Summary of Altimmune Fireside Chat Company Overview - **Company**: Altimmune - **Focus**: Development of pemvidutide, a GLP-1/glucagon dual receptor agonist for treating serious liver diseases, particularly NASH (Non-Alcoholic Steatohepatitis) [3][4] Core Points and Arguments Pemvidutide and NASH - Pemvidutide is designed to have direct effects on the liver and provide metabolic benefits, primarily through weight loss [3][4] - Approximately 80% of NASH patients are overweight or obese, indicating that addressing both liver health and weight is crucial for treatment [4] - The drug shows significant reductions in liver fat, inflammation, and fibrosis, alongside weight loss [4] - Currently in a 48-week phase 2b trial for NASH, with 24-week data recently reported [5][6] Trial Design and Results - The phase 2b trial enrolled 212 patients with three treatment arms: placebo, 1.2 mg, and 1.8 mg of pemvidutide [6][7] - Class-leading NASH resolution was observed at the 24-week biopsy endpoint, exceeding results from other compounds [7][8] - Non-invasive tests showed robust anti-inflammatory and anti-fibrotic activity, with results indicating potential for FDA approval based on these tests [8][9] - The company plans to meet with the FDA to discuss transitioning from biopsy-based endpoints to non-invasive test-based endpoints for phase 3 trials [10][12] FDA Engagement and Future Plans - The company aims to align with the FDA on trial design, dose regimens, and endpoints during the end-of-phase 2 meeting [12][13] - Pemvidutide has shown excellent tolerability with no adverse event discontinuations, a significant advantage over other NASH treatments [15][17] - The company is preparing for phase 3 trials in NASH, expected to start in 2026 [5][10] Broader Implications and Market Position - The treatment landscape for NASH is evolving, with recent approvals for other drugs like semaglutide, which primarily focuses on metabolic components [23][24] - The combination of direct liver effects and weight loss in pemvidutide is positioned as a unique advantage over existing therapies [24][25] - The company is also exploring the use of pemvidutide in treating Alcohol Use Disorder (AUD) and Alcoholic Liver Disease (ALD), with ongoing trials [34][36] Additional Important Insights - The FDA has accepted applications for non-invasive tests, indicating a shift towards less invasive methods for evaluating liver health [9][10] - Pemvidutide's weight loss efficacy at the 2.4 mg dose was reported at 15.6% over 48 weeks, with potential for greater weight loss over longer periods [26][27] - The drug's ability to preserve lean mass during weight loss is highlighted as a critical factor, especially for older patients [28][29] - The company has received fast track status for AUD, emphasizing its commitment to addressing serious conditions related to obesity [39] Conclusion Altimmune is strategically positioned in the NASH treatment landscape with pemvidutide, focusing on both liver health and weight loss. The upcoming phase 3 trials and FDA meetings are critical milestones for the company's future in addressing serious liver diseases and related conditions.