Summary: Black-swan-level clinical outcome expected to drive a massive near-term rally in ABVX.

@avidresearch Seriously a black swan level outcome for $ABVX.  This is going to be the biggest rip we have seen in a while.

Endoscopic improvement delta almost Rinvoq like but with cleaner safety. Cc @A_May_MD


Summary: Bullish LXEO; author argues stock remains far below fair value despite multiple positive developments.

structural marker; pre-classified as canonical yfinance ticker

@Sanctuary_Bio Should go through the $LXEO 1Y chart and timestamp all the positive developments they’ve had over that period, while the stock went from $20 to $1.50.

Starting to recover some now, but not even close to where it should be given all the good things that have happened, IMO.

What's kind of interesting about this $LXEO btd is that it's broad rather than FA-CM

The company has effectively had nothing but positive results this year. The only thing that was kind of yucky was the raise at a pretty suboptimal time

-28% ytd https://t.co/4T5Lx6eEBM


$BBIO has multiple underappreciated assets then 😎 … I just think this launch is going to be gangbusters

Summary: Bullish BBIO: multiple underappreciated assets + expects gangbusters product launch.

@PCM_bio So $BBIO has multiple underappreciated assets then 😎

I get what you’re saying though.  The baking in of an M&A premium is harder to expect with the hub and spoke model.  I just think this launch is going to be gangbusters.

@A_May_MD The difference is $vrna is single product whereas $bbio is hub-and-spoke. Not sure they are appropriate comps


Shorted some after hours. Don't expect the current biotech market to be forgiving of this kind of thing.

Summary: Short NTLA after Grade 4 liver enzyme elevations in ATTR study; biotech market unlikely to forgive safety signal.

$NTLA $BBIO $ALNY $PFE $IONS

$NTLA with scary liver enzyme elevation signal in their ATTR study.

Seriously…Grade 4 means elevation beyond 20x the upper limit of normal (!!)

Shut this nonsense down.

$NTLA running a study here that is unnecessary with stabilizers and silencers that treat this condition very well.  No need to be pursuing diseases like this with risky/unproven technology.

Shorted some after hours.  Don’t expect the current biotech market to be forgiving of this kind of thing.

---

C’mon Tony - unblock me if you want to share screenshots of my tweets and fight about them 😊 @GeneInvesting https://t.co/oEbjzYwCdq


Summary: Enthusiastic about RGLS acquisition premium+CVR; frames deal as broadly positive for biotech/XBI.

$RGLS premium is great and a *massive* CVR to boot.  Fantastic to see for biotech! $XBI $BBC

@pawcio2009 update those leaderboards 😉

Regulus Therapeutics Enters into Agreement to be Acquired by Novartis AG $RGLS https://t.co/N05HFcHtSx


Summary: Long NKTR: AD readout underpriced by market; hit scenario = large upside, miss + liquidation scenario still offers ~75% upside from current levels.

Sticking with my theme for the day of biotech zombie liquidations, $NKTR is a good example of a company that could have significant *UPSIDE* upon *FAILURE* if they chose to responsibly liquidate in the event that their June atopic derm readout misses.

Of course, as my pitch has detailed, I think they have a much better chance of hitting in AD than the market is giving them credit for.  Obviously if they hit on a P2 AD trial the stock should be up a ton and the liquidation discussion should be off the table.

However, if they miss and expeditiously start the liquidation process, the upside from here could actually still be *very* significant despite a trial failure.

So what should $NKTR do if they miss in AD in June?

1⃣Immediately conduct an unplanned interim analysis on their alopecia areata study.  If this is showing signs of success, then that's unexpectedly great news - keep going!  If not, SHUT THE WHOLE THING DOWN IMMEDIATELY.
2⃣Sub-lease their facilities in order to eliminate or at least reduce their lease liabilities (they have no significant debt/liabilities otherwise).
3⃣Monetize their:
     ↪Ownership in Amerpsand Capital (recently acquired at a value of $20M)
     ↪Dapirolizumab milestone & royalty streams (arguably potentially worth as much as ~$150M, but still highly impactful at even half that amount)

If $NKTR were expeditious in completing the above liquidation plan after an atopic dermatitis failure, the downside protection for the AD readout would be huge, and they could even generate >50% upside like $THRD did today.  In a perfect world, $NKTR would discuss the possibility of a plan like this on their 1st quarter earnings call that should happen before the atopic derm readout occurs.  Investors would reward them for this.

I did some very rough math on what liquidation could look like in a "bullish" scenario for $NKTR.  That back of the napkin math is pictured below, and suggests that ~75% upside from today's price could be possible DESPITE a failure in the AD readout if the team acted decisively and quickly (very open to feedback on this rough math!).

This would be the right thing for the company to do for its investors in the event that the AD trial doesn't work out.  Of course, hopefully AD hits and it doesn't come to that, but failure is always a very real possibility in any clinical trial.  It would be highly encouraging to see $NKTR joining the likes $THRD in acting responsibly with investor capital in the event of failure.

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

This thread provides a very basic overview of the setup.  For greater depth, I have provided a link to a much longer pitch at the end of this first "slide".

Although I am clearly bullish (and long) $NKTR at its current prices, I am NOT arguing that their AD readout has an atypically high probability of success (POS).  Rather, I argue that its POS is being underwritten as *zero* in spite of encouraging P1b proof of concept (POC) data.

I will analyze NKTR's MOA, existing data, competitor data, financial position, and the (much larger) valuations that have recently been ascribed to similar AD readouts that clearly had much weaker rationale than $NKTR going into data.

For those looking for greater depth than this thread provides, here is the link to the pitch (via Google Doc):
https://t.co/Li9AZZUhVC


Summary: Agrees CTMX has more upside re-rating ahead.

@PickingMyOwn @avidresearch Definitely has more rerating to do imo

@avidresearch It’s so crazy I think folks are having difficulty digesting it.  It’s like aliens landing in your yard.  At first your brain simply can’t process it.  $CTMX


Summary: Bearish HIMS; expects further decline from sub-$30 levels.

Drug Manufacturers - Specialty & Generic

@himshouse Mind blown for prices not seen since January?  It’s going lower.

$HIMS HAS FALLEN BELOW $30 🤯

WHO'S BUYING MORE?! https://t.co/T6L2ymayGP


Summary: Strongly bullish ABVX on first-line oral designation with no new safety signals; believes 1000%+ upside is fully merited.

$ABVX unhalt time keeps getting moved back.  It is because the bids for it are too high.  I sincerely believe that the stock *should* be up 1000%+.

We are talking about the first line oral here now with no new safety signals.  We'll see.  Such moves usually don't happen in one session, but in my biased opinion that sort of upside is fully merited.


I think $LXEO keeps moving up substantially. It'll look odd to 'outsiders' seeing a stock that moved up 200%+ from lows on 'no news', but I personally think that's what'll happen here.

Summary: Strongly bullish LXEO on gene therapy narrative reversal and unjust selloff; expects 200%+ move from lows; also bullish small-cap biotech via XBI.

I still think $LXEO is probably the biotech that is “most emblematic” of the severity of the small cap biotech selloff.

But I also think $LXEO will also be emblematic of how powerfully & quickly things can turn around.

This ~$3 stock was $10 literally 6 months ago (which is also already ~50% downside from 52 week highs!!!) Since then they’ve had nothing but objectively positive news in terms of both clinical data *and* regulatory discussions with the FDA.

If $LXEO had all that news back when they were trading at $10, they would’ve been able to raise cash at >$10.

But, unfortunately they got caught up in the biotech meltdown and got an extra penalty for the (now mostly dead) narrative that Peter Marks leaving the FDA was going to destroy gene therapy companies.

This now looks almost certainly untrue, but $LXEO’s most important (and *very* positive) dataset came out *right* at the nadir of doom and gloom in the historic biotech meltdown.  The timing couldn’t have been worse, and they were just unluckily crushed for it.

With the FDA narrative for gene therapies having flipped from ultra bearish to likely even more bullish than before, and the first signs of biotech starting to outperform the broader markets (as it should continue to do) IMO, I think $LXEO keeps moving up substantially.

It’ll look odd to “outsiders” seeing a stock that moved up 200%+ from lows on “no news”, but I personally think that’s what’ll happen here.  You just have to appreciate the insane magnitude of selloff this stock went through despite repeatedly sharing good news (again - forced selling?).

The selloff here was just Out. Of. Control.  Emblematic of and someday maybe a good case study for how truly awful things had gotten in small cap biotechs!

At some point likely in the not too distant future I expect small cap biotechs to have a huge rally and outperform the broader markers substantially.

10 year charts for context/perspective:

1⃣ $SPY up ~160%
2⃣ $XLV (large cap pharma) up not quite 100%
3⃣ $XBI (small-mid cap https://t.co/7WRtv5cv49


the first signs of biotech starting to outperform the broader markets (as it should continue to do)


I've been publicly bearish on the whole lot for years, despite being impressed by what they've been able to accomplish scientifically

Summary: Long-standing bearish stance on the entire CRISPR therapeutic field due to poor target selection; specifically mentions BEAM and CRSP.

CRISPR gene-editing sector basket; removed VERV (failed verification)

I’m not super interested in broadening this argument to 6+ companies, but the crispr field, by and large, has been plagued by poor target selection.   I’ve been publicly bearish on the whole lot for years, despite being impressed by what they’ve been able to accomplish scientifically.

@A_May_MD Fine.

$BEAM was down 90%. What was the bad data? Superior SCD. First actual gene correction in history. $CRSP almost down as much. $EDIT, $VERV, and $PRME I understand. You don't think that CRISPR is being especially hit hard? Nobel in 2020, NTLA '21 data created a unique bubble


the crispr field, by and large, has been plagued by poor target selection


I hope the value of the stock better represents (what is in my opinion) the value of the company soon

Summary: Long NKTR; believes stock is undervalued vs intrinsic value and hopes price will close the gap.

@Sanctuary_Bio @BiotechSho99376 You’re both right.  I hope they do raise soon, but I also hope the value of the stock better represents (what is in my opinion) the value of the company soon!

---

One other thing I’d add is that actually $NKTR past in deal making is actually strong imo.  I know they have the value destruction reputation, but the deal they got from $BMY for bempeg was massive and the terms were actually quite good.  All that for a drug that didn’t even work too, and this one does!

They’d never have the opportunity to destroy so much value (quote unquote) if they hadn’t gotten such a massive chunk of cash from that deal in the first place.

Their history of monetizing royalty streams is also solid.

I am hopeful that they’ll remain as capable as they’ve historically been in this aspect!


The 'peptide upside' narrative is 100% made up bullshit being fed to gullible investors. Hims can copy Sema for as long as that lasts, but that's as far as it goes.

Summary: Bearish HIMS: peptide upside narrative is fabricated, illegal to sell for human use, and biotech pivot is implausible — growth story ends with Sema compounding.

I keep seeing $HIMS longs talking about upside coming from peptides.  Most of you clearly have no idea that the peptides most people are talking about are literally illegal to sell for human consumption.

And I’m sorry, but pitching $HIMS becoming a biotech company that actually runs clinical trials to get peptides FDA approved is suicidally stupid.  Go ahead and ask biotech investors how the market is looking for companies studying investigational drugs these days.

You want to be treated like a biotech?  Prepare to trade below cash.  This is not a welcoming market.  There’s zero chance $HIMS does this.

The “peptide upside” narrative is 100% made up bullshit being fed to gullible investors.  Hims can copy Sema for as long as that lasts, but that’s as far as it goes.


Summary: Bearish HIMS: NVO legal action against compounded semaglutide personalization is a material threat; stock not down enough yet.

$HIMS

“NOVO NORDISK EXPANDS LEGAL ACTION TO PROTECT US PATIENTS FROM UNSAFE, NON-FDA-APPROVED COMPOUNDED SEMAGLUTIDE” https://t.co/3Y8ArQKsfd

---

$NVO literally going after the $HIMS popularized personalization scam.

It’s finally happening.  $HIMS is not down enough.


This was an obvious dip buy, like I've said since the day the news crashed the market

Summary: Reiterates SRPT is a dip buy; FDA gene therapy session supportive, Prasad concerns overblown.

@NoToAI_ It’s consistent with what he has been on record saying for years actually.  Numerous podcasts, publications, etc.  everybody focussed on the most extreme statements re $SRPT.  This was an obvious dip buy, like I’ve said since the day the news crashed the market.

@A_May_MD The FDA gene therapy session was very supportive of rare disease.   Prasad effect is way overblown.


Summary: Bullish SRRK in the $30s; views it as undervalued on SMA opportunity alone, with positive weight loss/muscle data adding upside.

$SRRK weight loss/muscle preservation data look good IMO.  People I know have been watching for this to be a “sell the news” event to buy more for SMA oppty.  Not sure any significant “sell the news” reaction happens from these data.

Very slightly less weight loss (1.1% delta) on the combo arm is fine.  $REGN saw slightly *more* WL with their combo but there are major caveats here.  $SRRK was combining with TZP whereas $REGN was with sema.  TZP weight loss is significantly more than sema’s at 24 weeks, so any combo with TZP is going to take longer to show greater weight loss than a sema combo IMO.  On top of that, $SRRK’s study was 2 weeks shorter than $REGN’s.

$SRRK preserved more lean mass and lost a great proportion of weight (again, TZP caveat).

Ultimately in 1 year+ studies I think these myostatin regimens are going to show increased weight loss overall, on top of much larger fat loss and more muscle retention.  How could that *not* lead to better cardiometabolic outcomes long term?

Myostatin is the way to go here IMO.  Broader MOAs won’t have the clean safety required, and myostatin alone actually seems to be getting the job done.

I’m impressed.  I think myostatin+GLP-1 is going to be a legitimate approach that multiple phase 3 studies are run for.  Hopefully ultimately getting commercialized…long way to go on that front obv.

$REGN in the lead?  $SRRK and $IBIO in pursuit.  $BHVN and $LLY with broader MOAs that I’m less fond of.

Maybe $SRRK gets sell the news today, IDK.  In the $30s I still think it is undervalued on SMA alone.


Summary: Bearish HIMS: compounded tirzepatide is $800+ more expensive than Lilly's own product, making the rally a pump-and-dump.

Enjoy the pump and dump $HIMS longs.  Nobody is buying Tirzepatide from $HIMS for $800 more than the list price of the $LLY autoinjector, and >$1,000 more than the Lilly Direct cost.

LOL this is why it's rallying????? $HIMS $LLY

This isn't even a cheaper partnership! Margins still suck! Fade this BS 😂😂

@StockMarketNerd @A_May_MD https://t.co/zCdp3eZCAS


Summary: Bearish NTLA; safety incident in permanent gene editing will be the breaking point for the stock.

@Sanctuary_Bio @GeneInvesting It’s insane to trivialize something like this with safe/cemented POC *especially* when permanent gene editing therapies are already under much higher scrutiny (deservedly so) for safety.  IMO this will be the straw that broke $NTLA back.

@A_May_MD @GeneInvesting It's truly disturbing that he thinks, and I quote 'You could have another one of these and it wouldn’t be a big deal in reality.'

The damage is already done. Look at Rezdiffra label. This single event was enough to make the label. https://t.co/F5YaPLHhXY


Summary: Endorses LLY as buyable at $750 despite pharma not being a focus area.

@Steptradez Pharma not my thing, but imo yes,

@A_May_MD Thoughts on LLY here at 750? Buyable?


$SLRN and $ALMS teaming up to do the WRONG thing. Together, they're tossing >$700M of investor capital into an absolute burn pit.

Summary: Bearish SLRN and ALMS on their merger: dead-end Tyk2 project in an overcrowded psoriasis market is destroying >$700M of capital.

Flip side of $THRD doing the right thing is $SLRN and $ALMS teaming up to do the WRONG thing.

$SLRN should've returned cash to shareholders, not forcibly hitched their wagon to $ALMS's dead-end Tyk2 project.

Together, they're tossing >$700M of investor capital into an absolute burn pit.  Shame.  These companies are a big part of the problem with our sector.

I'd be glad to be wrong about this, so be sure to call me out if someday I am.  Right now you just can't convince me that yet another Tyk2 venture is a remotely good idea, especially in a world where the main market (psoriasis) is incredibly well-served, and is about to be even more so with $PTGX/$JNJ Icotrokinra.

Huge props to $THRD for doing the "right thing" and liquidating to return cash to shareholders.  The biotech sector at large would be in a much better position if more companies would follow $THRD's lead.

$THRD stock is +40% today and +55% from recent YTD lows.  That sort of


Summary: Disclosed buying NKTR during the recent market selloff ahead of approaching data catalyst.

@stockblues Bought a bunch this past week

@A_May_MD still feed good about nktr?  Adding at all?  Kinda sucks that the worst week in the history of the stock market came as data is approaching.


Summary: Long LLY as the superior GLP-1 play; short NVO on botched compounder handling; bearish HIMS on NVO legal action targeting personalization loophole.

$NVO confirms in earnings today that it is pursuing legal action against compounders while specifically naming the “false guise of personalization”.

They’re talking about $HIMS.  All the bulls want you to think $NVO won’t do anything.  Time for $NVO to defend its IP.

---

$NVO named new CEO at the same time too.  Clearly going after compounders is a key goal of the new “regime” at $NVO.  I would expect this to weigh on $HIMS.

---

Hopefully for them the new CEO can turn it around.  This $NVO + $HIMS relationship and breakup/compounding/personalization situation has been absolutely devastating for $NVO’s image IMO.  Easily one of the most embarrassing sagas I’ve ever seen for a big pharma.  Handled it about as poorly as they possibly could have.

---

I’m with @Citrini7 on this too.  $LLY is the champ here.  Buy the company with the superior drug AND the ability to actually handle its business.  Sell $NVO into the dirt until they prove they can actually stand their ground.


Sell $NVO into the dirt until they prove they can actually stand their ground.


Summary: Compounders denied injunction — bearish HIMS, bullish LLY and NVO as branded GLP-1 makers benefit.

Compounders’ injunction #Denied

Good.

$HIMS $LLY $NVO

https://t.co/XDlsNs2rfz


Summary: Top pick NKTR; VRNA & SRRK flagged as top buyout candidates; FULC a small-cap M&A sleeper.

@pawcio2009 lol well putting my mouth where my money is means $NKTR is my top pick, but not a near term buyout candidate at this moment.

$VRNA & $SRRK would be top buyout odds for me.  $FULC a small cap sleeper that could surprise with M&A like $RGLS.

@A_May_MD I don’t believe it ever happened, nicely done 💪👏,  but more importantly give me your next buyout with a target price 🍻


$VRNA & $SRRK would be top buyout odds for me


$FULC a small cap sleeper that could surprise with M&A


Summary: High-conviction long ABVX: market underprices probability of success; author sees 10x+ upside based on clinical data read.

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

The name is $ABVX (Abivax).


Summary: Bearish HIMS; expects price to go lower from $57 on weak quarterly net adds.

$HIMS

Lowest quarterly net adds since Q2'23!!! (73k vs 91k)


This ban taking place would be very bad for $HIMS. There's a reason most of their ads refer directly to specific drugs. Get ready for that "moat" to fill in completely.

Summary: Bearish HIMS: proposed DTC drug ad ban would destroy their advertising-based moat, which author argues is their primary competitive advantage.

Oh hey look!  What timing!

This ban taking place would be very bad for $HIMS.  There’s a reason most of their ads refer directly to specific drugs.

“$HIMS moat is their great advertising!!!”  Yeah, ok.  Get ready for that “moat” to fill in completely.

https://t.co/5LUqJgN3jL

🚨 BREAKING: SENATORS BERNIE SANDERS AND ANGUS KING TO PROPOSE BAN ON DIRECT-TO-CONSUMER DRUG ADS

- would include TV, radio, print, digital, and social media
- would apply to all prescription drug advertisements

$HIMS $LLY $NVO


Summary: Bullish NKTR: Rezpeg addresses dupi non-responders; $100M EV with Phase-3-ready drug makes bear case unconvincing.

That $NKTR’s drug will be used in some portion of the ~half of patients that either never respond to dupi or lose response to dupi *is* the bull case as far as I’m concerned.  If you think that to be true, you’re a bull, especially with the stock trading at $100M enterprise value with a P3 ready drug.

I don’t see people saying it is going to “compete” with dupi, but would agree such takes are wrong.  No, Rezpeg is not as good as the $15B/year drug - but that in itself is not a bear case for a company being valued at $100M net of cash!


go ahead and study the oral vs injectable market in psoriasis and let me know how bullish that is for late coming oral therapies vs sparsely administered injectables. I know what I'm talking about on this.

Summary: Bullish NKTR on injectable vs oral dynamics in derm; dismisses KYMR as a threat with no Ph1 data and equivalent cost burden.

Kymr doesn’t even have phase 1 data and the same trial costs apply to them.

Also, go ahead and study the oral vs injectable market in psoriasis and let me know how bullish that is for late coming oral therapies vs sparsely administered injectables.

I know what I’m talking about on this.

@A_May_MD I hear your enthusiasm on $nktr but orals like $KYMR are coming to atopic derm, and oral options are moving ahead faster. That’s why $NKTR is trading at negative EV. Plus don’t forget the immense amount of capital to run a ph3 AD study and commercialize in the space


Summary: NKTR is author's biggest position; remains bullish on phase 2 atopic dermatitis trial.

@mickeychiku Yeah my biggest position.  We’ll see if they can pull it off.

@A_May_MD Are you still bullish on NKTR phase 2 AD?


Not making that mistake with $BBIO. The launch is going to be excellent. It seems obvious, but the price doesn't reflect that. Sticking to that conviction this round. I am getting ~$20.4M from my very rough model for 1Q Attruby revenue vs consensus ~$13M

Summary: Long BBIO; expects Attruby launch to crush expectations, own Q1 revenue estimate ~$20.4M well above ~$13M consensus.

Once again, $BBIO is currently where $VRNA was at this time last year.

Launch is going to absolutely crush initial (and current) expectations.  Felt obvious to me for $VRNA but I didn’t size it up the way I thought I should based on the assumption I was missing something.  Not making that mistake with $BBIO.

The launch is going to be excellent.  It seems obvious, but the price doesn’t reflect that.  Sticking to that conviction this round.

---

Maybe overly aggressive versus consensus that I've seen ~$13M, but I am getting ~$20.4M from my very rough model for 1Q Attruby revenue.  $BBIO

We will see tomorrow!


Summary: Expects CTMX to grind higher from current levels after beating benchmarks on ORR/PFS/Safety.

@avidresearch I did too.  Agree I think it probably grinds up from here.

@A_May_MD Expected a bigger bounce for $CTMX. Maybe it will grind higher slowly. It beat my expectations on every benchmark (ORR/PFS/Safety)


at a measly $100M enterprise value, I feel strongly that the market has not yet priced $NKTR appropriately… this stock sitting on a P3 ready atopic derm drug with numerous other shots on goal and a paltry <$200M EV…it just looks like a steal to me

Summary: Long NKTR: $100M EV is far too cheap given competitive AtD data, alopecia areata optionality, Dapi royalty stream, LLY lawsuit upside, and completed cash raise removing the overhang.

🚨PITCH UPDATE🚨$NKTR (link to master document below)

The atopic dermatitis readout I pitched was a success, and the stock is up >150%!

With that said, at a measly $100M enterprise value, I feel strongly that the market has not yet priced $NKTR appropriately in light of the AtD results and everything else that the company has going for it:

➡A real opportunity in Alopecia Areata
➡Now significantly increased odds of a big payout in the $LLY "botched data" lawsuit
➡What I estimate to be $50-$150M in potential value from licensing their Dapirolizumab royalty stream (yes, this asset alone could, in my opinion, be worth more than their entire current enterprise value...)

Why is it so cheap?!  Well, the market was obviously getting this one wrong to begin with, as the 0% probability of success they were given in atopic derm was clearly wrong 😜

But, beyond that, there are 2 other major factors to consider that could help explain the cheap $100M EV price tag:
1⃣I suspect the company is going to raise cash via stock offering this week.  This is not a bad thing, but it can often leave a cap on upside as funds often delay open market purchasing until stock offerings have been completed.  I personally would expect the stock to rally off of a raise that is well-executed.  I know there is some talk about partnership possibilities, but I still think it is best and most likely that a raise gets done.
2⃣$NKTR just finished up getting deleted from the Russell 3,000 index this past Friday!  This likely created false selling pressure throughout the entire last month, however that all culminated on Friday - especially in the last 10 minutes where $NKTR experienced a visible sharp drop-off likely related to trading dynamics from this index deletion!
      ↪Check out this thread by @KevinLMak  that explains why such deletions often cause dramatic price moves in the last few minutes of trading  https://t.co/3TdUNieMKq

Like with my original pitch, I will openly share my diligence with you all for free via google doc linked right here 👉https://t.co/Eu9xhukcGy

However, in this X thread I want to discuss 2 highlights of the document that I think drive home $NKTR's current valuation as pitifully cheap:
1⃣The AtD data are very competitive, and the market is clearly not understanding how massive the unmet need is for new drugs in this condition!
2⃣$NKTR now has a real shot on goal at a second blockbuster indication in alopecia areata, which is not even close to being accounted for in its current valuation.

---

$NKTR Rezpeg is a highly competitive drug in atopic derm, and people are underestimating how big this market is!

The Data:
➡Rezpeg:  EASI75 (Abs/Delta) = 44%/27%
➡Dupi:       EASI75 (Abs/Delta) = 47%/33%

As you can see, the efficacy on the primary/registrational endpoint is very close to dupilumab's!!!

💡Rezpeg's efficacy is basically indistinguishable from the upcoming Ox40 class (which pharma giants $AMGN and $SNY both have seen fit to bring their own drug to market for despite the fact that they will be competing with each other having the same MoA...).
       ↪With that in mind, how can it be that $NKTR's enterprise value is only $100M⁉  Pharma companies don't mess around with opportunities that small, especially when they know their market is going to be split by a competitor with the same MoA!  $NKTR's unique MoA with Ox40-level efficacy would seem clearly worth more than $100M to me...

This brings me to the big misconception that I am seeing:  The market clearly does not appreciate how giant the unmet need is in atopic dermatitis!
       ↪In the last few days I have come to realize that there is this misconception out there that Dupi has taken care of atopic derm, but this could not be further from the truth!

👉Only about half of Dupi patients even respond (with EASI75 efficacy) to the drug in the first place!
       ↪Another 5-10% will have side effects like conjunctivitis
       ↪Increasingly, now that Dupi has been on the market long enough, we (yes "we", as I am a board certified dermatologist myself) are seeing people lose their response to dupilumab over time.  This phenomenon has long been seen with psoriasis medications, and it opens the door/need even further for new drugs with new MOAs on top of the ~half of the market that doesn't have great efficacy/safety in the first place!

Speaking of psoriasis, let's use that market as a case study to drive home the point that there is a TON of room for new drugs in atopic derm!
1⃣ There are WAY more atopic derm patients than psoriasis patients to begin with...AtD is >2x larger as an indication!
2⃣Psoriasis drugs are WAY more efficacious than dupilumab is in atopic derm
       ↪Only ~50% of AtD patients meet EASI75 efficacy on dupi, while >90% of Psoriasis patients meet PASI75 efficacy on drugs like Skyrizi and Taltz (among many others!!!)
3⃣Despite psoriasis having far fewer patients and far fewer patients among them who don't respond to therapy than atopic dermatitis, there are MANY more successful drugs currently in the psoriasis landscape than there are for atopic dermatitis.

This Psoriasis market comp is fantastic evidence that the door for new drugs to reach blockbuster status in atopic derm is wide open, but lets drive that home with another point:  👉The brand new Nemluvio and Ebglyss launches in atopic derm are smashing expectations, proving that the market is already being proven wrong about AtD being "well-served" with dupi.
1⃣Nemluvio is a terrible drug for atopic derm...its EASI75 delta was 13%, vs 33% for dupi, and 27% for Rezpeg.  AWFUL!
      ↪But!  Nemluvio is a different mechanism of action (IL-31) from the 3 other IL4/13 biologics currently approved for AtD (Dupi, Lebri, and Tralo).  The fact that a drug with such awful efficacy is launching so well goes to show how badly we dermatologists need drugs with alternative MoAs for the MANY people who are failing the IL4/13 inhibitors!
2⃣Ebglyss is a great atopic derm drug, BUT it is a "me-three" drug with the same pathway as Dupi and Tralo that both came years before it.  Still, despite that, it is launching WAY faster than anyone imagined, breaking the pace of monster drug launches like Skyrizi!
       ↪Its main point of differentiation is Q4W instead of Q2W dosing.  Now, imagine if $NKTR's P1b proof of concept for the possibility of Q12W dosing plays out in larger studies...That $APGE valuation of $2.6B (with $APGE's me-four mechanism of action) starts looking pretty incredible for $NKTR (it would be ~$200/share at $NKTR's current OS...)

In my opinion, everything that I'm looking at here, from the psoriasis market supporting many successful drugs with a much smaller market/need, to pharma giants like $AMGN and $SNY pushing forward with AtD drugs that look identical to Rezpeg's efficacy, to the rocket launches of Ebglyss and Nemluvio in atopic derm just in the last 6-7 months...it all screams to me that the market for more MoAs in atopic derm is going to be extremely robust, and that the current $100M enterprise value for $NKTR is far too cheap!

---

$NKTR  I think that Nektar should also be getting some credit in its valuation for the possibility that Rezpeg could hit in alopecia areata by the end of this very year!

The AA P2 study is ongoing, and prior to AtD hitting, it was deservedly adding $0 in value to the company.  However, now that Rezpeg's success in AtD has proven beyond the shadow of a doubt that the drug is active, it is time we start considering the possibility that this AA shot on goal could actually work!

‼In fact!  You may be surprised by this statement‼:
Rezpeg has never failed to show benefit in skin disease in any of the diseases it has been studied in so far (atopic derm, psoriasis, and lupus).
       ↪Yes, that means that if Rezpeg fails in AA, it would be literally the first time it has ever failed in cutaneous disease.  The drug really appears to be active in the skin based on what we have seen so far!

On top of that, we have intriguing proof of concept data from old studies of low dose IL-2 that suggest Rezpeg's MoA might actually be active in alopecia areata!
      ↪Although the old low-dose IL-2 RCT failed to show stat sig benefits, there were trends toward efficacy despite questionable dosing protocols (efficacy was assessed 9 MONTHS after the last dose was given⁉🤔), and PD data showing that the low dose IL-2 didn't even create stat sig increases in T-Reg cells (which Rezpeg consistently HAS shown in its studies).
       ❓So, could NKTR's superior drug (which has also engineered out the problematic pro-inflammatory aspects of natural IL-2) build on these early signs of efficacy and actually hit in the upcoming AA study?

➡Previously, even I attributed zero value to this shot on goal.  But now, the evidence is strong enough that we have to consider what would happen if this AA trial surprises to the upside.
      ↪The current AA market offers JAK inhibitors as the only advanced treatment option for patients...This means that ANY safe biologic that can show stat sig efficacy in AA would be used FIRST, BEFORE JAK inhibitors (due to their safety issues that dermatologists are averse to).  The bar for success here is LOW.  If $NKTR can just hit stat sig at all, it will be a big. deal.

🤑AA is a very difficult disease, so the odds of success here are lower than they were for AtD.  However, the reward upside here is very clear - this could be another billion dollar opportunity for $NKTR, and it is now time to start giving the company some valuation credit for this legitimate shot on goal!

The $100M EV for the entire company, in my opinion, isn't cutting it!

---

As predicted $NKTR raised cash!  I strongly believe that anticipation of this offering was holding the stock back.

The interesting part to me is that $100M here is tiny.  This is as small of a raise as I thought they would even consider.  I have no doubt they could’ve raised more if they wanted to, but they are staying small with this.  Interesting! 🧐

This, IMO, increases the probabilities that they are:
1⃣ Anticipating further sources of capital coming in soon (Dapi royalty and or $LLY settlement)
2⃣ Actually serious about being able to find a partner/deal for Rezpeg in AtD

Any of those, of course, would likely be excellent news.  For now, this stock sitting on a P3 ready atopic derm drug with numerous other shots on goal and a paltry <$200M EV…it just looks like a steal to me (congrats to the funds who were able to get allocated 😅).

Hopefully $NKTR follows the recent biotech trend of share offerings removing the lid from the price action 📈 🤞🏻


$ABVX 16.4% clinical remission delta is *higher* than literally any biologic drug has shown in P3, ever…hard to see how this isn't about to be a huge drug

Summary: Bullish ABVX: 16.4% clinical remission delta exceeds any biologic in P3 history; poised to be a blockbuster drug.

@BiotechObserver Idk, but $ABVX 16.4% clinical remission delta is *higher* than literally any biologic drug has shown in P3, ever…so, yeah.  No matter how you look at it, hard to see how this isn’t about to be a huge drug.

@A_May_MD The bloodwork, tests, monitoring, etc really do get in the way of initiating these oral drugs. But how much of their poor market performance is due to perception that biologics simply work better and it's better to start off on most efficacious systemic drug in first line?


Summary: Bullish SRRK: clean dataset, established endpoint, no safety issues — FDA approval expected regardless of regulatory leadership changes; selloff is unwarranted.

$SRRK has a squeaky clean dataset with the well established regulatory endpoint in a fatal genetic rare disease and no known significant safety events *whatsoever*.

Whoever steps in at the FDA isn’t blocking this drug.  The SMA community would stage a violent revolt 😅.

This is the kind of stuff that should not be participating in any Peter Marks related selloff, IMO.

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

Myostatin 💪🏻 💪🏻 $SRRK $IBIO

 https://t.co/4q36xOumoK


The rest of biopharma will continue to be "fine" (to perhaps even *more* lenient in some rare diseases) from a regulatory standpoint IMO. $XBI $BBC $IBB

Summary: Avoids vaccine biotech as uninvestable; bullish on broader biopharma (XBI/BBC/IBB) continuing under lenient regulatory environment.

If you still had hope for vaccine biotech investibility up until today then yeah idk what to tell you.  No fly zone for me.

The rest of biopharma will continue to be “fine” (to perhaps even *more* lenient in some rare diseases) from a regulatory standpoint IMO.  $XBI $BBC $IBB

Maybe nail in the coffin for any type of additional vaccine approvals


Summary: Bearish HIMS on legal liability from personalized-dosing semaglutide strategy; bullish NVO as the winner in the dispute.

My opinion is that it was extremely stupid of $HIMS to go so hard after this “personalized dosing” semaglutide nonsense.  I think they’ve opened themselves up to major legal liability in return for what’s likely to be relatively minimal potential return.

On paper, $HIMS is going to lose & $NVO is going to win.  In reality, the lawyers (on both sides) are the ones taking the W here while laughing all the way to the bank.

Btw, the stock is still up almost 30% YTD 🥱


That's ~66% downside from today's levels.

Summary: Bearish VKTX: comparable deal valuation implies ~66% downside; competitors pricing far below current enterprise value.

If Hansoh achieves every. single. penny of the biobucks in this deal after the paltry $80M up front, their value would *still* be less than the current $VKTX enterprise value.

Hansoh is already in phase 3.  $VKTX still hasn’t started theirs (tick tock btw - what’s the holdup?).

With ~$800M in cash, what would $VKTX be valued at today *if* they were able to get a similar deal?  Biobucks aren’t getting much credit in this environment.  Maybe ~$1B altogether?

That’s ~66% downside from today’s levels.

What am I missing here?  Who is going to pay up for Viking’s current valuation with competitors going for price tags like this?


$ABVX target to $112 from $70 at Piper 🫡 Getting warmer 👍🏻

Summary: Shares/endorses Piper raising ABVX PT to $112 from $70; author views it as directionally correct given higher personal targets.

$ABVX Valuation Summary & My BIASED Opinion:

The high end of IBD M&A comps of $10.8B would put $ABVX's current valuation at $146/share.  The (very rough) $PTGX "value" comparison gets it close to $170/share.  Despite these numbers conveying significant upside from here, I don't


No question that this commentary qualifies as "bullish" for the biotech market

Summary: Bullish biotech market on reduced regulatory uncertainty at the FDA.

US biotech sector; XBI (SPDR S&P Biotech ETF) is primary proxy

Arguments to be made philosophically in either direction about whether or not this is overarchingly “good” IMO.  No strong opinion on that front from me.

As far as how the biotech market is concerned, there is no question. The market has been worried about unclear changes to regulatory burdens and the FDA’s ability to actuate them.  No question that this commentary qualifies as “bullish” for the biotech market.

“Bullish” and “good” are often used as synonyms.  Not my intent here 🫡

@A_May_MD @AAMortazavi @Biohazard3737 and that's supposed to be great?


$HIMS Look out below. $HIMS opened ~$28 the day before the $NVO partnership was made. Don't look down 😬

Summary: Bearish HIMS: NVO ditching them targets their GLP-1 personalized dosing revenue, implying significant downside from ~$28 pre-partnership price.

$NVO wises up and ditches $HIMS.

$HIMS Look out below.

---

$HIMS opened ~$28 the day before the $NVO partnership was made.  Don’t look down 😬

$NVO wouldn’t be doing this, IMO, if they weren’t going after $HIMS for the “personalized” GLP-1 dosing scam, which apparently is currently making up a significant chunk of $HIMS revenue.  Ouch.


Summary: Strongly bullish LXEO; argues it should be significantly higher on today's data, was already severely undervalued prior.

$LXEO should’ve been green today on this dataset, full stop.  Any form of rational market values this significantly higher today than yesterday (at which point it was likely already *severely* undervalued).  Selling is just beyond out of control in some small cap bios.


LLY dip this morning seemed a little extreme… Beat and raise for $LLY counters that fear… The beat and raise should counter any orfo weakness pretty nicely, imo

Summary: LLY dip overdone; beat-and-raise proves GLP-1 demand intact, not slowing; NVO sales flagged as weak implying relative underperformance.

Pharma is definitely not my specialty but $LLY dip this morning seemed a little extreme.  Stock has been very weak on fears that GLP-1 business is losing steam, *especially* after $NVO had the unscheduled call to notify everyone their recent sales were 🗑.  Beat and raise for $LLY counters that fear…just the best drug winning, not the industry slowing down.  $LLY revenue generation still firing on all cylinders.

I get that orfo WL number wasn’t quite what some hoped, but it’s still solid, and dropout rates were higher on pbo than drug.  There was no “hard bar” here, because there’s no other drug on the market like orfo.  Coming in a few percentage points below “expectations” is not the same as coming in below an established competitor bar.  Orfo will be fine.

The beat and raise should counter any orfo weakness pretty nicely, imo 🤷🏻♂


My biggest position. I think the valuation is absolutely insane in light of the AD POC they have as well as other "shots on goal" to bring in more cash.

Summary: Long NKTR as biggest position; valuation seen as irrationally low given AD proof-of-concept and pipeline optionality.

@mic_h_el My biggest position.  I think the valuation is absolutely insane in light of the AD POC they have as well as other “shots on goal” to bring in more cash.

@A_May_MD what about $nktr ? i am long with august 2$ calls thanks


$LXEO I would fully expect to bounce. It's down 75% from YTD high... IMO $LXEO is inarguably in a better position right now than it was at the start of the year

Summary: Strong bounce expected in LXEO on positive data, cash-raise ability, and extreme undervaluation; hopes SRRK obesity data catalyze a recovery.

$IBIO data were fine yesterday IMO, but I think the stock sold off because people were hoping there’d be a capital raise w/ data.  Will have to wait and hope $SRRK obesity data are positive now.  In a perfect world they’d have funding secured beforehand, but obviously the Biotech Great Depression makes it tough to raise cash right now.

---

$LXEO is another one with data yesterday that was (more obviously) very positive yet traded down and no raise was done.  Unlike $IBIO, I think $LXEO ultimately will be fully able to raise cash from this dataset.  Timing of course was awful with biotech potentially having hit an all-time bottom yesterday.  Funds are reeling, trying to keep up with the crash, and many likely dealing with *some* degree of redemptions — or at the very least planning for what they’ll do if redemptions eventually come.  I would think offerings/PIPEs simply aren’t being done at the moment.

Not an easy time to be asking funds for money.  But things will eventually settle down, and people will gladly bet on $LXEO’s registrational FA trial.  It is relatively high POS, unmet need is huge, and obviously the valuation here far less than cash is an absolute pittance.

$LXEO I would fully expect to bounce.  It’s down 75% from YTD high, which was already a big drawdown beforehand.  IMO $LXEO is inarguably in a better position right now than it was at the start of the year, despite the fact it would need to 4x just to get back to those pre-data levels.

Hopefully this is one of those situations we can look back at down the road and marvel at the opportunities this crash presented.


Will have to wait and hope $SRRK obesity data are positive now


Summary: Bearish HIMS: author claims NVO will sue HIMS over corporate practice of medicine / personalized dosing scam, laying legal groundwork now.

$LLY would be suing $HIMS under the same premise right now if $HIMS had ever sold Tirzepatide.  They are laying the groundwork here for $NVO to take this same attack against $HIMS IMO.

Won’t be long.

https://t.co/3S9asD1I9n

---

“alleged that the two companies…engaged in the corporate practice of medicine, which refers to controlling and influencing prescribing decisions of health care providers”

This *is* what is happening with the $HIMS personalized dosing scam (emphasis on SCAM).  $HIMS *will* be sued for this.


Bidding war over $ABVX is $JNJ vs $LLY with both pharmas trying to establish the GOATed safe label oral combo treatment that can't be replicated

Summary: Bullish ABVX on bidding war between JNJ and LLY for the company post Phase 3 data.

@DueDoctor Bidding war over $ABVX is $JNJ vs $LLY with both pharmas trying to establish the GOATed safe label oral combo treatment that can’t be replicated (IL23+obefazimod for $JNJ and a4b7+obefazimod for $LLY)

Who says no!?

$JNJ buying $ABVX makes A LOT of sense post Phase 3 data https://t.co/9C8XaeJ1Uj


Summary: Bearish ABVX: CEO has history of selling before stock declines (Corvidia, CINC pattern), predicts ABVX will be next.

@WarrrenSmith @biotech_bro $ABVX CEO sold Corvidia too before he sold $CINC.  $ABVX will be next.

@A_May_MD @biotech_bro CEO sold CINC prior too


Cheap is cheap… You have to fully believe that gene therapy is truly completely dead forever for this type of valuation to make sense. I just don't but that

Summary: Bullish LXEO: deeply undervalued vs RCKT's comparable-stage peak; gene therapy not dead, implying significant upside from current price.

@plainyogurt21 @sharkbiotech @Sanctuary_Bio @MattyKirsh @VPrasadMDMPH I mean ok but also RCKT was valued several multiples higher than even RCKT is right now back when they were at LXEOs stage 😉

Market dynamics etc etc I get it.  But just saying.  Cheap is cheap.

---

RCKT peak valuation a couple years ago that they achieved via basically the same POC that LXEO currently has for roughly comparable markets would be a 30x from LXEO’s current price.

You have to fully believe that gene therapy is truly completely dead forever for this type of valuation to make sense.  I just don’t but that 🤷🏻♂


Summary: Bullish ABVX: owns 100% of its drug vs PTGX's 6-10%, implying ~10x larger upside move on similar data.

@s86CoffeeDev Noo, The $PTGX move was absolutely MASSIVE!  PTGX only owns 6-10% of their drug (JNJ owns the rest) so whatever move they have would be ~10x larger if they owned the whole drug like $ABVX does.

$PTGX was a >$10B move if you adjust for their small ownership of the drug.

@A_May_MD great work - thx. Q: the PTGX data was similar? and the stock didnt move in the way you expect ABVX to move. What am I missing?


Summary: Buy VRTX; avoid CRSP.

@BioStocks BUY SOMETHING $VRTX

---

@BioStocks NOT $CRSP THOUGH


Real sema had 83% of patients stay on drug for 68 weeks

Summary: Bearish HIMS: CEO misrepresenting poor 60% retention vs NVO's real 83% at 68 weeks; calls practices shambolic and legally/ethically questionable. Implicitly long NVO on superior real-world data.

$HIMS CEO bragging about 60% of patients still being on treatment by week 12 and claiming that’s better than branded sema.  This is actually a poor retention rate.

Check out the real $NVO data for yourself.  *Real* sema had 83% of patients stay on drug for 68 weeks!

$HIMS discontinuation rate is >100% higher than $NVO’s was in a >5x *shorter* timespan.

This kind of data selection/manipulation is to be expected from this company that is constantly pushing boundaries of legality and ethics - check out the real data for yourself from the NEJM’s supplementary appendix.

https://t.co/cNc8nCEdvx

---

I’m genuinely surprised that $HIMS personalized GLP-1 retention is this awful.  These are people who are *specifically* seeking out GLP-1s by coming to $HIMS and going through all the loopholes to “qualify” (bullshit) for personalized GLP-1 dosing.

…and still 40% of them are quitting by only 3 months?

And *this* is the evidence $HIMSZ wants to use to “justify” the need for personalized dosing?  This is worse than what $NVO saw in their (real) studies!  This is an absolute sham - good luck to $HIMS in defending this practice with those data.  Absolutely shambolic.


put all my chips on the table for small cap biotech. I've never seen a massacre like what is happening in that sector right now. $XBI $BBC

Summary: Closing HIMS short and going all-in on small cap biotech via XBI and BBC after historic sector massacre.

See ya later $HIMS.

Time to close out and put all my chips on the table for small cap biotech.  I’ve never seen a massacre like what is happening in that sector right now.  Truly unbelievable.  $XBI $BBC https://t.co/Hpp7gFdWtx

My $HIMS short thread.

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

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

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

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


Summary: Expects ABVX to rise more than 500% from current levels.

@Buffalo51766917 Will listen to the call, but I expect $ABVX to be up more than 500%.


Summary: NKTR is significantly undervalued at current price; bullish.

@Nina15325786 @Str8hedgeD I think it is worth *a lot* more than its current valuation

@A_May_MD @Str8hedgeD Do you think $NKTR can keep the momentum going, or is it a quick flip?


Summary: Expects LLY and GPCR up, NVO and VKTX down on the day's reaction.

@felandostephen1 My opinion is:

➡ $LLY and $GPCR up

➡ $NVO and $VKTX down

@A_May_MD Will be interesting how $vktx stock reacts by the end of the day. Usually gets crushed and hides in a corner. If it holds up, could be change in character of stock. Let's find out!


I bought some premarket (avg $35.30). Big momentum day coming for $HIMS.

Summary: Bought HIMS premarket at $35.30; expects major momentum day as short thesis reversal on NVO partnership removes litigation risk at all-time-high short interest.

The $HIMS news on $NVO partnership probably isn’t huge for $HIMS revenue/bottom line, but I think it does a *lot* to remove the litigation risks that I discussed in this short thesis.

Hard to believe it, but I bought some premarket (avg $35.30).  Have to recognize when a thesis shifts, and also when an extremely momentum-sensitive stock has legitimately positive news at a time when short interest is literally at its all time high.

Big momentum day coming for $HIMS.

---

Took partial profits on this $HIMS trade today.


Summary: Bullish ABVX: OLE data superior across all open-label and responder-enriched comparisons, countering open-label discount concern.

@knowdo1_bio 1) baseline characteristics are published - can find side by side comparison in my larger document

2) OLE apples to apples comps of both open label and responder enriched datasets still show $ABVX data is superior in every comparison I could find

@A_May_MD One thing to consider, the company published in Jan that the phase 3 baseline aligns with phase 2b, so my feeling is the population is still sick in general? I also like the OLE data very much. However we may need to discount the data given it is open label? Just some thoughts.


Summary: Bearish CVS for retaliatory move against Lilly direct program; bullish LLY as superior drug at lower cost via direct channel.

$CVS Pharmacy/PBMs mad at and trying to take revenge on $LLY for the Lilly direct program that allows patients to buy Zepbound without paying tribute to the pharmaceutical middlemen?

$NVO has this now too, but $LLY pioneered it.  Historically Lilly has consistently sold their superior drug for less money - odd move by CVS IMO unless it’s motivated by some form of retribution.


$RCKT will blame safety event on immunosuppression regimen I'm sure. It all comes back to the virus though

Summary: Bearish RCKT on safety concerns from high viral dose; bullish LXEO as safer alternative with lower dose and opportunity to enter Danon program as RCKT falters.

$LXEO with a likely safer AAVrh10 vector that uses lower viral dose than $RCKT AAV9.

$LXEO should use some of the $$$ they raised this morning to start a Danon program now that $RCKT is likely out 🤷🏻♂ https://t.co/UgHRPEQ9MB

---

$RCKT Danon viral dose of 6.7E13 is ~55x higher than $LXEO FA viral dose of 1.2E12.

If you don’t think that makes a difference for safety I’m not sure what to tell you.

$RCKT will blame safety event on immunosuppression regimen I’m sure.  It all comes back to the virus though - that’s the reason you need the immunosuppression after all.


$LXEO with a likely safer AAVrh10 vector that uses lower viral dose than $RCKT AAV9. $LXEO should use some of the $$$ they raised this morning to start a Danon program now that $RCKT is likely out


Summary: Bullish ABVX: zero prior-auth friction vs S1P1 class competitors means easier prescribing and faster patient uptake.

Need bloodwork, an ecg, and eye exam BEFORE starting.  3 more visits before you can even write for the drug.  Completely destroyed the S1P1 launches.  $ABVX you should be able to send your patient from your first visit with them Rx in hand - done.  Zero friction, massive massive plus

@AppleHelix I'm not sure if prior auth has just been incredibly burdensome or what. But anyways something to keep in mind


Summary: Bullish LLY on CEO/insider open-market buying vs. bearish HIMS on CEO dumping $30M+ of shares.

Hahaha check this out $HIMS trolls!  $LLY CEO (who also owns multiple hundreds of millions of dollars of company stock) is open market BUYING over a million dollars of $LLY shares.

3 other execs/insiders also joined him in 6-7 figure open market buys.

THAT is how you want your C-suite to handle a dip!  Dave Ricks already has as much skin in the game as Dudum does, but when his company’s stock goes down, he makes million dollar PURCHASES.  Dudum makes >$30 million dollar SALES.

https://t.co/fckcd6iues

$HIMS CEO Andrew Dudum continues absolute *DUMPING* stock on the $HIMS cult.  He just sold 666,000 shares for ***$33,562,320***

The $HIMS cult thinks the low $50s is a "dip" to buy.  Meanwhile the CEO is dumping tens of millions of dollars at...$50.58/share...

Dudum knows what


Summary: Bullish on ABVX; minimal dilution from offering viewed as highly positive.

$ABVX Not even 10% dilution.  Just absolutely BEAUTIFUL.  Party in the 9th arrondissement tonight! https://t.co/Rfq9RnvHRQ


Summary: Bullish LXEO; pharma buyout of a competitor with <500 NA patients implies LXEO's FA-CM patient pool is multiples larger, very positive catalyst.

@sububoston And pharma buying out a company with <500 North American patients identified this morning…FA-CM def multiples of that.  Very positive for $LXEO.

$LXEO vs $RCKT: PKP2 expression  between competing therapies. $LXEO should be up tmrw https://t.co/nb7Tf73dDJ


Summary: Bullish NKTR as sole remaining functional IL-2 drug heading to market, with large unmet need in atopic dermatitis expected to be recognized.

$NKTR widens its lead as the first/only IL-2 T-Reg expander heading to market.

Eventually people will realize the *large* unmet need post-IL4/13 (and pre-JAKi) in AtD.  Just noise until then.

https://t.co/tE0opzPBiZ

Also I missed this , $mrk writes off their IL2 drug from the $pand purchase.
This means only ONE IL-2 drug left and it WORKS $nktr


when bonds *do* start to cooperate, it's going to be a face ripping rally for some of these left for dead biotechs

Summary: Biotech poised for a violent rally once bonds cooperate, despite current severe underperformance.

To be fair, it’s already not working.  $XBI was down *way* more than the broader markets before the crash.  Biotech was still down more than the broader markets *during* the crash.  Then today NASDAQ was +12% while biotech was only+7%.  Lagging way behind despite being down orders of magnitude worse.  Sector is still in absolute ruins.

The flip side view of this is when bonds *do* start to cooperate, it’s going to be a face ripping rally for some of these left for dead biotechs.

$XBI I hate to say this, but I think you're going to have more opportunities to buy your favorite biotech stock at a screaming value. This "all clear" whistle won't blow until this starts to cooperate, IMO. https://t.co/lLe4jFub0t


Summary: FATE is deeply undervalued at 0.33x fully diluted cash with a lupus data catalyst in 2-3 months; implied bullish.

$FATE at $0.77 is trading at 0.33x cash (FULLY diluted) with new lupus data in ~2-3 months.


Summary: Long VKTX at current ~$24 price despite drug limitations; sees value at this drawdown level.

The number of people coming after me for being long $VKTX because they think I have been saying their drug has “no value” is a good demonstration of how low IQ the entire conversation around this company has been.

I have *constantly* said that the drugs have *some* value, but I’ve simply been calling out basic facts like the SubQ tolerability data are worse than Lilly’s are and that the oral API won’t scale.

Apparently since this isn’t “SUPER BULLISH BEST DRUG BUYOUT COMING” braindead drivel that retail longs like to hear from people like Pharmdca, this makes me an uber bear who thinks the company is a zero. This has literally never been the case, but somehow the Viking retailers have managed to have a group hallucination over things I’ve never said.

We have to be capable of realizing the limitations of a dataset and adjusting that to different valuations.  Not everything is black and white, and people calling out flaws in a company’s data or valuation aren’t all permabears.

I can simultaneously believe that Viking has issues to overcome but also that it makes sense as a long when the price falls from $90 to $24.

Somehow trying to hold multiple contradictory opinions at once like that is too much brain power for many Viking longs like @Matthew_ABCD

If people didn’t split their opinions so sharply on people making bearish points such that you ignore them just because they’re “on the other side of the trade”, you might have a better chance of avoiding such massive drawdowns.

---

And while wait for these people to show me proof of where I supposedly said the $VKTX programs “had no value” (which, again, is something y’all hallucinated), here are 4 examples of where I have been saying the literal opposite for months:

https://t.co/t4jEVAdcB4

https://t.co/w91OkpeoqX

https://t.co/Ad4BiBdsyA


Summary: Bearish HIMS as Novo Nordisk's 130+ lawsuits and injunctions threaten telehealth compounded semaglutide business.

“Telehealth companies where corporations, not doctors, improperly steer patient care to compounded semaglutide drugs using sham claims of personalization, violating California law."

Night night, $HIMS

🚨 JUST IN: Novo Nordisk expands legal action to protect US patients from unsafe, non-FDA-approved compounded semaglutide.

$NVO $HIMS

- The company has filed more than 130 lawsuits across 40 states, resulting in 44 permanent injunctions to stop unsafe, illegal marketing and https://t.co/ezPlQ9yxxD


Summary: Holds a long position in VKTX, hoping for a short timeline to realize gains.

@A_May_MD So what's your timeline for your long VKTX?


Summary: Bullish LLY as dominant leader in obesity space while rivals disappoint.

$LLY is king, maybe even God-Emperor, of obesity at this point.

$AMGN down on disappointing MariTide data.
$NVO down on disappointing CagriSema data.
$HIMS down on $NVO breaking off their deal/calling their operation “illegal”.

All today. https://t.co/B2VzL2Eghq


Summary: BBIO FY25 revenue forecast slightly above $400M.

@TTRAmyloid Hair over $400M for FY25 $BBIO

@A_May_MD What is 37 mil on track for in 1 year?


Summary: Bullish small-cap biotech (XBI, BBC) and large-cap pharma (XLV, IBB) on expected M&A wave 2H25-1H26, cheap valuations, safe-haven dynamics, and improving FDA environment.

At some point likely in the not too distant future I expect small cap biotechs to have a huge rally and outperform the broader markers substantially.

10 year charts for context/perspective:

1⃣ $SPY up ~160%
2⃣ $XLV (large cap pharma) up not quite 100%
3⃣ $XBI (small-mid cap biotech) essentially flat
4⃣ $BBC (small cap, clinical stage biotech) down roughly *50%* over the course of TEN YEARS.

You could’ve well over doubled your money in $SPY while losing *half* of it in small cap bios over the same time period.

The sector has been just absolutely left for dead, to the extent that valuations recently got so out of control that I suspect forced selling from fund/pos liquidations sent things down even *lower*.

There are plenty of negative narratives.  High bond yields, uncertain FDA regulatory bars, concern over possible FDA gridlock, total lack of pharma M&A.  I personally think $XBI/$BBC got to the point where they were fully pricing all of them in (and then some).

I just do not believe that *every* worst case scenario will remain true for biotech.

---

$XBI $BBC $IBB $XLV

Let’s not forget that healthcare has historically consistently been seen as a safe-haven asset class during economic downturns.  People may put off buying a new car or laptop and cancel the family vacation, but by-in-large they keep taking their medicine.

$XLV (large cap pharma) wasn’t up as much as $SPY over this historic bull run.  I would suspect that if there is an economic slowdown, that this evens back out in relatively short order.  You’ll still have giants like $LLY and $NVO absolutely printing cash while shooting out dividends…

It’s also no secret that pharma patent cliffs are looking about as large as they ever have.  “They need to do M&A” has been a rallying cry for biotech that has been said so consistently to no avail over the last few years that it has started to seem false.  But it isn’t.  Even early stage Chinese assets aren’t what pharma needs to fill impending revenue gaps - which *are* real.

IMO pharma played chicken on M&A valuations and won - biotechs are CHEAP now.  The time to buy is coming soon.  Given some idea of what normalcy looks like in a post-trade war world, I think M&A picks up significantly.  *Probably* a lot of biotech M&A 2H25-1H26 IMO.

*If* you could combine this M&A surge with:
1⃣ Lower bond yields from a broader economic slowdown and a resolved trade war (on top of the “old” inflation dying out after recent CPI prints have shown this being crushed much faster than expected)
-and-
2⃣ An FDA that “plays ball” with improving efficiency, speeding up processes, *and* allowing us to compete with Chinese drug farms that have stymied small cap biotechs’ opportunities…

Then you’ve got a biotech meltup.

I actually think that the path to the friendly FDA and an uptick in M&A are very clear and at this point frankly quite predictable.  However, the bond yield situation remains troublesome.  Still, when the market is pricing in the worst case scenario for everything at once, you don’t need *everything* to go perfectly in order to trade up.

---

$XBI $BBC $IBB $XLV

And then, just a word on pharma tariffs.

As a blanket construct, I simply do not believe that this is going to happen in any meaningful sense.  Moves to disrupt the supply of life saving medications is clearly a political nightmare.  Why do we think these tariffs weren’t imposed with all the others if the admin is so dead-set on them?  They aren’t.

I think we will continue to see pharma companies committing billions to re-shoring manufacturing in US/Puerto Rico, and the administration will declare this as a victory and back down.  We have already started to see this taking place IMO.


$BBC (small cap, clinical stage biotech) down roughly *50%* over the course of TEN YEARS... The time to buy is coming soon.


if there is an economic slowdown, that this evens back out in relatively short order


Even a few $HIMS bulls out there are wising up to the clear growth deceleration and what it means for the company. If there was some magic new vertical that would come in and immediately save $HIMS' stalling growth, they'd have launched it by now. Keep ignoring the data at your own peril.

Summary: Bearish HIMS: growth deceleration is real, no new vertical to rescue stalling momentum, bulls in denial.

Even a few $HIMS bulls out there are wising up to the clear growth deceleration and what it means for the company.

If there was some magic new vertical that would come in and immediately save $HIMS’ stalling growth, they’d have launched it by now.

Keep ignoring the data at your own peril.  Just because it doesn’t make you feel good about your long position doesn’t mean it isn’t real.

📉

If this data from Morgan Stanley Research proves accurate, it’s not a great look for $HIMS.

Monthly app downloads are now falling below the levels seen prior to compounded GLP-1 launch.

In July, app downloads fell 3% MoM and 20% YoY.

$HIMS seriously needs to introduce new https://t.co/aCQQu7c85S


Summary: Bullish ABVX on 16.4% clinical remission delta; expects black-swan-level upside.

$ABVX 16.4% clinical remission delta.  Black swan level upside incoming.


Summary: Expects ABVX to be acquired within 3 months after JPM26; pharma unlikely to wait for maintenance readout, which would only drive up the price.

Well it’s generally a crapshoot who gets bought out and who doesn’t - predicting WHEN a buyout would occur on top of predicting WHO will get bought is a fools errand.  But, just for fun and not to be taken too seriously…

I think $ABVX takes a ton of meetings at JPM26 and goes to the highest bidder within 3 months after.  Makes no sense for pharma to let this get to the maintenance readout IMO, as it will almost certainly be positive and drive up the market’s asking price further.

@A_May_MD Your pre-readout call was amazing.  Any ballpark on what the typical time frame is between great P3 results and a buyout?  I would think big pharma should move pretty quick (< 6 months).  But I'm also brand new to biotech.


Summary: Long NKTR: FDA 1-P3-trial rule cuts financing overhang, biotech funding eased, OX40-like atopic derm + alopecia opportunity; expects substantial upside from here.

The other recent tailwind for $NKTR that I haven’t seen people discussing is the recent news about the FDA only requiring 1 instead of 2 Phase 3 trials.

This is especially impactful for $NKTR because right now basically the only real knock on the company I’ve got left is that they don’t actively enough cash on hand to complete the entire P3 program.

Requiring 1 trial instead of 2 would lead to *major* cost saving for $NKTR, making them unexpectedly a lot closer to having all the financing that they need.  Atopic derm studies are large and very expensive.  As far as I can tell, this news didn’t impact Nektar’s stock at all, but IMO it very clearly should have.

Maybe they raise now.  Maybe they wait until maintenance data in early 2026.  Either way, the recent biotech bull market has brought back significant ease of funding that wasn’t available when Nektar first hit on atopic derm this summer.

At this point with the new “1 P3 trial” rule, $NKTR may be able to run P3 programs in *both* atopic derm and alopecia areata for roughly the same price that it would have cost them to run just one or the other a few weeks ago.

That’s a huge reduction in financing overhang coupled with the recent surge in biotech financings.

Once that is all cleared up and these trials get going, I believe NKTR should trade up substantially from here.

I’m a broken record here but again, OX40 was clearly worth well over $10B between $AMGN and $SNY before it flopped and $NKTR looks like they have what could be what people thought OX40 was in atopic.   Then, on top of that you now have a clear opportunity at a safe effective drug in AA…

People clearly have a hard time seeing through the company’s history, management team, etc etc.  But there’s serious value here.  If you’re a mid sized pharma you have to take a serious look at  bolting on $NKTR here IMO.  You’ve got a chance at paying a few billion $ for a drug that could easily do a multi-billion peak sales if developed properly.  Rare opportunity if executed well.

---

And one last $NKTR point before this becomes perseveration/beating of dead horses.

The market got the initial reaction to the atopic dermatitis readout blatantly wrong too.  The stock traded as low as the *teens* that day and settled in the low $20s, only to eventually rally and reach the mid $60s several times since then.

I expect history to repeat itself here.  Maybe it will, maybe it won’t, but we’ve seen this story before.

---

Hm.  Didn’t take long to get blocked by the “if the longs are right it won’t be because they’re right it’ll be because they got lucky” pontificating dude who is also currently taking a victory lap on having supposedly predicted the trial outcome even though what actually happened was a scenario he publicly said had a <10% chance of happening 🤷🏻♂

Won’t go far in biotech investing if you can’t handle even the slightest bit of polite pushback.


Summary: Long QURE on gene therapy brain opportunity thesis.

@AB1001_disciple @venkmurthy Yes.  One of the many reasons I am long $QURE

@A_May_MD @venkmurthy Adam, the 21st century in gene therapy is going to be owned by the brain. There's a tail of thousands of candidates that can safely be targeted with stereotaxis.


$ABBV is clearly more worried about $ABVX as a competitive threat than I thought… the DSMB has already been taking clean safety cuts from the ongoing maintenance data for years now… patients already on drug for >5 years!….again, with no issues

Summary: Strongly bullish ABVX on clean safety data and ABBV's FUD-level competitive fear; bearish ABBV as IBD revenue threatened by ABVX and poor fit as acquirer.

Actually laughed out loud while reading the $ABBV comments on $ABVX today.

Frankly, they’re ridiculous and the company should’ve stuck to the boilerplate “we monitor all competitive drugs but are highly confident in the profile of our current programs” drivel that pharma usually falls on.

The “concerns” they highlighted just show how legitimately worried they are about $ABVX as a competitive threat (as they very well should be).

No other large pharma gets a portion of its revenue from IBD as large as $ABBV does.  It’s their company’s entire core.  Furthermore, no large pharma makes *less* sense as an acquirer of $ABVX than $ABBV does.  I’m highly skeptical that the FTC would even allow that particular deal to go down (certainly the prior FTC wouldn’t have), but $ABBV has little to gain from $ABVX success and a lot to lose.

$ABVX would make a very poor combination partner with $ABBV’s Rinvoq.  Rinvoq’s whole issue is a beast of a black box warning (SAFETY FIRST).  Combining their drug with Obefazimod wouldn’t make much sense, as the strict safety counseling and monitoring are still required.  You basically erase the huge safety benefit of Obefazimod by pairing with a dirty drug like Rinvoq.  A partner like $JNJ’s oral IL-23, or perhaps someday an oral PDE4, make much more sense, fully leaning into a SAFE and ORAL regimen.

But $ABBV highlighting transient mild *headaches* as the key safety problem for $ABVX is comedic gold…because they’re actively comparing it to their own drug Rinvoq, with a black box warning for:

-Death from bacterial/fungal/viral infections
-Death from stroke
-Death from heart attack
-Death from thrombolic events
-Death from cancer (including lymphoma and lung cancer)

They comparing *that* to a safety profile of….<10% of patients have a mild headache that lasts <1 week and never comes back.  LMAO.  I mean this is like a microcap shitco-level argument out of one of the largest pharmas in the world.  Embarrassing.

Let’s also acknowledge that the $ABVX DSMB has already been taking clean safety cuts from the ongoing maintenance data for years now.  Remember, that trial enrolled slow.  Used to be a bear case, now it’s a bull case.  They have a large sample of patients *already done* with maintenance right now.  Safety reviews per DSMB…No issues.  Let’s also note that the original P2a/p2b patients have enrolled in extra long OLE phases, with patients already on drug for >5 years!….again, with no issues.

Kind of hilarious that the CEO also mentions cardiac monitoring they were doing in the study as if it’s a bad thing.  Yeah.  They have been doing cardiac monitoring, AND THEY HAVEN’T HAD ANY ISSUES 😂.  Just because they’re looking doesn’t mean there’s a problem!  The best case would be that there could’ve been a safety event that they *weren’t* looking for 🤦🏻♂

tl;dr $ABBV is clearly more worried about $ABVX as a competitive threat than I thought.  I once said I’d never use the term “FUD” unironically, but folks, this is it.  Literal LOL material from $ABBV.


Summary: Bearish NTLA: fatal AE overhang, ATTR dead, HAE data irrelevant; stock belongs below $5, should be negative EV.

Good luck to anyone hoping that $NTLA data updates are going to be anything other than another liquidity event.

ATTR is dead now so the data are irrelevant, and at the last HAE update the company gave us in June showed that all patients they updated on were attack free.  “100% attack free” and the stock didn’t care…

What could they possibly show in HAE now to actually move the stock up?  The “perfect” efficacy readout couldn’t move the stock last time, and that was *before* their platform had this fatal adverse event overhang.

Stock belongs <$5.  Should be a negative EV company.

---

People buying/holding this thing >$9.50 right now should be studied.  Actually insane.


$LLY surmount-5 is an actual randomized study and shows clear CVOT superiority of $LLY's tirzepatide

Summary: Bearish NVO on junk data; bullish LLY on SURMOUNT-5 showing clear CVOT superiority of tirzepatide.

@ResearchPulse1 @tuduni90782 This is downright junk data/analysis from $NVO.  $LLY surmount-5 is an actual randomized study and shows clear CVOT superiority of $LLY’s tirzepatide (new data from today).

@A_May_MD @tuduni90782 I can’t see where they get 4 months from 🤔 in today’s presentation it clearly says 8.3 months for sema and 8.6 months for Tirzepatide. Mean follow up time.

Patients are taken from a large US data set with patients who are overweight/obese and with established ASCVD and taken


Summary: Long NKTR: wildly undervalued with dual dermatology indications, deepening AA trial data, and safe biologic profile expected to dominate JAKis in both atopic derm and alopecia areata.

Another long $NKTR post after sleeping on the new data (bear with me here - the stock *is* still up ~400% since I pitched it earlier this year, after all☺)

I am just convinced that $NKTR is wildly undervalued here, sitting on a dual indication drug for two large dermatology TAMs and likely the opportunity to run a single P3 study for *each* of them (a massive tailwind that didn't exist until a couple weeks ago).

The AA data are *far* better than what dupixent ever showed, on par with low dose JAKs, *and* appear to be further deepening.

We only got case studies from 3 of the handful of patients who completed extended treatment past 36 weeks so far (the waterfall plot says only 7 patients overall have completed), but these 3 case studies echo what the downward slope on the 32-36 week chart for the overall population says:  $NKTR's response data are going to get better with continued treatment.

I'm attaching those 3 case studies below, showing ~15%, ~40% (!!!), and ~15% further deepening of responses with continued treatment.  And for the most part they are basically bottoming out at that point near SALT10 levels.  Even if only a fraction of patients continue to have deepening like this, the numbers in the P3 are going to look *better* than low dose JAKi, which has a clear plateau effect essentially by week 24.

This is extremely encouraging for $NKTR, and the company already stated that the P3 trial will be longer, a full year's duration.

At this point I fully expect that P3 AA trial to succeed, and given the safety issues with JAKi plus the need to stay on them *FOREVER *, Rezpeg would likely be the preferred treatment for AA.

Safe biologics dominate in dermatology.  Period.  It is already the case in atopic derm where JAKis are WAY more effective than Dupi, but Dupi does >5x more AtD sales than the JAKs.  The same will happen with a safe biologic in Rezpeg.  There are 4 (!!!) me-too JAKis in alopecia areata right now, with pharma seeing fit to continue launching the same MoA into this indication and still being able to make a profit on it.

I'm telling you as someone who would literally be prescribing this drug - a safe biologic with 52 week results even on par with 36 weeks of low dose JAKi would dominate the first line in this disease.  Full stop.  And keep in mind that the deepening of effect we have seen so far might make the results better than low dose JAKi.  I could be wrong about a drug with that profile dominating first line in AA...but that is my strong professional/specialist opinion, and it is backed by every proof of concept that we have in biopharma showing safe biologics crushing JAKis across different disease indications.

The other angle that I see upside for is post JAKi induction maintenance with Rezpeg.  This makes total sense with the MoA of T-Reg expansion.  If you could pitch the JAKi portion of the treatment as a short duration stint followed up by a safer long term maintenance to avoid heart attack, blood clot, severe infection, and cancer risks that comes with the JAKi label, patients would sign up for that.  And as the long-term half of that regimen, Rezpeg would still dominate the revenue/earnings over JAKis.  This would be a brilliant way for one of the 4 pharmas currently marketing undifferentiated JAKis in AA to separate themselves from the pack by having a proprietary combination for safe maintenance of disease.

Hell, $ABBV could even try this rezpeg maintenance approach in atopic derm after induction with Rinvoq!  Why not?  They've been disappointed with its uptake in AtD so far (again, because derms don't like JAKs).  The cost of that P3 would pay for itself many times over if it works.  This could be their "foot in the door" for both indications.

A smaller player like $INCY or Sun Pharma should take a *serious* look at buying or partnering with $NKTR too, IMO.  Digestible assets with legitimate potential to become multi-billion dollar drugs if developed properly are very rare.  I don't think that the current $NKTR prices in the $40s will last, but if they do, it's a no-brainer for a mid sized pharma to go after this IMO.

IDK why the market doesn't appreciate it yet, but to my eyes $NKTR is clearly on track to be a real player in both atopic derm and alopecia areata (whether that be in induction, maintenance, or both).

*So* much positive news has broken their way recently, from OX40's flop bursting the atopic dermatitis door wide open, to the FDA likely cutting their P3 trial costs roughly *in half* totally out of the blue, to yesterday's success in a totally new, large indication with zero approved safe/effective treatments.

The stock never seems to get credit right away.  I felt like I was shouting into the void about it when this thing was trading at <$0.50 (<$7.50 split adjusted) before the atopic derm data, but ultimately over time the value has slowly been growing.  I feel similarly to how I felt back then right now, looking at new AA data that to me clearly say this drug is going to work in a P3 study and be widely adopted in clinical practice.  Maybe the outcome will be the same again, with another delayed round of major appreciation in the stock price.

For now, I'll look forward to the 1Q26 atopic derm maintenance data (right around the corner!).  If they show deepening like what we appear to be seeing in the AA dataset so far...look out!


Summary: Bullish on PALI as the most promising early-stage IBD play.

@SaintEquitie $ABVX won’t be needing her for further clinical operations 😉

On to the next company that needs their IBD trials designed & executed.  $PALI is the most promising thing at that early stage.


Come on. Let's wrap this bullshit up and reach a settlement.

Summary: Bullish NKTR on settlement expectations; LLY's case seen as weak after discontinuing based on falsely calculated data.

So $LLY (with its own competing atopic derm program) is requesting *more* data than what $NKTR has publicly disclosed?  The competitor wants internal, undisclosed data on their competitor’s program?  Ok, lol.

Lilly’s discontinuation of rezpeg’s development plan was informed by falsely calculated efficacy data.  They’re literally not even debating this.  That’s just about all we should need to know here.

Come on.  Let’s wrap this bullshit up and reach a settlement.


Summary: Bullish ABVX: post phase-3, unique MoA with no me-toos, superior to RXDX in every respect.

@physioo $ABVX isn’t phase 3 ready, its post phase 3.  $RXDX was pre phase 3.

And $ABVX is the only company with this MoA, unlike $RXDX with multiple me-toos.

$ABVX better in every way.

$abvx vs $rxdx

Rxdx sold for $10.8b on crohns/uc data on a phase 2 drug sc injection

Abvx $8b market cap on a phase 3 ready drug oral med with novel moa

And don’t tell me patients prefer sc over oral…my patients hate needles


Summary: Bearish NTLA: fatal liver tox event rate ~6x higher than an MS drug just rejected by FDA for the same issue; safety risk is real, not theoretical.

What?….even I assume fatal liver tox  won’t happen years after dosing.

It actually doesn’t matter if you die early or die late.  Whether or not the frug kills you is what matters.  In fact, earlier fatal events make the profile *worse* for $NTLA.

You’re using totally twisted logic and have it exactly backwards.

Your logic is ok only to predict the probability of hepatic events *before* we have an event rate from real world trials.

I.e. what you are saying is “if you only give 1 dose of a drug, you are much less likely to have adverse events over the long term, because you are no longer being exposed to the drug like you would in chronic therapy.”

So yes, on a purely THEORETICAL basis, the liver tox risk should be lower with a one time therapy without cumulative exposure risk.  This was a viable point to make about $NTLA’s safety risk BEFORE they started to actually encounter fatal liver toxicity in the real world.

The problem is, and where your logic totally fails, is that WE ALREADY HAVE AN EVENT RATE (and a relatively high one at that).

The EVENT RATE predicts the rate of further events moving forward.  This theoretical/academic exercise of “well since it’s a one time treatment the risk should be lower” BS is now officially out the window.

What you’re saying couldn’t possibly matter less.  The event rate predicts the event rate, and what $NTLA currently has is a fatal event rate that is ~6x higher than an MS drug that just got CRLd for the same problem.

“But it’s not given chronically so the risk *SHOULD* be lower!!!

Oh yeah?? Well it’s not!  The risk is literally *higher* than drugs that the FDA is currently rejecting.

@SnackBioTech @unsureoptimist @A_May_MD @KlausMolle I understand. However, we haven’t really seen reports of long-term ALT/AST elevations. We can’t assume that this will (or could) occur in a large patient population based on those dosed over 24 months ago.


Summary: Agrees QURE would jump even higher than 50s if the person in question gets fired.

@byebyegoodguy I’d assume higher but yeah

@A_May_MD If he gets fired, I imagine $QURE jumps to 50s instantly.


Summary: Bullish ABVX: UC market expansion + DSMB milestone drives M&A value higher.

Prediction:   High penetration of the existing UC market is one thing, but $ABVX expanding the UC market on their own will be looked back on as the key piece that ultimately took the M&A value to the next level.

Do the math on how many of these current "conventional therapy" patients you actually need to treat with Obe to move the needle...

---

Oh, and yet another DSMB hurdle achieved.  Beautiful.  What a drug!


Summary: Bullish NKTR: Rezpeg as even a partial 1L player or lock in 2L represents multi-billion dollar drug potential.

@byebyegoodguy Dupi will always dominate 1L, but if Rezpeg can take *any* share of 1L it's HUGE, and if Rezpeg can get to the same (or better?) efficacy at longer timepoints...2L is a lock.  That's a multi-billion dollar drug.

@A_May_MD Are you saying Rezpeg could be the 1L therapy for Atd?$NKTR


Summary: Bullish QURE; expects HD market penetration far above the 4% assumption in parent's valuation model, implying much higher peak sales and fair value.

@MattyKirsh Yeah penetration is going to be astronomically higher than 4%.

@A_May_MD I've been long since pre-data so I'm a fan but how do you read commercial potential?

I want to buy into the 20,000 diagnosed US HD patients so lets say you treat ~4% of those in your peak year (20K * 4% * $3M = $2.4B peak sales) so ~$6-$8B fair valuation upon approval, but $qure


Summary: Bought VKTX dip on obesity M&A thesis; still bearish NTLA despite covering; PFE pressured to do obesity M&A if NVO wins MTSR bid.

Well, with all this dip buying in the last couple days I made the sad decision to cover the $NTLA short (IMO too early).

Perhaps even more disturbing is that one of this dips I’ve bought is…. $VKTK

The bidding war escalating to ~$10B for $MTSR has gotten too significant to ignore.  It also seems like the momentum favors $NVO winning over $PFE, which would leave $PFE with basically nothing in obesity.

$PFE wins, $NVO doesn’t necessarily need to do anything in obesity.  $NVO wins, I do think $PFE is pressured to do obesity M&A, and like it or not $VKTX *does* make sense on paper.

No, I’m not joining any cults here, but $VKTX being down in spite of the obesity bidding war evolving as it has doesn’t make much sense to me, so it’s worth a bet.

It’s still very much my opinion that $NTLA should trade Significantly lower, but as previously noted, my margin capabilities are heavily constrained by a large unmarginable $ABVX position at present.  Gotta make tough decisions, and in a bull market dip, covering shorts to return to long bets just makes sense.

Covering $NTLA to buy $VKTX kind of has me like 🤢…but oh well - sometimes you’ve got to hold your nose and push the button!

---

$VKTX $MTSR $NVO $PFE

---

$VKTX should insert themselves into this conversation and offer to sell themselves for $50-$60/share

$NVO $PFE $MTSR https://t.co/hrSu4Tm56N


It's still very much my opinion that $NTLA should trade Significantly lower


there's still a long way to go (down) before that really sinks in for most people

Summary: Bearish HIMS; stock has a long way down before retail bulls capitulate.

@paulcerro A few people are starting to realize the constant bullishness fed to them on $HIMS was all pumping bullshit from overly promotional accounts (in some cases fraudsters - Linares).

But there’s still a long way to go (down) before that really sinks in for most people.

If you follow any $HIMS pumper accounts that said this would be bullish for them, you should do yourself a favor and unfollow them because they have absolutely no idea what they're talking about.

Choose your information sources wisely. The cult is nothing but a joke. https://t.co/42jQaRRmeR


Summary: Strongly bullish biotech ETFs XBI and BBC into year-end on rate-cut thesis and rotation out of high-valuation tech.

$XBI and $BBC already with a >2% delta over the major indices today.

Seriously, the biotech revival could be *very* strong through year end if jobs look bad, the economy gets sluggish, and rates come down.  The rotation from nosebleed valuation generalist tech stuff into  beaten up biotech could be pretty violent.

Frankly, we deserve it after years of misery while the rest of the market has constantly made new all time highs!

Let’s see what the yearly revision in jobs data looks like on Tuesday.  Jobs way down would mean biotech way up.

$XBI $BBC should like the “bad” jobs print today.

Big jobs data this coming Tuesday as well.

Could it finally be biotech’s turn?


Jobs way down would mean biotech way up.


Looks good. numbers look competitive with Dupixent and Xolair.

Summary: Bullish NKTR: data looks competitive with Dupixent and Xolair.

@jawnzilla Date night (not with you).  Looks good. Caveat emptor (this was not an asthma study obviously), numbers look competitive with Dupixent and Xolair.

That’s all I’ve got for tonight 🫡

$NKTR

Preparing the warm bath, dim lights, candle, and gentle nite music for when Adam May puts out his analysis $NKTR


Summary: Bearish NTLA; should trade below cash as bulls disappear and safety issues weigh on the platform.

@BiotechAnalysst @Sanctuary_Bio $NTLA bulls are disappearing.  Should trade below cash.

@A_May_MD @Sanctuary_Bio
next one downgrading $NTLA
even removing any PT:
do #not
see any fundamental gas to drive the stock higher
#safety issues likely would #bleed into
a firmwide overhang on #all platform https://t.co/LUOJS2giox


Summary: JNJ seen as top acquirer for ABVX; LLY also has strategic fit with ABVX to fill a MORF-sized gap via oral IL-23 from DICE acquisition.

@2035Bio $JNJ is a front runner runner to go for $ABVX for sure.

Of course, $LLY has a $MORF sized hole that $ABVX could more than fill, and I’d bet my bottom dollar they’ve got their own oral IL-23 program cooking from the $DICE acquisition as we speak.

@A_May_MD Me like $JNJ/$PTGX and $ABVX crushing Abbvie


$LLY has a $MORF sized hole that $ABVX could more than fill, and I'd bet my bottom dollar they've got their own oral IL-23 program cooking


$NKTR could have easily been up 100% or more today and I would've found it reasonable... $NKTR would 10x even from here... I don't think that today's $NKTR +26% move priced in how big of a deal the $SNY news were for Nektar *at all*

Summary: Strong long NKTR: unique MoA, OX40 out of race for 2L atopic derm, 10x potential; SNY implicitly bearish after P3 efficacy decay.

Final Numbers:  $SNY down $12.2B, $NKTR up $0.11B.  $SNY lost ~111x what $NKTR gained today.

I'm a broken (and biased) record on $NKTR's valuation, but seriously - why isn't this thing getting *any* respect for the size of the 2L+ atopic derm market and the P2b data they already have?

I feel like I'm going insane when I review all the data and market sizes here and ending up with this <$700M valuation.  It's similar to how I felt when I posted what I considered to be borderline mathematical proof that $ABVX was going to hit in P3, only for the stock to trade down a few cents over the next 36 hours (right before starting an >700% rally, of course!).

$NKTR could have easily been up 100% or more today and I would've found it reasonable.  OX40/OX40L has been unanimously the single most threatening competitor to $NKTR.  With OX40 looking out of the race for 2L, what else is there?  $NKTR already had the only unique MoA in atopic derm to begin with, and now it looks like it *could* be the clear 2nd best.

Add in potentially very sparse administration and remittive effect...this could VERY easily be a multi-billion dollar drug in atopic derm alone.  *If* that ends up being true, $NKTR would 10x even from here (of course this would take years to prove).

I'll recycle the image on the atopic derm market size as well as the launch curves of Ebglyss (me-three MoA) and Nemluvio (HORRIBLE efficacy).  People who look at these data and still think this condition is well-served by Dupi alone, or that "competing with" dupi is the bar for a 2L+ drugs are just wrong.  There's no way for me to look at those arguments as anything other than flatly ridiculous.  And not to play the card too much, but...I *am* an actual dermatologist, so I do think I should have *some* idea as to the unment need and relative bar here (hint:  Very high and very low, respectively).

This is all just atopic derm too.  If somehow Rezpeg actually works in AA, look out.  Multi-indication derm launch would be a big, big deal.  Oh and this also doesn't include dapi royalties and $LLY settlement potential.

So yeah, it still feels like I am taking crazy pills when I look at $NKTR's miniscule valuation.  Hopefully it's actually the market that is insane here, and not me!

---

And one more thing - I do hear the argument "well $SNY traded down because P3 efficacy got worse compared to P2.  Couldn't the same thing happen to $NKTR?"

Sure it could, but $SNY's efficacy decayed almost entirely due to higher placebo response rates in P3 compared to P2, jumping from 11% to 19%.

$NKTR's P2b pbo rate was already 17% - just 2 points off of where $SNY's P3 ended up.

$NKTR is in a *fantastic* spot to be able to reproduce a P3 EASI75 delta in the same range as their P2's was.  If that happens, this will be a biotech "phoenix from the ashes" story of the ages!

Last time I'll say it.  I don't think that today's $NKTR +26% move priced in how big of a deal the $SNY news were for Nektar *at all*.

---

$AMGN OX40 data are so encouraging that they PR'd the topline data at 8:04pm on a Monday and didn't even include a single datapoint in the PR.  Nice!

$NKTR still cooking 🔥
$SNY $AMGN

https://t.co/TvnxtAW7To


$QURE is a lock imo. AA is as sure as it gets in my view. For me the flier outcome is full approval, not CRL. At this point it's hard for me to fathom this doesn't get cleared.

Summary: High conviction QURE accelerated approval is near-certain; SRPT implied resilient to FDA pressure as a comparator.

$QURE is a lock imo.  FDA agreed to 3 year external control with the 1 year controlled data in hand.

Dose dependent, hit on prespecified external control for both cUHRDS and TMC.

KOLs going berserk over it and hundreds of patients calling in to inquire about the treatment.  Popular press calling it a cure.  No chance FDA reneges on this.

Vinay is going to take this down?  He couldn’t even take down $SRPT whose drug is literally killing kids with AEs (has not happened with $QURE).   Huntington’s affects >3x as many patients too.

AA is as sure as it gets in my view.  For me the flier outcome is full approval, not CRL.

Not saying it’s right/wrong.  Is what it is.  At this point it’s hard for me to
fathom this doesn’t get cleared.

@plainyogurt21 @A_May_MD @anthonystaj As in worse than pbo should lead to AA?

The mistake was always allowing external ctrl, Prasad has been reversing some of the FDA's peevious "flexible" decisions (REPL, CAPR, IOBT?), a QURE CRL wouldn't surprise me and it should be celebrated.


Vinay is going to take this down? He couldn't even take down $SRPT whose drug is literally killing kids with AEs


Summary: Bearish NTLA: Hy's Law liver event + trial hold means company is worth less than cash on hand.

??? Not before it went to the $5s

$NTLA has run on literally nothing but the bull market for the last several weeks.

This.  This breaks it.  This is Hy’s Law.  Different and FAR worse than the last event that lacked bilirubin elevation.  And this time the trial is getting put on hold.

The company as it currently exists, in my opinion, is worth less than the cash they currently hold.

@A_May_MD I don't disagree with any of this, but what do you think breaks it? This was all pretty clear after the last liver event too, and the stock still ~quadrupled