Summary of Biogen's Conference Call on Felzartamab and Nephrology Developments Company and Industry Overview - **Company**: Biogen - **Industry**: Biopharmaceuticals, specifically focusing on nephrology and autoimmune diseases Key Takeaways from ASN Meeting - The ASN meeting highlighted a significant shift towards innovative therapies in nephrology, emphasizing the potential for cures rather than just managing complications of kidney diseases [3][4] - There is a growing enthusiasm for new therapies that could transform treatment paradigms in nephrology [3] Felzartamab (Felza) Overview - Felzartamab is a targeted therapy developed for severe immune diseases, particularly focusing on conditions like IgA nephropathy and antibody-mediated rejection (AMR) [5][6] - The therapy targets CD38, which is expressed on antibody-producing cells, offering a novel approach in treating autoimmune diseases [9][10] Indications and Clinical Studies - Initial indications for Felza include: - **IgA Nephropathy**: Demonstrated durable treatment effects extending beyond dosing intervals, with significant efficacy observed in early studies [12][14] - **AMR**: A small phase two study showed an 80% resolution rate in microvascular inflammation, indicating transformative efficacy [12][24] - **Primary Membranous Nephropathy (PMN)**: Targeting high-risk patients who are refractory to existing therapies [33] Competitive Landscape and Market Positioning - The treatment landscape for IgA nephropathy is evolving, with multiple therapies expected to enter the market soon, including foundational therapies and targeted therapies [15][16] - Felza is positioned as a disease-modifying therapy that may provide a durable response without the need for continuous dosing, unlike other therapies that require ongoing administration [17][18] Regulatory and Development Strategy - The primary endpoint for the phase three AMR study is the resolution of AMR by histology, with a focus on durability and stabilization of kidney function [29][30] - The anticipated timeline for AMR data is 2027, with a filing expected in 2028, followed by studies for isolated microvascular inflammation and PMN [36][37] Safety and Efficacy Considerations - Long-term safety data is still needed, as current studies have been relatively small and of short duration [18] - The potential for combination therapies and patient preferences will play a crucial role in treatment decisions [18][22] Future Directions and Insights - Ongoing research aims to deepen the understanding of disease mechanisms, particularly the role of NK cells in AMR and the complexities of antibody-mediated diseases [40][41] - Biogen is exploring subcutaneous dosing options for Felza to improve patient access and tolerability [38] Conclusion - Biogen is at the forefront of advancing Felzartamab in nephrology, with promising data and a strategic approach to addressing significant unmet needs in autoimmune kidney diseases [42][43]

Biogen's Strategic Direction - Biogen is broadening its portfolio across Neuro, Immunology & Rare Disease, aiming for long-term sustainable growth[4,17] - Approximately 50% of Biogen's total company revenue is projected to come from outside of MS, including Biosimilars[17] Felzartamab's Potential in Nephrology - Felzartamab targets CD38-expressing cells, offering a differentiated approach for antibody-mediated diseases[27,29] - Phase 3 programs for Felzartamab are underway, targeting Antibody Mediated Rejection (AMR), IgA Nephropathy (IgAN), and Primary Membranous Nephropathy (PMN)[106] Antibody Mediated Rejection (AMR) - Late AMR affects approximately 11,000 patients in the U S, with >75% transplant loss and a median graft survival of ~2 years after diagnosis[36,37,40] - In a Phase 2 study, Felzartamab treatment resulted in >80% biopsy late AMR resolution at week 24, compared to 20% in the placebo group[53] - A Phase 3 study for Felzartamab in late AMR is underway, with data expected in 2027[56] IgA Nephropathy (IgAN) - IgAN affects approximately 130,000 patients in the U S, with up to 40% of patients reaching end-stage kidney disease within 20 years of diagnosis[61] - Phase 2 data showed that with 5 months of Felzartamab treatment, patients had sustained clinical benefit out to 2 years, with ~50% UPCR reduction at 24 months in the 9-dose group[69,71] - A Phase 3 study for Felzartamab in IgAN is designed to demonstrate improvement in kidney function, with data expected in 2029[74] Primary Membranous Nephropathy (PMN) - PMN affects approximately 36,000 patients in the U S, with up to 40% progressing to end-stage kidney disease within 15 years[80,81,103] - Phase 2 data showed robust and sustained reductions in anti-PLA2R and improvements in both newly diagnosed/relapsed (NDR) and refractory PMN patients[103] - A Phase 3 study for Felzartamab in PMN is designed to demonstrate complete remission of proteinuria, with data expected in 2029[100]