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Nasdaq: ETNB Powerful Science
Meaningful Medicines Changing Lives October 2020 Exhibit 99.1
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89bio - Investment Highlights Validated
in NASH demonstrating strong efficacy results, favorable safety/tolerability profile, and potential best-in-class dosing BIO89-100 has potential to be a leading DRUG FOR LIVER AND CARDIO-METABOLIC DISORDERS BIO89-100 DELIVERS ON THE PROMISE OF FGF21
FGF21 is a highly differentiated approach and potential backbone of treatment in NASH PURSUING Two Promising Large Indications NASH: Compelling benefit-risk profile in a differentiated class SHTG: Potential for quicker path to market with
competitive differentiation (first FGF21 to market based on registrational trials planned in 2022) MAJOR ANTICIPATED MILESTONES NASH: Initiation of a Phase 2b trial as part of a potential Phase 2b/3 trial in 1H21 SHTG: Topline data from Phase 2
trial in 2H21 ESTABLISHED MANUFACTURING EXPERTISE AND IP PROTECTION INTO 2038 AND BEYOND
ROBUST EFFIACCY RESULTS Statistically
significant reductions in liver fat and in key liver markers (ALT) Majority of patients achieved a 30% (up to 88%) or a 50% (up to 71%) reduction in liver fat KEY UPCOMING MILESTONES Initiation of a Phase 2b trial as part of a
potential Phase 2b/3 trial: 1H21 FAVORABLE SAFETY/TOLERABILITY PROFILE Very low frequency of GI adverse events and overall profile comparable to placebo Expected to drive physician adoption and patient compliance in this chronic, generally
asymptomatic patient population BIO89-100: A Compelling Drug Candidate for NASH POTENTIAL best in class dosing REGIMEN First FGF21 analog to show benefit in NASH with two-week dosing
NASH is a Serious Liver Condition With
Significant Co-Morbidities 16.5 million cases projected to grow to 27 million cases by 2030 Expected to become the leading cause of liver transplant Co-morbidity Prevalence in NASH population Hypertriglyceridemia 83% Obesity 82% Hyperlipidemia /
Dyslipidemia 72% Metabolic syndrome 71% Type 2 diabetes 44% Healthy liver NAFLD (Non-Alcoholic Fatty Liver Disease) NASH Cirrhosis Lipogenesis Inflammation Fibrosis Metabolic Dysregulation Excess Liver Fat Accumulation Progressive
Disease INSULIN RESISTANCE HEPATOCYTE INJURY FIBROSIS LIPID HANDLING
FGF21 Has Potential To Be Mainstay of
Therapy In NASH Endogenous metabolic hormone that regulates energy expenditure and glucose and lipid metabolism Reduces liver fat by action within liver and from periphery Impacts liver fibrosis via metabolic pathway and upregulation of adiponectin
Native FGF21 has a short half-life of < 2 hours FGF21 Glucose uptake Lipolysis Energy expenditure Adipogenesis M2 M polarization M2 M proliferation Adipose Muscle Lipid clearance
Insulin sensitivity Ceramide accumulation Liver Blood vessel HPA axis FGF21 adiponectin FGF21
FGF21 FGF19 FXR PPAR* THR- GLP-1
Liver fat reduction Fibrosis improvement ? Triglyceride reduction LDL-C improvement Worsens LDL Worsens LDL HDL-C
improvement Glycemic control Limited Side Effects GI effect** LDL Pruritis LDL Weight Gain Edema Drug-drug interaction GI effect Route of administration/ Dosing frequency
Injectable QD/QW/Q2W Injectable QD Oral QD Oral QD Oral QD Injectable QD Ability to address underlying co-morbidities Efficacy with respect to liver pathologies Well tolerated at effective dose FGF21 - Validated and Highly Differentiated
Mechanism for NASH * Based on pan-PPAR ** for some FGF21 analogs Note: Table representative of data published and/or presented on the mid/late stage clinical programs targeting these mechanisms. Conclusions on this slide are not based on head to
head results. Third party company data taken from publications/publicly available presentations. Effective Indeterminate Modest Effect ? Unknown or Unchanged
RELATIVE Change in liver fat from
PLACEBO (% reduction) FGF21 - Highly Promising Mechanism for NASH * Not placebo controlled; **No worsening of NAS (NAFLD Activity Score) Note: All data regarding third-party studies on this slide are based on third-party trials, some of which
are in different stages of development. Conclusions on this slide are not based in head-to-head results. Efficacy shown here may change in future clinical trials; Graphs are representative of data published and/or presented on the mid/late stage
clinical programs targeting these mechanisms 20mg QW 10 mg QD -32% -20% Pegbelfermin 16 week (n=23) (n=22) 27mg QW 36mg Q2W (n=10) (n=9) -60% BIO89-100 -70% 12 week (n=20) (n=19) 28mg QW 50mg QW Efruxifermin -71% -63% 12 week Liraglutide FGF21 1mg
QD Aldafermin (n=53) -26% 24 weeK FGF19 Resmetirom 80-100mg QD -26% 12 week (n=78) THRB 25mg QD OCA -17% 72 week (n=40) FXR 24 week (n=68) 1.2mg QD -31%* GLP-1 Reductions in liver fat as demonstrated through decreases in MRI-PDFF have been shown to
correlate with histology benefits especially in the case of proportion of patients achieving a 30% reduction in liver fat from baseline
BIO89-100 Is An FGF21 Optimally
Engineered To Balance Potential for Efficacy and Long Dosing Interval glycoPEG(20kD) C-terminus X Strong and flexible linker (glycoPEGylation technology) Mutations in positions 173 and 176 (glycoPEG attached at position 173) X N-terminus Position
182 FGF21 FGF21 is an endogenous metabolic hormone that regulates energy expenditure and glucose and lipid metabolism Proprietary glycoPEGylation technology with site-specific mutations Long half-life of 55-100 hours vs. native FGF21 half-life of
< 2 hours based on single ascending dose study Low nanomolar potency against FGF receptors 1c, 2c, 3c, similar to native FGF21; no activity against receptor 4 that can lead to increased LDL levels C-terminus N-terminus FGFR FGFR C-terminus
-Klotho -Klotho Signal transduction Functional response
Extensive Pre-clinical and Early
Clinical Data With BIO89-100 Reduced Hepatocyte Injury Reduced Liver Steatosis, Inflammation & Fibrosis Improved Lipid Handling* Improved Insulin Sensitivity Body Weight Reduction PRECLINICAL STUDIES DIN mouse model (10 weeks)
DIN mouse model (19 weeks) Diabetic obese cynomolgus monkey study (8 weeks; weekly dosing) Not evaluated Diabetic
obese cynomolgus monkey study (4 weeks; weekly & 2-week dosing) Not evaluated HUMAN Single Ascending Dose Study in healthy volunteers BIO89-100 was safe, well tolerated, showed significant improvements in
key lipid parameters, and had a half-life of 55-100 hours with dose proportional PK Statistically significant benefit observed * Improved TG and cholesterol
Note: Obeticholic acid, 25 mg/kg
tested as active control - did not separate from control in this study Scoring system: Steatosis (0-3), Inflammation (0-3), Fibrosis (0-4), NAS (0-13) - all were assessed at week 19; mean scores *** *** Reduction In Steatosis, Inflammation,
Fibrosis and NAFLD Activity Score With BIO89-100 In DIN Model * Vehicle BIO89-100, 0.02 mg/kg BIO89-100, 0.1 mg/kg BIO89-100, 0.5 mg/kg *p<0.05 **p<0.01 ***p<0.001
Phase 1b/2a Results: Promising
Benefit-Risk Profile with Convenient Dosing Significant benefits across key liver parameters observed across all dose groups and patient populations Up to 60% reduction in liver fat versus baseline and up to 70% versus placebo Up to 44% reduction in
ALT (35 U/L decrease in high ALT group) Up to 27% reduction in Pro-C3 Significant responder rates- Up to 88% and 71% of subjects showed fat reduction 30% and 50% Significant improvements in lipids-triglycerides, non-HDL and
LDL ROBUST EFFICACY RESULTS FAVORABLE SAFETY RESULTS & TOLERABILITY Well tolerated at all doses with low incidence of adverse events that occurred in 10% of subjects Very low frequency of gastrointestinal events and similar profile to
placebo No hypersensitivity or tremor observed; no adverse effects on heart rate or blood pressure POTENTIAL BEST-IN-CLASS DOSING REGIMEN Strong efficacy and favorable tolerability seen with weekly and two-week dosing
BIO89-100-002: Trial Design (n=2)
9mg Placebo (n=14) (n=4) (n=12) (n=3) (n=6) 3mg Placebo 18mg Placebo 18mg Placebo 27mg Placebo 36mg Placebo 12-week treatment duration + 4-week safety follow up Placebo (n=19) combined across cohorts for analysis (n=9) (n=3) (n=11) (n=4) (n=10)
(n=3) KEY TRIAL ENDPOINTS Safety, PK Relative changes in liver fat Serum lipids, liver and metabolic markers NASH* or phenotypic NASH (PNASH)# PDFF 10% *Subjects with biopsy-proven F1-3 #Central obesity plus T2DM or evidence of liver injury
KEY INCLUSION CRITERIA Randomization QW SC Q2W SC Randomized, pharmacodynamic (PD) and safety analysis set n=81; Study completers n=71 MRI analysis set n=75 (subjects with post-baseline MRI)
Baseline Characteristics Parameter
Mean or % Placebo (n=19) Pooled BIO89-100 (n=62) 3mg QW (n=6) 9mg QW (n=12) 18mg QW (n=11) 27mg QW (n=10) 18mg Q2W (n=14) 36mg Q2W (n=9) Age (years) 52.6 51.7 56.1 49.5 51.5 52.0 51.2 52.5 Male/Female 36.8% 38.7% 16.7% 50% 27.3% 20% 28.6% 88.9%
Weight (kg) 93.6 93.6 87.9 87.2 87.1 94.0 101.5 101.1 BMI (kg/m2) 33.8 34.8 34.3 32.7 32.8 36.8 37.0 34.8 Type 2 Diabetes 63.2% 40.3% 83.3% 33.3% 63.6% 40.0% 21.4% 22.2% ALT (U/L) 38.8 42.3 45.0 32.8 38.4 53.3 39.1 50.4 AST (U/L) 29.0 31.5 34.5 22.8
30.9 39.0 28.8 38.1 MRI-PDFF (%) 21.8 21.2 22.4 21.4 19.3 22.0 21.6 20.9 Baseline characteristics were similar between NASH (n=15) and PNASH (n=66) subjects
Up to 43% of subjects normalized
their liver fat (<5%) BIO89-100 significantly reduced liver volume up to 15% Changes in liver fat were similar between NASH and PNASH subjects BIO89-100 Significantly Reduces Liver Fat Across All Dose Groups MRI Analysis Set; MMRM LS Mean; *
p<0.05; ** p<0.01; *** p<0.001 versus placebo ** *** *** *** *** *** Absolute Change in Liver Fat (%) from Baseline at Week 13 Q2W QW
BIO89-100 Reduces Liver Fat in
Significant Percentage of Subjects MRI Analysis Set; MMRM LS Mean; * p<0.05; ** p<0.01; *** p<0.001 versus placebo *** *** *** *** *** *** Proportion of Subjects with 30% Relative Reduction in Liver Fat Placebo 0% QW 3mg 60%** 9mg
82%*** 18mg 60%** 27mg 86%*** Q2W 18mg 69%** 36mg 88%*** Relative Reduction in Liver Fat from Baseline at Week 13 Q2W QW 30% relative reduction in liver fat has been correlated with NASH resolution and fibrosis improvement
Majority of Subjects on BIO89-100
Achieved 50% Reduction in Liver Fat MRI Analysis Set; MMRM LS Mean; * p<0.05; ** p<0.01; *** p<0.001 versus placebo Proportion of Subjects with 50% Relative Reduction in Liver Fat Placebo 0% QW 3mg 20% 9mg 54%** 18mg 50%**
27mg 71%*** Q2W 18mg 39%** 36mg 50%** Relative Reduction in Liver Fat versus Placebo at Week 13 *** *** *** *** *** ***
BIO89-100 Showed Substantial
Reduction in Liver Fat and Liver Volume After 12 Weeks of Treatment (Subject at 27mg QW) Liver fat (%) Parameter Baseline Liver fat 41.1% Liver volume (L) 2.2 Week 13 % Change 5.1% -87.6% 1.4 -35.4%
BIO89-100 Significantly Reduces ALT
PD Analysis Set; Pre-planned sensitivity analysis; MMRM LS Mean; * p<0.05; ** p<0.01; *** p<0.001 versus placebo *** * * *** Percent Change from Baseline at Week 13 Percent Change Over Time -30 U/L -22 U/L * *** ** * *** * * * *** *** Q2W
BIO89-100 has Clinically Meaningful
Impact on Subjects with High ALT PD Analysis Set in baseline ALT > 45 U/L (placebo n=6, pooled BIO89-100 n=22); Pre-planned sensitivity analysis; MMRM LS Mean; * p<0.05; ** p<0.01; *** p<0.001 versus placebo n=5 n=17 Change in ALT of
17 U/L has been correlated with improvement in fibrosis * Placebo Pooled BIO89-100 * Absolute Change in ALT (U/L) (Baseline ALT > 45 U/L) Absolute Change in ALT at Week 13 (Baseline ALT > 45 U/L) -17 U/L
Decrease from baseline in BIO89-100
treated subgroup with baseline TG 200 mg/dL TG: 33%-49% Non-HDL: 8%-29% BIO89-100 Significantly Reduces Triglycerides with Greater Benefit Observed in Subjects with High Triglycerides PD Analysis Set; MMRM LS Mean; * p<0.05; ** p<0.01;
*** p<0.001 versus placebo; # TG <150 mg/dL * * * Percentage Change from Baseline at Week 13 (All Subjects) Q2W QW TG Normalization# Rate at week 13 (Subgroup with Baseline TG 200 mg/dL) 53%
Safety Overview Treatment Emergent
Adverse Event (TEAE) Placebo (n=18) 3mg QW (n=7) 9mg QW (n=12) 18mg QW (n=11) 27mg QW (n=10) 18mg Q2W (n=14) 36mg Q2W (n=9) TEAE Leading to Death 0 0 0 0 0 0 0 TEAE Leading to Discontinuation 0 0 0 0 1a 1b 0 Serious Adverse Event COVID 19 [Not Drug
Related] 0 0 0 0 0 1 1 Safety Analysis Set; one placebo subject received one dose of BIO89-100 3mg and is summarized in 3mg QW group a skin rash; b hyperglycemia [Not Drug Related]
Treatment-Related Emergent AEs in
10% of Pooled BIO89-100 Group Preferred Term n (%) Placebo (n=18) Pooled BIO89-100 (n=63) 3mg QW (n=7) 9mg QW (n=12) 18mg QW (n=11) 27mg QW (n=10) 18mg Q2W (n=14) 36mg Q2W (n=9) Increased Appetite 0.0% 15.9% 4 2 0 2 2 0 Safety Analysis Set;