Core Insights - Fractyl Health, Inc. announced positive results from the REVEAL-1 Cohort, showing that participants who lost 24% of total body weight on GLP-1 drugs maintained stable weight and glycemic control six months after a single Revita treatment [1][3][6] - Revita demonstrated a mean weight change of 1.5% after six months, significantly lower than the ~10% weight regain observed in third-party studies following GLP-1 withdrawal [1][6] - The company anticipates key clinical data releases in 2026, including the REMAIN-1 Midpoint Cohort data in January and potential PMA filing in H2 2026 [1][13] Company Overview - Fractyl Health focuses on innovative treatments for obesity and type 2 diabetes, aiming to transform metabolic disease management from chronic symptomatic treatment to durable, disease-modifying therapies [11] - The company has a robust intellectual property portfolio with 35 granted U.S. patents and approximately 45 pending applications [11] - Revita, the company's lead product, is designed to remodel the duodenal lining to reverse damage caused by unhealthy diets, and has received FDA Breakthrough Device designation for weight maintenance after GLP-1 drug discontinuation [12] Study Details - The REVEAL-1 Cohort included 22 participants who had lost at least 15% of their body weight on GLP-1 medications and chose to discontinue therapy [9][10] - Participants maintained stable weight and minimal change in HbA1c levels after the Revita procedure, indicating potential for long-term metabolic health [6][8] - The study reported excellent tolerability, with no serious adverse events and mild, transient treatment-emergent adverse events in 36% of participants [6][8] Future Outlook - Fractyl Health is preparing for multiple clinical readouts in 2026, including 1-year data from the REVEAL-1 Cohort and the REMAIN-1 Pivotal Cohort [13] - The company is experiencing rapid clinical enrollment in its pivotal studies, reflecting a strong demand for non-drug alternatives in obesity treatment [8]

Core Insights - Fractyl Health is addressing the critical need for weight maintenance solutions post-GLP-1 therapy, with strong demand from patients and physicians for its REMAIN-1 study [2][4] - The company plans to submit the first Clinical Trial Application (CTA) module for RJVA-001 in type 2 diabetes in H1 2025, with preliminary data expected in 2026 if authorized [7][20] - 2025 is anticipated to be a pivotal year for Fractyl, with multiple key clinical milestones ahead [3] Company Developments - Fractyl Health reported significant progress in the REMAIN-1 pivotal study, enrolling over 189 patients across 13 clinical sites within six months [4] - The company has paused investment in its Revita programs for type 2 diabetes to focus exclusively on weight maintenance through the REMAIN-1 study [10] - The Revita product candidate aims to remodel the duodenal lining to reverse damage caused by high-fat and high-sugar diets, and has received U.S. FDA Breakthrough Device designation for weight maintenance [18] Financial Performance - For Q4 2024, Fractyl reported a net loss of $25.0 million, compared to a net loss of $19.2 million in Q4 2023, attributed to increased operating expenses [14] - Research and development expenses rose to $20.3 million in Q4 2024 from $10.1 million in Q4 2023, primarily due to advancements in the REMAIN-1 study [12] - As of December 31, 2024, the company had approximately $67.5 million in cash and cash equivalents, sufficient to fund operations through key clinical milestones into 2026 [15]

Table of Contents Registration No. 333-276046 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 AMENDMENT NO. 1 to Index to Financial Statements FORM S-1 REGISTRATION STATEMENT UNDER As filed with the Securities and Exchange Commission on January 29, 2024. THE SECURITIES ACT OF 1933 FRACTYL HEALTH, INC. (Exact name of registrant as specified in its charter) (State or other jurisdiction of incorporation or organization) Delaware 3841 27-3553477 (Primary Standard Industrial Classificatio ...

Table of Contents Index to Financial Statements As filed with the Securities and Exchange Commission on December 14, 2023. Registration No. 333- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM S-1 REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933 FRACTYL HEALTH, INC. Harith Rajagopalan, M.D., Ph.D. Chief Executive Officer Fractyl Health, Inc. 17 Hartwell Avenue Lexington, MA 02421 (781) 902-8800 (Name, address, including zip code, and telephone number, including area code, ...