Viking Therapeutics, Inc. Aktie

Welcome to the Viking Therapeutics VK2735 Maintenance Study Top Line Data Conference Call. [Operator Instructions] As a reminder, this conference call is being recorded today, September 22, 2026. 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; Hubert Chen, Viking's Chief Medical Officer; Greg Zante, Viking's CFO; and Dr. Louis Aronne, former President of the Obesity Society and a renowned investigator and KOL in the field of weight loss therapeutics.

Before we begin, I'd like to caution that comments made during this conference call today, September 22, 2026, 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 morning to everyone joining us on the call today. Earlier this morning, we issued a press release describing the top line results from Viking's novel maintenance dosing study of VK2735. As a reminder, VK2735 is a dual agonist of the GLP-1 and GIP receptors in development for the potential treatment of obesity.

Co-activation of these receptors has been shown to decrease glucose, reduce appetite, lower body weight and improve insulin sensitivity in patients with obesity, type 2 diabetes or both. Due to these 2 mechanisms having complementary activities, this approach has shown generally improved therapeutic benefits compared with GLP-1 monoagonism.

As we look across the development program for VK2735, as this slide shows, we have a lot of activity going on. Viking is currently conducting 2 Phase III clinical studies with subcutaneous formulation of VK2735 called VANQUISH-1 and VANQUISH-2. VANQUISH-1 is evaluating VK2735 for the treatment of adults with obesity and VANQUISH-2 is evaluating the treatment of adults with obesity and type 2 diabetes.

Both trials are fully enrolled, and we expect the results from the program to be available in 2027. We are also excited to be developing an oral tablet formulation of VK2735. We're planning to begin in the near future, 2 additional Phase III trials with this formulation.

These 2 studies will mirror the subcutaneous VANQUISH studies and target patients with obesity and patients with obesity and type 2 diabetes. Today's focus will be on the right-hand side of this slide, and that's our recently completed innovative dose-ranging study designed to evaluate multiple more convenient, less frequent dosing regimens for the long-term maintenance of weight loss.

Prior clinical and nonclinical studies with VK2735 demonstrated the compound's differentiated exposure and pharmacokinetic profile, including a slower time to peak exposure, which may mitigate gastrointestinal side effects. Additionally, VK2735 has an extended half-life that suggests the potential for more convenient and less frequent regimens for weight management.

In particular, our prior Phase II VENTURE study demonstrated prolonged plasma exposures at levels we believe suggested correspondingly prolonged therapeutic benefits. The totality of these prior results led us to explore the novel maintenance dosing study that we are reporting this morning.

We believe providing patients with flexible dosing options will help ensure that each individual can tailor their treatment for maximal effect and convenience. Less frequent dosing regimens could represent attractive options for those patients who have achieved their weight loss goals and are seeking to maintain that weight loss moving forward. Importantly, by using the same therapeutic agent for both the initial weight loss and for the longer-term maintenance phase of weight management, we believe patients may experience reduced side effects compared with options that require switching between different therapeutic agents.

By reducing side effects, we believe adherence to treatment may be improved, allowing patients to ultimately realize the long-term benefits of weight loss such as improved cardiovascular health, enhanced physical function and increased quality of life.

During the fourth quarter of 2025, Viking initiated a novel dose range finding study to explore various maintenance dosing regimens. In this study, all subjects initially received weekly doses of VK2735, followed by a transition to a range of maintenance regimens, including weekly, monthly and every other week dosing or placebo.

The objectives of the study were to evaluate the safety, tolerability and pharmacokinetic profile of VK2735 under these various regimens. Exploratory endpoints are assessing the change in body weight from baseline as well as the change in body weight during the maintenance portion of the study. The results from this study will help inform the selection of doses in the upcoming VANQUISH extension studies expected to begin late 2026 or early 2027. Before we discuss the results, I'd like to remind everyone that we have only recently received these data.

We believe we have enough information to report on certain of the study's objectives, but we have not yet received all of the data nor have we had time to rigorously evaluate every line item in the data received.

As these are top line results, there may be differences in certain elements of the data that arise upon receipt of the final results later this year. We also plan to present the results at future medical meetings, so we may wish to preserve certain details until those presentations.

With that background, we're pleased to share with you on this call an overview of the initial results as well as key takeaways from the study. This slide summarizes the maintenance study design. This is an elegant study that could actually be viewed as 4 studies in 1, a 21-week induction study, a 12-week monthly maintenance dosing study, a 12-week every other week maintenance dosing study and a 33-week study utilizing a 17.5 milligram weekly dose. 180 subjects were randomized across 11 treatment groups and subjects were randomized to have a BMI of at least 30 but no other comorbidities. Induction doses ranged from 15 milligrams per week up to 22.5 milligrams per week or placebo administered once weekly by subcutaneous injection for 21 weeks.

Final doses were achieved via titration that generally followed 2-week dosing blocks for successively higher doses. Following the 21-week induction period, subjects were transitioned to a range of maintenance regimens, including monthly and every other week dosing or placebo for an additional 12 weeks.

This slide shows the weight loss achieved through the initial 21 weeks of weekly dosing. Here, we see a nice steep progression at all dose levels with no signs of plateau at 21 weeks for any dose. Week 21 weight loss ranged from approximately 16% to approximately 19% compared with approximately 0% for placebo.

All doses clearly separated from placebo starting at week 4 with p-values at each dosing level less than 0.0001 compared with placebo. This slide shows the proportion of subjects across combined VK2735 treatment groups achieving specific weight loss thresholds. Among treated subjects, 98% achieved 5% weight loss, 90% achieved 10%, 65% achieved 15% weight loss and 32% achieved 20% weight loss. This compares well with the placebo cohort, of which only 13% achieved 5% weight loss and none achieved 10%, 15% or 20% weight loss at week 21.

These are very robust data and based on the trajectory shown on the prior slide, almost certainly expected to improve with continued dosing. Turning now to the maintenance portion of the study.

This slide is looking at the maintenance effect when subjects were transitioned to every other week dosing from weekly dosing, and it shows the proportion of the initial weight loss that was retained following the transition from weekly to every other week dosing.

Among VK2735 treated subjects, the mean weight loss retained at week 33 ranged from 83% to 97% compared with 61% among subjects transitioned from 17.5 milligrams weekly to placebo with p-values less than 0.01 for each cohort versus placebo. Here, we can see the placebo cohort demonstrating a rapid decline of weight loss benefit over the 12-week treatment window compared to each of the every other week dosing regimens. Given the fact that dosing was effectively reduced by up to 85% in these treatment groups, the data are particularly impressive and support the concept of less frequent dosing as a potentially viable regimen for longer-term weight management.

Turning to the monthly maintenance portion of the study. Here, we see the proportion of the initial weight loss that was retained following the transition from weekly to monthly dosing. Among VK2735 treated subjects, the mean weight loss retained at week 33 ranged from 82% to 90% compared with 61% for placebo with p-values less than 0.01 for each cohort versus placebo.

As with every other week dosing, the fact that dosing was effectively reduced by up to 85% in these cohorts demonstrates a compelling maintenance signal and supports the concept of less frequent monthly dosing as a potentially viable regimen for longer-term weight management.

When we look at the cohort of subjects who were maintained on a 17.5 milligram weekly dose for the entire 33-week treatment window, this slide shows the continued weight loss trajectory for the cohort throughout the study period, reaching 21.7% weight loss from baseline and 22% placebo adjusted. No plateau was observed, suggesting further weight loss might be expected with continued dosing. We believe these results are very encouraging. Looking across the current treatment landscape, the currently approved GLP-1/GIP agonist has demonstrated approximately 14% placebo-adjusted weight loss at week 33.

In addition, the most advanced triple agonist in development with glucagon activity demonstrated approximately 17% placebo-adjusted weight loss at the 33-week time point. These are, of course, published data using different titration methods and not head-to-head study data. But nonetheless, we understand it will be a top-of-mind question despite the significant caveats and risks in cross-trial comparisons.

Turning to tolerability. This slide shows the discontinuations and GI adverse events reported for the 21-week induction period of the study. Overall, there were very few discontinuations due to adverse events. And looking at the common GI adverse events of nausea, vomiting, diarrhea and constipation, we see a profile very consistent with what was observed in our prior Phase II VENTURE study with maybe slightly lower rates of nausea and slightly higher rates of vomiting, but overall, very consistent with what was observed previously. This is really quite interesting as these subjects titrate faster every 2 weeks compared with the 3-week schedule used in the Phase II study. Overall, no surprises here and a consistent profile despite accelerated titration. Turning to tolerability under an every other week dosing regimen. Here, we see a very clean profile.

Treatment-emergent adverse events were similar to placebo and GI-related adverse events were generally low and no different from placebo. This is very encouraging and indicates no incremental change in adverse events versus placebo when dosing under an every other week schedule. Even more impressive are the adverse events under the monthly dosing schedule.

Here again, we see a clean overall profile with minimal GI-related adverse events. As this table shows, overall rates of nausea, vomiting, diarrhea and constipation were not meaningfully different from placebo, suggesting excellent tolerability under a monthly dosing regimen.

In addition to the impressive weight maintenance effects discussed a minute ago, this is an equally exciting result from this study. When we started the study, we were cautiously optimistic that the tolerability profile that might be observed when subjects extend their dosing intervals to 4 weeks would be close to that observed under the standard weekly schedule for use for titration. These data suggest that despite a gap of 4 weeks between doses, these individuals did not resensitize to GI adverse events such as nausea or vomiting.

This supports our view that VK2735's differentiated PK profile with an extended half-life and excellent long-term exposures may provide for greater flexibility in dosing compared with existing options. In summary, we are extremely pleased with the outcome of this study as we believe it demonstrates a credible maintenance effect, which was a key objective going in.

We have observed a high rate of weight loss maintenance up to 97% following transition to every other week dosing from weekly induction. The trial also demonstrated up to 90% weight loss maintenance following transition to monthly dosing, suggesting the potential viability of both regimens in the setting of maintenance dosing. We also saw a highly competitive weight loss of 22% among subjects titrated to 17.5 milligrams weekly for 33 weeks and no evidence of a plateau at that point, which suggests there may be more to go. Finally, under both maintenance regimens, we observed tolerability that was not meaningfully different from placebo. This again suggests the viability of less frequent dosing without incremental worsening of common adverse events. More work is needed, but we're certainly happy with the results. I'll close by reiterating that we believe long-term weight management will not follow a standard one-size-fits-all approach.

Individuals pursuing sustainable weight loss will seek a range of treatment options that allow them to personalize their weight loss journey at every stage. We believe offering flexibility and optionality to patients will lead to improved adherence to treatments, allowing patients a greater opportunity to realize the long-term benefits of weight loss such as improved cardiovascular health, enhanced physical function and increased quality of life.

Dr. Louis Aronne, who has unmatched experience in developing and prescribing GLP-1 and dual GLP-1/GIP agonist is also joining us on this call and can share his perspectives in the Q&A session on what these promising findings mean for patients. This concludes our prepared comments for today. Thanks for joining us, and we'll now open the call for questions. Operator?

We will now begin the Q&A session. [Operator Instructions]. Please note that we have large number of participants in the queue, the company will do its best to answer as many questions as possible. Thank you. At this time, we will pause momentarily to assemble our roster.

[Betsy], this is Brian Lian on here. While we're compiling the queue, maybe I'll take the first question and just ask Dr. Aronne if he can share any thoughts on the data and what it might mean for patients. Dr. Aronne?

Thank you very much, Brian, for letting me see the data and inviting me to participate. What I can say is that based on my 35 years of experience doing this, I think it's pretty clear that VK2735 is highly effective. It's among the best that we've seen for available drugs at 22% weight loss over 33 weeks. One of the things that we're learning is that efficacy, maximum efficacy is maybe not the most important thing these days now that we've gotten such good efficacy, but that treatment persistence is actually key.

And having simpler and less frequent treatment regimens would make sense as a better way to use these. We're actually seeing that clinically. Our patients, once they hit a plateau are starting to use the drugs that are currently available less frequently. One of the interesting things is that here, lower doses seem to be effective and quite tolerable for maintenance.

So the full dose, if someone saying 17.5 weekly, you don't need to use 70 milligrams monthly in order to maintain significantly lower doses appear to be maintaining the maximal weight loss or something close to that. Another interesting aspect to this trial is how well tolerated the drug is. It appears to me to be at least as well tolerated as the currently available options despite the rapid titration scheme.

That's usually when we see most of the side effects and the fact that it's tolerable even though it was about twice as fast as we would normally titrate, I think, speaks to its tolerability. It looks like 17.5 milligrams is the best balance. It produced the greatest weight loss, and that may be because it had fewer side effects than the higher doses, but we're seeing this in other trials where one dose seems to shine through.

And I think that in the long run, this is very promising for less frequent treatment regimen. I think that every other week is clearly realistic and once a month in other subjects or other patients is how this will be used. So I think an important point you made is that flexibility in treatment is what's key.

And when people look at the fact that not everybody continues on the current medications, it's because we need more medications with slightly different mechanisms of action and slightly different ways of taking them. So thanks very much for asking me to comment on this.

Thanks very much, Dr. Aronne. We'll open the call up now for questions, operator.

The first question today comes from Steve Seedhouse with Cantor Fitzgerald.

Congrats on a really nice data set. I have just a 2-part question on dose selection and then one follow-up, if I could. So on the doses, first of all, have you decided on the maintenance dose that you would incorporate into the Phase III open-label extension?

And is it possible that you could incorporate something like patient choice, flexibility to choose their dose as you've been articulating on the call here. And then also, the press release mentioned the opportunity to evaluate additional higher doses.

And I'm curious if that's referring to like higher than 22.5 mg or higher than 17.5 in the Phase III or what that's referring to? And if you would test that in the oral maintenance study?

Yes. Thanks, Steve. For the second question, yes, it does mean that based on the very clean tolerability that we've seen here, it opens the possibility to explore higher doses. Just -- we just see no real impact on tolerability at all in the maintenance phase.

What doses that we plan to take on in the maintenance, we haven't decided yet. We're still in the process of going through all the data. But I think we have a reasonably good idea of what that range would be, but we're not prepared to announce those doses today. But I think it gives us plenty of options based on the data.

Okay. And then the other question I had was just Obviously, there's sort of 2 factors in the induction phase here weighing on adverse events, there's the aggressive titration, but then there's that 1.25 milligram mini step at the start.

And obviously, you've incorporated that in a sense in Phase III as well. And I'm curious if you have the data on AEs by week and if you can basically see if that 1.25 milligram step was helpful and mitigated some of the early adverse events relative to Phase II.

Yes. Thanks, Steve. It seems to help a little bit. We don't have all the per cohort data for those histograms that we like to present. But it does suggest that -- first of all, I'll say, across the entire induction phase, if you look at the combined treatment groups, the rates of GI adverse events were always extremely low, probably in the 5% range across the induction period.

But how important that 1.25 is, I think it's helpful. We'll have a better idea once we get the breakouts, but I do think that does help.

The next question comes from Biren Amin with Piper Sandler.

On the data. Maybe on the maintenance phase of the study, Brian, could you maybe just talk about the placebo arm? I think 61% of the patients kept weight loss. Was that as expected when you designed the study? Or was that higher than expected based on your original assumptions?

Yes. Well, the data show that the placebo cohort, the mean of the placebo cohort was a 61% retention. So in other words, they rebounded by 39%, if that makes sense.

And that is within range from published studies over 12 weeks, when you withdraw therapy, you typically see anywhere from, call it, 15% to 40% rebound in a 12-week period. And so that 39% rebound is within range from what's been published previously.

And then maybe just one question on the 17.5 milligram weekly dose for both induction period as well as at week 33. Clearly, you're seeing progressive weight loss across both time periods.

Can you just maybe talk about the nausea and vomiting rates that you saw with those doses and just read-throughs into VANQUISH-1 based on these data, given that's the high dose that you're testing in VANQUISH-1 and VANQUISH-2?

Yes. Very well tolerated in that maintenance period for the 17.5. It seems like -- and this is not unique to Viking. It just seems like the GI adverse event profile of GLP-1 activation tends to be an early GI tolerability signal that fades over time. So no real difference there. I think it's very well tolerated.

And as Dr. Aronne said, despite the acceleration in titration in that 21-week induction period, tolerability was really consistent with what we've seen in the Phase II study.

The next question comes from William Wood with B. Riley.

On the very nice data. Just thinking about for the induction period, 20 mg came out the best with 22.5 mg actually coming in slightly worse than 22.5, at least on the weight loss. So I was curious if you could speak to any differences in the patient population that may have been enrolled or discontinuations? Or how do you think sort of -- is this more sort of towards a small sample size?

And then following the weekly to monthly transition, you actually achieved a higher percent maintenance with the 17.5 mg dose than the 22 mg. So just curious as you think why that may be occurring? Any thoughts on that on those 2 would be very appreciated.

Yes. Thanks, William. I think the -- when you look at the cohorts, really all of them, I don't know, better or worse is the right characterization. They all are very good. And as far as the 22.5, I think it's a very small cohort.

So probably the most likely explanation there is that the N was small. You do see a modest dose response when you go up from 17.5 mg to 20 mg -- 15 mg, 17.5 mg to 20 mg and then a slight downtick in the 22.5 mg. But really, that doesn't concern us. It's a very small cohort size there.

Got it. And then maybe if I can squeeze in one more. Just given the lack of tolerability spiking it on a per month basis and now incorporating those lower doses, could you provide how you sort of think about tolerability improving even further in the VANQUISH-1 trial coming out?

Yes. Thanks, William. Well, we think the data support our thesis that we had after the VENTURE study, the Phase II study that it seems like the PK profile where we have sort of a slower onset of action, a later Tmax, it probably serves to mitigate some of the common GI adverse events that are observed.

And then you couple that with a lower starting dose of 1.25, and we would hope that, that would mitigate some of the GI adverse events that are really common to these therapies.

The next question comes from Annabel Samimy with Stifel.

Congratulations on the data. So I mean, I have to say you have a wide luxury of options here. So I just want to go back to the question regarding what your expectations are for the open label, how you might use this data to select an actual dose range because it seems like there's a pretty clear -- there's a consistency of response anywhere between 85 and 90 regardless of the dose.

So is there a possibility to offer a physician's choice for the open-label section of VANQUISH? And what would the regulatory requirements be for that phase of the trial?

Yes. Thanks, Annabel. I think what we'd like to do, we haven't made decisions on doses just yet, but what we'd like to do is incorporate probably examples of both the every other week and the monthly regimen in the extension.

We do have some questions in front of the FDA right now about dose selection and dose frequency. So when we receive our responses from the FDA, we can make a better informed decision. But right now, I think we have nice options, as you say, to select doses either monthly or every other week, every week.

The next question comes from Mike Ulz with Morgan Stanley.

It's Abhinav on the line for Mike. Congratulations on the data. I guess just thinking about the oral maintenance study coming up, I guess what we see is the read-through from the subcu to the oral. Should we expect similar tolerability and then -- and weight maintenance?

And then I guess a question for Dr. Aronne is with the data on hand today, I guess, how would you integrate VK2735 into your practice should it be made available? And I guess also on that, could you talk about the importance of having an oral option?

I'll take the first question with the oral. The oral doses that we selected are 17.5, 27.5 and 35. The exposures there with -- since the oral has lower exposures, we expect the exposure to come down a little bit versus the subcu, but it's offset a little bit by the daily dose regimen.

So how that actually plays out, we won't know until we see the data. But I think there's offsetting factors there that make us pretty excited about the potential for the oral maintenance option. And I'll turn it over to Dr. Aronne for the second question.

Yes. I think that having the option of every other week and once monthly dosing is going to turn out to be very useful in the long run. And we need that in order to maintain persistence. If you look at the biggest threat to weight loss maintenance with the current drugs, it's that people stop taking them after a period of time.

And if they could take them less frequently, I firmly believe that they would do a better job of it. So to me, the fact that you could take 10 milligrams every other week and maintain the weight loss, that's pretty remarkable. So I can see where this fits right away.

The next question comes from Gregory Renza with Truist.

It's [Anish] on for Greg. Congrats on the data this morning. Just first, in the context of retention, how do you think about the 4-week on maintenance exposure? And is there a dose below which the every other week construct stops holding?

And second is a quick one. How durable do you see weight loss off drug? And how does that shape the commercial case for staying on a maintenance dose at all?

Yes. Thanks, Anish. So it looks like even down to that 5 mg every other week, you see a pretty effective maintenance despite coming way down in dose from that 17.5 mg per week. You do see a little bit of a dose response there. So the exposures are showing up there. But I would say an 80% weight loss maintenance is still very, very encouraging. And I think some people would gravitate to that.

Where it goes from there, obviously, if you go to 2.5 every other week, that's probably going to give you a less effective maintenance dose. But that -- the floor looks like it's sub-5 milligrams, which is surprisingly good for that. And what was your second question?

The second question was just on the durability of weight loss off drug. I know we're not here yet, but just a good chance to kind of give us a sense of how you're thinking about that in the commercial case for staying on a maintenance dose.

Yes. Well, we know -- and I think Dr. Aronne probably has far more insight on this than I do. But we know that as you see in the placebo cohort that withdrawing therapy leads to a pretty rapid regain. And I don't know, Dr. Aronne, if you have any other comments on that.

Sure. There's tremendous variability from person to person in how long they can maintain if they don't take medication. We see some people who must continue taking it weekly or even more frequently than weekly with the current medications.

And others can seemingly take a dose every 10 days, 2 weeks or even once a month, even with the current meds. So I think that having flexibility being able to accommodate patients' needs is really the key to long-term persistence.

The next question comes from Ryan Deschner with Raymond James.

Congratulations on the impressive data readout. The weight loss maintenance appeared to kick up, I guess, in the maintenance in the final weeks in that week 29 to week 33. How are you thinking about what's driving this?

And how do you think this might mature over subsequent time points as we'll see it in the extension for some of these cohorts? And I have a follow-up.

Yes. Thanks, Ryan. I think you're pointing out a really interesting observation, and that is in that first little period following the transition, you see a little bit of a -- I don't know, a little bit of a rebound, a little bit of decline in the maintenance effect.

And then it begins to -- I don't know, it looks like you're seeing a resumption in the weight loss and the and the maintenance effect. How that plays out over time, we don't know, but all of the curves are pretty consistent and I think very encouraging for longer-term maintenance.

That was a bit of a surprise to us that you would see this uptick, but it's very consistent and it clearly looks real. So that's a really encouraging sign.

And then I also wanted to ask the -- post the transition, the safety and tolerability data is remarkably good. Does this make you more aggressive in terms of the dose selections for an expanded oral maintenance cohorts later on next year?

Yes. It's a good question. It makes us more, I think, encouraged for both oral and subcu. It looks like we have we have good room on the tolerability side to potentially dose up.

So we haven't made any final decisions on what additional subcu doses we would pursue. But having that room to dose up with good tolerability is a really nice place to be a nice optionality.

The next question comes from Andy Shay with William Blair.

Congratulations on the data. So what we saw is really kind of the short-term goals of weight and maintenance. I'm curious if Brian or Dr. Aronne, want to comment on potential readthrough to longer and perhaps most important, which is the cardiorenal protection.

So any sort of extrapolation from today's data that you can extrapolate to the multi-organ protection benefits of incretins. And then Dr. Aronne, I'm curious if you can comment on really kind of the third aspect of extended dosing. You mentioned about the weight maintenance.

You mentioned about the improved tolerability with extended dosing, but perhaps the cost savings for patients in your clinic by extending it 2x, 4x and how that would lead to better persistence?

Sure. I'll take -- go ahead, Dr. Aronne. -- Go ahead.

Go ahead, Brian, you can start.

Well, I was going to say just a global comment that it seems like the more weight loss you can maintain in these longer-term dosing periods, the more benefit you retain, whether it's better sleep apnea or cardiorenal protection or we see these cardiometabolic parameters once you can maintain at least 75% of that initial weight loss, those parameters would seem to be maintained as well, providing a strong suggestion of long-term benefits. And I'll give it to you, Dr. Aronne.

So the evidence is growing that once you get to 15% weight loss or greater, you get the majority of the benefit for many of the cardiorenal, cardiometabolic complications of obesity. Once you get to 20%, you get 98%, I would like to say.

But then there are some that are clearly dose weight loss dose related, like sleep apnea. The more weight you lose, the better you do. So there's a mixture of these. But in general, I think we're going to be targeting somewhere between 15% to 20%, you're going to do great. And with this compound, it looks like that is definitely in the cards. As far as the idea of taking it less frequently, many of our patients are paying out of pocket for these.

And so they take it less frequently just because it is less expensive. So I think that this will be very appealing to patients knowing that they can take it less than every single week. The idea -- so you take it every week for 9 months and then you go to every other week and then depending upon how you do, maybe you take it every month.

I think that, that idea would be appealing to patients, but also the payers that it's not that the patient has to take it every single week. Now it may be that for the maximum weight loss, you do need to take it every week. But again, that -- it may be that, that's not necessary for the average person.

The next question comes from Jay Olson with Oppenheimer.

Congrats on these impressive results. Can you talk about the level of derisking these data provide for your Phase III subcu program?

And then related to that, since you've now set a really high bar for subcu maintenance efficacy and tolerability, what would you like to see from your oral maintenance program?

Yes. Thanks, Jay. It's hard to predict what the outcome of the Phase III trials will be. But I think that signal we see at -- for the 17.5 at both 21 weeks and 33 weeks is certainly very encouraging and very competitive with what's out there. It looks a little better than what's out there right now.

So I think very exciting and as far as derisking, different studies, but really a positive initial read here. As far as the oral maintenance study, we'll be beginning that imminently here.

And I think what we see in this -- especially the pattern that I think Ryan mentioned earlier, the initial rebound then muted and you see a larger weight maintenance effect in months 2 and 3, also very promising. It will be interesting to see how that manifests with the oral dosing.

The next question comes from Thomas Smith with Leerink Partners.

This is Brian on for Tom. Congrats on the nice data. Maybe just on the oral, understanding you plan to start the Phase III oral program in the fourth quarter, and we don't have all the design details yet.

But can you talk about your expectations on maybe the ballpark size of the studies and expected pace of enrollment relative to the VANQUISH program?

Yes. No, thanks. Good questions. The size of the study since we will be leveraging the safety database from the subcu formulation in the oral data package, the size of the oral studies will be significantly smaller than the subcu studies, still large studies, but quite a bit smaller and quite a bit less expensive as well. And what was the second part of the question?

Pace of enrollment?

The pace of enrollment, yes. We have seen unusually rapid enrollment in the subcu studies. We see a really high level of enthusiasm for the oral. So hard to predict, but I would say we would expect those trials to enroll reasonably quickly, but really hard to predict until we get the study up and running. But a lot of enthusiasm based on the subcu data.

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

On great outcomes. Just one question in terms of the AE. We noticed that in the 7.5 mg every other weeks, the diarrhea rate is about 15%, which is presumably higher than across the board in many others.

And -- but we also noticed that this seems to be one occasion with a much higher numbers here with only 2 patients have that problem. So I wonder whether you see this is -- this could be an anomaly with a small patient size or there's anything you can read from that?

Yes. Thanks, Yale. We don't think so. It's -- to your point, 2 people had experienced diarrhea in that every other week. There's no dose response there. So that's just a function of small numbers there. We don't think there's any sort of a GI issue with the 7.5 a week.

And maybe a quick follow-up in terms of any colors you will provide for the oral maintenance in terms of dose ranging and maybe as well as duration. Any color you can share at this point?

Yes. Thanks, Yale. The oral maintenance will follow the same template as this study. So 21 weeks of subcu dosing and then we'll have a 12-week period of maintenance dosing.

So same overall trial design. It's under the same protocol and the doses that we talked about there are 17.5, 27.5 and 55 mg. So no real changes. What we may do is incorporate some of these findings from this study into that second maintenance study, but still looking more at the oral cohorts in that study.

The next question comes from Hardik Parikh with JPMorgan.

I just had one theoretical question for both Brian and Dr. Aronne. I was thinking, how would you think these maintenance results would change if the trial was done, let's say, with patients switching from one of the currently approved injectables such as Zepbound and Wegovy? And then same question if patients were originally on a triple agonist as retatrutide, how would the maintenance do you think could potentially be different than what you saw here today?

Thanks, Hardik. I'll turn that over to Dr. Aronne for a better perspective than I have on that.

So what we see both clinically and in trials. We've done switching trials now going from dual agonist to a mono agonist, which is oral. And we see that there's some weight regain. When you take away one mechanism of action or you give a compound that has lesser efficacy, you see weight regain.

Now the patient doesn't regain all their weight, but they tend to migrate towards the efficacy of the other -- of the second compound that they're now on. But interestingly, they are somewhere in between. They don't go all the way to that weight, at least not initially over the length of our trials, which have been generally 9 months to a year.

So I would say that in making these switches, the maintenance would be as you expect, going from a triagonist to a dual agonist, you might expect some weight gain going from a mono agonist to a dual agonist, you'd expect greater weight loss. I think that's what we're going to see. As far as going from dual agonist to dual agonist, I think that when we look at the magnitude of weight losses that we have so far, they're going to be similar.

The next question comes from Jeet Mukherjee with BTIG.

Congrats once again on the impressive data. Two questions, if you don't mind. One for Dr. Aronne. So net-net and overall, does this weight loss and tolerability profile fall in line with approved agents and ones in development? Or does it seem superior? And my second question was just how do you contextualize this data today with studies such as SURMOUNT-MAINTAIN for tirzepatide or the VESPER-3 trial for Pfizer's molecule?

What I think is it's too early to tell comparing head-to-head because this is a small Phase II type trial, and those are Phase III trials. and you really can't compare them. So having 12 people in a dosing arm or 20 people in the dosing arm versus having several hundred or thousand in the arm are definitely different.

And what we've seen over time is that as the trials get larger, the weight loss is not necessarily as great as it has been. The reason we do these giant trials is really to look at safety. The important point is that this is clearly competitive. This is in the ballpark. Is it more or less?

We can't tell yet. Right now, the result we have is exactly on target with tirzepatide, but at an earlier point. It's at 33 weeks where tirzepatide wouldn't reach that for a somewhat longer period of time. Now that could be due to the more rapid titration. There's no way to know until we do the study. We finally started doing head-to-head trials. We did a head-to-head trial we published in the New England Journal recently showing that there is greater efficacy with the dual agonist tirzepatide.

But it doesn't mean that any compound isn't going to be used or isn't going to be good. Again, once we get to 15% weight loss, we get the majority of the health benefits. And we're seeing that in these trials that even though you may not get as much weight loss, you do get the same kind of health benefits, although the magnitude may not be as great.

Remember that not everybody needs maximal efficacy. Not everyone needs that. Many people will do great and live a much longer, healthier life with somewhat lesser efficacy. But the important point is that this puts it right in the range of the most competitive compounds out there.

As we are nearing the conclusion of today's call, our final question will come from Roger Song with Jefferies.

This is Fiona on for Roger. Congrats on the data. So the week 33 from the 17.5 mg weekly dose, at 22% placebo-adjusted weight loss is very encouraging. How should we think about the translation to Phase III in understanding the difference in titration scheme? And just related question for Dr. Aronne.

We seem to be seeing a signal of rapid weight loss with VK2735, which seems consistent from the 13-week VENTURE study. How important do you think this kinetics of weight loss or fast onset is for patients compared to what's available or upcoming in the treatment landscape?

I'll take the first part of the question. It's really hard to predict based on these data what the Phase III readout will be. I think what we see is different titration rates and different sizes and so forth.

But I think we're just very encouraged by the slope being sharply negative, the slope remaining negative at both 21 and 33 weeks. It would suggest that longer treatment window might see that further mature, but hard to really predict with confidence, but we're really encouraged by the week 33 slopes and the magnitude that we see there. I'll turn the rest over to Dr. Aronne.

As far as the rapidity of the weight loss, it's kind of a good news, bad news thing. The good news is the weight loss is rapid. But some people have suggested that if you go past a certain velocity of weight loss, you could wind up losing more lean mass. That will be investigated in future trials.

But it is encouraging to have this kind of magnitude. There are people for whom this will be very appealing. There are others who will not care. It's just that the weight needs to get off because of metabolic issues, and they're going to get it off over whatever period of time.

But I think there are a certain group of patients out there who really want this kind of efficacy. And the thing to me that was most encouraging about the rate of weight loss was the tolerability that is -- I think it's -- the rate is because of the rapid titration but the rapid titration speaks to the tolerability. I don't know what the ultimate way this will be used will be, but the fact that it could be used this way, even with some of the compounds we have now, if you try to titrate it faster, the big issue is tolerability. Here, we did not seem to run into that.

That concludes today's call and today's question-and-answer session. I would like to turn the conference back over 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. Thank you.

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

All right. Good afternoon, everyone, and thanks for joining us at the Morgan Stanley Global Healthcare Conference. I'm Mike Ulz, one of the biotech analysts here. It's my pleasure to introduce the team from Viking Therapeutics. To my immediate left is Brian Lian, CEO. To his left is Neil Aubuchon, Chief Commercial Officer; and to his left is Greg Zante, CFO.

But before we get started, I just need to read a quick disclaimer for important disclosures. Please see the Morgan Stanley research disclosure website at www.morganstanley.com/researchdisclosures. [Operator Instructions] And maybe with that, Brian, I can just hand it over to you to make some introductory comments, and then we can go into Q&A.

Sure. Sure. No. Thanks a lot to Morgan Stanley for the invitation. We've got a great schedule and really happy to be here. We really appreciate it. So a lot happening at Viking this year. We have 2 ongoing -- the main program is in obesity. It's a peptide we call VK2735, completed Phase II study and showed approximately 15% weight loss from baseline after 13 weeks. We advanced it into Phase III development.

We have 2 ongoing Phase III trials today. One is called VANQUISH-1 in patients with obesity and one is called VANQUISH-2, and that's in patients with obesity and Type 2 diabetes. Both trials fully enrolled and both likely to read out data toward the second half of 2027. We have -- those are weekly subcutaneous injections. We've got another formulation of the same compound. It's an oral tablet formulation, showed promising data in the Phase II trial.

So we're planning to move that into 2 very similar Phase III trials in the fourth quarter. And so I think of that program as being 12 to 18 months behind the subcu program. So we'll kick those off in the fourth quarter. And we've really been focused on with the company providing products that give patients the greatest amount of optionality, whether it's subcutaneous injection, oral tablet, and we're conducting a study now that explores different dosing regimens.

So following weight loss with a weekly regimen, we're transitioning people to an every other week regimen or a monthly regimen. And looking at -- we call it maintenance study, we're looking at what happens to body weight after you transition from weekly to every other week or monthly. And the goal there is to keep people roughly where they were when they made the transition to less frequent dosing. And we've guided to data from that study this quarter, and we'll maintain that guidance today.

Great. Thanks for that introduction. A lot going on and a lot to talk about here. So maybe just to start, a big picture question, and you touched a little bit on this in your prepared remarks here about differentiation in obesity, right? There's a lot of change happening and maybe where do you see your products kind of fitting into the market?

Yes. Well, we would hope that for the general population, BMI above 30 or 27 plus 1 comorbidity, we would provide a viable therapeutic option. And one thing that I think, differentiates us from other development programs and marketed programs is we have the same molecule, GLP-GIP in both the subcu and the oral formulation. So you could transition presumably from one to the other without necessarily an increase in the risk of new adverse events or anything like that.

If we can successfully develop the less frequent dosing regimen, it's another opportunity to keep patients on therapy and improve persistence. Long-term persistence is a big challenge with these patients. But long-term persistence is really what's required to realize the long-term benefits of sustained weight loss. So we would hope that we're differentiated because we can provide more options to keep people on therapy for a longer period of time and maintain a healthy weight.

In terms of options, you also mentioned your oral option here, and there's been sort of some recent approvals there. Maybe talk about how you think that market is evolving and where ultimately orals might play in the market here.

Yes. We've seen the -- the way we look at the orals, it's going to probably continue to be the smaller component of the market, still a pretty substantial component of the market. But the way we see it is 75-25, something like that injectable oral. The recent launches, the peptide launch that was earlier this year has done remarkably well. The -- and it's sort of been assisted by having the same brand name for both the injectable and the oral product.

The second launch, small molecule oral GLP-1 agonist, a little bit slower out of the gate, but now picking up steam. So we see both as, I think, really expanding the market, not necessarily cannibalizing the injectable market, but leading to an expansion. And ultimately, we see the orals as maybe being a little bit of a funnel to the injectable products since the orals don't match the same degree of weight loss compared to the injectables.

So once someone is on an oral, they're comfortable with the side effect profile. They're excited to be losing weight and they get to maybe 8% to 10% weight loss. There's really only one way they can go to achieve higher weight loss, and that's through an injectable product. So we see conversely, the oral market is really potentially being a big expander to the subcu market.

Yes. Makes sense. And you mentioned your peptide. And just given that one of the questions that comes up frequently is just manufacturing capacity, et cetera. So I know you've done a lot of work there. So maybe just talk about the current state of...

Yes. Because there were shortages in some of the earlier launches, we spent a lot of time looking at sourcing manufacturing capacity. And so right now, we have a base agreement with CordenPharma, I think a well-known party in the peptide manufacturing space. Our agreement there is for a multi-ton capacity of API, at least 100 million units of vial and syringe products, at least 100 million units of auto-injector products and then at least 1 billion tablets as well.

And all of those elements are expandable at our option. We've since the CordenPharma agreement, I think we announced that in March of '25. We've added 3 additional API manufacturers, all in the sort of multi-ton range. And we will continue to build in redundancies across the supply chain for vial syringe as well as auto-injectors. So all continuing to develop there. But I think we feel pretty good about the API situation.

Great. And I wanted to touch a little bit on just your current thinking in commercialization. I know Neil joined earlier this year, and you've kind of been developing that. So maybe just talk about some of the options you're thinking about and how you think about partnering as well.

Sure. I can start. I'm sure Brian will add. So first of all, we've stated publicly that we are always open to strategic collaborations. So whatever we do is not going to get in the way of that. But at the same time, we have to plan for the business as if we're running it ourselves. So it's great to start out with a really good product. We know that the dual agonists tend to perform better than the mono-agonist in clinical trials.

We're going to have the second injectable dual agonist. We're going to have the first GLP-1/GIP dual agonist oral. It's going to be -- it's the same molecule. So you'd expect it to be the same brand name. So we think that is going to give us commercial efficiency. So those are some things definitely is a good starting point. Second is, as a smaller company, one of the challenges we -- smaller companies have is access. 50% of the business now is in cash.

And so from Day 1, we're going to have equal access to all of the big players. We're also seeing the Medicare Bridge program go extremely well. The uptake, at least early days has been very positive. We'd expect to have access to that. The other thing we're starting to see is companies are carving out this benefit. They're creating what they call a direct-to-employer option where they're sort of treating this like a gym membership, where they're subsidizing, let's say, $100 or $150 a month to their employees and the employees are paying the incremental, call it, whatever, $150 a month out of pocket.

And in that model, patients can go to whatever product they want. There is no formulary. So we can sort of debate the exact percentage it's going to be. But unlike almost any other category, when we launch, we're going to have exposure to the vast majority of the market with no access restrictions. So that is a huge advantage for us. The other thing is that there are companies out there now that are doing direct-to-consumer engagement and marketing, frankly, better than big pharma companies are doing.

And all of those companies want to work with us, and we are having conversations with many of them. And that is a very efficient path for us to get consumer engagement. So for all those reasons, we have to be humble. We have to see how the data reads out, et cetera. But for all those reasons, it gives us a lot of optimism that we can commercialize successfully ourselves.

Great. And I just wanted to shift now to VK2735 and specifically your subcu formulation. Brian, you mentioned you recently completed enrollment in the Phase III and you should have data sort of second half of next year sometime. So maybe just talk about your expectations around the profile and maybe how it might compare to treatments that are available today.

Yes. Yes. I mean hard to predict how the Phase III will perform. But in the Phase II, we had dosed up to 15 milligrams weekly. And after 13 weeks, we saw 14.7% weight loss from baseline, which feels pretty competitive versus the existing landscape, certainly competitive -- easily competitive with the GLP-1 mono-agonist class. The trial we're doing now will increase the dose at the top end to 17.5 mg and extend the dosing window to 78 weeks total.

Where that leads us on efficacy, it's hard to predict. But we think overall, the trajectory from that 13-week study should be, I don't know, promising when you consider extending out 78 weeks. So the goal would be to have something that is well tolerated, low rates of nausea and vomiting, predominantly mild side effects and something that gives efficacy that's really competitive with the existing agents. I mean it's a really significant market opportunity. There's going to be increased fragmentation as the market matures. We don't need 40% market share to be successful. I think we can have a much smaller portion of the market and really, really have a successful franchise.

Can you talk a little bit more about just safety expectations? You mentioned you're dosing higher in the Phase III versus the Phase II, but I think there's some differences in titration and also where you start. How do you think that all sort of plays out in the safety profile you might see?

Yes. So in the Phase II study, we had started at 2.5 mg in 3 of the cohorts and 5 mg in one of the cohorts. And what we saw when we compare the cohort started at 5 versus the cohort started at 2.5 is we saw much lower rates of nausea in the 2.5 mg initiation versus the 5 mg. And so we've seen this across the space as well as the lower you start. So the better tolerated. So what we did in the Phase III is we've started people at 1.25 mg for 2 weeks and then go up to 2.5 for 4 and you go up in 2.5 mg increments in 4-week blocks.

And so the thinking is there that maybe you have this little teaser dose, low dose, maybe that helps with some of the known GI side effects, nausea, vomiting, constipation diarrhea that are known to happen when you start a GLP-1-based therapy. So that's -- even though we're going higher at 17.5, we're hoping that, that initial 2 weeks might ease people into it a little bit more smoothly. Another advantage just intrinsically with the molecule, the Tmax is a little bit later. It's at 3 days. So even starting at 1.25, you're starting low and you've got that gradual onset, it almost serves as kind of the micro titration that we would hope would lead to an improvement in adverse event profile. We don't know yet, though.

Yes. Makes sense. And maybe similar sort of line of questioning for your oral formulation, maybe highlight what you saw in your Phase II study and maybe how that profile compares to currently available agents.

Yes. The profile for the oral, we had seen, I think, about 12% weight loss in the high dose, which was 120 mg. We're coming down a little bit in dose in the Phase III study. One thing we learned in the Phase II is we had dosed people with 4 tablets, and they were a little bit larger tablets. That wasn't a great experience for some people. So we focused on reducing the tablet size, reducing the tablet count and really kind of on the middle of that dose response curve from the Phase II, which had gone up to 120 mg.

So we haven't disclosed the design yet. We'll disclose that when we start the studies in the fourth quarter. But overall, similar population, study would be in obesity, study in obese diabetics, shorter studies, smaller studies, a lot less expensive than the subcu. And like I said earlier, probably 12 to 18 months behind the subcu studies.

Why are you confident in sort of shorter, smaller studies?

Yes, yes. So we had asked the FDA since it's the same molecule, both the subcu and the oral, we asked in an end of Phase II meeting, can we leverage the human data, safety data that will be generated in the subcu Phase III program for the oral Phase III program. And the FDA indicated if everything works out, yes, that's -- I mean they always point out risks if something behaved unexpectedly, but under a normal set of circumstances that should be acceptable.

So we are able then to leverage the safety data. We knew we could do it with the animal tox data, so we didn't have to redo the animal tox. So we're leveraging the subcu human data, and that allows us to shrink the sizes of the studies from a total of about 5,600, 5,700 in the Phase III subcu down to 75% lower than that. And because we don't titrate as long, we can shorten the overall. You got to be 52 weeks at the post-titration dose, but the titration window is shorter, so it makes the whole trial shorter. So the expense of the oral Phase III is quite a bit lower than the subcu Phase III.

Makes sense. Okay. Great. And maybe now we can shift to the maintenance study. You mentioned 3Q. I know everyone wants to talk about this, so let's get into it. We're all waiting. But maybe just at a high level, unmet need for maintenance right now and kind of the advantages of your approach maybe.

Yes. I mean the goal is to provide options that allow people to conveniently stay on therapy. And so when people reach their target weight range, we'd like to provide a more convenient means of staying at that target weight range. And so a lot of ways to do it, you can just reduce your weekly dose, but that isn't really a convenience advantage. We thought if -- because our half-life is around 9 days, and one old rule of thumb is you dose every 4 to 5 half-lives, we thought, well, maybe you can dose once a month.

And the PK from the Phase II indicated, yes, maybe that's possible. So we designed the study to look at from weekly dosing to every other week dosing and monthly dosing. And with the monthlies, we've gone up from 17.5 mg per month to 22.5 mg per month is the top dose there. And then in the -- every other week, we're looking at 5 mg, 7.5 mg and 10 mg every other week. And so completed the study earlier in the summer, and we're waiting for the data.

But what we'd like to see there on the big picture, we'd like to see at week 21, which is when people transition from weekly to less frequent, we'd like to see negative slopes through that window without a plateau. When you transition to the less frequent dosing, we'd like to see moderate side effect profile. Big question is when you dose less frequently, do you reinitiate the adverse events because you haven't had a dose in a little while and the plasma levels have gone down. So that's a big question. Because if you maintain, but everybody vomits, no one is going to want to take the drug.

So if we can show a decent tolerability profile through the maintenance window, that's a really important thing to show in the study. We have an arm that goes 17.5 mg all the way through 33 weeks. Will it be important regardless of the magnitude at week 33, what does the slope look like? Is the slope continuing negative without evidence of a plateau at 33 weeks. And so that's another really, really important element to look at. And then how do you define maintenance? That's an open question.

But when we look at the emerging literature, it seems like if you can keep people within 75% of their initial weight loss, you're likely to retain the cardiometabolic benefits that were achieved in the initial weight loss. So in the maintenance period, if we can, after 12 weeks, keep people within 75% of the weight loss that they had achieved at week 21, I think that would be of interest as well. And what we'll do with the data then, our VANQUISH Phase III study is going to be entering into a 52-week extension study that will happen late this year or early in 2027. We'd like to -- if we see interesting data in the maintenance study, bring 1, 2, 3 arms into that extension study and explore maintenance then over a longer dosing window, which would be 52 weeks.

Great. Can you talk about the -- just the titration schedule and how it compares to your Phase II versus your Phase III because they're all a little bit different and that's kind of been a focus for people. And what does it really mean, I guess, or how do you interpret titration schedules as far as if you're making the comparison with the tolerability and efficacy?

The goal of this study was to really get people to the high dose where you can transition to the monthly dosing regimen. So we wanted to push people up there as quickly as possible, but without giving too many headaches on tolerability. So we've compressed the titration steps to 2 weeks -- and we've also started a little bit lower. So the first dose is 1.25 mg. Second week is 2.5 mg. And then from there, it's every 2 weeks, you go up 2.5 mg.

So you're going twice as fast as our Phase III trial and a little bit faster than the Phase II. The Phase II went in 3-week blocks. So I'm less -- I mean, tolerability is a risk with this, but I'm less concerned about tolerability in the 21-week window because the goal of the study is to really explore that week 21 transition to less frequent dosing and look through week 33.

Understood. Maybe in the maintenance period, you touched on this a little bit with the safety and the theoretical risk of if you extend the dose, you might sort of get some spikes in exposure. But at the same time, right, after you treat patients for a longer period, they kind of get accustomed to it, and maybe less...

No, no. So what we've seen in prior studies is this GI constellation of adverse events, which is nausea, vomiting, constipation diarrhea, tends to happen, call it, the first 6 weeks or so of dosing. And then it really kind of tapers from there. So the question is, when you go from weekly and suppose you're at 21 weeks, that rate is going to be low at 21 weeks, and then you transition to a monthly dose that's pretty high, like a 20, 22.5 mg dose. If you don't take a dose for a month and then you take that high dose, are you going to trigger all the same GI adverse events?

I can see it either way. The trough level after 30 days is going to be fairly low, and then you can take a drug in plasma. You can take a dose that's going to bump it really high. So that might reinitiate some of the adverse events. But the other way to look at it is you've got meaningful plasma levels of drug throughout the course of the month. So it's not like you're going from 0, and it's not like you're truly going a month from the last meaningful plasma level. Which of those wins, I don't know. But that's -- if you can show decent tolerability through the maintenance period, it's really important. I'd say almost more important than the maintenance effect because if you can show good tolerability, it gives you room to maybe push the dose higher if it's well tolerated.

So it makes a lot of sense. In terms of this top line result, we're going to get here fairly shortly. Can you just clarify what we'll get? Obviously, safety is important and people are going to want to see the difference between the maintenance phase and the induction phase. And then you also pointed out your 17.5 milligram dose that goes 33 all the way out to 33 weeks on a weekly basis. So will we get separate weight loss for that arm specifically as well? Or just how -- I think those have to be what people are focused on.

I haven't received it yet, but we probably want to report all of the above. I know there's high interest in that 17.5. It's -- you're looking at 15 people, so hard to know how that's going to predict a 4,000-patient study. But I know people interested in that, so we'd probably want to report that. And then the tolerability in the maintenance period, also the proportion of weight loss that's maintained through the maintenance window also would be something we'd want to report.

And for that 33-week 17.5 milligram arm, is there -- what do you think the bar there is? Or what are you hoping to see? I know you said continued downward slope, but this is going to kind of be the longest data you've seen on -- it's a hard question.

It's a hard question because I don't know. I think no matter what I say, it's going to come back to me. So I don't know. I mean we hope to exceed what we saw in the 13-week study, obviously. But if the 33-week slope is still negative, I think that's a really important finding. And the efficacy will mature in over time if it's -- if dosing is continued.

Yes. Understood. Makes sense, and we're all looking forward to that. Maybe we can just switch to VK3019, that's your amylin agonist. Maybe give us just a brief background there, what you've seen preclinically, maybe how it stacks up and kind of next step.

Yes. Interesting molecule. It's a peptide, long-acting peptide in the binding assays, it's fairly well balanced on calcitonin and amylin in rodents, very competitive with cagrilintide, another advanced amylin agonist. When we looked at obese monkeys, the weight loss effect was greater than with the VK2735.

So everything looked really interesting in the initial data that we've generated. We haven't published a lot of these data, but look promising. And right now, we're doing a single ascending dose study, and we would hope if that looks attractive, we'd follow it up with a multiple ascending dose study, a 4-week weekly study.

Okay. Great. And maybe now in the last few minutes, we can go through a couple of survey questions. These questions are across the biotech team here. We're asking all companies, and they're kind of in the hot topic areas, but maybe if we start with the first one, it's just how is the rise of China origin innovation sort of changed your competitive positioning and your R&D versus BD playbook?

We've always considered China to be a pretty rich source of programs. We spent a lot of time in the FXR class back when NASH was really hot in 2018, '19, '20 and saw a lot of programs out of China that looked interesting. So we've always felt that China is a big source of programs. But for whatever reason, some of them -- a lot of them don't proceed too far. Maybe it's capital, maybe it's other issues. We don't know.

We've seen a lot more, I guess, publicity around some of these Chinese assets, particularly in the obesity space. So that's the only space we look at really, but maybe in other spaces as well. But more recently, it's been more prominent. So I don't know -- I don't really know how to think about that because we see -- we saw so many before.

What our understanding is, though, is that the price points have maybe equalized a little bit more, whereas maybe 5 years ago, a lot cheaper to get something out of China because it's resulted in this rush of interest, the price points have changed and there isn't necessarily the large delta that there was previously. But I would expect it to continue to be a source of new programs.

Yes. Okay. Then moving to the second question. This is a more recent hot topic, just implementing AI adoption. Are you doing that? If so, where does it sort of change any decisions or time lines or costs or probabilities of success? Any measurable evidence there? And how should we expect that to kind of evolve in the future?

Yes. We're kind of dabbling a little bit in AI, not -- it's -- everybody is trying to figure out how to best use it. So where we're using it is in trying to improve efficiencies if you can design a development plan quickly with a particular asset, maybe AI can help with some of just the administrative side of development plans, protocol development as well, maybe you can use it there.

So I'm sure there are a gazillion places, but we've been pretty kind of incremental with our use of AI. We haven't necessarily done it with discovery programs. I think we have some ideas as to how to use it properly, especially in the peptide space, but very, very early in our adoption there.

One thing we can say is that consumers are using it. And so by the time we come to market, it's something we need to be ready for. So I think this is going to hit the industry, not only on the R&D side, but also increasingly on the commercial side.

Makes sense. And then third and lastly, just which policy variable, whether it's FDA, Medicare negotiations, MFN, tariffs, global pricing matter most to your economics? And what have you changed, if anything, because of it? I know some of that doesn't quite fully apply to everything, but it might impact some of your business.

No. Pricing is a big deal. And where does the obesity market really price out at? We haven't talked about pricing. It's a little ways out for us, but we would hope that pricing still sustains reasonable margins for a company like us. As far as FDA, FDA has been in a lot of flux recently, fortunately, for us. We haven't seen real changes in response times or engagement or anything like that, which is a bit of a surprise given that we feel like there has been a lot of turnover there, at least maybe a lot of reduction in force there. So, so far, so good with our engagement with the FDA.

The big question is going to be the Medicare Bridge program. What's going to happen to that in 2029? So there's still a lot of political uncertainty around that. So that's something we're obviously watching quite carefully. Yes.

Okay. Great. Looks like we're out of time, so well, we'll end it there. Thanks, Brian, Neil and Greg, I appreciate your time today.

Thanks, Mike.

Good day, and welcome to the Viking Therapeutics Second Quarter 2026 Financial Results Conference Call. [Operator Instructions] And as a reminder, this conference call is being recorded today, July 29, 2026. 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, July 29, 2026, 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 second quarter and 6 months ended June 30, 2026, and review recent updates across our pipeline programs and organization. During the second quarter, we continued to advance each of the programs within our expanding obesity franchise. With respect to our lead compound, VK2735, a dual agonist of the GLP-1 and GIP receptors. Viking's Phase III VANQUISH clinical program continued on track. The VANQUISH program includes 2 studies: VANQUISH-1 evaluating the treatment of adults with obesity and VANQUISH-2 to evaluating the treatment of adults with obesity and type 2 diabetes. Both trials are fully enrolled and during the second quarter, both proceeded to advance according to plan.

Also during the second quarter, the company continued preparing for the initiation of a Phase III program to evaluate the oral tablet formulation of VK2735. This program will consist of 2 studies and will generally mirror the VANQUISH Phase III program for the subcutaneous formulation. During the second quarter, our team continued to make progress toward initiation of these important studies, which are expected to begin in the fourth quarter of this year.

During the second quarter, Viking also continued to execute its novel maintenance dosing study of VK2735. This range finding study is designed to explore a variety of dosing regimens to identify suitable doses for further evaluation. The maintenance study leverages VK2735's unique in vivo profile and will assess the effects of weekly, monthly and every other week regimens to identify those that may best support the individualized and long-term care often required to achieve and sustain a healthy weight. We expect to report the results of this study later this quarter.

Finally, during the second quarter, Viking expanded its clinical stage obesity portfolio, with the initiation of a Phase I single ascending dose trial of VK3019, an investigational dual amylin and ocotonin receptor agonist. We are excited to have this new program in clinical development which we believe may offer another important potential treatment option for patients with obesity.

I'll have additional comments on our operations and development activities following a review of our financial results for the second quarter and 6 months ended June 30. 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 shortly. I'll now go over our results for the second quarter and 6 months ended June 30, 2026, beginning with the quarter. Research and development expenses were $115.8 million for the 3 months ended June 30, 2026, compared to $60.2 million for the same period in 2025. The increase was primarily due to increased expenses related to clinical studies, salaries and benefits, stock-based compensation and third-party consultants partially offset by decreased expenses related to manufacturing for our drug candidates and preclinical studies.

General and administrative expenses were $16.9 million for the 3 months ended June 30, 2026, compared to $14.4 million for the same period in 2025. The increase was primarily due to increased expenses related to third-party consultants, legal and patent services and salaries and benefits partially offset by decreased expenses related to stock-based compensation.

For the 3 months ended June 30, 2026, Viking reported a net loss of $128.1 million or $1.10 per share compared to a net loss of $65.6 million or $0.58 per share in the corresponding period of 2025. The increase in net loss for the 3 months ended June 30, 2026, was primarily due to increased research and development expenses and general and administrative expenses noted previously compared to the same period in 2025.

I'll now go over our results for the 6 months ended June 30, 2026. Research and development expenses were $266 million for the 6 months ended June 30, 2026, and compared to $101.5 million for the same period in 2025. The increase was primarily due to increased expenses related to clinical studies, salaries and benefits, third-party consultants and stock-based compensation. partially offset by decreased expenses related to manufacturing for our drug candidates and preclinical studies.

General and administrative expenses were $30.9 million for the 6 months ended June 30, 2026, compared to $28.5 million for the same period in 2025. The increase was primarily due to increased expenses related to third-party consultants and salaries and benefits partially offset by decreased expenses related to stock-based compensation and legal and patent services. For the 6 months ended June 30, 2026, Viking reported a net loss of $286.5 million or $2.47 per share compared to a net loss of $111.2 million or $0.99 per share in the corresponding period in 2025.

The increase in net loss for the 6 months ended June 30, 2026, was primarily to increased research and development expenses and general and administrative expenses noted previously compared to the same period of 2025.

Turning to the balance sheet. At June 30, 2026, Viking held cash, cash equivalents and short-term investments of $502 million compared to $706 million as of December 31, 2025. This concludes my financial review, and I'll now turn the call back over to Brian.

Thanks, Greg. I'll now provide an update on Viking's clinical programs, beginning with our lead obesity program, VK2735. As I mentioned in my initial comments, VK2735 is a dual agonist of the glucagon-like peptide 1, or GLP-1 receptor and the glucose-dependent insulinotropic polypeptide, or GIP receptor that has demonstrated promising efficacy, safety and tolerability across multiple clinical trials.

Viking is currently advancing both an injectable and an oral formulation of VK2735 for the treatment of obesity. In addition, we are evaluating VK2735 in a novel maintenance dosing protocol designed to support long-term weight management. I'm pleased to report that all of these efforts continue to advance during the quarter. With respect to the subcutaneous VK2735 program, as previously reported, Viking's Phase I and Phase II trials successfully achieved their primary and secondary end points demonstrating significant weight loss compared with placebo as well as an impressive safety, tolerability and pharmacokinetic profile.

In the Phase II VENTURE study, patients receiving weekly VK2735 doses demonstrated statistically significant reductions in mean body weight from baseline ranging up to 14.7% after 13 weekly doses with no signs of plateau. The VENTURE study also showed VK2735 to be safe and well tolerated through 13 weeks of dosing with the majority of treatment-emergent adverse events characterized as mild or moderate and resolving quickly. These results were highlighted in a presentation at the 2025 ObesityWeek Conference last November, and the final results were published in January of this year in obesity, the peer-reviewed Journal of the Obesity Society.

As a result of the positive Phase II results as well as feedback from Viking's Type C and end of Phase II meetings with the FDA, the company advanced subcutaneous VK2735 into Phase III development initiating the VANQUISH Phase III registration program in June of last year. The VANQUISH program consists of 2 clinical trials, 1 in adults with obesity and 1 in adults with obesity and type 2 diabetes. Each study is a randomized, double-blind, placebo-controlled multicenter trial designed to assess the efficacy and safety of VK2735 administered by subcutaneous injection once weekly for 78 weeks.

Enrollment in each of these trials was rapid with the VANQUISH-1 study enrolling approximately 4,500 patients by November 2025, approximately 5 months after initiation. Enrollment in the VANQUISH-2 study was completed in the first quarter of this year, enrolling approximately 1,000 patients. Participants in each trial have been randomized to weekly doses of 7.5 milligrams, 12.5 milligrams, 17.5 milligrams or placebo. The primary endpoint of the VANQUISH trials is the percent change in body weight from baseline for participants receiving VK2735 as compared to placebo after 78 weeks of treatment.

Secondary and exploratory endpoints will evaluate a range of additional safety and efficacy measures, including the percentage of patients who achieve at least 5%, 10%, 15% and 20% weight loss. Each study will include an extension portion, allowing participants the opportunity to continue receiving treatment following completion of the primary dosing period, including patients who were randomized to placebo for the initial 78-week treatment period. During the second quarter, both VANQUISH studies continue to advance according to plan.

Turning to Viking's oral tablet formulation of VK2735, consistent with our subcutaneous results, the company's prior Phase I and Phase II studies evaluating oral VK2735 successfully achieved their objectives. In the company's Phase II venture oral dosing study of VK2735, participants receiving once daily doses of the tablet formulation demonstrated statistically significant reductions in mean body weight after 13 weeks, ranging up to 12.2% from baseline.

Statistically significant differences compared to both baseline and placebo were observed for all doses above 15 milligrams starting at week 1 and continuing throughout the 13-week treatment period. Up to 80% of subjects in VK2735 treatment groups achieved at least 10% weight loss after 13 weeks compared with only 5% of placebo-treated subjects. The tablet formulation also demonstrated encouraging safety and tolerability through 13 weeks of daily dosing. The vast majority of drug-related treatment emergent adverse events were characterized as mild or moderate in severity.

Importantly, in the dose range we plan to explore in future studies, we believe the data show no meaningful difference in GI-related adverse events between subjects treated with VK2735 and placebo. The tolerability data from the venture oral dosing study also suggests that future titration regimens starting at lower doses and utilizing longer titration intervals are likely to further improve oral VK2735's tolerability profile.

In addition to these top line results, further data from the Phase II trial were presented in May of this year at the European Congress obesity in Istanbul, Turkey. The full data set provided the detailed picture of VK2735 response over time, affirming its compelling efficacy, a clear dose response and an encouraging tolerability profile through the 13-week treatment period.

Based on these positive results as well as feedback from Viking's end of Phase II meeting with the FDA, the company is advancing oral VK2735 into Phase III development for the treatment of obesity. During the second quarter, we continued to prepare for these trials, which we expect to initiate in the fourth quarter of this year. With this timing, we believe the VK2735 is positioned to become the first oral formulation of a dual GLP-1/GIP agonist to reach the market. This represents a competitive advantage that we believe patients and their clinicians will value significantly.

I'll now provide an update on Viking's novel maintenance study. As a reminder, given its distinctive potency and PK profile, we believe VK2735 may be uniquely suited for regimens that utilize less frequent dosing than the weekly regimen currently used by existing agents. Less frequent dosing regimens could represent attractive options for those patients who have achieved their weight loss goals and are seeking to maintain that weight loss moving forward. Importantly, by using the same therapeutic agent for both the initial weight loss and for the longer-term maintenance phase of weight management we believe patients may experience reduced side effects compared with options that require switching between different therapeutic agents.

By reducing side effects, we believe adherence to treatment may be improved, allowing patients to ultimately realize the long-term benefits of weight loss, such as improved cardiovascular health enhanced physical function and increased quality of life. During the fourth quarter of 2025, Viking initiated a range finding study to explore a variety of maintenance dosing regimens. In this study, all subjects are receiving initial doses of VK2735 for a fixed treatment period followed by a transition to a range of intense regimens, including on weekly, monthly and every other dosing or placebo.

The objectives of the study are to evaluate the safety, tolerability and pharmacokinetic profile of VK2735 under these various regimens. Exploratory endpoints will assess the change in body weight from baseline as well as the change in body weight during the maintenance portion of the study. This trial is nearing completion, and we expect to announce the results later this quarter. We believe the results from the maintenance study could serve to inform the selection of doses in the upcoming VANQUISH extension studies expected to begin in late 2026 or early 2027.

Upon completion of the subcutaneous maintenance dosing cohorts, we will continue the maintenance study to evaluate a range of oral maintenance regimens. We expect that portion of the study to be completed in the first half of 2027.

Moving to our earlier-stage pipeline. During the second quarter, we were pleased to announce that Viking's newest program, VK3019 have entered Phase I clinical development. VK3019 is an investigational dual amylin and calcitonin receptor agonist in development for the potential treatment of obesity. Preclinical data for this program showed impressive effects on body weight, fluid intake and metabolism in healthy rats, diet-induced obese mice and obese primates compared to control-treated analysts.

Results showed reduced food intake in lean rats after single subcutaneous doses at 72 hours, these compounds reduced body weight by up to 8% compared to controls. Earlier this year, following clearance of an IND application, the company initiated a Phase I single ascending dose clinical trial to evaluate VK3019 in healthy volunteers. The Phase I trial is a randomized, double-blind, placebo-controlled, single ascending dose study in healthy adults with a BMI of 27 or more.

The primary objective of the study are to evaluate the safety, tolerability and pharmacokinetics of single subcutaneous doses of VK3019. Exploratory pharmacodynamic assessments include evaluations of changes in body weight after a single dose administration. The addition of our amylin agonist program represents an important expansion of our VC franchise and further illustrates Viking's commitment to treating obesity first with the goal of helping patients achieve and maintain a weight that will allow them to improve their overall health and quality of life.

As our clinical pipeline continues to advance and expand and as we approach potential product approvals and commercialization, we are also building our internal infrastructure, adding capabilities to enable us to maximize the opportunities ahead. In the first quarter, we added a Chief Commercial Officer, Neil Aubuchon, to lead our commercial strategy. During the second quarter, we announced the appointment of Hubert Chen, MD as Chief Medical Officer. Hubert brings more than 2 decades of leadership experience in senior executive roles spanning drug discovery, clinical development, regulatory strategy and product approvals across multiple therapeutic areas, including an extensive knowledge of obesity, metabolic disorders and endocrinology. Hubert's experience and track record make him well qualified to lead Viking's expanding clinical, medical and regulatory affairs activities.

We are happy to have him on the Viking team and look forward to his contributions moving forward. Subsequent to the quarter end, the company also appointed Dorothy Gemmell to its Board of Directors. Ms. Gemmell is a highly experienced executive and Board adviser with over 25 years of leadership experience across health care, digital health and commercialization strategies. She has served as President or Chief Commercial Officer at numerous companies, including GoodRx, Capsule and Havas Life, leading growth initiatives, scaling organizations and developing revenue models as payer, provider, employer and pharmaceutical markets.

In addition to establishing the appropriate corporate infrastructure, the company continues to ensure that its balance sheet is strong and capable of supporting our current and future initiatives. As Greg reported a few minutes ago, company held over $500 million in cash at the end of the second quarter, which allows us to reach important corporate milestones, including the completion of our ongoing Phase III obesity trials as well as to pursue development of our additional programs.

In closing, I'd like to make a few comments about our mission at Viking. In recent years, the clinical success of VK2735 has afforded our team the opportunity to engage at a high level with KOLs and health care providers, patient advocates and other key stakeholders around the world, all of whom are working to identify effective treatments for obesity, which is increasingly recognized as a chronic disease that requires chronic treatment. We know that patients living with obesity have not chosen this condition, and will power alone will not resolve the complex task of managing the disease and its related metabolic conditions.

We also believe that long-term weight management will not follow a standardized one-size-fits-all approach. Individuals pursuing sustainable weight loss will seek a range of treatment options that allow them to personalize their weight loss journey at every stage. Recognizing this unmet need, Viking is committed to delivering a pipeline of therapeutic options designed to serve the needs of this diverse population. Some individuals will prefer to receive treatment subcutaneously using a vial and syringe or an auto-injector.

For people with more modest weight loss targets, or for those who wish to sustain their achieved weight loss, a daily oral tablet could be the best choice. In addition, different people may prefer different long-term dosing options. To this end, our ongoing maintenance study is intended to identify the most effective dosing strategies to support patients transitioning from 1 stage of their weight loss journey to another.

And finally, novel therapies directed to new targets such as Viking's amylin and calcitonin receptor agonist VK3019, represent important development areas as people continue to seek new options for weight loss. These compounds have the potential to be used alone or in combination with other therapies, potentially opening the door to further choices, which may lead to improved treatment persistence. We believe improved adherence to therapy increases the probability of realizing the long-term benefits of weight loss.

At Viking, we are committed to achieve improved health by treating obesity first, and we are proud to be developing a therapeutic pipeline directed at this important mission.

This concludes our prepared comments for today. Thanks for joining us, and we'll now open the call for questions. Operator?

[Operator Instructions] And our first question today will come from Steve Seedhouse with Cantor.

I wanted to first just get your expanded thoughts on the titration schema that you're using in this maintenance study. And if you're expecting, I guess, at a high level, if it will mitigate or increase the GI adverse events that you saw in Phase II? And then also, when you announced the data, I'm curious specifically if you're going to be able to break out the cadence of events in the way you have your prior studies, specifically in the initial weeks when you're working through that 1.25 milligram step since that's a feature in Phase III, it's a bit of a novelty, I think that would be an interesting analysis.

Yes. Thanks, Steve. With the titration scheme, so we were most focused on getting to the maintenance portion of the study and figured if we started at a monthly or every other week cadence, it would take us forever to get there. So we compress the titration blocks in that first 21-week treatment period weren't really too concerned about the adverse event rates since that wasn't really the goal of the study, knowing that the [indiscernible] studies we'll be using 2- to 4-week blocks, 2 weeks at the 1.25 mg and 4 weeks of every step after that. So it wasn't a real focus for us.

With respect to the like the histograms that we've normally disclosed, we'll see what's available. If we have some of that available at the time of the top line data, we would certainly hope to provide that. But a lot of times, these data come in kind of tranches and that might not be available immediately.

Okay. I appreciate that. One more for me. Just when you think about the analysis of the 12-week maintenance period then in that space. So if we look at surmount maintain the sort of recently published tirzepatide maintenance study. Obviously, they didn't do extended dose intervals, but they tested lower maintenance doses, and that was after a longer induction. But just when we look at the pace of the weight rebound, I guess, or just sort of how things settle out, in that low-dose maintenance in that study. Is that the right benchmark or a good benchmark to sort of compare it to or data 2 when you present it and just see how it stacks up? Or are there other comparisons or precedents or caveats to that, that you would point to?

Yes. It's a good question because it's hard to compare since that maintenance window is so much longer than our 12-week window. I think coming out of the study, we want to identify call it, 2 to 4 cohorts that merit further evaluation in the VANQUISH extension studies. And so long term, what is a good maintenance range. And it seems like there's emerging data that would suggest that if you can retain 80% of the weight loss that you achieved in the initial portion of treatment that will likely retain the cardiometabolic benefits that the target weight loss actually provided. There's another paper that says 25%.

So if you can kind of keep people in that, call it, 75% to 80% of the weight loss maintained through that extension period, that's really going to lead to improved health long term and give people the real benefit of weight loss. But what we'll see in that 12-week window, I think it's going to be really hard to make those cross-trial comparisons, not only because it's a cross trial, but also because the winds are so much different.

Our next question comes from Ryan Deschner with Raymond James.

Congrats on the progress. Just 2 questions. One on how firmed up the updated dosing strategy may be for the oral portion of the maintenance study? And if you expect a similar number of core cohorts as you're running in the injectable maintenance portion, and then also, obviously, it's very early in the program. But curious what your base case manufacturing strategy is for the Dacron program -- is this something that would likely end up being an expansion of the large deal you currently have with CordenPharma.

Yes, that question, I can take first. Yes, the CordenPharma agreement, some elements are specific to a specific compound. Others are not. So we do have flexibility, especially on the API production side to add just generally peptides, not necessarily a specific peptide to the agreement. So it's very flexible in that regard. With respect to the -- what was the first question, Ryan, sorry. .

Updated dosing strategy.

Yes, yes. Sorry. So the -- yes, we'll look at multiple doses there. I'd say the number of arms would be very similar to the VANQUISH study. So probably give all those details when we initiate the study in the fourth quarter.

And our next question comes from Mike Ulz with Morgan Stanley.

Maybe just a follow-up on Steve's question related to the maintenance study and specifically safety given the fact that you might expect to see a little bit more safety events sort of in the initial titration phase. But I think the focus here is really more on maintenance. So I guess, will you be able to sort of break out safety between those 2 periods of the study?

Yes. Thanks, Mike. And I think it's important we're not really worried about safety. I think you're referring to more of the GI tolerability. I think we're pretty secure on safety. And I would hope that yes, we would be able to break out that initial period versus the maintenance period because it's really important. It's an important question in that maintenance portion how does reducing the dose at these higher levels -- I'm sorry, reducing dose frequency at these higher levels, kind of feed into the tolerability profile. It's a really important question for that maintenance period. .

And our next question comes from Hardik Parikh with JPMorgan.

First one is just on the Phase III oral [indiscernible] initiate in 4Q. I understand some of the details you can't share with us. But just internally, what are some of the trial design or trial design protocols that you're kind of still working through, that's kind of still undecided. And then the second one is just you guys have been doing a good job building out your executive staff. I was just wondering what other functions or infrastructure do you still think you have to build out further?

Yes. Thanks, Hardik. With the Phase I -- I'm sorry, Phase III trials we're pretty set on the designs there. It's more getting the manufacturing of the tablets and everything kind of getting ready to roll there. And that requires some lead time. But design elements, it will be 2 studies, smaller and shorter in duration than the VANQUISH studies quite a bit smaller, so the expense will be quite a bit lower as a result. The titration windows, probably will stick with that 4-week cadence that is common across the space. So pretty standard overall designs.

Again, as I said some of the earlier, multi-arm studies. with respect to hiring, a good question. We're hiring quite a bit. We've obviously added recently Hubert Chen, who's with me here, Chief Medical Officer, a really important hire. We've added people with sort of payer and reimbursement expertise recently. We've grown in clinical operations, clinical development, regulatory affairs, data management. A lot of these sort of important fleshing out functions that are really key to a successful organization. And quality is another area that we've really kind of targeted for growth. So a lot of activity, a lot of hiring, and we're still going to be really lean, but we have to fill out a lot of these roles.

And our next question will come from Biren Amin with Piper Sandler.

For the maintenance trial, the 15-milligram and the 17.5-milligram dose cohorts in the first 21 weeks, how should we think about the placebo-adjusted weight loss compared to the 15-milligram cohort in the Phase II trial where you reported a 13.1% placebo-adjusted weight loss. Should we expect comparable weight loss at week 21 in the first 21 weeks of the maintenance trial? Or should we expect something greater than that? And what read-throughs would you have to the week 21 data that could provide us insights to VANQUISH-1? Yes. So maybe I'll just stop there and answer for my question.

No, it's a good question. Always hard to do these cross-trial comparisons because the titration rates are different. We're starting a little lower here as well. So I don't know. I mean, really hard to give guidance there. I would expect it to be certainly in the range of the 13-week study. But again, large air bars only comment like that due to the difference in titration rates. .

With respect to read through to VANQUISH, again, hard to know. We are having a 33-week 17.5 mg arm that we've had a lot of questions about externally. So it'd be interesting to see what that arm shows. But I think more important than a number is what does the trajectory look like? Is it plateauing or not? Because that's really the important observation that we want to see. If somebody is plateauing in this relatively shorter window that might predict something that's suboptimal on overall weight loss. We're seeing a continued trajectory that would be really encouraging, and that's kind of another element of the data that we'll be interested in looking at.

And maybe one follow-up, Brian. For oral Phase III that's about to embark in Q4. Should we think about design kind of similar to like oral sema OASIS-1 obesity study where they enrolled around 667 patients?

I guess, broadly speaking, yes, in that neighborhood, yes. What we've said in the past, you can call it, 75% smaller than the VANQUISH study. So yes, that's not a bad guess. I wouldn't say it's exact, but it's not a bad guess. .

Our next question will come from Andy Hsieh with William Blair.

Two, if you don't mind, it's actually related. So one on the commercial perspective, I think recent trials have shown more unusual placebo effects, perhaps patients are taking GLP-1s outside of the silica trial setting. So maybe in the commercial setting, are you going to communicate VK2735 profile in a sebo-adjusted matter or a growth matter? And then the second question is actually pretty similar to the first one. In the VANQUISH study, are you going to have critical optimization so that patients will report off trial usage of incretins in perhaps more honest way so you don't see a huge surprising placebo effect once it reads out.

Yes. Thanks, Andy. Great questions. I think what we've always done is report both. We kind of have the placebo and the treated arms in all the same tables and graphs to eliminate this sort of guess work when someone reports placebo-adjusted weight loss. So I think we would continue with that moving forward. And with respect to this sort of uncontrolled compounding or people taking compound to GLP-1s or not compounded GLP-1s in the placebo arm. Yes, I think it's hard to control everybody. It's certainly not allowed in the study. GLP-1 use is an exclusion criteria and so we haven't heard from our sites or investigators that this is an issue. It doesn't mean it couldn't be an issue, but we were a little surprised to see that report that I think you're referring to back at ADA, the level of compounded use because we just have not heard or seen that to date in our studies.

Our next question will come from Annabel Samimy with Stifel.

I had a couple here. So I'm a little bit surprised to hear that you're not so much concerned about the safety and the maintenance trials given your I mean pretty meaningfully exceeding the doses from VENTURE like up to 20 and 22.5. So is there anything that you're trying to draw from some of those higher dose as far as how far you can push the dose and tolerability there? And then secondly, I thought I'd bring up the Phase I DACRAs. Is there a clear threshold here for a profile or a good no-go decision for this compound, for example, if it doesn't show much differentiation over 2735. Is this something that you still want to move forward? And just if you want to talk about what you're looking for in that program, that would be great.

Yes, sure. On that question, it's kind of hard to make any decisions based on a single ascending dose study unless there's some very obvious safety concerns. So we'll have to get through the MAD portion of the Phase I study, which would follow the SAD. And so we'll know the answer to that probably in the '27 time frame. With respect to dosing higher in the maintenance study that we dosed previously. Yes. I don't think we -- first of all, we've got really good margins there for safety. But for tolerability, I think what we've seen just across the space with the peptide therapeutics is when you experience the GI-related side effects, it's typically in your first few weeks of experience with them. And once you can get through that initial treatment window and the titration window, the tolerability really seems to be well accommodated. And so even though we are dosing higher, I guess, always a risk, but I don't know that it's a huge risk that we would see any surge in adverse events going higher. .

Our next question will come from Jay Olson with Oppenheimer.

Congrats on all the progress. Another question on the DACRA program. Now that you have 3019 entering the clinic. How are you thinking about it long term in terms of monotherapy versus a combination partner with 2735? And I guess, what do you know now or hope to learn soon about the combinability of 3019 with 2735.

Yes. Thanks, Jay. I think the mechanism has a role as a stand-alone and in combination. And if you think about it as a stand-alone what we've typically seen from the Amylin is with 1 exception, they're generally a little bit less potent than the GLP-1s and so maybe you would see the Amylin mechanism being used for someone who's in the BMI range of 32 to 35 or something like that, that doesn't need a tremendous amount of weight loss. And would just need 8% to 10% weight loss. That's a nice opportunity for the Amylin mechanism.

And the other as a single agent is in the patient who is truly intolerant of GLP-1 agonist. And it's a small percentage of people, but the market is so enormous that it's really quite a large market opportunity there. So those would be the, I think, the most obvious options for the single agent. In combination, we think it's a nice add-on. When you add a Amylin onto a GLP-1, you typically see 40% to 50% improvement in efficacy. And so if we could see that on top of our dual agonist that would represent a really industry-leading level of efficacy. So that's an area that we're also looking at. And with regard to that formulation is always a challenge. So it's an area we've done a lot of work on, and we're going to continue to proceed on both paths with the single agent and the combo. The combo will probably follow later than the single agent just so we can understand the single-agent profile first.

Our next question will come from Yale Jen with Laidlaw & Company .

Just a follow-up from the previous one, a similar line, which is that for 3019, although this current study, the Phase I studies or commerce -- but strategically, when you're going forward maybe to the Phase II or other late-stage studies, would you be focusing more on certain patients or you will still be more likely the all comers so what sort of strategic decision you might think of at this point?

Yes. Thank you. For the Phase I, it's, I guess, all comers, they're healthy, but their BMI has to be at least 27. So overweight, but otherwise and obviously, not on weight loss drugs, that sort of thing, but otherwise, all comers. And I think for Phase II, we would probably want to incorporate the same exclusion inclusion criteria, which would call for a 27 plus 1 comorbidity or 30 and above on BMI. It's pretty standard with respect to other studies.

Okay. Great. That's very helpful. Maybe just a quick question for Greg. For the second quarter, I think the cash use is about $100 million, if I'm correct. Just curious whether this is just a onetime or this could be higher advances for the future quarters?

Yes. Yale, I think the cash usage will start to go down a bit, taper a bit from here, certainly next year versus this year. But I think we've been a little higher earlier on and getting to the meat of our Phase III subcu trial. So I think this is really the heaviest usage period. But I do think we'll see a little bit of relief on that going forward and a little bit less cash usage. And our guidance remains intact that we have cash into 2028. So we're on track with our plans and what we've communicated previously.

Okay. Great. Congrats on the progress. .

Our next question will come from Roger Song with Jefferies.

This is Fiona for Roger. Just a quick one from us for the maintenance study. Did you implement a forced titration schedule during the induction period? Or do you allow slower titration as advance patient gets to the target dose. And on the cadence of reporting GIA numbers will be reported separately during the induction versus maintenance period or just overall numbers.

Yes. Thanks, Fiona. We try to keep people on schedule for that up-titration period if there is some intolerability issue, I think we allow a dose holiday. But really, we try to limit it on that flexibility. With respect to the breakout of periods and GI events or tolerability in general, I think that's an important breakout for us internally. So we would hope to have those data at the time of the release. But whether or not we have the week-by-week data to, I think, Steve's question earlier, I'm not sure that we would have that granularity, but we would hope to have just rates during the 2 periods. .

And our next question will come from William Wood with B. Riley.

So 2 quick clarifications for me. I'm just -- I want to verify that in the top line readout for your maintenance trial coming up. You had mentioned the importance of those dose curves, and I just want to make sure that we will get the dose curve for both the induction and the maintenance setting and then also just to verify, remind me or what are you thinking in terms of dosing for your Phase III oral trial? I don't think I've heard that yet. This is the -- yes, the Phase III oral.

And then lastly, in terms of your subcu oral maintenance trial, I believe that's going to be getting going soon, so it will be out a little bit next year. How should we think about that in terms of the design and sort of the number of arms, would that be expected to sort of match. Similarly, your subcu to subcu? Or are there any specific learnings you're looking to incorporate from your subcu from the ongoing maintenance trial?

Yes, good question on that. I think right now, it would be really a similar structure overall with the induction period about the same length. And then implementing multiple oral doses following the induction period and the 12-week window there as well. As far as the Phase III doses for the oral. We haven't disclosed those yet, but we would plan to have all those details then when we announce the initiation of the Phase III program and for the curves, what I -- sorry if I misspoke there. .

The curves are very important to us, whether or not we'll report the trajectories in the initial readout. I don't know if some of those take a little bit longer to generate, but it's very important in the overall data set to understand how the trajectories are maturing. So we hope to have a comment on that. But if we -- whether we have every single curve through every single week, I'm not sure if that would be available in the initial data release.

And our next question will come from Thomas Smith with Leerink Partners.

This is Brian on for Tom. So just on VANQUISH, we know the studies were initiated using a violent syringe for administration, but you transitioned to the auto-injector earlier this year. We're wondering if you received or if you're able to share any early feedback on how that transition has been for prescribers and patients.

Yes. Thanks. So it's been pretty smooth. There are 3 different windows that people can transition from the vial and the syringe to the auto-injector. And I think certainly, with VANQUISH-1, everybody is now on an auto-injector. I think for VANQUISH-2, almost everybody is on the auto-injector. So it's been a pretty smooth transition with respect to that. And it's helpful to the patients you think visits dropped from 4 per month to 1 per month. So it helps with that sort of the trial burden. .

Our next question will come from Jeet Mukherjee with BTIG.

Could you just remind us again how your Amylin program differs from others that are in development? And just from a clinical perspective, how quickly can you move to combo dosing with 273.

Yes. Thanks, Jeet. Well, it's a novel compound. In the animal studies that we looked at, it seemed to be very potent, more potent than we think the most advanced amylin agonist is today, pretty evenly balanced on calcitone and Amylin 3 seemed in obese primates to be more potent than VK2735 and sort of head-to-head work in obese primate. So overall, really encouraging, but you never know until you get into people and see what the tolerability and weight loss effects are. So that's what we're eager to understand.

And as far as the combination. I mean we're doing some of that preliminary work now. But I guess, entering the clinic with any sort of combo product wouldn't be until next year, I would say, at the earliest.

And our next question will come from Gregory Renza with Truist Securities.

Brian, team, congrats on the progress. Brian, you mentioned of expanding that internal infrastructure of adding Hubert, of course, advancing 3019. My question is just on portfolio construction. Just how are you thinking about the pipeline build? Do you feel as though you and the team have the right assets, the right staging, perhaps to be competitive and to really optimize the value of 2735 as well as sort of see that opportunity when it comes to customized treatments for patients.

Yes. Thanks a lot, Greg. Yes. So we do feel like the pipeline offers a lot of benefits and a lot of differentiation. I think -- we have the most advanced GLP-1, GIP agonist that's available in both the oral and subcu formulation. And I think our oral would be the first dual agonist approved when we think about how the maintenance study matures, every other week dosing, every month dosing, those would represent really important potential treatment options for people looking to maintain the weight loss that they've achieved. And I don't think we've seen really a lot of other data there for dual agonists that can succeed with less frequent dosing. So I think the pipeline and the overall profile of VK2735, really, really competitive, I think, differentiated from other advanced programs.

And we're continuing to explore additional novel areas and that one would be some of the questions we received today on the potential Amylin combination. We have a pretty robust early-stage development group as well, and we do a lot of work as science continues to evolve here. We do a lot of work looking at more experimental therapies and I think we see a lot of exciting things in the early-stage pipeline as well. So yes, I think we're pretty satisfied with the portfolio and everything we've done with a very lean structure.

And as we are nearing the conclusion of today's call, our final question today will come from Daniel Brims with Lake Street Capital Markets.

Thanks for fitting me into the call. And just curious, you've said that the GI tolerability typically is at the beginning and then once patients acclimate, typically those side effects subside. So you're not expecting switching from induction to maintenance to have much of an issue. Do you -- but since you're looking at using this more generally as a maintenance therapy, regardless of which induction therapy patients probably were on, do you think it's essentially going to be the induction phase to any integration is where that acclimation needs to occur. So switching from any drug to 2735, you're not expecting any new acclimation effects?

Yes. It's a great question, Dan, and really don't know the answer with any degree of certainty there. I think one thing that's good for us is that we will have if we're successful, a product that is very effective on a weekly basis, we think probably very effective on an oral basis. and then potentially very effective with a reduced dosing frequency sort of option and no one else has that. So we have more opportunities to keep people at this low risk of experiencing new side effects from transitioning to a different therapeutic agent.

If someone were to come in on another peptide-based therapy to our therapy, I just don't know how that side effect profile might manifest. But if it's a straight up GLP-1 transferring a peptide GLP-1 transitioning to GLP/GIP. You might expect the GLP/GIP to have slightly more moderate AE profile and maybe that would be an okay switch. But again, hard to know until we've actually done those switch type studies. But fortunately, for us, we'll have plenty of options for people to remain on therapy. I think that's a really nice attribute of the compound.

I'm looking forward to seeing that data later this quarter.

Thanks a lot, Dan.

And this will conclude our question-and-answer session. I'd like to turn the conference back over to Stephanie Diaz for any closing remarks.

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

The conference has now concluded. Thank you for attending today's presentation. You may now disconnect your lines at this time.

All right. Welcome, everyone, to Jefferies' 2026 Global Healthcare Conference. My name is Roger Song, senior analyst covering SMID cap biotech. It is my pleasure to have the fireside chat with our next company, Viking Therapeutics. We have the full group here, but welcome, gentlemen, and then Brian.

And yes, maybe, Brian, why don't you start with some company overview and the state of hour for Viking? You have a lot going on in the coming months and years. So let's start with that.

Yes, yes, sure. Sure. Thanks, Roger. Thanks to Jefferies for the invitation. Really appreciate it. We've got a great schedule. And I'm joined here by Greg Zante, our Chief Financial Officer; and Neil Aubuchon, our Chief Commercial Officer, as well.

A lot going on at Viking, it's a busy year. We have -- our obesity program is in Phase III development. We have 2 Phase III trials ongoing called VANQUISH-1 and VANQUISH-2. VANQUISH-1 is in obese patients, VANQUISH-2 is in obese patients with type 2 diabetes, both studies fully enrolled. And moving forward, we're expecting to read out the data -- right now, second half '27 seems like the time frame for those studies.

We also have an oral formulation of the same compound in Phase II. It showed a very nice weight loss trajectory, and we will be moving into 2 Phase III trials later this year with the oral tablet formulation. And that would represent, we think, the first -- if it's successful, the first oral formulation of a GLP-1/GIP co-agonist molecule.

We have another clinical study ongoing that will read out data in the third quarter that's looking at a transition from a weekly injection to every other week or a monthly injection, and that's intended to explore the potential maintenance effect of less frequent dosing. We think the half-life should support that sort of injection frequency. And so that will be an important data point. So we'll have those data available hopefully in the third quarter.

And then finally, earlier this quarter, we announced that we had filed an IND with an amylin agonist, a novel amylin agonist. And we're going to be starting a single ascending dose study with that molecule later this quarter, so this month. And the single ascending dose study would probably read out data, just really PK tolerability data sometime late this year or in the first part of next year.

Excellent. All right, Brian. One thing, I think it's a very positive development. You're -- you've got the alignment with the FDA to go right into the Phase III for your oral GIP. So what leads into that? And then on outside world, the investor side, that was the upside case you can convince FDA to do that? And then how should we think about the confidence you can go right into Phase III? Two is what will be the gating factor before you can start the Phase III in terms of any other CMC or any bridging or PK you need to complete before you can start the Phase III?

Yes. Yes. So for the first question, we had actually with the subcutaneous injection formulation after our 13-week Phase II study, we had a Type C meeting to ask if it would be okay to go into Phase III, and then we had an end of Phase II meeting as well, which supported our decision to go into Phase III directly with the subcu formulation.

And our thinking was with the oral formulation, since the subcu formulation is going to be generating so much safety data in such a large population of patients, probably close to 6,000 people all in, can we leverage those human safety data for the oral program? And if so, it would suggest that maybe we could abbreviate some of the development of the oral formulation and go from Phase II to Phase III using a smaller Phase III trial program and overall, much less expensive trial approach there.

And the FDA -- we had an end of Phase II meeting in the fourth quarter last year, and the FDA was -- they pointed out risks going from Phase II to Phase III, but they were okay with it. And so we planned and have been designing the studies and we're finalizing the protocols, and we'll be going into Phase III in the fourth quarter.

What's gating there, nothing really. We're going as fast as we can, just manufacturing the doses and getting the -- all of the titration doses prepared as well. So things are going okay there, but it's -- we've only got 65 people. So it's a heavy lift for a company our size to go into 4 different Phase III trials. But nothing is gating. Everything is kind of moving as fast as it can go.

Got it. And then I think you alluded already, this oral Phase III will be smaller than the injectable. And then maybe tie those two together, is that possible the readout from both sides of the Phase III will be in the relatively kind of similar kind of time frame?

Yes. So with the subcu, we think the Phase III data, we're looking at rough estimate here, second half '27. The oral, I think of that as always about 12 to 18 months behind the subcu. So the cadence of the subcu data, we would expect the VANQUISH-1 study to read out first since that was enrolled first, and then VANQUISH-2 to read out second.

And then with the oral, I don't know, if they enroll at the exact same rate, they'd read out at the same time. But I expect there may be disparity in enrollment rates there, too. But overall, we look at the oral being about 12 to 18 months behind the subcu.

Okay. Got it. How about the duration of the Phase III for oral versus subcu? Because subcu, you do have the titration all the way to the top dose, and then for oral, maybe less so. And then I understand all the obesity trial need to be 1 year on the maintenance at the top dose.

Yes, yes. So the titration, we haven't disclosed the doses yet for the oral, but the titration period will be shorter with the oral formulation. There will be fewer titration steps. So that means fewer weeks to get to that 52-week steady treatment phase of the study.

So overall, the subcu trials are 78 weeks. The oral studies will be shorter than that. And they're also smaller, but probably 75% smaller overall for the oral. So that should help to tighten the time line between the oral and the subcu, but still going to be probably 18 months -- 12, 18 months behind the subcu.

Got it. Okay. All right. And then you will have the maintenance study in third quarter. And then you recently announced you want to prioritize from subcu to subcu, weekly to every other week and then monthly. First of all, why did you make that decision? And then would that be even more favorable to incorporate that into the Phase III, it's already ongoing for the Phase III?

Yes. We designed this study -- so the compound has a pretty long half-life. It's 8 to 10 days or so half-life. And if you think of a dosing regimen being preferably every 4 to 5 half-lives, it raised the possibility early on that maybe we could dose monthly and reduce the frequency of injections. So we decided then to design this maintenance study where people titrate up to a high weekly dose and then transition to a less frequent dose, every other week or monthly. And that study was initiated in the fourth quarter of last year.

And when we -- as the trial evolved and the Phase IIIs evolved, it looked like the maintenance data was going to read out in a time frame that would allow us to use those maintenance arms, if they look good, in the VANQUISH 1-year extension. So the Phase III VANQUISH trials will have a 1-year extension that allows people to continue on therapy for a year after the trial stops. With the maintenance data reading out third quarter of this year, if everything works well, we could take anything that looks attractive from the maintenance study and then implement 2 or 3 arms into the 1-year extension of the VANQUISH studies.

And so that wasn't the way we planned it, but that's just the way the time lines seem to be converging. So we decided then if we're going to do something like that, let's get a better view of what the reasonable doses would look like. So the trial originally had 3 oral dosing arms. So we decided to defer those arms and incorporate more -- we put 2 more every other week arms, and we put 3 more subcu arms, and they're looking at every other week and monthly. So we just expanded the subcu.

No one -- when we made that decision, no one had yet moved into the maintenance phase, so it didn't really interrupt anything. And what we'll do with the maintenance then is basically do a Part 2 to the study where you do the same thing, initiate on weekly and then transition to an oral for a maintenance phase. But the oral wasn't as time sensitive as the every other week and monthly injection. So it just seemed to work out well that way. It seemed to be in our best interest to look at a wider range of doses for the 1-year extension.

Got it. On one hand, it's good that you explore many different regimen. On the other hand, it is a task for you to be able to discern the difference among all the regimen and how you're going to decide which one you want to put into the long-term extension for the Phase III. So tell us, what's the profile you're looking at, how to differentiate among all the regimen and then how many regimen you want to put into the Phase III?

Yes. We would look to bring in 2 to 3 -- if 2 or 3 look good, 2 to 3, we'd like to bring in. And what do we think of the trial outcomes and how does that drive our decision on which arms? Well, we kind of look at the trial outcomes there as 3 potential possibilities. One is when you transition to monthly, you continue losing weight, just the slope changes a little bit. So you're still kind of negative slope, but the slope is different.

Second possibility is that people flatline. They don't bounce. They just kind of stay within 5% of where that transition weight was. And the third possibility is people rebound after they transition. So we're hoping for a flatlining or maybe a slower rate of weight loss.

And then we would just look at the overall picture. There's kind of a mosaic. What is the tolerability profile? Are there any injection site reactions? What's the efficacy look like? What's the slopes -- what do the slopes look like? And we would just choose the 3 most attractive then.

Got it. And then the 5% is your internal bar in terms of you consider as a flat?

Yes, that's kind of what -- when you think of maintenance, I don't know if that's what people think of as a 5% delta. Either way, it means you've been maintained. If you bounce more than 5%, it's not so much.

Got it. Okay. Yes. Okay. And then in terms of the tolerability, which arm you think you may have some risk? Or you don't -- at least from the PK perspective, you don't expect to that GI will be worsening?

Yes, it's a complicated question because what we've seen in all the prior studies is those GI side effects tend to occur early, and they're transient. They just kind of go away. And when you look over time then like a histogram of GI adverse events, they just asymptotically approach 0.

So the question in this study is if you reduce the dose frequency to every 28 days but you're using a high dose, do you reintroduce some of those GI side effects? We don't know. I suspect the risk is low because you have drug on board through the month. So it's not like you're going from 0 to 60, so to speak. You've got slow decay of plasma levels. And then you bump it up a little bit, but you're still within a therapeutic range when you take the next dose.

So -- and you've gone through that initial sensitive period where you're just getting the drug on board and you see some nausea and things like that associated with GLP-1 activation. So I hope that there is good tolerability there, but that's one of the key questions with the maintenance study.

And then what will be considered as comparable tolerability into the rates? Or any numbers in your mind?

Yes. I mean, we look -- it seems like nausea is not as important to people. People expect it, clinicians expect it. You wouldn't want to see 75% nausea, but we're really sensitive to vomiting rates. We'd want to have a pretty low vomiting rate once you transition to the less frequent regimen. And I think that's fairly low risk that we would see a reintroduction of vomiting, but we'll see what the data show.

Because this is like a reintroduced new regimen -- because a normal trial, we know over whatever the time period, they get to 40%, 20% nausea and vomiting, 20% considered to be pretty good. And then when you give them a new regimen, are you considered as an incidence, another 20%? Or that's the -- maybe that's the bar, a bit too high?

We would -- I don't know, but I think that seems high because people are not getting it for the first time. They're on therapy for many weeks ahead of time. And again, once you transition to that monthly, you're taking a high dose. And so it's slowly decaying through the course of the month, but it's always, we think, therapeutic. So you're always going to be modulating the receptors. So you're just going to bump up to a higher concentration. So I would think that risk is low.

Yes. It's kind of like a titration. You just give them a little bit longer for the initial dosing, and then you are a little bit different in terms of the dosing regimen?

That's right.

Okay. Good. All right. So one thing I want to highlight is that you are one of the leading companies having the same API with different formulation in both injectable and then oral, with both of them moving to the Phase III or if not already in Phase III. How important that is in the commercial setting? Maybe, Neil, you can comment on that?

And then based on your current kind of understanding of the market, payer, patient, physician and then how this will play in favor too. Because we know the current market, you have 2 basically incumbent and then 1 have a both formulation, but kind of profile is not necessarily the winning profile. The other one is they have injectable very good, but the oral is not the same API or not even the same kind of modality. So how do you think this will play in favor of you? Anything you want to comment on that?

Yes, I'll take the first part. I think having the same molecule in multiple formulations and multiple dosing frequencies we think reduces the risk of seeing a new side effect appear once you transition from subcu to oral. It's the same compound.

If you go to oral, the exposure is probably going to be lower. It just seems to be a pretty clean transition. Should be, anyway. And I think we've seen that now with the comfort of people transitioning from subcu or Wegovy to oral Wegovy to the extent people do that, it's a different risk profile from transitioning to a totally different molecule. But Neil, do you want to talk about the commercial opportunity there?

Yes, sure. Well, first of all, it helps when you have, I think, a really good product. So we are seeing that the GLP-1/GIP dual agonist class seems to be the most efficacious class, and we would be the second injectable, but we'd be the first oral to launch. So that gives us the opportunity to be a first-in-class and potentially best-in-class oral.

And so you have to kind of separate the markets a little bit, the oral market and the injectable market. What we're seeing now is that the oral market uptake is really very good overall. And it's not cannibalizing the injectable market, hardly at all. So it does seem to be incremental growth. So for us to be able to come in and potentially have a first-in-class, best-in-class oral is very encouraging.

In terms of commercial synergy, the fact that we can have the same brand name, I think, is actually a big deal for us because being a smaller company, we're looking to have as much commercial efficiency as possible. And we see with the first entrant, it's the same brand name, to your point. And so that allows you to not have to build that brand awareness among consumers and physicians, et cetera. So that will be the same situation that we'll be in. The injectable will launch first, and the oral will launch second under the same brand name. And so that only makes our job easier.

Got it. Okay. And then I think, Brian, you've been talking about the potential partnership strategy, but you're ready to launch the drug by yourself if you don't want to partner. And then what would be the sensible commercial strategy if you want to do that on your own? I think you're targeting 5% to 10% market share, which I think -- single digit, high single digit is reasonable. But on the other side, it is a massive undertaking for a company and then how you're going to -- I know you're going to help you. But on the other side is how are you going to make that achievable as a company?

Yes. Yes. To your point about partnering, we're always receptive to inbound interest. And I'd say there's very high awareness across the industry in our program and I think high interest in participating in obesity by a number of larger players. So we're always open to that.

And we've always felt that having the muscle of a larger party involved would be beneficial to the product because there's probably greater reach and greater depth of resources. But we need to run the business, and we need to be prepared to launch successfully as a stand-alone. And that's what we're doing, putting in place all of the pieces that will allow us to be successful.

What we've seen with obesity which is somewhat unusual is this rapid evolution of direct-to-consumer channels that really hasn't been there historically. And it allows a company like Viking to credibly enter a market the size of the obesity market and capture market share. When you look at the compounders, for example, really no infrastructure there, but they took 15% of the market. We think these unique distribution channels would allow a company like us with maybe fewer resources than some of the large caps to launch a product that would be really, really successful for our size footprint. But Neil's got a much more detailed view of it [ because he's in it ] every day.

Sure. I'll just add a few comments. I think Brian characterized it well. But I would just say that really can't overstate how much the ecosystem has evolved in the last year or 2. And there's the direct-to-consumer channel. And these companies, frankly, do direct-to-consumer marketing better than big pharma does.

And you have to think of these as almost like supermarkets. They don't want -- they want to sell both Coke and Pepsi, right? So they don't want to do exclusive deals. And we talked about our clinical profile a few minutes ago. Any situation where we're competing just purely on our clinical profile, I like our chances. And so to be able to partner with direct-to-consumer companies -- and we're talking to just about all of them now -- gives us a really good opportunity. And some of the larger companies have stated recently that 50% of their business is cash pay. So this segment is continuing to grow.

The other segment that is growing -- well, about to grow really a lot in the next 6 months is direct-to-employer. So employers are carving this benefit out and they're treating it like a gym membership, where they're subsidizing the cost of GLP-1s to their employees. And then the employees are paying the incremental difference with out of their HSA, for example. So the affordability is actually increasing for commercial employees. And again, the great thing about this is that it's not through PBM, so there's no rebate wall that we have to worry about.

And then finally, Medicare is going to be covering these drugs as of July 1. Now there's still a lot to be understood about exactly how that's going to work. But I do believe that this will not be a duopoly. And if you match the price, the U.S. government is going to be, hey, the more competition, the better. So I think that, that channel is going to be open to us as well.

So if we think about kind of the commercial constraints we have, usually, it's around access. And usually, it's via the PBMs and the rebate wall. And what I'm saying is that the channels are evolving to such a degree that, that is going to become less and less of an issue for us.

Agree. Yes. Okay. Good. I think we'll spend most of the time on the GLP-1 and GIP side, which is understandable. But you do have the amylin, which is another major class for future obesity, either as a monotherapy, alternative therapy or as a combination. And how differentiated do you think the amylin DC is looking like? And then what's the target profile you want to achieve?

Yes. Well, it's very potent. So when we look at sort of head-to-head studies in monkeys versus the 2735, the GLP/GIP co-agonist, it seems to be more potent at the same dose level. So that, I think, is really encouraging.

We won't know the tolerability and PK profile until we get into our Phase I program, but the early data look pretty impressive. And we think it's at least competitive with the efficacy that we've seen from other agents in the market. It's pretty balanced on the amylin-3 and calcitonin receptor, almost 1:1 ratio there. The PK profile, again, we don't have in humans, but in monkeys would suggest that a weekly regimen is feasible. So if the potency holds up and that PK profile holds up, we think it would be maybe a reasonable single agent to look at.

When we conceived the program, we thought adding amylin onto the dual agonist would be the best approach because it would kick the efficacy up to be best in industry level. But as we've seen the market evolve, amylin agonists have a pretty attractive place in their own right as an option for somebody who maybe doesn't need to lose 100 pounds. Somebody starts at a BMI 32, 34, or somebody who can't tolerate a GLP-1. And that's a small percentage of the population. But when you're looking at the size of this population, it's a very large market opportunity. So both of those will be opportunities for the single agent in addition to the combo.

Yes. I think amylin field is still in the early innings compared to the GLP-1, right, or the [ incretin ] side because you have so many companies working on it. Not necessarily all in the latest like you guys, but a lot of people are working on it. But amylin side is still figuring out what's the right profile, what's the ratio.

I think from preclinical, you like your compound. So moving to the clinical. So what we're going to see for the initial data readout, and then what the profile you think you'll be happy to move into the Phase II?

Yes. Well, with the Phase I, we would hope the PK supports a weekly regimen. We think it should, but we don't have the data yet. And then tolerability, we'd like to see good tolerability. And that can be a challenge with the amylin activation.

So the first single ascending dose stage is just 1 dose. You take 1 dose and then look at PK and look at tolerability. The test of what's the weight loss program look like or the weight loss efficacy look like, you just need to dose over a 4-week window in the first multiple ascending dose setting.

So -- and that will depend what do the curves look like, what's the shape -- the slope of the curves look like and what's tolerability look like as you step up. So that will be an important data set. Hard to gauge the magnitude of the weight loss in the MAD setting because you want to look at everything, the slope and the tolerability and the exposures. But that will be a next year data set.

Got it. And then you will combine the SAD and the MAD together? Or so what's the timing of the data readout?

Well, we'll probably have them -- because there will be a time line difference there, if there's something interesting to say about the SAD, we release that first.

Okay. And then the MAD probably will be late next year or something?

Yes, probably a '27 event for the MAD, yes.

Yes. If you release SAD it will be this year?

End of the year, beginning of the year, something like beginning of next year or something like that, yes.

Got it. Okay. Great. I think we went through everything related to your pipeline and upcoming events. Anything else we missed and that you want to discuss?

Well, we can talk about the balance sheet.

Yes. Okay. Yes.

Thanks, Roger. So we ended the first quarter with over $600 million. We're funded nicely to get through our top line data for our subcu program, which we anticipate data in the second half of '27. We also -- I think the cash would carry us through our oral -- what we see as our oral Phase III program, which will be quite a bit smaller than our subcu, as Brian mentioned. So that will allow us -- so we have cash into the early portion of '28.

A very high percentage of our spend at the company, of course, because we're so small is on direct expenses for our clinical trials. So we have a very efficient cash spend footprint at the company.

Got it. And then maybe as you go into the first half of 2028, how much pre-commercial you will be prepared? And now how much is baked in the current runway?

Yes, there's a lot of spend also on additional amylin work that we're doing and some other programs that we haven't disclosed. But there is some other spend there in the pre-clinical side.

On the commercial...

And the commercial side, yes, Greg and I have sat down pretty closely. And as I started, I wanted to make sure I had enough cash to be able to commercialize. And we feel -- we still need to fine-tune it, et cetera, but we feel pretty good about where we're at. Yes.

Okay. Good. All right. I think that's it from my side. Any closing comments, Brian?

No. exciting year for us with the Phase IIIs ongoing, and the oral Phase III is about to start. The maintenance data in the third quarter, I think, will be a really interesting data set to digest. And then hopefully apply into the Phase III extension studies, and then look forward to '27 with the registration data.

Excellent. Thank you, gentlemen. Thank you, everyone.

Welcome to the Viking Therapeutics First Quarter 2026 Financial Results Conference Call. [Operator Instructions] As a reminder, this conference call is being recorded today, April 29, 2026. I would now like to turn the conference over to Viking's Manager of Investor Relations, Stephanie Diaz. Thank you, and over to you.

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 29, 2026, 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, 2026, and review recent progress with our pipeline programs and operations.

During the first quarter, we made significant progress with our obesity franchise, highlighted by our lead compound, VK2735, a dual agonist of the GLP-1 and GIP receptors. As we have previously reported, in June 2025, following the positive results from our Phase II VENTURE study, Viking initiated its Phase III VANQUISH clinical program evaluating VK2735 dosed as a weekly subcutaneous injection. The Phase III VANQUISH program includes 2 studies: VANQUISH-1 evaluating the treatment of adults with obesity and VANQUISH-2 evaluating the treatment of adults with obesity and type 2 diabetes. Enrollment in the VANQUISH-1 trial was completed in the fourth quarter of last year. And during the first quarter of 2026, we were pleased to announce the completion of enrollment in the VANQUISH-2 trial. Both studies continue to proceed on track.

Also in the first quarter, the company made progress with its oral VK2735 program. Following an end of Phase II meeting with the FDA, and based on the positive top line results reported in our Phase II VENTURE-Oral dosing study, the company elected to advance oral VK2735 into Phase III clinical development, which we plan to initiate later this year. Concurrent with the planning and execution of our subcutaneous and oral registration programs in October 2025, Viking initiated a maintenance dosing study with VK2735 to assess the effect of various maintenance regimens, including monthly, every other week or weekly dosing. This [indiscernible] has advanced rapidly with enrollment completed in the first quarter of this year, less than 3 months after initiation. We expect to report the results of this study in the third quarter.

Finally, in the first quarter, we filed an IND with our novel amylin receptor agonist and pending clearance are on track to initiate the clinical development of this compound later this quarter. I'll have additional comments on our operations and development activities following a review of our financial results for the first quarter ended March 31.

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 shortly.

I'll now go over our results for the first quarter ended March 31, 2026. Research and development expenses were $115.2 million for the 3 months ended March 31, 2026, and compared to $41.4 million for the same period in 2025. The increase was primarily due to increased expenses related to clinical studies, manufacturing for our drug candidates, consultants, salaries and benefits and preclinical studies, partially offset by a decrease in expenses related to stock-based compensation.

General and administrative expenses were $14 million for the 3 months ended March 31, 2026, compared to $14.1 million for the same period in 2025. The decrease was primarily due to decreased expenses related to legal and patent services and stock-based compensation, partially offset by increased expenses related to consulting, salaries and benefits and scientific and disease education. For the 3 months ended March 31, 2026, Viking recorded a net loss of $158.3 million or $1.37 per share compared to a net loss of $45.6 million or $0.41 per share in the corresponding period in 2025. The increase in net loss for the 3 months ended March 31, 2026, was primarily due to increased research and development expenses partially offset by decreased general and administrative expenses compared to the same period in 2025.

Turning to the balance sheet. At March 31, 2026, Viking [indiscernible] cash, cash equivalents and short-term investments of $603 million compared to $706 million as of December 31, 2025.

This concludes my financial review. And I'll now turn the call back over to Brian.

Thanks, Greg. I'll now provide an update on Viking's clinical and operational progress, beginning with our lead obesity program, VK2735. 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 that has demonstrated promising efficacy, safety and tolerability across multiple clinical trials.

As I mentioned in my opening comments, Viking is developing both an injectable and an oral formulation of VK2735 for the treatment of obesity as well as evaluating a novel maintenance dosing protocol to support long-term weight management. During the first quarter, Viking made substantial progress in each of these areas.

With respect to the subcutaneous VK2735 program, Viking's prior Phase I and Phase II trial successfully achieved their primary and secondary endpoints, demonstrating significant weight loss compared with placebo as well as an impressive safety, tolerability and pharmacokinetic profile. In the Phase I subcutaneous study, subjects receiving VK2735 achieved up to approximately 8% weight loss from baseline after 4 weekly doses with no signs of plateau.

In the Phase II VENTURE study, patients demonstrated statistically significant reductions in mean body weight from baseline ranging up to 14.7% after 13 weekly doses, again with no signs of plateau. Importantly, the VENTURE study also showed VK2735 to be safe and well tolerated through 13 weeks of dosing with the majority of treatment-emergent adverse events characterized as mild or moderate and resolving quickly. These results were highlighted in a presentation at the 2025 ObesityWeek Conference last November. The final results were also published in January 2026 in obesity, the peer-reviewed Journal of the Obesity Society.

Following the VENTURE Phase II study, Viking held a Type C meeting with the FDA and subsequently an end of Phase II meeting with the agency. Based on feedback from these meetings in June of last year, the company initiated the VANQUISH Phase III registration program, evaluating subcutaneous VK2735 in patients with obesity. The VANQUISH program consists of 2 clinical trials, 1 in adults with obesity and 1 in adults with obesity and type 2 diabetes. Each study is a randomized, double-blind, placebo-controlled multicenter trial designed to assess the efficacy and safety of VK2735 administered by subcutaneous injection once weekly for 78 weeks.

Enrollment in each of these trials was rapid with the VANQUISH-1 study enrolling approximately 4,500 patients by November 2025, approximately 5 months after trial initiation. Enrollment in the VANQUISH-I study was completed in the first quarter, enrolling approximately 1,000 patients. Participants in each trial are being randomized to weekly doses of 7.5 milligrams 12.5 milligrams, 17.5 milligrams or placebo. Primary endpoint of the VANQUISH trials is the percent change in body weight from baseline for participants receiving VK2735 as compared to placebo after 78 weeks of treatment. Secondary and exploratory endpoints will evaluate a range of additional safety and efficacy measures, including the percentage of patients who achieve at least 5%, 10%, 15% and 20% weight loss.

Each study will include an extension portion, allowing participants the opportunity to continue receiving treatment following completion of the primary dosing period, including patients who were randomized to placebo for the initial 78-week treatment period. Another important achievement during the first quarter for both the VANQUISH-1 and VANQUISH-2 studies was the successful introduction of an auto-injector device into the trials. As a reminder, both VANQUISH-1VANQUISH and VANQUISH-2 were initiated using a vial and syringe for administration of VK2735. In the fourth quarter of 2025, Viking conducted a bioequivalent study to facilitate the introduction of an auto-injector, which we believe will add optionality to treatment and may represent a more convenient method of administration for patients. This study was successfully completed. And in the first quarter of 2026, participants in both VANQUISH studies began transitioning to the auto-injector device. This transition has been proceeding smoothly, and we are very pleased to now have both VANQUISH studies advancing with our state-of-the-art auto-injector.

I would now like to provide an update on Viking's oral tablet formulation of VK2735. I referenced a moment ago that we believe the auto-injector device in our subcutaneous VANQUISH studies will provide optionality and treatment. The concept of optionality is becoming increasingly important based on our conversations with physicians and KOLs about treatment regimens. Every patient's weight loss journey is unique, and we consistently hear from health care providers about the need for flexible treatment and administration options. We have long believed that an oral tablet formulation has the potential to be an attractive option for those who prefer to initiate treatment with an oral therapy or for those seeking to maintain the weight loss they have already achieved via weekly injection. Providing this optionality has been an important driver for the development of our oral program.

Given the recent success of another oral peptide for obesity, we are even more optimistic about the promise of oral administration. Viking's prior Phase I and Phase II studies evaluating oral VK2735 successfully achieved their objectives, in addition to excellent safety and tolerability, our Phase I study demonstrated dose-dependent reductions in mean body weight from baseline ranging up to 8.2% after 28 daily doses.

In addition, the Phase II VENTURE-Oral dosing study of VK2735 achieved its primary and secondary endpoints with participants receiving once daily doses of the tablet formulation demonstrating statistically significant reductions in mean body weight after 13 weeks, ranging up to 12.2% from baseline. Statistically significant differences compared to both baseline and placebo were observed for all doses above 15 milligrams starting at week 1 and continuing throughout the 13-week treatment period. Up to 80% of subjects in VK2735 treatment groups achieved at least 10% weight loss after 13 weeks compared with only 5% of placebo-treated subjects.

The tablet formulation of VK2735 also demonstrated encouraging safety and tolerability through 13 weeks of once daily dosing. The vast majority, 98% and of drug-related treatment emergent adverse events were characterized as mild or moderate in severity. Importantly, in the dose range we plan to explore in future studies we believe the data show no meaningful difference in GI-related adverse events between subjects treated with VK2735 and placebo. The tolerability data from the VENTURE-Oral dosing study also suggests that future titration regimens, starting at lower doses and utilizing longer titration intervals are likely to further improve oral VK2735's tolerability profile.

As with our subcutaneous program, following the completion of the VENTURE-Oral dosing study, we held an end of Phase II meeting with the FDA. Based on feedback from this meeting, the company plans to advance oral VK2735 into Phase III development for the treatment of obesity. We currently expect to initiate this program in the fourth quarter of this year, and we'll provide more details on study design at that time.

As part of our goal to create an optimal treatment experience for patients on their weight loss journey, Viking is actively engaged with KOLs and health care providers and advocates who are focused on improving the lives of those living with obesity. Through these relationships, we have the opportunity to listen to a range of stakeholders in the community and to work towards solutions that best meet their treatment needs. Viking's efforts at developing a novel maintenance dosing strategy emerged as a result of these conversations. In approaching how the best design a maintenance study, we consider the unique characteristics of the VK2735 molecule, namely its potency and unique PK profile. We believe these features may allow the development of maintenance regimens that utilize less frequent dosing than the weekly regimens used by existing agents. This could be an attractive option for those patients who have achieved their weight loss goals and are seeking to maintain that weight loss going forward.

By using the same therapeutic agent for both the induction and the longer-term maintenance phase of weight management, we believe patients may experience reduced side effects compared with options that require switching between different therapeutic agents. By reducing side effects, we believe adherence to treatment may be improved, allowing patients to ultimately realize the long-term benefits of weight loss and maintenance, including improved cardiovascular health enhanced physical function and increased quality of life.

With these goals in mind, in the fourth quarter of 2025, we initiated a Phase I study to explore a range of maintenance dosing regimens. In this study, all subjects will receive initial weekly doses of VK2735, followed by a transition to a range of maintenance regimens or placebo. The objectives of the study are to evaluate the safety, tolerability and pharmacokinetic profile of VK2735 under these various regimens. Exploratory endpoints will assess the change in body weight from baseline as well as the change in body weight from the time of transition to the end of the study. The timing of this study is particularly important to our broader development program as we believe the results from these maintenance regimens could be utilized in the upcoming 52-week VANQUISH extension studies.

As a result of this timing, and the importance of selecting doses for immediate use in the subcutaneous extension studies, we have bifurcated the study to focus first on the subcutaneous maintenance cohorts followed by the oral maintenance cohorts. To this end, we've expanded the number of subcutaneous dosing arms in this study from 4 to 8. This increase in cohorts will provide a broad and robust data set from which to choose for inclusion in the VANQUISH extension study. Following the completion of the subcutaneous maintenance cohorts, we will continue the study to evaluate a similarly wide range of oral cohorts. We expect to report the results of the subcutaneous portion of the study in the third quarter of this year and expect to report the oral maintenance results in the first half of next year.

Moving to our other pipeline programs. Viking is also evaluating a series of novel agonists of the amylin receptor. Early data demonstrate that activation of the amylin receptor is an important potential mechanism for regulating appetite and body weight making this program an excellent addition to our obesity franchise. In 2025, we made significant progress with our lead amylin agonist VK3019, and we recently filed an IND for this program. Pending clearance, we expect to initiate a Phase I clinical trial for VK3019 later this quarter.

As VK2735 advances through Phase III development and toward potential approval and commercialization, we continue to thoughtfully grow our organization to meet the opportunities and challenges that lie in the not-too-distant future. Key recent additions to our team include staffing across a range of scientific and operational roles, including supply chain management, manufacturing and quality.

To coalesce these functions into an efficient and effective commercialization strategy, the company announced in the first quarter the appointment of Neil Aubuchon as its first Chief Commercial Officer. Neil brings to Viking more than 20 years of industry experience, including nearly 17 years at Eli Lilly. He has held leadership roles across global commercial and marketing functions in the cardiometabolic space, making him uniquely qualified to lead our commercial strategy for VK2735. We are excited to have him on board to lead this critical operation.

As always, Viking remains vigilant in managing the company's balance sheet to ensure we're able to successfully execute our objectives. As Greg reported a few minutes ago, the company held approximately $600 million in cash at the end of the first quarter, which allows us to reach important corporate milestones, including the completion of our ongoing Phase III obesity trials as well as to pursue development of our additional programs.

In conclusion, I'm happy to report that the advances and momentum of 2025 have continued through the first quarter of 2026. Looking ahead, we plan to have both our subcutaneous and oral VK2735 programs in Phase III registration trials during the year. Our maintenance dosing trial continues, and we look forward to reporting data from this study in the third quarter. With respect to our earlier stage pipeline, we expect to initiate a Phase I trial for our amylin agonist VK3019, shortly. Operationally, as our programs continue to progress toward potential approval and commercialization. Our organization continues to evolve as well. Our team is focused on executing a timely and strategic expansion plan that ensures that Viking has the partnerships, vendors and in-house expertise required to succeed in all areas including clinical, regulatory, manufacturing and commercialization.

And finally, we expect to offer industry-leading options with respect to administration, dosing and maintenance that physicians and patients need to optimize the path to individual weight loss goals and long-term health. We look forward to reporting our advances on these fronts in the coming months.

This concludes our prepared comments for today. Thanks for joining, and we'll now open the call for questions. Operator?

[Operator Instructions] We have the first question from the line of Steve Seedhouse from Cantor.

First is just on the change from 4 to 8 subcu maintenance cohorts in the ongoing study. I was hoping you could just elaborate on what like doses and intervals, the new 8 cohorts are testing. And then also, if you wouldn't mind just quickly commenting on R&D just for our modeling, maybe connecting the dots between the like $160 million-ish or so net loss versus about $100 million in net cash change. And I think folks specifically were expecting R&D to come down a bit this quarter from some onetime Phase III start-up costs. So I just would hope if you could clarify if you're expecting R&D cost to come down next quarter or if this is maybe the new run rate?

Thanks, Steve. This is Brian. I'll take the clinical question, and Greg will take the cash question. So on the maintenance study, just given the importance of this study for implementation into the VANQUISH extensions, we decided to extend the cohorts and then defer the oral dosing to a second part. So we'll retain those first 4 cohorts that we had earlier, which were 22.5, 20 17.5 mg monthly as well as 7.5 mg every other week. But we've added 15 monthly, 10 monthly 10 every other week and 5 every other week. So we got a nice range of every other week and a broader range of monthly doses.

Yes. And Steve, on the OpEx and cash, for one, the disconnect on that a bit is really timing, a function of timing. They just were higher expenses and cash usage and that stuff evens out over time. But over the -- looking ahead in this next quarter, I think our cash usage and expense will be around where we were at quarter 1, maybe a bit lower. But toward the second half of this year, I would expect this to taper down a little bit. So the overall usage is still in line with our projections from our last call. And we would anticipate having cash into '28 and through the catalysts we've talked about, including the oral Phase III data points. So we remain funded as we expected, but we probably used a little bit more in the first quarter than I anticipated, but we are on track.

We have the next question from the line of Thomas Smith from Leerink Partners.

This is Nathanael on for Tom Smith. We have a couple of questions. So the first one now that both VANQUISH-1 and VANQUISH-2 full enrolled, what baseline characteristics are you seeing? And are they consistent with your expectations? Are you seeing any difference of enthusiasm, seen failure rates or retention between VANQUISH-1 and VANQUISH-2? And we have a follow-up.

Yes, sure. So we're actually going to present the baseline demographics at 2 conferences this year. I think in the European Congress of obesity, we'll have the VANQUISH-1 demographics. And then at EASD, we'll have VANQUISH-2 demographics. So I'll defer to those conferences for the demographic disclosures. But I don't think anything is kind of out of the ordinary with respect to the population relative to other studies that are kind of down the middle of the fairway.

Got it. Yes. And the second one, how should investors think about the expected weight loss in type 2 diabetic versus nondiabetic OBC patients?

Yes. Hard to know. It's obviously the individual investor to make that estimation. But generally, type 2 patients are a little bit more resistant to weight loss than non-type 2 patients. So I don't think that would be surprising to see in the weight loss data from these studies. I think probably see more robust effect in the straight obesity and maybe a little bit lower efficacy in type 2 diabetics, just like everybody else has shown.

And finally, on the Phase II initiation of oral VK2735, which is now expected in 4Q '26, what changed versus prior expectation for [ 2226 ].

Nothing really changed. We're moving incredibly fast and scaling up dramatically here. And as you do that, you learn a lot about the process and efficiencies, making 100 tablets is different than making 1 million tablets. And so you learn a little bit more about engineering processes and et cetera, that get optimized along the way just to ensure you got the most efficient and cost-effective methods in place. And all of that takes some time. We feel good about the supply chain and the capacity and efficiencies and where we're at in the development cycle. So I look forward to initiating as early as possible in the fourth quarter.

We have the next question from the line of Mike Ulz from Morgan Stanley.

Maybe just a follow-up on the maintenance study. Obviously, you're testing a number of different regimens, subcu, oral, et cetera. Just curious, early in the study, if you're getting a sense of which one of those options that's sort of resonating most with the patients? And could it be the monthly dosing? Or is that a wrong interpretation?

Yes, we're not really getting that level of feedback, Mike, and it would be hard to interpret because it's a placebo-controlled study. But we made the addition of the subcu cohorts before anybody had transitioned to the maintenance setting. So no one had actually entered into the oral maintenance portion. We made the decision and expanded the subcu portions. We'll do the oral then in a separate part of the study.

We have the next question from the line of Ryan Deschner from Raymond James.

What were the key factors that went in selecting the 19-week period as the subcu induction time period for the maintenance study? And then I have a follow-up.

Yes. Thanks, Ryan. It was really driven by the time to titrate to the 22.5 mg dose. That was the highest dose, and we wanted to put people -- first get people up there and then keep them there for I think it's a 3-week treatment time there and then transition everybody to the maintenance at the same time point. So that was sort of the rate-limiting factor, the time it took to titrate to the highest dose.

Got it. That's helpful. And I guess I just wanted to kind of feel out what the odds might be. Would you add an additional oral cohorts potentially later on in the maintenance study. Is that something that could be on the table?

Yes, absolutely. Great question. Yes, we will be adding more cohorts to the oral portion of the study. So we'll probably look at a few more doses as well as potentially alternative regimens.

We have a next question from the line of Anna Samimy from Stifel.

So obviously, with the addition of new cohorts or maintenance studies seems to have gotten a little bit more involved. And I guess I'm trying to figure out what the various possibilities are for that extension trial? Are you going to select 1 of these cohorts? Are you going to give the option for multiple cohorts going into the extension study? Like what is the purpose of having all these 8 additional cohorts. I'm just trying to understand exactly what you intend to do with these cohorts going forward? Is it just for information purposes and their selection in the extension study? And then I guess taking it forward, are you going to develop it any further past this extension study for possible inclusion in the label? Or is it just developing a wealth of data for physicians to draw and sort of use the data as an art rather than a very prescriptive formula for maintenance for these patients.

Yes. Thanks, Annabel. Two great questions. I think with the second question, at a minimum, we would hope to be able to publish the extension data from the VANQUISH extension, utilizing some of these maintenance cohorts. So that would provide valuable information in the form of publications to clinicians and patients. And what do we expect to learn from the maintenance cohorts? So really, the best maintenance strategy to employees is every other week dosing preferable. It seems like a lot of people are doing that now just out in the real world. is monthly going to be the better strategy. And if so, what dose. And so we had only 3 monthly doses and 1 every other week dose in the prior study.

And so we thought to better inform the cohorts that would go into the extension of VANQUISH, and there will be more than 1 dosing arm in the extension studies for maintenance and Vanquish. It just made sense to expand the subcu cohorts and then defer the oral since we went as time sensitive on the oral to a separate part of the study.

Okay. Got it. So just to clarify, you will have a very defined set of cohorts in that extension study. Drawing from this data, the Phase I data?

Oh, sure. Yes, definitely. It will be multiple maintenance cohorts there that will be drawn from these data. Yes. Thanks, Annabel.

We have the next question from the line of Biren Amin from Piper Sandler.

Brian, I guess just on the VANQUISH expansion, when will the maintenance doses be introduced for the subcu? Will that be at week 78 or week 84? And how long will you be evaluating those subcu doses? And I guess just a follow-on question for the VANQUISH dose cohorts in the treatment phase of 7.5 and 12.5 weekly, how do you think about the transition of those patients to maintenance doses given the maintenance trials evaluating 15 milligrams weekly and higher in that 19-week induction period.

Yes. Well, we'll -- for the first question, we'll transition people at 78 weeks won't be a sort of a washout or anything like that out and we plan to run the extension for 52 weeks. As far as the transition from $17.5 million to whatever the maintenance dose might be. Yes, if you were to go from 17.5% to a higher 22.5 mg dose or something like that, there could be some incremental adverse events. That's not really what you see after a prolonged exposure like this, but those are all the things that we'll find out during the trial. Thanks, Biren.

We have the next question the line of Jay Olson from Oppenheimer.

Congrats on all the progress. Just a follow-up on some of the factors that informed your decision to initiate the Phase III oral study in the fourth quarter. Did you want to see the results of the Phase I maintenance study in the third quarter before starting the Phase III oral study in the fourth quarter? Or were there other factors involved -- and then we also had a question on 3019. Could you just talk about your plans for the Phase I amylin program? Are you thinking about induction, maintenance combination, I guess, what's kind of on the table there for your amylin program.

Yes. Thanks, Jay. For the oral study, no, we weren't planning to wait for the data. They're just independent factors, the maintenance data and the initiation of the oral studies that were not related. With the 3019 molecule, the first study will be -- before you think about combos and that sort of thing, first, you want to understand the compounds basic properties. And so the first 2 studies will be a SAD study and then a MAD study. We are initiating combo talks with the 2735 compound. So longer term, I think that's a really promising area to look at. But the initial studies will just be single agent. And it would be kind of the playbook we used for 2735 with a [indiscernible] followed by a 28-day mat. Nice opportunity with this mechanism to potentially target people who are a little lower BMI, 32 to 34, 35 or people who can't maybe can't tolerate the GLP-1 and want to try something different, but both are very significant opportunities for the amylin program.

We have the next question from the line of Andy Hsieh from William Blair.

Just for the extension portion of the VANQUISH study, I'm curious about maybe the patient's ability to select just given the open-label nature of the study? And also do you allow patients to maybe down titrate if you're they're at a higher monthly dose or up titrate if they actually see like a weight regain -- just maybe from a practical protocol-related nation.

Yes. Thanks, Andy. Great question. It's not really an open-label study. And so people -- if you were on placebo, you will be randomized to active agents, but you don't know which dose level you'll be at -- and we're not going to, I think, discuss many design details otherwise until we actually start the study, but you can imagine some people staying on their current therapy and some people transitioning maybe to a maintenance regimen. So different groups of people might be randomized to different cohorts. I think it's a very elegant and nice study design, but we probably won't discuss too many details until we actually start it. Thanks, Andy.

We have the next question from the line of Roger Song from Jefferies.

Great. To put a final point on the VANQUISH extension regimen from the maintenance data you will report. I understand that you want to expand every 2 weeks dosing. And then is that fair to say you want to pick 1 monthly on for every 2 weeks. And how much delta among those dosing regimens you will take multiple within those 2 frequency?

Thanks, Roger. Yes. So I think more generally, we want to select the most effective arms and doses. So not wedded to a certain number of every other week or a certain number of monthly just whatever seems to be the most effective. So we would look at multiple arms to come forward, and those will be based on whatever seems to look best in this initial 102 maintenance study. Thanks, Roger.

We have the next question from the line of William Wood from B. Riley Securities.

Very nice progress you've been making. So two from us, one upfront and then a follow-up. I'm just curious in terms of your maintenance trial with the additions of the new subcu and then also it sounds like the new additions of the oral. Should we expect any delay in timing throughout the third quarter, maybe from the beginning to the end and/or should we expect sort of multiple data cuts throughout the third quarter in terms of whether it's at the 19-week and then the final maintenance or we'll get the subcu first and then the oral. Maybe just if you could clarify on that? And then I have a follow-up.

Yes. Thanks, William. It will probably be 2 data releases, 1 for the subcu cohorts and then subsequently for the oral cohorts. But the subcu will be in the third quarter, and we don't anticipate there being a substantial difference in the timing for the data to be available. Maybe a little bit, but nothing significant.

Right. That's very helpful. And then on your VK3019. You've mentioned in the past that, that asset has shown better efficacy or potentially weight loss than your 2735, at least preclinically. I was curious if you could provide some of those comparative parameters of the 2 drugs, maybe Cmax, Tmax or half-life or even weight loss understanding it all be preclinical and how this might have compared to tirzepatide or even per amylin, if you've done any of those studies. Just sort of trying to get a better understanding of what stood out on this particular asset that decided for you to bring it to the clinic.

Yes. Thanks, William. Yes, unfortunately, I don't carry a lot of those data around in my head. There's too much other junk up there. But it was very potent on the receptors, very good PK profile that would be amenable to weekly dosing, we think, and that marries up nicely with the 2735-PK profile. When we looked at data in rodents, it seemed to be better than cagrilintide. When we looked in obese monkeys, it seemed to provide better weight loss than VK2735.But I don't have those numbers off the top of my head, these are just general comments. Thanks, William.

We have the next question from the line of Hardik Parikh from JPMorgan.

Just a couple of questions on the oral program. So just one is I know in the past, you've talked about you're working on reducing the number of tablets you have to take at a dose. I was wondering if you have any updates there on where you are in that progress? And then just a high-level question on -- you mentioned the launch of another oral peptide -- just what are you -- how are you -- where do you think the takeaways from that launch in terms of just what it says about the overall market and then the role of oral peptides in general?

Yes. Thanks, Hardik. So we would want to have no more than 2 tablets as the higher dose option lower doses would be 1 tablet. So in the Phase II trial, everybody took 4 tablets and the feedback we received was that's just people weren't real satisfied with that -- so no more than 2 tablets. And we generally don't comment too much about competitive dynamics. But I think the launch of the current oral peptide has been very robust, and it supports this real, I think, high interest level in the oral modality. And interestingly, it's represented more of a market expansion than any sort of cannibalization of the injectable market. So it's been, I think, a very, very impressive launch. And Neil Aubuchon is our Chief Commercial Officer. He's here as well. Neil, do you have any additional color on that?

Yes. Brian, I think you characterized it well, Hardik, this is Neil here. Yes, I think what we're seeing is this is growing the market. So it just goes to show that there's significant opportunities still -- it's too early to comment on the latest launch. I think it's just several weeks in. So we wouldn't have commented in any way, but it's awfully early. It's going to be quite competitive dynamic between these 2 companies, as you would expect. The only thing I would also just remind you is that both the orals on the market are GLP-1s, where ours is going to be a dual agonist oral. So we expect to have the first dual agonist oral on the market. And I don't know if that's fully appreciated by folks in the ecosystem. So we're pretty excited about the opportunity for oral. Thanks, Hardik.

We have a next question from the line of Yale Jen from Laidlaw & Company.

In terms of the VANQUISH expansion study, would that also include both VANQUISH-1 and VANQUISH-2 in terms of the type 2 diabetes patients as well as if you will incorporate some maintenance regimen into those -- in that study, would that also include type 2 diabetes patients as well.

Yes, it will. Yes.

Our final question will come from Jeet Mukherjee from BTIG.

This is [ Blake ] on for Jeet. In regards to the subcu maintenance data coming in the third quarter, what does good look like to you guys in -- are you comfortable reporting a modest [indiscernible]? If so, is there a BARDA standard that qualifies as weight to retention?

Yes. Thanks, Blake. It's a good question. I guess the way we look at it is best case scenario is you see a continuation of weight loss when you transition to the maintenance regimen, just slope might change a little bit. I think our base case is -- which is a great outcome. It's just a real maintenance, less than really a few percent either way up or down. And then the worst case would be you see a sharp rebound. So those are kind of the general scenarios that we're looking at. And I think a flat lining or relatively flat after the transition would be a really great outcome for us.

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.

Thank you. The conference has now concluded. Thank you for attending.

Great. Good morning, everyone. Thanks for joining us here at day 2 of the Leerink Partners Global Healthcare Conference. My name is Tom Smith. I'm one of the senior biotech analysts here at Leerink. And it's my pleasure to welcome our next company to the stage, Viking Therapeutics, joined by CEO, Brian Lian; CFO, Greg Zante; and Chief Commercial Officer, Neil Aubuchon. Gentlemen, thanks for joining us. Looking forward to the discussion.

Thank you.

Such a dynamic space, obesity. A lot of developments, obviously, and you guys had a great year of execution in '25, a number of data sets coming up here in '26 and then some important pivotal data coming in '27. Think there's probably a high awareness of what you guys are up to in the audience. But Brian, maybe if you want to just talk through some of that execution in '25 and what you're looking forward to here in the year ahead?

Yes. Yes. '25 was a big year for us. '26 is going to be a big year as well. But in '25, I think the big accomplishments there were to get our registration program underway for our dual agonist, VK2735, two Phase III trials underway, VANQUISH -1 and VANQUISH-2. We started those around midyear, and we've enrolled the VANQUISH-1 study in obesity in the fourth quarter. And then the VANQUISH-2 study, we expect to enroll very shortly here. So both of them enrolled a little more quickly than we expected. But really, really happy with the progress.

And then the second thing that happened for us in '25 was the first Phase II data from our oral formulation, which showed a really nice profile overall. And at the end of the year, we had an end of Phase II meeting with the FDA, and we'll bring the oral program into Phase III now in the third quarter of this year. So by the end of the year, we'd have 4 Phase III trials ongoing.

So a lot of execution for us in '26 and a big data set coming in the third quarter for our maintenance study, which is a transition study where people start with a weekly dose for some period of time and then transition to either a monthly dose or an oral dose. So all of that pretty exciting for data readouts in the third quarter.

Awesome. And then let's start with the subcu and VANQUISH-1 enrolled way ahead of schedule. VANQUISH-2, you said like well on your way. Maybe just describe, I guess, like what's driving the rapid enrollment there, some of the feedback that you're hearing from sites and investigators, like what is driving preference towards your subcu dual agonist?

Yes. Really high enthusiasm, I think, for weight loss therapies in general. And when we had that investigators meeting in the summer of '25. We were a little surprised by the attendance there. It was quite a bit better attended than you might expect for an investigator's meeting, and it was kind of interesting to see the number of investigators themselves who came, not just study coordinators or nurses from different sites, but the actual primary investigator came from many, many sites. So that struck us as kind of interesting.

And then when we opened up enrollment, the enrollment was rapid. We kind of thought that might have been just a little burst as we started the study, but it held up, and we were able to enroll the study pretty quickly. And a larger size, too, we added more than we had actually targeted. So I don't know what the driver is, I guess, a very high awareness of GLP-1 therapies. I think some enthusiasm for the mechanism, a dual agonist versus a single agonist. But -- so hard to really put your finger on what drove it, but very nice to have the speed of enrollment.

Awesome. And you also recently completed a bioequivalent study for your auto-injector. You've talked about introducing the auto-injector into the VANQUISH program. Just remind us sort of blocking and tackling wise, like how do you expect to incorporate that? And what -- first, what you saw in the bioequivalence?

Yes. We had started the two studies with the vial and the syringe presentation and plan to introduce the auto-injector in the first half of this year. So we did the bioequivalent study and showed bioequivalence between the 2 dosage routes. And so we'll be introducing the auto-injector, and we've already introduced some. It's every -- they're on 4-week blocks. So the trial is 78 weeks long, and we want to have people go home with a 4 pack, so just backing up from 78 weeks at a multiple of 4. We've got 3 different windows where people will transition to the auto-injector, but that's already underway.

Okay. Cool. And just remind us the dosing that you're looking at in VANQUISH, and the titration schedule that you're using and how that compares to the Phase II experience?

Yes. So in the Phase II experience, we started everybody at 2.5 mg and they went to 5 mg, 7.5 mg, 10 mg and then 15 mg. So it's a bigger jump than from that 10 mg to the 15 mg than we're doing in the Phase III. In Phase III, everybody starts at a 1.25 mg dose for 2 weeks and then steps up at 2.5 milligram increments every 4 weeks. So 1.25 mg for 2 weeks, 2.5 mg for 4 weeks, 5 mg for 4 weeks. The first set dose is 7.5 mg. So when people reach 7.5 mg, that cohort will then stay at 7.5 mg. The next fixed dose is 12.5 mg, and then the highest fixed dose is 17.5 mg. So it takes about 26 weeks to get to that top 17.5 mg dose and then the guidance requires everybody stick at the final dose for 52 weeks. So that's the -- the 17.5 mg is the rate-limiting dose there.

That makes sense. And yes, just looking forward to VANQUISH-1 readout, like help frame, I guess, expectations. What's the weight loss that you're looking for? And then we'll come back and talk about the safety tolerability.

Yes. We haven't really given much guidance on the weight loss. We saw about 15% in 13 weeks with the 15-milligram dose. We saw no plateau at any dose there. So I would hope that we would be competitive with the agents that are currently available. I think we should be, probably a little better than a GLP-1 monoagonist, but really hard to project compared with other polyagonists out there. We'll just have to see where the data fall out. But when we model, it looks, I'd say, competitive to say the least.

Right. And one of the things I felt was striking from the Phase II was the safety tolerability experience, the GI tolerability looks quite compelling, I think. How do you project that forward into this 70 long-term readout and incorporating you're looking at a higher dose here, but your titration schedule and I guess, path to getting there seems reasonable?

Yes. When you see these GI-related side effects, they tend to happen, I don't know, call it, the first 4 to 6 weeks or so. And then for most people, they go away. So the idea when you design these studies is try to minimize that initial experience, so people have a good experience when they first start the therapies.

And so here, we dropped the starting dose down to 1.25 mg and just have them stick there for two doses, really just to ease into the mechanism. And hopefully, that would give some improvement in tolerability. Once you get past the first couple of up titrations, I don't think tolerability is really an issue. It just kind of wanes over time. So it's not like you see a bump once you get to later doses.

Understood. I guess, projecting forward a competitive profile relative to the other dual agonists and tirzepatide specifically. But just remind us attributes of the compound, where you think you may be differentiated and how you think some of that differentiation could manifest in the VANQUISH program?

Yes. One big difference with this compound versus the approved agents is the half-life is quite a bit longer. It's about 8, 9 days in that range. And like the Cmax is higher at the same doses versus, say, for example, tirzepatide, the Tmax is later. All of these things give it just a different biological profile. Notably, we think over time, you get an accumulation if you stay on that weekly cadence. So the plasma levels begin to accumulate because the half-life is so long. We don't know, but hopefully, that would translate to an improvement in overall efficacy. And we have seen that in obese monkeys, a nice improvement in efficacy in head-to-head studies with other agents.

Where we think it might be really advantageous for us and for patients would be in a less frequent dosing regimen. So if you get to some target weight using the weekly dose, because the half-life is long enough, we think then transitioning people to a monthly dose might be well received by people who are looking for a little bit more convenient maintenance regimen. And that was the whole basis for the maintenance study that's going to read out. So because of the unique PK profile, we think it opens that door anyway, and that's what we're planning to assess yes.

Great. Maybe I could bring Neil in and just talk about with the profile that Brian has just laid out, I guess, how you think about competing in a subcu market where you have pretty entrenched competition? And I guess, specifically with the resources of a SMID cap biotech, yes, just walk us through sort of the initial commercial plans around the subcu?

Sure. Well, it's always great to start with a good product, right? So the CagriSema data that's come out recently shows that the dual agonist class seems to be kind of the best one out there, and we're going to be the next dual agonist to launch. Of course, we're going to have an oral -- we should be the first oral to launch in terms of the dual agonist class. So that's a great starting point.

The thing that's really nice for us is there's some disadvantages being small, but there's also some advantages. So we don't need to get 30% market share. We need to get 5% to 10% share, and we're extremely successful. So I look at a few different things.

So one is ex U.S. opportunity, I don't think is being considered. So that's something for us to think about. The other thing is that Lilly and Novo have to -- they're in all segments. So they have to balance across various stakeholders. We don't have to do that. So we can be more aggressive in different segments. We can go after cash market. Lilly has been quite aggressive going after direct to employers recently. I think there's some room for us there potentially as well. So I mean, if we come in with a top-tier efficacy, which I'd expect to do, and being nimble and only having to get 5% to 10% share for us to have success, there's lots of ways being nimble that we can do that.

Interesting. And you brought up the cash pay market. Maybe you could talk a little bit about how you're thinking about pricing overall? Obviously, it's early. We don't have the Phase III data. But we have seen Novo cut their pricing. I think some investors are a bit concerned that it could be somewhat of a commoditized, or race to the bottom type of dynamic. Like how do you guys view pricing 12, 36 months from now?

Yes, I'm glad you raised that because what we've seen -- I think we have to differentiate between list price reductions and net price reduction. So you've seen a lot of list price reductions, which, as we know, isn't really what's important. It's at the net level. So you have basically a duopoly with the two companies. I used to work at Lilly for 17 years. I think both companies are rational actors. When you have a duopoly, if you lower your price, you're just effectively lowering your own margins, right?

So, I think, the other thing that's I think, quite encouraging is the crackdown on the compounders. So the compounders were, I would argue, irrational actors in the marketplace. So I think that is going to start to go away. And when you're left with just Lilly and Novo, I think you're going to have quite a bit of price stability going forward. And I think other companies entering the market are also going to be quite rational. So I kind of think that the way companies look at this, big companies, they look at sort of a price volume trade-off, and I think we sort of hit an equilibrium. And at this point, I think it's going to stay relatively stable, and we feel pretty good about this pricing level.

Got it. And maybe just early, I know you joined the company here relatively recently, but how do you think about like resourcing behind the potential commercialization? Like what's the size of the sales force that one might need to compete against the large pharma duopoly as you call it?

Yes. So it's actually -- again, it's actually an opportunity, not a problem, I think, because I don't need to tell this audience that there's a lot of inefficiencies in the health care system. So we have a -- we can look at this market with a blank slate, look at how we can take costs out of the system, which I think there's ample room to do.

The other thing is that some of these channel partners that are out there, I won't go through the list of names. They do direct-to-consumer marketing extremely well. In fact, they do it better than big pharma companies do. So I think the fact that we are smaller means that we can actually leverage the channel infrastructure that's been developed and be able to leverage their expertise in a very efficient way. So I don't anticipate us.

One of the things we can't do is we can't out Lilly, Lilly, right? So that's not going to be successful. So we have to look at orthogonal commercial models that are capital light. And again, when you're looking to get the 5% to 10% share, I think there's different ways that we can do that. So I'm actually -- the more I look at it, the more optimistic that I am that there is a path for us.

And I want to get to the oral clinical program, but just sticking with commercial for a minute. Just talk about, I guess, the value of having both a subcu and oral options, same molecule, sort of continuum of care optionality maybe for prescribers. Like how do you think about that value proposition?

Well, a couple of things. I mean, I think Brian will probably talk about the trial, but the fact that we're able to do the trial and it's the same molecule, just a different formulations. So the fact we're able to leverage some efficiencies in the clinical trial means that it can accelerate the time line compared to what we had thought. So that's the first thing. So the lag time between the two is going to be shorter.

The second thing is as this market matures, it's going to get more and more segmented. And this is true with all markets. And so, I think, patients are going to want to -- like I think the maintenance segment is going to continue to grow. And so the fact that patients could either go from an oral to an injectable, or an injectable to an oral, it's the same molecule. So the tolerability, in theory, at least, we have to see how this plays out, should be improved as a result of staying with the same molecule. So even in the case of Lilly, they are about to launch orforglipron, it's, of course, not the same molecule as tirzepatide. So as you switch between one and the other, you might have some tolerability challenges where we think we will be able to avoid that having the same molecule.

Yes. That makes sense. Brian, I want to talk about the oral program. And you generated, I thought, very nice weight loss in the Phase II VENTURE-Oral study. I think it's up to 12.2%. Maybe talk about, sort of, the highlights from that data set and then you just came out of an end of Phase II discussion like incorporating the learnings into your planned Phase III?

Yes. We completed that study in the summer, read the data out in the, I guess, third quarter of last year. We saw a really nice dose response from 15 milligrams to 120 milligrams up to 12%. And really, until we get to the higher doses, outstanding tolerability, I think when you look at the comparison of the placebo arm, we had, I think, 4 arms that were really indistinguishable from placebo. But when you got to the 90 mg and the 120 mg, you did see a little bit of an uptick in the standard GI adverse events, probably driven in part by the higher starting dose and the rapid titration.

We thought based on the Phase I data, we could start high. It didn't look like you really even needed to titrate from the Phase I to it was so clean. So we were a little more aggressive than we might have been had we seen more GI tolerability signals in the Phase I. When we go to the Phase III, we'll drop that starting dose down and stretch the blocks out to 4 weeks. And I think that should be pretty effective.

We went to the FDA in -- yes, in the fourth quarter with all of the data from the oral program, as well as some of the tox data from the subcu program, and asked if it would be okay to move into Phase III and the FDA was okay with that. So we've been planning to move into Phase III now, full steam ahead there, hopefully starting 2 studies in the third quarter. And that program will be different from the subcu because we expect to be able to leverage some of the data, the safety data, the size of the studies and humans from the subcu program for the oral program. So likely much, much smaller, 75% or more smaller than the subcu program. Shorter, we will probably reduce the trial size probably by a couple -- or trial duration probably by a couple of months.

And another thing is the visit schedule will be reduced relative to the VANQUISH subcu studies where the first 30 to 40 weeks, people are coming in every week, and then this trial will be more of a monthly visit. So all of those combined to dramatically change the expense associated with the Phase III oral program. It will be a much, much cheaper overall program than the VANQUISH studies.

Yes. So a much more efficient program. And just -- I'm sorry, on the size of the -- so like 25% less patients?

No, no, more like 75% less patients. Yes. Now it relies on us being able to use the subcu safety database from the VANQUISH studies, but there's no reason to think that we can't do that and the FDA is also on board with that approach.

Yes. Okay.

Since it's the same molecule, going back to your question earlier, because of that having the same active agent, you can leverage some of the -- like we're able to leverage the tox data. We should be able to leverage the VANQUISH human safety data. So all of those are favorable since it's the same molecule.

Yes. And I guess what can you say about expected dosing levels in the Phase III? So in the subcu, you explored a higher dose, probably not a need to explore a higher dose in oral. But like how are you thinking about dose? And you alluded to the longer titration walk?

Yes. Yes. So we went up to 120 mg in the Phase II. So we'll come down maybe kind of in the middle of that range, 0 mg to 120 mg, I mean, in the Phase III multi-dose study. So 2 to 3 active doses. And you're right, start at a lower dose and titrate up into those final doses. But we'll have all the details when we initiate the studies.

Awesome. And you mentioned the maintenance study fully enrolled, and you're looking at both the subcu and the oral in the maintenance study. Maybe just remind us on the design because you have a number of different cohorts in there, and then what you're looking to learn, we're going to see data from that study in Q3?

Yes, very complicated study. So everybody starts with a weekly dose and you titrate people -- now this is an accelerated titration up to 17.5 mg on a weekly basis. And then it kind of splits in two. The subcu side has people transitioning from a weekly subcu injection to a monthly subcu injection. We also have a cohort that goes from a weekly to an every other week subcu. So we'll have a lot of data from maintenance at both every other week and monthly. And the doses range from 7.5 mg every 2 weeks to 17.5 mg a month, 20 mg per month and 22.5 mg per month. And then we have two controls. One of the controls is 17.5 mg parked through the whole 31-week window. Another one titrates people up to 17.5 mg and then drops into placebo for the maintenance period. So -- week 19 to week 31, you're on placebo. That's the subcu side.

The oral side is people come up to 17.5 mg weekly with the injection. And then after 19 weeks, transition to 17.5 mg daily oral, 27.5 mg daily oral, or 110 mg weekly oral. So you have a nice range of doses and regimens there on the oral side to look at maintenance also. And that component of the study also has two controls. One is a daily oral placebo and one is a weekly oral placebo. So really complicated, but should have a lot of information when that study reads out.

Yes. And what would be, I guess, the next step -- the kind of goal of the study and the next steps?

Yes. Goal is to understand what's feasible with maintenance. If monthly works, what's the right -- what's the best dose? What about every other week? Is that better than monthly? I don't know. And then if it's oral, what's the right dose? Same questions.

So we -- with the VANQUISH studies, we do have a 1-year extension after everybody reaches at week 78, they're able to enroll in an extension study. With the maintenance data, if we're interested in one or more arms, we may have an opportunity then to introduce that maintenance regimen into that 1-year extension for VANQUISH. So really nice opportunity. Just the timing worked out well for us that might be able to give us some nice maintenance data that potentially could make it into a label.

Yes. Very interesting. And maybe, Neil, could you comment on, I guess, what the market research suggests in terms of like optimal dosing frequency like just the less frequent, the better? Or is there kind of like a sweet spot?

Well, no, I don't think there is a sweet spot. I think that as the market matures, it's going to get more and more segmented. So I think that some patients actually -- you asked them, they actually say they like it once a week. People are concerned in some cases about side effects. So you think oh, once a month is better, but actually, no, if you have the nausea, then for the entire month, then that could actually be worse. So there are a segment of the population that's needle flow that's going to want an oral, and that's going to be fine.

So I don't think you can sort of say there's sort of one size that fits all. I think this market is going to have multiple winners in it. And the fact that we have the -- we're going to generate this maintenance data. The fact of the matter is it's kind of the Wild West out there right now. Patients are actually kind of just experimenting on their own. So the fact we're actually going to have some data to guide patients, I think it's going to be a positive and can allow us to potentially take some share there.

That makes sense. I want to ask you about -- a deal you signed actually about 1 year ago, which is a manufacturing supply agreement with Corden. And this is large-scale API, fill/finish. Just talk -- like how are you thinking about ability to supply like a commercial supply? Is Corden going to end up being sufficient for everything? Are you still out there looking for additional manufacturing capacity?

Yes. Good agreement. I think it's -- we're at the 1-year anniversary of that agreement. I think we might have announced it last year at your conference, right? Yes. So yes, I think a great agreement. So it covers a multi-ton annual API supply. And then one of the things that set Corden apart from some of the other manufacturing partners we talked to was their ability to provide fill and finish services.

So we've got 100 million vial and syringe units, 100 million auto-injector units and then 1 billion tablets in the initial agreement. So it's really kind of 4 agreements bundled in one. All of those components are expandable at our option. So we have good flexibility there. If we run out of capacity, we'll be okay. That's -- but so that we don't run out of capacity, we're adding redundancy across the chain there. But I think right now, it's well into the double-digit billions what that agreement can support as far as a product launch.

Yes. Makes sense. I want to ask about your amylin program that you're putting into the clinic. We've seen some readouts very recently. Would love to, I guess, get your thoughts around the recent data and how you're thinking about the mechanism, how that fits into the broader portfolio of what you're doing?

Yes. A lot of data is continuing to emerge from the amylin class. It looks like most of the compounds have this right in that 8% to 10% weight loss range with the exception of this eloralintide compound, which is nearly double that. So it seems like generally, outside of that Alora compound, these would be targeted for people who maybe don't need to lose 100 pounds. But BMI maybe 32, 34 that need to lose a little bit less weight. Or for the population that maybe can't tolerate a GLP-1 and so they're looking for something else. So those sound niche, but those are massive niches. So those are really, really big opportunities given the overall size of the market.

How does ours compare? Don't know. It looks -- we haven't had in humans yet. In obese monkeys, it looks more effective than our dual agonist, but those are monkeys. So hard to project into humans. We'll start the single ascending dose study as soon as the IND clears, we're going to file the IND this quarter and go into the SAD study and see what the dose tolerability looks like on the SAD dosing paradigm and then move into a MAD following the SAD study.

When we think of the attributes of the amylin relative to eloralintide to look more -- I guess, more similar to that versus what we just saw from the Roche-Zealand compound? Or how does this stack up?

It's hard to say because the changes between the compounds are a little bit different. I mean, without getting too far in the [indiscernible], the changes made with the petrelintide and that Guber compound are on this little cyclic component on the -- what I look at the left hand of the chain. And those are intended to improve solution stability, but it seems like they had an impact on potency.

With the eloralintide, I guess we look maybe a little bit more like a hybrid between cagrilintide and eloralintide structurally, I guess. We're more balanced. I mean, eloralintide is more amylin focused. We're a little bit more even on the calcitonin and amylin 3 receptors, but still seem to retain very, very good potency. So overall, I mean, it's an interesting compound.

Yes. And how are you thinking of like first-in-human experience very similar to what you did with 2735? And I guess, is it possible like when we think about potential for clinical data, something we could see later this year or?

Yes. The first study is going to be a SAD study, single ascending dose study. So -- and those are a little bit pedestrian. You do one cohort at a time. So it's hard to gauge much on the efficacy side with those sorts of studies. But I think if we had something interesting, we'd report it. But the more meaningful data would be after the multiple ascending dose study. And hopefully, that would be something we'd have next year.

Awesome. All right. Well, unfortunately, we're up against time. But thank you, Viking team for joining us and sharing the insights and a lot to look forward to here in '26.

Thanks a lot, Tom.

Thank you.

Welcome to the Viking Therapeutics Fourth Quarter and Full Year 2025 Financial Results Conference Call. [Operator Instructions] As a reminder, this conference call is being recorded today, February 11, 2026.

I would now like to turn the call over to Viking's Manager of Investor Relations, Ms. 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, February 11, 2026, 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 fourth quarter and full year ended December 31, 2025, and review recent progress with our development programs and operations.

2025 was another strong year for Viking, with the company achieving multiple important milestones with our expanding obesity pipeline. With the subcutaneous formulation of our lead molecule, VK2735, following the positive efficacy, safety and tolerability data generated from our Phase II VENTURE study, Viking initiated its Phase III VANQUISH clinical program in obesity. The Phase III VANQUISH program includes 2 studies. VANQUISH-1 is evaluating the treatment of adults with obesity, and VANQUISH-2 is evaluating the treatment of adults with obesity and type 2 diabetes.

In the fourth quarter, we announced completion of enrollment ahead of schedule in VANQUISH-1. Enrollment in VANQUISH-2 is nearing completion. With respect to our oral VK2735 program, in the third quarter of last year, the company announced positive top line results from the Phase II VENTURE oral dosing study in patients with obesity. This trial successfully achieved its primary and secondary endpoints, with patients receiving VK2735 demonstrating statistically significant reductions in body weight compared with placebo. We recently completed an end of Phase II meeting with the FDA regarding next steps with the oral formulation and are excited to advance this program further into development.

Other important milestones achieved during 2025 include the initiation of a maintenance dosing study with VK2735 to assess the effect of various maintenance regimens, including monthly subcutaneous dosing, daily oral dosing or weekly oral dosing. Earlier in the year, Viking also signed a comprehensive manufacturing and supply agreement with CordenPharma to support the potential commercialization of VK2735. Under the terms of the agreement, CordenPharma will provide large-scale supply of active pharmaceutical ingredients, as well as fill and finish capacities for both our subcutaneous and oral formulations. We believe this agreement provides supply potentially sufficient to support a multibillion-dollar revenue opportunity.

Also during the year, the company continued to add key staff in clinical, supply chain and manufacturing roles, and we recently announced the appointment of Neil Aubuchon as the company's Chief Commercial Officer. In this role, Neil will oversee the development and execution of our commercial strategy.

I will have additional comments on our operations and development activities following a review of our financial results for the fourth quarter and year ended December 31. With 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-K filing with the Securities and Exchange Commission, which we expect to file shortly. I'll now go over our results for the fourth quarter and full year ended December 31, 2025, beginning with the quarter.

Research and development expenses were $153.5 million for the 3 months ended December 31, 2025, compared to $31 million for the same period in 2024. The increase was primarily due to expenses related to running 2 Phase III clinical trials, stock-based compensation and salaries and benefits, partially offset by decreased expenses related to manufacturing for our drug candidates and preclinical studies. General and administrative expenses were $11.3 million for the 3 months ended December 31, 2025, compared to $15.3 million for the same period in 2024. The decrease was primarily due to decreased expenses related to legal and patent services, partially offset by increased expenses related to stock-based compensation.

For the 3 months ended December 31, 2025, Viking reported a net loss of $157.7 million or $1.38 per share compared to a net loss of $35.4 million or $0.32 per share in the corresponding period in 2024. The increase in net loss for the 3 months ended December 31, 2025, was primarily due to increased research and development expenses, partially offset by decreased general and administrative expenses and increased interest income compared to the same period in 2024.

I'll now go over the results for the full year ended December 31, 2025. Research and development expenses were $345 million for the year ended December 31, 2025, compared to $101.6 million for the same period in 2024. The increase was primarily due to increased expenses related to clinical studies, manufacturing for our drug candidates, stock-based compensation, salaries and benefits, regulatory services and consultants, partially offset by decreased expenses related to preclinical studies. General and administrative expenses were $48.4 million for the year ended December 31, 2025, compared to $49.3 million for the same period in 2024. The decrease was primarily due to decreased expenses related to legal and patent services, partially offset by increased expenses related to stock-based compensation, insurance and salaries and benefits.

For the year ended December 31, 2025, Viking reported a net loss of $358.5 million or $3.19 per share compared to a net loss of $110 million or $1.01 per share in the corresponding period in 2024. The increase in net loss for the year ended December 31, 2025, was primarily due to increased research and development expenses, partially offset by decreased general and administrative expenses and increased interest income compared to the year ended December 31, 2024.

Turning to the balance sheet. At December 31, 2025, Viking held cash, cash equivalents and short-term investments of $706 million compared to $903 million as of December 31, 2024.

This concludes my financial review, and I'll now turn the call back over to Brian.

Thanks, Greg. In 2025, Viking made significant progress with our lead obesity program, VK2735. 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 that has demonstrated promising efficacy, safety and tolerability across multiple clinical trials. Viking is developing both an injectable and an oral formulation of VK2735 for the treatment of obesity.

During 2025, we continued to advance both of these formulations further into development. We also initiated a novel study designed to explore maintenance dosing with this compound. With respect to the subcutaneous VK2735 program, the company's prior Phase I and Phase II studies both demonstrated impressive weight loss and encouraging safety, tolerability and pharmacokinetics following weekly dosing in subjects with obesity. In the Phase I study, participants receiving VK2735 demonstrated up to approximately 8% weight loss from baseline after 4 weekly doses with no signs of plateau.

The company's subsequent Phase II VENTURE study demonstrated statistically significant reductions in mean body weight from baseline ranging up to 14.7% after 13 weekly doses with no signs of plateau. The VENTURE study also showed VK2735 to be safe and well tolerated through 13 weeks of dosing, with the majority of treatment-emergent adverse events characterized as mild or moderate. Adverse events generally occurred early in the course of treatment, resolved quickly and were primarily related to the expected gastrointestinal effects resulting from activation of the GLP-1 receptor.

These results were highlighted in a presentation at the 2025 ObesityWeek Conference in November. The final results were also published last month in Obesity, the peer-reviewed Journal of the Obesity Society.

Following the VENTURE study, the company completed a Type C meeting with the FDA as well as an end of Phase II meeting to discuss next steps with the subcutaneous formulation. Based on feedback from the agency, in June of 2025, the company initiated the VANQUISH Phase III registration program. The VANQUISH program consists of 2 clinical trials evaluating VK2735, 1 in adults with obesity and 1 in adults with obesity and type 2 diabetes. Each study is a randomized, double-blind, placebo-controlled multicenter trial designed to assess the efficacy and safety of VK2735 administered by subcutaneous injection once weekly for 78 weeks.

The VANQUISH-1 study was designed to target enrollment of approximately 4,500 patients, and the VANQUISH-2 study is targeting enrollment of approximately 1,100 patients. Participants in each trial will be randomized to weekly doses of 7.5 milligrams, 12.5 milligrams, 17.5 milligrams or placebo. The primary endpoint of the VANQUISH trials is the percent change in body weight from baseline for participants receiving VK2735 as compared to placebo after 78 weeks of treatment. Secondary and exploratory endpoints will evaluate a range of additional safety and efficacy measures, including the percentage of patients who achieve at least 5%, 10%, 15% and 20% weight loss. Each study will include an extension portion, allowing participants the opportunity to continue receiving treatment following completion of the primary dosing period, including patients who were randomized to placebo for the initial 78-week treatment period.

In November 2025, 5 months after initiation, we announced that the VANQUISH-1 study was fully enrolled and that enrollment had exceeded the planned 4,500 patient enrollment target. Enrollment in the VANQUISH-2 study is ongoing, and we expect to complete enrollment later this quarter. Both the VANQUISH-1 and VANQUISH-2 studies were initiated using a vial and syringe for administration of VK2735.

In the fourth quarter of 2025, we initiated a bioequivalent study to allow for the introduction of an auto-injector device, which may represent a more convenient method of administration for some people. We are happy to report that this study was successfully completed, enabling the introduction of the auto-injector for all participants in the VANQUISH program. We expect this transition to occur later this quarter.

I will now provide an update on Viking's oral tablet formulation of VK2735. We believe an oral tablet formulation may represent an attractive option for those who might prefer to initiate treatment with an oral therapy or for those seeking to maintain the weight loss they have already achieved. Preliminary data tracking the recent launch of another oral peptide for obesity has demonstrated promising initial uptake. We believe this indicates continued interest in new weight-loss therapies among both patients and clinicians and represents an expansion of the overall market opportunity.

As with our subcutaneous program, prior Phase I and Phase II studies evaluating the oral formulation of VK2735 successfully achieved their objectives. In the Phase I study, cohorts receiving VK2735 demonstrated dose-dependent reductions in mean body weight from baseline ranging up to 8.2% after 28 daily doses. The Phase I study also demonstrated encouraging safety and tolerability, with the majority of observed treatment-emergent adverse events reported as mild or moderate, with most reported as mild.

Following the Phase I study, we completed the Phase II study of VK2735 called the VENTURE-Oral dosing study. In the third quarter of 2025, the company announced positive top line results from this study, with participants receiving once daily doses of the tablet formulation demonstrating statistically significant reductions in mean body weight after 13 weeks, ranging up to 12.2% from baseline. Statistically significant differences compared to both baseline and placebo were observed for all doses greater than 15 milligrams starting at week 1 and continuing throughout the 13-week treatment period. Up to 80% of subjects in VK2735 treatment groups achieved at least 10% weight loss after 13 weeks compared with only 5% of placebo-treated subjects.

The VENTURE-Oral dosing study also included an exploratory cohort designed to assess weight loss maintenance. In this cohort, participants were rapidly up titrated to a 90-milligram daily dose. After 4 weeks of daily dosing at 90 milligrams, participants were down titrated to 30-milligram daily doses and maintained at 30 milligrams daily for 7 weeks. Weight loss in this cohort was shown to be rapid and progressive through the 90-milligram treatment period, reaching a mean reduction of 8.1% from baseline at 6 weeks. Following down titration to 30-milligram daily doses for the remaining 7 weeks of the study, mean weight loss was further improved to 9.2% from baseline.

These results support our belief that effective weight maintenance may be achieved with a low-dose oral treatment strategy following down titration from either higher oral doses or potentially from a subcutaneous dosing regimen. The progressive weight loss observed following transition to lower doses also suggests that effective weight maintenance might be achieved with doses lower than the 30-milligram level evaluated in this study. Importantly, the oral tablet formulation of VK2735 also demonstrated encouraging safety and tolerability through 13 weeks of once-daily dosing. Among VK2735 recipients, 98% of drug-related treatment emergent adverse events were characterized as mild or moderate in severity.

In the dose range we plan to explore in future studies, we believe the data show no meaningful difference between GI-related adverse events in subjects treated with VK2735 compared with placebo. The tolerability data from the VENTURE-Oral dosing study also suggests that future titration regimens starting at lower doses and utilizing longer titration intervals are likely to further improve oral VK2735's tolerability profile.

Following completion of the VENTURE-Oral dosing study, we held an end of Phase II meeting with the FDA to discuss potential next steps in the oral clinical development program. Based on feedback from the agency, the company plans to advance oral VK2735 into Phase III development for obesity. We currently expect to initiate this program in the third quarter of this year, and we'll provide more details on study design in the coming months.

A unique and differentiating characteristic of VK2735 is its extended half-life and PK profile relative to other agents. We believe this provides an opportunity to introduce dosing regimens that potentially improve convenience and flexibility for some patients. An important factor in this differentiation is the ability to use the same dual-acting GLP-1 and GIP co-agonist molecule in both subcutaneous and oral formulations. This affords patients the ability to remain on the same active compound during their treatment with either the tablet or injection formulations and may lead to reduced side effects compared with options that require switching between different therapeutic agents. We believe this could improve adherence to treatment, which is a key element in realizing the long-term benefits of weight loss, such as improved cardiovascular health, enhanced physical function and increased quality of life.

To further explore VK2735's potential for novel dosing, in the fourth quarter of 2025, we initiated the Phase I study to evaluate a range of maintenance dosing regimens. In this study, all subjects will receive initial weekly doses of VK2735 for 19 weeks. Subjects will subsequently transition to a range of maintenance regimens, including monthly, weekly and every other week subcutaneous doses, as well as weekly oral doses, daily oral doses or placebo. The objectives of the study are to evaluate the safety, tolerability and pharmacokinetic profile of VK2735 under these various dosing regimens. Exploratory endpoints will assess change in body weight from baseline, as well as change in body weight from week 19 to the end of the study at week 31.

In January, we announced that enrollment in the maintenance study was complete, and we currently expect to report the results in the third quarter of this year. Beyond our VK2735 program, in 2025, we made significant progress advancing a series of novel agonists of the amylin receptor. Early data demonstrate that activation of the amylin receptor represents an important potential mechanism for the regulation of appetite and body weight. We have continued to make progress with our lead amylin agonist, and we expect to file an IND for this program later this quarter.

As Viking's pipeline expands and matures, we continue to carefully manage other key corporate matters to support and optimize our programs. As part of this process, we have increased staffing across a range of scientific and operational roles, including supply chain management, manufacturing and quality. In addition, in January of this year, the company announced the appointment of Neil Aubuchon as the company's Chief Commercial Officer. Neil brings more than 20 years of industry experience, including nearly 17 years at Eli Lilly. He has held leadership roles across global commercial and marketing functions within the cardiometabolic space, making him uniquely qualified to lead our commercial strategy for VK2735, and we are excited to have him on board at this important time in the company's evolution.

With respect to further commercial preparation, in 2025, Viking also signed a broad manufacturing agreement with CordenPharma, a global leader in peptide manufacturing, to supply large-scale active pharmaceutical ingredient as well as fill and finish capabilities for both our subcutaneous and oral formulations. This comprehensive and fully transferable agreement allows us to hit the ground running at the appropriate time and is a sufficient scale to enable meaningful revenue generation.

Finally, we continue to carefully manage our balance sheet to ensure that we are financially positioned for success. As Greg reported a few minutes ago, the company held over $700 million in cash at the end of 2025, which allows us to reach important corporate milestones, including the completion of our ongoing Phase III obesity trials for VK2735 as well as pursuing development of our additional programs.

In conclusion, 2025 was a year of important clinical achievements which position us to execute and increase the opportunities for our pipeline in the years ahead. We expect both our subcutaneous and oral VK2735 programs to be in Phase III trials this year, setting the stage to potentially introduce the industry's first oral and subcutaneous therapeutic options, utilizing the same dual GLP-1 and GIP coagonist molecule. In addition, our maintenance study results are expected later this year, providing an opportunity to further differentiate our programs with novel dosing regimens.

Our amylin program is expected to advance into clinical development shortly, adding further depth to our weight loss portfolio. We have also established a foundation for commercial activities by entering into a comprehensive manufacturing agreement, appointing commercial leadership and maintaining a strong balance sheet to support us through key upcoming milestones. We look forward to providing further updates in the coming quarters.

This concludes our prepared comments for today. Thanks for joining us, and we'll now open the call for questions. Operator?

[Operator Instructions] Please note that we have a large number of participants in the queue. The company will do its best to answer as many questions as possible. Our first question will come from Steve Seedhouse with Cantor Fitzgerald.

This is [ Timur Vanica ] on for Steve. Congratulations on the oral program advancement to Phase III. So first, could you talk about whether you will also need to run a Phase III study in patients with diabetes? And then, did you receive any feedback from the FDA on improving nausea rates even in the placebo arm, perhaps to lower the nausea rates with extended titration regimen?

Thanks for the questions. We're probably not going to get into too many details with respect to the specifics of the communication from the FDA, but I think we feel pretty comfortable with the transition into Phase III. What was the first part of that question again?

Phase III.

Oh, yes, yes. So we'll talk about all the design elements as we get closer to launch. But you might imagine that it would parallel the VANQUISH-1 and VANQUISH-2 overall design paradigm.

The next question will come from Joon Lee with Truist Securities.

A lot's changed in the obesity space since you embarked on the Phase III program, including the growing influence of [ row and HIS ]. Does this change your go-to-market strategy? And would you consider partnering with either [ Row or HIMS ] or someone like them to help sell 2735? And also, we appreciate that you don't need an outcomes trial in obesity, but since the competition has, they have outcomes data, would you need to generate outcomes data to be reimbursed by payers? Or would your focus be more on the cash paying patients? And by the way, does the $700 million in cash cover the expense for developing oral 2735?

Thanks, Joon. A lot to unpack there. I'll go through the first part and then let Neil comment on the commercial strategy. What was the -- yes. Yes. As far as partnering, there are a lot of different options available to us. And I think those companies are -- they provide a pretty good avenue to access the market, but probably not something that we're going to disclose at this point. But a lot of different options available to us. Neil, do you want to add to that? Our new Chief Commercial Officer is here.

Yes. Thanks, Joon. Look, I think there's -- what I always say on this is that there are some disadvantages with being a small company, but there's also some advantages. And as you point out, things are changing very, very rapidly. And we're starting here really from a blank slate. And so that we can take a look at the market with a blank slate mentality and think about where it's heading not just today, but where it's going to be a couple of years from now and optimize our commercial strategy accordingly.

So as Brian said, we wouldn't disclose what that strategy is at this moment. But suffice to say that we're looking at all options and all channel possibilities and deciding what's going to be the right approach for us. But the fact that we have flexibility is something that is an advantage for us for sure.

And you're right to say, Joon, that the space is really evolving on a weekly basis. And so what might look attractive today might be different when we're getting set to launch. I mean I think 2 years ago, people probably wouldn't have given a lot of credence to the compounding avenue or some of these other partnering opportunities, where now, they're very important players in the space. So rapid evolution here, and we'll be able to, I think, adapt quickly to whatever the market dictates at that time.

And Joon, on the cash front, yes, the short answer is we do have sufficient cash to get through 3 major catalysts, including the upcoming maintenance trial, data from our Phase III subcu trials. And also, yes, the oral Phase III trials get into top line data, we are sufficiently funded to get there.

Your next question will come from Hardik Parikh with JPMorgan.

Congratulations on the update so far. I was just wondering on the Phase III, I understand you can't give much detail there. I was just wondering on the design of actual tablet itself. I remember in the Phase IIa program, you guys used tablets that were in 30-milligram increments. Would you consider anything different here for the design of the tablet itself for Phase III?

Yes. That's a good question, Hardik. Yes, and again, like you mentioned, we'll give all details at the appropriate time. But the tablet size and tablet count were a little high in that Phase II study. We learned a lot from that. So we'll be reducing both of those in the upcoming Phase III program, both the size and the count.

Your next question will come from Andy Hsieh with William Blair.

So maybe 2 parter, if you don't mind. For the maintenance study, I'm curious about your view on successes. I mean, there's a lot of different scientific questions you're asking. But just in light of ortho with the [ attainment can ] actually gaining 5 pounds, I'm just curious about your view on what success looks like?

Second part, it has to do with the Phase III trial. I know you kind of frame it as an oral Phase III trial, but is it possible to include, let's say, like a subcu arm that basically titrate patients until the maximum weight loss is obtained and then transition to the oral, basically uncovering a longer-term maintenance dosing strategy?

Yes. Thanks, Andy. Really good questions. What does success look like? Well, we look at 3, I guess, major buckets there. Everybody titrates up to this high weekly level. And then you have some people transitioning to monthly injections, some transitioning to every other week injections, some transitioning to oral daily and some transitioning to oral weekly.

So after that transition to the maintenance period, I think the best case scenario would be you see a continued progression of weight loss. That would indicate that you could continue on after the initial weekly dose and continue to lose weight with a less frequent dosing regimen. I think the base case is that you would stay flat and prevent weight regain once you've into the maintenance portion of the study. And then obviously, the least desirable -- although it will depend on the data -- the least desirable would be a rebound following the transition.

I think we're favorably positioned there because of the extended half-life. So I think we should have good coverage at the doses we're exploring to activate the receptors through the course of the month, but we won't know. I think an important question also is when you reduce the frequency and you are still at that elevated dose, do you reintroduce any sort of GI signal. And what we've seen from other agents being dosed less frequently is that seems to be less of a risk than maybe we thought earlier on.

As far as the -- sorry, the transition for what the maintenance or the extension window might look like in the VANQUISH studies, yes, we're not sure. We'd like to see these data and then let that drive what the extension window might look like. I mean right now, the extension in the VANQUISH studies allows people who are on placebo to continue on and be guaranteed access to therapy. But if we see something really intriguing in the maintenance study, we may have some options to introduce a less frequent dosing regimen or other regimen into that maintenance window for the VANQUISH study. So I think you were asking more about the oral Phase IIIs, but we may have an opportunity to do something creative in the extension for the VANQUISH studies.

Your next question will come from William Wood with B. Riley Securities.

Congratulations on a very nice quarter and year for that matter. Just curious in terms of your Phase I maintenance, it looks like you've split your 15 mg once every month into a once every 2 weeks dosing. And so I'm just kind of curious on what the decision was behind that in terms of PK modeling and then also potentially just sort of GI, how that may actually lead to further insight on what you can do with maintenance?

Yes. Thanks, William. Yes, we originally planned to do the 15 mgs once monthly. Once we got the trial underway, we started receiving more and more of these comments from investigators and just from our own market research that people were going to less frequent regimens every 2 weeks, every 3 weeks. And we thought, well, since we've got the study up and running, we could split that 15 into [ 27.5 ] and get an answer at a lower every other week maintenance dose. And we didn't have an every other week regimen in there. So it seemed like an opportune time to make a slight adjustment there while retaining those higher dose -- higher strength of monthly doses.

And then also just maybe thinking about the end of Phase II outcome and sort of the Phase III trials coming up. When we say trials, should we expect 1? Or do you think we can probably get -- or do you think it will be more 2? And then in terms of size, do you think we can get a reduced size sort of based on what we are -- since it is the same molecule based on what we've seen in the VANQUISH trials?

Yes, great question. As I said earlier, probably it's going to look like the VANQUISH program. So I think you could do a single study and have diabetes patients in there as well, but it's likely cleaner to keep them separate and do 2 studies.

And your point about same molecule, that's a really important point. And you might imagine that, yes, we would be able to leverage some of the data generated in the subcu program to reduce the overall size of the oral Phase III program, and that's very important to leverage some of those data.

The next question will come from Roger Song with Jefferies.

Great. Congrats for the update. I understand that you will give us more detail around the Phase III oral design. Just curious about the thinking around the duration. Given you -- this is oral [ map ], do you think about [indiscernible] can test this a little bit shorter than the VANQUISH right now, maybe making this [ order ] and the subcu can get to the Phase III result relatively close and get those 2 into the label and approval in the relatively similar time fashion? And another question is anything you need to finish or generate before you start the Phase III oral in 3Q?

Yes. Thanks, Roger. Really good questions. I think good point. The trial duration we expect in the oral program will likely be not as long as the VANQUISH study. So you could see a reduction in the length, possibly. You could see a reduction in the size, and you might see a reduction in the intensity of clinic visits. And all of those might speak to a cheaper and more efficient execution on the Phase III program orally -- oral Phase III program. And that might compress that window from the availability of all of the subcu Phase III data and the oral Phase III data. Likely still be separate filings, but I wouldn't anticipate that as being a dramatic delay between the 2, given the efficiencies of the oral program.

Got it. Anything -- any data you need to generate before you start the Phase III oral in 3Q?

No, nothing that's really gating there. No.

Your next question will come from Annabel Samimy with Stifel.

Just a question on the maintenance studies, I want to drill down a little bit more. Do you expect that we can get a good sense of oral tolerability from the maintenance study? Anything with the injectable to the oral arm that could give us an idea of GI effects? Or do you expect that given that these patients were already on the injectable GLP, GIP, they wouldn't really have those tolerability effects? So I guess, what are your expectations with the tolerability there?

Yes. Thanks, Annabel. I would expect the tolerability to be pretty good. You're coming off these higher subcu doses which give really high exposures to an oral dose that is a fairly low oral dose than the exposures are lower with the tablet anyway. So I would expect to see minimal GI side effects. But it's possible, but I guess it would be a surprise to see something significant there.

Your question will come from Biren Amin with Piper Sandler.

Maybe just to start on the oral Phase III program. Have you gained agreement with the FDA on patient numbers and duration for the oral Phase III trial? So maybe that's the first question. And second question, on the supply of oral 2735 for the Phase III, is that readily available? Or are you going to need to make supply? Is that the gating item for starting the trial in Q3?

Yes. Thanks, Biren. We have a constant chain of supply moving through at different stages. So we wouldn't anticipate there to be a real challenge on the supply side. I mean, obviously, all these things are difficult, but we don't think supply is really going to be an issue there. It takes a little while to make it, but it's -- we shouldn't have any shortages or anything like that.

As far as the sizes of the studies, I mean, we, of course, outlined our anticipated clinical development plan to the FDA, and we feel comfortable with the responses that we're okay to proceed at the design level that we presented.

Perfect. And then maybe if I could just have a couple of follow-ups. Can you talk about the status of the auto-injector and when you plan to introduce that into the VANQUISH studies? So that's first. And then on the amylin, when can we expect the Phase I to start given IND filing later this quarter? And could we expect Phase I data later this year? And what does that look like?

Yes. Thanks. The auto-injector, we did complete the bioequivalent study since our last quarterly update. It was a great study, turned out very positive for us, and we anticipate introducing the auto-injector this quarter. So that went according to schedule.

As far as the amylin agonist, later in the quarter, we'll file the IND. And if we're able to proceed, and I would expect that we should be able to -- probably, the first dosing would occur in the second quarter. A little early to say just yet, but that's probably the likely timing. And it would parallel the VK2735 clinical program where we start with the SAD study, a single ascending dose study and then proceed to a multiple ascending dose study. So I would say if any data are available, likely be later in '26 for the stat portion.

The next question will come from Mike Ulz with Morgan Stanley.

This is Rohit on for Mike. Can you just talk about any read-throughs to oral VK2735 from the strong early uptake of Novo's oral Wegovy? And then secondly, in regards to R&D spend, should we consider the quarterly spend the new norm moving forward?

Yes. Thanks, Rohit. Good question. I think we've seen now with the oral peptide uptake, it's the fastest drug launch in history. So I think that bodes well for anybody developing an oral peptide. And for that compound, in particular, it sort of puts to bed -- we hope puts to bed this nonsense around how bad 30 minutes is to consume anything. And it's just kind of a joke that that's a big deal.

And on the quarterly cash usage, I think -- you can think about it will range a bit as we move forward here between likely $60 million and $90 million per quarter. So that's about all I could say about that. So a range in that window there.

The next question will come from Thomas Smith with Leerink Partners.

Congrats on the progress. Now that you have the maintenance study fully enrolled, are there any notable differences you'd highlight here specifically on the baseline characteristics relative to the VENTURE subcu or the oral studies? And then maybe a follow-up on the amylin program. Is this going to be a similar design and execution out of Australia as what you did with the 2735 Phase I experience? And could you help frame expectations for what you'd be looking for out of the MAD portion of that study with respect to weight loss?

Yes. Thanks, Tom. No, I think we'd be targeting a U.S.-based for the amylin study, U.S.-based clinical sites. And hard to say it's SAD. The first part will be a SAD study. So always difficult to really interpret any efficacy data from a single dose. But in primates, it looks pretty potent, more potent than the VK2735 compounded under both single and multiple dose scenarios. So it looks pretty good, but haven't been in humans yet.

On the demographics for the maintenance study, the main baseline is people had to be -- BMI greater than 30. They're pretty small cohorts. So I don't know -- I would anticipate -- and I don't have access to that, I don't know the answer right now, but I expect there to be more women than men. I expect it to be mostly white. And they're all normal glycemic, so no diabetics. But I wouldn't expect it to be dramatically different than the VENTURE Phase II demographics, but I don't have the demographics in front of me.

The next question will come from Yale Jen with Laidlaw & Company.

Congrats on the quarters and the year. Two questions here. First one is that in terms of the maintenance study, although we are still seeking for -- looking for the data, do you -- depends on that, do you anticipate you will have -- you still need a larger scale so the maintenance study to be sort of finalized the alternate path forward as well as when you -- at the same time, you're conducting the Phase II study -- Phase III study for the oral?

Yes. Thanks, Yale. Unknown yet. As I mentioned earlier, it might be possible to introduce some maintenance arms into the extension in the VANQUISH studies, but we don't know yet. I would anticipate, though, a larger subsequent study, whether that's part of an extension or a stand-alone, that would likely be required to really understand longer-term maintenance and what the ideal dose is.

Okay. And maybe just a quick one on the auto injectors. I don't know whether that will be [ a year pain ] in terms of supply issue. And how do you see that going forward that -- once you transition everything into the -- all the subcu to the auto injectors?

Yes. We don't anticipate any supply issues there with the auto-injectors. The supplier is capable of producing a very high capacity. So no anticipated issues at this point with auto-injector supply.

As we are nearing the conclusion of today's call, our final question will come from Ryan Deschner with Raymond James.

Was there any notable differences in the end of Phase II meeting minutes for oral VK2735 versus the meeting you had for the injectable version? And would any patients in the maintenance study be transitioned to auto-injector?

On the second part, no, it's a good question, but no, these are going to be a vial and syringe, and the study is well underway now. So no, we're not going to introduce the auto-injector in the maintenance study.

As far as the oral end of Phase II and the subcu into Phase II, we're not getting into the details of the discussions. But I'd say the feedback was consistent with what we heard from the end of Phase II for the subcu formulation. Different INDs, but many of the same people participated. So I think that we're comfortable going forward and pretty consistent feedback between the two meetings.

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

Thank you again for your participation and continued support of Viking Therapeutics. We look forward to updating you again in the coming months. Bye-bye.

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

My name is Hardik Parikh. I'm an equity research analyst at JPMorgan covering Pharmaceuticals. Delighted to have here today, Brian Lian, CEO of Viking Therapeutics. I'll turn the stage over to him for a brief presentation. before we go into our Q&A. Thank you.

Thanks to JPMorgan for the invitation. It's great to be here. We've got a great schedule. So really appreciate it. I'll be making some forward-looking statements today. I'd refer anybody hearing this presentation to the Securities and Exchange Commission website for the most current information on Viking Therapeutics. So we're based in San Diego, we're focused on a portfolio of novel therapeutics for metabolic and endocrine diseases. We're going to spend most of the time today on our metabolic disease programs that's highlighted by a peptide called VK2735, which is a dual agonist of the GLP-1 and GLP receptors currently in a Phase III program called the VANQUISH program, we have an oral formulation of the same molecule that is just completed the Phase I study last summer, late last summer, and we are submitting those data for the European conference in obesity in the second quarter of this year.

Then we have an amylin program as well. I hope to file an IND with that program later this quarter. We have a couple of earlier stage or additional programs we're not actively developing on the thyroid receptor space. So VK2809 is a thyroid receptor beta agonist for MASH completed a successful Phase IIb study. and VK0214, another thyroid beta receptor for X-linked adrenoleukodystrophy that's been through a successful Phase Ib study. This is kind of a graphical representation of the pipeline here, VK2735 in the registration program, 2 Phase III trials in progress. We also have a Phase I maintenance study that we just announced last week has fully enrolled. We expect to read out those data around the middle of the year [indiscernible] third quarter.

With the oral program, Phase IIa is complete and then with the amylin agonist moving into an IND later this quarter. So moving more into the peptide hormone program. We started working on these compounds back in 2019. We looked at the GLP-1 monoagonist, and we have I think a good family of potent mono agonists. We also have the dual agonist, which I'll talk about today. And we also spend time on the triple agonist where glucagon was added and the glucagon didn't necessarily present any additional incremental efficacy. So we really prioritize the dual GLP-1/GIP agonist VK2735 was selected as the the lead compound. We have 2 follow-ons, IND ready with the 2735 compound, we completed and read out data from a Phase I SAD/MAD study in the first half of 2023.

Followed that with a Phase II study in the first half of '24 and then started the Phase III program last summer, VANQUISH registration program. With the oral formulation, we've completed the Phase I SAD/MAD study and then read out data from a Phase II obesity study third quarter of last year. A couple of new slides. We've talked about this stuff in the past, we haven't really presented slides on it before.

But when we look at the -- something that made us really exciting about VK2735 is the PK profile in monkeys looked really differentiated versus other compounds in development. This is a plot of comparison head-to-head study against tirzepatide in single-dose study in primates. What you can see in these curves is the [indiscernible] a little bit later relative to tirzepatide. Cmax is clearly higher, half-life, quite a bit longer than [indiscernible] and over time, that results in a significant improvement in AUC. When we look at over time how that delta manifests the right-hand graph shows the effect after 8 weeks focusing in lease primates, again, head-to-head study. And you can see a significant difference in the overall exposures of VK2735. And you would hope that this would translate to some benefit in how the efficacy profile manifests. And so this is head-to-head in obese [indiscernible] the body weight changes in that study. We saw significant progressive weight reduction over 8 weeks, about a 40% improvement over the comparator. And so it does align with the profile that you would expect to see from the PK profile, and it certainly supports the delta and exposures that we see.

I'll talk about the tablet first since there's the most recent data in the tablet formulation. This is some of the early work we did a 28-day Phase I study where we dosed from 2.5 mg per day up to 100 mgs per day. And in this study, we saw a nice dose-dependent reduction in body weight up to a little over 8% from baseline after 28 days. And I think a really nice progression in weight loss as well. And this shows the trajectory of weight loss in that study, something that really struck us when we were looking at these data is most pronounced in the bottom 3 lines, but really easier to see in the red line. This was looking at day 1 through 28. That's the steep part of the curve there. And then we had several follow-up visits out to day 57. So another 4 weeks after the last dose. And when you look at the efficacy, we saw 8.2% at 28 days and then 8.3% at 57 days. So it really speaks to this interesting durability in body weight reduction. And we think that is sort of in line with what you might expect in the long half-life that we see with the compound. When we look at the Phase I data from GI tolerability, really remarkably well tolerated in this study. You see a little bit of an uptick in nausea as you go across to the 100-milligram arm, but really a mild nausea vomiting as well, pretty much a nonissue.

But overall, the tolerability profile is really excellent in this first study. So the study takeaways from the Phase I study up to 8.2% reduction in body weight after 28 days of dosing progressive effect, we think it has suggested, obviously, [indiscernible], you'll see better weight loss. Majority of the effect maintained 4 weeks after the last dose really excellent tolerability with the majority of the AEs mild to moderate, low rates of vomiting, diarrhea and constipation. And then we had an exploratory cohort as well. the transition people from 80 mg daily to 80 mgs every other day. I don't have that slide in this deck, but really showed minimal difference between those 2. It suggested once you get some inertia to the weight loss, maybe you could transition to a lower dose and is the first kind of hint that maintenance dosing would be really interesting with the oral. This was the Phase II study that we then conducted a multi-arm study, 13 weeks went from 15 milligrams to 120 milligrams.

And then we -- the green line there at the bottom is an exploratory cohort where we dosed people up to 90 milligrams. And then for the final 7 weeks brought them back down to 30 milligrams, just another exploratory effort on understanding of maintenance effect. This slide shows the weight change at 13 weeks. So we saw beautiful dose-dependent reduction in body weight, up to a little over 12% at the 120-milligram dose really no plateau and highly significant in every cohort, except for the lowest dose. And we're going to focus more in the future on this 20 to 75-milligram dose range where we think you see a really nice efficacy effect and really great tolerability. This slide shows the trajectory in this -- all of the cohorts here. So a really nice progressive effect across the board here, up to 12% in that 20-milligram arm and statistically significant at all time points other than the 15 milligrams at all time points, starting with week 1. We also looked at maintenance durability here in this study, and we saw a really encouraging signal here.

Looking at the 30, 60 and 90-milligram cohorts here, and that's kind of the sweet spot, we think, for further development. When we look at the body weight change of 13 weeks, the range was 7% to 11% and you look at 3 weeks after that last dose largely maintained effect, 6.7 to 10.3%. So the majority of that weight loss is is maintain that additional 3 weeks again, further data on a durability signal. This is a really interesting slide which shows that exploratory maintenance cohort that I talked about. The gold line is the cohort that was titrated up to the 90-milligram final dose and just held at 90 through the study.

The green line is a cohort that was titrated up to 90% and then at week 6, transitioned back down to 30. And this was to explore. Once you get some inertia what happens if you drop the dose. And what was interesting here is that when we drop that dose, you see more than just a flat line, you see sort of a continued more gradual, but a continued reduction in body weight up to 9.2%. So it suggests maybe maintenance dosing could be achieved at doses below 30 milligrams. So really encouraging cohort there. When we look at discontinuation rates and treatment-emergent adverse events from the study, we did see, if you look on the -- as you go to the far right side of the table, dose-dependent increase in discontinuations and overall treatment emergent adverse events, drug-related treatment emergent adverse events also maybe an uptick at the higher doses.

But really, when we look at the drug-related treatment emergent adverse events leading to discontinuation, really no difference from placebo vast majority mild to moderate. I think -- some of this is probably related to the titration rate that we used here. We did 2 week blocks in this study. I think in the future studies, we'd want to use 4-week blocks to ease into that exposure a little bit better. And most common treatment-emergent adverse pass leading to discontinuation with the expected GI-related adverse events. When we look at the the cohorts where we would really be looking at the sweet spot going forward, pretty minimal delta from placebo in that 20 to 75-milligram range. So that's what makes that range very exciting. Looking at the GI tolerability profile from this study. You again, pretty flat across the board until you get to the far right of the table, then you see a an uptick in nausea, a little bit of an uptick in vomiting. But when we look at the anticipated future dose range compared to placebo, there really is no difference.

That's what makes us really excited thinking starting low and going slow would be the best approach here. This is the GI adverse event frequency over time. Through the course of the study, it's all cohorts combined, constipation in green, diarrhea [indiscernible], nausea and blue and vomiting in gold. And you can see the up-titration steps there. So accelerated titration here every 2 weeks. We thought we could get away with that because of the Phase I study was so well tolerated. But when you look at these adverse events over time, you can see obviously the first week is by far, the greatest incidence of adverse events and nausea, [indiscernible] is, by far, the most common.

The next most common occurs in that first step up in titration at week 3.

So it suggests that if you were to start lower, we started at 30 milligrams in the study, we started about 10, stepped over 4 weeks, you probably mitigate a lot of these GI-related adverse events. So the oral study takeaways up to 12% body weight after 13 weeks of dosing, progressive effect, dose-dependent across all of the treatment arms. We thought the maintenance cohort was particularly exciting because it did demonstrate that proof of concept. You can drop the dose and not necessarily see a rebound. Good tolerability. Most of the treatment-emergent adverse events were mild to moderate. The majority of the GI-related adverse events also mild to moderate and transient. As I said, I think we can optimize that quite a bit with a different titration scheme. And we're also -- I'll show a slide later conducting now a subcu to oral maintenance study than we hope to have the data later this year.

I'll now move into the the subcu formulation. We've done a SAD/MAD Phase II study and that we're in Phase III in the SAD study. We saw data consistent with what we saw in primates later [indiscernible], pretty gradual onset 72 hours, half life up to a little over 10 days. We think that's amenable to weekly dosing in the MAD study, we saw a dose-dependent improvement of up to around 8% from baseline after 4 weeks durable weight loss 21 days after the last dose. We also looked at MRI PDF theft in the study. And so I really -- I don't have a slide here, but we did see a nice reduction in liver fat up to 50% in the 28-day study and then excellent exposures from weekly dosing, suggesting that a monthly regimen might be a possibility. And then finally, really good tolerability.

Following the Phase I, we conducted the Phase II study we call the VENTURE study. This was a multi-arm Phase II study, 2.5 milligrams to 15 milligrams, 2.5 was a flat dose, 2.5 mgs a week for 13 weeks to 5, started 2.5 for 3 weeks and then it went to 5 for the remaining 10 weeks. 10 started the 2.5 and stepped up in 2.5 mg increments. The 15% was a different titration schedule. [indiscernible] 2 things different. It started at 5 and then went to 7.5 and 10 and then it jumped from 10 to 15. So I'll show whether that's important when we get to the tolerability slide. But really a lot of great information came out of this study. When we look at the primary endpoint here, body weight change after 13 weeks, we saw a significant reduction, really at all doses up to about 15%, 14.7% after 13 weeks, highly significant in every cohort. When we look at the trajectory of weight loss in this study as well, no plateau at all, and again, 9% to 14.7% weight loss.

So we would anticipate a longer dosing window leading to a further improvement in body weight. When we look at the GI tolerability and majority of the expected GI-specific treatment-emergent adverse events were mild to moderate. You can see the the nausea ticking up a little bit as you go up to the higher doses, but still a reasonable rate of nausea, vomiting also slightly higher at higher doses. But overall, nothing surprising in the adverse event profile. It's the GI tolerability profile. This slide is another histogram like I showed with the oral and it's really interesting because when you look at the left-hand graph, this is the 10-milligram cohort. So these guys started at 10 and then at week. After 3 weeks, they went up to 5 mg and then 7.5 and then 10. And you can see, just like with the oral same color scheme constipation, diarrhea, nausea and vomiting, you see a higher rate of nausea in that first exposure. Then the second highest rate is in your first step up in titration. And after that, pretty much a nonissue at all. But when you look at the right-hand graph, very interesting.

And the 2 things that are different about this cohort are clearly evident these guys started at 5 milligrams. So you can see that rate of nausea is quite a bit higher because you're starting at twice the dose as the 10-milligram started Similarly, when you get out to that week 10 time point, they went from 10 to 15 milligrams there. So a larger jump. And you can see that led to a commensurately higher rate of nausea even though you've been exposed to the drug for some time. So it's a great clinical example of that mantra start low and go slow. So the study takeaways from the Phase II trial up to 14.7% weight loss after 13 weeks. Most of the drug-related treatment emergent adverse events were mild to moderate. Most of them occur early and then resolve.

I didn't show it in this deck, but when we look 4 weeks after the last dose, more than 90% of the weight loss efficacy was maintained for a month after the dose. We think the durability and PK profile suggests that a monthly regimen would be worth exploring, and that's what we are exploring. And the results from this day were just published in obesity last Friday. And what we're doing now with the subcu formulation is conducting the Phase III VANQUISH program.

This is 2 studies. We initiated them last June. VANQUISH-1 is enrolling patients with obesity and Vanquish-2 is enrolling patients with obesity and type 2 diabetes. Both studies will include a a 1-year extension to look at long-term safety and efficacy. And we announced last year that VANQUISH-1 had completed enrollment, and we're on track to complete enrollment in Vanquish 2 in the first quarter. This is the study design for the Vanquish trial. So 4 arms, placebo, 7.5, 12.5 and 17.5. All of these will go with a 2.5 mg uptick in titration, but they will also start at 1.25 mg. So 2 weeks at 1.25 and then 4 weeks at 2.5, 4 weeks at 5 and so on up to 17.5.

When you get to 17.5, that's when the 52-week stable dose window starts. Primary endpoint is change in body weight and secondary and exploratory endpoints will look at proportion with certain thresholds of body weight reduction maps as well as changes in function and other metrics. I also mentioned earlier, maintenance studies. So this is an outline very complicated slide, but an outline of the maintenance study. The top half of the slide above that blue bar is the subcu portion of this study. So we are randomizing people into a variety of arms, you dose up on a weekly basis all the way up to 22.5 mgs.

And then after 19 weeks, people are then transitioned to a range of different monthly doses, 22.5 to 17.5 as you go down that slide. And then we have a 7.5 mg every other week cohort. We have a control arm that stays on 17.5 through the duration, 31 weeks. And then we've got a 17.5 mg arm that transitioned to placebo at week 19 to look at the delta from someone who comes off therapy completely to someone goes to monthly, somebody goes to every other week.

In the same study, if you go to the bottom half of the slide, we have an oral portion. So in this part of the study, everybody's titrated up to 17.5 mg weekly. And then after 19 weeks, [indiscernible] is randomized to a 17.5 mg daily dose. Another cohort explores 27.5 mg daily. And then we have a weekly cohort where people are dosed with 110 mg weekly. So a lot of moving parts in this study, but it should give us a really, really interesting data set, and we expect that midyear. We announced it was completed enrollment last week and hope to have data around midyear or third quarter.

A quick snapshot of the financials. We're really fortunate to have a strong balance sheet, over $700 million in cash as of the end of the third quarter. And we think this gives us a good runway through several clinical catalysts. And this brings us back to the first slide. So overall, focused on novel therapeutics for metabolic and endocrine diseases. Metabolic disease programs in [indiscernible] Phase III trials for obesity, the VANQUISH program, the oral program just completed Phase II study readout data last fall. And then the amylin program, I didn't talk about that that's moving into a Phase I program -- Phase I trial, first half of the year, the IND is planned for the first quarter. So that was the last slide I can [indiscernible] thanks very much for your attention.

[indiscernible] move on to the Q&A. So you mentioned there's [indiscernible] trials going on. The first one in just pure obesity has already finished enrollment. And you said you had commented previously that it had kind of the pace of enrollment was faster than you expected. How is the pace coming along for this [ VANQUISH-2 ] your executions?

Yes. The first one enrolled probably faster. We overenrolled it because we had so much demand. So it rolled to larger and more quickly. The second one is it's slower because that was so abnormally fast. It's really kind of going along what we expected to be the enrollment schedule. So that one is just according to plan.

And when do you expect readouts for.

Right. They're 18 months from last patient's first visit. So you can probably expect data in the 2027 time frame.

What do you think good data here looks like there's obviously a lot of competition and the bar seems to be changing quite a bit. So what do you think [indiscernible]

Yes, very fluid. Well, I would hope that the weight loss is competitive with other increases agonists. I think tolerability is becoming a more important metric for people, but it's hard to project. I mean, obviously, we'd certainly anticipate the data will be better than the Phase II data by a good margin, but hard to know what the actual 78-week efficacy signal.

And then you -- in the slides, you were talking about how the highest dose in the anchor trial is a little bit higher than [indiscernible] How did you kind of walk me through how the risk-benefit rationale there?

Yes, it was higher than what we had explored in the Phase study. We thought that the safety and tolerability profile looked really encouraging. So we thought that you could probably come up maybe a little bit in dose. It's always question whether or not the FDA will be okay with it moving up in dose and they didn't have a problem with it, provided that we had more randomized to those higher dose arms than the lower dose arms, and there was no problem. So we decided to proceed there.

The 7.5 is a little bit smaller than the 12.5 and the 17.5.

I think audience question? [indiscernible]

So I'm curious about the 2809 for [indiscernible] that you had positive readout in 2024. What is the plan forward for that program?

Yes, that's open for licensing. We probably aren't going to pursue that at least near term by ourselves. So -- and I'd say a fair amount of interest in that program these days.

So we also want to move on to the FDA had come out with some developments towards in December. One of them was the FDA commissioner saying that they would require only kind of 1 Phase III trial. I wanted to see, does that impact any of your program specifically in terms of what you would have to kind of do and time lines?

No. It's interesting. We had gone kind of back and forth internally on the oral I suppose we went into an oral Phase III, would we do 1 study or 2 studies. And I think you could do either, but we had decided to do to do 2 if we were going to go forward. One in just like the Vanquish, 1 in a dedicated obesity population and then a smaller 1 in the type 2 population. You could put them in the same study, but it just gets a little bit more complicated on the the data interpretate data analysis. So it doesn't -- the suggestion from FDA didn't change any of our plans. We were planning to do to.

Okay. Okay. And then we've also seen a couple of these GLP-1 therapies recently received the FDA and PV designation, basically cutting down the review time line to 1 to 2 months. Do you think that that's like -- do you think going forward that's going to be applied to the class broadly, like whenever a new GLP-1 comes to FDA's desk? Or do you think it's more of a drug-by-drug basis? And then second part of the question is, is that something you guys have thought about for your drug.

To answer that, yes, is something we've thought about Unclear if it's going to be something that's really likely to be available to subsequent compounds, but certainly something that we would be I mean, everybody's best interest to ask about it.

What are some of the positives and negatives you like about that program?

Well, the quicker review time is the big positive I don't know that there would be an obvious negative. It's just -- is the agency going to allow multiple examples of a particular mechanism or something like that to proceed on that really accelerate.

And then you mentioned -- I think in the past, you said the FDA end of Phase II review for the oral was in December. I don't know if you can comment on how those talks have progressed and when you would hear from the FDA about potentially moving directly into Phase III [indiscernible]

Yes. We did have that meeting in December, and we have not yet received the minutes yet, so it's hard to comment on what the next steps are until you really get a minute, you wouldn't want to say something that you have to later [indiscernible]

But you're still fairly confident that you don't see any reason why it wouldn't be able to move forward.

Nothing obvious to us, but we got to get the mine.

I think you were -- you had kind of tailored down the next kind of doses and fusion programs for the oral therapy. And I was just wondering, in those specific dose ranges. Where do you see the role of that oral formulation in the market?

Yes. We've always thought the oral is best utilized in a maintenance setting. So if you start with the injectable, the net just work well, everybody is comfortable with them. Once you get to some target weight range then transitioning to a low dose oral, that's the way we've thought about -- I know everything is about this differently, but that's kind of the way we thought about it. And so 1 advantage with the molecule is since we have 2 formulations. If you lose weight with the injectable and then your thinking about transitioning, we have our potential monthly dose for the injectable or a potential low-dose oral to keep your weight maintained at that target range. And having the same molecule, we think probably mitigates the risk of new or unexpected side effects after that transition. And I'll get to the maintenance study in just a bit. But I was wondering, I think you had said in the past that you would start this next phase of the oral program at a lower dose. I don't know if you commented on.

Specific dose you are we have thinking about it.

No, we haven't commented on that. We started in that Phase II just because the Phase I was just pristine, really, really clean. So that is even starting in that top 100-milligram cohort in the Phase I started the 80 for 2 weeks and then went to 100 or 80 for a week and it went to 100 and there was no tolerability signal. Now that we've got more experience, and we've seen the aggressive titration rate led to a little bit higher instance of GI side effects. If we could start it I don't know, 10, 15 milligrams or something like that and then keep people there for 4 weeks and just kind of the standard 4-week cadence that is more common, confident that, that would really, really produce a nice adverse event profile.

Got it. And then in that Phase IIa trial for the oral, you talked about that little arm that you did where you went from 90 milligrams for 6 weeks, and I think you transitioned people into 70, right? -- for 7 weeks. Do you think the fact that they lost on average 1 percentage point, how consistent was that from -- in the overall patient group? I don't know if you have that idea. And then two, -- do you think that was due to really kind of a residual tail effect of the 90-milligram -- or do you think it [indiscernible]

Yes. I mean it's a good question. There could be some contribution there, but you would think that is the half-life around 8, 9 days, you'd think that after 7 weeks, you probably see something. And it was a pretty consistent a little bumpy, but a pretty consistent negative slope there. Yes, is it driven by a couple of people. I don't think so, but I can't remember [indiscernible] not really an outlier that's pulling that down.

.

Okay. But it was generally consistent. Okay. And then [indiscernible] at the end of last year also put out its maintain trial for [indiscernible], showing basically people who switch from both semaglutide to ortho and then to appetite -- what were your main takeaways in terms of what are the read-throughs to your maintain trial?

Yes. So for the the injectable portion of our maintenance study, not a lot to read through, it's just different. We're keeping with the same subcu formulation. With the subcu to oral. I don't know. I mean we're looking at multiple doses. We're also looking at that weekly. And we're looking at the same compound. There's a big difference there if you switch from [indiscernible] focused peptide and a dual agonist focus peptide to a small molecule. So I don't know how translatable those data would be predictive for us. It's the same compound, and we're giving it at exposures that should produce some pharmacologic effect. So what was interesting, you did see a little more rebound in the -- through [indiscernible], not a lot, but a little bit more of a rebound there than in the semaglutide to [indiscernible], but I don't know if you can mix and match our study to that study.

Yes. Obviously, you guys are keeping with the same underlying molecule. Yes, right. So let's say you fast forward into the commercial stage, what's your -- just your -- your gut feeling that you think potentially oral 2735 could be a better maintenance therapy than awful good for people transitioning off of tirzepatide specifically because of the same GL you want to give [indiscernible]

Yes, you have to do the study to really answer that intelligently. But I just think it might resonate more with people if they know they're not switching molecules or staying the same molecule, it's just a different formulation. And when you switch to the oral, the exposures are lower. So that should reduce the the risk of any new side effect ring.

Okay. I know you didn't get a chance to talk about the [indiscernible], but I know you say correct me [indiscernible] time line is you will file an IND in the first quarter Yes. go into trial first half. Could you talk about just how you think that this molecule is differentiated. Obviously, there's a lot of minds now going out -- do you think it's differentiated from a chemistry perspective or an overall profile perspective?

Yes. It seems to be potent. That's the thing that stands out to us is the -- best monkeys has a pretty powerful effect on body weight reduction, more than the compound. So we think that, that is an interesting stand-alone. We think maybe it would be an interesting compound to layer on top of 2735, but these are sort of future studies. The first 1 will be a SAD study. Just like the early 2735 do a single ascending dose study and then follow with a 28-day multiple same dose study. And then what we have in the back combination studies kind of progressing along.

And what do you kind of see -- still up for debate what the role of amylin is? And just what do you kind of -- what do you -- if you [indiscernible]SP-8 5, 10 years.

Yes. It's kind of a roller coaster of sentiment on the mechanism. We originally thought that amylin would probably best as a combo agent on top of GLP-1 or a dual agonist. But you see pretty good efficacy with the amylin. So maybe for someone who's BMI is 32 to 35, not 45 maybe amylin would be interesting for that population. Another group might be somebody who can't tolerate a GLP-1, amylin might be a suitable candidate. But I think the single agent and the combos are pretty interesting with that mechanism.

Okay. And then last question is just you talked about the combined ability. Do you think you could do some sort of a net combination or [indiscernible]

Yes. Very complicated, but encouraging, I think, what we've seen so far, but too early to say. -- if you're looking at oral single-dose combo versus 2 tablets, 2 tablets, 1 single compound we need to have it might be just a logistically easier, but we've spent a fair amount of time on both of those.

And then last question is just can you just talk about the breadth of kind of strategic interest you're seeing here in this space as pharma companies try to [indiscernible]

Yes, it's been pretty steady over the last couple of years. I think the interest is probably probably broader than is visible. I think that there are more parties sort of circling, I guess, the space and very intrigued, but trying to understand what is the -- how do we commit to obey. Do we pursue a brand-new mechanism? Do we pursue something that's proven? Do we go really early at a low price point. We a little more expensive at a later price point. I don't know, all those things feels like are kind of under consideration. But I'd say what we're happy about is as we continue to develop our program. It should get more valuable, and we think there is a fair amount of interest out there across the industry.

Got it. Brian, thank you. I appreciate you taking the time. I hope we see you again next year.

Thanks a lot.

All right. Welcome, everyone, to Jefferies Healthcare London Conference. My name is Roger Song, one of the senior analysts who cover semi-cap biotech in the U.S. It is my pleasure to introduce our presenting company, Viking Therapeutics, CEO, Brian Lian.

Thanks, Roger. Thanks to Jefferies for the invitation to present. I really have a great schedule today. So I really appreciate it. I'll make some forward-looking statements today. I'd encourage anybody hearing this presentation to refer to the Securities and Exchange Commission website for the most current information on Viking Therapeutics.

I'm the Founder and CEO. We're a San Diego-based company. We've got about 55 employees. We are focused on metabolic and endocrine disorders. We think our clinical programs have demonstrated best-in-class efficacy data. And we'll talk a lot today about our metabolic disease program. So VK2735 is a GLP-1/GIP dual agonist that we're developing for obesity. It's currently in a Phase III program we call the VANQUISH program. We have an oral formulation of the same molecule that recently completed the Phase II study, and I'll walk through some of those data today as well.

And then we have an amylin agonist that is approaching the clinic, and we expect to file an IND in the first quarter. We have additional programs focused on the thyroid receptor beta, 2 agonists: one, VK2809 that's been through a Phase IIb study in MASH; and one, VK0214 that's been through a Phase Ib study in X-linked adrenoleukodystrophy. We're not actively developing those programs.

Here's a graphical representation of the pipeline here. You can see the VK2735 in Phase III with the subcu formulation, and then the oral formulation just completed a Phase II study and then the amylin moving toward the clinic. The additional programs are not being actively developed right now with the MASH program and the X-ALD program.

So with the peptide hormone agonist program, we started working on these molecules back in 2019. We looked at the GLP-1 mono-agonist and then a dual-agonist where GIP activity is added and then the triple-agonist where glucagon activity is added on top of those. And we prioritized the dual-agonist mechanism because they just seem to work the best. When we added glucagon, there wasn't any incremental benefit. So we focused on the dual GLP-1/GIP co-agonist. VK2735 was selected as the lead development compound. We have 2 follow-ons that are IND-ready today.

The injectable formulation completed the SAD/MAD study in the first half of 2023. And then the -- subsequently, we took it into Phase III called the VANQUISH-2 Phase III programs -- studies. And then the oral formulation has been through a similarly a Phase I SAD/MAD and also a Phase II study with the most recent data reported in the third quarter of last year.

I'll move to the oral formulation. It's a little bit earlier stage than the subcu, but it's where we have the most recent data. And these are some data from a 28-day study we conducted with the tablet formulation. This is once-daily dosing. And with this formulation after 28 days, we saw a nice dose response. You can see up to around 8% from baseline at 100 milligrams, placebo adjusted around 7%. So a very nice overall dose response. This shows the trajectory of weight change following 28 days of dosing.

And what was interesting in this graph is when you -- it's most obvious in that red line, the top dose, 100 milligrams. You can see the dotted line there showing where treatment was stopped. And for the following 57 days, we saw a pretty good maintenance effect that lasted 4 weeks after that last dose. Actually, we had 8.3% after 57 days and 8.2% after 28 days. So really held on nicely. And it suggested in our view that maybe once someone has attained some degree of weight loss that the maintenance could be feasible with a low dose for a longer period of time.

When we look at the GI tolerability summary from the Phase I study, very, very encouraging tolerability and very little titration in these. Most of the cohorts started at the top dose from the prior cohort and just went at that top dose for a week and then went to the target dose for 3 weeks. So for example, the 80-milligram cohort started at 60 for a week and then went to 80 for 3 weeks. And despite that accelerated titration, we saw very nice tolerability.

So the Phase I takeaways here from the 28-day study up to 8.2% body weight reduction after 28 days of dosing, progressive effect in most cohorts suggested that further weight loss is likely to occur with longer treatment. The majority of the weight loss was maintained 4 weeks after the final dose. And we saw in this study, excellent tolerability through 100 milligrams with the vast majority of adverse events being characterized as mild or moderate. We saw low rates of vomiting, diarrhea and constipation in the higher dose cohorts.

And then we did a -- I didn't have it in the slides here, but an exploratory transition cohort where people were titrated up to 80 milligrams daily for the first 2 weeks, and then they transitioned to an every other day regimen. And these people also continued to demonstrate weight loss. So it suggested that, again, you might be able to transition people to a lower daily dose and continue to see weight loss.

So following this study, we conducted a Phase II study called the VENTURE oral dosing study. And this was a dose-ranging study, went from 15 milligrams up to 120 milligrams daily. The green cohort at the bottom of the diagram there was an experimental cohort where people were titrated very quickly up to 90 milligrams and then down-titrated to 30 milligrams for the final 7 weeks of the study, and that was to further explore this maintenance concept.

These are the weight change data. These data were reported back in August, and we saw a really nice dose response here up to a little over 12% after 13 weeks of daily dosing, but every dose cohort showed a successively greater impact on weight loss. So we're very happy with the efficacy profile here. And when we look at the likely target doses moving forward, we're expecting to really focus on that 20 to 75-milligram range in future studies. And we feel that the profile and the weight loss profile here is very competitive after 13 weeks.

This shows the trajectory of weight loss through 13 weeks, showing up to 12%, so 7% to 12% progressive in every cohort and statistically significant versus placebo at every time point after the first week for every cohort above 15 milligrams. When we look at the follow-up data here, here are some data that we received later on in October. And we can see in this range that we're really interested in that 20 to 75-milligram range, a nice maintenance of weight loss for the 3 weeks following completion of dosing.

And this further supports this concept of durability that we see. Here are the results from that exploratory maintenance cohort. So the gold line here shows the cohort that was just titrated up to 90 milligrams and held there through the 13-week window and showed around 11% weight loss. The green line here is that cohort that was transitioned from 90 milligrams to 30 milligrams. So at week 6, these people were down-titrated back to 30 milligrams and held there for the following 7 weeks.

And we were gratified to see that they had lost 8.1% after the first 6 weeks. And then after the transition to 30 milligrams, they continued to lose weight very gradually and ended with 8.2%. So it suggested to us that this concept of a lower maintenance dose is very promising. When we look at discontinuations here and treatment-emergent adverse events, really not a lot of difference. When you go to the far right on that 120-milligram cohort, you do see an uptick in discontinuations and overall treatment-emergent adverse events.

But when we look at the range that we're expecting to focus on in future studies, really not a great deal of difference between the treated cohorts and the placebo cohorts. Majority of the treatment-emergent adverse events were mild to moderate and discontinuations probably due to this accelerated titration rate here. We -- based on the Phase I data, we had used 2-week titration blocks, and we started at 30 milligrams. I think in future studies, we probably start a little lower and extend the titration block to 4 weeks.

And most of the treatment-emergent adverse events that led to discontinuation were GI related. When we look specifically at the GI tolerability summary, again, a little bit higher as you go to the far right of the table relative to placebo. But overall, when we focus on the dose range that we're most likely to utilize in future studies, really no significant difference from placebo on nausea or other GI adverse events, a little bit of an uptick in vomiting, but we think that starting low and going slow is likely to address that. Again, most of these mild.

This is an interesting histogram that shows the time course of GI adverse events. And this is consistent with what I'll show in a few minutes on the -- from the subcu experience, and that is that usually when GI adverse events are observed, the most common occurrence is in that first week of treatment when people are first exposed to the mechanism. The second most common window of GI adverse events is in the first step in up-titration.

And you can see that here. Week 1 was the initiation of treatment, then week 3 is your first step up, and that's where you see the highest rate of nausea in blue. Following that then after you get to week 4 and beyond, really very little difference from baseline and background rates on constipation, diarrhea and vomiting. So the Phase II study takeaways and next steps. We saw up to 12.2% reduction in body weight after 13 weeks of oral dosing, progressive dose-dependent weight loss across all treatment cohorts. The maintenance cohort is exploratory, but it was very promising.

It showed a proof of concept there after you transition to a lower dose, you continue to see some weight loss. We thought excellent tolerability through the 120-milligram dose with the majority of treatment-emergent adverse events characterized as mild to moderate. And we think that starting low 10 to 15 milligram starting dose and then 4-week titration blocks are likely to greatly improve the tolerability profile observed here. The majority of the GI adverse events also were mild to moderate.

I'll talk in a few minutes about a study that we have ongoing today, which is a transition study where people start with a subcu dosing regimen and then transition to oral daily, a low-dose oral daily regimen. That study is ongoing. And we currently, with this formulation, plan to talk to the FDA by the end of the year and have an end of Phase II meeting and then decide what the appropriate next steps are for the oral tablet.

Now I'll move to the subcu formulation. This has been through a SAD/MAD study and also a Phase II 13-week study. This is just a brief summary of the SAD/MAD takeaways from the SAD study, single ascending dose study. We saw a T-max of about 72 hours, which indicates a fairly gradual onset of action. Half-life, 170 to 250 hours, which we think makes the formulation amenable to weekly dosing and potentially monthly dosing. In the MAD study, we saw a dose-dependent improvement in weight loss up to 7.8% after 28 days, and that was in subjects with an elevated BMI.

And then we saw durable weight loss 21 days after the last dose. In this -- in the MAD study, we also looked at liver fat. We saw up to about a 50% reduction in liver fat in the patients who received MRIs. And we think it's a pretty rapid effect and indicates a broad metabolic benefit from the mechanism. And then really excellent exposures from weekly, suggesting that a monthly is certainly a possibility.

And then finally, excellent tolerability with 98% of the adverse events characterized as mild to moderate. Following the Phase I, we designed and initiated this Phase II study, we call it the VENTURE study, very similar to that oral study I just talked about, but was used weekly injections, dose range from 2.5 mg up to 15 milligrams. And the 2.5 was a flat dose, the 5, 10 and 15 utilized titrations every 3 weeks. The primary endpoint here was change in body weight at week 13 versus placebo.

This slide shows the primary endpoint in that study, looking at change in body weight after 13 weeks, very nice dose response ranging from 9% to approximately 15% from baseline, statistically significant starting at week 1 and maintaining all the way through the 13-week endpoint. And that's shown here, the progressive weight loss over 13 weeks. You can see a very nice initiation of weight loss and then sustained trajectory through the entire treatment window. No evidence in any cohort of a plateau, and we think that suggests a further improvement in body weight with longer dosing.

Here's a GI tolerability summary. And we can see here, like with the oral, generally, you see an increase in GI adverse events, nausea, vomiting and diarrhea as dose increases, but it's not always purely dose dependent. You can see the -- for example, the 10 mg is maybe a little bit better than the 5 mg. So a general increase, but we don't think a significant issue with GI or anything that's different or unexpected from the mechanism. This is an interesting slide because it shows the time course of GI adverse events in 2 cohorts. The 10-milligram cohort is on the left and the 15-milligram cohort is on the right.

And the big difference in these 2 cohorts is that the 10-milligram cohort started at 2.5 mg. And so you can see in that first week, just like we saw with the oral, an elevation in nausea and a little bit of constipation there in that first week, which then declines very rapidly and then ticks up again when you hit week 4, which was the first titration step. So the difference between the left-hand graph and the right-hand graph is the 15-milligram cohort started at twice the dose. The 15-milligram cohort started at 5 milligrams.

And you can see here a large increase in nausea and it really speaks to that -- just that mantra that everybody talks about with this mechanism, start low and go slow. When you look out on the right-hand side of that right graph, you can also see when they were titrated to 15 milligrams, you see another uptick in nausea. Well, this was the largest uptick because people went from 10 milligrams to 15 milligrams. They skipped the 2.5 mg dose. So we learned 2 things from this cohort.

One, you want to start below 5 milligrams; and two, you don't want to jump more than 2.5 mgs in each titration step. So very valuable learnings from this cohort, again, to start low and go slow. So the Phase II study takeaways are summarized here up to 14.7% mean weight loss after 13 weeks. We think very promising tolerability with over 90% of drug-related treatment-emergent adverse events mild to moderate. The majority of GI-related adverse events occur early and then resolve. And then we see good durability here.

We don't have the slide in this deck, but when we look 4 weeks after the last administration of study drug, more than 90% of the efficacy was retained, which further suggests that possibility of a less frequent than weekly dosing. And to that end, the PK profile suggests that a potential monthly regimen would be worth exploring. Where we are today with the subcu formulation? We initiated 2 Phase III studies in the second quarter. The VANQUISH-1 study is enrolling patients with obesity and the VANQUISH-2 study is enrolling patients with obesity and type 2 diabetes.

Both of these studies include an extension to look at long-term safety and efficacy, a 52-week extension. VANQUISH-1, we just announced before this presentation this morning. We've completed enrollment, and that was over-enrolled versus the target enrollment number there. And VANQUISH-2, we expect to complete enrollment in the first quarter. This is a diagram of the study design for both studies. The -- 3 treatment arms versus placebo, 7.5, 12.5 and 17.5. All of the cohorts started 1.25 milligrams. They're held there for 2 weeks, and then they undergo 4-week blocks at 2.5 mg. So it takes about 26 weeks for the 17.5 mg to reach that top target dose.

And then once that 17.5 mg dose is reached, they're held there for 52 weeks. Primary endpoint is a change in body weight from baseline and secondary endpoints look at proportions with the 5%, 10%, 15% and 20% weight loss. And then finally, this is a maintenance study that we kicked off in October. Complicated slide, it's a complicated study. But if you focus on the top hand -- or the top part of this diagram, you can see cohorts are titrated on a weekly basis up to a range of weekly doses, and they range from 15 milligrams weekly up to 22.5 milligrams weekly.

At week 19, then cohorts are transitioned to a monthly regimen. And the monthly regimen ranges from 15 milligrams up to 22.5 milligrams. And we have a control in there that keeps 17.5 mg weekly through the whole window. Another control that titrates up to 17.5 and then transitions people to placebo and then a placebo, the entire duration of the study as well as a control. The bottom hand -- the bottom half of the study of the slide shows an oral set of cohorts here.

So these cohorts are titrated up to 17.5 mg weekly. And at week 19, they are transitioned to either 17.5 mg daily oral, 27.5 mg daily oral or 110 mg weekly oral once a week. So a lot of really, really useful information will come out of this study, and we expect to report the data around the middle of next year.

Finally, I'll wrap up with the financial summary. We ended the third quarter with a little over $700 million in cash. We expect that to get us through the VANQUISH Phase III data readouts and really fortunate to have the runway that we have today. So that's the story. So we're focused on metabolic and endocrine disorders. The metabolic disease program highlighted by VK2735. That's the dual agonist for obesity, currently in the VANQUISH Phase III trial program with VANQUISH-1 completed enrollment as we announced this morning.

VANQUISH-2, we expect to complete in the first quarter of next year. The oral formulation completed Phase II. We will have an end of Phase II meeting by the end of the year and then make a decision on what the next steps are with the oral formulation. And then I didn't talk about it, but we do have an amylin agonist that's moving towards the clinic, and we expect to file an IND in the first quarter of 2026. So I'll stop there. Thanks very much for your attention. Really appreciate it.

Just one quick question. I think one of the new information I picked up is the oral formulation, the Phase II, you decided to focus on the low end of the -- the middle end of the dose cohort. So is that guided by the PK and the GI? Or what -- and then what's the TPP for that dose cohorts?

What's the what?

What's the target product profile?

Yes. So we focused on those mid-range doses. So what I did mention is that this -- the VENTURE oral study, everybody took 4 tablets, even the placebos. And the tablets were 30-milligram tablets and the 30 mg is -- it's a lot to put in 1 tablet. So when we thought about doses to take forward, we wanted to -- kind of a lot of things went into that decision. What's the right tablet size, how many tablets do people want to take? What are the margin considerations as you go up in dose?

And that 25 to 75 is really kind of the sweet spot for all of those items. So that's why we decided to stay in that range. We have that weekly dose in the maintenance study. That should be really interesting because the half-life is around 8.5 days. So it's possible that once you reach a target dose with the subcu, you could transition to that once-a-week dose and maintain body weight.

Thank you. Thank you, everyone.

Thanks.

Welcome to the Viking Therapeutics Third Quarter 2025 Financial Results Conference Call. [Operator Instructions] As a reminder, this conference call is being recorded today, October 22, 2025.

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, October 22, 2025, and 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 third quarter and 9 months ended September 30, 2025, and review recent progress with our development programs and operations.

The third quarter was a busy and productive time for Viking. The early part of the quarter was focused on ramping up our Phase III VANQUISH Obesity program evaluating VK2735, our dual agonist of the glucagon-like peptide on and glucose-dependent insulin entropic polypeptide receptors. Later in the quarter, we were excited to announce positive top line results from a Phase II clinical trial of the oral tablet formulation of VK2735 in patients with obesity. This trial, called the VENTURE Oral dosing trial successfully achieved its primary and secondary end points with patients receiving VK2735 demonstrating statistically significant reductions in bodyweight compared with placebo.

The study also showed VK2735 treatment to be safe and well tolerated through 13 weeks of daily dosing with the majority of treatment-emergent adverse events categorized as mild or moderate. In addition to the third quarter clinical activities, we recently announced the initiation of a clinical study to evaluate maintenance dosing with VK2735. This novel study will assess weight loss maintenance using monthly subcutaneous dosing daily oral dosing or weekly oral dosing. I'll have additional comments on our operations and development activities following a review of our third quarter and 9-month financial results.

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 shortly.

I'll now go over our results for the third quarter and first 9 months of 2025, beginning with the quarter. Research and development expenses were $90 million for the 3 months ended September 30, 2025, compared to $22.8 million for the same period in 2024. The increase was primarily due to increased expenses related to clinical studies, manufacturing for the company's drug candidates, salaries and benefits and regulatory services, partially offset by a decrease in stock-based compensation.

General and administrative expenses were $8.6 million for the 3 months ended September 30, 2025, compared to $13.8 million for the same period in 2024. The decrease was primarily due to decreased expenses related to legal and patent services and stock-based compensation. partially offset by increased expenses related to salaries and benefits.

For the 3 months ended September 30, 2025, Viking reported a net loss of $90.8 million or $0.81 per share compared to a net loss of $24.9 million or $0.22 per share in the corresponding period in 2024. The increase in net loss for the 3 months ended September 30, 2025, and was primarily due to the increase in research and development expenses noted previously compared to the same period in 2024.

I'll now go over the results for the first 9 months of 2025. Research and development expenses were $191.5 million for the 9 months ended September 30, 2025, compared to $70.7 million for the same period in 2024. The increase was primarily due to increased expenses related to clinical studies, manufacturing for the company's drug candidates, salaries and benefits, stock-based compensation and regulatory services partially offset by decreased expenses related to preclinical studies.

General and administrative expenses were $37.1 million for the 9 months ended September 30, 2025, compared to $34 million for the same period in 2024. The increase was primarily due to increased expenses related to stock-based compensation and insurance, partially offset by decreased expenses related to legal and patent services.

For the 9 months ended September 30, 2025, Viking reported a net loss of $202 million or $1.80 per share compared to a net loss of $74.5 million or $0.69 per share in the corresponding period in 2024. The increase in net loss for the 9 months ended September 30, 2025, was partly 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 2024.

Turning to the balance sheet. At September 30, 2025, Viking held cash, cash equivalents and short-term investments of $715 million compared to $903 million as of December 31, 2024.

This concludes my financial review, and I'll now turn the call back over to Brian.

Thanks, Greg. I'll now provide an update on Viking's clinical advancements and other progress from the third quarter, beginning with our lead obesity program, VK2735. 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. Viking is advancing both subcutaneous and oral formulations of VK2735 for the treatment of obesity.

With respect to the subcutaneous formulation, prior Phase I and Phase II study results demonstrated impressive weight loss as well as encouraging safety, tolerability and pharmacokinetics following weekly dosing in subjects with obesity. In the multiple dose Phase I study, participants receiving VK2735 demonstrated up to approximately 8% weight loss from baseline after 28 days of once weekly dosing with no signs of plateau.

Following completion of the Phase I studies, the company conducted a Phase II study called the VENTURE study. The results from this study demonstrated statistically significant reductions in mean body weight from baseline, ranging up to 14.7% after 13 weekly doses. The study also showed VK2735 to be safe and well tolerated through 13 weeks of dosing with the majority of treatment-emergent adverse events characterized as mild or moderate. Adverse events generally occurred early in the course of treatment and were primarily related to the expected gastrointestinal effects resulting from activation of the GLP-1 receptor.

These Phase II data were highlighted in a presentation at the 2024 Obesity Week Conference. A manuscript describing the results of the VENTURE study has been accepted for publication in a leading medical journal, which we expect to publish in early 2026. Following completion of the VENTURE study, we scheduled a Type C meeting with the FDA and the subsequent end of Phase II meeting with the agency to review our development plans. Based on feedback from these meetings, the company advanced VK2735 into Phase III development for obesity.

In June of this year, the company announced the initiation of the VANQUISH Phase III registration program. The VANQUISH program consists of 2 trials evaluating VK2735, one in adults with obesity and one in adults with obesity and type 2 diabetes. Each study is a randomized, double-blind, placebo-controlled multicenter trial designed to assess the efficacy and safety of VK2735 administered by subcutaneous injection once weekly for 78 weeks.

The VANQUISH-1 study is targeting enrollment of approximately 4,500 patients. The VANQUISH-2 study will target enrollment of approximately 1,100 patients. Participants in each of these trials will be randomized to weekly treatment arms of 7.5 milligrams, 12.5 milligrams, 17.5 milligrams or placebo. The primary endpoint of these trials is the percent change in body weight from baseline for participants receiving VK2735 as compared to placebo after 78 weeks of treatment.

Secondary and exploratory endpoints will evaluate a range of additional safety and efficacy measures, including the percentage of patients who achieved greater than 5%, 10%, 15% and 20% body weight reduction. Each study will include an open-label extension, allowing participants the opportunity to continue receiving treatment following completion of the primary dosing period.

Enrollment in the VANQUISH studies has been proceeding well. We currently expect the VANQUISH-1 study to complete enrollment by the end of this year, and we expect the VANQUISH-1 study to complete enrollment in the first quarter of 2026. Along with the development of a subcutaneous formulation, Viking is also advancing an oral tablet formulation of VK2735. The company believes a tablet formulation could represent an attractive option for those who might prefer to initiate treatment with an oral therapy or for those seeking to maintain the weight loss they've already achieved.

An important differentiating feature of our obesity program is that both the tablet formulation and the subcutaneous formulation utilizes the same molecule. We believe this may reduce the risk of unexpected safety or tolerability challenges that might occur when transitioning patients from one therapeutic to another.

A prior Phase I study of the oral formulation successfully achieved its objectives with cohorts receiving VK2735 demonstrating dose-dependent reductions in mean body weight from baseline ranging up to 8.2% after 28 days of daily dosing. The Phase I study also demonstrated encouraging safety and tolerability through 28 days at doses up to and including 100 milligrams per day. The majority of observed treatment-emergent adverse events were mild or moderate with most reported as mild. These results were presented at the 2024 ObesityWeek Conference last November.

Following these positive Phase I results, in January of this year, we announced the initiation of a Phase II study called the VENTURE-Oral dosing study to evaluate the tablet formation of VK2735 in subjects with obesity. This study was a randomized, double-blind, placebo-controlled multicenter study designed to evaluate the safety, tolerability, pharmacokinetics and weight loss efficacy of VK2735 dosed as an oral tablet once daily for 13 weeks. The primary endpoint of the study was the percent change in body weight from baseline after 13 weeks of treatment.

In the third quarter, the company announced positive top line results from the VENTURE-Oral dosing study. The study successfully achieved its primary and secondary endpoints with impressive reductions in body weight observed as well as an encouraging safety and tolerability profile. Participants receiving once daily doses of the oral tablet formulation of VK2735 demonstrating statistically significant reductions in mean body weight after 13 weeks, ranging up to 12.2% from baseline. Reductions in body weight were progressive at all doses through the course of the study.

Statistically significant differences compared to both baseline and placebo were observed for all doses greater than 15 milligrams starting at week 1 and continuing throughout the 13-week treatment period. Up to 97% of subjects in the VK2735 treatment groups achieved at least 5% weight loss compared with 10% of placebo-treated subjects and up to 80% of subjects in VK2735 treatment groups achieved at least a 10% weight loss compared with only 5% of placebo-treated subjects.

The VENTURE-Oral dosing study also included an exploratory cohort designed to assess the weight loss maintenance. In this cohort, participants were rapidly up titrated to a 90-milligram daily dose. After 4 weeks of daily dosing at 90 milligrams, participants were down-titrated to 30-milligram daily doses and maintained at 30 milligrams daily for 7 weeks. Weight loss in this cohort was shown to be rapid and progressive through the 90-milligram treatment period, reaching a mean reduction of 8.1% from baseline. Following down titration to 30-milligram daily doses for 7 weeks, mean weight loss was further improved to 9.2% from baseline.

These results support our belief that an effective weight maintenance may be achieved with a low-dose oral treatment strategy following down titration from either high oral doses or potentially from a subcutaneous dosing regimen. The data also suggests that effective weight maintenance might be achieved with doses lower than the 30-milligram strength evaluated in this study.

Importantly, the oral tablet formulation of VK2735 also demonstrated encouraging safety and tolerability through 13 weeks of once-daily dosing. Among subjects receiving VK2735, 98% of reported drug-related treatment emergent adverse events were characterized as mild or moderate in severity. In addition, 99% of treatment-emergent adverse events that were GI in nature were also reported as mild or moderate.

When assessing these results, particularly in the dosing range expected in future studies, we believe the data suggests no meaningful difference overall between GI adverse events among subjects treated with VK2735 compared with placebo. Importantly, GI-related adverse events were generally observed early in treatment with decreasing frequencies reported upon repeat dosing. Across the combined study arms, the weekly rates of nausea or vomiting did not exceed 5% at any point after the third week of the study.

The overall tolerability data suggests that future titration regimens, starting at lower doses and utilizing longer titration intervals are likely to further improve oral VK2735's tolerability profile. In the coming days, we plan to submit to the FDA and end of Phase II meeting request to discuss potential next steps for oral VK2735. Under normal circumstances, we would expect to hold this meeting later in the fourth quarter of this year.

As I mentioned a moment ago, the subcutaneous Phase II VENTURE results were highlighted in the presentation at the 2024 ObesityWeek Conference. This presentation also showed that subjects receiving VK2735 maintain the majority of their weight loss through follow-up visits occurring up to 7 weeks after administration of the last dose. This included the 2.5 milligram weekly dose, the lowest dose evaluated for which over 90% of the initial weight loss was maintained 7 weeks after administration of the last dose.

In a subset of participants, an evaluation of VK2735 plasma levels was conducted at various time points following completion of the 13-week dosing period. We believe the combined PK and durability results from this study support the potential for once-monthly dosing in the maintenance setting.

To this end, yesterday, we announced the initiation of a Phase I study designed to evaluate maintenance dosing regimens following initial weight loss achieved with weekly subcutaneous injections. In this study, all subjects will receive initial weekly doses of VK2735 for a period of up to 19 weeks. Subjects will subsequently transition to a range of VK2735 maintenance doses, including monthly subcutaneous doses, weekly oral doses, daily oral doses or placebo.

The objectives of the study are to evaluate the safety, tolerability and pharmacokinetic profile of VK2735 under these various dosing regimens. Exploratory endpoints will assess change in body weight from baseline as well as change in body weight from week 19 to the end of the study at week 31. We expect to report the results from this study in the mid 2026 time frame.

In addition to the progress we've made this year with our VK2735 program, the company has continued to advance a series of novel agonist targeting the amylin receptor. Early data support our belief that activation of the amylin receptor represents an important additional mechanism for the regulation of appetite and body weight. During the third quarter, we continued to make progress toward an IND, which we expect to file in the first quarter of 2026. The planned Phase I studies will consist of an initial single ascending dose study followed by a multiple ascending dose study.

Finally, as our pipeline progresses, Viking continues to carefully manage its balance sheet to ensure that we are financially positioned to achieve multiple value inflection points. As Greg reported a few minutes ago, the company had $715 million in cash as of the end of the third quarter, which allows us to complete our planned Phase III obesity trials for VK2735., as well as to pursue development of our additional programs.

In conclusion, during the first 3 quarters of 2025, the company continued to make strong and steady progress with each of our programs. In June of this year, Viking initiated the Phase III VANQUISH registration program, including trials in patients with obesity and patients with obesity and type 2 diabetes. Enrollment for these trials is proceeding well, and we look forward to completing enrollment in both studies in the relatively near term.

In the third quarter, we announced positive top line results from the Phase II VENTURE-Oral dosing study which successfully achieved its primary and secondary endpoints, with patients receiving VK2735 demonstrating statistically significant reductions in body weight compared to placebo. The study also showed VK2735 to be safe and well tolerated through 13 weeks of daily dosing. The study achieved an important development goal, which was to identify a suitable dosing range moving forward. In the near term, we plan to submit an end of Phase II meeting request to the FDA in order to discuss potential next steps with the oral formulation.

We also recently initiated a Phase I study of VK2735 designed to evaluate a range of novel maintenance dosing strategies, and we expect to report the results of this study in 2026.

This concludes our prepared comments for today. Thanks for joining us. And we'll now open the call for questions. Operator?

[Operator Instructions] The first question comes from Steve Seedhouse with Cantor.

Thanks for the broad update. Just obviously, enrollment is going very well in Phase III. I wanted to ask if you had any sense of early signs of patient persistence, discontinuation rate? And if you're happy with what you see there on trial execution side, and then on the maintenance study, hoping you could expand on just the 19-week induction versus 12-week maintenance. What are you doing during that induction phase? How fast are you titrating patients up what dose is being contemplated there? I would appreciate any details there.

Yes. Thanks, Steve. Yes, the VANQUISH studies have enrolled maybe a little ahead of schedule. I think that reflects a fair amount of enthusiasm for the program, and we're happy to see that nothing notable at this point. We're still pretty early in the treatment windows. There's nothing that's suggestive of any persistence issues or anything like that. It's so far going very well according to plan.

With the maintenance study, we're titrating people up. We can't start the maintenance portion on that -- the level of dose that we're targeting. So you got to titrate up to that dose before transitioning to the monthly cadence. And so we'll titrate people up to 17.5 mg. Some will go up to 22.5%, some to 20, and then we'll have another cohort go up to 15 milligrams. So those titration windows are what takes us to get up to 19 weeks. And it's a little bit of an acceleration in the titration window versus the 4-week blocks in the Phase III study. And then I don't know, was there another question on that?

No, that was it. Just can I follow up on the maintenance study? Are you making any changes to just the tablets like the size or dose in the tablets for the maintenance phase? Or like is the auto-injector for the subcutaneous formulation available for this study?

Yes. Good questions. No, there's no auto-injector here. This will be the vial and the syringe form and the tablets are smaller. There's a 17.5% and 27.5% for the dailies and then 110 mg dose for the weekly.

The next question comes from Joon Lee with Truist Securities.

Just following up on the prior question on the maintenance study, are you able to share what the month -- the doses for the monthly subcu daily oral and the weekly oral that are being tested? And I have a quick follow-up after that.

Yes. The monthly doses will continue from their last weekly dose. So that's -- the range would be 15, 17.5, 20 and 22.5 on the monthly cadence. And the dailies then will be 17.5 and a second one at 27.5, and then the weekly is 110 mg for the oral. .

Got it. Is there any reason why the 19 weeks doses are entered it up to 17, 22 and 20. They seem to be a little bit higher than what you're testing in Phase II.

Yes. Well, it's right. The reason is we don't know -- we want to explore what is the right monthly dose. And we don't know what that is right now. So it's a little bit of a range finder on what's the right monthly dose level.

Got it. And last question for the [indiscernible], what are some of the key considerations as you're screening for multiple compounds? Is it just a efficacy and tox profile or potential compatibility with 2735? And will it be a small molecule, peptide, would it be subcu or orally dose?

Yes. Thanks, Joon. I'd say all of the above are important for us. I think historically, the -- and ours is a peptide. And historically, the amylin peptides formulation has been challenging there. So we look at all of those fairly early in the development program. And I think we have a very good lead here that is the one we're going to bring into the clinic.

The next question comes from Ryan Deschner with Raymond James.

My question is, if the maintenance study shows compelling evidence supporting one or more regimen. What's the next clinical step for validating a maintenance regimen and potentially getting it on a future label? And is it a realistic option at all to add an expansion arm to the banker study?

I think that latter question is probably a little more challenging. Those studies are well on their way and adding a monthly regimen to the extension, probably -- it just probably complicates things. I think the next step there would be depending on what the data show a longer study, whether that's a Phase IIb or a Phase III to go right to label language. We don't know yet. We'll have to see what these data show us.

And then maybe really quick. Can you notice any impact from the government shutdown on either the enrollment for the VANQUISH studies? Or has it had any impact on the timing of the amylin program?

No. We've actually -- I've been surprised that the line of communication with the FDA has been relatively unchanged a little bit of a surprise to us in a good way. So there hasn't been any impact just yet. Where we think it has a possibility of impacting is in the timing of an end of Phase II meeting. I mean we would hope based on when we plan to submit that packet that we would have that meeting by the end of the year. But I know there's a lot of people involved in those meetings. So we're not sure what, if any, impact of the timing would -- or the shutdown would have on that timing.

The next question comes from Thomas Smith at Leerink.

This is [ William Patel ] on for Thomas Smith. Congratulations on issuing the maintenance trial, really excited for those results. I just wanted to clarify what I think I may have heard earlier. So for the daily maintenance regimen, it will be 2 doses, it's going to be 17.5 milligrams and 27.5 milligrams, whereas the monthly or sorry, the weekly oral maintenance will be 100 milligrams. Are those the only dose you'll be testing? And then for the 27.5 milligram, Will there be any up titration from the 17.5 to the 27.5? Or will it be directly to the 27.5?

Yes. On the first part of the question, the oral dose is 17.5 mg a day, 27.5 mg a day, and the weekly is 110 milligrams per week. There won't be a titration to the oral from the subcu because the subcu exposures are just so much higher than the oral that we wouldn't anticipate any reason to titrate when you transition to the oral.

The next question comes from Annabel Samimy with Stifel.

Just following on that question. When you move from the weekly injectable to the weekly oral, then at 110 milligrams. You don't believe there needs to be any titration. And there shouldn't be any tolerability issue jumping from the weekly injection to the weekly oral?

I wouldn't think so. I mean maybe that's one of the reasons we're doing the study, but we wouldn't anticipate there to be a significant tolerability challenge there, no.

And in any of those cohorts, are you having any kind of down titration for maintenance like you had in the Phase II VENTURE where you had 90 and then you went down to 30?

No. I think that's what's happening generally when you're going like from 17.5 mg subcu to 17.5 mg oral, that is the down titration once you're on the oral, a further down titration, we -- that's not contemplated nor is it expected to be required.

Okay. And then I guess, maybe just bigger picture. Can you tell us how you can best leverage the maintenance data, given that there's no real regulatory path to get that maintenance on the label. So is this something that you plan to leverage payers perhaps, given how important persistence is to get ultimate clinical benefit and then further justification to reimburse. Have you talked to payers about how a maintenance regimen might potentially bring preferential adoption? Just any color around that would be great.

Yes. Thanks, Annabel. It's a really important point, and you're exactly right. It's really a big deal to payers, and we've had a lot of discussions with payers, even though it's somewhat early in the commercial planning phase. We think these data could be quite powerful in providing evidence for how to keep people on therapy. That's the best way to realize the long-term benefits, and that's the way payers will ultimately save money is keeping people on and increasing persistence rates. And that's exactly why we're exploring these different maintenance options.

The next question comes from Hardik Parikh with JPMorgan.

Congratulations on the progress thus far. I just wanted to ask you, with the recent Pfizer Mattera deal, I was just wondering, could you give your high-level thoughts on just what aspects of the deal you found favorable/unfavorable for Mattera?

Oh gosh. We typically don't comment on other people's deals. I think it's a much better question for Pfizer or Mattera management team. I don't really have any additional color than what's out there in the public domain.

Right. And just you talked about the next steps for the oral 275, you talked -- you don't have the FDA meeting later this quarter. Do you think you could have a green light on whether it's proceeding to a Phase IIb or Phase III by end of the year?

We hope to get information that will help us make that decision, whether we receive the final minutes by the end of the year, I don't know if not, it would probably be in the January time frame. But hopefully, we would have some understanding of any potential concerns at the agency with the potential to transition directly to Phase III. But yes, hard to know what the exact timing is right now.

The next question comes from Jay Olson with Oppenheimer.

Brian, congrats on all the progress across so many different fronts, including your pioneering maintenance study. Maybe just to shift gears for a moment to bigger picture question. what sort of lessons learned or read across have you gotten from recent dynamics in the oral GLP-1 space? It seems like yesterday's update on Turn 601 kind of shows the high rate of attrition there and especially potential for safety and tolerability concerns with small molecule oral GLP-1s, what do you think is the read across or learnings that are important for your program? And then I had a follow-up, if I could.

Yes. Well, I think one thing that we think stands apart with our program is that -- the safety profile looks very strong. The tolerability profile looks very strong as well. We learned a lot from our own the Phase II VENTURE-Oral dosing study about probably best to start at a lower dose than we started there and extend the titration windows. But what we saw from that study based on the trajectories was really, really encouraging as we look at a longer-term dosing window.

I think what you see in the oral studies generally is -- I mean, it's really difficult small molecule peptide or anything. It's really, really difficult to develop these therapeutics. So the attrition is, I guess, just a reflection of those challenges. But I think we feel really good about where we are in the competitive landscape with the oral peptide.

Okay. And if I could please just ask a quick one on your DACRA IND filing. Can you just talk about what are some of the limiting steps and what sort of work you're doing there?

Yes. Thanks, Jay. One of the things that we are thinking about with that program just based on the potency looking a little bit better than the dual agonist 2735. One of the things we're trying to understand is a better candidate for oral therapy since the potency would suggest that if it were to be replicated in oral, you might be able to dose at a fairly reasonably low level. So we're working hard to understand that and would be, I think, a truly differentiated, really exciting compound. I think it's exciting anyway, it's a subcu formulation. But if the oral looks like we think it might, that might be something that's particularly exciting to pursue.

The next question comes from Mayank Mamtani with B. Riley FBR.

Yes. B. Riley Securities. Appreciate the detailed updates, Brian. Could you touch on what topics of interest are for this end of Phase II meeting regarding the oral? And how much of the subcu packages relevant here? And if you're looking for anything from the oral semi and the also FDA review also ongoing? And I don't believe I heard from you what dose levels you're contemplating for the next study, whether it be Phase III or Phase IIb for the oral? And then I have a follow-up.

Yes. Thanks, Mayank. No, we haven't disclosed the doses that we would contemplate. We'd like to talk to the FDA about what the overall study design might look like, what the duration might look like, how are safety package looks. One thing we think we are able to leverage is the subcu safety package in the oral when it comes to long-term talks for the oral. So that's helpful. But understanding how the existing data would support transitioning to Phase III or for Phase IIb would be better. That's kind of what the goal of the and the Phase II meeting is.

Okay. And just maybe high level, as you also think about the broader financial structure of the company. Is the CV outcome trial still part of the consideration? And what else commercially you think you need beyond the studies you've talked about like the maintenance study, but are there other studies, any head-to-head studies versus current GLP-1s that are being thought about that we should think as we think about the spend in the next 2 years?

Yes. I think important studies that would support an NDA filing are kind of blocking and tackling type studies, renal impairment study, a hepatic impairment study, drug-drug interaction studies. These are sort of expected studies to conduct prior to filing. As far as an additional Phase III study or anything like that, nothing contemplated just yet. So we wouldn't anticipate any major expense on that side.

The next question comes from Mike Ulz with Morgan Stanley.

This is Rohit on for Mike. Can you just talk about your expectations for OpEx spend moving forward? Should we continue -- should we expect R&D to continue going up further? And then secondly, given the recent interest and activity in the MASH space, are there still plans to partner VK2809?

I think you -- our OpEx is up from prior quarter, obviously due to the progress on the Phase III activities. And we would expect that pace to continue approximately going forward. It could move around a little bit by quarter, but we would expect these higher levels as we get through the trial.

And when we consider the MASH space, yes, you're right, Rohit. There is -- obviously, the space has come back a little bit into focus for investors and partners. And yes, I think we have seen a little bit of that uptick in interest. And what you've seen in the in the space generally is this recognition of value, whether it's the M&A we've seen in the obesity space or the M&A we've seen in the mass space we have 2 fantastically valuable assets in the same company. So I think we're in a really, really good position, and we have seen a little bit of interest in that -- in the MASH asset.

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

Congrats on all the progress. I just have 2 here. The first question is that the if the next step for the oral will be a Phase III eventually, would you consider basically just oral to oral in other words, high dose to low dose or subcu to our transition a little bit like the maintenance study. Then I have a follow-up.

No, I think the oral study would be more of a traditional, you titrate up to a level and then stay there for 52 weeks, just to stay vanilla and stay within the confines of the guidance.

Okay. Great. And also in terms of both the VANQUISH 1 and 2 study, there's a little bit time gap I guess in terms of completing the enrollment. So although this is a little bit early, it would you anticipate to report both data at the same time or report them sequentially when they are available?

Thanks, Yale. Good question. I can't answer that yet because I don't know the actual time difference in when the data would be available. I think historically, what we've seen as far as the reports has been companies report the data when they're available. And so if there's a few months' difference, you'd probably want to report them separately. And it's also important, I think, to give the study its own breathing room, so to speak, and have a single press release on each study.

The next question comes from Roger Song with Jefferies. .

Great. Maybe a quick 1 from us. One is, Brian, I believe you said before in the Phase IIa or Phase I or studies you plan to give us some update on the week of treatment, follow-up and then maybe some PK data. So just curious when -- and yes, the data is still coming in the coming months. And then the other thing is related to the dosing for the oral potential pilot Phase II understanding you haven't disclosed the full detail, but how likely a weekly given you are testing that in the maintenance study? And then how should we think about the now starting growth getting towards like 17.5 and 27.5 versus the higher dose as you get for the Phase II.

Yes. Thanks, Roger. Yes, I think we'll have to see what these data show and then go forward with what the that transition from subcu to oral would show for maintenance and make a decision on what the right maintenance dose would be following completion of this study. I think if we plan the phase -- supposing we could go into Phase III for the oral, we would. If we were to add an extension to the Phase III studies that's the point at which we would think about adding a low-dose maintenance in those studies.

So early to make that call right now, but I think we have some time, and we can add doses and make modifications to the extension period if we were to add an extension to the oral studies, again, assuming we can go into Phase III. With respect to the additional data, we've not received the final PK report from the oral dosing study, the ventral oral dosing study. We expect to within the next couple of weeks, but just haven't received that yet.

The next question comes from Andy Hsieh with William Blair.

Congratulations on the likely enrollment phase for the VANQUISH program. So I'm very interesting by the maintenance study as probably everybody else does. So curious about your thoughts on the dose required for maintaining the weight loss during the active weight loss period. versus once patients reach maximum weight loss. So I guess at 19 weeks, it's likely that they're still very much in the active weight loss period. So how are you thinking about extrapolating that data into locations where most of them have reached maximum weight loss and transitioning into the maintenance loss?

Yes. Thanks, Andy. It's a good question. I think the point here is that you're right. Probably most of these people will not have reached the full depth of their weight loss. But our goal really is to understand what is the dose that can prevent weight regain. And I think then it's probably less important, we think that they've reached the nadir versus 40% of the nadir or something like that. The goal really is to understand what prevents that regain. It's possible that drive to rebound is greater once you experience a larger amount of weight loss. But I think we'll have a signal anyway here from a pretty substantial weight loss, what can keep them at that body weight. So I don't know that it would be significantly different if you actually hit somebody at the absolute bottom of their weight loss.

I see. That's fair. Maybe another one. I'm curious about your thinking in terms of Eli Lilly's cardiovascular outcomes in type 2 diabetes. It seems like additional A1C and weight loss didn't translate into additional cardiovascular protection. So obviously, you have a dual agonist, the same mechanism. So I'm curious about maybe your interpretation of that.

Yes. I don't think we've seen the full results from that study, so it's hard to know all of the details. I would expect a larger weight loss and accompanying A1C reductions to translate, but I don't think we have all of the details from that particular study.

As we are nearing the conclusion of today's call, our final question will come from Justin Zelin with BTIG.

Brian, we talked about the trends and increasing strategic interest in the metabolic disease and OBC space. Can you talk about your latest thinking on how you're thinking about either partnership or let's say, going alone towards commercialization in the obesity fields?

Yes. Justin, yes, nothing has changed as far as our position. We're certainly receptive to outside interest and nothing's changed with respect to our thoughts that having a larger party involved would be very helpful in driving the program through commercialization. That said, I don't think it's mandatory. I think it's probably a preference, but it's not mandatory. So I think we're prepared to go alone, but we're also prepared to engage with anybody who is interested. And in the meantime, I think it's just execute the Phase III trials and continue the commercial preparation that we've already embarked on.

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 great day. .

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

Wonderful. Thank you, guys. It is wonderful to see you all here today. Thank you so much for taking the time. It is my privilege to have the Viking team here with me. I've got Gregory and Brian, CEO and CFO of the company. This is a particularly interesting and exciting time in the world of cardiometabolic obesity and kind of all the places that you guys play in. And so undoubtedly, there's lots of questions and lots of things that everyone wants to dive into.

For those of you who don't know me, my name is Courtney Breen. I am the U.S. biopharma lead analyst here at Bernstein. So think about -- a lot about all the large-cap names, but also all the companies that are coming in to look to compete with many of those large-cap names or partner with them over the years.

So we're going to spend a bit of time with the Viking team walking us through some presentation materials, and then we'll dive into Q&A. Just a reminder, we do have the Pigeonhole app available. So if anyone has any questions, please feel free to put those through on Pigeonhole, and I'll be happy to integrate them into the Q&A at the end.

So with that, I will hand over to you to walk through some of these presentation slides.

Great. Thanks, Courtney. Thanks also to Bernstein for the opportunity to participate. We've got a great schedule, and it's good to see you all today. I'll make some forward-looking statements. I'd refer anybody listening to this presentation or viewing these slides to the Securities and Exchange website -- Commission's website for the most current information on Viking.

So happy to walk through the story. We're developing novel therapeutics for metabolic and endocrine diseases. We have multiple clinical programs that have demonstrated what we believe to be best-in-class data. The metabolic disease programs are highlighted by our VK2735 molecule. It's a dual agonist of the GLP-1 and GIP receptors. It's currently in a Phase III program we call the VANQUISH Phase III program for obesity, and there's two trials underway there. We have an oral formulation of the same compound that has recently completed a Phase II study, successfully achieved primary and secondary endpoints in that study. And then finally, we have an amylin agonist, a novel amylin agonist that we plan to move into the clinic late this year or early next year following the filing of the IND.

We have additional programs that are focused on the thyroid beta receptor. VK2809 is a thyroid beta receptor agonist that completed Phase IIb in NASH. And then we have a separate molecule, VK0214, that's completed a study in X-linked adrenoleukodystrophy. And both of those are in-house available for licensing, but not something we'll focus on in the near term. This slide shows the pipeline where we stand today, the VK2735 subcutaneous formulation in Phase III, the oral formulation just completed the Phase IIa study, and then the amylin agonist heading into the clinic later this year.

So a little bit of the background on the peptide hormone program. We initiated this program back in 2019. And we looked at all of the agonist, the mono GLP-1 agonist, the dual agonist where you add the GIP activity on top and then the triple agonist with the glucagon agonist on top of the dual. And we selected the dual agonist really because the triples didn't look any better to us, and duals just seem to be very attractive. So we stuck with those. VK2735 was the lead that we selected based on the initial profile, and it has completed now a Phase I SAD/MAD study that we reported in the first half of '23, a Phase II study reported last year, and the Phase III studies are underway with the VANQUISH registration program. With the oral formulation, we completed the SAD/MAD work last year, and then a Phase II study just recently read out in the third quarter.

This just shows some of the early data. All of our compounds are very potent at the GLP-1 and GIP receptors. Robust weight loss has been observed in multiple species. And this slide just shows the weight loss over 14 days, generally up to about 30% weight loss relative to vehicle. Pretty clean PK, 2- to 7-day half-life in primates. This shows a compound we call VK2745. And just an example of how tight the PK profiles are, very consistent, well-behaved PK profiles. So we had selected VK2735 as the compound to bring further into development.

And we just reported some data in August from the oral tablet formulation. So I'll walk through the tablet first, and then the subcu formulation after that. These are the Phase I data from the oral tablet. This is a 28-day study, daily dosing for 28 days. And in this study, we did see a dose-dependent reduction in body weight across all of the arms leading up to around 8% from baseline at the 100-milligram dose, about 7% placebo-adjusted. But overall, I think, an attractive dose response here in a 28-day study.

When we look at the trajectories from this study, really nice, again, dose response and a consistent progressive effect through the 28-day window. And one thing that was interesting when we looked at the follow-up data from this study was this period following 28 days out to day 57. You can see, it's most obvious here with the 100 milligram, really a durable effect. This was 8.2% from baseline at 28 days, 8.3% from baseline at 57 days. So a very nice maintenance effect reflects, we think, the long half-life. And I think it suggests that maintenance might be feasible at lower doses than the induction window.

The takeaways from the Phase I study, up to 8.2% reduction in body weight after 28 days. Progressive effect across all doses suggests that you should see an extension of that efficacy with longer treatment. Majority of the weight loss in every arm was maintained 4 weeks after the final dose, and very good tolerability in the Phase I study. 99% of the adverse events were mild to moderate, very minimal GI adverse events with low rates of the common GI adverse events, nausea, vomiting and so forth. We did include an exploratory cohort in this study that looked to transition from 80 mgs daily to 80 mgs every other day. And we think those data looked very promising. Weren't in this deck, but they're in our poster from ObesityWeek, suggests a feasibility of a lower dose for maintenance, providing a good maintenance effect.

And so the Phase I data supported advancing into Phase II. So we designed this study, we call it the VENTURE oral dosing study, 13-week study, multiple dosing arms. Lowest dose was 15 milligrams flat for 13 weeks. Second dose, 30 milligrams flat for 13 weeks. And then 60 milligrams, 90 milligrams and 120 milligrams, each of these titrated starting at 30 milligrams for 2 weeks and then to the next dose for 2 weeks and the next dose in 30-milligram increment. So the 120, for example, started at 30 for 2 weeks, went to 60 for 2 weeks, 90 for 2 weeks and then 120.

We have at the bottom here, an exploratory cohort that we thought was really interesting. These subjects were titrated very rapidly to 90 milligrams. So 30 mgs per week, 60 mgs per week and then 90 mgs for 4 weeks and then transitioned back down to 30 milligrams daily for 7 weeks, and that was to further explore the potential for a low-dose maintenance regimen.

Here are the data that we reported in August. This shows the percent change in body weight at 13 weeks. And again, just like what we had shown previously with the subcu formulation, a really nice dose response here, leading up to 12% from baseline at the top 120-milligram dose. Progressive and dose-dependent across all of the treatment arms would suggest that an enhancement of the effect should occur with longer dosing.

And when we look now as we head forward, we'll probably be focusing on these doses in the 20- to 75-milligram range. And so that's why I circled this range here, 30 -- 15 to 90, really attractive and competitive weight loss here, 7% to 8.7% with the 60-milligram dose.

Here's the data from the maintenance cohort. So this again was the cohort that rapidly titrated up to 90 milligrams and then brought people back down to 30. And so this is in comparison. This line here is the cohort that titrated up to 90 and held at 90. And there, you see 11.1% weight loss from baseline. The green line shows the cohort that titrated very quickly up to 90 and then at week 6, transitioned to 30 milligrams daily. And you can see after 6 weeks, 4 weeks of which were at 90, you see 8% weight loss, transition people to 30 and hold them there for 7 weeks, and we saw another 1.1%. So it clearly supports this transition phenomenon where you can go to a lower dose, and here not only suggest maintenance, but actually a continued improvement in body weight.

This shows a secondary endpoint, the proportion of patients achieving at least a 5% weight loss. Again, nice dose dependency, up to 97% at the 120-milligram dose. But even at the low dose, you're about 3x what the placebo rate was. So very positive on the secondary endpoint there.

A bit delayed on the buttons here. Maybe the battery died. Okay. Okay. Proportion of patients, another secondary endpoint proportion with a 10% weight loss. And again, a nice dose response, 7.5%. Not significant there, but moving up to around 80%, experiencing 10% weight loss at 13 weeks, with the trajectory suggesting that all of these bars should improve over time with longer-term dosing.

When we look at discontinuation rates in this study, here, we can see the proportion who discontinued treatment early that's stopping taking the medication. And you do see 18% in placebo trending up a little bit higher in the higher doses and discontinuation of the study really pretty flat across here, maybe a little uptick at the highest dose here, but pretty flat. Overall treatment emergent adverse events also reasonably consistent across the treatment arms. Drug-related, maybe a slight uptick when you get to the higher doses, but that would be expected from the GI adverse events. And then the drug-related treatment of emergent adverse events leading to discontinuation, really no signal related to placebo. So the majority of the treatment of emergent adverse events were mild to moderate here.

And when we look then at the doses that we'll likely be bringing forward, that 20- to 75-milligram range, again, really not a significant difference relative to placebo on discontinuations or overall treatment emergent adverse events or those types of things. When we look at GI tolerability, what everybody likes to look at with the GLP-1 mechanism, we do see, as you go across doses, an uptick in overall nausea at the higher doses. These middle doses really didn't separate too much from placebo. Placebo had a pretty high rate of nausea. Vomiting slightly higher in the treated arms, likely addressable with slower titration rate. And then the other adverse events, really not much of a signal at all. So again, when we look at our likely future doses here between that 20-milligram and 75-milligram range, compared to placebo, really not a significant delta at all on any endpoint. So we're very satisfied with the AE profile, given this rapid titration compared to placebo as being highly competitive.

This slide is really interesting because it shows the time course of adverse events over the course of the study. And so you can see here, by far, the majority of the nausea and other GI events happened in that first week of treatment. So that's the initial exposure to the mechanism. Following that first week, you see a substantial drop off. It ticks up a little bit here at week 3, and that's your first up titration. But following that first up titration, really drops to pretty much 0 across the rest of the treatment window.

So the lesson here and from the prior tables is you want to start low and you want to go slow. And you will probably this pull in quite a bit, and these probably remain pretty flat. This is all doses combined. We don't yet have the individual cohort data. But overall, this graph looks very similar to what the subcu data showed, and that was initial exposure gives you a little bit of nausea. Following that, it never comes back, really.

So the VENTURE Phase II oral study takeaways, up to 12% reduction in body weight after 13 weeks of oral dosing. We see a progressive dose-dependent effect across all of the treatment groups. The maintenance cohort, very exciting for us as we successfully demonstrated the proof of concept from high dose to low dose, maintaining body weight, really promising tolerability profile with a vast majority of adverse events, mild to moderate. In particular, the majority of the GI adverse events were mild to moderate and transient, and we expect those to improve with the optimized titration that we would pursue in a subsequent study, which would probably have 4-week treatment windows or titration windows. And then next steps here with the oral would be to initiate a subcu to oral maintenance study, which we've talked about in the past, and that will begin late this quarter or early next quarter.

Now I'll quickly review the other formulation. This is a subcu formulation, a weekly dose. This was data we reported last year from the Phase II, we call it the VENTURE, the other one is VENTURE oral, this is VENTURE, they're pretty much the same study design. This went from 2.5 mgs to 15 milligrams, a parallel cohort with a 3-week titration blocks for the 5-, 10- and 15-milligram doses.

This study achieved its primary endpoint, a significant reduction in body weight observed after 13 weeks. This is the dose response from 2.5 up to 15 milligrams. Beautiful dose response, approximately 15% from baseline after 13 weekly doses, and progressive with no sign of moderation through the treatment window. This is the trajectory for weight loss from the weekly injection study. Again, we see a nice dose response and a very rapid effect throughout the 13 weeks. All doses statistically significant starting at week 1 and remaining that way through the course of the study.

This summarizes the GI tolerability in the subcu study. So pretty modest GI effects, what you would expect to see. You see a dose-dependent uptick again in the higher doses here, 15 milligrams and 10 milligrams. But overall -- and same with a little bit of an uptick in vomiting as well. But overall, nothing that you wouldn't expect from this mechanism. And again, the majority of these are mild to moderate.

This shows the time course of adverse events for the 2 higher doses. This is the 10-milligram cohort, this is the 15-milligram cohort. And I show these because it dramatically illustrates the effect of titration. So the 10-milligram cohort, blue here, is nausea. And you can see a 15%, 16% rate of nausea, and that first dose drops off a cliff and then comes back at your first titration step and then pretty much goes to 0 after that. So this cohort started at 2.5 milligrams.

This is the 15-milligram cohort. Big difference with the 15 is these guys started at 5 milligrams. So you can see this massive change in nausea that's brought way down by just starting at a lower dose. So following that first week, then you see a rapid drop in GI adverse events. You see a little bit of a tick up here, and this was when you went from 10 milligrams to 15 milligrams. So it just further illustrates that mantra, start low and go slow. This guy started twice as high and did twice as high a step here out late. So you just want to be steady through the treatment window to minimize GI adverse events. And I think these 2 cohorts really show that nicely.

So the study takeaways from the subcu study, up to nearly 15% weight loss after 13 weeks of treatment. A very encouraging tolerability, over 90% of the drug-related treatment emergent adverse events were mild to moderate. GI-related adverse events generally occurred early and then resolved quickly. When we look at durability here, we saw that more than 90% of the efficacy that was observed at week 13 was retained at week 17, so a very attractive durability signal. And we think the PK profile from this study suggests that a monthly regimen would be feasible, particularly in the maintenance setting.

So the current status of the subcu formulation. We've got two studies ongoing, VANQUISH-1 is our study in obese patients. That's about 4,500 people. VANQUISH-2 is in patients with diabetes and obesity, that's a little over 1,100 people. Both studies include an extension to assess long-term safety and efficacy, and we initiated these in the second quarter of this year.

Something that's upcoming for the subcu formulation is this monthly dosing study, and this is designed to evaluate a monthly regimen in the setting of maintenance. So you titrate people up to a high weekly dose and then transition them to a monthly regimen. Second element of that study is a low-dose oral regimen. So we'll bring people from a high weekly dose to a low-dose oral or to a monthly regimen. And this will look at PK tolerability and weight maintenance.

So I'll wrap up with the balance sheet here. We ended the second quarter with over $800 million in cash, and that's, we think, provides a runway to finish the Phase III trials, very fortunate to have the runway that we have and to support the programs to develop them aggressively.

Bringing us back to the first slide. So pipeline is focused on metabolic and endocrine diseases. The VK2735 compound for obesity is the lead program, the subcu formulation in Phase III, the oral formulation just completing a successful Phase II, and then the earlier program is an amylin agonist that we hope to move into the clinic towards the end of the year or early next year. And that's all I have, and thanks for your attention, and I'll open up to questions. Thanks.

Fantastic. Thank you so much for walking us through there. And obviously, the recent Phase II data for the oral has been kind of the source of a lot of investor focus, a lot of investor questions. And maybe just to talk through the next steps off the back of that. I think you've highlighted that there is the oral maintenance study that you anticipate to get up and running in the back part of this year. The next question is kind of the oral weight loss study and kind of the potential path to achieving that. What do you need to see? What do you need to explore? What do you need to validate on your oral [ asset ] before you are in a position to initiate that Phase III?

Yes, we hope to have in the fourth quarter, an end of Phase II meeting with the FDA to review all of the data, the animal data, the human data and then understand what might -- what additional work might be required prior to Phase III. And so we're hoping to schedule that in the fourth quarter and then decide on the next steps from there.

In the interim, yes, we will be starting near term, the -- that study I just mentioned where we transition people from a high weekly dose to a variety of oral maintenance. We have 2 cohorts that will be a low-dose oral daily, and then 1 cohort that will be a weekly oral dose as well, just to explore the maintenance effect. So that would be the nearest term with the oral. But the end of Phase II, I think, will be very valuable in mapping the path forward there.

Fantastic. And as you think about kind of the endpoints that exist in these trials today and the labels that we see for some of the GLP-1s and GLP-1 GIPs that are out there, they tend to be based on weight loss rather than necessarily weight maintenance. As you think about the path for the oral coming to market, do you need to have in your mind, individual studies that generate weight loss evidence for that oral? Or is there a path that you can foresee kind of purely in that maintenance setting?

Yes, there isn't a maintenance approval path right now. So every cohort that you would look at in a Phase III oral study would be designed for weight change from beginning to end. And it would be up to the commercializing party to position it in maintenance or an induction, which is one of the reasons we're exploring these maintenance to see where is that dose for the maintenance effect. But it's true, there's not a regulatory path for maintenance. So every drug that's approved today anyway is approved for weight loss.

Fantastic. And perhaps as I look at kind of some of the Phase IIIs that you've got up and running, the VANQUISH-1 study, you've made the decision to have a BMI cutoff at 30. You contrast that with some of the other studies that we see out there tend to go down to 27 with kind of patients that have comorbidities. You've decided to kind of keep it a little higher. Can you talk about kind of that particular decision, why that feels like the right decision for you? Is that a trade-off of kind of expense of the trial, getting the right patients in, delivering the evidence versus where the product might be used in the market?

Well, both studies allow -- both studies -- it's 30 and above or 27 and above with the comorbidity. So they are kind of in that traditional bucket. It turns out that the vast majority are always above 30, but we did drop it. If you've got a weight-related comorbidity, we drop to 27 as the standard.

Great. That's super, super helpful. One other thing that I think is really important as we look at development of drugs in this space is -- and this was certainly a large part of the conversation at EASD last week on the ground with physicians -- is the idea of placebo-controlled trials and whether they still make sense. And this really comes down to kind of two parts of the puzzle, one on the patient side, kind of how are you going to kind of ethically, in some instances, offer a placebo to a patient who needs weight loss. And then the second side of it is kind of for the company itself, how do you entice enough patients to come into a trial so you can recruit appropriately, but also maintain enough patients in your trial over your 60-, 70- or 80-week long trial that they may be in for that Phase III.

As you look at kind of your position in the market, entering a market that's rapidly maturing, how are you making those trade-offs at the moment? Because it obviously impacts cost of trials, it impacts speed of trials. It impacts a lot of different factors that I'm sure you're weighing up.

Yes. The retention of placebo -- right now, the registration path is it requires placebo-controlled studies. Active comparators could be an important component in the future, but the registration trials are placebo-controlled, according to guidance. But yes, the question is, how do you keep those guys in. It's a really huge challenge for anybody working in the space. If you've got a person enrolled in the study who's not losing any weight and doesn't feel any GI adverse events, they sometimes feel like maybe they're on placebo.

Everybody faces the challenge. I think one thing that really helps with retention, probably the best thing to help with retention is to guarantee access to active therapy upon completion of the primary endpoint date. And that -- as long as people are sure they're going to get active therapy and they're getting it for free and they're receiving active medical care, that really does make a difference in retention. But it's always there, and I think everybody needs to try to navigate that. It's always a challenge.

Absolutely. Yes, it was a much louder part of the conversation, I think, over the last week at this conference than it has been in the past.

I want to talk a little bit about Viking as a company as well. We've been deep in kind of the drugs, the trial design, kind of where you're going. As a company, as you think about the next 3, 5 years, we're going to be going through some of these Phase III clinical trials, beginning to get to kind of some of the data cards turning over at the end. What does success look like for you at Viking? And you made a comment kind of on your last couple of slides, you've got about $800 million of cash sitting there to fund kind of the position that you're in right now. What degrees of freedom does that enable you? And kind of what are the pathways will you be wanting to explore to ensure that you've got all the choices that you might need to have so that you can have viable commercial products that are really competitive entering the market and Viking sitting in the best place that it can?

Yes. We're pretty lean. We've always run pretty lean. We have just over 50 employees today, and that will probably grow over the next couple of years as the Phase III trials mature as we prepare for commercialization. But we've always, I think, gotten a lot done with limited resources. And all of our expenses are -- or most of them are to external execution-related vendors.

And I think what's really unique about the obesity market, which probably wasn't in existence before the obesity market started to expand so rapidly, is the direct to patient is a really effective means. And when you look at the successes of these compounding pharmacies and the compounders, they don't have any sales infrastructure. And our estimate is that over $10 billion in revenue right now is going to that channel.

So it's a very unique market, the way obesity is maturing. And it, I think, fits nicely with a company like Viking that's always been very lean on infrastructure and has had a pretty low expense burden for infrastructure. So I think the market here is set up very nicely for a company like Viking to be really successful. We just don't have that underlying infrastructure expense that a larger entity might have.

Super, super useful. And as I think about some of the big choices you have to make ahead of you, one of those is something that you reiterated, I think, a couple of times in the session was that -- the presentation, which is that notion of go low, go slow, which we hear repeated as a mantra from so many physicians. And I think the most extreme version of this that I hear from some physicians today is, oh, I don't even get any AEs in my patients at all these days because they are going much lower and much slower than what the labels tell me for the products that are out there.

And so this is a growing appreciation, I think, in this market that you can really tolerize these patients with time and you can manage their adverse events. But it's a trade-off on kind of being able to deliver efficacy, a kind of weight loss demonstration or health outcome demonstration over an efficient length of trial. And so as you look forward and kind of making that deployment of cash against some of these future clinical trials, how are you thinking about that particular trade-off?

Yes. Well, for the Phase III trials, we did slow down the titration rate just to make sure there are 4-week blocks and ease people into the dose escalation. But for all of the studies for registration, you've got to be at 52 weeks from the post titration dose to the endpoint. And so ours is 78 weeks. I think if you titrate faster, you can compress that a little bit, but the tolerability profile will suffer as a result. And in the real world, people titrate to tolerability, really.

And so I think for us, it's just the way our titration works is it's going to get us through 78 weeks before we get to the endpoint. But in the real world, we would expect it to be used kind of custom -- just like we see right now with the current weight loss agency, people dose up to whatever they can tolerate.

What's interesting, we've heard anecdotally from some investigators is we've heard about patients coming into their clinician and asking to be up titrated because they're not feeling any more GI adverse events. And they feel like, oh, it's not working anymore so I'm not seeing -- so it's kind of a backwards way to think. They shouldn't think that way, but I -- it tells you that some people are really looking for that. And we think we probably saw a little bit of that in our -- in the oral Phase II study with the higher-than-expected rate of nausea in placebo. It's just that everybody knows somebody who's on a GLP-1, and they all -- everybody talks about the GI profile.

Absolutely. And certainly, on that point, I think -- two things that came to mind in your comment there. In my old life back in industry, kind of I do think there is this idea, it's almost a bimodal distribution of patients, patients that want to treat a disease as hard and fast as they possibly can, and the other patients that want to forget that they have the disease and want to make sure that, that drug is kind of unrecognizable in kind of the course of their lifestyle. And so I do think kind of there are different shapes to the way that this kind of shows up.

Perhaps just as we kind of get into our last 5 minutes or so of this conversation, I do want to open up to kind of the market evolution. Because as we think about the GLP-1 space -- and you made the comments about the direct-to-consumer platform, which I think is a really important one. What other fundamental parameters of the GLP-1 market or the obesity market that are critical to framing the opportunity that you think you have? How do you see the market evolving? And kind of do you see Viking and your assets as they come to market joining a growing market or disrupting a growing market?

Yes, it's a good question. We think the #1 fundamental that both patients and clinicians want is efficacy. Everybody wants the most effective weight-loss drug. And so you have to expect that and really be able to compete on that. And that's why I think our study, with the doses we selected and the profile we've seen with the drug so far, should be highly competitive on efficacy.

I think second then, tolerability becomes more important following efficacy, and then learning how to properly titrate somebody is an important element of that. And how we see us entering the market, I think the 2735 molecule will be very competitive based on the profile we've seen thus far. And as we look to the future and we expect efficacy to always be the attractive -- most attractive characteristic for most people.

When we think of our amylin program, we think an opportunity to combine the amylin with the dual agonist would, we think, possibly provide a weight loss effect that's above and beyond anything we've seen thus far in the pipeline. So that's where we see sort of the next step, just like we've seen with the GLP-1 and then GLP amylin, GLP GIP, GLP GIP glucagon. Adding different mechanisms on top of that GLP-1 backbone will likely continue to incrementally improve efficacy. And I think if the amylin program matures and the way we hope it does, it should allow us to be really, really competitive.

Fantastic. And one of the other things I want to ask, you mentioned as you kind of we're talking about the Phase III clinical program that you've been a very lean organization over time and the roles and capabilities will kind of need to evolve that you lean into. As you look at different ways of doing that, kind of doing that fully in-house versus partnering versus collaborating, how do you think about kind of those decisions and ensuring that you're taking on the right risk within your own entity versus sharing risk with other players that might want a piece of the opportunity as well?

Yes. Well, we have to be receptive to ideas. And we've always felt that the programs could be most effectively developed with the help of a larger party, so we're certainly open to collaborating with larger companies. But we also have to be able to map out the future if that doesn't materialize, and that's what we've been focused on a lot.

So whether you build in-house or contract and the contracting is a little bit more expensive, but it is more a variable cost, so it's easier to terminate than an in-house sales force. We're actually looking at all of those options right now, what's the best path. Our feeling is that if you build carefully and thoughtfully, in-house is probably a better model than the rent a sales force, any of these more external models when it comes to commercialization. When you're in development, it's much, much more effective to outsource things, and that's the model we pursued this far -- thus far.

Absolutely. And then our last couple of minutes, if you were thinking about Viking in 5 to 10 years in the future, what does success look like? And what are the challenges where you pinpoint and say, these are the biggest decisions I've had to make that's enabled this success?

Well, I think where we would see the company is hopefully having more than one product on the market and an international footprint. A lot of work to do there, but I think with the sort of direct-to-patient model, that can be utilized in the U.S. and utilized in Europe. It can be utilized globally. And I think that's -- it allows us to remain lean. Building appropriately where we need to, but it would allow us to remain lean and also competitive.

But I think at the end of the day, it's the products. The products need to be the most effective or compelling to patients because, again, when you look at the compounders, these products sell themselves. People are going to compounders and health spas and asking for products that they're not -- doctors aren't getting detailed in those places. So it's just a unique opportunity that I think is suited really nicely for a company like Viking.

Absolutely. Absolutely. Well, I think we're sitting here on the precipice of lots of exciting decisions ahead for Viking and lots of exciting data cards to continue turning over as well. So thank you so much for taking the time with us today. It's been a pleasure to have this conversation with you. And I hope everyone who's listened in has had the chance to understand the story a little bit more and see the catalysts that are on the horizon for Viking.

Thanks, Courtney. Thanks.