Core Insights - Windtree Therapeutics has strengthened its cardiovascular patent estate with recent notifications of allowed patents for Istaroxime in Canada and Mexico, and a granted patent for pure SERCA2a activators in Israel [1][2][5] Patent Developments - The company now holds a total of 59 issued or allowed patents and 17 pending patents related to Istaroxime and its SERCA2a activators [1][2] - The cardiovascular patent estate includes patents for Istaroxime, dual mechanism SERCA2a activators, and pure SERCA2a activators aimed at treating heart failure, preventing arrhythmias, and addressing cardiogenic shock [2] Market Context - Heart failure affects approximately 60 million people globally, with around 20 million annual hospital admissions due to acute heart failure, including 1.5 million in the US [3] - Current treatment options for acute heart failure are limited and can lead to side effects such as arrhythmias and renal function issues [4] Product Profile - Istaroxime is a first-in-class dual-mechanism therapy designed to enhance both systolic and diastolic cardiac function, showing significant improvement in cardiac function and blood pressure without increasing heart rate or causing significant cardiac rhythm disturbances [7] - The pure SERCA2a activators are being evaluated in preclinical studies, including both oral and intravenous formulations for heart failure [8]

Summary of Edgewise Therapeutics FY Conference Call Company Overview - **Company**: Edgewise Therapeutics (NasdaqGS:EWTX) - **Event**: 2025 Healthcare Innovations Conference - **Date**: November 11, 2025 Key Points Industry and Product Focus - Edgewise Therapeutics is focused on developing treatments for hypertrophic cardiomyopathy (HCM) and heart failure with preserved ejection fraction (HFpEF) [1][2] PART-D Study Insights - The PART-D data is expected to be released by the end of the year, with ongoing discussions about the efficacy data from the 25 mg dose [7][9] - Initial data from the PART-BC study showed no correlation between ejection fraction changes and drug concentration, indicating a differentiated profile compared to current treatments [2][13] - The company has faced enrollment challenges but has implemented measures to ensure a representative patient group [4][6] Efficacy and Safety Observations - Significant improvements were noted in patient feel and function, as measured by New York Heart Association (NYHA) changes and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores [2][21] - The compound was generally well tolerated, with a few cases of atrial fibrillation observed, which is common in HCM patients [2][3] - The company aims to eliminate the need for multiple echocardiograms in dosing, which is a barrier for many cardiology practices [14][15][20] Competitive Landscape - Edgewise's drug aims to provide a safer alternative to current treatments that require titration and monitoring of ejection fraction [14][15] - The company believes that their drug can be a first-line treatment for patients with borderline ejection fraction, potentially replacing current therapies that have safety concerns [16][17] Future Studies and Registration Plans - Plans for future studies include potentially head-to-head trials against beta blockers and similar studies to previous successful trials [27][30] - The primary endpoints for future studies will likely include KCCQ and NT-proBNP levels, with a focus on achieving significant clinical benefits [33][37] HFpEF Program Development - The company plans to initiate a phase 2A study in HFpEF, focusing on NT-proBNP as a primary measure of efficacy [36][38] - The anticipated timeline for this study is in 2026, with a focus on patient tolerability and dose range [37][38] Sarasantan and DMD Strategy - Discussions are ongoing regarding the registration study for Sarasantan in Duchenne Muscular Dystrophy (DMD), with a focus on patient backgrounds and competitive landscape [39][40] - The company is considering using SV95 as a primary endpoint for DMD studies, pending discussions with regulatory agencies [42][43] Financial Position - Edgewise Therapeutics has $560 million in cash, which is expected to fund operations through 2028, supporting their commercialization plans [47][51] Conclusion - Edgewise Therapeutics is positioned to make significant advancements in the treatment of HCM and HFpEF, with promising data and a strong financial foundation to support ongoing and future studies [52][56]

Financial Data and Key Metrics Changes - The company reported a net loss of $134.4 million or $1.12 per share for Q2 2025, an improvement from a net loss of $143.3 million or $1.31 per share in Q2 2024 [33] - Cash, cash equivalents, and investments decreased to approximately $1.04 billion from $1.09 billion at the end of Q1 2025 [32] - R&D expenses increased to $112.6 million from $79.6 million in the same period last year, primarily due to advancing clinical trials and higher personnel costs [32] - G&A expenses rose to $65.7 million from $50.8 million, attributed to investments in commercial readiness and personnel costs [32] Business Line Data and Key Metrics Changes - The company is advancing its clinical trials for aficamtan, with positive top-line results reported from the Maple HCM trial, showing significant improvement in peak oxygen uptake compared to metoprolol [22][11] - The Acacia HCM trial for non-obstructive HCM is fully enrolled, with expected top-line results in 2026 [11][27] - The company is also progressing in its trials for omecamtiv mecarbil and CK-586 (now called ulicamten), with ongoing enrollment in the COMMID HF and AMBER HFpEF trials [30][29] Market Data and Key Metrics Changes - The company is targeting Germany for its first potential launch of aficamtan following EMA approval in 2026, with ongoing preparations for commercial readiness across multiple EU countries [21][9] - In the U.S., the company is focused on recruiting a world-class sales force, with nearly all territories filled, and expects to have the sales team trained by Q4 2025 for a Q1 2026 launch [15][14] Company Strategy and Development Direction - The company aims to be a leading muscle-focused specialty biopharma, with a vision to improve patient lives through global access to innovative medicines [5] - The strategy includes enhancing commercial launch readiness for aficamtan, optimizing distribution networks, and engaging key stakeholders [10][16] - The company is also focused on expanding its market presence in both the U.S. and Europe, with a clear plan for regulatory submissions and commercial strategies [37][21] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the regulatory position of aficamtan, citing strong clinical data and ongoing dialogue with the FDA [7][6] - The company anticipates significant growth opportunities as it approaches key milestones, including potential approvals in the U.S., Europe, and China [36][9] - Management highlighted the importance of addressing unmet needs in heart failure and HCM, positioning aficamtan as a potential first-line treatment option [12][11] Other Important Information - The company has received a PDUFA date extension for aficamtan to December 26, 2025, with a late cycle review meeting scheduled for September [5][6] - The company is actively engaging with payers to educate them on the clinical and economic burden of HCM, aiming to build foundational health economics models [19][20] Q&A Session Summary Question: Can you elaborate on the MAPLE data and its potential impact on treatment guidelines? - Management indicated that the MAPLE data could lead to a reevaluation of treatment guidelines, particularly regarding the superiority of aficamtan over metoprolol in exercise tolerance [41][44] Question: What are the key factors that will support Acacia's success compared to Kymzios? - Management emphasized the importance of trial design and dosing regimens, noting that Acacia's optimized approach could lead to better outcomes [48][50] Question: What does an ideal label for aficamtan look like? - Management stated that an ideal label would reflect the engineered properties of aficamtan and its clinical trial results, supporting differentiation in the market [53][56] Question: What are the expectations for REMS differences between the U.S. and EU? - Management noted that while the EU does not have a formal REMS program, they anticipate similarities in risk mitigation strategies across both regions [77][78] Question: How will the company approach the market opportunity in non-obstructive HCM? - Management indicated that the initial physician target list would remain the same, with potential expansion of the sales force depending on market dynamics [83][90]

Barostim Device & Clinical Trial Results - Barostim improves exercise capacity in HFrEF patients, showing a 19%-20% improvement versus the control arm in clinical trials[19, 37] - The BeAT-HF pivotal trial demonstrated a clinically meaningful improvement of 60 meters in exercise capacity and a -14 point change in quality of life for Barostim patients[27, 28] - The BeAT-HF pivotal trial showed a 25% reduction in NT-proBNP levels with Barostim, which is considered clinically meaningful[34] Market Opportunity & Patient Identification - The initial annual market opportunity for Barostim in the U S and the five largest EU countries is estimated at $2 9 billion[44] - The U S market consists of 6 3 million patients, while the 5 EU countries have 8 6 million patients[42] - The initial addressable patient incidence rate is 55,000 patients per year in the U S and 61,000 patients per year in the 5 EU countries[42] - Patient identification for Barostim is straightforward, based on NYHA II/III symptoms, LVEF ≤ 35%, and NT-proBNP < 1600pg/ml[47] Commercial Strategy & Financial Performance - The company aims to add 3 new account managers every quarter to create new territories and activate implanting centers[58] - The goal is to have 5 active implanting centers per territory, with each center implanting 12 Barostim units per year[58] - Full year 2022 revenue was $7 0 million - $7 1 million, with US HF revenue at $5 9 million (+118%)[67] - The company projects total revenue between $35 0 million and $38 0 million for the full year of 2023[68]

Market Opportunity & Disease Burden - Heart failure affects over 6 million people in the U S [9], leading to over 1 1 million hospital discharges and over 1 3 million emergency room visits annually [11] - The annual costs associated with heart failure are expected to reach $70 billion by 2030 in the U S [11] - The U S annual net addressable market for Barostim is estimated at $2 2 billion, assuming an average selling price (ASP) of $29,000 [37] Barostim Therapy & Clinical Evidence - Barostim is presented as a neuromodulation therapy designed to improve heart failure symptoms [8] - Barostim implantation is a 60-minute procedure with a 97% freedom from major complications [46, 48] - Real-world evidence demonstrates an 85% relative reduction in hospital visits per year post-Barostim implant (average 1 92 years) compared to pre-implant (12 months) [67] Financial Performance & Guidance - Worldwide revenue for 2024 was $51 3 million, representing 31% growth [87, 88] - The gross margin for 2024 was 84% [87, 88] - The company's revenue guidance for full year 2025 is $55 0 – $58 0 million, with a gross margin of 83% – 84% and operating expenses of $95 0 – $98 0 million [90]

Financial Performance & Position - FUROSCIX achieved \$12.2 million in Q4 2024 net revenue, a 21% sequential increase from Q3 2024[7,47] - Full Year 2024 net revenue reached \$36.3 million, up 167% from Full Year 2023[7,47] - The company held \$75.7 million in cash and cash equivalents as of year-end 2024[8] FUROSCIX & Market Opportunity - FUROSCIX is indicated for congestion due to fluid overload in adult patients with chronic heart failure, delivering 80 mg/10 mL dose over 5 hours with 99.6% bioavailability[16] - The addressable US market opportunity for heart failure is estimated at \$9.9 billion[11,39] - The average cost of a heart failure hospitalization is \$11,840, with heart failure patients representing 33% (\$123B) of annual Medicare Part A and B spending[25] Clinical Study Results - The AT HOME-HF Study showed FUROSCIX subjects demonstrated augmented decongestion vs enhanced oral diuretics, with a 37% relative risk reduction in heart failure hospitalizations[21,23] - The Autoinjector PK/PD study achieved a bioavailability of 107.3% (90% CI: 103.9 – 110.8) compared to IV furosemide[84] Long-Term Growth Initiatives - The company received FDA approval for expanded FUROSCIX indication to include NYHA Class IV heart failure patients on August 9, 2024, representing approximately 10% of all heart failure patients[58,59] - The company received FDA approval for Chronic Kidney Disease indication on March 6, 2025, with launch planned in April 2025[9,57] - The addressable market opportunity for Chronic Kidney Disease is estimated at \$3.32 billion, targeting 0.7 million FUROSCIX addressable CKD fluid events[75] - The company is targeting an sNDA submission to the FDA for the 80mg/1mL FUROSCIX Autoinjector in 2025, which could reduce COGS by approximately 70%[9,56,82]

Financial Data and Key Metrics Changes - Revenue for Q1 2025 was $12.3 million, representing a 15% increase compared to Q1 2024 [4][17] - Gross profit was $10.3 million, a 13% increase year-over-year, with a gross margin of 84% [19] - Net loss for Q1 2025 was $13.8 million, or $0.53 per share, compared to a net loss of $22.2 million, or $1.04 per share in Q1 2024 [21] - Cash and cash equivalents as of March 31, 2025, were $102.7 million [21] Business Line Data and Key Metrics Changes - Heart failure revenue in the US totaled $11.1 million for Q1 2025, up from $9.7 million in Q1 2024 [17] - The number of active implanting centers in the US increased to 227 from 223 as of December 31, 2024 [18] - Revenue generated in Europe was $1.1 million for Q1 2025, a 23% increase year-over-year [18] Market Data and Key Metrics Changes - The number of sales territories in the US decreased by three to a total of 45 [18] - Total revenue units in Europe increased to 59 for Q1 2025 from 44 in the prior year [19] Company Strategy and Development Direction - The company is focused on three strategic priorities: building a world-class sales organization, targeting high-potential centers, and addressing barriers to adoption [7][8][9] - A new compensation plan was introduced to align with a program-focused selling approach, generating strong enthusiasm among the sales team [8] - The company is working with CMS to create a level six neurostimulator APC within the outpatient prospective payment system [9][10] Management's Comments on Operating Environment and Future Outlook - Management remains optimistic about long-term prospects despite Q1 revenue performance, citing low exposure to macroeconomic uncertainties [23][24] - The company expects to see productivity improvement and account stabilization as new sales representatives gain experience [5][16] - Management highlighted the importance of compelling clinical evidence, including an 85% reduction in heart failure hospitalizations, to drive adoption [25] Other Important Information - R&D expenses decreased by 18% to $2.5 million, driven by a reduction in consulting expenses [20] - The company plans to conduct a pragmatic randomized controlled trial to expand its total addressable market [15] Q&A Session Summary Question: How much of the sales force changes were self-inflicted versus natural turnover? - The majority of changes were initiated by the company due to a reevaluation of the sales organization [27][28] Question: What does the 2025 guidance imply regarding new center additions and overall utilization? - The company expects high single to low double-digit new center additions and plans to add around three territories per quarter [31][32] Question: How much of the softness in Q1 was related to seasonality versus sales rep challenges? - The majority of the softness was attributed to disruptions in the sales team rather than seasonality [37][38] Question: What is the current mix of the sales team in terms of tenure? - About 50% of territory managers were hired in the last 15 months, with the other half being more tenured staff [41] Question: Are there specific patient segments where Barostim adoption has shown good signs of penetration? - There is no specific patient segment; the adoption is more dependent on physician behavior and conservatism [60] Question: What are the timelines for the potential randomized controlled trial? - The company hopes to reach an agreement with the FDA in the next month or two and plans to enroll between 1,000 to 2,000 patients across 100 to 150 centers [68][69]