Upstream Bio (UPB) 43rd Annual J.P. Morgan Healthcare Conference 2025 summary

Strategic focus and pipeline development

• Focused on developing verecitug, a fully human IgG1 antibody targeting the TSLP receptor for severe respiratory diseases, including severe asthma, chronic rhinosinusitis with nasal polyps (CRSwNP), and COPD.

• Verecitug is the only known drug in development targeting the TSLP receptor, offering a differentiated mechanism compared to competitors targeting the ligand.

• Phase 2 programs are underway for severe asthma and CRSwNP, with a COPD program set to begin in the second half of the year.

• All phase 2 studies are designed as potentially registration-enabling trials, following established regulatory pathways.

• The company is not currently pursuing atopic dermatitis or other indications, focusing resources on respiratory diseases.

Clinical data and differentiation

• Verecitug demonstrates rapid, substantial, and sustained receptor occupancy and biomarker reduction, supporting infrequent dosing intervals (every 12 or 24 weeks).

• Phase 1 and multiple ascending dose studies show the drug is well tolerated, with a predictable pharmacokinetic profile and no significant immunogenicity.

• Reductions in FeNO and blood eosinophils are at least comparable, if not superior, to those observed with tezepelumab.

• PK/PD modeling indicates verecitug achieves higher potency, with EC50 and EC90 values approximately 300-fold lower than tezepelumab.

• Two dosing regimens (100 mg q12 weeks and 400 mg q24 weeks) are being tested in phase 2 severe asthma trials.

Market opportunity and competitive landscape

• Biologic sales in severe asthma are projected to grow at 6% annually through 2032, with sales potentially exceeding $12 billion.

• New, differentiated drugs can drive market penetration without eroding existing market share, as seen with Tezspire.

• Extended dosing intervals are highly attractive to prescribers, payers, and patients, with market research indicating strong preference for q12 or q24 week regimens.

• The competitive landscape is evolving rapidly, with most competitors targeting the ligand and using Fc engineering for extended dosing.

• Verecitug's unique MOA and robust data position it favorably in the long-acting TSLP space.