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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
 
 
FORM 8-K
 
 
 
CURRENT REPORT
Pursuant to Section 13 of 15(d)
of the Securities Exchange Act of 1934
 
Date of report (Date of earliest event reported): June 30, 2022
 
 
 
9 Meters Biopharma, Inc.
(Exact name of registrant as specified in its charter)
 
 
 
Delaware 001-37797 27-3948465
(State or other jurisdiction of
incorporation or organization)
 (Commission
File Number)
 (I.R.S. Employer
Identification No.)
 
8480 Honeycutt Road, Suite 120, Raleigh, NC 27615
(Address of principal executive offices) (Zip Code)
 
(919) 275-1933
(Registrant’s telephone number, include area code)
 
N/A
(Former Name or Former Address, if Changed Since Last Report)
 
 
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
 
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
 
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
 
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
 
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
 
Securities registered pursuant to Section 12(b) of the Act:
Title of each classTrading Symbol(s)Name of each exchange on which registered
Common Stock $0.0001 Par ValueNMTRThe Nasdaq Stock Market LLC

Indicate by check mark whether the registrant is an emerging growth company as defined in as defined in Rule 405 of the Securities Act of 1933 (§ 230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§ 240.12b-2 of this chapter).
 



Emerging growth company
 
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.

Item 8.01.Other Events.
On June 30, 2022, the Company issued a press release announcing positive preliminary results from its Phase 2 trial of vurolenatide in short bowel syndrome. A copy of the press release is filed as Exhibit 99.1 to this Current Report on Form 8-K and is incorporated herein by reference.

On June 30, 2022, the Company provided an overview of vurolenatide for short bowel syndrome which can be found on the Company's website at www.9meters.com under the section titled Investors. A copy of the Company's presentation is filed as Exhibit 99.2 to this Current Report on Form 8-K and is incorporated by reference herein.

Item 9.01.Financial Statements and Exhibits.

(d) Exhibits

Exhibit No.Description
Exhibit 99.1
Exhibit 99.2
Exhibit 104Cover Page Interactive Data File (embedded within the Inline XBRL document).






  
 




SIGNATURES
 
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
 
    
 9 Meters Biopharma, Inc.
    
Date: June 30, 2022By: /s/ Bethany Sensenig
   Bethany Sensenig
   Chief Financial Officer
 
 
 
 

 

 
 
 


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9 Meters Biopharma Announces Positive Preliminary Results from Phase 2 Study of Vurolenatide in Short Bowel Syndrome

Phase 2 VIBRANT study identifies a dose and dosing interval with >25% improvement in the primary endpoint of 24-hour mean total stool output reduction over 6 weeks
Vurolenatide was generally well tolerated with no adverse events leading to early study withdrawal
End-of-Phase 2 meeting with FDA scheduled for mid-third quarter
Phase 3 study for vurolenatide could begin as early as fourth quarter 2022 pending outcome of end-of-Phase 2 meeting; Study planning and logistics well underway

RALEIGH, NC / ACCESSWIRE / June 30, 2022 / 9 Meters Biopharma, Inc. (NASDAQ:NMTR), a clinical-stage company pioneering novel treatments for people with rare or debilitating digestive diseases, today announced positive preliminary topline results from the VIBRANT study (VurolenatIde for short Bowel syndrome Regardless of pArenteral support requiremeNT), its Phase 2 trial of vurolenatide, a proprietary, long-acting GLP-1 receptor agonist in development for the treatment of adult patients with short bowel syndrome (SBS). Based on positive results from this Phase 2 study and other supportive data, an end-of-Phase 2 meeting with FDA has been scheduled for mid-third quarter.

The topline preliminary results are based on data from a complete randomization block and are intended to support an end-of-Phase 2 meeting. The study remains ongoing and blinded in order to collect additional safety data and potentially enable utilization of the complete results to support a future NDA submission.

Results are based on the first 11 randomized patients with appropriate distribution across the four arms of the ongoing study and successfully identified the most effective and tolerable dose and dosing interval intended to progress into the planned Phase 3 study. Overall, 7 of 11 patients met the primary efficacy definition of TSO responder (greater than or equal to 10% reduction from baseline in 24-hour mean TSO) over the 6-week efficacy evaluation period. The arm of the study anticipated to be taken forward into Phase 3 showed a mean reduction in TSO of greater than 25%. Parenteral support volume, a secondary endpoint, was evaluated over the 6-week treatment period. Three of the five patients in the study with a parenteral support requirement, all of whom were randomly assigned to active drug, demonstrated a mean decrease (defined as greater than or equal to 20%) in their parenteral support volume requirement over the treatment period.

Vurolenatide was generally well tolerated with mild to moderate and transient side effects including nausea and vomiting, which are typical for GLP-1 agonists. There were no adverse events leading to early study withdrawal. Two serious adverse events were reported, which were deemed to be unrelated to study drug; both were central catheter infections, which are common in patients with a central line. Overall results from the study support and build upon the findings from 9 Meters prior Phase 1b/2a trial of vurolenatide in SBS.



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“Given the severity and life-threatening nature of SBS, as well as the significant impact on quality of life, we are very pleased to have identified a vurolenatide dose and dosing interval to progress into Phase 3 development. Vurolenatide may offer a novel and alternative approach to treating appropriate individuals with SBS as it has been shown to decrease total stool output and reduce parenteral support needs which are critical to the health and well-being of individuals with short bowel syndrome,” said Patrick H. Griffin, M.D., FACP, Chief Medical Officer at 9 Meters. “The Phase 2 study findings are supportive of the efficacy and safety of vurolenatide and will serve as the basis for our end-of-Phase 2 meeting. Further details of the study will be made available at a later date given the study is ongoing and remains blinded pending our discussion with FDA and our plan to ensure the trial meets the adequate and well-controlled standard.”

John Temperato, President and Chief Executive Officer of 9 Meters, commented, “I am very pleased with the progress we are making with vurolenatide in our mission to provide novel treatments for those suffering from debilitating digestive diseases in just over two years since the company’s inception. Based on the product profile and clinical data to date, we believe vurolenatide has the potential to play a critical role in the first-line treatment of patients with short bowel syndrome, as many patients are not candidates for the current standard of care, GLP-2 therapy.”

The Company plans to communicate additional details from the study as well as plans for the Phase 3 trial following the end-of-Phase 2 meeting with FDA that is set for mid-third quarter. The Company currently anticipates initiating the VIBRANT-2 Phase 3 study as early as the fourth quarter of 2022. Plans for the study, including site identification and recruitment, are well underway.

About the VIBRANT Study

The Phase 2 trial known as VIBRANT is a multicenter, double-blind, placebo-controlled parallel group study evaluating the safety, efficacy, and tolerability of vurolenatide in adult patients with SBS. The Phase 2 study was conducted to inform the design of the Phase 3 program including the dose and dosing interval. The trial includes 4 parallel treatment arms: vurolenatide 50 mg weekly, vurolenatide 50 mg every other week, vurolenatide 100 mg every other week, and placebo. The primary efficacy endpoint for the study is improvement in 24-hour total stool output (TSO) volume over the six-week double-blind treatment period compared to baseline. Reduction in TSO is thought to be indicative of slowed gastrointestinal transit resulting in improved fluid and nutrient absorption. The study is designed to include up to 22 patients, with the first 11 patients assessed for efficacy and safety of vurolenatide to support an end-of-Phase 2 meeting. Patients continue to be enrolled in the study to further assess safety.

About Vurolenatide

Vurolenatide is an investigational drug in Phase 2 development for the treatment of all adult patients with short bowel syndrome regardless of the need for parenteral support. Vurolenatide is a proprietary long-acting injectable GLP-1 receptor agonist that utilizes proprietary XTEN® technology to extend its circulating half-life. GLP-1, often referred to as the “ileal brake”, is a hormone that slows the transit of food and fluid through the stomach and


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upper intestine following meals. GLP-1 may be compromised in patients with short bowel syndrome due to the removal or shortening of the portion of the ilium that primarily secretes GLP-1. Vurolenatide has been shown to improve gastric motility in multiple post-surgical phenotypes of SBS patients. Vurolenatide was previously evaluated in an open-label, two-dose Phase 1b/2a clinical trial evaluating the safety and tolerability of three escalating fixed doses of vurolenatide in 9 adults with SBS for 56 days. Vurolenatide was found to be generally well tolerated, with all patients evaluated showing a meaningful reduction in TSO within 48 hours of the first dose.

About Short Bowel Syndrome

Short bowel syndrome (SBS) is a rare, debilitating disorder resulting from the loss of functional small intestine. SBS in adults most often results from intestinal resection from trauma, vascular events, malignancies and chronic inflammatory bowel disease (IBD). SBS can have a significant impact on quality of life and life expectancy due to complications including diarrhea, dehydration, and malnutrition related to the intestine’s compromised ability to digest food and absorb nutrients, electrolytes, and water (Storch, KJ, 2014; Parrish, C., 2017). The precise prevalence of SBS is unknown, but it is estimated to affect between 15,000 - 20,000 people in the U.S. and an additional 11,000 in the E.U.4 plus U.K. and Canada.

About 9 Meters Biopharma

9 Meters Biopharma, Inc. is a clinical-stage company pioneering novel treatments for people with rare digestive diseases, GI conditions with unmet needs, and debilitating disorders in which the biology of the gut is a contributing factor. 9 Meters is developing vurolenatide, a proprietary Phase 2 long-acting GLP-1 agonist, for SBS; larazotide, a tight junction regulator; and several near clinical-stage assets.

For more information please visit www.9meters.com or follow 9 Meters on Twitter, LinkedIn and Facebook.

Forward-Looking Statements

This press release includes forward-looking statements based upon 9 Meters' current expectations. Forward-looking statements include, but are not limited to, statements that express our intentions, beliefs, expectations, strategies, predictions, anticipated milestones, and any other statements relating to our future activities or other future events or conditions. These statements are based on current expectations, estimates and projections about our business based, in part, on assumptions made by management. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of various risks and uncertainties, which include, without limitation: risks related to our ability to successfully implement our strategic plans; uncertainties associated with the clinical development and regulatory approval of product candidates, including reliance on blinded data; uncertainties in obtaining successful clinical results for product candidates and unexpected costs that may result therefrom; risks related to the failure to realize any value from product candidates and preclinical programs being developed and anticipated to be developed in light of inherent risks and difficulties involved in successfully bringing product candidates to market; intellectual property risks; the impact of COVID-19 on our operations, enrollment in and timing


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of clinical trials; risks related to the inability of 9 Meters to obtain sufficient additional capital to continue to advance these product candidates and its preclinical programs, including in light of current stock market conditions; risk of delisting from Nasdaq; reliance on collaborators; reliance on research and development partners; risks related to cybersecurity and data privacy; and risks associated with acquiring and developing additional compounds. These and other risks and uncertainties are more fully described in periodic filings with the SEC, including the factors described in the section entitled "Risk Factors" in 9 Meters’ Annual Report on Form 10-K for the year ended December 31, 2021, and in other filings that 9 Meters has made and future filings 9 Meters will make with the SEC. You should not place undue reliance on these forward-looking statements, which are made only as of the date hereof or as of the dates indicated in the forward-looking statements. 9 Meters expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein to reflect any change in its expectations with regard thereto or any change in events, conditions, or circumstances on which any such statements are based.

Corporate Contact
Al Medwar
SVP, Investor Relations & Corporate Communications
9 Meters Biopharma, Inc.
investor-relations@9meters.com

Media Contact
Veronica Eames
LifeSci Communications, LLC
veames@lifescicomms.com
203-942-4626

Source: 9 Meters Biopharma, Inc.

Pioneering Novel Treatments with a one-tract mind FOCUSED ON RARE AND UNMET NEEDS IN DIGESTIVE DISEASES AND UNIQUE GI B IOLOGY June 28 , 2022


 
forward-looking statements This presentation includes forward-looking statements based upon the Company's current expectations. Forward- looking statements include, but are not limited to, statements that express our intentions, beliefs, expectations, strategies, predictions, anticipated milestones and any other statements relating to our future activities or other future events or conditions. These statements are based on current expectations, estimates and projections about our business based, in part, on assumptions made by management. Actual results and the timing of events could differ materially from those anticipated in such forward- looking statements as a result of various risks and uncertainties, which include, without limitation: the impact of COVID-19 on our operations, enrollment in and timing of clinical trials; reliance on research and development partners; uncertainties associated with the clinical development and regulatory approval of product candidates; uncertainties in obtaining successful clinical results for product candidates and unexpected costs that may result therefrom; risks related to the failure to realize any value from product candidates and preclinical programs being developed and anticipated to be developed in light of inherent risks and difficulties involved in successfully bringing product candidates to market; risks related to the inability of the Company to obtain sufficient additional capital to continue to advance these product candidates and its preclinical programs; reliance on collaborators; and risks associated with acquiring and developing additional compounds. These and other risks and uncertainties are more fully described in periodic filings with the SEC, including the factors described in the section entitled "Risk Factors" in the Company's Annual Report on Form 10-K for the year ended December 31, 2021, Form 10-Q for the quarter ended March 31, 2022, and in other filings that the Company has made and future filings the Company will make with the SEC. You should not place undue reliance on these forward-looking statements, which are made only as of the date hereof or as of the dates indicated in the forward-looking statements. The Company expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein to reflect any change in its expectations with regard thereto or any change in events, conditions or circumstances on which any such statements are based. 2


 
Changing the world through novel therapeutic approaches that treat people with rare and debilitating conditions via unique gut related pathways. vision changing the world for patients mission Developing innovative treatments to liberate patients from rare and underserved diseases through our deep understanding of GI biology. 3


 
investor highlights 9 meters at a glance Focused on rare and debilitating diseases by modulating the biology of the GI tract vurolenatide Proprietary long-acting GLP-1 agonist for short bowel syndrome with Phase 3 initiation planned for 2H 2022 a straight-forward strategy Employing capital efficient development & commercialization pathways 4 robust preclinical pipeline Promising preclinical pipeline addressing unmet needs in GI diseases leading institutional investor support and coverage by leading health care analysts Nasdaq listed: NMTR larazotide Oral, non-absorbed tight junction regulator and only therapeutic in Phase 3 for celiac disease


 
John Temperato PRESIDENT & CHIEF EXECUTIVE OFFICER Bethany Sensenig, MBA, CMA CHIEF FINANCIAL OFFICER Patrick H. Griffin, MD CHIEF MEDICAL OFFICER Sireesh Appajosyula, PharmD SVP, CORPORATE DEVELOPMENT & OPERATIONS Nir Barak, MD SVP, SCIENTIFIC AFFAIRS Matthew D. Bryant, PharmD VP, MEDICAL AFFAIRS Sarah Liu, MBA CHIEF COMMERCIAL OFFICER Al Medwar, MBA SVP, INVESTOR RELATIONS & CORPORATE COMMUNICATIONS leadership team 5


 
develop capital efficient & regulatory predicates acquire/ partner aligned to focus commercialize efficient US footprint; strategic ROW partnerships rare, unmet needs & unique GI biology digestive disease-centric, patient-focused • Acquire targeted clinical compounds • Agnostic within GI tract if needs are unmet • Rare & unmet needs allow for targeted patient profiling focus provides • Capital efficient development pathways • Market protection enhancements • Capital efficient commercialization • Payer leverage 9 meters in circuitous length BUT A STRAIGHT-FORWARD STRATEGY 6


 
NOTE: All programs are New Chemical Entities. NOTE: All programs are globally licensed except NM-004, which excludes Asia, except for Japan. * 9 Meters Press release, June 21, 2022 **MIS-C = multisystem inflammatory syndrome in children clinical trial in collaboration with European Biomedical Research Institute of Salerno (EBRIS); GLP-1 = glucagon-like peptide- 1; GLP-2 = glucagon-like peptide-2; GIP = glucose-dependent insulinotropic polypeptide; hu-mAb = humanized monoclonal antibody pipeline – one tract with multiple meaningful opportunities 7 PROGRAM Indication CLASS ROUTE PRE-CLINICAL PHASE 1 PHASE 2 PHASE 3 MILESTONES Enrollment on hold. Next steps TBD based on further analysis* Vurolenatide Short Bowel Syndrome Long-Acting GLP-1 Injectable NM-003 Orphan Indication TBD Long-Acting GLP-2 Injectable IND-enabling planning underway NM-102 Orphan Indication TBD Tight Junction Microbiome Modulator Oral Larazotide Adult Celiac Disease Tight Junction Regulator Oral; Gut Restricted Phase 2 data → 2Q 2022 IND-enabling underway NM-136 Targeted Obesity Disorders NM-004 Orphan Indication TBD Immunomodulator Oral; Gut Restricted Injectable Phase 2 ready IND-enabling underwayAnti-GIP hu-mAb Larazotide MIS-C** Tight Junction Regulator Oral; Gut Restricted Phase 2a topline data → 2H 2022


 
vurolenatide: long-acting glp-1 agonist Short Bowel Syndrome (SBS); Orphan Designation


 
patients with sbs typically have compromised levels of glp-1 Illustration of one phenotype of SBS with colon-in-continuity; Other phenotypes exist with and without colon-in-continuity 9 • GLP-1 is naturally produced in a portion of the ileum that is removed during surgical resection • Natural GLP-1 prevents the GI tract from moving rapidly: known as an “ileal brake” • Without this brake, there is unregulated gut motility, causing an SBS patient’s remaining bowels to empty rapidly and frequently • Inability to absorb nutrients and fluids • Intractable, malabsorptive diarrhea with frequent bowel movements and excessive stool output • Production of natural GLP-1 is compromised in patients with SBS • Portion of the ileum secreting GLP-1 may be removed during resection • GLP-2 analogues do not appreciably slow motility to affect rapid GI transit time associated with SBS • An ideal therapy for SBS patients should: • Be safe and tolerable, while providing convenient dosing and administration • Rapidly decrease gut motility to improve absorption of nutrients and fluids • Rapidly reduce total stool output (TSO) volume and bowel movement frequency


 
9 reasons to believe Vurolenatide has the potential to advance the treatment of SBS 1) Faster1 Onset of Action Within hours or days of dosing vs. weeks or Months with GLP-2 6) 15 years of patient experience with active molecule 7) Transient side effects vs. REMS with current GLP-2 2) Slows Gut Motility to increase time for nutrient absorption Demonstrated Reductions in: 3) TSO 4) Meal-related and nocturnal diarrhea 5) Parenteral Support 8) Weekly or bi-weekly dosing vs. daily dosing or twice- weekly dosing 9) Fixed dosing vs. weight-based dosing (teduglutide) In cr e as e d N u tr ie n t A b so rp ti o n M o re T ra n si t Ti m e O n se t o f A ct io n P o ten tial fo r Lo w e r D o sin g B u rd e n Fe w e r Safe ty C o n ce rn s MOA and Efficacy Differentiation… …while reducing the burdens associated with GLP-2s 10 *1Vurolenatide remains investigational and has not been evaluated in head-to-head trials against GLP-2 therapies”


 
vurolenatide replaces glp-1 and restores the “ileal brake” short bowel syndrome with glp-1 GLP-1 travels through the blood, which affects gut motility elsewhere in the body. Motility is slowed, allowing more time for nutrient uptake. Vurolenatide rapidly replaces physiological effects of missing GLP-1 to normalize GI transit with potentially twice- or once-monthly dosing. XTEN R Molecule is an NCE through recombinantly derived process exenatide ~4.2 kDa Asp HisGly Thr ThrSerPheGluGly Asp Leu Ser LysGlnMetGluGluAlaVal GluArg Phe Leu Ile GluTrpLeu ProLys GlyGly Ser Ser Gly GlyAlaProProSer vurolenatide ~80 kDa + 11


 
vurolenatide is XTENylatedTM with ultra-long half-life Asp HisGly Thr ThrSerPheGluGly Asp Leu Ser LysGlnMetGluGluAlaVal GluArg Phe Leu Ile GluTrpLeu ProLys GlyGly Ser Ser Gly GlyAlaProProSer • Dipeptidyl peptidase 4 cleaves native GLP-1 and GLP-2 in minutes • Exenatide still limited by half-life (2.5 h) • Long-acting depot formulation (Bydureon®) not optimized for SBS • Vurolenatide is created in recombinant process via technology licensed from Amunix (now Sanofi) • XTENylation process is a recombinant protein engineering method to fuse protein polymers using a limited number of AAs Exenatide 4.2 kDa XTENylation Key Benefits: • Increases exenatide half-life from ~2 to ~170 h (PK data) • Not PEGylation conjugation • Fully recombinant process • Increased drug stability • Fully biodegradable • Defined chemical structure • Purifiable drug product • Manufacturing known and scalable • Clinically validated: Human PoC using exenatide-XTEN completed; multiple other targets also completed clinical studies vurolenatide 80 kDa 12


 
vurolenatide open-label single-center phase 1b/2a trial results


 
phase 1b/2a study: sbs clinical trial design *The study protocol called for an analysis of urine output; however, it proved difficult to measure in an ambulatory setting. open label, 2-dose, dose-escalation study of vurolenatide in adult patients with sbs Vurolenatide given twice, at 3 different dose levels, in 3 cohorts Doses were administered on Days 1 and 15 by subcutaneous injection. MAIN OUTCOMES: Safety & tolerability Key secondary outcome: Total stool output (TSO) volume/bowel movement frequency Patients were followed for 6 weeks after the second dose. Screening 50 mg cohort n=2 50 mg cohort n=1 100 mg cohort n=2 100 mg cohort n=2 150 mg cohort n=1 150 mg cohort n=1 Overall demographics in trial: 5m/4f (8 Caucasian); avg age = 51.8 y; avg height = 175.1 cm; avg weight = 68.0 kg; avg BMI = 22.1 kg/m2 14


 
phase 1b/2a trial: treatment-emergent adverse events Vurolenatide was generally safe and well tolerated: 17 TEAEs were observed in 9 patients, 15 of which were mild, transient and self-limited without further intervention. The majority of TEAEs were GI-related (nausea and vomiting). 15 Study confirmed single ascending dose in T2DM study data


 
phase 1b/2a efficacy: total stool output (tso) *Patient 6 did not receive a second dose. †The baseline prior to the second dose in this patient was substantially higher than the original baseline volume due to rapid increase in oral intake. 16


 
fda response on initiated phase 2 program FDA Type C meeting communication supported plan to initiate Phase 2 study with vurolenatide for SBS using TSO as the primary efficacy outcome measure Multicenter, double-blind, double-dummy, randomized placebo-controlled trial; FDA has provided global anchor questions and specific guidance for performance of exit interviews to support clinical meaningfulness of observed efficacy Secondary endpoints will include diarrhea impact, nocturnal stool output, meal-related stool output, parenteral requirements, sleep quality, and quality of life 17


 
VIBRANT phase 2 study VurolenatIde for short Bowel syndrome Regardless of pArenteral support requiremeNT Study objectives, design & preliminary results


 
VIBRANT: phase 2 sbs trial design & timeline Timeline: preliminary results expected 2Q22 50 mg PBOGroup 1 Group 2 Group 3 Group 4 Study population: all comers (regardless of phenotype and/or PS requirement) 50 mg PBO 50 mg 100 mg PBO 100 mg PBO 100 mg 50 mg 50 mg 50 mg 50 mg 50 mg PBO PBO PBO PBO PBO DAY 0 DAY 7 DAY 14 DAY 21 DAY 28* VIBRANT = VurolenatIde for short Bowel syndrome Regardless of pArenteral support requiremeNT; PS = parenteral support. *Patients will be followed 2 additional weeks for efficacy.19


 
VIBRANT trial objectives and enrollment • Evaluate previous open label trial efficacy in placebo-controlled and blinded setting • Confirm overall tolerability and safety profile in placebo-controlled and blinded setting • Identify go-forward dose and dose regimen for Phase 3 • Design and execute photo image diary for collection of intake and output • Gain experience with both patient and site interactions, patient dynamics and SBS trial execution challenges to maximize success in Phase 3 • Enrollment was in-line with standard metrics in this indication • Standard is 0.2 patients per site per month (confirmed by four international CROs with significant rare disease experience) • VIBRANT enrollment was 0.28 patients per site per month 20


 
VIBRANT demographics, disposition and phenotype • Demographics: • N = 11 • 3/8 (M/F) • Mean Age: 54.1; (44 – 67; min – max) • Race: Black/African American (2); White (9) • Ethnicity: Not Hispanic or Latino (11) • Study Disposition • No patient withdrew from the study in 11 patients • SBS anatomic phenotype • 9 ostomy patients; 2 colon-in-continuity • Parenteral Support • 5 yes/6 no 21


 
VIBRANT phase 2 trial objectives met • Safety and tolerability Confirmed • No Adverse Event leading to early withdrawal • 2 SAEs – central catheter infections (Unrelated to Study Drug) • Efficacy Confirmed • Overall, 7/11 met definition for TSO Responder over the 6 weeks post randomization [Conservative Responder Definition* = Change From Baseline in 24 hour Mean TSO reduction ≥ 10%] • Parenteral support volume effect observed • 3/5 Patients on active drug showed a meaningful decrease in PS volume • Of the 3 active drug groups, one vurolenatide dose and dosing interval identified (i.e., best tolerated efficacious dose vis-a-vis safety and tolerability) • Mean TSO reduction > 25% in the go-forward vurolenatide group 22 *Greater than 10% defined by 9 Meters, not pre-specified, in-line with observed benefit of several approved GI drugs including Xifaxan®, Trulance®, Amitiza®, Viberzi® and Linzess®.


 
VIBRANT phase 2 trial timeline & regulatory next steps • Study remains ongoing and blinded to maximize EOP2 discussion value • FDA meeting granted for mid-third quarter 23


 
VIBRANT2 phase 3 planning VurolenatIde for short Bowel syndrome Regardless of pArenteral support requiremeNT - 2 Start-up timing & CRO selection


 
VIBRANT2 - phase 3 start up and planning • Anticipated phase 3 start – Q4 2022 • All six VIBRANT phase 2 sites will be first to be initiated for phase 3 • Utilizing CRO with bona fide Rare Disease experience (with SBS experience in EU) • Feasibility for US & Canada identified multiple viable sites • Initial P3 feasibility/capability will look at Ex-North America to meet currently defined first-patient-in to last-patient-out timeline • Community trial participation program can be incorporated 25


 
vurolenatide: market opportunity Short Bowel Syndrome (SBS); Orphan Designation


 
short bowel syndrome: a debilitating orphan disease Results from massive resection of the small intestine due to recurrent Crohn’s disease, mesenteric vascular events, trauma, malignancy or complications from abdominal surgery1 Clinical consequences are far reaching • Includes malnutrition, diarrhea, dehydration, depression, mental confusion, weakness, early kidney failure, cardiac arrhythmia, impaired wound healing 1 • Overall mortality is 15-47% in adults with SBS, depending upon age and length of parenteral nutrition 2 Limited treatment options with many patients dependent on long-term parenteral support (PS) • Costs of PS are estimated between $100 - $586k per year 3 • Can lead to complications such as bacterial infections, low bone calcium uptake, liver disease, kidney disease1 • Gattex (teduglutide) is a GLP-2 analogue approved in the US in 2012 for treatment of short bowel syndrome • >$600MM in global sales in 2020/20214 United States ~15 – 20k patients EU4 + UK + CAN ~11k patients 1. Massaroni, S et al. Understanding short bowel syndrome: Current status and future perspectives. Digestive and Liver Disease 52 (2020) 253-261 2. Schalamon, J. et al. Mortality and Economics in Short Bowel Syndrome. Best Practices Rest Clin Gastro, 2003 Dec;17(6):931-42 3. Transparency Market Research. Short Bowel Syndrome Market (Product: Glucagon-like Peptide-2 [GLP2], Growth Hormone, Glutamine, and Others; and Distribution Channel: Hospital Pharmacies, Retail Pharmacies, and Online Sales) - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast, 2021-2031 4. Takeda Quarterly Financial Report. March, 31, 2022 27


 
the patient journey: short bowel syndrome Sources: 1.) Messing et al. Long-term Survival and Parenteral Nutrition Dependence in Adult Patients with the Short Bowel Syndrome. Gastroenterology 1999. 2.) Winkler, Marion. Et al. An Exploration of Quality of Life and the Experience of Living with Home Parenteral Nutrition. JPEN July 2010. Average Age at Constitution: 52 Years Remnant Small Bowel Length: • <50 cm (35%) • 50-99 cm (31%) • 100-150 cm (34%) Transient PN (52%) PN Dependence: (48%)* Among PN Dependent, Progression to Intestinal Failure (IF) (45% at 5 years) Factors related to PN Dependency: • Remnant Small Bowel Length • End-jejunostomy vs. Colon-in-Continuity • Absence of Ileocecal Valve and Cecum Cause of Resection: • Mesenteric Infarction • Radiation Enteritis • Crohn’s Disease • Small Bowel Volvulus • Other Initiation of Parenteral Nutrition (PN) Overall Mortality 10 Years Post Resection: 40% Cause of Death: • Related to PN (22%) • Related to Short Bowel (13%) • Related to Primary Disease (31%) • Other (34%) Diarrhea, Fatigue, Abdominal Pain, Ostomy Leakage, Infusion Schedules, Social Impact2 *GLP-2 therapies target patients on PN 28


 
Vurolenatide is poised to address unmet needs in the SBS market 29 Degree of Malabsorption D e gr e e o f Fl u id / N u tr it io n al S u p p o rt Additional Oral Intake (hyperphagia) Parenteral Support • Gattex/Revestive (teduglutide) target population is limited to patients on parenteral support (PS) • Apraglutide, glepaglutide positioned to reduce time on PS Vurolenatide aims to treat SBS along the full spectrum of disease by slowing gut motility and restoring full nutrient absorption Intestinal Failure Intestinal Insufficiency ~15-20K SBS patients in US ~11K SBS patients in EU4 +UK and Canada Adapted from Jeppesen, P. Expert Opinion on Orphan Drugs. 2013 >$1.5bn Sales Opportunity* Peak year sales potential in major regions (US, EU 4 + UK & CAN, APAC (incl. China)) *Other regions (LATAM, MENA) represent upside


 
8480 Honeycutt Road, Suite 120 Raleigh, NC 27615 Telephone: 1-919-275-1933 info@9meters.com www.9meters.com Twitter LinkedIn