Upstream Bio (UPB) Piper Sandler 36th Annual Healthcare Conference summary

Differentiation and mechanism of action

• Verekitug is a monoclonal antibody uniquely targeting the TSLP receptor, unlike competitors that target the ligand, conferring specific pharmacological advantages.

• Rapid and sustained receptor occupancy is achieved, with 100% occupancy lasting up to 24 weeks post-dose, enabling extended dosing intervals.

• Extended dosing is an intrinsic property of the molecule, not due to Fc engineering, differentiating it from other long-acting biologics.

• Preclinical and clinical data show substantial reductions in disease biomarkers, supporting efficacy.

• Market research indicates dosing interval alone is a powerful differentiator, driving theoretical uptake.

Clinical development and trial progress

• Phase 2 trial in severe asthma is well into enrollment, with top-line data expected in the second half of 2026.

• The VIBRANT study in chronic sinusitis with nasal polyps is progressing on track, with data expected in the second half of the year.

• Both studies are robustly designed, placebo-controlled, and powered to detect clinically meaningful differences.

• The asthma study aims for a 50% reduction in annualized exacerbations, comparable to Dupilumab.

• A phase 2 study in COPD is planned to start in the second half of 2025, with design details to be finalized.

Market landscape and opportunities

• The severe asthma biologics market is valued at $7.5 billion annually, with a projected CAGR of 5–6% over the next decade.

• Biologics penetration in eligible patients is about 25%, indicating significant growth potential.

• New entrants with novel mechanisms and improved dosing can gain significant share, often expanding the market rather than displacing competitors.

• There is a clear trend toward long-acting therapies, with the potential to be the second long-acting drug in severe asthma if approved.

• The chronic sinusitis with nasal polyps market is estimated at 900,000 eligible patients, with potential for expansion as treatment guidelines evolve.