ABVX is an *INCREDIBLY* rare exception by making it past phase 3 with zero competition behind it. The drug's uniqueness is literally one of its single most defining BULL cases.

Summary: Strongly bullish ABVX: obefazimod is uniquely competition-free post-Phase 3, unlike every other effective MOA in pharma.

Yours couldn’t possibly be more worthless.  You’re aware that almost every drug on the market currently has multiple me too drugs coming right after it with the same MOA right?  You could apply this lazy logic to almost every drug in the world EXCEPT for obefazimod.

ABVX is an *INCREDIBLY* rare exception by making it past phase 3 with zero competition behind it.  None.  Meanwhile there are tens of TL1A drugs out there, S1P1s, IL17s, 23s, etc etc etc.  Every effective MoA out there is *riddled* with me-too competition in modern pharma.  *Except* for obefazimod.

Beyond that, many people don’t even think that mir-124 is the actual MoA of the drug, so good luck getting people to believe that your mir-124agon drug does the same thing.  They won’t.

Truly, yours is one of the most braindead bear cases I have EVER heard.  The drug’s uniqueness is literally one of its single most defining BULL cases.  🤦🏻♂

@A_May_MD Thank you very much for your scientifically valuable comment.


Bought the $NKTR dip. This is worth far more than $1B in my book, and IMO the stock should be green today after showing it is meaningfully active in AA. Once they raise $$$ for the AtD P3 this stock should do very well, especially into maintenance data for AtD (and AA) in 1H26.

Summary: Long NKTR; Rezpeg superior to Nemluvio in atopic derm + larger AA market opportunity; stock worth far more than current sub-$1B market cap, should re-rate into 1H26 data.

structural marker; pre-classified as canonical yfinance ticker

Bought the $NKTR dip.  Modified IL-2 works in alopecia strata.

Even including the 4 erroneously enrolled patients, the separation of both arms from placebo and continued decline in SALT scores all the way out the week 36 is very encouraging.  I’m fine to ignore the mITT stuff altogether.  We don’t need to play any statistical games IMO to see that the data there are good enough and certainly well above the bar of the market consensus that was basically “this won’t be active”.

This has a high probability of success in a P3 trial, which would make it the first and only safe FDA approved biologic for AA.

So what do we have in Rezpeg then?  This would be a multi-indication derm drug.  The best analogue would be Galderma’s Nemluvio.

Nemluvio is approved but very inefficacious in atopic derm (still gets used because we don’t have other MoAs in atopic derm).  Nemluvio’s 2nd indication is Prurigo Nodularis.  Note that alopecia Areata is a ~10x larger marker than prurigo nodularis…

So $NKTR would have a dual indication launch that we can compare to Nemluvio expect:
-$NKTR is *far* better than Nemluvio in atopic dermatitis
-$NKTR’s 2nd indication is ~10x larger than Nemluvio’s.

Now, Nemluvio is having a killer launch.  Galerma is projecting Nemluvio peak sales >$2B and it’s going to be blockbuster already in ‘27.   Some sellsiders have Nemluvio doing >$3B peak.

If Nemluvio was a standalone company, its valuation would almost certainly be between $7-$10B.

In the mid $40s now $NKTR is falling below *1* billion.

I see a drug in Rezpeg that will clearly be superior to Nemluvio in atopic derm and has a chance to establish itself as the safe go-to biologic in an AA market that is a *way* larger TAM than Nemluvio’s PN.  Even if it were to be “just” a post-JAK AA maintenance drug, that’d still make it the dominant revenue generator in the AA space as the chronic treatment of choice.   This could legitimately be a $2B+ drug like Nemluvio.

The market just constantly doubts $NKTR for whatever reason.  This thing was at <0.4x cash at times before the atopic derm data.  The stock gets virtually no credit, so I’m not surprised to see this happening again today.

They’ve got the next-to-market MoA after the (now floundering) OX40 class, and IMO rezpeg will be used in 2 indications.  That’s a big deal.

This is worth far more than $1B in my book, and IMO the stock should be green today after showing it is meaningfully active in AA.  That said, I’m not surprised that it’s red currently.   Par for the course for $NKTR.

Once they raise $$$ for the AtD P3 this stock should do very well, especially into maintenance data for AtD (and AA) in 1H26.  Eventually I think the market will appreciate the >$10B void/vacuum left behind by OX40 flopping and start giving $NKTR some credit for their ability to help fill it.


Summary: NKTR is severely mispriced to the downside; expects continued upward re-rating as disbelief fades.

$NKTR always does this.  Was up like 20% the day that OX40 flopped, then 3 days in a row *after* that it kept going up ~10% every day.  People are just in disbelief and many don't like the stock for historic failures with other drugs.  I think it continues to be severely mispriced.

@A_May_MD Im curious to why the market is not responding to results yet... Premarket sent it +13% even but after dropped to 4ish% I would have thought that the efficasy would have been pretty similar to 16 weeks results were significantly better


I was actually able to grab a few cheapies … Bullish for Obefazimod's durability, if anything!

Summary: Bought ABVX during flash crash caused by erroneous Bloomberg blurb; bullish on Obefazimod durability, views dip as already recovered non-event.

Anyone wondering what that >10% flash crash was for $ABVX at close?  Bloomberg published a blurb saying that their P2 ulcerative colitis trial has been delayed by 2+ years.

The issue?  That trial already read out 4 years ago 🤣

Clearly spooked someone who spooked some algos who spooked some more algos.

It has all recovered back to closing price ~$112 already obviously. Was in the high $90s for a couple minutes!

Shoutout to @KevinLMak who brought this to my attention so quickly that I was actually able to grab a few cheapies 😅

---

The error comes from the https://t.co/HzJuHeEJVg page being updated for the phase 2 trial today.  $ABVX appears to have extended the long term extension phase of the study *again* because patients from way back in the phase 2 era must still want to stay on the drug…so Abivax is lengthening the trial to accommodate that.

Bullish for Obefazimod’s durability, if anything!

Wild error on BBG’s part to pick this up as a trial delay though.  They should look into that.

@plainyogurt21 might be willing you help you guys optimize your computers’ https://t.co/HzJuHeEJVg interactions 😅 @Bloomberg


Summary: Bullish NKTR post-offering; expects 40%+ rally similar to previous post-offering move.

$NKTR offering!  There you go.  Wasted no time there!  Now can it get on with rallying 40%+ like it did after the last offering???

This afternoon I noticed volume was surprisingly low, which basically guaranteed this was coming.  The real buyers were on the sidelines waiting.


Even if $ABVX was *only* trading at 2x of Entyvio's projected peak sales...That's $16.5B...~50% upside from $ABVX's current levels

Summary: Strongly bullish ABVX: tears apart Wedbush bear report, argues ~50%+ upside on peak sales math, superior efficacy/safety, no real competition, and M&A optionality at $17-18B bids.

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.

---

"We are skeptical that efficacy signals will hold at a one-year readout."

Ok, well, the bear thesis for $ABVX *used* to be that the induction was weak, whereas the maintenance data were super strong.  *By far* the strong point of the P2 dataset was the maintenance data.

As I have previously discussed,  $ABVX's P2 maintenance dataset showed a higher remission rate than literally any phase 3 trial has ever shown...And it actually wasn't even *close*.

When only looking at induction responders (which is how P3s are run), Obe produced a 65% remission rate...the 2nd highest of any drug was Rinvoq (top of the market efficacy) with 52%.  13% difference.

The caveat here is that ABVX's trial was open label, whereas the Rinvoq study was blinded.  That makes a difference, but 13% is a hell of a lot of breathing room...In fact, that's higher than the placebo remission rate in Rinvoq's study!

And Rinvoq is above the rest of the pack.  If you compare Obe's 65% to Entyvio (42%), Skyrizi (38%), or even the supposedly "exciting" TL1A inhibitors like Tuli (48%) and RVT-3101 (36%)....ABVX's 65% with Obe is blowing everything on the market out of the water.  Yes, even stuff with safety warnings, yes even "novel" stuff like TL1A.

And that was in the P2 where the induction responses weren't even that strong...

So, Wedbush's first bear point is that they aren't sure that maintenance efficacy will hold up...OK...why?  No reason?  Just pure conjecture that goes directly in the face of the proof of concept data that we have.

---

"Market cap implies sales greatly exceeding Entyvio."

WWWHHHHAAAATTTT?!?!?!?!?!?  (please emphasize that in your mind when you read it as hard as you possibly can).

Entyvio is already doing $6B in sales, and $TAK projects $7.5B-$9B peak sales.  Let's take the midpoint of $8.25B

Even if $ABVX was *only* trading at 2x of Entyvio's projected peak sales, and you made that $8.25B...That's $16.5B...~50% upside from $ABVX's current levels

WTF is Wedbush even talking about?  Legitimately - I do not understand.

If $ABVX were a standalone company with a projected peak sales of $8.25B, it would more likely traded at a 2.5-3x peak sales, with M&A potential taking it to 4-5x on a buyout...That's almost small cap pharma territory.  We would be talking about a ~$25B valuation at ~3x peak sales...

But it's not even $8.25B...it's supposedly more!  Wedbush says the market is already pricing in $ABVX sales "greatly exceeding" entyvio's?  So if it is say $10B in peak sales that the market is projecting for $ABVX, that means it is trading at a ~1x peak sales multiple?  Legitimately, I'm completely lost on this point by Wedbush, it is so truly bizarre.

Believe me...If $ABVX were even pricing in a multiple on $8B in peak revenues (let alone "greatly exceeding"), the stock price would currently be double or more.  Full stop.

---

"Our survey does not support oral administration expanding the addressable market".

Ok, well then you wrote a shitty survey.  *Safe* oral options expand market sizes, period.  File that under things you don't need a doc survey to teach you.

---

"Emergence of other miR -124 enhancers will erode market share and limit ROI for an acquirer. One candidate is publicly announced (KMR301 from Formation Bio)"

This one I actually cannot believe that I am reading in a report by someone who was apparently paid to write it.  I mean, I can see this being a twitter shitpost, but this is simply not serious work here, folks.

They are referring to a *PRE-PHASE 1* drug in China...

That puts them ~8 *YEARS* behind $ABVX.

THIS IS THE LONGEST ***POSSIBLE*** LEAD YOU CAN ***EVER*** HAVE IN THE MODERN PHARMACEUTICAL INDUSTRY WITH AN EXCITING NOVEL TARGET.  EVER!!!

There is a me-too China drug waiting close behind for *every* target these days...except for $ABVX's obefazimod.  This is for 2 reasons:
1)  Everybody totally wrote this drug off for so long and didn't believe in it at all until *after* the finally released resounding phase 3 data
2)  Nobody is convinced that miR-124 enhancement is the actual MoA of this drug.  There are all kinds of theories about how it could "truly" or "also" be working besides miR-124.  But nobody has had a me-too for this because nobody has known how to make one.

There are  *at least* 10 TL1a drugs in development right now...TEN.  Probably more if I spent more time digging.  And they are all relatively close to each other in timeline.

This is what happens in modern pharma.  A new target is discovered and even minimally validated, and a dozen copy-cat me two drugs pop out of the woodwork.

$ABVX's obefazimod is an *absurdly* rare exception to this rule in the modern era.  Wedbush is presenting a PRE-CLINICAL Chinese drug that is almost a decade behind as a bear thesis for $ABVX...this is CLEARY one of the single greatest BULL cases for the company.

Inability to see this simple fact is beyond amateurish.  This is flat out trolling-level bullshit.

Their own table showing umpteen TL1A competitors is included below, showing they MUST be aware of this phenomenon, and are just making an intentionally contrived bear case here.

---

"$ABVX lacks a CCO and does not appear to be building a sales force"

1.) 😈
2.) LMAO

Think through this one yourselves, folks.  I'm confident 99.9% of you have the brain power it takes.

---

"In contrast to induction studies for biologics, which use a 12 -week timepoint, and the obefazimod Phase 2b UC trial, which used a 16 -week induction period, both ABTECT induction trials used a shorter induction timepoint of only 8 weeks. ABVX states its rationale for this timepoint was to maximize placebo -adjusted efficacy, because reductions in modified Mayo score plateaued beginning at 8 weeks in the Phase 2b UC trial, while placebo responses continued through 16 weeks. We view this justification as reducing the validity of any cross -trial comparisons, and see increased clinical risk for placebo -adjusted efficacy in upcoming maintenance results"

1)  Just flat out wrong.  Induction efficacy was measured and presented at 8 weeks for P2, same as P3.
2) Numerous other oral therapies use the exact same 8 week induction efficacy assessment timepoint.  WTF are you talking about "reducing validity of cross trial comparisons"?  You want to compare this to Rinvoq??? Well they had the exact same induction timepoint...so again, WTF are you even talking about?

Then they go on to say that the placebo arm response rate is going to go up with longer timepoints, reducing the delta in P3 maintenance.

Oh yeah?  Then why did Tulisokibart (TL1A) have a *****1%***** placebo remission rate at their ***12 week*** induction timepoint?  Complete nonsense cherrypicking of data to build their narrative here.

Oh, and again, this "shrinking delta with longer treatment" nonsense would require that Obefazimod's efficacy on treatment wanes with time...except the P2 studies literally show that its efficacy *deepens* with further treatment...again, this was literally *the* strongpoint of P2 dataset.

And another reminder:  In the P2 dataset, Obe had the 2nd worst induction remission delta of all the 9 P3 datasets I analyzed...In its P3 dataset, Obe had the 3rd *highest* induction remission delta of all the drugs analyzed...

---

Now we get into their doc survey portion.  These things are always "grain of salt" territory.  These surveys can give *wildly* inaccurate results compared to real world practice.  But, what's comical here is Wedbush's apparent inability to even remotely interpret their own data...which are basically all bullish $ABVX

Slide 1)  This slide cites "aversion to needles/injections" as one of the lowest ranking reasons for patients avoiding a drug.  Wedbush uses this as a bear case for ABVX's adoption because Obe is an oral therapy....But the data shows this is still near 1/3 of the market, which is currently *completely* dominated by injectable drugs!!

The 2nd thing the first slide just ignores is what the most common reason for avoiding certain advanced therapies was:  "Concern about side effects"...

Obe's immaculate safety and tolerability are perhaps its ultimate bullish attribute.  Wedbush focusses on supposedly few patients with needle aversion (actually a 3rd of the market) and ignores the biggest barrier to patient treatment adoption...safety, which has been Obe's clearest benefit.

So not only is it a pill for the ~1/3 of the market that is needle phobic, it is a SAFE option with ZERO severe safety warnings, which 2/3 of the market cares about most.  Obefazimod is the ONLY pill with these attributes.  WEDBUSH EVEN SAYS THIS THEMSELVES A REW SLIDES BEFORE!!

"Because no commercial precedent exists for an effective oral therapeutic with high tolerability in UC, we conducted a survey of 50 gastroenterologists"

They are stating the facts, showing the data, and yet *somehow* arriving at a conclusion that is directly at odds with what they're saying 😅

---

Obe's biggest oral competitor is Rinvoq (JAKi).  Which severe safety problems are docs most concerned with for JAKis?  Oh.  All of them!  Perhaps because they're all *potentially fatal* adverse events.

Which of these risks has $ABVX's obefazimod been shown to have?  Literally zero.

---

This slide might be my favorite.  They collected liklihood of docs prescribing Obe *instead* of other drugs, with 10 being most likely.  5 you could consider neutral.

Hey look!  Obe beat...every drug.  Wow.  This is supposed to be...bearish?

Again, I ask:  What. The. Fuck. Are. These. Guys. Talking. About?

---

This one is pretty funny too.  "How likely would you be to prescribe a combination of TL1A with another mechanism instead of other drugs?  Yeah, we don't have the data for that combo yet because it doesn't really exist, but imagine the combination!  You pick what the combo partner is!"

Yeah...this showed slightly higher preference of prescription rates than Obe did...honestly, I'm surprised it wasn't higher.  You are going to put Obe up against an imaginary dataset of combining multiple MoAs?  Obviously docs are going to want the combo.

Which, comes back to one of Obe's key strengths yet again...You could combo Obe with anything because of how safe it is.  The "combo therapies will be preferred" argument is literally a *strong* bull case for $ABVX.

(The 2nd slide here is just an unbelievably ridiculous comparison that I truly cannot believe someone published collected and published - Incredible).

---

Hey look!  Obe is *already* the next-gen drug that the most providers are the most familiar with! https://t.co/WG0fWzo6ZB

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The report repeatedly refers to supposed patent risk, and then at the end of the doc they assign this a probability of...5%...and it's just a patent extension, not even a go/no-go on IP.

---

Here's their own projected launch curve...once again I do not understand how I am supposed to read this as bearish.  The "UC only" curve shows ~$22B in life cycle revenue....This is the bear case?

The CD case also shows the drug surpassing $8B in peak sales...back to the early slides - if they hit in CD and that number becomes consensus, this thing is trading *CHEAP* at current levels.

Wedbush also notes their bearish point that they expect the Obefazimod launch curve to be slower than Entyvio's because of "more competition" than when Entyvio launched years ago.

They are ignoring some absolutely key points here:

1)  The UC market has grown *massively* since Entyvio launched.  The market is far bigger now, and will continue to grow far bigger in years to come.  Advanced therapy penetration has grown extremely high, *and* the cycle rate is extremely high because of low overall response rates.  There will be big demand for Obe's brand new MoA for patients not satisfied with current options (there are *many*).

2)  Entyvio's efficacy is quite low compared to Obe's.  Entyvio's P3 induction remission delta is the 2nd lowest I can find at 12%.  $ABVX's is the 3rd highest at 16% and, and again - the other 2 above do NOT have clean safety labels like Obe will.

3)  ENTYVIO LAUNCHED AS AN ***INTRAVENOUS888 THERAPY.  Not subcutaneous injection.  Infusion clinic, needle in vein, sit and wait for the drug to be infused.  Late in its launch it now has a SubQ version available (recent).  But it's launch was severely handicapped by IV requirement, whereas Obefazimod is a simple, at home, once a day pill...

And again....Obe even matching Entyvio's launch curve should be a bull case...we are talking about a >$7B peak sales drug...how is matching that a bear case?  And don't forget all the points above that, IMO, suggest the launch curve will be steeper than Entyvio's was.

Finally, even Wedbush acknowledges that if ABVX hits in CD it's launch is going to exceed Entyvio's...I just legitimately cannot fathom how this is being said by someone who is bearish.

---

On the $ABVX M&A rumors...this part is hilarious to me.  They got the rumored bids wrong and THE COMPANY'S DILUTED SHARE COUNT WRONG.  They are writing this whole report...and they have the fdOS wrong...Just, literally the valuation of the company that they are trying to value and they don't have that number correct.  Incredible.  Truly, remarkable.

It is 88M, BTW.  $LLY rumor bid would be ~$198.  $AZN rumor bid would be a little higher than that.

Another fun excerpt:

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

Oh!  Ok...so, "if the P3 data look THE SAME as the P2 data, then yeah the company immediately gets taken out for huge upside"

Well that's interesting...especially since the P3 induction data were actually much *BETTER* than the P2 induction data...Now you're saying, if the maintenance data can just simply *replicate* the P2 maintenance data, this gets bought out at a big premium?  Again, I ask, this is a bear case?!?!

Once again I just do not know how to marry what they're literally saying with the conclusions they are somehow drawing.  Totally at odds with each other.

Then again, they don't even have the fdOS down...what should I expect?

---

There's some lazy attempt at saying "but what if there's a NEW safety problem with the drug?!" in here too.

It's so lazy it's almost not even worth talking about, but let's just review the facts to shut this up.

1)  $ABVX has seen no safety or  tolerability issues with this drug.  A minority of patients get a mild headache that lasts for 1 day (1. single. day.) and that's it...like, this is one of the cleanest safety/tolerability profiles of an advanced therapy in *any* indication, let alone UC that is flooded with black box warnings and severe infection risks!

2)  $ABVX has had patients on drug for up to ***7 years*** from the P2 studies...zero safety risks emerged.

3)  The drug was originally studied in HIV patients!!! No infection risk even in them!  Pristine!

4)  The kicker...The company has already reported that >80% of the P3 trial has already passed through safety monitoring past 52 weeks (the study's length)...with ZERO new safety events.

So the argument is basically, what if a new safety event that has never been seen anywhere with this drug, including in patients treated for 5-7 years, *after* 80% of the P3 patients have already shown zero new safety signals...somehow in the final 20% of patients.  Oh, and it has to be a safety event that is severe enough to be a big deal and recurrent enough that it can be causally linked to the drug.

You can *always* make the "what about a random safety event???" argument about *any* drug in any stage of development.  Almost NEVER do you have more proof that the drug is safe than $ABVX currently does.

This is a lazy, lazy, lazy "what if" bear thesis that is firmly contradicted by the data we already have.

---

All of this nonsense and the bearish PT they arrive at is...$110?  Like...not even 15% downside from here?  Well...ok, maybe that does check out then 😅

The biggest bear on the street is making essentially zero since, contradicting all their own key points throughout their report, and then arrives at a *slightly* bearish price target that reflects prices we saw like 3 weeks ago...ok 🤷♂

There's lots of other stuff in there that I could nitpick on.  These were just the big glaring issues.  I'm sure I'll vent about it some more here in the comments, but for now:

Rant over.

P.S.  I didn't proof read a single word of this.  Sorry in advance.


Summary: Bearish HIMS on Novo pursuing treble damages; bullish NVO on aggressive litigation stance finally materializing.

Update... $NVO itself is already talking about the possibility for treble damages from $HIMS.  They specifically address this possibility in the STAT interview this morning.

The article is full of quotes from $NVO that all spell TROUBLE for $HIMS.  This article has several of the most direct statements I've seen out of pharma execs.

Novo is out for blood, FINALLY, after a year+ of looking spineless on this issue.

I strongly recommend reading this article if you have any sort of stake in this situation.  It legitimately surprised me how aggressive the tone is.

https://t.co/5amoPgaunu

---

I started copy/pasting "oh shit" quotes from the article but the whole thing is basically just a series of them.  Just read it.


the $NVO weight loss is higher than $LLY's

Summary: NVO oral Wegovy beats LLY's oral GLP-1 on weight loss at labeled doses, implying NVO gains competitive edge over LLY.

@janthecurious1 @EAlasalmi You’re wrong about literally both sides here.

$LLY 17.2mg approval is tablet formulation which is equivalent to the 36mg capsule studied in trials.

$NVO oral wegovy absolutely *is* approved at 25mg.

And yes, the $NVO weight loss is higher than $LLY’s.

@EAlasalmi You’re comparing two non-approved doses across different trials.

Novo’s 25 mg isn’t approved  - just like Lilly’s 36 mg

The real question is: how do they compare at labeled doses?
There’s no head-to-head data on that


Summary: Expects further upside in NVO.


$NKTR bears will still look at you with a straight face and tell you that an adverse event (ISRs) that led to a ***LESS THAN 1%*** discontinuation rate is the bear thesis… You'll see.

Summary: Bullish NKTR; dismisses ISR bear thesis as FUD given <1% discontinuation rate, signals price will vindicate bulls.

$NKTR bears will still look at you with a straight face and tell you that an adverse event (ISRs) that led to a ***LESS THAN 1%*** discontinuation rate is the bear thesis…

The ISR brain damage done to y’all by those Lilly legal documents really is wild.

Good biotech investors know how to dodge biological FUD but apparently legal FUD is a one-shot kill for some.

You’ll see.

@A_May_MD we know $nktr rezpeg causes potentially severe injection site reactions in 70%+ of patients and has a delayed onset of action in a small % of population - commercial failure coming, most big pharma won’t touch it.

no safety reports to date for $crvs soquelitinib.


Wonder how that's gonna look in Q2 when the earnings actually fully reflect the loss of the pirated sema business

Summary: Bearish HIMS: Q1 margin collapse happened before compounded sema shutdown fully hit; Q2 will be worse as full impact is reflected.

Drug Manufacturers - Specialty & Generic

BTW $HIMS cultists, the $NVO deal wasn’t struck until March 9th - almost the end of Q1.  And you know all those pirated sema patients didn’t switch to branded overnight.

Basically, this horrible earnings print and margin compression happened WITHOUT major impact from the shutdown of their compounded sema business….which was the entire reason they had decent margins to begin with.

Wonder how that’s gonna look in Q2 when the earnings actually fully reflect the loss of the pirated sema business 🤔 🤔

Expect them to have the grift engine running full blast on the peptide wave!


Summary: Bullish NKTR to $100+; upsized offering marks a turning point, still cheap vs comps.

Excellent, upsized offering for $NKTR.  The company is turning a new page here and IMO the stock is now on the march to $100+, which would still yield a much lower valuation relative to similar stage comps.

Will share more thoughts in greater detail soon!


Summary: Long NKTR (buying the -10% dip, PFE news is irrelevant to its post-IL4/13 MoA); short APGE above $73 as PFE is a direct competitor in its first-line IL4/13 market.

I swear I've never seen a market understand a disease/disease landscape worse than atopic derm.
The $NKTR and $APGE price actions are absolutely WRONG today, and I'll tell you why.

Apparently (?) the market is selling $NKTR today because of $PFE data with their phase 2 IL4/13+TSLP data this morning.  If you asked me before the market opened if I thought this would affect $NKTR at all I would've said "no".  In fact, in private conversations before open I did just that.

The $PFE drug is yet another IL4/13 axis drug, adding in TSLP, which has a checkered past and may or may not actually add to IL4/13 blockade (there is both some reason to believe that the target is not active in AtD at al and/or that it is not additive to IL4/13 since these are all heavily TH2-skewed targets).

The $PFE drug vies for first line positioning, where IL4/13 is used...

...for the millionth time...THE ENTIRE POINT OF $NKTR'S DRUG IS TO BE USED ***AFTER*** IL4/13 DRUGS.  There is no world in which a patient should fail an IL4/13+TSLP drug and then go onto a plain old IL4/13 drug....This is where a completely differentiated MoA like NKTR's is needed...this is the *ENTIRE* point of the drug...

So who could the $PFE news actually significantly affect?

$APGE!!!

$APGE is trying to develop long acting IL4/13 drugs to take their share of this first line IL4/13 market...the $PFE news gives them a DIRECT competitor in that market, with $PFE's drug adding an extra MoA that $APGE lacks.

$APGE went with OX40 as their IL4/13 combo partner target, because they observed that TSLP had failed in prior trials and that the TSLP pathway simply overlaps with IL4/13 (meaning it might be a redundant target).

$APGE went with OX40, which as we all now know is potentially dead in AtD due to cancer risks.

So, $APGE should be down today, right?  Right?!  They now have a direct competitor in $PFE that is vying for space in their same line of therapy/target.  New competitive risk, right?!

Well, $APGE is *GREEN* today, while $NKTR is -10%.

This. Market. Reaction. Is. Wrong. Period.

These price actions should be reversed by any sane logic.

If you want to argue $APGE should be flat/green because the AtD market is so massive that it can handle more drugs, then fine.  But there is absolutely ZERO reason for $NKTR to be -10% while $APGE is green on this "news".  $PFE is a DIRECT competitor for $APGE versus an oblique competitor for $NKTR at worst.

I cannot comprehend how it is possible that people STILL do not understand the "differentiated MoA" use case of $NKTR's rezpeg.  It is truly hard for me to fathom how a market can be this STUPID and inefficient.

As far as market inefficiencies go, the AtD space is the gift that keeps on giving.  Absolutely insane.

Yet again, moving more stuff to buy $NKTR -10%.  I'd love short more $APGE >$73 too...but alas, capital constraints push more to the better r/r of the two.  There's clearly no competition there AFAIC.


I'd love short more $APGE >$73 too...but alas, capital constraints push more to the better r/r of the two


Summary: Bearish on oral Wegovy expectations; $4B peak vs $30B Foundayo peak thesis means market overestimates oral Wegovy, implying downside for Novo Nordisk.

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

@plainyogurt21 @investinguab @lfholt @CloisterRes That’s part of the bull thesis - the other part is expectations.  $30B peak for Foundayo vs $4B peak for oral Wegovy.

It will not play out that way.  The market still has not adjusted to that reality.

@investinguab @lfholt @A_May_MD @CloisterRes (this is just OOP) and the WEgovy TOTAL ramp looks like this rn. https://t.co/VQK17TZmr8


Summary: Decisively bearish on NKTR — every day is bad news for Nektar.

@MashReez @PickingMyOwn @Getoutofmyway1 The sun coming up in the morning each day is bad news for Nektar

@PickingMyOwn @Getoutofmyway1 @A_May_MD So is this bad news for NKTR ?


Summary: NVO will trade down on the day LLY's orforglipron gets approved.

On the day that $LLY orforglipron gets approved, $NVO will trade down:

---

You’ve only got until close to submit your votes now $NVO $LLY


Summary: Bearish NTLA: pharma filing shows continued ODT demand, undermining Intellia's thesis; bullish PHVS as the real beneficiary.

This is literally a bear case for $NTLA.  It shows the pharma companies believe there’s still massive demand for ODT treatment (which is the polar opposite of what $NTLA offers and actually something intellia’s drug is *supposed* to obviate).

This filing is bullish for $PHVS if anything, which is red today.   Clearly just trading dynamics for Intellia.


This filing is bullish for $PHVS if anything


They're going to have to fire up the ATM to keep diluting, or they're going to have to take on debt. Not pretty.

Summary: Bearish NTLA: raised only $150M of ~$500M needed, ~20-week runway, forced dilution or debt ahead.

$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 less than 20 weeks of burn… They’re going to have to fire up the ATM to keep diluting, or they’re going to have to take on debt.

Not pretty.


$HIMS knows they are screwed... Rack up as much $$$ as they can before regulators finally turn the lights off. This company is VILE.

Summary: Bearish HIMS: discount campaign seen as desperate cash-grab before regulators shut down GLP-1 production; company is cornered.

Omg… $HIMS knows they are screwed.

So what do they do?  Try to get as many patients locked into a *long term* GLP-1 treatment plan as possible in order to:

1) Use these patients as living, breathing leverage to prevent an court injunction to stop GLP-1 production by saying “BUT LOOK HOW MANY PEOPLE ARE USING OUR DRUG YOU CAN’T MAKE US STOP!”

2) Rack up as much $$$ as they can before regulators finally turn the lights off.

Seriously…they couldn’t even wait a single day to launch the biggest sale ever (***but only if you lock in the long term deal!***)?  How much more transparent can you be?

This company is VILE.

🚨 BREAKING: $HIMS IS NOW OFFERING 20% OFF ON ORDERS OF $500+

Promo *includes* GLP-1s, which brings price to $159/mo - the lowest we've seen in a while, maybe ever

Hims just kicked off this text message campaign with GLP-1 photo: https://t.co/AB1CQOXqzR


Summary: Bearish HIMS: DOJ interview signals full GLP-1 operation is targeted, not just oral, which author calls catastrophic for the stock.

Fresh CNBC interview with head of DOJ on $HIMS.

Please watch this if you still think that they’re only coming for the oral.  This makes it very clear they’re going after the whole GLP-1 operation.

Catastrophic for $HIMS. https://t.co/57dc3L1O3A

---

Plain as day for me:

“What we’re really talking about here is protecting the intellectual investments of companies that focus on cures for the American people in comparison to companies that knock off cures and knock off solutions at the last minute, undercutting those investments from legitimate companies.”


Summary: Sarcastically rejects 'no pipeline' narrative on NVO; UBT251 shows superior A1c reduction vs LLY's triple G at shorter duration, implying NVO pipeline is stronger than perceived.

$NVO triple G drug at 2.16 A1c reduction at only week 24 vs a lower 1.9 A1c reduction at a longer 40 weeks for the max dose of the $LLY triple G.  But Novo has no pipeline…?

🤷🏻♂ https://t.co/CFcnGZGMqt

AL Sydbank on $NVO ’s new UBT251 data:

“Remarkably strong” blood sugar results in Phase 2

• HbA1c reduction up to 2.16% after 24 weeks

• ~10% weight loss in type 2 diabetes patients

Earlier obesity data showed up to ~19.7% weight loss

UBT251 is a triple agonist (GLP-1,


Summary: IBRX will rise more than TERN's 13% takeover premium tomorrow.

@threadanddoc $TERN longs watching $IBRX be up more than this tomorrow https://t.co/jePRdSxWRD

$TERN take over, 13% premium on yesterday close https://t.co/bwNgMjd2zO


at this valuation, that doesn't need to matter

Summary: Bullish NKTR: even without 1L adoption upside, current valuation already makes it attractive.

@WalterA09213626 Nothing would prevent 1L prescriptions.  I’m just given IL4/13 credit for being entrenched, which they are.  I wouldn’t bet too much on 1L adoption, but at this valuation, that doesn’t need to matter.

@A_May_MD 1. What would prevent $NKTR being prescribed as a 1L treatment  if it maintains the current efficacy & safety profile in P3?  It could gain market share in 1L & still be the only option for 2L. Am I missing something?
2. Is your timeline based on 1 or 2 P3 studies? FDA reforms


Summary: Long NVO (held position) and bullish LLY on crackdown on mass compounding acting as a major tailwind for both legitimate GLP-1 drugs.

I went/stayed long novo because if the mass compounding finally gets cracked down on it would be hugely positive for novo (and for Lilly, which would also benefit because some “compounding” patients would choose their legitimate drugs over novo’s legitimate drugs).

It would be a very big tailwind IMO.

@A_May_MD Adam, how do you feel this will affect real companies such as $NVO in the near to medium future?


for Lilly, which would also benefit because some "compounding" patients would choose their legitimate drugs over novo's legitimate drugs


Summary: Bearish HIMS: DOJ referral + regulatory crackdown could threaten entire GLP-1 business, not just the new pill.

Coincidence that $HIMS has suddenly taken down all ads touting “the same active ingredient as Wegovy”?

$HIMS may have finally called enough attention to their bullshit antics to get regulators to finally crack down on them.

This could end up being much worse for them than simply being told not to launch the pill they announced yesterday - it could threaten their entire (STOLEN) GLP1 business.

Own goal of epic proportions.

Based on a review of the applicable facts, earlier today @HHSOGC referred Hims & Hers Health, Inc. (“Hims”) to the Department of Justice for investigation for potential violations by Hims of the Federal Food, Drug, and Cosmetic Act and applicable Title 18 provisions.


I am buying the Novo dip... owning a drug company at 5 year lows that is also in the middle of the literal fastest drug launch of all time...does seem a bit asymmetric

Summary: Buying NVO dip at 5-year lows amid record-fast oral Wegovy launch; calls it asymmetric and calls the bottom.

$NVO is in the midst of the fastest drug launch of all time with oral Wegovy over the last 2 months.  Not the fastest for $NVO.  The fastest for any drug company ever.

Yet, during that same time period, their stock has (*checks notes*)...experienced its sharpest decline ever...EVER!

A fascinating case study is developing here over pricing in investor expectations and the extremes to which sentiment can swing.

Not only has $NVO had its worst stock crash *ever* (down >40% since late January) right in the middle of the fastest drug launch of all time...

...$NVO has now round tripped its entire obesity run...as if the whole obesity craze never even happened!

The stock was in the $40s on the day that injectable Wegovy launched back in 2021, now 5 years later it struggles to maintain the mid $30s.  If you go back 10 years from today, the stock is up only ~30% over the last decade, getting absolutely trounced by any index you want to put it up against.

All of that with the society-altering obesity craze in between.

Coming back to the recent move, it's been bizarre to see investors' negative reaction to the cagrisema vs tirzepatide study reading out negative for cagrisema when...anyone who even remotely analyzed existing cagrisema data had to have known that study never had a *CHANCE* at hitting.  The fact that the markets could be *that* inefficient by pricing in so much value for that cagrisema study is almost too much of a stretch for me to believe...

Investors have focused on the cargisema study not meeting (apparently somehow still very bullish???) expectations while largely ignoring the oral Wegovy launch that has been breaking every expectation that they had previously set for it...Negative sentiment begets negative sentiment, sometimes directly in the face of objective reality.

Like I've mentioned, pharma isn't really my specialty, but this will be an interesting case study for me to continue to learn from.  It'll probably be a good one for the pharma industry at large down the road given how extreme the changes in sentiment have been.

In the meantime, I am buying the Novo dip, though my pharma trades tend to be very short term largely because I use margin to conduct them.

So, will the nonstop $NVO stock crash reverse soon?  IDK, but owning a drug company at 5 year lows that is also in the middle of the literal fastest drug launch of all time...does seem a bit asymmetric 😅

---

Oh and the company is actively running a buyback program that is authorized to buy like 10% of the company 😅

$NVO

---

(Yes, I'm calling the bottom today, just for style points 😅)


First line treatment for AA. You'll see.

Summary: Bullish NKTR; expects AA maintenance data presentation + first-line approval catalyst imminent.

$NKTR AA existing data to be presented as late breaking oral at AAD.

Then entering a quiet period for AA maintenance on April 1st.  Meaning ➡ AA maintenance coming very soon.

First line treatment for AA.  You’ll see.


Summary: Remains short APGE after covering some shares on the dip; still expects further downside after AMGN confirmed target not worth taking to market.

@PikaCapital Covered a few thousand shares on this 10% dip this morning to $62s $63s.  Still plenty more to go.

$AMGN confirming this morning that the target is simply not worth taking to market.

#Short $APGE

---

@PikaCapital Added them back, $66.60


I'll go out on a limb and predict deep red by EOD

Summary: Predicts NTLA ends deep red by EOD after early short squeeze; XBI also fading -2%.

Looks like someone blew out of a big $NTLA short at open.  Tough month for many L/S managers.  Stock was roughly +8% on nearly 2M shares in the first 15 minutes.

Fading now, and $XBI -2%.  I’ll go out on a limb and predict deep red by EOD 🫡


Summary: Bullish ABVX: cancer rate below FDA black-box-warning threshold; post-hours selloff was irrational overreaction to irrelevant comparator.

That may be true, but again "vs placebo" rates are not relevant for this type of AE.  It's Vs background rates and Vs FDA precedent.

$ABVX "cancer rate" is very clearly *LOWER* than the FDA precedent for "no black box warning".  The market simply did not calculate this during the after hours before reaction instinctually to an irrelevant Vs placebo comp, hence the ultimately irrational knee-jerk reaction.

@A_May_MD If the placebo group dropped out much sooner that would imply that there was less chance of detecting cancer in that group. https://t.co/l62930ecx4


$HIMS buying more unprofitable revenue. Nothing to see here. Pop fades.

Summary: Sarcastic bearish take on HIMS acquiring unprofitable revenue; expects the pop to fade.

Foolproof get rich quick hack:

Step 1)
Buy $500M in minoxidil

Step 2)
Sell $500M of minoxidil for $400M

Step 3)
Get acquired by $HIMS for 3x revenue.


It'll go a lot lower if any of the above comes to fruition. How likely is it that they lose the GLP-1 business? IMO, likely.

Summary: Short HIMS: GLP-1 compounding likely to stop, catastrophic revenue loss + legal fees + convertible debt could send stock far below $17.

Interesting read on the risk of treble damages that $HIMS *could* be liable for to $NVO.

I really have no idea how likely it is that things go that far.  Odds could be very high or very low as far as I know, but I do know that if this were to happen, it would be catastrophic for $HIMS.  They simply cannot afford this, especially with the convertible debt overhang.

But again, treble damages don't really have to happen for $HIMS to be at serious risk.  Just having to stop GLP-1 compounding alone would be an absolute disaster for them.

Subtract GLP-1 revenues, add in substantially increased legal fees from this battle, and suddenly you have a negative growth company that may not even be turning a profit anymore.  *Could* be a death spiral with the convertible debt added on top.

How likely is it that they lose the GLP-1 business?  IMO, likely.

Per Cowen this morning:  "GLP-1 compounding likely to decline if not stop..."  😬😬😬

$17s premarket.  It'll go a lot lower if any of the above comes to fruition.  I will still likely cover soon, as I have done well with quick in and out trades with this stock and have caught the move from $27 to $17 perfectly in the last few days.


Summary: Bullish NVO; expects the stock to keep rising on the HIMS partnership news.

@Frenchmontana67 @TheRealBirnbaum $NVO is literally up on this news and will continue to be up on this news, sir.

@A_May_MD @TheRealBirnbaum Adam fall from grace .after his beloved company NVo announcing partnership with trash company $hims lmao https://t.co/CECdnc81uH


I'm a novo bull at these prices as I've repeatedly said

Summary: Long Novo Nordisk at current prices; dismisses Lilly's 17mg vs 36mg issue as a nothingburger.

They had to run studies and then submit the bioequivalence data with the fda filings that were sent in months ago.

This has clearly been the plan for a very long time internally.

I’m a novo bull at these prices as I’ve repeatedly said, but this 17 vs 36 mg thing for Lilly is a nothingburger.

@A_May_MD A question nobody is asking about $LLY's Foundayo launch.

$1.5 billion in pre-launch inventory.
Phase 3 trials: capsules up to 36mg.
FDA approval: tablets up to 17.2mg.

What's in the boxes?

If capsules: they can't sell them. FDA approved tablets, not capsules.

If tablets: the


Summary: Holds NVO long and is relieved to not be short HIMS following the Novo/Hims GLP-1 partnership news.

Can’t say I respect $NVO for this move, but I am definitely glad that I find myself long the stock at the time that they made it 😅

And, of course, glad that I’m *not* short $HIMS 😮💨

🚨 BREAKING: $HIMS AND $NVO END FEUD

$HIMS WILL SELL NOVO'S BRANDED GLP-1s ON PLATFORM AGAIN

SOURCE SPOKE ON CONDITION OF ANONYMITY

TO BE FORMALLY ANNOUNCED AS SOON AS MONDAY

SOURCE: BLOOMBERG (@G0INGMAD) https://t.co/Auxn3ZPcyc


Summary: Bullish NKTR as the only new MoA in atopic dermatitis coming to market soon, following SNY's P2b failure.

$SNY next-gen atopic dermatitis drug failed in P2b.  Missed primary endpoint.  MOA was IL13xTSLP.

Now what have they got to follow up dupi if (when?) they discontinue amlitelimab?

$NKTR 👀 🤷🏻♂  Remains the only new MoA slated to come to market any time soon….

https://t.co/zQtQNGhF2S


Summary: Confirms still holding short position in Intellia Therapeutics.

@kms_ghostt @GeneInvesting Still short Intellia, and:

@A_May_MD @GeneInvesting I knew you had covered your NTLA short. What’s up with TENX? Holding through or sold the pump?


Summary: Sees SRRK as undervalued and back on M&A radar despite CMC issues.

@byebyegoodguy Probably on the cheaper side - back on the M&A menu despite ongoing cmc issues

@A_May_MD Wdyt of the current valuation for $SRRK? Seems fair for Apitegromab alone right?


Summary: Bearish SNY: discontinuing amlitelimab in asthma while pushing forward in eczema despite poor efficacy and cancer risk signals poor risk/reward for the company.

This morning $SNY finally discontinued development of amlitelimab (OX40)……..in asthma!  But, somehow, they’re still planning on regulatory submission for *eczema* in the 2nd half of this year!

Asthma, a potentially fatal condition where drugs with black box warnings like Xolair are approved and *frequently* used, was apparently deemed an inappropriate risk/reward balance for the drug.

Apparently, that balance is not bad enough in eczema, which is obviously not fatal and is dominated by drugs with pristine safety labels.

What we are really seeing here, IMO, is a statement on the size of the atopic dermatitis market.  It is just incredibly massive, so they’re pushing this drug forward despite poor efficacy and cancer risk to boot!

That says a lot about the size and market opportunity for new MoAs in atopic dermatitis, which $SNY of all companies should know.

Who am I to contradict them, but my prediction:  This move to plow forward with OX40 in AtD does not play out well for $SNY.


doesn't seem like $NVO or $LLY have responded adequately to the out of the gate rocket signal we are seeing for oral launches

Summary: NVO and LLY not yet pricing in strong oral GLP-1 launch demand; obesity market has another leg up.

Tbh doesn’t seem like $NVO or $LLY have responded adequately to the out of the gate rocket signal we are seeing for oral launches.

Seems to be a lot of pent up demand, which I’m guessing comes from marginally obese/overweight people who don’t feel like they need an injectable and are willing to pay DTC prices for a pill.

Obesity market has another heave in it, IMO.

---

“But everyone can see the launch numbers, why wouldn’t it be adequately priced in?”

If I had a nickel


Even the "worst case" of a black box you've got a multi billion dollar drug here

Summary: Bullish ABVX: physician prescribing behavior unaffected by warning labels; worst-case black box still yields a multi-billion dollar drug.

@Dok__Tok Would be a different story if this were psoriasis.

GIs frequently/unanimously write for JAKs with far worse labels than this. Even the “worst case” of a black box you’ve got a multi billion dollar drug here.

@A_May_MD Corrected - point is has Zero 0⃣ impact on physician scrip behavior or patient adoption. Street sell off $ABVX completely ignores how physician/patient or Big Pharma view such warnings/trial data with  few CA cases - same with IV Cinqair infusion in asthma $TEVA (many other e.g.)


Summary: Any spike on APGE maintenance data will be temporary and reverse, as the results are already expected; bearish on a sustained move.

I don't think anybody at all expects $APGE to be worse than dupi in maintenance.  In fact, the universal expectation should be that it is better than Dupi in maintenance.  $APGE binds literally the exact same epitope as Lebrikizumab does, and Lebri already has better maintenance data than dupi.

$APGE is just Lebri with a longer half-life.  Maybe the stock spikes a bit on data that look the same as Lebri with Q3M and Q6M intervals.  It'll come back down to earth shortly after, because these results are *expected*.

---

As for $APGE survey data, it is entirely unreliable.  Another example in addition to my original post above:

I will eat an entire couch cushion live on X if 90% of well controlled dupi patients switch off of dupi onto $APGE.  Hell, I'll eat the entire couch.  These "results" are *that* ridiculous.


Summary: Short HIMS at ~$27 mid; oral semaglutide without SNAC is a dud with razor-thin margins; implicitly favors NVO's superior bioavailability tech.

Hahaha ok so $HIMS is now not just scamming pharma companies for their IP, they’re also scamming their own patients too!

They’re making a semaglutide pill *without* the (proprietary) SNAC formulation that $NVO uses to prevent the peptide from being totally dissolved/digested right when you swallow it.  YOUR STOMACH BREAKS DOWN PEPTIDES WHEN YOU SWALLOW THEM.  $NVO uses a proprietary technology called SNAC to make their oral formulation more bioavailable.  $HIMS cannot.

Patients are buying a dud here, thinking it’s similar to the real deal.  SCAM.

It’ll be biologically active, sure, but bioavailability for this is going to be almost nothing.

Also, this is still a *ton* of peptide to manufacture = BAD margins.

25 mg of peptide per day is >70x more peptide of the max injectable dose!!!

$HIMS selling this at a discount to what $NVO is means their margins are going to be razor thin.

Of all the fake bullshit pump and dumps that $HIMS has pulled, this one might be the fakest and most bullshit of all.  Not in the least part because they pivoted to just full blown scamming their customers (IMO), pitching an unprotected oral peptide as similar to what $NVO is selling.  It is NOT even remotely equivalent.

Shorted on the pump this morning, average mid $27s.  $HIMS deserves to finish red today with the rest of the market.


$NVO uses a proprietary technology called SNAC to make their oral formulation more bioavailable. $HIMS cannot


Summary: Endorses Obefazimod EU patent monopoly through 2039/2040, supporting the bullish thesis on ABVX.

@biotech_jack Anyone who has done any actual work on this has come back and said yeah, 2039 it is.

$ABVX EU market: The patent wall stands. Thanks to the Supplementary Protection Certificate (SPC), Obefazimod's monopoly is legally cemented through 2040. BP pays for time. https://t.co/IiWPJDHTFC


Summary: Bullish ABVX: colonic dysplasia rate in trials (0.12/100PY) is 15x below baseline UC population rate, making the AE a positive signal for obefazimod's safety profile.

I'd respond to @meremrtl in his post directly, but he blocked me for politely disagreeing with him on $NKTR.  There's something VERY important that he is VERY wrong about that I'd like to highlight.

It's funny that he recognizes that the 2 solid tumor cases in the $ABVX trial are mere bad luck/noise.  I agree with him that the latency argument for solid tumors argues that these cancers pre-dated the $ABVX study given that they were slow-growing cancer types identified far too early (6-8 months) to be due to $ABVX's drug.  These are the cases the market has been freaking out about, so...good to see you're an $ABVX bull, Stephen!

Now the point he is making about colonic dysplasia is very, very (very very very) stupid.  He is trying to say that the single case of colonic dysplasia is the worrisome finding in the $ABVX study.  I'll provide data to show you that his take is objectively stupid, so that he doesn't whine about me saying so.  I'm not being mean - I'm calling a spade a spade, and of course very smart people can make very stupid points sometimes😉

There was 1 case of colonic dysplasia in the entire P2-P3 program for $ABVX.

In P3 we have ~310 patient years of exposure across arms (388 patients x ~80% 1 year completion rate).  In reality 310 is a slight underestimate as we don't know when the other 20% discontinued, but it wasn't day 0.  Still, let's be conservative.

In P2, we have ~130 patients treated across 5-7 years in the long term open label extension.  Let's be overly conservative here too, and say 100 patients for 5 years = 500 more patient years.

So, very conservatively, we have ~810 patient years of obefazimod exposure.

1 case of colonic dysplasia.  810PY.  That makes the colonic dysplasia event rate 0.12/100 Patient-Years on Obefazimod so far.

What Stephen (very very stupidly) fails to ask is:  "What is the expected rate of colonic dysplasia in this patient population at baseline?".

The answer is ~1.77/100PY.  ~15x higher than what $ABVX is showing.

Yeah, the expected background rate of colonic dysplasia in this population (long-term UC patients with median age in the 40s) is ~1.77/100PY, FIFTEEN TIMES HIGHER THAN WHAT IS BEING SEEN IN THE $ABVX TRIALS.

Colonic dysplasia is actually a relatively common (nonmalignant) event in general, but it is especially common in ulcerative colitis patients because their chronically inflamed colons are at a high risk of accumulating DNA mutations and immune dysfunction that leads to carcinogenesis.

What we are seeing in the $ABVX trials is actually a DRAMATICALLY lower than expected rate of colonic dysplasia, which is suggestive of A DECREASED RISK OF COLONIC DYSPLASIA AND COLON CANCER due to high levels of disease control.

Really, it's very simple...UC patients have a high risk of colon dysplasia/cancer because their colons are so severely inflamed...$ABVX's obefazimod stops that inflammation, LOWERING their risk of developing it.  Not only is this mechanistically supported...the DATA support it as well.

What Stephen is highlighting as the big scary AE for $ABVX is actually an objective POSITIVE for the company if you have the brain and objectivity to analyze the data.  However, some people (like Stephen) are just here to stir the pot!  Oh well.  The data are very clear, and they are bullish for $ABVX.

But hey, even Stephen signed off on the "real cancers" as not being a concern!  Maybe he is coming around to be an $ABVX bull himself!

Source data: https://t.co/kDtghxb5T3

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This is the reply that he blocked me over, BTW.  Decide for yourself. https://t.co/4nQfquBOzd

---

Wants to talk trash but keeps everyone blocked.  Childish.

Won’t address the fact his idiotic comment on colonic dysplasia was completely debunked too.  Just pretend like you never saw it and it can’t hurt you Stephen! https://t.co/WktJQDfg3s


Summary: Bearish on HIMS sleep opportunity: insurance-based market requiring in-person tests leaves no role for HIMS; low-margin dead end.

@himshouse @davidmaris Not a chance.  This is a primarily insurance based market, and you DO actually have to have physical tests done in person to make these diagnoses…what’s the point of HIMS in this process?

Another low margin non-opportunity.  It will go nowhere.

.@davidmaris says sleep is a billion-dollar opportunity for $HIMS and nobody on Wall Street has priced it in:

"I haven't seen any sell-side report talk about the sleep opportunity. And to me that's another billion-dollar opportunity for them. I think it's just a home run for https://t.co/fKAGVwEGae


Summary: NKTR will be green tomorrow despite the $300M offering.

Boom!  $300M!

$NKTR green tomorrow 🫡

https://t.co/sEwjfGWhLZ

$NKTR excellent strength into close despite $XBI floundering.

Let’s see that offering!


Summary: Long NVO; higher dosing makes the oral ozempic a legitimately better drug, not a rebrand, and market is slow to price it in — opportunity to accumulate.

Beyond the branding, the higher dosing is legitimately a huge difference.  It’s going to be a legitimately far better drug, not just a rebranding for $NVO

Thankfully (if frustratingly), the market will apparently appreciate these things slowly enough for us to own as much as we want ahead of time 😅

It is really dumb.

But I think “Ozempic pill” does way more numbers than Rybelsus. Like 10x.

And I think hearing “ozempic pill” funnels more people to both wegovy oral and Foundayo as well.


Summary: Bullish ABVX on ~$200/share unofficial bid plus two more potential bidders; author views deal completion as inevitable.

$ABVX has an unofficial bid for ~$200/share if you believe the reporting out of France this morning, plus two more potential bidders circling.  Of course, the source is reputable enough that the little old Wall Street Journal has picked up the story as well.

Trade it however you want.  My hands are tied (in the manner that Eddie's are below), because IMO it all is simply a matter of time🥱

https://t.co/5qm1Ey1IfT

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https://t.co/DcSvF8RnJL https://t.co/ljK5DR7n0i


Summary: Rezpeg/Nektar is massively undervalued vs Nemluvio on clinical data; author sees a wide mispricing in favor of the cheaper asset.

Nektar Therapeutics, Nasdaq: NKTR; rezpeg pipeline context matches

Maybe, but then the whole point of the lead in is to eliminate the steroid responsive patients, no?  And we both know that, in aggregate, even uncontrolled patients do not use topical steroids consistently with plenty of data to prove this (300gm outlier patients notwithstanding).

In any case, if we are moving the argument down to Nemluvio is ~equal on itch and worse on rash, then sure!  I think the data roughly demonstrate this on itch and clearly demonstrate it on rash.

This same dynamic, based on existing data, applies to rezpeg as well!  So, on average, why would I choose Nemluvio over rezpeg if the overall efficacy for Nemluvio is worse and it’s dosed 3x more often?

TBD!  More data needed, as always.  I’ll note that the data so far show very low DC 2/2 AE rates for rezpeg - tolerability concerns are likely overblown (there’s a reason Eli Lilly is relying on ISRs in their legal battle against Nektar and NOT arthralgias/headaches).

The market wrinkle of this is that the company/rezpeg are not being valued even close to what Nemluvio is valued at (not even CLOSE).  The discrepancy between what the clinical data show and what the market valuations show is very wide between these drugs.  The efficacy/safety gap seems to favor the cheaper asset.  Not your realm, I know, but hopefully this helps frame where I’m coming from.

@A_May_MD @semodough I actually wouldn't say it's better in terms of absolute improvement.  It's that it's so much faster.

I think of it as same efficacy but faster as a more effective drug.  Essentially more AUC.

It is much slower in terms of improving the visible appearance.

But an article a


Summary: Bearish SYRE: ABBV's single bispecific (IL23+TL1A) will outcompete SYRE's two-drug combo plan on trial cost/speed, questioning SYRE's $8-12B valuation; also bearish ORKA on rising competition.

$ABBV confirming this morning they are taking forward their extended half life IL23.  Sorry $ORKA.  There’s yet another competitor for you.

Oh, and $SYRE…. $ABBV also has an extended half life BISPECIFIC antibody for both IL23 and TL1A.

$SYRE has both of those programs individually…their plan is to give 2 separate drugs together.  $ABBV already has it as one drug.  This makes a *huge* difference in the clinical trial cost and speed, because $SYRE is going to have to run insanely expensive trials with multiple different combo arms (FDA requiring this).  $ABBV will breeze right through and with much less expense.

See $JNJ’s P2 UC study enrolling 600 patients (!!!!!!) with 1:2:2:2:2:2 randomization (no, I’m not making a joke - 1:2:2:2:2:2).

Good luck $SYRE.  Better raise a few billion more.  Going to be a long haul just to compete against a bunch of generics and branded extended half life bispecs antibodies to boot!

“But $SYRE has a4b7 too!!!”

Clearly these pharmas aren’t bothered by making these extended half life antibodies themselves.  Why pay a premium (maybe $12B??) on top of the current $8B price tag today for an early stage asset?  Again, this thing is open label P2a stage…….

We got extended half life antibodies at home.   Pop the bubble.


$ABBV also has an extended half life BISPECIFIC antibody for both IL23 and TL1A


blue sky scenario here is a $10B/year peak sales drug with a near 4x M&A multiple that puts a 3 handle on the stock price… That multiple is a major sandbag

Summary: Bullish ABVX: blue-sky M&A scenario implies 3-handle stock price; 2.2x comp multiple is a major sandbag given ABVX's superior data, phase advancement, oral route, and sole MoA status.

@seedy19tron @PickingMyOwn Tell Stephen that an actual “blue sky” scenario here is a $10B/year peak sales drug with a near 4x M&A multiple that puts a 3 handle on the stock price.

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2.2x from prior IBD M&A comps is of course very low for M&A standards, reflecting the fact that other IBD companies WERE BOUGHT OUT WITH ONLY PHASE 2 DATA *AND WITH MULTIPLE SAME MECHANISM OF ACTION COMPETITORS.

$ABVX is *years* more advanced than prior IBD M&A comps were when they were bought out.  *And* their data is better. *And* the drug is oral.  *AND* they’re the company in the world with this MoA.

That multiple is a major sandbag


It's also a good thing for $ABVX, since their longer term (5-7 years) P2 dataset shows no such time-dependent risk. Every angle I look at this from = no black box.

Summary: Bullish ABVX: 5-7yr Phase 2 data shows no time-dependent cancer risk, supporting no black box warning outcome.

Accumulating/accelerating of cases with longer time is discussed in FDA review docs.  It is a known criterion the fda uses to evaluate these risks and was part of the problem for JAKis.

It’s also a good thing for $ABVX, since their longer term (5-7 years) P2 dataset shows no such time-dependent risk.

Every angle I look at this from = no black box.

@Clarksterh @A_May_MD Totally agree that the cancers propably emerge too quickly. But afaik there isn‘t a publically available data set that lists the occurence of NMSC case by case by time of occurence after starting a therapy. So who knows when curves separate?


I cannot believe the degree to which we can disprove the $ABVX "cancer risk" crap while the market continues to completely price it in as real

Summary: Bullish ABVX: cancer risk narrative is disproven by patient-level data yet market still prices it in, implying significant upside as the fear unwinds.

I cannot believe the degree to which we can disprove the $ABVX “cancer risk” crap while the market continues to completely price it in as real 🤷🏻♂🤷🏻♂🤷🏻♂🤷🏻♂🤷🏻♂

$ABVX

Now that you have details from Abivax for each patient, see how 23 non-NMSC and 6 NMSC cases were reviewed for omvoh resulting in conclusion that not induced by the drug as the rate was still within the background rate for UC patients. Also, FDA review below.


Summary: Short HIMS: FDA crackdown on GLP-1 ops threatens ~1/3 of revenue, core business slowing, no moat, and $1B convertible debt maturity wall in 2030 could be existential.

Do people even realize how bad things could get for $HIMS?

Flash back to my post on $HIMS 6 months ago, where I was already highlighting a little-recognized/understood threat for HIMS that could seriously destabilize the company/stock...

👉👉The convertible debt deal.

In May the company sold convertible $1B worth of convertible notes at a ~$70 strike price, with 0% interest, maturing in 2030.

The stock was slightly <$60 at the time.  Naturally retail bulls pumped this deal as "selling stock to hedge funds at $70 when the stock was under $60!!!"

It's obviously idiotic to believe that hedge funds are that stupid, but nobody seemed interested in actually understanding how the deal works.

Those notes could act as either stock in the company, or debt owed by the company to the noteholder, and $HIMS doesn't get to decide which - the market/noteholders do.  For brevity, I won't discuss *why* hedge funds wanted to do this deal, but it was NOT because they were super bullish $HIMS, like arrogant and foolish retail longs touted.

So, simplistically, there are two possible outcomes from this deal:

1⃣ The good:  $HIMS does great, the stock in 2030 is >$70, and the convertible notes become shares.  This makes sense, because the noteholders paid $70 for the notes - if the stock is at $100 in 2030, they want to turn those notes into shares!
      ↪New shares in the company are minted, so the existing shareholders are diluted a little and the market cap of the company increases.  However, this was a good move, because ultimately the company raised cash *above market price* in 2025 to foster growth.  Their aggressive financing (or gamble, as I see it) paid off.

2⃣ The bad:  $HIMS does poorly, the stock in 2030 is <$70, and the convertible notes become debt.  Simplistically, the noteholders demand repayment of the $1B they spent on these convertible notes, and $HIMS is now on the hook for paying out money they don't have.  Now, in such a situation where the stock is suffering in 2030, the company obviously aren't sitting on a mountain of unused cash.  They CAN'T pay this money back.  The noteholders also don't want to drive the company into insolvency if they can avoid it, because their $1B investment is on the hook here!

So, in reality what often happens is a form of refinancing/restructuring, such as offering new converts with much less favorable terms, or true debt with terms that are reasonable enough to allow the company to survive, but likely too unfavorable for the stock to do well.  Of course, if things get really bad for $HIMS, this deal could ultimately be a major part of a death spiral/insolvency process.

↪Let's say that the stock is at $20 in 2030, where it trades today.  *If* noteholders are willing to stay exposed to a form of equity, Hims would likely have to dilute existing shareholders by about 3x more than they'd have to in the "success" scenario (with original strikes having been at $70).

$HIMS would basically have two options.  Print new converts/shares like they're Weimar Reichsmarks, or be a billion dollars in debt.  Both outcomes are disastrous for existing shareholders, ESPECIALLY in a scenario where $HIMS has done so poorly that their stock is still this "cheap" in 2030.

Now, in the current day, the big threat for $HIMS is that their antics with the GLP-1 copycat pill have drawn the FDA's ire, and current commentary suggests the FDA is going to go after their entire GLP-1 operation, including the injectables.

There is no argument that what $HIMS is doing with the injectables is legitimate.  None.  It has been a bizarre examples of regulatory apathy that the $HIMS GLP-1 intellectual property scam hasn't been shut down already.  *If* the FDA and Department of Justice are finally waking up (which it looks they have), the GLP-1 revenues that currently comprise ~1/3 of $HIMS entire business could fall completely flat.

The company is barely profitable as is.  Their "low hanging fruit" verticals like erectile dysfunction and hair loss pills have been slowing/shrinking as competition becomes fierce.  New verticals that longs once hyped as massive growth opportunities have repeatedly failed to deliver...and the company is NOT sitting on some revenue growth secret weapon for no reason.  There isn't one.  This is, and always has been, a generic drug company selling generic drugs at marked up prices thanks to smooth marketing.  No moat.  No innovation.

If GLP-1s are gone, this company that is barely profitable as-is will be losing ~1/3 of their revenue in a flash.  Sure, someday they'll be able to offer the GLP-1s again when the drugs go generic...BUT SO WILL EVERYONE ELSE.  This will be reflected in the same poor margins and high CAC that have inverted the growth curves of the ED and hair loss verticals.

Please understand this:

$HIMS' "edge" in the GLP-1 compounding industry has come only from the fact that they were willing to do something blatantly wrong and cross lines that other compounders weren't willing to cross.  They should, and apparently are going to, be punished for this.

Here's the recipe for disaster:
1⃣Take a minimally profitable "growth" company that has a consistently slowing core business
2⃣Launch new verticals and expand into new territories that fail to generate meaningful growth
3⃣Regulators attack the GLP-1 IP scam, making you subtract 1/3 of your revenue and only consistent source of growth
4⃣Add in mounting legal costs over said GLP-1 scams
5⃣At the end of all that, encounter a 1-billion-dollar-high debt maturity wall in 2030, which the company itself foolishly built in 2025 when they thought they could do no wrong.

Sure, the current GLP-1 drama looks bad for $HIMS.  In the long run, if other growth verticals don't turn this ship around, the current crisis could evolve into something existential for the $5B company we see today.

---

And just for the record, the hedge funds who bought these $HIMS convert notes in May largely did it because they wanted to *short* the stock.  Not because they were “getting hosed” by retail and Dudum by buying notes above market value.

They aren’t idiots, and many of them were likely NOT $HIMS bulls.

$HIMS basically monetized their stock’s tendency to short squeeze, and in so doing prevented any major squeeze from ever happening again.

Unironically, few understand this.


severely oversold at these prices…the drug replaces JAK inhibitors

Summary: ABVX severely oversold; drug is objectively superior to Rinvoq in every metric, positioned to replace JAK inhibitors in a multi-billion IBD market.

At worst $ABVX is a *more effective* Rinvoq without the need for lab monitoring and with a far superior safety label (even if it does get 1 black box bullet point).

It’s objectively better than Rinvoq in every way even in the *worst* case scenario, and the JAKis do several billion in IBD already (peaks will be higher).

That’s why I really really don’t understand the $ABVX price action…even if you *do* think the cancer risk leads to a black box….it’s *severely* oversold at these prices…the drug replaces JAK inhibitors…

$ABVX 50% remission and a 40% pbo adjusted delta with random incidences of common cancers over many hundreds of patient years. At worst, it's Rinvoq without the need for monitoring. I wouldn't be surprised if the pending offering is once again up sized and oversubscribed.


$NKTR is *CLEARLY* the biggest direct beneficiary of this in the entire market. As always, I'm biased, but I'm just mind blown that this isn't already a $100 stock.

Summary: Strongly bullish NKTR as prime beneficiary of amlitelimab's safety crisis; bearish SNY as OX40 program faces discontinuation.

🚨🚨🚨 The 2nd case of amlitelimab (OX40) induced Kaposi sarcoma was just disclosed by $SNY today at AAD.

Somehow $NKTR is still in the double digits…*surely* the complete death of Amlitelimab would change this?

Up until very recently (weeks) $SNY has *still* been projecting amlitelimab to be a $3-$5B peak sales drug in atopic derm ALONE.

If Amli is discontinued (as it should be) $NKTR’s rezpeg would be slated to be the next new MoA on the market for AtD, and THE ONLY non-IL4/13 biologic besides the ineffective Nemluvio (…which is still going to be a $4B+ peak mega blockbuster despite its lack of efficacy……..)

Right now, $NKTR’s efficacy vastly exceeds nemluvio’s and beats OX40’s by a healthy ~10% delta.  All of that WITHOUT causing cancer.  $3-$5B peak for OX40???  What’s $NKTR worth?

OH! And that’s just the sales projections for AtD…I expect that soon the market will wake up to the fact that Rezpeg is a legitimate drug for alopecia areata too, which currently seems to be priced totally out of the stock.

IMO $NKTR already went into the weekend the most mispriced name in my book.  Now the death knell for OX40 is coming into view.  $NKTR is *CLEARLY* the biggest direct beneficiary of this in the entire market.

As always, I’m biased, but I’m just mind blown that this isn’t already a $100 stock.  Let’s see if the market starts to accept that OX40 is finally done for.  That could be explosive news for $NKTR.


Summary: Long NKTR as the most undervalued biotech name; bearish SNY whose $3-5B Amli peak-sales projection is a pipe dream as OX40 faces more Kaposi sarcoma cases.

More cases of Kaposi sarcoma for OX40. OX. 40. Is. Done.  $SNY still projecting $3-$5B peak sales for Amli is a pipe dream.  This value is going to $NKTR.

$NKTR is, IMO, the single most undervalued name I can find in biotech.  It was *before* this news.  Now…

📈 📈 📈

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Market is out of its fucking mind with this $NKTR valuation IMO.  About all I can say at this point 🤷🏻♂


$SNY still projecting $3-$5B peak sales for Amli is a pipe dream


$NVO raised guidance. Thank God. Even European trading hasn't started yet, but this should open green.

Summary: NVO raised guidance; expects the stock to open green on the news.

$NVO raised guidance.  Thank God.  Even European trading hasn’t started yet, but this should open green.

Back to bed!

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Chuckled a bit at Doustar's not at all subtle ploy to show us how small the Wegovy pill is in the $NVO video announcement from this morning.

Clearly trying to show people this is not like the giant Rybelsus pills.  Bet you some "analysts" are surprised to learn this fact since I have seen "horse pill" come up as a bear point for oral Wegovy 😅

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Doustdar* sorry king


Summary: Decisively bearish on Nektar; every passing day is bad news for the stock.

@MashReez @PickingMyOwn @Getoutofmyway1 The sun coming up each day is bad news for Nektar


Summary: Bearish HIMS; expects continued decline.

@TheRealBirnbaum @Cattletech You know we can both be right based on different timelines, you just don’t get to decide that someone is wrong even though the stock has collapsed since you said you were bullish and I said I was bearish.

Anyway, it’ll keep going down.  Enjoy that.

@A_May_MD @Cattletech Dude you are insufferable. Are we talking about your short position? No. You are. I bought $HIMS way below current prices. I’m aiming to hold for 10-20 years. I’m doing just fine, and so is the business. Literally none of your predictions have come true—litigation collapse,


Summary: Adding to long NKTR position; stock undervalued despite repeated positive catalysts.

$NKTR is not getting a *fraction* of the credit it deserves.  One positive development after another, and the stock simply cannot break out.  Look at all that has happened since the stock was at these same levels 2 months ago…

I cannot understand why the market keeps handing $NKTR to me on a silver platter like this, but I guess I just have to accept it as an incredible opportunity...

Bought a bit more this afternoon 🤷🏻♂


Summary: Bullish ABVX: new corporate slides show cancer cases predated trial enrollment, prior drug exposures with black-box warnings, and UC baseline cancer risk — strongly exculpates obefazimod.

$ABVX seems to have (in the last hour or so?) quietly released a new corporate deck with 3 important slides at the end.  All, in my opinion, providing strong new information showing that these cancer cases were unrelated to drug and equivalent to expected background noise.

Most important is the slide on the 2 non-nonmelanoma skin cancers.  BOTH of these were more indolent, low/intermediate subtypes of their respective cancer (prostate and breast).  Not only does this mean that the cancers are less threatening, it also means that THEY ARE SLOWER GROWING CANCERS.  Why is this particularly important?  Because it means that the development of the cancers very (very) likely PREDATES THEIR ENROLLMENT IN THE TRIAL.  Look into the doubling times of grade 2 (Gleason 7) prostate cancer and grade 2 NST breast carcinoma.  These are slow-growing tumors that very likely existed before these patients ever even had a dose of obefazimod.

That relates to another key finding on this slide - the prostate cancer case was identified via PSA screening at 8.5 months into the study (remember earlier is better).  In the Guggenheim conference they had said it was confirmed at day 367...they must have been referring to the biopsy confirmation of the subtype, not PSA confirmation of the prostate cancer diagnosis.  This new information speaks to an earlier diagnosis.  The breast cancer patient was diagnosed even earlier than that!  Only 6.8 months of Obe exposure.

Also, these new slides give us actual information on the prior drug exposures - before this afternoon we knew that they were on some prior treatments, but we didn't know what...THE PROSTATE CANCER WAS PREVIOUSLY EXPOSED TO ***5*** DRUGS WITH LABELED CANCER WARNINGS BEFORE ENROLLING IN THE STUDY!  3 OF THEM HAD ***BLACK BOX WARNINGS*** FOR CANCER RISK!
-Humira (black box)
-Infliximab (black box)
-Rinvoq (black box)
-Entyvio (warnings and precautions)
-Stelara (warnings and precautions)

We also just got new info on the NMSC cases (which matter far less but which spooked the market anyway).

How you can look at the details of these skin cancer cases and think they are related to the drug is beyond me (but then again, these details just got released - quietly, for some reason).

First of all, ***ALL OF THE 4 50MG CASES OF NMSC OCCURED IN 6 MONTHS OR LESS!!!  Again, too rapid to be reasonably assumed drug-related.  The fact that they all happened in the first half of this study is actually extremely exculpating evidence for $ABVX.

Other details:
-4/5 were 60+ years old (STRONGLY associated with skin cancer risk)
-3/5 had PRIOR SKIN CANCER ALREADY(!!!!!)
-4/5 had prior exposure to other drugs that are known to increase skin cancer risk.

Finally, they also added a slide discussing that some studies have shown the elevated risks of these cancers for UC patients at baseline.
-~5x higher risk of prostate cancer in IBD patients
-~2x higher risk of breast cancer in IBD patients

Why did $ABVX add these 3 slides to the corporate deck randomly, silently, on a Friday afternoon?  IDK.  Legitimately good news in those slides!  I'd have pressed released this info as soon as I had it, because the details really help alleviate the (already statistically misguided) concern that these cancers could've been caused by Obefazimod.

Here's the link: https://t.co/KqItMbPVwO


Should bounce. you can buy it at essentially 52 week lows *right now*

Summary: Expects NVO to bounce from near 52-week lows after two-day selloff driven by a nothingburger FDA move.

“Fair price” is beyond my scope.  I just think the stock was hit extremely hard 2 days in a row from near lows already, and one of the things that caused the biggest move down today is actually a nothingburger with the FDA stepping in.  Should bounce.

I’ve been critical of the company for a long time, but you can buy it at essentially 52 week lows *right now*, and they admittedly do have some tailwinds.

@A_May_MD What would fair price for NVO be in your opinion?


$NKTR is <half the valuation with a differentiated MoA, also Q12W dosing, and a 2nd indication in AA that APGE won't hit. Discrepancy makes zero sense

Summary: APGE valuation too steep relative to pipeline; NKTR at <half valuation with better MoA and 2nd indication looks relatively cheap.

I think that’s generally the right take.  But at >$5B valuation and an undifferentiated MOA in the lead position, it sure didn’t seem to lose much of the “upside potential” when OX40 hit the dust over the last couple months.

777 won’t fail.  It’ll be approved and used.  How much?  Idk.  I think risk/time adjusted the current valuation is steep without a clear 2nd drug candidate now that ox40 has been hit (TSLP may help in respiratory).

Meanwhile $NKTR is <half the valuation with a differentiated MoA, also Q12W dosing, and a 2nd indication in AA that APGE won’t hit.   Discrepancy makes zero sense.  Whether one is too expensive or the other is too cheap - something’s gotta give.

@semodough Is there anything wrong with the Wedbush take on $APGE?

There is nothing controversial: 777 is the make-or-break for the company. If it fails, this goes to cash. 279 would be upside (more and more limited with each kaposi case).

@A_May_MD  - any thoughts ? That guy dough never


Summary: Short APGE; author argues company is fabricating ISR discontinuation claims contradicted by clinical trials and real-world data, undermining their competitive thesis.

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 "the most common reason for discontinuing Dupixent is ISRs".  Huh?  What?!  ISRs are the most common cause of stopping Dupi???

That is absolutely INSANE to me, because I have treated hundreds of patient with Dupixent and LITERALLY NOT EVER (NOT ONCE) HAVE I HAD TO DISCONTINUE A PATIENT'S DUPIXENT BECAUSE OF ISRs.  In fact, I've never even had to go as far as giving them advice on how to mitigate ISRs, such as treating the injection site with a cold compress.  Literally:  Nothing. Ever.  In hundreds of patients.

I *have* discontinued patients due to conjunctivitis.  If we are talking AEs, the most common causes for discontinuation in *my* experience are
1) Conjunctivitis
2) Facial erythema (some derms believe this to be psoriasis caused by the drug)
***gap***
3) Joint pain (rare)

Again, I can't even rank ISRs on that list at all because *LITERALLY* this has never ever happened with any of my patients.

So, that is *my* clinical experience, which goes directly in the face of what $APGE is claiming.  I say that I've literally never even seen it happen, yet $APGE says that ISRs are the literal top cause of dupixent discontinuations...Sure, I'm biased, but so are they.

They want to convince you that conjunctivitis is not a big deal because they've seen higher rates of that side effect than dupixent/ebglyss so far.  Instead, they want to create a strawman side effect that they can point at and say...
"Hey, we caused more conjunctivitis so far, but it's actually ISRs that are the problem!"

So, if we are both biased, what can we do to resolve the discrepancy?  Look at the actual clinical data!  In clinical trials, were patients more likely to discontinue from conjunctivitis, or from ISRs?  Let's look at the actual data!

P3 5-year extension trials (n~2700):
-> 14 patients discontinued due to conjunctivitis
-> Zero (?) patients discontinuing due to ISRs?  ISR is not even listed as a reason for discontinuation in the publication.

Real world dataset from the Netherlands (n~1300):
-> 38 patients discontinued due to conjunctivitis...the most common cause of AE-related discontinuation in the study *by far*
-> 2nd place for discontinuations was muscle/joint pain
-> Yet again...***ZERO*** cases of discontinuation due to ISR.  None.  ZERO!

So, $APGE is going out on these roadshows and repeatedly telling everyone that ISRs are literally the single most common cause of dupixent discontinuation, yet with only a few minutes of research you can get to a sample size of ~4,000 patients treated with dupixent for multiple years showing DOZENS of cases of discontinuation due to ISRs and LITERALLY NOT ONE SINGLE CASE of discontinuation from ISRs...Again, this matches my clinical experience precisely, where conjunctivitis is the most common cause and I've *never* seen ISRs drive discontinuation once.

So WTF is $APGE talking about?  How are they making this bold claim that goes directly in the face of the entire body of medical evidence?

Well, if you read the tiny footnote in this slide from their corporate deck, this bold claim is apparently coming from "independent market research" via some sort of physician survey...

...ok.  Well, hopefully I don't have to convince people that you can design a survey such that it gives you almost any result you want.  IDK how this internal dataset looks, how it was collected, etc etc, so I can't tell you exactly what's wrong with it.  But, I can tell you that across my own clinical experience and literally THOUSANDS of patients in the literature, I cannot find a SINGLE case of discontinuation due to ISR, whereas there are DOZENS of confirmed cases due to conjunctivitis.

Yet here is $APGE going around and repeatedly spreading the same ISR FUD that the $LLY legal team has tried to invent in order to screw over $NKTR.  You can take my biased word that this is absolute bullshit if you want, but fortunately thousands of patients worth of objective clinical data happen to be on my side here.

I think $APGE is absolutely *Full*. *Of*. *Shit*. with this ISR vs conjunctivitis nonsense.

Fortunately for me, the publicly available data unequivocally agree.

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https://t.co/L6tvXKnyBJ

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And here are my sources

Long-Term Effectiveness and Reasons for Discontinuation of Dupilumab in Patients With Atopic Dermatitis | Dermatology | JAMA Dermatology | JAMA Network

Dupilumab in Adults With Moderate to Severe Atopic Dermatitis: A 5-Year Open-Label Extension Study | Dermatology | JAMA Dermatology | JAMA Network


yes I am long the stock! making a pretty convincing case that we can already tell that the cancer signal Is. Not. Real. And that Obefazimod will get a perfectly clean safety label! the stock could return to the $130-$150 range even before we get the updated dataset

Summary: Long ABVX; detailed diligence argues the cancer signal is false, existing data already supports a clean label, and stock should recover to $130-$150 before the June update and potentially $175+ after.

It has been a while since I shared a full-blown diligence write up document here.  I try to save them for really compelling situations...without a doubt, the current $ABVX situation definitely deserves one, so here we go!

I won't give a full blown thread here on X to outline it.  You'll have to click on the Google Doc link here and in the first comment to read the deeper details, but I will give just a few very key points that I think people must know about this (IMO false) "cancer signal" debacle that $ABVX finds itself in:

➡The panic here was largely management's fault for the way they:
      1⃣FALSELY called colonic dysplasia "colon cancer" thus falsely elevating the "cancer rate"
      2⃣Foolishly lumped 4 cases of NMSC in with the "real" cancers, which the FDA specifically calls *non*NMSC for a reason (they are *NOT* "legitimate" cases of dangerous cases and they DO NOT lead to black box warnings!!!)
      3⃣Were not prepared to explain the cancer cases because they (correctly but naively) didn't think they would need explaining!
            ↪This further led to the perception that management was actually unwilling (and not just unable) to answer questions about "cancer signals", spurring panic that management was hiding something, thus driving further panic selling during the crash.

➡People do not realize that you CANNOT reasonably/usefully compare treatment arm cancer rates to the placebo arm rate...the study is NOT AT ALL powered to detect differences in such rare events, and what we saw in the 50mg arm is textbook statistical noise.
      ↪On top of that, nobody seems to have realized that the adverse event capture in the placebo arm is actually MUCH LOWER than the adverse event capture in the drug arms, DESPITE matching sample sizes.  Exactly how and why is explained in the doc, but suffice it to:  We absolutely SHOULD expect higher cancer rates to appear in the drug arms than the placebo arm (Hint: The reason why has to do with attrition).

➡THE BIGGEST POINTS:
      ↪The observed nNMSC ("cancer") rate in the 50mg Obe arm is in line with expectations for UC patients at baseline!!! (~0.59 cases/100PY versus 0.5/100PY).  This fact ALONE refutes the idea that Obefazimod would get a black box cancer warning, but people failed to calculate this rate correctly because they:
                (1) Falsely included colonic dysplasia and NMSC cases in the calculation!
                (2) Falsely excluded (forgot about) the GIANT phase 2 safety database than dramatically lowers the 50mg cancer rate!!!
      ↪The 50mg Obe arm also has the same rate as another UC drug that has NO CANCER WARNING ON THE LABEL WHATSEOVER (not just no black box, no mention of cancer risk on the label whatsoever) - Obe with ~0.59, Omvoh with 0.60.  Obe should get the same squeaky clean label as this drug with the same cancer rate (which, again, is roughly the expected background rate!!!
      ↪Bears might point to Rinvoq that also had a 0.60/100PY cancer rate...the same as Omvoh with a clean label, yet Rinvoq has a full blown black box...what gives?
            ➡Rinvoq got its black box warning as JAK inhibitor *CLASS EFFECT WARNING*, which actually derived from much higher cancer rates that were seen with a DIFFERENT JAK inhibitor (Xeljanz) in a DIFFERENT DISEASE (rheumatoid arthritis).
                  ↪If Rinvoq only had its 0.6 cancer rate in UC in a vacuum, it would have the same squeaky clean cancer label that Omvoh has, and that Obefazimod is on its way to having!

➡These data above VERY CLEARLY demonstrate that the EXISTING data that we ALREADY HAVE for $ABVX show that obefazimod is headed for a clean label...that is to say, we can actually already, objectively refute the idea that there is an nNMSC signal that will give Obfazimod a black box warning!  Of course, the stock price does NOT reflect that fact at $101 right now, because the market has confused/missed a lot of facts and a lot of data.
      ↪Management could have been prepared to fully explain that this "signal" isn't real and prevented the stock price crash that we are currently enduring at $101.  In fact, the stock would likely have sniffed $200/share on the back of the unbelievably strong efficacy data they provided that blew away all expectations and hopes.  However, management was (IMO correctly) so certain that no cancer signal exists that they (IMO naively) did not prepare to explain to people why that is the case.  So now we are left to sort through the wreckage...ultimately this may prove to have been an opportunity.

➡Investors now appear to be waiting for the June update where we will not only get more details on the existing cases and likely context from management showing that these existing cases are already occurring at the EXPECTED baseline rates for UC patients, but we will also get NEW data from the very large "part 2" sample of the P3 study.

➡Although you can already (IMO) objectively disprove the idea that Obefazimod is headed for a black box warning with the EXISTING data (as I think I can convincingly lay out in the larger document) the market may wait for the part 2 data to come out to before giving $ABVX the credit that it deserves to shoot back to those $175+ prices that it briefly saw after the maintenance data were released

➡We should take note that MORE CANCER CASES ARE A NEAR STATISTICAL CERTAINTY IN THE UPCOMING PART 2 UPDATE.  This is actually an even larger on-drug sample size than what we have already.  In all, ~3 cases of "true" non-nonmelanoma skin cancer should be expected to occur in this cohort of patients just based on the background rate of cancers we see in UC patients at baseline.  If the rate comes in at that level or lower, then the case is even more tightly sealed than it already was by the first round of data, and there will be little to no merit left in the argument that Obefazimod could get a black box warning....

❓What does this mean for $ABVX's valuation?  I think that if people catch on to the appropriate analysis of the existing data that we already having showing that Obfazimod's EXISTING cancer rate is:
      ↪In line with the baseline rate of cancers in UC patients
      ↪In line with UC drugs like Omvoh that have ZERO cancer risk on their label
....then the stock could return to the $130-$150 range even before we get the updated dataset.

➡It cannot be overstated how unbelievably positive the maintenance efficacy data were, especially with the endoscopic remission rate DOUBLING the placebo adjusted delta of the previously unchallenged Rinvoq (comparing high dose to high dose)...these efficacy results were truly unprecedent, and again, would likely have gotten the stock to nearly $200/share without the (IMO false) safety baggage clinging on.
      ↪Given how convincingly we can already refute this cancer safety risk claim with the existing data that we already have, getting the stock back to the ~$150 range BEFORE the June update does not seem like that tall of a task to me, though we will see if the market is able to psychologically get over that brief crash!

➡The document goes over all these points in far greater detail, in my BIASED opinion (yes I am long the stock!) making a pretty convincing case that we can already tell that the cancer signal Is. Not. Real.

And that Obefazimod will get a perfectly clean safety label!
      ↪I also discuss how I think this impacts the current and future valuation of the company and my thoughts around potential M&A (IMO the highest they've ever been over the next 6 months)

That's enough for here - check out the document below!
https://t.co/P3fmfMlkaE

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Google doc link posted here in the first comment to avoid the need to scroll to the bottom of the original post...

https://t.co/RI2m5etecc


long term $NTLA bear… the company is in trouble… Not pretty for $NTLA

Summary: Bearish NTLA: weak HAE data, tiny TAM, stiff competition, safety risks, stalled ATTR trials, funding crisis, and likely forced ATM dilution.

$NTLA has to raise cash, badly.  IMO they need *at least* $500M.

They’ve not been able to conduct a secondary offering since…….

…..2022!!!

When I saw that even I, as a long term $NTLA bear, was shocked.  That’s an incredibly long period of time to not have been able to raise any money from serious funds.

The company has essentially no dedicated biotech specialist investors.  The reason for that? If you’re actually a specialist biotech investor who knows what you’re doing, you know this company is in trouble and you want nothing to do with it.

They just reported HAE data that underwhelmed relative to expectations.  They’ll launch in a small TAM against half a dozen very strong competitors, none of which bring the known and unknown safety risks that $NTLA does.  Shortly after launch, the single most-used drug in the disease, Takhyzro, will go biosimilar.

That’s a big headwind in the US, but it likely makes the EU opportunity worth near zero, especially in the setting of MFN pricing (no sweetheart deals for the EU = they’ll just wait for the generic drugs).

They need at least 1 year runway into the launch, which means they need to raise at least $500M IMO, maybe more depending on how launch expenses look.

On top of all of that, the ATTR studies *still* have not resumed recruiting, and those timeline extensions are adding hundreds of millions of dollars of extra burn to reach ATTR datasets.  And, with the major safety signal out of that asset (Hy’s law is literally the worst thing that can happen to a drug), ATTR-PN is unlikely to get approved without the ATTR-CM safety data.   We are looking at several years before their next commercialization.

If the HAE launch isn’t profitable enough to sustain the company’s burn (which IMO is nearly a guarantee), how are they going to be able to fund ATTR to completion??

Increasing the size of the ATM.  If they can’t do a big, legitimate offering here, they’re in DEEP trouble IMO.  They’ll have to dump 10s of millions of shares onto open market traders (not long term investors) via ATM sales.  *Or* they can go deep into debt.  They absolutely *need* to pull off a big secondary offering here.

Not pretty for $NTLA.

$NTLA amends the size of ATM offering from $750M to $1.04B
So far, it has raised $635M


Summary: Long NKTR at ~$100; expects post-data rally similar to prior atopic derm run (>100% gains), plus a capital raise and sustained follow-through.

Recalling that $NKTR was barely green at ~$40/share at this time on the day of the atopic derm maintenance data.  Then the stock rallied all day long.  Then they raised cash at $58/share...Then the stock ran up to $85 over the next few weeks...

$NKTR quickly saw well over 100% gains on the immediate post-data prices and then almost a 50% on the post OFFERING prices...

IMO we should see something similar today and the days after.  Offering should be coming soon IMO, hopefully at a higher price than the measly $100 opening of this morning.  Then, I hope that history repeats itself with another sustained rally after that!

I really really really don't get why $NKTR is priced this low (~$100)...yes, I have been saying that for well over a year now, but when I first started saying it, the stock was at <$10/share! 😅

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$NKTR at $100 post data feels highly reminiscent of $ABVX at $60 post data.

IMO people just have not woken up to what the data mean.  🤷🏻♂

Can’t believe I keep buying more of this 🤦🏻♂ I really need to reduce my ballooning exposure to this thing at some point 🤣