EX-99.2 7 d501508dex992.htm EX-99.2 EX-99.2

Exhibit 99.2 Corporate overview June 2023


Disclaimer This communication contains “forward-looking statements” within the meaning of the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995, including but not limited to, express or implied statements regarding the structure, timing and completion of the proposed Merger; the combined company’s listing on Nasdaq after closing of the proposed Merger; expectations regarding the ownership structure of the combined company; the anticipated timing of closing; each company’s and the combined company’s expected cash position at the closing of the proposed Merger and cash runway of the combined company; the future operations of the combined company; the nature, strategy and focus of the combined company; the development and commercial potential and potential benefits of TOUR006; anticipated preclinical and clinical drug development activities and related timelines, including the expected timing for data and other clinical results; the competitive landscape of the combined company; anticipated intellectual property timelines; and other statements that are not historical fact. All statements other than statements of historical fact contained in this communication are forward-looking statements. These forward-looking statements are made as of the date they were first issued, and were based on the then-current expectations, estimates, forecasts, and projections, as well as the beliefs and assumptions of management. Forward-looking statements are subject to a number of risks and uncertainties, many of which involve factors or circumstances that are beyond Talaris’, Tourmaline’s or the combined company’s control. Actual results could differ materially from those stated or implied in forward-looking statements due to a number of factors, including but not limited to (i) the risk that the conditions to the closing of the proposed Merger are not satisfied, including the failure to timely obtain shareholder approval for the transaction, if at all; (ii) uncertainties as to the timing of the consummation of the proposed Merger and the ability of each of Talaris and Tourmaline to consummate the proposed Merger; (iii) risks related to Talaris’ ability to manage its operating expenses and its expenses associated with the proposed merger pending closing; (iv) risks related to the failure or delay in obtaining required approvals from any governmental or quasi-governmental entity necessary to consummate the proposed Merger; (v) the risk that as a result of adjustments to the exchange ratio, Talaris shareholders and Tourmaline stockholders could own more or less of the combined company than is currently anticipated; (vi) risks related to the market price of Talaris’ common stock relative to the value suggested by the exchange ratio; (vii) unexpected costs, charges or expenses resulting from the transaction; (viii) potential adverse reactions or changes to business relationships resulting from the announcement or completion of the proposed Merger; (ix) the uncertainties associated with Tourmaline’s platform technologies, as well as risks associated with the clinical development and regulatory approval of product candidates, including potential delays in the commencement, enrollment and completion of clinical trials; (x) risks related to the inability of the combined company to obtain sufficient additional capital to continue to advance these product candidates and its preclinical programs; (xi) uncertainties in obtaining successful clinical results for product candidates and unexpected costs that may result therefrom; (xii) risks related to the failure to realize any value from product candidates and preclinical programs being developed and anticipated to be developed in light of inherent risks and difficulties involved in successfully bringing product candidates to market; (xiii) risks associated with the possible failure to realize certain anticipated benefits of the proposed Merger, including with respect to future financial and operating results; (xiv) risks associated with Talaris’ financial close process; (xv) the risk that the pre-closing financing is not consummated; and (xvi) the risk that Talaris shareholders receive more or less of the cash dividend than is currently anticipated, among others. Actual results and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these risks and uncertainties. These and other risks and uncertainties are more fully described in filings that Talaris makes and will make with the SEC in connection with the proposed Merger, including the Proxy Statement described above under “Additional Information about the Proposed Merger Transaction and Where to Find It.” You should not place undue reliance on these forward-looking statements, which are made only as of the date hereof or as of the dates indicated in the forward-looking statements. Talaris, Tourmaline and the combined company expressly disclaims any obligation or undertaking to release publicly any updates or revisions to any forward-looking statements contained herein to reflect any change in its expectations with regard thereto or any change in events, conditions or circumstances on which any such statements are based. Tourmaline obtained the industry, market and competitive position data used throughout this presentation from its own internal estimates and research, as well as from industry and general publications, and research, surveys and studies conducted by third parties. Internal estimates are derived from publicly available information released by industry analysts and third-party sources, Tourmaline’s internal research and its industry experience, and are based on assumptions made by Tourmaline based on such data and its knowledge of the industry and market, which it believes to be reasonable. In addition, while Tourmaline believes the industry, market and competitive position data included in this presentation is reliable and based on reasonable assumptions, Tourmaline has not independently verified any third-party information, and all such data involve risks and uncertainties and are subject to change based on various factors. 2


Disclaimer (continued) This presentation contains trademarks, services marks, trade names and copyrights of Tourmaline and other companies, which are the property of their respective owners. The use or display of third parties’ trademarks, service marks, trade name or products in this presentation is not intended to, and does not imply, a relationship with Tourmaline, or an endorsement of sponsorship by Tourmaline. Solely for convenience, the trademarks, service marks and trade names referred to in this presentation may appear with the ®, TM or SM symbols, but such references are not intended to indicate, in any way, that the company will not assert, to the fullest extent under applicable law, their rights or the right of the applicable licensor to these trademarks, service marks and trade name. Participants in the Solicitation This communication relates to the proposed merger transaction involving Talaris and Tourmaline and may be deemed to be solicitation material in respect of the proposed merger transaction. In connection with the proposed merger transaction, Talaris will file relevant materials with the U.S. Securities and Exchange Commission (the “SEC”), including a registration statement on Form S-4 (the “Form S-4”) that will contain a proxy statement (the “Proxy Statement”) and prospectus. This communication is not a substitute for the Form S-4, the Proxy Statement or for any other document that Talaris may file with the SEC and or send to Talaris’ shareholders in connection with the proposed merger transaction. BEFORE MAKING ANY VOTING DECISION, INVESTORS AND SECURITY HOLDERS OF TALARIS ARE URGED TO READ THE FORM S-4, THE PROXY STATEMENT AND OTHER DOCUMENTS FILED WITH THE SEC CAREFULLY AND IN THEIR ENTIRETY WHEN THEY BECOME AVAILABLE BECAUSE THEY WILL CONTAIN IMPORTANT INFORMATION ABOUT TALARIS, THE PROPOSED MERGER TRANSACTION AND RELATED MATTERS. Additional Information and Where to Find It Investors and security holders will be able to obtain free copies of the Form S-4, the Proxy Statement and other documents filed by Talaris with the SEC through the website maintained by the SEC at http://www.sec.gov. Copies of the documents filed by Talaris with the SEC will also be available free of charge on Talaris’ website at www.talaristx.com, or by contacting Talaris’ Investor Relations at investors@talaristx.com. Talaris, Tourmaline, and their respective directors and certain of their executive officers may be considered participants in the solicitation of proxies from Talaris’ shareholders with respect to the proposed merger transaction under the rules of the SEC. Information about the directors and executive officers of Talaris is set forth in its Annual Report on Form 10-K for the year ended December 31, 2022, which was filed with the SEC on March 31, 2023, and in subsequent documents filed with the SEC. Additional information regarding the persons who may be deemed participants in the proxy solicitations and a description of their direct and indirect interests, by security holdings or otherwise, will also be included in the Form S-4, the Proxy Statement and other relevant materials to be filed with the SEC when they become available. You may obtain free copies of this document as described above. No Offer or Solicitation This communication does not constitute an offer to sell or the solicitation of an offer to buy any securities nor a solicitation of any vote or approval with respect to the proposed transaction or otherwise. No offering of securities shall be made except by means of a prospectus meeting the requirements of Section 10 of the U S. Securities Act of 1933, as amended, and otherwise in accordance with applicable law. 3


Company highlights Our mission: developing transformative medicines that dramatically improve the lives of patients with life-altering immune diseases Our product candidate: TOUR006, a Phase 2/pivotal-ready anti-IL-6 monoclonal antibody with best-in-class potential • Originally developed by Pfizer • High affinity, long half-life, low immunogenicity; delivered in ≤1mL subcutaneous injection • Completed multiple Phase 1 and Phase 2 clinical trials while under development by Pfizer (448 subjects dosed) Our focus: immune-mediated diseases where IL-6 blockers have been underexplored despite compelling signals of clinical activity Our lead indication: thyroid eye disease (TED), an autoantibody disease that affects the tissue surrounding the eye • TOUR006’s potential administration profile (low volume, low frequency) and upstream mechanism of action could make it an ideal treatment option for TED • Mechanism clinically validated after >200 TED patients treated with IL-6 blockers, showing autoantibody reductions and evidence of clinical benefit • Phase 2b TED study expected to begin in Q3 2023 Our second indication: atherosclerotic cardiovascular disease (ASCVD), a leading cause of global morbidity and mortality • Emerging clinical evidence appears to validate decades-long research on IL-6 as a key cardiovascular risk factor • TOUR006 could pursue a fast follower strategy, with potential for less frequent dosing than competitor IL-6 agents in ASCVD • Phase 2 ASCVD biomarker trial expected to begin in 2024 $112 million Series A financing with participation from leading biotechnology investors 4


Transaction summary • Talaris Therapeutics, Inc. (NASDAQ: TALS) to acquire 100% of outstanding equity interests of Tourmaline Bio, Inc. structured as a traditional reverse merger Overview • Surviving entity name / proposed ticker: Tourmaline Bio (TRML) • Issuer of shares in private placement: Tourmaline • $387.5M pro forma value of combined company ― $230M value of Tourmaline 1 Transaction ― $82.5M value of Talaris net of up to a $64.8M cash dividend ― $75M private placement Summary • ~$210M pro forma cash balance for combined company estimated at close excluding dividend • Pro forma ownership split: ~59.4% Tourmaline, ~21.3% Talaris, ~19.3% private placement Use of • Expected to fund Tourmaline through 2026 and provide sufficient capital for key clinical programs including Phase 2b TED study, Phase 2 TED basket study, and Phase 2 CV study Proceeds Projected • Closing expected H2 2023 Timing 1. Subject to certain adjustments at close 5


Leadership team Sandeep Kulkarni, MD Yung Chyung, MD Brad Middlekauff, JD Susan Dana Jones, PhD Ryan Iarrobino Kevin Johnson, PhD Dora Rau Co-founder and Chief Medical Chief Business Officer Chief Technology Senior Vice President, Chief Regulatory Senior Vice President, Chief Executive Officer Officer and General Counsel Officer Product Development Officer Head of Quality 6


Board of directors, advisors, and investors Board of Directors Advisors Tim Anderson Burt Adelman, MD Marco Sales-Sanz, MD Managing Director, Cowen Healthcare Investments Co-founder and Chairman of the Board, Verve Therapeutics and Clear Creek Bio; Head of Orbital and Oculoplastic Surgery Unit, Hospital Universitario Ramón y Cajal former EVP of R&D and Portfolio Strategy, Biogen; former Evp of R&D and CMO, (Madrid) and IMO Grupo Miranza (Madrid) Dyax Corp. Caley Castelein, MD Co-founder, Tourmaline Bio and Managing Partner, KVP Capital Pouya N. Dayani, MD Stuart Seiff, MD Vitreoretinal Surgery and Ocular Inflammation Retina-Vitreous Associates Medical Professor, Ophthalmology, Senate Emeritus, University of California San Francisco; Cariad Chester Group; Adjunct Clinical Professor USC Keck School of Medicine, USC Roski Eye Medical Director and CEO, Pacific Center for Oculofacial and Aesthetic Plastic Partner, TCG Crossover Institute Surgery Aaron Kantoff Kristine Erickson, OD Marius Stan, MD Managing Partner, Scion Life Sciences Former Global Ophthalmology Clinical Lead for sarilumab, Regeneron; former VP Consultant in Endocrinology, Associate Professor in Medicine, and Chair of the Clinical Research, Aerie Pharmaceuticals Thyroid Core Group, Mayo Clinic (Rochester) Rebecca Luse Principal, Deep Track Capital Jarmila Heissigerová, MD, PhD Edward J. Wladis, MD Head, Department of Ophthalmology, Charles University and General University Professor and Chair of the Lions Eye Institute, Department of Ophthalmology, Albany Hospital in Prague Medical College; Chief of Service for Ophthalmology, Albany Medical Center Hospital Parvinder Thiara Chief Investment Officer, Athanor Capital Quan Dong Nguyen, MD Professor, Ophthalmology (Retina and Uveitis), Pediatrics (Rheumatology), and Sandeep Kulkarni, MD Medicine (Immunology / Rheumatology); Director, Uveitis and Ocular Inflammation Co-founder and Chief Executive Officer, Tourmaline Bio Service, Byers Eye Institute at Stanford University Investors 7


TOUR006 (formerly PF-04236921), a fully human, high affinity antibody that neutralizes IL-6 Fully human antibody that neutralizes IL-6 levels with high Median serum concentration time profile of CRP from all subjects following affinity day 1, 28, and 56 following multiple intravenous doses of TOUR006 to RA • Kd of 6 pM subjects (Study B0151002) • Terminal half-life 47-58 days 12 • Generated from Medarex transgenic mouse platform 10 Robust existing clinical data package • Two Phase 2 studies completed (SLE and Crohn’s) 8 • 448 subjects have been dosed with TOUR006 6 Durable and deep IL-6 signaling blockade observed with infrequent dosing as low as 10mg every 4 weeks 4 • As measured by C-reactive protein (CRP), a pharmacodynamic marker of IL-6 signaling 2 Limited immunogenicity • Across 448 subjects dosed with TOUR006, only 2 subjects 0 1 7 14 28 35 42 56 63 70 84 generated ADAs following treatment Study Day Safety profile to date generally consistent with IL-6 class TOUR006 30 mg TOUR006 10 mg Placebo Source: PF-04236921 Investigator’s Brochure, dated February 2015 8 Median Value for C-Reactive Protein (mg/L)


IL-6 drives production of autoantibodies and inflammation 1 IL-6 mediated impacts on B and T cell pathways Translational evidence • IL-6 enhances antibody production and TOUR006 induces plasma cell differentiation and TGF-β IL-6 2 survival IL-6 CD4 + CD4 CD8 T- + TFh T-cell T-cell cell TH17 • In ex vivo experiments using samples from patients with NMO, IL-6 shown to promote IL-6 IL-21 IL-21 TOUR006 IL-6 + plasmablast survival and stimulate anti- TOUR006 + 3 AQP4 secretion Survival Cytotoxic IL-21 B-cell CD8 • Extensive observations in TED and other T-cell Plasma cell IL-6 autoantibody disease that IL-6 blockade + TOUR006 suppresses autoantibody levels Memory • Recent approval of satralizumab in NMOSD Antibody Extracellular Intracellular B-cell production immunity immunity offers strong evidence of anti-IL-6’s potential in autoantibody driven diseases 1. Adapted from Cabezas et al., Front. Immunol. (2022) 9 2. Dienz et al., JEM (2009) 3. Chihara et al., Proc. Natl. Acad. Sci. U.S.A. (2019)


IL-6 has the potential to address a wide range of autoantibody driven and other inflammation meditated conditions US Prevalence (2022) Cardiovascular Atherosclerotic cardiovascular disease Atherosclerotic disease 24M Pemphigus vulgaris Pemphigus vulgaris 30K Dermatology Bullous pemphigoid Bullous pemphigoid 8K Endocrinology Graves' disease* Graves' disease* 120K Crohn's disease Crohn's disease 570K Gastrointestinal Ulcerative colitis Ulcerative colitis 500K Idiopathic thrombo Idic op yta otpe hicn tihr c o pu mr b pu ocry atopenic purpura 67K Hematology Thrombotic thrombocytopenic purpura Thrombotic thrombocytopenic purpura 3K IgA nephropathy IgA nephropathy 60K Nephrology Membranous nephropathy* Membranous nephropathy* 4K Primary progressive multiple sclerosis Primary-Progressive MS 620K Relapsing remitting multiple sclerosis Relapsing-Remitting MS 91K Myasthenia gravis Myasthenia gravis 58K Autoimmune encephalitis Neurology Autoimmune encephalitis 46K Chr C o hr nioni c ic nf iln afm lam mm ata otr or y y d d ee m m yy ee lilna inattiing ng p po ol ly yn ne eur uro op p a a thy thy 16K Inclusion body myositis Inclusion body myositis 11K Neuromyelitis optica spectrum diN se ou rde rom r yelitis optica 7K Diabetic macular edema Diabetic macular edema 750K Ophthalmology Non-infectious uveitis Non-infectious uveitis 400K Thyroid eye disease* Thyroid eye disease* 30K Sarcoidosis Sarcoidosis 200K Idiopathic pulmonary fibrIo ds iop isathic pulmonary fibrosis 70K Respiratory Systemic scle Sy ro st se is m in ic sc terls etrit oia sis i l lu nn te gr d stis itie ala ls ue ng disease 24K Chronic hypersens Chr itioni vity c p hy ne pe um rse ons niittiis vity pneumonitis 7K Pulmonary alveolar proP te ul in m o osna isry alveolar proteinosis 7K Key ANCA-associated vasculitis ANCA-associated vasculitis 38K Polyarticular juP ve on lya ile rt id icu io la p ra jt u h vic en a ile rt i hd rio itis pathic arthritis 25K Autoantibody driven Sjögren's syndrome Sjögren's syndrome 20K Rheumatology Other mechanisms Systemic juvenile id Sy io stp ea m th icic ju a vr e tn hir le it i is diopathic arthritis 13K Wegener's granulomatosisWegener's granulomatosis 10K IgG4 related disease IgG4 related disease <1K *Incidence figure 10 Publications available upon request


TOUR006 offers a potentially best-in-class profile: subcutaneous, low volume, low frequency injections TOUR006 Actemra Kevzara Enspryng Sylvant Ziltivekimab Clazakizumab (tocilizumab) (sarilumab) (satralizumab) (siltuximab) Company Tourmaline Roche Regeneron Roche EUSA Corvidia / Novo CSL Antibody Type Human Humanized Human Humanized Chimeric Human Humanized Target IL-6 IL-6 receptor IL-6 receptor IL-6 receptor IL-6 IL-6 IL-6 Stage of In Phase 2b Approved Approved Approved Approved In Phase 3 In Phase 2/3 development Indications being TED, ASCVD RA, GCA, PJIA, SJIA, RA, PMR NMOSD, AE, MG, MCD ASCVD (CKD), HF AMR, ASCVD (ESKD) pursued CRS, SSc-ILD, COVID19 MOGAD Black box warning N/A Yes Yes No No N/A N/A Terminal half-life 47-58 days 21.5 days Up to 10 days 30 days 20.6 days 45-65 days ~30 days Anti-drug <1% of patients 1-2% of patients 14-19% of patients 38-73% of patients 0-2% of patients 6-13% of patients 2-10% of patients antibodies (~20% increase in drug clearance) Injection site 0-9% of patients 7-41% of patients 5-7% of patients 9% of patients N/A 0-6% of patients 10-24% of patients reactions Route of admin Subcutaneous (SC) IV SC SC SC IV SC IV SC Standard dose 20 or 50mg 8-12mg/kg 162mg 200mg 120mg 11mg/kg 15mg TBD 12.5mg Dosing regimen Q8W / Q12W Q4W QW / Q2W Q2W Q4W Q3W Q4W Q4W Q4W Source: company reports, publications, FDA review documents, package inserts AE: Autoimmune Encephalitis; AMR: Antibody-Mediated Rejection; ASCVD: Atherosclerotic Cardiovascular Disease; CKD: Chronic Kidney Disease; COVID-19: Coronavirus Disease 2019; CRS: Cytokine Release Syndrome; ESKD: End-stage 11 Kidney Disease; GCA: Giant Cell Arteritis; HF: Heart Failure; MCD: Multicentric Castleman’s Disease; MG: Myasthenia Gravis; MOGAD: Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease; NMOSD: Neuromyelitis Optica Spectrum Disorder; PJIA: Polyarticular Juvenile Idiopathic Arthritis; PMR: Polymyalgia Rheumatica; RA: Rheumatoid Arthritis; SJIA: Systemic Juvenile Idiopathic Arthritis; SSc-ILD: Systemic Sclerosis-Associated Interstitial Lung Disease


Clinical development plan for TOUR006 by end of 2023 Indication Preclinical Phase 1 Phase 2 Phase 3 Expected Key Milestones Phase 2b expected to begin Thyroid Eye Disease in Q3 2023 Phase 2 open label basket Thyroid Eye Disease trial expected to begin in H2 Expansion Cohorts 2023 Atherosclerotic Phase 2 expected to begin Cardiovascular in 2024 Disease Additional indications under evaluation 12


TOUR006 regulatory exclusivity and intellectual property Regulatory Exclusivity • In the US, we expect to rely on 12 years’ data exclusivity for biologics • Regulatory counsel has confirmed this is a reasonable expectation Patent Protection • We have filed 4 new patent applications on TOUR006 • Incorporating claims on: • Indication-specific methods of use • Dosing regimens • If issued, will expire in 2043 (or later) • Additional patent applications in process • Pfizer has abandoned all previous Pfizer patents/applications relating to TOUR006 • No freedom to operate issues identified 13


Thyroid eye disease


Thyroid eye disease (also called Graves’ ophthalmopathy and Graves’ orbitopathy) Autoimmune disease associated with proliferation and inflammation of the cell types surrounding the eye • Symptoms include proptosis, double-vision, and disfigurement • Involvement of optic nerve can be sight-threatening and requires emergent surgery Approximately 30,000 new cases per year (of all severities), of 1 which we estimate 15,000-20,000 are moderate-to-severe Pathophysiology driven by autoantibodies that bind to the TSH receptor, which is expressed on cell types surrounding the eye • Same autoantibody can also cause Graves’ hyperthyroidism (GH); Source: Getty Images 2 up to 95% of TED patients also have GH IL-6 is elevated in patients with TED and experimental evidence 3 suggests a role in disease pathogenesis 1. Bartalena et al., Front. Endocrinol. (2020); Lazarus, Best Pract. Res. Clin. Endocrinol. Metab. (2021) 15 2. Sabini et al., Eur. Thyroid J. (2018) 3. Hiromatsu et al., J. Clin. Endocrinol. Metab. (2000); Slowik et al., Endocr. Res. (2012); Jyonouchi et al., Thyroid (2001); Hwang et al., Invest Ophthalmol Vis Sci (2009)


IL-6 inhibition has potential to block multiple steps in TED pathogenesis TOUR006 has been observed to inhibit IL-6, a key node in TED pathogenesis 1) Inhibits formation of autoantibodies TOUR006 2) Inhibits T-cell driven inflammation IL-6 TGF-β CD4 TFh + IL-6 T-cell IL-6 + CD4 Th17 IL-6 T-cell + IL-21 Survival B-cell IL-6 Plasma cell Orbital fibroblasts + IL-17A IL-22 Memory B-cellTNFα IL-1β Anti-TSHR/IGF-1R autoantibodies Orbital tissue expansion: 3) Inhibits orbital fibroblast signaling and differentiation Inflammation: • Proptosis • Pain • Diplopia • Redness • Eyelid retraction • Swelling Hyaluronan Myofibroblasts Adipocytes • Optic nerve compression Adapted from Huang et al., Eye (2018); Hodgson and Rajaii, Ophthalmol Ther (2020); Fang et al, Front Endocrinol (2021); Smith, Eye (2019); and Cabezas et al., Front. 16 Immunol. (2022)


TED market remains vastly underpenetrated even as teprotumumab sales have stagnated Sales stagnating over last 6 quarters Most patients not receiving tepro Potential barriers to adoption 1 2 Teprotumumab sales by quarter ($M) Teprotumumab US LTM penetration 1. Inconvenience: – IV dosing every 3 weeks $700 100% $616 – Burdensome approval 90% $590 3 process $600 80% – Limited access to infusion $502 $491 $494 $480 3 $500 centers $453 70% Untreated $405 60% 16,000 $400 2. Limited durability: high 80% $344 50% relapse rates observed in $287 4 $300 long-term follow-up 40% $166 30% $200 3. Safety: potentially permanent 20% side effects $100 Treated with tepro $24 10% 4,000 $2 20% – 0% Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 High Proptosis, High CAS TED Patients 2020 2020 2020 2020 2021 2021 2021 2021 2022 2022 2022 2022 2023 1. Horizon company reports and filings 4. Kahaly et al., Thyroid (2021) (ATA 2021 presentation) 17 2. Horizon Q3 2022 earnings call; LTM = last twelve months 3. Horizon Q1 2023 10Q % of Patients


“Teprotumumab for Graves’ orbitopathy and ototoxicity: 1 moving problems from eyes to ears?” Hearing loss in series of patients treated with teprotumumab for • Hearing impairment likely represents an on-target 1 Graves’ Orbitopathy 2 consequence of IGF-1 pathway inhibition – IGF-1 required for normal inner ear function N. of cases N. of Author (references) of hearing Resolved Persistent – Likely just as relevant for SC as IV Patients loss • 15% of patients reporting hearing impairment across case Smith et al. (2017) 43 3 2 1 1 reports – Of these, 45% reported as persistent Douglas et al. (2020) 41 5 5 0 • Ototoxicity appears cumulative, emerging after mean of 3 Douglas et al. (2021) 51 6 3 3 3.6 infusions in one series Sears et al. (2022) 27 11 5 6 • Some investigators recommending serial audiograms to 4 monitor hearing loss Belinsky et al. (2022) 28 4 1 3 • Ongoing legal actions filed by patients suffering hearing 5 impairments attributed to teprotumumab across 38 lawsuits Total 190 29 16 13 • As of May 2023, there have been 384 ear and hearing- related adverse events captured in the FAERS database, Total (%) 15.2% 8.4% 6.8% including reports of permanent deafness 1. Bartalena et al., J. Endocrinol. Invest. (2022) 4. Chow et al., BMJ Case Rep (2022) 18 2. Yamamoto et al, Front Pharmacol (2014); Gao et al, Front Cell Neurosci (2020) 5. Tourmaline research as of May 2023 3. Kossler et al., J. Endocrinol (2021)


TOUR006 has the potential to address the unmet need in TED st Elements of ideal 1 line therapy for TED Potential improvements to standard of care • Meaningful benefits on multiple outcome measures: proptosis, CAS, Broad, deep, and diplopia durable effects • Low rates of relapse • Expected avoidance of permanent or irreversible side effects Well-tolerated safety • Safety concerns can be managed with routine monitoring profile • Finite treatment course for majority of patients • Mechanistically acts upstream in disease cascade to stop disease Resolution of • Limited time window to achieve maximal effect underlying biology • Clinical data supporting early versus delayed treatment initiation Patient-centric • Ease of access and ease of use • Suitable for longer term usage, if indicated experience The characteristics presented reflect outcomes that may not be representative of TOUR006. The results of past clinical trials may not be indicative of future results, and the 19 results of future or ongoing clinical trials may not demonstrate some or any of the characteristics presented.


Studies using tocilizumab in steroid-refractory TED patients demonstrate consistent evidence of clinical benefit Study Details Key Endpoints Number Proptosis CAS % reduction in We believe these reports First author Year Study type treated response rate response rate autoantibodies may be understating true Perez-Moreiras 2021 Retrospective 54 78 89 75 Sánchez-Bilbao 2020 Observational 48 NR NR NR efficacy of IL-6 blockade Perez-Moreiras 2014 Prospective 18 72 100 76 Perez-Moreiras 2018 Randomized Controlled 15 93 60 NS Pampín-Sánchez 2022 Retrospective 11 75 67 NR • Most studies enrolled Moi 2022 Retrospective 10 Clear improvement 80 75 steroid-refractory Silkiss 2020 Case Series 9 Clear improvement 56 74 Smith 2021 Retrospective 9 78 100 54 patients Ceballos-Marcias Jose 2020 Case Series 8 NR 75 41 Bennedjai 2020 Retrospective 7 NR NR 73 • Most patients treated de Pablo Gomez 2018 Case Series 5 NR 60 NR Maldiney 2020 Case Series 3 67 NR NR were >9 months out Stevens 2022 Retrospective 3 100 67 NR from symptom onset, Russell 2017 Case Series 2 NR 0 NR Sy 2017 Case Series 2 Clear improvement 50 69 i.e. their disease may Copperman 2019 Case Series 2 100 0 NR have exited the active Coy 2019 Case Series 2 NR 50 NR phase Mehmet 2020 Case Report 1 0 NR NR Cayon-Blanco 2020 Case Report 1 NR 100 NR Albrashdi 2022 Case Report 1 100 NR NR • Exposure to treatment Moleiro 2022 Case Report 1 100 NR 86 may have been Weighted mean 79% 78% 69% suboptimal (<6 months) Tepro Phase 2 71% 69% N/A Tepro Phase 3 83% 59% N/A NR: not reported 20 NS: not significant Publications available upon request


TED patients had mostly long disease durations before starting tocilizumab, likely impacting efficacy of IL-6 blockade Median (IQR) duration of TED symptoms at time of enrollment (n) Perez-Moreiras 2021 (54)* Sánchez-Bilbao 2020 (48) Perez-Moreiras 2014 (18) Perez-Moreiras 2018 (15) Pampín-Sánchez 2022 (11) Silkiss 2020 (9) Smith 2021 (9)* Bennedjai 2020 (7)* de Pablo Gomez 2018 (5) Albrashdi 2022 (1) Moleiro 2022 (1) Tepro Ph2b (43)* Tepro OPTIC (41)* 0 6 12 18 24 30 36 42 48 54 TED duration (mos.) Tocilizumab studies Teprotumumab studies Only includes publications which reported complete disease duration data. * Perez-Moreiras 2021: range, not IQR; Smith 2021: mean and range; Bennedjai 2020 & tepro 21 trials: mean +/- one standard deviation


Recent case series demonstrate IL-6 inhibition’s potential in first-line TED patients Investigator-led retrospective analysis using tocilizumab • 9 subjects included in analysis • Average CAS: 6 (out of 7) • Treatment with tocilizumab 8mg/kg monthly • Mean time from symptom onset to first treatment: 2.89 months • Mean number of infusions: 4.2 • Median change in autoantibody levels from baseline: 61% decline 100% 100% OPTIC trial 83% 80% 80% OPTIC 60% 60% trial: 59% 40% 40% 20% 20% 0% 0% Before After first After final Last follow-up Before After first After final Last follow-up treatment infusion infusion treatment infusion infusion Smith et al., Ophthalmic Plast Reconstr Surg (2021) 22 CAS responder (0 or 1) rate Proptosis responder rate


Planned Phase 2b: dose-ranging study in first-line TED Double masked, placebo-controlled trial Open label Period A: Primary efficacy Period B: Extension 24 weeks 24 weeks Proptosis 24 weeks non- responders* TOUR006 SC n=27 Follow-up TOUR006 SC 50mg Q8W x 3 50mg Q8W x 3 pts per arm TOUR006 SC 20mg Q8W x 3 R Placebo Follow-up Proptosis responders Study drug dosed at Day 1, Week 8, & Week 16; primary efficacy assessed at Week 20 Study population: Primary efficacy endpoint: • Moderate-severe TED, with proptosis ≥ 3mm above • Proptosis response rate at week 20 normal (based on race and gender) • Active phase, with symptom onset ≤ 12 months, CAS ≥ 4 Additional endpoints: and positive TSI • CAS • First-line setting, with cap on prior corticosteroid use (< • Diplopia 1g methylprednisolone or equivalent) • QoL, safety, PK/PD/ADA *Any patient who receives rescue therapy/intervention in Period A will not receive TOUR006 in Period B and will instead undergo follow-up only 23


TOUR006: Therapeutic potential to address broad segments of the TED population (and beyond) Underlying Thyroid First Line Post-First Line Disorder Active TED High CAS without Prior therapy- Extended treatment Graves’ disease (moderate-severe) significant proptosis experienced (beyond initial course) • TED treatment- • Active • Teprotumumab: • Subset of patients • Graves without naïve or limited inflammation but that may have TED: address o Inadequate response prior treatment minimal or no inadequate thyroid disease o Relapse (e.g., modest proptosis response to o Unable to tolerate • Pre-TED: prevent exposure to systemic TOUR006 after TED • Other agents (e.g., glucocorticoids) initial 16-week full glucocorticoid • Early/mild stages course course) of TED: stabilize or reverse Evaluate through Evaluate through Evaluate through Evaluate through Phase 2b trial TED basket trial Phase 2b trial other trial(s) 24


TOUR006 has the potential to be the first-in-class IL-6 inhibitor approved for use in TED Efgartigimod TOUR006 Teprotumumab Batoclimab IV or SC VRDN-001 Linsitinib Lonigutamab Company Mechanism of FcRn antibody IL-6 antibody IGF-1R antibody FcRn antibody IGF-1R antibody IGF-1R inhibitor IGF-1R antibody action fragment Registrational trial Stage of Planned Phase 2b Approved Phase 3 expected to start Phase 3 Phase 2/3 Phase 1/2 development start in Q3 2023 in Q4 2023 Route of SC (up to 4mL per SC IV IV or SC IV Oral SC delivery administration) Frequency Q8W Q3W QW QW Q3W BID Q4W Market cap Private ~$23B ~$2.7B ~$22B ~$1.4B Private ~$1.8B Source: company reports 25 Market data as of close on May 31, 2023


Atherosclerotic Cardiovascular Disease (ASCVD)


ASCVD continues to be underserved despite the wide availability of statins Significant unmet need for patients despite ~24M ASCVD patients in the US alone availability of statins 100% • ASCVD consists of major adverse cardiovascular events including heart attacks, coronary heart disease, 90% and stroke, resulting in ~700k deaths per year in the 9.5M 80% 4 not on a LLT US 70% • Some patients on statins do not reach their LDL-C Other lipid-lowering therapies 60% goals and those that do may maintain major residual (LLTs) (e.g. PCSK9 class) with <1M on other therapy 5 <5% usage in US ASCVD patients risk from other factors like inflammation 50% 40% • Despite their wide availability, patient adherence to ~55% of US patients get put on statins is low due to adverse side effects and perceived 30% statins, of which only 50% have 6 lack of benefit 13M 1,2,3 an adequate response on statins 20% • There remains a large untapped patient population who 10% may be better addressed by an infrequently 0% administered therapy targeting other key risk factors US ASCVD patients such as inflammation 1. Gu et al. Am J Prev Cardiol (2022). 4. CDC, Heart Disease 27 2. Nelson et al. JACC (2022) 5. Ridker. Circ Res (2017) 3. Akeya et al. Heart (2018) 6. Colantonio et al. JAHA (2018)


IL-6 inflammation emerging as key cardiovascular risk factor • Inflammation has an established role in plaque formation and disruption • CRP thought to be a key biomarker of inflammation-related CV risk – CRP is a marker of IL-6 pathway activation – CRP levels often elevated in patients with CV disease • Genetic experiments demonstrate that certain IL-6R polymorphisms are associated with lower levels of CRP and reduced CV risk Ridker PM and Luscher TF. European Heart Journal, Volume 35, Issue 27, 14 July 2014, Pages 1782–1791 28


Decades of research have indicated elevated CRP as a predictor of major CV events Evidence for the role of CRP has accumulated CRP reduction was an equal predictor as 4 over 20 years LDL-C reduction of statin therapeutic benefit • High levels of CRP are a known risk factor for ASCVD, nearly tripling risk of occurrence of MACE in 1 one study • CRP levels ≥2.0 mg/L is listed as a risk-enhancing factor alongside elevated LDL-C and other well- 2 known risk factors by the ACC & AHA • Chronic inflammatory conditions associated with elevated CRP such as RA are also included along with primary hypercholesterolemia and metabolic 2 disorders as potential risk factors • Multiple large cardiovascular outcome studies have demonstrated reductions in CRP were associated with improved outcomes and has been a powerful 3 predictor for therapeutic benefit 1. Ridker et al., NEJM (2000) 4. Ridker et al., PROVE-IT (atorvastatin vs pravastatin), NEJM (2005) 29 2. Arnett et al., J Am Coll Cardiol (2019) 3. CARE (pravastatin); JUPITER (rosuvastatin); CANTOS (canakinumab); CLEAR (bempedoic acid)


Analysis from CANTOS highlights the therapeutic potential of IL-6 inhibition in ASCVD In canakinumab’s Phase 3 CV outcomes trial (CANTOS) greater IL-6 and hsCRP reductions associated with greater CV benefit 1 2 3 CANTOS primary endpoint CANTOS stratified by hsCRP reductions CANTOS stratified by IL-6 reductions HR (95% CI) p HR (95% CI) p HR (95% CI) p Placebo 1 (ref) (ref) Placebo 1 (ref) (ref) Placebo 1 (ref) (ref) Canakinumab, 150 mg 0.85 (0.74-0.98) P=0.021 On-treatment hsCRP ≥ 2.0 mg/L 0.95 (0.84-1.09) 0.48 On-treatment IL-6 ≥ 1.65 ng/L 1.06 (0.90-1.25) 0.49 On-treatment hsCRP <2.0mg/L 0.75 (0.66-0.85) <0.0001 On-treatment IL-6 < 1.65 ng/L 0.64 (0.54,0.77) <0.0001 0.25 0.25 0.25 0.20 0.20 0.20 0.15 0.15 0.15 0.10 0.10 0.10 0.05 0.05 0.05 0 0 0 0 1 2 3 4 5 0 1 2 3 4 5 0 1 2 3 4 5 Follow-up (years) Follow-up (years) Follow-up (years) Hazard ratio improvement 1. Ridker et al., N. Engl. J. Med. (2017) 30 2. Ridker et al., Lancet (2018) 3. Ridker et al., Eur. Heart J. (2018) Cumulative incidence of MACE (3 point) Cumulative incidence of MACE (3 point) Cumulative incidence of MACE (3 point)


Ziltivekimab, an anti-IL-6 antibody developed by Corvidia, produced deeper CRP reductions than canakinumab Canakinumab only achieved 59-68% median Primary endpoint of Phase 2b RESCUE study: 1 2 CRP reduction at higher doses at week 12 92% reduction in median CRP at week 12 0% 0% -4% -20% -20% -17% -40% -40% -47% -60% -60% -59% -68% -80% -80% -77% -88% -92% -100% -100% PBO Canakinumab 50mg Canakinumab Canakinumab PBO Ziltivekimab Ziltivekimab Ziltivekimab Q3M 150mg Q3M 300mg Q3M 7.5 mg Q4W 15 mg Q4W 30 mg Q4W 1. Ridker et al, NEJM (2017) 31 2. Ridker et al., Lancet (2021)


Novo studying ziltivekimab in ZEUS, a Ph3 CV outcomes trial in 1 ASCVD patients with kidney disease Topline data readout expected in 2 2025 Potential opportunity for TOUR006 to enter market with a less frequently administered product 1. Novo Nordisk R&D Day Investor Deck June 28, 2021 32 2. Estimated primary completion date listed on Clinicaltrials.gov: NCT05021835


PK/PD modeling for TOUR006 supports potential for quarterly administration Simulations with 50mg Q12W with CRP >2mg/L & <10mg/L Black straight line is the median th th Red dotted lines are the 5 and the 95 percentiles th th Blue dotted lines are the 25 and 75 percentiles Green dashed line 90% decline of the CRP from baseline Note: To mitigate against ceiling effects from CRP levels entering into the normal range, any Over 90% of patients achieve target CRP reductions patient with CRP attaining a value < 2 mg/L was considered to have achieved a 90% decrease from baseline in CRP Source: Tourmaline PK/PD modeling, conducted by Certara 33


Infrequent dosing expected to drive adoption of Novartis’ Leqvio in the competitive PCSK9 class 1 Historic and projected WW sales of PCSK9 class ($M) $6,000 $5,333 $4,918 $5,000 $4,236 $4,000 $3,506 $2,918 $3,000 $2,398 $2,000 $2,000 $1,603 $1,300 $978 $881 $1,000 $527 $257 $20 $0 Product Dosing 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 Repatha Q2W / Q4W 50% 55% 63% 65% 70% 72% 73% 67% 63% 59% 54% 49% 46% 43% (AMGN/Astellas) Praluent Q2W / Q4W 50% 45% 37% 35% 30% 28% 26% 27% 20% 17% 15% 13% 11% 11% (SNY/REGN) Leqvio (NVS) Q6M – – – – – – 1% 6% 16% 24% 31% 38% 43% 47% 1. Evaluate Pharma 34 WW Sales ($M)


Potential Phase 2 CV trial* Randomized, double-blind, placebo-controlled trial N = 80 TOUR006 dose level 1 Q3M (20 per TOUR006 dose level 2 Q3M arm) R TOUR006 dose level 3 QM Placebo SC monthly treatment: Day 1, Month 1, Month 2, & Month 3 Follow-up through Note: arms with quarterly administered TOUR006 will receive placebo on Months 1 and 2 Month 12 visit Study population: Key endpoints: • Study population similar to CV outcomes trials (e.g. • PD: hsCRP and other biomarkers ZEUS) • PK, ADA • Exclude patients at higher risk for safety • Safety complications (e.g., immunocompromised patients) *Trial design is preliminary and subject to change 35


Next Steps


Near-term catalysts Indication Milestone Expected timing Status Gain FDA alignment on proposed TED program Q2 2023 P q File TED IND Mid-2023 q TED Initiate Phase 2b TED trial Q3 2023 q Initiate TED basket trial H2 2023 q Gain FDA alignment on proposed CV program Q4 2023 q ASCVD Initiate Phase 2 CV trial 2024 q 37