PAR Capital Raising Presentation
Released
Released
Announcement PDF
December 2024
Capital Raising Presentation
Not for release to US wire services or distribution in
the United States
Paradigm Biopharma
DEC 2024
2
Disclaimer
This document, together with any information communicated by Paradigm Biopharmaceuticals Ltd ASX:PAR (known as “Paradigm”, “Paradigm Biopharma” or “the Company”), in any presentation or discussion relating to this document (collectively,
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Not an offer
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restricted by law. Persons who come into possession of this presentation should observe any such restrictions as any non-compliance could contravene applicable securities laws. See “International Offer Restrictions" for more information
Paradigm Biopharma
DEC 2024
Executive Summary
Background
•
•
•
FDA-cleared to
proceed to PH3
•
Paradigm Biopharmaceuticals Limited (Paradigm, PAR or Company) is a late-stage clinical biotech company developing Pentosan
Polysulfate Sodium (PPS, iPPS,Zilosul®) for the treatment of Osteoarthritis (OA).
Molecule is a non-opioid with 60 years of success treating pain, inflammation, and thrombosis in humans.
Multiple PH2 clinical trials have demonstrated efficacy, safety and durability of effect out to 12 months at 2mg/kg twice weekly.
•
•
Cleared by the FDA to proceed with PH3 trial for knee OA on November 28 2024, at optimal dosing regimen of 2mg/kg twice weekly –
replicating successful PH2 trials.
466 patients, primary endpoint improvement in pain from baseline, interim analysis 1H CY26, final readout 1H CY27.
Fast track designation received from FDA – recognising need for non-opioid solution to treat OA.
•
•
•
Blockbuster potential with 72m+ in key target markets affected by OA – 5% market penetration = $5bn p.a. revenue potential.
Commercial-scale manufacturing ready – 25-year exclusivity from launch from bene pharmaChem, only FDA-approved manufacturer.
Significant patent and exclusivity protection out to at least 2042 in the US.
•
•
•
Capital raising of A$16.0 million via a Placement at A$0.40 per share.
Funds raised will allow Paradigm to immediately commence PH3 enrolment in Australia and US.
Non-dilutive funding from partnering or regional licensing deals to materially extend runway – counterparties have been seeking FDA
approval of PH3 trial design, which is now received.
Market
potential
Capital
raising
3
Paradigm Biopharma
Blockbuster
market
opportunity
Zilosul® is a non-opioid
subcutaneous
injectable aimed to treat
pain and function in
osteoarthritis.
•
•
FDA Fast Track
Designation
Market size potential
US$10B+ p.a.4
DEC 2024
People affected by OA in 20203
Knee and Hip (Global)
m+
72
69
People affected by OA by 20303
OA patients dissatisfied with current
treatments1
m+
120
81
%
%
Target uptake: 10%
dissatisfied market1
Markets: US, UK, France, Germany, Italy,
Spain, Canada and Australia.
Compared with 2020, cases of OA are
projected to increase 74·9% for knee and
78·6% for hip by 2050.5
of all OA
1.
2.
3.
4.
5.
Zilosul indicative price:
US$2500 per year2
National Institute of Health; Emerging drugs for osteoarthritis; Hunter DJ and Matthews G
16(3): 479–491; 2011 September.
Global Pricing Research conducted by Paradigm.US, UK Germany, France
OARSI. Osteoarthritis: A Serious Disease, Submitted to the U.S. Food and Drug
Administration December 1, 2016
Calculation based on 10% penetration dissatisfied patients with Knee and Hip OA in the 72m
addressable market, at price of US$2500.
Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to
2050: a systematic analysis for the Global Burden of Disease Study 2021
4
Paradigm Biopharma
DEC 2024
5
“Most patients with OA of the hip and/or knee either initiate on or switch to opioids for
long-term management of OA-related pain despite known risks. This highlights the need
for new treatments that delay or prevent use of opioids1”.
Effective
Market
Demand
Non-validated
Ineffective
Invasive
Analgesics,
NSAIDS
Opioids
Limited
treatment
options as
degenerative
OA disease
progresses
*Royal Australian College of General Practitioners hold a ‘strong against’ recommendation
*Hyaluronic Acid
Injectable*Plateletrich Plasma, *Stem
Cells
Steroid injectable
Surgery - Total Knee
Arthroplasty
Stage 1
Minor OA
CV = Cardiovascular; GI = Gastrointestinal
Stage 2
Mild OA
Stage 3
Moderate OA
•
•
Daily use
GI, CV risk with
prolonged use.
•
•
Severe side-effects
Addictive
•
•
Limited pain relief
Royal Australian
College of General
Practitioners hold a
‘strong against’
recommendation.
•
•
Limited pain relief
Evidence of further
cartilage
degradation
•
•
High cost
Patients opting for
alternative
treatments
Stage 4
Severe OA
1. Source: https://www.tandfonline.com/doi/full/10.1080/03007995.2023.2234727?scroll=top&needAccess=true&role=tab
Paradigm Biopharma
DEC 2024
Phase 3 derisked by multiple Phase 2 trials
PARA_005
Phase 2
Pain & Function
PARA_OA_008
Phase 2
Pain, Function, mechanism of action
• 6-week treatment, 20-week follow-up, n=126
• Primary endpoint met, statistically significant
improvement from baseline in pain & function.
• iPPS showed a 37% pain reduction vs 23% in placebo
at Day 53.
• Durable pain & function improvement up to Day 165.
• 6-week treatment, 46-week follow-up, n=61
• Key endpoints, improvement from baseline in pain &
function.
• iPPS showed a 50% pain reduction vs 30% in placebo
at Day 56.
• Durable effect with statistical improvements out to 1year.
PARA_OA_002
Safety & Dose Optimisation
• 6-week treatment, 18-week
follow-up, n=601.
• Confirmation of minimum
effective dose for phase 3
trial.
• Safety profile consistent
across all doses.
• Structural improvements via MRI at 6 months.
PARA_OA_012
Phase 3
Pain & Function
• 6-week treatment, 52-week follow-up, n~466
• Primary endpoint: Change from baseline in pain
• Key secondary endpoints:
• Change from baseline in function
• Patient Global Impression of Change (PGIC)
Phase 2
• Regulatory Alignment
• FDA feedback on clinical endpoints and statistical
procedures.
• Structural changes will be evaluated via X-ray and
MRI as secondary endpoints consistent with
regulatory guidance.
6
Osteoarthritis
Recap of PH2 results
Paradigm Biopharma
Phase 2: PARA_005
adjusted least squares
Pain Reduction KOOS
mean change from baseline. FAS.
2 mg/kg SC twice weekly v placebo for 6 weeks,
followed up for 6 months
adjusted least squares
Function ADL KOOS
mean change from baseline. FAS.
Patient Global Impression of Change (PGIC)
•
DEC 2024
PGIC significantly higher in the PPS group than placebo group at Day
56 (4.42 mean versus 3.42, respectively; mean difference between PPS
and placebo 1.0 [95% CI 0.24, 1.8]; p=0.0106).
LS Mean Change +/- Standard Error
FAS: Full Analysis Set
KOOS: Knee Injury and Osteoarthritis Outcome Score
8
Paradigm Biopharma
Phase 2: PARA_OA_008
DEC 2024
9
2 mg/kg IBW SC twice weekly v placebo for 6
weeks, followed up for 12 months (n=61)
A single 6-week course of twice-weekly iPPS demonstrates durable clinical outcomes out to 12 months
least squares adjusted mean
Function WOMAC
change from baseline. FAS.
least squares adjusted mean
Pain Reduction WOMAC
change from baseline. FAS.
p=0.045
p=0.054
Rescue medication use
•
5x lower cumulative use of rescue medication in iPPS group.
p=0.017
p=0.048
LS Mean Change +/- Standard Error
FAS: Full Analysis Set
WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index
Paradigm Biopharma
Market
Demand
iPPS Durability
Compared to
Current OA
Therapies
Current OA medication effect duration.
Representative infographic reflecting current
literature on the timing of the peak and estimated
duration of treatment effect of currently available
OA medications* and iPPS data from the
PARA_OA_008 clinical trial.
*References available in Day 365 ASX Release.
Phase 2 Data
01/04/21
DEC
2024
1010
Paradigm Biopharma
Para_OA_005
Exploratory
Endpoints
•
2 mg/kg SC twice-weekly v placebo
•
PPS showed significantly reduced serum levels of cartilage degradation biomarkers and
significant reduction in BML size as compared with placebo controls.
Reduction in size of bone marrow lesions
Grade 3
Grade 2
medial tibial BML
at baseline
medial tibial BML
at follow-up day 53
DEC 2024
Reduction in serum levels of COMP & CTX-II biomarkers
%
Mean change (%) of biomarker levels from baseline at day 53
20
15
10
Among subjects with
symptomatic knee OA,
a single measurement
of increased COMP
predicted subsequent
cartilage loss on MRI1.
5
0
-5
-10
-15
-20
-25
iPPS
-30
COMP
CTX-II
ADAMTS-5
p = 0.0024
p = 0.0116
p = 0.1925
placebo
11
Paradigm Biopharma
01/04/21
DEC
2024
Day 168 Top-Line Results – Changes in Synovial Fluid,
Serum, and Urinary Biomarkers
• Molecular biomarkers of cartilage degradation in iPPS-treated
subjects were favourable compared to placebo control.
Molecular
Biomarkers
PARA_OA_008
Molecular Biomarker
Day 168 iPPS v placebo
C2C (Se)
Reduced (p= 0.024)
CTX II (U)
Reduced
COMP (SF)
Reduced
COMP (Se)
Reduced
ARGS (SF)
Reduced (p=0.024)
ARGS (Se)
Reduced
ARGS = Aggrecan amino acids alanine, arginine, glycine, and serine; C2C = collagen type-II C-terminal cleavage
neoepitope; COMP = cartilage oligomeric matrix protein; CTX II = C-terminal crosslinked telopeptide type II collagen;
Se = serum; SF = synovial fluid; U = urine.
1212
Paradigm Biopharma
PARA_OA_008
DEC 2024
13
Top-Line Day 168
Quantitative MRI Results
Changes in Cartilage Thickness from baseline
• Twice weekly iPPS arm, demonstrated a
consistent pattern of improvement in cartilage
thickness across all key regions of medial and
lateral compartments at 6 months
• Placebo showed a loss in cartilage thickness in all
key regions at 6 months.
Cartilage Thickness (µm) Adj. CFB (abs.) LSM results by key regions of the
medial and lateral compartments in knee
• iPPS increased the cartilage thickness in the
central medial femur by 60µm (0.06mm)
compared to a reduction of -20µm (-0.02mm) in
the placebo group at 6 months.
• Placebo group demonstrated cartilage loss rate
consistent with the natural progression of knee OA
(-40µm or 0.04mm per year).
Osteoarthritis
Pivotal PH3 Trial
Paradigm Biopharma
DEC 2024
Positive FDA Update
FDA
approval to
commence
PH3 at
2mg/kg
dose
FDA review completed and PAR can proceed with PH3 trial as per company desired
protocol:
o
2mg/kg twice weekly for 6-weeks dose regimen.
o
466 patients randomised 1:1, double blinded, placebo control.
o
Primary endpoint: Change in baseline in pain at Day 112 (Average daily pain
score (ADP)).
o
Key Secondary: WOMAC Function at Day 112, Patient Global Impression of
Change (PGIC) at Day 112.
o
Secondary endpoints
§ WOMAC Pain and function assessments at multiple timepoints to Day 404.
o
§
IPPS effects on Rescue Medication use.
§
Stuctural changes via X-Ray and MRI from baseline day 168, 404
Site Activation
§
Approximately 10 sites in Australia expected to be activated
§
Approximately 50 sites anticipated in the US
§
High performing sites from PARA_OA_002 expected to participate.
15
Paradigm Biopharma
DEC 2024
16
PARA_OA_012 Phase 3
Follow-up Period 46 weeks
Treatment Period 6 weeks
Screening
PPS 2mg/kg (max 200 mg)
N = 233*
Placebo
N = 233*
Day
39
1
Last Inj.
First Injection
Projected Time
Objective
Q1 CY25
Start-up Activities – Australia.
Q1 CY25
First Patient enrolled
Q2 CY25
US Site Initiation
2H CY25
50% Recruitment
1H CY26
Interim Analysis
1H CY26
100% Recruitment
56
84
112
Interim
Analysis
140
168
224
280
336
404
End of Study
Interim Analysis (IA)
• Conducted once 50% of subjects (~233)
reach Day 112.
• Plan assess efficacy and possible early
conclusion of trial based on target effect size.
• DSMB to conduct Interim Analysis.
• Interim Analysis expected early CY26.
NB: Timelines are subject to funding and based on enrolment projections
and may be subject to change.
Paradigm Biopharma
DEC 2024
17
Valuation (Market Capitalisation ($Am)
Company
ASX PH3
Comparison
Table
Upside from
current
valuation
P3 Trial Indication
FDA
Designations
At IND Clearance
Current
~A$500
~A$880
Opthea Ltd (OPT)
Wet age-related macular
degeneration (Wet AMD)
Mesoblast Ltd (MSB)
Chronic heart failure
~A$1,500
~A$2,000
Immutep Ltd (IMM)
Metastatic non-small cell
lung cancer
~A$535
~A$470
Dimerix Ltd (DXB)
Focal segmental
glomeruloscler osis
(FSGS)
Orphan
~A$90
(May-22)
~A$200
Neuren
Pharmaceuticals Ltd (NEU)
Phelan-McDermid
syndrome (PMS)
Orphan
~A$500
(Mar-22)
~A$1,600
Botanix
Pharmaceuticals Ltd (BOT)
Primary axillary
hyperhidrosis
~A$190
(Oct-23)
~A$650
Paradigm
Biopharmaceuticals Ltd (PAR)
Osteoarthritis of the
knee
Fast track
Fast track
~A$180
Source: Market capitalisations are approximate only. IRESS as of 29 November 2024. NEU and BOT have since completed PH3 studies and are in
production likely to positively affect current market capitalisation above.
Paradigm Biopharma
DEC 2024
Current status
Nonconfidential
information
CDA
Confidential
Information
Non-binding
offer
Board
approval
Dataroom
access
Binding
offer
Board
approval
Final
negotiations
Deal
Ongoing Commercial Partnering Efforts
Current
Partnering
Activity
•
Active engagement with key potential partners to support and co-fund late-stage
development and future commercialisation.
•
FDA PH3 trial acceptance was a critical milestone to progress these discussions –
multiple parties in multiple regions in dataroom stage expected to move to binding
offers.
Region
Indication(s)
United States
OA
China
OA
South Korea
OA
Latin America
OA, MPS
Europe
MPS
18
Paradigm Biopharma
Funding position and use of funds
• Capital raising of A$16.0 million funds initiation of Phase 3 activities and early enrolment in Australia and the US.
• A$26.9m December pro forma cash balance post capital raising1. Non-dilutive funding from partnering or regional licensing deal to
materially extend its runway. In addition, loyalty options could raise an additional ~A$63.3 million from shareholders in early 2026.
Activity (A$m)
16.0
Global Initiation of Phase 3 clinical trial setup
5.5
Phase 3 clinical trial site recruitment initiation (Aus & key US sites)
6.1
Inventory and Manufacturing (Phase 3 and NDA submission)
1.5
NDA enabling studies
1.2
Working capital including new hires for Phase 3 Clinical trial and costs of Offer
1.7
1.
Cash balance of A$13.15 million as of 30 September 2024, expected December 2024 quarter spend of $7.00m maximum and R&D Refund provision estimate of $5.5m.
The above table is a statement of current intentions as at the date of this Presentation. Investors should note that, as with any budget, the allocation of funds set out in the above table may
change depending on a number of factors, including the outcome of sales performance, operational and development activities, regulatory developments, and market and general economic
conditions. In light of this, Paradigm reserves its right to alter the way the funds are applied. Some figures may be subject to rounding errors.
DEC 2024
19
Paradigm Biopharma
TGA
Feedback
on
Provisional
Pathway
DEC 2024
Paradigm received feedback from the TGA acknowledging that preliminary clinical
results for PPS show potential benefits for patients with moderate to severe knee
osteoarthritis (OA), although the TGA noted, OA at the milder end is not considered
seriously debilitating.
The TGA indicated:
o
Data (Phase 2 clinical data package and Phase 3 protocol) supports
pursuing full registration via the traditional pathway (CTX) rather than a
provisional determination application
o
Confirmed that execution of Paradigm’s proposed Phase 3 program, along
with comprehensive safety and efficacy data, will provide the evidence
needed for full registration of PPS in Australia.
Given the TGA feedback, Paradigm will proceed with the full registration of PPS in
Australia and not proceed down the Provisional Approval pathway.
20
Paradigm Biopharma
DEC 2024
21
News flow & catalysts
Upcoming
Catalysts
Event
Target Date
FDA 30-day review completion, proceed to Pivotal Phase 3 PARA_OA_012 trial
Complete
Australian Ethics Submission – Phase 3 PARA_OA_012
Q4 CY2024
Regional licensing agreement(s) in OA and MPS.
CY2025
PARA_OA_012 – First Australian participant enrolled.
Q1 CY2025
PARA_OA_012 – First US participant enrolled.
Q2 CY2025
PARA_OA_008 Peer Review Publications – 2 manuscripts submitted to separate journals
for review and anticipated publishing in CY25.
1H CY2025
PARA_OA_012 – 50% Recruitment of participants
2H CY2025*
PARA_OA_012 Interim Analysis – 50% participants reach Day 112
1H 2026*
*The above is a statement of current intentions as at the date of this presentation. Investors should note that the above upcoming events are subject to funding or new circumstances.
Paradigm Biopharma
Offer
Summary
Paradigm is
undertaking a
capital raising of
A$16.0 million.
Offer Structure
and Size
DEC 2024
• Placement to institutional, sophisticated and professional investors to raise A$16.0 million (Placement or
Offer).
• 40.0 million new fully paid ordinary shares (New Shares) to be issued under the Offer, representing
approximately 11.5% of existing Paradigm shares on issue (prior to the Offer).
• The Placement will utilise the Company’s existing 15% placement capacity under ASX Listing Rule 7.1.
Offer Price
• New shares under the Offer will be issued at A$0.40 per Share (Offer Price), representing:
o A ~10.6% discount to Paradigm's 15-day volume-weighted average price (VWAP) on Wednesday, 4
December 2024 of A$0.4474; and
o A ~2.9% premium to Paradigm’s 30-day volume-weighted average price (VWAP) on Wednesday, 4
December 2024 of A$0.3886.
Ranking
• New Shares issued under the Offer will rank pari passu with existing Paradigm shares on the date of issue.
Lead Manager
• Bell Potter Securities Limited ("Bell Potter") is acting as Sole Lead Manager and Bookrunner to the Offer.
Co-Manager
• Blue Ocean Equities Limited ("Blue Ocean") is a Co-Manager to the Offer.
Loyalty Options
• It is the Company’s current intention that every four (4) fully paid ordinary shares held on the record date of 4
business days following lodgement of a prospectus for the Loyalty Options will receive one (1) listed loyalty
option ("Loyalty Option"). Loyalty Options will be exercisable at A$0.65 and have an expiry date 12 months
after the record date.
• Upon exercise, every two (2) Loyalty Options will receive one (1) piggyback option, which is exercisable at
A$1.00, expiring 24 months from the expiry date of the Loyalty Option. The Company will release a
prospectus for the issue of Loyalty options in Q1CY25.
22
Paradigm Biopharma
DEC 2024
Indicative Offer Timetable
Event
Date
Trading halt
Thursday, 5 December 2024
Announcement of completion of Placement and recommencement of trading
Monday, 9 December 2024
Settlement of Placement
Thursday, 12 December 2024
Allotment and normal trading of New Shares issued under the Placement
Friday, 13 December 2024
This timetable is indicative only and subject to change. The Company reserves the right to vary the above dates and times, subject to ASX Listing Rules and the Corporations Act 2001
and other applicable laws.
23
Appendix
Paradigm Biopharma
Mechanism
of action
Pentosan Polysulfate Sodium (PPS)
NF-κB
• Multiple modes of action
• Previous phase 2B, SAS,
and EAP experience
• New phase 2 data
OA
Inflammation
TNF-α, IL-1β, IL-6
Pain
NGF, Prostanoids
MPS
Tissue Preservation
ADAMTS-4 & -5, MMPs
HA
Improved Blood
Flow
Cell-adhesion molecules
Anti-thrombotic effects
ARDS
HF
Viral
Arthralgia
Current hypothesis for PPS mechanism of action
DEC 2024
Immune
Cells
Sensory
Nerve
Cells
Tissue/
Cartilage
Cells
Capillary
Endothelial
Cells
ADAMTS = a disintegrin and metalloproteinase with thrombospondin motif; ARGS = aggrecan amino acids alanine, arginine, glycine,
and serine; NF-κB = nuclear factor kappa B; NGF = nerve growth factor; C2C = c-terminal telopeptide; COMP = cartilage oligomeric
matrix protein; CTX–II = Type II collagen; IL= Interleukin; TNF-α = tumor necrosis factor alpha; TIMP-1 = tissue inhibitor matrix
metalloproteinase 1.
25
Paradigm Biopharma
DEC 2024
26
26
Extensive
market
protection
•
•
Multiple method of use patents,
continually refined and expanded
with additional patents being
pursued.
IP portfolio expansion as new
data is obtained from clinical and
pre-clinical studies being
undertaken.
Complex
molecule
Alphavirus
Heart
Failure
?
Severe
OA
Exclusive
supply
Arthroplasty
Pain
Allergic
Rhinitis
ARDS
PPS universe of protection
MPS
Exclusive
supply
Psoriasis
BML
?
Pulmonary
Fibrosis
Complex
molecule
Paradigm Biopharma
Target
pricing
Pricing potential of Zilosul in P&F and
DM compared to price benchmark
• Achievable for P&F
label with PAR
current clinical
program
• Price is per course of
treatment.
• High gross margin
on sales.
Achievable price range (USD year)
Price points for comparators
Weak opioids
CS IA
HA IA
8000
$6K+
7000
6000
5000
4000
3000
2000
$2-3K1
DM
P&F
1000
0
US
1. Reasonable price - higher prices may be achievable but will likely trigger restrictions on use by payers
2. Zilosul is the registered name for iPPS for OA
P&F: iPPS Pain and Function
DM: iPPS Disease Modifying
CS IA: Corticosteroid
HA IA: Hyaluronic Acid
DEC 2024
27
Paradigm Biopharma
DEC 2024
28
Risk Factors
Shareholders should consider the investment in the context of their individual risk profile for speculative investments, investment objectives and individual financial circumstances. Each Shareholder should consult their own
stockbroker, solicitor, accountant or other professional adviser before deciding whether or not to invest in the New Shares offered under this document (Securities).
An investment in Securities should be regarded as very speculative and involves many risks. The Securities carry no guarantee with respect to the payment of dividends, returns of capital or the market value of those
Securities.
If any of the following risks actually occurs, our business, prospects, financial condition and results of operations could be materially and adversely affected, the trading price of the Shares could decline and you could lose all
or part of your investment.
This section identifies some of the major risks associated with an investment in the Company. Intending Applicants before any decision is made to subscribe for shares should read the Company's prior continuous
disclosure announcement to the ASX market in order to fully appreciate the risks particular to an investment in a medical device company such as Paradigm Biopharmaceuticals Limited and in particular the risks faced by
the Company in the continued development and proposed commercialisation of its intellectual property rights.
Paradigm’s assets and business is subject to a number of risk factors both specific to its assets / business and of a general nature which may impact on its future performance and forecasts. This is not an exhaustive list of
the relevant risks and the risks set out below are not in order of importance. Many of the risks below are outside the control of Paradigm and its directors. These risks and other risks not specifically referred to below, may in
the future materially adversely affect the value of Paradigm shares and their performance. Accordingly, no assurance or guarantee of future performance or profitability is given by Paradigm in respect of Paradigm shares
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