Core Insights - Denali Therapeutics Inc. announced the publication of results from the Phase 1/2 clinical trial of tividenofusp alfa for Hunter syndrome, with FDA Priority Review for its Biologics License Application expected by April 5, 2026 [1][5] Company Overview - Denali Therapeutics is focused on developing biotherapeutics that can cross the blood-brain barrier using its proprietary TransportVehicle™ platform [13] - The company is advancing a portfolio of therapeutic candidates aimed at treating neurodegenerative and lysosomal storage diseases [13] Clinical Trial Results - The Phase 1/2 trial involved 47 participants, showing that tividenofusp alfa significantly reduced central nervous system and peripheral biomarkers of substrate accumulation and neuronal injury [3][6] - Key findings included a 91% reduction in cerebrospinal fluid levels of heparan sulfate and an 88% reduction in urine levels at Week 24, with normalization of liver volume and improvements in hearing and cognitive skills [11][5] Treatment Mechanism - Tividenofusp alfa is designed to deliver the iduronate 2-sulfatase enzyme to the brain and body, addressing both neurological and physical symptoms of Hunter syndrome [4][7] - The treatment has received multiple designations from the FDA, including Rare Pediatric Disease Designation and Breakthrough Therapy Designation [7] Future Developments - Denali is conducting the Phase 2/3 COMPASS study to support global approval, comparing tividenofusp alfa with standard treatment idursulfase [8] - The company is also exploring the potential of its TransportVehicle platform for delivering other therapeutic agents, including antibodies and oligonucleotides [12]

Denali Therapeutics Investor Day Summary Company Overview - **Company**: Denali Therapeutics (NasdaqGS:DNLI) - **Event**: 2025 Investor Day - **Date**: December 04, 2025 Key Messages 1. **Biotherapeutics Delivery**: Denali aims to deliver biotherapeutics to the entire body, including the brain, utilizing their transferrin receptor-enabled technology, which enhances delivery to hard-to-reach tissues [2][3] 2. **Market Opportunity**: The company is poised to capture a billion-plus opportunity in enzyme replacement therapies with their ETV franchise, addressing a significant unmet need in the market [4][5] 3. **Focus on Alzheimer's**: Denali is focusing on Alzheimer's disease, leveraging their transport vehicle technology to enhance treatment efficacy [5][6] 4. **Execution Strategy**: The company emphasizes efficient execution and capital allocation to expand their programs quickly and cost-effectively [6][9] Transport Vehicle Technology - **Innovation**: Denali's transport vehicle technology allows for the delivery of enzymes, oligonucleotides, and antibodies across the blood-brain barrier and to other tissues [6][11] - **Clinical Validation**: The technology has been validated through clinical data, demonstrating its ability to enhance delivery to the brain and other tissues [12][14] - **Competitive Landscape**: Denali is positioned as a leader in transferrin receptor-enabled therapeutics, with multiple clinical stage programs and a robust pipeline [15][16] Enzyme Replacement Therapy (ERT) Franchise 1. **Market Potential**: The combined market opportunity for Hunter syndrome (MPS II) and Sanfilippo syndrome (MPS III) is estimated at around $1 billion [16][17] 2. **Patient Population**: Over 30,000 individuals are living with lysosomal storage disorders, with a significant portion experiencing CNS manifestations [17][18] 3. **Regulatory Updates**: Denali has signed a deal with Royalty Pharma potentially worth up to $275 million, contingent on the approval of their drug tividenofusp alfa (TIVI) [6][7] 4. **Clinical Progress**: The company has made significant progress with TIVI, including a late-cycle meeting with the FDA and ongoing label negotiations [8][58] Clinical Data Highlights - **TIVI Efficacy**: Clinical data show greater than 90% reduction in cerebrospinal fluid heparan sulfate levels, indicating effective treatment for MPS II [54][55] - **Safety Profile**: The primary adverse events associated with TIVI are infusion-related reactions, which are generally mild to moderate and decrease over time with continued treatment [56] - **Ongoing Studies**: The COMPASS study is a pivotal trial comparing TIVI to the current standard of care, idursulfase, focusing on both neurological and peripheral outcomes [57][58] Future Outlook - **D3 Strategy**: Denali's strategy focuses on discovering, developing, and delivering innovative therapies, with a goal of launching multiple clinical stage programs in the next few years [9][10] - **Long-term Vision**: The company aims to build a strong portfolio of clinical and commercial products, addressing both immediate and long-term patient needs in lysosomal storage disorders [10][11] Additional Insights - **Unmet Needs**: There is a significant unmet need in treating neurodegenerative aspects of lysosomal storage disorders, particularly in MPS II and MPS III, where current therapies do not adequately address CNS manifestations [33][41] - **Patient Advocacy**: The involvement of patient advocates and experts in the field highlights the importance of addressing the needs of individuals affected by these disorders [19][20] This summary encapsulates the key points discussed during Denali Therapeutics' Investor Day, focusing on their innovative approaches, market opportunities, and the clinical landscape surrounding their therapies.

Core Insights - Denali Therapeutics Inc. announced that the FDA has accepted the Biologics License Application (BLA) for tividenofusp alfa, seeking accelerated approval for the treatment of Hunter syndrome, with a target action date of January 5, 2026 [1][7]. Company Overview - Denali Therapeutics is a biotechnology company focused on developing therapies that can cross the blood-brain barrier (BBB) for neurodegenerative and lysosomal storage diseases [9]. - The company utilizes a proprietary TransportVehicle™ platform designed to deliver large therapeutic molecules across the BBB, enhancing drug efficacy [8]. Product Details - Tividenofusp alfa is an investigational enzyme replacement therapy designed to address both neurological and physical symptoms of Hunter syndrome by delivering the iduronate 2-sulfatase (IDS) enzyme into the brain and body [2][4]. - The therapy has received Fast Track and Breakthrough Therapy designations from the FDA, as well as Priority Medicines designation from the European Medicines Agency [4]. Clinical Studies - The BLA submission is supported by data from a Phase 1/2 study involving 47 participants with Hunter syndrome [3]. - Denali is conducting an ongoing Phase 2/3 COMPASS study to support global regulatory approvals, with participants randomized to receive either tividenofusp alfa or idursulfase [5]. Disease Context - Hunter syndrome (MPS II) is a rare genetic disorder caused by a deficiency in the IDS enzyme, leading to the accumulation of glycosaminoglycans and resulting in cognitive decline, behavioral issues, and physical complications [6]. - Current therapies do not effectively address neurological symptoms due to their inability to cross the BBB, highlighting the unmet need for new treatments [6].