsor and Service provider will be responsible to create the SAE narrative for reporting in the CIOMS and providing to the Medical Writer for the clinical study report.  Sponsor is responsible for reviewing and approving the SAE narrative prior to approving the CIOMS for submission.

Annual & Periodic Safety Update Generation & Filing

 

ü

 

A

 

Service provider will be responsible to create annual safety reports to update Health Authorities in the EU and Hong Kong.  Sponsor will be responsible to approve the annual safety reports prior to submission. Sponsor is responsible for creating and submitting annual reports to the FDA

Health Authority Reporting

 

ü

 

ü

 

Sponsor will be responsible to submit SAE CIOMS Initial and Follow up to the FDA.  Service provider will be responsible to submit the CIOMS Initial and Follow up to all other Health Authorities.  Reports are required to be made within 7 or 15 days depending on the type of SAE identified in the Safety Plan.

SAE CIOMS Site Distribution

 

ü

 

 

 

Service provider will be responsible to notify the sites and distribute the CIOMS forms to the sites for reporting to local ethics, as required.

SAE Reconciliation with Data Management

 

ü

 

ü

 

Sponsor and Service provider will be responsible to perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock.  The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Final Safety Report for HA, EC, IRB submission

 

ü

 

ü

 

Sponsor and Service provider will be responsible to create the final safety report at the end of the study.  Sponsor will submit final safety report to FDA and NB

 

Attachment 2, Attachment C-11



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve

 

Nordic

 

 

 

 

R = Review

 

Biosciences

 

Radius

 

Expectation

 

 

 

 

 

 

to other HAs and ECs.

Statistics

 

 

 

 

 

 

Randomization Scheme

 

 

 

ü

 

Sponsor’s statistician will be responsible to create and maintain the randomization scheme only unblinding after database lock.

Statistical Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the Statistical Analysis Plan (SAP) prior to database lock.

Statistical Programming

 

 

 

ü

 

Sponsor’s statistician and statistical programmer will be responsible to develop the statistical programming for the analyses and TLFs

TLF Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate all tables, listings, and figures for the study.

Data Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to perform the study analyses.

DSMB Table Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the required tables and data for the DSMB.

Population PK Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the PopPK analysis plan prior to database lock.

Population PK Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the programming and analyses for the Population PK analysis.

QT Prolongation Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the programming and analyses for the ECG data collected for determination of QT Prolongation

Medical Writing

 

 

 

 

 

 

Clinical Study Report

 

 

 

ü

 

Sponsor’s Medical Writer will be responsible to write the clinical study report

CSR Narratives (SAE, AE Discontinuation)

 

ü

 

ü

 

Service provider’s Safety & Pharmacovigilance group will be responsible for generation of the safety narratives for the CSR during the clinical study.  The Sponsor’s Medical Writer will be responsible for incorporating the narratives into the CSR.

Quality

 

 

 

 

 

 

CRO Qualification

 

 

 

ü

 

Sponsor will be responsible for qualification of the Service provider.

CRO GCP and systems audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct Service provider GCP and systems audits.

Third party qualification and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct qualifications and audits for third party vendors.

 

Attachment 2, Attachment C-12



 

ü  = Owner

 

Activity Responsible

 

 

A = Approve

 

Nordic

 

 

 

 

R = Review

 

Biosciences

 

Radius

 

Expectation

Investigator site audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct investigator site audits.

Health Authority inspections/audits

 

ü

 

ü

 

In the event of an Health Authority inspection of the Service provider or sites, the Service provider and Sponsor will be responsible for assisting with the inspection, providing responses to inspector requests, and drafting follow up responses to the inspection inquiries.

Clinical trial documents review and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to review and/or audit the Service provider’s clinical trial documents (i.e., trial master files).

 

Attachment 2, Attachment C-13



 

Work Statement NB-1

Attachment D

Core Team Members/Key Personnel

 

The following core team members will conduct the services listed in Attachment A.

 

Sponsor will be notified of any changes to the core team member.

 

Study Safety Officer

 

Bente Juel Riis

 

[*]

 

Clinical Trial Leader

 

Jeppe Ragnar Andersen

 

[*]

 

Clinical Trial Manager

 

Morten Thorup Pedersen

 

[*]

 

Pharmacovigilance Manager

 

Bodil Simonsen

 

[*]

 

Clinical Data Managers

 

Henrik Bo Hansen
Ole Eskildsen

 

[*]

 

Statistical Advisor

 

Inger Byrjalsen

 

[*]

 

Medical Writer/Coder

 

Lina Saem Stoy

 

[*]

 

Lead CRA

 

Anders Enok Olsen

 

[*]

 

Head of Central Laboratory

 

Per Qyist

 

[*]

 

Clinical Regulatory Coordination

 

Lisa Thomsen

 

[*]

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment D-1


 

Work Statement NB-1

Attachment E

Protocol or Protocol Summary

 

Attachment 2, Attachment E-1



 

CLINICAL STUDY PROTOCOL

 

 

A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture

 

·       This study will be conducted according to the protocol and in compliance with Good Clinical Practice, the ethical principles stated in the Declaration of Helsinki, and other applicable regulatory requirements.

 

 

·    Protocol Number:

 

·       Protocol BA058-05-003

 

 

 

 

 

·    EudraCT Number:

 

·       2010-022576-30

 

 

 

 

 

·    Protocol Date (Version):

 

·       2 December 2010 (Version 1.0)

 

 

 

 

 

·    Study Sponsor:

 

·       Radius Health, Inc. (RADIUS)

201 Broadway, 6 th  Floor
Cambridge, MA 02139, USA
Tel:  617.551.4700  Fax:  617.551.4701

 

 

 

 

 

·    Sponsor Medical Monitor:

 

·       Louis St.L. O’Dea, MB BCh BAO. FRCP(C)

Chief Medical Officer, Radius Health, Inc.
Tel:  617.551.4706.  Fax:  617.551.4701.
Email:  lodea@radiuspharm.com

 

 

 

 

 

·    Study Safety Officer:

 

·       Bente Juel Riis, MD

Medical Advisor, Nordic Bioscience A/S
Tel: +45 22 90 13 17.  Fax: +41 91 970 2988

Email:  bjr@nordicbioscience.com

 

 

 

 

 

·    Contract Research Organization (CRO):

 

·       Nordic Bioscience A/S

·       Herlev Hovedgade 207

2730 Herlev, Denmark
Tel:  +45 4452 5252. 
Fax: +45 4452 5251

 

 

 

 

 

·    Study Site:

 

·       Multicenter; international

 

 

 

 

 

·    Principal Investigator:

 

·       TBD

Address
Contacts

 

·               Disclosure Statement
This document contains information that is confidential and proprietary to Radius Health, Incorporated (RADIUS).  This information is being provided to you solely for the purpose of evaluation and/or conducting a clinical trial for RADIUS.  You may disclose the contents of this document only to study personnel under your supervision and/or to your institutional review board(s) or ethics committee(s) who need to know the contents for this purpose and who have been advised on the confidential nature of the document.

 

Attachment 2, Attachment E-2



 

Radius Health, Inc.

Confidential

 

 

PROTOCOL SYNOPSIS

 

·               Title:      A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture

·               Protocol Number:  BA058-05-003

·               Phase:  3

·               Test Drug:  BA058 for Injection 80 µg

·               Study Objectives:

 

The primary objective of this study is to determine the safety and efficacy of BA058 for Injection 80 µg when compared to a matching Placebo for prevention of vertebral fracture in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis.  Patients, investigators and independent assessors will be blinded as to treatment for that outcome.  The secondary outcomes, also double-blind, of this study are to determine the safety and efficacy of BA058 80 µg when compared to Placebo for prevention of non-vertebral fractures and for change in vertical height.  Additional key secondary efficacy outcomes include bone mineral density of spine, hip and femoral neck and hypercalcemia when compared to teriparatide (Forteo ® /Forsteo ® , Eli Lilly and Co.), which will be assessor-blind.

 

The specific objectives of this study are to:

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on lumbar spine, hip, and femoral neck bone mineral density (BMD) in otherwise healthy ambulatory postmenopausal women with severe osteoporosis when compared to teriparatide.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of non-vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the overall safety and tolerability of 18 months of treatment with BA058 80 µg, and specifically the number of patients with hypercalcemic events, in otherwise healthy ambulatory postmenopausal women with severe osteoporosis when compared to teriparatide and Placebo.

 

·                   Provide additional evidence of bone safety through histomorphometric assessment of bone biopsy samples in a randomized subset of patients from the BA058 80 µg and Placebo groups.

 

·                   Provide additional evidence of renal safety through radiological assessment by CT scan of a randomized subset of patients from the BA058 80 µg, Placebo and teriparatide groups.

 

·               Study Population:

 

Inclusion Criteria:

 

Otherwise healthy ambulatory postmenopausal ( > 5 years) women from 50 to 85 years of age (inclusive) who meet the study entry criteria and have provided written informed consent are eligible for the study.  The women are to have a BMD T-score <  -2.5 and > -5.0 at the lumbar spine or hip (femoral neck) by dual energy x-ray absorptiometry (DXA) and radiological evidence of 2 or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years.  Postmenopausal women older than 65 who meet the above fracture criteria but have a T-score <  -2.0 and > -5.0 may be enrolled.  Women older than 65 who do not meet the fracture criteria may also be enrolled if their T-score is < -3.0 and > -5.0.

 

All patients are to be in good general health as determined by medical history, physical examination (including vital signs) and clinical laboratory testing.  Serum calcium, PTH(1-84), serum phosphorus and serum alkaline

 

Attachment 2, Attachment E-3



 

phosphatase values must be within the normal range during the Screening Period.  Serum 25-hydroxy Vitamin D must be above 15 ng/mL and within 3 times the upper normal range to be eligible for enrollment.  The resting 12-lead ECG obtained during screening should have no clinically significant abnormality and a QTc (Bazett’s correction) of < 470 msec.  Patients with more than four mild or moderate fractures, or any severe fractures, will be excluded from the study.  In addition, patients with fewer than 2 evaluable lumbar vertebrae or patients with unevaluable hip BMD will be excluded from the study.

 

Patients with unexplained elevation of serum alkaline phosphatase, with a history of Paget’s disease, of any cancer within the past 5 years other than basal cell or squamous cancer of the skin, will be ineligible for enrollment.  Also, patients with a history of Cushing’s disease, hyperthyroidism, hypo- or hyperparathyroidism or malabsorptive syndromes within the past year are also ineligible for enrollment.  Patients who have ever received treatment with a PTH or PTHrP drug will be excluded.  Treatment with bisphosphonates, fluoride or strontium in the past 5 years, or treatment with androgens, other anabolic steroids, corticosteroids or selective estrogen receptor modulators within the past 12 months will also exclude patients from enrollment. Patients who had a short course of bisphosphonate treatment (3 months or less) and were intolerant of the treatment may be considered for study participation.  Estrogens administered as hormone replacement therapy (HRT), with or without progestins, are not exclusionary. Patients who have participated in a clinical study of any novel unapproved medication in the past 12 months will also be excluded from participation.

 

The specific inclusion and exclusion criteria are described in Sections 4.2 and 4.3 of the protocol, respectively.

 

·               Study Design and Methodology:

 

Number of Patients

 

A total of 2400 patients are planned to be enrolled in the study in 11 medical centers.

 

Design

 

This is a randomized, double-blind, placebo-controlled, comparative Phase 3, multicenter international study to evaluate the efficacy and safety of BA058 80 µg in the prevention of fracture in otherwise healthy ambulatory postmenopausal women with severe osteoporosis.

 

A total of 2400 eligible patients will be randomized equally to receive one of the following: BA058 80 µg, a matching Placebo, or teriparatide 20 µg for 18 months.  Study drug will be blinded to patients and medical personnel until the randomization process is completed.  Treatment with BA058 80 µg or Placebo will remain blinded to all parties throughout the study.  As a proprietary prefilled drug and device combination marketed product, teriparatide cannot be repackaged and blinded.  Study medication will be self-administered daily by SC injection for a maximum of 18 months.  Patients unable to self-administer drug may be injected by a third party after appropriate training of that person by the study site personnel.

 

The dosages of study medications and the number of patients to be enrolled are shown below:

 

Treatment
Regimen

 

Study Medication

 

Daily
Dose (SC)

 

Duration

 

Number of
Patients

 

1

 

BA058

 

80 µg

 

18 months

 

800

 

2

 

Placebo

 

 

18 months

 

800

 

3

 

Teriparatide

 

20 µg

 

18 months

 

800

 

 

 

 

 

 

 

Total

 

2400

 

 

All enrolled patients will also receive Calcium and Vitamin D supplementation from the time of enrollment until the end of the Treatment Period; it will be recommended to patients that they also continue these supplements through the Follow-up Period.

 

Attachment 2, Attachment E-4



 

Study Visits

 

Upon signing of the informed consent, patients will enter a 1-4 week period of screening and prestudy training.  Patients will be trained on self-administration of study drug and on recording of medication usage and local tolerance.  After eligibility is assessed during the Screening period, a one week Pretreatment period is used to collect baseline data.  Once enrolled, patients will return to their study center for safety and efficacy assessments at baseline (Day 1) and 1, 3, 6, 9, 12, and 18 months, and at any other time as warranted by safety, efficacy or compliance concerns.  A final study visit is planned one month after the last dose of study drug.

The study periods and number of clinic visits are summarized below:

 

Study
Period

 

Duration of
Study Period

 

Scheduled
Visits (#)

 

1.

Screening

 

1-3 weeks

 

1

 

2.

Pretreatment

 

1 week

 

1

 

3.

Treatment

 

78 weeks

 

7

 

4.

Follow-up

 

4 weeks

 

1

 

 

Total

 

84-86 weeks

 

10

 

 

Procedures and Assessments

 

Efficacy

 

The primary efficacy endpoint will be the number of BA058-treated patients showing new vertebral fractures at End-of-Treatment when compared to Placebo.  New incident vertebral fractures will be evaluated according to the method of Genant (1).  Efficacy assessments will therefore include documentation of the incidence of clinical and radiographic fractures of the lumbar and thoracic spine.  Patients will undergo baseline and End-of-Treatment antero-posterior and lateral radiographs of the lumbar and thoracic spine.  All radiographs will be viewed and assessed by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fracture will be assessed according to a set of pre-determined criteria.  A second blinded radiologist will review the assessment of the first reviewer for all patient radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.  A standardized graded scale of severity of the vertebral deformity will be evaluated according to the method of Genant (1).

 

Secondary efficacy parameters will also include reduction in the incidence of non-vertebral fractures (wrist, hip, rib, etc.) and reduction in moderate and severe vertebral fractures.  Clinical fracture occurring de novo at these anatomical sites during the study will also be assessed and analyzed.  Other secondary efficacy endpoints will include changes in BMD of spine, hip, and femoral neck, and wrist from baseline to end-of-treatment as assessed by DXA.  Patients will undergo BMD assessments at Screening (spine and hip; all patients), at Day 1 (wrist; in a subset of patients), and at Months 6, 12 and 18 (End-of-Treatment) of study participation.  Any patient who shows a continuing significant deterioration (>7%) of BMD at spine or hip will have the assessment repeated and, if confirmed, will be discontinued from the study.  Patients sustaining an incident vertebral or non-vertebral fragility fracture will be informed of the finding and offered the opportunity to remain in or discontinue from the study.

 

Additional secondary endpoints will include change in standing height and changes in serum bone markers across treatment, such as PINP, osteocalcin, and bone-specific alkaline phosphatase.  Serum C-telopeptides (CTX), a marker of bone resorption and collagen breakdown, will be measured and reported.  Bone markers will be assessed Pretreatment and at Months 6, 12 and 18 (End-of-Treatment).  Urine samples will be collected for the measurement of calcium and creatinine to determine the Calcium:Creatinine ratio.  The Calcium:Creatinine ratio will be measured at each visit during the Treatment Period.  The frequency of hypercalcemia across treatment groups will also be assessed.

 

Attachment 2, Attachment E-5



 

Patients who discontinue study participation prematurely will undergo End-of-Treatment and End-of-Study assessments once their discontinuation is confirmed.

 

Safety

 

Safety evaluations to be performed will include physical examinations, vital signs, 12-lead ECGs, clinical laboratory tests, and monitoring and recording of adverse events.  Specific safety assessments will include post-dose (4 hours) determination of serum calcium, determination of Creatinine Clearance, post-dose ECG assessments at selected visits, and assessments of postural hypotension (60 minutes post-dose) at selected clinic visits.

 

The incidence and severity of adverse events by dose and cumulative dose and pathological changes in hematology, chemistry and urinalysis data will be recorded and summarized.  Changes in physical examination (including height), vital signs, ECG and clinical laboratory tests will be descriptively summarized.  Shift frequencies will be summarized for clinical laboratory tests.

 

Injection sites will be graded to assess local tolerance to study medication.

 

ECG and safety laboratory assessments will be performed at all scheduled visits and at any unscheduled visit as deemed necessary by the Investigator.  QT interval assessments will be performed for all study subjects across the Treatment Period.

 

Bone biopsy of the iliac crest will be performed in a subset of patients receiving BA058 80 µg and Placebo (up to 100 per group to obtain 75 evaluable biopsies per treatment group) between Visits 8 and 9 for assessment of quantitative bone histomorphometry using a duel-labeling procedure.  All bone biopsies will be read blinded to treatment at a central specialized facility.

 

A further subset of patients, 100 per treatment group in all 3 groups, will undergo a renal CT scan at the end of the study, which will also be read (blinded as to treatment) centrally, to assess the renal parenchyma and collecting system.

 

Study safety will be monitored by an independent Data Safety Monitoring Board.

 

Complete details of the study assessments are provided in Section 7.0, in the Schedule of Visits and Procedures (Appendix 14.1) and in the Suggested Schedule of Events and Procedures by Study Visit (Appendix 14.2).

 

Statistical Considerations:

 

Sample Size

 

A sample size of 622 patients per treatment arm provides 90% power at a two-sided alpha of 0.05 to detect a superiority difference of 4% between placebo patients and BA058 80 µg for injection-treated patients on vertebral fracture incidence.  To ensure an evaluable population of 622 patients, an overall sample size of 800 patients per treatment arm will be recruited.  For statistically powered secondary endpoints the sample size will have greater than 90% power at an alpha of 0.05 to detect a 1.15%, 2.45%, and 2.00% difference for spine, hip, and femoral neck BMD, respectively, between BA058 and teriparatide.  The study sample size will also provide more than 90% power to detect differences between BA058 and teriparatide in the number of patients reporting one or more events of hypercalcemia.

 

Baseline Comparisons

 

Baseline characteristics, medical history, physical examination, vital signs and ECG, will be summarized using standard descriptive statistics by treatment group. Specific demographic and baseline parameters will be tested for overall agreement across treatment groups using one-way ANOVA or Chi-square tests as appropriate for the type of data.

 

Efficacy Analyses

 

The primary efficacy endpoint will be the number of BA058-treated patients showing new vertebral fractures at End-of-Treatment when compared to Placebo.

 

Attachment 2, Attachment E-6



 

Key secondary endpoints that will be statistically analyzed include change in BMD (spine, hip, and femoral neck) and differences in the number of patients reporting one or more events of hypercalcemia from baseline to End-of-Treatment for BA058 80 µg when compared to teriparatide.  Additional secondary efficacy endpoints will include the change in vertical height in BA058 80 µg patients when compared to Placebo and the incidence of BA058 80 µg patients with new non-vertebral fractures from baseline to End-of-Treatment when compared to Placebo.  Severity of vertebral fractures, fracture incidence over time by treatment group, and new vertebral fractures in teriparatide patients compared to Placebo will also be assessed.

 

Other efficacy endpoints will include change in wrist BMD in BA058-treated patients, and changes in serum PINP, bone-specific alkaline phosphatase, osteocalcin, and CTX across treatment.

 

Population PK/PD Analysis

 

Samples for measurement of serum levels of BA058 will be taken to evaluate population PK effects on demographics, efficacy, and safety.

 

Safety Analysis

 

All patients who receive at least one dose of study medication will be included in the safety analysis that will be performed on the following parameters:

 

Incidence and severity of AEs; dose and cumulative dose at which the AE occurred.

 

Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory.

 

Frequency of hypercalcemia will also be compared across treatment groups.

 

Bone histomorphometry as assessed by bone biopsy at End-of-Treatment in a randomized subset of BA058 and Placebo patients.

 

Renal safety as assessed at End-of-Treatment by renal CT scan in a randomized subset of patients in all treatment groups.

 

All AEs collected prior to first injection will be separately summarized in a fashion similar to the TEAEs.

 

Treatments Administered:

 

BA058 80 µg Drug Product for Injection (2.0 mg/mL BA058 in 5 mg/mL tri-hydrate sodium acetate and 5mg/mL of phenol (preservative) adjusted at pH 5.1 with acetic acid) will be supplied as a liquid in a 1.5 mL Type 1 glass cartridge and is stored refrigerated at 5 ± 3ºC.  The multi-dose cartridge is designed to deliver a dose of 80 µg of BA058 in 40 µL of fluid or a half dose of 40 µg of BA058 in 20 µL of fluid when inserted into the Pen Injector device.  Each cartridge contains enough study medication to deliver the required daily dose for 30 days.  Patients will be provided with a sufficient number of cartridges to continue on treatment until the next scheduled clinic visit.  Study medication should be stored in refrigerated conditions (2-8 ºC) until dispensed for use.  In-use storage may be at room temperature, up to 25 ºC for 30 days.

 

Placebo is formulated similarly but without active BA058 and will be similarly supplied as a liquid in a 1.5 mL Type 1 glass cartridge and is stored refrigerated at 5 ± 3ºC.  The multi-dose cartridge is designed to deliver a dose of Placebo in 40 µL of fluid when inserted into the Pen Injector device.  Each cartridge contains enough study medication to deliver the required daily dose for 30 days.  Storage and dispensing conditions will match those of active study drug.

 

Teriparatide (rDNA origin) injection (250 µg/mL) will be supplied in multi-dose disposable pens containing a glass cartridge.  Each pen contains enough study medication to deliver the required daily dose for 28 days.  Study medication should be stored in refrigerated conditions (2-8 ºC) until dispensed for use.  In use storage should also be in refrigerated conditions, 2-8 ºC.

 

Calcium (500—1000 mg) and Vitamin D (400—800 IU) supplements will be provided at the study site.

 

Attachment 2, Attachment E-7



 

Duration of Subject Participation:

 

The maximum total duration of study participation for an individual patient is approximately 20 months from the initial screening visit to the completion of final study evaluations.  Patients will complete screening and study-specific procedures within 4 weeks.  After completion of the Screening and Pretreatment Periods, patients will be randomized and will receive the first dose of study medication on Day 1 of the Treatment Period.  The Treatment Period will be a maximum of 18 months with daily SC dosing.  After completion of dosing, patients will enter the Follow-up Period for 1 month.  The End-of-Study Visit will be scheduled at the end of the Follow-up Period and patients will be terminated from the study.

 

Post-study Treatments and Assessments:

 

Placebo Patients

 

Placebo patients who complete 18 months of study participation or experience a clinical fracture will be given the opportunity to receive treatment with a bisphosphonate for 24 months.  Patients will receive standard-of-care management including assessment of BMD during this period.

 

BA058 Patients

 

BA058 patients who complete 18-months of study participation will be given the opportunity to receive an additional 6 months of treatment with BA058 80 µg, to assess the safety and efficacy of BA058 80 µg over,a total of 24 months of treatment.  On completion of BA058 treatment, patients will be assessed for maintenance of BMD benefit over 12 months post-treatment or will receive a bisphosphonate to assess the benefit of sequential treatment with bisphosphonate after BA058, for 12 months.

 

Teriparatide Patients

 

There will be no post-study treatments or assessments for patients completing treatment with teriparatide.

 

Attachment 2, Attachment E-8


 

 

TABLE OF CONTENTS

 

Table of Contents

9

List of Abbreviations

12

1.0

INTRODUCTION

14

 

1.1

Background Information

14

 

1.2

Drug under Study

15

 

1.3

Study Rationale and Selection of Doses

18

 

 

1.3.1

Study Rationale

18

 

 

1.3.2

Study Design and Rationale for Placebo

18

 

 

1.3.3

Study Population

19

 

 

1.3.4

Selection of Endpoints

20

 

 

1.3.5

Selection of Dose

20

2.0

STUDY OBJECTIVES

22

3.0

INVESTIGATIONAL PLAN

23

 

3.1

Overall Design and Study Plan

23

 

 

3.1.1

Screening Period

25

 

 

3.1.2

Pretreatment Period

26

 

 

3.1.3

Treatment Period

26

 

 

3.1.4

Follow-up Period

27

4.0

SELECTION OF STUDY POPULATION

28

 

4.1

Number of Subjects

28

 

4.2

Inclusion Criteria

28

 

4.3

Exclusion Criteria

29

 

4.4

Withdrawal of Patients from the Study

31

 

4.5

Temporary Suspension of Treatment

32

 

 

4.5.1

Treatment Suspension due to Hypercalcemia

33

 

 

4.5.2

Treatment Suspension due to Hypercalciuria

34

 

4.6

Replacement of Patients

35

5.0

STUDY TREATMENTS

36

 

5.1

Study Medications

36

 

 

5.1.1

BA058 80 µg, Placebo and Teriparatide

36

 

 

5.1.2

Calcium and Vitamin D Supplements

36

 

5.2

Packaging, Labeling and Storage

37

 

 

5.2.1

Packaging

37

 

 

5.2.2

Labeling

37

 

 

5.2.3

Storage

37

 

5.3

Treatment Assignment

37

 

5.4

Study Medication Administration

38

 

5.5

Treatment Compliance

39

 

5.6

Unblinding of Study Medication

39

 

 

5.6.1

Medical Emergency

39

6.0

CONCOMITANT MEDICATIONS

40

 

6.1

Concomitant Medications

40

 

6.2

Prohibited Medications

41

7.0

STUDY ASSESSMENTS

42

 

Attachment 2, Attachment E-9



 

 

7.1

Clinical Procedures/Assessments

42

 

 

7.1.1

Informed Consent

42

 

 

7.1.2

Medical History

42

 

 

7.1.3

Physical Examination

43

 

 

7.1.4

Vital Signs, Weight and Height

43

 

 

7.1.5

Electrocardiogram

43

 

 

7.1.6

Clinical Laboratory Evaluations

43

 

 

7.1.7

Serum Markers of Bone Metabolism

46

 

 

7.1.8

Clinical and Radiologic Evaluation of Fractures

46

 

 

7.1.9

Bone Mineral Density

47

 

 

7.1.10

Quantitative Bone Histomorphometry Assessment

48

 

 

7.1.11

Renal assessment by CT Scan

48

 

 

7.1.12

BA058 Serum Level and Antibody Assessments

48

 

 

7.1.13

Local Tolerance

48

 

 

7.1.14

Patient Diaries

49

 

 

7.1.15

Activity and Diet

50

8.0

ADVERSE EVENTS AND SAFETY EVALUATION

50

 

8.1

Definitions, Documentation, and Reporting

50

 

 

8.1.1

Adverse Event Definition

50

 

 

8.1.2

Serious Adverse Event Definition

50

 

8.2

Monitoring of Adverse Events and Period of Observation

51

 

8.3

Procedures for Recording and Reporting AEs and SAEs

52

 

8.4

Rules for Suspension of the Study

54

9.0

Statistical Procedures

55

 

9.1

Sample Size

55

 

9.2

Randomization, Stratification and Blinding

56

 

9.3

Populations for Analysis

57

 

 

9.3.1

Safety Population

57

 

 

9.3.2

Modified Intent-to-Treat Population

57

 

 

9.3.3

Per Protocol Population

57

 

9.4

Procedures for Handling Missing, Unused, and Spurious Data

57

 

9.5

Statistical Methods

57

 

 

9.5.1

Baseline Comparisons

57

 

 

9.5.2

Efficacy Analysis

57

 

 

9.5.3

Safety Analysis

60

 

 

9.5.4

Interim Analysis

60

 

 

9.5.5

Procedures for Reporting Deviations to Original Statistical Analysis Plan

61

 

9.6

Data Oversight

61

 

 

9.6.1

Central Review of Radiographs and DXA Scans

61

 

 

9.6.2

Data Safety Monitoring Board

61

10.0

ADMINISTRATIVE REQUIREMENTS

62

 

10.1

Good Clinical Practice

62

 

10.2

Ethical Considerations

62

 

10.3

Subject Information and Informed Consent

62

 

10.4

Protocol Compliance

62

 

Attachment 2, Attachment E-10



 

 

10.5

Case Report Form Completion

63

 

10.6

Source Documents

63

 

10.7

Study Monitoring

63

 

10.8

On-Site Audits

64

 

10.9

Drug Accountability

64

 

10.10

Record Retention

64

 

10.11

Study Termination

65

 

10.12

Liability and Insurance

65

11.0

USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

66

 

11.1

Use of Information

66

 

11.2

Publication

66

12.0

INVESTIGATOR AGREEMENT

67

13.0

REFERENCES

68

14.0

APPENDICES

70

 

14.1

Schedule of Visits and Procedures

71

 

14.2

Suggested Schedule of Events and Procedures by Study Visit

73

 

14.3

Body Mass Index Table

85

 

14.4

WHO (World Health Organization) Toxicity Criteria by Grade

86

 

14.5

Declaration of Helsinki

89

 

Attachment 2, Attachment E-11



 

LIST OF ABBREVIATIONS

 

Abbreviation

 

Term

°C

 

Degree celsius

°F

 

Degree fahrenheit

µg

 

Microgram

µL

 

Microliter

µmol

 

Micromole

AE

 

Adverse event

ALT

 

Alanine aminotransferase

ANOVA

 

Analysis of variance

AST

 

Aspartate aminotransferase

BMD

 

Bone mineral density

BMI

 

Body mass index

bpm

 

Beats per minute

BSAP

 

Bone-specific alkaline phosphatase

BUN

 

Blood urea nitrogen

cm

 

Centimeter

CPK

 

Creatine phosphokinase

CRF

 

Case report form

CRO

 

Contract research organization

CTX

 

C-telopeptides of type 1 collagen crosslinks (serum)

DXA

 

Dual energy x-ray absorptiometry

ECG

 

Electrocardiogram

eCRF

 

Electronic case report form

FDA

 

Food and Drug Administration

FRAX

 

Tool developed by WHO to evaluate fracture risk of patients

FSH

 

Follicle-stimulating hormone

g

 

Gram

GCP

 

Good clinical practice

GGT

 

Gamma-glutamyltranspeptidase

GLP

 

Good laboratory practice

GMP

 

Good manufacturing practice

HEENT

 

Head, eye, ear, nose, and throat

hPTH1R

 

Human parathyroid hormone receptor 1

ICH

 

International Conference on Harmonization

IEC

 

Independent ethics committee

IRB

 

Institutional review board

ITT

 

Intent-to-treat

IU

 

International unit

IV

 

Intravenous

 

Attachment 2, Attachment E-12



 

Abbreviation

 

Term

IVRS

 

Interactive voice response system

kg

 

Kilogram

L

 

Liter

LDH

 

Lactate dehydrogenase

MCH

 

Mean corpuscular hemoglobin

MCHC

 

Mean corpuscular hemoglobin concentration

MCV

 

Mean corpuscular volume

MedDRA

 

Medical dictionary for regulatory activities

mg

 

Milligram

mL

 

Milliliter

mmHg

 

Millimeter of mercury

msec

 

Millisecond

MTD

 

Maximal tolerated dose

N.P.O.

 

Nothing by mouth

ng

 

Nanogram

NOAEL

 

No observed adverse effect level

NSAID

 

Non-steroidal anti-inflammatory drug

pg

 

Picogram

PINP

 

N-terminal propeptide of type I procollagen

PT

 

Prothrombin time

PTH

 

Parathyroid hormone

PTHrP

 

Parathyroid hormone related peptide

PTT

 

Partial thromboplastin time

PVCs

 

Premature ventricular complexes

QT

 

Total depolarization and repolarization time

QTc

 

Total depolarization and repolarization time corrected with heart rate

RBC

 

Red blood cell

rDNA

 

Recombinant deoxyribonucleic acid

rhPTH

 

Recombinant hPTH

SAE

 

Serious adverse event

SC

 

Subcutaneous

SD

 

Standard deviation

SERMs

 

Selective estrogen receptor modulators

SOP

 

Standard operating procedure

ULN

 

Upper Limit of Normal

WBC

 

White blood cells

WHO

 

World Health Organization

WMA

 

World Medical Association

 

Attachment 2, Attachment E-13



 

INTRODUCTION

 

Background Information

 

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue which leads to enhanced fragility and increased risk of fractures (2).  The common therapeutic approach is to decrease bone loss with the use of antiresorptive agents such as estrogens, selective estrogen receptor modulators (SERMs) and bisphosphonates (3).  However, when osteoporosis is severe, these classes of pharmacological agents provide only a moderate rate of return of bone mass and take a number of years to effect their fracture reduction benefit.  A preferable approach is to more rapidly reduce fracture risk by inducing a faster and greater return of bone mass through use of bone anabolic agents.  To date, only one class of bone anabolic drugs, PTH and its analogs, has been approved to prevent fractures in postmenopausal women with osteoporosis who are at risk of fracture.  PTHrP, and specifically BA058, offers another and potentially better therapeutic option than PTH in this indication and shows particular potential for reversing bone loss at the hip, the site of the most debilitating osteoporotic fractures in elderly women.

 

Human parathyroid hormone (hPTH) is a naturally occurring 84-amino acid hormone and is primarily a regulator of calcium homeostasis (4).  PTH acts directly on bone to increase calcium resorption, on the gastrointestinal system to increase calcium absorption, and on the kidney to increase calcium reabsorption and 1,25-dihydroxy Vitamin D production.  In turn, hPTH levels are tightly regulated by Calcium and Vitamin D levels.  When present at high doses or when administered in a continuous manner, hPTH has a catabolic effect on the skeleton through its ability to activate and increase osteoclast number which leads to increased serum calcium levels and decreased bone mass in humans (5).  However, when given intermittently at low doses, hPTH has a well-documented anabolic effect on bone, and can increase bone mineral density (BMD) in a number of intact animal models as well as in osteoporotic patients (6).

 

The 34-amino acid terminal fragment of hPTH, known as hPTH(1-34), appears to contain the full biological activity of native PTH(1-84) with regard to restoration of bone (7).  Teriparatide (Forteo ® /Forsteo ® ; Eli Lilly and Co., Indianapolis, Indiana), a recombinant human PTH (rhPTH(1-34)), was approved by FDA in 2002 as a new therapy for osteoporosis.  Teriparatide can stimulate bone formation, increase bone mass and reduce the risk of fractures in both animals and humans (8).

 

Human PTH-related peptide (hPTHrP) is a member of the PTH family that is secreted endogenously and which is partially homologous with the sequence of hPTH at the amino-terminus, where 8 of the first 13 amino acids are identical in both peptides (9).  Different to hPTH, PTHrP is produced by osteoblasts (10) and, like hPTH, hPTHrP is also involved in calcium homeostasis (9) but to a lesser degree than PTH.  PTHrP has also been shown to have an important role in normal skeletal development (11), and has been shown to restore bone mass in people when administered in an intermittent pattern (12).  When administered daily for three months by subcutaneous injection to women with severe postmenopausal

 

Attachment 2, Attachment E-14



 

osteoporosis, PTHrP(1-36) in a dose of 6.6 µg/kg (approximately 400 µg/day) increased lumbar spine BMD by 4.7%, a value that was statistically different from placebo (1.4%).  In addition, there was no associated hypercalcemia reported and no evidence of bone resorption when assessed by changes in serum markers of bone resorption (12).

 

BA058 is a 34-amino acid analog of hPTHrP, with molecular modifications of specific amino acids.  BA058 is expected to have similar or greater efficacy in restoring BMD in individuals with osteoporosis than hPTH(1-34), but with less risk of causing hypercalcemia.  Initial in vitro and in vivo studies identified BA058 as displaying such properties (13-16).  Clinical evaluations have shown BA058 to be well tolerated and to have significant positive effect on bone formation.

 

Drug under Study

 

As noted above, BA058 is an analog of the first 34 amino acids of hPTHrP(1-34).  BA058 was originally discovered and developed by the Beaufour-Ipsen Pharma Group (Ipsen) under the names BIM44058 and BIM44058C.  Radius Health, Inc. (hereafter referred to as RADIUS) acquired the license for the compound and is developing BA058 to treat postmenopausal women with osteoporosis who are at high risk of fracture.

 

Nonclinical pharmacology and toxicology studies have demonstrated that BA058 is a potent and selective agonist of the human parathyroid hormone receptor 1 (hPTH1R).  It has significantly less calcium mobilizing activity at higher doses than the native hormone and is a potent anabolic agent capable of fully restoring BMD in ovariectomized, osteopenic rats.

 

Results from safety pharmacology studies indicate that BA058 is generally safe.  The subcutaneous bioavailability was estimated to be 33% after administration of a single dose of 10 µg/kg in rats.  Tachycardia and hypotension were observed in dogs following both intravenous and subcutaneous administrations, however such effects have not been observed in other species or in human studies.  Minor pharmacological effects (increased bone formation, transient slightly higher blood total calcium levels after dosing) were observed at low doses in the toxicology studies.  The No Observed Adverse Effect Level (NOAEL) was 15, 25 and 25 µg/kg/day in rats in the 4-, 13, and 26-week studies, respectively, and 100, 50 and £ 10 µg/kg/day in monkeys in the 4-, 13- and 39-week studies, respectively.  No local clinical signs or microscopic findings were noted at the injection sites in rats and monkeys treated daily in the toxicity studies.  In the 39-week study, minimal to moderate mineralization of lung and kidney was observed at all doses evaluated.  There were slight but progressive and occasionally significant changes in blood parameters.  Significant hypercalcemia associated with premortem morbidity was also observed.  The repeated-dose studies revealed the presence of specific antibodies against BA058 in a proportion of animals tested, particularly following longer term exposure at higher doses, and more commonly in monkeys than in rats.  The presence of antibodies did not appear to neutralize the therapeutic effect of BA058.

 

To date, BA058 has been studied in single and multiple dose Phase 1 clinical trials in which BA058 was evaluated in healthy male and female subjects.  In addition, a Phase 2 dose

 

Attachment 2, Attachment E-15



 

finding clinical study was performed in postmenopausal women with osteoporosis to evaluate a range of doses of BA058.

 

The Phase 1 program involved 3 studies, a single-dose PK and bioavailability clinical trial (Study 2-52-52127-001) that enrolled healthy male and female subjects > 55 years of age, a repeated dose 7-day PK/PD study (Study BA058-05-001) that enrolled 39 healthy postmenopausal women from 50 to 73 years of age, and Study BA058-05-001B, a second repeated dose 7-day PK/PD study that investigated a new liquid formulation of BA058 presented as a prefilled multi-dose cartridge for use in a pen injector device.  The single exposure PK study investigated subcutaneous doses of 5 m g to 120 m g.  The single exposure study determined that BA058 was well-tolerated up to 80 m g, was 100% bioavailable, had approximately dose-proportional kinetics, and had a half-life of approximately 2.25 hours.  The repeated dose studies determined that BA058 was well-tolerated up to 100 m g, had limited hypercalcemic effect, induced early changes in bone formation markers and that 100  m g was the maximal tolerated dose.  Cardiac safety monitoring was conducted for all subjects in all BA058 Phase 1 studies and no clinically significant findings were identified.

 

A Phase 2 dose-finding clinical trial (Study BA058-05-002) was conducted in four countries (the United States, Argentina, India, and the United Kingdom) to evaluate the safety and efficacy of BA058 in women with osteoporosis (T-score £ -2.5).  This was a randomized, placebo- and comparator-controlled, parallel group dose-finding study of BA058 to evaluate the effects of daily SC injections of BA058 for six months in 225 postmenopausal women with osteoporosis, subsequently extended to 12 months in a subset of patients.  Following enrollment, patients underwent a 4-week Pretreatment Period of Calcium and Vitamin D supplementation and instruction in study medication self-administration, at the end of which patients were randomized to daily SC self-administration of placebo, BA058 20 m g, 40  m g, 80  m g or teriparatide.

 

The study was powered for change from baseline in primary study endpoints: BMD (spine) by DXA, and change in anabolic bone markers (serum PINP, BSAP, and osteocalcin).  Other anatomical sites were also assessed by DXA for change in BMD and additional anabolic and resorptive bone markers were also assessed.  Routine clinical and laboratory safety assessments were employed with additional monitoring of cardiac safety, serum calcium levels and local tolerance assessment by patient diary.  Two hundred and seventy patients were enrolled into pretreatment, 222 patients were randomized and 221 received study drug.   One hundred and eighty-seven patients completed treatment and 155 patients were evaluable as the Per Protocol Population.  The age of the study population ranged from 54 to 84 years old (mean 65) and mean spinal T-score at screening was -2.9.

 

Mean percent changes in total analyzable BMD of the spine at Week 24 increased with BA058 dose (1.4%, 3.5%, 1.5%, and 2.9% in the placebo, BA058 20 m g, BA058 40  m g, and BA058 80  m g groups, respectively) for the Per Protocol Population.  The test for a linear trend (dose response) was statistically significant (p<0.001).  Mean percent change in the teriparatide group at this visit was similar to the placebo group.  The anabolic bone markers showed a similar statistically significant dose response.

 

Attachment 2, Attachment E-16



 

Treatment emergent adverse events (TEAEs) were reported in 164 (74%) of the 221 patients through the End-of-Study visit (Week 28) and were similar in number and profile across all treatment groups.  Treatment emergent and unrelated serious adverse events of bronchitis, ovarian cancer, and diverticulitis were reported in 3 patients (1%) overall in the placebo, 20  m g and 80  m g groups, respectively.

 

Serum calcium levels were measured pre- and post-dose at multiple times through the study and were higher throughout the study in the teriparatide study group.  Episodes of hypercalcemia (both above normal at any time or above the alert value) post-dose were more common in teriparatide patients.  Overall, 27% of patients treated with BA058 80 m g and 53% of patients treated with teriparatide had a serum calcium level above normal ( ³ 10.2 mg/mL) on one or more occasions, while the corresponding results for post-dose calcium values of ³ 10.2 mg/mL were 17% and 48%, respectively.  In addition, 18% of patients treated with BA058 80  m g and 40% of patients treated with teriparatide had a clinically significant elevation of serum calcium level ( ³ 10.5 mg/mL) on one or more occasions, while the corresponding results for post-dose calcium values of ³ 10.5 mg/mL were 11% and 40%, respectively.

 

Low titer anti-drug antibodies were reported in 17 patients after 6 months of BA058 treatment. Of the 17 positive patients, 1 was in the placebo group, 2 were in the BA058 20 µg group, 8 were in the BA058 40 µg group and 6 were in the BA058 80 µg group.  There were no associated safety events and no attenuation of treatment efficacy.  One antibody-positive patient in the BA058 for Injection 40 µg group was found to have evidence of neutralizing activity at 24 weeks.  The patient did not appear to have any attenuation of drug efficacy, having a 9.3% gain in total analyzable spine BMD at the Week 24 assessment.  Finally, there were no clinically significant changes on intensive cardiac safety assessments conducted in approximately 30% of patients.

 

Fifty-five patients continued into a second 6 months of treatment with their original treatment assignment; 48 of these patients completed the additional treatment period.  BMD continued to show time-dependent and dose-dependent increases.  At the end of study, final spinal BMD was approximately 50% greater in the BA058 80 µg dose group than teriparatide and hip and femoral neck BMD were approximately 100% greater than teriparatide.  The second six months of treatment did not uncover additional safety considerations; the overall percent of patients experiencing a TEAE over 48 weeks of study treatment was 81% as compared to 74% in the 24-week study exposure.  One additional unrelated SAE of bilateral crural hernia was reported in the second 24 weeks of study conduct in the BA058 80  m g group.

 

In conclusion, this study demonstrated that BA058 induces a substantial positive dose- and time-dependent change in BMD at both spine and hip in women with osteoporosis and achieves this benefit safely and with substantially less hypercalcemic effect than teriparatide.

 

Across the studies conducted with BA058, BA058-related AEs were generally mild and did not require discontinuation of treatment.  The most common AEs observed in patients were influenza, nasopharyngitis, bronchitis, headache, hypercalciuria, back pain and arthralgia.  Occasional events of changes in orthostatic blood pressure were noted but were mild or

 

Attachment 2, Attachment E-17



 

moderate and did not appear to be dose related.  Reported local tolerance reactions were generally mild and resolved quickly, with redness being the most commonly reported symptom.  Elevated calcium levels were observed in a subset of patients to a lesser degree than that observed in patients treated with teriparatide.

 

According to the FDA-approved labeling for teriparatide, AEs reported in clinical trials were usually mild and generally did not require discontinuation of therapy.  The most commonly reported adverse events were pain, arthralgia, rhinitis, asthenia, nausea, dizziness, headache, hypertension, cough increased, pharyngitis, constipation, dyspepsia, and diarrhea.  Transient episodes of symptomatic orthostatic hypotension were observed infrequently.  In addition, teriparatide caused osteosarcomas in long-term toxicology studies in rats but the clinical relevance of this finding is unknown.

 

For additional details on potential AEs and precautions with the use of BA058, please refer to the Investigator’s Brochure.

 

Study Rationale and Selection of Doses

 

Study Rationale

 

This study is designed as a randomized, double-blind, placebo-controlled, comparative Phase 3 study of BA058 in the treatment of postmenopausal women with severe osteoporosis and at risk of fracture.  The purpose of the study is to evaluate the efficacy and safety of BA058 80 µg in the prevention of fracture in otherwise healthy ambulatory postmenopausal women with severe osteoporosis.  The dose chosen for this study is based on the safety and pharmacodynamic information derived in study BA058-05-002 according to predetermined criteria provided in the protocol.  The population to be studied is the recommended and intended population for treatment, postmenopausal women with severe osteoporosis (17-19).  Daily SC doses of BA058 80 µg, Placebo or teriparatide 20 µg will be self-administered for 18 months (78 weeks) to patients randomized [equally] to one of 3 treatment groups.

 

Study Design and Rationale for Placebo

 

This study is designed as a randomized, double-blind, parallel-group, clinical trial.  There will be 3 treatment arms, one of which will be BA058 80 µg, one of which will be a placebo to BA058 80 µg, the study drug, and one of which will be teriparatide 20 µg.  Therefore, 2 of 3 patients treated will receive an active treatment.  All subjects, regardless of treatment assignment, will receive Calcium and Vitamin D supplements during the Pretreatment and Treatment Periods.

 

The study will be blinded up to the time of randomization and assignment of the patient to treatment.  On opening of the assigned treatment, although patients and study personnel will remain blinded to BA058 80 µg or Placebo, it will become apparent to them whether a BA058-based treatment or teriparatide has been assigned.  An independent blinded evaluator will review all study radiographs.  A second blinded evaluator will confirm all findings. A Data Safety Monitoring Board (DSMB) will monitor study safety.

 

Attachment 2, Attachment E-18


 

The total period of placebo exposure and therefore of potential delay of specific treatment is 18 months.  Placebo is the usual and recommended comparator for studies in this indication.  While the indication infers the prevention of fractures with treatment, the actual benefit is a reduction in fracture incidence in women at risk.  It is calculated that while fractures may occur in patients both on active treatment and Placebo, it is estimated that treatment will result in a relative reduction of fracture risk of approximately 60% over 18 months.

 

In the RADIUS Phase 2 study (Study BA058-05-002), patients randomized to placebo and supplemented with Calcium and Vitamin D over their 6-12 months of study participation demonstrated no overall reduction in spinal or hip BMD and reported no fractures while on study treatment.  In addition, all Placebo patients will be offered the opportunity to transition to an approved active treatment (a bisphosphonate) for 24 months on completion of 18 months of study participation or earlier if a clinical fracture occurs.

 

Study Population

 

The study population in this protocol is the population recommended by Regulatory Authorities (17-19) for the clinical evaluation of PTH and PTH-like drugs in this indication: postmenopausal women (50 to 85 years of age) who are more than 5 years post menopause and whose menopause has been confirmed by an elevated serum FSH and a BMD T-score of < -2.5 (2.5 SD below the population norm) and > -5.0 at the lumbar spine or hip (femoral neck) by dual energy x-ray absorptiometry (DXA) and radiological evidence of 2 or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years.  However, postmenopausal women older than 65 who meet the above fracture criteria but have a T-score <  -2.0 and > -5.0 may be enrolled.  In addition, women older than 65 who do not meet the fracture criteria may also be enrolled if their T-score is < -3.0 and > -5.0.  Women who are intolerant of bisphosphonates as outlined in exclusion criterion # 17 (Section 0) and meet the above criteria will also be allowed to enroll.

 

Based on midpoint demographics of the proposed study population, the anticipated 10-year fracture rate in Study BA058-05-003 is estimated to fall within the recommended ranges in the relevant guideline (CPMP/EWP/552/95 Rev.2) when calculated using the FRAX assessment tool (http://www.shef.ac.uk/FRAX/).

 

A sample size of 622 patients per treatment arm provides 90% power at a two-sided alpha of 0.05 to detect a difference of 4% between treatments, assuming a vertebral fracture rate of 7% in placebo patients and 3% in BA058 80 µg for injection-treated patients when the large scale approximation of the binomial method is employed.  This superiority assessment infers a relative risk reduction of 57% and presupposes the availability of a pretreatment and post-treatment radiological assessment.  To ensure a per protocol population of 622 patients, an overall sample size of 800 patients per treatment arm will be recruited, anticipating that approximately 20% of

 

Attachment 2, Attachment E-19



 

patients may not have a second evaluable X-ray film available for analysis.  Prior studies have demonstrated that approximately 20% of enrolled patients drop out over the lengthy period of the study and a further proportion (10%) fail to provide an evaluable End-of-Treatment X-ray, therefore a sample size of 800 patients per arm is proposed.

 

Selection of Endpoints

 

Bone remodeling is a constant process in the adult human skeleton and maintains the integrity of the skeleton through a process of replacing old bone (resorption) with new bone formation (anabolism).  Both cortical and trabecular bone are involved in this process which needs to be in balance to maintain normal bone density and strength (20).  In childhood, the balance favors bone formation and, with aging, the process favors the resorptive component, causing bone loss.  Assessments of this balance of formation and resorption can be performed over the long-term by quantitative imaging of bone density.  Consequences of bone loss are commonly observed as fracture in a severe osteoporotic population.  An improvement in bone quality and quantity can reduce the risk of existing and incidental fracture.  Therefore, while earlier studies have demonstrated the benefit of BA058 for improvement in BMD in postmenopausal women, this study will assess the relative efficacy and safety of BA058 80 µg for prevention of new fractures in the same population but among the cohort of patients with a history of fracture, or those who are at an increased risk of fracture.  While all new fractures will be assessed, the relative short duration of treatment anticipated with BA058 is unlikely to yield definitive evidence of fracture prevention benefit at all anatomical sites, therefore the study is designed to identify a statistically significant benefit on vertebral fracture.  Non-vertebral fractures will be assessed as a secondary efficacy endpoint as will BMD changes by DXA at spine, hip and femoral neck as additional indices of bone anabolic benefit.

 

In addition to BMD by DXA, bone formation and resorption markers will also be assessed over time (21).  The rise in the markers of bone formation indicates restoration of lost bone, in particular the lost microarchitecture that places osteoporotic women at an increased risk for fracture.  Increases in the principal markers of bone formation: N-terminal propeptide of type I procollagen (PINP),  osteocalcin, and bone-specific alkaline phosphatase (BSAP) are accepted predictors of BMD change (21,22).  Serum C-telopeptides (CTX), a marker of bone resorption and collagen breakdown, will also be measured in this study.  Markers of anabolic effect and resorptive effect have become valuable tools in the management of osteoporosis since they can provide early information on potential treatment efficacy (23).

 

Selection of Dose

 

The BA058 dose to be studied in this Phase 3 trial has been previously studied in the Phase 1 and Phase 2 clinical trials.  The dose chosen for this study is based on the safety and pharmacodynamic information derived in study BA058-05-002 according

 

Attachment 2, Attachment E-20



 

to predetermined criteria provided in the protocol. The 80 µg dose was the maximum efficacy dose in the BA058 Phase 2 clinical program, was well tolerated (refer to Section 0) and demonstrated a significant increase in mean lumbar spine and mean femoral neck BMD when compared to Placebo.  This beneficial effect was achieved safely and with substantially less hypercalcemia than teriparatide.  Doses of up to 120 µg have been studied in the Phase 1 program and 100 µg has been determined to be the maximum tolerated dose, due to patients experiencing an increase in nausea and one discontinuation due to vomiting at the 120 µg dose.

 

BA058 80 µg per day will be dosed by SC self-administered injection.  In addition, a matching Placebo comparator will be employed in one treatment arm and teriparatide will be employed as a reference drug and comparator for secondary efficacy and safety outcomes.  All enrolled patients will also receive Calcium (500-1000 mg) and Vitamin D (400-800 IU) supplementation, or a dose to be determined by the Investigator and agreed by the Sponsor Medical Monitor, according to the patient’s need, from the Pretreatment Period until the end of the Treatment Period; it will be recommended to patients that they continue these supplements through the Follow-up Period.  The treatment regimens are summarized in the table in Section 0.

 

Attachment 2, Attachment E-21



 

STUDY OBJECTIVES

 

The primary objective of this study is to determine the safety and efficacy of BA058 80 µg when compared to Placebo for prevention of vertebral fracture in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis.  The secondary objectives of this study are to determine the safety and efficacy of BA058 80 µg when compared to Placebo for prevention of non-vertebral fractures and for additional secondary efficacy outcomes (bone mineral density of spine, hip and femoral neck) and safety (hypercalcemia) when compared to teriparatide (Eli Lilly and Co.) in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis.

 

The specific objectives of this study are to:

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on lumbar spine, total hip, and femoral neck bone mineral density (BMD) in otherwise healthy ambulatory postmenopausal women with severe osteoporosis when compared to teriparatide.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of non-vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the overall safety and tolerability of 18 months of treatment with BA058 80 µg, and specifically the number of patients with hypercalcemic events, in otherwise healthy postmenopausal women with severe osteoporosis when compared to teriparatide and Placebo.

 

·                   Provide additional evidence of bone safety through histomorphometric assessment of bone biopsy samples in a subset of patients from the BA058 80 µg and Placebo groups.

 

·                   Provide additional evidence of renal safety through radiological assessment by CT scan of a subset of patients from the BA058 80 µg, Placebo and teriparatide groups.

 

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INVESTIGATIONAL PLAN

 

Overall Design and Study Plan

 

This is a randomized, double-blind, placebo-controlled, comparative Phase 3, multicenter, international study to evaluate the efficacy and safety of BA058 80 µg in the prevention of fracture in otherwise healthy ambulatory postmenopausal women with severe osteoporosis.  Women who are postmenopausal for > 5 years and are 50 years old to 85 years old (inclusive) with a bone mineral density T-score < -2.5 and > -5.0 at the lumbar spine or hip (femoral neck) by dual energy x-ray absorptiometry (DXA) and radiological evidence of 2 or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years may be enrolled.  Postmenopausal women older than 65 who meet the above fracture criteria but have a T-score <  -2.0 and > -5.0 may be enrolled.  Women older than 65 who do not meet the fracture criteria may also be enrolled if their T-score is < -3.0 and > -5.0.

 

The study consists of a Screening Period (1-3 weeks), a Pretreatment Period (1 week), a Treatment Period (78 weeks) and a Follow-up Period (4 weeks).  The duration and number of scheduled visits for each study period, and the study medications being administered in each study period are summarized in the table below.

 

Study
Period

 

Duration of
Study Period

 

Scheduled
Visits (#)

 

Active
Treatment

 

1.

Screening

 

1-3 weeks

 

1

 

None

 

2.

Pretreatment

 

1 week

 

1

 

Calcium, Vitamin D

 

3.

Treatment

 

78 weeks

 

7

 

Calcium, Vitamin D, Study Medication

 

4.

Follow-up

 

4 weeks

 

1

 

Calcium, Vitamin D

 

 

Total

 

84-86 weeks

 

10

 

 

 

 

The total duration of study participation for an individual patient is approximately 84-86 weeks from the initial screening visit to final study evaluations.  The total duration of dosing with active medication (or placebo) is 18 months (78 weeks).

 

The 18-month treatment study will be followed by an Extension Study, administered as a separate protocol. For patients who received BA058 80 µg in Study BA058-05-003, the study will be comprised of 2 periods: a 6—month extension of BA058 80 µg treatment to assess the continued safety and efficacy of BA058 80 µg up to a total of 24 months.  The second study period will assess both the retention of benefit of BA058 over 12 months following withdrawal of treatment and will assess the benefit of adding a bisphosphonate to retain or augment BMD benefit on completion of a course of BA058 treatment. Patients will be randomized to one of these two treatment options on completion of BA058 exposure.

 

Placebo patients who complete 18 months of study participation or experience a clinical fracture will be given the opportunity to receive treatment with a bisphosphonate for 24 months.  Patients will receive standard-of-care management including assessment of BMD during this period.

 

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During the Screening Period, informed consent is obtained, eligibility for study entry is assessed and screening evaluations are performed, including baseline radiographic and DXA (hip and spine) assessments and baseline (routine) safety laboratory tests including serum biochemistry and hematology, and ECG.

 

Patients who are eligible for the study on the basis of screening evaluations will enter the Pretreatment Period of the study and will have baseline assessments of 1,25-dihydroxy Vitamin D, serum markers of bone metabolism and BA058 serum antibody levels.  Patients will be given daily Calcium and Vitamin D supplements, which will continue until the end of the Treatment Period; it will be recommended to patients that they continue these supplements through the Follow-up Period.  In addition, patients will undergo training in self-injection with the device to be employed for administration of BA058 80 µg or Placebo.  Patients subsequently randomized to treatment with teriparitide will be trained to use the teriparatide pen on Day 1 prior to the first injection.  Patients with medically significant abnormalities, or any patient who experiences a serious adverse event during the Screening or Pretreatment Periods, will be excluded from further study participation and treatment.  At the end of the Pretreatment Period, all patients who continue to meet the eligibility criteria for the study will enter the Treatment Period.

 

Patients who remain eligible for study participation will be randomized on Day 1 to treatment with one of the 3 treatment regimens shown below.

 

Treatment
Regimen

 

Study Medication

 

Daily 
Dose (SC)

 

Calcium and 
Vitamin D*

 

Number of
Patients

 

1

 

BA058

 

80 µg

 

500–1000 mg/day and 400–800 IU/day

 

800

 

2

 

Placebo

 

 

as above

 

800

 

3

 

teriparatide

 

20 µg

 

as above

 

800

 

 

 

 

 

 

 

Total

 

2400

 

 


*or a dose determined by the Investigator and agreed by the Sponsor Medical Monitor, according to the patients’s need.

 

Treatment will be blinded to patients and investigators until the time of randomization and assignment of treatment.  Blinding will be maintained between BA058 80 µg and Placebo, but not with regard to teriparatide.

 

During the Treatment Period, patients will self-administer a single subcutaneous dose of study medication once a day.  Study procedures during this study period will include the collection of x-rays and DXA scans to evaluate fractures and of serum samples to assess serum markers of bone formation and resorption. A subset of patients in the BA058 80 µg and Placebo treatment groups (up to 100 per group to obtain 75 evaluable biopsies per treatment group) will be asked to undergo a bone biopsy at the end of the Treatment Period.  A further subset of patients in all 3 treatment groups (100 per treatment group) will be asked to undergo a renal CT scan at the end of the Treatment Period.  Serum samples for evaluation of study medication levels and anti-BA058 antibody formation will be drawn at specified visits during the Treatment Period.  Monitoring for adverse events, concomitant medications

 

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and other safety assessments will be conducted throughout the course of the study (Pretreatment through End-of Study).

 

During the month after the last dose of study medication has been administered (Follow-up Period), it will be recommended to patients that they continue to take Calcium and Vitamin D supplements until they return for an End-of-Study Visit during which final clinical evaluations are performed.  Patients eligible to continue in the Extension Study will not undergo the End-of-Study Visit and will transition into the Extension Study during the Follow-up Period.

 

The maximum duration of study participation for an individual patient is estimated as 20 months (86 weeks) from the initial screening visit to the End-of-Study Visit.  Ten clinic visits are planned during the study; additional visits may be scheduled for clinical laboratory retesting or to obtain protocol-specified evaluations, if required.

 

Visit windows are allowed for flexibility in scheduling of study visits.  For initial visits which are scheduled at shorter intervals, a ± 1 or ± 3 day window is allowed.  For visits later in the study, which occur at longer intervals, a ± 7 day window is allowed.

 

Overall, the Screening and Pretreatment Periods must be completed within 28 days. The Treatment Period is 18 months.  Therefore, all patients are to receive 78 weeks of treatment.  The allowable windows for each study visit are provided in Appendix 14.1 and Appendix 0.

 

A brief summary of each study period is provided below.  For a summary of the study assessments to be performed, refer to Section 7.0 (Study Assessments) and to the Schedule of Visits and Procedures (Appendix 14.1).  A more detailed description of the study procedures on a by-visit basis is provided in Appendix 0 (Suggested Schedule of Events and Procedures by Study Visit).  A suggested order of procedure conduct is also provided in this schedule.

 

Screening Period

 

The purpose of the Screening Period is to verify that the patient’s medical history and current status are consistent with the inclusion and exclusion criteria (refer to Sections 0 and 0, respectively), to ascertain the patient’s willingness to participate in the study, to obtain written informed consent and to establish baselines for the physical and laboratory parameters to be followed for the duration of the study.  Patients will undergo baseline radiographic (lumbar and thoracic spine) and DXA (hip and lumbar spine) evaluations.  One clinic visit (Visit 1) is scheduled during the Screening Period (Study Days -28 to -8).

 

Prior to entering the Screening Period, each potential study participant will have a preliminary assessment of inclusion/exclusion criteria by the investigator.  A complete description of the study will provided to each potential participant and written informed consent will be obtained.  After informed consent is obtained, the patient is entered into the Screening Period and procedures are conducted according to the Schedule of Visits and Procedures (refer to Appendix 14.1).  Data should be recorded for patients who fail to complete screening or fail to meet study eligibility

 

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criteria, including the reason for failure.  Patients who meet the study requirements based upon the Screening Period assessments will enter the Pretreatment Period.

 

Pretreatment Period

 

During the Pretreatment Period, one visit (Visit 2) is scheduled.  Patients will have baseline evaluations performed as outlined in the Schedule of Visits and Procedures (Appendix 14.1).

 

Patients will undergo baseline efficacy labs.  This study visit is to be scheduled within 7 days prior to the anticipated first day of treatment to allow confirmation of clinical laboratory test results and continued eligibility.  Patients who have experienced a serious adverse event during the Pretreatment Period will be terminated from the study.

 

Patients will undergo training on self-injection with the BA058 pen injector device in anticipation of treatment assignment.  Teriparatide is a marketed treatment; therefore, if the patient is subsequently randomized to teriparatide, training will be done with the teriparatide pen after randomization but before the first injection on Day 1 (Visit 3).  In addition, patients will be provided with daily Calcium (500—1000 mg) and Vitamin D (400—800 IU) supplementation, or a dose to be determined by Investigator and agreed upon by the Sponsor Medical Monitor, according to the patient’s need, which will be continued until the end of the Treatment Period; it will be recommended to patients that they continue these supplements through the Follow-up Period.  Patients will be instructed to take the supplements during the evening with or without food or as otherwise instructed by the Investigator.  Only the daily doses of Calcium and Vitamin D identified in the study protocol and determined by the Investigator may be taken during the study.  Any patient unable to take the preparation of Calcium and Vitamin D supplied may be recommended a different preparation of Calcium and Vitamin D by the Investigator as long as the same daily dose of both Calcium and Vitamin D is administered.

 

On completion of the Pretreatment period, eligible patients will enter the Treatment Period.

 

Treatment Period

 

The Treatment Period starts on Day 1 and continues for 18 months (78 weeks).  Patients are randomized to treatment on Day 1 and begin treatment the same day.  A subset of 300 patients per group will have a wrist DXA scan, which will occur after randomization to study drug and can occur anytime up to 24 hours after the first injection.  Those patients who are randomized to treatment with teriparatide will be trained with the teriparatide pen prior to the first injection on Day 1.

 

A total of 7 clinic visits are scheduled during the Treatment Period (Visits 3-9); the final Treatment Period visit will be scheduled to occur one day after the last dose of study medication.  Treatment will be daily, by self-injection.  During the first 30 days

 

Attachment 2, Attachment E-26



 

of treatment patients will record drug dose, site of injection and any local reactions in a patient diary card.  Local tolerance will again be assessed during a second 30-day period.  This second diary will be provided to the patient either at the Month [9] (Visit 7) or will be forwarded later by mail, as appropriate, for completion by the patient during the 30 days of treatment in Month [11] of treatment.  The diary will be collected and reviewed with the patient for treatment compliance and adverse events at the Month [1] (Visit 4) and Month [12] (Visit 8) visits.  The patient will also maintain a diary throughout the study to summarize all study drug administration on a weekly basis.

 

Study patients will continue Calcium and Vitamin D supplementation during the Treatment Period.

 

Safety will be assessed at each study visit during the Treatment Period.  Efficacy assessments will include one evaluation by x-ray after 18 months of treatment (End-of-Treatment, Visit 9) and evaluations of BMD by DXA after [6], [12] and [18] months of treatment (Visits 6, 8 and 9).  Serum markers of bone metabolism, BA058 antibody and BA058 serum levels will also be measured during the Treatment Period.  Additionally, a subset of patients treated with BA058 80 µg or Placebo (up to [100] per group to obtain [75] evaluable biopsies per treatment group) will consent and have a bone biopsy performed between Visit 8 and the End-of-Treatment visit (Visit 9).  A further subset of 100 patients per treatment group (BA058 80 µg, Placebo and teriparatide) will undergo a renal CT scan at End-of-Treatment (Visit 9).  Procedures are to be performed according to the Schedule of Visits and Procedures (Appendix 14.1).

 

Patients who discontinue from the study prior to completing the Treatment Period will have all End-of-Treatment Visit evaluations performed as close to the time a patient is permanently discontinued from treatment as possible.  If possible, an End-of-Study Visit should also be scheduled one month after the last dose of study medication was administered.

 

Follow-up Period

 

The Follow-up Period is the one month interval after the last dose of study medication during which patients are followed for adverse events, including clinically significant laboratory abnormalities.  At the end of the Follow-up Period, patients will return to the clinic to undergo final study assessments (End-of-Study Visit; Visit 10).  Patients will be recommended to continue their Calcium and Vitamin D supplements until the End-of-Study Visit (Visit 10).

 

Any clinically significant adverse events occurring during the Follow-up Period will be assessed and recorded at the End-of-Study Visit.  Any adverse event or clinical laboratory abnormality recorded at this final visit will be monitored until it has resolved or has become chronic or stable.

 

Attachment 2, Attachment E-27



 

After the End-of-Study Visit, patients who received Placebo and completed 18 months of treatment, as well as patients who received Placebo or BA058 and were withdrawn due to incident vertebral or non-vertebral fragility fracture, will be given the opportunity to receive treatment with a bisphosphonate for 24 months.  Patients will receive standard-of-care management, including assessment of BMD benefit, during this period.

 

Patients eligible to continue in the Extension Study will not undergo the End-of-Study Visit and will transition into the Extension Study during the Follow-up Period.

 

SELECTION OF STUDY POPULATION

 

Number of Subjects

 

A sufficient number of otherwise healthy postmenopausal women aged 50 to 85 with osteoporosis will be screened so that 2400 eligible patients qualify for the study and are randomized.

 

For the purposes of this study, osteoporosis is defined as a BMD that is 2.5 standard deviations or more below the norm of the adult female population.  Postmenopausal women older than 65 who meet the fracture criteria but have a T-score < -2.0 and > -5.0 may be enrolled.  Additionally, women older than 65 who do not meet the fracture criteria may also be enrolled if their T-score is < -3.0 and > -5.0.

 

The specific inclusion and exclusion criteria for enrolling patients in this study are presented below in Sections 0 and 0, respectively.  Exceptions to these criteria should occur infrequently and should be discussed in advance and approved by the Sponsor Medical Monitor.  If the exception is agreed upon (rare) and a patient is allowed to participate, the Sponsor Medical Monitor will send confirmation to the study site acknowledging the exception.  The confirmation form or letter must be kept with the study records. Minor variations from the normal range in clinical laboratory test results (hematology, chemistry, and urinalysis) are acceptable if they are determined to be not medically significant by the Investigator in that they do not compromise patient safety or the assessment of efficacy and are documented as such.  Any unexpected clinically significant abnormality that would exclude the patient from participation in the study may be retested once.  If the parameter is normal on retest, the patient may be included in the study.

 

Inclusion Criteria

 

Patients must meet all of the following criteria to be eligible to participate in this study.

 

1.                                       The patient is a healthy ambulatory postmenopausal woman from 50 to 85 years of age (inclusive) with osteoporosis.

 

2.                                       The patient has been postmenopausal for at least 5 years.  Postmenopausal status will be established by a history of amenorrhea for at least 5 years and by an elevated serum follicle-stimulating hormone (FSH) value of >  30 IU/L.

 

Attachment 2, Attachment E-28


 

3.                                       The patient has a bone mineral density T-score <  -2.5 and > -5.0 at the lumbar spine (L1-L4) or hip (femoral neck) by dual energy x-ray absorptiometry (DXA) and radiological evidence of 2 or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years.  Postmenopausal women older than 65 who meet the above fracture criteria but have a T-score <  -2.0 and > -5.0 may be enrolled.  Women older than 65 who do not meet the fracture criteria may be enrolled if their T-score is £ -3.0 and > -5.0.

 

4.                                       The patient is in good general health as determined by medical history and physical examination (including vital signs), has a body mass index (BMI) of 18.5 to 33 (Appendix 0), inclusive, and is without evidence of clinically significant abnormality in the opinion of the Investigator.

 

5.                                       Any required concomitant medications which are not excluded in Section 6.0 may be continued through the study.  Every effort should be made to maintain the medication at a stable dose throughout the study, subject to the Investigator’s medical judgment.

 

6.                                       The patient has serum calcium, PTH(1-84), serum phosphorus and alkaline phosphatase values all within the normal range during the Screening Period.  Any patient with an elevated alkaline phosphatase value, and who meets all other entry criteria, would be required to have a normal bone-specific alkaline phosphatase result to be enrolled.

 

7.                                       The patient has serum 25-hydroxy Vitamin D values above 15 ng/mL and within 3 times the upper normal range.

 

8.                                       The patient’s resting 12-lead electrocardiogram obtained during screening shows no clinically significant abnormality and a QTc <  470 msec (Bazett’s correction).

 

9.                                       The patient’s systolic blood pressure is > 100 and < 155 mmHg, diastolic blood pressure is > 40 and < 95 mmHg, and heart rate is > 45 and < 100 bpm.

 

10.                                The patient has no clinically significant abnormality of serum hemoglobin, hematocrit, WBC and platelets, or usual serum biochemistry: electrolytes, renal function, liver function and serum proteins.

 

11.                                The patient has read, understood, and signed the written informed consent form.

 

Exclusion Criteria

 

Patients with any of the following characteristics are not eligible to participate in the study.

 

General exclusion criteria:

 

1.                                       History of more than 4 spine fractures, mild or moderate, or any severe fractures.

 

2.                                       Presence of abnormalities of the lumbar spine that would prohibit assessment of spinal bone mineral density, defined as having at least 2 radiologically evaluable vertebrae within L1-L4.

 

Attachment 2, Attachment E-29



 

3.                                       Unevaluable hip BMD or patients who have undergone bilateral hip replacement (unilateral hip replacement is acceptable).

 

4.                                       History of bone disorders (e.g., Paget’s disease) other than postmenopausal osteoporosis.

 

5.                                       Unexplained elevation of serum alkaline phosphatase.

 

6.                                       History of radiotherapy (radiation therapy).

 

7.                                       History of chronic or recurrent renal, hepatic, pulmonary, allergic, cardiovascular, gastrointestinal, endocrine, central nervous system, hematologic or metabolic diseases, or immunologic, emotional and/or psychiatric disturbances to a degree that would interfere with the interpretation of study data or compromise the safety of the patient.

 

8.                                       History of Cushing’s disease, hyperthyroidism, hypo- or hyperparathyroidism or malabsorptive syndromes within the past year.

 

9.                                       History of significantly impaired renal function (serum creatinine >177 µmol/L or >2.0 mg/dL).

 

10.                                History of any cancer within the past 5 years (other than basal cell or squamous cancer of the skin).

 

11.                                History of osteosarcoma at any time.

 

12.                                History of nephrolithiasis or urolithiasis within the past five years.

 

13.                                Decrease of 20 mmHg or more in systolic blood pressure or 10 mmHg or more in diastolic blood pressure from supine to standing (5 minutes lying and 3 minutes standing) and/or any symptomatic hypotension at screening (24,25).

 

14.                                Patients known to be positive for Hepatitis B, Hepatitis C, HIV-1 or HIV-2.  Testing is not required in the absence of clinical signs and symptoms suggestive of HIV infection or acute or chronic hepatitis.

 

Medication-related exclusion criteria:

 

15.                                Known history of hypersensitivity to any of the test materials or related compounds.

 

16.                                Prior treatment with PTH or PTHrP drugs, including BA058.  Patients who previously screened for this study cannot be rescreened and entered into the study.

 

17.                                Prior treatment with bisphosphonates*, fluoride or strontium in the past five years or prior treatment with gallium nitrate, or with as yet unapproved bone-acting investigational agents at any time (26).

 


(*Patients who had a short course of bisphosphonate treatment (3 months or less) and were intolerant of the treatment are not excluded from study participation.)

 

18.                                Prior treatment with denosumab, calcitonin, SERMs (such as raloxifene or tamoxifen), tibolone, or anabolic steroids in the past 12 months. Estrogens

 

Attachment 2, Attachment E-30



 

administered as hormone replacement therapy (HRT), with or without progestins, are not exclusionary.

 

19.                                Treatment with thiazide diuretics during the 7 days prior to the Screening Period, or ongoing treatment with thiazide diuretics.

 

20.                                Treatment with anticonvulsants or anticoagulants within the 6 months prior to the Screening Period.

 

21.                                Daily treatment with oral, intranasal or inhaled corticosteroids within the 12 months prior to the Screening Period.

 

22.                                Exposure to general anesthesia within the 12 weeks prior to the Screening Period.

 

23.                                Exposure to an investigational drug within the 12 months prior to the Screening Period.

 

Lifestyle-related exclusion criteria:

 

24.                                Abnormal nutritional status (abnormal diets, excessive or unusual vitamin or herbal intakes, malabsorption, significant recent weight change), Vitamin D intake of > [1200] IU/day or Vitamin A intake of > [10,000] IU/day.

 

25.                                Patient is known to abuse alcohol or use illegal drugs within 12 months of the Screening Period.

 

Withdrawal of Patients from the Study

 

Patients will be informed that they have the right to withdraw from the study at any time for any reason without prejudice to their medical care.

 

The Investigator must withdraw patients from the study for the following reasons:

 

·              Continuing significant deterioration from baseline (>7%) of BMD at spine or hip (after confirmation of the finding)

 

·              Hypercalcemia or hypercalciuria as described in Section 4.6;

 

·              Treatment-related SAEs;

 

·              Severe hypersensitivity to BA058 or teriparatide;

 

·              Refusal of treatment;

 

·              Inability to complete study procedures;

 

·              Lost to follow-up.

 

The Investigator also has the right to withdraw patients from the study for any of the following reasons:

 

·              WHO Grade 3 or 4 adverse events [Refer to Appendix 0];

 

·              A complex of adverse events which, in the judgment of the Investigator justifies treatment cessation;

 

Attachment 2, Attachment E-31



 

·              Serious intercurrent illness;

 

·              Non-compliance;

 

·              Protocol violations;

 

·              Administrative reasons.

 

Patients will be offered the opportunity to discontinue from the study for the following reasons after site consultation with the Study Medical Monitor:

 

·              Incident vertebral or non-vertebral fragility fracture

 

If a patient is withdrawn or discontinued from the study, the reason for withdrawal from the study is to be recorded in the source documents and on the case report form.  All patients withdrawn prior to completing the study should be encouraged to complete study procedures scheduled for the End-of-Treatment and End-of-Study Visits.  The End-of-Treatment procedures should be conducted as close to the time a patient is permanently discontinued from treatment.  If possible, the End-of-Study Visit should be scheduled one month after the last dose of study medication was administered.  All adverse events should be followed as described in Section 0.

 

Patients treated with BA058 or Placebo who withdraw due to incident vertebral or non-vertebral fragility fracture will be offered standard-of-care treatment with a bisphosphonate for 24 months.

 

Temporary Suspension of Treatment

 

The investigator has the right to suspend treatment with study medication for up to 14 continuous days or 28 cumulative days, without withdrawal of the patient from the study.  Reasons for temporary suspension of treatment may include a medical reason unrelated to an adverse event (e.g., a planned procedure), or important social or administrative events.  The reason for the suspension of treatment is to be documented in the case report form and in source documents.  Such patients should not be unblinded as to study medication. When treatment is restarted, the patient should resume treatment with the next scheduled dose and continue until the scheduled End-of-Treatment.

 

If the treatment suspension is due to a medical emergency and study medication needs to be unblinded, please refer to Section 0 for the procedures to be followed.

 

Response to Hypercalcemia or Hypercalciuria

 

Patients who develop hypercalcemia or hypercalciuria during the study are to have treatment with study medication reduced or study medication temporarily suspended as described below.

 

Attachment 2, Attachment E-32



 

Treatment Suspension due to Hypercalcemia

 

For any serum calcium value which is > 0.3 to 1.0 mg/dL above the upper limit of normal (ULN) (inclusive), confirm hypercalcemia by drawing a new serum sample as soon as the result is received:

 

·                   If the result of the retest remains within this range, discontinue Calcium and Vitamin D supplements for 7 days and perform a second retest.  The patient is to continue study medication administration during this interval.

 

·                   If the second retest is normal, the patient may continue on study and resume Calcium and Vitamin D supplements.

 

·                   If the second retest is still elevated and the patient is receiving BA058/Placebo, the patient continues on study with a dose reduction for BA058 from 80 µg to 40 µg, but without Calcium and Vitamin D supplements.

 

·                   If the second retest is still elevated and the patient is receiving teriparatide, the patient is to be discontinued from the study.

 

·                   If the patient continues in the study (with Calcium and Vitamin D supplements) and has a repeat episode of a serum calcium value > 0.3 to 1.0 mg/dL above the ULN (inclusive), repeat the above assessment.

 

·                   If the patient again returns to normal when not taking Calcium and Vitamin D supplements, the patient may continue in the study without Calcium and Vitamin D supplements.

 

·                   If the hypercalcemia is confirmed in the absence of Calcium and Vitamin D supplements and the patient is receiving BA058/Placebo, the patient continues on study with a dose reduction for BA058 from 80 µg to 40 µg, but without Calcium and Vitamin D supplements.

 

·                   If the hypercalcemia is confirmed in the absence of Calcium and Vitamin D supplements and the patient is receiving teriparatide, the patient is to be discontinued from the study.

 

·                   If a BA058/Placebo patient continues on the study at the reduced dose of 40 µg (without Calcium and Vitamin D supplements) and has another episode of a serum calcium value > 0.3 to 1.0 mg/dL above the ULN (inclusive), perform a retest.

 

·                   If the retest is normal, the patient may continue on study at the reduced dose (without Calcium and Vitamin D supplements).

 

·                   If the retest is still elevated, the patient is to be discontinued from the study.

 

Attachment 2, Attachment E-33



 

For any serum calcium value >1.0 mg/dL above ULN:

 

·                   Discontinue Calcium and Vitamin D supplements and discontinue the study medication as soon as the result is received.  Confirm hypercalcemia by drawing a new serum sample as soon as possible.

 

·                   If the result of the retest remains >1.0 mg/dL above ULN, perform a second retest after 3 days without Calcium and Vitamin D supplements and study medication.

 

·                   If the second retest is normal, the patient may continue on study and resume study medication and Calcium and Vitamin D supplements.

 

·                   If the second retest remains elevated ( > 0.3 mg/dL above ULN) and the patient is receiving BA058/Placebo, the patient continues on study with a dose reduction for BA058 from 80 µg to 40 µg, but without Calcium and Vitamin D supplements.

 

·                   If the second retest remains elevated ( > 0.3 mg/dL above ULN) and the patient is receiving teriparatide, the patient is to be discontinued from the study.

 

·                   If a BA058/Placebo patient continues on the study at the reduced dose of 40 µg (without Calcium and Vitamin D supplements) and has another episode of a serum calcium value > 0.3 mg/dL above the ULN, perform a retest.

 

·                   If the retest is normal, the patient may continue on study at the reduced dose (without Calcium and Vitamin D supplements).

 

·                   If the retest is still elevated, the patient is to be discontinued from the study.

 

If the patient continues in the study and has a repeat episode of serum calcium >1.0 mg/dL above ULN, the patient is to be discontinued from the study.

 

Treatment Suspension due to Hypercalciuria

 

For a Calcium:Creatinine ratio >0.4 mg/mg, check the patient’s serum calcium and apply the algorithm outlined in Section 4.5.1 if Calcium is elevated.

 

If the Calcium:Creatinine ratio is >0.4 mg/mg and the serum calcium is normal:

 

·                   Discontinue Calcium and Vitamin D supplements and recheck urine Calcium:Creatinine values after 7 days.

 

·                   If the urine Calcium:Creatine ratio continues to be >0.4 mg/mg in the presence of normal serum calcium, the patient may continue in the study under medical supervision.

 

Attachment 2, Attachment E-34



 

·                   If the urine Calcium:Creatine ratio returns to normal, the patient may restart Calcium and Vitamin D supplements and continue in the study.

 

If the patient restarts the Calcium and Vitamin D supplements and hypercalciuria returns, Calcium and Vitamin D supplementation should be terminated.  The patient may continue in the study under medical supervision.

 

Therefore, patients with hypercalciuria will not be discontinued from the study in the absence of hypercalcemia except at the discretion of the Investigator.

 

Replacement of Patients

 

Patients who have been randomized into the study and subsequently withdraw or drop out of the study will not be replaced.

 

Attachment 2, Attachment E-35



 

STUDY TREATMENTS

 

Study Medications

 

All study medications are for investigational use only and are to be used only within the context of this study.  The Sponsor will supply all study medications.

 

BA058 80 µg, Placebo and Teriparatide

 

BA058 80 µg, Placebo and teriparatide will be supplied by the Sponsor.  Pen devices and needles for administration of study medications also will be supplied to the study sites.

 

BA058 80 µg for Injection:  Each multi-dose cartridge contains 2 mg/mL BA058 (free base) in 5 mg/mL tri-hydrate sodium acetate and 5 mg/mL of phenol (preservative) adjusted at pH 5.1 with acetic acid.  BA058 80 µg is supplied as a liquid in a 1.5 mL Type 1 glass cartridge and is stored refrigerated at 5 ± 3ºC.  The multi-dose cartridge is designed to deliver a dose of 80 µg of BA058 in 40 µL of fluid when inserted into the Pen Injector device.  The pen is also capable of delivering a half dose of BA058, or 40 µg of BA058 in 20 µL of fluid, with appropriate manual adjustment.  When in use, multi-dose cartridges of BA058 80 µg can be stored for up to 30 days at room temperature.  When used with the supplied pen and needles, each cartridge may be used to deliver study medication at the required daily dose for 30 days.  Patients will be provided with a sufficient number of cartridges to continue on treatment until the next scheduled return to the study site.

 

Placebo:  Placebo is formulated similarly but without active BA058 and is similarly supplied as a liquid in a 1.5 mL Type 1 glass cartridge and is stored refrigerated at 5 ± 3ºC.  The multi-dose cartridge is designed to deliver a dose of Placebo in 40 µL of fluid when inserted into the Pen Injector device.  The pen is also capable of delivering a half dose of 20 µL with appropriate manual adjustment.  When in use, multi-dose cartridges of Placebo can be stored for up to 30 days at room temperature.  When used with the supplied pen and needles, each cartridge may be used to deliver study medication at the required daily dose for 30 days.  Patients will be provided with a sufficient number of cartridges to continue on treatment until the next scheduled return to the study site.

 

Teriparatide (rDNA origin) injection (250 µg/mL) will be supplied in multi-dose disposable pens containing a glass cartridge.  Each pen contains enough study medication to deliver the required daily dose for 28 days.  Patients will be provided with a sufficient number of pens to continue on treatment until the next scheduled return to the study site.

 

Calcium and Vitamin D Supplements

 

Calcium and Vitamin D supplements will be provided by the sites.

 

Attachment 2, Attachment E-36



 

Packaging, Labeling and Storage

 

Packaging

 

BA058 80 µg and Placebo will be supplied and packaged as identical cartridges and pens.  The study will not be blinded with regard to teriparatide which is supplied from marketed product; however, because teriparatide will be supplied to the site in identical outer packaging as BA058 80 µg and Placebo, the site will remain blinded until treatment is assigned, the package is opened, and its contents are dispensed.  All packaging operations will be performed in accordance with Good Manufacturing Practices.

 

Calcium and Vitamin D supplements will be provided as packaged by the manufacturer.

 

Labeling

 

Each study medication kit will be labeled with an identifying kit number.  In addition, each kit will be labeled with a caution statement and other information required by local Regulatory Authorities.

 

Calcium and Vitamin D supplements will not be relabeled for the study.

 

Storage

 

All study medications (BA058 80 µg, Placebo, teriparatide) must be kept in a secure, limited-access storage area at 2° to 8°C (36° to 46°F) until dispensed for use to a study patient or until returned to the Sponsor.  Once dispensed, BA058 80 µg or Placebo is stable for 30 days at room temperature.  When more than one cartridge of BA058 80 µg or Placebo is dispensed for 30 days of use each, it is recommended that the cartridges not in use be kept refrigerated until required.

 

The teriparatide pen should be stored under refrigeration at 2° to 8°C (36° to 46°F) at all times.

 

Calcium and Vitamin D supplements may be stored at room temperature.

 

Treatment Assignment

 

All patients who are screened for the study will be assigned a unique 7 digit patient number which will be used to identify patients throughout the study and on the CRFs.  Patient numbers will be assigned as follows:

 

XXX YYYY, where:

 

·              XXX represents the study site number;

 

·              YYYY represents the patient ID number

 

Patients who meet all inclusion criteria and none of the exclusion criteria and successfully complete the Screening and Pretreatment Periods of the study will be assigned sequentially to

 

Attachment 2, Attachment E-37



 

a randomized treatment group on Day 1 of the Treatment Period.  Patients will only receive one study ID at the time of screening and therefore will not receive a new identifier at randomization.  During the randomization call, sites will enter the kit number assigned to the subject into the IVRS system.  The IVRS system will record the site number, the subject number and the kit/randomization number within the system.  Information regarding treatment assignment will reside within the IVRS system, as part of the study blinding.

 

Study medication kits will be assigned sequential numbers beginning with 001.  The study medication kit number assigned to an eligible patient will be recorded in the source documents, on the appropriate page of the CRF, and reported to the IVRS system as described above.  Once a kit has been assigned, it may not be reused.

 

The Sponsor statistician will be responsible for overseeing the preparation of the master randomization scheme that will be used to package study medication into kits and for the IVRS system.

 

Study Medication Administration

 

Patients will self-administer study medication on a daily basis during the Treatment Period.  The first self-administration is to occur at the study site under observation.  On the days of clinic visits, study medication must be administered in the clinic to accommodate pre-injection and post-injection procedures; study personnel may administer the study medication.

 

Patients will be trained by study personnel during the Pretreatment Period to self-inject study medication with the BA058/Placebo cartridge and pen device.  Those patients who are subsequently randomized to teriparatide treatment on Day 1 will be trained in the use of the teriparatide pen on Day 1.  If a patient requires assistance with study medication administration, an individual (e.g., a family member) who has been trained by study personnel may provide assistance.

 

Patients will be instructed by the study site to inspect the contents of their study medication device before each injection.  If the cartridge or pen contents are not clear and colorless, or if the contents contain particles, the patients will be instructed not to use that cartridge or pen and to contact the study site for further guidance.

 

Injections should be administered in the morning and preferably at the same time each day.  All injections are to be given in the periumbilical region, rotating the exact site of injection each day.  If it is deemed medically necessary by the investigator for an injection to be administered at a site other than the abdomen, the alternate site of injection is to be recorded and the reason for the change documented in the medical chart.

 

On the first day of study medication administration, the patient should self-inject while in a sitting or lying position at the study site and remain in that position for approximately 5 minutes.  The patient is to remain under observation for a minimum of 60 minutes.  An orthostatic blood pressure measurement will be taken 60 minutes after the injection.  On the days when blood sampling is required after study medication injection, the patient is to

 

Attachment 2, Attachment E-38


 

remain in the vicinity of the clinic for the blood collections scheduled up to 4 hours post-injection.

 

BA058 80 µg and Placebo will be supplied in cartridges, each containing enough study medication to deliver the required daily dose for 30 days. Patients are to be instructed to change cartridges after 30 days, regardless of how much medication is left in the initial cartridge. Teriparatide will be supplied as a pre-filled pen, each with enough study medication for 28 days. Patients will be instructed to use a new pen after each 28-day period. At each clinic visit during the Treatment Period, the used BA058 80 µg or Placebo cartridges, but not pen, or the used teriparatide pens should be returned and a sufficient number of new cartridges or teriparatide pens are to be provided to last until the next clinic visit or as needed to replenish drug supply. Compliance, adverse events, and use of concomitant medications should be reviewed upon drug re-supply.

 

Treatment Compliance

 

In order to evaluate the safety, efficacy and tolerance of BA058 80 µg, it is critical that patients comply with the treatment regimen to which they were randomized and honor the schedule of visits and procedures required by the study. Patient compliance will be ascertained by three methods: patient diaries, cartridge accountability, and site-assessment of remaining drug content of returned cartridges.

 

The location, date and time that each dose of study medication was administered will be recorded in a patient diary for the first 30 days of treatment for review at the Month1 (Visit 4), and for the 30 days of Month 11 for review at the Month 12 (Visit 8) study visit, and entered in the appropriate case report form. Weekly summaries of study drug administration will also be maintained by the patient throughout the study. All doses of study medication are to be self-administered or administered by an individual trained in giving the injection (e.g., a family member). Study personnel may administer the injection on days of clinic visits.

 

If a patient does not take all study medication (BA058 80 µg, Placebo, teriparatide, Calcium and Vitamin D supplements), the reason for the missed dosing is to be recorded in source documents and on the appropriate case report form. During the Follow-up Period, it is recommended that patients continue taking the Calcium and Vitamin D supplements, but treatment compliance will not be assessed during this post-treatment period.

 

The residual volume of returned cartridges will be measured by the height of the fluid column and recorded in source documents and on the appropriate case report form by the site personnel when the cartridge is returned by the patient.

 

Unblinding of Study Medication

 

Medical Emergency

 

Breaking the study blind for a patient should be done only in the event of a medical emergency where the identity of study medication is necessary to appropriately treat the

 

Attachment 2, Attachment E-39



 

patient. The Investigator may unblind the patient as to study medication through the IVRS system. The IVRS system will automatically document and record any such unblinding and notify the Sponsor Medical Monitor and the Study Safety Officer of the unblinding. In addition, the Sponsor Medical Monitor and the Study Safety Officer also have the ability to unblind the study medication in a medical emergency.

 

If the Investigator determines that the medical event that resulted in unblinding of the study medication is not treatment related (relationship is documented as “none”; see Section 8.3 for definitions of relationship), the patient may continue treatment and participation in the study, providing no more than 14 days has elapsed since the last dose of study medication (refer to Section 0 for details regarding temporary suspension of treatment).

 

If the patient discontinues from further treatment with study medication, they should undergo the End-of-Treatment and End-of-Study procedures as outlined in Section 7.0 and the Schedule of Visits and Procedures (Appendix 14.1).

 

CONCOMITANT MEDICATIONS

 

Concomitant Medications

 

Calcium (500-1000 mg/day) and Vitamin D (400-800 IU/day) supplements, or a dose to be determined by Investigator and agreed upon by the Sponsor Medical Monitor according to the patient’s need, are required to be administered daily from the Pretreatment Period until the end of the Treatment Period. It is recommended that patients continue taking these supplements through the Follow-up Period. The doses and schedule of Calcium and Vitamin D supplements, which are part of the study medication protocol, should be adhered to and not be changed other than for medical necessity (Section 3.1.2). The supplements should be taken in the evening with or without food or as otherwise instructed by the Investigator.

 

For any required concomitant medication, such as statins or antihypertensives, the patient must be on a stable dose at study entry and every effort should be made to maintain a stable dose during study participation.

 

The occasional use of over-the-counter medications at approved doses (e.g., ibuprofen or acetaminophen) for headache or minor discomfort is allowed. These are to be recorded on the appropriate case report form. Patients should not take any other medications, including over-the-counter medications, herbal medications, or mega-doses of vitamins during the study without prior approval of the Investigator.

 

If it becomes necessary for a patient to take any other medication during the study, the specific medication(s) and indication(s) must be discussed with the Investigator. All concomitant medications taken during the course of the study must be recorded in the patient’s medical record or source document and transcribed into the case report form.

 

Attachment 2, Attachment E-40



 

Prohibited Medications

 

Patients cannot take any medications, including over-the-counter, non-prescription medication, with the exception of those noted in Section 0, within 72 hours prior to dosing on Day 1.

 

As outlined in the exclusion criteria (Section 0), patients who have been treated with bisphosphonates, fluoride or strontium in the past five years or received prior treatment with gallium nitrate, or with as yet unapproved bone-acting investigational agents at any time are to be excluded from study participation. Patients treated with a short course of bisphosphonates (3 months or less) who were intolerant of the treatment may be considered for study participation.

 

Estrogens given as HRT are allowed at entry into the study but cannot be initiated during the study except for local low dose vaginal estrogen.

 

In addition, patients are ineligible for the study if they have received general anesthesia within 12 weeks or have an abnormal nutritional status (abnormal diets, excessive or unusual vitamin or herbal intakes, malabsorption).

 

Patients are ineligible for the study if they require or are receiving thiazide diuretics. The use of thiazide diuretics must be discontinued at least one week prior to screening for study participation.

 

Patients are ineligible for the study if they require or have received anticonvulsants or anticoagulants within 6 months of study participation.

 

Attachment 2, Attachment E-41



 

STUDY ASSESSMENTS

 

The study protocol will consist of a Screening Period, a Pretreatment Period, a Treatment Period and a Follow-up Period. During the Screening Period, patients will be assessed to establish study eligibility and to collect baseline measurements.

 

In the Pretreatment Period, patients will undergo baseline efficacy labs, receive training in the techniques of self-injection with the BA058/Placebo pen device, receive diary training and begin taking Calcium and Vitamin D supplements.

 

The Treatment Period will begin with randomization. Patients randomized to teriparatide treatment will be trained in the use of the teriparatide pen on Day 1. During the Treatment Period, patients will continue to take Calcium and Vitamin D supplements and will self-administer the assigned study medication. Safety, efficacy and pharmacodynamic evaluations will be performed.

 

During the Follow-up Period (the one month interval after the completion of study treatment) it is recommended that patients continue the daily supplementation of Calcium and Vitamin D. This will culminate in an End-of-Study Visit where final study evaluations are performed and the patient is terminated from the study.

 

The assessments performed at each study visit are displayed in the Schedule of Visits and Procedures in Appendix 14.1. Appendix 0 provides a more detailed schedule of the study procedures by study visit with a suggested order of procedure conduct. Day 1 is defined as the first date that study medication is administered. All days prior to this point are designated with a ‘minus’ sign (e.g., Day —2, Day —1).

 

Exact procedures for centrifuging, storage, and shipping of laboratory samples will be detailed in a separate document. The actual time of each sample collection will be recorded in the case report form.

 

Study-specific assessments are to be conducted only after the patient has provided written informed consent to participate in this study. The study assessments are described in more detail in Section 0 below.

 

Clinical Procedures/Assessments

 

Informed Consent

 

Signed informed consent is obtained before any study-specific procedures are performed.

 

Medical History

 

A complete medical history and review of body systems along with demographic data will be obtained for all patients during the Screening Period (Days —28 to -8). Data to be recorded in the case report form include the patient’s gender, race, date of birth,

 

Attachment 2, Attachment E-42



 

tobacco use history, alcohol and caffeine use, and use at any time of hormone replacement therapy. Prior fracture history will also be recorded.

 

Physical Examination

 

A complete physical examination (general appearance, head/ears/eyes/nose/throat [HEENT], lungs/chest, heart, abdomen, lymph nodes, musculoskeletal, and extremities) will be performed during the Screening Period and at the End-of-Treatment. Any treatment-related findings should be followed up at the final study visit during the Follow-up Period (Visit 10).

 

Interim or symptom-directed physical examinations may be performed at other times at the discretion of the Investigator, if necessary, to evaluate adverse events or clinical laboratory abnormalities.

 

Vital Signs, Weight and Height

 

Vital signs (orthostatic blood pressure, body temperature (°C) and respiration rate (breaths/minute)) are to be measured and recorded at each study visit.

 

All blood pressure assessments will be conducted as orthostatic measurements. Blood pressure (mmHg; measured in the same arm each visit) and pulse rate (bpm) will be measured after five minutes in the supine position. Immediately following this measurement blood pressure will be measured again after three minutes in the standing position. At Treatment Visits 3, 4, 5, 6, 7, and 8, orthostatic blood pressure will be measured prior to injection and again 60 minutes after injection.

 

Height (cm) will be measured at Visit 1, 2 and 9. Height will be measured in the standing position at the Pretreatment and End-of-Treatment visits using a medical stadiometer and standardized procedures each time.

 

Weight (kg) will be measured at Visits 1, 8, 9 and 10.

 

Electrocardiogram

 

Twelve-lead supine electrocardiograms (ECGs) will be performed according to the Schedule of Visits and Procedures. The following ECG parameters will be recorded: rhythm, heart rate, PR interval, QRS duration and QT/QTc. ECGs will be performed during the Screening Period (Visit 1), the Treatment Period (Visits 3-9), and the Follow-up Period (Visit 10). At Treatment Visits 3, 4, 5, 6, 7, and 8, ECGs will be measured prior to injection and again 1 hour after injection. More than one ECG may be performed per time-point.

 

Clinical Laboratory Evaluations

 

Clinical laboratory evaluations will be performed by a central laboratory. Prior to starting the study, the Sponsor (or its designee) will provide each Investigator with

 

Attachment 2, Attachment E-43



 

copies of the appropriate laboratory certifications and normal ranges for all laboratory parameters to be performed by that laboratory.

 

Routine clinical laboratory tests will be assessed during the Screening, Pretreatment and Treatment Periods until the End-of-Treatment Visit (Visit 9). Bone-specific laboratory tests (serum calcium, PTH(1-84), and 25-hydroxy Vitamin D) will be conducted during the Screening and Treatment Periods as outlined in Appendix 14.1. Once eligibility has been confirmed, anabolic (PINP, osteocalcin, and BSAP) and resorptive bone marker (CTX) and 1,25-dihydroxy Vitamin D will be measured during the Pretreatment and Treatment Periods as outlined in Appendix 14.1. Urine Calcium:Creatinine ratio will be determined during the Treatment Period at Visits 3, 4, 5, 6, 7, 8, and 9. Creatinine Clearance also will be determined during the Treatment Period at Visits 3, 4, 5, 6, 7, 8, and 9. Serum calcium will be measured at treatment Visits 1 and 3, 4, 5, 6, 7, 8, and 9. Four hour post-dose serum calcium will be measured at treatment Visits 3, 4, 5, 6, 7, and 8. Hypercalcemia and hypercalciuria are to be evaluated as described in Sections 4.5.1 and 4.5.2, respectively. In addition, all clinically significant laboratory abnormalities indicating an adverse event will be followed up by repeat testing and further investigated according to the judgment of the Investigator.

 

Clinical laboratory evaluations are to be performed according to the Schedule of Visits and Procedures (Appendix 14.1). Specific tests to be run are described below.

 

Note: blood and urinalysis samples are to be obtained under fasting conditions (N.P.O. for 8 hours; water is acceptable) in the morning of each scheduled study visit prior to injection of the study medication with the exception of blood samples for BA058 post-injection drug levels and 4-hour post-injection calcium levels. For the 24-hour urine collection, patients will be instructed to begin the collection by discarding the first morning void (~6 a.m.) the day prior to the scheduled clinic visit and to then collect their urine for 24 hours. A final void is to be collected at the end of the 24-hour period and the urine collection transported to the clinic by the patient. Routine urinalyses are to be performed using samples freshly voided during the clinic visit.

 

Hematology :

·     Hemoglobin

 

 

·     Hematocrit

 

 

·     WBC count with differential in absolute counts

 

 

·     RBC count

 

 

·     Mean corpuscular volume (MCV)

 

 

·     Mean corpuscular hemoglobin concentration (MCHC)

 

 

·     Mean corpuscular hemoglobin (MCH)

 

 

·     Platelet count

 

 

 

 

Coagulation

·     Prothrombin time (PT)

 

 

·     Partial thromboplastin time (PTT)

 

 

Attachment 2, Attachment E-44



 

Chemistry

·     Sodium

 

 

·     Potassium

 

 

·     Chloride

 

 

·     Inorganic phosphorus

 

 

·     Albumin

 

 

·     Total protein

 

 

·     Glucose

 

 

·     Blood urea nitrogen (BUN)

 

 

·     Creatinine

 

 

·     Uric acid

 

 

·     Aspartate aminotransferase (AST)

 

 

·     Alanine aminotransferase (ALT)

 

 

·     Gamma-glutamyltranspeptidase (GGT)

 

 

·     Creatine phosphokinase (CPK)

 

 

·     Alkaline phosphatase

 

 

·     Total bilirubin

 

 

·     Lactate dehydrogenase (LDH)

 

 

·     Cholesterol

 

 

·     Triglycerides

 

 

·     Total calcium

 

Vitamin D

 

 

 

·     1, 25-dihydroxy Vitamin D level

 

 

·     25-hydroxy Vitamin D level

 

Urine

 

 

24-hr.

·     Calcium

 

Collection

·     Creatinine

 

 

 

 

Urinalysis

·     pH

 

 

·     Glucose

 

 

·     Protein

 

 

·     Ketones

 

 

·     Bilirubin

 

 

·     Blood

 

 

·     Urobilinogen

 

 

·     Specific gravity

 

 

·     Nitrite

 

 

·     Leukocytes

 

Urine microscopic examination will be done, if positive findings noted on dipstick.

 

 

 

 

Endocrine Tests

 

 

 

·     PTH(1-84)

 

 

·     *Serum FSH

 

 

·     *Serum estradiol

 

 

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* Only performed during Screening Period .

 

Serum Markers of Bone Metabolism

 

Blood samples will be taken to measure efficacy-related markers of bone metabolism during the Pretreatment Period and at specified visits during the Treatment Period in a subset of 600 patients.

 

The following markers of bone formation will be measured:

 

·                   Serum N-terminal propeptide of type I procollagen (PINP)

·                   Serum bone-specific alkaline phosphatase (BSAP)

·                   Serum osteocalcin

 

The following marker of bone resorption and collagen breakdown will be measured:

 

·                   Serum C-telopeptides of type 1 collagen crosslinks (CTX)

 

Clinical and Radiologic Evaluation of Fractures

 

To be eligible for randomization and entry into the Treatment Period, patients must have radiological evidence of 2 or more mild or one or more moderate lumbar or thoracic vertebral fractures, or history of low trauma forearm, humerus, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years. Women older than 65 who do not meet the fracture criteria may also be enrolled if their T-score is < -3.0 and > -5.0.

 

All patients will have x-rays taken to document fractures of the spine, lumbar and thoracic vertebrae. Patients will undergo antero-posterior and lateral radiographs of the lumbar and thoracic spines during the Screening Period and at the End-of-Treatment visit. However, in the event that qualifying lumbar or thoracic vertebral x-rays have been obtained as a consequence of routine patient care within 3 months prior to the Screening visit and comply with the study x-ray procedures, such x-rays may be used for assessment of eligibility.

 

Patients will also be clinically evaluated for non-vertebral fractures (wrist, hip, rib, etc) which occur de novo during the Treatment Period.

 

All radiographs will be viewed and assessed centrally by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fracture will be assessed according to the severity scale of Genant (1). A second blinded radiologist will confirm the assessment of the first reviewer for all patient radiographs in which an incident fracture has been identified. In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture. A standardized graded scale of severity of the vertebral deformity will be provided for this assessment.

 

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Fractures identified during the study will not be recorded as AEs unless the patient is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the patient’s underlying osteoporosis. All fractures will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

Bone Mineral Density

 

To be eligible for randomization and entry into the Treatment Period, each patient must have a BMD T-score < -2.5 and > -5.0 at the lumbar spine or hip by dual energy x-ray absorptiometry (DXA). Postmenopausal women older than 65 who meet the fracture criteria but have a T-score < -2.0 and > -5.0 may be enrolled as well as women older than 65 who do not meet the fracture criteria but who do have a T-score < -3.0 and > -5.0.

 

All patients will have BMD measurements taken via DXA during the Screening (Visit 1) and Pretreatment (Visit 2) Periods and during the Treatment Period (Visits 6, 8 and 9). However, in the event that qualifying BMD scans have been obtained as a consequence of routine patient care within 3 months prior to the Screening visit and comply with the study DXA procedures, such scans may be used for assessment of eligibility and need not be redone at Screening.

 

The initial DXA will be performed during the Screening Period and will be used to determine eligibility for participation in the study in conjunction with the radiological evaluations of fractures. The DXA is to be performed on the hip (femoral neck) and spine (L1-L4) at this visit and a qualifying T-score from either location can be used to determine eligibility. The spinal DXA is to be taken in the postero-anterior projection with any subsequent spinal DXA to be taken in the same projection. Patients who meet the entry criterion for BMD who satisfy all other eligibility criteria, and who have no exclusionary findings, will then be enrolled. On Day 1, a subset of 300 patients per group will have a wrist DXA scan. BMD measurements by DXA will be repeated at the lumbar spine (L1-L4), hip, and wrist during the Treatment Period (Visits 6, 8 and 9).

 

Details regarding the procedures for the conduct and processing of DXA scans will be provided in separate instruction manual. Patient eligibility will be determined based on local analysis of the BMD scan at the study site. The Central Imaging CRO will subsequently confirm the acceptability of each DXA scan with the study sites. If any scan is unacceptable for technical or other reasons, a repeat scan must be completed as soon as possible. Investigators will be blinded to the results of all follow-up DXA scan results throughout the study unless a safety issue is identified by the independent radiologist.

 

If the independent radiologist identifies any patient who shows a continuing significant deterioration from baseline (>7%) of BMD at spine or hip during the study, the study physician will be notified, the assessment will be repeated and, if confirmed, the patient will be discontinued from the study. The study physician will

 

Attachment 2, Attachment E-47



 

make this determination on the basis of the centrally read DXA relative to the baseline measurement in consultation with the Sponsor Medical Monitor. All such instances will be communicated to the DSMB.

 

Quantitative Bone Histomorphometry Assessment

 

In a subset of patients receiving BA058 80 µg or Placebo (up to 100 per group to obtain 75 evaluable biopsies per treatment group), bone biopsy of the iliac crest will be performed between Visit 8 and the End-of-Treatment Visit (Visit 9) for assessment of quantitative bone histomorphometry using a dual-labeling procedure. Details regarding the procedures for the conduct and processing of the bone biopsy will be provided in separate instruction manual. All bone biopsies will be read at a central specialized facility. A separate consent form will be obtained for those patients agreeing to undergo the biopsy procedure and additional clinic visits will be scheduled, as required, to prepare for the bone biopsy procedure between Visit 8 and Visit 9.

 

Renal assessment by CT Scan

 

In a subset of patients, (up to 100 per treatment group), a CT scan of the kidneys will be performed at the End-of-Treatment Visit (Visit 9) to assess the renal parenchyma and collecting system for renal calcification. Details regarding the procedures for the conduct and processing of renal CT scans will be provided in separate instruction manual. A separate consent form will be obtained for patients participating in the procedure.

 

BA058 Serum Level and Antibody Assessments

 

Samples for measurement of serum levels of BA058 will be taken at Visits 3, 4, 5, 6, 8 and 9 during the Treatment Period as part of a Population PK assessment. One peak level is to be drawn per patient per visit at the following varying post-injection times: 10 minutes to 30 minutes; 30 minutes to 1 hour; 1 hour to 2 hours; 2 hours to 3 hours; 3 hours to 4 hours. These draw times are to be randomized across Visits 3, 4, 5, 6, and 8. At the End-of-Treatment (Visit 9), only a trough level will be measured. Patients randomized to teriparatide will not have samples drawn for BA058 serum levels.

 

Samples for anti-BA058 antibody assessment will be obtained at Visit 3 (Day 1) and Visit 9 during the Treatment Period. Any patients who show presence of antibodies at End-of-Treatment will have additional time points tested to determine first occurrence of antibody positivity.

 

Local Tolerance

 

Assessment of local tolerance will consist of a self-evaluation by the patient of any dermal reaction to study medication injection during the first 30 days of study treatment for review at the Month1 (Visit 4), and for the 30 days of Month 11 for

 

Attachment 2, Attachment E-48


 

review at the Month 12 (Visit 8) study visit, and entered in the appropriate case report form.  This second diary will be dispensed at the Month 9 (Visit 7) or forwarded to the patient by mail, as appropriate.  Each injection site will be graded twice, 1 hour and 24 hours after the injection was performed and information will be recorded by the patient into the patient diary.  In addition, at each study visit during the Treatment Period, the Investigator will review and assess the injection sites for any evidence of dermal reaction.

 

Each injection site will be graded according to the following skin reaction scale.

 

Redness

0 =                          none

1 =                          minimal erythema, barely perceptible

2 =                          definite erythema, readily visible, less than 1 inch (2.54 cm) in diameter

3 =                          definite erythema, extensive, greater than 1 inch (2.54 cm) in diameter

Swelling

0 =                          none

1 =                          minimal swelling, without elevation

2 =                          definite swelling, readily visible; elevation less than 1 inch (2.54 cm) in diameter

3 =                          definite swelling, extensive, greater than 1 inch (2.54 cm) in diameter

Pain

0 =                          none

1 =                          minimal pain

2 =                          moderate pain, similar to a paper cut

3 =                          severe pain, similar to a bee sting or greater

Tenderness

0 =                          none

1 =                          minimal tenderness to touch

2 =                          moderate tenderness, no withdrawal to touch

3 =                           severe tenderness, withdraws to touch

 

Any injection site reaction with a grade of 3 will continue to be evaluated and recorded in the diary by the patient at 24 hour intervals until the symptom or sign has resolved.  If any reactions are severe or persistent at any time during the Study, the patient will be instructed to contact the Investigator.

 

Patient Diaries

 

As noted above in Section 7.1.13, a diary to record study drug administration and local tolerance will be maintained by patients during two 30-day periods of the study.

 

The first diary will be provided on Day 1 (the first day of study treatment) for the patient to record the date, time and site of study medication injection and to assess local tolerance using the scale described in Section 7.1.13.  Patients will record the required information daily during the first 30 days of the Treatment Period and at the Month 1 (Visit 4) clinic visit study personnel will review the diary with the patient.

 

Attachment 2, Attachment E-49



 

The Investigator will assess the information recorded by the patient for adverse events.  The second diary will be dispensed at the Month 9 (Visit 7) or later mailed to the patient, as appropriate, for completion by the patient for the 30 days of Month 11.  The diary will be collected and reviewed at the Month 12 (Visit 8) visit.  The diary data will be entered into the CRF, and any abnormality or adverse event will be followed up with the patient.

 

In addition, a diary summarizing all study drug administration will also be completed by the patient on a weekly basis.  The weekly diary will be maintained by the patient throughout the study and will be reviewed at each visit.

 

Activity and Diet

 

Patients who qualify for enrollment in the study will have no restrictions placed on their usual level of activity or on their usual diet.

 

ADVERSE EVENTS AND SAFETY EVALUATION

 

Timely, accurate, and complete reporting and analysis of safety information from clinical studies are crucial for the protection of subjects, Investigators and the Sponsor, and is mandated by Regulatory Agencies worldwide.  The Sponsor (or its designee) has established Standard Operating Procedures (SOPs) in conformity with regulatory requirements worldwide to ensure appropriate reporting of safety information.  All clinical trials sponsored by the Sponsor will be conducted in accordance with those procedures.

 

Definitions, Documentation, and Reporting

 

Adverse Event Definition

 

An adverse event (AE) is any untoward medical occurrence in a subject administered a pharmaceutical product, which does not necessarily have a causal relationship with the treatment.  An AE can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it is considered to be study drug related.  This includes any newly occurring event or previous condition that has increased in severity or frequency since the administration of study drug.

 

Serious Adverse Event Definition

 

A serious adverse event (SAE) is any adverse event, occurring at any dose and regardless of causality that:

 

·                                           Results in death .

 

·                                           Is life-threatening .  Life-threatening means that the subject was at immediate risk of death from the reaction as it occurred, i.e., it does not include a reaction which hypothetically might have caused death had it occurred in a more severe form.

 

Attachment 2, Attachment E-50



 

·                                           Requires in-patient hospitalization or prolongation of existing hospitalization .  Hospitalization admissions and/or surgical operations scheduled to occur during the study period, but planned prior to study entry are not considered AEs if the illness or disease existed before the subject was enrolled in the trial, provided that it did not deteriorate in an unexpected manner during the trial (e.g., surgery performed earlier than planned).

 

·                                           Results in persistent or significant disability/incapacity .  Disability is defined as a substantial disruption of a person’s ability to conduct normal life functions.

 

·                                           Is a congenital anomaly/birth defect .  This includes any anomaly detected at or after birth, or any anomaly that results in fetal loss.

 

·                                           Is an important medical event .  An important medical event is an event that may not result in death, be life-threatening, or require hospitalization, but may be considered an SAE when, based upon appropriate medical judgment, it may jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the outcomes listed in the definitions for SAEs.  Examples of such medical events include allergic bronchospasm requiring intensive treatment in an emergency room or at home, blood dyscrasias or convulsions that do not result in inpatient hospitalization, or the development of drug dependency or drug abuse.

 

Clarification should be made between the terms “serious” and “severe” since they are not synonymous.  The term “severe” is often used to describe the intensity (synonym: severity) of a specific event (as in mild, moderate, or severe myocardial infarction); the event itself, however, may be of relatively minor medical significance (such as a severe headache).  This is not the same as “serious,” which is based on subject/event outcome or action criteria described above and are usually associated with events that pose a threat to a subject’s life or functioning.  A severe adverse event does not necessarily need to be considered serious.  For example, persistent nausea of several hours duration may be considered severe nausea but not an SAE.  On the other hand, a stroke resulting in only a minor degree of disability may be considered mild, but would be defined as an SAE based on the above noted criteria.  Seriousness (not severity) serves as a guide for defining regulatory reporting obligations.

 

Monitoring of Adverse Events and Period of Observation

 

All AEs will be monitored until they are resolved or have become chronic or stable.  AEs will be recorded on the case report forms starting from the time of patient entry into the Pretreatment Period (Visit 2) of the study until 30 days after the last dose of study medication.  SAEs will be collected up to 30 days after the last dose of study medication.  Any SAEs that occur at any time after completion of the study, which the Investigator considers to be related to study drug, must be reported to the Sponsor or its designee.

 

Attachment 2, Attachment E-51



 

Procedures for Recording and Reporting AEs and SAEs

 

All adverse events spontaneously reported by the subject and/or in response to an open question from study personnel or revealed by observation, physical examination or other diagnostic procedures must be recorded in the source document and on the appropriate page of the case report form.  Any clinically relevant deterioration in laboratory assessments or other clinical findings is considered an adverse event and must be recorded on the appropriate pages of the case report form.  When possible, signs and symptoms indicating a common underlying pathology should be noted as one comprehensive event.

 

All SAEs that occur during the course of the study, as defined by the protocol, must be reported by the Investigator to the Study Safety Officer by completing and transmitting the SAE Form within one working day from the point in time when the Investigator becomes aware of the SAE.  In addition, all SAEs including all deaths, which occur up to and including 30 days after administration of the last dose of study drug, must be reported to the Study Safety Officer within one working day.  All SAEs and deaths must be reported whether or not considered causally related to the study drug.  SAE forms will be provided to the study site.  The information collected will include a minimum of the following: subject number, a narrative description of the event, and an assessment by the Investigator as to the intensity of the event, and relatedness to study drug.  Follow-up information on the SAE may be requested by the CRO, the Study Safety Officer or the Sponsor Medical Monitor.  Contact information for reporting SAEs to the Study Safety Officer is provided on the SAE form.

 

Study Safety Officer Contact Information

 

PLEASE SEE SERIOUS ADVERSE EVENT REPORTING FORM FOR DETAILED
REPORTING OF SAEs, INCLUDING CONTACT INFORMATION (e.g., FAX, EMAIL
OR TELEPHONE CONTACT NUMBERS)

 

It is the responsibility of the Investigator to promptly notify the Institutional Review Board (IRB)/Independent Ethics Committee (IEC) of all serious adverse drug reactions involving risk to human subjects in accordance with the requirements of the IRB/IEC.  An unexpected event is one that is not reported in the Investigator’s Brochure.

 

Planned hospital admissions or surgical procedures for an illness or disease that existed before the subject was enrolled in the trial or before study drug was given are not to be considered AEs unless they occur at a time other than the planned date.

 

Fractures identified during the study are not to be recorded as AEs unless the patient is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the patient’s underlying osteoporosis.  All fractures will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

For both serious and non-serious adverse events, the Investigator must determine the intensity of the event and the relationship of the event to study drug administration.

 

Attachment 2, Attachment E-52



 

Intensity for each AE will be defined according to the following criteria:

 

Intensity

Definition

Mild

Awareness of sign or symptom, but easily tolerated.

Moderate

Discomfort enough to cause interference with normal daily activities.

Severe

Inability to perform normal daily activities

 

If the intensity of an adverse event changes within a day, the maximum intensity should be recorded.  If the intensity changes over a longer period of time, the changes should be recorded as separate events (having separate onset and stop dates for each intensity).

 

Relationship to study drug administration will be determined by the Investigator according to the following criteria:

 

Relationship

Definition

None

No relationship between the event and the administration of study drug. The event is related to other etiologies, such as concomitant medications or subject’s clinical state.

 

 

Unlikely

The current state of knowledge indicates that a relationship to study drug is unlikely or the temporal relationship is such that study drug would not have had any reasonable association with the observed event.

 

 

Possible

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction might have been produced by the subject’s clinical state or other modes of therapy administered to the subject.

 

 

Probable

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction cannot be reasonably explained by the known characteristics of the subject’s clinical state or other modes of therapy administered to the subject.

 

For the purpose of safety analyses, all AEs that are classified with a relationship to study medication administration of possible or probable will be considered treatment-related events.

 

Attachment 2, Attachment E-53



 

Rules for Suspension of the Study

 

The study will be immediately suspended and no additional doses of study medication will be administered if one or more patients develop any of the following serious adverse events deemed to be possibly or probably attributable to study medication by the Investigator and/or Sponsor Medical Monitor, based upon close temporal relationship or other factors:

 

·                   Death,

 

·                   Serious anaphylaxis characterized by severe angioedema, hypotension, shock, bronchospasm, hypoxia or respiratory distress,

 

·                   New development or discovery of osteosarcoma in humans.

 

The study will be suspended pending review and discussion of all appropriate study data with local Regulatory Authorities.  The study will not be restarted until all parties have agreed to the course of action to be taken, the IRBs and Regulatory Authorities have been notified, and IRB approval is confirmed.

 

Attachment 2, Attachment E-54



 

STATISTICAL PROCEDURES

 

The purpose of this section is to outline prospectively the types of analyses and presentations of data that will answer the study objectives outlined in the protocol, and to explain how the data will be handled and analyzed, adhering to commonly accepted standards and practices of biostatistical analysis in the pharmaceutical industry.

 

The primary objective of this study is to determine the safety and efficacy of BA058 80 µg when compared to a matching placebo (Placebo) for prevention of vertebral fracture in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis.  The secondary objectives of this study are to determine the safety and efficacy of BA058 80 µg when compared to Placebo for prevention of non-vertebral fractures and change in vertical height.  Additional secondary efficacy outcomes include BMD (spine, hip and femoral neck) and safety (hypercalcemia) when compared to teriparatide in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis.

 

The specific objectives of this study are to:

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on lumbar spine, hip, and femoral neck bone mineral density (BMD) in otherwise healthy ambulatory postmenopausal women with severe osteoporosis when compared to teriparatide.

 

·                   Determine the comparative efficacy of 18 months of treatment with BA058 80 µg on reduction of non-vertebral fracture incidence in otherwise healthy ambulatory postmenopausal women at risk of fracture from severe osteoporosis when compared with Placebo.

 

·                   Determine the overall safety and tolerability of 18 months of treatment with BA058 80 µg, and specifically the number of patients with hypercalcemic events, in otherwise healthy postmenopausal women with severe osteoporosis when compared to teriparatide and Placebo.

 

·                   Provide additional evidence of bone safety through histomorphometric assessment of bone biopsy samples in a subset of patients from the BA058 80 µg and Placebo groups.

 

·                   Provide additional evidence of renal safety through radiological assessment by CT scan of a subset of patients from the BA058 80 µg, Placebo and teriparatide groups.

 

Sample Size

 

A sample size of 622 patients per treatment arm provides 90% power at a two-sided alpha of 0.05 to detect a difference of 4% between treatments, assuming a vertebral fracture rate of

 

Attachment 2, Attachment E-55



 

7% in placebo patients and 3% in BA058 80 µg for injection-treated patients when the large scale approximation of the binomial method is employed.  This superiority assessment infers a relative risk reduction of 57% and presupposes the availability of a pretreatment and post-treatment radiological assessment.  This population analysis would therefore be considered a modified ITT and will constitute the primary analysis population for this study.  To ensure an analysis size of 622 patients, an overall sample size of 800 patients per treatment arm will be recruited, anticipating that approximately 20% of patients may not have a second evaluable X-ray film available for analysis.  Should the projected fracture rate of 7% in placebo patients not be achieved, the sample size retains greater than 90% power at an alpha of 0.05 to detect a 4% difference between treatments based on placebo fracture incidence of 6% or 5%.

 

For statistically-powered secondary endpoint assessments, the sample size will have more than 90% power (n=275) at a two-sided alpha of 0.05 to detect a 1.15 percent difference between BA058 and teriparatide for spinal BMD based on a superiority hypothesis.  Similarly, for total analyzable hip BMD, the sample size will provide more than 90% power (n=25) at a two-sided alpha of 0.05 to detect a 2.45 percent difference between BA058 and teriparatide treatment effect and to detect a 2.00 percent difference between BA058 and teriparatide for femoral neck BMD (n=125) based on the same hypothesis.

 

For differences in the number of patients in the BA058 and teriparatide treatment groups reporting one or more events of hypercalcemia, both above the upper limit of normal and at a value of 0.3 mg/mL above the upper limit of normal, the medically significant elevation, the study sample size will also provide more than 90% power to detect such a difference using a two-sided alpha of 0.05.

 

Additional and other secondary endpoints will also be satisfied by these study sizes and will be included in the details provided in the Statistical Analysis Plan (SAP).

 

Randomization, Stratification and Blinding

 

Patients who have signed informed consent, completed the Screening and Pretreatment Periods, and are eligible for the study will be equally randomized into the three treatment groups on Day 1 of the Treatment Period.  A balanced randomized block assignment will be utilized to insure that an equal number of patients are assigned to each treatment group after a pre-specified block size has been achieved.

 

The Population PK sample timings will be randomized across visits for each patient.

 

Subsets of the population will be randomized to undergo bone biopsies, renal CT scans, serum bone markers and DXA’s to analyze wrist BMD in such a manner to ensure equal representation throughout the study.

 

No stratification is planned in this study.

 

BA058 80 µg and Placebo study medications will be prepared in a blinded fashion.  The study will not be blinded with regard to teriparatide which is supplied from marketed product; however, because teriparatide will be supplied to the site in identical outer

 

Attachment 2, Attachment E-56



 

packaging as BA058 80 µg and Placebo, the site will remain blinded until treatment is assigned, the package is opened, and its contents are dispensed.  Therefore, teriparatide will not be blinded in use relative to BA058 80 µg or Placebo.

 

Populations for Analysis

 

All analyses and data summaries will be presented for the Intent-to-Treat (ITT) or Safety Population.  In addition key selected endpoints will also be analyzed for the Per Protocol Population.

 

Safety Population

 

The Safety Population is comprised of all patients who receive one or more doses of study medication.

 

Modified Intent-to-Treat Population

 

The Modified ITT Population includes all patients with Pretreatment and End-of-Treatment evaluable radiologic assessments.

 

Per Protocol Population

 

The Per Protocol Population includes all patients who meet the study entry criteria and provide complete data, are at least 90% compliant with study treatment, and have no dose adjustments.

 

Procedures for Handling Missing, Unused, and Spurious Data

 

All available data will be included in the data listings and tabulations. Where appropriate, imputations of values for missing data for primary and secondary efficacy analyses using the safety population will be performed using last observation carried forward and will be specified in the Statistical Analysis Plan.  All data recorded on the CRF will be included in the data listings that will accompany the clinical study report.

 

Statistical Methods

 

Baseline Comparisons

 

Baseline characteristics, medical history, physical examination, vital signs and ECG, will be summarized using standard descriptive statistics by treatment group.  Specific demographic and baseline parameters will be tested for overall agreement (uniformity across treatment groups) using one-way ANOVA or Chi-square tests as appropriate for the type of data and specified in the Statistical Analysis Plan.

 

Efficacy Analysis

 

The primary efficacy endpoint will be the number of BA058-treated patients showing new vertebral fractures at End-of-Treatment when compared to Placebo.  New

 

Attachment 2, Attachment E-57



 

incident vertebral fractures will be evaluated according to the method of Genant (1).  This analysis will be performed using a Fisher’s Exact test on the modified intent to treat population.

 

Secondary efficacy endpoints will be analyzed using a Fisher’s Exact test (categorical variables) or analyses of covariance employing the baseline measure as the covariate (continuous variable) on the modified intent to treat population unless otherwise noted below.  For continuous variables, analyses will be performed on the last available assessment for each variable.

 

A hierarchical approach to the following key secondary analyses will be employed.  Secondary variables will be analyzed in the order below using two-sided alphas of 0.05.  Once an alpha is obtained that is above 0.05, the inferential analysis of secondary outcomes in the hierarchy will stop and no further secondary inferential analyses of the hierarchical variables will take place.

 

·                   The change in Spine BMD from baseline to End-of-Treatment in BA058-treated patients when compared to teriparatide.

 

·                   The change in Total Hip BMD from baseline to End-of-Treatment in BA058-treated patients when compared to teriparatide.

 

·                   The change in Femoral Neck BMD from baseline to End-of-Treatment in BA058-treated patients when compared to teriparatide.

 

An additional key powered secondary efficacy analysis will be the assessment of hypercalcemia.

 

·                   The difference in number of patients with hypercalcemia in BA058-treated patients at End-of-Treatment when compared to teriparatide.

 

Additional non-hierarchical analyses will be employed on the following efficacy parameters:

 

·                   The change in vertical height in patients treated with BA058 when compared to Placebo.

 

·                   The number of BA058-treated patients showing new non-vertebral fractures at End-of-Treatment when compared to Placebo.

 

·                   The difference in severity of incident vertebral fractures in BA058-treated patients at End-of-Treatment when compared to Placebo.  The analysis will employ a Chi-Square approach as severity is assessed in multiple grades.

 

·                   Kaplan-Meier estimates of fracture incidence over time by treatment group.  Point estimates (differences in incidence) of absolute and relative risk reduction (hazard ratio) and the corresponding 95% confidence intervals will

 

Attachment 2, Attachment E-58


 

be provided.  Data will be censored at the time of study termination for those not experiencing a fracture.

 

·                   The number of teriparatide-treated patients showing new vertebral fractures at End-of-Treatment when compared to Placebo.  New incident vertebral fractures will be evaluated according to the method of Genant (1). This analysis will be performed using a Fisher’s Exact test on the modified intent to treat population with a two-sided alpha of 0.20.  As the study is not statistically powered for the comparison of teriparatide to Placebo and alpha of 0.20 will be employed to claim a statistical difference.

 

·                   The change in distal 1/3 radius BMD from baseline to End-of-Treatment in BA058-treated patients when compared to Placebo.

 

·                   The changes in serum PINP, bone-specific alkaline phosphatase, osteocalcin and CTX across treatment.

 

Where any single parameter is analyzed against more than one comparator within the three treatments, an adjustment for multiplicity will be employed as specified in the Statistical Analysis Plan.

 

Analyses of continuous variables (e.g., change in BMD and height) will be analyzed using the Safety Population with last observations carried forward as noted in section 9.4.

 

In addition, efficacy analyses for patients who have a dose adjustment and continue on the study at a reduced dose, data may be summarized and tabulated.

 

All specified endpoints will be summarized by treatment groups and study period using standard descriptive statistics (N, mean, SD, median, minimum, maximum).  Changes in serum markers of bone metabolism (PINP, bone-specific alkaline phosphatase, osteocalcin, and CTX) will be analyzed using repeated measures Analysis of Variance (ANOVA) with factors for treatment (treatment groups), time (study period) and their interaction.

 

A population PK/PD analysis will be performed on samples for measurement of serum levels of BA058.  The PK/PD analyses and exposure response modeling will be described in a separate SAP and report and will generally follow the guidance provided by FDA (Exposure-Response Relationships — Study Design, Data Analysis, and Regulatory Applications, U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER), April 2003).

 

Additional exploratory analyses will be presented as either pre-planned or post-hoc to complement the overall understanding of study results.

 

Attachment 2, Attachment E-59



 

Safety Analysis

 

All patients who receive at least one dose of study medication will be included in the safety analysis that will be performed on the following parameters:

 

·                   Incidence and severity of AEs.  Dose and cumulative dose at which the AE occurred will also be recorded.

 

·                   Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory.

 

·                   Frequency of hypercalcemia across treatment groups (see Section 0)

 

·                   Bone histomorphometry as assessed by bone biopsy at End-of-Treatment in a subset of BA058 and Placebo patients.

 

·                   Renal safety as assessed by serum and urine creatinine (all patients) and renal CT scan (subset of patients) in all treatment groups.

 

Safety assessments for changes in physical examination, vital signs (systolic and diastolic blood pressure plus heart rate), ECG (normal and abnormal), and laboratory tests will be descriptively summarized by group and selected study periods.  In addition laboratory tests will be classified as low range, normal range, or high range and shift frequencies summarized between the Screening Period and the End-of-Treatment Visit.  Concomitant medication classes will be coded employing the WHO drug dictionary and summarized by number and percent of patients using each class and preferred drug term by treatment group.  All treatment emergent adverse events will be coded for body system, preferred term, and lowest level term using MedDRA and the number (%) patients experiencing each type of adverse event will be summarized by treatment group, cumulative dose, relationship to treatment, and severity.  All serious adverse events (SAE) and adverse events leading to study discontinuation will be listed and the number (%) patients presented by treatment group.

 

All adverse events collected prior to the first injection will be separately summarized in a fashion similar to the treatment emergent adverse events.

 

Adverse event rates will be compared across treatment groups with Chi-square and/or Fisher’s Exact test provided there is sufficient frequency of events to justify the testing.  In addition, 95% confidence intervals will be presented for rate differences between Placebo and each active treatment group.

 

Interim Analysis

 

No interim analyses are planned for this study.

 

Attachment 2, Attachment E-60



 

Procedures for Reporting Deviations to Original Statistical Analysis Plan

 

All deviations from the original statistical analysis plan will be provided in the final clinical study report.

 

Data Oversight

 

Central Review of Radiographs and DXA Scans

 

All radiographs will be viewed and assessed by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fracture will be assessed according to a set of pre-determined criteria.  A second blinded radiologist will review the assessment of the first reviewer for all patient radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.  All study DXA scans will also be evaluated centrally by a blinded independent reviewer.  The primary objective of the independent review is to provide an objective, unbiased evaluation of the critical eligibility criteria at screening and during the course of the study to provide objective efficacy data to determine the treatment benefit as demonstrated on the pertinent radiologic and clinical data associated with this study.  Finally, all renal CT scans will also be evaluated centrally by a blinded independent reviewer and confirmed by a second reviewer to ensure unbiased assessment of the renal parenchyma and collecting system.

 

Data Safety Monitoring Board

 

The DSMB will be responsible for overseeing study safety during the course of the trial.

 

Attachment 2, Attachment E-61



 

ADMINISTRATIVE REQUIREMENTS

 

Good Clinical Practice

 

This study will be conducted in accordance with the International Conference on Harmonization (ICH) for Good Clinical Practice (GCP) (27) and the appropriate regulatory requirements.  The Investigator will be thoroughly familiar with the appropriate use of the study medication as described in the protocol and the Investigator’s Brochure.  Essential clinical documents will be maintained to demonstrate the validity of the study and the integrity of the data collected.  The Investigator/institution should establish master files at the beginning of the study which will be maintained and updated during the study and retained thereafter according to the appropriate regulations.

 

Ethical Considerations

 

The study will be conducted in accordance with ethical principles founded in the Declaration of Helsinki (28).  The Institutional Review Board (IRB)/Independent Ethics Committee (IEC) will review all appropriate study documentation in order to safeguard the rights, safety and well-being of the subjects.  The study can only be conducted at study sites where IRB/IEC approval has been obtained.  The protocol, informed consent form, Investigator’s Brochure, advertisements (if applicable), and all other forms of information given to subjects will be provided to the IRB/IEC by the Investigator.  In addition, reports on the progress of the study will be submitted to the IRB/IEC by the Investigator at the appropriate intervals.

 

Subject Information and Informed Consent

 

Each subject (or a legally authorized representative) must give written informed consent prior to any study-specific procedures being conducted.  It is the responsibility of the Investigator to ensure written informed consent is obtained from each subject participating in this study after an explanation of the objectives, methods, discomforts and potential risks of the study has been provided.  The Investigator (or study personnel) must also explain to each subject that he/she is free to refuse participation in the study or to withdraw from it at any time.  Each subject will also be told that his/her records may be examined by competent authorities and authorized persons but that personal information will be treated as strictly confidential and will not be publicly available.

 

The informed consent form must be in accordance with the Declaration of Helsinki, ICH and GCP guidelines, and be approved by the Sponsor and the IRB/IEC.  State or local laws may require additional information.  Each subject (or his/her legally authorized representative) must sign and be given a copy of the informed consent form.  Each subject’s signed informed consent form must be maintained by the Investigator and be readily available for review by the Sponsor (or its designee) or the Regulatory Authorities.

 

Protocol Compliance

 

The Investigator will conduct this study in compliance with the protocol provided by the Sponsor and given approval/favorable opinion by the IRB/IEC and the appropriate

 

Attachment 2, Attachment E-62



 

Regulatory Authority(ies).  Changes to the protocol should not be made without agreement of the Sponsor Medical Monitor.  All changes to the protocol will require IRB/IEC approval prior to implementation, except when necessary to eliminate an immediate hazard to study subjects or when the change involves only logistical or administrative aspects of the study (e.g., change in Sponsor Medical Monitor or telephone number).  The IRB/IEC may provide, if applicable regulations permit, expedited review and approval/favorable opinion for minor changes in ongoing studies.  The Sponsor will submit all protocol changes to the appropriate Regulatory Authority in accordance with the governing regulations.

 

In situations requiring a departure from the protocol, the Investigator or other physician in attendance will contact the Sponsor Medical Monitor by telephone, email or fax.  If possible, this contact will be made before implementing any departure from the protocol.  In all cases, contact with the Sponsor Medical Monitor must be made as soon as possible in order to discuss the situation and agree on an appropriate course of action.  The case report form and source document will describe any departure from the protocol and the circumstances requiring it.

 

Case Report Form Completion

 

Paper and/or electronic case report forms (eCRFs) will be developed to collect information obtained during this study.  It is the Investigator’s responsibility to ensure that CRFs are completed for each subject enrolled in this study and for the accuracy, completeness, legibility and timeliness of the data reported in each CRF.  Data for subjects who are screened but not enrolled into the study because they do not meet study criteria or do not complete all screening procedures, should be recorded in the CRF.

 

CRFs or eCRFs will be completed and any corrections of data will be made according to procedures provided by the Sponsor (or designee).

 

Source Documents

 

Source documents are defined as original documents, data and records.  This may include hospital records, clinical and office charts, laboratory data/information, work sheets, subjects’ diaries or evaluation checklists, pharmacy dispensing and other records, recorded data from automated instruments, microfiches, photographic negatives, microfilm or magnetic media, ECG printouts, and/or x-rays.

 

The Investigator(s)/institution(s) will permit trial-related monitoring, audits, IRB/IEC review, and regulatory inspection(s), providing direct access to source data documents.

 

Study Monitoring

 

The Sponsor (or its designee) will ensure that the study is monitored in accordance with ICH-GCP Guidelines.  Monitoring is the act of overseeing the progress of a clinical trial and of ensuring that it is conducted, recorded, and reported in accordance with the protocol, standard operating procedures, Good Clinical Practice, and the applicable regulatory requirements and that the study data are accurate, complete and verifiable from source data.

 

Attachment 2, Attachment E-63



 

All study documentation and other source data will be made available to the Sponsor (or its designee), the IRB and to Regulatory Authorities for inspection upon request.

 

On-Site Audits

 

Representatives of the IRB or the Sponsor (or designee) may visit the study site to carry out an audit of the study in compliance with regulatory guidelines and company policy.  Such audits will require access to all study records including source documents, CRFs, and other study documents.  Direct access to these study records must be guaranteed by the Investigator, who must provide support for these activities at all times.

 

Similar auditing procedures may also be conducted by agents of any Regulatory Authority reviewing the results of this study.  The Investigator/institution should immediately notify the Sponsor if they have been contacted by a Regulatory Authority concerning an upcoming inspection.

 

Drug Accountability

 

Accountability for the study medication at the study site is the responsibility of the Investigator.  The Investigator will ensure that the study medication is used only in accordance with this protocol.  Where allowed, the Investigator may choose to assign some of the study medication accountability responsibilities to a pharmacist or other appropriately trained individual.

 

Study medication accountability records indicating the delivery date to the study site, inventory at the study site and dispensing/use will be maintained.  These records will adequately document that the study medications were dispensed and returned as specified in the protocol and according to the randomization scheme.  Accountability records for all study medications will include dates, quantities, batch/lot numbers, kit numbers, cartridge numbers, and patient numbers.  The Sponsor (or its designee) will review study medication accountability records at the study site on an ongoing basis during the study.  All used and unused supplies must be inventoried, accounted for, and returned to the Sponsor (or its designee), or if authorized, disposed of at the study site.  Records of disposal must be maintained with the study records.

 

Record Retention

 

The Investigator will maintain all study records according to ICH/GCP and applicable regulatory requirements.  Essential documents must be retained for two years after the final marketing approval in an ICH region or at least two years have elapsed since the discontinuation of clinical development of the study medication.  It is the responsibility of the Sponsor to inform the Investigator of when these documents can be destroyed.  In addition, all patient medical records and other source documentation will be kept for the maximum time permitted by the hospital, institution or medical practice.

 

The Investigator/institution will take measures to prevent accidental or premature destruction of these documents.  If the responsible Investigator retires, relocates, or for other reasons

 

Attachment 2, Attachment E-64



 

withdraws from the responsibility of keeping the study records, custody must be transferred to a person who will accept the responsibility.  The Sponsor must be notified in writing of the name and address of the new custodian.

 

Study Termination

 

This study may be terminated at any time, if in the opinion of the Sponsor, the Investigator or the DSMB, there is sufficient reasonable cause.  Circumstances that may warrant termination include, but are not limited to:

 

·                   Determination of unexpected, significant, or unacceptable risk to subjects.

 

·                   Failure of enrollment

 

·                   Administrative reasons

 

·                   Plans to modify, suspend or discontinue the development of the study drug.

 

In addition, individual study sites may be terminated from study participation for reasons including, but not limited to the following:

 

·                   Failure to enter subjects at an acceptable rate.

 

·                   Insufficient adherence to protocol requirements.

 

·                   Incomplete and/or non-evaluable data.

 

In all cases, the terminating parties will provide written notification documenting the reason for study termination to all the relevant parties.

 

Should the study or an individual site be prematurely closed, all study materials (completed, partially completed, and blank CRFs, study drug, etc) must be returned to the Sponsor (or its designee).

 

Liability and Insurance

 

The Sponsor has subscribed to an insurance policy covering, in its terms and provisions, its legal liability for injuries caused to participating persons and arising out of this research performed strictly in accordance with the scientific protocol as well as with applicable law and professional standards.

 

Attachment 2, Attachment E-65



 

USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

 

Use of Information

 

All information regarding BA058 supplied by the Sponsor (or its designee) to the Investigator is privileged and confidential information.  The Investigator agrees to use this information to accomplish the study and will not use it for other purposes without prior consent from the Sponsor.

 

The information developed during the conduct of this clinical study is also considered confidential and will be used by the Sponsor in connection with the development of BA058.  This information may be disclosed as deemed necessary by the Sponsor to other clinical investigators, other pharmaceutical companies, and to Regulatory Authorities.  To allow for the use of the information derived from this study and to ensure complete and thorough analysis, the Investigator is obligated to provide the Sponsor (or its designee) with complete study results and all data developed in this study and to allow direct access to source data/documents for study-related monitoring, audits, IRB/IEC review, and regulatory inspection.

 

Publication

 

Results of this study may not be published prior to the completion of this study and completion of the formal clinical study report and other required regulatory reports and documents.

 

A single large publication of complete data from the study is planned.  It is anticipated that the results of this study will be presented at scientific meetings and/or published in a peer reviewed scientific or medical journal.  A Publications Committee composed of Investigators participating in the study and representatives from the Sponsor as appropriate will be formed to oversee the publication of the study results, which will reflect the experience of all participating study centers.

 

Subsequently, individual Investigators may publish results from the study in compliance with their agreement with the Sponsor.  A pre-publication manuscript must be provided to the Sponsor at least 30 days prior to the submission of the manuscript to a publisher.  Similarly, the Sponsor will provide any company prepared manuscript to the Investigators for review at least 30 days prior to submission to a publisher.

 

The Investigator shall comply with the policy of the Sponsor regarding confidential or proprietary information in any such paper and agrees to withhold publication of same for an additional 60 days in order to permit the Sponsor to obtain patent or other proprietary rights protection, if the Sponsor deems it necessary.

 

Attachment 2, Attachment E-66



 

INVESTIGATOR AGREEMENT

 

To be completed by the Investigator

 

I have read Protocol BA058-05-003: A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture.

 

I agree to conduct the study as detailed herein and in compliance with ICH Guidelines for Good Clinical Practice and applicable regulatory requirements and to inform all who assist me in the conduct of this study of their responsibilities and obligations.

 

The signature below constitutes my agreement to the contents of this protocol.

 

 

 

 

 

Signature of Principal Investigator

 

Date

 

 

Principal Investigator (print)

 

 

 

Signature of Sponsor’s Medical Officer (where applicable)

 

 

 

 

 

Louis St.L. O’Dea. MB BCh BAO. FRCP(C)

 

Date

 

Attachment 2, Attachment E-67



 

REFERENCES

 

1.               Genant HK, Wu CY, van KC, and Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993; 8:1137-1148.

2.               Rizzoli R, Bonjour JP, and Ferrari SL. Osteoporosis, genetics and hormones. J Mol Endocrinol 2001; 26:79-94.

3.               Rosen CJ. Clinical practice. Postmenopausal osteoporosis. N Engl J Med 2005; 353:595-603.

4.               Mannstadt M, Juppner H, and Gardella TJ. Receptors for PTH and PTHrP: their biological importance and functional properties. Am J Physiol 1999; 277:F665-F675.

5.               Slovik DM, Neer RM, and Potts JT, Jr. Short-term effects of synthetic human parathyroid hormone-(1-34) administration on bone mineral metabolism in osteoporotic patients. J Clin Invest 1981; 68:1261-1271.

6.               Dempster DW, Cosman F, Parisien M, Shen V, and Lindsay R. Anabolic actions of parathyroid hormone on bone. Endocr Rev 1993; 14:690-709.

7.               Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O, and Mitlak BH. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med 2001; 344:1434-1441.

8.               Reeve J. Recombinant human parathyroid hormone. BMJ 2002; 324:435-436.

9.               Strewler GJ, Nissenson RA. Parathyroid Hormone-Related Protein. In: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism . Chapter 14, Fourth Edition. Philadelphia: Lippincott, Williams and Wilkins, 1999.

10.       Martin TJ. Osteoblast-derived PTHrP is a physiological regulator of bone formation. J Clin Invest 2005; 115:2322-2324.

11.        Miao D, He B, Jiang Y, Kobayashi T, Soroceanu MA, Zhao J, Su H, Tong X, Amizuka N, Gupta A, Genant HK, Kronenberg HM, Goltzman D, and Karaplis AC. Osteoblast-derived PTHrP is a potent endogenous bone anabolic agent that modifies the therapeutic efficacy of administered PTH 1-34. J Clin Invest 2005; 115:2402-2411.

12.        Horwitz MJ, Tedesco MB, Gundberg C, Garcia-Ocana A, and Stewart AF. Short-term, high-dose parathyroid hormone-related protein as a skeletal anabolic agent for the treatment of postmenopausal osteoporosis. J Clin Endocrinol Metab 2003; 88:569-575.

13.        Culler MD, Dong J, Shen Y, Taylor JE, Carlile L, Sullivan T, Batista I, Bonin P, Carlson M, Lauer J, Savola A, Kasprzyk P, Morgan BA, Fisch C, Becret A, Legrand J, and Woon CW. BIM44058, a novel analog of PTHrP with enhanced bone building activity, but decreased calcium mobilization potential. Twenty third Annual Meeting of the American Society of Bone and Mineral Research, Phoenix, Arizona, USA, October 12-16, 2001. Journal of Bone and Mineral Research 2001;16 (suppl.1):S540.

14.        Legrand J, Guillaumat P, Forster R, Dong JZ, Woon CW, Claude J, and Culler MD. BIM44058, a novel PTHrP analog, does not increase total plasma calcium in cynomolgus monkeys at an effective pharmacological dose. Twenty third Annual Meeting of the American Society of Bone and Mineral Research, Phoenix, Arizona, USA, October 12-16, 2001. Journal of Bone and Mineral Research 2001;16 (suppl.1):S539.

15.        Legrand J, Becret A, Fisch C, Attia M, de Jouffrey S, Dong JZ, Woon CW, Claude J, and Culler MD. BIM44058, a novel PTHrP analog, increases bone formation but not bone resorption histomorphometric parameters in old ovariectomized osteopenic cynomolgus

 

Attachment 2, Attachment E-68



 

monkeys. Twenty third Annual Meeting of the American Society of Bone and Mineral Research, Phoenix, Arizona, USA, October 12-16, 2001. Journal of Bone and Mineral Research 2001;16 (suppl.1):S539.

16.        Legrand J, Fisch C, Guillaumat P, de Jouffrey S, Dong JZ, Woon CW, Claude J, and Culler MD. BIM44058, a novel PTHrP analog, restores in vivo spinal bone mineral density in old ovariectomized osteopenic cynomolgus monkeys. Twenty third Annual Meeting of the American Society of Bone and Mineral Research, Phoenix, Arizona, USA, October 12-16, 2001. Journal of Bone and Mineral Research 2001;16 (suppl.1):S539.

17.        EMEA. Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis.2006.

18.        FDA. Guidelines for preclinical and clinical evaluation of agents used in the prevention or treatment of postmenopausal osteoporosis.1994.

19.        FDA. Draft guidance:  Development of parathyroid hormone for the prevention and treatment of osteoporosis.2000.

20.       Martin TJ, Quinn JM, Gillespie MT, Ng KW, Karsdal MA, and Sims NA. Mechanisms involved in skeletal anabolic therapies. Ann N Y Acad Sci 2006; 1068:458-470.

21.        Chen P, Satterwhite JH, Licata AA, Lewiecki EM, Sipos AA, Misurski DM, and Wagman RB. Early changes in biochemical markers of bone formation predict BMD response to teriparatide in postmenopausal women with osteoporosis. J Bone Miner Res 2005; 20:962-970.

22.        Bauer DC, Garnero P, Bilezikian JP, Greenspan SL, Ensrud KE, Rosen CJ, Palermo L, and Black DM. Short-term changes in bone turnover markers and bone mineral density response to parathyroid hormone in postmenopausal women with osteoporosis. J Clin Endocrinol Metab 2006; 91:1370-1375.

23.        Delmas PD. Markers of bone turnover for monitoring treatment of osteoporosis with antiresorptive drugs. Osteoporos Int 2000; 11 Suppl 6:S66-S76.

24.        Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology 1996; 46:1470.

25.        Lipsitz LA. Orthostatic hypotension in the elderly. N Engl J Med 1989; 321:952-957.

26.        Black DM, Schwartz AV, Ensrud KE, Cauley JA, Levis S, Quandt SA, Satterfield S, Wallace RB, Bauer DC, Palermo L, Wehren LE, Lombardi A, Santora AC, and Cummings SR. Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial. JAMA 2006; 296:2927-2938.

27.        Guidance for Industry. E6 Good Clinical Practice: Consolidated Guidance. U.S.Department of Health and Human Services, Food and Drug Administration. April 1996.

28.        World Medical Association Declaration of Helsinki. The World Medical Association, Inc. 2008.

 

Attachment 2, Attachment E-69



 

APPENDICES

 

Attachment 2, Attachment E-70


 

Schedule of Visits and Procedures

 

Study Period

 

Screening

 

Pretreatment

 

Treatment

 

Follow-up

 

 

Visit:

 

1

 

2

 

3

 

4

 

5

 

6

 

7

 

8

 

9

 

10

Procedure

 

Study Day/ Month:

 

-28 to –8

 

-7 to -1

 

D1

 

1

 

3

 

6

 

9

 

12

 

18

 

19

 

 

Visit Window (Days)

 

NA

 

NA

 

± 1

 

± 3

 

± 7

 

± 7

 

± 7

 

± 7

 

± 7

 

± 3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Informed consent

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Review of entrance criteria

 

X

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medical history

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Physical examination (1)

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

Vital signs, weight and height measurements (2), (3)

 

X

 

X

 

X(3)

 

X(3)

 

X(3)

 

X(3)

 

X(3)

 

X(3)

 

X

 

X

Electrocardiogram(4)

 

X

 

 

 

X(4)

 

X(4)

 

X(4)

 

X(4)

 

X(4)

 

X(4)

 

X

 

X

Urinalysis (dipstick) (5),(6)

 

X

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Chemistry blood collection (6)

 

X

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Hematology blood collection (6)

 

X

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Coagulation (PT and PTT) blood collection (6)

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

FSH and serum estradiol (6)

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PTH(1-84) (6)

 

X

 

 

 

 

 

 

 

 

 

X

 

 

 

X

 

X

 

 

25-hydroxy Vitamin D level (6)

 

X

 

 

 

 

 

X

 

 

 

X

 

 

 

X

 

X

 

 

1,25-dihydroxy Vitamin D level (6)

 

 

 

X

 

 

 

X

 

 

 

X

 

 

 

X

 

X

 

 

Serum markers of bone metabolism (6), (7)

 

 

 

X

 

 

 

 

 

 

 

X

 

 

 

X

 

X

 

 

BA058 antibody levels (6)

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

 

 

X

 

 

BA058 trough and peak (at randomized time) drug levels (8)

 

 

 

 

 

X(8)

 

X(8)

 

X(8)

 

X(8)

 

 

 

X(8)

 

X

 

 

Calcium (4 hour post-injection) (9)

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

 

 

 

24-hour urine collection (10) (for Calcium:Creatinine and Creatinine Clearance)

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Clinical and radiologic (spine, lumbar and thoracic vertebrae) fracture assessments

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

Bone mineral density of hip and spine by DXA (11)

 

X

 

 

 

 

 

 

 

 

 

X

 

 

 

X

 

X

 

 

Bone mineral density of wrist by DXA (11)

 

 

 

 

 

X

 

 

 

 

 

X

 

 

 

X

 

X

 

 

Renal CT Scan (in subset of patients)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

Quantitative Bone Histomorphometric Assessment (biopsy in subset of patients) (12)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

X

 

 

Calcium and Vitamin D supplements(13)

 

 

 

Daily Administration

Injection training for patients (14)

 

 

 

X

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Study medication kit assignment via IVRS

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Study medication administration (3)

 

 

 

 

 

Daily Administration (3)

 

 

Local tolerance (dermal reactions) assessment (15)

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Patient diary review (16)

 

 

 

 

 

X

 

X

 

X

 

X

 

X

 

X

 

X

 

 

Document adverse events and concomitant medications

 

 

 

At any time; question patients at study visits

 

71


 

14.1                         Schedule of Visits and Procedures (continued)

 


(1)                                  Interim or symptom directed physical examinations may be conducted at other time points to assess adverse events or clinical laboratory abnormalities.

(2)                                  Vital signs (orthostatic blood pressure, pulse rate, body temperature, and respiration rate) are to be recorded at each study visit.
Height is to be measured at Visits 1, 2 and 9.  Height will be measured at Visits 2 and 9 in the standing position using a medical stadiometer.
Weight is to be measured during the Screening Period, at Visit 8, at the End-of-Treatment (Visit 9) and the Follow-up visit (Visit 10) only.
Orthostatic blood pressure is to be measured initially after 5 minutes in the supine position and then again after standing for 3 minutes.

(3)                                  Study medication injections are to be administered under supervision in the study clinic during scheduled clinic visits.  Assessments of orthostatic blood pressure will be done pre-dose and 60 minutes post-dose at Visits 3, 4, 5, 6, 7, and 8.

(4)                                  ECGs are to be obtained pre-dose and 1 hour post-dose on Visits 3, 4, 5, 6, 7 and 8.

(5)                                  On days of 24-hour urine collection, routine urinalysis will be performed on a sample freshly voided during the clinic visit.

(6)                                  These blood and urine samples are to be obtained under fasting conditions (N.P.O. for 8 hours; water is acceptable) in the morning of each scheduled study visit.  They are to be collected prior to injection of the study medication during the Treatment Period.

(7)                                  Includes blood samples for PINP, bone-specific alkaline phosphatase, serum osteocalcin and CTX (subset of 600 patients).

(8)                                  One peak level is to be drawn per patient per visit at the following varying post-injection times:  10 minutes to 30 minutes; 30 minutes to 1 hour; 1 hour to 2 hours; 2 hours to 3 hours; 3 hours to 4 hours.  These draw times are to be randomized across Visits 3, 4, 5, 6, and 8. At the End-of-Treatment (Visit 9), only a trough level will be measured.  No BA058 serum levels will be drawn for patients randomized to teriparatide.

(9)                                  These samples are to be drawn post-injection; the patient no longer needs to be fasting.  The patient is to remain near the clinic for the post-injection blood collections.

(10)                           This urine collection will be used for urinary calcium and urinary creatinine measurements.  Patients will discard the 1 st  void and begin a 24-hour urine collection the day prior to the clinic visit.  If a routine urinalysis is to be performed during the clinic visit, a separate sample freshly voided during the clinic visit will be used.

(11)                           DXA is to be performed initially on the hip (femoral neck) and spine (L1-L4) during the Screening visit.  A DXA of the wrist should be performed in a subset of patients on Day 1.  Each DXA for a given patient must be performed on the same machine, preferably by the same technician.

(12)                           Patients who agree to undergo the quantitative bone histomorphometric assessment will have additional clinic visits scheduled, as required, to prepare for the bone biopsy performed between Visit 8 and the End-of-Treatment visit (Visit 9).

(13)                           Calcium and Vitamin D supplements begin at the Pretreatment Period visit and continue until the end of the Treatment Period; it will be recommended to patients that they continue these supplements through the Follow-up visit.  A supply of supplements is provided for each patient.  At each study visit, the patient’s supply is to be assessed and the patient resupplied as necessary.  Drug usage reconciliation is to be performed when a new supply is provided.

(14)                           All patients will be trained on the use of the BA058/Placebo cartridge/pen delivery device at Visit 2; patients who are subsequently randomized to receive teriparatide will be trained on the use of the teriparatide pen at Visit 3.

(15)                           The Investigator is to review and assess the injection sites at each Treatment Period visit.

(16)                           Diaries will be provided to patients to record information regarding study medication injections (date/time/site of injection; local tolerance) for the first 30 days of treatment and for 30 days prior to Month 12 (Visit 8). In addition, the patient will also maintain a diary throughout the study to summarize all study drug administration on a weekly basis. The diaries are to be reviewed with the patient at each study visit.

 

72


 

Suggested Schedule of Events and Procedures by Study Visit

 

The purpose of this guide is to provide more detailed instructions for the study procedures listed in Appendix 14.1.  This guide presents the procedures in a suggested sequence of performance at each study visit.  Further information may be found within the protocol and in other study reference manuals (e.g., ECG, clinical lab sample processing).

 

Of note:

 

·                   During the Treatment Period, on the days of clinic visits, study medication must be injected at the clinic to accommodate pre-injection and post-injection procedures; study personnel may administer the study medication on those days.

 

·                   Pre-injection procedures include assessments of the patient, vital signs, ECG, and pre-injection blood/urinalysis collections.

 

·                   Pre-injection blood and urinalysis samples are to be obtained under fasting conditions (N.P.O. for 8 hours; water is acceptable) in the morning of each scheduled study visit; post-injection blood samples do not require fasting.

 

·                   BMD Scans: Always use the same study-validated machine; preferably the same technician.

 

·                   The 24-hour urine collection will be started at home the day before the clinic visit where the collection is required.  Patients will be instructed to discard the first morning void and begin the collection at least 24 hours before their clinic visit the following day.  They will collect all urine for 24 hours with a final void before coming to the clinic.  Routine urinalyses are to be performed using samples freshly voided during the clinic visit.

 

·                   Pen devices and needles for administration of study medications will be provided.  BA058 80 µg and Placebo will be supplied in cartridges, each containing enough study medication to deliver the required daily dose for 30 days.  Patients are to be instructed to change to a new cartridge after 30 days, regardless of how much medication is left in the cartridge.  At each clinic visit, the used BA058 80 µg or Placebo cartridges, but not pen, are to be returned and a sufficient number of new cartridges to last until the next clinic visit are to be provided.  Teriparatide will be supplied as pre-filled pens, each with enough medication for 28 days.  At each clinic visit, the used teriparatide pens should be returned and a sufficient number of new pens provided to last until the next clinic visit.

 

·                   Patients will be instructed to take the Calcium and Vitamin D supplements daily (in the evening with or without food or as otherwise instructed by the Investigator) until they are discharged from the study.  This is required until the End-of-Treatment.  During the Follow-up Period it is recommended that they continue the supplements.

 

·                   Patients will be approached at Visit 8 regarding participation in the quantitative bone histomorphometric evaluations.  Patients who consent to this assessment will undergo a bone biopsy between Visit 8 and Visit 9.  Additional clinic visits will be scheduled to complete all necessary preparations for the procedure.

 

73



 

Definitions of Common Procedures:

 

The terms used in the by-visit schedule that follows are further defined below.

 

Recent Health Status (document any changes from last visit)

 

·                   Question patient regarding any new health issues

·                   Question patient regarding any new adverse events

·                   Question patient regarding any new concomitant medications

·                   Question patient regarding any new issues related to ability to continue with study

 

Vital Signs and Weight

 

·                   Orthostatic Blood pressure (mmHg) (measured in same arm each time/each visit) is measured after five minutes in the supine position followed immediately by a measurement taken after 3 minutes in the standing position

·                   Pulse rate (beats/minute) is taken after approximately five minutes in the supine position

·                   Respiration rate (breaths/minute)

·                   Body temperature (°C)

·                   Weight (kg)

 

Height

 

·                   At Visits 2 and 9 standing measurements (cm) are to be performed using the same medical stadiometer and standardized procedures each time.

 

ECG

 

·                   Twelve-lead supine electrocardiogram

·                   Print hard copy for reading by qualified study personnel

 

24 Hour Urine Collection

 

·                   Patient to discard first morning void (suggest 6 a.m.) on day before clinic visit

·                   Patient to collect urine for approximately 24 hours

·                   Patient to collect final void at end of collection and bring collection to clinic.

·                   Process for calcium and creatinine

 

Urinalysis

 

·                   Obtain under fasting conditions (N.P.O. except water for 8 hours)

·                   Routine urinalysis is to be performed using a sample freshly voided during the clinic visit.

 

Review study medication injection procedures with patient

 

·                   Injections should be given daily, preferably at the same time each morning

·                   Injections are to be given in the periumbilical region, rotating the exact site of injection each day to minimize discomfort

·                   If medically necessary for an injection to be administered at a site other than the abdomen, the alternate site is to be recorded and the reason is to be documented in the medical chart

·                   Patients are to self-inject study medication; if the patient is unable to self-inject, she may be assisted by a competent companion (e.g., family member) trained to use the injection devices

·                   Study personnel may administer the study medication at clinic visits

 

Scheduling and instructions for next clinic visit

 

·                   Schedule visit

·                   Remind patient of any fasting requirements

·                   Provide urine collection instructions as necessary

·                   Remind patient that injections are to be administered at the clinic during Treatment Period study visits

 

Vitamins and Calcium Supplements

 

·                   Calcium and Vitamin D supplements begin during the Pretreatment Period and continue until the end of the Treatment Period.  Only those supplements supplied as part of study medication may be used and are to be used at the daily recommended dose (see Section 3.1.2) .

·                   Supplements should be taken in the evening, with or without food as instructed by the Investigator.

·                   Recommend to patients that they continue these supplements through the Follow-up Visit.

·                   Dispense the initial supply of supplements for each patient at Visit 2.

·                   At each study visit, assess the patient’s supply and resupply as necessary.

·                   Drug usage reconciliation is to be performed when a new supply is provided.

 

74



 

SCREENING PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 1

 

-[28 ]to –[8]

 

Written informed consent

 

 

Screening Visit

 

 

 

·       Must be obtained before any study-specific procedure is performed

Review of entrance criteria

Medical history and concomitant medications

Physical exam

*Vital Signs and Weight and Height (stadiometer not necessary)

*ECG

Urinalysis — dipstick:   fasting conditions (N.P.O. except water for 8 hours)

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

·       Coagulation (PT and PTT)

·       FSH and serum estradiol

·       PTH(1-84)

·       25-hydroxy Vitamin D level

Clinical and Radiologic Fracture Evaluations

·       Obtain antero-posterior and lateral radiographs of the lumbar and thoracic spine

·       Document any non-vertebral fractures

Bone Mineral Density DXA

·       Perform hip (femoral neck) and spine (L1-L4) DXA

*Scheduling and Instructions for next Clinic Visit

Screen Failures:

·       Data for patients who do not successfully complete screening procedures or do not meet study eligibility requirements should be entered into the eCRF, including the reason for failure.

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

75



 

PRETREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 2

 

-7 to -1

 

 

*Recent Health Status

·       Document any changes from Visit 1 including changes in medical history, including any new adverse events or concomitant medications

*Vital Signs

* Height (cm):   standing height measurement with medical stadiometer

Blood Collection:  fasting conditions (N.P.O. except water for 8 hours)

·       1,25-dihydroxy Vitamin D levels

·       Serum markers of bone metabolism

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

Calcium and Vitamin D Supplements

·       Dispense supply of Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

*Training in Self-Injection

·       Instruct patient in use of the BA058/Placebo device

·       If patient is unable to self-inject, train competent companion (e.g., family member) to use the injection device

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

76



 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 3

 

First Treatment Visit

 

1

( ± 1 day)

 

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage.

·       Record deviations in dosing or any AEs in source documents and CRFs.

·       Dispense study medication diary card for recording of date, time, site of injection and local tolerance on a daily basis.

·       Dispense weekly patient diary.

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs

*ECG

*24 Hour Urine Collection and Urinalysis

Study medication kit assignment via IVRS :

·       Call IVRS system: provide patient screening number and DOB

Blood Collection

·       Chemistry

·       BA058 antibody sample (if a BA058 treatment is assigned)

Bone Mineral Density DXA in a subset of  patients

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Patients randomized to teriparatide are to be trained in injection procedures

·       Observe/Assist patient with injection

·       patient should self-inject while in a sitting or lying position

·       patient should remain in that position for approx. 5 min.

·       Observe patient in clinic for a minimum of 60 minutes

·       Provide patient with study medication: 1 pen and cartridges for BA058 80 µg or Placebo; prefilled pen(s) for teriparatide.

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (1hour post-injection)

Blood Collection :  non-fasting

·       BA058 peak drug levels (at randomized time).  Only draw for patients randomized to BA058, Placebo

·       Calcium (4 hours post-injection)

Local tolerance assessment

·       Remind patients to assess dermal reactions 1 and 24 hours post-injection

·       Investigator to review diary and assess injection sites

Calcium and Vitamin D Supplements

·       Assess patient’s supply of Calcium and Vitamin D supplements; resupply as necessary

·       Instruct patient to take daily until they are discharged from the study

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 4

 

Month [1]

 

*Recent Health Status

 

77



 

 

After [1 st] ] Month of Treatment

 

( ± 3 days)

 

 

·       Document any changes from last visit

Patient Review

·       Review  Calcium and Vitamin D supplement usage

·       Review diaries of study medication usage/injection site reactions

·       Record dosing deviations or any AEs in source documents and CRFs

·       Dispense weekly patient diary, if needed

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

·       25-hydroxy Vitamin D level

·       1,25-dihydroxy Vitamin D levels

*24 Hour Urine Collection and Urinalysis

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Assist with drug injection as necessary

·       BA058 80 µg or Placebo: collect used cartridges; supply new cartridges as necessary

·       Teriparatide: collect used pen; supply new pre-filled pens as necessary

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (60 minutes post-injection)

Blood Collection :  non-fasting

·       BA058 peak drug levels (at randomized time).  Only draw for patients randomized to BA058, Placebo

·       Calcium (4 hours post-injection)

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

78


 

 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 5

 

After [3] Months of Treatment

 

Month [3]

( ± 7 days)

 

 

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage

·       Review study medication usage/injection site reactions

·       Review weekly patient diary

·       Record dosing deviations or any AEs in source documents and CRFs

·       Dispense weekly patient diary, if needed

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

*24 Hour Urine Collection and Urinalysis

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Assist with drug injection as necessary

·       BA058 80 µg or Placebo: collect used cartridges; supply new cartridges as necessary

·       Teriparatide: collect used pen; supply new pre-filled pens as necessary

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (60 minutes post-injection)

Blood Collection :  non-fasting

·       BA058 peak drug levels (at randomized time).  Only draw for patients randomized to BA058, Placebo

·       Calcium (4 hours post-injection)

Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

79



 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 6

 

After [6] Months of Treatment

 

Month [6]

( ± 7 days)

 

 

 

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage

·       Review study medication usage/injection site reactions

·       Review weekly patient diary

·       Record dosing deviations or any AEs in source documents and CRFs.

·       Dispense weekly patient diary, if needed

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

·       PTH(1-84)

·       25-hydroxy Vitamin D levels

·       1, 25-dihydroxy Vitamin D levels

·       Serum markers of bone metabolism:

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

*24 Hour Urine Collection and Urinalysis

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Assist with drug injection as necessary

·       BA058 80 µg or Placebo: collect used cartridges; supply new cartridges as necessary

·       Teriparatide: collect used pen; supply new pre-filled pens as necessary

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (60 minutes post-injection)

Blood Collection :  non-fasting

·       BA058 peak drug levels (at randomized time).  Only draw for patients randomized to BA058, Placebo

·       Calcium (4 hours post-injection)

Bone Mineral Density

·       Perform hip (femoral neck), spine (L1-L4) and radius DXA.

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

80



 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 7

 

After [9] Months of Treatment

 

 

Month [9]

( ± 7 days)

 

 

 

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage

·       Review study medication usage/injection site reactions

·       Review weekly patient diary

·       Record dosing deviations or any AEs in source documents and CRFs.

·       Dispense study medication diary card for recording of date, time, site of injection and local tolerance on a daily basis for the 30 days of Month 11. The diary can also be sent later to the patients by post.

·       Dispense weekly patient diary, if needed

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

*24 Hour Urine Collection and Urinalysis

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Assist with drug injection as necessary

·       BA058 80 µg or Placebo: collect used cartridges; supply new cartridges as necessary

·       Teriparatide: collect used pens; supply new pre-filled pens as necessary

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (60 minutes post-injection)

Blood Collection :  non-fasting

·       Calcium ([4] hours post-injection)

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

81



 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 8

After [12] Months of Treatment

 

 

Month [12]

( ± 7 days)

 

 

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage

·       Review diaries of study medication usage/injection site reactions

·       Dispense weekly patient diary, if needed

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

BEFORE STUDY MEDICATION ADMINISTRATION

*Vital Signs and Weight

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

·       PTH(1-84)

·       25-hydroxy Vitamin D levels

·       1, 25-dihydroxy Vitamin D levels

·       Serum markers of bone metabolism

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

*24 Hour Urine Collection and Urinalysis

 

STUDY MEDICATION ADMINISTRATION

·       *Review study medication injection procedures with patient

·       Assist with drug injection as necessary

·       BA058 80 µg or Placebo: collect used cartridges; supply new cartridges as necessary

·       Teriparatide: collect used pens; supply new pre-filled pens as necessary

AFTER STUDY MEDICATION ADMINISTRATION

*Vital Signs - Repeat orthostatic blood pressure (60 minutes post-injection)

*ECGs - (60 minutes post-injection)

Blood Collection :  non-fasting

·       BA058 peak drug levels (at randomized time).  Only draw for patients randomized to BA058, Placebo

·       Calcium (4 hours post-injection)

Bone Mineral Density

·       Perform hip (femoral neck), spine (L1-L4) and radius DXA

*Quantitative Bone Histomorphologic Assessment:

·       Discuss with patient and sign informed consent

·       Schedule visits to prepare for biopsy (between Visit 8 and Visit 9)

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

82



 

TREATMENT PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 9

 

End-of-Treatment Visit

 

 

Month 18

( ± 7 days)

 

(one day after the last dose of study drug)

 

Physical Examination

*Recent Health Status

·       Document any changes from last visit

Patient Review

·       Review Calcium and Vitamin D supplement usage

·       Review study medication usage/injection site reactions

·       Review weekly patient diary

·       Record dosing deviations or any AEs in source documents and CRFs.

Calcium and Vitamin D Supplements

·       Assess and resupply patient’s Calcium and Vitamin D supplements

·       Instruct patient to take daily until they are discharged from the study

Local tolerance assessment

·       Investigator to review and assess injection sites

*Vital Signs and Weight

* Height (cm):   standing measurement with medical stadiometer

*ECG

Blood Collection:   fasting conditions (N.P.O. except water for 8 hours)

·       Chemistry

·       Hematology

·       Coagulation (PT and PTT)

·       PTH(1-84)

·       25-hydroxy Vitamin D levels

·       1, 25-dihydroxy Vitamin D levels

·       Serum markers of bone metabolism

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

·       BA058 trough drug levels (only for patients randomized to BA058, Placebo)

·       BA058 antibody levels

*24 Hour Urine Collection and Urinalysis

THERE IS NO STUDY MEDICATION ADMINISTRATION

·       Collect used study medication pens and cartridges

Clinical and Radiologic Fracture Evaluations

·       Obtain antero-posterior and lateral radiographs of the lumbar and thoracic vertebrae

·       Document any non-vertebral fractures

Bone Mineral Density

·       Perform spine (L1-L4), hip, and wrist (in subset of patients) DXA.

Renal CT Scan

·       Perform renal CT scan on subset of patients who consented to this procedure.

Discuss continuing treatment options with qualified patients

*Scheduling and Instructions for next Clinic Visit

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

83



 

FOLLOW-UP PERIOD

 

VISIT

 

STUDY DAY

 

ACTIVITIES

Visit 10

 

Final Study Visit

 

Month 19

( ± 3 days)

 

*Recent Health Status

·       Document any changes from last visit

Calcium and Vitamin D Supplements

·       Collect any leftover supplements

*Vital Signs and Weight

*ECG

Discharge patient from study

·       Patient is terminated from the study unless abnormal clinical laboratory tests or adverse events require further follow-up

·       Discuss continuing treatment options with qualified patients

 


*Refer to “Definitions of Common Procedures” for more detailed information regarding these procedures

 

84


 

Body Mass Index Table

 

A BMI of 18.5 to 33, inclusive, is required for study participation.

 

 

 

Normal

 

Overweight

 

Obese

 

BMI

 

19

 

20

 

21

 

22

 

23

 

24

 

25

 

26

 

27

 

28

 

29

 

30

 

31

 

32

 

33

 

34

 

35

 

36

 

37

 

38

 

39

 

Height
(inches)

 

Body Weight (pounds)

 

58

 

91

 

96

 

100

 

105

 

110

 

115

 

119

 

124

 

129

 

134

 

138

 

143

 

148

 

153

 

158

 

162

 

167

 

172

 

177

 

181

 

186

 

59

 

94

 

99

 

104

 

109

 

114

 

119

 

124

 

128

 

133

 

138

 

143

 

148

 

153

 

158

 

163

 

168

 

173

 

178

 

183

 

188

 

193

 

60

 

97

 

102

 

107

 

112

 

118

 

123

 

128

 

133

 

138

 

143

 

148

 

153

 

158

 

163

 

168

 

174

 

179

 

184

 

189

 

194

 

199

 

61

 

100

 

106

 

111

 

116

 

122

 

127

 

132

 

137

 

143

 

148

 

153

 

158

 

164

 

169

 

174

 

180

 

185

 

190

 

195

 

201

 

206

 

62

 

104

 

109

 

115

 

120

 

126

 

131

 

136

 

142

 

147

 

153

 

158

 

164

 

169

 

175

 

180

 

186

 

191

 

196

 

202

 

207

 

213

 

63

 

107

 

113

 

118

 

124

 

130

 

135

 

141

 

146

 

152

 

158

 

163

 

169

 

175

 

180

 

186

 

191

 

197

 

203

 

208

 

214

 

220

 

64

 

110

 

116

 

122

 

128

 

134

 

140

 

145

 

151

 

157

 

163

 

169

 

174

 

180

 

186

 

192

 

197

 

204

 

209

 

215

 

221

 

227

 

65

 

114

 

120

 

126

 

132

 

138

 

144

 

150

 

156

 

162

 

168

 

174

 

180

 

186

 

192

 

198

 

204

 

210

 

216

 

222

 

228

 

234

 

66

 

118

 

124

 

130

 

136

 

142

 

148

 

155

 

161

 

167

 

173

 

179

 

186

 

192

 

198

 

204

 

210

 

216

 

223

 

229

 

235

 

241

 

67

 

121

 

127

 

134

 

140

 

146

 

153

 

159

 

166

 

172

 

178

 

185

 

191

 

198

 

204

 

211

 

217

 

223

 

230

 

236

 

242

 

249

 

68

 

125

 

131

 

138

 

144

 

151

 

158

 

164

 

171

 

177

 

184

 

190

 

197

 

203

 

210

 

216

 

223

 

230

 

236

 

243

 

249

 

256

 

69

 

128

 

135

 

142

 

149

 

155

 

162

 

169

 

176

 

182

 

189

 

196

 

203

 

209

 

216

 

223

 

230

 

236

 

243

 

250

 

257

 

263

 

70

 

132

 

139

 

146

 

153

 

160

 

167

 

174

 

181

 

188

 

195

 

202

 

209

 

216

 

222

 

229

 

236

 

243

 

250

 

257

 

264

 

271

 

71

 

136

 

143

 

150

 

157

 

165

 

172

 

179

 

186

 

193

 

200

 

208

 

215

 

222

 

229

 

236

 

243

 

250

 

257

 

265

 

272

 

279

 

72

 

140

 

147

 

154

 

162

 

169

 

177

 

184

 

191

 

199

 

206

 

213

 

221

 

228

 

235

 

242

 

250

 

258

 

265

 

272

 

279

 

287

 

73

 

144

 

151

 

159

 

166

 

174

 

182

 

189

 

197

 

204

 

212

 

219

 

227

 

235

 

242

 

250

 

257

 

265

 

272

 

280

 

288

 

295

 

74

 

148

 

155

 

163

 

171

 

179

 

186

 

194

 

202

 

210

 

218

 

225

 

233

 

241

 

249

 

256

 

264

 

272

 

280

 

287

 

295

 

303

 

75

 

152

 

160

 

168

 

176

 

184

 

192

 

200

 

208

 

216

 

224

 

232

 

240

 

248

 

256

 

264

 

272

 

279

 

287

 

295

 

303

 

311

 

76

 

156

 

164

 

172

 

180

 

189

 

197

 

205

 

213

 

221

 

230

 

238

 

246

 

254

 

263

 

271

 

279

 

287

 

295

 

304

 

312

 

320

 

 

 

 

Extreme Obesity

 

BMI

 

40

 

41

 

42

 

43

 

44

 

45

 

46

 

47

 

48

 

49

 

50

 

51

 

52

 

53

 

54

 

Height
(inches)

 

Body Weight (pounds)

 

58

 

191

 

196

 

201

 

205

 

210

 

215

 

220

 

224

 

229

 

234

 

239

 

244

 

248

 

253

 

258

 

59

 

198

 

203

 

208

 

212

 

217

 

222

 

227

 

232

 

237

 

242

 

247

 

252

 

257

 

262

 

267

 

60

 

204

 

209

 

215

 

220

 

225

 

230

 

235

 

240

 

245

 

250

 

255

 

261

 

266

 

271

 

276

 

61

 

211

 

217

 

222

 

227

 

232

 

238

 

243

 

248

 

254

 

259

 

264

 

269

 

275

 

280

 

285

 

62

 

218

 

224

 

229

 

235

 

240

 

246

 

251

 

256

 

262

 

267

 

273

 

278

 

284

 

289

 

295

 

63

 

225

 

231

 

237

 

242

 

248

 

254

 

259

 

265

 

270

 

278

 

282

 

287

 

293

 

299

 

304

 

64

 

232

 

238

 

244

 

250

 

256

 

262

 

267

 

273

 

279

 

285

 

291

 

296

 

302

 

308

 

314

 

65

 

240

 

246

 

252

 

258

 

264

 

270

 

276

 

282

 

288

 

294

 

300

 

306

 

312

 

318

 

324

 

66

 

247

 

253

 

260

 

266

 

272

 

278

 

284

 

291

 

297

 

303

 

309

 

315

 

322

 

328

 

334

 

67

 

255

 

261

 

268

 

274

 

280

 

287

 

293

 

299

 

306

 

312

 

319

 

325

 

331

 

338

 

344

 

68

 

262

 

269

 

276

 

282

 

289

 

295

 

302

 

308

 

315

 

322

 

328

 

335

 

341

 

348

 

354

 

69

 

270

 

277

 

284

 

291

 

297

 

304

 

311

 

318

 

324

 

331

 

338

 

345

 

351

 

358

 

365

 

70

 

278

 

285

 

292

 

299

 

306

 

313

 

320

 

327

 

334

 

341

 

348

 

355

 

362

 

369

 

376

 

71

 

286

 

293

 

301

 

308

 

315

 

322

 

329

 

338

 

343

 

351

 

358

 

365

 

372

 

379

 

386

 

72

 

294

 

302

 

309

 

316

 

324

 

331

 

338

 

346

 

353

 

361

 

368

 

375

 

383

 

390

 

397

 

73

 

302

 

310

 

318

 

325

 

333

 

340

 

348

 

355

 

363

 

371

 

378

 

386

 

393

 

401

 

408

 

74

 

311

 

319

 

326

 

334

 

342

 

350

 

358

 

365

 

373

 

381

 

389

 

396

 

404

 

412

 

420

 

75

 

319

 

327

 

335

 

343

 

351

 

359

 

367

 

375

 

383

 

391

 

399

 

407

 

415

 

423

 

431

 

76

 

328

 

336

 

344

 

353

 

361

 

369

 

377

 

385

 

394

 

402

 

410

 

418

 

426

 

435

 

443

 

 

Source: Adapted from Clinical Guidelines on the i dentification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report.

 

85


 

WHO (World Health Organization) Toxicity Criteria by Grade

 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

 

Haematology

 

 

 

 

 

 

 

 

 

 

 

WBC (x10 9 /L)

 

4

 

3.0 - 3.9

 

2.0 - 2.9

 

1.0 - 1.9

 

< 1.0

 

Platelets (x10 9 /L)

 

WNL

 

75.0 - normal

 

50.0 - 74.9

 

25.0 - 49.9

 

< 25.0

 

Haemoglobin (g/L);
(mmol/L)

 

WNL

 

100.0 – normal;
6.2 - normal

 

80.0 - 99.0;
5.0 – 6.1

 

65.0 - 79.0
4.0 – 4.9

 

< 65.0
< 4.0

 

Granulocytes/ Bands (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

 

Lymphocytes (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

 

Haemorrhage

 

none

 

mild, no transfusion

 

gross, 1 - 2 units transfusion per episode

 

gross, 3 - 4 units transfusion per episode

 

massive, > 4 units transfusion per episode

 

Coagulation

 

 

 

 

 

 

 

 

 

 

 

Fibrinogen

 

WNL

 

0.99 - 0.75 x N

 

0.74 - 0.50 x N

 

0.49 - 0.25 x N

 

< 0.25 x N

 

Prothrombin time(quick)

 

WNL

 

1.01 - 1.25 x N

 

1.26 - 1.50 x N

 

1.51 - 2.00 x N

 

> 2.00 x N

 

Partial thromboplastin time

 

WNL

 

1.01 - 1.66 x N

 

1.67 - 2.33 x N

 

2.34 - 3.00 x N

 

> 3.00 x N

 

Metabolic

 

 

 

 

 

 

 

 

 

 

 

Hyperglycaemia (mmol/L)

 

< 6.4

 

6.4 – 8.9

 

9.0 – 13.9

 

14.0 – 27.8

 

> 27.8 or ketoacidosis

 

Hypoglycaemia (mmol/L)

 

> 3.6

 

3.6 – 3.1

 

3.0 – 2.3

 

2.2 – 1.7

 

< 1.7

 

Amylase

 

WNL

 

< 1.5 x N

 

1.5 - 2.0 x N

 

2.1 - 5.0 N

 

> 5.0 x N

 

Hypercalcaemia (mmol/L)

 

< 2.65

 

2.65 - 2.88

 

2.89 - 3.13

 

3.14 - 3.36

 

> 3.37

 

Hypocalcaemia (mmol/L)

 

> 2.10

 

2.10 - 1.94

 

1.93 - 1.74

 

1.73 - 1.52

 

< 1.51

 

Hypomagnesaemia (mmol/L)

 

> 0.58

 

0.58 - 0.48

 

0.47 - 0.36

 

0.35 - 0.24

 

< 0.23

 

Gastrointestinal

 

 

 

 

 

 

 

 

 

 

 

Nausea

 

none

 

able to eat reasonable intake

 

intake significantly decreased but can eat

 

no significant intake

 

 

Vomiting

 

none

 

1 episode in 24 hrs

 

2 - 5 episodes in 24 hrs

 

6 - 10 episodes in 24 hrs

 

> 10 episodes in 24 hrs or requiring parenteral support

 

Diarrhoea

 

none

 

increase of 2 - 3 stools/day over pre-Rx

 

increase of 4 – 6 stools/day, or nocturnal stools, or moderate cramping

 

increase of 7 - 9 stools/day, or incontinence, or severe cramping

 

increase of > 10 stools/day or grossly bloody diarrhoea, or need for parenteral support

 

Stomatitis

 

none

 

painless ulcers, erythema, or mild soreness

 

painful erythema, oedema, or ulcers but can eat solids

 

painful erythema, oedema, or ulcers and cannot eat solids

 

requires parenteral or enteral support for alimentation

 

Liver

 

 

 

 

 

 

 

 

 

 

 

Bilirubin (N = 17 µmol/L)

 

WNL

 

 

< 1.5 x N

 

1.5 - 3.0 x N

 

> 3.0 x N

 

 

86


 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

 

Transaminase (SGOT, SGPT)

 

WNL

 

2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

 

Alkaline phosphatase or 5-nucleotidase

 

WNL

 

< 2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

 

Liver- clinical

 

No change from baseline

 

 

 

precoma

 

hepatic coma

 

Kidney, bladder

 

 

 

 

 

 

 

 

 

 

 

Creatinine

 

WNL

 

< 1.5 x N

 

1.5 - 3.0 x N

 

3.1 - 6.0 x N

 

> 6.0 x N

 

Proteinuria

 

No change

 

1 (+) or
< 0.3 g% or 3 g/L

 

2 - 3 (+) or
0.3-1.0 g% or 3-10 g/L

 

4 (+) or
> 1.0 g% or > 10g/L

 

nephrotic syndrome

 

Haematuria

 

Negative

 

microscopic only

 

gross, no clots no Rx needed

 

gross and clots bladder irrigation

 

requires transfusion or cystectomy

 

Weight gain/ loss

 

< 5.0 %

 

5.0 - 9.9 %

 

10.0 - 19.9 %

 

20.00%

 

 

Pulmonary

 

 

 

 

 

 

 

 

 

 

 

Pulmonary

 

none or no change

 

asymptomatic, with abnormality in PFTs

 

dyspnoea on significant exertion

 

dyspnoea at normal level of activity

 

dyspnoea at rest

 

Cardiac

 

 

 

 

 

 

 

 

 

 

 

Cardiac arrhythmias

 

none

 

asymptomatic, transient, requiring no therapy

 

recurrent or persistent, no therapy required

 

requires treatment

 

requires monitoring; or hypotension, or ventricular tachycardia or fibrillation

 

Cardiac function

 

none

 

asymptomatic, decline of resting ejection fraction by less than 20 % of baseline value

 

asymptomatic, decline of resting ejection fraction by more than 20 % of baseline value

 

mild CHF, responsive to therapy

 

severe or refractory CHF

 

Cardiac ischaemia

 

none

 

non-specific T- wave flattening

 

asymptomatic, ST and T wave changes suggesting ischaemia

 

angina without evidence of infraction

 

acute myocardial infarction

 

Cardiac- pericardial

 

none

 

asymptomatic effusion, no intervention required

 

pericarditis (rub, chest pain, ECG changes)

 

symptomatic effusion; drainage required

 

tamponade; drainage urgently required

 

Hypertension

 

none or no change

 

asymptomatic, transient increase by greater than 20 mmHg (D) or to > 150/100 if previously WNL.
No treatment required.

 

recurrent or persistent increase by greater than 20 mmHG (D) or to > 150/100 if previously WNL.
No treatment required.

 

requires therapy

 

hypertensive crisis

 

Hypotension

 

none or no change

 

changes requiring no therapy (including transient orthostatic hypotension)

 

requires fluid replacement or other therapy but not hospitalisation

 

requires therapy and hospitalisation; resolves within 48 hrs of stopping the agent

 

requires therapy and hospitalisation for > 48 hrs after stopping the agent

 

 

87


 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

 

Neurologic

 

 

 

 

 

 

 

 

 

 

 

Neuro: sensory

 

none or no change

 

mild paraesthesias; loss of deep tendon reflexes

 

mild or moderate objective sensory loss moderate paraesthesias

 

severe objective sensory loss or paraesthesias that interfere with function

 

 

Neuro: motor

 

none or no change

 

subjective weakness; no objective findings

 

mild objective weakness without significant impairment of function

 

objective weakness with impairment of function

 

paralysis

 

Neuro: cortical

 

none

 

mild somnolence or agitation

 

moderate somnolence or agitation

 

severe somnolence, (>50 % waking hours), agitation, confusion, disorientation or hallucinations

 

coma, seizures, toxic psychosis

 

Neuro: cerebellar

 

none

 

slight incoordination, dysdiadochokinesia

 

intention tremor, dysmetria, slurred speech, nystagmus

 

locomotor ataxia

 

cerebellar necrosis

 

Neuro: mood

 

no change

 

mild anxiety or depression

 

moderate anxiety or depression

 

severe anxiety or depression

 

suicidal ideation

 

Neuro: headache

 

none

 

mild

 

moderate or severe but transient

 

unrelenting and severe

 

 

Neuro: constipation

 

none or no change

 

mild

 

moderate

 

severe

 

ileus > 96 hrs

 

Neuro: hearing

 

none or no change

 

asymptomatic, hearing loss on audiometry only

 

tinnitus

 

hearing loss interfering with function but correctable with hearing aid

 

deafness not correctable

 

Neuro: vision

 

none or no change

 

 

 

symptomatic subtotal loss of vision

 

blindness

 

Pain

 

 

 

 

 

 

 

 

 

 

 

Pain

 

none

 

mild

 

moderate

 

severe

 

reg. narcotics

 

Skin

 

 

 

 

 

 

 

 

 

 

 

Skin

 

none or no change

 

scattered macular or papular eruption or erythema that is asymptomatic

 

scattered macular or papular eruption or erythema with pruritus or other associated symptoms

 

generalised symptomatic macular, papular or vesicular eruption

 

exfoliative dermatitis or ulcerating dermatitis

 

Alopecia

 

 

 

 

 

 

 

 

 

 

 

Alopecia

 

no loss

 

mild hair loss

 

pronounced or total hair loss

 

 

 

 

88


 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

 

Allergy

 

 

 

 

 

 

 

 

 

 

 

Allergy

 

none

 

transient rash, drug fever <38°C (<100.4°F)

 

urticaria, drug fever 38°C (100.4°F), mild bronchospasm

 

serum sickness, bronchospasm requiring parenteral medication

 

anaphylaxis

 

Local

 

 

 

 

 

 

 

 

 

 

 

Local

 

none

 

pain

 

pain and swelling with inflammation or phlebitis

 

ulceration

 

plastic surgery indicated

 

Fever of unknown origin

 

 

 

 

 

 

 

 

 

 

 

Fever of unknown origin

 

none

 

37.1 - 38.0° C
98.7° - 100.4° F

 

38.1 - 40.0° C
100.5 - 104° F

 

> 40.0°C (> 104° F) for less than 24hrs

 

> 40.0° C (> 104° F) for more than 24 hrs or accompanied by hypotension

 

Infection

 

 

 

 

 

 

 

 

 

 

 

Infection

 

none

 

mild

 

moderate

 

severe

 

life-threatening

 

Additional events

 

 

 

 

 

 

 

 

 

 

 

Asthenia

 

analogous to Karnofsky index (WHO grading)

 

 

 

 

 

 

 

 

 

Chills

 

analogous to fever

 

 

 

 

 

 

 

 

 

Peripheral oedema

 

analogous to weight gain

 

 

 

 

 

 

 

 

 

Anorexia

 

analogous to weight loss

 

 

 

 

 

 

 

 

 

 

89


 

Declaration of Helsinki

 

WORLD MEDICAL ASSOCIATION DECLARATION OF HELSINKI
Ethical Principles for Medical Research Involving Human Subjects
Adopted by the 18th WMA General Assembly, Helsinki, Finland, June 1964 and amended by the:
29th WMA General Assembly, Tokyo, Japan, October 1975
35th WMA General Assembly, Venice, Italy, October 1983
41st WMA General Assembly, Hong Kong, September 1989
48th WMA General Assembly, Somerset West, Republic of South Africa, October 1996
52nd WMA General Assembly, Edinburgh, Scotland, October 2000
53rd WMA General Assembly, Washington 2002 (Note of Clarification on paragraph 29 added)
55th WMA General Assembly, Tokyo 2004 (Note of Clarification on Paragraph 30 added)
59th WMA General Assembly, Seoul, October 2008

 

A. INTRODUCTION

 

1. The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human subjects, including research on identifiable human material and data.

 

The Declaration is intended to be read as a whole and each of its constituent paragraphs should not be applied without consideration of all other relevant paragraphs.

 

2. Although the Declaration is addressed primarily to physicians, the WMA encourages other participants in medical research involving human subjects to adopt these principles.

 

3. It is the duty of the physician to promote and safeguard the health of patients, including those who are involved in medical research. The physician’s knowledge and conscience are dedicated to the fulfilment of this duty.

 

4. The Declaration of Geneva of the WMA binds the physician with the words, “The health of my patient will be my first consideration,” and the International Code of Medical Ethics declares that, “A physician shall act in the patient’s best interest when providing medical care.”

 

5. Medical progress is based on research that ultimately must include studies involving human subjects. Populations that are underrepresented in medical research should be provided appropriate access to participation in research.

 

6. In medical research involving human subjects, the well-being of the individual research subject must take precedence over all other interests.

 

7. The primary purpose of medical research involving human subjects is to understand the causes, development and effects of diseases and improve preventive, diagnostic and therapeutic interventions (methods, procedures and treatments). Even the best current interventions must be evaluated continually through research for their safety, effectiveness, efficiency, accessibility and quality.

 

8. In medical practice and in medical research, most interventions involve risks and burdens.

 

9. Medical research is subject to ethical standards that promote respect for all human subjects and protect their health and rights. Some research populations are particularly vulnerable and need special protection. These include those who cannot give or refuse consent for themselves and those who may be vulnerable to coercion or undue influence.

 

10. Physicians should consider the ethical, legal and regulatory norms and standards for research involving human subjects in their own countries as well as applicable international norms and standards. No national or international ethical, legal or regulatory requirement should reduce or eliminate any of the protections for research subjects set forth in this Declaration.

 

B. PRINCIPLES FOR ALL MEDICAL RESEARCH

 

11. It is the duty of physicians who participate in medical research to protect the life, health, dignity, integrity, right to self-determination, privacy, and confidentiality of personal information of research subjects.

 

12. Medical research involving human subjects must conform to generally accepted scientific principles, be based on a thorough knowledge of the scientific literature, other relevant sources of information, and adequate laboratory and, as appropriate, animal experimentation. The welfare of animals used for research must be respected.

 

90



 

13. Appropriate caution must be exercised in the conduct of medical research that may harm the environment.

 

14. The design and performance of each research study involving human subjects must be clearly described in a research protocol. The protocol should contain a statement of the ethical considerations involved and should indicate how the principles in this Declaration have been addressed. The protocol should include information regarding funding, sponsors, institutional affiliations, other potential conflicts of interest, incentives for subjects and provisions for treating and/or compensating subjects who are harmed as a consequence of participation in the research study. The protocol should describe arrangements for post-study access by study subjects to interventions identified as beneficial in the study or access to other appropriate care or benefits.

 

15. The research protocol must be submitted for consideration, comment, guidance and approval to a research ethics committee before the study begins. This committee must be independent of the researcher, the sponsor and any other undue influence. It must take into consideration the laws and regulations of the country or countries in which the research is to be performed as well as applicable international norms and standards but these must not be allowed to reduce or eliminate any of the protections for research subjects set forth in this Declaration. The committee must have the right to monitor ongoing studies. The researcher must provide monitoring information to the committee, especially information about any serious adverse events. No change to the protocol may be made without consideration and approval by the committee.

 

16. Medical research involving human subjects must be conducted only by individuals with the appropriate scientific training and qualifications. Research on patients or healthy volunteers requires the supervision of a competent and appropriately qualified physician or other health care professional. The responsibility for the protection of research subjects must always rest with the physician or other health care professional and never the research subjects, even though they have given consent.

 

17. Medical research involving a disadvantaged or vulnerable population or community is only justified if the research is responsive to the health needs and priorities of this population or community and if there is a reasonable likelihood that this population or community stands to benefit from the results of the research.

 

18. Every medical research study involving human subjects must be preceded by careful assessment of predictable risks and burdens to the individuals and communities involved in the research in comparison with foreseeable benefits to them and to other individuals or communities affected by the condition under investigation.

 

19. Every clinical trial must be registered in a publicly accessible database before recruitment of the first subject.

 

20. Physicians may not participate in a research study involving human subjects unless they are confident that the risks involved have been adequately assessed and can be satisfactorily managed. Physicians must immediately stop a study when the risks are found to outweigh the potential benefits or when there is conclusive proof of positive and beneficial results.

 

21. Medical research involving human subjects may only be conducted if the importance of the objective outweighs the inherent risks and burdens to the research subjects.

 

22. Participation by competent individuals as subjects in medical research must be voluntary. Although it may be appropriate to consult family members or community leaders, no competent individual may be enrolled in a research study unless he or she freely agrees.

 

23. Every precaution must be taken to protect the privacy of research subjects and the confidentiality of their personal information and to minimize the impact of the study on their physical, mental and social integrity.

 

24. In medical research involving competent human subjects, each potential subject must be adequately informed of the aims, methods, sources of funding, any possible conflicts of interest, institutional affiliations of the researcher, the anticipated benefits and potential risks of the study and the discomfort it may entail, and any other relevant aspects of the study. The potential subject must be informed of the right to refuse to participate in the study or to withdraw consent to participate at any time without reprisal. Special attention should be given to the specific information needs of individual potential subjects as well as to the methods used to deliver the information. After ensuring that the potential subject has understood the information, the physician or another appropriately qualified individual must then seek the potential subject’s freely-given informed consent, preferably in writing. If the consent cannot be expressed in writing, the non-written consent must be formally documented and witnessed.

 

25. For medical research using identifiable human material or data, physicians must normally seek consent for the collection, analysis, storage and/or reuse. There may be situations where consent would be impossible or impractical to obtain for such research or would pose a threat to the validity of the research. In such situations the research may be done only after consideration and approval of a research ethics committee.

 

91



 

26. When seeking informed consent for participation in a research study the physician should be particularly cautious if the potential subject is in a dependent relationship with the physician or may consent under duress. In such situations the informed consent should be sought by an appropriately qualified individual who is completely independent of this relationship.

 

27. For a potential research subject who is incompetent, the physician must seek informed consent from the legally authorized representative. These individuals must not be included in a research study that has no likelihood of benefit for them unless it is intended to promote the health of the population represented by the potential subject, the research cannot instead be performed with competent persons, and the research entails only minimal risk and minimal burden.

 

28. When a potential research subject who is deemed incompetent is able to give assent to decisions about participation in research, the physician must seek that assent in addition to the consent of the legally authorized representative. The potential subject’s dissent should be respected.

 

29. Research involving subjects who are physically or mentally incapable of giving consent, for example, unconscious patients, may be done only if the physical or mental condition that prevents giving informed consent is a necessary characteristic of the research population. In such circumstances the physician should seek informed consent from the legally authorized representative. If no such representative is available and if the research cannot be delayed, the study may proceed without informed consent provided that the specific reasons for involving subjects with a condition that renders them unable to give informed consent have been stated in the research protocol and the study has been approved by a research ethics committee. Consent to remain in the research should be obtained as soon as possible from the subject or a legally authorized representative.

 

30. Authors, editors and publishers all have ethical obligations with regard to the publication of the results of research. Authors have a duty to make publicly available the results of their research on human subjects and are accountable for the completeness and accuracy of their reports. They should adhere to accepted guidelines for ethical reporting. Negative and inconclusive as well as positive results should be published or otherwise made publicly available. Sources of funding, institutional affiliations and conflicts of interest should be declared in the publication. Reports of research not in accordance with the principles of this Declaration should not be accepted for publication.

 

C. ADDITIONAL PRINCIPLES FOR MEDICAL RESEARCH COMBINED WITH MEDICAL CARE

 

31. The physician may combine medical research with medical care only to the extent that the research is justified by its potential preventive, diagnostic or therapeutic value and if the physician has good reason to believe that participation in the research study will not adversely affect the health of the patients who serve as research subjects.

 

32. The benefits, risks, burdens and effectiveness of a new intervention must be tested against those of the best current proven intervention, except in the following circumstances:

 

· The use of placebo, or no treatment, is acceptable in studies where no current proven intervention exists; or

 

· Where for compelling and scientifically sound methodological reasons the use of placebo is necessary to determine the efficacy or safety of an intervention and the patients who receive placebo or no treatment will not be subject to any risk of serious or irreversible harm. Extreme care must be taken to avoid abuse of this option.

 

33. At the conclusion of the study, patients entered into the study are entitled to be informed about the outcome of the study and to share any benefits that result from it, for example, access to interventions identified as beneficial in the study or to other appropriate care or benefits.

 

34. The physician must fully inform the patient which aspects of the care are related to the research. The refusal of a patient to participate in a study or the patient’s decision to withdraw from the study must never interfere with the patient-physician relationship.

 

35. In the treatment of a patient, where proven interventions do not exist or have been ineffective, the physician, after seeking expert advice, with informed consent from the patient or a legally authorized representative, may use an unproven intervention if in the physician’s judgement it offers hope of saving life, re-establishing health or alleviating suffering. Where possible, this intervention should be made the object of research, designed to evaluate its safety and efficacy. In all cases, new information should be recorded and, where appropriate, made publicly available.

 

92


 

Work Statement NB-1

Attachment F

Reports and Information Management/Regular Meetings

 

The Project Committee for Work Statement NB-1 shall be composed of the following members from Radius and the following members from NB:

 

Radius Members:  (1) Nicholas Harvey, (2) Louis O’Ded and (3) Richard Lyttle.

 

NB Members:  (1) Bente Juel Riis and (2) Claus Christiansen.

 

Attachment 2, Attachment F-2


 

Work Statement NB-1

Attachment G

Special Insurance

 

Radius will maintain the following insurance with respect to the following jurisdictions during the conduct of the clinical study that is the subject of Work Statement NB-1:

 

Brazil

Insurer, coverage:  QBE Brasil Seguros S.A, $1,000,000

Czech Republic

Insurer, coverage:  Lloyd’s of London € 2,500,000, € 250,000 (per subject)

Denmark

Insurer, coverage:  Lloyd’s of London, € 500,000,000

Estonia

Insurer, coverage:  Lloyd’s of London € 500,000,000

Hong Kong

Insurer, coverage:  HDI — Gerling, 20,000,000 HKD, 10,000,000 HKD (per subject)

Lithuania

Insurer, coverage:  Lloyd’s of London, 24,000,000 LTL, 100,000 LTL (per subject)

Poland

Insurer, coverage:  Lloyd’s of London, € 500,000,000

Romania

Insurer, coverage:  Lloyd’s of London, € 500,000,000

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 2, Attachment G-1



 

Work Statement NB-1

Attachment H

Transfer of Obligation

 

See Work Statement NB-1 Attachment C.

 

Attachment 2, Attachment H-1



 

Attachment 3

Form of Enterprise CTA

CLINICAL TRIAL AGREEMENT

 

Protocol No.  BA058-05-003

 

This Clinical Trial Agreement (“Agreement”) is entered into by and among CENTER FOR CLINICAL AND BASIC RESEARCH A/S, Telegrafvej 4, 1, 2750 Ballerup, Denmark (“CCBR”) on behalf of itself and its ten [affiliated][controlled] Clinical Study Sites listed below and Nordic Bioscience A/S, Herlev Hovedgade 207, 2730 Herlev , Denmark (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Sponsor”) concerning:

 

Protocol No. BA058-05-003, “A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 (“Study Drug”) for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture ” (together with any of its subsequent amendments, the “Protocol”), which will guide the performance of the Study, has been prepared by Radius and Nordic Bioscience and accepted by the Clinical Study Sites.

 

CCBR has the legal authority to bind the following clinical study sites (the “Clinical Study Site(s)”):

 

1.                           CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

 

2.                           CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

 

3.                           CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

 

4.                           CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

 

5.                           CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

 

6.                           CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

 

7.                           CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

 

8.                           CCBR-Czech, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

 

9.                           CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

 

10.                    CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Kong

 

WHEREAS, the Clinical Study Sites each employ a Principal Investigator and are willing to conduct a clinical trial (the “Study”), in accordance with the above-referenced Protocol and Nordic Bioscience requests each Clinical Study Site to undertake such Study;

 

NOW THEREFORE, the parties agree as follows:

 

1.                     SCOPE OF WORK

 

Nordic Bioscience hereby appoints each of the Clinical Study Sites to conduct the Study, and each of the Clinical Study Sites, each having a Principal Investigator who is an employee of such Clinical Study Site, undertakes that such Clinical Study Site’s employees, agents, and staff shall carry out the Study in a professional, competent manner in accordance with the terms of the Protocol and this Agreement. Each of the Clinical Study Sites hereby confirms that it has enough time and resources to perform the Study according to the highest quality standards.

 

The Principal Investigators shall each review all case report forms (“CRFs”) for Study subjects enrolled at the applicable Clinical Study Site to ensure their accuracy and completeness, shall review and understand the information in the investigator’s brochure, shall ensure that all informed consent requirements are met, and shall ensure that all required reviews and approvals (or favorable opinions) by applicable regulatory authorities and Independent Ethics Committees (“ECs”) are obtained. The Clinical Study Sites and the Principal Investigators shall each ensure that all clinical data are accurate, complete, and legible.

 

Attachment 3-1



 

2.                     PERFORMANCE PERIOD AND ENROLLMENT OF STUDY SUBJECTS

 

The Study will commence upon execution of this Agreement and will continue until completion of the Study as required by the Protocol (including any amendments thereto), unless this Agreement is terminated earlier pursuant to Section 14 hereof.

 

The Study will involve the enrollment and completion of a maximum of two thousand four hundred (2,400) evaluable study subjects meeting all Protocol eligibility requirements and protocol procedures (the “Study subjects”). Nordic Bioscience shall not be obligated to pay any sums for tests performed on Study subjects who do not meet all Protocol eligibility criteria or for additional study subjects who are enrolled in the Study without Nordic Bioscience’s prior written approval.

 

Nordic Bioscience will close study subject enrollment into the Study when the Protocol-specified target number of study subjects have been enrolled at all Clinical Study Sites. Therefore, study subject enrollment into the Study may be closed before a specified number of study subjects have been enrolled at any particular Clinical Study Site.

 

Nordic Bioscience will provide financial support for the Study conducted at the Clinical Study Sites according to the terms specified in Schedule A.

 

3.                     DATA

 

Sponsor shall own all data and work product relating to the Study, including all CRF’s, data, documentation, information, materials and results in whatever form generated during the conduct of the Study. Each of the Clinical Study Sites and/or the Principal Investigators shall ascertain that it may store data in a computerized form and also that it is entitled to transfer all such computerized data to Nordic Bioscience. Each of the Clinical Study Sites may use the data and work product it generates under this Agreement solely for purposes of performing the Study in accordance with the terms of this Agreement.  Each of the Clinical Study Sites and/or the Principal Investigators shall promptly and fully produce all data, records and information relating to the Study to Nordic Bioscience and the Sponsor and their representatives during normal business hours, and shall assist them in promptly resolving any questions and in performing audits or reviews of original subject records, reports, or data sources. Each of the Clinical Study Site agrees to cooperate with the representatives of Nordic Bioscience and Sponsor who visit the Clinical Study Site.

 

4.                     COST AND PAYMENT

 

Cost and payment terms are set forth in Schedule A attached to this Agreement and incorporated herein by reference. Each of the Clinical Study Sites agrees to provide Nordic Bioscience with all requests for payment under the terms set forth in Schedule A within six (6) months of Study completion by Clinical Study Sites under the terms of this Agreement. Nordic Bioscience shall not be obligated to make any payments to Clinical Study Sites after this six (6) month period has expired.  Study completion is defined herein as Nordic Bioscience has received all data and no further follow up is necessary with the Clinical Study Sites.

 

5.                     CONFIDENTIAL INFORMATION

 

During the term of this Agreement and for a period of [five (5)] years after completion of the Study, the Clinical Study Sites and the Principal Investigators shall not disclose or use for any purpose other than performance of the Study, all information (including but not limited to the terms of this Agreement, the Protocol, CRF’s, and any secrets, know-how, privileged records or other confidential or proprietary information and data disclosed to the Clinical Study Sites), and materials (including, but not limited to, the Study Drug and comparator products), provided to the Clinical Study Site by Nordic Bioscience, Sponsor, or their agents, and all data, reports and information, relating to the Study or its progress developed by the Clinical Study Sites and/or the Principal Investigator under this Agreement (the “Confidential Information”). Sponsor shall own the Confidential Information.  The Clinical Study Sites and the Principal Investigators shall keep the Confidential Information strictly confidential and shall disclose it only to those personnel involved in conducting the Study on a need-to-know basis. These confidentiality obligations shall not apply to Confidential Information to the extent that it: (a) is or becomes publicly available through no fault of the Clinical Study Site; (b) is disclosed to the Clinical Study Site by a third party not subject to any obligation of confidence; (c) must be disclosed to ECs, or applicable regulatory authorities; (d) must be included in any subject’s informed consent form; (e) is published in accordance with Section 6; or (f) is required to be disclosed by applicable law.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 3-2



 

6.                     PUBLICATIONS

 

6.1.                             Any and all results of the Study shall be the sole property of Sponsor.  Sponsor will have the right to use the results of the Study in any manner deemed appropriate to Sponsor’s business interest and Sponsor and Nordic Bioscience will each have the right to report the names of the Clinical Study Sites as required by law or governmental regulation. Neither Sponsor nor any party to this Agreement, however, will use another party’s (or Sponsor’s) name in advertising, promotions, or other commercial material without the other party’s (or Sponsor’s) express written permission, except that Nordic Bioscience and Sponsor may quote from and/or reference any publications resulting from the Study authored by, or reviewed and approved by the Clinical Study Sites.

 

6.2.                             It is the intention to publish the Study results in scientific journals.  Any publication of Study results or data shall be made in accordance with the provisions of Section 11.2 of the Protocol.

 

7.                     LICENSE

 

7.1.                             Each Clinical Study Site and Principal Investigator acknowledges that Sponsor owns all proprietary and intellectual property rights in the Study Drug and the related materials being provided to the Principal Investigator and the Clinical Study Site pursuant to this Agreement, including but not limited to the Protocol and the CRF’s produced in the performance of the Study (collectively, “Sponsor Technology”).  Each Clinical Study Site and Principal Investigator agrees to take no action inconsistent with Sponsor’s ownership of such proprietary and intellectual property rights.  It is agreed that neither Nordic Bioscience (including Sponsor) nor the Clinical Study Sites transfers to the other by operation of this Agreement any patent right, copyright right, or other proprietary right of either party, except as contemplated by Section 7.2.  Each Clinical Study Site and Principal Investigator agrees to disclose promptly and fully to Nordic Bioscience all creative ideas, developments, discoveries, methodologies, improvements and inventions, whether or not patentable, arising as a direct result of the work performed under the Study. The Sponsor, acting through Nordic Bioscience, hereby grants each of the Clinical Study Sites a nonexclusive, non-transferable, royalty-free license to use the Study Drug and Sponsor Technology at the Clinical Study Site solely for purposes of conducting the Study.  Neither the Clinical Study Site nor the Principal Investigator will use or permit use of Study Drug or Sponsor Technology by any third party for any purpose other than the completion of the Study without Sponsor’s prior written permission

 

7.2.                             If a Clinical Study Site, as a direct consequence of the work on the Clinical Study, conceives or reduces to practice any new invention, then: (i) if such invention is conceived or reduced to practice solely by the Clinical Study Site, it shall be owned by the Clinical Study Site and (ii) if such invention is conceived or reduced to practice by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience, it shall be jointly owned by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience.  All of the Clinical Study Site’s rights to any new invention related to a new use for the Study Drug will be licensed to Sponsor, upon its request and on commercially reasonable terms.  For new inventions which are not related to a new use for the Study Drug, Clinical Study Site grants Sponsor a first option to obtain an exclusive license to any invention owned in whole or in part by the Clinical Study Site, which shall be negotiated by the parties and contain commercially reasonable terms.  Such option shall be exercisable for a period of six (6) months from the date the Clinical Study Site discloses the invention to Sponsor. . Clinical Study Sites will fully cooperate with Nordic Bioscience in obtaining whatever patent protection may be available on inventions, ideas, and developments arising from their work on the Study, and will further cooperate with Nordic Bioscience in executing all documents deemed necessary by Nordic Bioscience or Sponsor for purposes of procuring such patent protection.

 

7.3.                             Each Clinical Study Site hereby represents and warrants to Nordic Bioscience that all personnel affiliated with the Clinical Study Site and participating in the Study, including the applicable Principal Investigator, are subject to written agreements requiring them to disclose and assign any new invention to the Clinical Study Site.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 3-3



 

8.                     USE OF NAME (ADVERTISING)

 

The Clinical Study Sites and/or Principal Investigators shall obtain prior written consent from Nordic Bioscience before using the name, symbols or marks of Nordic Bioscience or Sponsor in any form of publicity in connection with the Study.  If any of the Clinical Study Sites or Nordic Bioscience is legally required to make any disclosure that identifies the existence or terms of the Agreement, then either may do so without prior written consent from the other but the applicable Clinical Study Site(s) must notify Nordic Bioscience within five (5) business days of such disclosure.

 

9.                     CHANGES TO THE PROTOCOL

 

9.1.                             Subject to Section 9.2, any changes to the Protocol may be made only with the prior agreement of the Sponsor. If these changes will affect the cost of the Study, Nordic Bioscience shall provide the Clinical Study Sites with a written estimate of such change in Study cost.

 

9.2.                             If generally accepted standards of Good Clinical Practice relating to the safety of study subjects require a deviation from the Protocol, these standards will be followed. Any party who becomes aware of the need for a deviation from the Protocol will immediately notify the other parties to this Agreement and the Sponsor of the facts causing the deviation as soon as, the facts are known to that party but no such deviation or change shall be implemented without the prior written approval of Nordic Bioscience and Sponsor; Nordic Bioscience and Sponsor shall promptly confer and provide a prompt written response regarding any deviation proposed pursuant to this Section 9.2.

 

9.3.                             Clinical Study Site shall coordinate, and shall cause each Principal Investigator to coordinate, with the relevant institutional review board or ethics committee (the “EC”) to obtain the EC’s written approval of such Principal Investigator’s conduct of the Study at Clinical Study Site, including approval of the Protocol and informed consent form to be executed by all subjects enrolled by Principal Investigator in the Study (the “Informed Consent Form”).  Clinical Study Site shall be responsible for providing Sponsor with a copy of each such approval, together with information about the members of the EC and all relevant correspondence with the EC. In addition, Clinical Study Site shall coordinate, and shall cause Principal Investigator to coordinate, with the EC to obtain review and approval in writing of any amendments made to a Protocol by the parties.  In the event the EC requires changes in the Protocol or Informed Consent Form, such changes shall not be implemented until Sponsor and Nordic Bioscience are notified and Sponsor gives its written approval.  In the event that the EC alters or withdraws its’ approval in any manner, Clinical Study Site shall promptly notify Sponsor and Nordic Bioscience.  The Protocol and the Informed Consent Form shall not be revised without the prior written agreement of Sponsor, Nordic Bioscience and the EC.  Clinical Study Site will use reasonable efforts to ensure that members of the EC agree to abide by the same obligations of confidentiality as apply to Clinical Study Site under this Agreement.

 

10.              MATERIALS

 

10.1.                      Sponsor will provide the Study Drug. The Clinical Study Sites will provide Materials derived from study subjects enrolled in the study to Nordic Bioscience. The term “Materials” shall include reagents and materials derived from study subjects enrolled in the Study, including blood, sera, and other biological materials. The Clinical Study Site shall use the Study Drug, and any comparator products provided in connection with the Study, solely for the purpose of properly completing the Study and shall maintain all Study Drug and any comparator products in a locked, secured area at all times. Only those persons who are under the Principal Investigator’s, or Principal Investigators’ direct control and who will be using the Study Drug (and any comparator products) or Materials for the Study shall have access to the Study Drug (and any comparator products) or Materials. Upon termination or completion of the Study, all unused Study Drug and comparator products and all Materials shall be returned to Nordic Bioscience or at Nordic Bioscience’s sole option, destroyed.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 3-4



 

11.              CONFORMANCE WITH LAW AND ACCEPTED PRACTICE

 

11.1.                      The Clinical Study Sites and Principal Investigators shall perform the Study in strict accordance with the protocol, and any subsequent amendments thereto, applicable federal, state, and local laws, regulations and guidelines, good clinical practices (“GCP”), and instructions provided by Nordic Bioscience.  The Clinical Study Sites and Principal Investigators shall permit Nordic Bioscience and agencies such as the FDA to inspect Study records including the Subjects’ medical records. The subject informed consent form signed by the Subjects shall provide for access to the Subjects’ medical records by Nordic Bioscience and by agencies such as the FDA.

 

11.2.                      The Principal Investigator will direct and supervise the Study in accordance with Section 1. Nordic Bioscience and Sponsor shall have the right to (a) monitor and audit the activities of the Principal Investigator and Principal Investigators in the conduct of the Study, and (b) monitor and audit the collection of data from the Study.

 

11.3.                      The Clinical Study Sites and Principal Investigators shall retain all records from the Study for the time required by applicable regulations and at the sole expense of Clinical Study Sites and/or the Principal Investigator, and to allow for direct access by the applicable government agencies and representatives of Nordic Bioscience of these records, including the study subjects’ medical records.

 

11.4.                      Each of the Clinical Study Sites and Principal Investigators hereby represent and warrant that neither the Clinical Study Sites, the Principal Investigators nor any of the Clinical Study Sites’ agents or employees rendering services in connection with the Study is presently:  (1) the subject of a debarment action or is debarred pursuant to the Generic Drug Enforcement Act of 1992; (2) the subject of a disqualification proceeding or is disqualified as a clinical investigator pursuant to 21 C.F.R. § 312.70; or (3) the subject of an exclusion proceeding or excluded from participation in any federal health care program under 42 C.F.R. Part 1001 et seq.  Clinical Study Sites shall notify Nordic Bioscience immediately upon any inquiry concerning, or the commencement of any such proceeding concerning Clinical Study Sites, Principal Investigators or any such agent or employee.

 

12.              INDEMNIFICATION

 

12.1.                      Pursuant to a separate indemnity letter in the form of Exhibit B, the Sponsor shall provide indemnification to the Clinical Study Sites, the Principal Investigators and any agents and employees of the Clinical Study Sites from any liabilities, claims, actions or suits for personal injury or death directly arising out of the administration or use of the Study Drug during the Study.

 

12.2.                      The Clinical Study Sites and Principal Investigators shall defend, indemnify and hold harmless Nordic Bioscience, Sponsor and any agents and employees of Nordic Bioscience and Sponsor from any liabilities, claims, actions or suits for personal injury or death directly arising from the negligence or willful misconduct of the Clinical Study Sites, Principal Investigators or their representatives.

 

13.              STUDY SUBJECT INJURY

 

If a study subject experiences an adverse reaction to the Study Drug, Sponsor shall provide reimbursement for reasonable and necessary medical expenses incurred by the study subject for the treatment of these adverse reactions pursuant to the separate indemnity letter in the form of Exhibit B.  Neither Nordic Bioscience nor Sponsor will be responsible for any adverse reactions, which are the result of the negligence or misconduct of the Clinical Study Sites, Principal Investigators or any of their representatives.

 

14.              TERM; TERMINATION

 

14.1.                      This Agreement shall commence on the date of signature of this Agreement and shall continue until delivery of the final validated Case Report Forms. The completion date is dependent on the delivery to the Clinical Study Sites by Nordic Bioscience of all supplies to be provided by Nordic Bioscience and necessary to the conduct of the Study. Any delay due to the failure of supply by Nordic Bioscience, shall be added to the term of the Study. Clinical Study Sites shall have the right to extend the Agreement should there be any delay due to the failure of the supply by Nordic Bioscience.

 

14.2.                      This Agreement may be terminated:

 

Attachment 3-5


 

14.2.1.               by a Clinical Study Site upon thirty (30) days’ prior written notice only for serious causes resulting in the material breach by Nordic Bioscience of its obligations to such Clinical Trial Site and only if not cured in a timely manner using reasonable commercial efforts;

 

14.2.2.               by Nordic Bioscience immediately upon written notice;

 

14.2.3.               by either a Clinical Study Sites or Nordic Bioscience immediately if the applicable Principal Investigator is unable to continue to serve and a successor acceptable to both the Clinical Study Site and Nordic Bioscience is not available; or

 

14.2.4.               upon the occurrence of an event qualifying as a termination event as described in the Protocol.

 

14.3.                     Upon the effective date of termination, the applicable Clinical Study Site(s) shall conduct an accounting, which is subject to verification by Nordic Bioscience.  Within thirty (30) days after Nordic Bioscience’s receipt of adequate documentation, Nordic Bioscience will make payment to the applicable Clinical Study Site(s) unless Nordic Bioscience objects to any charge, in which case, the parties shall use best efforts to resolve expeditiously any disagreement.  The payments made by Nordic Bioscience subject to this Section 14.3, will be for:

 

14.3.1.               all services properly rendered and monies properly expended by the Clinical Study Site  prior to the date of termination and not yet paid for; and

 

14.3.2.               any reasonable non-cancelable obligations properly incurred for the Study by the Clinical Study Site prior to the effective date of termination.

 

14.3.3.               The Clinical Study Site shall credit or return to Nordic Bioscience any funds not expended by the Clinical Study Site for the Study prior to the effective termination date.

 

14.4.                     Immediately upon receipt of a notice of termination, the Principal Investigator shall stop enrolling study subjects into the Study and shall cease conducting procedures on study subjects already enrolled in the Study as directed by Nordic Bioscience, to the extent medically permissible and appropriate.

 

14.5.                     Termination of this Agreement by Nordic Bioscience or the Clinical Study Sites shall not affect the rights and obligations of the parties accrued prior to the effective date of the termination. The rights and duties under Sections 3, 5, 6, 7, 8, 10, 11, 12, 14, 15, 17 and 18 of this Agreement survive the termination of this Agreement.

 

14.6.                     If this Agreement is terminated prior to completion of the Study, the Clinical Study Sites shall furnish Nordic Bioscience an acceptable investigator’s report for the Study.

 

15.              MISCELLANEOUS

 

This Agreement and the Protocol may only be amended by the mutual written consent of the parties to this Agreement. This Agreement represents the entire understanding of the parties with respect to the subject matter of this Agreement. In the event of any inconsistency between this Agreement and the Protocol, the terms of this Agreement shall govern. The invalidity or unenforceability of any term or provision of this Agreement shall not affect the validity or enforceability of any other term or provision of this Agreement. No waiver of any term, provision or condition of this Agreement in any instance shall be considered to be a continuing waiver of the same term, provision or condition, or of any other term, provision or condition of this Agreement.  This Agreement may be executed in any number of counterparts, each of which shall be an original and all of which together shall be one document binding on all the parties even though each of the parties may have signed different counterparts. This Agreement shall also be considered executed by the parties upon receipt by Nordic Bioscience by facsimile transmission of the counterparts signed by all the parties.  This Agreement shall be interpreted under the laws of the state or province and country in which the applicable Clinical Study Site conducts the Study.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

Attachment 3-6



 

15A.  ASSIGNMENT

 

Neither CCBR nor a Clinical Study Site nor a Principal Investigator may assign or transfer any rights or obligations under this Agreement without the written consent of Nordic Bioscience.  Upon Nordic Bioscience’s or Sponsor’s request, CCBR may assign this Agreement to Nordic Bioscience or to Sponsor or to a third party, and thereafter CCBR shall not have any obligations or liabilities under this Agreement, and CCBR shall obtain from each Clinical Study Site such Clinical Study Site’s prior consent to such an assignment.  Each affected Clinical Study Site will be given prompt notice of such assignment by the assignee.

 

16.              ACKNOWLEDGEMENT OF PRINCIPAL INVESTIGATORS

 

CCBR shall obtain an executed Acknowledgement of Obligations from each Clinical Investigator, including each Principal Investigator, participating in the Study under this Agreement, in the form of Exhibit A hereto, prior to the date that any such Clinical Investigator shall commence performing services for the Study.  “Clinical Investigator” means a listed or identified investigator or subinvestigator for the Study who is directly involved in the treatment or evaluation of research subjects and such investigator’s spouse and each dependent child of such investigator.

 

17.              FINANCIAL DISCLOSURE

 

The Clinical Study Sites agrees that, for each listed or identified Clinical Investigator who is directly involved in the treatment or evaluation of research subjects, shall return to Nordic Bioscience a financial disclosure form that has been completed and signed by such Clinical Investigator, which shall disclose any applicable interests held by those investigators or subinvestigators or their spouses or dependent children. The Clinical Study Sites shall ensure that all such forms are promptly updated as needed to maintain their accuracy and completeness during the Study and for one year after its completion. The Clinical Study Sites agrees that the completed forms may be subject to review by governmental or regulatory agencies, Nordic Bioscience and their AGENTS , and the Clinical Study Sites consents to such review. The Clinical Study Sites further consents to the transfer of its financial disclosure data to Nordic Bioscience country of origin, and to the United States of America (“U.S.”) if the Clinical Study Sites is outside of the U.S., even though data protection may not exist or be as developed in those countries as in the Clinical Study Site’s own country.

 

18.             ELECTRONIC RECORDS

 

If the data produced by the Clinical Study Sites will be used in support of an application to the United States Food and Drug Administration (“FDA”) and if the Clinical Study Sites  uses electronic systems for creating, modifying, maintaining, archiving, retrieving or transmitting any records that are required by, or subject to inspection by, the FDA, including, but not limited to, CRFs, medical records, informed consent forms, test results, or other source documents, then the Clinical Study Sites  warrants that its systems for such electronic records are in compliance with Section 21 of the United States Code of Federal Regulations, Part 11. The Clinical Study Sites further warrants THAT , in order to comply with Part 11, it will not use any electronic signatures on any documents required by, submitted to, or supporting a submission to the FDA unless it has certified to the FDA that it intends such electronic signatures to be the legally binding equivalent of a hand-written signature.

 

19.  SPONSOR AS THIRD PARTY BENEFICIARY OF CERTAIN PROVISIONS

 

It is understood and agreed that Sponsor is a THIRD party beneficiary of Sections 3, 5, 6, 7, 11 and 12 of this Agreement

 

IN WITNESS WHEREOF , the parties hereto have caused their duly authorized representatives to execute this Agreement as of the date first above.

 

NORDIC BIOSCIENCE A/S

Bente Riis, Head, Clinical Development

CENTER FOR CLINICAL AND BASIC RESEARCH A/S, on behalf of itself and each of the Clinical Study Sites

Ralph Reyes, CEO

 

 

 

 

Signature

 

 

 

 

 

Signature

 

 

Attachment 3-7



 

Date:

 

 

 

 

 

 

Date:

 

 

Attachment 3-8



 

SCHEDULE A

 

Cost and Payment:

 

Attachment 3-9



 

EXHIBIT A

 

PRINCIPAL INVESTIGATOR’s ACKNOWLEDGEMENT OF OBLIGATIONS

 

The undersigned Clinical Investigator acknowledges and agrees that I and Center for Clinical and Basic Research, Denmark have entered into a Clinical Trial Agreement with Nordic Bioscience A/S representing the interests of Radius Health, Inc.  to perform the clinical study under Protocol No. BA058-05-003:

 

“A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture”

 

I agree that Center for Clinical and Basic Research, Denmark was authorized to enter into the Agreement on my behalf.

 

My payment for my involvement in the trial will not in any way be dependant of the outcome of the trial. I will not be paid bonuses or the like in case of positive or negative results. I (including for purposes of this paragraph my spouse and my dependent children, in each case to the extent applicable) do not own nor shall I become entitled to own any of the Radius Health, Inc. securities that are subject to the certain Stock Issuance Agreement entered into between Radius Health, Inc. and Nordic Bioscience A/S or to otherwise receive any compensation or other benefit from such Radius Health, Inc. securities or the proceeds of such Radius Health, Inc. securities.

 

I will, prior to shipment of clinical supplies to my Clinical Study Site provide Nordic Bioscience with all original documentation necessary for submission to regulatory authorities, including the U.S. Food & Drug Administration, including a completed and signed FDA Form 3455 and Form 1572.

 

I agree to comply with all the terms and conditions set forth in the Protocol and in the Agreement and to be responsible for assuring that any investigators and study staff under their direct supervision performing work for the Study contemplated by the Agreement and the Protocol similarly comply with the terms and conditions contained therein.

 

NAME AND ADDRESS OF PI

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

Sign:

 

 

 

Attachment 3-10



 

Exhibit B

Form of Indemnity Letter

 

[RADIUS HEALTH, INC. LETTERHEAD]

 

[Name of Clinical Study Site]

[Address]

[City, State, Country]

CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

[CCBR-Czech, Hybešova 18, 60200 Brno, Czech Republic]

CCBR-Czech, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Ko

 

Re:  Clinical Trial No. BA058-05-003 (the “Study”) Risk Allocation

 

Dear Ladies and Gentlemen:

 

This letter is delivered to you pursuant to Section 13 of the certain Clinical Trial Agreement dated                  , 2010 among Center for Clinical and Basic Research A/Sk (“CCBR”) on behalf of itself and its affiliates CCBR-Ballerup, CCBR-Ålborg, CCBR-Vejle, CCBR-Tallinn, CCBR-Vilnius, CCBR-Bucharest, CCBR-Rio de Janeiro, CCBR-Czech, Hybešova CCBR-Czech Masarykovo, CCBR-Warsaw and CCBR Hong Kong and Nordic Bioscience (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Radius”) (the “Agreement”).  Capitalized terms used in this letter and not defined in this letter are used with the Agreement.  The Agreement concerns the performance of the Study in accordance with Radius Protocol No. BA058-05-003, “A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 (“Study Drug”) for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture” (the “Protocol”).

 

1.               Subject to Paragraph 3, Radius hereby agrees to defend, indemnify and hold harmless [CLINICAL STUDY SITE NAME] (“Clinical Study Site”), including its officers and administrators, employees and agents, including the Principal Investigator and his/her co-investigators and assistants in the Study (collectively, “Indemnitees”) from and against any and all damages, suits, judgments, and liabilities (including expenses and reasonable attorneys’ fees) (collectively, “Losses”) arising from or related to any third party claims of injury, illness or adverse side effects to a patient in the Study that are attributable to the Study Drug.  The indemnification obligation set forth in this Paragraph 1 shall not apply in the event and to the extent that:  (a) such Loss(es) arose as a result of intentional misconduct or negligence by Indemnitees; or (b) the Principal Investigator and those assisting him/her did not adhere to the terms of the Protocol and to Radius’ written instructions relative to the use of Study Drug or failed to employ reasonable care in the conduct of the Study in conformity with the generally accepted standards of the medical community or violated any applicable laws or regulations in any material respect.  For purposes of this Paragraph 1, a violation shall be deemed “material” if it adversely affects the safety, health or welfare of Study subjects.

 

2.               In the event a patient participating in the Study suffers an illness or injury which the Principal Investigator and Radius reasonably determine to be an adverse reaction directly associated with the Study Drug, and not due to a reason other than the Study Drug, then subject to the provisions of Paragraph 3, Radius shall pay all necessary and reasonable medical and hospital expenses directly associated with the medical treatment of such adverse reaction which are in excess of that portion covered by the patient’s own insurance or other insurance, or third-party payment programs .  In the event diagnostic procedures are required to determine the etiology of

 



 

the patient’s symptoms, Radius shall pay the reasonable expense of such diagnostic work-up without regard to the final diagnosis, so long as Radius agrees to the need for the diagnostic work-up but Radius shall not be responsible for expenses connected with the subsequent treatment of the patient if the work-up establishes that the patient’s symptomology is not related to the administration of the Study Drug.  Payments under this Paragraph 2 shall be in addition to any payments specified in Paragraph 1.

 

3.               To receive the benefit of Paragraph 1 or Paragraph 2, the appropriate personnel at Clinical Study Site must (a) promptly notify Nordic Bioscience and Sponsor in writing of any claim of injury, illness, adverse side effects or adverse reaction to the Study Drug; provided , that failure to give such notice shall not relieve Radius of its obligations under Paragraph 1 or Paragraph 2 except where, and solely to the extent that, such failure actually and materially prejudices the rights of Radius; (b) tender to Radius (and its insurer) full authority to defend or settle the claim or suit; provided that no settlement requiring any admission by an Indemnitee or that imposes any obligation on an Indemnitee shall be made without the Indemnitee’s consent; and (c) cooperate fully with Radius in its handling of such claim or suit.  A Clinical Study Site’s failure to perform its obligations under this Paragraph 3 shall relieve Radius of its obligations under Paragraphs 1 and 2. [ Radius will reimburse Indemnitees for all reasonable expenses incurred at Radius’ request in connection with this Paragraph 3 except to the extent and in the proportion that Indemnitees are responsible under Paragraph 1 ] .

 

4.               Any notice to Radius shall be in writing and shall be deemed given to Radius when delivered by hand or sent by internationally recognized overnight courier (such mailed or courier notice to be effective on the date which is two (2) business days after the date of mailing) or sent by facsimile (such notice sent by telefax to be effective one (1) business day after sending, if immediately confirmed by overnight courier as aforesaid), in each case addressed to the following addresses: Radius Health, Inc., 201 Broadway, 6 th  Floor, Cambridge, MA 02139 USA Attn: [              ], Fax No.: 01.617.551.4701; Phone No.: 01.617.444.1834.

 

IN WITNESS WHEREOF, the undersigned has executed this letter intending it to take effect as of                       , 2010.

 

 

RADIUS HEALTH, INC.

 

 

 

By:

 

 

Name, Title

 

 



 

Attachment 4

Form of Indemnity Letter

 

[RADIUS HEALTH, INC. LETTERHEAD]

 

[Name of Clinical Study Site]

[Address]

[City, State, Country]

CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

[ CCBR -Czech, Hybešova 18, 60200 Brno, Czech Republic]

CCBR-Czech, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Ko

 

Re:  Clinical Trial No. BA058-05-003 (the “Study”) Risk Allocation

 

Dear Ladies and Gentlemen:

 

This letter is delivered to you pursuant to Section 13 of the certain Clinical Trial Agreement dated                  , 2010 among Center for Clinical and Basic Research A/Sk (“CCBR”) on behalf of itself and its affiliates CCBR-Ballerup, CCBR-Ålborg, CCBR-Vejle, CCBR-Tallinn, CCBR-Vilnius, CCBR-Bucharest, CCBR-Rio de Janeiro, CCBR-Czech, Hybešova CCBR-Czech Masarykovo, CCBR-Warsaw and CCBR Hong Kong and Nordic Bioscience (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Radius”) (the “Agreement”).  Capitalized terms used in this letter and not defined in this letter are used with the Agreement.  The Agreement concerns the performance of the Study in accordance with Radius Protocol No. BA058-05-003, “A Randomized, Double-blind, Placebo-controlled, Comparative Phase 3 Multicenter Study to Evaluate the Safety and Efficacy of BA058 (“Study Drug”) for Injection for Prevention of Fracture in Ambulatory Postmenopausal Women with Severe Osteoporosis and at Risk of Fracture” (the “Protocol”).

 

1.              Subject to Paragraph 3, Radius hereby agrees to defend, indemnify and hold harmless [CLINICAL STUDY SITE NAME] (“Clinical Study Site”), including its officers and administrators, employees and agents, including the Principal Investigator and his/her co-investigators and assistants in the Study (collectively, “Indemnitees”) from and against any and all damages, suits, judgments, and liabilities (including expenses and reasonable attorneys’ fees) (collectively, “Losses”) arising from or related to any third party claims of injury, illness or adverse side effects to a patient in the Study that are attributable to the Study Drug.  The indemnification obligation set forth in this Paragraph 1 shall not apply in the event and to the extent that:  (a) such Loss(es) arose as a result of intentional misconduct or negligence by Indemnitees; or (b) the Principal Investigator and those assisting him/her did not adhere to the terms of the Protocol and to Radius’ written instructions relative to the use of Study Drug or failed to employ reasonable care in the conduct of the Study in conformity with the generally accepted standards of the medical community or violated any applicable laws or regulations in any material respect.  For purposes of this Paragraph 1, a violation shall be deemed “material” if it adversely affects the safety, health or welfare of Study subjects.

 

2.              In the event a patient participating in the Study suffers an illness or injury which the Principal Investigator and Radius reasonably determine to be an adverse reaction directly associated with the Study Drug, and not due to a reason other than the Study Drug, then subject to the provisions of Paragraph 3, Radius shall pay all necessary and reasonable medical and hospital expenses directly associated with the medical treatment of such adverse reaction which are in excess of that portion covered by the patient’s own insurance or other insurance, or third-party payment programs .  In the event diagnostic procedures are required to determine the etiology of the patient’s symptoms, Radius shall pay the reasonable expense of such diagnostic work-up without regard to the

 

Attachment 4-1



 

final diagnosis, so long as Radius agrees to the need for the diagnostic work-up but Radius shall not be responsible for expenses connected with the subsequent treatment of the patient if the work-up establishes that the patient’s symptomology is not related to the administration of the Study Drug.  Payments under this Paragraph 2 shall be in addition to any payments specified in Paragraph 1.

 

3.              To receive the benefit of Paragraph 1 or Paragraph 2, the appropriate personnel at Clinical Study Site must (a) promptly notify Nordic Bioscience and Sponsor in writing of any claim of injury, illness, adverse side effects or adverse reaction to the Study Drug; provided , that failure to give such notice shall not relieve Radius of its obligations under Paragraph 1 or Paragraph 2 except where, and solely to the extent that, such failure actually and materially prejudices the rights of Radius; (b) tender to Radius (and its insurer) full authority to defend or settle the claim or suit; provided that no settlement requiring any admission by an Indemnitee or that imposes any obligation on an Indemnitee shall be made without the Indemnitee’s consent; and (c) cooperate fully with Radius in its handling of such claim or suit.  A Clinical Study Site’s failure to perform its obligations under this Paragraph 3 shall relieve Radius of its obligations under Paragraphs 1 and 2. [ Radius will reimburse Indemnitees for all reasonable expenses incurred at Radius’ request in connection with this Paragraph 3 except to the extent and in the proportion that Indemnitees are responsible under Paragraph 1 ] .

 

4.              Any notice to Radius shall be in writing and shall be deemed given to Radius when delivered by hand or sent by internationally recognized overnight courier (such mailed or courier notice to be effective on the date which is two (2) business days after the date of mailing) or sent by facsimile (such notice sent by telefax to be effective one (1) business day after sending, if immediately confirmed by overnight courier as aforesaid), in each case addressed to the following addresses: Radius Health, Inc., 201 Broadway, 6 th  Floor, Cambridge, MA 02139 USA Attn: [              ], Fax No.: 01.617.551.4701; Phone No.: 01.617.444.1834.

 

IN WITNESS WHEREOF, the undersigned has executed this letter intending it to take effect as of                       , 2010.

 

 

RADIUS HEALTH, INC.

 

 

 

By:

 

 

Name, Title

 

 

Attachment 4-2


 

Confidential Treatment Requested

Under 17 C.F.R. §§ 200.80(b)(4) and 240.24b-2

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 1 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement ( “Work Statement NB-1” ) as of March 29, 2011 ( “Effective Date” )

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 1 to Work Statement NB-1 ( Amendment No. 1” ) effective as of December 9, 2011 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 1 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 1, the parties agree as follows:

 

1.  Addition of non-CCBR A/S Sites in India and the United States of America.   (a)  Radius or its authorized representative will contract with certain clinical trial sites in India and the United States of America to enroll patients in the clinical study that is the subject of Work Statement NB-1 in order to facilitate the timely achievement of the enrollment targets for such study.

 

(b)  The NB representations and warranties set forth in Sections 8.2, 8.3, 8.5 and 8.6(ii) of the Agreement shall not apply to the personnel, including Clinical Investigators, that perform the clinical study at the study sites located in India or the United States.  Radius shall be responsible for securing the applicable representations and warranties from these clinical study sites and personnel, including Clinical Investigators.

 

(c)  The Study Assumptions table on the first page of Attachment A to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to increase the total Number of Sites from 11 to 35-37, to add the following information concerning sites in India and the United States of America as well as additional sites in Argentina and Peru, to increase the number of sites in Poland and the Czech Republic, to increase the number of patients to be pre-screened to reflect patient recruitment experience to date, to add a 2-month screening period and to add an additional patient visit at month 15.  As amended, the Study Assumptions table will read in full as follows:

 

Protocol Number

 

BA058-05-003

Number of Sites:

 

35-37

Denmark

 

3

Estonia

 

1

Lithuania

 

1

Romania

 

1

Poland

 

2

Czech Republic

 

3

Brazil

 

1-2

Argentina

 

1-2

Peru

 

1

Hong Kong

 

1

India

 

15

USA

 

5

Number of Patients to be Pre-Screened

 

[ * ]

Number of Patients to Enroll:

 

2,400

Screening Period:

 

2 months

Treatment Period:

 

18 months

Safety Follow up Period

 

1 month

Visits per Completed Subject:

 

11

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

(d)  The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new Paragraph (10) immediately following Paragraph (9) of the Payment Schedule, which shall read in full as follows:

 

(10)  The purchase price for the Services with respect to subjects enrolled at the study sites located in India or the United States of America shall be paid solely in cash and shall not include payment of a First Monthly Amount detailed under Paragraph (4).  The purchase price for the Services with respect to subjects enrolled at the study sites located in India or the United States of America shall include payment of a separate amount in consideration of the incremental administrative costs that NB will bear to integrate and manage data being supplied by these clinical sites.  The amount of this incremental payment shall be:

 

(a)  €717,700 for the EURO denominated portion of the clinical study that is the subject of Work Statement NB-1 for the 15 study sites located in India and $289,663 for the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1 for the 15 study sites located in India (exclusive of certain shipping costs concerning central imaging services which shall be billed separately).

 

(b)  €1,234,790 for the EURO denominated portion of the clinical study that is the subject of Work Statement NB-1 for the 5 study sites located in the United States of America and $143,369 for the U.S. Dollar denominated portion of the clinical study that is the subject of Work Statement NB-1 for the 5 study sites located in the United States of America.

 

Radius shall be invoiced and shall pay NB the U.S. Dollar denominated portion of these incremental fees ($ [ * ] for the 15 study sites located in India and $ [ * ] for the 5 study sites located in the United States of America) as pass thru costs.  Radius shall be invoiced and shall pay NB € [ * ] of the EURO denominated portion of these incremental fees (relating to the expansion of the eCRF to the 20 new sites in India and the United States of America) as pass through costs.

 

Radius shall pay NB € [ * ] of the EURO denominated portion of these incremental fees for the 15 study sites located in India and € [ * ] of the EURO denominated portion of these incremental fees for the 5 study sites located in the United States of America within 15 days of the Effective Date.  Radius shall pay NB the balance of the EURO denominated portion of these incremental fees (€ [ * ] for the 15 study sites located in India; and € [ * ] for the 5 study sites located in the United States of America) in pro rata installments at the time it pays each installment of the Second Monthly Amount and the Third Monthly Amount.”

 

(e)  The “Trial Activities and Delegation of Responsibilities” table set forth in Attachment C to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to provide that NB, as Service provider, shall not have the responsibilities assigned to it under the following activity categories listed in Attachment C with respect to the clinical study sites located in India and the United States of America.  NB shall continue to hold all other responsibilities enumerated as those of the “Service provider” in Attachment C with respect to the clinical study sites located in India and the United States of America.  The specific Service provider responsibilities that NB is relieved of with respect to the study sites located in India and the United States of America are as follows having reference to the activity categories listed in Attachment C:

 

Regulatory

 

(i) IND/CTA Preparation, (ii) CTA Submissions & Updates, (iii) Informed Consent Form (ICF, PIS), (iv) Ethics Committees/IRB Submissions & Updates, (v) Health Authority SAE Submissions & Follow Up(s), (vi) Legal Representative and Regulatory & Study Documents translations and (vii) Regulatory & Study Documents translations.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

Clinical Trial Materials

 

(i) Vitamin D & Calcium , (ii) Tote Bags/Ice Packs (Sponsor will be responsible for these in all jurisdictions) and (iii) Study Drug Reconciliation — Patient, Site, & Study.

 

Clinical Trial Conduct

 

(i) Clinical Trial Project Plan (Sponsor will be responsible to provide India-specific information) (ii) Clinical Trial Budget Forecasting & Tracking, (iii) Vendor Management — Labs, X-ray, Dexa, Renal, Imaging, ECG, (iv) Vendor Management - PK, Antibody, Drug Manufacture/Package, IVRS, Central IRB (Sponsor will now be responsible for the Central IRB for all jurisdictions), (v) Patient Recruitment, Screening, Enrollment (for India but Service provider shall remain responsible for USA), (vi) Site Selection, (vii) Site Management (for India but Service provider will be responsible for USA), (vii) Site Confidentiality Agreements, (viii) Site Contract/Agreement, (ix) Clinical Trial Monitoring & Plan (for India but Service provider will be responsible for USA), (x) Clinical Trial Monitoring Reports (for India but Service provider shall remain responsible for USA), (xi) Clinical Trial Monitors (for India but Service provider will be responsible for USA), (xii) Monitor Travel Expense (for India but Service provider will be responsible for USA), (xiii) CRA Meetings (for India but Service provider will be responsible for USA) (xiv) Trial Staff Training (for India but Service provider will be responsible for USA), (xv) Trial Master File and Site Trial File (for India but Service provider will be responsible for USA), (xvi) Investigator Site Payments, (xvii) Essential Document Collection (for India but Service provider will be responsible for USA) and (xviii) Printing Study Documents (for India but Service provider will be responsible for USA).

 

Labs

 

(i)Central or Local Safety Labs , (ii) Central/Safety/Bone Marker Labs Data Reporting (SI Units), (iii) Central/Safety/Bone Marker Labs Data Reporting (SI Units), (iv) Lab Specimen Management, Shipping & Reconciliation, (v) Lab Kits & Supplies,  (vi) Lab Sample Storage, (vii)Lab Sample Destruction.

 

Safety & Pharmacovigilance

 

(i) Annual & Periodic Drug Safety Update Generation & Filing (ii) Health Authority reporting and (iii) Final Safety Report for HA, EC, IRB submission.  In addition, Service provider shall no longer be responsible for Annual & Periodic Drug Safety Update Generation & Filing for European Union countries, in these countries, Sponsor shall be responsible for this activity and Service provider’s responsibility shall be limited to providing Sponsor with data from the studies in such countries that are being managed by Service provider.

 

Quality

 

Health Authority inspections/audits (for India but Service provider will be responsible for USA).

 

(f)  Attachment G to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to provide that Radius will maintain the following insurance with respect to the following additional jurisdictions during the conduct of the clinical study that is the subject of Work Statement NB-1:

 

“India

Insurer, coverage: ICICI Lombard, $ [ * ] (Coverage quoted, not yet bound) .

 

United States of America

Insurer, coverage:  Chubb, $ [ * ] .

 

Argentina

Insurer, coverage: SMG Seguros , $ [ * ] .

 

Peru

Insurer, coverage: La Positiva, $ [ * ] .

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 1, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 1.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

3



 

3.  General.   This Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank - signature page follows]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

4



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 1 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 1 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL

 

 

DEVELOPMENT VII A/S

 

 

 

/s/ Michael S. Wyzga

 

/s/ Bente Juel Riis

By: Michael S. Wyzga

 

By: Bente Juel Riis

Title: President and Chief Executive Officer

 

Title: Medical Director

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 2 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1 to Work Statement NB-1 as of December 9, 2011 (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 2 to Work Statement NB-1 ( “Amendment No. 2” ) effective as of June 18, 2012 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 2 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 2, the parties agree as follows:

 

1. Addition of Sites and Adjustment to Payment Schedule (a)  At Radius’ request, NB will contract with up to 12 CCBR and non-CCBR A/S Sites in Europe, Brazil and Argentina to be managed by NB ( “New Sites” ) to enroll patients in the clinical study that is the subject of Work Statement NB-1 in order to facilitate the timely achievement of the enrollment targets for such study.  Radius wishes to provide for payment to NB for Services for the New Sites.  In addition, Radius and NB also wish to provide for additional payments to NB for certain extra site activities as well as provide for adjustments in payments to NB related to subjects to be enrolled in clinical trial sites in India and the United States of America.

 

(b)  The NB representations and warranties set forth in Sections 8.2, 8.3, 8.5 and 8.6(ii) of the Agreement shall apply to the personnel, including Clinical Investigators, that perform the clinical study at the New Sites.  NB shall be responsible for securing the applicable representations and warranties from these clinical study sites and personnel, including Clinical Investigators.

 

(c)  The Study Assumptions table on the first page of Attachment A to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to increase the total Number of Sites from 35-37 to 42. As amended, the Study Assumptions table will read in full as follows:

 

Protocol Number

 

BA058-05-003

 

Number of Sites:

 

42

 

Denmark

 

3

 

Estonia

 

2

 

Lithuania

 

1

 

Romania

 

1

 

Poland

 

6

 

Czech Republic

 

3

 

Brazil

 

4

 

Argentina

 

2

 

Hong Kong

 

1

 

India

 

15

 

USA

 

4

 

Number of Patients to be Pre-Screened

 

[*]

 

Number of Patients to Enroll:

 

2,400

 

Screening Period:

 

2 months

 

Treatment Period:

 

18 months

 

Safety Follow up Period

 

1 month

 

Visits per Completed Subject:

 

11

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

(d) The paragraph at the bottom Attachment B to Work Statement NB-1 ( Budgets, Fees, Pass-through Costs, and Payment Schedule* ) is hereby amended to read in full as follows:

 

“*The pricing specified in this Budget is calculated based upon 2,040 subjects randomized and completed at sites managed by NB, excluding sites in India and the United State of America, and is not subject to any adjustment for the number of patients to be Pre-screened/Advertisement, the screen failure rate after the Patient Informed Consent has been signed, or the drop-out rate. However, this Budget as well as the Bonus Equity Payment Amount under the Amended and Restated Stock Issuance Agreement dated May 16, 2011 shall each be reduced by an amount of € [*] per subject for any subjects enrolled in India or the United States. Such reduction to be applied in pro rata installments at the time of payment of the Second Monthly Amount and the Third Monthly Amount. Otherwise, all pricing will be adjusted on a pro rata fashion to reflect the actual study activities completed by the study subjects.  For bone biopsies, this pro rata adjustment for biopsies less than or greater than 200 shall be € [*] for each bone biopsy at sites managed by NB and € [*] for sites in India and the United State of America. For CT-scans, this pro rata adjustment for CT-scans less than or greater than 300 shall be € [*] for each CT-scan at sites managed by NB.”

 

(e) The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new sixth subparagraph to the end of Paragraph (10) of the Payment Schedule, which shall appear immediately following the fifth paragraph and shall read in full as follows:

 

“The pricing specified for the Services with respect to subjects enrolled at the study sites located in India or the United States of America is based upon 300 subjects randomized at 15 sites in India and 75 subjects randomized at 5 sites in the United States of America and shall be adjusted on a pro rata basis to reflect the actual number of sites initiated and the actual number of subjects enrolled in India and the United States of America. Such adjustment to be applied in pro rata installments at the time of payment of the Second Monthly Amount and the Third Monthly Amount.”

 

(f) The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new Paragraph (11) immediately following Paragraph (10) of the Payment Schedule, which shall read in full as follows:

 

(11)  The purchase price for the Services with respect to the extra site activities (at currently existing sites) as well as for the addition of the New Sites managed by NB located in Europe, Brazil and Argentina shall be paid solely in cash and shall include payment of a First Monthly Amount detailed under Paragraph (4). The amount of this incremental payment for the Services shall be:

 

(a)  €811,200 for the extra site activities (at currently existing sites) based upon 2,400 subject randomized at clinical sites managed by NB and shall be reduced on a pro rata basis for any patients enrolled in India or the United States.

 

(b) €100,000 for the extra site activities associated with obtaining new informed consent from subjects already enrolled in the Phase 3 study due to Protocol amendments.

 

(c) €2,739,450 for the EURO denominated portion and $205,540 for the U.S. Dollar denominated portion for the 12 New Sites study sites located in Europe, Brazil and Argentina. Radius shall be invoiced and shall pay the EURO denominated portion of any shipmen costs related to Synarc Research Laboratory as pass through costs.

 

Radius shall pay NB €[*] of the EURO denominated portion and $[*] for the U.S. Dollar denominated portion of these incremental fees for the extra site activities and the New Sites located in Europe, Brazil and Argentina within 15 days of the Effective Date.  Radius shall pay NB the balance of the EURO and U.S. Dollar incremental fees (€[*] and $[*]) in pro rata installments at the time it pays each installment of the Second Monthly Amount and the Third Monthly Amount.”

 

(g)  The “Trial Activities and Delegation of Responsibilities” table set forth in Attachment C to Work Statement NB-1 ( Attachment 2 to the Agreement), as amended, shall apply to New Sites managed by NB.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 2, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 2.

 

3.  General.   This Amendment No. 2 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

[remainder of this page intentionally left blank - signature page follows]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

3



 

 

IN WITNESS WHEREOF the parties have caused this Amendment No.2 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 2 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

 

 

 

/s/ B. Nicholas Harvey

 

/s/ Bente Juel Riis

By: B. N. Harvey

 

By: Bente Juel Riis

Title: CFO

 

Title: Medical Director

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Execution Copy

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 3 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1 and Amendment No. 2 to Work Statement NB-1 as of December 9, 2011and June 18, 2012 respectively, (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 3 to Work Statement NB-1 ( “Amendment No. 3” ) effective as of November 6, 2013 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 3 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 3, the parties agree as follows:

 

1. Addition of Antibody Surveillance Program (a) At Radius’ request, NB will initiate an antibody surveillance program at CCBR and non-CCBR sites to monitor any patients with positive antibodies in the clinical study that is the subject of Work Statement NB-1 (collectively, “Ab Services”). Radius wishes to provide for payment to NB for these Ab Services under Work Statement NB-1.

 

(b)  The NB representations and warranties set forth in Sections 8.2, 8.3, 8.5 and 8.6(ii) of the Agreement shall apply to the personnel, including Clinical Investigators, that perform the Ab Services.  NB shall be responsible for securing the applicable representations and warranties from these clinical study sites and personnel, including Clinical Investigators.

 

(c) A new section at the bottom Attachment B to Work Statement NB-1 ( Budgets, Fees, Pass-through Costs, and Payment Schedule* ) is hereby amended to read in full as follows:

 

“Antibody — BA058-05-003

 

Cost Proposal 08 October 2013

 

Sponsor:

 

RADIUS

 

 

Protocol ID:

 

Antibody - BA058-05-003

 

 

Development Phase:

 

N/A

 

 

Disease:

 

Osteoporosis

 

 

Nordic Start Study Activity

 

1-Jun-13

 

 

Expected Date of first follow up patient first visit

 

24-Apr-13

 

Based on FPLT 24-OCT-2012

Expected Date of last follow up patient first visit

 

1-Apr-15

 

Based on LPLV 01-OCT-2014

Expected Date of last follow up patient last visit

 

1-Oct-15

 

Based on Last FUP last visit 6 months after Last FUP first vist

Expected Length of total Follow-up period (months):

 

30

 

 

Duration of Nordic Involvement

 

16

 

Period from 01-JUN-13 to 31-JUN-14 is covered in the antibody budget for 007.

Number of visits per patient:

 

2

 

Estimated 2 extra samples per positive patient up to a period of 12 months after last study drug.

Number of Countries:

 

10

 

 

Number of Sites:

 

28

 

 

 

 

1



 

Total Budget 

 

EURO

 

 

Clinic Fee

 

€40 per scheduled visit; €96 per unscheduled visit

 

Estimated 75% unscheduled visits

CRO Activities (Nordic Bioscience)

 

32,640

 

Period until LPLV in 005 is partly covered in existing work orders. Only extra is increased study and site management and pharmacovigilance

Central Lab Fee (Synarc Lab)

 

€26.40 per sample per patient

 

Shipment not included. Shipment to be invoiced as pass through. Estimated to be 180,000 Euro

EDC system

 

0

 

Not applicable

 

Pass through Cost

 

EURO

 

 

Translation

 

Not included

 

 

Investigator Meeting

 

Not included

 

 

Lab shipments

 

Not included

 

 

Submission to EC and CA

 

Not included

 

 

EDC system

 

Not included

 

 

Data Monitoring Committe

 

Not included

 

 

Patient insurrance

 

Not included

 

 

Annual reports to the FDA

 

Not included

 

 

External advisory Board

 

Not included

 

 

Statistical Data analysis and Clinical Study Report

 

Not included

 

 

 

The CRO fee is not subject to any adjustment for the number of antibody positive patients. The Clinic Fee and Central Lab Fee will be adjusted to reflect the actual number of antibody positive patients and visits completed for surveillance activities. The Central Lab Fee will be adjusted on a pro rata basis based on the number of samples per antibody positive patient.

 

(d) The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new Paragraph (12) immediately following Paragraph (11) of the Payment Schedule, which shall read in full as follows:

 

(12)  The purchase price for the Ab Services shall be paid solely in cash as follows:

 

(a)  The CRO fee shall be paid in fixed monthly installments over the expected 30 month period of delivery of the Ab Services commencing May 1, 2013 with an expected last patient, last follow-up visit of October 1, 2015 equal to €1,088 per month.

 

(b) The Clinic fee shall be paid as clinic visits and procedures are performed based on a scheduled visit fee of €40 and an unscheduled visit fee of €96.

 

(c) The Central Lab Fee shall be paid as clinic visits and procedures are performed based on €26.40 per sample per antibody positive patient.

 

(d) Shipping shall be paid as a pass-through costs as incurred.

 

2



 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 3, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 3.

 

3.  General.   This Amendment No. 3 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

[remainder of this page intentionally left blank - signature page follows]

 

3



 

IN WITNESS WHEREOF the parties have caused this Amendment No.3 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 3 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

/s/ B. Nicholas Harvey

 

/s/ Bente Juel Riis

By: B.N. Harvey

By: Bente Juel Riis

Title: CFO

Title: CEO

 

 

Notice Address

Notice Address

Radius Health, Inc.

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

Herlev Hovedgade 207

Cambridge, MA 02139

2730 Herlev

USA

Denmark

Attn: President

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

 

 

Phone: 01.617.444.1834

Phone: 45.4452.5251

Fax: 01.617.551.4701

Fax: 45.4452.525

 


 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 4 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1, Amendment No. 2, and Amendment No. 3 to Work Statement NB-1 as of December 9, 2011, June 18, 2012 and November 6, 2013 respectively, (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 4 to Work Statement NB-1 ( “Amendment No. 4” ) effective as of March 28, 2014 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 4 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 3, the parties agree as follows:

 

1. Addition of Performance Incentive Bonus Program (a) In order to facilitate the timely completion of activities related to the Phase III clinical study of the subcutaneous injection form of abaloparatide (formerly, BA058) under Work Statement NB-1, Radius wishes to provide for an additional incentive payment of up to $5 million to NB.

 

(b) A new section at the bottom Attachment B to Work Statement NB-1 ( Budgets, Fees, Pass-through Costs, and Payment Schedule* ) is hereby amended to read in full as follows:

 

After the Amendment Date, NB shall receive an additional fee of $500,000 for every 50 subjects that complete End-of-Study visits and all procedures that are required to be performed according to the Schedule of Visits and Procedures as set out in Appendix 14.1 of the Protocol for the BA058-05-003 study (“Study Completers”), subject to a maximum payment amount of $5 million (the “Performance Incentive Bonus Program”).

 

(d) The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new Paragraph (13) and Paragraph (14) immediately following Paragraph (12) of the Payment Schedule, which shall read in full as follows:

 

(13)  In the event that an underwritten initial public offering of shares of Radius’ common stock (an “IPO”) is consummated prior to May 31, 2014, the purchase price for the Performance Incentive Bonus Program shall be paid solely in cash. Payments will be made by Radius upon submission of an invoice by NB for each group of 50 Study Completers until 450 subjects have completed and been invoiced under the Performance Incentive Bonus Program. The final payment of $500,000 for the last 50 Study Completers under the Performance Incentive Bonus Program will be due up the completion of the last study subject for BA058-05-003.

 

Should an IPO not be consummated by Radius prior to May 31, 2014, any payments due under the Performance Incentive Bonus Program shall be instead be paid in the form of Bonus Shares as part of the Bonus Equity Payment Amount in lieu of cash under the same model as for Work Statement NB-1, NB-2 and NB-3 under an amended Stock Issuance Agreement modeled on the Amended and Restated Stock Issuance Agreement entered into by the parties as of May 16, 2011.”

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 4, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 4.

 

3.  General.   This Amendment No. 4 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

[remainder of this page intentionally left blank - signature page follows]

 

1



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 4 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 4 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

/s/ Robert E. Ward

 

/s/ Thomas Nielson

By:

Robert E. Ward

By:

Thomas Nielson

Title:

President and CEO

Title:

CFO

 

 

Notice Address

Notice Address

Radius Health, Inc.

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

Herlev Hovedgade 207

Cambridge, MA 02139

2730 Herlev

USA

Denmark

Attn: President

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

Phone: 45.4452.5251

Fax: 01.617.551.4701

Fax: 45.4452.525

 


 

Execution Copy

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 5 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1, Amendment No. 2, Amendment No. 3 and Amendment No. 4 to Work Statement NB-1 as of December 9, 2011, June 18, 2012, November 6, 2013 and March 28, 2014 respectively, (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 5 to Work Statement NB-1 ( “Amendment No. 5” ) effective as of May 19, 2014 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 5 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 5, the parties agree as follows:

 

1. Amendment of the IPO date. The latest date upon which an IPO is to be consummated by Radius under Paragraph 13 and 14 of the Payment Schedule set forth in Attachment B to Work Statement NB-1 is hereby amended from May 31, 2014 to June 30, 2014.

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 5, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 5.

 

3.  General.   This Amendment No. 5 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

IN WITNESS WHEREOF the parties have caused this Amendment No. 5 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 5 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

/s/ B.N. Harvey

 

/s/ Thomas Nielson

By: B.N. Harvey

 

By: Thomas Nielson

Title: CFO

 

Title: CFO

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor /

 

 

Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 


 

Execution Copy

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 6 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1, Amendment No. 2, Amendment No. 3, Amendment No. 4 and Amendment No. 5 to Work Statement NB-1 as of December 9, 2011, June 18, 2012, November 6, 2013, March 28, 2014 and May 19, 2014 respectively, (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 6 to Work Statement NB-1 ( “Amendment No. 6” ) effective as of July 22, 2014 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 6 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 6, the parties agree as follows:

 

1. Reconciliation of costs related to clinical sites, renal CT and QCT scans and Adjustment to Payment Schedule

 

(a) At Radius’ request, NB has previously initiated 4 additional non-CCBR sites in Brazil (2), United States (1) and Hong Kong (1) and discontinued 3 non-CCBR sites in Argentina (1), Brazil (1) and the US (1) in the clinical study that is the subject of Work Statement NB-1. In addition, Radius has previously requested NB to increase the number of renal CT scans to be obtained and analyzed and to obtain new QCT scans (collectively, “A6 Services”). Radius wishes to now provide for a reconciliation of payments to NB for these A6 Services under Work Statement NB-1.

 

(b)  The NB representations and warranties set forth in Sections 8.2, 8.3, 8.5 and 8.6(ii) of the Agreement shall apply to the personnel, including the Clinical Investigators, who perform the clinical study under the A6 Services. NB shall be responsible for securing the applicable representations and warranties from these clinical study sites and personnel, including Clinical Investigators.

 

(c)  The Study Assumptions table on the first page of Attachment A to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to reduce the total Number of Sites from 42 to 28 reflecting this Amendment No. 6 as well as the final number of sites, including deletion of sites in India that were not initiated by Radius. As amended, the Study Assumptions table will read as follows:

 

Protocol Number

 

BA058-05-003

Number of Sites:

 

28

Denmark

 

3

Estonia

 

2

Lithuania

 

1

Romania

 

1

Poland

 

6

Czech Republic

 

3

Brazil

 

5

Argentina

 

1

Hong Kong

 

1

USA

 

5

 

1



 

(d) The paragraph at the bottom Attachment B to Work Statement NB-1 ( Budgets, Fees, Pass-through Costs, and Payment Schedule* ) is hereby amended to read in full as follows:

 

“The pricing specified in this Budget is calculated based upon 2,040 subjects randomized and completed at sites managed by NB, excluding sites in India and the United State of America, and is not subject to any adjustment for the number of patients to be Pre-screened/Advertisement, the screen failure rate after the Patient Informed Consent has been signed, or the drop-out rate. However, this Budget as well as the Bonus Equity Payment Amount under the Amended and Restated Stock Issuance Agreement dated May 16, 2011 shall each be reduced by an amount of €11,941 per subject for any subjects enrolled in India or the United States. Such reduction to be applied in pro rata installments at the time of payment of the Second Monthly Amount and the Third Monthly Amount. Otherwise, all pricing will be adjusted on a pro rata fashion to reflect the actual study activities completed by the study subjects.

 

For bone biopsies, this pro rata adjustment for biopsies less than or greater than 200 shall be €4,153 for each bone biopsy at sites managed by NB and €2,008 for sites in India and the United State of America.

 

For obtaining of CT-scans, this pro rata adjustment for CT-scans less than or greater than 300 shall be €610 for each CT-scan at sites managed by NB.

 

For CT-scans image analysis, this pro rata adjustment for CT-scans less than or greater than 300 shall be €180 for each CT-scan for all sites. In addition, there will be a charge of €4,134 for the first 100 Data Clarification Forms (DCF) and €41 for each additional DCF greater than 100. In addition, there will be a 10 per cent management charge to NB related to obtaining and the analysis of CT-scans greater than 300.

 

For obtaining QCT-scans, the cost of €176,681 for 534 QCT-scans will be sent as pass-through from Synarc, Inc. through NB and shall be adjusted on a pro-rata basis for less than 534 QCT-scans. A separate amendment agreement will be negotiated for QCT-scan image analysis between Radius and Synarc, Inc. which is not included in the Amendment No. 6.

 

The following table related to the A6 Services is inserted immediately below the above paragraph in Attachment B to Work Statement NB-1:

 

New sites:
Brazil (125, 126)
HK (182),
US (216)
Not active sites:
US (215)
Argentina (202)
Brazil (122)
Extra CT scan activity

 

Sponsor:

 

RADIUS

Protocol ID; 3 new sites

 

BA058-05-003

Development Phase:

 

III

Disease:

 

Osteoporosis

Site 126: Brazil; Dr. Albergaria

 

49

Site 125: Brazil; Dr. Borges

 

12

Site 182: Hong Kong; Dr. Liu Po Lung, Paul

 

0

Site 216 (US)

 

21

 

2



 

Number of sites in

 

3

Expected Date of FPFV:

 

Q3-2012

Preparation time

 

3

Expected Length of Recruitment (months):

 

2

Treatment Duration (months):

 

19

Close Out (months)

 

2

Total Study duration (Nordic involvement)

 

26

Number of Visits per patient

 

10

Number of patient visits

 

820

 

 

 

Responsibility

 

 

 

 

 

CRO - Task Description

 

Radius

 

Nordic

 

Total

 

Remarks

 

 

 

 

 

 

 

 

 

 

 

Project Coordination

 

 

 

 

 

 

 

 

 

Project Management

 

 

 

X

 

26,000

 

 

 

 

 

 

 

 

 

 

 

 

 

Prepare Study Materials

 

 

 

 

 

 

 

 

 

Informed Consent local version

 

 

 

X

 

0

 

 

 

Circulate source data and other documents

 

 

 

X

 

3,000

 

Site 125, 126, 216

 

 

 

 

 

 

 

 

 

 

 

Site Identification & Initiation Visits

 

 

 

 

 

 

 

 

 

Pre-Study feasibility

 

 

 

X

 

1,500

 

Site 182, 125, 126

 

Site Identification

 

 

 

X

 

1,500

 

Site 182, 125, 126

 

Site Selection Visits

 

 

 

X

 

9,000

 

Site 182, 125, 126

 

Site Initiation Visits

 

 

 

X

 

9,000

 

Site 125, 126, 216

 

Prepare site contracts

 

 

 

X

 

3,000

 

Site 182, 125, 126

 

Administration of Site payment (including calcium/D suppl)

 

 

 

X

 

2,000

 

Site 125, 126

 

 

 

 

 

 

 

 

 

 

 

Study Start-up Activities

 

 

 

 

 

 

 

 

 

Set-up Investigators Study File

 

 

 

X

 

600

 

Site 125, 126, 216

 

 

 

 

 

 

 

 

 

 

 

Regulatory

 

 

 

 

 

 

 

 

 

Submission to EC and RA; Brazil - 2 sites

 

 

 

X

 

38,625

 

Site 125, 126

 

Submission to EC and RA; Hong Kong

 

 

 

X

 

5,000

 

Site 182

 

 

 

 

 

 

 

 

 

 

 

Study Drug

 

 

 

 

 

 

 

 

 

Coordinate Drug Shipment to sites

 

X

 

X

 

2,600

 

 

 

 

3



 

Discount

 

 

 

 

 

-1,300

 

For site 202 and 215 not active

 

IVR training

 

X

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pharmacovigilance

 

 

 

 

 

 

 

 

 

Extra PV management time

 

 

 

X

 

7,800

 

 

 

Discount

 

 

 

 

 

-2,600

 

For site 202 and 215 not active

 

 

 

 

 

 

 

 

 

 

 

Data Management / EDC

 

 

 

 

 

 

 

 

 

Add sites to EDC System

 

 

 

X

 

30,000

 

Site 125, 126, 216

 

Site Installation & Training for EDC

 

 

 

X

 

3,000

 

Site 125, 126, 216

 

Data Management

 

 

 

X

 

52,000

 

 

 

Discount

 

 

 

 

 

-26,000

 

For site 202 and 215 not active

 

 

 

 

 

 

 

 

 

 

 

Monitoring and site Administration

 

 

 

 

 

 

 

 

 

Extra fee to external CRO (Quintiles)

 

 

 

X

 

131,331

 

Site 125, 126 discounted for all site 202 activity

 

US site 216

 

 

 

X

 

50,000

 

 

 

Discount

 

 

 

 

 

-45,000

 

For site 215 not active

 

Site Contact & Administration

 

 

 

X

 

54,600

 

Site 125, 126, 216

 

Discount

 

 

 

 

 

-18,200

 

For site 215 not active

 

Audits

 

 

 

X

 

9,000

 

Site 125, 126, 216

 

 

 

 

 

 

 

 

 

 

 

Close-Out

 

 

 

 

 

 

 

 

 

Close-Out Visits

 

 

 

X

 

9,000

 

Site 125, 126, 216

 

Discount

 

 

 

 

 

-3,000

 

For site 215 not active

 

Final Archiving (to be negotiated separately)

 

 

 

 

 

0

 

 

 

 

 

 

 

 

 

 

 

 

 

Synarc Research Laboratory

 

 

 

 

 

99,450

 

Extra lab kits and project management; shipment as pass through

 

 

 

 

 

 

 

 

 

 

 

1.TOTAL (EURO)

 

 

 

 

 

425,906

 

 

 

 

4



 

Start-up Cost for the new HK site

 

Equipment

 

Cost (HKD)

 

Remarks

 

 

 

 

 

Centrifuge

 

75,000.00

 

Eppendoff

 

1 TOTAL

 

425,906.15

 

ECG

 

25,000.00

 

Schiller AG

 

2 TOTAL

 

16,353.00

 

Refrigerator 4oC

 

8,000.00

 

Non-medical

 

3 TOTAL

 

215,016.69

 

Freezer -18 to -20oC

 

10,000.00

 

Non-medical

 

PASS-THROUGH

 

176,680.92

 

Thermometer (x3)

 

1,050.00

 

HKD350 each

 

TOTAL

 

833,956.76

 

Printer

 

3,000.00

 

 

 

 

 

 

 

Internet 10G with emergency phone number

 

6,000.00

 

USB HKD400/ month

 

 

 

 

 

Balance

 

2,980.00

 

Charder MS4900

 

 

 

 

 

Standiometer

 

18,500.00

 

Holtain

 

 

 

 

 

WelchAllyn Connex ProBP Monitor

 

7,000.00

 

 

 

 

 

 

 

2. TOTAL

 

163,530

 

16,353.00

 

 

 

 

 

 

CT - Service

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

QCT up to 300 scans:

 

$

211,304.00

 

Pass-Through

 

 

 

 

 

QCT from 300 to 534:

 

$

15,210.00

 

Pass-Through

 

 

 

 

 

CT up to 300 scans:

 

$

0.00

 

 

 

 

 

 

 

CT from 300 to 534:

 

$

245,302.20

 

 

 

 

 

 

 

Additional DCF’s:

 

$

5,300.00

 

 

 

 

 

 

 

SubTotal (USD)

 

$

250,602.20

 

 

 

 

 

 

 

Nordic Management Fee 10%

 

$

25,060.22

 

 

 

 

 

 

 

PASS-THROUGH (QCT)

 

$

226,514.00

 

 176,680.92

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

$

275,662.42

 

 215,016.69

 

 

 

 

 

 

(e) The “Payment Schedule” set forth in Attachment B to Work Statement NB-1 ( Attachment 2 to the Agreement) is amended to add a new Paragraph (15) immediately following Paragraph (14) of the Payment Schedule, which shall read in full as follows:

 

(15) The total purchase price for the A6 Services shall be €833,957 assuming 534 CT and QCT scans are completed under this Amendment No. 6 and shall be paid solely in cash denominated in euros, as follows:

 

(a)  €326,456 for the net extra site activities

 

(b) €99,450 for extra lab kits, project management and shipment as a pass through

 

(c) €16,353 for the start-up costs for the additional Hong Kong site.

 

(d) €215,017 for obtaining and analysis of the additional CT scans greater than 300 including the NB management fee.

 

(e) €176,681 for obtaining the additional QCT scans.

 

Radius shall pay NB €376,968 of these incremental fees within 15 days of the effective date representing (i) €261,165 equal to 80 per cent of the net extra site activities; plus (ii)  the total Hong Kong start-up costs of €16,353; plus (iii) €99,450 for the extra lab kits and project management. Radius shall pay NB for the shipments costs as pass-through costs as incurred. Radius shall pay NB the balance for obtaining and analyzing the additional CT-scans and for obtaining the QCT-scans as well as any additional DCF and shipments costs as pass-through costs as incurred. Radius shall pay the balance of costs for the A6 Services of €65,291 when the study database for the clinical study that is the subject of Work Statement NB-1 is locked and transferred to Radius”

 

(g)  The “Trial Activities and Delegation of Responsibilities” table set forth in Attachment C to Work Statement NB-1 ( Attachment 2 to the Agreement), as amended, shall apply to New Sites managed by NB.

 

5



 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 6, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect. The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 6.

 

3.  General.   This Amendment No. 6 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

[remainder of this page intentionally left blank - signature page follows]

 

6



 

IN WITNESS WHEREOF the parties have caused this Amendment No.6 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 6 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

/s/ Robert E. Ward

 

/s/ Jeppe Ragnar Andersen

By: R. E. Ward

 

By: Jeppe Ragnar Andersen

Title: President & CEO

 

Title: CEO

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 


 

Execution copy

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 7 TO WORK STATEMENT NB-1

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-1 under the Agreement as of March 29, 2011 ( “Effective Date” ), and entered into an Amendment No. 1, Amendment No. 2, Amendment No. 3, Amendment No. 4, Amendment No. 5, and Amendment No. 6 to Work Statement NB-1 as of December 9, 2011, June 18, 2012, November 6, 2013, March 28, 2014, May 19, 2014 and July 22, 2014 respectively, (as amended, “Work Statement NB-1” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 7 to Work Statement NB-1 ( “Amendment No. 7” ) effective as of July 22, 2014 ( “Amendment Date” ).  Capitalized terms used in this Amendment No. 7 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-1.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 7, the parties agree as follows:

 

1. Addition of SAE Narrative Writing and Review (a) At Radius request and direction, NB will assign qualified personnel to write Serious Adverse Event (SAE) narratives and perform SAE narrative review for BA058-05-003 according to version 1 of the narrative writing procedures agreed upon May 23 rd , 2014.

 

(b) A new section at the bottom Attachment B to Work Statement NB-1 ( Budgets, Fees, Pass-through Costs, and Payment Schedule ) is hereby amended to read in full as follows:

 

Budget

 

Euro

 

SAE Narrative writing (each)

 

115

 

SAE Narrative review (each)

 

60

 

 

The price per narratives written is €115, and the price per narrative review is €60, paid by invoice on a quarterly basis based on actual work performed.

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 7, all of the terms, provisions and conditions of the Agreement and Work Statement NB-1 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-1”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-1 as amended by this Amendment No. 7.

 

3.  General.   This Amendment No. 7 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank - signature page follows]

 

1



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 7 under Work Statement NB-1 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 7 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL
DEVELOPMENT VII A/S

 

 

 

 

 

 

/s/ Robert E. Ward

 

/s/ Jeppe Ragnar Andersen

By: R.E. Ward

 

By: Jeppe Ragnar Andersen

Title: President & CEO

 

Title: CEO

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President & CEO

 

Attn: CEO

Phone: 01.617.551.4700

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 

2




Exhibit 10.12

 

Confidential Treatment Requested
Under 17 C.F.R. §§ 200.80(b)(4) and
240.24b-2

 

 

Work Statement NB-2

 

This Work Statement NB-2 is entered into as of February 21, 2013 pursuant to Section 2.1 of the Clinical Trial Services Agreement dated as of March 29, 2011, by and between Radius Health, Inc. (“ Radius ”) and Nordic Bioscience Clinical Development VII A/S (“ NB ”) (the “ Agreement ”).  Capitalized terms used in this Work Statement NB-2 and not defined in this Work Statement NB-2 are used with the meanings ascribed to them in the Agreement.  This Work Statement NB-2 is attached to and becomes, upon execution by both parties below, a part of the Agreement, and sets forth the specific terms and conditions relating to the Services and Deliverables described herein.

 

In consideration of the mutual promises contained in the Agreement and for other good and valuable consideration the receipt and adequacy of which each of the parties does hereby acknowledge, the parties hereby agree to the terms of this Work Statement NB-2 entitled: BA058-05-007 “A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis.”

 

This Work Statement NB-2 contains the following Attachments, each of which is made a part hereof:

 

Attachment A — Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

 

Attachment B — Budgets, Fees, Pass-through Costs, and Payment Schedule

 

Attachment C — Materials Provided by Either Party

 

Attachment D — Core Team Members/Key Personnel

 

Attachment E — Protocol or Protocol Summary

 

Attachment F — Reports and Information Management/Regular Meetings

 

Attachment G — Special Insurance

 

Attachment H - Transfer of Obligation

 

Attachment I — Clinical Trial Agreement Template

 

Attachment K -  Indemnity Letter Template

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

IN WITNESS WHEREOF the parties have executed this Work Statement NB-2 intending it to take effect as an instrument under seal as part of the Agreement as of February 21, 2013.

 

 

RADIUS HEALTH, INC.

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

 

By:

/s/ B. Nicholas Harvey

 

By:

/s/ Bente Juel Riis

 

 

 

 

 

Name:

B. Nicholas Harvey

 

Name:

Bente Juel Riis

 

 

 

 

 

Title:

Chief Financial Officer

 

Title:

Chief Executive Officer

 

 

 

 

 

Date:

February 21, 2013

 

Date:

February 21, 2013

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment A

 

Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

Study Assumptions

 

Radius Health, Inc.

Protocol:  BA058-05-007, “A Randomized Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis”

 

Protocol Number

 

BA058-05-007

Number of active Sites:

 

9

Denmark

 

3

Estonia

 

1

Poland

 

2

 

 

 

USA

 

3

Back-up: 3 in Czech, 1 in Lithuania, 1 in Romania, Hong Kong

 

6

Number of Patients to be Screened:

 

500

Number of Patients to Enroll:

 

250

Enrollment Period:

 

See below

Treatment Period:

 

6 months

Safety Follow up Period

 

1 month

Visits per Completed Subject:

 

11

Nordic Involvement

 

19 months

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Clinical Trial Timeline

 

BA058-05-007 Milestones

 

Estimated
Timelines

 

Nordic start study activity

 

1 April 2012

 

Regulatory Submissions

 

31 May 2012

 

First Regulatory Approval; estimated

 

26 July 2012 (non-US sites)

 

Last Regulatory Approval: estimated

 

1 October 2012 (Hong Kong)

 

IMP ready at EU sites

 

22 October 2012

 

First Patient screened

 

15 August  2012

 

First Patient Randomized at EU sites

 

22 October 2012

 

Last Patient Randomized

 

3 January  2013

 

Treatment Period

 

6m + 1m

 

Last Patient last treatment

 

15 July  2013

 

Last Patient Last Study Visit

 

15 August  2013

 

Database Lock

 

15 Sept 2013

 

Locked Database Transfer to Sponsor

 

15 Sept 2013

 

Site Close-out Visits

 

Oct 2013

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment B

 

Budgets, Fees, Pass-through Costs, and Payment Schedule*

 

BA058-05-007 Draft Protocol Synopsis (Synopsis BA058-05-007 DRAFT 14Mar12.doc)

 

Sponsor:

 

Radius Health, Inc.

 

 

Protocol ID:

 

BA058-05-007

 

 

Development Phase:

 

II

 

 

Disease:

 

Osteoporosis

 

 

Total # of Randomized Subjects (CCBR):

 

250

 

Numbers are adjusted for 7.5 % overall drop out (DO) = 231

PK/PD Study; *samples for BA058 on 250 subjects, samples for s-calcium on 250 subjects:

 

All

 

Adjusted for Drop Out

ECG pre-and post dose:

 

All

 

Adjusted for Drop Out

Bone Biopsy:

 

None

 

 

Expected Date of FPFV:

 

Q3-2012

 

 

Expected Length of Recruitment (months):

 

See above

 

 

Treatment Duration (months):

 

6 + FU (1 month)

 

 

Number of visits:

 

11

 

 

Number of Active Sites:

 

9

 

 

 

Page 1 of 2

 

 

RADIUS

 

 

BA058-05-007

 

 

Protocol 24 May 2012

 

 

Cost Proposal Version 24 January 2013

 

 

 

 

 

Sponsor:

 

 

Protocol ID:

 

BA058-05-007

Development Phase:

 

II

Disease:

 

Osteoporosis

Total # of Randomized Subjects:

 

250

PK Study

 

250

ECG pre- and 30 minutes post dose

 

185

ECG pre- and 60 minutes post dose

 

46

Bone Biopsy

 

0

Renal CT

 

0

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Total Budget 

 

EURO

 

Clinic Activities (randomized and completed) (CCBR) (adjusted for 7.5% DO rate)

 

[*]

 

CRO Activities (Nordic Bioscience) (risk based monitoring, 231 subjects)

 

[*]

 

Central Lab Fee (Synarc Lab) (based on 7.5% DO rate, not include shipment, est Euro 400,000)

 

[*]

 

Calcium and Vitamin D supplement (purchased locally)

 

[*]

 

Extra patient visits due to drug supply delay

 

[*]

 

Total Budget (Euro)

 

3,601,718

 

 

 

 

USD

 

Central Imaging Reading (Synarc Imaging) (based on 7.5% DO rate, not include shipment, est USD 6,000)

 

257,853

 

Total Budget (USD)

 

257,853

 

 

Pass through Cost

 

EURO

 

Containers for 24-h urine collection

 

Included

 

Local Hematology Test’s

 

Included

 

Advertisement

 

Included

 

Monitoring Travel Expenses & Accommodations/ other travels

 

Included

 

Shipments of imaging and labs

 

Not included

 

Translation

 

Included

 

Investigator Meeting (TC)

 

Included

 

Submission Fee to ERC and CA

 

Not included

 

eCRF

 

Not included

 

Data Monitoring Committee

 

Not included

 

Patient insurance

 

Not included

 

Annual reports to the FDA

 

Not included

 

External advisory Board

 

Not included

 

Statistical Data analysis and Clinical Study Report

 

Not included

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

 

The Cash budget is Euro 3,601,718 and USD 257,853 = USD 4,940,086 with exchange rate 1.30.

 

The Bonus Equity Payment Amount budget is = USD 2,919,945 .

 

The Cash budget will be paid as follows:

 

Euro

 

 

 

3,601,718

 

upfront

 

 

 

[*]

 

Enrollment (250)

 

[*]

 

[*]

 

treatment

 

[*]

 

[*]

 

Rest

 

 

 

[*]

 

USD

 

 

 

257,853

 

upfront

 

 

 

[*]

 

Enrollment (250)

 

[*]

 

[*]

 

treatment

 

[*]

 

[*]

 

Rest

 

 

 

[*]

 

 

·                   Euro 697,129 of the Euro cash budget and USD 51,571 of the USD cash was paid at signing of the LOI.

·                   During enrollment Euro [*] and USD [*] will be paid per randomized patient at CCBR sites for total Euro [*] and USD [*] based on 250 patients

·                   After enrollment Euro [*] and USD [*] will be paid on a monthly basis over [*] months starting after patient randomization is completed for total Euro [*] and USD [*]

·                   The balance of the Euro and USD cash budget of Euro [*] and USD [*] will be paid when the database is locked and transferred to and accepted by Radius.

 

The Equity budget will be paid in concert with the cash payment after the same model as for Work Statement NB-1 under a separate Stock Issuance Agreement modeled on the Amended and Restated Stock Issuance Agreement entered into by the parties as of May 16, 2011.

 

Pass through costs will be invoiced on a 3-monthly basis.

 

The pricing specified in this Budget is calculated based upon 231 subjects randomized and completed but will be adjusted for the number of completed patients  less than 231 subjects on a fully pro rata basis for the Clinic Activities Fee, the Central Lab Fee and the Central Imaging Reading Fee. However, the Cash Budget shall be reduced by an amount of Euro [*] per subject and the Bonus Equity Payment Amount shall be reduced by an amount of USD [*] per subject for Clinic Activities not performed at CCBR sites for any patients enrolled in the United States. Such reductions to be applied in pro rata installments to monthly payments after patient randomization is completed.   Otherwise, all pricing will be adjusted on a pro rata fashion to reflect the actual study activities completed by the study subjects.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment C

 

Materials Provided by Either Party

 

Trial Activities & Delegation of Responsibilities

 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Sponsor & Service provider Governance

 

 

 

 

 

 

CCBR - Radius Governance Committee

 

ü

 

ü

 

Sponsor and Service provider will responsible for creating an Executive Governance Committee to oversee program strategy and implementation.

Clinical Trial Joint Development Team

 

ü

 

ü

 

Sponsor and Service provider will appoint members of the clinical trial joint development team to implement the clinical study.

 

 

 

 

 

 

 

Regulatory

 

 

 

 

 

 

IND/CTA Preparation

 

R

 

ü

 

Sponsor will be responsible to create all IND and CTA submission documents. Service provider will be responsible for any required translations for the CTA.

FDA IND Submission & Updates

 

 

 

ü

 

Sponsor will be responsible for all FDA submissions.

CTA Submissions & Updates

 

ü

 

A

 

Service provider will be responsible for all CTA submissions. Sponsor approval of the submissions is required prior to submission.

Health Authority, EC, IRB Queries & Response

 

ü

 

ü

 

Sponsor and Service provider will be responsible to provide responses to Health Authority, Ethics Committee, and IRB queries, if necessary.

EUDRACT Registration

 

ü

 

ü

 

Sponsor will be responsible to register the clinical study to obtain an EUDRACT

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

number and service provider will create the XML file for submission.

Investigator’s Brochure

 

 

 

ü

 

Sponsor will be responsible to create the Investigator Brochure and any updates.

Clinical Study Protocol

 

R

 

ü

 

Sponsor will be responsible to create the study protocol, and any amendments, if necessary. Service provider will be responsible to review the study protocol and any amendments, if necessary.

Clinical Study Extension Protocol

 

R

 

ü

 

Sponsor will be responsible to create the Extension study protocol, and any amendments, if necessary. Service provider will be responsible to review the Extension study protocol and any amendments, if necessary.

Informed Consent Form (ICF, PIS)

 

ü

 

R

 

Service provider will be responsible to create the Informed Consent Documents and/or Patient Information Sheets. Sponsor will be responsible to review the ICF or PIS.

Ethics Committees/IRB Submissions & Updates

 

ü

 

 

 

Service Provider will be responsible for all country and site Ethics Committees and/or local IRBs submissions.

FDA SAE Submission & Follow Up(s)

 

 

 

ü

 

Sponsor will be responsible for FDA SAE submissions. See Health Authority reporting in Safety and Pharmacovigilance

Health Authority SAE Submissions & Follow Up(s)

 

ü

 

A

 

Service provider will be responsible for all Health Authority SAE submissions except FDA. Sponsor will be responsible for approving the HA submissions. See Health Authority reporting in Safety and Pharmacovigilance

Legal representative (if required)

 

ü

 

 

 

Service provider will be responsible to provide Legal Representative services, on behalf of the sponsor, if required by local regulation.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Regulatory & Study Documents translations

 

ü

 

 

 

Service provider will be responsible to provide all necessary document translations for regulatory and study documents.

Clinicaltrials.gov registration & management

 

 

 

ü

 

Sponsor will be responsible to register the clinical study on clinicaltrials.gov and manage the status of the study as required by regulation.

Clinical Trial Materials

 

 

 

 

 

 

BD Pen II Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture to BD Pen injection device

BA058 80 mcg Cartridge Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture the BA058 80 mcg cartridges.

BA058 50 mcg, 100 mgc, and 150 mcg Microneedle Patch Manufacture

 

 

 

ü

 

 

BA058 Placebo Microneedle Patch Manufacture

 

 

 

ü

 

Sponsor will be responsible to manufacture the BA058 placebo patches.

BA058/placebo transdermal patch and application tools

 

 

 

ü

 

 

Qualified Person for Drug Release

 

 

 

ü

 

Sponsor will be responsible to provide a Qualified Person (QP) for drug release in the EU, if necessary.

Study Drug Shipping

 

 

 

ü

 

Sponsor will be responsible for shipping study drug to the study centers.

Package Clinical Trial Materials

 

 

 

ü

 

Sponsor will be responsible to package the clinical trial material, including payment of any third party costs related to packaging.

Vitamin D & Calcium

 

ü

 

 

 

Service provider will be responsible to procure the Vitamin D & Calcium required to be taken concomitantly during the study.

Country specific labels

 

ü

 

ü

 

Sponsor will be required for labeling the

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

study drug kits. Service provider will be responsible to provide label translation and review label prior to packaging.

Instructions for Use - BA058 BD Pen

 

R

 

ü

 

Sponsor will be responsible to create and provide an Instructions for Use for the BA058 BD Pen in English. Service provider will be responsible for translating the Instructions for Use, as required by local regulations.

BD 31g 8mm Needles

 

 

 

ü

 

Sponsor will be responsible to procure and supply the BD 31g 8 mm needles for use with the BA058 cartridges and pens.

Sharps containers

 

ü

 

 

 

Service provider will be responsible to provide each patient with a sharps container for disposal of study needles.

Alcohol Swabs

 

ü

 

 

 

Service provider will be responsible to provide each patient with alcohol swabs.

Tote Bags/Coolers

 

ü

 

 

 

Service provider will be responsible to provide each patient with tote bags and coolers.

Study Drug Release & Distribution (IVRS)

 

 

 

ü

 

Sponsor will be responsible to release study drug and distribute to clinical study sites. The sponsor will be responsible to contract an IVRS vendor.

Study Drug Reconciliation — Patient, Site, & Study

 

ü

 

R

 

Service provider will be responsible to perform drug accountability during the clinical study. Each study cartridge and transdermal foil pouch and vitamin D and calcium tablet will need to be accounted for during and at the end of the study for each patient at every clinical site. The patient and site drug reconciliation documentation will be sent to the sponsor for review on a regular basis.

Study Drug Destruction

 

 

 

ü

 

Sponsor will be responsible for final study drug destruction.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Study Drug: Import Broker, License & Requirements

 

 

 

ü

 

Sponsor will be responsible to provide all information necessary to import the study drug and clinical trial materials, as needed. Sponsor will be responsible to contract with a local customs or import broker to facilitate the import of clinical trial materials, if necessary.

Proforma Invoice

 

 

 

ü

 

Sponsor will be responsible to create the proforma invoices for importing study drug. Sponsor will be responsible to provide necessary information to complete the proforma invoice.

Clinical Trial Conduct

 

 

 

 

 

 

Data Safety Monitoring Board

 

 

 

ü

 

Sponsor will be responsible to create a Data Safety Monitoring Board for the clinical study.

Clinical Trial Project Plan

 

ü

 

A

 

Service provider will be responsible for developing a Clinical Trial Project Plan to identify the goals, objectives, timelines, milestones, organization chart, vendor list (including roles & responsibilities), and budget forecast and tracking for the clinical study. The Sponsor will be required to approve the clinical trial project plan prior to screening.

Clinical Trial Budget Forecasting & Tracking

 

ü

 

R

 

Service provider will be responsible for forecasting and tracking the trial expense and reporting to the Sponsor on a monthly basis.

Clinical Trial Insurance

 

 

 

ü

 

Sponsor will be responsible for obtaining and maintaining insurance for the clinical trial. Sponsor will be responsible to provide proof of insurance to the Service provider, as required.

Medical Monitoring

 

ü

 

R

 

Service provider will be responsible for medical monitoring. Sponsor will review Service provider’s performance and may

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

request adjustments.

Vendor Management - Labs, X-ray, Dexa,

 

ü

 

 

 

Service provider will be responsible for qualifying, contracting, payment for services, data collection, and quality and compliance for any service contracted out by the Service provider.

Vendor Management - PK, Antibody, Drug Manufacture/Package, IVRS, EDC

 

 

 

ü

 

Sponsor will be responsible for the vendor management of the PK sampling, Antibody testing, and Study drug manufacture, packaging, and/or procurement.

Vendor Payments

 

ü

 

ü

 

Sponsor and Service provider will be responsible to pay third party vendors to whom they have contracted required study services.

Patient Recruitment, Screening, Enrollment

 

ü

 

R

 

Service provider will be responsible for patient recruitment, screening, and enrollment. Service provider will provide, until enrollment completes, the Sponsor with a weekly update of cumulative number of patients recruited, cumulative number screened, number screened within the reporting week, number screened but not enrolled, number failed screening, and number enrolled.

Site Selection

 

ü (ex-US)

 

ü (US)

 

Service provider will be responsible for site identification and selection for participation in the clinical study. Sponsor will be responsible for approving the list of sites identified by the Service provider.

Site Management

 

ü

 

 

 

Service provider will be responsible for site management activities.

Site Confidentiality Agreements

 

ü (ex-US)

 

ü (US)

 

Service Provider will be responsible to collect Site Confidentiality agreements prior to communicating any study specific information. A copy of the CDA

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

will be sent to the Sponsor upon execution of the document..

Site Contract/Agreement

 

ü (ex-US)

 

ü (US)

 

Service Provider will be responsible to create and manage the Site Contracts. A copy of the Site Agreement will be sent to the Sponsor upon execution of the document..

Clinical Trial Monitoring & Plan

 

ü

 

A

 

Service provider will be responsible to create a clinical trial monitoring plan as per the Service provider’s SOP for Clinical Monitoring and monitor the clinical study conduct at the sites. The Sponsor is responsible for approving the monitoring plan prior to study start.

Clinical Trial Monitoring Reports

 

ü

 

R

 

Service provider will be responsible to create clinical trial monitoring reports that document the clinical trial monitoring visit. The clinical trial monitoring report will be generated using the format identified in the Service provider’s SOP. The monitoring reports will be made available to the Sponsor for review within 10 -20 days of the monitoring visit.

Clinical Trial Monitors

 

ü

 

A

 

Service provider will be responsible to provide qualified clinical trial monitors to perform required monitoring duties.

Monitor Travel Expense

 

ü

 

 

 

Service provider will be responsible for monitoring expenses.

CRA Meetings

 

ü

 

R

 

Service provider will be responsible for scheduling, conducting, and creating meeting minutes for CRA meetings. The Service provider will include the Sponsor as a participant to the CRA meetings.

Sponsor Meetings

 

ü

 

ü

 

Sponsor and Service provider will be responsible for scheduling Sponsor Meetings on a weekly basis during enrollment and monthly after enrollment

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

completes. Meetings can also happen on an ad-hoc basis as required by the Sponsor or Service provider.

Sponsor Meeting Minutes

 

A

 

ü

 

Service provider will be responsible to create the meeting minutes for the Sponsor meetings and circulate a draft within 24 hours. Sponsor will review and provide comment within 24 hours. Meeting minutes will be required to be final within 72 hours.

Trial Staff Training

 

ü

 

R

 

Service provider will be responsible for training of all trial staff as well as documenting the training for new trial staff members. The training records will be made available for the Sponsor’s review.

Investigator Meeting & Training

 

ü

 

ü

 

Service provider will be responsible for planning and conducting the study investigator meetings. Sponsor will be responsible to assist in the preparation and approval of investigator meeting training materials.

Central Imaging Analysis (BMD)

 

ü

 

 

 

Service provider will be responsible to provide central imaging services to assess the protocol required measures for fracture, bone mineral density, and renal tissue mineralization and function.

 

 

 

 

 

 

 

Protocol Deviation & Waiver

 

ü

 

ü

 

Service provider will be responsible to identify and/or collect all protocol deviations. All violations will be reviewed by the Study Safety Officer and the Medical Monitor prior to deciding if the patient can participate in the study or must be excluded. Waivers should minimized and inclusion/exclusion criteria adhered to.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Sponsor Project Update Reports

 

ü

 

 

 

Service provider will be responsible to create monthly study status update reports.

Trial Master File

 

ü

 

 

 

Service provider will be responsible to create, maintain, and reconcile the trial master file including all required Essential Documents. At the end of the study, the trial master file will be sent to the Sponsor. The Sponsor will be responsible for archiving the trial master file.

Site Trial File

 

ü

 

 

 

Service provider will be responsible to insure the site trial file is complete at all times during the study. The Service provider will be responsible to reconcile the site file against the trial master file site file.

Investigator Site Payments

 

ü

 

 

 

Service provider will be responsible for all site payments.

Essential Document Collection

 

ü

 

 

 

Service provider will be responsible to collect and file all required GCP Essential Documents. The Essential Documents will be part of the trial master file.

Printing Study Documents

 

ü

 

 

 

Service provider will be responsible to print or contract printing services for all study documents for sites and patients.

Labs

 

 

 

 

 

 

Central or Local Safety Labs

 

ü

 

 

 

Service provider will be responsible for the central and safety lab vendor contracting, management, payments, sampling of patient samples, and reporting of sample results.

Central/Safety/Bone Marker Labs Data Reporting (SI Units)

 

ü

 

 

 

Service provider will be responsible for the transfer specification and transfer of lab data from the central labs. Service provider will be responsible for validating the transfer and reconciling the

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

lab data with the study database.

Abnormal lab value flags

 

ü

 

A

 

Service provider will be responsible for creating flags for abnormal lab values. Sponsor will be responsible for the approval of the lab value flags.

Lab Specimen Management, Shipping & Reconciliation

 

ü

 

 

 

Service provider will be responsible for lab sample management, shipping, storage, and reconciliation.

Lab Manual

 

ü

 

A

 

Service provider will be responsible to develop a lab manual with lab collection, handling, and shipping instructions for distribution to the site. The Sponsor will be responsible to approve the lab manual prior to study start.

Lab Kits & Supplies

 

ü

 

 

 

Service provider will be responsible to provide the lab kits and supplies to the study sites.

Lab Sample Storage

 

ü

 

 

 

Service provider will be responsible for storage of lab samples until all lab data are final and reported.

Lab Sample Destruction

 

ü

 

A

 

Service provider will be responsible for destroying lab samples. Sponsor approval is required prior to destroying any lab samples.

Bone Marker Analysis & Data Reporting

 

ü

 

 

 

Service provider is responsible for the bone marker sample analysis and data reporting. The data transfer will be validated and reconciled with the study database.

PK & PK Data Reporting

 

ü (sample collection & delivery)

 

ü (analysis and reporting)

 

Sponsor will be responsible for PK sampling and data reporting.

Antibody (including NAbs) analysis & Data Reporting

 

 

 

ü

 

Sponsor will be responsible for Anti-drug antibody and neutralizing antibody sampling and data reporting.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Data Management

 

 

 

 

 

 

Data management plan

 

ü

 

A

 

Service provider will be responsible to create the Data Management Plan for the study upon approval of the CRF. Sponsor will be required to approve the plan before first patient first visit.

Annotated Case Report Form

 

 

 

ü

 

Sponsor will be responsible to create the Annotated Case Report Forms based on CDISC SDTM. .

CRF

 

A

 

ü

 

Service provider will be responsible to create the Case Report Forms for data entry. Sponsor will be required to approve the CRF during the eCRF user acceptance tests (eCRF screen review meetings).

CRF Completion Instructions

 

ü

 

 

 

Service provider will be responsible to create the CRF completion instructions and distribute to the study sites. Sponsor will be required to approve the CRF completion instructions prior to site distribution.

Data validation checks

 

ü

 

ü

 

Service provider will be responsible to create the data entry data validation checks. The data validation checks will be provided for Sponsor review.

Database Development, Testing, and Validation

 

R

 

ü

 

Service provider will be responsible for database development, testing, and validation in compliance with 21 CFR Part 11. BioClinica is responsible for the EDC database. Nordic saves the output files from this database. Nordic Bioscience will “only” do user acceptances testing of the EDC system not validating the EDC database.

EDC System User Acceptance Testing

 

ü

 

 

 

Service provider will be responsible for user acceptance testing the EDC system before it is release for production environment. Changes to the EDC system

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

during the study must be tested before released to production

Data Cleaning & Query Management

 

ü

 

R

 

Service provider will be responsible to manage the study data collection, data cleaning, and query management process.

Double Data Entry

 

NA

 

 

 

For paper-based CRFs, Service provider will be responsible to double data enter the CRF data into the study database.

Data Transfers Specifications

 

ü

 

ü

 

Service provider will be responsible to create the data transfer specifications for all data collected outside the study database from third party vendors. The data transfer specification will be provided for Sponsor review.

Data Transfers & Merge

 

ü

 

ü

 

Service provider will be responsible to collect and validate the external data transfer and merge the datasets into the study database. The data transfer specification will be provided for Sponsor : BioClinica is responsible for the EDC database. Nordic saves the output files from this database. Nordic Bioscience will “only” do user acceptances testing of the EDC system not validating the EDC database.review.

DSMB Data Preparation & Transfer

 

ü

 

ü

 

Service provider will be responsible to prepare for a DSMB meeting to clean the data and manage the queries and prepare a database transfer to the Sponsor’s statistician. The database transfer specification will be provided to the Sponsor for approval prior to the first data transfer.

Data Listings for Medical & Sponsor Review

 

ü

 

R

 

Service provider will be responsible to generate data listings for Medical and Sponsor Review during the study. The data listings will include: Reasons for Enrollment Failure (during screening; data will come from IVRS), Baseline

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

Demographics (during screening), Adverse Events (monthly), Concomitant Medications (monthly), Study Drug Administration (monthly), , Abnormal Labs (monthly), Elevated Calcium (3 monthly monthly).

Data Coding (MeDRA, WHO Drug)

 

ü

 

A

 

Service provider will be responsible to code all Adverse Events, Medical History and Concomitant Medications with MeDRA and WHO Drug. Sponsor will be responsible to approve the coding of events and medications appropriately.

eCRF and Query Tracking

 

ü

 

 

 

Service provider will be responsible to manage and track site compliance with data entry by tracking CRFs and queries.

SAE Database Reconciliation

 

ü

 

ü

 

Sponsor and Service provider will be responsible to perform a reconciliation of the events in the safety and trial database. Service provider will perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock. The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Local Tolerance Diary

 

A

 

ü

 

The Sponsor will be responsible to create the Local Tolerance Diary.

Drug Compliance Diary

 

A

 

ü

 

The Sponsor will be responsible to create the Drug Compliance Diary.

Patient CRFs for CSR (SAE or AE Discontinued)

 

ü

 

 

 

Service provider will be responsible to generate copies of the entire individual patient case report forms for all patients who had a serious adverse event or discontinued due to adverse event.

Investigator Signoff of Patient eCRF

 

ü

 

 

 

Service provider will be responsible to insure that the investigator has signed off on the patient case report forms that the data are reviewed and accurate.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Blinded Data Review Meeting with Sponsor

 

ü

 

A

 

Service provider will be responsible to provide the Sponsor with a completed database for blinded data review prior to database lock. Sponsor will be required to review and approve the database and data prior to database lock.

Database Lock

 

ü

 

A

 

Service provider will be responsible to lock the study database. Sponsor will be required to review and approve all changes or queries generated during the blinded study review meeting have been resolved and the database can be locked.

Data Transfer to Sponsor

 

ü

 

 

 

Service provider will be responsible to transfer the study data and database to the sponsor.

Data Archiving & PDF

 

ü

 

 

 

Service provider will be responsible to generate data and PDF for archiving. Service provider will be responsible to provide each study center a data archive for the sites’ patients.

Safety & Pharmacovigilance

 

 

 

 

 

 

Safety Monitor

 

ü

 

A

 

Service provider will be responsible to provide a Safety Monitor Medical Director to oversee and report on any serious adverse event.

Safety Plan

 

ü

 

A

 

Service provider will be responsible to develop a safety plan that documents the safety reporting process and health authority submission responsibilities.

Safety Reporting Database

 

ü

 

ü

 

Service provider will be responsible to enter serious adverse events data in a validated 21 CFR Part 11 compliant database provided by Sponsor.

SAE Site Reporting Form

 

ü

 

A

 

Service provider will be responsible to provide an SAE reporting form at the start of the study. This form will capture all the necessary reporting information requiring for submitting a CIOMS form

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

to the Health Authorities. Sponsor will be responsible to approve the SAE reporting form.

ICSR CIOMS Initial & Follow up Forms

 

ü

 

A

 

Service provider will be responsible to complete the CIOMS form for all initial and follow up Suspected Unexpected Serious Adverse Event

ICSR Tracking of Health Authority filings

 

ü

 

R

 

Service provider will be responsible to create a tracking tool for all reported serious adverse events and report status (i.e., initial, follow up, dates of submission). Study Safety Officer is responsible for performing routine review of AEs and SAEs and performing an analysis of similar events.

Serious Adverse Event Narrative

 

ü

 

ü

 

Sponsor and Service provider will be responsible to create the SAE narrative for reporting in the CIOMS and providing to the Medical Writer for the clinical study report. Sponsor is responsible for reviewing and approving the SAE narrative prior to approving the CIOMS for submission.

DSUR; Annual & Periodic Safety Update Generation & Filing

 

ü

 

ü

 

Sponsor is responsible for creating the DSUR and will submit it to the FDA. Service provider will be responsible to submit it to all other Health Authorities.

Health Authority Reporting

 

ü

 

ü

 

Sponsor will be responsible to submit SAE CIOMS Initial and Follow up to the FDA. Service provider will be responsible to submit the CIOMS Initial and Follow up to all other Health Authorities. Reports are required to be made within 7 or 15 days depending on the type of SAE identified in the Safety Plan.

SAE CIOMS Site Distribution

 

ü

 

 

 

Service provider will be responsible to notify the sites and distribute the CIOMS forms to the sites for reporting to local

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

 

 

 

 

 

 

ethics, as required.

SAE Reconciliation with Data Management

 

ü

 

ü

 

Sponsor and Service provider will be responsible to perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock. The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Final Safety Report for HA, EC, IRB submission

 

ü

 

ü

 

Sponsor and Service provider will be responsible to create the final safety report at the end of the study, as part of the CSR. Sponsor will submit final safety report to FDA and NB to other HAs and ECs.

Statistics

 

 

 

 

 

 

Randomization Scheme

 

 

 

ü

 

Sponsor’s statistician will be responsible to create and maintain the randomization scheme only unblinding after database lock.

Statistical Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the Statistical Analysis Plan (SAP) prior to database lock.

Statistical Programming

 

 

 

ü

 

Sponsor’s statistician and statistical programmer will be responsible to develop the statistical programming for the analyses and TLFs

TLF Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate all tables, listings, and figures for the study.

Data Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to perform the study analyses.

DSMB Table Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the required tables and data for the DSMB.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Population PK Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the PopPK analysis plan prior to database lock.

Population PK Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the programming and analyses for the Population PK analysis.

Medical Writing

 

 

 

 

 

 

Clinical Study Report

 

 

 

ü

 

Sponsor’s Medical Writer will be responsible to write the clinical study report

CSR Narratives (SAE, AE Discontinuation)

 

ü

 

ü

 

Service provider’s Safety & Pharmacovigilance group will be responsible for generation the CIOMS forms during the clinical study. The Sponsor’s Medical Writer will be responsible for incorporating the narratives into the CSR.

Quality

 

 

 

 

 

 

CRO Qualification

 

 

 

ü

 

Sponsor will be responsible for qualification of the Service provider.

CRO GCP and systems audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct Service provider GCP and systems audits.

Third party qualification and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct qualifications and audits for third party vendors.

Investigator site audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct investigator site audits.

Health Authority inspections/audits

 

ü

 

ü

 

In the event of an Health Authority inspection of the Service provider or sites, the Service provider and Sponsor will be responsible for assisting with the inspection, providing responses to inspector requests, and drafting follow up responses to the inspection inquiries.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner

A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius

 

Expectation

Clinical trial documents review and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to review and/or audit the Service provider’s clinical trial documents (i.e., trial master files).

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment D

 

Core Team Members/Key Personnel

 

The following core team members will conduct the services listed in Attachment A.

 

Sponsor will be notified of any changes to the core team member.

 

 

 

 

 

Study Safety Officer

 

Bente Juel Riis

[*]

Clinical Trial Leader

 

Jeppe Ragnar Andersen

[*]

Clinical Trial Manager

 

Morten Thorup Pedersen

[*]

Pharmacovigilance Manager

 

Bodil Simonsen

[*]

Clinical Data Managers

 

Henrik Bo Hansen

[*]

 

 

Ole Eskildsen

[*]

Statistical Advisor

 

Inger Byrjalsen

[*]

Medical Coder

 

Lisbeth Heiden

[*]

Head of Central Laboratory

 

Per Qvist

[*]

Clinical Regulatory Coordinator

 

Lisa Thomsen

[*]

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment E

 

Protocol title and date

 

BA058-05-007 “A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis”, Dated 24 May 2012

 

BA058-05-007 Protocol Version 2, 24May2012

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

CLINICAL STUDY PROTOCOL

 

A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Study of BA058 Administered via a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis

 

This study will be conducted according to the protocol and in compliance with Good Clinical Practice, the ethical principles stated in the Declaration of Helsinki, and other applicable regulatory requirements.

 

Protocol Number:

 

Protocol BA058-05-007

 

 

 

EudraCT Number:

 

2012-001921-29

 

 

 

Protocol Date (Version):

 

24 May 2012 (Version 2.0)

3 May 2012 (Version 1.0)

 

 

 

Study Sponsor:

 

Radius Health, Inc.

201 Broadway Street, 6 th  Floor

Cambridge, MA 02139, USA

Tel: 617.551.4700. Fax: 617.551.4701

 

 

 

Sponsor Medical Monitor:

 

Louis Brenner, MD

Chief Medical Officer, Radius Health, Inc.

Tel: 617.551.4006. Fax: 617.551.4701.

Email: [*]

 

 

 

Safety Officer

 

Bente Juel Riis, MD

Medical Advisor, Nordic Bioscience A/S

Tel: +45 22 90 13 17. Fax: +41 91 970 2988

Email: [*]

 

 

 

Contract Research Organization (CRO):

 

Nordic Bioscience A/S

Herlev Hovedgade 207

2730 Herlev, Denmark

Tel: +45 4452 5252. Fax: +45 4452 5251

 

 

 

Study Site:

 

Multi-center

 

Disclosure Statement:  This document contains information that is confidential and proprietary to Radius Health, Incorporated (Radius Health).  This information is being provided to you solely for the purpose of

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

evaluation and/or conducting a clinical trial for Radius Health.  You may disclose the contents of this document only to study personnel under your supervision and/or to your institutional review board(s) or ethics committee(s) who need to know the contents for this purpose and who have been advised on the confidential nature of the document.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

PROTOCOL SYNOPSIS

 

Title:   A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered via a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis

 

Protocol Number:   BA058-05-007

 

Phase: 2

 

Test Drug:   BA058 Transdermal

 

Study Objectives

 

The overall objectives of this study are to determine the clinical safety and efficacy of BA058 Transdermal in otherwise healthy postmenopausal women with osteoporosis as assessed by changes in bone mineral density (BMD) and serum markers of bone metabolism when compared to Transdermal Placebo and BA058 Injection (subcutaneous or SC).

 

The specific objectives are to:

 

·                   Determine the effects of six months of treatment with BA058 Transdermal on changes in lumbar spine BMD in otherwise healthy postmenopausal women with osteoporosis when compared to placebo.

 

·                   Determine the effects of six months of treatment with BA058 Transdermal on changes in hip and forearm BMD in otherwise healthy postmenopausal women with osteoporosis when compared to placebo.

 

·                   Determine the effects of six months of treatment with BA058 Transdermal on serum markers of bone formation and resorption in otherwise healthy postmenopausal women with osteoporosis when compared to placebo.

 

·                   Determine the pharmacokinetics, efficacy and safety of BA058 Transdermal when compared to BA058 Injection (SC).

 

·                   Determine the safety and tolerability of six months of dosing with BA058 Transdermal in otherwise healthy postmenopausal women with osteoporosis.

 

·                   Select a dose level of BA058 Transdermal for further clinical evaluation based upon BA058 Injection (SC) as a reference drug.

 

Study Population

 

Inclusion Criteria

 

Subjects must meet all of the following criteria to be eligible to participate in this study.

 

·                   The subject is a healthy ambulatory postmenopausal woman, not older than 85 years of age, with osteoporosis.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

·                   The subject has been postmenopausal for at least 5 years.  Postmenopausal status will be established by a history of amenorrhea for at least 5 years or documentation of surgically induced menopause.

·                   The subject has a BMD T-score <  -2.5 at the lumbar spine or hip (femoral neck) by dual energy x-ray absorptiometry (DXA).(1)

·                   Subjects may also be included if they have a BMD T-score of < -2.0 and a prior low-trauma forearm, humerus, vertebral, sacral, pelvic, hip, femoral, or tibial fracture within the past 5 years, or who have an additional risk factor such as age 65 to 85, or a strong maternal history of osteoporosis defined as a fracture related to osteoporosis or a diagnosis of osteoporosis.

·                   The subject is in good general health as determined by medical history and physical examination (including vital signs), has a body mass index (BMI) of 18.5 to 33, inclusive (refer to Appendix 14.3) and is without evidence of clinically significant medical abnormality in the opinion of the Investigator.

·                   The subject has serum calcium (albumin-corrected), PTH (1-84), serum phosphorus and alkaline phosphatase values all within the normal range during the Screening Period.  Subjects with minor elevations or reductions in serum calcium may be enrolled if serum ionized calcium is normal. Any subject with an elevated alkaline phosphatase value, and who meets all other entry criteria, would be required to have a normal bone-specific alkaline phosphatase result to be enrolled.

·                   The subject has a serum 25-hydroxy vitamin D value >15 ng/mL (37.4 nmol/L) and within 3 times the upper normal range.

·                   The subject’s resting 12-lead electrocardiogram obtained during screening shows no clinically significant abnormality and a QTc < 470 msec (Bazett’s correction).

·                   The subject’s systolic blood pressure is > 100 and < 155 mmHg, diastolic blood pressure is > 40 and < 95 mmHg, and heart rate is > 45 and < 100 bpm.

·                   The subject has no clinically significant abnormality of serum hemoglobin, hematocrit, WBC and platelets, or serum biochemistry: electrolytes, renal function, liver function and serum proteins.

·                   The subject has read, understood, and signed the written informed consent form and is capable of complying with the protocol requirements.

 

Exclusion Criteria

 

Subjects with any of the following characteristics will not be eligible to participate in the study.

 

General exclusion criteria:

 

·                   The subject has a BMD T-score <  -5.0 at the lumbar spine or hip (femoral neck).

·                   Presence of abnormalities of the lumbar spine that would prohibit assessment of spinal BMD, defined as having at least 2 of the 4 vertebrae within L1-L4 radiologically unevaluable.

 


(1)  DXA examinations that are up to three months old at screening using the appropriate equipment may be used as the baseline scan.  Eligibility will be determined using the actual BMD values in g/cm 2 .

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

·                   Unevaluable hip BMD or subjects who have undergone bilateral hip replacement (unilateral hip replacement is acceptable).

·                   History of bone disorders (e.g., Paget’s disease) other than postmenopausal osteoporosis.

·                   History of previous chronic radiotherapy (radiation therapy) other than radioiodine.

·                   History of chronic or recurrent renal, hepatic, pulmonary, allergic, dermatologic, cardiovascular, gastrointestinal, endocrine, central nervous system, hematologic or metabolic diseases, or immunologic, emotional and/or psychiatric disturbances to a degree that in the opinion of the investigator would interfere with the interpretation of study data or compromise the safety of the subject.

·                   History of significantly impaired renal function (serum creatinine >177 µmol/L or >2.0 mg/dL).  If the serum creatinine is >1.5 and < 2.0 mg/dL (>0.13 and < 0.18 mmol/L), the calculated creatinine clearance (Cockcroft-Gault) must be > 37 mL/min.

·                   History of any cancer within the past 5 years (other than basal cell or squamous cancer of the skin).

·                   History of osteosarcoma at any time.

·                   History of nephrolithiasis or urolithiasis within the past five years.

·                   Decrease of 20 mmHg or more in systolic blood pressure or 10 mmHg or more in diastolic blood pressure from supine to standing (5 minutes lying and 3 minutes standing) and/or any symptomatic hypotension at screening

·                   Subjects known to be positive for Hepatitis B, Hepatitis C, HIV-1 or HIV-2.  Testing is not required in the absence of clinical signs and symptoms suggestive of HIV infection or acute or chronic hepatitis.

 

Medication-related exclusion criteria:

 

·                   Known history of hypersensitivity to any of the test materials or related compounds.

·                   Prior treatment with PTH or PTHrP drugs, including BA058.

·                   Prior treatment with bisphosphonates or strontium in the past five years, or prior treatment with gallium nitrate, or with a bone-acting investigational agent at any time.  Subjects who have had a short course of bisphosphonate treatment (3 months or less) and/or were intolerant of the treatment are not excluded from study participation.

·                   Prior treatment with denosumab, calcitonin, SERMs (such as raloxifene or tamoxifen), tibolone, or anabolic steroids in the past 12 months.  Estrogens administered as hormone replacement therapy (HRT), with or without progestins, are not exclusionary as long as a steady dose is maintained.

·                   Treatments with anticonvulsants that affect vitamin D metabolism (phenobarbital, carbamazepine or primidone) or with chronic heparin within the 6 months prior to the Screening Period.

·                   Daily treatment with oral, intranasal or inhaled corticosteroids above the equivalent of 5 mg oral prednisone one per day within the 12 months prior to the Screening Period.  Occasional use of corticosteroids ( < 3 months for seasonal allergies or asthma) is not exclusionary.

·                   Exposure to general anesthesia within the four weeks prior to the Screening Period.

·                   Exposure to an investigational drug within the 12 months prior to the Screening Period.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Lifestyle-related exclusion criteria:

 

·                   Abnormal nutritional status (abnormal diets, excessive or unusual vitamin or herbal intakes, malabsorption, significant recent weight change), vitamin D intake of > 4,000 IU/day or vitamin A intake of > 10,000 IU/day.

·                   Subject is known to abuse alcohol or use illegal drugs within 12 months of the Screening Period.

 

Study Design and Methodology

 

Number of Subjects

 

A total of 240 subjects are planned to be enrolled in the study in up to 15 medical centers.

 

Design

 

This study is designed as a randomized, double-blind, placebo- controlled, dose-finding study of BA058 Transdermal in four dose presentations (including placebo) for the treatment of postmenopausal women with osteoporosis, using BA058 Injection (SC) at a dose of 80 µg as a reference drug for optimal Transdermal dose selection for future development.

 

A total of 240 eligible subjects will be randomized equally to receive one of five treatment regimens.  BA058 Transdermal at daily doses of 0 µg (Transdermal Placebo), 50 µg, 100 µg and 150 µg with a wear time of five minutes, or BA058 Injection (SC) each administered daily for six months.  All study medication will be administered to the periumbilical region.

 

Treatment with BA058 Transdermal or Transdermal Placebo will remain blinded to all parties throughout the study.  Because BA058 Injection (SC) is administered subcutaneously rather than transdermally this treatment arm will not be blinded. However, centralized readers of the dual energy x-ray absorptiometry (DXA) results will be blinded to treatment assignment as will the results of bone marker analysis.

 

The randomization will be managed by an interactive voice/web response system (IVR/IWR).  Following training by the site personnel, study medication will be self-administered by the subject daily for a six month period.  Subjects unable to self-administer the study medication may be dosed by a third party after appropriate training of that person by the study site personnel.

 

Subjects who remain eligible for study participation will be randomized on Day 1 to treatment in one of the five treatment regimens shown in Table 1, below.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Treatment
Group

 

Study
Medication

 

Daily 
Dose

 

Route of
Administration

 

Wear
time

 

No. of
Subjects

1

 

Transdermal Placebo

 

0 µg

 

Transdermal

 

5 minutes

 

48

2

 

BA058 Transdermal

 

50 µg

 

Transdermal

 

5 minutes

 

48

3

 

BA058 Transdermal

 

100 µg

 

Transdermal

 

5 minutes

 

48

4

 

BA058 Transdermal

 

150 µg

 

Transdermal

 

5 minutes

 

48

5

 

BA058 Injection (SC)

 

80 µg

 

Subcutaneous

 

N/A

 

48

Table 1

 

 

 

 

 

 

 

 

 

Total

240

 

Study Visits

 

The study consists of a Screening Period, a Pretreatment Period, a Treatment Period and a Follow-up Period.  The study periods are summarized in Table 2, below.

 

Table 2

 

Study
Period

 

Duration of
Study
Period*

 

Scheduled
Visits (#)

 

Study
Treatment

Screening

 

Up to 2 months

 

1-2

 

None (vitamin D in subjects with low vitamin D at baseline)

Pretreatment

 

Up to 2 weeks

 

1

 

Vitamin D and calcium

Treatment

 

6 months

 

8

 

Vitamin D, calcium, Study Medication

Follow-up

 

1 month

 

1

 

Vitamin D and calcium

Total

 

9-10 months

 

11-12

 

 

 


* For the purposes of this study one month is equal to 30 days.

 

The first self-administration of study medication is to occur at the clinical site under observation.  On the days of clinic visits, study medication must be administered in the clinic to accommodate pre- and post-administration procedures.  In addition, on days of clinic visits, study personnel will evaluate the application/injection site and patch adhesion (if applicable) using the same scales used by the subject.  This information is to be entered into the e-CRF and source documents.  Upon the removal of the transdermal patch on the days of clinic visits, the used patch will be carefully replaced into the collar assembly using minimal manipulation and will be frozen (-20ºC) for return to the manufacturer (3M, St. Paul MN) for further inspection and analysis (Refer to the study operations manual for detailed instructions).  On the days when study medication is administered in the subject’s home, the subject is to dispose of the used patch in a

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

sharps container and maintain the foil pouch for return to the study center for accountability purposes.  Subjects randomized to the BA058 Injection arm should bring their used and unused BA058 Injection cartridges to each clinic visit for accountability purposes.

 

Procedures and Assessments

 

Complete details of the study assessments are provided in Section 7.0 and Appendix 14.1.  Appendix 14.2 provides a detailed list of activities for each study visit.

 

Safety

 

Safety evaluations include physical examinations, vital signs, 12-lead ECGs, clinical laboratory tests and monitoring and recording of adverse events.  Transdermal patch application and subcutaneous injection sites will be graded to assess local tolerance to study medication.

 

The occurrence of anti-drug antibodies will be assessed at the completion of the study.  Serum samples will be drawn on Day 1 and Month 6, and additional samples will be collected at Month 1 and Month 3 and retained for assay as needed in those subjects whose samples are confirmed positive for the presence of anti-BA058 antibodies(2) based on the 6 Month sample.  Subjects who test positive will be retested at 6 months and again at 12 months post-study completion under a separate Safety Surveillance protocol.

 

Pharmacodynamics

 

BMD will be measured by DXA during Screening (hip [femoral neck] and spine), Day 1 (wrist) and during the Treatment Period at Month 3 and Month 6 (lumbar spine, hip [femoral neck] and wrist).

 

The bone formation markers N-terminal propeptide of type 1 procollagen (PINP), C-terminal propeptide of type 1 procollagen (PICP), bone specific alkaline phosphatase (BSAP) and serum osteocalcin) will be assessed by analysis of blood samples.  Serum C-telopeptides of type 1 collagen (CTXI) a marker of bone resorption will also be measured and reported.  Bone markers will be assessed at Day 1, Month 1, Month 3 and Month 6.

 

Pharmacokinetic (PK) Analysis

 

All subjects (both transdermal and subcutaneous) will have BA058 trough levels drawn prior to dosing on Day 1, Day 8 and Month 3.  BA058 peak levels will be drawn at 10 and 20 minutes post dose on Day 1, Day 8 and Month 3.

 

Treatments Administered

 

If not already taking calcium and vitamin D supplements at the time of screening, each subject will also begin taking Vitamin D and calcium supplements at the start of the Pretreatment Period

 


(2)  The samples will be retained on site or shipped to the centralized facility.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

and will continue throughout the Follow-up Period.  Supplements will be provided by the study site.

 

BA058 is an analog of the first 34 amino acids of human Parathyroid hormone related peptide (hPTHrP[1-34]).  BA058 Transdermal (50 µg, 100 µg and 150 µg) and Transdermal Placebo (0µg) will be supplied as individually packaged coated transdermal arrays attached to a self-adhesive backing and mounted in a supportive cylindrical collar for use with the supplied applicator.  All transdermal patches are supplied as identical presentations individually packaged for once-daily self-application.  BA058 Injection will be supplied as a multi-dose cartridge for use with a pen injector.  Further details for BA058 Transdermal, the BA058 Transdermal Placebo and BA058 Injection are provided in Section 5.0.

 

Endpoints and Data Analysis

 

Demographics and baseline characteristics of the subject population will be summarized.  Treatment groups will be assessed for uniformity at baseline (baseline characteristics, medical history, physical examination, vital signs, ECG and parathyroid hormone [PTH] level).

 

The efficacy endpoints to be assessed are:

 

·                   Change in BMD across 6 months of treatment;

 

·                   Changes in levels of PINP, PICP, BSAP, osteocalcin and CTXI across 6 months of treatment.

 

Safety analyses will include the incidence and severity of adverse events by treatment, dose and cumulative exposure and pathological changes in hematology, chemistry and urinalysis data.  Serum calcium and phosphate will be measured 4 hours post-dose at study visits occurring on Day 1, Day 8, Month 1, Month 2, Month 3, Month 4 and Month 5.

 

Changes in physical examination, vital signs, ECG and clinical laboratory will be descriptively summarized.  Laboratory tests will be classified as low range, normal range, or high range and shift frequencies summarized between the Baseline result and the End of Treatment Visit.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Optimal Dose Selection

 

Following formal analysis of the efficacy and safety data of the study, the dose(s) to be carried forward into further development of BA058 Transdermal will be determined on the basis of the following considerations:

 

·                   Efficacy as assessed by analysis of changes in vertebral BMD

 

·                   Efficacy as assessed by analysis of serum anabolic bone markers

 

·                   Safety as assessed by serious adverse event frequency or occurrence of other adverse events of concern; including the relative frequency of hypercalcemia

 

·                   Overall risk: benefit profile as determined by the integrated assessment of the above safety and efficacy parameters.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment F

 

Reports and Information Management/Regular Meetings

 

The Project Committee for Work Statement NB-2 shall be composed of the following members from Radius and the following members from NB:

 

Radius Members:  (1) Nicholas Harvey, (2) Louis Brenner and (3) Michael Wyzga.

 

NB Members:  (1) Bente Juel Riis and (2) Claus Christiansen.

 

The Committee will meet on the telephone when needed and in person when appropriate.

 



 

Work Statement NB-2

 

Attachment G

 

Special Insurance

 

Radius will maintain insurance with respect to the following jurisdictions during the conduct of the clinical study that is the subject of Work Statement NB-2.

 

 

 

 

 

 

 

Local Policy

 

Local Policy

 

Primary Policy Limit

 

Country

 

Protocol

 

Policy Period

 

Limit

 

Sublimit

 

(Aggregate)

 

 

MASTER US POLICY

 

 

 

January 30, 2013 - January 30, 2014

 

$

10,000,000

 

N/A

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DENMARK

 

BA058-05-007

 

May 15, 2012 - November 15, 2013

 

5,000,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ESTONIA

 

BA058-05-007

 

May 15, 2012 - November 15, 2013

 

5,000,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLAND

 

BA058-05-007

 

May 15, 2012 - November 15, 2013

 

4,000,000

 

NONE

 

$

10,000,000

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-2

 

Attachment H

 

Transfer of Obligation

 

See Work Statement NB-2 Attachment C.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Attachment I

 

Form of Enterprise CTA

 

CLINICAL TRIAL AGREEMENT WITH INVESTIGATOR

 

Protocol No. BA058-05-007

 

This Clinical Trial Agreement (“Agreement”) is entered into by and among CENTER FOR CLINICAL AND BASIC RESEARCH A/S, Telegrafvej 4, 1, 2750 Ballerup, Denmark (“CCBR”) on behalf of itself and its ten [affiliated][controlled] Clinical Study Sites listed below and Nordic Bioscience A/S, Herlev Hovedgade 207, 2730 Herlev , Denmark (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Sponsor”) concerning:

 

BA058-05-007 “A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Presented as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis” which will guide the performance of the Study, has been prepared by Radius and Nordic Bioscience and accepted by the Clinical Study Sites.

 

CCBR has the legal authority to bind the following clinical study sites (the “Clinical Study Site(s)”):

 

1.                         CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

 

2.                         CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

 

3.                         CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

 

4.                         CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

 

5.                         CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

 

6.                         CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

 

7.                         CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

 

8.                         CCBR-Sao Paolo, Avenida Indianópolis nº 1005, Moema. São Paulo - SP - ZIP CODE: 04063-002

 

9.                         CCBR-Pardubuce, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

 

10.                  CCBR-Brno, Hybešova 18, 60200 Brno, Czech Republic

 

11.                  CCBR-Prague, Vinohradská 1597/174 Praha 3 — Vinohrady 130 00 Czech Republic

 

12.                  CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

 

13.                  CCBR-Lodz, Al Pilsudskiego 9 90-368 Lodz Poland

 

14.                  CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Kong

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

15.        CCBR-Buenos Aires, Fitz Roy 2468 1st floor Buenos Aires, Argentina

 

WHEREAS, the Clinical Study Sites each employ a Principal Investigator and are willing to conduct a clinical trial (the “Study”), in accordance with the above-referenced Protocol and Nordic Bioscience requests each Clinical Study Site to undertake such Study;

 

NOW THEREFORE, the parties agree as follows:

 

1.                     SCOPE OF WORK

 

Nordic Bioscience hereby appoints each of the Clinical Study Sites to conduct the Study, and each of the Clinical Study Sites, each having a Principal Investigator who is an employee of such Clinical Study Site, undertakes that such Clinical Study Site’s employees, agents, and staff shall carry out the Study in a professional, competent manner in accordance with the terms of the Protocol and this Agreement. Each of the Clinical Study Sites hereby confirms that it has enough time and resources to perform the Study according to the highest quality standards.

 

The Principal Investigators shall each review all case report forms (“CRFs”) for Study subjects enrolled at the applicable Clinical Study Site to ensure their accuracy and completeness, shall review and understand the information in the investigator’s brochure, shall ensure that all informed consent requirements are met, and shall ensure that all required reviews and approvals (or favorable opinions) by applicable regulatory authorities and Independent Ethics Committees (“ECs”) are obtained. The Clinical Study Sites and the Principal Investigators shall each ensure that all clinical data are accurate, complete, and legible.

 

2.                     PERFORMANCE PERIOD AND ENROLLMENT OF STUDY SUBJECTS

 

The Study will commence upon execution of this Agreement and will continue until completion of the Study as required by the Protocol (including any amendments thereto), unless this Agreement is terminated earlier pursuant to Section 14 hereof.

 

The Study will involve the enrollment and completion of a maximum of Two Hundred Forty (240) evaluable study subjects meeting all Protocol eligibility requirements and protocol procedures (the “Study subjects”). Nordic Bioscience shall not be obligated to pay any sums for tests performed on Study subjects who do not meet all Protocol eligibility criteria or for additional study subjects who are enrolled in the Study without Nordic Bioscience’s prior written approval.

 

Nordic Bioscience will close study subject enrollment into the Study when the Protocol-specified target number of study subjects have been enrolled at all Clinical Study Sites. Therefore, study subject enrollment into the Study may be closed before a specified number of study subjects have been enrolled at any particular Clinical Study Site.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Nordic Bioscience will provide financial support for the Study conducted at the Clinical Study Sites according to the terms specified in Schedule A.

 

3.                     DATA

 

Sponsor shall own all data and work product relating to the Study, including all CRF’s, data, documentation, information, materials and results in whatever form generated during the conduct of the Study. Each of the Clinical Study Sites and/or the Principal Investigators shall ascertain that it may store data in a computerized form and also that it is entitled to transfer all such computerized data to Nordic Bioscience. Each of the Clinical Study Sites may use the data and work product it generates under this Agreement solely for purposes of performing the Study in accordance with the terms of this Agreement.  Each of the Clinical Study Sites and/or the Principal Investigators shall promptly and fully produce all data, records and information relating to the Study to Nordic Bioscience and the Sponsor and their representatives during normal business hours, and shall assist them in promptly resolving any questions and in performing audits or reviews of original subject records, reports, or data sources. Each of the Clinical Study Site agrees to cooperate with the representatives of Nordic Bioscience and Sponsor who visit the Clinical Study Site.

 

4.                     COST AND PAYMENT

 

Cost and payment terms are set forth in Schedule A attached to this Agreement and incorporated herein by reference. Each of the Clinical Study Sites agrees to provide Nordic Bioscience with all requests for payment under the terms set forth in Schedule A within six (6) months of Study completion by Clinical Study Sites under the terms of this Agreement. Nordic Bioscience shall not be obligated to make any payments to Clinical Study Sites after this six (6) month period has expired.  Study completion is defined herein as Nordic Bioscience has received all data and no further follow up is necessary with the Clinical Study Sites.

 

5.                     CONFIDENTIAL INFORMATION

 

During the term of this Agreement and for a period of five (5) years after completion of the Study, the Clinical Study Sites and the Principal Investigators shall not disclose or use for any purpose other than performance of the Study, all information (including but not limited to the terms of this Agreement, the Protocol, CRF’s, and any secrets, know-how, privileged records or other confidential or proprietary information and data disclosed to the Clinical Study Sites), and materials (including, but not limited to, the Study Drug and comparator products), provided to the Clinical Study Site by Nordic Bioscience, Sponsor, or their agents, and all data, reports and information, relating to the Study or its progress developed by the Clinical Study Sites and/or the Principal Investigator under this Agreement (the “Confidential Information”). Sponsor shall own the Confidential Information.  The Clinical Study Sites and the Principal Investigators shall keep the Confidential Information strictly confidential and shall disclose it only to those personnel involved in conducting the Study on a need-to-know basis. These confidentiality obligations shall not apply to Confidential Information to the extent that it: (a) is or becomes publicly available through no fault of the Clinical Study Site; (b) is disclosed to the Clinical Study Site by a third party not subject to any obligation of confidence; (c) must be disclosed to ECs, or applicable regulatory authorities; (d) must be included in any subject’s informed consent form; (e) is published in accordance with Section 6; or (f) is required to be disclosed by applicable law.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

6.                     PUBLICATIONS

 

6.1.                             Any and all results of the Study shall be the sole property of Sponsor.  Sponsor will have the right to use the results of the Study in any manner deemed appropriate to Sponsor’s business interest and Sponsor and Nordic Bioscience will each have the right to report the names of the Clinical Study Sites as required by law or governmental regulation. Neither Sponsor nor any party to this Agreement, however, will use another party’s (or Sponsor’s) name in advertising, promotions, or other commercial material without the other party’s (or Sponsor’s) express written permission, except that Nordic Bioscience and Sponsor may quote from and/or reference any publications resulting from the Study authored by, or reviewed and approved by the Clinical Study Sites.

 

6.2.                             It is the intention to publish the Study results in scientific journals.  Any publication of Study results or data shall be made in accordance with the provisions of Section  11.2 of the Protocol.

 

7.                     LICENSE

 

7.1.                             Each Clinical Study Site and Principal Investigator acknowledges that Sponsor owns all proprietary and intellectual property rights in the Study Drug and the related materials being provided to the Principal Investigator and the Clinical Study Site pursuant to this Agreement, including but not limited to the Protocol and the CRF’s produced in the performance of the Study (collectively, “Sponsor Technology”).  Each Clinical Study Site and Principal Investigator agrees to take no action inconsistent with Sponsor’s ownership of such proprietary and intellectual property rights.  It is agreed that neither Nordic Bioscience (including Sponsor) nor the Clinical Study Sites transfers to the other by operation of this Agreement any patent right, copyright right, or other proprietary right of either party, except as contemplated by Section 7.2.  Each Clinical Study Site and Principal Investigator agrees to disclose promptly and fully to Nordic Bioscience all creative ideas, developments, discoveries, methodologies, improvements and inventions, whether or not patentable, arising as a direct result of the work performed under the Study. The Sponsor, acting through Nordic Bioscience, hereby grants each of the Clinical Study Sites a nonexclusive, non-transferable, royalty-free license to use the Study Drug and Sponsor Technology at the Clinical Study Site solely for purposes of conducting the Study.  Neither the Clinical Study Site nor the Principal Investigator will use or permit use of Study Drug or Sponsor Technology by any third party for any purpose other than the completion of the Study without Sponsor’s prior written permission

 

7.2.                             If a Clinical Study Site, as a direct consequence of the work on the Clinical Study, conceives or reduces to practice any new invention, then: (i) if such invention is conceived or reduced to practice solely by the Clinical Study Site, it shall be owned by the Clinical Study Site and (ii) if such invention is conceived or reduced to practice by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience, it shall be jointly owned by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience.  All of the Clinical Study Site’s rights to any new invention related to a new use for the Study Drug will be licensed to Sponsor, upon its request and on commercially reasonable terms.  For new inventions which are not related to a new use for the Study Drug, Clinical Study Site grants Sponsor a first option to obtain an exclusive license to any invention owned in whole or in part by the Clinical Study Site, which shall be negotiated by the parties and contain commercially reasonable terms.  Such option shall be exercisable for a period of six (6) months from the date the Clinical Study Site discloses the invention to Sponsor. . Clinical Study Sites will fully cooperate with Nordic Bioscience in obtaining whatever patent protection may be available on inventions, ideas, and developments arising from their work on the Study, and will further cooperate with Nordic Bioscience in executing all documents deemed necessary by Nordic Bioscience or Sponsor for purposes of procuring such patent protection.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

7.3.                             Each Clinical Study Site hereby represents and warrants to Nordic Bioscience that all personnel affiliated with the Clinical Study Site and participating in the Study, including the applicable Principal Investigator, are subject to written agreements requiring them to disclose and assign any new invention to the Clinical Study Site.

 

8.                     USE OF NAME (ADVERTISING)

 

The Clinical Study Sites and/or Principal Investigators shall obtain prior written consent from Nordic Bioscience before using the name, symbols or marks of Nordic Bioscience or Sponsor in any form of publicity in connection with the Study.  If any of the Clinical Study Sites or Nordic Bioscience is legally required to make any disclosure that identifies the existence or terms of the Agreement, then either may do so without prior written consent from the other but the applicable Clinical Study Site(s) must notify Nordic Bioscience within five (5) business days of such disclosure.

 

9.                    CHANGES TO THE PROTOCOL

 

9.1.                             Subject to Section 9.2, any changes to the Protocol may be made only with the prior agreement of the Sponsor. If these changes will affect the cost of the Study, Nordic Bioscience shall provide the Clinical Study Sites with a written estimate of such change in Study cost.

 

9.2.                             If generally accepted standards of Good Clinical Practice relating to the safety of study subjects require a deviation from the Protocol, these standards will be followed. Any party who becomes aware of the need for a deviation from the Protocol will immediately notify the other parties to this Agreement and the Sponsor of the facts causing the deviation as soon as, the facts are known to that party but no such deviation or change shall be implemented without the prior written approval of Nordic Bioscience and Sponsor; Nordic Bioscience and Sponsor shall promptly confer and provide a prompt written response regarding any deviation proposed pursuant to this Section 9.2.

 

9.3.                             Clinical Study Site shall coordinate, and shall cause each Principal Investigator to coordinate, with the relevant institutional review board or ethics committee (the “EC”) to obtain the EC’s written approval of such Principal Investigator’s conduct of the Study at Clinical Study Site, including approval of the Protocol and informed consent form to be executed by all subjects enrolled by Principal Investigator in the Study (the “Informed Consent Form”).  Clinical Study Site shall be responsible for providing Sponsor with a copy of each such approval, together with information about the members of the EC and all relevant correspondence with the EC. In addition, Clinical Study Site shall coordinate, and shall cause Principal Investigator to coordinate, with the EC to obtain review and approval in writing of any amendments made to a Protocol by the parties.  In the event the EC requires changes in the Protocol or Informed Consent Form, such changes shall not be implemented until Sponsor and Nordic Bioscience are notified and Sponsor gives its written approval.  In the event that the EC alters or withdraws its’ approval in any manner, Clinical Study Site shall promptly notify Sponsor and Nordic Bioscience.  The Protocol and the Informed Consent Form shall not be revised without the prior written agreement of Sponsor, Nordic Bioscience and the EC.  Clinical Study Site will use reasonable efforts to ensure that members of the EC agree to abide by the same obligations of confidentiality as apply to Clinical Study Site under this Agreement.

 

10.              MATERIALS

 

10.1.                      Sponsor will provide the Study Drug. The Clinical Study Sites will provide Materials derived from study subjects enrolled in the study to Nordic Bioscience. The term “Materials” shall include reagents and materials derived from study subjects enrolled in the Study, including blood, sera, and other biological materials. The Clinical Study Site shall use the Study Drug, and any comparator products

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

provided in connection with the Study, solely for the purpose of properly completing the Study and shall maintain all Study Drug and any comparator products in a locked, secured area at all times. Only those persons who are under the Principal Investigator’s, or Principal Investigators’ direct control and who will be using the Study Drug (and any comparator products) or Materials for the Study shall have access to the Study Drug (and any comparator products) or Materials. Upon termination or completion of the Study, all unused Study Drug and comparator products and all Materials shall be returned to Nordic Bioscience or at Nordic Bioscience’s sole option, destroyed.

 

11.              CONFORMANCE WITH LAW AND ACCEPTED PRACTICE

 

11.1.                      The Clinical Study Sites and Principal Investigators shall perform the Study in strict accordance with the protocol, and any subsequent amendments thereto, applicable federal, state, and local laws, regulations and guidelines, good clinical practices (“GCP”), and instructions provided by Nordic Bioscience.  The Clinical Study Sites and Principal Investigators shall permit Nordic Bioscience and agencies such as the FDA to inspect Study records including the Subjects’ medical records. The subject informed consent form signed by the Subjects shall provide for access to the Subjects’ medical records by Nordic Bioscience and by agencies such as the FDA.

 

11.2.                      The Principal Investigator will direct and supervise the Study in accordance with Section 1. Nordic Bioscience and Sponsor shall have the right to (a) monitor and audit the activities of the Principal Investigator and Principal Investigators in the conduct of the Study, and (b) monitor and audit the collection of data from the Study.

 

11.3.                      The Clinical Study Sites and Principal Investigators shall retain all records from the Study for the time required by applicable regulations and at the sole expense of Clinical Study Sites and/or the Principal Investigator, and to allow for direct access by the applicable government agencies and representatives of Nordic Bioscience of these records, including the study subjects’ medical records.

 

11.4.                      Each of the Clinical Study Sites and Principal Investigators hereby represent and warrant that neither the Clinical Study Sites, the Principal Investigators nor any of the Clinical Study Sites’ agents or employees rendering services in connection with the Study is presently:  (1) the subject of a debarment action or is debarred pursuant to the Generic Drug Enforcement Act of 1992; (2) the subject of a disqualification proceeding or is disqualified as a clinical investigator pursuant to 21 C.F.R. § 312.70; or (3) the subject of an exclusion proceeding or excluded from participation in any federal health care program under 42 C.F.R. Part 1001 et seq.  Clinical Study Sites shall notify Nordic Bioscience immediately upon any inquiry concerning, or the commencement of any such proceeding concerning Clinical Study Sites, Principal Investigators or any such agent or employee.

 

12.              INDEMNIFICATION

 

12.1.                      Pursuant to a separate indemnity letter in the form of Exhibit B, the Sponsor shall provide indemnification to the Clinical Study Sites, the Principal Investigators and any agents and employees of the Clinical Study Sites from any liabilities, claims, actions or suits for personal injury or death directly arising out of the administration or use of the Study Drug during the Study.

 

12.2.                      The Clinical Study Sites and Principal Investigators shall defend, indemnify and hold harmless Nordic Bioscience, Sponsor and any agents and employees of Nordic Bioscience and Sponsor from any liabilities, claims, actions or suits for personal injury or death directly arising from the negligence or willful misconduct of the Clinical Study Sites, Principal Investigators or their representatives.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

13.                                STUDY SUBJECT INJURY

 

If a study subject experiences an adverse reaction to the Study Drug, Sponsor shall provide reimbursement for reasonable and necessary medical expenses incurred by the study subject for the treatment of these adverse reactions pursuant to the separate indemnity letter in the form of Exhibit B.  Neither Nordic Bioscience nor Sponsor will be responsible for any adverse reactions, which are the result of the negligence or misconduct of the Clinical Study Sites, Principal Investigators or any of their representatives.

 

14.              TERM; TERMINATION

 

14.1.                      This Agreement shall commence on the date of signature of this Agreement and shall continue until delivery of the final validated Case Report Forms. The completion date is dependent on the delivery to the Clinical Study Sites by Nordic Bioscience of all supplies to be provided by Nordic Bioscience and necessary to the conduct of the Study. Any delay due to the failure of supply by Nordic Bioscience, shall be added to the term of the Study. Clinical Study Sites shall have the right to extend the Agreement should there be any delay due to the failure of the supply by Nordic Bioscience.

 

14.2.                      This Agreement may be terminated:

 

14.2.1.                 by a Clinical Study Site upon thirty (30) days’ prior written notice only for serious causes resulting in the material breach by Nordic Bioscience of its obligations to such Clinical Trial Site and only if not cured in a timely manner using reasonable commercial efforts;

 

14.2.2.                 by Nordic Bioscience immediately upon written notice;

 

14.2.3.                 by either a Clinical Study Sites or Nordic Bioscience immediately if the applicable Principal Investigator is unable to continue to serve and a successor acceptable to both the Clinical Study Site and Nordic Bioscience is not available; or

 

14.2.4.                 upon the occurrence of an event qualifying as a termination event as described in the Protocol.

 

14.3.                      Upon the effective date of termination, the applicable Clinical Study Site(s) shall conduct an accounting, which is subject to verification by Nordic Bioscience.  Within thirty (30) days after Nordic Bioscience’s receipt of adequate documentation, Nordic Bioscience will make payment to the applicable Clinical Study Site(s) unless Nordic Bioscience objects to any charge, in which case, the parties shall use best efforts to resolve expeditiously any disagreement.  The payments made by Nordic Bioscience subject to this Section 14.3, will be for:

 

14.3.1.                 all services properly rendered and monies properly expended by the Clinical Study Site prior to the date of termination and not yet paid for; and

 

14.3.2.                 any reasonable non-cancelable obligations properly incurred for the Study by the Clinical Study Site prior to the effective date of termination.

 

14.3.3.                 The Clinical Study Site shall credit or return to Nordic Bioscience any funds not expended by the Clinical Study Site for the Study prior to the effective termination date.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

14.4.                      Immediately upon receipt of a notice of termination, the Principal Investigator shall stop enrolling study subjects into the Study and shall cease conducting procedures on study subjects already enrolled in the Study as directed by Nordic Bioscience, to the extent medically permissible and appropriate.

 

14.5.                      Termination of this Agreement by Nordic Bioscience or the Clinical Study Sites shall not affect the rights and obligations of the parties accrued prior to the effective date of the termination. The rights and duties under Sections 3, 5, 6, 7, 8, 10, 11, 12, 14, 15, 17 and 18 of this Agreement survive the termination of this Agreement.

 

14.6.                      If this Agreement is terminated prior to completion of the Study, the Clinical Study Sites shall furnish Nordic Bioscience an acceptable investigator’s report for the Study.

 

15.              MISCELLANEOUS

 

This Agreement and the Protocol may only be amended by the mutual written consent of the parties to this Agreement. This Agreement represents the entire understanding of the parties with respect to the subject matter of this Agreement. In the event of any inconsistency between this Agreement and the Protocol, the terms of this Agreement shall govern. The invalidity or unenforceability of any term or provision of this Agreement shall not affect the validity or enforceability of any other term or provision of this Agreement. No waiver of any term, provision or condition of this Agreement in any instance shall be considered to be a continuing waiver of the same term, provision or condition, or of any other term, provision or condition of this Agreement.  This Agreement may be executed in any number of counterparts, each of which shall be an original and all of which together shall be one document binding on all the parties even though each of the parties may have signed different counterparts. This Agreement shall also be considered executed by the parties upon receipt by Nordic Bioscience by facsimile transmission of the counterparts signed by all the parties.  This Agreement shall be interpreted under the laws of the state or province and country in which the applicable Clinical Study Site conducts the Study.

 

15A.  ASSIGNMENT

 

Neither CCBR nor a Clinical Study Site nor a Principal Investigator may assign or transfer any rights or obligations under this Agreement without the written consent of Nordic Bioscience.  Upon Nordic Bioscience’s or Sponsor’s request, CCBR may assign this Agreement to Nordic Bioscience or to Sponsor or to a third party, and thereafter CCBR shall not have any obligations or liabilities under this Agreement, and CCBR shall obtain from each Clinical Study Site such Clinical Study Site’s prior consent to such an assignment.  Each affected Clinical Study Site will be given prompt notice of such assignment by the assignee.

 

16.              ACKNOWLEDGEMENT OF PRINCIPAL INVESTIGATORS

 

CCBR shall obtain an executed Acknowledgement of Obligations from each Clinical Investigator, including each Principal Investigator, participating in the Study under this Agreement, in the form of Exhibit A hereto, prior to the date that any such Clinical Investigator shall commence performing services for the Study.  “Clinical Investigator” means a listed or identified investigator or subinvestigator for the Study who is directly involved in the treatment or evaluation of research subjects and such investigator’s spouse and each dependent child of such investigator.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

17.                                FINANCIAL DISCLOSURE

 

The Clinical Study Sites agrees that, for each listed or identified Clinical Investigator who is directly involved in the treatment or evaluation of research subjects, shall return to Nordic Bioscience a financial disclosure form that has been completed and signed by such Clinical Investigator, which shall disclose any applicable interests held by those investigators or subinvestigators or their spouses or dependent children. The Clinical Study Sites shall ensure that all such forms are promptly updated as needed to maintain their accuracy and completeness during the Study and for one year after its completion. The Clinical Study Sites agrees that the completed forms may be subject to review by governmental or regulatory agencies, Nordic Bioscience and their agents, and the Clinical Study Sites consents to such review. The Clinical Study Sites further consents to the transfer of its financial disclosure data to Nordic Bioscience country of origin, and to the United States of America (“U.S.”) if the Clinical Study Sites is outside of the U.S., even though data protection may not exist or be as developed in those countries as in the Clinical Study Site’s own country.

 

18.              ELECTRONIC RECORDS

 

If the data produced by the Clinical Study Sites will be used in support of an application to the United States Food and Drug Administration (“FDA”) and if the Clinical Study Sites uses electronic systems for creating, modifying, maintaining, archiving, retrieving or transmitting any records that are required by, or subject to inspection by, the FDA, including, but not limited to, CRFs, medical records, informed consent forms, test results, or other source documents, then the Clinical Study Sites warrants that its systems for such electronic records are in compliance with Section 21 of the United States Code of Federal Regulations, Part 11. The Clinical Study Sites further warrants that, in order to comply with Part 11, it will not use any electronic signatures on any documents required by, submitted to, or supporting a submission to the FDA unless it has certified to the FDA that it intends such electronic signatures to be the legally binding equivalent of a hand-written signature.

 

19.  SPONSOR AS THIRD PARTY BENEFICIARY OF CERTAIN PROVISIONS

 

It is understood and agreed that Sponsor is a third party beneficiary of Sections 3, 5, 6, 7, 11 and 12 of this Agreement

 

IN WITNESS WHEREOF , the parties hereto have caused their duly authorized representatives to execute this Agreement as of the date first above.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S   

CENTER FOR CLINICAL AND BASIC RESEARCH A/S, on behalf of itself and each of the Clinical Study Sites   

 

 

 

Hans Chr. Hoeck , MD, CEO

Bente Riis, MD, CEO

 

 

 

 

 

Signature

 

 

Signature

 

 

 

 

 

 

 

Date:

 

 

Date:

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

EXHIBIT A

 

PRINCIPAL INVESTIGATOR’s ACKNOWLEDGEMENT OF OBLIGATIONS

 

The undersigned Clinical Investigator acknowledges and agrees that I and Center for Clinical and Basic Research, Denmark have entered into a Clinical Trial Agreement with Nordic Bioscience A/S representing the interests of Radius Health, Inc. to perform the clinical study under Protocol No. BA058-05-007:

 

“A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis”

 

I agree that Center for Clinical and Basic Research, Denmark was authorized to enter into the Agreement on my behalf.

 

My payment for my involvement in the trial will not in any way be dependant of the outcome of the trial. I will not be paid bonuses or the like in case of positive or negative results. I (including for purposes of this paragraph my spouse and my dependent children, in each case to the extent applicable) do not own nor shall I become entitled to own any of the Radius Health, Inc. securities that are subject to the certain Stock Issuance Agreement entered into between Radius Health, Inc. and Nordic Bioscience A/S or to otherwise receive any compensation or other benefit from such Radius Health, Inc. securities or the proceeds of such Radius Health, Inc. securities.

 

I will, prior to shipment of clinical supplies to my Clinical Study Site provide Nordic Bioscience with all original documentation necessary for submission to regulatory authorities, including the U.S. Food & Drug Administration, including a completed and signed FDA Form 3455 and Form 1572.

 

I agree to comply with all the terms and conditions set forth in the Protocol and in the Agreement and to be responsible for assuring that any investigators and study staff under their direct supervision performing work for the Study contemplated by the Agreement and the Protocol similarly comply with the terms and conditions contained therein.

 

NAME AND ADDRESS OF PI

 

 

 

Date:

 

 

 

 

 

Sign:

 

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Attachment K

 

Indemnity Letter Template

 

[RADIUS HEALTH, INC. LETTERHEAD]

 

[Name of Clinical Study Site]

 

[Address]

 

[City, State, Country]

 

CCBR-Ballerup, Ballerup Byvej 222, DK-2750 Ballerup, Denmark

 

CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

 

CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

 

CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

 

CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

 

CCBR-Lodz, Lodzkie Centrum Osteoporozy, Al. Pilsudskiego 9, PL90-368 Lodz

 

CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Kong

 

[Add backup sites?]

 

Re:  Clinical Trial No. BA058-05-007 (the “Study”) Risk Allocation

 

Dear Ladies and Gentlemen:

 

This letter is delivered to you pursuant to Section 13 of the certain Clinical Trial Agreement dated                  , 2012 among Center for Clinical and Basic Research A/S (“CCBR”) on behalf of itself and its affiliates CCBR-Ballerup, CCBR-Ålborg, CCBR-Vejle, CCBR-Tallinn, CCBR-Warsaw, CCBR Lodz and CCBR Hong Kong and Nordic Bioscience (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Radius”) (the “Agreement”).  Capitalized terms used in this letter and not defined in this letter are used with the Agreement.  The Agreement concerns the performance of the Study in accordance with Radius Protocol No. BA058-05-007 “A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis”  (the “Protocol”).

 

1.               Subject to Paragraph 3, Radius hereby agrees to defend, indemnify and hold harmless [CLINICAL STUDY SITE NAME] (“Clinical Study Site”), including its officers and administrators, employees and agents,

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

including the Principal Investigator and his/her co-investigators and assistants in the Study (collectively, “Indemnitees”) from and against any and all damages, suits, judgments, and liabilities (including expenses and reasonable attorneys’ fees) (collectively, “Losses”) arising from or related to any third party claims of injury, illness or adverse side effects to a patient in the Study that are attributable to the Study Drug.  The indemnification obligation set forth in this Paragraph 1 shall not apply in the event and to the extent that:  (a) such Loss(es) arose as a result of intentional misconduct or negligence by Indemnitees; or (b) the Principal Investigator and those assisting him/her did not adhere to the terms of the Protocol and to Radius’ written instructions relative to the use of Study Drug or failed to employ reasonable care in the conduct of the Study in conformity with the generally accepted standards of the medical community or violated any applicable laws or regulations in any material respect.  For purposes of this Paragraph 1, a violation shall be deemed “material” if it adversely affects the safety, health or welfare of Study subjects.

 

2.               In the event a patient participating in the Study suffers an illness or injury which the Principal Investigator and Radius reasonably determine to be an adverse reaction directly associated with the Study Drug, and not due to a reason other than the Study Drug, then subject to the provisions of Paragraph 3, Radius shall pay all necessary and reasonable medical and hospital expenses directly associated with the medical treatment of such adverse reaction which are in excess of that portion covered by the patient’s own insurance or other insurance, or third-party payment programs .  In the event diagnostic procedures are required to determine the etiology of the patient’s symptoms, Radius shall pay the reasonable expense of such diagnostic work-up without regard to the final diagnosis, so long as Radius agrees to the need for the diagnostic work-up but Radius shall not be responsible for expenses connected with the subsequent treatment of the patient if the work-up establishes that the patient’s symptomology is not related to the administration of the Study Drug.  Payments under this Paragraph 2 shall be in addition to any payments specified in Paragraph 1.

 

3.               To receive the benefit of Paragraph 1 or Paragraph 2, the appropriate personnel at Clinical Study Site must (a) promptly notify Nordic Bioscience and Sponsor in writing of any claim of injury, illness, adverse side effects or adverse reaction to the Study Drug; provided , that failure to give such notice shall not relieve Radius of its obligations under Paragraph 1 or Paragraph 2 except where, and solely to the extent that, such failure actually and materially prejudices the rights of Radius; (b) tender to Radius (and its insurer) full authority to defend or settle the claim or suit; provided that no settlement requiring any admission by an Indemnitee or that imposes any obligation on an Indemnitee shall be made without the Indemnitee’s consent; and (c) cooperate fully with Radius in its handling of such claim or suit.  A Clinical Study Site’s failure to perform its obligations under this Paragraph 3 shall relieve Radius of its obligations under Paragraphs 1 and 2. [ Radius will reimburse Indemnitees for all reasonable expenses incurred at Radius’ request in connection with this Paragraph 3 except to the extent and in the proportion that Indemnitees are responsible under Paragraph 1 ] .

 

4.               Any notice to Radius shall be in writing and shall be deemed given to Radius when delivered by hand or sent by internationally recognized overnight courier (such mailed or courier notice to be effective on the date which is two (2) business days after the date of mailing) or sent by facsimile (such notice sent by telefax to be effective one (1) business day after sending, if immediately confirmed by overnight courier as aforesaid), in each case addressed to the following addresses: Radius Health, Inc., 201 Broadway, 6 th  Floor, Cambridge, MA 02139 USA Attn: [              ], Fax No.: 01.617.551.4701; Phone No.: 01.617.444.1834.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

IN WITNESS WHEREOF, the undersigned has executed this letter intending it to take effect as of                       , 2010.

 

 

RADIUS HEALTH, INC.

 

 

 

 

 

By:

 

 

Name, Title

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Study Protocol

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Execution Copy

 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 1 TO WORK STATEMENT NB-2

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into the certain Clinical Trial Services Agreement ( “Agreement” ) and that certain Work Statement NB-2 under the Agreement (“Work Statement NB-2”) as of February 21, 2012 ( “Effective Date” ).

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 1 to Work Statement NB-2 ( “Amendment No. 1” ) effective as of November 6, 2013 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 1 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-2.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 1, the parties agree as follows:

 

1. Addition of Antibody Surveillance Program (a) At Radius’ request, NB will initiate an antibody surveillance program at CCBR and non-CCBR sites to monitor any patients with positive antibodies in the clinical study that is the subject of Work Statement NB-2 (collectively, “Ab Services”). Radius wishes to provide for payment to NB for these Ab Services under Work Statement NB-2.

 

(b)  The NB representations and warranties set forth in Sections 8.2, 8.3, 8.5 and 8.6(ii) of the Agreement shall apply to the personnel, including Clinical Investigators, that perform the Ab Services.  NB shall be responsible for securing the applicable representations and warranties from these clinical study sites and personnel, including Clinical Investigators.

 

(c) A new section at the bottom Attachment B to Work Statement NB-2 ( Budgets, Fees, Pass-through Costs, and Payment Schedule* ) is hereby amended to read in full as follows:

 

“Antibody — BA058-05-007

 

Cost Proposal 08 October 2013

 

Sponsor:

 

RADIUS

 

 

Protocol ID:

 

Antibody - BA058-05-007

 

 

Development Phase:

 

N/A

 

 

Disease:

 

Osteoporosis

 

 

Nordic Start Study Activity

 

1-Jun-13

 

 

Expected Date of first follow up patient first visit

 

20-Nov-13

 

Based on FPLT 20-MAR-2013

Expected Date of last follow up patient first visit

 

31-Dec-13

 

Based on LPLT 31-JUN-2013

Expected Date of last follow up patient last visit

 

1-Jul-14

 

Based on Last FUP last visit 6 months after Last FUP first vist

Expected Length of total Follow-up period (months):

 

12

 

 

 

 

 

 

 

Duration of Nordic Involvement

 

13

 

 

Number of visits per patient:

 

2

 

Estimated 2 extra samples per positive patient up to a period of 12 months after last study drug.

Number of Countries:

 

4

 

 

 

 

 

 

 

Number of Sites:

 

9

 

 

 

1



 

Total Budget

 

EURO

 

 

Clinic Fee

 

€40 per scheduled visit; €96 per unscheduled visit

 

All visits unsheduled

CRO Activities (Nordic Bioscience)

 

19,630

 

Period until LPLV in 005 is partly covered in existing work orders. Only extra is increased study and site management and pharmacovigilance

 

 

 

 

 

Central Lab Fee (Synarc Lab)

 

€26.40 per sample per patient

 

Shipment not included. Shipment be invoiced as pass through. Estimated to be 4.000 Euro

 

 

 

 

 

EDC system

 

0

 

Not applicable

 

Pass through Cost

 

EURO

 

 

Translation

 

Not included

 

 

Investigator Meeting

 

Not included

 

 

Lab shipments

 

Not included

 

 

Submission to EC and CA

 

Not included

 

 

EDC system

 

Not included

 

 

Data Monitoring Committe

 

Not included

 

 

Patient insurrance

 

Not included

 

 

Annual reports to the FDA

 

Not included

 

 

External advisory Board

 

Not included

 

 

Statistical Data analysis and Clinical Study Report

 

Not included

 

 

 

The CRO fee is not subject to any adjustment for the number of antibody positive patients. The Clinic Fee and Central Lab Fee will be adjusted to reflect the actual number of antibody positive patients and visits completed for surveillance activities. The Central Lab Fee will be adjusted on a pro rata basis based on the number of samples per antibody positive patient.

 

The purchase price for the Ab Services shall be paid solely in cash as follows:

 

(a)  The CRO fee shall be paid in fixed monthly installments over the expected 13 month period of delivery of the Ab Services commencing June 1, 2013 with an expected last patient, last follow-up visit of July 1, 2015 equal to €1,510 per month.

 

(b) The Clinic fee shall be paid as clinic visits and procedures are performed based on a scheduled visit fee of €40 and an unscheduled visit fee of €96.

 

(c) The Central Lab Fee shall be paid as clinic visits and procedures are performed based on €26.40 per sample per antibody positive patient.

 

(d) Shipping shall be paid as a pass-through costs as incurred.

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 3, all of the terms, provisions and conditions of the Agreement and Work Statement NB-2 are hereby ratified and confirmed and shall remain in full

 

2



 

force and effect.  The term “Work Statement NB-2”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-2 as amended by this Amendment No. 1.

 

3.  General.   This Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument

 

[remainder of this page intentionally left blank - signature page follows]

 

3



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 1 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 1 under seal as of the Amendment Date.

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL
DEVELOPMENT VII A/S

 

 

 

/s/ B. Nicholas Harvey

 

/s/ Bente Juel Riis

By: B.N. Harvey

 

By: Bente Juel Riis

Title: CFO

 

Title: CEO

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 




Exhibit 10.13

 

Confidential Treatment Requested

Under 17 C.F.R. §§ 200.80(b)(4) and 240.24b-2

 

Work Statement NB-3

 

WORK STATEMENT

 

This Work Statement NB-3 is entered into as of February 21, 2013 pursuant to Section 2.1 of the Clinical Trial Services Agreement dated as of March 29, 2011, by and between Radius Health, Inc. (“ Radius ”) and Nordic Bioscience Clinical Development VII A/S (“ NB ”) (the “ Agreement ”).  Capitalized terms used in this Work Statement NB-3 and not defined in this Work Statement NB-3 are used with the meanings ascribed to them in the Agreement.  This Work Statement NB-3 is attached to and becomes, upon execution by both parties below, a part of the Agreement, and sets forth the specific terms and conditions relating to the Services and Deliverables described herein.

 

In consideration of the mutual promises contained in the Agreement and for other good and valuable consideration the receipt and adequacy of which each of the parties does hereby acknowledge, the parties hereby agree to the terms of this Work Statement NB-3 entitled: BA058-05-005 “An Extension of Study BA058-05-003 to Evaluate 18 Months of BA058 Injection 80 µg/Placebo Treatment Followed by Six Months of Standard-of-Care Osteoporosis Treatment.”

 

This Work Statement NB-3 contains the following Attachments, each of which is made a part hereof:

 

Attachment A – Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

Attachment B – Budgets, Fees, Pass-through Costs, and Payment Schedule

Attachment C – Materials Provided by Either Party

Attachment D – Core Team Members/Key Personnel

Attachment E – Protocol or Protocol Summary

Attachment F – Reports and Information Management/Regular Meetings

Attachment G – Special Insurance

Attachment H - Transfer of Obligation

Attachment I – Clinical Trial Agreement Template

Attachment K - Indemnity Letter Template

 

IN WITNESS WHEREOF the parties have executed this Work Statement NB-3 intending it to take effect as an instrument under seal as part of the Agreement as of February 21, 2013.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

By:

/s/ B. Nicholas Harvey

 

By:

/s/ Bente Juel Riis

 

 

 

 

 

Name:

B. Nicholas Harvey

 

Name:

Bente Juel Riis

 

 

 

 

 

Title:

Chief Financial Officer

 

Title:

Chief Executive Officer

 

 

 

 

 

Date:

February 21, 2013

 

Date:

February 21, 2013

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

Work Statement NB-3

 

Attachment A

 

Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

Study Assumptions

 

Radius Health, Inc.

Protocol:  BA058-05-005, “An Extension of Study BA058-05-003 to Evaluate 18 Months of BA058 Injection 80 µg/Placebo Treatment Followed by Six Months of Standard-of-Care Osteoporosis Treatment”

 

Protocol Number: BA058-05-005

 

 

Number of Sites:

 

29

Argentina

 

1

Brazil

 

5

Czech Republic

 

3

Denmark

 

3

Estonia

 

2

Hong Kong

 

1

India

 

0

Lithuania

 

1

Poland

 

6

Romania

 

1

USA

 

6

Visits per Completed Subject:

 

3

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Clinical Trial Timeline and Budget

 

RADIUS

BA058-05-005

Protocol 23 July 2012

Cost Proposal 06 February 2013

 

Sponsor:

 

RADIUS

 

 

Protocol ID:

 

BA058-05-005

 

 

Development Phase:

 

III

 

 

Disease:

 

Osteoporosis

 

 

Total # of Randomized and completed subjects

 

925

 

 

Nordic Start Study Activity

 

1-Apr-12

 

 

Expected Date of FPFV:

 

1-Oct-12

 

 

Expected Length of Recruitment (months):

 

18

 

 

Treatment duration (months)

 

6

 

 

Follow-up duration (months)

 

0

 

 

Close Out (months)

 

3

 

 

Duration of Nordic Involvement

 

27

 

 

Number of visits per patient:

 

3

 

 

Number of Countries:

 

10

 

Ar, Br, Dk, Cz, Ee, Li, Po, Ro, HK, USA

Number of Sites:

 

29

 

Ar x 1, Br x 5, Dk x 3, Cz x 3, Ee x 2, Li x 1, Po x 6, Ro x 1, HK x 1, USA x 6

 

Total Budget

 

EURO

 

 

 

 

Clinic Fee

 

[*]

 

925 subjects

 

 

Standard of Care Fee

 

[*]

 

 

 

 

CRO Activities (Nordic Bioscience)

 

[*]

 

All sites; excluding India

 

 

Central Lab Fee (Synarc Lab)

 

[*]

 

Shipment not included. Will be invoiced as pass through. Estimated to be 250,000 Euro

 

 

EDC system

 

 

 

Pass through. Estimated to be below 100,000 Euro

 

 

Calcium and D

 

 

 

Pass through. Estimated to be 15 Euro per month per subject

 

 

Alendronate

 

 

 

Pass through. Estimated to be 30 Euro per month per subject

 

 

Total Budget (Euro)

 

4,519,863

 

6,101,815

 

1.350

 

 

 

USD

 

USD

Central Imaging Reading (Synarc Imaging)

 

579,495

 

Scalable and invoiced as pass through + shipment estimated 19,782 USD

Total Budget (USD)

 

6,681,310

 

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

Pass through Cost

 

EURO

 

Containers for 24-h urine collection

 

Included

 

Local Hematology Test’s

 

Included

 

Advertisement

 

Included

 

Monitoring Travel Expenses & Accomodations/ other travels

 

Included

 

Translation

 

Included

 

Investigator Meeting

 

Included

 

Alendronate

 

Not included

 

Image and Lab shipments

 

Not included

 

Submission Fee to ERC and CA

 

Not included

 

EDC system

 

Not included

 

Data Monitoring Committe

 

Not included

 

Patient insurrance

 

Not included

 

Annual reports to the FDA

 

Not included

 

External advisory Board

 

Not included

 

Statistical Data analysis and Clinical Study Report

 

Not included

 

 

Payment schedule

 

Euro

 

 

 

 

 

 

 

 

 

Upfront

 

[*]

 

17.84275262

%

1,641 per enrolled subject

 

[*]

 

33.58342833

%

216,784 per month for 7 months

 

[*]

 

33.57375989

%

Subtotal

 

3,841,881

 

84.99994084

%

Rest

 

677,982

 

15.00005916

%

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2


 

Work Statement NB-3

 

Attachment B

 

Budgets, Fees, Pass-through Costs, and Payment Schedule*

BA058-05-005 Protocol 23 July 2012

 

The Cash budget is Euro 4,519,863 and USD 579,495

 

The Bonus Equity Payment Amount budget is Euro 4,519,863 and USD 310,000

 

The Cash budget will be paid as follows:

 

·                   18% (Euro 806,468) has been paid at signing of the LOI dated October 22, 2012.

·                   [*] % (Euro [*] ) of the Euro cash budget will be paid during enrollment at Euro [*] per randomized patients at all non-US sites (the SITES).

·                   The USD budget will be paid according to invoices received from Synarc Inc.

·                   [*] % (Euro [*] ) of the Euro cash budget will be paid on a monthly basis over [*] months starting after patient randomization is completed with Euro [*] per month.

·                   The USD budget will be paid according to invoices received from Synarc Inc.

·                   [*] % (Euro [*] ) of the Euro cash budget will be paid when the database is locked and transferred to and accepted by Radius.

·                   The USD budget will be paid according to invoices received from Synarc Inc.

 

Pass through costs will be invoiced on a monthly basis.

 

The Equity budget will be paid in concert with the cash payment after the same model as for Work Statement NB-1 and NB-2 under an amended Stock Issuance Agreement modeled on the Amended and Restated Stock Issuance Agreement entered into by the parties as of May 16, 2011.

 

The pricing specified in this Budget is calculated based upon 925 subjects randomized and completed but will be adjusted for the number of completed patients greater or less than 925 subjects as follows (i) on a fully pro rata basis for the Clinic Fee, the Central Lab Fee and the Central Imaging Reading Fee; and (ii) by an amount of euro [*] per subject for the CRO Activities Fee. However, the Cash Budget and the Bonus Equity Payment Amount shall be reduced by an amount of euro [*] per subject for Clinic Activities not performed at the SITES for any patients enrolled in the United States. Such reduction to be applied in pro rata installments to monthly payments after patient randomization is completed.  Otherwise, all pricing will be adjusted on a pro rata fashion to reflect the actual study activities completed by the study subjects.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-3

 

Attachment C

 

Materials Provided by Either Party

 

Trial Activities & Delegation of Responsibilities

 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Sponsor & Service provider Governance

 

 

 

 

 

 

CCBR - Radius Governance Committee

 

ü

 

ü

 

Sponsor and Service provider will be responsible for creating an Executive Governance Committee to oversee program strategy and implementation.

Clinical Trial Joint Development Team

 

ü

 

ü

 

Sponsor and Service provider will appoint members of the clinical trial joint development team to implement the clinical study.

 

 

 

 

 

 

 

Regulatory

 

 

 

 

 

 

IND/CTA Preparation

 

R

 

ü

 

Sponsor will be responsible to create all IND and CTA submission documents. Service provider will be responsible for any required translations for the CTA.

FDA IND Submission & Updates

 

 

 

ü

 

Sponsor will be responsible for all FDA submissions.

CTA Submissions & Updates

 

ü

 

A

 

Service provider will be responsible for all CTA submissions. Sponsor approval of the submissions is required prior to submission. Sponsor is responsible for USA.

Health Authority, EC, IRB Queries & Response

 

ü (ex-US)

 

ü (US)

 

Sponsor and Service provider will be responsible to provide responses to Health Authority, Ethics Committee, and IRB queries, if necessary.

EUDRACT Registration

 

ü

 

ü

 

Sponsor will be responsible to register the clinical study to obtain an EUDRACT number and service provider will create the XML file for submission.

Investigator’s Brochure

 

 

 

ü

 

Sponsor will be responsible to create the Investigator Brochure and any updates.

Clinical Study Protocol

 

R

 

ü

 

Sponsor will be responsible to create the study protocol, and any amendments, if necessary. Service provider will be responsible to review the study protocol and any amendments, if necessary.

Clinical Study Extension Protocol

 

R

 

ü

 

Sponsor will be responsible to create the Extension study protocol, and any amendments, if necessary. Service provider will be responsible to review the Extension study protocol and any amendments, if necessary.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Informed Consent Form (ICF, PIS)

 

R

 

ü

 

Sponsor will be responsible to create the Informed Consent Documents and/or Patient Information Sheets. Service provider will be responsible to review the ICF or PIS.

Ethics (IRB) Committees submissions & Updates

 

ü (ex-US)

 

ü (US)

 

Service Provider will be responsible for country and site Ethics Committees (IRB)

FDA SAE Submission & Follow Up(s)

 

 

 

ü

 

Sponsor will be responsible for SAE submissions to USA. See Health Authority reporting in Safety and Pharmacovigilance

Health Authority SAE Submissions & Follow Up(s)

 

ü

 

A

 

Service provider will be responsible for all Health Authority SAE submissions except USA. Sponsor will be responsible for approving the HA submissions. See Health Authority reporting in Safety and Pharmacovigilance

Legal representative (if required)

 

ü

 

 

 

Service provider will be responsible to provide Legal Representative services, on behalf of the sponsor, if required by local regulation.

Regulatory & Study Documents translations

 

ü

 

ü

 

Service provider will be responsible to provide all necessary document translations for regulatory and study documents.

Clinicaltrials.gov registration & management

 

 

 

ü

 

Sponsor will be responsible to register the clinical study on clinicaltrials.gov and manage the status of the study as required by regulation.

Clinical Trial Materials

 

 

 

 

 

 

Calcium and Vitamin D

 

ü

 

 

 

Service provider will manage sites to purchase calcium and vitamin D.

Alendronate

 

ü

 

ü

 

Service provider will manage sites to purchase initial supply of Alendronate until such time as Sponsor can provide Alendronate from a central source. Where central supply is not feasible, service provider will continue to manage local alendronate purchase.

Qualified Person for Drug Release

 

 

 

ü

 

Sponsor will be responsible for shipping study drug to the study centers

Study Drug Shipping

 

 

 

ü

 

Sponsor will be responsible for shipping study drug to the study centers.

Package Clinical Trial Materials

 

NA

 

ü

 

Sponsor will be responsible to package the clinical trial material, including payment of any third party costs related to packaging.

Country specific labels

 

NA

 

ü

 

Sponsor will be required for labeling

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

 

 

 

 

 

 

the study drug kits. Service provider will be responsible to provide label translation and review label prior to packaging.

Instructions for Use - Alendronate

 

NA

 

NA

 

Sponsor is responsible to provide the Package inserts

Sharps containers

 

NA

 

NA

 

 

Alcohol Swabs

 

NA

 

NA

 

 

Study Drug Release & Distribution (IVRS)

 

NA

 

NA

 

 

Study Drug Reconciliation — Patient, Site, & Study

 

ü

 

R

 

Service provider will be responsible to perform site level drug accountability during the clinical study. Each alendronate and vitamin D and calcium tablet will need to be accounted for during and at the end of the study for each patient at every clinical site.

Study Drug Destruction

 

 

 

ü

 

Sponsor will be responsible for final study drug destruction and accountability.

Study Drug: Import Broker, License & Requirements

 

 

 

ü

 

Sponsor will be responsible to provide all information necessary to import the study drug and clinical trial materials, as needed. Sponsor will be responsible to contract with a local customs or import broker to facilitate the import of clinical trial materials, if necessary.

Proforma Invoice

 

 

 

ü

 

Sponsor will be responsible to create the proforma invoices for importing study drug. Sponsor will be responsible to provide necessary information to complete the proforma invoice.

Clinical Trial Conduct

 

 

 

 

 

 

Data Safety Monitoring Board

 

 

 

ü

 

Sponsor will be responsible to create a Data Safety Monitoring Board for the clinical study as needed.

Clinical Trial Project Plan

 

R

 

ü

 

Sponsor will be responsible for developing a Clinical Trial Project Plan to identify the goals, objectives, timelines, milestones, organization chart, vendor list (including roles & responsibilities), and budget forecast and tracking for the clinical study. The Sponsor will be required to approve the clinical trial project plan prior to screening.

Clinical Trial Budget Forecasting & Tracking

 

ü

 

R

 

Service provider will be responsible for forecasting and tracking the trial expense and reporting to the Sponsor on a monthly basis.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Clinical Trial Insurance

 

 

 

ü

 

Sponsor will be responsible for obtaining and maintaining insurance for the clinical trial. Sponsor will be responsible to provide proof of insurance to the Service provider, as required.

Safety Monitoring

 

ü

 

 

 

Service provider will be responsible for safety monitoring.

Medical Monitoring

 

 

 

ü

 

Sponsor is responsible for Medical Monitoring

Vendor Management - Labs, Dexa, EDC

 

ü

 

 

 

Service provider will be responsible for qualifying, contracting, payment for services, data collection, and quality and compliance for any service contracted out by the Service provider.

Vendor Management — Central Drug Manufacture/Package

 

 

 

ü

 

For geographies where central supply is feasible, Sponsor will secure centrally-sourced alendronate and ensure appropriate packaging for clinical use as needed.

Vendor Management - PK, AntibodyIVRS

 

NA

 

NA

 

 

Vendor Payments

 

ü

 

ü

 

Sponsor and Service provider will be responsible to pay third party vendors to whom they have contracted required study services.

Patient Recruitment, Screening, Enrollment

 

ü

 

R

 

Service provider will be responsible for patient recruitment, screening, and enrollment. Service provider will provide, until enrollment completes, the Sponsor with a weekly update of cumulative number of patients completed for 003 by week, , number screened within the reporting week, number screened but not enrolled, number failed screening, and number enrolled in 005.

Site Selection

 

N/A)

 

N/A

 

Site selection pre-determined in 003 study.

Site Management

 

ü

 

 

 

Service provider will be responsible for site management activities.

Site Confidentiality Agreements

 

ü (ex-US)

 

ü (US)

 

Service Provider will be responsible to collect Site Confidentiality agreements prior to communicating any study specific information. A copy of the CDA will be sent to the Sponsor upon execution of the document..

Site Contract/Agreement

 

ü (ex-US)

 

ü (US)

 

Service Provider will be responsible to create and manage the Site Contracts. A copy of the Site Agreement will be sent to the Sponsor upon execution of the document.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Clinical Trial Monitoring & Plan

 

ü

 

A

 

Service provider will be responsible to create a clinical trial monitoring plan as per the Service provider’s SOP for Clinical Monitoring and monitor the clinical study conduct at the sites. The Sponsor is responsible for approving the monitoring plan prior to study start.

Clinical Trial Monitoring Reports

 

ü

 

R

 

Service provider will be responsible to create clinical trial monitoring reports that document the clinical trial monitoring visit. The clinical trial monitoring report will be generated using the format identified in the Service provider’s SOP. The monitoring reports will be made available to the Sponsor for review within 10-20 days of the monitoring visit - .

Clinical Trial Monitors

 

ü

 

A

 

Service provider will be responsible to provide qualified clinical trial monitors to perform required monitoring duties.

Monitor Travel Expense

 

ü

 

 

 

Service provider will be responsible for monitoring expenses.

 

 

 

 

 

 

 

Sponsor Meetings

 

ü

 

ü

 

Sponsor and Service provider will be responsible for scheduling Sponsor Meetings on a weekly basis during enrollment and monthly after enrollment completes. Meetings can also happen on an ad-hoc basis as required by the Sponsor or Service provider.

Sponsor Meeting Minutes

 

A

 

ü

 

Sponsor will be responsible to create the meeting minutes for the Sponsor meetings and circulate a draft within 24 hours. Service provider will review and provide comment within 24 hours. Meeting minutes will be required to be final within 72 hours.

Trial Staff Training

 

ü

 

R

 

Service provider will be responsible for training of all trial staff as well as documenting the training for new trial staff members and retraining of existing trial staff members. The training records will be made available for the Sponsor’s review.

Investigator Meeting & Training

 

ü

 

ü

 

Service provider will be responsible for planning and conducting the study investigator meetings. Sponsor will be responsible to assist in the preparation and approval of

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

 

 

 

 

 

 

investigator meeting training materials.

Central Imaging Analysis (BMD)

 

ü

 

 

 

Service provider will be responsible to provide central imaging services to assess the protocol required measures for bone mineral density.

Protocol Deviation & Waiver

 

ü

 

ü

 

Service provider will be responsible to identify and/or collect all protocol deviations and violations. All violations will be reviewed by the Study Safety Officer and the Medical Monitor prior to deciding if the patient can participate sin the study or must be excluded. Waivers should minimized and inclusion/exclusion criteria adhered to.

Sponsor Project Update Reports

 

ü

 

 

 

Service provider will be responsible to create monthly study status update reports as agreed with the CTL and MD.

Trial Master File

 

ü

 

 

 

Service provider will be responsible to create, maintain, and reconcile the trial master file including all required Essential Documents. At the end of the study, the trial master file will be sent to the Sponsor. The Sponsor will be responsible for archiving the trial master file. The TMF is electronic.

Site Trial File

 

ü

 

 

 

Service provider will be responsible to ensure the site trial file is complete at all times during the study. The Service provider will be responsible to reconcile the site file against the trial master file site file.

Investigator Site Payments

 

ü (ex-US)

 

ü (US)

 

Service provider will be responsible for site payments except the US.

Essential Document Collection

 

ü

 

 

 

Service provider will be responsible to collect and file all required GCP Essential Documents. The Essential Documents will be part of the trial master file.

Printing Study Documents

 

ü

 

 

 

Service provider will be responsible to print or contract printing services for all study documents for sites and patients.

Labs

 

 

 

 

 

 

Central or Local Safety Labs

 

ü

 

 

 

Service provider will be responsible for the central and safety lab vendor contracting, management, payments, sampling of patient samples, and reporting of sample results.

Central/Safety/Bone Marker Labs Data Reporting (SI Units)

 

ü

 

 

 

Service provider will be responsible for the transfer specification and

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

 

 

 

 

 

 

transfer of lab data from the central labs. Service provider will be responsible for validating the transfer and reconciling the lab data with the study database.

Abnormal lab value flags

 

ü

 

 

 

Service provider will be responsible for creating flags for abnormal lab values and ensuring these are communicated to the clinical sites.

Lab Specimen Management, Shipping & Reconciliation

 

ü

 

 

 

Service provider will be responsible for lab sample management, shipping and storage according to the required conditions, and reconciliation.

Lab Manual

 

ü

 

A

 

Service provider will be responsible to develop a lab manual with lab collection, handling, and shipping instructions for distribution to the site. The Sponsor will be responsible to approve the lab manual prior to study start.

Lab Kits & Supplies

 

ü

 

 

 

Service provider will be responsible to provide the lab kits and supplies to the study sites.

Lab Sample Storage

 

ü

 

 

 

Service provider will be responsible for storage of lab samples according to the required conditions until all lab data are final and reported.

Lab Sample Destruction

 

ü

 

A

 

Service provider will be responsible for destroying lab samples. Sponsor approval is required prior to destroying any lab samples.

Bone Marker Analysis & Data Reporting

 

ü

 

 

 

Service provider is responsible for the bone marker sample analysis and data reporting. The data transfer will be validated and reconciled with the study database.

PK & PK Data Reporting

 

NA

 

NA

 

 

Antibody (including NAbs) analysis & Data Reporting

 

 

 

ü

 

Sponsor will be responsible for Anti-drug antibody and neutralizing antibody sampling and data reporting.

Data Management

 

 

 

 

 

 

Data management plan

 

ü

 

A

 

Service provider will be responsible to create the Data Management Plan for the study upon approval of the CRF. Sponsor will be required to approve the plan before first patient first visit..

Annotated Case Report Form

 

ü

 

A

 

Service provider will be responsible to create the Annotated Case Report Forms based on CDISC SDTM. .

CRF

 

ü

 

A

 

Service provider will be responsible to create the Case Report Forms for data entry. Sponsor will be required to approve the CRF during the eCRF

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

ü  = Owner

A = Approve

R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

 

 

 

 

 

 

user acceptance tests (eCRF screen review meetings).

CRF Completion Instructions

 

ü

 

 

 

Service provider will be responsible to create the CRF completion instructions and distribute to the study sites. Sponsor will be required to approve the CRF completion instructions prior to site distribution.

Data validation checks

 

ü

 

R

 

Service provider will be responsible to create the data entry data validation checks. The data validation checks will be provided for Sponsor review.

Database Development, Testing, and Validation

 

R

 

ü

 

Service provider will be responsible for database development, testing, and validation in compliance with 21 CFR Part 11.

EDC System User Acceptance Testing

 

ü

 

 

 

Service provider will be responsible for user acceptance testing the EDC system before it is release for production environment. Changes to the EDC system during the study must be tested before released to production

Data Cleaning & Query Management

 

ü

 

R

 

Service provider will be responsible to manage the study data collection, data cleaning, and query management process.

Double Data Entry

 

NA

 

 

 

For paper-based CRFs, Service provider will be responsible to double data enter the CRF data into the study database.

Data Transfers Specifications

 

ü

 

R

 

Service provider will be responsible to create the data transfer specifications for all data collected outside the study database from third party vendors. The data transfer specification will be provided for Sponsor review.

Data Transfers & Merge

 

ü

 

ü

 

Service provider will be responsible to collect and validate the external data transfer and merge the datasets into the study database. The data transfer specification will be provided for Sponsor review.

DSMB Data Preparation & Transfer

 

ü

 

 

 

Service provider will be responsible for cleaning the data, managing the queries and preparing a database transfer to the Sponsor’s statistician for a DSMB meeting.

Data Listings for Medical & Sponsor Review

 

ü

 

R

 

Service provider will be responsible to generate data listings for Medical and Sponsor Review during the study. The data listings will include: Reasons for Enrollment Failure, Baseline Demographics (during screening), Adverse Events (monthly),

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

 

 

 

 

 

 

Concomitant Medications (on request), Study Drug Administration (on request), Abnormal Labs (monthly), Elevated Calcium (on request).

Data Coding (MeDRA, WHO Drug)

 

ü

 

A

 

Service provider will be responsible to code all Adverse Events, Medical History and Concomitant Medications with MeDRA and WHO Drug and provide medical review and oversight of the coding. Sponsor will be responsible to approve the coding of events and medications appropriately.

eCRF and Query Tracking

 

ü

 

 

 

Service provider will be responsible to manage and track site compliance with data entry by tracking CRFs and queries.

SAE Database Reconciliation

 

ü

 

A

 

Sponsor and Service provider will be responsible to perform a reconciliation of the events in the safety and trial database. Service provider will perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock. The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Local Tolerance Diary

 

A

 

ü

 

The Sponsor will be responsible to create the Local Tolerance Diary.

Drug Compliance Diary

 

A

 

ü

 

The Sponsor will be responsible to create the Drug Compliance Diary.

Patient CRFs for CSR (SAE or AE Discontinued)

 

ü

 

 

 

Service provider will be responsible to generate copies of the entire individual patient case report forms for all patients who had a serious adverse event or discontinued due to adverse event.

Investigator Signoff of Patient eCRF

 

ü

 

 

 

Service provider will be responsible to insure that the investigator has signed off on the patient case report forms that the data are reviewed and accurate.

Blinded Data Review Meeting with Sponsor

 

ü

 

A

 

Service provider will be responsible to provide the Sponsor with a completed database for blinded data review prior to database lock. Sponsor will be required to review and approve the database and data prior to database lock.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Database Lock

 

ü

 

A

 

Service provider will be responsible to lock the study database. Sponsor will be required to review and approve all changes or queries generated during the blinded study review meeting have been resolved and the database can be locked.

Data Transfer to Sponsor

 

ü

 

 

 

Service provider will be responsible to transfer the study data and database to the sponsor.

Data Archiving & PDF

 

ü

 

 

 

Service provider will be responsible to generate data and PDF for archiving. Service provider will be responsible to provide each study center a data archive for the sites’ patients.

Safety & Pharmacovigilance

 

 

 

 

 

 

Study Safety Officer

 

ü

 

A

 

Service provider will be responsible to provide a Safety Officer to oversee and report on any serious adverse event.

Pharmacovigilance (PV) Plan

 

ü

 

A

 

Service provider will be responsible to develop a PV plan that documents the safety reporting process and health authority submission responsibilities.

Safety Reporting Database

 

ü

 

ü

 

Service provider will be responsible to enter serious adverse events data in a validated 21 CFR Part 11 compliant database provided by Sponsor.

SAE Site Reporting Form

 

ü

 

A

 

Service provider will be responsible to provide an SAE reporting form at the start of the study. This form will capture all the necessary reporting information requiring for submitting a CIOMS form to the Health Authorities. Sponsor will be responsible to approve the SAE reporting form.

ICSR CIOMS Initial & Follow up Forms

 

ü

 

A

 

Service provider will be responsible to complete the CIOMS form for all initial and follow up Suspected Unexpected Serious Adverse Event

ICSR Tracking of Health Authority filings

 

ü

 

R

 

Service provider will be responsible to create a tracking tool for all reported serious adverse events and report status (i.e., initial, follow up, dates of submission). Study Safety Officer is responsible for performing routine review of AEs and SAEs and performing an analysis of similar events.

Serious Adverse Event Narrative

 

 

 

ü

 

Sponsor will be responsible to create the SAE narrative for the clinical study report.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

DSUR; Annual & Periodic Safety Update Generation & Filing

 

ü

 

ü

 

Sponsor is responsible for creating the DSUR and will submit it in USA. Service provider will be responsible to submit it to all other Health Authorities.

Health Authority Reporting

 

ü

 

ü

 

Sponsor will be responsible to submit SAE CIOMS Initial and Follow up to USA. Service provider will be responsible to submit the CIOMS Initial and Follow up to all other Health Authorities. Reports are required to be made within timelines given in the PV Plan.

SAE CIOMS Site Distribution

 

ü

 

 

 

Service provider will be responsible to notify the sites and distribute the CIOMS forms to the sites for reporting to local ethics, as required.

SAE Reconciliation with Data Management

 

ü

 

ü

 

Sponsor and Service provider will be responsible to perform an SAE reconciliation of the trial database with safety & pharmacovigilance reporting database prior to database lock. The Sponsor will be responsible to approve the SAE reconciliation has been performed accurately.

Final Safety Report for HA, EC, IRB submission

 

ü

 

ü

 

Sponsor and Service provider will be responsible to create the final safety report at the end of the study as part of the CSR. Sponsor will submit final safety report to USA and Service Provider to other HAs and ECs.

Statistics

 

 

 

 

 

 

Randomization Scheme

 

 

 

ü

 

Sponsor’s statistician will be responsible to create and maintain the randomization scheme only unblinding after database lock.

Statistical Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the Statistical Analysis Plan (SAP) prior to database lock.

Statistical Programming

 

 

 

ü

 

Sponsor’s statistician and statistical programmer will be responsible to develop the statistical programming for the analyses and TLFs

TLF Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate all tables, listings, and figures for the study.

Data Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to perform the study analyses.

DSMB Table Generation

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the required tables and data for the DSMB.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ü  = Owner
A = Approve
R = Review

 

 

 

Activity Responsible

 

 

 

 

Nordic
Bioscience

 

Radius
(Sponsor)

 

Expectation

Population PK Analysis Plan

 

 

 

ü

 

Sponsor’s statistician will be responsible to create the PopPK analysis plan prior to database lock.

Population PK Analysis

 

 

 

ü

 

Sponsor’s statistician will be responsible to generate the programming and analyses for the Population PK analysis.

Medical Writing

 

 

 

 

 

 

Clinical Study Report

 

 

 

ü

 

Sponsor’s Medical Writer will be responsible to write the clinical study report

CSR Narratives (SAE, AE Discontinuation)

 

ü

 

ü

 

Service provider’s Safety & Pharmacovigilance group will be responsible for generation the CIOMS forms during the clinical study. The Sponsor’s Medical Writer will be responsible for generating and incorporating the narratives into the CSR.

Quality

 

 

 

 

 

 

CRO Qualification

 

 

 

ü

 

Sponsor will be responsible for qualification of the Service provider.

CRO GCP and systems audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct Service provider GCP and systems audits.

Third party qualification and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct qualifications and audits for third party vendors.

Investigator site audits

 

 

 

ü

 

Sponsor may be responsible, from time to time, to conduct investigator site audits.

Health Authority inspections/audits

 

ü

 

ü

 

In the event of an Health Authority inspection of the Service provider or sites, the Service provider and Sponsor will be responsible for assisting with the inspection, providing responses to inspector requests, and drafting follow up responses to the inspection inquiries.

Clinical trial documents review and audit

 

 

 

ü

 

Sponsor may be responsible, from time to time, to review and/or audit the Service provider’s clinical trial documents (i.e., trial master files).

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-3

 

Attachment D

 

Core Team Members/Key Personnel

 

The following core team members will conduct the services listed in Attachment A.

 

Sponsor will be notified of any changes to the core team member.

 

Study Safety Officer

 

Bente Juel Riis

[*]

Clinical Trial Leader

 

Jeppe Ragnar Andersen

[*]

Clinical Trial Manager

 

Morten Thorup Pedersen

[*]

Pharmacovigilance Manager

 

Bodil Simonsen

[*]

Clinical Data Managers

 

Henrik Bo Hansen
Ole Eskildsen

[*]
[*]

Statistical Advisor

 

Inger Byrjalsen

[ *]

Medical Coder

 

Lisbeth Heiden

[*]

Head of Central Laboratory

 

Per Qvist

[ *]

Clinical Regulatory Coordinator

 

Bodil Simonsen

[ *]

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-3

 

Attachment E

 

Protocol title and date

 

Study Protocol BA058-05-005: An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003, dated 23 July 2012.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Radius Health, Inc.

Confidential

 

 

CLINICAL STUDY PROTOCOL

 

An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003

 

This study will be conducted according to the protocol and in compliance with Good Clinical Practice, the ethical principles stated in the Declaration of Helsinki, and other applicable regulatory requirements.

 

Protocol Number:

 

Protocol BA058-05-005

Protocol Date (Version):

 

Original (23 July 2012)

EudraCT Number

 

2012-002216-10

IND Number:

 

73,176

Study Sponsor:

 

Radius Health, Inc.
201 Broadway, 6
th  Floor Cambridge, MA 02139, USA
Tel: 617.551.4700. Fax: 617.551.4701

Sponsor Medical Monitor:

 

Louis Brenner, MD
Chief Medical Officer, Radius Health, Inc.
Tel: 617.551.4006. Fax: 617.551.4701.
Email: [ *]

Study Safety Officer

 

Bente Juel Riis, MD
Medical Advisor, Nordic Bioscience A/S
Tel: +45 22 90 13 17. Fax: +41 91 970 2988
Email: [*]

Contract Research
Organization (CRO):

 

Nordic Bioscience A/S
Herlev Hovedgade 207
2730 Herlev, Denmark
Tel: +45 4452 5252. Fax: +45 4452 5251

 

Disclosure Statement
This document contains information that is confidential and proprietary to Radius Health, Incorporated (RADIUS).  This information is being provided to you solely for the purpose of evaluation and/or conducting a clinical trial for RADIUS.  You may disclose the contents of this document only to study personnel under your supervision and/or to your institutional review board(s) or ethics committee(s) who need to know the contents for this purpose and who have been advised on the confidential nature of the document.

 

Protocol BA058-05-005 ( Original ) 23 July 2012

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

PROTOCOL SYNOPSIS

 

Title:      An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003

 

Protocol Number:   BA058-05-005

 

Test Drug:   BA058 Injection

 

Study Objectives:

 

The primary objective of this study is to collect clinical information regarding six months of standard-of-care osteoporosis management, including treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection or Placebo in Study BA058-05-003.  Safety data will be obtained via clinical, laboratory and radiologic assessments.  Since it is recommended and anticipated that the majority of the subjects will be treated with alendronate during the six month study, the study objectives are based upon alendronate treatment.

 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate in subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

Study Population:

 

Subjects with postmenopausal osteoporosis who completed the End-of-Treatment Visit (Visit 9) for Study BA058-05-003 and were previously randomized to either blinded BA058 Injection 80 µg or blinded Placebo are eligible for inclusion into this Extension Study provided that they fulfill the Inclusion/Exclusion criteria described below.

 

Inclusion/Exclusion Criteria

 

Otherwise healthy ambulatory postmenopausal women who participated in, and who completed 18 months of treatment with either blinded BA058 Injection 80 µg or blinded Placebo in Study BA058-05-003, are scheduled to complete or have completed the End-of-Treatment visit (Visit 9 in Study BA058-05-003), and who have provided a new written informed consent for the Extension Study, are eligible for enrollment into this study.  Participants must be no more than 33 days from last dose of study medication in Study BA058-05-003 to be eligible for this study.  The physical exam and labs from the End-of-Treatment visit from Protocol BA058-05-003 (Visit 9) of the BA058-05-003 study will provide baseline data for this Extension Study.  In addition, the subjects must, in the opinion of the Investigator, be appropriate candidates for further osteoporosis management.

 

Subjects will not be enrolled if they experienced a treatment-related SAE as assessed by the Investigator, or if they were withdrawn from Study BA058-05-003 for any reason.  Subjects who are not candidates for alendronate treatment will receive standard-of-care management determined to be

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

appropriate by the Investigator.  Specific inclusion and exclusion criteria are described in Section 4.1 and Section 4.2, respectively.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Study Design and Methodology:

 

Number of Subjects

 

All subjects who were randomized to the BA058 Injection 80 µg/Placebo arms in Study BA058-05-003, and who completed 18 months of treatment will be offered the opportunity to participate in this study.  There will, therefore, be a potential maximum of 1,600 subjects eligible to be enrolled in this study.

 

Design

 

This study will be an open-label extension of Study BA058-05-003.  The purpose of the study is to provide longer term safety data, fracture data and BMD data after six months of standard-of-care osteoporosis treatment, including treatment with alendronate, in otherwise healthy ambulatory postmenopausal women with severe osteoporosis who have previously received 18 months of blinded treatment with BA058 Injection or Placebo.

 

Subjects randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 and who are candidates for ongoing osteoporosis care, will receive six months of treatment with oral alendronate at a dose of 10 mg per day.  Subjects who are sensitive to alendronate, or who are not candidates for alendronate, may also participate in the study and be treated with an alternative osteoporosis medication according to the Investigator.  Both groups of subjects will undergo protocol specified procedures (Section 7.0, Appendix 14.1 and 14.2) including BMD and fracture assessment.  The study design is presented in Figure 1, below.

 

Figure 1: Protocol BA058-05-005 Study Design

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Figure 1:  Protocol BA058-05-005 Study Design

 

 

In this study, the Follow-up Visit from the 18 month study (Visit 10 from Study BA058-05-003) will serve as the Day 1 Visit (Visit 1) for this six month extension study (Study BA058-05-005).

 

All subjects will continue to take calcium and vitamin D supplementation throughout the Extension Study.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Study Visits

 

At the End-of-Treatment Visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with subjects randomized to BA058 80 µg/Placebo.  This Extension Study will be comprised of standard-of-care osteoporosis management, including six months of treatment with alendronate, if appropriate.  In the month between Visit 9 and Visit 10 (between months 18 and 19 of Study BA058-05-003), the Investigator will consider the results of the assessments performed at Visit 9, including a local review of BMD, and determine if alendronate, or an alternative therapy, is appropriate for the subject, as part of this extension study.

 

At the Follow-up (Visit 10 for Protocol BA058-05-003, Day 1 for Protocol BA058-05-005) subjects; who were randomized to BA058 Injection 80 µg/Placebo, who fulfill the inclusion/exclusion criteria (Section 4.1 and Section 4.2), and who have agreed to participate in the Extension Study; will sign the Informed Consent Form and be enrolled in the study.

 

Alendronate is the recommended osteoporosis treatment for this extension study.  Subjects who have been determined by the Investigator to be candidates for alendronate therapy will receive open-label oral alendronate treatment at a dose of 10 mg per day for six months.  Subjects will be instructed to take their first dose of alendronate for Study BA058-05-005 in the morning, on the day following their Day 1 visit.  Subjects who are not candidates for alendronate will receive alternative standard-of-care management, as determined by the Investigator, for osteoporosis for six months.

 

All subjects will have clinic visits for study related procedures at Day 1, Month 3 and Month 6.  For the purpose of this study one month is equal to 30 days.

 

Statistical Considerations:

 

Exploratory statistical analyses will assess longer term safety, fracture incidence (including vertebral and non-vertebral fracture), and BMD change following treatment with alendronate for six months after the completion of a subject’s participation of 18 months in study BA058-05-003.

 

Fractures and BMD Analyses

 

All specified endpoints will be summarized by treatment group and study period using standard descriptive statistics (n, mean, SD, median, minimum, maximum or n and %, as appropriate).  The fracture incidence; either clinically or radiologically determined, based on clinical events or protocol-directed vertebral x-rays at Month 6 of this Extension Study; will be tabulated.  In addition, BMD results from the six months of treatment with alendronate will also be tabulated, with additional tabular categories for results from the entire contiguous 24 months from baseline of study BA058-05-003 through the end of Study BA058-05-005, as well as the results during the 18 months of study BA058-05-003, for subjects who eventually enter study BA058-05-005.  These descriptive analyses will be conducted on all subjects with baseline and post-baseline data.  The analyses for the group that does not receive alendronate will also be descriptive in nature.

 

Safety Analysis

 

Data will be summarized and tabulated based on the enrolled population for this Extension Protocol.  All subjects enrolled in the Extension Protocol will be included in the safety analysis that will be performed on the following parameters:

 

·                   Incidence and severity of AEs.

 

·                   Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory, if applicable.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Safety assessments for changes in physical examination, vital signs, ECG, and laboratory tests will be descriptively summarized by treatment and study periods.  Concomitant medication classes will be categorized using World Health Organization (WHO) drug dictionary and summarized by number and percent of subjects using each class by treatment group.  All treatment emergent adverse events (TEAEs) will be coded for system organ class (SOC) and preferred term (PT) using MedDRA and the number (%) of subjects experiencing each AE (SOC/PT) will be summarized by treatment, relationship to treatment, and severity.  All serious adverse events (SAE) will be listed and the number (%) of subjects with an SAE presented by treatment group.

 

Procedures and Assessments

 

Fractures and BMD

 

The End-of-Treatment (Visit 9) evaluations for vertebral fracture assessment, non-vertebral fracture assessment and BMD from Study BA058-05-003 will serve as the baseline evaluations in this study.  The Day 1 assessment will be concurrent with the Follow-up Visit (Visit 10) for Study BA058-05-003.  Subjects will return to the clinic for assessment of BMD at spine, hip and wrist (for those subjects who had wrist DXAs performed in Study BA058-05-003) at Month 6.  Clinical and radiographic assessments for fractures, bone marker assessments of anabolism (PINP, bone-specific alkaline phosphatase and osteocalcin) and resorption (CTX) will be performed at Month 6.

 

Safety

 

Safety evaluations performed will include physical examinations, vital signs, 12-lead ECGs, clinical laboratory tests, and monitoring and recording of adverse events.

 

Complete details of the study assessments are provided in Section 7.0, in the Schedule of Visits and Procedures (Appendix 14.1) and in the Suggested Schedule of Events and Procedures by Study Visit (Appendix 14.2).

 

Treatments Administered

 

Alendronate sodium (Fosamax®, Merck & Co., Inc., or other approved generic manufacturer) 10 mg tablets for oral administration contain 13.05 mg of alendronate monosodium salt trihydrate which is the molar equivalent of 10 mg free acid and excipients.  Alendronate should be stored in a well-closed container at room temperature, 15-30ºC.  The alendronate may be generic substitutable approved versions which contain different inactive ingredients, but the amount of active free alendronate must be equivalent to 10 mg.  Alendronate will be sourced locally by the medical center and reimbursed by the Sponsor.

 

Any alternative treatment(s) for osteoporosis will be sourced locally at the discretion of the Investigator.  The Sponsor and the Investigator will not provide or be responsible for the costs of the alternative medication, should one be prescribed.  This will be at the discretion of the Investigator and subject.

 

Calcium (500—1000 mg) and vitamin D (400—800 IU) supplements will be sourced locally by the medical center and provided to the subjects at the expense of the Sponsor.  Independent of alendronate, or other prescribed osteoporosis medication, subjects will continue to take calcium and vitamin D as they did in Study BA058-05-003.

 

Duration of Subject Participation:

 

Participation will be approximately seven months (28 weeks) from enrollment to completion of final study evaluations.  In combination with Study BA058-05-003, subjects will participate in this clinical

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

postmenopausal osteoporosis program for 26 to 27 months.  The first visit of Study BA058-05-005 will be concurrent with Visit 10 of Study BA058-05-003.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

TABLE OF CONTENTS

 

PROTOCOL SYNOPSIS

3

 

 

 

Table of Contents

10

 

 

 

List of Abbreviations

14

 

 

 

1.0

introduction

16

 

1.1

Background Information

16

 

1.2

Drug Under Study

16

 

 

1.2.1

Efficacy of Alendronate

16

 

 

1.2.2

Safety of Alendronate Sodium

17

 

1.3

Study Rationale and Selection of Doses

18

 

 

1.3.1

Study Rationale

18

 

 

1.3.2

Study Design

18

 

 

1.3.3

Study Population

19

 

 

1.3.4

Selection of Endpoints

19

 

 

1.3.5

Selection of Dose

19

 

 

 

2.0

STUDY OBJECTIVES

19

 

 

 

3.0

INVESTIGATIONAL PLAN

20

 

3.1

Overall Design and Study Plan

20

 

 

3.1.1

Treatment Period

21

 

 

 

4.0

SELECTION OF STUDY POPULATION

22

 

4.1

Number of Subjects

22

 

4.2

Inclusion Criteria

22

 

4.3

Exclusion Criteria

22

 

4.4

Withdrawal of Subjects from the Study

23

 

4.5

Temporary Suspension of Treatment

23

 

4.6

Replacement of Subjects

23

 

 

 

5.0

STUDY TREATMENTS

24

 

5.1

Study Medications

24

 

 

5.1.1

Alendronate

24

 

 

5.1.1.1

Restrictions on Alendronate Use

24

 

 

5.1.2

Alternative Osteoporosis Medication

24

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

 

5.1.3

Calcium and Vitamin D Supplements

24

 

5.2

Packaging, Labeling and Storage

24

 

 

5.2.1

Storage

24

 

5.3

Treatment Assignment

25

 

5.4

Study Medication Administration

25

 

 

5.4.1

Alendronate Administration

25

 

 

5.4.2

Alternative Osteoporosis Medication Administration

25

 

5.5

Treatment Compliance

25

 

5.6

Unblinding of Study Medication

26

 

 

 

6.0

CONCOMITANT MEDICATIONS

26

 

6.1

Concomitant Medications

26

 

6.2

Prohibited Medications

26

 

 

 

7.0

STUDY ASSESSMENTS

27

 

7.1

Clinical Procedures/Assessments

27

 

 

7.1.1

Informed Consent

27

 

 

7.1.2

Medical History

27

 

 

7.1.3

Physical Examination

27

 

 

7.1.4

Vital Signs

27

 

 

7.1.5

Orthostatic Blood Pressure and Heart Rate

27

 

 

7.1.6

Electrocardiogram

28

 

 

7.1.7

Clinical Laboratory Evaluations

28

 

 

7.1.8

Clinical Chemistry and Urinalysis (Dipstick)

28

 

 

7.1.9

Hematology

29

 

 

7.1.10

Coagulation

29

 

 

7.1.11

24-Hour Urine Collection

29

 

 

7.1.12

Bone Mineral Density

30

 

 

7.1.13

Serum Markers of Bone Metabolism

30

 

 

7.1.14

Clinical and Radiologic Evaluation of Fractures

30

 

 

7.1.15

BA058 Antibody Assessments

30

 

 

7.1.16

Subject Diaries

31

 

 

7.1.17

Activity and Diet

31

 

 

 

8.0

ADVERSE EVENTS AND SAFETY EVALUATION

31

 

8.1

Definitions, Documentation, and Reporting

31

 

 

8.1.1

Adverse Event Definition

31

 

 

8.1.2

Serious Adverse Event Definition

31

 

8.2

Monitoring of Adverse Events and Period of Observation

32

 

8.3

Procedures for Recording and Reporting AEs and SAEs

32

 

8.4

Rules for Suspension of the Study

34

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

9.0

Statistical Procedures

34

 

9.1

Sample Size

35

 

9.2

Randomization, Stratification and Blinding

35

 

9.3

Populations for Analysis

35

 

 

9.3.1

Safety Population

35

 

9.4

Procedures for Handling Missing, Unused, and Spurious Data

35

 

9.5

Statistical Methods

35

 

 

9.5.1

Statistical Considerations

35

 

 

9.5.2

Baseline Comparisons

35

 

 

9.5.3

Fractures and BMD Analysis

36

 

 

9.5.4

Safety Analysis

36

 

 

9.5.5

Procedures for Reporting Deviations to Original Statistical Analysis Plan

36

 

9.6

Data Oversight

36

 

 

9.6.1

Central Review of Radiographs and DXA Scans

36

 

 

 

10.0

ADMINISTRATIVE REQUIREMENTS

37

 

10.1

Good Clinical Practice

37

 

10.2

Ethical Considerations

36

 

10.3

Subject Information and Informed Consent

37

 

10.4

Protocol Compliance

37

 

10.5

Case Report Form Completion

38

 

10.6

Source Documents

38

 

10.7

Study Monitoring

38

 

10.8

On-Site Audits

39

 

10.9

Drug Accountability

39

 

10.10

Record Retention

39

 

10.11

Study Termination

39

 

10.12

Liability and Insurance

40

 

 

 

11.0

USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

40

 

11.1

Use of Information

40

 

11.2

Publication

41

 

 

 

12.0

INVESTIGATOR AGREEMENT

42

 

 

 

13.0

References

43

 

 

 

14.0

APPENDICES

44

 

14.1

Schedule of Visits and Procedures

45

 

14.2

Suggested Schedule of Events and Procedures by Study Visit

47

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

14.3

Eastern Cooperative Oncology Group (ECOG) Common Toxicity Criteria

1

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

LIST OF ABBREVIATIONS

 

Abbreviation

 

Term

°C

 

Degree Celsius

°F

 

Degree Fahrenheit

µg

 

Microgram

µmol

 

Micromole

AE

 

Adverse event

ALT

 

Alanine aminotransferase

AST

 

Aspartate aminotransferase

BMD

 

Bone mineral density

BMI

 

Body mass index

bpm

 

Beats per minute

BSAP

 

Bone-specific alkaline phosphatase

BUN

 

Blood urea nitrogen

cm

 

Centimeter

CPK

 

Creatine phosphokinase

CRF

 

Case report form

CRO

 

Contract research organization

CTX

 

C-telopeptides of type 1 collagen crosslinks (serum)

DXA

 

Dual energy x-ray absorptiometry

ECG

 

Electrocardiogram

eCRF

 

Electronic case report form

FDA

 

Food and Drug Administration

g

 

Gram

GCP

 

Good clinical practice

GGT

 

Gamma-glutamyltranspeptidase

GLP

 

Good laboratory practice

GMP

 

Good manufacturing practice

hPTH1R

 

Human parathyroid hormone receptor 1

ICH

 

International Conference on Harmonization

IEC

 

Independent ethics committee

IRB

 

Institutional review board

ITT

 

Intent-to-treat

IU

 

International unit

IV

 

Intravenous

IVRS

 

Interactive voice response system

kg

 

Kilogram

L

 

Liter

LDH

 

Lactate dehydrogenase

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Abbreviation

 

Term

MCH

 

Mean corpuscular hemoglobin

MCHC

 

Mean corpuscular hemoglobin concentration

MCV

 

Mean corpuscular volume

MedDRA

 

Medical dictionary for regulatory activities

µL

 

Microliter

mg

 

Milligram

mL

 

Milliliter

mmHg

 

Millimeter of mercury

msec

 

Millisecond

NPO

 

Nothing by mouth

ng

 

Nanogram

ONJ

 

Osteonecrosis of the jaw

pg

 

Picogram

PINP

 

N-terminal propeptide of type I procollagen

PT

 

Prothrombin time

PTH

 

Parathyroid hormone

PTHrP

 

Parathyroid hormone related peptide

PTT

 

Partial thromboplastin time

PUBs

 

Upper respiratory perforations, ulcers and bleeds

QT

 

Total depolarization and repolarization time

QTc

 

Total depolarization and repolarization time corrected with heart rate

RBC

 

Red blood cell

rhPTH

 

Recombinant hPTH

SAE

 

Serious adverse event

SC

 

Subcutaneous

SD

 

Standard deviation

SERMs

 

Selective estrogen receptor modulators

SOP

 

Standard operating procedure

ULN

 

Upper Limit of Normal

WBC

 

White blood cells

WHO

 

World Health Organization

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

1.0        INTRODUCTION

 

1.1                          Background Information

 

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue which leads to enhanced fragility and increased risk of fractures (Rizzoli, 2001).  It is estimated that over 200 million people worldwide have osteoporosis (Reginster, 2006) and osteoporosis causes more than 8.9 million fractures worldwide, of which more than 4.5 million occur in the Americas and Europe (WHO Scientific Group, 2007).  The vast majority of osteoporotic fractures occur in elderly women and incidence increases markedly with age.  Most fractures occur at the spine, wrist and hip.  Of these, hip fractures carry the highest morbidity and mortality.  In 1990, the total number of hip fractures in men and women was estimated to be 1.26 million worldwide, and it is estimated that this number will increase to 3.6 million by 2025 and to 4.5 million by 2050 (Gullberg, 1997).

 

Subject enrolled in this Extension Study will have completed 18 months of treatment with BA058 Injection 80 µg/Placebo.  BA058 is a synthetic 34 amino acid analog of PTHrP, with molecular modifications of specific amino acids, and is under clinical development for the prevention of fractures in postmenopausal women with severe osteoporosis who are at a risk for fracture.  BA058 shows particular potential for reversing bone loss at both the spine and the hip, the site of the most debilitating osteoporotic fractures in elderly women.  BA058 is a synthetic analog of PTHrP (1-34) designed to give a greater anabolic effect than hPTH.  Initial in vitro and in vivo studies identified BA058 as displaying bone anabolic properties without a significant hypercalcemic effect.  In humans, BA058 has different pharmacokinetics (PK) and pharmacodynamics (PD) properties than hPTH(1-34) and has been shown in a Phase 2 study (BA058-05-002) to have similar or greater efficacy in restoring bone mineral density (BMD) in individuals with osteoporosis than hPTH(1-34).  Overall, BA058 has been well tolerated in previous studies.

 

This is an open-label Extension of Study BA058-05-003.  Enrollment requires previous participation in, and successful completion of, 18 months of treatment with BA058 Injection 80 µg/Placebo in Study BA058-05-003.  The purpose of this extension is to accumulate longer-term safety, fracture, and BMD data in subjects who receive six months of standard-of-care osteoporosis treatment, including treatment with alendronate, following 18 months of treatment with blinded BA058/Placebo treatment.  Alendronate, a bisphosphonate, is approved and marketed world-wide for the treatment and prevention of osteoporosis in postmenopausal women.

 

1.2                                Drug Under Study

 

1.2.1                      Efficacy of Alendronate

 

Alendronate is a bisphosphonate that acts as a specific inhibitor of osteoclast-mediated bone resorption.  Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.  At the cellular level, alendronate shows preferential localization to sites of bone resorption, specifically under osteoclasts.  The osteoclasts adhere normally to the bone surface but lack the ruffled border that is indicative of active resorption.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Alendronate does not interfere with osteoclast recruitment or attachment, but it does inhibit osteoclast activity. (Fosamax Package Insert)

 

Bisphosphonates including alendronate are widely used to treat osteoporosis.  In animal models, minipigs treated with alendronate exhibited a direct correlation between cancellous bone volume and bone strength (Lefage 1995).  In primates, treatment with alendronate increased the strength of cancellous bone between 44 and 100% (the effect was dose dependent) when compared to vehicle, and also increased bone mass (Balena 1993).  In dogs, this increase in bone mass occurred without causing abnormalities in bone modeling of bone structure (Balena, 1996).

 

In postmenopausal women, alendronate has been demonstrated to increase bone mineral density, decrease bone turnover and reduce the risk of fracture among women with osteoporosis (Tucci, 1996; Devogelaer, 1996; Liberman, 1995).  The therapeutic effects on bone density, remodeling and fracture prevention persist following daily treatment at an oral dose of 10 mg for up to 10 years (Bone, 2004).  Studies have demonstrated that sequential treatment of osteoporosis with one year of treatment with PTH followed by one year of treatment with alendronate resulted in an increase in vertebral bone density that was considerably greater than previously reported for alendronate alone (Rittmaster, 2000).  In subjects receiving PTH(1-84) followed by alendronate, there were significant increases in BMD, in particular trabecular spine, when compared to PTH(1-84) followed by placebo (31% vs. 14%, p<0.001) (Black, 2005).

 

1.2.2                      Safety of Alendronate Sodium

 

According to the US package insert for Fosamax® (alendronate sodium), in studies of up to five years duration, adverse experiences usually were mild and generally did not require discontinuation of therapy.  In a three-year, placebo-controlled, double blind study in which 196 subjects were treated with 10 mg/day, discontinuation due to any adverse experience occurred in 4.1% of subjects treated with alendronate, and 6% of 397 subjects treated with placebo.  The most frequently reported adverse event (occurring in > 2% of subjects treated with alendronate) in this study were abdominal pain, musculoskeletal pain, nausea, dyspepsia, constipation, diarrhea, flatulence, headache and acid regurgitation.

 

Alendronate may cause local irritation of the upper gastrointestinal mucosa.  Esophageal adverse experiences, such as esophagitis, esophageal ulcers and esophageal erosions occasionally with bleeding and rarely followed by esophageal stricture or perforation have been reported.  Osteonecrosis of the jaw (ONJ), which can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, has been reported in subjects taking alendronate.  For subjects requiring dental procedures, discontinuation of alendronate therapy may reduce the risk for ONJ.

 

Atypical, low-energy, or low trauma fractures of the femoral shaft have been reported in bisphosphonate-treated patients.  These fractures can occur anywhere in the femoral shaft from just below the lesser trochanter to above the supracondylar flare and are transverse or short oblique in orientation without evidence of comminution.  Causality has not been established as these fractures also occur in osteoporotic patients who have not been treated with bisphosphonates.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Atypical femur fractures most commonly occur with minimal or no trauma to the affected area.  They may be bilateral and many patients report prodromal pain in the affected area, usually presenting as dull, aching thigh pain, weeks to months before a complete fracture occurs.  A number of reports note that patients were also receiving treatment with glucocorticoids (e.g. prednisone) at the time of fracture.

 

Any patient with a history of bisphosphonate exposure who presents with thigh or groin pain should be suspected of having an atypical fracture and should be evaluated to rule out an incomplete femur fracture.  Patients presenting with an atypical fracture should also be assessed for symptoms and signs of fracture in the contralateral limb.  Interruption of bisphosphonate therapy should be considered, pending a risk/benefit assessment, on an individual basis.

 

According to the Summary of Product Characteristics for alendronate from the EMA, the following adverse experiences have been reported in alendronate treated subject during clinical trials and/or post-marketing use:

 

Common:  Headache, abdominal pain, dyspepsia, constipation, diarrhea, flatulence, esophageal ulcer, dysphagia, abdominal distension, acid regurgitation and musculoskeletal pain.

 

Uncommon:  Nausea, vomiting, gastritis, esophagitis, esophageal erosions, melena, rash, pruritus and erythema.

 

Rare:  Hypersensitivity reactions including urticarial and angioedema, symptomatic hypocalcemia (often in association with predisposing conditions), uveitis, scleritis, episcleritis, esophageal stricture, oropharyngeal ulceration, upper gastrointestinal perforations, ulcers and bleeds (PUBs), rash with photosensitivity, osteonecrosis of the jaw, atypical subtrochanteric and diaphyseal femoral fractures and transient symptoms as in an acute-phase response (myalgia, malaise and rarely, fever), typically associated with initiation of treatment.

 

1.3                                Study Rationale and Selection of Doses

 

1.3.1                      Study Rationale

 

The purpose of the study is to provide longer term safety data, fracture data and BMD data after six months of standard-of-care osteoporosis treatment, including treatment with alendronate, in otherwise healthy ambulatory postmenopausal women with severe osteoporosis who have previously received 18 months of blinded treatment with BA058 Injection or Placebo.

 

1.3.2                      Study Design

 

Subjects randomized to BA058 Injection 80 µg/Placebo, who have completed 18 months of treatment in Protocol BA058-05-003 and, who meet the Inclusion/Exclusion criteria (Sections 4.2 and 4.3) are eligible to participate in this study.  Subjects originally randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 and who are candidates for ongoing osteoporosis care, will receive six months of daily open-label alendronate treatment at a dose of 10 mg/day.  Subjects who are sensitive to alendronate, or who are not candidates

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

for alendronate, may also participate in the study and be treated with an alternative osteoporosis medication according to the Investigator.

 

1.3.3                      Study Population

 

The study population in this protocol is comprised of otherwise healthy ambulatory postmenopausal women who:

 

1.               have participated in Study BA058-05-003,

2.               were randomized to either BA058 Injection 80 µg/Placebo,

3.               have completed the End-of-Treatment Visit (Visit 9 in Study BA058-05-003), and

4.               have provided a new written informed consent for this protocol.

 

Subjects will not be enrolled if they experienced treatment-related SAE or were withdrawn from Study BA058-05-003 for any reason.

 

1.3.4                      Selection of Endpoints

 

The fracture incidence; either clinically or radiologically determined, based on clinical events or protocol-directed vertebral x-rays at Month 6 of this Extension Study; will be tabulated.  In addition, BMD results from the six months of treatment with alendronate will also be tabulated, with additional tabular categories for results from the entire contiguous 24 months from baseline of study BA058-05-003 through the end of Study BA058-05-005, as well as the results during the 18 months of study BA058-05-003, for subjects who eventually enter study BA058-05-005. Bone formation (PINP, osteocalcin, BSAP) and resorption (CTX) markers will also be assessed.  The End-of-Treatment (Visit 9) evaluations for BMD, vertebral fracture, and non-vertebral fracture assessments from BA058-05-003 will serve as the baseline evaluations in this study.

 

Subjects will be monitored for safety events and will have safety assessments performed at each study visit.  At the end of the study, at Month 6, BMD by DXA, as well as clinical and radiologic assessment of the spine for assessment of fractures will be performed.  Bone formation and resorption markers will also be assessed at Month 6.  Further details of these assessments are in Section 7.0, and in Appendix 14.1 and 14.2.

 

1.3.5                      Selection of Dose

 

The dose of alendronate (10 mg per day, oral) selected for this study is based upon the recommended daily dose in the product’s prescribing information.  Should an alternative treatment for osteoporosis be used, the dose and route of administration will be according to that product’s prescribing information.

 

All enrolled subjects will also continue to receive calcium (500-1000 mg) and vitamin D (400-800 IU) supplementation.

 

2.0        STUDY OBJECTIVES

 

The primary objective of this study is to evaluate data obtained following six months of standard-of-care osteoporosis treatment, including treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.  Safety will be evaluated with clinical, laboratory and radiologic assessment.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Since it is anticipated that the majority of subjects will be treated with alendronate, the study objectives are based upon this assumption.

 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate in subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

3.0          INVESTIGATIONAL PLAN

 

3.1                                Overall Design and Study Plan

 

This study is an open-label extension of Study BA058-05-003.  Subjects and Investigators who participate in Study BA058-05-005 will remain blinded to prior treatment assignment as part of BA058-05-003.  At the End-of-Treatment visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with subjects randomized to BA058 80 µg/Placebo.  The Extension Study will be comprised of standard-of-care osteoporosis management, including six months of treatment with alendronate, if appropriate.  In the month between Visit 9 and Visit 10, the Investigator will review the results of the assessments performed at Visit 9, including a local interpretation of BMD, and determine if alendronate, or an alternative therapy is appropriate for the subject.  All subjects will continue to receive vitamin D and calcium supplementation as they did in Study BA058-05-003.  The study design is presented in Figure 2, below.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Figure 2:  Protocol BA058-05-005 Study Design

 

 

The total duration of study participation for an individual subject is approximately six months from the initial treatment visit to final study evaluations.  There are a total of three clinic visits during the course of the study.

 

A brief summary of the study is provided below.  For a summary of the study assessments to be performed, refer to Section 7.0 (Study Assessments) and to the Schedule of Visits and Procedures (Appendix 14.1).  A more detailed description of the study procedures on a by-visit basis is provided in Appendix 14.2 (Suggested Schedule of Events and Procedures by Study Visit).  A suggested order of procedures is also provided in this schedule.

 

3.1.1                      Treatment Period

 

Subjects will enter into Study BA058-05-005 on Day 1, and Day 1 will also serve as Visit 10 (the Follow-up Visit) for Study BA058-05-003.  The Informed Consent must be signed prior to undergoing any BA058-05-005 study related procedures, and may be signed at either Visit 9 or Visit 10 of Study BA058-05-003.  Subjects who received BA058 Injection 80 µg/Placebo in Study BA058-05-003 will receive six months of open-label oral alendronate treatment, or an alternative osteoporosis treatment as part of this study (BA058-05-005).

 

If determined by the Investigator to be appropriate, treatment will be daily, by oral administration of alendronate at a dose of 10 mg.  Should an alternative treatment for osteoporosis be used, the dose and route of administration will be according to that product’s prescribing information.  Subjects will be given a weekly diary card to record missed doses of medication including calcium and vitamin D.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

A total of three clinic visits are scheduled during the study (Day 1, Month 3, and Month 6).

 

Subjects will be instructed to take their first dose of study drug for Study BA058-05-005 in the morning on the day following their Day 1 visit (Day 2 of this study).  Study subjects will continue calcium and vitamin D supplementation during this study as was administered during BA058-05-003 (Section 6.1).

 

At Month 3, subjects will return to the clinic for medication resupply, subject diary review and questioning as to their use of concomitant medications and the occurrence of adverse events.

 

The Month 6 visit will be scheduled to occur after the last dose of alendronate, at which time vital signs, ECG, and safety labs will be performed.  Vertebral fractures will be determined clinically and via protocol directed Month 6 x-ray evaluation; non-vertebral fractures will be determined clinically.  In addition, subjects will undergo a DXA of the hip and spine (and wrist, if the subject was enrolled in the wrist DXA sub-study in Study BA058-05-003), and have samples drawn for bone markers and anti-BA058 antibodies.  Any adverse event or clinical laboratory abnormality recorded at the Month 6 Visit will be monitored until it has resolved, become chronic or stable.  Procedures are to be performed as described in Section 7.0, Appendix 14.1 and Appendix 14.2.

 

4.0        SELECTION OF STUDY POPULATION

 

4.1                                Number of Subjects

 

Subjects who completed 18 months of treatment with either BA058 Injection 80 µg/Placebo in Study BA058-05-003 will be given the opportunity to participate in the Extension Study at all participating centers.  Based on randomization to the BA058 Injection 80 µg/Placebo arms in Study BA058-05-003, up to 1,600 subjects may be entered into this study.

 

The specific inclusion and exclusion criteria for enrolling subjects in this study are presented below in Sections 4.2 and 4.3, respectively.  Exceptions to these criteria should occur infrequently and should be discussed in advance and approved by the Sponsor Medical Monitor.

 

4.2                                Inclusion Criteria

 

Subjects must meet all of the following criteria to be eligible to participate in this study:

 

1.                                       The subject was enrolled, randomized to BA058 Injection 80 µg/Placebo and completed 18-months of blinded treatment within Study BA058-05-003.

 

2.                                       The subject is no more than 33 days from last study medication administration.

 

3.                                       The subject has read, understood, and signed the written informed consent form for the Extension Study.

 

4.3                                Exclusion Criteria

 

Subjects with any of the following characteristics are not eligible to participate in the study:

 

1.                                       Subjects who were withdrawn from Study BA058-05-003 for any reason.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

2.                                       Subjects who experienced a treatment-related SAE during Study BA058-05-003.

 

4.4                                Withdrawal of Subjects from the Study

 

Subjects will be informed that they have the right to withdraw from the study at any time for any reason without prejudice to their medical care.

 

Consistent with the prior protocol, BA058-05-003, the Investigator must withdraw subjects from the study prior at any time in the study for the following reasons:

 

·              Treatment-related SAEs;

 

·              Refusal of treatment;

 

·              Refusal or inability to complete study procedures;

 

·              Lost to follow-up.

 

The Investigator should exercise his/her best judgment and also has the right to withdraw subjects from the study during the study for any of the following reasons:

 

·              ECOG Grade 3 or 4 adverse events [Refer to Appendix14.3];

 

·              A complex of adverse events which, in the judgment of the Investigator justifies treatment cessation;

 

·              Serious intercurrent illness;

 

·              Non-compliance;

 

·              Protocol violations;

 

·              Administrative reasons.

 

If a subject is withdrawn or discontinued from the study, the reason for withdrawal is to be recorded in the source documents and on the case report form.  All subjects withdrawn prior to completing the study should be encouraged to complete the Month 6 Visit including any outstanding radiologic assessment or BMD assessment by DXA.

 

4.5                                Temporary Suspension of Treatment

 

The Investigator has the right to suspend treatment with alendronate without withdrawal of the subject from the study.  Reasons for temporary suspension of treatment may include a medical reason unrelated to an adverse event (e.g., a planned procedure), or important social or administrative events.  The reason for the suspension of treatment is to be documented in the electronic case report form (eCRF) and in source documents.

 

When treatment with alendronate is restarted, the subject should resume treatment with the next scheduled dose (as if treatment had not been interrupted).

 

4.6                                Replacement of Subjects

 

Subjects who have been enrolled into the study and subsequently withdraw or drop out of the study will not be replaced.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

5.0                          STUDY TREATMENTS

 

5.1                                Study Medications

 

Alendronate will be sourced locally.  Calcium and vitamin D will be provided by the study centers, similar to their provision in Study BA058-05-003.

 

5.1.1                      Alendronate

 

Alendronate will be sourced locally at the expense of the Sponsor.

 

Subjects will receive daily oral alendronate at a dose of 10 mg beginning on Day 2 for six months.  Additional provisions for dosing of alendronate should be followed based on the prescribing information.  Alendronate provided will be in the approved, marketed formulation.  The alendronate may be generic substitutable approved versions which contain different inactive ingredients, but the amount of active free alendronate must be equivalent to 10 mg.

 

5.1.1.1            Restrictions on Alendronate Use

 

Subjects should not receive alendronate if they have the following conditions/limitations:

 

·                                           Abnormalities of the esophagus and other factors which delay espophageal emptying such as stricture or achalasia.

 

·                                           Inability to stand or sit upright for at least 30 minutes.

 

·                                           Hypocalcemia.

 

·                                           Known history of hypersensitivity to alendronate, alendronate excipients, or related compounds.

 

5.1.2                      Alternative Osteoporosis Medication

 

Any alternative treatment(s) for osteoporosis will be sourced locally at the discretion of the Investigator.  The Sponsor and the Investigator will not provide or be responsible for the costs of that alternative medication should they be prescribed.

 

5.1.3                      Calcium and Vitamin D Supplements

 

Calcium and vitamin D supplements will be sourced locally and provided by the sites at the expense of the Sponsor.

 

5.2                                Packaging, Labeling and Storage

 

Alendronate will not be relabeled for the study.

 

Any alternative osteoporosis medication will not be relabeled for the study.

 

Calcium and vitamin D supplements will not be relabeled for the study.

 

5.2.1                      Storage

 

Alendronate must be kept in a secure, limited-access storage area until dispensed for use to a study subject.   Alendronate sodium should be stored in a well-closed container at room temperature, 15-30ºC (59-86ºF).

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

The alternative osteoporosis medication will be stored by the subject according to the instructions provided in the prescribing information and by the local pharmacy where the medication is purchased.

 

Calcium and vitamin D supplements may be stored at room temperature.

 

5.3                                Treatment Assignment

 

All subjects who participate will continue to be identified by the same 7-digit subject number that was assigned upon enrollment into Study BA058-05-003 throughout the study and on the eCRF.

 

5.4                                Study Medication Administration

 

5.4.1                      Alendronate Administration

 

Alendronate must be taken with water only (not mineral water) at least 30 minutes before the first food, beverage or medicinal product (including antacids, calcium supplements and vitamins) of the day.  Other beverages (including mineral water), food and some medicinal products are likely to reduce the absorption of alendronate.

 

The following instructions should be followed exactly in order to minimize the risk of esophageal irritation and related adverse reactions.

 

·                   Alendronate should only be swallowed after getting up for the day with a full glass of water (not less than 200 mL or 7 fl. oz.).

·                   Subjects should only swallow alendronate whole.  Subjects should not crush or chew the tablet or allow the tablet to dissolve in their mouths because of a potential for oropharyngeal ulceration.

·                   Subjects should not lie down until after their first food of the day.

·                   Subjects should not lie down for at least 30 minutes after taking alendronate.

·                   Alendronate should not be taken at bedtime or before arising for the day.

 

At the Month 3 visit, the unused alendronate tablets are to be returned to the clinic and the subject will be supplied with additional alendronate.  At the Month 6 visit, all unused alendronate tablets are to be returned to the study site.

 

5.4.2                      Alternative Osteoporosis Medication Administration

 

If it is determined by the Investigator that an alternative medication to alendronate is more appropriate for a particular subject, the dose and route of administration will be according to the products prescribing information.

 

5.5                                Treatment Compliance

 

The study site personnel will perform drug accountability at each clinic visit and review each subject diary (refer to Section 7.1.16).  Accountability will be documented on the appropriate forms and subjects will be re-trained on administration as appropriate.  All doses of study medication are to be self-administered.

 

If a subject does not administer or take all study medication including vitamin D or calcium, the reason for the missed dosing is to be recorded in source documents and on the eCRF.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Returned, unused alendronate will be accounted for by the study site.

 

5.6                                Unblinding of Study Medication

 

Not applicable.

 

6.0        CONCOMITANT MEDICATIONS

 

6.1                                Concomitant Medications

 

Vitamin D and calcium supplements are required to be administered daily from Day 1 (continuing from Protocol BA058-05-003) until the Month 6 Visit.  Vitamin D and calcium supplements will be administered in the following doses: 400-800 IU/day (Vitamin D) and 500-100mg/day (calcium), or at a dose to be determined by the Investigator and agreed upon by the Sponsor Medical Monitor according to the subjects need.  The doses and schedule of Vitamin D and calcium supplements, which are part of the study medication protocol, should be adhered to and not be changed other than for medical necessity.  The supplements should be taken in the evening with or without food or as otherwise instructed by the Investigator.

 

For any required concomitant medication, such as statins or antihypertensives, the subject must be on a stable dose at study entry and every effort should be made to maintain a stable dose during study participation.

 

The occasional use of over-the-counter medications at approved doses (e.g., ibuprofen or acetaminophen) for headache or minor discomfort is allowed.  Occasional short term ( < 3 months) use of corticosteroids for seasonal allergies or asthma is also allowed.  These are to be recorded on the appropriate case report form.  Subjects should not take any other medications, including over-the-counter medications, herbal medications, or mega-doses of vitamins during the study without prior approval of the Investigator.

 

If it becomes necessary for a subject to take any other medication during the study, the specific medication(s) and indication(s) must be discussed with the Investigator.  All concomitant medications taken during the course of the study must be recorded in the Subject’s medical record or source document and transcribed into the case report form.

 

6.2                                Prohibited Medications

 

Subjects who require treatment during the course of the study with either an anticonvulsant (phenobarbital, phenytoin, carbamazepin or primidone) or chronic treatment with any form of heparin will be discontinued.  Estrogens given as HRT are allowed at entry into the study but cannot be initiated during the study except for local low dose vaginal estrogen.

 

Drugs that may compromise renal function such as non-steroidal anti-inflammatory drugs should be used with caution.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

7.0                          STUDY ASSESSMENTS

 

Subjects randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 will receive alendronate at a dose of 10 mg daily for six months, or an alternative osteoporosis treatment at the discretion of the Investigator.

 

The assessments performed at each study visit are displayed in the Schedule of Visits and Procedures in Appendix 14.1.  Appendix 14.2 provides a more detailed schedule of the study procedures by study visit with a suggested order of procedure conduct.  Exact procedures for centrifuging, storage, and shipping of lab samples will be detailed in a separate document.  The actual time of each blood collection will be recorded on the appropriate source documents and in the eCRF.

 

Study-specific assessments are to be conducted only after the subject has provided written informed consent to participate in this study.  The study assessments are described in more detail in Section 7.1 below.

 

7.1                                Clinical Procedures/Assessments

 

7.1.1                      Informed Consent

 

At the End-of-Treatment Visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with the subjects randomized to BA058 80 µg/Placebo.  The Informed Consent must be signed prior to undergoing any BA058-05-005 study related procedures, and may be signed at either Visit 9 or Visit 10 of Study BA058-05-003.

 

7.1.2                      Medical History

 

The subject’s medical history will be updated from their last visit in Study BA058-05-003, as necessary.  Any changes in medical history should be recorded as an adverse event, as appropriate.

 

7.1.3                      Physical Examination

 

The physical exam from the End-of-Treatment visit (Visit 9) of Study BA058-05-003 will be the baseline for this study (Day 1).  A physical exam will also be performed at Month 6.

 

Interim or symptom-directed physical examinations may be performed at other times at the discretion of the Investigator, if necessary, to evaluate adverse events or clinical laboratory abnormalities.

 

7.1.4                      Vital Signs

 

Blood pressure, body temperature (ºC), pulse (bpm) and respiration rate (breaths per minute) are to be measured and recorded at each study visit (Day 1, Month 3 and Month 6).  Only the Day 1 blood pressure assessments need be conducted as an orthostatic measurement (See Section 7.1.5).

 

7.1.5                      Orthostatic Blood Pressure and Heart Rate

 

The Day 1 orthostatic blood pressure measurement for Study BA058-05-005 will serve as the Visit 10 orthostatic blood pressure for Study BA058-05-003.  Blood pressure (mmHg;

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

measured in the same arm at each visit) and pulse rate (bpm) will be measured after five minutes in the supine position.  Immediately following this measurement, blood pressure will be measured again after three minutes in the standing position.

 

7.1.6                      Electrocardiogram

 

A twelve-lead supine electrocardiograms (ECGs) will be performed and the following ECG parameters will be recorded: rhythm, heart rate, PR interval, QRS duration and QT/QTc.

 

The Day 1 ECG measurement for Study BA058-05-005 will serve as the Visit 10 ECG measurement for Study BA058-05-003.  An ECG will also be obtained at Month 6.

 

7.1.7                      Clinical Laboratory Evaluations

 

Clinical laboratory evaluations will be performed by a central laboratory.  Prior to starting the study, the Sponsor (or its designee) will provide each Investigator with copies of the appropriate laboratory certifications and normal ranges for all laboratory parameters to be performed by that laboratory.

 

The majority of the blood and urinalysis samples are to be obtained under fasting conditions (NPO for 8 hours; water is acceptable) in the morning of each scheduled study visit prior to the administration of the study medication, the exceptions are noted below.

 

All clinically significant laboratory abnormities indicating an adverse event will be followed up by repeat testing and further investigated as necessary, according to the judgment of the Investigator.

 

7.1.8                      Clinical Chemistry and Urinalysis (Dipstick)

 

Clinical chemistry and dipstick urinalysis will be performed on Day 1 and at Month 6.  Urinalysis will be performed using samples freshly voided during the clinic visit.  If there are positive findings noted on the dipstick, a urine microscopic examination will be performed.  The following tests will be performed:

 

Serum Chemistry

·       Sodium

 

·       Potassium

 

·       Chloride

 

·       Inorganic phosphorus

 

·       Albumin

 

·       Total protein

 

·       Glucose

 

·       Blood urea nitrogen (BUN)

 

·       Creatinine

 

·       Uric acid

 

·       Aspartate aminotransferase (AST)

 

·       Alanine aminotransferase (ALT)

 

·       Gamma-glutamyltranspeptidase (GGT)

 

·       Creatine phosphokinase (CPK)

 

·       Alkaline phosphatase

 

·       Total bilirubin

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

·       Lactate dehydrogenase (LDH)

 

·       Cholesterol

 

·       Triglycerides

 

·       Total calcium

Urinalysis

·       pH

 

·       Glucose

 

·       Protein

 

·       Ketones

 

·       Bilirubin

 

·       Blood

 

·       Urobilinogen

 

·       Specific gravity

 

·       Nitrite

 

·       Leukocytes

 

7.1.9                      Hematology

 

Hematology testing will also be performed on Day 1 and at Month 6.  The following tests will be performed:

 

Hematology :

·       Hemoglobin

 

·       Hematocrit

 

·       WBC count with differential in absolute counts

 

·       RBC count

 

·       Mean corpuscular volume (MCV)

 

·       Mean corpuscular hemoglobin concentration (MCHC)

 

·       Mean corpuscular hemoglobin (MCH)

 

·       Platelet count

 

7.1.10               Coagulation

 

Coagulation testing will also be performed on Day 1 and at Month 6.  The following tests will be performed:

 

 

·       Prothrombin time (PT)

 

·       Partial thromboplastin time (PTT)

 

7.1.11               24-Hour Urine Collection

 

The 24-hour urine collection is to be begun the day before the Day 1 and Month 6 visits.  Subjects are to be instructed to begin the urine collection by discarding the first morning void (~6 a.m.) the day prior to the scheduled clinic visit and to then collect their urine for 24 hours.  A final void is to be collected at the end of the 24-hour period and the urine collection transported to the clinic by the subject.  The 24-hour urinalysis will be used to measure urinary calcium and urinary creatinine.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

7.1.12               Bone Mineral Density

 

All subjects will have bone mineral density measurements (BMD) taken via DXA at Month 6.  The End-of-Treatment (Visit 9) bone mineral density tests for Study BA058-05-003 will serve as the baseline BMD measurements for Study BA058-05-005.

 

DXAs will be performed on the hip (femoral neck) and spine (L1-4).  The spinal DXA is to be taken in the postero-anterior (PA) projection with any subsequent spinal DXA to be taken in the same projection.  Subjects who underwent wrist DXAs in Study BA058-05-003 will also have wrist DXAs performed at Month 6.

 

7.1.13               Serum Markers of Bone Metabolism

 

Blood samples to measure bone markers will be taken on Day 1 and at Month 6.  The results of the bone markers will be reported in the same subset of subjects reported on for Study BA058-05-003.

 

The following markers of bone formation will be measured:

 

·                   Serum N-terminal propeptide of type I procollagen (PINP);

 

·                   Serum bone-specific alkaline phosphatase (BSAP);

 

·                   Serum osteocalcin.

 

 

The following marker of bone resorption will be measured:

 

·                   Serum C-telopeptides of type 1 collagen crosslinks (CTX).

 

7.1.14               Clinical and Radiologic Evaluation of Fractures

 

Subjects will undergo protocol directed antero-posterior and lateral radiographs of the lumbar and thoracic spines at Month 6.  The End-of-Treatment (Visit 9) clinical and radiological evaluation of fractures for Study BA058-05-003 will serve as the baseline assessments for Study BA058-05-005.  Subjects will also be clinically evaluated for non-vertebral fractures (wrist, hip, rib, etc.) that occur de novo during the Treatment Period.

 

All radiographs will be viewed and assessed centrally by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity.  Fractures will be assessed according to the severity scale of Genant (1993).  A second blinded radiologist will confirm the assessment of the first reviewer for all subject radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.

 

Fractures identified during the study will not be recorded as AEs unless the subject is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the subject’s underlying osteoporosis.  All fractures (vertebral and non-vertebral) will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

7.1.15               BA058 Antibody Assessments

 

The occurrence of anti-drug antibodies will be assessed at the completion of the study.  Serum samples will be drawn at Month 6.  Any positive subjects will be retested at 6 months

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

and 12 months after completion of this study (BA058-05-005) under a separate Safety Surveillance protocol.  Exact procedures for collection, preparation, storage, and shipping of these samples will be detailed in a separate document.  The actual time and date of each blood collection will be recorded on the appropriate source document and in the eCRF.

 

7.1.16               Subject Diaries

 

A weekly diary will be completed by the subject beginning on the Day 1 visit and continuing until the last day of Month 6.  This diary will capture missed doses of vitamin D, calcium and alendronate or other osteoporosis medications.  The weekly diary will be reviewed at each study visit.

 

7.1.17               Activity and Diet

 

Subjects who qualify for enrollment in the study will have no restrictions placed on their usual level of activity or on their usual diet, unless directed by the treating physician for medically justified reasons.

 

8.0                          ADVERSE EVENTS AND SAFETY EVALUATION

 

Timely, accurate, and complete reporting and analysis of safety information from clinical studies are crucial for the protection of subjects, Investigators and the Sponsor, and is mandated by Regulatory Agencies worldwide.  All clinical trials sponsored by RADIUS will be conducted in accordance with Standard Operating Procedures (SOPs) that have been established to conform to regulatory requirements worldwide to ensure appropriate reporting of safety information.

 

8.1                          Definitions, Documentation, and Reporting

 

8.1.1                      Adverse Event Definition

 

An adverse event (AE) is any untoward medical occurrence in a subject administered a pharmaceutical product, which does not necessarily have a causal relationship with the treatment.  An AE can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it is considered to be study drug related.  This includes any newly occurring event or previous condition that has increased in severity or frequency since the administration of study drug.

 

8.1.2                      Serious Adverse Event Definition

 

A serious adverse event (SAE) is any adverse event, occurring at any dose and regardless of causality that:

 

·                   Results in death.

 

·                   Is life-threatening.  Life-threatening means that the subject was at immediate risk of death from the reaction as it occurred, i.e., it does not include a reaction which hypothetically might have caused death had it occurred in a more severe form.

 

·                   Requires in-patient hospitalization or prolongation of existing hospitalization.  Hospitalization admissions and/or surgical operations scheduled to occur during

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

the study period, but planned prior to study entry are not considered AEs if the illness or disease existed before the subject was enrolled in the trial.  Provided that the illness/disease did not deteriorate in an unexpected manner during the trial (e.g., surgery performed earlier than planned).

 

·                   Results in persistent or significant disability/incapacity.  Disability is defined as a substantial disruption of a person’s ability to conduct normal life functions.

 

·                   Is a congenital anomaly/birth defect.  This includes any anomaly detected at or after birth, or any anomaly that results in fetal loss.

 

·                   Is an important medical event.  An important medical event is an event that may not result in death, be life-threatening, or require hospitalization, but may be considered an SAE when, based upon appropriate medical judgment, it may jeopardize the subject and may require medical or surgical intervention to prevent one of the outcomes listed in the definitions for SAEs.  Examples of such medical events include allergic bronchospasm requiring intensive treatment in an emergency room or at home, blood dyscrasias or convulsions that do not result in in-patient hospitalization, or the development of drug dependency or drug abuse.

 

Clarification should be made between the terms “serious” and “severe” since they are not synonymous.  The term “severe” is often used to describe the intensity (synonym: severity) of a specific event (as in mild, moderate, or severe myocardial infarction); the event itself, however, may be of relatively minor medical significance (such as a severe headache).  This is not the same as “serious,” which is based on subject/event outcome or action criteria described above and are usually associated with events that pose a threat to a subject’s life or functioning.  A severe adverse event does not necessarily need to be considered serious.  For example, persistent nausea of several hours duration may be considered severe nausea but not an SAE.  On the other hand, a stroke resulting in only a minor degree of disability may be considered mild, but would be defined as an SAE based on the above noted criteria.  Seriousness (not severity) serves as a guide for defining regulatory reporting obligations.

 

8.2                          Monitoring of Adverse Events and Period of Observation

 

All AEs will be monitored until they are resolved or have become chronic or stable.  AEs and SAEs will be recorded on the case report forms starting from the time of subject entry from Day 1 of the study until the final study visit (Month 6).  Any SAEs that occur at any time after completion of the study, which the Investigator considers to be related to study drug, must be reported to the Sponsor or its designee.

 

8.3                          Procedures for Recording and Reporting AEs and SAEs

 

All adverse events spontaneously reported by the subject and/or in response to an open question from study personnel or revealed by observation, physical examination or other diagnostic procedures must be recorded in the source document and on the appropriate page of the case report form.  Any clinically relevant deterioration in laboratory assessments or other clinical findings is considered an adverse event and must be recorded on the appropriate pages of the case report form.  When possible, signs and symptoms indicating a common underlying pathology should be noted as one comprehensive event.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

All SAEs that occur during the course of the study, as defined by the protocol, must be reported by the Investigator to the Study Safety Officer by completing and transmitting the SAE Form within one working day from the point in time when the Investigator becomes aware of the SAE.  In addition, all SAEs including all deaths, which occur up to and including 30 days after administration of the last dose of study drug, must be reported to the Study Safety Officer within one working day.  All SAEs and deaths must be reported whether or not considered causally related to the study drug.  SAE forms will be provided to the study site.  The information collected will include a minimum of the following: Subject number, a narrative description of the event, and an assessment by the Investigator as to the intensity of the event, and relatedness to study drug.  Follow-up information on the SAE may be requested by the CRO, the Study Safety Officer or the Sponsor Medical Monitor.  Contact information for reporting SAEs to the Study Safety Officer is provided on the SAE form.

 

Study Safety Officer Contact Information

 

PLEASE SEE SERIOUS ADVERSE EVENT REPORTING FORM FOR DETAILED REPORTING OF SAEs, INCLUDING CONTACT INFORMATION (e.g., FAX, EMAIL OR TELEPHONE CONTACT NUMBERS)

 

It is the responsibility of the Investigator to promptly notify the Institutional Review Board (IRB)/Independent Ethics Committee (IEC) of all serious adverse drug reactions involving risk to human subjects in accordance with the requirements of the IRB/IEC.  An unexpected event is one that is not reported in the Investigator’s Brochure.

 

Planned hospital admissions or surgical procedures for an illness or disease that existed before the subject was enrolled in the trial or before study drug was given are not to be considered AEs unless they occur at a time other than the planned date.

 

Fractures identified during the study are not to be recorded as AEs unless the subject is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the subject’s underlying osteoporosis.  All fractures will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

For both serious and non-serious adverse events, the Investigator must determine the intensity of the event and the relationship of the event to study drug administration.

 

Intensity for each AE will be defined according to the following criteria:

 

Intensity

 

Definition

Mild

 

Awareness of sign or symptom, but easily tolerated.

Moderate

 

Discomfort enough to cause interference with normal daily activities.

Severe

 

Inability to perform normal daily activities

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

If the intensity of an adverse event changes within a day, the maximum intensity should be recorded.  If the intensity changes over a longer period of time, the changes should be recorded as separate events (having separate onset and stop dates for each intensity).

 

Relationship to study drug administration will be determined by the Investigator according to the following criteria:

 

Relationship

 

Definition

 

None

 

No relationship between the event and the administration of study drug. The event is related to other etiologies, such as concomitant medications or subject’s clinical state.

 

 

 

 

 

Unlikely

 

The current state of knowledge indicates that a relationship to study drug is unlikely or the temporal relationship is such that study drug would not have had any reasonable association with the observed event.

 

 

 

 

 

Possible

 

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction might have been produced by the subject’s clinical state or other modes of therapy administered to the subject.

 

 

 

 

 

Probable

 

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction cannot be reasonably explained by the known characteristics of the subject’s clinical state or other modes of therapy administered to the subject.

 

 

For the purpose of safety analyses, all AEs that are classified with a relationship to study medication administration of possible or probable will be considered treatment-related events.

 

8.4                          Rules for Suspension of the Study

 

As this is an Extension Study using standard-of-care management of osteoporosis, including products approved for treatment, it is not anticipated that the study will need to be suspended, and therefore, suspension rules are not assigned.  In the event that the prior study (Study BA058-05-003) is suspended, the circumstances of the Study BA058-05-003 suspension will be considered to determine if this study, Study BA058-05-005, should be suspended as well.

 

9.0                          STATISTICAL PROCEDURES

 

The primary objective of this study is to evaluate data obtained following six months of standard-of-care osteoporosis treatment, including treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.  Safety data will be obtained with clinical, laboratory and radiologic assessment.  Since it is anticipated that the majority of the subjects will be treated with alendronate, the study objectives are based upon this assumption.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate of subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

9.1                          Sample Size

 

As this is an Extension study, no formal sample size analysis was performed for this study.  Study data will be tabulated and summarized.

 

9.2                          Randomization, Stratification and Blinding

 

Osteoporosis treatment will be open label and no randomization is required.

 

9.3                          Populations for Analysis

 

All analyses and data summaries will be presented for the Safety Population.

 

9.3.1                      Safety Population

 

The Safety Population is comprised of all subjects who qualify on the basis of Study BA058-05-003 and provide informed consent to enroll in this Extension Protocol.

 

9.4                          Procedures for Handling Missing, Unused, and Spurious Data

 

All available data will be included in the data listings and tabulations. Where appropriate, imputations of values for missing data will be performed using last observation carried forward and specified in the Statistical Analysis Plan.  All data recorded on the CRF will be included in the data listings that will accompany the clinical study report.

 

9.5                          Statistical Methods

 

9.5.1                      Statistical Considerations

 

Statistical analysis will focus on longer term safety, fracture incidence, including vertebral fracture and BMD change following six months of standard-of-care osteoporosis treatment in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.

 

9.5.2                      Baseline Comparisons

 

Baseline characteristics, medical history, physical examination, vital signs and ECG, will be summarized using standard descriptive statistics.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

9.5.3                      Fractures and BMD Analysis

 

All specified endpoints will be summarized by treatment group and study period using standard descriptive statistics (n, mean, SD, median, minimum, maximum, or n and %, as appropriate).  The fracture incidence and BMD results from the additional six months of treatment with alendronate will be tabulated, with additional tabular categories for results from the entire contiguous 24 months from the baseline of Study BA058-05-003, for subjects who eventually enter study BA058-05-005.  These descriptive analyses will be conducted on all subjects with baseline and post-baseline data.

 

9.5.4                      Safety Analysis

 

Data will be summarized and tabulated based on the enrolled population for this Extension protocol.  All subjects enrolled in the Extension protocol will be included in the safety analysis that will be performed on the following parameters:

 

·                   Incidence and severity of AEs;

 

·                   Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory, if applicable;

 

·                   Fracture incidence either clinically or radiologically determined as part of the Extension protocol.

 

Safety assessments for changes in physical examination, vital signs, ECG, and laboratory tests will be descriptively summarized by treatment and study periods.  The results of anti-BA058 testing will be summarized.  Concomitant medication classes will be categorized using World Health Organization (WHO) drug dictionary and summarized by number and percent of subjects using each class by treatment group.  All treatment emergent adverse events (TEAEs) will be coded for system organ class (SOC) and preferred term (PT) using MedDRA and the number (%) of subjects experiencing each AE (SOC/PT) will be summarized by treatment, relationship to treatment, and severity.  All serious adverse events (SAE) will be listed and the number (%) of subjects with an SAE presented by treatment group.

 

9.5.5                      Procedures for Reporting Deviations to Original Statistical Analysis Plan

 

All deviations from the original statistical analysis plan will be provided in the final clinical study report.

 

9.6                          Data Oversight

 

9.6.1                      Central Review of Radiographs and DXA Scans

 

All radiographs will be viewed and assessed by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fractures will be assessed according to the method of Genant.  A second blinded radiologist will review the assessment of the first reviewer for all subject radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.  All study DXA scans will also be evaluated centrally by a blinded independent reviewer.  The primary objective of the independent review is to provide

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

objective data to determine the treatment benefit as demonstrated on the pertinent radiologic and clinical data associated with this study.

 

10.0                   ADMINISTRATIVE REQUIREMENTS

 

10.1                   Good Clinical Practice

 

This study will be conducted in accordance with the International Conference on Harmonization (ICH) for Good Clinical Practice (GCP) and the appropriate regulatory requirements.  The Investigator will be thoroughly familiar with the appropriate use of the study medication as described in the protocol and the Investigator’s Brochure.  Essential clinical documents will be maintained to demonstrate the validity of the study and the integrity of the data collected.  The Investigator/institution should establish master files at the beginning of the study which will be maintained and updated during the study and retained thereafter according to the appropriate regulations.

 

10.2                   Ethical Considerations

 

The study will be conducted in accordance with ethical principles founded in the Declaration of Helsinki.  The Institutional Review Board (IRB)/Independent Ethics Committee (IEC) will review all appropriate study documentation in order to safeguard the rights, safety and well-being of the subjects.  The study can only be conducted at study sites where IRB/IEC approval has been obtained.  The protocol, informed consent form, Investigator’s Brochure, advertisements (if applicable), and all other forms of information given to subjects will be provided to the IRB/IEC by the Investigator.  In addition, reports on the progress of the study will be submitted to the IRB/IEC by the Investigator at the appropriate intervals.

 

10.3                   Subject Information and Informed Consent

 

Each subject (or a legally authorized representative) must give written informed consent prior to any new study-specific procedures being conducted.   It is the responsibility of the Investigator to ensure written informed consent is obtained from each subject participating in this study after an explanation of the objectives, methods, discomforts and potential risks of the study has been provided.  The Investigator (or study personnel) must also explain to each subject that he/she is free to refuse participation in the study or to withdraw from it at any time.  Each subject will also be told that his/her records may be examined by competent authorities and authorized persons but that personal information will be treated as strictly confidential and will not be publicly available.

 

The informed consent form must be in accordance with the Declaration of Helsinki, ICH and GCP guidelines, and be approved by the Sponsor and the IRB/IEC.  State or local laws may require additional information.  Each subject (or his/her legally authorized representative) must sign and be given a copy of the informed consent form.  Each subject’s signed informed consent form must be maintained by the Investigator and be readily available for review by the Sponsor (or its designee) or the Regulatory Authorities.

 

10.4                   Protocol Compliance

 

The Investigator will conduct this study in compliance with the protocol provided by the Sponsor and given approval/favorable opinion by the IRB/IEC and the appropriate

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Regulatory Authority(ies).  Changes to the protocol should not be made without agreement of the Sponsor Medical Monitor.  All changes to the protocol will require IRB/IEC approval prior to implementation, except when necessary to eliminate an immediate hazard to study subjects or when the change involves only logistical or administrative aspects of the study (e.g., change in Sponsor Medical Monitor or telephone number).  The IRB/IEC may provide, if applicable regulations permit, expedited review and approval/favorable opinion for minor changes in ongoing studies.  The Sponsor will submit all protocol changes to the appropriate Regulatory Authority in accordance with the governing regulations.

 

In situations requiring a departure from the protocol, the Investigator or other physician in attendance will contact the Sponsor Medical Monitor by telephone, e-mail or fax.  If possible, this contact will be made before implementing any departure from the protocol.  In all cases, contact with the Sponsor Medical Monitor must be made as soon as possible in order to review the situation and agree on an appropriate course of action.  The case report form and source document will describe any departure from the protocol and the circumstances requiring it.

 

10.5                   Case Report Form Completion

 

eCRFs will be developed to collect information obtained during this study.  It is the Investigator’s responsibility to ensure that the e-CRFs are completed for each subject enrolled in this study and for the accuracy, completeness, legibility and timeliness of the data reported in each e-CRF.  Data for subjects who are screened but not enrolled into the study because they do not meet study criteria or do not complete all screening procedures, should be recorded in the e-CRF.

 

eCRFs will be completed and any corrections of data will be made according to procedures provided by the Sponsor (or designee).

 

10.6                   Source Documents

 

Source documents are defined as original documents, data and records.  This may include hospital records, clinical and office charts, laboratory data/information, work sheets, subjects’ diaries or evaluation checklists, pharmacy dispensing and other records, recorded data from automated instruments, microfiches, photographic negatives, microfilm or magnetic media, ECG printouts, and/or x-rays.

 

The Investigator(s)/institution(s) will permit trial-related monitoring, audits, IRB/IEC review, and regulatory inspection(s), providing direct access to source data documents.

 

10.7                   Study Monitoring

 

The Sponsor (or its designee) will ensure that the study is monitored in accordance with ICH-GCP Guidelines.  Monitoring is the act of overseeing the progress of a clinical trial and of ensuring that it is conducted, recorded, and reported in accordance with the protocol, standard operating procedures, Good Clinical Practice, and the applicable regulatory requirements and that the study data are accurate, complete and verifiable from source data.  All study documentation and other source data will be made available to the Sponsor (or its designee), the IRB and to Regulatory Authorities for inspection upon request.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

10.8                   On-Site Audits

 

Representatives of the IRB or the Sponsor (or designee) may visit the study site to carry out an audit of the study in compliance with regulatory guidelines and company policy.  Such audits will require access to all study records including source documents, CRFs, and other study documents.  Direct access to these study records must be guaranteed by the Investigator, who must provide support for these activities at all times.

 

Similar auditing procedures may also be conducted by agents of any Regulatory Authority reviewing the results of this study.  The Investigator/institution should immediately notify the Sponsor if they have been contacted by a Regulatory Authority concerning an upcoming inspection.

 

10.9                   Drug Accountability

 

Accountability for the study medication at the study site is the responsibility of the Investigator.  Drug accountability will be performed only on alendronate, calcium and vitamin D.  The Investigator will ensure that the study medication is used only in accordance with this protocol.  Where allowed, the Investigator may choose to assign some of the study medication accountability responsibilities to qualified study personnel.

 

Study medication accountability records indicating the delivery date to the study site, inventory at the study site and dispensing/use will be maintained.  These records will adequately document that the study medications were dispensed and returned as specified in the protocol.  Accountability records will include dates, quantities, and subject numbers.  The Sponsor (or its designee) will review study medication accountability records at the study site on an ongoing basis during the study.  All used and unused study medication must be inventoried, accounted for, and returned to the Sponsor (or its designee) for destruction.  Records of disposal must be maintained with the study records.

 

10.10            Record Retention

 

The Investigator will maintain all study records according to ICH/GCP and applicable regulatory requirements.  Essential documents must be retained for two years after the final marketing approval in an ICH region or at least two years have elapsed since the discontinuation of clinical development of the study medication.  It is the responsibility of the Sponsor to inform the Investigator of when these documents can be destroyed.  In addition, all subject medical records and other source documentation will be kept for the maximum time permitted by the hospital, institution or medical practice.

 

The Investigator/institution will take measures to prevent accidental or premature destruction of these documents.  If the responsible Investigator retires, relocates, or for other reasons withdraws from the responsibility of keeping the study records, custody must be transferred to a person who will accept the responsibility.  The Sponsor must be notified in writing of the name and address of the new custodian.

 

10.11            Study Termination

 

This study may be terminated at any time by the Sponsor if there is sufficient reasonable cause.  Circumstances that may warrant termination include, but are not limited to:

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

·                   Determination of unexpected, significant, or unacceptable risk to subjects.

 

·                   Failure of enrollment

 

·                   Administrative reasons

 

·                   Plans to modify, suspend or discontinue the development of the study drug.

 

In addition, individual study sites may be terminated from study participation for reasons including, but not limited to the following:

 

·                   Failure to enter subjects at an acceptable rate.

 

·                   Insufficient adherence to protocol requirements.

 

·                   Incomplete and/or non-evaluable data.

 

In all cases, the terminating parties will provide written notification documenting the reason for study termination to all the relevant parties.

 

Should the study or an individual site be prematurely closed, all study materials (completed, partially completed, and blank CRFs, study drug, etc.) must be returned to the Sponsor (or its designee).

 

10.12            Liability and Insurance

 

The Sponsor has subscribed to an insurance policy covering, in its terms and provisions, its legal liability for injuries caused to participating persons and arising out of this research performed strictly in accordance with the scientific protocol as well as with applicable law and professional standards.

 

11.0                   USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

 

11.1                   Use of Information

 

All information regarding BA058 supplied by the Sponsor (or its designee) to the Investigator is privileged and confidential information.  The Investigator agrees to use this information to accomplish the study and will not use it for other purposes without prior consent from the Sponsor.

 

The information developed during the conduct of this clinical study is also considered confidential and will be used by the Sponsor in connection with the development of BA058.  This information may be disclosed as deemed necessary by the Sponsor to other clinical Investigators, other pharmaceutical companies, and to Regulatory Authorities.  To allow for the use of the information derived from this study and to ensure complete and thorough analysis, the Investigator is obligated to provide the Sponsor (or its designee) with complete study results and all data developed in this study and to allow direct access to source data/documents for study-related monitoring, audits, IRB/IEC review, and regulatory inspection.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

11.2                   Publication

 

One publication of the study data is planned.  A Publications Committee composed of Investigators participating in the study and representatives from the Sponsor as appropriate will be formed to oversee the publication of the study results, which will reflect the experience of all participating study centers.

 

Subsequently, individual Investigators may publish results from the study in compliance with their agreement with the Sponsor.  A pre-publication manuscript must be provided to the Sponsor at least 30 days prior to the submission of the manuscript to a publisher.  Similarly, the Sponsor will provide any company prepared manuscript to the Investigators for review at least 30 days prior to submission to a publisher.

 

The Investigator shall comply with the policy of the Sponsor regarding confidential or proprietary information in any such paper and agrees to withhold publication of same for an additional 60 days in order to permit the Sponsor to obtain patent or other proprietary rights protection, if the Sponsor deems it necessary.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

12.0                         INVESTIGATOR AGREEMENT

 

To be completed by the Investigator

 

I have read Protocol BA058-05-005: “An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003”.

 

I agree to conduct the study as detailed herein and in compliance with ICH Guidelines for Good Clinical Practice and applicable regulatory requirements and to inform all who assist me in the conduct of this study of their responsibilities and obligations.

 

The signature below constitutes my agreement to the contents of this protocol.

 

 

 

 

 

Signature of Principal Investigator

Date

 

 

 

 

Principal Investigator (print)

 

 

 

 

 

Signature of Sponsor’s Medical Officer (where applicable)

 

 

 

 

 

 

 

 

Louis Brenner, MD

Date

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

13.0                   REFERENCES

 

EMEA. Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. 2007.

 

FDA. Guidelines for preclinical and clinical evaluation of agents used in the prevention or treatment of postmenopausal osteoporosis. 1994.

 

FDA. Draft guidance:  Development of parathyroid hormone for the prevention and treatment of osteoporosis. 2000.

 

Genant HK, Wu CY, van KC, and Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. 1993;  J Bone Miner Res 8:1137-1148.

 

Guidance for Industry. E6 Good Clinical Practice: Consolidated Guidance. U.S.Department of Health and Human Services, Food and Drug Administration. April 1996.

 

Gullberg B, Johnell O, Kanis JA.  World-wide projections for hip fracture.  Osteoporos Int 1997, 7:407-413.

 

Martin TJ.  Osteoblast-derived PTHrP is a physiological regulator of bone function.  J Clin Inv 2005;115(9):2322-2324.

 

Miao D, He B, Jiang Y, Kobayashi T, Soroceanu MA, Zhao J, Su H, Tong X, Amizuka N, Gupta A, Genant HK, Kronenberg HM, Goltxman D, Karaplis AC.  Osteoblast-derived PTHrP is a potent endogenous bone metabolic agent that modifies the therapeutic efficacy of administered PTH 1-34.  J Clin Inv 2005;115(9):2402-2411.

 

Reginster JY, Burlet N.  Osteoporosis: still increasing prevalence.  Bone 2006, 38(Suppl 1):S4-9.

 

Rizzoli R, Bonjour JP, and Ferrari SL. Osteoporosis, genetics and hormones. J Mol Endocrinol 2001; 26:79-94.

 

Rosen CJ. Clinical practice.  Postmenopausal osteoporosis. N Engl J Med 2005; 353:595-603.

 

Schluter KD.  PTH and PTHrP: Similar structures but different functions.  News Physiol Sci 1999;14:243-249.

 

WHO Scientific Group on the assessment of osteoporosis at primary health care level.  World Health Organization Summary Meeting Report 2007.

 

World Medical Association Declaration of Helsinki. The World Medical Association, Inc. 2008.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

14.0                                                APPENDICES

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

14.1                  Schedule of Visits and Procedures

 

 

 

Visit

 

1

 

2

 

3

 

Study Day/Month:

 

Visit 10 003/
Visit 1(1) 005

 

Month 3

 

Month 6

 

 

Day

 

1

 

90

 

180

Procedure

 

Visit Window (Days)

 

N/A

 

± 5

 

± 14

Informed consent

 

X

 

 

 

 

Review of entrance criteria

 

X

 

 

 

 

Medical history

 

 

 

 

 

 

Physical examination(2)

 

 

 

 

 

 

Recent health status

 

X

 

X

 

 

Vital signs, weight and height measurements(3)

 

X

 

X

 

X

Electrocardiogram

 

X

 

 

 

X

Urinalysis (dipstick) (4)

 

X

 

 

 

X

Chemistry blood collection(5)

 

X

 

 

 

X

Hematology blood collection(5)

 

X

 

 

 

X

Coagulation blood collection(5)

 

X

 

 

 

X

PTH(1-84)

 

 

 

 

 

X

25-hydroxy vitamin D level

 

 

 

 

 

X

1,25-dihydroxy vitamin D level

 

 

 

 

 

X

Serum markers of bone metabolism (6)

 

X

 

 

 

X

BA058 antibody levels

 

 

 

 

 

X

24-hour urine collection (for calcium:creatinine and creatinine clearance)(7)

 

X

 

 

 

X

Clinical and radiologic (spine, lumbar and thoracic vertebrae) fracture assessments

 

 

 

 

 

X

Bone mineral density of hip and spine by DXA(8)

 

 

 

 

 

X

Bone mineral density of wrist by DXA(9)

 

 

 

 

 

X

Calcium and vitamin D supplements

 

<———————Daily———————>

Alendronate administration (if applicable)

 

<———————Daily———————>

Other osteoporosis medication administration (if applicable)

 

<—Dosing as per prescribing information—>

Study medication resupply (if applicable)

 

 

 

X

 

 

Subject diary review(10)

 

 

 

X

 

X

Document adverse events and concomitant medications

 

<———————Daily———————>

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

14.2                  Suggested Schedule of Events and Procedures by Study Visit

 

The purpose of this guide is to provide more detailed instructions for the study procedures listed in Appendix 14.1.  This guide presents the procedures in a suggested sequence of performance at each study visit.  Further information may be found within the protocol and in other study reference manuals (e.g., ECG, clinical lab sample processing).

 

Of note:

 

·                  Blood and urinalysis samples are to be obtained under fasting conditions (NPO. for 8 hours; water is acceptable) in the morning of each scheduled study visit.

 

·                  DXA Scans: Always use the same study-validated machine; preferably the same technician.

 

·                  The 24-hour urine collection will be started at home the day before the clinic visit where the collection is required.  Subjects will be instructed to discard the first morning void and begin the collection at least 24 hours before their clinic visit the following day. They will collect all urine for 24 hours with a final void before coming to the clinic. Routine urinalyses are to be performed using samples freshly voided during the clinic visit.  Subjects should receive a reminder to initiate their 24-hour urine 2 days before their scheduled visit.

 

·                  The osteoporosis medication will be sourced locally. The cost of alendronate will be reimbursed by the Sponsor.  The Sponsor or the Investigator will not be responsible for the costs of the alternative medication should one be prescribed.

 

·                  Subjects will be instructed to take the calcium and vitamin D supplements daily (in the evening with or without food or as otherwise instructed by the Investigator) until discharge from the study.  This is required until the end of Month 6.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Definitions of Common Procedures:

 

The terms used in the by-visit schedule that follows are further defined below.

 

Recent health status (document any changes from last visit)

 

·                  Question subject regarding any new health issues

·                  Question subject regarding any new adverse events

·                  Question subject regarding any new concomitant medications

·                  Question subject regarding any new issues related to ability to continue with study

 

Pulse, respiration and temperature:

 

·                  Pulse rate (beats/minute) taken after approximately five minutes in the supine position.

·                  Respiration rate (breaths/minute).

·                  Body temperature (°C).

 

Weight and height measurements:

 

·                  Weight (kg).

·                  Height (cm) standing measurements are to be performed using the same medical stadiometer and standardized procedures each time.

 

Orthostatic blood pressure:

 

·                  Orthostatic blood pressure (mmHg) (measured in same arm each time/each visit) is measured after five minutes in the supine position followed by a measurement taken after 3 minutes in the standing position.

 

ECG

 

·                  Twelve-lead supine electrocardiogram

·                  Print hard copy for reading by qualified study personnel

·                  More than one ECG may be performed per time point.

 

24 hour urine collection

 

·                  Subject to discard first morning void (suggest 6 a.m.) on day before clinic visit

·                  Subject to collect urine for approximately 24 hours

·                  Subject to collect final void at end of collection and bring collection to clinic.

·                  Process for calcium and creatinine

 

Urinalysis

 

·                  Obtain under fasting conditions (NPO. except water for 8 hours)

·                  Routine urinalysis is to be performed using a sample freshly voided during the clinic visit (microscopic examination if positive dipstick).

 

Review study medication administration procedures with subject

 

·                  Alendronate should be taken daily, preferably at the same time each morning

 

Scheduling and instructions for next clinic visit

 

·                  Schedule visit

·                  Remind subject of any fasting requirements

·                  Provide urine collection instructions and materials as necessary

·                  Remind subjects to complete the diaries until the end of the study

 

Vitamin D and calcium supplements

 

·                  Vitamin D and calcium supplements are required throughout the study.  Only those supplements supplied as part of study medication may be used and are to be used at the daily recommended dose (see Section 5.1.3) .

·                  Supplements should be taken in the evening, with or without food as instructed by the Investigator.

·                  At each study visit, assess the subject’s supply and resupply as necessary.

·                  Drug usage reconciliation is to be performed when a new supply is provided.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Visit 10 for Study BA058-05-003
Day 1 Visit for Study BA058-05-005
Day 1

 

 

 

VISIT

 

ACTIVITIES

Day 1

Day 1
Visit for
Study
BA058-
05-005

 

Visit 10
for Study
BA058-
05-003

 

Written informed consent must be obtained
Recent health status

·                   Document any changes since End-of-Treatment visit (Visit 9) from Study BA058-05-003

Study staff will receive your prior days 24-hour urine sample
Subject diary review

·                   Review study medication diary (calcium and vitamin D)/dispense new diary if necessary

·                   Record deviations in dosing or any AEs in source documents and CRFs

·                   Collect diaries and enter data into CRF

Vital signs
Orthostatic blood pressure
Weight and height
ECG
Blood collection: fasting conditions (NPO except water for 8 hours)

·                   Chemistry

·                   Hematology

·                   Coagulation (PT and PTT)

·                   Serum markers of bone metabolism, where applicable

·                   PINP

·                   bone-specific alkaline phosphatase

·                   serum osteocalcin

·                   serum CTX

·                   Urinalysis (Dipstick)

Study medication

·                   Dispense three month supply of osteoporosis medication

·                   Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary

·                   Instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·                   Remind subject to take study medication as instructed

·                   Remind subject to record study medication use

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Month 3 Visit for Study BA058-05-005
Day 90 (±5 days)

 

 

 

VISIT

 

Activities

Month 3

 

Recent health status

·                   Document any changes since previous visit

Vital signs

Subject diary review

·                   Review study medication diary/dispense new diary if necessary

·                   Record deviations in dosing or any AEs in source documents and CRFs.

·                   Collect diaries and enter data into CRF

Study medication

·                   Dispense additional three month supply of osteoporosis medication

·                   Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary, instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·                   24-hour urine collection: Dispense urine collection container and instruct subjects to perform 24-hour urine collection beginning the morning 24 hours prior to their next scheduled visit (Month 6)

·                  Remind subject to take study medication as instructed

·                   Remind subject to record study medication use

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Month 6 Visit for Study BA058-05-005
Day 180 (±14 Days)

 

 

 

VISIT

 

Activities

Month 6

 

Recent Health Status

·                   Document any changes from last visit

Collect 24 hour urine sample from subject

Study staff will receive your prior days 24-hour urine sample

·                   Review diary of study medication

·                   Collect diary and enter data into CRF, record dosing deviations or any AEs in source documents and CRFs

Calcium and vitamin D supplements

·                   Collect any leftover supplements

Vital signs, weight and height measurement

Orthostatic blood pressure

ECG

Blood collection: fasting conditions (NPO except water for 8 hours)

·                   Chemistry

·                   Hematology

·                   Coagulation (PT and PTT)

·                   Serum markers of bone metabolism, where applicable

·                   PINP

·                   bone-specific alkaline phosphatase

·                   serum osteocalcin

·                   serum CTX

·                   BA058 antibody levels

·                   Urinalysis (Dipstick)

·                   Collect unused study medication

Clinical and radiologic fracture evaluations

·                   Obtain antero-posterior and lateral radiographs of the lumbar and thoracic vertebrae

·                   Document any non-vertebral fractures

Bone mineral density

·                   Perform DXA of spine (L1-L4), hip (femoral neck), and wrist (distal 1/3 radius), where applicable.

Discharge subject from study

·                   Subject is terminated from the study unless abnormal clinical laboratory tests or adverse events require further follow-up

Discuss continuing treatment options

·                   Following the Extension Study completion, all subjects will be given the opportunity to receive an additional 18 months of treatment with alendronate

·                   Subjects will receive standard-of-care management according to their physician

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

14.3        Eastern Cooperative Oncology Group (ECOG) Common Toxicity Criteria

 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Haematology

 

 

 

 

 

 

 

 

 

 

WBC (x10 9 /L)

 

4

 

3.0 - 3.9

 

2.0 - 2.9

 

1.0 - 1.9

 

< 1.0

Platelets (x10 9 /L)

 

WNL

 

75.0 - normal

 

50.0 - 74.9

 

25.0 - 49.9

 

< 25.0

Haemoglobin (g/L);
(mmol/L)

 

WNL

 

100.0 - normal;
6.2 - normal

 

80.0 - 99.0;
5.0 - 6.1

 

65.0 - 79.0
4.0 - 4.9

 

< 65.0
< 4.0

Granulocytes/ Bands (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

Lymphocytes (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

Haemorrhage

 

none

 

mild, no transfusion

 

gross,
1 - 2 units transfusion per episode

 

gross,
3 - 4 units transfusion per episode

 

massive,
> 4 units transfusion per episode

Coagulation

 

 

 

 

 

 

 

 

 

 

Fibrinogen

 

WNL

 

0.99 - 0.75 x N

 

0.74 - 0.50 x N

 

0.49 - 0.25 x N

 

< 0.25 x N

Prothrombin time(quick)

 

WNL

 

1.01 - 1.25 x N

 

1.26 - 1.50 x N

 

1.51 - 2.00 x N

 

> 2.00 x N

Partial thromboplastin time

 

WNL

 

1.01 - 1.66 x N

 

1.67 - 2.33 x N

 

2.34 - 3.00 x N

 

> 3.00 x N

Metabolic

 

 

 

 

 

 

 

 

 

 

Hyperglycaemia (mmol/L)

 

< 6.4

 

6.4 - 8.9

 

9.0 - 13.9

 

14.0 - 27.8

 

> 27.8 or ketoacidosis

Hypoglycaemia (mmol/L)

 

> 3.6

 

3.6 - 3.1

 

3.0 - 2.3

 

2.2 - 1.7

 

< 1.7

Amylase

 

WNL

 

< 1.5 x N

 

1.5 - 2.0 x N

 

2.1 - 5.0 N

 

> 5.0 x N

Hypercalcaemia (mmol/L)

 

< 2.65

 

2.65 - 2.88

 

2.89 - 3.13

 

3.14 - 3.36

 

> 3.37

Hypocalcaemia (mmol/L)

 

> 2.10

 

2.10 - 1.94

 

1.93 - 1.74

 

1.73 - 1.52

 

< 1.51

Hypomagnesaemia (mmol/L)

 

> 0.58

 

0.58 - 0.48

 

0.47 - 0.36

 

0.35 - 0.24

 

< 0.23

Gastrointestinal

 

 

 

 

 

 

 

 

 

 

Nausea

 

none

 

able to eat reasonable intake

 

intake significantly decreased but can eat

 

no significant intake

 

Vomiting

 

none

 

1 episode
in 24 hrs

 

2 - 5 episodes
in 24 hrs

 

6 - 10 episodes
in 24 hrs

 

> 10 episodes in 24 hrs or requiring parenteral support

Diarrhoea

 

none

 

increase of 2 - 3 stools/day over pre-Rx

 

increase of 4 - 6 stools/day, or nocturnal stools, or moderate cramping

 

increase of 7 - 9 stools/day, or incontinence, or severe cramping

 

increase of > 10 stools/day or grossly bloody diarrhoea, or need for parenteral support

Stomatitis

 

none

 

painless ulcers, erythema, or mild soreness

 

painful erythema, oedema, or ulcers but can eat solids

 

painful erythema, oedema, or ulcers and cannot eat solids

 

requires parenteral or enteral support for alimentation

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Liver

 

 

 

 

 

 

 

 

 

 

Bilirubin (N = 17 µmol/L)

 

WNL

 

 

< 1.5 x N

 

1.5 - 3.0 x N

 

> 3.0 x N

Transaminase (SGOT, SGPT)

 

WNL

 

2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

Alkaline phosphatase or 5-nucleotidase

 

WNL

 

< 2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

Liver- clinical

 

No change from baseline

 

 

 

precoma

 

hepatic coma

Kidney, bladder

 

 

 

 

 

 

 

 

 

 

Creatinine

 

WNL

 

< 1.5 x N

 

1.5 - 3.0 x N

 

3.1 - 6.0 x N

 

> 6.0 x N

Proteinuria

 

No change

 

1 (+) or
< 0.3 g% or 3 g/L

 

2 - 3 (+) or
0.3-1.0 g% or 3-10 g/L

 

4 (+) or
> 1.0 g% or > 10g/L

 

nephrotic syndrome

Haematuria

 

Negative

 

microscopic only

 

gross,
no clots no Rx needed

 

gross and clots
bladder irrigation

 

requires transfusion
or cystectomy

Weight gain/ loss

 

< 5.0 %

 

5.0 - 9.9 %

 

10.0 - 19.9 %

 

20.00%

 

Pulmonary

 

 

 

 

 

 

 

 

 

 

Pulmonary

 

none or no change

 

asymptomatic, with abnormality in PFTs

 

dyspnoea on significant exertion

 

dyspnoea at normal level of activity

 

dyspnoea at rest

Cardiac

 

 

 

 

 

 

 

 

 

 

Cardiac arrhythmias

 

none

 

asymptomatic, transient, requiring no therapy

 

recurrent or persistent, no therapy required

 

requires treatment

 

requires monitoring; or hypotension, or ventricular tachycardia or fibrillation

Cardiac function

 

none

 

asymptomatic, decline of resting ejection fraction by less than 20 % of baseline value

 

asymptomatic, decline of resting ejection fraction by more than 20 % of baseline value

 

mild CHF, responsive to therapy

 

severe or refractory CHF

Cardiac ischaemia

 

none

 

non-specific T- wave flattening

 

asymptomatic, ST and T wave changes suggesting ischaemia

 

angina without evidence of infraction

 

acute myocardial infarction

Cardiac- pericardial

 

none

 

asymptomatic effusion, no intervention required

 

pericarditis (rub, chest pain, ECG changes)

 

symptomatic effusion; drainage required

 

tamponade; drainage urgently required

Hypertension

 

none or no change

 

asymptomatic, transient increase by greater than 20 mmHg (D) or to > 150/100 if previously WNL.
No treatment required.

 

recurrent or persistent increase by greater than 20 mmHG (D) or to > 150/100 if previously WNL.
No treatment required.

 

requires therapy

 

hypertensive crisis

Hypotension

 

none or no change

 

changes requiring no therapy (including transient orthostatic hypotension)

 

requires fluid replacement or other therapy but not hospitalisation

 

requires therapy and hospitalisation; resolves within 48 hrs of stopping the agent

 

requires therapy and hospitalisation for > 48 hrs after stopping the agent

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Neurologic

 

 

 

 

 

 

 

 

 

 

Neuro: sensory

 

none or no change

 

mild paraesthesias;
loss of deep tendon reflexes

 

mild or moderate objective sensory loss moderate paraesthesias

 

severe objective sensory loss or paraesthesias that interfere with function

 

Neuro: motor

 

none or no change

 

subjective weakness;
no objective findings

 

mild objective weakness without significant impairment of function

 

objective weakness with impairment of function

 

paralysis

Neuro: cortical

 

none

 

mild somnolence or agitation

 

moderate somnolence or agitation

 

severe somnolence, (>50 % waking hours), agitation, confusion, disorientation or hallucinations

 

coma, seizures, toxic psychosis

Neuro: cerebellar

 

none

 

slight incoordination, dysdiadochokinesia

 

intention tremor, dysmetria, slurred speech, nystagmus

 

locomotor ataxia

 

cerebellar necrosis

Neuro: mood

 

no change

 

mild anxiety or depression

 

moderate anxiety or depression

 

severe anxiety or depression

 

suicidal ideation

Neuro: headache

 

none

 

mild

 

moderate or severe
but transient

 

unrelenting and severe

 

Neuro: constipation

 

none or no change

 

mild

 

moderate

 

severe

 

ileus > 96 hrs

Neuro: hearing

 

none or no change

 

asymptomatic, hearing loss on audiometry only

 

tinnitus

 

hearing loss interfering with function but correctable with hearing aid

 

deafness not correctable

Neuro: vision

 

none or no change

 

 

 

symptomatic subtotal loss of vision

 

blindness

Pain

 

 

 

 

 

 

 

 

 

 

Pain

 

none

 

mild

 

moderate

 

severe

 

reg. narcotics

Skin

 

 

 

 

 

 

 

 

 

 

Skin

 

none or no change

 

scattered macular or papular eruption or erythema that is asymptomatic

 

scattered macular or papular eruption or erythema with pruritus or other associated symptoms

 

generalised symptomatic macular, papular or vesicular eruption

 

exfoliative dermatitis or ulcerating dermatitis

Alopecia

 

 

 

 

 

 

 

 

 

 

Alopecia

 

no loss

 

mild hair loss

 

pronounced or total hair loss

 

 

Allergy

 

 

 

 

 

 

 

 

 

 

Allergy

 

none

 

transient rash,
drug fever < 38
o C (<100.4 o F)

 

urticaria,
drug fever 38
o C (100.4 o F),
mild bronchospasm

 

serum sickness, bronchospasm requiring parenteral medication

 

anaphylaxis

Local

 

 

 

 

 

 

 

 

 

 

Local

 

none

 

pain

 

pain and swelling with inflammation or phlebitis

 

ulceration

 

plastic surgery indicated

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Fever of unknown origin

 

 

 

 

 

 

 

 

 

 

Fever of unknown origin

 

none

 

37.1 - 38.0 o  C
98.7
o  - 100.4 o  F

 

38.1 - 40.0 o  C
100.5 - 104
o  F

 

> 40.0 o C (> 104 o  F) for less than 24hrs

 

> 40.0 o  C (> 104 o  F) for more than 24 hrs or accompanied by hypotension

Infection

 

 

 

 

 

 

 

 

 

 

Infection

 

none

 

mild

 

moderate

 

severe

 

life-threatening

Additional events

 

 

 

 

 

 

 

 

 

 

Asthenia

 

analogous to Karnofsky index (WHO grading)

 

 

 

 

 

 

 

 

Chills

 

analogous to fever

 

 

 

 

 

 

 

 

Peripheral oedema

 

analogous to weight gain

 

 

 

 

 

 

 

 

Anorexia

 

analogous to weight loss

 

 

 

 

 

 

 

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Work Statement NB-3

Attachment F

Reports and Information Management/Regular Meetings

 

The Project Committee for Work Statement NB-3 shall be composed of the following members from Radius and the following members from NB:

 

Radius Members:  (1) Nicholas Harvey, (2) Louis Brenner and (3) Michael Wyzga.

 

NB Members:  (1) Bente Juel Riis and (2) Claus Christiansen.

 

The Committee will meet on the telephone when needed and in person when appropriate.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-3

Attachment G

Special Insurance

 

Radius will maintain insurance with respect to the following jurisdictions during the conduct of the clinical study that is the subject of Work Statement NB-3.

 

 

 

 

 

 

 

 

 

 

 

Primary

 

 

 

Trial

 

 

 

Local Policy

 

Local Policy

 

Policy Limit

 

Country

 

Phase

 

Policy Period

 

Limit

 

Sublimit

 

(Aggregate)

 

 

 

MASTER US POLICY

 

 

 

January 30, 2013 - January 30, 2014

 

$

10,000,000

 

N/A

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DENMARK

 

III

 

August 9, 2012 - August 9, 2014

 

5,000,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CZECH REPUBLIC

 

III

 

September 30, 2012 - March 31, 2015

 

2,500,000

 

250,000

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ESTONIA

 

III

 

August 9, 2012 - August 9, 2014

 

5,000,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LITHUANIA

 

III

 

September 30, 2012 - March 31, 2015

 

11,700,000 LTL

 

100,000 LTL

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLAND

 

III

 

August 9, 2012 - August 9, 2014

 

5,000,000

 

NONE

 

$

10,000,000

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

 

 

 

 

 

 

 

 

 

Primary

 

 

 

Trial

 

 

 

Local Policy

 

Local Policy

 

Policy Limit

 

Country

 

Phase

 

Policy Period

 

Limit

 

Sublimit

 

(Aggregate)

 

 

 

ROMANIA

 

III

 

September 30, 2012 - March 31, 2015

 

5,000,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BRAZIL

 

III

 

September 30, 2012 - March 31, 2015

 

$

500,000

 

NONE

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HONG KONG

 

III

 

August 9, 2012 - August 9, 2014

 

20,000,000 HKD

 

10,000,000 HKD

 

$

10,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ARGENTINA

 

III

 

September 30, 2012 - March 31, 2015

 

$

1,000,000

 

$

100,000

 

$

10,000,000

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Work Statement NB-3

Attachment H

Transfer of Obligation

 

See Work Statement NB-3 Attachment C.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Attachment I

Form of Enterprise CTA

CLINICAL TRIAL AGREEMENT WITH INVESTIGATOR

 

Protocol No. BA058-05-005

 

This Clinical Trial Agreement (“Agreement”) is entered into by and among CENTER FOR CLINICAL AND BASIC RESEARCH A/S, Telegrafvej 4, 1, 2750 Ballerup, Denmark (“CCBR”) on behalf of itself and its ten [affiliated][controlled] Clinical Study Sites listed below and Nordic Bioscience A/S, Herlev Hovedgade 207, 2730 Herlev , Denmark (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Sponsor”) concerning:

 

Study Protocol BA058-05-005: An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003, which will guide the performance of the Study, has been prepared by Radius and Nordic Bioscience and accepted by the Clinical Study Sites.

 

CCBR has the legal authority to bind the following clinical study sites (the “Clinical Study Site(s)”):

 

1.               CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

2.               CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

3.               CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

4.               CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

5.               CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

6.               CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

7.               CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

8.               CCBR-Sao Paolo, Avenida Indianópolis nº 1005, Moema. São Paulo - SP - ZIP CODE: 04063-002

9.               CCBR-Pardubuce, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

10.        CCBR-Brno, Hybešova 18, 60200 Brno, Czech Republic

11.        CCBR-Prague, Vinohradská 1597/174 Praha 3 — Vinohrady 130 00 Czech Republic

12.        CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

13.        CCBR-Lodz, Al Pilsudskiego 9 90-368 Lodz Poland

14.        CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Kong

15.        CCBR-Buenos Aires, Fitz Roy 2468 1st floor Buenos Aires, Argentina

 

WHEREAS, the Clinical Study Sites each employ a Principal Investigator and are willing to conduct a clinical trial (the “Study”), in accordance with the above-referenced Protocol and Nordic Bioscience requests each Clinical Study Site to undertake such Study;

 

NOW THEREFORE, the parties agree as follows:

 

1.                     SCOPE OF WORK

 

Nordic Bioscience hereby appoints each of the Clinical Study Sites to conduct the Study, and each of the Clinical Study Sites, each having a Principal Investigator who is an employee of such Clinical Study Site, undertakes that such Clinical Study Site’s employees, agents, and staff shall carry out the Study in a professional, competent manner in accordance with the terms of the Protocol and this Agreement. Each of the Clinical Study Sites hereby confirms that it has enough time and resources to perform the Study according to the highest quality standards.

 

The Principal Investigators shall each review all case report forms (“CRFs”) for Study subjects enrolled at the applicable Clinical Study Site to ensure their accuracy and completeness, shall review and understand the information in the investigator’s brochure, shall ensure that all informed consent requirements are met, and shall ensure that all required reviews and approvals (or favorable opinions) by applicable regulatory authorities and Independent Ethics Committees (“ECs”) are obtained. The Clinical Study Sites and the Principal Investigators shall each ensure that all clinical data are accurate, complete, and legible.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

2.                     PERFORMANCE PERIOD AND ENROLLMENT OF STUDY SUBJECTS

 

The Study will commence upon execution of this Agreement and will continue until completion of the Study as required by the Protocol (including any amendments thereto), unless this Agreement is terminated earlier pursuant to Section 14 hereof.

 

The Study will involve the enrollment and completion of a maximum of Two Hundred Forty (240) evaluable study subjects meeting all Protocol eligibility requirements and protocol procedures (the “Study subjects”). Nordic Bioscience shall not be obligated to pay any sums for tests performed on Study subjects who do not meet all Protocol eligibility criteria or for additional study subjects who are enrolled in the Study without Nordic Bioscience’s prior written approval.

 

Nordic Bioscience will close study subject enrollment into the Study when the Protocol-specified target number of study subjects have been enrolled at all Clinical Study Sites. Therefore, study subject enrollment into the Study may be closed before a specified number of study subjects have been enrolled at any particular Clinical Study Site.

 

Nordic Bioscience will provide financial support for the Study conducted at the Clinical Study Sites according to the terms specified in Schedule A.

 

3.                     DATA

 

Sponsor shall own all data and work product relating to the Study, including all CRF’s, data, documentation, information, materials and results in whatever form generated during the conduct of the Study. Each of the Clinical Study Sites and/or the Principal Investigators shall ascertain that it may store data in a computerized form and also that it is entitled to transfer all such computerized data to Nordic Bioscience. Each of the Clinical Study Sites may use the data and work product it generates under this Agreement solely for purposes of performing the Study in accordance with the terms of this Agreement.  Each of the Clinical Study Sites and/or the Principal Investigators shall promptly and fully produce all data, records and information relating to the Study to Nordic Bioscience and the Sponsor and their representatives during normal business hours, and shall assist them in promptly resolving any questions and in performing audits or reviews of original subject records, reports, or data sources. Each of the Clinical Study Site agrees to cooperate with the representatives of Nordic Bioscience and Sponsor who visit the Clinical Study Site.

 

4.                     COST AND PAYMENT

 

Cost and payment terms are set forth in Schedule A attached to this Agreement and incorporated herein by reference. Each of the Clinical Study Sites agrees to provide Nordic Bioscience with all requests for payment under the terms set forth in Schedule A within six (6) months of Study completion by Clinical Study Sites under the terms of this Agreement. Nordic Bioscience shall not be obligated to make any payments to Clinical Study Sites after this six (6) month period has expired.  Study completion is defined herein as Nordic Bioscience has received all data and no further follow up is necessary with the Clinical Study Sites.

 

5.                     CONFIDENTIAL INFORMATION

 

During the term of this Agreement and for a period of five (5) years after completion of the Study, the Clinical Study Sites and the Principal Investigators shall not disclose or use for any purpose other than performance of the Study, all information (including but not limited to the terms of this Agreement, the Protocol, CRF’s, and any secrets, know-how, privileged records or other confidential or proprietary information and data disclosed to the Clinical Study Sites), and materials (including, but not limited to, the Study Drug and comparator products), provided to the Clinical Study Site by Nordic Bioscience, Sponsor, or their agents, and all data, reports and information, relating to the Study or its progress developed by the Clinical Study Sites and/or the Principal Investigator under this Agreement (the “Confidential Information”). Sponsor shall own the Confidential Information.  The Clinical Study Sites and the Principal Investigators shall keep the Confidential Information strictly confidential and shall disclose it only to those personnel involved in conducting the Study on a need-to-know basis. These confidentiality obligations shall not apply to Confidential Information to the extent that it: (a) is or becomes publicly available through no fault of the Clinical Study Site; (b) is disclosed to the Clinical Study Site by a third party not subject to any obligation of confidence; (c) must be disclosed to ECs, or applicable regulatory authorities; (d) must be included in any subject’s informed consent form; (e) is published in accordance with Section 6; or (f) is required to be disclosed by applicable law.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

6.                     PUBLICATIONS

 

6.1.                             Any and all results of the Study shall be the sole property of Sponsor.  Sponsor will have the right to use the results of the Study in any manner deemed appropriate to Sponsor’s business interest and Sponsor and Nordic Bioscience will each have the right to report the names of the Clinical Study Sites as required by law or governmental regulation. Neither Sponsor nor any party to this Agreement, however, will use another party’s (or Sponsor’s) name in advertising, promotions, or other commercial material without the other party’s (or Sponsor’s) express written permission, except that Nordic Bioscience and Sponsor may quote from and/or reference any publications resulting from the Study authored by, or reviewed and approved by the Clinical Study Sites.

 

6.2.                             It is the intention to publish the Study results in scientific journals.  Any publication of Study results or data shall be made in accordance with the provisions of Section  11.2 of the Protocol.

 

7.                     LICENSE

 

7.1.                             Each Clinical Study Site and Principal Investigator acknowledges that Sponsor owns all proprietary and intellectual property rights in the Study Drug and the related materials being provided to the Principal Investigator and the Clinical Study Site pursuant to this Agreement, including but not limited to the Protocol and the CRF’s produced in the performance of the Study (collectively, “Sponsor Technology”).  Each Clinical Study Site and Principal Investigator agrees to take no action inconsistent with Sponsor’s ownership of such proprietary and intellectual property rights.  It is agreed that neither Nordic Bioscience (including Sponsor) nor the Clinical Study Sites transfers to the other by operation of this Agreement any patent right, copyright right, or other proprietary right of either party, except as contemplated by Section 7.2.  Each Clinical Study Site and Principal Investigator agrees to disclose promptly and fully to Nordic Bioscience all creative ideas, developments, discoveries, methodologies, improvements and inventions, whether or not patentable, arising as a direct result of the work performed under the Study. The Sponsor, acting through Nordic Bioscience, hereby grants each of the Clinical Study Sites a nonexclusive, non-transferable, royalty-free license to use the Study Drug and Sponsor Technology at the Clinical Study Site solely for purposes of conducting the Study.  Neither the Clinical Study Site nor the Principal Investigator will use or permit use of Study Drug or Sponsor Technology by any third party for any purpose other than the completion of the Study without Sponsor’s prior written permission

 

7.2.                             If a Clinical Study Site, as a direct consequence of the work on the Clinical Study, conceives or reduces to practice any new invention, then: (i) if such invention is conceived or reduced to practice solely by the Clinical Study Site, it shall be owned by the Clinical Study Site and (ii) if such invention is conceived or reduced to practice by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience, it shall be jointly owned by the Clinical Study Site and Sponsor or Clinical Study Site and Nordic Bioscience.  All of the Clinical Study Site’s rights to any new invention related to a new use for the Study Drug will be licensed to Sponsor, upon its request and on commercially reasonable terms.  For new inventions which are not related to a new use for the Study Drug, Clinical Study Site grants Sponsor a first option to obtain an exclusive license to any invention owned in whole or in part by the Clinical Study Site, which shall be negotiated by the parties and contain commercially reasonable terms.  Such option shall be exercisable for a period of six (6) months from the date the Clinical Study Site discloses the invention to Sponsor. . Clinical Study Sites will fully cooperate with Nordic Bioscience in obtaining whatever patent protection may be available on inventions, ideas, and developments arising from their work on the Study, and will further cooperate with Nordic Bioscience in executing all documents deemed necessary by Nordic Bioscience or Sponsor for purposes of procuring such patent protection.

 

7.3.                             Each Clinical Study Site hereby represents and warrants to Nordic Bioscience that all personnel affiliated with the Clinical Study Site and participating in the Study, including the applicable Principal Investigator, are subject to written agreements requiring them to disclose and assign any new invention to the Clinical Study Site.

 

8.                     USE OF NAME (ADVERTISING)

 

The Clinical Study Sites and/or Principal Investigators shall obtain prior written consent from Nordic Bioscience before using the name, symbols or marks of Nordic Bioscience or Sponsor in any form of publicity in connection with the Study.  If any of the Clinical Study Sites or Nordic Bioscience is legally required to make any disclosure

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

that identifies the existence or terms of the Agreement, then either may do so without prior written consent from the other but the applicable Clinical Study Site(s) must notify Nordic Bioscience within five (5) business days of such disclosure.

 

9.                     CHANGES TO THE PROTOCOL

 

9.1.                             Subject to Section 9.2, any changes to the Protocol may be made only with the prior agreement of the Sponsor. If these changes will affect the cost of the Study, Nordic Bioscience shall provide the Clinical Study Sites with a written estimate of such change in Study cost.

 

9.2.                             If generally accepted standards of Good Clinical Practice relating to the safety of study subjects require a deviation from the Protocol, these standards will be followed. Any party who becomes aware of the need for a deviation from the Protocol will immediately notify the other parties to this Agreement and the Sponsor of the facts causing the deviation as soon as, the facts are known to that party but no such deviation or change shall be implemented without the prior written approval of Nordic Bioscience and Sponsor; Nordic Bioscience and Sponsor shall promptly confer and provide a prompt written response regarding any deviation proposed pursuant to this Section 9.2.

 

9.3.                             Clinical Study Site shall coordinate, and shall cause each Principal Investigator to coordinate, with the relevant institutional review board or ethics committee (the “EC”) to obtain the EC’s written approval of such Principal Investigator’s conduct of the Study at Clinical Study Site, including approval of the Protocol and informed consent form to be executed by all subjects enrolled by Principal Investigator in the Study (the “Informed Consent Form”).  Clinical Study Site shall be responsible for providing Sponsor with a copy of each such approval, together with information about the members of the EC and all relevant correspondence with the EC. In addition, Clinical Study Site shall coordinate, and shall cause Principal Investigator to coordinate, with the EC to obtain review and approval in writing of any amendments made to a Protocol by the parties.  In the event the EC requires changes in the Protocol or Informed Consent Form, such changes shall not be implemented until Sponsor and Nordic Bioscience are notified and Sponsor gives its written approval.  In the event that the EC alters or withdraws its’ approval in any manner, Clinical Study Site shall promptly notify Sponsor and Nordic Bioscience.  The Protocol and the Informed Consent Form shall not be revised without the prior written agreement of Sponsor, Nordic Bioscience and the EC.  Clinical Study Site will use reasonable efforts to ensure that members of the EC agree to abide by the same obligations of confidentiality as apply to Clinical Study Site under this Agreement.

 

10.             MATERIALS

 

10.1.                      Sponsor will provide the Study Drug. The Clinical Study Sites will provide Materials derived from study subjects enrolled in the study to Nordic Bioscience. The term “Materials” shall include reagents and materials derived from study subjects enrolled in the Study, including blood, sera, and other biological materials. The Clinical Study Site shall use the Study Drug, and any comparator products provided in connection with the Study, solely for the purpose of properly completing the Study and shall maintain all Study Drug and any comparator products in a locked, secured area at all times. Only those persons who are under the Principal Investigator’s, or Principal Investigators’ direct control and who will be using the Study Drug (and any comparator products) or Materials for the Study shall have access to the Study Drug (and any comparator products) or Materials. Upon termination or completion of the Study, all unused Study Drug and comparator products and all Materials shall be returned to Nordic Bioscience or at Nordic Bioscience’s sole option, destroyed.

 

11.              CONFORMANCE WITH LAW AND ACCEPTED PRACTICE

 

11.1.                      The Clinical Study Sites and Principal Investigators shall perform the Study in strict accordance with the protocol, and any subsequent amendments thereto, applicable federal, state, and local laws, regulations and guidelines, good clinical practices (“GCP”), and instructions provided by Nordic Bioscience.  The Clinical Study Sites and Principal Investigators shall permit Nordic Bioscience and agencies such as the FDA to inspect Study records including the Subjects’ medical records. The subject informed consent form signed by the Subjects shall provide for access to the Subjects’ medical records by Nordic Bioscience and by agencies such as the FDA.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

11.2.                      The Principal Investigator will direct and supervise the Study in accordance with Section 1. Nordic Bioscience and Sponsor shall have the right to (a) monitor and audit the activities of the Principal Investigator and Principal Investigators in the conduct of the Study, and (b) monitor and audit the collection of data from the Study.

 

11.3.                      The Clinical Study Sites and Principal Investigators shall retain all records from the Study for the time required by applicable regulations and at the sole expense of Clinical Study Sites and/or the Principal Investigator, and to allow for direct access by the applicable government agencies and representatives of Nordic Bioscience of these records, including the study subjects’ medical records.

 

11.4.                      Each of the Clinical Study Sites and Principal Investigators hereby represent and warrant that neither the Clinical Study Sites, the Principal Investigators nor any of the Clinical Study Sites’ agents or employees rendering services in connection with the Study is presently:  (1) the subject of a debarment action or is debarred pursuant to the Generic Drug Enforcement Act of 1992; (2) the subject of a disqualification proceeding or is disqualified as a clinical investigator pursuant to 21 C.F.R. § 312.70; or (3) the subject of an exclusion proceeding or excluded from participation in any federal health care program under 42 C.F.R. Part 1001 et seq.  Clinical Study Sites shall notify Nordic Bioscience immediately upon any inquiry concerning, or the commencement of any such proceeding concerning Clinical Study Sites, Principal Investigators or any such agent or employee.

 

12.              INDEMNIFICATION

 

12.1.                      Pursuant to a separate indemnity letter in the form of Exhibit B, the Sponsor shall provide indemnification to the Clinical Study Sites, the Principal Investigators and any agents and employees of the Clinical Study Sites from any liabilities, claims, actions or suits for personal injury or death directly arising out of the administration or use of the Study Drug during the Study.

 

12.2.                      The Clinical Study Sites and Principal Investigators shall defend, indemnify and hold harmless Nordic Bioscience, Sponsor and any agents and employees of Nordic Bioscience and Sponsor from any liabilities, claims, actions or suits for personal injury or death directly arising from the negligence or willful misconduct of the Clinical Study Sites, Principal Investigators or their representatives.

 

13.              STUDY SUBJECT INJURY

 

If a study subject experiences an adverse reaction to the Study Drug, Sponsor shall provide reimbursement for reasonable and necessary medical expenses incurred by the study subject for the treatment of these adverse reactions pursuant to the separate indemnity letter in the form of Exhibit B.  Neither Nordic Bioscience nor Sponsor will be responsible for any adverse reactions, which are the result of the negligence or misconduct of the Clinical Study Sites, Principal Investigators or any of their representatives.

 

14.              TERM; TERMINATION

 

14.1.                      This Agreement shall commence on the date of signature of this Agreement and shall continue until delivery of the final validated Case Report Forms. The completion date is dependent on the delivery to the Clinical Study Sites by Nordic Bioscience of all supplies to be provided by Nordic Bioscience and necessary to the conduct of the Study. Any delay due to the failure of supply by Nordic Bioscience, shall be added to the term of the Study. Clinical Study Sites shall have the right to extend the Agreement should there be any delay due to the failure of the supply by Nordic Bioscience.

 

14.2.                      This Agreement may be terminated:

 

14.2.1.                 by a Clinical Study Site upon thirty (30) days’ prior written notice only for serious causes resulting in the material breach by Nordic Bioscience of its obligations to such Clinical Trial Site and only if not cured in a timely manner using reasonable commercial efforts;

 

14.2.2.                 by Nordic Bioscience immediately upon written notice;

 

14.2.3.                 by either a Clinical Study Sites or Nordic Bioscience immediately if the applicable Principal Investigator is unable to continue to serve and a successor acceptable to both the Clinical Study Site and Nordic Bioscience is not available; or

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

14.2.4.                 upon the occurrence of an event qualifying as a termination event as described in the Protocol.

 

14.3.                      Upon the effective date of termination, the applicable Clinical Study Site(s) shall conduct an accounting, which is subject to verification by Nordic Bioscience.  Within thirty (30) days after Nordic Bioscience’s receipt of adequate documentation, Nordic Bioscience will make payment to the applicable Clinical Study Site(s) unless Nordic Bioscience objects to any charge, in which case, the parties shall use best efforts to resolve expeditiously any disagreement.  The payments made by Nordic Bioscience subject to this Section 14.3, will be for:

 

14.3.1.                 all services properly rendered and monies properly expended by the Clinical Study Site  prior to the date of termination and not yet paid for; and

 

14.3.2.                 any reasonable non-cancelable obligations properly incurred for the Study by the Clinical Study Site prior to the effective date of termination.

 

14.3.3.                 The Clinical Study Site shall credit or return to Nordic Bioscience any funds not expended by the Clinical Study Site for the Study prior to the effective termination date.

 

14.4.                      Immediately upon receipt of a notice of termination, the Principal Investigator shall stop enrolling study subjects into the Study and shall cease conducting procedures on study subjects already enrolled in the Study as directed by Nordic Bioscience, to the extent medically permissible and appropriate.

 

14.5.                      Termination of this Agreement by Nordic Bioscience or the Clinical Study Sites shall not affect the rights and obligations of the parties accrued prior to the effective date of the termination. The rights and duties under Sections 3, 5, 6, 7, 8, 10, 11, 12, 14, 15, 17 and 18 of this Agreement survive the termination of this Agreement.

 

14.6.                      If this Agreement is terminated prior to completion of the Study, the Clinical Study Sites shall furnish Nordic Bioscience an acceptable investigator’s report for the Study.

 

15.              MISCELLANEOUS

 

This Agreement and the Protocol may only be amended by the mutual written consent of the parties to this Agreement. This Agreement represents the entire understanding of the parties with respect to the subject matter of this Agreement. In the event of any inconsistency between this Agreement and the Protocol, the terms of this Agreement shall govern. The invalidity or unenforceability of any term or provision of this Agreement shall not affect the validity or enforceability of any other term or provision of this Agreement. No waiver of any term, provision or condition of this Agreement in any instance shall be considered to be a continuing waiver of the same term, provision or condition, or of any other term, provision or condition of this Agreement.  This Agreement may be executed in any number of counterparts, each of which shall be an original and all of which together shall be one document binding on all the parties even though each of the parties may have signed different counterparts. This Agreement shall also be considered executed by the parties upon receipt by Nordic Bioscience by facsimile transmission of the counterparts signed by all the parties.  This Agreement shall be interpreted under the laws of the state or province and country in which the applicable Clinical Study Site conducts the Study.

 

15A.  ASSIGNMENT

 

Neither CCBR nor a Clinical Study Site nor a Principal Investigator may assign or transfer any rights or obligations under this Agreement without the written consent of Nordic Bioscience.  Upon Nordic Bioscience’s or Sponsor’s request, CCBR may assign this Agreement to Nordic Bioscience or to Sponsor or to a third party, and thereafter CCBR shall not have any obligations or liabilities under this Agreement, and CCBR shall obtain from each Clinical Study Site such Clinical Study Site’s prior consent to such an assignment.  Each affected Clinical Study Site will be given prompt notice of such assignment by the assignee.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

16.              ACKNOWLEDGEMENT OF PRINCIPAL INVESTIGATORS

 

CCBR shall obtain an executed Acknowledgement of Obligations from each Clinical Investigator, including each Principal Investigator, participating in the Study under this Agreement, in the form of Exhibit A hereto, prior to the date that any such Clinical Investigator shall commence performing services for the Study.  “Clinical Investigator” means a listed or identified investigator or subinvestigator for the Study who is directly involved in the treatment or evaluation of research subjects and such investigator’s spouse and each dependent child of such investigator.

 

17.              FINANCIAL DISCLOSURE

 

The Clinical Study Sites agrees that, for each listed or identified Clinical Investigator who is directly involved in the treatment or evaluation of research subjects, shall return to Nordic Bioscience a financial disclosure form that has been completed and signed by such Clinical Investigator, which shall disclose any applicable interests held by those investigators or subinvestigators or their spouses or dependent children. The Clinical Study Sites shall ensure that all such forms are promptly updated as needed to maintain their accuracy and completeness during the Study and for one year after its completion. The Clinical Study Sites agrees that the completed forms may be subject to review by governmental or regulatory agencies, Nordic Bioscience and their agents, and the Clinical Study Sites consents to such review. The Clinical Study Sites further consents to the transfer of its financial disclosure data to Nordic Bioscience country of origin, and to the United States of America (“U.S.”) if the Clinical Study Sites is outside of the U.S., even though data protection may not exist or be as developed in those countries as in the Clinical Study Site’s own country.

 

18.              ELECTRONIC RECORDS

 

If the data produced by the Clinical Study Sites will be used in support of an application to the United States Food and Drug Administration (“FDA”) and if the Clinical Study Sites  uses electronic systems for creating, modifying, maintaining, archiving, retrieving or transmitting any records that are required by, or subject to inspection by, the FDA, including, but not limited to, CRFs, medical records, informed consent forms, test results, or other source documents, then the Clinical Study Sites  warrants that its systems for such electronic records are in compliance with Section 21 of the United States Code of Federal Regulations, Part 11. The Clinical Study Sites further warrants that, in order to comply with Part 11, it will not use any electronic signatures on any documents required by, submitted to, or supporting a submission to the FDA unless it has certified to the FDA that it intends such electronic signatures to be the legally binding equivalent of a hand-written signature.

 

19.  SPONSOR AS THIRD PARTY BENEFICIARY OF CERTAIN PROVISIONS

 

It is understood and agreed that Sponsor is a third party beneficiary of Sections 3, 5, 6, 7, 11 and 12 of this Agreement

 

IN WITNESS WHEREOF , the parties hereto have caused their duly authorized representatives to execute this Agreement as of the date first above.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

CENTER FOR CLINICAL AND BASIC RESEARCH A/S, on behalf of itself and each of the Clinical Study Sites

Bente Riis, MD, CEO

 

Hans Chr. Hoeck , MD, CEO

 

 

 

 

 

 

Signature

 

 

Signature

 

 

 

 

 

 

Date:

 

 

Date:

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

EXHIBIT A

 

PRINCIPAL INVESTIGATOR’s INVESTIGATOR’S ACKNOWLEDGEMENT OF OBLIGATIONS

 

The undersigned Clinical Investigator acknowledges and agrees that I and Center for Clinical and Basic Research, Denmark have entered into a Clinical Trial Agreement with Nordic Bioscience A/S representing the interests of Radius Health, Inc.  to perform the clinical study under Protocol No. BA058-05-005:

 

An Extension Study to Evaluate Six Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003.

 

I agree that Center for Clinical and Basic Research, Denmark was authorized to enter into the Agreement on my behalf.

 

My payment for my involvement in the trial will not in any way be dependant of the outcome of the trial. I will not be paid bonuses or the like in case of positive or negative results. I (including for purposes of this paragraph my spouse and my dependent children, in each case to the extent applicable) do not own nor shall I become entitled to own any of the Radius Health, Inc. securities that are subject to the certain Stock Issuance Agreement entered into between Radius Health, Inc. and Nordic Bioscience A/S or to otherwise receive any compensation or other benefit from such Radius Health, Inc. securities or the proceeds of such Radius Health, Inc. securities.

 

I will, prior to shipment of clinical supplies to my Clinical Study Site provide Nordic Bioscience with all original documentation necessary for submission to regulatory authorities, including the U.S. Food & Drug Administration, including a completed and signed FDA Form 3455 and Form 1572.

 

I agree to comply with all the terms and conditions set forth in the Protocol and in the Agreement and to be responsible for assuring that any investigators and study staff under their direct supervision performing work for the Study contemplated by the Agreement and the Protocol similarly comply with the terms and conditions contained therein.

 

NAME AND ADDRESS OF PI

 

 

 

 

 

Date:

 

 

 

 

 

 

 

 

Sign:

 

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Attachment K

Indemnity Letter Template

 

[RADIUS HEALTH, INC. LETTERHEAD]

 

[Name of Clinical Study Site]

[Address]

[City, State, Country]

 

1.                    CCBR-Ballerup, Ballerup Byvej 222, DK 2750 Ballerup, Denmark

2.                    CCBR-Ålborg, Hobrovej 42D, DK-9000 Ålborg, Denmark

3.                    CCBR-Vejle, Orla Lehmannsgade 1, DK-7100 Vejle

4.                    CCBR-Tallinn, Pärna 4, 10128 Tallinn, Estonia

5.                    CCBR-Vilnius, Smélio 20, Vilnius, Lithuania

6.                    CCBR-Bucharest, 2-4 Aleea Buchetului, sector 3, bl. C2, Bucharest, Romania

7.                    CCBR-Rio de Janeiro, Rua Meno Barreto, Botafogo, Rio de Janeiro, Brazil

8.                    CCBR-Sao Paolo, Avenida Indianópolis nº 1005, Moema. São Paulo - SP - ZIP CODE: 04063-002

9.                    CCBR-Pardubuce, Masarykovo náměstí 2667, 530 02 Pardubice, Czech Republic

10.             CCBR-Brno, Hybešova 18, 60200 Brno, Czech Republic

11.             CCBR-Prague, Vinohradská 1597/174 Praha 3 — Vinohrady 130 00 Czech Republic

12.             CCBR-Warsaw, Al. Dzieci Polskich PL04-730 Warsaw

13.             CCBR-Lodz, Al Pilsudskiego 9 90-368 Lodz Poland

14.             CCBR Hong Kong, Center for Health and Medical Research, Hong Kong, 6 Floor, Tower II, New World Tower, 18 Queen’s Road Central, Hong Kong

15.             CCBR-Buenos Aires, Fitz Roy 2468 1st floor Buenos Aires, Argentina

16.             Other sites to be added as relevant

 

Re:  Clinical Trial No. BA058-05-005 (the “Study”) Risk Allocation

 

Dear Ladies and Gentlemen:

 

This letter is delivered to you pursuant to Section 13 of the certain Clinical Trial Agreement dated                  , 2012 among Center for Clinical and Basic Research A/S (“CCBR”) on behalf of itself and its affiliates CCBR-Ballerup, CCBR-Ålborg, CCBR-Vejle, CCBR-Tallinn, CCBR-Warsaw, CCBR Lodz  and CCBR Hong Kong and Nordic Bioscience (“Nordic Bioscience”), representing the interests of Radius Health, Inc. (“Radius”) (the “Agreement”).  Capitalized terms used in this letter and not defined in this letter are used with the Agreement.  The Agreement concerns the performance of the Study in accordance with Radius Protocol No. BA058-05-005 “A Randomized, Double-Blind, Placebo Controlled, Phase 2 Study of BA058 Administered as a Coated Transdermal Microarray Delivery System (BA058 Transdermal) in Healthy Postmenopausal Women with Osteoporosis”  (the “Protocol”).

 

1.               Subject to Paragraph 3, Radius hereby agrees to defend, indemnify and hold harmless [CLINICAL STUDY SITE NAME] (“Clinical Study Site”), including its officers and administrators, employees and agents, including the Principal Investigator and his/her co-investigators and assistants in the Study (collectively, “Indemnitees”) from and against any and all damages, suits, judgments, and liabilities (including expenses and reasonable attorneys’ fees) (collectively, “Losses”) arising from or related to any third party claims of injury, illness or adverse side effects to a patient in the Study that are attributable to the Study Drug.  The indemnification obligation set forth in this Paragraph 1 shall not apply in the event and to the extent that:  (a) such Loss(es) arose as a result of intentional misconduct or negligence by Indemnitees; or (b) the Principal Investigator and those assisting him/her did not adhere to the terms of the Protocol and to Radius’ written instructions relative to the use of Study Drug or failed to employ reasonable care in the conduct of the Study in conformity with the generally accepted standards of the medical community or violated any applicable laws or regulations in any material respect.  For purposes of this Paragraph 1, a violation shall be deemed “material” if it adversely affects the safety, health or welfare of Study subjects.

 

2.               In the event a patient participating in the Study suffers an illness or injury which the Principal Investigator and Radius reasonably determine to be an adverse reaction directly associated with the Study Drug, and not due to a reason other than the Study Drug, then subject to the provisions of Paragraph 3, Radius shall pay all necessary and reasonable medical and hospital expenses directly associated with the medical treatment of such adverse

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

reaction which are in excess of that portion covered by the patient’s own insurance or other insurance, or third-party payment programs .  In the event diagnostic procedures are required to determine the etiology of the patient’s symptoms, Radius shall pay the reasonable expense of such diagnostic work-up without regard to the final diagnosis, so long as Radius agrees to the need for the diagnostic work-up but Radius shall not be responsible for expenses connected with the subsequent treatment of the patient if the work-up establishes that the patient’s symptomology is not related to the administration of the Study Drug.  Payments under this Paragraph 2 shall be in addition to any payments specified in Paragraph 1.

 

3.               To receive the benefit of Paragraph 1 or Paragraph 2, the appropriate personnel at Clinical Study Site must (a) promptly notify Nordic Bioscience and Sponsor in writing of any claim of injury, illness, adverse side effects or adverse reaction to the Study Drug; provided , that failure to give such notice shall not relieve Radius of its obligations under Paragraph 1 or Paragraph 2 except where, and solely to the extent that, such failure actually and materially prejudices the rights of Radius; (b) tender to Radius (and its insurer) full authority to defend or settle the claim or suit; provided that no settlement requiring any admission by an Indemnitee or that imposes any obligation on an Indemnitee shall be made without the Indemnitee’s consent; and (c) cooperate fully with Radius in its handling of such claim or suit.  A Clinical Study Site’s failure to perform its obligations under this Paragraph 3 shall relieve Radius of its obligations under Paragraphs 1 and 2. [ Radius will reimburse Indemnitees for all reasonable expenses incurred at Radius’ request in connection with this Paragraph 3 except to the extent and in the proportion that Indemnitees are responsible under Paragraph 1 ] .

 

4.               Any notice to Radius shall be in writing and shall be deemed given to Radius when delivered by hand or sent by internationally recognized overnight courier (such mailed or courier notice to be effective on the date which is two (2) business days after the date of mailing) or sent by facsimile (such notice sent by telefax to be effective one (1) business day after sending, if immediately confirmed by overnight courier as aforesaid), in each case addressed to the following addresses: Radius Health, Inc., 201 Broadway, 6 th  Floor, Cambridge, MA 02139 USA Attn: [              ], Fax No.: 01.617.551.4701; Phone No.: 01.617.444.1834.

 

IN WITNESS WHEREOF, the undersigned has executed this letter intending it to take effect as of                       , 2010.

 

 

RADIUS HEALTH, INC.

 

 

 

By:

 

 

Name, Title

 

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Attachment L

 

Cash Budget: TRANSDERMAL_BUDGET_V3.1_26April-2012

 


(1) The procedures for the Follow-up visit (Visit 10) for Study BA058-05-003 will serve as the procedures performed at Day 1 (for Study BA058-05-005).  The consent form will need to be signed if it was not signed during the End-of-Treatment Visit (Visit 9) of Study BA058-05-003.

(2) Interim or symptom directed physical examinations may be conducted at other time points to assess adverse events or clinical laboratory abnormalities.

(3) Vital signs (blood pressure, pulse rate, body temperature, and respiration rate) are to be recorded at each study visit.  Only the blood pressure assessment on Day 1 (Visit 10) needs to be orthostatic.  Height is to be measured on Day 1 (Visit 10) and Month 6 in the standing position using a medical stadiometer.  Weight is to be measured on Day 1 (Visit 10) and Month 6.  Orthostatic blood pressure is to be measured initially after 5 minutes in the supine position and then again after standing for three minutes.

(4) All routine urinalysis will be performed on a sample freshly voided during the clinic visit.

(5) These blood samples are to be obtained under fasting conditions (N.P.O. for 8 hours; water is acceptable) in the morning of each scheduled study visit.

(6) Includes blood samples for PINP, bone-specific alkaline phosphatase, serum osteocalcin and CTX.

(7) Twenty-four hour urine collection will be used for urinary calcium and urinary creatinine measurements. Subjects will discard the 1 st  void and begin a 24-hour urine collection the day prior to the clinic visit.

(8) Each DXA for a given subject should be performed on the same machine, and if available, preferably by the same technician

(9)   Each DXA for a given subject should be performed on the same machine, and if available, preferably by the same technician.  Only subjects who had wrist DXA assessments in Study BA058-05-003 will have wrist DXAs performed.

(10) The subjects will maintain a diary throughout the study to record missed doses of medication (including supplements) on a weekly basis; the diaries are to be reviewed with the subject at each study visit.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

CLINICAL TRIAL SERVICES AGREEMENT AMENDMENT NO. 1 TO WORK STATEMENT NB-3

 

RADIUS HEALTH, INC., a Delaware corporation (“ Radius ”) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation (“ NB ”) that is a wholly-owned subsidiary of Nordic Bioscience Clinical Development A/S entered into a Clinical Trial Services Agreement dated March 29, 2011 ( “Agreement” ) and Work Statement NB-3 under the Agreement ( “Work Statement NB-3” ) as of February 21, 2013 ( “Effective Date” )

 

Pursuant to Section 2.3, 2.11 and 11.7 of the Agreement, the parties wish to enter into this Amendment No. 1 to Work Statement NB-3 ( Amendment No. 1” ) effective as of February 28, 2014 ( “Amendment Date” ). Capitalized terms used in this Amendment No. 3 and not defined herein are used with the meanings ascribed to them in the Agreement and Work Statement NB-3.

 

NOW THEREFORE , in consideration of the mutual promises contained in the Agreement and for other good and valuable consideration the receipt and adequacy of which each of the parties does hereby acknowledge, the parties hereby agree to the terms of this Amendment No. 1 to Work Statement NB-3 as follows:

 

1.  Addition of Period 2 to NB-3.   (a)  At Radius’ request, NB will contract with up to 28 CCBR and non-CCBR Sites to enroll patients in a Period 2 extension of the clinical study that is the subject of Work Statement NB-3 entitled: BA058-05-005 “An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-00” ( Attachment 3 to the Agreement).  Radius wishes to provide for payment to NB for Services during Period 2 under this Amendment No. 1.

 

(b) Attachment A to Work Statement NB-3 is amended to add Study Assumptions for Period 2 immediately following the Payment Schedule table for Period 1 ( Attachment 1 to the Agreement).

 

(c)  Attachment B to Work Statement NB-3 is amended to add Payment Schedule for Period 2 immediately following the final paragraph ( Attachment 2 to the Agreement).

 

This Amendment No. 1 to Work Statement NB-3 contains the following Attachments, each of which is made a part hereof:

 

Attachment 1 — Specifications/Key Assumptions/Services/Division of

Responsibilities/Timeline Specifications

Attachment 2 — Budgets, Fees, Pass-through Costs, and Payment Schedule

Attachment 3 — Protocol

 

2.  Ratification.   Except to the extent expressly amended by this Amendment No. 1, all of the terms, provisions and conditions of the Agreement and Work Statement NB-3 are hereby ratified and confirmed and shall remain in full force and effect.  The term “Work Statement NB-3”, as used in the Agreement, shall henceforth be deemed to be a reference to Work Statement NB-3 as amended by this Amendment No. 1.

 

3.  General.   This Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

1



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 1 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 1 under seal as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL

DEVELOPMENT VII A/S

 

 

 

  /s/ Robert E. Ward

 

  /s/ Jeppe R. Andersen

By: Robert E. Ward

 

By: Jeppe R. Andersen

Title: Chief Executive Officer

 

Title: Chief Executive Officer

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6 th  Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor /

Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.525

 

2



 

Amendment No. 1 to Work Statement NB-3

Attachment 1

Specifications/Key Assumptions/Services/Division of Responsibilities/Timeline Specifications

Study Assumptions for Period 2

Radius Health, Inc.

 

Protocol:  BA058-05-005, “An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-00”

 

Protocol Number: BA058-05-005

Number of Sites:

28

 

Argentina

 

1

Brazil

 

5

Czech Republic

 

3

Denmark

 

3

Estonia

 

2

Hong Kong

 

1

Lithuania

 

1

Poland

 

6

Romania

 

1

USA

 

5

 

3



 

Clinical Trial Timeline and Budget

 

Page 1 of 2

RADIUS

BA058-05-005 Amendment 1 (Period 2)

Protocol 05 February 2013

Cost Proposal 02 April 2013

 

Sponsor:

 

RADIUS

 

 

 

Protocol ID:

 

BA058-05-005 Amendment 1 (Period 2)

 

 

 

Development Phase:

 

III

 

 

 

Disease:

 

Osteoporosis

 

 

 

Total # of Randomized and completed subjects

 

925

 

 

 

Nordic Start Study Activity

 

1-Mar-13

 

 

 

Expected Date of FPFV:

 

1-May-13

 

 

 

Expected Length of Recruitment (months):

 

18

 

 

 

Treatment duration (months)

 

18

 

 

 

Follow-up duration (months)

 

1

 

 

 

Close Out (months)

 

Transferred from period 1

 

 

 

Duration of Nordic Involvement

 

37

 

 

 

Number of visits per patient:

 

2.5

 

 

 

Number of Countries:

 

10

 

Ar, Br, Dk, Cz, Ee, Li, Po, Ro, HK, USA

 

Number of Sites:

 

28

 

Ar x 1, Br x 5, Dk x 3, Cz x 3, Ee x 2, Li x 1, Po x 6, Ro x 1, HK x 1, USA x 5

 

 

Total Budget 

 

EURO

 

 

 

Clinic Fee

 

1,802,138

 

925 subjects

 

CRO Activities (Nordic Bioscience)

 

1,165,500

 

 

 

Central Lab Fee (Synarc Lab)

 

0

 

No lab tests to be performed

 

EDC system

 

 

 

Pass through. Estimated to be below 100,000 Euro

 

Calcium and D

 

 

 

Pass through. Estimated to be 15 Euro per month per subject

 

Alendronate

 

 

 

Pass through. Estimated to be 30 Euro per month per subject

 

Total Budget (Euro)

 

2,967,638

 

 

 

 

 

 

USD

 

 

 

Central Imaging Reading (Synarc Imaging)

 

527,740

 

Scalable and invoiced as such + shipment estimated 41,617 USD

 

Total Budget (USD)

 

527,740

 

 

 

 

4



 

Page 2 of 2

 

Pass through Cost

 

EURO

 

 

 

Monitoring Travel Expenses & Accommodations/ other travels

 

Included

 

 

 

Translation

 

Included

 

 

 

Investigator Meeting

 

NA

 

 

 

Alendronate and calcium/ D supllement

 

Not included

 

 

 

Image shipments

 

Not included

 

 

 

Submission Fee to ERC and CA

 

Not included

 

 

 

EDC system

 

Not included

 

 

 

Data Monitoring Committe

 

Not included

 

 

 

Patient insurance

 

Not included

 

 

 

Medical writing

 

Not included

 

 

 

External advisory Board

 

Not included

 

 

 

Statistical Data analysis and Clinical Study Report

 

Not included

 

 

 

 

Payment schedule

 

Euro

 

 

 

 

 

 

 

 

 

Upfront

 

222,573

 

 

 

1,243 per enrolled subject

 

1,149,775

 

 

 

60,514 per month for 19 months

 

1,149,766

 

 

 

Rest

 

445,524

 

 

 

 

 

2,967,638

 

 

 

 

5



 

Amendment No. 1 to Work Statement NB-3

Attachment B

Budgets, Fees, Pass-through Costs, and Payment Schedule*

For Period 2

 

Protocol:  BA058-05-005, “An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-00”

 

The Cash budget is Euro 2,967,638 and USD 527,740

 

The Bonus Equity Payment Amount budget is Euro 2,967,638 and USD 527,740

 

The Cash budget will be paid as follows:

 

·                   7.5% (Euro 222,573) upon execution.

·                   39% (Euro 1,149,775) of the Euro cash budget will be paid during enrollment at Euro 1,243 per randomized patients at all non-US sites (the SITES).

·                   The USD budget will be paid according to invoices received from Synarc Inc.

·                   39% (Euro 1,149,766) of the Euro cash budget will be paid on a monthly basis over 19 months starting after patient randomization is completed with Euro 60,514 per month.

·                   The USD budget will be paid according to invoices received from Synarc Inc.

·                   15% (Euro 445,524) of the Euro cash budget will be paid when the database is locked and transferred to and accepted by Radius.

 

Pass through costs will be invoiced on a monthly basis.

 

The Equity budget will be paid in concert with the cash payment after the same model as for Work Statement NB-1, NB-2 and NB-3 (Period 1) under an amended Stock Issuance Agreement modeled on the Amended and Restated Stock Issuance Agreement entered into by the parties as of May 16, 2011.

 

The pricing specified in this Budget is calculated based upon 925 subjects randomized and completed but will be adjusted for the number of completed patients greater or less than 925 subjects as follows (i) on a fully pro rata basis for the Clinic Fee and the Central Imaging Reading Fee; and (ii) by an amount of euro 487 per subject for the CRO Activities Fee. Should greater than 925 patients be randomized into the study, Euro 1,243 per patient shall be paid at the time of randomization of the additional patients. Thereafter, at the time of completion of patient randomization for the study, the monthly payments over the remaining 19 months of clinic activities shall be adjusted to reflect the actual number of randomized patients but also factoring in the actual drop-out rate at the time of completion of patient randomization and preserving a 15% final payment amount when the database is locked and transferred to Radius. The rate of drop-outs will be monitored over the 19 month period and appropriate adjustments will be made on a quarterly basis to the monthly payment amount as well as the final payment amount to reflect a higher or lower drop-out rate following completion of patient randomization according to following table.

 

6



 

Dropout time

 

Payment (if  no  radiology performed)

 

Payment (if radiology performed)

 

 

 

 

 

After Visit 3, before Visit 4

 

EUR 643 (33% of the total Clinic Fee)

 

EUR 1,123.5 (58% of the total Clinic Fee)

 

 

 

 

 

After Visit 4, before Visit 5

 

EUR 1,052 (54% of the total Clinic Fee)

 

EUR 1,535.8 (78.88% of the total Clinic Fee)

 

 

 

 

 

After Visit 5

 

n/a radiology is mandatory

 

EUR 1,948 (100% of the total Clinic Fee)*

 


*The additional payment for radiology shall not be owed for any patient that is lost to follow-up and no radiology is completed

 

The Cash Budget and the Bonus Equity Payment Amount shall be reduced by an amount of euro 1,948 per subject for Clinic Activities not performed at the SITES for any patients enrolled in the United States. Such reduction to be applied in pro rata installments to monthly payments after patient randomization is completed.  Otherwise, all pricing will be adjusted on a pro rata fashion to reflect the actual study activities completed by the study subjects.

 

7


 

 

CLINICAL STUDY PROTOCOL

 

An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003

 

This study will be conducted according to the protocol and in compliance with Good Clinical Practice, the ethical principles stated in the Declaration of Helsinki, and other applicable regulatory requirements.

 

Protocol Number:

Protocol BA058-05-005

Protocol Date (Version):

Original (23 July 2012)

Amendment 1, Version 1 (13 February 2013)

EudraCT Number

2012-002216-10

IND Number:

73,176

Study Sponsor:

Radius Health, Inc.

201 Broadway, 6 th  Floor

Cambridge, MA 02139, USA

Tel: 617.551.4700. Fax: 617.551.4701

Sponsor Medical Monitor:

Louis Brenner, MD

Chief Medical Officer, Radius Health, Inc.

Tel: 617.551.4006. Fax: 617.551.4701.

Email: lbrenner@radiuspharm.com

Study Safety Officer

Bente Juel Riis, MD

Medical Advisor, Nordic Bioscience A/S

Tel: +45 22 90 13 17. Fax: +41 91 970 2988

Email: bjr@nordicbioscience.com

Contract Research Organization (CRO):

Nordic Bioscience A/S

Herlev Hovedgade 207

2730 Herlev, Denmark

Tel: +45 4452 5252. Fax: +45 4452 5251

 

Disclosure Statement

 

This document contains information that is confidential and proprietary to Radius Health, Incorporated (RADIUS). This information is being provided to you solely for the purpose of evaluation and/or conducting a clinical trial for RADIUS. You may disclose the contents of this document only to study personnel under your supervision and/or to your institutional review board(s) or ethics committee(s) who need to know the contents for this purpose and who have been advised on the confidential nature of the document.

 

8



 

PROTOCOL SYNOPSIS

 

Title:      An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003

 

Protocol Number:   BA058-05-005

 

Test Drug:   BA058 Injection

 

Study Objectives:

 

The primary objective of this study is to collect clinical information regarding six months of treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection or Placebo in Study BA058-05-003.  Safety data will be obtained via clinical, laboratory and radiologic assessments.  Following the initial six months of treatment in the study, subjects will then enter the long-term observational phase of the study during which subjects will continue to receive alendronate treatment for an additional 18 months (for a total of 24 months).

 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate in subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on BMD change and osteoporosis status associated with 24 months of treatment with alendronate after 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

The analysis performed at six months of this Extension Study will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  The analyses performed on data in this study will be descriptive in nature.  Full details of the statistical procedures to be used will be provided in the Statistical Analysis Plan.

 

Study Population:

 

Subjects with postmenopausal osteoporosis who completed the End-of-Treatment Visit (Visit 9) for Study BA058-05-003 and were previously randomized to either blinded BA058 Injection 80 µg or blinded Placebo are eligible for inclusion into this Extension Study provided that they fulfill the Inclusion/Exclusion criteria described below.

 

Inclusion/Exclusion Criteria

 

Otherwise healthy ambulatory postmenopausal women who participated in, and who completed 18 months of treatment with either blinded BA058 Injection 80 µg or blinded Placebo in Study BA058-05-003, are scheduled to complete or have completed the End-of-Treatment visit (Visit 9 in Study BA058-05-003), and who have provided a new written informed consent for the Extension Study, are eligible for enrollment into this study.  Participants must be no more than 40 days from Visit 9 in Study BA058-05-003 to be eligible for this study.  The physical examinations and clinical laboratory measurements from the End-of-Treatment visit from Protocol BA058-05-003 (Visit 9) of the BA058-

 

9



 

05-003 study will provide baseline data for this Extension Study.  In addition, the subjects must, in the opinion of the Investigator, be appropriate candidates for further osteoporosis management.

 

Subjects will not be enrolled if they experienced a treatment-related SAE as assessed by the Investigator, or if they were withdrawn from Study BA058-05-003 for any reason.  Subjects who are not candidates for alendronate treatment will receive standard-of-care management determined to be appropriate by the Investigator.  Specific inclusion and exclusion criteria are described in Section 4.1 and Section 4.2, respectively.

 

Study Design and Methodology:

 

Number of Subjects

 

All subjects who were randomized to the BA058 Injection 80 µg/Placebo arms in Study BA058-05-003, and who completed 18 months of treatment will be offered the opportunity to participate in this study.  There will, therefore, be a potential maximum of 1,600 subjects eligible to be enrolled in this study.

 

Design

 

This study will be an open-label extension of Study BA058-05-003.  The purpose of the study is to provide longer term safety data, fracture data and BMD data after six months of treatment with alendronate, in otherwise healthy ambulatory postmenopausal women with severe osteoporosis who have previously received 18 months of blinded treatment with BA058 Injection or Placebo.  The analysis performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  In addition, this study will examine changes in osteoporosis status after 24 months of treatment with alendronate in otherwise healthy ambulatory women with severe osteoporosis who have previously received 18 months of blinded treatment with BA058 Injection/Placebo.  The analysis performed at 24 months will be descriptive in nature.

 

Subjects randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 and who are candidates for ongoing osteoporosis care, will receive six months of treatment with oral alendronate at a total dose of 70 mg once per week for 24 months.  All subjects will undergo protocol specified procedures (Section 7.0, Appendix 14.1 and 14.2) including BMD and fracture assessment.  The study design is presented in Figure 1, below.

 

10



 

Figure 1:  Protocol BA058-05-005 Study Design

 

 

In this study, the Follow-up Visit from the 18 month study (Visit 10 from Study BA058-05-003) will serve as the Day 1 Visit (Visit 1) for this six month Extension Study (Study BA058-05-005).

 

Following the initial six months of treatment, subjects will enter the long-term observational phase of this study during which the subjects will continue to receive alendronate treatment for an additional 18 months.  During the long-term follow-up of this study, subjects will continue to undergo study related procedures as outlined in Section 14.1 and Section 14.2.

 

All subjects will continue to take calcium and vitamin D supplementation throughout the Extension Study.

 

Study Visits

 

At the End-of-Treatment Visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with subjects randomized to BA058 80 µg/Placebo.  This Extension Study will be comprised of standard-of-care osteoporosis management, including 24 months of treatment with alendronate.  In the month between Visit 9 and Visit 10 (between months 18 and 19 of Study BA058-05-003), the Investigator will consider the results of the assessments performed at Visit 9, including a local review of BMD, and determine if alendronate is appropriate for the subject, as part of this Extension Study.

 

At the Follow-up (Visit 10 for Protocol BA058-05-003, Day 1 for Protocol BA058-05-005) subjects; who were randomized to BA058 Injection 80 µg/Placebo, who fulfill the inclusion/exclusion criteria (Section 4.1 and Section 4.2), and who have agreed to participate in the Extension Study; will sign the Informed Consent Form and be enrolled in the study.

 

Alendronate is the recommended osteoporosis treatment for this Extension Study.  Subjects who have been determined by the Investigator to be candidates for alendronate therapy will receive open-label oral alendronate treatment at a total dose of 70 mg once per week for 24 months.  Subjects will be instructed to take their first dose of alendronate for Study BA058-05-005 in the morning, on the day following their Day 1 visit.  Following the initial six months of treatment in this study, subjects will

 

11



 

enter the long-term observational phase of this study, during which subjects will continue to receive alendronate treatment for an additional 18 months.

 

All subjects will have clinic visits for study related procedures at Day 1, Month 3, Month 6, Month 12, Month 18 and Month 24.  For the purpose of this study one month is equal to 30 days.

 

Statistical Considerations:

 

Exploratory statistical analyses will assess longer term safety, fracture incidence (including vertebral and non-vertebral fracture), and BMD change following treatment with alendronate for six months after the completion of a subject’s participation of 18 months in study BA058-05-003.

 

The analyses performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  At this time-point, subjects will be analyzed based on the randomization assignment in the BA058-05-003 study.  Other analyses performed on the data in this study will be descriptive in nature.

 

Fractures and BMD Analyses

 

All specified endpoints will be summarized by treatment group and study period using standard descriptive statistics (n, mean, SD, median, minimum, maximum or n and %, as appropriate).  The fracture incidence; either clinically or radiologically determined, based on clinical events or protocol-directed vertebral x-rays at Month 6 of this Extension Study; will be tabulated.  In addition, BMD results from the six months of treatment with alendronate will also be tabulated based on the treatment arm they were randomized to in the BA058-05-003 study, with additional tabular categories for results from the entire contiguous 24 months from baseline of study BA058-05-003 through the end of Study BA058-05-005, as well as the results during the 18 months of study BA058-05-003, for subjects who eventually enter study BA058-05-005.  These descriptive analyses will be conducted on all subjects with baseline and post-baseline data.

 

Safety Analysis

 

Data will be summarized and tabulated based on the enrolled population for this Extension Study.  All subjects enrolled in the Extension Study will be included in the safety analysis that will be performed on the following parameters:

 

·                   Incidence and severity of AEs.

 

·                   Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory, if applicable.

 

Safety assessments for changes in physical examination, vital signs, ECG, and laboratory tests will be descriptively summarized by treatment and study periods.  Concomitant medication classes will be categorized using World Health Organization (WHO) drug dictionary and summarized by number and percent of subjects using each class by treatment group.  All treatment emergent adverse events (TEAEs) will be coded for system organ class (SOC) and preferred term (PT) using MedDRA and the number (%) of subjects experiencing each AE (SOC/PT) will be summarized by treatment, relationship to treatment, and severity.  All serious adverse events (SAE) will be listed and the number (%) of subjects with an SAE presented by treatment group.

 

Procedures and Assessments

 

Fractures and BMD

 

The End-of-Treatment (Visit 9) evaluations for vertebral fracture assessment, non-vertebral fracture assessment and BMD from Study BA058-05-003 will serve as the baseline evaluations in this study.  The Day 1 assessment will be concurrent with the Follow-up Visit (Visit 10) for Study BA058-05-003.  Subjects will return to the clinic for assessment of BMD at spine, hip and wrist (for those

 

12



 

subjects who had wrist DXAs performed in Study BA058-05-003) at Month 6 and at Month 24.  Clinical and radiographic assessments for fractures will be performed at Month 6 and Month 24, and bone marker assessments of anabolism (PINP, bone-specific alkaline phosphatase and osteocalcin) and resorption (CTX) will be performed at Day 1 and Month 6.

 

Safety

 

Safety evaluations performed will include physical examinations, vital signs, 12-lead ECGs, clinical laboratory tests, and monitoring and recording of adverse events.

 

Complete details of the study assessments are provided in Section 7.0, in the Schedule of Visits and Procedures (Appendix 14.1) and in the Suggested Schedule of Events and Procedures by Study Visit (Appendix 14.2).

 

Treatments Administered

 

Alendronate sodium (Fosamax®, Merck & Co., Inc., or other approved generic manufacturer) 70 mg tablets for oral administration contain 91.35 mg of alendronate monosodium salt trihydrate which is the molar equivalent of 70 mg free acid and excipients.  Alendronate should be stored in a well-closed container at room temperature, 15-30ºC.  The alendronate may be generic substitutable approved versions which contain different inactive ingredients, but the amount of active free alendronate must be equivalent to 70 mg.  Alendronate for Europe, Hong Kong and the US will be sourced centrally; alendronate for South America will be sourced locally by the medical center and reimbursed by the Sponsor.

 

Calcium (500—1000 mg) and vitamin D (400—800 IU) supplements will be sourced locally by the medical center and provided to the subjects at the expense of the Sponsor. Subjects will continue to take calcium and vitamin D as they did in Study BA058-05-003.

 

Duration of Subject Participation:

 

Participation in the initial phase of this study will be approximately six months from enrollment to completion of the six month study evaluations.  Participation for both the initial and observational phases of the study will be approximately 24 months.  In combination with Study BA058-05-003, subjects will participate in this clinical postmenopausal osteoporosis program for 43 to 44 months.  The first visit of Study BA058-05-005 will be concurrent with Visit 10 of Study BA058-05-003.

 

13


 

TABLE OF CONTENTS

 

PROTOCOL SYNOPSIS

9

 

 

Table of Contents

14

 

 

List of Abbreviations

17

 

 

1.0

introduction

19

 

1.1

Background Information

19

 

1.2

Drug Under Study

20

 

 

1.2.1

Efficacy of Alendronate

20

 

 

1.2.2

Safety of Alendronate Sodium

20

 

1.3

Study Rationale and Selection of Doses

21

 

 

1.3.1

Study Rationale

21

 

 

1.3.2

Study Design

22

 

 

1.3.3

Study Population

22

 

 

1.3.4

Selection of Endpoints

22

 

 

1.3.5

Selection of Dose

22

 

 

 

2.0

STUDY OBJECTIVES

23

 

 

 

3.0

INVESTIGATIONAL PLAN

23

 

3.1

Overall Design and Study Plan

23

 

 

3.1.1

Treatment Period

24

 

 

 

4.0

SELECTION OF STUDY POPULATION

25

 

4.1

Number of Subjects

25

 

4.2

Inclusion Criteria

25

 

4.3

Exclusion Criteria

25

 

4.4

Withdrawal of Subjects from the Study

26

 

4.5

Temporary Suspension of Treatment

26

 

4.6

Replacement of Subjects

26

 

 

 

5.0

STUDY TREATMENTS

27

 

5.1

Study Medications

27

 

 

5.1.1

Alendronate

27

 

 

5.1.1.1

Restrictions on Alendronate Use

27

 

 

5.1.2

Calcium and Vitamin D Supplements

27

 

5.2

Packaging, Labeling and Storage

27

 

 

5.2.1

Storage

27

 

14



 

 

5.3

Treatment Assignment

27

 

5.4

Study Medication Administration

28

 

 

5.4.1

Alendronate Administration

28

 

5.5

Treatment Compliance

28

 

5.6

Unblinding of Study Medication

28

 

 

 

6.0

CONCOMITANT MEDICATIONS

28

 

6.1

Concomitant Medications

28

 

6.2

Prohibited Medications

29

 

 

 

 

7.0

STUDY ASSESSMENTS

29

 

7.1

Clinical Procedures/Assessments

29

 

 

7.1.1

Informed Consent

29

 

 

7.1.2

Recent Health Status

30

 

 

7.1.3

Vital Signs

30

 

 

7.1.4

Height and Weight

30

 

 

7.1.5

Orthostatic Blood Pressure and Heart Rate

30

 

 

7.1.6

Electrocardiogram

30

 

 

7.1.7

Clinical Laboratory Evaluations

30

 

 

7.1.8

Clinical Chemistry and Urinalysis (Dipstick)

31

 

 

7.1.9

Hematology

31

 

 

7.1.10

Coagulation

32

 

 

7.1.11

24-Hour Urine Collection

32

 

 

7.1.12

Bone Mineral Density

32

 

 

7.1.13

Serum Markers of Bone Metabolism

32

 

 

7.1.14

Clinical and Radiologic Evaluation of Fractures

33

 

 

7.1.15

BA058 Antibody Assessments

33

 

 

7.1.16

Subject Diaries

33

 

 

7.1.17

Activity and Diet

33

 

 

 

8.0

ADVERSE EVENTS AND SAFETY EVALUATION

33

 

8.1

Definitions, Documentation, and Reporting

34

 

 

8.1.1

Adverse Event Definition

34

 

 

8.1.2

Serious Adverse Event Definition

34

 

8.2

Monitoring of Adverse Events and Period of Observation

35

 

8.3

Procedures for Recording and Reporting AEs and SAEs

35

 

8.4

Rules for Suspension of the Study

36

 

 

 

9.0

Statistical Procedures

37

 

9.1

Sample Size

37

 

9.2

Randomization, Stratification and Blinding

37

 

9.3

Populations for Analysis

37

 

 

9.3.1

Safety Population

37

 

9.4

Procedures for Handling Missing, Unused, and Spurious Data

37

 

15



 

 

9.5

Statistical Methods

38

 

 

9.5.1

Statistical Considerations

38

 

 

9.5.2

Baseline Comparisons

38

 

 

9.5.3

Fractures and BMD Analysis

38

 

 

9.5.4

Safety Analysis

38

 

 

9.5.5

Procedures for Reporting Deviations to Original Statistical Analysis Plan

39

 

9.6

Data Oversight

39

 

 

9.6.1

Central Review of Radiographs and DXA Scans

39

 

 

 

10.0

ADMINISTRATIVE REQUIREMENTS

39

 

10.1

Good Clinical Practice

39

 

10.2

Ethical Considerations

39

 

10.3

Subject Information and Informed Consent

40

 

10.4

Protocol Compliance

40

 

10.5

Case Report Form Completion

40

 

10.6

Source Documents

41

 

10.7

Study Monitoring

41

 

10.8

On-Site Audits

41

 

10.9

Drug Accountability

41

 

10.10

Record Retention

42

 

10.11

Study Termination

42

 

10.12

Liability and Insurance

42

 

 

 

11.0

USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

43

 

11.1

Use of Information

43

 

11.2

Publication

43

 

 

 

12.0

INVESTIGATOR AGREEMENT

44

 

 

 

13.0

References

45

 

 

 

14.0

APPENDICES

47

 

14.1

Schedule of Visits and Procedures

48

 

14.2

Suggested Schedule of Events and Procedures by Study Visit

49

 

14.3

Eastern Cooperative Oncology Group (ECOG) Common Toxicity Criteria

57

 

16



 

LIST OF ABBREVIATIONS

 

Abbreviation

 

Term

°C

 

Degree Celsius

°F

 

Degree Fahrenheit

µg

 

Microgram

µmol

 

Micromole

AE

 

Adverse event

ALT

 

Alanine aminotransferase

AST

 

Aspartate aminotransferase

BMD

 

Bone mineral density

BMI

 

Body mass index

bpm

 

Beats per minute

BSAP

 

Bone-specific alkaline phosphatase

BUN

 

Blood urea nitrogen

cm

 

Centimeter

CPK

 

Creatine phosphokinase

CRF

 

Case report form

CRO

 

Contract research organization

CTX

 

C-telopeptides of type 1 collagen crosslinks (serum)

DXA

 

Dual energy x-ray absorptiometry

ECG

 

Electrocardiogram

eCRF

 

Electronic case report form

FDA

 

Food and Drug Administration

g

 

Gram

GCP

 

Good clinical practice

GGT

 

Gamma-glutamyltranspeptidase

GLP

 

Good laboratory practice

GMP

 

Good manufacturing practice

ICH

 

International Conference on Harmonization

IEC

 

Independent ethics committee

IRB

 

Institutional review board

ITT

 

Intent-to-treat

IU

 

International unit

IV

 

Intravenous

IVRS

 

Interactive voice response system

kg

 

Kilogram

L

 

Liter

LDH

 

Lactate dehydrogenase

MCH

 

Mean corpuscular hemoglobin

MCHC

 

Mean corpuscular hemoglobin concentration

 

17



 

Abbreviation

 

Term

MCV

 

Mean corpuscular volume

MedDRA

 

Medical dictionary for regulatory activities

µL

 

Microliter

mg

 

Milligram

mL

 

Milliliter

mmHg

 

Millimeter of mercury

msec

 

Millisecond

NPO

 

Nothing by mouth

ng

 

Nanogram

ONJ

 

Osteonecrosis of the jaw

PA

 

Posterior-anterior

PD

 

Pharmacodynamic

pg

 

Picogram

PINP

 

N-terminal propeptide of type I procollagen

PK

 

Pharmacokinetic

PT

 

Prothrombin time

PTH

 

Parathyroid hormone

PTHrP

 

Parathyroid hormone related peptide

PTT

 

Partial thromboplastin time

PUBs

 

Upper gastrointestinal perforations, ulcers and bleeds

QT

 

Total depolarization and repolarization time

QTc

 

Total depolarization and repolarization time corrected with heart rate

RBC

 

Red blood cell

SAE

 

Serious adverse event

SC

 

Subcutaneous

SD

 

Standard deviation

SERMs

 

Selective estrogen receptor modulators

SOC

 

System organ class

SOP

 

Standard operating procedure

TEAEs

 

Treatment emergent adverse events

ULN

 

Upper Limit of Normal

WBC

 

White blood cells

WHO

 

World Health Organization

 

18


 

1.0                          INTRODUCTION

 

1.1                          Background Information

 

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue which leads to enhanced fragility and increased risk of fractures (Rizzoli, 2001).  It is estimated that over 200 million people worldwide have osteoporosis (Reginster, 2006) and osteoporosis causes more than 8.9 million fractures worldwide, of which more than 4.5 million occur in the Americas and Europe (WHO Scientific Group, 2007).  The vast majority of osteoporotic fractures occur in elderly women and incidence increases markedly with age.  Most fractures occur at the spine, wrist and hip.  Of these, hip fractures carry the highest morbidity and mortality.  In 1990, the total number of hip fractures in men and women was estimated to be 1.26 million worldwide, and it is estimated that this number will increase to 3.6 million by 2025 and to 4.5 million by 2050 (Gullberg, 1997).

 

Subject enrolled in this Extension Study will have completed 18 months of treatment with BA058 Injection 80 µg/Placebo.  BA058 is a synthetic 34 amino acid analog of parathyroid hormone related peptide(PTHrP), with molecular modifications of specific amino acids, and is under clinical development for the prevention of fractures in postmenopausal women with severe osteoporosis who are at a risk for fracture.  BA058 shows particular potential for reversing bone loss at both the spine and the hip, the site of the most debilitating osteoporotic fractures in elderly women.  BA058 is a synthetic analog of PTHrP (1-34) designed to give a greater anabolic effect than human parathyroid hormone (hPTH).  Initial in vitro and in vivo studies identified BA058 as displaying bone anabolic properties without a significant hypercalcemic effect.  In humans, BA058 has different pharmacokinetics (PK) and pharmacodynamics (PD) properties than hPTH(1-34) and has been shown in a Phase 2 study (BA058-05-002) to have similar or greater efficacy in restoring bone mineral density (BMD) in individuals with osteoporosis than hPTH(1-34).  Overall, BA058 has been well tolerated in previous studies.

 

This is an open-label extension of Study BA058-05-003.  Enrollment requires previous participation in, and successful completion of, 18 months of treatment with BA058 Injection 80 µg/Placebo in Study BA058-05-003.  The purpose of this extension is to accumulate longer-term safety, fracture, and BMD data in subjects who receive six months of standard-of-care osteoporosis treatment, including treatment with alendronate, following 18 months of treatment with blinded BA058/Placebo treatment.  Following the initial six months of treatment in this study, subjects will then enter the long-term observational phase of this study during which the subjects will continue to receive alendronate treatment for an additional 18 months.  The analyses performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  Other analyses performed on the data in this study will be descriptive in nature.  Full details of the statistical procedures to be used will be provided in the Statistical Analysis Plan.  Alendronate, a bisphosphonate, is approved and marketed world-wide for the treatment and prevention of osteoporosis in postmenopausal women.

 

19



 

1.2                                Drug Under Study

 

1.2.1                      Efficacy of Alendronate

 

Alendronate is a bisphosphonate that acts as a specific inhibitor of osteoclast-mediated bone resorption.  Bisphosphonates are synthetic analogs of pyrophosphate that bind to the hydroxyapatite found in bone.  At the cellular level, alendronate shows preferential localization to sites of bone resorption, specifically under osteoclasts.  The osteoclasts adhere normally to the bone surface but lack the ruffled border that is indicative of active resorption.  Alendronate does not interfere with osteoclast recruitment or attachment, but it does inhibit osteoclast activity. (Fosamax Package Insert)

 

Bisphosphonates including alendronate are widely used to treat osteoporosis.  In animal models, minipigs treated with alendronate exhibited a direct correlation between cancellous bone volume and bone strength (Lefage 1995).  In primates, treatment with alendronate increased the strength of cancellous bone between 44 and 100% (the effect was dose dependent) when compared to vehicle, and also increased bone mass (Balena 1993).  In dogs, this increase in bone mass occurred without causing abnormalities in bone modeling of bone structure (Balena, 1996).

 

In postmenopausal women, alendronate has been demonstrated to increase bone mineral density, decrease bone turnover and reduce the risk of fracture among women with osteoporosis (Tucci, 1996; Devogelaer, 1996; Liberman, 1995).  The therapeutic effects on bone density, remodeling and fracture prevention persist following daily treatment at an oral dose of 10 mg for up to 10 years (Bone, 2004).  Studies have demonstrated that sequential treatment of osteoporosis with one year of treatment with PTH followed by one year of treatment with alendronate resulted in an increase in vertebral bone density that was considerably greater than previously reported for alendronate alone (Rittmaster, 2000).  In subjects receiving PTH(1-84) followed by alendronate, there were significant increases in BMD, in particular trabecular spine, when compared to PTH(1-84) followed by placebo (31% vs. 14%, p<0.001) (Black, 2005).

 

1.2.2                      Safety of Alendronate Sodium

 

According to the US package insert for Fosamax® (alendronate sodium), in studies of up to five years duration, adverse experiences usually were mild and generally did not require discontinuation of therapy.  In a three-year, placebo-controlled, double blind study in which 196 subjects were treated with 10 mg/day, discontinuation due to any adverse experience occurred in 4.1% of subjects treated with alendronate, and 6% of 397 subjects treated with placebo.  The most frequently reported adverse event (occurring in > 2% of subjects treated with alendronate) in this study were abdominal pain, musculoskeletal pain, nausea, dyspepsia, constipation, diarrhea, flatulence, headache and acid regurgitation.

 

Alendronate may cause local irritation of the upper gastrointestinal mucosa.  Esophageal adverse experiences, such as esophagitis, esophageal ulcers and esophageal erosions occasionally with bleeding and rarely followed by esophageal stricture or perforation have been reported.  Osteonecrosis of the jaw (ONJ), which can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, has been reported in subjects taking alendronate.  For subjects requiring dental procedures, discontinuation of alendronate therapy may reduce the risk for ONJ.

 

20



 

Atypical, low-energy, or low trauma fractures of the femoral shaft have been reported in bisphosphonate-treated patients.  These fractures can occur anywhere in the femoral shaft from just below the lesser trochanter to above the supracondylar flare and are transverse or short oblique in orientation without evidence of comminution.  Causality has not been established as these fractures also occur in osteoporotic patients who have not been treated with bisphosphonates.

 

Atypical femur fractures most commonly occur with minimal or no trauma to the affected area.  They may be bilateral and many patients report prodromal pain in the affected area, usually presenting as dull, aching thigh pain, weeks to months before a complete fracture occurs.  A number of reports note that patients were also receiving treatment with glucocorticoids (e.g. prednisone) at the time of fracture.

 

Any patient with a history of bisphosphonate exposure who presents with thigh or groin pain should be suspected of having an atypical fracture and should be evaluated to rule out an incomplete femur fracture.  Patients presenting with an atypical fracture should also be assessed for symptoms and signs of fracture in the contralateral limb.  Interruption of bisphosphonate therapy should be considered, pending a risk/benefit assessment, on an individual basis.

 

According to the Summary of Product Characteristics for alendronate from the EMA, the following adverse experiences have been reported in alendronate treated subject during clinical trials and/or post-marketing use:

 

Common:  Headache, abdominal pain, dyspepsia, constipation, diarrhea, flatulence, esophageal ulcer, dysphagia, abdominal distension, acid regurgitation and musculoskeletal pain.

 

Uncommon:  Nausea, vomiting, gastritis, esophagitis, esophageal erosions, melena, rash, pruritus and erythema.

 

Rare:  Hypersensitivity reactions including urticarial and angioedema, symptomatic hypocalcemia (often in association with predisposing conditions), uveitis, scleritis, episcleritis, esophageal stricture, oropharyngeal ulceration, upper gastrointestinal perforations, ulcers and bleeds (PUBs), rash with photosensitivity, osteonecrosis of the jaw, atypical subtrochanteric and diaphyseal femoral fractures and transient symptoms as in an acute-phase response (myalgia, malaise and rarely, fever), typically associated with initiation of treatment.

 

1.3                                Study Rationale and Selection of Doses

 

1.3.1                      Study Rationale

 

The purpose of the study is to provide longer term safety data, fracture data and BMD data after six months of treatment with alendronate, in otherwise healthy ambulatory postmenopausal women with severe osteoporosis who have previously received 18 months of blinded treatment with BA058 Injection or Placebo.  Following the initial six months of treatment in this study, subjects will enter the long-term observational phase of the study during which the subjects will continue to receive alendronate for an additional 18 months.

 

21



 

1.3.2                      Study Design

 

Subjects randomized to BA058 Injection 80 µg/Placebo, who have completed 18 months of treatment in Protocol BA058-05-003 and, who meet the Inclusion/Exclusion criteria (Sections 4.2 and 4.3) are eligible to participate in this study.  Subjects originally randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 and who are candidates for ongoing osteoporosis care, will receive 24 months of daily open-label alendronate treatment at a total dose of 70 mg/week.

 

1.3.3                      Study Population

 

The study population in this protocol is comprised of otherwise healthy ambulatory postmenopausal women who:

 

1.               have participated in Study BA058-05-003,

2.               were randomized to either BA058 Injection 80 µg/Placebo,

3.               have completed the End-of-Treatment Visit (Visit 9 in Study BA058-05-003), and

4.               have provided a new written informed consent for this protocol.

 

Subjects will not be enrolled if they experienced treatment-related SAE or were withdrawn from Study BA058-05-003 for any reason.

 

1.3.4                      Selection of Endpoints

 

The fracture incidence; either clinically or radiologically determined, based on clinical events or protocol-directed vertebral x-rays at Month 6 of this Extension Study; will be tabulated.  In addition, BMD results from the six months of treatment with alendronate will also be tabulated, with additional tabular categories for results from the entire contiguous 24 months from baseline of study BA058-05-003 through the end of Study BA058-05-005, as well as the results during the 18 months of study BA058-05-003, for subjects who eventually enter study BA058-05-005. Bone formation (PINP, osteocalcin, BSAP) and resorption (CTX) markers will also be assessed.  Clinical incidence of any fracture and radiologic incidence of vertebral fracture will also be evaluated at Month 24.  The End-of-Treatment (Visit 9) evaluations for BMD, vertebral fracture, and non-vertebral fracture assessments from BA058-05-003 will serve as the baseline evaluations in this study.

 

Subjects will be monitored for safety events and will have safety assessments performed at each study visit.  At Month 6 and Month 24, BMD by DXA, as well as clinical and radiologic assessment of the spine for assessment of fractures will be performed.  Bone formation and resorption markers will also be assessed at Day 1 and Month 6.  Further details of these assessments are in Section 7.0, and in Appendix 14.1 and 14.2.

 

1.3.5                      Selection of Dose

 

The dose of alendronate (70 mg per week, oral) selected for this study is based upon the recommended daily dose in the product’s prescribing information.

 

All enrolled subjects will also continue to receive calcium (500-1000 mg) and vitamin D (400-800 IU) supplementation.

 

22



 

2.0                          STUDY OBJECTIVES

 

The primary objective of this study is to evaluate data obtained following six months of treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.  Safety will be evaluated with clinical, laboratory and radiologic assessment.     The analysis at six months will be based on the treatment that subjects were randomized to in the BA058-05-003 study.  Following the initial six months of treatment in this study, subjects will then enter the long-term observational phase of the study during which the subjects will continue to receive alendronate treatment for an additional 18 months.

 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate in subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on BMD change and osteoporosis status associated with 24 months of treatment with alendronate after 18 months of BA058 Injection 80 µg/Placebo.

 

The analysis performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  Additional analyses performed on the data in this study will be descriptive in nature.  Full details of the statistical procedures to be used will be provided in the Statistical Analysis Plan.

 

3.0                                INVESTIGATIONAL PLAN

 

3.1                                Overall Design and Study Plan

 

This study is an open-label extension of Study BA058-05-003.  Subjects and Investigators who participate in Study BA058-05-005 will remain blinded to prior treatment assignment as part of BA058-05-003.  At the End-of-Treatment visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with subjects randomized to BA058 80 µg/Placebo.  The Extension Study will be comprised of an initial six months of treatment with alendronate.  In the month between Visit 9 and Visit 10, the Investigator will review the results of the assessments performed at Visit 9, including a local interpretation of BMD, and determine if alendronate is appropriate for the subject.  All subjects will continue to receive vitamin D and calcium supplementation as they did in Study BA058-05-003.  The study design is presented in Figure 2, below.

 

23



 

Figure 2:  Protocol BA058-05-005 Study Design

 

 

Participation for both the initial and observational phases of the will be approximately 24 months.  There are a total of six clinic visits during the course of the study.

 

A brief summary of the study is provided below.  For a summary of the study assessments to be performed, refer to Section 7.0 (Study Assessments) and to the Schedule of Visits and Procedures (Appendix 14.1).  A more detailed description of the study procedures on a by-visit basis is provided in Appendix 14.2 (Suggested Schedule of Events and Procedures by Study Visit).  A suggested order of procedures is also provided in this schedule.

 

3.1.1                      Treatment Period

 

Subjects will enter into Study BA058-05-005 on Day 1, and Day 1 will also serve as Visit 10 (the Follow-up Visit) for Study BA058-05-003.  The Informed Consent must be signed prior to undergoing any BA058-05-005 study related procedures, and may be signed at either Visit 9 or Visit 10 of Study BA058-05-003.  Subjects who received BA058 Injection 80 µg/Placebo in Study BA058-05-003 will receive six months of open-label oral alendronate treatment as part of this study (BA058-05-005).  Following the initial six months of treatment in this study, subjects will then enter the long-term observational phase of this study during which the subjects will continue to receive osteoporosis care for an additional 18 months.

 

If determined by the Investigator to be appropriate, treatment will be by oral administration of alendronate at a total dose of 70 mg once per week. Subjects will be given a weekly diary card to record missed doses of medication including calcium and vitamin D.

 

A total of six clinic visits are scheduled during the study (Day 1, Month 3, Month 6, Month 12, Month 18 and Month 24).

 

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Subjects will be instructed to take their first dose of study drug for Study BA058-05-005 in the morning on the day following their Day 1 visit (Day 2 of this study).  Study subjects will continue calcium and vitamin D supplementation during this study as was administered during BA058-05-003 (Section 6.1).

 

At Month 3, subjects will return to the clinic for medication resupply, subject diary review and questioning as to their use of concomitant medications and the occurrence of adverse events.

 

At the Month 6 visit ECG, and safety labs will be performed.  Vertebral fractures will be determined clinically and via protocol directed x-ray evaluation; non-vertebral fractures will be determined clinically.  In addition, subjects will undergo a DXA of the hip and spine (and wrist, if the subject was enrolled in the wrist DXA sub-study in Study BA058-05-003), and have samples drawn for bone markers and anti-BA058 antibodies.  Procedures are to be performed as described in Section 7.0, Appendix 14.1 and Appendix 14.2.

 

At Months 12 and 18, subjects will return to the clinic for medication resupply, subject diary review and questioning as to their use of concomitant medications and occurrence of adverse events.

 

At Month 24, subjects will return to the clinic and will undergo clinical and radiologic fracture assessments and have DXA of the hip and spine (and wrist, if the subject was enrolled in the wrist DXA sub-study in Study BA058-05-003).  Any adverse event or clinical laboratory abnormality recorded at the Month 6 Visit will be monitored until it has resolved, become chronic or stable.

 

4.0                          SELECTION OF STUDY POPULATION

 

4.1                                Number of Subjects

 

Subjects who completed 18 months of treatment with either BA058 Injection 80 µg/Placebo in Study BA058-05-003 will be given the opportunity to participate in the Extension Study at all participating centers.  Based on randomization to the BA058 Injection 80 µg/Placebo arms in Study BA058-05-003, up to 1,600 subjects may be entered into this study.

 

The specific inclusion and exclusion criteria for enrolling subjects in this study are presented below in Sections 4.2 and 4.3, respectively.  Exceptions to these criteria should occur infrequently and should be discussed in advance and approved by the Sponsor Medical Monitor.

 

4.2                                Inclusion Criteria

 

Subjects must meet all of the following criteria to be eligible to participate in this study:

 

1.                                       The subject was enrolled, randomized to BA058 Injection 80 µg/Placebo and completed 18-months of blinded treatment within Study BA058-05-003.

 

2.                                       The subject is no more than 40 days from Visit 9 in Study BA058-05-003.

 

3.                                       The subject has read, understood, and signed the written informed consent form for the Extension Study.

 

4.3                         Exclusion Criteria

 

Subjects with any of the following characteristics are not eligible to participate in the study:

 

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1.                                       Subjects who were withdrawn from Study BA058-05-003 for any reason.

 

2.                                       Subjects who experienced a treatment-related SAE during Study BA058-05-003.

 

4.4                                Withdrawal of Subjects from the Study

 

Subjects will be informed that they have the right to withdraw from the study at any time for any reason without prejudice to their medical care.

 

Consistent with the prior protocol, BA058-05-003, the Investigator must withdraw subjects from the study prior at any time in the study for the following reasons:

 

·              Treatment-related SAEs;

 

·              Refusal of treatment;

 

·              Refusal or inability to complete study procedures;

 

·              Lost to follow-up.

 

The Investigator should exercise his/her best judgment and also has the right to withdraw subjects from the study during the study for any of the following reasons:

 

·              ECOG Grade 3 or 4 adverse events [Refer to Appendix14.3];

 

·              A complex of adverse events which, in the judgment of the Investigator justifies treatment cessation;

 

·              Serious intercurrent illness;

 

·              Non-compliance;

 

·              Protocol violations;

 

·              Administrative reasons.

 

If a subject is withdrawn or discontinued from the study, the reason for withdrawal is to be recorded in the source documents and on the case report form.  All subjects withdrawn prior to completing the study should be encouraged to complete the Month 6 or Month 24 Visit (depending on the length of time on study) including any outstanding radiologic assessment or BMD assessment by DXA.

 

4.5                                Temporary Suspension of Treatment

 

The Investigator has the right to suspend treatment with alendronate without withdrawal of the subject from the study.  Reasons for temporary suspension of treatment may include a medical reason unrelated to an adverse event (e.g., a planned procedure), or important social or administrative events.  The reason for the suspension of treatment is to be documented in the electronic case report form (eCRF) and in source documents.

 

When treatment with alendronate is restarted, the subject should resume treatment with the next scheduled dose (as if treatment had not been interrupted).

 

4.6                                Replacement of Subjects

 

Subjects who have been enrolled into the study and subsequently withdraw or drop out of the study will not be replaced.

 

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5.0                                STUDY TREATMENTS

 

5.1                                Study Medications

 

Alendronate will be sourced locally.  Calcium and vitamin D will be provided by the study centers, similar to their provision in Study BA058-05-003.

 

5.1.1                      Alendronate

 

Alendronate will be sourced centrally for Europe, Hong Kong and the US, and will be sourced locally for South America at the expense of the Sponsor.

 

Subjects will receive total weekly dose of oral alendronate at a dose of 70 mg once per week beginning on Day 2 for 24 months.  Additional provisions for dosing of alendronate should be followed based on the prescribing information.  Alendronate provided will be in the approved, marketed formulation.  The alendronate may be generic substitutable approved versions which contain different inactive ingredients, but the amount of active free alendronate must be equivalent to 70 mg per week.

 

5.1.1.1            Restrictions on Alendronate Use

 

Subjects should not receive alendronate if they have the following conditions/limitations:

 

·                                           Abnormalities of the esophagus and other factors which delay espophageal emptying such as stricture or achalasia.

 

·                                           Inability to stand or sit upright for at least 30 minutes.

 

·                                           Hypocalcemia.

 

·                                           Known history of hypersensitivity to alendronate, alendronate excipients, or related compounds.

 

5.1.2                      Calcium and Vitamin D Supplements

 

Calcium and vitamin D supplements will be sourced locally and provided by the sites at the expense of the Sponsor.

 

5.2                                Packaging, Labeling and Storage

 

Centrally supplied alendronate will not be repackaged for the study, but will be over-labeled according to local regulatory requirements as necessary.

 

Calcium and vitamin D supplements will not be relabeled for the study.

 

5.2.1                      Storage

 

Alendronate must be kept in a secure, limited-access storage area until dispensed for use to a study subject.  Alendronate sodium should be stored in the container provided at room temperature, 15-30ºC (59-86ºF).

 

Calcium and vitamin D supplements may be stored at room temperature.

 

5.3                                Treatment Assignment

 

All subjects who participate will continue to be identified by the same 7-digit subject number that was assigned upon enrollment into Study BA058-05-003 throughout the study and on the eCRF.

 

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5.4                                Study Medication Administration

 

5.4.1                      Alendronate Administration

 

Alendronate must be taken with water only (not mineral water) at least 30 minutes before the first food, beverage or medicinal product (including antacids, calcium supplements and vitamins) of the day.  Other beverages (including mineral water), food and some medicinal products are likely to reduce the absorption of alendronate.

 

The following instructions should be followed exactly in order to minimize the risk of esophageal irritation and related adverse reactions.

 

·                   Alendronate should only be swallowed after getting up for the day with a full glass of water (not less than 200 mL or 7 fl. oz.).

·                   Subjects should only swallow alendronate whole.  Subjects should not crush or chew the tablet or allow the tablet to dissolve in their mouths because of a potential for oropharyngeal ulceration.

·                   Subjects should not lie down until after their first food of the day.

·                   Subjects should not lie down for at least 30 minutes after taking alendronate.

·                   Alendronate should not be taken at bedtime or before arising for the day.

 

At the Month 3, Month 6, Month 12 and Month 18 visits, the unused alendronate tablets are to be returned to the clinic for counting and the subject will be dispensed additional alendronate.  At the Month 24 visit, all unused alendronate tablets are to be returned to the study site.

 

5.5                                Treatment Compliance

 

The study site personnel will perform drug accountability at each clinic visit and review each subject diary (refer to Section 7.1.16).  Accountability will be documented on the appropriate forms and subjects will be re-trained on administration as appropriate.  All doses of study medication are to be self-administered.

 

If a subject does not administer or take all study medication including vitamin D or calcium, the reason for the missed dosing is to be recorded in source documents and on the eCRF.

 

Returned, unused alendronate will be accounted for by the study site and destroyed as appropriate.

 

5.6                                Unblinding of Study Medication

 

Not applicable.

 

6.0                          CONCOMITANT MEDICATIONS

 

6.1                                Concomitant Medications

 

Vitamin D and calcium supplements are required to be administered daily from Day 1 (continuing from Protocol BA058-05-003) until the Month 6 Visit.  Vitamin D and calcium supplements will be administered in the following doses: 400-800 IU/day (Vitamin D) and 500-100mg/day (calcium), or at a dose to be determined by the Investigator and agreed upon by the Sponsor Medical Monitor according to the subjects need.  The doses and schedule of Vitamin D and calcium supplements, which are part of the study medication protocol, should

 

28


 

be adhered to and not be changed other than for medical necessity.  The supplements should be taken in the evening with or without food or as otherwise instructed by the Investigator.

 

For any required concomitant medication, such as statins or antihypertensives, the subject must be on a stable dose at study entry and every effort should be made to maintain a stable dose during study participation.

 

The occasional use of over-the-counter medications at approved doses (e.g., ibuprofen or acetaminophen) for headache or minor discomfort is allowed.  Occasional short term ( < 3 months) use of corticosteroids for seasonal allergies or asthma is also allowed.  These are to be recorded on the appropriate case report form.  Subjects should not take any other medications, including over-the-counter medications, herbal medications, or mega-doses of vitamins during the study without prior approval of the Investigator.

 

If it becomes necessary for a subject to take any other medication during the study, the specific medication(s) and indication(s) must be discussed with the Investigator.  All concomitant medications taken during the course of the study must be recorded in the Subject’s medical record or source document and transcribed into the case report form.

 

6.2                                Prohibited Medications

 

Subjects who require treatment during the course of the study with either an anticonvulsant (phenobarbital, phenytoin, carbamazepin or primidone) or chronic treatment with any form of heparin will be discontinued.  Estrogens given as HRT are allowed at entry into the study but cannot be initiated during the study except for local low dose vaginal estrogen.

 

Drugs that may compromise renal function such as non-steroidal anti-inflammatory drugs should be used with caution.

 

7.0                                STUDY ASSESSMENTS

 

Subjects randomized to BA058 Injection 80 µg/Placebo in Study BA058-05-003 will receive alendronate at a dose of 70 mg once per week for a total of 24 months.

 

The assessments performed at each study visit are displayed in the Schedule of Visits and Procedures in Appendix 14.1.  Appendix 14.2 provides a more detailed schedule of the study procedures by study visit with a suggested order of procedure conduct.  Exact procedures for centrifuging, storage, and shipping of laboratory samples will be detailed in a separate document.  The actual time of each blood collection will be recorded on the appropriate source documents and in the eCRF.

 

Study-specific assessments are to be conducted only after the subject has provided written informed consent to participate in this study.  The study assessments are described in more detail in Section 7.1 below.

 

7.1                                Clinical Procedures/Assessments

 

7.1.1                      Informed Consent

 

At the End-of-Treatment Visit (Visit 9) for Study BA058-05-003, the possibility of participating in the Extension Study will be discussed with the subjects randomized to BA058 80 µg/Placebo.  The Informed Consent must be signed prior to undergoing any

 

29



 

BA058-05-005 study related procedures, and may be signed at either Visit 9 or Visit 10 of Study BA058-05-003.

 

7.1.2                      Recent Health Status

 

The subject’s health status will be updated from their last visit in Study BA058-05-003, as necessary.  Any changes in health status should be recorded as an adverse event, as appropriate.

 

The physical examination from the End-of-Treatment visit (Visit 9) of Study BA058-05-003 will be the baseline for this study (Day 1).

 

Interim or symptom-directed physical examinations may be performed at the discretion of the Investigator, if necessary, to evaluate adverse events or clinical laboratory abnormalities.

 

7.1.3                      Vital Signs

 

Blood pressure, body temperature (ºC), pulse (bpm) and respiration rate (breaths per minute) are to be measured and recorded at each study visit (Day 1, Month 3 and Month 6, Month 12, Month 18 and Month 24).  Only the Day 1 blood pressure assessments need be conducted as an orthostatic measurement (See Section 7.1.5).

 

7.1.4                      Height and Weight

 

Height and weight are to be measured at each study visit (Day 1, Month 3, Month 12, Month 18 and Month 24).  Height is to be measured in the standing position using a medical stadiometer.

 

7.1.5                      Orthostatic Blood Pressure and Heart Rate

 

The Day 1 orthostatic blood pressure measurement for Study BA058-05-005 will serve as the Visit 10 orthostatic blood pressure for Study BA058-05-003.  Blood pressure (mmHg; measured in the same arm at each visit) and pulse rate (bpm) will be measured after five minutes in the supine position.  Immediately following this measurement, blood pressure will be measured again after three minutes in the standing position.

 

7.1.6                      Electrocardiogram

 

A twelve-lead supine electrocardiograms (ECGs) will be performed and the following ECG parameters will be recorded: rhythm, heart rate, PR interval, QRS duration and QT/QTc.

 

The Day 1 ECG measurement for Study BA058-05-005 will serve as the Visit 10 ECG measurement for Study BA058-05-003.  An ECG will also be obtained at Month 6.

 

7.1.7                      Clinical Laboratory Evaluations

 

Clinical laboratory evaluations will be performed by a central laboratory.  Prior to starting the study, the Sponsor (or its designee) will provide each Investigator with copies of the appropriate laboratory certifications and normal ranges for all laboratory parameters to be performed by that laboratory.

 

The blood and urinalysis samples are to be obtained under fasting conditions (NPO for 8 hours; water is acceptable) in the morning of each scheduled study visits on Day 1 and Month 6.

 

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All clinically significant laboratory abnormities indicating an adverse event will be followed up by repeat testing and further investigated as necessary, according to the judgment of the Investigator.

 

7.1.8                      Clinical Chemistry and Urinalysis (Dipstick)

 

Clinical chemistry and dipstick urinalysis will be performed on Day 1 and at Month 6.  Urinalysis will be performed using samples freshly voided during the clinic visit.  If there are positive findings noted on the dipstick, a urine microscopic examination will be performed.  The following tests will be performed:

 

Serum Chemistry

·

Sodium

 

·

Potassium

 

·

Chloride

 

·

Inorganic phosphorus

 

·

Albumin

 

·

Total protein

 

·

Glucose

 

·

Blood urea nitrogen (BUN)

 

·

Creatinine

 

·

Uric acid

 

·

Aspartate aminotransferase (AST)

 

·

Alanine aminotransferase (ALT)

 

·

Gamma-glutamyltranspeptidase (GGT)

 

·

Creatine phosphokinase (CPK)

 

·

Alkaline phosphatase

 

·

Total bilirubin

 

·

Lactate dehydrogenase (LDH)

 

·

Cholesterol

 

·

Triglycerides

 

·

Total calcium

Urinalysis

·

pH

 

·

Glucose

 

·

Protein

 

·

Ketones

 

·

Bilirubin

 

·

Blood

 

·

Urobilinogen

 

·

Specific gravity

 

·

Nitrite

 

·

Leukocytes

 

7.1.9                      Hematology

 

Hematology testing will be performed on Day 1 and at Month 6. The following tests will be performed:

 

Hematology :

·

Hemoglobin

 

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·

Hematocrit

 

·

WBC count with differential in absolute counts

 

·

RBC count

 

·

Mean corpuscular volume (MCV)

 

·

Mean corpuscular hemoglobin concentration (MCHC)

 

·

Mean corpuscular hemoglobin (MCH)

 

·

Platelet count

 

7.1.10               Coagulation

 

Coagulation testing will be performed on Day 1 and at Month 6. The following tests will be performed:

 

 

·

Prothrombin time (PT)

 

·

Partial thromboplastin time (PTT)

 

7.1.11               24-Hour Urine Collection

 

The 24-hour urine collection is to be begun the day before the Day 1 and Month 6 visits.  If a sample was not able to be collected on the day prior to the Day 1 visit (i.e., if the subject had not yet signed the ICF for study participation), a 24-hour urine sample must be collected on the day prior to the Month 3 visit.  Subjects are to be instructed to begin the urine collection by discarding the first morning void (~6 a.m.) the day prior to the scheduled clinic visit and to then collect their urine for 24 hours.  A final void is to be collected at the end of the 24-hour period and the urine collection transported to the clinic by the subject.  The 24-hour urinalysis will be used to measure urinary calcium and urinary creatinine.

 

7.1.12               Bone Mineral Density

 

All subjects will have bone mineral density measurements (BMD) taken via DXA at Month 6 and at Month 24.  The End-of-Treatment (Visit 9) bone mineral density tests for Study BA058-05-003 will serve as the baseline BMD measurements for Study BA058-05-005.

 

DXAs will be performed on the hip (femoral neck) and spine (L1-4).  The spinal DXA is to be taken in the postero-anterior (PA) projection with any subsequent spinal DXA to be taken in the same projection.  Subjects who underwent wrist DXAs in Study BA058-05-003 will also have wrist DXAs performed at Month 6 and Month 24.  The same side of the hip and wrist that were used in Study BA058-05-003 must be used for the DXA scan, and the same scanner should be used throughout the study, when possible.

 

7.1.13               Serum Markers of Bone Metabolism

 

Blood samples to measure bone markers will be taken on Day 1 and at Month 6.  The results of the bone markers will be reported in the same subset of subjects reported on for Study BA058-05-003.

 

The following markers of bone formation will be measured:

 

·                   Serum N-terminal propeptide of type I procollagen (PINP);

 

·                   Serum bone-specific alkaline phosphatase (BSAP);

 

·                   Serum osteocalcin.

 

The following marker of bone resorption will be measured:

 

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·                   Serum C-telopeptides of type 1 collagen crosslinks (CTX).

 

7.1.14               Clinical and Radiologic Evaluation of Fractures

 

Subjects will undergo protocol directed antero-posterior and lateral radiographs of the lumbar and thoracic spines at Month 6 and Month 24.  The End-of-Treatment (Visit 9) clinical and radiological evaluation of fractures for Study BA058-05-003 will serve as the baseline assessments for Study BA058-05-005.  Subjects will also be clinically evaluated for non-vertebral fractures (wrist, hip, rib, etc.) that occur de novo during the Treatment Period.

 

All radiographs will be viewed and assessed centrally by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity.  Fractures will be assessed according to the severity scale of Genant (1993).  A second blinded radiologist will confirm the assessment of the first reviewer for all subject radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.

 

Fractures identified during the study will not be recorded as AEs unless the subject is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the subject’s underlying osteoporosis.  All fractures (vertebral and non-vertebral) will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

7.1.15               BA058 Antibody Assessments

 

The occurrence of anti-drug antibodies will be assessed at the completion of the initial six months of the study.  Serum samples will be drawn at Month 6.  Any subject who tests positive, or has previously tested positive for antibodies subjects will be retested at six month intervals under a separate Safety Surveillance protocol.  Exact procedures for collection, preparation, storage, and shipping of these samples will be detailed in a separate document.  The actual time and date of each blood collection will be recorded on the appropriate source document and in the eCRF.

 

7.1.16               Subject Diaries

 

A weekly diary will be completed by the subject beginning on the Day 1 visit and continuing until the last day of Month 24.  This diary will capture missed doses of vitamin D, calcium and alendronate.  The weekly diary will be reviewed at each study visit.

 

7.1.17               Activity and Diet

 

Subjects who qualify for enrollment in the study will have no restrictions placed on their usual level of activity or on their usual diet, unless directed by the treating physician for medically justified reasons.

 

8.0                          ADVERSE EVENTS AND SAFETY EVALUATION

 

Timely, accurate, and complete reporting and analysis of safety information from clinical studies are crucial for the protection of subjects, Investigators and the Sponsor, and is mandated by Regulatory Agencies worldwide.  All clinical trials sponsored by RADIUS will be conducted in accordance with Standard Operating Procedures (SOPs) that have been established to conform to regulatory requirements worldwide to ensure appropriate reporting of safety information.

 

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8.1                          Definitions, Documentation, and Reporting

 

8.1.1                      Adverse Event Definition

 

An adverse event (AE) is any untoward medical occurrence in a subject administered a pharmaceutical product, which does not necessarily have a causal relationship with the treatment.  An AE can be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not it is considered to be study drug related.  This includes any newly occurring event or previous condition that has increased in severity or frequency since the administration of study drug.

 

8.1.2                      Serious Adverse Event Definition

 

A serious adverse event (SAE) is any adverse event, occurring at any dose and regardless of causality that:

 

·                   Results in death.

 

·                   Is life-threatening.  Life-threatening means that the subject was at immediate risk of death from the reaction as it occurred, i.e., it does not include a reaction which hypothetically might have caused death had it occurred in a more severe form.

 

·                   Requires in-patient hospitalization or prolongation of existing hospitalization.  Hospitalization admissions and/or surgical operations scheduled to occur during the study period, but planned prior to study entry are not considered AEs if the illness or disease existed before the subject was enrolled in the trial.  Provided that the illness/disease did not deteriorate in an unexpected manner during the trial (e.g., surgery performed earlier than planned).

 

·                   Results in persistent or significant disability/incapacity.  Disability is defined as a substantial disruption of a person’s ability to conduct normal life functions.

 

·                   Is a congenital anomaly/birth defect.  This includes any anomaly detected at or after birth, or any anomaly that results in fetal loss.

 

·                   Is an important medical event.  An important medical event is an event that may not result in death, be life-threatening, or require hospitalization, but may be considered an SAE when, based upon appropriate medical judgment, it may jeopardize the subject and may require medical or surgical intervention to prevent one of the outcomes listed in the definitions for SAEs.  Examples of such medical events include allergic bronchospasm requiring intensive treatment in an emergency room or at home, blood dyscrasias or convulsions that do not result in in-patient hospitalization, or the development of drug dependency or drug abuse.

 

Clarification should be made between the terms “serious” and “severe” since they are not synonymous.  The term “severe” is often used to describe the intensity (synonym: severity) of a specific event (as in mild, moderate, or severe myocardial infarction); the event itself, however, may be of relatively minor medical significance (such as a severe headache).  This is not the same as “serious,” which is based on subject/event outcome or action criteria described above and are usually associated with events that pose a threat to a subject’s life or functioning.  A severe adverse event does not necessarily need to be considered serious.  For example, persistent nausea of several hours duration may be considered severe nausea but not

 

34



 

an SAE.  On the other hand, a stroke resulting in only a minor degree of disability may be considered mild, but would be defined as an SAE based on the above noted criteria.  Seriousness (not severity) serves as a guide for defining regulatory reporting obligations.

 

8.2                          Monitoring of Adverse Events and Period of Observation

 

All AEs will be monitored until they are resolved or have become chronic or stable.  AEs and SAEs will be recorded on the case report forms starting from the time of subject entry from Day 1 of the study until the final study visit (Month 24).  Any SAEs that occur at any time after completion of the study, which the Investigator considers to be related to study drug, must be reported to the Sponsor or its designee.

 

8.3                          Procedures for Recording and Reporting AEs and SAEs

 

All adverse events spontaneously reported by the subject and/or in response to an open question from study personnel or revealed by observation, physical examination or other diagnostic procedures must be recorded in the source document and on the appropriate page of the case report form.  Any clinically relevant deterioration in laboratory assessments or other clinical findings is considered an adverse event and must be recorded on the appropriate pages of the case report form.  When possible, signs and symptoms indicating a common underlying pathology should be noted as one comprehensive event.

 

All SAEs that occur during the course of the study, as defined by the protocol, must be reported by the Investigator to the Study Safety Officer by completing and transmitting the SAE Form within one working day from the point in time when the Investigator becomes aware of the SAE.  In addition, all SAEs including all deaths, which occur up to and including 30 days after administration of the last dose of study drug, must be reported to the Study Safety Officer within one working day.  All SAEs and deaths must be reported whether or not considered causally related to the study drug.  SAE forms will be provided to the study site.  The information collected will include a minimum of the following: Subject number, a narrative description of the event, and an assessment by the Investigator as to the intensity of the event, and relatedness to study drug.  Follow-up information on the SAE may be requested by the CRO, the Study Safety Officer or the Sponsor Medical Monitor.  Contact information for reporting SAEs to the Study Safety Officer is provided on the SAE form.

 

It is the responsibility of the Investigator to promptly notify the Institutional Review Board (IRB)/Independent Ethics Committee (IEC) of all serious adverse drug reactions involving risk to human subjects in accordance with the requirements of the IRB/IEC.  An unexpected event is one that is not reported in the Investigator’s Brochure.

 

Planned hospital admissions or surgical procedures for an illness or disease that existed before the subject was enrolled in the trial or before study drug was given are not to be considered AEs unless they occur at a time other than the planned date.

 

Fractures identified during the study are not to be recorded as AEs unless the subject is hospitalized, the fracture is complicated, or the Investigator considers the fracture to be unrelated to the subject’s underlying osteoporosis.  All fractures will be identified and evaluated as part of the disease assessment and will be documented in the case report forms and source documents.

 

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For both serious and non-serious adverse events, the Investigator must determine the intensity of the event and the relationship of the event to study drug administration.  Intensity for each AE will be defined according to the following criteria:

 

Intensity

 

Definition

Mild

 

Awareness of sign or symptom, but easily tolerated.

Moderate

 

Discomfort enough to cause interference with normal daily activities.

Severe

 

Inability to perform normal daily activities

 

If the intensity of an adverse event changes within a day, the maximum intensity should be recorded.  If the intensity changes over a longer period of time, the changes should be recorded as separate events (having separate onset and stop dates for each intensity).

 

Relationship to study drug administration will be determined by the Investigator according to the following criteria:

 

Relationship

 

Definition

None

 

No relationship between the event and the administration of study drug. The event is related to other etiologies, such as concomitant medications or subject’s clinical state.

Unlikely

 

The current state of knowledge indicates that a relationship to study drug is unlikely or the temporal relationship is such that study drug would not have had any reasonable association with the observed event.

Possible

 

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction might have been produced by the subject’s clinical state or other modes of therapy administered to the subject.

Probable

 

A reaction that follows a plausible temporal sequence from administration of the study drug and follows a known response pattern to the suspected study drug. The reaction cannot be reasonably explained by the known characteristics of the subject’s clinical state or other modes of therapy administered to the subject.

 

For the purpose of safety analyses, all AEs that are classified with a relationship to study medication administration of possible or probable will be considered treatment-related events.

 

8.4                          Rules for Suspension of the Study

 

As this is an extension study using standard-of-care management of osteoporosis, including products approved for treatment, it is not anticipated that the study will need to be suspended, and therefore, suspension rules are not assigned.  In the event that the prior study (Study BA058-05-003) is suspended, the circumstances of the Study BA058-05-003 suspension will be considered to determine if this study, Study BA058-05-005, should be suspended as well.

 

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9.0                          STATISTICAL PROCEDURES

 

The primary objective of this study is to evaluate data obtained following six months of standard-of-care osteoporosis treatment, including treatment with alendronate, in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.  Safety data will be obtained with clinical, laboratory and radiologic assessment.  Following the initial six months of treatment in this study, subjects will then enter the long-term observational phase of this study during which the subjects will continue to receive alendronate treatment for an additional 18 months.

 

The specific objectives of this study are to:

 

·                   Provide additional information on safety in study subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide information on the vertebral fracture rate of subjects receiving six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on non-vertebral fractures and BMD change associated with six months of treatment with alendronate following 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

·                   Provide additional information on BMD change and osteoporosis status associated with 24 months of treatment with alendronate after 18 months of treatment with BA058 Injection 80 µg/Placebo.

 

The analysis performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  Additional analyses performed on data in this study will be descriptive in nature.  Full details of the statistical procedures to be used will be provided in the Statistical Analysis Plan.

 

9.1                          Sample Size

 

As this is an extension study, no formal sample size analysis was performed for this study.  Study data will be tabulated and summarized.

 

9.2                          Randomization, Stratification and Blinding

 

Osteoporosis treatment will be open label and no randomization is required.

 

9.3                          Populations for Analysis

 

All analyses and data summaries will be presented for the Safety Population.

 

9.3.1                      Safety Population

 

The Safety Population is comprised of all subjects who qualify on the basis of Study BA058-05-003 and provide informed consent to enroll in this Extension Study.

 

9.4                          Procedures for Handling Missing, Unused, and Spurious Data

 

All available data will be included in the data listings and tabulations. Where appropriate, imputations of values for missing data will be performed using last observation carried

 

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forward and specified in the Statistical Analysis Plan.  All data recorded on the CRF will be included in the data listings that will accompany the clinical study report.

 

9.5                          Statistical Methods

 

9.5.1                      Statistical Considerations

 

Statistical analysis will focus on longer term safety, fracture incidence, including vertebral fracture and BMD change following six months of standard-of-care osteoporosis treatment in subjects who have previously received 18 months of blinded treatment with BA058 Injection 80 µg/Placebo.  The analyses will be performed based on the treatment arm they were randomized to in the BA058-05-003 study.  The analyses performed on data collected at Month 12 and Month 24 will be descriptive in nature and will be summarized descriptively with number, percentage (for categorical variables), mean, standard deviation, median, minimum and maximum (for continuous variables).

 

The analyses performed at six months will be used as a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  At this time-point, subjects will be analyzed based upon the randomization assignment in the BA058-05-003 study.

 

9.5.2                      Baseline Comparisons

 

Baseline characteristics, medical history, physical examination, vital signs and ECG, will be summarized using standard descriptive statistics.

 

9.5.3                      Fractures and BMD Analysis

 

All specified endpoints will be summarized by treatment group and study period using standard descriptive statistics (n, mean, SD, median, minimum, maximum, or n and %, as appropriate).  The fracture incidence and BMD results from the additional six months of treatment with alendronate will be tabulated based on the treatment arm they were randomized to in the BA058-05-003 study, with additional tabular categories for results from the entire contiguous 24 months from the baseline of Study BA058-05-003, for subjects who eventually enter study BA058-05-005.  These descriptive analyses will be conducted on all subjects with baseline and post-baseline data.  The analysis performed at six months will be used a follow-up to the 18 month fracture endpoint for Study BA058-05-003.  The data collected at Month 12 and Month 24 will be tabulated for each efficacy endpoint (vertebral fracture, non-vertebral fracture, and spine, femoral neck and forearm BMD).  This information will be summarized according to original treatment assignment, osteoporosis medications taken between Month 6 and Month 24, and other patient characteristics.

 

9.5.4                      Safety Analysis

 

Data will be summarized and tabulated based on the enrolled population for this Extension Study.  All subjects enrolled in the Extension Study will be included in the safety analysis that will be performed on the following parameters:

 

·                   Incidence and severity of AEs;

 

·                   Pathological changes in hematology, chemistry and urinalysis data based on normal ranges supplied by the clinical laboratory, if applicable;

 

Safety assessments for changes in physical examination, vital signs, ECG, and laboratory tests will be descriptively summarized by treatment and study periods.  The results of anti-

 

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BA058 testing will be summarized.  Concomitant medication classes will be categorized using World Health Organization (WHO) drug dictionary and summarized by number and percent of subjects using each class by treatment group.  All treatment emergent adverse events (TEAEs) will be coded for system organ class (SOC) and preferred term (PT) using MedDRA and the number (%) of subjects experiencing each AE (SOC/PT) will be summarized by treatment, relationship to treatment, and severity.  All serious adverse events (SAE) will be listed and the number (%) of subjects with an SAE presented by treatment group.

 

9.5.5                      Procedures for Reporting Deviations to Original Statistical Analysis Plan

 

All deviations from the original statistical analysis plan will be provided in the final clinical study report.

 

9.6                          Data Oversight

 

9.6.1                      Central Review of Radiographs and DXA Scans

 

All radiographs will be viewed and assessed by a blinded, independent assessor (radiologist) on the basis of existing baseline and study-acquired vertebral deformity, and fractures will be assessed according to the method of Genant.  A second blinded radiologist will review the assessment of the first reviewer for all subject radiographs in which an incident fracture has been identified.  In the case of any disagreement, a third consensus assessment will be made to adjudicate the incident fracture.  All study DXA scans will also be evaluated centrally by a blinded independent reviewer.  The primary objective of the independent review is to provide objective data to determine the treatment benefit as demonstrated on the pertinent radiologic and clinical data associated with this study.

 

10.0                   ADMINISTRATIVE REQUIREMENTS

 

10.1                   Good Clinical Practice

 

This study will be conducted in accordance with the International Conference on Harmonization (ICH) for Good Clinical Practice (GCP) and the appropriate regulatory requirements.  The Investigator will be thoroughly familiar with the appropriate use of the study medication as described in the protocol and the Investigator’s Brochure.  Essential clinical documents will be maintained to demonstrate the validity of the study and the integrity of the data collected.  The Investigator/institution should establish master files at the beginning of the study which will be maintained and updated during the study and retained thereafter according to the appropriate regulations.

 

10.2                   Ethical Considerations

 

The study will be conducted in accordance with ethical principles founded in the Declaration of Helsinki.  The Institutional Review Board (IRB)/Independent Ethics Committee (IEC) will review all appropriate study documentation in order to safeguard the rights, safety and well-being of the subjects.  The study can only be conducted at study sites where IRB/IEC approval has been obtained.  The protocol, informed consent form, Investigator’s Brochure, advertisements (if applicable), and all other forms of information given to subjects will be provided to the IRB/IEC by the Investigator.  In addition, reports on the progress of the study will be submitted to the IRB/IEC by the Investigator at the appropriate intervals.

 

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10.3                   Subject Information and Informed Consent

 

Each subject (or a legally authorized representative) must give written informed consent prior to any new study-specific procedures being conducted.  It is the responsibility of the Investigator to ensure written informed consent is obtained from each subject participating in this study after an explanation of the objectives, methods, discomforts and potential risks of the study has been provided.  The Investigator (or study personnel) must also explain to each subject that he/she is free to refuse participation in the study or to withdraw from it at any time.  Each subject will also be told that his/her records may be examined by competent authorities and authorized persons but that personal information will be treated as strictly confidential and will not be publicly available.

 

The informed consent form must be in accordance with the Declaration of Helsinki, ICH and GCP guidelines, and be approved by the Sponsor and the IRB/IEC.  State or local laws may require additional information.  Each subject (or his/her legally authorized representative) must sign and be given a copy of the informed consent form.  Each subject’s signed informed consent form must be maintained by the Investigator and be readily available for review by the Sponsor (or its designee) or the Regulatory Authorities.

 

10.4                   Protocol Compliance

 

The Investigator will conduct this study in compliance with the protocol provided by the Sponsor and given approval/favorable opinion by the IRB/IEC and the appropriate Regulatory Authority(ies).  Changes to the protocol will not be made without agreement of the Sponsor Medical Monitor.  All changes to the protocol will require IRB/IEC approval prior to implementation, except when necessary to eliminate an immediate hazard to study subjects or when the change involves only logistical or administrative aspects of the study (e.g., change in Sponsor Medical Monitor or telephone number).  The IRB/IEC may provide, if applicable regulations permit, expedited review and approval/favorable opinion for minor changes in ongoing studies.  The Sponsor will submit all protocol changes to the appropriate Regulatory Authority in accordance with the governing regulations.

 

In situations requiring a departure from the protocol, the Investigator or other physician in attendance will contact the Sponsor Medical Monitor by telephone, e-mail or fax.  If possible, this contact will be made before implementing any departure from the protocol.  In all cases, contact with the Sponsor Medical Monitor must be made as soon as possible in order to review the situation and agree on an appropriate course of action.  The case report form and source document will describe any departure from the protocol and the circumstances requiring it.

 

10.5            Case Report Form Completion

 

eCRFs will be developed to collect information obtained during this study.  It is the Investigator’s responsibility to ensure that the e-CRFs are completed for each subject enrolled in this study and for the accuracy, completeness, legibility and timeliness of the data reported in each e-CRF.  Data for subjects who are screened but not enrolled into the study because they do not meet study criteria or do not complete all screening procedures, should be recorded in the e-CRF.

 

eCRFs will be completed and any corrections of data will be made according to procedures provided by the Sponsor (or designee).

 

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10.6                   Source Documents

 

Source documents are defined as original documents, data and records.  This may include hospital records, clinical and office charts, laboratory data/information, work sheets, subjects’ diaries or evaluation checklists, pharmacy dispensing and other records, recorded data from automated instruments, microfiches, photographic negatives, microfilm or magnetic media, ECG printouts, and/or x-rays.

 

The Investigator(s)/institution(s) will permit trial-related monitoring, audits, IRB/IEC review, and regulatory inspection(s), providing direct access to source data documents.

 

10.7                   Study Monitoring

 

The Sponsor (or its designee) will ensure that the study is monitored in accordance with ICH-GCP Guidelines.  Monitoring is the act of overseeing the progress of a clinical trial and of ensuring that it is conducted, recorded, and reported in accordance with the protocol, standard operating procedures, Good Clinical Practice, and the applicable regulatory requirements and that the study data are accurate, complete and verifiable from source data.  All study documentation and other source data will be made available to the Sponsor (or its designee), the IRB and to Regulatory Authorities for inspection upon request.

 

10.8                   On-Site Audits

 

Representatives of the IRB or the Sponsor (or designee) may visit the study site to carry out an audit of the study in compliance with regulatory guidelines and company policy.  Such audits will require access to all study records including source documents, CRFs, and other study documents.  Direct access to these study records must be guaranteed by the Investigator, who must provide support for these activities at all times.

 

Similar auditing procedures may also be conducted by agents of any Regulatory Authority reviewing the results of this study.  The Investigator/institution should immediately notify the Sponsor if they have been contacted by a Regulatory Authority concerning an upcoming inspection.

 

10.9            Drug Accountability

 

Accountability for the study medication at the study site is the responsibility of the Investigator.  Drug accountability will be performed only on alendronate, calcium and vitamin D.  The Investigator will ensure that the study medication is used only in accordance with this protocol.  Where allowed, the Investigator may choose to assign some of the study medication accountability responsibilities to qualified study personnel.

 

Study medication accountability records indicating the delivery date to the study site, inventory at the study site and dispensing/use will be maintained.  These records will adequately document that the study medications were dispensed and returned as specified in the protocol.  Accountability records will include dates, quantities, and subject numbers.  The Sponsor (or its designee) will review study medication accountability records at the study site on an ongoing basis during the study.  All used and unused study medication must be inventoried, accounted for, and approved by the Sponsor (or its designee) prior to destruction.  If the site is not capable of study drug disposal/destruction, the Sponsor will arrange for an alternative method.  Records of disposal must be maintained with the study records.

 

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10.10            Record Retention

 

The Investigator will maintain all study records according to ICH/GCP and applicable regulatory requirements.  Essential documents must be retained for two years after the final marketing approval in an ICH region or at least two years have elapsed since the discontinuation of clinical development of the study medication.  It is the responsibility of the Sponsor to inform the Investigator of when these documents can be destroyed.  In addition, all subject medical records and other source documentation will be kept for the maximum time permitted by the hospital, institution or medical practice.

 

The Investigator/institution will take measures to prevent accidental or premature destruction of these documents.  If the responsible Investigator retires, relocates, or for other reasons withdraws from the responsibility of keeping the study records, custody must be transferred to a person who will accept the responsibility.  The Sponsor must be notified in writing of the name and address of the new custodian.

 

10.11            Study Termination

 

This study may be terminated at any time by the Sponsor if there is sufficient reasonable cause.  Circumstances that may warrant termination include, but are not limited to:

 

·                   Determination of unexpected, significant, or unacceptable risk to subjects.

 

·                   Failure of enrollment

 

·                   Administrative reasons

 

·                   Plans to modify, suspend or discontinue the development of the study drug.

 

In addition, individual study sites may be terminated from study participation for reasons including, but not limited to the following:

 

·                   Failure to enter subjects at an acceptable rate.

 

·                   Insufficient adherence to protocol requirements.

 

·                   Incomplete and/or non-evaluable data.

 

In all cases, the terminating parties will provide written notification documenting the reason for study termination to all the relevant parties.

 

Should the study or an individual site be prematurely closed, all study materials (completed, partially completed, and blank CRFs, study drug, etc.) must be returned to the Sponsor (or its designee).

 

10.12            Liability and Insurance

 

The Sponsor has subscribed to an insurance policy covering, in its terms and provisions, its legal liability for injuries caused to participating persons and arising out of this research performed strictly in accordance with the scientific protocol as well as with applicable law and professional standards.

 

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11.0                   USE OF INFORMATION AND PUBLICATION OF STUDY FINDINGS

 

11.1                   Use of Information

 

All information regarding BA058 supplied by the Sponsor (or its designee) to the Investigator is privileged and confidential information.  The Investigator agrees to use this information to accomplish the study and will not use it for other purposes without prior consent from the Sponsor.

 

The information developed during the conduct of this clinical study is also considered confidential and will be used by the Sponsor in connection with the development of BA058.  This information may be disclosed as deemed necessary by the Sponsor to other clinical Investigators, other pharmaceutical companies, and to Regulatory Authorities.  To allow for the use of the information derived from this study and to ensure complete and thorough analysis, the Investigator is obligated to provide the Sponsor (or its designee) with complete study results and all data developed in this study and to allow direct access to source data/documents for study-related monitoring, audits, IRB/IEC review, and regulatory inspection.

 

11.2                         Publication

 

One publication of the study data is planned.  A Publications Committee composed of Investigators participating in the study and representatives from the Sponsor as appropriate will be formed to oversee the publication of the study results, which will reflect the experience of all participating study centers.

 

Subsequently, individual Investigators may publish results from the study in compliance with their agreement with the Sponsor.  A pre-publication manuscript must be provided to the Sponsor at least 30 days prior to the submission of the manuscript to a publisher.  Similarly, the Sponsor will provide any company prepared manuscript to the Investigators for review at least 30 days prior to submission to a publisher.

 

The Investigator shall comply with the policy of the Sponsor regarding confidential or proprietary information in any such paper and agrees to withhold publication of same for an additional 60 days in order to permit the Sponsor to obtain patent or other proprietary rights protection, if the Sponsor deems it necessary.

 

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12.0                         INVESTIGATOR AGREEMENT

 

To be completed by the Investigator

 

I have read Protocol BA058-05-005: “An Extension Study to Evaluate 24 Months of Standard-of-Care Osteoporosis Management Following Completion of 18 Months of BA058 or Placebo Treatment in Protocol BA058-05-003”.

 

I agree to conduct the study as detailed herein and in compliance with ICH Guidelines for Good Clinical Practice and applicable regulatory requirements and to inform all who assist me in the conduct of this study of their responsibilities and obligations.

 

The signature below constitutes my agreement to the contents of this protocol.

 

 

 

 

 

Signature of Principal Investigator

 

Date

 

 

 

 

 

 

Principal Investigator (print)

 

 

 

 

Signature of Sponsor’s Medical Officer (where applicable)

 

 

 

 

 

Louis Brenner, MD

 

Date

 

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13.0                   REFERENCES

 

Balena R, Toolan BC, Shea M, Markatos A, Myers ER, Lee SC, Opas EE, Seedor JG, Klein H, Frankenfield D, Quartuccio H, Fiovanti C, Clair J, Brown E, Hayes WC, Rodan GA.  The effects of 2-year treatment with the aminobisphosphonate alendronate on bone metabolism, bone histomorphometry, and bone strength in ovariectomized nonhuman primates.  J Clin Invest 1993; 92:2577-2586.

 

Balena R, Markatos A, Seedor JG, Gentile M, Stark C, Peter CP, Rodan GA.  Long-term safety of the aminobisphosphonate alendronate in adult dogs.  II Histomorphometric analysis of the L5 vertebrae.  J Pharmacol Exp Ther 1996; 276(1):277-83.

 

Black DM, Bilezikian JP, Ensrud KE, Greenspan SL, Palermo L, Hue T, Lang TF, McGowan JA, Rosen CJ.  One year of alendronate after one year of parathyroid hormone (1-84) for osteoporosis. N Engl J Med 2005; 353(6):555-565.

 

Bone HG, Hosking D, Devogelaer JP, Tucci JR, Emkey RD, Tonito RP, Rodriguez-Portales JA, Downs RW, Grupta J, Santora AC, Liberman UA, Alendronate Phase III Osteoporosis Treatment Study Group.  Ten years’ experience with alendronate for osteoporosis in postmenopausal women.  N Eng J Med 2004 ; 350(12):1189-99.

 

Devogelaer JP, Broll H, Correa-Rotter R, Coming DC, De Deuxchaisnes CN, Geusens P, Hosking D, Jaeger P, Kaufman JM, Leite M, Leon J, Liberman U, Menkes CJ, Meunier PJ, Reid I, Rodriguez J, Romanowicz A, Seeman E, Vermeulen A, Hirsch LJ, Lombardi A, Plezia K, Santora AC, Yates AJ, Yuan W.  Oral alendronate induces progressive increases in bone mass of the spine, hip and total body over 3 years in postmenopausal women with osteoporosis.  Bone 1996; 18(2):141-50.

 

EMEA. Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. 2007.

 

FDA. Guidelines for preclinical and clinical evaluation of agents used in the prevention or treatment of postmenopausal osteoporosis. 1994.

 

FDA. Draft guidance:  Development of parathyroid hormone for the prevention and treatment of osteoporosis. 2000.

 

Fosamax® Prescribing Information.  Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2012.

 

Genant HK, Wu CY, van KC, and Nevitt MC. Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 1993; 8:1137-1148.

 

Guidance for Industry. E6 Good Clinical Practice: Consolidated Guidance. U.S.Department of Health and Human Services, Food and Drug Administration. April 1996.

 

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Gullberg B, Johnell O, Kanis JA.  World-wide projections for hip fracture.  Osteoporos Int 1997; 7:407-413.

 

Lefage M-H, Balena R, Battle MA, Shea M, Seedor JG, Klein H, Hayes WC, Rodan GA.  Comparison of alendronate and sodium fluoride effects on cencellous and cortical bone in minipigs.  J Clin Invest 1995; 95:2127-2133.

 

Liberman UA, Weiss SR, Broll J, Minne HW, Quan H, Bell NH, Rodriguez-Portales J, Downs Jr. RW, Dequeker J, Favus M, Seeman E, Recker RR, Capizzi T, Santora AC, Lombardi A, Shah RV, Hirsch LJ, Karpe DB.  Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis.  N Engl J Med 1995; 333(22):1437-43.

 

Reginster JY, Burlet N.  Osteoporosis: still increasing prevalence.  Bone 2006; 38(Suppl 1):S4-9.

 

Rittmaster RS, Bolognese M, Ettinger MP, Hanley DA, Hodsman AB, Kendler DL, Rosen CJ.  Enhancement of bone mass in osteoporotic women with parathyroid hormone followed by alendronate.  J Clin Endocrinol Metab 2000; 85(6):2129-34.

 

Rizzoli R, Bonjour JP, and Ferrari SL. Osteoporosis, genetics and hormones. J Mol Endocrinol 2001; 26:79-94.

 

Tucci JR, Tonino RP, Emkey RD, Peverly CA, Kher U, Santora AC 2 nd .  Effect of three years of oral alendroneate treatment in postmenopausal women with osteoporosis. Am J Med 1996; 101(5):488-501.

 

WHO Scientific Group on the assessment of osteoporosis at primary health care level.  World Health Organization Summary Meeting Report 2007.

 

World Medical Association Declaration of Helsinki. The World Medical Association, Inc. 2008.

 

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14.0                                                 APPENDICES

 

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Visit 1 2 3 4 5 6 Procedure Study Day/Month: Visit 10 003/ Visit 11 005 Month 3 Month 6 Month 12 Month 18 Month 24 Day 1 90 180 360 540 720 Visit Window (Days) N/A ± 5 ± 14 ± 14 ± 14 ± 14 Informed consent X Review of entrance criteria X Recent health status X X X X X X Vital signs, weight and height measurements2 X X X X X X Electrocardiogram X X Urinalysis (dipstick) 3 X X Chemistry blood collection4 X X Hematology blood collection5 X X Coagulation blood collection5 X X PTH(1-84) X 25-hydroxy vitamin D level X 1,25-dihydroxy vitamin D level X Serum markers of bone metabolism 5 X X BA058 antibody levels X 24-hour urine collection (for calcium:creatinine and creatinine clearance)6 X X7 X Clinical and radiologic (spine, lumbar and thoracic vertebrae) fracture X X assessments Bone mineral density of hip and spine by DXA8 X X Bone mineral density of wrist by DXA9 X X Calcium and vitamin D supplements Daily Alendronate administration (if applicable) Dosing as per prescribing information Study medication resupply (if applicable) X X X X Subject diary review10 X X X X X Document adverse events and concomitant medications Daily

 

 

 

14.2                   Suggested Schedule of Events and Procedures by Study Visit

 

The purpose of this guide is to provide more detailed instructions for the study procedures listed in Appendix 14.1.  This guide presents the procedures in a suggested sequence of performance at each study visit.  Further information may be found within the protocol and in other study reference manuals (e.g., ECG, clinical laboratory sample processing).

 

Of note:

 

·                   Blood and urinalysis samples are to be obtained under fasting conditions (NPO. for 8 hours; water is acceptable) in the morning of Day 1 and Month 6.

 

·                   DXA Scans: Always use the same study-validated machine; preferably the same technician.

 

·                   The 24-hour urine collection will be started at home the day before the clinic visit where the collection is required.  Subjects will be instructed to discard the first morning void and begin the collection at least 24 hours before their clinic visit the following day. They will collect all urine for 24 hours with a final void before coming to the clinic. Routine urinalyses are to be performed using samples freshly voided during the clinic visit.  Subjects should receive a reminder to initiate their 24-hour urine 2 days before their scheduled visit.

 

·                   Alendronate for Europe, Hong Kong and the US will be sourced centrally; alendronate for South America will be sourced locally by the medical center and reimbursed by the Sponsor.

 

·                   Subjects will be instructed to take the calcium and vitamin D supplements daily (in the evening with or without food or as otherwise instructed by the Investigator) until discharge from the study.  This is required until the end of Month 24.

 

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Definitions of Common Procedures:

 

The terms used in the by-visit schedule that follows are further defined below.

 

Recent health status (document any changes from last visit)

·                   Question subject regarding any new health issues

·                   Question subject regarding any new adverse events

·                   Question subject regarding any new concomitant medications

·                   Question subject regarding any new issues related to ability to continue with study

Pulse, respiration and temperature:

·                   Pulse rate (beats/minute) taken after approximately five minutes in the supine position.

·                   Respiration rate (breaths/minute).

·                   Body temperature (°C).

Weight and height measurements:

·                   Weight (kg).

·                   Height (cm) standing measurements are to be performed using the same medical stadiometer and standardized procedures each time.

Orthostatic blood pressure:

·                   Orthostatic blood pressure (mmHg) (measured in same arm each time/each visit) is measured after five minutes in the supine position followed by a measurement taken after 3 minutes in the standing position.  Only the blood pressure assessment on Day 1 (Visit 10) needs to be orthostatic.

ECG

·                   Twelve-lead supine electrocardiogram

·                   Print hard copy for reading by qualified study personnel

·                   More than one ECG may be performed per time-point.

24 hour urine collection

·                   Subject to discard first morning void (suggest 6 a.m.) on day before clinic visit

·                   Subject to collect urine for approximately 24 hours

·                   Subject to collect final void at end of collection and bring collection to clinic.

·                   Process for calcium and creatinine

Urinalysis

·                   Obtain under fasting conditions (NPO. except water for 8 hours)

·                   Routine urinalysis is to be performed using a sample freshly voided during the clinic visit (microscopic examination if positive dipstick).

Review study medication administration procedures with subject

·                   Alendronate should be taken daily, preferably at the same time each morning/day of the week

Scheduling and instructions for next clinic visit

·                   Schedule visit

·                   Remind subject of any fasting requirements

·                   Provide urine collection instructions and materials as necessary

·                   Remind subjects to complete the diaries until the end of the study

Vitamin D and calcium supplements

·                   Vitamin D and calcium supplements are required throughout the study.  Only those supplements supplied as part of study medication may be used and are to be used at the daily recommended dose (see Section 5.1.2) .

·                   Supplements should be taken in the evening, with or without food as instructed by the Investigator.

·                   At each study visit, assess the subject’s supply and resupply as necessary.

·                   Drug usage reconciliation is to be performed when a new supply is provided.

 

50



 

Visit 10 for Study BA058-05-003

Day 1 Visit for Study BA058-05-005

Day 1

 

VISIT

 

ACTIVITIES

Day 1

 

Day 1 Visit for Study BA058-05-005

 

Visit 10 for Study BA058-05-003

 

Written informed consent must be obtained

Recent health status

·       Document any changes since End-of-Treatment visit (Visit 9) from Study BA058-05-003

Study staff will receive your prior days 24-hour urine sample (if a 24-hour urine sample was not collected prior to Day 1, the subject must begin a 24-hour urine sample on the day prior to the Month 3 visit

Subject diary review

·       Review study medication diary (calcium and vitamin D)/dispense new diary if necessary

·       Record deviations in dosing or any AEs in source documents and CRFs

·       Collect diaries and enter data into CRF

Vital signs, weight and height measurement

Orthostatic blood pressure

ECG

Blood collection:   fasting conditions (NPO except water for 8 hours)

·       Chemistry

·       Hematology

·       Coagulation (PT and PTT)

·       Serum markers of bone metabolism, where applicable

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

·       Urinalysis (Dipstick)

Study medication

·       Dispense three month supply of alendronate

·       Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary

·       Instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·       Remind subject to take study medication as instructed

·       24-hour urine collection:  If subjects did not provide a 24-hour urine sample for Visit 1, dispense urine collection container and instruct subjects to perform 24-hour urine collection beginning the morning 24 hours prior to their next scheduled visit (Month 3)

·       Remind subject to record study medication use

               

51



 

Month 3 Visit for Study BA058-05-005

Day 90 (±5 days)

 

VISIT

 

Activities

Month 3

 

Recent health status

·       Document any changes since previous visit

Study staff will receive the prior days 24 hour urine sample, if applicable

Vital signs, height and weight measurement

Subject diary review

·       Review study medication diary/dispense new diary if necessary

·       Record deviations in dosing or any AEs in source documents and CRFs.

·       Collect diaries and enter data into CRF

Study medication

·       Dispense three month supply of alendronate

·       Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary, instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·       24-hour urine collection:  Dispense urine collection container and instruct subjects to perform 24-hour urine collection beginning the morning 24 hours prior to their next scheduled visit (Month 6)

·       Remind subject to take study medication as instructed

·       Remind subject to record study medication use

 

52



 

Month 6 Visit for Study BA058-05-005

Day 180 (±14 Days)

 

VISIT

 

Activities

Month 6

 

Physical Examination

Recent Health Status

·       Document any changes from last visit

Collect 24 hour urine sample from subject

Study staff will receive your prior days 24-hour urine sample

·       Review diary of study medication

·       Collect diary and enter data into CRF, record dosing deviations or any AEs in source documents and CRFs

Vital signs, weight and height measurement

ECG

Blood collection:  fasting conditions (NPO except water for 8 hours)

·       Chemistry

·       Hematology

·       Coagulation (PT and PTT)

·       Serum markers of bone metabolism, where applicable

·       PINP

·       bone-specific alkaline phosphatase

·       serum osteocalcin

·       serum CTX

·       BA058 antibody levels

·       Urinalysis (Dipstick)

Clinical and radiologic fracture evaluations

·       Obtain antero-posterior and lateral radiographs of the lumbar and thoracic vertebrae

·       Document any non-vertebral fractures

Bone mineral density

·       Perform DXA of spine (L1-L4), hip (femoral neck), and wrist (distal 1/3 radius), where applicable.

Study Medication

·       Dispense six month supply of alendronate

·       Assess subject’s supply of calcium and vitamin D supplements, resupply as necessary

Scheduling and instructions for next clinic visit

·       Remind subject to take study medication as instructed

·       Remind subject to record study medication use

 

53



 

Month 12 Visit for Study BA058-05-005

Day 360 (±5 days)

 

VISIT

 

Activities

Month 12

 

Recent health status

·       Document any changes since previous visit

Vital signs, height and weight measurement

Subject diary review

·       Review study medication diary/dispense new diary if necessary

·       Record deviations in dosing or any AEs in source documents and CRFs.

·       Collect diaries and enter data into CRF

Study medication

·       Dispense six month supply of alendronate

·       Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary, instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·       Remind subject to take study medication as instructed

·       Remind subject to record study medication use

 

54



 

Month 18 Visit for Study BA058-05-005

Day 540 (±5 days)

 

VISIT

 

Activities

Month 18

 

Recent health status

·       Document any changes since previous visit

Vital signs, height and weight measurement

Subject diary review

·       Review study medication diary/dispense new diary if necessary

·       Record deviations in dosing or any AEs in source documents and CRFs.

·       Collect diaries and enter data into CRF

Study medication

·       Dispense six month supply of aalendronate

·       Assess subject’s supply of calcium and vitamin D supplements; resupply as necessary, instruct subject to take daily until they are discharged from the study

Scheduling and instructions for next clinic visit

·       Remind subject to take study medication as instructed

·       Remind subject to record study medication use

 

55



 

Month 24 Visit for Study BA058-05-005

Day 720 (±5 days)

 

VISIT

 

Activities

Month 24

 

Recent health status

·       Document any changes since previous visit

Vital signs, height and weight measurement

Subject diary review

·       Review study medication diary

·       Record deviations in dosing or any AEs in source documents and CRFs.

·       Collect diaries and enter data into CRF

Clinical and radiologic fracture evaluations

·       Obtain antero-posterior and lateral radiographs of the lumbar and thoracic vertebrae

·       Document any non-vertebral fractures

Bone mineral density

·       Perform DXA of spine (L1-L4), hip (femoral neck), and wrist (distal 1/3 radius), where applicable.

Study medication

·       Collect unused study medication

Discharge subject from study

·       Subject is terminated from the study unless adverse events require further follow through

Discuss continuing treatment options

·       Subjects will receive standard-of-care management according to their physician

 

56


 

14.3      Eastern Cooperative Oncology Group (ECOG) Common Toxicity Criteria

 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Haematology

 

 

 

 

 

 

 

 

 

 

WBC (x10 9 /L)

 

4

 

3.0 - 3.9

 

2.0 - 2.9

 

1.0 - 1.9

 

< 1.0

Platelets (x10 9 /L)

 

WNL

 

75.0 - normal

 

50.0 - 74.9

 

25.0 - 49.9

 

< 25.0

Haemoglobin (g/L);

(mmol/L)

 

WNL

 

100.0 - normal;

6.2 - normal

 

80.0 - 99.0;

5.0 - 6.1

 

65.0 - 79.0

4.0 - 4.9

 

< 65.0

< 4.0

Granulocytes/ Bands (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

Lymphocytes (x10 9 /L)

 

2

 

1.5 - 1.9

 

1.0 - 1.4

 

0.5 - 0.9

 

< 0.5

Haemorrhage

 

none

 

mild, no transfusion

 

gross,
1 - 2 units transfusion per episode

 

gross,
3 - 4 units transfusion per episode

 

massive,
> 4 units transfusion per episode

Coagulation

 

 

 

 

 

 

 

 

 

 

Fibrinogen

 

WNL

 

0.99 - 0.75 x N

 

0.74 - 0.50 x N

 

0.49 - 0.25 x N

 

< 0.25 x N

Prothrombin time(quick)

 

WNL

 

1.01 - 1.25 x N

 

1.26 - 1.50 x N

 

1.51 - 2.00 x N

 

> 2.00 x N

Partial thromboplastin time

 

WNL

 

1.01 - 1.66 x N

 

1.67 - 2.33 x N

 

2.34 - 3.00 x N

 

> 3.00 x N

Metabolic

 

 

 

 

 

 

 

 

 

 

Hyperglycaemia (mmol/L)

 

< 6.4

 

6.4 - 8.9

 

9.0 - 13.9

 

14.0 - 27.8

 

> 27.8 or ketoacidosis

Hypoglycaemia (mmol/L)

 

> 3.6

 

3.6 - 3.1

 

3.0 - 2.3

 

2.2 - 1.7

 

< 1.7

Amylase

 

WNL

 

< 1.5 x N

 

1.5 - 2.0 x N

 

2.1 - 5.0 N

 

> 5.0 x N

Hypercalcaemia (mmol/L)

 

< 2.65

 

2.65 - 2.88

 

2.89 - 3.13

 

3.14 - 3.36

 

> 3.37

Hypocalcaemia (mmol/L)

 

> 2.10

 

2.10 - 1.94

 

1.93 - 1.74

 

1.73 - 1.52

 

< 1.51

Hypomagnesaemia (mmol/L)

 

> 0.58

 

0.58 - 0.48

 

0.47 - 0.36

 

0.35 - 0.24

 

< 0.23

Gastrointestinal

 

 

 

 

 

 

 

 

 

 

Nausea

 

none

 

able to eat reasonable intake

 

intake significantly decreased but can eat

 

no significant intake

 

Vomiting

 

none

 

1 episode
in 24 hrs

 

2 - 5 episodes
in 24 hrs

 

6 - 10 episodes
in 24 hrs

 

> 10 episodes in 24 hrs or requiring parenteral support

Diarrhoea

 

none

 

increase of 2 - 3 stools/day over pre-Rx

 

increase of 4 - 6 stools/day, or nocturnal stools, or moderate cramping

 

increase of 7 - 9 stools/day, or incontinence, or severe cramping

 

increase of > 10 stools/day or grossly bloody diarrhoea, or need for parenteral support

Stomatitis

 

none

 

painless ulcers, erythema, or mild soreness

 

painful erythema, oedema, or ulcers but can eat solids

 

painful erythema, oedema, or ulcers and cannot eat solids

 

requires parenteral or enteral support for alimentation

Liver

 

 

 

 

 

 

 

 

 

 

Bilirubin (N = 17 µmol/L)

 

WNL

 

 

< 1.5 x N

 

1.5 - 3.0 x N

 

> 3.0 x N

Transaminase (SGOT, SGPT)

 

WNL

 

2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

Alkaline phosphatase or 5-nucleotidase

 

WNL

 

< 2.5 x N

 

2.6 - 5.0 x N

 

5.1 - 20.0 x N

 

> 20.0 x N

 

57



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Liver- clinical

 

No change from baseline

 

 

 

precoma

 

hepatic coma

Kidney, bladder

 

 

 

 

 

 

 

 

 

 

Creatinine

 

WNL

 

< 1.5 x N

 

1.5 - 3.0 x N

 

3.1 - 6.0 x N

 

> 6.0 x N

Proteinuria

 

No change

 

1 (+) or
< 0.3 g% or 3 g/L

 

2 - 3 (+) or
0.3-1.0 g% or 3-10 g/L

 

4 (+) or
> 1.0 g% or > 10g/L

 

nephrotic syndrome

Haematuria

 

Negative

 

microscopic only

 

gross,
no clots no Rx needed

 

gross and clots
bladder irrigation

 

requires transfusion
or cystectomy

Weight gain/ loss

 

< 5.0 %

 

5.0 - 9.9 %

 

10.0 - 19.9 %

 

20.00%

 

Pulmonary

 

 

 

 

 

 

 

 

 

 

Pulmonary

 

none or no change

 

asymptomatic, with abnormality in PFTs

 

dyspnoea on significant exertion

 

dyspnoea at normal level of activity

 

dyspnoea at rest

Cardiac

 

 

 

 

 

 

 

 

 

 

Cardiac arrhythmias

 

none

 

asymptomatic, transient, requiring no therapy

 

recurrent or persistent, no therapy required

 

requires treatment

 

requires monitoring; or hypotension, or ventricular tachycardia or fibrillation

Cardiac function

 

none

 

asymptomatic, decline of resting ejection fraction by less than 20 % of baseline value

 

asymptomatic, decline of resting ejection fraction by more than 20 % of baseline value

 

mild CHF,
responsive to therapy

 

severe or
refractory CHF

Cardiac ischaemia

 

none

 

non-specific T- wave flattening

 

asymptomatic, ST and T wave changes suggesting ischaemia

 

angina without evidence of infraction

 

acute myocardial infarction

Cardiac- pericardial

 

none

 

asymptomatic effusion, no intervention required

 

pericarditis (rub, chest pain, ECG changes)

 

symptomatic effusion; drainage required

 

tamponade; drainage urgently required

Hypertension

 

none or no change

 

asymptomatic, transient increase by greater than 20 mmHg (D) or to > 150/100 if previously WNL.
No treatment required.

 

recurrent or persistent increase by greater than 20 mmHG (D) or to > 150/100 if previously WNL.
No treatment required.

 

requires therapy

 

hypertensive crisis

Hypotension

 

none or no change

 

changes requiring no therapy (including transient orthostatic hypotension)

 

requires fluid replacement or other therapy but not hospitalisation

 

requires therapy and hospitalisation; resolves within 48 hrs of stopping the agent

 

requires therapy and hospitalisation for > 48 hrs after stopping the agent

Neurologic

 

 

 

 

 

 

 

 

 

 

Neuro: sensory

 

none or no change

 

mild paraesthesias;
loss of deep tendon reflexes

 

mild or moderate objective sensory loss moderate paraesthesias

 

severe objective sensory loss or paraesthesias that interfere with function

 

 

58



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Neuro: motor

 

none or no change

 

subjective weakness;
no objective findings

 

mild objective weakness without significant impairment of function

 

objective weakness with impairment of function

 

paralysis

Neuro: cortical

 

none

 

mild somnolence or agitation

 

moderate somnolence or agitation

 

severe somnolence, (>50 % waking hours), agitation, confusion, disorientation or hallucinations

 

coma, seizures,
toxic psychosis

Neuro: cerebellar

 

none

 

slight incoordination, dysdiadochokinesia

 

intention tremor, dysmetria, slurred speech, nystagmus

 

locomotor ataxia

 

cerebellar necrosis

Neuro: mood

 

no change

 

mild anxiety or depression

 

moderate anxiety or depression

 

severe anxiety or depression

 

suicidal ideation

Neuro: headache

 

none

 

mild

 

moderate or severe
but transient

 

unrelenting and severe

 

Neuro: constipation

 

none or no change

 

mild

 

moderate

 

severe

 

ileus > 96 hrs

Neuro: hearing

 

none or no change

 

asymptomatic, hearing loss on audiometry only

 

tinnitus

 

hearing loss interfering with function but correctable with hearing aid

 

deafness not correctable

Neuro: vision

 

none or no change

 

 

 

symptomatic subtotal loss of vision

 

blindness

Pain

 

 

 

 

 

 

 

 

 

 

Pain

 

none

 

mild

 

moderate

 

severe

 

reg. narcotics

Skin

 

 

 

 

 

 

 

 

 

 

Skin

 

none or no change

 

scattered macular or papular eruption or erythema that is asymptomatic

 

scattered macular or papular eruption or erythema with pruritus or other associated symptoms

 

generalised symptomatic macular, papular or vesicular eruption

 

exfoliative dermatitis or ulcerating dermatitis

Alopecia

 

 

 

 

 

 

 

 

 

 

Alopecia

 

no loss

 

mild hair loss

 

pronounced or total hair loss

 

 

Allergy

 

 

 

 

 

 

 

 

 

 

Allergy

 

none

 

transient rash,
drug fever < 38
o C (<100.4 o F)

 

urticaria,
drug fever 38
o C (100.4 o F),
mild bronchospasm

 

serum sickness, bronchospasm requiring parenteral medication

 

anaphylaxis

Local

 

 

 

 

 

 

 

 

 

 

Local

 

none

 

pain

 

pain and swelling with inflammation or phlebitis

 

ulceration

 

plastic surgery indicated

Fever of unknown origin

 

 

 

 

 

 

 

 

 

 

Fever of unknown origin

 

none

 

37.1 - 38.0 o  C
98.7
o  - 100.4 o  F

 

38.1 - 40.0 o  C
100.5 - 104
o  F

 

> 40.0 o C (> 104 o  F) for less than 24hrs

 

> 40.0 o  C (> 104 o  F) for more than 24 hrs or accompanied by hypotension

Infection

 

 

 

 

 

 

 

 

 

 

Infection

 

none

 

mild

 

moderate

 

severe

 

life-threatening

 

59



 

Category
Toxicity (units)

 

Grade 0

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

Additional events

 

 

 

 

 

 

 

 

 

 

Asthenia

 

analogous to Karnofsky index (WHO grading)

 

 

 

 

 

 

 

 

Chills

 

analogous to fever

 

 

 

 

 

 

 

 

Peripheral oedema

 

analogous to weight gain

 

 

 

 

 

 

 

 

Anorexia

 

analogous to weight loss

 

 

 

 

 

 

 

 

 


(1)The procedures for the Follow-up visit (Visit 10) for Study BA058-05-003 will serve as the procedures performed at Day 1 (for Study BA058-05-005).  The consent form will need to be signed if it was not signed during the End-of-Treatment Visit (Visit 9) of Study BA058-05-003.

(2) Vital signs (blood pressure, pulse rate, body temperature, and respiration rate) are to be recorded at each study visit.  Only the blood pressure assessment on Day 1 (Visit 10) needs to be orthostatic.  Height is to be measured at each visit in the standing position using a medical stadiometer.  Weight is to be measured at each visit.  Orthostatic blood pressure is to be measured initially after 5 minutes in the supine position and then again after standing for three minutes.

(3) All routine urinalysis will be performed on a sample freshly voided during the clinic visit.

(4) These blood samples are to be obtained under fasting conditions (N.P.O. for 8 hours; water is acceptable) in the morning of each scheduled study visit.

(5) Includes blood samples for PINP, bone-specific alkaline phosphatase, serum osteocalcin and CTX.

(6) Twenty-four hour urine collection will be used for urinary calcium and urinary creatinine measurements. Subjects will discard the 1 st  void and begin a 24-hour urine collection the day prior to the clinic visit.

(7) A 24-hour urine collection will be collected at Month 3 only if a sample was not collected for the Day 1 (Visit 10).

(8) Each DXA for a given subject should be performed on the same machine, and if available, preferably by the same technician

(9) Each DXA for a given subject should be performed on the same machine, and if available, preferably by the same technician.  Only subjects who had wrist DXA assessments in Study BA058-05-003 will have wrist DXAs performed.

(10) The subjects will maintain a diary throughout the study to record missed doses of medication (including supplements) on a weekly basis; the diaries are to be reviewed with the subject at each study visit.

 

60




Exhibit 10.14

 

Execution Copy

 

AMENDED AND RESTATED STOCK ISSUANCE AGREEMENT

 

This Amended and Restated Stock Issuance Agreement (this “Agreement” ) is entered into as of May 16, 2011 ( “Effective Date” ) by and between RADIUS HEALTH, INC., a Delaware corporation ( “Radius” ) and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation ( “NB” ).

 

Background

 

Radius and NB are parties to that certain Clinical Trial Services Agreement dated as of March 29, 2011 (the “CTS Agreement” ) and a certain Work Statement NB-1 under the CTS Agreement. Pursuant to Work Statement NB-1, NB has agreed to perform certain services relating to a Phase III clinical study of a Radius drug candidate known as BA058. Radius, in consideration of the activities of NB pursuant to the CTS Agreement and Work Statement NB-1 has authorized the sale to NB of shares of Series A-5 Convertible Preferred Stock, par value $0.01 per share (the “Series A-5 Preferred Stock” ) of Radius having a value of €371,864, which shares entitle the holder to receive stock dividends payable in shares of Series A-6 Preferred Stock or (in the event that the Series A-5 Preferred Stock is converted and stock dividends are no longer payable) to receive payment in shares of another class or series of capital stock of Radius or any other Person having an aggregate value of up to an additional €36,814,531 as calculated on the date that such stock dividends or other payments accrue. Radius and NB entered into that certain Stock Issuance Agreement as of March 29, 2011 and now wish to enter into this Amended and Restated Stock Issuance Agreement to reflect additional detail not available on March 29, 2011 concerning the Series A-1 Financing and the capitalization of Radius immediately before and following the initial closing of the Series A-1 Financing.

 

NOW THEREFORE, in consideration of the premises and mutual covenants set forth herein, the parties hereby agree as follows:

 

1.  DEFINITIONS

 

1.1  Defined Terms . Capitalized terms used in this Agreement and not otherwise defined herein shall have the meaning set forth below.

 

“Affiliate” means with respect to either party, any Person that, directly or indirectly, is controlled by, controls or is under common control with such party. For purposes of this definition only, “control” means, with respect to any Person, the direct or indirect ownership of more than fifty percent (50%) of the voting or income interest in such Person or the possession otherwise, directly or indirectly, of the power to direct the management or policies of such Person.

 

“Applicable Quarterly Amount” means, with respect to each calendar quarter commencing with the calendar quarter in which the first subject is enrolled in the clinical study that is the subject of Work Statement NB-1, the portion of the Bonus Equity Payment Amount that NB is due with respect to such calendar quarter as determined in accordance with Section 3.1(a).

 

“Bonus Equity Payment Amount” means €36,814,531, which represents the maximum portion of the fees and expenses payable to NB in connection with all services rendered by, or on behalf of NB, pursuant to the CTS Agreement and Work Statement NB-1 under the CTS Agreement that NB has agreed Radius may satisfy by issuing the Bonus Shares pursuant to, and in accordance with, the provisions of this Agreement.

 

“Bonus Shares” means, collectively, (a) the number of shares of Series A-6 Preferred Stock that accrue as a stock dividend with respect to all issued and outstanding shares of Series A-5 Preferred Stock pursuant to, and in accordance with, this Agreement; and (b) the number of shares of preferred stock or common stock of Radius or any other Person that accrue pursuant to, and in accordance with, the provisions of the second paragraph of Section 3.1(k) or the provisions of Section 3.1(l). The meaning of the term Bonus Shares shall be subject to change in accordance with the provisions of Section 3.1(m).

 

1



 

“Business Day” means any day other than a Saturday or Sunday that is not a national holiday in the U.S..

 

“Event of Sale” means (a) the sale by the stockholders of Radius in a single transaction or a series of related transactions, of issued and outstanding shares of capital stock of Radius that represent a majority of the voting power of Radius to one or more third parties that are not Affiliates of such stockholders, provided that this clause (a) shall not be applicable to Radius from and after the earlier of (i) the closing of the initial public offering of Radius and (ii) the date on which any preferred stock or common stock of Radius is otherwise publicly traded or registered under the Securities Exchange Act of 1934, as amended; (b) the merger, consolidation or reorganization with or into any other corporation, entity or Person or any other corporate reorganization, in which the holders of the capital stock of Radius immediately prior to such merger, consolidation or reorganization, together with such holder’s Affiliates, do not hold shares of capital stock of the surviving entity that represent more than 50% of the voting power of the surviving entity (or, if the surviving entity is a wholly owned subsidiary, its parent) immediately after such merger, consolidation or reorganization; or (c) the sale, exclusive license or other disposition of all or substantially all of the assets or intellectual property of Radius, in a single transaction or series of related transactions, to one or more third parties that are not Affiliates of Radius. For purposes of clarification, Event of Sale shall not include any transaction involving Radius and the Shell Company Successor that is described in clause (iii) of the Shell Company Successor definition.

 

“Fair Market Value” means, with respect to each Accrual Date, the greater of (i) the Series A-5 Purchase Price Per Share (as such price per share may be adjusted for any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events affecting such Series A-5 Preferred Stock), (ii) the price per share of the preferred stock or common stock sold by Radius in the most recent equity financing closed by Radius prior to such Accrual Date (as such price per share may be adjusted for any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events affecting such preferred stock or common stock, as applicable); and (iii) the average of the closing prices of any preferred stock or the common stock (whichever has the higher trading price as of such Accrual Date) of Radius on a securities exchange (if such preferred stock or common stock, as applicable, is traded on an exchange) or the average of the closing sale prices or secondarily the closing bid prices of any preferred stock or the common stock (whichever has the higher trading price as of such Accrual Date) of Radius (if such preferred stock or common stock, as applicable, is regularly traded over-the-counter) over the twenty (20) calendar day period ending two (2) calendar days prior to such Accrual Date (as such closing prices, closing sale prices or closing bid prices, as applicable, may be adjusted for any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events affecting such preferred stock or common stock, as applicable).

 

“Person” means any individual, corporation, association, partnership (general or limited), joint venture, trust, estate, limited liability company, limited liability partnership, unincorporated organization, government (or any agency or political subdivision thereof) or other legal entity or organization, other than Radius or NB.

 

“Project Committee” has the meaning ascribed to it under the CTS Agreement.

 

“Shell Company Successor” means a shell company that (i) has securities registered under the Securities Exchange Act of 1934, as amended, (ii) has nominal operations and nominal assets (prior to any of the transactions described in the next clause) and (iii) directly or indirectly through one or more direct or indirect subsidiaries acquires Radius and/or all or substantially all of its assets or business (whether pursuant to a stock purchase, an asset purchase, a merger or any other similar transaction). and in consideration for such acquisition issues to the former stockholders of Radius shares of capital stock of such shell company.

 

1.2  Other Defined Terms . The following terms shall have the meanings set forth in the section appearing opposite such term:

 

“Accrual Date”

 

Section 3.1(a)

“Agreement”

 

Recitals

“Arbitration”

 

Section 3.1(d)

“Arbitrator”

 

Section 3.1(f)

 

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“Bonus Shares Report”

 

Section 3.1(c)

“Closing”

 

Section 2.1(b)

“Conversion Shares”

 

Section 2.2

“Common Stock”

 

Section 4.4

“CTS Agreement”

 

Recitals

“Dispute Notice”

 

Section 3.1(d)

“Effective Date”

 

Recitals

“Independent Accounting Firm”

 

Section 3.1(e)

“NB”

 

Recitals

“Preferred Stock”

 

Section 4.4

“Radius”

 

Recitals

“Restated Certificate”

 

Section 2.2

“Rules”

 

Section 3.1(f)

“Securities Act”

 

Section 4.4

“Series A-1 Financing”

 

Section 6.6

“Series A-5 Preferred Stock”

 

Recitals

“Series A-5 Purchase Price Per Share”

 

Section 2.1(a)

“Series A-5 Shares”

 

Section 2.1(a)

“Series A-6 Preferred Stock”

 

Section 2.2

“Stage I Closing”

 

Section 6.6

“Stockholders Agreement”

 

Section 4.1

“Transaction Documents”

 

Section 4.1.

 

2.  ISSUANCE OF SERIES A-5 PREFERRED STOCK

 

2.1  Purchase and Sale of Series A-5 Preferred Stock . (a)  On May 17, 2011, NB will purchase and Radius will sell and issue to NB 64,430 shares of Radius Series A-5 Preferred Stock (the “Series A-5 Shares” ), representing the quotient (rounded to the nearest whole number) obtained by dividing (x)  the U.S. Dollar equivalent (determined in accordance with the provisions of the next sentence) of €371,864 by (y)  US$8.142 per share (the “Series A-5 Purchase Price Per Share” ). Radius shall determine the U.S. Dollar equivalent of such €371,864 using the exchange rate for buying U.S. Dollars with EUROS set forth in The Wall Street Journal(Online Edition) Market Data Center at http://online.wsj.com/mdc/public/page/marketsdata.html on the Business Day that is two (2) Business Days preceding the date of the Closing. The aggregate purchase price payable by NB for the Series A-5 Shares shall be €371,864.

 

(b)  The purchase and sale of the Series A-5 Shares to be purchased and sold pursuant to Section 2.1(a) shall take place at the offices of Bingham McCutchen LLP, One Federal Street, Boston, Massachusetts, at 10:00 a.m. local time on May 17, 2011 (which time and place are referred to as the “Closing” ).

 

(c)  At the Closing, Radius will deliver to NB a certificate registered in NB’s name representing the Series A-5 Shares, against payment of the purchase price therefor by wire transfer in accordance with Radius’s instructions;.

 

2.2  Reservation of Series A-5 Preferred Stock and Series A-6 Preferred Stock . Radius will, prior to the Closing, authorize: (a) the sale and issuance of the Series A-5 Shares; (b) the accrual and issuance of all of the shares of Series A-6 Convertible Preferred Stock, par value $0.01 per share (the “Series A-6 Preferred Stock” ), of Radius in accordance with the provisions of this Agreement; and (c) the reservation of shares of Common Stock, par value $0.01 per share for issuance upon conversion of the Series A-5 Preferred Stock and the Series A-6 Preferred Stock (the “Conversion Shares” ). The Series A-5 Preferred Stock, the Series A-6 Preferred Stock and the Common Stock have the rights, privileges, preferences and restrictions set forth in the Fourth Amended and Restated Certificate of Incorporation of Radius, including those summarized in the Term Sheet in the form attached hereto as Attachment A , with such changes and additional provisions as may be made by Radius after the date hereof in connection with the negotiation by Radius of the closing documents for the Series A-1 Financing with prospective investors in the Series A-1 Financing (the “Restated Certificate” ). The Series A-5 Preferred Stock and the Series A-6 Preferred Stock shall have the same right, privileges, preferences and restrictions except that the Series A-6 Preferred Stock shall not be entitled to accrue any shares of capital stock of Radius, whether as a stock dividend or otherwise, pursuant to, and in accordance with, the terms and conditions of this Agreement.

 

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3.  BONUS SHARES

 

3.1  Calculation of Bonus Shares; Issuance of Bonus Shares . (a)  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), the holders of shares of Series A-5 Preferred Stock shall be entitled to receive stock dividends, payable in shares of Series A-6 Preferred Stock in accordance with the provisions of this Section 3.1, having an aggregate value (determined as provided in this Section 3.1) of up €36,814,531 as calculated on the date that such stock dividends accrue in accordance with this Section 3.1. Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), on the last Business Day of each calendar quarter (each, an “Accrual Date” ), beginning with the calendar quarter during which the first subject is enrolled in the clinical study that is the subject of Work Statement NB-1, each outstanding share of Series A-5 Preferred Stock shall accrue, as a stock dividend, a number of shares of Series A-6 Preferred Stock having a value (determined as provided further below in this Section 3.1) equal to (x)  €36,814,531 minus the aggregate value of any prior stock dividends that accrue pursuant to this Section 3.1(a) (with such aggregate value of such prior stock dividends being determined as of the applicable prior Accrual Date) divided by (y)  the number of calendar quarters the Project Committee has determined it will take to complete the clinical study that is the subject of Work Statement NB-1 and lock the study database and transfer the study database to Radius in its then most recent determination delivered in accordance with Section 3.1(b).

 

(b)  When calculating the aggregate number of Bonus Shares accruing in each calendar quarter, Radius shall convert the portion of €36,814,531 to accrue in such calendar quarter into U.S. Dollars using the simple average of the exchange rate for buying U.S. Dollars with EUROS set forth in The Wall Street Journal(Online Edition) Market Data Center at http://online.wsj.com/mdc/public/page/marketsdata.html for all Mondays’ in such calendar quarter. Radius shall then calculate the aggregate number of Bonus Shares accrued in such calendar quarter by dividing (x)  the U.S. Dollar equivalent (determined in accordance with the provisions set forth in the preceding sentence) of the Applicable Quarterly Amount, by (y)  the Fair Market Value as of the applicable Accrual Date, and rounding down the resulting quotient to the nearest whole number. In the event that the Bonus Shares that accrue in any calendar quarter are in the form of stock dividends accruing on the shares of Series A-5 Preferred Stock that are outstanding on the Accrual Date applicable to such calendar quarter, the number of Bonus Shares accruing in such calendar quarter with respect to each share of Series A-5 Preferred Stock outstanding on the applicable Accrual Date shall be equal to the quotient (rounded down to the nearest whole number) obtained by dividing (i)  the number of Bonus Shares that accrue on such applicable Accrual Date by (ii)  the total number of shares of Series A-5 Preferred Stock issued and outstanding as of such applicable Accrual Date.

 

(c)  Radius and NB, acting through the Project Committee in accordance with Section 3 of the CTS Agreement, will evaluate the study timeline and update the completion date for the clinical study that is the subject of Work Statement NB-1 set forth in Work Statement NB-1 to account for delays or accelerations in the performance of the clinical study that is the subject of Work Statement NB-1. Not later than five (5) calendar days before the end of each calendar quarter, the Project Committee will provide Radius with a written update detailing the number of calendar quarters that the Project Committee determines it will take to complete the clinical study that is the subject of Work Statement NB-1 and lock the study database and transfer the study database to Radius. Based upon such written update provided by the Project Committee, Radius shall calculate, on the applicable Accrual Date, the number of Bonus Shares that accrue on such applicable Accrual Date in accordance with the provisions of Section 3.1(a). Within thirty (30) days following the end of each calendar quarter, Radius shall provide NB with a written report (each, a “Bonus Shares Report” ) setting forth the calculation of the number of Bonus Shares that accrued in such calendar quarter in accordance with Section 3.1(a) and the aggregate Bonus Shares accrued as of the end of such calendar quarter. Such Bonus Shares Report shall be certified by the Chief Financial Officer (or equivalent financial and accounting officer) of Radius to be correct to the best of Radius’ knowledge and information.

 

(d)  The Bonus Shares Report as prepared by Radius shall be conclusive and binding on NB unless NB shall notify Radius in writing within thirty (30) days after receipt thereof that, in the opinion of NB, the number of Bonus Shares set forth on the Bonus Shares Report has not been calculated correctly. Such notice (the “Dispute Notice” ) shall set forth in reasonable detail each item and amount with which NB disagrees and the basis for such disagreement. Radius and NB shall attempt to resolve such dispute and agree in writing upon the final content of the Bonus Shares Report and the final calculation of the number of Bonus Shares accrued in the period. If the

 

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parties cannot so agree within ten (10) Business Days after the delivery by NB to Radius of the Dispute Notice, then either Radius or NB may submit such dispute to an independent arbitrator for determination (an “Arbitration” ) in accordance with the terms set forth in Section 3.1(e)-(g).

 

(e)  Any request for Arbitration shall be made in writing to an independent accounting firm of recognized national standing to be mutually selected by Radius and NB, which firm shall not be an auditing firm for either party and shall not have provided material services to either party during the two (2) year period prior to the date of Arbitration initiation. The firm to which such request is made shall, upon agreeing in writing to determine the number of Bonus Shares that have accrued in such quarterly period in accordance with the terms of this Section 3.1, be the “Independent Accounting Firm” , as that term is used in this Section 3.1. If the parties are not able to agree within five (5) Business Days after the receipt by a party of the arbitration request, the New York Office of the American Arbitration Association shall be responsible for selecting an Independent Accounting Firm within ten (10) Business Days of being approached by a party.

 

(f)  The Arbitration shall be conducted under the auspices of the Independent Accounting Firm and shall be conducted in accordance with the then current expedited procedures applicable to the then current Commercial Arbitration Rules and Supplementary Procedures for Large Complex Disputes ( “Rules” ) of the American Arbitration Association, as such Rules and procedures may be modified by this Section 3.1(f). The Independent Accounting Firm shall, within five (5) Business Days of its agreement to determine the number of Bonus Shares that have accrued in such quarterly period, provide to Radius and NB the name of its partner who will serve as the individual responsible for conducting the Arbitration (the “Arbitrator” ). Within five (5) Business Days after the designation of the Arbitrator, the parties shall each simultaneously submit to the Arbitrator and one another a written statement of their respective positions on such disagreement. Each party shall have ten (10) Business Days from receipt of the other party’s submission to submit to the Arbitrator and the other party a written response thereto. The Arbitrator shall have the right to meet with the parties, either alone or together, as necessary to make a determination. The Arbitrator shall conduct an Arbitration to determine the number of Bonus Shares that have accrued in such quarterly period. The Arbitrator shall make such determination subsequent to conducting the Arbitration and shall set forth such determination in a written ruling, which ruling shall be rendered within forty-five (45) days of the selection date of the Arbitrator and shall be delivered to Radius and NB.

 

(g)  The locale of all hearings conducted by the Arbitrator in connection with the Arbitration shall be the New York office of the Independent Accounting Firm. The ruling of the Arbitrator shall be final, binding, and conclusive on Radius and NB; shall have the legal effect of an arbitral award; and shall be subject only to the judicial review permitted by the Federal Arbitration Act. Judgment on the ruling of the Arbitrator may be entered and enforced in any court having jurisdiction over the parties or their assets. The fees and disbursements of the Independent Accounting Firm shall be allocated and payable between Radius on the one hand and NB on the other hand in the same proportion that (i) the additional number of Bonus Shares that have been determined by the Arbitrator to have accrued in such period bears to (ii) the additional number of Bonus Shares that NB initially claimed in its Dispute Notice accrued in such period. If a party fails to proceed with Arbitration, unsuccessfully challenges the arbitration award, or fails to comply with the arbitration award, the other party is entitled to costs, including reasonable attorneys’ fees, for having to compel arbitration or defend or enforce the award. Except as otherwise required by law, the parties and the Arbitrator and Independent Accounting Firm will maintain as confidential all information or documents obtained during the arbitration process, including the resolution of the dispute. The parties knowingly and voluntarily waive their rights to have their dispute tried and adjudicated by a judge and jury; provided that nothing in this Section 3.1(g) will prevent a party from resorting to judicial proceedings if: (1) interim relief from a court is necessary to prevent serious and irreparable injury to such party; or (2) litigation is required to be filed prior to the running of the applicable statute of limitations. The use of any alternative dispute resolution procedure will not be construed under the doctrine of latches, waiver or estoppel to affect adversely the rights of either party. The parties shall use the procedure set forth in Section 3.1(e)-(g) for any dispute concerning calculation of Bonus Shares; any other disputes concerning this Agreement and the transactions contemplated hereby shall be resolved in accordance with Section 8.12.

 

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(h)  Bonus Shares that accrue pursuant to Section 3.1(a) shall be subject to proportionate and equitable adjustment upon any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events involving or affecting the Series A-5 Preferred Stock.

 

(i)  Bonus Shares that accrue pursuant to Section 3.1(a) shall be payable, when, as and if declared or paid by the Board of Directors of Radius. The Board of Directors of Radius shall be required to declare and pay such Bonus Shares accrued pursuant to Section 3.1(a) hereof: (i) upon the request of the holder(s) of a majority of the shares of common stock or other capital stock issued or issuable in respect of Series A-5 Preferred Stock or (ii) on any Event of Sale.

 

(j)  The stock dividend feature of Section 3.1(a), as well as all other forms of accrual of Bonus Shares under this Agreement (including, without limitation, any contractual accrual of Bonus Shares pursuant to the second paragraph of Section 3.1(k) below or pursuant to Section 3.1(l) below) shall terminate upon an Event of Sale. Upon an Event of Sale, the Person that becomes the successor of Radius as a result of such Event of Sale shall, in lieu of accruing Bonus Shares pursuant to this Agreement, make cash payments to NB for the services to be rendered pursuant to Work Statement NB-1.

 

(k)  The stock dividend feature of Section 3.1(a) hereof shall also terminate upon the occurrence of any event that is not an Event of Sale if such event causes all outstanding shares of Series A-5 Preferred Stock of Radius to convert into, or be exchanged for, common stock of Radius or any other Person (including a Shell Company Successor) or any other class or series of capital stock of Radius or any other Person (including a Shell Company Successor); provided , however , that such stock dividend feature shall not terminate if such event that is not an Event of Sale consists of an acquisition of Radius, directly or indirectly, by such Shell Company Successor pursuant to which all shares of each of Series A-5 Preferred Stock and Series A-6 Preferred Stock of Radius shall convert into, or be exchanged for, shares of a series of preferred stock of the Shell Company Successor that has adopted and incorporated substantially the same terms provided under this Agreement with respect to the Series A-5 Preferred Stock or the Series A-6 Preferred Stock, as the case may be, of Radius, in which case such stock dividend feature shall be applicable to such series of preferred stock of the Shell Company Successor.

 

Upon termination of the stock dividend feature pursuant to this Section 3.1(k) in connection with an event that is not an Event of Sale: (1) all accrued Bonus Shares not yet issued or paid shall automatically convert into the right to receive a distribution of that number of accrued but not yet issued or paid shares of such common stock or such other class or series of capital stock that a holder of such accrued but not yet issued Bonus Shares would have been entitled to receive with respect to such Bonus Shares if such holder had claimed such Bonus Shares using the procedure described in Section 3.1(i)(i) and been the holder of record of such Bonus Shares immediately prior to the occurrence of such event; and (2) all Bonus Shares, if any, that would have accrued pursuant to Section 3.1(a) at any time after the occurrence of such event if such event had not occurred, shall accrue pursuant to this clause (2) on the same terms and conditions as if such accrual had been under Section 3.1(a) hereof and be payable in shares of such common stock of Radius or any other Person (including a Shell Company Successor), as the case may be, or such other class or series of capital stock of Radius or any other Person (including a Shell Company Successor), as the case may be, in accordance with the terms of this Agreement as if such accrual had been pursuant to Section 3.1(a). For purposes of clarification, any accrual of Bonus Shares pursuant to clause (2) of this paragraph shall be a contractual accrual and not an accrued stock dividend.

 

(l)  The stock dividend feature of Section 3.1(a) shall also terminate upon the transfer by NB of any or all of the Series A-5 Shares to any Person. Upon termination of the stock dividend feature pursuant to this Section 3.1(m), all Bonus Shares, if any, that would have accrued pursuant to Section 3.1(a) at any time after the occurrence of such transfer of Series A-5 Shares by NB if such transfer had not occurred, shall accrue pursuant to this Section 3.1(m) for the exclusive benefit of NB (and not the Person to whom such Series A-5 Shares were transferred) on the same terms and conditions as if such accrual had been under Section 3.1(a) hereof and be payable in shares of Series A-6 Preferred Stock subject to, and in accordance with, the terms of this Agreement as if such accrual had been pursuant to Section 3.1(a). For purposes of clarification, any accrual of Bonus Shares pursuant to this Section 3.1(l) shall be a contractual accrual and not an accrued stock dividend.

 

(m)  Notwithstanding anything express or implied in this Agreement to the contrary, in the event of any transaction involving Radius and a Shell Company Successor pursuant to which such Shell Company Successor,

 

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directly or indirectly, acquires Radius or all or substantially all of its assets, then (1) such transaction shall not be treated as an Event of Sale, (2) such Shell Company Successor shall succeed to all of the rights and obligations of Radius under this Agreement and (3) if the stock dividend feature of Section 3.1(a) hereof does not terminate pursuant to the first paragraph of Section 3.1(k), all references in this Agreement to the terms Series A-5 Preferred Stock and Series A-6 Preferred Stock shall be deemed and treated as if they were references to the applicable series of preferred stock of such Shell Company Successor into which, or for which, such Series A-5 Preferred Stock and such Series A-6 Preferred Stock was converted or exchanged, as applicable.

 

3.2  Bonus Shares to be Duly Authorized and Issued, Fully Paid and Non-Assessable . Radius covenants and agrees that it will take all such action as may be necessary to ensure that all Bonus Shares issued pursuant to this Agreement shall, at the time of delivery of the certificates for such Bonus Shares, be duly and validly authorized and issued and fully paid and non-assessable shares.

 

3.3  Stock Record Date . No Person shall be deemed to have become the holder of record of any Bonus Shares until the date that the Board of Directors declare such accrued Bonus Shares payable in accordance with Section 3.1(i) and any certificate for such accrued Bonus Shares shall be dated as of such date. Prior to such date, no Person shall be entitled to any rights of a stockholder of Radius with respect to the Bonus Shares which may be issuable pursuant to this Agreement including, without limitation, the right to vote, to receive dividends or other distributions or to exercise any preemptive rights and shall not be entitled to receive any notice of any proceedings of Radius, except as provided herein.

 

3.4  Limitation . (a)  Subject to Section 3.4(b), notwithstanding anything to the contrary expressed or implied in this Agreement, in the event that, at any time after Radius is acquired, directly or indirectly, by a Shell Company Successor, any accrual of Bonus Shares in accordance with the provisions of this Agreement would cause the cumulative number of Bonus Shares (calculated on an as converted to Common Stock basis) accrued pursuant to this Agreement from and after the effective date of such acquisition (whether or not such accrued Bonus Shares have been or are issued) to exceed 19.9% of the issued and outstanding shares of capital stock of such Shell Company Successor as of such effective date and as of each Accrual Date after such effective date (calculated on an as converted to Common Stock basis and after giving effect to appropriate and equitable adjustments upon any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events), then no such accrual shall be made pursuant to this Agreement, and Radius shall, in lieu of such accrual, make payment of any Applicable Quarterly Amount in cash.

 

(b)  The limitation imposed by Section 3.4(a) may be waived by Radius in its sole and absolute discretion at any time and from time to time. Any such waiver by Radius of such limitation in any particular instance shall not constitute a waiver of such limitation in any other instance.

 

4.  REPRESENTATIONS AND WARRANTIES OF RADIUS.

 

Radius hereby represents and warrants to NB as follows, as of the Closing:

 

4.1  Organization and Standing; Power and Authority . Radius is a corporation duly organized and validly existing under the laws of the State of Delaware and has the requisite corporate power and authority to (a) own and operate its properties and assets, (b) conduct its business as currently conducted, (c) execute and deliver this Agreement and the Amended and Restated Stockholders’ Agreement among Radius and the other parties thereto including those summarized in the Term Sheet in the form attached as Attachment A , with such changes and additional provisions as may be made by Radius after the date hereof in connection with the negotiation by Radius of the closing documents for the Series A-1 Financing with prospective investors in the Series A-1 Financing (the “Stockholders’ Agreement” and collectively with this Agreement the “Transaction Documents” ), (d) issue and sell the Series A-5 Preferred Stock, and (e) perform its obligations pursuant to the Transaction Documents and the Restated Certificate.

 

4.2  Execution; Enforceability . All corporate action on the part of Radius, its stockholders and its directors necessary for the authorization, execution and delivery of the Transaction Documents by Radius, the authorization, sale, issuance and delivery of the Series A-5 Preferred Stock, the Bonus Shares and the Conversion Shares, and the performance of all of Radius’ obligations under the Transaction Documents to be performed as of the Closing has

 

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been taken or will be taken prior to the Closing. All action on the part of the officers of Radius necessary for the execution and delivery of the Transaction Documents, the performance of all obligations of Radius under the Transaction Documents to be performed as of the Closing, and the issuance and delivery of the Series A-5 Preferred Stock has been taken or will be taken prior to the Closing. The Transaction Documents, when executed and delivered by Radius, shall constitute valid and binding obligations of Radius, enforceable in accordance with their terms, except (a) to the extent that the indemnification provisions contained in the Stockholders’ Agreement may be limited by applicable laws and principles of public policy; (b) as limited by bankruptcy, insolvency, reorganization, moratorium and other laws of general application affecting enforcement of creditors’ rights generally; and (c) as limited by laws relating to the availability of specific performance, injunctive relief or other equitable remedies or by general principles of equity.

 

4.3  Authority . The execution of, and performance of, the transactions contemplated by the Transaction Documents and compliance with the provisions of the Transaction Documents by Radius will not, to the best of its knowledge, violate any provision of law and, if applicable, will not conflict with or result in any material breach of any of the terms, conditions or provisions of, or constitute a material default under, or require a consent or waiver under, its Restated Certificate or By-laws (each as amended to date and as in effect as of the date the Series A-5 Preferred Stock or the Bonus Shares are issued to NB) or any material indenture, lease, agreement or other instrument to which Radius is a party or by which it or any of its properties (whether tangible or intangible) is bound.

 

4.4  Capitalization . (a)  Radius shall have a total authorized capitalization immediately prior to the Stage I Closing consisting of: (i) 34,859,964 shares of Common Stock, $.01 par value per share (the “Common Stock” ), of which (1) 522,506 shares shall be validly issued and outstanding, fully paid and nonassessable (including 266 shares issuable upon exercise of warrants to purchase Common Stock); (2) 29,364,436 shares shall have been duly reserved for issuance upon conversion of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and Series A-6 Preferred Stock (including 147,384 shares of Series A-1 Preferred Stock issuable upon exercise of warrants to purchase Series A-1 Preferred Stock); and (3) 2,015,666 shares shall have been duly reserved for issuance under Radius’ 2003 Long-Term Incentive Plan, as amended (the “2003 Plan Option Shares” ); and (ii) 29,364,436 shares of Preferred Stock, $.01 par value per share (the “Preferred Stock” ), (1) of which 63,000 shares shall have been designated as Series A[ Preferred] Stock, 61,664 of which shall be issued and outstanding, fully paid and nonassessable; (2) of which 1,600,000 shares shall have been designated as Series B [Preferred ]Stock, 1,599,997 of which shall be issued and outstanding, fully paid and nonassessable; (3) of which 10,146629 shares shall have been designated as Series C Preferred Stock, all of which shall be issued and outstanding, fully paid and nonassessable; (4) of which 10,000,000 shares shall have been designated as Series A-1 Preferred Stock, none of which shall be issued and outstanding; (5) of which 9,832,133 shall have been designated the Series A-2 Preferred Stock, none of which shall be issued and outstanding; (6) of which 1,422,300 shall have been designated the Series A-3 Preferred Stock, none of which shall be issued and outstanding; (7) of which 40,003 shall have been designated the Series A-4 Preferred Stock, none of which shall be issued and outstanding; (8) of which 70,000 shall have been designated the Series A-5 Preferred Stock, none of which shall be issued and outstanding; and (9) of which 8,000,000 shall have been designated the Series A-6 Preferred Stock, none of which shall be issued and outstanding.

 

(b)  Radius shall have a total authorized capitalization immediately following the Stage I Closing, assuming compliance by all parties with the provisions of the Series A-1 Financing documents by each of the investors thereunder, consisting of: (i) 34,859,964 shares of Common Stock, of which: (1) 522,506 shall be validly issued and outstanding, fully paid and nonassessable (including 266 shares issuable upon exercise of warrants to purchase Common Stock); (2) 29,364,436 shares shall have been duly reserved for issuance upon conversion of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and Series A-6 Preferred Stock (including 147,384 shares of Series A-1 Preferred Stock issuable upon exercise of warrants to purchase Series A-1 Preferred Stock); and (3) 2,015,666 shares shall have been duly reserved for issuance in connection with options available under the Corporation’s 2003 Long-Term Incentive Plan, as amended; (ii) 29,364,436 shares of Preferred Stock of which: (1) 63,000 shall have been designated the Series A Preferred Stock, none of which shall be issued and outstanding; (2) 1,600,000 shall have been designated the Series B Preferred Stock, none of which shall be issued and outstanding; (3) 10,146,629 shall have been designated the Series C Preferred Stock, none of which shall be issued and outstanding; (4) 10,000,000 shall have been designated the Series A-1 Preferred Stock, of which 4,136,912 shall be validly issued and outstanding, fully paid and nonassessable; (5) 9,832,133 shall have been designated the

 

8



 

Series A-2 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable; (6) 1,422,300 shall have been designated the Series A-3 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable; (7) 40,003 shall have been designated the Series A-4 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable; (8) 70,000 shall have been designated the Series A-5 Preferred Stock, of which 66,028 shall be validly issued and outstanding, fully paid and nonassessable; and (9) 8,000,000 shall have been designated the Series A-6 Preferred Stock, none of which shall be issued and outstanding.

 

(c)  All of the issued and outstanding shares of Common Stock have been duly authorized and validly issued and are fully paid and nonassessable, and were issued in accordance with the registration or qualification provisions of the Securities Act of 1933, as amended (the “Securities Act” ) and any relevant state securities laws, or pursuant to valid exemptions therefrom. All shares of capital stock issuable upon exercise of outstanding options have been duly authorized and reserved and, when issued in accordance with the terms of such options, will be validly issued, fully paid and nonassessable. All shares of capital stock issuable upon exercise of outstanding warrants have been duly authorized and reserved, and the shares of Common Stock or Preferred Stock when issued in accordance with the terms of such warrants will be validly issued, fully paid and nonassessable.

 

(d)  The Series A-5 Preferred Stock, when issued, delivered and paid for in compliance with the provisions of this Agreement and the Bonus Shares when issued and delivered in compliance with this Agreement, will be validly issued, fully paid and nonassessable. The Conversion Shares have been duly and validly reserved and, when issued in compliance with the provisions of this Agreement, the Restated Certificate and applicable law, will be validly issued, fully paid and nonassessable. The Series A-5 Preferred Stock, the Bonus Shares and the Conversion Shares will be free of any liens or encumbrances, other than any liens or encumbrances created by NB; provided, however, that the Series A-5 Preferred stock, the Bonus Shares and the Conversion Shares are subject to restrictions on transfer under U.S. state and/or federal securities laws and as set forth herein and in the Stockholders’ Agreement.

 

4.5  Issuance of Shares . The issuance, sale and delivery of the Series A-5 Preferred Stock in accordance with this Agreement, and the issuance and delivery of the Conversion Shares upon conversion of the Series A-5 Preferred Stock, have been duly authorized by all necessary corporate action on the part of Radius, and all such shares have been duly reserved for issuance. The shares of Series A-5 Preferred Stock when so issued, sold and delivered against payment therefor in accordance with the provisions of this Agreement, and the Conversion Shares, if and when issued upon such conversion, will be duly and validly issued, fully paid and non-assessable. The Bonus Shares when issued and delivered in accordance with the provisions of Section 3.1(i), and any shares of common stock if and when issued on conversion of such Bonus Shares (if applicable) will be duly and validly issued, fully paid and non-assessable.

 

4.6  Offering . Subject to the accuracy of the NB’s representations and warranties in Section 5, the offer, sale and issuance of the Series A-5 Preferred Stock to be issued in conformity with the terms of this Agreement and the issuance of the Conversion Shares and the issuance of the Bonus Shares to be issued in accordance with the terms of this Agreement, as applicable, constitute transactions exempt from the registration requirements of Section 5 of the Securities Act and from the registration or qualification requirements of applicable state securities laws, and neither Radius nor any authorized agent acting on its behalf will take any action hereafter that would cause the loss of such exemption.

 

4.7  Brokers . Radius has not retained, utilized or been represented by any broker or finder in connection with the transactions contemplated by this Agreement and neither NB nor any investor in Radius has, nor will, incur, directly or indirectly, as a result of any action taken by the Radius, any liability for brokerage or finders’ fees or agents’ commissions or any similar charges in connection with the Transaction Documents.

 

4.8  Consents . All consents, approvals, orders and authorizations required on the part of Radius in connection with the execution, delivery or performance of the Transaction Documents and the consummation of the transactions contemplated thereby have been obtained.

 

5.  REPRESENTATIONS AND WARRANTIES OF NB.

 

NB represents and warrants to Radius as follows:

 

9



 

5.1  Accredited Investor . NB is an “accredited investor” within the meaning of Rule 501(a) under the Securities Act, and understands that Radius has relied upon its being an accredited investor in deciding to proceed with the transactions contemplated hereby, and in ascertaining the requirements of law applicable to the issuance and sale of the Shares and the Bonus Shares. NB’s financial condition is such that it is able to bear all economic risks of investment in the Series A-5 Preferred Stock or the Bonus Shares, including a complete loss of NB’s investment therein. NB acknowledges that Radius has provided it with adequate access to financial and other information concerning Radius as requested and that it has had the opportunity to ask questions of and receive answers from Radius concerning the transactions contemplated under this Agreement and the Stockholders’ Agreement and to obtain therefrom any additional information necessary to make an informed decision regarding an investment in Radius.

 

5.2  Investment . NB is acquiring the Series A-5 Preferred Stock and the Bonus Shares, for its own account for investment, not as a nominee or agent, and not with a view to, or for sale in connection with, any distribution thereof, nor with any present intention of distributing or selling the same; and, except as contemplated by this Agreement and the Stockholders’ Agreement, NB has no present or contemplated agreement, undertaking, arrangement, obligation, indebtedness or commitment providing for the disposition thereof.

 

5.3  Not Registered . NB understands that the Series A-5 Preferred Stock, the Conversion Shares and the Bonus Shares have not been registered under the Securities Act, and must be held indefinitely until such time as they are subsequently registered under the Securities Act or an exemption from such registration is available. NB has been independently advised or is aware of the provisions of Rule 144 promulgated under the Securities Act that afford exemptions from registration depend on the satisfaction of various conditions, including, among other things: the availability of certain current public information about Radius, the resale occurring not less than one year after a party has purchased and paid for the security to be sold, the sale being through an unsolicited “broker’s transaction” or in transactions directly with a market maker (as such term is defined under the Securities Exchange Act of 1934, as amended) and the number of shares being sold during any three-month period not exceeding specified limitations. NB also acknowledges that Radius is not under any obligation to register or to cause any Person to register any securities under the Securities Act.

 

5.4  Principal Place of Business . The address of the principal place of business, and the office in which NB’s investment decision was made, is located at Herlev Hovedgade 207, 2730 Herlev, Denmark.

 

5.5  Authority . NB has full power and authority to enter into and to perform this Agreement and the Stockholders’ Agreement in accordance with their respective terms. NB represents that it has not been organized, reorganized or recapitalized specifically for the purpose of investing in Radius. This Agreement has been duly executed and delivered by NB and constitutes a valid and binding obligation of NB enforceable against it in accordance with its terms. The execution of, and performance of, the transactions contemplated by the Transaction Documents and compliance with the provisions of the Transaction Documents by NB will not, to the best of its knowledge, violate any provision of law and, if applicable, will not conflict with or result in any material breach of any of the terms, conditions or provisions of, or constitute a material default under, or require a consent or waiver under, its organizational documents (if any, and each as amended to date and as in effect as of the date the Series A-5 Preferred Stock or the Bonus Shares are issued to NB) or any material indenture, lease, agreement or other instrument to which NB is a party or by which it or any of its properties (whether tangible or intangible) is bound.

 

5.6  Brokers . NB has not retained, utilized or been represented by any broker or finder in connection with the transactions contemplated by this Agreement and neither Radius nor any investor in Radius has, nor will, incur, directly or indirectly, as a result of any action taken by the NB, any liability for brokerage or finders’ fees or agents’ commissions or any similar charges in connection with the Transaction Documents.

 

5.7  Consents . All consents, approvals, orders and authorizations required on the part of NB in connection with the execution, delivery or performance of this Agreement and the consummation of the transactions contemplated herein have been obtained and are effective.

 

5.8  Non-United States Person Consents . NB hereby represents that NB is satisfied as to the full observance of the laws of NB’s jurisdiction in connection with any invitation to subscribe for the Series A-5 Preferred Stock or any use of the Transaction Documents, including (a) the legal requirements within NB’s jurisdiction for the purchase of

 

10


 

Series A-5 Preferred Stock, (b) any foreign exchange restrictions applicable to such purchase, (c) any governmental or other consents that may need to be obtained and (d) the income tax and other tax consequences, if any, that may be relevant to the purchase, holding, redemption, sale or transfer of such securities. NB’s subscription and payment for, and NB’s continued beneficial ownership of, the Series A-5 Preferred Stock, will not violate any applicable securities or other laws of such NB’s jurisdiction.

 

6.  CLOSING CONDITIONS OF NB

 

NB’s obligation to purchase the Series A-5 Preferred Stock at the Closing is subject to the fulfillment on or before the Closing of each of the following conditions, unless waived by NB:

 

6.1  Representations and Warranties . The representations and warranties made by Radius in Section 4 shall be true and correct in all material respects as of the date of the Closing.

 

6.2  Covenants . All covenants, agreements and conditions contained in the Transaction Documents to be performed by Radius on or prior to the date of the Closing shall have been performed or complied with in all material respects as of the date of the Closing.

 

6.3  Restated Certificate . Prior to the Closing, the Restated Certificate shall have been duly authorized, executed and filed by Radius with and accepted by the Secretary of State of the State of Delaware.

 

6.4  Certificates and Documents . Radius shall deliver to NB a Certificate of the Secretary or an Assistant Secretary of Radius, dated as of the Closing, certifying that attached thereto: (a) is a true and complete copy of the Restated Certificate; (b) is a true and complete copy of the Radius By-Laws; and (c) is a true and complete copy of the resolutions of the Board of Directors and the stockholders of Radius authorizing and approving all matters in connection with this Agreement and the transactions contemplated hereby.

 

6.5  Compliance Certificate . Radius shall have delivered to NB a certificate executed by the Chief Executive Officer of Radius on behalf of Radius, certifying the satisfaction of the conditions to the Closing listed in Sections 6.1 and 6.2.

 

6.6  Series A-1 Financing . Radius shall have consummated an equity financing pursuant to which it shall have issued and sold shares of its Series A-1 Convertible Preferred Stock, par value $0.01 per share, to existing and/or new investors resulting in aggregate gross proceeds being received by Radius in an amount equal to approximately twenty million U.S. Dollars (US$20,000,000) (the “Stage I Closing” ) and Radius and such investors shall have committed themselves to the issuance of two additional US$20,000,000 tranches of financing for the purchase of shares of Series A-1 Convertible Preferred Stock for aggregate gross proceeds being received by Radius from all three tranches in an amount equal to approximately sixty million U.S. Dollars (US$60,000,000) (the “Series A-1 Financing” ).

 

7.  CLOSING CONDITIONS OF RADIUS

 

Radius’ obligation to sell and issue the Series A-5 Preferred Stock at the Closing is subject to the fulfillment on or before the Closing of the following conditions, unless waived by Radius:

 

7.1  Representations and Warranties . The representations and warranties made by NB in Section 5 shall be true and correct in all material respects as of the date of the Closing.

 

7.2  Covenants . All covenants, agreements and conditions contained in the Transaction Documents to be performed by NB on or prior to the date of the Closing shall have been performed or complied with in all material respects as of the date of the Closing.

 

7.3  Restated Certificate . Prior to the Closing, the Restated Certificate shall have been duly authorized, executed and filed by Radius with and accepted by the Secretary of State of the State of Delaware.

 

7.4  Stockholders’ Agreement . Prior to the Closing, NB shall have executed and delivered a counterpart to the Stockholders’ Agreement.

 

11



 

7.5  Securities Laws . Prior to the Closing, Radius shall be satisfied that the offer and sale of the Series A-5 Preferred Stock, the Conversion Shares and the Bonus Shares shall be qualified or exempt from registration or qualification under all applicable federal and state securities laws (including receipt by Radius of all necessary blue sky law permits and qualifications required by any state, if any).

 

7.6  Series A-1 Financing . Radius shall have consummated the Series A-1 Financing.

 

8.  GENERAL.

 

8.1  Notices . Unless otherwise provided herein, any notice, report, payment or document to be given by one party to another shall be in writing and shall be deemed given when delivered personally or mailed by certified or registered mail, postage prepaid (such mailed notice to be effective on the date which is three (3) Business Days after the date of mailing), or sent by nationally recognized overnight courier (such notice sent by courier to be effective one (1) Business Day after it is deposited with such courier), or sent by telefax (such notice sent by telefax to be effective when sent, if confirmed by certified or registered mail or overnight courier as aforesaid) to the address set forth on the signature page to this Agreement or to such other place as a party may designate as to itself by written notice to the other party. With respect to any notice given by Radius under any provision of the Delaware General Corporation Law or Radius’ charter or bylaws, NB agrees that such notice may be given by facsimile or by electronic mail. Each such notice or other communication shall for all purposes of this Agreement be treated as effective or having been given when delivered if delivered personally, or, if sent by air mail, at the earlier of its receipt or 48 hours after the same has been deposited in a regularly maintained receptacle for the deposit of the U.S. mail, addressed and mailed as aforesaid or, if sent by facsimile, upon confirmation of facsimile transfer or, if sent by electronic mail, upon confirmation of delivery when directed to the electronic mail address set forth below.

 

8.2  Applicable Law . This Agreement shall be governed by, subject to, and construed in accordance with the substantive laws of Massachusetts without regard for any choice or conflict of laws rule or provision that would result in the application of the substantive law of any other jurisdiction.

 

8.3  Waivers; Amendments . (a)  The waiver by a party of a breach or default under any provision under this Agreement or the failure of such party to exercise its rights under this Agreement in any instance shall not operate or be construed as a continuing waiver or a waiver of any subsequent breach or default No waiver of any of the provisions of this Agreement shall be deemed or shall constitute a waiver of any other provision hereof (whether or not similar).

 

(b)  No agreement or understanding extending this Agreement or varying its terms shall be binding upon either party unless it is in a writing specifically referring to this Agreement and signed by a duly authorized representative of the applicable party. Any such amendment effected in accordance with this Section 8.3(b) shall be binding upon each holder of any securities issued pursuant to this Agreement at the time outstanding (including securities into which such securities have been converted or exchanged or for which such securities have been exercised) and each future holder of all such securities.

 

8.4  Integration . The terms and provisions contained in this Agreement (including the Attachments) and the CTS Agreement (including Work Statement NB-1) constitute the entire understanding of the parties with respect to the transactions and matters contemplated hereby and supersede all previous communications, representations, agreements and understandings relating to the subject matter hereof. No representations, inducements, promises or agreements, whether oral or otherwise, between the parties not contained in this Agreement and the CTS Agreement (including Work Statement NB-1) shall be of any force or effect.

 

8.5  Severability . In the event that any one or more of the provisions contained in this Agreement shall, for any reason, be held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provision of this Agreement and such invalid or unenforceable provision shall be construed by limiting it so as to be valid and enforceable to the maximum extent compatible with, and possible under, applicable law.

 

12



 

8.6  Binding Effect, Benefits . This Agreement, and any and all rights, duties and obligations hereunder, shall not be assigned, transferred, delegated or sublicensed by NB without the prior written consent of Radius. Any attempt by NB without such permission to assign, transfer, delegate or sublicense any rights, duties or obligations that arise under this Agreement shall be void. Subject to the foregoing, this Agreement shall inure to the benefit of and be binding upon the parties and their respective successors and assigns; nothing in this Agreement, expressed or implied, is intended to confer on any Person other than the parties hereto or, as applicable, their respective successors and permitted assigns, any rights, remedies, obligations or liabilities under or by reason of this Agreement.

 

8.7  Headings . The Section headings are inserted for convenience of reference only and are not intended to be a part of or to affect the meaning or interpretation of this Agreement

 

8.8  Counterparts . This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. Facsimile signatures shall be accepted as original signatures, orders may be transmitted electronically and any document created pursuant to this Agreement may be maintained in an electronic document storage and retrieval system, a copy of which shall be considered an original.

 

8.9  Further Assurances . Each party covenants and agrees that, subsequent to the execution and delivery of this Agreement and without any additional consideration, it will execute and deliver any further legal instruments and perform any acts that are or may become reasonably necessary to effectuate the purposes of this Agreement.

 

8.10  Rules of Construction . The parties agree that they have participated equally in the formation of this Agreement and that the language and terms of this Agreement shall not be construed against a party by reason of the extent to which such party or its professional advisors participated in the preparation of this Agreement.

 

8.11  Word Meanings . Words such as herein, hereinafter, hereof and hereunder refer to this Agreement as a whole and not merely to a section or paragraph in which such words appear, unless the context otherwise requires. The singular shall include the plural, and each masculine, feminine and neuter reference shall include and refer also to the others, unless the context otherwise requires.

 

8.12  Dispute Resolution . Except as otherwise provided in Section 3.1(e)-(g) with respect to disputes concerning the accuracy of the calculation of Bonus Shares set forth on a Bonus Shares Report, any dispute among the parties concerning this Agreement and the transactions contemplated hereby shall be resolved using the procedures set forth in Section 10.1 and Section 10.2(a)-(b) of the CTS Agreement.

 

[remainder of this page intentionally left blank - signature page follows]

 

13



 

IN WITNESS WHEREOF the parties have caused this Agreement to be executed on their behalf by their duly authorized representatives as of the Effective Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

/s/ C. Richard Lyttle

 

/s/ Claus Christiansen

By: Cecil Richard Lyttle

 

By: Clause Christiansen

Title: President and Chief Executive Officer

 

Title: Chief Executive Officer

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6th Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor / Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.5251

 

Attachment A Term Sheet for Series A-1 Financing

 

14



 

Attachment A

 

Term Sheet for Series A-1 Financing
[attached]

 

A-1


 

Radius Health Inc.

 

Project Fishbone

 

Key Terms of Series A-1 Preferred Stock Investment,
Strategic Alliance and Proposed Reverse Merger

 

THESE KEY TERMS ARE FOR DISCUSSION PURPOSES ONLY AND ARE NON-BINDING.

 

SERIES A-1 PREFERRED STOCK INVESTMENT (the “Series A-1 Offering”):

 

Issuer:

 

Radius Health Inc, a Delaware corporation (“ Radius ” or the “ Company ”)

 

 

 

Type of security:

 

Series A-1 Convertible Preferred Stock, par value $.01 per share (the “ Series A-1 Stock ”)

 

 

 

Investors:

 

Existing Preferred Stock Investors in the Company (the “ Lead Investors ”) other investors acceptable to the Lead Investors (collectively the “ Investors ”)

 

 

 

Investor Amounts:

 

 

 

 

 

Pro Rata Portion

 

Super Pro Rata
Amount

 

Total Series A-1
Offering Investment

 

MPM Bioventures III Funds

 

$

8,038,666

 

$

6,961,334

 

$

15,000,000

 

MPM Bio IV NVS Strategic Fund

 

$

5,460,982

 

$

1,932,348

 

$

7,393,329

 

Wellcome Trust

 

$

6,234,069

 

 

$

6,234,069

 

HealthCare Ventures VII

 

$

6,031,732

 

 

$

4,800,000

 

OB Partners IV or Saints Capital

 

$

4,185,146

 

 

$

3,958,011

 

mRNA Fund II

 

$

41,989

 

 

$

41,989

 

BB Biotech Ventures II

 

$

3,117,035

 

$

1,882,965

 

$

5,000,000

 

Scottish Widows

 

$

1,662,418

 

 

$

1,662,418

 

Dr. Raymond F. Schinazi

 

$

57,462

 

 

$

57,462

 

Other Series A

 

$

170,501

 

 

$

0

 

Total

 

$

35,000,000

 

$

10,776,647

 

$

44,147,279

 

 

 

 

 

 

 

 

 

 

 

Brookside

 

 

 

$

10,000,000

 

 

 

BB Biotech AG

 

 

 

$

5,000,000

 

 

 

Potential Second Closing

 

 

 

$

852,721

 

 

 

 

 

 

 

 

 

 

 

Equity Raise

 

 

 

$

60,000,000

 

 

 

Venture Debt

 

 

 

$

25,000,000

 

 

 

Total Financing

 

 

 

$

85,000,000

 

 

Aggregate Amount of Financing:

 

Approximately Sixty Million Dollars ($60,000,000) in three equal installments. First installment to be issued by Radius. Second and

 

2



 

 

 

Third installment to be issued by Surviving Corporation (See “Proposed Reverse Merger” below). For all purposes of this term sheet, the term Pro Rata Portion (as defined below) shall be based on $35,000,000 only and not the full $60,000,000 of gross proceeds to be raised in connection with the Series A-1 Offering. See Attachment. The term “ Series A-1 Offering Existing Investor Available Amount ” shall mean such $35,000,000 portion of such $60,000,000 in gross proceeds to be raised pursuant to the Series A-1 Offering.

 

 

 

Reverse Stock Split:

 

At any time prior to the closing of the first installment of the Series A-1 Offering (including immediately prior to such closing) the Company shall effect a 15:1 reverse stock split of all of its capital stock (the “ Reverse Stock Split ”). Any fractional shares resulting from computations made in connection with the Reverse Stock Split will be paid out in cash at such closing.

 

 

 

Series A-1 Original Purchase Price Per Share:

 

$8.142 (which price reflects the consummation of the Reverse Stock Split)

 

 

 

Rights Offering:

 

Each holder of the Company’s existing Series A Junior Convertible Preferred Stock, par value $.01 per share (the “ Existing A Preferred ”), Series B Convertible Redeemable Preferred Stock, par value $.01 per share (the “ Existing B Preferred ”), and Series C Convertible Preferred Stock, par value $.01 per share (the “ Existing C Preferred ” and together with the Existing A Preferred and the Existing B Preferred, the “ Existing Preferred ”), if such holder is an accredited investor under applicable United States securities laws, shall be given the opportunity to purchase such holder’s Pro Rata Portion (as defined below) of the Series A-1 Offering Existing Investor Available Amount.

 

 

 

Pro Rata Portion:

 

For purposes of the Series A-1 Offering, the term “Pro Rata Portion” shall mean, with respect to any holder of Existing Preferred, that percentage figure which expresses the ratio that (a) the number of shares of issued and outstanding Common Stock then owned by such holder of Existing Preferred bears to (b) the aggregate number of shares of issued and outstanding Common Stock then owned by all holders of Existing Preferred. For purposes of the computation set forth in clauses (a) and (b) above, all issued and outstanding securities held by holders of Existing Preferred that are convertible into or exercisable or exchangeable for shares of Common Stock (including any issued and issuable shares of Existing Preferred Stock) or for any such convertible, exercisable or exchangeable securities, shall be treated as having been so converted, exercised or exchanged at the rate or price at which such securities are convertible, exercisable or exchangeable for shares of Common Stock in effect at the time in question, whether or not such securities are at such time immediately convertible, exercisable or exchangeable.

 

 

 

Participation by Existing Preferred Stockholders:

 

Any holder of Existing Preferred that does not purchase its full Pro Rata Portion of the Series A-1 Offering Existing Investor Available

 

3



 

 

 

Amount shall be forced to convert the Applicable Portion (as defined below) of such holder’s shares of Existing Preferred into shares of Common Stock, par value $.01 per share, of the Company on a 5-for-1 basis and shall forfeit any and all accrued dividends on the Applicable Portion of such holder’s Existing Preferred being converted into Common Stock. The term “ Applicable Portion ” means that percentage of such holder’s Pro Rata Portion not purchased by such holder in the Series A-1 Offering.

 

 

 

 

 

Each holder of Existing C Preferred that participates in the Series A-1 Offering shall, subject to the “Super Pro Rata Participation” provisions set forth below, (a) exchange each remaining share of Existing C Preferred of such holder (after giving effect to the forced conversion provisions of the immediately preceding paragraph) for one share of Series A-2 Convertible Preferred Stock, par value $.01 per share (the “ Series A-2 Stock ”), and (b) forfeit any and all accrued dividends on such holder’s Existing C Preferred.

 

 

 

 

 

Each holder of Existing B Preferred that participates in the Series A-1 Offering shall, subject to the “Super Pro Rata Participation” provisions set forth below, (a) exchange each remaining share of Existing B Preferred of such holder (after giving effect to the forced conversion provisions of the immediately preceding paragraph) for one share of Series A-3 Convertible Preferred Stock, par value $.01 per share (the “ Series A-3 Stock ”), and (b) forfeit any and all accrued dividends on such holder’s Existing B Preferred.

 

 

 

 

 

Each holder of Existing A Preferred that participates in the Series A-1 Offering shall exchange each remaining share of Existing A Preferred of such holder (after giving effect to the forced conversion provisions of the immediately preceding paragraph) for one share of Series A-4 Convertible Preferred Stock, par value $.01 per share (the “ Series A-4 Stock ”).

 

 

 

Super Pro Rata Participation:

 

Notwithstanding the foregoing, any holder of Existing B Preferred or Existing C Preferred that purchases more than its full Pro Rata Portion of the Series A-1 Offering Existing Investor Available Amount shall, in connection with such holder’s exchange of shares of Existing Preferred Stock for shares of Series A-2 Stock or Series A-3 Stock, as applicable, in accordance with the provisions set forth above in this term sheet, not forfeit that amount of accrued dividends on such holder’s Existing Preferred equal to the dollar amount invested in the Series A-1 Offering by such holder that is in excess of its Pro Rata Portion of the Series A-1 Offering Existing Investor Available Amount (the “ Super Pro Rata Amount ”), but rather shall only forfeit accrued dividends in excess of the Super Pro Rata Amount and shall exchange the right to receive accrued dividends in an amount equal to the Super Pro Rata Amount for that number of additional shares of Series A-1 Stock obtained by dividing (a) such holder’s Super Pro Rata Amount by (b) the Series A-1 Original Purchase Price Per Share.

 

4



 

Going Forward Pay-to-Play:

 

Other than the potential forced conversion of shares of Existing Preferred into shares of Common Stock on a 5-for-1 basis as described under “Participation by Existing Preferred Stockholders” above, following the issuance of the Series A-1 Stock there will never be any pay-to-play provisions made applicable to, or implemented against, the New Preferred Stock (as defined below).

 

 

 

Conditions:

 

The closing of the Series A-1 Offering shall be conditioned upon (1) the prior or simultaneous execution and delivery of definitive documentation relating to the strategic alliance with, and related equity issuance to, Nordic (as defined below) and (2) the immediately subsequent closing of the Merger (as defined below).

 

 

 

Required Merger Approval:

 

In the definitive documentation for the purchase of shares of Series A-1 Stock, each investor will be required to (1) approve and adopt the Merger, as well as authorize the officers of the Company to execute and deliver such agreements, instruments and documents, for and in the name and on behalf of the Company, as such officer or officers may deem necessary, advisable or appropriate in order to effectuate the Merger, and (2) waive all rights, if any, under Section 262 of the Delaware General Corporation Law to seek an appraisal of any shares New Preferred Stock (as defined below) or Common Stock held by or acquired by such investor.

 

 

 

STRATEGIC ALLIANCE

 

 

 

Description:

 

Radius and Nordic Bioscience (“ Nordic ”) intend to enter into a strategic alliance under which Nordic will initially provide all services necessary and appropriate for the Phase 3 clinical trial for the subcutaneous formulation of BA058 (“ Fracture Study ”) (a detailed description of services will be included in the final strategic alliance agreement). The strategic alliance with Nordic may be extended to other BA058 clinical studies, including extension studies and transdermal formulation studies on terms to be agreed by the parties. In consideration for the services to be provided by Nordic, Radius will issue to Nordic the number of shares of Radius’ Series A-5 Convertible Preferred Stock, par value $.01 per share (the “ Series A-5 Stock ” and together with the Series A-1 Stock, the Series A-2 Stock, the Series A3 Stock, the Series A-4 Stock and the Series A-6 Stock described below, the “ New Preferred Stock ”) upon the execution of definitive documentation relating to the transaction (the “ Initial Nordic Shares ”) equal to the quotient (rounded to the nearest whole number) obtained by dividing (x) the United States Dollar equivalent of €371,864 by (y) the Series A-5 Purchase Price Per Share. The Initial Nordic Shares shall accrue quarterly dividends to be paid in the form of shares of Series A-6 Convertible Preferred Stock, par value $.01 per share (the “Series A-6 Stock”) as these services are delivered, as more fully described below.

 

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PROPOSED REVERSE MERGER

 

 

 

Description:

 

Prior to the closing of the Series A-1 Offering, Radius shall have entered into an Agreement and Plan of Merger pursuant to which the Company would complete a reverse merger with a Form 10 Shell. The reverse merger would take place in two steps: First, the Form 10 Shell would form a wholly-owned subsidiary that would merge with and into the Company (the “ Merger ”) resulting in the Company becoming a wholly-owned subsidiary of the Form 10 Shell; and Second, the Company would be merged up and into the Form 10 Shell pursuant to Section 253 of the Delaware General Corporation Law in a “short-form merger” (the resulting corporation being hereinafter referred to as the “ Surviving Corporation ”).

 

 

 

Consideration:

 

As consideration for the Merger, the Stockholders of the Radius will receive, in exchange for their shares of New Preferred Stock or Common Stock of Radius, shares of preferred stock and common stock, as the case may be, in the Surviving Corporation with terms, rights and preferences substantially similar (subject to the conversion rights/ratio of the preferred stock described below) to those of the shares of equity of Radius held by such stockholder prior to the closing of the Merger. Upon the consummation of the Merger, shares of Common Stock of Radius will be exchanged for shares of common stock of the Surviving Corporation at a ratio of 1:1. Due to the number of shares of preferred stock that the Surviving Corporation currently has authorized, and to avoid having to file a proxy statement with the SEC in connection with increasing such number of authorized shares, upon the consummation of the Merger, shares of New Preferred Stock will be exchanged for shares of preferred stock of the Surviving Corporation at a 10:1 ratio (i.e., 10 shares of New Preferred Stock will be exchanged for one share of corresponding preferred stock of the Surviving Corporation). Any fractional shares resulting from computations made in connection with such exchange will be paid out in cash. Each share of preferred stock of the Surviving Corporation will have the voting power equivalent of ten shares of common stock of the Surviving Corporation. To maintain as-converted ownership percentages, following the Merger, shares of preferred stock of the Surviving Corporation will be convertible into shares of common stock of the Surviving Corporation at a ratio of 1:10 (i.e., 1 share of preferred stock will convert into 10 shares of common stock).

 

 

 

TERMS OF THE NEW PREFERRED STOCK

 

 

 

Series A-1 Original Purchase Price Per Share:

 

$8.142

 

 

 

Series A-2 Original Purchase Price Per Share:

 

$8.142

 

 

 

Series A-3 Original Purchase Price Per Share:

 

$8.142

 

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Series A-4 Original Purchase Price Per Share:

 

$8.142

 

 

 

Series A-5 Original Purchase Price Per Share:

 

$8.142

 

 

 

Series A-6 Original Purchase Price Per Share:

 

$8.142

 

 

 

Ranking:

 

As to liquidation and dividends (other than with respect to the quarterly payment of the Series A-5 Accruing Dividend), each share of Series A1 Stock shall rank equally with each other share of Series A-1 Stock and senior to all shares of Series A-2 Stock, Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock. As to liquidation and dividends (other than with respect to the quarterly payment of the Series A-5 Accruing Dividend), each share of Series A-2 Stock shall rank equally with each other share of Series A-2 Stock and senior to all shares of Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock. As to liquidation and dividends (other than with respect to the quarterly payment of the Series A-5 Accruing Dividend) each share of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock shall rank equally with each other share of Series A-3 Stock, Series A5 and Series A-6 Stock and senior to all shares of Series A-4 Stock. Each share of Series A-4 Stock, shall rank equally with each other share of Series A-4 Stock.

 

 

 

Accruing Dividends:

 

Series A-1 Stock Accruing Dividend : 8% per annum compounding annually and payable only upon liquidation, dissolution or winding up of the Company. Accrued dividends shall be paid upon conversion of the Series A-1 Preferred Stock to Common Stock in either, at the sole discretion of the Company, the payment of cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by dividing (x) amount of such accrued and unpaid dividends thereon by (y) the then fair market value of a share of Common Stock.

 

 

 

 

 

Series A-2 Stock Accruing Dividend : 8% per annum compounding annually and payable only upon liquidation, dissolution or winding up of the Company. Accrued dividends shall be paid upon conversion of the Series A-2 Preferred Stock to Common Stock in either, at the sole discretion of the Company, the payment of cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by dividing (x) amount of such accrued and unpaid dividends thereon by (y) the then fair market value of a share of Common Stock.

 

 

 

 

 

Series A-3 Stock Accruing Dividend : 8% per annum compounding annually and payable only upon liquidation, dissolution or winding up of the Company. Accrued dividends shall be paid upon conversion of the Series A-3 Preferred Stock to Common Stock in either, at the sole discretion of the Company, the payment of cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by

 

7



 

 

 

dividing (x) amount of such accrued and unpaid dividends thereon by (y) the then fair market value of a share of Common Stock.

 

 

 

 

 

Series A-5 Stock Accruing Dividend : Accruing dividend payable in shares of Series A-6 Stock, representing up to an aggregate €36,814,531 in value for the Fracture Study (such stock dividend shares, the “ Bonus Shares ”). The number of Bonus Shares that Nordic shall be entitled to receive in the aggregate shall accrue on a calendar quarterly basis starting with the calendar quarter in which the first subject is enrolled in the Phase III clinical trial to be conducted by Nordic. The quarterly amounts of such Bonus Shares shall be calculated based upon the estimated time that will be required to complete the clinical study (following enrollment of the first study subject), lock the study database, transfer the study database to Radius and for Radius to accept the Final Tables Listings and Figures for the clinical study based on the study database. The parties, acting through a Project Committee, will evaluate the study timeline and adjust the pro rata amount to account for delays or accelerations in the performance of such Fracture Study. The amount of each quarterly dividend shall be determined by dividing the portion of €36,814,531 to be accrued in such quarter by the Fair Market Value (as defined below) on the date the dividend accrues. “ Fair Market Value ” for purposes of this calculation will equal the greater of (i) the Series A-5 Purchase Price Per Share (as such price per share may be adjusted for any stock splits, stock dividends, reverse stock splits, recapitalizations, mergers and other similar events affecting such Series A-5 Stock), (ii) the price per share of the preferred stock or common stock sold by Radius or a Shell Company Successor (as defined below) in the then most recent equity financing closed by Radius or the Shell Company Successor prior to the applicable accrual date; and (iii) the average of the closing prices of the common stock of Radius or a Shell Company Successor, as the case may be, on a securities exchange (if such common stock is traded on an exchange) or the average of the closing sale prices or secondarily the closing bid prices of such common stock (if such common stock is regularly traded over-the-counter) over the twenty (20) calendar day period ending two (2) calendar days prior to the date the stock dividend accrues. “ Shell Company Successor ” means a shell company that (i) has securities registered under the Securities Exchange Act of 1934, as amended, (ii) has nominal operations and nominal assets (prior to any of the transactions described in clause (iii)) and (iii) directly or indirectly through one or more direct or indirect subsidiaries acquires Radius and/or all or substantially all of its assets or business (whether pursuant to a stock purchase, an asset purchase, a merger or any other similar transaction) and in consideration for such acquisition issues to the former stockholders of Radius shares of capital stock of such shell company. Upon any conversion of the Series A-5 Stock, the Bonus Shares will continue to be paid but shall be paid in shares of Common Stock.

 

 

 

 

 

Series A-4 Stock and Series A-6 . There shall be no accruing dividends with respect to shares of Series A-4 Stock or Series A-6 Stock.

 

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Liquidation preference:

 

In the event of any liquidation, dissolution or winding up of the Company,

 

 

 

 

 

(a) the holders of Series A-1 Stock shall be entitled to receive, on a preferential basis with the liquidation preference payable to Series A-2 Stock, Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock, an amount per share equal to the Series A-1 Original Purchase Price Per Share, plus any accrued but unpaid dividends on such shares of Series A-1 Stock, and

 

 

 

 

 

(b) the holders of Series A-2 Stock shall be entitled to receive, on a preferential basis with the liquidation preference payable to Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock, an amount per share equal to the Series A-2 Original Purchase Price Per Share, plus any accrued but unpaid dividends on such shares of Series A-2 Stock, and

 

 

 

 

 

(c) the holders of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock shall be entitled to receive, on a pari passu basis with the liquidation preference payable to the holders of all other shares of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock but in preference to the liquidation preference payable to the holders of Series A-4 Stock and Common Stock, an amount per share equal to the applicable Original Purchase Price Per share, plus any accrued but unpaid dividends on such Shares of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock, if any; and

 

 

 

 

 

(d) the holders of Series A-4 Stock shall be entitled to receive, on a pari passu basis with the liquidation preference payable to the holders of all other shares of Series A-4 Stock but in preference to the liquidation preference payable to the holders of Common Stock, an amount per share equal to the Series A-4 Original Purchase Price Per share, plus any declared but unpaid dividends on such Shares of Series A-2 Stock; and

 

 

 

 

 

(e) after the payment of the liquidation preference of all outstanding shares of New Preferred Stock, all remaining proceeds shall be distributed among the holders of Series A-1 Stock, Series A-2 Stock, Series A-3 Stock and Common Stock on an as-converted basis.

 

 

 

 

 

A sale of the Company shall be deemed to be a liquidation unless waived by a vote of the holders of not less than the Required Investor Majority (as defined below).

 

 

 

Conversion:

 

Voluntary Conversion . Each holder of New Preferred Stock shall have the right to convert their shares New Preferred Stock, at any time, into shares of Common Stock. The initial conversion rate for each series of New Preferred Stock shall be 1:1, subject to any adjustment for any stock splits, stock dividends, reverse splits and similar events.

 

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Mandatory Conversion . Each share of New Preferred Stock will be subject to automatic conversion, at the then applicable conversion price, into Common Stock upon: (1) an election to convert made by holders of the Required Investor Majority, or (2) completion of listing of the Common Stock on a national securities exchange.

 

 

 

Voting Rights:

 

Generally . All of the New Preferred Stock will vote together as a single class with the Common Stock, except as outlined below in the sections entitled “Directors” and “Protective Provisions”.

 

 

 

Directors:

 

The Company’s charter and by-laws shall allow for up to seven (7) members on the Company’s Board of Directors. The size of the Board of Directors shall be initially set at seven (7). Holders of Series A-1 Stock shall have the right to elect two (2) directors (the “ A-1 Directors ”), who will initially be Martin Muenchbach and Ansbert Gadicke. Oxford Biosciences, HealthCare Ventures and Wellcome Trust, by majority vote, voting together, shall have the right to elect one (1) director (the “ G3 Director ”), who initially shall be Jonathan Fleming. One (1) member of the Board of Directors shall be the Company’s CEO. MPM Capital shall have the right to elect one (1) director who shall be an individual with particular expertise in the development of pharmaceutical products (the “ Industry Expert Director ”) and who initially shall be Elizabeth Stoner. The remaining two (2) directors will be designated “independent directors” and be nominated by a majority of the Board of Directors including a majority of the A-1 Directors, the G3 Director and the Industry Expert Director, acting together, and shall be elected by the holders of New Preferred Stock and Common Stock voting together as a single class. Such “independent directors” shall initially be Alan Auerbach and Kurt Graves. Until such time as shares of the Company’s capital stock are traded on a national securities exchange and all shares of the New Preferred Stock are converted into Common Stock, HealthCare Ventures shall have the right to have one (1) observer present at all meetings of the Board of Directors.

 

 

 

Protective Provisions:

 

Existing fundamental corporate transactions shall require the prior written approval or consent of holders of at least 70% of the outstanding shares of Series A-1 Stock, Series A-2 Stock and Series A-3 stock, voting together as a single class (the “ Required Investor Majority ”).

 

 

 

Registration Rights:

 

As soon as practicable, but not later than 60 days following the closing of the Merger, the Surviving Corporation shall file a registration statement with the SEC on the appropriate form to allow the resale of all shares of Common Stock of the Surviving Corporation outstanding as well as all shares of Common Stock issuable upon conversion of the shares of Preferred Stock of the Surviving Corporation issued in consideration of the Merger to the Preferred Stockholders. Following the closing of the Series A-1 Offering until the date on which the Common Stock becomes listed on a national securities exchange, the holders of New Preferred Stock shall have piggyback registration

 

10



 

 

 

rights on terms substantially similar to the piggyback registration rights held by the holders of Existing Preferred.

 

 

 

No Redemption:

 

None of the New Preferred Stock shall be redeemable.

 

 

 

Anti-dilution Protection:

 

All shares of Series A-1 Stock, Series A-2 and Series A-3 Stock shall have weighted-average anti-dilution protection (based on the applicable Original Purchase Price Per Share of such share of New Preferred Stock) and anti-dilution protection upon the occurrence of any subdivision or combination of the Common Stock, stock dividend and other distribution, reorganization, reclassification or similar event affecting the Common Stock, all on terms substantially similar to the anti-dilution protection afforded the Existing Preferred. Shares of Series A-4 Stock, Series A-5 Stock and Series A-6 Stock shall have no anti-dilution protection other than anti-dilution protection upon the occurrence of any subdivision or combination of the Common Stock, stock dividend and other distribution, reorganization, reclassification or similar event affecting the Common Stock on terms substantially similar to the anti-dilution protection afforded the Existing Series A Preferred.

 

 

 

Pre-emptive Rights:

 

Each holder of shares of Series A-1 Stock, Series A-2 and Series A-3 Stock shall have pre-emptive rights on terms substantially similar to the pre-emptive rights held by the holders of Existing Preferred.

 

 

 

Lock-Up:

 

Each Investor shall agree to a lock-up agreement as part of the final definitive investment documentation pursuant to which shares of Company capital stock will be subject to restrictions on transfer in certain circumstances.

 

11


 

AMENDMENT NO. 1

TO AMENDED AND RESTATED STOCK ISSUANCE AGREEMENT

 

RADIUS HEALTH, INC., a Delaware corporation ( “Radius” ), and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation ( “NB” ), are parties to that certain Amended and Restated Stock Issuance Agreement dated as of May 16, 2011 (the “Agreement” ). Pursuant to Section 8.3(b) of the Agreement, Radius and NB wish to enter into this Amendment No. 1 to the Agreement ( “Amendment No. 1” ) effective as of February 21, 2013 ( “Amendment Date” ).  Capitalized terms used in this Amendment No. 1 and not defined herein shall have the meanings ascribed to them in the Agreement.

 

Background

 

Radius and NB are, effective as of the Amendment Date, entering into certain Work Statements NB-2 and NB-3 ( “Work Statement NB-2 and NB-3” ) under the Clinical Trial Services Agreement dated as of March 29, 2011 (the “CTS Agreement” ).  Pursuant to Work Statement NB-2, NB has agreed to perform certain services relating to a Phase II clinical study of a transdermally delivered form of the Radius drug candidate known as BA058 in return for certain payments by Radius in the form of cash and equity. Pursuant to Work Statement NB-3, NB has agreed to perform certain services relating to an initial extension of the Phase III clinical study of the subcutaneous injection form of BA058 for an additional six months of standard-of-care osteoporosis treatment in return for certain payments by Radius in the form of cash and equity. Radius, in consideration of the activities of NB pursuant to the CTS Agreement and Work Statement NB-1 has previously sold to NB 6,443 shares of Series A-5 Convertible Preferred Stock, par value $0.0001 per share, of Radius (the “Series A-5 Preferred Stock” ), which shares entitle the holder to receive stock dividends payable in shares of Series A-6 Convertible Preferred Stock, par value $0.0001 per share, of Radius (the “ Series A-6 Preferred Stock ”) or (in the event that the Series A-5 Preferred Stock is converted and stock dividends are no longer payable) to receive payment in shares of another class or series of capital stock of Radius or any other Person having an aggregate value of up to an additional €36,814,531 in respect of services performed by NB pursuant to Work Statement NB-1 under the CTS Agreement as calculated on the date that such stock dividends or other payments accrue.  The parties now wish to amend the Agreement to provide for additional stock dividends payable in shares of Series A-6 Preferred Stock or (in the event that the Series A-5 Preferred Stock is converted and stock dividends are no longer payable) to receive payment in shares of another class or series of capital stock of Radius or any other Person having (i) an aggregate value of up to $2,919,945 in respect of services performed by NB pursuant to Work Statement NB-2; and (ii) an aggregate value of up to €4,519,863 and $310,000 in respect of services performed by NB pursuant to Work Statement NB-3;   as calculated on the date that such stock dividends or other payments accrue .

 

NOW THEREFORE, in consideration of the premises and mutual covenants set forth herein, the parties hereby agree as follows:

 

1. Series A-5 Preferred Stock Purchase Price Per Share.   It is understood and agreed that on the Amendment Date the Series A-5 Purchase Price Per Share is $81.42, and this value shall be used with respect to calculation of Bonus Shares in respect of Services provided pursuant to Work Statement NB-2 and NB-3.

 

2.    Reservation of Additional Series A-6 Preferred Stock.  Section 2 of the Agreement is hereby amended to add a new Section 2.3 to follow Section 2.2 and to read in full as follows:

 

“2.3  Reservation of Series A-6 Preferred Stock in respect of NB Services pursuant to Work Statements NB-2 and NB-3   Radius will, on or prior to the Amendment Date, authorize: (a) the accrual and issuance of all of the shares of Series A-6 Convertible Preferred Stock, par value $0.0001 per share (the “Series A-6 Preferred Stock” ), of Radius issuable to NB in respect of services provided pursuant to Work Statements NB-2and NB-3 in accordance with the provisions of this Agreement; and (b) the reservation of shares of Common Stock, par value $0.0001 per share for issuance upon conversion of the Series A-6 Preferred Stock issuable to NB in respect of services provided pursuant to Work Statements NB-2and NB-3 (the “Conversion Shares” ).  The Series A-5 Preferred Stock, the Series A-6 Preferred Stock and the Common Stock have the rights, privileges, preferences and restrictions set forth in the Certificate of Incorporation of Radius as filed with the Secretary of State of the State of Delaware on February 4, 2008, as amended by (i) a Certificate of Ownership and Merger and a Certificate of Designations of the Series A-1 Convertible Preferred Stock, Series A-2 Convertible Preferred Stock, Series A-3 Convertible Preferred Stock, Series A-4 Convertible Preferred Stock, Series A-5 Convertible Preferred Stock and Series A-6 Convertible Preferred Stock

 

1



 

(the “ Certificate of Designations ”), as filed with the Secretary of State of the State of Delaware on May 17, 2011, (ii) a Certificate of Amendment to the Certificate of Designations, as filed with the Secretary of State of the State of Delaware on January 19, 2012, (iii) a Certificate of Amendment to the Certificate of Designations, as filed with the Secretary of State of the State of Delaware on March 8, 2012, and (iv) a Certificate of Amendment to the Certificate of Designations, as filed with the Secretary of State of the State of Delaware on October 8, 2012  (such amendment filed on October 8, 2012, the “Charter Amendment” and the Certificate of Incorporation of Radius as described in the preceding clauses (i) through (iv) being referred to herein as the “Charter” ).  The Series A-5 Preferred Stock and the Series A-6 Preferred Stock shall have the same rights, privileges, preferences and restrictions except that the Series A-6 Preferred Stock shall not be entitled to accrue any shares of capital stock of Radius, whether as a stock dividend or otherwise, pursuant to, and in accordance with, the terms and conditions of this Agreement.

 

3.    Bonus Shares in Respect of Work Statement NB-2.  Section 3.1 of the Agreement is hereby amended to add a new Section 3.1(a1) and new Section 3.1(a2) to follow Section 3.1(a) and to read in full as follows:

 

“3.1(a1)  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), NB shall be entitled to receive stock dividends in respect of the Services it provides pursuant to Work Statement NB-2, payable in shares of Series A-6 Preferred Stock in accordance with the provisions of this Section 3.1, having an aggregate value (determined as provided in this Section 3.1) of up $2,919,945 as calculated on the date that such stock dividends accrue in accordance with this Section 3.1.  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), on each Accrual Date, beginning with the Accrual Date for the calendar quarter during which the first subject is enrolled in the clinical study that is the subject of Work Statement NB-2, each outstanding share of Series A-5 Preferred Stock shall accrue, as a stock dividend, a number of shares of Series A-6 Preferred Stock having a value (determined as provided further below in this Section 3.1) equal to (x)  $2,919,945 minus the aggregate value of any prior stock dividends that accrue pursuant to this Section 3.1(a1) (with such aggregate value of such prior stock dividends being determined as of the applicable prior Accrual Date) divided   by (y)  the number of calendar quarters the Project Committee has determined it will take to complete the clinical study that is the subject of Work Statement NB-2 and lock the study database and transfer the study database to Radius in its then most recent determination delivered in accordance with Section 3.1(b).

 

“3.1(a2)  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), NB shall be entitled to receive stock dividends in respect of the Services it provides pursuant to Work Statement NB-3, payable in shares of Series A-6 Preferred Stock in accordance with the provisions of this Section 3.1, having an aggregate value (determined as provided in this Section 3.1) of up €4,519,863 and $310,000 as calculated on the date that such stock dividends accrue in accordance with this Section 3.1.  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), on each Accrual Date, beginning with the first calendar quarter of 2013, each outstanding share of Series A-5 Preferred Stock shall accrue, as a stock dividend, a number of shares of Series A-6 Preferred Stock having a value (determined as provided further below in this Section 3.1) equal to (x)  the U.S. dollar equivalent of €4,519,863 (converted from euro to dollars in accordance with the provisions set forth in Section 3(b)) and $310,000 minus the aggregate value of any prior stock dividends that accrue pursuant to this Section 3.1(a2) (with such aggregate value of such prior stock dividends being determined as of the applicable prior Accrual Date) divided   by (y)  the number of calendar quarters the Project Committee has determined it will take to complete the clinical study that is the subject of Work Statement NB-3 and lock the study database and transfer the study database to Radius in its then most recent determination delivered in accordance with Section 3.1(b).

 

4.  Representations and Warranties of Radius Sections 4.1-4.5 of the Agreement shall not apply to the transactions contemplated by this Amendment No. 1.  Sections 4.6-4.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 1.  Radius hereby confirms that the representation and warranties of Radius set forth in Sections 4.6-4.8 of the Agreement are true and correct in all material respects and that all conditions required to be performed by Radius under the terms of the Agreement prior to or on the Amendment Date have been performed.

 

5.   Representations and Warranties of NB.    Sections 5.1-5.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 1 and the Bonus Shares to be issued NB pursuant to this Amendment No. 1.  NB hereby confirms that the representations and warranties of NB set forth in Sections 5.1-5.8 of the Agreement are true and correct in all material respects on the Amendment Date.

 

2



 

6.    Closing Conditions of NB.  NB’s obligation to enter into this Amendment No. 1 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of each of the following conditions, unless waived by NB:

 

6.1  Representations and Warranties.   The representations and warranties made by Radius in Section 4 shall be true and correct in all material respects as of the Amendment Date.

 

6.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No,. 1 to be performed by Radius on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date..

 

6.3  Certificates and Documents.   Radius shall deliver to NB a Certificate of the Secretary or an Assistant Secretary of Radius, dated as of the Amendment Date, certifying that attached thereto: (a) is a true and complete copy of the Charter, as amended by the Charter Amendment; (b) is a true and complete copy of the Radius By-Laws; and (c) is a true and complete copy of the resolutions of the Board of Directors and the stockholders of Radius authorizing and approving all matters in connection with this Agreement and the transactions contemplated hereby.

 

6.4  Compliance Certificate.   Radius shall have delivered to NB a certificate executed by the Chief Executive Officer of Radius on behalf of Radius, certifying the satisfaction of the conditions to the Amendment Date listed in Section 6.1.

 

7.    Closing Conditions of Radius Radius’ obligation to enter into this Amendment No. 1 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of the following conditions, unless waived by Radius:

 

7.1  Representations and Warranties.   The representations and warranties made by NB in Section 5 shall be true and correct in all material respects as of the Amendment Date.

 

7.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No. 1 to be performed by NB on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date.

 

7.3  Charter Amendment.   Prior to the Amendment Date, the Charter Amendment shall have been duly authorized, executed and filed by Radius with and accepted by the Secretary of State of the State of Delaware.

 

7.4  Securities Laws.   Prior to the Amendment Date, Radius shall be satisfied that the offer and sale of the Bonus Shares pursuant to this Amendment No. 1 shall be qualified or exempt from registration or qualification under all applicable federal and state securities laws (including receipt by Radius of all necessary blue sky law permits and qualifications required by any state, if any).

 

8.  Ratification.  Except to the extent expressly amended by this Amendment No. 1, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment No. 1.

 

9.  General.  Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank - signature page follows]

 

3



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 1 to be executed on their behalf by their duly authorized representatives as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

 

 

/s/ B. Nicholas Harvey

 

 

/s/ Thomas Nielsen

By:

B. Nicholas Harvey

 

By:

Thomas Nielsen

Title:

Chief Financial Officer

 

Title:

Chief Financial Officer

 

 

 

 

Notice Address

Notice Address

Radius Health, Inc.

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6th Floor

Herlev Hovedgade 207

Cambridge, MA 02139

2730 Herlev

USA

Denmark

Attn: President

Attn: Clinical Trial Leader & Medical Advisor /

 

Clinical Studies

Phone: 01.617.444.1834

Phone: 45.4452.5251

Fax: 01.617.551.4701

Fax: 45.4452.5251

 

4


 

AMENDMENT NO. 2

TO AMENDED AND RESTATED STOCK ISSUANCE AGREEMENT

 

RADIUS HEALTH, INC., a Delaware corporation ( “Radius” ), and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation ( “NB” ), are parties to that certain Amended and Restated Stock Issuance Agreement dated as of May 16, 2011 (as amended, the “Agreement” ). Pursuant to Section 8.3(b) of the Agreement, Radius and NB wish to enter into this Amendment No. 2 to the Agreement ( “Amendment No. 2” ) effective as of March 28, 2014 ( “Amendment Date” ).  Capitalized terms used in this Amendment No. 2 and not defined herein shall have the meanings ascribed to them in the Agreement.

 

Background

 

Firstly, Radius and NB are, effective as of the Amendment Date, entering into an Amendment No. 1 to Work Statement NB-3 ( “Work Statement NB-3” ) under the Clinical Trial Services Agreement dated as of March 29, 2011 (the “CTS Agreement” ).  Pursuant to Amendment No. 1 to Work Statement NB-3, NB has agreed to perform certain services relating to a Period 2 extension of the Phase III clinical study of the subcutaneous injection form of abaloparatide (formerly, BA058) for an additional eighteen months of standard-of-care osteoporosis treatment in return for certain payments by Radius in the form of cash and equity. Radius, in consideration of the activities of NB pursuant to the CTS Agreement and Work Statement NB-1 under the CTS Agreement (“ Work Statement NB-1 ”) has previously sold to NB 6,443 shares of Series A-5 Convertible Preferred Stock, par value $0.0001 per share, of Radius (the “Series A-5 Preferred Stock” ), which shares entitle NB, as the holder thereof, to receive stock dividends payable in shares of Series A-6 Convertible Preferred Stock, par value $0.0001 per share, of Radius (the “ Series A-6 Preferred Stock ”) or (in the event that the Series A-5 Preferred Stock is converted and stock dividends are no longer payable) to receive payment in shares of another class or series of capital stock of Radius or any other Person, in each case, having an aggregate value of up to: (i) an additional €36,814,531 in respect of services performed by NB pursuant to Work Statement NB-1; (ii) an aggregate value of up to $2,919,945 in respect of services performed by NB pursuant to Work Statement NB-2 under the CTS Agreement (“ Work Statement NB-2 ”); and (iii) an aggregate value of up to €4,519,863 and $310,000 in respect of services performed by NB pursuant to Work Statement NB-3, as calculated on the date that such stock dividends or other payments accrue.  The parties now wish to amend the Agreement to provide for additional stock dividends payable in shares of Series A-6 Preferred Stock or (in the event that the Series A-5 Preferred Stock is converted and stock dividends are no longer payable) to receive payment in shares of another class or series of capital stock of Radius or any other Person, in each case, as follows:

 

(A)        having an aggregate value of up to €2,967,638 and $527,740 in respect of services performed by NB pursuant to Amendment No. 1 to Work Statement NB-3 (as calculated on the date that such stock dividends or other payments accrue); and

 

(B)        having an aggregate value of up to $5,000,000 for the Performance Incentive Bonus Program described in Amendment No. 4 to Work Statement NB-1 (the “ PIBP ”) in relation to timely completion of activities by NB related to the Phase III clinical study of the subcutaneous injection form of abaloparatide pursuant to Amendment No. 4 to Work Statement NB-1 (as calculated on the date that such stock dividends or other payments accrue should there be no underwritten initial public offering of shares of Radius’ common stock (an “ IPO ”) that is consummated prior to May 31, 2014 and any payments under the PIBP are paid as part of the Bonus Equity Payment Amount rather than cash).

 

Secondly, in anticipation of a possible IPO the parties wish to modify the payment terms under the Agreement by (i) the immediate payment of certain stock dividends payable to NB in shares of Series A-6 Preferred Stock that would have accrued during 2014; and (ii) the conversion of the right to receive an aggregate value of stock dividends beyond 2014 into the right to receive a substitute cash payment upon certain conditions.

 

Thirdly, the parties wish to modify the method of calculation of the number of Bonus Shares that accrue in any calendar quarter in the form of stock dividends accruing on the number of shares of Series A-5 Preferred Stock issued and outstanding as of an applicable Accrual Date to not round down in performing such calculation to a whole number less than one for any Work Statement.

 

NOW THEREFORE, in consideration of the premises and mutual covenants set forth herein, the parties hereby agree as follows:

 



 

1. Series A-5 Preferred Stock Purchase Price Per Share.   It is understood and agreed that on the Amendment Date the Series A-5 Purchase Price Per Share is $81.42, and this value shall be used with respect to calculation of Bonus Shares in respect of Services provided pursuant to Amendment No. 1 of Work Statement NB-3 and the Performance Incentive Bonus Shares.

 

2.    Definition of Bonus Equity Payment Amount.   The definition of “Bonus Equity Payment Amount” in Section 1.1 of the Agreement is hereby amended and restated in its entirety to read as follows:

 

Bonus Equity Payment Amount ” means the sum of (i) €36,814,531, which represents the maximum portion of the fees and expenses payable to NB in connection with all services rendered by, or on behalf of NB, pursuant to the CTS Agreement and Work Statement NB-1 under the CTS Agreement that NB has agreed Radius may satisfy by issuing the Bonus Shares pursuant to, and in accordance with, the provisions of this Agreement, (ii)  $2,919,945, which represents the maximum portion of the fees and expenses payable to NB in connection with all services rendered by, or on behalf of NB, pursuant to the CTS Agreement and Work Statement NB-2 under the CTS Agreement that NB has agreed Radius may satisfy by issuing the Bonus Shares pursuant to, and in accordance with, the provisions of this Agreement and (iii) €7,487,501 and $837,740, which amounts represent the maximum portion of the fees and expenses payable to NB in connection with all services rendered by, or on behalf of NB, pursuant to the CTS Agreement and Work Statement NB-3 under the CTS Agreement that NB has agreed Radius may satisfy by issuing the Bonus Shares pursuant to, and in accordance with, the provisions of this Agreement; provided, however, that such amount may be increased as necessary to account for any amounts payable in Bonus Shares pursuant to the terms of the Performance Incentive Bonus Program described in Amendment No. 4 to Work Statement NB-1 (the “ PIBP ”).”

 

3.  Bonus Shares in Respect of Amendment No. 1 to Work Statement NB-3.  Section 3.1 of the Agreement is hereby amended to add a new Section 3.1(a3) to follow Section 3.1(a2) and to read in full as follows:

 

“3.1(a3)  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), NB shall be entitled to receive stock dividends in respect of the Services it provides pursuant to Amendment No. 1 to Work Statement NB-3, payable in shares of Series A-6 Preferred Stock in accordance with the provisions of this Section 3.1, having an aggregate value (determined as provided in this Section 3.1) of up to €2,967,638 and $527,740 as calculated on the date that such stock dividends accrue in accordance with this Section 3.1.  Accordingly, subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), on each Accrual Date during the calendar quarters that the Project Committee has determined it will take to complete the clinical study that is the subject of Work Statement NB-3 and lock the study database and transfer the study database to Radius in its then most recent determination delivered in accordance with Section 3.1(b), beginning with the Accrual Date that occurs in the second calendar quarter of 2013, each outstanding share of Series A-5 Preferred Stock shall accrue, as a stock dividend, a number of shares of Series A-6 Preferred Stock having a value (determined as provided further below in this Section 3.1) equal to (x)  the U.S. dollar equivalent of €2,967,638 (converted from euro to dollars in accordance with the provisions set forth in Section 3(b)) and $527,740 minus the aggregate value of any prior stock dividends that accrue pursuant to this Section 3.1(a3)(with such aggregate value of such prior stock dividends being determined as of the applicable prior Accrual Date) divided by (y)  the number of calendar quarters the Project Committee has determined it will take to complete the clinical study that is the subject of Work Statement NB-3 and lock the study database and transfer the study database to Radius in its then most recent determination delivered in accordance with Section 3.1(b).

 

4.    Performance Incentive Bonus Shares in Respect of Amendment No. 4 to Work Statement NB-1.  Section 3.1 of the Agreement is hereby amended to add a new Section 3.1(a4) to follow Section 3.1(a3) and to read in full as follows:

 

“3.1(a4)  Subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), in the event that no underwritten initial public offering of shares of Radius’ common stock (an “ IPO ”) has occurred prior to May 31, 2014 and any payments under the PIBP are accordingly to be made as part of the Bonus Equity Payment Amount rather than in cash pursuant to the terms of Amendment No. 4 to Work Statement NB-1, NB shall be entitled to receive stock dividends in respect of any amounts due under the PIBP pursuant to Amendment No. 4 to Work Statement NB-1, payable in shares of Series A-6 Preferred Stock in accordance with the provisions of this Section 3.1, having an aggregate value (determined as provided in this Section 3.1) of up to $5,000,000 as calculated on the date that such stock dividends accrue in accordance with this Section 3.1.”

 

2



 

5.    Modification of Payment Terms.  Section 3.1 of the Agreement is hereby amended to add a new Section 3.1(a5) to follow Section 3.1(a4) and to read in full as follows:

 

“3.1(a5) As soon as reasonably practical after execution of this Amendment No. 2 and subject to the terms and conditions of this Agreement (including the limitations set forth in Section 3.4), Radius shall declare a stock dividend of 29 shares of Series A-6 Preferred Stock for each Series A-5 Preferred Share held by NB for a total of 186,847 shares of Series A-6 Preferred Stock in full satisfaction of all stock dividends payable in 2014 under this Agreement in relation to Work Statement NB-1 and Work Statement NB-3, excluding the PIBP under Section 3.1(a4). Furthermore, in the event an IPO occurs prior to May 31, 2014, the balance owed in relation to Work Statement NB-1 and Work Statement NB-3 for all periods of time after 2014, excluding the PIBP, shall be converted into the right to receive a total cash payment of $4,300,000 payable in ten equal monthly instalments of $430,000 beginning on March 31, 2015.  For purposes of clarification, from and after the consummation of an IPO, any and all consideration to be paid to Nordic pursuant to this Agreement shall be paid in cash.

 

6.    Calculation of Bonus Shares in the form of stock dividends.   Section 3.1 of the Agreement is hereby amended to replace Section 3.1(b) thereof with a new Section 3.1(b) to read in full as follows:

 

“(b) When calculating the aggregate number of Bonus Shares accruing in each calendar quarter, Radius shall convert the portion of €36,814,531 to accrue in such calendar quarter into U.S. Dollars using the simple average of the exchange rate for buying U.S. Dollars with EUROS set forth in The Wall Street Journal(Online Edition) Market Data Center at http://online.wsj.com/mdc/public/page/marketsdata.html for all Mondays in such calendar quarter.  Radius shall then calculate the aggregate number of Bonus Shares accrued in such calendar quarter by dividing (x)  the U.S. Dollar equivalent (determined in accordance with the provisions set forth in the preceding sentence) of the Applicable Quarterly Amount, by (y)  the Fair Market Value as of the applicable Accrual Date, and rounding down the resulting quotient to the nearest whole number.  In the event that the Bonus Shares that accrue in any calendar quarter are in the form of stock dividends accruing on the shares of Series A-5 Preferred Stock that are outstanding on the Accrual Date applicable to such calendar quarter, the number of Bonus Shares accruing in such calendar quarter with respect to each share of Series A-5 Preferred Stock outstanding on the applicable Accrual Date shall be equal to the quotient (rounded down to the nearest whole number but not less than one for each applicable Work Statement) obtained by dividing (i)  the number of Bonus Shares that accrue on such applicable Accrual Date by (ii)  the total number of shares of Series A-5 Preferred Stock issued and outstanding as of such applicable Accrual Date.”

 

7.    Tax Withholding.  Section 8 of the Agreement is hereby amended to add a new Section 8.13 to follow Section 8.12 and to read in full as follows:

 

“Radius shall be entitled to deduct and withhold from any consideration or other payment payable pursuant to this Agreement to NB such amounts as are required to be deducted or withheld therefrom under any applicable legal requirement.  To the extent that amounts are deducted or withheld for any required withholding, such amounts shall be treated for all purposes hereunder as having been paid to NB.  NB hereby agrees that it will timely pay all taxes and fees upon the income and other compensation it has earned from Radius, and will indemnify and hold Radius harmless against the claims of any governmental taxing authority made in connection with the revenue and other compensation derived by NB under this Agreement.”

 

8.  Representations and Warranties of Radius Sections 4.1-4.5 of the Agreement shall not apply to the transactions contemplated by this Amendment No. 2.  Sections 4.6-4.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 2.  Radius hereby confirms that the representation and warranties of Radius set forth in Sections 4.6-4.8 of the Agreement are true and correct in all material respects and that all conditions required to be performed by Radius under the terms of the Agreement prior to or on the Amendment Date have been performed.

 

9.   Representations and Warranties of NB.    Sections 5.1-5.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 2 and the Bonus Shares to be issued to NB pursuant to this Amendment No. 2.  NB hereby confirms that the representations and warranties of NB set forth in Sections 5.1-5.8 of the Agreement are true and correct in all material respects on the Amendment Date.

 

3


 

10.    Closing Conditions of NB.  NB’s obligation to enter into this Amendment No. 2 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of each of the following conditions, unless waived by NB:

 

10.1  Representations and Warranties.   The representations and warranties made by Radius in Section 4 shall be true and correct in all material respects as of the Amendment Date.

 

10.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No. 2 to be performed by Radius on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date.

 

11.    Closing Conditions of Radius Radius’ obligation to enter into this Amendment No. 2 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of the following conditions, unless waived by Radius:

 

11.1  Representations and Warranties.   The representations and warranties made by NB in Section 5 shall be true and correct in all material respects as of the Amendment Date.

 

11.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No. 2 to be performed by NB on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date.

 

11.3  Securities Laws.   Prior to the Amendment Date, Radius shall be satisfied that the offer and sale of the Bonus Shares pursuant to this Amendment No. 2 shall be qualified or exempt from registration or qualification under all applicable federal and state securities laws (including receipt by Radius of all necessary blue sky law permits and qualifications required by any state, if any).

 

12.  Ratification.  Except to the extent expressly amended by this Amendment No. 2, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended to date, including by this Amendment No. 2.

 

13.  General.  This Amendment No. 2 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

14.  Applicable Law . This Amendment No. 2 shall be governed by, subject to, and construed in accordance with the substantive laws of Massachusetts without regard for any choice or conflict of laws rule or provision that would result in the application of the substantive law of any other jurisdiction.

 

[remainder of this page intentionally left blank - signature page follows]

 

4



 

IN WITNESS WHEREOF the parties have caused this Amendment No. 2 to be executed on their behalf by their duly authorized representatives as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

/s/ Robert E. Ward

 

/s/ Thomas Nielson

By: Robert E. Ward

By: Thomas Nielson

Title: President and CEO

Title: CFO

 

 

Notice Address

Notice Address

Radius Health, Inc.

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6th Floor

Herlev Hovedgade 207

Cambridge, MA 02139

2730 Herlev

USA

Denmark

Attn: President

Attn: Clinical Trial Leader & Medical Advisor /

 

Clinical Studies

Phone: 01.617.444.1834

Phone: 45.4452.5251

Fax: 01.617.551.4701

Fax: 45.4452.5251

 


 

AMENDMENT NO. 3

TO AMENDED AND RESTATED STOCK ISSUANCE AGREEMENT

 

RADIUS HEALTH, INC., a Delaware corporation ( “Radius” ), and NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S, a Danish corporation ( “NB” ), are parties to that certain Amended and Restated Stock Issuance Agreement dated as of May 16, 2011 (as amended, the “Agreement” ). Pursuant to Section 8.3(b) of the Agreement, Radius and NB wish to enter into this Amendment No. 3 to the Agreement ( “Amendment No. 3” ) effective as of May 19, 2014 ( “Amendment Date” ).  Capitalized terms used in this Amendment No. 3 and not defined herein shall have the meanings ascribed to them in the Agreement.

 

Background

 

Radius and NB are now wish to amend the IPO date under the Agreement. NOW THEREFORE, in consideration of the premises and mutual covenants set forth herein, the parties hereby agree as follows:

 

1.    Amendment of the IPO date. The latest date upon which and IPO is to be consummated by Radius under Section 3.1(a4) and Section 3.1(a5) is hereby amended from May 31, 2014 to June 30, 2014.

 

2.  Representations and Warranties of Radius Sections 4.1-4.5 of the Agreement shall not apply to the transactions contemplated by this Amendment No. 3.  Sections 4.6-4.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 3.  Radius hereby confirms that the representation and warranties of Radius set forth in Sections 4.6-4.8 of the Agreement are true and correct in all material respects and that all conditions required to be performed by Radius under the terms of the Agreement prior to or on the Amendment Date have been performed.

 

3.   Representations and Warranties of NB.    Sections 5.1-5.8 of the Agreement shall apply to the transactions contemplated by this Amendment No. 3 and the Bonus Shares to be issued to NB pursuant to this Amendment No. 3.  NB hereby confirms that the representations and warranties of NB set forth in Sections 5.1-5.8 of the Agreement are true and correct in all material respects on the Amendment Date.

 

4.    Closing Conditions of NB.  NB’s obligation to enter into this Amendment No. 3 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of each of the following conditions, unless waived by NB:

 

5.1  Representations and Warranties.   The representations and warranties made by Radius in Section 4 shall be true and correct in all material respects as of the Amendment Date.

 

5.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No. 3 to be performed by Radius on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date.

 

6.    Closing Conditions of Radius Radius’ obligation to enter into this Amendment No. 3 on the Amendment Date is subject to the fulfillment on or before the Amendment Date of the following conditions, unless waived by Radius:

 

7.1  Representations and Warranties.   The representations and warranties made by NB in Section 5 shall be true and correct in all material respects as of the Amendment Date.

 

7.2  Covenants.   All covenants, agreements and conditions contained in this Amendment No. 3 to be performed by NB on or prior to the Amendment Date shall have been performed or complied with in all material respects as of the Amendment Date.

 

7.3  Securities Laws.   Prior to the Amendment Date, Radius shall be satisfied that the offer and sale of the Bonus Shares pursuant to this Amendment No. 3 shall be qualified or exempt from registration or qualification under all applicable federal and state securities laws (including receipt by Radius of all necessary blue sky law permits and qualifications required by any state, if any).

 

8.  Ratification.  Except to the extent expressly amended by this Amendment No. 3, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term

 



 

“Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended to date, including by this Amendment No. 3.

 

9.  General.  This Amendment No. 3 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

10.  Applicable Law . This Amendment No. 3 shall be governed by, subject to, and construed in accordance with the substantive laws of Massachusetts without regard for any choice or conflict of laws rule or provision that would result in the application of the substantive law of any other jurisdiction.

 

IN WITNESS WHEREOF the parties have caused this Amendment No. 3 to be executed on their behalf by their duly authorized representatives as of the Amendment Date.

 

 

RADIUS HEALTH, INC.

 

NORDIC BIOSCIENCE CLINICAL DEVELOPMENT VII A/S

 

 

 

/s/ B.N. Harvey

 

 

/s/ Thomas Nielson

By: B.N. Harvey

 

 

By: Thomas Nielson

Title: CFO

 

 

Title: CFO

 

 

 

Notice Address

 

Notice Address

Radius Health, Inc.

 

Nordic Bioscience Clinical Development VII A/S

201 Broadway, 6th Floor

 

Herlev Hovedgade 207

Cambridge, MA 02139

 

2730 Herlev

USA

 

Denmark

Attn: President

 

Attn: Clinical Trial Leader & Medical Advisor /

 

 

Clinical Studies

Phone: 01.617.444.1834

 

Phone: 45.4452.5251

Fax: 01.617.551.4701

 

Fax: 45.4452.5251

 

2




Exhibit 10.15

 

CONFIDENTIAL

 

LICENSE AGREEMENT*

 

BETWEEN

 

SCRAS S.A.S.

 

AND

 

NUVIOS

 

27 September 2005

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

TABLE OF CONTENTS

 

 

 

Page

 

 

 

ARTICLE 1

INTERPRETATION — DEFINITIONS

1

 

 

 

ARTICLE 2

GRANT OF RIGHTS

9

 

 

 

ARTICLE 3

MILESTONE PAYMENTS

13

 

 

 

ARTICLE 4

PAYMENTS BASED ON SALES OF LICENSED PRODUCT

15

 

 

 

ARTICLE 5

PAYMENT, REPORTING, AUDITING

17

 

 

 

ARTICLE 6

DEVELOPMENT GOVERNANCE

19

 

 

 

ARTICLE 7

DEVELOPMENT PLAN AND CONDUCT OF DEVELOPMENT ACTIVITIES

21

 

 

 

ARTICLE 8

DEVELOPMENT — REGULATORY AND SAFETY

24

 

 

 

ARTICLE 9

MANUFACTURE AND SUPPLY

26

 

 

 

ARTICLE 10

COMMERCIALIZATION

28

 

 

 

ARTICLE 11

INTELLECTUAL PROPERTY

31

 

 

 

ARTICLE 12

CONFIDENTIAL INFORMATION

38

 

 

 

ARTICLE 13

PUBLICATION AND PRESS RELEASE

39

 

 

 

ARTICLE 14

REPRESENTATIONS, WARRANTIES AND COVENANTS

41

 

 

 

ARTICLE 15

TERM AND TERMINATION

44

 

 

 

ARTICLE 16

INDEMNIFICATION

48

 

 

 

ARTICLE 17

DISPUTE RESOLUTIONS AND GOVERNING LAW

49

 

 

 

ARTICLE 18

MISCELLANEOUS

50

 

 

 

APPENDIX A - CHEMICAL STRUCTURE OF BIM-44058

54

 

 

APPENDIX B - IPSEN PATENT RIGHTS

55

 

 

APPENDIX C — NUVIOS DEVELOPMENT PLAN

57

 

 

APPENDIX D —

 

 

 

APPENDIX E — IPSEN INDS AND OTHER APPLICATIONS FOR REGULATORY APPROVAL

85

 



 

CONFIDENTIAL

 

LICENSE AGREEMENT

 

This License Agreement (“Agreement”) is entered into on September 27, 2005 by and between, on the one hand, SCRAS S.A.S., a French corporation, with its principal office at 42, Rue du Docteur Blanche, 75016 Paris, France, on behalf of itself and its Affiliates (collectively, “Ipsen”), and, on the other hand, Nuvios, Inc., a United States corporation, with its principal office at 300 Technology Square — 5 th  floor, Cambridge, MA 02139, on behalf of themselves and their Affiliates (collectively, “Nuvios”).

 

Recitals

 

1.                                       Ipsen has developed and owns intellectual property rights related to proprietary compounds known as BIM 44058 and analogs and possesses know-how including know-how related to formulation technology including sustained release formulations.

 

2.                                       The management of Nuvios has expertise in the development of pharmaceutical products for the treatment of osteoporosis.

 

3.                                       Nuvios has interest in having access to BIM-44058 and analogs claimed under the Ipsen Patent Rights (as defined below), to pursue a worldwide development program, and thereafter, to commercialize the resulting products.

 

4.                                       The Parties have prepared this Agreement to govern the development and commercialization of products resulting from this Agreement.

 

Now, therefore, in consideration of the premises and the mutual covenants and agreements contained in this Agreement, the Parties, intending to be legally bound, do hereby agree as follows:

 

ARTICLE 1   INTERPRETATION — DEFINITIONS

 

1.1.                             In this Agreement, unless the context otherwise requires, all references to a particular Article, Section, or Appendix, shall be a reference to that Article, Section or Appendix, in or to this Agreement, as it may be amended from time to time pursuant to this Agreement.

 

1.1.1.                                      Headings are inserted for convenience only and shall not affect the meaning or interpretation of any provision of this Agreement.

 

1.1.2.                                      This Agreement incorporates all Appendices as a part of this Agreement by reference.

 

1.1.3.                                      The term “including” (or any variation thereof such as “include”) shall be without limitation to the generality of the preceding words.

 

1.1.4.                                      Unless the contrary intention appears, words in the singular shall include the plural and vice versa.

 

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1.1.5.                                      Unless the contrary intention appears, words denoting persons shall include any individual, partnership, company, corporation, joint venture, trust, association, organization or other entity.

 

1.1.6.                                      Reference to any statute or regulation includes any modification or re-enactment of that statute or regulation.

 

The following capitalized terms, whether used in the singular or the plural, shall have the following meanings as used in this Agreement unless otherwise specifically indicated:

 

1.2.                             Accounting Period shall mean each calendar quarter commencing respectively on January 1, April 1, July 1 and October 1, each being the first day of an Accounting Period, and finishing respectively on March 31, June 30, September 30 and December 31, each being the last day of an Accounting Period.

 

1.3.                             Affiliate shall mean (a) an entity which owns, directly or indirectly, a controlling interest in a Party, by stock ownership or otherwise, (b) any entity in which a. Party owns a controlling interest, by stock ownership or otherwise; or (c) any entity, under direct or indirect common control with a Party. For purposes of this paragraph, “controlling interest” and “control” mean ownership of fifty percent (50%) or more of the voting stock permitted to vote for the election of the board of directors or any other arrangement resulting in control or the right to control the management and the affairs of the Party.

 

1.4.                             BIM-44058 shall mean the compound the chemical structure of which is set forth on Appendix A.

 

1.5.                             Bundled Product shall mean Licensed Product(s) sold to a third party with one or more other products or services in circumstances where either (i) the price of the Licensed Product(s) is not shown separately on the invoice or (ii) the Licensed Product(s) (or a portion of the units of Licensed Product(s)) are detailed on a separate invoice where the price is shown as nil (free of charge) for the Licensed Product(s) (or for those units of the Licensed Product(s)).

 

1.6.                             Confidential Information shall have the meaning set forth in Article 12.

 

1.7.                             Contractor shall mean any third party with whom Nuvios enters into an agreement pursuant to which Nuvios grants to such third party the right to commercialize (including, without limitation, the right to promote, market and/or sell) Licensed Product in any country of the Territory. Notwithstanding the foregoing, the term “Contractor” shall in no event include (i) any Affiliate of Nuvios or (ii) any such third party which whom Nuvios enters into an agreement if the relationship established between Nuvios and such third party pursuant to such agreement is for such third party to be a wholesaler of Licensed Product in any country of the Territory.

 

1.8.                             Cover (as an adjective or as a verb including conjugations and variations such as “Covered,” “Coverage” or “Covering”) shall mean that the developing, making, using, offering for sale, promoting, selling or importing of a given compound, formulation or product would infringe a Valid Claim of an issued patent in the absence of a license under such Valid Claim.

 

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The determination of whether a compound, formulation or product is covered by a particular Valid Claim shall be made on a country-by-country basis.

 

1.9.                             Development shall mean the Pre-clinical Studies, Phase I, II & III Clinical Trials, filing of NDAs, and other activities, including pharmaceutical and manufacturing development as well as regulatory work, necessary to obtain Regulatory Approval of a Licensed Product.

 

1.10.                      Development Plan shall mean any version and variations of a document prepared for the Development of a Licensed Product in the Territory, that outlines the Development activities including regulatory strategies, to be performed by Nuvios under this Agreement. Such a document shall contain targeted timelines of the Development phases and clinical endpoints.

 

1.11.                      Effective Date shall mean the latest of the dates of signature by each Party as shown on the signature page of this Agreement.

 

1.12.                      EMEA shall mean the European Medicines Agency or any successor agency.

 

1.13.                      FDA shall mean the United States of America Food and Drug Administration or any successor agency.

 

1.14.                      First Commercial Sale shall mean, in each country of the Territory, each first invoiced sale to a third party of Licensed Product in the country after obtaining Regulatory Approval in such country.

 

1.15.                      FTE shall mean a period equivalent to the number of hours that an employee in the full time employment of either Party would be obliged to spend at work in any twelve (12) month period of continuous employment.

 

1.16.                      Gross Sales shall mean the gross amount invoiced by Nuvios, its Affiliates or Contractors for sales of a Licensed Product to third parties in the Territory. For purposes of clarification, the gross amount invoiced among Nuvios, its Affiliates or Contractors with respect to sales of Licensed Product shall not be considered as Gross Sales. Notwithstanding the foregoing provisions of this definition, sales of Licensed Product for use in clinical or pre-clinical trials or other research or development activities or free of charge dispositions of Licensed Product for purposes of a commercially reasonable sampling program shall not give rise to any Gross Sales for purposes of this Agreement.

 

1.17.                      Health Agency shall mean a governmental or official body in a given country of the Territory, including FDA and EMEA, as well as any national or international or local regulatory agency, department, bureau or other governmental entity, which reviews, validates and/or delivers Regulatory Approvals.

 

1.18.                      IND shall mean an application to the FDA, the filing of which is necessary for the first administration to humans of Licensed Product, or the equivalent application to the equivalent agency in any other country or group of countries.

 

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1.19.                      Infringe (as a noun, adjective or verb including conjugations and variations such as “Infringed,” “Infringes”, “Infringing” and “Infringement”) shall mean infringement, misappropriation, unauthorized use, misuse or other violation of the Patent Rights, know-how, inventions, trade secrets or other intellectual property (except trademarks) of any person or entity, whether such person or entity owns such Patent Rights, Know-How, inventions, trade secrets or other intellectual property (except trademarks) or otherwise has the valid right of use thereof, including, without limitation, pursuant to a license.

 

1.20.                      Invention shall mean any invention or discovery, whether or not patentable, made as a result of the research or Development activities of a Party or the Parties pursuant to, or in connection with, this Agreement and which relates to Licensed Product or to Licensed Compound. An “Invention” may be made by employees of Ipsen solely or jointly with a third party (an “Ipsen Invention” ), by employees of Nuvios solely or jointly with a third party (a “Nuvios Invention” ), or jointly by employees of Ipsen and Nuvios with or without a third party (a “Joint Invention” ), in each instance as determined by U.S. laws of inventorship.

 

1.21.                      Ipsen Compound Know How shall mean all Ipsen Know-How other than Ipsen Formulation Know-How.

 

1.22.                      Ipsen Compound Patent Rights shall mean all Ipsen Patent Rights other than Ipsen Formulation Patent Rights. The Ipsen Compound Patent Rights on the Effective Date are listed in Appendix B1 to this Agreement.

 

1.23.                      Ipsen Compound Technology shall mean all Ipsen Compound Know-How and Ipsen Compound Patent Rights.

 

1.24.                      Ipsen Formulation Know How shall mean all Ipsen Know-How that is related to the delivery or formulation of peptides (including Ipsen Solid Technology).

 

1.25.                      Ipsen Formulation Patent Rights shall mean all Ipsen Patent Rights that are related to the delivery or formulation of peptides (including Ipsen Solid Technology) The Ipsen Formulation Patent Rights on the Effective Date are listed in Appendix B2 to this Agreement.

 

1.26.                      Ipsen Formulation Technology shall mean all Ipsen Formulation Know-How and Ipsen Formulation Patent Rights.

 

1.27.                      Ipsen Joint Technology Rights shall mean all of Ipsen’s right, title and interest in the Joint Patent Rights and the Joint Inventions.

 

1.28.                      Ipsen Know-How shall mean all Know-How that (A) Ipsen owns, or otherwise under which Ipsen has right to grant licenses or to give access to use, as of the Effective Date or at any time during the Term and (B) is necessary or useful to the research, Development, manufacture, marketing, promotion, use, sale, import or export of Licensed Compound or Licensed Product, including, without limitation, all data and information regarding the safety and efficacy of Licensed Compound or Licensed Product. The term “Ipsen Know-How” shall also include all Know-How in connection with Ipsen Inventions, but shall not include any Joint Inventions.

 

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1.29.                      Ipsen Patent Rights means all Patent Rights that (A) Ipsen owns, or otherwise under which Ipsen has the right to grant licenses, as of the Effective Date or at any time during the Term and (B) is necessary or useful to the research, Development, manufacture, marketing, promotion, use, sale, import or export of Licensed Compound or Licensed Product. The term “Ipsen Patent Rights” shall also include all Patent Rights claiming Ipsen Inventions, but shall not include any Joint Patent Rights. Appendix B lists all Ipsen Patent Rights as of the Effective Date.

 

1.30.                      Japanese Development Plan shall mean the then current version of a document that details the development activities and other activities, including pharmaceutical and manufacturing as well as regulatory work to be performed by Teijin in Japan that are necessary or useful to obtain Regulatory Approval and commercialize Licensed Product in Japan.

 

1.31.                      Joint Patent Rights means Patent Rights that claim Joint Inventions.

 

1.32.                      JSC shall mean the Joint Steering Committee referred to in Article 6.

 

1.33.                      Know-How shall mean technical and other information, including information comprising or relating to concepts, discoveries, data, designs, formulae, ideas, inventions, methods, models, assays, research plans, procedures, designs for experiments and tests and results of experimentation and testing (including results of research or Development or other developments), formulations, processes (including manufacturing processes, specifications and techniques), laboratory records, chemical, pharmacological, toxicological, clinical, analytical and quality control data, trial data, case report forms, data analyses, reports, manufacturing data, pre-clinical data and summaries and information contained in submissions to, and information from, ethical committees and Health Agencies, including documents containing any of the above.

 

1.34.                      Licensed Compound means (i) BIM-44058 or (ii) any analog of BIM-44058.

 

1.35.                      Licensed Product Claim means, for a given Licensed Product in a given country of the Territory, a Valid Claim of Ipsen Compound Patent Rights, Ipsen Formulation Patent Rights or Joint Patent Rights that Covers such Licensed Product in such country.

 

1.36.                      Licensed Product shall mean all formulations, dosage forms, and presentations (including vials and pre-filled syringes) of a product or pharmaceutical composition containing a Licensed Compound as a pharmaceutically active agent. Licensed Product may be formulated under the Ipsen Formulation Technology or under the formulation of a third party.

 

1.37.                      Manufacturing Cost shall mean, the internal (calculated with reference to FTE where applicable) and external costs and expenses determined in accordance with generally accepted accounting principles as consistently applied by a Party in the ordinary course of its business, in relation to the manufacture of Licensed Compound and Licensed Product, which costs shall include, but not be limited to the sum of (a) the cost of goods produced, including, but not limited to, direct labor, material, depreciation, energy, quality control, waste disposal and production management, payments to third parties for costs incurred and product testing, as well as allocable overhead, (b) any value

 

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added tax or other applicable tax (but not income tax) paid or payable by a Party in connection with the manufacture or supply of Licensed Compound or Licensed Product, and (c) any other costs borne by a Party for the packaging, transport, customs clearance, and storage of Product (e.g., containers, freight, duties, insurance and warehousing).

 

1.38.                      NDA Filing shall mean a New Drug Application filed as a result of activities under this Agreement with the FDA, or the equivalent application to the equivalent agency in any other country of the Territory, the filing of which is necessary to market and sell a Licensed Product, including all amendments and supplements to any of the foregoing.

 

1.39.                      Net Sales shall mean shall mean Gross Sales less deductions (not otherwise taken into account) for the (a) transportation charges including insurance, if included in the invoiced price, (b) sales taxes, excise taxes, value added taxes, customs duties and any use or turnover taxes imposed by any governmental authority upon the production, importation, use or sale of Licensed Products, that are required to be paid to the government by the seller and included in the invoiced price, (c) normal and customary trade, quantity and cash discounts (including prompt pay discounts) allowed and taken, (d) allowances or credits to customers on account of actual rejection or return of Licensed Products or on account of discounts, retroactive price reductions, rebates or administrative fees affecting Licensed Products and (e) amounts written off as uncollectible as actually incurred (and specifically identified) as bad debt in accordance with the seller’s normal accounting procedures, consistently applied.

 

In the event that a Licensed Product is sold as a component of a Bundled Product, then Net Sales shall be determined by multiplying the Net Sales of the Bundled Product by the fraction A/(A+B) where A equals the average selling price of such Licensed Product sold separately in finished form and B equals the aggregate average selling price of the relevant other product(s) included in such Bundled Product sold separately in finished form, in each case in the relevant country in which sales of such Bundled Product were made, during the same Accounting Period and in similar volumes. In the event that no separate sale of such Licensed Product is made during the applicable Accounting Period in similar volumes and in the relevant country in which the sale of such Bundled Product was made and that there are separate sales of the relevant other product(s) included in such Bundled Product in similar volumes and in the relevant country in which the sale of such Bundled Product was made, then Net Sales shall be determined by multiplying the Net Sales of the Bundled Product by the fraction (E — B)/E, where E equals the average selling price of the Bundled Product for the country in which sales were made. In the event that no separate sale of either such Licensed Product or the relevant other product(s) is made during the applicable Accounting Period in similar volumes and in the relevant country in which the sale of such Bundled Product was made, then Net Sales shall be determined by multiplying the Net Sales of the Bundled Product by the fraction C/(C+D), where C equals the fully absorbed cost of manufacturing such Licensed Product and D equals the fully absorbed cost of manufacturing the relevant other product(s).

 

1.40.                      Nuvios Joint Technology Rights shall mean all of Nuvios’ right, title and interest in the Joint Patent Rights and the Joint Inventions.

 

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1.41.                      Nuvios Know-How shall mean all Know-How (A) that is obtained by Nuvios as a result of works performed by Nuvios, or by third parties appointed by Nuvios, pursuant to or in connection with the Development Plan and (B) that is necessary or useful to the research, Development, manufacture, marketing, promotion, use, sale, import or export of Licensed Compound or Licensed Product. The term “ Nuvios Know-How ” shall also include (i) all INDs and NDAs filed by Nuvios with respect to Licensed Product and all related data and files in connection with such INDs and NDAs and (ii) all Know-How in connection with Nuvios Inventions. Notwithstanding anything express or implied in the foregoing provisions of this definition, the term “ Nuvios Know-How ” shall not include any Joint Inventions or any invention or Know-How claimed in the Joint Patent Rights.

 

1.42.                      Nuvios Patent Rights means all Patent Rights (A) that are obtained by Nuvios as a result of works performed by Nuvios, or by third parties appointed by Nuvios, pursuant to or in connection with the Development Plan and (B) that are necessary or useful to the research, Development, manufacture, marketing, promotion, use, sale, import or export of Licensed Compound or Licensed Product. Nuvios Patent Rights include (i) any Patent Rights claiming any improvement, invention or discovery obtained or made by Nuvios with respect to Licensed Compounds and/or Licensed Product and (ii) all Patent Rights claiming Nuvios Inventions. Notwithstanding anything express or implied in the foregoing provisions of this definition, the term “ Nuvios Patent Rights ” shall not include any or all Joint Patent Rights.

 

1.43.                      Nuvios Trademark shall have the meaning attributed to it under Section 11.1.

 

1.44.                      Party shall mean, individually, SCRAS S.A.S. or Nuvios, Inc., and “Parties” shall mean collectively, SCRAS S.A.S. and Nuvios, Inc.

 

1.45.                      Patent Rights shall mean all rights under any patent or patent application in any country of the world, including any substitution, extension or supplementary protection certificate, reissue, re-examination, renewal, division, continuation or continuation-in-part thereof.

 

1.46.                      Phase I Clinical Trial shall mean a human clinical trial normally conducted in healthy volunteers with the aim of establishing the pharmacokinetic, pharmacodynamic and early safety profile.

 

1.47.                      Phase Ib Clinical Trial shall mean a human clinical trial normally conducted in healthy volunteers but in certain circumstances in patients, with the aim of establishing the pharmacokinetic, pharmacodynamic and early safety profile.

 

1.48.                      Phase I Initiation shall mean the date when a Licensed Product is first administered to human subjects for a Phase I Clinical Trial in the Territory.

 

1.49.                      Phase II Clinical Trial shall mean a human clinical trial that is required for Regulatory Approval where a product is tested in a limited number of patients for the purpose of establishing dose ranging and/or first indication of efficacy of product for a therapeutic or prophylactic use.

 

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1.50.                      Phase II Initiation shall mean the date when a Licensed Product is first administered to patient for a Phase II Clinical Trial in the Territory.

 

1.51.                      Phase III Clinical Trial shall mean a pivotal multi-center human clinical trial in a large number of patients to establish safety or efficacy in the particular claim and indication tested and required to obtain Regulatory Approval.

 

1.52.                      Phase III Initiation shall mean the date when a Licensed Product is first administered to a patient for a Phase III Clinical Trial in the Territory.

 

1.53.                      Pre-Clinical Package shall mean a package containing available research and pre-clinical data with respect to Licensed Compound or Licensed Product.

 

1.54.                      Pre-Clinical Study shall mean those laboratory tests and studies on animals which are conducted to gather evidence justifying a Phase I Clinical Trial.

 

1.55.                      Regulatory Approval shall mean any and all approvals, licenses, registrations or authorizations (including pricing and reimbursement approvals) whether or not conditional, that are granted by FDA, EMEA or other Health Agency and are necessary for the commercial sale of Licensed Product in a regulatory jurisdiction in the Territory and obtained as a result of activities under this Agreement.

 

1.56.                      Related Agreement shall mean any agreement entered or to be entered into between the Parties pursuant to, and in accordance with, Section 7.3, 8.4, 9.1, Section 9.3 or Section 10.2.

 

1.57.                      Research Agreement shall mean the agreement referred to Article 7.3 whereby Ipsen should carry out research work on the Ipsen Formulation Technology with Licensed Compound and/or Licensed Product.

 

1.58.                      ROW shall mean all countries of the Territory except the United States of America.

 

1.59.                      Royalty Term shall mean for each Licensed Product and each country of the Territory, the later of (a) expiration of the last to expire Licensed Product Claim in such country with respect to such Licensed Product and (b) ten (10) years from the First Commercial Sale in such country of such Licensed Product. With regards to the calculation of the ten-year period, the EU shall be considered as one country. Notwithstanding anything express or implied in the foregoing provisions of this definition, if, with respect to any Licensed Product in any country of the Territory, on the date that is ten (10) years from the First Commercial Sale in such country of such Licensed Product, there is no Valid Claim of an issued patent within the Ipsen Patent Rights or the Joint Patent Rights that Covers such Licensed Product in such country, then the Royalty Term for such Licensed Product in such country shall automatically expire and terminate on such date.

 

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1.60.                      Teijin means Teijin Pharma Ltd, Iino Building, 1-1, Uchisaiwaicho 2-chome, Chiyoda-ku, Tokyo 100-8585, Japan, Ipsen’s current third party licensee in Japan licensed under Ipsen Patent Rights and Ipsen Know-How to develop, market, distribute, offer for sale, sell, and/or import, Licensed Product in Japan. In the event that any other person or entity becomes licensed under Ipsen Patent Rights and Ipsen Know-How to research, develop, market, distribute, offer for sale, sell and/or import Licensed Product in Japan or in the event that Ipsen develops, markets, distributes, offer for sale, sells and/or imports Licensed Product in Japan, then, for purposes of this Agreement, the term “Teijin” shall mean such other person or entity, or Ipsen, as the case may be.

 

1.61.                      Teijin Agreement means that certain agreement between Teijin and Ipsen, as in effect from time to time, pursuant to which, among other things, Ipsen has licensed Teijin under the Ipsen Patent Rights and Ipsen Know-How to research, develop, market, distribute, offer for sale, sell and/or import Licensed Product in Japan.

 

1.62.                      Term shall have the meaning set forth in Section 15.1.

 

1.63.                      Territory shall mean all countries of the world, except Japan, and subject to co-marketing and co-promotion rights reserved to Ipsen in France pursuant to this Agreement.

 

1.64.                      Unlicensed Product shall mean, with respect to any Licensed Product in any given country within the Territory, any product or pharmaceutical composition that (A) consists of or contains the same active pharmaceutical ingredient as such Licensed Product, and (B) is commercially available in such country other than as a result of the licenses granted by Ipsen to Nuvios pursuant to this Agreement.

 

1.65.                      Valid Claim shall mean a claim in any (a) unexpired and issued Patent Right that has not been dedicated to the public, disclaimed, revoked or held invalid by a final unappealable decision or unappealed decision of a court of competent jurisdiction after the period for filing an appeal has expired or (b) pending patent application which patent application has been on file with the application patent office for no more than fifteen (15) years from the earliest date from which the patent application was filed or claims earliest priority, provided in case the patent application concerned is a Nuvios Patent Right or Ipsen Patent Right, Nuvios or Ipsen (as applicable) has undertaken good faith, consistent and reasonable commercial efforts to advance to issuance of a Patent Right.

 

ARTICLE 2   GRANT OF RIGHTS

 

2.1.                             License to Nuvios.

 

Subject to the terms of this Agreement, Ipsen grants to Nuvios:

 

·                                           an exclusive (even as to Ipsen ) right and license in all countries of the Territory, under the Ipsen Compound Technology and the Ipsen Joint Technology Rights, to research, develop, register, use, make, have made, import, export, market,

 

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distribute, offer for sale and sell Licensed Compound and/or Licensed Product in the Territory (it being understood and agreed that, notwithstanding the foregoing exclusive grant to Nuvios, Nuvios hereby authorizes and consents to the exercise by Ipsen of any and all rights under the Ipsen Compound Technology if and to the extent necessary for the sole purpose of Ipsen performing its obligations under Section 9.1 of this Agreement or under the Research Agreement),

 

·                                           an exclusive (even as to Ipsen and Teijin) right and license under the Ipsen Compound Technology and the Ipsen Joint Technology Rights, to make and have made Licensed Compound and/or Licensed Product in Japan (it being understood that the foregoing exclusive grant to Nuvios shall not limit or diminish the obligations of Nuvios pursuant to Article 9 hereof), and

 

·                                           an exclusive (even as to Ipsen) license in all countries of the Territory, under Ipsen Formulation Technology, for use thereof only and solely to develop, register, use, make, have made, import, export, market, distribute, offer for sale and sell Licensed Compound and/or Licensed Product in the Territory, to the exclusion of any use of the Ipsen Formulation Technology for research purposes. Notwithstanding the foregoing exclusive license rights granted to Nuvios in this paragraph with respect to the Ipsen Formulation Technology, Nuvios shall not exercise any or all of such exclusive license rights with respect to any formulation for Licensed Compound and/or Licensed Product that is different from the current formulation therefore as of the Effective Date unless and until Nuvios and Ipsen enter into the Research Agreement. During the Term, (i) Ipsen shall not, except pursuant to the Research Agreement, use all or any portion of the Ipsen Formulation Technology for research purposes related to, or in connection with, Licensed Compound and/or Licensed Product, and (ii) Ipsen shall not grant to any third party the right to use all or any portion of the Ipsen Formulation Technology for research purposes related to, or in connection with, Licensed Compound and/or Licensed Product. During the Term, (x) Ipsen shall not use all or any portion of the Ipsen Formulation Technology for any purpose or use (including, without limitation, research, development and commercial purpose or use) related to, or in connection with, Parathyroid Hormone (“PTH”), PTH related protein (“PTHrP”) or analogs of PTH or PTHrP, and (y) Ipsen shall not grant to any third party the right to use all or any portion of the Ipsen Formulation Technology for any purpose or use (including, without limitation, research, development and commercial purpose or use) related to, or in connection with, PTH, PTHrP or analogs of PTH or PTHrP.

 

2.2.                             Rights retained by Ipsen:

 

For the avoidance of doubt, Ipsen retains all rights to and under the Ipsen Formulation Technology (i) in relation to any compounds, or products containing any compound, other than Licensed Compound, Licensed Product, PTH, PTHrP or analogs of PTH or PTHrP, and (ii) to perform Ipsen’s obligations under the Research Agreement.

 

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In respect of Licensed Compound and Licensed Product in France: Ipsen may elect to co-promote or co-market Licensed Product in France under the conditions set forth in Article 10.2 hereof, in which case Ipsen shall co-promote or co-market, as the case may be, Licensed Product in France pursuant to, and in accordance with, the provisions of Article 10.2.

 

All rights in and to the Ipsen Compound Technology and Ipsen Formulation Technology not expressly granted to Nuvios under this Agreement are reserved exclusively to Ipsen.

 

2.3.                             Sublicenses

 

The rights and licenses granted to Nuvios under Section 2.1 shall include the right to grant sublicenses to a third party under such rights and licenses, in whole or in part, and shall also include the right to grant to any direct or indirect third party sublicensee of such rights and licenses granted to Nuvios under Section 2.1 the right of such direct or indirect third party sublicensee to further sublicense such rights and licenses to Nuvios under Section 2.1 to another third party. If Nuvios grants a sublicense pursuant to this Section 2.3, Nuvios shall ensure that all of the applicable terms and conditions of this Agreement shall apply to the third party sublicensee to the same extent as they apply to Nuvios with respect to, and to the extent, of the rights sublicensed. Nuvios shall assume full responsibility for the performance of all obligations so imposed by Nuvios on such third party sublicensee and will itself account to Ipsen for all payments due under this Agreement by reason of such sublicense.

 

2.4.                             Contractors

 

The rights and licenses granted to Nuvios under Section 2.1 shall include the right to grant rights to Contractors under such rights and licenses, in whole or in part, and shall also include the right to grant to any direct or indirect third party Contractors the right of such direct or indirect Contractors to further subcontract such rights to another third party. If Nuvios enter into an agreement with a Contractor pursuant to this Section 2.4, Nuvios shall ensure that all of the applicable terms and conditions of this Agreement shall apply to the Contractor to the same extent as they apply to Nuvios with respect to, and to the extent, of the rights granted. Nuvios shall assume full responsibility for the performance of all obligations so imposed by Nuvios on Contractor and will itself account to Ipsen for all payments due under this Agreement by reason of such subcontract.

 

2.5.                             Licenses to Ipsen

 

Subject to the terms of this Agreement, Nuvios shall grant to Ipsen an exclusive (even as to Nuvios) royalty free license under Nuvios Inventions, Nuvios Joint Technology Rights, Nuvios Know-How and Nuvios Patent Rights, to research, develop, register, use, import, export, market, distribute, offer for sale and sell Licensed Compound and/or Licensed Product in Japan; provided , however , that (i) such Licensed Compound and/or Licensed Product is Covered by a Valid Claim of Ipsen Patent Rights in the United States, Canada and the European Union and (ii) such Licensed Compound and/or Licensed Product is the same compound or product as Licensed Compound and/or Licensed Product Developed or being Developed by Nuvios pursuant to the Development Plan. Nuvios shall make and implement any such grant of exclusive license rights

 

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to Ipsen at such time as Ipsen shall have presented evidence reasonably satisfactory to Nuvios that all inventions, know-how or patent rights owned or controlled by Teijin that are necessary or useful to research, develop, register, use, import, export, market, distribute, offer for sale and sell Licensed Compound and/or Licensed Product in the Territory are included within Ipsen Compound Technology. Such evidence may include a written agreement executed by Teijin acknowledging and agreeing that, for purposes of this Agreement, all inventions, know-how or patent rights owned or controlled by Teijin that are necessary or useful to research, develop, register, use, import, export, market, distribute, offer for sale and sell Licensed Compound and/or Licensed Product in the Territory are included within Ipsen Compound Technology. Ipsen shall have the right to sublicense to Teijin any or all of the exclusive license rights that Nuvios shall grant to Ipsen in the manner contemplated under this paragraph, and otherwise Ipsen shall not have the right to sublicense, assign or otherwise transfer to any person or entity any or all of such exclusive license rights. Subject to the terms of this Agreement, Nuvios shall grant to Ipsen a non-exclusive license under Nuvios Inventions, Nuvios Know-How and Nuvios Patent Rights, to co-promote or co-market Licensed Compound and/or Licensed Product in France pursuant to, and in accordance with, the provisions of Article 10.2. Nuvios shall make and implement any such grant of non-exclusive license rights to Ipsen in the co-promotion agreement or co-marketing agreement to be entered into by the Parties pursuant to, and in accordance with, the provisions of Article 10.2. Ipsen shall not have the right to sublicense, assign or otherwise transfer to any person or entity any or all of the non-exclusive license rights that Nuvios shall grant to Ipsen in the manner contemplated under this paragraph.

 

2.6.                             Prohibited Uses and Activities

 

2.6.1.                                      Ipsen shall not use any Ipsen Compound Technology, Ipsen Formulation Technology or any Ipsen Joint Technology Rights in contravention or violation of the exclusive license rights granted to Nuvios pursuant to Section 2.1. Ipsen shall not grant licenses or otherwise transfer any rights to any person or entity (other than Nuvios) if and to the extent that any such grant or other transfer would violate, contravene, conflict with, or be inconsistent with the exclusive license rights granted to Nuvios pursuant to Section 2.1.

 

2.6.2.                                      In addition, at any time from and after the Effective Date and for as long as Ipsen receives royalties pursuant to Article 4 of this Agreement with respect to any country of the Territory and there is no Unlicensed Product being sold in such country of the Territory by persons other than Ipsen or any of its Affiliates, (i) none of Ipsen and its Affiliates, shall register, use, make, import, export, market, distribute, offer for sale and sell any Unlicensed Product in such country of the Territory, and (ii) none of Ipsen and its Affiliates shall enter into any agreement with any person or entity (other than Nuvios) pursuant to which such person or entity other than Nuvios shall research, develop, register, use, make, have made, import, export, market, distribute, offer for sale and sell Licensed Compound, Licensed Product and/or Unlicensed Product in such country of the Territory.

 

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ARTICLE 3   MILESTONE PAYMENTS

 

3.1.                             Subject to the provisions of Sections 3.2 and 3.3 below, Nuvios shall pay to Ipsen the following non-refundable and non-creditable amounts upon the occurrence of the following events:

 

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Events

 

Amount

 

 

 

 

 

Concurrently with the execution of this Agreement

 

USD

250,000

 

 

 

 

 

Within 60 days of the first of (i) completion of the first Phase Ib final study report where the clinical endpoints set forth in the Development Plan are reached or (ii) Phase II Initiation by Nuvios

 

USD

250,000

 

 

 

 

 

Within 60 days of completion of the first Phase II final study report where the clinical endpoints set forth in the Development Plan are reached

 

USD

500,000

 

 

 

 

 

Within 15 days of initiation of the first Phase III study (at the election of Nuvios, up to 50% payable in Nuvios stock provided stock price has been agreed within a 60-day negotiation period)

 

EUR

1 million

 

 

 

 

 

Within 15 days of the submission of the NDA to the FDA, and the acceptance by the FDA of such submission for review

 

EUR

[*]

 

 

 

 

 

Within 15 days of approval of the NDA by the FDA

 

EUR

[*]

 

 

 

 

 

Within 15 days of Regulatory Approval by the EMEA or first Regulatory Approval by any European Union Member State.

 

EUR

[*]

 

 

 

 

 

Within 90 days of end of first calendar year in which Net Sales of Licensed Product in such calendar year are equal to or greater than USD 250 m

 

EUR

 [*]

 

 

 

 

 

Within 90 days of end first calendar year in which Net Sales of Licensed Product in such calendar year exceed USD 300 m

 

EUR

 [*]

 

 

Each milestone payment by Nuvios to Ipsen pursuant to the foregoing provisions of this Section 3.1 shall be paid only once, regardless of how many times a particular milestone is achieved and notwithstanding that more than one Licensed Product achieves a given milestone. Without limiting the generality of the foregoing sentence, in no event shall the aggregate amount of milestone payments made by Nuvios to Ipsen pursuant to this Section 3.1 under any circumstances exceed (i) one million (1,000,000) USD and thirty six million (36,000,000) EUR.

 

3.2.                             Subject to the provisions of Section 3.3 below, should Nuvios sublicense or otherwise grant or transfer, whole or part of this Agreement to a third party sublicensee or Contractor, Nuvios shall make payment to Ipsen of the Share (defined below) of all upfront fees and all milestone payments received by Nuvios from such sublicensees or Contractors in direct or indirect consideration for such grant of rights.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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3.3.                             The Share shall depend on when the agreement referred to in article 3.2 above with such sublicensee or Contractor is executed by Nuvios:

 

Date of execution of the agreement

 

Share payable within
thirty (30) days following
execution of the agreement

 

Before Phase Ib is completed

 

[*]

%

 

 

 

 

After Phase Ib is completed and before first NDA filing

 

[*]

%

 

 

 

 

After first NDA filing

 

[*]

%

 

provided however that:

 

3.3.1.                                      in the event that Nuvios grants rights to a sublicensee or Contractor with respect to all countries in the Territory, then the payments that Nuvios is required to make to Ipsen pursuant to Section 3.2 hereof and this Section 3.3 shall be in lieu of remaining Milestone Payments that Nuvios would otherwise be required to pay to Ipsen pursuant to Section 3.1 above, and

 

3.3.2.                                      in the event that Nuvios grants rights to a sublicensee or Contractor with respect to only some of the countries in the Territory, then all remaining Milestone Payments owed by Nuvios to Ipsen pursuant to Section 3.1 shall be appropriately and equitably reduced to reflect and account for the market size that is accounted for by those countries in the Territory in respect of which Nuvios has granted such rights relative to the market size that is accounted for by all countries in the Territory.

 

ARTICLE 4   PAYMENTS BASED ON SALES OF LICENSED PRODUCT

 

4.1.                             Royalties.

 

(a)                                  In consideration for the rights and license granted under Section 2.1. and regardless of the fact that Ipsen Formulation Technology is, or is not an element of Licensed Product, Nuvios shall, subject to the provisions of Sections 4.2 and 4.3 below, pay royalties to Ipsen based upon Net Sales of any given Licensed Product in any given country in the Territory during the Royalty Term applicable to sales of such Licensed Product in such country, which royalties shall be equal to 5% of such Net Sales. For purposes of clarification, the determination of the amount of royalties due Ipsen pursuant to this Section 4.1(a) shall be made on a Licensed Product-by-Licensed Product basis and on a country-by-country basis. Payment of royalties due to Ipsen pursuant to this Section 4.1(a) shall be made in accordance with the provisions of Article 5 hereof.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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(b)                                  In consideration for the rights and license under Ipsen Know-How granted to Nuvios pursuant to this Agreement, Nuvios shall pay royalties to Ipsen based upon net sales by Nuvios, its Affiliates, sublicensees or other commercialization contractors of any pharmaceutical product (other than Licensed Compound or Licensed Product) that is a Nuvios Invention and that was derived from or based on Ipsen Know-How that is Confidential Information of Ipsen, which royalties shall be equal to [*] percent ([*]%) of such net sales. For the purpose of calculating the royalties due to Ipsen pursuant to this Section 4.1(b), the provisions of Section 4.1(a) (other than the royalty rate specified therein), Section 4.2, Section 4.3 and Article 5 hereof and the definition of Net Sales shall apply “mutatis mutandis”. Nuvios shall have the unilateral right to terminate Ipsen’s rights under this Section 4.1(b), upon written notice to Ipsen with immediate effect, if Ipsen in any country of the world brings an action or proceeding seeking to have a Nuvios Patent Right or Joint Patent Right declared invalid or unenforceable

 

(c)                                   Notwithstanding the foregoing provisions of Section 4.1(a) and Section 4.1(b) or any other provisions of this Agreement to the contrary, in the event that Ipsen or its Affiliates, has committed a material breach of article 2.1 or article 2.6 as a result of any actions or activities of Ipsen or its Affiliates in a country of the Territory, then all obligations of Nuvios, its Affiliates, sublicensees or Contractors under this Section 4.1 to pay royalties in such country shall terminate effective immediately upon Nuvios giving written notice of termination to Ipsen.

 

4.2.                             Adjustments related to Unlicensed Products.

 

Notwithstanding anything express or implied in Section 4.1 to the contrary, if, in a given country of the Territory, (i) there is no Valid Claim of an issued patent within Ipsen Patent Rights or Joint Patent Rights that Covers the composition of matter of a Licensed Product, the methods of use thereof and/or manufacturing or formulation processes thereof in such country, and (ii) either:

 

(A) aggregate unit sales in such country of Unlicensed Products constitute more than [*] % of the market share on a per unit basis with respect to all unit sales of such Unlicensed Products and such Licensed Product in such country THEN Nuvios, its Affiliates, sublicensees or Contractors shall have the right to calculate royalty payments by including only [*]% of the amount of Net Sales Nuvios, its Affiliates, sublicensees or Contractors would have otherwise included for such country to calculate royalty payments, or constitute more than [*] % of the market share on a per unit basis with respect to all unit sales of such Unlicensed Products and such Licensed Product in such country THEN the obligation of Nuvios, its Affiliates, sublicensees or Contractors to pay royalties to Ipsen pursuant to Section 4.1(a) with respect to sales of such Licensed Product in such country shall terminate and be of no further force or effect.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

16



 

OR (B) Unlicensed Products are commercially available in such country and the per unit retail price of such Licensed Product has suffered a decline of more than [*]% from the per unit price at which such Licensed Product was being sold in such country immediately prior to the commercial entry of such Unlicensed Products in such country, THEN Nuvios, its Affiliates, sublicensees or Contractors shall have the right to calculate royalty payments by including only [*]% of the amount of Net Sales Nuvios, its Affiliates, sublicensees or Contractors would have otherwise included for such country to calculate royalty payments, or has suffered a decline of more than [*] % from the per unit price at which such Licensed Product was being sold in such country immediately prior to the commercial entry of such Unlicensed Products in such country, THEN the obligation of Nuvios, its Affiliates, sublicensees or Contractors to pay royalties to Ipsen pursuant to Section 4.1(a) with respect to sales of such Licensed Product in such country shall terminate and be of no further force or effect.

 

4.3.                             Adjustments Related to third party Payments.

 

If, in connection with any Licensed Compound or Licensed Product, Nuvios is obligated to remit payments to third parties in relation to intellectual property rights owned by such third parties, including, without limitation, when Nuvios licenses in formulation technology from third party for use with Licensed Compound or Licensed Product and/or as determined pursuant to Article 11.7 of this Agreement, Nuvios shall be permitted to offset against payments due to Ipsen under this Agreement up to fifty percent (50%) of any payments due to such third parties during any calendar year, provided however that this offset does not result in a reduction of more than [*]% of the royalty payments that would otherwise have been due to Ipsen in any calendar year. In case Nuvios has not been able to offset any allowed amount during any relevant calendar year, no resulting payment shall be due from Ipsen to Nuvios as a result of such shortfall, but Nuvios shall be entitled to carry over such shortfall to one or more subsequent calendar years and seek to offset the full amount of such shortfall against payments otherwise due to Ipsen in such subsequent calendar year or calendar years (subject always to the limitation set forth in this Section 4.3 that in no event shall royalty payments that would otherwise have been due to Ipsen during in any calendar year be reduced by more than [*]%).

 

ARTICLE 5   PAYMENT, REPORTING, AUDITING

 

5.1.                             Currency and Conversion.

 

All payments under this Agreement shall be in Euros except the milestone payments indicated in 3.1 to be in US Dollars as well as royalty payments referred to in this Article 5.1 with respect to Net Sales in the USA.

 

Calculation of Net Sales and royalties by Nuvios:

 

With respect to the USA: For the purpose of the royalty calculation for the USA, Nuvios shall calculate Net Sales and calculate and pay corresponding royalties in USD.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

17



 

With respect to ROW: For the purpose of the royalty calculation for the ROW, Nuvios shall calculate Net Sales and corresponding royalties in Euros. For this purpose, whenever calculations of Net Sales or royalties require conversion from any currency (other than Net Sales achieved in the Euro zone), Nuvios shall convert into EUROS the amount of Gross Sales and Net Sales, using the middle market spots exchange rates (as published in the Wall Street Journal European Edition or if no longer available any other sources mutually-agreed by the Parties) of the last working day of each applicable Accounting Period.

 

5.2.                             Payments and Reporting.

 

After the First Commercial Sale of Licensed Product in the Territory, Nuvios shall calculate royalties quarterly at the end of each Accounting Period (i.e., March 31, June 30, September 30 and December 31) and shall pay royalties on Net Sales quarterly within sixty (60) days after the end of each Accounting Period.

 

With each such payment, Nuvios shall provide in writing to Ipsen for the relevant Accounting Period at least the following information split by United States of America, EU, and any other countries of the Territory:

 

·                                           Gross Sales (expressed in the currency in which the sale of Licensed Product is made, and for Gross Sales achieved in the ROW, the applicable conversion rates and the resulting amount in Euros);

 

·                                           Net Sales (expressed in the currency in which the sale of Licensed Product is made, and for Net Sales achieved in the ROW, the applicable conversion rates and the resulting amount in Euros);

 

·                                           Total royalty payable (expressed in USD for the Net Sales achieved in the USA and in Euros with respect to ROW).

 

5.3.                             Late payments. Any payment under Articles 3 and 4 that is not timely paid shall bear interest, to the extent permitted by applicable law, at the average one month European Interbank Offered Rate (EURIBOR) as reported by Datastream (or a successor or similar organization) from time to time, calculated on the number of days such a payment is overdue, plus two (2) percentage points.

 

5.4.                             Taxes

 

Each Party shall pay all sales, turnover, income, revenue, value added, and other taxes levied on account of payments accruing or made to it under this Agreement. Nothing in the foregoing sentence shall be deemed to affect the definition of Manufacturing Cost and/or any right that either Party specifically is provided or granted under this Agreement to charge and collect from the other Party the Manufacturing Cost incurred by such Party in connection with Licensed Product supplied by such Party to the other Party.

 

18


 

If provision is made in law or regulation of any country for withholding of taxes of any type, levies or other charges with respect to any amounts payable under this Agreement to a Party, the other Party (“Withholding Party”) shall promptly pay such tax, levy or charge for and on behalf of the Party to the proper governmental authority, and shall promptly furnish the Party with a signed original certificate of such tax deduction. The Withholding Party shall have the right to deduct any such tax, levy or charge actually paid from payment due by the Party or be promptly reimbursed by the Party if no further payments are due by the Party. Each Party agrees to assist the other Party in claiming exemption from such deductions or withholdings under double taxation or similar agreement or treaty from time to time in force and in minimizing the amount required to be so withheld or deducted.

 

5.5.                             Blocked Countries. If by reason of law Nuvios is unable to convert to Euros a portion of the amount due by it under this Agreement, then Nuvios shall notify Ipsen in writing and Nuvios shall pay to Ipsen such portion in the currency of any other country designated by Ipsen and legally available to Nuvios.

 

5.6.                             Accounting.

 

Nuvios shall maintain and shall cause its Affiliates and Contractors to maintain full, true and accurate books of account containing all particulars that may be necessary for the purpose of calculating all royalties payable under this Agreement. Such books of account shall be kept at their principal place of business. Nuvios shall permit Ipsen, by independent qualified public accountants selected by Ipsen and reasonably acceptable to Nuvios, to examine such books and records at any reasonable time, but not later than three (3) years following the rendering of any corresponding reports, accountings and payments pursuant to this Agreement. The foregoing right of review may be exercised only once during each twelve (12) month period. Such accountants may be required by Nuvios to enter into a reasonably acceptable confidentiality agreement, and in no event shall such accountants disclose to Ipsen any information other than such as relates to the accuracy of reports and payments made or due hereunder. The opinion of said independent accountants regarding such reports, accountings and payments shall be binding on the parties other than in the case of manifest error. Ipsen shall bear the cost of any such examination and review; provided that if the inspection and audit shows an underpayment of royalty of more than five percent (5%) of the amount due for the applicable Accounting Period, then Nuvios shall promptly reimburse Ipsen for all costs incurred in connection with such examination and review. Nuvios shall promptly pay to Ipsen the amount of any such underpayment revealed by an examination and review together with late payment interest pursuant to Article 5.3.

 

ARTICLE 6   DEVELOPMENT GOVERNANCE

 

6.1.                             Joint Steering Committee:

 

The Parties shall establish a Joint Steering Committee (JSC) which shall act as a consultative body for the purpose of monitoring the design and implementation of the Development Plan and generally as the forum for information sharing with respect to the

 

19



 

Development Plan. The JSC will consist of an equal number of representatives from each Party (one or more). Each Party shall, within forty five (45) days after the Effective Date, select its initial representatives and set a date shortly thereafter (no later than 45 days) for the first meeting of such JSC. Each Party may replace its representatives at any time on prior written notice to the other Party. The Chairperson of the JSC shall be from Nuvios. The Chairperson shall be responsible for providing an agenda for each meeting at least ten (10) business days in advance of such meeting.

 

The JSC shall be responsible for:

 

·                                           Monitoring the Development activities carried out by Nuvios under the Development Plan

 

·                                           co-ordinating the Development Plan and Japanese Development Plan and activities thereunder, including scheduling and prioritization thereof;

 

·                                           deciding on changes to Development Plan;

 

6.2.                             Japanese Development Committee: Development works to be undertaken in Japan shall be set forth in the Japanese Development Plan which shall be (i) consistent with the Development Plan, (ii) consistent with the determinations made by the JSC with respect to development activities to be pursued, continued, discontinued or modified in Japan for the purposes of optimizing the global development of Licensed Compound or Licensed Product in both the Territory and Japan or for purposes of reducing the risk of global development of Licensed Compound or Licensed Product in both the Territory and Japan and (iii) determined in collaboration with Teijin within the framework of a committee made of representatives of Ipsen and Teijin (Japanese Development Committee). The chairman of the Japanese Development Committee shall at all times be a member appointed by Ipsen. Ipsen shall represent Nuvios’ interest on the basis of Nuvios’ instructions to Ipsen in the Japanese Development Committee and shall not take without prior approval from Nuvios any decision with regards to the clinical and the regulatory strategy in Japan. Nuvios shall provide Ipsen with detailed written instructions related to the Japanese Development Plan and its performance in a timely manner so as to enable Ipsen to comply with its obligations under this article 6.2.

 

6.3.                             Meetings of the Joint Steering Committee:

 

The JSC shall meet at least twice (2) per year, with at least one (1) meeting during each year in person (the location of each meeting in person to alternate between the offices of each Party), for so long as the Development Plan contemplates clinical development of a Licensed Product. The JSC may appoint working sub-groups to communicate frequently and outside formal meetings.

 

The Party hosting a meeting shall prepare written draft minutes of the meeting in reasonable detail and distribute such draft minutes to all members of the JSC for comment and review within ten (10) business days after the relevant meeting. The JSC members shall have seven

 

20



 

(7) business days to provide comments. The Party preparing the minutes shall incorporate timely received comments and distribute finalized minutes to all members of the JSC within twenty four (24) business days of the relevant meeting.

 

6.4.                             Meetings of the Japanese Development Committee:

 

The Japanese Development Committee shall first meet no later than sixty days following signature of the first Development Plan. Thereafter the Japanese Development Committee shall meet no less than every four (4) months as decided by the chairman of the Japanese Development Committee. Additional meetings can be convened by Ipsen or Teijin with no less than thirty (30) days prior written notice which shall include the agenda for such extraordinary meeting. The agenda of the meetings shall be prepared by the chairman of the Japanese Development Committee and shall include any matter raised by Ipsen or Teijin for discussion within the Japanese Development Committee.

 

Meetings of the Japanese Development Committee shall take place alternatively in Teijin’s or Ipsen premises, in person or by video or teleconference. Ipsen shall invite and Nuvios shall be entitled to attend and participate in all meetings of the Japanese Development Committee, but shall have no voting right. Minutes of the meetings shall be prepared and sent to all members of the Japanese Development Committee by the chairman of the Japanese Development Committee. Ipsen shall, without delay, supply Nuvios with a copy thereof for Nuvios’ comments as appropriate.

 

6.5.                             Decision-making authority:

 

Decisions of the JSC shall generally be taken by consensus. In the event of a disagreement or a deadlock, Nuvios shall have the right to cast a tie-breaking vote. It is understood and agreed that the exercise by Nuvios of a tie-breaking vote so as to resolve a disagreement or deadlock at the Joint Steering Committee shall in no way result in the elimination or reduction of Nuvios’ obligation to use reasonable commercial efforts to develop and commercialize Licensed Product in those countries within the Territory where it is commercially reasonable to do so in accordance with the applicable provisions of Article 7.

 

ARTICLE 7   DEVELOPMENT PLAN AND CONDUCT OF DEVELOPMENT ACTIVITIES

 

7.1.                             Development Plan

 

The Parties have agreed upon the first Development Plan in the form attached as Appendix C.

 

21



 

7.2.                             Conduct of Development activities

 

Subject to the provisions set forth below in this Section 7.2, Nuvios shall use reasonable commercial efforts to develop the Licensed Product for registration and commercialization in those countries within the Territory where it is commercially reasonable to do so.

 

Subject to the provisions set forth below in this Section 7.2, Nuvios shall use reasonable commercial efforts to complete the Development Plan in order to obtain FDA, EMEA and any other Regulatory Approvals for one Licensed Product in those countries within the Territory where it is commercially reasonable to do so. Nuvios shall use reasonable commercial efforts to conduct its tasks and obligations under the Development Plan:

 

·                                           in accordance with Good Laboratory, Good Clinical and Good Manufacturing Practices, to the extent these are applicable;

 

·                                           in accordance with all relevant legal requirements and shall be responsible for obtaining all necessary approvals therefore from any Health Agency or applicable competent authority; and,

 

·                                           keeping or causing to be kept written laboratory notebooks and other records and reports of the results and progress of the works to be performed in sufficient detail for to accomplish its obligations under this Agreement.

 

Nuvios shall have ultimate responsibility for all aspects of Development of Licensed Product in the Territory, and shall bear all related costs. Nuvios shall have no responsibility for development and costs of Licensed Product in Japan.

 

The Parties acknowledge that time shall be of the essence in this Agreement and thus that the time deadlines defined in any Development Plan should be complied with and, as a matter of principle, not be postponed. However, the Parties agree that the time deadlines defined in any Development Plan may be reasonably modified by the JSC.

 

Notwithstanding the provisions of the immediately preceding paragraph or the other provisions of this Agreement (including, without limitation, this Article 7) to the contrary, Nuvios reserves the right to cause the JSC at any time to change or modify the Development Plan or any of the preclinical studies or clinical trials described in the Development Plan (and the time deadlines defined in the Development Plan), or to abandon any portion of the Development Plan or discontinue any such preclinical studies or clinical trials, in response to (i) regulatory requirements, (ii) scientific constraints, (iii) significant increases in the anticipated costs of Development, (iv) any significant adverse event or condition relating to the safety or efficacy of a Licensed Product, (v) significant changes in the anticipated costs of manufacturing, (vi) significant adverse changes in market conditions or in market potential of a drug candidate, or (viii) any reasonable determination made by Nuvios in good faith that such change, modification, abandonment or discontinuation is designed ultimately to improve the probability of obtaining Regulatory Approval of Licensed Product in the Territory.

 

Nuvios shall communicate to Ipsen in a timely manner all Nuvios Know How, and Ipsen shall be authorized to communicate to Teijin all of such Nuvios Know How, free of charge,

 

22



 

provided that Ipsen takes appropriate steps (including, without limitation, entering into appropriate confidentiality agreements) to ensure that all of such Nuvios Know How disclosed by Ipsen to Teijin is only considered, evaluated and (to the extent permitted pursuant to Section 2.5 hereof) used by Teijin for purposes related only and exclusively to the development and further commercialization of License Product in Japan. At the request of Nuvios, Ipsen shall cause Teijin to enter into a confidentiality agreement with Nuvios in form and substance reasonably satisfactory to Nuvios and Teijin. Nuvios’ agreement and obligations under this paragraph are subject to compliance by Ipsen with all of its agreements and obligations set forth in the next paragraph.

 

Ipsen shall communicate, or shall cause Teijin to communicate to Ipsen or Nuvios, free of charge and in a timely manner all Know-How, intellectual property rights and data resulting from the performance of the Japanese Development Plan provided that all of such Know-How, intellectual property rights and data disclosed by Ipsen to Nuvios is only considered, evaluated and used by Nuvios for purposes related only and exclusively to the development and commercialization of Licensed Product in the Territory. At the request of Teijin, Nuvios shall enter into confidentiality with Teijin in form and substance reasonably satisfactory to Nuvios and Teijin. Ipsen’s agreement and obligations under this paragraph are subject to compliance by Nuvios with all of its agreements and obligations set forth in the immediately preceding paragraph.

 

Ipsen shall ensure that the Japanese Development Plan is consistent in all material respects with the Development Plan, and Ipsen shall cause Teijin and the Japanese Development Committee to make such changes to the Japanese Development Plan to ensure that it is consistent in all material respects to the Development Plan. In addition, in the event that the Development Committee determines that changing or modifying the Japanese Development Plan or any of the preclinical studies or clinical trials described in the Japanese Development Plan (or the time deadlines defined in the Japanese Development Plan), or the abandonment of any portion of the Japanese Development Plan or discontinuation of any preclinical studies or clinical trials described in the Japanese Development Plan, is in the best interests of the global development and commercialization of Licensed Product in both the Territory and Japan, then Ipsen shall use reasonable commercial efforts (including, without limitation, enforcing Ipsen’s rights under the Teijin Agreement) to cause Teijin and the Japanese Development Committee to make and/or implement such changes, modifications, abandonment or discontinuation.

 

It is understood that Teijin shall have responsibility for day to day operations under the Japanese Development Plan.

 

7.3.                             Research programme on Ipsen Formulation Technology

 

In the event Nuvios intends to develop a formulation of the Licensed Product with the Ipsen Formulation Technology, Nuvios and Ipsen shall agree and enter into a separate research agreement containing a research work program and budget under which Ipsen shall use reasonable commercial efforts to carry out research activities to provide Nuvios with a Licensed Product formulated with Ipsen Formulation Technology. All research activities carried out by Ipsen pursuant to this Section 7.3 will be charged by Ipsen to Nuvios at the following rates:

 

23



 

·                                           Internal costs: USD [*] per FTE

 

·                                           External costs: at cost.

 

Any such costs shall be invoiced by Ipsen to Nuvios quarterly in advance (with respect to internal costs) and shall be payable within thirty (30) days of the date of each invoice which shall also set forth those third party invoices received during the preceding quarter. Invoice shall include the addition of value added tax or any similar tax which may be applicable. In no event shall Ipsen invoice Nuvios, and Nuvios be required to pay, for amounts in excess of the amounts set forth in the budget agreed upon by the Parties, unless otherwise agreed between the Parties.

 

Ipsen provides no guarantee of success that its research activities under such research agreement will be successful and will result in a Licensed Compound formulated with Ipsen Formulation Technology that is eligible for further development activities.

 

The Parties acknowledge that time shall be of the essence in this Agreement and thus that the time deadlines defined in any research work program agreed by both Parties pursuant to this Section 7.3 should be complied with and, as a matter of principle, not be postponed. However, the Parties agree that the time deadlines defined in any such research work program may be reasonably modified by the Parties.

 

Ipsen may not transfer, delegate or assign any of its obligations under this Section 7.3 to any person or entity without the prior written consent of Nuvios, which shall not be unreasonably withheld or delayed.

 

ARTICLE 8   DEVELOPMENT — REGULATORY AND SAFETY

 

8.1.                             Transfer of Ipsen Know-How and Documentation to Nuvios. The Parties agree that, promptly following the Effective Date, at the reasonable request from Nuvios, Ipsen shall transfer:

 

·                                           Any historical Serious Adverse Events reports - Research and development reports

 

·                                           Any copies of any correspondence in its possession or under its control with any regulatory agencies related to Licensed Compound

 

·                                           Copies of all documents in its possession or under its control relating to any Ipsen Know-How pertaining to the research, Development or manufacture of Licensed Compound or Licensed Product

 

·                                           Copies of all patents and patent applications included within Ipsen Patent Rights pertaining to Licensed Compound or Licensed Product

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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Upon the reasonable request from Nuvios made at any time or from time to time during the Term, Ipsen shall transfer to Nuvios all of the items listed above to the extent that such items have not previously been transferred to Nuvios.

 

In addition, from time to time during the Term, at the reasonable request of Nuvios, Ipsen agrees to make available to Nuvios those of Ipsen’s employees and consultants that have knowledge and expertise in connection with researching, developing, manufacturing, obtaining regulatory approval for, or creating and prosecuting intellectual property with respect to, any of the Licensed Compounds or Licensed Products for purposes of facilitating the transfer of all Ipsen Know-How to Nuvios in connection with any such Licensed Compound or Licensed Product. The performance by Ipsen of its obligations under this paragraph shall be at no cost to Nuvios.

 

8.2.                             Responsibility for Regulatory Affairs. Nuvios shall be responsible for all regulatory affairs in the Territory related to Licensed Compound and Licensed Product, including the preparation and filing of applications for Regulatory Approval, as well as any or all governmental approvals required to manufacture, or have manufactured, Licensed Compound or Licensed Product. Nuvios shall file all such applications in its own name, or that of its Affiliate. Nuvios shall provide Ipsen with copies of all correspondence and final filings (including, without limitation, IND filings and NDA Filings) related to Licensed Product with regulatory authorities for Ipsen and/or Teijin’, provided that Ipsen has complied with all of its obligations in the next sentence. Ipsen shall provide, or cause Teijin to provide, Nuvios with copies of all correspondence and final filings (including, without limitation, IND filings and NDA Filings) made by Teijin related to Licensed Product with regulatory authorities in Japan.

 

8.3.                             Ownership of Regulatory Approvals: Nuvios shall own all Regulatory Approval files and Regulatory Approvals in the Territory, provided that with respect to France, if Ipsen has elected to co-market the Licensed Product in France pursuant to, and in accordance with, the provisions of Section 10.2, Nuvios shall apply for two NDAs to allow co-marketing in France. One NDA shall be in the name of Nuvios and the other NDA shall be in the name of Ipsen.

 

8.4.                             Drug Safety Database and pharmaco-vigilance responsibility. Nuvios shall be the holder of the reference global safety database. With respect to Japan and France, as the case may be, the Parties further agree that Nuvios will execute with Ipsen or Teijin (as Ipsen shall indicate) and when deemed appropriate by the Parties before Nuvios initiates any clinical trial, a separate pharmaco-vigilance agreement (the “Pharmacoviligance Agreement”) in form and substance reasonably satisfactory to Nuvios and the other party or parties thereto that will include the mutually agreed process to be used for the exchange of pharmaco-vigilance data. The Pharmacovigilance Agreement shall include the following: Upon identification of any potential safety issue, Nuvios’ Drug Safety group will contact all Parties’ members of the joint Drug Safety Committee (as defined in the Pharmacovigilance Agreement) if an urgent need requires such a committee to meet. The joint Drug Safety Committee will at its meeting agree on appropriate measures to deal with the relevant safety issue and all Parties shall fully implement such measures. The joint Drug Safety Committee shall operate by consensus with the exception that, if there is disagreement or deadlock at the joint Drug Safety Committee, Nuvios shall have

 

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the final say as holder of the main regulatory responsibilities to the extent permitted by applicable laws and regulations. Ipsen shall cause Teijin to comply with the provisions of this Section 8.4.

 

ARTICLE 9   MANUFACTURE AND SUPPLY

 

9.1.                             Clinical Supply for the Phase I and Phase II Clinical Trials. Except as otherwise agreed by the JSC, Ipsen shall make and supply, or cause to be made and supplied, all necessary clinical supply of the injection formulation of the Licensed Compound and/or Licensed Product (described in Appendix D hereto) that is available to Ipsen on the Effective Date for use by Nuvios for the performance of Phase I and first Phase II Clinical Trials under the Development Plan. Clinical supply of Licensed Compound or Licensed Product to Nuvios under this Section 9.1 shall be provided at Ipsen’s Manufacturing Cost. The Parties shall enter into a clinical supply agreement and a technical agreement with respect to such clinical supplies by Ipsen to Nuvios. Such supply agreement and technical agreement are appended hereto in Appendix D. Ipsen shall not be obligated to manufacture clinical supply of Licensed Compound and/or Licensed Product for any Phase III clinical study or for commercial supply.

 

9.2.                             Transition.

 

At the request of Nuvios, Ipsen shall provide to Nuvios a manufacturing transfer package no later than sixty (60) days from the date of request by Nuvios, and Ipsen shall use reasonable commercial efforts to transfer to Nuvios all Ipsen Know-How and methods pertaining to the manufacture of Licensed Compound and/or Licensed Product and Nuvios shall use commercial reasonable efforts to understand and implement such Ipsen Know How and methods pertaining to the manufacture of Licensed Compound and/or Licensed Product. The timing and the steps to be followed by the Parties in connection with any such transfer shall be set out in more detail in the clinical supply and technical agreement contemplated under Section 9.1 above. Nuvios shall request that Ipsen proceed to the transfer contemplated by this Section 9.2 in a timely manner so that the timing set forth in the clinical supply and technical agreement contemplated under Section 9.1 above is complied with. Prior to the commencement of a Phase III Clinical Trial with respect to Licensed Compound or Licensed Product by Nuvios, Nuvios shall use reasonable commercial efforts to review and implement and scale-up the manufacturing processes in a timely manner so as to be capable of supplying adequate quantities of conforming Licensed Compound and Licensed Product for a Phase III Clinical Trial in compliance with the targeted timelines of the Development Plan and the Japanese Development Plan. Clinical supply of Licensed Product to Ipsen for onward supply to Teijin under this Article 9.2 shall be provided at Nuvios’ Manufacturing Cost for such clinical supply at the time of the manufacture thereof. At such time as Nuvios shall have successfully implemented and scaled-up the manufacturing processes so as to be capable of supplying adequate quantities of conforming Licensed Compound and Licensed Product for such Phase III Clinical Trial, Ipsen shall cease all manufacturing activities with respect to Licensed Compound and Licensed Product.

 

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9.3.                             Commercial Supply.

 

Nuvios shall be solely and exclusively responsible for the manufacture, in accordance with good manufacturing practice, and supply of commercial quantities of Licensed Product in the Territory (including France) and Japan after receipt of Regulatory Approval therefore in the applicable jurisdiction or jurisdictions.

 

With respect to Japan: Nuvios shall supply commercial quantities of finished and fully labeled Licensed Product (and shall provide any clinical supplies that may be required after obtaining Regulatory Approval) to Ipsen for Teijin in Japan at a supply price equal to 10% of net sales in Japan. Should the manufacturing costs be anticipated to exceed 10% of net sales in Japan, as evidenced by Nuvios, then the Parties shall discuss in good faith to define a new supply price which shall be no less than a supply price equal to such manufacturing costs plus a reasonable markup (not to exceed [*] percent of such manufacturing costs).

 

With respect to France if Ipsen has elected to co-market Licensed Product in France: Nuvios shall supply commercial quantities of finished and fully labeled Licensed Product (and shall provide any clinical supplies that may be required after obtaining Regulatory Approval) to Ipsen for France at a supply price equal to (i) for commercial supplies, Nuvios’ Manufacturing Cost plus a [*] percent ([*] %) margin, and (ii) for clinical supplies, Nuvious Manufacturing Cost.

 

The Parties, with respect to the supply of Licensed Product for France and for Japan contemplated pursuant to this Section 9.3, shall agree on the terms of a commercial supply agreement and a technical agreement no later than the date of first NDA filing for Licensed Product in the corresponding country. It shall be a condition precedent to Nuvios’ supply obligations under this Section 9.3 that the Parties shall have agreed upon the terms of, and executed and delivered to each other, such supply agreement and such technical agreement. Without limiting the foregoing provisions of this paragraph, such agreements should provide standard provisions commonly used in the industry, including:

 

·                                           that Ipsen or Teijin shall provide binding forecasts of the clinical and commercial quantities of Licensed Product required for Japan,

 

·                                           that Nuvios or its contractor shall manufacture in accordance with good manufacturing practice and supply Licensed Product compliant to specifications,

 

·                                           that disruption of supply shall be remedied by equitable sharing of available stock,

 

·                                           that Ipsen or Teijin shall bear the costs (including, without limitation, capital costs) associated with establishing any special manufacturing process or changing any established manufacturing process, in either case that may be required in Japan for the manufacture of Licensed Product but is not required in the Territory,

 

·                                           audit of the manufacturing facility and the manufacturing process implemented in the manufacture of Licensed Compound and Licensed Product so as to ensure that Nuvios or its contractor manufactures in accordance with good manufacturing

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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practice and the Regulatory Approvals, including the Japanese Regulatory Approvals;

 

·                                           audit of Nuvios’ or its contractor’s Manufacturing Cost and that upon request from Ipsen, Nuvios will provide to Ipsen a certificate from the Nuvios auditors confirming the determination of Manufacturing Cost in accordance with IAS as consistently applied by Nuvios or its contractor in determining the cost of goods.

 

ARTICLE 10   COMMERCIALIZATION

 

10.1.                      Nuvios, at its own expense, shall have sole responsibility and decision-making authority for the marketing, promotion, sale and distribution of Licensed Product in the Territory under Nuvios’s Regulatory Approvals. Subject to obtaining any required Regulatory Approvals and subject also to the provisions set forth below in Section 10.4, Nuvios shall use reasonable commercial efforts to market, promote, sell and distribute the Licensed Product in those countries within the Territory where it is commercially reasonable to do so.

 

10.2.                      Ipsen may, at any time during the term of this Agreement, elect to co-market or co-promote a Licensed Product in France, free of charge, provided that (i) at the time of such election Nuvios has either elected to file for Regulatory Approval to sell such Licensed Product in France or is selling such Licensed Product in France, (ii) at the time of such election such Licensed Product is Covered by a Valid Claim of Ipsen Patent Rights in France and (iii) at the time of such election Ipsen is not in material breach of this Agreement or any of the Related Agreements. In the event that Ipsen makes any such election, the Parties shall, within thirty days following the notification of such election to Nuvios, enter into either a co-promotion agreement or co-marketing agreement containing standard provisions as usual in the pharmaceutical industry and the following particular conditions:

 

10.2.1.                               Nuvios will be responsible for ensuring that the requisite Regulatory Approvals are submitted and, if necessary, varied or transferred and shall use reasonable commercial efforts to obtain the same in order to permit such co-marketing or co-promotion in France.

 

10.2.2.                               Co-promotion particular provisions:

 

·                                           All revenues from sales of Licensed Product in France will be booked by Nuvios.

 

·                                           Nuvios shall have final say as to the identity of the accounts to be called on by the respective sales forces of Nuvios and Ipsen, as to the number, frequency and priority of sales calls, and as to the allocation of sales call responsibilities among the respective sales forces of Nuvios and Ipsen.

 

·                                           Ipsen shall elect the percentage (not to exceed [*]%) of the revenues from sales of Licensed Product in France to which Ipsen shall be entitled, Ipsen shall be allocated such percentage of such revenues, and Ipsen shall be allocated that same

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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percentage of the aggregate amount (the “ Co-Promotion Expenses Amount ”) of those costs and expenses incurred by both Nuvios and Ipsen in connection with such co-promotion efforts that would be customarily shared costs and expenses in a typical drug co-promotion arrangement in the pharmaceutical industry.

 

·                                           The Parties shall make payments to each other on a quarterly basis to the extent necessary so that each Party is allocated its proper percentage of the revenues from sales of Licensed Product in France during the applicable calendar quarter and its proper percentage of the Co-promotion Expenses Amount during the applicable calendar quarter.

 

·                                           Ipsen will pay Nuvios on a quarterly basis a [*]% royalty on Ipsen’s allocable portion of the net revenues from sales of Licensed Product in France during the applicable calendar quarter.

 

10.2.3.                               Co-marketing provisions:

 

·                                           Each of Nuvios and Ipsen will be a Regulatory Approval holder, unless dual Regulatory Approval holders are not permitted under the applicable law, in which case Nuvios shall be the Regulatory Approval holder. Nuvios shall have responsibility for all pricing/ reimbursement approvals. Each Party will market and distribute Licensed Product in France under such Party’s own brand. For purposes of this Section 10.2.3, Licensed Product co-marketed by Ipsen in France shall be referred to as “ Ipsen Licensed Product ”.

 

·                                           Ipsen will purchase finished Ipsen Licensed Product from Nuvios at Nuvios Manufacturing Cost plus a [*]% markup. Ipsen Licensed Product shall be packaged and labeled in such manner so as to clearly distinguish Ipsen Licensed Product from Licensed Product commercialized by Nuvios in France or elsewhere in the Territory.

 

·                                           Ipsen will pay Nuvios on a quarterly basis a [*]% royalty on Ipsen’s net sales from the sale of Ipsen Licensed Product in France during the applicable calendar quarter, and Nuvios will pay Ipsen on a quarterly basis a [*]% royalty on Net Sales from the sale of Licensed Product in France by Nuvios, its Affiliates or Contractors during the applicable calendar quarter.

 

·                                           In the event that either Party becomes aware that units of Ipsen Licensed Product sold or intended for sale in France by Ipsen are being exported from France and imported into and sold in another country in the Territory, such Party shall provide written notice to the other Party and Ipsen shall have a period of ninety (90) days to remedy the situation. If, within such ninety (90) day period, Ipsen is unable to cause the export of Licensed Product from France and sale in any other country or countries to stop, then Nuvios may require that an independent qualified public

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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accountant selected by Nuvios and reasonably acceptable to Ipsen examine, at the expense of Nuvios, the books and accounts of Ipsen with respect to the sales of Ipsen Licensed Product with a view to determine whether a material quantity of such Ipsen Licensed Product have been exported from France. If and when it is determined that a material quantity of such Ipsen Licensed Product have been exported from France, the cost of such examination incurred by Nuvios shall be reimbursed by Ipsen and Ipsen shall be required to make payment to Nuvios of an amount equal to [*] percent ([*]%) of the net sales of Ipsen in France with respect to any units of Ipsen Licensed Product that have been determined to have been exported from France.

 

10.2.4.                               Assignment and sub license:

 

Ipsen’s rights under this Section 10.2 may not be assigned, sublicensed or transferred to any person or entity.

 

10.2.5.                               Condition Precedent:

 

The respective rights and obligations of the Parties under this Section 10.2 are subject to the condition precedent that the Parties shall have mutually agreed upon, and executed and delivered to each other, a co-promotion agreement or co-marketing agreement, as the case may be, with respect to sales and commercialization of Licensed Product in France that incorporates the provisions of this Section 10.2.

 

10.3.                      In the event that either Party becomes aware that units of Licensed Product sold or intended for sale in Japan by Teijin, its Affiliates or sublicensees are being exported from Japan and imported into and sold in any country or countries in the Territory, such Party shall provide written notice to the other Party and Teijin and, thereafter, Ipsen or Teijin shall have a period of ninety (90) days to remedy the situation. If, within such ninety (90) day period, neither Ipsen nor Teijin is able to cause the export of Licensed Product from Japan and sale in any other country or countries to stop, then Nuvios may require that an independent qualified public accountant selected by Nuvios and reasonably acceptable to Teijin examine, at the expense of Nuvios, the books and accounts of Teijin with respect to the sales of Licensed Product with a view to determine whether a material quantity of such Licensed Product has been exported from Japan. If and when it is determined that a material quantity of such Licensed Product has been exported from Japan, the cost of such examination incurred by Nuvios shall be reimbursed by Ipsen or Teijin and Ipsen shall be required to make payment, or to cause Teijin to make payment, to Nuvios of an amount equal to [*] percent ([*]%) of the net sales of Teijin in Japan with respect to any units of Licensed Product that have been determined to have been exported from Japan.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

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ARTICLE 11   INTELLECTUAL PROPERTY

 

11.1.                      Trademarks

 

Nuvios shall identify and select one or more trademarks to be used to register, distribute and promote Licensed Product in the Territory (collectively, “ Nuvios Trademarks ” and each individually a “ Nuvios Trademark ”). Unless otherwise agreed between the Parties, Ipsen shall not avail itself of any license on any Nuvios Trademark, shall not register or use any Nuvios Trademark and shall not license, register or use any other trademark or trade name which is the same as, or confusingly similar to, any Nuvios Trademark in any country, except Japan where Ipsen or Teijin may use the Nuvios Trademark and in such event, Nuvios shall grant appropriate license free of charge to Ipsen or Teijin for use of such Nuvios Trademark in Japan (except to the extent provided in the next sentence). Nuvios shall own and, at its cost, shall be responsible for procurement, registration, maintenance and enforcement of all Nuvios Trademarks used or registered in connection with any Licensed Product, except that Ipsen or Teijin shall pay for all of the costs and expenses of Nuvios in connection with procuring, registering, maintaining and enforcing Nuvios Trademarks in Japan.

 

Ipsen shall identify and select one or more trademarks to be used to register, distribute and promote such Licensed Product under Ipsen Regulatory Approvals in France (collectively, “ Ipsen Trademarks ” and each individually an “ Ipsen Trademark ”), provided that, in identifying, selecting, registering and/or using any such Ipsen Trademark, Ipsen complies with all of the provisions of the first paragraph of this Section 11.1 that are applicable to Ipsen. Unless otherwise agreed between the Parties, Nuvios shall not avail itself of any license on any Ipsen Trademark, shall not register or use any Ipsen Trademark and shall not license, register or use any other trademark or trade name which is the same as, or confusingly similar to, any Ipsen Trademark in France. Ipsen shall own and, at its cost, shall be responsible for procurement, maintenance and enforcement of all Ipsen Trademarks used or registered in connection with any Licensed Product.

 

11.2.                      Infringements of Trademarks

 

Nuvios and Ipsen shall give prompt written notice to the other Party of any suspected or actual infringement by any person of Nuvios’ rights in the Nuvios Trademarks, or any potential or actual infringement of any person’s rights which might result from use of any Nuvios Trademark, that comes to the attention of the Parties during the term of this Agreement. Nuvios shall have the right but not the obligation to initiate proceedings against, or defend claims made by, any person in connection with any Nuvios Trademark. The commencement, strategies, termination, settlement or defense of any action relating to the validity or infringement of Nuvios Trademarks shall be decided by Nuvios. Any such proceedings shall be at the expense of Nuvios. Any damages or costs recovered by Nuvios as a result of any such proceedings or claims, shall be for the sole benefit and account of Nuvios.

 

Nuvios and Ipsen shall give prompt written notice to the other Party of any suspected or actual infringement by any person of Ipsen’s rights in the Ipsen Trademarks, or any potential or actual infringement of any person’s rights which might result from use of any Ipsen Trademark, that comes to the attention of the Parties during the term of this Agreement. Ipsen shall have the right but not the obligation to initiate proceedings against, or defend claims made by, any person in connection with any Ipsen Trademark. The commencement, strategies, termination, settlement or defense of any action relating to the validity or infringement of Ipsen Trademarks shall be

 

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decided by Ipsen. Any such proceedings shall be at the expense of Ipsen. Any damages or costs recovered by Ipsen as a result of any such proceedings or claims, shall be for the sole benefit and account of Ipsen.

 

11.3.                      Patent Right and Know-How Ownership

 

11.3.1.                               Ipsen shall own all Ipsen Inventions, Nuvios shall own all Nuvios Inventions, and Ipsen and Nuvios shall jointly own all Joint Inventions. Each Party promptly will notify the other Party in writing of (i) any Inventions that the notifying Party believes is a Joint Invention and (ii) any Inventions for which the notifying Party intends to file a patent application. Each Party shall require all of its employees and contractors to assign all Inventions made by them to such Party.

 

11.3.2.                               As between Ipsen and Nuvios, any and all Ipsen Know-How, Ipsen Patent Rights and Ipsen Formulation Technology are and shall remain vested in and owned by Ipsen, subject only to the exclusive licenses granted by Ipsen to Nuvios pursuant to Section 2.1.

 

11.3.3.                               As between Ipsen and Nuvios, any and all Nuvios Know-How and Nuvios Patent Rights are and shall remain vested in and owned by Nuvios.

 

11.3.4.                               Any and all Joint Inventions and Joint Patent Rights shall be owned by the Parties in equal undivided shares. Except to the extent otherwise provided elsewhere in this Agreement to the contrary (including, without limitation, the provisions of Section 2.1 pursuant to which Ipsen granted to Nuvios an exclusive license to all of Ipsen’s right, title and interest in and to all of the Joint Inventions and Joint Patent Rights for certain uses specified therein), each Party shall be free to use its undivided share of any and all Joint Inventions or any and all Joint Patent Rights without having to obtain the agreement or consent of the other Party, without having to provide notice of such use to the other Party and without having to make any accounting to the other Party for such use or any revenues or profits derived from such use. In addition, except to the extent otherwise provided elsewhere in this Agreement to the contrary, each Party shall be free to sell, assign, license and otherwise transfer or dispose of all or any portion of such Party’s undivided share in any and all Joint Inventions or any and all Joint Patent Rights without having to obtain the agreement or consent of the other Party, without having to provide notice of such sale, assignment, license or other transfer or disposition to the other Party and without having to make any accounting to the other Party for such sale, assignment, license or other transfer or disposition or any revenues or profits derived from such sale, assignment, license or other transfer or disposition; provided , however , that (x) any buyer, assignee, licensee or other transferee of all or any portion of the Joint Inventions and Joint Patent Rights shall take all or the portion of the Joint Inventions and/or Joint Patent Rights so transferred subject to all of the agreements and obligations under this Agreement of the transferring Party (including, without limitation, the exclusive licenses granted by Ipsen to Nuvios pursuant to Section 2.1 hereof with respect to certain uses of Ipsen’s right, title and interest to the Joint Inventions and Joint Patent Rights), (y) such buyer, assignee, licensee or other transferee shall, as a condition precedent to the

 

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effectiveness of any such sale, assignment, license or other transfer or disposition, execute an instrument in writing agreeing to assume all of the agreements and obligations under this Agreement of the transferring Party to the extent applicable to the Joint Inventions or Joint Patent Rights, or the portion thereof, transferred to such buyer, assignee, licensee or other transferee, and (z) any such sale, assignment, license or other transfer or disposition shall not operate to release the transferring Party from any of its agreements or obligations under this Agreement.

 

Nuvios may use during the Term any and all Joint Inventions and Joint Patent Rights for the purposes contemplated in this Agreement.

 

11.4.                      Filing — Prosecution and Maintenance of Ipsen Patent Rights and Nuvios Patent Rights

 

Ipsen shall at its own cost and expense be solely responsible for the filing, prosecution and maintenance of the Ipsen Patent Rights in the Territory, including the conduct and defense of any claims or proceedings relating to the Ipsen Patent Rights in the Territory (including but not limited to any interference, reissue or re-examination or opposition proceedings); provided , however , that Ipsen shall (i) provide Nuvios with all material documentation and correspondence from, sent to or filed with patent offices in the Territory regarding the Ipsen Patent Rights, (ii) provide Nuvios with a reasonable opportunity to review and comment upon all filings with such patent offices in advance of submissions to such patent offices, and (iii) shall consider, in good faith, incorporating any reasonable comments provided by Nuvios with respect to any such filings. Without limiting the generality of the foregoing provisions of this Section 11.4, Ipsen shall at its own cost and expense file, prosecute and maintain Ipsen Patent Rights in any country in the Territory as reasonably requested by Nuvios acting in a reasonable commercial manner with regards the market potential of such country, including the conduct and defense of any claims or proceedings relating to the Ipsen Patent Rights in such country (including but not limited to any interference, reissue or re-examination or opposition proceedings). If Ipsen determines in its sole discretion to abandon or not to file, prosecute or maintain any claim, patent or patent application within the Ipsen Patent Rights in any country in the Territory, including the conduct and defense of any claims or proceedings relating to such claim, patent or patent application (including but not limited to any interference, reissue or re-examination or opposition proceedings), then Ipsen shall provide Nuvios with thirty (30) days prior written notice of such determination, and shall provide Nuvios with the opportunity to file, prosecute and maintain such claim, patent or patent application in such country in the name of Nuvios (or an Affiliate of Nuvios) as assignee, including the conduct and defense of any claims or proceedings relating to such claim, patent or patent application in such country (including but not limited to any interference, reissue or re-examination or opposition proceedings), and Ipsen shall assign to Nuvios its entire right in such claim, patent or patent application in such country, and thereafter Nuvios shall be responsible for all costs and expenses in connection with the filing, prosecution or maintenance of any such claim, patent or patent application assigned by Ipsen to Nuvios pursuant to this Section 11.4(a). Ipsen shall also pay for all costs and expenses in connection with any assignment by Ipsen to Nuvios of any claim, patent or patent application pursuant to

 

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this Section 11.4(a). Nuvios shall upon first request from Ipsen deliver to Ipsen the original of any Regulatory Approval for the purpose of applying for any supplementary protection certificates of any Ipsen Patent Rights.

 

11.4.1.                               Nuvios shall at its own cost and expense be solely responsible for the filing, prosecution and maintenance of the Nuvios Patent Rights, including the conduct and defense of any claims or proceedings relating to the Nuvios Patent Rights in the Territory (including but not limited to any interference, reissue or re-examination or opposition proceedings).

 

11.4.2.                               Each Party will take account of the other Party’s interest in the performance of its obligations under this Section 11.4. Each Party shall provide to the other all assistance reasonably requested by the other Party on all such matters (at the expense of such other Party), including agreeing to and taking all steps and executing all documents necessary to be joined as claimant or defendant in any proceedings in any country.

 

11.5.                      Filing — Prosecution and Maintenance of Joint Patent Rights. Unless the Parties otherwise mutually agree in writing, Nuvios shall have the first right to file, prosecute and maintain the Joint Patent Rights in any and all countries of the world, including the conduct and defense of any claims or proceedings relating to the Joint Patent Rights in any and all countries of the world (including but not limited to any interference, reissue or re-examination or opposition proceedings), provided however, in the event that Nuvios determines in its sole discretion to abandon or not to file, prosecute or maintain any claim, patent or patent application within the Joint Patent Rights in any country of the world, including the conduct and defense of any claims or proceedings relating to such claim, patent or patent application (including but not limited to any interference, reissue or re-examination or opposition proceedings), then Nuvios shall provide Ipsen with thirty (30) days prior written notice of such determination, and Ipsen shall have such right and upon exercise of such right, Ipsen shall have the right to file, prosecute and maintain such claim, patent or patent application in such country, including the conduct and defense of any claims or proceedings relating to such claim, patent or patent application in such country (including but not limited to any interference, reissue or re-examination or opposition proceedings). In each case under this Section 11.5, the filing Party (A) shall give the non-filing Party a reasonable opportunity to review the text of the application or submission before filing, (B) shall consult with the non-filing Party with respect thereto, (C) shall, prior to filing any application or submission, incorporate any reasonable comments that the non-filing Party shall make on a timely basis to such application or submission and (D) shall supply the non-filing Party with a copy of the application or submission as filed, together with notice of its filing date and serial number and all substantive prosecution. Each Party shall keep the other advised of the status of the actual and prospective patent filings described above in this Section 11.5 and, upon the request of the other, provide advance copies of any papers related to the filing, prosecution and maintenance of such patent filings. Nuvios shall promptly give notice to Ipsen of the grant, lapse, revocation, surrender, invalidation or abandonment in the Territory or outside the Territory of any Joint Patent Rights being prosecuted by Nuvios. Ipsen shall promptly give notice to

 

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Nuvios of the grant, lapse, revocation, surrender, invalidation or abandonment in the Territory or outside the Territory of any Joint Patent Rights being prosecuted by Ipsen. With respect to all filings under this Section 11.5, the filing Party shall be responsible for payment of all costs and expenses related to such filings (including, without limitation, fees and disbursements of outside legal counsel in connection with such filings), subject to prompt reimbursement from the non-filing Party for fifty percent (50%) of all of such costs and expenses. Either Party may disclaim its interest in any particular patent or patent application included in the Joint Patent Rights, in which case (X) the disclaiming Party shall assign its ownership interest in such patent or patent application to the other Party for no additional consideration, (Y) the Party which is then the sole owner shall be solely responsible for all future costs of such patent or patent application and (Z) the disclaiming Party shall hold no further rights thereunder.

 

11.6.                      Infringement

 

Each Party shall give prompt written notice to the other of any suspected or actual Infringement by a third party of all or any portion of the Ipsen Compound Technology, Ipsen Formulation Technology, Nuvios Patent Rights, Nuvios Know-How, Nuvios Inventions, Joint Inventions or Joint Patent Rights (the Infringed Rights) that comes to the attention of that Party during the Royalty Term with respect to any and all countries in the Territory. Nuvios shall have the first right but not the obligation to initiate and pursue proceedings against such third party in connection with any such suspected or actual Infringement of all or any portion of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights„ and Nuvios shall have the sole right but not the obligation to initiate and pursue proceedings against such third party in connection with any such suspected or actual Infringement of all or any portion of Nuvios Patent Rights, Nuvios Know-How or Nuvios Inventions. The commencement, strategies, termination, and settlement of any action or proceedings relating to the validity or suspected or actual Infringement of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights, or any portion thereof shall be decided by Nuvios in consultation with Ipsen. The commencement, strategies, termination, and settlement of any action or proceedings relating to the validity or suspected or actual Infringement of Nuvios Patent Rights, Nuvios Know-How or Nuvios Inventions, or any portion thereof, shall be decided solely by Nuvios without any requirement that Nuvios consult with Ipsen. Any proceedings initiated and pursued by Nuvios pursuant to this Section 11.6 shall be at the expense of Nuvios. Nothing in this Agreement, however, shall be deemed to require Nuvios to enforce all or any portion of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights„ Nuvios Patent Rights, Nuvios Know-How or Nuvios Inventions against others; provided, however, that if Nuvios does not enforce all or any portion of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights„ Ipsen may do so at its expense and, if necessary under the relevant law of the concerned jurisdiction, in the name of Nuvios as a plaintiff, unless Nuvios reasonably believes that pursuit by Ipsen of any such enforcement action jeopardizes all or any portion of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights„ including the validity thereof, and sends written notice to Ipsen stating that Ipsen should not pursue any such enforcement action for this reason, in which case Ipsen shall

 

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not pursue any such enforcement action. Ipsen may not settle any proceedings or other enforcement action without the prior written consent of Nuvios, which consent shall not be unreasonably withheld or delayed. At the request of the Party bringing such enforcement action or proceeding under this Section 11.6, the other Party shall cooperate reasonably with such Party, including without limitation by having such other Party agree to be named as a party if necessary to such enforcement action or proceeding, and any such reasonable cooperation by such other Party shall be at the sole cost and expense of such Party that requested such cooperation. The Party not bringing an enforcement action or proceeding under this Section 11.6 shall be entitled to separate representation in such matter by counsel of its own choice and at its own expense. Any damages, costs or other amounts recovered in connection with any action or proceeding initiated and pursued by Nuvios or Ipsen pursuant to this Section 11.6, including, without limitation, any settlement thereof, shall be allocated first to the reimbursement of any reasonable expenses incurred by the Party that initiated and pursued such action or proceeding pursuant to this Section 11.6, and any remaining amounts shall be allocated as follows: (i) in the case of any action or proceeding initiated and pursued by Nuvios, such remaining amounts shall be treated as Net Sales and the royalty on such sums shall be payable to Ipsen pursuant to Article 4, and (ii) in the case of any action or proceeding initiated and pursued by Ipsen, such remaining amounts shall be split fifty percent (50%) to Nuvios and fifty percent (50%) to Ipsen.

 

11.7.                      third party intellectual property rights

 

11.7.1.                               Each Party shall give prompt written notice to the other of any intellectual property rights of any third party which could reasonably be considered as constituting impediment on the use of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights in accordance with the provisions of this Agreement or on the research, development, manufacture, use, marketing, promotion, distribution, sale, import or export of Licensed Compound or Licensed Product, in which event the Parties shall agree on the strategy and procedural steps to be taken in respect of opposing and/or settling such potential impediment.

 

11.7.2.                               Each Party shall give prompt written notice to the other of claims or suits arising out of actual or alleged Infringement of Patent Rights, Know-How or other intellectual property owned by a third party, as a result of any use of the Ipsen Compound Technology, Ipsen Formulation Technology, Joint Inventions or Joint Patent Rights in accordance with the provisions of this Agreement or on the research, development, manufacture, use, marketing, promotion, distribution, sale, import or export of Licensed Compound or Licensed Product, in which event Nuvios shall have up to ninety (90) days from receipt of such written notice to contest or defend such claim or suit on behalf of itself and on behalf of Ipsen. If Nuvios elects to contest or defend such claim or suit, Nuvios shall notify Ipsen of such election, and shall keep Ipsen fully informed of any development in such claim or suit, including by transmitting copies of all documents in such claim or suit. If Nuvios contests or defends a claim or suit pursuant to this Section 11.7.2, then (a) Nuvios shall control of the defense of such claim or suit, (b) Ipsen shall provide assistance in the defense of such claim or suit in a reasonable and timely manner

 

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upon reasonable request of Nuvios and at Nuvios’ sole cost and expense; and (c) Nuvios shall have the right to compromise or settle such claim or suit; provided, however, that such compromise or settlement shall be subject to Ipsen’s prior written approval, which shall not be unreasonably withheld. Notwithstanding Nuvios’ control of the defense of any such claim or proceeding, Ipsen shall have the right to participate in such defense using counsel of its own choice and at its own expense.

 

11.7.3.                               If, within such ninety (90) day period, Nuvios elects not to contest or defend, or fails to notify Ipsen of its intent to contest to or defend, such claim or suit, then Ipsen shall have the right to contest or defend such claim or suit on behalf of itself and Nuvios and shall keep Nuvios fully informed of any development in such claim or suit, including by transmitting copies of all documents submitted in such claim or suit. If Ipsen contests or defends a claim or suit pursuant to this Section 11.7.3, then (a) Ipsen shall control the defense of such claim or suit, (b) Nuvios shall provide assistance in the defense of such claim or suit in a reasonable and timely manner upon reasonable request of Ipsen and at Ipsen’s sole cost and expense and (c) Ipsen shall have the right to compromise or settle such claim or suit; provided, however, that such compromise or settlement shall be subject to Nuvios’s prior written approval, which shall not be unreasonably withheld. Notwithstanding Ipsen’s control of the defense of any such claim or proceeding, Nuvios shall have the right to participate in such defense using counsel of its own choice and at its own expense.

 

11.7.4.                               The defending Party shall bear its own costs and expenses (including, without limitation, attorneys fees and court costs) in connection with the defense of any claim or suit pursuant to Section 11.7.2 or Section 11.7.3, and the defending Party shall also bear the costs and expenses of the other Party if and to the extent that such costs and expenses were incurred by such other Party in connection with reasonable assistance provided by such other Party in connection with such defense at the request of the defending Party.

 

11.7.5.                               In the event that, in connection with the defense of any claim or suit pursuant to this Section 11.7 or any settlement thereof, the defending Party shall receive damages, costs or other amounts, such damages, costs or other amounts shall be treated in the manner contemplated under Section 11.6 as if they had been received by the defending Party in connection with any action or proceeding initiated and pursued by the defending Party pursuant to Section 11.6 above.

 

11.7.6.                               The provisions of this Section 11.7 and the respective rights and obligations of the Parties under this Section 11.7 shall be without prejudice to any of the provisions of Article 16 or any of the respective rights and obligations of the Parties under Article 16.

 

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11.8.                      Patent Notices.

 

All notices provided under this Article 11 to Nuvios shall be given to:

 

Nuvios, Inc.

300 Technology Square — 5 th  floor

Cambridge, MA 02139

Attn: Bart Henderson, Chief Business Officer

 

with a copy to:

 

Hamilton Brook Smith & Reynolds, P.C.

530 Virginia Road

P.O. Box 9133

Concord, MA 01742

Attn: David Brook, Esq.

 

All notices provided under this Article 11 to Ipsen shall be given to:

 

SCRAS S.A.S.

24, Rue Erlanger

75016 Paris, France

Attn: Head, Patent Law

 

ARTICLE 12   CONFIDENTIAL INFORMATION

 

12.1.                      Non-Disclosure and Non-Use. In performing under this Agreement, the Parties will share proprietary information (“Confidential Information”) with each other. A Party receiving Confidential Information under this Agreement (“Receiver”) from the other disclosing Party (“Discloser”) shall maintain such Confidential Information as follows:

 

The Receiver of a given item of Confidential Information agrees:

 

not to use such Confidential Information for any purpose other than in connection with the purpose of carrying out this Agreement;

 

to treat such Confidential Information as it would for its own confidential information of the same nature and importance; and

 

to take all reasonable precautions to prevent the disclosure of such Confidential Information to any third party without the prior written consent of the Discloser, except to the extent otherwise permitted pursuant to Section 12.3 below.

 

12.2.                      Exceptions. A Receiver shall be relieved of any and all obligations under Section 12.1 regarding Confidential Information which:

 

was known to the Receiver or its Affiliates prior to receipt hereunder or under any confidentiality agreements signed prior to the Effective Date between the Parties; or

 

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as demonstrated by the Receiver by competent written proof, is independently generated by the Receiver or its Affiliates by persons who have not had access to or knowledge of the Confidential Information disclosed hereunder; or

 

at the time of disclosure by the Discloser to the Receiver, was generally available to the public, or which after disclosure hereunder becomes generally available to the public through no fault attributable to the Receiver, or its Affiliates or sublicensees; or

 

is hereafter made available to the Receiver or its Affiliates for use and unrestricted disclosure by the Receiver from any third party having a right to do so.

 

12.3.                      Authorized Disclosure.

 

12.3.1.                               Nothing in this Agreement shall prohibit disclosure by a Receiver of Confidential Information to its Affiliates, employees, consultants, potential sublicensees or assignees, sublicensees, assignees, advisors, clinical investigators, contract manufacturers, potential lenders, lenders, potential investors, investors, or other third parties, if any, but only on a strict need to know basis for purposes of (i) carrying out, or causing to be carried out, any of the provisions of this Agreement, (ii) the exercise by such Receiver of any of its rights under this Agreement, and (iii) providing for the delegation of any of the obligations of such Receiver under this Agreement; provided , however , that, except in the case of any such disclosure to Receiver’s Affiliates, such disclosure occurs in the context of a written confidentiality agreement containing provisions substantially as protective as those of this Article.

 

12.3.2.                               The restrictions set forth in this Article 12 shall not prevent either Party from disclosing any Confidential Information related to Licensed Compound or Licensed Product to government agencies to the extent reasonably necessary to secure government approval for the development, manufacture or commercialization of a Licensed Compound or a Licensed Product.

 

The restrictions set forth in this Article shall not prevent disclosure to the extent required by law or pursuant to a judicial or governmental order, provided that the Receiver makes reasonable efforts to minimize the extent of any required disclosure and gives the Discloser sufficient notice to permit the Discloser to seek a protective order or other similar order with respect to such Confidential Information, with Receiver’s reasonable assistance therefore.

 

12.4.                      Survival. This Article 12 shall survive any termination or expiration of this Agreement for a period of ten (10) years.

 

ARTICLE 13   PUBLICATION AND PRESS RELEASE

 

13.1.                      Publications.

 

Neither Party shall publish or publicly present the results of studies carried out under this Agreement without the opportunity for prior review by the other Party in accordance with the provisions set forth below in this Section 13.1, and Ipsen shall not publish or publicly present the

 

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results of studies carried out under this Agreement by Nuvios, its Affiliates, sublicensees or contractors. For purposes of this Section 13.1, the term “ Publication Eligible Material ” shall mean any proposed abstracts, manuscripts or presentations (including verbal presentations) that relate to any Licensed Compound or Licensed Product and that are eligible for publication or public presentation by a given Party under this Section 13.1 upon compliance with all of the procedures set forth in this Section 13.1 for publication. Each Party agrees to provide the other Party the opportunity to review any Publication Eligible Material that such Party proposes to publish or publicly present at least sixty (60) days prior to their intended submission for publication and agrees, upon request, not to submit or publicly present any such Publication Eligible Material until the other Party is given a reasonable period of time (not to exceed sixty (60) days) to secure patent protection for any material in such publication or presentation that is owned by the non-publishing Party (either individually or jointly with the publishing Party) and which the non-publishing Party believes to be patentable. Neither Party shall have the right to publish or publicly present Confidential Information of the other Party, and each Party shall remove the Confidential Information of the other Party from any proposed publication or presentation upon request by such other Party. Nothing contained in this Section 13.1 shall prohibit the inclusion of information necessary to file a patent application with a government authority, except for Confidential Information of the non-filing Party, provided the non-filing Party is given a reasonable opportunity to review the information to be included prior to submission of such patent application. Notwithstanding the foregoing, the Parties recognize that independent investigators have been engaged, and will be engaged in the future, to conduct clinical trials of Licensed Products. Such independent investigators are understood to operate in an academic environment and shall be allowed to release information regarding such studies in a manner consistent with academic standards. In the event that either Party submits any manuscript or other publication relating to any Licensed Compound or Licensed Product, it will consider and acknowledge the contributions of the other Party, including, as appropriate, co-authorship.

 

13.2.                      Press Release; Public Disclosure of Agreement. The Parties shall issue a mutually agreed upon joint press release at an agreed date promptly following the execution of this Agreement. Ipsen and Nuvios will jointly discuss and agree in writing on any statement to the public regarding this Agreement or any aspect of this Agreement, subject in each case to disclosure otherwise required by law or regulation as determined in good faith by each Party. When a Party elects to make any such statement it will give the other Party at least ten (10) day’s notice to the other Party to review and comment on such statement.

 

13.3.                      Non-Disclosure of Termination Event. In the event of a termination of this Agreement by Nuvios under Section 15.4, Nuvios will not disclose or cause to be disclosed to any third party the facts or circumstances regarding such termination, except for any such disclosure which is required by law (including if requested by any regulatory agency, taxing authority or commission of competent jurisdiction). As part of its obligation under this Section 13.3, except as is required by law (including if requested by any regulatory agency, taxing authority or commission of competent jurisdiction), Nuvios will not (i) issue any press release with respect to the facts or circumstances regarding termination of this Agreement under Section 15.4 or (ii) respond to press inquiries with respect to the facts or circumstances regarding such termination, other than responses which are materially consistent with public disclosure regarding the same by Ipsen. For purposes of clarity, nothing in this Section 13.3 shall prevent or

 

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restrict Nuvios from disclosing or causing to be disclosed publicly or to any third party the fact that Nuvios has terminated this Agreement for any reason or no reason if and when such termination has in fact occurred. In addition, notwithstanding anything express or implied in this Section 13.3 to the contrary, Nuvios shall be free to disclose the facts or circumstances regarding any termination of this Agreement by Nuvios under Section 15.4 to any third party to whom Nuvios is entitled to disclose Confidential Information of Ipsen pursuant to Section 12.3 (it being understood that, for purposes of this sentence and the provisions of Section 12.3, such facts and circumstances shall be treated as Confidential Information of Ipsen).

 

ARTICLE 14   REPRESENTATIONS, WARRANTIES AND COVENANTS

 

14.1.                      Mutual Representations and Warranties. Each Party hereby represents and warrants as follows:

 

(a)                                  It is a corporation duly organized, validly existing and in good standing under the laws of the jurisdiction in which it is incorporated, and has full corporate power and authority and the legal right to own and operate its property and assets and to carry on its business as it is now being conducted and as contemplated in this Agreement, including, without limitation, the right to grant the licenses it is granting hereunder.

 

(b)                                  On the Effective Date, (i) it has the full right and authority to enter into this Agreement and perform its obligations hereunder, (ii) it is not aware of any impediment that would prevent it from entering into the Agreement or that would inhibit its ability to perform its obligations under this Agreement, (iii) it has taken all necessary corporate action on its part required to authorize the execution and delivery of this Agreement and the performance of its obligations hereunder, and (iv) this Agreement has been duly executed and delivered on behalf of such Party, and constitutes a legal, valid and binding obligation of such Party that is enforceable against it in accordance with its terms.

 

(c)                                   It has not entered into any agreement with any third party that is in conflict with the rights granted to the other Party under this Agreement, and has not taken any action that would in any way prevent it from granting the rights granted to the other Party under this Agreement, or that would otherwise materially conflict with or materially adversely affect the rights granted to the other Party under this Agreement. Its performance and execution of this Agreement will not result in a breach of any other contract to which it is a party.

 

(d)                                  On the Effective Date, it is not aware of any action, suit, inquiry or investigation instituted by any third party which questions or threatens the validity of this Agreement.

 

(e)                                   All necessary consents, approvals and authorizations of all governmental authorities and other persons or entities required to be obtained by such Party in

 

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connection with the execution, delivery and performance of this Agreement have been obtained.

 

(f)                                    To the best of its knowledge, each Party has, on the Effective Date, the right to grant to the other Party the rights and licenses granted by such Party to the other Party pursuant to this Agreement.

 

(g)                                   Each Party has, on the Effective Date, the necessary qualified personnel, equipment, technical know-how and other means to perform its duties under this Agreement in a timely manner in accordance with the terms hereof.

 

14.2.                      Ipsen Representations and Warranties.

 

Ipsen warrants and represents that:

 

(a)                                  Ipsen is the owner of the Ipsen Patent Rights and the Ipsen Know-How that exist on the Effective Date, free and clear (on the Effective Date) of all liens or security interests. On the Effective Date, Ipsen is not aware of any right or license of any third party that is required to permit Ipsen to perform its obligations under this Agreement in accordance with the terms of this Agreement or to permit Nuvios to exercise its rights hereunder in accordance with the terms of this Agreement.

 

(b)                                  On the Effective Date, Ipsen does not own, control or otherwise have the right to use or practice any rights under any patent or patent application that are not included in the Ipsen Patent Rights on the Effective Date and that would be necessary or useful to the research, Development, manufacture, marketing, promotion, use, sale, import or export of Licensed Compound or Licensed Product.

 

(c)                                   On the Effective Date and to Ipsen’s knowledge, there are no claims against Ipsen asserting that the Ipsen Compound Technology or the Ipsen Formulation Technology Infringes the rights of any third party. On the Effective Date and to Ipsen’s knowledge (after conducting a reasonable investigation), there are no patents or patent applications of any third party that have published prior to the Effective Date or that are otherwise publicly available prior to the Effective Date and that would be Infringed by the use, practice or exploitation of all or any portion of Ipsen Compound Technology.

 

(d)                                  On or prior to the Effective Date, Ipsen has not given any notice to any third party asserting Infringement by such third party of all or any portion of the Ipsen Compound Technology or the Ipsen Formulation Technology and to Ipsen’s knowledge, Ipsen is not aware of any such Infringement.

 

(e)                                   On the Effective Date, Ipsen is not a party to any contract or agreement with a third party pursuant to which Ipsen licensed-in or otherwise acquired or has the right to use the Ipsen Compound Technology or Ipsen Formulation Technology or pursuant to which Ipsen or Nuvios (or any of Nuvios’ sublicensees or

 

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Contractors) is or will be required to make payments on account of the use, practice or exploitation of all or any portion of the Ipsen Compound Technology or Ipsen Formulation Technology.

 

(f)                                    Appendix E sets forth an accurate and complete list of all INDs and other applications for Regulatory Approval with respect to Licensed Compound and/or Licensed Product filed by Ipsen anywhere in the world on or prior to the Effective Date. Ipsen is on the Effective Date the owner of all INDs and other applications for Regulatory Approval set forth on Appendix E, free and clear (as of the Effective Date) of all liens, encumbrances or security interests in favor of third parties. On and prior to the Effective Date and to Ipsen’s knowledge, Ipsen has complied in all material respects with all laws applicable to all INDs and other applications for Regulatory Approval set forth on Appendix E.

 

(g)                                   Ipsen has disclosed to Nuvios (i) the results of all preclinical and clinical testing in its possession or control or that are known to Ipsen on the Effective Date; and (ii) all information in its possession or control or that are known to Ipsen on the Effective Date concerning side effects, injury, toxicity or sensitivity reaction and incidents or severity thereof with respect to Licensed Compound and/or Licensed Product. Ipsen has not withheld any information which, in Ipsen’s reasonable judgment, is material to this transaction. All information and data disclosed by Ipsen to Nuvios are complete and accurate in all material respects.

 

(h)                                  On the Effective Date, there is no litigation against Ipsen with respect to all or any portion of the Ipsen Compound Technology or Ipsen Formulation Technology.

 

(i)                                      On or prior to the Effective Date, Ipsen has not entered into any agreement with a third party pursuant to which Ipsen shall have agreed not to enforce any right of Ipsen to preclude such third party from using or practicing any or all of the Ipsen Compound Technology or the Ipsen Formulation Technology.

 

(j)                                     On the Effective Date, Ipsen is not aware that it is in breach of all or any portion of the Teijin Agreement. On or prior to the Effective Date, Ipsen has not been notified by Teijin that Teijin believes that Ipsen is in breach of all or any portion of the Teijin Agreement.

 

(k)                                  In the event of a deadlock or disagreement in the Japanese Development Committee, Ipsen has the right to cast a tie-breaking vote and that the Teijin Agreement provides that (i) the ultimate decision-making power and authority with respect to all matters concerning the development of Licensed Compound or Licensed Product in Japan is with the Japanese Development Committee and (ii) Teijin is required to abide by any decision made by the Japanese Development Committee with respect to the development of Licensed Compound or Licensed Product in Japan.

 

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(l)                                      During the course of negotiation of this Agreement prior to the Effective Date, Nuvios, or representatives of Nuvios, have had the opportunity to ask questions of and receive answers from representatives of Ipsen concerning, and to obtain information, documents, records and books relative to, Ipsen, its business, Licensed Compound, Licensed Product, and Ipsen represents and warrants that it did not knowingly withhold any material information from Nuvios in response to Nuvios’s inquiries or otherwise in connection with the subject matter of this Agreement.

 

(m)                              Appendix B sets forth an accurate and complete list of all Ipsen Patent Rights on the Effective Date. Appendix B1 sets forth an accurate and complete list of all Ipsen Compound Patent Rights on the Effective Date. Appendix B2 sets forth an accurate and complete list of all Ipsen Formulation Patent Rights on the Effective Date.

 

14.3.                      Nuvios Representations and Warranties. Nuvios warrants and represents that as of the Effective Date, Nuvios did not knowingly withhold any material information related to the Ipsen Patent Rights with regards to third party intellectual property rights.

 

14.4.                      No Other Representations or Warranties. EXCEPT AS EXPRESSLY PROVIDED IN THIS AGREEMENT OR IN ANY OTHER WRITTEN AGREEMENT BETWEEN THE PARTIES, THE FOREGOING REPRESENTATIONS AND WARRANTIES ARE IN LIEU OF, AND EACH PARTY EXPRESSLY DISCLAIMS, ANY AND ALL REPRESENTATIONS AND WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING, WITHOUT LIMITATION, WARRANTIES OF DESIGN, MERCHANTABILITY, AND FITNESS FOR A PARTICULAR PURPOSE.

 

14.5.                      Mutual Covenants. Each Party covenants the following:

 

That it shall comply in all material respects with all federal, state, provincial, territorial, governmental and local laws, rules and regulations applicable to the development, manufacture and commercialization of Licensed Product by such Party.

 

That it shall disclose immediately to the other Party all information in its possession or control and as to which it becomes aware concerning side effects, injury, toxicity or sensitivity reaction and incidents or severity thereof with respect to Licensed Product.

 

ARTICLE 15   TERM AND TERMINATION

 

15.1.                      Term. The Term of this Agreement shall commence upon the Effective Date. This Agreement is entered into for a period commencing on the Effective Date and, unless this Agreement is terminated sooner as provided in this Article 15, ending on the date when no payment obligations under this Agreement are or will become due pursuant to Article 4.1 under any and all countries in the Territory. Upon expiration of the Term of this Agreement, the licenses granted by Ipsen to Nuvios pursuant to Section 2.1 hereof, to the extent they remain in full force and effect at the time of such expiration, shall thereafter become irrevocable, perpetual

 

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and fully paid-up exclusive licenses and shall survive such expiration of the Term of this Agreement.

 

In any event of early termination of this Agreement (other than due to early termination by Nuvios on account of material breach by Ipsen of any of its obligations under this Agreement), all licenses granted by Ipsen to Nuvios pursuant to Section 2.1 hereof shall terminate and Ipsen Know-How and Ipsen Patent Rights shall revert back to Ipsen at no cost. In any event of early termination of this Agreement (other than due to early termination by Nuvios on account of material breach by Ipsen of any of its obligations under this Agreement), Nuvios preclinical, clinical and manufacturing data and improvements with respect to Licensed Product shall be transferred to Ipsen or its designee, at no cost to Ipsen.

 

In any event of early termination of this Agreement (other than due to early termination by Nuvios on account of material breach by Ipsen of any of its obligations under this Agreement), Nuvios shall in accordance with Section 15.5 of this Agreement (i) transfer to Ipsen or a third party appointed by Ipsen, at no cost to Ipsen, all of the then ongoing development activities and the manufacturing Know-How with respect to Licensed Product, and (ii) use reasonable commercial efforts to effect such transfer so as to avoid or minimize disruptions in the ongoing development or supply of Licensed Product.

 

15.2.                      Breach. A Party (“Non-Breaching Party”) shall have the right, in addition to any other rights and remedies, to terminate this Agreement in the event the other Party (“Breaching Party”) is in breach of any of its material obligations under this Agreement. The Non-Breaching Party shall provide written notice to the Breaching Party, which notice shall identify the breach. The Breaching Party shall have a period of sixty (60) days after such written notice is provided to cure such breach. If such breach is not cured within the relevant period, this Agreement shall terminate.

 

The waiver by either Party of any breach of any term or condition of this Agreement shall not be deemed a waiver as to any subsequent or similar breach.

 

The right to terminate this Agreement under this Section 15.2 is in addition to any other right and protection that may otherwise be available as a result of a breach, including, without limitation, the right to damages.

 

15.3.                      Voluntary Termination.

 

Nuvios may terminate the Agreement for any reason, any time after the final study report Phase Ib has been delivered to Ipsen.

 

15.4.                      Ipsen Right to Voluntarily Terminate.

 

Ipsen shall have the unilateral right to terminate this Agreement in its entirety, upon written notice to Nuvios with immediate effect, if Nuvios in any country of the world brings an action or proceeding seeking to have an Ipsen Patent Right declared invalid or unenforceable.

 

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Ipsen may terminate this Agreement pursuant to, and in accordance with, the provisions of Section 15.2 in the event that Nuvios fails to use reasonable commercial efforts to develop the Licensed Product for sale and commercialization in those countries within the Territory where it is commercially reasonable to do so subject to, and in accordance with, the provisions of Section 7.2 hereof, or fails to use reasonable commercial efforts to perform its obligations under the latest revised version of the Development Plan approved by the JSC subject to, and in accordance with, the provisions of Section 7.2 hereof, or fails to use reasonable commercial efforts to launch and sell one Licensed Product in those countries within the Territory where it is commercially reasonable to do so subject to, and in accordance with, the provisions of Sections 10.1 and 10.4 hereof.

 

Ipsen may terminate this Agreement pursuant to, and in accordance with, the provisions of Section 15.2 in the event that this Agreement is assigned or sublicensed or in the event that a third party acquires Nuvios or in the event that Nuvios acquires control over a PTH or a PTHrP compound that is in clinical development or is commercially available in the Territory and that, following such assignment, sublicense, acquisition, or acquisition of control by Nuvios, such assignee, sublicensee, acquirer or Nuvios fails to meet the timetable under the latest revised version of the Development Plan approved by the JSC. Any failure to meet such timetable under the circumstances contemplated in this paragraph shall be deemed, for purposes of this paragraph and Section 15.2, a material breach of Nuvios’ obligations under this Agreement.

 

15.5.                      Consequences of Early Termination by Nuvios without Cause or by Ipsen for Cause. Upon termination of this Agreement by Nuvios pursuant to Section 15.3 or upon termination of this Agreement by Ipsen pursuant to Section 15.2 or Section 15.4:

 

15.5.1.                               Nuvios shall:

 

15.5.2.1 make its personnel reasonably available to Ipsen as necessary to effect an orderly transition of development and commercial responsibilities, with the reasonable cost of such personnel to be borne by Nuvios for such services; and

 

15.5.2.2 assign and transfer to Ipsen and execute all such documents as may be reasonably required, therefore, at no expense to Ipsen, all of Nuvios’s right, title and interest in the following to the extent they pertain to Licensed Product:

 

·                                           all regulatory filings (such as INDs and drug master files), Regulatory Approvals, clinical trial agreements (to the extent assignable and not cancelled); and

 

·                                           all data, including formulation data, results, clinical trial data, support documentation having arisen out of the materials and other information, in Nuvios’s possession and control related to Licensed Product in the Territory; and

 

46



 

·                                           all customer lists, marketing and promotional material, and all other documentation related to marketing, sale, and promotion of the Licensed Product in the Territory, and

 

·                                           all trademarks used for Licensed Product, provided however that the responsibility of preparing and filing of the documents for the recordation of the assignments with the competent authorities in each applicable country and any action required ancillary, shall be borne by Ipsen and that each Party shall bear its expenses caused by its activities in connection with the assignments and transfer of the trademarks.

 

15.5.2.                               Nuvios shall initiate transfer (and complete the same in a timely manner), to Ipsen of all technical and industrial know how related to the manufacturing of Licensed Product for use by Ipsen and shall provide reasonable assistance and support (up to a reasonable number of person-days of qualified personnel) as may be reasonably required by Ipsen to be in a position to make Licensed Compound and Licensed Product itself. Any such transfer under this Section 15.5.3 shall be at Nuvios expense during the termination notice period and at Ipsen’s expense thereafter.

 

15.5.3.                               All licenses granted by Ipsen to Nuvios under this Agreement, and all licenses granted by Nuvios to Ipsen or Teijin under this Agreement, shall terminate on the effective date of termination. Notwithstanding anything in this Section 15.5.4 or elsewhere in this Agreement to the contrary, Nuvios may for a period not exceeding six months continue making, marketing, promoting and selling Licensed Compound and Licensed Product in the Territory after the termination of such licenses.

 

15.5.4.                               No compensation or refund shall be due by either Party to the other Party, otherwise than damages as determined by a court of competent jurisdiction:

 

15.5.5.                               Nuvios shall agree to take such actions and execute such instruments, agreements and documents as are necessary to effect the foregoing.

 

15.5.6.                               Unless otherwise agreed by the Parties, the termination of this Agreement shall cause the automatic termination of all ancillary agreements related hereto, including, but not limited to, the supply agreements and technical agreements referred to in Article 9.

 

15.6.                      Accrued Rights; Surviving Rights and Obligations.

 

Expiration or termination of this Agreement, for any reason, will not relieve either Party of any obligation accruing prior to such expiration or termination. Articles and Sections 1, 5.6, 12, 13, 14, 15, 16, 17 and 18 shall survive expiration or termination of this Agreement. In addition, the obligations and rights of any other provisions of this Agreement, which by their nature of the provision and the nature of the termination or expiration, are intended to survive, shall survive and continue to be enforceable.

 

47



 

ARTICLE 16   INDEMNIFICATION

 

16.1.                      Indemnification by Ipsen. Ipsen agrees to indemnify, hold harmless and defend Nuvios and its Affiliates and their respective directors, officers, employees and agents (collectively, the “ Nuvios Indemnitees ”) from and against any and all suits, claims, actions, demands, liabilities, expenses and/or loss, cost of defense (including without limitation reasonable attorneys’ fees, court costs, witness fees, damages, judgments, fines and amounts paid in settlement) and any other amounts (collectively, “ Losses ”) that any Nuvios Indemnitee becomes legally obligated to pay to a third party, because of any claim or claims against such Nuvios Indemnitee to the extent that such claim or claims arise out of or resulted from (i) a breach of a representation or warranty or covenant by Ipsen under Article 14; (ii) a breach by Ipsen of any other provision of this Agreement or of any representation, warranty, covenant or other provision in any Related Agreement; (iii) the manufacture by or on behalf of Ipsen under Article 9; (iv) the use, development, handling or commercialization of any Licensed Compound, any Licensed Product or the Ipsen Formulation Technology by or on behalf of Ipsen or any of its Affiliates, licensees, sublicensees, distributors or contractors, or any of their respective employees or agents; or (iv) the gross negligence or willful misconduct of Ipsen, its Affiliates, licensees, sublicensees, distributors or contractors, or any of their respective employees or agents; provided, however, that Ipsen shall not be required to indemnify the Nuvios Indemnitees for any Losses pursuant to this Section 16.1 to the extent that (1) such Losses arise from Nuvios’ breach of any of the provisions of this Agreement or any Related Agreement, (2) such Losses arise or result from the gross negligence or willful misconduct of Nuvios or any of its Affiliates, licensees, sublicensees, contractors or distributors, or any of their respective agents or employees, or (3) Ipsen’s liability for such Losses is limited pursuant to Section 16.4.

 

16.2.                      Indemnification by Nuvios. Nuvios agrees to indemnify, hold harmless and defend Ipsen and its Affiliates and their respective directors, officers, employees and agents (collectively, the “ Ipsen Indemnitees ”) from and against any and all Losses that any Ipsen Indemnitee becomes legally obligated to pay to a third party, because of any claim or claims against such Ipsen Indemnitee to the extent that such claim or claims arise out of or resulted from (i) a breach of a representation or warranty or covenant by Nuvios under Article 14, (ii) a breach by Nuvios of any other provision of this Agreement or of any representation, warranty, covenant or other provision in any Related Agreement, (iii) the manufacture by or on behalf of Nuvios under Article 9; (iv) the making, use, development, handling or commercialization of any Licensed Compound or any Licensed Product by or on behalf of Nuvios or any of its Affiliates, licensees, sublicensees or Contractors, or any of their respective employees or agents or (v) the gross negligence or willful misconduct of Nuvios, its Affiliates, licensees, sublicensees or Contractors, or any of their respective employees or agents; provided , however , that Nuvios shall not be required to indemnify the Ipsen Indemnitees for any Losses pursuant to this Section 16.2 to the extent that (1) such Losses arise from Ipsen’s breach of any of the provisions of this Agreement or any Related Agreement, (2) such Losses arise or result from the gross negligence or willful misconduct of Ipsen or any of its Affiliates, licensees, sublicensees, contractors or distributors, or any of their respective agents or employees, (3) such Losses arise or result from any Infringement of the patent rights or other intellectual property rights of any third party by all or any portion of the Ipsen Patent Rights, Ipsen Know-How or Ipsen Formulation Technology or (4) Nuvios’ liability for such Losses is limited pursuant to Section 16.4.

 

48


 

16.3.                      Procedure. In the event of a claim by a third party against any person entitled to indemnification under this Agreement (“Indemnified Person”), the Indemnified Person shall promptly notify the Party having the indemnification obligation under this Agreement with respect to such claim (such Party, the “Indemnifying Party”) in writing of the claim. The indemnifying Party shall have the right to assume the defense of any such third party claim for which it is obligated to indemnify the Indemnified Person under this Article XVI. The Indemnified Person shall cooperate with the Indemnifying Party (and its insurer) as the Indemnifying Party may reasonably request, and at the Indemnifying Party’s sole cost and expense. The Indemnified Person shall have the right to participate, at its own expense and with counsel of its choice, in the defense of any claim or suit that has been assumed by the Indemnifying Party. The Indemnifying Party shall have no obligation to indemnify an Indemnified Person in connection with any settlement made without the Indemnifying Party’s prior written consent. If the Parties cannot agree as to the application of this Article XVI to any third party claim, the Parties may conduct separate defenses of such claims, with each Party retaining the right to claim indemnification from the other in accordance with this Article XVI upon resolution of the underlying claim.

 

16.4.                      NOTWITHSTANDING ANYTHING EXPRESS OR IMPLIED IN THIS AGREEMENT TO THE CONTRARY, IN NO EVENT SHALL EITHER PARTY BE LIABLE TO THE OTHER PARTY FOR LOSS OF PROFITS, SPECIAL, INDIRECT, INCIDENTAL, PUNITIVE OR CONSEQUENTIAL DAMAGES ARISING OUT OF THIS AGREEMENT.

 

ARTICLE 17   DISPUTE RESOLUTIONS AND GOVERNING LAW

 

17.1.                      Disputes. Unless otherwise set forth in this Agreement, in the event of a dispute arising under this Agreement between the Parties, the Parties shall remain bound by the terms of this Agreement and each Party shall refer such dispute to one executive officer, and such executive officer shall attempt in good faith to resolve such dispute.

 

17.2.                      Arbitration. If the Parties are unable resolve a given dispute pursuant to Section 17.1 within sixty (60) days of referring such dispute to the executive officers, the Parties shall remain bound by the terms of this Agreement and either Party may have the given dispute settled by binding arbitration in the manner described below:

 

17.3.                      Arbitration Request. If a Party intends to begin an arbitration to resolve a dispute arising under this Agreement, such Party shall provide written notice (the “Arbitration Request”) to the other Party of such intention and the issues for resolution.

 

17.4.                      Additional Issues. Within thirty (30) business days after the receipt of the Arbitration Request, the other Party may, by written notice, add additional issues for resolution.

 

17.5.                      Arbitration Procedure. Any arbitration to resolve a dispute arising under this Agreement shall be a final and binding arbitration pursuant to the then-current Rules of Arbitration of the International Chamber of Commerce as hereinafter provided:

 

49



 

17.5.1.                               The Arbitration Tribunal shall consist of three (3) arbitrators. Each party shall nominate in the Arbitration Request and the answer thereto one (1) arbitrator and the two (2) arbitrators so named will then jointly appoint the third arbitrator as chairman of the Arbitration Tribunal. If one Party fails to nominate its arbitrator or, if the parties’ arbitrators cannot agree on the person to be named as chairman within sixty (60) days, the International Chamber of Commerce shall make the necessary appointments for arbitrator or chairman in accordance with the Rules of Arbitration of the International Chamber of Commerce.

 

17.5.2.                               The place of arbitration shall be in London, England, and the arbitration proceedings shall be held in English. The procedural law of the place of arbitration shall apply where the said Rules are silent.

 

17.5.3.                               The award of the Arbitration Tribunal shall be final and judgment upon such an award may be entered in any competent court or application may be made to any competent court for juridical acceptance of such an award and order of enforcement.

 

17.5.4.                               Notwithstanding the referral of any dispute, controversy or claim arising out of or in connection with this Agreement to arbitration pursuant to this Section 17.5, both Parties shall remain free to seek interim, injunctive or conservatory relief, provided that the order of the relevant judicial authority shall not in any way prejudice the above tribunals’ power to settle the dispute referred to them in accordance with the Rules of Arbitration of the International Chamber of Commerce.

 

17.6.                      Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of New York, U.S.A., without reference to its conflict of laws principles, and shall not be governed by the United Nations Convention of International Contracts on the Sale of Goods (the Vienna Convention).

 

ARTICLE 18   MISCELLANEOUS

 

18.1.                      Agency - Independent Contractor. Neither Party is an employee, agent or representative of the other Party for any purpose, and nor shall this Agreement create or establish an employment, agency or any other relationship. Except as may be specifically provided herein, neither Party shall have any right, power, or authority, nor shall they represent themselves as having authority to assume, create or incur any expense, liability or obligation, express or implied, on behalf of the other Party, or otherwise act as an agent for the other Party for any purpose.

 

18.1.1.                               The Parties agree that the relationship of Ipsen and Nuvios established by this Agreement is that of independent licensee and licensor. This Agreement does not, is not intended to, and shall not be construed to; establish a partnership or joint venture.

 

18.2.                      Entire Agreement. This Agreement, including all appendices, schedules and attachments, embodies the entire understanding of the Parties with respect to the subject matter

 

50



 

hereof and supersedes all previous communications, representations or understandings, and agreements, whether oral or written, between the Parties relating to the subject matter hereof.

 

18.3.                      Assignment. Except to the extent otherwise expressly provided elsewhere in this Agreement, either Party may assign this Agreement or any of such Party’s rights and obligations under this Agreement to any of its Affiliates or any third party, provided that the rights and obligations of the Parties under this Agreement shall be binding upon and inure to the benefit of the successors and assigns of the Parties and that an assignment or delegation of this Agreement by a Party or of any of a Party’s obligations under this Agreement shall not operate to release such Party from any of its obligations under this Agreement or from the specific obligation assigned or delegated by such Party. Any assignment not in accordance with this Agreement shall be void.

 

18.4.                      Notices. Any notice or other communication under this Agreement, unless otherwise specified, shall be in writing and provided when delivered to the addressee at the address listed below (a) on the date of delivery if delivered in person or (b) three (3) days after mailing to the other Party by express mail or overnight delivery service, which obtains a signed receipt:

 

In the case of Ipsen:

 

SCRAS S.A.S.

42, Rue du Docteur Blanche

75016 Paris

Attn.: General Counsel

 

In the case of Nuvios:

 

Nuvios Inc.

300 Technology Square — 5 th  Floor

Cambridge, MA 02139

Attn: M. Bart Hendersson — Chief Business Officer

 

Either Party may change its address for communications by a notice in writing to the other Party in accordance with this Section.

 

18.5.                      Force Majeure. Any prevention, delay or interruption of performance (collectively “Delay”) by any Party under this Agreement shall not be a breach of this Agreement if and to the extent caused by occurrences beyond the reasonable control of the Party affected by the force majeure, including but not limited to acts of God, embargoes, governmental restrictions, terrorism, general strike, fire, flood, earthquake, explosion, riots, wars (declared or undeclared), civil disorder, rebellion or sabotage. The affected Party shall immediately notify the other Party upon the commencement and end of the Delay. During the Delay, any time for performance hereunder by either Party shall be extended by the actual time of Delay. If the Delay resulting from the force majeure exceeds six (6) months, the other Party, upon written

 

51



 

notice to the affected Party, may elect to (a) treat such Delay as a material breach solely for purposes of exercising the right to terminate this Agreement for material breach pursuant to, and in accordance with, Section 15.2, or (b) extend the term of this Agreement for an amount of time equal to the Delay.

 

18.6.                      Severability. If any of the provisions of this Agreement are held to be void or unenforceable by a court of competent jurisdiction, then such void or unenforceable provisions shall be replaced by valid and enforceable provisions which will achieve as far as possible the economic business intentions of the Parties. However the remainder of this Agreement will remain in full force and effect, provided that the material interests of the Parties are not affected, i.e. the Parties would presumably have concluded this Agreement without the unenforceable provisions.

 

18.7.                      No Right to Use Names. Except as otherwise expressly provided herein, this Agreement provides no grant of right to a Party, express or implied, to use in any manner the housemarks or trademarks of the other Party or its Affiliates.

 

18.8.                      Bankruptcy. All rights and licenses granted under or pursuant to this Agreement by Nuvios or Ipsen are, and will otherwise be deemed to be, for purposes of Section 365(n) of the U.S. Bankruptcy Code (or the equivalent provisions, if any, in the bankruptcy laws of the applicable jurisdiction) licenses of right to “intellectual property” as defined under Section 101 of the U.S. Bankruptcy Code. The Parties agree that the Parties, as licensees of such rights under this Agreement, will retain and may fully exercise all of their rights and elections under the U.S. Bankruptcy Code. The Parties further agree that, in the event of the commencement of a bankruptcy proceeding by or against either Party under the U.S. Bankruptcy Code, the Party hereto that is not a party to such proceeding will be entitled to a complete duplicate of (or complete access to, as appropriate) any such intellectual property and all embodiments of such intellectual property, and same, if not already in their possession, will be promptly delivered to them (a) upon any such commencement of a bankruptcy proceeding upon their written request therefore, unless the Party subject to such proceeding elects to continue to perform all of its obligations under this Agreement, or (b) if not delivered under (a) above, following the rejection of this Agreement by or on behalf of the Party subject to such proceeding upon written request therefore by the non-subject Party.

 

18.9.                      Performance by Affiliates. Each of Nuvios and Ipsen acknowledge that obligations under this Agreement may be performed by Affiliates of Nuvios and Ipsen. Each of Nuvios and Ipsen guarantee and warrant any performance of this Agreement by its Affiliates. Wherever in this Agreement the Parties delegate responsibility to Affiliates, the Parties agree that such entities may not make decisions inconsistent with this Agreement, amend the terms of this Agreement or act contrary to its terms in any way.

 

18.10.               Counterparts. The Parties may execute this Agreement in counterparts, each of which the Parties shall deem an original, but all of which together shall constitute one and the same instrument.

 

52



 

18.11.               Waiver. A waiver of any default, breach or non-compliance under this Agreement is not effective unless signed by the Party to be bound by the waiver. No waiver will be inferred from or implied by any failure to act or delay in acting by a Party in respect of any default, breach, non-observance or by anything done or omitted to be done by the other Party. The waiver by a Party of any default, breach or non-compliance under this Agreement will not operate as a waiver of that Party’s rights under this Agreement in respect of any continuing or subsequent default, breach or non-compliance (whether of the same or any other nature).

 

In Witness Whereof, the Parties have executed this Agreement in two originals by their proper officers as of the date and year first above written.

 

 

SCRAS S.A.S.

 

 

Nuvios Inc

 

 

 

 

 

By:

/s/ C. Giraut

 

By:

/s/ C. R. Lyttle

 

 

 

 

 

Name:

C. Giraut

 

Name:

C. Richard Lyttle

 

 

 

 

 

Title:

President

 

Title:

President & CEO

 

53



 

APPENDIX A - CHEMICAL STRUCTURE OF BIM-44058

 

Description of the Product

 

Denomination/Code Number

 

Laboratory code: BIM444058 (free base)/ BIM44058 (acetate salt)

 

Chemical Formula

 

[Glu 22.23 , Leu 23.28.31 , Aib 29 , Lys 26.30 ] hPTHrP (1-34) NH 2

 

This peptide is available as an acetate salt designated BIM44058

 

Molecular Formula and Weight

 

Molecular formula (base): C 174  H 300  N 56  O 49 .

 

Molecular weight (base): 3960.7.

 

Molecular Structure:

 

 

54



 

APPENDIX B - IPSEN PATENT RIGHTS

 

APPENDIX B 1 - IPSEN COMPOUND PATENT RIGHTS

 

Patent Family In Which BIM-44058 Is Claimed

 

Biomeasure
Reference No.

 

Application
Country

 

Serial No.

 

Application File
Date

 

Patent Number

 

Patent Issue Date

 

Patent Expiry

 

 

 

 

 

 

 

 

 

 

 

 

 

038/US2

 

United States

 

08/779,768

 

01-07-97

 

5,969,095

 

10-19-1999

 

03-29-2016

038/US/PCT2

 

PCT

 

PCT/US96/11292

 

07-03-96

 

 

 

 

 

 

038/US/PCT2/EP

 

Europe

 

96924355.9

 

01-30-98

 

0 847 278

 

09-24-2003

 

07-03-2016

Registration: AT, BE, CH, DE, DK, ES, FI, FR, GB, GR, IE, IT, LI, LU, MC, NL, PT, SE; Ext: AL, LT, LV, SI

038/US/PCT2/EP-A

 

Europe

 

03077383.2

 

07-30-2003

 

Pending

 

 

 

 

038/US/PCT2/JP

 

Japan

 

9-505897

 

01-12-98

 

Pending

 

 

 

 

038/US/PCT2/JP-A

 

Japan

 

2003-008027

 

01-16-2003

 

Pending

 

 

 

 

038/US/PCT2/AU

 

Australia

 

64834/96

 

07-03-96

 

707094

 

07-01-1999

 

07-03-2016

038/US/PCT2/CA

 

Canada

 

2,226,177

 

12-19-97

 

Pending

 

 

 

 

038/US/PCT2/CN

 

China

 

96196926.1

 

07-03-96

 

Pending

 

 

 

 

038/US/PCT2/CN-A

 

China

 

200410005427.7

 

07-03-96

 

Pending

 

 

 

 

038/US/PCT2/CN/HK

 

Hong Kong

 

99100132.1

 

01-13-99

 

Pending

 

 

 

 

038/US/PCT2/HU

 

Hungary

 

P9901718

 

07-03-96

 

Pending

 

 

 

 

038/US/PCT2/IL

 

Israel

 

122837

 

07-03-96

 

122837

 

02-11-2003

 

07-03-2016

038/US/PCT2/KR

 

Korea

 

1998-0700249

 

01-13-98

 

0500853

 

07-04-2005

 

07-03-2016

038/US/PCT2/KR-A

 

Korea

 

2004-706338

 

04-28-2004

 

Pending

 

 

 

 

038/US/PCT2/KR-B

 

Korea

 

2004-706339

 

04-28-2004

 

Pending

 

 

 

 

038/US/PCT2/KR-C

 

Korea

 

2004-706340

 

04-28-2004

 

Pending

 

 

 

 

038/US/PCT2/KR-D

 

Korea

 

2004-706341

 

04-28-2004

 

Pending

 

 

 

 

038/US/PCT2/MX

 

Mexico

 

PA/a/1998/000418

 

07-03-96

 

222317

 

08-26-2004

 

07-03-2016

038/US/PCT2/NZ

 

New Zealand

 

312899

 

01-20-98

 

312899

 

02-08-2000

 

07-03-2016

038/US/PCT2/PL

 

Poland

 

P.325905

 

01-12-98

 

186710

 

08-07-2003

 

07-03-

2016038/US/PCT2/RU

 

Russia

 

98102406

 

07-03-96

 

2,157,699

 

10-20-2000

 

07-03-2016

038/US/PCT2/SG

 

Singapore

 

9706046-1

 

07-03-96

 

51260

 

10-16-2001

 

07-03-2016

038/US/TW

 

Taiwan

 

85108390

 

07-11-96

 

153897

 

08-07-2002

 

07-11-2016

 

 

 

 

 

 

 

 

 

 

 

 

 

Closely Related Patent Cases

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

038/US

 

United States

 

08/626,186

 

03-29-96

 

5,723,577

 

03-03-1998

 

03-29-2016

 

55



 

038/US3

 

United States

 

08/813,534

 

03-07-97

 

5,955,574

 

09-21-1999

 

03-29-2016

03B/US3/PCT2

 

PCT

 

PCT/US97/22498

 

12-08-97

 

 

 

 

 

 

038/US3/PCT2/US2

 

United States

 

09/399,499

 

09-20-99

 

6,544,949

 

04-08-2003

 

03-29-2016

038/US3/PCT2/US2-A

 

United States

 

10/289,519

 

11-06-2002

 

6,921,750

 

07-26-2005

 

03-29-2016

038/US3/PCT2/US2-B

 

United States

 

11/094,662

 

03-30-2005

 

Pending

 

 

 

 

038/US3/PCT2/EP

 

Europe

 

97951595.4

 

07-08-99

 

Allowed

 

 

 

 

038/US3/PCT2/JP

 

Japan

 

10-530865

 

12-08-97

 

Pending

 

 

 

 

038/US3/PCT2/AU

 

Australia

 

55199/98

 

12-08-97

 

741584

 

03-21-2002

 

12-08-2017

038/US3/PCT2/CA

 

Canada

 

2,276,614

 

07-02-99

 

2,276,614

 

06-11-2002

 

12-08-2017

038/US3/PCT2/CN

 

China

 

97181915.7

 

12-08-97

 

ZL97181915.7

 

02-11-2004

 

12-08-2017

038/US3/PCT2/CN-HK

 

Hong Kong

 

00105467.3

 

12-08-2000

 

1026215

 

07-09-2004

 

12-08-2017

038/US3/PCT2/CZ

 

Czech Republic

 

PV 1999-2398

 

07-02-99

 

Pending

 

 

 

 

038/US3/PCT2/HU

 

Hungary

 

P9904596

 

12-08-97

 

Pending

 

 

 

 

038/US3/PCT2/IL

 

Israel

 

130794

 

07-06-2000

 

Pending

 

 

 

 

038/US3/PCT2/IN

 

India

 

7/MAS/98

 

01-01-98

 

Pending

 

 

 

 

038/US3/PCT2/KR

 

Korea

 

1999-7006165

 

07-07-99

 

0497709

 

06-17-2005

 

12-08-2017

038/US3/PCT2/MX

 

Mexico

 

PA/a/1999/006387

 

07-07-99

 

222316

 

08-26-2004

 

12-08-2017

038/US3/PCT2/NO

 

Norway

 

1999 3341

 

12-08-97

 

Pending

 

 

 

 

038/US3/PCT2/NZ

 

New Zealand

 

336610

 

07-06-99

 

336610

 

11-09-2001

 

12-08-2017

038/US3/PCT2/PL

 

Poland

 

P.334438

 

07-15-99

 

Pending

 

 

 

 

038/US3/PCT2/PL-A

 

Poland

 

P.370525

 

10-04-2004

 

Pending

 

 

 

 

038/US3/PCT2/RU

 

Russia

 

99117145

 

08-06-99

 

2,198,182

 

02-10-2003

 

12-08-2017

038/US3/PCT2/SG

 

Singapore

 

9903165-0

 

07-05-99

 

66567

 

07-18-2000

 

12-08-2017

038/US3/AR2

 

Argentina

 

P 98 01 00058

 

01-06-98

 

Pending

 

 

 

 

038/US3/AR2-A

 

Argentina

 

P 03 01 00515

 

02-17-2003

 

Pending

 

 

 

 

038/US2/US3/TW

 

Taiwan

 

87100028

 

01-02-98

 

156542

 

06-01-2002

 

01-02-2018

 

APPENDIX B 2 — IPSEN FORMULATION PATENT RIGHTS

 

·                                           Solid drugs (minicylinders) also referred to as “IRE”: WO 96/07397 = EP 778,767

·                                           Needle-less: WO 96/08289= EP 782,465 = US 5,542,920

·                                           Vac: WO 97/46202

·                                           Micro-VAC 2” (WO 01/26718).

 

56


 

APPENDIX C — NUVIOS DEVELOPMENT PLAN

 

 

BA058 Development Plan

 

Version:

1.0

 

 

Date:

September 20, 2005

 

Nuvios, Inc.

300 Technology Square, 5th Floor

Cambridge, MA 02139

Tel: 617.551.4700

 

Disclosure Statement

 

This document contains information that is confidential and proprietary to Nuvios, Incorporated. Any unauthorized use or disclosure of such information without the prior written authorization of Nuvios, Incorporated is expressly prohibited.

 

57



 

TABLE OF CONTENTS

 

1.0

Executive Summary

59

 

 

 

2.0

CLINICAL PROGRAM

61

 

 

 

 

2.1

Phase 1 Program

61

 

2.2

Phase 2 Clinical Program

63

 

2.3

Phase 3 Clinical Program

66

 

2.4

Other Clinical Studies

68

 

 

 

3.

FORMULATION STUDIES

70

 

 

 

4.

NON-CLINICAL PROGRAM

70

 

 

 

 

4.1

Toxicology/Pharmacology

70

 

 

 

5.

REGULATORY STRATEGY

70

 

 

 

6.

TIMELINES

71

 

58



 

1.0                                EXECUTIVE SUMMARY

 

BA058 is an analogue of the first 34 amino acids of human parathyroid hormone-related peptide [hPTHrP(1-34)]. BA058 was originally discovered and developed by the Beaufour-Ipsen Pharma Group under the name BIM44058. Nuvios, Inc. plans to develop BA058 for the treatment of osteoporosis in postmenopausal women and men at risk of fracture.

 

This development plan for BA058 is premised upon a strategy of demonstrating a substantial improvement in dosing regimen over Forteo® teriparatide (rDNA origin) injection [rhPTH(1-34)] for the treatment of patients with osteoporosis, improving convenience for patients with severe osteoporosis for whom the current 18 month regimen of daily Forteo® injections is inconvenient.

 

Pre-clinical data suggest that BA058 has a better therapeutic index compared to Forteo® which should enable an improved dosing regimen cycle that is shorter in total duration, or requires less frequent injections, or which can be delivered in novel formulations. Specifically, the preclinical data support the ability to give higher doses of BA058 than Forteo® without inducing resorption or hypercalcemia.

 

Based on the commercial strategy for BA058 and the current regulatory climate (refer to the FDA guidance document for the “Development of Parathyroid Hormone for the Prevention and Treatment of Osteoporosis,” [1]), the first step is to conduct a one week, multiple ascending dose study in healthy postmenopausal women with the following goals:

 

·                   To demonstrate that BA058 has the potential for an improved therapeutic index, enabling the delivery of a more effective anabolic dose without inducing hypercalcemia in comparison to Forteo®.

 

·                   To evaluate PK, pharmacodynamics and safety after multiple doses.

 

The results from the Phase IB study will be used to select two doses of BA058 for use in a 3-month proof-of-concept (POC) study to be conducted in postmenopausal women with osteoporosis. This study would be a comparative trial vs. Forteo® and is designed to answer the following questions:

 

·                   Does BA058 induce resorption to any significant degree (when compared to measures of bone formation and the corresponding changes in bone markers of the comparator )?

 

·                   What is the effect of 3 months of BA058 treatment on BMD and how does this compare to the Forteo® arm in the study? How does BA058’s effect on BMD compare to changes observed when Forteo® is given for 12-18 months (i.e., historical controls)?

 

·                   Does BA058 induce hypercalcemia and is it less than Forteo®?

 

59



 

·                   Does BA058 have acceptable tolerability, patient satisfaction, and an acceptable safety, PK and pharmacodynamic profile?

 

Target Product Profile - osteoporosis

 

Indication:

 

BA058 is indicated for the treatment of postmenopausal women with osteoporosis who are at high risk of fracture.

 

BA058 is indicated to increase bone mass in men with primary or hypogonadal osteoporosis who are at high risk of fracture.

 

 

 

Efficacy:

 

Statistically equivalent or superior effect on BMD relative to Forteo®.

 

 

 

Dosing:

 

Significantly shortened dosing cycle to restore BMD (vs. 12+ months for Forteo®) when administered QD via subcutaneous administration.

 

Alternatively, significantly shortened dosing schedule than once-daily (e.g. 3 times/week).

 

Improved formulations that allow a significant advance in dosing convenience along with reduced pain.

 

 

 

Safety:

 

Absence of significant hypercalcemia with BA058 treatment.

 

60



 

2.0 CLINICAL PROGRAM

 

2.1                                Phase 1 Program

 

The overall objective of the Phase 1 program is to characterize the safety, tolerability, and pharmacokinetic profile of BA058 following single and multiple dosing.

 

Phase 1a: Single ascending dose study

 

This study was completed in March 2005 and the full clinical study report is being prepared by Ipsen. Full study results are required for the pre-IND meeting with FDA and subsequent IND filing.

 

 

Title:

 

A Phase I Single-Center study in two parts assessing the safety, pharmacokinetics, pharmacodynamics and absolute bioavailability of BIM44058, a hPTHrP(1-34) analogue, administered as single doses to healthy elderly volunteers of both genders: Part A, randomized, double-blind, dose-escalating, parallel groups, placebo-controlled design; Part B, randomized, open-label, two-period, cross-over design

 

 

 

Protocol Number:

 

2-52-52127-001

 

Phase 1b:  Multiple ascending dose study

 

The strategic goals for this study are...

 

1)                                      To demonstrate that BA058 has the potential for an improved therapeutic index, enabling the delivery of higher doses than Forteo® without inducing hypercalcemia.

 

2)                                      To evaluate PK, pharmacodynamics and safety after multiple doses.

 

These goals will be met if the compound achieves clinical endpoints that suggest no clinically meaningful incidence of hypercalcemia, and the ability to deliver a more effective anabolic dose of BA058 with good safety and tolerability than is possible with Forteo®.

 

The study will be a randomized, double-blind, placebo-controlled, ascending multiple-dose safety, tolerability, and pharmacokinetic study of subcutaneously administered BA058 in healthy postmenopausal women.

 

61



 

Title:

 

A Randomized, Double-Blind, Placebo-Controlled, Ascending Multiple-Dose Safety, Tolerability, Pharmacokinetic and Pharmacodynamic Study of BA058 in Healthy Postmenopausal Women ( Pending FDA Approval)

 

 

 

Protocol Number:

 

BA058-05-001

 

The study will be designed to:

 

·                   Determine the safety and tolerability of multiple subcutaneous doses of BA058 in healthy postmenopausal women.

 

·                   Determine the effect of BA058 on serum calcium levels.

 

·                   Determine the pharmacokinetics and pharmacodynamics of multiple subcutaneous doses of BA058 in healthy postmenopausal women.

 

A total of 40 eligible subjects will be sequentially enrolled into one of four study groups consisting of 10 subjects each. Within each study group of 10 subjects, 8 will be randomly assigned to receive BA058 and 2 will be randomly assigned to receive placebo. All subjects at each dosage level will start dosing on the same day and receive a total of 7 doses of study medication. After a dose level has been determined to be well tolerated, different subjects will be entered into the next study group. The proposed dosages and number of subjects that will receive study medication are shown below.

 

 

 

 

 

 

 

Number of Subjects Randomized

 

Study Group

 

Proposed
Doses

 

Days of
Dosing

 

Total Number
of Subjects

 

BA058

 

Placebo

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

5 µg

 

7

 

10

 

8

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

20 µg

 

7

 

10

 

8

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

40 µg

 

7

 

10

 

8

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

80 µg

 

7

 

10

 

8

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

40

 

32

 

8

 

 

62



 

Assumptions for Phase 1 Study:

 

1.                                       Study will be conducted in healthy, postmenopausal women meeting stated inclusion/exclusion criteria. [Note: requires FDA agreement to proceed in this population of subjects.]

 

2.                                       All subjects will receive a subcutaneous dose of study medication (BA058 or placebo) once daily for 7 days.

 

3.                                       Study assessments:

 

·                   Physical examinations, vital signs, ECGs, clinical labs (hematology, chemistry, urinalysis), adverse events, and local tolerability.

 

·                   Pharmacokinetics: full PK profile on Days 1 and 7 and trough samples on other study days.

 

·                   Pharmacodynamics: serum total and ionized calcium, phosphorus, cAMP, procollagen 1 carboxy terminal propeptide (PICP), and bone specific alkaline phosphatase. Urine calcium, phosphorus, cAMP, and creatinine execretion

 

·                   Presence of Anti-BA058 antibodies.

 

Timing:

 

1.                                       Total time involvement = 9 months from first patient in (FPI) to draft clinical study report.

 

2.                                       FPI in 1Q06 and draft clinical study report available 4Q06.

 

2.2                                Phase 2 Clinical Program

 

The Phase 2 study will be a proof-of-concept (POC) study assessing the effects of several doses of BA058 on markers of bone turnover and BMD. The primary objectives of this study are to assess the dose response of BA058, compare BA058 to Forteo®, and to select the BA058 doses that will be used in subsequent efficacy studies. The strategic goal for this trial will be to confirm the ability to deliver more effective anabolic doses of BA058 with good safety and tolerability than is possible with Forteo, with clinical endpoints that demonstrate a wider anabolic window for BA058 (i.e. greater effects on BMD at 3 months, and a higher ratio of bone formation vs. resorption) compared to Forteo.

 

Phase 2: 3-month treatment study

 

The Phase 2 study will be a randomized, double-blind, parallel group study in which study medications will be administered for a total of 3 months. The study will compare two doses of BA058 to Forteo® (20 µg) and placebo. Postmenopausal women with BMD T scores below -2.5 will potentially be eligible for the study.

 

63



 

Title:

 

A Randomized, Double-Blind, Parallel-Group Study to Evaluate the Safety and Effectiveness of BA058 on Bone Mineral Density in Postmenopausal Women with Moderate to Severe Osteoporosis

 

 

 

Protocol Number:

 

BA058-05-002

 

The objectives of this study follow:

 

·                   Determine the safety and tolerability of BA058 after 3 months of dosing in postmenopausal women with osteoporosis.

 

·                   Determine the pharmacokinetics of BA058 after 3 months of dosing in postmenopausal women with osteoporosis.

 

·                   Determine pharmacodynamic effects (i.e., effects on mineral metabolism and biochemical markers of bone formation and resorption) after 3 months of treatment with BA058.

 

·                   Determine effects on BMD after 3 months of treatment with BA058.

 

A total of 300 eligible patients will be enrolled and randomized to one of the four treatments below:

 

Study Group

 

Study Medication

 

Dose (sc)

 

Number of Patients

 

 

 

 

 

 

 

 

 

1

 

BA058

 

To be determined

 

75

 

 

 

 

 

 

 

 

 

2

 

BA058

 

To be determined

 

75

 

 

 

 

 

 

 

 

 

3

 

Forteo®

 

20 µg

 

75

 

 

 

 

 

 

 

 

 

4

 

Placebo

 

 

75

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

 

300

 

 

Assumptions for Phase 2 Study:

 

1.                                       The study will be conducted in postmenopausal women with osteoporosis defined as a BMD T score below -2.5.

 

64



 

2.                                       The study consists of a (minimum) 1 month Screening Period, 3-month Treatment Period, and a one-month Follow-up Period (no study medications). Therefore, each patient is in the trial for a total of 4 months.

 

3.                                       All subjects will receive a subcutaneous dose of study medication (BA058, Forteo® 20 µg, or placebo) once daily for 3 months.

 

4.                                       All subjects to receive calcium supplements and vitamin D.

 

5.                                       Study assessments:

 

·                   Physical examinations, vital signs, ECGs, clinical labs (hematology, chemistry, urinalysis), serum total and ionized calcium, phosphorus, thyroid hormones, adverse events, and local tolerability.

 

·                   Pharmacokinetics: serial PK samples taken on a subgroup of patients.

 

·                   Pharmacodynamics (i.e., biochemical markers of bone metabolism and resorption): procollagen 1 carboxy terminal propeptide (PICP), bone specific alkaline phosphatase (BSAP) osteocalcin, cathepsin K, urine N telopeptide (NTX), urinary free deoxypyridinoline, nephrogenic cAMP level, urinary calcium excretion, creatinine clearance vitamin D intact PTH (1-84)

 

·                   Efficacy: measure changes in BMD (lumbar spine, hip, forearm).

 

·                   Anti-BA058 antibody.

 

6.                                       With 75 patients in each dosing arm, this study would be powered to detect a difference of 4% increase in lumbar BMD, (i.e. from a 1% difference for placebo to 5% for BA058, or from a 4% difference for Forteo® to an 8% increase for Tharp). However, anticipated differences in markers of bone formation and resorption have to be examined before final determination on the number of patients required.

 

7.                                       Sufficient BA058 is available and packaged in time to start the study.

 

We will compare BA058’s effects on markers of bone formation, resorption and on BMD with Forteo®. Also important would be the comparison of BA058’s effects on BMD to the historical effects on BMD previously reported with longer term treatment with Forteo®. If the data from this POC study shows that BA058 effect on BMD or bone formation and resorption markers is statistically better than Forteo®, then the next step would be to proceed to a Phase 3 study to evaluate long-term treatment with BA058 to assess effects on BMD and reduction of fractures.

 

Timing:

 

1.                                       Total time involvement = 24 months from first patient in (FPI) to preliminary clinical results.

 

65



 

2.                                       FPI in 1Q07, LPI 2Q08,LPO 4Q08 and draft clinical study report available 1Q09.

 

Estimated Study Metrics:

 

Number of sites:

 

15-18

 

 

 

Number of site visits:

 

15-18 qualification and initiation visits

8 interim visits per site / per site

1 close-out visit / per site

 

 

 

Investigator’s Meeting:

 

For all study sites

 

 

 

Number of subjects screened:

 

750-900

(assumes 2.5-3.1 ratio of screened: enrolled)

 

 

 

Number of subjects enrolled:

 

300 (75 per treatment group)

 

 

 

Screening rate:

 

7-9 / site / month

 

 

 

Enrollment rate:

 

2-3 patients / site / month

 

2.3                                Phase 3 Clinical Program

 

The Phase 3 study will be a non-inferiority trial versus Forteo® to be conducted in postmenopausal women with osteoporosis at risk of fracture.

 

Phase 3: 4-6 month BA058 treatment versus 12-month Forteo® treatment.

 

The Phase 3 study will be a randomized, double-blind study with a primary endpoint of proportion of patients with one or more new vertebral fractures. The tentative plan for this study is to assess a more convenient dosing regimen of BA058 (e.g. 4-6 months of daily SC injections) versus a 12-month treatment regimen with Forteo®. After completion of the study, an observational post-treatment follow up study will be conducted to assess whether patients continue to benefit from prior treatment with study medication.

 

Title:

 

Effects of BA058 in the Treatment of Postmenopausal Women with Osteoporosis

 

 

 

Protocol Number:

 

BA058-05-003

 

66


 

Title:

 

Extended Follow-Up of Patients in BA058 Clinical Trials

 

 

 

Protocol Number:

 

BA058-05-004

 

The primary objective of the study is to:

 

·                   Demonstrate a reduction in the proportion of patients with new vertebral fractures following treatment with study medication.

 

The secondary objectives of the study are to:

 

·                   Establish the safety of chronic administration of BA058 in postmenopausal women with osteoporosis.

 

·                   Compare the effects of chronic administration of BA058 with calcium and vitamin D versus Forteo® with calcium and vitamin D on lumbar spine and hip BMD in postmenopausal women with osteoporosis.

 

·                   Assess the effects of chronic administration of BA058 on biochemical markers of bone formation and resorption.

 

·                   Assess the durability of response by following patients in a long-term post-study observational period.

 

A total of 3200 eligible patients will be enrolled and randomized to one of the two treatments below:

 

Study Group

 

Study Medication

 

Dose (sc)

 

Number of Patients

1

 

BA058

 

To be determined

 

1,600*

2

 

Forteo®

 

20µg

 

1,600*

 

 

 

 

Total

 

3,200

 


*Assumes a ratio of BA058: Forteo of 1:1.

 

Assumptions for Phase 3 Study:

 

1.                                       New formulation will be available for patients to self-administer study medications.

 

67



 

2.                                       The study will be conducted in postmenopausal women with BMD T scores below -2.5 and meeting all other stated inclusion/exclusion criteria.

 

3.                                       The Phase 3 study consists of a (minimum) one-month Screening Period, 12-month Treatment Period, and a one-month Follow-Up Period (no study medication). Each patient is in the trial for a total of 14 months.

 

4.                                       The extended follow-up part of the study starts once a patient completes the Phase 3 study.

 

5.                                       All subjects to receive calcium supplements and vitamin D.

 

6.                                       Study assessments.

 

·                   Physical examinations, vital signs, ECGs, clinical labs (hematology, chemistry, urinalysis), serum total and ionized calcium, phosphorus, thyroid hormones, adverse events, and local tolerability.

 

·                   Pharmacokinetics: serial PK samples taken on a subgroup of patients.

 

·                   Pharmacodynamics (i.e., biochemical markers of bone metabolism and resorption): procollagen 1 carboxy terminal propeptide (PICP) bone specific alkaline phosphatase (BSAP), osteocalcin, cathepsin K, urine N telopeptide (NTX) urinary free deoxypyridinoline, nephrogenic cAMP level, urinary calcium excretion, creatinine clearance, vitamin D, intact PTH (1-84).

 

·                   Efficacy: measure a reduction in the proportion of patients with new vertebral fractures following treatment. Other assessments changes in BMD (lumbar spine, hip, forearm).

 

·                   Anti-BA058 antibody.

 

Timing:

 

It’s assumed that 12 months of treatment and an additional 12-month post-study observational period would be required. Thus, the Phase 3 program from the start of the trial to completion of the long-term follow-up period, will take ~56 months.

 

Estimated Study Metrics:

 

To be determined.

 

2.4          Other Clinical Studies

 

New Formulations

 

Upon the availability of alternative formulations or delivery systems, bioavailability studies will have to be conducted to compare the old/new formulations.

 

68



 

Alternative Dosing Schedules

 

Exploring various dosing frequencies or dosing cycles (i.e., less frequently than once-daily) may need additional clinical studies to prove efficacy and safety and/or additional study arms in the currently planned studies.

 

69



 

3. FORMULATION STUDIES

 

BA058 is currently supplied for clinical use as a freeze dried lyophilizate (i.e., freebase) in glass vials which are reconstituted with sterile 0.9% sodium chloride for subcutaneous injection. A liquid/aqueous form was also developed and used for intravenous dosing in the initial clinical study.

 

The plan is to continue with the same freeze dried lyophilizate formulation for the scheduled Phase lb study in which BA058 will be administered once daily by subcutaneous injection in a controlled environment. However, prior to conducting longer term studies (i.e. the Phase II study) with BA058, another formulation (auto injector?) will have to be developed so that the product can be used by out patients with osteoporosis who will participate in these studies. Prior to use of any new formulation (or delivery system), a bioavailability study when have to be conducted to demonstrate bioequivalence with the previously used formulation.

 

4. NON-CLINICAL PROGRAM

 

4.1          Toxicology/Pharmacology

 

The currently available toxicology package includes both a 3-month rat and a 3-month monkey study. In order to proceed with longer term clinical studies, we anticipate conducting the following studies:

 

·                   12-month rat study

 

·                   12-month monkey study

 

In addition, prior to NDA submission, we need to plan and conduct a 24 month rat carcinogenicity study.

 

Studies will have to be conducted to quantitate anti-BA058 antibody production and development of neutralizing antibodies.

 

5. REGULATORY STRATEGY

 

The current plan is to have a pre-IND meeting with FDA in 4Q05 followed by filing of the full IND to FDA within one month of the meeting. This will enable start of the proposed Phase lb program in 1Q06 (estimated first patient in is January 7, 2006).

 

Other meetings with FDA would occur after results from the Phase lb study are available (Pre-Phase 2 meeting) and after results from the Phase 2 study are available (End-of-Phase 2 or Pre-Phase 3 meeting).

 

70



 

6. TIMELINES

 

Tentative timelines for each the IND filing and individual studies are provided below:

 

Pre-IND and IND

 

Pre-IND meeting request to FDA:

 

01 Sep 05

Pre-IND package to FDA*:

 

Oct 17

Pre-IND meeting:

 

Nov 19

IND filing:

 

Dec 05/Jan 06

 


*Requires full results from Phase la clinical study.

 

Phase 1b study

 

First Patient In (FPI):

 

1Q06

Last Patient Out (LPO):

 

2Q06

Enrollment rate:

 

Full cohort of 10 subjects at the same time

Subsequent cohorts:

 

3 week intervals

Study close out:

 

2Q06 (1 month)

Queries and data base lock:

 

3Q06 (1.5 months)

Analysis and draft clinical study report (includes PK, ECG, and biomarker reports):

 

4Q06 (2.5 months)

 

Phase 2 study

 

IND Amendment:

 

4Q06 (submission of Phase 2 protocol and any other required documents)

First Patient In (FPI):

 

1Q07

Last Patient Out (LPO):

 

4Q08

Enrollment rate:

 

2-3 patients / per site / per month

 

71



 

Study close out:

 

4Q08

Queries and data base lock:

 

1Q09

Analysis and draft clinical study report (includes PK, ECG, and biomarker reports):

 

1Q09

 

Phase 3 study

 

End-of-Phase 2 meeting:

 

2Q09

IND Amendment:

 

2Q09 (submission of Phase 3 protocol and any other required documents)

First Patient In (FPI):

 

3Q09

Last Patient In (LPI):

 

4Q10

Last Patient Out (LPO):

 

4Q11

Enrollment rate:

 

2-3 patients / per site / per month

Study close out:

 

1Q11

Queries and data base lock:

 

1Q12

Analysis and draft clinical study report (includes PK, ECG, and biomarker reports):

 

2Q12

Post-Study Observational Period - LPO:

 

2Q13

 

72



 

APPENDIX D — CLINICAL SUPPLY AND TECHNICAL TRANSFER AGREEMENT

BIM 44058 INJECTION CLINICAL SUPPLIES AND TECHNOLGY TRANSFER

 

BETWEEN

 

Beaufour Ipsen Industrie S.A.S, rue d’Ethe Virton, 28100, France, duly represented by Mike Dey, Vice-President, Pharmaceutical Development

 

Hereinafter referred to as IPSEN, on the one hand,

 

AND

 

NUVIOS Inc, a United States Corporation , having its registered office at 300 Technology Square-5 th  Floor, Cambridge, MA, USA duly represented by Richard Lyttle, Chief Execuive Officer

 

hereinafter referred to as NUVIOS, , on the other hand,

 

WHEREAS :

 

NUVIOS and [SCRAS S.A.S. (a company organised and existing under the laws of France, having its registered office at 42 rue du Dr. Blanche, 75016 Paris, France)] (to be confirmed) have entered into an agreement named “License Agreement between [SCRAS] and Nuvios” for BIM 44058,  dated XX September, 2005, which is hereinafter referred to as the BIM 44058 Agreement.

 

IPSEN is SCRAS S.A.S.’ Affiliate (as defined in the BIM 44058 Agreement) designated by SCRAS S.A.S. to manufacture for NUVIOS , the Compound and Formulated Compound as defined in the BIM 44058 Agreement.

 

NUVIOS and IPSEN wish to enter into this agreement contemplated under Section 9.1 of the BIM 44058 Agreement in relation to the manufacturing of Product for use thereof by NUVIOS as part of the Development of the Compound under the BIM 44058 Agreement.

 

NOW, THEREFORE THE PARTIES HERETO AGREE AS FOLLOWS:

 

DEFINITIONS

 

All capitalised terms used in this Agreement and which are not specifically defined herein shall have the meaning attributed to them under the BIM 44058  Agreement.

 

1.2          Compound shall mean the Licensed Compound as defined in the BIM 44058 Agreement.

 

1.3                      Formulated Compound shall mean the Compound, formulated as a freeze dried injection, contained in a glass vial as described in Table 1 below.

 

1.4          cGMP shall mean current Good Manufacturing Practices in effect in European Union and USA for clinical studies.

 

1.5          Manufacturing & Analytical Procedure shall mean the procedure governing the manufacturing and analysis operations of the Compound and Formulated Compound which may be specifically required in US or EU.  This procedure is established when necessary by mutual agreement of the Parties, and is signed by the Responsible Persons appointed by each Party.

 

73



 

Table 1 Composition of BIM 44058 Injection

 

Material

 

Supplier

 

Unitary Formula
(per vial)

BIM44058C
Dextran 70
Citric acid 0.25% (w/v)
Water for injections**

 

Kinerton
Interchemical
Prolabo meram

 

0.1 mg (free base)
50 mg
qs pH 4.5*
qs 1 g

Type I clear glass vial, 11-13 ml
Grey chlorobutyl PTFE stopper, 20 mm
Flip-off metal crimp

 

Verretubex
Djikyo
West
Pharma

 

1
1
1

 


* to get pH5 5.5 after lyophilisation ** removed after freeze-drying step .

 

1.6          Responsible Person shall mean: - For Ipsen , the Vice President ,Pharmaceutical Development, who is responsible for manufacturing clinical supplies of Compound and Formulated Compound, as well as for Quality Control thereof, ensuring procedures are performed as required by cGMP and that records and samples are maintained as required under this Agreement, and for ensuring correct release for despatch of Compound and Formulated Compound for clinical use by NUVIOS under this Agreement.  These activities can be delegated to appropriate individuals described in Ipsen SOPs for clinical supplies. - For NUVIOS ,

 

1.7          Safety Agreement shall mean the document referred to in Section 8.4 of the BIM44058 Agreement as the “Pharmacovigilance Agreement”, covering operational aspects of the conduct of clinical trials under the BIM 44058 Agreement regarding pharmacovigilance, including but not limited to withdrawal proceedings, complaints handling, definitions of adverse events format of the different reports and reporting procedures between the Parties and vis-à-vis third parties.

 

1.8          Technical Specifications shall m ean the technical documents that consist of investigational drug supply request signed by Responsible Person of NUVIOS and investigational drug supply acceptance signed by Responsible Person of IPSEN to be agreed and signed for each clinical trial, covering all technical, quality and logistical aspects of the manufacturing, control and delivery to NUVIOS of the Formulated Compound manufactured by IPSEN for NUVIOS for the purpose of this Agreement.
Each Technical Specifications sets out the specifications of the Compound / or Formulated Compound as well as the manufacturing, control, storage and delivery procedures for the Compound or Formulated Compound as well as instruction on reserve samples. Each Technical Specifications shall be signed by the Responsible Persons appointed by each Party.

 

74



 

PURPOSE

 

The purpose of this Agreement is to establish the terms and conditions governing

 

(i) the manufacturing and delivery by IPSEN (or by IPSEN’s designated manufacturer) for NUVIOS of the Compound for the purposes of the conduct by NUVIOS of Phase I and first Phase II Clinical Trials under the Development Plan as provided in the BIM 44058 Agreement;

 

(ii)  the manufacturing and delivery by IPSEN (or by IPSEN’s designated manufacturer) for NUVIOS of the Formulated Compound for the purposes of the conduct by NUVIOS of Phase I and Phase II Clinical Trials under the Development Plan as provided in the BIM 44058 Agreement ;

 

(iii) the provision by IPSEN (or by IPSEN’s designated manufacturer) of the following services to NUVIOS: release, intermediate labeling and bulk packing using packaging and labelling materials of Ipsen’s specification or using packaging and labelling materials laid-out and supplied by NUVIOS to IPSEN when appropriate, as well as delivery of Compound and Formulated Compound to NUVIOS and retainment of reserve samples and reanalysis of appropriate samples ;

 

(iv) support activities for transfer of process and analytical technology to the NUVIOS selected contractor.  The costings and estimated timescales shown in Appendix 2, assume a single contractor for each of drug substance and drug product.  Packaging and labeling of primary containers of Compound and Formulated Compound either NUVIOS shall use the Compound or Formulated Compound supplied to NUVIOS by IPSEN under this Agreement solely in accordance with and for the purposes of the performance of Phase I and Phase II Clinical Trials under the Development Plan of the Compound and Formulated Compound as provided under the terms and conditions of the BIM 44058 Agreement.

 

For the avoidance of doubt, IPSEN shall not be required to supply NUVIOS with Compound or Formulated Compound for Phase III Clinical Trial.

 

All relevant terms and conditions of the BIM 44058 Agreement shall fully apply to and govern this Agreement.

 

MANUFACTURING - ORDERS — DELIVERY - REANALYSIS

 

IPSEN certifies that it possesses or that IPSEN’s designated manufacturer for the purposes herein possesses, adequate premises and equipment, and sufficient experience and knowledge as well as a competent personnel in order to carry out the operations contemplated under Clause 2.1 of this Agreement, in a satisfactory manner and in accordance with regulations governing medicine for human use, cGMP (if and to the extent applicable), the Technical Specifications and the Manufacturing & Analytical Procedure.

 

IPSEN declares that it or that IPSEN’s designated manufacturer for the purposes herein holds, the authorisations required in their respective countries in order to manufacture, store, and deliver the Compound and Formulated Compound.

 

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The Technical Specifications for Clinical Trials and the Manufacturing & Analytical Procedure are the subject of a document drawn up and signed by the Parties separately from the present Agreement for each Clinical Trial to be conducted by NUVIOS under the BIM 44058 Agreement.  The Technical Specifications for Clinical Trials shall cover the aspects relevant to this Agreement and listed in the procedure GCP004 - “Investigational Product Order for Clinical Studies” and GCP026 - “Clinical Investigational Product Handling Procedure”, copies of which shall be made available by IPSEN to NUVIOS and are appended to this Agreement,Appendices 3 and 4 respectively.

 

The rules and systems governing orders placed by NUVIOS for NUVIOS’s required quantities of Compound and Formulated Compound shall be described in the Technical Specifications.

 

Interpretation and summary of cGMP covering the manufacture of the Compound and Formulated Compound, requirements for quality control and responsibilities of both Parties is attached as Appendix 1 hereto.

 

IPSEN undertakes to manufacture each Compound and Formulated Compound in accordance with the manufacturing, analysis and control methods stipulated in the corresponding Technical Specifications and Manufacturing & Analytical Procedure.  In particular, after required quality control checks, and verification of the appropriate manufacture under cGMP, IPSEN shall supply the primary containers of Compound and Formulated Compounds to NUVIOS, packed and labelled either using packaging and labelling materials of Ipsen’s specfication or using the packaging and labelling materials laid-out and supplied by NUVIOS when appropriate.  Compound and Formulated Compound shall be supplied to NUVIOS for final labelling and packaing operations, and quality assurance release by NUVIOS

 

IPSEN may entrust other pharmaceutical ingredients or products manufacturers with all or part of the operations contemplated under this Agreement.  IPSEN shall inform NUVIOS of the identity of any such third-party manufacturers and the operations entrusted by IPSEN thereto.

 

NUVIOS undertakes that all the administrative prerequisites relating to each Clinical Trial shall be obtained for each Clinical Trial centre prior to delivery of Compound or Formulated Compound thereto.

 

IPSEN shall, with each delivery of Compound or Formulated Compound to NUVIOS, supply or procure the supply of a certificate of analysis related to each delivered batch showing that such batch conforms with the then current specifications and quality standards of Compound or Formulated Compound as shown in the applicable Technical Specifications or Manufacturing & Analytical Procedure.

 

Each delivery of Compound to the persons and places indicated by NUVIOS shall be accompanied by (i) the documents referred to in the procedures GCP004 - “Investigational Product Order for Clinical Studies” and GCP026 - “ Clinical Investigational Product Handling Procedure”, including a delivery slip mentioning the name of the Compound , the batch number, the use-by date, the storage conditions, and the quantities delivered. and, (ii) the documents which might be required by NUVIOS for the purpose of complying with relevant regulations in EU or US applicable to the Compound or Formulated Compound.

 

76


 

NUVIOS shall ensure and inform IPSEN in writing that the delivery thus carried out was made to the correct addressee and that the latter took proper delivery.

 

Upon receipt of the Compound or Formulated Compound NUVIOS shall perform necessary labelling, packaging and quality checking thereof as shall be determined in the Technical Specifications or in the Manufacturing & Analytical Procedure before releasing the Compound or Formulated Compound for use in clinical studies.

 

Unused quantities of Compound or Formulated Compound shall at NUVIOS option either be returned to NUVIOS or with IPSEN prior written consent,  locally destroy unused quantities of Compound or Formulated Compound.  In such case, NUVIOS shall send to IPSEN the corresponding certificates of destruction.

 

IPSEN shall retain reserve samples as specified in the Technical Specification for duration stated in clinical GMP.  IPSEN shall perform reanalysis of reserve samples when required under Ipsen SOPs, or when agreed with NUVIOS.

 

NON-COMPLIANCE OF BATCHES

 

NUVIOS shall notify IPSEN of any deficiency in quantity or any defect which was immediately discoverable - in writing within 10 working days after the delivery to NUVIOS of the Compound or Formulated Compound.  NUVIOS shall promptly notify IPSEN in writing of any latent defect that was not immediately discoverable in the quality checking but found before the expiry date of the Compound or Formulated Compound.  NUVIOS shall not use any quantity of the Compound or Formulated Compound that NUVIOS has discovered is defective.

 

In case of notification of a defect of the delivered quantities of Compound or Formulated Compound, within the time period mentioned hereabove, IPSEN shall at IPSEN option, take back or have NUVIOS destroy, the relevant quantities of Compound or Formulated Compound, at IPSEN’s expenses and IPSEN shall replace them as soon as practicable so as to avoid any disruption of supply to NUVIOS.

 

In case of discrepancies of the results of the analysis performed by NUVIOS and IPSEN on the delivered quantities of the Compound or Formulated Compound, and in case of any dispute between the Parties regarding the quality of the Compound or Formulated Compound, NUVIOS or IPSEN shall appoint an independent expert to whom the other Party may not unreasonably object and who shall assess whether the delivered quantities are defective or not.  In case the delivered quantities of the Compound or Formulated Compound are found to be defective, IPSEN shall pay for the costs of appointment of such expert.  In case the delivered quantities of Compound are found not to be defective, NUVIOS shall pay for the costs of appointment of such expert.

 

FINANCIAL CONDITIONS — REPORTING OBLIGATIONS

 

In consideration for the provision by IPSEN to NUVIOS of the manufacturing, delivery, release, packaging, and labelling services under this Agreement, before delivery of each

 

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subject batch or lot of Formulated Compound or BIM44058 Compound, NUVIOS shall make the following payment to IPSEN:

 

First batch of approximately 1600 vials manufactured;

 

65,000

 

 

 

 

 

Subsequent lots if 1600 vials of the same Product

 

55,000

 

 

 

 

 

Raw Materials , sufficient for 150 g Compound

 

50,000

 

 

 

 

 

Delivery of agreed amount of peptide; 150 g

 

400,000

 

 

If quantitities of Compound less than 150 g are agreed for supply then the costs will be agreed prior to manufacture and the remaining raw materials purchased would be provided to NUVIOS at no further cost, other than transportation and any importation cost which would be charged at cost.

 

The sum stipulated in Article 5.1 shall be paid by NUVIOS to IPSEN following receipt by NUVIOS of the corresponding invoice and before delivery.

 

PHARMACOVIGILANCE -CLAIMS - LIABILITY - WITHDRAWAL

 

The Parties will carry out their obligation with respect to safety data exchanging of the Compound or Formulated Compound in accordance with the procedures defined in BIM 44058 Agreement.  However, that nothing contained herein shall be construed as restricting either Party’s right to make a timely report of such matter to any government agency or take other action that it deems to be appropriate or required by applicable law or regulations in the territory.

 

In relation with Clinical Trials only, conducted by NUVIOS under the BIM 44058 Agreement, NUVIOS shall, if required under NUVIOS procedures,  implement the Formulated Compound batch recall or withdrawal in accordance with NUVIOS relevant standard operating procedure.  Such withdrawal will be notified to the Responsible Persons under this Agreement, immediately such formal decision is reached within NUVIOS.

 

Liabilities and indemnification of the Parties in connection with the operations contemplated under this Agreement, shall be governed by the terms and conditions of the BIM 44058 Agreement.

 

CONFIDENTIALITY

 

In addition to the Parties’ respective obligations under Article 12  of the BIM 44058 Agreement, NUVIOS undertakes to keep strictly confidential and to use exclusively in accordance with the terms and conditions of the BIM 44058 Agreement, in particular in accordance with Article 12 of the BIM 44058 Agreement, all information in relation to the operations contemplated under this Agreement, of whatever nature, form or media, including without limitation, the processes and methods of manufacturing the Compound and Formulated Compound, including if deemed appropriate by IPSEN,

 

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Chemistry, Manufacturing and Control data in relation thereto, communicated or developed by IPSEN or its third-party designated manufacturer.  For the avoidance of doubt, all information made available to NUVIOS under this Agreement shall be deemed to be Ipsen Development Information under the BIM 44058 Agreement.

 

ENTRY INTO EFFECT AND TERM

 

This Agreement enters into effect on the day of its signature by the Parties. This Agreement shall expire upon completion of the Phase II Clinical Trials contemplated under this Agreement, unless extended by mutual agreement of the Parties.

 

Either Party may terminate this Agreement at any time with immediate effect upon notice to the other Party, in case of termination of (i) the Development of the Compound or Formulated Compound under the BIM 44058 Agreement, (ii) the Detailed Development Plan under the BIM 44058 Agreement, or (iii) the BIM 44058 Agreement.

 

Either Party may terminate this Agreement for those other applicable causes identified in Article 15 of the BIM 44058 Agreement.

 

Notwithstanding early termination of this Agreement, this Agreement shall remain applicable to any ongoing Clinical Trial identified in the Technical Specifications until signature of the final report of the last Clinical Trial, unless the corresponding Technical Specifications is earlier terminated by mutual agreement of the Parties.

 

MISCELLANEOUS

 

In case one of the provisions of this Agreement would be considered null and void, it shall be considered to be unwritten but shall not lead to the nullity of the Agreement.

 

The Technical Specifications, the Manufacturing & Analytical Procedure, the Safety Agreement, form an integral part of this Agreement.

 

Articles 17 and 18 of the License Agreement shall apply to this Agreement mutatis mutandis.

 

Signed in two copies, one for each Party

 

79



 

CLINICAL SUPPLY AGREEMENT APPENDIX 1 — Interpretation and summary of cGMP Responsibilities for specific stages of the manufacture and supply of Compound or Formulated Compound are described in Table 1 below.

 

Definitions of the terms used in the table are stated in clinical Good Manufacturing Practices.

 

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TABLE 2   Responsibility for Clinical Supplies

 

Content

 

Summary

 

Responsibility

Study Co-ordination

 

Assign Clinical Project Manager

Obtain all Ethical and regulatory approvals for study

Order required numbers of Clinical Supplies

 

Nuvios

 

 

 

 

 

Protocol

 

Prepare protocol including all details of centers, study blinding, randomization requirements

 

Nuvios

 

 

 

 

 

Technical Specifications

 

Prepare Technical Specifications documentation

Approval for all clinical protocol requirements being met

Approval for all regulatory requirements being met

Approval for all Technical and Product Quality requirements being met at manufacture

 

Nuvios

Nuvios

Nuvios

Ipsen

 

 

 

 

 

Manufacture and Quality Control

 

Procure, store, perform lot analysis of raw materials, and manage retain samples

 

Manufacture, perform lot analysis of BIM 44058 Injection, and manage retain samples.

Provide Certificate of Analysis in required format

 

Ipsen

 

Ipsen

 

Ipsen

 

 

 

 

 

Shipment of Formulated Compound

 

Packing of bulk product in suitable protective packaging to ensure correct storage and shipment to Paris airport.

Receipt, interim storage and arrangements for transatlantic shipment to Nuvios contracted Clinical Research Organisation.

Receipt, customs clearance and transportation to Nuvios CRO

 

Ipsen

 

Nuvios

 

Nuvios

 

 

 

 

 

Packaging and labeling

 

Receipt, acceptance tests (if required) and all labeling and Packaging for clinical supplies

Provision of all labeling and packaging components and materials labeling, including translation sand verification of translated text.

 

Nuvios

 

Nuvios

 

 

 

 

 

Release of investigational product

 

Quality Assurance release of investigational product based on Ipsen provided Certificate of Analysis for formulated product and upon successful review of packaging & labeling batch records.

 

Nuvios

 

 

 

 

 

Ongoing Stability

 

If required, periodic testing of stored samples to verify ongoing stability

 

Nuvios

 

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Testing

 

and compliance with specifications, of formulated compound

 

 

 

 

 

 

 

Complaint & recall

 

Perform complaint managing, recall actions

 

Nuvios

 

 

 

 

 

Manufactuing Document retention

 

Retain all manufacturing and product testing documents for at least 10 years after expiry of the Compound or Formulated compound lot.

Retain all Packaging and Labelling documentation as required

 

Ipsen

 

Nuvios

 

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CLINICAL SUPPLY AGREEMENT APPENDIX 2; Outline Program Timings and Costs for Manufacture of BIM 44058 Compound Clinical Supplies and Process Transfers to NUVIOS Contractor

 

Phasing of Costs for BIM 44058 for Transfer to Nuvios

 

 

 

Total

 

2005

 

2006

 

Item

 

€000s

 

3Q

 

4Q

 

Total 05

 

1Q

 

2Q

 

3Q

 

4Q

 

Total 06

 

Active Ingredient

 

492

 

42

 

50

 

92

 

0

 

400

 

0

 

0

 

400

 

Testing GMP Lot for CT supply

 

12

 

12

 

 

 

12

 

 

 

 

 

 

 

 

 

0

 

Starting materials for API supply for 150g

 

50

 

 

 

50

 

50

 

 

 

 

 

 

 

 

 

0

 

Manufacture API Lot 150g

 

400

 

 

 

 

 

0

 

 

 

400

 

 

 

 

 

400

 

Stock of API existing Lot

 

24

 

24

 

 

 

24

 

 

 

 

 

 

 

 

 

0

 

Working Ref Std vials ; c 900 vials + 0.9g

 

6

 

6

 

 

 

6

 

 

 

 

 

 

 

 

 

0

 

Technology Transfer Support for API

 

139

 

33

 

54

 

87

 

40

 

12

 

0

 

0

 

52

 

Process transfer (@€1000 per day; 240k/FTE)

 

62

 

18

 

26

 

44

 

12

 

6

 

 

 

 

 

18

 

Analytical transfer (@€1000 per day; 240k/FTE)

 

57

 

15

 

18

 

33

 

18

 

6

 

 

 

 

 

24

 

Travel to US 2 trips x 2 scientists

 

20

 

 

 

10

 

10

 

10

 

 

 

 

 

 

 

10

 

Drug Product Clinical Supplies

 

190

 

0

 

130

 

130

 

0

 

60

 

0

 

0

 

60

 

Placebo Lot x nominal 1600 vials Fill c 19 Sep

 

65

 

 

 

65

 

65

 

 

 

 

 

 

 

 

 

0

 

Active Lot x nominal 1600 vials Fill c 26 Sep

 

65

 

 

 

65

 

65

 

 

 

 

 

 

 

 

 

0

 

Additional Active Lot Fill c April 2006

 

60

 

 

 

 

 

0

 

 

 

60

 

 

 

 

 

60

 

Technology Transfer Support for Drug Product

 

108

 

31

 

38

 

69

 

33

 

6

 

0

 

0

 

39

 

Process transfer (@€1000 per day; 240k/FTE)

 

28

 

13

 

10

 

23

 

5

 

6

 

 

 

 

 

5

 

Analytical transfer (@€1000 per day; 240k/FTE)

 

60

 

18

 

18

 

36

 

18

 

 

 

 

 

 

 

24

 

Travel to US 2 trips x 2 scientists

 

20

 

 

 

10

 

10

 

10

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRAND TOTAL

 

929

 

106

 

272

 

378

 

73

 

478

 

0

 

0

 

551

 

 

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CLINICAL SUPPLY AGREEMENT APPENDIX 3  GCP004 - “Investigational Product Order for Clinical Studies”

 

Ipsen Group

 

R&D Standard Operating Procedure

Effective: 10 March 2005

 

Number: GCP004.05

 


 

INVESTIGATIONAL MEDICINAL PRODUCT ORDER
FOR CLINICAL STUDIES

 


 

R&D SOP AUTHOR:

 

L. EGGINK

Clinical Research Manager

Clinical Operations, R&D

 

PRIMARY REVIEWER:

 

C. MARTIN

On behalf of the R&D SOP Committee

 

R&D STEERING COMMITTEE SOP AUTHORISATION

 

P. MERAT

Senior Vice-president, Clinical Development,

R&D, Ipsen Group

 

 

SIGN:

/s/ Patrick Merat

 

DATE:

February 15, 2005

 

Copy No. 67

 

 

 

CONFIDENTIAL

The contents of this document are confidential and proprietary to the Ipsen group.
Unauthorised use, disclosure or reproduction is strictly prohibited

 

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TABLE OF CONTENTS

 

 

 

Page

 

 

 

1.

INTRODUCTION

86

 

 

 

 

1.1

Objective

86

 

1.2

Scope

86

 

1.3

Roles and Responsibilities

86

 

 

 

2.

PROCEDURE

87

 

 

 

 

2.1

Processing the Investigational Medicinal Product Orders

87

 

 

2.1.1

Forecasting of Investigational Medicinal Products requirements

87

 

 

2.1.2

Ordering of Bulk Formulated Product

87

 

 

2.1.3

Technical Specification

87

 

 

2.1.4

Packaging Order

88

 

2.2

Labelling Instructions

88

 

2.3

Release of Investigational Medicinal Product

89

 

2.4

Use of Clinical Supplies Tracking Workflow application

89

 

2.5

Archiving

89

 

 

2.5.1

At Sponsor

89

 

 

2.5.2

At Manufacturer and/or CTSU

89

 

2.6

Flowchart: Ordering Investigational Medicinal Products for Clinical Trials

90

 

 

 

3.

CONTINGENCIES

91

 

 

 

4.

R&D SOP FORMS AND TEMPLATES

91

 

 

 

5.

BIBLIOGRAPHIC REFERENCES

91

 

85



 

1.                                       INTRODUCTION

 

1.1                                Objective

 

This procedure defines the different stages and documentation required to plan, prepare and order Investigational Medicinal Products (IMP) for clinical studies from the Clinical Trials Supplies Unit (CTSU) .

 

1.2                                Scope

 

This procedure must be followed for IMP orders and any compassionate use supplies within the Ipsen group.

 

This procedure should also be enforced for clinical studies sponsored by industrial partners but where Ipsen is only responsible for the IMP supply.

 

1.3                                Roles and Responsibilities

 

·                                           CTSU must ensure that a technical and quality agreement exists between the sponsor and the manufacturing site specifying assigned responsibilities of each party in accordance with current Good Manufacturing Practice (GMP) requirements.

 

·                                           The Clinical Study Coordinator (CSC) is responsible for submitting to the CTSU (or CTSU contact) forecasts of intended IMP requirements and updating the amount at least quarterly.

 

·                                           The CSC is responsible for the coordination of all IMP ordering activities for each of his/her delegated studies.

 

·                                           The CTSU is responsible for providing the Technical Specification for the CSC and the Regulatory Affairs representative to approve and, to provide the final approved and signed Technical Specification to the CSC.

 

·                                           The CTSU is responsible for supplying IMP in accordance with GMP and Good Clinical Practice (GCP) and to the specifications (outlined in the Technical Specification and any registered Investigational Medicinal Product Dossier (IMPD) or Investigational New Drug (IND)) agreed between the CSC, CTSU, Pharmaceutical Development, QA and Regulatory Affairs.

 

·                                           The CSC and the Regulatory Affairs representative are responsible for approving master labels for the study.  There should exist a representative for labeling in each participating Ipsen or Contract Research Organisation (CRO) office, who will verify and document compliance with local regulations.  Responsibilities for the local representative for labeling are:

 

86



 

·                                           Providing translations of core labels text, when necessary, to the CSC and CTSU, which are compliant with local legal requirements.  This is done through liaison with Regulatory Affairs, where available.

 

·                                           Checking Master Labels

 

2.                                       PROCEDURE

 

2.1                                Processing the Investigational Medicinal Product Orders

 

2.1.1                      Forecasting of Investigational Medicinal Products requirements

 

At least quarterly, the CTSU sends an IMP forecast sheet to the CSC for completion and return back to the CTSU.

 

The CSC will complete forecasts of supplies up to one year in advance taking into account IMP manufacturing lead time and shelf life, treatment duration and recruitment period.

 

2.1.2                      Ordering of Bulk Formulated Product

 

A request for the manufacture of Bulk Formulated Product will be placed by the CSC as soon as possible after the Ipsen Study Approval is obtained.  The request for Bulk Formulated Product manufacture should be made using the Bulk Formulated Product Manufacturing Order (Ref. GCP004-A).

 

The request for manufacturing Bulk Formulated Product must contain the requirements for all countries participating in the study for a 12-month period.  If the study duration is expected to exceed significantly beyond 12 months, an additional order must be submitted before the 12-month period covered if the first order has finished.

 

A copy of the approved protocol synopsis must be attached to the Bulk Formulated Product Manufacturing Order (GCP004-A).

 

2.1.3                      Technical Specification

 

The CTSU will provide a first draft of the Technical Specification to the CSC for review.  The Technical Specification contains information valid for the study including:

 

·                                           Study design

 

·                                           Randomisation numbers and their syntax, strata label and period (if applicable)

 

·                                           Estimated Times Frames

 

·                                           Participating Countries

 

·                                           Description of Packs and Labelling

 

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·                                           Calculation of IMP Requirements

 

·                                           Despatch Requirements

 

·                                           Return & Product destruction requirements

 

·                                           Approval of master and translated labels by Ipsen local affiliates or by central regulatory affairs.

 

The CSC completes, reviews and returns the Technical Specification to the CTSU for finalisation.  Both CSC and CTSU agree on packaging design, presentation of the IMP and on timelines for setting up the IMP.

 

The CSC and CTSU representative must ensure and document that the Technical Specification is consistent with the final approved protocol.

 

The Technical Specification represents the official agreement between the CTSU and the CSC on IMP specifications.

 

2.1.4                      Packaging Order

 

The CSC/designee must submit a Packaging Order (GCP004-B) to the CTSU once the protocol has been approved. This form is used to order a specific amount of IMP and must be used for the first supplies as well as re-supplies or additional supplies.

 

The signed and completed Packaging Order (GCP004-B) is sent back to the CSC and filed in the Trial Master File (TMF) .  A copy is kept at the CTSU.

 

2.2                                Labelling Instructions

 

Labelling text must be in local language and complaint with national laws in force.  The core label texts for all packaging units are created by the CTSU in collaboration with the CSC.  They will be defined in the Technical Specification and are compliant with the requirements of Annex 13 of The Rules Governing Medicinal Products in the European Union and US FDA 21 CFR 312.6 Labelling of an Investigational New Drug.

 

When applicable, a “local law complaint” translation (or adjustment) of the core label text must be requested by the CSC to the local responsible person for labeling.  Label translations (or adjustments) are included as part of the Technical Specification.

 

The CTSU is responsible for preparing master labels and translations provided in the Technical Specification.

 

Written approval of the master labels and translated labels must be given by the CSC and the Regulatory Affairs representative.

 

88



 

The CTSU is responsible for production and quality control of the labels produced and maintaining copies of those labels for reference.

 

2.3                                Release of Investigational Medicinal Product

 

The CTSU’s issue of the Certificate of Analysis (CofA) for the Bulk Formulated Product and the Pack Batch Release Certificate of the finished drug product, is considered the “ Technical Green Light ” for the IMP to be released.

 

These certificates are sent by the CTSU to the CSC to the CSC for archiving in the TMF.

 

The CSC authorises the release of IMP for delivery to a clinical trial site following the requirements of the IMP Release Form (Ref. GCP088-B).

 

IMP supply to a clinical trial site will be done just prior to or during the site initiation visit after the CSC has completed the IMP Despatch Form (GCP026-A) and sent it to the CTSU or an interim storage facility.  IMP may only be supplied to clinical trial sites when all required documentation, as specified in SOP GCP088, has been obtained.

 

2.4                                Use of Clinical Supplies Tracking Workflow application

 

In case the Clinical Supplies Tracking Workflow (CSTW) application is used for a clinical study, the procedure described in this SOP will still apply but the forms GCP004-A and GCP004-B are replaced by their equivalent electronic form within the CSTW.

 

When filing is required, a paper copy of the electronically approved form will be accepted.

 

2.5                                Archiving

 

2.5.1                      At Sponsor

 

All the documents must be archived in the TMF in compliance with Ipsen R&D SOPs (Ref. GEN031, GCP092) and GCP.

 

2.5.2                      At Manufacturer and/or CTSU

 

All the documents must be archived according to manufacturer’s and/or CTSU SOPs and current GMP.

 

89



 

2.6                                Flowchart:  Ordering Investigational Medicinal Products for Clinical Trials

 

 

90



 

3.                                       CONTINGENCIES

 

None

 

4.                                       R&D SOP FORMS AND TEMPLATES

 

Title

 

Reference

 

Status

Bulk Formulated Product Manufacturing Order

 

GCP004-A

 

Compulsory

Packaging Order (for Beaufour Ipsen Industrie, Dreux)

 

GCP004-B

 

Compulsory

 

5.                                       BIBLIOGRAPHIC REFERENCES

 

1.                                       Directive 2003/94/EC on GMP for Medicinal Products for Human Use.

2.                                       “Manufacture of Investigational Medicinal Products” Most current version of Annex 13 of the EU guide to GMP.

3.                                       US FDA 21 CFR part 210: Current GMP in manufacturing, processing, packing, or holding of drugs; general.

4.                                       US FDA 21 CFR part 211: Current GMP for finished pharmaceuticals.

5.                                       Ipsen Group R&D SOP GCP088 Initiation of Clinical Trial Sites.

6.                                       Ipsen Group R&D SOP GCP026 Clinical Investigation Product Handling Procedures.

7.                                       Ipsen Group R&D SOP GCP092 Management of the Trial Master File & Investigator Site File.

8.                                       Ipsen Group R&D SOP GEN031: R&D Records, Archiving and Retention.

 

91


 

 

CLINICAL SUPPLY AGREEMENT APPENDIX 4 GCP026 - “Clinical Investigational Product Handling Procedure”

 

Ipsen Group

 

R&D Standard Operating Procedure

Effective: 10 March 2005

 

Number: GCP026.04

 


 

CLINICAL INVESTIGATIONAL MEDICINAL

PRODUCT HANDLING PROCEDURES

 


 

R&D SOP AUTHOR :

 

FRANCIS SÉGUY

Clinical Research Manager

Clinical Operations, R&D

 

PRIMARY REVIEWER :

 

LIZ COXON

On behalf of the R&D SOP Committee

 

R&D STEERING COMMITTEE SOP AUTHORISATION

 

P. MERAT

Senior Vice-President, Clinical Development,

R&D, Ipsen Group

 

SIGN:

/s/Patrick Merat

 

DATE:

February 15, 2005

 

92



 

TABLE OF CONTENTS

 

 

 

Page

 

 

 

1.

INTRODUCTION

94

 

 

 

 

1.1.

Objective

94

 

1.2.

Scope

94

 

1.3.

Roles and Responsibilities

94

 

 

 

2.

PROCEDURE

95

 

 

 

 

2.1.

IMP Despatch

95

 

 

2.1.1.

Despatch request

95

 

 

2.1.2.

Packaging and despatch specifications

95

 

 

2.1.3.

Despatch confirmation

96

 

2.2.

IMP accountability

96

 

2.3.

IMP Storage / Shipment Incidence

96

 

2.4.

Expired IMP and relabelling procedures

96

 

2.5.

Returned investigational product

97

 

2.6.

Destruction of an investigational product

97

 

 

 

3.

CLINICAL SUPPLIES TRACKING WORKFLOW APPLICATION

98

 

 

 

4.

CONTINGENCIES

98

 

 

 

5.

R&D SOP FORMS AND TEMPLATES

98

 

 

 

6.

BIBLIOGRAPHIC REFERENCES

98

 

93



 

1.                                       INTRODUCTION

 

1.1.                             Objective

 

To describe the procedures to be followed for handling clinical Investigational Medicinal Products (IMP) in order to comply with applicable regulations and guidelines for Good Clinical Practice (GCP) and Good Manufacturing Practice (GMP) .

 

1.2.                             Scope

 

This Research & Development (R&D) Standard Operating Procedure (SOP) applies to Ipsen R&D, Ipsen affiliates and any staff delegated the responsibility for the handling and documenting of IMP movements. Any consultants or Contract Research Organisations (CRO) required to handle IMP on behalf of Ipsen are included within the requirements of this SOP. This procedure covers the mechanisms for storage, transfer and documentation of IMP for outward despatch to investigational and other sites and their complete accountability, retrieval and destruction.

 

1.3.                             Roles and Responsibilities

 

·                                           The Clinical Trial Supplies Unit (CTSU) is responsible for ensuring that validated packaging and appropriate shipping conditions are used when an IMP is despatched directly to either an Interim Storage Facility or an investigational site.

 

·                                           The CTSU must ensure that all IMPs sent to the investigational site or Interim Storage Facility can be tracked at any time.

 

·                                           If an Interim Storage Facility is used, it is the CTSU’s responsibility to ensure that the facility has adequate controls for storage of IMP and that the packaging used is in compliance with the Technical Specification.

 

·                                           The Clinical Study Coordinator ( CSC ) , in consultation with regulatory affairs and CTSU representatives, should ensure that correct IMP import/export documentation is in place prior to IMP despatch.

 

·                                           The CSC or designee is responsible, in association with the CTSU, for ensuring that the shelf-life of the IMP available at the investigational site is adequate in the context of their intended use.

 

·                                           The CSC or designee is responsible for requesting the despatch of an IMP to investigational ( or other ) sites from the CTSU and where appropriate from any Interim Storage Facility or labelling and packaging facility that may be used.

 

·                                           The CSC or designee is responsible, if applicable, for providing the block randomisation information to the CTSU and for ensuring that the study IMP are distributed by blocks to the centres.

 

94



 

·                                           The CSC or designee is responsible for ensuring adequate accountability of all IMP sent to the investigational site or Interim Storage Facility, during the clinical trial, and in particular before any retrieval of IMP from the investigational site for destruction.

 

·                                           Monitors are responsible for reviewing, checking any IMP accountability documentation at the investigational sites and for ensuring the accountability is adequate and for requesting the return or destruction of used ( when applicable ) and unused IMP, to or at the appropriate facility.

 

·                                           The CSC is responsible for authorising the destruction of the IMP.

 

·                                           The CTSU is responsible for providing storage for returned IMP, destroying IMP upon request and ensuring proper labelling in the event of reallocating or extending the expiry date.

 

2.                                       PROCEDURE

 

2.1.                             IMP Despatch

 

2.1.1.                   Despatch request

 

IMPs can be despatched either directly from the CTSU to an investigational site or to an Interim Storage Facility, or from an Interim Storage Facility to an investigational site. The CSC or designee must request all transfers of IMPs on the IMP Despatch Form  ( GCP026-A ) . The CSC must provide the CTSU with a list of designees, with their signatures, who are authorised to sign the IMP Despatch Form. A copy of this form must also be filed in the Trial Master File (TMF) .

 

The CTSU out source, manufacture and pack the IMP in accordance with current GMP. The CTSU must also provide the CSC or designee with Certificate of Analysis (CofA) and the Pack Batch Release Certificate for each batch of an IMP supplied which is considered the technical green light .

 

The IMP Despatch Form must be sent by the CSC or designee to the despatch office ( CTSU or Interim Storage Facility ) .

 

Additional supporting documentation can be attached to the IMP Despatch Form where appropriate ( e.g., a letter of approval from the doctor for compassionate/named patient supplies, import licence ) .

 

IMP Despatch Forms must be filed in the TMF.

 

2.1.2.                   Packaging and despatch specifications

 

Supplies will be despatched to the recipient named on the IMP Despatch Form. The Monitor must check that the required delivery date specified on the form takes into account the range of acceptable delivery dates.

 

95



 

The packaging used for the shipment must be clearly and distinctly labelled with warnings and handling instructions, according to the requirements detailed in the approved Technical Specification document for this clinical study.

 

Each package will include a Shipment Note and Acknowledgement of Receipt ( GCP026-B ) partly completed by the despatch office, CofA and/or Pack Batch Release Certificate, if required. The IMP must be dispatched as per the Technical Specification document.

 

2.1.3.                   Despatch confirmation

 

The CTSU or Interim Storage Facility must complete the despatch details at the bottom of the IMP Despatch Form and send it to the requestor and recipient to confirm despatch and the expected date of arrival. If applicable, the requestor should specify in the comments section of the IMP Despatch Form whether other people/entities have to be notified of the IMP despatch. The completed IMP Despatch Form and associated documentation is filed in the TMF.

 

Once the IMP has been delivered, the recipient at the investigational site or Interim Storage Facility must complete the relevant sections of the Shipment Note and Acknowledgement of Receipt, with date and condition of IMP on arrival and forward it to the CTSU/Interim Storage Facility. The CTSU/Interim Storage Facility will transmit the Shipment Note and Acknowledgement of Receipt to the CSC for filing in the TMF. If the Shipment Note and Acknowledgement of Receipt are not returned from the recipient, the CTSU/Interim Storage Facility must either contact the intended recipient or inform the monitor to ensure delivery has occurred and to request the Shipment Note and Acknowledgement of Receipt.

 

2.2.                             IMP accountability

 

All IMP accountability checks at site must be documented on the IMP Accountability Log ( GCP026-C ) and in the monitoring report ( R&D SOPs GCP030 and GCP089 ) . All IMP accountability at the Interim Storage Facility must be documented, and copies filed in the TMF.

 

2.3.                             IMP Storage / Shipment Incidence

 

Any deviations/problems in either storage or shipping conditions must be notified to the CSC via the IMP Incident Form  ( GCP026-F ) who should then report details of the incident to the CTSU. The Quality Assurance of the Pharmaceutical Development Dpt. will decide whether the affected IMPs can still be authorised for use. The decision must be documented and filed in the TMF.

 

2.4.                             Expired IMP and relabelling procedures

 

If IMP is due to expire within the next three months, the CSC or designee must liaise with the CTSU, to assess if the expiry date of the IMPs can be extended or if they must be replaced. Depending on the outcome, the CTSU is required to organise replacement supplies or relabelling in case of expiry date extension.

 

96



 

When an extension of expiry date has been agreed and has been documented by the CTSU, the CSC or designee has to request additional labels from the CTSU. The CSC or designee confirms with the CTSU the batch number, box/pack numbers, centre numbers and quantity of labels required.

 

The CTSU provides the CSC or designee with documentation confirming the expiry date extension and additional labels. The additional labels must be affixed to the IMP and should state the new expiry date and repeat the batch number. The additional labels may be superimposed on the old expiry date, but not on the original batch number.

 

The relabelling should be performed at an appropriately authorised manufacturing site. If agreed by the CTSU and the CSC, this may be performed at the investigational site by or under the supervision of the clinical trial site pharmacist, or designee in accordance with national regulations. Where this is not possible, it may be performed by the clinical trial monitor ( s ) . The operation should be performed in accordance with GMP principles, and should be checked by a second person. This operation must be documented on the IMP Relabelling Form  ( GCP026-E ) . This form should be duly signed and dated by the person performing the operation and the second person checking this activity, on the day of completion and filed in the batch records at the CTSU and a copy filed in the TMF.

 

2.5.                             Returned investigational product

 

When used or unused IMPs are being retrieved from the investigational site, an IMP Return/Destruction Form must be completed ( GCP026-D ) , and approved ( signed and dated ) by both a representative at the investigational site and the monitor before despatching the IMPs. The original must be sent with the returned IMPs, a copy must be sent to the CSC for filing in the TMF and a copy must remain at site.

 

Used and unused IMPs can either be destroyed on the investigational site or returned to the CTSU or Interim Storage Facility as defined in the protocol. Used or unused IMPs returned from investigational sites must be stored at either the Interim Storage Facility or at the original CTSU with labels on the containers to describe the contents. This storage must be maintained until IMP destruction has been agreed between the CSC and storage facility ( refer to section 2.6 ) .

 

If IMPs cannot be returned, the monitor should instruct the site that supplies must not be destroyed until the monitor has performed an IMP accountability check and has ensured the accountability is adequate.

 

2.6.                             Destruction of an investigational product

 

The IMP can be destroyed during and after the clinical trial, either at the investigational site, the Interim Storage Facility or at the CTSU facility, only upon formal CSC or designee’s request. The CSC is responsible for informing the CTSU or local Interim Storage Facility ( as appropriate ) when destruction of an IMP is requested through the IMP Return/Destruction Form  ( GCP026-D ) .

 

97



 

The delivered, used and recovered quantities of IMP should be recorded, reconciled and verified by the monitor for each trial site and each trial period. Destruction of unused IMPs should be carried out for a given trial site or a given trial period only after any discrepancies have been investigated and satisfactorily explained and the reconciliation has been accepted.

 

In case of long-lasting clinical studies, it is advisable to proceed with ongoing destruction of IMP s.

 

Records of IMP destruction ( including batch numbers, box/pack numbers if applicable, method of destruction and quantity destroyed ) should be signed and dated by the relevant person performing the destruction and the approval of a second person. Records of IMP destruction and corresponding documentation must be collected by the monitor and filed in the TMF ( R&D SOP GCP090 ) .

 

3.                                       CLINICAL SUPPLIES TRACKING WORKFLOW APPLICATION

 

In case the Clinical Supplies Tracking Workflow (CSTW) application is used for a clinical study, the procedure described in this SOP will still apply but the forms GCP026-A and GCP026-B are replaced by their equivalent electronic form within the CSTW. When filing is required, a paper copy of the electronically approved form will be accepted.

 

4.                                       CONTINGENCIES

 

None.

 

5.                                       R&D SOP FORMS AND TEMPLATES

 

Title

 

Reference

 

Status

IMP Despatch Form

 

GCP026-A

 

Compulsory

Shipment Note and Acknowledgement of Receipt

 

GCP026-B

 

Example

IMP Accountability Log

 

GCP026-C

 

Example

IMP Return/Destruction Form

 

GCP026-D

 

Compulsory

IMP Relabelling Form

 

GCP026-E

 

Compulsory

IMP Incident Form

 

GCP026-F

 

Compulsory

 

6.                                       BIBLIOGRAPHIC REFERENCES

 

1.                                       EU Clinical Trial Directive 2001 / 20 / EC

 

2.                                       ICH Harmonised Tripartite Guidelines: E6 Guideline for Good Clinical Practice

 

3.                                       Ipsen Group R&D SOP GCP030 Management of Study Manuals

 

98



 

4.                                       Ipsen Group R&D SOP GCP089 Monitoring of Clinical Trial Sites

 

5.                                       Ipsen Group R&D SOP GCP090 Close-out of Clinical Trial Sites

 

99



 

APPENDIX E — IPSEN INDs AND OTHER APPLICATIONS FOR REGULATORY APPROVAL

 

US INDs —None

 

Other EU CTAs — No EU CTAs.

 

A deposition (notification) for the phase 1 study conducted in 2004 by Ipsen was submitted in Germany January 23 2004 (see attached). The registration number received from the BfArM acknowledging receipt of this deposition was 4021410 (see attached original and English translation).

 

Subsequent correspondence February 26 2004 (see attached) from MDS Pharma Services to the BfArM notified the Authority of BIM44058 Toxicology and Safety Pharmacology studies completed and sponsored by Ipsen

 

Regulatory (market) approvals - None

 

100


 

 

[ILLEGIBLE]

 

 

 

 

Postanschrift:

 

EINGEGANGEN

Kurt-Georg-Kiesinger-Allee 3

MDS Pharma Services

 

D-53175 Bonn

z.Hd. Herrn Steffen Hoppe

26. Jan. 2004

Telefon: (0228) 207 - 30

Arnikastr. 4

 

Telefax: (0228) 207 - 5207

 

 

IVBB: 01888 - 307 -

85635 Hohenkirchen

 

e-mail: poststelle@bfarm.de

 

Ihre Zeichen und Nachricht vom

Gesch.Z.: [ILLEGIBLE]

Telefon: (0228) 207-

Bonn

 

 

7140-00-37/Z 172.10/12

5845

23.01.2004

 

Eingangsbestätigung

 

Klinische Prūfung § 40 Abs. 1 Nr. 6 AMG

 

Ihre Unterlagen vom 15.01.2004 sind am 19.01.2004 bei uns eingegangen:

 

Voriagenummer:

4021410

 

 

Name der Studie:

2-52-52127-001

 

Wir bitten, bei weiteren Einreichungen zu diesem prüfplan sowie bei allen Anzeigen von Verdachtsfällen auf schwerwiegende unerwünschte Arzneimittelwirkungen gemäß § 29 (1) AMG stets die Vorlagenummer anzugèben.

 

Mit freundlichen Grüssen

 

Im Auftrag

[ILLEGIBLE]

 

 

101


 

[ Illegible ]

 

 

 

 

Postanschrift:

MDS Pharma Services

EINGEGANCEN

Kurt-Georg-Kiesinger-Allee 3

Germany GmbH

 

D-53175 Bonn

Herrn Steffen Hoppe

02. Feb. 2004

Telefon:

(01888) - 307 - 0

Arnikastraße 4

 

 

(0228) 207 - 30

 

 

Telefax:

(01888) - 307 - 5207

 

 

 

(0228) 207 - 5207

85635 Höhenkirchen/Siegertsbrunn

Nachrichtlich

e-mail:

poststelle@bfarm.de

 

Landesbehörden Bayern / Hamburg

 

vorab per Fax: 08102/4007

Ihre Zelchen and Nachricht vorn

Gesch.Z: [ Illegible ]

 

Telefon: (01888) 307-

Bonn

15.01.2004

B VP2. A-7140-00-37/

 

4320

29. JAN. 2004

 

4021410

 

 

 

 

Betr.:

Klinische Prüfung §40 Abs. 1 Satz 1 Nr. 6 AMG.

 

Eingangsdatum BfArm

:

19. Januar 2004

 

Vorlage der Unterlagen

:

vollständig

 

Votum der zuständigen EK

:

zustimmend mit Auflagen, Auflagen wurden erfüllt

 

Vorlagenummer

:

4021410

 

Klinische Prüfung                      :      A phase I single-centre study in two parts assessing the safety, pharmacokinetics, pharmacodynamics and absolute bioavailability of BIM44058, a hPTHrP (1-34) analogue, administered as single doses to healthy elderly volunteers of both genders: Part A, randomised, double-blind, dose-escalating, parallel groups, placebo-controlled design; Part B, randomised, open-label, two-period, cross-over design (Protokoll einschl. Amendment 1 v. 05.12.2003)

 

Code

:

2-52-52127-001

 

Leiter der Klinischen Prüfung gemäß § 40 Abs. 1 Satz 1 Nr.4 und 7 AMG: Werner Weber, Hamburg

 

Vorlage Unterlagen zur pharmakologisch-toxikologischen Prüfung: Investigator’s Brochure für BIM44058, Version 2 (23.10.2003) wurde vorgelegt

 

Sehr geehrte Damen und Herren,

 

es wird bestätigt, dass zur o.g. klinischen Prüfung Ihre Unterlagen zum Zweck der Vorlage gemäß § 40 Abs. 1 Satz 1 Nr. 6 AMG beim BfArM eingegangen sind. Die Unterlagen sind nach formaler Prüfung und unter Berūcksichtigung des vorgelegten Prüfplanes Vollständig. Es liegt ein zustimmendes Votum der für den Leiter der Klinischen Prüfung Zuständigen Ethik-Kommission vor. Mit Eingang der bisherigen Unterlagen beim BfArM wurden die Voraussetzungen für den Beginn einer Klinischen Prüfung gemäß § 40 Abs. 1 Satz 1 Nr. 6 und Satz 2 AMG erfüllt.

 

Die Unterlagen werden unter der o.g. Vorlagenummer verwahrt. Bitte geben Sie die Vorlage-Nr. und den Code des Prüfplans stets im weiteren Schriftverkehr zur o.g. klinischen Prüfung an und verwenden Sie als Postanschrift:

 

Bundesinstitut für Arzneimittel und Medizinprodukte, Fachregistratur Z 172.22,

Kurt-Georg-Kiesinger-Allee 3, D-53175 Bonn,

Tel. +49 (0)228-207-5854, Fax +49 (0)228-207-5207

 

Hinweis: Die nach § 2 Abs. 9 der verordnung zur Ǎnderung der Kostenverordnung für die Zulassung von Arzneimitteln durch das Bundesinstitut für Arzneimittel und Medizinprodukte und das Bundesinstitut für gesundheitlichen Verbraucherschutz und Veterinärmedizin vom 19. Mārz 2002 (BGBI. 2002 Teil I vom 22 .

 

102


 

März 2002) fūr die Bearbeitung von Unterlagen nach § 40 Abs. 1 des AMG zu erhebenden Gebühren werden Ihnen mit einem gesonderten Kostenbescheld von der Kostenstelle des BfArM mitgeteilt.

 

Mit freundlichen Grūßen

im Auftrag

 

[ILLEGIBLE]

 

 

Dr. med. F. Hackenberger

 

103


 

Bf ArM, Bonn

to MDS Pharma Services

 

Copy to

Land authorities of Bavaria / Hamburg

 

29 January 2004

 

Ref.:

Clinical study § 40 section 1 sentence 1 no. 6 AMG

 

Date of receipt by BfArM

:

19 January 2004

 

Presentation of documents

:

complete

 

Vote by the responsible ethics committee

:

approved with conditions, conditions have been fulfilled

 

Submission number

:

4021410

 

Clinical study

:

A phase 1 single-centre study in two parts assessing the safety,

 

pharmacokinetics, pharmacodynamics and absolute bioavailablity of BIM44058, a hPTHrP(1-34) analogue, administered as single doses to healthy elderly volunteers of both genders: Part A, randomised, double-blind, does-escalating, parallel groups, placcbo-controlled design; Part B, randomised, open-label, two-period, cross-over design (Protocol including amendment 1 of 05.12.2003)

 

Code

:

2-52-52127-001

 

Director of the clinical study pursuant to § 40 section 1 sentence no. 4 and 7 AMG:  Werner Weber, Hamburg

 

Documents submitted concerning pharmacological-toxi cological studies:  Investigator’s brochure for BIM44058, version 2 (23.10.2003) has been presented

 

Dear Sir or Madam,

 

herewith we confirm that the BfArM has received the documents you submitted pursuant to § 40 section 1 sentence 1 no. 6 AMG for the clinical study mentioned above. After a formal review and taking into account the protocol submitted the documents are complete. The ethics committee responsible for the director of the clinical study has voted to approve the study. With the receipt of the said document by the BfArM the conditions pursuant to § 40 section 1 sentence 1 no. 6 and sentence 2 AMG for initiating a clinical study have been met.

 

The documents will be filed under the submission number mentioned above. Please always quote the submission number and the code of the protocol in any further correspondence on the clinical study mentioned above and use the following postal address:

 

Bundesinstitut für Arzneimittel und Medizinprodukte, Fachregistratur Z 172.22,

Kurt-Georg-Kiesinger-Allee 3, D-53175 Bonn,

Phone +49(0)228-207-5845, Fax +49 (0)228-207-5207

 

104



 

Note: You will be informed by the cost centre of the BfArM about the fee to be paid according to § 2 section 9 of the Official Regulation Concerning the Change of the Fee Schedule for the Licensing of Drugs by the Federal Institute for Drugs and Medical Devices and the Federal Institute for Consumer Health Care and Veterinary Medicine of 19 March 2002 (BGBI. 2002 part I of 22 March 2002) for reviewing documents pursuant to § 40 para 1 AMG.

 

Yours sincerely

by order

 

 

signature

Dr. med. F. Hackenberger

 

105


 

 

Arnikastrasse 4

 

D-85635 Höhenkirchen/Siegertsbrunn, Gern

 

www.mdsps.com

 

email: mds.munich@mdsps.com

 

Tel: +49 81 02 808 0 Fax : +49 8102 400 7

 

 

Bundesinstitut für

 

Arzneimittel und Medizinprodukte

26.02.2004

Fachregistratur Z 172.10

 

Kurt-Georg-Kissinger-Allee 3

 

 

53175 Bonn

 

MDS Studie Nr. AA15328

Vorlage-Nummer: 402 1410

Titel:

A Phase I single-centre study in two parts assessing the safety, pharmacokinetics, pharmacodynamics and absolute bioavailability of BIM44058, a hPTHrP(1-34) analogue, administered as single doses to healthy elderly volunteers of both genders: Part A, randomised, double-blind, dose-escalating, parallel groups, placebo-controlled design; Part B, randomised, open-label, two-period, cross-over design

 

Sehr geehrte Damen und Herren,

 

der Sponsor der Studie hats uns gebeten, Safety Pharmacology Reports und Toxicology Reports über die Studienmedikation BIM44058 an Sie weiterzuleiten.

 

Nachfolgend sende ich Ihnen eine Aufstellung über die Reports sowie jeweils ein Exemplar der Reports zu.

 

Mit freundlichen Grüβen

 

 

[ILLEGIBLE]

 

Steffen Hoppe

Clinical Study Manager

 

 

MDS Pharma Services Germany GmbH

 

[ILLEGIBLE]:

 

[ILLEGIBLE] Hamburg HRB 28 004

 

[ILLEGIBLE] Bank 24

 

[ILLEGIBLE]

 

[ILLEGIBLE]

 

106


 

MDS to BfArM

 

26.02.2004

 

MDS Study no. AA15328

 

Dear Sir or Madam,

 

The sponsor of the study has asked us to forward Safety Pharmacology Reports and Toxicology Reports concerning study medication BIM44058 to you.

 

Enclosed I will send you a list of the reports and one copy each of the reports.

 

107


 

 

BIM44058 - Safety Pharmacology reports

 

[ILLEGIBLE]

 

[ILLEGIBLE]

 

 

 

D01.377/1

 

Safety pharmacology study of neurobehavioral effects (irwin test) after subcutaneous or intravenous administration in the rat

 

 

 

D01.378/1

 

Safety pharmacology study of effects on sodium barbital sleeping time after subcutaneous administration in the rat

 

 

 

D01.379/1

 

Safety pharmacology study of effects on Electroconvulsive Shock Treshold after subcutaneous administration in the rat

 

 

 

D01.380/1

 

Safety pharmacology study effects on Pentylenetetrazole Seizure after subcutaneous administration in the rat

 

 

 

D01.381/1

 

Safety pharmacology study of hemodynamic effects after intravenous administration in the anesthetized dog

 

 

 

D01.382/1

 

Safety pharmacology study of assessment of cardiovascular risk after subcutaneous administration in the conscious dog monitored by telemetry

 

 

 

D01.383/3

 

Evaluation of arrhythmogenic risk in an in vitro model (Purkinje fiber) in the rabbit

 

 

 

D01.384/1

 

in vitro effect on HERG recorded in Human Embryonic Kidney (HEK) 293 Cells

 

 

 

D01.385/1

 

Safety pharmacology study of effects on respiration after subcutaneous administration in the conscious rat

 

 

 

D01.386/1

 

Safety pharmacology study of effects on gastrointestinal transit after subcutaneous administration in the rat

 

 

 

D01.387/1

 

Safety pharmacology study of ulcerogenic effects after subcutaneous administration in the rat

 

 

 

D01.388/1

 

Safety pharmacology study of effects on Gastric Acid Secretion after subcutaneous administration in the rat

 

 

 

D01.389/1

 

Safety pharmacology study of effects on diuresis and urinary excretion after subcutaneous administration in the rat

 

 

 

D01.390/1

 

Safety pharmacology study of effects on bleeding time after subcutaneous administration in the anesthetized rat

 

 

 

D02.031/1

 

Safety pharmacology study of effects on Activity Meter after subcutaneous or intravenous administration in the rat

 

108



 

BIM44058 - Toxicology reports

 

[ILLEGIBLE]

 

[ILLEGIBLE]

 

 

 

17458 TAS

 

BIM-44058 Acute intravenous toxicity in mice

 

 

 

17459 TAS

 

BIM-44058 Acute subcutaneous toxicity in mice

 

 

 

18431 TAR

 

BIM-44058 Acute intravenous toxicity in rats

 

 

 

18432 TAR

 

BIM-44058 Acute subcutaneous toxicity in rats

 

 

 

434/89

 

BIM-44058 Reverse mutation in four histidine-requiring strains of salmonella typhimurium and one tryptophan-requiring strain of Escherichia coli

 

 

 

434/90

 

BIM-44048 Induction of chromosome aberrations in cultured human peripheral blood lymphocytes

 

 

 

18455 TSP

 

BIM-44058 Four week toxicity study by subcutaneous administration to cynomolgus monkeys

 

 

 

19022 TCP

 

BIM-44058 13-week toxicity study by subcutaneous injection in cynomolgus monkeys followed by a ‘-week treatement free period

 

109


 

CONFIDENTIAL— Execution Copy

 

LICENSE AGREEMENT AMENDMENT NO. 1

 

This Amendment No.°1 (the “ Amendment No. 1 ”) is entered into on September 12, 2007 (the “ Amendment Date ”) by and between Radius Health Inc., a Delaware Corporation, formerly known as Nuvios, Inc. with its principal office at 300 Technology Square 5 th  floor, Cambridge, MA 02139, United States of America, on behalf of itself and its Affiliates (“ Radius ”), and SCRAS S.A.S., a French corporation, with its principal office at 42 rue du Docteur Blanche, 75016 Paris, France on behalf of itself and its Affiliates (“ Ipsen ”).

 

RECITALS

 

1.                           Ipsen and Radius (the “ Parties ”) entered into the certain license agreement as of September 27, 2005 (the “ Agreement ”).

 

2.                           The Parties wish to enter into this Amendment No. 1 to amend certain provisions of the Agreement in connection with the grant by Radius to Novartis International Pharmaceutical Ltd. (“ Novartis ”) of certain option rights to take a sublicense from Radius.

 

NOW THEREFORE , in consideration of the mutual covenants and promises contained in this Amendment No. 1, the Parties agree as follows:

 

ARTICLE 1  —  CONDITIONS PRECEDENT

 

This Amendment No. 1 shall enter into force upon the completion of the following cumulative conditions precedent:

 

1.1          Radius and Novartis enter into an option agreement whereby Novartis will have an option to license certain intellectual property rights from Radius under terms and conditions to be agreed (the “ Option Agreement ”); and

 

1.2          Radius and Novartis agree on the terms of a fully-fledged license agreement which will be attached to the Option Agreement (the “ Radius-Novartis Agreement ”) as set forth in the Option Agreement; and

 

1.3          Novartis exercises its option under the Option Agreement within six (6) months after Novartis has received the Study Report (as defined in the Option Agreement) and Radius and Novartis execute the Radius-Novartis Agreement.

 

In the event the condition precedent in paragraph 1.1 is not completed by 31 December 2007, or the condition precedent in paragraph 1.2 is not completed by 31 March 2008 or the condition precedent in paragraph 1.3 is not completed as set forth above, this Amendment No. 1 shall be deemed null and void at the later date relating to the completion of these three conditions precedent as set forth above.

 

ARTICLE 2  —  AMENDMENTS TO CERTAIN PROVISIONS OF THE AGREEMENT

 

2.1          Third Party Payments. Section 4.3 of the Agreement is amended to read in full as follows:

 



 

“4.3 Adjustments Related to Third Party Payments. If, in connection with any Licensed Compound or Licensed Product, Nuvios is obligated to remit payments to third parties in relation to intellectual property rights owned by such third parties including when Nuvios is obliged to license in formulation technology from third party for use with the Licensed Product and/or as determined pursuant to Article 11.7 of this Agreement Nuvios shall be permitted to offset against payments due to Ipsen under this Agreement up to fifty percent (50%) of any payments due to such third parties during any calendar year, provided however that this offset does not result in a reduction of more than 50% of the royalty payments that would otherwise have been due to Ipsen in any calendar year.

 

If (i) in connection with any Licensed Compound or Licensed Product, Novartis is obligated to remit payment to third parties in relation to intellectual property rights owned by such third parties including when Novartis is obliged to license in formulation technology from third party for use with the Licensed Product and/or as determined pursuant to Article 11.7 of this Agreement (the “ NVS Third Party Payments ”) and (ii) pursuant to the Radius-Novartis Agreement, Novartis is entitled to deduct part or all of NVS Third Party Payments from the payments due by Novartis to Nuvios (the “ Novartis Deduction ”), Nuvios shall be permitted to offset against royalty payments due to Ipsen under this Agreement up to fifty percent (50%) of the Novartis Deduction during any calendar year, provided however that (a) this offset does not result in a reduction of more than 50% of the royalty payments that would otherwise have been due to Ipsen in any calendar year and (b) this offset is not superior to 25% of the NVS Third Party Payments.

 

In no event shall the provisions of the two (2) above paragraphs be applied cumulatively and in no event shall any offset(s) pursuant to this Section 4.3 result in a reduction of more than 50% of the royalty payments that would otherwise have been due to Ipsen in any calendar year.

 

2.2          Royalty Term. Section 1.59 of the Agreement is amended to read in full as follows:

 

“1.59 Royalty Term shall mean for each Licensed Product and each country of the Territory, the later of (a) expiration of the last to expire Licensed Product Claim in such country with respect to such Licensed Product and (b) ten (10) years from the First Commercial Sale in such country of such Licensed Product. Notwithstanding anything express or implied in the foregoing provisions of this definition, if, with respect to any Licensed Product in any country of the Territory, on the date that is ten (10) years from the First Commercial Sale in such country of such Licensed Product, there is no Valid Claim of an issued patent within the Ipsen Patent Rights or the Joint Patent Rights that Covers such Licensed Product in such country, then the Royalty Term for such Licensed Product in such country shall automatically expire and terminate on such date.

 

2.3          Payment of Share of Sublicense. Section 3.3 is revised to include the following text in the header to the right hand column of the table:

 

“Share payable within seven (7) days following receipt of payments from Novartis under the Radius-Novartis Agreement. Nuvios shall issue the invoice to Novartis promptly upon the occurrence of the event triggering the payments and shall inform Ipsen promptly upon receipt of the corresponding payments from Novartis. In case of a failure of Novartis to pay the due sums to Nuvios within the delay as set forth in the Radius-Novartis Agreement, Nuvios shall pay the

 

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Share due to Ipsen within seven (7) days upon expiry of the delay granted to Novartis for the payment due to Nuvios as set forth in the Radius-Novartis Agreement.”

 

2.4          Treatment of Sublicensee on Termination. A new Section 15.7 is added to the Agreement to read in full as follows:

 

“15.7 Sublicenses. Notwithstanding any provision of this Agreement to the contrary, in the event this Agreement is terminated by Ipsen pursuant to Section 15.2 and in the event such termination does not result from a material breach of Nuvios’ obligations which results from the performance or the lack of performance by Novartis of its obligations under the Radius-Novartis Agreement, Radius-Novartis Agreement shall be novated from Nuvios to Ipsen and shall become a direct license between Ipsen and Novartis under the following conditions: (i) Novartis agrees to such novation in a writing pursuant to which it acknowledges each of the statements in the following clauses (ii)-(iv), (ii) Ipsen shall have all Nuvios’ rights as provided in the Radius-Novartis Agreement; (iii) Ipsen shall not be bound by obligations towards Novartis in excess of its obligations as set forth in this Agreement including in particular but without limitation Ipsen shall not assume, and shall not be responsible to Novartis for any representations and warranties other than the ones stated in this Agreement, and (iv) Novartis shall remain bound by the terms and conditions of the Radius-Novartis Agreement as if the Radius-Novartis Agreement had been entered into by Ipsen and Novartis.

 

2.5          Payments and Financial Reporting.

 

(a) Section 1.39 of the Agreement is amended to read in full as follows:

 

Net Sales ” means the net sales made by Nuvios, Novartis and any of their Affiliates or sublicensees (the “ Selling Party ”) of the Licensed Product sold to Third Parties other than sublicensees in bona fide, arm’s-length transactions, as determined in accordance with the Selling Party’s usual and customary accounting methods, which are in accordance with its Accounting Standards as consistently applied by such Selling Party: (a) in the case of any sale or other disposal of a Licensed Product between or among Novartis and its Affiliates or sublicensees, for resale, Net Sales shall be calculated only on the value charged or invoiced on the first arm’s length sale thereafter to a Third Party; (b) in the case of any sale which is not invoiced or is delivered before invoice, Net Sales shall be calculated at the time of shipment or when the Licensed Product is paid for, if paid for before shipment or invoice; (c) in the case of any sale or other disposal for value, such as barter or counter-trade, of any Licensed Product, or part thereof other than in an arm’s-length transaction exclusively for money, Net Sales shall be calculated on the value of non-cash consideration received or the fair market price (if higher) of the Licensed Product in the country of sale or disposal; and (d) in the event the Licensed Product is sold as a Bundled Licensed Product, the Net Sales of the Licensed Product, for the purposes of determining royalty payments, shall be determined by multiplying the Net Sales of the Bundled Licensed Product by the fraction, A/(A+B) where A is the weighted (by sales volume) average sale price in a particular country of the Licensed Product when sold separately in finished form and B is the weighted average sale price in that country of the other Licensed Product(s) sold separately in finished form. In the event that such average sale price cannot be determined for both the Licensed Product and the other Licensed Product(s) in Bundled Licensed Product, Net Sales for purposes of determining royalty payments shall be agreed by the Parties based on the relative value contributed by each component, such agreement not to be unreasonably withheld. For the avoidance of doubt, sales between Novartis, its Affiliates, sublicensees and designees shall not be considered Net Sales (unless such Person is the end user of the Licensed Product), which shall be calculated on Net Sales of Novartis, its Affiliates, sublicensees and designees to independent third party customers.”

 

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(b) Section 5.4 of the Agreement is revised to include the following text at the end of Section 5.4:

 

“Ipsen will pay any and all taxes levied on account of any payments made to it under this Agreement. If any taxes are required to be withheld by Nuvios, Nuvios will: (a) deduct such taxes from the payment made to Ipsen; (b) timely pay the taxes to the proper taxing authority; (c) promptly send proof of payment to Ipsen; and (d) promptly and reasonably assist Ipsen in its efforts to obtain a credit for such tax payment. Each Party agrees to reasonably assist the other Party in lawfully claiming exemptions from and/or minimizing such deductions or withholdings under double taxation laws or similar circumstances.”

 

(c) The first sentence of Section 5.2 of the Agreement is revised to read in full as follows:

 

5.2 Payments and Reporting. After the First Commercial Sale of Licensed Product in the Territory, Nuvios shall calculate royalties quarterly at the end of each Accounting Period (i.e., March 31, June 30, September 30 and December 31) and shall pay royalties on Net Sales quarterly within sixty (60) days after the end of each Accounting Period. Nuvios may delay the payment of royalties on Net Sales until a maximum of ninety (90) days after the end of each Accounting Period provided that Nuvios shall pay to Ipsen interest on such late payment between the 60 th  and the effective date of payment of the royalties, at the rate of EURIBOR 1 month plus 0.50% on sales in EURO and LIBOR 1 month USD plus 0.5% on sales in USD.”

 

2.6          No other changes. Except to the extent expressly amended by this Amendment No. 1, all of the terms, provisions and conditions of the Agreement remain unchanged and in full force and effect. The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment No. 1.

 

ARTICLE 3  —  MISCELLANEOUS

 

3.1          Duration. This Amendment No.1 shall enter into force as set forth in Article 1 and shall remain in full force and effect until the Agreement is terminated, provided however that Articles 2.4 and 3.3 of this Amendment No. 1 shall survive any expiry or termination of the Agreement.

 

3.2          Definitions. Capitalized terms used in this Amendment No. 1 and not defined herein are used with the meanings ascribed to them in the Agreement.

 

3.3          Execution Copy. This Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

IN WITNESS WHEREOF, the Parties hereto have caused this Amendment No. 1 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 1 as of the Amendment Date.

 

RADIUS HEALTH INC.

SCRAS S.A.S

 

 

 

 

 

By:

/s/ C. R. Lyttle

 

By:

/s/ Claire Giraut

Name:

C. Richard Lyttle

 

Name:

Claire Giraut

Title:

President & CEO

 

Title:

Director General

 

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Execution Copy

 

LICENSE AGREEMENT AMENDMENT NO. 2

 

Radius Health Inc., a Delaware Corporation, formerly known as Nuvios, Inc. ( Radius” ), and Ipsen Pharma SAS, a French corporation formerly known as SCRAS S.A.S., on behalf of itself and its Affiliates ( Ipsen ) (the “Parties” ) entered into the certain License Agreement as of September 27, 2005 ( Effective Date” ) , as amended by that certain License Agreement Amendment No. effective as of September 12, 2007 (as amended, the “Agreement” ).  The Parties wish to enter into this License Agreement Amendment No. 2 ( Amendment No. 2” ) effective as of May 11, 2011 ( Amendment Date” ) to amend certain provisions of the Agreement .

 

NOW THEREFORE, in consideration of the mutual covenants and promises contained in this Amendment No. 2, the Parties agree as follows:

 

1.  Phase III Clinical Trial Milestone Payment.  The provision of the fifth table cell of Section 3.1 of the Agreement concerning payment by Radius to Ipsen of EUR 1 million in connection with initiation of a first Phase III study is revised to read in full as follows:

 

Events

 

Amount

(a)  Within 15 days of the initiation of the first Phase III study ( as such period may be extended with interest in accordance with Section 2 below), Nuvios shall pay Ipsen EUR 1 million. Ipsen shall in lieu of payment of such amount in cash accept payment in the form of the of having Nuvios issue shares of Nuvios Series A-1 Preferred Stock, provided that (i) the issuance of the Series A-1 Preferred Stock to Ipsen shall be made pursuant to a Series A-1 Convertible Preferred Stock Issuance Agreement in the form of Attachment 1 to this Amendment No. 2, executed concurrently herewith ( “Series A-1 SPA” ); and (ii) Ipsen shall not have terminated such agreement due to the failure of the conditions to be satisfied prior to June 30, 2011. If Ipsen does terminate the agreement, the milestone payment shall be immediately due and payable in cash, along with any interest accrued pursuant to paragraph 2 below.

 

EUR 1 million

 

2.  Payment Mechanics for Phase III Clinical Trial Milestone.  The shares of Series A-1 Preferred Stock issuable to Ipsen will be issued in connection with the Stage-1 closing of the Series A-1 SPA. As such financing is not scheduled to close until after the 15-day period set forth in the fifth table cell of Section 3.1 of the Agreement, Radius may defer payment pending Closing of the Series A-1 SPA (or termination of the Series A-1 SPA), and Radius shall pay Ipsen interest on such milestone payment at the rate specified in Section 5.3 of the Agreement during the period between the 15 th  day following the initiation of the Phase III study and the date that Radius issues the shares of Series A-1 Preferred Stock to Ipsen.  Such interest shall be paid in cash at the time the shares of Series A-1 Preferred Stock are issued to Ipsen.

 

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3.  Other Terms Related to the A-1 Financing.   Radius represents and warrants that it has provided to Ipsen the agreements containing the terms of other investors in the Series A-1 financing and that such agreements and schedules thereto are current and accurate.  Radius also agrees to notify Ipsen should Radius waive the transfer restrictions of any Series A-1 Preferred stockholder, and agrees to provide Ipsen with the opportunity to transfer a pro-rata portion of Ipsen’s Series A-1 Preferred Stock on the same terms.

 

4.  Confidentiality.   Notwithstanding Article 12 of the Agreement, neither Party shall disclose any Confidential Information, or the terms of the Agreement, including Amendment No. 1 or this Amendment No. 2 except to the extent required by a court or other governmental authority (and specifically including necessary disclosures pursuant to requirements of the Securities Exchange Commission ( “SEC” ) or any securities exchange upon which such Party’s securities are listed), provided that the disclosing Party (a) gives the other Party advance written notice of the disclosure, (b) uses reasonable efforts to resist disclosing such information, (c) cooperates with the other Party on request to obtain a confidential treatment or otherwise limit the disclosure (including the redaction of information reasonably requested by such other Party), and (d) as soon as reasonably possible, provides a letter from its counsel confirming that such information is, in fact, required to be disclosed by such governmental authority.

 

5.  Change of Radius Notice Address.  Section 18.4 of the Agreement is revised to replace the current notice address for Nuvios with the following notice address:

 

“Radius Health, Inc.

201 Broadway, 6th Floor

Cambridge, MA 02139, USA

Attn: President.”

 

6.  Ratification . Except to the extent expressly amended by this Amendment No. 2, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect. The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment No. 2.

 

7.  General .

 

(a)  Capitalized terms used in this Amendment No. 2 and not defined herein are used with the meanings ascribed to them in the Agreement.

 

(b)  This Amendment No. 2 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

(c)  This Amendment No. 2 shall take effect as of the Amendment Date and shall remain in effect in accordance with the terms and provisions of the Agreement.

 

IN WITNESS WHEREOF, the Parties hereto have caused this Amendment No. 2 to be executed by their respective duly authorized officers, and have duly delivered and executed this Amendment No. 2 under seal as of the Amendment Date.

 

RADIUS HEALTH INC.

IPSEN PHARMA SAS

 

 

BY:

/s/ C. Richard Lyttle

 

BY:

/s/ Marc de Garidel

NAME:

/s/ C. Richard Lyttle

 

NAME:

Marc de Garidel

TITLE:

President & CEO

 

TITLE:

Chairman and CEO

 

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Execution Copy

 

Attachment 1

 

FORM OF

SERIES A-1 CONVERTIBLE PREFERRED

STOCK ISSUANCE AGREEMENT

 

THIS SERIES A-1 CONVERTIBLE PREFERRED STOCK ISSUANCE AGREEMENT, dated this 11th day of May, 2011 (“ Agreement ”) is entered into by and among Radius Health, Inc., a Delaware corporation (the “ Corporation ”), and Ipsen Pharma SAS, a French corporation formerly known as SCRAS S.A.S. (“ Investor ”).

 

WHEREAS, the Corporation and the Investor are parties to that certain License Agreement dated as of September 27, 2005, as amended by that certain License Agreement Amendment No. 1 effective as of September 12, 2007 and that certain License Agreement Amendment No. 2 effective as of May 11, 2011 (the “ License Agreement ”) and pursuant to Amendment No. 2 have agreed that the Corporation shall issue shares of Series A-1 Convertible Preferred Stock (as hereinafter defined) to the Investor in satisfaction of the €1,000,000 milestone due Investor by the Corporation upon the initiation of the first Phase III study as provided in the fifth table cell of Section 3.1 of the License Agreement.

 

WHEREAS, the Corporation has entered into a Series A-1 Convertible Preferred Stock Purchase Agreement dated April 25, 2011 with several other investors providing for the issuance to such investors of an aggregate US $60,000,000 of Series A-1 Convertible Preferred Stock (as hereinafter defined), as more specifically set forth therein (the “ April 25 Agreement ”).

 

NOW, THEREFORE, in consideration of the mutual covenants and agreements herein contained, the parties hereto, intending to be legally bound, hereby agree as follows:

 

SECTION 1.                             Filing of Restated Certificate of Incorporation .

 

1.1                                Recapitalization .

 

(a)                                  Prior to the Stage I Closing (as defined in Section 4(a) hereof), the Corporation shall have filed the Fourth Amended and Restated Certificate of Incorporation of the Corporation, in the form attached hereto as Exhibit A (the “ Restated Certificate ”).  Pursuant to the Restated Certificate, among other things:

 

(i)                                      simultaneously with the effective date of the filing of the Restated Certificate (the “ Split Effective Date ”), a reverse split (the “ Reverse Split ”) of the Corporation’s outstanding capital stock shall occur as follows: (A) each share of the Corporation’s Common Stock, par value $.01 per share (“ Common Stock ”), issued and outstanding or held as treasury shares immediately prior to the Split Effective Date shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Common Stock from and after the Split Effective Date, (B) each share of the Corporation’s Series A Junior Convertible Preferred Stock, par value $.01 per share (“ Series A Stock ”), issued and outstanding or held as treasury shares immediately prior to the Split Effective Date shall automatically without any action on the part of the holder thereof, be

 

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reclassified and changed into 0.06666667 of one share of Series A Stock from and after the Split Effective Date, (C) each share of the Corporation’s Series B Convertible Redeemable Preferred Stock, par value $.01 per share (“ Series B Stock ”), issued and outstanding or held as treasury shares immediately prior to the Split Effective Date shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Series B Stock from and after the Split Effective Date and (D) each share of the Corporation’s Series C Convertible Redeemable Preferred Stock, par value $.01 per share (“ Series C Stock ” and together with the Series A Stock and the Series B Stock, the “ Existing Preferred Stock ”), issued and outstanding or held as treasury shares immediately prior to the Split Effective Date shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Series C Stock from and after the Split Effective Date;

 

(ii)                                   in the event that a current stockholder of the Corporation does not participate in the financing contemplated hereby at least at the level of its Pro Rata Share (as defined below), by committing to purchase and purchasing (or securing an investor who commits to purchase and purchases) at least at the level of its Pro Rata Share, a percentage of each series of such holder’s Existing Preferred Stock equal to such holder’s Applicable Portion (as defined in the Restated Certificate) shall automatically convert into shares of Common Stock (all such shares of Common Stock being referred to herein, collectively, as the “ Forced Conversion Shares ”), at a rate of 1 share of Common Stock for every 5 shares of Existing Preferred Stock to be so converted, such automatic conversion (hereinafter, the “ Forced Conversion ”) to occur and become effective immediately prior to the consummation of the Stage I Closing (the “ Effective Time ”);

 

(iii)                                each share of Series C Stock remaining outstanding after the Forced Conversion shall, immediately following the Forced Conversion, automatically be reclassified and converted into one (1) share of Series A-2 Preferred Stock (as defined in Section 1.2 hereof), and all accrued dividends on such reclassified share of Series C Stock shall be forfeited;

 

(iv)                               each share of Series B Stock remaining outstanding after the Forced Conversion shall, immediately following the Forced Conversion, automatically be reclassified and converted into one (1) share of Series A-3 Preferred Stock (as defined in Section 1.2 hereof), and all accrued dividends on such reclassified share of Series B Stock shall be forfeited; and

 

(v)                                  each share of Series A Stock remaining outstanding after the Forced Conversion shall, immediately following the Forced Conversion, automatically be reclassified and converted into one (1) share of Series A-4 Preferred Stock (as defined in Section 1.2 hereof) (the automatic reclassification and conversion of the Existing Preferred Stock pursuant to the Restated Certificate into shares of Series A-2 Preferred Stock, Series A-3 Preferred Stock and Series A-4 Preferred Stock, as applicable, as described in the provisions set forth above, is hereinafter referred to as the “ Automatic Reclassification ”). The Reverse Split, the Forced Conversion and the Automatic Reclassification are hereinafter referred to, collectively, as the “ Recapitalization ”.

 

(b)                                  As used in this Agreement, the term “ Pro Rata Share ” means, with

 

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respect to any holder of Existing Preferred Shares (an “ Existing Preferred Holder ”), that amount equal to $35,000,000 multiplied by the quotient obtained by dividing (A) the number of shares of issued and outstanding Common Stock owned by such Existing Preferred Holder as of March 31, 2011 (or, in the case of a holder of Existing Preferred Stock who received all of its shares of Existing Preferred Stock in a transfer from a former holder of Existing Preferred Stock occurring after March 31, 2011, the number shares of issued and outstanding Common Stock owned by such former holder of Existing Preferred Stock as of March 31, 2011) by (B) the aggregate number of shares of issued and outstanding Common Stock owned as of such date by all Existing Preferred Holders.  For purposes of the computation set forth in clauses (i) and (ii) above, all issued and outstanding securities held by Existing Preferred Holders that are convertible into or exercisable or exchangeable for shares of Common Stock (including any issued and issuable shares of Existing Preferred Stock) or for any such convertible, exercisable or exchangeable securities, shall be treated as having been so converted, exercised or exchanged at the rate or price at which such securities are convertible, exercisable or exchangeable for shares of Common Stock in effect at the time in question, whether or not such securities are at such time immediately convertible, exercisable or exchangeable.

 

(c)                                   The procedures for implementing the Recapitalization are more specifically set forth in the Restated Certificate.

 

(d)                                  All stock numbers and prices set forth in this Agreement give effect to the Reverse Split and no further adjustments are necessary with respect thereto.

 

1.2                                Rights and Preferences of the Authorized Stock .  In addition to setting forth the Recapitalization, the Restated Certificate also sets forth, among other things, the terms, designations, powers, preferences, and relative, participating, optional, and other special rights, and the qualifications, limitations and restrictions of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and Series A-6 Preferred Stock (as such terms are hereinafter defined).  Pursuant to the Restated Certificate, the Corporation shall be authorized to issue up to (i) 34,859,964 shares of Common Stock, par value $.01 per share (“ Common Stock ”), and (ii) 29,364,436 shares of Preferred Stock (the “ Preferred Stock ”), 10,000,000 of which shall have been designated as Series A-1 Convertible Preferred Stock, par value $.01 per share (“ Series A-1 Preferred Stock ”), 9,832,133 of which shall have been designated as Series A-2 Convertible Preferred Stock, par value $.01 per share (“ Series A-2 Preferred Stock ”), 1,422,300 of which shall have been designated as Series A-3 Convertible Preferred Stock, par value $.01 per share (“ Series A-3 Preferred Stock ”), 40,003 of which shall have been designated as Series A-4 Convertible Preferred Stock, par value $.01 per share (“ Series A-4 Preferred Stock ”), 70,000 of which shall have been designated as Series A-5 Convertible Preferred Stock, par value $.01 per share (“ Series A-5 Preferred Stock ”), and 8,000,000 of which shall have been designated as Series A-6 Convertible Preferred Stock, par value $.01 per share (“ Series A-6 Preferred Stock ”).  The Common Stock and the Preferred Stock shall have the respective terms as set forth in the Restated Certificate.

 

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SECTION 2.                             Authorization of Issuance and Sale of Series A-1 Preferred Stock; Reservation of Reserved Common Shares .

 

Subject to the terms and conditions of the April 25 Agreement, the Corporation has authorized the following:

 

(a)                                  the issuance on the Stage I Closing Date (as defined in Section 4(a) hereof) of an aggregate of 2,631,845 shares of Series A-1 Preferred Stock (subject to adjustment to reflect stock splits, stock dividends, stock combinations, recapitalizations and like occurrences other than the Reverse Split) (such shares of Series A-1 Preferred Stock being sometimes hereinafter referred to as the “ Stage I Preferred Shares ”), and the reservation of an equal number of shares of Common Stock for issuance upon conversion of the Stage I Preferred Shares (such reserved Common Stock being sometimes hereinafter collectively referred to as the “ Stage I Reserved Common Shares ”).

 

(b)                                  the issuance on the Stage II Closing Date (as defined in the April 25 Agreement) of an aggregate of 2,631,845 shares of Series A-1 Preferred Stock (subject to adjustment to reflect stock splits, stock dividends, stock combinations, recapitalizations and like occurrences other than the Reverse Split) (such shares of Series A-1 Preferred Stock being sometimes hereinafter referred to as the “ Stage II Preferred Shares ”), and the reservation of an equal number of shares of Common Stock for issuance upon conversion of the Stage II Preferred Shares (such reserved Common Stock being sometimes hereinafter collectively referred to as the “ Stage II Reserved Common Shares ”).

 

(c)                                   the issuance on the Stage III Closing Date (as defined in the April 25 Agreement) of an aggregate of 2,631,845 shares of Series A-1 Preferred Stock (subject to adjustment to reflect stock splits, stock dividends, stock combinations, recapitalizations and like occurrences other than the Reverse Split) (such shares of Series A-1 Preferred Stock being sometimes hereinafter referred to as the “ Stage III Preferred Shares ”), and the reservation of an equal number of shares of Common Stock for issuance upon conversion of the Stage III Preferred Shares (such reserved Common Stock being sometimes hereinafter collectively referred to as the “ Stage III Reserved Common Shares ” and together with the Stage I Reserved Common Shares and the Stage II Reserved Common Shares, the “ Reserved Common Shares ”).

 

SECTION 3.                             Issuance of Series A-1 Preferred Stock .

 

3.1                                Agreement to Issue the Series A-1 Preferred Stock . Subject to the terms and conditions hereof, the Corporation is selling to the Investor and the Investor is purchasing from the Corporation the number of shares of Series A-1 Preferred Stock set forth next to such Investor’s name of Schedule 1 hereto under the caption “Stage 1 Preferred Shares” for the consideration set forth in Section 3.3.

 

3.2                                Delivery of Series A-1 Preferred Stock . At the Closing (as defined in Section 4), the Corporation shall deliver to the Investor a certificate, registered in the name of the Investor, representing that number of shares of Series A-1 Preferred Stock equal to the quotient (rounded up to the nearest whole number) obtained by dividing (x)  the U.S. Dollar equivalent (determined in accordance with the provisions of the next sentence) of €1,000,000 by (y)  US$8.142 per share.  The Corporation shall determine the U.S. Dollar equivalent of such €1,000,000 using the

 

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exchange rate for buying U.S. Dollars with EUROS set forth in The Wall Street Journal (Online Edition) Market Data Center at http://online.wsj.com/mdc/public/page/marketsdata.html on the Business Day that is two (2) Business Days preceding the date of the Closing.  Delivery of certificate representing Series A-1 Preferred Stock to the Investor shall be made in satisfaction of the milestone due Investor by the Corporation pursuant to fifth table cell of Section 3.1 of the of the License Agreement upon the initiation of the first Phase III study.

 

SECTION 4.                             The Closing .

 

The closing (the “ Stage I Closing ” or the “ Closing ”) hereunder with respect to the transactions contemplated by Sections 2(a) and 3.1 hereof will take place by facsimile transmission of executed copies of the documents contemplated hereby delivered on either (i) May 17, 2011 or (ii) if on such date the conditions precedent set forth in Section 7.1 and 7.2 hereof have not been satisfied or waived, no later than the third (3d) business day after the conditions set forth in Sections 7.1 and 7.2 hereof have been satisfied or waived in writing by the Majority Investors, such Stage I Closing to be held at the offices of Bingham McCutchen LLP, One Federal Street, Boston, MA 02110 (such date sometimes being referred to herein as the “ Stage I Closing Date ”).

 

SECTION 5.                             Representations and Warranties of the Corporation to the Investor .

 

Except as set forth in the Corporation’s disclosure schedule dated as of April 25, 2011 and delivered herewith (the “ Corporation’s Disclosure Schedule ”), which shall be arranged to correspond to the representations and warranties in this Section 5, or, in each case, as applicable to the relevant other Sections of this Agreement, and the disclosure in any portion of the Corporation’s Disclosure Schedule shall qualify the corresponding provision in this Section 5 and any other provision of this Agreement, including but not limited to the provisions of this Section 5, to which it is reasonably apparent on its face that such disclosure relates notwithstanding the lack of any explicit cross-reference, the Corporation hereby represents and warrants to the Investors as of the date of this Agreement and as of the Effective Time as follows:

 

5.1                                Organization . The Corporation is a corporation duly organized, validly existing and in good standing under the laws of the State of Delaware and has all requisite corporate power and authority to own and lease its property and to carry on its Business (as defined in Section 5.6) as presently conducted and as proposed to be conducted as described in the Executive Summary (as defined in Section 5.6).  The Corporation is duly qualified to do business as a foreign corporation in the states set forth on Schedule 5.1 of the Corporation’s Disclosure Schedule.  The Corporation does not own or lease property or engage in any activity in any other jurisdiction which would require its qualification in such jurisdiction and in which the failure to be so qualified would have a material adverse effect on the Business, properties, assets, liabilities, condition (financial or otherwise) or prospects of the Corporation (a “ Corporation Material Adverse Effect ”).

 

5.2                                Capitalization .

 

(a)                                  The authorized capital stock of the Corporation immediately prior

 

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to the Stage I Closing shall consist of:

 

(i)                                      34,859,964 shares of Common Stock, of which:

 

(1)                                  522,506 shall be validly issued and outstanding, fully paid and nonassessable (including 266 shares issuable upon exercise of warrants to purchase Common Stock);

 

(2)                                  29,364,436 shares shall have been duly reserved for issuance upon conversion of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and Series A-6 Preferred Stock (including 147,384 shares of Series A-1 Preferred Stock issuable upon exercise of warrants to purchase Series A-1 Preferred Stock); and

 

(3)                                  2,015,666 shares shall have been duly reserved for issuance in connection with options available under the Corporation’s 2003 Long-Term Incentive Plan, as amended (the “ 2003 Plan Option Shares ”).

 

(ii)                                   29,364,436 shares of Preferred Stock of which:

 

(1)                                  63,000 shall have been designated the Series A Stock, 61,664 of which shall be issued and outstanding, fully paid and nonassessable;

 

(2)                                  1,600,000 shall have been designated the Series B Stock, 1,599,997 of which shall be issued and outstanding, fully paid and nonassessable;

 

(3)                                  10,146,629 shall have been designated the Series C Preferred Stock, all of which shall be issued and outstanding, fully paid and nonassessable;

 

(4)                                  10,000,000 shall have been designated the Series A-1 Preferred Stock, none of which shall be issued and outstanding;

 

(5)                                  9,832,133 shall have been designated the Series A-2 Preferred Stock, none of which shall be issued and outstanding;

 

(6)                                  1,422,300 shall have been designated the Series A-3 Preferred Stock, none of which shall be issued and outstanding;

 

(7)                                  40,003 shall have been designated the Series A-4 Preferred Stock, none of which shall be issued and outstanding;

 

(8)                                  70,000 shall have been designated the Series A-5 Preferred Stock, none of which shall be issued and outstanding;

 

(9)                                  8,000,000 shall have been designated the Series A-6 Preferred Stock, none of which shall be issued and outstanding.

 

(b)                                  The authorized capital stock of the Corporation immediately

 

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following the Stage I Closing, assuming compliance with all of the provisions of this Agreement by each of the Investors, shall consist of:

 

(i)                                      34,859,964 shares of Common Stock, of which:

 

(1)                                  522,506 shall be validly issued and outstanding, fully paid and nonassessable (including 266 shares issuable upon exercise of warrants to purchase Common Stock);

 

(2)                                  29,364,436 shares shall have been duly reserved for issuance upon conversion of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and Series A-6 Preferred Stock (including 147,384 shares of Series A-1 Preferred Stock issuable upon exercise of warrants to purchase Series A-1 Preferred Stock); and

 

(3)                                  2,015,666 shares shall have been duly reserved for issuance in connection with options available under the Corporation’s 2003 Long-Term Incentive Plan, as amended;

 

(ii)                                   29,364,436 shares of Preferred Stock of which:

 

(1)                                  63,000 shall have been designated the Series A Preferred Stock, none of which shall be issued and outstanding;

 

(2)                                  1,600,000 shall have been designated the Series B Preferred Stock, none of which shall be issued and outstanding;

 

(3)                                  10,146,629 shall have been designated the Series C Preferred Stock, none of which shall be issued and outstanding;

 

(4)                                  10,000,000 shall have been designated the Series A-1 Preferred Stock, of which 4,136,912 shall be validly issued and outstanding, fully paid and nonassessable;

 

(5)                                  9,832,133 shall have been designated the Series A-2 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable;

 

(6)                                  1,422,300 shall have been designated the Series A-3 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable;

 

(7)                                  40,003 shall have been designated the Series A-4 Preferred Stock, all of which shall be validly issued and outstanding, fully paid and nonassessable;

 

(8)                                  70,000 shall have been designated the Series A-5 Preferred Stock, of which 66,028 shall be validly issued and outstanding, fully paid and nonassessable; and

 

(9)                                  8,000,000 shall have been designated the Series A-6 Preferred

 

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Stock, none of which shall be issued and outstanding.

 

(c)                                   Except (i) pursuant to the terms of this Agreement, (ii) at any time prior to the Stage I Closing, pursuant to the terms of the Amended and Restated Stockholders’ Agreement, dated as of December 15, 2006, by and among the Corporation and the stockholders named therein, as amended to date (the “ Existing Stockholders’ Agreement ”), (iii) as of and at all times following the Stage I Closing, pursuant to the terms of that certain Amended and Restated Stockholders’ Agreement to be entered into in connection with the Stage I Closing, as contemplated by Section 7.2(b), in the form attached hereto as Exhibit B (the “ Stockholders’ Agreement ”), and (iv) as set forth in Schedule 5.2 attached hereto, there are and, immediately following the Stage I Closing, there will be: (1) no outstanding warrants, options, rights, agreements, convertible securities or other commitments or instruments pursuant to which the Corporation is or may become obligated to issue, sell, repurchase or redeem any shares of capital stock or other securities of the Corporation (other than the 2003 Plan Option Shares); (2) no preemptive, contractual or similar rights to purchase or otherwise acquire shares of capital stock of the Corporation pursuant to any provision of law, the Restated Certificate, the by-laws of the Corporation (the “ by-laws ”) or any agreement to which the Corporation is a party or may otherwise be bound; (3) no restrictions on the transfer of capital stock of the Corporation imposed by the Restated Certificate or by-laws of the Corporation, any agreement to which the Corporation is a party, any order of any court or any governmental agency to which the Corporation is subject, or any statute other than those imposed by relevant state and federal securities laws; (4) no cumulative voting rights for any of the Corporation’s capital stock; (5) no registration rights under the Securities Act of 1933, as amended (the “ Securities Act ”), with respect to shares of the Corporation’s capital stock; (6) to the Corporation’s Knowledge, no options or other rights to purchase shares of capital stock from stockholders of the Corporation granted by such stockholders; and (7) no agreements, written or oral, between the Corporation and any holder of its securities, or, to the Corporation’s Knowledge, among holders of its securities, relating to the acquisition, disposition or voting of the securities of the Corporation.

 

5.3                                Authorization of this Agreement and the Stockholders’ Agreement . The execution, delivery and performance by the Corporation of this Agreement and the Stockholders’ Agreement and the consummation of the transactions contemplated hereby and thereby, including the Recapitalization and the Merger, have been duly authorized by all requisite action on the part of the Corporation. Each of this Agreement and the Stockholders’ Agreement has been duly executed and delivered by the Corporation and constitutes a valid and binding obligation of the Corporation, enforceable in accordance with its respective terms. The execution, delivery and performance of this Agreement and the Stockholders’ Agreement, the filing of the Restated Certificate and the compliance with the provisions hereof and thereof by the Corporation, will not:

 

(a)                                  violate any provision of law, statute, ordinance, rule or regulation or any ruling, writ, injunction, order, judgment or decree of any court, administrative agency or other governmental body;

 

(b)                                  conflict with or result in any breach of any of the terms, conditions or provisions of, or constitute (with due notice or lapse of time, or both) a default (or give rise to any right of termination, cancellation or acceleration) under (i) any agreement, document,

 

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instrument, contract, understanding, arrangement, note, indenture, mortgage or lease to which the Corporation is a party or under which the Corporation or any of its assets is bound, which conflict, breach or default would have a Corporation Material Adverse Effect, (ii) the Restated Certificate, or (iii) the by-laws;

 

(c)                                   result in the creation of any lien, security interest, charge or encumbrance upon any of the properties or assets of the Corporation; or

 

(d)                                  conflict with any stockholder’s rights to participate in the transactions contemplated hereby, including but not limited to any rights to purchase Series A-1 Preferred Stock hereunder.

 

5.4                                Authorization of Series A-1 Preferred Stock and Reserved Common Shares .

 

(a)                                  The issuance, sale and delivery of the Series A-1 Preferred Stock pursuant to the terms hereof and the issuance sale and deliver of the Series A-2 Preferred Stock, the Series A-3 Preferred Stock and the Series A-4 Preferred Stock pursuant to the Recapitalization, have been duly authorized by all requisite action of the Corporation, and, when issued, sold and delivered in accordance with this Agreement or the Recapitalization, the shares of Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock and Series A-4 Preferred Stock will be validly issued and outstanding, fully paid and nonassessable, with no personal liability attaching to the ownership thereof, and, except as may be set forth in the Stockholders’ Agreement (with respect to which the Corporation is in compliance with its obligations thereunder), not subject to preemptive or any other similar rights of the stockholders of the Corporation or others.

 

(b)                                  The reservation, issuance, sale and delivery by the Corporation of the Reserved Common Shares and of all shares of Common Stock issuable upon conversion of shares of Series A-2 Preferred Stock, Series A-3 Preferred Stock and Series A-4 Preferred Stock have been duly authorized by all requisite action of the Corporation, and the Reserved Common Shares have been duly reserved in accordance with Section 2 of this Agreement. Upon the issuance and delivery of the Reserved Common Shares in accordance with the terms of this Agreement, the Reserved Common Shares will be validly issued and outstanding, fully paid and nonassessable and not subject to preemptive or any other similar rights of the stockholders of the Corporation or others.

 

5.5                                Consents and Approvals . No authorization, consent, approval or other order of, or declaration to or filing with, any governmental agency or body (other than filings required to be made under applicable federal and state securities laws) or any other person, entity or association is required for: (a) the valid authorization, execution, delivery and performance by the Corporation of this Agreement and the Stockholders’ Agreement; (b) the valid authorization, issuance, sale and delivery of the Series A-1 Preferred Stock; (c) the valid authorization, reservation, issuance, sale and delivery of the Reserved Common Shares; or (d) the filing of the Restated Certificate.  The Corporation has obtained all other consents that are necessary to permit the consummation of the transactions contemplated hereby and thereby, other than the Merger.

 

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5.6                                Business of the Corporation .

 

(a)                                  Except as set forth in Schedule 5.6(a) of the Corporation’s Disclosure Schedule, the business of the Corporation (the “ Business ”) is described in the executive summary of the Corporation, a copy of which is attached hereto as Exhibit C (the “ Executive Summary ”).

 

(b)                                  Schedule 5.6 of the Corporation’s Disclosure Schedule sets forth a list of all agreements or commitments to which the Corporation is a party or by which the Corporation or the Corporation’s assets and properties are bound that are material to the business of the Corporation as currently conducted, and, without limitation, of the foregoing, all of the types of agreements or commitments set forth below (each, a “ Material Agreement ”):

 

(i)                                      agreements which require future expenditures by the Corporation in excess of $100,000 or which might result in payments to the Corporation in excess of $100,000;

 

(ii)                                   employment and consulting agreements, employee benefit, bonus, pension, profit-sharing, stock option, stock purchase and similar plans and arrangements;

 

(iii)                                agreements involving research, development, or the license of Intellectual Property (as defined in Section 5.12) (other than research, development, or license agreements which require future expenditures by the Corporation in amounts less than $100,000 or which might result in payments to the Corporation in amounts less than $100,000 in each case that do not grant to a third party or to the Corporation any rights in connection with the commercialization of any products), the granting of any right of first refusal, or right of first offer or comparable right with respect to any Intellectual Property or payment or receipt by the Corporation of milestone payments or royalties;

 

(iv)                               agreements relating to a joint venture, partnership, collaboration or other arrangement involving a sharing of profits, losses, costs or liabilities with another person or entity;

 

(v)                                  distributor, sales representative or similar agreements;

 

(vi)                               agreements with any current or former stockholder, officer or director of the Corporation or any “affiliate” or “associate” of such persons (as such terms are defined in the rules and regulations promulgated under the Securities Act), including without limitation agreements or other arrangements providing for the furnishing of services by, rental of real or personal property from, or otherwise requiring payments to, any such person or entity;

 

(vii)                            agreements under which the Corporation is restricted from carrying on any business, or competing in any line of business, anywhere in the world;

 

(viii)                         indentures, trust agreements, loan agreements or notes that involve or evidence outstanding indebtedness, obligations or liabilities for borrowed money;

 

(ix)                               agreements for the disposition of a material portion of the

 

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Corporation’s assets (other than for the sale of inventory in the ordinary course of business);

 

(x)                                  agreements of surety, guarantee or indemnification;

 

(xi)                               interest rate, equity or other swap or derivative instruments;

 

(xii)                            agreements obligating Corporation to register securities under the Securities Act; and

 

(xiii)                         agreements for the acquisition of any of the assets, properties, securities or other ownership interests of the Corporation or another person or the grant to any person of any options, rights of first refusal, or preferential or similar rights to purchase any of such assets, properties, securities or other ownership interests.

 

(c)                                   The Corporation has no present expectation or intention of not fully performing all of its obligations under each Material Agreement and, to the Corporation’s Knowledge, there is no breach or anticipated breach by any other party or parties to any Material Agreements.

 

(d)                                  All of the Material Agreements are valid, in full force and effect and binding against the Corporation and to the Corporation’s Knowledge, binding against the other parties thereto in accordance with their respective terms.  Neither the Corporation, nor, to the Corporation’s Knowledge, any other party thereto, is in default of any of its obligations under any of the agreements or contracts listed on the Schedule 5.6 of the Corporation’s Disclosure Schedule, nor, to the Corporation’s Knowledge, does any condition exist that with notice or lapse of time or both would constitute a default thereunder.  The Corporation has delivered to each Investor or its representative true and complete copies of all of the foregoing Material Agreements or an accurate summary of any oral Material Agreements (and all written amendments or other modifications thereto).

 

(e)                                   Except as provided in Schedule 5.6(e) of the Corporation’s Disclosure Schedule: (i) there are no actions, suits, arbitrations, claims, investigations or legal or administrative proceedings pending or, to the Corporation’s Knowledge, threatened, against the Corporation, whether at law or in equity; (ii) there are no judgments, decrees, injunctions or orders of any court, government department, commission, agency, instrumentality or arbitrator entered or existing against the Corporation or any of its assets or properties for any of the foregoing or otherwise; and (iii) the Corporation has not admitted in writing its inability to pay its debts generally as they become due, filed or consented to the filing against it of a petition in bankruptcy or a petition to take advantage of any insolvency act, made an assignment for the benefit of creditors, consented to the appointment of a receiver for itself or for the whole or any substantial part of its property, or had a petition in bankruptcy filed against it, been adjudicated a bankrupt, or filed a petition or answer seeking reorganization or arrangement under the federal bankruptcy laws or any other laws of the United States or any other jurisdiction.

 

(f)                                    Except as set forth in Schedule 5.6(f) of the Corporation’s Disclosure Schedule, the Corporation is in compliance with all obligations, agreements and conditions contained in any evidence of indebtedness or any loan agreement or other contract or agreement (whether or not relating to indebtedness) to which the Corporation is a party or is

 

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subject (collectively, the “ Obligations ”), the lack of compliance with which could afford to any person the right to accelerate any indebtedness or terminate any right of or agreement with the Corporation. To the Corporation’s Knowledge all other parties to such Obligations are in compliance with the terms and conditions of such Obligations.

 

(g)                                   Except for employment and consulting agreements set forth on Schedule 5.6 attached hereto and for agreements and arrangements relating to the 2003 Plan Option Shares and except as provided in Schedule 5.6(g) of the Corporation’s Disclosure Schedule, this Agreement and the Stockholders’ Agreement, there are no agreements, understandings or proposed transactions between the Corporation and any of its officers, directors or other “affiliates” (as defined in Rule 405 promulgated under the Securities Act).

 

(h)                                  To the Corporation’s Knowledge, no employee of or consultant to the Corporation is in violation of any term of any employment contract, patent disclosure agreement or any other contract or agreement, including, but not limited to, those matters relating (i) to the relationship of any such employee with the Corporation or to any other party as a result of the nature of the Corporation’s Business as currently conducted, or (ii) to unfair competition, trade secrets or proprietary or confidential information.

 

(i)                                      Each employee and director of or consultant to the Corporation, and each other person who has been issued shares of the Corporation’s Common Stock or options to purchase shares of the Corporation’s Common Stock is a signatory to, and is bound by, the Stockholders’ Agreement and, in the case of Common Stock issued to employees, directors and consultants, a stock restriction agreement, all with stock transfer restrictions and rights of first offer in favor of the Corporation in a form previously approved by the Board of Directors of the Corporation (the “ Board of Directors ”). In addition, each such stock restriction agreement contains a vesting schedule previously approved by the Board of Directors.

 

(j)                                     The Corporation does not have any collective bargaining agreements covering any of its employees or any employee benefit plans.

 

(k)                                  The Corporation has at all times complied with all provisions of its by-laws and Restated Certificate, and is not in violation of or default under any provision thereof, any contract, instrument, judgment, order, writ or decree to which it is a party or by which it or any of its properties are bound, and the Corporation is not in violation of any material provision of any federal or state statute, rule or regulation applicable to the Corporation.

 

5.7                                Disclosure .  None of this Agreement, the Stockholders’ Agreement or the Executive Summary, nor any document, certificate or instrument furnished to any of the Investors or their counsel in connection with the transactions contemplated by this Agreement, contains or will contain any untrue statement of a material fact or omits or will omit to state a material fact necessary in order to make the statements contained herein or therein, in light of the circumstances under which they were made, not misleading.  To the Corporation’s Knowledge, there is no fact which the Corporation has not disclosed to the Investors or their counsel which would reasonably be expected to result in a Corporation Material Adverse Effect.

 

5.8                                Financial Statements .  The Corporation has furnished to each of the

 

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Investors a complete and accurate copy of (i) the unaudited balance sheet of the Corporation at December 31, 2010 and the related unaudited statements of operations and cash flows for the fiscal year then ended, and (ii) the unaudited balance sheet of the Corporation (the “ Balance Sheet ”) at February 28, 2011 (the “ Balance Sheet Date ”) and the related unaudited statements of operations and cash flows for the two month period then ended (collectively, the “ Financial Statements ”).   The Financial Statements are in accordance with the books and records of the Corporation, present fairly the financial condition and results of operations of the Corporation at the dates and for the periods indicated, and have been prepared in accordance with generally accepted accounting principles (“ GAAP ”) consistently applied, except, in the case of any unaudited Financial Statements, for the absence of footnotes normally contained therein and subject to normal and recurring year-end audit adjustments that are substantially consistent with prior year-end audit adjustments.

 

5.9                                Absence of Undisclosed Liabilities .  The Corporation has no liabilities of any nature (whether known or unknown and whether absolute or contingent), except for (a) liabilities shown on the Balance Sheet and (b) contractual and other liabilities incurred in the ordinary course of business which are not required by GAAP to be reflected on a balance sheet and which would not, either individually or in the aggregate, have or result in a Corporation Material Adverse Effect.  The Corporation does not have any liabilities (and there is no basis for any present or, to the Corporation’s Knowledge, future proceeding against the Corporation giving rise to any liability) arising out of any personal injury and/or death or damage to property relating to or arising in connection with any clinical trials conducted by or on behalf of the Corporation.

 

5.10                         Absence of Changes .  Since the Balance Sheet Date and except as contemplated by this Agreement, there has been (i) no event or fact that individually or in the aggregate has had a Corporation Material Adverse Effect, (ii) no declaration, setting aside or payment of any dividend or other distribution with respect to, or any direct or indirect redemption or acquisition of, any of the capital stock of the Corporation, (iii) no waiver of any valuable right of the Corporation or cancellation of any debt or claim held by the Corporation, (iv) no loan by the Corporation to any officer, director, employee or stockholder of the Corporation, or any agreement or commitment therefor, (v) no increase, direct or indirect, in the compensation paid or payable to any officer, director, employee or agent Corporation and no change in the executive management of the Corporation or the terms of their employment, (vi) no material loss, destruction or damage to any property of the Corporation, whether or not insured, (vii) no labor disputes involving the Corporation, or (viii) no acquisition or disposition of any assets (or any contract or arrangement therefor), nor any transaction by the Corporation otherwise than for fair value in the ordinary course of business.

 

5.11                         Payment of Taxes . The Corporation has prepared and filed within the time prescribed by, and in material compliance with, applicable law and regulations, all federal, state and local income, excise or franchise tax returns, real estate and personal property tax returns, sales and use tax returns, payroll tax returns and other tax returns required to be filed by it, and has paid or made provision for the payment of all accrued and paid taxes and other charges to which the Corporation is subject and which are not currently due and payable. The federal income tax returns of the Corporation have never been audited by the Internal Revenue Service. Neither the Internal Revenue Service nor any other taxing authority is now asserting nor is

 

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threatening to assert against the Corporation any deficiency or claim for additional taxes or interest thereon or penalties in connection therewith, and the Corporation does not know of any such deficiency or basis for such deficiency or claim.

 

5.12                         Intellectual Property .

 

(a)                                  Schedule 5.12(a) lists each patent, patent application, copyright registration or application therefor, mask work registration or application therefor, and trademark, trademark application, trade name, service mark and domain name registration or application therefor owned by the Corporation, licensed by the Corporation or otherwise used by the Corporation (collectively, the “ Listed Rights ”). For each of the Listed Rights set forth on Schedule 5.12(a), an assignment to the Corporation of all right, title and interest in the Listed Right (or license to practice the Listed Right if owned by others) has been executed. All employees of and consultants to the Corporation have executed an agreement providing for the assignment to the Corporation of all right, title and interest in any and all inventions, creations, works and ideas made or conceived or reduced to practice wholly or in part during the period of their employment or consultancy with the Corporation, including all Listed Rights, to the extent described in any such agreement and providing for customary provisions relating to confidentiality and non-competition.

 

(b)                                  Except as set forth on Schedule 5.12(b), the Listed Rights comprise all of the patents, patent applications, registered trademarks and service marks, trademark applications, trade names, registered copyrights and all licenses that have been obtained by the Corporation, and which, to the Corporation’s Knowledge, are necessary for the conduct of the Business of the Corporation as now being conducted and as proposed to be conducted in the Executive Summary. Except as set forth on Schedule 5.12(b), the Corporation owns all of the Listed Rights and Intellectual Property, as hereinafter defined, free and clear of any valid and enforceable rights, claims, liens, preferences of any party against such Intellectual Property. To the Corporation’s Knowledge, except as set forth in Schedule 5.12(b), the Listed Rights and Intellectual Property are valid and enforceable rights and the practice of such rights does not infringe or conflict with the rights of any third party.

 

(c)                                   To the Corporation’s Knowledge, the Corporation owns or has the right to use all Intellectual Property necessary (i) to use, manufacture, market and distribute the Customer Deliverables (as defined below) and (ii) to operate the Internal Systems (as defined below). The Corporation has taken all reasonable measures to protect the proprietary nature of each item of Corporation Intellectual Property (as defined below), and to maintain in confidence all trade secrets and confidential information that it owns or uses. To the Corporation’s Knowledge no other person or entity has any valid and enforceable rights to any of the Corporation Intellectual Property owned by the Corporation (except as set forth in Schedule 5.12(c)), and no other person or entity is infringing, violating or misappropriating any of the Corporation Intellectual Property.

 

(d)                                  To the Corporation’s Knowledge, none of the Customer Deliverables, or the manufacture, marketing, sale, distribution, importation, provision or use thereof, infringes or violates, or constitutes a misappropriation of, any valid and enforceable Intellectual Property rights of any person or entity; and, to the Corporation’s Knowledge neither

 

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the marketing, distribution, provision or use of any Customer Deliverables currently under development by the Corporation will, when such Customer Deliverables are commercially released by the Corporation, infringe or violate, or constitute a misappropriation of, any valid and enforceable Intellectual Property rights of any person or entity that exist today. To the Corporation’s Knowledge, none of the Internal Systems, or the use thereof, infringes or violates, or constitutes a misappropriation of, any valid and enforceable Intellectual Property rights of any person or entity.

 

(e)                                   There is neither pending nor overtly threatened, or, to the Corporation’s Knowledge, any basis for, any claim or litigation against the Corporation contesting the validity or right to use any of the Listed Rights or Intellectual Property, and the Corporation has not received any notice of infringement upon or conflict with any asserted right of others nor, to the Corporation’s Knowledge, is there a basis for such a notice. To the Corporation’s Knowledge, no person, corporation or other entity is infringing the Corporation’s rights to the Listed Rights or Intellectual Property. Schedule 5.12(e) lists any complaint, claim or notice, or written threat thereof, received by the Corporation alleging any such infringement, violation or misappropriation, and the Corporation has provided to the Investors complete and accurate copies of all written documentation in the possession of the Corporation relating to any such complaint, claim, notice or threat. The Corporation has provided to the Investors complete and accurate copies of all written documentation in the Corporation’s possession relating to claims or disputes known to each of the Corporation concerning any Corporation Intellectual Property.

 

(f)                                    Except as otherwise provided in Schedule 5.12(f), the Corporation, to the Corporation’s Knowledge has no obligation to compensate others for the use of any Listed Right or any Intellectual Property, nor has the Corporation granted any license or other right to use, in any manner, any of the Listed Rights or Intellectual Property, whether or not requiring the payment of royalties. Schedule 5.12(f) identities each license or other agreement pursuant to which the Corporation has licensed, distributed or otherwise granted any rights to any third party with respect to any Corporation Intellectual Property. Except as described in Schedule 5.12(f), the Corporation has not agreed to indemnify any person or entity against any infringement, violation or misappropriation of any Intellectual Property rights with respect to any Corporation Intellectual Property.

 

(g)                                   Schedule 5.12(g) identifies each item of Corporation Intellectual Property that is owned by a party other than the Corporation, and the license or agreement pursuant to which the Corporation uses it (excluding off-the-shelf software programs licensed by the Corporation pursuant to “shrink wrap” licenses).

 

(h)                                  The Corporation has not disclosed the source code for any software developed by it, or other confidential information constituting, embodied in or pertaining to such software, to any person or entity, except pursuant to the agreements listed in Schedule 5.12(h), and the Corporation has taken reasonable measures to prevent disclosure of any such source code.

 

(i)                                      All of the copyrightable materials incorporated in or bundled with the Customer Deliverables have been created by employees of the Corporation within the scope

 

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of their employment by the Corporation or by independent contractors of the Corporation who have executed agreements expressly assigning all right, title and interest in such copyrightable materials to the Corporation. Except as listed in Schedule 5.12(i), no portion of such copyrightable materials was jointly developed with any third party.

 

(j)                                     To the Corporation’s Knowledge, the Customer Deliverables and the Internal Systems are free from significant defects or programming errors and conform in all material respects to the written documentation and specifications therefor.

 

(k)                                  For purposes of this Agreement, the following terms shall have the following meanings:

 

(i)                                      Customer Deliverables ” shall mean (a) the products that the Corporation (i) currently manufactures, markets, sells or licenses or (ii) currently plans to manufacture, market, sell or license in the future and (b) the services that the Corporation (i) currently provides or (ii) currently plans to provide in the future.

 

(ii)                                   Internal Systems ” shall mean the internal systems of each of the Corporation that are presently used in its Business or operations, including, computer hardware systems, software applications and embedded systems.

 

(iii)                                Intellectual Property ” shall mean all: (A) patents, patent applications, patent disclosures and all related continuation, continuation-in-part, divisional, reissue, reexamination, utility model, certificate of invention and design patents, design patent applications, registrations and applications for registrations, including Listed Rights; (B) trademarks, service marks, trade dress, internet domain names, logos, trade names and corporate names and registrations and applications for registration thereof; (C) copyrights and registrations and applications for registration thereof; (D) mask works and registrations and applications for registration thereof; (E) computer software, data and documentation; (F) inventions, trade secrets and confidential business information, whether patentable or nonpatentable and whether or not reduced to practice, know-how, manufacturing and product processes and techniques, research and development information, copyrightable works, financial, marketing and business data, pricing and cost information, business and marketing plans and customer and supplier lists and information; (G) other proprietary rights relating to any of the foregoing (including remedies against infringements thereof and rights of protection of interest therein under the laws of all jurisdictions); and (H) copies and tangible embodiments thereof.

 

(iv)                               Corporation Intellectual Property ” shall mean the Intellectual Property owned by or licensed to the Corporation and incorporated in, underlying or used in connection with the Customer Deliverables or the Internal Systems.

 

(v)                                  Corporation’s Knowledge ” shall mean (a) with respect to matters relating directly to the Corporation and its operations, the knowledge of Richard Lyttle, Nicholas Harvey, Louis O’Dea and Gary Hattersley (the “Officers”) as well as other knowledge which such Officers would have possessed had they made diligent inquiry of appropriate employees and agents of the Corporation with respect to the matter in question; provided, that such Officers shall not be obligated to inquire further with respect to any list herein or in any

 

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schedule hereto, and (b) with respect to external events or conditions, the actual knowledge of the Officers.

 

5.13                         Securities Laws . Neither the Corporation nor anyone acting on its behalf has offered securities of the Corporation for sale to, or solicited any offers to buy the same from, or sold securities of the Corporation to, any person or organization, in any case so as to subject the Corporation, its promoters, directors and/or officers to any Liability under the Securities Act, the Securities and Exchange Act of 1934, as amended, or any state securities or “blue sky” law (collectively, the “ Securities Laws ”).  The offer, grant, sale and/or issuance of the following were not, are not, or, as the case may be, will not be, in violation of the Securities Laws when offered, sold and issued in accordance with this Agreement and the 2003 Long-Term Incentive Plan, as amended:

 

(a)                                  the Series A-1 Preferred Stock, as contemplated by this Agreement and the Exhibits and Schedules hereto, and in partial reliance upon the representations and warranties of the Investors set forth in Section 6 hereof;

 

(b)                                  the Series A-2 Preferred Stock, the Series A-3 Preferred Stock and the Series A-4 Preferred Stock in the Recapitalization;

 

(c)                                   the Common Stock issuable upon the conversion of Existing Preferred Stock in the Forced Conversion and the conversion of the Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock or Series A-4 Preferred Stock and in partial reliance upon the representations and warranties of the Investors set forth in Section 6 hereof; and

 

(d)                                  the 2003 Plan Option Shares and stock options covering such shares.

 

5.14                         Title to Properties .

 

(a)                                  The Corporation has valid title to, or in the case of leased properties and assets, valid leasehold interests in, all of its properties and assets, necessary to conduct the Business in the manner in which it is currently conducted (in each case, free and clear of all liens, security interests, charges and other encumbrances of any kind, except liens for taxes not yet due and payable), including without limitation, all rights under any investigational drug application of the Corporation filed in the United States and in foreign countries, all rights pursuant to the authority of the FDA and any foreign counterparts to conduct clinical trials with respect to any investigational drug application filed with such agency relating to biologics or drugs relating to the Business and all rights, if any, to apply for approval to commercially market and sell biologics or drugs and none of such properties or assets is subject to any lien, security interest, charge or other encumbrance of any kind, other than those the material terms of which are described in Schedule 5.14(a).

 

(b)                                  The Corporation does not own any real property or any buildings or other structures, nor have options or any contractual obligations to purchase or acquire any interest in real property.  Schedule 5.14(b) lists all real property leases to which the Corporation is a party and each amendment thereto.  All such current leases are in full force and effect, are

 

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valid and effective in accordance with their respective terms, and there is not, under any of such leases, any existing default or event of default (or event that with notice or lapse of time, or both, would constitute a default).  The Corporation, in its capacity as lessee, is not in violation of any zoning, building or safety ordinance, regulation or requirement or other law or regulation applicable to the operation of its leased properties, nor has it received any notice of violation with which it has not complied.

 

(c)                                   The equipment, furniture, leasehold improvements, fixtures, vehicles, any related capitalized items and other tangible property material to the Business are in good operating condition and repair, ordinary wear and tear excepted.

 

5.15                         Investments in Other Persons . Except as indicated in Schedule 5.15 attached hereto, (a) the Corporation has not made any loan or advance to any person or entity which is outstanding on the date hereof nor is it committed or obligated to make any such loan or advance, and (b) the Corporation has never owned or controlled and does not currently own or control, directly or indirectly, any subsidiaries and has never owned or controlled and does not currently own or control any capital stock or other ownership interest, directly or indirectly, in any corporation, association, partnership, trust, joint venture or other entity.

 

5.16                         ERISA . Except as set forth in Schedule 5.16, neither the Corporation nor any entity required to be aggregated with the Corporation under Sections 414(b), (c), (m) or (n) of the Code (as hereinafter defined), sponsors, maintains, has any obligation to contribute to, has any liability under, or is otherwise a party to, any Benefit Plan.  For purposes of this Agreement, “Benefit Plan” shall mean any plan, fund, program, policy, arrangement or contract, whether formal or informal, which is in the nature of (i) any qualified or non-qualified employee pension benefit plan (as defined in Section 3(2) of the Employee Retirement Income Security Act of 1974, as amended (“ERISA”)) or (ii) an employee welfare benefit plan (as defined in section 3(1) of ERISA).  With respect to each Benefit Plan listed in Schedule 5.16, to the extent applicable:

 

(a)                                  Each such Benefit Plan has been maintained and operated in all material respects in compliance with its terms and with all applicable provisions of ERISA, the Internal Revenue Code of 1986, as amended (the “ Code ”), and all statutes, orders, rules, regulations, and other authority which are applicable to such Benefit Plan;

 

(b)                                  All contributions required by law to have been made under each such Benefit Plan (without regard to any waivers granted under Section 412 of the Code) to any fund or trust established thereunder in connection therewith have been made by the due date thereof:

 

(c)                                   Each such Benefit Plan intended to qualify under Section 401(a) of the Code is the subject of a favorable unrevoked determination letter issued by the Internal Revenue Service as to its qualified status under the Code, which determination letter may still be relied upon as to such tax qualified status, and no circumstances have occurred that would adversely affect the tax qualified status of any such Benefit Plan;

 

(d)                                  The actuarial present value of all accrued benefits under each such

 

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Benefit Plan subject to Title IV of ERISA did not, as of the latest valuation date of such Benefit Plan, exceed the then current value of the assets of such Benefit Plan allocable to such accrued benefits, all as based upon the actuarial assumptions and methods currently used for such Benefit Plan;

 

(e)                                   None of such Benefit Plans that are “employee welfare benefit plans” as defined in Section 3(1) of ERISA provides for continuing benefits or coverage for any participant or beneficiary of any participant after such participant’s termination of employment, except as required by applicable law; and

 

(f)                                    Neither the Corporation nor any trade or business (whether or not incorporated) under common control with the Corporation within the meaning of Section 4001 of ERISA has, or at any time has had, any obligation to contribute to any “multiemployer plan” as defined in Section 3(37) of ERISA.

 

5.17                         Use of Proceeds . The net proceeds received by the Corporation from the sale of the Series A-1 Preferred Stock shall be used by the Corporation generally for the purposes set forth in Schedule 5.17 attached hereto.

 

5.18                         Permits and Other Rights; Compliance with Laws .  The Corporation has all permits, licenses, registrations, certificates, accreditations, orders, authorizations or approvals from any Governmental Entity (“ Permits ”) issued to or held by the Corporation.  Other than the Permits listed on Schedule 5.18, there are no Permits, the loss or revocation of which would result in a Corporation Material Adverse Effect.  The Corporation has all Permits necessary to permit it to own its properties and to conduct its Business as presently conducted and as proposed to be conducted.  Each such Permit is in full force and effect and, to the Corporation’s Knowledge, no suspension or cancellation of such Permit is threatened and there is no basis for believing that such Permit will not be renewable upon expiration.  The Corporation is in compliance in all material respects under each such Permit, and the transactions contemplated by this Agreement will not cause a violation under any of such Permits.  The Corporation is in compliance in all material respects with all provisions of the laws and governmental rules and regulations applicable to its Business, properties and assets, and to the products and services sold by it, including, without limitation, all such rules, laws and regulations relating to fair employment practices and public or employee safety. The Corporation is in compliance with the Clinical Laboratories Improvement Act of 1967, as amended.

 

5.19                         Insurance . Schedule 5.19 sets forth a true and complete list of all policies or binders of fire, theft, liability, product liability, workmen’s compensation, vehicular, directors’ and officers’ and other insurance held by or on behalf of the Corporation.  Such policies and binders are in full force and effect, are in the amounts not less than is customarily obtained by corporations of established reputation engaged in the same or similar business and similarly situated and are in conformity with the requirements of all leases or other agreements to which the Corporation is a party and are valid and enforceable in accordance with their terms.  The Corporation’s product liability insurance covers its clinical trials.  The Corporation is not in default with respect to any provision contained in such policy or binder nor has the Corporation failed to give any notice or present any claim under any such policy or binder in due and timely fashion.  There are no outstanding unpaid claims under any such policy or binder.  The

 

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Corporation has not received notice of cancellation or non-renewal of any such policy or binder.

 

5.20                         Board of Directors . Except as provided in Schedule 5.20 attached hereto, the Corporation has not extended any offer or promise or entered into any agreement, arrangement, understanding or otherwise, whether written or oral, with any person or entity by which the Corporation has agreed to allow such person or entity to participate, in any way, in the affairs of the Board of Directors, including without limitation, appointment or nomination as a member, or right to appear at, or receive the minutes of a meeting of the Board of Directors.

 

5.21                         Books and Records .  The minute books of the Corporation contain complete and accurate records of all meetings and other corporate actions of the stockholders and Boards of Directors and committees thereof.  The stock ledger of the Corporation is complete and accurate and reflects all issuances, transfers, repurchases and cancellations of shares of capital stock of the Corporation.

 

5.22                         Environmental Matters .

 

(a)                                  The Corporation has not used, generated, manufactured, refined, treated, transported, stored, handled, disposed, transferred, produced, processed or released (together defined as “ Release ”) any Hazardous Materials (as hereinafter defined) in any manner or by any means in violation of any Environmental Laws (as hereinafter defined). To the Corporation’s Knowledge, neither the Corporation nor any prior owner or tenant of the Property (as hereinafter defined) has Released any Hazardous Material or other pollutant or effluent into, on or from the Property in a way which can pose a risk to human health or the environment, nor is there a threat of such Release. As used herein, the term “Property” shall include, without limitation, land, buildings and laboratory facilities owned or leased by the Corporation or as to which the Corporation now has any duties, responsibilities (for clean-up, remedy or otherwise) or liabilities under any Environmental Laws, or as to which the Corporation or any subsidiary of the Corporation may have such duties, responsibilities or liabilities because of past acts or omissions of the Corporation or any such subsidiary or their predecessors, or because the Corporation or any such subsidiary or their predecessors in the past was such an owner or operator of, or some other relationship with, such land, buildings and/or laboratory facilities, all as more fully described in Schedule 5.22(a) of the Corporation’s Disclosure Schedule. The term “Hazardous Materials” shall mean (A) any chemicals, materials or substances defined as or included in the definition of “hazardous substances,” “hazardous wastes,” “hazardous materials,” “extremely hazardous wastes,” “restricted hazardous wastes,” “toxic substances,” “toxic pollutants,” “hazardous air pollutants,” “contaminants,” “toxic chemicals,” “toxins,” “hazardous chemicals,” “extremely hazardous substances,” “pesticides,” “oil” or related materials as defined in any applicable Environmental Law, or (B) any petroleum or petroleum products, oil, natural or synthetic gas, radioactive materials, asbestos-containing materials, urea formaldehyde foam insulation, radon, and any other substance defined or designated as hazardous, toxic or harmful to human health, safety or the environment under any Environmental Law.

 

(b)                                  No notice of lien under any Environmental Laws has been filed against any Property of the Corporation.

 

(c)                                   The use of the Property complies with lawful, permitted and

 

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conforming uses in all material respects under all applicable building, tire, safety, subdivision, zoning, sewer, environmental, health, insurance and other such laws, ordinances, rules, regulations and plan approval conditions of any governmental or public body or authority relating to the use of the Property.

 

(d)                                  Except as described in Schedule 5.22(d) of the Corporation’s Disclosure Schedule, to the Corporation’s Knowledge, the Property does not contain: (i) asbestos in any form; (ii) urea formaldehyde foam insulation; (iii) transformers or other equipment which contain dialectic fluid containing levels of polychlorinated biphenyls; (iv) radon; or (v) any other chemical, material or substance, the exposure to which is prohibited, limited or regulated by a federal, state or local government agency, authority or body, or which, even if not so regulated, to the Corporation’s Knowledge after reasonable investigation, may or could pose a hazard to the health and safety of the occupants of the Property or the owners or occupants of property adjacent to or in the vicinity of the Property.

 

(e)                                   The Corporation has not received written notice that the Corporation is a potentially responsible party for costs incurred at a cleanup site or corrective action under any Environmental Laws.  The Corporation has not received any written requests for information in connection with any inquiry by any Governmental Authority (as defined hereinafter) concerning disposal sites or other environmental matters. As used herein, “Governmental Authority” shall mean any nation or government, any federal, state, municipal, local, provincial, regional or other political subdivision thereof and any entity or person exercising executive, legislative, judicial, regulatory or administrative functions of, or pertaining to, government, Schedule 5.22(e) of the Corporation’s Disclosure Schedule identifies all locations where Hazardous Materials used in whole or in part by the Business of the Corporation or resulting from the Business, facilities or Property of the Corporation have been stored or disposed of by or on behalf of the Corporation. As used herein, “Environmental Laws” shall mean all applicable federal, state and local laws, ordinances, rules and regulations that regulate, fix liability for, or otherwise relate to, the handling, use (including use in industrial processes, in construction, as building materials, or otherwise), storage and disposal of hazardous and toxic wastes and substances, and to the discharge, leakage, presence, migration, threatened Release or Release (whether by disposal, a discharge into any water source or system or into the air, or otherwise) of any pollutant or effluent. Without limiting the preceding sentence, the term “Environmental Laws” shall specifically include the following federal and state laws, as amended:

 

FEDERAL

 

Comprehensive Environmental Response Compensation and Liability Act of 1980, as amended by the Superfund Amendments and Reauthorization Act of 1986, 42 U.S.C. § 9601 et seq.; the Emergency Planning and Community Right-to-Know Act, 42 U.S.C. § 11001 et seq.; the Resource Conservation and Recovery Act, 42 U.S.C. § 6901 et seq.; the Federal Water Pollution Control Act, 33 U.S.C. § 1251 et seq.; the Federal Insecticide, Fungicide and Rodenticide Act, 7 U.S.C. § 136 et seq.; the Toxic Substance Control Act, 15 U.S.C. § 2601 et seq.; the Oil Pollution Act of 1990, 33 U.S.C. § 1001 et seq.; the Hazardous Materials

 

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Transportation Act, as amended, 49 U.S.C. § 1801 et seq.; the Atomic Energy Act, as amended 42 U.S.C. § 2011 et seq.; the Occupational Safety and Health Act, as amended, 29 U.S.C. § 651 et seq.; the Federal Food, Drug and Cosmetic Act, as amended 21 U.S.C. § 301 et seq. (insofar as it regulates employee exposure to Hazardous Substances); the Clean Air Act, 42 U.S.C. 7401 et. seq.

 

STATE

 

MASSACHUSETTS ENVIRONMENTAL STATUTES

 

Massachusetts Clean Waters Act, Mass. Gen. L. Ch. 21, Section 26, et. seq., and regulations thereto; Massachusetts Solid Waste Disposal Laws. Mass. Gen. L. Ch. 16, Section 18, et. seq., and Ch. 111, Section 1 05A, and regulations thereto; Massachusetts Oil and Hazardous Materials Release Prevention and Response Act, Mass. Gen. L., Ch. 21 E, Section 1, et. seq., and regulations thereto; Massachusetts Solid Waste Facilities Law, Mass. Gen. L., Ch. 21H, Section 1, et. seq., and regulations thereto; Massachusetts Toxic Use Reduction Act, Mass. Gen. L., Ch. 211, Section 1, et. seq., and regulations thereto; Massachusetts Litter Control Laws, Mass. Gen. L. Ch. 111. Section 1 50A, et. seq., and regulations thereto; Massachusetts Wetlands Protection Laws, Mass. Gen. L., Ch. 130, Section 105, et. seq., and regulations thereto; Massachusetts Environmental Air Pollution Control Law, Mass. Gen. L.. Ch. 101, Section 2B, et. seq., and regulations thereto; Massachusetts Environmental Policy Act, Mass. Gen. L. Ch. 30, Section 61, et. seq., and regulations thereto; and Massachusetts Hazardous Waste Laws, Mass. Gen. L. Ch. 21C, Section 1, et. seq., and regulations thereto.

 

(f)                                    The Corporation has maintained all environmental and operating documents and records substantially in the manner and for the time periods required by the Environmental Laws and any other laws, regulations or orders and has never conducted an environmental audit except as disclosed in Schedule 5.22(f) of the Corporation’s Disclosure Schedule. For purposes of this Section 5.22(f), an environmental audit shall mean any evaluation, assessment, study or test performed at the request of or on behalf of a Governmental Authority, including, but not limited to, a public liaison committee, but does not include normal or routine inspections, evaluations or assessments which do not relate to a threatened or pending charge, restraining order or revocation of any permit, license, certificate, approval, authorization, registration or the like issued pursuant to the Environmental Laws and any other law, regulation or order.

 

(g)                                   To the Corporation’s Knowledge, no part of the Property of the Corporation is (i) located within any wetlands area, (ii) subject to any wetlands regulations, or (iii) included in or is proposed for inclusion in, or abuts any property included in or proposed for inclusion in, the National Priority List or any similar state lists.

 

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5.23                         FDA Matters.

 

(a)                                  The Corporation has (i) complied in all material respects with all applicable laws, regulations and specifications with respect to the manufacture, design, sale, storing, labeling, testing, distribution, inspection, promotion and marketing of all of the Corporation’s products and product candidates and the operation of manufacturing facilities promulgated by the U.S. Food and Drug Administration (the “ FDA ”) or any corollary entity in any other jurisdiction and (ii) conducted, and in the case of any clinical trials conducted on its behalf, caused to be conducted, all of its clinical trials with reasonable care and in compliance in all material respects with all applicable laws and the stated protocols for such clinical trials.

 

(b)                                  All of the Corporation’s submissions to the FDA and any corollary entity in any other jurisdiction, whether oral, written or electronically delivered, were true, accurate and complete in all material respects as of the date made, and remain true, accurate and complete in all material respects and do not misstate any of the statements or information included therein, or omit to state a fact necessary to make the statements therein not materially misleading.

 

(c)                                   The Corporation has not committed any act, made any statement or failed to make any statement that would breach the FDA’s policy with respect to “Fraud, Untrue Statements of Material Facts, Bribery, and Illegal Gratuities” set forth in 56 Fed. Reg. 46191 (September 10, 1991) or any similar laws, rules or regulations, whether under the jurisdiction of the FDA or a corollary entity in any other jurisdiction, and any amendments or other modifications thereto.  Neither the Corporation nor, to the Corporation’s Knowledge, any officer, employee or agent of the Corporation has been convicted of any crime or engaged in any conduct that would reasonably be expected to result in (i) debarment under 21 U.S.C. Section 335a or any similar state or foreign law or regulation or (ii) exclusion under 42 U.S.C. Section 1320a 7 or any similar state or foreign law or regulation, and neither the Corporation nor, to the Corporation’s Knowledge, any such person has been so debarred or excluded.

 

(d)                                  The Corporation has not sold or marketed any products prior to receiving any required or necessary approvals or consents from any federal or state governmental authority, including but not limited to the FDA under the Food, Drug & Cosmetics Act of 1976, as amended, and the regulations promulgated thereunder, or any corollary entity in any jurisdiction.  The Corporation has not received any notice of, nor is the Corporation aware of any, actions, citations, warning letters or Section 305 notices from the FDA or any corollary entity.

 

5.24                         Compliance with Privacy Laws

 

(a)                                  For purposes of this Agreement:

 

(i)                                      Foreign Privacy Laws ” shall mean (a) the Directive 95/46/EC of the Parliament and of the Council of the European Union of 24 October 1995 on the protection of individuals with regard to the collection, use, disclosure, and processing of personal data and on the free movement of such data, (b) the corresponding national rules, regulations, codes, orders, decrees and rulings thereunder of the member states of the European Union and (c) any rules, regulations, codes, orders, decree, and rulings thereunder related to privacy, data protection or data transfer issues implemented in other countries.

 

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(ii)                                   US Privacy Laws ” shall mean any rules, regulations, codes, orders, decrees, and rulings thereunder of any federal, state, regional, county, city, municipal or local government of the United States or any department, agency, bureau or other administrative or regulatory body obtaining authority from any of the foregoing that relate to privacy, data protection or data transfer issues, including all implementing laws, ordinances or regulations, including, without limitation, the Health Insurance Portability and Accountability Act of 1996, as amended; the Children’s Online Privacy Protection Act (COPPA) of 1998, as amended; the Financial Modernization Act (Graham-Leach-Bliley Act) of 2000, as amended; the Fair Credit Reporting Act of 1970, as amended; the Privacy Act of 1974, as amended; the Family Education Rights and Privacy Act of 1974, as amended; the Right to Financial Privacy Act of 1978, as amended; the Privacy Protection Act of 1980, as amended; the Cable Communications Policy Act of 1984, as amended; the Electronic Communications Privacy Act of 1986, as amended; the Video Privacy Protection Act of 1988, as amended; the Telephone Consumer Protection Act of 1991, as amended; the Driver’s Privacy Protection Act of 1994, as amended; the Communications Assistance for Law Enforcement Act of 1994, as amended; the Telecommunications Act of 1996, as amended; and any implementing regulations related thereto;

 

(b)                                  The Corporation is currently and has been at all times in compliance in all material respects with all Foreign Privacy Laws and US Privacy Laws; and the Corporation has not received notice (in writing or otherwise) regarding violation of such Foreign Privacy Laws or US Privacy Laws.

 

(c)                                   No action, suit, proceeding, investigation, charge, complaint, claim, demand, or notice has been filed or commenced against the Corporation, nor to the Corporation’s Knowledge threatened against the Corporation, relating to Foreign Privacy Laws and US Privacy Laws; nor has the Corporation incurred any material liabilities (whether accrued, absolute, contingent or otherwise) under any Foreign Privacy Laws or US Privacy Laws.

 

(d)                                  Health Insurance Portability and Accountability Act of 1996 .  The Corporation (i) has assessed the applicability of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (collectively, “ HIPAA ”) to the Corporation, including the fully insured and self-insured health plans that the Corporation sponsors or has sponsored or contributes to or has contributed to and health care provider activities, if any, in which the Corporation engages, (ii) has complied in all relevant respects with HIPAA, including 45 C.F.R. Part 160 and Subparts A and E of Part 164 (the “ HIPAA Privacy Rule ”), including but not limited to HIPAA Privacy Rule requirements relating to health information use and disclosure, notices of privacy rights, appointment of a Privacy Officer, adoption of a privacy policy, amendment of plan documents, and implementation of employee training as to the handling of protected health information, and (iii) if required under the HIPAA Privacy Rule, has entered into business associate agreements on behalf of the Corporation’s health plans covering the handling of protected health information with vendors and others categorized under HIPAA as business associates of the Corporation’s health plans.

 

(e)                                   Other Health Information Laws .  Without limiting the generality of Section 5.24(a) through Section 5.24(d),

 

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(i)                                      the Corporation is currently, and has been at all times since its incorporation, in compliance in all material respects with all applicable health insurance, health information security, health information privacy, and health information transaction format Laws (each a “ Health Information Law ”), including, without limitation, any rules, regulations, codes, orders, decrees, and rulings thereunder of any federal, state, regional, county, city, municipal or local government, whether foreign or domestic, or any department, agency, bureau or other administrative or regulatory body obtaining authority from any of the foregoing; and

 

(ii)                                   no action, suit, proceeding, investigation, charge, complaint, claim, demand, or notice has been filed or commenced against the Corporation nor to the Corporation’s Knowledge threatened against the Corporation, alleging any failure to comply with any Health Information Law; nor has the Corporation incurred any material liabilities (whether accrued, absolute, contingent or otherwise) under any Health Information Law.

 

5.25                         Health Care and Affiliated Transactions; Stark and Anti-Kickback Laws .

 

(a)                                  For purposes of the Stark II law and implementing regulations, if applicable, none of the directors or officers of the Corporation, or physicians employed by the Corporation, any other affiliates of the Corporation, or any of their respective immediate family members is (i) to the Corporation’s Knowledge, a partner or stockholder or has any other economic interest in any customer or supplier of the Corporation; (ii) a party to any transaction or contract with the Corporation; or (iii) indebted to the Corporation.  The Corporation has not paid, or incurred any obligation to pay, any fees, commissions or other amounts to and is not a party to any agreement, business arrangement or course of dealing with any firm of or in which any of directors, officers or affiliates of the Corporation, or any of their respective immediate family members, is a partner or stockholder or has any other economic interest, other than ownership of less than one percent (1%) of a publicly traded corporation.  No physician or family member of a physician has a financial relationship with the Corporation in violation of Section 1877 of the Social Security Act.  The Corporation has made all filings required by Section 1877 of the Social Security Act.

 

(b)                                  The Corporation has complied with all applicable state and federal “anti-kickback,” fraud and abuse, false claims and related statutes and regulations.  The Corporation has received no notice of nor is otherwise aware of any inquiries, audits, subpoenas or other investigations involving Corporation by the U.S. Department of Health and Human Services, the U.S. Office of Inspector General, any U.S. Attorney’s Office or any other federal or state agency with jurisdiction over such statutes or regulations.

 

SECTION 6.                             Representations and Warranties of the Investor to the Corporation .

 

The Investor represents and warrants to the Corporation as follows:

 

(a)                                  It is acquiring the Series A-1 Preferred Stock and, in the event it should acquire Reserved Common Shares upon conversion of the Series A-1 Preferred Stock, it will be acquiring such Reserved Common Shares, for its own account, for investment and not with a view to the distribution thereof within the meaning of the Securities Act.

 

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(b)                                  It is an “accredited investor” as such term is defined in Rule 501(a) promulgated under the Securities Act.

 

(c)                                   It agrees that the Corporation may place a legend on the certificates delivered hereunder stating that the Series A-1 Preferred Stock and any Reserved Common Shares have not been registered under the Securities Act, and, therefore, cannot be offered, sold or transferred unless they are registered under the Securities Act or an exemption from such registration is available and that the offer, sale or transfer of the Series A-1 Preferred Stock and any Reserved Common Shares is further subject to any restrictions imposed by this Agreement and the Stockholders’ Agreement.

 

(d)                                  The execution, delivery and performance by it of this Agreement have been duly authorized by all requisite action of it.

 

(e)                                   It further understands that the exemptions from registration afforded by Rule 144 and Rule 144A (the provisions of which are known to it) promulgated under the Securities Act depend on the satisfaction of various conditions, and that, if applicable, Rule 144 may afford the basis for sales only in limited amounts.

 

(f)                                    It has such knowledge and experience in business and financial matters and with respect to investments in securities of privately-held companies so as to enable it to understand and evaluate the risks of its investment in the Series A-1 Preferred Stock and form an investment decision with respect thereto.  It has been afforded the opportunity during the course of negotiating the transactions contemplated by this Agreement to ask questions of, and to secure such information from, the Corporation and its officers and directors as it deems necessary to evaluate the merits of entering into such transactions.

 

(g)                                   It is duly organized and validly existing and has the power and authority to enter into this Agreement and it has not been organized, reorganized or recapitalized specifically for the purpose of acquiring the securities of the Corporation.

 

(h)                                  It has adequate net worth and means of providing for its current needs and personal contingencies to sustain a complete loss of its investment in the Corporation.  The Investors understand that the foregoing representations and warranties shall be deemed material and to have been relied upon by the Corporation.

 

SECTION 7.                             Closing Conditions .

 

(a)                                  It shall be a condition precedent to the obligations of the Corporation hereunder to be performed at the Stage I Closing, as to the Investor that the representations and warranties contained herein of the Investor hereunder shall be true and correct as of the date of such Closing with the same force and effect as though such representations and warranties had been made on and as of such date.

 

(b)                                  The Stage I Closing pursuant to the April 25 Agreement shall have occurred or, if the Closing takes place on May 17, 2011, shall occur concurrently with the Closing hereunder, and in each case the sale of stock under such Agreement shall be at a per

 

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share purchase price equal to that hereunder and aggregate proceeds to the Company shall not be at less $20 million.

 

(c)                                   Ipsen has become a party to the Amended and Restated Stockholders’ Agreement dated April 25, 2011 among the Company and the other parties named therein.

 

SECTION 8.                             Acknowledgement Regarding the Merger .

 

The Investor hereby, in its capacity as a future stockholder of the Corporation, (a) acknowledges that such Investor is aware that the Corporation has, prior to the execution and delivery of this Agreement, entered into an Agreement and Plan of Merger with MPMAC and Merger Sub with respect to the proposed Merger, an executed copy of which is attached hereto as Exhibit F (the “ Merger Agreement ”), and (b) acknowledges that such Investor has received and reviewed the Merger Agreement.

 

SECTION 9.                             Expenses and Fees .

 

The Corporation shall pay, and hold the Investor harmless against all liability for the payment of all costs and other expenses incurred by the Investor in connection with the Corporation’s performance of and compliance with all agreements and conditions contained herein or contemplated hereby on its part to be performed or complied with.  The Corporation further agrees that it will pay, and hold the Investor harmless from, any and all liability with respect to any stamp or similar taxes which may be determined to be payable in connection with the execution and delivery of this Agreement or any modification, amendment or alteration of the terms or provisions of this Agreement and that it will similarly pay, and hold the Investor harmless from, all issue taxes in respect of the issuance of the Series A-1 Preferred Stock to the Investor.  the

 

SECTION 10.                      Certain Covenants.

 

Without the prior written consent of the holders of a majority of the shares of Series A-1 Preferred Stock issued and outstanding at the time (the “ Majority Investors ”), the Corporation shall not issue any shares of Series A-1 Preferred Stock or any securities convertible into shares of Series A-1 Preferred Stock other than (i) Excluded Stock (as defined in the Certificate of Incorporation of the Corporation), (ii) pursuant to the terms of this Agreement or (iii) pursuant to agreements, warrants or arrangements described on Schedule 10 hereof.

 

SECTION 11.                      Brokers or Finders .

 

The Corporation represents and warrants to the Investor, and the Investor represents and warrants to the Corporation, that, other than Leerink Swann LLC, which has acted as advisor to the Corporation in connection with the transactions contemplated by this Agreement, no person or entity has or will have, as a result of the transactions contemplated by this Agreement, any right, interest or valid claim against or upon the Corporation or the Investors for any commission, fee or other compensation as a finder or broker because of any act or omission by the Corporation or the Investor or by any agent of the Corporation or the Investors.

 

29



 

SECTION 12.                      Exchanges Lost. Stolen or Mutilated Certificates .

 

Upon surrender by the Investor to the Corporation of shares of Series A-1 Preferred Stock or Reserved Common Shares acquired by such Investor hereunder, the Corporation, at its expense, will issue in exchange therefor, and deliver to such Investor, a new certificate or certificates representing such shares in such denominations as may be requested by such Investor. Upon receipt of evidence satisfactory to the Corporation of the loss, theft, destruction or mutilation of any certificate representing any shares of Common Stock or Preferred Stock purchased or acquired by any Investor hereunder and, in case of any such loss, theft or destruction, upon delivery of any indemnity agreement satisfactory to the Corporation, or in case of any such mutilation, upon surrender and cancellation of such certificate, the Corporation, at its expense, will issue and deliver to such Investor a new certificate for such shares of Common Stock or Preferred Stock, as applicable, of like tenor, in lieu of such lost, stolen or mutilated certificate.

 

SECTION 13.                      Survival of Representations and Warranties .

 

The representations and warranties set forth in Sections 5 and 6 hereof shall survive the Closings indefinitely.

 

SECTION 14.                      Indemnification .

 

The Corporation shall indemnify, defend and hold the Investor harmless against any and all liabilities, loss, cost or damage, together with all reasonable costs and expenses related thereto (including legal and accounting fees and expenses), arising from, relating to, or connected with the untruth, inaccuracy or breach of any statements, representations, warranties or covenants of the Corporation contained herein, including, but not limited to, all statements, representations, warranties or covenants concerning environmental matters.

 

SECTION 15.                      Remedies .

 

In case any one or more of the representations, warranties, covenants and/or agreements set forth in this Agreement shall have been breached by any party hereto, the party or parties entitled to the benefit of such representations, warranties, covenants or agreements may proceed to protect and enforce its or their rights either by suit in equity and/or action at law, including, but not limited to, an action for damages as a result of any such breach and/or an action for specific performance of any such covenant or agreement contained in this Agreement.  The rights, powers and remedies of the parties under this Agreement are cumulative and not exclusive of any other right, power or remedy which such parties may have under any other agreement or law.  No single or partial assertion or exercise of any right, power or remedy of a party hereunder shall preclude any other or further assertion or exercise thereof.

 

SECTION 16.                      Successors and Assigns .

 

Except as otherwise expressly provided herein, this Agreement shall bind and inure to the benefit of the Corporation and the Investor and the respective permitted successors and assigns of the Investor and the permitted successors and assigns of the Corporation. Subject to the provisions of Sections 3.1, 3.2, 3.3 and 3.10 of the Stockholders’ Agreement, this Agreement and

 

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the rights and duties of the Investor set forth herein may be freely assigned, in whole or in part, by the Investor.  Neither this Agreement nor any of the rights or duties of the Corporation set forth herein shall be assigned by the Corporation, in whole or in part, without having first received the written consent of the Majority Investors.  Notwithstanding the foregoing, upon the consummation of the Merger and with respect to all times following the consummation of the Merger, (i) the Corporation shall, and hereby does, assign all of its rights, duties and obligations under this Agreement to MPMAC and (ii) all references to the “Corporation” in this Agreement and to its capital stock or any other aspects of the Corporation shall be deemed to be references to MPMAC and its capital stock and other applicable aspects of MPMAC.  MPMAC, by executing this Agreement as an anticipated successor and assign to the Corporation, does hereby assume, effective upon the consummation of the Merger, all of the Corporation’s rights, duties and obligations under this Agreement and Radius will be released from its duties and obligations under this Agreement.  All parties to this Agreement hereby consent to the assignment and assumption contemplated between the Corporation and MPMAC set forth in this paragraph.

 

SECTION 17.                      Entire Agreement .

 

This Agreement, together with the other writings referred to herein, including the Restated Charter and the Stockholders’ Agreement, or delivered hereunder and which form a part hereof, contains the entire agreement among the parties with respect to the subject matter hereof and amends, restates and supersedes all prior and contemporaneous arrangements or understandings, whether written or oral, with respect thereto.

 

SECTION 18.                      Notices .

 

All notices, requests, consents and other communications hereunder to any party shall be deemed to be sufficient if contained in a written instrument delivered in person or duly sent by first class registered, certified or overnight mail, postage prepaid, or telecopied or e-mailed with a confirmation copy by regular mail, addressed, telecopied or e-mailed, as the case may be, to such party at the address, telecopier number or e-mail address, as the case may be, set forth below or such other address, telecopier number or e-mail address, as the case may be, as may hereafter be designated in writing by the addressee to the addressor listing all parties:

 

(i)                                      if to the Corporation. to:

 

Radius Health, Inc.

201 Broadway

Sixth Floor

Cambridge, MA 02139

Attention: B. Nicholas Harvey

Telecopier: (617) 444-1834
E-mail: bnharvey@radiuspharm.com

 

with a copy to:

 

Bingham McCutchen

One Federal Street

Boston. MA 02110-1726

 

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Attention: Julio E. Vega, Esq.

Telecopier: (617) 951-8736
E-mail:  Julio.vega@bingham.com

 

(ii)                                   if to Investor, as set forth on Schedule 1.

 

All such notices, requests, consents and other communications shall be deemed to have been received: (a) in the case of personal delivery, on the date of such delivery; (b) in the case of mailing, on the third business day following the date of such mailing; (c) in the case of overnight mail, on the first business day following the date of such mailing; (d) in the case of facsimile transmission, when confirmed by facsimile machine report; or (e) in the case of e-mail delivery, when confirmed by the sender’s e-mail system.

 

SECTION 19.                      Changes .

 

The terms and provisions of this Agreement may not be modified or amended, or any of the provisions hereof waived, temporarily or permanently, except pursuant to a writing executed by a duly authorized representative of the Corporation, MPMAC and the Investor..

 

SECTION 20.                      Counterparts .

 

This Agreement may be executed in any number of counterparts, and each such counterpart shall be deemed to be an original instrument, but all such counterparts together shall constitute but one agreement.

 

SECTION 21.                      Headings .

 

The headings of the various sections of this Agreement have been inserted for convenience of reference only and shall not be deemed to be a part of this Agreement.

 

SECTION 22.                      Nouns and Pronouns .

 

Whenever the context may require, any pronouns used herein shall include the corresponding masculine, feminine or neuter forms, and the singular form of names and pronouns shall include the plural and vice-versa.

 

SECTION 23.                      Severability .

 

Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction.

 

SECTION 24.                      Further Assurances .

 

The parties shall cooperate reasonably with each other in connection with any steps

 

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required to be taken as part of their respective obligations under this Agreement, and shall furnish upon request to each other such further information, execute and deliver to each other such other documents, and do such other acts and things, all as the other party may reasonably request for purposes of carrying out the intend of this Agreement and consummating the transactions contemplated hereby.

 

SECTION 25.                      Governing Law .

 

This Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, excluding choice of laws rules thereof.

 

( Remainder of Page Left Intentionally Blank. )

 

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(Signature Page to Stock Purchase Agreement)

 

IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date first above written.

 

 

THE CORPORATION:

 

 

 

RADIUS HEALTH, INC.

 

 

 

 

 

By:

 

 

Name:

C. Richard Edmund Lyttle

 

Title:

President

 

 

 

 

 

As an anticipated successor and assign to the Corporation under Section 16 hereof:

 

 

 

MPM ACQUISITION CORP.

 

 

 

 

 

By:

 

 

Name:

C. Richard Edmund Lyttle

 

Title:

President

 

 

 

 

 

INVESTOR:

 

 

 

IPSEN PHARMA SAS

 

 

 

 

 

By:

 

 

Name:

Marc de Garidel

 

Title:

Chairman and CEO

 

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Schedule I

 

Name of Investors

 

Address of Record

 

Stage I
Preferred
Shares

Ipsen Pharma SAS

 

Attn: Ipsen Pharma SAS 42 Rue du Docteur Blanche 75016 Paris, France

 

See calculation in Section 3.2

TOTAL:

 

 

 

 

 

35


 

Exhibit A

 

Form of Restated Certificate

 

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FOURTH AMENDED AND RESTATED

 

CERTIFICATE OF INCORPORATION

 

OF

 

RADIUS HEALTH, INC .

 

(Pursuant to Section 242 and 245 of the

General Corporation Law of the State of Delaware)

 

Radius Health, Inc., a Delaware corporation hereby certifies as follows:

 

1.               The name of the corporation is Radius Health, Inc. (the “ Corporation ”). The Corporation filed its original Certificate of Incorporation with the Secretary of State of the State of Delaware on October 3, 2003 and the name under which it was originally incorporated was NuVios, Inc.

 

2.               This Fourth Amended and Restated Certificate of Incorporation (the “ Certificate ”) amends, restates and integrates the provisions of the Third Amended and Restated Certificate of Incorporation as heretofore in effect (the “ Prior Certificate ”), has been duly adopted in accordance with the provisions of Sections 242 and 245 of the General Corporation Law of the State of Delaware (“ DGCL ”), and has been approved by written consent of the stockholders of the Corporation in accordance with the provisions of Section 228 of the DGCL (prompt notice of such action having been given to those stockholders who did not consent in writing).

 

3.               Effective immediately at the effective date of the filing of this Certificate (the “ Effective Time ”), the Prior Certificate, as heretofore amended, is hereby further amended and restated to read in its entirety as follows:

 

ARTICLE I
Name

 

The name of the corporation is Radius Health, Inc.

 

ARTICLE II
Purpose

 

The Corporation is organized to engage in any lawful act or activity for which a corporation may be organized under the DGCL.

 

ARTICLE IIA
Reverse Split

 

Simultaneously with the Effective Time (the “ Split Effective Date ”), a reverse split (the “ Reverse Split ”) of the Corporation’s outstanding capital stock shall occur as follows: (a) each share of Common Stock issued and outstanding or held as treasury shares immediately prior to the Split Effective Date (the “ Old Common Stock ”) shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Common Stock from and after the Split Effective Date (the “ New Common Stock ”), (b) each share of Series A Stock issued and outstanding or held as treasury shares immediately prior to the Split Effective Date (the “ Old Series A Stock ”) shall automatically without any action on the part of the holder thereof, be reclassified and changed into

 

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0.06666667 of one share of Series A Stock from and after the Split Effective Date (the “ New Series A Stock ”), (c) each share of Series B Stock issued and outstanding or held as treasury shares immediately prior to the Split Effective Date (the “ Old Series B Stock ”) shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Series B Stock from and after the Split Effective Date (the “ New Series B Stock ”) and (d) each share of Series C Stock issued and outstanding or held as treasury shares immediately prior to the Split Effective Date (the “ Old Series C Stock ”) shall automatically without any action on the part of the holder thereof, be reclassified and changed into 0.06666667 of one share of Series C Stock from and after the Split Effective Date (the “ New Series C Stock ”).  No fractional shares of Common Stock or Preferred Stock shall be issued upon such reclassification effected by the Reverse Split.  Rather, if such reclassification would result in the issuance of any fractional share to any stockholder after aggregating all fractional shares of any class or series of stock otherwise issuable to such stockholder, the Corporation shall, in lieu of issuing any fractional share to such stockholder, pay a cash amount to such stockholder equal to the sum of (A) the product of any fractional share of New Common Stock pertaining to such stockholder multiplied by $8.142, (B) the product of any fractional share of New Series A Stock pertaining to such stockholder multiplied by $8.142, (C) the product of any fractional share of New Series B Stock pertaining to such stockholder multiplied by $8.142 and (D) the product of any fractional share of New Series C Stock pertaining to such stockholder multiplied by $8.142.  Subject to the rest of the provisions of this Certificate, each holder of a certificate or certificates, which immediately prior to the Split Effective Date represented outstanding shares of Old Common Stock, Old Series A Stock, Old Series B Stock and Old Series C Stock, as applicable (the “ Old Certificates ”), shall, from and after the Split Effective Date, be entitled to receive upon surrender of such Old Certificates to the Corporation’s transfer agent for cancellation, a certificate or certificates (the “ New Certificates ”) representing the shares of New Common Stock, New Series A Stock, New Series B Stock and New Series C Stock, as applicable, into which the shares of Old Common Stock, Old Series A Stock, Old Series B Stock and Old Series C Preferred Stock formerly represented by such Old Certificates so surrendered are reclassified under the terms hereof.  All stock numbers and prices set forth in this Certificate (including, without limitation, those share numbers set forth in Article III) give effect to the Reverse Split and no further adjustments are necessary with respect thereto.

 

ARTICLE III
Capital Stock

 

Authorization . The total number of shares of all classes of stock which the Corporation shall have authority to issue is Seventy-six Million Thirty-four Thousand Twenty-nine (76,034,029) shares, consisting of Sixty Three Thousand (63,000) shares of Series A Junior Convertible Preferred Stock, par value $.01 per share (the “ Series A Stock ”), One Million Six Hundred Thousand (1,600,000) shares of Series B Convertible Redeemable Preferred Stock, par value $.01 per share (the “ Series B Stock ”), Ten Million One Hundred Forty-six Thousand Six Hundred Twenty-nine (10,146,629) shares of Series C Convertible Preferred Stock, par value $.01 per share, (the “ Series C Stock ”, and together with the Series B Stock, the “ Existing Senior Preferred Stock ”, and collectively with the Series A Stock and Series B Stock, the “ Existing Preferred Stock ”), Ten Million (10,000,000) shares of Series A-1 Convertible Preferred Stock, par value $.01 per share (the “ Series A-1 Stock ”), Nine Million Eight Hundred Thirty-two Thousand One Hundred Thirty-three (9,832,133) shares of Series A-2 Convertible Preferred Stock, par value $.01 per share (the “ Series A-2 Stock ”), One Million Four Hundred Twenty-two Thousand Three Hundred (1,422,300) shares of Series A-3 Convertible Preferred Stock, par value $.01 per share, (the “ Series A-3 Stock ” and together with the Series A-1 Stock and Series A-2 Stock, the “ Participating Preferred Stock ”), Forty Thousand and Three (40,003) shares of Series A-4 Convertible Preferred Stock, par value $.01 per share (the “ Series A-4 Stock ”), Seventy Thousand (70,000) shares of Series A-5 Convertible Preferred Stock, par value $.01 per share (the “ Series A-5 Stock ”) and Eight Million (8,000,000) shares of Series A-6 Convertible Preferred Stock, par value $.01 per share (the “ Series A-6

 

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Stock ”, and together with the Series A-1 Stock, the Series A-2 Stock, the Series A-3 Stock, the Series A-4 Stock and the Series A-5 Stock, the “ New Preferred Stock ”), and Thirty-four Million Eight Hundred Fifty-nine Thousand Nine Hundred Sixty-four (34,859,964) shares of Common Stock, par value $.01 per share (the “ Common Stock ”).

 

SPECIAL NOTE :  The terms, conditions, designations, preferences and privileges of the Existing Preferred Stock are set forth below in Part A of this Article III, however, it is expected that upon the Stage I Closing (as defined in the Series A-1 Purchase Agreement) of the Qualified Financing (as defined herein), all shares of Existing Preferred Stock will be converted into shares of New Preferred Stock or Common Stock, the terms, conditions, designations, preferences and privileges of which are set forth in Part B and Part C of this Article III, respectively.

 

PART A. EXISTING PREFERRED STOCK

 

1.               Designation and Amount .  The number of shares, powers, terms, conditions, designations, preferences and privileges, relative, participating, optional and other special rights, and qualifications, limitations and restrictions, if any, of the Existing Preferred Stock shall be as set forth in this Part A. The number of authorized shares of the Series A Stock is Sixty Three Thousand (63,000), the number of authorized shares of the Series B Stock is One Million Six Hundred Thousand (1,600,000), and the number of authorized shares of the Series C Stock is Ten Million One Hundred Forty-six Thousand Six Hundred Twenty-nine (10,146,629).

 

2.               Ranking .  The Corporation’s shares of Series C Stock shall rank, as to dividends and upon Liquidation (as defined in Section A.4(b) hereof) and Event of Sale (as defined in Section A.4(h) hereof), equally with each other and senior and prior to the Corporation’s shares of  Series B Stock and Series A Stock.  The Corporation’s shares of Series B Stock shall rank, as to dividends and upon Liquidation and Event of Sale, equally with each other and senior and prior to the Corporation’s shares of Series A Stock.  With respect to dividends, Liquidation and Event of Sale prior, the Series A Stock, Series B Stock and Series C Stock shall rank senior and prior to the Corporation’s Common Stock and to all other classes or series of stock issued by the Corporation, except as otherwise approved by the affirmative vote or consent of the holders shares of Existing Senior Preferred Stock representing at least a majority of the shares of the voting power of the Existing Senior Preferred Stock then outstanding (determined as set forth in the second sentence of Section A.6(a) hereof) (the “ Existing Senior Majority ”).

 

3.               Dividend Provisions .

 

(a)                                  Series C Stock .  The holders of shares of the Series C Stock shall be entitled to receive dividends at the rate of 8% of the Series C Original Purchase Price (as defined in Section A.8 hereof) per annum, compounding annually, and which will accrue on a quarterly basis commencing on the applicable date of issuance of each of such shares of Series C Stock.  The holders of Series C Stock shall be entitled to receive dividends prior in right to the payment of dividends and other distributions (whether in cash, property or securities of the Corporation, including subscription or other rights to acquire securities of the Corporation) on the Series B Stock, Series A Stock and Common Stock.  Dividends hereunder shall be payable in cash, when, as and if declared or paid by the Board of Directors and, as accrued, on any Liquidation (as defined in Section A.4(b) hereof) or Event of Sale (as defined in Section A.4(h)(vii) hereof), or upon any Redemption Date (as defined in Section A.5(c) hereof).  Dividends hereunder shall be payable in shares of Common Stock (calculated based upon the then effective Series C Conversion Price), as accrued, upon the conversion of the Series C Stock into Common Stock.  Whenever any dividend may be declared or paid on any shares of Series C Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series C Stock then outstanding, so that all outstanding shares of Series C Stock

 

39



 

will participate equally with each other and ratably per share (calculated as provided in Section A.3(d) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series C Stock then outstanding so that all outstanding shares of Series C Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section A.3(d) hereof); or (ii) any shares of any other series of Preferred Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series C Stock then outstanding so that all outstanding shares of Series C Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share Series C Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series C Stock then outstanding).

 

(b)                                  Series B Stock .  Following payment in full of required dividends to the holders of Series C Stock in accordance with Section A.3(a) above, the holders of shares of the Series B Stock shall be entitled to receive dividends at the rate of 8% of the Series B Original Purchase Price (as defined in Section A.8 hereof) per annum, compounding annually, and which will accrue on a quarterly basis commencing on the applicable date of issuance of each of such shares of Series B Stock.  The holders of Series B Stock shall be entitled to receive dividends prior in right to the payment of dividends and other distributions (whether in cash, property or securities of the Corporation, including subscription or other rights to acquire securities of the Corporation) on the Series A Stock and Common Stock.  Dividends hereunder shall be payable in cash, when, as and if declared or paid by the Board of Directors and, as accrued, on any Liquidation (as defined in Section A.4(b) hereof) or Event of Sale (as defined in Section A.4(h) hereof), or upon any Redemption Date (as defined in Section A.5(c) hereof).  Dividends hereunder shall be payable in shares of Common Stock (calculated based upon the then effective Series B Conversion Price), as accrued, upon the conversion of the Series B Stock into Common Stock.  Whenever any dividend may be declared or paid on any shares of Series B Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series B Stock then outstanding, so that all outstanding shares of Series B Stock will participate equally with each other and ratably per share (calculated as provided in Section A.3(d) hereof).  Whenever any dividend, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series B Stock then outstanding so that all outstanding shares of Series B Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section A.3(d) hereof); or (ii) any shares of Series A Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series B Stock then outstanding so that all outstanding shares of Series B Stock will participate in such dividend ratably with such shares of Series A Stock (based on the number of shares of Common Stock into which each share of Series B Stock and each share of Series A Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of Series A Stock as compared with the Series B Stock then outstanding).

 

(c)                                   Series A Stock .  Following payment in full of required dividends to the holders of Series C Stock and Series B Stock in accordance with Sections A.3(a) and (b) above, the holders of shares of the Series A Stock shall be entitled to receive, when, if and as declared by the Board of Directors, dividends on any shares of Series A Stock, out of funds legally available for that purpose, at a rate to be determined by the Board of Directors if and when they may so declare any dividend on the Series A Stock.

 

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(d)                                  In connection with any dividend declared or paid hereunder, each share of Existing Preferred Stock shall be deemed to be that number of shares (including fractional shares) of Common Stock into which it is then convertible, rounded up to the nearest one-tenth of a share.  No fractional shares of capital stock shall be issued as a dividend hereunder. The Corporation shall pay a cash adjustment for any such fractional interest in an amount equal to the fair market value thereof on the last Business Day (as defined in Section A.8 hereof) immediately preceding the date for payment of dividends as determined by the Board of Directors in good faith.

 

4.               Liquidation Rights .

 

(a)                                  With respect to rights on Liquidation (as defined in Section A.4(b) hereof): (i) the shares of Series C Stock shall rank equally with each other and senior and prior to the shares of Series B Stock, Series A Stock and the Common Stock and to all other classes or series of stock issued by the Corporation, except as otherwise approved by the affirmative vote or consent of the Existing Senior Majority; (ii) the shares of Series B Stock shall rank equally with each other and senior and prior to the shares of Series A Stock and the shares of Common Stock and to all other junior classes or series of stock issued by the Corporation, and junior to the Series C Stock; and (iii) the Series A Stock shall rank senior and prior to the Corporation’s Common Stock and to all other junior classes or series of stock issued by the Corporation, and junior to the Existing Senior Preferred Stock.

 

(b)                                  In the event of any liquidation, dissolution or winding-up of the affairs of the Corporation (collectively, a “ Liquidation ”): (i) the holders of shares of Series C Stock then outstanding (the “ Series C Stockholders ”) shall be entitled to receive out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the holders of Series B Stock then outstanding (the “ Series B Stockholders ”), the holders of Series A Stock then outstanding (the “ Series A Stockholders ,” and collectively with the Series C Stockholders and the Series B Stockholders, the “ Existing Preferred Stockholders ”), or the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series C Stock, an amount per share equal to the Series C Original Purchase Price (as defined in Section A.8 hereof), plus an amount equal to any declared or accrued but unpaid dividends thereon, calculated pursuant to Section A.3(a) hereof; (ii) after the distribution to the Series C Stockholders of the full amount to which they are entitled to receive pursuant to this Section A.4(b), the Series B Stockholders shall be entitled to receive out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the Series A Stockholders or the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series B Stock, an amount per share equal to the Series B Original Purchase Price (as defined in Section A.8 hereof), plus an amount equal to any declared or accrued but unpaid dividends thereon, calculated pursuant to Section A.3(b) hereof; and (iii) after the distribution to the Series B Stockholders of the full amount to which they are entitled to receive pursuant to this Section A.4(b), the Series A Stockholders shall be entitled to receive out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series A Stock, an amount per share equal to the Series A Original Purchase Price (as defined in Section A.8 hereof), plus an amount equal to any declared but unpaid dividends thereon, calculated pursuant to Section A.3(c) hereof. Notwithstanding the foregoing or anything else expressed or implied herein, the transactions contemplated by that certain Agreement and Plan of Merger dated as of April 25, 2011 by and among the Corporation, MPM Acquisition Corp. and RHI Merger Corp. (the “ Merger Agreement ”) shall not be a “Liquidation” for purposes of this Certificate.

 

(c)                                   If, upon any Liquidation the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series C Stockholders the full amount to which each of

 

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them shall be entitled pursuant to Section A.4(b) above, then the Series C Stockholders shall share ratably in any distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series C Stock held upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(d)                                  If, upon any Liquidation the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series B Stockholders the full amount to which each of them shall be entitled pursuant to Section A.4(b) above, then after payment to the Series C Stockholders of the full amount to which such stockholders are entitled pursuant to Section A.4(b) above, the Series B Stockholders shall share ratably in any remaining distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series B Stock held upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(e)                                   If, upon any Liquidation the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series A Stockholders the full amount to which each of them shall be entitled pursuant to Section A.4(b) above, then after payment to the Series C Stockholders and Series B Stockholders of the full amount to which such stockholders are entitled pursuant to Section A.4(b) above, the Series A Stockholders shall share ratably in any remaining distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series A Stock held upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(f)                                    In the event of any Liquidation, after payment shall have been made to the Existing Preferred Stockholders of the full amount to which they shall be entitled pursuant to Section A.4(b), the holders of each other class or series of capital stock (other than Common Stock) ranking on Liquidation junior to such Series C Stock, Series B Stock and Series A Stock (in descending order of seniority), but senior to the Common Stock, as a class, shall be entitled to receive an amount equal (and in like kind) to the aggregate preferential amount fixed for each such junior class or series of capital stock.  If, upon any Liquidation prior to the Initial Closing of the Qualified Financing, after payment shall have been made to the Existing Preferred Stockholders of the full amount to which they shall be entitled pursuant to Section A.4(b), the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay a class or series of capital stock (other than the Common Stock) junior to the Series C Stock, Series B Stock and Series A Stock the full amount to which they shall be entitled pursuant to the preceding sentence, the holders of such other class or series of capital stock shall share ratably, based upon the number of then outstanding shares of such other class or series of capital stock, in any remaining distribution of assets according to the respective preferential amounts fixed for such junior class or series of capital stock or which would be payable to them in respect of the shares held by them upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(g)                                   In the event of any Liquidation prior, after payments shall have been made first to the Existing Preferred Stockholders and then to the holders of each junior class or series of capital stock (other than Common Stock) which is junior to the Series C Stock, Series B Stock and the Series A Stock but senior to the Common Stock, of the full amount to which they each shall be entitled as aforesaid, the holders of Common Stock, as a class, shall be entitled to share ratably with the Series C Stockholders and Series B Stockholders (calculated with respect to such Series C Stock and Series B Stock as provided in the last sentence in this Section A.4(g)) in all remaining assets of the Corporation legally available for distribution to its stockholders.  For purposes of calculating the amount of any payment to be paid upon any such Liquidation pursuant to the participation feature described in this Section A.4(g), each share of such Existing Senior Preferred Stock shall be deemed to be that number of shares (including fractional shares and any shares attributable to the payment of accrued and unpaid

 

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dividends upon conversion of such Preferred Stock pursuant to Section A.7(b)) of Common Stock into which it is then convertible, rounded to the nearest one-tenth of a share.

 

(h)                                  (i) In the event of and simultaneously with the closing of an Event of Sale (as hereinafter defined), the Corporation shall, unless waived by the Existing Senior Majority or otherwise prevented by law, redeem all of the shares of Series C Stock, Series B Stock and Series A Stock then outstanding for a cash amount per share determined as set forth below in this Section A.4(h) hereof (the “ Special Liquidation Price ,” said redemption being referred to herein as a “ Special Liquidation ”).  In the event the Event of Sale involves consideration that does not consist of cash, then the Special Liquidation Price may be paid with such consideration having a value equal to the Special Liquidation Price.  To the extent there is any cash consideration in connection with an Event of Sale, at the option of the holders of a majority of the Series C Stock, the cash consideration will first (i) be applied to satisfy the Special Liquidation Price payable to the Series C Stockholders (in relative proportion to the full liquidation preference the Series C Stockholders would have received had there been sufficient cash consideration to have paid their liquidation preference in full); then (ii) be applied to satisfy the Special Liquidation Price payable to the holders of Series B Stock (in relative proportion to the full liquidation preference the Series B Stockholders would have received had there been sufficient cash consideration to have paid their liquidation preference in full), prior to the payment thereof to any other stockholders of the Corporation; and (iii) then be applied to satisfy the Special Liquidation Price payable to the holders of Series A Stock (in relative proportion to the full liquidation preference the Series A Stockholders would have received had there been sufficient cash consideration to have paid their liquidation preference in full), prior to the payment thereof to any other stockholders of the Corporation.  For all purposes of this Section A.4(h), the Special Liquidation Price shall be equal to that amount per share which would be received by each Existing Preferred Stockholder if, in connection with an Event of Sale, all the consideration paid in exchange for the assets or the shares of capital stock (as the case may be) of the Corporation were actually paid to and received by the Corporation and the Corporation were immediately thereafter liquidated and its assets distributed pursuant to Sections A.4(a) through (h) hereof.  To the extent that one or more redemptions (as described in Section A.5 hereof) and/or Special Liquidations are occurring concurrently, the Special Liquidation under this Section A.4(h) shall be deemed to occur first.  The date upon which the Special Liquidation shall occur is sometimes referred to herein as the “ Special Liquidation Date ”.

 

(ii)                                   In the absence of an applicable waiver pursuant to Section A.4(h)(i) above, at any time on or after the Special Liquidation Date, an Exisiting Preferred Stockholder shall be entitled to receive the Special Liquidation Price for each such share of Series C Stock, Series B Stock or Series A Stock owned by such holder.  Subject to the provisions of Section A.4(h)(iii) hereof, payment of the Special Liquidation Price will be made to each such holder upon actual delivery to the Corporation or its transfer agent of the certificate of such holder representing such shares of Series A Stock, Series B Stock or Series C Stock, as the case may be, or an affidavit of loss as to the same.

 

(iii)                                If on the Special Liquidation Date less than all the shares of either Series C Stock, Series B Stock or Series A Stock then outstanding may be legally redeemed by the Corporation, the Special Liquidation shall be made first as to the Series C Stock pro rata with respect to such Series C Stock based upon the number of outstanding shares of Series C Stock then owned by each such holder thereof until such holders are satisfied in full, then to the holders of the Series B Stock pro rata with respect to such Series B Stock based upon the number of outstanding shares of Series B Stock then owned by each holder thereof, and then to the holders of the Series A Stock pro rata with respect to such Series A Stock based upon the number of outstanding shares of Series A Stock then owned by each holder thereof.

 

(iv)                               On and after any Special Liquidation Date, all rights in respect of the shares of Existing Preferred Stock to be redeemed shall cease and terminate except the right to receive the applicable Special Liquidation Price as provided herein, and such shares of Existing Preferred Stock shall

 

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no longer be deemed to be outstanding, whether or not the certificates representing such shares of Existing Preferred Stock have been received by the Corporation; provided , however , that, if the Corporation defaults in the payment of the Special Liquidation Price with respect to any Existing Preferred Stock, the rights of the holder(s) thereof with respect to such shares of Existing Preferred Stock shall continue until the Corporation cures such default.

 

(v)                                  Anything contained herein to the contrary notwithstanding, all or any of the provisions of this Section A.4(h) may be waived by the Existing Senior Majority, by delivery of written notice of waiver to the Corporation prior to the closing of any Event of Sale.

 

(vi)                               Any notice required to be given to the holders of shares of Preferred Stock pursuant to Section A.7(g) hereof in connection with an Event of Sale shall include a statement by the Corporation of (A) the Special Liquidation Price which each Preferred Stockholder shall be entitled to receive upon the occurrence of a Special Liquidation under this Section A.4(h) and (B) the extent to which the Corporation will, if at all, be legally prohibited from paying each holder of Preferred Stock the Special Liquidation Price.

 

(vii)                            For purposes of this Section A.4(h), an “Event of Sale” shall mean: (A) the sale by the stockholders of voting control of the Corporation, (B) the merger, consolidation or reorganization with or into any other corporation, entity or person or any other corporate reorganization, in which (I) the capital stock of the Corporation immediately prior to such merger, consolidation or reorganization represents less than 50% of the voting power of the surviving entity (or, if the surviving entity is a wholly owned subsidiary, its parent) immediately after such merger, consolidation or reorganization or (II) the surviving entity (or, if the surviving entity is a wholly owned subsidiary, its parent) has a class of securities that is (or has been within 90 days prior to such transaction) tradeable on any public market or exchange or (C) the sale, exclusive license or other disposition of all or substantially all of the assets or intellectual property of the Corporation in a single transaction or series of related transactions. Notwithstanding the foregoing or anything else expressed or implied herein, the transactions contemplated by the Merger Agreement shall not be an “Event of Sale” for purposes of this Certificate.

 

5.               Redemption .

 

(a)                                  At the request of the Existing Senior Majority (the “ Requesting Holders ”) made at any time on or after December 15, 2011, the Corporation shall redeem on the Redemption Date, unless otherwise prevented by law, at a redemption price per share equal to the Series C Original Purchase Price for each share of Series C Stock and Series B Original Purchase Price for each share of Series B Stock, plus in each case an amount equal to any declared or accrued but unpaid dividends thereon, all of the Existing Senior Preferred Stock outstanding at the time that such request is made.  The total sum payable per share of Existing Senior Preferred Stock on the Redemption Date is hereinafter referred to as the “Redemption Price,” and the payment to be made on the Redemption Date is hereinafter referred to as the “Redemption Payment.”  Notwithstanding any limitations specified in this Section A.5, in the event that the Corporation at any time breaches any of the provisions in the this Certificate or any of its representations, warranties, covenants and/or agreements set forth in (i) that certain Stockholders’ Agreement among the Corporation and the parties set forth therein (as amended, the “ Stockholders’ Agreement ”) or that certain Series C Convertible Redeemable Preferred Stock Purchase Agreement among the Corporation and the signatories thereto (the “ Stock Purchase Agreement ”), each as entered into contemporaneously with the filing of the Prior Certificate, or (ii) that certain Series B Convertible Redeemable Preferred Stock Purchase Agreement dated as of November 14, 2003 among the Corporation and the signatories thereto (as amended, the “ Series B Stock Purchase Agreement ”), then upon any such breach the Senior Majority may elect, at their sole discretion, if any such breach is not cured by the 60th day after receipt by the Corporation of notice of such breach from a holder, to accelerate the maturity of

 

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the rights of all of the holders under this Section A.5(a) and cause the immediate redemption of all of the shares of Existing Senior Preferred Stock held by them (less any shares that the Corporation is prevented by law from redeeming, which shall be redeemed by the Corporation as soon as permitted under law).  With respect to a breach of which the Corporation is aware or reasonably should be aware, such 60 day period within which the Corporation shall have the right to cure such breach shall be deemed to have commenced on the tenth day after the occurrence of such breach, irrespective of notice of such breach from any holder, if the Corporation shall not have notified the holders of such breach by such date.

 

(b)                                  On and after the Redemption Date, all rights of any Requesting Holder with respect to those shares of Existing Senior Preferred Stock being redeemed by the Corporation pursuant to Section A.5(a), except the right to receive the applicable Redemption Price per share, shall cease and terminate, and such shares of Existing Senior Preferred Stock shall no longer be deemed to be outstanding, whether or not the certificates representing such shares have been received by the Corporation; provided , however , that, notwithstanding anything to the contrary set forth herein, (A) if the Corporation defaults in the payment of the Redemption Payment, the rights of the Requesting Holder with respect to its shares of Existing Senior Preferred Stock shall continue until the Corporation cures such default, and (B) without limiting any other rights of a Requesting Holder, upon the occurrence of a subsequent Liquidation, with respect to the shares of Existing Senior Preferred Stock in respect of which no Redemption Payment has been received by a Requesting Holder, such Requesting Holder shall be accorded the rights and benefits set forth in Section A.4 hereof in respect of such remaining shares, as if no prior redemption request had been made.

 

(c)                                   If the Requesting Holders elect to exercise redemption rights hereunder, such Requesting Holders shall send notice of such election (the “ Redemption Notice ”) by first-class, certified mail, return receipt requested, postage prepaid, to the Corporation at its principal place of business or to any transfer agent of the Corporation.  Within five (5) Business Days after receipt of the Redemption Notice, the Corporation shall notify in writing all other Existing Senior Preferred Stockholders of the request by a Requesting Holder for the redemption of Existing Senior Preferred Stock (the “ Corporation Notice ”).  On the twentieth (20th) Business Day following the date upon which the Corporation received the Redemption Notice, the Corporation shall pay each holder of Existing Senior Preferred Stock the applicable Redemption Price pursuant to the terms of Section A.5(a), provided that the Corporation or its transfer agent has received the certificate(s) representing the shares of Existing Senior Preferred Stock to be redeemed.  Such payment date shall be referred to herein as the “Redemption Date.”  If, on the Redemption Date, less than all the shares of Existing Senior Preferred Stock may be legally redeemed by the Corporation, the redemption of Existing Senior Preferred Stock shall be pro rata according to the respective amounts which would be payable to the Existing Senior Preferred Stockholders in respect of their shares of Existing Senior Preferred Stock if the Redemption Price were paid in full for all such shares, and any shares of Existing Senior Preferred Stock not redeemed shall be redeemed on the first date following such Redemption Date on which the Corporation may lawfully redeem such shares (pro rata according to the respective amounts which would be payable to the Existing Senior Preferred Stockholders in respect of the remaining shares of Existing Senior Preferred Stock if the Redemption Price were paid in full for all such shares).  The Corporation shall redeem (to the extent permitted by law) the shares of Existing Senior Preferred Stock on the Redemption Date and the Corporation shall promptly advise each holder of Existing Senior Preferred Stock of the Redemption Date or of the relevant facts applicable thereto preventing such redemption.  Upon redemption of only a portion of the number of shares covered by a Existing Senior Preferred Stock certificate, the Corporation shall issue and deliver to or upon the written order of the holder of such Existing Senior Preferred Stock certificate, at the expense of the Corporation, a new certificate covering the number of shares of the Existing Senior Preferred Stock representing the unredeemed portion of the Existing Senior Preferred Stock certificate, which new certificate shall entitle the holder thereof to all the rights, powers and privileges of a holder of such shares.

 

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(d)                                  Shares of the Existing Senior Preferred Stock are not subject to or entitled to the benefit of any sinking fund.

 

6.               Voting .

 

(a)                                  Subject to any separate voting rights provided for herein or otherwise required by law, for so long as Existing Senior Preferred Stock remains outstanding, the holders of Existing Preferred Stock shall be entitled to vote, together with the holders of Common Stock as one class, on all matters as to which holders of Common Stock shall be entitled to vote, in the same manner and with the same effect as such holders of Common Stock.  In any such vote, each share of Existing Preferred Stock shall entitle the holder thereof to the number of votes per share that equals the number of shares of Common Stock (including fractional shares) into which each such share of Preferred Stock is then convertible, rounded up to the nearest one-tenth of a share, but not including any shares of Common Stock issuable upon conversion of any dividends accrued on such Existing Preferred Stock.

 

(b)                                  In addition to the rights specified in Section A.6(a), for so long as any shares of Existing Senior Preferred Stock are outstanding, the holders of the Existing Senior Preferred Stock, voting as a separate class, shall have the right to elect six (6) members of the Board of Directors of the Corporation (such directors, the “ Existing Preferred Directors ”).  In any election of Existing Preferred Directors pursuant to this Section A.6(b), each holder of Existing Senior Preferred Stock shall be entitled to one vote for each share of Common Stock (including fractional shares) into which each such share of Existing Senior Preferred Stock is then convertible, rounded up to the nearest one-tenth of a share (determined as set forth in the second sentence of Section A.6(a) hereof), and no holder of Existing Senior Preferred Stock shall be entitled to cumulate its votes by giving one candidate more than one vote per share.  The voting right of the holders of Existing Senior Preferred Stock, contained in this Section A.6(b), may be exercised at a special meeting of the holders of Existing Senior Preferred Stock called as provided in accordance with the by-laws of the Corporation, at any annual or special meeting of the stockholders of the Corporation, or by written consent of such holders of Existing Senior Preferred Stock in lieu of a meeting.  The Existing Preferred Directors elected pursuant to this Section A.6(b) shall serve from the date of their election and qualification until their successors have been duly elected and qualified.

 

(c)                                   A vacancy in the directorships elected by the holders of Existing Senior Preferred Stock pursuant to Section A.6(b), may be filled by a vote at a meeting called in accordance with the by-laws of the Corporation or written consent in lieu of such meeting of the holders of such Existing Senior Preferred Stock.

 

(d)                                  For so long as Existing Preferred Stock remains outstanding, the holders of capital stock of the Corporation, voting as a single class, shall elect the remaining member or members of the Board of Directors of the Corporation.  In any election of directors pursuant to this Section A.6(d), each stockholder shall be entitled to one vote for each share of Common Stock held or, if Existing Preferred Stock, into which each such share of Existing Preferred Stock is then convertible (determined in accordance with Section A.6(a) hereof), and no stockholder shall be entitled to cumulate its votes by giving one candidate more than one vote per share.  The voting right of the stockholders contained in this Section A.6(d) apply only so long as shares of Existing Preferred Stock remains and outstanding and may be exercised at a special meeting of the stockholders called as provided in accordance with the by-laws of the Corporation, at any annual or special meeting of the stockholders of the Corporation, or by written consent of the stockholder in lieu of a meeting.  The director or directors elected pursuant to this Section A.6(d) shall serve from the date of their election and qualification until their successors have been duly elected and qualified.

 

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(e)                                   A vacancy in the directorship or directorships elected by the stockholders pursuant to Section A.6(d), may be filled by a vote at a meeting called in accordance with the by-laws of the Corporation or written consent in lieu of such meeting of the stockholders of the Corporation.

 

(f)                                    For so long as shares of Existing Preferred Stock are outstanding, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of the Existing Senior Majority, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation (“ Notice ”) shall have been given to each holder of such Existing Senior Preferred Stock, do the following:

 

(i)                                      sell, abandon, transfer, lease or otherwise dispose of all or substantially all of its or any subsidiary’s properties or assets;

 

(ii)                                   sell, abandon, transfer, exclusively license or otherwise dispose of or encumber any of its material intellectual property;

 

(iii)                                purchase, lease or otherwise acquire all or substantially all of the assets of another entity or acquire the securities of any other entity;

 

(iv)                               except as otherwise required by this Certificate or as contemplated in the Series A-1 Purchase Agreement, alter the rights, preferences or privileges of or reclassify any of its or its subsidiaries’ securities or declare or pay any dividend or make any distribution with respect to shares of its capital stock (whether in cash, shares of capital stock or other securities or property);

 

(v)                                  except as otherwise required by this Certificate or as contemplated in the Series A-1 Purchase Agreement, make any payment on account of the purchase, redemption, or other retirement of any share of capital stock of the Corporation or any subsidiary, or distribute to holders of Series B Stock, Series A Stock or Common Stock shares of the Corporation’s capital stock (other than Common Stock in connection with a stock split by way of stock dividend) or other securities of other entities, evidences of indebtedness issued by the Corporation or other entities, or other assets or options or rights other than the repurchase of shares of Common Stock issued pursuant to the Corporation’s 2003 Long-Term Incentive Plan, as amended, for employees or consultants;

 

(vi)                               except as contemplated by the Merger Agreement (as defined herein) merge, consolidate or reorganize with or into, or permit any subsidiary to merge, consolidate or reorganize with or into, any other corporation or corporations or other entity or entities;

 

(vii)                            voluntarily dissolve, liquidate or wind-up or carry out any partial liquidation or distribution or transaction in the nature of a partial liquidation or distribution;

 

(viii)                         except as otherwise required by this Certificate or as contemplated in the Series A-1 Purchase Agreement, in any manner alter or change the designations, powers, preferences, rights, qualifications, limitations or restrictions of the Series C Stock or Series B Stock;

 

(ix)                               take any action to cause any amendment, alteration or repeal of any of the provisions of this Certificate or the by-laws of the Corporation or the organizational documents of the Corporation’s subsidiaries if any;

 

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(x)                                  except as otherwise required by this Certificate or as contemplated in the Series A-1 Purchase Agreement and except for the issuance of capital stock or other securities constituting shares of Excluded Stock (as defined in Section A.7(e)(ii) below), authorize, designate, create, increase or decrease the authorized number of, reclassify, or issue or agree to issue any equity or debt security of the Corporation or any subsidiary or any security, right, option or warrant convertible into, or exercisable or exchangeable for, shares of the capital stock of the Corporation or any capitalized lease with an equity feature with respect to the capital stock of the Corporation;

 

(xi)                               adopt, approve, amend or modify any stock option plan of the Corporation or adopt, approve amend or modify the form of any stock option agreement or restricted stock purchase agreement, or amend or modify any stock option agreement or restricted stock purchase agreement entered into between the Corporation and its employees, directors or consultants except for immaterial changes made thereto from time to time by officers of the Corporation;

 

(xii)                            accelerate the vesting schedule or exercise date or dates of any such options or in any stock option agreement or restricted stock purchase agreement entered into between the Corporation and its directors, officers, employees, consultants or independent contractors, or waive or modify the Corporation’s repurchase rights with respect to any shares of the Corporation’s stock issuable pursuant to any restricted stock purchase agreement entered into between the Corporation and its directors, officers, employees, consultants or independent contractors;

 

(xiii)                         grant any stock options with an exercise price per share that is less than the fair market value of such share on the date of such grant (as determined by the Board of Directors of the Corporation) or issue or sell capital stock of the Corporation pursuant to restricted stock awards or restricted stock purchase agreements at a price per share less than the fair market value of such share on the date of such issuance or sale (as determined by the Board of Directors of the Corporation);

 

(xiv)                        increase the number of shares of Common Stock authorized for issuance under the Corporation’s 2003 Long-Term Incentive Plan, as amended;

 

(xv)                           except as otherwise required by this Certificate or as contemplated in the Series A-1 Purchase Agreement, increase or decrease the authorized number of the members of the Board of Directors;

 

(xvi)                        participate or allow any subsidiary to participate in any business other than which it is engaged as of the date of this Certificate or subsequent to the date of this Certificate as approved by the Board of Directors; or

 

(xvii)                     incur any indebtedness by the Corporation or any subsidiary above and beyond the amounts set forth herein, in the Series A-1 Purchaser Agreement or in the Stockholders’ Agreement.

 

The foregoing approval shall be obtained in addition to any approval required by law.

 

(g)                                   The Corporation shall obtain the consent of the Board of Directors before it may authorize or issue any additional shares of capital stock of the Corporation, other than the issuance of any shares of New Preferred Stock as contemplated by this Certificate or the Series A-1 Purchase Agreement, or any of its subsidiaries.

 

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7.               Conversion .

 

(a)                                  Any Existing Preferred Stockholder shall have the right, at any time or from time to time, to convert any or all of its shares of Existing Preferred Stock into that number of fully paid and nonassessable shares of Common Stock for each share of Existing Preferred Stock so converted equal to the quotient of the Series A Original Purchase Price, Series B Original Purchase Price or Series C Original Purchase Price, as applicable, for such share divided by the Series A Conversion Price, the Series B Conversion Price or the Series C Conversion Price (each as defined in Section A.7(e) hereof), as applicable, for such share of Existing Preferred Stock, as last adjusted and then in effect, rounded up to the nearest one-tenth of a share; provided , however , that cash shall be paid in lieu of the issuance of fractional shares of Common Stock, as provided in Section A.7(d) hereof.

 

(b)                                  (i) Any Existing Preferred Stockholder who exercises the right to convert shares of Existing Preferred Stock into shares of Common Stock, pursuant to this Section A.7 shall be entitled to payment of all accrued dividends, whether or not declared and all declared but unpaid dividends payable with respect to such Existing Preferred Stock pursuant to Section A.3 herein, up to and including the Conversion Date (as defined in Section A.7(b)(iii) hereof).

 

(ii)                                   Any Existing Preferred Stockholder may exercise the right to convert such shares into Common Stock pursuant to this Section A.7 by delivering to the Corporation during regular business hours, at the office of the Corporation or any transfer agent of the Corporation or at such other place as may be designated by the Corporation, the certificate or certificates for the shares to be converted (the “ Existing Preferred Certificate ”), duly endorsed or assigned in blank to the Corporation (if required by it) or an affidavit of loss as to the same.

 

(iii)                                Each Existing Preferred Certificate shall be accompanied by written notice stating that such holder elects to convert such shares and stating the name or names (with address) in which the certificate or certificates for the shares of Common Stock (the “ Common Certificate ”) are to be issued.  Such conversion shall be deemed to have been effected on the date when such delivery is made, and such date is referred to herein as the “ Conversion Date .”

 

(iv)                               As promptly as practicable thereafter, the Corporation shall issue and deliver to or upon the written order of such holder, at the place designated by such holder, (A) a Common Certificate for the number of full shares of Common Stock to which such holder is entitled and (B) a check or cash in respect of any fractional interest in shares of Common Stock to which such holder is entitled, as provided in Section A.7(d) hereof, payable with respect to the shares so converted up to and including the Conversion Date.

 

(v)                                  The person in whose name the Common Certificate or Certificates are to be issued shall be deemed to have become a holder of record of Common Stock on the applicable Conversion Date, unless the transfer books of the Corporation are closed on such Conversion Date, in which event the holder shall be deemed to have become the stockholder of record on the next succeeding date on which the transfer books are open, provided that the Series A Conversion Price, Series B Conversion Price or Series C Conversion Price, as applicable, upon which the conversion shall be executed shall be that in effect on the Conversion Date.

 

(vi)                               Upon conversion of only a portion of the number of shares covered by an Existing Preferred Certificate, the Corporation shall issue and deliver to or upon the written order of the holder of such Existing Preferred Certificate, at the expense of the Corporation, a new certificate covering the number of shares of Existing Preferred Stock representing the unconverted portion of the Existing Preferred Certificate, which new certificate shall entitle the holder thereof to all the rights, powers and privileges of a holder of such Existing Preferred Stock.

 

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(c)                                   If an Existing Preferred Stockholder shall surrender more than one share of the same class of Existing Preferred Stock for conversion at any one time, then the number of full shares of Common Stock issuable upon conversion thereof shall be computed on the basis of the aggregate number of shares of Existing Preferred Stock so surrendered.

 

(d)                                  No fractional shares of Common Stock shall be issued upon conversion of Existing Preferred Stock. The Corporation shall instead pay a cash adjustment for any such fractional interest in an amount equal to the Current Market Price thereof on the Conversion Date, as determined in accordance with Section A.7(e)(vii) hereof.

 

(e)                                   For all purposes of this Article III, Part A, the initial conversion price of the Series A Stock shall be the Series A Original Purchase Price, the initial conversion price of the Series B Stock shall be the Series B Original Purchase Price and the initial conversion price of the Series C Stock shall be the Series C Original Purchase Price, in each case subject to adjustment from time to time as follows (the conversion price of any or each of the Series A Stock, Series B Stock and the Series C Stock, as adjusted from time to time, is sometimes referred to generically in this Section A.7 as the “ Conversion Price ”):

 

(i)                                      Subject to Section A.7(e)(ii) and A.7(e)(x) below, if the Corporation shall, at any time or from time to time after the Effective Time, issue or sell any shares of Common Stock (which term, for purposes of this Section A.7(e)(i), including all subsections thereof, shall be deemed to include all other securities convertible into, or exchangeable or exercisable for, shares of Common Stock (including, but not limited to, Existing Preferred Stock) or options to purchase or other rights to subscribe for such convertible or exchangeable securities, in each case other than Excluded Stock (as defined in Section A.7(e)(ii) below), for a consideration per share less than the Series C Conversion Price in effect immediately prior to the issuance of such Common Stock or other securities (a “ Dilutive Issuance ”), then (X) the Conversion Price for the Series A Stock (the “ Series A Conversion Price ”) in effect immediately prior to each such Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series A Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, upon exercise of outstanding stock options and warrants or otherwise under Section A.7(e)(i)(d)) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at such Series C Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, upon exercise of outstanding stock options or otherwise under Section A.7(e)(i)(d)) plus the number of shares of additional stock so issued, (Y) the Conversion Price for the Series B Stock (the “ Series B Conversion Price ”) in effect immediately prior to each such Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series B Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Existing Preferred Stock) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at such Series C Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of

 

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additional stock so issued, and (Z) the Conversion Price for the Series C Stock (the “ Series C Conversion Price ”) in effect immediately prior to each such Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series C Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Existing Preferred Stock) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at such Series C Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Existing Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Existing Preferred Stock) plus the number of shares of additional stock so issued.  For purposes of this Section A.7(e)(i), the number of shares of Common Stock deemed issuable upon conversion of such outstanding shares of Existing Preferred Stock shall be determined without giving effect to any adjustments to the applicable Conversion Price resulting from the Dilutive Issuance that is the subject of this calculation.  For the purposes of any adjustment of the Conversion Price pursuant to this Section A.7(e)(i), the following provisions shall be applicable.

 

a.                                       In the case of the issuance of Common Stock in whole or in part for cash, the consideration shall be deemed to be the amount of cash paid therefor after deducting therefrom any discounts, commissions or other expenses allowed, paid or incurred by the Corporation for any underwriting or otherwise in connection with the issuance and sale thereof, plus the value of any property other than cash received by the Corporation, determined as provided in Section A.7(e)(i)(b) hereof, plus the value of any other consideration received by the Corporation determined as set forth in Section A.7(e)(i)(c) hereof.

 

b.                                       In the case of the issuance of Common Stock for a consideration in whole or in part in property other than cash, the value of such property other than cash shall be deemed to be the fair market value of such property as determined in good faith by the Board of Directors, irrespective of any accounting treatment; provided , however , that such fair market value of such property as determined by the Board of Directors shall not exceed the aggregate Current Market Price (as defined in Section A.7(e)(viii) hereof) of the shares of Common Stock or such other securities being issued, less any cash consideration paid for such shares, determined as provided in Section A.7(e)(i)(a) hereof and less any other consideration received by the Corporation for such shares, determined as set forth in Section A.7(e)(i)(c) hereof.

 

c.                                        In the case of the issuance of Common Stock for consideration in whole or in part other than cash or property, the value of such other consideration shall be deemed to be the aggregate par value of such Common Stock (or the aggregate stated value if such Common Stock has no par value).

 

d.                                       In the case of the issuance of options or other rights to purchase or subscribe for Common Stock or the issuance of securities by their terms convertible into or exchangeable or exercisable for Common Stock or options to purchase or other rights to subscribe for such convertible or exchangeable or exercisable securities:

 

i.                                           the aggregate maximum number of shares of Common Stock deliverable upon exercise of such options to purchase or rights to subscribe for Common Stock shall be deemed to have been issued at the time such options or rights were issued and for a consideration equal to the consideration (determined in the manner provided in Sections A.7(e)(i)(a), (b)

 

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and (c) hereof), if any, received by the Corporation upon the issuance of such options or rights plus the minimum purchase price provided in such options or rights for the Common Stock covered thereby (the consideration in each case to be determined in the manner provided in Sections A.7(e)(i)(a), (b) and (c) hereof);

 

ii.                                        the aggregate maximum number of shares of Common Stock deliverable upon conversion of, or in exchange for, any such convertible or exchangeable securities or upon the exercise of options to purchase or rights to subscribe for such convertible or exchangeable securities and subsequent conversion or exchange thereof shall be deemed to have been issued at the time such securities were issued or such options or rights were issued and for a consideration equal to the consideration received by the Corporation for any such securities and related options or rights (excluding any cash received on account of accrued interest or accrued dividends), plus the minimum additional consideration, if any, to be received by the Corporation upon the conversion or exchange of such securities or the exercise of any related options or rights (the consideration in each case to be determined in the manner provided in Sections A.7(e)(i)(a), (b) and (c) hereof);

 

iii.                                     if there is any change (whether automatic pursuant to the terms contained therein or as a result of the amendment of such terms) in the exercise price of, or number of shares deliverable upon exercise of, any such options or rights or upon the conversion or exchange of any such convertible or exchangeable securities (other than a change resulting from the original antidilution provisions thereof in place at the time of issuance of such security), then the applicable Conversion Price shall automatically be readjusted in proportion to such change (notwithstanding the foregoing, no adjustment pursuant to this clause shall have the effect of increasing the applicable Conversion Price to an amount which exceeds the lower of (i) the applicable Conversion Price on the original adjustment date, or (ii) the applicable Conversion Price that would have resulted from any Dilutive Issuances between the original adjustment date and such readjustment date);

 

iv.                                    upon the expiration of any such options or rights or the termination of any such rights to convert or exchange such convertible or exchangeable securities (or in the event that the change that precipitated an adjustment pursuant to Section A.7(e)(i)(d)(iii) hereof is reversed or terminated, or expires), then the applicable Conversion Price shall be automatically readjusted to the applicable Conversion Price that would have been obtained had such options, rights or convertible or exchangeable securities not been issued; and

 

v.                                       if the terms of any option or convertible security (excluding options or convertible securities which, upon exercise, conversion or exchange thereof, would entitle the holder thereof to receive shares of Common Stock which are Excluded Stock), the issuance of which was not a Dilutive Issuance, are revised after the Original Issuance Date (either automatically pursuant the provisions contained therein or as a result of an amendment to such terms) to provide for either (1) any increase in the number of shares of Common Stock issuable upon the exercise, conversion or exchange of any such option or convertible security or (2) any decrease in the consideration payable to the Corporation upon such exercise, conversion or exchange, then such option or convertible security, as so amended, and the shares of Common Stock subject thereto shall be deemed to have been issued effective upon such increase or decrease becoming effective.

 

(ii)                                   “Excluded Stock” shall mean:

 

a.                                       Common Stock issued upon conversion of any shares of Existing Preferred Stock, including any shares of Common Stock issuable upon conversion of any dividends accrued on such Existing Preferred Stock;

 

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b.                                       Common Stock issued or issuable to officers, directors or employees of or consultants or independent contractors to the Corporation, pursuant to any written agreement, plan or arrangement to purchase, or rights to subscribe for, such Common Stock, including Common Stock issued under the Corporation’s 2003 Long-Term Incentive Plan, as amended, or other equity incentive plan or other agreements that have been approved in form and in substance by the Existing Senior Majority, calculated in accordance with Section A.6(a) of Article III herein (including, in such calculation, any outstanding restricted stock awards held by such holders), and which, as a condition precedent to the issuance of such shares, provide for the vesting of such shares and subject such shares to restrictions on transfer and rights of first offer in favor of the Corporation, and restricted stock grants to directors, employees or consultants as approved by the Board of Directors of the Corporation; provided , however , that the maximum number of shares of Common Stock heretofore or hereafter issuable pursuant to the Corporation’s 2003 Long-Term Incentive Plan, as amended, and all such agreements, plans and arrangements shall not exceed 2,015,666 shares of Common Stock;

 

c.                                        Common Stock issued as a stock dividend or distribution on the Existing Preferred Stock payable in shares of Common Stock, or capital stock of any other class issuable upon any subdivision, recombination, split-up or reverse stock split of all the outstanding shares of such class of capital stock;

 

d.                                       Common Stock or other securities issued or issuable to banks, lenders or landlords, provided that each such issuance is approved by the Board of Directors, including, but not limited to, warrants to acquire Common Stock held by Silicon Valley Bank (or its affiliates, successors and assignees), warrants to purchase Preferred Stock issued or to be issued to GE Healthcare Financial Services, Inc. (“ GEHFS ”) and Oxford Finance Corporation (“ OFC ”) pursuant to a proposed debt financing approved by the Board of Directors (the “ GE Financing ”), shares of Preferred Stock issued or issuable to GE in connection with the GE Financing or upon exercise by GEHFS or OFC of warrants issued in the GE Financing and shares of common stock issuable upon conversion of any such shares of Preferred Stock issued to GEHFS or OFC pursuant to the GE Financing;

 

e.                                        Common Stock or other securities issued or issuable to third parties in connection with strategic partnerships or alliances, corporate partnerships, joint ventures or other licensing transactions, provided that each such transaction and related issuance is approved by the Board of Directors, including, but not limited to, (A) any shares of Preferred Stock or Common Stock issued or issuable to Ipsen Pharma SAS (“ Ipsen ”), pursuant to the terms of that certain License Agreement, as amended and may be amended with the approval of the Board of Directors of the Corporation and in effect from time to time, by and between the Corporation and Ipsen as payment milestones in lieu of cash payments and (B) hares of Series A-5 Stock issued or issuable pursuant to that certain Stock Issuance Agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience and the letter agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience, pursuant to which the Corporation will issue shares of the Corporation’s Series A-5 Convertible Preferred Stock, $0.01 par value per share and the issuance of Series A-6 Stock issued or to be issued as dividends on such Series A-5 Stock, and shares of Common Stock issuable upon conversion of any such shares of Series A-5 Stock and Series A-6 Stock;

 

f.                                         Common Stock or other securities issued or issuable pursuant to the acquisition by the Corporation of any other corporation, partnership, joint venture, trust or other entity by any merger, stock acquisition, reorganization, or purchase of substantially all assets or otherwise in which the Corporation or its stockholders of record immediately prior to the effective date of such transaction, directly or indirectly, own at least a majority of the voting power of the acquired entity or the resulting entity after such transaction, in each case so long as approved by the Board of Directors;

 

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g.                                        Common Stock or other securities, the issuance of which is approved by the Existing Senior Majority, with such approval expressly waiving the application of the anti-dilution provisions of this Section A.7 as a result of such issuance;

 

h.                                       Preferred Stock (and Common Stock issuable upon conversion of such Preferred Stock) or Common Stock issued or issuable pursuant to any warrant outstanding as of the date hereof or any warrant and any shares of Preferred Stock or common stock, or common stock issued upon exercise of any Preferred Stock, issued in connection with the Qualified Financing, including, but not limited to a warrant for shares of Series A-1 Preferred Stock issued or issuable to Leerink Swan, any shares of Preferred Stock or Common Stock upon exercise thereof and any Common Stock issuable upon conversion of such Preferred Stock issued upon exercise thereof;

 

j.                                          All shares of Preferred Stock issued in connection with the Qualified Financing as provided in this Certificate and the Series A-1 Purchase Agreement, and all shares of Common Stock issued or issuable upon conversion of any such shares of Preferred Stock.

 

(iii)                                If the number of shares of Common Stock outstanding at any time after the Effective Time is increased by a stock dividend payable in shares of Common Stock or by a subdivision or split-up of shares of Common Stock, then, following the record date fixed for the determination of holders of Common Stock entitled to receive such stock dividend, subdivision or split-up, the applicable Conversion Price shall be appropriately decreased in the form of a Proportional Adjustment (as defined in Section A.8) so that the number of shares of Common Stock issuable on conversion of each share of Existing Preferred Stock shall be increased in proportion to such increase in outstanding shares.

 

(iv)                               If the number of shares of Common Stock outstanding at any time after the Effective Time is decreased by a combination of the outstanding shares of Common Stock (other than pursuant to the Reverse Split), then, following the record date for such combination, the applicable Conversion Price shall be appropriately increased in the form of a Proportional Adjustment so that the number of shares of Common Stock issuable on conversion of each share of Existing Preferred Stock shall be decreased in proportion to such decrease in outstanding shares.

 

(v)                                  Except as contemplated in Certificate and the Series A-1 Purchaser Agreement, if at any time after the Effective Time, the Corporation shall make or issue, or fix a record date for the determination of holders of Common Stock entitled to receive, a dividend or other distribution payable in securities of the Corporation (other than shares of Common Stock) or in cash or other property, then and in each such event provision shall be made so that the holders of the Existing Preferred Stock shall receive upon conversion thereof in addition to the number of shares of Common Stock receivable thereupon, the kind and amount of securities of the Corporation, cash or other property which they would have been entitled to receive had the Existing Preferred Stock been converted into Common Stock on the date of such event and had they thereafter, during the period from the date of such event to and including the conversion date, retained such securities receivable by them as aforesaid during such period, giving application to all adjustments called for during such period under this paragraph with respect to the rights of the holders of the Existing Preferred Stock; and provided further, however, that no such adjustment shall be made if the holders of Existing Preferred Stock simultaneously receive a dividend or other distribution of such securities, cash, or other property in an amount equal to the amount of such securities, cash, or other property as they would have received if all outstanding shares of Existing Preferred Stock had been converted into Common Stock on the date of such event.

 

(vi)                               Subject to the provisions of Section A.4(h) above, in the event, at any time after the Effective Time, of any capital reorganization, or any reclassification of the capital stock of the

 

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Corporation (other than pursuant to the Reverse Split, other than as contemplated under this Certificate and the Series A-1 Purchase Agreement and other than a change in par value or from par value to no par value or from no par value to par value or as a result of a stock dividend or subdivision, split-up or combination of shares), or the consolidation or merger of the Corporation with or into another person (other than pursuant to the Merger Agreement and other than any consolidation or merger in which the Corporation is the continuing corporation and which does not result in any change in the powers, designations, preferences and rights, or the qualifications, limitations or restrictions, if any, of the capital stock of the Corporation) or of the sale or other disposition of all or substantially all the properties and assets of the Corporation in their entirety to any other person (any such transaction, an “ Extraordinary Transaction ”), then the Corporation shall provide appropriate adjustment in the form of a Proportional Adjustment to the applicable Conversion Price with respect to each share of Existing Preferred Stock outstanding after the effectiveness of such Extraordinary Transaction (excluding any Existing Preferred Stock redeemed pursuant to Section A.5 hereof in connection therewith) such that each share of Existing Preferred Stock outstanding immediately prior to the effectiveness of the Extraordinary Transaction (other than shares redeemed pursuant to Section A.5 hereof) shall be convertible into the kind and number of shares of stock or other securities or property of the Corporation, or of the corporation resulting from or surviving such Extraordinary Transaction, that a holder of the number of shares of Common Stock deliverable (immediately prior to the effectiveness of the Extraordinary Transaction) upon conversion of such share of Existing Preferred Stock would have been entitled to receive upon such Extraordinary Transaction. The provisions of this Section A.7(e)(v) shall similarly apply to successive Extraordinary Transactions.

 

(vii)                            All calculations under this Section A.7(e) shall be made to the nearest one-tenth of a cent ($.001) or to the nearest one-tenth of a share, as the case may be.

 

(viii)                         For the purpose of any computation pursuant to Section A.7(d) hereof or this Section A.7(e), the Current Market Price at any date of one share of Common Stock shall be defined as the average of the daily closing prices for the 30 consecutive Business Days ending on the fifth (5th) Business Day before the day in question (as adjusted for any stock dividend, split-up, combination or reclassification that took effect during such 30 Business Day period), determined as follows:

 

a.                                       If the Common Stock is listed or admitted for trading on a national securities exchange, then the closing price for each day shall be the last reported sales price regular way or, in case no such reported sales took place on such day, the average of the last reported bid and asked prices regular way, in either case on the principal national securities exchange on which the Common Stock is listed or admitted to trading.

 

b.                                       If the Common Stock is not at the time listed or admitted for trading on any such exchange, then such price shall be equal to the last reported bid and asked prices on such day as reported by the NASD OTCBB or the National Quotation Bureau, Inc., or any similar reputable quotation and reporting service if such quotation is not reported by the NASD OTCBB or the National Quotation Bureau, Inc.

 

c.                                        If the Common Stock is not traded in such manner that the quotations referred to in this Section A.7(d)(viii) are available for the period required hereunder, then the Current Market Price shall be the fair market value of such share, as determined in good faith by a majority of the entire Board of Directors.

 

(ix)                               In any case in which the provisions of this Section A.7(e) shall require that an adjustment shall become effective immediately after a record date for an event, the Corporation may defer until the occurrence of such event (A) issuing to the holder of any shares of Existing Preferred Stock

 

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converted after such record date and before the occurrence of such event the additional shares of capital stock issuable upon such conversion by reason of the adjustment required by such event over and above the shares of capital stock issuable upon such conversion before giving effect to such adjustment, and (B) paying to such holder any cash amounts in lieu of fractional shares pursuant to Section A.7(d) hereof; provided , however , that the Corporation shall deliver to such holder a due bill or other appropriate instrument evidencing such holder’s right to receive such additional shares and such cash upon the occurrence of the event requiring such adjustment.

 

(x)                                  If a state of facts shall occur that, without being specifically controlled by the provisions of this Section A.7, would not fairly protect the conversion rights of the holders of the Existing Preferred Stock in accordance with the essential intent and principles of such provisions, then the Board of Directors shall make an adjustment in the application of such provisions, in accordance with such essential intent and principles, so as to protect such conversion rights.

 

(xi)                               Notwithstanding the foregoing, there shall be no adjustment to the Conversion Price for any issuance or deemed issuance of any shares of Common Stock (which term, for purposes of this Section A.7(e)(x), including all subsections thereof, shall be deemed to include all securities convertible into, or exchangeable or exercisable for, whether directly or indirectly, shares of Common Stock) for a consideration per share greater than the Series C Original Purchase Price.

 

(f)                                    Whenever the applicable Conversion Price shall be adjusted as provided in Section A.7(e) hereof, the Corporation shall forthwith file and keep on record at the office of the Secretary of the Corporation and at the office of its transfer agent or at such other place as may be designated by the Corporation, a statement, signed by both its President or Chief Executive Officer and its Treasurer or Chief Financial Officer, showing in detail the facts requiring such adjustment and the applicable Conversion Price that shall be in effect after such adjustment. The Corporation shall also cause a copy of such statement to be sent by first-class, certified mail, return receipt requested, postage prepaid, to each Existing Preferred Stockholder at such holder’s address appearing on the Corporation’s records. Where appropriate, such copy shall be given in advance of any such adjustment and shall be included as part of a notice required to be mailed under the provisions of Section A.7(g) hereof.

 

(g)                                   In the event the Corporation shall propose to take any action of the types described in Section A.7(e)(i), (iii), (iv) or (v) hereof, or any other Event of Sale, the Corporation shall give notice to each Existing Preferred Stockholder in the manner set forth in Section A.7(f) hereof, which notice shall specify the record date, if any, with respect to any such action and the date on which such action is to take place. Such notice shall also set forth such facts with respect thereto as shall be reasonably necessary to indicate the effect of such action (to the extent such effect may be known at the date of such notice) on the applicable Conversion Price with respect to the Existing Preferred Stock, and the number, kind or class of shares or other securities or property which shall be deliverable or purchasable upon each conversion of Preferred Stock. In the case of any action that would require the fixing of a record date, such notice shall be given at least 20 days prior to the record date so fixed, and in the case of any other action, such notice shall be given at least 30 days prior to the taking of such proposed action.

 

(h)                                  The Corporation shall pay all documentary, stamp or other transactional taxes attributable to the issuance or delivery of shares of capital stock of the Corporation upon conversion of any shares of Existing Preferred Stock; provided , however , that the Corporation shall not be required to pay any taxes which may be payable in respect of any transfer involved in the issuance or delivery of any certificate for such shares in a name other than that of the Existing Preferred Stockholder in respect of which such shares of Existing Preferred Stock are being issued.

 

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(i)                                      The Corporation shall reserve out of its authorized but unissued shares of Common Stock, solely for the purpose of effecting the conversion of the Existing Preferred Stock, sufficient shares of Common Stock to provide for the conversion of all outstanding shares of Existing Preferred Stock.

 

(j)                                     All shares of Common Stock which may be issued in connection with the conversion provisions set forth herein will, upon issuance by the Corporation, be validly issued, fully paid and nonassessable, not subject to any preemptive or similar rights, and free from all taxes, liens or charges with respect thereto created or imposed by the Corporation.

 

(k)                                  Upon the consummation of a qualified firm commitment underwritten public offering of Common Stock of the Corporation registered under the Securities Act of 1933, as amended, pursuant to which (i) the Company valuation prior to the offering is equal to or greater than $200 million and (ii) the aggregate gross proceeds to the Corporation (before deduction of underwriters commissions and expenses) are at least $40 million (a “ Qualified Public Offering ”), each share of Existing Preferred Stock then outstanding shall, by virtue of and immediately prior to the closing of such qualified firm commitment public offering and without any action on the part of the holder thereof, be deemed automatically converted into that number of shares of Common Stock of which the Existing Preferred Stock would be convertible if such conversion were to occur immediately prior to closing of the Qualified Public Offering. The holder of any shares of Existing Preferred Stock converted into Common Stock pursuant to this Section A.7(k) shall be entitled to payment of all declared or accrued but unpaid dividends, if any, payable on or with respect to such shares up to and including the date of the closing of such Qualified Public Offering which shall be deemed the Conversion Date for purposes of this Section A.7(k).

 

8.               Definitions .  As used in this Part A of Article III of this Certificate, the following terms shall have the corresponding meanings:

 

Business Day ” shall mean any day other than a Saturday, Sunday or day on which banks are closed in the city and state where the principal executive office of the Corporation is located.

 

Series A Original Purchase Price ” shall mean, with respect to the Series A Stock and after giving effect to the Reverse Split, $15.00 per share, subject, for all purposes other than Section A.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series B Original Purchase Price ” shall mean, with respect to the Series B Stock and after giving effect to the Reverse Split, $15.00 per share, subject, for all purposes other than Section A.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series C Original Purchase Price ” shall mean, with respect to the Series C Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section A.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Proportional Adjustment ” shall mean an adjustment made to the price of the Preferred Stock upon the occurrence of a stock split, reverse stock split, stock dividend, stock combination reclassification or other similar change with respect to such security, such that the price of one share of the Preferred Stock before the occurrence of any such

 

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change shall equal the aggregate price of the share (or shares or fractional share) of such security (or any other security) received by the holder of the Preferred Stock with respect thereto upon the effectiveness of such change. Notwithstanding the foregoing, the Reverse Split shall not rigger or give rise to any Proportional Adjustment.

 

9.               Forced Conversion in the Qualified Financing .

 

(a)                                  Definitions .  For purposes of this Section A.9 of Article III, the following definitions shall apply:

 

(i)                                      Applicable Portion ” shall mean that percentage of a holder of Existing Preferred Stock’s Pro Rata Portion not committed to be purchased by such holder in the Qualified Financing.

 

(ii)                                   Offered Securities ” shall mean the Series A-1 Stock offered for sale in the Qualified Financing.

 

(iii)                                Pro Rata Portion ” shall mean, with respect to any holder of Existing Preferred Stock, that percentage figure which expresses the ratio that (A) the number of shares of issued and outstanding Common Stock owned by such holder of Existing Preferred Stock as of March 31, 2011 (or, in the case of a holder of Existing Preferred Stock who received all of its shares of Existing Preferred Stock in a transfer from a former holder of Existing Preferred Stock occurring after March 31, 2011, the number shares of issued and outstanding Common Stock owned by such former holder of Existing Preferred Stock as of March 31, 2011) bears to (B) the aggregate number of shares of issued and outstanding Common Stock owned as of such date by all holders of Existing Preferred Stock.  For purposes of the computation set forth in clauses (A) and (B) above, all issued and outstanding securities held by holders of Existing Preferred Stock (or former holders of Existing Preferred Stock, as applicable, under clause (A) above) that are convertible into or exercisable or exchangeable for shares of Common Stock (including any issued and issuable shares of Existing Preferred Stock) or for any such convertible, exercisable or exchangeable securities, shall be treated as having been so converted, exercised or exchanged at the rate or price at which such securities are convertible, exercisable or exchangeable for shares of Common Stock in effect at the time in question, whether or not such securities are at such time immediately convertible, exercisable or exchangeable.

 

(iv)                               Qualified Financing ” shall mean the transaction involving the issuance of shares of Series A-1 Stock pursuant to the terms of the Series A-1 Purchase Agreement.

 

(v)                                  Series A-1 Offering Existing Investor Available Amount ” means Thirty Five Million Dollars ($35,000,000) of the total amount of Offered Securities in the Qualified Financing.

 

(vi)                               Series A-1 Purchase Agreement ” shall mean that certain Series A-1 Convertible Preferred Stock Purchase Agreement dated as of April 25, 2011 by and among the Corporation and the “Investors” party thereto.

 

(b)                                  Conversion of Existing Preferred Stock to Common Stock in Connection with the Qualified Financing .  In the event that an Existing Preferred Stockholder does not participate in the Qualified Financing by committing to purchase and purchasing (or securing an investor who commits to purchase and purchases), pursuant to the terms of the Series A-1 Purchase Agreement, in the Qualified Financing in the aggregate and within the time period specified in the Series A-1 Purchase Agreement such holder’s Pro Rata Portion of the Series A-1 Offering Existing Investor Available Amount, then the Applicable Portion of each series of Existing Preferred Stock held by such holder shall automatically, and without any further action on the part of such holder, be converted into shares of Common Stock at a rate

 

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of 1 share of Common Stock for every 5 shares of Existing Preferred Stock to be so converted and all accrued dividends on such shares of Existing Preferred Stock shall be forfeited. The conversion set forth in this paragraph (b) is referred to as the “ Forced Conversion ”. The Forced Conversion shall become effective immediately prior to, but subject to the consummation of, the Stage I Closing (as defined in the Series A-1 Purchase Agreement).

 

(c)                                   Conversion of Series C Stock to Series A-2 Stock in the Qualified Financing .  Each share of Series C Stock that remains outstanding after the Forced Conversion shall, immediately following the Forced Conversion and upon the consummation of the Stage I Closing, automatically, and without any further action by any holder thereof, be reclassified and converted into one (1) share of Series A-2 Stock and all accrued dividends on such reclassified shares of Series C Stock shall be forfeited.

 

(d)                                  Conversion of Series B Stock to Series A-3 Stock in the Qualified Financing .  Each share of Series B Stock that remains outstanding after the Forced Conversion shall, immediately following the Forced Conversion and upon the consummation of the Stage I Closing, automatically, and without any further action by any holder thereof, be reclassified and converted into one (1) share of Series A-3 Stock and all accrued dividends on such reclassified shares of Series B Stock shall be forfeited.

 

(e)                                   Conversion of Series A Stock to Series A-4 Stock in the Qualified Financing .  Each share of Series A Stock that remains outstanding after the Forced Conversion shall, immediately following the Forced Conversion and upon the consummation of the Stage I Closing, automatically, and without any further action by any holder thereof, be reclassified and converted into one (1) share of Series A-4 Stock.

 

(f)                                    Procedure .                                        Immediately following the Stage I Closing, all stock certificates representing shares of Existing Preferred Stock shall be deemed cancelled and shall thereafter be deemed to evidence only (i) the number of shares of Common Stock into which such shares of Existing Preferred Stock were converted as a result of the Forced Conversion or (ii) the number of shares of Series A-2 Stock, Series A-3 or Series A-4 Stock into which such shares of Existing Preferred Stock were reclassified and converted pursuant to the foregoing provisions of this Section A.9 of Article III.  Each holder of a certificate or certificates that, immediately before the Stage I Closing, represented shares of Existing Preferred Stock shall, as soon as practicable after the Stage I Closing, surrender such certificate or certificates, duly endorsed for transfer or with duly executed stock transfer powers sufficient to permit transfers attached, at the office of the Corporation or any transfer agent for such shares of Existing Preferred Stock (or such holder shall notify the Corporation or any transfer agent that such certificate or certificates have been lost, stolen or destroyed and shall execute an agreement reasonably satisfactory to the Corporation to indemnify the Corporation from any loss incurred by it in connection therewith).  The Corporation shall, as soon as practicable thereafter, issue and deliver at such office to such holder, or to such holder’s nominee or nominees, a certificate or certificates for the number of shares of Common Stock into which such holder’s shares of Existing Preferred Stock were converted pursuant to the Forced Conversion or shares of Series A-2 Stock, Series A-3 or Series A-4 Stock, as applicable, to which such holder shall be entitled as aforesaid.  From and after the Stage I Closing, each stock certificate that, prior to the Stage I Closing, represented shares of Existing Preferred Stock that were converted into Common Stock pursuant to the Forced Conversion or reclassified and converted into shares of Series A-2 Stock, Series A-3 or Series A-4 Stock as provided above shall, until its surrender, be deemed to represent the number of shares of Common Stock, Series A-2 Stock, Series A-3 or Series A-4 Stock, as applicable, into which such shares of Existing Preferred Stock were converted or reclassified.

 

(g)                                   No Reissue of Converted Existing Preferred Stock . No share of Existing Preferred Stock that is converted pursuant to any of the provisions of this Section A.9 shall be reissued, and the

 

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Corporation shall not hold such share of Existing Preferred Stock so converted in treasury but, instead, shall retire and cancel such share immediately upon the conversion thereof pursuant to this Section A.9.

 

PART B. NEW PREFERRED STOCK

 

1.               Designation and Amount .  The number of shares, powers, terms, conditions, designations, preferences and privileges, relative, participating, optional and other special rights, and qualifications, limitations and restrictions, if any, of the New Preferred Stock shall be as set forth in this Part B. The number of authorized shares of the Series A-1 Stock is Ten Million (10,000,000), the number of authorized shares of the Series A-2 Stock is Nine Million Eight Hundred Thirty-two Thousand One Hundred Thirty-three (9,832,133), the number of authorized shares of the Series A-3 Stock is One Million Four Hundred Twenty-two Thousand Three Hundred (1,422,300), the number of authorized shares of the Series A-4 Stock is Forty Thousand and Three (40,003), the number of authorized shares of the Series A-5 Stock is Seventy Thousand (70,000) and the number of authorized shares of the Series A-6 Stock is Eight Million (8,000,000).

 

2.               Ranking .  As to dividends (other than with respect to the payment of the Series A-5 Accruing Dividend which shall rank senior in payment to any other dividends payable on any and all series of New Preferred Stock) and upon Liquidation (as defined in Section B.4(b) hereof) or an Event of Sale (as defined in Section B.5 hereof), each share of Series A-1 Stock shall rank equally with each other share of Series A-1 Stock and senior to all shares of Series A-2 Stock, Series A-3 Stock, Series A-4 Stock, Series A-5 Stock, Series A-6 Stock and shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time; each share of Series A-2 Stock shall rank equally with each other share of Series A-2 Stock and senior to all shares of Series A-3 Stock, Series A-4 Stock, Series A-5 Stock, Series A-6 Stock and shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time; each share of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock shall rank equally with each other share of Series A-3 Stock, Series A-5 and Series A-6 Stock and senior to all shares of Series A-4 Stock and shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time; except, in all cases, as otherwise approved by the affirmative vote or consent of holders of shares of Series A-1 Stock, Series A-2 Stock and/or Series A-3 Stock representing at least 70% of the voting power of the shares of Series A-1 Stock, Series A-2 Stock and Series A-3 Stock then outstanding (determined as set forth in the second sentence of Section A.6(a) hereof) (the “ New Senior Majority ”). Each share of Series A-4 Stock, shall rank equally with each other share of Series A-4 Stock and senior to all shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time, except as otherwise approved by the affirmative vote or consent of the New Senior Majority.

 

3.               Dividend Provisions .

 

(a)                      Series A-1 Stock .  The holders of shares of Series A-1 Stock shall be entitled to receive a per share dividend at the rate of 8% of the Series A-1 Original Purchase Price (as defined in Section B.8 hereof) per annum, compounding annually (the “ Series A-1 Accruing Dividend ”), and which will accrue on a quarterly basis commencing on the date of issuance of such share of Series A-1 Stock. The holders of Series A-1 Stock shall be entitled to receive dividends prior in right to the payment of dividends and other distributions (whether in cash, property or securities of the Corporation, including subscription or other rights to acquire securities of the Corporation) on the Series A-2 Stock, Series A-3 Stock, Series A-4 Stock, Series A-5 Stock, Series A-6 Stock and Common Stock, but not with respect to the payment of the Series A-5 Special Accruing Dividend, as set forth in Section B.3(d) below, which shall rank senior in payment to any dividends payable with respect to the Series A-1 Stock.  Any dividends with respect to the Series A-1 Stock shall be payable, at the sole discretion of the Board of Directors, in cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by dividing (x) the amount of such

 

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accrued and unpaid dividends thereon by (y) the Current Market Price of a share of Common Stock, when, as and if declared or paid by the Board of Directors and, as accrued, on any Liquidation or Event of Sale.  Dividends with respect to the Series A-1 Stock shall be payable in shares of Common Stock (calculated based upon the then effective Series A-1 Conversion Price), as accrued, upon the conversion of the Series A-1 Stock into Common Stock.  Whenever any dividend may be declared or paid on any share of Series A-1 Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series A-1 Stock then outstanding, so that all outstanding shares of Series A-1 Stock will participate equally with each other and ratably per share (calculated as provided in Section B.3(f) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series A-1 Stock then outstanding so that all outstanding shares of Series A-1 Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section B.3(e) hereof); or (ii) any shares of any other series of Preferred Stock (other than the Series A-2 Accruing Dividend, the Series A-3 Accruing Dividend and the Series A-5 Special Accruing Dividend), the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series A-1 Stock then outstanding so that all outstanding shares of Series A-1 Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share of Series A-1 Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series A-1 Stock then outstanding).

 

(b)                      Series A-2 Stock .  The holders of shares of Series A-2 Stock shall be entitled to receive a per share dividend at the rate of 8% of the Series A-2 Original Purchase Price (as defined in Section B.8 hereof) per annum, compounding annually (the “ Series A-2 Accruing Dividend ”), and which will accrue on a quarterly basis commencing on the date of issuance of such share of Series A-2 Stock. The holders of Series A-2 Stock shall be entitled to receive dividends prior in right to the payment of dividends and other distributions (whether in cash, property or securities of the Corporation, including subscription or other rights to acquire securities of the Corporation) on the Series A-3 Stock, Series A-4 Stock, Series A-5 Stock, Series A-6 Stock and Common Stock, but not with respect to the payment of the Series A-5 Special Accruing Dividend, as set forth below in Section B.3(d) below, which shall rank senior in payment to any dividends payable with respect to the Series A-2 Stock.  Any dividends with respect to the Series A-2 Stock shall be payable, at the sole discretion of the Board of Directors, in cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by dividing (x) the amount of such accrued and unpaid dividends thereon by (y) the then fair market value of a share of Common Stock, when, as and if declared or paid by the Board of Directors and, as accrued, on any Liquidation or Event of Sale. Dividends with respect to the Series A-2 Stock shall be payable in shares of Common Stock (calculated based upon the then effective Series A-2 Conversion Price), as accrued, upon the conversion of the Series A-2 Stock into Common Stock.  Whenever any dividend may be declared or paid on any share of Series A-2 Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series A-2 Stock then outstanding, so that all outstanding shares of Series A-2 Stock will participate equally with each other and ratably per share (calculated as provided in Section B.3(f) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series A-2 Stock then outstanding so that all outstanding shares of Series A-2 Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section B.3(f) hereof); or (ii) any shares of any other series of Preferred Stock (other than the Series A-1 Accruing Dividend, the Series A-3 Accruing Dividend and the Series A-5 Special Accruing Dividend), the Board of Directors shall also declare and pay

 

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a dividend on the same terms, at the same or equivalent rate upon each share of the Series A-2 Stock then outstanding so that all outstanding shares of Series A-2 Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share of Series A-2 Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series A-2 Stock then outstanding).

 

(c)                       Series A-3 Stock .  The holders of shares of Series A-3 Stock shall be entitled to receive a per share dividend at the rate of 8% of the Series A-3 Original Purchase Price (as defined in Section B.8 hereof) per annum, compounding annually (the “ Series A-3 Accruing Dividend ”), and which will accrue on a quarterly basis commencing on the date of issuance of such share of Series A-3 Stock. The holders of Series A-3 Stock shall be entitled to receive dividends prior in right to the payment of dividends and other distributions (whether in cash, property or securities of the Corporation, including subscription or other rights to acquire securities of the Corporation) on the Series A-4 Stock, Series A-5 Stock, Series A-6 Stock and Common Stock, but not with respect to the payment of the Series A-5 Special Accruing Dividend, as set forth below in Section B.3(d) below, which shall rank senior in payment to any dividends payable with respect to the Series A-3 Stock.  Any dividends with respect to the Series A-3 Stock shall be payable, at the sole discretion of the Board of Directors, in cash or the issuance of that number of shares of Common Stock equal to the quotient obtained by dividing (x) amount of such accrued and unpaid dividends thereon by (y) the then fair market value of a share of Common Stock, when, as and if declared or paid by the Board of Directors and, as accrued, on any Liquidation or Event of Sale. Dividends with respect to the Series A-3 Stock shall be payable in shares of Common Stock (calculated based upon the then effective Series A-3 Conversion Price), as accrued, upon the conversion of the Series A-3 Stock into Common Stock.  Whenever any dividend may be declared or paid on any share of Series A-3 Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series A-3 Stock then outstanding, so that all outstanding shares of Series A-3 Stock will participate equally with each other and ratably per share (calculated as provided in Section B.3(f) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series A-3 Stock then outstanding so that all outstanding shares of Series A-3 Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section B.3(f) hereof); or (ii) any shares of any other series of Preferred Stock (other than the Series A-1 Accruing Dividend, the Series A-2 Accruing Dividend and the Series A-5 Special Accruing Dividend), the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series A-3 Stock then outstanding so that all outstanding shares of Series A-3 Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share of Series A-3 Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series A-3 Stock then outstanding).

 

(d)                      Series A-5 Stock .  Without regard to the payment of the required dividends to the holders of Series A-1 Stock, Series A-2 Stock and Series A-3 Stock in accordance with Section B.3(a), (b) and (c), respectively, above, the holders of shares of the Series A-5 Stock shall be entitled to receive a per share dividend (the “ Series A-5 Special Accruing Dividend ”) that shall accrue and be paid in the form of Series A-6 Stock or other securities subject to and in accordance with the provisions of that certain Stock Issuance Agreement to which the Corporation and Nordic Bioscience Clinical Development VII A/S are party dated March 29, 2011 (the “ Stock Issuance Agreement ”). Whenever any dividend may be declared or paid on any shares of Series A-5 Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series A-5 Stock then

 

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outstanding, so that all outstanding shares of Series A-5 Stock will participate equally with each other and ratably per share (calculated as provided in Section B.3(f) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series A-5 Stock then outstanding so that all outstanding shares of Series A-5 Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section B.3(f) hereof); or (ii) any shares of any other series of Preferred Stock (other than the Series A-1 Accruing Dividend, the Series A-2 Accruing Dividend and the Series A-3 Accruing Dividend), the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series A-5 Stock then outstanding so that all outstanding shares of Series A-5 Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share of Series A-5 Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series A-5 Stock then outstanding).

 

(e)                       Series A-4 Stock and Series A-6 Stock .  Following payment in full of required dividends to the holders of Series A-1 Stock, Series A-2 Stock, Series A-3 and Series A-5 Stock or any other class or series of capital stock that is senior to or on parity with the any such series of Preferred Stock as to dividends, in accordance with Sections B.3(a), (b), (c) or (d) above or any other section of this Certificate as in effect from time to time, the holders of shares of the Series A-4 Stock and Series A-6 Stock shall be entitled to receive, when, if and as declared by the Board of Directors, dividends on any shares of Series A-4 Stock or Series A-6 Stock, as the case may be, out of funds legally available for that purpose, at a rate to be determined by the Board of Directors if and when they may so declare any dividend on the Series A-4 Stock or A-6 Stock, as the case may be.  Whenever any dividend may be declared or paid on any shares of Series A-4 Stock or Series A-6 Stock, as applicable, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each other share of the Series A-4 Stock or the Series A-6 Stock, as applicable, then outstanding, so that all outstanding shares of Series A-4 Stock or Series A-6 Stock, as applicable, will participate equally with each other and ratably per share (calculated as provided in Section B.3(f) hereof).  Whenever any dividend or other distribution, whether in cash or property or in securities of the Corporation (or subscription or other rights to purchase or acquire securities of the Corporation), may be declared or paid on: (i) any shares of the Common Stock, the Board of Directors shall also declare and pay a dividend on the same terms, at the same rate and in like kind upon each share of the Series A-4 Stock and Series A-6 Stock then outstanding so that all outstanding shares of Series A-4 Stock and Series A-6 Stock will participate in such dividend ratably with such shares of Common Stock (calculated as provided in Section B.3(f) hereof); or (ii) any shares of any other series of Preferred Stock (other than the Series A-1 Accruing Dividend, the Series A-2 Accruing Dividend, the Series A-3 Accruing Dividend and the Series A-5 Special Accruing Dividend), the Board of Directors shall also declare and pay a dividend on the same terms, at the same or equivalent rate upon each share of the Series A-4 Stock and Series A-6 Stock then outstanding so that all outstanding shares of Series A-4 Stock and Series A-6 Stock will participate in such dividend ratably with such shares of such other series of Preferred Stock (based on the number of shares of Common Stock into which each share of Series A-4 Stock and Series A-6 Stock and each share of such other series of Preferred Stock is then convertible, if applicable, or, otherwise, the relative liquidation preference per share, of such other series of Preferred Stock as compared with the Series A-4 Stock and Series A-6 Stock then outstanding).

 

(f)                        In connection with any dividend declared or paid hereunder, each share of Preferred Stock shall be deemed to be that number of shares (including fractional shares) of Common Stock into which it is then convertible, rounded up to the nearest one-tenth of a share.  No fractional shares of capital stock shall be issued as a dividend hereunder. The Corporation shall pay a cash adjustment for any

 

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such fractional interest in an amount equal to the fair market value thereof on the last Business Day (as defined in Section B.8 hereof) immediately preceding the date for payment of dividends as determined by the Board of Directors in good faith.

 

4.               Liquidation Rights .

 

(a)                      As to rights upon any Liquidation or an Event of Sale, each share of Series A-1 Stock shall rank equally with each other share of Series A-1 Stock and senior to all shares of Series A-2 Stock, Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock; each share of Series A-2 Stock shall rank equally with each other share of Series A-2 Stock and senior to all shares of Series A-3 Stock, Series A-4 Stock, Series A-5 Stock and Series A-6 Stock; each share of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock shall rank equally with each other share of Series A-3 Stock, Series A-5 and Series A-6 Stock and senior to all shares of Series A-4 Stock and shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time, except as otherwise approved by the affirmative vote or consent of the New Senior Majority. Each share of Series A-4 Stock, shall rank equally with each other share of Series A-4 Stock and senior to all shares of Common Stock and all other classes or series of stock not authorized by this Certificate as of the Effective Time, except as otherwise approved by the affirmative vote or consent of the New Senior Majority.

 

(b)                      In the event of any liquidation, dissolution or winding-up of the affairs of the Corporation (collectively, a “ Liquidation ”): (i) the holders of shares of Series A-1 Stock then outstanding (the “ Series A-1 Stockholders ”) shall be entitled to receive, ratably with each other, out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the holders of Series A-2 Stock then outstanding (the “ Series A-2 Stockholders ”), Series A-3 Stock then outstanding (the “ Series A-3 Stockholders ”), Series A-4 Stock then outstanding (the “ Series A-4 Stockholders ”), Series A-5 Stock then outstanding (the “ Series A-5 Stockholders ”)  or Series A-6 Stock then outstanding (the “ Series A-6 Stockholders ” and collectively with the Series A-1 Stockholders, Series A-2 Stockholders, Series A-3 Stockholders, Series A-4 Stockholders and the Series A-5 Stockholders, the “ New Preferred Stockholders ”), or the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series A-1 Stock, an amount per share equal to the Series A-1 Original Purchase Price (as defined in Section B.8 hereof), plus an amount equal to any declared or accrued but unpaid dividends thereon, calculated pursuant to Section B.3(a) hereof; and (ii) after the distribution to the Series A-1 Stockholders, and any other class or series of capital stock that is senior to the Series A-2 Stock as to Liquidation, of the full amount to which they are entitled to receive pursuant to this Section B.4(b) or any other section of this Certificate as in effect from time to time, the Series A-2 Stockholders, shall be entitled to receive, ratably with each other, out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the Series A-3 Stockholders, the Series A-4 Stockholders, the Series A-5 Stockholders or the Series A-6 Stockholders, or the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series A-2 Stock, an amount per share equal to the Series A-2 Original Purchase Price (as defined in Section B.8 hereof), plus an amount equal to any declared or accrued but unpaid dividends thereon, calculated pursuant to Section B.3(b) hereof; (iii) after the distribution to the Series A-1 Stockholders, the Series A-2 Stockholders and holders of any other class or series of capital stock that is senior the Series A-3 Stock as to Liquidation, of the full amount to which they are entitled to receive pursuant to this Section B.4(b) or any other section of this Certificate as in effect from time to time, the Series A-3 Stockholders, the Series A-5 Stockholders, and the Series A-6 Stockholders shall be entitled to receive out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the Series A-4 Stockholders or the holders of Common Stock or any other class or series of stock ranking

 

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on Liquidation junior to such Series A-3 Stock, Series A-5, or Series A-6 Stock an amount per share equal to the Series A-3 Original Purchase Price (as defined in Section B.8 hereof), Series A-5 Original Purchase Price (as defined in Section B.8 hereof) or Series A-6 Original Purchase Price (as defined in Section B.8 hereof), respectively, plus an amount equal to any declared or accrued but unpaid dividends thereon, calculated pursuant to Section B.3 hereof; and (iv) after the distribution to the Series A-1 Stockholders, the Series A-2 Stockholders, the Series A-3 Stockholders, the Series A-5 Stockholders, the Series A-6 Stockholders and holders of any other class or series of capital stock that is senior to the Series A-4 Stock as to Liquidation, of the full amount to which they are entitled to receive pursuant to this Section B.4(b) or any other section of this Certificate as in effect from time to time, the Series A-4 Stockholders shall be entitled to receive out of the assets of the Corporation legally available for distribution to its stockholders, whether from capital, surplus or earnings, before any payment shall be made to the holders of Common Stock or any other class or series of stock ranking on Liquidation junior to such Series A-4 Stock an amount per share equal to the Series A-4 Original Purchase Price (as defined in Section B.8 hereof), plus an amount equal to any declared but unpaid dividends thereon, calculated pursuant to Section B.3 hereof.

 

(c)                       If, upon any Liquidation, the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series A-1 Stockholders the full amount to which each of them shall be entitled pursuant to Section A.4(b) above, then the Series A-1 Stockholders shall share ratably in any distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series A-1 Stock held upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(d)                      If, upon any Liquidation, the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series A-2 Stockholders the full amount to which each of them shall be entitled pursuant to Section B.4(b) above and to pay to the holders of any other class or series of capital stock that is on a parity with the Series A-2 Stock upon Liquidation the full amount to which each of such holders shall be entitled pursuant to Section B.4(b) or any other section of this Certificate as in effect from time to time, then the Series A-2 Stockholders and such holders shall share ratably in any distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series A-2 Stock and the shares of such other class or series of capital stock held upon such distribution if all amounts payable on or with respect to all of such shares were paid in full.

 

(e)                       If, upon any Liquidation, the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series A-3 Stockholders, the Series A-5 Stockholders and the Series A-6 Stockholders the full amount to which each of them shall be entitled pursuant to Section B.4(b) above and to pay to the holders of any other class or series of capital stock that is on a parity with the Series A-3, Series A-5 Stock and the Series A-6 Stock upon Liquidation the full amount to which each of such holders shall be entitled pursuant to Section B.4(b) or any other section of this Certificate as in effect from time to time, then the Series A-3 Stockholders, the Series A-5 Stockholders, the Series A-6 Stockholders and such holders shall share ratably in any distribution of assets according to the respective amounts which would be payable to them in respect of the shares of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock and the shares of such other class or series of capital stock, as the case may be, held upon such distribution if all amounts payable on or with respect to all of such shares were paid in full.

 

(f)                        If, upon any Liquidation, the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay the Series A-4 Stockholders the full amount to which each of them shall be entitled pursuant to Section B.4(b) above and to pay to the holders of any other class or series of capital stock that is on a parity with the Series A-4 Stock upon Liquidation the full amount to which each of such holders shall be entitled pursuant to Section B.4(b) or any other section of this Certificate as in effect from time to time, then the Series A-4 Stockholders and such holders shall share ratably in any distribution of assets according to the respective amounts which would be payable to them in respect of the

 

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shares of Series A-4 Stock and the shares of such other class or series of capital stock held upon such distribution if all amounts payable on or with respect to all of such shares were paid in full.

 

(g)                       In the event of any Liquidation, after payment shall have been made to the New Preferred Stockholders of the full amount to which they shall be entitled pursuant to Section B.4(b) and to the holders of any class or series of capital stock that is senior to or on parity with the New Preferred Stock, or any series, thereof, as in effect from time to time, the holders of each other class or series of capital stock (other than Common Stock) ranking on Liquidation junior to the New Preferred Stock, but senior to the Common Stock, as a class, shall be entitled to receive an amount equal (and in like kind) to the aggregate preferential amount fixed for each such junior class or series of capital stock.  If, upon any Liquidation, after payment shall have been made to the New Preferred Stockholders of the full amount to which they shall be entitled pursuant to Section B.4(b), the assets of the Corporation available for distribution to its stockholders shall be insufficient to pay a class or series of capital stock (other than the Common Stock) junior to the New Preferred Stock the full amount to which they shall be entitled pursuant to the preceding sentence, the holders of such other class or series of capital stock shall share ratably, based upon the number of then outstanding shares of such other class or series of capital stock, in any remaining distribution of assets according to the respective preferential amounts fixed for such junior class or series of capital stock or which would be payable to them in respect of the shares held by them upon such distribution if all amounts payable on or with respect to such shares were paid in full.

 

(h)                      In the event of any Liquidation, after payments shall have been made first to the New Preferred Stockholders and to the holders of any class or series of capital stock that is senior to or on parity with the New Preferred Stock, or any series thereof, as in effect from time to time, and to the holders of class or series of capital stock that is junior to or on parity with the New Preferred Stock but senior to the Common Stock, of the full amount to which they each shall be entitled as aforesaid, the holders of Common Stock, as a class, shall be entitled to share ratably with the holders of Participating Preferred Stock as provided in the last sentence in this Section B.4(h)) in all remaining assets of the Corporation legally available for distribution to its stockholders.  For purposes of calculating the amount of any payment to be paid upon any such Liquidation pursuant to the participation feature described in this Section B.4(h), each share of such Participating Preferred Stock shall be deemed to be that number of shares (including fractional shares and any shares attributable to the payment of accrued and unpaid dividends upon conversion of such Participating Preferred Stock pursuant to Section B.7(b)) of Common Stock into which it is then convertible, rounded to the nearest one-tenth of a share.

 

(i)                          (i) In the event of and simultaneously with the closing of an Event of Sale, the Corporation shall, unless waived by the New Senior Majority or otherwise prevented by law, redeem all of the shares of New Preferred Stock then outstanding for a cash amount per share determined as set forth in Sections B.4(a) through (h) hereof (the “ Special Liquidation Price ,” said redemption being referred to herein as a “ Special Liquidation ”).  In the event the Event of Sale involves consideration that does not consist of cash, then the Special Liquidation Price may be paid with such consideration having a value equal to the Special Liquidation Price.  To the extent there is any cash consideration in connection with an Event of Sale, at the option of the New Senior Majority, the cash consideration will first (i) be applied to satisfy the Special Liquidation Price payable to the Series A-1 Stockholders and to the holders of any other class or series of capital stock that is senior to or on parity with the Series A-1 Stock as to Liquidation; and then (ii) be applied to satisfy the Special Liquidation Price payable to the holders of Series A-2 Stock and to the holders of any other class or series of capital stock that is junior to the Series A-1 Stock but senior to or on parity with the Series A-2 Stock as to Liquidation; and then (iii) be applied to satisfy the Special Liquidation Price payable to holders of Series A-3 Stock, Series A-5 Stock, Series A-6 Stock and any other class or series of capital stock that is junior to the Series A-2 Stock but senior to or on parity with the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock as to Liquidation (in relative proportion to the full liquidation preference the Series A-3 Stockholders, Series A-5 Stockholders, Series A-6 Stockholders and

 

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the holders of such other class or series of capital stock would have received had there been sufficient cash consideration to have paid their liquidation preference in full) and then (iv) be applied to satisfy the Special Liquidation Price payable to the holders of Series A-4 Stock and to the holders of any other class or series of capital stock that is junior to the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock but senior to or on parity with the Series A-4 Stock, in all cases, prior to the payment thereof to any other stockholders of the Corporation.  For all purposes of this Section B.4(i), the Special Liquidation Price shall be equal to that amount per share which would be received by each New Preferred Stockholder if, in connection with an Event of Sale, all the consideration paid in exchange for the assets or the shares of capital stock (as the case may be) of the Corporation were actually paid to and received by the Corporation and the Corporation were immediately thereafter liquidated and its assets distributed pursuant to Sections B.4(a) through (h) hereof.  To the extent that one or more redemptions (as described in Section B.5 hereof) and/or Special Liquidations are occurring concurrently, the Special Liquidation under this Section B.4(i) shall be deemed to occur first.  The date upon which the Special Liquidation shall occur is sometimes referred to herein as the “ Special Liquidation Date ”.

 

(ii)                                   In the absence of an applicable waiver pursuant to Section B.4(i) above, at any time on or after the Special Liquidation Date, a New Preferred Stockholder shall be entitled to receive the Special Liquidation Price for each such share of New Preferred Stock owned by such holder.  Subject to the provisions of Section B.4(i)(iii) hereof, payment of the Special Liquidation Price will be made to each such holder upon actual delivery to the Corporation or its transfer agent of the certificate of such holder representing such shares of New Preferred Stock, as the case may be, or an affidavit of loss as to the same.

 

(iii)                                If on the Special Liquidation Date less than all the shares of New Preferred Stock then outstanding may be legally redeemed by the Corporation, the Special Liquidation shall be made first as to the Series A-1 Stock (and any other class or series of capital stock that is senior to or on parity with the Series A-1 Stock as to Liquidation), pro rata with respect to such Series A-1 Stock  (or such other class or series of capital stock that is senior to or on parity with the Series A-1 Stock as to Liquidation) based upon the number of outstanding shares of Series A-1 Stock (or such other class or series of capital stock that is senior to or on parity with the Series A-1 Stock as to Liquidation) then owned by each such holder thereof until such holders are satisfied in full, and then to the Series A-2 Stock (and any other class or series of capital stock that is junior to the Series A-1 Stock but senior to or on parity with the Series A-2 Stock as to Liquidation), pro rata with respect to such Series A-2 Stock (or such other class or series of capital stock that is junior to the Series A-1 Stock but senior to or on parity with the Series A-2 Stock as to Liquidation) based upon the number of outstanding shares of Series A-2 Stock (or such other class or series of capital stock that is junior to the Series A-1 Stock but senior to or on parity with the Series A-2 Stock as to Liquidation) then owned by each such holder thereof until such holders are satisfied in full, and then to the holders of the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock (and any other class or series of capital stock that is junior to the Series A-2 Stock but senior to or on parity with the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock as to Liquidation), pro rata with respect to such Series A-3, Stock Series A-5 Stock and Series A-6 Stock (or such other class or series of capital stock that is junior to the Series A-2 Stock but senior to or on parity with the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock as to Liquidation) based upon the number of outstanding shares of Series A-3 Stock, Series A-5 Stock and Series A-6 Stock (or such other class or series of capital stock that is junior to the Series A-2 Stock but senior to or on parity with the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock as to Liquidation) then owned by each holder thereof, and then to the Series A-4 Stock (and any other class or series of capital stock that is junior to the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock but senior to or on parity with the Series A-4 Stock as to Liquidation), pro rata with respect to such Series A-4 Stock (or such other class or series of capital stock that is junior to the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock but senior to or on parity with the Series A-4 Stock as to Liquidation) based upon the number of outstanding shares of Series A-4 Stock (or such other

 

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class or series of capital stock that is junior to the Series A-3 Stock, Series A-5 Stock and Series A-6 Stock but senior to or on parity with the Series A-4 Stock as to Liquidation) then owned by each such holder thereof until such holders are satisfied in full.

 

(iv)                               On and after any Special Liquidation Date, all rights in respect of the shares of New Preferred Stock to be redeemed shall cease and terminate except the right to receive the applicable Special Liquidation Price as provided herein, and such shares of New Preferred Stock shall no longer be deemed to be outstanding, whether or not the certificates representing such shares of New Preferred Stock have been received by the Corporation; provided , however , that, if the Corporation defaults in the payment of the Special Liquidation Price with respect to any New Preferred Stock, the rights of the holder(s) thereof with respect to such shares of New Preferred Stock shall continue until the Corporation cures such default.

 

(v)                                  Anything contained herein to the contrary notwithstanding, all or any of the provisions of this Section B.4(i) may be waived by the New Senior Majority, by delivery of written notice of waiver to the Corporation prior to the closing of any Event of Sale.

 

(vi)                               Any notice required to be given to the holders of shares of New Preferred Stock pursuant to Section B.7(g) hereof in connection with an Event of Sale shall include a statement by the Corporation of (A) the Special Liquidation Price which each New Preferred Stockholder shall be entitled to receive upon the occurrence of a Special Liquidation under this Section B.4(i) and (B) the extent to which the Corporation will, if at all, be legally prohibited from paying each holder of New Preferred Stock the Special Liquidation Price.

 

5.               Definition of “Event of Sale” and “Shell Company Successor ”.  For purposes of this Part B of Article III, an “ Event of Sale ” shall mean: (A) the sale by the stockholders of voting control of the Corporation, (B) the merger, consolidation or reorganization with or into any other corporation, entity or person or any other corporate reorganization, in which (I) the capital stock of the Corporation immediately prior to such merger, consolidation or reorganization represents less than 50% of the voting power of the surviving entity (or, if the surviving entity is a wholly owned subsidiary, its parent) immediately after such merger, consolidation or reorganization or (II) the surviving entity (or, if the surviving entity is a wholly owned subsidiary, its parent) has a class of securities that is (or has been within 90 days prior to such transaction) tradeable on any public market or exchange or (C) the sale, exclusive license or other disposition of all or substantially all of the assets or intellectual property of the Corporation in a single transaction or series of related transactions. Notwithstanding the foregoing and for purposes of clarification, the term “Event of Sale” shall not include any transaction involving the Corporation and the Shell Company Successor that is described in clause (iii) of the Shell Company Successor definition set forth below. “ Shell Company Successor ” means a shell company that (i) has securities registered under the Securities Exchange Act of 1934, as amended, (ii) has nominal operations and nominal assets (prior to any of the transactions described in clause (iii)) and (iii) directly or indirectly through one or more direct or indirect subsidiaries acquires the Corporation and/or all or substantially all of its assets or business (whether pursuant to a stock purchase, an asset purchase, a merger or any other similar transaction), and in consideration for such acquisition issues to the former stockholders of the Corporation shares of capital stock of such shell company.

 

6.               Voting .

 

(a)                      Subject to any separate voting rights provided for herein or otherwise required by law, the holders of New Preferred Stock shall be entitled to vote, together with the holders of Common Stock as one class, on all matters as to which holders of Common Stock shall be entitled to vote, in the same manner and with the same effect as such holders of Common Stock.  In any such vote, each share of

 

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New Preferred Stock shall entitle the holder thereof to the number of votes per share that equals the number of shares of Common Stock (including fractional shares) into which each such share of New Preferred Stock is then convertible, rounded up to the nearest one-tenth of a share, but not including any shares of Common Stock issuable upon conversion of any dividends accrued on such New Preferred Stock.

 

(b)                      In addition to the rights specified in Section B.6(a):

 

(i)                            for so long as any shares of Series A-1 Stock are outstanding, the holders of a majority of the shares of Series A-1 Stock outstanding, voting as a separate class, shall have the right to elect two (2) members of the Board of Directors of the Corporation; and

 

(ii)                         Oxford Bioscience Partners IV L.P. (including for this purpose, members of the Oxford/Saints Group (as defined in the Stockholders’ Agreement), HealthCare Ventures or Wellcome Trust (collectively, the “ G3 Holders ”) voting as a separate class shall have the right to elect one (1) member of the Board of Directors of the Corporation by majority vote of the shares of Series A-1 Stock held by them; provided, however, that in order to be eligible to vote or consent with respect to the election of such member of the Board of Directors, a G3 Holder together with members of such G3 Holders’ Group (as defined in the Stockholders’ Agreement) must hold greater than twenty percent (20%) of the shares of Series A-1 Stock purchased under the Series A-1 Stock Purchase Agreement by such G3 Holder and the members of such G3 Holders’ Group; and

 

(iii)                      MPM Capital L.P., voting as a separate class, shall have the right to elect one (1) member of the Board of Directors of the Corporation by majority vote of the shares of Series A-1 Stock held by MPM Capital L.P.; provided that such member of the Board of Directors shall be an individual with particular expertise in the development of pharmaceutical products; and, provided, further, that in order to be eligible to vote or consent with respect to the election of such member of the Board of Directors, MPM Capital L.P. together with members of the MPM Group (as defined in the Stockholders’ Agreement) must hold greater than twenty percent (20%) of the shares of Series A-1 Stock purchased under the Series A-1 Stock Purchase Agreement by MPM Capital L.P. and the members of the MPM Group.

 

(iv)                     The members of the Board of Directors elected by the Series A-1 Stockholders, the G3 Holders and MPM Capital L.P. pursuant to this Section B.6(b) are referred to herein as the “ New Preferred Directors ”.

 

(c)                       In any election of New Preferred Directors pursuant to Section B.6(b), each holder of New Preferred Stock eligible to participate in the election of New Preferred Directors shall be entitled to one vote for each share of Common Stock (including fractional shares) into which each such share of New Preferred Stock held by such holder is then convertible, rounded up to the nearest one-tenth of a share (determined as set forth in the second sentence of Section B.6(a) hereof), and no holder of New Preferred Stock shall be entitled to cumulate its votes by giving one candidate more than one vote per share.  The voting right of the Series A-1 Stockholders, the G3 Holders and the MPM Holder contained in Section B.6(b), may be exercised at a special meeting of the applicable holders of New Preferred Stock called as provided in accordance with the by-laws of the Corporation, at any annual or special meeting of the stockholders of the Corporation, or by written consent of such applicable holders of New Preferred Stock in lieu of a meeting.  The New Preferred Directors elected pursuant to Section B.6(b) shall serve from the date of their election and qualification until their successors have been duly elected and qualified.  The number of directors constituting the entire membership of the Board of Directors of the Corporation shall be set by the Board of Directors pursuant to the By-Laws of the Corporation.

 

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(d)                      A vacancy in the directorships elected by the Series A-1 Stockholders, the G3 Holders or the MPM Holder pursuant to Section B.6(b), may be filled by a vote at a meeting called in accordance with the by-laws of the Corporation or written consent in lieu of such meeting of the applicable holders of New Preferred Stock, respectively or by the remaining directors as provided in the by-laws of the Corporation.

 

(e)                       The holders of capital stock of the corporation, voting as a single class, shall elect the remaining member or members of the Board of Directors of the Corporation.  In any election of directors pursuant to this Section B.6(e), each stockholder shall be entitled to one vote for each share of Common Stock held or, if New Preferred Stock, into which each such share of New Preferred Stock is then convertible (determined in accordance with Section B.6(a) hereof), and no stockholder shall be entitled to cumulate its votes by giving one candidate more than one vote per share.  The voting right of the stockholders contained in this Section B.6(e) may be exercised at a special meeting of the stockholders called as provided in accordance with the by-laws of the Corporation, at any annual or special meeting of the stockholders of the Corporation, or by written consent of the stockholder in lieu of a meeting.  The director or directors elected pursuant to this Section B.6(e) shall serve from the date of their election and qualification until their successors have been duly elected and qualified.

 

(f)                        A vacancy in the directorship or directorships elected by the stockholders pursuant to Section B.6(e), may be filled by a vote at a meeting called in accordance with the by-laws of the Corporation or written consent in lieu of such meeting of the stockholders of the Corporation or by the remaining directors as provided in the by-laws of the Corporation.

 

(g)                       Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of the New Senior Majority acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each Series A-1 Stockholder, Series A-2 Stockholder and Series A-3 Stockholder to do the following:

 

(i)                                      authorize, create, designate, issue or sell any class or series of capital stock (including any shares of treasury stock) or rights, options, warrants or other securities convertible into or exercisable or exchangeable for capital stock which by its terms is convertible into or exchangeable for any equity security, other then Excluded Stock, which, as to the payment of dividends or distribution of assets, including without limitation distributions to be made upon a Liquidation, is senior to or on a parity with the Series A-1 Stock; or

 

(ii)                                                 amend, alter or repeal any provision of this Certificate; or

 

(iii)                                              permit, approve or agree to any Liquidation, Event of Sale, dissolution or winding up of the Corporation.

 

The foregoing approval shall be obtained in addition to any approval required by law.

 

(h)                      Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-1 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or

 

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by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-1 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-1 Stock in a manner that materially adversely affects the Series A-1 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-1 Stock. The foregoing approval shall be obtained in addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-1 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-1 Stock.

 

(i)                          Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-2 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-2 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-2 Stock in a manner that materially adversely affects the Series A-2 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-2 Stock. The foregoing approval shall be obtained in addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-2 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-2 Stock.

 

(j)                         Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-3 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-3 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-3 Stock in a manner that materially adversely affects the Series A-3 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-3 Stock. The foregoing approval shall be obtained in addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-3 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-3 Stock.

 

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(k)                      Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-4 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-4 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-4 Stock in a manner that materially adversely affects the Series A-4 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-4 Stock. The foregoing approval shall be obtained in addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-4 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-4 Stock.

 

(l)                          Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-5 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-5 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-5 Stock in a manner that materially adversely affects the Series A-5 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-5 Stock. The foregoing approval shall be obtained in addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-5 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-5 Stock.

 

(m)                  Except as otherwise expressed, implied or contemplated in this Certificate, the Series A-1 Purchase Agreement or the Merger Agreement, the Corporation shall not, directly or indirectly, through a merger, consolidation, reorganization or otherwise, without the affirmative approval of holders of a majority of the then outstanding shares of Series A-6 Stock, acting separately from the holders of Common Stock or any other securities of the Corporation, given by written consent in lieu of a meeting or by vote at a meeting called for such purpose, for which meeting or approval by written consent timely and specific notice in the manner provided in the by-laws of the Corporation shall have been given to each holder of such Series A-6 Stock, amend, alter or repeal any provision of this Certificate if such amendment, alteration or repeal would (i) alter or change the rights, preferences or privileges of the Series A-6 Stock in a manner that materially adversely affects the Series A-6 Stock and such amendment does not change or alter the comparable rights, preferences or privileges of any other series of New Preferred Stock in a manner that materially adversely affects such other series of New Preferred Stock or (ii) increases or decreases the authorized number of shares of Series A-6 Stock. The foregoing approval shall be obtained in

 

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addition to any approval required by law. For purposes of clarification, the creation, authorization or issuance of any new class or series of capital stock of the Corporation having rights, preferences or privileges senior to or on a parity with the Series A-6 Stock (and any amendment to the certificate of incorporation of the Company for purposes of creating or authorizing such new class or series of capital stock) shall not be deemed or treated as materially adversely affecting the Series A-6 Stock.

 

(n)                      The Corporation shall obtain the consent of the Board of Directors before it may authorize or issue any additional shares of capital stock of the Corporation or any of its subsidiaries.

 

7.               Conversion .

 

(a)                      Any New Preferred Stockholder shall have the right, at any time or from time to time, to convert any or all of its shares of New Preferred Stock into that number of fully paid and nonassessable shares of Common Stock for each share of New Preferred Stock so converted equal to the quotient of the Series A-1 Original Purchase Price, Series A-2 Original Purchase Price, Series A-3 Original Purchase Price, Series A-4 Original Purchase Price, Series A-6 Original Purchase Price or Series A-6 Original Purchase Price, as applicable, for such share divided by the Series A-1 Conversion Price, the Series A-2 Conversion Price, Series A-3 Conversion Price, Series A-4 Conversion Price, Series A-5 Conversion Price or the Series A-6 Conversion Price (each as defined in Section B.7(e)(i) hereof), as applicable, for such share of New Preferred Stock, as last adjusted and then in effect, rounded up to the nearest one-tenth of a share; provided , however , that cash shall be paid in lieu of the issuance of fractional shares of Common Stock, as provided in Section B.7(d) hereof.

 

(b)                      (i) Any New Preferred Stockholder who exercises the right to convert shares of New Preferred Stock into shares of Common Stock pursuant to this Section B.7 shall be entitled to payment of all accrued dividends, whether or not declared and all declared but unpaid dividends payable with respect to such New Preferred Stock pursuant to Section B.3 herein, up to and including the Conversion Date (as defined in Section B.7(b)(iii) hereof).

 

(ii)                                   Any New Preferred Stockholder may exercise the right to convert such shares into Common Stock pursuant to this Section B.7 by delivering to the Corporation during regular business hours, at the office of the Corporation or any transfer agent of the Corporation or at such other place as may be designated by the Corporation, the certificate or certificates for the shares to be converted (the “ New Preferred Certificate ”), duly endorsed or assigned in blank to the Corporation (if required by it) or an affidavit of loss as to the same.

 

(iii)                                Each New Preferred Certificate shall be accompanied by written notice stating that such holder elects to convert such shares and stating the name or names (with address) in which the certificate or certificates for the shares of Common Stock (the “ Common Certificate ”) are to be issued.  Such conversion shall be deemed to have been effected on the date when such delivery is made, and such date is referred to herein as the “ Conversion Date .”

 

(iv)                               As promptly as practicable thereafter, the Corporation shall issue and deliver to or upon the written order of such holder, at the place designated by such holder, (A) a Common Certificate for the number of full shares of Common Stock to which such holder is entitled and (B) a check or cash in respect of any fractional interest in shares of Common Stock to which such holder is entitled, as provided in Section B.7(d) hereof, payable with respect to the shares so converted up to and including the Conversion Date.

 

(v)                                  The person in whose name the Common Certificate or Certificates are to be issued shall be deemed to have become a holder of record of Common Stock on the applicable

 

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Conversion Date, unless the transfer books of the Corporation are closed on such Conversion Date, in which event the holder shall be deemed to have become the stockholder of record on the next succeeding date on which the transfer books are open, provided that the Series A-1 Conversion Price, the Series A-2 Conversion Price, Series A-3 Conversion Price, Series A-4 Conversion Price, the Series A-5 Conversion Price or the Series A-6 Conversion Price, as applicable, upon which the conversion shall be executed shall be that in effect on the Conversion Date.

 

(vi)                               Upon conversion of only a portion of the number of shares covered by a New Preferred Certificate, the Corporation shall issue and deliver to or upon the written order of the holder of such New Preferred Certificate, at the expense of the Corporation, a new certificate covering the number of shares of New Preferred Stock representing the unconverted portion of the New Preferred Certificate, which new certificate shall entitle the holder thereof to all the rights, powers and privileges of a holder of such New Preferred Stock.

 

(c)                       If a New Preferred Stockholder shall surrender more than one share of the same class of New Preferred Stock for conversion at any one time, then the number of full shares of Common Stock issuable upon conversion thereof shall be computed on the basis of the aggregate number of shares of New Preferred Stock so surrendered.

 

(d)                      No fractional shares of Common Stock shall be issued upon conversion of New Preferred Stock. The Corporation shall instead pay a cash adjustment for any such fractional interest in an amount equal to the Current Market Price thereof on the Conversion Date, as determined in accordance with Section B.7(e)(vi) hereof.

 

(e)                       For all purposes of this Article III, Part B, the initial conversion price of the Series A-1 Stock shall be the Series A-1 Original Purchase Price, the initial conversion price of the Series A-2 Stock shall be the Series A-2 Original Purchase Price,  the initial conversion price of the Series A-3 Stock shall be the Series A-3 Original Purchase Price, the initial conversion price of the Series A-4 Stock shall be the Series A-4 Original Purchase Price, the initial conversion price of the Series A-5 Stock shall be the Series A-5 Original Purchase Price, and the initial conversion price of the Series A-6 Stock shall be the Series A-6 Original Purchase Price, in each case subject to adjustment from time to time as follows (the conversion price of any or each of the Series A-1 Stock, the Series A-2 Stock, the Series A-3 Stock, the Series A-4 Stock, the Series A-5 Stock and the Series A-6 Stock is sometimes referred to generically in this Section B.7 as the “ Conversion Price ”):

 

(i)                                      Subject to Section B.7(e)(ii) and B.7(e)(x) below, if the Corporation shall, at any time or from time to time after the Series A-1 Original Issuance Date, issue or sell any shares of Common Stock (which term, for purposes of this Section B.7(e)(i), including all subsections thereof, shall be deemed to include all other securities convertible into, or exchangeable or exercisable for, shares of Common Stock (including, but not limited to, Preferred Stock) or options to purchase or other rights to subscribe for such convertible or exchangeable securities, in each case other than Excluded Stock (as defined in Section B.7(e)(ii) below), for a consideration per share less than the Series A-1 Conversion Price in effect immediately prior to the issuance of such Common Stock or other securities (a “ New Dilutive Issuance ”), then (X) the Conversion Price of the Series A-1 Stock (the “ Series A-1 Conversion Price ”) in effect immediately prior to each such New Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series A-1 Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at

 

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such Series A-1 Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of additional stock so issued, (Y) the Conversion Price for the Series A-2 Stock (the “ Series A-2 Conversion Price ”) in effect immediately prior to each such New Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series A-2 Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at such Series A-2 Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of additional stock so issued, and (Z) the Conversion Price for the Series A-3 Stock (the “ Series A-3 Conversion Price ”) in effect immediately prior to each such New Dilutive Issuance shall automatically be reduced to a price equal to the product obtained by multiplying such Series A-3 Conversion Price by a fraction, the numerator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of Common Stock that the aggregate consideration received by the Corporation for the additional stock so issued would purchase at such Series A-3 Conversion Price as in effect immediately prior to such issuance, and the denominator of which shall be the number of shares of Common Stock outstanding immediately prior to such issuance (including, without limitation, shares of Common Stock issued or issuable upon conversion of the outstanding Preferred Stock, but excluding shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock) plus the number of shares of additional stock so issued.  For purposes of this Section B.7(e)(i), the number of shares of Common Stock deemed issuable upon conversion of such outstanding shares of Existing Preferred Stock shall be determined without giving effect to any adjustments to the applicable Conversion Price resulting from the New Dilutive Issuance that is the subject of this calculation.  For purposes of Part B of this Certificate, the term “ Series A-4 Conversion Price ” shall mean the Conversion Price of the Series A-4 Stock, the term “ Series A-5 Conversion Price ” shall mean the Conversion Price of the Series A-5 Stock and the term “ Series A-6 Conversion Price ” shall mean the Conversion Price of the Series A-6 Stock.  For the purposes of any adjustment of the Conversion Price pursuant to this Section B.7(e)(i), the following provisions shall be applicable.

 

a.                                       In the case of the issuance of Common Stock in whole or in part for cash, the consideration shall be deemed to be the amount of cash paid therefor after deducting therefrom any discounts, commissions or other expenses allowed, paid or incurred by the Corporation for any underwriting or otherwise in connection with the issuance and sale thereof, plus the value of any property other than cash received by the Corporation, determined as provided in Section B.7(e)(i)(b) hereof, plus the value of any other consideration received by the Corporation determined as set forth in Section B.7(e)(i)(c) hereof.

 

b.                                       In the case of the issuance of Common Stock for a consideration in whole or in part in property other than cash, the value of such property other than cash shall be deemed to be the fair market value of such property as determined in good faith by the Board of

 

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Directors, irrespective of any accounting treatment; provided , however , that such fair market value of such property as determined by the Board of Directors shall not exceed the aggregate Current Market Price (as defined in Section B.7(e)(viii) hereof) of the shares of Common Stock or such other securities being issued, less any cash consideration paid for such shares, determined as provided in Section B.7(e)(i)(a) hereof and less any other consideration received by the Corporation for such shares, determined as set forth in Section B.7(e)(i)(c) hereof.

 

c.                                        In the case of the issuance of Common Stock for consideration in whole or in part other than cash or property, the value of such other consideration shall be deemed to be the aggregate par value of such Common Stock (or the aggregate stated value if such Common Stock has no par value).

 

d.                                       In the case of the issuance of options or other rights to purchase or subscribe for Common Stock or the issuance of securities by their terms convertible into or exchangeable or exercisable for Common Stock or options to purchase or other rights to subscribe for such convertible or exchangeable or exercisable securities:

 

i.                                           the aggregate maximum number of shares of Common Stock deliverable upon exercise of such options to purchase or rights to subscribe for Common Stock shall be deemed to have been issued at the time such options or rights were issued and for a consideration equal to the consideration (determined in the manner provided in Sections B.7(e)(i)(a), (b) and (c) hereof), if any, received by the Corporation upon the issuance of such options or rights plus the minimum purchase price provided in such options or rights for the Common Stock covered thereby (the consideration in each case to be determined in the manner provided in Sections B.7(e)(i)(a), (b) and (c) hereof);

 

ii.                                        the aggregate maximum number of shares of Common Stock deliverable upon conversion of, or in exchange for, any such convertible or exchangeable securities or upon the exercise of options to purchase or rights to subscribe for such convertible or exchangeable securities and subsequent conversion or exchange thereof shall be deemed to have been issued at the time such securities were issued or such options or rights were issued and for a consideration equal to the consideration received by the Corporation for any such securities and related options or rights (excluding any cash received on account of accrued interest or accrued dividends), plus the minimum additional consideration, if any, to be received by the Corporation upon the conversion or exchange of such securities or the exercise of any related options or rights (the consideration in each case to be determined in the manner provided in Sections B.7(e)(i)(a), (b) and (c) hereof);

 

iii.                                     if there is any change (whether automatic pursuant to the terms contained therein or as a result of the amendment of such terms) in the exercise price of, or number of shares deliverable upon exercise of, any such options or rights or upon the conversion or exchange of any such convertible or exchangeable securities (other than a change resulting from the original antidilution provisions thereof in place at the time of issuance of such security), then the applicable Conversion Price shall automatically be readjusted in proportion to such change (notwithstanding the foregoing, no adjustment pursuant to this clause shall have the effect of increasing the applicable Conversion Price to an amount which exceeds the lower of (i) the applicable Conversion Price on the original adjustment date, or (ii) the applicable Conversion Price that would have resulted from any Dilutive Issuances between the original adjustment date and such readjustment date);

 

iv.                                    upon the expiration of any such options or rights or the termination of any such rights to convert or exchange such convertible or exchangeable securities (or in the event that the change that precipitated an adjustment pursuant to Section

 

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B.7(e)(i)(d)(iii) hereof is reversed or terminated, or expires), then the applicable Conversion Price shall be automatically readjusted to the applicable Conversion Price that would have been obtained had such options, rights or convertible or exchangeable securities not been issued; and

 

v.                                       if the terms of any option or convertible security (excluding options or convertible securities which, upon exercise, conversion or exchange thereof, would entitle the holder thereof to receive shares of Common Stock which are Excluded Stock), the issuance of which was not a New Dilutive Issuance, are revised after the Series A-1 Original Issuance Date (either automatically pursuant the provisions contained therein or as a result of an amendment to such terms) to provide for either (1) any increase in the number of shares of Common Stock issuable upon the exercise, conversion or exchange of any such option or convertible security or (2) any decrease in the consideration payable to the Corporation upon such exercise, conversion or exchange, then such option or convertible security, as so amended, and the shares of Common Stock subject thereto shall be deemed to have been issued effective upon such increase or decrease becoming effective.

 

(ii)                                   Excluded Stock ” shall mean:

 

a.                                       Common Stock issued upon conversion of any shares of Preferred Stock, including any shares of Common Stock issuable upon conversion of any dividends accrued on such Preferred Stock;

 

b.                                       Common Stock issued or issuable to officers, directors or employees of or consultants or independent contractors to the Corporation, pursuant to any written agreement, plan or arrangement to purchase, or rights to subscribe for, such Common Stock, including Common Stock issued under the Corporation’s 2003 Long-Term Incentive Plan, as amended, or other equity incentive plan or other agreements that have been approved in form and in substance by the New Senior Majority, calculated in accordance with Section B.6(a) of Article III herein (including, in such calculation, any outstanding restricted stock awards held by such holders), and which, as a condition precedent to the issuance of such shares, provide for the vesting of such shares and subject such shares to restrictions on transfer and rights of first offer in favor of the Corporation, and restricted stock grants to directors, employees or consultants as approved by the Board of Directors of the Corporation; provided , however , that the maximum number of shares of Common Stock heretofore or hereafter issuable pursuant to the Corporation’s 2003 Long-Term Incentive Plan, as amended, and all such agreements, plans and arrangements shall not exceed 2,015,666 shares of Common Stock;

 

c.                                        Common Stock issued as a stock dividend or distribution on the Preferred Stock payable in shares of Common Stock, or capital stock of any other class issuable upon any subdivision, recombination, split-up or reverse stock split of all the outstanding shares of such class of capital stock;

 

d.                                       Common Stock or other securities issued or issuable to banks, lenders or landlords, provided that each such issuance is approved by the Board of Directors, including, but not limited to, warrants to acquire Common Stock held by Silicon Valley Bank (or its affiliates, successors and assignees), warrants to purchase Preferred Stock issued or to be issued to GE Healthcare Financial Services, Inc. (“ GEHFS ”) and Oxford Finance Corporation (“ OFC ”) pursuant to a proposed debt financing approved by the Board of Directors (the “ GE Financing ”), shares of Preferred Stock issued or issuable to GE in connection with the GE Financing or upon exercise by GEHFS or OFC of warrants issued in the GE Financing and shares of common stock issuable upon conversion of any such shares of Preferred Stock issued to GEHFS or OFC pursuant to the GE Financing;

 

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e.                                        Common Stock or other securities issued or issuable to third parties in connection with strategic partnerships or alliances, corporate partnerships, joint ventures or other licensing transactions, provided that each such transaction and related issuance is approved by the Board of Directors, including, but not limited to, (A) any shares of Preferred Stock or Common Stock issued or issuable to Ipsen Pharma SAS (“ Ipsen ”), pursuant to the terms of that certain License Agreement, as amended and may be amended with the approval of the Board of Directors of the Corporation and in effect from time to time, by and between the Corporation and Ipsen as payment for milestones in lieu of cash payments and (B) shares of Series A-5 Stock issued or issuable pursuant to that certain Stock Issuance Agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience and the letter agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience, pursuant to which the Corporation will issue shares of the Corporation’s Series A-5 Convertible Preferred Stock, $0.01 par value per share and the issuance of Series A-6 Stock issued or to be issued as dividends on such Series A-5 Stock, and shares of Common Stock issuable upon conversion of any such shares of Series A-5 Stock and Series A-6 Stock;

 

f.                                         Common Stock or other securities issued or issuable pursuant to the acquisition by the Corporation of any other corporation, partnership, joint venture, trust or other entity by any merger, stock acquisition, reorganization, or purchase of substantially all assets or otherwise in which the Corporation or its stockholders of record immediately prior to the effective date of such transaction, directly or indirectly, own at least a majority of the voting power of the acquired entity or the resulting entity after such transaction, in each case so long as approved by the Board of Directors;

 

g.                                        Common Stock or other securities, the issuance of which is approved by the New Senior Majority, with such approval expressly waiving the application of the anti-dilution provisions of this Section B.7 as a result of such issuance;

 

h.                                       Preferred Stock or Common Stock issued or issuable pursuant to any warrant outstanding as of the date hereof or any warrant and any shares of Preferred Stock or common stock, or common stock issued upon exercise of any Preferred Stock, issued in connection with the Qualified Financing, including, but not limited to a warrant for shares of Series A-1 Preferred Stock issued or issuable to Leerink Swan, any shares of Preferred Stock or Common Stock upon exercise thereof and any Common Stock issuable upon conversion of such Preferred Stock issued upon exercise thereof; and

 

i.                                           All shares of New Preferred Stock and Common stock issued in connection with the Qualified Financing as provided in this Certificate and the Series A-1 Purchaser Agreement, and all shares of Common Stock issued or issuable upon conversion of any such shares of New Preferred Stock.

 

(iii)                                If the number of shares of Common Stock outstanding at any time after the Series A-1 Original Issuance Date (as defined in Section B.8) is increased by a stock dividend payable in shares of Common Stock or by a subdivision or split-up of shares of Common Stock, then, following the record date fixed for the determination of holders of Common Stock entitled to receive such stock dividend, subdivision or split-up, the applicable Conversion Price shall be appropriately decreased in the form of a Proportional Adjustment (as defined in Section B.8) so that the number of shares of Common Stock issuable on conversion of each share of New Preferred Stock shall be increased in proportion to such increase in outstanding shares.

 

(iv)                               If the number of shares of Common Stock outstanding at any time after the Series A-1 Original Issuance Date is decreased by a combination of the outstanding shares of Common Stock

 

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(other than pursuant to the Reverse Split), then, following the record date for such combination, the applicable Conversion Price shall be appropriately increased in the form of a Proportional Adjustment so that the number of shares of Common Stock issuable on conversion of each share of New Preferred Stock shall be decreased in proportion to such decrease in outstanding shares.

 

(v)                                  Except as otherwise contemplated in the Series A-1 Purchase Agreement, if at any time after the Series A-1 Original Issuance Date, the Corporation shall make or issue, or fix a record date for the determination of holders of Common Stock entitled to receive, a dividend or other distribution payable in securities of the Corporation (other than shares of Common Stock) or in cash or other property, then and in each such event provision shall be made so that the holders of the New Preferred Stock shall receive upon conversion thereof in addition to the number of shares of Common Stock receivable thereupon, the kind and amount of securities of the Corporation, cash or other property which they would have been entitled to receive had the New Preferred Stock been converted into Common Stock on the date of such event and had they thereafter, during the period from the date of such event to and including the conversion date, retained such securities receivable by them as aforesaid during such period, giving application to all adjustments called for during such period under this paragraph with respect to the rights of the holders of the New Preferred Stock; and provided further, however, that no such adjustment shall be made if the holders of New Preferred Stock simultaneously receive a dividend or other distribution of such securities, cash, or other property in an amount equal to the amount of such securities, cash, or other property as they would have received if all outstanding shares of New Preferred Stock had been converted into Common Stock on the date of such event.

 

(vi)                               Subject to the provisions of Section B.4(i) above, in the event, at any time after the Series A-1 Original Issuance Date, of any capital reorganization, or any reclassification of the capital stock of the Corporation (other than pursuant to the Reverse Split, other than as contemplated under this Certificate and the Series A-1 Purchase Agreement and other than a change in par value or from par value to no par value or from no par value to par value or as a result of a stock dividend or subdivision, split-up or combination of shares), or the consolidation or merger of the Corporation with or into another person (other than pursuant to the Merger Agreement and other than a consolidation or merger in which the Corporation is the continuing corporation and which does not result in any change in the powers, designations, preferences and rights, or the qualifications, limitations or restrictions, if any, of the capital stock of the Corporation) or of the sale or other disposition of all or substantially all the properties and assets of the Corporation in their entirety to any other person (any such transaction, an “ Extraordinary Transaction ”), then the Corporation shall provide appropriate adjustment in the form of a Proportional Adjustment to the applicable Conversion Price with respect to each share of New Preferred Stock outstanding after the effectiveness of such Extraordinary Transaction such that each share of New Preferred Stock outstanding immediately prior to the effectiveness of the Extraordinary Transaction shall be convertible into the kind and number of shares of stock or other securities or property of the Corporation, or of the corporation resulting from or surviving such Extraordinary Transaction, that a holder of the number of shares of Common Stock deliverable (immediately prior to the effectiveness of the Extraordinary Transaction) upon conversion of such share of New Preferred Stock would have been entitled to receive upon such Extraordinary Transaction. The provisions of this Section B.7(e)(vi) shall similarly apply to successive Extraordinary Transactions.

 

(vii)                            All calculations under this Section B.7(e) shall be made to the nearest one-tenth of a cent ($.001) or to the nearest one-tenth of a share, as the case may be.

 

(viii)                         For the purpose of any computation pursuant to Section B.7(d), Section B.3(a) hereof or this Section B.7(e), the “ Current Market Price ” at any date of one share of Common Stock shall be defined as the average of the daily closing prices for the 20 consecutive Business Days ending on the fifth (5th) Business Day before the day in question (as adjusted for any stock dividend, split-up,

 

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combination or reclassification that took effect during such 20 Business Day period), determined as follows:

 

a.                                       If the Common Stock is listed or admitted for trading on a national securities exchange, then the closing price for each day shall be the last reported sales price regular way or, in case no such reported sales took place on such day, the average of the last reported bid and asked prices regular way, in either case on the principal national securities exchange on which the Common Stock is listed or admitted to trading.

 

b.                                       If the Common Stock is not at the time listed or admitted for trading on any such exchange, then such price shall be equal to the last reported bid and asked prices on such day as reported by the NASD OTCBB or the National Quotation Bureau, Inc., or any similar reputable quotation and reporting service if such quotation is not reported by the NASD OTCBB or the National Quotation Bureau, Inc.

 

c.                                        If the Common Stock is not traded in such manner that the quotations referred to in this Section B.7(d)(viii) are available for the period required hereunder, then the Current Market Price shall be the fair market value of such share, as determined in good faith by a majority of the entire Board of Directors.

 

(ix)                               In any case in which the provisions of this Section B.7(e) shall require that an adjustment shall become effective immediately after a record date for an event, the Corporation may defer until the occurrence of such event (A) issuing to the holder of any shares of New Preferred Stock converted after such record date and before the occurrence of such event the additional shares of capital stock issuable upon such conversion by reason of the adjustment required by such event over and above the shares of capital stock issuable upon such conversion before giving effect to such adjustment, and (B) paying to such holder any cash amounts in lieu of fractional shares pursuant to Section B.7(d) hereof; provided , however , that the Corporation shall deliver to such holder a due bill or other appropriate instrument evidencing such holder’s right to receive such additional shares and such cash upon the occurrence of the event requiring such adjustment.

 

(x)                                  If a state of facts shall occur that, without being specifically controlled by the provisions of this Section B.7, would not fairly protect the conversion rights of the holders of the New Preferred Stock in accordance with the essential intent and principles of such provisions, then the Board of Directors shall make an adjustment in the application of such provisions, in accordance with such essential intent and principles, so as to protect such conversion rights.

 

(f)                        Whenever the applicable Conversion Price shall be adjusted as provided in Section B.7(e) hereof, the Corporation shall forthwith file and keep on record at the office of the Secretary of the Corporation and at the office of its transfer agent or at such other place as may be designated by the Corporation, a statement, signed by both its President or Chief Executive Officer and its Treasurer or Chief Financial Officer, showing in detail the facts requiring such adjustment and the applicable Conversion Price that shall be in effect after such adjustment. The Corporation shall also cause a copy of such statement to be sent by first-class, certified mail, return receipt requested, postage prepaid, to each New Preferred Stockholder at such holder’s address appearing on the Corporation’s records. Where appropriate, such copy shall be given in advance of any such adjustment and shall be included as part of a notice required to be mailed under the provisions of Section B.7(g) hereof.

 

(g)                       In the event the Corporation shall propose to take any action of the types described in Section B.7(e)(i), (iii), (iv) or (v) hereof, or any other Event of Sale, other then the transactions contemplated by the Series A-1 Purchase Agreement and the Merger Agreement, the Corporation shall give

 

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notice to each New Preferred Stockholder in the manner set forth in Section B.7(f) hereof, which notice shall specify the record date, if any, with respect to any such action and the date on which such action is to take place. Such notice shall also set forth such facts with respect thereto as shall be reasonably necessary to indicate the effect of such action (to the extent such effect may be known at the date of such notice) on the applicable Conversion Price with respect to the New Preferred Stock, and the number, kind or class of shares or other securities or property which shall be deliverable or purchasable upon each conversion of New Preferred Stock. In the case of any action (other than any action contemplated or required by the Series A-1 Purchase Agreement or Merger Agreement) that would require the fixing of a record date, such notice shall be given at least 20 days prior to the record date so fixed, and in the case of any other action, such notice shall be given at least 30 days prior to the taking of such proposed action.

 

(h)                      The Corporation shall pay all documentary, stamp or other transactional taxes attributable to the issuance or delivery of shares of capital stock of the Corporation upon conversion of any shares of New Preferred Stock; provided , however , that the Corporation shall not be required to pay any taxes which may be payable in respect of any transfer involved in the issuance or delivery of any certificate for such shares in a name other than that of the New Preferred Stockholder in respect of which such shares of New Preferred Stock are being issued.

 

(i)                          The Corporation shall reserve out of its authorized but unissued shares of Common Stock, solely for the purpose of effecting the conversion of the New Preferred Stock, sufficient shares of Common Stock to provide for the conversion of all outstanding shares of New Preferred Stock.

 

(j)                         All shares of Common Stock which may be issued in connection with the conversion provisions set forth herein will, upon issuance by the Corporation, be validly issued, fully paid and nonassessable, not subject to any preemptive or similar rights, and free from all taxes, liens or charges with respect thereto created or imposed by the Corporation.

 

8.               Definitions .  As used in this Part B of Article III of this Certificate, the following terms shall have the corresponding meanings:

 

Business Day ” shall mean any day other than a Saturday, Sunday or day on which banks are closed in the city and state where the principal executive office of the Corporation is located.

 

Series A-1 Original Issuance Date ” shall mean the date of issuance by the Corporation of the first share of Series A-1 Stock to be issued by the Corporation.

 

Series A-1 Original Purchase Price ” shall mean, with respect to the Series A-1 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series A-2 Original Purchase Price ” shall mean, with respect to the Series A-2 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series A-3 Original Purchase Price ” shall mean, with respect to the Series A-3 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

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Series A-4 Original Purchase Price ” shall mean, with respect to the Series A-4 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series A-5 Original Purchase Price ” shall mean, with respect to the Series A-5 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Series A-6 Original Purchase Price ” shall mean, with respect to the Series A-6 Stock and after giving effect to the Reverse Split, $8.142 per share, subject, for all purposes other than Section B.7 hereof (which provisions shall be applied in accordance with their own terms), to Proportional Adjustment.

 

Proportional Adjustment ” shall mean an adjustment made to the price of the Preferred Stock upon the occurrence of a stock split, reverse stock split, stock dividend, stock combination reclassification or other similar change with respect to such security, such that the price of one share of the New Preferred Stock before the occurrence of any such change shall equal the aggregate price of the share (or shares or fractional share) of such security (or any other security) received by the holder of the New Preferred Stock with respect thereto upon the effectiveness of such change.  Notwithstanding the foregoing, the Reverse Split shall not trigger or give rise to any Proportional Adjustment.

 

9.               Forced Conversion and Forfeiture Upon Failure to Perform Future Funding Obligations Pursuant to the Series A-1 Purchase Agreement .

 

(a)                      Trigger Event .  In the event that an Investor (as defined in the Series A-1 Purchase Agreement) does not timely and completely fulfill his, her or its Future Funding Obligations (as defined in the Series A-1 Purchase Agreement) in the Qualified Financing pursuant to the terms of Series A-1 Purchase Agreement, then (i) all shares of New Preferred Stock then held by such Investor shall automatically, and without any further action on the part of such Investor, be converted into shares of Common Stock at a rate of 1 share of Common Stock for every 10 shares of New Preferred Stock to be so converted and (ii) the Corporation shall have the right to repurchase and such holders shall be required to sell all shares of Common Stock issued upon conversion (either pursuant to the foregoing clause (i) or otherwise) of all Additional A-1 Preferred Stock (as defined in the Series A-1 Purchase Agreement), all Series A-2 Stock, all Series A-3 Stock and all Series A-4 Stock issued to such Investor pursuant to the Automatic Reclassification (as defined in the Series A-1 Purchase Agreement) (the “ Repurchased Shares ”) for a per share purchase price equal to the par value of such Repurchased Share and all such Repurchased Shares shall thereafter be cancelled by the Corporation and no longer be issued and outstanding shares of capital stock of the Corporation, in accordance with Section 4(e) of the Series A-1 Purchase Agreement and Section 9.(b) below. The conversion and repurchase of shares to the Corporation set forth in this Section 9.(a) is referred to as a “ Subsequent Closing Adjustment ”.

 

(b)                      Procedural Requirements .  Upon a Subsequent Closing Adjustment, each holder of shares of New Preferred Stock converted pursuant to Section B.9(a) shall be sent written notice of such Subsequent Closing Adjustment and the place designated for mandatory conversion of all such shares of New Preferred Stock and the repurchase of all Repurchased Shares.  Upon receipt of such notice, each holder of such shares of New Preferred Stock and Repurchased Shares shall surrender his, her or its certificate or certificates for all such shares (or, if such holder alleges that such certificate has been lost, stolen or destroyed, a lost certificate affidavit and agreement reasonably acceptable to the Corporation to

 

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indemnify the Corporation against any claim that may be made against the Corporation on account of the alleged loss, theft or destruction of such certificate) to the Corporation at the place designated in such notice. If so required by the Corporation, certificates surrendered for conversion or repurchase shall be endorsed or accompanied by written instrument or instruments of transfer, in form satisfactory to the Corporation, duly executed by the registered holder or by his, her or its attorney duly authorized in writing.  All rights with respect to the New Preferred Stock so converted or such Repurchased Shares to be repurchased, including the rights, if any, to receive notices and vote (other than as a holder of shares of Common Stock that are not Repurchased Shares), will terminate at the time of the failure to fulfill the obligations of any Closing (as defined in the Series A-1 Purchase Agreement) (notwithstanding the failure of the holder or holders thereof to surrender the certificates for such shares at or prior to such time), except only the rights of the holders thereof, upon surrender of their certificate or certificates therefor (or lost certificate affidavit and agreement), to receive the items provided for in the next sentence of this Section B.9(b).  As soon as practicable after the surrender of the certificate or certificates (or lost certificate affidavit and agreement) for New Preferred Stock so converted that is not included among the Repurchased Shares, the Corporation shall issue and deliver to such holder, or to his, her or its nominees, a certificate or certificates for the number of full shares of Common Stock issuable on such conversion in accordance with the provisions hereof, together with cash as provided in B.7(d) in lieu of any fraction of a share of Common Stock otherwise issuable upon such conversion and the payment of any declared but unpaid dividends on the shares of New Preferred Stock converted.  Such converted New Preferred Stock, together with all Repurchased Shares pursuant to B.9(a)(ii) shall be retired and cancelled and may not be reissued as shares of such series, and the Corporation may thereafter take such appropriate action (without the need for stockholder action) as may be necessary to reduce the authorized number of shares of New Preferred Stock and Common Stock accordingly.

 

10.                    Special Mandatory Conversion .

 

(a)                      Trigger Events .  Each share of New Preferred Stock shall be automatically converted into fully paid and non-assessable shares of Common Stock at the then-effective applicable Conversion Price in the event that (i) the New Senior Majority shall have elected to convert all shares of New Preferred Stock or (2) the Common Stock of the Corporation becomes listed for trading on a national securities exchange. Each of the conversions set forth in this Section B.10(a) is referred to as a “ Special Mandatory Conversion .”  All accrued but unpaid dividends on shares New Preferred Stock shall be paid, in cash or additional shares at the discretion of the Board of Directors, in connection with any Special Mandatory Conversion.

 

(b)                      Procedural Requirements .  Upon a Special Mandatory Conversion, each holder of shares of New Preferred Stock converted pursuant to Section B.10(a) shall be sent written notice of such Special Mandatory Conversion and the place designated for mandatory conversion of all shares of New Preferred Stock.  Upon receipt of such notice, each holder of such shares of New Preferred Stock shall surrender his, her or its certificate or certificates for all such shares (or, if such holder alleges that such certificate has been lost, stolen or destroyed, a lost certificate affidavit and agreement reasonably acceptable to the Corporation to indemnify the Corporation against any claim that may be made against the Corporation on account of the alleged loss, theft or destruction of such certificate) to the Corporation at the place designated in such notice. If so required by the Corporation, certificates surrendered for conversion shall be endorsed or accompanied by written instrument or instruments of transfer, in form satisfactory to the Corporation, duly executed by the registered holder or by his, her or its attorney duly authorized in writing.  All rights with respect to the New Preferred Stock so converted, including the rights, if any, to receive notices and vote (other than as a holder of Common Stock), will terminate at the time of the Special Mandatory Conversion (notwithstanding the failure of the holder or holders thereof to surrender the certificates for such shares at or prior to such time), except only the rights of the holders thereof, upon surrender of their certificate or certificates therefor (or lost certificate affidavit and agreement), to receive

 

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the items provided for in the next sentence of this Section B.10(b).  As soon as practicable after the Special Mandatory Conversion and the surrender of the certificate or certificates (or lost certificate affidavit and agreement) for New Preferred Stock so converted, the Corporation shall issue and deliver to such holder, or to his, her or its nominees, a certificate or certificates for the number of full shares of Common Stock issuable on such conversion in accordance with the provisions hereof, together with cash as provided in B.7(d) in lieu of any fraction of a share of Common Stock otherwise issuable upon such conversion and the payment of any declared but unpaid dividends on the shares of New Preferred Stock converted, and a new certificate for the number of shares, if any, of New Preferred Stock represented by such surrendered certificate and not converted pursuant to B.10(a).  Such converted New Preferred Stock shall be retired and cancelled and may not be reissued as shares of such series, and the Corporation may thereafter take such appropriate action (without the need for stockholder action) as may be necessary to reduce the authorized number of shares of New Preferred Stock accordingly.

 

(c)                       Duration of Section . This Section B.10 and the rights and obligations of the parties hereunder shall automatically terminate on the consummation of a Liquidation or an Event of Sale.

 

PART C. COMMON STOCK

 

1.               Designation and Amount .  The number of shares, powers, terms, conditions, designations, preferences and privileges, relative, participating, optional and other special rights, and qualifications, limitations and restrictions of the Common Stock shall be as set forth in this Part C of Article III of this Certificate.  The number of authorized shares of Common Stock shall initially be Thirty-four Million Eight Hundred Fifty-nine Thousand Nine Hundred Sixty-four (34,859,964) shares. Such authorized shares of Common Stock may be increased or decreased (but not below the combined number of shares thereof then outstanding and those reserved for issuance upon conversion of the Preferred Stock) by the affirmative vote of the holders of the majority of the stock of the Corporation entitled to vote, irrespective of the provisions of Section 242(b)(2) of the Delaware General Corporation Law.  The affirmative vote of the holders of shares of Common Stock, voting alone as a class, will not be required in connection therewith.

 

2.               Voting .  Except as provided in this Certificate or by applicable law, each Common Stockholder shall be entitled to one vote only for each share of Common Stock held of record on all matters as to which holders of Common Stock shall be entitled to vote, which voting rights shall not be cumulative.

 

3.               Other Rights .  Each share of Common Stock issued and outstanding shall be identical in all respects with each other such share, and no dividends shall be paid on any shares of Common Stock unless the same dividend is paid on all shares of Common Stock outstanding at the time of such payment. Except for and subject to those rights expressly granted to the holders of Preferred Stock and except as may be provided by the laws of the State of Delaware, the holders of Common Stock shall have all other rights of stockholders, including, without limitation, (a) the right to receive dividends, when and as declared by the Board of Directors, out of assets lawfully available therefor, and (b) in the event of any distribution of assets upon a Liquidation or Liquidation, after and subject to distribution to the holders of Preferred Stock and any other class or series of capital stock (other than the Common Stock) ranking senior to Common Stock of all amounts such class is entitled to receive pursuant to this Certificate, the right to receive ratably and equally, together with the holders of the Series A-1 Stock, Series A-2 Stock and Series A-3 Stock pursuant to this Certificate, all the remaining assets and funds of the Corporation.

 

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ARTICLE IV
Registered Agent

 

The address of its registered office in the State of Delaware is 2711 Centerville Road, Suite 400, Wilmington, Delaware 19808, New Castle County. The name of its registered agent at such address is: Corporation Service Company.

 

ARTICLE V
Board of Directors

 

The entire Board of Directors of the Corporation shall consist of seven (7) persons.  Unless and except to the extent that the by-laws of the Corporation otherwise require, the election of directors of the Corporation need not be by written ballot.

 

ARTICLE VI
By-laws

 

In furtherance and not in limitation of the powers conferred by the laws of the State of Delaware, the Board of Directors is expressly authorized to adopt, amend or repeal the by-laws of the Corporation subject to the provisions of Section A.6(f)(ix) of Article III hereof.

 

ARTICLE VII
Perpetual Existence

 

The Corporation is to have perpetual existence.

 

ARTICLE VIII
Amendments and Repeal

 

Except as otherwise specifically provided in this Certificate, the Corporation reserves the right at any time, and from time to time, to amend, alter, change or repeal any provision contained in this Certificate, and to add or insert other provisions authorized at such time by the laws of the State of Delaware, in the manner now or hereafter prescribed by law; and all rights, preferences and privileges of whatsoever nature conferred upon stockholders, directors or any other persons whomsoever by and pursuant to this Certificate in its present form or as hereafter amended are granted subject to the rights reserved in this Article VIII.

 

ARTICLE IX
Compromises and Arrangements

 

Whenever a compromise or arrangement is proposed between this Corporation and its creditors or any class of them and/or between this Corporation and its stockholders or any class of them, any court of equitable jurisdiction within the State of Delaware may, on the application in a summary way of this Corporation or of any creditor or stockholder thereof or on the application of any receiver or receivers appointed for this Corporation under the provisions of Section 291 of Title 8 of the DGCL or on the application of trustees in dissolution or of any receiver or receivers appointed for this Corporation under the provisions of Section 279 of Title 8 of the DGCL, order a meeting of the creditors or class of creditors, and/or of the stockholders or class of stockholders of this Corporation, as the case may be, which parties are to be summoned in such manner as the court directs.  If a majority in number representing three-fourths (3/4) in value of either the creditors or a class of creditors and/or of the stockholders or a class of stockholders of this Corporation, as the case may be, agree to any compromise

 

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or arrangement and to any reorganization of this Corporation as a consequence of such compromise or arrangement, said compromise or arrangement and said reorganization shall, if sanctioned by the court to which said application has been made, be binding on all the creditors or class of creditors and/or on all the stockholders or class of stockholders of this Corporation, as the case may be, and also on this Corporation.

 

ARTICLE X
Limitation of Liability

 

1.               The Corporation shall, to the fullest extent permitted by Section 145 of the DGCL, as the same may be amended and supplemented from time to time, indemnify and advance expenses to (i) its directors (including observers to the Board of Directors) and officers, and (ii) any person who at the request of the Corporation is or was serving as a director (including observers to the Board of Directors), officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise, from and against any and all of the expenses, liabilities, or other matters referred to in or covered by said section as amended or supplemented (or any successor thereto), provided , however , that except with respect to proceedings to enforce rights to indemnification, the by-laws of the Corporation may provide that the Corporation shall indemnify any director (including observers to the Board of Directors), officer or such person in connection with a proceeding (or part thereof) initiated by such director (including observers to the Board of Directors), officer or such person only if such proceeding (or part thereof) was authorized by the Board of Directors of the Corporation.  The Corporation, by action of its Board of Directors, may provide indemnification or advance expenses to employees and agents of the Corporation or other persons only on such terms and conditions and to the extent determined by the Board of Directors in its sole and absolute discretion.  The indemnification provided for herein shall not be deemed exclusive of any other rights to which those indemnified may be entitled under any by-law, agreement, vote of stockholders or disinterested directors or otherwise, both as to action in their official capacity and as to action in another capacity while holding such office.  The indemnification provided for herein shall continue as to a person who has ceased to be a director, officer, employee, or agent of the Corporation and shall inure to the benefit of the heirs, executors and administrators of such a person.

 

2.               No director (including observers to the Board of Directors) of this Corporation shall be personally liable to the Corporation or its stockholders for monetary damages for breach of fiduciary duty as a director, except to the extent that exemption from liability or limitation thereof is not permitted under the DGCL as in effect at the time such liability or limitation thereof is determined.  No amendment, modification or repeal of this Article X shall apply to or have any effect on the liability or alleged liability of any director of the Corporation for or with respect to any acts or omissions of such director occurring prior to such amendment, modification or repeal. If the DGCL is amended after approval by the stockholders of this Article to authorize corporate action further eliminating or limiting the personal liability of directors, then the liability of a director of the Corporation shall be eliminated or limited to the fullest extent permitted by the DGCL.

 

3.               The Corporation hereby renounces, to the fullest extent permitted by Section 122(17) of the DGCL, any interest or expectancy of the Corporation in, or in being offered an opportunity to participate in, any business opportunities that are presented to any of its directors who are not otherwise employed by the Corporation, other than business opportunities that are presented to any director acting solely and specifically in his or her capacity as a director of the Corporation.  No amendment or repeal of this Article shall apply to or have any effect on the liability or alleged liability of any such director for or with respect to any opportunities of which such director become aware prior to such amendment or repeal.

 

(remainder of this page intentionally left blank.)

 

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IN WITNESS WHEREOF, the undersigned has caused this Certificate to be duly executed on behalf of the Corporation on                                           , 2011.

 

 

RADIUS HEALTH, INC.

 

 

 

 

By:

 

 

Name: C. Richard Edmund Lyttle

 

Title:  Chief Executive Officer and President

 

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Exhibit B

 

Form of Stockholders’ Agreement

 

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FORM OF
AMENDED AND RESTATED
STOCKHOLDERS’ AGREEMENT

 

THIS AMENDED AND RESTATED STOCKHOLDERS’ AGREEMENT, dated this       day of May, 2011, is entered into by and among (i) Radius Health, Inc., a Delaware corporation (the “ Corporation ”), (ii) those common stockholders of the Corporation listed on Schedule 1 hereto (hereinafter referred to collectively as the “ Common Stockholders ”), (iii) those stockholders of the Corporation who hold Series A-1 Convertible Preferred Stock, par value $.01 per share (“ Series A-1 Preferred Stock ”), listed on Schedule 2 hereto (hereinafter referred to collectively as the “ Series A-1 Stockholders ”), (iv) those stockholders of the Corporation who hold Series A-2 Convertible Preferred Stock, par value $.01 per share (“ Series A-2 Preferred Stock ”), listed on Schedule 3 hereto (hereinafter referred to collectively as the “ Series A-2 Stockholders ”), (v) those stockholders of the Corporation who hold Series A-3 Convertible Preferred Stock, par value $.01 per share (“ Series A-3 Preferred Stock ”), listed on Schedule 4 hereto (hereinafter referred to collectively as the “ Series A-3 Stockholders ”), (vi) those stockholders of the Corporation who hold Series A-4 Convertible Preferred Stock, par value $.01 per share (“ Series A-4 Preferred Stock ”), listed on Schedule 5 hereto (hereinafter referred to collectively as the “ Series A-4 Stockholders ”), (vii) that certain stockholder of the Corporation who holds Series A-5 Convertible Preferred Stock, par value $.01 per share (“ Series A-5 Preferred Stock ”), listed on Schedule 6 hereto (hereinafter referred to as the “ Series A-5 Stockholder ”) and (viii) any person or entity that becomes a party hereto pursuant to Section 17 hereof or otherwise (the “ Additional Stockholders ”).

 

WITNESSETH:

 

WHEREAS, the Corporation and the Series A-1 Stockholders have entered into a Series A-1 Convertible Preferred Stock Purchase Agreement, dated the date hereof (the “ Stock Purchase Agreement ”), in connection with which the Corporation has agreed to sell shares Series A-1 Preferred Stock, and the Corporation desires to grant to the Series A-1 Stockholders certain registration and other rights with respect to such shares;

 

WHEREAS, the Corporation and certain of the other parties hereto entered into an Amended and Restated Stockholders’ Agreement, dated December 15, 2006, as amended by Amendment No. 1 to Amended and Restated Stockholders’ Agreement, dated February 22, 2007, Amendment No. 2 to Amended and Restated Stockholders’ Agreement, dated August 17, 2007, and Amendment No. 3 to Amended and Restated Stockholders’ Agreement, dated October 18, 2008 (as so amended, the “ Prior Agreement ”), which Prior Agreement the requisite persons desire to amend and restate in its entirety as set forth herein; and

 

WHEREAS, as a condition to Series A-1 Stockholders entering into the Stock Purchase Agreement, the Common Stockholders, Series A-2 Stockholders, Series A-3 Stockholders, Series A-4 Stockholders, Series A-5 Stockholder and Series A-6 Stockholder (as hereinafter defined) have agreed to certain restrictions on their rights to dispose of their shares of Common Stock (as hereinafter defined) and Preferred Stock (as hereinafter defined) as contained in this Agreement;

 

NOW, THEREFORE, in consideration of the foregoing and of the respective covenants and undertakings of the Corporation and the Stockholders hereunder and under the Stock Purchase Agreement, the parties hereto do hereby agree as follows:

 

SECTION 1.  Definitions . As used herein, the following terms shall have the following respective meanings:

 

Board shall mean the Board of Directors of the Corporation.

 

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BB Bio shall mean BB Biotech Ventures II, L.P. including any successor thereto or any assignee of the interest, in whole or in part, of BB Bio under this Agreement

 

BB Bio Group shall mean: (i) BB Bio; (ii) BB BIOTECH AG, (iii) any investment fund limited partnership now existing or hereafter formed which is affiliated with or under common control with one or more general partners of any general partner of any of the foregoing (a “ BB Bio Fund ”); (iv) any limited partners or affiliates of BB Bio or any other BB Bio Fund; and (v) any successors or assigns of any of the foregoing.

 

Brookside shall mean Brookside Capital Partners Fund L.P., a Delaware limited partnership, including any successor thereto or any assignee of the interest, in whole or in part, of Brookside Capital Partners Fund L.P. under this Agreement.

 

Brookside Group shall mean: (i) Brookside; (ii) any investment fund limited partnership now existing or hereafter formed which is affiliated with or under common control with one or more general partners of any general partner of Brookside (a “ Brookside Fund ”); (iii) any limited partners or affiliates of Brookside or any other Brookside Fund; and (iv) any successors or assigns of any of the foregoing.

 

Certificate shall mean the Fourth Amended and Restated Certificate of Incorporation of the Corporation and the certificate of incorporation of the Corporation’s successors and assigns, each as amended from time to time.

 

Commission shall mean the U.S. Securities and Exchange Commission.

 

Common Stock shall mean the Common Stock, par value $.01 per share, of the Corporation.

 

Effectiveness Date means, with respect to the Registration Statement required to be filed under Section 3.4(a), the 90th calendar day following the Closing Date; provided , however , that, if the Commission reviews and has written comments to the filed Registration Statement, then the Effectiveness Date shall be the 180th calendar day following the Closing Date; provided further , however , that in the event the Corporation is notified by the Commission that the Registration Statement will not be reviewed or is no longer subject to further review and comments, the Effectiveness Date shall be the fifth Trading Day following the date on which the Corporation is so notified if such date precedes the dates required above; provided further , however , that if the Effectiveness Date falls on a Saturday, Sunday or other day on which the Commission is not open for business, then the Effectiveness Date shall be extended to the next day on which the Commission is open for business.

 

Effectiveness Period shall have the meaning set forth in Section 3.4(a) hereof.

 

Equity Percentage shall mean, as to any Series A-1 Stockholder or Other Preferred Stockholder, as applicable, that percentage figure which expresses the ratio that (a) the number of shares of issued and outstanding Common Stock then owned by such Series A-1 Stockholder or Other Preferred Stockholder bears to (b) the aggregate number of shares of issued and outstanding Common Stock then owned by all Series A-1 Stockholders and Other Preferred Stockholders. For purposes solely of the computation set forth in clauses (a) and (b) above and the right of oversubscription (as set forth in Section 2.3(d)), all issued and outstanding securities held by the Series A-1 Stockholders and Other Preferred Stockholders that are convertible into or exercisable or exchangeable for shares of Common Stock (including any issued and issuable shares of Preferred Stock) or for any such convertible, exercisable or exchangeable securities, shall be treated as having been so converted, exercised or exchanged at the rate

 

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or price at which such securities are convertible, exercisable or exchangeable for shares of Common Stock in effect at the time in question (which, for purposes of Section 2.3 of this Agreement, shall be at the time of delivery by the Corporation of the notice of the Offer contemplated by Section 2.3(b)), whether or not such securities are at such time immediately convertible, exercisable or exchangeable.

 

Event shall have the meaning set forth in Section 3.4(b) hereof.

 

Event Date shall have the meaning set forth in Section 3.4(b) hereof.

 

Exchange Act shall mean the Securities Exchange Act of 1934, as amended.

 

Exchange Act Registration Statement shall have the meaning set forth in Section 2.5 hereof.

 

Excess Securities shall have the meaning set forth in Section 2.3(d) hereof.

 

Excess Securities Notice shall have the meaning set forth in Section 2.3(d) hereof.

 

Excess Securities Period shall have the meaning set forth in Section 2.3(d) hereof.

 

Excluded Forms shall have the meaning given such term in Section 3.5 hereof.

 

Excluded Securities shall mean, collectively:

 

(i)             the Reserved Shares:

 

(ii)            Common Stock issued or issuable to officers, directors or employees of or consultants or independent contractors to the Corporation, pursuant to any written agreement, plan or arrangement, including pursuant to any options granted under the 2003 Long-Term Incentive Plan, as amended, of the Corporation, to purchase, or rights to subscribe for, such Common Stock, that has been approved in form and in substance by the holders of a majority of the voting power of the Series A-1 Preferred Stock then outstanding, calculated in accordance with Section A.6(a) of Article III of the Certificate, and which, as a condition precedent to the issuance of such shares, provides for the vesting of such shares and subjects such shares to restrictions on Transfers and rights of first offer in favor of the Corporation; provided , however , that the maximum number of shares of Common Stock heretofore or hereafter issuable pursuant to the 2003 Long-Term Incentive Plan, as amended, and all such agreements, plans and arrangements shall not exceed 2,015,666 shares of Common Stock;

 

(iii)           Common Stock issued as a stock dividend payable in shares of Common Stock, or capital stock of any class issuable upon any subdivision, recombination, split-up or reverse stock split of all the outstanding shares of such class of capital stock of the Corporation;

 

(iv)           Common Stock or other securities issued or issuable pursuant to the acquisition by the Corporation of any other corporation, partnership, joint venture, trust or other entity by any merger, stock acquisition, reorganization, purchase of substantially all assets or otherwise in which the Corporation, or its stockholders of record immediately prior to the effective date of such transaction, directly or indirectly, own at least a majority of the voting power of the acquired entity or the resulting entity after such transaction, in each case so long as such transaction is approved by the Board of Directors;

 

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(v)            Common Stock or other securities issued or issuable to banks, lenders or landlords, provided that each such issuance is approved by the Board of Directors, including, but not limited to, warrants to acquire Common Stock held by Silicon Valley Bank (or its affiliates, successors and assignees), warrants to purchase Preferred Stock issued or to be issued to GE Healthcare Financial Services, Inc. (“ GEHFS ”) and Oxford Finance Corporation (“ OFC ”) pursuant to a proposed debt financing approved by the Board of Directors (the “ GE Financing ”), shares of Preferred Stock issued or issuable to GE in connection with the GE Financing or upon exercise by GEHFS or OFC of warrants issued in the GE Financing and shares of common stock issuable upon conversion of any such shares of Preferred Stock issued to GEHFS or OFC pursuant to the GE Financing;

 

(vi)           Common Stock or other securities issued or issuable to third parties in connection with strategic partnerships or alliances, corporate partnerships, joint ventures or other licensing transactions, provided that each such transaction and related issuance is approved by the Board of Directors, including, but not limited to, (A) any shares of Preferred Stock or Common Stock issued or issuable to Ipsen Pharma SAS (“ Ipsen ”), pursuant to the terms of that certain License Agreement, as amended and may be amended with the approval of the Board of Directors of the Corporation and in effect from time to time, by and between the Corporation and Ipsen as payment milestones in lieu of cash payments and (B) shares of Series A-5 Stock issued or issuable pursuant to that certain Stock Issuance Agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience and the letter agreement as of March 29, 2011 by and between the Corporation and Nordic Bioscience, pursuant to which the Corporation will issue shares of the Corporation’s Series A-5 Convertible Preferred Stock, $0.01 par value per share and the issuance of Series A-6 Stock issued or to be issued as dividends on such Series A-5 Stock, and shares of Common Stock issuable upon conversion of any such shares of Series A-5 Stock and Series A-6 Stock;

 

(vii)          Common Stock or other securities, the issuance of which is approved by the Majority Investors, with such approval expressly waiving the application of the anti-dilution or right of first refusal provisions of the Agreement as a result of such issuance;

 

(viii)         Preferred Stock or Common Stock issued or issuable pursuant to any warrant outstanding as of the date hereof or any warrant and any shares of Preferred Stock or common stock, or common stock issued upon exercise of any Preferred Stock, issued in connection with the Qualified Financing, including, but not limited to a warrant for shares of Series A-1 Preferred Stock issued or issuable to Leerink Swan, any shares of Preferred Stock or Common Stock upon exercise thereof and any Common Stock issuable upon conversion of such Preferred Stock issued upon exercise thereof; and

 

(ix)           All shares of Preferred Stock and Common Stock issued pursuant to the Stock Purchase Agreement and related recapitalization, as the same may be amended from time to time by the parties thereto in accordance with its terms, and all shares of Common Stock issued or issuable upon conversion of any such shares of Preferred Stock.

 

Filing Date means, with respect to the Registration Statement required to be filed under Section 3.4, the 60th calendar day following the date of consummation of the Merger; provided , however , that if the Filing Date falls on a Saturday, Sunday or other day on which the Commission is not open for business, then the Filing Date shall be extended to the next day on which the Commission is open for business.

 

FINRA shall have the meaning set forth in Section 3.4(b)(viii) hereof.

 

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Group shall mean: (i) as to any Stockholder that is a corporation or other entity, any and all of the venture capital limited partnerships or corporations now existing or hereafter formed that are affiliated with or under common control with one or more of the controlling stockholders of such Stockholder and any predecessor or successor thereto; (ii) in the case of any member of the HCV Group, any other member of the HCV Group; (iii) in the case of any member of the MPM Group, any other member of the MPM Group; (iv) in the case of any member of the Brookside Group, any other member of the Brookside Group; (v) in the case of any member of the Oxford/Saints Group, any other member of the Oxford/Saints Group; (vi) in the case of any member of the BB Bio, any other member of the BB Bio Group and (vi) in the case of Wellcome, any successor trustee of the Wellcome Trust or additional trustee or trustees of the Wellcome Trust from time to time, or any company whose shares are all held directly or indirectly by the Wellcome Trust, or any nominee or custodian of any such person.

 

HCV Group shall mean: (i) HCV VII; (ii) any venture capital limited partnership now existing or hereafter formed which is affiliated with or under common control with one or more general partners of any general partner of HCV VII (an “ HCV Fund ”); (iii) any limited partners or affiliates of HCV VII or any other HCV Fund; and (iv) any successors or assigns of any of the foregoing.

 

HCV VII shall mean HealthCare Ventures VII, L.P. a Delaware limited partnership, including any successor thereto or any assignee of the interest, in whole or in part, of HCV VII under this Agreement.

 

Holder or Holders means the holder or holders, as the case may be, from time to time of Registrable Securities.

 

Independent Directors shall have the meaning set forth in Section 4.1(b) hereof.

 

Industry Expert Director shall have the meaning set forth in Section 4.1(b) hereof.

 

Investor Directors shall have the meaning set forth in Section 4.1(b) hereof.

 

Investors shall mean each of the persons listed on Schedule 2 hereto, severally, but not jointly and severally.

 

Issuer Filing shall have the meaning set forth in Section 3.4(g) hereof.

 

Majority Investors shall mean the holders of a majority of the voting power of the Series A-1 Preferred Stock, Series A-2 Preferred Stock and Series A-3 Preferred Stock then outstanding, voting together as a single class, calculated in accordance with Section A.6 of Article III of the Certificate (including, in such calculation, any shares issued upon conversion of such Series A-1 Preferred Stock, Series A-2 Preferred Stock and Series A-3 Preferred Stock then outstanding).

 

Merger shall have the meaning ascribed thereto in the Stock Purchase Agreement.

 

MPM shall mean MPM Capital L.P.

 

MPM Group shall mean (i) MPM BioVentures III, L.P., (ii) MPM BioVentures III QP. L.P., (iii) MPM BioVentures III GmbH & Co. Beteiligungs KG, (iv) MPM BioVentures III Parallel Fund, L.P., (v) MPM Asset Management Investors 2003 VIII LLC, (vi) MPM Bio IV NVS Strategic Fund, L.P., (vii) any other venture capital limited partnership now existing or hereafter formed which is affiliated with or under common control with the foregoing or one or more general partners of the foregoing, and (viii) any successors or assigns of the foregoing.

 

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Notice of Acceptance shall have the meaning set forth in Section 2.3(c) hereof.

 

Offer shall have the meaning set forth in Section 2.3(b) hereof.

 

Offered Securities shall mean, except for Excluded Securities, (i) any shares of Common Stock, Preferred Stock or any other equity security of the Corporation, (ii) any debt security, (iii) any capitalized lease with any equity feature with respect to the Corporation, or (iv) any option, warrant or other right to subscribe for, purchase or otherwise acquire any such equity security, debt security or capitalized lease.

 

Option Shares shall mean the 2003 Plan Option Shares as defined in Section 5.2(a)(i)(3) of the Stock Purchase Agreement.

 

Other Preferred Stockholder shall mean any holder of shares of Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock or Series A-6 Preferred Stock.

 

Other Shares shall have the meaning set forth in Section 3.5(e) hereof.

 

Oxford shall mean Oxford Bioscience Partners IV L.P., until such time as such entity shall have transferred all of its Common Stock and Preferred Stock to OBP IV — Holdings LLC, at which time “Oxford” shall mean OBP IV — Holdings LLC.

 

Oxford/Saints Group shall mean (i) Oxford Bioscience Partners IV L.P., (ii) mRNA Fund II L.P., (iii) OBP IV — Holdings LLC, (iv) mRNA II — Holdings LLC, (v) Saints Capital VI, L.P., (vi) any other venture capital limited partnership now existing or hereafter formed which is affiliated with or under common control with the foregoing or one or more general partners of the foregoing, and (vii) any successors or assigns of the foregoing.

 

Person (whether or not capitalized) means an individual, corporation, partnership, limited partnership, limited liability company, syndicate, trust, association or entity or government, political subdivision, agency or instrumentality of a government.

 

Plan of Distribution shall have the meaning set forth in Section 3.4(a) hereof.

 

Preferred Shares shall mean shares of Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock, Series A-4 Preferred Stock, Series A-5 Preferred Stock and shares of the Corporation’s Series A-6 Convertible Preferred Stock, par value $0.01 per share (the “ Series A-6 Preferred Stock ”, with any holder of Series A-6 Preferred Stock being referred to herein as a “ Series A-6 Stockholder ”).

 

Preferred Stock shall mean the Preferred Stock, par value $.01 per share, of the Corporation.

 

Preferred Stockholders shall mean, collectively, all holders of shares of Preferred Stock of the Corporation.

 

Prospectus means the prospectus included in a Registration Statement (including, without limitation, a prospectus that includes any information previously omitted from a prospectus filed as part of an effective registration statement in reliance upon Rule 430A promulgated under the Securities Act), as amended or supplemented by any prospectus supplement, with respect to the terms of the offering of

 

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any portion of the Registrable Securities covered by a Registration Statement, and all other amendments and supplements to the Prospectus, including post-effective amendments, and all material incorporated by reference or deemed to be incorporated by reference in such Prospectus.

 

Qualified Public Offering shall have the same meaning as that set forth in the Certificate.

 

Refused Securities shall have the meaning set forth in Section 2.3(f) hereof.

 

Registrable Securities shall mean all of the Preferred Shares, the Common Stock issued or issuable upon the conversion of the Preferred Shares, all shares of Common Stock issued or issuable in respect thereof by way of stock splits, stock dividends, stock combinations, recapitalizations or like occurrences, and any other shares of Common Stock or other securities of the Corporation which may be issued hereafter to any of the Investors or any member of their Group which are convertible into or exercisable for shares of Common Stock (including, without limitation, other classes or series of convertible Preferred Stock, warrants, options or other rights to purchase Common Stock or convertible debentures or other convertible debt securities) and the Common Stock issued or issuable upon such conversion or exercise of such other securities, which have not been sold (a) in connection with an effective registration statement filed pursuant to the Securities Act or (b) pursuant to Rule 144 or Rule 144A promulgated by the Commission under the Securities Act.

 

Registrable Shares shall mean the shares of Common Stock issued or issuable upon the conversion or exchange of the Registrable Securities or otherwise constituting a portion of the Registrable Securities.

 

Registration Statement means any registration statement required to be filed by the Corporation under Section 3.4 and any additional registration statement contemplated by Section 3.4(b)(iii), including (in each case) the Prospectus, amendments and supplements to such registration statement or Prospectus, including pre- and post-effective amendments, all exhibits thereto, and all material incorporated by reference or deemed to be incorporated by reference in such registration statement.

 

Reserved Shares shall mean the shares of Common Stock issued or issuable by the Corporation upon the conversion of the Preferred Shares.

 

Restricted Stock shall mean all shares of capital stock of the Corporation, excluding the Series A-1 Registrable Securities, Series A-2 Registrable Securities and Series A-3 Registrable Securities, including (i) all shares of Common Stock, (ii) all shares of Series A-4 Preferred Stock, (iii) all shares of Series A-5 Preferred Stock, (iv) all shares of Series A-6 Preferred Stock, (v) all additional shares of capital stock of the Corporation hereafter issued and outstanding, (vi) all shares of capital stock of the Corporation into which such shares may be converted or for which they may be exchanged or exercised and (vii) all other shares of capital stock issued or issuable by way of stock splits, stock dividends, stock combinations, recapitalizations or like occurrences on such shares.

 

Rule 415 means Rule 415 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended from time to time, or any similar rule or regulation hereafter adopted by the Commission having substantially the same purpose and effect as such Rule.

 

Rule 424 means Rule 424 promulgated by the Commission pursuant to the Securities Act, as such Rule may be amended from time to time, or any similar rule or regulation hereafter adopted by the Commission having substantially the same purpose and effect as such Rule.

 

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Securities Act shall mean the Securities Act of 1933, as amended.

 

Selling Stockholder Questionnaire shall have the meaning set forth in Section 3.4(a) hereof.

 

Sell shall mean as to any Restricted Stock, to sell, or in any other way directly or indirectly, transfer, assign, distribute, encumber or otherwise dispose of either voluntarily or involuntarily; provided , however , that the term “Sell” shall not include the transfer, by gift or otherwise without consideration, of any Restricted Stock (a) by a Common Stockholder, Series A-4 Stockholder, Series A-5 Stockholder or Series A-6 Stockholder to any or all members of a class of persons consisting of his or her spouse, other members of his or her immediate family and/or his, her or their descendants, or to a trust of which all of the beneficiaries are members of such class, or (b) by a Common Stockholder, Series A-4 Stockholder, Series A-5 Stockholder or Series A-6 Stockholder that is a trust, employee benefit plan or individual retirement account, to the beneficiary or beneficiaries of such trust, employee benefit plan or individual retirement account, as applicable (each, a “ Related Transferee ”); provided, that any such transfer to a Related Transferee shall be permitted only on, and subject to, the express conditions that:

 

(i)             such Related Transferee shall be deemed to be a Common Stockholder, Series A-4 Stockholder, Series A-5 Stockholder or Series A-6 Stockholder, as applicable, hereunder and shall hold the Restricted Stock subject to the provisions of this Agreement; and

 

(ii)            such Related Transferee executes all documents necessary or desirable, in the reasonable judgment of the Corporation and the Investors, to become a party to, and be bound by the terms of this Agreement, including but not limited to an Instrument of Adherence pursuant to Section 17 hereof.

 

Series A-1 Directors shall have the meaning set forth in Section 4.1(b) hereof.

 

Series A-1 Preferred Stock shall have the meaning set forth in the second paragraph of this Agreement.

 

Series A-2 Preferred Stock shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-3 Preferred Stock shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-4 Preferred Stock shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-5 Preferred Stock shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-6 Preferred Stock shall have the meaning set forth in the definition of “Preferred Shares” above.

 

Series A-1 Registrable Shares shall mean the shares of Common Stock issued or issuable upon the conversion or exchange of the Series A-1 Registrable Securities or otherwise constituting a portion of the Series A-1 Registrable Securities.

 

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Series A-1 Registrable Securities shall mean any of the Series A-1 Preferred Stock, the Common Stock issued or issuable upon the conversion of the Series A-1 Preferred Stock, all shares of Common Stock issued or issuable in respect thereof by way of stock splits, stock dividends, stock combinations, recapitalizations or like occurrences, and any other shares of Common Stock or other securities of the Corporation which may be issued hereafter to any of the Series A-1 Stockholders or any member of their Group which are convertible into or exercisable for shares of Common Stock (including, without limitation, other classes or series of convertible Preferred Stock, warrants, options or other rights to purchase Common Stock or convertible debentures or other convertible debt securities) and the Common Stock issued or issuable upon such conversion or exercise of such other securities, which have not been sold (a) in connection with an effective registration statement tiled pursuant to the Securities Act or (b) pursuant to Rule 144 or Rule 144A promulgated by the Commission under the Securities Act.

 

Series A-2 Registrable Shares shall mean the shares of Common Stock issued or issuable upon the conversion or exchange of the Series A-2 Registrable Securities or otherwise constituting a portion of the Series A-2 Registrable Securities.

 

Series A-2 Registrable Securities shall mean any of the Series A-2 Preferred Stock, the Common Stock issued or issuable upon the conversion of the Series A-2 Preferred Stock, all shares of Common Stock issued or issuable in respect thereof by way of stock splits, stock dividends, stock combinations, recapitalizations or like occurrences, and any other shares of Common Stock or other securities of the Corporation which may be issued hereafter to any of the Investors or any member of their Group which are convertible into or exercisable for shares of Common Stock (including, without limitation, other classes or series of convertible Preferred Stock, warrants, options or other rights to purchase Common Stock or convertible debentures or other convertible debt securities) and the Common Stock issued or issuable upon such conversion or exercise of such other securities, which have not been sold (a) in connection with an effective registration statement tiled pursuant to the Securities Act or (b) pursuant to Rule 144 or Rule 144A promulgated by the Commission under the Securities Act.

 

Series A-3 Registrable Shares shall mean the shares of Common Stock issued or issuable upon the conversion or exchange of the Series A-3 Registrable Securities or otherwise constituting a portion of the Series A-3 Registrable Securities.

 

Series A-3 Registrable Securities shall mean any of the Series A-3 Preferred Stock, the Common Stock issued or issuable upon the conversion of the Series A-3 Preferred Stock, all shares of Common Stock issued or issuable in respect thereof by way of stock splits, stock dividends, stock combinations, recapitalizations or like occurrences, and any other shares of Common Stock or other securities of the Corporation which may be issued hereafter to any of the Investors or any member of their Group which are convertible into or exercisable for shares of Common Stock (including, without limitation, other classes or series of convertible Preferred Stock, warrants, options or other rights to purchase Common Stock or convertible debentures or other convertible debt securities) and the Common Stock issued or issuable upon such conversion or exercise of such other securities, which have not been sold (a) in connection with an effective registration statement tiled pursuant to the Securities Act or (b) pursuant to Rule 144 or Rule 144A promulgated by the Commission under the Securities Act.

 

Series A-1 Stockholder shall have the meaning set forth in the second paragraph of this Agreement.

 

Series A-2 Stockholders shall have the meaning set forth in the first paragraph of this Agreement.

 

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Series A-3 Stockholders shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-4 Stockholder shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-5 Stockholder shall have the meaning set forth in the first paragraph of this Agreement.

 

Series A-6 Stockholder shall have the meaning set forth in the definition of “Preferred Shares” above.

 

Specified Preferred Director shall have the meaning set forth in Section 4.1(b) hereof.

 

Specified Preferred Holder shall mean each of Oxford, Wellcome and HCV VII.

 

Stock Purchase Agreement shall mean the Series A-1 Convertible Preferred Stock Purchase Agreement, dated as of the date hereof, among the Corporation and the Investors listed on Schedule I thereto.

 

Stockholders shall mean all holders of capital stock of the Corporation.

 

Trading Day shall have the meaning set forth in Section 3.4(a) hereof.

 

30-Day Period shall have the meaning set forth in Section 2.3(b) hereof.

 

Transfer shall include any disposition of any Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock or of any interest therein which would constitute a sale thereof within the meaning of the Securities Act.

 

Wellcome shall mean The Wellcome Trust Limited, as trustee of the Wellcome Trust.

 

SECTION 2.  Certain Covenants of the Corporation .

 

2.1           Meetings of the Board of Directors .  The Corporation shall call, and use its best efforts to have, regular meetings of the Board not less often than quarterly. The Corporation shall promptly pay all reasonable and appropriately documented travel expenses and other out-of-pocket expenses incurred by directors who are not employed by the Corporation in connection with attendance at meetings to transact the business of the Corporation or attendance at meetings of the Board or any committee thereof.

 

2.2           Reservation of Shares of Common Stock and Preferred Stock, Etc .  The Corporation shall at all times have authorized and reserved out of its authorized but unissued shares of Common Stock a sufficient number of shares of Common Stock to provide for the conversion of the Preferred Shares. Neither the issuance of the Preferred Shares nor the shares of Common Stock issuable upon the conversion of the Preferred Shares shall be subject to a preemptive right of any other Stockholder.

 

2.3           Right of First Refusal .

 

(a)            The Corporation shall not issue, sell or exchange, agree to issue, sell or exchange, or reserve or set aside for issuance, sale or exchange, any Offered Securities, unless in each

 

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case the Corporation shall have first offered to sell to the Series A-1 Stockholders, Series A-2 Stockholders and the Series A-3 Stockholders (collectively, the “ ROFR Stockholders ”) all of such Offered Securities on the terms set forth herein. Each ROFR Stockholder shall be entitled to purchase up to its Equity Percentage of the Offered Securities. Each ROFR Stockholder may delegate its rights and obligations with respect to such Offer to one or more members of its Group, which members shall thereafter be deemed to be “ROFR Stockholders” for the purpose of applying this Section 2.3 to such Offer.

 

(b)            The Corporation shall deliver to each ROFR Stockholder written notice of the offer to sell the Offered Securities, specifying the price and terms and conditions of the offer (the “ Offer ”). The Offer by its terms shall remain open and irrevocable for a period of 30 days from the date of its delivery to such ROFR Stockholders (the “ 30-Day Period ”), subject to extension to include the Excess Securities Period (as such term is hereinafter defined).

 

(c)            Each ROFR Stockholder shall evidence its intention to accept the Offer by delivering a written notice signed by such ROFR Stockholder, as applicable, setting forth the number of shares that such ROFR Stockholder elects to purchase (the “ Notice of Acceptance ”). The Notice of Acceptance must be delivered to the Corporation prior to the end of the 30-Day Period. The failure by a ROFR Stockholder to exercise its rights hereunder shall not constitute a waiver of any other rights or of the right to receive notice of and participate in any subsequent Offer.

 

(d)            If any ROFR Stockholder fails to exercise its right hereunder to purchase its Equity Percentage of the Offered Securities, the Corporation shall so notify the other ROFR Stockholders in a written notice (the “ Excess Securities Notice ”). The Excess Securities Notice shall be given by the Corporation promptly after it learns of the intention of any ROFR Stockholder not to purchase all of its Equity Percentage of the Offered Securities, but in no event later than ten (10) business days after the expiration of the 30-Day Period. The ROFR who or which have agreed to purchase their Equity Percentage of the Offered Securities shall have the right to purchase the portion not purchased by such ROFR Stockholders (the “ Excess Securities ”), on a pro rata basis, by giving notice within ten (10) business days after receipt of the Excess Securities Notice from the Corporation. The twenty (20) business day period during which (i) the Corporation must give the Excess Securities Notice to the applicable ROFR Stockholders, and (ii) each of them must then give the Corporation notice of their intention to purchase all or any portion of their pro rata share of the its Excess Securities, is hereinafter referred to as the “ Excess Securities Period .”

 

(e)            If the ROFR Stockholders tender their Notice of Acceptance prior to the end of the 30-Day Period, indicating their intention to purchase all of the Offered Securities, or, if prior to the termination of the Excess Securities Period the ROFR Stockholders tender Excess Securities Notices to purchase all of the Excess Securities, the Corporation shall schedule a closing of the sale of all such Offered Securities. Upon the closing of the sale of the Offered Securities to be purchased by the ROFR Stockholders and the Excess Securities to be purchased by ROFR Stockholders, each ROFR Stockholder shall (i) purchase from the Corporation that portion of the Offered Securities and Excess Securities, as applicable, for which it tendered a Notice of Acceptance and an Excess Securities Notice, as applicable, upon the terms specified in the Offer, and (ii) execute and deliver an agreement further restricting transfer of such Offered Securities substantially as set forth in Section 3.1, 3.2 and 3.3 of this Agreement. In addition, with respect to the Offered Securities and Excess Securities being purchased by the ROFR Stockholders, the Corporation shall provide each such ROFR Stockholder with the rights and benefits set forth in this Agreement. The obligation of the ROFR Stockholders to purchase such Offered Securities and Excess Securities, as applicable, is further conditioned upon the preparation of a purchase agreement embodying the terms of the Offer, which shall be reasonably satisfactory in form and substance to such ROFR Stockholder and each of their respective counsels.

 

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(f)             The Corporation shall have ninety (90) days from the expiration of the 30-Day Period, or the Excess Securities Period, if applicable, to sell the Offered Securities (including the Excess Securities) refused by the ROFR Stockholders (the “ Refused Securities ”) to any other person or persons, but only upon terms and conditions which are in all material respects (including, without limitation, price and interest rate) no more favorable to such other person or persons, and no less favorable to the Corporation, than those set forth in the Offer. Upon and subject to the closing of the sale of all of the Refused Securities (which shall include full payment to the Corporation), each ROFR Stockholder shall (i) purchase from the Corporation those Offered Securities and Excess Securities, as applicable, for which it tendered a Notice of Acceptance and an Excess Securities Notice, if applicable, upon the terms specified in the Offer, and (ii) execute and deliver an agreement restricting transfer of such Offered Securities and Excess Securities, as applicable, substantially as set forth in Sections 3.1, 3.2 and 3.3 of this Agreement. In addition, with respect to the Offered Securities or Excess Securities being purchased by the ROFR Stockholders, the Corporation shall provide each such ROFR Stockholder with the rights and benefits set forth in this Agreement. The Corporation agrees, as a condition precedent to accepting payment for and making delivery of any Refused Securities to any executive officer, employee, consultant or independent contractor of or to the Corporation, or to any other person, to have each and every such person execute and deliver this Agreement, as may be modified or amended from time to time pursuant to Section 11 hereof, to the extent such purchaser has not already executed this Agreement. The obligation of the ROFR Stockholders to purchase such Offered Securities and Excess Securities, as applicable, is further conditioned upon the preparation of a purchase agreement embodying the terms of the Offer, which shall be reasonably satisfactory in form and substance to such ROFR Stockholder and each of their respective counsels.

 

(g)            In each case, any Offered Securities not purchased either by the ROFR Stockholders or by any other person in accordance with this Section 2.3 may not be sold or otherwise disposed of until they are again offered to the ROFR Stockholders under the procedures specified in Paragraphs (a), (b), (c), (d), (e) and (f) hereof.

 

(h)            Each ROFR Stockholder may, by prior written consent, waive its rights under this Section 2.3. Such a waiver shall be deemed a limited waiver and shall only apply to the extent specifically set forth in the written consent of such ROFRR Stockholder.

 

(i)             This Section 2.3 and the rights and obligations of the parties hereunder shall automatically terminate on the consummation of a Qualified Public Offering.

 

2.4           Filing of Reports Under the Exchange Act .

 

(a)            The Corporation shall give prompt notice to the holders of Preferred Stock of (i) the filing of any registration statement (an “ Exchange Act Registration Statement ”) pursuant to the Exchange Act, relating to any class of equity securities of the Corporation, (ii) the effectiveness of such Exchange Act Registration Statement, and (iii) the number of shares of such class of equity securities outstanding, as reported in such Exchange Act Registration Statement, in order to enable the Stockholders to comply with any reporting requirements under the Exchange Act or the Securities Act. Upon the written request of the Majority Investors, the Corporation shall, at any time after the Corporation has already registered shares of Common Stock under the Securities Act file an Exchange Act Registration Statement relating to any class of equity securities of the Corporation or issuable upon conversion or exercise of any class of debt or equity securities or warrants or options of the Corporation then held by the Series A-1 Stockholders, whether or not the class of equity securities with respect to which such request is made shall be held by the number of persons which would require the filing of a registration statement under Section 12(g)(I) of the Exchange Act.

 

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(b)            If the Corporation shall have filed an Exchange Act Registration Statement or a registration statement (including an offering circular under Regulation A promulgated under the Securities Act) pursuant to the requirements of the Securities Act, which shall have become effective (and in any event, at all times following the initial public offering of any of the securities of the Corporation), then the Corporation shall comply with all other reporting requirements of the Exchange Act (whether or not it shall be required to do so) and shall comply with all other public information reporting requirements of the Commission as a condition to the availability of an exemption from the Securities Act for the sale of any of the Restricted Stock by any holder of Restricted Stock or the sale of any of the Series A-1 Stock by any holder of Series A-1 Stock (including any such exemption pursuant to Rule 144 or Rule 144A thereof, as amended from time to time, or any successor rule thereto or otherwise). The Corporation shall cooperate with each holder of Registrable Securities in supplying such information as may be necessary for such holder to complete and file any information reporting forms presently or hereafter required by the Commission as a condition to the availability of an exemption from the Securities Act (under Rule 144 or Rule 144A thereunder or otherwise) for the sale of any Registrable Securities.

 

2.5           Directors’ & Officers’ Insurance .  The Corporation shall continue to maintain a directors’ and officers’ liability insurance policy covering all directors, observers and executive officers of the Corporation.

 

2.6           Properties and Business Insurance .  The Corporation shall continue to maintain from responsible and reputable insurance companies or associations valid policies of insurance against such casualties, contingencies and other risks and hazards and of such types and in such amounts as is customary for similarly situated businesses.

 

2.7           Preservation of Corporate Existence .  The Corporation shall preserve and maintain its corporate existence, rights, franchises and privileges in the jurisdiction of its incorporation, and qualify and remain qualified as a foreign corporation in each jurisdiction in which (i) such qualification is necessary or desirable in view of its business and operations or the ownership or lease of its properties or (ii) the failure to so qualify would have a material adverse effect on the business, properties, assets or condition (financial or otherwise) of the Corporation.

 

2.8           Compliance with Laws .  The Corporation shall comply with all applicable laws, rules, regulations, requirements and orders of the United States or any applicable foreign jurisdiction in the conduct of its business including, without limitation, all labor, employment, wage and hour, health and safety, environmental, health insurance, health information security, privacy, data protection and data transfer laws, and shall adopt and monitor policies and procedures designed to comply with all such applicable laws, rules, regulations and orders, except where noncompliance would not have a material adverse effect on the business, properties, assets or condition (financial or otherwise) of the Corporation.

 

2.9           Payment of Taxes .  The Corporation will pay and discharge all lawful Taxes (as defined below) before such Taxes shall become in default and all lawful claims for labor, materials and supplies which, if not paid when due, might become a lien or charge upon its property or any part thereof; provided, however, that the Corporation shall not be required to pay and discharge any such Tax, assessment, charge, levy or claim so long as the validity thereof is being contested by or for the Corporation in good faith by appropriate proceedings and an adequate reserve therefore has been established on its books. The term “ Tax ” (and, with correlative meaning, “ Taxes ”) means all United States federal, state and local, and all foreign, income, profits, franchise, gross receipts, payroll, transfer, sales, employment, use, property, excise, value added, ad valorem, estimated, stamp, alternative or add-on minimum, recapture, environmental, withholding and any other taxes, charges, duties, impositions or

 

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assessments, together with all interest, penalties, and additions imposed on or with respect to such amounts, or levied, assessed or imposed against the Corporation.

 

2.10         Management Compensation .  The Board of Directors (upon the recommendation of the Compensation Committee or otherwise) shall determine the compensation to be paid by the Corporation to its management. Any grants of capital stock or options to employees, officers, directors or consultants of the Corporation and its Subsidiaries shall be made pursuant to the Plan.

 

2.11         No Further Pay-to-Play Provisions .  The Corporation hereby covenants and agrees that at no time after the date of this Agreement, without the prior written consent of each of Wellcome, one member of the HCV Group, one member of the MPM Group, one member of the Brookside Group, one member of the BB Bio Group, and one member of the Oxford/Saints Group, shall it enter into any agreement or amend the Certificate to implement terms that would automatically convert Preferred Shares into shares of Common Stock, or impose any other penalty on the holder of Preferred Shares, solely because the holders of such Preferred Shares fail to participate at any level in a transaction pursuant to which the Corporation raises funds through the issuance of debt or equity securities (other than any Closing contemplated by the Stock Purchase Agreement).

 

2.12         Confidentiality, Assignment of Inventions and Non-Competition Agreements for Key Employees .  The Corporation shall cause each person who becomes an employee of or a consultant to the Corporation subsequent to the date hereof, and who shall have or be proposed to have access to confidential or proprietary information of the Corporation, to execute a confidentiality, assignment of inventions, and non-competition agreement in form and substance attached hereto as Exhibit A or otherwise approved by the Board prior to the commencement of such person’s employment by the Corporation in such capacity.

 

2.13         Duration of Section .  Sections 2.5 through 2.12 and the rights and obligations of the parties hereunder shall automatically terminate on the earlier of (i) the consummation of an Event of Sale (as defined in the Certificate) or (ii) the automatic conversion of all of the Preferred Stock of the Corporation pursuant to the terms and conditions of the Certificate upon  the listing, or the admitting for trading, of the Common Stock on a national securities exchange.

 

SECTION 3.  Transfer of Securities .

 

3.1           Restriction on Transfer .  The Series A-1 Preferred Stock, Series A-2 Preferred Stock, the Series A-3 Preferred Stock and the Restricted Stock shall not be transferable, except upon the conditions specified in this Section 3, which conditions are intended solely to ensure compliance with the provisions of the Securities Act in respect of the Transfer thereof.  In addition, no Series A-1 Preferred Stock, Series A-2 Preferred Stock, the Series A-3 Preferred Stock or Restricted Stock shall be transferred unless, as conditions precedent to such transfer, the transferee thereof agrees in writing to be bound by the obligations of the transferring Stockholder hereunder.

 

3.2           Restrictive Legend .  Each certificate evidencing any Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock and Restricted Stock and each certificate evidencing any such securities issued to subsequent transferees of any Series A-1 Preferred Stock, Series A-2 Preferred Stock, Series A-3 Preferred Stock and Restricted Stock shall (unless otherwise permitted by the provisions of Section 3.3 or 3.10 hereof) be stamped or otherwise imprinted with a legend in substantially the following form:

 

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THE SECURITIES REPRESENTED BY THIS CERTIFICATE HAVE BEEN ACQUIRED FOR INVESTMENT AND HAVE NOT BEEN REGISTERED UNDER THE SECURITIES ACT OF 1933, AS AMENDED (THE “ SECURITIES ACT ”), OR ANY STATE SECURITIES LAW. THE SECURITIES MAY NOT BE PLEDGED, HYPOTHECATED, SOLD OR TRANSFERRED IN THE ABSENCE OF AN EFFECTIVE REGISTRATION STATEMENT FOR THE SECURITIES UNDER THE SECURITIES ACT OR ANY APPLICABLE STATE SECURITIES LAW OR AN EXEMPTION THEREFROM UNDER SUCH ACT OR LAW.

 

3.3           Notice of Transfer .  By acceptance of any Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock, the holder thereof agrees to give prior written notice to the Corporation of such holder’s intention to effect any Transfer and to comply in all other respects with the provisions of this Section 3.3. Each such notice shall describe the manner and circumstances of the proposed Transfer and shall be accompanied by: (a) the written opinion of counsel for the holder of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock, or, at such holder’s option, a representation letter of such holder, addressed to the Corporation (which opinion and counsel, or representation letter, as the case may be, shall be reasonably acceptable to the Corporation), as to whether, in the case of a written opinion, in the opinion of such counsel such proposed Transfer involves a transaction requiring registration of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock under the Securities Act and applicable state securities laws or an exemption thereunder is available, or, in the case of a representation letter, such letter sets forth a factual basis for concluding that such proposed transfer involves a transaction requiring registration of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock under the Securities Act and applicable state securities laws or that an exemption thereunder is available, or (b) if such registration is required and if the provisions of Section 3.4 hereof are applicable, a written request addressed to the Corporation by the holder of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock, describing in detail the proposed method of disposition and requesting the Corporation to effect the registration of such Registrable Shares pursuant to the terms and provisions of Section 3.4 hereof; provided , however , that (y) in the case of a Transfer by a holder to a member of such holder’s Group, no such opinion of counsel or representation letter of the holder shall be necessary, provided that the transferee agrees in writing to be subject to Sections 3.1, 3.2, 3.3, 3.10 hereof to the same extent as if such transferee were originally a signatory to this Agreement, and (z) in the case of any holder of Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock that is a partnership, no such opinion of counsel or representation letter of the holder shall be necessary for a Transfer by such holder to a partner of such holder, or a retired partner of such holder who retires after the date hereof, or the estate of any such partner or retired partner if, with respect to such Transfer by a partnership, (i) such Transfer is made in accordance with the partnership agreement of such partnership, and (ii) the transferee agrees in writing to be subject to the terms of Sections 3.1, 3.2, 3.3, 3.10 hereof to the same extent as if such transferee were originally a signatory to this Agreement. If in an opinion of counsel or as reasonably concluded from the facts set forth in the representation letter of the holder (which opinion and counsel or representation letter, as the case may be, shall be reasonably acceptable to the Corporation), the proposed Transfer may be effected without registration under the Securities Act and any applicable state securities laws or “blue sky” laws, then the holder of Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock shall thereupon be entitled to effect such Transfer in accordance with the terms of the notice delivered by it to the Corporation. Each certificate or other instrument evidencing the securities issued upon such Transfer (and each certificate or other instrument evidencing any such securities not Transferred) shall bear the legend set forth in Section 3.2 hereof unless: (a) in such opinion of such counsel or as can be concluded from the representation letter of such holder (which opinion and counsel or representation letter shall be reasonably acceptable to the

 

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Corporation) the registration of future Transfers is not required by the applicable provisions of the Securities Act and state securities laws, or (b) the Corporation shall have waived the requirement of such legend; provided , however , that such legend shall not be required on any certificate or other instrument evidencing the securities issued upon such Transfer in the event such transfer shall be made in compliance with the requirements of Rule 144 (as amended from time to time or any similar or successor rule) promulgated under the Securities Act. The holder of Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock shall not effect any Transfer until such opinion of counsel or representation letter of such holder has been given to and accepted by the Corporation (unless waived by the Corporation) or, if applicable, until registration of the Registrable Shares involved in the above-mentioned request has become effective under the Securities Act. In the event that an opinion of counsel is required by the registrar or transfer agent of the Corporation to effect a transfer of Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock in the future, the Corporation shall seek and obtain such opinion from its counsel, and the holder of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock shall provide such reasonable assistance as is requested by the Corporation (other than the furnishing of an opinion of counsel) to satisfy the requirements of the registrar or transfer agent to effectuate such transfer.  Notwithstanding anything to the contrary herein, the provisions of this Section 3.3 and of Sections 3.1 and 3.2 shall not apply, and shall be deemed of no force or effect, with respect to shares of capital stock of the Corporation that are subject to a re-sale registration statement under the Securities Act, provided that such registration statement has been declared, and continues to remain, effective by the Commission.

 

3.4           Registration Rights .

 

(a)            Shelf Registration .

 

(i)             On or prior to the Filing Date, the Corporation shall prepare and file with the Commission a Registration Statement covering the resale of all of the Registrable Shares for an offering to be made on a continuous basis pursuant to Rule 415. The Registration Statement shall be on Form S-1 or another appropriate form in accordance herewith and shall contain (unless otherwise directed by Holders of at least 85% of the then outstanding Registrable Shares) substantially the “ Plan of Distribution ” attached hereto as Annex A . Subject to the terms of this Agreement, the Corporation shall use its reasonable best efforts to cause such Registration Statement to be declared effective under the Securities Act as promptly as possible after the filing thereof, but in any event on or prior to the Effectiveness Date, and shall use its reasonable best efforts to keep the Registration Statement continuously effective (whether on Form S-1 or amended to Form S-3 or another appropriate form in accordance herewith) under the Securities Act until all Registrable Shares have been sold, or may be sold without volume restrictions pursuant to Rule 144, as determined by the counsel to the Corporation pursuant to a written opinion letter to such effect, addressed and acceptable to the transfer agent of the Corporation and the affected Holders (the “ Effectiveness Period ”). The Corporation shall telephonically request effectiveness of the Registration Statement as of 5:00 p.m. New York City time on a day during which the public markets are open for trading stocks (a “ Trading Day ”). The Corporation shall immediately notify the Holders via facsimile or by e-mail delivery of a “.pdf” format data file of the effectiveness of the Registration Statement on the same Trading Day that the Corporation telephonically confirms effectiveness with the Commission, which shall be the date requested for effectiveness of the Registration Statement. The Corporation shall, by 9:30 a.m. New York City time on the Trading Day after the Effective Date, file a final Prospectus with the Commission as required by Rule 424. Failure to so notify the Holder within 1 Trading Day of such notification of effectiveness or failure to file a final Prospectus as foresaid shall be deemed an Event under Section 3.4(b).

 

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(ii)            If: (A) the Registration Statement is not filed on or prior to the Filing Date or has not been declared effective by the Commission by the Effectiveness Date, or (B) the Corporation fails to file with the Commission a request for acceleration in accordance with Rule 461 promulgated under the Securities Act, within 5 Trading Days of the date that the Corporation is notified (orally or in writing, whichever is earlier) by the Commission that a Registration Statement will not be “reviewed” or not be subject to further review, or (C) prior to the Effectiveness Date of a Registration Statement, the Corporation fails to file a pre-effective amendment and otherwise respond in writing to comments made by the Commission in respect of such Registration Statement within 14 calendar days after the receipt of comments by or notice from the Commission that such amendment is required in order for such Registration Statement to be declared effective, or (D) after the Effectiveness Date of a Registration Statement, such Registration Statement ceases for any reason to remain continuously effective as to all Registrable Securities included in such Registration Statement, or the Holders are otherwise not permitted to utilize the Prospectus therein to resell such Registrable Securities, for more than 20 consecutive calendar days or more than an aggregate of 40 calendar days during any 12-month period (which need not be consecutive calendar days) (any such failure or breach being referred to as an “ Event ”, and for purposes of clause (A) the date on which such Event occurs, or for purposes of clause (B) the date on which such 5 Trading Day period is exceeded, or for purposes of clause (C) the date which such 14 calendar day period is exceeded, or for purposes of clause (D) the date on which such 20 or 40 calendar day period, as applicable, is exceeded being referred to as an “ Event Date ”), then, in addition to any other rights the Holders may have hereunder or under applicable law, on each such Event Date and on each monthly anniversary of each such Event Date (if the applicable Event shall not have been cured by such date) until the applicable Event is cured, the Corporation shall pay to each Holder an amount in cash, as partial liquidated damages and not as a penalty, equal to 1% of the aggregate purchase price paid by such Holder pursuant to the Stock Purchase Agreement for any Registrable Securities then held by such Holder.  The parties agree that the maximum aggregate liquidated damages payable to a Holder under this Agreement shall be sixteen percent (16%) of the aggregate Purchase Price (as defined in the Stock Purchase Agreement) paid by such Holder pursuant to the Stock Purchase Agreement.  If the Corporation fails to pay any partial liquidated damages pursuant to this Section 3.4(b) in full within seven days after the date payable, the Corporation will pay interest thereon at a rate of ten percent (10%) per annum (or such lesser maximum amount that is permitted to be paid by applicable law) to the Holder, accruing daily from the date such partial liquidated damages are due until such amounts, plus all such interest thereon, are paid in full. The partial liquidated damages pursuant to the terms hereof shall apply on a daily pro-rata basis for any portion of a month prior to the cure of an Event.

 

(iii)           In the event that the Corporation is unable for any reason to include in the Registration Statement required to be filed under Section 3.4(a)(i) all of the Registrable Securities, then the Corporation shall use its reasonable best efforts to file and cause to be declared effective additional Registration Statements, in order to uphold its obligations under Section 3.4(a)(i), as promptly as practicable. If not all Registrable Securities may be included in any one Registration Statement, then the Registrable Securities to be included shall be allocated among Holders of such Registrable Securities on a pro rata basis based on the total number of Registrable Securities held by all Holders that have not been included in a Registration Statement.

 

(b)            Registration Procedures . In connection with the Corporation’s registration obligations hereunder, the Corporation shall:

 

(i)             Not less than seven Trading Days prior to the filing of any Registration Statement and not less than two Trading Days prior to the filing of any related Prospectus or any amendment or supplement thereto, (A) furnish to each Holder copies of all such documents proposed to be filed, which documents (other than those incorporated or deemed to be incorporated by reference) will be subject to the review of such Holders, and (B) cause its officers and directors, counsel and

 

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independent certified public accountants to respond to such inquiries as shall be necessary, in the reasonable opinion of respective counsel to each Holder, to conduct a reasonable investigation within the meaning of the Securities Act; and not file a Registration Statement or any such Prospectus or any amendments or supplements thereto to which the Holders of 67% of the Registrable Securities shall reasonably object in good faith, provided that the Corporation is notified of such objection in writing no later than 5 Trading Days after the Holders have been so furnished copies of a Registration Statement or 1 Trading Day after the Holders have been so furnished copies of any related Prospectus or amendments or supplements thereto. Each Holder agrees to furnish to the Corporation a completed questionnaire in the form attached to this Agreement as Annex B or other form reasonably acceptable to the Corporation (a “ Selling Stockholder Questionnaire ”) not less than 2 Trading Days prior to the Filing Date or by the end of the 4th Trading Day following the date on which such Holder receives draft materials in accordance with this Section. During any periods that the Corporation is unable to meet its obligations hereunder with respect to the registration of the Registrable Securities because the Holders of 67% of the Registrable Securities exercise their rights under this section to object to the filing of a Registration Statement, any liquidated damages that are accruing, at such time shall be tolled and any Event that may otherwise occur because of the exercise of such rights or such delay shall be suspended, until the Holders of 67% of the Registrable Securities no longer object to the filing of such Registration Statement ( provided that such tolling shall only occur if the Corporation uses commercially reasonable efforts to resolve such objection). If any Holder fails to furnish its Selling Stockholder Questionnaire related to a particular Registration Statement not less than 2 Trading Days prior to the Filing Date or by the end of the 4 th  Trading Day following the date on which such Holder receives draft materials in accordance with this Section, any liquidated damages that are accruing, as well as any other rights of such Holder under this Agreement with regard to such Registration Statement, including without limitation, the right to include such Holder’s Registrable Securities in such Registration Statement, shall be tolled as to such Holder until such information is received by the Corporation; provided , however , that the Corporation shall use commercially reasonable efforts to include such Registrable Securities in such Registration Statement or the next most available Registration Statement as soon as possible after such information is furnished to the Corporation.

 

(ii)            (A) Prepare and file with the Commission such amendments, including post-effective amendments, to a Registration Statement and the Prospectus used in connection therewith as may be necessary to keep a Registration Statement continuously effective as to the applicable Registrable Securities for the Effectiveness Period and prepare and file with the Commission such additional Registration Statements in order to register for resale under the Securities Act all of the Registrable Securities; (B) cause the related Prospectus to be amended or supplemented by any required Prospectus supplement (subject to the terms of this Agreement), and as so supplemented or amended to be filed pursuant to Rule 424; (C) respond as promptly as reasonably possible to any comments received from the Commission with respect to a Registration Statement or any amendment thereto and provide as promptly as reasonably possible to the Holders true and complete copies of all correspondence from and to the Commission relating to a Registration Statement ( provided that the Corporation may excise any information contained therein which would constitute material non-public information as to any Holder which has not executed a confidentiality agreement with the Corporation); and (D) comply in all material respects with the provisions of the Securities Act and the Exchange Act with respect to the disposition of all Registrable Securities covered by a Registration Statement during the applicable period in accordance (subject to the terms of this Agreement) with the intended methods of disposition by the Holders thereof set forth in such Registration Statement as so amended or in such Prospectus as so supplemented.

 

(iii)           If during the Effectiveness Period, the number of Registrable Securities at any time exceeds 100% of the number of shares of Common Stock then registered in a Registration Statement, file as soon as reasonably practicable an additional Registration Statement covering the resale by the Holders of not less than the number of such Registrable Securities.

 

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(iv)           Notify the Holders of Registrable Securities to be sold (which notice shall, pursuant to clauses (C) through (F) hereof, be accompanied by an instruction to suspend the use of the Prospectus until the requisite changes have been made) as promptly as reasonably possible (and, in the case of (A)(1) below, not less than 1 Trading Day prior to such filing, in the case of (C) and (D) below, not more than 1 Trading Day after such issuance or receipt and, in the case of (E) below, not less than 3 Trading Days prior to the financial statements in any Registration Statement becoming ineligible for inclusion therein) and (if requested by any such Person) confirm such notice in writing no later than 1 Trading Day following the day (A)(1) when a Prospectus or any Prospectus supplement or post-effective amendment to a Registration Statement is proposed to be filed; (2) when the Commission notifies the Corporation whether there will be a “review” of such Registration Statement and whenever the Commission comments in writing on such Registration Statement (in which case the Corporation shall provide true and complete copies thereof and all written responses thereto to each of the Holders that pertain to the Holders as a selling stockholder or to the Plan of Distribution, but not information which the Corporation believes would constitute material and non-public information); and (3) with respect to a Registration Statement or any post-effective amendment, when the same has become effective; (B) of any request by the Commission or any other federal or state governmental authority for amendments or supplements to a Registration Statement or Prospectus or for additional information; (C) of the issuance by the Commission or any other federal or state governmental authority of any stop order suspending the effectiveness of a Registration Statement covering any or all of the Registrable Securities or the initiation of any Proceedings for that purpose; (D) of the receipt by the Corporation of any notification with respect to the suspension of the qualification or exemption from qualification of any of the Registrable Securities for sale in any jurisdiction, or the initiation or threatening of any Proceeding for such purpose; (E) of the occurrence of any event or passage of time that makes the financial statements included in a Registration Statement ineligible for inclusion therein or any statement made in a Registration Statement or Prospectus or any document incorporated or deemed to be incorporated therein by reference untrue in any material respect or that requires any revisions to a Registration Statement, Prospectus or other documents so that, in the case of a Registration Statement or the Prospectus, as the case may be, it will not contain any untrue statement of a material fact or omit to state any material fact required to be stated therein or necessary to make the statements therein, in light of the circumstances under which they were made, not misleading; and (F) the occurrence or existence of any pending corporate development with respect to the Corporation that the Corporation believes may be material and that, in the good faith determination of the Corporation, based on the advice of counsel, makes it not in the best interest of the Corporation to allow continued availability of a Registration Statement or Prospectus, provided that any and all of such information shall remain confidential to each Holder until such information otherwise becomes public, unless disclosure by a Holder is required by law; provided , further , that notwithstanding each Holder’s agreement to keep such information confidential, the Holders make no acknowledgement that any such information is material, non-public information.

 

(v)            Use its reasonable best efforts to avoid the issuance of, or, if issued, obtain the withdrawal of (A) any order suspending the effectiveness of a Registration Statement, or (B) any suspension of the qualification (or exemption from qualification) of any of the Registrable Securities for sale in any jurisdiction, at the earliest practicable moment.

 

(vi)           If requested by a Holder, furnish to such Holder, without charge (A) at least one conformed copy of each such Registration Statement and each amendment thereto, including financial statements and schedules, all documents incorporated or deemed to be incorporated therein by reference to the extent requested by such Person, and all exhibits to the extent requested by such Person (including those previously furnished or incorporated by reference) promptly after the filing of such documents with the Commission, and (B) during the Effectiveness Period, as many copies of the Prospectus included in the Registration Statement and any amendment or supplement thereto as such

 

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Holder may reasonably request; provided , however , that the Corporation shall have no obligation to provide any document pursuant to this clause that is available on the Commission’s EDGAR system.

 

(vii)          Subject to the terms of this Agreement, consent to the use of each Prospectus and each amendment or supplement thereto by each of the selling Holders in connection with the offering and sale of the Registrable Securities covered by such Prospectus and any amendment or supplement thereto, except after the giving of any notice pursuant to Section 3.4(b)(iv).

 

(viii)         Effect a filing with respect to the public offering contemplated by the Registration Statement (an “ Issuer Filing ”) with the Financial Industry Regulatory Authority (“ FINRA ”) Corporate Financing Department pursuant to FINRA Rule 5110 within 1 Trading Day of the date that the Registration Statement is first filed with the Commission and pay the filing fee required by such Issuer Filing; and use commercially reasonable efforts to pursue the Issuer Filing until FINRA issues a letter confirming that it does not object to the terms of the offering contemplated by the Registration Statement.

 

(ix)           Prior to any resale of Registrable Securities by a Holder, use its reasonable best efforts to register or qualify or cooperate with the selling Holders in connection with the registration or qualification (or exemption from the registration or qualification) of such Registrable Securities for the resale by the Holder under the securities or blue sky laws of such jurisdictions within the United States as any Holder reasonably requests in writing, to keep each registration or qualification (or exemption therefrom) effective during the Effectiveness Period and to do any and all other acts or things reasonably necessary to enable the disposition in such jurisdictions of the Registrable Securities covered by a Registration Statement; provided , that the Corporation shall not be required to qualify generally to do business in any jurisdiction where it is not then so qualified, subject the Corporation to any material tax in any such jurisdiction where it is not then so subject or file a general consent to service of process in any such jurisdiction.

 

(x)            If requested by the Holders, cooperate with the Holders to facilitate the timely preparation and delivery of certificates representing Registrable Securities to be delivered to a transferee pursuant to a Registration Statement, which certificates shall be free, to the extent permitted by the Stock Purchase Agreement, of all restrictive legends, and to enable such Registrable Securities to be in such denominations and registered in such names as any such Holders may request. In connection therewith, if required by the Corporation’s transfer agent, the Corporation shall promptly after the effectiveness of a Registration Statement cause an opinion of counsel as to the effectiveness of the Registration Statement to be delivered to and maintained with the transfer agent, together with any other authorizations, certificates and directions required by the transfer agent, which authorize and direct the transfer agent to issue such Registrable Securities without legend upon sale by the holder of such shares of Registrable Securities under the Registration Statement.

 

(xi)           Upon the occurrence of any event contemplated by this Section 3.4(b), as promptly as reasonably possible under the circumstances taking into account the Corporation’s good faith assessment of any adverse consequences to the Corporation and its stockholders of the premature disclosure of such event, prepare a supplement or amendment, including a post-effective amendment, to a Registration Statement or a supplement to the related Prospectus or any document incorporated or deemed to be incorporated therein by reference, and file any other required document so that, as thereafter delivered, neither a Registration Statement nor Prospectus will contain an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein, in light of the circumstances under which they were made, not misleading. If the Corporation notifies and instructs the Holders in accordance with clauses (iii) through (vi) of Section 3.4(b)(iv) above to suspend the use of any Prospectus until the requisite changes to such

 

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Prospectus have been made, then the Holders shall suspend use of such Prospectus; use its reasonable best efforts to ensure that the use of the Prospectus may be resumed as promptly as is practicable; and be entitled to exercise its right under this Section 3.4(b)(xi) to suspend the availability of a Registration Statement and Prospectus, subject to the payment of partial liquidated damages pursuant to Section 3.4(a)(ii), for a period not to exceed 40 calendar days (which need not be consecutive days) in any 12 month period.

 

(xii)          Comply with all applicable rules and regulations of the Commission.

 

(c)            The Corporation may require each selling Holder to furnish to the Corporation a certified statement as to the number of shares of Common Stock beneficially owned by such Holder and any affiliate thereof and as to any FINRA affiliations and, if required by the Commission, of any natural persons that have voting and dispositive control over the Registrable Securities. During any periods that the Corporation is unable to meet its obligations hereunder with respect to the registration of the Registrable Securities solely because any Holder fails to furnish such information within 3 Trading Days of the Corporation’s request, any liquidated damages that are accruing at such time as to such Holder only, as well as any other rights of such Holder under this Agreement, including without limitation, the right to include such Holder’s Registrable Securities in a Registration Statement shall be tolled and any Event that may otherwise occur solely because of such delay shall be suspended as to such Holder only, until such information is delivered to the Corporation; provided , however , that the Corporation shall use commercially reasonable efforts to include such Registrable Securities in such Registration Statement or the next most available Registration Statement as soon as possible after such information is furnished to the Corporation.

 

3.5           Piggyback Registration .

 

(a)            Each time that the Corporation proposes for any reason to register any of its securities under the Securities Act, other than pursuant to a registration statement on Form S-4, Form S-8 or Form S-1 or similar or successor forms, but in regard to Form S-1 only in connection with the initial public offering of the Corporation’s Common Stock (collectively, “ Excluded Forms ”), the Corporation shall promptly give written notice of such proposed registration to all holders of Registrable Securities, which notice shall also constitute an offer to such holders to request inclusion of any Registrable Shares in the proposed registration.

 

(b)            Each holder of Registrable Securities shall have 30 days from the receipt of such notice to deliver to the Corporation a written request specifying the number of Registrable Shares such holder intends to sell and the holder’s intended method of disposition.

 

(c)            In the event that the proposed registration by the Corporation is, in whole or in part, an underwritten public offering of securities of the Corporation, any request under Section 3.5(b) may specify that the Registrable Shares be included in the underwriting (i) on the same terms and conditions as the shares of Common Stock, if any, otherwise being sold through underwriters under such registration, or (ii) on terms and conditions comparable to those normally applicable to offerings of common stock in reasonably similar circumstances in the event that no shares of Common Stock other than Registrable Shares are being sold through underwriters under such registration.

 

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(d)            Upon receipt of a written request pursuant to Section 3.5(b), the Corporation shall promptly use its best efforts to cause all such Registrable Shares to be registered under the Securities Act, to the extent required to permit sale or disposition as set forth in the written request.

 

(e)            Notwithstanding the foregoing, if the managing underwriter of any such proposed registration determines and advises in writing that the inclusion of all Registrable Shares proposed to be included in the underwritten public offering, together with any other issued and outstanding shares of Common Stock proposed to be included therein by holders other than the holders of Registrable Securities (such other shares hereinafter collectively referred to as the “ Other Shares ”) would interfere with the successful marketing of the Corporation’s securities, then the total number of such securities proposed to be included in such underwritten public offering shall be reduced, (i) first by the shares requested to be included in such registration by the holders of Other Shares, (ii) second, if necessary by all Registrable Securities which are not Series A-2 Registrable Securities, Series A-3 Registrable Securities or Series A-1 Registrable Securities, and (iii) third, if necessary, (A) one-half (1/2) by the securities proposed to be issued by the Corporation, and (B) one-half (1/2) by the holders of Series A-2 Registrable Shares, Series A-3 Registrable Shares and/or Series A-1 Registrable Shares proposed to be included in such registration by the holders thereof, on a pro rata basis calculated based upon the number of Registrable Shares, Series A-2 Registrable Shares, Series A-3 Registrable Shares or Series A-1 Registrable Shares sought to be registered by each such holder; provided , that the aggregate number of securities proposed to be included in such registration by the holders of Series A-2 Registrable Shares, Series A-3 Registrable Shares and/or Series A-1 Registrable Shares shall only be reduced hereunder if and to the extent that such securities exceed twenty-five percent (25%) of the aggregate number of securities included in such registration. The shares of Common Stock that are excluded from the underwritten public offering pursuant to the preceding sentence shall be withheld from the market by the holders thereof for a period, not to exceed 90 days from the closing of such underwritten public offering, that the managing underwriter reasonably determines as necessary in order to effect such underwritten public offering.

 

3.6           Registrations on Form S-3 .  At such time as the Registration Statement contemplated by Section 3.4 shall no longer be effective, each holder of Registrable Securities shall have the right to request in writing an unlimited number of registrations on Form S-3. Each such request by a holder shall: (a) specify the number of Registrable Shares which the holder intends to sell or dispose of, (b) state the intended method by which the holder intends to sell or dispose of such Registrable Shares, and (c) request registration of Registrable Shares having a proposed aggregate offering price of at least $1,000,000. Upon receipt of an adequate request pursuant to this Section 3.6, the Corporation shall use its best efforts to effect such registration or registrations on Form S-3.

 

3.7           Preparation and Filing .  If and whenever the Corporation is under an obligation pursuant to the provisions of Sections 3.5 and/or 3.6 to use its best efforts to effect the registration of any Registrable Shares, the Corporation shall, as expeditiously as practicable:

 

(a)            prepare and file with the Commission a registration statement with respect to such securities and use its best efforts to cause such registration statement to become and remain effective in accordance with Section 3.7(b) hereof;

 

(b)            prepare and file with the Commission such amendments and supplements to such registration statement and the prospectus used in connection therewith as may be necessary to keep such registration statement effective until the earlier of (i) the sale of all Registrable Shares covered thereby or (ii) nine months from the date such registration statement first becomes effective, and to comply with the provisions of the Securities Act with respect to the sale or other disposition of all Registrable Shares covered by such registration statement;

 

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(c)            furnish to each holder whose Registrable Shares are being registered pursuant to this Section 3 such number of copies of any summary prospectus or other prospectus, including a preliminary prospectus, in conformity with the requirements of the Securities Act, and such other documents as such holder may reasonably request in order to facilitate the public sale or other disposition of such Registrable Shares;

 

(d)            use its best efforts to register or qualify the Registrable Shares covered by such registration statement under the securities or blue sky laws of such jurisdictions as each holder whose Registrable Shares are being registered pursuant to this Section 3 shall reasonably request, and do any and all other acts or things which may be necessary or advisable to enable such holder to consummate the public sale or other disposition in such jurisdictions of such Registrable Shares; provided , however , that the Corporation shall not be required to consent to general service of process for all purposes in any jurisdiction where it is not then subject to process, qualify to do business as a foreign corporation where it would not be otherwise required to qualify or submit to liability for state or local taxes where it is not otherwise liable for such taxes;

 

(e)            at any time when a prospectus covered by such registration statement and relating thereto is required to be delivered under the Securities Act within the appropriate period mentioned in Section 3.7(b) hereof, notify each holder whose Registrable Shares are being registered pursuant to this Section 3 of the happening of any event as a result of which the prospectus included in such registration, as then in effect, includes an untrue statement of a material fact or omits to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the circumstances then existing and, at the request of such holder, prepare, file and furnish to such holder a reasonable number of copies of a supplement to or an amendment of such prospectus as may be necessary so that, as thereafter delivered to the purchasers of such shares, such prospectus shall not include an untrue statement of a material fact or omit to state a material fact required to be stated therein or necessary to make the statements therein not misleading in the light of the circumstances then existing;

 

(f)             if the Corporation has delivered preliminary or final prospectuses to the holders of Registrable Shares that are being registered pursuant to this Section 3 and after having done so the prospectus is amended to comply with the requirements of the Securities Act, the Corporation shall promptly notify such holders and, if requested, such holders shall immediately cease making offers of Registrable Shares and return all prospectuses to the Corporation. The Corporation shall promptly provide such holders with revised prospectuses and, following receipt of the revised prospectuses, such holders shall be free to resume making offers of the Registrable Shares; and

 

(g)            furnish, at the request of any holder whose Registrable Shares are being registered pursuant to this Section 3, on the date that such Registrable Shares are delivered to the underwriters for sale in connection with a registration pursuant to this Section 3 if such securities are being sold through underwriters, or on the date that the registration statement with respect to such securities becomes effective if such securities are not being sold through underwriters, (i) an opinion, dated such date, of the counsel representing the Corporation for the purposes of such registration, in form and substance as is customarily given to underwriters in an underwritten public offering, addressed to the underwriters, if any, and to the holder or holders making such request, and (ii) a letter dated such date, from the independent certified public accountants of the Corporation, in form and substance as is customarily given by independent certified public accountants to underwriters in an underwritten public offering, addressed to the underwriters, if any, and to the holder or holders making such request.

 

3.8           Expenses .  The Corporation shall pay all expenses incurred by the Corporation in complying with this Section 3, including, without limitation, all registration and filing fees (including

 

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all expenses incident to filing with the FINRA), fees and expenses of complying with the securities and blue sky laws of all such jurisdictions in which the Registrable Shares are proposed to be offered and sold, printing expenses and fees and disbursements of counsel (including with respect to each registration effected pursuant to Sections 3.4, 3.5 and 3.6, the reasonable fees and disbursements of a counsel for the holders of Registrable Shares that are being registered pursuant to this Section 3, such counsel for the holders of Registrable Shares shall be designated by a vote of a majority of the holders of Registrable Shares to be included in such registration, determined in accordance with Article III, Section A.6(a) of the Certificate); provided , however , that all underwriting discounts and selling commissions applicable to the Registrable Shares covered by registrations effected pursuant to Section 3.4, 3.5 or 3.6 hereof shall be borne by the seller or sellers thereof, in proportion to the number of Registrable Shares sold by each such seller or sellers.

 

3.9           Indemnification .

 

(a)            In the event of any registration of any Registrable Shares under the Securities Act pursuant to this Section 3 or registration or qualification of any Registrable Shares pursuant to Section 3.7(d) hereof, the Corporation shall indemnify and hold harmless the seller of such shares, each underwriter of such shares, if any, each broker or any other person acting on behalf of such seller and each other person, if any, who controls any of the foregoing persons, within the meaning of the Securities Act, against any losses, claims, damages or liabilities, joint or several, to which any of the foregoing persons may become subject under the Securities Act or otherwise, insofar as such losses, claims, damages or liabilities (or actions in respect thereof) arise out of or are based upon an untrue statement or alleged untrue statement of a material fact contained in any registration statement under which such Registrable Shares were registered under the Securities Act, any preliminary prospectus or final prospectus contained therein, or any amendment or supplement thereto, or any document incident to registration or qualification of any Registrable Shares pursuant to Section 3.7(d) hereof or arise out of or are based upon the omission or alleged omission to state therein a material fact required to be stated therein or necessary to make the statements therein not misleading or, with respect to any prospectus, necessary to make the statements therein, in light of the circumstances under which they were made, not misleading, or any violation by the Corporation of the Securities Act or any state securities or blue sky laws applicable to the Corporation and relating to action or inaction required of the Corporation in connection with such registration or qualification under the Securities Act or such state securities or blue sky laws. The Corporation shall reimburse on demand such seller, underwriter, broker or other person acting on behalf of such seller and each such controlling person for any legal or any other expenses reasonably incurred by any of them in connection with investigating or defending any such loss, claim, damage, liability or action; provided, however, that the Corporation shall not be liable in any such case to the extent that any such loss, claim, damage or liability arises out of or is based upon an untrue statement or alleged untrue statement or omission or alleged omission made in said registration statement, preliminary or final prospectus or amendment or supplement thereto or any document incident to registration or qualification of any Registrable Shares pursuant to Section 3.7(d) hereof, in reliance upon and in conformity with written information furnished to the Corporation by such seller, underwriter, broker, other person or controlling person specifically for use in the preparation hereof.

 

(b)            Before Registrable Shares held by any prospective seller shall be included in any registration pursuant to this Section 3, such prospective seller and any underwriter acting on its behalf shall have agreed to indemnify and hold harmless (in the same manner and to the same extent as set forth in paragraph (a)) the Corporation, each director of the Corporation, each officer of the Corporation who signs such registration statement and any person who controls the Corporation within the meaning of the Securities Act, with respect to any untrue statement or omission from such registration statement, any preliminary prospectus or final prospectus contained therein, or any amendment or supplement thereto, if such untrue statement or omission was made in reliance upon and in conformity

 

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with written information furnished to the Corporation through an instrument duly executed by such seller or such underwriter specifically for use in the preparation of such registration statement, preliminary prospectus, final prospectus or amendment or supplement; provided , however , that the maximum amount of liability in respect of such indemnification shall be limited, in the case of each prospective seller, to an amount equal to the net proceeds actually received by such prospective seller from the sale of Registrable Shares effected pursuant to such registration.

 

(c)            Promptly after receipt by an indemnified party of notice of the commencement of any action involving a claim referred to in Section 3.9(a) or (b) hereof, such indemnified party will, if a claim in respect thereof is to be made against the indemnifying party under this Section 3.9, give written notice to the latter of the commencement of such action. In case any such action is brought against an indemnified party, the indemnifying party will be entitled to participate in and to assume the defense thereof jointly with any other indemnifying party similarly notified to the extent that it may wish, with counsel reasonably satisfactory to such indemnified party, and, after notice to such indemnified party from the indemnifying party of its election to assume the defense thereof, the indemnifying party shall be responsible for any legal or other expenses subsequently incurred by such indemnifying party in connection with the defense thereof; provided , however , that, if any indemnified party shall have reasonably concluded that there may be one or more legal defenses available to such indemnified party which are different from or additional to those available to the indemnifying party, or that such claim or litigation involves or could have an effect upon matters beyond the scope of the indemnity agreement provided in this Section 3.9, the indemnifying party shall not have the right to assume the defense of such action on behalf of such indemnified party, and such indemnifying party shall reimburse such indemnified party and any person controlling such indemnified party for the fees and expenses of counsel retained by the indemnified party which are reasonably related to the matters covered by the indemnity agreement provided in this Section 3.9. The indemnifying party shall not make any settlement of any claims in respect of which it is obligated to indemnify an indemnified party or parties hereunder, without the written consent of the indemnified party or parties, which consent shall not be unreasonably withheld.

 

(d)            In order to provide for just and equitable contribution to joint liability under the Securities Act, in any case in which either (i) any holder of Registrable Shares exercising rights under this Agreement, or any controlling person of any such holder, makes a claim for indemnification pursuant to this Section 3.9, but it is judicially determined (by the entry of a final judgment or decree by a court of competent jurisdiction and the expiration of time to appeal or the denial of the last right of appeal) that such indemnification may not be enforced in such case notwithstanding the fact that this Section 3.9 provides for indemnification in such case, or (ii) contribution under the Securities Act may be required on the part of any such holder or any such controlling person in circumstances for which indemnification is provided under this Section 3.9; then, in each such case, the Corporation and such holder will contribute to the aggregate losses, claims, damages or liabilities to which they may be subject as is appropriate to reflect the relative fault of the Corporation and such holder in connection with the statements or omissions which resulted in such losses, claims, damages or liabilities, it being understood that the parties acknowledge that the overriding equitable consideration to be given effect in connection with this provision is the ability of one party or the other to correct the statement or omission which resulted in such losses, claims, damages or liabilities, and that it would not be just and equitable if contribution pursuant hereto were to be determined by pro rata allocation or by any other method of allocation which does not take into consideration the foregoing equitable considerations. Notwithstanding the foregoing, (i) no such holder will be required to contribute any amount in excess of the proceeds to it of all Registrable Shares sold by it pursuant to such registration statement, and (ii) no person or entity guilty of fraudulent misrepresentation, within the meaning of Section 11(f) of the Securities Act, shall be entitled to contribution from any person or entity who is not guilty of such fraudulent misrepresentation.

 

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(e)            Notwithstanding any of the foregoing, if, in connection with an underwritten public offering of any Registrable Shares, the Corporation, the holders of such Registrable Shares and the underwriters enter into an underwriting or purchase agreement relating to such offering which contains provisions covering indemnification among the parties, then the indemnification provision of this Section 3.9 shall be deemed inoperative for purposes of such offering.

 

3.10         Removal of Legends, Etc .  Notwithstanding the foregoing provisions of this Section 3, the restrictions imposed by this Section 3 upon the transferability of any Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock shall cease and terminate when (a) any such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock are sold or otherwise disposed of in accordance with the intended method of disposition by the seller or sellers thereof set forth in a registration statement or such other method contemplated by Section 3.3 hereof that does not require that the securities transferred bear the legend set forth in Section 3.2 hereof, including a Transfer pursuant to Rule 144 or a successor rule thereof (as amended from time to lime), or (b) the holder of Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock has met the requirements for transfer of such Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock pursuant to subparagraph (b)(1) of Rule 144 or a successor rule thereof (as amended from time to time) promulgated by the Commission under the Securities Act. Whenever the restrictions imposed by this Section 3 have terminated, a holder of a certificate for Restricted Stock, Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock as to which such restrictions have terminated shall be entitled to receive from the Corporation, without expense, a new certificate not bearing the restrictive legend set forth in Section 3.2 hereof and not containing any other reference to the restrictions imposed by this Section 3. Notwithstanding the above, nothing herein shall limit the restrictions imposed upon transfer of the Restricted Securities pursuant to Section 8 hereof nor the imposition of the legend provided for therein.

 

3.11         Lock-up Agreement .

 

(a)            Each Stockholder agrees that, during the 180-day period following the date hereof, such Stockholder will not, without the prior written consent of the Company, sell, assign, transfer, make a short sale of, loan, grant any option for the purchase of, or exercise registration rights with respect to any shares of Common Stock or shares of capital stock or other securities of the Corporation convertible into or exercisable for, whether directly or indirectly, shares of Common Stock, other than to a member of such Stockholder’s Group; provided, however, that notwithstanding the foregoing but subject to the provisions of Section 3.11(b) below, (i) on or at any time after each of the dates listed in the table below under the caption “Initial Lock-up Release Date”, such Stockholder shall be permitted to sell, assign, transfer, make a short sale of, loan, or grant any option for the purchase of, with respect to that number of shares of Common Stock issued or issuable upon conversion of shares of Series A-1 Conversion Shares (the “ Series A-1 Conversion Shares ”) held or issuable to such Stockholder that corresponds to a percentage of the total number of Series A-1 Conversion Shares held or issuable to such Stockholder at such time, which percentage is set forth in the table below under the caption “Initial Lock-up Release Percentage”.

 

Initial Lock-up Release Date

 

Initial Lock-up Release Percentage

 

 

 

 

 

30 th  day after the date of this Agreement

 

5

%

 

 

 

 

60 th  day after the date of this Agreement

 

15

%

 

 

 

 

90 th  day after the date of this Agreement

 

30

%

 

 

 

 

120 th  day after the date of this Agreement

 

50

%

 

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(b)            Notwithstanding the foregoing, (A) subject to clause (C) below, the restriction on transfer set forth in Section 3.11(a) above shall not apply to block trades of 10,000 shares or more of the Series A-1 Conversion Shares, (B) subject to clause (C) below, if, on or at any time after any date listed in the table set forth in Section 3.11(a) above, the average of the closing bid and ask price of the Company’s Common Stock if quoted on any electronic quotation system, including but not limited to the OTC:BB for the five (5) trading days ending on such date, or the average last-sale price of the Company’s Common Stock if listed on a national securities exchange for the five (5) trading days ending on such date, is greater than $16.29 per share (subject to proportionate and equitable adjustment upon any stock split, stock dividend, reverse stock split or similar event that becomes effective after the date of this Agreement), the percentage in the table set forth in Section 3.11(a) above that corresponds to such date shall be doubled and (C) in no event shall any Stockholder be permitted, during the period commencing on the date hereof and ending on the date of the listing of the Company’s Common Stock on a national securities exchange, to sell, assign, transfer, make a short sale of, loan, grant any option for the purchase of, or exercise registration rights with respect to any Series A-1 Conversion Shares for a price less than $8.142 (subject to proportionate and equitable adjustment upon any stock split, stock dividend, reverse stock split or similar event that becomes effective after the date of this Agreement), except (x) with the prior written consent of the Company or (y) to a member of such Stockholder’s Group.

 

(c)            Each Stockholder agrees further that, if the Company or a managing underwriter so requests of such Stockholder in connection with a registered public offering of securities of the Company, such Stockholder will not, without the prior written consent of the Company or such underwriters, sell, assign, transfer, make a short sale of, loan, grant any option for the purchase of, or exercise registration rights with respect to any shares of Common Stock or shares of capital stock or other securities of the Corporation convertible into or exercisable for, whether directly or indirectly, shares of Common Stock, other than to a member of such Stockholder’s Group, during the period of (i)180 days following the closing of the first public offering of securities offered and sold for the account of the Corporation that is registered under the Securities Act, or (ii) 90 days following the closing of any other public offering of securities offered and sold for the account of the Corporation that is registered under the Securities Act ; provided that such request is made of all officers, directors and 1% and greater Stockholders and each such person shall be similarly bound; and, provided , further , that nothing in this Section 3.11(c) shall prevent any Stockholder from participating in any registered public offering of the Corporation as a selling stockholder or security holder.

 

(d)            In the event that the Corporation releases or causes to be released any Stockholder from any restrictions on transfer set forth in the foregoing provisions of this Section 3.11, the Corporation shall release or cause to be released all other Stockholders in similar fashion and any such release of all Stockholders shall be implemented on a pro rata basis.

 

3.12         Duration of Section .  With respect to each holder of Registrable Shares, Sections 3.4, 3.5 and 3.6 shall automatically terminate for that holder on the fourth anniversary of the Filing Date.

 

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SECTION 4.  Election of Directors .

 

4.1           Voting for Directors .  At the first annual meeting of the Stockholders of the Corporation after the Stage I Closing, and thereafter at each annual meeting and each special meeting of the Stockholders of the Corporation called for the purposes of electing directors of the Corporation, and at any time at which Stockholders of the Corporation shall have the right to, or shall, vote or consent to the election of directors, then, in each such event, each Stockholder shall vote all shares of Preferred Stock, Common Stock and any other shares of voting stock of the Corporation then owned (or controlled as to voting rights) by it, him or her, whether by purchase, exercise of rights, warrants or options, stock dividends or otherwise:

 

(a)            to fix and maintain the number of directors on the Board at seven (7);

 

(b)            to the extent entitled under the Certificate as in effect as of the date of this Agreement, to elect as Directors of the Corporation on the date hereof and in any subsequent election of Directors the following individuals:

 

(i)             in the case of the two (2) directors to be elected by the holders of Series A-1 Preferred Stock under the Certificate, two (2) individuals to be designated by the affirmative vote or written consent of the holders of a majority of the outstanding shares of Series A-1 Preferred Stock (the “ Series A-1 Directors ”), who shall initially be Ansbert Gadicke and Martin Muenchbach.

 

(ii)            in the case of the one (1) director to be elected by the G3 Holders (as defined in the Certificate), one (1) director to be designated by the affirmative vote or written consent of those G3 Holders holding a majority of the shares held by the G3 Holders (the “ Specified Preferred Director ”), who shall initially be Jonathan Fleming, provided , however , that in order to be eligible to vote or consent with respect to the designation of an individual as a nominee for election as the Specified Preferred Director, a G3 Holder together with members of such G3 Holders’ Group must hold greater than twenty percent (20%) of the Preferred Stock purchased under the Series A-1 Stock Purchase Agreement by such G3 Holder and members of such G3 Holders’ Group;

 

(iii)           in the case of the one (1) director to be elected by MPM, one (1) director to be designated by the affirmative vote or written consent of MPM, provided that such director be an individual with particular expertise in the development of pharmaceutical products, as reasonably determined by MPM, if any (the “ Industry Expert Director ” and together with the Series A-1 Directors and the Specified Preferred Director, the “ Investor Directors ”), who shall initially be Elizabeth Stoner, provided , further , however , that in order to be eligible to vote or consent with respect to the designation of an individual as a nominee for election as the Industry Expert Preferred Director, MPM together with members of the MPM Group must hold greater than twenty percent (20%) of the Preferred Stock purchased under the Series A-1 Stock Purchase Agreement by MPM and members of the MPM Group.

 

(iv)           in the case of the remaining directors to be elected by the holders of Preferred Stock and Common Stock, voting together as a single class, under the Certificate, three (3) individuals as follows:

 

a.              two industry or market experts, each of whom shall be designated by a majority of the other members of the Board, including a majority of the Investor Directors (the “ Independent Directors ”), and who shall initially be Alan Auerbach and Kurt Graves; and

 

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b.              the Chief Executive Officer of the Corporation, who shall initially be Richard Lyttle.

 

4.2           Observer Rights .

 

(a)            HCV VII shall have the right to appoint an observer to the Board (the “ HCV Observer ”) as long as HCV VII, together with members of the HCV Group, holds greater than seventy five percent (75%) of the Series A-1 Preferred Stock originally purchased by HCV VII and members of the HCV Group pursuant to the Purchase Agreement. The HCV Observer shall have the right to attend all meetings of the Board in a non-voting observer capacity, and the Corporation shall provide to the HCV Observer all materials provided to the members of the Board and notice of such meetings, all in the manner and at the time provided to the members of the Board; provided , however , that the Corporation reserves the right to exclude such representatives from access to any material or meeting or portion thereof if the Corporation believes upon advice of counsel that such exclusion is necessary to preserve the attorney-client privilege or to protect highly confidential information, the disclosure of which should not be made to any person who does not have a fiduciary or other similar duty to the Corporation. The decision of the Board with respect to the privileged or confidential nature of such information shall be final and binding. HCV VII’s rights under this Section 4.2(a) may only be assigned in connection with the transfer of all of the Preferred Stock held by HCV VII to the assignee. In addition and without limiting the foregoing, in the event that HCV VII appoints any person to be the HCV Observer under this Section 4.2(a) who, in the good faith determination of the Board, has conflicting interests with the Corporation, then the Corporation shall have the right, at any time and from time to time, to exclude the HCV Observer from access to any meeting, or any portion thereof, and/or deny the HCV Observer access to any information and documents, or any portions thereof.

 

(b)            Saints Capital IV, L.P. (“ Saints ”) shall have the right to appoint an observer to the Board (the “ Saints Observer ”) as long as Saints, together with other members of the Saints/Oxford Group, holds greater than seventy-five percent (75%) of the Series A-1 Preferred Stock originally purchased by Saints and the other member of the Saints/Oxford Group pursuant to the Purchase Agreement. The Saints Observer shall have the right to attend all meetings of the Board in a non-voting observer capacity, and the Corporation shall provide to the Saints Observer all materials provided to the members of the Board and notice of such meetings, all in the manner and at the time provided to the members of the Board; provided, however, that the Corporation reserves the right to exclude such representatives from access to any material or meeting or portion thereof if the Corporation believes upon advice of counsel that such exclusion is necessary to preserve the attorney-client privilege or to protect highly confidential information, the disclosure of which should not be made to any person who does not have a fiduciary or other similar duty to the Corporation. The decision of the Board with respect to the privileged or confidential nature of such information shall be final and binding. Saints’ rights under this Section 4.2(b) may only be assigned in connection with the transfer of all of the Preferred Stock held by Saints to the assignee. In addition and without limiting the foregoing, in the event that Saints appoints any person to be the Saints Observer under this Section 4.2(b) who, in the good faith determination of the Board, has conflicting interests with the Corporation, then the Corporation shall have the right, at any time and from time to time, to exclude the Saints Observer from access to any meeting, or any portion thereof, and/or deny the Saints Observer access to any information and documents, or any portions thereof.

 

(c)            Brookside shall have the right to appoint an observer to the Board (the “ Brookside Observer ”) as long as Brookside, together with other members of the Brookside Group, holds greater than seventy-five percent (75%) of the Series A-1 Preferred Stock originally purchased by Brookside and the other member of the Brookside Group pursuant to the Purchase Agreement. The Brookside Observer shall have the right to attend all meetings of the Board in a non-voting observer

 

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capacity, and the Corporation shall provide to the Brookside Observer all materials provided to the members of the Board and notice of such meetings, all in the manner and at the time provided to the members of the Board; provided, however, that the Corporation reserves the right to exclude such representatives from access to any material or meeting or portion thereof if the Corporation believes upon advice of counsel that such exclusion is necessary to preserve the attorney-client privilege or to protect highly confidential information, the disclosure of which should not be made to any person who does not have a fiduciary or other similar duty to the Corporation. The decision of the Board with respect to the privileged or confidential nature of such information shall be final and binding. Brookside’s rights under this Section 4.2(c) may only be assigned in connection with the transfer of all of the Preferred Stock held by Brookside to the assignee. In addition and without limiting the foregoing, in the event that Brookside appoints any person to be the Brookside Observer under this Section 4.2(c) who, in the good faith determination of the Board, has conflicting interests with the Corporation, then the Corporation shall have the right, at any time and from time to time, to exclude the Brookside Observer from access to any meeting, or any portion thereof, and/or deny the Brookside Observer access to any information and documents, or any portions thereof.

 

(d)            Wellcome shall have the right to appoint an observer to the Board (the “ Wellcome Observer ”) as long as Wellcome holds greater than seventy five percent (75%) of the Series A-1 Preferred Stock originally purchased by Wellcome pursuant to the Purchase Agreement. The Wellcome Observer shall have the right to attend all meetings of the Board in a non-voting observer capacity, and the Corporation shall provide to the Wellcome Observer all materials provided to the members of the Board and notice of such meetings, all in the manner and at the time provided to the members of the Board; provided , however , that the Corporation reserves the right to exclude such representatives from access to any material or meeting or portion thereof if the Corporation believes upon advice of counsel that such exclusion is necessary to preserve the attorney-client privilege or to protect highly confidential information, the disclosure of which should not be made to any person who does not have a fiduciary or other similar duty to the Corporation. The decision of the Board with respect to the privileged or confidential nature of such information shall be final and binding. Wellcome’s rights under this Section 4.2(a) may only be assigned in connection with the transfer of all of the Preferred Stock held by Wellcome to the assignee. In addition and without limiting the foregoing, in the event that Wellcome appoints any person to be the Wellcome Observer under this Section 4.2(a) who, in the good faith determination of the Board, has conflicting interests with the Corporation, then the Corporation shall have the right, at any time and from time to time, to exclude the Wellcome Observer from access to any meeting, or any portion thereof, and/or deny the Wellcome Observer access to any information and documents, or any portions thereof.

 

4.3           Cooperation of the Corporation .  The Corporation shall use its best efforts to effectuate the purposes of this Section 4, including (i) taking such actions as are necessary to convene annual and/or special meetings of the Stockholders for the election of directors and (ii) promoting the adoption of any necessary amendment of the by-laws of the Corporation and the Certificate.

 

4.4           Notices . The Corporation shall provide the Series A-1 Stockholders, MPM and the Specified Preferred Holders with at least twenty (20) days’ prior notice in writing of any intended mailing of notice to the Stockholders of a meeting at which directors are to be elected, and such notice shall include the names of the persons designated by the Corporation pursuant to this Section 4.  The Series A-1 Stockholders, MPM and the Specified Preferred Holders shall notify the Corporation in writing at least three (3) days prior to such mailing of the persons designated by them respectively pursuant to Section 4.1 above as nominees for election to the Board.  In the absence of any notice from the Series A-1 Stockholders, MPM and the Specified Preferred Holders, the director(s) then serving and previously designated by the Series A-1 Stockholders, MPM and the Specified Preferred Holders, as applicable, shall be renominated.

 

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4.5                                Removal .  Except as otherwise provided in this Section 5, no Stockholder shall vote to remove any member of the Board designated in accordance with the foregoing provisions of this Section 4 unless the party or group of stockholders, as applicable, who designated such director (the “ Designating Party ”) shall so vote or otherwise consent, and, if the Designating Party shall so vote or otherwise consent, then the non-designating Stockholders shall likewise so vote. Any vacancy on the Board created by the resignation, removal, incapacity or death of any person designated under the foregoing provisions of this Section 4 may be filled by another person designated by the original Designating Party. Each Stockholder shall vote all shares of voting stock of the Corporation owned or controlled by such Stockholder in accordance with each such new designation.

 

4.6                                Quorum .  A quorum for any meeting of the Board of Directors shall consist of a majority of all directors; provided , that at least a majority of the Investor Directors is in attendance at such meeting. If, at any meeting, a quorum is not present for any reason, then another Board of Directors meeting may be convened within no less than two (2) and no more than ten (10) business days and, at such meeting, a majority of all directors shall constitute a quorum for all purposes.

 

4.7                                Committees .  Each of the Investor Directors shall have the right to sit on any committee of the Board of Directors.

 

4.8                                Duration of Section .  This Section 4 and the rights and obligations of the parties hereunder shall automatically terminate on the earlier of (i) the consummation of an Event of Sale (as defined in the Certificate) or (ii) the automatic conversion of all of the Preferred Stock of the Corporation pursuant to the Certificate as a result of the listing, or the admitting for trading, of the Common Stock on a national securities exchange. Prior to such termination, the rights and obligations of any Preferred Stockholder under this Section 4 shall terminate upon the date on which such Preferred Stockholder or its Group no longer owns any Preferred Stock, whereupon the obligations of the remaining Stockholders to vote in favor of the designee of such Preferred Stockholder shall also terminate.

 

SECTION 5.  Indemnification .

 

5.1                                Indemnification of Investors .  In the event that any Series A-1 Preferred Stockholder, Series A-2 Preferred Stockholder, Series A-3 Preferred Stockholder, Series A-5 Preferred Stockholder, Series A-6 Preferred Stockholder or any director, officer, employee, affiliate or agent thereof (the “ Indemnitees ”), become involved in any capacity in any action, proceeding, investigation or inquiry in connection with or arising out of any matter related to the Corporation or any Indemnitee’s role or position with the Corporation, the Corporation shall reimburse each Indemnitee for its legal and other expenses (including the cost of any investigation and preparation) as they are incurred by such Indemnitee in connection therewith. The Corporation also agrees to indemnify each Indemnitee, pay on demand and protect, defend, save and hold harmless from and against any and all liabilities, damages, losses, settlements, claims, actions, suits, penalties, fines, costs or expenses (including, without limitation, attorneys’ fees) (any of the foregoing, a “ Claim ”) incurred by or asserted against any Indemnitee of whatever kind or nature, arising from, in connection with or occurring as a result of this Agreement or the matters contemplated by this Agreement; provided , however , that the Corporation shall not be required to indemnify any Indemnitee hereunder in connection with any matter as to which a court of competent jurisdiction has made a final non-appealable determination that such Indemnitee has acted with gross negligence or willful or intentional misconduct in connection therewith. The foregoing agreement shall be in addition to any rights that any Indemnitee may have at common law or otherwise.

 

5.2                                Advancement of Expenses .  The Corporation shall advance all expenses reasonably incurred by or on behalf of the Indemnitees in connection with any Claim or potential Claim

 

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within twenty (20) days after the receipt by the Corporation of a statement or statements from the Indemnitee requesting such advance payment or payments from time to time.

 

SECTION 6.  Remedies .  In case any one or more of the covenants and/or agreements set forth in this Agreement shall have been breached by any party hereto, the party or parties entitled to the benefit of such covenants or agreements may proceed to protect and enforce its or their rights, either by suit in equity and/or action at law, including, but not limited to, an action for damages as a result of any such breach and/or an action for specific performance of any such covenant or agreement contained in this Agreement.  The rights, powers and remedies of the parties under this Agreement are cumulative and not exclusive of any other right, power or remedy which such parties may have under any other agreement or law. No single or partial assertion or exercise of any right, power or remedy of a party hereunder shall preclude any other or further assertion or exercise thereof.

 

SECTION 7.  Successors and Assigns .

 

7.1                                Series A-1, A-2 and A-3 Stockholders .  Except as otherwise expressly provided herein, this Agreement shall bind and inure to the benefit of the Corporation and each of the Series A-1 Stockholder, Series A-2 Stockholder and Series A-3 Stockholder parties hereto and the respective successors and permitted assigns of the Corporation and each of the Series A-1 Stockholder, Series A-2 Stockholder and Series A-3 Stockholder parties hereto (including any member of a Stockholder’s Group). Subject to the requirements of Section 3 hereof, this Agreement and the rights and duties of the Series A-1 Stockholder, Series A-2 Stockholder and Series A-3 Stockholder set forth herein may be freely assigned, in whole or in part, by each Series A-1 Stockholder, Series A-2 Stockholder and Series A-3 Stockholder to any member of their respective Group, provided such transferee is an “affiliate” of such Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, as the case may be, as such term is defined under Rule 501 of the Securities Act (it being recognized and agreed that each member of the Oxford/Saints Group shall be deemed to be “affiliates” of each other for this purpose). Any transferee from a Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, as the case may be, to whom rights under Section 3 are transferred shall, as a condition to such transfer, deliver to the Corporation a written instrument by which such transferee identifies itself, gives the Corporation notice of the transfer of such rights, identities the securities of the Corporation owned or acquired by it and agrees to be bound by the obligations imposed hereunder to the same extent as if such transferee were a Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, as applicable, hereunder. A transferee to whom rights are transferred pursuant to this Section 7.1 will be thereafter deemed to be a Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, as applicable, for the purpose of the execution of such transferred rights and may not again transfer such rights to any other person or entity, other than as provided in this Section 7.1.  Upon the consummation of the Merger: (i) all of the rights and obligations of this Agreement pertaining to the Series A-1 Stockholders and the shares of Series A-1 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-1 Preferred Stock, par value $0.0001 per share of MPM Acquisition Corp., a Delaware corporation (“ MPMAC ”), and the shares of such MPMAC Series A-1 Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-1 Preferred Stock for all purposes of this Agreement; (ii) all of the rights and obligations of this Agreement pertaining to the Series A-2 Stockholders and the shares of Series A-2 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-2 Preferred Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Series A-2 Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-2 Preferred Stock for all purposes of this Agreement; and (iii) all of the rights and obligations of this Agreement pertaining to the Series A-3 Stockholders and the shares of Series A-3 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-3 Preferred Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Series A-3

 

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Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-3 Preferred Stock for all purposes of this Agreement.

 

7.2                                Other Stockholders .  Except as otherwise expressly provided herein, this Agreement shall bind and inure to the benefit of the Corporation and each of the Common Stockholders and the Series A-4 Stockholders, Series A-5 Stockholders and Series A-6 Stockholders (collectively, the “ Other Stockholders ”) and the respective successors and permitted assigns of the Corporation and each of the Other Stockholders. Subject to the requirements of Section 3 hereof, this Agreement and the rights and duties of the Other Stockholders set forth herein may be assigned, in whole or in part, by any Other Stockholder to a Related Transferee or to any member of their respective Group, provided such transferee is an “affiliate” of such Other Stockholder, as such term is defined under Rule 501 of the Securities Act (it being recognized and agreed that each Member of the Oxford/Saints Group shall be deemed to be “affiliates” of each other for this purpose). Any transferee from an Other Stockholder to whom rights under Section 3 are transferred shall, as a condition to such transfer, deliver to the Corporation a written instrument by which such transferee identifies itself, gives the Corporation notice of the transfer of such rights, identifies the securities of the Corporation owned or acquired by it and agrees to be bound by the obligations imposed hereunder to the same extent as if such transferee were an Other Stockholder hereunder. A transferee to whom rights are transferred pursuant to this Section 7.2 will be thereafter deemed to be an Other Stockholder for the purpose of the execution of such transferred rights and may not again transfer such rights to any other person or entity, other than as provided in this Section 7.2.  Upon the consummation of the Merger: (i) all of the rights and obligations of this Agreement pertaining to the holders of Common Stock and the shares of Common Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Common Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Common Stock held by them, respectively, as if such shares of MPMAC stock were shares of Common Stock for all purposes of this Agreement; (ii) all of the rights and obligations of this Agreement pertaining to the Series A-4 Stockholders and the shares of Series A-4 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-4 Preferred Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Series A-4 Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-4 Preferred Stock for all purposes of this Agreement; (iii) all of the rights and obligations of this Agreement pertaining to the Series A-5 Stockholders and the shares of Series A-5 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-5 Preferred Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Series A-5 Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-5 Preferred Stock for all purposes of this Agreement; and (iv) all of the rights and obligations of this Agreement pertaining to the Series A-2 Stockholders and the shares of Series A-6 Preferred Stock of the Corporation held by them shall be deemed to apply in the same manner to the holders of Series A-6 Preferred Stock, par value $0.0001 per share of MPMAC, and the shares of such MPMAC Series A-6 Preferred Stock held by them, respectively, as if such shares of MPMAC stock were shares of Series A-6 Preferred Stock for all purposes of this Agreement.

 

7.3                                The Corporation .  Neither this Agreement nor any of the rights or duties of the Corporation set forth herein shall be assigned by the Corporation, in whole or in part, without having first received the written consent of the Majority Investors.  Notwithstanding the foregoing, upon the consummation of the Merger with respect to all times after the consummation of the Merger, (i) the Corporation shall, and hereby does, assign all of its rights, duties and obligations under this Agreement to MPMAC and (ii) all references to the “Corporation” in this Agreement and to its capital stock or any other aspects of the Corporation shall be deemed to be references to MPMAC and its capital stock and other applicable aspects of MPMAC.  MPMAC, by executing this Agreement as an anticipated successor and assign to the Corporation, does hereby assume, effective upon the consummation of the

 

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Merger, all of the Corporation’s rights, duties and obligations under this Agreement.  All parties to this Agreement hereby consent to the assignment and assumption contemplated between the Corporation and MPMAC set forth in this paragraph.

 

SECTION 8.  Duration of Agreement .  The rights and obligations of the Corporation and each Stockholder set forth herein shall survive indefinitely, unless and until, by the respective terms of this Agreement, they are no longer applicable.

 

SECTION 9.  Entire Agreement .  This Agreement, together with the other writings referred to herein or delivered pursuant hereto which form a part hereof, contains the entire agreement among the parties with respect to the subject matter hereof and amends, restates and supersedes all prior and contemporaneous arrangements or understandings with respect thereto.

 

SECTION 10.  Notices .  All notices, requests, consents and other communications hereunder to any party shall be deemed to be sufficient if contained in a written instrument delivered in person or duly sent by first class registered, certified or overnight mail, postage prepaid, or telecopied with a confirmation copy by regular mail, addressed or telecopied, as the case may be, to such party at the address or telecopier number, as the case may be, set forth below or such other address or telecopier number, as the case may be, as may hereafter be designated in writing by the addressee to the addressor listing all parties:

 

(i)                                      if to the Corporation, to:

 

Radius Health, Inc.

201 Broadway

Sixth Floor

Cambridge, MA 02139

Attention: Chief Executive Officer

 

Telecopier: (617) 551-4701

 

with a copy to:

 

Bingham McCutchen LLP

One Federal Street

Boston, MA 02110-1726

Attention: Julio E. Vega, Esq.

Telecopier: (617) 951-8736

 

(ii)                                   if to the Investors, as set forth on Schedule 2; to the Common Stockholders, as set forth on Schedule 1; to the holders of Series A-2 Preferred Stock, as set forth on Schedule 3; to the holders of Series A-3 Preferred Stock, as set forth on Schedule 4; to the holders of Series A-4 Preferred Stock, as set forth on Schedule 5; to the holder of Series A-5 Preferred Stock and/or Series A-6 Preferred Stock, as set forth on Schedule 6,

 

All such notices, requests, consents and communications shall be deemed to have been received (a) in the case of personal delivery, on the date of such delivery, (b) in the case of mailing, on the third business day following the date of such mailing, (c) in the case of overnight mail, on the first business day following the date of such mailing, and (d) in the case of facsimile transmission, when confirmed by facsimile machine report.

 

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SECTION 11.  Changes .  The terms and provisions of this Agreement may not be modified or amended, or any of the provisions hereof waived, temporarily or permanently, except pursuant to the written consent of the Corporation and the Majority Investors, and to the extent that there is a material adverse effect of any such modification or amendment on the rights and obligations of the holders of shares of Series A-4 Preferred Stock, Series A-5 Preferred Stock or Series A-6 Preferred Stock in a manner more adverse than such effect on the holders of Series A-1 Preferred Stock, Series A-2 Preferred Stock or Series A-3 Preferred Stock, respectively, a majority in combined voting power of the such more affected series then outstanding, determined in accordance with Section A.6(a) of Article III of the Certificate. Additional parties who become Common Stockholders or Series A-4 Stockholders, Series A-5 Stockholders or Series A-6 Stockholders pursuant to an instrument of adherence will not constitute a change under this Section 11. Notwithstanding the foregoing, (a) any modification or amendment to this Agreement that would adversely affect one Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder in a manner that is directed specifically to such Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, rather than to all Series A-1 Stockholders, Series A-2 Stockholders and Series A-3 Stockholders, shall be subject to the approval of each such Series A-1 Stockholder, Series A-2 Stockholder or Series A-3 Stockholder, as applicable, (b) any modification or amendment to Section 2.11 hereof shall be subject to the further approval of Wellcome, at least one member of HCV Group, one member of the MPM Group, one member of the Brookside Group, one member of the BB Bio Group, and the Oxford/Saints Group, (c) any modification to Section 4.1(b)(i) shall be subject to the further approval of Stockholders holding at least a majority of the outstanding shares of Series A-1 Preferred Stock, (d) any modification to Section 4.1(b)(ii) shall be subject to the further approval of at least two of the Specified Preferred Holders, (e) any modification to Section 4.1(b)(iii) shall be subject to the further approval of at least one member of the MPM Group, (f) any modification to Section 4.2(a) shall be subject to the further approval of at least one member of the HCV Group, (g) any modification to Section 4.2(b) shall be subject to the further approval of Saints, (h) any modification to Section 4.2(c) shall be subject to the further approval of at least one member of the Brookside Group and (i) any modification to Section 4.2(d) shall be subject to the further approval of Wellcome. It is understood that this separate consent would not be required if any such adverse effect results from the application of criteria uniformly to all Stockholders even if such application may affect Stockholders differently.

 

SECTION 12.  Counterparts .  This Agreement may he executed in any number of counterparts, each such counterpart shall be deemed to he an original instrument and all such counterparts together shall constitute but one agreement.

 

SECTION 13.  Headings .  The headings of the various sections of this Agreement have been inserted for convenience of reference only, and shall not be deemed to be a part of this Agreement.

 

SECTION 14.  Nouns and Pronouns .  Whenever the context may require, any pronouns used herein shall include the corresponding masculine, feminine or neuter forms, and the singular form of names and pronouns shall include the plural and vice-versa.

 

SECTION 15.  Severability .  Any provision of this Agreement that is prohibited or unenforceable in any jurisdiction shall, as to such jurisdiction, be ineffective to the extent of such prohibition or unenforceability without invalidating the remaining provisions hereof, and any such prohibition or unenforceability in any jurisdiction shall not invalidate or render unenforceable such provision in any other jurisdiction.

 

SECTION 16.  Governing Law .  This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Massachusetts, excluding choice of law rules thereof.

 

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SECTION 17.                      Additional Parties .  Notwithstanding anything to the contrary contained herein, any Stockholder may become a party to this Agreement following the delivery to, and written acceptance by, the Corporation of an execute and Instrument of Adherence to this Agreement in the Form attached hereto as Annex C .  No action or consent by Stockholder parties hereto shall be required for such joinder to this Agreement by such additional Stockholder, so long as such additional Stockholder has agreed in writing to be bound by all of the obligations as Stockholder party hereunder as indicated in the Instrument of Adherence and the Instrument of Adherence has been accepted in writing by the Corporation.

 

[remainder of page intentionally left blank]

 

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(Signature Page to Stockholders’ Agreement)

 

IN WITNESS WHEREOF the parties hereto have executed this Agreement on the date first above written.

 

 

THE CORPORATION:

 

 

 

RADIUS HEALTH, INC.

 

 

 

By:

 

 

 

Name: C. Richard Edmund Lyttle

 

 

Title: President

 

 

 

 

 

 

 

As an anticipated successor and assign to the Corporation under Section 7.3 hereof:

 

 

 

 

MPM ACQUISITION CORP.

 

 

 

 

 

By:

 

 

 

Name: C. Richard Edmund Lyttle

 

 

Title: President

 

 

 

 

 

 

 

INVESTORS:

 

 

 

BB BIOTECH VENTURES II, L.P.

 

By:

 

 

 

Its:

 

 

 

 

 

 

 

By:

 

 

 

Name:

Ben Morgan

 

 

Title:

Director

 

 

 

 

 

 

 

BB BIOTECH GROWTH N.V.

 

By:

 

 

 

Its:

 

 

 

 

 

 

 

By:

 

 

 

Name:

H. J. Van Neutegem

 

 

Title:

Managing Director

 

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HEALTHCARE VENTURES VII, LP,

 

By:

HealthCare Partners VII, L.P.

 

 

Its General Partner

 

 

 

 

 

 

 

By:

 

 

 

Name: Jeffrey Steinberg

 

 

Title: Administrative Partner of HealthCare Partners VII, L.P.

 

 

The General Partner of HealthCare Ventures VII, L.P.

 

 

 

 

 

 

 

MPM BIOVENTURES III, L.P.

 

 

 

By:

MPM BioVentures III GP, L.P.,

 

 

its General Partner

 

By:

MPM BioVentures III LLC,

 

 

its General Partner

 

 

 

 

By:

 

 

 

Name: Ansbert Gadicke

 

 

Title: Series A Member

 

 

 

 

 

 

 

MPM BIOVENTURES III-QP, L.P.

 

 

 

By:

MPM BioVentures III GP, L.P.,

 

 

its General Partner

 

By:

MPM BioVentures III LLC,

 

 

its General Partner

 

 

 

 

By:

 

 

 

Name: Ansbert Gadicke

 

 

Title: Series A Member

 

 

 

 

 

 

 

MPM BIOVENTURES III GMBH & CO. BETEILIGUNGS KG

 

 

 

By:

MPM BioVentures III GP, L.P.,

 

 

in its capacity as the Managing Limited Partner

 

By:

MPM BioVentures III LLC,

 

 

its General Partner

 

 

 

 

By:

 

 

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Name: Ansbert Gadicke

 

 

Title: Series A Member

 

 

 

 

 

 

 

MPM BIOVENTURES III PARALLEL FUND, L.P.

 

 

 

 

By:

MPM BioVentures III GP, L.P.,

 

 

its General Partner

 

By:

MPM BioVentures III LLC,

 

 

its General Partner

 

 

 

 

By:

 

 

 

Name: Ansbert Gadicke

 

 

Title: Series A Member

 

 

 

 

 

 

 

MPM ASSET MANAGEMENT INVESTORS 2003 BVIII LLC

 

 

 

By:

 

 

 

Name: Ansbert Gadicke

 

 

Title: Manager

 

 

 

 

 

 

 

MPM BIO IV NVS STRATEGIC FUND, L.P.

 

 

 

 

By:

MPM BioVentures IV GP LLC,

 

 

its General Partner

 

By:

MPM BioVentures IV LLC,

 

 

its Managing Member

 

 

 

 

By:

 

 

 

Name: Ansbert Gadicke

 

 

Title:

 

 

 

 

 

 

 

HEALTHCARE PRIVATE EQUITY LIMITED PARTNERSHIP

 

By:

Waverley Healthcare Private Equity

 

 

Limited, its general partner

 

 

 

 

 

 

 

By:

 

 

 

Name: Andrew November

 

 

Title: Director

 

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THE WELLCOME TRUST LIMITED, AS TRUSTEE OF THE WELLCOME TRUST

 

 

 

 

 

By:

 

 

 

Name: Peter Percisa Gray

 

 

Title: Managing Director

 

 

 

 

 

 

 

 

 

Dr. Raymond F. Schinazi

 

 

 

 

 

 

 

OXFORD BIOSCIENCE PARTNERS IV L.P.

 

By:

OBP Management IV L.P.

 

 

 

 

 

 

 

By:

 

 

 

Name: Jonathan Fleming

 

 

Title: General Partner

 

 

 

 

 

 

 

MRNA Fund II L.P.

 

By:

OBP Management IV L.P.

 

 

 

 

 

 

 

By:

 

 

 

Name: Jonathan Fleming

 

 

Title: General Partner

 

 

 

 

 

 

 

SAINTS CAPITAL VI, L.P.,

 

a limited partnership

 

 

 

By:

Saints Capital VI LLC,

 

a limited liability company

 

 

 

 

 

By:

 

 

 

Name: David P. Quinlivan

 

 

Title: Managing Member

 

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EXPLANATORY NOTE

 

The following Plan of Distribution was not attached as Annex A to this Stockholders Agreement at the time this Stockholders Agreement was executed and it is not part of the executed agreement.  The Plan of Distribution was subsequently distributed to the stockholders of the Company separate from the Stockholders Agreement and is being include here for informational purposes only.

 

Annex A

 

PLAN OF DISTRIBUTION

 

We are registering the shares offered by this prospectus on behalf of the selling stockholders. The selling stockholders, which as used herein includes donees, pledgees, transferees or other successors-in-interest selling shares of common stock or interests in shares of common stock received after the date of this prospectus from a selling stockholder as a gift, pledge, partnership distribution or other transfer, may, from time to time, sell, transfer or otherwise dispose of any or all of their shares of common stock or interests in shares of common stock on any stock exchange, market or trading facility on which the shares are traded or in private transactions. These dispositions may be at fixed prices, at prevailing market prices at the time of sale, at prices related to the prevailing market price, at varying prices determined at the time of sale, or at negotiated prices.

 

The selling stockholders may use any one or more of the following methods when disposing of shares or interests therein:

 

·                                          ordinary brokerage transactions and transactions in which the broker-dealer solicits purchasers;

 

·                                          block trades in which the broker-dealer will attempt to sell the shares as agent, but may position and resell a portion of the block as principal to facilitate the transaction;

 

·                                          purchases by a broker-dealer as principal and resale by the broker-dealer for its account;

 

·                                          an exchange distribution in accordance with the rules of the applicable exchange;

 

·                                          privately negotiated transactions;

 

·                                          short sales;

 

·                                          through the writing or settlement of options or other hedging transactions, whether through an options exchange or otherwise;

 

·                                          broker-dealers may agree with the selling stockholders to sell a specified number of such shares at a stipulated price per share;

 

·                                          a combination of any such methods of sale; and

 

·                                          any other method permitted pursuant to applicable law.

 

The selling stockholders may, from time to time, pledge or grant a security interest in some or all of the shares of common stock owned by them and, if they default in the performance of their secured obligations, the pledgees or secured parties may offer and sell the shares of common stock, from time to time, under this prospectus, or under an amendment to this prospectus under Rule 424(b)(3) or other applicable provision of the Securities Act amending the list of selling stockholders to include the pledgee, transferee or other successors in interest as selling stockholders under this prospectus. The selling stockholders also may transfer the shares of common stock in other circumstances, in which case the transferees, pledgees or other successors in interest will be the selling beneficial owners for purposes of this prospectus.

 

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In connection with the sale of our common stock or interests therein, the selling stockholders may enter into hedging transactions with broker-dealers or other financial institutions, which may in turn engage in short sales of the common stock in the course of hedging the positions they assume. The selling stockholders may also sell shares of our common stock short and deliver these securities to close out their short positions, or loan or pledge the common stock to broker-dealers that in turn may sell these securities. The selling stockholders may also enter into option or other transactions with broker-dealers or other financial institutions or the creation of one or more derivative securities which require the delivery to such broker-dealer or other financial institution of shares offered by this prospectus, which shares such broker-dealer or other financial institution may resell pursuant to this prospectus (as supplemented or amended to reflect such transaction).

 

The aggregate proceeds to the selling stockholders from the sale of the common stock offered by them will be the purchase price of the common stock less discounts or commissions, if any. Each of the selling stockholders reserves the right to accept and, together with their agents from time to time, to reject, in whole or in part, any proposed purchase of common stock to be made directly or through agents. We will not receive any of the proceeds from this offering. Upon any exercise of the warrants by payment of cash, however, we will receive the exercise price of the warrants.

 

The selling stockholders also may resell all or a portion of the shares in open market transactions in reliance upon Rule 144 under the Securities Act of 1933, provided that they meet the criteria and conform to the requirements of that rule.

 

The selling stockholders and any broker-dealers that act in connection with the sale of the shares offered hereby might be deemed to be “underwriters” within the meaning of Section 2(11) of the Securities Act, and any commissions received by such broker-dealers and any profit on the resale of the securities sold by them while acting as principals might be deemed to be underwriting discounts or commissions under the Securities Act.

 

To the extent required, the shares of our common stock to be sold, the names of the selling stockholders, the respective purchase prices and public offering prices, the names of any agents, dealer or underwriter, any applicable commissions or discounts with respect to a particular offer will be set forth in an accompanying prospectus supplement or, if appropriate, a post-effective amendment to the registration statement that includes this prospectus.

 

In order to comply with the securities laws of some states, if applicable, the common stock may be sold in these jurisdictions only through registered or licensed brokers or dealers. In addition, in some states the common stock may not be sold unless it has been registered or qualified for sale or an exemption from registration or qualification requirements is available and is complied with.

 

The anti-manipulation rules of Regulation M under the Exchange Act may apply to sales of shares in the market and to the activities of the selling stockholders and their affiliates. In addition, we will make copies of this prospectus (as it may be supplemented or amended from time to time) available to the selling stockholders for the purpose of satisfying the prospectus delivery requirements of the Securities Act. The selling stockholders may indemnify any broker-dealer that participates in transactions involving the sale of the shares against certain liabilities, including liabilities arising under the Securities Act.

 

We have agreed to indemnify the selling stockholders against liabilities, including liabilities under the Securities Act and state securities laws, relating to the registration of the shares offered by this prospectus.

 

We have agreed with the selling stockholders to keep the registration statement of which this prospectus constitutes a part effective until the earlier of (1) such time as all of the shares covered by this prospectus have been disposed of pursuant to and in accordance with the registration statement or (2) the date on which the shares may be sold pursuant to Rule 144 of the Securities Act.

 

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EXPLANATORY NOTE

 

The following Questionnaire for Selling Stockholders was not attached as Annex B to this Stockholders Agreement at the time this Stockholders Agreement was executed and it is not part of the executed agreement.  The Questionnaire for Selling Stockholders was subsequently distributed to the stockholders of the Company separate from the Stockholders Agreement and is being include here for informational purposes only.

 

 

Annex B

 

Radius Health, Inc.

 

Questionnaire for Selling Stockholders

 

All questions should be answered as of the date you sign this Questionnaire, unless otherwise specified.  Please return the completed Questionnaire by fax or other electronic transmission (with the originally signed copy to follow by mail) to:

 

 

Kathryn Ostman, Esq.

Bingham McCutchen LLP

One Federal Street

Boston, MA 02110

617-951-8637

With a copy to :

Nicholas Harvey

Chief Financial Officer

Radius Health, Inc.

201 Broadway, Sixth Floor

Cambridge, MA 02139

 

 

Please state the Selling Stockholder’s

name and mailing address:

 

 

 

Please answer the following questions:

 

(a)                                 Within the past three years, have you held any position or office or (other than as a securityholder) had any relationship with the Company or affiliates (1) ?

 

Yes o           No o

 

If yes, please describe.

 


(1)  Please refer to the definition of affiliate in Appendix A hereto.

 

131



 

(b)                                  Set forth below the number of shares of Common Stock of the Company owned beneficially (2)  by you after the Merger (the “Shares”).  For each holding, please state under the column entitled “Statements Concerning Beneficial Ownership” (a) the name in which the securities are held, (b) if issuable upon conversion of preferred stock held, indicate the type and number of preferred shares held, (c) if issuable upon exercise of common or preferred share purchase warrants, indicate the type of warrant and exercise price, (d) the number of securities with respect to which you have sole voting power, (3)  (e) the number of securities with respect to which you have shared voting power, (4)  (f) the amount and/or number of securities with respect to which you have sole investment power, (5)  (g) the amount and/or number of securities with respect to which you have shared investment power, (6)  and (h) the amount and/or number of securities with respect to which you have the right to acquire beneficial (7)  ownership by AUGUST 22, 2011.

 

Shares Beneficially Owned

 

Number of Shares

 

Statements Concerning
Beneficial Ownership

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(c)           Number of Shares to be Offered Pursuant to the Registration Statement:

 

ALL                 If less than ALL, number of Shares to be Offered:

 

(d)                                 Attached as Appendix B hereto is a draft of the “Plan of Distribution” section of the Registration Statement.  Do you propose to offer or sell any securities of the Company by means other than those described in Appendix B ?

 

Yes o               No o

 

If yes, please describe.

 


(2)  Please refer to the definition of affiliate in Appendix A hereto.

(3)  Please refer to the discussion on voting power in the definition of beneficial ownership in Appendix A .

(4)  Please refer to the discussion on voting power in the definition of beneficial ownership in Appendix A .

(5)  Please refer to the discussion on investment power in the definition of beneficial ownership in Appendix A .

(6)  Please refer to the discussion on investment power in the definition of beneficial ownership in Appendix A .

(7)  Please refer to the definition of affiliate in Appendix A hereto.

 

132



 

(e)                                  Do you currently have specific plans to offer any securities of the Company through the selling efforts of brokers or dealers?

 

Yes o               No o

 

If yes, briefly describe the terms of any agreement, arrangement or understanding, entered into or proposed to be entered into with any broker or dealer, including any discounts or commissions to be paid to dealers.

 

(f)                                   Are any of the securities of the Company to be offered otherwise than for cash?

 

Yes o               No o

 

If yes, please describe.

 

(g)                                  Are any finders to be involved in the offering or sale of any of the securities of the Company?

 

Yes o               No o

 

If yes, please describe.

 

The undersigned hereby represents that all the information supplied herein is true, correct and complete as of the date hereof. The undersigned understands that the foregoing information will be use in connection with a proposed filing of a Registration Statement, and that the answers to the questions submitted will be relied on by the Company and its officers and directors in preparing the Registration Statement. The undersigned agrees to notify Radius Health, Inc. immediately of any material change in the forgoing answers.  In connection with his, her or its purchase of securities, the

 

 

Dated:

 

 

(Name of Holder)

 

 

 

 

 

By:

 

 

Name:

 

 

Title:

 

 

133



 

APPENDIX A

 

DEFINITIONS

 

(1)           Affiliate of a specified person (as defined below), means a person who directly or indirectly through one or more intermediaries, controls (as defined below), or is controlled by, or is under common control with, the person specified.

 

(2)           Beneficial , or beneficially , as applied to the ownership of securities, has been defined by the Securities and Exchange Commission to mean the following:

 

A beneficial owner of a security includes any person (as defined below) who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise has or shares “voting power” and/or “investment power”.  Voting power includes the power to vote, or to direct the voting of, such security; investment power includes the power to dispose, or to direct the disposition, of such security.

 

Note that more than one person may have a beneficial interest in the same securities; one may have voting power and the other may have investment power.

 

Even if a person, directly or indirectly, creates or uses a trust, proxy, power of attorney, pooling arrangement or any other contract, arrangement or device with the purpose or effect of divesting such person of beneficial ownership of a security or preventing the vesting of such beneficial ownership to avoid the reporting requirements of section 13(d) of the Securities Exchange Act, he will still be deemed to be the beneficial owner of such security.

 

A person is deemed to be the beneficial owner of a security if that person has the right to acquire beneficial ownership of such security at any time within 60 days, including but not limited to any right to acquire:  (i) through the exercise of any option, warrant or right; (ii) through the conversion of a security; (iii) pursuant to the power to revoke a trust, discretionary account, or similar arrangement; or (iv) pursuant to the automatic termination of a trust, discretionary account or similar arrangement.

 

A member of a national securities exchange is not deemed to be a beneficial owner of securities held directly or indirectly by it on behalf of another person solely because such member is the record holder of such securities and, pursuant to the rules of such exchange, may direct the vote of such securities, without instruction, on other than contested matters or matters that may affect substantially the rights or privileges of the holders of the securities to be voted, but is otherwise precluded by the rules of such exchange from voting without instruction.

 

A person who in the ordinary course of business is a pledgee of securities pursuant to a bona fide pledge agreement will not be deemed to be the beneficial owner of such pledged securities merely because there has been a default under such an agreement, except during such time as the event of default shall remain uncured for more than 30 days or at any time before a default is cured if the power acquired by the pledgee pursuant to the default enables him to change or influence control of the issuer.

 

A person may also be regarded as the beneficial owner of securities held in the name of his spouse, his minor children or other relatives of his or her spouse sharing his home, or held in a trust of which he is a beneficiary or trustee, if the relationships are such that he has voting power and/or investment power with respect to such securities.

 

134



 

If you have any reason to believe that any interest you have, however remote, might be described as a beneficial interest, describe such interest.

 

(3)           Control means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract, or otherwise.

 

(4)           Person includes two or more persons acting as a partnership, limited partnership, syndicate or other group for the purpose of acquiring, holding, or disposing of securities of an issuer.

 

135



 

APPENDIX B

 

PLAN OF DISTRIBUTION

 

We are registering the shares offered by this prospectus on behalf of the selling stockholders. The selling stockholders, which as used herein includes donees, pledgees, transferees or other successors-in-interest selling shares of common stock or interests in shares of common stock received after the date of this prospectus from a selling stockholder as a gift, pledge, partnership distribution or other transfer, may, from time to time, sell, transfer or otherwise dispose of any or all of their shares of common stock or interests in shares of common stock on any stock exchange, market or trading facility on which the shares are traded or in private transactions. These dispositions may be at fixed prices, at prevailing market prices at the time of sale, at prices related to the prevailing market price, at varying prices determined at the time of sale, or at negotiated prices.

 

The selling stockholders may use any one or more of the following methods when disposing of shares or interests therein:

 

·                                          ordinary brokerage transactions and transactions in which the broker-dealer solicits purchasers;

 

·                                          block trades in which the broker-dealer will attempt to sell the shares as agent, but may position and resell a portion of the block as principal to facilitate the transaction;

 

·                                          purchases by a broker-dealer as principal and resale by the broker-dealer for its account;

 

·                                          an exchange distribution in accordance with the rules of the applicable exchange;

 

·                                          privately negotiated transactions;

 

·                                          short sales;

 

·                                          through the writing or settlement of options or other hedging transactions, whether through an options exchange or otherwise;

 

·                                          broker-dealers may agree with the selling stockholders to sell a specified number of such shares at a stipulated price per share;

 

·                                          a combination of any such methods of sale; and

 

·                                          any other method permitted pursuant to applicable law.

 

The selling stockholders may, from time to time, pledge or grant a security interest in some or all of the shares of common stock owned by them and, if they default in the performance of their secured obligations, the pledgees or secured parties may offer and sell the shares of common stock, from time to time, under this prospectus, or under an amendment to this prospectus under Rule 424(b)(3) or other applicable provision of the Securities Act amending the list of selling stockholders to include the pledgee, transferee or other successors in interest as selling stockholders under this prospectus. The selling stockholders also may transfer the shares of common stock in other circumstances, in which case the transferees, pledgees or other successors in interest will be the selling beneficial owners for purposes of this prospectus.

 

In connection with the sale of our common stock or interests therein, the selling stockholders may enter into hedging transactions with broker-dealers or other financial institutions, which may in turn engage in short sales of the common stock in the course of hedging the positions they assume. The selling stockholders may also sell shares of our common stock short and deliver these securities to close out their short positions, or loan or pledge the common stock to broker-dealers that in turn may sell these securities. The selling stockholders may also enter into option or other transactions with broker-dealers or other financial institutions or the creation of one or more

 

136



 

derivative securities which require the delivery to such broker-dealer or other financial institution of shares offered by this prospectus, which shares such broker-dealer or other financial institution may resell pursuant to this prospectus (as supplemented or amended to reflect such transaction).

 

The aggregate proceeds to the selling stockholders from the sale of the common stock offered by them will be the purchase price of the common stock less discounts or commissions, if any. Each of the selling stockholders reserves the right to accept and, together with their agents from time to time, to reject, in whole or in part, any proposed purchase of common stock to be made directly or through agents. We will not receive any of the proceeds from this offering. Upon any exercise of the warrants by payment of cash, however, we will receive the exercise price of the warrants.

 

The selling stockholders also may resell all or a portion of the shares in open market transactions in reliance upon Rule 144 under the Securities Act of 1933, provided that they meet the criteria and conform to the requirements of that rule.

 

The selling stockholders and any broker-dealers that act in connection with the sale of the shares offered hereby might be deemed to be “underwriters” within the meaning of Section 2(11) of the Securities Act, and any commissions received by such broker-dealers and any profit on the resale of the securities sold by them while acting as principals might be deemed to be underwriting discounts or commissions under the Securities Act.

 

To the extent required, the shares of our common stock to be sold, the names of the selling stockholders, the respective purchase prices and public offering prices, the names of any agents, dealer or underwriter, any applicable commissions or discounts with respect to a particular offer will be set forth in an accompanying prospectus supplement or, if appropriate, a post-effective amendment to the registration statement that includes this prospectus.

 

In order to comply with the securities laws of some states, if applicable, the common stock may be sold in these jurisdictions only through registered or licensed brokers or dealers. In addition, in some states the common stock may not be sold unless it has been registered or qualified for sale or an exemption from registration or qualification requirements is available and is complied with.

 

The anti-manipulation rules of Regulation M under the Exchange Act may apply to sales of shares in the market and to the activities of the selling stockholders and their affiliates. In addition, we will make copies of this prospectus (as it may be supplemented or amended from time to time) available to the selling stockholders for the purpose of satisfying the prospectus delivery requirements of the Securities Act. The selling stockholders may indemnify any broker-dealer that participates in transactions involving the sale of the shares against certain liabilities, including liabilities arising under the Securities Act.

 

We have agreed to indemnify the selling stockholders against liabilities, including liabilities under the Securities Act and state securities laws, relating to the registration of the shares offered by this prospectus.

 

We have agreed with the selling stockholders to keep the registration statement of which this prospectus constitutes a part effective until the earlier of (1) such time as all of the shares covered by this prospectus have been disposed of pursuant to and in accordance with the registration statement or (2) the date on which the shares may be sold pursuant to Rule 144 of the Securities Act.

 

137



 

Annex C

 

Instrument of Adherence
to
Amended and Restated
Stockholders’ Agreement
dated             , 2011

 

Reference is hereby made to that certain THIS AMENDED AND RESTATED STOCKHOLDERS’ AGREEMENT (the “ Agreement ”), dated the          day of                             , 2011, entered into by and among (i) Radius Health, Inc., a Delaware corporation (the “ Corporation ”) and the Stockholder parties thereto. Capitalized terms used herein without definition shall have the respective meanings ascribed thereto in the Agreement.

 

The undersigned (the “ New Stockholder Party ”), in order to become the owner or holder of                                    shares of                                                                              and all other shares of the Corporation’s capital stock hereinafter acquired, of the Company (the “ Acquired Shares ”), hereby agrees that, from and after the date hereof, the undersigned has become a party to the Agreement in the capacity of a                                                                  party to the Agreement, and is entitled to all of the benefits under, and is subject to all of the obligations, restrictions and limitations set forth in, the Agreement that are applicable to such Stockholder parties and shall be deemed to have made all of the representations and warranties made by such Stockholder parties thereunder.  This Instrument of Adherence shall take effect and shall become a part of the Agreement on the latest date of execution by both the New Stockholder Party and the Corporation.

 

Executed under seal as of the date set forth below under the laws of the Commonwealth of Massachusetts.

 

 

Print Name:

 

 

 

 

 

 

 

 

Signature:

 

 

 

Name:

 

 

Title:

 

 

 

 

Accepted:

RADIUS HEALTH, INC.

 

 

By:

 

 

 

Name:

 

 

Title:

 

 

 

 

Date:

 

 

 

138


 

Exhibit F

 

Executed Agreement and Plan of Merger

 

Filed as Exhibit 10.1 to the Form 8-K/A filed on October 24, 2011

 

139



 

Disclosure Schedules

 

140


 

RADIUS HEALTH, INC.

 

Disclosure Schedule (“ Schedule ”) to the Series A-1 Convertible Preferred Stock Purchase Agreement, dated April 25, 2011 (the “ Purchase Agreement ”)

 

The following Schedule is delivered by Radius Health, Inc., a Delaware corporation (the “ Corporation ”) in connection with the Stage I Closing under the Purchase Agreement.  This Schedule sets forth exceptions to the representations and warranties of the Corporation to be given at the Stage I Closing (which exceptions shall be deemed to be representations and warranties as if made under the Purchase Agreement).  The information in this Schedule is provided as of the Stage I Closing Date.

 

The disclosure of any item or information in this Schedule shall not be construed as an admission that such item or information is material to the Corporation, and any inclusion in the Schedule shall expressly not be deemed to constitute an admission, or otherwise imply, that any such item or information is material or creates measures of materiality for the purposes of the Purchase Agreement.  Nothing in this Schedule constitutes an admission of any liability or obligation of the Corporation to any third party, nor an admission to any third party against the Corporation’s interests.

 

With respect to any matter that is clearly disclosed in any Section of this Schedule in such a way as to make its relevance to the information called for by another Section of this Schedule readily apparent, such matter shall be deemed to have been included in the Schedule in response to such other Section, notwithstanding the omission of any appropriate cross-reference thereto. The Section numbers referred to in this Schedule correspond to the Section numbers in the Purchase Agreement.  Capitalized terms not otherwise defined in this Schedule shall have the meanings set forth in the Purchase Agreement.

 

141



 

Schedule 5.1

 

Organization

 

1.               The Corporation is qualified to do business as a foreign corporation in the Commonwealth of Massachusetts.

 

142


 

Schedule 5.2

 

Capitalization

 

1.               Capitalization of the Corporation Immediately Following the Stage I Closing:

 

RADIUS

 

 

 

CAPITALIZATION AFTER 1ST SERIES A-1, A-5 and IPSEN CLOSING

 

 

 

%

 

Post

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Series A-1

 

Common

 

Common

 

Post

 

Shares

 

Fully Diluted

 

Fully

 

 

 

Series A-1

 

Series A-2

 

Series A-3

 

Series A-4

 

Series A-5

 

Common

 

Warrants

 

Warrants

 

Options

 

Shares

 

Out

 

Shares

 

Diluted

 

Preferred Holders

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MPM Bioventures III Funds

 

82,225

 

121,944

 

29,850

 

 

 

 

 

 

 

 

 

 

 

 

234,019

 

1.46

%

234,019

 

1.32

%

MPM Bioventures III-QP, L.P.

 

1,222,905

 

1,813,643

 

443,959

 

 

 

 

 

 

 

 

 

 

 

 

3,480,507

 

21.69

%

3,480,507

 

19.67

%

MPM Bioventures III GMBH & Co.

 

103,351

 

153,275

 

37,520

 

 

 

 

 

 

 

 

 

 

 

 

294,146

 

1.83

%

294,146

 

1.66

%

MPM Bioventures III Parallel Fund, L.P.

 

36,932

 

54,773

 

13,408

 

 

 

 

 

 

 

 

 

 

 

 

105,113

 

0.66

%

105,113

 

0.59

%

MPM Asset Management Investors 2003

 

23,681

 

35,114

 

8,595

 

 

 

 

 

 

 

 

 

 

 

 

67,390

 

0.42

%

67,390

 

0.38

%

MPM Bio IV NVS Strategic Fund

 

540,013

 

1,842,426

 

 

 

 

 

 

 

 

 

 

 

 

 

2,382,439

 

14.85

%

2,382,439

 

13.47

%

Wellcome Trust

 

255,223

 

2,103,250

 

 

 

 

 

 

 

 

 

 

 

 

 

2,358,473

 

14.70

%

2,358,473

 

13.33

%

HealthCare Ventures VII

 

196,512

 

982,789

 

636,632

 

 

 

 

 

83,113

 

 

 

 

 

 

 

1,899,046

 

11.83

%

1,899,046

 

10.73

%

Saints Capital (OBP IV Holdings)

 

162,133

 

1,086,285

 

249,830

 

 

 

 

 

15,173

 

 

 

 

 

 

 

1,513,421

 

9.43

%

1,513,421

 

8.56

%

Saints Capital (mRNA Fund II Holdings)

 

1,627

 

10,900

 

2,506

 

 

 

 

 

151

 

 

 

 

 

 

 

15,184

 

0.09

%

15,184

 

0.09

%

BB Biotech Ventures II

 

435,965

 

1,051,625

 

 

 

 

 

 

 

 

 

 

 

 

 

1,487,590

 

9.27

%

1,487,590

 

8.41

%

Scottish Widows

 

68,059

 

560,866

 

 

 

 

 

 

 

 

 

 

 

 

 

628,925

 

3.92

%

628,925

 

3.56

%

Raymond F. Schinazi

 

7,575

 

15,243

 

 

4,142

 

 

 

 

 

 

 

 

 

 

26,960

 

0.17

%

26,960

 

0.15

%

David E. Thompson Revocable Trust

 

1,964

 

 

 

 

 

16,190

 

 

 

 

 

 

 

 

 

 

18,154

 

0.11

%

18,154

 

0.10

%

Hostetler Family Trust

 

 

 

 

 

 

 

 

 

3,071

 

 

 

 

 

 

 

3,071

 

0.02

%

3,071

 

0.02

%

H.Watt Gregory, III

 

1,329

 

 

 

 

 

10,957

 

 

 

 

 

 

 

 

 

 

12,286

 

0.08

%

12,286

 

0.07

%

The Richman Trust

 

650

 

 

 

 

 

5,357

 

 

 

 

 

 

 

 

 

 

6,007

 

0.04

%

6,007

 

0.03

%

Breining Family Trust

 

407

 

 

 

 

 

3,357

 

 

 

 

 

 

 

 

 

 

3,764

 

0.02

%

3,764

 

0.02

%

Dr. Dennis A. Carson

 

 

 

 

 

 

 

 

 

533

 

 

 

 

 

 

 

533

 

0.00

%

533

 

0.00

%

B Van Wyck

 

 

 

 

 

 

 

 

 

363

 

 

 

 

 

 

 

363

 

0.00

%

363

 

0.00

%

Jonnie K. Westbrook

 

 

 

 

 

 

 

 

 

363

 

 

 

 

 

 

 

363

 

0.00

%

363

 

0.00

%

Nordic Bioscience

 

 

 

 

 

 

 

 

 

64,430

 

 

 

 

 

 

 

 

 

64,430

 

0.40

%

64,430

 

0.36

%

Brookside

 

409,400

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

409,400

 

2.55

%

409,400

 

2.31

%

BB Biotech AG

 

409,400

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

409,400

 

2.55

%

409,400

 

2.31

%

Ipsen

 

173,263

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

173,263

 

1.08

%

173,263

 

0.98

%

Leerink

 

 

 

 

 

 

 

 

 

 

 

 

 

8,188

 

 

 

 

 

 

0.00

%

8,188

 

0.05

%

 

143


 

RADIUS

 

 

 

CAPITALIZATION AFTER 1ST SERIES A-1, A-5 and IPSEN CLOSING

 

 

 

%

 

Post

 

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Series A-1

 

Common

 

Common

 

Post

 

Shares

 

Fully Diluted

 

Fully

 

 

 

Series A-1

 

Series A-2

 

Series A-3

 

Series A-4

 

Series A-5

 

Common

 

Warrants

 

Warrants

 

Options

  

Shares

  

Out

 

Shares

 

Diluted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common Holders

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alan Auerbach

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

256,666

 

 

0.00

%

256,666

 

1.45

%

Stavros C. Manolagas

 

 

 

 

 

 

 

 

 

 

 

91,040

 

 

 

 

 

 

91,040

 

0.57

%

91,040

 

0.51

%

Michael Rosenblatt

 

 

 

 

 

 

 

 

 

 

 

46,664

 

 

 

 

 

41,168

 

46,664

 

0.29

%

87,832

 

0.50

%

John Thomas Potts Trust

 

 

 

 

 

 

 

 

 

 

 

20,291

 

 

 

 

 

 

20,291

 

0.13

%

20,291

 

0.11

%

John Thomas Potts, Jr.

 

 

 

 

 

 

 

 

 

 

 

4,496

 

 

 

 

 

47,245

 

4,496

 

0.03

%

51,741

 

0.29

%

John Katzenellenbogen Trust

 

 

 

 

 

 

 

 

 

 

 

40,438

 

 

 

 

 

 

40,438

 

0.25

%

40,438

 

0.23

%

John Katzenellenbogen

 

 

 

 

 

 

 

 

 

 

 

8,961

 

 

 

 

 

6,666

 

8,961

 

0.06

%

15,627

 

0.09

%

Bart Henderson

 

 

 

 

 

 

 

 

 

 

 

30,468

 

 

 

 

 

 

30,468

 

0.19

%

30,468

 

0.17

%

Board of Trustees of the Uni of Arkansas

 

 

 

 

 

 

 

 

 

 

 

17,333

 

 

 

 

 

 

17,333

 

0.11

%

17,333

 

0.10

%

Sillicon Valley Bank

 

 

 

 

 

 

 

 

 

 

 

 

 

 

266

 

 

 

0.00

%

266

 

0.00

%

Ben Lane

 

 

 

 

 

 

 

 

 

 

 

8,125

 

 

 

 

 

 

8,125

 

0.05

%

8,125

 

0.05

%

Ruff Trust

 

 

 

 

 

 

 

 

 

 

 

5,124

 

 

 

 

 

 

5,124

 

0.03

%

5,124

 

0.03

%

H2 Enterprises, LLC

 

 

 

 

 

 

 

 

 

 

 

5,124

 

 

 

 

 

 

5,124

 

0.03

%

5,124

 

0.03

%

Dr. Karl Y. Hostetler

 

 

 

 

 

 

 

 

 

 

 

5,124

 

 

 

 

 

 

5,124

 

0.03

%

5,124

 

0.03

%

Czerepak, Elizabeth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11,666

 

 

0.00

%

11,666

 

0.07

%

Stavroula Kousteni, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

421

 

 

 

 

 

 

421

 

0.00

%

421

 

0.00

%

Robert L. Jilka, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

572

 

 

 

 

 

 

572

 

0.00

%

572

 

0.00

%

Robert S. Weinstein, M.D.

 

 

 

 

 

 

 

 

 

 

 

421

 

 

 

 

 

 

421

 

0.00

%

421

 

0.00

%

Teresita M. Bellido, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

234

 

 

 

 

 

 

234

 

0.00

%

234

 

0.00

%

Chris Glass

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1,333

 

 

0.00

%

1,333

 

0.01

%

Dotty McIntyre, RA

 

 

 

 

 

 

 

 

 

 

 

891

 

 

 

 

 

 

891

 

0.01

%

891

 

0.01

%

Thomas E. Sparks, Jr.

 

 

 

 

 

 

 

 

 

 

 

883

 

 

 

 

 

 

883

 

0.01

%

883

 

0.00

%

Sam Ho

 

 

 

 

 

 

 

 

 

 

 

833

 

 

 

 

 

 

833

 

0.01

%

833

 

0.00

%

Charles O’Brien, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

140

 

 

 

 

 

 

140

 

0.00

%

140

 

0.00

%

Alwyn Michael Parfitt, M.D.

 

 

 

 

 

 

 

 

 

 

 

280

 

 

 

 

 

 

280

 

0.00

%

280

 

0.00

%

Barry Pitzele

 

 

 

 

 

 

 

 

 

 

 

266

 

 

 

 

 

 

266

 

0.00

%

266

 

0.00

%

Benita S. Katzenellenbogen, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

187

 

 

 

 

 

 

187

 

0.00

%

187

 

0.00

%

Kelly Colbourn

 

 

 

 

 

 

 

 

 

 

 

102

 

 

 

 

 

 

102

 

0.00

%

102

 

0.00

%

Julie Glowacki, Ph.D.

 

 

 

 

 

 

 

 

 

 

 

93

 

 

 

 

 

 

93

 

0.00

%

93

 

0.00

%

Socrates E. Papapoulos, M.D.

 

 

 

 

 

 

 

 

 

 

 

93

 

 

 

 

 

 

93

 

0.00

%

93

 

0.00

%

Tonya D. Smith

 

 

 

 

 

 

 

 

 

 

 

66

 

 

 

 

 

 

66

 

0.00

%

66

 

0.00

%

Kent Westbrook, M.D.

 

 

 

 

 

 

 

 

 

 

 

46

 

 

 

 

 

 

46

 

0.00

%

46

 

0.00

%

Edie Estabrook

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4,266

 

 

0.00

%

4,266

 

0.02

%

Maysoun Shomali

 

 

 

 

 

 

 

 

 

 

 

2,383

 

 

 

 

 

 

2,383

 

0.01

%

2,383

 

0.01

%

Lumpkins, Mary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

400

 

 

0.00

%

400

 

0.00

%

Guerriero, Jonathan

 

 

 

 

 

 

 

 

 

 

 

2,500

 

 

 

 

 

12,166

 

2,500

 

0.02

%

14,666

 

0.08

%

Grunwald, Maria

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14,666

 

 

0.00

%

14,666

 

0.08

%

McCarthy, Daniel F.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3,200

 

 

0.00

%

3,200

 

0.02

%

Sullivan, Kelly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1,666

 

 

0.00

%

1,666

 

0.01

%

Welch, Kathy

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6,400

 

 

0.00

%

6,400

 

0.04

%

Richard Lyttle

 

 

 

 

 

 

 

 

 

 

 

66,666

 

 

 

 

 

489,227

 

66,666

 

0.42

%

555,893

 

3.14

%

Louis O’Dea

 

 

 

 

 

 

 

 

 

 

 

29,207

 

 

 

 

 

165,355

 

29,207

 

0.18

%

194,562

 

1.10

%

Nick Harvey

 

 

 

 

 

 

 

 

 

 

 

30,000

 

 

 

 

 

143,716

 

30,000

 

0.19

%

173,716

 

0.98

%

Gary Hattersley

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

83,384

 

 

0.00

%

83,384

 

0.47

%

Chris Miller

 

 

 

 

 

 

 

 

 

 

 

33,355

 

 

 

 

 

30,498

 

33,355

 

0.21

%

63,853

 

0.36

%

ESOP Remaining

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

315,172

 

 

0.00

%

315,172

 

1.78

%

Additions to Option Plan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0.00

%

 

0.00

%

Total

 

4,132,614

 

9,832,133

 

1,422,300

 

40,003

 

64,430

 

555,594

 

8,188

 

266

 

1,634,860

 

16,047,074

 

100.00

%

17,690,388

 

100.00

%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Per Share

 

$

8.1420

 

 

 

$

8.1420

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Post-money $

 

$

130,655,277

 

 

 

$

144,035,139

 

 

 

 

144


 

2.      In connection with that certain Loan and Security Agreement, dated as of August 6, 2004, by and between the Corporation and Silicon Valley Bank (“ SVB ”), as amended, the Corporation issued to SVB a warrant exercisable for the purchase of an aggregate of up to 20,000 shares of Series A Junior Convertible Preferred Stock at $1.00 per share (as amended, the “ SVB Warrant ”).  The warrant, which expires in August 2014, will be amended and restated as of the Stage I Closing Date to purchase shares of the Corporation’s common stock.  The warrant was 100% vested as of the grant date.

 

3.      Series A Convertible Redeemable Preferred Stock Purchase Agreement, dated November 14, 2003, by and among the Corporation and the stockholders listed on the schedules thereto.

 

4.      Series B Convertible Redeemable Preferred Stock Purchase Agreement, dated November 14, 2003, by and among the Corporation and the stockholders listed on the schedules thereto.

 

5.      Series C Convertible Redeemable Preferred Stock Purchase Agreement, dated December 15, 2006, by and among the Corporation and the Investors referenced therein, as amended by Amendment No. 1 thereto, dated February 12, 2007, Amendment No. 2 thereto, dated February 22, 2007, Amendment No. 3 thereto, dated August 17, 2007, and Amendment No. 4 thereto, dated November 14, 2008.

 

6.      Fourth Amended and Restated Certificate of Incorporation of the Corporation filed with the Secretary of State of the State of Delaware on May 17, 2011.

 

7.      Growth Capital Loan Proposal Letter by and among the Corporation, GE Healthcare Financial Services, Inc., and Oxford Finance Corporation, dated December 21, 2010.  The proposed loan documents would include an obligation of the Corporation to issue a warrant to purchase Series A-1 Convertible Preferred Stock for 4% of the principal as drawn, equaling $1,000,000 (4% of $25 million).

 

8.      In connection with that certain Letter Agreement by and between the Corporation and Leerink Swann LLC (“ Leerink ”), dated September 24, 2010, the Corporation is obligated to issue a warrant to purchase Series A-1 Convertible Preferred Stock of the Corporation (the “ Leerink Warrant ”).

 

9.      Stock Issuance Agreement by and between the Corporation and Nordic Bioscience Clinical Development VII A/S (“ Nordic ”), dated March 29, 2011.

 

10.   In connection with that certain License Agreement, dated September 27, 2005, by and between SCRAS S.A.S., a French corporation, with its principal office at 42, Rue du Docteur Blanche, 75016 Paris, France, on behalf of itself and its Affiliates (collectively, “ Ipsen ”), and the Corporation, as amended on September 12, 2007, and assigned by SCRAS S.A.S. to successor Ipsen Pharma SAS on January 1, 2009 (the “ Ipsen License Agreement ”), the Corporation is currently in discussions with Ipsen to make its payment milestones to Ipsen pursuant to the Ipsen License Agreement with shares of Series A-1 Preferred Stock at $8.142 per share.

 

11.   2007 Amended and Restated Management and Employee Bonus Plan approved at a meeting of the Board of Directors of the Corporation held on October 1, 2009 and approved by the Stockholders by written consent on November 11, 2009, which shall be terminated by written agreement of the participants effective upon the Closing.

 

145



 

Schedule 5.6(a)

 

Business of the Corporation

 

None.

 

146



 

Schedule 5.6

 

Business of the Corporation

 

A.     Loan Agreements

 

1.      Growth Capital Loan Proposal Letter by and among the Corporation, GE Healthcare Financial Services, Inc., and Oxford Finance Corporation, dated December 21, 2010.

 

2.      Demand Promissory Note issued by MPM Acquisition Corp. to the Corporation, dated November 22, 2010.

 

B.     License Agreements

 

1.      Ipsen License Agreement.

 

2.      Pharmaceutical Development Agreement by and between the Corporation and Ipsen, dated January 2, 2006, as amended by Amendment No. 1, dated January 1, 2007, Amendment No. 2, dated January 1, 2009, and Amendment No. 3, dated June 16, 2010.

 

3.      License Agreement, dated June 29, 2006, by and between Eisai Co. and the Corporation.

 

C.     Research, Development and/or Service Agreements

 

1.          Development and Clinical Supplies Agreement by and between the Corporation, 3M Company and 3M Innovative Properties (3M Company and 3M Innovative Properties, collectively, “ 3M ”), dated June 19, 2009, as amended on each of May 5, 2009, December 31, 2009, March 3, 2010, September 16, 2010, September 29, 2010, February 4, 2011, and March 2, 2011.

 

2.          Letter of Payment Authorization for Study No. 670364 by and between the Corporation and Charles River Laboratories (“ CRL ”), dated November 20, 2010.

 

3.          Letter of Payment Authorization for Dawley Rat - Rat Bone Quality Study by and between the Corporation and CRL, dated February 7, 2011.

 

4.          Work Order No. 2 by and between the Corporation and LONZA Sales Ltd. (“ Lonza ”), dated January 15, 2010, as amended April 27, 2010, and as further amended December 15, 2010.

 

5.          Letter Agreement by and between the Corporation and Leerink , dated February 4, 2010.

 

6.          Letter Agreement by and between the Corporation and Leerink, dated September 24, 2010.

 

7.          Stock Issuance Agreement by and between the Corporation and Nordic, dated March 29, 2011.

 

8.          Amendment Letter by and between the Corporation and Nordic, dated February 1, 2011.

 

147



 

9.          Clinical Trial Services Agreement and Work Statement NB-1 by and between the Corporation and Nordic, dated March 29, 2011.

 

10.       Side Letter by and between the Corporation and Nordic, dated March 29, 2011.

 

11.       Engagement Letter by and between the Corporation and Ernst & Young LLP, dated October 5, 2010.

 

12.       Master Clinical Services Agreement by and between the Corporation and Celerion, Inc., dated November 2, 2010, as amended by Work Order No. 1, dated November 3, 2010.

 

13.       Change Order No. 2 to Statement of Work by and between the Corporation and INC Research, Inc., dated September 3, 2010.

 

14.       Letter of Payment Authorization for Chronic Dermal Toxicity Study by and between the Corporation and CRL, dated April 29, 2011.

 

D.     Real Property

 

1.      Sublease by and between the Corporation and Sonos, Inc., dated January 14, 2011, for the property located at 201 Broadway, Cambridge, Massachusetts.

 

E.     ERISA

 

1.      Radius Health, Inc. 401(k) Plan

 

2.      Radius Health, Inc. Flexible Spending Account Plan

 

F.      Indemnification Agreements

 

1.      Please see Schedule 5.6(g).

 

2.      Please see general commercial agreement indemnification provisions included in the material license agreements listed above.

 

G.     Other Agreements

 

1.      Pursuant to an engagement with Leerink Swann LLC (“Leerink”) for services in connection with the Series A-1 Financing, the Corporation has agreed to issue to Leerink a Warrant to purchase 24,564 shares of Series A-1 Convertible Preferred Stock at the Stage I Closing.

 

2.      Amended and Restated Stockholders’ Agreement, dated as of December 15, 2006, by and between the Corporation, the Investors, the Original Stockholders, the Series A Stockholders and the Series B Stockholders (each as defined therein), as amended by Amendment No. 1 thereto, dated as of February 22, 2007, Amendment No. 2 thereto, dated as of August 17, 2007, and Amendment No. 3 thereto, dated as of October    , 2008.

 

3.      The Corporation has granted Alan Auerbach registration rights with respect to shares issuable upon exercise of granted options.

 

148



 

4.      The Corporation has granted registration rights to SVB pursuant to the terms of the SVB Warrant.

 

5.      The Corporation has granted board observation rights to BB Biotech Ventures II, L.P. pursuant to a Letter Agreement dated as of February 22, 2007, by and between the Corporation and BB Biotech Ventures II, L.P.

 

H.     Stock Option Plans

 

1.      2003 Long Term Incentive Plan

 

2.      2007 Management and Employee Bonus Plan approved at a meeting of the Board of Directors of the Corporation held on December 6, 2007 and approved by the Stockholders by written consent on February 14, 2008, which shall be terminated by written agreement of the participants effective upon the Closing.

 

149



 

I.      Stock Option Agreements

 

The Corporation has entered into Stock Option Agreements with the following individuals:

 

Option
Number

 

Name

 

# Options

 

Grant
Date

 

Options
Canceled

 

Options
Outstanding

04-051

 

Ho, Sam

 

10,000

 

5/4/2004

 

 

 

03-002

 

Lane, Ben

 

325,000

 

12/16/2003

 

203,125

 

03-003

 

Henderson, Bart

 

650,000

 

12/16/2003

 

192,969

 

03-001

 

Hattersley, Gary

 

162,500

 

12/16/2003

 

 

 

162,500

04-003

 

O’Brien, Charles

 

8,000

 

2/5/2004

 

 

 

8,000

04-005

 

Kousteni, Stavroula

 

30,000

 

2/5/2004

 

 

 

30,000

03-005

 

Manolagas, Stavros

 

1,108,812

 

11/14/2003

 

 

 

03-008

 

Rosenblatt, Michael

 

370,241

 

11/14/2003

 

 

 

03-007

 

Potts, John Thomas

 

304,374

 

11/14/2003

 

 

 

03-006

 

Katsenellenbogen, John

 

606,573

 

11/14/2003

 

 

 

03-004

 

Pitzele, Barnett

 

5,000

 

12/16/2003

 

1,000

 

04-001

 

Bellido, Teresita

 

17,000

 

2/4/2004

 

 

 

17,000

04-002

 

Jilka, Robert

 

28,000

 

2/4/2004

 

 

 

25,725

04-004

 

Weinstien, Robert

 

17,000

 

2/4/2004

 

 

 

17,000

04-072

 

Glass, Chris

 

10,000

 

8/12/2004

 

 

 

10,000

04-052

 

Estabrook, Edith

 

24,000

 

5/4/2004

 

 

 

24,000

04-071

 

Colbourn, Kelly

 

1,000

 

8/12/2004

 

 

 

04-103

 

Lyttle, Richard

 

1,625,000

 

10/28/2004

 

 

 

1,625,000

04-101

 

Guy, Keisha

 

8,000

 

10/28/2004

 

8,000

 

04-102

 

McIntyre, Dotty

 

8,000

 

10/28/2004

 

2,000

 

04-100

 

Shomali, Maysoun

 

15,000

 

12/28/2004

 

15,000

 

05-01

 

Glass, Chris

 

10,000

 

12/6/2005

 

 

 

10,000

06-02

 

Hattersley, Gary

 

81,250

 

2/15/2006

 

 

 

81,250

06-04

 

Guy, Keisha

 

8,000

 

2/15/2006

 

8,000

 

06-05

 

McIntyre, Dotty

 

8,000

 

2/15/2006

 

4,000

 

06-06

 

Shomali, Maysoun

 

15,000

 

2/15/2006

 

15,000

 

06-01

 

Ho, Sam

 

10,000

 

2/15/2006

 

7,500

 

06-03

 

Colbourn, Kelly

 

3,000

 

2/15/2006

 

2,469

 

06-07

 

O’Dea, Louis

 

570,000

 

2/15/2006

 

 

 

339,625

07-01

 

McIntyre, Dotty

 

27,000

 

7/12/2007

 

23,625

 

07-08

 

Lyttle, Richard

 

2,377,688

 

7/12/2007

 

 

 

2,377,688

07-07

 

O’Dea, Louis

 

830,941

 

7/12/2007

 

 

 

623,206

07-09

 

Harvey, B. Nicholas

 

1,250,840

 

7/12/2007

 

 

 

1,250,840

07-06

 

Hattersley, Gary

 

356,653

 

7/12/2007

 

 

 

356,653

07-10

 

Miller, Chris

 

500,336

 

7/12/2007

 

 

 

07-11

 

Katsenellenbogen, John

 

100,000

 

7/12/2007

 

 

 

100,000

07-12

 

Potts, John Thomas

 

540,790

 

7/12/2007

 

 

 

540,790

07-13

 

Rosenblatt, Michael

 

660,491

 

7/12/2007

 

 

 

412,805

07-02

 

Shomali, Maysoun

 

44,000

 

7/12/2007

 

8,250

 

07-03

 

Estabrook, Edith

 

16,000

 

7/12/2007

 

 

 

16,000

07-05

 

Lumpkins, Mary

 

3,000

 

7/12/2007

 

 

 

3,000

 

150



 

07-04

 

Guerriero, Jonathan

 

100,000

 

7/12/2007

 

 

 

62,500

07-14

 

Grunwald, Maria

 

137,500

 

12/6/2007

 

 

 

137,500

07-15

 

Herendeen, Hillary

 

8,000

 

12/6/2007

 

8,000

 

07-16

 

Downall, Julie

 

8,000

 

12/6/2007

 

8,000

 

08-01

 

Welch, Kathy

 

60,000

 

2/7/2008

 

 

 

60,000

08-09

 

Lyttle, Richard

 

3,040,081

 

5/8/2008

 

 

 

3,040,081

08-05

 

O’Dea, Louis

 

1,064,028

 

5/8/2008

 

 

 

1,064,028

08-06

 

Harvey, B. Nicholas

 

950,025

 

5/8/2008

 

 

 

950,025

08-08

 

Hattersley, Gary

 

456,012

 

5/8/2008

 

 

 

456,012

08-07

 

Miller, Chris

 

380,010

 

5/8/2008

 

23,751

 

356,259

08-02

 

McCarthy, Daniel F.

 

30,000

 

5/8/2008

 

 

 

30,000

08-03

 

Zielstorff, Mark

 

10,000

 

5/8/2008

 

10,000

 

08-04

 

Gallacher, Kyla

 

10,000

 

5/8/2008

 

10,000

 

08-14

 

Lyttle, Richard

 

1,295,640

 

12/3/2008

 

 

 

1,295,640

08-10

 

O’Dea, Louis

 

453,474

 

12/3/2008

 

 

 

453,474

08-11

 

Harvey, B. Nicholas

 

404,888

 

12/3/2008

 

 

 

404,888

08-13

 

Hattersley, Gary

 

194,346

 

12/3/2008

 

 

 

194,346

08-12

 

Miller, Chris

 

161,955

 

12/3/2008

 

60,734

 

101,221

08-26

 

Potts, John Thomas

 

167,891

 

12/3/2008

 

 

 

167,891

08-25

 

Rosenblatt, Michael

 

204,715

 

12/3/2008

 

 

 

204,715

08-16

 

Grunwald, Maria

 

82,500

 

12/3/2008

 

 

 

82,500

08-15

 

Guerriero, Jonathan

 

120,000

 

12/3/2008

 

 

 

120,000

08-17

 

Shomali, Maysoun

 

50,000

 

12/3/2008

 

50,000

 

08-18

 

Welch, Kathy

 

36,000

 

12/3/2008

 

 

 

36,000

08-19

 

Estabrook, Edie

 

24,000

 

12/3/2008

 

 

 

24,000

08-20

 

McCarthy, Daniel F.

 

18,000

 

12/3/2008

 

 

 

18,000

08-21

 

Gallacher, Kyla

 

6,000

 

12/3/2008

 

6,000

 

08-22

 

Zielstorff, Mark

 

6,000

 

12/3/2008

 

6,000

 

08-23

 

Downall, Julie

 

4,800

 

12/3/2008

 

4,800

 

08-24

 

Lumpkins, Mary

 

3,000

 

12/3/2008

 

 

 

3,000

09-01

 

Sullivan, Kelly

 

25,000

 

4/9/2009

 

 

 

25,000

09-02

 

McKay, Kathleen

 

45,000

 

4/9/2009

 

45,000

 

09-03

 

Czerepak, Elizabeth

 

75,000

 

4/9/2009

 

 

 

75,000

09-04

 

Czerepak, Elizabeth

 

75,000

 

12/2/2009

 

 

 

75,000

10-01

 

Auerbach, Alan

 

2,084,602

 

10/12/2010

 

 

 

2,084,602

10-02

 

Auerbach, Alan

 

1,765,398

 

10/12/2010

 

 

 

1,765,398

10-03

 

Czerepak, Elizabeth

 

25,000

 

11/30/2010

 

 

 

25,000

 

151



 

Option
Number

 

Name

 

# Options

 

Grant
Date

 

Options
Canceled

 

Options
Outstanding

04-051

 

Ho, Sam

 

10,000

 

5/4/2004

 

 

 

03-002

 

Lane, Ben

 

325,000

 

12/16/2003

 

203,125

 

03-003

 

Henderson, Bart

 

650,000

 

12/16/2003

 

192,969

 

03-001

 

Hattersley, Gary

 

162,500

 

12/16/2003

 

 

 

162,500

03-005

 

Manolagas, Stavros

 

1,108,812

 

11/14/2003

 

 

 

03-008

 

Rosenblatt, Michael

 

370,241

 

11/14/2003

 

 

 

03-007

 

Potts, John Thomas

 

304,374

 

11/14/2003

 

 

 

03-006

 

Katsenellenbogen, John

 

606,573

 

11/14/2003

 

 

 

03-004

 

Pitzele, Barnett

 

5,000

 

12/16/2003

 

1,000

 

04-072

 

Glass, Chris

 

10,000

 

8/12/2004

 

 

 

10,000

04-052

 

Estabrook, Edith

 

24,000

 

5/4/2004

 

 

 

24,000

04-071

 

Colbourn, Kelly

 

1,000

 

8/12/2004

 

 

 

04-103

 

Lyttle, Richard

 

1,625,000

 

10/28/2004

 

 

 

1,625,000

04-101

 

Guy, Keisha

 

8,000

 

10/28/2004

 

8,000

 

04-102

 

McIntyre, Dotty

 

8,000

 

10/28/2004

 

2,000

 

04-100

 

Shomali, Maysoun

 

15,000

 

12/28/2004

 

15,000

 

05-01

 

Glass, Chris

 

10,000

 

12/6/2005

 

 

 

10,000

06-02

 

Hattersley, Gary

 

81,250

 

2/15/2006

 

 

 

81,250

06-04

 

Guy, Keisha

 

8,000

 

2/15/2006

 

8,000

 

06-05

 

McIntyre, Dotty

 

8,000

 

2/15/2006

 

4,000

 

06-06

 

Shomali, Maysoun

 

15,000

 

2/15/2006

 

15,000

 

06-01

 

Ho, Sam

 

10,000

 

2/15/2006

 

7,500

 

06-03

 

Colbourn, Kelly

 

3,000

 

2/15/2006

 

2,469

 

06-07

 

O’Dea, Louis

 

570,000

 

2/15/2006

 

 

 

339,625

07-01

 

McIntyre, Dotty

 

27,000

 

7/12/2007

 

23,625

 

07-08

 

Lyttle, Richard

 

2,377,688

 

7/12/2007

 

 

 

2,377,688

07-07

 

O’Dea, Louis

 

830,941

 

7/12/2007

 

 

 

623,206

07-09

 

Harvey, B. Nicholas

 

1,250,840

 

7/12/2007

 

 

 

1,250,840

07-06

 

Hattersley, Gary

 

356,653

 

7/12/2007

 

 

 

356,653

07-11

 

Katsenellenbogen, John

 

100,000

 

7/12/2007

 

 

 

100,000

07-12

 

Potts, John Thomas

 

540,790

 

7/12/2007

 

 

 

540,790

07-13

 

Rosenblatt, Michael

 

660,491

 

7/12/2007

 

 

 

412,805

07-02

 

Shomali, Maysoun

 

44,000

 

7/12/2007

 

8,250

 

07-03

 

Estabrook, Edith

 

16,000

 

7/12/2007

 

 

 

16,000

07-05

 

Lumpkins, Mary

 

3,000

 

7/12/2007

 

 

 

3,000

07-04

 

Guerriero, Jonathan

 

100,000

 

7/12/2007

 

 

 

62,500

07-14

 

Grunwald, Maria

 

137,500

 

12/6/2007

 

 

 

137,500

07-15

 

Herendeen, Hillary

 

8,000

 

12/6/2007

 

8,000

 

07-16

 

Downall, Julie

 

8,000

 

12/6/2007

 

8,000

 

08-01

 

Welch, Kathy

 

60,000

 

2/7/2008

 

 

 

60,000

08-09

 

Lyttle, Richard

 

3,040,081

 

5/8/2008

 

 

 

3,040,081

08-05

 

O’Dea, Louis

 

1,064,028

 

5/8/2008

 

 

 

1,064,028

08-06

 

Harvey, B. Nicholas

 

950,025

 

5/8/2008

 

 

 

950,025

08-08

 

Hattersley, Gary

 

456,012

 

5/8/2008

 

 

 

456,012

08-02

 

McCarthy, Daniel F.

 

30,000

 

5/8/2008

 

 

 

30,000

 

152



 

08-03

 

Zielstorff, Mark

 

10,000

 

5/8/2008

 

10,000

 

08-04

 

Gallacher, Kyla

 

10,000

 

5/8/2008

 

10,000

 

08-14

 

Lyttle, Richard

 

1,295,640

 

12/3/2008

 

 

 

1,295,640

08-10

 

O’Dea, Louis

 

453,474

 

12/3/2008

 

 

 

453,474

08-11

 

Harvey, B. Nicholas

 

404,888

 

12/3/2008

 

 

 

404,888

08-13

 

Hattersley, Gary

 

194,346

 

12/3/2008

 

 

 

194,346

08-26

 

Potts, John Thomas

 

167,891

 

12/3/2008

 

 

 

167,891

08-25

 

Rosenblatt, Michael

 

204,715

 

12/3/2008

 

 

 

204,715

08-16

 

Grunwald, Maria

 

82,500

 

12/3/2008

 

 

 

82,500

08-15

 

Guerriero, Jonathan

 

120,000

 

12/3/2008

 

 

 

120,000

08-17

 

Shomali, Maysoun

 

50,000

 

12/3/2008

 

50,000

 

08-18

 

Welch, Kathy

 

36,000

 

12/3/2008

 

 

 

36,000

08-19

 

Estabrook, Edie

 

24,000

 

12/3/2008

 

 

 

24,000

08-20

 

McCarthy, Daniel F.

 

18,000

 

12/3/2008

 

 

 

18,000

08-21

 

Gallacher, Kyla

 

6,000

 

12/3/2008

 

6,000

 

08-22

 

Zielstorff, Mark

 

6,000

 

12/3/2008

 

6,000

 

08-23

 

Downall, Julie

 

4,800

 

12/3/2008

 

4,800

 

08-24

 

Lumpkins, Mary

 

3,000

 

12/3/2008

 

 

 

3,000

09-01

 

Sullivan, Kelly

 

25,000

 

4/9/2009

 

 

 

25,000

09-02

 

McKay, Kathleen

 

45,000

 

4/9/2009

 

45,000

 

09-03

 

Czerepak, Elizabeth

 

75,000

 

4/9/2009

 

 

 

75,000

09-04

 

Czerepak, Elizabeth

 

75,000

 

12/2/2009

 

 

 

75,000

10-01

 

Auerbach, Alan

 

2,084,602

 

10/12/2010

 

 

 

2,084,602

10-02

 

Auerbach, Alan

 

1,765,398

 

10/12/2010

 

 

 

1,765,398

10-03

 

Czerepak, Elizabeth

 

25,000

 

11/30/2010

 

 

 

25,000

 

153


 

J.      Consulting Agreements

 

The Corporation has entered into consulting agreements with the following parties:

 

Party

 

Effective Date

1.   Dr. John Bilezidian

 

9/14/2005

2.   Dr. David Archer

 

10/24/2005

3.   Beckloff Associates, Inc

 

6/18/2004

4.   Terisita Bellido

 

6/24/2004

5.   Dr. M. Shalender Bashin

 

1/3/2006

6.   IntaPro LLC

 

3/22/2005

7.   Access BIO, LC

 

7/8/2005

8.   Dr. John C. Chabala

 

5/3/2004

9.   SVC Associates, Inc

 

10/25/2005

10. Burton G Christensen

 

7/23/2004

11. Dr. Mitchell Creinin

 

10/17/2005

12. Frame and Spence Consulting LLP

 

7/21/2005

13. Dr. Christopher Glass

 

9/1/2004

14. Dr. Frances J. Hayes

 

4/21/2005

15. TLG Consulting Inc

 

7/1/2005

16. Robert A. Jassmond

 

4/18/2006

17. Robert Jilka

 

6/24/2004

18. Dr. John Katzenellenbogen

 

11/14/2003

19. Cathy Kerzner

 

11/18/2005

20. Stavroula Kousteni

 

6/24/2004

21. Richard Labaudiniere

 

1/1/2004

22. Robert Lindsay

 

07/26/2004

23. Willis Maddrey

 

07/23/2004

24. Dr. Stavros C. Manolagas

 

11/14/2003

25. Dr. Stavros C. Manolagas

 

12/14/2005

26. Musso and Associates LLC

 

06/24/2005

27. Musso and Associates LLC

 

03/08/2006

28. Robert M. Neer

 

11/22/2005

29. Anthony Norman

 

6/4/2004

30. Charles O’Brien

 

06/24/2004

31. Skokie Valley Consulting Agrmt

 

12/01/2003

32. PK Noonan & Associates LLC

 

07/08/2005

33. Dr. John Thomas Potts, Jr

 

11/14/2003

34. Dr. Cliff Rosen

 

07/22/2005

35. Dr. Michael Rosenblatt

 

11/14/2003

36. Joseph S. Simon

 

07/08/2005

37. Ian Smith

 

07/13/2004

38. Gilbert Stork

 

07/13/2004

39. KellySci Consulting Inc.

 

11/16/2007

40. Robert J. Szot

 

06/22/2005

41. Robert Weinstein

 

06/24/2004

42. ChanTest Inc

 

11/08/2005

43. Diamond BioPharm Ltd

 

10/26/2007

44. Diamond BioPharm Ltd

 

8/15/2007

 

154



 

45. Diamond BioPharm Ltd

 

8/15/2007

46. Team Consulting Ltd

 

8/18/2007

47. Joel Morganroth

 

10/23/2007

48. Joel Morganroth

 

10/10/2006

49. INTAPRO LLC

 

3/22/2005

50. Roy Swaringen

 

3/6/2008

51. Skokie Valley Consulting Corp.

 

12/1/2003

52. Target Health Inc.

 

4/14/2006

53. LGL Consulting LLC

 

4/28/2008

54. David Archer

 

3/26/2008

55. Osheroff Consulting Services LLC

 

8/15/2008

56. Dylan J. Callahan a.k.a. d/b/a Organized Minds

 

6/1/2008

57. PK Noonan & Associates LLC

 

9/15/2008

58. Matrix BioAnalytical Laboratories Inc

 

4/11/2008

59. Prof David Handelsman

 

2/9/2009

60. David Goltzman

 

3/4/2009

61. Professor Dennis Black

 

4/14/2009

62. Dr. Radha Iyengar

 

7/20/2009

63. Frame and Spence Consulting LLP

 

5/5/2009

64. Access Bio LC

 

8/20/2009

65. David Archer, MD

 

3/27/2009

66. Jean-Francois Sibi

 

11/2/2009

67. Diamond Biopharm Ltd

 

11/9/2009

68. Harry Genant, MD

 

12/12/2009

69. Radha Iyengar

 

1/19/2010

70. Safety Partners, Inc.

 

06/03/2004

71. Joel Morganroth

 

10/10/2006

72. Joel Morganroth

 

10/23/2007

73. Robert Schenken

 

07/24/2004

74. Kathleen Banks

 

11/13/2009

75. Goldmann Consulting LLC

 

7/5/2010

76. Duck Flats Pharma LLC

 

8/2/2010

77. Dennis Black

 

11/29/2010

78. Welsh Consulting

 

1/20/2011

79. Michael Gross

 

5/3/2011

 

K.     Employment Agreements

 

1.      Letter Agreement by and between the Corporation and C. Richard Edmund Lyttle, dated July 2, 2004.

 

2.      Letter Agreement by and between the Corporation and B. Nicholas Harvey, dated November 15, 2006.

 

3.      Letter Agreement by and between the Corporation and Louis St. Laurence O’Dea, dated January 30, 2006, as amended by Letter Agreement dated July 21, 2008.

 

4.      Letter Agreement by and between the Corporation and Gary Hattersley, dated November 21, 2003, as amended by Letter Agreement dated July 21, 2008.

 

155



 

5.      See also Attachment A to this Schedule 5.6 for the Form of Letter Agreement entered into by and between the Corporation and its at-will employees.

 

156


 

Attachment A to

Schedule 5.6

 

Form of Employee Letter Agreement

 

                              ,2007

 

Dear               :

 

It is my pleasure to offer you the position of                                            at Radius Health, Inc. (the “Company”).  As you know, I am excited about the contributions that I expect you will make to the success of the Company.  Accordingly, if you accept this offer, I would like us to agree that you could start at Radius on or before                                (the “Start Date”).  This offer may be accepted by you by countersigning where indicated at the end of this letter.

 

DUTIES AND EXTENT OF SERVICE

 

As                                           , you will report to                                            and you will have responsibility for performing those duties as are customary for, and are consistent with, such position, as well as those duties that may be designated to you from time to time.  As you know, your employment will be contingent upon your agreeing to abide by the rules, regulations, instructions, personnel practices, and policies of the Company and any changes therein that the Company may adopt from time to time, and your execution of the Company’s standard Nondisclosure, Developments, and Non-Competition Agreement.

 

COMPENSATION AND BENEFITS

 

Your salary will be $                       per semi-monthly pay period, minus applicable taxes and withholdings.  Such salary may be adjusted from time to time in accordance with normal business practice and in the sole discretion of the Company.

 

You will be entitled to three weeks paid vacation annually.  You will also be entitled to participate in such employee benefit plans and fringe benefits as may be offered or made available by the Company to its employees.

 

STOCK OPTIONS

 

At the first meeting of the Company’s Board of Directors following your Start Date, it is my intention that the Company will recommend to the Board of Directors that you receive a common stock option grant of                shares.  This offer is contingent upon approval by the Board of Directors of your option grant specifically.  Promptly after the Grant Date, the Company and you will execute and deliver to each other the Company’s then standard form of stock option agreement, evidencing the Option and the terms thereof.  As you know, the Option shall be subject to, and governed by, the terms and provisions of the Plan and your stock option agreement.

 

NONDISCLOSURE, DEVELOPMENTS AND NON-COMPETITION

 

As you know, prior to commencing, and as a condition to your employment with the Company, all employees are required to agree to sign a copy of the Company’s standard Nondisclosure, Developments, and Non-Competition Agreement.  The Company will ask you to sign this agreement after you have signed and returned this letter and prior to or on your Start Date.

 

157



 

At-Will Employment

 

This letter shall not be construed as an agreement, either expressed or implied, to employ you for any stated term, and shall in no way alter the Company’s policy of employment at-will, under which both you and the Company remain free to terminate the employment relationship, with or without cause, at any time, with or without notice.  Similarly, nothing in this letter shall be construed as an agreement, either express or implied, to pay you any compensation or grant you any benefit beyond the end of your employment with the Company.   In addition, nothing in any documents published by the Company shall in any way modify the above terms and these terms cannot be modified in any way by any oral or written representations made by anyone employed by the Company, except by written document signed by C. Richard Lyttle.

 

NO CONFLICTING OBLIGATION AND OBLIGATIONS

 

You represent and warrant that the performance by you of any or all of the terms of this letter agreement and the performance by you of your duties as an employee of the Company do not and will not breach or contravene (i) any agreement or contract (including, without limitation, any employment or consulting agreement, any agreement not to compete or any confidentiality or nondisclosure agreement) to which you are or may become a party on or at an time after the Start Date or (ii) any obligation you may otherwise have under applicable law to any former employer or to any person to whom you have provided, provide or will provide consulting services.

 

I am pleased on behalf of Radius to extend this offer to have you join us.  This is an exciting time for Radius and we would be delighted to have you as part of our organization.

 

Please acknowledge your acceptance of this offer and the terms of this letter agreement by signing below and returning a copy to me.

 

Sincerely,

 

I hereby acknowledge that I have had a full and adequate opportunity to read, understand and discuss the terms and conditions contained in this letter agreement prior to signing hereunder.

 

Date this          day of                             , 20

 

158



 

Schedule 5.6(e)

 

Business of the Corporation

 

None.

 

159



 

Schedule 5.6(f)

 

Business of the Corporation

 

None.

 

160



 

Schedule 5.6(g)

 

Business of the Corporation

 

1.               Indemnification Agreement, dated November 14, 2003, by and between the Corporation and Michael Rosenblatt, M.D.

 

2.               Indemnification Agreement, dated November 14, 2003, by and between the Corporation and Christopher Mirabelli.

 

3.               Indemnification Agreement, dated November 14, 2003, by and between the Corporation and Augustine Lawlor.

 

4.               Indemnification Agreement, dated November 14, 2003, by and between the Corporation and Ansbert K. Gadicke.

 

5.               Indemnification Agreement, dated November 14, 2003, by and between the Corporation and Edward Mascioli, M.D.

 

6.               Indemnification Agreement, dated October 12, 2010, by and between the Corporation and Alan Auerbach.

 

161



 

Schedule 5.12(a)

 

Intellectual Property

 

1.               The Corporation has filed for registration of its trademark rights in the following marks:

 

·                   N (Design), Application No. 78/391,239, Filing Date: 26-Mar-2004

 

·                   RADIUS, Application No. 78/707,397, Filing Date: 06-Sep-2005

 

·                   RADIUS, Application No. 78/707,419, Filing Date: 06-Sep-2005

 

·                   RADIUS (& Design), Application No. 78/797,031, Filing Date: 23-Jan-2006

 

·                   RADIUS (& Design), Application No. 78/797,016), Filing Date: 23-Jan-2006

 

2.               Domain name:  www.radiuspharm.com

 

3.               See also Attachment A to this Schedule 5.12(a).

 

162


 

Attachment A to

Schedule 5.12(a)

 

RADIUS PATENT AND PATENT APPLICATION SUMMARY

 

RAD-1901

 

A.            Owned by Radius

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Title

3803.1016-000
(US)

 

61/127,025
(5/09/08)

 

Richard C. Lyttle,
Gary Hattersley, Louis O’Dea

 

Expired

 

Pharmaceutical Combinations and Methods of Using Same

3803.1016-001
(PCT)

 

PCT/US2009/002885
(5/07/09)

 

Richard C. Lyttle,
Gary Hattersley, Louis O’Dea

 

Pending

 

Pharmaceutical Combinations and Methods of Using Same

3803.1016-002
(US)

 

12/991,791
(5/7/09)

 

Richard C. Lyttle,
Gary Hattersley, Louis O’Dea

 

Pending

 

Pharmaceutical Combinations and Methods of Using Same

3803.1022-000
(US)

 

61/334,095
(5/12/10)

 

Richard C. Lyttle,
Gary Hattersley, Louis O’Dea

 

Pending
(Provisional)

 

Therapeutic Regimens

 

B.            Jointly Owned by Radius and Eisai

 

HBSR Docket No.

 

Application Number
(Pub. Number-Date)
and
Filing Date

 

Inventors

 

Status

 

Title

3803.1001-000
(US)

 

60/816,191
(6/23/06)

 

Richard C. Lyttle, Bart Henderson, Gary Hattersley

 

U.S. Provisional;
(Expired 06/23/07)

 

Treatment of Vasomotor Symptoms With Selective Estrogen Receptor Modulators

3803.1001-002
(PCT)

 

PCT/US2007/014598
(WO2008/002490-1/3/08)
6/22/07

 

Richard C. Lyttle, Bart Henderson, Gary Hattersley

 

Expired

 

Treatment of Vasomotor Symptoms With Selective Estrogen Receptor Modulators

 

163



 

C.            Solely Owned by Radius

 

HBSR Docket No.

 

Application Number
(Pub. Number-Date)
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1001-003
(US)

 

12/308,640
 (6/22/07)

 

(US 2010/0105733 A1-4/29/2010)

 

Richard C. Lyttle, Bart Henderson, Gary Hattersley

 

U.S. National Stage of PCT
Pending

 

Treatment of Vasomotor Symptoms With Selective Estrogen Receptor Modulators

3803.1001-004
(Europe)

 

07796378.3
(6/22/07)

 

(EP2037905-3/25/09)

 

Richard C. Lyttle, Bart Henderson, Gary Hattersley

 

EP Regional Phase
Pending

 

Treatment of Vasomotor Symptoms With Selective Estrogen Receptor Modulators

3803.1001-005
(Canada)

 

2656067
 (6/22/07)

 

Richard C. Lyttle, Bart Henderson, Gary Hattersley

 

Canadian National Stage of PCT
Pending

 

Treatment of Vasomotor Symptoms With Selective Estrogen Receptor Modulators

 

D.            Licensed to Radius by Eisai

 

HBSR Reference
No.

 

Country

 

App.and/or Patent Number
(Pub. Number-Date) and
Filing Date

 

Status

 

Short Description

3803.0020-003

 

Australia

 

2003292625 B2
(2003292625 A1-7/22/2004)
12/25/03

 

Granted
11/6/2008
Australian National Stage of PCT

 

Selective Estrogen Receptor Modulators

3803.0020-004

 

Canada

 

2512000
12/25/03

 

Pending
Canadian National Stage of PCT

 

Selective Estrogen Receptor Modulators

3803.0020-002

 

Europe

 

EP 2003782904
 (1577288 A1-9/21/05)
12/25/03

 

Pending
European Regional Stage of PCT

 

Selective Estrogen Receptor Modulators

3803.0020-001

 

USA

 

US. Patent No. 7,612,114
11/158,245
(2006/0116364-6/1/06)
6/22/05

 

Granted
Continuation-in-Part of U.S. Designation of PCT

 

Selective Estrogen Receptor Modulators

 

164



 

HBSR Reference
No.

 

Country

 

App.and/or Patent Number
(Pub. Number-Date) and
Filing Date

 

Status

 

Short Description

3803.0020-000

 

PCT

 

PCT/JP2003/016808
(12/25/03)
Publication No. WO 2004/058682
(7/15/04)

 

Expired

 

Selective Estrogen Receptor Modulators

3803.0020-005

 

India

 

2829/DELNP/2005
(12/25/2003)

 

Pending
Indian National Stage of PCT

 

Selective Estrogen Receptor Modulators

3803.0020-006

 

Australia

 

Div. of 2003292625 B2

 

Pending

 

Selective Estrogen Receptor Modulators

3803.0020-007

 

United States

 

Application No. 12/544,965
8/20/2009
Publication No. US2009/0325930
12/31/2009

 

Pending

 

Selective Estrogen Receptor Modulators

 

SARMS

 

A.            Owned by Radius

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1015-000
(US)

 

61/066,697
(02/22/08)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1015-001
(US)

 

61/132,353
(6/18/08)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1015-002
(US)

 

61/205,727
(1/21/09)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1015-003
(PCT)

 

PCT/US2009/001035
(2/19/09)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1015-004
(US)

 

12/378,812
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-005
(US)

 

12/541,489
(8/14/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

 

165



 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1015-006
(US)

 

12/806,636
(8/17/10)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-007
(Australia)

 

2009215843
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-008
(Brazil)

 

PI09078444
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-009
(Canada)

 

2716320
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-010
(Europe)

 

09712082.8
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-011
(India)

 

6324DELNP2010
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-012
(Japan)

 

2010547633
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

3803.1015-013
(Mexico)

 

MXA2010009162
(2/19/09)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1019-000
(US)

 

61/212,399
(4/10/99)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1019-001
(PCT)

 

PCT/US2010/030480 (4/9/10)

 

Chris P. Miller

 

Pending

 

Published as
WO2010/118287 (10/14/10)

 

Selective Androgen Receptor Modulators

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1021-000
(US)

 

61/301,492
(2/4/10)

 

Chris P. Miller

 

Expired

 

Selective Androgen Receptor Modulators

3803.1021-001
(PCT)

 

PCT/US2011/023768 (2/4/11)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

 

166



 

HBSR Docket No.

 

Application
Number and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1023-000
(US)

 

61/361,168
(7/2/10)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

 

HBSR Docket No.

 

Application
Number and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1024-000
(US)

 

61/387,440
(9/28/10)

 

Chris P. Miller

 

Pending

 

Selective Androgen Receptor Modulators

 

BaO58

 

A.            Jointly Owned by Radius and Ipsen

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1004-000
(US)

 

60/848,960
(10/3/06)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Expired

 

PTHrP Formulation

3803.1004-002
(PCT)

 

PCT/US2007/021216
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Expired

 

PTHrP Formulation

3803.1004-003
(US)

 

12/151,975
(5/9/08)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Granted
US Patent No. 7,803,770
(9/28/10)

 

PTHrP Formulation

3803.1004-004
(Australia)

 

2007322334
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

 

167



 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1004-005
(Brazil)

 

PU07198213
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-006
(Canada)

 

2664734
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-007
(China)

 

200780037021.9
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-008
(Europe)

 

07870768.4
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-009
(India)

 

2340DELNP2009
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-010
(Israel)

 

197926
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-011
(Japan)

 

2009531434
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-012
(Korea)

 

1020097008736
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-013
(Mexico)

 

MXA2009003569
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

 

168



 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1004-014
(New Zealand)

 

576682
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-015
(Norway)

 

20091545
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-016
(Russian Federation)

 

2009116531
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-017
(Singapore)

 

2009922401
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-018
(Ukraine)

 

200904264
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-019
(US)

 

12/311,418
(10/3/07)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-020
(PCT)

 

PCT/US2009/002868
(5/8/09)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Abandoned

 

PTHrP Formulation

3803.1004-021
(Hong Kong)

 

09109160.6
(10/2/09)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

3803.1004-022
(US)

 

12/855,458
(8/12/10)

 

Michael J. Dey, Nathalie Mondoly, Benedice Rigaud, Bart Henderson and
Richard C. Lyttle

 

Pending

 

PTHrP Formulation

 

169


 

B.            Licensed to Radius by Ipsen (BaO58)

 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US

 

USA

 

08/626,186
(03/29/96)

 

U.S. Patent 5,723,577
(03/03/98)
Expires 03/29/16

 

Analogs of PTH

038/US2

 

USA

 

08/779,768
(01/07/97)

 

U.S. Patent 5,969,095 (10/19/99)
Expires 3/29/16

 

Claims BA058

038/US/PCT2

 

PCT

 

PCT/US96/11292
(07/03/96)

 

Expired

 

Analogs of PTH

038/US/PCT2/EP

 

Europe

 

96924355.9
(01/30/98)

 

Regional Phase entry of
PCT/US96/11292

 

European Patent 0 847 278
(09/24/03)
Expires 07/03/16
Activation in AT, BE, CH, DE, DK, ES, FI, FR, Gb, GR, IE, IT, LI, LU, MC, NL, PT, SE; Ext: AL, LT, LV, SI
Now Abandoned in AL, LT, LU, MC, SI, LV

 

Analogs of PTH

038/US/PCT2/EP-A

 

Europe

 

03077383.2
(07/30/03)

 

Divisional of
96924355.9

 

European Patent No.:1405861
Expires 7/3/2016

 

Activation in AT, BE, CH, DE, DK, ES, FI, FR, Gb, GR, IE, IT, LI, LU, MC, NL, PT, SE

 

Analogs of PTH

038-EP-EPD[3]

 

Europe

 

10156965.5
(3/18/2010)

 

Pending

 

Analogs of PTH

038/US/PCT2/JP

 

Japan

 

9-505897
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Pending
Published 8/17/1999

 

Analogs of PTH

 

170



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US/PCT2/JP-A

 

Japan

 

008027/03
(01/16/03)
Divisional of 9-505897

 

Patent No. 4008825
Granted 08/23/07
Expires 7/3/2016

 

Analogs of PTH

038/US/PCT2/AU

 

Australia

 

64834/96
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 707094
(07/01/99)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/CA

 

Canada

 

2,226,177
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No.:2,226,177

 

Expires 7/3/2016

 

Analogs of PTH

038/US/PCT2/CN

 

China

 

96196926.1
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. ZL96 196926.1
(2/25/06)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/CN-A

 

China

 

200410005427.2
(07/03/96)

 

Divisional of
96196926.1

 

Patent No.. ZL200410005427.7
(8/20/02)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/CN-C

 

China

 

2006 10100113.4
(7/21/06)

 

Divisional of
2004 10005427.7

 

Patent No.: ZL200610100113

 

Expires 7/3/2016

 

Analogs of PTH

038-CN-DIV[4]

 

China

 

20100150544.8

 

Pending

 

Analogs of PTH

038/US/PCT2/CN-HK

 

Hong Kong

 

99100132.1
(01/13/99)
Registration in Hong Kong of 961 96926.1

 

Patent No. 1 014 876
Expires 07/03/16

 

Analogs of PTH

 

171



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US/PCT2/HU

 

Hungary

 

P9901718
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No.: 226935

 

Expires 7/3/2016

 

Analogs of PTH

038/US/PCT2/IL

 

Israel

 

122837
(07/03/96

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 122837
(02/11/03)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/KR

 

Korea

 

1998-0700249
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 0500853
(07/04/05)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/KR-A

 

Korea

 

2004-706338
(04/28/04)
Divisional of 1998-0700249

 

Patent No. 0563600
(3/16/06)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/KR-B

 

Korea

 

2004-706339
(04/28/04)
Divisional of 1998-0700249

 

Patent No. 0563601
(3/16/06)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/KR-C

 

Korea

 

2004-706340
(04/28/04)
Divisional of 1998-0700249

 

Patent No. 0563602
(3/16/06)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/KR-D

 

Korea

 

2004-706341
(04/28/04)
Divisional of 1998-0700249

 

Patent No. 0563112
(3/15/06)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/MX

 

Mexico

 

PA/a/1998/000418
(07/03/96)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 222317
(08/26/04)
Expires 07/03/16

 

Analogs of PTH

 

172



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US/PCT2/NZ

 

New Zealand

 

312899
(01/20/98)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 312899
(02/08/00)
Expires 07/03/16

 

Analogs of PTH

038/US/PCT2/PL

 

Poland

 

P.325905
(01/12/98)

 

Regional Phase entry of
PCT/US96/11292

 

Patent No. 186710
(08/07/03)
Expires 07/03/16

 

Analogs of PTH

* 038/US/PCT2/RU

 

Russia

 

98/102406
(7/3/96)

 

Patent No. 2,157,699
(10/20/00)

 

Analogs of PTH

* 038/US/PCT2/SG

 

Singapore

 

9706046.1
(7/3/96)

 

Patent No. P-51260
(10/16/01)

 

Analogs of PTH

* 038/US/TW

 

Taiwan

 

85108390
(07/11/96)

 

Patent No. 153897
(08/07/02)

 

Analogs of PTH

038/US3

 

USA

 

08/813,534
(03/07/97)

 

Patent No. 5,955,574
(09/21/99)
Expires 03/29/16

 

Analogs of PTH

038/US3/PCT2

 

PCT

 

PCT/US97/22498
(12/08/97)

 

Expired

 

Analogs of PTH

038/US3/PCT2/US2

 

USA

 

09/399,499
(09/20/99)

 

Patent No. 6,544,949
(04/08/03)
Expires 03/29/16

 

Claims a method of treating osteoporosis with BA058 and a pharmaceutical composition including BA058

038/US3/PCT2/US2-A

 

USA

 

10/289,519
(11/06/02)

 

Patent No. 6,921,750
(07/26/05)
Expires 03/29/16
Reissue Application filed 9/16/06
Application No. 11/523,812

 

Analogs of PTH

 

173



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US3/PCT2/US2-B

 

USA

 

11/094,662
(03/30/05)

 

Patent No. 7632811

 

Expires 9/6/2019

 

Analogs of PTH

038/US3/PCT2/EP

 

Europe

 

97951595.4
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. EP0948541
(03/29/06)
Expires 12/08/17

 

Activation in: AT, BE, CH, LI, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE;
Extension States: AL, LT, LV, MK, RO and SI
Now Abandoned in AL, LT, LU, MK, MC, RO, SI

 

Analogs of PTH

038/US3/PCT2/EP-A

 

Europe

 

05026436.5
(12/12/05)

 

Divisional of EP 97951595.4

 

European Patent No. 1645566

 

Expires 12/8/2017

 

Activation in: AT, BE, CH, DE, DK, ES, FI, FR, GB, GR, IE, IT, NL, PT, SE

 

Analogs of PTH

038/US3/PCT2/JP

 

Japan

 

10-530865
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 3963482
06/01/07
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/AU

 

Australia

 

55199/98
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 741584
(03/21/02)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/CA

 

Canada

 

2,276,614
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 2,276,614
(06/11/02)
Expires 12/08/17

 

Analogs of PTH

 

174



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US3/PCT2/CN

 

China

 

97181915.7
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. ZL97181915.7
(02/11/04)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/CN-HK

 

Hong Kong

 

00105467.3
(12/08/00)
Registration of 97181915.7

 

1026215
(07/09/04)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/CZ

 

Czech Republic

 

PV 1999-2398
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No.298937
(02/06/08)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/CZ-A

 

Czech Republic

 

PV2005-594
(9/16/05)

 

Divisional of
PV 2398-99

 

Pending

 

Analogs of PTH

038/US3/PCT2/HU

 

Hungary

 

P9904596
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Pending
Published
6/28/2000

 

Analogs of PTH

038/US3/PCT2/HU-A

 

Hungary

 

P0600009
(1/11/06)

 

Divisional of
HU P 99 04596

 

Pending
Published 01/26/2006

 

Analogs of PTH

038/US3/PCT2/IL

 

Israel

 

130794
(12/08/07)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No.130794
(07/03/06)
Expires 12/08/17

 

Analogs of PTH

 

175



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US3/PCT2/IN

 

India

 

7/MAS/98
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 228906

 

Expires 1/1/2018

 

Analogs of PTH

038/US3/PCT2/IN-A

 

India

 

63/CHE/2008
 (01/08/08)
Divisional of 7/MAS/98

 

Pending

 

Analogs of PTH

038/US3/PCT2/IN-B

 

India

 

456/CHE/2008
(02/22/08)
Divisional of 7/MAS/98

 

Pending

 

Analogs of PTH

038/US3/PCT2/KR

 

Korea

 

1999-7006165
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 0497709
(06/17/05)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/KR-A

 

Korea

 

2005-7003295
(2/25/05)

 

Divisional of
KR 1999-7006165

 

Patent No. 0699422
(3/19/07)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/MX

 

Mexico

 

Pa/a/1999/006387
(12/08/97)

 

Patent No. 222316
(08/26/04)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/NZ

 

New Zealand

 

336610
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 336610
(11/09/01)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/PL

 

Poland

 

P-334438
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 191898
(2/15/06)
Expires 12/08/17

 

Analogs of PTH

 

176



 

Ipsen Reference No.

 

Country

 

Application Number
Filing Date and
Priority

 

Status

 

Short Description

038/US3/PCT2/PL-A

 

Poland

 

P.370525
(10/04/04)
Divisional of P.33438

 

Patent No. 191239
(09/03/07)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/RU

 

Russia

 

99117145
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 2,198,182
(02/10/03)
Expires 12/08/17

 

Analogs of PTH

038/US3/PCT2/SG

 

Singapore

 

9903165.0
(12/08/97)
National Stage of PCT/US97/22498
(12/08/97)

 

Patent No. 66567
(07/18/00)
Expires 12/08/17

 

Analogs of PTH

038/US2/US3/TW

 

Taiwan

 

87100028
(01/02/98)

 

Patent No. 156542
(06/01/02)
Expires 01/02/18

 

Analogs of PTH

038/US/PCT2/CN-C/HK

 

HK

 

Filing 07103960.3
4/16/2007

 

Patent No. HK1096976
Expires 7/3/2016

 

Analogs of PTH

038/US3/PCT2/US2-C

 

US

 

Filing 11/684,383
3/09/2007

 

Patent No. 7,410,948
(8/12/08)
Expires 03/29/16

 

Analogs of PTH

 

B.            Jointly Owned by Radius and 3M

 

HBSR Docket No.

 

Application Number
and
Filing Date

 

Inventors

 

Status

 

Short Description

3803.1025-000
(US)

 

61/478,466
(4/22/2011)

 

Gary Hattersley, Kris J. Hansen, Amy S. Determan

 

Pending

 

Method of drug delivery for PTH, PTHrP, and related peptides.

 

177


 

Schedule 5.12(b)

 

Intellectual Property

 

1.               See items listed as “Jointly Owned” or “Licensed to Radius” in Item 3 of Schedule 5.12(a).

 

2.               Certain rights licensed to 3M pursuant to that certain Development and Clinical Supplies Agreement with 3M dated June 19, 2009.

 

178



 

Schedule 5.12(c)

 

Intellectual Property

 

1.               See items listed as “Jointly Owned” or “Licensed to Radius” in Item 3 of Schedule 5.12(a).

 

2.               Certain rights licensed to 3M pursuant to that certain Development and Clinical Supplies Agreement with 3M dated June 19, 2009.

 

179



 

Schedule 5.12(e)

 

Intellectual Property

 

None.

 

180



 

Schedule 5.12(f)

 

Intellectual Property

 

1.               See items listed as “Jointly Owned” or “Licensed to Radius” in Item 3 of Schedule 5.12(a).

 

2.               Certain rights licensed to 3M pursuant to that certain Development and Clinical Supplies Agreement with 3M dated June 19, 2009.

 

181



 

Schedule 5.12(g)

 

Intellectual Property

 

1.               See items listed as “Jointly Owned” or “Licensed to Radius” in Item 3 of Schedule 5.12(a).

 

2.               Certain rights licensed to the Corporation pursuant to that certain Development and Clinical Supplies Agreement with 3M dated June 19, 2009.

 

182



 

Schedule 5.12(h)

 

Intellectual Property

 

None.

 

183



 

Schedule 5.12(i)

 

Intellectual Property

 

None.

 

184



 

Schedule 5.14(a)

 

Title to Properties

 

None.

 

185



 

Schedule 5.14(b)

 

Title to Properties

 

1.               Sublease by and between the Corporation and Sonos, Inc., dated January 14, 2011, for the property located at 201 Broadway, Cambridge, Massachusetts.

 

186



 

Schedule 5.15

 

Investments in Other Persons

 

1.               Demand Promissory Note issued by MPM Acquisition Corp. to the Corporation, dated November 22, 2010.

 

187



 

Schedule 5.16

 

ERISA

 

1.               Radius Health, Inc. 401(k) Plan

 

2.               Radius Health, Inc. Flexible Spending Account Plan

 

188



 

Schedule 5.17

 

Use of Proceeds

 

1.               The Corporation anticipates using the net proceeds from the sale of the Series A-1 Preferred Stock to complete enrollment of the Phase 3 study of the subcutaneous form of the Corporation’s product candidate BA058 (PTHrP analog), complete the Phase 1b study of the transdermal form of BA058, bolster the Corporation’s balance sheet to improve negotiation leverage with  potential partners, and to complete a reverse merger with a publicly reporting Form 10 shell enabling the Corporation to eventually become publicly traded and listed on a national securities exchange such as Nasdaq.  The amounts actually expended by the Corporation for the above purposes may vary significantly depending on numerous factors, including future revenue growth, if any, the progress of the Corporation’s research and development efforts and technological advances and hence, the Corporation’s management will retain broad discretion in the allocation of the net proceeds from the Series A-1 Preferred Stock.

 

189



 

Schedule 5.18

 

Permits and Other Rights; Compliance with Laws

 

None.

 

190


 

Schedule 5.19

 

Insurance

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

COMMERCIAL PACKAGE

 

Travelers Property Casualty Co. of AME

 

6305876P819

 

01/30/2011 - 01/30/2012

 

$5,598.00

 

 

 

 

 

 

 

 

 

PROPERTY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Replacement Cost Valuation on Personal Property

 

 

 

 

 

 

 

 

Special Form Causes of Loss including Equipment Breakdown

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Scheduled Location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

201 Broadway

 

 

 

 

 

 

 

 

Cambridge , MA 02139

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Limits

 

 

 

 

 

 

 

 

 

Business Personal Property

$1,050,000

 

 

 

 

 

 

 

 

Business Income/Extra Expense

$250,000

 

 

 

 

 

 

 

 

Property at Unscheduled Location

$50,000

 

 

 

 

 

 

 

 

Property in Transit

$50,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deductibles

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Property

$2,500

 

 

 

 

 

 

 

 

Business Income Waiting Period

24 Hours

 

 

 

 

 

 

 

 

 

191


 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

COMMERCIAL PACKAGE

 

Travelers Property Casualty Co. of AME

 

6305876P819

 

01/30/2011 - 01/30/2012

 

$5,598.00

 

 

 

 

 

 

 

 

 

GENERAL LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General Aggregate Limit

$2,000,000

 

 

 

 

 

 

 

 

Products/Completed Operations Aggregate

Excluded

 

 

 

 

 

 

 

 

Each Occurrence Limit

$1,000,000

 

 

 

 

 

 

 

 

Advertising Injury and Personal Injury Limit

$1,000,000

 

 

 

 

 

 

 

 

Premises Damage

$300,000

 

 

 

 

 

 

 

 

Medical Expense

$10,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYEE BENEFITS LIABILITY (CLAIMS-MADE)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Each Claim Limit

$1,000,000

 

 

 

 

 

 

 

 

Aggregate Limit

$3,000,000

 

 

 

 

 

 

 

 

Deductible

$0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

FOREIGN PACKAGE

 

Travelers Property Casualty Co. of AME

 

TE06904263

 

01/30/2011 - 01/30/2012

 

$2,500.00

 

 

 

 

 

 

 

 

 

INTERNATIONAL GENERAL LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

General Aggregate Limit

$2,000,000

 

 

 

 

 

 

 

 

Products/Completed Operations Aggregate

Excluded

 

 

 

 

 

 

 

 

Each Occurrence Limit

$1,000,000

 

 

 

 

 

 

 

 

Advertising Injury and Personal Injury Limit

$1,000,000

 

 

 

 

 

 

 

 

Premises Damage

$300,000

 

 

 

 

 

 

 

 

Medical Expense

$10,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INTERNATIONAL AUTOMBOBILE

 

HIRED & NON-OWNED AUTO LIABILITY – EXCESS/DIC

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combined Single Limit for Bodily Injury and/or Property Damage

$1,000,000

 

 

 

 

 

 

 

 

 

192


 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

FOREIGN PACKAGE

 

 

Travelers Property Casualty Co. of AME

 

TE06904263

 

01/30/2011  - 01/30/2012

 

$2,500.00

 

 

 

 

 

 

 

 

 

 

Medical Payments

$10,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

FOREIGN PACKAGE

 

Travelers Property Casualty Co. of AME

 

TE06904263

 

01/30/2011  - 01/30/2012

 

$2,500.00

 

 

 

 

 

 

 

 

 

 

FOREIGN VOLUNTARY WORKERS’ COMPENSATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Description of Covered Employees

 

 

 

 

 

 

 

 

 

International Executive Employees -

State of Hire Benefits

 

 

 

 

 

 

 

 

Other International Employees -

Country of Origin Benefits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER’S LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Limits of Liability

 

 

 

 

 

 

 

 

 

Bodily Injury by Accident (Each Accident)

$1,000,000

 

 

 

 

 

 

 

 

Bodily Injury by Disease (Aggregate)

$1,000,000

 

 

 

 

 

 

 

 

Bodily Injury by Disease (Each Employee)

$1,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Coverage Extensions

 

 

 

 

 

 

 

 

 

Repatriation/Transportation - Each Person

$25,000

 

 

 

 

 

 

 

 

Repatriation/Transportation - Aggregate

$50,000

 

 

 

 

 

 

 

 

 

193


 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

COMMERCIAL AUTOMOBILE

 

Charter Oak Fire Ins. Co.

 

BA5881P281

 

01/30/2011  - 01/30/2012

 

$683.00

 

 

 

 

 

 

 

 

 

HIRED & NON-OWNED AUTO LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combined Single Limit for Bodily Injury and/or Property Damage

$1,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HIRED CAR PHYSICAL DAMAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Limit

Actual Cash Value

 

 

 

 

 

 

 

 

Comprehensive Deductible

$0

 

 

 

 

 

 

 

 

Collision Deductible

$500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

WORKERS’ COMPENSATION

 

Charter Oak Fire Ins. Co.

 

UB9485C327

 

01/30/2011  - 01/30/2012

 

$4,040.00

Subject to Audit

COVERAGE A –

WORKERS’ COMPENSATION

 

 

 

 

 

 

 

 

 

Statutory in MA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE B –

EMPLOYER’S LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bodily Injury by Accident (Each Accident)

$500,000

 

 

 

 

 

 

 

 

Bodily Injury by Disease (Aggregate)

$500,000

 

 

 

 

 

 

 

 

Bodily Injury by Disease (Each Employee)

$500,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE C –

OTHER STATES except

 

 

 

 

 

 

 

 

 

ND, OH, WA, WY & those listed in Coverage A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Note:

Coverage C has limitations.  Please contact WGA if you begin operations in any state not listed under Coverage A.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Based on estimated payroll as follows:

 

 

 

 

 

 

 

 

 

194


 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

WORKERS’ COMPENSATION

 

Charter Oak Fire Ins. Co.

 

UB9485C327

 

01/30/2011  - 01/30/2012

 

$4,040.00

Subject to Audit

MA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Class Code

Class Description

Payroll

 

 

 

 

 

 

 

 

8810

Clerical Office Employees NOC

$1,300,000

 

 

 

 

 

 

 

 

4512

Biomedical Research Laboratories

$1,400,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

COMMERCIAL UMBRELLA

 

St. Paul Fire & Marine Insurance Co.

 

TE06904241

 

01/30/2011  - 01/30/2012

 

$4,004.00

 

 

 

 

 

 

 

 

 

 

LIMITS OF LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Per Occurrence

$5,000,000

 

 

 

 

 

 

 

 

General Aggregate

$5,000,000

 

 

 

 

 

 

 

 

Self-Insured Retention

$10,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Underlying Coverages

Domestic General Liability

Domestic Employee Benefits Liability

Domestic Employer’s Liability

Domestic Automobile Liability

Foreign General Liability

Foreign Employer’s Liability

Foreign Automobile Liability

 

 

 

 

 

 

 

 

 

 

195


 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

PRODUCTS LIABILITY

 

Federal Insurance Company

 

35854927

 

01/30/2011  - 01/30/2012

 

$55,500.00

 

 

 

 

 

 

 

 

 

 

LIMITS OF LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aggregate Limit

$10,000,000

 

 

 

 

 

 

 

 

Each Occurrence Limit

$10,000,000

 

 

 

 

 

 

 

 

Deductible – Each Event

$25,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Retroactive Dates:

 

 

 

 

 

 

 

 

 

$5,000,000

1/20/2006

 

 

 

 

 

 

 

 

$5,000,000 excess of $5,000,000

7/17/2008

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rated on Number of Participant

2,448

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claims-Made Coverage

Defense Costs included in Limit of Liability

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

WORLD WIDE TRANSIT

 

Allianz Global Corporate Specialty-AGCS

 

OC91225900

 

03/25/2011  - 03/25/2012

 

$16,600.00

 

 

 

 

 

 

 

 

 

 

Transit Limits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Any One Vessel/Connecting Conveyance

$1,200,000

 

 

 

 

 

 

 

 

Any One Aircraft/Connecting Conveyance

$1,200,000

 

 

 

 

 

 

 

 

Any One Inland Conveyance

$1,200,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deductible

$2,500

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Storage Limits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Aptuit

$8,500,000

 

 

 

 

 

 

 

 

12 Clinical Sites

$3,200,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deductible

$5,000

 

 

 

 

 

 

 

 

 


* No Single Location to exceed $1,100,000

 

196


 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

MANAGEMENT LIABILITY

 

Federal Insurance Company

 

82108432

 

10/08/2010  - 10/08/2011

 

$23,445.00

 

 

 

 

 

 

 

 

 

 

DIRECTORS’ & OFFICERS’ LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Maximum Aggregate Limit

$5,000,000

 

 

 

 

 

 

 

 

Dedicated Limit for Executives

$500,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deductibles:

 

 

 

 

 

 

 

 

 

Non-Indemnified Loss

$0

 

 

 

 

 

 

 

 

Indemnified Loss

$25,000

 

 

 

 

 

 

 

 

Company Loss

$25,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prior & Pending Litigation Date

4/29/2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claims-Made Coverage

Defense Costs included in Limit of Liability

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

MANAGEMENT LIABILITY

 

Federal Insurance Company

 

82108432

 

10/08/2010  - 10/08/2011

 

$23,445.00

 

 

 

 

 

 

 

 

 

 

EMPLOYMENT PRACTICES LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Maximum Aggregate Limit

$5,000,000

 

 

 

 

 

 

 

 

Third Party Liability Limit

$5,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Deductibles:

 

 

 

 

 

 

 

 

 

EPL

$5,000

 

 

 

 

 

 

 

 

 

197


 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

MANAGEMENT LIABILITY

 

Federal Insurance Company

 

82108432

 

10/08/2010  - 10/08/2011

 

$23,445.00

 

 

 

 

 

 

 

 

 

 

Third Party

$5,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  Prior & Pending Litigation Date

4/29/2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claims-Made Coverage

Defense Costs included in Limit of Liability

 

FIDUCIARY LIABILITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Maximum Aggregate Limit

$1,000,000

 

 

 

 

 

 

 

 

Deductible

$0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prior & Pending Litigation Date

4/29/2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Claims-Made Coverage

Defense Costs included in Limit of Liability

 

KIDNAP & RANSOM COVERAGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Kidnapping and Extortion Threat

$1,000,000

 

 

 

 

 

 

 

 

Custody

$1,000,000

 

 

 

 

 

 

 

 

Expense

$1,000,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Accidental Loss

$1,000,000

 

 

 

 

 

 

 

 

(i) Loss of Life

$1,000,000

 

 

 

 

 

 

 

 

(ii) Mutilation

25%

 

 

 

 

 

 

 

 

(iii) All other

100%

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Legal Liability Costs

$1,000,000

 

 

 

 

 

 

 

 

Emergency Political Repatriation

$500,000

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

DENMARK – FOREIGN CLINICAL TRIAL

 

Newline

 

59001710A188

 

10/14/2010 - 10/14/2013

 

$45,000

(plus 14% tax)

Policy Limit

€5,000,000

 

 

 

 

 

 

 

 

Deductible

€1,500

 

 

 

 

 

 

 

 

 

198


 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

DENMARK – FOREIGN CLINICAL TRIAL

 

Newline

 

59001710A188

 

10/14/2010 – 10/14/2013

 

$45,000

(plus 14% tax)

Number of Subjects

750

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

CZECH REPUBLIC – FOREIGN CLINICAL TRIAL

 

Newline

 

59001710A187

 

10/19/2010 – 10/19/2013

 

$21,375

 

 

 

 

 

 

 

 

 

 

Policy Limit

€2,500,000

 

 

 

 

 

 

 

 

Policy Sublimit

€250,000

 

 

 

 

 

 

 

 

Deductible

€0

 

 

 

 

 

 

 

 

Number of Subjects

225

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

ESTONIA – FOREIGN CLINICAL TRIAL

 

QBE Syndicate 1886

 

10ME222515KA076

 

10/19/2010 – 10/19/2013

 

$17,750

 

 

 

 

 

 

 

 

 

 

Policy Limit

€5,000,000

 

 

 

 

 

 

 

 

Deductible

€1,500

 

 

 

 

 

 

 

 

Number of Subjects

175

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

LITHUANIA – FOREIGN CLINICAL TRIAL

 

QBE Syndicate 1886

 

10ME222515KA077

 

10/19/2010 – 10/19/2013

 

$17,750

 

 

 

 

 

 

 

 

 

 

Policy Limit

17,500,000 LTL

 

 

 

 

 

 

 

 

Policy Sublimit

100,000 LTL

 

 

 

 

 

 

 

 

Deductible

€1,500

 

 

 

 

 

 

 

 

Number of Subjects

175

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

POLAND – FOREIGN CLINICAL TRIAL

 

QBE Syndicate 1886

 

10ME222515KA078

 

10/19/2010 – 10/19/2013

 

$17,750

 

 

 

 

 

 

 

 

 

 

Policy Limit

€5,000,000

 

 

 

 

 

 

 

 

Deductible

€0

 

 

 

 

 

 

 

 

Number of Subjects

150

 

 

 

 

 

 

 

 

 

199


 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

LITHUANIA – FOREIGN CLINICAL TRIAL

 

QBE Syndicate 1886

 

10ME222515KA077

 

10/19/2010 – 10/19/2013

 

$17,750

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

ROMANIA – FOREIGN CLINICAL TRIAL

 

Newline

 

59001710A189

 

10/19/2010 – 10/19/2013

 

$14,000

 

 

 

 

 

 

 

 

 

 

Policy Limit

€5,000,000

 

 

 

 

 

 

 

 

Deductible

€1,500

 

 

 

 

 

 

 

 

Number of Subjects

125

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

BRAZIL – FOREIGN CLINICAL TRIAL

 

HDI-Gerling

 

39001162602140

 

10/20/2010 – 10/20/2013

 

$33,000

 

 

 

 

 

 

 

 

 

 

Policy Limit

$1,000,000

 

 

 

 

 

 

 

 

Deductible

$10,000

 

 

 

 

 

 

 

 

Number of Subjects

400

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COVERAGE AND LIMITS

 

INSURANCE COMPANY

 

POLICY NUMBER

 

TERM

 

PREMIUM

HONG KONG – FOREIGN CLINICAL TRIAL

 

HDI-Gerling

 

16000000245983

 

10/20/2010 – 10/20/2013

 

297,400 HKD

 

 

 

 

 

 

 

 

 

 

Policy Limit

20,000,000 HKD

 

 

 

 

 

 

 

 

Policy Sublimit

10,000,000 HKD

 

 

 

 

 

 

 

 

Deductible

50,000 HKD

 

 

 

 

 

 

 

 

Number of Subjects

400

 

 

 

 

 

 

 

 

 


* All Foreign Clinical Trial premiums are subject to audit at expiration.

 

200


 

 

Schedule 5.20

 

Board of Directors

 

1.               The Corporation has agreed pursuant to that certain Term Sheet dated March 31, 2011, to allocate four of the seven seats on the Board of Directors to certain of the Investors listed in Schedule I to the Purchase Agreement.

 

2.               The Corporation has agreed, in Article III, Section A.6(b) of its Fourth Amended and Restated Certificate of Incorporation, filed with the Secretary of State of the State of Delaware on May 17, 2011, to allocate four of the seven seats on the Board of Directors to certain of the Investors listed in Schedule I to the Purchase Agreement.

 

201



 

Schedule 5.22(a)

 

Environmental Matters

 

None.

 

202



 

Schedule 5.22(d)

 

Environmental Matters

 

1.         The following chemicals, radioactive materials, or other potentially harmful materials or substances were present or used on the Property at 300 Technology Square, Cambridge, Massachusetts 02139, which is no longer occupied by the Corporation:

 

Less than 10 liters

 

Less than 1 liter

 

Less than 1 kg

 

Less than 10g

Acetone

 

acetic acid

 

4-C2-Hydroxyethyl-1- piperazineethanesulfonic acid

 

Adenoslne 5’ Triposphate Disodium

Ethanol

 

acetonitrile

 

acrylamide

 

All Gel Dydrazide

Isopentyl alcohol

 

Benzyl alcohol

 

agarose

 

abendonate

Methanol

 

butanol

 

albumin

 

Bromopherol blue

Wescodyne

 

chloroform

 

aromoblum acetate

 

Cholecalciferol

Xylene

 

Citric Acid

 

beta-cyclodextrin

 

Dihydroxytestosterone

bleach

 

Coomassie Blue Stain

 

Calcium Chloride

 

estradiol

 

 

DEPC water

 

Carbamychofine Chloride

 

Ethldium Bromide

 

 

diethyl pyrocarbonate

 

Chloramidopropyl (Dimethylammonio)-2 Hydroxy-1-Propoanesultonate

 

Forskolin

 

 

dimethylacetamide

 

Chloramphenicol

 

Geneticin

 

 

dimethylformamide

 

dextran sulfate

 

Heparin Sodium

 

 

dimethylsuloxide

 

dithothrepl

 

ketamine

 

 

Ethyl Acetate

 

ettylepadiamine tetraacetic acid

 

Lipopolysaccharide

 

 

Ethyl Alcohol

 

Gelatin

 

nandrolone

 

 

Ethylene Glycol

 

Glucose

 

Phorbal – 12-myristate 13 acetate

 

 

formic acid

 

glycine

 

raloxfene

 

 

glycerol

 

Guanldine thcyanate

 

streptavicin

 

 

heptane

 

hemaloxylin

 

tamoxlene

 

 

Hexane

 

Hepes Free Acid

 

testosterone

 

 

hydrochloric acid

 

Hexamine cobalt trichloride

 

tetracycline hydrochloride

 

 

hydrogen peroxide

 

Histopaque 1077

 

toluidine blue

 

 

isoflurane

 

magnesium chloride

 

xyazine

 

 

isopropyl alcohol

 

Magnesium Sulfate

 

xylene canole

 

 

mercapioethanol

 

melthycellulose

 

 

 

 

octane

 

methylmethacrylate

 

 

 

 

pH calibration buffers 4, 7, 10

 

paraffin wax

 

 

 

 

phenol

 

Paraformaldehyde

 

 

 

 

phenopthalein

 

Phosphate buffered saline

 

 

 

 

phosphate buffered saline

 

polyvinlypyrolidone

 

 

 

 

phosphoric acid

 

Potassium Acetate

 

 

 

 

polyoxyethylene

 

potassium chloride

 

 

 

 

potassium hydroxide

 

Potassium Hydroxide

 

 

 

 

Propanol

 

sodium Acetate

 

 

 

 

propylene glycol

 

sodium Azide

 

 

 

 

sulphuric acid

 

sodium bicarbonate

 

 

 

 

Tetramethylbenzidine

 

Sodium Carbonate

 

 

 

 

trichioroacatic acid

 

Sodium chloride

 

 

 

 

triethanplamine

 

Sodium hydroxide

 

 

 

 

Tritton X-100

 

Sodium phosphate

 

 

 

 

 

 

Sucrose

 

 

 

 

 

 

Tetraethylammonium chloride

 

 

 

 

 

 

Thioglycolic acid

 

 

 

 

 

 

trishydorchloride

 

 

 

203



 

Human Cell Line

 

Murine Cell Line

 

Other Cell Lines

 

 

 

 

 

HeLa

 

C2C12

 

HEK293

HOB

 

ST2

 

COS

SaOs2

 

MC3T3E1

 

 

MG63

 

U32

 

 

U2OS

 

OB6

 

 

 

 

UMR106

 

 

 

 

MLOY4

 

 

 

 

 

 

 

Radioactive Material

 

Chemical/Physical Form

 

Maximum Possession Limit

 

 

 

 

 

A.

Hydrogen-3

A.

Any

A

20 millicuries

 

B.

Carbon-14

B.

Any

B.

5 millicuries

 

C.

Phosphorus-32

C.

Any

C.

20 millicuries

 

D.

Phosphorus-33

D.

Any

D.

20 millicuries

 

E.

Sulfur-35

E.

Any

E.

20 millicuries

 

F.

Iodine-125

G.

Bound

G.

5 millicuries

 

 

204



 

Schedule 5.22(e)

 

Environmental Matters

 

1.               The premises previously subleased by the Corporation and located at 300 Technology Square, Cambridge, Massachusetts 02139.

 

205



 

Schedule 5.22(f)

 

Environmental Matters

 

None.

 

206


 

Schedule 10

 

Certain Covenants

 

1.               Pursuant to an engagement with Leerink Swann LLC ( Leerink ) for services in connection with the Series A-1 Financing, the Corporation has agreed to issue to Leerink a Warrant to purchase 24,564 shares of Series A-1 Convertible Preferred Stock at the Stage I Closing.

 

2.               On December 21, 2010, the Corporation Accepted and Agreed to a Proposal from GE Healthcare Financial Services, Inc. ( GEHFS ) and Oxford Finance Corporation ( Oxford Finance ) which forth the terms on which GEHFS and Oxford Finance Corporation would provide debt financing to the Corporation in an aggregate amount of $25m in tree tranched term loans.  As part of the Proposal, the Corporation would be required to issue to GEHFS and Oxford Finance warrants to purchase, in the aggregate, 122,820 shares of Series A-1 Convertible Preferred Stock and to grant to GEHFS the right to purchase up to an additional 122,820 shares on terms substantially the same as those on which MPM is making their investment in the Corporation in the Series A-1 Financing. It is expected that operative documents pertaining to such debt financing will be finalized on or about the Stage I Closing Date.

 

3.               Pursuant to the terms of that certain License Agreement by and between the Corporation and Ipsen Pharma SAS ( Ipsen ), as amended, the Corporation may issue shares of Series A-1 Preferred Stock to Ipsen as payment milestones, in lieu of cash payments, at $8.142 per share.

 

207




Exhibit 10.16

 

PHARMACEUTICAL DEVELOPMENT AGREEMENT TO DEVELOP
A MULTIDOSE INJECTION FOR BIM 44058*

 

This Pharmaceutical Development Agreement (this “ Agreement ”), dated as of January 2, 2006 , is made by and between

 

BEAUFOUR IPSEN INDUSTRIE S.A.S. , a French corporation with its principal office at Beaufour Ipsen Industrie S.A.S, rue d’Ethe Virton, 28100, France (“ Ipsen ”).

 

and

 

RADIUS HEALTH Inc. , a corporation incorporated under the laws of the State of Delaware, United States with its principal office at 300 Technology Square — 5 th  floor, Cambridge, MA 02139 and formerly known as Nuvios, Inc. (“ Radius ”).

 

RECITALS

 

WHEREAS , Ipsen and Radius are parties to that certain License Agreement dated September 27 2005 (the “ License Agreement ”);

 

WHEREAS , within the framework of the License Agreement, Radius desires to have Ipsen develop a formulation of the Licensed Product (as such term is defined in the License Agreement)

 

WHEREAS , Radius desires to have Ipsen develop, and Ipsen is willing to develop, upon the terms and conditions set forth in this Agreement, a formulation of the Licensed Product

 

NOW , THEREFORE , in consideration of the foregoing premises, and obligations set forth in this Agreement, the parties hereby agree as follows:

 

1.             Definitions . Capitalized terms used herein without definition shall have the respective meanings ascribed thereto in the License Agreement including Appendices thereto.

 

2.             Objective . The objective of this Agreement and the research and development activities to be performed pursuant to this Agreement is for Ipsen to research, develop and make a new formulation of Licensed Compound and/or Licensed Product no later than the date agreed by the Parties in the Work Plan, that meets the specifications for such new formulation set forth in the Work Plan (as defined below), provided , that such date may be extended by mutual written agreement of the parties. For purposes of this Agreement, the term “ New Formulation Licensed Product ” shall mean a new formulation of Licensed Compound and/or Licensed Product that meets the specifications for such new formulation set forth in the Work Plan.

 

3.             Work Plan . Attached hereto as Exhibit A is a work plan (the “ Work Plan ”) setting forth, among other things, (i) the research and development tasks and activities to be performed by Ipsen (including timelines for the performance thereof), (ii) the FTEs or contractors to be

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

employed by Ipsen to accomplish such research and development tasks and activities within such timelines, and (iii) the estimated budget associated with such research tasks and activities.

 

The Work Plan (or any portion thereof) may be amended or modified at any time and from time to time by mutual written agreement of Radius and Ipsen.

 

4.             Performance of Research and Development Activities; Warranties . Subject to and upon the terms and conditions of this Agreement, Ipsen agrees to diligently and competently perform on a timely basis the research and development tasks and activities described in the Work Plan. Ipsen represents and warrants that it will perform the research activities under the Work Plan in a good and workmanlike manner in accordance with good research practices and good laboratory practices and in compliance with all applicable federal, supranational, state or local laws, regulations and guidelines governing the conduct of such research activities, including, without limitation, all applicable export and import control laws; provided , however , that in no event does Ipsen represent, warrant or otherwise guarantee that it will be successful in developing a new formulation of Licensed Compound and/or Licensed Product that meets the specifications therefore set forth in the Work Plan, nor that it will meet the timelines for completion of the Work Plan. Although Ipsen does not warrant that it will meet the timelines for completion of the Work Plan, Ipsen does warrant that it will complete all of the activities contemplated under the Work Plan in consideration of the payments to be made by Radius pursuant to Section 10 hereof.

 

5.             Subcontractors . Ipsen may perform some of its obligations under the Work Plan through one or more subcontractors provided that (i) Radius has given its written consent (which shall not be unreasonably withheld or delayed), (ii) the subcontractor undertakes in writing obligations of confidentiality and non-use regarding Confidential Information which are substantially the same as those undertaken by the parties pursuant to Section 11 hereof, and (iii) the subcontractor agrees in writing that all of its right, title and interest in and to any and all inventions or discoveries, whether or not patentable, made by such subcontractor in the course of performing the research tasks and activities subcontracted by Ipsen shall be owned by, and assigned to, Ipsen. In the event that Ipsen performs one or more of its obligations under the Work Plan through a subcontractor, then Ipsen will at all times be responsible for the performance and payment of such subcontractor. Ipsen shall require each such subcontractor to enter into a subcontract agreement with Ipsen containing provisions consistent with, and that will enable Ipsen to comply with its obligations under, the provisions of this Agreement, including, without limitation, Sections 6, 7, 8, 9 and 12 of this Agreement.

 

6.             Records . Ipsen shall maintain records in sufficient detail and in accordance with good laboratory practices and good research practices and as will properly reflect, and will document in a manner appropriate for purposes of supporting the filing of potential patent applications, all work done and results achieved in the performance of the Work Plan (including all data in the form required under any applicable governmental regulations). Ipsen shall provide Radius the right to inspect and copy such records to the extent reasonably required for the exercise of its rights under this Agreement subject to a fifteen (15) calendar days prior written notice.

 



 

7.             Reporting Obligations .

 

(a)           Ipsen shall provide written quarterly reports to Radius and the JSC summarizing all data, results, Inventions, Know-How and Patent Rights generated by Ipsen and/or its subcontractors in the course of carrying out the research activities and tasks under, or in connection with, the Work Plan. A final report will be submitted by Ipsen to Radius and the JSC within 90 days after the expiration or termination of this Agreement.

 

(b)           At each meeting of the JSC, Ipsen shall update the JSC as to the status of the research tasks and activities of Ipsen under this Agreement and shall present to the JSC all data, results, Inventions, Know-How and Patent Rights generated by Ipsen from such research tasks and activities. The JSC shall consider and discuss all of the data, results, Inventions, Know-How and Patent Rights presented by Ipsen, shall provide feedback to Ipsen concerning such data, results, Inventions, Know-How and Patent Rights, and shall make suggestions and recommendations, based on the data, results and Inventions presented by Ipsen, of changes and modifications that Ipsen and Radius should consider making to the Work Plan, including, without limitation, (i) changes to the research activities and tasks required or contemplated under the Work Plan, (ii) changes and modifications to the specifications set forth in the Work Plan with respect to the New Formulation of Licensed Compounds and/or Licensed Products and (iii) changes to the budget included as part of the Work Plan. The suggestions and recommendations made by the JSC pursuant to this Section 7(b) shall not be binding on Ipsen or Radius.

 

(c)           Ipsen shall, from time to time at the reasonable request of Radius, (a) provide Radius with access to all data, results, Inventions, Know-How, Patent Rights and information employed in or arising out of the research activities and tasks under, or in connection with, the Work Plan, and (b) provide Radius with information concerning such research activities and tasks.

 

8.             Supply of Compounds . From time to time during the term of this Agreement or upon the reasonable request of Radius, Ipsen shall supply Radius with reasonable quantities of compounds generated or formulated by Ipsen in the course of performing its research tasks and activities under the Work Plan for purposes of enabling Radius to test such compounds and the formulation thereof and for purposes of allowing Radius to assess the extent to which such compounds meet the specifications for a New Formulation Licensed Product.

 

The supply of New Formulation Licensed Product by Ipsen to Radius for use in phase II clinical trials will be managed under the terms agreed in Appendix D of the License Agreement dated September 27 2005 “Clinical Supply and Technical Transfer Agreement BIM 44058 injection clinical supplies and technology transfer” (hereinafter the “Clinical Supply Agreement”). All terms of such Clinical Supply Agreement apply to the supply by Ipsen to Radius of New Formulation Licensed Product for phase II clinical trials to the exception of the Technical Specifications, Manufacturing and Analytical Procedure and Safety Agreement and the price for the clinical supplies and work associated and quantities of clinical batches. For the New Formulation Licensed Product for phase II clinical trials the following will apply: The relevant Technical Specifications will be set by the Joint Steering Committee; the price for the clinical supplies of New Formulation Licensed Product for phase II clinical trials and work associated

 



 

and quantities of clinical batches of New Formulation Licensed Product for phase II clinical trials will be as provided in the Work Plan, as amended from time to time; the Manufacturing and Analytical Procedure and the Safety Agreement applicable to New Formulation Licensed Product for phase II clinical trials will be mutually agreed by the Parties.

 

Under the Clinical Supply Agreement, Ipsen will manufacture or have manufactured and tested the bulk product and devices applicable to the New Formulation Licensed Product for phase II clinical trials, and will provide the analytical control data, with suitable documentation from contract manufacturing company, and Radius will complete final clinical packaging/labeling, and final Quality Assurance release of the clinical supplies of New Formulation Licensed Product for phase II clinical trials.

 

9.             Technology Transfer .

 

(a)           At the request of Radius made at any time on or prior to the first anniversary of the expiration or termination of this Agreement, Ipsen shall prepare a report that sets forth a reasonably detailed description of the methods, steps, techniques and processes that Radius needs to follow in order to practice or use any of the Inventions, Know-How and Patent Rights generated by Ipsen from the research activities and tasks under, or in connection with, the Work Plan. Such report shall be accompanied by copies of all documents in the possession of Ipsen that are necessary, or useful in order for Radius to practice or use or learn how to practice or use such Inventions, Know-How and Patent Rights.

 

(b)           Ipsen shall also take such other actions, as Radius may reasonably request at any time on or prior to the first anniversary of the expiration or termination of this Agreement, for purposes of effectively transferring to Radius the methods, steps, techniques and processes that Radius needs to follow in order to practice or use any or all of the Inventions, Know-How and Patent Rights generated by Ipsen from the research activities and tasks under, or in connection with, the Work Plan.

 

(c)           Without limiting the generality of the foregoing provisions of this Section 9, Ipsen shall provide Radius, at any time on or prior to the first anniversary of the expiration or termination of this Agreement, with reasonable access to consult with pertinent Ipsen employees that have had prior experience working with any of the methods, steps, techniques and processes that Radius needs to follow in order to practice or use any or all of the Inventions, Know-How and Patent Rights generated by Ipsen from the research activities and tasks under, or in connection with, the Work Plan. Such consultations shall occur at mutually agreeable times and places (or by telephone or other method of communication) so as to not unduly interfere with such Ipsen employee’s duties and responsibilities as employees of Ipsen.

 

10.          Payments .

 

(a)           Subject to any modification of the budget included in the Work Plan to be prior agreed in writing by the parties by Mike Dey, Vice-President, Pharmaceutical Development for Ipsen and by Bart Henderson, Chief Business Officer for Radius, the total amount to be paid by Radius to Ipsen in connection with the research activities and tasks pursuant to the Work Plan and this

 



 

Agreement shall be as specified in the here attached Exhibit A for the 2006 activities required to deliver Phase II clinical supply.

 

Such total amount includes all costs in connection with such research activities, including costs of materials, supplies, services, personnel, subcontractors and overhead, regardless of whether such research activities are performed by Ipsen or by a subcontractor or both. The budget included in the Work Plan shows the breakdown by calendar quarter of such total amount in Euros.

 

(b)           Ipsen shall invoice Radius no later than thirty days prior to the beginning of each calendar quarter for the amount of the payment shown in such budget as being due for such calendar quarter. Radius shall make payment of each such invoice within thirty days after receipt thereof in Euros.

 

(c)           Without the prior written consent of Radius, in no event shall Ipsen invoice Radius for an amount due in respect of any calendar quarter that is greater than the amount budgeted for such calendar quarter in the Work Plan plus the ten percent limit defined in article 10 (d). In addition, and notwithstanding anything expressed or implied in this Agreement to the contrary (including, without limitation, the Work Plan), in no event shall Radius have any obligation to make payments to Ipsen pursuant to this Agreement for any work done by Ipsen at any time after December 31, 2006 unless Radius shall have authorized in writing any such work.

 

Radius shall pay for all work in respect of which Ipsen has entered into legally binding commitments with subcontractors before December 31, 2006 that may not be cancelled by Ipsen without incurring penalties, provided that (i) all of such work is within the framework of the Work Plan and the cost of such work is within the budget included in the Work Plan and (ii) if the work to be performed pursuant to such legally binding commitments is to be performed after December 31, 2006, Radius has agreed in writing that such work may be performed after December 31, 2006.

 

The remaining samples from stability studies will be made available for Radius to ship to Radius nominated contract laboratory by 31 December 2006. Should Radius request in writing that Ipsen conduct work on Radius behalf, Ipsen will be under no obligation to conduct such work.

 

(d)           Should external costs incurred by Ipsen in relation to the performance of the Work Plan be more than as specified in the Work Plan, Radius shall reimburse Ipsen such additional costs up to a maximum of 10% of the amount included in budget attached in the Work Plan for the performance of the specific tasks that resulted in such additional costs. Any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, absent any such prior agreement by Radius, shall be the responsibility of Ipsen.

 

Should internal costs incurred by Ipsen in relation to the performance of the Work Plan be more than the number of FTEs specified in the Work Plan, Radius shall reimburse Ipsen such additional costs up to a maximum of 10% of the amount included in budget attached in the Work Plan for the performance of the specific tasks that resulted in such additional costs. Any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, absent any such prior agreement by Radius, shall be the responsibility of Ipsen.

 



 

11.          Confidentiality; Publication; Press Releases .

 

(a)           The results of any research tasks and activities carried out or performed pursuant to, or in connection with, this Agreement shall be deemed to be, and treated as, Confidential Information of each of Ipsen and Radius for all purposes of the License Agreement, and such results shall be subject to all of the applicable provisions of the License Agreement that pertain to Confidential Information, including, without limitation, all of the provisions of Article 12 of the License Agreement.

 

(b)           The provisions of Article 13 of the License Agreement shall apply to the results of any research tasks and activities carried out or performed pursuant to, or in connection with, this Agreement to the same extent as if such results were the results of studies or research or development tasks and activities carried out pursuant to, or in connection with, the License Agreement.

 

12.          Inventions; Intellectual Property Rights . Any and all inventions or discoveries, whether or not patentable, made as a result of the research tasks and activities pursuant to, or in connection with, this Agreement shall be deemed to be, and treated as, Inventions for all purposes of the License Agreement and shall also be deemed to be, and be treated as, Know-How or Patent Rights, as applicable, for all purposes of the License Agreement. Any and all of such inventions or discoveries shall be subject to all of the provisions of the License Agreement that pertain to Inventions and shall be subject to all of the applicable provisions of the License Agreement that pertain to Know-How and Patent Rights. Ipsen does not warrant that any and all of such Inventions and Know How which may be discovered in the Work Plan set out in Appendix A will be patentable, nor that they can be used without infringing third parties rights. Nothing in this Section 12 shall be deemed to limit, alter, modify, change or amend any of the obligations of either party under the License Agreement.

 

13.          Term; Termination .

 

(a)           The term of this Agreement shall commence on the date of this Agreement and shall terminate upon completion of the Work Plan unless terminated earlier pursuant to the provisions set forth below in this Section 13.

 

(b)           Radius shall have the rights to terminate this Agreement at any time and for any reason by giving a three months prior written notice to Ipsen. Upon receipt of such notice Ipsen shall have the right to invoice Radius, and Radius shall make payment on each such invoice, for any identified running expense or otherwise to which Ipsen had made commitment, prior to or on the day of receiving written notice of termination by Radius.

 

(c)           This Agreement shall automatically terminate on the effective date of the termination of the License Agreement.

 

(d)           Either party (the “Non-Breaching Party”) shall have the right to terminate this Agreement in the event the other party (the “Breaching Party”) is in breach of any of its material obligations under this Agreement or the License Agreement. The Non-Breaching Party shall provide written notice to the Breaching Party, which notice shall identify the breach. The Breaching Party shall

 



 

have a period of sixty (60) days after such written notice is provided to cure such breach. If such breach is not cured within the relevant period, this Agreement shall terminate. The right of the Non-Breaching Party to terminate this Agreement under this Section 13(d) is in addition to any other right or remedy that may otherwise be available to the Non-Breaching Party in connection with such breach, including, without limitation, the right to damages.

 

(e)           Expiration or termination of this Agreement, for any reason, will not relieve either party of any obligation accruing prior to such expiration or termination. This Section 13(e) and Sections 1, 6, 7(a), 9, 10, 11, 12, 14, 15 and 16 shall survive expiration or termination of this Agreement. Section 7(c) shall survive expiration or termination of this Agreement as provided in Article 8.1 of the License Agreement for the Term of the License Agreement (as defined in Article 15.1 of the Licence Agreement).

 

14.          Dispute Resolution . The provisions of Article 17 of the License Agreement (other than Section 17.6 of the License Agreement) shall apply to this Agreement as if the full text of such Article 17 (other than Section 17.6 thereof) were set forth herein and, for this purpose, any reference in such Article 17 (other than Section 17.6 thereof) to the term “Agreement” shall be deemed to be, and treated as, a reference to this Agreement.

 

15.          Certain Other Provisions . The provisions of Sections 18.1, 18.4, 18.5, 18.7 and 18.9 of the License Agreement shall apply to this Agreement to the same extent as if the full text of such Sections were set forth herein and, for this purpose, any reference in any of such Sections to the term “Agreement” shall be deemed to be, and treated as, a reference to this Agreement.

 

16.          Miscellaneous .

 

(a)           This Agreement shall be governed by and construed in accordance with the laws of the State of New York, U.S.A., without reference to its conflict of laws principles, and shall not be governed by the United Nations Convention of International Contracts on the Sale of Goods (the Vienna Convention).

 

(b)           This Agreement, including all appendices, schedules and attachments, embodies the entire understanding of the Parties with respect to the subject matter hereof and supersedes all previous communications, representations or understandings, and agreements, whether oral or written, between the Parties relating to the subject matter hereof.

 

(c)           No modification or amendment to this Agreement shall be valid and binding unless set forth in writing and duly signed and executed by Ipsen and Radius.

 

(d)           The insertion of section headings is for ease of reference only and shall not affect the interpretation of this Agreement.

 

(e)           A waiver of any default, breach or non-compliance under this Agreement is not effective unless signed by the Party to be bound by the waiver. No waiver will be inferred from or implied by any failure to act or delay in acting by a Party in respect of any default, breach, non-observance or by anything done or omitted to be done by the other Party. The waiver by a Party

 



 

of any default, breach or non-compliance under this Agreement will not operate as a waiver of that Party’s rights under this Agreement in respect of any continuing or subsequent default, breach or non-compliance (whether of the same or any other nature).

 

(f)            This Agreement shall inure to the benefit of, be binding upon the respective successors, and permitted assigns of the parties hereto. This Agreement cannot be assigned in whole or in part by either party without the prior written consent of the other party except upon and in connection with the sale of either party or its business (through a merger, sale of assets or otherwise) to a third party that expressly assumes in writing the obligations under this Agreement of the assigning party for the benefit of the other party.

 

(g)           Time is of the essence in this Agreement.

 

(h)           The Parties may execute this Agreement in counterparts, each of which the Parties shall deem an original, but all of which together shall constitute one and the same instrument.

 

[ Remainder of page intentionally left blank. ]

 



 

IN WITNESS WHEREOF , the parties have executed this Agreement as an instrument under seal at the place and as of the date referred to above.

 

RADIUS HEALTH, INC.

 

BEAUFOUR IPSEN INDUSTRIE

 

 

 

 

 

 

 

 

By:

/s/ Bart Henderson

 

By:

/s/ Mike DEY

Name: Bart Henderson

 

Mike DEY

 

Title: CEO

 

Vice-President, Pharmaceutical Development

 



 

CONFIDENTIAL

 

Exhibit A

 

Development and Supply of Ph II Supply of BA058 Ready to Use Pen

Injection and cGMP Active Pharmaceutical Ingredient for Radius

 

Proposal Dated 31 Mar 2006

 

Key Deliverables;

 

Multi-dose, ready to use Injection for administration using commercially available Pen injector, to deliver a fixed dose between 40-100mcg per day, with 28 days doses in 1.5ml cartridge.

 

Stretch objectives for timelines agreed at

 

·                                           Confirm up to 3 selected formulations for animal PK study and manufacture of non clinical/stability lots at contractor in June/July

·                                           Supply Ph II to allow first patient dosing on Dec 1 2006 (with Ph II of 75 patients x 2 active doses; 3 months treatment

·                                           Supply c 10g API for stability testing in May 2006

·                                           Remaining c 40g clinical use API at end June 2006

 

Ipsen scope of work includes all activities to develop and supply bulk cartridges and selected pen for Ph II supplies, in bulk, which would then be labelled, packaged. released and distributed by Radius. At this time, the Radius-approved budget covers these activities. Further work (beyond supply of Ph II in 2006) will require a separate approval from Radius and Ipsen.

 

Beyond supply of Ph II in 2006, stability testing activities would continue into 2007/2008, to allow Radius updating of shelf-life for product in IMPDs.

 

Technology transfer support has been budgeted at up to 1.5 FTEs to cover all API, product, process, device, analytical and regulatory support work. This will be completed in 2007, with no Ipsen resource for this work required beyond 2007.

 

Outline of Plan for Product Development

 

Various antimicrobial preservatives will be screened for compatibility with a 2mg/ml solution formulation of BA058. By testing to pharmacopoeia) tests for anti-microbial preservative activity, and short term, accelerated stability tests, up to three selected formulations will be chosen for further evaluation.

 

No placebo formulation will be developed, (including preservative nor stability data) for any of the formulations.

 

The program includes manufacture of stability test batches at contract manufacturer, filled into cartridges, and longer term stability tests and confirmation of anti-microbial efficacy.

 



 

From these data, the optimal formulation for Ph II supply would then be chosen and clinical supplies produced, using suitably validated process. The Ph II manufacturing scale of c 2,000 cartridges, with a batch size of 3.5 litres is assumed.

 

The plan assumes one Ph II clinical lot made at the selected contractor, for clinical supply (2 arms x 75 patients x 3 cartridges per patient = c 500 cartridges, plus samples and retain samples = 1,000 cartridges) with remaining c 1,000 units for stability tests.

 

Overall Timelines

 

Development Plan for BA058 Ready to Use Multi-dose Injection

 

·                   Evaluation of primary packaging

·                   Optimization of formulation (preservatives)

·                   Stability study on 3 selected formulations

·                   Manufacturing process study

 

·                   Analytical and microbiological method set up & validation

·                   Phase II clinical batches supply

 

·                   ICH stability final formulation

·                   Process optimization & scale up

·                   Phase III clinical supply

·                   Registration Stability

·                   Device extractables

·                   Manufacturing process validation

·                   PDR + NDA filing (CMC part)

 

 

 

Radius activity  n                Ipsen activity       ¨

 

Stage

 

 

 

Total

 

2006

 

2007

 

2008

Formulation Plan

 

€ 000s

 

1863

 

1044

 

669

 

150

 

FTEs

 

6.1

 

2.8

 

2.7

 

0.6

 

 

 

 

 

 

 

 

 

 

 

API Supply

 

€ 000s

 

[*]

 

[*]

 

0

 

0

 

FTEs

 

0

 

0

 

0

 

0

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

€ 000s

 

[*]

 

[*]

 

[*]

 

[*]

 

FTEs

 

6.1

 

2.8

 

2.7

 

0.6

 

The above programs include;

 

FTE rate of $[*] converted at $1.20/€ to give r€[*].

API supply of 50g, at €[*]/g, equates with €[*]. Radius purchase of raw materials for 150g API, in 2005, reduces this amount by €[*] (€[*] x 50/150), to €[*].

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 


 

Detailed breakdown of the phasing and costs for Formulation and Technology Transfer support is provided in Table 2 below

 

Development of Multidose Preserved Cartridge-Formulation to Ph II Supply and Technology Transfer

 

 

 

Total

 

2006

 

2007

 

2008

 

Item

 

€000s

 

1Q

 

2Q

 

3Q

 

4Q

 

Total06

 

1Q

 

2Q

 

3Q

 

4Q

 

Total07

 

1Q

 

2Q

 

3Q

 

4Q

 

Total08

 

Optimise Formulation

Select optimal Preservative &formulation

Stability test various formulations

Performance tests with selected Device

Select Optimised Formulation

Develop process at Ph II scale; Validate Filters etc.

Confirm Preservative Efficacy overspecification range

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

0

 

0

 

0

 

0

 

0

0

0

0

0

0

0

 

0

 

0

 

0

 

0

 

0

0

0

0

0

0

0

 

Manufacture Lots for Ph II

 

[*]

 

0

 

[*]

 

[*]

 

[*]

 

[*]

 

0

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Manufacture Stability batches at Contractor

Stability Test Product

3 mth data to prepare IMPD

5 mths and Later data to update IMPD

Manufacture Clinical Lots at Contractor for Ph II

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Manufacture Lots for Ph III

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

Scale Up and Optimise process for Ph III

Process Validation Protocol

Make Ph IIVPV Lots

Package Ph III Supplies

Stability Test Ph III Lots

 

0

 

0

 

0

 

0

 

0

 

0

0

0

0

0

 

0

 

0

 

0

 

0

 

0

0

0

0

0

 

0

 

0

 

0

 

0

 

0

0

0

0

0

 

Device Support Work

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

Device Extractadables Methods Validation

Device Extractables study on stability

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

Analytical Methods and Specifications

 

144

 

63

 

81

 

0

 

0

 

144

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

0

 

Develop Analytical methods for Preservative

Confirm validation of existing Methods

Confirm Full Validation for Ph III registration

 

113

31

0

 

63

 

50

31

 

0

 

0

 

113

31

0

 

0

 

0

 

0

 

0

 

0

0

0

 

0

 

0

 

0

 

0

 

0

0

0

 

Technology Transfer

 

[*]

 

0

 

0

 

0

 

0

 

0

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

0

 

0

 

0

 

0

 

0

 

Technology Transfer Support-API

Technology Transfer-Product

Prepare Development Reports/NDA/MAA

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

0

0

0

 

Device Supply €000s

API Supply in grammes

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

0

 

0

 

[*]

 

0

 

0

 

0

 

0

 

0

 

GRAND TOTAL €000s

 

1863

 

144

 

420

 

329

 

251

 

1044

 

206

 

225

 

200

 

88

 

669

 

75

 

0

 

56

 

19

 

150

 

Full Time Equivalents Required

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Notes

Full Time Equivalent Rate €000s per year

 

[*]

 

Ex Rate

 

[*]

 

$000s/FTE

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 


 

STRICTLY CONFIDENTIAL

 

AMENDMENT N°1 TO PHARMACEUTICAL DEVELOPMENT*
AGREEMENT

 

BETWEEN

 

BEAUFOUR IPSEN INDUSTRIE S.A.S., a French corporation incorporated under the laws of France, located at rue d’Ethe Virton, 28100, France, duly represented by Jean-Pierre Dubuc, President,

 

hereinafter referred to as “Ipsen”, on the one hand,

 

AND

 

RADIUS HEALTH Inc., a United States corporation incorporated under the laws of the State of Delaware, United States, with its principal office at 300 Technology Square5 th  Floor, Cambridge, MA, USA and formerly known as Nuvios, Inc., duly represented by Richard Lyttle, Chief Executive Officer,

 

hereinafter referred to as “Radius”, on the other hand.

 

WHEREAS

 

A.                                     Ipsen and Radius are parties to that certain License Agreement dated September 27, 2005 (the “ License Agreement ”).

 

B.                                     Within the framework of the License Agreement, Ipsen and Radius have entered into a pharmaceutical development agreement to develop a multidose injection for BIM 44058 dated as of January 2, 2006 (the “ Pharmaceutical Development Agreement ”) pursuant to which Ipsen performs certain research and development tasks and activities in view of developing a new formulation of Licensed Compound and/or Licensed Product.

 

C.                                     Since (i) the work to be performed by Ipsen has taken longer than originally planned in the Work Plan of the Pharmaceutical Development Agreement and (ii) Radius wishes Ipsen to perform additional work to the work initially set out in the Work Plan, Ipsen and Radius have decided to further extend the duration and the scope of the Work Plan and to provide for the consideration relating to such an extension under an amendment to the Pharmaceutical Development Agreement (this “ Amendment n°1 ”).

 

NOW, THEREFORE, in consideration of the premises and the performance of the covenants herein contained, IT IS AGREED AS FOLLOWS:

 

1.                                       In this Amendment n°1, unless otherwise expressly provided herein, the capitalized words and phrases shall have the same meaning as in the Pharmaceutical Development Agreement.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

1



 

2.                                       The December 31, 2006 deadline initially agreed upon for the performance by Ipsen or its subcontractors of all the work set out in the Work Plan as it exists prior to this Amendment (the “Original Work Plan”) and its payment by Radius, is extended to May 31, 2007.

 

For sake of clarity, any reference to the date of December 31, 2006 in Article 10 of the Pharmaceutical Development Agreement which relates to the performance of the Original Work Plan shall be replaced by and extended to May 31, 2007. The budget agreed upon in respect to all the work described in the Original Work Plan shall remain unchanged, except for the over overrun of €98,000 approved by Radius in Q4, 2006.

 

3.                                       The Work Plan is amended so as to include the work described in Appendix A to this Amendment n°1 (the “Extended Work Plan” ), some of which is to be performed in 2007 and the rest in 2008. For clarity, all references to the Work Plan in the Pharmaceutical Development Agreement shall be deemed to include all work described in the Extended Work Plan, as well as the work described in the Original Work Plan. Should Radius wish Ipsen to perform any other work in addition to the 2007 and 2008 activities described in the Extended Work Plan, Radius and Ipsen shall enter into a new agreement or amendment.

 

4.                                       Payments:

 

(a) Subject to any modification of the budget included in the Extended Work Plan to be prior agreed in writing by the parties by Mike Dey, Vice-President, Pharmaceutical Development for Ipsen and by Nick Harvey, Chief Financial Officer to Radius or by any other representative designated by the relevant Party, the total amount to be paid by Radius to Ipsen in connection with the research activities and tasks pursuant to the Extended Work Plan and this Amendment n°1 shall be as specified in the here attached Appendix B, that is to say:

 

(i) The total amount to be paid by Radius to Ipsen in connection with the 2007 activities described Appendix A shall be:

 

·                                           Seventy three thousand euros (73K€) for the additional activities on Drug Substance;

 

·                                           Two hundred thirty four thousand four hundred euros (234.4K€) for additional activities on Drug Product;

 

(ii) The total amount to be paid by Radius to Ipsen in connection with the 2008 activities described in Appendix A shall be:

 

·                                           Twenty eight thousand euros (28K€) for the additional activities on Drug Substance;

 

·                                           One hundred and ninety six thousand euros (196K€) for additional activities on Drug Product;

 

Such total amount includes all costs in connection with such research activities, including costs of materials, supplies, services, personnel, subcontractors and overhead, regardless of whether such research activities are performed by Ipsen or by a subcontractor or both. The budget included in the Extended Work Plan as described in Appendix B to this Amendment shows the breakdown by calendar quarter of such total amounts in Euros.

 

2



 

(b) Ipsen shall invoice Radius no later than thirty days after the end of each calendar quarter for the amount corresponding to actual FTE time spent as per timesheets incurred plus actual external cost bills received and approved by Ipsen during the elapsed quarter, as shall in each case be reported in reasonable detail on the invoice annex. Radius shall make payment of each invoice within thirty days after receipt thereof in Euros.

 

(c) Without the prior written consent of Radius, in no event shall Ipsen invoice Radius for an amount due in respect of any calendar year that is greater than the amount budgeted for such calendar year in the Extended Work Plan plus the ten percent (10%) limit defined in article 4(d) of this Amendment n°1. In addition, and notwithstanding anything expressed or implied in this Agreement to the contrary (including without limitation, the Extended Work Plan), in no event shall Radius have any obligation to make payments to Ipsen pursuant to this Amendment n°1 for any work done by Ipsen at any time after December 31, 2008 unless Radius shall have authorized in writing any such work.

 

Radius shall pay for all work in respect of which Ipsen has entered into legally binding commitments with subcontractors and which occurs before December 31, 2008, that may not be cancelled by Ipsen without incurring penalties, provided that all of such work is within the framework of the Extended Work Plan and the cost of such work is within the budget included in the Extended Work Plan.

 

The remaining samples from stability studies will be made available for Radius to ship to Radius nominated contract laboratory by December 31, 2008. Should Radius request in writing that Ipsen conduct work on Radius behalf, Ipsen will be under no obligation to conduct such work.

 

(d)           Notwithstanding any overruns which have been approved by Radius with respect to work under the Original Work Plan, should external costs incurred by Ipsen in relation to the performance of 2007 or 2008 activities described in the Extended Work Plan be more than as specified in Appendix B hereby attached for such activities, Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix B for the performance of the specific tasks that resulted in such additional costs. In addition, should internal costs incurred by Ipsen in relation to performance of the Work Plan be more than as specified in Exhibit B due to an increase in the number of FTE’s required (but not the cost per FTE), Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix B for the performance of the specific tasks that resulted in such additional costs. In either case, any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, in the absence of any such prior agreement by Radius, shall be the responsibility of Ipsen. Ipsen shall use all reasonable efforts to avoid any such cost overruns. For clarity, the maximum ten adjustment permitted in 2007 will be of thirty thousand seven hundred (30.7) euros and in 2008 of twenty two thousand four hundred (22.4) euros. Any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, absent any such prior agreement by Radius, shall be the responsibility of Ipsen.

 

3



 

5.                                       This Amendment n°1 shall enter into force retroactively upon its signature as of January 1 st , 2007 and shall remain in full force and in effect until complete performance of the Extended Work Plan or termination of the Pharmaceutical Development Agreement in accordance with its terms.

 

6.                                       All other terms and conditions of the Pharmaceutical Development Agreement shall remain in full force and effect and shall apply to this Amendment n°1 which is made part of the Pharmaceutical Development Agreement.

 

7.                                       This Amendment n°1 shall be governed by, interpreted and construed in accordance with the laws of the State of New York, U.S.A., without regard to the conflicts of law principles, and shall not be governed by the United Nations Conventions of International Contracts on the Sale of Goods (the Vienna Convention).

 

IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be duly executed by their respective duly authorized representatives:

 

 

Date:   July 16, 2007

 

Date: 29.06.07

 

 

 

SIGNED by B.N. Harvey

 

SIGNED by Jean-Pierre Dubuc

 

 

 

/s/ B.N. Harvey

 

/s/ Jean-Pierre Dubuc

on behalf of
RADIUS HEALTH Inc.

 

as President of
BEAUFOUR IPSEN INDUSTRIE S.A.S.

 

4



 

APPENDIX A

 

EXTENDED WORK PLAN

 

 

BA058 : DEVELOPMENT PLAN

 

OF READY TO USE PEN INJECTION

 

FOR PHASE II

 

 

 

ADDITIONAL ACTIVITIES - 2007 & 2008

 

5


 

 

 

 

APPENDIX A

 

BA058 : Development plan
of Ready to Use Pen
Injection for Phase II

 

Additional activities - 2007 & 2008

 

6



 

Content

 

·                   Drug Substance

 

·                   Drug Product

·                   Proposed IND stability commitment

·                   Stability program

·                   Stability batches

·                   Clinical batches

·                   Stability-in-use

·                   Cost estimation for 2007 & 2008

 

7


 

 

8


 

Activities to support IND submission (API)

 

- Additional test on batch 01-402:

 

 

 

 

 

 

(residual solvents , TFA, and optical rotation)

 

2007

 

External cost

 

07k €

 

 

 

 

 

 

 

- Stability study of batch 01-402:

 

2007

 

[*]FTE

 

55k €

 

 

2008

 

[*]FTE

 

28k €

 

 

 

 

 

 

 

Retest of reference material

 

2007

 

[*]FTS

 

11k €

 

 

 

 

 

 

 

TOTAL

 

 

 

73k € in 2007

 

 

 

 

 

 

 

 

 

 

 

 

 

28k € in 2008

 

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

9


 

 

10


 

 

Proposed IND Stability Commitment

 

Continue the stability study in accelerated (25°C/60%RH) and long-term (5°C) storage conditions in parallel to the clinical study.

 

Monitor periodically clinical batches in a re-assay program at the label claim storage condition (i.e. 5°C).

 

The shelf life period will be extended based on data from accelerated and long-term studies, as well as results from by this re-assay program.

 

11



 

Stability Program: 0.5 & 2 mg/ml

 

Time
Point

 

Pull
Date

 

Storage Conditions

 

Shelf life
(extrapolation)

 

Use Date
of clinical
supplies *

 

FTE to support analytical
work (physicochemical and
microbiological tests - report @
6, 12 and 24 months)

6 months

 

03/26/07

 

5°C & 25°C/60%RH (including preservative effectiveness at 25°C/60%RH)

 

12 months

 

End Oct. 07

 

[*]+[*] (µbio)
+ [*]€ (external cost)**

9 months

 

06/26/07

 

5°C

 

18 months

 

End April 08

 

[*]

12 months

 

09/26/07

 

5°C (including preservative effectiveness)

 

24 months

 

End Oct. 08

 

[*]+[*] (µbio)

18 months

 

March 08

 

5°C

 

24 months

 

End Oct. 08

 

[*]

24 months

 

Sept. 08

 

5°C (including preservative effectiveness)

 

24 months

 

End Oct. 08

 

[*]+[*] (µbio)
+ [*] € (external cost)**

 

* Use date = manufacturing date + shelf life

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

12



 

Stability Program: Placebo

 

Time
Point

 

Pull
Date

 

Storage Conditions

 

Shelf life
(extrapolation)

 

Use Date
of clinical
supplies *

 

FTE to support analytical
work (physicochemical and
microbiological tests - report
@ 6, 12 and 24 months)

6 months

 

02/16/07

 

5°C & 25°C/60%RH (including preservative effectiveness at 25°C/60%RH)

 

12 months

 

End Oct. 07

 

[*]+[*] (µbio)

9 months

 

05/16/07

 

5°C

 

18 months

 

End 08April

 

[*]

12 months

 

08/16/07

 

5°C (including preservative effectiveness)

 

24 months

 

End Oct. 08

 

[*]+[*] (µbio)

18 months

 

Feb. 08

 

5°C

 

24 months

 

End Oct. 08

 

[*]

24 months

 

Aug. 08

 

5°C (including preservative effectiveness)

 

24 months

 

End Oct. 08

 

[*]+[*] (µbio)

 

* Use date = manufacturing date + shelf life

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

13



 

Re-assay program: 0.5, 1, 2 mg/ml & Placebo

 

·                   To ensure the quality of the clinical supplies throughout the study :

 

It is proposed to re-test clinical batches stored at the label claim storage condition (i.e. 5°C) every 6 months until the end of the phase II clinical study

 

Re-Test Date

 

Re-Test Time Point

 

FTE

April 07

 

6 months

 

[*]

October 07

 

12 months

 

[*]

April 08

 

18 months

 

[*]

October 08

 

24 months

 

0.06 + 0.10 (µbio)
+ [*] € (external cost)**

 

** Subcontracting of sterility test at VETTER

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

14



 

Stability program: stability in-use

 

·                   To simulate patient use, as far as possible

·                   Cartridge activated, inside the pen

·                   Storage at room temperature

·                   1 simulation of injection per day, during 1 month

 

Time point

 

Pull date

 

Storage conditions

 

FTE

1 month

 

Feb. 07

 

25°C/60%RH

 

[*]+[*] (µbio)

At shelf life

 

Nov. 08

 

25°C/60%RH

 

[*]+ [*] (µbio)

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

15



 

Drug Product: cost estimation 2007 & 2008

 

Year

 

FTE

 

FTE cost *
(in k€)

 

External cost
(in k€)

 

Total
(in k€)

2007

 

[*]+ [*] (µbio)

 

[*]

 

[*]**

 

234.4

2008

 

[*]+[*] (µion)

 

[*]

 

[*] **

 

196.0

 

· FTE rates of $[*], converted at $[*]/€ to give €[*] per year

 

** Subcontracting of sterility test at VETTER + shipment

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

16



 

APPENDIX B

 

EXTENDED WORK PLAN

 

I.              2007 BUDGET

 

I.1            DRUG SUBSTANCE

 

Additional test on batch 01- 402
(residual solvents, TFA and optical rotation)

 

External cost*

 

07k€

Stability study of batch 01- 402

 

Internal cost — FTE**
[*]

 

55k€

Retest of reference material

 

Internal cost — FTE**
[*]

 

11k€

Total

 

 

 

73k

 


* Subcontracting of Additional test on batch 01- 402 at EXPANSIA + shipment
** FTE rates at [*]€

 

1.2           DRUG PRODUCT

 

FTE

 

FTE cost*

 

External cost**

 

Total

[*] + [*] (µbio)

 

[*]€

 

[*]€

 

234.4

 


* FTE rates at [*]€
** Subcontracting of sterility test at VETTER + shipment

 

1.3           QUARTERLY BREAKDOWN FOR EXTENDED WORK PLAN ACTIVITIES  PERFORMED IN 2007

 

 

 

2007

 

2007

 

In K€

 

Q1

 

Q2

 

Q3

 

Q4

 

Total

 

External Costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Internal Costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

FTEs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Total Costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

17



 

II.             2008 BUDGET

 

II. 1.        DRUG SUBSTANCE

 

Stability study of batch 01- 402

 

Internal cost — FTE**
[*]

 

[*]€

Total

 

 

 

[*]€

 


** FTE rates at [*]€

 

11.2         DRUG PRODUCT

 

FTE

 

FTE cost *

 

External cost**

 

Total

[*] + [*] ( bio)

 

[*]€

 

[*]€

 

[*]€

 


* FTE rates at [*]€

** Subcontracting of sterility test at VETTER + shipment

 

11.3         QUARTERLY BREAKDOWN FOR EXTENDED WORK PLAN ACTIVITIES PERFORMED IN 2008

 

 

 

2008

 

2008

 

 

 

Q1

 

Q2

 

Q3

 

Q4

 

Total

 

External costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Internal costs (Drug Substance)

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Internal costs (Drug Product)

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

FTEs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

Total costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

18


 

 

STRICTLY CONFIDENTIAL

 

AMENDMENT N°2 TO PHARMACEUTICAL DEVELOPMENT*

AGREEMENT

 

BETWEEN

 

BEAUFOUR IPSEN INDUSTRIE S.A.S. , a French corporation incorporated under the laws of France, located at rue d’Ethe Virton, 28100, France, duly represented by Jean-Pierre Dubuc, President,

 

hereinafter referred to as “ Ipsen ”, on the one hand,

 

AND

 

RADIUS HEALTH Inc. , a United States corporation incorporated under the laws of the State of Delaware, United States, with its principal office at 300 Technology Square-5th Floor, Cambridge, MA, USA and formerly known as Nuvios, Inc., duly represented by Richard Lyttle, Chief Executive Officer,

 

hereinafter referred to as “ Radius ”, on the other hand.

 

WHEREAS

 

A.                                     Ipsen and Radius are parties to that certain License Agreement dated September 27, 2005 (the “ License Agreement ”).

 

B.                                     Within the framework of the License Agreement, Ipsen and Radius have entered into a pharmaceutical development agreement to develop a multidose injection for BIM 44058 dated as of January 2, 2006 (the “ Pharmaceutical Development Agreement ”) pursuant to which Ipsen performs certain research and development tasks and activities in view of developing a new formulation of Licensed Compound and/or Licensed Product.

 

C.                                     Ipsen and Radius have decided to further extend the duration and the scope of the Work Plan and to provide for the consideration relating to such an extension under an amendment to the Pharmaceutical Development Agreement ( “ Amendment n°1 ”).

 

D.                                     Radius has requested, and Ipsen had agreed to manufacture some further stability batches and therefore to further extend the duration and the scope of the Work Plan under a second amendment to the Pharmaceutical Development Agreement (this “ Amendment n°2 ”).

 

NOW, THEREFORE, in consideration of the premises and the performance of the covenants herein contained, IT IS AGREED AS FOLLOWS:

 

1.                                       In this Amendment n°2, unless otherwise expressly provided herein, the capitalized words and phrases shall have the same meaning as in the Pharmaceutical Development Agreement and in Amendment n°1.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

2.                                       The May 31, 2007 deadline agreed upon for the performance by Ipsen or its subcontractors of all the work set out in the Extended Work Plan further to Amendment n°1 and its payment by Radius, is extended to December 31, 2012.

 

For sake of clarity, any reference to the date of December 31, 2006 in Article 10 of the Pharmaceutical Development Agreement and May 31, 2007 in the Amendment n°1 which relates to the performance of the Original Work Plan and the Extended Work Plan shall be replaced by and extended to December 31, 2012. The budget agreed upon in respect to all the work described in the Original Work Plan and the Extended Work Plan shall remain unchanged, except for the over overrun of €98,000 approved by Radius in Q4, 2006.

 

3.                                       The Work Plan is amended so as to include the work described in Appendix A to this Amendment n°2 (the “ Second Extended Work Plan ”). For clarity, all references to the Work Plan in the Pharmaceutical Development Agreement shall be deemed to include all work described in the Extended Work Plan, the Second Extended Work Plan as well as the work described in the Original Work Plan. Should Radius wish Ipsen to perform any other work in addition to the activities described in the Second Extended Work Plan, Radius and Ipsen shall enter into a new agreement or amendment.

 

4.                                       Timelines described in Appendix A are subject to the execution by Ipsen of an amendment to its existing agreement with Vetter.

 

5.                                       Activities related to the manufacture of Phase III clinical batches by Vetter and tested by Ipsen in the Second Extended Work Plan as identified in paragraphs 2, 4, 5 of Appendix A shall not be commenced by Ipsen unless authorized in writing by Nick Harvey, Chief Financial Officer of Radius or other representative designated in writing by Radius.

 

6.                                       Payments:

 

(a)                                  Subject to any modification of the budget included in the Second Extended Work Plan to be prior agreed in writing by the parties by Mike Dey, Vice-President, Pharmaceutical Development for Ipsen and by Nick Harvey, Chief Financial Officer to Radius or by any other representative designated by the relevant Party, the total amount to be paid by Radius to Ipsen in connection with the research activities and tasks pursuant to the Second Extended Work Plan and this Amendment n°2 shall be as specified in the here aftached Appendix A. Such total amount includes all costs in connection with such research activities, including costs of materials, supplies, services, personnel, subcontractors and overhead, regardless of whether such research activities are performed by Ipsen or by a subcontractor or both. The budget included in the Second Extended Work Plan as described in Appendix A to this Amendment n°2 shows the breakdown by calendar quarter of such total amounts in Euros.

 

(b)                                  Ipsen shall invoice Radius no later than thirty (30) days after the end of each calendar quarter for the amount corresponding to actual FTE time spent as per

 

2



 

timesheets incurred plus actual external cost bills received and approved by Ipsen during the elapsed quarter, as shall in each case be reported in reasonable detail on the invoice annex. Radius shall make payment of each invoice within thirty (30) days after receipt thereof in Euros.

 

(c)                                   Without the prior written consent of Radius, in no event shall Ipsen invoice Radius for an amount due in respect of any calendar year that is greater than the amount budgeted for such calendar year in the Second Extended Work Plan plus the ten percent (10%) limit defined in article 4(d) of this Amendment n°2. In addition, and notwithstanding anything expressed or implied in this Amendment n°2 to the contrary (including without limitation, the Second Extended Work Plan), in no event shall Radius have any obligation to make payments to Ipsen pursuant to this Amendment n°2 for any work done by Ipsen at any time after December 31, 2012 unless Radius shall have authorized in writing any such work.

 

Radius shall pay for all work in respect of which Ipsen has entered into legally binding commitments with subcontractors and which occurs before December 31, 2012, that may not be cancelled by Ipsen without incurring penalties, provided that all of such work is within the framework of the Second Extended Work Plan and the cost of such work is within the budget included in the Second Extended Work Plan.

 

The remaining samples from stability studies will be made available for Radius to ship to Radius nominated contract laboratory by December 31, 2012. Should Radius request in writing that Ipsen conduct work on Radius behalf, Ipsen will be under no obligation to conduct such work.

 

(d)                                  Should external costs incurred by Ipsen in relation to the performance of the activities described in the Second Extended Work Plan be more than as specified in Appendix A hereby attached for such activities, Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs. In addition, should internal costs incurred by Ipsen in relation to performance of the Second Extended Work Plan be more than as specified in Appendix A due to an increase in the number of FTE’s required (but not the cost per FTE), Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs. In either case, any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, in the absence of any such prior agreement by Radius, shall be the responsibility of Ipsen. Ipsen shall use all reasonable efforts to avoid any such cost overruns.

 

7.                                       This Amendment n°2 shall enter into force retroactively upon its signature as of January 1st, 2009 and shall remain in full force and in effect until complete performance of the

 

3



 

Second Extended Work Plan or termination of the Pharmaceutical Development Agreement in accordance with its terms.

 

8.                                       All other terms and conditions of the Pharmaceutical Development Agreement shall remain in full force and effect and shall apply to this Amendment n°2 which is made part of the Pharmaceutical Development Agreement.

 

9.                                       This Amendment n°2 shall be governed by, interpreted and construed in accordance with the laws of the State of New York, U.S.A., without regard to the conflicts of law principles, and shall not be governed by the United Nations Conventions of International Contracts on the Sale of Goods (the Vienna Convention).

 

IN WITNESS WHEREOF, the Parties hereto have caused this Amendment n°2 to be duly executed by their respective duly authorized representatives:

 

Date: January 30, 2009

 

Date: January 17, 2009

 

 

 

SIGNED by B.N. HARVEY

 

SIGNED by Jean-Pierre Dubuc

CFO

 

 

 

 

 

/s/ B.N. Harvey

 

/s/ Jean-Pierre Dubuc

on behalf of

 

as President of

RADIUS HEALTH Inc.

 

BEAUFOUR IPSEN INDUSTRIE S.A.S.

 

4



 

APPENDIX A

 



 

CMC Activities for BA058
Phase III
Radius / Ipsen

 

1 Stability Batches at Vetter

 

·                   Component Supply for 1.5ml Cartridge with new crimp cap + current bromobutyl stopper

·                   Stoppers available as standard stock item in Vetter.

·                   Standard RTS crimp caps require 12-14 weeks delivery; as already ordered, estimated delivery date week commencing 26th Jan 2009

·                   Machinability test (cartridges fill with new crimp caps and maximum filling volume and dimensional limits) Project work = [*]€

 

 

·                   Stability Batches Scheduled at Vetter in March 2009

·

 

BA058 placebo

 

 

·

 

BA058 2mg/ml solution

 

3,500 cartridges / batch

·

 

BA058 1mg/ml solution

 

 

 

 

 

 

 

Uses same equipment as used in Ph III

 

 

Manufacturing starting date

 

March 09

Stability studies start

 

April 2009

 

·                   Costs and Timings

 

Cartridge fill volume will be increased to maximum, to increase assurance of delivering 28 doses from each cartridge

 

Filling Stability/Technical batches

 

[*]

From €[*] for placebo & [*]€ for stability batches 1&2mg/ml, + [*]€ project management, microbiological validation [*]€, Closure container integrity test [*]€.

 

2 Clinical Batches 1.5 ml Cartridges

 

·                   Manufacturing of 3 Clinical Batches by Vetter and Tested by lpsen

·                   BA058 placebo

·                   BA058 2mg/ml solution 5,000 cartridges / batch

·                   BA058 1mg/ml solution

 

·                   Planned in May 2009 :

·                   Clinical studies start in July 2009

 

·

 

Costs

 

[*]

·                   From [*] per lot + [*]€ project management costs

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

3 Stability Testing of Phase III Preparation Lots

 

Activities

 

Duration

 

FTE*

 

FTE cost,
(k€)**

 

External cost
(k€)

Formulation and Process Development

 

 

 

 

 

 

 

 

New crimp caps Supply

 

14 weeks

 

 

 

[*]

Sterile filtration validation with new API (Millipore)

 

4 months

 

F: [*]
A: [*]

 

[*]

 

[*]

Stability Studies

 

 

 

 

 

 

 

 

Machinability test & project work

 

1 month

 

 

 

[*]

36-month ICH stability study (2 active + 1 placebo): manufacturing + stab study at 5°C for 36months & 25°C for 6 months & stab-in-use + Mixing study, filtration trials (Vetter) + µbio validation

 

43 months (including agreement) Final time point: 05/2012

 

F: [*]
A: [*]
µ: [*]

 

[*]

 

[*]

 

 

TOTAL

 

 

 

590

 

320

 


* F: formulation - A: Analytical - µ: Microbiology

** FTE rates of € [*] per year

 

4 Testing of Ph III Supplies

 

Activities

 

Duration

 

FTE*

 

FTE cost,
(k€)**

 

External cost
(k€)

Clinical Supply

 

 

 

 

 

 

 

 

Phase III clinical batches manufacturing + release (2 active + 1 placebo)

 

9 months (including agreement)

 

F: [*]
A: [*]
µ: [*]

 

[*]

 

[*]

Re-assay program to verify stability

 

36months

 

A: [*]
µ: [*]

 

[*]

 

[*]

IND

 

3 months

 

F: [*]

 

[*]

 

[*]

Project Management

 

 

F: [*]

 

[*]

 

[*]

 

 

 

 

TOTAL

 

455

 

218

 

 

 

 

 

 

673

 

 

 


* F: formulation - A: Analytical - µ: Microbiology

** FTE rates of € [*] per year

 

5 Phasing of Costs for Ph III Program

 

BA058 Phase III Quarterly breakdown for work plan activities

 

Drug Substance & Drug Product Program

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2009

 

2010

 

2011

 

2012

 

 

In €000

 

Q1

 

Q2

 

Q3

 

Q4

 

Q1

 

Q2

 

Q3

 

Q4

 

Q1

 

Q2

 

Q3

 

Q4

 

Q1

 

Q2

 

Q3

 

Q4

 

Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

External costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

540

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Internal costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

1,043

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total costs/Quarter

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

1,583

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

Total cost/year

 

1,182

 

 

 

 

 

 

 

173

 

 

 

 

 

 

 

136

 

 

 

 

 

 

 

92

 

 

 

 

 

 

 

1,583

 

API costs not included; API is supplied by Radius

 



 

6 API needed for Drug Product development activities

 

·                   Estimation based on available BA058 API available in stock on September, 2008

 

Activities

 

Units manufactured

 

API (pure)
needed

 

API batch #

Stability studies (ICH Current Formulation with new crimp caps [*]mg/ml & [*]mg/ml

 

4,000 cartridges as 1 x 4,000 ea of 2mg/ml, 1mg/ml & placebo

 

[*]g + [*]g = [*]g

 

Lonza API in final cartridge CC and stopper at Vetter at scale for Ph III

Optimize/Validate analytical Method

 

/

 

[*] g

 

M12507 (Ipsen batch)

Finalise API methods

 

/

 

[*]g

 

Lonza API

Sterile filtration validation

 

3,000mL

 

[*]g

 

Lonza API to mimic Ph III process

Clinical batches for Ph III
Made to a suitable Validation protocol & to provide stability lots for long-term storage

 

1 x 5,000 cart x 2mg/m1 + 1 x 5,000cart x 1mg/m1+1 x 5,000cart x placebo

 

(GMP batch)
[*]g
[*]g
[*]g

 

Two strength to be manufactured at Vetter at Ph III scale
1st lots mid 2009
2nd lots end 2009
3rd lots early 2010

 

· Total new API needed for Phase III activities = 96 g (pure peptide)

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 


 

STRICTLY CONFIDENTIAL

 

AMENDMENT N°3 TO PHARMACEUTICAL DEVELOPMENT AGREEMENT*

 

BETWEEN

 

BEAUFOUR IPSEN INDUSTRIE S.A.S. , a French corporation incorporated under the laws of France, located at rue d’Ethe Virton, 28100, France, duly represented by Jean-Pierre Dubuc, President,

 

hereinafter referred to as “ Ipsen” , on the one hand,

 

AND

 

RADIUS HEALTH Inc., a United-States corporation incorporated under the laws of the State of Delaware, United Sates, with its principal office at 300 Technology Square-5 th  Floor, Cambridge, MA, USA and formerly known as Nuvios, Inc., duly represented by Richard Lyttle, Chief Executive Officer,

 

hereinafter referred to as “Radius” , on the other hand.

 

WHEREAS

 

A.                                     Ipsen and Radius are parties to that certain License Agreement dated September 27, 2005 (the “ License Agreement ”).

 

B.                                     Within the framework of the License Agreement, Ipsen and Radius have entered into a pharmaceutical development agreement to develop a multidose injection for BIM 44058 dated as of January 2, 2006 (the “Pharmaceutical Development Agreement ”) pursuant to which Ipsen performs certain research and development tasks and activities in view of developing a new formulation of Licensed Compound and/or Licensed Product.

 

C.                                     Ipsen and Radius have decided to further extend the duration and the scope of the Work Plan and to provide for the consideration relating to such an extension under an amendment to the Pharmaceutical Development Agreement ( “ Amendment n°1 ”).

 

D.                                     Radius has requested, and Ipsen had agreed to manufacture some further stability batches and therefore to further extend the duration and the scope of the Work Plan under a second amendment to the Pharmaceutical Development Agreement (“ Amendment n°2 ”).

 

E.                                      The manufacture of Phase III clinical batches under the Second Extended Work Plan as identified in paragraphs 2, 4, 5 of Appendix A of Amendment n°2 was not commenced by Ipsen with authorization in writing by a Radius representative prior to the effective date of this Amendment n°3. However, the stability batches and related stability testing activities (the “Reduced Second

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 



 

Extended Work Plan”) as identified in paragraphs 1 and 3 of Appendix A of Amendment n°2 were completed or are ongoing pursuant to the terms of Amendment n°2. Accordingly, Amendment n°2 shall remain in full force and in effect until complete performance of the Reduced Second Extended Work Plan or termination of the Pharmaceutical Development Agreement in accordance with its terms.

 

F.                                       Radius has requested, and Ipsen had agreed to manufacture Phase III batches and to upgrade analytical methods to NDA filing levels for purity/impurities testing to meet full ICH requirements and therefore to further extend the duration and the scope of the Work Plan under a third amendment to the Pharmaceutical Development Agreement (this “ Amendment n°3 ”).

 

NOW, THEREFORE, in consideration of the premises and the performance of the covenants herein contained, IT IS AGREED AS FOLLOWS:

 

1.               In this Amendment n°3, unless otherwise expressly provided herein, the capitalized words and phrases shall have the same meaning as in the Pharmaceutical Development Agreement and in Amendment n°1 and Amendment n°2 .

 

2.               The Work Plan is amended so as to include the work described in Appendix A to this Amendment n°3 (the “ Third Extended Work Plan ”). For clarity, all references to the Work Plan in the Pharmaceutical Development Agreement shall be deemed to include all work described in the Extended Work Plan, the Reduced Second Extended Work Plan as well as the work described in the Original Work Plan. Should Radius wish Ipsen to perform any other work in addition to the activities described in the Third Extended Work Plan, Radius and Ipsen shall enter into a new agreement or amendment.

 

3.               Timelines described in Appendix A are subject to the execution by Ipsen of an amendment to its existing agreement with Vetter.

 

4.               Activities related to the manufacture of additional Phase III clinical batches by Vetter and tested by Ipsen in 2011 or 2012 and any batch Scale Up Plans in the Third Extended Work Plan as identified in paragraphs 2 and 4 of Appendix A shall not be commenced by Ipsen unless authorized in writing by Nick Harvey, Chief Financial Officer of Radius or other representative designated in writing by Radius.

 

5.               Payments:

 

(a)          Subject to any modification of the budget included in the Third Extended Work Plan to be prior agreed in writing by the parties by Mike Dey, Vice-President, Pharmaceutical Development for Ipsen and by Nick Harvey, Chief Financial

 

2



 

Officer to Radius or by any other representative designated by the relevant Party, the total amount to be paid by Radius to Ipsen in connection with the research activities and tasks pursuant to the Third Extended Work Plan and this Amendment n°3 shall be as specified in the here attached Appendix A. Such total amount includes all costs in connection with such research activities, including costs of materials, supplies, services, personnel, subcontractors and overhead, regardless of whether such research activities are performed by Ipsen or by a subcontractor or both. The budget included in the Third Extended Work Plan as described in Appendix A to this Amendment n°3 shows the breakdown by calendar quarter of such total amounts in Euros.

 

(b)          Ipsen shall invoice Radius no later than thirty (30) days after the end of each calendar quarter for the amount corresponding to actual FTE time spent as per timesheets incurred plus actual external cost bills received and approved by Ipsen during the elapsed quarter, as shall in each case be reported in reasonable detail on the invoice annex. Radius shall make payment of each invoice within thirty (30) days after receipt thereof in Euros.

 

(c)           Without the prior written consent of Radius, in no event shall Ipsen invoice Radius for an amount due in respect of any calendar year that is greater than the amount budgeted for such calendar year in the Third Extended Work Plan plus the ten percent (10%) limit defined in article 4(d) of this Amendment n°3. In addition, and notwithstanding anything expressed or implied in this Amendment n°3 to the contrary (including without limitation, the Third Extended Work Plan), in no event shall Radius have any obligation to make payments to Ipsen pursuant to this Amendment n°3 for any work done by Ipsen at any time after December 31, 2014 unless Radius shall have authorized in writing any such work.

 

Radius shall pay for all work in respect of which Ipsen has entered into legally binding commitments with subcontractors and which occurs before December 31, 2014, that may not be cancelled by Ipsen without incurring penalties, provided that all of such work is within the framework of the Third Extended Work Plan and the cost of such work is within the budget included in the Third Extended Work Plan.

 

The remaining samples from stability studies will be made available for Radius to ship to Radius nominated contract laboratory by December 31, 2014. Should Radius request in writing that Ipsen conduct work on Radius behalf, Ipsen will be under no obligation to conduct such work.

 

(d)          Should external costs incurred by Ipsen in relation to the performance of the activities described in the Third Extended Work Plan be more than as specified in Appendix A hereby attached for such activities, Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs. In addition, should internal costs incurred by Ipsen in relation to performance of the Third Extended Work Plan be more than as specified in Appendix A due to an increase in the number of FTE’s required (but not the cost per FTE), Radius shall reimburse Ipsen such additional costs up to a

 

3



 

maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs.  In either case, any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, in the absence of any such prior agreement by Radius, shall be the responsibility of Ipsen. Ipsen shall use all reasonable efforts to avoid any such cost overruns.

 

6.               This Amendment n°3 shall enter into force retroactively upon its signature and shall remain in full force and in effect until complete performance of the Third Extended Work Plan or termination of the Pharmaceutical Development Agreement in accordance with its terms.

 

7.               All other terms and conditions of the Pharmaceutical Development Agreement shall remain in full force and effect and shall apply to this Amendment n°3 which is made part of the Pharmaceutical Development Agreement.

 

8.               This Amendment n°3 shall be governed by, interpreted and construed in accordance with the laws of the State of New York, U.S.A., without regard to the conflicts of law principles, and shall not be governed by the United Nations Conventions of International Contracts on the Sale of Goods (the Vienna Convention).

 

IN WITNESS WHEREOF, the Parties hereto have caused this Amendment n°2 to be duly executed by their respective duly authorized representatives:

 

 

Date: June 13, 2010

 

Date: June 16, 2010

 

 

 

SIGNED by B.N. Harvey

 

SIGNED by Jean-Pierre Dubuc

/s/ B.N. Harvey

 

/s/ Jean-Pierre Dubuc

 

 

 

on behalf of

 

as President of

RADIUS HEALTH Inc.

 

BEAUFOUR IPSEN INDUSTRIE S.A.S.

 

4



 

APPENDIX  A

 

5



 

Updated CMC Activities for BA058

Phase III Supply

28 th  May 2010

 

1 Manufacture of Clinical Batches 1.5 ml Cartridges

 

·                   Manufacturing of 6 Clinical Batches by Vetter and Tested by Ipsen

·                   Gives nominally 5,000 each, placebo and 2mg/ml cartridges

·                   from 3 x approximately 5,000 cartridge lots of placebo

·                   from 3 x approximately 5,000 cartridge lots BA 058 2mg/ml

·                   based on removal of required

·                   QC and retention (300 units) from each lot

·                   full ICH stability samples (1,000 units) on one lot

 

·                   to provide at least 11,600 cartridges for clinical use,

·                   from 3 x 4,500 cartridges per lot post filling and inspection

·                   less 300 x 3 for QC + 1,000 for stability = 1,600 cartridges

·                   Manufacturing dates agreed with Vetter for active/placebo batches made in three campaigns in 2010, weeks 30-34, 37-38 and 41-42.

·                   Cartridges despatch to Radius nominated CRO is planned :

·                   1 batch active and placebo despatched by end October

·                   1 batch active and placebo despatched by end November

·                   1 batch active and placebo despatched by end December

 

 

·                   Requiring re-supply in 2Q 2011, for 1,200 patients recruited at 200-500 per month, over Nov 2010 to Jan 2011.  Slower recruitment e.g. over 6 months would mean re-supply in 3Q 2011.

 

·                   Assumes

·                   Purchase Order for € [*] k for 6 lots approved by end May 2010

·                   API received by Vetter with C of A by end Jun 2010 , with full release for use in Ph III documented by Radius

·                   Crimp Caps delivered to Vetter with C of A by mid July 2010

·                   6 weeks post manufacture release by Vetter QA department

 

·                   Costs for Manufacture of 6 lots by Vetter   € [*] k

·                   From € [*] /lot, € [*] project management and € [*] microbiological validation costs

 

2 Testing, Release and Stability Testing of Phase III L ots

 

Supply assumptions above include 11,600 cartridges (active and placebo] from which samples are assumed to be removed for full ICH stability on one lot.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

6



 

·       Upgrade analytical methods for assay/purity to meet ICH requirements, for testing of Ph III supplies:

 

FTE Costs

185 k

 

 

External

15 k

 

 

 

 

·       Testing of 6 phase III batches in 2010 :

 

 

210 k

 

 

 

 

·       Full ICH stability study ( 3 -months) on one 2 mg/mL lot with upgraded methods:

 

FTE cost

137 k

 

 

External

8 k

 

 

 

 

·       Project management activities at Ipsen:

 

 

100 k

 

 

 

 

·       IND update :

 

 

110 k

 

Phasing of costs is shown below.

 

Costs €000s

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

Make and test Ph III Lots 3 x2mg/ml and 3 x Placebo

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

Full ICH Stability on one 2010 Lot

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

Analytical Methods Upgrade

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

IND Update

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

Project Management activities

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

Make and test Ph III Lots 1 x 2mg/ml and 1 x Placebo 2011

 

[*]

 

[*]

 

 

 

 

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

Full ICH Stability on one 2011 Lot

 

[*]

 

[*]

 

 

 

 

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

Make and test Ph III Lots 1 x 2mg/ml and 1 x Placebo 2012

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

[*]

 

[*]

 

 

 

 

 

 

 

 

Full ICH Stability on one 2011 Lot

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

SUBTOTAL

 

1216

 

750

 

542

 

432

 

211

 

149

 

234

 

157

 

107

 

4

 

99

 

6

GRAND TOTAL

 

1966

 

974

 

360

 

391

 

111

 

105

 

Costs based on € [*] k per FTE

 

3 API needed for Manufacture and Stability Testing

 

Based on 3 x 5000 cartridge lots, each requiring 22g API, gives 66g pure peptide weight, for manufacture of lots in 2010.  Method upgrades would require 2g peptide.

 

Reference Standard from Lonza sourced API will be required to QC test and stability test product.  Depending on how supplied, the quantities would vary from 2g bulk or e.g. 250 vials of 1mg.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

7



 

4. Scale Up Plans

 

The process currently proven has a maximum batch size of ~500 cartridges.  To scale-up process, dedicated compounding vessel/equipment will be required.  Two facilities/filling scales are available for future development with approximately 40- 50,000 maximum and 100,000 cartridges.

 

Based on initial annual requirements of 100,000 rising over [*] years to 1,000,000 cartridges per year, a batch size of 25,000 to ~ 50,000 would allow a step in scale of within [*]-[*]x, and [*]-[*] lots per year.  Batch size of 5,000 cartridges requires [*]g peptide, so increasing to 40,000 or 100,000 would require either ~[*]g or ~ [*]g of pure peptide.

 

Once Radius estimated volumes and preferences were confirmed (assumed by end May 10), Vetter plan for scale-up would be developed for Radius agreement (assumed Sep 10) for implementation in 2011, or later.

 

This option would allow a single scaled up lot made in 2011 to re-supply the entire remaining Ph III program in 2011, with an assumed 24m expiry.  As stability data confirms good stability of the product, this expiry date could also be extended.  This option would also provide for one additional full ICH stability study to be conducted.

 

As three lots would be required, a second lot would need to be manufactured.  The plan assumes this in 2012, which would then provide less  storage time data.  Alternatively, by making two lots in 2011, and stability studies on both, longer term data on all three lots would be provided, with additional spend in 2011 of ~ €270k.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

8


 

STRICTLY CONFIDENTIAL

 

Confidential Treatment Requested

 

Under 17 C.F.R. §§ 200.80(b)(4) and
240.24b-2

 

 

Execution Copy

 

AMENDMENT N°4 TO PHARMACEUTICAL DEVELOPMENT AGREEMENT

 

BETWEEN:

 

BEAUFOUR IPSEN INDUSTRIE S.A.S. , a French corporation incorporated under the laws of France, located at rue d’Ethe Virton, 28100, France, duly represented by Jean-Pierre Dubuc, President,

 

hereinafter referred to as “ Ipsen” , on the one hand,

 

AND

 

RADIUS HEALTH Inc., a United-States corporation incorporated under the laws of the State of Delaware, United Sates, with its principal office at 300 Technology Square-5 th  Floor, Cambridge, MA, USA and formerly known as Nuvios, Inc., duly represented by Richard Lyttle, Chief Executive Officer,

 

hereinafter referred to as “Radius” , on the other hand.

 

WHEREAS

 

A.                                     Ipsen and Radius are parties to that certain License Agreement dated September 27, 2005 (the “ License Agreement ”).

 

B.                                     Within the framework of the License Agreement, Ipsen and Radius have entered into a pharmaceutical development agreement to develop a multidose injection for BIM 44058 dated as of January 2, 2006 (the “Pharmaceutical Development Agreement ”) pursuant to which Ipsen performs certain research and development tasks and activities in view of developing a new formulation of Licensed Compound and/or Licensed Product.

 

C.                                     Ipsen and Radius have decided to further extend the duration and the scope of the Work Plan and to provide for the consideration relating to such an extension under an amendment to the Pharmaceutical Development Agreement (“ Amendment n°1 ”).

 

D.                                     Radius has requested, and Ipsen had agreed to manufacture some further stability batches and therefore to further extend the duration and the scope of the Work Plan under a second amendment to the Pharmaceutical Development Agreement (“ Amendment n°2 ”).

 

E.                                      Radius has requested, and Ipsen had agreed to manufacture Phase III batches and to upgrade analytical methods to NDA filing levels for purity/impurities testing to meet full ICH requirements and therefore to further extend the duration and the scope of the Work Plan under a third amendment to the Pharmaceutical Development Agreement (“ Amendment n°3 ”).

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

F.                                       Radius has requested, and Ipsen had agreed to manufacture, test and release extra Phase III batches and run stability studies and therefore to further extend the duration and the scope of the Work Plan under a fourth amendment to the Pharmaceutical Development Agreement (this “ Amendment n°4 ”).

 

NOW , THEREFORE, in consideration of the premises and the performance of the covenants herein contained , IT IS AGREED AS FOLLOWS:

 

1.               In this Amendment n°4, unless otherwise expressly provided herein, the capitalized words and phrases shall have the same meaning as in the Pharmaceutical Development Agreement and in Amendment n°1, Amendment n°2 and Amendment n°3.

 

2.               The Work Plan is amended so as to include the work described in Appendix A to this Amendment n°4 (the “ Fourth Extended Work Plan ”). For clarity, all references to the Work Plan in the Pharmaceutical Development Agreement shall be deemed to include all work described in the Extended Work Plan, the Reduced Second Extended Work Plan, the Third Extended Work Plan as well as the work described in the Original Work Plan. Should Radius wish Ipsen to perform any other work in addition to the activities described in the Fourth Extended Work Plan, Radius and Ipsen shall enter into a new agreement or amendment.

 

3.               Timelines described in Appendix A are subject to the execution by Ipsen of an amendment to its existing agreement with Vetter.

 

4.               Activities related to the manufacture of additional Phase III clinical batches by Vetter and tested by Ipsen in 2011 or 2012 and any batch Scale Up Plans in the Fourth Extended Work Plan as identified in paragraphs 2 and 3 of Appendix A shall not be commenced by Ipsen unless authorized in writing by Nick Harvey, Chief Financial Officer of Radius or other representative designated in writing by Radius.

 

5.               Payments

 

(a)          Subject to any modification of the budget included in the Fourth Extended Work Plan to be prior agreed in writing by the parties by Aidan Murphy, Senior Vice-President, CMC and Engineering for Ipsen and by Nick Harvey, Chief Financial Officer for Radius or by any other representative designated by the relevant Party, the total amount to be paid by Radius to Ipsen in connection with the research activities and tasks pursuant to the Fourth Extended Work Plan and this Amendment n°4 shall be as specified in the here attached Appendix A.

 

Such total amount includes all costs in connection with such research activities, including costs of materials, supplies, services, personnel, subcontractors and overhead, regardless of whether such research activities are performed by Ipsen or by a subcontractor or both. The budget included in the Fourth Extended Work Plan as described in Appendix A to this Amendment n°4 shows the breakdown by calendar quarter of such total amounts in Euros.

 

(b)          Ipsen shall invoice Radius no later than thirty (30) days after the end of each calendar quarter for the amount corresponding to actual FTE time spent as per timesheets incurred plus actual external cost bills received and approved by Ipsen during the elapsed quarter, as shall in each case be reported in reasonable detail on the invoice annex. Radius shall make payment of each invoice within thirty (30) days after receipt thereof in Euros.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

(c)           Without the prior written consent of Radius, in no event shall Ipsen invoice Radius for an amount due in respect of any calendar year that is greater than the amount budgeted for such calendar year in the Fourth Extended Work Plan plus the ten percent (10%) limit defined in article 4(d) of this Amendment n°4. In addition, and notwithstanding anything expressed or implied in this Amendment n°4 to the contrary (including without limitation, the Fourth Extended Work Plan), in no event shall Radius have any obligation to make payments to Ipsen pursuant to this Amendment n°4 for any work done by Ipsen at any time after December 31, 2014 unless Radius shall have authorized in writing any such work.

 

Radius shall pay for all work in respect of which Ipsen has entered into legally binding commitments with subcontractors and which occurs before December 31, 2014, that may not be cancelled by Ipsen without incurring penalties, provided that all of such work is within the framework of the Fourth Extended Work Plan and the cost of such work is within the budget included in the Fourth Extended Work Plan.

 

The remaining samples from stability studies will be made available for Radius to ship to Radius nominated contract laboratory by December 31, 2014. Should Radius request in writing that Ipsen conduct work on Radius behalf, Ipsen will be under no obligation to conduct such work.

 

(d)          Should external costs incurred by Ipsen in relation to the performance of the activities described in the Fourth Extended Work Plan be more than as specified in Appendix A hereby attached for such activities, Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs. In addition, should internal costs incurred by Ipsen in relation to performance of the Fourth Extended Work Plan be more than as specified in Appendix A due to an increase in the number of FTE’s required (but not the cost per FTE), Radius shall reimburse Ipsen such additional costs up to a maximum of ten percent (10%) of the relevant annual amount described in Appendix A for the performance of the specific tasks that resulted in such additional costs.  In either case, any reimbursement of costs in excess of such percentage will have to be prior agreed by Radius and, in the absence of any such prior agreement by Radius, shall be the responsibility of Ipsen. Ipsen shall use all reasonable efforts to avoid any such cost overruns.

 

6.               This Amendment n°4 shall enter into force retroactively upon its signature as of January 2, 2011 and shall remain in full force and in effect until complete performance of the Fourth Extended Work Plan or termination of the Pharmaceutical Development Agreement in accordance with its terms.

 

7.               Section 4 of Appendix A to Amendment n°3 to the Pharmaceutical Development Agreement is renumbered as Section 3, there being no Section 3 in Annex A to Amendment n°3.

 

8.               All other terms and conditions of the Pharmaceutical Development Agreement shall remain in full force and effect and shall apply to this Amendment n°4 which is made part of the Pharmaceutical Development Agreement.

 

9.              This Amendment n°4 shall be governed by, interpreted and construed in accordance with the laws of the State of New York, U.S.A., without regard to the conflicts of law principles, and shall not be governed by the United Nations Conventions of International Contracts on the Sale of Goods (the Vienna Convention).

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

3



 

IN WITNESS WHEREOF, the Parties hereto have caused this Amendment n°4 to be duly executed by their respective duly authorized representatives intending it to take effect as of January 2, 2011:

 

 

Date: December 7, 2011

 

Date: December 15, 2011

 

 

 

SIGNED by

 

SIGNED by Jean-Pierre Dubuc

 

 

 

/s/ B. Nicholas Harvey, CFO

 

/s/ Jean-Pierre Dubuc

 

 

 

 

 

 

on behalf of

 

as President of

RADIUS HEALTH Inc.

 

BEAUFOUR IPSEN INDUSTRIE S.A.S.

 

[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

4



 

APPENDIX  A

 

Updated CMC Activities for BA058

Phase III Supply Amendment 4

28 th  May 2010

Version Updated 6th October 2011

 

1. Summary of Work Program from 2010

 

Requested Manufacture of Clinical Batches 1.5 ml Cartridges x 6 completed and product supplied in late 2010, As per Proposal from 28 th  May

 

·                   Manufacturing of 6 Clinical Batches by Vetter and Tested by Ipsen

·                   Gives nominally 5,000 each, placebo and 2mg/ml cartridges

·                   Provided for clinical use by end Oct, Nov and Dec

 

·                   Testing, Release and Stability Testing of Phase III L ots

 

Upgrade of analytical methods completed and full testing and release of three lots each of active and placebo completed.

 

Stability testing of last lot made in 2010, set up in early 2011, so € [*] FTE costs transferred to updated 2011 costs.

 

Invoiced amounts for 2010 and Q1 2011 are compared with initial budgeted amounts for 2010.

 

Planned in 2010

 

Variance Vs
Budget 2010

 

Actual 2010

 

Moved to 2011

 

 

Cost €000s

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

Comments

Stability works from amendment 2

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

 

Make and test Ph III Lots 3 x 2mg/ml and 3 x Placebo

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

Completed; FTE costs decreased for testing m

Full ICH Stability on one 2010 Lot

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

Started in early 2011; € [*] transfer to 2011

Analytical Methods Upgrade

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

Completed as planned

IND Update

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

No update required

Project Management activities

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

 

SUBTOTAL

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

GRAND TOTAL

 

-111

 

923

 

57

 

 

 

 

 

 

 

 

 

 

 

FTE Costs

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

External

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

Total

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

923

 

 

 

Improvement in costs by € [*] , from € [*] to ~€ [*] achieved by simultaneous QC testing of multiple lots.  Stability costs (€ [*] ), initially planned for late 2010, now transferred to 2011, as lot was released very late 2010, and study set up in early 2011, rather than late 2010.  Also IND update was not required.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

5



 

2. Updated plan for 2011-2014, for supply of Ph III lots

 

·                   Stability testing ongoing in 2011-2014 for

Lot Made in 2009 and Lot made in 2010

 

·                   Supply of additional lots from Nominal 5,000 scale cartridge lot of BA058 2mg/ml and Placebo scheduled as

 

One lot Placebo

 

week of 23 rd  May 2011

 

 

One lot BA058 2mg/ml

 

week of 6 th  June 2011

 

 

 

 

 

 

 

One lot Placebo

 

week of 26 th  Sep 2011

 

 

One lot BA 058 2mg/ml

 

week of 28 th  Sep 2011

 

 

 

 

 

 

 

One lot Placebo

 

week of 12 th  Dec 2011

 

 

One lot BA 058 2mg/ml

 

week of 19 th  Dec 2011

 

 

 

·                   Additional stability testing

On lot to be made in Sep 2011 and on lot to be made in Dec 2011

 

Costing included here based on 5,000 cartridge scale, under this updated schedule for Amendment 3, pending Radius decision on future scale up to larger scale batches to be included in a next Amendment.

 

 

 

Amendment 3 Plan Updated for 2011 Planning

 

Total

 

 

 

2011

 

 

 

2012

 

 

 

2013

 

 

 

2014

 

 

 

2015

 

 

 

 

 

PROPOSED PLAN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#

 

Cost €000s

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

FTE Cost

 

External

 

1

 

Stability tests ons ongoing Lots from 2009

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

Stability test Lot from Dec 2010

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

 

 

[*]

 

[*]

 

 

 

 

 

3

 

Stability on Lot to be made in Sep 2011

 

[*]

 

[*]

 

 

 

 

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

[*]

 

 

 

 

 

4

 

Stability on Lot to be made in Dec 2011

 

[*]

 

[*]

 

 

 

 

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

 

 

[*]

 

[*]

 

5

 

Make and test Ph III Lot (mg/ml and Placebo) - May 2011

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

 

Make and test Ph III Lot (mg/ml and Placebo) - Sep 2011

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

Make and test Ph III Lot (mg/ml and Placebo) - Dec 2011

 

[*]

 

[*]

 

 

 

 

 

[*]

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

IND update

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

9

 

Project Management activities

 

[*]

 

[*]

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

[*]

 

 

 

 

 

SUBTOTAL

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

[*]

 

 

 

GRAND TOTAL

 

1333

 

552

 

445

 

140

 

129

 

67

 

 

Costs based on € 250k per FTE

 

3 API needed for Manufacture and Stability Testing

 

Based on 3 x 5000 cartridge lots, each requiring [*] g API, gives [*] g pure peptide weight, for manufacture of lots in 2011.

API should be delivered to Vetter temper evident sealed with appropriate documentation 2 months before manufacture.

 

Updated Schedule and Budget under Amendment 4 agreed as of January 2, 2011.

 

 

/s/ B. Nicholas Harvey

 

/s/ Aidan Murphy

 

 

 

B. N Harvey, CFO

 

A. Murphy, Vice President

Radius Health

 

CMC and Engineering, Ipsen

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

6




Exhibit 10.17

 

Execution Copy

 

DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT

 

THIS DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT is made and entered into as of October 16, 2007 (the “ Effective Date ”) by and between RADIUS HEALTH, INC., a Delaware corporation having an address at 300 Technology Square, 5 th  Floor, Cambridge, MA 02139 (together with its Affiliates, “RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “Manufacturer”).

 

RECITALS:

 

WHEREAS, RADIUS desires to engage Manufacturer to perform certain Development or Manufacturing Services (as those terms are defined below), on the terms and conditions set forth below, and Manufacturer desires to perform such Services for RADIUS.

 

AGREEMENT:

 

NOW, THEREFORE, in consideration of the foregoing premises and the mutual covenants of the parties set forth in this Agreement, the parties hereto agree as follows:

 

1.              Definitions .  Unless this Agreement expressly provides to the contrary, the following terms, whether used in the singular or plural, have the respective meanings set forth below:

 

1.1           Affiliate ” means, with respect to a party, any person or entity which controls, is controlled by or is under common control with such party.  As used in this Section, “ control ”  means (a) in the case of corporate entities, direct or indirect ownership of at least fifty percent (50%) of the stock or shares having the right to vote for the election of directors, and (b) in the case of non-corporate entities, the direct or indirect power to manage, direct or cause the direction of the management and policies of the non-corporate entity or the power to elect at least fifty percent (50%) of the members of the governing body of such non-corporate entity.

 

1.2           Agreement ” means this Development and Manufacturing Services Agreement, together with all Appendices attached hereto, as amended from time to time by the parties in accordance with Section 15.6, and all fully signed Work Orders entered into by the parties.

 

1.3           API/Drug Substance ”  means the active pharmaceutical ingredient identified on the applicable Work Order or any intermediate of such active pharmaceutical ingredient.

 

1.4           Applicable Law ” means all applicable ordinances, rules, regulations, laws, guidelines, guidances, requirements and court orders of any kind whatsoever of any Authority, as amended from time to time, including without limitation, cGMP (if applicable).

 

1.5           Authority ” means any government regulatory authority responsible for granting approvals for the performance of Services under this Agreement or for issuing regulations

 

CONFIDENTIAL

 

1



 

pertaining to the Manufacture and/or use of Product in the intended country of use, including, without limitation, the FDA.

 

1.6           Batch ” means a specific quantity of Product that is intended to be of uniform character and quality, within specified limits, and is produced during the same cycle of Manufacture as defined by the applicable Batch Record.

 

1.7           Batch Documentation ” has the meaning set forth in Section 6.2.

 

1.8           Certificate of Analysis ” means a document, signed by an authorized representative of Manufacturer, describing Specifications for, and testing methods applied to, Product, and the results thereof.

 

1.9           Certificate of Compliance ” means a document, signed by an authorized representative of Manufacturer, certifying that a particular Batch was Manufactured in accordance with cGMP (if applicable), all other Applicable Law, and the Specifications.

 

1.10         cGMP ” means current good manufacturing practices applicable to the Manufacture of Product promulgated by any Authority.

 

1.11         Change Order ” has the meaning set forth in Section 5.3.

 

1.12         Confidential Information ”  has the meaning set forth in Section 10.

 

1.13         Develop ” or “ Development ” means the studies and other activities conducted by Manufacturer under this Agreement to develop all or any part of a Manufacturing Process including, without limitation, analytical tests and methods, formulations and dosage forms.

 

1.14         Equipment ” means any equipment or machinery used by Manufacturer in the Development and/or Manufacturing of Product, or the holding, processing, testing, or release of Product.

 

1.15         Facility ” means the facilities of Manufacturer’s Affiliate Lonza S.A., Chausée de Tubize 297, B-1420 Braine l’Alleud, Belgium, unless otherwise identified in the applicable Work Order.

 

1.16         FDA ” means the United States Food and Drug Administration, and any successor agency having substantially the same functions.

 

1.17         FDCA ” means the United States Federal Food, Drug and Cosmetic Act, 21 U.S.C.  §321 et seq., as amended from time to time.

 

1.18         force majeure ” has the meaning set forth in Section 15.3.

 

1.19         Improvements ” means all Technology and discoveries, inventions, developments, modifications, innovations, updates, enhancements, improvements, writings or rights (whether or not protectable under patent, trademark, copyright or similar laws) that are

 

2



 

conceived, discovered, invented, developed, created, made or reduced to practice in the performance of Services under this Agreement.

 

1.20         IND ” means an Investigational New Drug application filed with the FDA in accordance with Applicable Law.

 

1.21         Manufacture ” and “ Manufacturing ” means any steps, processes and activities necessary to produce Product, including without limitation, the manufacturing, processing, packaging, labeling, quality control testing, release, storage or supply of Product.

 

1.22         Manufacturer Indemnitee ” has the meaning set forth in Section 12.2.

 

1.23         Manufacturer Technology ” means the Technology of Manufacturer (a) existing prior to the Effective Date, or (b) developed or obtained by or on behalf of Manufacturer independent of this Agreement and without reliance upon Confidential Information of RADIUS.

 

1.24         Manufacturing Process ” means any and all processes (or any step in any process) used or planned to be used by Manufacturer to Manufacture Product, consistent with the relevant Work Order and as evidenced in the Batch Documentation or master Batch Documentation.

 

1.25         Product ” means any API/Drug Substance or drug product comprised of API/Drug Substance, and any intermediates of the foregoing, in each case as specified in the applicable Work Order, including, if applicable, bulk packaging and/or labeling as provided in such Work Order.

 

1.26         Quality Agreement ” has the meaning set forth in Section 2.2.

 

1.27         RADIUS Indemnitee ” has the meaning set forth in Section 12.1.

 

1.28         RADIUS Equipment ” means the Equipment, if any, identified on the applicable Work Order as being provided by RADIUS or purchased or otherwise acquired by Manufacturer at RADIUS’ expense.

 

1.29         RADIUS Materials ” means the materials, and any intermediates or derivatives thereof, identified in the applicable Work Order as being provided by RADIUS including labels (if any) for Product.

 

1.30         RADIUS Technology ” means (a) RADIUS Materials, (b) Product and any intermediates or derivatives thereof, (c) Specifications, and (d) the Technology of RADIUS owned, developed or obtained by or on behalf of RADIUS prior to the Effective Date, or developed or obtained by or on behalf of RADIUS independent of this Agreement and without reliance upon the Confidential Information and Technology of Manufacturer.

 

1.31         Records ” has the meaning set forth in Section 5.4(a).

 

1.32         Representative ” has the meaning set forth in Section 3.1.

 

3



 

1.33         Reprocess ” and “ Reprocessing ” means introducing a Product back into the process and repeating appropriate manipulation steps that are part of the established Manufacturing Process.  Continuation of a process step after an in-process control test show the process to be incomplete is not considered reprocessing.

 

1.34         Rework ” and “ Reworking ” means subjecting a Product to one or more processing steps that are different from the established Manufacturing Process.

 

1.35         Services ” means the Development, Manufacturing and/or other services described in a Work Order entered into by the parties.

 

1.36         Specifications ” means the list of tests, references to any analytical procedures and appropriate acceptance criteria which are numerical limits, ranges or other criteria for tests described in order to establish a set of criteria to which Product at any stage of Manufacture should conform to be considered acceptable for its intended use that are provided by or approved by RADIUS, as such specifications are amended or supplemented from time to time by RADIUS in writing.

 

1.37         Technology ” means all methods, techniques, trade secrets, copyrights, know-how, data, documentation, regulatory submissions, specifications and other intellectual property of any kind (whether or not protectable under patent, trademark, copyright or similar laws).

 

1.38         Work Order ” means a written work order, substantially in the form attached hereto as Appendix A , for the performance of Services by Manufacturer under this Agreement.

 

2.              Engagement of Manufacturer.

 

2.1           Services and Work Orders .  From time to time, RADIUS may wish to engage Manufacturer to perform Services for RADIUS.  Such Services will be set forth in a Work Order.  Each Work Order will be appended to this Agreement and will set forth the material terms for the project, and may include the scope of work, specified Services, Specifications, deliverables, estimated timelines, milestones (if any), quantity, budget, payment schedule and such other details and special arrangements as are agreed to by the parties with respect to the activities to be performed under such Work Order.  No Work Order will be effective unless and until it has been agreed to and signed by authorized representatives of both parties.  Documents relating to the relevant project, including without limitation Specifications, proposals, quotations and any other relevant documentation, will be attachments to the applicable Work Order and incorporated in the Work Order by reference.  Each fully signed Work Order will be subject to the terms of this Agreement and will be incorporated herein and form part of this Agreement.  Manufacturer will perform the Services specified in each fully signed Work Order, as amended by any applicable Change Order(s), and in accordance with the terms and conditions of such Work Order and this Agreement.  Notwithstanding the foregoing, nothing in this Agreement will obligate either party to enter into any Work Order under this Agreement.

 

2.2           Quality Agreement .  If appropriate or if required by Applicable Law, the parties will also agree upon a Quality Agreement containing quality assurance provisions for the Manufacture of Product (“ Quality Agreement ”), which agreement will also be attached to the applicable Work Order and incorporated by reference in the Work Order.

 

4



 

2.3           Conflict Between Documents .  If there is any conflict, discrepancy, or inconsistency between the terms of this Agreement and any Work Order, Quality Agreement, purchase order, or other form used by the parties, the terms of this Agreement will control.

 

3.              Project Performance .

 

3.1           Representatives .  Each party will appoint a representative having primary responsibility for day-to-day interactions with the other party for the Services (each, a “ Representative ”), who will be identified in the applicable Work Order.  Each party may change its Representative by providing written notice to the other party in accordance with Section 15.3; provided that Manufacturer will use reasonable efforts to provide RADIUS with at least forty-five (45) days prior written notice of any change in its Representative for the Services.  Except for notices or communications required or permitted under this Agreement, which will be subject to Section 15.3, or unless otherwise mutually agreed by the parties in writing, all communications between Manufacturer and RADIUS regarding the conduct of the Services pursuant to such Work Order will be addressed to or routed directly through the parties’ respective Representatives.

 

3.2           Communications .  The parties will hold project team meetings via teleconference or in person, on a periodic basis as agreed upon by the Representatives.  Manufacturer will make written reports to RADIUS as specified in the applicable Work Order.

 

3.3           Subcontracting .  Manufacturer may not subcontract with any third party to perform any of its obligations under this Agreement without the prior written consent of RADIUS.  Manufacturer will be solely responsible for the performance of any permitted subcontractor, and for costs, expenses, damages, or losses of any nature arising out of such performance as if such performance had been provided by Manufacturer itself under this Agreement.  Manufacturer will cause any such permitted subcontractor to be bound by, and to comply with, the terms of this Agreement, as applicable, including without limitation, all confidentiality, quality assurance, regulatory and other obligations and requirements of Manufacturer set forth in this Agreement.

 

3.4           Duty to Notify .  If Manufacturer, at any time during the term of this Agreement, has reason to believe that it will be unable to perform or complete the Services, Manufacturer will promptly notify RADIUS thereof.  Compliance by Manufacturer with this Section 3.4 will not relieve Manufacturer of any other obligation or liability under this Agreement.

 

4.              Materials and Equipment .

 

4.1           Supply of Materials .  Unless the parties otherwise agree in a Work Order, Manufacturer will supply, in accordance with the relevant approved raw material specifications, all materials to be used by Manufacturer in the performance of Services under a Work Order other than the RADIUS Materials specified in such Work Order.  RADIUS or its designees will provide Manufacturer with the RADIUS Materials.  Manufacturer agrees (a) to account for all RADIUS Materials, (b) not to provide RADIUS Materials to any third party without the express prior written consent of RADIUS, (c) not to use RADIUS Materials for any purpose other than

 

5



 

conducting the Services, including, without limitation, not to analyze, characterize, modify or reverse engineer any RADIUS Materials or take any action to determine the structure or composition of any RADIUS Materials unless required pursuant to a signed Work Order, and (d) to destroy or return to RADIUS all unused quantities of RADIUS Materials according to RADIUS’ written directions.

 

4.2           Ownership of Materials .  RADIUS will at all times retain title to and ownership of the RADIUS Materials, Product, any intermediates (and components thereof), and any work in process at each and every stage of the Manufacturing Process.  Manufacturer will provide within the Facility an area or areas where the RADIUS Materials, Product, any intermediates (and components thereof), and any work in process are segregated and stored in accordance with the Specifications and cGMP (if applicable), and in such a way as to be able at all times to clearly distinguish such materials from products and materials belonging to Manufacturer, or held by it for a third party’s account.  Manufacturer will at all times take such measures as are required to protect the RADIUS Materials, Product, any intermediates (and components thereof), and any work in process from risk of loss or damage at all stages of the Manufacturing Process.  Manufacturer will ensure that RADIUS Materials, Product, any intermediates (and components thereof), and any work in process are free and clear of any liens or encumbrances.  Manufacturer will immediately notify RADIUS if at any time it believes any Product or RADIUS Materials have been damaged, lost or stolen.

 

4.3           Supply of Equipment .  Unless otherwise agreed in a Work Order, Manufacturer will supply all Equipment necessary to perform the Services.

 

5.              Development and Manufacture of Product .

 

5.1           Resources; Applicable Law .  Manufacturer will comply with all Applicable Law in performing Services.

 

5.2           Facility .

 

(a)            Performance of Services .  Manufacturer will perform all Services at the Facility, provide all staff necessary to perform the Services in accordance with the terms of the applicable Work Order and this Agreement, and hold at such Facility all Equipment, RADIUS Equipment, RADIUS Materials and other items used in the Services.  Manufacturer will not change the location of such Facility or use any additional facility for the performance of Services under this Agreement without at least ninety (90) days prior written notice to, and prior written consent from, RADIUS, which consent will not be unreasonably withheld or delayed (it being understood and agreed that RADIUS may withhold consent pending satisfactory completion of a quality assurance audit and/or regulatory impact assessment of the new location or additional facility, as the case may be).  Manufacturer will maintain, at its own expense, the Facility and all Equipment required for the Manufacture of Product in a state of repair and operating efficiency consistent with the requirements of the cGMP (if applicable) and all Applicable Law.

 

6



 

(b)            Validation .  Manufacturer will be responsible for performing all validation of the Facility, Equipment and cleaning and maintenance processes employed in the Manufacturing Process in accordance with cGMP, Manufacturer’s internal SOPs, the applicable Quality Agreement, Applicable Law, and in accordance with any other reasonable validation procedures established by RADIUS and made known in writing to Manufacturer.  Manufacturer will also be responsible for ensuring that all such validated processes are carried out in accordance with their terms.

 

(c)            Licenses and Permits .  Manufacturer will be responsible for obtaining, at its expense, any Facility or other licenses or permits, and any regulatory and government approvals necessary for the performance of Services by Manufacturer under this Agreement.  At RADIUS’ request, Manufacturer will provide RADIUS with reasonable copies of all such approvals and submissions to Authorities, and RADIUS will have the right to use any and all information contained in such approvals or submissions in connection with regulatory approval and/or commercial development of Product.

 

(d)            Access to Facility .  Upon prior notice, Manufacturer will permit RADIUS or its duly authorized representatives, such representatives having to enter into a reasonable separate confidentiality agreement with Manufacturer, to reasonably observe and consult with Manufacturer during the performance of Services under this Agreement, including without limitation the Manufacturing of any Batch of Product.  Manufacturer also agrees that RADIUS and its duly authorized agents, upon prior notice, will have reasonable access, during operational hours and during active Manufacturing, to inspect the Facility and Manufacturing Process to ascertain compliance by Manufacturer with the terms of this Agreement, including, without limitation, inspection of (i) the Equipment and materials used in the performance of Services, (ii) the holding facilities for such materials and Equipment, and (iii) all Records relating to such Services and the Facility.  RADIUS will also have the right, at its expense, to reasonably conduct “mock” pre-approval audits upon prior notice to Manufacturer, and Manufacturer agrees to cooperate with RADIUS in such “mock audits.”

 

5.3           Changes to Work Orders, Manufacturing Process and Specifications .

 

(a)            Changes to Work Orders .  If the scope of work of a Work Order changes, especially the estimated timelines, then the applicable Work Order may be amended as provided in this Section 5.3(a).  If a required modification to a Work Order is identified by RADIUS, or by Manufacturer, the identifying party will notify the other party in writing as soon as reasonably possible.  Manufacturer will provide RADIUS with a change order containing a description of the required modifications and their effect on the scope, fees and estimated timelines specified in the Work Order (“ Change Order ”) and will use reasonable efforts to do so within ten (10) business days of receiving or providing such notice, as the case may be.  No Change Order will be effective unless and until it has been signed by authorized representatives of both parties.  If RADIUS does not approve such Change Order, and has not terminated the Work Order, but requests the Work Order to be amended to take into account the modification, then the parties will use reasonable efforts to agree on a Change Order that is mutually acceptable.  If practicable, Manufacturer will continue to work on the existing Work Order during any such negotiations, provided such efforts would facilitate the completion of the work envisioned in the

 

7



 

proposed Change Order, but will not commence work in accordance with the Change Order until it is authorized in writing by RADIUS.

 

(b)            Process/Specifications Changes .  Any change or modification to the Manufacturing Process or Specifications for any Product must be approved in advance by both parties and will be made in accordance with the change control provisions of the applicable Quality Agreement.  Any such change or modification can result in lower or higher costs, and the parties herewith agree to enter into good-faith negotiations concerning any such price deviation; provided, however, that RADIUS will not be responsible for any increase in price unless agreed in writing by RADIUS.

 

5.4           Record and Sample Retention .

 

(a)            Records .  Manufacturer will keep complete and accurate records (including without limitation reports, accounts, notes, data, and records of all information and results obtained from performance of Services) of all work done by it under this Agreement, in form and substance as specified in the applicable Work Order, the applicable Quality Agreement, and this Agreement (collectively, the “ Records ”).  Manufacturer will not transfer, deliver or otherwise provide any such Records to any party other than RADIUS, without the prior written approval of RADIUS.  Upon prior notice, Records will be available at reasonable times for inspection, examination and copying by or on behalf of RADIUS.  All original Records of the Development and Manufacture of Product under this Agreement will be retained and archived by Manufacturer in accordance with cGMP (if applicable) and Applicable Law, but in no case for less than a period of five (5) years following completion of the applicable Work Order.  Upon RADIUS’ request, Manufacturer will promptly provide RADIUS with copies of such Records.  Five (5) years after completion of a Work Order, all of the aforementioned records will be sent to RADIUS or RADIUS’ designee; provided , however , that RADIUS may elect to have such records retained in Manufacturer’s archives for an additional period of time at a reasonable charge to RADIUS.  For the avoidance of doubt, RADIUS herewith takes note that certain Records are written in French as the Facility is in Belgium.  RADIUS shall pay all costs incurred with any translation of such Records requested by RADIUS.

 

(b)            Sample Retention .  Manufacturer will take and retain, for such period and in such quantities as may be required by cGMP (if applicable) and the applicable Quality Agreement, samples of Product from the Manufacturing Process produced under this Agreement.  Further, Manufacturer will submit such samples to RADIUS, upon RADIUS’ written request.

 

5.5           Regulatory Matters .

 

(a)            Regulatory Approvals .  RADIUS will be responsible for obtaining, at its expense, all regulatory and governmental approvals and permits necessary for RADIUS’ use of any Product Developed and/or Manufactured under this Agreement, including, without limitation, IND submissions and any analogous submissions filed with the appropriate Authority of a country other than the United States.  Manufacturer will be responsible for providing

 

8


 

RADIUS with all supporting data and information relating to the Development and/or Manufacture of Product reasonably necessary for obtaining such approvals, including, without limitation, all Records, raw data, reports, authorizations, certificates, methodologies, Batch Documentation, raw material specifications, SOPs, standard test methods, Certificates of Analysis, Certificates of Compliance and other documentation in the possession or under the control of Manufacturer relating to the Development and Manufacture of Product (or any component thereof).

 

(b)            Regulatory Inspections .  Manufacturer will permit RADIUS or its agents to be present and participate in any visit or inspection by any Authority of the Facility (to the extent it relates in any way to any RADIUS Product) or the Manufacturing Process.  Manufacturer will give as much advance notice as possible to RADIUS of any such visit or inspection.  Manufacturer will provide to RADIUS a copy of any report or other written communication received from such Authority in connection with such visit or inspection, and any written communication received from any Authority relating to any RADIUS Product, the Facility (if it relates to or affects the Development and/or Manufacture of Product) or the Manufacturing Process, within twenty-four (24) hours after receipt thereof, and will consult with RADIUS before responding to each such communication.  Manufacturer will provide RADIUS with a copy of its final responses within five (5) business days after submission thereof.

 

5.6           Waste Disposal .  The generation, collection, storage, handling, transportation, movement and release of hazardous materials and waste generated in connection with the Services will be the responsibility of Manufacturer at Manufacturer’s sole cost and expense.  Without limiting other applicable requirements, Manufacturer will prepare, execute and maintain, as the generator of waste, all licenses, registrations, approvals, authorizations, notices, shipping documents and waste manifests required under Applicable Law.

 

5.7           Safety Procedures .  Manufacturer will be solely responsible for implementing and maintaining health and safety procedures for the performance of Services and for the handling of any materials or hazardous waste used in or generated by the Services.  Manufacturer, in consultation with RADIUS, will develop safety and handling procedures for API/Drug Substance and Product; provided , however , that RADIUS will have no responsibility for Manufacturer’s health and safety program.  Should such safety and handling procedures materially deviate from Manufacturer’s existing health and safety program and require additional investment on the part of Manufacturer, the parties shall agree in writing in advance on reasonable charges to RADIUS for such procedures.

 

5.8           Technology Transfer .  If RADIUS elects to Manufacture Product, or to have Product Manufactured by a third party, then Manufacturer will provide to RADIUS, or its designee, all Manufacturing information, including, without limitation, documentation, technical assistance, materials and cooperation by appropriate employees of Manufacturer as RADIUS or its designee may reasonably require in order to Manufacture Product.  RADIUS will compensate Manufacturer for such assistance at the hourly-rate(s) set forth in the applicable Work Order, or such other reasonable rate(s) as the parties may agree in writing.  If such a move or replication of

 

9



 

Manufacture of Product involves Manufacturer Technology incorporated into the Manufacturing Process pursuant to the express terms of any relevant Work Order, the parties will negotiate in good-faith in order to determine a reasonably royalty fee or other reasonable consideration to be paid to Manufacturer by RADIUS for the right to continue to use such Manufacturer Technology.

 

6.              Testing and Acceptance Process .

 

6.1           Testing by Manufacturer .  The Product to be Manufactured under this Agreement will be Manufactured in accordance with cGMP, unless otherwise stated in the Work Order, and the Manufacturing Process approved by RADIUS.  Each Batch of Product will be sampled and tested by Manufacturer against the Specifications, and the quality assurance department of Manufacturer will review the records relating to the Manufacture of the Batch and will assess if the Manufacture has taken place in compliance with cGMP (if applicable) and the Manufacturing Process.

 

6.2           Provision of Records .  If, based upon such tests, a Batch of Product conforms to the Specifications and was Manufactured according to cGMP (if applicable) and the Manufacturing Process, then a Certificate of Compliance will be completed and approved by the quality assurance department of Manufacturer.  This Certificate of Compliance, a Certificate of Analysis and the Specifications (collectively, the “ Batch Documentation ”, excluding any batch and master batch records) for each Batch of Product will be delivered to RADIUS by a reputable overnight courier or by registered or certified mail, postage prepaid, return receipt required to verify delivery date.  Upon reasonable request, Manufacturer will also deliver to RADIUS all raw data, reports, authorizations, certificates, methodologies, raw material specifications, SOPs, standard test methods, and other documentation in the possession or under the control of Manufacturer relating to the Manufacture of each Batch of Product.  If RADIUS has not received all such Batch Documentation at the time of receipt of the Batch, RADIUS will notify Manufacturer in writing.  If RADIUS requires additional copies of such Batch Documentation, these will be provided by Manufacturer to RADIUS at cost.

 

(a)            Review of Batch Documentation; Acceptance .  RADIUS will review the Batch Documentation for each Batch of Product and may test samples of the Batch of Product against the Specifications.  For the avoidance of doubt, RADIUS herewith takes note that certain parts of the Batch Documentation will be written in French as the Facility is in Belgium.  RADIUS shall pay all costs incurred with any translation of such Records requested by RADIUS.  RADIUS will notify Manufacturer in writing of its acceptance or rejection of such Batch within six (6) weeks of receipt of the complete Batch Documentation relating to such Batch.  During this review period, the parties agree to respond promptly, but in any event within ten (10) days, to any reasonable inquiry by the other party with respect to such Batch Documentation.  RADIUS has no obligation to accept a Batch if such Batch does not comply with the Specifications and/or was not Manufactured in compliance with cGMP (if applicable) and the Manufacturing Process.

 

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6.3           Disputes .  In case of any disagreement between the parties as to whether Product conforms to the applicable Specifications or cGMP (if applicable), the quality assurance representatives of the parties will attempt in good faith to resolve any such disagreement and RADIUS and Manufacturer will follow their respective SOPs to determine the conformity of the Product to the Specifications and cGMP (if applicable).  If the foregoing discussions do not resolve the disagreement in a reasonable time (which will not exceed thirty (30) days), a representative sample of such Product will be submitted to an independent testing laboratory mutually agreed upon by the parties for tests and final determination of whether such Product conforms with such Specifications.  The laboratory must meet cGMP (if applicable), be of recognized standing in the industry, and consent to the appointment of such laboratory will not be unreasonably withheld or delayed by either party.  Such laboratory will use the test methods contained in the applicable Specifications.  The determination of conformance by such laboratory with respect to all or part of such Product will be final and binding on the parties.  The fees and expenses of the laboratory incurred in making such determination will be paid by the party against whom the determination is made.

 

6.4           Product Non-Compliance and Remedies .  If a Batch of Product fails to conform to the Specifications due to the fault of Manufacturer or was not Manufactured in compliance with cGMP (if applicable) and the Manufacturing Process, then Manufacturer will, at RADIUS’ sole option:

 

(a)            refund in full the fees and expenses paid by RADIUS for such Batch, including the costs of RADIUS Materials used in the Manufacture of such Batch; or

 

(b)            at Manufacturer’s cost and expense, including the costs of RADIUS Materials used in the Manufacture of such Batch, produce a new Batch of Product as soon as reasonably possible; or

 

(c)            Rework or Reprocess the Product, at Manufacturer’s cost and expense, so that the Batch can be deemed to have been Manufactured in compliance with cGMP (if applicable) and the Manufacturing Process, and to conform to Specifications.

 

Moreover, the parties will meet to discuss, evaluate and analyze the reasons for and implications of the failure to comply with cGMP (if applicable) and/or the Manufacturing Process and will decide whether to proceed with or to amend the applicable Work Order, or to terminate such Work Order.

 

6.5           Disposition of Non-Conforming Product .  The ultimate disposition of non-conforming Product will be the responsibility of RADIUS’ quality assurance department and RADIUS’ expense.

 

7.              Shipping and Delivery .

 

7.1           Shipping; Delivery .  Manufacturer agrees not to ship Product to RADIUS or its designee until it has received a written approval to ship from RADIUS.  Manufacturer will

 

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ensure that each Batch will be delivered to RADIUS’ designee, (a) on the estimated delivery date and to the destination designated by RADIUS in writing, and (b) in accordance with the instructions for shipping given to Manufacturer by RADIUS and packaging specified by RADIUS in the applicable Work Order or as otherwise agreed to by the parties in writing.  Delivery terms will be FCA the Facility (Incoterms 2000).  A bill of lading will be furnished to RADIUS with respect to each shipment.  For the avoidance of doubt, RADIUS will reimburse Manufacturer for any packaging materials that are outside of the packaging normally used by Manufacturer for like products as the Product.

 

8.              Price and Payments .

 

8.1           Price .  The price of Product and/or the fees for the performance of Services will be set forth in the applicable Work Order.

 

8.2           Invoice .  Upon performance of Services and/or release of Batch(es), such release to be conducted exclusively by Manufacturer, Manufacturer will invoice RADIUS according to the payment schedule in the applicable Work Order.  Payment of undisputed invoices will be due thirty (30) days after date of Manufacturer’s invoice.  Any undisputed invoices that remain unpaid by RADIUS after the aforementioned timeframe shall be subject to a late payment charge of 1% (one percent) per calendar month for each full calendar month that the payment remains outstanding in Manufacturer’s accounts.

 

8.3           Payments .  RADIUS will make all payments pursuant to this Agreement by check or wire transfer to a bank account designated in writing by Manufacturer.  All payments under this Agreement will be made in Euros (EUR).

 

8.4           Financial Records .  Manufacturer will keep accurate records of all Services performed and invoice calculations, and, upon the request of RADIUS, will permit an independent accountant appointed by RADIUS to examine such records upon prior notice and during normal business hours for the purpose of verifying the correctness of all such calculations.

 

8.5           Taxes .  Duty, sales, use or excise taxes imposed by any governmental entity that apply to the provision of Services will be borne by RADIUS (other than taxes based upon the income of Manufacturer).

 

9.              Intellectual Property Rights .

 

9.1           RADIUS Technology .  All rights to and interests in RADIUS Technology will remain solely in RADIUS and no right or interest therein is transferred or granted to Manufacturer.  Manufacturer acknowledges and agrees that it does not acquire a license or any other right to RADIUS Technology except for the limited purpose of carrying out its duties and obligations under this Agreement and that such limited, non-exclusive, license will expire upon the completion of such duties and obligations or the termination or expiration of this Agreement, whichever is the first to occur.

 

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9.2           Manufacturer Technology .  All rights to and interests in Manufacturer Technology will remain solely in Manufacturer and no right or interest therein is transferred or granted to RADIUS.  RADIUS acknowledges and agrees that it will not acquire a license or any other right to Manufacturer Technology except as otherwise set forth in this Agreement.  If RADIUS wishes to move or replicate the Manufacture of Product, where the relevant Manufacturing Process involves Manufacturer Technology incorporated into the Manufacturing Process pursuant to the express terms of any relevant Work Order, the parties will negotiate in good-faith in order to determine a reasonably royalty fee or other reasonable consideration to be paid to Manufacturer by RADIUS for the right to continue to use such Manufacturer Technology.

 

9.3           Improvements .  Manufacturer agrees that all Improvements will be the sole and exclusive property of RADIUS and are hereby assigned to RADIUS (or its designee) without additional compensation to Manufacturer.  Manufacturer will take such steps as RADIUS may reasonably request (at RADIUS’ expense) to vest in RADIUS (or its designee) ownership of the Improvements.

 

9.4           Non-Exclusive License .  RADIUS agrees to grant to Manufacturer a non-exclusive, perpetual, fully paid-up, worldwide license, with the right to sub-license, to use Improvements that relate solely to Manufacturer Technology or the Confidential Information of Manufacturer, in the manufacture of products that do not contain an API/Drug Substance or derivative that is the subject of a Work Order under this Agreement or that use other Confidential Information of RADIUS.

 

9.5           Patent Filings .  RADIUS will have the exclusive right and option, but not the obligation, to prepare, file, prosecute, maintain and defend at its sole expense, any patents that claim and/or cover the Improvements.  If RADIUS declines to file and prosecute any patent applications, or maintain any patents, relating to Improvements, it will give Manufacturer reasonable notice to this effect and, thereafter, Manufacturer may, upon written notice to RADIUS, file and prosecute such patent applications and/or maintain such patents, in the name of RADIUS and at Manufacturer’s sole expense.

 

10.           Confidentiality .

 

10.1         Definition .  As used in this Agreement, “ Confidential Information ”  means any scientific, technical, trade or business information which is given by one party to the other under this Agreement or any confidentiality agreement entered into in contemplation of this Agreement and which is treated by the disclosing party as confidential or proprietary, or which is developed by one party for the other under the terms of this Agreement.  The disclosing party will, to the extent practical, use reasonable efforts to label or identify as confidential, at the time of disclosure all such Confidential Information that is disclosed in writing or other tangible form.  Confidential Information of Manufacturer includes, but is not limited to, Manufacturer Technology, whether or not labeled confidential.  Confidential Information of RADIUS includes, but is not limited to, RADIUS Technology and Improvements, whether or not labeled confidential.

 

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10.2         Obligations .  Each party agrees (a) to keep confidential the Confidential Information of the other party, (b) not to disclose the other party’s Confidential Information to any third party without the prior written consent of such other party, and (c) to use such Confidential Information only as necessary to fulfill its obligations or in the reasonable exercise of rights granted to it under this Agreement; provided, however, that the foregoing obligations shall not apply to Confidential Information that is (i) in possession of the receiving party at the time of disclosure, as reasonably demonstrated by written records and without obligation of confidentiality, (ii) later becomes part of the public domain through no fault of the receiving party, (iii) received by the receiving party from a third party without obligation of confidentiality, or (iv) developed independently by the receiving party without use of, reference to, or reliance upon the disclosing party’s Confidential Information by individuals who did not have access to Confidential Information.  Notwithstanding the foregoing, a party may disclose (y) Confidential Information of the other party to its Affiliates, and to its and their directors, employees, consultants, and agents in each case who have a specific need to know such Confidential Information and who are bound by a like obligation of confidentiality and restriction on use, and (z) Confidential Information of the other party to the extent such disclosure is required to comply with Applicable Law or the rules of any stock exchange or listing entity, or to defend or prosecute litigation; provided, however, that the receiving party provides prior written notice of such disclosure to the disclosing party and takes reasonable and lawful actions to avoid or minimize the degree of such disclosure.  Moreover, RADIUS may disclose Confidential Information of Manufacturer relating to the Development and/or Manufacture of Product to entities with whom RADIUS has (or may have) a marketing and/or development collaboration or to bona fide actual or prospective underwriters, investors, lenders or other financing sources or to potential acquirors of the business to which this Agreement relates, and who in each case have a specific need to know such Confidential Information and who are bound by a like obligation of confidentiality and restrictions on use.

 

10.3         Public Statements .  Except to the extent required by Applicable Law or the rules of any stock exchange or listing entity, neither party will make any public statements or releases concerning this Agreement or the transactions contemplated by this Agreement, or use the other party’s name in any form of advertising, promotion or publicity, without obtaining the prior written consent of the other party, which consent will not be unreasonably withheld or delayed.

 

11.           Representations and Warranties .

 

11.1         Manufacturer’s Representations and Warranties .  Manufacturer represents and warrants to RADIUS that:

 

(a)            it has the full power and right to enter into this Agreement and that there are no outstanding agreements, assignments, licenses, encumbrances or rights of any kind held by other parties, private or public, inconsistent with the provisions of this Agreement;

 

(b)            the Services will be performed with requisite care, skill and diligence, in accordance with Applicable Law and industry standards, and by individuals who are appropriately trained and qualified;

 

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(c)            to the best of its knowledge, the Services will not infringe the intellectual property rights of any third party and it will promptly notify RADIUS in writing should it become aware of any claims asserting such infringement;

 

(d)            at the time of delivery to RADIUS, the Product Manufactured under this Agreement (i) will have been Manufactured in accordance with cGMP (if applicable) and all other Applicable Law, the Manufacturing Process, the applicable Quality Agreement, and Specifications, and (ii) will not be adulterated or misbranded under the FDCA or other Applicable Law; and

 

(e)            it has not been debarred, nor is it subject to a pending debarment, and that it will not use in any capacity in connection with the Services any person who has been debarred pursuant to section 306 of the FDCA, 21 U.S.C.  § 335a, or who is the subject of a conviction described in such section.  Manufacturer agrees to notify RADIUS in writing immediately if Manufacturer or any person who is performing Services is debarred or is the subject of a conviction described in section 306, or if any action, suit, claim, investigation, or proceeding is pending, or to the best of Manufacturer’s knowledge, is threatened, relating to the debarment or conviction of Manufacturer or any person performing Services.

 

11.2         RADIUS Representations and Warranties .  RADIUS represents and warrants to Manufacturer that:

 

(a)            it has the full power and right to enter into this Agreement and that there are no outstanding agreements, assignments, licenses, encumbrances or rights held by other parties, private or public, inconsistent with the provisions of this Agreement, and

 

(b)            to the best of its knowledge, the use of RADIUS Technology as contemplated in the Services will not infringe the intellectual property rights of any third party and that it will promptly notify Manufacturer in writing should it become aware of any claims asserting such infringement.

 

11.3         Disclaimer of Other Representations and Warranties .  EXCEPT AS EXPRESSLY SET FORTH IN THIS AGREEMENT, NEITHER PARTY MAKES ANY REPRESENTATIONS OR EXTENDS ANY WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT.

 

12.           Indemnification .

 

12.1         Indemnification by Manufacturer .  Manufacturer will indemnify, defend and hold harmless RADIUS, its Affiliates and their respective officers, directors, employees and agents (each a “ RADIUS Indemnitee ”) from and against any and all losses, damages, liabilities or expenses (including reasonable attorneys fees and other costs of defense) (collectively, “ Losses ”)  in connection with any and all actions, suits, claims or demands that may be brought or instituted against any RADIUS Indemnitee by any third party based on, arising out of, or resulting from, any (a) breach by Manufacturer of its representations, warranties or covenants under this

 

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Agreement, or (b) negligent act or omission or the willful misconduct of any Manufacturer Indemnitees in performing obligations under this Agreement.

 

12.2         Indemnification by RADIUS .  RADIUS will indemnify, defend and hold harmless Manufacturer, its Affiliates and their respective officers, directors, employees and agents (each a “ Manufacturer Indemnitee ”) from and against any and all Losses in connection with any and all actions, suits, claims or demands that may be brought or instituted against any Manufacturer Indemnitee by any third party based on, or arising out of, or resulting from (a) the use of the Product, except to the extent that such Losses are within the scope of the indemnification obligation of Manufacturer under Section 12.1, (b) any breach by RADIUS of its representations, warranties or covenants under this Agreement, or (c) any negligent act or omission or the willful misconduct of any RADIUS Indemnitees in performing obligations under this Agreement.

 

12.3         Procedures .  Each party agrees to notify the other party within thirty (30) days of receipt of any claims made for which the other party might be liable under Section 12.1 or 12.2, as the case may be.  Subject to Section 12.4, the indemnifying party will have the right to defend, negotiate, and settle such claims.  The party seeking indemnification will provide the indemnifying party with such information and assistance as the indemnifying party may reasonably request, at the expense of the indemnifying party.  The parties understand that no insurance deductible will be credited against losses for which a party is responsible under this Section 12.

 

12.4         Settlement .  Neither party will be responsible or bound by any settlement of any claim or suit made without its prior written consent; provided, however, that the indemnified party will not unreasonably withhold or delay such consent.  If a settlement contains an absolute waiver of liability for the indemnified party, and each party has acted in compliance with the requirements of Section 12.3, then the indemnified party’s consent will be deemed given.  Notwithstanding the foregoing, Manufacturer will not agree to settle any claim on such terms or conditions as would impair RADIUS’ ability or right to Manufacture, market, sell or otherwise use Product, or as would impair Manufacturer’s ability, right or obligation to perform its obligations under this Agreement.

 

12.5         Limitation of Liability .  NOTWITHSTANDING ANYTHING IN THIS AGREEMENT TO THE CONTRARY, IN NO EVENT WILL EITHER PARTY BE LIABLE FOR ANY SPECIAL, INCIDENTAL, CONSEQUENTIAL OR INDIRECT DAMAGES ARISING OUT OF THIS AGREEMENT, HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY.  THIS LIMITATION WILL APPLY EVEN IF THE OTHER PARTY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE; PROVIDED , HOWEVER , THAT THIS LIMITATION WILL NOT APPLY TO DAMAGES RESULTING FROM BREACHES BY A PARTY OF ITS DUTY OF CONFIDENTIALITY AND NON-USE IMPOSED UNDER SECTION 10 OR ITS INDEMNIFICATION OBLIGATIONS UNDER THIS SECTION 12.

 

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13.           Insurance .

 

13.1         Manufacturer Insurance .  Manufacturer will secure and maintain in full force and effect throughout the term of this Agreement (and for at least five (5) years thereafter for claims made coverage), insurance with coverage and minimum policy limits set forth as follows:

 

(a)            Comprehensive General Liability and Personal Injury , including coverage for contractual liability assumed by Manufacturer and coverage for Manufacturer’s independent contractor(s), with per occurrence limits of at least One Million dollars ($1,000,000) each and a general aggregate limit of Two Million dollars ($2,000,000);

 

(b)            Products Liability , exclusive of the coverage provided by the Comprehensive General Liability policy, with an aggregate limit of at least Five Million dollars ($5,000,000); and

 

(c)            All Risk Property , valued at replacement cost, covering loss or damage to the Facility and RADIUS’ property and materials in the care, custody, and control of Manufacturer.

 

13.2         Evidence of Insurance .  Upon request, Manufacturer will furnish to RADIUS a certificate from an insurance carrier (having a minimum AM Best rating of A) demonstrating the insurance requirements set forth above.  Thirty (30) days prior written notice will be given to RADIUS of cancellation or any material change in the policies.

 

13.3         Insurance Information .  Manufacturer will comply, at RADIUS’ expense, with reasonable requests for information made by RADIUS’ insurance provider representative(s), including permitting such representative(s) to inspect the Facility during operational hours and upon reasonable notice to Manufacturer.  In regard to such inspections, the representative(s) will adhere to such guidelines and policies pertaining to safety and non-disclosure as Manufacturer may reasonably require.

 

14.           Term and Termination .

 

14.1         Term .  This Agreement will take effect as of the Effective Date and, unless earlier terminated pursuant to this Section 14, will expire on the later of (a) two (2) years from the Effective Date, or (b) the completion of Services under the last Work Order executed by the parties prior to the second anniversary of the Effective Date.  The term of this Agreement may be extended by RADIUS continuously for additional two (2) year periods upon written notice to Manufacturer at least thirty (30) days prior to the expiration of the then current term.

 

14.2         Termination by RADIUS .  RADIUS will have the right, in its sole discretion, to terminate this Agreement and/or any Work Order (a) upon thirty (30) days prior written notice to Manufacturer, or (b) immediately upon written notice if (i) in RADIUS’ reasonable judgment, Manufacturer is or will be unable to perform the Services in accordance with the agreed upon timeframe and/or budget set forth in the applicable Work Order, or (ii) Manufacturer fails to

 

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obtain or maintain any material governmental licenses or approvals required in connection with the Services.

 

14.3         Termination by Either Party .  Either party will have the right to terminate this Agreement or any signed Work Orders that are pending by written notice to the other party, upon the occurrence of any of the following:

 

(a)            the other party files a petition in bankruptcy, or enters into an agreement with its creditors, or applies for or consents to the appointment of a receiver or trustee, or makes an assignment for the benefit of creditors, or becomes subject to involuntary proceedings under any bankruptcy or insolvency law (which proceedings remain undismissed for sixty (60) days);

 

(b)            the other party fails to start and diligently pursue the cure of a material breach of this Agreement within thirty (30) days after receiving written notice from the other party of such breach; or

 

(c)            a force majeure event that will, or continues to, prevent performance (in whole or substantial part) of this Agreement or any pending Work Order for a period of at least ninety (90) days.  In the case of a force majeure event relating to a pending Work Order, the right to terminate will be limited to such Work Order.

 

14.4         Effect of Termination .  Manufacturer will, upon receipt of a termination notice from RADIUS, promptly cease performance of the applicable Services and will take all reasonable steps to mitigate the out-of-pocket expenses incurred in connection therewith.  In particular, Manufacturer will use its best efforts to:

 

(a)            immediately cancel, to the greatest extent possible, any third party obligations;

 

(b)            promptly inform RADIUS of any irrevocable commitments made in connection with any pending Work Order(s) prior to termination;

 

(c)            promptly return to the vendor for a refund all unused, unopened materials in Manufacturer’s possession that are related to any pending Work Order; provided that RADIUS will have the option, but not the obligation, to take possession of any such materials;

 

(d)            promptly inform RADIUS of the cost of any remaining unused, unreturnable materials ordered, or work in progress pursuant to any pending Work Order(s), and either deliver such materials to RADIUS (or its designee) or properly dispose of them, as instructed by RADIUS, upon which Manufacturer shall invoice RADIUS for any such associated costs; and

 

(e)            perform only those services and activities mutually agreed upon by RADIUS and Manufacturer as being necessary or advisable in connection with the close-out of any pending Work Order(s).

 

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14.5         Return of Materials/Confidential Information .  Upon the expiration or termination of this Agreement, each party will promptly return all Confidential Information of the other party that it has received pursuant to this Agreement, provided however that Manufacturer is allowed to keep one copy of such Confidential Information for archival purposes only.  Manufacturer will also promptly return all RADIUS Materials, RADIUS Equipment, retained samples, data, reports and other property, information and/or know-how in recorded form that was provided by RADIUS, or developed in the performance of the Services, that are owned by or licensed to RADIUS.

 

14.6         Inventories .  Upon expiration or termination of this Agreement or a pending Work Order, RADIUS (a) will purchase from Manufacturer any existing inventories of Product conforming to the Specifications and Manufactured in accordance with cGMP (if applicable) and the Manufacturing Process, at the price for such Product set forth in the applicable Work Order, and (b) may either (i) purchase any Product in process held by Manufacturer as of the date of the termination, at a price to be mutually agreed (it being understood that such price will reflect, on a pro rata basis, work performed and non-cancelable out-of-pocket expenses actually incurred by Manufacturer with respect to the Manufacture of such in-process Product), or (ii) direct Manufacturer to dispose of such material at RADIUS’ cost.

 

14.7         Payment Reconciliation .  Within thirty (30) days after the close-out of a Work Order, Manufacturer will provide to RADIUS a written itemized statement of all work performed by it in connection with the terminated Work Order, an itemized breakdown of the costs associated with that work, and a final invoice for that Work Order.  If RADIUS has pre-paid to Manufacturer more than the amount in a final invoice then Manufacturer agrees to promptly refund that money to RADIUS, or to credit the excess payment toward another existing or future Work Order, at the election of RADIUS.

 

14.8         Survival .  Expiration or termination of this Agreement for any reason will not relieve either party of any obligation accruing prior to such expiration or termination or of any rights and obligations of the parties that by their terms survive termination or expiration of this Agreement or of any Work Order, including, without limitation, Sections 1, 2.3, 4, 5.2(c), 5.2(d), 5.4, 5.5, 5.6, 5.7, 5.8, 6, 9 through 13, 14.4, 14.5, 14.6, 14.7, 14.8 and 15, and the provisions of the applicable Quality Agreement.

 

15.           Miscellaneous .

 

15.1         Independent Contractor .  All Services will be rendered by Manufacturer as an independent contractor and this Agreement does not create an employer-employee relationship between RADIUS and Manufacturer.  Manufacturer will not in any way represent itself to be a partner or joint venturer of or with RADIUS.

 

15.2         Force Majeure .  Except as otherwise expressly set forth in this Agreement, neither party will have breached this Agreement for failure or delay in fulfilling or performing any term of this Agreement when such failure or delay is caused by or results from causes

 

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beyond the reasonable control of the affected party, including, without limitation, fire, floods, embargoes, shortages, epidemics, quarantines, war, acts of war (whether war be declared or not), insurrections, riots, civil commotion, strikes, acts of God or acts, omissions, or delays in acting, by any governmental authority (“ force majeure ”).  The party affected by any event of force majeure will promptly notify the other party, explaining the nature, details and expected duration thereof.  Such party will also notify the other party from time to time as to when the affected party reasonably expects to resume performance in whole or in part of its obligations under this Agreement, and to notify the other party of the cessation of any such event.  A party affected by an event of force majeure will use its reasonable efforts to remedy, remove, or mitigate such event and the effects thereof with all reasonable dispatch.  If a party anticipates that an event of force majeure may occur, such party will notify the other party of the nature, details and expected duration thereof.  Upon termination of the event of force majeure , the performance of any suspended obligation or duty will promptly recommence.

 

15.3         Notices .  All notices must be written and sent to the address or facsimile number identified below or in a subsequent notice.  All notices must be given (a) by personal delivery, with receipt acknowledged, (b) by facsimile followed by hard copy delivered by the methods under (c) or (d), (c) by prepaid certified or registered mail, return receipt requested, or (d) by prepaid recognized next business day delivery service.  Notices will be effective upon receipt or at a later date stated in the notice.

 

If to Manufacturer, to:

Lonza Ltd

 

Legal Department

 

Muenchensteinerstrasse 38

 

CH-4002 Basel

 

Switzerland

 

 

 

Facsimile number: +41 61 316 83 14

 

 

If to RADIUS, to:

Chief Financial Officer

 

Radius Health, Inc.

 

300 Technology Square, 5 th  Floor

 

Cambridge, MA 02139

 

15.4         Assignment .  This Agreement may not be assigned or otherwise transferred by either party without the prior written consent of the other party; provided , however , that RADIUS may, without such consent, but with notice to the Manufacturer, assign this Agreement, in whole or in part, (a) in connection with the transfer or sale of all or substantially all of its assets or the line of business or Product to which this Agreement relates, (b) to a successor entity or acquirer in the event of a merger, consolidation or change of control, (c) to any Affiliate, or (d) to any licensee of RADIUS’ rights to the relevant Product.  Any purported assignment in violation of the preceding sentence will be void.  Any permitted assignee will assume the rights and obligations of its assignor under this Agreement.

 

15.5         Entire Agreement .  This Agreement, including the attached Appendices and any fully-signed Work Orders, each of which are incorporated herein, constitute the entire agreement between the parties with respect to the specific subject matter hereof and all prior agreements

 

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with respect thereto are superseded.  Each party hereto confirms that it is not relying on any representations or warranties of the other party except as specifically set forth herein.

 

15.6         No Modification .  This Agreement and and/or any Work Order or Quality Agreement may be changed only by a writing signed by authorized representatives of both parties.

 

15.7         Severability; Reformation .  Each provision in this Agreement is independent and severable from the others, and no restriction will be rendered unenforceable because any other provision may be invalid or unenforceable in whole or in part.  If the scope of any restrictive provision in this Agreement is too broad to permit enforcement to its full extent, then such restriction will be reformed to the maximum extent permitted by law.

 

15.8         Governing Law .  This Agreement will be construed and interpreted and its performance governed by the laws of the State of New York, USA, without regard to any choice of law principle that would dictate the application of the law of another jurisdiction.  The application of the 1980 United Nations Convention on Contracts for the International Sale of Goods is hereby specifically excluded.

 

15.9         Arbitration .  Any dispute which may arise between the parties in relation to this Agreement shall be settled amicably between the parties.  If, contrary to expectation, no amicable settlement can be reached, both parties hereto agree to settle the dispute by arbitration in accordance with the rules and regulations of the International Chamber of Commerce.  The number of arbitrators shall be three, the seat of the arbitration shall be in New York, New York, USA and the language that the proceedings are held in shall be English.  The decision or award rendered by the arbitrator shall be final and non-appealable, and judgment may be entered upon it in any court of competent jurisdiction.

 

15.10       Waiver .  No waiver of any term, provision or condition of this Agreement in any one or more instances will be deemed to be or construed as a further or continuing waiver of any other term, provision or condition of this Agreement.  Any such waiver, extension or amendment will be evidenced by an instrument in writing executed by an officer authorized to execute waivers, extensions or amendments.

 

15.11       Counterparts .  This Agreement may be executed in any number of counterparts, each of which will be deemed an original and all of which together will constitute one and the same instrument.

 

15.12       Headings .  This Agreement contains headings only for convenience and the headings do not constitute or form a part of this Agreement, and should not be used in the construction of this Agreement.

 

15.13       No Benefit to Third Parties .  The representations, warranties, covenants and agreements set forth in this Agreement are for the sole benefit of the parties hereto and their successors and permitted assigns, and they will not be construed as conferring any rights on any other persons.

 

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IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their duly authorized representatives as of the date first above written.

 

RADIUS HEALTH, INC.

LONZA SALES LTD

 

 

 

 

 

 

 

 

 

 

By:

/s/ B.N. Harvey

 

By:

/s/ Daniel Burgin / Y. Kesch

 

 

 

 

 

Print Name:

B. Nicholas Harvey

 

Print Name:

Daniel Burgin / Y. Kesch

 

 

 

 

 

Title:

CPO

 

Title:

Director Director Sales & BD / legal counsel

 

 

 

 

 

Date:

October 16, 2007

 

Date:

October 9, 2007

 

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APPENDIX A

SAMPLE WORK ORDER

 

THIS WORK ORDER is by and between RADIUS HEALTH, INC. (“RADIUS”) and [FULL MANUFACTURER NAME] (“Manufacturer”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated [EFFECTIVE DATE OF AGREEMENT] (the “Agreement”).  Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.              API/Drug Substance and Product.

 

Describe the specific API/Drug Substance(s) and Product(s).

 

2.              Services.   Manufacturer will render to RADIUS the following Services:

 

Describe the specific Services to be conducted by Manufacturer (summarize) or attach Manufacturer’s proposal.  If Manufacturer Technology is to be incorporated in any Manufacturing Process, expressly indicate that here.

 

3.              Facilit(ies).   The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

Include alternate Facility address(es).

 

4.              RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

Describe specific materials being provided by RADIUS to Manufacturer.

 

5.              RADIUS Equipment.

 

Include any equipment that will be provided by RADIUS to Manufacturer to be used by Manufacturer in performance of the Services.

 

6.              Manufacturer Representative.        Name and Title

 

7.              RADIUS Representative.                   Name and Title

 

8.              Compensation.   The total compensation due Manufacturer for Services under this Work Order is INSERT WRITTEN AMOUNT (numerical amount) .  Such compensation will be paid INSERT PAYMENT SCHEDULE OR REFERENCE PROPOSAL .  RADIUS and Manufacturer must agree in advance of either party making any change in compensation.  Manufacturer will invoice RADIUS to the attention of INSERT NAME for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of date of invoice.

 

23



 

9.              [ Quality Agreement.   The provisions of the Quality Agreement, attached hereto as Attachment 1, are incorporated herein by reference.]

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

 

 

 

 

 

By:

 

 

By:

 

 

 

 

 

 

Print Name:

 

 

Print Name:

 

 

 

 

 

 

Title:

 

 

Title:

 

 

 

 

 

 

Date:

 

 

Date:

 

 

24


 

[Attachment 1]

 

 

 

Lonza

Radius - Lonza QUALITY AGREEMENT

 

Radius Health
300 Technology Square, 5th Floor
Cambridge, MA 02139 USA

 

and

 

Lonza Sales Ltd
Muenchensteinerstrasse 38
4002 Basel, Switzerland

 

1



 

Supplier’s & Client’s Name

 

Lonza Sales Ltd (“Supplier”) and Radius Health (“Client”) wish to define the individual responsibilities of the parties as to the quality aspects of manufacturing and release of Product as defined in Appendix 1 to ensure compliance with the approved Product application and/or Client requirements.

 

In order to do so, this Quality Agreement (“Quality Agreement”) takes the form, in part, of a detailed listing of activities associated with manufacture, supply, production, analysis, and release of Product. Unless otherwise indicated, responsibility for each activity is assigned to either Client, Supplier, or is assigned to both Supplier and Client.

 

In consideration of the parties’ agreement to perform the activities provided in this Quality Agreement and for other valuable consideration the receipt dad sufficiency of which is hereby acknowledged, and intending to be legally bound, Supplier and Client agree as provided in this Quality Agreement as follows:

 

2



 

1.                                       Effective Date

 

The Effective Date of this Quality Agreement shall be the date of last signature (the “Effective Date”).

 

2.                                       Scope

 

The purpose of this Quality Agreement between Supplier and Client is to formalize an agreement with regard to the quality responsibilities and activities between companies and is based on the quality procedures in place.

 

3.                                       Other Agreements

 

This Agreement is primarily a technical agreement, not a business agreement. Examples of some standard items excluded from this Agreement are: general business terms and conditions, pricing and escalator clauses, forecasting, delivery terms, confidentiality obligations, liability limitations and the protocol for resolution of disputes; which are described in the Development and Manufacturing Service Agreement as of 16 October 2007 (DMA). Therefore, if there are any inconsistencies between the DMSA and the Quality Agreement, the DMSA will take precedence over the Quality Agreement; except with respect to any specific quality issue that may adversely Regulatory Compliance or product quality and safety.

 

4.                                       Amendments to the Quality Agreement

 

This Quality Agreement may be amended by the written consent of both parties.  The parties agree to amend tees of this Qualify Agreement that must be amended in order that the Product continue to meet regulator y requirements of applicable regulatory agencies, as may exist from time to time.

 

If an amendment to this Quality Agreement is proposed, the proposing party will circulate the proposed amendment to the appropriate contact person at Supplier and Client for review and internal approval. The appropriate contact person at Supplier and Client is listed in Appendix 2 (Contacts and Responsibilities).

 

5.                                       Object of the Agreement

 

The provisions of this Agreement apply to all orders for the manufacture of drug products or other services provided by Supplier to Client after the Effective Date and prior to its termination in effect. This Agreement also applies to existing orders issued by CLIENT, which have not been completed at the date of signing.

 

6.                                       Subcontracting

 

As defined in Section 3.3 of the DMSA.

 

3



 

If client request the use of a specific subcontractor, the client remains fully responsible for the quality of the materials or services provided by subcontractors and for all commitments as agreed upon with this Quality Agreement.

 

7.                                       Survival Clause

 

All regulatory obligations contained herein that are required of either party or both parties by an applicable regulatory authority shall survive termination of this Quality Agreement.

 

8.                                       Assignment

 

As defined in Section 15.4 of the DMSA.

 

9.                                       Product Specifications

 

Changes to the agreed upon specifications must be mutually agreed upon and communicated in writing between the parties to this Quality Agreement via the Change Control process, except for applicable compendia changes which can be ;implemented without mutual agreement. Compendia changes must be implemented by the compendia implementation date.

 

10.                                Resolution of Quality Issues

 

Quality related disagreements between Supplier and Client that are not resolved in the normal course of business shall be brought to the attention of the appropriate contact person for notices at the Supplier and Client; in writing, as listed in Appendix 2 (Contacts and Responsibilities). If both parties agree that a resolution of the disagreement is reasonably possible, then both Supplier and Client shall agree to work jointly to develop a strategy for such resolution. Supplier and Client further Wee to record such resolution in writing.

 

11.                                Debarment

 

Supplier warrants and represents that it is not debarred under the Generic Drug Enforcement Act of 1992, 21 U.S.C. 335[a] (the “Generic Drug Enforcement Act”), and that it has not been convicted of a crime for which it could be debarred under the Generic Drug Enforcement Act. In connection with the Product, the Supplier further warrants and represents, in that it shall not use in any capacity the services of any person debarred under the Generic Drug Enforcement Act, or convicted of a crime for which a person can be debarred under the Generic Drug Enforcement Act.

 

12.                                Confidentiality

 

The contents of this Agreement and all information, representations, documents, etc. received from Supplier or its Affiliates are confidential in accordance with Section 10 of the DMSA.

 

4



 

13.                                Choice of Law: Jurisdiction/Miscellaneous

 

The applicable law shall be as defined in Section 15.8 of the DMSA. Any dispute shall be resolved in according to clause 15.9 of the DMSA.

 

All appendices to this Quality Agreement are attached hereto and incorporated herein by reference. In this Quality Agreement, unless the contrary intention appears: (a) the words “including” and “include” mean “including, but not limited to”;(b) the singular includes the plural and vice versa; (c) a reference to a person or entity (including Supplier or Client) includes a reference to the person’s executors, administrators, successors, substitutes and assigns; and (d) headings are for reference only and do not form part of this contract.

 

14.                                Manufacturing and Testing Locations

 

Product will be manufactured and tested at the following locations: Address:

 

Lonza Braine SA

Chaussée de Tubize 297

B-1420 Braine-l’Alleud, Belgium

 

SGS Laboratoires Simon s.a.

Vieux Chemin du Poète 10

B-1301 Wavre

Belgium

 

Any additional testing locations will go through Change Control process

 

15.                                Applicable GMP Standard

 

Supplier shall manufacture all products manufactured for Client (listed in Appendix 2) in compliance with current Good Manufacturing Practices (cGMP).

 

For the purposes of this agreement; cGMP shall mean the principles (i) described in the ICH Q7 and FDA CFR 21 Parts 11 and 211, and (ii) promulgated by any Governmental Authority having jurisdiction over the manufacture of all products manufactured for Client, in the form of laws or guidance documents, where the guidance documents are to be implemented within the pharmaceutical manufacturing industry for such products.

 

16.                                Certificate of Analysis / Conformance

 

The following documentation is required for batches of all products manufactured for Client shipped to or on behalf of Client:

 

·                                           Certificate of Analysis and Conformance for each batch, issued by the independent Quality Unit

 

5



 

·                                           Copies of investigation reports regarding quality incidents (Critical Deviations, OOS results, or similar), if applicable

 

The Certificates of Analysis and Conformance shall be dated and signed by a responsible person of Supplier’s Quality Unit, or it may be produced by a computer system which provides a degree of control equivalent to that given by a signature. The Certificate of Analysis states that the batch is suitable for release, and it must include — as a minimum —

 

·                                           Supplier name and address, (original manufacturing site),

·                                           BA058 API name and grade (if applicable),

·                                           Supplier batch/lot number,

·                                           Reference to the agreed specification,

·                                           Test parameters and corresponding specification requirements,

·                                           Test results (numerical, where applicable) for each chemical, physical or microbiological test performed,

·                                           Date of release and expiration or retest date of the all products manufactured for Client.

 

17.                                Change Control

 

Supplier shall have a documented and effective Change Control system in place and is required to provide advanced notification to Client of Major Changes to the process, specifications and analytical methods (API, intermediate, and raw materials), storage, labelling and primary packaging, which may have an in act on the quality of all products manufactured for Client, and/or on any regulatory applications related to all products manufactured for Client.

 

Principles:

 

·                                           All products manufactured for Client _produced -by a new process shall not be accepted unless the process change has first been reviewed and delivery approved by Client.

·                                           Change requests should be supported by appropriate technical documents to support the change and to confirm that technical performance has not been altered.

·                                           Modifications relating to specifications of product shall be processed according to Section 9 of this Agreements.

·                                           For those changes required to comply with applicable laws and regulatory agency requirements, Supplier shall notify Client of such requirements after Supplier becomes aware of the need for such change Client shall assess any change request received from Supplier in a timely manner. Unless there are justified scientific reasons to reject the change request, Client will not unreasonably withhold its approval of the request.

·                                           Client is responsible for the submission of all necessary change notifications to all competent authorities in full compliance with the applicable regulations, respectively.

·                                           Client will inform Supplier of the receipt of the necessary acknowledgement of the validity of the notification and, depending on the type of change, the acceptance or approval of the change by the competent authorities.

 

6



 

18.                                Right to Audit

 

Supplier shall allow Client representatives to carry out on-site audits by appointment. Supplier shall permit all reasonable access to the manufacturing, packaging, warehousing and laboratory areas related to the manufacture of the BA058 API, including pertinent documentation, during normal business hours on reasonable prior notice.

 

The results of the audit and the observation(s) shall be sent to Supplier by means of a written report. Supplier must ensure a satisfactory follow up to the observations made during the audit performed by Client, and take corrective actions mutually agreed upon by the parties.

 

The frequency of the audit shall depend upon the results of the audit and the quality performance of Supplier. In the absence of critical quality incidents the frequency shall be not more than once per year. If quality issues arise Client shall have the right to audit more frequently.

 

19.                                Authority Inspections

 

Supplier shall notify Client of all regulatory authority inspections that take place at the facility where product is manufactured or the testing laboratory where any of the associated testing is performed. If areas of concern exist which specifically involve any products manufactured for Client, Client should be notified prior to the inspection. In all other cases information on the results of the inspection is appropriate. Such notification will include;

 

·                                           Written notification of any observation, if any, that may impact the manufacture of any products manufactured for Client

·                                           Written notification of all related corrective actions and planned completion dates

·                                           Any further correspondence with the regulatory authority (if the manufacture of any products manufactured for Client is concerned)

 

20.                                Retention of samples (BA058 API)

 

Supplier will store retention samples, sufficient to perform at least two (2) full specification analyses, in containers that are equivalent to or more protective than the commercial packaging. Samples are to be retained for 5 years.:

 

Samples should be labelled with the following information:

 

·                                           Product name

·                                           Supplier batch/lot number

·                                           Date of manufacture

 

Supplier will make retention sample available to Client promptly upon Client’s justified request.

 

7


 

21.                                Stability

 

Supplier is responsible for performing process validation stability and commercial stability studies per ICH guidelines and Client requirements.

 

Supplier is responsible for generating stability protocols, methods and specifications. Client is responsible for approving stability protocols, methods and specifications.

 

Supplier will upon request or at least annually provide updated data from the stability program to Client.

 

Supplier will inform Client if there are any adverse trends that could impact on current retest date.

 

22.                                Complaints

 

All complaints related to any products manufactured for Client reported, regardless of source (e.g., consumers, doctors, pharmacists, sales representatives) will be handled by Client and communicated to Supplier.

 

Supplier is responsible for recording and investigating all quality-related complaints on any products manufactured for Client and will maintain the complete complaint database and complaint files.

 

Supplier will complete their investigation and respond to Client in writing to all complaints within one month of receipt.

 

A formal written report on the complaint detailing identifiable root causes and corrective and preventive actions where applicable shall be prepared by Supplier and sent to Client.

 

In case the investigation could not be finalized within 20 business days, Supplier will provide an interim report to Client.

 

Supplier is responsible for implementing a corrective action plan to correct any deficiencies identified during an investigation.

 

Client will make relevant information and samples of the affected product available to assist in the investigation of Supplier.

 

23.                                Recall

 

In the event that Supplier believes a recall of any products manufactured for Client maybe necessary or appropriate, Supplier `All immediately, i.e. within twenty-four (24) business hours, notify Client. The two parties will take joint decisions on the disposition of product or (if applicable) final drug product made thereof or user information, where required. Client is responsible for. the final decision and the coordination of any recalls or field alert activities.

 

8



 

Supplier shall provide any information required by Client relating to recall or field alert activities within two (2) business days of the request, if such information is readily available at Supplier.

 

Supplier will not initiate any notifications to health authorities concerning a (potential) nonconformance without the prior agreement of Client.

 

Supplier will collaborate, if needed, in any recall of a defective batch of any products manufactured for Client.

 

24.                                Storage and distribution

 

Supplier shall make commercially reasonable efforts to exclude, during packaging and storage of any products manufactured for Client, the possibility of deterioration, contamination, or mix-ups with any other material.

 

Supplier will send a Certificate of Analysis with each shipment of product.

 

Supplier will provide an up-to-date MSDS to Client with each shipment or at least on an annual basis.

 

25.                                BSE/TSE

 

Supplier shall provide to Client a BSE/TSE certificate for any products manufactured for Client listed in accordance with the EMEA Note for Guidance EMEA/410/01 (current revision). The certificate shall indicate if any products manufactured for Client is (are) of human or animal origin, and if materials of human or animal origin are used during the manufacturing process of any products manufactured for Client. An updated BSE/TSE certificate must be issued after any change to the manufacturing process which involves new raw materials or for raw materials that have been sourced from a different Supplier.

 

26.                                Raw materials

 

Supplier shall be responsible for the purchase, storage, handling, sampling, testing and approval or rejection of materials used in manufacturing any products manufactured for Client pursuant to this agreement, with the exception of any -Material supplied by Client. Supplier shall implement a vendor qualification program for evaluating the Suppliers of critical materials, with the only exception of materials supplied by Client. Supplier shall only purchase materials from qualified Suppliers.

 

Supplier must utilize documented maternal inspection, plans and testing procedures. The results of this inspection and testing must be in accordance with specifications filed by Client. Raw materials supplied by qualified vendors and those supplied by Client can be subject to reduced testing but a minimum ID testing (or visual examination in case of hazardous or highly toxic raw materials) needs to be performed for each delivery and each lot.

 

9



 

Supplier shall store and handle materials used in manufacturing any products manufactured for Client pursuant to his Agreement under appropriate conditions, consistent with cGMPs, all applicable laws, rules and regulations, and industry standards. Client shall inform Supplier on the storage conditions of any ‘aerial supplied to Supplier.

 

Supplier shall have all necessary and appropriate controls in place to prevent cross-contamination of the raw materials and intermediates used in the manufacture of any products manufactured for Client from other chemicals stored, used, or manufactured by Supplier, including but not limited to potent hormones, cytotoxic compounds, highly potent drugs or non-pharmaceutical chemicals.

 

27.                                Qualification / Validation

 

Equipment qualification, process validation, analytical methods validation and validation of computerized systems, if used, are in place and covered by Change Control. Validation documentation shall be available for review during an audit. On request, the Client will get copies or summaries from the process validation reports.

 

Development (Early clinical phase)

Supplier’s equipment qualification and Change Control process are in place. Verification of analytical methods for intended use (see Note).

 

Note: in case API lots will be used for clinical phase 3 studies, or prior to the validation campaign at the latest, the analytical methods should be validated according to ICH Q2 (RI) guidelines.

 

28.                                Reprocessing

 

Reprocessing shall be performed according to the current regulatory dossier and reported to Client. Reasons for reprocessing have to be investigated, and the results shall be communicated with Client.

 

Development:

Reprocessed batches have to be reported and agreed with the Client.

 

29.                                Reworking

 

Reworking is only possible after approval by Client.  Additional stability tests and analytical testing of reworked batches may be required.

 

Development:

Reworked batches have to be reported and approved by Client.  Reworking process could be part of the experience through process development.

 

10



 

30.                                Deviations / OOS (incl . stability)

 

Supplier must have a formal procedure for handling deviations as well as non-conforming laboratory test results (OOS results) that is in accordance with cGMP.

 

Supplier will notify Client promptly (target: within 3 business days) in the event of any Critical Deviation(s). A Critical Deviation is defined as a departure from an approved process step, process condition, test requirement, or other relevant parameter or item that must be controlled within predetermined criteria to ensure that the final Product meets its specification or established standard and that has an adverse impact on the final Product quality and/or stability and/or physical characteristics.

 

Client may participate in any investigation concerning the OOS results. Supplier will implement any agreed actions arising out of the completed investigation report in order to avoid the reoccurrence of similar issues in the future. In all cases, Supplier must investigate any confirmed OOS result and forward a copy of the completed investigation report to Client within a reasonable period of time. The investigation report will be maintained as part of the executed batch record.

 

For all confirmed OOS stability test results that indicate that any products manufactured for Client has (have) failed to remain within specifications, Supplier will notify and discuss with Client promptly (within 3 business days) and provide the stability data. The investigation report will be maintained as part of the stability report.

 

31.                                Labelling

 

Supplier shall comply with the requirements in ICH Q7 in relation to labelling, in particular:

 

·                                           Labelling operations shall be conducted to prevent mix ups,

·                                           Labels shall be checked for accuracy before application,

 

This agreement does not absolve Supplier from complying with any legal requirements in relation to the transportation of any products manufactured for Client.

 

32.                                Regulatory documents

 

Upon request by, and in mutual consultation with Client, Supplier shall be responsible for preparation of documentation on Manufacture of any products manufactured for Client as required for the Regulatory Submissions of Client, limited to Supplier’s activities under this agreement.

 

Client shall provide portions of Regulatory Submissions, related to any products manufactured by Supplier for Client and Supplier’s, activities performed under this agreement, to Supplier for review and written consent, prior to submission to any Regulatory Authority. Client shall, upon submission to any Regulatory Authority, provide Supplier with current copies of portions of

 

11



 

Regulatory Submissions. including amendments and supplements thereto, related to any products manufactured by Supplier for Client and Supplier’s activities performed under this agreement.

 

Supplier will provide, in mutually agreed timelines, all other information related to any products manufactured by Supplier for Client that Client may reasonably request for its Regulatory Submissions, including any data for annual reports (e.g. annual stability reports).

 

When a change is known to require, or has the potential to require a Regulatory Submission, Supplier with Client will develop a joint strategy to secure the appropriate regulatory approval prior to implementation of the change at Supplier and Client. For Change Control see section 3.

 

Supplier shall be responsible for preparation of the Drug Master File related to any products manufactured for Client and submission of such documents to any Regulatory Authority, including maintaining such submissions (hereafter altogether called ‘DMF’).

 

33.                                Product release

 

Supplier quality unit has the responsibility to review and approve the executed batch production records prior to batch release. Supplier has the responsibility to release any products manufactured by Supplier for Client for shipment to Client.

 

At the Client’s request, the executed batch production records will be sent to Client for review prior to batch disposition.

 

Supplier will not ship any products manufactured for Client to any destination, as identified by Client, until the product(s) manufactured for Client is or are released for shipment, unless prior written approval has been received from Client to perform such a shipment under quarantine.

 

Supplier is responsible for the issuance for each batch of product manufactured for Client a Certificate of Analysis and Certificate of Conformance (see also section 16).

 

34.                                Reference standards

 

All reference standards should be stored in accordance with the Suppliers recommended storage conditions and used within their given expiry or retest date.

 

Client is responsible for the purchase and certification of the reference standards.

 

Client shall provide to Supplier reasonable quantities of any non-compendial or not commercially available reference standards necessary to perform the tests included in product specifications.

 

35.                                Analytical methods

 

Analytical methods used for testing the API(s): compendial analytical methods must be verified and all others must be validated prior to use

 

12


 

Development (early clinical phase)

Supplier provides verification of analytical methods for intended use (see Note).

Note: in case API lots will be used for clinical phase 3 studies, or prior to the validation campaign at the latest, the analytical methods should be validated according to ICH Q2 (R1) guidelines.

 

Any significant changes to these analytical methods must be approved by the Client via a formal Change Control system.

 

36.                                Manufacturing

 

Supplier shall have appropriate control procedures in place to ensure that only authorised personnel has access to Supplier’s manufacturing facilities.

 

37.                                Division of Responsibilities Table

 

§

 

Responsibilities

 

Not
Applicable

 

Client

 

Supplier

1.

 

General Provisions

 

 

 

 

 

 

1.01

 

Follow applicable current Good Manufacturing Practices (cGMPs), including International Conference on Harmonization (ICH) Q7 Good Manufacturing Practice Guidance for Active Pharmaceutical Ingredients (API)) and locally imposed requirements.

 

 

 

 

 

X

1.02

 

Manufacture, package, ship, store and test the Product and materials in an environment meeting the applicable GMP regulations, which is designed, constructed and maintained in a manner that a) permits the operation therein to be performed under clean, sanitary and orderly conditions; b) permits the effective cleaning of pertinent surfaces; and c) prevents the contamination of the Product and the addition of extraneous material to the Product.

 

 

 

 

 

X

1.03

 

Manufacture the Product in adherence to applicable regulatory submissions, such as Drug Master File (DMF), if applicable.

 

 

 

 

 

X

1.04

 

Operate in compliance with applicable environmental,

occupational health and safety laws and regulations.

 

 

 

 

 

X

2.

 

Organization and Personnel

 

 

 

 

 

 

2.01

 

Implement procedures and/or documented training to meet obligations under this Agreement

 

 

 

 

 

X

2.02

 

There shall be a quality control unit that shall have the responsibility and authority to approve or reject all components, drug product containing, closures, in-process materials, packaging material labeling, and drug products, and the authority to review production records to assure that no errors have occurred or if errors have occurred, that they have been full investigated.  The quality control unit shall be responsible for approving or rejecting drug products manufactured, processed, packed, or held under contract by another company.

 

 

 

 

 

X

 

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2.03

 

The responsibilities and procedures applicable to the quality control unit shall be in writing; such written procedures shall be followed.

 

 

 

 

 

X

2.04

 

Maintain a quality unit that is independent of production that fulfils both quality assurance and quality control responsibilities.

 

 

 

 

 

X

2.05

 

Involve the quality unit in all quality related matters and have them review and approve all quality critical related documents.

 

 

 

 

 

X

2.06

 

As it relates to this Quality Agreement, notify the other party of name change, corporate reorganization, consolidation, merger or acquisition or sale of the party’s company. Notify other party of key personnel changes.

 

 

 

 

 

X

3.

 

Facilities and Equipment

 

 

 

 

 

 

3.01

 

Ensure that facilities, equipment and systems, pertaining to the product(s) outlined in this Agreement, are qualified and maintained compliant to cGMP regulations.

 

 

 

 

 

X

3.02

 

Sharing information on toxicity of API and raw materials, process aids and intermediates, if available

 

 

 

X

 

X

3.03

 

Establishing solubility of API and intermediates in cleaning agent used

 

 

 

 

 

X

3.04

 

Assessing/verifying cleanliness of used equipment

 

 

 

 

 

X

3.05

 

Releasing equipment after cleaning

 

 

 

 

 

X

4.

 

Production and In Process Controls, Packaging and Labelling

 

 

 

 

 

 

4.01

 

Procure, test as required, and release raw materials and packaging and labelling materials used in manufacture of Product.

 

 

 

X

 

X

4.02

 

Establish and document specifications for raw materials- Product labelling and packaging materials and other materials that would likely affect product quality.

 

 

 

X

 

X

4.03

 

Prepare/develop master batch production records in accordance with applicable cGMP requirements or guidelines, as applicable for lifecycle of product.

 

it

 

 

 

X

4.04

 

Review and approval of all master batch documentation.

 

 

 

 

 

X

4.05

 

Inspect, weigh and measure raw materials used for Product manufacturing and verify critical weighing by a second individual or validated automated system.

 

 

 

 

 

X

4.06

 

Manufacture Product in ?Mariner that prevents contamination by other materials including carryovers.

 

 

 

 

 

X

4.07

 

Provide product label to include: name and address of the manufacturer, identifying code, batch number, quantity of contents, storage and special transport conditions if applicable, the retest or expiry date and any special requirements. Revise label per Change Control as necessary.

 

 

 

 

 

X

4.08

 

Review and approval of batch production records by quality unit prior to batch release.

 

 

 

 

 

X

4.09

 

Release Product by quality unit for shipment to the client.

 

 

 

 

 

X

4.09
bis

 

Deciding on final disposition of API

 

 

 

X

 

 

4.10

 

Provide label for intermediates, samples, and waste. Revise label per SOP as necessary.

 

 

 

 

 

X

4.11

 

Specifying packaging material for API

 

 

 

X

 

X

 

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4.12

 

Specifying packaging material for materials before the API, if needed

 

 

 

 

 

X

4.13

 

Purchasing packaging material

 

 

 

 

 

X

5.

 

Documentation and Records

 

 

 

 

 

 

5.01

 

Have a controlled system to initiate, review, revise, approve, obsolete and archive all Good Manufacturing Practices documentation. At a minimum, all production, control, and distribution records should be retained for at least 1 year after the expiry date of the batch. For APIs with retest dates, records should be retained for at least 3 years after the batch is completely distributed.

 

 

 

 

 

X

5.02

 

Have written procedures for the review and approval of all batch documentation.

 

 

 

 

 

X

5.03

 

Maintain a document control system for specifications and test methods, including: raw materials, Product labeling, packaging materials and other materials that would likely affect product quality.

 

 

 

 

 

X

5.04

 

Review and approval of specifications and test methods, including: Product labeling, packaging materials and other materials that would likely affect product quality.

 

 

 

X

 

X

5.05

 

Provide a complete Certificate of Analysis for the Product, containing “at minimum” the following information:

Supplier Product number

Supplier lot/batch number.

Name of Product

Name of the tests Specification limit

Expiration or retest date, if applicable

Test result (as a numerical value, unless designated

Pass/Fail in the specification limit, statistical values can be used if data supports their use except for assays and impurity tests), including retest results if required

Quality Assurance approval and date.

Manufacturing Site (name and address)

Manufacturing Date

 

 

 

 

 

X

5.06

 

Provide certification that the Product was manufactured in a cGMP compliant facility and was tested in accordance with and meets specifications

 

 

 

 

 

X

5.07

 

Where applicable, electronic  signatures used on the certificate of analysis or other controlled documents should be authenticated and secure.

 

 

 

 

 

X

5.08

 

Archiving the original documents

 

 

 

 

 

X

6.

 

Change Control

 

 

 

 

 

 

6.01

 

Have established written procedures for control of changes impacting the Product including manufacturing components or process, computer hardware/software, Product specifications, test methods, vendors, and subcontractors, if applicable.

 

 

 

 

 

X

6.02

 

Notify Client within a reasonable time of intent to make Major changes that could impact the identity, strength, safety, potency, stability, purity, or regulatory status prior to implementation of the change.

 

 

 

 

 

X

6.03

 

Issue to Client a written evaluation of the Major Change including change justification so that Client can determine the

 

 

 

 

 

X

 

15



 

 

 

impact of use of Product in Client’s finished product.

 

 

 

 

 

 

6.04

 

Have Major Changes reviewed and approved by the Supplier’s quality unit.

 

 

 

 

 

X

6.05

 

Jointly establish a strategy to secure regulatory approvals for Major Changes, as necessary.

 

 

 

X

 

X

7.

 

Deviations

 

 

 

 

 

 

7.01

 

Have procedures for the identification, investigation, and reporting of each departure from an approved instruction or established standard (deviations) and Out-of-Specification (OOS) results that occur during the manufacture and testing of the Product.

 

 

 

 

 

X

7.02

 

Document and explain all deviations. Investigate OOS results and Critical Deviations. Extend the investigation to other lots that may have been associated with the failure as appropriate. Include preventive actions and track these to completion.

 

 

 

 

 

X

7.03

 

Evaluate deviations to determine their impact on the predetermined criteria that ensure the Product meets its g- specification or applicable validation/qualification study.

 

 

 

 

 

X

7.04

 

Issuing notifications on atypical results on stability (e.g.. 00E) to Client within 3 business days of occurrence

 

 

 

 

 

X

7.05

 

Issuing reports on OOS, Critical Deviations, failures to Client within 3 business days of occurrence

 

 

 

 

 

X

8.

 

Reprocess and Batch Adjustments /Rework/Retest

 

 

 

 

 

 

8.01

 

Have procedures for batch adjustments and reprocessing, if applicable. Reprocessing is defined as introducing an intermediate or API, including one that does not conform to standards or specifications, back into the process and repeating a crystallization step or other appropriate chemical or physical manipulation steps (e.g. distillation, filtration, chromatography. and milling) that are part of the manufacturing process.

 

 

 

 

 

X

8.02

 

Will not blend Out of Specification batches with other batches for the purpose of meeting specifications.

 

 

 

 

 

X

8.03

 

Have a protocol for Product requiring rework describing the rationale and justification for rework for approved filed rework processes, if applicable. Rework is defined as subjecting an intermediate or API that does not conform to standards or specifications to one or more processing steps that are different from the established manufacturing process to obtain an acceptable quality intermediate or API (e.g. recrystallizing with a different solvent).

 

 

 

 

 

X

8.04

 

Receive written approval by Client for rework outside of approved filed rework processes.

 

 

 

 

 

X

8.05

 

Will not perform recovery of materials and/or solvents unless approved procedures and specifications are in place.

 

 

 

 

 

X

9.

 

Laboratory Controls

 

 

 

 

 

 

9.01

 

Have written procedures for sample management, testing, approval, disposition, recording, storage, retention and disposal of laboratory data.

 

 

 

 

 

X

9.02

 

Retain samples as required by regulatory agencies.

 

 

 

 

 

X

9.03

 

Have written procedures and appropriately document the preparation, use and management of reagents, solutions, and

 

 

 

 

 

X

 

16



 

 

 

standards.

 

 

 

 

 

 

9.04

 

Have appropriate specifications and test procedures for the Product which are consistent with the applicable approved  filing and/or compendia) monograph.

 

 

 

X

 

X

9.05

 

Test Product in accordance with approved validated or qualified methods and specifications using calibrated equipment.

 

 

 

 

 

X

9.06

 

Have a program for qualification, calibration, and preventive maintenance of all analytical equipment.

 

 

 

 

 

X

9.07

 

Responsible for analytical method development, qualification and or validation as appropriate.

 

 

 

X

 

X

9.08

 

Responsible for transferring any developed methods to Supplier.

 

 

 

X

 

 

9.09

 

Providing development reports, test procedures, validation documents, etc and other source documents

 

 

 

X

 

X

9.10

 

If commercially available reference standards are not’- available, reference standards for the Product ‘will be provided.

 

 

 

X

 

X

10.

 

Storage and Distribution

 

 

 

 

 

 

10.01

 

Maintain storage facilities appropriate for conditions specified on the Product label. Maintain records of any critical storage conditions.

 

 

 

 

 

X

10.02

 

Have systems for controlling quarantined, rejected or recalled materials.

 

 

 

 

 

X

10.03

 

Provide Material Safety Data Sheets or equivalent.

 

 

 

X

 

 

10.04

 

Notify Client in a timely manner if Supplier finds a quality issue post Supplier release/shipment.

 

 

 

 

 

X

10.05

 

Storing API under labelled conditions

 

 

 

 

 

X

10.06

 

Qualifying of carrier

 

 

 

X

 

X

10.07

 

Preparing API for dispatch and loading of vehicles

 

 

 

 

 

X

10.08

 

Maintaining storage conditions during transportation until agreed transition point

 

 

 

X

 

X

11.

 

Complaints

 

 

 

 

 

 

11.01

 

Have written procedures in place to document, investigate, and respond to all quality related complaints.

 

 

 

 

 

X

11.02

 

Assist in investigations as reasonably requested by Client for complaints associated with Product.

 

 

 

X

 

X

11.03

 

Retain complaint investigation records and evaluate trends and severity. Implement corrective and preventive actions as necessary.

 

 

 

 

 

X

11.04

 

Implementing corrective actions, if necessary

 

 

 

 

 

X

11.05

 

Responding to external customers

 

 

 

X

 

 

11.06

 

Clarifying root cause

 

 

 

X

 

X

11.07

 

Storing or disposing returned product

 

 

 

 

 

X

12.

 

Recalls

 

 

 

 

 

 

12.01

 

In the event that either Client or Supplier determines that an event or circumstance has occurred relating to the manufacture or stability of the Product which may result in the need for a recall, stock recovery or market withdrawal of Client’s finished drug product, Supplier and Client shall consult with each other in a timely manner. The final decision to recall any of the Client’s drug products shall be made by

 

 

 

X

 

 

 

17



 

 

 

Client.

 

 

 

 

 

 

12.02

 

Notification of the recall or similar action to the authorities, distributors and customers of the finished drug product shall be made by Client

 

 

 

X

 

X

12.03

 

Supplier will have procedures in place to facilitate the recall of an API as necessary. Supplier will provide assistance to the Client for the recall of drug product incorporating the Supplier’s API.

 

 

 

 

 

X

13.

 

Annual Product Reviews

 

 

 

 

 

 

13.01

 

Have procedures to conduct and document annual product reviews, if applicable.

 

 

 

 

 

X

13.02

 

Allow viewing of the Annual Product Review APR) for  the Product during an on-site audit.

 

 

 

 

 

X

14.

 

Stability

 

 

 

 

 

 

14.01

 

Maintain a documented, ongoing stability program to monitor the stability of the Product using stability indicating procedures.

 

 

 

 

 

X

14.02

 

Data analysis and trending reporting will be performed.

 

 

 

 

 

X

14.03

 

OOS notification to Client will be provided in a timely manner.

 

 

 

 

 

X

14.04

 

Use data to confirm appropriateness of storage conditions and retest or expiry date:,

 

 

 

 

 

X

14.05

 

Store stability samples in commercial size and/or simulated market containers under ICH storage conditions.

 

 

 

 

 

X

14.06

 

Place the first three commercial production batches and at least one batch per year (if a batch is produced in the year) on stability or as required by applicable regulatory agencies.

 

 

 

 

 

X

14.07

 

Preparing stability protocols

 

 

 

 

 

X

14.08

 

Approving stability protocols

 

 

 

X

 

X

15.

 

Validation/Qualification

 

 

 

 

 

 

15.01

 

Determine according to Product lifecycle and guidance documents when process validation is required.

 

 

 

 

 

X

15.02

 

Have a written master validation/qualification plan for the facilities, equipment/instruments, manufacturing process, cleaning procedures, analytical procedures, in process control tests and computerized systems as appropriate. These to be approved by the quality unit.

 

 

 

 

 

X

15.03

 

Responsible for developing, preparing and maintaining validation documentation approved by the quality unit, including protocols, reports and associated documentation.

 

 

 

 

 

X

15.04

 

Qualify as necessary all critical systems and equipment used for the manufacture and control of Product (Installation Qualification (IQ), Operational Qualification (OQ), and/or Performance Qualification (PQ)).

 

 

 

 

 

X

15.04

 

Allow viewing of the validation documentation for the Product during an onsite audit.

 

 

 

X

 

X

16.

 

Right to Audit

 

 

 

 

 

 

16.01

 

Client has the right to audit Supplier’s facilities and systems and review documents as they relate to the manufacture of Product. Such inspections and document review shall be conducted by Client at a time, date and duration mutually agreeable to the Supplier and Client and subject to Client

 

 

 

X

 

 

 

18



 

 

 

signature of a separate confidentiality agreement with the Supplier entity owning the production site.

 

 

 

 

 

 

16.02

 

Client retains the right to conduct reasonable “for cause” audits.  Specific goals/scope of the audit, proposed dates and names of the auditors will be agreed upon mutually by the Client and the Supplier.

 

 

 

X

 

 

16.03

 

Issue Supplier a confidential audit report summarizing audit observations within 30 days of audit.

 

 

 

X

 

 

16.04

 

Issue responses to all observations documented in the issued audit report in writing to Client Quality Assurance within 30 days of receipt of the report.

 

 

 

 

 

X

16.05

 

Maintain internal GMP audit program.

 

 

 

X

 

X

16.06

 

Maintain external GMP audit program for Suppliers of raw materials and components, or other suitable qualification program.

 

 

 

X

 

X

17.

 

Regulatory Inspections and Exchanges

 

 

 

 

 

 

17.01

 

Notify Client within three business days of the receipt of a Regulatory Authority inspection report, deficiency letter or written regulatory  compliance observation, which contains any significant adverse findings that relate to the Product or the facilities used to produce, test or warehouse the Product sold to Client. A significant adverse finding is herein defined as the following: conditions, practices, or processes that adversely affect or may potentially adversely affect product or service quality and/or the rights, safety or well being of subjects/patients and/or the quality and integrity of data, documentation, or other materials or information addressed in the inspection.

 

 

 

 

 

X

17.02

 

Provide copies of the inspection report, deficiency letter or written regulatory compliance observation that relate to the Product or the facilities used to produce, test or warehouse the Product sold to Client. This shall be edited to exclude

Supplier or other Client’s proprietary information or a complete summary report containing the description of the adverse finding as stated in the inspection report, deficiency letter or regulatory compliance observation to Client by facsimile or electronically within five (5) business days of the receipt of the inspection report.

 

 

 

 

 

X

18.

 

Regulatory Filings and Regulatory Status

 

 

 

 

 

 

18.01

 

Responsible for submission, maintenance, approvals and updates/amendments to regulatory filings for Product (including API DMF). Client will be notified as per FDA or EU requirements.

 

 

 

 

 

X

18.02

 

Responsible for providing to the agencies all requested documentation/data required for regulatory filings.

 

 

 

X

 

X

18.03

 

Responsible for communicating to the other party approvals, deficiencies or rejections by agencies regarding submissions, amendments or updates.

 

 

 

X

 

X

18.04

 

Responsible for submission and maintenance of drug product registration and current site registration and obtaining labeler code as required by regulatory agencies.

 

 

 

 

 

X

18.05

 

Client shall provide Supplier with the following information regarding the use of the product:

 

 

 

X

 

 

 

19



 

 

 

Clinical phase of development of the drug product that Product is used in and any change regarding this status Intended use of the drug product in which that Product is used Regulatory agencies with which the drug product is filed and if Product is included in the filing.

 

 

 

 

 

 

18.06

 

Notify Supplier if Supplier will be name in any governmental filing prior to such filing being made.

 

 

 

X

 

 

18.07

 

Coordinate the activities necessary to ensure readiness prior to Regulatory Agency Pre-Approval Inspection (PAI).

 

 

 

X

 

X

18.08

 

Provide Letter of Authorization for Client to permit reference to Supplier submissions in the registration of the Client’s drug product.

 

 

 

 

 

X

19.

 

Animal Derived Materials:

 

 

 

 

 

 

19.01

 

Evaluate and control the risk of Transmissible Spongiform Encephalopathy (TSE) for raw Materials and components. Maintain appropriate records for each lot of animal derived material to ensure traceability. Where required by local regulations, Supplier will assure that the country of origin or slaughtering information (either or both, which ever can be obtained from the manufacturer) will be documented and provided to Client.

 

 

 

 

 

X

 

20


 

Glossary

 

Active Pharmaceutical Ingredient (API) — Any API or mixture of APIs, intended to be used in the manufacture of a drug (or: medicinal) product and that, when used in the production of a drug, becomes an active ingredient of the drug product. Such APIs are intended to furnish pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment or prevention of disease or to affect the structure or any function of the body of man or animals.

 

Business day — Any day of the week, other than Saturday, Sunday, or day on which the party required to take action is regularly closed for business, i.e., Monday to Friday (European working hours) except any official national or regional bank holidays or shut down of the plant.

 

CEP — A certificate issued by the European Directorate for the Quality of Medicines which demonstrates that the Product complies with the requirements of the European Pharmacopoeia monograph and / or Transmissible Spongiform Encephalopathy (TSE) requirements. Also known as “CoS” = Certificate of Suitability.

 

Certificate of Analysis — A document identified as such, provided by the Supplier signed by its Responsible Person, or produced by a computer system which provides a degree of control equivalent to that given by a signature, which sets forth the analytical test results, obtained from testing of a representative sample, against the specifications for the batch to be delivered.

 

Certificate of Conformance   — A document identified as such, provided by the Supplier and signed by a nominated representative of its Quality Unit; or produced by a computer system which provides a degree of control equivalent to that given by a signature, which certifies that each batch of Product was produced and -tested in compliance with the agreed specifications, cGMP, and the relevant pharmacopoeial monographs, as applicable.

 

Contract — Business agreement for supply of goods or performance of work at a specified price.

 

Contract Manufacture — Performance of some aspect of manufacture, under a contract, on behalf of the original manufacturer.

 

Client — The company or organisation receiving the product (API or intermediate) once it has left the control of the Supplier; includes users and distributors.

 

Critical Deviation — Departure from an approved process step, process condition, test requirement, or other relevant parameter or item that must be controlled within predetermined criteria to ensure that the API meets its specification or established standard and has an adverse impact on the final Product quality and/or stability and/or physical characteristics.

 

Distributor — Any party in the distribution/supply chain starting from the point at which an API or intermediate is transferred outside the control of the original manufacturer’s material management system including parties involved in trade and distribution, such as (re)processors,

 

21



 

(re)packagers, transport and warehousing companies, forwarding agents, brokers, traders, and Suppliers other than the original manufacturer.

 

DMF — Drug Master File. The Supplier’s dossier for providing confidential information to a regulatory authority about facilities, processes, or articles relating to product used in the manufacturing, processing, packaging, and storing of one or more drug (or: medicinal) products.

 

GMP — Good Manufacturing Practice. Requirements for the Quality System under which drug (or: medicinal) products and their (active) ingredients are manufactured. Current Good Manufacturing Practice (cGMP) is the applicable term in the United States. For the purposes of this guideline, the terms GMP and cGMP are equivalent.

 

Immediately — Generally no more than twenty-four (24) business hours. This period may be exceeded due to events or circumstances beyond the reasonable control of the responsible party.

 

Laws — All laws, statutes, rules, regulations (including, without limitation, cGMPs, NDA regulations, and other relevant provisions enforced by any applicable governmental authority), ordinances and other pronouncements having the binding effect of law of any governmental authority.

 

Major Changes — Changes to a process step, process condition, test requirement, or other relevant parameter or item that must be controlled within predetermined criteria to ensure that the API meets its specification or established standard that could impact the identity, strength, safety, potency, stability, purity, and/or regulatory status.

 

Manufacturing License — With respect to a country, any regulatory authorisation required to manufacture one or more products or classes of product as granted by the relevant governmental authority.

 

Non-conformance — Departure of a quality characteristic from its intended level or state such as to cause an associated material or activity not to comply with its specification, cGMP, marketing authorisation or applicable law.

 

Original Manufacturer — Person or company manufacturing a material to the stage at which it is designated as a pharmaceutical starting material.

 

Product Quality Review — The PQR is an assessment to verify the operational consistency of a process based on results trending and non-conformances.

 

Promptly — Generally no more than three (3) -business days. This period may be exceeded due to events or circumstances beyond the reasonable control of the responsible party.

 

Quality Agreement — A legally binding agreement that is mutually negotiated and concluded between (the Quality Departments of) API manufacturers and their customers. It is intended to define, in a formalised manner responsibilities relative to quality tasks to assure the manufacture, supply and use of safe in aerials acceptable for pharmaceutical use It may also include

 

22



 

commitments between the parties regarding (a) the provision of information, documents, or samples, and (b) communication and notification rules including contacts.

 

Quality Incident — An incident relating to an issue or defect which is not necessarily detected by the specification parameters but which potentially could result in a non-conformance. A “critical” quality incident is relating to a defect or fault that makes a product unsuitable for use and which could potentially result in a recall, retrieval or withdrawal.

 

Record — Document stating results obtained and/or providing evidence of activities performed. The medium may be paper, magnetic, electronic or optical, photography etc. or a combination thereof.

 

Responsible Person — The person(s) within the Quality Unit at the Supplier who is accountable for the release of batches of product.

 

Sample — A part or parts of the product taken to show the quality of the whole.

 

Site — A location where the API or intermediate manufactured. This may be any operational area within the Supplier’s facility referred to in the section “Parties to the agreement” of the Quality Agreement (see chapter 5.2, I.1 of this guideline), or at a remote facility that may be the facility of an affiliate of the Supplier or a sub-contractor.

 

Sub-Contractor — A third party contractor, engaged and qualified by the Supplier to perform any part of the Supplier’s cGMP obligations under the License, Supply or Quality Agreements.

 

Supplier — Person or company providing APIs or intermediates on request. Suppliers may be (original) manufacturers or distributors.

 

Supply chain — For the purpose of this guideline, supply chain is defined as all steps in the entire chain of distribution starting from the point at which an API or intermediate is transferred outside the control of the original manufacturer’s material a management system downstream to the final user(s).

 

Timely manner — As soon as can be expected considering the typical operations and processes at manufacturers, the defined responsibilities and the agreed communication pathways. A “reasonable period of time” is considered as practically synonymous. The exact period of time depends on the respective subject.

 

User — A party who utilises an API in the manufacture of a drug product or an intermediate in the manufacture of an API.

 

23



 

Appendices:

 

1.                                       List of Products manufactured by Supplier for Client

 

2.                                       List of Key Contacts

 

3.                                       Product Specifications

 

4.                                       Examples of Changes that do not require notification

 

5.                                       Examples of OOS/Critical Deviations

 

24



 

Appendix 1:

 

List of Products manufactured by Supplier for Client:

 

BA058 API

 

25



 

Appendix 2:

 

List of Key Contacts:

 

Client

 

Supplier

 

 

 

J. Guerriero

 

F. Mutterer

 

 

 

L. O’Dea

 

P. Loosen

 

26



 

Appendix 4:

 

Examples of Changes that Do Not Require Notification (not intended to be all inclusive)

 

Editorial changes to procedures, batch records, or manufacturing/testing procedures, which are of a typographical, grammatical/presentation updates or which provide additional detail/clarity in describing an existing established practice.

 

Environmental control changes, which do not affect the processes, product or service (e.g., changes in sample frequency or locations)

 

Safety changes, which do not affect the process, product or services.

 

Like-for-like changes to equipment or parts. Like-for-like changes are those that use the same replacement part from the same Supplier or parts from a different Supplier, but which are deemed and documented by the user to be identical in functionality and performance.

 

New procedures that are created to document an existing established practice, provided that the new details are in accordance with the process as described in the master batch record.

 

Routine and preventative maintenance updates that do not have an associated change to an operating parameter.

 

27



 

Appendix 5:

 

Examples of Examples of OOS/ Critical Deviations that Require Notification (not intended to be all inclusive)

 

Any manufacturing, holding, packaging, labelling, sampling or testing OOS/deviation that may affect the quality, safety, purity, or integrity of the product.

 

Any reprocessing, reworking or process amendments.

 

Any aberrant result, including yields and analytical test results.

 

Any physical contamination, cross-contamination, chemicalor microbiological contamination of the product or processes.

 

Critical departures from the master batch record, validation, analytical methods, or stability.

 

Equipment failure / calibration failure only if impact or the product quality.

 

28



 

Done in two (2) original copies, each party having received its copy.

 

 

Company Approval

 

It has been approved by:

 

RADIUS

 

 

Signed:

 

Date:

 

 

 

 

 

 

/s/ Nick Harvey

 

 

Dec. 13, 2010

 

Nick Harvey

 

 

 

CFO

 

 

 

 

 

 

 

 

 

 

 

Signed:

 

Date:

 

 

 

 

 

 

/s/ Louis O’Dea

 

 

Dec. 15, 2010

 

Louis O’Dea

 

 

 

CMO

 

 

 

 

 

 

 

 

 

 

LONZA

 

 

 

 

 

 

Signed:

 

Date:

 

 

 

 

 

 

/s/ Frederique Mutterer

 

 

Dec. 21, 2010

 

Frederique Mutterer

 

 

 

Head of Quality Assurance and Regulatory Affairs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signed:

 

Date:

 

 

 

 

 

 

/s/ Patrick Loosen

 

 

Dec. 21, 2010

 

Patrick Loosen

 

 

 

General Manager Head of Operations

 

 

 

29


 

AMENDMENT NO. 1

 

to

 

DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT

 

This Amendment No. 1 to the DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT is entered into on May 19, 2011 by and between Radius Health Inc., a Delaware Corporation, with its principal office at 201 Broadway — 6 th  floor, Cambridge, MA 02139, United States of America (“RADIUS”), and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinertrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “Manufacturer”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “Agreement”).  Capitalized terms in this Amendment will have the same meanings as set forth in the Agreement, as amended to date.

 

WHEREAS

 

RADIUS and Manufacturer have agreed to amend the Agreement with respect to its term.

 

NOW, THEREFORE, IT IS AGREED AS FOLLOWS:

 

According to Article 14.1 of the Agreement, RADIUS wishes to extend the term of the Agreement for an additional two (2) year period effective April 4, 2011.

 

All other terms and conditions of the Agreement will apply to this Amendment and shall remain in full force and effect.

 

AMENDMENT AGREED TO AND ACCEPTED BY:

 

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

 

 

 

 

 

 

 

By

/s/ B.N. Harvey

 

By

/s/ John Eley

 

/s/ Oliv Brunner

Print Name

B.N. Harvey

 

Print Name

John Eley

 

Oliv Brunner

Title

CFO

 

Title

Legal Counsel

 

Legal Counsel

Date

 

 

Date

20 May 11

 

 

 


 

AMENDMENT NO. 2

TO

DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT

 

This Amendment No. 2 (the “ Amendment ”) to the DEVELOPMENT AND MANUFACTURING SERVICES AGREEMENT is entered into on January 30, 2014 by and between Radius Health Inc., a Delaware corporation, with its principal office at 201 Broadway — 6 th  floor, Cambridge, MA 02139, United States of America (“RADIUS”), and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “Manufacturer”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “Original Agreement”), as amended to date.  Capitalized terms in this Amendment will have the same meanings as set forth in the Agreement, as amended to date.

 

WHEREAS , RADIUS and Manufacturer are parties to the Original Agreement; and

 

WHEREAS , RADIUS and Manufacturer are parties to Amendment No. 1, entered into on May 19, 2011, to the Original Agreement (such Amendment No. 1 together with the Original Agreement, the “Agreement”); and

 

WHEREAS , the Parties desire to further amend the Agreement as set forth herein.

 

NOW THEREFORE , in consideration of the above premises and the mutual covenants herein set forth, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties hereto agree as follows:

 

1.                                       Amendment to Section 14.1 .  The Parties hereby agree to extend the term of the Agreement to December 31, 2015, unless earlier terminated pursuant to Section 14 of the Agreement.  Any further extensions of the term shall be mutually agreed by the Parties.

 

2.                                       Ratification .  All lawful actions taken by RADIUS and Manufacturer which are consistent with the terms of the Agreement are hereby authorized, approved and ratified, regardless of whether any such actions were taken prior to the date of this Amendment.

 

3.                                       Remainder of Agreement .  Except as modified by this Amendment, all other terms and provisions of the Agreement shall remain in full force and effect in accordance with their terms.

 

4.                                       Entire Agreement .  This Amendment and the Agreement supersede all other prior agreements, understandings, representations and warranties, oral or written between the parties hereto in respect of the subject matter hereof.

 

5.                                       Governing Law; Jurisdiction .  This Amendment shall be construed, interpreted and enforced in accordance with the internal substantive laws of the State of New York, without reference to the choice of law doctrine of such state.

 

1



 

6.                                       Counterparts; Delivery .  This Amendment may be executed in any number of counterparts, each of which shall for all purposes be deemed an original and all of which shall constitute the same instrument.  Delivery of an executed signature page of this Amendment by facsimile or other electronic transmission shall be as effective as delivery of an original executed counterpart of this Amendment.

 

[Remainder of Page Intentionally Left Blank]

 



 

IN WITNESS WHEREOF , the parties hereto have caused this Amendment to be executed by their respective authorized representatives effective as of the date first above written.

 

 

LONZA SALES LTD

RADIUS HEALTH, INC.

 

 

 

 

 

By:

/s/ Sven Frie

 

By:

/s/ B.N. Harvey

 

 

 

 

 

Name:

Sven Frie

 

Name:

B.N. Harvey

 

 

 

 

 

Title:

Head of Business Dev.

 

Title:

CFO

 

 

 

 

 

 

 

 

 

 

By:

/s/ Nadia Zieger

 

 

 

 

 

 

 

 

Name:

Nadi Zieger

 

 

 

 

 

 

 

 

Title:

Legal Counsel

 

 

 

 


 

WORK ORDER NO. 2*

 

THIS WORK ORDER NO. 2 is by and between RADIUS HEALTH, INC. (“RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “Manufacturer”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “Agreement”).  Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.              API/Drug Substance and Product.

 

BA058

 

Nomenclature :   Chemical Name:  Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-GlyLys-Ser-IIc-GIn-Asp-Leu-Arg-Arg-GIu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH 2  [Glu 22,25 , Leu 23,28,31 , Aib 29 , Lys 26,30 ] hPTHrP(1-34) NH 2 ; The active pharmaceutical ingredient (API), BA058 API, is isolated with associated water and acetate.

 

2.              Services.   Manufacturer will render to RADIUS the following Services:

 

Manufacturer will produce Product hereunder for use by Radius in a Phase III clinical study.  Such work shall be performed in accordance with Exhibits A-C plus such additional requirements as discussed below.

 

Production :  Manufacturer will perform a solid-phase-peptide-synthesis process (SPPS) characterized by the stepwise addition of Fmoc-amino acids using Fmoc-Aas and coupling agents, followed by cleavage I deprotection and work-up in accordance with the “ Proposal for the Manufacture of 50g and 100g, 150g and 200g of BA058 and upgrading of analytical methods to NDA filing levels for Radius Health, Inc. ” attached hereto as Exhibit A ).  Production will be performed in a 20L reactor.  Two purification steps will be performed by reverse phase HPLC, which is followed by isolation by means of lyophilization.  The purification will be monitored using the Manufacturer’s methods FG1 and VG1.

 

Analytical development :  As a first step, method comparability between TG1, VG1 and FG1 will be established in accordance with the “ Analytical Development Proposal for BA058, API Project (Lonza RDS-001) ” attached here as Exhibit B ).  If needed, additional method development may be performed to identify the method of choice.  Once identified, the methods of choice (probably two) that are suitable for quantification of process impurities and supportive of ICH-stability studies will identified and agreed by the parties.  Resulting product will be greater than 97% pure as measured by the Manufacturer’s method FG1.  Release will be performed using the TG1 method, originally developed by Ipsen, unless otherwise agreed upon in advance based upon the outcome of the analytical method qualification.

 

Stability :  an ICH-stability study will be performed according to the requirements in “ SP-RDS-001 Stability Protocol for BA058 API, an Analog of Human Parathyroid-related Peptide (PTHrP) ” ( Exhibit C ).

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

CONFIDENTIAL

 

1



 

The above requirements, and any additional requirements that are agreed by the parties as contemplated above, shall be deemed part of the Specifications for the Product for purposes of the Agreement.

 

a)             Production will be initiated by the week of January 25, 2010.  Analytical development will commence in the week of January 18, 2010.  The deliverables will include regular updates (status reports, conference calls), as requested by Radius.  Release specifications are listed in Exhibit D , which for clarity shall be deemed part of the Specifications for the Product for purposes of the Agreement.  Modifications may be required, as the development status changes, and shall be agreed by the parties in writing.

 

b)             In the activities outlined in (a) and (b), which may include Manufacturer Processes, Manufacturer Technology may be incorporated with the prior consent of RADIUS.

 

c)              RADIUS will specify the number and size of aliquots to be produced and notify the Manufacturer.  The material can be stored at the Manufacturer’s site for up to three (3) months after release free of charge.  It will be shipped after notification of RADIUS by Manufacturer.  Amber glass packaging is assumed.  Upon request by RADIUS, Manufacturer will provide additional dispensing at additional charge to be communicated to RADIUS beforehand.

 

d)             A project team will be formed which will work closely with the team at RADIUS.  The project team will include technical project leaders as well as the appropriate QC, QA, and Regulatory personnel.  Communications with RADIUS will include weekly teleconferences as needed.  Audits of the manufacturing plants and general customer visits may be scheduled as needed.

 

e)              For further details, please refer to Exhibits A, B and C attached hereto.

 

f)              All Services hereunder will be conducted in compliance with analytical standards suitable for NDA filing and in compliance with cGMP for Phase III product.

 

3.              Completion:

 

Production will be completed by week of 26th April 2010 and API will be shipped to RADIUS by week of 3rd of May 2010.

 

Preparation:

 

week of December 11, 2009

Start of Upstream:

 

week of January 25, 2010 (week 4)

Global deprotection:

 

week of February 15, 2010 (week 7)

Start of Downstream:

 

week of February 22, 2010 (week 8)

Lyophilisation step:

 

week of March 15, 2010 (week 11)

API QC/QA release:

 

week of April 26, 2010 (week 17)

Shipment of API:

 

week of May 3, 2010 (week 18)

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

2



 

4.              Facilities.   The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

Lonza S.A., Chausée de Tubize 297, B-1420 Braine l’Alleud, Belgium

 

5.              RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 

6.              RADIUS Equipment.

 

None

 

7.              Manufacturer Representative.

 

Raimund Miller, Director, Sales and Business Development, Lonza Custom Manufacturing

 

8.              RADIUS Representative.

 

Louis O’Dea, Senior Vice President and Chief Medical Officer

 

9.              Compensation.   The total compensation due Manufacturer for Services under this Work Order is €341,500.

 

 

 

Gram

 

€/gram

 

 

 

 

 

[*]g

 

$[*]

 

 

Raw Materials

 

 

 

 

 

[*]

 

Production (incl. SPPS, IPC, DSP)

 

 

 

 

 

[*]

 

QC, QA release

 

 

 

 

 

[*]

 

HPLC methods comparability

 

 

 

 

 

[*]

 

Additional method development (optional)

 

 

 

 

 

[*]

 

HPLC method qualification

 

 

 

 

 

[*]

 

ICH-stability

 

 

 

 

 

[*]

 

TOTAL cost

 

 

 

 

 

341,500

 

 

Such compensation will be paid in installments.  20% of the costs listed above are due upon, signing of this Work Order.  The remaining payments are due upon completion of the Services and delivery of the resulting material.  RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder.  Manufacturer will invoice RADIUS to the attention of Nick Harvey, SVP and CFO, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

3



 

10.           Insurance will be provided as required by the Agreement.

 

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

By

/s/ B. N. Harvey

 

By

/s/ Raimund Miller

 

 

 

 

 

Print Name

Nick Harvey

 

Print Name

Raimund Miller, PhD.

 

 

 

 

 

Title

CPO

 

Title

Director, Sales & BD

 

 

 

 

 

Date

Jan 15, 2010

 

Date

Jan. 15, 2010

 

4



 

Exhibit A

 

Proposal for the Manufacture of 50g and 100g, 150g and 200g of BA058 and upgrading of analytical methods to NDA filing levels for Radius Health, Inc.

 

5



 

 

PROPOSAL for the MANUFACTURE of 50g and 100g, 150g and 200g

of BA058 (Lonza Designation:  RDS-001)

and upgrading of analytical methods to NDA filing levels

for RADIUS Health, Inc.

(As per the March 19 and April 06, ‘09 RFPs)

1st Amendment dated April 28, ‘09

(all new text in blue)

2nd Amendment dated April 30, ‘09

(all new text in dark yellow)

3rd Amendment dated Nov. 30, ‘09 and Dec. 01, ‘09, and Dec. 3, ‘09

(for 50g and 100g; all new text in red)

 

 

Prepared for:

Maria Grunwald, Ph.D., MBA

Director, Business Development

Radius

300 Technology Square, 5 th  Floor

Cambridge, MA 02139

 

 

Prepared by:

Raimund J. Miller, PhD.

Director, Sales & Business Development

Lonza Custom Manufacturing

25 Commerce Drive

Allendale, NJ 07401

 

 

Date:

April 20, 2009

April 28, 2009

April 30, 2009

Nov. 30, 2009, Dec. 01, ‘09, Dec. 3, ‘09

 

DISCLAIMER

 

THIS DOCUMENT IS ISSUED BY LONZA FOR DISCUSSION PURPOSES ONLY.  IT IS NOT INTENDED TO CONSTITUTE ANY SORT OF OFFER OR TO CREATE ANY LEGAL RELATIONS BETWEEN LONZA AND ANY OTHER PARTY.

 

THE SUPPLY OF THIS DOCUMENT IN ELECTRONIC FORM IS STRICTLY ON THE UNDERSTANDING THAT NO AMENDMENTS WILL BE MADE TO IT WHICH ARE NOT EXPLICITLY DRAWN TO LONZA’S ATTENTION EITHER BY MARKING THE CHANGES IN THE TEXT ITSELF OR OTHERWISE IN WRITING.  LONZA DOES NOT AGREE TO ANY AMENDMENT

 

CONFIDENTIAL

 

1



 

WHICH IS NOT SO EXPLICITLY BROUGHT TO OUR ATTENTION.

 

1)             Background

 

On March 19, ‘09 Dr. Maria Grunwald asked for a cost proposal + timelines for upgrading the analytical methods, which were employed in the 1st BA-058 campaign, to NDA filing levels.  This was followed by a request for proposal on April 6, ‘09 for pricing for a 150g Ph III / cGMP campaign.  On April 29, ‘09 Radius placed a request to include pricing for a 200g as well.  The 04/30/09 2 nd  proposal amendment provides pricing for the 200g. On Nov. 23, ‘09 Radius requested a proposal for a 50g batch for Phase 3 (requiring manufacture to GMP standards).  On Nov. 30, ‘09 Radius requested that pricing be added for a 100g campaign as well.  On Dec. 3, ‘09, Radius requested a “break” on the 100g price which Lonza is willing to give in support of Radius’ program.

 

In mid 2008 Lonza Braine performed the 1 st  BA-058 campaign (C1 campaign) which yielded [*]g peptide corresponding to [*]g net peptide.  An extra quantity of [*]g powder weight was generated during this first campaign.

 

Campaign summaries were provided in Process Analytical reports which were sent to Radius on March 2, ‘09 (PAR-S-RDS-001-103 C1, concerning upstream process description) and on March 9, ‘09 (PAR-P-RDS-001-Campaign 1-Lot 8AG1, concerning downstream process description).

 

To date (April 20, ‘09) the following shipments were made out of this C1 campaign:

 

1) In February ‘09, 40.0g (8 x 5.0g powder weight) were sent to Vetter Pharma (Germany).

 

2) In March ‘09, 4.0g (1 x 1.5g + 1 x 2.5g powder weight) were sent to Charles River Laboratories (Canada)

 

2)             BA058—the Product

 

The BA058 (RDS-001) Peptide is an amide 34 mer with one non natural AA: H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH 2

 

General Information

 

Nomenclature

 

Chemical Name:

 

Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-ALa-NH 2  [GIU 22,25 , Leu 23,28,21 , Aib 29 , Lys 26,30 ] hPTHrP(1-34)-NH 2

 

 

 

USAN Name:

 

Not assigned

 

 

 

Research Names:

 

BA058

(Radius Code)

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

2



 

CAS Registry

 

247062-33-5, 512206-66-5, 506422-98-6

Numbers:

 

 

 

Structure

 

The structure of BA058 peptide is depicted in Figure 1.

 

Figure 1:                Structure of BA058 Peptide

 

 

The active pharmaceutical ingredient (API), BA058 API, is isolated with associated water and acetate.

 

3)             Process :

 

The manufacturing process which Radius asked Lonza to quote on for the 1 st  campaign was outlined in the 4/17/07 RFP.  The process is a solid-phase-peptidesynthesis process (SPPS) characterized by the [*] amino acids [*] and coupling agents, followed by cleavage, deprotection and work-up; the purification is performed by reverse phase HPLC which is followed by isolation by means of lyophilization.

 

In the course of the feasibility study performed by Lonza Braine in early ‘08, two different analytical methods were developed in order to properly monitor purification of the peptide.  These two methods provide much better resolution than the one received from Radius using a TFA based system.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

3


 

During the C1 campaign, these methods were used for the monitoring of the primary purification of the peptide.  This has resulted in an 00C (out of criteria), as the min. of 97.0% purity was not reached at the end of this step of purification.

 

In an internal meeting, it was decided to implement a second step of purification using acetic acid medium in order to increase the purity of fractions.  At the same time, Radius requested to use the TFA method for the QC lot release.  Lonza proposed to add one of our methods for supportive data during this release.

 

By using Lonza’s analytical method, it was possible to produce an extra pure lot at 99.1% HPLC purity (Radius method).  This means also that recovery and productivity were low due to a secondary step of purification and recycling to reach the required purity.

 

The new pricing is based on yields and recoveries obtained during the C1 campaign, which should not be considered as a representative campaign.

 

For the future C2 campaign, norms to reach will be performed in TFA method (using the Radius HPLC method).

 

Concerning change of equipment, assembly of the peptide on the resin during C1 campaign has been performed in a 20 L-Pepsynloop reactor.  For a batch size of 150g NPW API, a bigger reactor will be used, such as a 50L-Pepsynloop reactor.  The upstream process will not be changed as the same technology is used in either reactor.

 

For the sake of this 1 st  amendment of the April 20 th  proposal all quantities to be produced have been revised, and the entire campaign has been recalculated.  The final quantity to be produced is 150g net peptide weight at 97.0% HPLC purity (by the Radius method) which is unchanged.  The upstream will be performed in two small-scale SPPS reactors (2 x 20 L) in parallel vs. a single 50 L reactor in the initial proposal.

 

For the sake of the 2 nd  amendment a totally new production concept has been worked up and costed.  In this case we can use mid-scale equipment:  one run in 50 L SPPS reactor and LC200 for downstream; considerably less manpower is required in this production scenario resulting in considerable cost savings vs. a 150g campaign.

 

For the sake of the 3 rd  amendment and as the request concerns the same batch size as for C1 campaign, we can use the same size equipment.  This means, small-scale SPPS reactor (20 L) and LC150 for downstream.  All improvements needed, coming from know-how acquired during C1 campaign, will be implemented in this new campaign.

 

4



 

4)            Price Proposal and Assumptions for new 50q and 100q cGMP campaigns.  The Quotation is in Euros (pro memoriam:  the 11/30/09 US$ / Euro exchange rate is 1.5035) :

 

 

 

50g

 

100g

 

Raw Materials

 

[*]

 

[*]

 

Production (incl. SPPS, IPC, DSP)

 

[*]

 

[*]

 

QC, QA release

 

[*]

 

[*]

 

TOTAL cost of 50g campaign

 

Euros 210,000

 

Euros 275,700
Euros 257,750

 

 

A 50g campaign is not well suited to the smallest reactor which we will have to use.  A 100g campaign is much better suited.

 

The target quality of the 50g and 100g campaigns (NPW, net peptide weight) will be 97.0% (HPLC, Radius method).

 

In terms of timing, synthesis + purification + QA/QC release are estimated to take 14 weeks for the 50g, 17 weeks for the 100g campaign.

 

5)             Price Proposal and Assumptions for a new 150q cGMP campaign.  The Quotation is in Euros (pro memoriam:  the 04/28/09 US$ / Euro exchange rate is 1.3153):  [SECTION 4 AND PRICING OF 150G REMAINS UNCHANGED IN THE 2 ND  AMENDMENT ]

 

Prior to the start of production, specific raw material purchasing and their QC/QA release have to be scheduled.  These tasks are estimated to take six weeks.

 

Production of 150g (NPW, net peptide weight) at 97.0% (HPLC, Radius method), including upstream, downstream, QC and QA release of the GMP lot.

 

Price :  €350,000 (all inclusive of raw materials, production, and margin)

 

This cost does NOT include Reference Standard qualification on this lot.  New internal QA guideline is a separate RS from the batch (extra pure one, which means:  two separate lyophilisation steps, 2 distinct QC releases and so on).  Associated costs have been calculated as follows:

 

Assumptions :

 

·

[ Extra pure API (part of the purification lot)

·

Lyophilisation

·

QC release ]

 

[*] €

·

5g net peptide weight

 

[*] €

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

5



 

Total costs for a new reference standard:  €32,500

 

6)             Price Proposal and Assumptions for a new 200q cGMP campaign.  The Quotation is in Euros (pro memoriam:  the 04/30/09 Euro / US$ exchange rate is 1.3205) :

 

Prior to the start of production, specific raw material purchasing and their QC/QA release have to be scheduled.  These tasks are estimated to take six weeks.

 

Production of 200g (NPW, net peptide weight) at 97.0% (HPLC, Radius method), including upstream, downstream, QC and QA release of the GMP lot.

 

Price :  €285,000 (all inclusive of raw materials, production, and margin; excluding the €[*] cost for the new stationary phase for the larger column)

 

This cost does NOT include Reference Standard qualification on this lot.  New internal QA guideline is a separate RS from the batch (extra pure one, which means:  two separate lyophilisation steps, 2 distinct QC releases and so on).  Associated costs have been calculated as follows:

 

Assumptions :

 

·

[ Extra pure API (part of the purification lot)

·

Lyophilisation

·

QC release ]

 

[*] €

·

5g net peptide weight

 

[*] €

 

Total costs for a new reference standard:  €26,335

 

7)             Price Proposal for Upgrading of Analytical Methods to NDA filing levels.  The Quotation is in Euros (pro memoriam:  the 04/17/09 Euro / US$ exchange rate is 1.3043) :

 

1.              Analytical activities (this should be performed in parallel of the GMP campaign, concerning validation methods.  For additional testing 3 extra weeks are needed after the release of the lot) .

 

·       Validation of analytical methods :  Price €100,000

 

·       HPLC / M-009-RDS-001TG1 (QC release method)

·       HPLC / M-009-RDS-001 FG1 (QC release method)

·       Acetate and Trifluoroacetate content in API

·       Water content

·       GC-Headspace (complement to general method)

·       Direct GC (complement to general method)

·       Specific rotation

·       Peptide content (Nitrogen)

·       HPLC for in-process control upstream and downstream (3 methods).

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

6



 

·       Additional testing requested for NDA filling :  Price:  €25,000

 

·       LC-MS profiles of one lot + one lot in stability study (study of degradation of API:  impurity profile).

·       Comparability study for lots coming from different suppliers

·       Heavy metals

·       General properties:  polymorphism, solubility, pH (isoelectric point), appearance, etc...

 

For all this analytical work, [*] g powder weight of API is needed.  We still have [*] g powder weight of lot 8AG1 in stock.  We will be able to use this material if Radius so decides.  Otherwise, we will have to use an extra quantity to be made available from this lot (this one has not been paid yet by Radius).  This will be discussed with Radius when necessary.

 

Total price:  €125,000

 

2.              Regulatory activities

 

NDA filing.  Price:  €57,500

 

15 weeks will be needed to finalize the NDA writing and associated corrections.

 

8)             Terms and Conditions

 

·       Proposal Validity:  May 31, ‘09.  After the expiry of the validity Lonza reserves the right to revisit all assumptions taken and outlined in this proposal.

·       Proposal Validity for 3rd Amendment:  May 31, ‘10.

·       Payment Terms:  a min. 30% upfront payment is required upon commencement of project related lab activities.

·       Packaging:  Lonza standard packaging is assumed.  Should any non-standard packaging be required, additional costs associated with this change will be charged separately.

·       INCO-terms:  FCA Lonza Braine.

 

KB / RJM

04 / 20 / 09

04 / 28 /09

04 /30 / 09

11 / 30 /09; 12/01/09; 12/03/09

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

7



 

Grunwald, Maria

 

From:

 

Miller Raimund - Allendale [raimund.miller@Ionza.com]

Sent:

 

Thursday, December 17, 2009 10:07 AM

To:

 

Grunwald, Maria

Cc:

 

Bouget Karine - Braine

Subject:

 

New Price offer for 75g

 

Hello Maria,

 

Per our telecon on Tuesday, Dec. 15, we are herewith re-quoting for a new 75g campaign which will produce 97% material by the FG1 method.  The 10% which were added to our Dec. 8, ‘09 quote for the same quantity, are to cover raw material supply and recycling steps during purification to reach the targeted purity.

 

Price Proposal and Assumptions for new 75q cGMP campaign .

 

The Quotation is in Euros (pro memoriam:  the 12/17/09 US$ / Euro exchange rate is 1.437) :

 

 

 

75g

 

Raw Materials

 

[*]

 

Production (incl. SPPS, IPC, DSP)

 

[*]

 

QC, QA release

 

[*]

 

TOTAL cost of 75g campaign

 

Euros 258,500

 

 

Assumptions:  same as in the most recent proposal dated Dec. 3, ‘09.

 

Thanks,

Raimund

 

Raimund J. Miller, PhD.

Lonza Custom Manufacturing

Lonza Inc.

25 Commerce Drive

Allendale, NJ 07401

Tel+1-201-316-9322

Cell +1-201-233-2006

Fax+1-201-696-3530

 

Lonza

raimund.miller@lonza.com

www.lonza.com

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

1



 

Exhibit B

 

Analytical Development Proposal for BA058, API project (Lonza RDS-001)

 

6



 

 

Analytical Development Proposal For BA058, API Project
(Lonza RDS-001)

 

Development proposal

 

The development proposal is divided into 3 steps that should be conducted prior to the next API batch release.

 

1.              HPLC methods comparability

 

A first step will be to establish method comparability between TG1, VG1 and FG1 HPLC methods, in order to understand the capabilities and pitfalls of these methods for true process impurities, including [3-34] and [4-34] truncated peptides.  The HPLC data will be backed up by LC/MS data to support identification of impurities and methods comparability in case of co-elution of impurities (either with the main peak or with other impurities).

 

This will also allow building a rationale for method change in future API release specifications.

 

This method comparability would be based on Lonza samples (including previously manufactured lots 5AG1R and 8AG1, [3-34] and [4-34] impurity markers, as well as DSP side fractions containing process impurities).  Should it be of interest to Radius, samples of BA058, API from other sources could also be added to this study in order to bridge these materials with the current Lonza material (8AG1).

 

Requirement:  Samples from Radius (if needed)

Timeline:  4 weeks

Deliverable:  Comparability report between 3 HPLC methods, including LC/MS identification of impurities.

Price:  €15,000

 

2.              Additional method development

 

Based on the above assessment, additional HPLC method development may have to be performed, in order to identify the method of choice (separate the critical [3-34] and [4-34] from the other process impurities), in addition to the identified HPLC method that will be used to assess overall purity and individual impurities.

 

For this, we could use alternative stationary phases (eg HILIC) or even move to UPLC (more resolution power than HPLC)

 

Timeline:  4 weeks

Deliverable:  HPLC method Development report

Price:  €15,000

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 


 

 

3.                                       HPLC methods qualification

 

Once identified, the methods of choice (probably two) found suitable for their intended purposes (quantitation of process impurities, and stability-indicating to support ICH stability studies of API and DP) will be qualified.  One of these methods could also be used to determine the API content in the powder (against an external reference standard), should this be a requirement from Radius.  This method qualification work will have to be completed before initiation of the next campaign release.

 

Timeline:  5 weeks (assuming 2 methods qualified in parallel)

Deliverable:  HPLC method Qualification protocol and report

Price:  €18,000 per method (in line with any previous proposal for method qualification)

 

JMP / KB / RJM

01/08/10

 



 

Exhibit C

 

SP-RDS-001 Stability Protocol for BA058 API, an Analog of Human Parathyroid-related Peptide (PTHrP)

 

7



 

SP-RDS-001-8AG1

 

BA058 API, an Analog of Human Parathyroid-related Peptide
(PTHRP)/RDS-001

 



 

Table of Contents

 

1.

OBJECTIVE

3

2.

INTRODUCTION

3

3.

STABILITY STUDY DESCRIPTION

3

3.1

Equipment description

3

3.2

Containers for stability samples

3

3.3

Analytical tests to be performed

4

3.4

Acceptance criteria

4

3.5

Testing schedule

4

3.5.1

Material required for each test per station and storage condition

4

3.5.2

Material sampling per station and storage condition

4

3.5.3

Material inventory

5

 



 

1.                                       OBJECTIVE

 

This protocol describes the experiments to be performed in order to assess the stability of batch 8AG1 of BA058 Active Pharmaceutical Ingredient (API), as produced in the current manufacturing process.

 

2.                                       INTRODUCTION

 

This study will be performed in different storage conditions up to 36 months.

 

The conditions meet the requirements of the International Conference for Harmonization, as described in Q1A(R2) “Stability Testing of New Drug Substances and Products”.

 

3.                                       STABILITY STUDY DESCRIPTION

 

3.1                                Equipment description

 

·                                          Freezer at - 78°C ± 8°C
Such as THERMO (Forma -86C ULT freezer)

 

Temperature records in Freezer at - 78°C ± 8°C :

·                                           Digital thermometer for permanent record

·                                           Manual record of temperature twice-weekly

·                                           The temperature uniformity is checked at least annually

 

·                                          Freezer at - 20°C ± 5°C
Such as Elbanton LTV650.

 

·                                          Cold room at + 5°C ± 3°C
Such as refrigerator WEISS

 

Temperature records in Freezer at - 20°C ± 5°C and in the cold room :

·                                           GTO monitoring for continuous monitoring and permanent record.

·                                           Manual record of temperature every day.

 

3.2                                Containers for stability samples

 

Stability samples will be stored in 8 mL HDPE bottle with suitable closure of the same quality as those used for bulk storage.

 

Two samples will be stored at below - 25°C as witness samples

 



 

3.3                                Analytical tests to be performed

 

Tests

 

Methods

Powder appearance by visual examination

 

M-001

Water content by coulometric KF

 

M-048

Overall purity and related substances

 

M-009-RDS-001TG1

Overall purity and related substances

 

M-009-RDS-001FG1

Peptide content

 

M-022

 

3.4                                Acceptance criteria

 

The norms set in the current specifications are applied to the stability results obtained at the recommended storage temperature (- 20°C ± 5°C).

 

3.5                                Testing schedule

 

Months

 

0

 

1

 

3

 

6

 

9

 

12

 

18

 

24

 

36

 

+ 5°C ± 3°C

 

 

A

 

A

 

A

 

 

 

 

 

 

 

 

 

 

 

- 20°C ± 5°C

 

A

 

 

A

 

A

 

A

 

A

 

A

 

A

 

A

 

 

3.5.1                      Material required for each test per station and storage condition

 

Tests & Methods

 

Quantity by test

·

 

Powder appearance by visual examination

 

 

 

 

(M-001)

 

10 mg

·

 

Water content by coulometric KF

 

 

 

 

(M-048)

 

30 mg

·

 

Peptide content, overall purity and related substances

 

 

 

 

(M-009-RDS-001TG1)

 

20 mg

·

 

Overall purity and related substances by SEC-HPLC

 

 

 

 

(M-009-RDS-001FG1)

 

20 mg

·

 

M-022 by nitrogen analysis

 

 

 

 

(M-022)

 

20 mg

 

3.5.2                      Material sampling per station and storage condition

 

One HDPE bottle container containing 200 mg (all tests in duplicate analyses).

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 



 

3.5.3                      Material inventory

 

The following table displays the material inventory required for this stability study :

 

 

 

Storage
condition

 

Control time
points

 

Reserve sample

 

Total number

Short term

 

+ 5°C

 

3

 

2

 

5

Long term

 

- 20°C

 

7

 

4

 

11

Witness sample

 

Below - 25°C

 

 

2

 

2

Initial

 

NA

 

1

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

This study will require 19 HDPE bottles containing 200 mg of powder.

 

A total quantity of 4.1g of peptide powder is requested for this stability study

 



 

Exhibit D

 

Batch Analysis of BA058 API

 

Test

 

Specification

Appearance

 

White to off-white powder

Identification:  HPLC

 

Co-Elutes with reference

Identification:  TLC

 

Single spot with Rf similar to reference

Assay Peptide content ( HPLC ) Peptide content ( HPLC, anhydrous, free base basis )

 

> [*] (w/w) [*] to [*]%

Purity BA058 (HPLC) Total related impurities Individual related impurities

 

> 97.0%, area %

< 3.0%

< 1.0% area %

Purity by Mass Spectrometry 44117D(3-34 analog) 44116D (4-34 analog)

 

Not detected**

Not detected

Acetate Content

 

< [*]% (w/w)

Water Content

 

< [*] % (w/w)

TFA Content

 

Report

Specific Optical Rotation (anhydrous free base corrected)

 

Report

Residual Solvents

 

Methanol <[*]% w/w

Acetonitrile <[*]% w/w

Ethyl Acetate <[*]% w/w

Triisopropylsilane <[*]% w/w

Dimethylformamid <[*]% w/w

Microbial content Bacteria Yeasts and Molds LAL

 

Report (cfu/g)

Report (cfu/g)

< [*]UI/mg

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission

 

8


 

 

AMENDMENT NO.3 to WORK ORDER NO.2*

 

This Amendment No. 3 to Work Order No.2 is entered into on December 15, 2010 by and between Radius Health Inc., a Delaware Corporation, with its principal office at 300 Technology Square - 5 th  floor, Cambridge, MA 02139, United States of America (“RADIUS”), and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “Manufacturer”), and upon execution will be incorporated into Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “Agreement”). Capitalized terms in this Amendment will have the same meanings as set forth in the Agreement.

 

WHEREAS

 

RADIUS and Manufacturer are parties to Work Order No.2 executed January 15, 2010 under which Manufacturer had agreed to produce Product for use by Radius in a Phase III clinical study.

 

Manufacturer has produced excess product, which RADIUS wishes Manufacturer to purify to yield 100 grams of product (“Purified Product”) under this amendment.

 

Purified Product will be released, dispensed and packaged separately from Product.

 

NOW, THEREFORE, IT IS AGREED AS FOLLOWS:

 

1.                      Services.   Manufacturer will render to RADIUS the following Services:

 

Manufacturer will purify Product and release, dispense and package Purified Product hereunder suitable for use by RADIUS in a Phase III clinical study. Such work shall be performed in accordance with Exhibit A plus such additional requirements as discussed below. Prior to purification of Product, Manufacturer will (i) perform analytical testing of Product as identified in the first three bullet points of Section 5 of Exhibit A, (ii) provide Radius with (a) a report identifying the results of such testing and (b) Batch Documentation for the Product (collectively, (a) and (b) are the “Analytical Test Reports”) and (iii) obtain RADIUS’ written consent for Manufacturer to proceed with the remaining activities in this Amendment (“Consent to Purify”). The decision as to whether the analytical testing yielded satisfactory results and the Analytical Test Reports are acceptable will be at RADIUS’ sole and absolute discretion and RADIUS is under no obligation to provide any Consent to Purify.  Unless and until Consent to Purify is provided by RADIUS, no further Services under this Amendment shall be performed by Manufacturer.  The above requirements, and any additional requirements that are agreed by the parties as contemplated above, shall be deemed part of the Specifications for the Product for purposes of the Agreement.

 

a)                 Analytical testing will commence in the week of January 17, 2011. Purification will be initiated by the week of February 7, 2011.  The deliverables will include regular updates (status reports, conference calls), as requested by Radius, and Batch Documentation for the Purified Product.  Release specifications for Purified Product are listed in Exhibit B , which for clarity shall be deemed part of the Specifications for the Product for purposes of the Agreement. Modifications may be required, as the development status changes, and shall be agreed by the parties in writing.

 

b)                 In the activities outlined in (a), which may include Manufacturer Processes, Manufacturer Technology may be incorporated with the prior consent of RADIUS.

 

c)                  Upon completion of the purification activities described herein, Manufacturer will provide RADIUS with the Batch Documentation for the Purified Product for

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

CONFIDENTIAL

 

1



 

RADIUS’ review.  No Purified Product will be shipped to RADIUS or its designee until it has received written approval to ship from RADIUS.

 

d)                 RADIUS will specify the number and size of aliquots to be produced and notify the Manufacturer.  The material can be stored at the Manufacturer’s site for up to three (3) months after release free of charge. It will be shipped after notification of RADIUS by Manufacturer.  HDPE packaging is assumed. Upon request by RADIUS, Manufacturer will provide additional dispensing at additional charge to be communicated to RADIUS beforehand.

 

e)                  A project team will be formed which will work closely with the team at RADIUS. The project team will include technical project leaders as well as the appropriate QC, QA, and Regulatory personnel. Communications with RADIUS will include weekly teleconferences as needed.  Audits of the manufacturing plants and general customer visits may be scheduled as needed.

 

f)                  For further details, please refer to Exhibits A and B attached hereto.

 

g)                  All Services hereunder will be conducted in compliance with analytical standards suitable for NDA filing and in compliance with cGMP for Phase III product.

 

2.                      Completion:

 

Analytical testing will be completed by January 21st, 2011. The Analytical Test Reports will be provided to RADIUS by January 21st, 2011.  Purification will be completed by week of 21st of March 2011 and API will be shipped to RADIUS by week of 4th of April 2011.

 

3.                      Facilities.  The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

Lonza S.A., Chausée de Tubize 297, B-1420 Braine l’Alleud, Belgium

 

4.                      RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 

5.              RADIUS Equipment.

 

None

 

6.              Manufacturer Representative.

 

Raimund Miller, Director, Sales and Business Development, Lonza Custom Manufacturing

 

7.                      RADIUS Representative.

 

Louis O’Dea, Senior Vice President and Chief Medical Officer

 

8.                      Compensation.  The total compensation due Manufacturer for proper performance of Services under this Amendment is €107,500. Such compensation will be paid in installments as follows: 20% of the fee listed above is due upon RADIUS providing Consent to Purify. The remaining amount will be invoiced to RADIUS upon acceptance of the Services and delivery of 100 grams of the Purified Product to RADIUS. For the

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

2



 

avoidance of doubt, no compensation will be due Manufacturer for any Services performed under this Statement of Work if RADIUS elects not to provide the Consent to Purify.   RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder. Manufacturer will invoice RADIUS to the attention of Nick Harvey, SVP and CFO, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Amendment.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 

9.              Insurance will be provided as required by the Agreement.

 

All other terms and conditions of the Agreement and Work Oder No. 2 will apply to this Amendment No.3.

 

 

AMENDMENT AGREED TO AND ACCEPTED BY:

 

 

 

 

 

 

 

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

 

 

 

 

 

By

/s/ B.N. Harvey

 

By

/s/ Syed T. Husain

 

 

 

 

 

Print Name

Nick Harvey

 

Print Name

Syed T. Husain

 

 

 

 

 

Title

CFO

 

Title

Head of Sales & BD

 

 

 

 

 

Date

Dec. 14, 2010

 

Date

15-Dec-10

 

3



 

Exhibit A

 

Radius

 

Page 1 of 3

 

LONZA

BA-058 (RDS-D01)

 

Version 1.1a

 

 

 

PROPOSAL

 

RADIUS

 

Product: BA-058

 

(Lonza Code: RDS-001)

 

Proposal for purification and Release of Overage ex C2 Campaign

 

([*] g NPW)

 

Version 1.1a

 

November 8, 2010

 

December 13, 2010

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission

 

4



 

Radius

 

Page 2 of 3

 

LONZA

BA-058 (RDS-D01)

 

Version 1.1a

 

 

 

1) Introduction

 

The quotation provided herewith covers all activities which are required to purify and release the overage which resulted out of the C2 BA-058 campaign.  The target amount is [*] g NPW.

 

2) Peptide Sequence

 

H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-

Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH 2

 

3) Assumptions / Remarks

 

·       This quotation is based on the yields and results obtained in the [*]g NPW campaign produced in 2010.

·       The same purification process will be used as the one used for C2 campaign: two HPLC purifications (primary and secondary purifications) in order to meet the expected customer specifications.  As a consequence, a final HPLC purity of the API > 97% is expected to be obtained (FG1 method).

·       Raw material prices: standard 2010 raw material prices were used in the cost calculation.  Only purification related raw materials are included in this quotation.

·       We expect a min. of [*] g peptide (NPW) to result out of this purification campaign.

 

4) Purification of C2 crude overage at 100g NPW scale

 

Raw materials (€)

 

[*]

Manpower Downstream (€)

 

[*]

Manufacturing facilities downstream (€)

 

[*]

 

 

 

Total Production (€)

 

[*]

 

 

 

QA/QC release (€)

 

[*]

 

 

 

TOTAL (€)

 

107,500

Prices per gram (€)

 

[*]

 

Timelines: 7 weeks; 1st purification line to become available in week 6 of 2011.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

5



 

RADIUS

 

Page 3 of 3

 

Lonza

BA-058 (RDS-001)

 

Version 1.1a

 

 

 

5) Activities to be performed prior to Purification (are all included in the quotation):

 

·       Analysis of the crude in IPC upstream HPLC release method, in order to check global purity.

·       LC-MS analysis in the same analytical method; comparison with the one available for the crude at t=0.

·       Assess potency of the crude by VG1 HPLC method before purification process.

·       Report of results as part of the purification batch record and review by Production and QA before purification.

·       Include decision point: apply C2 purification process, if there is no degradation. If there is degradation, include discussions to define a new process.

 

BK / RJM

11/08/10

12/13/10

 

6



 

Exhibit B

 

7



 

Test

 

Specification

 

 

 

Appearance

 

White to off-white powder

 

 

 

Identification: HPLC

 

Co-Elutes with reference

 

 

 

Identification: TLC

 

Single spot with Rf similar to reference

 

 

 

Assay
Peptide content (HPLC)
Peptide content (HPLC, anhydrous, free base basis)

 

 

> [*] % (w/w)
[*] to [*] %

 

 

 

Purity BA058 (HPLC)
Total related impurities
Individual related impurities

 

> 97% ,area %
£ 3.0%
£ 1.0% area %

 

 

 

Purity by Mass Spectrometry
44117D(3-34 analog)
44116D (4-34 analog)

 

 

Not detected**
Not detected

 

 

 

Acetate Content

 

£ [*]% (w/w)

 

 

 

Water Content

 

£ [*] % (w/w)

 

 

 

TFA Content

 

Report

 

 

 

Specific Optical Rotation (anhydrous free base corrected)

 

Report

 

 

 

Residual Solvents

 

Methanol <[*]% w/w
Acetonitrile <[*]% w/w
Ethyl Acetate <[*]% w/w
Triisopropylsilane <[*]% w/w
Dimethylformamid <[*]% w/w

 

 

 

Microbial content
Bacteria
Yeasts and Molds
LAL

 

 

Report (cfu/g)
Report (cfu/g)
< [*] UI/mg

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

8


 

 

Confidential Treatment Requested

 

Under 17 C.F.R. §§ 200.80(b)(4) and 240.24b-2

 

WORK ORDER NO. 4

 

THIS WORK ORDER NO. 4 is by and between RADIUS HEALTH, INC. (“RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “ Manufacturer ”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “ Agreemen t”). Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.                                       API/Drug Substance and Product .

 

BA058

 

Peptide Sequence :  H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH2

 

2.                                       Services.   Manufacturer will render to RADIUS the following Services:

 

Manufacturer will perform activities required for RADIUS’ filing of a new drug application (“NDA”) in the United States with the FDA and similar applications required by the European Medicines Agency (EMEA) and other Authorities, excluding authorities in Japan, for BA058 including, but not limited to, production of three (3) validation Batches.  These activities will provide for full process qualification and process validation and all required documentation necessary for regulatory submissions of the NDA to the FDA and the NDA equivalents to other Authorities.

 

Such work will be performed in accordance with Exhibits A and B of this Work Order plus such additional requirements as discussed below.  The Services are identified in terms of a particular numbered activity (each, an “ Activity ”).  All Services under this Work Order, including Manufacture of any Batches, will be conducted in compliance with standards suitable for an NDA filing by RADIUS.  All Batches will be Manufactured in compliance with cGMP, will conform to Specifications provided to Manufacturer prior to commencement of the applicable Batch, and the other requirements of the Agreement and this Work Order.   Except for Activities 1 and 6, Manufacturer will not proceed to a subsequent numbered Activity until it provides a report to RADIUS with the status of and results of the prior numbered Activity and RADIUS provides Manufacturer with written authorization to proceed to the next Activity.

 

Activity 1: Development Work : The objective for this Activity is to define the best conditions for the preparation of the BA058 peptide.  As a first step, Manufacturer will identify which parameters have influenced the unexpected high yield in the C2 campaign.  In addition, Manufacturer will investigate the chemistry to ensure repeatability/reproducibility of such results. The criteria to be evaluated and the deliverables to be provided are as set forth in Section 4 of Exhibit B.

 

Activity 2: Pre-qualification activities : Manufacturer will challenge the parameters identified as critical as a result of the performance of Activity 1 and identify working ranges for the parameters to ensure a robust process for upstream and downstream activities.  In addition, the studies identified in Section 5 of Exhibit B will have to be conducted on different steps of the process in order to define “holding points”.  If conducted on any intermediate products, all stability studies conducted by Manufacturer will be

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

conducted in accordance with the Manufacturer generated stability protocol to be approved by RADIUS in writing.

 

Activity 3: Qualification Campaign :  Manufacturer will not commence this Activity without the prior written consent of RADIUS.  Manufacturer will Manufacture a qualification Batch at a purification scale of NPW (net peptide weight) selected by RADIUS from the table in Exhibit A; however, the assembly and cleavage reaction that will lead to the crude will be performed at a scale of 180g NPW equivalent. The Batch will be Manufactured in a 20L SPPS reactor. An amount identified by RADIUS out of the crude that was Manufactured will be purified on an LC150 HPLC column and lyophilized in a GT10 lyophilizer. The excess of crude will be stored and will be purified by Manufacturer, if so requested by RADIUS in writing (“Additional Purification”). These activities are further described in Section 6 of Exhibit B.

 

Activity 4: Qualification Stability : Manufacturer will perform a stability study from samples of the Product Manufactured pursuant to Activity 3 in accordance with ICH requirements and the time points required by ICH requirements (at a minimum, the following time points:  0, 3, 6, 9, 12, 18, 24, 36 months). The study will be performed according to a stability protocol to be generated by Manufacturer and approved by RADIUS in writing.

 

Activity 5: Pre-validation activities : Based on pre-qualification Batches (C1 and C2 which were previously Manufactured) and the qualification Batch (C3 — still to be produced), Manufacturer will prepare and deliver the reports and protocols identified in Section 8 of Exhibit B.

 

Activity 6: Analytical Methods Validation : Manufacturer will validate the analytical methods identified in Section 9 of Exhibit B and provide reports on the analytical methods. These Services described in this Activity will commence immediately. Completion dates are planned to allow the qualification Batch described in Activity 3 to be tested with the required methods validated in this Activity.  In any event, all methods will be validated before the commencement of Activity 7.

 

Activity 7: Validation Campaign :

 

Manufacturer will Manufacture and release three (3) Batches of Product at a scale of NPW (net peptide weight) selected by RADIUS from the table in Exhibit A; however, the assembly and cleavage reaction that will lead to the crude will be performed at a scale of 180g API equivalent. Manufacturer will commence Manufacture of a Batch only with the prior written consent of RADIUS . The excess of crude will be stored and Additional Purification will be performed by Manufacturer, if so requested by RADIUS in writing. These activities are further described in Section 10 of Exhibit B.

 

Activity 8: Validation Reports:   Manufacturer will provide the following reports:

 

·                                           Upstream process validation reports

·                                           Downstream process validation report

 

Activity 9: Validation Stability : Manufacturer will perform a stability study from samples of the Product Manufactured pursuant to Activity 7 in accordance with ICH QIA requirements and the time points required by ICH requirements (at a minimum, the following time points:  0, 3, 6, 9, 12, 18, 24, 36 months). The study will be performed in according to a stability protocol to be generated by Manufacturer and approved by RADIUS in writing.

 

Activity 10: DMF Filing :  Manufacturer will prepare, submit to applicable Authorities identified by Radius, or to Radius for submission, and manage the Drug Master File (DMF) using information about processes, equipment, facilities, qualifications, controls and as needed.  Manufacturer will provide the DMF to Radius for review and approval prior to submission.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

For each Batch of Product Manufactured under this Work Order, Manufacturer shall Manufacture, in accordance with cGMP and the Manufacturing Process, enough crude to yield 180 grams (or such other amount specified by Radius in writing) of Product.

 

The above requirements, including the yield requirements, and any additional requirements that are agreed by the parties as contemplated above, shall be deemed part of the Specifications for the Product for purposes of the Agreement.

 

a)                                                  Manufacturer will commence performance of this Work Order by the week of January 2, 2012. The deliverables will include regular updates (status reports, conference calls), as requested by RADIUS.   Release specifications will be provided by Radius, which for clarity shall be deemed part of the Specifications for the Product for purposes of the Agreement. Modifications may be required, as the development status changes, and shall be agreed by the parties in writing.

 

b)                                                  In the activities identified above, which may include Manufacturing Processes, Manufacturer Technology may be incorporated with the prior written consent of RADIUS.

 

c)                                                   A project team will be formed which will work closely with the team at RADIUS. The project team will include technical project leaders as well as the appropriate QC, QA, and Regulatory personnel. Communications with RADIUS will include teleconferences as needed.  Audits of the manufacturing plants and general customer visits may be scheduled as needed.

 

d)                                                  For further details, please refer to Exhibits A and B attached hereto.

 

3.                                       Completion:  Manufacturer will use commercially reasonable efforts to complete the Services no later than the following:

 

Activity 1: Development Work

 

Week of March 19, 2012

Activity 2: Pre-qualification activities

 

Week of May 28, 2012

Activity 3: Qualification Campaign

 

Week of June 29, 2012

Activity 4: Qualification Stability

 

Stability study to start by July 31, 2012 and continue according to protocol

Activity 5: Pre-validation activities

 

Week of Sept 24, 2012

Activity 6: Analytical Methods Validation

 

Week of May 30, 2012

Activity 7: Validation Campaign (Batch #1-3)

 

Batch #1 and #2: Week of Dec 26, 2012. Batch #3: Week of Feb 11, 2013 (or 2 weeks earlier, if small quantity has been requested).

Activity 8: Validation Reports

 

20 working days after completion of Validation Batch #3, or 20 days from date requested by RADIUS

Activity 9: Validation Stability

 

Stability study to start within one month of batch purification and continue according to protocol

Activity 10: DMF Filing

 

Within 40 working days of date requested by RADIUS, but not earlier than 3.5 months after the end of the Validation Campaign.

 

4.                                       Facilities.  The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

3



 

Lonza S.A., Chausée de Tubize 297, B-1420 Braine l’Alleud, Belgium

 

5.                                       RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 

6.                                       RADIUS Equipment.

 

None

 

7.                                       Manufacturer Representative.

 

Raimund Miller, Director, Sales and Business Development, Lonza Custom Manufacturing

 

8.                                       RADIUS Representative.

 

Louis Brenner, Senior Vice President and Chief Medical Officer

 

9.                                       Compensation.  The total compensation due Manufacturer for Services under this Work Order will not exceed €363,500 plus the applicable charges for Activities 3 and 7, as shown in Exhibit A.  The reduced prices for validation Batch #2 and #3 will apply, if validation Batches can be Manufactured simultaneously. The fees for the performance of the Activities described above are set forth below.

 

 

 

Activity 1: Development Work

 

[*]

Activity 2: Pre-qualification activities

 

[*]

Activity 3: Qualification Campaign

 

See Exhibit A

Activity 4: Qualification Stability

 

[*]

Activity 5: Pre-validation activities

 

[*]

Activity 6: Analytical Methods Validation

 

[*]*

Activity 7: Validation Campaign, Batch #1-3

 

See Exhibit A

Activity 8: Validation Reports

 

[*]

Activity 9: Validation Stability

 

[*]

Activity 10: DMF Filing

 

[*]

 

In addition, the prices for the Additional Purification, as described in Activity 3 and 7, are identified in Exhibit A.

 

To the extent that a regulatory approval process is substantially different from FDA or EMEA and requires additional effort as part of Activity 10, an additional fee may apply as may be agreed to in writing by the parties.

 

Invoicing : Compensation will be paid in installments as follows: Twenty percent (20%) of the fee listed above for an Activity (or in the case of Activity 3 and 7, the applicable Batch or Additional Purification) will be invoiced upon commencement of such Activity; the remaining fee for the Activity will be invoiced upon completion of all Services for such Activity including, but not limited, delivery to RADIUS of the resulting material, if applicable.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

4



 

Expenses: Radius will be invoiced €22,500 for a stationary phase of an HPLC column used by Manufacturer in the Manufacture of the Product. This stationary phase will become the property of Radius upon payment to Manufacturer of the applicable invoice.

 

General : RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder. Manufacturer will invoice RADIUS to the attention of Nick Harvey, SVP and CFO, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 

10.                                Insurance will be provided as required by the Agreement.

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

 

By

/s/ Nick Harvey

 

By

/s/ Rachel Corder

 

 

 

 

 

 

Print Name

Nick Harvey

 

Print Name

Rachel Corder

Title

CFO

 

Title

Senior Legal Counsel

Date

December 22, 2011

 

Date

December 23, 2011

 

 

 

 

 

 

 

 

By

/s/ John Eley

 

 

 

 

 

 

 

 

Print Name

John Eley

 

 

Title

Legal Counsel

 

 

Date

December 23, 2011

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

5


 

Exhibit A

 

Pricing for Activity 3 and Activity 7

 

Pricing is identified below for several options which Radius may elect for the Activities identified below.

 

Activity 3, Qualification Campaign

 

 

 

First Purification (after synthesis at a scale of
180g NPW equivalent)

 

Additional
Purification

 

 

 

50g

 

100g

 

150g

 

180g

 

50g

 

Qualification Batch

 

[*

]

[*

]

[*

]

[*

]

[*

]

per gram

 

[*

]

[*

]

[*

]

[*

]

[*

]

 

Activity 7, Validation Campaign

 

 

 

First Purification (after synthesis at a scale of 180g NPW
 equivalent)

 

Additional
Purification

 

 

 

50g

 

100g

 

150g

 

180g

 

50g

 

Validation Batch #1

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

per gram

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

Validation Batch #2

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

per gram

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

Validation Batch #3

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

per gram

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 

[*

]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

6



 

Exhibit B

 

Proposal

RADIUS

Product: BA-058

(Lonza Code: RDS-001)

Proposal for Pre-Validation and Validation Activities (Regulatory Roadmap)

(Version 1.7)


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

7



 

 

PROPOSAL

 

RADIUS

 

Product: BA-058

 

(Lonza Code: RDS-001)

 

Proposal for Pre-Validation and Validation Activities

 

[Regulatory Roadmap]

 

Version 1.5

 

July 20, 2010

 

September 29, 2010

 

October 6, 2010

 

October 13, 2010

 

October 18, 2010

 

October 25, 2010

 

October 18, 2011 (version 1.5)

 

October 21, 2011 (version 1.6)

 

December 05, 2011 (version 1.7)

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

8



 

CONFIDENTIAL

 

CONFIDENTIAL

 

This proposal contains information proprietary to Lonza Sales AG, and must not be copied or otherwise distributed other than for the purpose of review by RADIUS in accordance with the terms of our existing CDA.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

9



 

Company: RADIUS

 

 

 

From:

 

Raimund Miller

 

 

 

 

 

 

Paul Tastenhoye

To:  

 

 

 

Date: Oct.18, 2011

 

 

Maria Grunwald, PhD

 

 

 

 

 

 

E-mail:

 

 

 

Page(s): 10

 

 

mgrunwald@radiuspharm.com

 

 

 

 

 

 

Subject: Regulatory Roadmap

 

 

 

Copy:

 

 

 

Dear Maria,

 

On behalf of Lonza, we are pleased to provide you with our proposal for Pre-Validation and Validation Activities [Regulatory Roadmap] for your BA-058 (Lonza Code: RDS-001).

 

We would like to thank you for giving us the opportunity to quote for these activities. We sincerely hope that this proposal will win your confidence, as Lonza is highly committed to meet your requirements to the fullest extent.

 

Kind regards,

 

 

 

 

 

Raimund Miller

 

Eric Bironneau

Director, Sales & BD

 

Head of Business Development - Peptides

Lonza Inc.

 

Lonza Sales Ltd.

Lonza Custom Manufacturing

 

Lonza Custom Manufacturing

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

10


 

1) Introduction

 

The quotation provided herewith covers all activities which are required prior to NDA filing of the BA-058 peptide; these activities are in addition to the two development campaigns, C1 and C2 (50 g and 300 g respectively), which were already run and which supported Radius’ product requirements for Ph II and Ph III clinical trials. These regulatory road-map activities comprise the following steps:

 

·                   Development work

·                   Pre-qualification activities

·                   Qualification campaign at 50g NPW scale

·                   Pre-validation documentation

·                   Analytical methods validation

·                   Validation campaigns - 3 batches at 50g NPW scale

·                   Post-validation documentation

·                   Master validation report

·                   DMF Filing

 

2)  Peptide Sequence

 

H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH 2

 

3)  Assumptions / Remarks

 

·                   The prices quoted are based on the yields and results obtained in the C2 campaign produced in 2010.

·                   The full SPPS strategy is the only strategy considered.

·                   The chemical assembly/cleavage process will be followed by two HPLC purifications (primary and secondary purifications) in order to meet the customer specifications. As a consequence, an expected final HPLC purity of the API > 97% will be obtained (by the FG1 method).

·                   Raw material prices: standard 2012 raw material prices were used in the cost calculations.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

11



 

4)  Development Work (all quotations are in Euros €; (pro memoriam, as of Oct.14, ’11, the US $ / € exchange rate was 1.38)

 

·                   Objective: Define the best conditions for the preparation of BA-058 peptide.

 

First of all, Lonza will have to define clearly which parameters have influenced the unexpected high yield in the C2 campaign. Moreover, Lonza needs to investigate the chemistry to ensure repeatability / reproducibility of such results for future campaigns. Various criteria will have to be evaluated.

 

1.               Concerning raw materials:

 

·                   In order to achieve the same quality for future campaigns, Lonza will have to test different resin suppliers and qualify at least two of them.

·                   Specifications of the starting resin should then be modified in order to fit the defined parameters.

 

2.               Concerning process, Lonza will have to challenge the different steps.

 

·                   Loading:

 

a)             use of preloaded resin or in-house loading?

b)             working range of loading. It has to be defined in terms of productivity and quality of the resulting crude material.

 

·                   Assembly:

 

a)             Identification of critical impurities in the crude coming from mono deletion or double addition. This analysis will be performed based on impurities present in C1 and C2 materials.

 

·                   Cleavage:

 

a)             Define the best conditions of cleavage in order to minimize impurities linked to this step (almost 15% HPLC area for two impurities formed during this cleavage step).

 

·                   Purification:

 

a)              Assessment of the potential impact of upstream development work on the purification process.

b)              Development of UPLC method for in process control corresponding to FG1 method (analysis time reduction).

 

·                   Deliverables:

 

Upstream (7 to 8 weeks)

 

·                   Development work - experimental part     € [*]

·                   Process development report — Compilation of the process knowledge (C1, C2, and development work)   € [*]

 

Downstream (2 to 3 weeks)

 

·                   Development work - experimental part   € [*]

·                   Process development report — Compilation of the process knowledge (C1, C2, and development work) € [*]

 

In order to reach Radius target in terms of price and timing, it has been decided to reduce tests performed during this development work.

 

Quotation for development activities (in Euros €) € 50,000 (Breakdown: see quotation for each activity; duration: almost 2.5 months with activities performed in parallel).

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

12



 

5) Pre-qualification Activities

 

·                   Objective: ensure we have a robust process by challenging parameters defined as critical for both upstream and downstream.

 

In order to ensure we have a robust process before running the qualification campaign, parameters defined as critical will have to be “challenged” in order to obtain a suitable working range for these parameters. Moreover, some stability studies will have to be conducted on different steps of the process in order to define “holding points”, such as:

 

For upstream part (2 weeks)     price € [*]

 

a)              stability of the peptide resin

b)              stability of the crude in neat TFA

c)               stability of the crude during evaporation step

d)              stability of the crude after precipitation

e)               stability of the crude during drying step

f)                stability of the crude upon storage, etc…

 

For downstream part (3 weeks)   price € [*].

Potential critical parameters such as column loading, gradient, chemical stability of fractions in purification and peptide concentration, tray volume, powder homogeneity in lyophilization will have to be assessed and challenged.

 

·                   Deliverables (4 weeks):

 

Upstream   € [*]

 

·                   Qualification parameter protocols

·                   Qualification parameter - experimental part

·                   Qualification parameter reports

·                   Definition of critical parameters Upstream

·                   Parameter List

·                   Robustness Testing

 

Downstream € [*]

 

·                   Qualification parameter protocols

·                   Qualification parameter experimental

·                   Qualification parameter reports

·                   Definition of critical parameters Downstream

·                   Parameter List

·                   Robustness Testing

 

Quotation for pre-qualification activities (in Euros €) € 80,000 (Breakdown: 37.5% upstream, 62.5% downstream; duration: 9 weeks with activities performed in parallel).

 

By reducing development work, less experiment needed for this part of the roadmap.

Costs have been decreased accordingly.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

13



 

6) Quotation for Qualification Campaign at 50g NPW scale (in Euros)

 

·                   Objective: Qualify the parameters defined as critical for both upstream and downstream for the preparation of BA-058 peptide.

 

Lonza will run the qualification campaign at a scale of 50g NPW; however, the assembly and cleavage reaction that will lead to the crude will be performed at a scale of 180g API equivalent, since this is the minimum scale at which the process can be validated later. The assembly will be performed in a 20L SPPS reactor. Only part of the crude (50g NPW out of 180g NPW) will be purified on an LC150 HPLC column and lyophilized in a GT10 lyophilizer. The excess of crude will be stored and can be purified later. Excellent 18M stability data of the crude are currently available.

 

The price is given for the first 50g NPW production (including the full cost of the crude at a scale of 180g NPW  API equivalent), as well is for the later processing of the excess crude (without crude processing cost and per 50g NPW API):

 

Quotation

 

First 50 g
NPW

 

50 g Price
without cost
of crude

 

First
100 g
NPW

 

First 150g
NPW

 

Full 180g
NPW

Raw Materials

 

[*

]

[*

]

[*

]

[*

]

[*]

Production:

 

 

 

 

 

 

 

 

 

 

·       Crude (at scale of 180 g API equivalent)

 

[*

]

[*

]

[*

]

[*

]

[*]

·      Purification and Lyophilisation

 

[*

]

[*

]

[*

]

[*

]

[*]

QC/QA Release

 

[*

]

[*

]

[*

]

[*

]

[*]

Total Quote

 

217,000

 

99,500

 

243,000

 

264,000

 

274,500

Price / g

 

[*

]

[*

]

[*

]

[*

]

[*]

 

·                   Lead time: 14 weeks

·                   Deliverables: see point 8

·                   Following Lonza SOP a Development Manufacturing Report will be issued after qualification, considered as engineering batch. In case of no change between this batch and validation batches, this is possible after an equivalency report to use this batch as commercial supply. Moreover, this batch may be use for clinical trials as far as API specifications are met, as for C1 and C2 campaigns material.

 

7) Qualification stability: 0, 6, 12, 24, 36 months

 

€ 21,600

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

14


 

8) Pre-validation Activities

 

·                   Objective: prepare validation campaigns

 

·                   Deliverables:

 

·                   Update Process development report — Compilation of the process knowledge (pre-qualification and qualification batch)

·                   Master validation protocol

·                   Upstream and Downstream process validation protocols

 

·                   Cost:

 

·                   Process development report upstream

·                   Master validation protocol

·                   Upstream process validation protocol

 

·                   Process development report downstream

·                   Downstream process validation protocol

 

Quotation for pre-validation activities (in Euros €):   € 30,000

 

·                   Expected time needed: ± 20 working days (upstream and downstream activities in parallel).

 

9) Analytical Methods Validation

 

·                   These activities should start at least 6 months before the first batch of validation.

·                   Validation of analytical methods :

 

·                   Acetate and Trifluoroacetate content in API € [*]

·                   Water content € [*]

·                   GC-Headspace (complement to general method) € [*]

·                   Direct GC (complement to general method)  € [*]*

·                   Specific rotation  € [*]

·                   Peptide content (Nitrogen) € [*]

·                   HPLC for in-process control upstream and downstream (3 methods). Need for HPLC methods will be discussed with Radius.

·                   HPLC for in-process control downstream : 2 methods (FG1 and VG1) € [*] each method

·                   HPLC for in-process control upstream : 3 methods: loading € [*], short method cleavage € [*], long method cleavage € [*]

 

Quotation for analytical methods validation (in Euros €):   € 71,000

 

Additional testing (if needed):

 

· LCMS comparability:

 

LC-MS analysis by TG1 method: € [*] per sample

Comparability report: € [*]

 

· reference standard [assuming 2 lots and 250mg of each minimum]

 

Sequencing by ES/MS/CAD/MS: € [*] for 2 samples

Amino acid analysis: € [*] for 2 samples

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

15



 

Limit test for residual amino acids: € [ *] for 2 samples

Secondary counter ions: € [ *] for 2 samples

 

· Heavy metals (USP/EP level)

 

€ [ 900 ]* per test sample (same method as for lot 4AI1) + $ [ *] for specific method validation (Sn, Cr, Hg, Pb, As, Cd per ICH guidelines)

 

· General properties:

 

Solubility: € [*] per test sample

pH: € [*] per test sample

isoelectric point: € [*] per test sample

 

10) Quotation for Validation Campaign at 50 g NPW scales (in Euros)

 

Lonza will  run do the validation campaign at a scale of 50g NPW; however, as for the qualification campaign, the assembly and cleavage reaction that will lead to the crude, will be performed at a scale of 180g API equivalent, since this is the minimum scale at which the process can be validated.

 

In order to make use of potential efficiencies, Radius asked for scenarios whereby validation batches V2 and V3 are performed in parallel. The quotes for these scenarios are presented in the table below:

 

·                   Validation batch 1 (V1) performed alone, no change in price

·                   Validation batches V2 and V3 performed in parallel in synthesis but not for purification

·                   2 releases in parallel for V2 and V3

 

The price is given for the first 50g NPW production (including the full cost of the crude at a scale of 180g NPW  API equivalent), as well is for the later processing of the excess crude (without crude processing cost and per 50g NPW API):

 

Validation 1:

 

Quotation

 

First 50 g
NPW

 

50 g Price
without cost
of crude

 

First
100 g
NPW

 

First 150g
NPW

 

Full 180g
NPW

 

Raw Materials

 

[*

]

[*

]

[*

]

[*

]

[*

]

Production:

 

 

 

 

 

 

 

 

 

 

 

·   Crude (at scale of 180 g API equivalent)

 

[*

]

[*

]

[*

]

[*

]

[*

]

·   Purification and Lyophilisation

 

[*

]

[*

]

[*

]

[*

]

[*

]

QC/QA Release

 

[*

]

[*

]

[*

]

[*

]

[*

]

Homogeneity Study

 

[*

]

[*

]

[*

]

[*

]

[*

]

Total Quote

 

226,750

 

99,500

 

252,750

 

273,750

 

284,250

 

Price / g

 

[*

]

[*

]

[*

]

[*

]

[*

]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

16



Validations 2 and 3:

 

Quotation

 

First 50 g
NPW

 

50 g Price
without cost
of crude

 

First
100 g
NPW

 

First 150g
NPW

 

Full 180g
NPW

 

Raw Materials

 

[*

]

[*

]

[*

]

[*

]

[*

]

Production:

 

 

 

 

 

 

 

 

 

 

 

·   Crude (at scale of 180 g API equivalent)

 

[*

]

[*

]

[*

]

[*

]

[*

]

·   Purification and Lyophilisation

 

[*

]

[*

]

[*

]

[*

]

[*

]

QC/QA Release

 

[*

]

[*

]

[*

]

[*

]

[*

]

Homogeneity Study

 

[*

]

[*

]

[*

]

[*

]

[*

]

Total Quote

 

209,000

 

97,750

 

235,000

 

256,000

 

266,500

 

Price / g

 

[*

]

[*

]

[*

]

[*

]

[*

]

 

Lead time: 17 weeks (3 validation campaigns)

 

Total price for the 3 validation campaigns at 50 g:   1 x €226,750 + 2 x €209,000 = €644,750

 

Concerning homogeneity, this study in plates is performed during prequalification activities. In the case of the validation batches, defined as the most representative material compared to commercial batches, the homogeneity study is performed on bulk material during dispensing. This work will be done on all validation batches and will assay water content, acetonitrile content and acetate content ( 9,750 per batch). This is the reason why validation batches are a bit more expensive than qualification batches.

 

No experience gain is expected between qualification and validation batches at that scale: same equipments, same scale.

 

11) Validation Reports

 

·                   Upstream process validation reports:               € [*] (20 working days)

·                   Downstream process validation report:           € [*] (20 working days)

 

Quotation for Validation reports:                 €22,500

 

12) Validation stability: ICH (0, 3, 6, 9, 12 etc. months)

 

€ 35,000 per batch

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

17



 

13) Stationary phase HPLC column

 

5kg of stationary phase of the HPLC column will be charged to Radius. This stationary phase is fully dedicated to BA-058 and cannot be used anymore for other products in case the RDS-001 project would stop for any reason. Therefore, it is now common practice at Lonza to sell the full amount of the phase directly to the customer at the start of a project. Once Radius has paid for it, it becomes Radius property.

 

€ 22,500€.

 

14) DMF Filing

 

Quotation for DMF filing: €40,000

 

15) Validity of Proposal

 

The validity of this proposal expires on December 31, 2011.

 

BK / RJM

07/20/10; 09/29/10; 10/06/10; 10/13/10; 10/18/10; 10/25/10.

 

PT/RJM

10/18/11; 10/21/11; 12/05/11

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

18


 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

WORK ORDER NO. 5

 

THIS WORK ORDER NO. 5 is by and between RADIUS HEALTH, INC. (“RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “ Manufacturer ”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007, as amended to date (the “ Agreemen t”). Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.                                       API/Drug Substance and Product .

 

BA058

 

Peptide Sequence :  H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH2

 

(collectively, “Product”)

 

2.                                       Services.   Manufacturer will render to RADIUS the following Services:

 

Activity 1: Production : Manufacturer will use commercially reasonable efforts to Manufacture a Batch of Product at a purification scale of approximately NPW (net peptide weight) 230 g. The Batch of Product will be manufactured in a 20L SPPS reactor and will be purified on an LC150 HPLC column and lyophilized in a GT10 lyophilizer.

 

Manufacturer shall use commercially reasonable efforts to manufacture, in accordance with cGMP and the Manufacturing Process, enough crude to yield approximately 230 grams NPW of Product to meet Specifications as agreed in Appendix A and deliver the actual quantity prepared to Radius.

 

Manufacturer plans to commence performance of this Work Order the week of January 5, 2015.

 

·                        Assembly: estimated week 2-5

·                        Purification: estimated week 9-10

·                        Lyophilisation: estimated week 11

·                        Release: estimated week 15 (April 13) — week 16 (April 20)

 

Radius shall place purchase orders with Manufacturer in accordance with Work Order 5 and shall not be permitted to terminate prior to the completion of the Services.

 

The deliverables will include regular updates (status reports, conference calls), as reasonably requested by RADIUS.

 

3.                                       Facilities.  The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

N/A

 

4.                                       RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

5.                                       RADIUS Equipment.

 

None

 

6.                                       Manufacturer Representative.

 

Debra Sponholtz, Director, Sales East Coast, Lonza

 

7.                                       RADIUS Representative.

 

David Hanley, Executive Director, Technical Operations

 

8.                                       Compensation.  Radius will be invoiced 1667 €/gram upon Manufacturer’s release of the Product. Radius shall purchase all surplus quantities of the Product arising from the manufacture of the Batch at a rate of 1667 €/gram. The total compensation due Manufacturer for Services under this Work Order is not expected to exceed €400,000.

 

9.                           General : RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder. Manufacturer will invoice RADIUS to the attention of David Hanley, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

By

/s/ David C. Hanley

 

By

/s/ Fabrice Gachot

 

 

 

 

 

 

 

 

 

Print Name

David C. Hanley

 

Print Name

Fabrice Gachot

Title

Executive Director

 

Title

Head of Business Development

Date

4 Dec 2014

 

Date

 

 

 

 

/s/ Greg Williams

3 Dec. 2014

 

 

 

 

 

By

/s/ Nadia Zieger

/s/ David C. Hanley

3 Dec. 2014

 

 

(Bob Ward by email)

 

Print Name

Nadia Zieger

 

 

Title

Senior Legal Counsel

 

 

Date

10 Dec. 14

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Exhibit A

 

Specifications

 

See attached

 

MLP ID

B0-40066PA

MLP Version

8

Modified on

12-May-2014 16:40

Modified by

AFRANCOIS

Description

180798 RDS-001 Abaloparatide

Product code

CR298021 Shell life : [*]

Product group

 

Version comment

 

Test schedule

B0-40066PA.08

Substance

180798

Document

 

Document Version

 

Modifiable

TRUE

Group

B0

 

Component

 

Type

 

 

 

Intern

 

Extern

 

Warning

 

Unit

 

DP

 

CoA

 

Pos

 

Short

 

Dyn
Lvl

 

Part
Samp

 

Std

B0VO11042A

 

T

 

Text

 

 

Powder

 

 

 

 

0

 

*

 

1

 

*

 

0

 

Y

 

Y

Appearance

 

 

 

Phrase

 

 

B0-40066PA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0VO11042A

 

T

 

Text

 

 

White to off-white

 

 

 

 

0

 

*

 

2

 

*

 

0

 

Y

 

Y

Colour

 

 

 

Phrase

 

 

B0-40066PB

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864C

 

T

 

Text

 

 

Complies

 

 

 

 

0

 

*

 

3

 

*

 

0

 

Y

 

Y

Coelution with reference

 

 

 

Phrase

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

sample (HPLC)

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864C

 

N

 

Min

 

 

[*]

 

 

%

 

1

 

*

 

4

 

*

 

0

 

Y

 

Y

Total Impurities (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864C

 

N

 

Min

 

 

[*]

 

 

%

 

1

 

*

 

5

 

*

 

0

 

Y

 

Y

Impurity, main (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864C

 

N

 

Min

 

 

[*]

 

 

%

 

1

 

*

 

6

 

*

 

0

 

Y

 

Y

Purity (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864C

 

N

 

Min

 

 

[*]

 

 

%w/w

 

1

 

*

 

7

 

*

 

0

 

Y

 

Y

API content (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0LO14864E

 

N

 

Min

 

 

 

 

 

 

2

 

*

 

8

 

*

 

0

 

Y

 

Y

Imp. unknowm, RRT,

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

>0.1%area (HPLC)

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Component

 

Type

 

 

 

Intern

 

Extern

 

Warning

 

Unit

 

DP

 

CoA

 

Pos

 

Short

 

Dyn
Lvl

 

Part
Samp

 

Std

B0L014864E

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

9

 

*

 

0

 

Y

 

Y

Impurity unknowm,

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

>0.1%area (HPLC)

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0M024591A

 

N

 

Min

 

 

[*]

 

 

Da

 

1

 

*

 

10

 

*

 

0

 

Y

 

Y

Mass, average (MS)

 

 

 

Max

 

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0L015151A

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

11

 

*

 

0

 

Y

 

Y

Total impurities (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0L015151A

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

12

 

*

 

0

 

Y

 

Y

Impurity, main (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0L015151A

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

13

 

*

 

0

 

Y

 

Y

Purity (HPLC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0M0007621

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

14

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0M0007621

 

N

 

Min

 

 

 

 

%

 

1

 

*

 

15

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0L022057A

 

N

 

Min

 

 

[*]

 

 

%w/w

 

1

 

*

 

16

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0L022057B

 

N

 

Min

 

 

[*]

 

 

%w/w

 

1

 

*

 

17

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0N024072A

 

N

 

Min

 

 

[*]

 

 

%w/w

 

1

 

*

 

18

 

*

 

0

 

Y

 

Y

Water (KF, coulom.)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G024588A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

19

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Component

 

Type

 

 

 

Intern

 

Extern

 

Warning

 

Unit

 

DP

 

CoA

 

Pos

 

Short

 

Dyn
Lvl

 

Part
Samp

 

Std

B0G024588A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

20

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G024588A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

21

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G024588A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

22

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G024588A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

23

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G024635A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

24

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0G012082A

 

N

 

Min

 

 

[*]

 

 

µg/g

 

0

 

*

 

25

 

*

 

0

 

Y

 

Y

Total residual solvents (GC)

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0O023196A

 

N

 

Min

 

 

[*]

 

 

*

 

1

 

*

 

26

 

*

 

0

 

Y

 

Y

Specific Optical Rotation

 

 

 

Max

 

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(on AFB)

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0K011068W

 

N

 

Min

 

 

[*]

 

 

EU/mg

 

0

 

*

 

27

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0K011091J

 

N

 

Min

 

 

[*]

 

 

CFU/100mg

 

0

 

*

 

28

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0K011091J

 

N

 

Min

 

 

[*]

 

 

CFU/100mg

 

0

 

*

 

29

 

*

 

0

 

Y

 

Y

[*]

 

 

 

Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B0A022698A

 

N

 

Min

 

 

[*]

 

 

%w/w

 

0

 

*

 

30

 

*

 

0

 

Y

 

Y

Mass balance (calculated)

 

 

 

Max

 

 

[*]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AQL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

3


 

WORK ORDER NO. 6

 

THIS WORK ORDER NO. 6 is by and between RADIUS HEALTH, INC. (“RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “ Manufacturer ”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “ Agreemen t”). Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.                                       API/Drug Substance and Product .

 

BA058

 

Peptide Sequence : H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH2

 

2.                                       Services.   Manufacturer will render to RADIUS the following Services:

 

Activity 1: Transfer of method FG2 to Vetter, (report containing analytical results).: 9,230€

Activity 2: Bridging study for API /DP. 12 batches or 120 samples to test:  14,615€

Activity 3: Bridging reports TG2 with TG1 and FG2 with FG1: 2,770€

Activity 4: 3 registration stability batches

1.               Time point 0: 3 batches — 3 conditions:  ( 9 x 7h =63h )

2.               Time point 1M: 3 batches — 2 conditions: ( 6 x 7h =42h )

3.               Time point 3M: 3 batches — 3 conditions:  ( 9 x 7h =63h )

 

Total Price: = 29,040€

 

Activity 5: Release testing of 3 Vetter batches with FG2:

·                   3 batches, or 30 samples : 4,710€

 

Radius shall place purchase orders with Manufacturer in accordance with Work Order 6.

 

The deliverables will include regular updates (status reports, conference calls), as requested by RADIUS.

 

3.                                       Facilities.  The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

N/A

 

4.                                       RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 

5.                                       RADIUS Equipment.

 

None

 

6.                                       Manufacturer Representative.

 

Debra Sponholtz, Director, Sales and Business Development, Lonza

 



 

7.                                       RADIUS Representative.

 

David Hanley, Executive Director, Technical Operations

 

8.                           Compensation.  Radius will be invoiced 50% upon signature of this WO and 50% upon Completion of each Activity. The total compensation due Manufacturer for Services under this Work Order is not expected to exceed €60,365

 

9.                           General : RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder. Manufacturer will invoice RADIUS to the attention of David Hanley, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

By

/s/ Greg Williams

 

By

/s/ Fabrice Gachot

 

/s/ Nadia Zieger

 

 

 

 

 

 

 

 

 

 

Print Name

Greg Williams

 

Print Name

Fabrice Gachot

 

Nadia Zieger

Title

CDO

 

Title

Head of Business Development

 

Senior Legal Counsel

Date

22 Dec 2014

 

Date

 

 

 

 


 

WORK ORDER NO. 7

 

THIS WORK ORDER NO. 7 is by and between RADIUS HEALTH, INC. (“RADIUS”) and LONZA Sales Ltd, a Swiss company having an address at Muenchensteinerstrasse 38, CH-4002 Basel, Switzerland (together with its Affiliates, “ Manufacturer ”), and upon execution will be incorporated into the Development and Manufacturing Services Agreement between RADIUS and Manufacturer dated October 16, 2007 (the “ Agreemen t”). Capitalized terms in this Work Order will have the same meanings as set forth in the Agreement.

 

RADIUS hereby engages Manufacturer to provide Services, as follows:

 

1.             API/Drug Substance and Product .

 

BA058

 

Peptide Sequence : H-Ala-Val-Ser-Glu-His-Gln-Leu-Leu-His-Asp-Lys-Gly-Lys-Ser-Ile-Gln-Asp-Leu-Arg-Arg-Arg-Glu-Leu-Leu-Glu-Lys-Leu-Leu-Aib-Lys-Leu-His-Thr-Ala-NH2

 

2.             Services.   Manufacturer will render to RADIUS the following Services:

 

Activity 1: R egulatory activities necessary to support submission of RDS-001 NDA by the customer Radius according to the defined timelines.

 

Scope of work will include full NDA module 3.2.S and corresponding 2.3.S section written by Lonza on templates provided by customer, based on finalised source documents available on site and/or provided by customer.

 

Estimation of regulatory activity:

 

Estimated cost includes familiarization with the project, internal review with technical experts, one review round with customer followed by one document update.

·         Writing of full NDA 3.2.S and corresponding 2.3.S sections for RDS-001 Drug Substance:

·         Estimated Time is 34-40 working days

 

Estimated price:

         68’000-80,000 Euro

 

Administrative charges and fees related to the legalization and/or issuing of original documents by local Health Authorities will be charged at additional cost to the customer.

 

Timelines

 

Expected submission date is 30 th  September 2015. Detailed timelines for review and finalisation of 3.2.S sections to be agreed by both Parties.

 

Additional Services

 

Additional services can be provided at a manday-rate basis (2000 Euro/day), examples provided here:

·         Support for Health Authority Questions

·         Support for follow-on submissions in additional regions

·         Maintenance of NDA throughout life cycle

 



 

In the event additional services are requested a separate work order will be agreed by both Parties.

 

Activity 2: Training of Vetter technicians in Braine on the Lonza method that is to be transferred to Vetter as outlined in WO6.

 

Price: 5270 Euro

 

Radius shall place purchase orders with Manufacturer in accordance with Work Order 7.

 

The deliverables will include regular updates (status reports, conference calls), as requested by RADIUS.

 

3.                                       Facilities.  The Services described above will be rendered at the Facility unless another facility of Manufacturer is indicated below:

 

N/A

 

4.                                       RADIUS Materials.   RADIUS will provide to Manufacturer the following materials to be used by Manufacturer to perform the Services:

 

None

 

5.                                       RADIUS Equipment.

 

None

 

6.                                       Manufacturer Representative.

 

Debra Sponholtz, Director, Sales and Business Development, Lonza

 

7.                                       RADIUS Representative.

 

David Hanley, Executive Director, Technical Operations

 

8.                           Compensation.  Radius will be invoiced 50% upon signature of this WO (€36,635) and 50% upon Completion of each Activity. The total compensation due Manufacturer for Services under this Work Order is not expected to exceed €85,270

 

9.                            General : RADIUS and Manufacturer must agree in advance of either party making any change in the compensation due hereunder. Manufacturer will invoice RADIUS to the attention of David Hanley, for Services rendered under this Agreement.  Manufacturer will invoice RADIUS for all amounts due under this Work Order.  All undisputed payments will be made by RADIUS within thirty (30) days of receipt of invoice.

 

All other terms and conditions of the Agreement will apply to this Work Order.

 

WORK ORDER AGREED TO AND ACCEPTED BY:

 

RADIUS HEALTH, INC.

 

LONZA SALES LTD

 

 

 

 

 

By

/s/ Gregory C. Williams

 

By

/s/ Marie Leblane

 

/s/ Nadia Ziegar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Print Name

Gregory C. Williams

 

Print Name

Marie Leblane

 

Nadia Ziegar

 



 

Title

Chief Development Officer

 

Title

Associate Director

Key Account Management

Senior Legal Counsel

Date

2/18/15

 

Date

24 February 2015

 




Exhibit 10.18

 

DEVELOPMENT AND CLINICAL SUPPLIES AGREEMENT*

 

This Development and Clinical Supplies Agreement (the “Agreement”) is entered into as of the 19th day of June 2009 (“Effective Date”) by and among:

 

1.                                       3M COMPANY (“3M”) and 3M INNOVATIVE PROPERTIES COMPANY (“3M IPC”) with its principal address as 3M Center, St. Paul, MN 55144 USA; and

 

2.                                       Radius Health Inc. with its principle address at 300 Technology Square, Cambridge, MA  02139 (“RADIUS”).

 

WHEREAS

 

1.                                       3M, through its Drug Delivery Systems Division, has developed expertise and has rights in technology relating to drug delivery, including a proprietary microstructured transdermal system (“MTS”) for delivering drugs into and through the skin;

 

2.                                       RADIUS has experience and expertise in the research, development and commercialization of pharmaceutical products, including expertise in their proprietary compound BA058 (“Compound”);

 

3.                                       3M and RADIUS have entered a Feasibility Agreement for the development of BA058 coated MTS product (“Product”) on December 5, 2008 (the “Feasibility Agreement”) and are nearing conclusion of work under that agreement;

 

4.                                       3M and RADIUS wish to continue the Product development activities and to have 3M provide clinical and toxicology supplies to RADIUS suitable for preclinical, phase I and phase II studies.  If successful, RADIUS or its sublicensee may wish to further develop and commercialize the Product and 3M may wish to further develop and manufacture such Product for RADIUS or its sublicensee.

 

IT IS AGREED as follows:

 

1.                                       DEFINITIONS

 

1.1                                                                    Affiliate ” shall mean any company, firm or other entity controlling, under common control with or controlled by the relevant entity by

 

1



 

ownership, direct or indirect, of more than fifty percent (50%) of the shares of outstanding capital stock thereof.  For the purpose of this Agreement, the terms “3M” and “Radius” shall include each Affiliate.

 

1.2                                                                    Information ” shall mean all written information relating to Compound, MTS, components, formulations, Product, Workplan and business plans, including but not limited to data; know-how; technical and non-technical materials; and compound and formulation samples, test results and specifications, which either Party shall deliver to the other pursuant to this Agreement or produced during performance of the work hereunder, stamped “Confidential” and all oral material which each Party declares to be “confidential” and confirms in writing within thirty (30) days of disclosure.

 

1.3                                                                    Invention ” shall mean all discoveries, inventions, ideas, data, know-how whether patentable or not arising during and out of the Program under this A greement .

 

1.4                                                                 Program ” shall mean a development and clinical supplies  program comprised of work conducted pursuant to a Workplan as amended in writing from time to time in accordance with the terms of this Agreement.

 

1.5                                                                 Workplan ” (an example is attached hereto as Exhibit A) shall mean a reasonably detailed definition of the scope of work to be performed, timeline and deliverables in connection with the Program.

 

2.                                       SCOPE and CONDUCT OF WORK :

 

2.1                                                             3M and RADIUS shall use reasonable commercial efforts to carry out their obligations in respect of the work described in the Workplan in a timely and effective manner making available those of their respective personnel necessary to perform the Workplan.  The Workplan is staged in a series of go/no go decision points.

 

2.2                                                             3M will carry out agreed development activities relating to the MTS array, coating, and applicator in conjunction with Compound as detailed in the Workplan.  3M will develop formulations as detailed in the Workplan.

 

2



 

2.3                                                             Any material change in the Workplan requiring more than a [*]% increase in the estimated cost to Radius specified in Exhibit C for any phase of the Workplan (having reference to the upper bound of the estimated cost for such phase) shall be agreed between the Parties in writing in the form of a change order, the form of which is attached hereto as Exhibit B (a “Change Order”) via the change order process provided in Section 2.4.

 

2.4                                                             If Radius elects to make changes to the subject matter or scope of any Program, Radius will provide 3M with the information set forth in Exhibit B (“Change Order Form”), and, within 10 business days, the Parties will in good faith negotiate any change to the Workplan including timelines or budget.  Neither Radius nor 3M will have any obligation to implement changes or recognize suggested changes unless and until a revised Change Order Form and amended Workplan is agreed and executed by the Parties.

 

2.5                                                             3M and Radius recognize that there is no certainty as to the outcome of any Workplan, and neither makes any warranties to the other regarding technical success, commercial success, or noninfringement of resulting Product.  Furthermore, neither Radius nor 3M has any obligation under this Agreement to proceed beyond the Workplan.

 

3.                                       MANAGEMENT OF PROGRAM

 

3.1                                                             In order to have appropriate coordination between the parties in the course of the implementation of the Workplan, each party agrees to (i) appoint a technical project leader, (ii) appoint a commercialization manager, (iii) set up a joint technical team for product development management, comprising appropriate membership from 3M and RADIUS.

 

3.2                                                             The commercialization managers shall be in charge of the daily and regular communication between the parties with respect to the implementation of the Workplan. The technical project leaders shall be in charge of overseeing the implementation of the Workplan. The Joint Technical Team shall provide general guidance to the parties with respect to the implementation of the Workplan, manage all issues that may occur in connection with the Workplan, and define timelines and budget .

 

3



 

3.3                                                             The parties will keep each other informed of their progress and provide written minutes following each meeting summarizing the results of work completed.

 

3.4                                                        Radius will supply to 3M such technical, scientific, and other information concerning the Compound and the Program as 3M shall reasonably require from time to time in order to complete the Workplan.

 

3.5                                                             Radius agrees to liaise with 3M during the course of the Program and to deal promptly within 15 business days with any reasonable requests for information or further instructions in connection with the Program.

 

4.                                       SUPPLY OF COMPOUND AND COMPONENTS

 

4.1                                                             Radius shall supply 3M (i) free of charge with sufficient quantities of the Compound to enable 3M to conduct the Program as set forth in the Workplan and (ii) a certificate of analysis for the Compound.  Any Compound unused by 3M for its Workplan activities at the termination of the Program shall be returned upon request to Radius.

 

4.2                                                             Radius shall promptly provide 3M with all information in or coming into its possession concerning the Compound that 3M will reasonably require for the safe handling, storage, testing, use and transport thereof.

 

4.3                                                             3M shall supply excipients, MTS and any other agreed upon materials or components required to complete its activities under the Workplan.

 

5.                                       CLINICAL STUDIES AND TOXICOLOGY STUDIES

 

5.1                                                             RADIUS shall at its own expense be responsible for any clinical studies and/or toxicology studies and all contact with any regulatory authority concerning the Product.

 

5.2                                                             RADIUS understands and acknowledges that it will have sole responsibility for the safe handling, storage, testing, use and transport of Product in preclinical and clinical studies.

 

4



 

5.3                                                             3M will provide a non-confidential data package with the CMC section of regulatory submissions in support of RADIUS’ regulatory filings.  If needed, 3M will provide for regulatory review by right of reference to Drug Master Files.

 

5.4                                                             At RADIUS’ request and expense, and with reasonable advance notice, 3M will attend and participate in meetings with the FDA or other regulatory authorities regarding Product.

 

5.5                                                             3M will also provide RADIUS any other relevant information required for regulatory filings (e.g. preclinical data, local tolerance of materials, etc.)

 

5.6                                                             3M will manufacture and release preclinical and clinical supplies under the Workplan meeting agreed upon specifications and in compliance with current Good Manufacturing Practices (“cGMPs”) and/or current Good Laboratory Practices (“cGLPs”).

 

6.                                       PAYMENTS

 

6.1                                                             Radius shall pay 3M at a rate of [*] Dollars ($[*]) per hour for work carried out in connection with the Workplan.  The estimated costs for the Workplan are listed on Exhibit C.  Both Parties acknowledge that the costs are estimates and 3M shall make reasonable efforts to stay within the estimates.  If during the program 3M anticipates that the estimated cost of the program will exceed 110 % of the costs listed in Exhibit C (i.e., exceed the upper bound of the estimated cost for any phase of the Workplan), the Parties shall meet to determine what if any adjustments in the Workplan and/or estimates should be made.  3M shall have the right to increase the hourly rate once per calendar year in an amount equal to the increase in the Employment Cost Index (“ECI”) over the previous calendar year upon thirty ( 30 ) days’ written notice to RADIUS with the first such notice delivered not earlier than January 31, 2010.

 

6.2                                                             RADIUS shall also reimburse 3M for its reasonable, and documented  incidental costs incurred pursuant to the Workplan including but not limited to travel and 3M’s out-of-pocket costs.

 

6.3                                                             Payments by Radius shall be net thirty (30) days from receipt of invoice with interest accruing at 1.0% per month for late payments.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

5



 

6.4                                                             RADIUS shall pay the above considerations by a wire transfer to a bank account designated by 3M.

 

Name of the bank:  JP Morgan Chase

Address:  1 Chase Manhattan Plaza

New York, NY  10081

 

ABA:  021000021

Beneficiary:  777180811

The Name of the Account Holder:  3M Company

Swift Address:  [*]

 

7.                                       INTELLECTUAL PROPERTY

 

7.1                                                             Except as necessary to conduct the work under this Agreement, neither 3M, 3M IPC, nor RADIUS grant any right or license under any patent rights or other intellectual property rights conceived prior to effective date of this Agreement.  It is, however, understood that the licenses previously granted by each party to the other party(ies) under the Feasibility Agreement shall remain in effect with respect to any rights in inventions, patents or data developed pursuant to the Feasibility Agreement in the event and to the extent such inventions, patents or data are necessary or useful to the performance of the activities contemplated by this Agreement (and subject to the provisions of this Section 7) treating such inventions, patents and data as if they were developed during and out of the work performed under this Agreement from and after the Effective Date.

 

7.2                                                             Except as otherwise provided below, any inventions conceived during and out of the work performed under this Agreement, and patents and applications filed thereon (“Program Patents”), shall be owned according to U.S. law as follows: those conceived solely by employees or agents of one party shall be owned by that party; those conceived jointly by an employee or agent of 3M and an employee or agent of Radius shall be owned jointly by 3M and Radius and will be considered Confidential Information of both parties with each joint owner having the right, subject to this Agreement, to practice, license, and transfer its undivided rights in such joint inventions without permission of or accounting to the other(s)) under the conditions provided for in this Agreement; provided that it is

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

6



 

expressly understood and agreed that other than to conduct the work contemplated by this Agreement, (a) 3M shall have no right to use jointly owned inventions or jointly owned Program Patents in conjunction with the Compound or any prescription pharmaceutical product that includes, as an active ingredient, any compound, other than the Compound, which is a PTH related protein, analogue or derivative but specifically excluding PTH itself or any analogue or derivative, and (b) RADIUS shall have no right to use jointly owned inventions or jointly owned Program Patents in conjunction with MTS.  Information and data developed during and resulting from the work under this Agreement (“Program Data”), solely by employees or agents of one party shall be owned by that party; those data developed jointly during and resulting from the work under this Agreement by an employee or agent of 3M and an employee or agent of Radius shall be owned jointly by 3M and Radius (and each joint owner shall have the right to practice, license, and transfer its undivided rights in such jointly owned Program Data without permission of or accounting to the other(s)) under the conditions provided for in this Agreement; provided that it is expressly understood and agreed that other than to conduct the work contemplated by this Agreement, (i) 3M shall have no right to use jointly owned Program Data in conjunction with the Compound or any prescription pharmaceutical product that includes, as an active ingredient, any compound, other than the Compound, which is a PTH related protein, analogue or derivative but specifically excluding PTH itself or any analogue or derivative, and (ii) RADIUS shall have no right to use jointly owned Program Data in conjunction with MTS.

 

7.3                                                             Notwithstanding the foregoing provisions of this Section 7, Program Patents and Program Data directly relating to the Compound, an improved Compound, or method of making or using Compound, regardless of inventorship, shall be owned by Radius; and Program Patents and Program Data directly relating to MTS devices (including manufacturing, coating, or uses thereof), regardless of inventorship, shall be owned by 3M.

 

7.4                                                             3M, 3M IPC and RADIUS grant each other a worldwide, perpetual, royalty-free, nonexclusive license under Program Data and Program Patents concerning or covering formulations of Compound solely for purposes of conducting the work contemplated by this Agreement.  It is expressly understood and agreed that other than to conduct the work contemplated by this Agreement, (a) 3M shall have no right to use such Program Data or Program Patents that are licensed to it by Radius under this Section 7.4 in conjunction with the Compound or any prescription

 

7



 

pharmaceutical product that includes, as an active ingredient, any compound, other than the Compound, which is a PTH related protein, analogue or derivative but specifically excluding PTH itself or any PTH analogue or derivative, and (b) RADIUS shall have no right to use such Program Data or Program Patents that are licensed to it by 3M or 3M IPC under this Section 7.4 in conjunction with MTS.

 

7.5                                                             The above licenses shall be transferable by 3M in connection with the sale of its MTS business or RADIUS in connection with sale of its pharmaceutical business, and sub licensable in relation to products developed, manufactured, or sold by 3M or RADIUS.

 

7.6                                                             Upon the termination of this Agreement, each party will, at its election, return or destroy any tangible materials embodying the technology owned by the other party.

 

7.7                                                             Each party shall promptly disclose to the other party(ies) any inventions to the extent related to the other party’s or parties’ materials or technology conceived during and out of the work under this Agreement, that might, under applicable law, be patentable or otherwise protectable.  Each party may prepare, file, prosecute, maintain, abandon, terminate, enforce, and otherwise handle solely owned patent rights at its sole discretion and expense.  Joint patent applications and patents may be prepared, filed, prosecuted, and maintained primarily by RADIUS at its expense if claiming an invention that is based primarily on the Compound and by 3M IPC at its expense if based primarily on the MTS devices, and if the invention being claimed is not clearly either of the foregoing, the parties will agree in good faith how best to handle the cost, preparation, filing, prosecution, maintenance, abandonment, or termination of such joint applications and patents.  Within forty five ( 45 ) days following the date of disclosure regarding the existence of particular jointly owned patents, the parties shall confer and mutually agree as to appropriate protection for such jointly owned patents, including an application, preparation, prosecution and maintenance strategy.  The parties shall use outside counsel reasonably acceptable to each party to execute the agreed upon protection strategy, which counsel shall be responsible to both RADIUS and 3M, and shall use reasonable efforts to solicit both RADIUS’ and 3M’s advice on material application, preparation, prosecution and maintenance matters related thereto.  If, within six ( 6 ) months of the date of disclosure regarding the existence of particular jointly owned

 

8


 

patent rights, the Parties have not reached mutual agreement on a protection strategy and outside counsel to execute the protection strategy, either party may initiate dispute resolution under Section 12.5.  All expenses incurred in obtaining and maintaining any patent on jointly owned patents shall be equally shared ( 50 % each), unless one party declines to share in such expenses, then in that event the other party may assume responsibility for the prosecution and maintenance thereof, at its sole expense, provided that:  (i) title to the patent remains in the names of both parties, and (ii) the non-paying party shall have an automatic, worldwide, royalty-free, nonexclusive license thereto.  If a party that proceeds to pursue patent prosecution or maintenance activities pursuant to the preceding sentence of this Section 7.7 subsequently declines to continue such prosecution and maintenance, then the other party may take over the prosecution and maintenance thereof, at its sole expense and subject to reimbursement of one-half (50%) of the expenses paid by the other party during the period when it was not funding its share of such activities, at which time such other party shall recapture all rights thereto.  It is understood and agreed that subject to compliance with this Section 7.7, the non-filing party shall consent to the disclosure of jointly owned Confidential Information concerning jointly owned Program Patents.

 

8.                                       CONFIDENTIALITY

 

8.1                                                        The Parties agree to use reasonable efforts to maintain Information disclosed by the other in confidence, including at least efforts fully commensurate with those to protect its own confidential information.  Neither Party will use the Information of the other Party except for the performance of the work described in the Program. Each Party will disclose the Information only to its officers and employees directly concerned with the Program to whom it is necessary or useful to disclose such Information, but will neither disclose the Information to any third party nor use the Information for any other purpose; provided that Radius may disclose the Information to third party collaborator(s) as necessary for purposes of establishing Radius’ satisfaction of development milestones with respect to the Compound if such collaborators are subject to a written confidentiality agreement no less restrictive than the terms of this Section 8.  Each Party acknowledges that, except for the rights expressly granted under this Agreement, it will not obtain any rights of any sort in or to the Information of the other Party as a result of such

 

9



 

disclosure and that any such rights must be the subject of separate written agreement(s).

 

8.2                                                            The disclosing Party may at any time notify the receiving Party in writing that such receiving Party must return to the disclosing Party the disclosing Party’s Information.  Each Party hereby agrees to, within thirty (30) days of such notification:  (i) return all documents and tangible items it or its employees or agents have received or created pursuant to this Agreement pertaining, referring or relating to the other Party’s Information; and (ii) return or certify (in a writing attested to by a duly authorized officer of such Party) destruction of all copies, summaries, modifications or adaptations that such Party or its employees or agents have made from the materials provided by the disclosing Party; provided, however, that a Party is permitted to retain one copy of such materials in its legal files to be used to verify compliance with its obligations hereunder.

 

8.3                                                            Neither Party will make any public announcement as to the execution of this Agreement or its terms without the prior written authorization of the other Party.  This shall not prevent a Party from such disclosures regarding the existence or terms of this Agreement to the extent required under applicable federal or state securities laws or any rule or regulation of any nationally recognized securities exchange.  In such event, however, the disclosing Party shall use good faith efforts to notify and consult with the other Party prior to such disclosure and, where applicable, shall diligently seek confidential treatment to the extent such treatment is available under applicable securities laws, rules, or regulations.  In addition, each Party may provide a copy of this Agreement or disclose the terms of this Agreement (i) to any finance provider in conjunction with a financing transaction, if such finance provider agrees to keep this Agreement confidential, (ii) to enforce its rights under this Agreement, (iii) to any legal or financial advisor of such Party, or (iv) in response to a subpoena or other validly issued administrative or judicial process requesting disclosure of same; provided , the Party that receives such order or process provides prompt notice to the disclosing Party before making any disclosure (to the extent possible) and permits the disclosing Party to oppose or narrow such request for disclosure and supports any of disclosing Party’s reasonable efforts to oppose such request (at disclosing Party’s expense) and shall disclose the terms of this Agreement only in the event of a final judgment or administrative order requiring such disclosure, and only to the extent necessary to comply with such request.

 

10



 

8.4                                                            The Parties’ obligation of nondisclosure and the limitations upon the right to use the other Party’s Information, samples and test results shall not apply to the extent that a recipient can demonstrate that the applicable Information:  (a)  was in its possession prior to the time of disclosure; or (b)  is or becomes public knowledge through no fault or omission of the receiving Party; or (c)  is obtained by the recipient from a third party under no obligation of confidentiality to the disclosing Party; or (d)  is independently developed by the receiving Party, as evidenced by the receiving Party’s written records, without access to the disclosing Party’s Information.  A receiving Party may also disclose Information if it is required to disclose the Information in response to a subpoena or other validly issued administrative or judicial process requesting disclosure of same, provided that such receiving Party will give the disclosing Party prompt notice of such request before making any disclosure (to the extent possible) and permit the disclosing Party to oppose or narrow such request for disclosure.  The disclosing Party may seek an appropriate protective order or other remedy and/or waive compliance with the provisions of this Agreement.  If such disclosing Party seeks a protective order or other remedy, the receiving Party will cooperate and support any of the disclosing Party’s reasonable efforts to oppose such request (at disclosing Party’s expense).  If such disclosing Party fails to obtain a protective order or waive compliance with the relevant provisions of this Agreement, the receiving Party will disclose only in the event of a final judgment or administrative order requiring such disclosure, and only to the extent necessary to comply with such request.

 

8.5                                                            The obligations with respect to maintaining confidentiality and non-use of Information under Section 8 shall survive the termination of this Agreement for a period of five (5) years with respect to the Workplan and Radius’ business information, but shall remain in effect for an indefinite period of time with respect to each Party’s technical information which the disclosing Party shall indicate to be a trade secret at the time of disclosure.  In this latter case the recipient Party shall keep this trade secret as confidential unless and until it ceases to be Confidential Information pursuant to items (a), (b), (c) or (d) of Section 8.4.  It is understood and agreed that nothing in this Agreement obligates any Party to disclose or receive any Confidential Information that is of a technical nature but that if a Party refuses to accept such Confidential Information and such Confidential Information is necessary to perform

 

11



 

the transactions contemplated by this Agreement then the disclosing Party may terminate this Agreement without any obligation to pay the costs set forth above.

 

9.                                       EXCLUSIVE RELATIONSHIP

 

9.1                                                             During the term of this Agreement the parties shall work exclusively with one another for Compound delivery by MTS.

 

9.2                                                             In the event that RADIUS elects to further develop the Product developed by 3M hereunder for commercialization, 3M shall have the exclusive right to further develop and manufacture Product for RADIUS and/or RADIUS licensees at a reasonable, good faith price, consistent with customary drug supply pricing and such other terms and conditions as are reasonable and customary in the commercial supply of pharmaceutical compounds.  Any such development and supply agreements shall be negotiated in good faith between the parties.  3M’s pricing for commercial supply of Product to RADIUS and/or RADIUS licensees will depend, among other things, on such factors as the components used, packaging, formulation, sales volume, and other costs that are not known at this time.  3M shall make its election with respect to further development and commercial manufacture/supply upon request by RADIUS at any time following completion of Phase I clinical testing of Product, and if 3M elects to further develop and manufacture/supply Product, 3M and RADIUS shall promptly negotiate in good faith the terms of a formal “Commercial Supply Agreement” within 6 months of the start of Phase II clinical testing.

 

9.3                                                             Neither RADIUS nor 3M has any obligation under this Agreement to proceed beyond the Workplan.

 

10.                                WARRANTIES, LIMITED REMEDY/LIMITIATION of LIABILITIES, and INDEMNIFICATION

 

10.1                                                      Each party warrants that it (i) has the right to enter into this Agreement; and (ii) it has no obligations to any other person or entity which are in conflict with its obligations under this Agreement.

 

12



 

10.2                                                      RADIUS hereby represents and warrants that all Compound supplies shall at the time of delivery to 3M meet specifications agreed upon in writing by 3M and RADIUS.

 

10.3                                                      3M warrants to RADIUS that 3M will store and handle the Compound supplied by RADIUS as well as the Products in accordance with RADIUS instructions.

 

10.4                                                      3M warrants that it will manufacture any toxicology supplies of the Product in accordance with cGLPs or cGMPs and any clinical supplies of the Product in accordance with cGMPs, and that such Product will at the time of shipment meet any specifications agreed upon in writing by the parties, provided that RADIUS’ sole remedy for supply of defective Product shall be replacement of such Product, and 3M shall have no obligation to replace Product or indemnify RADIUS pursuant to this section for Product that does not meet the specifications because of RADIUS’ failure to supply Compound meeting the agreed specifications.

 

10.5                                                      EXCEPT AS EXPRESSLY SET FORTH IN THIS SECTION 10, NEITHER PARTY GIVES ANY EXPRESS OR IMPLIED WARRANTY RELATED TO THIS AGREEMENT, THE PERFORMANCE OR NON-PERFORMANCE OF THIS AGREEMENT, OR ANY OTHER MATTER OR SUBJECT ARISING OUT OF THIS AGREEMENT, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT OF THIRD PARTY PATENT RIGHTS.

 

10.6                                                      3M shall indemnify, defend, and hold RADIUS harmless from and against any and all third party loss or liability for any and all judgments, claims, causes of action, suits, proceedings, losses, damages, demands, fees, expenses, fines, penalties or costs (including without limitation reasonable attorney’s fees, costs and disbursements) arising from any personal injury or alleged personal injury claim against Radius to the extent that such claim results from 3M’s breach of warranty, and, provided that 3M shall be liable only to the extent such breach resulted in the harm or injury for which RADIUS seeks indemnification.

 

10.7                                                      Except for the preceding indemnification provided by 3M for supplying Product that fails to meet specifications, RADIUS shall indemnify, defend, and hold 3M and 3M IPC harmless from and against any and all other third party loss or liability for any and all judgments, claims, causes

 

13



 

of action, suits, proceedings, damages, demands, fees, expenses, fines, penalties and costs (including without limitation reasonable attorney’s fees, costs and disbursements) arising from RADIUS’ or its agent’s use, testing or clinical studies of Product.

 

10.8                                                      Both RADIUS and 3M are obligated to promptly notify the other party of any claim for which they intend to seek indemnification under the terms of this Agreement.  Failure to give notice shall not constitute a defense, in whole or in part, to any claim by any indemnified entity hereunder except to the extent the rights of the indemnitor are materially prejudiced by such failure to give notice.  If either party accepts the defense of and indemnification for a case without reserving the right to later seek contribution or indemnity from the tendering party, then the tendering party shall have no control over the defense of such case.  If either party accepts the defense of and indemnification for a case, but reserves the right to later seek indemnity or contribution from the tendering party, then the tendering party shall have the right to actively participate in the defense of the case with the non-tendering party and outside counsel, and any settlements shall require the consent of both parties. If a claim arises within the scope of an indemnity, the party seeking indemnity will fully cooperate in the defense of any such claim.

 

10.9                                                      If both parties desire to defend a case together, then the parties shall jointly control the defense of such case. If either party desires to defend a case with separate counsel, then each party shall be entitled to control its own legal defense of any claim; provided, however, that any party seeking indemnification or contribution shall in good faith consult with the other party regarding the defense strategy to be employed throughout the case, but only to the extent such consultation does not reveal matters that may be at issue between the party seeking indemnification and the other party.  A party seeking indemnification or contribution from the other party cannot settle a case without the consent of the other party.

 

10.10                                               EXCEPT FOR THE INDEMNIFICATION OBLIGATIONS SET FORTH ABOVE, AND NOTWITHSTANDING ANYTHING IN THIS AGREEMENT TO THE CONTRARY, NEITHER PARTY SHALL BE LIABLE TO THE OTHER FOR INDIRECT, INCIDENTAL, SPECIAL, PUNITIVE OR CONSEQUENTIAL DAMAGES RELATED TO PRODUCT OR PERFORMANCE OR NON-PERFORMANCE OF THIS AGREEMENT REGARDLESS OF THE LEGAL THEORY ASSERTED INCLUDING, BUT NOT LIMITED TO, CONTRACT, FAULT, NEGLIGENCE OR STRICT LIABILITY.

 

14



 

11.                                TERM AND TERMINATION

 

11.1                                                      The Agreement shall remain in force for the earlier of (a) two (2) years from the date of execution by the Parties or (b) completion of work and deliverables under the Workplan, after which time the Agreement shall expire.

 

11.2                                                      Either Party may terminate this Agreement in the event of a material breach of the Agreement by the other Party that the breaching Party has failed to cure within thirty (30) days of receipt of written notice from the non-breaching Party.  In the event of termination of this Agreement by 3M pursuant to this provision, Radius shall be obliged to pay 3M within thirty (30) days of termination any unpaid balance of the fees or expenses for work performed prior to termination.

 

11.3                                                      Radius may terminate without cause this Agreement upon sixty (60) days written notice to 3M.  Upon receiving notice of Radius’s intent to terminate, 3M shall make commercially reasonable efforts to stop all activities under any Workplan as soon as practicable.

 

11.4                                                      All charges and expenses owed to 3M prior to the effective date of termination shall become due and payable, and except in the event of termination due to 3M’s breach, Radius shall pay all charges and expenses reasonably incurred by 3M in winding down its activities at a rate of $[*] per hour during the sixty (60) day notice periods referred to above, provided that 3M shall act diligently to minimize all wind down costs, upon receipt of a termination notice. In the event of termination for any reason, the parties shall upon request provide the other party, if not in material breach, with any preliminary data (preclinical or clinical) and any unanalyzed samples available within 30 days of termination.

 

11.5                                                      In the event this Agreement expires or is terminated, the provisions of Sections 7, 8, 10, and paragraphs 12.1, 12.4, 12.5, 12.7 and 12.8 shall survive said expiration or termination in accordance with their terms.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

15



 

12.                                MISCELLANEOUS

 

12.1                                                      This Agreement contains the complete and entire agreement between the parties hereto, and supersedes any previous communications, representations, or agreements whether verbal or written relating to the subject matter hereof.

 

12.2                                                      No change, addition, waiver, amendment, or modification of any of the terms or conditions hereof shall be valid or binding on either party unless in writing and signed by authorized representatives of both parties.

 

12.3                                                      Neither Radius nor 3M shall be considered in default or be liable to the other Party for any delay in performance or non-performance caused by circumstances beyond the reasonable control of such Party, including but not limited to acts of God, explosion, fire, flood, earthquake, war whether declared or not, accident, labor strike or labor disturbances, sabotage, transportation strike or interference, order or decrees of any court or action of governmental authority or shortages in or an inability to procure materials; provided, however, that diligent efforts are made to resume performance as quickly as possible.

 

12.4                                                      The Parties consent to and this Agreement shall be construed under Delaware law, notwithstanding any choice of law provision to the contrary.   The failure to enforce any right or provision herein shall not constitute a waiver of that right or provision.  If any provisions herein are found to be unenforceable on the grounds that they are overly broad or in conflict with applicable laws, it is the intent of the Parties that such provisions be replaced, reformed, or narrowed so that their original business purpose can be accomplished to the extent permitted by law, and that the remaining provisions shall not in any way be affected or impaired thereby.  The rights and obligations of Radius and 3M which by intent or meaning have validity beyond such termination or expiration (including, but not limited to, rights with respect to confidentiality, intellectual property, and liability limitations) shall survive the termination or expiration of this Agreement or any Workplan.

 

12.5                                                      Any questions, claims, disputes or litigation arising from or related to the making, performance or alleged breach of this Agreement, or to any available remedies (a “dispute”), shall be governed by the laws of Delaware, without regard to conflicts of law principles, and shall be resolved as follows: (i) upon written notice of dispute (the “notice”), by in-person negotiation between senior business representatives of the

 

16


 

 

parties who have authority to fully resolve the dispute; (ii) if within 60 days of the notice the dispute has not been fully resolved, the parties shall conduct a confidential mediation using a location, mediator, and rules acceptable to both parties (with the costs of mediation shared equally); (iii) if the dispute is not then resolved, and as a last resort only, either party may commence litigation.  Nothing herein shall preclude either party from taking whatever actions it deems necessary to prevent immediate, irreparable harm to its interests.

 

12.6                                                      This Agreement may not be assigned by either Party except by prior written consent of the other Party (not to be unreasonably withheld); provided that this Agreement may be assigned by 3M without the consent of Radius in connection with the sale of substantially all of 3M’s MTS drug delivery business (whether by merger, consolidation or sale of all or substantially all the assets relating to such business (including the grant of an exclusive license covering all or substantially all of the intellectual property rights of such business)); and this Agreement may be assigned by Radius without the consent of 3M in connection with the sale of substantially all of Radius’ business relating to the Compound (whether by merger, consolidation or sale of all or substantially all the assets relating to such business (including the grant of an exclusive license covering all or substantially all of the intellectual property rights of such business).

 

12.7                                                      Radius and 3M shall comply in all material respects with the requirements of all applicable laws, rules, regulations and orders of any government authority in handling or disposing of the Compound and formulations.

 

12.8                                                      Any notice or other communications sent or delivered hereunder shall be in writing and shall be effective if hand delivered or if sent by telex, express delivery service or certified or registered mail, postage prepaid.

 

If to Radius :

 

Radius Health, Inc.

 

 

300 Technology Square

 

 

Cambridge, MA 02139

 

 

Attention: Chief Executive Officer

 

 

 

If to 3M :

 

3M Drug Delivery Systems

 

 

3M Center Building 275-3E-10

 

 

St. Paul, MN 55144-1000

 

17



 

 

 

Attention: Division Vice President

 

With a copy to Legal Affairs at the above address

 

 

EXECUTED by the parties

 

 

 

 

 

 

 

 

For and on behalf of:

 

 

 

 

 

3M COMPANY

 

 

 

 

 

 

 

 

Signed:

/s/ James A. Vaughan

 

Dated:

June 23, 2009

 

 

 

 

 

Printed: James A. Vaughan

 

Title: 3M Drug Delivery System
Division Vice- President

 

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

 

 

 

 

 

 

 

 

Signed:

/s/ Robert W. Sprague

 

Dated:

June 23, 2009

 

 

 

 

 

Printed: Robert W. Sprague

 

Title: Secretary

 

 

 

 

 

 

RADIUS HEALTH, INC.

 

 

 

 

 

 

 

 

 

Signed:

/s/ B.N. Harvey

 

Dated:

June 19, 2009

 

 

 

Printed: B. Nicholas Harvey

 

Title: Chairman, President, Chief
Executive Officer

 

18



 

Exhibit A

 

WORK PLAN SUMMARY

 

Objective:

 

The objective of the work plan is to develop two additional BA-058 sMTS patch formulations and processes ( 150 and 200 µg/array), and to prepare four strengths of product ( 50 , 100 , 150 , 200 µg/array) plus a placebo to be utilized by Radius to complete preclinical tox evaluations and a Phase I clinical study.

 

Deliverables:

 

·                   Shipment of 4 distinct formulations/strengths of BA-058 sMTS (Ex Works 3M’s site) for preclinical toxicology studies and a Phase I clinical POC study (50, 100, 150, 200 µg/array)

·                   Shipment of a representative placebo sMTS (Ex Works 3M’s site) for preclinical toxicology studies and a Phase I clinical POC study

·                   Data to support the stability of key formulations of the product through the time needed to conduct the Phase I clinical POC study

·                   Data to support the stability of key formulations of the product through the proposed shelf life of the product (up to 2 years)

·                   On-site training support for clinicians for application of the sMTS

·                   3M shall establish and maintain proprietary Drug Master Files (DMFs) including information on the components, coating and manufacturing processes sufficient to support regulatory filings in the U.S. and Canada.  A right of reference to 3M’s DMFs will be granted to Radius to support regulatory filings in the U.S. and Canada.  Outside the U.S., 3M will provide Radius with nonconfidential information from the DMFs necessary to support regulatory filing in said country

·                   Formulation information sufficient to support regulatory filings in the U.S. and Canada

 

Timing :

 

The overall time estimate from start of Stage 3 to shipment of clinical supplies for the Phase I study is estimated to be 4-7 months.

 

This estimate assumes initiation of the Phase I trial as soon as possible following the preclinical tox study.  The estimate does not include timing associated with the in-vivo portion of the preclinical toxicology study.

 

19



 

Assumptions of the work plan:

 

·                   Lot sizes for BA058-sMTS drug product not to exceed [*] GMP-grade units; lot size for placebo unit not to exceed [*] units.

·                   The starting formulation (BA-058 + excipients) will be provided to 3M by Radius, sterile and in a form compatible with aseptic processing unless the formulation is determined to be stable through terminal sterilization.

·                   Radius will be responsible for executing all elements (protocols, regulatory filings, conduct) of the GLP toxicology studies.

·                   Radius will be responsible for executing all elements (protocols, regulatory filings, conduct) of the Phase I trial.

·                   Work plan assumes the use of the POC MTS applicator system and patch design.

·                   Timing required for conducting the GLP toxicology studies is not included in the estimate; timing assumes the Phase I trial will start as soon as possible following the toxicology studies.

·                   If results determine that additional doses of BA058-sMTS arrays are needed, additional costs and time may be incurred.

·                   Quantity of BA-058 required to perform the work plan is to be determined.

·                   sMTS patches for use in the POC clinical study will be bulk labeled by 3M and provided to Radius for further labeling according to the requirements of the clinical protocol.

·                   The clinical trial will be conducted in the United States or Canada under an IND sponsored by Radius.  Stability studies on key formulations will be a maximum of 24 months in length; the stability report will be completed within 2 months of the completion of the stability study.

·                   If results from Stage 2 of the feasibility agreement indicate, the supplies will be terminally sterilized.

 

Stage 3 : Formulation development, preparation of toxicology and clinical supplies

 

Summary:   3M will develop 2 additional doses of BA058-sMTS (150 and 200 µg/array), manufacture toxicology supplies and GMP supplies for shipment to Radius for preclinical toxicology testing and for a Phase I clinical study.  3M will write and submit DMF(s) for reference by Radius and contribute documentation needed to support a pre-IND and IND filing.  3M will also run the supporting stability studies with these studies going out to 2 years for key doses.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

20



 

3M Tasks

Develop and optimize 2 additional BA058-sMTS products (150 and 200 µg/array)

Complete experiments to demonstrate BA058 release in vivo in selected animal model

Agree with Radius on study design for preclinical toxicology evaluation; consult with Radius on clinical study protocol and with the clinical site for aspects related to sMTS application

Adapt and verify BA-058 patch manufacturing processes, as required

Finalize specifications and methods for array patch and applicator supplies

Develop and verify low bioburden or terminal sterilization mfg. approach; verify supplies meet low bioburden or sterility criteria, as applicable

Draft and approve protocols for assembly, sterilization, formulation, coating, and bulk packaging of supplies; write methods and specifications to characterize toxicology supplies and Phase I supplies

3M/Radius to finalize specifications for BA-058 s-MTS selected formulations

Complete raw material/component clearances, including API

Provide sterile ready to coat formulation (BA058+excipients).

Mold arrays, manufacture and characterize for toxicology studies and Phase I study

Manufacture and ship toxicology and clinical supplies to Radius (FOB)

Initiate screening stability studies on selected formulations

Provide Certificate of Conformance and Certificate of GMP compliance along with shipment of BA058-sMTS product

Provide chemistry, manufacturing and controls (CMC) information pertaining to BA058-sMTS formulation.  Write and provide documents describing manufacturing process for regulatory submissions. 3M to provide Radius with letters of authorization to reference 3M DMFs describing the device manufacture and coating processes.

Perform stability studies on select doses (6 months for all doses; up to 24 months for 1-2 key doses)

 

Radius Tasks

Develop regulatory strategy

3M/Radius to finalize specifications and methods for selected formulations and final products

3M/Radius to agree on stability testing plan

Design and perform GLP toxicology studies

Receive, label and provide final product clearance of Phase I clinical supplies

Author Investigators Brochure, pre-IND and IND submission

Write clinical protocol, define safety and efficacy endpoints

Execute or oversee the Phase I clinical study

 

21



 

Exhibit B

 

Change Order Form

 

Change order under Agreement dated: [add title and date of agreement]

 

Between:

 

Project Name:

 

 

Change requested by:

Name:

Company:

Date:

 

Description of change: [Include details here of the task changes or additions and any change in timelines and/or fees, with reference to the original tasks, timeline or fees where applicable.  These details may be attached as a schedule to this change order.]

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

RADIUS HEALTH, INC.:

 

3M COMPANY:

Name:

 

Name:

Signature:

 

Signature:

Position:

 

Position:

Date (dd/mm/yy):

 

Date (dd/mm/yy):

 

22



 

Exhibit C

 

Estimated Costs by Stage

 

Stage

 

Timing

 

Program Cost Estimate

 

 

 

 

 

Stage 3 — Formulation development, Preparation of Toxicology and Clinical Supplies

 

4-7 month

 

$750,000 - $1,250,000

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

23


 

DEVELOPMENT AND CLINICAL SUPPLIES AGREEMENT AMENDMENT NO. 1*

 

Radius Health Inc. (“RADIUS”) and 3M COMPANY (“3M”) and 3M INNOVATIVE PROPERTIES COMPANY (“3M IPC”) entered into the certain Development and Clinical Supplies Agreement (the “Agreement”) as of June 19, 2009 (“Effective Date”).

 

Pursuant to Paragraph 9.4 of the Agreement, the parties wish to enter into this Amendment No. 1 to the Agreement (“Amendment No. 1”) effective as of December 31, 2009 (“Amendment Date”).  Capitalized terms used in this Amendment No. 1 and not defined herein are used with the meanings ascribed to them in the Agreement.

 

NOW THEREFORE, in consideration of the mutual covenants and promises contained in this Amendment No. 1, the parties agree as follows:

 

1.  Change in Work Plan; Change in Price Structure.  The parties were required to undertake additional work not contemplated by the Work Plan concerning viscosity experiments with respect to the Product.  This additional work increased the costs to perform Stage 3 of the Work Plan above the Program Cost Estimate set forth in the Agreement.  The parties have conferred with respect to these incremental costs as well as the activities and pricing outlined in the Work Plan and have agreed that the costs for these viscosity experiments as well as all other activities outlined in the Work Plan, including but not limited to preclinical and clinical activities relating to the development and manufacturing of the [*] and [*] mcg doses, stability testing, information supporting manufacturing and regulatory filings, as well as on site training support for clinicians shall not exceed $1,325,000 in the aggregate.

 

2.  Ratification.  Except to the extent expressly amended by this Amendment No. 1, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment No. 1.

 

3.  General.  This Amendment No. 1 may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank]

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

1



 

IN WITNESS WHEREOF, the parties hereto have caused this Amendment No. 1 to be executed and duly delivered by their respective duly authorized officers, intending it to take effect as of the Amendment Date.

 

3M COMPANY

 

 

 

 

 

 

 

 

 

 

 

Signed:

/s/ James A. Vaughan

 

Dated:

01/18/2010

 

 

 

 

 

Printed: James A. Vaughan

 

Title: 3M Drug Delivery System Division
Vice-President

 

 

 

 

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

 

 

 

 

 

 

 

 

Signed:

/s/ Robert W. Sprague

 

Dated:

January 13, 2010

 

 

 

 

 

Printed: Robert W. Sprague

 

Title: Secretary

 

 

 

 

 

 

RADIUS HEALTH INC.

 

 

 

 

 

 

Signed:

/s/ B.N. Harvey

 

Dated:

2/24/10

 

 

 

 

 

Printed: B. Nicholas Harvey

 

Title: Chief Financial Officer

 

2


 

Second Amendment To Development and Clinical Supplies Agreement*

 

This Amendment, dated September 16, 2010 by and between 3M Company, and 3M Innovative Properties Company having a principal office at 3M Center, Building 275-3E-10, St. Paul, MN  55144-1000 (hereinafter “3M”), and Radius Health Inc. having a principal office at 300 Technology Square, Cambridge, MA (hereinafter “Radius”) amends the Development and Clinical Supplies Agreement dated June 19, 2009  (hereinafter “the Agreement”) as follows:

 

RECITALS:

 

A.             Whereas, 3M and Radius have previously entered into a Development and Clinical Supplies Agreement dated June 19, 2009 (“Agreement”) for the development and delivery of clinical supplies up through Phase II for a BA058 coated MTS  product (“Product”);

B.             Whereas,  Radius has conducted preclinical and clinical trials with Product; including a Phase Ia clinical trial with Product which rendered results that did not meet predetermined criteria;

C.             Whereas, Radius is willing to repeat the Phase Ia clinical trial with new Product made by 3M using a different, proprietary array material;

D.             Whereas, 3M is willing to manufacture new clinical supplies of Product at its own expense subject to the terms of this Amendment.

E.              Whereas, Radius also requires additional clinical supplies, including Phase Ib supplies.

F.               Whereas, 3M will have the capability or producing Phase II supplies by August 31, 2011 and will assume the capital expenditures costs for Phase II supplies;

G.             Whereas, all terms of the Agreement not explicitly amended by this Amendment shall remain in full force and effect.  To the extent not modified or defined by this Amendment, all capitalized and defined terms shall have the meaning ascribed to them in the Agreement.

 

NOW, THEREFORE, in consideration of the Recitals (which are incorporated herein) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows:

 

1.               3M shall manufacture three (3) doses plus Placebo of Phase Ia/b clinical supplies of Product using 3M’s proprietary array material in quantities and for such uses as set forth below.  Phase Ia will be provided at 3M’s expense.  Included in the runs shall be small quantities of 200 mcg and Placebo (50 each) for preclinical studies. Such supplies shall be manufactured in September and October 2010 with a target release of approximately three (3) weeks after each run. The supplies will be manufactured in the following order: 100 mcg, Placebo, 200 mcg and 150 mcg. Production of the 100 mcg dose is targeted September 27, 2010, with the target release date on or before October 31, 2010. The Placebo is targeted to be released within a week or less afterwards. The 200 mcg and 150 mcg doses are targeted

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

1



 

to be released one and two weeks after that, respectively. The preclinical supplies, 200 mcg and Placebo, are targeted to be released under quarantine by October 11 and October 18, 2011, respectively.

 

 

 

100 mcg dose

 

150 mcg dose

 

200 mcg dose

 

Placebo

Study supplies (Phase 1+7-day tox)

 

198

 

215

 

232

 

218

Extras

 

15

 

15

 

15

 

15

Retains

 

100

 

100

 

100

 

100

Release

 

55

 

55

 

55

 

40

Stability

 

140

 

140

 

140

 

0

 

 

 

 

 

 

 

 

 

Needed Arrays

 

508

 

525

 

542

 

373

Total with 25% overage

 

635

 

656

 

678

 

466

 

2.                                       3M shall conduct a limited stability protocol on all three doses of the clinical supplies of Product.  The stability protocol shall include two storage conditions: 4C/ambient humidity with four (4) pulls (1,3,6, and 12 months), not including release, and 25C/60%RH with a single (1) pull at 1 month.  3M shall also conduct a limited stability protocol on the ready-to-coat (RTC) solutions for Phase 1a/b supplies.  The stability protocol shall include one storage condition: 4C/ambient humidity with five (5) pulls (1,2,3,4 and 6 months) for each solution. The RTC solution will also be tested prior to each manufacturing run for confirmation of formulation. 3M shall invoice Radius [*] Dollars ($[*]) per pull point for this stability testing at the conclusion of testing of the each pull.

 

3.                                       Upon request by 3M, Radius shall provide 3M with certain requested preclinical and clinical data generated by Radius under any previous Workplans; Radius shall not be required to provide preclinical or clinical data to 3M in the event and to the extent that the relevant data is being used or intended for use to support a patent application unless the parties mutually agree upon a method of disclosure that does not present a risk to the integrity of the applicable patent application.  3M shall have the right to use the preclinical and clinical data provided by Radius pursuant to this Section 3 (as well as any preclinical and clinical data previously provided to 3M by Radius) for purposes of marketing its MTS technology, so long as 3M does not disclose (i) the identity of Radius, (ii) the identity of BA058, or (iii) any information related to BA058 that would allow any third party to ascertain the identity of BA058, the therapeutic areas for which BA058 is useful for, including but not limited to the prevention and/or treatment of osteoporosis.  Before disclosing any Radius preclinical or clinical data provided pursuant to this Section 3 (as well as any preclinical and clinical data previously provided to 3M by Radius), 3M shall provide Radius with a draft of the portions of any proposed disclosure that contain such data no fewer than thirty (30) days prior to the

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

2



 

planned disclosure date so that Radius may review the planned disclosure and confirm that it does not disclose any of the information covered by (i)-(iii).  3M shall comply with Radius’ reasonable request to delete references to information covered by (i)-(iii).  If there is a dispute regarding publications, such dispute shall be resolved by the parties and will include an undertaking by each party to propose scientifically meaningful equivalent disclosure that does not disclose the information covered by (i)-(iii).  It is specifically understood that disclosure of preclinical and/or clinical information to 3M under this Section 3 shall not alter its status (if applicable) as Radius Confidential Information.  It is further understood that after a disclosure has been approved by Radius under this Section 3 and approved that disclosure may be reused in the same format without resort to a separate review by Radius.  Radius also agrees to provide 3M with certain requested clinical data generated under any future Workplans upon Radius approval, which shall not be unreasonably withheld, and subject to the limitations set forth above with respect to data generated by Radius under previous Workplans.

 

4.                                       3M shall provide approximately seven hundred (700) Phase Ib supplies (included in the table above in (1)) 3M shall invoice Radius for such supplies on a time and material basis.  The estimated cost for the Phase Ib supplies is $85,000.

5.                                       3M shall provide proof to Radius that a DMF reference letter is on file. 3M shall provide Radius with an updated CMC section and finalized non-redacted copies of preclinical and clinical reports describing safety of the TAZ arrays, as well as any other information necessary for Radius regulatory filings.

6.                                       3M shall provide up to fifty (50) applicators for clinical use.

7.                                       The term of the Agreement shall be extended until June 19, 2013.

 

IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed in duplicate as of the date and year the last Party signs below.

 

ACCEPTED AND AGREED TO:

 

3M COMPANY

 

Radius Health, Inc.

 

 

 

By

/s/ Jim A. Vaughan

 

By

/s/ B.N. Harvey

Print Name

Jim A. Vaughan

 

Print Name

B.N. Harvey

Title

Division VP & GM

 

Title

CFO and SVP

Date

Sept. 22, 2010

 

Date

16 Sept, 2010

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

By

/s/ Robert W. Sprague

 

 

3



 

Print Name

Robert W. Sprague

 

Title

Secretary

 

Date

9-20-2010

 

 

ACR # 201004140

 

 

4


 

EXECUTION COPY

 

Third Amendment To Development and Clinical Supplies Agreement*

 

This Amendment, dated September 29, 2010 by and between 3M Company, and 3M Innovative Properties Company having a principal office at 3M Center, Building 275-3E-10, St. Paul, MN  55144-1000 (hereinafter “3M”), and Radius Health Inc. having a principal office at 300 Technology Square, Cambridge, MA (hereinafter “Radius”) amends the Development and Clinical Supplies Agreement dated June 19, 2009  (hereinafter “the Agreement”) as follows:

 

RECITALS:

 

A.             Whereas, 3M and Radius have previously entered into a Development and Clinical Supplies Agreement dated June 19, 2009 for the development and delivery of clinical supplies up through Phase II for a BA058 coated MTS  product (“Product”) and have entered into a Second Amendment to the Agreement dated September 16, 2010 (the “Agreement”);

B.             Whereas, Radius also requires additional clinical supplies, including chronic dermal toxicology supplies

C.             Whereas, Radius  may require stability testing of any clinical or toxicology  supplies provided by 3M;

D.             Whereas, to meet Radius required timing, 3M must invest in additional facilities and equipment;

E.              Whereas Radius is willing to guaranty repayment of a portion of the planned work to enable 3M to justify its investment in the event that Radius does not expend certain additional sums with 3M under existing and future Workplans by Dec 20, 2011 ;

F.               Whereas, all terms of the Agreement not explicitly amended by this Amendment shall remain in full force and effect.  To the extent not modified or defined by this Amendment, all capitalized and defined terms shall have the meaning ascribed to them in the Agreement.

 

NOW, THEREFORE, in consideration of the Recitals (which are incorporated herein) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to amend the Agreement as follows:

 

1.                                       3M shall provide approximately seven thousand five hundred (7,800) chronic dermal toxicology supplies (at two doses and Placebo) in amounts shown in the table below.  3M shall invoice Radius for such supplies on a time and material basis.  The estimated cost for the Chronic Dermal Toxicology supplies is $475,000.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

1



 

The chronic dermal toxicology supplies will be produced in two runs. The first of each lot is targeted to be manufactured by January 1, 2011. The second of each lot is targeted to be completed by March 1, 2011.

 

 

 

100 mcg dose

 

200 mcg dose

 

Placebo

6 Month Tox

 

2,400

 

2,400

 

2,400

Extras

 

0

 

0

 

0

Retains

 

100

 

100

 

100

Release

 

55

 

55

 

40

Stability

 

250

 

250

 

0

 

 

 

 

 

 

 

Needed Arrays

 

2,805

 

2,805

 

2,540

 

2.                                       3M shall conduct a stability protocol on the two doses of the chronic dermal toxicology supplies. The stability protocol shall include two storage conditions: 5C/ambient humidity with two (2) pulls (6 and 12 months), not including release, and 25C/60%RH with a single pull at one (1) month. 3M shall also conduct a limited stability protocol on the ready-to-coat (RTC) solutions for the chronic dermal toxicology supplies.  The stability protocol shall include one storage condition: 5C/ambient humidity with five (5) pulls (1,2,3,4 and 6 months) for each solution. The RTC solution will also be tested prior to each manufacturing run for confirmation of formulation. 3M shall invoice Radius Three Thousand Six Hundred Dollars ($3,600) per pull point for stability testing at the conclusion of testing of the each pull for any requested stability work.

 

3.                                       Radius understands that for 3M to meet Radius’ requirements under paragraph 1.3M will need to invest in additional facilities and equipment and that the expected revenue from providing these requirements is not sufficient to cover 3M’s investment.  Therefore, Radius agrees that if Radius does not fund at least $1.8 million of work under existing and future Workplans, including the cost of  supplies above and the $85,000 payment made pursuant to the Second Amendment to the Agreement dated September 16, 2010, starting after the effective date of this Amendment and ending by no later than December 20, 2011, or if Radius terminates the Agreement without cause or 3M terminates the Agreement for cause and at the time of such termination or expiration Radius has not expended an aggregate $1.8 million of work during the period from the effective date of this Amendment until the effective date of termination, 3M shall invoice Radius any shortfall from this amount by December 31, 2011 and Radius shall pay 3M unless otherwise agreed by 3M.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

2



 

4.                                       Notwithstanding the foregoing, in the event that the results from Radius Phase Ia study from either application sites (the thigh or the abdomen) meet the criterion listed below, Radius shall be obligated to pay for any shortfall under the circumstances set forth in paragraph 3.

Criteria for Phase Ia results:

 

·                   Cmax of low dose OR mid dose will be equal to or exceed 95% of the Cmax associated with the 80 mcg SC dose

·                   Cmax of mid dose OR high dose will be equal to or exceed 125% of the Cmax associated with the 80 mcg SC dose

 

5.                                       Except to the extent expressly amended by this Third Amendment, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Third Amendment.

 

6.                                       This Third Amendment may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed in duplicate as of the date and year the last Party signs below.

 

ACCEPTED AND AGREED TO:

 

3M COMPANY

 

Radius Health Inc.

 

 

 

 

 

 

 

 

 

 

By

/s/ Jim A. Vaughan

 

By

/s/ B. N. Harvey

 

 

 

 

 

Print Name

Jim A. Vaughan

 

Print Name

B. N. Harvey

 

 

 

 

 

Title

Division VP & GM

 

Title

SVP and CFO

 

 

 

 

 

Date

10/7/2010

 

Date

September 29, 2010

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

 

By

/s/ Robert W. Sprague

 

 

 

 

Print Name

Robert W. Sprague

 

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

3



 

Title

Secretary

 

 

 

 

Date

October 5, 2010

 

 

 

 

 

ACR # 201004143

 

 

4


 

EXECUTION COPY

 

FOURTH AMENDMENT TO DEVELOPMENT AND CLINICAL SUPPLIES AGREEMENT*

 

This Fourth Amendment (this Amendment”) is entered into as of March 2, 2011 by and between 3M Company, and 3M Innovative Properties Company having a principal office at 3M Center, Building 275-3E-10, St. Paul, MN 55144-1000 (hereinafter “3M”), and Radius Health, Inc. having a principal office at 201 Broadway, 6th Floor, Cambridge, MA (hereinafter “Radius”) and amends the Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010 and the Third Amendment dated as of September 29, 2010 (hereinafter, the “Agreement”). Capitalized terms used in this Amendment and not defined herein are used with the meanings ascribed to them in the Agreement.

 

RECITALS:

 

WHEREAS, the Parties wish to enter into this Amendment to address certain matters relating to the development and supply of Product to Radius by 3M for use in a Phase II clinical study.

 

NOW, THEREFORE, in consideration of the Recitals (which are incorporated herein) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to amend the Agreement as follows:

 

1.                                       3M shall perform the Workplan attached as Attachment 1 to this Amendment with respect to the development and supply of Product for use by Radius in a Phase II clinical study for the Product.  The Workplan may not fully disclose the detailed technical plans and protocols that 3M will follow in the performance of the Workplan, but 3M represents and warrants that it has adopted such plans and protocols and will provide them to Radius upon request. Such requests shall be submitted as Change Orders and shall be provided at Radius’ expense in the event and to the extent that 3M is required to draft such plans and non-proprietary protocols and cannot utilize plans and protocols that exist at the time that Radius makes such request.  If 3M can utilize plans and protocols that are documented at the time Radius makes such request, 3M shall provide such plans and protocols to Radius at no charge.  3M will deliver Product no later than 14 months after the effective date of this Amendment and will use commercially reasonable efforts to accomplish delivery by March 15, 2012.   The costs for development and supply of Product for the Phase II clinical study is estimated to be $5.9 million, based on the assumptions and tasks outlined in Attachment 1 .The Parties shall confer regarding the estimated hours set forth in the Workplan attached as Attachment 1 and such hours may be subject to an adjustment in the event that the Parties determine that the hours required to perform the Workplan are different from the estimated hours set forth in Attachment 1 .  3M will provide Radius with a list of significant tasks identified in the Workplan and the hours associated with them. 3M and Radius will meet regularly to review the progress and budget.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

3M Drug Delivery Systems

Confidential

 

1



 

2.                                       3M will provide Radius with a copy of documentation as agreed in the Quality Agreement.  3M will also provide a development plan that addresses sterility issues and provides a strategic outline for further development activities until commercialization to Radius.  The plan and any subsequent modifications to the plan will be reviewed with Radius and Radius’ comments will be reasonably considered.   It is understood and agreed that the current plan will be a strategic document that will be subject to revision as the parties move forward.

 

3.                                       Section 2.3 of the Agreement is hereby amended to read in full as follows:

 

“2.3  Either Party may at any time propose a change to the Workplan.  If 3M reasonably believes that a proposed change will increase 3M’s costs or delay completion of the Workplan, the Parties will negotiate in good faith to accommodate such requests.  No such change will be effective unless and until set forth in a written Change Order to the Workplan with an agreed budget and timeline that is approved and signed by authorized representatives of the Parties.  ”

 

4.                                       A new Section 3.6 is hereby added to the Agreement to read in full as follows:

 

“3.6  (a)  A Steering Committee (“Steering Committee”) shall be established with the responsibilities and authority set forth in this Section 3.6.  The Steering Committee shall consist of four (4) members, two (2) members to be appointed by each of Radius and 3M.  The initial Radius members shall be Richard Lyttle and Nick Harvey and the initial 3M members shall be Steve Wick and Ann Meitz.  Each party may, with notice to the other, substitute any of its members serving on the Steering Committee.  The Parties may also, by mutual agreement, increase or decrease the number of members serving on the Steering Committee; provided that the number of members representing each party remains equal.  Radius shall have the right to appoint one of its members to be the chairperson of the Steering Committee.

 

(b)  The general purpose of the Steering Committee is to oversee the performance of the Workplan concerning the development and supply of Product for the Phase II clinical study.  The Steering Committee shall have the responsibility and authority to: (i) monitor each of Radius’ and 3M’s implementation of their respective responsibilities under the Workplan; (ii) consider, review and approve any proposed amendments to the services or the deliverables set forth in the Workplan; (iii) report regularly to the management of both Parties upon the progress of the Workplan; (iv) provide a forum for exchange of information related to the efforts of each party with respect to the Workplan; (v) resolve disputes (if any) arising among the members of the Joint Technical Team; and (vi) conduct any other functions as Radius and 3M may agree in writing.

 

(c)  The Steering Committee shall hold meetings as mutually agreed by the Parties (but in no event less than quarterly, unless mutually agreed by the Parties).  The first meeting of the Steering Committee shall be held by April 15, 2011 and shall be held in Cambridge, Massachusetts.  After the initial meeting, meetings may be held by telephone or video

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

2



 

conference, provided that the Parties shall meet in person at least once per year, and such meetings shall be held in Cambridge, Massachusetts or St. Paul, Minnesota unless the Parties mutually agree to hold such meetings elsewhere.  Minutes of all meetings setting forth decisions of the Steering Committee shall be prepared by the chairperson and circulated to all Parties within thirty (30) days after each meeting, and shall not become official until approved by all Parties in writing; minutes shall be presented for approval as the first order of business at the subsequent Steering Committee meeting, or if it is necessary to approve the minutes prior to such subsequent meeting, then the Parties shall approve the minutes within thirty (30) days of receipt thereof.

 

(d)  The quorum for Steering Committee meetings shall be four (4) members, provided there is at least two (2) members from each of Radius and 3M present.  The Steering Committee will render decisions by unanimous vote.  The members of the Steering Committee shall act in good faith to cooperate with one another and to reach agreement with respect to issues to be decided by the Steering Committee.

 

(e)  Disagreements among the Steering Committee will be resolved via good-faith discussions; provided , that in the event of a disagreement that cannot be resolved within forty five (45) days after the date on which the disagreement arose, then Radius will have the right to make the final decision and such decision shall be final and binding and shall not be subject to Section 12.5; provided that the right of Radius to exercise such final decision under this Section 3.6(e) (i) shall not compel 3M to assume additional costs not agreed to under a Change Order, (ii)  shall not apply to disputes with respect to the interpretation, breach, termination or invalidity of this Agreement, (iii) shall not compel 3M to perform any activities that 3M reasonably considers to be contrary to applicable laws, regulations or ethical principles, and (iv) shall impose a duty on Radius to indemnify and hold 3M harmless from the consequences of any such Radius decision.  Any deadlock not covered by the preceding sentence shall be resolved pursuant to Section 12.5.

 

(f)  The Parties acknowledge and agree that the deliberations and decision-making of the Steering Committee shall be in accordance with the following operating principles:  (i) decisions should be made in a prompt manner; and (ii) the Parties’ mutual objective is to maximize the commercial success of the Product that is the subject of each Workplan, consistent with sound and ethical business and scientific practices.

 

(g)  The Steering Committee will have only such powers as are specifically delegated to it in this Agreement, and will have no power to amend this Agreement or waive a party’s rights or obligations under this Agreement.”

 

5.                                       5.3 will be amended as follows:

 

“5.3  3M will provide a data package to Radius in support of the Drug Product CMC section of regulatory submissions or into 3M’s DMF in support of RADIUS’ regulatory

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

3



 

filings, such data package to include any data required by applicable regulatory authorities. It is understood and acknowledged that the Phase II clinical study that is the subject of the Workplan may be undertaken in the United States and/or in selected countries outside the United States and, accordingly, 3M will be responsible for providing Radius with all chemistry, manufacturing and control information related to the Product necessary for Radius’ regulatory filings in respect of the Product with any regulatory authority or government agency, such information may be submitted to the government agency in a DMF if this system exists in the country in which the Phase II study is undertaken.  3M shall provide such information by right of reference to a Drug Master File or in support of a Common Technical Document (CTD).  3M acknowledges and agrees that it will also be responsible for maintaining, updating, and providing all supporting chemistry, manufacturing and control information related to the Product necessary to maintain regulatory filings in respect of the product with any regulatory authority or government agency whether through a Drug Master File or in support of a Common Technical Document.”

 

6.                                       A new Section 5.7 is added to the Agreement to read in full as follows:

 

“5.7  (a)  3M shall promptly notify Radius of an impending inspection or audit by any regulatory authority of any facility(ies) where services pursuant to the Workplan are being performed as provided for in Section 5.1 of the Quality Agreement.

 

(b)  3M will notify and inform Radius with respect to the response to any inquiry or observation from any regulatory authority or government agency relating in any way to the Product or the manufacture of the Product at the 3M facility in accordance with the terms and provisions of Section 5.1 of the Quality Agreement.

 

(c)  During an inspection by the FDA or other regulatory authority concerning the services performed pursuant to the Workplan, 3M will not disclose information and materials that are not required to be disclosed to such regulatory authority, without the prior consent of Radius, which shall not unreasonably be withheld.  Such information and materials includes, and is limited to: (i) financial data and pricing data (including, but not limited to, the budget and payment sections of the applicable Workplan); (ii) sales data (other than shipment data); and, (iii) personnel data (other than data as to qualification of technical and professional persons performing functions subject to regulatory requirements).

 

7.                                       Section 6.1 and Section 11.4 of the Agreement are hereby amended to replace the $[*] per hour rate for 3M with the rate of $[*] per hour for work that is not the subject of a Change Order and the rate of $[*] per hour for work that is the subject of a Change Order.

 

8.                                       A new Section 11.3A is hereby added to the Agreement to read in full as follows:

 

“11.3A Radius may terminate within six months of February 28, 2011 with notice to 3M in the event that Radius has determined that the Phase I clinical study for the Product needs to be

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

4



 

repeated or that additional clinical data is required with respect thereto in order to initiate the Phase II clinical study for the Product.  Radius will provide 3M upon request with certain data concerning the Phase I clinical study upon any termination pursuant to this Section 11.3A in accordance with the provisions of the Agreement concerning the provision of preclinical and clinical data.”

 

9.                                       Except to the extent expressly amended by this Amendment, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment.

 

10.                                This Amendment may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank]

 

5



 

IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed in duplicate as of the date set forth above

 

 

3M COMPANY

 

RADIUS HEALTH INC.

 

 

 

 

 

By

/s/ Jim A. Vaughan

 

By

/s/ B.N. Harvey

 

 

 

 

 

Print Name

Jim A. Vaughan

 

Print Name

B.N. Harvey

 

 

 

 

 

Title

Division VP & GM

 

Title

CPO

 

 

 

 

 

Date

3-3-2011

 

Date

March 2, 2011

 

 

 

 

 

 

 

 

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

 

 

 

 

 

 

 

By

/s/ Robert W. Sprague

 

 

 

 

 

 

 

 

Print Name

Robert W. Sprague

 

 

 

 

 

 

 

 

Title

Secretary

 

 

 

Date

March 3, 2011

 

 

 

 

# 201104023

 

 

 

 

6


 

Attachment 1

 

PROPOSAL TO RADIUS HEALTH INC.

 

FOR DEVELOPMENT OF A BA058-COATED MICROSTRUCTURED

 

TRANSDERMAL SYSTEM FOR EVALUATION IN A

 

PHASE II CLINICAL STUDY

 

PRESENTED

 

BY

 

o Drug Delivery Systems

 

CONFIDENTIAL

 

7



 

- PROPOSAL -

RADIUS BA058 SMTS PROGRAM

 

EXECUTIVE SUMMARY

 

3M Drug Delivery Systems is pleased to provide Radius Health Inc. (Radius) with this estimate for development and delivery of Phase II clinical supplies for its BA058 product delivered via 3M’s solid Microstructured Transdermal System (sMTS).

 

This estimate supports the attached work plan summary and is based on information exchanged between Radius and 3M regarding the requirements for a BA058 sMTS product.  The scope of work outlined in the summary includes all activities required for formulation development and delivery of clinical supplies to enable Radius to perform a Phase II clinical study in humans. As discussed with Radius, 3M will deliver clinical supplies no later than 14 months after the effective date of this Amendment and will use commercially reasonable efforts to accomplish delivery by March 15, 2012 if Radius approves the Phase II Workplan and initiates work on or before March 2, 2011.  If work does not commence on March 2, 2011, 3 months must be added to the time below to provide sufficient ramp up time to obtain and train resources to re-initiate the project.

 

The estimate for the activities listed in the work plan summary is provided below:

 

 

 

PROGRAM
HOURLY
ESTIMATE

 

TIMING

Scale-up Process Optimization and Preparation of GMP Supplies for Phase II Trial

 

[*] hours

 

(as per indicated in the above paragraph)

Direct Costs (Arrays and Applicators based on quantities defined below arrays for each strength and 300 applicators)

 

$177.3k

 

 

Deliverables, timing and assumptions are presented in the work plan summary.

 

3M reserves the right to revise this proposal if the intended scope of work deviates from the work outlined.  Any change in this proposal shall be subject to execution of a Change Order.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

8



 

WORK PLAN SUMMARY

 

Objective:

 

The objective of the work plan is to optimize manufacturing and analytical activities around the production of BA058-sMTS which will be produced using a new automated process. This work plan will result in the production of BA058-sMTS patches at three different dosage strengths, and a matching placebo patch. This work plan will also support the application for and completion of a Phase 2 clinical study by Radius.

 

Deliverables:

 

·                   Delivery of up to 3 distinct GMP clinical doses of BA058 sMTS product plus 1 placebo dose for a Phase II clinical study and supporting stability work. This includes a maximum of 54,600 patches (detail for quantities is shown below.) and [*] POC applicators. Any additional patches or applicators required to support the clinical trial, stability program and the requirement for clinical retains (as per 3M’s SOP for a non-bioequivalence clinical study) will be provided under a Change Order at Radius request and expense.

 

Planned usage

 

Active patches

 

Placebo patches

clinical study supplies

 

11,250

 

11,250

Release testing

 

150

 

150

Retains

 

450

 

600

Stability

 

2100

 

0

3M SOP retains

 

250

 

 

Total quantity

 

14,200

 

12,000

 

·                   Crossed over and validated analytical methods to monitor the manufacturing process, the release activities and the stability program

·                   Stability data for each of the three active product lots, as described below.

·                   A stability program for the RTC formulation for up to 6 months as defined in this Workplan

·                   3M shall establish and maintain proprietary Drug Master Files (DMFs) including information on the components, coating and drying manufacturing processes to support regulatory filings in the U.S. and Canada. A right of reference to 3M’s DMFs will be granted to Radius to support regulatory filings in the U.S. and Canada. Outside the U.S., 3M will provide Radius with information necessary to support regulatory filing in all countries where Clinical Development of BA058-sMTS is sited.

 

This estimate does not include the time associated with execution of the Phase II clinical studies nor completion of support stability.

 


* Confidential Treatment Requested by the Registrant. Redacted Portion Filed Separately with the Commission.

 

9



 

Milestones for the Workplan:

 

All dates assume Amendment signed by March 2, 2011.  Should the Amendment be signed at a later date, then the target dates for milestones need to be adjusted accordingly.

 

1.               Start preliminary RTC optimization – March 2, 2011

2.               March API requirements delivered by Radius to 3M – March 2, 2011

3.               Methods provided to 3M for crossover – March 4, 2011

4.               April API requirements delivered by Radius to 3M – April 1, 2011

5.               May API requirements delivered by Radius to 3M – May 1, 2011

6.               Initiation of coating optimization – May 1, 2011

7.               RTC optimization concludes – June 30, 2011

8.               July API requirements delivered by Radius to 3M – July 1, 2011

9.               Equipment installation – August 1, 2011

10.        Initiation of final optimization of coating and process verification – November 28, 2011

11.        Completion of coating process verification – December 31, 2011

12.        Release phase II supplies – by March 15, 2012

 

3M assumptions of the work plan:

 

·                   Validated analytical methods exist and can be crossed over to 3M from Radius – if method development is required, a Change Order will be required at Radius expense

·                   No more than 10 analytical methods need to be crossed over

·                   Adequate GMP BA058 starting material will be provided free of charge to 3M for development and clinical supply manufacture by Radius for phase II clinical supplies.

·                   Work plan assumes the use of the POC MTS applicator system and patch design in Phase 2.

·                   Lot size is not to exceed the quantities listed above of GMP-grade BA058 sMTS arrays to best meet the needs of the Phase 2 study and stability program plans.

·                   An additional 300 units per dose will be manufactured for retains in accordance with 3M’s SOPs. Any additional supplies beyond what is shown in the above table can be provided under a Change Order at Radius’ expense.

·                   Phase II product will be manufactured as low bioburden compatible with the process for Phase 3.

·                   sMTS patches and applicators for use in the Phase II clinical study will be bulk labeled by 3M and provided to Radius for further labeling according to the requirements of the clinical protocol.

·                   Radius will be responsible for executing all elements (protocols, regulatory filings, conduct) of the Phase II trial.

·                   The clinical trial will be conducted in countries to be identified by Radius.

·                   Wear time associated with the array is 24 hours or less.

·                   Stability studies on the product in support of Phase II will be performed as indicated; the stability report will be completed within 4 months of the completion of the stability study.

 

10



 

·                   DMFs for BA058-sMTS CCS and Coating and Drying Process will be filed at least 3 month prior to Phase 2 initiation.

 

Radius assumptions of the work plan:

 

·                   The work plan will cover the currently planned activities related to the manufacturing and support of all Phase 2 transdermal clinical trial supplies.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

·                   This work plan also covers the currently planned CMC/Quality activities required for support of the Phase 2 program for BA058-sMTS, including the 2-year ICH stability program.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

 

·                   This work plan also covers the currently planned Regulatory activities required for support of the Phase 2 program for BA058-sMTS in the regions and countries selected for the study.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

 

·                   Patches will be supplied in quantities indicated in the above table to support the clinical trial, clinical retains and the stability program.  Any additional quantities required can be provided on a Change Order.

·                   Phase 2 supplies will be manufactured with a low bioburden and will be compatible with the manufacturing process planned for Phase 3.

·                   Phase 2 supplies will be manufactured with residual solvents consistent with USP 467 and its European equivalent, extractables,

·                   Each major work plan task identified below will be associated with a protocol (either existing or to be written under a Change Order) and report, both to be reviewed and agreed with Radius.  Such reports may be redacted to protect 3M proprietary information

·                   All manufacturing activities will be compliant with:

 

ICH Q1A(R2): Stability Testing of New Drug Substances and Products 3M level 2 validation of analytical procedures.  3M will provide data supporting chemistry, manufacturing and control information necessary for regulatory filings with authorities in and outside the United States

 

WORKPLAN SUMMARY OF TASKS:

BA058-sMTS Drug Product Development and

Manufacturing Process Scale-up including Phase 2 Supply Production

 

3M Environmental Health and Safety

 

Update Hazard R eview

 

11



 

Update Risk Assessment (internal)

Update Animal Use Protocols

Qualification of Suppliers

 

3M Product Development

 

Terminal sterilization study

RM Receipt and Part Manufacture

RTC Optimization/Characterization

Formulation Optimization/Characterization

Process Optimization (including drying)

Packaging Optimization

[stability program is defined elsewhere]

Supply Production for additional Bridging Tox, if required (additional charge)

 

3M Product Scale-up to Phase 2

 

RM Receipt and Part Manufacture

System Integration

Product Development/Optimization:  RTC Optimization, Process Optimization

Process/Product Verifications

 

3M Support for Execution of Phase 2 Supply Manufacture

 

Validate Analytical Methods required for the manufacturing process, release and stability programs associated with the Phase 2 clinical trial supplies

Development and Verification of Specifications for Phase 2

Development and Verification of Shipping and Storage Requirements

Update Regulatory Documentation:  Provide up-to-date Drug Product CMC data to support updated IND, File Product Specific DMFs (sMTS-BA058 CCS and sMTS-BA058 Coating and Drying Process)

 

3M Phase 2 Supply Manufacture and Stability

 

RM Receipt and Part Manufacture

RM and Component Clearance

RTC Formulation Manufacture and Clearance

Execute Clinical Tickets: Applicator Construction, estimated 300 units; 3 active doses at a maximum as indicated in the table above.

Stability of RTC at 5C/ambient RH – 1,3,6 months

Stability of RTC at 25C/60% RH – 2 days, 1 week

Stability of Phase 2 Supplies:  5C/ambient RH – 1,3,6,9,12 months; 25C/60% RH - 1,3,6,9,12 months; 40C/75% RH – 1,3,6 months; the 18 and 24 months timepoints will be added under a Change Order.

Clear, release and ship Clinical Supplies

 

12



 

Radius Clinical Supplies Manufacturing Tasks

 

Provide GMP-grade, BA058 API, ready for formulating

Receive, label and release Phase II clinical supplies

Author Investigators Brochure and IND submission

Write clinical protocol, define safety and efficacy endpoints

Execute or oversee the Phase II clinical study

 

13



 

3M DRUG DELIVERY SYSTEMS CONTACT INFORMATION

 

For inquiries related to the proposal, please contact:

 

Mary Mathisen

Product Commercialization Manager

3M Drug Delivery Systems

3M Center, Bldg. 260-4N-12

St. Paul, MN 55144

Tel:  651-733-9125

Fax:  651-5751729

Cell: 651-503 0861

E-Mail: mmathisen@mmm.com

 

Mark Tomai Ph.D.

Head of Vaccine Business

3M Drug Delivery Systems

3M Center, Bldg. 275-3E-10

St. Paul, MN 55144

Tel:  651-733-5375

Cell: 651-403-0455

E-Mail: matomai@mmm.com

 

14


 

Confidential Treatment Requested

 

 

Under 17 C.F.R. §§ 200.80(b)(4) and

 

 

240.24b-2

 

 

 

FIFTH AMENDMENT TO DEVELOPMENT AND CLINICAL SUPPLIES AGREEMENT

 

This Fifth Amendment (“Amendment”) is entered into as of November 30, 2012 by and between 3M Company, and 3M Innovative Properties Company having a principal office at 3M Center, Building 275-3E-10, St. Paul, MN  55144-1000 (hereinafter “3M”), and Radius Health, Inc. having a principal office at 300 Technology Square, Cambridge, MA (hereinafter “RADIUS”) and amends the Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated as of March 2, 2011 (hereinafter, the “Agreement”). Capitalized terms used in this Amendment and not defined herein are used with the meanings ascribed to them in the Agreement.

 

RECITALS:

 

WHEREAS, 3M, through its Drug Delivery Systems Division, has developed expertise and has rights in technology relating to active transdermal, intradermal, and microneedle drug delivery, including its proprietary microstructured transdermal system (“MTS”) for delivering drugs into and through the skin;

 

WHEREAS, RADIUS has experience and expertise in the research, development and commercialization of pharmaceutical products, including expertise in its proprietary compound BA058 (“Compound”);

 

WHEREAS, the Parties wish to enter into this Amendment to address certain matters relating to exclusivity and to the development and supply of Product to RADIUS by 3M for use in a Phase III clinical study.

 

NOW, THEREFORE, in consideration of the Recitals (which are incorporated herein) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to amend the Agreement as follows:

 

1.               Section 1 shall be amended to include the following:

 

1.6                                “PTH” shall mean synthetic, natural or recombinant parathyroid hormone and/or any of its active fragments, analogues, derivatives and/or other variants.

 

1.7                                “PTH Related Protein” shall mean synthetic, natural or recombinant parathyroid hormone-related protein and/or any of its active fragments, analogues, derivatives and/or other variants.

 

2.                                       Section 9.1 shall be replaced in its entirety as follows:

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

During the term of this Agreement, with respect to the delivery of Compound, PTH and/or PTH Related Protein via active transdermal, intradermal, or microneedle technology, 3M shall work exclusively with RADIUS and RADIUS shall work exclusively with 3M.

 

3.                                       3M shall perform the Workplan attached as Exhibit A and Exhibit B to this Amendment with respect to the development and supply of Product for use by RADIUS in a Phase III clinical study for the Product.

 

4.                                       Section 6.1 and Section 11.4 of the Agreement are hereby amended to replace the $ [*] per hour rate for 3M with the rate of $ [*] per hour for work that is not the subject of a Change Order and the rate of $ [*] per hour for work that is the subject of a Change Order, with the following exception: for work performed by 3M from the effective date of this Amendment through June 30 th , 2013, the rate per hour will be $ [*] , whether or not the subject of a Change Order.

 

5.                                       3M shall provide phase III supplies as requested by RADIUS.  RADIUS shall pay 3M [*] dollars ($ [*] ) per unit for coated arrays and [*] ($ [*] ) per unit for applicators, both to be used in Phase III studies.

 

6.                                       Section 7.2 shall be replaced in its entirety as follows:

 

Except as otherwise provided below, any inventions conceived during and out of the work performed under this Agreement, and patents and applications filed thereon (“Program Patents”), shall be owned according to U.S. law as follows: those conceived solely by employees or agents of one party shall be solely owned by that party; those conceived jointly by an employee or agent of 3M and an employee or agent of RADIUS shall be owned jointly by 3M and RADIUS and will be considered Confidential Information of both parties with each joint owner having the right, subject to this Agreement, to practice, license, and transfer its undivided rights in such joint inventions without permission of or accounting to the other(s)) under the conditions provided for in this Agreement; provided that it is expressly understood and agreed that other than to conduct the work contemplated by this Agreement, during the term of the Agreement and, if applicable, any commercial supply agreement among the Parties related to any product containing the Compound and/or PTH Related Protein, (a) 3M shall have no right to use jointly owned inventions or jointly owned Program Patents in conjunction with the Compound or any pharmaceutical product that includes, as an active ingredient, PTH or PTH Related Protein and (b) RADIUS shall have no right to use jointly owned inventions or jointly owned Program Patents in conjunction with the Compound or any pharmaceutical product that includes, as an active ingredient, PTH or PTH Related Protein with any active transdermal, intradermal, or microneedle delivery technology.  Information and data developed during and resulting from the work under this Agreement (“Program Data”), solely by employees or agents of one party shall be solely owned by that party;

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

those data developed jointly during and resulting from the work under this Agreement by an employee or agent of 3M and an employee or agent of RADIUS shall be owned jointly by 3M and RADIUS (and each joint owner shall have the right to practice, license, and transfer its undivided rights in such jointly owned Program Data without permission of or accounting to the other(s)) under the conditions provided for in this Agreement; provided that it is expressly understood and agreed that other than to conduct the work contemplated by this Agreement, during the term of the Agreement and, if applicable, any commercial supply agreement among the Parties related to any product containing the Compound and/or PTH Related Protein, (i) 3M shall have no right to use jointly owned Program Data in conjunction with the Compound or any pharmaceutical product that includes, as an active ingredient, PTH or PTH Related Protein and (ii) RADIUS shall have no right to use jointly owned Program Data in conjunction with the Compound or any pharmaceutical product that includes, as an active ingredient, PTH or PTH Related Protein with any active transdermal, intradermal, or microneedle delivery technology.  In the event that the Parties are no longer working together under this Agreement or a commercial supply agreement related to any product that includes, as an active ingredient, the Compound, PTH or PTH Related Protein, then for a period of three years after termination, 3M shall have no right to use jointly owned Program Patents or jointly owned Program Data in conjunction with the Compound or PTH Related Protein, provided that (i) Radius has made commercially reasonable good faith efforts to submit the regulatory filing for the Product in the US by [*] or if not, (ii) Radius has made commercially reasonable good faith efforts to financially and operationally support the Workplan through [*] .  In the event that Radius has not complied with (i) above and has not complied with (ii) above, 3M shall have no restriction on the use of jointly owned Program Patents or jointly owned Program Data.  For the avoidance of doubt, 3M may use jointly owned Program Patents and jointly owned Program Data in conjunction with a pharmaceutical product that includes, as an active ingredient, PTH.

 

7.                                       Section 7.3 shall be replaced in its entirety with the following:

 

Notwithstanding the foregoing provisions of this Section 7, Program Patents and Program Data directed towards and claiming (in the case of Program Patents) the Compound, or a method of making or using the Compound, regardless of inventorship, shall be solely owned by RADIUS; and Program Patents and Program Data directed towards active transdermal, intradermal, or microneedle delivery technology, including, without limitation, microneedle devices, components, arrays, applicators, manufacturing, coating and formulations, packaging, or uses thereof, regardless of inventorship, shall be solely owned by 3M.

 

8.                                       Section 7.4 shall be replaced in its entirety with the following:

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

3M, 3M IPC and RADIUS grant each other a worldwide, royalty-free, license under Program Data and Program Patents owned solely by the other Party, solely for purposes of conducting the work under this Agreement or a commercial supply agreement related to any product containing the Compound and/or PTH Related Protein.  The licenses under this Section 7.4 shall be exclusive with respect to any product containing the Compound and/or PTH Related Protein, but only as long as the Parties are working together under this Agreement or a commercial supply agreement among the Parties related to any product containing the Compound and/or PTH Related Protein.  In the event that the Parties are no longer working together under this Agreement or a commercial supply agreement related to any product containing the Compound and/or PTH Related Protein, the exclusive licenses to any Program Patents under this Section 7.4 are terminated, but the Parties shall continue to have a non-exclusive, worldwide, royalty-free, license under Program Patents and Program Data owned solely by the other Party, provided that 3M shall have no right to such Program Patents and Program Data solely owned by RADIUS in conjunction with the Compound and/or PTH Related Protein, and (ii) RADIUS shall have no right to use such Program Patents and Program Data solely owned by 3M in conjunction with any active transdermal, intradermal, or microneedle delivery technology.

 

For clarity, the licenses under this Section 7.4 are limited to Program Data or Program Patents do not and shall not be construed to give the licensees any right or license, by implication or otherwise, to any of the licensor’s other intellectual property.

 

9.                                       Upon execution of this Fifth Amendment, 3M shall take action to procure capital equipment to enable the manufacture of phase III supplies.  In the event that the Agreement is terminated prior to [*] without RADIUS submitting a regulatory filing for the Product in the US, RADIUS shall reimburse 3M for [*] percent [ *] the cost of any such equipment specifically procured for RADIUS’ phase III supplies, with RADIUS’ share estimated to be approximately [*] Dollars ($ [*] ) if (i) RADIUS has not made commercially reasonable good faith efforts to financially and operationally support the Workplan through [*] or (b) if terminated by 3M for RADIUS material breach or (c) if terminated by RADIUS for any reason other than 3M material breach,

 

10.                                Except to the extent expressly amended by this Amendment, all of the terms, provisions and conditions of the Agreement are hereby ratified and confirmed and shall remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Amendment.

 

11.                                This Amendment may be executed in counterparts, each of which will be deemed an original with all such counterparts together constituting one instrument.

 

[remainder of this page intentionally left blank]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

IN WITNESS WHEREOF, the parties hereto have caused this Amendment to be duly executed in duplicate as of the date set forth above

 

 

3M COMPANY

 

RADIUS HEALTH INC.

 

 

 

 

 

By

/s/ James D. Ingebrand

 

By

/s/ Michael Wyzga

 

 

 

 

 

Print Name

James D. Ingebrand

 

Print Name

Michael Wyzga

 

 

 

 

 

Title

President and GM

 

Title

President and CEO

 

 

 

 

 

Date

December 14, 2012

 

Date

December 14, 2012

 

 

 

 

 

 

 

 

 

 

3M INNOVATIVE PROPERTIES COMPANY

 

 

 

 

 

 

 

 

By

/s/ Robert W. Sprague

 

 

 

 

 

 

 

 

Print Name

Robert W. Sprague

 

 

 

 

 

 

 

 

Title

Secretary

 

 

 

 

 

 

 

 

Date

December 14, 2012

 

 

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

EXHIBIT A

 

WORK PLAN SUMMARY 07SEPT2012

 

Note:  This workplan summary represents 3M’s estimated hours and tasks as of the September 7, 2012, but does not reflect the rate reduction contemplated in Section 4 of this amendment.  The impact of the rate reduction is summarized in a footnote at the end of Exhibit A.

 

Objective

 

This work plan covers the development of the BA058-sMTS drug product from the current configuration through manufacture of Phase III clinical supplies.  The work includes optimization and characterization of a modified formulation for the drug product as well as generation of preclinical tox and bridging Phase I clinical supplies to verify the suitability of the new dose for inclusion in the Phase III study.

 

The work plan includes 12 months of stability data to be collected prior to submission of the IND for Phase III.  This stability study will be reflective of the final formulation and container closure system (CCS) material configuration for the Phase III product.  Further, the work plan includes the documentation and analysis necessary to support verification of the [*] manufacturing process that will be used to manufacture [*] BA058-sMTS Phase III supplies, [*] .

 

The work plan includes the development (as necessary), documentation, and full validation of analytical methods and development of specifications necessary to support clearance and characterization of the drug product, CCS, and raw materials.  These methods include validation of the [*] and a shipping study to verify the suitability of the CCS.

 

The work plan includes the manufacture and clearance of approximately [*] Phase III supplies along with development of CMC/IND documentation needed to support regulatory filings in the US and/or the EU.

 

The work described here (through manufacture of Phase III clinical supplies) is expected to take [*]  months from the date of initiation and assumes that a single dose formulation has been identified.

 

Work Plan Assumptions

 

·                   Work plan assumes the development of a sterile (aseptically manufactured), single-dose BA058-sMTS drug product with a minimum of [*] months stability at room temperature that is intended to be administered with a reusable applicator

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

designed to meet the needs of the target patient population (post-menopausal women with osteoporosis or pre-osteoporosis).

·                   Work plan assumes that work required to optimize the sMTS applicator for the BA058-sMTS product will be started immediately upon initiation of the work plan.  Certain elements of this work plan (e.g. Product Stability to Support Phase III Filing and Bridging Phase I Supply Manufacture) are dependent on the timely execution of tasks within the Applicator Development work plan.

·                   Work plan assumes Radius will provide sufficient quantities of BA058 on time to complete the product and process development work described here.

·                   Work plan assumes that a single dose of BA058-sMTS, plus placebo, will be prepared for GLP preclinical tox studies ( [*] units each) and for the bridging Phase I clinical study ( [*] units each); these supplies will meet previously established specifications [*] .  The quantities listed include supplies sufficient to cover stability and retains.  If additional quantities are required, a change order will be issued.

·                   GLP preclinical tox supplies will utilize the existing POC applicator system.

·                   Phase I clinical supplies will be applied utilizing the new applicator.

·                   Work plan assumes that the stability work initiated to support the pre-Phase III filing will be completed using materials, but not necessarily the dimensions or mechanical configuration, representative of the final CCS.

·                   Work plan assumes that BA058-sMTS Phase III supplies will be manufactured as a [*] .

·                   Work plan assumes all supply manufacturing work described will be conducted in 3M’s St. Paul 260 Clinical Supply Area.

·                   Work plan assumes that all sterilization, sterility testing, process simulation testing, microbial testing and endotoxin testing will be done at outside contract facilities.

·                   Any 3M out-of-pocket expenses to be reimbursed by Radius including tooling and testing and will be billed at 3M’s actual cost.

·                   Work plan assumes that [*] supplies (single dose + placebo) will be manufactured for Phase III via lots sizes of approximately [*] units/lot.  The stability of each lot will be characterized.  The quantities listed include supplies sufficient to cover stability and retains assuming the lot size indicated and that [*] units are used for dosing.  If additional quantities are required, a change order will be issued.

·                   Work plan assumes that the GLP preclinical tox study, the Phase I clinical study and the Phase III clinical study will be conducted by Radius.

·                   Work plan assumes that all clinical work will be conducted in the US and/or the EU.

·                   Work plan assumes that some product/process development work described here may not represent the final state and that additional DOE and process characterization work may be necessary prior to commercial launch.

·                   3M will initiate approval procedures for the capital expenditure upon signed agreement of the Amendment.

·                   Radius is responsible for transport of product from St. Paul to tox or clinical facility.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

·                   This work plan is developed following the general project plan and technical and regulatory strategy agreed to by the Radius/3M JTT on 01 August 2012.  Assumptions re: project timing depends on both 3M and Radius completing critical path activities on time including, finalization of product specific applicator, dose/formulation selection for GLP preclinical tox work, initiation and completion of bridging Phase I study, dose/formulation selection for Phase III supply manufacture.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Work Plan Tasks and Projected Resource Needs

 

Estimated Costs

 

Start

 

Finish

 

Project Tasks

 

Deliverables

[*] hours

 

[*]

 

[*]

 

Product and Process Risk Management

Required documentation and process analysis for drug product including risk identification, risk analysis, risk evaluation, risk mitigation, re-evaluation, risk management report

 

·       Product risk management report, suitable for regulatory submission, including elements addressed in adjacent column

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

Product and Process Design Control Documentation

Required documentation and analysis for drug product and process including update of the Design Requirements Specification (DRS), Design Specification (DS), Design Failure Mode and Effects Analysis (DFMEA), Design Reviews, Design Verification

 

·       Design Requirements Specification

·       Device Specification

·       Design Review Reports (including FMEA)

·       Product Breakdown Structure

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

Product Design Formulation Development

Forced degradation study for final formulation and product, GMP process development for Tox Supply generation at target dose

 

·       Formulation development report (for submission)

·       Forced degradation report (for submission)

·       GMP process for Tox supplies, 1 active dose + 1 placebo

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

$ [*] sterilization facility/bioburden testing

 

[*]

 

[*]

 

Terminal Sterilization Process for Components

Dose titration and component characterization (physical and chemical), patient wear panel re: stick to skin adhesion for final conditions in target population, terminal sterilization analysis and report

 

·       Aseptic Process Justification Report

·       Component characterization, Bioburden and Dose Selection Report

·       Validated Terminal Sterilization Process and Validation Report

 

 

 

 

 

 

 

 

 

[*] hours

 

$ [*] tray tooling

 

[*]

 

[*]

 

Primary Packaging Characterization

[*] , array CCS optimization for shipping and applicator coupling, shipping study, label creation and validation

 

Note:  This does not include the development of the primary packaging which will be outsources.

 

·       [*]

·       Validation Process for Label creation and Validation Report

·       Tooling for Primary Packing

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

Ready to Coat (RTC) - Process Characterization and Validation

Mixing, filtering, material compatibility characterization, mixing qualification, filter qualification, stability

 

·       RTC Mixing and Filtration Process master batch record

·       Stability Data and Report on Final RTC Process

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

Coating - Process Characterization and Improvements

Coating conditions with final formulation

 

·       Coating Process master batch record

·       Optimized coating process including development report

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

[*]

 

[*]

 

Product Stability to Support Phase III Filing (minimum 12 months stability on 1 formulation)

Full ICH Stability on select formulation with representative CCS (materials)

 

·       Twelve month stability study report with CCS materials suitable for supporting Phase III filing

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

[*] Process Characterization for BA058-sMTS

Required documentation and analysis for drug product including risk assessment, HAZOP, HACCP, process definition

 

·       [*] process risk management plan

·       [*] process definition

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

[*] Process Simulation for BA058-sMTS

[*] test method, process simulation design and protocol development, simulation study,  analysis and study report

 

·       Process simulation protocol

·       [*] modifications completed, hardware installed, optimized and characterized

·       Process simulation report

 

 

 

 

 

 

 

 

 

[*] hours

 

$ [*] for materials for supplies

 

[*]

 

[*]

 

Bridging GLP Preclinical Tox Supply – new formulation, existing applicator, ([*] doses active; [*] doses placebo)

RM characterization, supply manufacture: components, supply manufacture: RTC, supply manufacture: coated patches, stability of supplies (assumes 12 months for 1 dose), stability report

 

·       GLP Supplies for 9M tox study, 1 active dose + 1 placebo

·       12 month stability data on tox supplies

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

$ [*] for materials for supplies

 

[*]

 

[*]

 

Bridging Phase I Clinical Supply – new formulation, new applicator ([*] doses active; [*] doses placebo)

IND/CMC documentation preparation, RM characterization, supply manufacture: components, supply manufacture: RTC, supply manufacture: coated patches, stability of supplies (assumes 12 months for 1 dose), stability report

 

·       Supplies for Phase I Clinical Study, 1 active dose + 1 placebo

·       Data and report on 12 M stability study on clinical supplies

·       Updated CMC documentation, including description and operation instructions for new applicator

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

CCS : Test Method Development, Method Development Report, Validation Protocol development, Validation (to Level 3) and Validation Report, Specification Development and Specification Justification Repor t

Methods anticipated: [*]

 

·       Validated methods and Validation reports for [*]

·       Method development reports for all methods, as appropriate

·       Validated [*] method for the drug product

·       Validated performance methods for [*]

 

 

 

 

 

 

 

 

 

[*] hours

 

$ [*] for lab equipment

 

[*]

 

[*]

 

API-related : Test Method Development, Method Development Report, Validation (to Level 3) and Validation Report, Specification Development and Specification Justification Report

Methods anticipated: [*]

 

·       Validated methods and validation reports for drug product and RTC testing (listed in adjacent column).

·       Method development reports for methods listed in adjacent column.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

[*]

 

[*]

 

Extractables: Test Method Development, Method Development Report, Validation (to Level 3) and Validation Report, Specification Development and Specification Justification Repor t

Methods anticipated: Liquid Chromatography (LC) and Size Exclusion Chromatography (SEC)

 

For array, filter, and syringe body:

·       Validated methods and validation reports for characterization of extractables (anticipate 2-4 methods/matrix)

·       Method development reports for extractables.

·       Extractables Study Protocol

·       Extractables Study Report

 

 

 

 

 

 

 

 

 

[*] hours

 

[*]

 

[*]

 

Drug Product Specification and Supplier Qualification

Characterization, analysis and specification development for RMs, RTC in-process analysis and specification development, drug product specification analysis and report,

 

·       Completed qualifications for all suppliers

·       DP Specifications and Specification Justification Reports

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours for mfg support

 

[*] hours for stability

 

$ [*] Phase III supplies

 

$ [*] process simulation testing

 

[*]

 

[*]

 

(stability continues after this date)

 

Phase III Clinical Supply ([*] doses active + placebo)

IND/CMC documentation preparation, RM characterization and clearance, supply manufacture and clearance: components, supply manufacture and clearance: RTC, supply manufacture and clearance: coated patches, stability of supplies (anticipate [*] months for 1 formulation), analysis and stability report

 

·       Cleared, Sterile product for Phase 3 clinical trial, 1 dose active + 1 placebo

·                   [*] clinical doses

·                   Release testing supplies

·                   Required retains

·                  Stability supplies

·       Stability Study

·                   Full ICH testing of 1 lot of active and 1 lot of placebo

·                   12M testing only, on [ *] other lots.

·       Final report on stability study

·       Updated CMC documentation

·       Process Simulation Protocol

·       Process Simulation Final Report

 

Summary of Costs (Original)

 

[*]
$ [*]

 

Labor Hours
Labor Costs ($ [*] /hour)

[*]

 

Tox and Clinical Supplies (Phase I & Phase III)

[*]

 

Direct Costs (materials, equipment, sterilization, etc)

 

Exibit A Footnotes

[*]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Summary of Costs (Revised 10Dec2012)

 

[*]

$ [*] ($ [*] /$ [*] )

 

Labor Hours

Labor Costs ($ [*] /hour/$ [*] /hour)

[*]

 

Tox and Clinical Supplies (Phase I & Phase III)

[*]

 

Direct Costs (materials, equipment, sterilization, etc)

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

EXHIBIT B

 

WORK PLAN SUMMARY 07SEPT2012

 

Note:  This workplan summary represents 3M’s estimated hours and tasks as of the September 7, 2012, but does not reflect the rate reduction contemplated in Section 4 of this amendment or the change in the mix of work between 3M and its design firm based on an updated quote.  The impact of the rate reduction and change in mix of work is summarized in a footnote at the end of Exhibit B.

 

Objective

 

This work plan covers the optimization of 3M’s existing prototype sMTS applicator for use with the BA058-sMTS drug product, with a primary patient population of post-menopausal women diagnosed with moderate to severe osteoporosis.   3M has made a significant investment in the development of applicator subsystems, general human factors studies, and characterization of critical application and wear performance for use of the sMTS array patches.  This work plan uses this foundation for optimization of the applicator specifically to support the approval of the BA058-sMTS drug product.

 

The work plan includes design refinement work provided by an external medical device design firm.  3M will manage this design firm and will work with Radius to establish critical device specifications and performance verification.  3M will oversee a VOC/Human Factors study with the target population to verify design choices.  3M will also manage suppliers and vendors necessary to manufacture Phase III and commercial supplies of the applicator.  The manufacture of these devices for clinical devices may include sub-contractors.  3M will characterize device performance during optimization and will provide verification of the device performance consistent with Design Control requirements in the US and the EU, including Human Factors studies.  Usability studies for the target patient population will be conducted by 3M with input from Radius input.

 

Although existing methods will be used whenever possible, the work plan includes the development (as necessary), documentation, and full validation of all analytical methods and specifications necessary to support clearance and characterization of the applicator and per the design requirements.  The work plan includes a stability study necessary to support the use of the device in Phase III.   The work described here is expected to take [*] months from the date of initiation.

 

Work Plan Assumptions

 

·                   3M has unrefined designs for each of the major applicator subsystems (i.e. energy source, array loading, counter, indicator, end of life lockout (end of life)) and general form factor data that will be used as a starting point for design of the BA058-sMTS drug product applicator optimization.

 

·                   3M has characterized critical parameters for array application and wear; these parameters will be used as a starting point for BA058-sMTS drug product applicator.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

·                   3M has developed and validated certain methods for characterization of device performance (e.g., [ *] ).  These methods will be used whenever possible to facilitate optimization and characterization of the BA058-sMTS applicator.

·                   The applicator will be designed for use by Radius’ target patient population (post-menopausal women) with 3M’s LCP sMTS arrays and array patches, currently in-use in Radius’ BA058-sMTS Phase II clinical trial.

·                   3M will select and manage the external medical device design firm with input from Radius on areas such as, but not limited to, Design Specifications, User Requirements and Risk Management.

·                   An external medical device design firm will be contracted to refine the applicator subsystems and refine the device human factors to fit the needs of the BA058-sMTS target patient population.  The external medical device design firm will be responsible for applicator design and the production of prototypes sufficient to support patient use and performance characterization studies.

·                   Any 3M out-of-pocket expenses to be reimbursed by Radius including tooling, external medical device firm and human factors facility will be billed at 3M’s actual cost.

·                   Single cavity tooling will be fabricated to support design verification.  Parts molded from this tooling may also be used in a Phase I, Phase II and/or Phase III clinical trials.

·                   3M will have responsibility to select and manage all suppliers and/or vendors needed to manufacture the applicator for Phase III and commercial supply manufacture.

·                   All clinical work utilizing the device will be conducted in the US and/or the EU.

·                   Radius will be responsible for the device design validation (Phase III clinical trial).

 

Work Plan Tasks and Projected Resource Needs

 

Original
Estimated
Costs

 

Revised
Estimated
Costs
(10Dec2012)

 

Start

 

Finish

 

Project Tasks

 

Deliverables

[*] hours

 

[*] hours

 

 

[*]

 

[*]

 

Project Initiation

Agreement between 3M and Radius on Project Charter, DRS , User Requirements, etc

 

·       Project Charter

·       Design Requirements Specification

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

$ [*] External Design Firm

 

[*] hours

 

$ [*] External Design Firm

 

$ [*] External Design Firm Capital Expenses

 

[*]

 

[*]

 

Management of External Medical Device Design Firm

Management of external medical device firm; host meetings (frequency to be agreed upon) between 3M, Radius and external medical device firm to progress optimization.  Engineering design consultation related to optimization of existing subsystems, critical device parameters and performance and design for manufacturability, maintenance of design control documentation.

 

Added (10Dec2012):

Patient Use and Human Factor Studies for Design

Design and orchestration of patient use studies, 1 in the US and 1 in the EU for the target patient population (estimated at 2 days each); construction of device stimulus supplies.  Studies at each site will include interviews with patients and/or health care providers and will be conducted under protocol and include a final summary report

 

 

·       Meeting Minutes

·       Engineering Drawings suitable for tooling manufacture

·       Summary reports of prototype testing

·       Design control documentation via Design History File

·       Engineering design review (including design for manufacturability) and critical device parameters input by 3M

 

Added (10Dec2012 ) :

·       Human Factors Study Protocols

·       Looks-like models for usability/HF testing

·       Patient feedback on design elements

·       Human Factors Study Final Report and Recommendations

·       Validated design requirements

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

$ [*] Human
Factors Test
Facility

 

$ [*] Travel

 

NA

 

NA

 

 

 

NA

 

[*]

 

[*]

 

Patient Use and Human Factor Studies for Design

Design and orchestration of patient use studies, 1 in the US and 1 in the EU for the target patient population (estimated at 2 days each); construction of device stimulus supplies.  Studies at each site will include interviews with patients and/or health care providers and will be conducted under protocol and include a final summary report.

 

This work will be completed by the External Design Firm per the previous row in this table.

 

·       Human Factors Study Protocols

·       Looks-like models for usability testing

·       Patient feedback on design elements

·       Human Factors Study Final Report and Recommendations

·       Validated design requirements

 

 

 

 

 

 

 

 

 

 

 

[*] hours

 

[*] hours

 

[*]

 

[*]

 

Device Characterization Studies, Development

On-going characterization as the design progresses to gauge success towards key design requirements, including [*]

 

·       Regular updates on test results

·       Refined device specification

·       Summary reports as appropriate, minimally for specified design requirements

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

[*] hours

 

[*]

 

[*]

 

Analytical Method and Validation (Level 3) and Specification Development

As needed, for example, [*]

 

·       Method validation protocols (estimated, n=8)

·       Method validation reports (estimated, n=8)

·       Method development reports (est. n=8)

·       Method documents

·       Component specifications and specification justification reports (number depends on final design)

 

 

 

 

 

 

 

 

 

 

 

[*] hours

 

[*] hours

 

[*]

 

[*]

 

Supplier Approval and Material Qualification

Risk assessment and analysis and independent testing of the raw materials, as applicable and dictated by the risk assessment.

 

·       Supplier Approval documents

·       Supply chain risk analysis

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

$ [*] Human
Factors Test
Facility

 

$ [*] Single
Cavity Tooling

 

 

$ [*] Devices

 

[*] hours

 

NA

 

 

 

$ [*] Single
Cavity
Tooling

 

$ [*] Devices

 

[*]

 

[*]

 

Device Verification Studies, including Human Factors

Applicators manufactured with molded parts will be characterized in-vivo in design verification studies prior to use in Phase III.  Human factors studies, 1 in the US and 1 in the EU, for the target patient population (estimated at 2 days each) designed to verify performance endpoints related to the target patient population will also be conducted.  Studies will be conducted under protocol and will include a final summary report.

 

·       Looks like/works like prototypes for Human Factors Study (using needleless, placebo arrays)

·       Human Factors study protocol

·       Human Factors Study Final Report

·       Regular updates on device verification test results

·       Design Review summary reports

·       Device ready for design validation (i.e. Phase 3)

 

 

 

 

 

 

 

 

 

 

 

[*] hours

 

[*] hours

 

[*]

 

[*]

 

Product Design Control Documentation

Required documentation and analysis of device and drug product performance including update of the Design Requirements Specification (DRS, Design Specification (DS), Design Failure Mode and Effects Analysis (DFMEA), Design Reviews, Design Verification, Device Specifications

 

·       Design Requirements Specification

·       Device Specification

·       Product Specification

·       Specification Justification Report

·       DFMEA report

·       Design review reports

·       Design History File

·       DHF Index

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

[*] hours

 

[*] hours

 

[*]

 

[*]

 

Device Stability

Device stability sufficient to support device use in Phase 3 (six months accelerated stability with testing at initial and final time points).

 

 

·       Stability Study Protocol

·       Stability Final Report

·       Thru-study updates on testing results

 

Summary of Costs (Original)

 

[*]
[*]

 

Labor Hours
Labor Costs ($ [*] /hour)

[*]

 

Direct Costs (external design firm deliverables, materials, facility use, etc)

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Exhibit B Footnotes

 

[*]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Summary of Costs (Revised 10Dec2012)

 

[*]
[*] ($ [*] /$ [*] )

 

Labor Hours
Labor Costs ($ [*] /hour/$ [*] /hour)

[*]

 

Direct Costs (external design firm deliverables, materials, facility use, etc)

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Change Order Form - Amendment 5*

 

Change order under Agreement dated: Development and Clinical Supply Agreement dated 19 June 2009

 

Between : Radius Health and 3M

 

Project Name: Radius Health proprietary compound BA058 and 3M proprietary microstructured transdermal system

 

Change requested by: Radius

 

Name:  Maria Grunwald

Company:  Radius Health, Inc

Date:   4 February 2011

 

Description of change:  Radius has asked 3M to prepare three Workplans that identify activities that could be initiated in February 2011.  These activities are summarized on the following Workplans:

 

Workplan #1 — Microscopic Evaluation of Clinical Supplies Workplan Summary

Workplan #2 — Residual Drug Analysis of Clinical Supplies Workplan Summary

Workplan #3 — Optimization of Ready-to-Coat Formulation and Process and Method  Development for Product Development Workplan Summary

Workplan #4 — DMF preparation for FDA response

 

In addition to the Workplans listed above, 3M will deliver responses to the FDA Advice/Information letter for the sMTS development received by Radius. These responses incorporate current testing plans (Workplan #1, #2, current manufacturing plan, in process controls, and the depth of penetration) & planned future development plan (i.e., DMFs development and sterile manufacturing process).  For the avoidance of doubt, 3M will provide Radius information on the depth of penetration studies funded by 3M at no charge to Radius.  The current responses to the FDA letter, and any authorized work, and reports conducted under the Workplans #1 and #2 will be completed by 3M and delivered to Radius by the end of February 2011 for Radius’ response submission.

 

Radius authorizes 3M to work up to a maximum of [*] hours at a rate of $[*] per hour in February under this change order.  Radius will prioritize the Workplans #1 and #2, and in the case of Workplan  #3, Radius will advise which tasks that it wishes 3M to commence in

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

1



 

February to complete the [*] authorized hours.  Radius understands that the deliverables accomplished under Workplan #3 will correlate to the amount of work authorized by Radius.

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius

3M

Name: Nick Harvey

Name: Mary Mathisen

Signature:

/s/ B.N. Harvey

 

Signature:

/s/ Mary Mathisen

Position: CFO

Position: Commercialisation Mgr

Date (dd/mm/yy): February 4, 2011

Date (dd/mm/yy):4 February 2011

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

2



 

Workplan #1

 

MICROSCOPIC EVALUATION WORK PLAN SUMMARY

 

Objective:

 

The objective of the work plan is to perform microscopic evaluation BA058-sMTS patches and arrays to assess for microneedle fracture, deformation of the needle, residual drug, or biological matter deposits following removal from dosed clinical subjects of Period 2, Protocol BA058-05-006.

 

Scope:

 

Approximately 49 patches (controls and samples) will be evaluated microscopically. Group 2a, Day 4 and Day 5 BA058-sMTS samples of each subject ([*]mcg) removed following dosing will be sent for residual drug analysis. Group 2b, Day 4 and Day 5 BA058-sMTS samples of each subject (Placebo and [*]mcg) removed following dosing will be send for residual drug analysis. Group 2c, Day 4 and Day 5 BA058-sMTS samples of each subject ([*]mcg) removed following dosing will be sent for residual drug analysis. Three BA058-sMTS unused samples from each dose (Placebo, [*]mcg, and [*]mcg) will be used as controls. Each BA058-sMTS will be examined at 100x power by microscope and assessed for microneedle fracture (breaks, cracks, and chips), deformation of the needle (bends and/or blunting), residual drug, or biological matter deposits.

 

Materials:

 

Forceps

Microscope, capable of 100x magnification and equipped with a digital camera

Control and sample patches (Placebo, [*]mcg, and [*]mcg) currently stored at 2-8°C.

 

Procedure:

 

Placebo Controls;

 

1.               Remove samples from 2-8°C and allow the sample to reach room temp. (about 1 hour).

 

2.               Carefully remove one of the BA058-sMTS placebo patches from the collar.

 

PATCHES THAT ARE DISLODGED FROM THE COLLAR DURING SHIPPING WILL NOT BE ASSAYED.

 

3.               Using 100x magnification examine the patch and array for microneedle fracture, deformation of the needle, residual drug, or biological matter deposits.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

3



 

4.               Document observations on Attachment 2.

 

5.               Photograph the damaged needles.

 

6.               Repeat 1 through 5 for the other BA058-sMTS placebo controls.

 

Repeat the above for the BA058-sMTS Placebo samples, [*]mcg controls, [*]mcg samples, [*]mcg controls and [*]mcg samples.

 

Projected Hours

 

Visual testing of 49 arrays                 [*] hours

Preparation, review, and release of report      [*] hours

Total Hours          [*]

 

Deliverables

 

A summary report describing the type and frequency of observations.

 

Attachments:

 

Example Photo

Observations

Summary Observations

 

Example Photo

 

GRAPHIC

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

4



 

OBSERVATIONS

 

Sample ID:

 

 

Describe appearance of patch:

 

5



 

Enter code for damaged array on to chart.

 

Codes: R — break, C — chip, K — crack, D — bend, L — blunt, B — biological matter, F — partial fill, S - residual drug

 

Add sequence number for digital image.

 

SUMMARY OBSERVATIONS

 

Sample
ID

 

Microneedle fracture
(breaks, cracks, and
chips)

 

Deformation of
the needle (bends
and/or blunting)

 

Residual
drug

 

Biological
matter
deposits

 

Digital
Photo

()

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

6



 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

 

 

 

7



 

Workplan #2

 

RESIDUAL DRUG ANALYSIS WORK PLAN SUMMARY

 

Objective:

 

The objective of the work plan is to perform residual drug analysis of BA058-sMTS arrays following removal from dosed clinical subjects of Period 2, Protocol BA058-05-006 to assess residual drug remaining on the array.

 

Scope:

 

Approximately 49 arrays (controls and samples) will be evaluated for residual drug. Group 2a, Day 6 and Day 7 BA058-sMTS samples of each subject ([*] mcg) removed following dosing will be sent for residual drug analysis. Group 2b, Day 6 and Day 7 BA058-sMTS samples of each subject (Placebo and [*]mcg) removed following dosing will be send for residual drug analysis. Group 2c, Day 6 and Day 7 BA058-sMTS samples of each subject ([*] mcg) removed following dosing will be sent for residual drug analysis. Three BA058-sMTS unused samples from each dose (Placebo, [*] mcg, and [*] mcg) will be used as controls. Each BA058-sMTS will be analyzed in accordance with Method-07-001836.

 

Materials:

 

Forceps

Snap-cap polypropylene sample vials (5mL, Nalgene Part 6250-0005)

BA058-sMTS Control and sample patches (Placebo, [*] mcg, and [*] mcg) stored at -20°C.

 

Procedure:

 

Prepare the controls and samples as follows;

 

7.               Remove samples from -20°C storage and allow to reach room temp. (approx. 2 hours).

 

8.               Carefully remove one of the BA058-sMTS patches from the collar.

 

PATCHES THAT ARE DISLODGED FROM THE COLLAR DURING SHIPPING WILL NOT BE ASSAYED.

 

9.               Separate the large circular adhesive from the hard plastic disc containing the micro array needles by holding the array patch across the patch diameter with the thumb and finger.

 

DO NOT TOUCH THE MICRO ARRAY.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

8


 

10.        Pinch the thumb and finger together to bend the patch away from the array. (Figure A).

 

Figure A.                Use the forceps to grab the array from the bent adhesive patch.

 

 

11.        Use a forceps to grasp the array and to peel the array from the patch (Figure A).

 

12.        Place the disc containing the micro array into a labeled plastic snap cap container (needles-down orientation) and seal.

 

13.        Analyze each in accordance with Method-07-001836.

 

Projected Hours

 

HPLC analysis and review of data for 49 patches

 

[*] hours

Preparation, review, and release of report

 

[*] hours

Total

 

[*] hours

 

Deliverables

 

Summary report describing residual BA058 content of arrays.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

9



 

Workplan #3

 

RTC Process Development and Analytical Methods WORK PLAN SUMMARY

 

Objective

 

Determine operating conditions for RTC mixing and filtration that provide a robust process for preparing sterile, homogeneous ready-to-coat (RTC) formulation.  Following these experiments, the process and parameters for preparing RTC should be finalized.

 

Some method development efforts are also addressed below.

 

Background

 

[*]  Consequently, the RTC formulation is prepared by using a [*].  This results in a very inhomogeneous formulation that needs to be thoroughly mixed prior to sterile filtration.  Currently, the RTC is [*] for [*] prior to sampling.   An additional [*] of [*] does not appear to effect the concentration, but limited data is available at this time point[*] after the filtration step appears to substantially improve the consistency of the RTC.

 

Process efficiency is currently about [*].  Variations in filtration media and devices will be investigated to improve this number.

 

Scope

 

Observed response variables for the mixing experiments are average content, variance of the content, and viscosity.  Two mixing methods will be investigated: [*] (the current method) and [*], a [*].  For [*], three times ([*],[*],[*]min) prefiltration and four times ([*],[*],[*],[*] minutes) postfiltration will be tested.  For [*], three times will be investigated prefiltration ([*],[*],[*] minutes) and four times postfiltration ([*],[*] ,[*], and [*] minutes).    To investigate the effect of the RTC concentration, mixing will be performed with [*]% and [*]% bulk drug substance (w/w).  The current manufacturing process uses [*]% w/w.

 

Only one lot of BA058 will be used.  Any variability due to the lot of BA058 should be minimal due to controls on its composition.

 

Materials

 

14 g BA058

Miscellaneous lab supplies

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

10



 

Procedure

 

For each mixing technique, the prefiltration experiments will be performed.  The best prefiltration mixing time will be used for the postfiltration experiments.  The procedure will be repeated for the two concentrations of BA058.

 

The average and variance of the content will be determined by taking multiple samples from each mixing experiment and assayed using a validated HPLC method (Method-07-001836).   Viscosity of the RTC following each experiment will be tested using a Rheosense m-VROC.

 

Each experiment will use [*]  mL of RTC ([*] g of bulk drug substance).  Smaller volumes would not be indicative of performance at larger scales, and larger amounts result in exessive consumption of BA058.  The 14 g figure is considerably larger than previously quoted.  The previous quote assumed material could be saved by using the RTC from the mixing experiments to begin the coating process experiments.  Of course, unused RTC from this work will be saved for future use.

 

To determine the optimal approach to sterile filtration, a solution of BSA will be prepared with a viscosity similar to that of the current RTC.  This solution will be used to test filtration setups for easy of use and efficiency.  Once a suitable configuration is found, it will be tested by sterile filtering RTC and checking for changes in viscosity, purity, and content.

 

Projected Hours

 

Mixing Process Development

 

Perform mixing and take samples

 

[*] hours

HPLC analysis

 

[*] hours

Viscosity measurements

 

[*] hours

Prepare report

 

[*] hours

Mixing Process Total

 

[*] hours

 

Filtration Process Development

 

Trial filtration runs

 

[*] hours

Confirm filtration parameters

 

[*] hours

Prepare reports

 

[*] hours

Filtration Process Total

 

[*] hours

RTC Process Development Total

 

[*] hours

 

Deliverables

 

1.               Summary report describing mixing experiments

2.               Summary report describing filtration experiments

3.               Master Batch Record for the ready to coat

4.               Updated specifications for the ready to coat

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

11



 

Analytical Method Development

 

The following analytical method development activities are proposed. Method development covers laboratory activities intended to define the method. Authoring of method development reports and validation activities are separate and not included in the estimates given here.

 

Identification method

 

Uses current HPLC method, mix 1:1 sample with reference material, show that only one peak elutes from HPLC. Update method document.

 

[*] hours

Aggregation method

 

Develop size exclusion chromatography method to characterize any formation of aggregates in drug product

 

[*] hours

Release Method

 

Explore and develop method for release testing of microneedle patches.

 

[*] hours

Pouch Integrity

 

Adapt ASTM method to microneedle patches

 

[*] hours

Patch Adhesion

 

Adapt ASTM method to microneedle patches

 

[*] hours

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

12



 

Workplan #4

 

FDA RESPONSE WORK PLAN SUMMARY

 

Objective:

 

Respond to FDA’s questions regarding 3M’s manufacturing process and controls.

 

Scope:

 

A DMF will be prepared with information about 3M’s sMTS manufacturing process and controls.

 

Materials:

 

Not Applicable

 

Procedure:

 

Not Applicable

 

Projected Hours

 

Prepare, review, and submit DMF

 

[*] hours

 

Deliverables

 

1)              DMF will be filed with FDA.

2)              Radius will be provided with the DMF number and a letter of access.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

13



 

3M DRUG DELIVERY SYSTEMS CONTACT INFORMATION

 

For inquiries related to the proposal, please contact:

 

Mary Mathisen

Product Commercialization Manager

3M Drug Delivery Systems

3M Center, Bldg. 260-4N-12

St. Paul, MN 55144

Tel:  651-733-9125

Fax:  651-575-1729

Cell: 617-503-0861

E-Mail: mmathisen@mmm.com

 

Mark Tomai Ph.D.

Head of Vaccine Business

3M Drug Delivery Systems

3M Center, Bldg. 275-3E-10

St. Paul, MN 55144

Tel:  617-733-5375

Cell: 651-403-0455

E-Mail: matomai@mmm.com

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

14


 

Change Order Form # 6

 

Change order under Agreement dated:   Third Amendment to Development and Clinical Supplies Agreement dated 29 September 2010

 

Between :  Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System


 

Change requested by:   Radius

 

Name:   Gary Hattersley

Company:  Radius

Date:  1 June 2011

 

Description of change:

 

3M has been requested to add 5ºC

8-month stability pull for CM-10-00503

3-month stability pull for TM-10-00569

3-month stability pull for TM-10-00570

4-month stability pull for TM-10-00584

@ [*] each pull.*

 

 

 

 

 

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.


Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Mary Mathisen

Signature: /s/ Nick Harvey

 

Signature: /s/ Mary Mathisen

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 6/16/11

 

Date (dd/mm/yy): 6/20/2011

 


* Confidential Treatment Requested by the Registrant.  Redact Portion Filed Separately with the Commission.

 

1


 

Change Order Form # 7

 

Change order under Agreement dated:   the Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated March 2, 2011 (the “Agreement”).

 

Between:   Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by:   3M

Name:   Tom Fenn

Company:   3M

Date:   8 June 2011

Description of change:

 

3M is requesting complete an analytical characterization of the impurities observed in the drug product.

 

BACKGROUND

Impurities are forming in the BA058-sMTS drug product.  These impurities elute [*]in the reverse phase HPLC chromatogram.  These impurities form much more quickly in the lots of [*] produced [*] than in the lots of [*] produced in the [*].  The cause for this has not been identified.  To solve this issue, more information about the identity of these impurities is needed.

 

PURPOSE

Identify the BA058-sMTS impurities at a level of detail sufficient to allow action to be taken to block their formation.

 

PROCEDURE

The work described below will be conducted by 3M’s Corporate Analytical Laboratory.  Be aware that this lab does not operate under GxP regulations.  As much as possible, HPLC conditions will match those used in previous impurities investigations conducted by Radius.

 

Degradation of BA-058

Exposure of BA-058 to [*]C and [*]% humidity produces about [*]% aggregation of the peptide after one week.  The retention times and peak areas of the impurities in samples aged in this fashion matches the results found in the aged drug product.

 

NMR

BA-058 drug substance and degraded BA-058 drug substance will be dissolved in D20 and characterized via two-dimensional NMR experiments to identify any new chemical

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 



 

functionalities present in the aged sample.  Any differences observed will be analyzed to determine possible chemical reactions responsible for the formation of the impurities.

 

We estimate this work will require [*] hours and 100 mg of BA-058.

 

MADI-TOF

Aged BA-058 drug substance will be fractionated by HPLC.  Accurate mass determinations of the impurities will be attempted by analysis of the mass spectra of BA-058 drug substance, degraded BA-058 drug substance, and the HPLC fractions.  The instrument that will be used is a Bruker Daltonics Ultraflex II MALDI-TOF/TOF.

 

We estimate this work will require [*]  hours and 100  mg of BA-058.

 

LC/MS Accurate mass

Analysis of BA-058 peptide samples (BA-058 drug substance and aged drug substance) will be analyzed on an Agilent 6540 Q-TOF LC-MS/MS equipped with an electrospray ionization interface.  Accurate masses will be determined and peptide sequence information may be obtained by fragmentation.

 

We estimate this work will require [*] hours and 200 mg of BA-058

 

Summary

 

 

 

 

Task

 

Hours

 

BA-058 needed

NMR

 

[*]

 

100 mg

MALDI- TOF

 

[*]

 

100 mg

LC/LM Accurate mass

 

[*]

 

200 mg

Total

 

72 hours

 

400 mg

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Mary Mathisen

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Mary Mathisen

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 7/29/11

 

Date (dd/mm/yy): 2 August 2011

 

2


 

Change Order Form # 8

 

Change order under Agreement dated:  the Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated March 2, 2011 (the “Agreement”).

 

Between:   Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by:   Radius

Name:   Maria Grunwald and Gary Hattersley

Company:   3M

Date:   20 July 2011

Description of change:

 

Radius is requesting 3M manufacture 420 patches for an additional clinical study Radius wishes to conduct.  The product strength is [*]mcg/array.  3M will continue with development work in accordance with the Agreement.  The additional requirement of these supplies affects the process group ability to meet the timelines in the Work Plan attached to the Fourth Amendment.  The net effect is a delay in the delivery of Phase II supplies by 4 weeks.

 

Planned Usage

 

Number of Patches

Clinical study supplies

 

[*]

Release testing

 

[*]

Retains

 

[*]

Stability

 

[*]

Customer retains

 

0

Total Quantity

 

420

 

We estimate this work will require 375 hours and 1.3 grams of BA-058.  Delivery of the clinical supplies is estimated to be the week of September 26.

 

Estimate of additional out of pocket expenses

Gamma treatment

 

$

1000

 

Decontamination of isolator and testing

 

$

1500

 

Rodac plates

 

$

500

 

Endotoxin testing

 

$

600

 

Shipping costs

 

$

500

 

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

1



 

Stability pulls — $[*]per pull point

Limited stability plan:  1, 3, 6, 12 months at 5°C and 1, 3, 6 at 25°C.  An intermediate time point to cover use period may be added at a later date.

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

Company: 3M

Name: Nick Harvey

Name: Mary Mathisen

Signature:

v/s/ Nick Harvey

 

Signature:

/s/ Mary Mathisen

Position: CFO

Position: Commercialization Mgr

Date (dd/mm/yy): 7/27/11

Date (dd/mm/yy): 7/28/11

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

2



 

- AMENDED AND RESTATED PROPOSAL -
RADIUS BA058 sMTS PROGRAM

 

EXECUTIVE SUMMARY

 

3M Drug Delivery Systems is pleased to provide Radius Health Inc. (Radius) with this estimate for development and delivery of Phase II clinical supplies for its BA058 product delivered via 3M’s solid Microstructured Transdermal System (sMTS).

 

This estimate supports the attached work plan summary and is based on information exchanged between Radius and 3M regarding the requirements for a BA058 sMTS product.  The scope of work outlined in the summary includes all activities required for formulation development and delivery of clinical supplies to enable Radius to perform a Phase II clinical study in humans.  As discussed with Radius, 3M will deliver clinical supplies no later than 14 months after the effective date of this Amendment and will use commercially reasonable efforts to accomplish delivery by March 15, 2012 if Radius approves the Phase II Workplan and initiates work on or before March 1, 2011.  If work does not commence on March l st  2011, 3 months must be added to the time below to provide sufficient ramp up time to obtain and train resources to re-initiate the project.  Effective July 20, 2011, Radius requested 3M manufacture additional Phase I clinical supplies in August 2011.  This will delay delivery of the Phase II clinical supplies four weeks later than previously stated in the Work Plan attached to the Agreement and the Milestone dates set forth below have been revised accordingly.

 

The estimate for the activities listed in the work plan summary is provided below:

 

 

 

PROGRAM HOURLY
ESTIMATE

 

TIMING

Scale-up Process Optimization and Preparation of GMP Supplies for Phase II Trial

 

[*]hours

 

(as per indicated in the above paragraph)

Direct Costs (Arrays and Applicators based on quantities defined below arrays for each strength and 300 applicators)

 

$[*] K

 

 

 

Deliverables, timing and assumptions are presented in the work plan summary.

 

3M reserves the right to revise this proposal if the intended scope of work deviates from the work outlined.  Any change in this proposal shall be subject to execution of a Change Order.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

3M Drug Delivery System

 

 

 

Confidential

 

1



 

WORIC PLAN SUMMARY

 

Objective:

The objective of the work plan is to optimize manufacturing and analytical activities around the production of BA058-sMTS which will be produced using a new automated process.  This work plan will result in the production of BA058-sMTS patches at three different dosage strengths, and a matching placebo patch.  This work plan will also support the application for and completion of a Phase 2 clinical study by Radius.

 

Deliverables:

·               Delivery of up to 3 distinct GMP clinical doses of BA058 sMTS product plus 1 placebo dose for a Phase II clinical study and supporting stability work.  This includes a maximum of 54,600 patches (detail for quantities is shown below.) and 300 POC applicators.  Any additional patches or applicators required to support the clinical trial, stability program and the requirement for clinical retains (as per 3M’s SOP for a non-bioequivalence clinical study) will be provided under a Change Order at Radius request and expense.

 

Planned usage

 

Active patches

 

Placebo patches

clinical study supplies

 

[*]

 

[*]

Release testing

 

[*]

 

[*]

Retains

 

[*]

 

[*]

Stability

 

[*]

 

0

3M SOP retains

 

[*]

 

 

Total quantity

 

14,200

 

12,000

 

·               Crossed over and validated analytical methods to monitor the manufacturing process, the release activities and the stability program

·               Stability data for each of the three active product lots through 2 years, as described below.

·               A stability program for the RTC formulation for up to 6 months as defined in this Workplan

·               3M shall establish and maintain proprietary Drug Master Files (DMFs) including information on the components, coating and drying manufacturing processes to support regulatory filings in the U.S. and Canada.  A right of reference to 3M’s DMFs will be granted to Radius to support regulatory filings in the U.S. and Canada.  Outside the U.S., 3M will provide Radius with information necessary to support regulatory filing in all countries where Clinical Development of BA058-sMTS is sited.

 

This estimate does not include the time associated with execution of the Phase II clinical studies nor completion of support stability.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

2



 

Milestones for the Workplan:

All dates assume Amendment signed by March 2, 2011.  Should the Amendment be signed at a later date, then the target dates for milestones need to be adjusted accordingly.

 

1.              Start preliminary RTC optimization — March 2, 2011

2.              March API requirements delivered by Radius to 3M — March 2, 2011

3.              Methods provided to 3M for crossover — March 4, 2011

4.              April API requirements delivered by Radius to 3M — April 1, 2011

5.              May API requirements delivered by Radius to 3M — May 1, 2011

6.              Initiation of coating optimization — May 1, 2011

7.              RTC optimization concludes — June 30, 2011

8.              July API requirements delivered by Radius to 3M — July 1, 2011

9.              Manufacture additional Phase I clinical supplies (150mcg/array) — by October 1, 2011

10.           Equipment installation — September 1, 2011

11.           Initiation of final optimization of coating and process verification — December 29, 2011

12.           Completion of coating process verification — January 31, 2012

13.           Release phase II supplies — by April 15, 2012

 

3M assumptions of the work plan :

·               Validated analytical methods exist and can be crossed over to 3M from Radius — if method development is required, a Change Order will be required at Radius expense

·               No more than 10 analytical methods need to be crossed over

·               Adequate GMP BA058 starting material will be provided free of charge to 3M for development and clinical supply manufacture by Radius for phase II clinical supplies.

·               Work plan assumes the use of the POC MTS applicator system and patch design in Phase 2.

·               Lot size is not to exceed the quantities listed above of GMP-grade BA058 sMTS arrays to best meet the needs of the Phase 2 study and stability program plans.

·               An additional three hundred units per dose will be manufactured for retains in accordance with 3M’s SOPs.  Any additional supplies beyond what is shown in the above table can be provided under a Change Order at Radius’ expense.

·               Phase II product will be manufactured as low bioburden compatible with the process for Phase 3.

·               sMTS patches and applicators for use in the Phase II clinical study will be bulk labeled by 3M and provided to Radius for further labeling according to the requirements of the clinical protocol.

·               Radius will be responsible for executing all elements (protocols, regulatory filings, conduct) of the Phase II trial.

·               The clinical trial will be conducted in countries to be identified by Radius.

·               Wear time associated with the array is 24 hours or less.

·               Stability studies on the product in support of Phase II will be a maximum of 2 years in length; the stability report will be completed within 4 months of the completion of the stability study.

 

3


 

·                                           DMFs for BA058-sMTS CCS and Coating and Drying Process will be filed at least 3 month prior to Phase 2 initiation.

 

Radius assumptions of the work plan :

·                                           The work plan will cover the currently planned activities related to the manufacturing and support of all Phase 2 transdermal clinical trial supplies.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

·                                           This work plan also covers the currently planned CMC/Quality activities required for support of the Phase 2 program for BA058-sMTS, including the 2-year ICH stability program.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

·                                           This work plan also covers the currently planned Regulatory activities required for support of the Phase 2 program for BA058-sMTS in the regions and countries selected for the study.  If additional activities are deemed necessary, such activities will be provided under a Change Order with budget and timelines agreed.

·                                           Patches will be supplied in quantities indicated in the above table to support the clinical trial, clinical retains and the stability program.  Any additional quantities required can be provided on a Change Order.

·                                           Phase 2 supplies will be manufactured with a low bioburden and will be compatible with the manufacturing process planned for Phase 3.

·                                           Phase 2 supplies will be manufactured with residual solvents consistent with USP 467 and its European equivalent, extractables,

·                                           Each major work plan task identified below will be associated with a protocol (either existing or to be written under a Change Order) and report, both to be reviewed and agreed with Radius.  Such reports may be redacted to protect 3M proprietary information

·                                           All manufacturing activities will be compliant with:

ICH Q1A(R2):  Stability Testing of New Drug Substances and Products 3M level 2 validation of analytical procedures.  3M will provide data supporting chemistry, manufacturing and control information necessary for regulatory filings with authorities in and outside the United States

 

WORKMAN SUMMARY OF TASKS:
BA058-sMTS Drug Product Development and
Manufacturing Process Scale-up including Phase 2 Supply Production

 

3M Environmental Health and Safety

Update Hazard Review

Update Risk Assessment (internal)

Update Animal Use Protocols

Qualification of Suppliers

 

4



 

3M Product Development

Terminal sterilization study

RM Receipt and Part Manufacture

RTC Optimization/Characterization

Formulation Optimization/Characterization

Process Optimization (including drying)

Packaging Optimization

[stability program is defined elsewhere]

Supply Production for additional Bridging Tox, if required (additional charge)

 

3M Product Scale-up to Phase 2

RM Receipt and Part Manufacture

System Integration

Product Development/Optimization:  RTC Optimization, Process Optimization

Process/Product Verifications

 

3M Support for Execution of Phase 2 Supply Manufacture

Validate Analytical Methods required for the manufacturing process, release and stability programs associated with the Phase 2 clinical trial supplies

Development and Verification of Specifications for Phase 2

Development and Verification of Shipping and Storage Requirements

Update Regulatory Documentation:  Provide up-to-date Drug Product CMC data to support updated IND, File Product Specific DMFs (sMTS-BA058 CCS and sMTS-BA058 Coating and Drying Process)

 

3M Phase 2 Supply Manufacture and Stability

RM Receipt and Part Manufacture

RM and Component Clearance

RTC Formulation Manufacture and Clearance

Execute Clinical Tickets:  Applicator Construction, estimated 300 units; three active doses at a maximum as indicated in the table above.

Stability of RTC at 5C/ambient RH — 1, 3, 6 months

Stability of RTC at 25C/60% RH — 2 days, 1 week

Stability of Phase 2 Supplies:  5C/ambient RH — 1, 3, 6, 9, 12, months; 25C/60% RH - 1, 3, 6, 9, 12, months; 40C/75% RH — 1, 3, 6 months

Clear, release and ship Clinical Supplies

 

Radius Clinical Supplies Manufacturing Tasks

Provide GMP-grade, BA058 API, ready for formulating

Receive, label and release Phase II clinical supplies

Author Investigators Brochure and IND submission

Write clinical protocol, define safety and efficacy endpoints

 

5



 

Execute or oversee the Phase II clinical study

 

6



 

3M DRUG DELIVERY SYSTEMS CONTACT INFORMATION

 

For inquiries related to the proposal, please contact:

 

Mary Mathisen
Product Commercialization Manager
3M Drug Delivery Systems
3M Center, Bldg. 260-4N-12
St. Paul, MN 55144
Tel:  651-733-9125
Fax:  651-5751729
Cell:  651-503 0861
E-Mail:

 

Mark Tomai Ph.D.
Head of Vaccine Business
3M Drug Delivery Systems
3M Center, Bldg. 275-3E-10
St. Paul, MN 55144
Tel:  651-733-5375
Cell:  651-403-0455
E-Mail:

 

7


 

 

Addendum to Change Order Form # 8

 

Change order under Agreement dated:   the Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated March 2, 2011 (the “Agreement”).

 

Between:   Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by:   Radius

Name:   Maria Grunwald and Gary Hattersley

Company:   3M

Date:   20 July 2011, Addendum 12 August 2011

Description of change:

 

As per Change Order #8, Radius has requested 3M manufacture 420 patches for an additional clinical study Radius wishes to conduct. An additional 12 patches are required per the addendum for visual inspection at time of release.  The product strength is [*]mcg/array.

 

Planned Usage

 

Number of Patches

Clinical study supplies

 

[*]

Release testing

 

[*] + 12 (visual inspection)

Retains

 

[*]

Stability

 

[*]

Customer retains

 

0

Total Quantity

 

420 + 12 = 432

 

The addendum to change order 8 is estimated to add 58 additional hours including, but not limited to visual examination of returned arrays and residual drug content analysis on [*] arrays.

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 


* Confidential Treatment Requested by the Registrant.  Redacted Portion Filed Separately with the Commission.

 

1



 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Mary Mathisen

Signature:

/s/Nick Harvey

 

Signature:

/ Mary Mathisen

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): August 12, 2011

 

Date (dd/mm/yy): 16 August 2011

 

2


 

 

Change Order Form # 9

 

Change order under Agreement dated:   The Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated March 2, 2011 (the “Agreement”).

 

Between:   Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by:   3M

 

Name:   Tom Fenn

Company:   3M

Date:   22 July 2011

Description of change:   Change Order to conduct initial manufacturing experiments for new strength, [*]mcg/array.

 

Radius is requesting 3M manufacture a new lower strength [*] mcg/array.  3M has not coated this strength before and proposes the following series of experiments:

 

Exp #1 - First screening of formulations and well depths on ATS in existing wells - total of 6.5 days

Exp #2 - Second screening of formulations and well depths on ATS in existing wells - total of 6.5 days

Exp #3 - Verification of well depth and wt% BA058 - total of 6.25 days

 

Efforts include drafting and approval of protocols, preparation of RTC and arrays, GMP experimentation, HPLC analysis and visual examination of coated arrays.

 

We estimate this work will be conducted over a 4 week period and require approximately 300 hours.

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 

Requested task, dates and costs are approved by:

Company: Radius Health, Inc

Company: 3M

Name: Nick Harvey

Name: Mary Mathisen

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Mary Mathisen

Position: CFO

Position: Commercialization Mgr

 


* Confidential Treatment Requested by the Registrant.  Redacted Potion Filed Separately with the Commission.

 



 

Date (dd/mm/yy): August 10, 2011

Date (dd/mm/yy): 12 August 2011

 


 

Change Order Form # 10

 

Change order under Agreement dated:  The Development and Clinical Supplies Agreement dated June 19, 2009, as amended by the Amendment dated as of December 31, 2009, the Second Amendment dated as of September 16, 2010, the Third Amendment dated as of September 29, 2010 and the Fourth Amendment dated March 2, 2011 (the “Agreement”).  Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011

 

Between:   Radius Health, Inc and 3M

 

Project Name:   For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by:   Radius

Name:   Gary Hattersley

Company:   3M is providing this proposal for a formal stability bracketing study

Date:   28 September 2011

Description of change:   Change Order to conduct a formal stability study bracketing study on approximately [*]% peptide by weight coated on [*] mcg/array and [*] mcg/array in Phase II packaging with/without desiccant.

 

Radius is requesting 3M manufacture [*]mcg and [*]mcg/array strengths and place on formal stability.  The [*] and [*]mcg/array strength will be packaged with desiccant; in a 3 rd  arm of the study, [*]mcg/array samples will be packaged without desiccant.  Attached is proposed stability study.

 

Drug Product Testing

 

Condition

 

Tests

 

Time points

NA

 

Content, Purity, Total Moisture, Depth of Coating, in vivo release

 

Initial

 

 

 

 

 

25C

 

Content, Purity, Aggregation

 

1,2,3,6 months

25C

 

Total Moisture

 

3, 6 months

5C

 

Content, Purity, Aggregation

 

1, 3, 6, 9, 12 months

5C

 

Total Moisture

 

3, 6, 12 months

 

Ready-to-Coat Testing

 

Condition

 

Tests

 

Time points

NA

 

Content, Purity, Viscosity

 

Initial

25C

 

Content, Purity

 

12 hours, 24 hours, 2 days, 3 days

25C

 

Viscosity

 

12 hours, 2 days

5C

 

Content, Purity, Viscosity

 

1 month, 2 months, 3 months

 


* Confidential Treatment Requested by the Registrant.  Redact Portion Filed Separately with the Commission.

 



 

3M estimates this work will be conducted over a 2-3 week period and require approximately 270 hours.  The stability costs for the RTC will be $[*]per pull point.  The stability costs for the arrays will be $[*]per pull point.  7.1 grams of BA-058 will be needed.

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect.  The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

Company: 3M

Name: Nick Harvey

Name: Mary Mathisen

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Mary Mathisen

Position: CFO

Position: Commercialization Mgr

Date (dd/mm/yy): 29/9/11

Date (dd/mm/yy): 3 October 2011

 


 

STRICTLY CONFIDENTIAL

 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240.24b-2

 

Change Order Form # 12

 

Change order under Agreement dated: Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius

Name: Mark Tomai

Company:  3M

Date:  03 Feb 2012

Description of change:

 

Radius has requested further development of a ready-to-coat formulation for preparation of sMTS supplies with increased stability compared to the current formulation.

 

OBJECTIVE

 

Optimize a new formulation for sMTS-BA058 to target a scalable formulation with a final configuration that provides 2 years stability under refrigerated conditions and 3 month stability at [*] C.

 

BACKGROUND

 

Initial experiments in using excipients to stabilize the sMTS-BA058 drug product show that certain excipients can dramatically increase the stability of the drug product.  These changes need to be investigated and evaluated with container-closure system (CCS) options.

 

PROCEDURE

 

1.               A composition and coatability study designed as a factorial experiment examining the effect of API concentration and different excipients.

 

2.               A drying study to determine the effect of a drying step on the performance of the trial formulations will be completed.  The study will be started concurrently with Step 1, as coated arrays are prepared.

 

3.               A study evaluating the potential for terminal sterilization of trial formulations will be completed.  Generally, the FDA requires proof that terminal sterilization is not feasible prior to giving approval of a product prepared by aseptic techniques.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

Therefore, this study needs to be completed to support strategic planning for development of the commercial product.

 

DELIVERABLES

 

·                   Formulations designed for improved stability.

 

·                   Development report describing viability of terminal sterilization for sMTS-BA058.

 

TIMING

 

The required effort in hours, duration of the study in months, and expected end dates (assuming a 01 Mar 2012 start date) for the major tasks covered by this work plan are summarized in the table below.

 

Task

 

Estimated
Effort
(hours)

 

Estimated
Duration
(months)

 

End Date

Composition and Coatability

 

[*]

 

3

 

20 May 2012

Terminal Sterilization Evaluation

 

[*]

 

2

 

27 May 2012

Drying Study

 

[*]

 

4

 

20 Jul 2012

 

Total elapsed time estimated: 4 months

Total hours estimated: [*] hours

Total direct costs: ~ $40,000

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: B. N. Harvey

 

Name: Mark Tomai

 

 

 

Signature:

/s/ B.N. Harvey

 

Signature:

/s/ Mark Tomai

Position: CFO

 

Position: Head of MTS Business Development

 

 

 

Date (dd/mm/yy): 23/02/12

 

Date (dd/mm/yy): 23/02/12

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2


 

STRICTLY CONFIDENTIAL

 

Confidential Treatment Requested

 

Under 17 C.F.R. §§ 200.80(b)(4) and

 

240.24b-2

 

 

Change Order Form # 13

 

Change order under Agreement dated: Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius

Name: Mark Tomai

Company:  3M

Date:  12Apr2012

Description of change:

 

Radius has requested further development of a ready-to-coat formulation for preparation of sMTS supplies with increased stability.

 

OBJECTIVE

Test stability of new formulations for sMTS-BA058 to target a scalable formulation with a final configuration that provides long-term stability under refrigerated conditions and supports short-term exposure at [*]C.  Prepare associated documentation to support clinical use of the new formulation.

 

BACKGROUND

A composition and coatability study is described in Change Order 12.  This Change Order describes the work needed to assess the stability of the formulation options developed in Change Order 12, and the effect of container-closure system (CCS) options.

 

PROCEDURE

1.               A stability study examining the effect of packaging.  The study uses the arrays coated under Change Order 12, and will be started concurrently with Change Order 12 as coated arrays are prepared.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

1



 

DELIVERABLES

 

·                   Stability Testing:

·                   [*]°C/ambient

·                   [*], [*], and [*] months for up to [*] formulations

·                   [*], [*], [*], [*], and [*] months for up to [*] formulations

·                   [*]°C/[*]%RH

·                   [*], [*], and [*] months for up to [*] formulations

·                   [*], [*], [*], [*], and [*] months for up to [*] formulations

·                   Formulation Screening Testing:

·                   [*]°C/[*]%RH at [*], [*], and [*] months for up to [*] formulations

 

·                   Tests to include:

·                   Content and purity at all time points

·                   Moisture and either dissolution or in-vivo release at initial time point and at [*] months, only

 

·                   Development report on effect of packaging options and final drying process, if any.

 

·                   Development report supporting performance and characterization of selected formulation.

 

TIMING

 

The required effort in hours, duration of the study in months, and expected end dates for the study covered by this work plan are summarized in the table below.

 

Task

 

Estimated
Effort
(hours)

 

Estimated
Duration
(months)

 

End Date

 

Stability Study

 

[*]

 

24

 

May 2014

 

 

Total elapsed time estimated: 2 years

Total hours estimated: [*] hours

Total direct costs: ~ $3,000

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 

2



 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name:  Nick Harvey

 

Name: Mark Tomai

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Mark Tomai

Position: CFO

 

Position: Head of MTS Business Development

Date (dd/mm/yy): 30/04/12

 

Date (dd/mm/yy): 01/05/12

 

3


 

Confidential Treatment Requested

Under 17 C.F.R. §§ 200.80(b)(4) and 230.406

 

 

Change Order Form # 14

 

Change order under Agreement dated: Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius Health, Inc.

Name: Michele Gehrt

Company:  3M

Date:  20Jul2012

Description of change: Radius has requested the addition of work to perform residual drug analysis and microscopic evaluation of BA058-sMTS patches and arrays (placebo, 50, 100, and 150 mcg/array) following use in the Phase II Clinical Study.

 

SCOPE:

[*] patches will be returned to 3M for residual drug analysis and microscopic evaluation.  The 11 clinical sites will collect the patches and ship them to 3M on a monthly basis.  The patches will be labeled with patient number, sample date, visit number and kit number.  The patches will be stored (at the clinical sites, 3M and PACE) and shipped at [*]°C.  Upon receipt at 3M, the samples will be segregated according to visit number. Patches that are dislodged from the collar during shipping will not be tested.  The analyses will be done at the end of the clinical study at which time Radius will instruct 3M to select certain patches by patient number.

 

Residual drug analysis will be done using 3M Method-07-001836.

 

Microscopic analysis will be done using a [*]x magnification and looking for microneedle fracture, breakage, chipping, deformation, or other damage.  Results for each array will be recorded on the attached observations sheet (Attachment 1) and observation summary sheet (Attachment 2).  Digital photos will be recorded.  An example image is included as Attachment 3.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

The following table summarizes the patches to be analyzed.

 

Description

 

Number of Patches

 

Used patches for Microscopic Analysis

·       [*] patches per dose

·       4 doses:  placebo, 50 mcg, 100 mcg, 150 mcg

·       Patches collected at Day [*]

 

 

 

[*]

 

Un-used patches for Microscopic Analysis

·       [*] patches per dose

·       2 doses:  placebo, 150 mcg

·       Patches collected at end of study (Day 180)

 

 

 

[*]

 

Used patches for Residual Drug Analysis

·       [*] patches per dose per timepoint

·       4 doses:  placebo, 50 mcg, 100 mcg, 150 mcg

·       Patches collected at Day [*], Day [*], Day [*]

 

 

 

[*]

 

 

DELIVERABLES:

·                   Summary report describing residual BA058 content of arrays

·                   Summary report describing the type and frequency of visual observations.

 

TIMING:

 

The estimated effort in hours is summarized in the table below.

 

Task

 

Estimated Effort (hours)

Preparation, review and approval of testing protocols and reports

 

[*]

Collection and organization of samples

 

[*]

Residual drug analysis and microscopic analysis

 

[*]

Total additional hours

 

[*]

 

Total estimated hours:   [*]

Estimated completion date:  August 2013 (60 days after end of clinical study)

Total estimated direct costs:  $5,000 (analytical supplies and storage costs at PACE)

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Michele Gehrt

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Michele Gehrt

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 15/08/2012

 

Date (dd/mm/yy):15/08/2012

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ATTACHMENT 1 — OBSERVATIONS

 

Sample ID:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Describe appearance of patch:

 

Enter code for damaged array on to chart.

 

Codes: R — break, C — chip, K — crack, D — bend, L — blunt, F — partial fill

 

Add sequence number for digital image.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

ATTACHMENT 2 — SUMMARY OBSERVATIONS

 

Sample ID

 

Microneedle fracture
(breaks, cracks, and
chips)

 

Deformation of
the needle
(bends and/or
blunting)

 

Comments

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

 

 

Breaks

 

Cracks

 

Chips

 

Bends

 

Blunting

 

 

 

ATTACHMENT 3 — EXAMPLE IMAGE

 

[*]

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Confidential Treatment Requested

 

Under 17 C.F.R. §§ 200.80(b)(4) and 230.406

 

 

Change Order Form # 15

 

Change order under Agreement dated: Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius Health, Inc.

Name: Michele Gehrt

Company:  3M

Date:  16July2012

Description of change: Radius has requested the addition of work to perform qualification testing of (3) lots of Phosphate Buffer Solution (from Amresco) per the findings of the QP audit.

 

SCOPE:

Three (3) different lots of Phosphate Buffer Solution (PBS) are to be sourced from Amresco and qualification testing to be performed.  The testing will include appearance (color, clarity, odor), pH and sterility and will be performed by Nelson Labs. Two (2) lots are available immediately and the testing of these two lots will be initiated upon receipt at Nelson labs.  The third lot will not be available for approximately 6-8 weeks dependent upon the depletion of inventory at the supplier.  This lot will be tested as soon as available.

 

DELIVERABLES:

·                   Test results for appearance, pH and sterility

 

TIMING:

The estimated effort in hours and costs are summarized in the table below.

 

Task

 

Estimated Effort
(hours)

 

Estimated Cost
(dollars)

 

3M Coordination of testing (ordering, shipping, reporting)

 

[*]

 

[*]

 

PBS

 

[*]

 

[*]

 

Nelson Labs: appearance, pH and sterility analysis

 

[*]

 

[*]

 

Total additional hours/cost

 

[*]

 

$

2,150

 

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Estimated completion date (4 weeks after receipt of PBS):  August 2012 for two (2) lots; October 2012 for the third lot (depending on availability from Amresco).

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Michele Gehrt

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Michele Gehrt

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 16/07/2012

 

Date (dd/mm/yy): 16/07/2012

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Change Order Form # 19

 

Change order under Agreement dated: Fourth Amendment to Development and Clinical Supplies Agreement dated March 2, 2011. Change Order #10 dated 03Oct2011.

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s BA-058 compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius

Name: Michele Gehrt

Company:  3M

Date:  03Oct2012

 

Description of change: Radius has requested additional testing for the bracketing stability study beyond that described in Change Order #10.   The bracketing stability study includes drug product containing 50 and 150 mcg BA058 per array.  The drug product was packaged with and without desiccant.

 

There are sufficient supplies in the stability chambers to allow six additional stability time points.  Attached is a proposed extension to the bracketing stability study.  Testing will only be performed on the supplies packaged in desiccant.

 

Drug Product Testing

 

Condition

 

Tests

 

Time points

5C

 

Content and Purity

 

11, 13, 14, 15, 18, 24 months

 

3M estimates this work (each pull point) will be conducted over a 2-3 week period.  The stability costs for the arrays will be $ [*] per pull point per lot.

 

Except to the extent expressly amended by this Change Order, the terms and conditions of the Agreement remain in full force and effect. The term “Agreement”, as used in the Agreement, shall henceforth be deemed to be a reference to the Agreement as amended by this Change Order.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Nick Harvey

 

Name: Michele Gehrt

Signature:

/s/ Nick Harvey

 

Signature:

/s/ Michele Gehrt

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 07/12/2012

 

Date (dd/mm/yy):10/12/2012

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Change Order Form # 21

 

Change order under Agreement dated: Fifth Amendment to Development and Clinical Supplies Agreement dated December 14, 2012

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’s Abaloparatide compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius

Name: Michele Gehrt

Company:  3M

Date:  26Feb2014

 

Description of change:

 

Radius has requested that 3M redevelop the Abaloparatide sMTS product to achieve a PK profile comparable to Abaloparatide-SC, as evaluated in [*].

 

OBJECTIVE

 

Redevelop the Abaloparatide product to achieve a PK profile comparable to SC injection. Redevelopment may include changes in [*], [*] or [*].  Prepare iterations of the optimized product for evaluation in [*] studies.

 

BACKGROUND

 

Results of the Phase II study showed lower than expected efficacy of the sMTS product when compared with the SC product.  Radius would like to determine if improved efficacy can be achieved with the sMTS product by changing the product to more closely match the PK profile of Abaloparatide achieved with SC injection.

 

PROCEDURE

 

3M anticipates working through several product iterations in an effort to achieve a more efficacious PK profile for Abaloparatide sMTS.  Planned iterations may include an evaluation of various [*] or [*], [*] and/or [*], and [*], all targeting [*] (relative to Phase II) [*] of BA058 over a [*] period of time.  In developing product iterations, 3M would expect to evaluate potential product configurations via [*],

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

[*] and [*]([*]).  3M would anticipate producing and packaging supplies to support approximately [*] rounds of in-vivo [*] studies (to be executed by Radius at a CRO). After the first [*] study, the use of [*] as an animal model would be reevaluated for its applicability.  If no correlation is seen between the [*] and [*] studies then this change order would be updated to reduce the use of the [*] model in subsequent iterations. These studies may be supported by minimal stability valuations to verify the integrity of the study. Upon agreement by the JTT, each round of [*] studies may contain up to ([*]) [*] product configurations.  Supplies for [*] studies would be produced as for past preclinical studies ([*], [*]) and shipped to the facility of Radius’ designation.  Stability for promising configurations would be characterized only grossly.  More complete stability characterization is anticipated in the next stage of work, once a promising product configuration has been identified via this evaluation.

 

3M anticipates detailed technical discussions of product development efforts with Radius throughout development and informed by the [*] PK studies carried out during this development period.  These PK data will be used along with data collected by 3M to help determine favorable product development plans.

 

DELIVERABLES

 

·                   Several product iterations characterized by 3M as described above, targeting the necessary PK profile identified by Radius as likely to enhance efficacy.

·                   Samples (approx [*] patch assemblies) for promising configurations agreed to by the JTT for further evaluation by Radius in [*].  It is estimated that [*] studies may be needed during this evaluation period.

·                   Gross stability evaluations for promising patch assembly configurations.

 

TIMING

 

The required effort in hours, duration of the study in months, and expected end dates for the study covered by this work plan are summarized in the table below.

 

Task

 

Estimated
Effort
(hours)

 

Estimated
Duration
(months)

 

Estimated
Direct Costs
($)

 

Estimated End
Date*

 

Reformulation Tasks; Assessment of Release in [*]; Preparation of Samples for PK Evaluation in [*]

 

2626

 

4

 

$

3,657

 

31Jul2014

 

 


*timing depends on duration of [*] studies

 

Total Estimated Costs:  $568,247

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: Robert Ward

 

Name: Michele Gehrt

Signature:

/s/ Robert Ward

 

Signature:

/s/ Michele Gehrt

Position: CEO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 18/03/14

 

Date (dd/mm/yy): 19/03/2014

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 


 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

Change Order Form # 22

 

Change order under Agreement dated: Fifth Amendment to Development and Clinical Supplies Agreement dated December 14, 2012

 

Between :  Radius Health, Inc and 3M

 

Project Name: For the development of Radius’ Abaloparatide compound delivered via 3M’s Microstructured Transdermal Delivery System

 

Change requested by: Radius

Name: Michele Gehrt

Company:  3M

Date:  21Jan2015

 

Description of change:

 

Radius has requested that 3M continue to progress the redevelopment of the Abaloparatide sMTS product to achieve a PK profile comparable to Abaloparatide-SC, as evaluated in non-human [*].  This change order will progress the work completed in Change Order #21.

 

Scope:

 

3M to continue to redevelop the Abaloparatide product to achieve a PK profile comparable to SC injection. Redevelopment may include changes in [*], [*] or [*].  3M to prepare up to [*] product configurations for evaluation in non-human [*] studies.

 

Assumptions:

 

·                   3M will progress several product configurations that will build on the knowledge from previous work.

·                   3M will evaluate potential product configurations via [*], [*] and  [*] ([*])

·                   The JTT will meet to review and agree upon the product configurations to be taken into each [*] study.

·                   Supplies for [*] studies would be produced as for past preclinical studies ([*], [*]) and shipped to the facility of Radius’ designation.

·                   Stability for promising configurations would be characterized only grossly

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 



 

Confidential Treatment Requested Under 17 C.F.R. §§ 200.80(b)(4) and 240-24b-2

 

DELIVERABLES

 

·                   Samples (approx [*] patch assemblies) for promising configurations agreed to by the JTT for further evaluation by Radius in [*].  It is estimated that up to [*] product configurations would be provided for [*] studies during this evaluation period.

·                   Gross stability evaluations for promising patch assembly configurations (limited testing at up to [*] time points for [*] storage condition).

 

TIMING

 

The required effort in hours, duration of the study in months, and expected end dates for the study covered by this work plan are summarized in the table below.

 

Task

 

Estimated
Effort
(hours)

 

Estimated
Duration
(months)

 

Estimated
Direct Costs
($)

 

Estimated End
Date*

 

Reformulation Tasks; Assessment of Release in [*]; Preparation of Samples for PK Evaluation in [*]

 

910

 

2

 

$

2,500

 

31Mar2015

 

 


*timing depends on duration and scheduling of [*] studies

 

Total Estimated Costs:  $ 198,150

 

In all other respects, the terms and conditions of the Agreement remain in full force and effect.

 

Requested task, dates and costs are approved by:

 

Company: Radius Health, Inc

 

Company: 3M

Name: B.N. Harvey

 

Name: Michele Gehrt

Signature:

/s/ B.N. Harvey

 

Signature:

/s/ Michele Gehrt

Position: CFO

 

Position: Commercialization Mgr

Date (dd/mm/yy): 3/2/15

 

Date (dd/mm/yy): 03/02/15

 


[*] Certain information in this document has been omitted and filed separately with the Securities and Exchange Commission. Confidential treatment has been requested with respect to the omitted portions.

 




Exhibit 10.20

 

NUVIOS, INC.

2003 LONG-TERM INCENTIVE PLAN

(As Amended)

 

1.             Definitions . In this Plan, except where the context otherwise indicates, the following definitions shall apply:

 

1.1.         “Affiliate” means a corporation, partnership, business trust, limited liability company or other form of business organization at least a majority of the total combined voting power of all classes of stock or other equity interests of which is owned by the Company, either directly or indirectly, and any other entity designated by the Committee in which the Company has a significant interest.

 

1.2.         “Agreement” means a written agreement or other document evidencing an Award that shall be in such form as maybe specified by the Committee and that may, but need not, be signed by a Participant, as determined by the Committee in its discretion.

 

1.3.         “Award” means a grant of an Option, Right, Restricted Stock, Incentive Shares or Performance Award.

 

1.4.         “Board” means the Board of Directors of the Company.

 

1.5.         “Code” means the Internal Revenue Code of 1986, as amended.

 

1.6.         “Committee” means the Compensation Committee of the Board or such other committee(s), subcommittee(s) or person(s) appointed by the Board to administer this Plan or to make and/or administer specific Awards hereunder. If no such appointment is in effect at any time, “Committee” shall mean the Board.

 

1.7.         “Common Stock” means the common stock, par value $0.01 per share, of the Company.

 

1.8.         “Company” means NuVios, Inc., a Delaware corporation, and any successor thereto.

 

1.9.         “Date of Exercise” means the date on which the Company receives notice of the exercise of an Option or Right in accordance with the terms of Section 8.1 hereof.

 

1.10.        “Date of Grant” means the date on which an Award is granted under this Plan.

 

1.11.       “Eligible Person” means any person who is (a) an Employee (b) hired to be an Employee, (c) a Non-Employee Director, or (d) a consultant or independent contractor to the Company or an Affiliate.

 



 

1.12.        “Employee” means any person determined by the Committee to be an employee of the Company or an Affiliate.

 

1.13.        “Exercise Price” means the price per Share at which an Option may be exercised.

 

1.14.        “Fair Market Value” means, (i) if the Common Stock is traded on a securities exchange or automated dealer quotation system, at the Committee’s election, either (A) the last sale price for a share, as of the relevant date, on such securities exchange or automated dealer quotation system as reported by such source as the Committee may select, or (B) the average of the closing prices of the Common Stock on such exchange or quotation system for the ten (10) trading days immediately preceding the relevant date, or (ii) if the Common Stock is not traded on a securities exchange or automated dealer quotation system, an amount equal to the then fair market value of a Share as determined by the Committee pursuant to a reasonable method adopted in good faith for such purpose.

 

1.15 .        “Incentive Shares” means an award providing for the contingent grant of Shares pursuant to the provisions of Section 10 hereof.

 

1.16.        “Incentive Stock Option” means an Option granted under this Plan that the Company designates as an incentive stock option under Section 422 of the Code.

 

1.17.        “Non-Employee Director” means any member of the Company’s or an Affiliate’s Board of Directors who is not an Employee.

 

1.18.        “Nonstatutory Stock Option” means an Option granted under this Plan that is not an Incentive Stock Option.

 

1.19.        “Option” means an option to purchase Shares granted under this Plan in accordance with the terms of Section 6 hereof.

 

1.20.        “Option Period” means the period during which an Option may be exercised.

 

1.21.        “Participant” means an Eligible Person who has been granted an Award hereunder.

 

1.22.        “Performance Award” means a performance award granted under the Plan in accordance with the terms of Section Ii hereof.

 

1.23.        “Plan” means the NuVios, Inc. 2003 Long-Term Incentive Plan, as amended from time to time.

 

1.24.        “Related Option” means an Option in connection with which, or by amendment to which, a Right is granted.

 



 

1.25.        “Related Right” means a Right granted in connection with, or by amendment to, an Option.

 

1.26.        “Restricted Stock” means Shares granted under the Plan pursuant to the provisions of Section 9 hereof.

 

1.27.        “Right” means a stock appreciation right granted under the Plan in accordance with the terms of Section 7 hereof.

 

1.28.        “Right Period” means the period during which a Right may be exercised.

 

1.29.        “Section 422 Employee” means an Employee who is employed by the Company or a “parent corporation” or “subsidiary corporation” (both as defined in Sections 424(e) and (1) of the Code) with respect to the Comp any.

 

1.30.        “Share” means a share of Common Stock.

 

1.31.        “Ten-Percent Stockholder” means a Section 422 Employee who (applying the rules of Section 424(d) of the Code) owns stock possessing more than ten percent (10%) of the total combined voting power of all classes of stock of the Company or a “parent corporation” or “subsidiary corporation” (both as defined in Sections 424(e) and (1) of the Code) with respect to the Company.

 

2.             Purpose . This Plan is intended to assist the Company and its Affiliates in attracting and retaining Eligible Persons of outstanding ability and to promote the identification of their interests with those of the stockholders of the Company and its Affiliates.

 

3.             Administration . The Committee shall administer this Plan and shall have plenary authority, in its discretion, to grant Awards to Eligible Persons, subject to the provisions of this Plan. The Committee shall have plenary authority and discretion, subject to the provisions of this Plan, to determine the Eligible Persons to whom Awards shall be granted, the terms (which terms need not be identical) of all Awards, including without limitation the Exercise Price of Options, the time or times at which Awards are granted, the number of Shares covered by Awards, whether an Option shall be an Incentive Stock Option or a Nonstatutory Stock Option, any exceptions to nontransferability, any provisions relating to vesting, and the period during which Options and Rights may be exercised and Restricted Stock shall be subject to restrictions. In making these determinations, the Committee may take into account the nature of the services rendered or to be rendered by Award recipients, their present and potential contributions to the success of the Company and its Affiliates, and such other factors as the Committee in its discretion shall deem relevant. Subject to the provisions of the Plan, the Committee shall have plenary authority to interpret the Plan and Agreements, prescribe, amend and rescind rules and regulations relating to them, and make all other determinations deemed necessary or advisable for the administration of this Plan and

 



 

Awards granted hereunder. The determinations of the Committee on the matters referred to in this Section 3 hereof shall be binding and final.

 

4.             Eligibility . Awards may be granted only to Eligible Persons.

 

5 .             Stock Subject to Plan .

 

5.1 .          Subject to adjustment as provided in Section 13 hereof, (a) the maximum number of Shares that may be issued under this Plan is 30,235,000 Shares.

 

5.2 .          If an Option or Right expires or terminates for any reason (other than termination by virtue of the exercise of a Related Option or Related Right, as the case may be) without having been fully exercised, if shares of Restricted Stock are forfeited, or if Shares covered by an Incentive Share Award or Performance Award are not issued or are forfeited, the unissued or forfeited Shares that had been subject to the Award shall be available for the grant of additional Awards.

 

5.3.          Upon exercise of a Right (regardless of whether the Right is settled in cash or Shares), the number of Shares with respect to which the Right is exercised shall be charged against the number of Shares issuable under the Plan and shall not become available for the grant of other Awards.

 

6.             Options .

 

6.1.          Options granted under this Plan to Eligible Persons shall be either Incentive Stock Options or Nonstatutory Stock Options, as designated by the Committee; provided, however, that Incentive Stock Options may only be granted to Eligible Persons who are Section 422 Employees on the Date of Grant. Each Option granted under this Plan shall be identified either as a Nonstatutory Stock Option or an Incentive Stock Option and shall be evidenced by an Agreement that specifies the terms and conditions of the Option. Options shall be subject to the terms and conditions set forth in this Section 6 hereof and such other terms and conditions not inconsistent with this Plan as the Committee may specify.

 

6.2.          The Exercise Price of an Incentive Stock Option granted under this Plan shall not be less than one hundred percent (100%) of the Fair Market Value of the Common Stock on the Date of Grant. Notwithstanding the foregoing, in the case of an Incentive Stock Option granted to an Employee who, on the Date of Grant is a Ten-Percent Shareholder, the Exercise Price shall not be less than one hundred and ten percent (110%) of the Fair Market Value of a share on the Date of Grant.

 

6.3.          The Option Period shall be determined by the Committee and specifically set forth in the Agreement; provided, however, that an Option shall not be exercisable after ten (10) years (five (5) years in the case of an Incentive Stock Option granted to a Ten-Percent Stockholder) from its Date of Grant.

 



 

7.             Rights .

 

7.1.          Rights granted under the Plan shall be evidenced by an Agreement specifying the terms and conditions of the Award.

 

7.2.          A Right may be granted under the Plan:

 

(a)    in connection with, and at the same time as, the grant of an Option under the Plan;

 

(b)    by amendment of an outstanding Option granted under the Plan; or

 

(c)    independently of any Option granted under the Plan.

 

A Right described in clause (a) or (b) of the preceding sentence is a Related Right. A Related Right may, in the Committee’s discretion, apply to all or any portion of the Shares subject to the Related Option.

 

7.3.          A Right may be exercised as a whole or in part as provided in the applicable Agreement, and, subject to the terms of the Agreement, entitles a Participant to receive, without payment to the Company (but subject to required tax withholding), either cash or that number of Shares (equal to the highest whole number of Shares), or a combination thereof, in an amount or having an aggregate Fair Market Value as of the Date of Exercise not to exceed the number of Shares subject to the portion of the Right exercised multiplied by an amount equal to the excess of (a) the Fair Market Value on the Date of Exercise of the Right over (b) either (i) the Fair Market Value on the Date of Grant (or such amount in excess of such Fair Market Value as may be specified by the Committee) of the Right if it is not a Related Right, or (ii) the Exercise Price as provided in the Related Option if the Right is a Related Right.

 

7.4.          The Right Period shall be determined by the Committee and specifically set forth in the Agreement; provided, however, that (a) a Right will expire no later than the earlier of(i) ten (10) years from the Date of Grant, or (ii) in the case of a Related Right, the expiration of the Related Option; and (b) a Right that is a Related Right to an Incentive Stock Option may be exercised only when and to the extent the Related Option is exercisable.

 

7.5.          The exercise, as a whole or in part, of a Related Right shall cause a reduction in the number of Shares subject to the Related Option equal to the number of Shares with respect to which the Related Right is exercised. The exercise, as a whole or in part, of a Related Option shall cause a reduction in the number of Shares subject to the Related Right equal to the number of Shares with respect to which the Related Option is exercised.

 

8.             Exercise of Options and Rights .

 

8.1.          An Option or Right may, subject to the terms of the applicable Agreement evidencing the Award, be exercised as a whole or in part by the delivery to the Company of a notice of the exercise, in such form as the Committee may prescribe, accompanied, in the case of an Option, by (a) a full payment for the Shares with respect to which

 



 

the Option is exercised or (b) irrevocable instructions to a broker to deliver promptly to the Company cash equal to the exercise price of the Option. To the extent provided in the applicable Agreement, payment may be made by (i) delivery (including constructive delivery) of Shares (provided that such Shares, if acquired pursuant to an option or other award granted hereunder or under any other compensation plan maintained by the Company or any Affiliate, have been held by the Participant for at least six (6) months) valued at Fair Market Value on the Date of Exercise or (ii) delivery of a promissory note as provided in Section 8.2 hereof.

 

8.2.          To the extent provided in an Agreement and permitted by applicable law, the Committee may accept as payment of all or a portion of the Exercise Price a promissory note executed by the Participant evidencing his or her obligation to make future cash payment thereof. Promissory notes made pursuant to this Section 8.2 shall (a) be secured by a pledge of the Shares received upon exercise of the Option, (b) bear interest at a rate fixed by the Committee, and (c) contain such other terms and conditions as the Committee may determine in its discretion.

 

9.             Restricted Stock Awards . Each grant of Restricted Stock under this Plan shall be subject to an Agreement specifying the terms and conditions of the Award. Restricted Stock granted under this Plan shall consist of Shares that are restricted as to transfer, subject to forfeiture, and subject to such other terms and conditions as may be determined by the Committee.

 

10.           Incentive Share Awards . Each grant of Incentive Shares under this Plan shall be evidenced by an Agreement that: (a) provides for the issuance of Shares to a Participant at such times and (b) contains such other terms and conditions, as determined by the Committee.

 

11.           Performance Awards . Each Performance Award granted under this Plan shall be evidenced by an Agreement that: (a) provides for the payment of cash and/or issuance of Shares to a Participant and (b) contains such other terms and conditions as may be determined by the Committee. For purposes of Section  5.2 hereof, a Performance Award shall be deemed to cover a number of Shares equal to the sum of (a) the maximum number of Shares that may be issued upon payment of the Award and (b) to the extent the Award is not payable in Shares, a number of Shares equal to the quotient obtained by dividing the maximum dollar amount of the Award that is not payable in Shares by the Fair Market Value of a Share as of the Date of Grant of the Award, rounded to the next highest whole number.

 

12.           Dividends and Dividend Equivalents . The terms of an Award may, subject to such terms and conditions as the Committee may specify, provide a Participant with the right to receive dividend payments or dividend equivalent payments with respect to Shares covered by the Award, which payments may be either made currently or credited to an account established for the Participant, and may be settled in cash or Shares, as determined by the Committee.

 

13.           Capital Adjustments . In the event of any change in the outstanding Common Stock by reason of any stock dividend, split-up, recapitalization, reclassification, combination or exchange of shares, merger, consolidation, liquidation or the like, the Committee may, in its discretion, provide for a substitution for or adjustment in (a) the number and class of shares

 



 

subject to outstanding Awards, (b) the Exercise Price of Options and the base price upon which payments under Rights that are not Related Rights are determined, and (c) the aggregate number and class of Shares for which Awards thereafter may be granted under this Plan.

 

14.           Termination or Amendment . The Board may amend or terminate this Plan in any respect at any time; provided, however, that after this Plan has been approved by the stockholders of the Company, no amendment or termination of this Plan shall be made by the Board without approval of(a) the Company’s stockholders to the extent stockholder approval of the amendment is required by applicable law or regulations or the requirements of the principal exchange or interdealer quotation system on which the Common Stock is listed or quoted, if any, and (b) each Participant whose rights or obligations under any Award granted prior to the date of such amendment or termination would be adversely affected by such amendment or termination.

 

15.           Modification, Substitution of Awards .

 

15.1 .        Subject to the terms and conditions of this Plan, the Committee may modify the terms of any outstanding Awards; provided, however, that no modification of an Award shall, without the consent of the Participant, adversely affect any of the Participant’s rights or obligations under such Award.

 

15.2 .        Notwithstanding anything contained herein to the contrary, Awards may, at the discretion of the Committee, be granted under this Plan in substitution for stock options and other awards relating to capital stock of another corporation that is merged into, consolidated with, or all or a substantial portion of the property or stock of which is acquired by, the Company or one of its Affiliates. The terms and conditions of the substitute Awards so granted may vary from the terms and conditions set forth in this Plan to such extent as the Committee may deem appropriate in order to conform, as a whole or in part, to the provisions of the awards in substitution for which they are granted.

 

16.           Foreign Employees . Without amendment of this Plan, the Committee may grant Awards to Eligible Persons who are subject to the laws of foreign countries or jurisdictions on such terms and conditions different from those specified in this Plan as may in the judgment of the Committee be necessary or desirable to foster and promote achievement of the purposes of this Plan. The Committee may make such modifications, amendments, procedures, sub-plans and the like as may be necessary or advisable to comply with provisions of laws of other countries or jurisdictions in which the Company or any of its Affiliates operate or have employees.

 

17.           Stockholder Approval . This Plan, and any amendments hereto requiring stockholder approval pursuant to Section 14 hereof, are subject to approval by vote of the stockholders of the Company at the next annual or special meeting of stockholders following adoption by the Board.

 

18.           Withholding . The Company’s obligation to issue or deliver Shares or pay any amount pursuant to the terms of any Award granted hereunder shall be subject to satisfaction of applicable federal, state and local tax withholding requirements. To the extent provided in the applicable Agreement and in accordance with rules prescribed by the Committee, a Participant

 



 

may satisfy any such withholding tax obligation by any of the following means or by a combination of such means: (a) tendering a cash payment, (b) authorizing the Company to withhold Shares otherwise issuable to the Participant, or (c) delivering to the Company already-owned and unencumbered Shares. In addition, if there is a public market for Shares at the time any such tax withholding obligations are to be satisfied, then except with respect to Incentive Stock Options, a Participant may satisfy such tax withholding obligations by (i) delivery (including telephonically to the extent permitted by the Corporation) of an irrevocable and unconditional undertaking by a broker acceptable to the Corporation to deliver promptly to the Corporation sufficient funds to satisfy the tax withholding obligations, or (ii) delivery by the Participant to the Corporation of a copy of irrevocable and unconditional instructions to a broker acceptable to the Corporation to deliver promptly to the Corporation cash or a check sufficient to satisfy the tax withholding obligations; provided that such amount is paid to the Corporation at such time as may be required by the Committee.

 

19.           Term of Plan . Unless sooner terminated by the Board pursuant to Section 14, this Plan shall terminate on the date that is ten (10) years after the earlier of that date that the Plan is adopted by the Board or approved by the Company’s stockholders, and no Awards may be granted or awarded after such date. The termination of this Plan shall not affect the validity of any Award outstanding on the date of termination.

 

20.           Indemnification of Committee . In addition to such other rights of indemnification as they may have as members of the Board or Committee, members of the Committee shall be indemnified by the Company against all reasonable expenses, including attorneys’ fees, actually and reasonably incurred in connection with the defense of any action, suit or proceeding, or in connection with any appeal therein, to which they or any of them may be a party by reason of any action taken or failure to act under or in connection with this Plan or any Award granted hereunder, and against all amounts reasonably paid by them in settlement thereof or paid by them in satisfaction of a judgment in any such action, suit or proceeding, if such members acted in good faith and in a manner which they believed to be in, and not opposed to, the best interests of the Company.

 

21.           General Provisions .

 

21.1.        The establishment of this Plan shall not confer upon any Eligible Person any legal or equitable right against the Company, any Affiliate or the Committee, except as expressly provided in this Plan. Participation in this Plan shall not give an Eligible Person any right to be retained in the service of the Company or any Affiliate.

 

21.2.        Neither the adoption of this Plan nor its submission to the Company’s stockholders shall be taken to impose any limitations on the powers of the Company or its Affiliates to issue, grant, or assume options, warrants, rights, or restricted stock, or other awards otherwise than under this Plan, or to adopt other stock option, restricted stock, or other plans, or to impose any requirement of stockholder approval upon the same.

 



 

21.3.        The interests of any Eligible Person under this Plan are not subject to the claims of creditors and may not, in any way, be assigned, alienated or encumbered except to the extent provided in an Agreement.

 

21.4.        This Plan shall be governed, construed and administered in accordance with the laws of the State of Delaware.

 

21.5 .        The Committee may require each person acquiring Shares pursuant to Awards granted hereunder to represent to and agree with the Company in writing that such person is acquiring the Shares without a view to distribution thereof. The certificates for such Shares may include any legend that the Committee deems appropriate to reflect any restrictions on transfer. All certificates for Shares issued pursuant to this Plan shall be subject to such stock transfer orders and other restrictions as the Committee may deem advisable under the rules, regulations and other requirements of the Securities and Exchange Commission, any stock exchange upon which the Common Stock is then listed or interdealer quotation system upon which the Common Stock is then quoted, and any applicable federal or state securities laws. The Committee may place a legend or legends on any such certificates to make appropriate reference to such restrictions.

 

21.6.        The Company shall not be required to issue any certificate or certificates for Shares with respect to Awards granted under this Plan, or record any person as a holder of record of such Shares, without obtaining, to the complete satisfaction of the Committee, the approval of all regulatory bodies deemed necessary by the Committee, and without complying to the Board’s or Committee’s complete satisfaction, with all rules and regulations, under federal, state or local law deemed applicable by the Committee.

 




Exhibit 10.24

 

RADIUS HEALTH, INC.

NON-EMPLOYEE DIRECTOR COMPENSATION PROGRAM

 

This Radius Health, Inc. (the “ Company ”) Non-Employee Director Compensation Program (this “ Program ”) has been adopted under the Company’s 2011 Equity Incentive Plan (the “ 2011 Plan ”).  The Equity Compensation portion of this Program is intended to constitute the Non-Employee Director Equity Compensation Policy contemplated by Section 6.2 of the 2011 Plan.  Capitalized terms not otherwise defined herein shall have the meaning ascribed thereto in the 2011 Plan.

 

Cash Compensation

 

Annual retainers will be paid in the following amounts to Non-Employee Directors:

 

Non-Employee Director:

 

$

35,000

 

Chair of Audit Committee:

 

$

15,000

 

Chair of Compensation Committee:

 

$

10,000

 

Chair of Nominating and Corporate Governance Committee:

 

$

7,500

 

Chair of Strategy Committee:

 

$

10,000

 

Audit Committee Member (other than Chair):

 

$

7,500

 

Compensation Committee Member (other than Chair):

 

$

5,000

 

Nominating and Corporate Governance Committee Member (other than Chair):

 

$

5,000

 

Strategy Committee Member (other than Chair):

 

$

5,000

 

Independent Chairman:

 

$

25,000

 

 

All annual retainers will be paid in cash quarterly in arrears promptly following the end of the applicable calendar quarter, but in no event more than thirty (30) days after the end of such quarter.  In the event a Non-Employee Director does not serve as a Non-Employee Director or in one of the other positions identified above for an entire calendar quarter, the retainer paid to the Non-Employee director for the applicable calendar quarter will be prorated for the portion of the calendar quarter during which the applicable services were actually rendered.

 

Equity Compensation

 

Initial Stock Option Grant:

Each Non-Employee Director who is initially elected or appointed to serve on the Board after the date hereof shall be granted an Option to purchase 30,000 shares of Common Stock under the 2011 Plan or any other applicable Company equity incentive plan then-maintained by the Company (the “ Initial Option ”).

 

The Initial Option will automatically, and without further action by the Board or Committee, be granted on the date on which such Non-Employee Director

 

1



 

 

commences service on the Board, and will vest in substantially equal installments on each of the first four anniversaries of the date of grant, subject to continued service as a Non-Employee Director through each vesting date.

 

 

Annual Stock Option Grant:

Each Director who has been serving on the Board as a Non-Employee Director for at least six months as of the date of each annual shareholder meeting of the Company (each, an “ Annual Meeting ”) shall be granted an Option to purchase 15,000 shares of Common Stock under the 2011 Plan or any other applicable Company equity incentive plan then-maintained by the Company (the “ Annual Option ”).

 

The Annual Option will automatically, and without further action by the Board or Committee, be granted on the date of the applicable Annual Meeting, and will vest in full on the earlier to occur of (i) the first (1 st ) anniversary of the date of grant and (ii) the date of the Annual Meeting immediately following the date of grant, subject in each case to continued service through the vesting date.

 

Change of Control

 

Upon a Change of Control, all outstanding equity awards granted under the 2011 Plan or any other equity incentive plan maintained by the Company that are held by a Non-Employee Director shall become fully vested and/or exercisable, irrespective of any other provisions of the Non-Employee Director’s Award Agreement.

 

Miscellaneous

 

The provisions of the 2011 Plan shall apply to the Options granted pursuant to this Program, except to the extent such provisions are inconsistent with this Program.  All applicable terms of the 2011 Plan apply to this Program as if fully set forth herein.  The grant of any Option under this Program shall be made solely by and subject to the terms set forth in a written agreement substantially in the form of the stock option agreement approved by the Board and duly executed by an executive officer of the Company.  The exercise price per share of Stock subject to an Option granted under this Program shall be the Market Value of a share of Stock on the Option’s date of grant.

 

Amendment, Modification and Termination

 

This Program may be amended, modified or terminated by the Board at any time in its sole discretion.  No Non-Employee Director shall have any rights hereunder, except with respect to an Option granted pursuant to the Program.

 

2



 

As amended by the Board of Directors, effective January 1, 2015.

 

3




Exhibit 10.30

 

INDEMNIFICATION AGREEMENT

 

THIS INDEMNIFICATION AGREEMENT (the “ Agreement ”) is made and entered into as of                                between Radius Health, Inc. , a Delaware corporation (the “ Company ”), and                                            (“ Indemnitee ”).

 

WITNESSETH THAT:

 

WHEREAS, highly competent persons have become more reluctant to serve corporations as directors or in other capacities unless they are provided with adequate protection through insurance or adequate indemnification against inordinate risks of claims and actions against them arising out of their service to and activities on behalf of the corporation;

 

WHEREAS, the Board of Directors of the Company (the “ Board ”) has determined that, in order to attract and retain qualified individuals, the Company will attempt to maintain on an ongoing basis, at its sole expense, liability insurance to protect persons serving the Company and its subsidiaries from certain liabilities.  Although the furnishing of such insurance has been a customary and widespread practice among United States-based corporations and other business enterprises, the Company believes that, given current market conditions and trends, such insurance may be available to it in the future only at higher premiums and with more exclusions.  At the same time, directors, officers, and other persons in service to corporations or business enterprises are being increasingly subjected to expensive and time-consuming litigation relating to, among other things, matters that traditionally would have been brought only against the Company or business enterprise itself.  The Bylaws and Certificate of Incorporation of the Company require indemnification of the officers and directors of the Company.  Indemnitee may also be entitled to indemnification pursuant to the General Corporation Law of the State of Delaware (“ DGCL ”).  The Bylaws, Certificate of Incorporation and the DGCL expressly provide that the indemnification provisions set forth therein are not exclusive, and thereby contemplate that contracts may be entered into between the Company and members of the board of directors, officers and other persons with respect to indemnification;

 

WHEREAS, the uncertainties relating to such insurance and to indemnification have increased the difficulty of attracting and retaining such persons;

 

WHEREAS, the Board has determined that the increased difficulty in attracting and retaining such persons is detrimental to the best interests of the Company’s stockholders and that the Company should act to assure such persons that there will be increased certainty of such protection in the future;

 

WHEREAS, it is reasonable, prudent and necessary for the Company contractually to obligate itself to indemnify, and to advance expenses on behalf of, such persons to the fullest extent permitted by applicable law so that they will serve or continue to serve the Company free from undue concern that they will not be so indemnified;

 

WHEREAS, this Agreement is a supplement to and in furtherance of the Bylaws and Certificate of Incorporation of the Company and any resolutions adopted pursuant thereto, and shall not be deemed a substitute therefor, nor to diminish or abrogate any rights of Indemnitee thereunder; and

 



 

WHEREAS, Indemnitee does not regard the protection available under the Company’s Bylaws and Certificate of Incorporation and insurance as adequate in the present circumstances, and may not be willing to serve as a director without adequate protection, and the Company desires Indemnitee to serve in such capacity.  Indemnitee is willing to serve, continue to serve and to take on additional service for or on behalf of the Company on the condition that he be so indemnified; and

 

NOW, THEREFORE, in consideration of Indemnitee’s agreement to serve as a director from and after the date hereof, the parties hereto agree as follows:

 

1.                                       Indemnity of Indemnitee .  The Company hereby agrees to hold harmless and indemnify Indemnitee to the fullest extent permitted by law, as such may be amended from time to time.  In furtherance of the foregoing indemnification, and without limiting the generality thereof:

 

(a)                                  Proceedings Other Than Proceedings by or in the Right of the Company .  Indemnitee shall be entitled to the rights of indemnification provided in this Section l(a)  if, by reason of his Corporate Status (as hereinafter defined), the Indemnitee is, or is threatened to be made, a party to or participant in any Proceeding (as hereinafter defined) other than a Proceeding by or in the right of the Company.  Pursuant to this Section 1(a) , Indemnitee shall be indemnified against all Expenses (as hereinafter defined), judgments, penalties, fines and amounts paid in settlement actually and reasonably incurred by him, or on his behalf, in connection with such Proceeding or any claim, issue or matter therein, if the Indemnitee acted in good faith and in a manner the Indemnitee reasonably believed to be in or not opposed to the best interests of the Company, and with respect to any criminal Proceeding, had no reasonable cause to believe the Indemnitee’s conduct was unlawful.

 

(b)                                  Proceedings by or in the Right of the Company .  Indemnitee shall be entitled to the rights of indemnification provided in this Section 1(b)  if, by reason of his Corporate Status, the Indemnitee is, or is threatened to be made, a party to or participant in any Proceeding brought by or in the right of the Company.  Pursuant to this Section 1(b) , Indemnitee shall be indemnified against all Expenses actually and reasonably incurred by the Indemnitee, or on the Indemnitee’s behalf, in connection with such Proceeding if the Indemnitee acted in good faith and in a manner the Indemnitee reasonably believed to be in or not opposed to the best interests of the Company; provided, however, if applicable law so provides, no indemnification against such Expenses shall be made in respect of any claim, issue or matter in such Proceeding as to which Indemnitee shall have been adjudged to be liable to the Company unless and to the extent that the Court of Chancery of the State of Delaware shall determine that such indemnification may be made.

 

(c)                                   Indemnification for Expenses of a Party Who is Wholly or Partly Successful .  Notwithstanding any other provision of this Agreement, to the extent that Indemnitee is, by reason of his Corporate Status, a party to and is successful, on the merits or otherwise, in any Proceeding, he shall be indemnified to the maximum extent permitted by law, as such may be amended from time to time, against all Expenses actually and reasonably incurred by him or on his behalf in connection therewith.  If Indemnitee is not wholly successful in such Proceeding but is successful, on the merits or otherwise, as to one or more but less than all claims, issues or matters in such Proceeding, the Company shall indemnify Indemnitee against all Expenses actually and reasonably incurred by him or on his behalf in connection with

 



 

each successfully resolved claim, issue or matter.  For purposes of this Section and without limitation, the termination of any claim, issue or matter in such a Proceeding by dismissal, with or without prejudice, shall be deemed to be a successful result as to such claim, issue or matter.

 

2.                                       Additional Indemnity .  In addition to, and without regard to any limitations on, the indemnification provided for in Section 1 of this Agreement, the Company shall and hereby does indemnify and hold harmless Indemnitee against all Expenses, judgments, penalties, fines and amounts paid in settlement actually and reasonably incurred by him or on his behalf if, by reason of his Corporate Status, he is, or is threatened to be made, a party to or participant in any Proceeding (including a Proceeding by or in the right of the Company), including, without limitation, all liability arising out of the negligence or active or passive wrongdoing of Indemnitee.  The only limitation that shall exist upon the Company’s obligations pursuant to this Agreement shall be that the Company shall not be obligated to make any payment to Indemnitee that is finally determined (under the procedures, and subject to the presumptions, set forth in Sections 6 and 7 hereof) to be unlawful.

 

3.                                       Contribution .

 

(a)                                  Whether or not the indemnification provided in Sections 1 and 2 hereof is available, in respect of any threatened, pending or completed action, suit or proceeding in which the Company is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), the Company shall pay, in the first instance, the entire amount of any judgment or settlement of such action, suit or proceeding without requiring Indemnitee to contribute to such payment and the Company hereby waives and relinquishes any right of contribution it may have against Indemnitee.  The Company shall not enter into any settlement of any action, suit or proceeding in which the Company is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding) unless such settlement provides for a full and final release of all claims asserted against Indemnitee.

 

(b)                                  Without diminishing or impairing the obligations of the Company set forth in the preceding subparagraph, if, for any reason, Indemnitee shall elect or be required to pay all or any portion of any judgment or settlement in any threatened, pending or completed action, suit or proceeding in which the Company is jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), the Company shall contribute to the amount of Expenses, judgments, fines and amounts paid in settlement actually and reasonably incurred and paid or payable by Indemnitee in proportion to the relative benefits received by the Company and all officers, directors or employees of the Company, other than Indemnitee, who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, from the transaction from which such action, suit or proceeding arose; provided, however, that the proportion determined on the basis of relative benefit may, to the extent necessary to conform to law, be further adjusted by reference to the relative fault of the Company and all officers, directors or employees of the Company other than Indemnitee who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, in connection with the events that resulted in such expenses, judgments, fines or settlement amounts, as well as any other equitable considerations which the Law may require to be considered.  The relative fault of the Company and all officers, directors or employees of the Company, other than Indemnitee, who are jointly liable with Indemnitee (or would be if joined in such action, suit or proceeding), on the one hand, and Indemnitee, on the other hand, shall be determined by reference to, among

 



 

other things, the degree to which their actions were motivated by intent to gain personal profit or advantage, the degree to which their liability is primary or secondary and the degree to which their conduct is active or passive.

 

(c)                                   The Company hereby agrees to fully indemnify and hold Indemnitee harmless from any claims of contribution which may be brought by officers, directors or employees of the Company, other than Indemnitee, who may be jointly liable with Indemnitee.

 

(d)                                  To the fullest extent permissible under applicable law, if the indemnification provided for in this Agreement is unavailable to Indemnitee for any reason whatsoever, the Company, in lieu of indemnifying Indemnitee, shall contribute to the amount incurred by Indemnitee, whether for judgments, fines, penalties, excise taxes, amounts paid or to be paid in settlement and/or for Expenses, in connection with any claim relating to an indemnifiable event under this Agreement, in such proportion as is deemed fair and reasonable in light of all of the circumstances of such Proceeding in order to reflect (i) the relative benefits received by the Company and Indemnitee as a result of the event(s) and/or transaction(s) giving cause to such Proceeding; and/or (ii) the relative fault of the Company (and its directors, officers, employees and agents) and Indemnitee in connection with such event(s) and/or transaction(s).

 

4.                                       Indemnification for Expenses of a Witness .  Notwithstanding any other provision of this Agreement, to the extent that Indemnitee is, by reason of his Corporate Status, a witness, or is made (or asked to) respond to discovery requests, in any Proceeding to which Indemnitee is not a party, he shall be indemnified against all Expenses actually and reasonably incurred by him or on his behalf in connection therewith.

 

5.                                       Advancement of Expenses .  Notwithstanding any other provision of this Agreement, the Company shall advance all Expenses incurred by or on behalf of Indemnitee in connection with any Proceeding by reason of Indemnitee’s Corporate Status within thirty (30) days after the receipt by the Company of a statement or statements from Indemnitee requesting such advance or advances from time to time, whether prior to or after final disposition of such Proceeding.  Such statement or statements shall reasonably evidence the Expenses incurred by Indemnitee and shall include or be preceded or accompanied by a written undertaking by or on behalf of Indemnitee to repay any Expenses advanced if it shall ultimately be determined that Indemnitee is not entitled to be indemnified against such Expenses.  Any advances and undertakings to repay pursuant to this Section 5 shall be unsecured and interest free.

 

6.                                       Procedures and Presumptions for Determination of Entitlement to Indemnification .  It is the intent of this Agreement to secure for Indemnitee rights of indemnity that are as favorable as may be permitted under the DGCL and public policy of the State of Delaware.  Accordingly, the parties agree that the following procedures and presumptions shall apply in the event of any question as to whether Indemnitee is entitled to indemnification under this Agreement:

 

(a)                                  To obtain indemnification under this Agreement, Indemnitee shall submit to the Company a written request, including therein or therewith such documentation and information as is reasonably available to Indemnitee and is reasonably necessary to determine whether and to what extent Indemnitee is entitled to indemnification.  The Secretary of the Company shall, promptly upon receipt of such a request for indemnification, advise the Board of

 



 

Directors in writing that Indemnitee has requested indemnification.  Notwithstanding the foregoing, any failure of Indemnitee to provide such a request to the Company, or to provide such a request in a timely fashion, shall not relieve the Company of any liability that it may have to Indemnitee unless, and to the extent that, such failure actually and materially prejudices the interests of the Company.

 

(b)                                  Upon written request by Indemnitee for indemnification pursuant to the first sentence of Section 6(a)  hereof, a determination with respect to Indemnitee’s entitlement thereto shall be made in the specific case by one of the following four methods, which shall be at the election of the board:  (1) by a majority vote of the disinterested directors, even though less than a quorum, (2) by a committee of disinterested directors designated by a majority vote of the disinterested directors, even though less than a quorum, (3) if there are no disinterested directors or if the disinterested directors so direct, by independent legal counsel in a written opinion to the Board of Directors, a copy of which shall be delivered to the Indemnitee, or (4) if so directed by the Board of Directors, by the stockholders of the Company.  For purposes hereof, disinterested directors are those members of the board of directors of the Company who are not parties to the action, suit or proceeding in respect of which indemnification is sought by Indemnitee.

 

(c)                                   If the determination of entitlement to indemnification is to be made by Independent Counsel pursuant to Section 6(b)  hereof, the Independent Counsel shall be selected as provided in this Section 6(c) .  The Independent Counsel shall be selected by the Board of Directors.  Indemnitee may, within 10 days after such written notice of selection shall have been given, deliver to the Company a written objection to such selection; provided, however, that such objection may be asserted only on the ground that the Independent Counsel so selected does not meet the requirements of “ Independent Counsel ” as defined in Section 13 of this Agreement, and the objection shall set forth with particularity the factual basis of such assertion.  Absent a proper and timely objection, the person so selected shall act as Independent Counsel.  If a written objection is made and substantiated, the Independent Counsel selected may not serve as Independent Counsel unless and until such objection is withdrawn or a court has determined that such objection is without merit.  If, within 20 days after submission by Indemnitee of a written request for indemnification pursuant to Section 6(a)  hereof, no Independent Counsel shall have been selected and not objected to, either the Company or Indemnitee may petition the Court of Chancery of the State of Delaware or other court of competent jurisdiction for resolution of any objection which shall have been made by the Indemnitee to the Company’s selection of Independent Counsel and/or for the appointment as Independent Counsel of a person selected by the court or by such other person as the court shall designate, and the person with respect to whom all objections are so resolved or the person so appointed shall act as Independent Counsel under Section 6(b)  hereof.  The Company shall pay any and all reasonable fees and expenses of Independent Counsel incurred by such Independent Counsel in connection with acting pursuant to Section 6(b)  hereof, and the Company shall pay all reasonable fees and expenses incident to the procedures of this Section 6(c) , regardless of the manner in which such Independent Counsel was selected or appointed.

 

(d)                                  In making a determination with respect to entitlement to indemnification hereunder, the person or persons or entity making such determination shall presume that Indemnitee is entitled to indemnification under this Agreement.  Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence.  Neither the failure of the Company (including by its directors or

 



 

independent legal counsel) to have made a determination prior to the commencement of any action pursuant to this Agreement that indemnification is proper in the circumstances because Indemnitee has met the applicable standard of conduct, nor an actual determination by the Company (including by its directors or independent legal counsel) that Indemnitee has not met such applicable standard of conduct, shall be a defense to the action or create a presumption that Indemnitee has not met the applicable standard of conduct.

 

(e)                                   Indemnitee shall be deemed to have acted in good faith if Indemnitee’s action is based on the records or books of account of the Enterprise, including financial statements, or on information supplied to Indemnitee by the officers of the Enterprise (as hereinafter defined) in the course of their duties, or on the advice of legal counsel for the Enterprise or on information or records given or reports made to the Enterprise by an independent certified public accountant or by an appraiser or other expert selected with reasonable care by the Enterprise.  In addition, the knowledge and/or actions, or failure to act, of any director, officer, agent or employee of the Enterprise shall not be imputed to Indemnitee for purposes of determining the right to indemnification under this Agreement.  Whether or not the foregoing provisions of this Section 6(e)  are satisfied, it shall in any event be presumed that Indemnitee has at all times acted in good faith and in a manner he reasonably believed to be in or not opposed to the best interests of the Company.  Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence.

 

(f)                                    If the person, persons or entity empowered or selected under Section 6 to determine whether Indemnitee is entitled to indemnification shall not have made a determination within sixty (60) days after receipt by the Company of the request therefor, the requisite determination of entitlement to indemnification shall be deemed to have been made and Indemnitee shall be entitled to such indemnification absent (i) a misstatement by Indemnitee of a material fact, or an omission of a material fact necessary to make Indemnitee’s statement not materially misleading, in connection with the request for indemnification, or (ii) a prohibition of such indemnification under applicable law; provided, however, that such 60-day period may be extended for a reasonable time, not to exceed an additional thirty (30) days, if the person, persons or entity making such determination with respect to entitlement to indemnification in good faith requires such additional time to obtain or evaluate documentation and/or information relating thereto; and provided, further, that the foregoing provisions of this Section 6(f)  shall not apply if the determination of entitlement to indemnification is to be made by the stockholders pursuant to Section 6(b)  of this Agreement and if (A) within fifteen (15) days after receipt by the Company of the request for such determination, the Board of Directors or the Disinterested Directors, if appropriate, resolve to submit such determination to the stockholders for their consideration at an annual meeting thereof to be held within seventy-five (75) days after such receipt and such determination is made thereat, or (B) a special meeting of stockholders is called within fifteen (15) days after such receipt for the purpose of making such determination, such meeting is held for such purpose within sixty (60) days after having been so called and such determination is made thereat.

 

(g)                                   Indemnitee shall cooperate with the person, persons or entity making such determination with respect to Indemnitee’s entitlement to indemnification, including providing to such person, persons or entity upon reasonable advance request any documentation or information which is not privileged or otherwise protected from disclosure and which is reasonably available to Indemnitee and reasonably necessary to such determination.  Any Independent Counsel, member of the Board of Directors or stockholder of the Company

 



 

shall act reasonably and in good faith in making a determination regarding the Indemnitee’s entitlement to indemnification under this Agreement.  Any costs or expenses (including attorneys’ fees and disbursements) incurred by Indemnitee in so cooperating with the person, persons or entity making such determination shall be borne by the Company (irrespective of the determination as to Indemnitee’s entitlement to indemnification) and the Company hereby indemnifies and agrees to hold Indemnitee harmless therefrom.

 

(h)                                  The Company acknowledges that a settlement or other disposition short of final judgment may be successful if it permits a party to avoid expense, delay, distraction, disruption and uncertainty.  In the event that any action, claim or proceeding to which Indemnitee is a party is resolved in any manner other than by adverse judgment against Indemnitee (including, without limitation, settlement of such action, claim or proceeding with or without payment of money or other consideration) it shall be presumed that Indemnitee has been successful on the merits or otherwise in such action, suit or proceeding.  Anyone seeking to overcome this presumption shall have the burden of proof and the burden of persuasion by clear and convincing evidence.

 

(i)                                      The termination of any Proceeding or of any claim, issue or matter therein, by judgment, order, settlement or conviction, or upon a plea of nolo contendere or its equivalent, shall not (except as otherwise expressly provided in this Agreement) of itself adversely affect the right of Indemnitee to indemnification or create a presumption that Indemnitee did not act in good faith and in a manner which he reasonably believed to be in or not opposed to the best interests of the Company or, with respect to any criminal Proceeding, that Indemnitee had reasonable cause to believe that his conduct was unlawful.

 

7.                                       Remedies of Indemnitee .

 

(a)                                  In the event that (i) a determination is made pursuant to Section 6 of this Agreement that Indemnitee is not entitled to indemnification under this Agreement, (ii) advancement of Expenses is not timely made pursuant to Section 5 of this Agreement, (iii) no determination of entitlement to indemnification is made pursuant to Section 6(b)  of this Agreement within 90 days after receipt by the Company of the request for indemnification, (iv) payment of indemnification is not made pursuant to this Agreement within ten (10) days after receipt by the Company of a written request therefor or (v) payment of indemnification is not made within ten (10) days after a determination has been made that Indemnitee is entitled to indemnification or such determination is deemed to have been made pursuant to Section 6 of this Agreement, Indemnitee shall be entitled to an adjudication in an appropriate court of the State of Delaware, or in any other court of competent jurisdiction, of Indemnitee’s entitlement to such indemnification.  Indemnitee shall commence such proceeding seeking an adjudication within 180 days following the date on which Indemnitee first has the right to commence such proceeding pursuant to this Section 7(a) .  The Company shall not oppose Indemnitee’s right to seek any such adjudication.

 

(b)                                  In the event that a determination shall have been made pursuant to Section 6(b)  of this Agreement that Indemnitee is not entitled to indemnification, any judicial proceeding commenced pursuant to this Section 7 shall be conducted in all respects as a de novo trial on the merits, and Indemnitee shall not be prejudiced by reason of the adverse determination under Section 6(b) .

 



 

(c)                                   If a determination shall have been made pursuant to Section 6(b)  of this Agreement that Indemnitee is entitled to indemnification, the Company shall be bound by such determination in any judicial proceeding commenced pursuant to this Section 7 , absent (i) a misstatement by Indemnitee of a material fact, or an omission of a material fact necessary to make Indemnitee’s misstatement not materially misleading in connection with the application for indemnification, or (ii) a prohibition of such indemnification under applicable law.

 

(d)                                  In the event that Indemnitee, pursuant to this Section 7 , seeks a judicial adjudication of his rights under, or to recover damages for breach of, this Agreement, or to recover under any directors’ and officers’ liability insurance policies maintained by the Company, the Company shall pay on his behalf, in advance, any and all expenses (of the types described in the definition of Expenses in Section 13 of this Agreement) actually and reasonably incurred by him in such judicial adjudication, regardless of whether Indemnitee ultimately is determined to be entitled to such indemnification, advancement of expenses or insurance recovery.

 

(e)                                   The Company shall be precluded from asserting in any judicial proceeding commenced pursuant to this Section 7 that the procedures and presumptions of this Agreement are not valid, binding and enforceable and shall stipulate in any such court that the Company is bound by all the provisions of this Agreement.  The Company shall indemnify Indemnitee against any and all Expenses and, if requested by Indemnitee, shall (within ten (10) days after receipt by the Company of a written request therefore) advance, to the extent not prohibited by law, such expenses to Indemnitee, which are incurred by Indemnitee in connection with any action brought by Indemnitee for indemnification or advance of Expenses from the Company under this Agreement or under any directors’ and officers’ liability insurance policies maintained by the Company, regardless of whether Indemnitee ultimately is determined to be entitled to such indemnification, advancement of Expenses or insurance recovery, as the case may be.

 

(f)                                    Notwithstanding anything in this Agreement to the contrary, no determination as to entitlement to indemnification under this Agreement shall be required to be made prior to the final disposition of the Proceeding.

 

8.                                       Non-Exclusivity; Survival of Rights; Insurance; Primacy of Indemnification; Subrogation .

 

(a)                                  The rights of indemnification as provided by this Agreement shall not be deemed exclusive of any other rights to which Indemnitee may at any time be entitled under applicable law, the Certificate of Incorporation, the Bylaws, any agreement, a vote of stockholders, a resolution of directors or otherwise, of the Company.  No amendment, alteration or repeal of this Agreement or of any provision hereof shall limit or restrict any right of Indemnitee under this Agreement in respect of any action taken or omitted by such Indemnitee in his Corporate Status prior to such amendment, alteration or repeal.  To the extent that a change in the DGCL, whether by statute or judicial decision, permits greater indemnification than would be afforded currently under the Certificate of Incorporation, Bylaws and this Agreement, it is the intent of the parties hereto that Indemnitee shall enjoy by this Agreement the greater benefits so afforded by such change.  No right or remedy herein conferred is intended to be exclusive of any other right or remedy, and every other right and remedy shall be cumulative and in addition to every other right and remedy given hereunder or now or hereafter existing at law or in equity or

 



 

otherwise.  The assertion or employment of any right or remedy hereunder, or otherwise, shall not prevent the concurrent assertion or employment of any other right or remedy.

 

(b)                                  To the extent that the Company maintains an insurance policy or policies providing liability insurance for directors, officers, employees, or agents or fiduciaries of the Company or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person serves at the request of the Company, Indemnitee shall be covered by such policy or policies in accordance with its or their terms to the maximum extent of the coverage available for any director, officer, employee, agent or fiduciary under such policy or policies.  If, at the time of the receipt of a notice of a claim pursuant to the terms hereof, the Company has director and officer liability insurance in effect, the Company shall give prompt notice of the commencement of such proceeding to the insurers in accordance with the procedures set forth in the respective policies.  The Company shall thereafter take all necessary or desirable action to cause such insurers to pay, on behalf of the Indemnitee, all amounts payable as a result of such proceeding in accordance with the terms of such policies.

 

(c)                                   In the event of any payment under this Agreement, the Company shall be subrogated to the extent of such payment to all of the rights of recovery of Indemnitee, who shall execute all papers required and take all action necessary to secure such rights, including execution of such documents as are necessary to enable the Company to bring suit to enforce such rights.

 

(d)                                  Except as provided in paragraph (c) above, the Company shall not be liable under this Agreement to make any payment of amounts otherwise indemnifiable hereunder if and to the extent that Indemnitee has otherwise actually received such payment under any insurance policy, contract, agreement or otherwise.

 

(e)                                   Except as provided in paragraph (c) above, the Company’s obligation to indemnify or advance Expenses hereunder to Indemnitee who is or was serving at the request of the Company as a director, officer, employee or agent of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise shall be reduced by any amount Indemnitee has actually received as indemnification or advancement of expenses from such other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise.

 

9.                                       Exception to Right of Indemnification . Notwithstanding any provision in this Agreement, the Company shall not be obligated under this Agreement to make any indemnity in connection with any claim made against Indemnitee:

 

(a)                                  for which payment has actually been made to or on behalf of Indemnitee under any insurance policy or other indemnity provision, except with respect to any excess beyond the amount paid under any insurance policy or other indemnity provision; or

 

(b)                                  for an accounting of profits made from the purchase and sale (or sale and purchase) by Indemnitee of securities of the Company within the meaning of Section 16(b)  of the Securities Exchange Act of 1934, as amended, or similar provisions of state statutory law or common law; or

 



 

(c)                                   in connection with any Proceeding (or any part of any Proceeding) initiated by Indemnitee, including any Proceeding (or any part of any Proceeding) initiated by Indemnitee against the Company or its directors, officers, employees or other indemnitees, unless (i) the Board of Directors of the Company authorized the Proceeding (or any part of any Proceeding) prior to its initiation or (ii) the Company provides the indemnification, in its sole discretion, pursuant to the powers vested in the Company under applicable law.

 

10.                                Duration of Agreement .  All agreements and obligations of the Company contained herein shall continue during the period Indemnitee is an officer or director of the Company (or is or was serving at the request of the Company as a director, officer, employee or agent of another corporation, partnership, joint venture, trust or other enterprise) and shall continue thereafter so long as Indemnitee shall be subject to any Proceeding (or any proceeding commenced under Section 7 hereof) by reason of his Corporate Status, whether or not he is acting or serving in any such capacity at the time any liability or expense is incurred for which indemnification can be provided under this Agreement.  This Agreement shall be binding upon and inure to the benefit of and be enforceable by the parties hereto and their respective successors (including any direct or indirect successor by purchase, merger, consolidation or otherwise to all or substantially all of the business or assets of the Company), assigns, spouses, heirs, executors and personal and legal representatives.

 

11.                                Security .  To the extent requested by Indemnitee and approved by the Board of Directors of the Company, the Company may at any time and from time to time provide security to Indemnitee for the Company’s obligations hereunder through an irrevocable bank line of credit, funded trust or other collateral.  Any such security, once provided to Indemnitee, may not be revoked or released without the prior written consent of the Indemnitee.

 

12.                                Enforcement .

 

(a)                                  The Company expressly confirms and agrees that it has entered into this Agreement and assumes the obligations imposed on it hereby in order to induce Indemnitee to serve as an officer or director of the Company, and the Company acknowledges that Indemnitee is relying upon this Agreement in serving as an officer or director of the Company.

 

(b)                                  This Agreement constitutes the entire agreement between the parties hereto with respect to the subject matter hereof and supersedes all prior agreements and understandings, oral, written and implied, between the parties hereto with respect to the subject matter hereof.

 

13.                                Definitions .  For purposes of this Agreement:

 

(a)                                  Corporate Status ” describes the status of a person who is or was a director, officer, employee, agent or fiduciary of the Company or of any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that such person is or was serving at the express written request of the Company.

 

(b)                                  Disinterested Director ” means a director of the Company who is not and was not a party to the Proceeding in respect of which indemnification is sought by Indemnitee.

 


 

(c)                                  Enterprise ” shall mean the Company and any other corporation, partnership, joint venture, trust, employee benefit plan or other enterprise that Indemnitee is or was serving at the express written request of the Company as a director, officer, employee, agent or fiduciary.

 

(d)                                 Expenses ” shall include all reasonable attorneys’ fees, retainers, court costs, transcript costs, fees of experts, witness fees, travel expenses, duplicating costs, printing and binding costs, telephone charges, postage, delivery service fees and all other disbursements or expenses of the types customarily incurred in connection with prosecuting, defending, preparing to prosecute or defend, investigating, participating, or being or preparing to be a witness in a Proceeding, or responding to, or objecting to, a request to provide discovery in any Proceeding.  Expenses also shall include Expenses incurred in connection with any appeal resulting from any Proceeding and any federal, state, local or foreign taxes imposed on the Indemnitee as a result of the actual or deemed receipt of any payments under this Agreement, including without limitation the premium, security for, and other costs relating to any cost bond, supersede as bond, or other appeal bond or its equivalent.  Expenses, however, shall not include amounts paid in settlement by Indemnitee or the amount of judgments or fines against Indemnitee.

 

(e)                                  Independent Counsel ” means a law firm, or a member of a law firm, that is experienced in matters of corporation law and neither presently is, nor in the past five years has been, retained to represent:  (i) the Company or Indemnitee in any matter material to either such party (other than with respect to matters concerning Indemnitee under this Agreement, or of other indemnitees under similar indemnification agreements), or (ii) any other party to the Proceeding giving rise to a claim for indemnification hereunder.  Notwithstanding the foregoing, the term “Independent Counsel” shall not include any person who, under the applicable standards of professional conduct then prevailing, would have a conflict of interest in representing either the Company or Indemnitee in an action to determine Indemnitee’s rights under this Agreement.  The Company agrees to pay the reasonable fees of the Independent Counsel referred to above and to fully indemnify such counsel against any and all Expenses, claims, liabilities and damages arising out of or relating to this Agreement or its engagement pursuant hereto.

 

(f)                                   Proceeding ” includes any threatened, pending or completed action, suit, arbitration, alternate dispute resolution mechanism, investigation, inquiry, administrative hearing or any other actual, threatened or completed proceeding, whether brought by or in the right of the Company or otherwise and whether civil, criminal, administrative or investigative, in which Indemnitee was, is or will be involved as a party or otherwise, by reason of the fact that Indemnitee is or was an officer or director of the Company, by reason of any action taken by him or of any inaction on his part while acting as an officer or director of the Company, or by reason of the fact that he is or was serving at the request of the Company as a director, officer, employee, agent or fiduciary of another corporation, partnership, joint venture, trust or other Enterprise; in each case whether or not he is acting or serving in any such capacity at the time any liability or expense is incurred for which indemnification can be provided under this Agreement; including one pending on or before the date of this Agreement, but excluding one initiated by an Indemnitee pursuant to Section 7 of this Agreement to enforce his rights under this Agreement.

 



 

14.                               Severability .  The invalidity or unenforceability of any provision hereof shall in no way affect the validity or enforceability of any other provision.  Without limiting the generality of the foregoing, this Agreement is intended to confer upon Indemnitee indemnification rights to the fullest extent permitted by applicable laws.  In the event any provision hereof conflicts with any applicable law, such provision shall be deemed modified, consistent with the aforementioned intent, to the extent necessary to resolve such conflict.

 

15.                               Modification and Waiver .  No supplement, modification, termination or amendment of this Agreement shall be binding unless executed in writing by both of the parties hereto.  No waiver of any of the provisions of this Agreement shall be deemed or shall constitute a waiver of any other provisions hereof (whether or not similar) nor shall such waiver constitute a continuing waiver.

 

16.                               Notice By Indemnitee .  Indemnitee agrees promptly to notify the Company in writing upon being served with or otherwise receiving any summons, citation, subpoena, complaint, indictment, information or other document relating to any Proceeding or matter which may be subject to indemnification covered hereunder.  The failure to so notify the Company shall not relieve the Company of any obligation which it may have to Indemnitee under this Agreement or otherwise unless and only to the extent that such failure or delay materially prejudices the Company.

 

17.                               Notices .  All notices and other communications given or made pursuant to this Agreement shall be in writing and shall be deemed effectively given:  (a) upon personal delivery to the party to be notified, (b) when sent by confirmed electronic mail or facsimile if sent during normal business hours of the recipient, and if not so confirmed, then on the next business day, (c) five (5) days after having been sent by registered or certified mail, return receipt requested, postage prepaid, or (d) one (1) day after deposit with a nationally recognized overnight courier, specifying next day delivery, with written verification of receipt.  All communications shall be sent:

 

(a)                                 To Indemnitee at the address set forth below Indemnitee signature hereto.

 

(b)                                 To the Company at:

 

Radius Health, Inc.
950 Winter Street
Waltham, MA 02451
Attention: Chief Executive Officer

 

or to such other address as may have been furnished to Indemnitee by the Company or to the Company by Indemnitee, as the case may be.

 

18.                               Counterparts .  This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same Agreement.  This Agreement may also be executed and delivered by facsimile signature and in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument.

 



 

19.                               Headings .  The headings of the paragraphs of this Agreement are inserted for convenience only and shall not be deemed to constitute part of this Agreement or to affect the construction thereof.

 

20.                               Governing Law and Consent to Jurisdiction.   This Agreement and the legal relations among the parties shall be governed by, and construed and enforced in accordance with, the laws of the State of Delaware, without regard to its conflict of laws rules. The Company and Indemnitee hereby irrevocably and unconditionally (i) agree that any action or proceeding arising out of or in connection with this Agreement shall be brought only in the Chancery Court of the State of Delaware (the “ Delaware Court ”), and not in any other state or federal court in the United States of America or any court in any other country, (ii) consent to submit to the exclusive jurisdiction of the Delaware Court for purposes of any action or proceeding arising out of or in connection with this Agreement, (iii) waive any objection to the laying of venue of any such action or proceeding in the Delaware Court, and (iv) waive, and agree not to plead or to make, any claim that any such action or proceeding brought in the Delaware Court has been brought in an improper or inconvenient forum.

 

SIGNATURE PAGE TO FOLLOW

 



 

IN WITNESS WHEREOF, the parties hereto have executed this Agreement on and as of the day and year first above written.

 

 

 

RADIUS HEALTH, INC.

 

 

 

 

 

By:

 

 

Name:

Robert E. Ward

 

Title:

President and Chief Executive Officer

 

 

 

 

 

INDEMNITEE

 

 

 

 

 

 

 

Name:

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 



 

SCHEDULE A

 

Signatories to Indemnification Agreement

 

Alan Auerbach

Willard H. Dere

Morana Jovan-Embiricos

Ansbert K. Gadicke

Kurt Graves

Owen Hughes

Martin Münchbach

Anthony Rosenberg

Elizabeth Stoner

 




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Exhibit 23.1

Consent of Independent Registered Public Accounting Firm

        We consent to the incorporation by reference in the Registration Statement on Form S-3 (Nos. 333-198513 and 333-201610) and Form S-8 (Nos. 333-177800 and 333-195521) of Radius Health, Inc. and in the related Prospectus of our reports dated March 10, 2015, with respect to the financial statements of Radius Health, Inc. and the effectiveness of internal control over financial reporting of Radius Health, Inc. included in this Annual Report on Form 10-K for the year ended December 31, 2014.

    /s/ Ernst & Young LLP

Boston, Massachusetts
March 10, 2015




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Consent of Independent Registered Public Accounting Firm

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Exhibit 31.1

Certifications

I, Robert E. Ward, certify that:

1.
I have reviewed this annual report on Form 10-K of Radius Health, Inc.;

2.
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.
The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)
Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)
Disclosed in this report any change in registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.
The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent functions):

(a)
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

(b)
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: March 10, 2015   /s/ ROBERT E. WARD

Robert E. Ward
President and Chief Executive Officer



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Exhibit 31.2

Certifications

I, B. Nicholas Harvey, certify that:

1.
I have reviewed this annual report on Form 10-K of Radius Health, Inc.;

2.
Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3.
Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4.
The registrant's other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)
Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)
Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles;

(c)
Evaluated the effectiveness of the registrant's disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)
Disclosed in this report any change in registrant's internal control over financial reporting that occurred during the registrant's most recent fiscal quarter (the registrant's fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant's internal control over financial reporting; and

5.
The registrant's other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant's auditors and the audit committee of registrant's board of directors (or persons performing the equivalent functions):

(a)
All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant's ability to record, process, summarize and report financial information; and

(b)
Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant's internal control over financial reporting.

Date: March 10, 2015   /s/ B. NICHOLAS HARVEY

B. Nicholas Harvey
Senior Vice President, Chief Financial Officer, Treasurer and Secretary



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Certifications

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Exhibit 32.1

CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

        In connection with the Annual Report of Radius Health, Inc. (the "Company") on Form 10-K for the fiscal year ended December 31, 2014 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, Robert E. Ward, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:

March 10, 2015   /s/ ROBERT E. WARD

Robert E. Ward
President and Chief Executive Officer

        A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.




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CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

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Exhibit 32.2

CERTIFICATION PURSUANT TO
18 U.S.C. SECTION 1350,
AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

        In connection with the Annual Report of Radius Health, Inc. (the "Company") on Form 10-K for the fiscal year ended December 31, 2014 as filed with the Securities and Exchange Commission on the date hereof (the "Report"), I, B. Nicholas Harvey, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of the Sarbanes-Oxley Act of 2002, that to my knowledge:

March 10, 2015   /s/ B. NICHOLAS HARVEY

B. Nicholas Harvey
Senior Vice President, Chief Financial Officer, Treasurer and Secretary

        A signed original of this written statement required by Section 906 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.




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CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002