Summary: Bullish Abivax: P2b success confirmed and exceeded in Phase 3, implying stock upside ahead.

Abivax SA listed on Nasdaq as ABVX; UC Phase 3 context matches

@willkyi Abivax succeeded in P2b 4 years ago and just exceeded those results in phase 3.  Cleared for takeoff 🫡

@A_May_MD The AMTI rise and fall in 2019-2022 is a good case study on UC hype.

Literally 8-9x ipo price at peak and a 99% subsequent fall from a failed phase 2b is sorta indicative of what large pharma expects from this indication


Summary: Rotating out of relative outperformer FATE into more NKTR; overall net long position increasing.

structural marker; pre-classified as canonical yfinance ticker

@stockblues Not selling anything except for (relative) over performers such as $FATE in order to buy more underperformers such as $NKTR

I have never been more net long.

@A_May_MD You bailing on anything at this point or just holding still?  Beat down city.  I expected nktr to run into data.  Seems so low it can’t get worse but I am proven wrong every day haha.  Brutal conditions out there.


Summary: Bullish NKTR: Wall Street underestimates the unmet clinical need for rezpeg in eczema patients who can't tolerate Dupixent.

@Amy11621 I see this often as a dermatologist and would use $NKTR rezpeg is many of these cases.  For some reason Wall Street seems to be behind on understanding the huge unmet need here.

@A_May_MD Dupixent worked great on my eczema but made my eyes ache and gave me blurry vision to the degree I struggled to work. I had to stop. I found NKTR while searching for alternatives and invested after seeing the data. Lots of us need this! Fingers crossed on both angles!


Summary: Expects Uplizna's MG launch to beat expectations at Dec 2025 PDUFA, bullish on the drug/company.

Uplizna now owned by Amgen (AMGN) after Horizon Therapeutics acquisition

@drug_smolecules Will beat expectations in MG too 🫡

Uplizna shaping up to be a decent drug; $176M in 2Q25 vs $91M 1Q25

Approved for IgG4-RD only in April

MG PDUFA in Dec'25 https://t.co/38zLrG9MNB


Summary: Bought VKTX at new 52W low; currently long on valuation after being bearish on drug superiority claims.

My point all along has been that people saying the $VKTX drug is superior to Tirzepatide are demonstrably wrong.  I stand by that *despite* currently being long.

I’ve also said that the oral data would be a “sell the news” event because the oral API won’t scale.  I was right.

I also said that a manufacturing deal would be a sell the news/non event.  I was right.

Now the stock traded at a new 52W low today and I bought it.

So what’s your problem?  Are you just upset that I’ve been playing the stock right all along?

Stocks trade on valuations don’t they?  We aren’t collecting stocks for fun here.  Pretty sure it’s a part of intelligent investing to buy low and sell high.  That’s not a revelation to you is it?

Grow up and quit whining.

You people are mad when I’m bearish $VKTX and somehow still butthurt when I’m bullish.  Ridiculous.

This guy all long didn’t like the data and took every opportunity to focus on SE profile of 2735.  Now all of a sudden claims to be long based on valuation ? If he stated his thesis on valuation concerns earlier that’s one thing but data hasn’t changed & co inking a manufacturing


They just aren't going to be able to compete with $LLY with how much better TZP is

Summary: Bullish LLY; Novo Nordisk can't compete given tirzepatide's clinical superiority.

@DrNadolsky @novonordisk @EliLillyandCo Autoinjector delivering a peptide at that price point…not gonna make enough money.  They just aren’t going to be able to compete with $LLY with how much better TZP is.

Hey @novonordisk some free marketing advice on how you compete with @EliLillyandCo

Make Wegovy $199 a month with a clickable pen (like Ozempic).

That’s it.

Anything else I don’t think you can compete.


16% lower rate of death on $LLY Mounjaro. I know which one I'd take

Summary: Bullish LLY on Mounjaro's 16% lower death rate vs Trulicity, implying strong clinical differentiation.

@db67583765 @DueDoctor 16% lower rate of death on $LLY Mounjaro.  I know which one I’d take 🤷🏻♂

@A_May_MD @DueDoctor Not really impressive though, 15mg Mounjaro vs 1.5mg Trulicity (4.5kg max dose) -didn’t show MACE superiority.


Summary: Bullish IONS: switch preference data for HAE program surprisingly strong and market is significantly underestimating the stock.

@ArtsStocks @Biohazard3737 The $IONS HAE switch preference data are surprisingly extremely strong.  Market is underestimating a ton for $IONS right now.

@A_May_MD @Biohazard3737 $ions We think the market does not fully appreciate the potential for differentiation, given a far less-frequent dosing regimen for #donidalorsen vs. SOC,” the analyst writes. $ibb $xbi $tak $atxs $bcrx $kalv


IMO the lawsuit is coming, and it won't be pretty when it happens… $HIMS stock price sees the teens if GLP1s go to zero… Things can go from sunshine and roses to fire and brimstone *quickly* if things don't work out here

Summary: Bearish HIMS: NVO lawsuit incoming, GLP1 loss would gut revenue, TRT launch will disappoint, and 2030 convertible debt wall creates existential risk.

Drug Manufacturers - Specialty & Generic

I think you’ve got to be a special kind of naive to truly think $NVO isn’t coming after $HIMS legally at this point.  Listen to those @DueDoctor clips from the $NVO earnings this morning, and also consider that…

➡New management is in, old management was ousted likely over inability to combat compounders.  New management will almost certainly focus on making a strong statement on this front.  This is the first step of what they were brought in for.

➡$NVO messaging around *why* the business is struggling has shifted to almost entirely blaming the compounders.  Investors are essentially demanding something be done about this.  The stock keeps making new lows…they *have* to do something.

➡$NVO just announced a ton of litigation yesterday SPECIFICALLY going after the personalization scam that I’ve been decrying here for months.  This is *new* messaging from them, but more than that it is actually *legal action*.
      ↪”But why hasn’t $NVO sued $HIMS yet then?”  Many have already pointed this out, but these smaller cases against tiny personalization compounders is likely a strategy to set legal precedents and learn things to strengthen their case for when they *do* go after $HIMS.

$HIMS is by FAR the single biggest personalization scammer in the industry right now.  Why *wouldn’t* $NVO go after them now that (since yesterday) they are specifically laying out a legal strategy to go after the personalization scam directly?

You really think they’ll just ignore the main/biggest culprit?  Why?  Because you’re long the stock?  Absolute hopium and naivety.  IMO the lawsuit is coming, and it won’t be pretty when it happens.

---

If $NVO can force $HIMS to stop this personalization compounding scam, $HIMS will be in a *dire* situation from its current valuation.  Like @himshouse said this week - $HIMS stock price sees the teens if GLP1s go to zero.

But IMO, it’s worse than that.  In the longer term, the company’s issues could become existential.

As we have seen, the “core” growth is withering.  GLP1s have saved them.  GLP1s going away would mean the core *has* to be revived.  The ED/Hair Loss/Sexual health markets are tapped out/saturated.  They have to expand to new verticals.

TRT is the big one most people talk about.  This is thrown around as a potential billion to multi-billion dollar vertical.  It will not be.  $HIMS longs will be disappointed by the TRT launch *IF* it even happens (again, review the Ryan Haight legislation to understand why this TRT vertical may never even get off the ground in the first place).

TRT is extremely burdensome with labs/in person/video visits required.  It is a heavily regulated controlled substance by the DEA (schedule 3 - only 1 level below FENTANYL, and 1 level *more* tightly regulated than XANAX).  The lab requirements/costs, red tape, and need to follow medical guidelines (I.e. not giving the drug to people who don’t qualify for it) will weigh the TRT launch down badly.  It will disappoint.

Other stuff like “medmatch” is just unmonetizable vaporware.  Useless for the valuation of the company.  And don’t get me started on the supposed “value” of the “medical data” that $HIMS is going to have.  Trust me.  The value of those data is $0, period.

---

This is all extra scary for $HIMS because…they have a potential $1B debt maturity wall coming up in 2030.  If their stock is not trading above $70 (roughly where the strike price of the convert shares was placed) at that time, THE COMPANY IS SUDDENLY GOING TO BE $1B IN DEBT as convertible note holders will not exercise, and instead allow these notes to behave as 0% bonds.

I gather that most $HIMS longs here don’t actually understand the mechanics of the convertible deal that the company did a few months ago, but the deal is actually EXTREMELY risky if they company ends up having any sort of financial trouble that hinders their vision for growth through 2030.

In a scenario where GLP1s dry up and they’re unable to revive the withering core business, the 2030 debt maturity wall starts looming LARGE.  Their financial woes that put them in this situation to begin with will snowball severely by the fact that the poor financial performance would suddenly place them in massive debt…how would they be able to handle $1B in debt when the reason they have the debt in the first place was because the business has been performing poorly?   Not good.

I think many $HIMS longs are doing themselves a severe disservice by not understanding how that convertible deal works.  Things can go from sunshine and roses to fire and brimstone *quickly* if things don’t work out here.

Anyway, good luck to the longs.  I think the $NVO lawsuit is coming, and it will be the first of 3 shoes to drop (novo lawsuit - withering core/new verticals - debt maturity wall) that will have people years from now looking back and laughing at the days when people said this was going to be the company to dominate modern healthcare.


Summary: Added to long NKTR position, endorsing compelling risk/reward ahead of AD readout at ~0.45x cash multiple.

🚨PITCH ALERT🚨 $NKTR
Currently at $0.676, representing a  ~0.45x cash multiple and approaching an atopic dermatitis (AD) readout that has a legitimate chance at success, $NKTR represents one of the most compelling risk/reward profiles I have ever seen in small cap biotech.


trading ~$30/share and a nearly $7B valuation is *far* too rich for a company selling cheap, low-margin generic drugs, with no moat protecting their business, while employing HIGHLY questionable practices that are likely to bring on massive litigation expenses

Summary: Short HIMS on legal/regulatory exposure, false advertising risk, IP violations, and overvalued at ~$7B; incidentally bullish NVO as likely litigant against HIMS.

My $HIMS short thread.

I’ve been open about being short $HIMS (so understand I am biased).  At first this was mostly a counter-momentum short during the short squeeze over $70.  However, since then, it has become clear to me that the company is being led into serious legal trouble with apparent reckless abandon.

I’m not a lawyer, but as a biotech investor I do have a better understanding of pharma IP than the “average” person, as well as a better understanding of physician liability as a doctor myself.  However, frankly, you really don’t need legal experience to understand why parts of the $HIMS strategy *cannot* not be allowed.  If bulls can take of their rose-tinted glasses at least momentarily and actually consider the points I’ll make here, I think basic common sense would suffice to arrive at many of the same conclusions I have.

tl;dr summary of points:
➡The personalized semaglutide scam being committed at scale would kill pharmaceutical IP, leading to the end of new drug development (yes, I'm serious). HIMS is on a one-way train to getting their assess sued off for this.
➡Physicians who take part in the personalized dosing scam should be aware that they are opening *themselves* up to huge legal liability in so doing.
➡HIMS CEO is making bold statements about the efficacy of the oral weight loss “solution” that go against medical evidence.  The company is at *high* risk of the FDA taking legal action on this false advertising.
➡The $HIMS super bowl ad also skirted drug advertising laws, and litigation for this appears likely to me as well.  Oh, and the blurred out images of Ozempic that they included in the commercial will bring $NVO lawyers knocking at their door as well.
➡The company employs unscrupulous and dangerous prescribing behaviors by pushing medications without appropriate medical review (as reviewed in a recent WSJ article)

All of this translates to an untrustworthy company.  Do you really want to take their word for how bullish their setup is *while their leadership is constantly dumping shares on the open market*?

---

The "personalized" semaglutide dosing scam.

$HIMS *cannot* be allowed to sell “personalized” semaglutide at scale.  The company has doubled & tripled down on this idea both on the recent earnings call and on the Hims House podcast last week.  The thought is that the company can make “personalized” (i.e. non-commercially available) doses of semaglutide through a 503A compounding pharmacy loophole that allows special doses to be made for patients in rare situations where, for some abnormal reason, the standard dosing will not work for them.

People must understand that exploiting this loophole “at scale” like $HIMS is trying to do WOULD MEAN THE END OF PHARMACEUTICAL INTELLECTUAL PROPERTY.

If a generic drug company like $HIMS can simply slightly modify dosing or formulation of an on-patent drug and suddenly be allowed to reap substantial profit from something that a pharma company discovered, developed, and owns, *what would stop generic drug companies from doing this with EVERY patented drug in the world?*  There would be nothing to stop generic/compounding companies from stealing the intellectual property of every drug on the market by simply dose-modifying or adding inert compounds to the formula.

$HIMS manipulating the 503A specialized dosing rule may seem innocuous at first - “So what, some people will get some cheap Ozempic and $NVO will lose some money.”  But if you actually consider the implications of this precedent even for a moment, it is clear that this scheme could be applied to *any* patented drug.  Suddenly pharmaceutical IP is meaningless, and now there is no longer *any* financial protection/incentive for discovering new drugs.  New drug development stops.

IMO, it is not at all a stretch to see how the first domino of $HIMS mass-selling “personalized” doses of semaglutide leads to others doing the same thing with other patented drugs, which leads to the end of the pharmaceutical industry and new drug development as we know it.

“Oh come on Adam, that will never happen”.  Correct.  It will not happen because $HIMS will NOT be allowed to get away with this.  The 503A specialized dose “loophole” exists for RARE exceptions in order to help patients who would be at risk of serious harm (example - a small child with a cancer that is treated by a drug that has so far only been approved in adults.  They need a much smaller dose than what is available, so 503A allows a compounding pharmacy to legally help this child with a non-commercially available dose).

The 503A specialized dose “loophole” does NOT exist so that $HIMS and other generic drug leeches can steal Novo Nordisk’s intellectual property and make their own c-suite rich by selling stock.  If the company actually goes through exploiting this well-intentioned rule in that way, they will be stopped.  They will be stopped because they *MUST* be stopped if we are going to preserve the system for developing new drugs.

The idea that $HIMS will actually be able to get away with this is ludicrous, and the CEO repeatedly telling his retail investors that it's not going to be a problem MASSIVELY undermines his credibility and trustworthiness in my book.  When he reassures us about something that is so obviously wrong/not going to work, why would we believe him about anything else?

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HIMS contracted physicians are at *huge* liability risk in the personalized dosing scam

Another note on this $HIMS “personalized” dosing scam.  The physicians who are complicit with prescribing these off-label doses en masse had better watch their backs.  You are opening yourself up to incredible legal liability by being a part of this IP scam.

Prescriber data is readily available to regulatory bodies.  Outlier prescribers of *any* drug/dose are easy to find.  If $HIMS is successful in pumping the personalize dosing scam to thousands of patients, we will be able to see that something like 0.01% of prescribers wrote >90% of the personalized doses of semaglutide.

How is it possible that these few physicians somehow have almost *all* of the patients in the world who needed “personalized” doses of semaglutide?  It isn’t.  This will be all the evidence we need to confirm that $HIMS has pushed this strategy and funneled patients down the path of seeking personalized doses in order to get cheap drug.

This necessitates that the physicians prescribing such high rates of non-standard semaglutide are COMMITTING MEDICAL FRAUD by repeatedly claiming that there is an indication for off-label dosing whether there actually is or not.  There is no way that *only* $HIMS patients are the ones who would “need” personalized dosing.

So, when the prescriber data shows that a bunch of the $HIMS contracted physicians are massive outlier prescribers of personalized doses, those physicians are going to have some explaining to do.

“How can you explain that 99% of physicians prescribed ZERO personalized semaglutide at all in 2025, yet you prescribed it to over half of your patients?  How is it possible that only *you* ended up with the few patients for whom this atypical dosing was indicated?”

Caught red handed, because the only plausible answer here is that it actually *wasn't* indicated - these physicians are just going along with the company's goal of pushing patients toward personalized doses whether there is a medical necessity or not.  The outlier prescriber data on this matter will not lie, and they will not be subtle.

If these complicit physicians don’t have legal action taken against them directly, I would bet that they'll be dragged into the broader lawsuits against $HIMS when shit finally hits the fan here.

Add in the questionable medical “assessments” that $HIMS performs (see WSJ article that discusses prescriptions being written within 60 seconds of requests having been submitted) and these docs are just setting themselves up for legal slaughter.  Good luck arguing that you thoroughly assessed all these patients and found that they needed some nuanced dose through your 1-minute long online assessment where you didn’t even talk to or examine the patient.  This won’t hold up.

Oh, and, by the way - these personalized doses are definitionally off-label.  This opens up yet another liability can of worms.

IMO the physicians contracted with $HIMS would be absolutely nuts to go along with this scam.

---

False advertising for the "oral weight loss solution"

$HIMS CEO should at least be called out (and IMO will very likely be sued) for his statements about the weight loss patients can expect with the “oral” weight loss plan.  He has repeatedly claimed that their oral product offers “2/3 to 3/4 of the weight loss (of semaglutide) for 1/3 of the price!”

I cannot emphasize enough how much these numbers are absolute bull shit, and the FDA will very likely have something to say about these claims.

$HIMS will likely point to some contrived and unscientific survey-based “study” that they performed where people said they were losing weight on this “treatment”.  However, it is very important to understand this next part:

THE DRUGS IN THE $HIMS WEIGHT-LOSS SOLUTION ARE FDA-REGULATED PRESCRIPTION DRUGS, WHICH MEANS MARKETING CLAIMS RELATED TO THEM ARE SUBJECT TO FDA SCRUTINY.

$HIMS does not get to decide what the advertised weight loss of these drugs is. The FDA does.  Full stop.  If Hims were peddling non-FDA regulated *supplements* they could make whatever claims about weight loss they wanted to, and cite “research” of whatever quality they choose.

However, with pharmaceutical products, the FDA actually gets to determine how you’re allowed to market a drug, down to the *letter* of the marketing messaging.  The FDA relies on robust clinical trials data to guide these marketing allowances.

Again, $HIMS will claim they have in-house “data” supporting these claims.  However, their data are not FDA reviewed, not double blinded, not controlled, not prospective, and not supported by actual clinical endpoints (patient reported weight loss is NOT an endpoint for weight loss drugs - you have to actually *weigh* the patients in obesity studies, because obviously people cannot be expected to accurately report their own weight loss progress).

If $HIMS took their oral weight loss “data” to the FDA, they’d be laughed out of the room instantaneously.  Their survey doesn’t meet a single component of scientific rigor required for generating data upon which pharmaceutical marketing claims can be made.

The $HIMS CEO is setting himself and the company up for MASSIVE liability by making clearly false claims about FDA-regulated prescription drugs.  “3/4 of the weight loss for 1/3 of the price” is a reckless and dumb statement to make when the data show it is not true and you are dealing with FDA-regulated products.

You want proof?  None of the drugs in the $HIMS oral weight loss solution are even FDA approved for weight loss, which is because NONE OF THEM ARE ANY GOOD AT CAUSING WEIGHT LOSS.

For starters, do you even know what’s in the $HIMS  “Oral weight loss kits”?  There are several different potential components, as follows:

Metformin (an old diabetes drug), Bupropion (a depression/anxiety drug better know as “Wellbutrin), Naltrexone (an opioid antagonist mostly used to treat alcohol addiction), Topiramate (a seizure drug) and Vitamin B12 (yeah, just a vitamin).

Some of these drugs had obesity studies ~20 years ago.  Most of them showed some weight loss, but so little weight loss that the FDA wouldn't even approve them for that indication.  By and large, weight loss with these drugs has primarily been identified as a small “side effect” in trials for other indications.  NONE of these drugs comes even CLOSE to generating 2/3-3/4 of the weight loss as semaglutide does.

➡Semaglutide generates ~13% placebo-adjusted weight loss.
➡Metformin gets to ~3% in long term studies.
➡Bupropion *combined* with naltrexone leads to ~4-5%
➡Topiramate has been able to get ~half the weight loss of semaglutide at higher doses, but this is limited by the fact that this seizure drug has a nasty side-effect profile.  It never came close to being FDA-approved for weight loss.

So, double blind, randomized, peer reviewed data *does* exist for weight loss with the drugs in the $HIMS oral obesity treatment regimen.  However, the company chooses not to refer to these data, because they prove that these drugs don’t come close to weight loss that semaglutide inspires (plus having highly questionable side effect profiles).  Yet, this hasn't stopped the $HIMS CEO from claming "3/4" of the weight loss with sema.

Again, remember that these are FDA-regulated prescription drugs.  By making false statements based on non-FDA sanctioned “data” (online surveys), $HIMS is exposing themselves to obvious legal liability.  I expect them to be sued for false/misleading advertising.

https://t.co/Atxdpp3SYq
https://t.co/P6Mn3vI20z
https://t.co/sbAWLUA0HQ
https://t.co/KP4o5Vn6jI

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The $HIMS Super Bowl ad is going to get them sued as well

Speaking of advertising, $HIMS is also likely to be sued for their super bowl commercial IMO.

They were clearly marketing pharmaceutical products in that advertisement, not supplements, which, again, puts the ad under FDA purview.  However, this ad was clearly NOT reviewed/approved by the FDA.  $HIMS didn’t even disclose potential side effects of their drugs in the ad, which is probably *the* most basic tenet of DTC advertising in the pharmaceutical industry.

“But they’re a compounding pharmacy, not a pharmaceutical company!”  Ok, but they were ADVERTISING A PHARMACEUTICAL PRODUCT.  This should put them under the same standards as a normal pharma ad, but $HIMS is relying on grey areas to try to skirt these laws.

“They never actually say "semaglutide" in the commercial, so how do you know they were even advertising that.”

This is where $HIMS REALLY messed up and committed a massive mistake:

THE SUPER BOWL COMMERCIAL LITERALLY SHOWS SEMAGLUTIDE INJECTOR PENS WITH THE LABELS BLURRED OUT!!!

Whoever’s idea that was made a huge (and extremely stupid) mistake.  This not only confirms beyond the shadow of a doubt that the advertising of semaglutide was not just *implied*, but rather *overt* in this commercial.

The FDA can now sue them for skirting pharmaceutical advertising regulations, and I’d bet that $NVO will have something to say about blurred images of their patented drug appearing in a commercial for a “competitor” company.  This was, IMO, an insanely stupid own goal by $HIMS.

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Inadequate medical review + higher risk drugs = EVEN MORE LITIGATION

All the discussion above is just a summary of all the reasons I think that $HIMS will be sued (and lose).  The rest of the story is messy as well.

The company is basically a pill mill pushing medications on patients with little to no physician/medical oversight.  Like the recent WSJ article highlighted, prescriptions are written within ~60 seconds of medical information having been submitted.  There is no argument that can be made to claim that adequate medical review and counseling is occurring here.  Especially when you consider that, for example, you don’t even have to supply photographs of your scalp when requesting hair loss drugs.  If a real-life physician prescribed a drug for a physically visible condition without conducting ANY form of physician exam, they would lose a lawsuit when sued for side effects of that drug 100 times out of 100.

This laissez-faire prescribing activity will come back to haunt $HIMS.

And it is going to get worse as they move into other areas like testosterone supplementation.  There are concerns that testosterone supplementation can have *major*, even life threatening side effects like increased risk of myocardial infarction (heart attacks) and prostate cancer.  As $HIMS moves into these higher risk areas of medicine, their lack of rigorous medical evaluation is going to set them up for easy lawsuits when some proportion of patients inevitably experience side effects.

The amount of litigation coming $HIMS way could be massive.  The generic drug industry is a low profit margin business that is unlikely to be able to support such litigation costs.  As $HIMS pushes the envelope by moving into medically higher risk treatments, this si only going to get messier.

---

In my biased opinion, $HIMS management team has shown themselves to be highly unreliable and untrustworthy.  They assure their investors that the personalized semaglutide loophole will hold in spite of almost no argument that it can be allowed to stand.  They falsely promote the oral weight loss solution as having similar efficacy to semaglutide, in spite of robust medical evidence to the contrary.  They employ legally risky advertising methods that skirt adverse event disclosure regulations, practically daring the FDA to come after them.  They push physicians to prescribe medication to anyone who asks with inadequate medical review.

I personally think this unreliability trickles into their 2025 financial guidance as well, which I do not trust to be met.  Their projections for the “oral weight loss solution are, IMO, too aggressive, since we know for a fact that the medications it uses are not effective weight loss drugs - patients are unlikely to stay on these treatments for long.  I think that overall we will start to see attrition rates growing, and as the steam of the semaglutide shortage keeps dissipating, the stock will cool off even more.

Once the major lawsuits start pouring in (which is a near guarantee in my opinion), things will get even messier.

Perhaps this is why the $HIMS c-suite is selling stock at an incredibly high pace.  While they paint a pretty picture for the retail investors that they pander to, do they actually realize what is coming?  I would say that their actions (dumping tons of stock) speak louder than their words (telling retail investors everything is going to be ok).

Now I’m not saying $HIMS is a zero, but the stock is still up a fair amount year to date despite major macro market weakness, and the fundamental thesis seems to have weakened SIGNIFICANTLY during that time.  I’m not saying that they haven’t built a real business here.  But IMO trading ~$30/share and a nearly $7B valuation is *far* too rich for a company selling cheap, low-margin generic drugs, with no moat protecting their business, a; while employing HIGHLY questionable practices that are likely to bring on massive litigation expenses.

Again, I’m biased because I’m short.  However, I personally am amazed that someone could review all of these risks in earnest and honestly determine that everything is just “fine” at $HIMS right now


$NVO will have something to say about blurred images of their patented drug appearing in a commercial for a "competitor" company


Summary: LLY's handling of MFN pricing fears is reassuring for LLY and broader pharma sector.

$LLY showing us how the MFN scare will be handled!  IMO this approach will qualm some fears for $LLY and other pharmas.

https://t.co/3NfKF4OFGr


qualm some fears for $LLY and other pharmas

US pharmaceuticals sector; XPH (SPDR S&P Pharmaceuticals ETF)


Summary: LXEO likely acquisition target for SRPT at a large premium; bullish on takeover potential.

@Getoutofmyway1 @drrichjlaw Yes. $LXEO getting snatched up by $SRPT in one of these huge premium but small overall cost deals is a real possibility imo.  Credit @Sanctuary_Bio for being the first to call that out and the one who gets all the praise if it actually happens.

@A_May_MD @drrichjlaw Probably worth a scan to see which small cap bios have investments from large caps like this.  $lxeo from $srpt rings a bell.


Summary: Bullish SRRK on FDA priority review for apitegromab, praising company execution.

Priority review (and likely approval) for apitegromab <1 year from top line data.  Fantastic execution by the company.

Myostatin 💪🏻 💪🏻 $SRRK $IBIO

 https://t.co/4q36xOumoK

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(Also credit where it’s due to the FDA for pumping through reviews - hopefully this qualifies as an easy one for them)


Summary: TARS on limit-up list; author identifies Megyn Kelly as a potential beneficiary of lotilaner, implying bullish momentum.

Getting around to listening to the interview.

28:18 ➡ Megyn Kelly has ocular rosacea.  She needs lotilaner so she can get off of doxycycline.  $TARS is on the limit up list now too.

https://t.co/hOrQoy4lZa

*clears throat*

Biotech limit up! $XBI $IBB $BBC

Gene therapy especially would benefit from this type of attitude as they have recently been crushed by Marks’ departure.

Like @Biohazard3737 was saying yesterday - no evidence that the regulatory bar for most therapies is


I continue to be baffled by the general idea that $NKTR's Rezpeg won't get significant use... I find it hard to see how people project anything less than $500M in peak sales for Rezpeg. In my opinion, it could actually go much higher than that

Summary: Strongly bullish NKTR/Rezpeg on unique MoA and large AtD market ($500M+ peak sales); cautious on APGE due to concerning conjunctivitis safety signal and unproven competitiveness.

Getting plenty of questions about $APGE data and their relation to $NKTR this morning.  Next two slides breaking that down (then some extras at the end):

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$APGE Data

✅The EASI75 delta of 42.5% is good!  This was the first thing everyone was going to look for, and it came in at the high end of the range that Lebri has shown in its studies, and higher than Lebri's avg overall.
      ↪So the "higher exposure higher efficacy" theory looks plausible if you're just looking at EASI 75.  However...

⚠The EASI90 delta of 19.2% looks worse than *both* Dupi and Lebri (28% and 26% respectively by my numbers).
      ↪Despite EASI75 being higher by a few percentage points, EASI90 looks worse by 8-10%.  What would explain this?  Which endpoint is "wrong"?  Will EASI75 come down in future studies to more closely match EASI90, or will EASI90 go up?

❌The Conjunctivitis rate is the potential big problem here for $APGE.  Their non-infectious conjunctivitis rate is *5x higher* than Dupi's was in its phase 3 studies.  $APGE's overall conjunctivitis rate is >2x higher than Lebri's P3s.
      ↪Conjunctivitis is an AE that frequently leads to drug discontinuation in the real world, *unlike* ISRs.  I have changed *many* patients from dupi to other treatments due to conjunctivitis in the real world, but as far as I recall, never *anyone* for having ISRs.  If this conjunctivitis rate is recreated in $APGE's P3, it will be a problem for them.

👉Overall Summary for APGE:  The EASI75 delta came in at the high end of expectations, which is great!  However, EASI90 rate being worse than dupi/lebri comps calls into question the validity of this discordant efficacy signal.  Furthermore, the conjunctivitis rate came in at what was probably a "worst case scenario" range, with 2-5x higher rates than comps.  Sparser dosing will be a differentiator for this drug no matter what, but the rest of the profile will matter, and its competitiveness still remains to be proven in larger studies.

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What do $APGE results mean for $NKTR

🤷♂To be honest, I never saw $APGE results impacting $NKTR dramatically either way, positive or negative.  Why?  Because $APGE is only testing drugs with MoAs that are already on the market/ahead of them.  APG777 will be the 4th IL4/13 inhibitor to market.
      ↪The entire reason we will use $NKTR's Rezpeg to begin with is because it has a differentiated mechanism of action.  Nobody is replacing IL4/13 for first line in AtD.  This is established - we know this.  $NKTR's niche was already meant for being used in patients who either didn't respond or had AEs on IL4/13 drugs.  This is no different with $APGE's results, good or bad.  I'm still going to want to use a DIFFERENT MoA in patients who fail IL4/13 inhibitors, not hit them with the same MoA again!  Rezpeg's target use doesn't change at all.
            ↪Note that the same actually applies to $APGE's P1 drug that combines IL13+Ox40.  Those MoAs will both already be on the market years from now when (if) that drug gets approved.  Rezpeg will still be the ONLY drug on the market with a unique MoA (apart from crappy Nemluvio), and its use-case will remain the same.

So, to summarize:  $APGE's data are mixed positive.  But with a me-four MoA, the data could've been fantastic or horrific, and it still wouldn't have changed the outlook for $NKTR's Rezpeg, as its use case will always be solid efficacy with a different MoA.

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Extra Point on ISRs:  $APGE $NKTR

The ISR rate for Dupilumab in phase 3 was 11%...that's almost 4x higher than Dupi's rate of conjunctivitis in those studies (3%)!

Yet, despite occurring at a much lower rate, ***conjunctivitis is the AE that everyone talks about with dupi!***

This is because patients are actually VERY bothered by conjunctivitis (redness and inflammation of the eyes), whereas ISRs are almost always a meaningless side effect to patients - a nuisance at most.

This is reflected in my real world practice, in which I have LITERALLY NEVER had to switch a patient off of a biologic drug (for any indication!) due to ISRs (EVER!), but I have had to change treatment plans for *many* Dupi patients who were having conjunctivitis.

Again, everyone knows dupi's main AE is conjunctivitis...despite the fact that Dupi's ISR rate is much higher.  What gives?  Conjunctivitis is a bothersome AE, while nobody actually cares about having mild ISRs!  People making a huge fuss out of $NKTR's ISR rate either don't understand what this AE is like in the real world or have been paying to much attention to $LLY's legal team!

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Bonus Point on AtD Market:  $NKTR $APGE $REGN $LLY

This market is ***GARGANTUAN***

In fact, you could argue that Atopic dermatitis is the single largest indication in ALL of I&I!

👉I will continue to draw comparisons to the MUCH smaller psoriasis market, where MANY more drugs currently exist and where response rates are MUCH higher than they are in atopic dermatitis (meaning there is less overall need for different drugs, because patients don't as often need to cycle through new drugs due to having failed what they're already on.  The higher "cycle rate" in atopic derm is GREAT for late market entrants, because it keeps the TAM big and churning!).

Psoriasis, as a much smaller market, with much higher response rates, still supports more than double the number of drugs we have in AtD, and many of those psoriasis drugs even have overlapping MoAs (like $APGE has with dupi/lebri/tralo).

I continue to be baffled by the general idea that $NKTR's Rezpeg won't get *significant* use.  Its efficacy matches that of the upcoming Ox40 class, and aside from Nemluvio (whose efficacy data are utterly horrendous) $NKTR's Rezpeg will be the ONLY drug on the market with its IL-2/T-Reg MoA!  This drug will be used, and, in my opinion, used frequently.

Honestly, at this rate with the way the AtD market is growing (remember, AtD is a much younger market than IBD, RA, and psoriasis, and AtD is still growing fast), I find it hard to see how people project anything less than $500M in peak sales for Rezpeg.  In my opinion, it could actually go much higher than that, especially if their sparse dosing shot on goal plays out.

How anyone could look at the size of this market and the uniqueness of $NKTR's asset and *not* see how rezpeg could do at least $500M here is...pretty surprising to me!

But hey, inefficient markets are what create opportunities! 😎


Summary: LLY wins on superior drugs; NVO and CVS criticized for deals blocking better treatments, implying bearish on both.

Hey $NVO and $CVS, in the future maybe you don’t make deals that intentionally prevent patients from getting objectively superior drugs?

$LLY wins. https://t.co/rsKE2sXwIU


Summary: Short HIMS at $57; GLP-1 business is a house of cards with major legal/regulatory risk from NVO.

@KNielsen2000 It’s a major house of cards now if there’s any threat to the GLP-1 business that’s barely keeping them afloat.  Being able to short it at $57 right now is, IMO, a gift.  Time will tell!

@A_May_MD This is one of the few times I regret not being able to short a US stock (not possible through my trading platform)

It’s only a matter of time before NVO will sue their pants off. And it’s so obviously that they can’t hide behind 503A since medicin has to be individually


Summary: Author discloses long position in VYNE.

@jeremyj0916 @A_May_MD I would also be keen to know what you think about VYNE, Adam.


Summary: Bearish NTLA; stock deserves all-time lows amid Plasma Guy/Cathie Wood value destruction narrative.

$NTLA Intellia Plasma Guy story would be such a hard one to explain to non-biotwitter people in a way that they’d truly appreciate it for the spectacle that it’s been.

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Oh my https://t.co/7MV35zh72c

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$NTLA Plasma Guy + Cathie Wood

The Shaq & Kobe of biotech value destruction

https://t.co/wo1dJ58Lf5 https://t.co/hgPXYTN8sQ

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Can someone not blocked ask Tony what comes after grade 4? https://t.co/ekWjD4n968

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Disgusting.  Stock deserves ATLs.


Summary: Bearish HIMS: Novo Nordisk is targeting their personalization compounding scheme, expects legal/regulatory pressure.

@C769440982 If you actually think novo is not going to go after HIMS while specifically saying they’re targeting the personalization scheme there is no getting through to you 😂

$HIMS is the single biggest perpetrator of this scam.  $NVO finally going to come after them.


We are looking at the beginning of the end of the $HIMS hyper-growth story… if $HIMS is going to be a 'hit the midpoint' company like this, it's lights out for the type of massive upside the stock has been seeing this year

Summary: Bearish HIMS: core business slowing badly, GLP-1 scheme unsustainable, hyper-growth story over; massive upside gone.

$HIMS bulls should be worried, IMO.

$HIMS revenue went down from $586M in Q1 to $545M in Q2.

They now need to hit ~$610M/Q in Q3 and Q4 just to hit the *midpoint* of their 2025 FY guide.  They are guiding for only $580M at the midpoint for Q3…

Yeah, that’s right - the midpoint of their Q3 guidance is STILL lower than their Q1 actual revenue.  LOWER projection for Q3 than for Q1 actual….Where’s this explosive growth all these delirious bulls keep yapping about?

The fact is, the core business is slowing *badly* and the phony GLP-1 personalization scheme is the only thing keeping this company’s stock on two feet (now staggering, admittedly).  Feel free to dream about a TRT launch.  That’ll be by FAR the most difficult vertical they’ve ever entered and the Ryan-Haight legislation situation could eliminate that vertical *completely* if things don’t go well.

We are looking at the beginning of the end of the $HIMS hyper-growth story.

I don’t care what the stock price does today/tomorrow/this week.  The retail cult has already proven itself (largely, with some exceptions) incapable of complex reasoning with this stock, and the option/short interest/convertible debt variables can do funny things to the stock price in the short term.  It should be down after its first “consensus miss” *ever*, but who knows.

In the long run, if $HIMS is going to be a “hit the midpoint” company like this, it’s lights out for the type of massive upside the stock has been seeing this year.


Summary: Expects NKTR to be well received post-offering and continue rising, analogous to LXEO's 50-60% post-raise rally.

Yes indeed!  Glad they’re getting this done.  I fully expect the $NKTR offering to be well received and for the stock to continue its rise after getting this out of the way.

For whatever reason, the market recently has been giving us plenty of time to buy after good data and even after good cash raises.

$LXEO could be bought CHEAP after data, then raised, then rallied 50-60% after that!  Personally expect $NKTR to follow a similar trajectory (it has so far).  Plenty of other recent examples as well.  $CTMX, $CDTX, etc.


Summary: Strongly bullish ABVX: zero mechanistic competitors, no Chinese me-too rivals — described as a once-in-a-lifetime setup.

@JoseRestonVA @uchi_wawa @seedy19tron And $RXDX has 2-3 other competitors in the pipeline with the same MoA.

ZERO mechanistic competitors for $ABVX.  Not even me-tops from China.  Once in a lifetime setup.

@A_May_MD @uchi_wawa @seedy19tron Agreed. I had Prometheus (RXDX) when bought out by Merck. If anything, that acquisition looks the closest as reference for this case, with the caveat that this case is a Phase 3. On the other hand, CD is still in Phase 2b for readout late ‘26…if a b/o occurs I would be surprised


Over time I think the $NKTR story plays out similarly. How $NKTR continues to sport a ~$100M EV is beyond me, but then again, I was baffled by the price of $VRNA 1 year (and 500%) ago as well

Summary: Long NKTR: unique MoA in massive atopic derm TAM analogous to VRNA's COPD setup; ~$100M EV deeply undervalues a drug that works.

Would’ve been more style points had I tweeted this last night, but was just having a conversation after the market closed *yesterday* about how the current $NKTR setup reminds me of $VRNA over the last 1-2 years (receipts in the photo).

The data for $VRNA, in my opinion, were unequivocal.  The drug worked well enough to make patients feel better, but people picked the company apart looking for every possible negative.

👎🏻“It wasn’t studied in triple therapy refractory patients!”
👎🏻”Nobody is going to want to use a nebulizer!”
👎🏻”There’s no way they can launch into this giant market alone!”
👎🏻”Biologics like Dupi are going to take over the COPD market!”

Etc etc etc.  The stock stayed cheap with all these bear theses floating around.

But every time I looked at this company, the takeaways for me were:
👍🏻It makes patients feel better
👍🏻It has a broad label that doesn’t specify line of treatment
👍🏻THE MARKET IS MASSIVE
👍🏻It is a NEW unique MoA in a field that hasn’t had a new MoA in years

This is the same bear/bull tug of war I see with $NKTR.

👎🏻”Rezpeg isn’t as good as dupi”
👎🏻”The drug causes ISRs”
👎🏻”They’ve got to fund huge P3 studies”

You can basically make the same argument for $NKTR as I did for $VRNA

👍🏻Rezpeg doesn’t NEED to be as good as dupi
👍🏻ISRs are easily tolerated for a drug that works (like a nebulizer is tolerated in COPD)
👍🏻The market is MASSIVE (atopic derm is literally a bigger TAM than COPD…)
👍🏻Rezpeg has a NEW unique MoA in a field that hasn’t had an effective new MoA in years

It was said time and time again for $VRNA…1% TAM penetration = $1B in sales…

$NKTR is in an even bigger market yet, with its unique, effective new MoA.  This, to me, speaks FAR louder than the $NKTR bear points do.  We saw this play out with a huge win for $VRNA (+500% over the last 52 weeks) despite the fact it stayed cheap for a long time *after* the data/trajectory looked obvious.  That’s where $NKTR is right now, IMO.

Over time I think the $NKTR story plays out similarly.  And that’s another key - the VRNA play took *TIME*.  It looked obvious to me, but these things never happen right away.  Early stages for $NKTR - time will tell!

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$NKTR $VRNA Recycling this image that I recently used to comp atopic derm to psoriasis in order to comp atopic derm to COPD…AtD is just unbelievably huge.

Like I said in the text…***sometimes it’s just not that complicated***…big market, unmet need, unique MoA, drugs that works = big sales.

How $NKTR continues to sport a ~$100M EV is beyond me, but then again, I was baffled by the price of $VRNA 1 year (and 500%) ago as well!


Why is the market still treating $LXEO's AA plan like it's this

Summary: Market undervaluing LXEO's accelerated approval plan despite FDA's Vinay not slowing rare disease approvals and peers recovering significantly.

$LXEO - Ever since we panicked over Vinay hurting rare disease approvals, he’s been saying he won’t slow down even *incremental* treatments for unmet needs

Most rare disease plays have recovered *significantly*.  Why is the market still treating $LXEO’s AA plan like it’s this: https://t.co/EbeE5iXQYG


Summary: NKTR selloff seen as tape-driven, not fundamental; valuation dislocation expected to correct upward over 2-4 weeks.

IP is solid, T reg MoA is relatively well elucidated imo.  This just keeps happening in biotech…anything that has run lately has a big sellof, lasts 2-4 weeks, then it resumes upward trajectory.  Idk.  Market has been tough and there’s some weird trading dynamics out there right now.  Think NKTR is caught up in the weird tape, but zooming out the valuation makes no sense to me and I think it corrects over time.

@A_May_MD Yeah it’s puzzling to me. Is it financing through Ph3 and fears of another blowup on the same name?

It seems like it’s obvious to try in refractory AtD pts given the new MoA. And it’s not clear to me the IP matters that much given it’s a complex drug conjugate

I haven’t been


Summary: Bullish on biotech ETFs XBI and BBC on weak jobs revision data acting as a macro catalyst.

“The stock market” doesn’t like this.

“The biotech market” should love it.

My brain didn’t even compute these numbers properly right away.  I assumed jobs were revised down by 19/14K…they were revised down *TO* 19/14K 🤯

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This is catnip for biotechs
$XBI $BBC https://t.co/IagB5ktBek

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And you thought $XBI was gonna be red today?  Smh.  Why?  Just because it’s red every single day no matter what?  Unreal.

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$XBI +2.4% delta over R2K today https://t.co/o9hsCqpWmS


Upward momentum will have a snowball effect here. As it becomes more fairly priced (still not there yet) the ability to raise cash increases. It's now in a positive feedback loop

Summary: Long LXEO: upward momentum snowball effect, still undervalued, positive feedback loop on cash-raising capacity continuing from here.

@Sanctuary_Bio Upward momentum will have a snowball effect here.  As it becomes more fairly priced (still not there yet) the ability to raise cash increases.

It’s now in a positive feedback loop that is the inverse of the forced selling that took it to beyond ridiculous levels to begin with!

$LXEO now a triple from the bottom

Was truly insane...i had a lot of people ask me the same thing https://t.co/rVyvZ3If7n


Summary: Bullish NKTR: current valuation is too low given dapirolizumab, possible Lilly settlement, and upcoming alopecia areata phase 2 readout.

@semodough $NKTR Plus dapirolizumab value, plus possible Lilly settlement cash, plus phase 2 readout in alopecia areata soon…such a low valuation is just silly to me.

Seriously @A_May_MD at $50 bucks $NKTR mcap only 550 million with 200 million in cash for new MOA on this large market - been around long enough to know that’s extremely reasonable & conservative for what we know now


Summary: Holds a short position in HIMS common stock.

@A_May_MD did you have HIMS puts prior to today?


IMO, the info they have disclosed says that they are *very* likely to hit stat sig when they report P3 data (likely next month)... IMO this subtle data disclosure *massively* increased the probability of success for this readout

Summary: Bullish ABVX: pre-disclosed P3 maintenance data massively raises probability of stat-sig hit at upcoming readout; market not appreciating the information.

It’s funny, I tried to highlight the most important portion of the $ABVX pitch yesterday, and that slide is still somehow tied for fewest views.  IMO people are really sleeping on the importance of these data…

$ABVX has literally given us a vitally important piece of the phase 3 dataset AHEAD OF TIME!!!

IMO, the info they have disclosed says that they are *very* likely to hit stat sig when they report P3 data (likely next month).  Is there still failure risk?  Absolutely - there’s no guarantees in biotech EVER.

But I have to say…I’ve never seen such an impactful pre-data disclosure from a P3 trial before, and the market still doesn’t seem to appreciate how big this information is.  I think it’s worth people’s time to really try to understand what’s going on in this part of the pitch.  IMO this subtle data disclosure *massively* increased the probability of success for this readout.

Slide 6⃣...The🔑 Slide!
👉Analyzing $ABVX's pre-disclosed P3 maintenance arm enrollment

🚨I consider this the most important slide of my $ABVX pitch, and I think it digs into a key piece of data that the market is totally missing the importance of!🚨

…$ABVX has pre-disclosed https://t.co/8gvKf1koTp


Summary: Holds long position in Viking Therapeutics VKTX.

I am exposed long to Viking Therapeutics $VKTX.

AMA

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Alright I’m out good luck.


Summary: ABVX at $100/share ($6.3B) is below the $6.7B floor of comparable post-P2b buyouts, implying meaningful upside.

No.  There is no ballpark benchmark for what P3 data like what $ABVX has is worth because literally EVERYTHING else has been bought out by big pharma BEFORE p3 data.  The lowest end of that post P2b data buyout list is $6.7B.  The high end is $10.8B.

$ABVX at $100/share is only $6.3B.

@seedy19tron Is there a ballpark standard for what p3 is worth vs p2 or p2b?  The difference represents so many things-- time & regulatory stage among others.

@A_May_MD  @seedy19tron


Summary: Prescriber channel checks show 2/3 switching away from PFE tafamidis to BBIO acora; market vastly underestimates BBIO share gains and PFE tafamidis erosion.

“Two intend to stop using tafamidis”
…out of three.  People are not modeling that AT ALL.

2/3 intend to use more acora than vutra and the 3rd and even split….people are not modeling that AT ALL.

Can it really just be as easy as listening to the prescribers telling us what they’re doing…?

$BBIO important nugget - many miss on $BBIO 40 to 50% of patients progress on $PFE tafamidis over twelve
months There have been recent papers on
NASCI &other places where they've come out about 50%, so I think that 40-50% range is
reasonable $BBIO momentum with switches building


Summary: Bullish biotech ETFs as FDA regulatory bar not rising under new regime removes a major headwind; gene therapy especially positioned to benefit.

*clears throat*

Biotech limit up! $XBI $IBB $BBC

Gene therapy especially would benefit from this type of attitude as they have recently been crushed by Marks’ departure.

Like @Biohazard3737 was saying yesterday - no evidence that the regulatory bar for most therapies is getting *higher* under the new regime.

In fact, evidence to the contrary is now mounting.

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This exchange even confirms that no FDA reviewers/inspectors have been cut.

Concerns about this type of thing have been a huge headwind for biotech.  This seems like genuinely market moving commentary for the biotech sector in my opinion. $XBI $BBC $IBB


Summary: Still short HIMS, a live position publicly called in real time from a prior entry point.

lol. Literally by far the call I’m catching the most heat/insults for right now is being short $HIMS (publicly, called in real time) from that red dot on the chart.

These trolls can’t even troll right.

We are currently at the bottom of the worst small cap biotech bear market of all time and they can’t even do the work to find a name we are actually down on (hint:  it should be that hard!)  😂

The worst you got is *checks notes* A FLAT LONG YTD??


Summary: APGE probably a buy here, though faces crowded IL-4/13 space and dosing interval as its only differentiator.

$2B is cheap if you think you have a real, late stage asset for AD that has a pitch for sparse dosing and non IL4/13 axis MOA.

Rocatinlimab as an exemplar has never shown efficacy results on par with dupi, but it’s going to have infrequent dosing and presents a non-IL4/13 MOA.  $AMGN moves >$2B at a time on rocat news and its NPV would *certainly* be higher than that in sellside models.

Easy to forget about these sorts of valuations in this market, but AD is massive.  There’s a reason $QTTB $ANAB and $CRVS all had huge multiples of $NKTR’s valuation into their AD data.  If someone hits here with a new MOA it’ll be extremely valuable.

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Also yes $APGE >$2B right now is another relevant comp that has also traded consistently in the $3-$4B range when the market was healthier.  Probably not a bad buy here but with dosing interval as it’s only differentiating factor competing with 3 other IL-4/13 AD drugs that will have been on the market for many years by the time it gets there.


Summary: Bullish LXEO: traded above $11 <6 months ago with worse data/no FDA alignment; current valuation is anomalously depressed.

Oh for sure.  $LXEO has traded >$11 less than 6 months ago with none of the back-to-back positive datasets they've just released or the FDA alignment on even less stringent approvable endpoints for FA...At the risk of sounding like a broken record - this should become a great example of biotech valuations getting WAY out of hand with likely forced selling.

$LXEO good to see this strength on a down day. If $XBI was $90 this would probably be $5+ on the data they have generated lately


Summary: Bearish NTLA: Grade 4 liver toxicity in a well-treated disease is a serious adverse event; stock should trade below cash value.

@CathieDWood Grade 4 LFT elevation for a disease that is extremely well treated with numerous approved and safe therapies.  That is a very serious AE.  $NTLA should trade below cash.

Another overreaction in the gene editing space $NTLA!


Added to what was my largest position already and still haven't sold a share. When something is up 300% but is still cheap, you've got to rely on the actual valuation, not how much it is already up. being able to recognize that the move isn't over yet has been the biggest contributor to massive returns

Summary: Added to NKTR and holding full position; argues 300% move isn't over as stock remains cheap on actual valuation.

Added to what was my largest position already and still haven’t sold a share.  People often make the mistake of selling biotech microcaps that are actively rerating to soon.  When something is up 300% but is still cheap, you’ve got to rely on the actual valuation, not how much it is already up.  Consistently, being able to recognize that the move isn’t over yet has been the biggest contributor to massive returns for me.

$NKTR

Guess those long term funds jumped in

Going to repeat, great call by my friend @A_May_MD and he bought MORE after data release https://t.co/2mGh6YhpHU


Summary: Initiated a long position in IONS after forced-selling-like crash to multi-year lows.

lol this is wild - I literally *just* bought $IONS for the first time in…maybe ever?  Not sure if I may have held a few briefly back in the $ISIS days.

$IONS on a list of a few names where the last few sessions have looked like maybe even forced selling.  Just insane crash, >10% yesterday.

Lots of potentially nice irons in the fire!

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@Sanctuary_Bio $IONS green on open now plummeted again to a new 5 year low.  Nearing 10 year low.  Absolutely out of control.


Hey look! Head of the FDA repeatedly making the point of SPEEDING UP drug approvals $XBI $BBC $IBB

Summary: Bullish biotech/gene therapy on FDA speeding up drug approvals; expects gene therapy recovery.

We have already crashed twice on this, and we have already bounced back twice.  How many times do we have to be fooled until it’s shame on *us* again?

Both of the prior appointments were also higher level than this.

Was just saying to someone else - maybe this biotech bear market has my amygdala fried beyond the point of appropriately processing fear, but I’m just not *that* worried about this 🤷🏻♂.  Maybe naive, but I’m not inclined to get super worked here.

Drugs will keep getting approved.  Rare disease bar isn’t going to get out of control (the man at the top has clearly stated he wants it *easier* to get to market for them).  Vast majority of drugs don’t fall under CBER to begin with...  then, if Vinay truly is exceptionally disruptive, he’ll be gone in 4 years.  Most companies don’t even have BLAs in that timespan anyway.

There are so many ways for everything to end up as “business as usual” here.

***except vaccines***

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Hey look!  Head of the FDA repeatedly making the point of *SPEEDING UP* drug approvals 🤷🏻♂ 🤷🏻♂ 🤷🏻♂

$XBI $BBC $IBB

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Cue the gene therapy recovery $LXEO $RCKT $QURE $RGNX etc


Cue the gene therapy recovery $LXEO $RCKT $QURE $RGNX etc


Actually insane to me that it is still priced the way that it is...extreme pessimism

Summary: Bullish ABVX: compelling P2a/b + P3 pooled response data make current pricing reflect extreme unwarranted pessimism.

That has historically been my $ABVX take too - the whole P2a/b dataset including maintenance/OLEs is HIGHLY compelling for activity.  BUT, the new data we have around the pooled response rate in the ongoing P3 makes it a hell of a lot less speculative.  Actually insane to me that it is still priced the way that it is...extreme pessimsm. https://t.co/8Zo1ZXbSaa

@A_May_MD I spec long'ed into the readout. My reasoning is that it's a totality of data thing. And valuation going into it allows for that.


I am long $ABVX… IMO $ABVX at $9.95 is not appropriately priced going into data at all, and should be trading at a significantly higher level before the readout comes based on the available data

Summary: Long ABVX at $9.95; extensive analysis of pre-disclosed P3 data suggests market underprices success probability, with 2-10x+ upside on August readout vs 90%+ downside if trial fails.

I won't share in depth pitches like $NKTR often (2/year?).  Only with really compelling setups.  I've got another one now.  The market says PoS is VERY low and that upside could be 10x+.  Like with $NKTR, I think the data say success is far more likely than the market thinks.

The name is $ABVX (Abivax).

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Like with $NKTR, I will share my long-form research on $ABVX, for free, via google doc (linked below).  This $ABVX research is extensive, and the document is substantially longer than $NKTR’s was at ~25,000 words.  It will take a lot to get through it, but I think the case for ABVX here is compelling.  IMO the market hasn’t even remotely priced the stock correctly for what I think are relatively high odds of success yielding multibagger potential in August.

With that said, we need to cover some REALLY important notes on bias and risk:
1⃣  I am long $ABVX, meaning my opinions here are heavily biased.  Keep this in mind throughout any of my research that you read.
2⃣THIS IS AN EXCEPTIONALLY RISKY READOUT WITH 90%+ DOWNSIDE POTENTIAL ⚠📉⚠
      ➡NKTR’s downside potential was “only” ~50%.  $ABVX is FAR riskier, and nearly your entire position could be wiped out when the data come if it fails.  PLEASE consider the extreme risk involved in this setup!!!

Now, I actually believe that $ABVX’s odds of success are higher than $NKTR’s were going into data, and I spend a ton of time attacking the existing $ABVX data from every possible angle in order to support this opinion.  I’ll post the link to my research below.  The next slide provides a rough outline of this thread.  If you’re not going to follow/understand anything else from this entire pitch, make sure you check out “Slide 6” 😉

https://t.co/10i67JmoZG

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Outline of $ABVX thread (don’t miss slide 6!):
Slide 1⃣:  Overview of $ABVX and its past
Slide 2⃣:  Why is it so cheap?! Overview of main bear theses
Slide 3⃣:  P2b Induction data
Slide 4⃣:  P2b Maintenance data
Slide 5⃣:  P2a+P2b Long term OLE data and attrition analysis
Slide 6⃣:  P3 pre-disclosed maintenance arm enrollment (the🔑slide, IMO!)
Slide 7⃣:  What is success worth?  UC M&A case studies
Slide 8⃣:  My projections for the upcoming P3 readout
Slide 9⃣:  Summary of thoughts

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Slide 1⃣:  Overview of $ABVX and its past.
$ABVX is a French biotech that’s been developing a drug called Obefazimod for years.  It was initially studied in HIV and later COVID, but has been repurposed for treating Ulcerative Colitis (UC).

The company has historically struggled with poor management as well as an EU-exclusive listing that limited access to capital.  More recently, they got new leadership and launched a US IPO, but it could not have possibly come at a worse time, occurring in October 2023 within hours of an $XBI rock-bottom of $63.85.  The stock has never really recovered from the busted IPO that it was limping into in the first place, and the market has posed a lot of bear theses pointing to the drug failing its upcoming P3 readout.

$ABVX has a make or break readout in ulcerative colitis coming in August.  The upside/downside skew is as wide as any I’ve ever seen, and the market is VERY skeptical that this little French company even has a chance to succeed.  My impression is that the consensus opinion has been that $ABVX will flat out fail in the upcoming P3 induction readout.

Let’s review some of these bear points in the next slide.

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Slide 2⃣:  Why is $ABVX so cheap?! Overview of main bear theses.

Bear thesis 1⃣:  The MoA makes no sense!
➡ Obefazimod’s supposed MoA is to increase the expression of a micro-RNA called miR-124.  However, the company has never really proven how exactly the drug accomplishes this, and frankly miR-124’s effects on the body aren’t straightforward.  When potential investors see the noisy P2b data and the obvious lack of understanding of what the drug actually does, they are consistently turned off by $ABVX as a potential investment.
      🙋♂My take:  I don’t really care what $ABVX’s MoA is, because I base my bull case on the clinical data and how they inform the PoS of P3.  To me, investors being scared away by a mysterious/unknown MoA presents an opportunity to buy the stock cheaper.  However, most investors strongly dislike the fact that the MoA is not understood and automatically write it off because of this.

Bear thesis 2⃣:  The P2b showed inverse dose response, suggesting the “efficacy” is all just noise!
➡It is true that the P2b showed  VERY strange inverse dose responses across all endpoints.  However, when the dosing arms are pooled, I think they are more impressive than $ABVX gets credit for.  Furthermore, I think we can explain the inverse dose response by the simple fact that…the company has no idea what the drug ACTUALLY does!  So, how would they have known how to dose it properly in Phase 2?!

Bear thesis 3:  The P2b’s weakest endpoint was Induction Clinical Remission, which is THE most important datapoint for the upcoming P3!
➡This point is also true - the induction clinical remission data were mediocre.  However, as you will see me argue in the rest of this thread, essentially every other piece of data we have points to a their drug being much more active than their P2b induction remission delta suggested!

There are more bear points for the company (covered in my full document), but the 3 above are the biggest ones.  Importantly, I think each one is able to be strongly countered with the diligence I have done on the company.

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Slide 3⃣:  $ABVX P2b Induction data
Although ABVX’s induction response rate/delta and endoscopic improvement/delta P2b data are quite competitive, the primary endpoint (and focus) in the upcoming P3 readout is going to be Clinical Remission Delta during induction.

Unfortunately for ABVX, this was their single worst datapoint in P2b, coming out at 10% when pooling all 3 dosing arms.  Now, the stock would still trade up if a stat sig 10% delta is accomplished in P3, but the upside would likely “only” be 2-3x since this would be on the low end of competitor efficacy.  The bears don't believe that even this "mediocre" bar will be met in P3.

The inverse dose response seen across 25, 50, and 100mg dosing arms also scares away a lot of investors, making them think the efficacy data are all just "noise" and that the drug is actually inactive.

Here are 4 main reasons why I think the upcoming P3 readout could have a higher remission delta than P2b data (excluding what I think is the single MOST important reason, which is discussed in slide 6)

1⃣Clinical remission delta is the only real outlier result in the P2b data.  Clinical response and endoscopic improvement are both far more competitive.  This supports the idea that clinical remission delta being so low was statistical noise in this small n dataset, and that remission delta is more likely to get better in P3 than it is to get worse.

2⃣The P2b placebo arm had literally the highest clinical remission score of any trial I investigated!!!  $ABVX’s 23% absolute clinical remission score is actually very competitive, but this impressive number is drowned out by the highest placebo remission rate that I’ve ever seen.
      ↪IMO this placebo arm outperformance is a pure statistical outlier, and the placebo arm in P3 will perform more in-line with historical rates in the phase 3, which could mean that the placebo response rate gets cut by as much as HALF.  If the active arm’s efficacy is preserved, the remission delta could be MUCH larger than the market is anticipating (see slide 6 to review how likely this might be).

3⃣$ABVX’s P2b patient population was the most severe population on every endpoint I assessed.  Their baseline MMS score was the highest.  Their fecal calprotectin levels were the highest (more than DOUBLING some other baseline populations’ levels).  Most importantly, the $ABVX patients had failed more advanced therapies than ANY other UC trial I studied.  This is especially marked by the 46% rate of patients having failed multiple advanced therapies, compared to rates usually being in the 20-30% range.
      ➡$ABVX’s P3 will be in a milder, more “normal” population, where I suspect their efficacy numbers will become more impressive.  Regardless, the fact that ABVX was able to show such efficacy in P2b despite having such a remarkably severe baseline population is largely overlooked.

4⃣After induction, $ABVX’s maintenance data suggest that their drug is extremely active.  This further supports the idea that the induction remission delta was the only outlier figure in ABVX’s body of work that suggests mediocre efficacy.  The rest all seem to point to a highly competitive drug.

5⃣Probably the most important reason that I think $ABVX’s P3 study will not only succeed but likely be even better than its P2b is discussed in Slide 6⃣.  Don’t miss it!  Spoiler ➡We actually already have a key piece of efficacy data from the phase 3 trial ahead of time, and I think the market has completely missed/ignored its massive importance. 😉

Attached photos:
(1) Table comparing ABVX’s induction data to other UC drugs
(2) ABVX P2b data broken down by dose level, showing the noisiness and inverse dose responses on multiple endpoints

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Slide 4⃣:  The $ABVX P2b Maintenance data look far better than their induction data

As you can see in the first table attached to this slide, $ABVX’s obefazimod has shown the highest long term clinical remission number I’ve been able to find for any drug.  This further cements my opinion that the drug is highly active and that the mediocre P2b induction remission delta was simply an outlier.

There are 2 major caveats to note when we doing cross-trial comparisons with these maintenance remission numbers, however.
      Caveat 1⃣:  $ABVX’s maintenance phase was open-label, which should artificially INFLATE their maintenance remission rate (though $ABVX’s open label numbers still beat other open label maintenance datasets)
      Caveat 2⃣:  Most competitors’ maintenance phases were “responder enriched” meaning that they only allowed patients who responded to induction to continue onto maintenance.  This artificially inflates the comparators' maintenance efficacy in comparison to $ABVX, whose trial allowed everyone to go onto maintenance whether they were responding to treatment or not.

The large comparator table attached here (first photo) is the same as the prior slide’s but now includes the maintenance data added on the right.

The 2nd table in this slide shows specific “apples-to-apples” comparisons that break down responder enrichment and open label designs.
      ↪Reviewing these data, we can see that $ABVX’s 55% ~1yr remission rate is tied for the highest rate among all drugs with similar trial designs.

Surprisingly, ABVX’s maintenance data even beats the much-hyped new TL1A drug Tulisokibart with 55% remission versus only 48%.  And that includes the fact that the Tulisokibart OLE *only enrolled induction responders*, whereas $ABVX’s maintenance phase enrolled everyone!
      ↪Then, if we look at the 3rd attached table, we compare open label datasets where only induction responders were allowed to be counted for efficacy (“responder enriched”).  This drives ABVX’s remission number way up to 66%, which crushes both Tulisokibart and Omvoh.

The 4th and final table summarizes the prior two, and drives home the point that ABVX seems to have the single best maintenance efficacy data of any comparison that we can make.
      ↪$ABVX even crushes the data we have from the TL1a class, which has been the most-hyped target on the market lately, bringing in 2 buyouts valued at ~$7-$10.8B (representing >11-17x $ABVX’s current market cap despite the fact those drugs only had P2-level data at the time of their buyouts!!!).

These comparisons help strengthen my opinion that the low clinical remission delta $ABVX saw in P1b was simply an outlier datapoint, and that the upcoming P3 readout is going to surprise to the upside.

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Slide 5⃣:  $ABVX P2a+P2b Pooled Induction and Long-term OLE Data With Attrition Analysis

Before their P2b, $ABVX had run a randomized and controlled P2a trial as well (important because many P2a studies, like $MORF’s, are done open label).  Unlike the P2b that had an outlier low remission delta, $ABVX’s P2a clinical remission delta was concordant with the rest of their efficacy data, coming in at a very impressive 24%!
      🗒Note, the P2a was a much smaller sample size, so the best utility of this dataset is to pool it with the P2b numbers.  Combining the P2a sample with the P2b sample raises $ABVX’s clinical remission delta from 10% to 12%, taking them from the bottom of efficacy comps up to matching the efficacy of the mega-blockbuster UC drug Entyvio!
      ↪This is yet another datapoint showing that $ABVX’s low P2b remission delta was likely a statistical outlier in the P2b dataset that consistently showed greater efficacy elsewhere!  See the comparison/pooled P2a/b data in the first table attached.

Beyond this, I found one more way to analyze the existing P2 data to gauge the drug’s level of activity:
👉Examining the attrition rates of $ABVX's super-long term OLE trials.

The basic premise is this:
↪ABVX enrolled the most severe population of UC patients in any trial I could find.  If these patients were being treated with an inactive drug, they’d be highly unlikely to stay on the drug for long periods of time.  So, if we can compare attrition rates on ABVX’s OLE to the OLE phases of FDA-approved drugs that we know for a fact are active, we can get an idea of if and how active $ABVX’s drug may be.

Real-world studies consistently show that the discontinuation rate of advanced therapies for UC is 50%+ by only 1 year.  I have discussed several of these studies in my full pitch document, but for brevity in this thread, let’s just look at clinical trial OLE comps for $ABVX...

$ABVX has run and published extremely long-term “extra” OLE data, with patients having been on drug for >2-4 years.  These data were generated by running an OLE after an OLE (4 years after the P2a and 2 years after the P2b).
      ↪We can tell how many patients continued on $ABVX's drug for longer than 2-4 years by the number of patients who enrolled into this “extra” OLE.  Of 239 eligible patients (those who had entered the first OLE 2-4 years earlier), 130 enrolled into the “extra” OLE.  130/239 = 54.4% enrollment rate, meaning 54.4% of patients who started the drug 2-4 years earlier were still on the drug!

Of all the drugs I analyzed, the only one with up to 4 years worth of P2 OLE data publicly available was Zeposia.  Note that, unlike $ABVX, the Zeposia trials ONLY ALLOWED RESPONDERS ONTO MAINTENANCE/OLE, meaning that Zeposia’s dataset is heavily responder enriched and thus artificially inflated (unlike ABVX’s studies which allowed NONresponders to continue on treatment).

Between 2-4 years, Zeposia’s (responder enriched) continuation rate ranged from 60% to 42%.  Comparing to $ABVX’s (non-enriched) rate of 54.4% with a blend of patients on drug for 2-4 years, I would say that $ABVX’s drug continuation rate is HIGHLY similar to, if not slightly better than, FDA-approved Zeposia’s.  In any case, this is NOT the sort of long-term drug continuation that I would expect to see for an INACTIVE compound in a set of VERY SEVERE patients.

See the 2nd photo attached for a table comparing these attrition data.  I believe that this is yet another strong datapoint supporting the idea that $ABVX’s obefazimod is not only active, but significantly so.

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Slide 6⃣...The🔑 Slide!
👉Analyzing $ABVX's pre-disclosed P3 maintenance arm enrollment

🚨I consider this the most important slide of my $ABVX pitch, and I think it digs into a key piece of data that the market is totally missing the importance of!🚨

…$ABVX has pre-disclosed the enrollment rate of their P3’s maintenance arm with 87% of the trial completed!

Why is this so important⁉

Because only induction responders are eligible to enroll into the maintenance arm, meaning...***we now know the pooled response rate of their phase 3 induction study*** 87% of the way through its completion!

This fact is disclosed on a single new slide from their June 2025 corporate deck (first photo attached).  We know that the data are complete through 87% of the trial (1111/1275 enrollment), and that 597 patients of the 1111 assessed so far have been responders!  So, the pooled response rate in the study 87% of the way to completion is 53.7% (597/1111).

The company does not discuss this fact further, and I’ve seen no deep analysis of these numbers elsewhere.  I think people have failed to dig further here and realize that these numbers are telling us that the trial is far more likely to succeed than the market is giving $ABVX credit for!  Let’s dig into the numbers and learn why I say this:

➡$ABVX’s P3 has the same randomization ratio of drug to placebo as the P2b did (3:1).  In a vacuum, we would thus expect their P3 and P2b pooled response and remission rates to be the same.
...However, as previously discussed, $ABVX’s P2b study had a VERY atypically high placebo remission rate and an above average placebo response rate.  Accordingly, if we expect the treatment-arm patients to perform the same in P3 as they did in P2 but for placebo patients to regress to the mean, we would expect the pooled response rate to come DOWN slightly in phase 3.

...However, with the data the company recently released, we know that $ABVX is actually seeing the opposite!  The P3 pooled response rate has been higher so far in P3 than in P2!
      ➡P2b pooled response rate: 51.2%
      ➡P3 pooled response rate: 53.7%
            ↪P3 is 2.5 percentage points higher!

Now we can use different sets of assumptions and apply them to the facts that we already know (pooled response rate and randomization ratio) in order to determine how the P3 study may be tracking.  The key assumption variables we must adjust are:
      ➡Placebo response & remission rates
      ➡Treatment response:remission ratio

I’ve built 2 main assumption cases to project what $ABVX’s trial may be on target for:

Case 1⃣➡ ABVX’s trial performs like prior P3 oral treatments have in the past.  This is the most robust case, as it uses a sample size >2,000 patients combining Rinvoq, Zeposia, and Velsipity P3 trial data (I will call this the “R+Z+V dataset”).  This dataset establishes:
👉Placebo response rate of 27.7%
👉Placebo remission rate of 5.5%
👉Treatment response:remission ratio of 2.46:1

Applying these historic P3 assumptions (the n>2000 R+Z+V dataset) to what $ABVX has already disclosed, we find that $ABVX would be on track for a clinical remission delta of 19.8% with the P3 study 87% completed.  This is huge.
      ↪This would be a black swan event from $ABVX’s current price, almost certainly (in my biased opinion) leading to triple digit stock prices (1,000%+ upside).  Normally such an outcome would be an extremely unlikely result, but what makes this setup so compelling to me is that:
            ↪...if you combine the data we literally already have from $ABVX’s trial with the simple assumption that the study will just perform like the average phase 3 study…it shows that this shocking level of efficacy is what the company is actually already on track for!  $ABVX’s current price does not come close to reflecting the real possibility that efficacy of this magnitude could be seen in the upcoming readout.

Case 2⃣➡ ABVX’s trials performs like its P2b trial, which had the highest placebo remission rate of any oral therapy I’ve ever seen (12.5%, versus 2nd closest of only 7% by Velsipity).  Assumptions:
      👉12.5% placebo remission rate (like what was seen in P2b)
      👉Treatment remission rate of 2.47:1 (note that R+Z+V’s rate was 2.46…incredibly consistent!)
      👉34.4% response rate (like what was seen in P2b)

One might assume that this case produces a bearish result, because ABVX’s P2b had record placebo remission rates that made their placebo-adjusted delta look bad.  However, with their pooled response rate trending higher in P3 so far, these “bearish” P2b-like assumptions not only lead to ABVX still hitting, but coming in at a very bullish 11.8% remission delta!
      ↪This would match Entyvio’s level of efficacy, and IMO still yield 3-5x upside potential.  Again, ABVX’s stock is pricing in a high chance of failure, but now that we know how high the pooled response rate in the P3 study is, we can apply even bearish assumptions for how the rest of the trial is going to go and STILL arrive at results that would cause the stock to rocket!

I've done the math for 2 more potential scenarios:
      ➡One scenario that assumes that the prior 2 scenarios simply meet in the middle, taking their average and yielding a 15.8% remission delta (a >5x upside case IMO).
      ➡One that assumes BOTH the worst P3 oral placebo response EVER, and the worst P3 response:remission ratio EVER somehow occur in ABVX’s study at the same time…the math says they could still be on track for a 10.3% delta (which I think would likely be stat sig, and yield 2-3x upside), despite these super bearish assumptions...

The math, in my opinion, suggests that the trial is heading for a remission delta in the mid-to-high teens, a scenario which has black-swan level upside potential.  The math also says that combining multiple “worst-ever” assumptions still likely leads to a successful trial, all based on ACTUAL data that we have from the P3 trial ahead of time.

Contrast these compelling numbers with the fact that $ABVX’s stock is largely priced for high odds of failure by the currently skeptical market…I do not think that this is appropriate, and I think the utility/significance of this subtle data disclosure that $ABVX recently made has been totally missed by the market at large.  I believe that this overlooked data/analysis is a major source of alpha for my investment case in $ABVX.

Guide to attached photos:
(1)  The slide where $ABVX disclosed the data in their June deck
(2)  The outcomes of the 4 assumption cases noted above, with R+Z+V trial comps included
(3)  The math/explanation that supports the data in the prior photo
(4)  The assumption cases placed in context of data for approved drugs (efficacy comparisons)

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Slide 7⃣:  What is $ABVX success potentially worth?  UC M&A case studies.

In the last slide I referenced the potential upside of numerous “trial hit” cases, and the numbers may look pretty steep (ranging from 2x to >10x).  How do I arrive at such high upside cases?  Well, other investors and sellside firms have been discussing 5-10x upside possibilities, but what is this all based on?

To benchmark the value $ABVX’s Obefazimod if it hits in its P3 UC trial, my preferred approach is looking at the valuations of the numerous M&A cases that have recently occurred in this space.  Let’s do that in this slide!

👉Between 2015 and 2023 there were 4 buyouts of UC assets that were post P2b data, but pre P3 induction data.  These deals ranged from $6.7B-$10.8B.  This fact alone puts $ABVX’s current ~$630M valuation into compelling context, especially when you consider that $ABVX is about to have P3 data in hand while these buyouts were done years before their P3 data would become available!
   ➡$RCPT (Zeposia), 2015, $7.2B.  Bought out ~4 years before P3 data. Me-two MoA.
   ➡$ARNA (Velsipity), 2022, $6.7B.  Bought out ~3 months before P3 data.  Me-two MoA.
   ➡$RXDX (Tulisokibart), 2023, $10.8B.  Bought out 3-4 years before P3 data.  Me-three MoA.
   ➡$ROIV (Televant - RVT-3101), 2023, $7.1B.  Bought out ~4 years before P3 data.  Me-three MoA.

The above 4 examples were all post-Phase 2 UC buyouts, with an average price of ~$8B (1170% upside from $ABVX’s current market cap).

Furthermore, all of these buyouts were for drugs with known competitors with the same MoA having already been approved or in the pipeline (me-two or me-three drugs), versus $ABVX’s obefazimod that is the ONLY drug even in development with its MoA.
      ↪Perhaps even more striking, these companies were bought 3 months to 4 YEARS *before* their P3 data would become available…Meanwhile, $ABVX will report its P3 data in the next few weeks.
      ↪Finally, if you look at apples-to-apples maintenance data comps for the bought-out drugs, $ABVX’s maintenance data so far actually looks better than all of them…

So, despite being WAY further along on timeline, having arguably better P2 maintenance data, and being the only drug candidate with a unique MoA on the market/in development, $ABVX trades at <1/12th of the average valuation of these Phase 2 acquisitions while $ABVX is going into their P3 data…

See all of that information broken down in the first attached table.

✌There are actually 2 more valuation case studies we should use for $ABVX:  $MORF and $PTGX

1⃣$MORF was bought out by $LLY last year for $3.2B.  Their drug was an oral therapy going after the same target as the mega-blockbuster UC drug Entyvio.  Although the target is clearly lucrative, $MORF had 3 big problems:
      Problem 1:  MORF’s data were extremely early.  They were bought out with only P2*a* data.  This is earlier than all the other buyout cases, and represented a >5 year path to market at the time of acquisition.
      Problem 2:  MORF's dataset was open label!  Even $ABVX’s P2a was blinded/randomized/controlled.  This made $MORF’s early p2a data even harder to trust.
      Problem 3:  Despite having the benefit of being open-label, $MORF’s data were still not super impressive.  Specifically, their endoscopic remission rate was surprisingly low - so low that the company purposely avoided disclosing it when they initially released the rest of the dataset!  When they finally did release the disappointing number at a conference months later, the stock cratered.

👉Despite all of these Problems, $MORF was bought out for $3.2B shortly after P2a data…With all that baggage, their upside was still 5x what $ABVX currently trades at.

2⃣$PTGX is also developing an oral therapy going after a target that is already on the market (IL-23).  However, they only own 6-10% royalties and some milestones for their drug - $JNJ owns the rest.
      ↪In March of last year $PTGX released P2b data (the equivalent of what $ABVX reported back in 2021).  It was already expected that the trial would hit, because the same drug had POC data from psoriasis, and the IL-23 target is already fully validated in UC (there are already 4 IL-23 targeting drugs FDA approved for UC).  So, the question was not if it would hit, but how strongly, meaning that some value for this indication was *already priced into the stock*

➡$PTGX’s data beat expectations, posting a 19% remission delta in their P2b readout.  This is a very competitive number, and the stock reacted favorably to this hit that was bigger than expected.
      ↪$PTGX added $1.25B in market cap that day (a day in which the $XBI was down as much as 5%!).  Adjusting roughly for $PTGX’s 6-10% royalty ownership of this drug by simply taking that number times 10, the equivalent “value” increase that $PTGX’s drug produced would be ~$12.5B!!!  And that was the upside to a scenario in which a "hit" was already expected!!!
      ↪The move was so profound that even the pharma giant $JNJ’s stock traded up on the news that day!  Although upside of this magnitude would be a stretch for any outcome that $ABVX could see from their P3 data, a valuation of $12.5B would be 1,884% upside from its current market cap…

So, in addition to the 4 buyout cases above, the $MORF and $PTGX case studies add further evidence that $ABVX’s upside on a successful P3 readout could be massive.  The lowest post-P2b buyout comp is $6.7B (>10x $ABVX’s market cap), and the $PTGX case shows a comp from this year reaching ~$12B in “value” for a drug that would have a me-five MoA and still come to market later than $ABVX would.

$ABVX will be post-P3 soon, making it more advanced than any of these valuation comps.  It is the only drug with a unique MoA with no competition in the pipeline.  It could be the first oral therapy to ever make it to the UC market with no black box or severe infection warning…Although I am not projecting for $ABVX to quite reach these M&A valuations right away if they hit, one could see why such a valuation might be possible given how unique $ABVX's asset is...

IMO, these valuation case studies suggest that even the low-end efficacy “success” cases should have >2-3x upside (~$1.2B-$1.8B market cap), and the upside cases of $PTGX-like efficacy could easily yield >10x upside.

$ABVX at even 10x from current prices would still have a lower market cap (slightly over $6B) than *all* the post P2b M&A comps...and unlike all of those comps,        would be post P3, with a unique MoA, and likely a clean label for an oral drug.  The upside potential here in the event of unexpectedly strong efficacy could be truly massive.

Of course - here’s another regular reminder that if this trial fails completely, the downside would be massive as well!

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Slide 8⃣:  My projections for the upcoming $ABVX P3 readout

I’ll refer back to slide 6’s main table for this, in which I used the company’s pre-disclosed P3 pooled response rate 87% of the way through the trial and applied various assumptions (both from prior $ABVX studies as well as large samples from pooled P3 studies).

I think the most likely range of clinical remission delta is probably somewhere in the 13-15% range.  This is based on my extensive analysis of both historical P2 data and the pre-disclosed P3 data that I’ve shared here.  Now, this does not mean that the probability of the clinical remission delta landing between 13-15% is high, or even >50% for that matter.
      ↪But of the *many* potential outcomes that are each individually unlikely, I think that the 13-15% remission delta captures what is the most likely.  Importantly, efficacy in this range would almost certainly yield >5x upside from current levels.  5x from here would still only be a ~$3.15B market cap, which looks tiny in the context of the M&A comps discussed above.

The blue sky upside case of a high teens to 20% clinical remission delta (which again, only assumes that $ABVX’s P3 placebo responses are simply performing in line with historic P3 comps…) would almost certainly yield >10x upside in my opinion.

With these degrees of upside on the table, the market is clearly underwriting a much lower probability of success for $ABVX than I am, and likely completely ignoring the possibility of “blue-sky” level outcomes.  IMO $ABVX at $9.95 is not appropriately priced going into data at all, and should be trading at a significantly higher level before the readout comes based on the available data.

Still, despite the realistic chances at major upside that I’ve discussed, we must not forget this: THE DOWNSIDE POTENTIAL IS STILL REAL AND WOULD BE DEVASTATING AT 90%+.

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Slide 9⃣:  $ABVX Key Points and Summary of Thoughts

The market is extremely skeptical that $ABVX is going to hit in the upcoming P3 readout, and the stock has largely been forgotten or even simply ignored for years.

Most of this pessimism stems from a questionable/uncertain mechanism of action and P2b data that showed an inverse dose response, as well as mediocre outcomes on the most important endpoint:  Induction clinical remission delta.

However, as I’ve discussed here, I’m not deterred by an unknown mechanism of action when the clinical data show me that the drug is active, which I strongly believe to be the case for $ABVX.  For years, I’ve been bullish on $ABVX’s odds of success due to:
      ➡The strength of the P2b results outside of the clinical remission delta (clinical response and endoscopic remission numbers looked more competitive)
      ➡The fact that $ABVX’s P2b study had the most severe population of any UC study I have evaluated, explaining why their results might look worse despite having an active drug.
      ➡The fact that the P2b maintenance data look as good as, if not better than any other maintenance datasets I can find and make apples-to-apples comparisons against.
      ➡The fact that $ABVX’s extra-long-term OLE studies show their severe patients stay on their drug at rates matching or even exceeding what is seen with drugs that are already FDA-approved for UC!

These data have all supported my $ABVX bullishness historically, but when I realized the importance of the maintenance arm enrollment rate data that the company subtly released in June, my enthusiasm for their POS increased significantly.
      ↪Knowing that the pooled response rate 87% of the way through the trial is actually higher than the P2b study’s was with its historically high placebo remission rate…I feel even more confident than before that the trial is going to hit, and I even consider it possible that “blue sky” level efficacy capable of generating >10x upside results could be in play.  I think that the market has totally missed how bullish this data disclosure is, which is a big part of why I felt this pitch was compelling enough to share.

I strongly believe that $ABVX trading at $9.95 does not reflect how positively skewed the risk:reward setup is going into data, but we also must remember that downside here is steep (90%+) if the readout does fail (which is ALWAYS possible).

I expect data to come in August.  In the meantime, I welcome feedback, thoughts, and questions on what I’ve shared here today!  I’ll post the link to my >25K word pitch document here again:
https://t.co/10i67JmoZG


Summary: Endorses parent's view that LLY settlement will be material; multiple upcoming catalysts cited.

@CloisterRes 100%.  Nobody more biased than me but I’m shocked how cheap this still it…P3 ready for atopic derm with new MOA…Lilly settlement…dapirolizumab royalty coming…P2 alopecia areata readout with this newly validated drug only a few months away.

wtf

You also have to assume the $LLY settlement will now be material because you can argue that correct data would have been worth a +160% move ie $150+m market cap, plus time value of money etc etc.


assuming it's going to keep grinding higher. Too much to ignore at a certain point

Summary: Bullish BBIO; expects continued grind higher once large seller exits, sees it as undervalued under $40.

@MBbiotech Some big old holder must be trying to get out for this thing to still be under $40.  Surprised it’s under that level but assuming it’s going to keep grinding higher.  Too much to ignore at a certain point.

$BBIO everyone is focusing today on Attruby; Cantor making the point this morning "...in the post-surgical hypoPTH setting, Encaleret alone could deliver $2B+ in peak sales and justify the entire valuation of the company. And yet it gets virtually no attention from investors".


Levering up small cap biotech. $XBI at $79

Summary: Levering long XBI at $79, expects -5% move to bounce; small-cap biotech can't get much worse.

BRB, Levering up small cap biotech.

$XBI
$XBI at $79
#WhatIsDeadMayNeverDie

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$XBI -5% bounces imo.  We’ll see 🤷🏻♂

Famous last words but some of these small caps “can’t get much worse”.


Summary: Bullish XBI: current levels undervalue biotech given prevailing yields; selloff overdone with worst-case already priced in.

$XBI has consistently traded higher than current levels with yields where they currently are or even slightly higher at times.  The recent selloff priced in *EVERYTHING* being worst case scenario.

Rates are important - but biotech can do better than the recent  *absolute doom* even if yields/rates don’t flip quickly.

Biotech probably been shorted to the other side of the blackhole by these funds - .. interesting that it is actually doing better even w/ the interest rate headwinds - ..


Summary: Strongly bullish BBIO: physicians unanimously preferring acora over vutri and citing easy approval/paperwork process as major adoption catalyst.

Probably any cardiac-related hospitalization would be my assumption. *Maybe* symptoms worsening?

But I'm more taken aback by the statements like saying you're not going to use Taf anymore...and basically unanimous agreement across all surveys/interviews that they'll use more $BBIO acora than vutri.

Also, when doctors say that their offices are having to fill out less paperwork for $BBIO's drug and that the approval process is easy....PAY ATTENTION TO THAT BIG. TIME.

@A_May_MD I like BBIO, but 'progress' in this context is odd to me

What does that mean? Patients having more cardiovascular-related hospitalizations than they would like?


it's still *far* below the near ~$5 range it was playing with before "the scare"… It should still be up more

Summary: Long LXEO (owned): still far below pre-scare ~$5 level, financing overhang removed, FA program strong; also bullish XBI on gene therapy recovery heating up.

Ehem.  Exactly one month later.  $XBI is now *UP* from the Vinay scare/crash, and the gene therapy recovery is heating up.
$XBI $BBC $IBB

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I’ll focus on $LXEO here a little too as it’s one of the gene tx companies I know more about (and own).

Since literally the minute the Vinay thing was announced, you could spend a couple hours and find numerous examples of him supporting accelerated approvals for rare disease.  Despite that, $LXEO plummeted and just would not rebound.  These examples of Vinay’s leniency were dug up and shared by people multiple times, yet $LXEO could barely bounce.  Before this news, it had traded briefly as high as the $5.50s since the liquidity crisis of $XBI $66.66.  It was cut in half from there on the Vinay scare.

Today it’s finally moving a little on this FDA round table discussion yesterday, where Vinay literally just repeated things that were a matter of public record all along about willingness to approve drugs with speed and surrogate endpoints.  If you had a level head about this, you could’ve bought a bunch more $LXEO knowing this scare was clearly overblown.  All this was pretty easy to find but nobody seemed to care…

As for $LXEO, it’s currently pumping l at $3.80 and it’s still *far* below the near ~$5 range it was playing with before “the scare”.

Since that time, $LXEO has
-Removed their financing overhang (now financed all the way through pivotal for FA)
-Potentially had the door opened to an indication that has long supported a ~$1B valuation for $RCKT follows Rocket’s safety issues.  The FA program so far is excellent POC - why can’t $LXEO become the leader in Danon too?

Yeah it has bounced a lot from the $66.66 crisis.  So what.  It has crashed a TON from 52wk highs.  It should still be up more 🤷🏻♂.  The people who participated in the recent financing got an absolute STEAL and should be rewarded for acting on basic information that was clearly evident while others were losing their heads.

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$LXEO Accelerated Approval Plan > Munich Agreement https://t.co/AnyVCiWlY5