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Enabling Oral Drug Delivery to Improve Patient Compliance May 28, 2019 Corporate Presentation Exhibit 99.1
Forward - Looking Statements This presentation contains forward - looking statements about Lipocine Inc. (the "Company"). These forward - looking statements are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These forward - looking statement s relate to the Company's product candidates, the expected timing of the resubmission of the NDA for TLANDO, FDA review process related to ou r resubmitted NDA for TLANDO , the expected timing of Phase 2 studies for LPCN 1144 and LPCN 1148, clinical and regulatory proc ess es and objectives, potential benefits of the Company's product candidates, intellectual property and related matters, all of which i nvo lve known and unknown risks and uncertainties. Actual results may differ materially from the forward - looking statements discussed in this pre sentation . Accordingly, the Company cautions investors not to place undue reliance on the forward - looking statements contained in, or made in connection with, this presentation . Several factors may affect the initiation and completion of clinical trials and studies, the potential advantages of the Company's product candidates and the Company's capital needs. The forward - looking statements contained in this presentation are qualified by the detailed discussion of risks and uncertainties set forth in the Company's annual report on For m 10 - K and other periodic reports filed by the Company with the Securities and Exchange Commission, all of which can be obtained on the Com pany's website at www.lipocine.com or on the SEC website at www.sec.gov . The forward - looking statements contained in this document represent the Company's estimates and assumptions only as of the date of this presentation and the Company undertakes no duty or obligation to update or revise publicly any forward - looking statements contained in this presentation as a result of new information, future events or changes in the Company's expectations. 2
Clinical Stage Biopharmaceutical Company Metabolic and Endocrine Focus 3 PRODUCT (Indication) PRE - CLINICAL PHASE 1 PHASE 2 PHASE 3 NDA LPCN 1144 (Oral Testosterone for pre - cirrhotic NASH) Paired Biopsy Phase 2 Study in NASH TLANDO (Oral Testosterone for TRT) PDUFA November 9, 2019 TLANDO XR (LPCN 1111) (Long Acting Oral Testosterone for TRT) Phase 2 Complete LPCN 1148 (Oral Testosterone for NASH Cirrhosis) POC Study Planned LPCN 1107 (Oral HPC for Prevention of PTB) EOP2 meeting Completed Propriety Drug Delivery Platform
4 Targeted for Non - Alcoholic Steatohepatitis ("NASH") A silent killer that affects 30 million Americans 1 1. CNBC; published December 30, 2018
Non - Alcoholic Fatty Liver Disease ("NAFLD") No Approved Product for the Treatment of NAFLD/NASH 5 LFTs: Liver function test, especially Alaninine amino transferase (ALT) and Aspartame amino transferase (AST) NASH: Non - alcoholic Steatohepatitis, TG: Triglyceride Fatty liver is a reversible condition wherein large vacuoles of triglyceride (TG) fat accumulate in liver cells via the process of steatosis Healthy Liver Fatty Liver - TGs - LFTs - Liver fat NASH Liver - Steatosis - Ballooning - Inflammation - Fibrosis Cirrhotic Liver - Late stage of fibrosis Hepatocellular Carcinoma 20 - 30% US Adults 15 - 20% NAFLDs 10 - 20% NASH Eligible for Liver Transplantation
Clinical Relationship Between Testosterone and NAFLD Across the Full Disease Spectrum Hepatic Steatosis NASH Cirrhosis " Men with low testosterone are at high risk for NAFLD ." 1 Free T ( pg /mL) " Levels of free T decreased significantly with the increased incidence of lobular inflammation, hepatocyte ballooning, NAFLD activity score, and fibrosis." 2 "Low T levels in cirrhotic men are associated with the combined outcome of death or transplantation." 3 Free T ( pg /mL) 1 Kim et al, Gastroenterol 2012; 2 Sumida et al, Gastroenterol Hepatol 2015; 3 Sinclair et al, Liver Trans 2016; 6
LPCN 1144: A Differentiated Oral NASH Therapy Candidate Prodrug of Endogenous Testosterone Liver Fat Reduction and Key Serum Biomarkers Potential Favorable Benefits in Systems Outside the Liver Suitable for Chronic Use Over 40% relative mean liver fat reduction after 16 - weeks of treatment 48% of the treated NAFLD subjects had NAFLD resolution, defined as < 5% liver fat T therapy known to improve muscle mass, bone density, hemopoiesis, sexual/mood dysfunction Good GI tolerability No mean LDL increase No signs of nephrotoxicity No signs of skeletal fragility No signs of drug induced liver toxicity 7
LPCN 1144: Additional Health Benefits Observed in Hypogonadal Subjects with Elevated ALT* SF - 36, Short Form - 36 (0 - 100); PDQ, Psychosexual Daily Questionnaire (0 - 7); * ALT > 40 U/L at Baseline in 52 week SOAR Trial (N=3 3) Mental Component Summary Mental Health Role Emotional Maintained Erection Sexual Activity Negative Mood Positive Mood Overall Sexual Desire -4 -2 0 2 4 6 8 Mean Change ( 95% CI) from Baseline SF - 36 PDQ 8
LPCN 1144: Extensive Clinical Safety Database Demonstrated No Unexpected Risks 0 5 10 15 % Subjects LPCN 1144 Topical T 9 - 650+ subjects in 14 studies with up to 52 week exposure - No drug related SAEs - No deaths or MACE events Gastrointestinal Disorders 1% in SOAR Trial (52 Weeks)
LPCN 1144: Multidimensional Mechanism of Action Across the Full Spectrum of NASH Pathogenesis Homeostasis Modifier 1, 2 Alter lipid, cholesterol, and glucose metabolism Reduce visceral abdominal fat Modify activity of hepatic lipase, and skeletal muscle/ adipose lipoprotein lipase Anti - inflammatory 2 / Antioxidant/Immuno - modulator 3 Restore mitochondrial turnover and normalizes oxygen consumption 4 Regeneration Booster 5,6 Stimulate satellite cells and myocyte precursor resulting in cell differentiation and myocyte proliferation 7 Increases circulating endothelial progenitor cells ("EPC") 8 Anabolic Agent 9 Increase muscle mass, bone density in men with liver disease 10 10 1. Shen and Shi, Int J Endocrinol, 2015 2. Kelly and Jones, J Endocrinol, 2013 3. Sinclair et al., J Gastroenterol Hepatol , 2015 4. Linda Vignozzi et al., University of Florence, IT, unpublished, 2018 5. A. Francavilla et al., Digest Dis Sci, 1989 6. Vic et al., Hepatol 1982 7. Sinha - Hikim et al., J Clin Endocrinol Metab , 2004 8. Liao CH et al., Andrology, 2013 9. Gentile MA et al., J Mol Endocrine, 2010 10. Sinclair et al., J Gastroenterol Hepatol 2016
LPCN 1144: Liver Fat Imaging Study ("LFS") Study Design and Baseline Liver Fat Subject Distribution 11 LFS was an open - label, multi - center single - arm 16 - week study (N=36) with LPCN 1144 in hypogonadal males LF = liver fat
LPCN 1144: Liver Fat Study Results Meaningful Relative Liver Fat % Change and Responder Rate 12 - 33% - 42% - 40% -60% -50% -40% -30% -20% -10% 0% BL 5% BL 8% BL 10% % Liver Fat CBL ( SEM) Mean Relative Liver Fat % Change 71% 80% 75% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% BL 5% BL 8% BL 10% % of Responders Responder Rate for Relative Liver Fat % Change* * Responder rate for relative change is % of patients with at least 30% for relative change from baseline.
LPCN 1144: Liver Fat Study Results Liver Fat Based Subject Distribution at Each Visit 13 38% 32% 6% 24% Baseline Pre treatment 55% 18% 6% 21% 8 Week Treatment 65% 15% 12% 9% 16 Week Treatment LF < 5% (NAFLD Free) 5% LF < 8% 8% LF < 10% LF > 10% NAFLD Free NAFLD Free NAFLD Free Longer Therapy Improved Proportion of Subjects with Disease Resolution N=34 N=33 N=34
LPCN 1144: Next Step Advancing Forward Initiating paired - biopsy Phase 2 clinical study in NASH subjects - Study Design Three - arm, double - blind placebo controlled Biopsy confirmed NASH male hypogonadal subjects with NAS 4 Paired biopsy at baseline and EOS (36 - weeks) - First - patient dosed targeted for 3Q 2019 14
15 Targeted for Testosterone Replacement Therapy Annual TRx ~7M
2018 2017 2016 2014 2015 350 375 400 425 450 475 500 525 550 575 600 625 650 675 Oct 14 Dec 14 Feb 15 Apr 15 Jun 15 Aug 15 Oct 15 Dec 15 Feb 16 Apr 16 Jun 16 Aug 16 Oct 16 Dec 16 Feb 17 Apr 17 Jun 17 Aug 17 Oct 17 Dec 17 Feb 18 Apr 18 Jun 18 Aug 18 Oct 18 Monthly TRx (000s) FDA Label Guidance Monthly TRT TRx Trend 16 TRT Market is Growing 2018 Annual TRx estimates of 7.3 million Source: IMS database TRx = Total prescriptions
Cumulative TRT Sales Last Six Years* Branded Topicals Dominated TRT Sales 17 ANDRODERM 5% ($438M) ANDROGEL 74% ($7B) FORTESTA 3% ($267M) TESTIM 7% ($667M) AXIRON 11% (~$1B) Topical Brands Total six years sales : $ 9.4 B Avg. annual sales: $ 1.6 B Topical Brands 82% Other Brands Generics 17% Sales for All TRTs Total six years sales : $ 11.5 B Avg. annual sales: ~$ 2B Source: IMS *Feb 2013 to Jan 2019 Year launched Androderm : 1995 Androgel : 2000 Testim : 2003 Fortesa : 2011 Axiron : 2011
Issues with Current Non - oral TRT Options Black Box Warning - Secondary exposure to testosterone - Pulmonary oil micro embolism (POME) and anaphylaxis shock Inconvenient application or painful injection Poor persistence reflects need for oral - Average days on therapy is 100 days More than 50% of patients need dosage adjustment - Burdensome for patients due to multiple doctor visits Potential Barrier To Newly Diagnosed and Existing Patients 18
Current TRT Dosing Regimes Over 50% of Patients Require Dose Adjustment with Current TRT Therapies * Current TRT n=412 Q16. Since you started using your current testosterone medication, how many times was the dose adjusted up or down until you reached your current dose level? 0 X 47% 1 X 33% 2 X 15% 3 X 2% >3 X 3% 0 X 37% 1 X 26% 2 X 20% 3 X 12% >3 X 5% Number of Current TRT Dose Adjustments by Form* Gel (n=200) Injectable (n=137) 19
TLANDO Attributes Patient and Physician Preferred Oral Option Key Advantages of Oral Route: No risk of accidental T transference Non - invasive; easy to use Less cumbersome/burdensome Potential for higher persistence/adherence PCP preferred fixed dosing regimen 450mg (225 mg BID) Daily TU capsule orally administered Start off with "right dose" for all patients Easy to use for patients and physicians to prescribe Fewer doctor visits (No dose adjustment visits for patients) More compliant - generalizable to real world male patient behavior Fixed/predictable cost for payers No need to get any additional fasting labs Differentiated hypertension ("HTN") profile ~ 1% new anti - HTN starts or increase in anti - HTN dose 32% of subjects with baseline sBP >140 mm Hg experienced a decrease to <140 mm Hg with mean change of - 3 mm Hg Consistent inter - day restoration of T levels 20
TLANDO = Opportunity Near Term FDA Decision TLANDO PDUFA date is November 9, 2019 Significant unmet patient and physician needs with current therapies TLANDO is clinically differentiated TRT prescriptions are growing; Share of voice all time low $2B+ Market Opportunity 21
TLANDO XR (LPCN 1111): Profile Once Daily Differentiated Oral TRT Once daily oral testosterone - New molecule with associated IP - Novel prodrug of testosterone for oral delivery through proprietary drug delivery technology TLANDO XR proof of concept established - Positive Phase 2b study results in hypogonadal men Once daily oral dose provides T levels in the eugonadal range Phase 3 daily dose identified based on multiple dose Phase 2 studies in hypogonadal male Next steps: - Obtain FDA feedback on Phase 3 clinical study design 23
24 For Treatment of NASH Cirrhosis
LPCN 1148: Oral T for NASH Cirrhosis No FDA Approved Product - Transplant Only Cure Cirrhotic Liver US Prevalence Cirrhotic Patients Characteristics: Increased morbidity and mortality Symptoms of hypogonadism: altered hair distribution, anemia, sexual dysfunction, testicular atrophy, muscle wasting, fatigue, osteoporosis, gynecomastia Late stage symptoms: jaundice, pruritis, hepatic encephalopathy, ascites, anasarca, GI bleeding Estes C. et al., Hepatology, 2018;*Yoon and Chen, National Institute on Alcohol Abuse and Alcoholism; surveillance report , 2 016 25 Among NASH population (2015): Fibrosis grade 4 (cirrhosis) case: 1.3M Compensated cirrhosis 1.16M Decompensated cirrhosis: 134,400 In 2013, cirrhosis cause mortality was ~38,000* and consistently twice the rate in males as females **
Low Testosterone Increases Adverse Outcome in Male Cirrhotic Patients T Levels Fall Progressively with Increasing Disease Severity 1 Low T reported in up to 90% of NASH cirrhosis patients 2 and is a predictor of mortality 3 Low T associated with: - Increased risk of major infections, death and/ or transplantation rates 1 - Increased risk of for hepatic decompensation 4 - Worsening of sarcopenia 4 - Higher Child Pugh score grade 4 - Severity of portal hypertension and ascites grade 4 - Higher MELD score 5 1. Sinclair et al., Liver Transplantation, 2016 2. Kim et al., Male Hypogonadism , edrs : Winters and Huhtaniemi , 2017 3. Sinclair M. et al., J. of Gastro and Hepatology, 2015 4. Paternostro et al, Hepatol Res 2019; 5. Sinclair et.al, Liver international, 2016 26
LPCN 1148: NASH Cirrhosis Oral T Therapy Potentially help patients survive longer while waiting for a liver transplant T levels positively correlate with muscle mass in men and modulates bone density, hemoglobin production, insulin resistance, and immunity , commonly impaired in cirrhosis 1 Testosterone therapy increased muscle mass in men with cirrhosis and low testosterone 2 Next Steps: Proof of Concept study in male NASH cirrhosis subjects 27 1. Sinclair M et al., J. of Gastro and Hepatology, 2016 2. Sinclair M et al., J. of Hepatology, 2016
Upcoming Milestones 28 Near Term Value Drivers Event Expected Timing TLANDO PDUFA Date November 9, 2019 LPCN 1144 Paired Biopsy Phase 2 First Patient Dosed in NASH Patients 3Q 2019
Key Financial Metrics 29 Stock Price, Market Cap, Cash Balance Ticker Symbol LPCN (Nasdaq Capital Market) Closing Stock Price (5/24/19) $1.57/share Market Capitalization (5/24/19) $38.6 million Cash Balance (3/31/19) $22.5 million* Bank Debt (3/31/19) $9.2 million * $5M restricted and becomes unrestricted upon TLANDO approval
High PTB Medical Costs 12% of all US pregnancies 1 (475 - 500K) result in PTB (< 37 weeks) - a leading cause of neonatal mortality and morbidity First year medical costs for PTB infants are ~ 10x higher than for full term infants 2 28% of preterm births are to women with histories of early delivery 32 $26 Billion Economic Impact 3 1. CDC (2010) 2. J. Maternal - Fetal and Neonatal Medicine, Dec. 2006, 19(12), 773 - 782 3. Institute of Medicine of the National Academies. July 2006
LPCN 1107: Prevention of Preterm Birth (PTB) United States Market Landscape $1B Market Opportunity 3 December 31, 2017 HPC TRx 3 Makena 1 50% Off Guidance 2 30% Compounded 17 - HPC 20% 117% 1. AMAG estimates Makena market share based on distributor dispensing data and all other market share based on physician mark et research data conducted by AMAG. 2. Off guidance represents patients treated outside of guidance of Society for Maternal Fetal Medicine, including patients tr eat ed with unapproved therapies and untreated patients. 3. IMS data 4. Annualized September 30, 2018 data 33 2% 0 10000 20000 30000 40000 50000 60000 70000 80000 90000 100000 2016 2017 2018 TRx 44,220 95,935 94,287 4
LPCN 1107: First Oral PTB Candidate 34 Characteristics of the Only Approved Product Options for PTB IM HPC, Makena : 20 - 25% patients below reported better efficacy HPC level threshold Total of 18 - 22 injections - Injection location: Upper - outer quadrant of the gluteus maximus - Weekly visit to/by health care provider - ~35% of patients experienced injection site pain during clinical trial - ~17% of patients reported site swelling - much greater than placebo during clinical trial Makena 21 gauge needle SubQ HPC, Makena : 20 - 25% patients below reported better efficacy HPC level threshold Total of 18 - 22 injections - Approved February 14, 2018 - Auto injector - ready to use device - Injection location: Upper back of the arm - Weekly visit to/by health care provider - 37.3% of subjects identified injection site pain as a treatment emergent adverse event compared to only 8.2% of subjects in the IM arm
LPCN 1107 - Oral HPC Potential for superior efficacy with Phase 3 target dose No patient discomfort upon administration Steady state achieved in 7 days Orphan drug designation - Major contribution to patient care Next steps: - Explore partnering opportunities LPCN 1107: First Oral PTB Candidate 35 Addresses Unmet Need
LPCN 1107: Economic Impact Potential Lower PTB Rate - US and Resulting Savings Assuming 4.3% lower PTB rate relative to Makena ~6000 fewer annual PTBs Estimated annual cost saving in ~$310M 36 : Assuming 100% of 140,000 eligible US population treated : Assuming ~$51,600 medical costs/PTB
LPCN 1107: First Oral PTB Candidate First Oral HPC for Prevention of Recurrent PTB Preferred route - of - administration is oral Strong Exclusivity Position Orphan Drug Designation Technology/IP protection Potential for Superior Efficacy Fewer PTB babies with significant healthcare cost savings Strong Pharmaco - Economic Justification Minimize travel related cost/time and healthcare provider cost/time Premium pricing potential to generic IM injections 37 Commercial Outlook/Drivers
LPCN 1107: HPC PK - PD Correlation 38 HPC Concentration and PTB Rate with IM HPC, Makena 1 N=315 1. Caritis et al., Am J Obstet Gynecol. 2014 (N=315 subjects) 2. C trough C avg for IM Makena Lower % PTB rate can be expected with daily C avg 2 HPC levels 8.2 ng/mL 46.3% 27.0% 29.6% 31.3%
LPCN 1107: Dose Finding Study Design Open - label, four - period, four - treatment study 12 healthy pregnant women - Ages 18 - 35 years; 16 - 18 weeks gestation All subjects received all four treatments 39 PK Study: Oral LPCN 1107 vs IM HPC, Makena Treatment D 250mg Weekly Treatment C 800mg BID Treatment B 600mg BID Treatment A 400mg BID IM HPC, Makena LPCN 1107, Oral HPC Multiple dose: 5 weeks Multiple doses for 8 days
LPCN 1107: Dose - Finding PK Study Results 1 40 Oral LPCN 1107 vs IM HPC, Makena 1. PK results obtained post 8 days of BID dosing for LPCN 1107 and post 5 weeks for weekly IM HPC, Makena Lower reported PTB rate threshold HPC levels below 8.2 ng/mL: - Target LPCN 1107 Phase 3 dose was 0% vs 20% subjects using IM HPC Makena per label Average HPC levels at target LPCN 1107 Phase 3 dose - ~ 3x greater than the comparator, IM HPC, Makena Target Phase 3 dose 0 10 20 30 40 50 60 0 100 200 300 400 500 600 700 800 900 1000 Cavg(0 - 24/ 0 - 168) (ng/mL) BID Dose (mg) IM 250 mg Oral 400 mg Oral 600 mg Oral 800 mg Weekly