Summary: Bearish APGE: high-dose data underperformed mid-dose, management's core dosing narrative is now falsified, results unimpressive vs Lebri P2b.

$APGE and their longs have spent years saying that Dupi/Lebri were underdosed and that higher dosing was going to improve efficacy.  Today their data show the inverse of that, with high dose underperforming mid dose in every way.

Watch how fast their management team completely abandons what (until today) was their key narrative now that it no longer suits them..."Ignore the 1,000 times we said that exposure thing...this thesis is intact and better than ever!"

This management team's constant spin bullshit drives me crazy (like saying ISRs are the biggest problem for Dupi - objectively and easily falsifiable bullshit.  Only was that was not a *lie* is if you accept they're unintelligent enough to misunderstand what an ISR is.  Which is worse?).

Anyway, look at their long-awaited high dose P2b results, and compare those to Lebri's (Ebglyss) P2b results...Sorry $APGE, I'm not impressed.


Summary: Margin compression concern is overstated vs. how far the market has sold the stock; implied bullish on Novo Nordisk.

Novo Nordisk ADR on NYSE: NVO; GLP-1 context matches

@CloisterRes “But margins have been compressed”

-analyst who couldn’t tell you what PBM stands for

*(The statement is true to an extent, but not nearly as far as the market has taken it)

A different way of looking at it:

Oral Wegovy starts are already higher than injectable Wegovy peak starts. That peak occurred in April '24.

Look where the stock was trading in April '24 vs today.... https://t.co/FQ4kyp6McN


the value of $ABVX, I believe, will be determined by big pharma, so in the end this should all be noise... a dataset that actually surpassed all bullish expectations... what ultimately may have been a major opportunity gifted by the pods

Summary: Bullish ABVX: pod-driven selloff was irrational given data that surpassed bullish expectations; specialists see no black-box risk and big pharma will determine value.

structural marker; pre-classified as canonical yfinance ticker

To better explain the the “pod bro” mentions on $ABVX you may have seen these last few days…

“Pod bro” is a (IMO somewhat derogatory) term describing investors who work at “pod shops”.  Pod shop is a slang term for a specific investment fund structure wherein a very very large firm (think hundreds of billions of dollars in assets under management) has many smaller hedge funds that all operate independently of the others.

So you may have “Giant Fund Capital” that is actually comprised of a bunch of smaller (though still large) independent funds under the larger fund’s name & reputation.

In biotech (and I imagine other sectors as well), “pod shops” have a reputation for piling into and piling out of names all together.  “Lemmings” behavior leading to massive overshoots in stock movements.

Now, to be clear, there are some absolutely brilliant pod shop managers and teams in biotech that could go toe to toe with any independent specialists.  I don’t want to suggest that “pod shop” is an automatically bad thing.  There are not just good ones, but fantastic ones.

But, based on what I have seen and heard in the last few days, I have very little doubt that some pod shops who were *way* out of their depth were likely the biggest part of why $ABVX sold off on data that specialists seem to unanimously agree was outstanding on all counts (including LACK of a cancer signal).

Sure $ABVX could’ve presented the data far better, but all the specialists seemed to understand it well almost right away and determined that no black box warning risk exists *despite* the communication fumble.

Some “retail” investors might’ve got swept up in the frenzy, but the volumes and magnitude of the move spoke to larger investors (pod shops) bailing out.

When you hear people complaining about pod shops we are complaining about sentiment/momentum investors that larping as biotech investors while not actually having the deep expertise needed to know what they’re doing (again, to be clear there ARE great pod shop managers, but even they would complain about the larpers).

Another huge “issue” with the pods is that they often have VERY strict risk criteria.  They operate under the rules of their parent fund, not their own.  This often entails requirements to sell when down moves are severe (whether for risk management or other reasons).   This is a HORRIBLE structure for small cap biotech because it’s insanely volatile, and big moves can happen at a moment’s notice.  This can cause an avalanche effect, which is likely another big component of what we saw Tuesday with $ABVX.

I personally have little doubt that “the pods” caused a huge part of the rapid $ABVX drawdown, which created a self fulfilling prophecy in the stock price among other pod shops and retailers:
      ➡ “Some people are saying there’s a cancer risk and the stock is suddenly CRASHING, so it *must* be true - I better sell too!”

And so we saw a ridiculous drawdown on a dataset that actually surpassed all bullish expectations.  The triggering event was $ABVX’s poor communication, sure, but the pre-existing risk factor was a group of undereducated investors managing more money than they should be allowed to in a highly technical field, all while having mandated “risk management” parameters that make them inflexible at the worst moments.  Selling begot selling begot selling.

Ultimately, the value of $ABVX, I believe, will be determined by big pharma, so in the end this should all be noise.  But if we are trying to understand how this stock could come down and (hopefully) all the way back up so fast, this is IMO the primary driver.

The specialists here can actually analyze these data and determine that the *existing* data do not constitute a black box warning even *before* we get the additional data that could further exculpate the drug.  They will get to capitalize on what ultimately may have been a major opportunity gifted by the pods!

@A_May_MD @CloisterRes What does pod bros mean? Who are these people? Sorry for asking such ignorant question!


Summary: Short APGE; expects the recent shine to fade, flagging a Black Box Warning as the catalyst.

A whole lot of that freshly minted shine is about to wear off.

$APGE

-short

---

*Ehem*

$APGE

#BlackBoxWarning


Summary: Confirms a new long position in NVO as of today, albeit reluctantly.

@byebyegoodguy As of today.  Sometimes you gotta hold your nose and cross your fingers that some Danes go into the office and get some shit done 🤢 🙏🏻 🙏🏻 😅

@A_May_MD Besides being short hims, you're long NVO?


NKTR's price should rise to a level where that is not tenable

Summary: NKTR price expected to rise as LLY opts to settle rather than buy or go to trial.

@somecuriousgirl @jayabacus IMO still low.  NKTR’s price should rise to a level where that is not tenable and imo Lilly should end up settling.  Insane to me to let this go to trial

@A_May_MD @jayabacus How do you btw see the chance of $LLY outright buying $NKTR after today's data?


bUt $HIMS DeSeRvEs A hIgHeR mUlTiPlE bEcAuSe ItS a GrOwTh CoMpAnY

It's over, folks.

Summary: Sarcastic mockery of HIMS growth-premium thesis after weak subscriber adds; author is bearish.

Drug Manufacturers - Specialty & Generic

bUt $HIMS DeSeRvEs A hIgHeR mUlTiPlE bEcAuSe ItS a GrOwTh CoMpAnY

It’s over, folks.

🚨 $HIMS ADDED ONLY 40,000 NET NEW SUBSCRIBERS IN Q4 2025

A GAIN OF JUST +2% vs Q3 2025 🤯 https://t.co/BUYilDWXPW


Summary: NVO wins by stopping HIMS IP theft and expanding legitimate channels; HIMS personalized dosing scam ended.

$NVO ***FINALLY*** ended the $HIMS “personalized dosing” scam!!!

$NVO had the leverage here, and this is a win/win for them ➡ Stopping IP theft *and* increasing access to their legitimate channels in one swoop.

Not the way I foresaw it playing out, but will give credit where it’s due to $NVO management:  100% the right business decision here.

---

Some food for the haters while we are at it https://t.co/gNiZaG5WtU


Summary: Added to NKTR at open; sees violent rerating to triple-digit price as institutional support arrives via new offering, closing massive valuation gap vs peers.

Bought more $NKTR at open.

Should’ve done it yesterday, but really don’t have dry firepower and already hugely overweight the name.  Had to move some stuff around to do so.

After sleeping on it, the thing for me is that this asset has been insanely undervalued for a long time, so “what changes that?” is the question.

What it has lacked has been institutional support (and thus, funding).

That’s going to change with this offering.

The disconnect on valuations to peers (which is a term I use somewhat begrudgingly as I think $NKTR is in many ways a superior asset to “peers” that hold multiples of its valuation) has been massive.

That gap is big enough that the name finally switching to a “legitimate” name with real specialist interest/support is likely going to lead to violent rerating.

I think it follows the $ABVX model and in relatively short order grinds up to a triple digit stock price.

IMO the legitimate inflection point is finally here for $NKTR.


Summary: Expects ORKA P2a data tomorrow to show IL23p19 beats placebo in psoriasis, but flags $5B fully diluted cap as a valuation concern.

Tomorrow $ORKA will show P2a data that will tell us whether or not IL23p19 inhibition (the most widely used FDA-approved target for psoriasis treatment in the history of the world) can accomplish a higher PASI100 response rate than placebo in psoriasis patients.  Exciting!

My opinion?  I predict that placebo doesn't stand a chance against the most effective target in the history of psoriasis treatment, as validated by over a decade of evidence from other IL23p19 inhibitors!

The stock is already up 115% since a few weeks ago in mid March, so let's hope that the P2a data tomorrow prove that not only can every other IL23p19 inhibitor ever invented treat psoriasis effectively, but also $ORKA's!

Otherwise, it sure would be tough to launch against the biosimilar IL23p19 inhibitors on the market!

Totally unrelated (because why does valuation matter to anything anyway?) - the fully diluted market cap is getting close to $5B already!


Summary: Bullish ABVX: new slide data shows cancers were pre-existing before Obefazimod exposure — earlier identification + indolent subtypes meaningfully de-risk the safety concern.

I would disagree that there are no surprises in the new $ABVX slides or that this was all shared at guggenheim.  For one thing, they were way off on the prostate cancer timing.  At gugg they said day 367, but it actually was identified much earlier.  Very important.

Also, they had said the patient was exposed to prior therapies, but they didn't say which...we now find out that FIVE of them have cancer labels, including 3 with black box cancer labels.  Very important info.

We also didn't know the cancer subtypes.  These could've been very aggressive, rapid growing tumors.  Instead we find out, not only were they identified earlier on in the study, they were also more indolent, slower growing subtypes, further supporting the idea that these cancers were PRE-EXISTING before these patients even had any exposure to Obefazimod.

New and quite meaningful info IMO.  Not sure what's up with the quiet disclosure of it.

So $abvx quietly updated corporate deck with the case by case breakdown this afternoon. https://t.co/tV9NOLBRzS

No surprises, everything that has been shared already by either some of us or sellside, but would’ve appreciated some better messaging from the co than just dropping https://t.co/RKR6229Uvy


Summary: Bearish Intellia: insufficient capital raise proves thesis; expects stock to fall from here.

@EliKorey You’re wrong.  I said they won’t be able to raise the amount of money that they need.  That was just proven right.  Quiet and watch the stock go down.

@A_May_MD It did not take long for your opinion that Intellia would not be able to raise money to be wrong. Also explains some of the weakness in the stock in the latter half of the day. The company was not going to raise their capital needs in one offering.


The fact these guys have to be so overly promotional and spew such absolute bullshit should concern $APGE investors IMO. If you've got to say absurd bullshit to keep the stock supported, you're not on good footing.

Summary: Short APGE: management making implausible claims that Dupixent going generic will have zero impact on their same-MoA drug launch; promotional BS signals weak fundamental position.

Another round of my eyes rolling completely out of my head every time I listen to $APGE management speak.

At GS they said, in no uncertain terms and multiple times, that Dupixent going generic will have ZERO impact on the launch of their own IL4/13.  ZERO impact?!?!  On the launch of a 12 year late drug with the same MoA?  None???

Absolutely absurd.  They went on about payer dynamics and never once mentioned prescriber dynamics.  You don’t think we will prescribe a drug that costs a few thousand dollars/year over one that costs $60,000 a year???  Ridiculous.

They try to cite the example of stelara going biosimilar with other IL23 launches still going well despite that…this is not at all an appropriate comparison, as Stelara is a DEMONSTRABLY inferior drug to the modern p19 IL23s (Stelara is a p40 IL12/23 drug).  Comparisons like this (slating obviously inferior/superior drugs against eachother) are a common defense for the YTE cabal, and they’re cope.

The fact these guys have to be so overly promotional and spew such absolute bullshit should concern $APGE investors IMO.  If you’ve got to say absurd bullshit to keep the stock supported, you’re not on good footing.

And to be clear, if you *actually* think that Dupixent going generic will have ZERO (!!!!) effect on the launch of other branded drugs with THE SAME MECHANISM OF ACTION, I sincerely think you are delusional.  Full stop, delusional.  Management doesn’t believe this “no impact” nonsense either - it would be *insulting* of me to think they actually do.

Btw, Ebglyss wasn’t mentioned a single time in the entire meeting 🤷🏻♂

I've got to complain about $APGE again.  You're welcome to take my opinion with a grain of salt since I've disclosed that I am short, but IMO they are spewing absolutely *blatant* bullshit about ISRs (add them to the LLY legal team!).

I heard them in 2 recent calls saying that https://t.co/pMMYwvYdif


Summary: LLY's nondepleting CD19 mAb failure is negative for ZBIO but positive for CLYM.

@AppleHelix $LLY mAb is nondepleting.  Negative readthrough to $ZBIO, positive readthrough to $CLYM.


This makes it the single most overvalued stock that I cover. $7B for phase 2a data that only matches existing bars and will have to go against massive biosimilar competition in the single most well-served indication in dermatology. Absolutely absurd. #Short

Summary: Short ORKA: $7B market cap for phase 2a data that merely matches existing IL-17/IL-23 bars, with massive biosimilar competition ahead in a saturated I&I indication.

$ORKA with 63% PASI100 at week 16.

High dose skyrizi in the knockout trial achieved 67%.

In phase 3 Bimzelx achieved 62%.

At >$100 parmarket, $ORKA’s market cap is nearly $7B.

This makes it the single most overvalued stock that I cover.   $7B for phase 2a data that only matches existing bars and will have to go against massive biosimilar competition in the single most well-served indication in dermatology, and likely in the entire landscape of I&I.  Absolutely absurd.

#Short


Summary: Bullish ABVX: current adverse-event rate already below clean-label comps; stock will trade up even if new cases emerge.

If that' one's true opinion then shorting $ABVX would be the logical conclusion, because statistically it is a near certainty that there will be "more cases".

FWIW I think your conclusion here is completely, demonstrably incorrect.

As long as the RATE of cases in the new data *stays* below the relevant comps of clean label drugs (yes, $ABVX's CURRENT rate is already there), the stock will trade up, even WITH new cases in the new data.

@A_May_MD @ezmoneymonty @byebyegoodguy @thetwitabides @AndrewRangeley For long term investors agree no issue. For those leveraged for a trade, or in short traded options, playing with Lady Luck. Another case and this plummets regardless.


Summary: Covering short in NTLA, implying bullish or at least closing bearish position.

@GeneInvesting sure talks about me a lot for someone that he has blocked.

Someone make sure he gets this, please.  $NTLA

(Buy = Buy to cover, obv). https://t.co/KZyD5CP9yg

---

$NTLA https://t.co/UaNsjQNlFT


The 'big pharma partner' thesis is stupid. Period. It is not an upside case. This was lightening in a bottle. Nobody is buying their ulcerative colitis drugs with cash from $HIMS. It's a low margin referral business. That's it.

Summary: Bearish HIMS: compounding arbitrage gone, big-pharma-partner thesis baseless, low-margin referral business with no proprietary edge beyond GLP-1 grift.

This is what the “$HIMS will be the go-to partner for big pharma!!!” Bull cases look like, BTW.  It’s a low margin referral business.  That’s it.

$HIMS made a ton of money last year by pushing the laws on compounding.  That’s it.  There was no secret sauce or proprietary edge.  They were just willing to bend and break rules that other public companies weren’t.  Works until it doesn’t.

Now that they can’t pirate sema IP anymore, they get a tiny cut from the legitimate partnership or they don’t get anything from sema at all.  That’s what the options should’ve been all along.

The “big pharma partner” thesis is stupid.  Period.  It is not an upside case. Especially because there isn’t any other pharma product ever before, and there will never be another pharma product ever again, that consumers wish to buy with cash more than the GLP-1 class.

This was lightening in a bottle.  Nobody is buying their ulcerative colitis drugs with cash from $HIMS.  I’ll say it again - the pharma partner thesis is stupid, even for sema, but ESPECIALLY for everything else.

Let’s see if $HIMS can recapture the grift upside from the (equally stupid) peptide craze.  I wouldn’t discount their ability and willingness to grift to make a buck there (hell, they were willing to sell their customers INERT oral semaglutide - scammers).

If there’s an upside case for $HIMS it’s that there’s probably nobody better positioned to profit off of the peptide grift.  Let’s see if Dudum can get retail to rally around that.

$HIMS YoY growth is lower than the 10Y yield and y’all were telling me I was wrong about assigning it lower multiples this time last year because it was a “gRoWtH sToCk WiTh TeCh MuLtIpLeS”

🥱


$NKTR has been the single most blatantly mispriced stock on my entire radar in the last few months…hopefully that starts to change today, but the mid $40s isn't even close to correcting that mispricing in my book given the results we are seeing today

Summary: Strongly long NKTR on stellar maintenance AtD data, superior efficacy/safety vs peers, and massive undervaluation vs APGE and CRVS.

The table below is something I built and have been using lately to reaffirm to myself that $NKTR’s current valuation is just absolutely asinine.  It shows that $NKTR is ahead of everyone on timeline as the next to market in AtD.  It is also the only drug with both a unique MoA and no glaring safety concerns. Its efficacy is clearly superior to Nemluvio, and clearly (so far) superior to Amlitelimab.  It now looks poised to have Q12W dosing as well...

Yet, its valuation has just been absolutely in the gutter…orders of magnitude lower than “me-too” AtD drugs like $APGE’s, and even ~4x lower than $CRVS, which has only a couple dozen patients worth of data and an MoA that *will* carry the baggage of potential safety events with it for years to come. (Note the EVs listed in the table are fully diluted and as of close last night).

Today we add on the maintenance AtD data, which look stellar now that I’ve seen the deck.  I can write in more detail later, but some highlights:
-The rate of maintaining responses is HIGHER than what Dupixent showed…
-There was major deepening of responses
      -Many patients converted from EASI50 to EASI75
      -Many patients converted from EASI50/75 to EASI90 or even EASI100 (!!!)
-Q12W DOSING LOOKS GREAT!  HUGE DEAL!!
-Note that with major deepening of responses occurring, their induction EASI75 rate could improve in P3 since they’re doing a 24-week induction protocol instead of 16 weeks!...Induction phase efficacy might ultimately end up...better than Dupi...
-Safety looks great with no new safety signals, plus:
      -ISRs rates when down considerably, especially factoring in that more doses were given
      -Infections were literally higher on placebo than on drug…come on

Recall that CRVS recently hovered around $12-$14 in the premarket after their (much smaller) P1 data, then the stock rallied all day long to gain over 100% more throughout the day, rising into the mid $20s…IMO $NKTR in the $40s premarket is just absurd value and should do something similar, but we will see!

Expect an offering tonight.  This is a GOOD thing, as they must raise more $ to fund the P3s.  Financing overhang has been the big lock on $NKTR’s stock price.  I think the market was worried that the maintenance data wouldn’t be resoundingly positive enough to allow for a big raise on great terms…IMO $NKTR could not possibly have hoped for maintenance data to have gone better than this (better maintenance efficacy than dupi plus continued clean safety??).

$NKTR has been the single most blatantly mispriced stock on my entire radar in the last few months…hopefully that starts to change today, but the mid $40s isn’t even close to correcting that mispricing in my book given the results we are seeing today.

I’ll write substantially more on this topic in the next few days, because the valuation disconnect is just Grand Canyon-like in my eyes.  I want to discuss:

1)  The maintenance data in greater depth
2)  How $SNY still thinks that Amlitelimab is a $3B+/yr drug DESPITE much worse efficacy and now a likely black box warning…while $NKTR is going to potentially have better efficacy, definitely, better safety, and likely the same Q12W dosing optionality
3)  How $NKTR’s alopecia areata opportunity was recently completely written off, but IMO is a $1B+ opportunity (yes, I think this could be a 1L AA drug).  Maintenance data there are coming soon and could help re-ignite that narrative.

More to come!


Summary: Short HIMS; long Novo Nordisk and Eli Lilly.

@SixSigmaCapital Shorted HIMS and bought both novo and Lilly today


Funny how the analysts can't see anything positive right now. "Yeah $NVO drug is similar to TZP but the real A1c test will be Reta!" Guys, Reta's A1c lowering is worse than TZP's….come on.

Summary: Bullish NVO: analysts miss positives; NVO's UBT251 compares well to TZP, while Lilly's Reta actually has worse A1c lowering.

@investseekers Funny how the analysts can’t see anything positive right now.  “Yeah $NVO drug is similar to TZP but the real A1c test will be Reta!”

Guys, Reta’s A1c lowering is worse than TZP’s….come on.  At least pretend like y’all know the data here.

Citi on $NVO ’s UBT251 data:

Encouraging Phase 2 results, but the real test is still ahead

• HbA1c reduction up to 2.16%

• ~9.8% weight loss after 24 weeks

Citi says results look comparable to $LLY ’s Mounjaro so far

But the key comparison will be against Lilly’s


you can still buy it at half price even though anyone who actually reads the data and understands the deepening of responses the drug shows should be able to tell that it's going to hit in AA P3 and be the first biologic ever marketed in the condition

Summary: Long NKTR at current depressed price; confident rezpeg hits AA Phase 3 as first biologic in the condition.

@Biolo_gic Instead you can still buy it at half price even though anyone who actually reads the data and understands the deepening of responses the drug shows should be able to tell that it’s going to hit in AA P3 and be the first biologic ever marketed in the condition.

Gift.  $NKTR

$NKTR Calling on all time travelers to exclude that one placebo patient with unstable AA. That would shift the continuum to:
- AA hits stat
- Rezpeg pipeline in molecule, MC 2x $2.5B
- Financing >100
- Proper reaction to stellar AD data, MC settles around $5B in line with peers https://t.co/cjkB53lj6f


I'm about as bullish on the stock now as I've ever been. yes, I am long and thus biased. the market is wrong to do that. IMO this is a BIG opportunity for $NKTR

Summary: Long NKTR with high conviction; market wrongly marking alopecia areata opportunity to zero and undervaluing atopic dermatitis; also sees potentially paradigm-shifting remittive data catalyst.

Ok, so I have finally gotten around to writing out my updated thoughts/thesis on $NKTR.  Link in this post.

I'm about as bullish on the stock now as I've ever been.

The document is very long (sorry, but it's free...give me a break).  I understand that most people won't read it all.

So, if you're only going to read portions of it, don't miss the alopecia areata section.  The market has marked this opportunity to zero and I am telling you...the market is wrong to do that.  IMO this is a BIG opportunity for $NKTR, no matter how badly the market reacted to the recent data.  Yes, IMO the market is getting the atopic dermatitis opportunity and valuation very wrong too, but some people are catching onto that by now...the AA opportunity is just totally (and wrongfully) abandoned.

I also think the portion discussing "remittive" data after the AA section is also informative, and it speaks to a potentially massive upside catalyst that nobody is appropriately considering the magnitude of if it hits.  Potentially paradigm shifting for one of the largest (if not the largest) indications in all of I&I...very big deal.

I often write out long threads with slides and data accompanying my write up.  I don't have the time to do that now, but please engage here with thoughts, questions, screenshots from the document, etc.  Show me what parts of the thesis interest/excite you, what you don't understand, or even what you think is BS or stupid.

It would be great to get some good discourse going on this opportunity, which I have to say I remain very excited about.  (Obvious disclaimer here as in the document, yes, I am long and thus biased.)

The link below is to the google doc.  Totally free.  No subscription, no email address, nothing...just a click on a link.

https://t.co/DwZTAiyPyp


Summary: Still holding a short position in NTLA.

Oh don’t worry Dirk, I’m still short some

You’re also just literally making up transaction dates, btw, and you’re totally wrong about them.

Left’s problem was that he was literally doing the opposite of what he was telling people within the same hour. Being publicly bearish or bullish a stock does not mean you are never allowed to close your position again.

@A_May_MD It seems that you use your online following to unload on your followers for a few percent gain (which your tweets move the market with).  Wondering about your recent 'long thesis'.

E.g. shorted $ntla on November 25 when stock was trading around $8.5 to soon cover on your


short $HIMS still like I said I was last night. This could be *hugely* detrimental to $HIMS, which has basically been a dying business outside of GLP-1s.

Summary: Holds short HIMS (GLP-1 franchise under regulatory scrutiny, dying business) and long NVO/LLY as compounding pharmacies face crackdown tailwind.

Well this might be the fastest a take of mine has aged like fine wine.

$HIMS just BLEW IT.  To me this reads like their whole GLP-1 franchise is going to be under extra scrutiny, not just the new bogus pill.

What they’ve just done is akin to getting pulled over for doing 80 in a school zone *while carrying drugs in the car*.

They did something egregious to get the law’s attention, thus bringing even more scrutiny and pain upon themselves for the *other* egregious shit they were already doing and somehow getting away with.

This could be *hugely* detrimental to $HIMS, which has basically been a dying business outside of GLP-1s.

It could also be a *massive* tailwind for $NVO (and to a lesser but perhaps meaningfully, to $LLY) by helping get these compounding thieves off of their backs.

Big time market moving news here.  If the $HIMS house of cards really is crumbling I’d expect $NVO to bounce *hard* off of these lows.

https://t.co/XCyDBYSYod

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(Long $NVO $LLY and short $HIMS still like I said I was last night)

---

Though I did cover a fraction of the Hims shares on today’s did, which was clearly a mistake.  Oh well


Long $NVO $LLY and short $HIMS still like I said I was last night. If the $HIMS house of cards really is crumbling I'd expect $NVO to bounce *hard* off of these lows.


Long $NVO $LLY and short $HIMS still like I said I was last night. a *massive* tailwind for $NVO (and to a lesser but perhaps meaningfully, to $LLY)


Summary: Rebuts NKTR bear thesis on Rezpeg CV safety; argues 1,000+ patient data shows no MACE/CV trend, implying bear case is overblown.

Nah.  There's enough patient data out there on Rezpeg to say there isn't a MACE/CV trend.  Over 1,000 patients across studies.

Dupixent is seen as the ultimate safe dermatology drug...

Dupixent CV events (CV deaths, MIs, and strokes):
➡QUEST (asthma 12y+):  5 events
➡CHRONOS (AtD ): 1 event
➡SOLO (AtD): 1 event *and* a patient death from asthma exacerbation
➡SINUS-24 (CRSwNP): 1 event
➡Study 1774 (EoE):‼2 deaths in a <160 patient sample size
https://t.co/jPVrcbKxpv

Here is my $nktr bear thesis and what I believe is the reason why it stayed so cheap after the rezolve AD data last june. A 38yo woman died of a heart attack in the escape arm. The death was attributed to multiple risk factors, not to rezpeg. See fine print below. 1/4 https://t.co/kA9G3NoK6D


Summary: Predicts ABVX closes 2026 above $180.

“Because I likely bought high”

Imagine basing your entire criticism on an assumption you just pulled out of thin air.

Just because Kevin isn’t bragging about his cost basis doesn’t mean it isn’t fantastic.

It also doesn’t mean his point about its irrelevance is wrong.

(Btw the stock will close 2026 >$180)

Imagine looking at these $ABVX charts and saying my cost basis is not relevant esp when buying purely for M&A.

10% weight on stock that ran 2500% in 7 months,  but hey my cost basis isn't relevant because I likely bought high and dont want to disclose my questionable entry https://t.co/2lKWwTcHhD


Summary: Bullish ABVX; dismantles Wedbush bear thesis on steroid tapering, arguing P2 data are overwhelmingly strong and P3 bar is highly achievable even under worst-case assumptions.

I guess the drawback of becoming the $ABVX guy is that I've got to respond to ridiculous takes as they pop up now.  Wedbush is making a full time job of it.

Their recent note tries to catastrophize about steroid tapering (or lack thereof) in the phase 2 dataset, claiming this undermines $ABVX's probability of success in phase 3.  If you're not in the weeds on the data here, I could see how you might read that and think "oh no, that doesn't sound good".

However, if you *are* remotely in the weeds on these data (as Wedbush should be but very clearly isn't), you can read that take and laugh at the analysis - so let's bring everyone into the weeds here.

First of all, it's funny that Wedbush is apparently just now stumbling across this contrived bear thesis that they're pretending is something new, because THE DATA THEY ARE TALKING ABOUT WERE LITERALLY PUBLISHED ***BEFORE*** THE PHASE 3 INDUCTION DATA CAME OUT IN JULY.  The publication was from May, and it mostly rehashed data that were actually already widely known for years from ABVX's prior conference presentations and corporate decks.

Welcome to the party, Wedbush - it's been going on for a while.  Have a seat.

Ok so what's the supposed issue?  Wedbush is saying that ABVX didn't force tapering of steroids in the P2 maintenance trial, which is standard practice in P3 trials.  The issue is.....Not forcing steroid tapers *is standard practice* for P2 trials...which is exactly what ABVX did, in line with standards...

In my ABVX pitch from July I discussed comparing their maintenance dataset to two of the most robust comparison P2 studies - those from Zeposia and Velsipity.  These are great comps because these drugs are all oral and all of the P2s had open label maintenance portions.

Oh, and also...none of the trials forced a steroid taper...because that is standard!

The Zeposia study literally didn't even MEASURE steroid free remission (ABVX and Velsipity studies at least measured what the steroid free remissions were, but none of them forced any tapering).

So, not only is Wedbush making a fuss out of a dataset that has been around since $ABVX was trading at $6/share, but what they're complaining about is just flat out standard practice...yet they're acting like it's some sort of new discovery that undermines the drug's activity altogether...after it just reported the 3rd highest UC induction remission delta of all time...Ok.

I'm going to point everyone to this table (attached) yet again.  As most will likely know by now, only induction responders enroll into the maintenance portion of UC P3s, so for $ABVX, the P2 maintenance remission number we look at is that 65% number on the far upper right corner (which was the P2 maintenance remission rate among patients who had responded upon induction).

Take a second to compare that 65% number to the numbers below it from other P3 trials.  65% would be, by far, the single highest number ever recorded in a phase 3, and it wouldn't even be CLOSE.  65% would literally DOUBLE the remission rates of some of the other (approved and used) drugs on that list.

Nobody (absolutely no one) believes $ABVX is going to repeat 65% maintenance remission in P3.  Yes, that is the appropriate responder-enriched number from the P2 that will be represented in the phase 3, but the P2 was open label, and yes, in P3 steroids will be forced to taper.

Look how much room they have for that number to get worse!  It could drop 12% points and still be the highest remission rate of all time (which is by no means necessary for success here).  The P2 maintenance remission data were so otherworldly good that we already all know the number has to come down in P3 - no way around it.  All the bulls have known this all along (just like we all understand the basic drug design of UC trials which involves forced steroid tapers in P3 but not in P2...apparently unlike some).

But, of course, the placebo adjusted delta is ultimately what will matter in P3.  20-30% delta has been broadly discussed as the target range for $ABVX, and I completely agree (as I said on the YAVP podcast last week, my guess is a middle ground bet on 25%).

How hard will that 20-30% target range be to hit?  Let's assume that the placebo remission rate mimics that of the R+Z+V dataset combining 3 of oral therapies on that table.  The average placebo remission rate among those trials was 12.7%.

If we assume ABVX has the same placebo remission rate in maintenance (which may not be fair as ABVX's placebo remission rate in induction was *lower* than the R+Z+V average), then $ABVX would only need a 32.7%-42.7% remission rate on drug to "hit the bar".  Again, this is versus the 65% achieved in the open label P2...

Wedbush tries to sensationally mislead investors into thinking that "1/3" of the remissions in the P2 were just "due to steroids", simply because 1/3 of the patients in remission had not come off of steroids.  This is inherently misleading in the first place because there was no forced taper of any kind on the study, meaning patients in remission may not have even *tried* to come off of steroids.  If there was a forced taper, without a doubt at least *some* of those 1/3 of patients who stayed on steroids despite not attempting a taper would have stayed in response when coming off of them.  Of course not all of them, but SOME of them would have maintained remission despite a forced taper.  So, that 1/3 number perhaps becomes 1/4 or 1/5 if a forced taper were implemented.

But, ok.  Let's play along with Wedbush's game anyway and just stick with the phony 1/3 number and say "Ok, take away 1/3 of the remissions due to steroid taper in the P3!

1/3 from 65% is...43.5%...

So, 43.5% less our estimated placebo response rate of 12.7% and we've got...30.8% remission delta!  Literally HIGHER than the high end of the bar!  And hey, that would beat Xeljanz to make $ABVX the 2nd highest maintenance remission delta of all time...only behind Rinvoq!

So, I guess that all I have to say to Wedbush is...Thanks!  Thanks for once again thinking you found something bearish that actually just serves to prove the point for the bulls.

Now please cut this out so I don't feel compelled to address such silly work.

Lot's of requests to discuss the Wedbush report on $ABVX today.  It's a doozy.  Obviously I'm a biased bull so sure, take my thoughts with a grain of salt, but this is truly, awful work from my perspective.  Let's dig in on a few of the key issues.


degen traders dumping the stock on a CNBC article saying exactly what I've been saying since the trial hit back in July... WAITING FOR MAINTENANCE DATA is the ideal negotiating leverage... Catalyst wait times don't get a lot shorter than 3 months in biotech, btw. CHILL.

Summary: Bullish ABVX; views dip as overdone, maintenance data in ~3 months is ideal M&A leverage, urging holders to hold through the sell-off.

$ABVX degen traders dumping the stock on a CNBC article saying exactly what I’ve been saying since the trial hit back in July, and what was already blatantly obvious from the earnings release yesterday.  WAITING FOR MAINTENANCE DATA is the ideal negotiating leverage.

Read the quote below from the CEO.  It could not be more obvious to me that this is the correct strategy.

Catalyst wait times don’t get a lot shorter than 3 months in biotech, btw.  CHILL.

https://t.co/aVOuiXWY6v


This is dumb. $SYRE raised cash at a $6.7B cap after open label P2a data using a me-too MOA where the currently approved drug will be generic soon after $SYRE's launch... Over $8B market cap now.

Summary: SYRE grossly overvalued vs ABVX: $8B+ cap on me-too MOA, small open-label P2a data, biosimilar competition, yet trades $1B+ above ABVX post-P3; calls it dumb.

Another angle on this comp for the YTE bubble.  $SYRE raised cash at a *higher* valuation post open label P2a than $ABVX did post *P3*.  Over a billion dollars higher!!!

$SYRE raised cash at a $6.7B cap after open label P2a data using a me-too MOA where the currently approved drug will be generic soon after $SYRE’s launch.

$ABVX raised cash at a $5.6B cap after their phase 3 trial with the first validation of an entirely new and highly effective MoA since the IL23p19s hit the scene half a decade ago in 2021.  Major breakthrough.

>$1B higher valuation at the offering for $SYRE with their me-too MoA, small n *open label* dataset, and ~5 year lag, *plus* multiple other pharmas already developing drugs with the same MoA and having to compete against the market leader becoming BIOSIMILAR.  Versus literally zero intra-MoA competition for $ABVX…

Oh, and of course, $SYRE has added another ~$1.4B in market cap since that raise over ~2 weeks…why not!

Over $8B market cap now.

This is dumb.

For perspective, $SYRE market cap is getting close to the $ABVX cap (not quite there but on pace to blow past it very soon if it keeps this up).

$ABVX was at the P2a stage in 2018, where $SYRE is today with nothing but me-too (or me 3, 4, 5, 6, 7) drugs in the pipeline.

It


Hopefully the market will wake up to the points above highlighting that the colonic dysplasia and NMSC cases can be almost completely written off... I sincerely do not believe that these two cases alone represent a signal against 0 in the placebo arm. This is textbook small sample statistical noise

Summary: Long ABVX: argues market is wrong to treat 7 cancer cases as serious — colonic dysplasia isn't cancer, 4 NMSC cases are trivial, leaving only 2 cases of statistical noise; expects narrative snapback on additional 50mg data.

I keep hearing people referring to "7" cases of cancer in the high dose arm for $ABVX.  I get it - that's what they technically showed in the table, but in observing a lot of conversation about this I gather that people don't actually realize what really matters there.  I am strongly of the opinion that there are really only 2 malignancy cases that matter for adjudication - the prostate cancer and breast cancer cases.

I initially started talking about these cases as "the 2" cases from the very beginning because I assumed that everyone would be on the same page that these were the only 2 that mattered...but I've found that people really are considering this as a case of *7* full blown malignancies in the 50mg arm...This is just not correct.

Let's break this down.

First of all, they're counting "colonic dysplasia" in this table as one of the "malignancies".  I cannot stress this enough:  Colonic dysplasia is, by definition, LITERALLY not cancer.  This is actually an unequivocal point that I don't understand how it could even be up for debate.

"Dysplasia" is a "precancerous" lesion.  Cervical dysplasia, colonic dysplasia, melanocyte dysplasia.  Terms exist for these PREcancerous findings because they are, by definition NOT CANCER (otherwise, if they were cancer, we'd call them cervical cancer, colon cancer, and melanoma)...

Dysplastic lesions, not being cancer, often regress on their own or simply never evolve into cancer, staying in the "dysplastic" state until death.  However, if they *do* become cancer, they do so through a process that is called "malignant transformation".  Literally, something that is NOT malignant TRANSFORMS into something that is.

Why did the ABVX management team include this in the list of "malignancies"?  Honestly, I don't know.  I think it is an evident mistake, and a strong piece of evidence that they didn't think they'd actually have to explain away a "cancer signal" in this dataset because their analysis of the data told them that there isn't one.  If they were worried that the market was going to interpret these data as a catastrophic malignancy risk (which, make no mistake, is what the current low $70s price tag is assuming), they would've likely adjudicated this more thoroughly and left the "malignancy" that is by definition NOT malignancy off of the "malignancy" table...

So that is tossed out easily IMO.  6 cases left now.  4 of those are NMSC (non-melanoma skin cancer).  I gather that people are dramatically overestimating what a diagnosis of NMSC means.  Far be it from me to minimize NMSC (since it is what I treat for a living as a dermatologist), but guys....this is NOT in the same category as ANY other malignancies.  NMSC is a milder category of its own, and I don't mean that as a matter of opinion.  Literally, "non-NMSC malignancies" is a distinct endpoint used to gauge risk of "serious" malignancies in clinical trials.   NMSCs are left out of that category because they almost never are "serious" - certainly almost never life threatening.

Here's an exercise anyone can do to drive this point home.  Google, or ask an LLM "what are the 10 most common cancers in the United States?".  They are all going to give you the same answer:  Breast & prostate will be the top 2 at slightly >300,000 cases/year.

So breast and prostate are the #1 and #2 most common cancers according to every source...except, those sources either ignore completely or footnote at the bottom that there is a type of cancer 15x more common...NMSC!!!

The point?  Ubiquitously, NMSC isn't even included on the list of "most common cancers" because they're frankly in a separate category altogether from cancers like breast and prostate.  It actually is controversial whether or not it is even possible for basal cell carcinoma to metastasize, and (aside from transplant patients), CSCC is almost never fatal unless left ignored/untreated for years (people ignoring a giant bleeding skin cancer is perhaps more common than you'd think, but not happening in any clinical trial patients).

These 4 50mg NMSC cases (vs 1 in the placebo group) are a not representative of serious malignancy risk even if the market is acting as if they are...they are absolutely in milder a category all their own, and lumping these all together is a mistake.

Again, if people think these 4 NMSC cases are some scary life threatening event, they're just flat out wrong.  There are >15x more cases of NMSC than breast cancer in the US/year, yet >10x more breast cancer deaths occur in the US per year.

Again, not to minimize my own career too greatly, but almost *always* NMSC are removed by VERY simple, ~10 minute procedures under local anesthesia.  Cutting out (or scraping away) the lesion typically takes me around 60 seconds, and the bulk of the procedure is actually spent stitching the patient back up.  Drive yourself to the office, drive yourself home, local anesthesia, under an hour, you're cured.  Hell, in many places in Europe it is actually standard practice to not even "treat" a basal cell carcinoma!  On many body locations they are simply biopsied, and once diagnosed they are considered cured by the biopsy itself!

It has become very clear to me that people are thinking that these NMSC cases are highly relevant cases of severe, potentially fatal cancer.  They simply are not.  There are *millions* of these in the US per year and most are treated with <15 minute procedures.  These are in a TOTALLY different, far less serious category of "cancer".

So again, why wasn't $ABVX prepared to discuss/explain this?  I legitimately think they did not expect to need to.  They may have overestimated the market's knowledge here and underestimated its potential for a knee-jerk reaction to the "C-Word".  It's a mistake, yes, but it ultimately doesn't change the profile of the drug.

So, I think we have compelling cases to write off the colonic dysplasia (literally not cancer) and NMSC cases, as I have usually found to be standard in these situations.

That leaves the breast and prostate cancer cases.  Again, the otherwise #1 and #2 most common cancer types...funny how that worked out!  I sincerely do not believe that these two cases alone represent a signal against 0 in the placebo arm.  This is textbook small sample statistical noise, ESPECIALLY for a drug with no mutagenic risk AND no immunosuppression (literally, HOW would this drug even be causing cancer then???).

However, clearly the market will want more info here on these two cases.

Hopefully the market will wake up to the points above (that $ABVX and I mistakenly thought were obvious) highlighting that the colonic dysplasia and NMSC cases can be almost completely written off.  After that, hopefully $ABVX can give us more info on these two "legit" cancer cases (breast and prostate).

Yes, they should've been ready to do so on the call.  they messed up, but let's see what the details show.  Some are saying we will see updates sooner than the October conference like they initially guided for on the call (at which point they clearly did not expect the market to be freaking out at all).

After that, we also need to see the data from the 50mg "escape/placebo" arm that was not part of the primary efficacy analysis.  That's is own topic of conversation, but that could significantly rewrite the narrative (now that $ABVX is aware a narrative needs to be rewritten after it got away from them).

I think the market thinks they are hiding these "escape/placebo" arm 50mg patients' data.  I believe they were just totally caught off guard by the market's reaction to the "cancer signal" here and didn't think they'd need to have that dataset ready to prove there's no cancer risk (they thought the initial dataset spoke for itself...I agree, but so far the market clearly doesn't).

There should be several hundred patients worth of extra 50mg patients in that group.  Ideally they can move up the release of that dataset to help qualm the market's fears and try to prove they aren't trying to hide anything there.  Depending on the sample size there, we should very likely expect a few "cases" there too, but if the rate comes in lower than the original 50mg data we got, this narrative could snap back rapidly.  Let's hope!


Summary: Long TENX at current prices ahead of Q3 P3 readout in PH-HFpEF; huge upside/downside binary but market underprices PoS vs author's estimate; small position only.

I’ve gotten a lot of messages asking about my BioPick selection for this year, $TENX.  I’ve responded to a few but don’t have the time to respond to everyone.

I actually considered making $TENX an official “pitch”, but I don’t think I can get there on the risk/reward skew to say that this is “one of the best setups I’ve ever seen” like I try to do for “official” pitches.

Still, it’s been an obscure name, and IMO very clearly has a heavily underappreciated 2026 catalyst that many people don't know about, so I think it's worth talking about.  I am long currently and there’s a decent chance that I’ll be exposed to the binary - at least I think that I’ll be exposed to the readout if the stock stays at these prices going into the data.

So, I won’t pitch it with a comprehensive thread like $NKTR & $ABVX, and I won’t share my full large diligence document like I did for those.  But, I hope the brief (by my standards) discussion here could lead to some solid sharing of thoughts with the “biotwitter” community.  Frankly, I'm not even sure the best way to "play" this one, so some feedback and collective diligence here could be useful.

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Everyone’s favorite part of the thread → Disclaimers!

First one is important - Don’t be fooled by your brokerage account telling you this has some tiny microcap valuation.  There are lots of warrants outstanding from the company’s history, making the fully diluted share count more like ~65M (by my calculations).

Second, much like $ABVX, the downside on a total fail by $TENX is huge.  Like 90%.  I’d also say that, for $ABVX, I eventually arrived at such high confidence that they were going to hit that I’d almost have called that a "guarantee" (although nothing in biotech ever actually is).  For TENX, the *massive* +500-1000% upside scenarios are certainly on the table like they were for $ABVX, but the odds of that happening versus the ~90% downside crash are certainly nowhere near as positively skewed for $TENX.  THE BINARY HERE IS GOING TO BE RISKY.

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The Disease:

$TENX aims to treat PH-HFpEF (i.e. patients who have pulmonary hypertension as a result of heart failure with preserved ejection fraction).  This is a very sick, and very large patient population for which there are zero FDA approved treatments.

Basically, the issue is that the patient’s heart has become stiff and is unable to fill up with blood appropriately.  This is HFpEF (heart failure with preserved ejection fraction).

But, over time, the HFpEF worsens to the extent that excess blood backs up behind the stiff heart and starts filling up the vessels in the lungs.  Over time these vessels also become stiff and thickened thanks to this backpressure from the heart.  *That* is the PH (pulmonary hypertension) of PH-HFpEF.

The US TAM for this condition is absolutely huge…~1.4M patients.  No approved drugs.

Other companies like $TECX and recently $MRK have been going after a smaller segment of the PH-HFpEF population.  I won’t go into the (deep) nitty gritty on the differences, but roughly, the 1.4M patient US PH-HFpEF TAM is comprised of

~0.4M CpCPH patients
~1.0M IpcPH patients
Recently, better known trials like those from $TECX and $MRK have focussed on the smaller 0.4M CpcPH sliver of the market.

$TENX, on the other hand, is studying their drug in the entire PH-HFpEF population.  Well over 1.4 million patients in the US alone, with extremely high unmet need.

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The Drug:

$TENX is studying an oral formulation of Levosimendan.  This drug has actually been approved overseas as an IV infusion for acute decompensated heart failure for many years.

It seems to have a pleiotropic mechanism of action, including inotropy (making the heart beat harder), and vasodilation (particularly with a strong effect on the “splanchnic” vasculature).

I’ll be honest - it’s hard to make a really convincing argument as to why the drug should work in PH-HFpEF from a purely mechanistic perspective (sort of like it was hard to be convinced by $ABVX’s unclear mechanism of action).  The strongest argument from my perspective is probably the significant splanchnic dilation that the drug causes.  It is established that PH-HFpEF patients have chronically constricted splanchnics, which forces more blood into “the system” and causes volume overload that exacerbates the disease.

The idea for TENX would be, at least partially, that it restores patients’ ability to dilate these splanchnic blood vessels, which opens a huge reservoir for blood to travel to, reducing the severe volume overload on the heart and lungs that PH-HFpEF patients experience.

Honestly?  IDK.  I could go WAY more in depth into the physiology here (I have probably a hundred pages of notes on the subject).  However, after studying this extensively myself *and* listening to a bunch of KOL discussions on the matter, I have decided…Nobody, not even the world’s leading experts, can be trusted to predict whether or not a drug is going to work in this indication.

This became evident listening to KOLs blatantly contradict each other nonstop about what matters in the hemodynamics of this disease, but what really drove it home was the fact that…the world’s leading experts keep launching PH-HFpEF studies of drugs they are excited about that ultimately end up HARMING the patients!  (See Lilly’s volenrelaxin program and a history of failed endothelin agonist trials).

Point being:  On paper, trust no one to tell you whether or not a drug is going to work in PH-HFpEF.

Clinical data must drive the hypothesis from my perspective…so let’s get into it.

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The $TENX P2 Data

The first time I looked at $TENX I really didn’t like it.  It actually hit in a P2 study on what is going to be the regulatory primary endpoint for the drug, 6MWT (6 minute walk test).  However, the “hit” looked like a pretty small signal, along with some luck.  As you can see in the first photo, the drug patients gained ~17 meters, while the placebo patients lost ~12 meters after 6 weeks of treatment.

Typically, you expect to see a mild increase for placebo patients on 6MWT.  So, it looks like $TENX got “lucky” with this 6MWT success in their small P2 study.  The 29 meter delta they saw in P2 would be amazing to see in P3, but they won’t be able to count on that placebo decrease in P3.

So, I actually think it’s fair to say that they did get lucky in P2.  This is what made me basically ignore the company the first time I looked at it.  However, I’ve come to feel that it’s not as simple as just “a small signal where the company got lucky”.

In the next 3 slides, I’ll outline why I’m bullish $TENX at its current valuation:
1⃣PK/PD nuance
2⃣KOL/Principle Investigator commentary
3⃣Upside skew

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Why I’ve flipped bullish $TENX at the current valuation Part 1:  The phase 2 study measured 6MWT efficacy with the drug at trough.

In the phase 2 study, the company only had access to the IV formulation of the drug.  The half life of the drug (really of its active metabolite) is WAY too short for once-weekly dosing.  However, the company knew that even a once-weekly 24-hour long infusion (!!!) was already a hurdle from a commercial perspective, so multiple doses were out of the question.

So, even though the science clearly said they needed to give multiple doses of the drug each week for patients to have adequate exposure, they were basically stuck with once weekly infusions (again, a 24 hour long infusion that basically decommissions patients for an entire day every week).

PK/PD modeling suggests that the drug would be at only 20-25% of its cmax concentration by 1 week from dosing when they measured efficacy.  As we can see from prior studies of the drug in other indications, the hemodynamic effects of the drug have nearly completely vanished by the time that $TENX measured efficacy in their P2 study (see first photo).

However, for the phase 3, the company got access to the oral formulation of the drug and will be dosing it TID.  So, the concentrations of the drug will be much higher when efficacy is measured than they were in the P2.  For a drug that works entirely by modulating patients’ hemodynamics, having adequate exposure at the time of efficacy measurement is absolutely key.

So, in the phase 2 we saw a weak 6MWT signal, which initially really turned me off to the stock…However, what I didn’t realize at the time was that we have a solid explanation for why the signal could get stronger in P3 without any luck.  The P3 oral dosing strategy solves what was a massive drug exposure problem in the P2 that could explain the “weakness” of the 6MWT signal (despite the fact that it did hit in P2).

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Why I’ve flipped bullish $TENX at the current valuation Part 2:  KOL Commentary.

KOL commentary should always be taken with grains of salt, but in all of the bullish commentary I’ve ever heard from KOLs who are on investigators on studies of a drug…the bullish commentary we are getting from the docs on the $TENX P2/3 studies is *up there*.

The company held a public KOL event in November that you can listen to (in fact I’d encourage you to do so).

But, to summarize/paraphrase some of what the KOLs are saying:

Dr. Barry Bourlag:
-”The patients love this drug”
-”We have been involved in a lot of trials over the last 20 years in HFpEF, but I would say that the effects that the patients are telling us are really, really impressive.”
-”Some of the stories are just really outrageous.  I mean, people that have been like converted to becoming totally sedentary, men are out in the fields shotting deer and dragging the buck carcass all the way back to their truck and stuff like that.”
-”...Telling me stories that they’re just night and day, just really life altering, that word is used.”

Dr. Sanjiv Shah:
-”It’s kind of phenomenal…But we see things we never see in trials unless they’re like positive, in a positive way.”
-”What we’ve seen which is really interesting is we saw patients who felt better during the randomized phase, they wash out for 2 weeks, they feel worse again, and then they start feeling better again.”
-”It’s rare in patients with HFpEF, especially PH-HFpEF, where they’re really debilitated, that anything makes them feel better.  That is quite different from other medications we’ve seen in this patient population.”

(There's quite a bit more like this on the November KOL call - I'd recommend checking it out if interested in the stock).

So, again, we have to take major grains of salt with this.  Some of what they’re saying could be overexcited KOL commentary.  Some (or even all) of what they’re seeing could be placebo effects.  But, these are highly seasoned KOLs who collectively have decades of PH-HFpEF trial experience…and they sure talk as if they are seeing things they haven’t seen before with this disease.

Not to beat a dead horse, but we have to be very careful with this type of “evidence”.  Still, the commentary is so overwhelmingly positive that for me it has to factor into the narrative/outlook for $TENX’s phase 3 readout this year.

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Why I’ve flipped bullish $TENX at the current valuation Part 3 :  The magnitude of potential upside on a hit.

There are 1.4M patients with this condition, in which patients have severe symptoms and poor life expectancy, and there are zero FDA approved medications to treat it…(again, lazy work here).

That TAM here is just incredibly huge, especially for a disease with no existing drugs (usually pharma has at least partially cracked open gold mines like this by now!).

Just lazily picking a price per year number like, say, $30,000, gets you to >$4B annual sales for every 10% of the market you penetrate…

For a condition with severe symptoms and no treatment options, a drug (potentially like TENX’s) that makes you feel better would likely launch like a rocket.

This is why pharma giants like $LLY, $AZN, and $MRK have been going after this condition.

$MRK specifically is a good case study for what $TENX could be worth. In November, $MRK press released that their drug sotatercept (currently approved for PAH) was successful in a P2 study of PH-HFpEF patients.

That day, $MRK traded up $8-$10B on the news (including a premarket jump in that range to help distinguish the move from general market “noise”).

However, there are 2 key factors to understand about MRK’s situation:
The “hit” was on a hemodynamic marker, PVR.  It was NOT a hit on 6MWT, the key regulatory endpoint.  This was not mentioned, so you may assume that they saw something on 6MWT.  But the fact remains that PVR is a hemodynamic marker of unclear therapeutic significance in this disease.  Just hitting on PVR does not necessarily mean that this trial was a success.
MRK is only studying the small ~400K patient CpcPH fragment of the PH-HFpEF population.

So, $MRK hit in ***Phase 2*** with an ***unclear non-regulatory endpoint*** in a ***small ~30% fragment of the PH-HFpEF population***.

On that, $MRK gained $8-10B in value…now, even if you cut that in HALF, this is demonstrative of the incredible potential market size that PH-HFpEF represents.

So, what would TENX be worth if it hits in a ***Phase 3*** study with the key ***regulatory endpoint (6MWT)*** in a study of the ***entire 1.4M+ patient TAM***?

There’s a reason my price target for $TENX in the BioPick contest was 10x (in addition to the fun double entendre).  The potential value of being the first drug in PH-HFpEF is just immense any way you slice it.

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Now, if it hits, that upside won’t happen all at once.  The size of the 6MWT delta would be very important, especially because $TENX is going to have to hit in a 2nd P3 that will already be running at the time of this year’s readout.  If the 6MWT hit is weak, confidence in the 2nd P3 might be low.  If the hit is strong, they could get a lot of credit for both P3s up front.

KOLs say the 6MWT delta bar is 15m, but the study is powered for 25m.

In P2 their delta was 29m…of course, that included some luck on the placebo response…of course, it was also measured with only a fraction of the drug in the patient’s system, which is a problem that should be solved for the phase 3.

There’s a lot more that I could discuss about $TENX (a lot more that I *would* discuss if I were doing a full on official pitch for it).  The interim stats look, the IV OLE, the IV OLE to oral transition, more detail on physiology, PK/PD, etc etc.

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The most succinct $TENX summary I can make is this:

➡PH-HFpEF is a huge market (1.4M patients) with no approved drugs, creating incredibly large upside on being the first to a successful P3
➡Competitors like $MRK, $AZN, and $TECX are currently behind TENX in P2 studies that are focussed on an unclear hemodynamic marker (PVR), not on the primary regulatory endpoint, and often studying smaller portions of the TAM (whereas $TENX is studying the whole pie)
➡$TENX is in P3 already (readout in Q3), and actually hit stat sig on the regulatory endpoint already in P2
➡Now, that “hit” on 6MWT in P2 was partially luck, but the signal could improve in P3 because $TENX was using an old IV formulation of the drug in P2, and efficacy was measured at a time where drug exposure was very low. This has been corrected in P3 with an oral formulation.
➡KOLs who have been on both studies are sharing borderline outlandish observations/anecdotes from patients on these trials…to be taken with grains of salt, but they are very positive

IMO this will be one of, if not the largest upside/downside skew catalyst of the year.  This is, of course, why I picked it for the Biopick contest.  If it hits, the upside will be hard to beat.  BUT, that type of upside doesn’t come without huge risk of downside and low odds of success.  If you want to win Biopick, you typically need to select all or nothing type plays!

IMO you’d have to be very aggressive to think this trial has a >50% chance of hitting.  Although I’m bullish, I think the PoS is lower than that.  Still, given the huge upside, I think the market is currently pricing in an even lower PoS than I would estimate.

I’d say that the odds favor that this one won’t work out.  However, given the upside/downside skew, if you had 100 opportunities exactly like this one to play, I think you’d come out on top.  Obviously that calculus shifts as the price changes up/down as well.  One certainly shouldn’t get involved in this stock at all if you don’t appreciate the dynamic of why you would be long something that is more likely than not to fail.

So again, I don’t think the PoS here is high enough for me to make a true full pitch out of this despite me being net bullish at current prices.  Overall this stock has gotten very little attention, especially given the fact that it has a catalyst coming up so soon that has such *massive* upside/downside potential (usually these are much buzzier situations).

I’d appreciate feedback from the community.  I’m often pleasantly surprised at the info I am able to get out of people I would’ve never otherwise talked to just by writing out & sharing my thoughts like this.

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Wise words from a wise account.  If the multiple notes to this effect throughout my own thread don’t get this point across - THIS ONE IS DANGEROUS and like even I as a bull am noting in here, it’s more likely than not to fail.  MUST understand the risk/reward dynamic.  Like I said, I think if you get 100 opportunities to play this you come out on top.  BUT YOU DONT GET 100 OPPORTUNITIES IF YOU BLOW YOUR ACCOUNT ON ONE CONCENTRATED PLAY.  This is one to hold only as a small position through data, if at all, as far as I’m concerned.


Summary: Sarcastic 'efficient markets' comment implies XNCR is undervalued at sub-$1B market cap given its pipeline.

@viewfromahill9 Yep those 1:2:2:2:2:2 trials are going to be an absolute bitch.

$XNCR not even a billion.  Not part of the YTE cabal, so there you go.  Efficient markets!

@A_May_MD Will be a tricky clinical path as you will have to do a factoral study to justify how much of each antibody to use. Also Xencor has a extended TLA1/IL23 bispecific going into p1.


They'll run an offering and the stock will continue to go up after that (all IMO) You're right - this efficacy and safety profile in a quarterly dosed AtD drug…at this price is absurd

Summary: Bullish LLY: financing overhang will be resolved via offering, stock continues higher; efficacy/safety profile makes current price absurdly cheap.

@Teslanomous Financing overhang.  They’ll run an offering and the stock will continue to go up after that (all IMO)

You’re right - this efficacy and safety profile in a quarterly dosed AtD drug…at this price is absurd

@A_May_MD is the LLY lawsuit keeping the price low? otherwise for qtrly maintenance (assuming replication in P3) this is absurdly cheap


Summary: Bearish APGE: thesis that Lebrikizumab was underdosed is fabricated, as is the ISR narrative around Dupixent — the bull case is invented.

@LSinnv @oakazaki This is also known as the “the entire pharma industry is unaware of PK/PD” bull theory

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It’s also part of thesis creep for $APGE too, where they claim Lebrikizumab may have been underdosed and that they’re going to fix that.

Despite the fact that the less frequent dosing interval of Lebri showed better efficacy over the more frequent interval (which was a 2x higher exposure) in maintenance.

Just made up BS, just like their narrative about ISRs being the biggest problem for Dupixent.  Imaginary.


Summary: Bullish ABVX on commercial team build as M&A negotiating leverage; cites VRNA as a successful comparable.

@Agent0088156721 I'm 100% on board with $ABVX hiring a CCO/commercial team.  AFAIC this is all part of negotiating leverage to be able to say "we are going to launch this drug on our own if we don't get a fair price today" - and to mean it too.

Worked out *beautifully* for $VRNA.

@A_May_MD Yes. For me, one of the most significant "updates" per the $ABVX 2026 outlook was a complete lack (purposefully imo) of any strategic imperative for hiring a world class team to thoughtfully build out a commercial rev/mrking org .THAT needs to happen in 2026, silence. FOR SALE


Summary: Bearish NTLA: disappointing trial data (87% attack reduction, 62% attack-free rate missed bar), cash raise will be difficult, ATTR studies not yet running — expects significant decline.

As soon as I saw zero numbers/data in the headline or first page of the press release I knew this was going to be bad for $NTLA.

They’re going to have a hard time raising the cash they direly need on this, and ATTR studies still aren’t running yet.

Should trade down significantly IMO.

$NTLA 87% attack reduction and only 62% attack free rate.  Attack free rate especially widely missed the bar set ahead of time by @GeneInvesting.

Legitimately worse than I expected. https://t.co/wmNFYfsQSj


Summary: Bullish ABVX: even the 'bearish' Wedbush note implies LLY buyout at ~$17.8B if Phase 3 data merely matches Phase 2b, which has already been better.

@JackMan724444 Yes.  If the data are simply the same (after being far better so far) then big buyout.

This is from the “bearish” report.

Can’t make this stuff up.

"Should Phase 3 maintenance data remain consistent with previous Phase 2b findings , we expect LLY will quickly consummate a rumored €15B/$17.8B bid."

Was that quote really in the $ABVX Wedbush note yesterday?  They actually wrote that, @A_May_MD


Summary: Bullish ABVX: obefazimod's endoscopic remission efficacy more than doubled Rinvoq's, calling results unprecedented and previously unimaginable.

@mickeychiku @Biohazard3737 And high dose obefazimod more than doubled high dose Rinvoq on ER delta…with Rinvoq previously having been head and shoulders above all other drugs on this endpoint in UC.

Truly unprecedented and likely previously unimaginable ER efficacy for obefazimod.  $ABVX

@A_May_MD @Biohazard3737 The IBD game has completely changed from symptom management (CR) to complete disease healing (ER). Now everyone will be forced to release ER. I don’t see CD failing with this kind of ER. I won’t be shocked if FDA also updates UC trial design & endpoint guidelines in future with


Summary: Bullish Abivax, bearish Spyre once market recognizes obefazimod as a superior competitor.

@AndyBradley93 @Abivax_ Once people realize what they’re going to have to compete against with obefazimod Abivax ⬆ Spyre ⬇

@A_May_MD Adam, if not for a mistake from the management @Abivax_ $ABVX the shares would be $200 now. This will get corrected - and yes, $SYRE is greatly inflated and will be slaughtered soon enough. Enjoy the day✌🏻


in the real world, I'm betting the T1/2 issue you note will favor $NVO

Summary: Bullish NVO: expects real-world tolerability to favor oral semaglutide over orforglipron due to T1/2 advantage.

@EganPeltan The opinion among investors is the orfo has the better tolerability.  Debatable from the trial data, but in the real world, I’m betting the T1/2 issue you note will favor $NVO

@A_May_MD I wonder what the real world tolerability data will look like. The shorter t1/2 and larger peak-troughs deltas daily for orforglipron would imply more N&V

I could see people preferring oral sema. Skipping breakfast is a partial diet plan


Summary: Bullish NVO: oral weight-loss market will beat expectations and NVO's share will exceed bearish projections even with orforglipron competition.

IMO:

1) The oral WL market will exceed currently bullish expectations
2) $NVO share of that market will exceed currently bearish expectations.

Both + for Novo.

Orfo could very easily take the majority of the market and Novo still exceed the current projections, which have become overly bearish.

*Especially* given that…clinically, the drug probably has a better profile…

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@plainyogurt21 @CloisterRes DEFINITELY not saying orfo launch wont impact them.  That’s going to be a supersonic launch too.  But the level of doom people are throwing at $NVO has started to get to the point that it’s downright contrived.


Summary: Bearish NTLA: FDA restricts drug to least-sick patients, existing options will dominate, company failed target/disease selection, diluting via ATM to retail.

$NTLA drug is off hold but now being restricted by the FDA to the least severe/sick patients, which would logically be those least likely to want/need an experimental gene editing therapy.

Existing options will dominate.

Target/disease selection is a key part of drug development, and the company flunked this.

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This is because biotech specialist funds won’t participate in their share offerings, BTW.

Just run the ATM on Cathie and retail.

$NTLA


Market isn't close to getting $NKTR right. IDK why it is so hard for the market to see $NKTR's current valuation is absolutely insane. They are wrong.

Summary: Long NKTR: market undervalues Rezpeg's superior MoA, larger AA indication vs PN, and weaker competition vs Nemluvio's blockbuster launch trajectory.

Market isn’t close to getting $NKTR right.

$GALD earnings this morning showing Nemluvio had a nearly $200M quarter.

They doubled their peak projection from “over $2 billion” to “over $4 billion.”

>$4B peak sales.  MASSIVE drug.

This is with a drug that has ***horrible*** efficacy in atopic dermatitis and has launched in a small 2nd indication (prurigo nodularis) against the most difficult competition in dermatology -> Dupixent.  On top of that, prurigo nodularis is a much smaller patient population than $NKTR’s alopecia areata population is.

The $NKTR bears would historically say “oh well all those Nemluvio sales are just prurigo nodularis sales, they can’t penetrate atopic derm”.

For the first time, $GALD just confirmed that atopic derm sales are roughly equal to PN sales….they’re *already* claiming an 8% penetration into new biologic starts in atopic derm…which is going to be a >$40B market….with a very shitty drug…

Hello???

This clearly demonstrates the massive demand that there is for ***NON-IL4/13*** drugs with unique MoAs in atopic derm.

$NKTR’s Rezpeg has a unique MoA, looks *far* more effective, and is likely to have a more favorable Q3M dosing interval (versus Q4W for Nemluvio).

*And* Rezpeg’s secondary indication (AA) is multiple times larger than Nemluvio’s PN market *and* the AA market has only dangerous JAK inhibitor drugs as competition….whereas Nemluvio is having to compete in PN against the dermatology GOAT drug (Dupixent).

IDK why it is so hard for the market to see $NKTR’s current valuation is absolutely insane.  I understand that people have written off the AA opportunity.  They are wrong.

OX40 is dead, crappy old Nemluvio is launching like a rocket, and there’s no other unique MoA left to hit the market before Rezpeg.  Wake up!!!


My novo long thesis started on 2/23 when the stock crashed due to the cagrisema readout while the OW launch was going exceptionally well in the background. I still like that, but now I also like the stock too!

Summary: Author is long NVO since Feb 23 crash on cagrisema readout; also bullish on biotech M&A theme via XBI.

I literally didn’t recommend anything.

I said I liked that the new CEO was saying they were going to buy a bunch of biotechs.  I liked that for the same reason I like $PFE buying all my shitcos, and I’d never touch Pfizer equity.  Me saying I liked the idea that novo would go on an M&A spree had absolutely nothing to do with $NVO equity, at all.

This guy is saying I “literally” recommended it when the “recommend” *literally* isn’t used at all and I was clearly talking about liking novo as a buyer of biotech stocks, not of novo’s stock.  Was just making a comment about how I like pharmas buying biotechs, which I often do about other pharmas too.

The guy is either intentionally being an ass hole pretending he doesn’t understand or is an idiot of epic proportions for not being able to understand something incredibly simple.

My novo long thesis started on 2/23 when the stock crashed due to the cagrisema readout while the OW launch was going exceptionally well in the background.

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I mean I literally even tagged the $XBI 😂

How could it be any clearer what I meant 🤷🏻♂

I spent 2025 hating on and making jokes about $NVO (as its stock price crashed).  Then in early 2026 they were suing $HIMS and saying they were going to go on a biotech M&A spree.

I liked that!

I still like that, but now I also like the stock too!


There's no way this works from these prices unless some pharma does something stupid here

Summary: Bearish SYRE at $7.5B market cap: long trial timelines, heavy dilution, and me-too targets against biosimilars make current valuation untenable.

So uhhh, how long are these mega-expensive P3 UC maintenance studies going to have to be run for $SYRE?

If only drug arm induction responders go onto maintenance (as is convention in P3 UC studies), how long do you need to run these things before you can be confident the placebo arm has had time to wash out the long half-life drug *and* give the patient time to relapse so you can actually beat placebo?

~40 weeks has been a rough standard for maintenance duration (52wks total after a 12 wk induction).

Seriously, are we looking at 96 weeks or something here?  Absurd.

Still ~$7.5B on open label a4b7 data BTW.

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Not that we need to be worrying about P3 or anything at this stage right?

I mean that’s *years* away and comes after the mega-expensive 6-arm P2 multi-combo studies that are sized roughly like P3 studies that they need to do first!

Again, we are only at the open label data phase right now!  Who cares if the P3s are gonna be 2 years long!  That’ll be forever from now!

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Add more dilution to run the longer studies *and* an extra year for your time weighted return projections for being long $SYRE today at $7.5B already…

…all to launch against biosimilars.

Combo P2as in 2027, likely late.  P2b data when?  2029?

Launch your P3s mid 2029, recruit/enroll for *at least* 2 years (generous - probably will take longer as you cannibalize your own enrollment here).

LPI mid 2031.  Run the maintenance studies for a year longer than everyone else does.  Complete mid 2033.  BLA then launch 2H2034?

If you want this to annualize 15% over the ~7 years it going to take them *just* to get to where $ABVX is today, you’re looking at a $20B cap.

That’s assuming ZERO dilution.  There will be a LOT more dilution.

If you want the *stock* to annualize ~15% returns, the market cap will need to do much more than that to account for dilution along the way…probably ~$25B or so?

Again, to launch 2 biosimilar targets and a me-twenty TL1a…we think you can wrack up a $25B market cap with a bunch of me too targets against biosimilars?

There’s no way this works from these prices unless some pharma does something stupid here.  Hard to imagine, but wouldn’t be the first or last time.


Summary: NKTR is mispriced; bullish on its IL-31 asset given nemolizumab's blockbuster trajectory despite weaker efficacy.

@cluelessbio Explain nemolizumab’s meteoric rise then.  That drug is absolutely garbage on efficacy, but it’s going to be a blockbuster in AtD alone (and in PN on top of that).

These are objective facts.  NKTR pricing is clearly wrong, imo.

@A_May_MD Anti-TSLP is marginally effective vs placebo. Surprised by the efficacy of pfizers drug.
But I wonder if we overstate the importance of a unique MoA relative to induction efficay. We treat up or across mostly, not down, even if different MoA. https://t.co/JXeEmLwHmV


Summary: Bullish ABVX: cancer signal in P3 is statistical noise given 5-7 years of P2 data with zero cancers; expects market to re-rate upward.

$ABVX
STIL here is making another highly relevant point - What he is referring to here is basically the  "latency" point.  It basically goes like this:

"A cancer signal seen so early is likely not a real cancer signal because cancer doesn't "develop" that fast.  What you are actually seeing is "latent" cancer that was there but undetectable at baseline."

This is also why it is important that...they've had >100 patients on the drug for ***5-7 YEARS WITH ZERO CANCERS***.  If it was a "super mega carcinogen" you'd now from the extremely long phase 2 study!

How could it be possible that the drug somehow causes cancer in a few weeks after NOT causing it in 5-7 YEARS?  The answer is *IT DOESN'T* - what we saw in those 2 cases in the P3 is just statistical NOISE!

I expect sharper minds to look at these facts and come to the same conclusion tomorrow.

@A_May_MD @drug_smolecules Another thing to think about: It was only 44 weeks.  If it's a carcinogen, it's a super mega carcinogen.

If they assigned half the trial a pack a day smoking habit and an alkylating agent, we probably wouldnt get 7 *new* measurable cancers by wk44.  Its probably noise.


I have bought more premarket. Let's hope for a similar outcome! Even at just ~1x multiple with only a $4B peak estimate, $NKTR's price per share would be >$130

Summary: Bought more NKTR premarket; argues >$130/share fair value on dual-indication launch (atopic derm + alopecia areata) with best-in-class profile and no black-box warning.

Obviously I will post in more detail later, but for now, the takeaway is this:

$NKTR has the FIRST LINE treatment for alopecia areata, an indication large enough that *4* separate pharmas have seen fit to launch 4 separate drugs that all share the same MoA (JAKi).  This is going to be a paradigm shift for how we treat a very common dermatology condition.  Big deal!

We are now looking at a dual indication launch where $NKTR will enter the market with the best non-IL4/13 clinical profile in the gigantic market of atopic dermatitis (now that OX40 is caput), and not just the first, but the ONLY biologic therapy for treating alopecia areata.  And the ONLY AA treatment without a black box safety warning (assuming safety continues to look great, as it has).

How do we value this?  Well, Nemluvio is well on its way to $4B peak sales as a dual-indication dermatology biologic in atopic derm (like $NKTR) and a secondary indication of prurigo nodularis.

$NKTR's data to date look far better than Nemluvio's in atopic dermatitis, *and* $NKTR will be offering a Q3M injection (4 shots per year versus 12-13 with Nemluvio).  That's a big differentiator.  Why shouldn't Rezpeg sell better than Nemluvio in atopic derm?

Then, Nemluvio's secondary indication (prurigo nodularis) is a *much* smaller patient population than Rezpeg's secondary indication (alopecia areata).

Not only is AA>>PN, but NEMLUVIO IS COMPETING WITH THE DERMATOLOGY GOAT IN PRURIGO NODULARS - DUPIXENT!!!  Rezpeg would be the ONLY safe biologic option to treat AA...no dupixent to compete with, because dupixent was never good enough to pursue in AA!  Rezpeg's only competition in AA is the 4 JAK inhibitors that people don't want to use because of safety issues.

If Nemluvio can do $4B+ peak despite all of that, why should we be modelling peaks sales of <$4B for Rezpeg with a better AtD profile with less frequent dosing, and now a second LARGE TAM where their only competition is JAKi?  IMO you could very easily argue for >$4B peak for rezpeg based on this analogue (though of course there is plenty more to look into than a single comp).

Then, what multiple do we use?  This is a drug with a unique MoA with no intraclass competition, and it is ready to enter P3 NOW for BOTH indications...Why use less than a 1x peak sales multiple?  If M&A discussions start heating up, we could be talking about MUCH more than that...

Even at just ~1x multiple with only a $4B peak estimate, $NKTR's price per share would be >$130...Calculate whatever value you think is appropriate!

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$NKTR opening at only $100 on this news is lame.  But of course, remember that when the AtD maintenance data were released in February the stock was RED premarket before ultimately going deep green that day and ultimately ending up more than doubling in the next weeks!

Like that day back in Feb I have bought more premarket.  Let's hope for a similar outcome!


I actually think this result brings the timeline of M&A forward. Get it now for a bargain, work your reg affairs team to the bone and hit a grand slam if you get this approved without black box

Summary: Bullish ABVX: M&A timeline pulled forward, big pharma will buy now at a bargain to control regulatory strategy for black-box outcome.

I actually think this result brings the timeline of M&A forward.  If you’re a big pharma you want to be in the driver’s seat of the regulatory discussions going for no black box (which is imo very feasible).  You don’t want to let this small inexperienced team run that operation if you’re big pharma.  Get it now for a bargain, work your reg affairs team to the bone and hit a grand slam if you get this approved without black box (again, very feasible from my perspective/review of the data).

$ABVX
Great review of the data below
The Obe will be approved bc of outstanding efficacy and durability
But the BO premium is gone - potential buyer(s) will wait until the approval and potential black box
NDA in Q4, PDUFA in Q4'27
No catalysts until Q1'27 Chron's data


There's no NMSC cluster, no signal whatsoever with that important note added

Summary: Bullish ABVX: refutes NMSC safety signal by noting 3/4 of cases had prior NMSC; no black box warranted per regulatory precedent.

3/4 of the $ABVX 50 mg NMSC cases ALREADY HAD PRIOR NMSC.  There’s no NMSC cluster, no signal whatsoever with that important note added.

Even if there *were* a signal, this would not yield a black box (regulator precedent is clear in regards to no black box with NMSC).

But again, the “signal” or “clustering” can be refuted altogether.

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@SowingAlphaSeed (*already had prior NMSC and/or prior exposure to drugs with known/labeled cancer risk)


Timing, valuation, and the demise of OX40 muddying their follow on opportunity are my reasons for bearishness. Easily the best company I've shorted in the last year or so.

Summary: Short on timing, valuation, and OX40 pipeline setback muddying follow-on opportunity; author's top short position.

Sanofi ADR on Nasdaq: SNY; OX40/dupixent context matches

I have to be clear as well - the company is most certainly not a zero by any stretch.  The drug has utility and will be used, no doubt.  Timing, valuation, and the demise of OX40 muddying their follow on opportunity are my reasons for bearishness.  Easily the best company I’ve shorted in the last year or so.

@A_May_MD @MelvinRiskMgmt All good - it was indeed a long day (multitasking) and you are right, that is not a reason. A little disingenuous I must admit from them.

From what I have seen with the available public data, it is conjunctivitis the primary discontinuation with dupi (and in spite of that,


Summary: Bullish NKTR: rezpeg trial data shows response retention rates exceeding Dupixent's even at Q12W dosing, with deep responses (EASI90/100); author calls it a real drug.

$NKTR We will get a lot more data/info than what is available in the PR, but what the PR shows is *very* good.  Caveat emptor, these response retention rates are higher than Dupixent's...EVEN FOR Q12W DOSING of rezpeg.  That's a big surprise to me given how management had seemed to talk down the Q12 vs the Q4.

It also looks like there was a lot of response deepening...EASI90s and EASI100s!

Will be looking at the slide data when we get it and analyzing that, but based on what the PR shows...this is a drug!


I'm going to make a lot of money on this one

Summary: Bullish NKTR; author disagrees with market's bearish differentiation narrative and expects significant upside.

@AlexandrG1980 If this is the reasoning that the market is relying on to keep the stock price so low then I’m going to make a lot of money on this one.

@A_May_MD $NKTR drug clearly works but i hardly can imagine it could compete with current data (which lacks differentiation) for meaningful mkt share


Summary: Short APGE as severely overvalued after OX40 black-box signal, lead candidate failure, and LLY competitor gaining favorable label; incidental LLY positive on Ebgylss Q8W approval.

$LLY Ebgylss approved for Q8Wk dosing.

Isn’t sparser dosing $APGE’s only remaining bull case after the OX40 and “higher dose superiority” thesis both just died?  (APGE targets the exact same epitope on IL-13 that Ebgylss does).

$APGE is severely overvalued.

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“Wow! Why is $APGE up so much over the last year?”

“Well, their OX40 candidate got new a black box cancer signal, their lead candidate failed to improve upon existing SOC, and their biggest competitor got a more favorable label.”

Ok. https://t.co/zfQd7ujNYZ


Summary: Newly short ORKA; live position just initiated.

?  My track record shorting is actually pretty impeccable.  $NTLA is down >90%.  I made millions shorting $HIMS.  And I just got short $ORKA, so we will see how that one plays out.

Also crushed $VKTX and $IOVA last year.

You’re so delusional you can watch me win time and time again and still say I’m losing 🤷🏻♂

$ntla $orka $hims never been good at shorting, but I'm happy to pass on my title as 'worst biotech short on X' to @A_May_MD.


Shorted a little for a quick trade. +27% premarket seems a bit hot for me.

Summary: Short SYRE on overreaction to uninformative open-label P2a data; long ABVX unaffected; PALI implied cheap vs SYRE's inflated market cap.

Kind of another one of those "do I really have to post about this?" things, but FWIW, $ABVX has absolutely no reason *AT ALL* to be concerned with the $SYRE data released this morning.

$ABVX posted their P2a data (which $SYRE just posted this morning) ***EIGHT*** years ago.  An 8 year gap, but that's not all...

$ABVX actually had a BLINDED study in P2a...$SYRE (for some reason???) did their P2a OPEN LABEL...no placebo group!   An open label study using a drug that has a mechanism of action (a4b7) that is already the single most-used ulcerative colitis drug in the world...........HELLO placebo response?

$ABVX was testing a totally unknown MoA with no proof of concept whatsoever, and they STILL used a controlled study.  $SYRE's drug is a me-too copycat of the most-used UC drug of all time...Entyvio - and they don't include a placebo control in the study??? That's fine for what P2a is used for, but let's not pretend like these data mean anything (at all).  You can't take the biggest MoA in the world for a disease, give it to patients open label, and still act surprised when it "works".

Also, the data just aren't even that impressive?

$ABVX P2a, placebo controlled, unknown MoA, only 8 week induction endpoint, oral pill:  35% clinical remission (8 years ago)

$SYRE P2a, no placebo control, world's #1 UC MoA, 12 week induction endpoint, IV infusion: 40% clinical remission (today)

The entire deck is stacked in $SYRE's favor in every possible way and they can only show a 40% remission number vs. ABVX's 35% from 8 years ago with everything stacked *against* them?  Ok 🤷♂

This part is besides the $ABVX point, but $SYRE is also going to have to launch this drug against GENERIC Entyvio...!?!  $SYRE is adding >$1B in market cap on these open label P2a data this morning.  Why?

Maybe they've got something useful in combination trials in the long run, but seriously:  Who cares about open label P2a infusion data with an a4b7 drug that's going to launch against the generic version of the ulcerative colitis GOAT (entyvio)?

+27% premarket seems a bit hot for me.  Shorted a little for a quick trade.  The data this morning are fine, but they don't tell us anything new at all, so why should the stock add >$1B in value?  We already knew a4b7 worked, ESPECIALLY in an open label setting!

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$SYRE +40% at open?  Glad to #short that.

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$PALI $SYRE
🤷♂🤷♂🤷♂🤷♂🤷♂🤷♂🤷♂🤷♂

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$SYRE is adding like 2-3 entire $PALI market caps on their open label data with a fully validated target.

Timelines are different, obviously, but as an investor/trader you’ve got to love inefficiencies like this.


$ABVX has absolutely no reason *AT ALL* to be concerned with the $SYRE data released this morning


$SYRE is adding like 2-3 entire $PALI market caps on their open label data with a fully validated target. as an investor/trader you've got to love inefficiencies like this


I'll have some ripe single digit prices to cover my shorts soon. Who knows, could even be today!

Summary: Short NTLA; expects single-digit price soon given insufficient cash runway and heavily discounted raise.

$NTLA still holding $11.82 premarket right now somehow.

To all the $NTLA cult shit-talkers - Enjoy double digits while they last.  It won’t be long.

I’ll have some ripe single digit prices to cover my shorts soon.  Who knows, could even be today! https://t.co/yGFuWSLolq

$NTLA raised not even 1/3 of the amount of cash they need to have a reasonable runway at launch.  Only $150M of about $500M needed given their ~$100M/Q net burn.

They had to give an almost 20% discount to close just to raise that tiny chunk of cash from investors! 🤮

That’s


Summary: Bullish NKTR after high-dose SALT<20 result of 27.6% unlocks the bull case.

$NKTR 27.6% SALT<20 at the high dose.

Bull case unlocked!!! https://t.co/dqeb6qstJn


Summary: Expects NTLA to fall below its offering price of $10.75.

@Cpacmanburrows Yet.  $NTLA should break offering price easily IMO.

@A_May_MD Surprised it didn’t drop further at 10.75 pricing 🤢