Welcome to the Viking Therapeutics First Quarter 2024 Financial Results Conference Call. [Operator Instructions] As a reminder, this conference call is being recorded today, April 24, 2024. I would now like to turn the conference over to Viking's Manager of Investor Relations, Stephanie Diaz. Please go ahead, Stephanie.

Hello, and thank you all for participating in today's call. Joining me today is Brian Lian, Viking's President and CEO; and Greg Zante, Viking's CFO. Before we begin, I'd like to caution that comments made during this conference call today, April 24, 2024, will contain forward-looking statements under the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995, including statements about Viking's expectations regarding its development activities, time lines and milestones. Forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially and adversely and reported results should not be considered as an indication of future performance. These forward-looking statements speak only as of today's date, and the company undertakes no obligation to revise or update any statement made today. I encourage you to review all of the company's filings with the Securities and Exchange Commission concerning these and other matters. I'll now turn the call over to Brian Lian for his initial comments.

Thanks, Stephanie, and good afternoon to everyone listening in by phone or on the webcast. Today, we'll review our financial results for the first quarter ended March 31, 2024, and provide an update on recent progress with our clinical programs and operations. During the first quarter, Viking announced positive results from 2 of the company's key pipeline programs. First, our Phase II VENTURE study, evaluating our dual GLP-1 and GIP receptor agonist, VK2735 in patients with obesity, successfully achieved its primary end point and all secondary end points demonstrating statistically significant reductions in body weight at all doses as compared to placebo. Also during the quarter, the company announced results from a Phase I clinical trial evaluating an oral tablet formulation of VK2735. This study demonstrated encouraging safety and tolerability as well as promising weight loss following 28 days of once-daily dosing. The company plans to advance both of these programs into further development later this year. In addition, during the first quarter, the company completed the final biopsies in the Phase IIb VOYAGE study evaluating the novel thyroid hormone receptor beta agonist, VK2809, in patients with NASH and fibrosis. We expect to report the biopsy results from this study later this quarter. Finally, during the quarter, Viking completed a public offering of common stock, raising gross proceeds of approximately $630 million. These funds substantially strengthened the company's balance sheet and will support our plans to aggressively develop our pipeline. I'll provide further details on our operations and development activities after we review our financial results for the first quarter of 2024. For that, I'll turn the call over to Greg Zante, Viking's Chief Financial Officer.

Thanks, Brian. In conjunction with my comments, I'd like to recommend that participants refer to Viking's Form 10-Q filing with the Securities and Exchange Commission, which we expect to file later today. I'll now go over our results for the first quarter ended March 31, 2024. Research and development expenses were $24.1 million for the 3 months ended March 31, 2024, compared to $11 million for the same period in 2023. The increase was primarily due to increased expenses related to manufacturing for our drug candidates, preclinical studies, clinical studies, stock-based compensation, salaries and benefits and services provided by third-party consultants. General and administrative expenses were $10 million for the 3 months ended March 31, 2024, compared to $9.5 million for the same period in 2023. The increase was primarily due to increased expenses related to stock-based compensation, salaries and benefits and services provided by third-party consultants, partially offset by decreased expenses related to legal and patent services. For the 3 months ended March 31, 2024, Viking reported a net loss of $27.4 million or $0.26 per share compared to a net loss of $19.5 million or $0.25 per share in the corresponding period in 2023. The increase in net loss for the 3 months ended March 31, 2024, was primarily due to the increase in research and development expenses and general and administrative expenses noted previously, partially offset by increased interest income compared to the same period in 2023. Turning to the balance sheet at March 31, 2024, Viking held cash, cash equivalents and short-term investments of $963 million compared to $362 million as of December 31, 2023. First quarter balance reflects receipt of gross proceeds of $630 million from the company's public offering, which closed on March 4, 2024. This concludes my financial review, and I'll now turn the call back over to Brian.

Thanks, Greg. The first quarter of 2024 was an eventful quarter as we received and reported the results from 2 key clinical trials. Our Phase II VENTURE trial evaluating subcutaneous VK2735 in patients with obesity. And our Phase I clinical trial, evaluating an oral tablet formulation of VK2735 in healthy volunteers. Both studies were successful, demonstrating promising weight loss and favorable safety and tolerability and we look forward to advancing both of these programs into further development later this year. As we have recently reviewed the results from each of these studies on separate conference calls, I'll briefly review key takeaways in my prepared comments, and refer you to our February 27 and March 26 press releases for more details. In addition, I'm happy to provide further detail in the Q&A portion of the call. I will first provide an update on our subcutaneous formulation of VK2735 for obesity. VK2735 is a dual agonist of the glucagon like peptide-1, or GLP-1 receptor and the glucose-dependent insulin atrophic polypeptide, or GIP receptor. In the first quarter of 2023, we announced positive results from a Phase I single ascending dose and multiple ascending dose study of VK2735. This study demonstrated the promising safety, tolerability and pharmacokinetics of VK2735 when administered as a weekly subcutaneous injection for 4 weeks. In addition, subjects in the study demonstrated up to 7.8% weight loss from baseline after 28 days with no signs of plateau. Based on these positive results, Viking initiated the Phase II trial called the VENTURE trial to evaluate VK2735 in patients with obesity. The VENTURE trial was a randomized, double-blind, placebo-controlled multicenter study that evaluated the safety, tolerability, pharmacokinetics and weight loss efficacy of VK2735 administered subcutaneously once weekly for 13 weeks. In the first quarter, Viking announced positive top line results from…

[Operator Instructions] The first question comes from Joon Lee with Truist.

Congrats on the quarter. Sarcopenia is getting a lot of attention these days and some companies are talking about adding SARM to GLP. You certainly have your share of experiences with SARM and sarcopenia in general. Any thoughts on bringing back 5211 as an add-on strategy? And I have a follow-up.

Joon, yes, thanks for the question. Yes, it is, I think, getting to be more popular in the conversation, what we have kind of always said and hasn't really changed. It's hard to understand the clinical significance of the loss in muscle and whether that actually has an impact on function or feeling or survival, which are what -- or typically used for approval. But -- it's a good point that 5211 compound is the most potent SARM that we're aware of. And to the extent muscle losses considered to be clinically relevant more so in the pharmacologic setting versus the regular diet exercise setting, it could be something that's really useful.

Okay. Looking forward to your update on that, can you update us on where you are with the oral VK2735 dosing and what the stopping criteria or the maximum dose that you tend to test for the oral?

Yes. Thanks, Joon. It's ongoing still and we are planning to continue dose escalation until we either get to some sort of a -- some reason for stopping or maybe a plateau on the exposures or a plateau on the weight change or some tolerability issue. And so we'll probably have more to say about that around the middle of the year when we have data from the additional cohorts.

Great. And one final question. At a steady state, stay around half year mark. Is it your expectation that VK2735 would drive percent weight loss greater than tirzepatide? Or would it be similar to tirzepatide and what is the basis for your thinking.

Sorry, on the -- were you talking about the overall or what...

Yes, for injectable, let's say, subcutaneous.

For the subcutaneous. Well, it seems that at any given dose, the exposures are significantly higher. And so whether it would be better or comparable hard to say. But I think at any given dose we should have greater load on board without -- in our view, without a meaningful change in the tolerability profile. So how that translates, I think we would have to see a longer study before making a call on that.

The next question comes from Roger Song with Jefferies.

This is Kambiz on for Roger. Maybe on VK2809, what's the general translatability of kind of the 12-week MRI-PDFF result into later histology endpoints and are you planning to move the program into -- the NASH program into Phase III yourself? Or do you intend to partner? And then maybe as a third and final question, how do you think the thyroid beta agonist market will develop. There's kind of been some recent evidence that GLP-1s, both dual GLP-1 and GIP and dual GLP-1 glucagon agonist have shown potentially fibrosis improvement. So just your thoughts on how that market will develop and will be really helpful.

Yes. Thanks, Kambiz. So with the translatability for liver fat to histologic improvement, generally, it has been shown that reducing liver fat, particularly above that 30% relative reduction threshold has led to improved odds of histologic benefit. There are some exceptions to that. But generally, there are more examples of that proving out than not. And I think it's more of a compound by compound situation when you try to translate to precise liver fat reduction to histologic improvement. I think the best comparator for us would be the other thyroid agonist that was recently approved. It showed in the -- somewhere in the teens range for NASH resolution and it did show some improvement in fibrosis. So to the extent we have a similar or better liver fat reduction, I think that would be sort of the range we would be looking at for NASH resolution and fibrosis improvement. With respect to the overall market, yes, it does seem like there is a rapid expansion of the GLP-1 utilization. And so that probably does create some headwind on the uptick of new NASH drugs, but we've not had an approved drug for NASH. So now that we do, I think it's going to be really important to see how the first few quarters mature there. And maybe there is a backlog of people waiting to try it and a backlog of clinicians waiting to prescribe it. So unknown right now, it's hard to project. But it is true that the GLP-1s are getting more and more utilization. There's a middle question in there, I think I skipped.

Yes. Just some plans on Phase III for your NASH program kind of intend to do it solo or maybe search secret partner?

Yes, yes. Great. Yes. So the -- we plan to do is, receive the data from the VOYAGE study, and then we'll schedule an into Phase II meeting with the FDA for later this year and get the current view of registration endpoints and any trial design suggestions the agency might have. And I think we'll have to see what the data look like, but we'll be -- we're probably looking for a partner with the program, but hard to say without having a look at the data first.

The next question comes from Annabel Samimy with Stifel.

I have 2 on the oral. So when you think about the additional doses for the oral, which already has shown some pretty respectable weight loss metrics. How are you balancing, how high you push the dose versus the manufacturing capacity issues getting a lot of questions around that, given the supply problems that current manufacturers have with their own therapies right now. So I just want to know if you're going into this with that thought in mind. And the second is, I guess, given some of the additional benefits that weight loss drugs are having, whether it's on CV risk or hypertension or kidney disease and now sleep apnea. Are there any additional trials or subpopulations that you can be baking into your later-stage development programs to sort of position yourself competitively even at a minimum from a payer perspective, as the space evolves without having to do Phase IV trials, but at least have some kind of idea or metric in the late-stage trials that you're already designing. So those are my questions for now.

Thanks, Annabel. Yes. For the second question, we'll probably focus mostly on obesity as the primary or early indication, but all of the subsets that you just mentioned and the successes in those populations are really important. So to the extent we could add a cohort with dyslipidemia or something like that to look at effects on plasma lipids that might have a read through the cardiovascular benefit that maybe we're primarily, though, looking at the weight loss indication for the Phase III program. With respect to manufacturing, it's an area that, yes, we're acutely aware of it. And I think a couple of things. We're right now in this very acute stage where these compounds have just been recently approved for weight loss and there is just overwhelming demand and the supply isn't quite there. We don't consider that to be a terminal state. We do see from the existing companies in the space, ramp-up in manufacturing capacity. We know on the contractor side, there is a massive attention being paid to this issue. And so I think the supply dynamics will probably evolve over the next few years. Still going to be a difficult challenge, but I think we're not in a permanent shortage state, we don't think.

The next question comes from Jay Olson with Oppenheimer.

Congrats on all the progress, and thank you for providing this update. For subcu VK2735, what kind of data should we expect in 2Q? And do you think you'll have enough data to support less frequent dosing? And then -- what are your latest thoughts on the Phase IIb study? And then I had a follow-up question, if I could.

Yes. Thanks, Jay. So we'll -- we haven't received the final data from the study yet. So we would be looking for the lipid data, some of the PK data, the exposure data after 4 and 6 weeks after the last dose. That sort of thing, I think, would be important for us to understand. And what's the proper form for presentation maybe some of it would trickle into earnings updates or corporate presentations. But probably later in the year, we would have a presentation at a medical conference. And with respect to less frequent dosing, and that's part of the PK data that we will receive, if it looks like we're in a therapeutic range at some period after the last dose, maybe that will be a feasible strategy and we would look to incorporate that into a subsequent trial. So really important data coming out of the PK data set.

Okay. Great. And latest thoughts on a Phase IIb study?

Phase IIb study, yes, we're going to have a Type C meeting with the FDA later this quarter. And so we would hope to be able to start the next study, a Phase IIb study seems likely, but we would look to start to that later in the year, probably fourth quarter would be the timing for that study.

Okay. Great. And if I could ask one more question. Given the positive data you've already presented for both injectable and oral VK2735 what additional cards would you like to turn over before seeking a partner or a potential strategic transaction.

Well, I think more data is always helpful to potential partners, but we don't view it as gating for us to have meaningful conversations. And I'm not sure it's necessarily gating for others to have meaningful conversations with us. But generally, the larger partners like to see more data as programs evolve. But again, not a -- I don't think that's a mandatory requirement right now.

Next question comes from Andrew Hsieh with William Blair.

So the first one I have is really on the potential framework for duration for the Phase II subcutaneous study, maybe from 2 directions. One is really on maybe the GLP talks, maybe you can provide us with an update regarding how long you can dose this upcoming study based on all the GLP talks that you've done to date? And then secondarily, it's mostly like a [indiscernible] question on how you view the importance of seeing a pretty consistent plateauing just to get the maximum weight loss data just in terms of derisking the program, is it important to see the plateauing.

Yes. Thanks, Andy. For the plateau, from what we've seen right now, the Phase IIb studies that were performed with semaglutide and tirzepatide had not plateaued prior to the registration studies being initiated. So it's hard to really know how the FDA will judge the assessment of a plateau when the currently approved drugs did not reach that in their Phase IIb studies. So that's one of the things we hope to learn a little bit about in the upcoming Type C meeting. With the tox coverage, we're finished with the chronic talk. So we don't have a limitation toxicity wise or GLP tox study limitation on duration. So we could dose as long as we'd like. And I think probably 6 months or 9 months would be the 2 most likely candidates for duration of the Phase Ilb.

Got it. That's helpful. Since we're talking about the upcoming discussion with the FDA, I'm just curious if you have any lingering questions or action items you'd like to discuss with the agency around midyear?

Well, we're not going to disclose the nature of the conversations, but we're interested in study design and duration and going back to your question about understanding the ideal duration prior to Phase III. So those are all key questions.

Got it. Okay. And then lastly, the Gannex dispute, obviously, we're expecting NASH data coming up. So curious if there's any sort of procedural things that we should anticipate with the IP dispute there.

Yes. So we would expect a ruling on that dispute sometime this quarter, but hard to speculate since it's ongoing litigation.

The next question comes from Steve Seedhouse with Raymond James.

This is Nick on for Steve. We have a question related to Annabel's on manufacturing. Are you able to specify what materials or factors are most gaining to ramp up commercial supply of 2735. And would this only be a potential issue for the higher doses of the oral formulation?

Yes. Thanks. I think it's an issue for all doses. When we look at the currently approved drugs that are difficult to start because of shortages. So I think all doses, it's relevant to today. With respect to overall, what is the -- where the great shortage. I mean, they're -- throughout the supply chain, solvents, whatever is needed for solid-phase synthesis fill and finish materials. So it's a pretty thorough shortfall right now. But again, we don't think that's going to be a terminal state for this class of compounds. When you look at the market opportunity, that incentive is pretty high to figure out these problems.

[Operator Instructions] The next question comes from Thomas Smith with Leerink Partners.

Just ahead of the VOYAGE study readout, can you remind us what your expectations are on the 2 histology endpoints, fibrosis improvement and NASH resolution. And -- can you comment on what data you expect to have available at the top line versus data sets that you expect to receive later or perhaps say, for presentation at a medical meeting?

Yes, yes. Thanks, Tom. So on the hurdles, what we've always thought is if we can show a NASH resolution delta in that low to mid-teens rate for treated versus placebo. And for the proportion of patients with a 1-point improvement without worsening of NASH, similarly, sort of low double digits, although with fibrosis, I would be -- I would not be expecting statistical significance just because the numbers are smaller. But those would be the key hurdles that we're looking for with the data set. With respect to what would be available and when, well, those are the primary components of the data that we'll receive. We will be receiving probably a little later data on paired biopsy reads, what is someone's NASH better, unchanged or worse at the end of the treatment period, that kind of thing since those take a little bit longer to evaluate.

Understood. That's helpful. And then just for oral 2735, can you just clarify, do you expect to report data from the ongoing higher dose cohort once that's available or is it possible that you could add some additional higher dose cohorts before we see any incremental data from the study?

Probably more of the latter. So we don't just kind of drip data out. We would probably want to report what we have when the study is completed rather than cohort by cohort.

The next question comes from Yale Jen with Laidlaw & Co.

Brian, you're talking about that 2735 later on will be presented at the medical conferences. Just curious anything in mind at this point that you are thinking?

Yes. Thanks, Yale. Last year, we presented the Phase I data at Obesity Week and so that would seem like a good candidate. We haven't submitted anything but that would seem like a good candidate for data presentation.

Okay. That's helpful. And a follow-up question here is that for the subcu version, 2 things here. One is the auto-injector, are you guys are already working on that? And secondly is that do you anticipate any kind of bridging PK study in between before you heading to more pivotal studies.

Yes. Great question, Yale. We will be using the pen type device. And we would hope that's available prior to initiation of the next clinical study, but we're not going to let that be a gating factor. So if the device is not ready, we would plan to start the study with vial and syringe and then transition on to the auto-injector.

But do you anticipate at one point, even whether you start earlier before that or later that you need a bridging study for that? Or you think that PK data could be supportive?

Well, no, I don't think we would need a bridging study at this point. That's not what we're contemplating. I mean, if we have to do when we would. But I don't think that's going to be a requirement we would transition people.

Congrats on the progress further.

The next question comes from Justin Zelin with BTIG.

Congrats on the progress. Brian, you just mentioned for the VOYAGE study for fibrosis, you mentioned that there might be a few patients here. Can you just remind us if the study is powered to show a difference in fibrosis in the study? And I have a follow-up.

Yes. Thanks, Justin. It wasn't powered on fibrosis. It was powered on NASH resolution rates. And I'm not sure we ever disclosed the power. It's in the 80% range to show approximately a 20% delta on NASH resolution. But it was not designed around fibrosis since that generally requires quite a bit larger end than we have in this study.

Understood. That's helpful. And maybe I'll ask because I don't think any others have asked yet. Just expectations on 0214 for X-ALD, what would be a success here in your view for the Phase Ib.

Yes. Yes. So we have previously shown with that compound, somewhere in the 20% range on LDL reduction and in the 20% range for ApoB [indiscernible]. So we know it's effective at lipid reduction. And we also looked at very long chain fatty acids in the healthy volunteers. It's kind of tough to look because they're -- they're healthy volunteers, and they don't really have abnormalities and very long chain fatty acids, but we did see some reductions in very long-chain fatty acids in the prior Phase I experience. So if we can see somewhere in the mid- to high teens on the very long chain fatty acid reduction, that would be pretty interesting, hopefully, more than that, but that would be probably the gating factor to consider further development in X-linked adrenoleukodystrophy.

This concludes our question-and-answer session. I would like to turn the conference back over to Stephanie Diaz for any closing remarks.

Thank you again for your participation and continued support of Viking Therapeutics. We look forward to updating you again in the coming months. Have a good afternoon.

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.