EX-99.2 3 d838099dex992.htm EX-99.2 EX-99.2

Exhibit 99.2 Topline Results from Phase 3 Study of ANX005 in Guillain-Barré Syndrome 1


Forward-Looking Statements This presentation contains “forwardlo ‐ oking” statements about Annexon, Inc. and our industry that involve substantial risks and uncertainties. All statements other than statements of historical facts, including statements regarding our clinical and preclinical programs, timing and commencement of future nonclinical studies and clinical trials and research and development programs, timing of clinical results, anticipated timing of submission of a Biologics Licensing Application, strategic plans for our business and product candidates, including additional indications which we may pursue, our financial position, runway and anticipated milestones, are forward‐looking statements. In some cases, you can identify forward‐ looking statements by terminology such as “aim,” “anticipate,” “assume,” “believe,” “contemplate,” “continue,” “could,” “design,” “due,” “estimate,” “expect,” “focus,” “goal,” “intend,” “may,” “objective,” “plan,” “positioned,” “potential,” “predict,” “seek,” “should,” “target,” “will,” “would” and other similar expressions that are predictions of or indicate future events and future trends, or the negative of these terms or other comparable terminology. Forward‐looking statements are not guarantees of future performance and are subject to risks and uncertainties that could cause actual results and events to differ materially from those anticipated, including, but not limited to, risks and uncertainties related to: our history of net operating losses; our ability to obtain necessary capital to fund our clinical programs; the early stages of clinical development of our product candidates; the effects of COVID19 o ‐ r other public health crises on our clinical programs and business operations; our ability to obtain regulatory approval of and successfully commercialize our product candidates; any undesirable side effects or other properties of our product candidates; our reliance on thirdp ‐ arty suppliers and manufacturers; the outcomes of any future collaboration agreements; and our ability to adequately maintain intellectual property rights for our product candidates. These and other risks are described in greater detail under the section titled “Risk Factors” contained in our Quarterly Report on Form 10Q ‐ filed with the Securities Exchange Commission (SEC) on May 13, 2024 and our other filings with the SEC from time to time. All forward‐ looking statements in this presentation speak only as of the date of this presentation. Except as required by law, we undertake no obligation to publicly update any forward‐ looking statements, whether as a result of new information, future events or otherwise. This presentation concerns drug candidates that are under clinical investigation, and which have not yet been approved for marketing by the U.S. Food and Drug Administration (FDA). These are currently limited by federal law to investigational use, and no representation is made as to their safety or effectiveness for the purposes for which they are being investigated. This presentation also contains estimates and other statistical data made by independent parties and by us relating to market size and growth and other data about our industry. This data involves a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates or statistical data. Neither we nor any other person makes any representation as to the accuracy or completeness of such data or undertakes any obligation to update such data after the date of this presentation. 2


Pursuing an Intentional and Rigorous Approach to Tackling an Array of Classical Complement-Mediated Diseases Poised for a transformational 2024 and beyond Stopping the Start of Broad Therapeutic Potential Significant Near Term Classical Pathway of Late-Stage Clinical Value Creating Catalysts Neuroinflammation Platform ON A PATH TO HELPING PATIENTS GET THEIR LIVES BACK ü GBS pivotal Ph3 data readout (Q2) Well-supported MOA demonstrated Suite of fit-for-purpose drug differentiated functional outcomes candidates for diseases of the body, GA pivotal Ph3 initiation (mid-yr) Oral program POC data readout (2H) across GBS, GA, HD and ALS brain and eye GBS: Guillain‐ Barré Syndrome; HD: Huntington’s Disease; ALS: amyotrophic lateral sclerosis 3


ANX005 Achieved a Breakthrough Phase 3 Win for GBS Patients Worldwide A single infusion demonstrated consistent benefit across multiple endpoints meaningful to patients Met Primary Endpoint Expedited Recovery Durable Treatment Effect Generally Well Tolerated P=0.0058 Patients Got Better Sooner 2.4-fold higher likelihood of Early, robust & clinically Maintained improvement over being in a better state of health meaningful benefit on multiple placebo at all timepoints across Safety data was similar to on GBS-DS at Week 8 outcome measures @ Week 8 multiple measures placebo ✓ FDA‐ agreed primary endpoint✓ Able to walk earlier vs placebo✓ Less time on ventilation ✓ Consistent, significant results ✓ Less overall disability ✓ No new safety signals ✓ Able to run earlier vs placebo from multiple pre‐ specified ✓ No increased infection rate ✓ Less nerve damage vs placebo analyses ✓ No difference in all‐ cause ✓ Larger effect in sub‐ group with mortality western baseline characteristics 4 Topline Results Subject to Change


GBS: Neurological Emergency with Long-Term Disability; Requires an Immediately Targeted and Effective Intervention • Following infection, complement‐ activating POST-INFECTIOUS autoantibodies attack nerves leading to COMPLEMENT- nerve damage & acute paralysis MEDIATED DISEASE • Can happen to anyone, anytime, anywhere • 22,000 patients hospitalized in US & Europe every year HIGH UNMET MEDICAL NEED • IVIg not FDA approved, unknown MOA, requires 5‐ day treatment • Notwithstanding IVIg treatment, GBS results in: • Severe weakness and paralysis SIGNIFICANT • Mechanical ventilation in 25% of patients MORBIDITY • Extensive nerve damage causing uncertain and incomplete recovery Weaned from mechanical ventilation MOA: mechanism of action 1) van Doorn, 2013; Willison et al., 2016 2(van den Berg et al., 2014) 3 Walgaard et al (2021) Lancet Neurology 20(4):275, 4AAN Guidelines “Immunotherapy for GBS”, 4Hund EF et al (1993) Crit Care Med 21:433, 5 454Fletcher D, et al. (2000) Neurology 27;54(12), 46, 5Van den Berg B, et al (2014) Nat Rev Neurol Aug;10(8), 6Stephan et al (2012) Neuroscience 35:369, 7Lansita et al (2017) Int. J. Toxicol. 36:449


Well Designed & Executed Pivotal Trial Showed Clear Results ANX005 for GBS Granted FDA Fast Track and FDA / EMA Orphan Drug Designation STUDY DESIGN • Baseline GBS‐ DS score 3‐ 5 • GBS diagnosed <10 days from onset of weakness • Patients stratified for baseline prognostic factors: muscle strength and time from onset of weakness • Conducted in Bangladesh and Philippines given high prevalence of GBS of all types, scientific leadership in GBS, and limited access to IVIg KEY ENDPOINTS 1 • Primary Outcome Measure: GBS‐ DS at week 8: well‐ accepted regulatory endpoint assessing functional status • Secondary Endpoints: Muscle strength (MRC sumscore), Motor TWO DOSES SELECTED TO DETERMINE Disability (ONLS), Duration of Ventilation, and others MOST EFFECTIVE DURATION OF INHIBITION 1 Analyzed using a proportional odds model, a common statistical analysis method (van Leeuwen, et al., 2019, doi.org/10.1371/journal.pone.0211404) 6 Topline Results Subject to Change


Baseline Characteristics Generally Well Balanced Across Treatment Groups Stratified by Key Prognostic Factors: MRC Sumscore and Time Since Onset of Weakness Placebo ANX005 30mg/kg ANX005 75mg/kg Baseline Characteristic (N=81) (N=79) (N=81) Age at Screening (years); mean (SD) 34.2 (12.59) 36.9 (14.88) 37.9 (15.29) Sex, n (%) Male 57 (70.4) 51 (64.6) 51 (63.0) Baseline GBS-DS Score, n (%) 3 Able to walk 10 meters across open space with help 7 (8.6) 12 (15.2) 10 (12.3) 64 (79.0) 56 (70.9) 60 (74.1) 4 Bedridden or chair bound 10 (12.3) 11 (13.9) 11 (13.6) 5 Requiring assisted ventilation for at least part of the day Baseline MRC Sumscore (range 0-60), n (%) 21‐ 60 Mild/moderate loss of muscle strength 42 (51.9) 41 (51.9) 44 (54.3) 0 ‐ 20 Severe loss of muscle strength 38 (46.9) 38 (48.1) 37 (45.7) Time since of onset of weakness to randomization 6.4 (1.7) 6.3 (1.9) 6.5 (2.0) Days, mean (SD) Time since of onset of weakness to treatment Days, mean (SD) 6.5 (1.7) 6.3 (1.9) 6.6 (2.0) Electrophysiology by Hadden criteria, n (%) 18 (22.2) 16 (20.3) 16 (19.8) Acute Inflammatory Demyelinating Polyneuropathy (AIDP) 49 (60.5) 50 (63.3) 50 (61.7) Acute Motor Axonal Neuropathy (AMAN) 14 (17.3) 13 (16.5) 15 (18.5) Other 7 Topline Results Subject to Change


ANX005 30 mg/kg Treated Patients Had Significant, Rapid and Sustained Improvement Across Multiple GBS Measures Achieved Goal of Helping Patients GET BETTER SOONER 1 1 1 ü Rapid & Complete ü Statistically Significant ü Statistically Significant ü Statistically Significant ü Statistically Significant Vent wk 26 Inhibition of classical Early Reduction in NfL Higher Odds of Being Early & Sustained Less Time on Ventilator complement cascade Better at Week 8 Improvement in over entire study (Primary Endpoint) Muscle Strength period C1q NfL GBS-DS MRC Sumscore Ventilation 1 nominal p‐ value 8 Topline Results Subject to Change


Overview of Primary Endpoint: GBS-DS at Week 8 FDA accepted endpoint with alignment on statistical methodology GBS-DS SCALE COLLAPSED INTO 3 CATEGORIES GBS-DS SCALE FOR PIVOTAL PHASE 3 Enhances Clinical Interpretability GBS-DS 3-point scale (trichotomy) Approach: Collapse 7‐ grade scale to a 3‐ grade scale 1 2 3 (trichotomy) Good State Severely Disabled of Health Disabled/Death • 0-1: Good State of Health 0 1 2 3 4 5 6 • 2-3: Disabled • 4-6: Severely Disabled/Death ANX005 Shift to Better Health Rationale: ü Enhances clinical interpretability by focusing on a subject’s actual health status at week 8 after receiving ANX005 or placebo ü Evaluates patients across all health states GBS Ph3 Study Population ü Most efficient statistical analysis approach GBS-DS Scores of 3-5 at Baseline 9 Topline Results Subject to Change


ANX005 30 mg/kg Showed Highly Significant and Clinically Meaningful Treatment Effect on GBS-DS at Week 8 (Primary Endpoint) 2.41-fold higher likelihood of being in a better state of health relative to placebo Grotta Bar of GBS-DS at Week 8 ANX005 30mg/kg N=78 OR 2.41, p=0.0058 Placebo N=81 10 Topline Results Subject to Change


Pre-Specified GBS-DS Responder Analysis at Week 8: ANX005 30 mg/kg Demonstrated a Significant ≥3-Point Improvement vs. Placebo Substantial treatment effect at week 8, further supporting primary analysis 1 1 nominal p‐ value 11 Topline Results Subject to Change


Getting Better Sooner: ANX005 30 mg/kg Increased Muscle Strength Earlier Relative to Placebo, and the Advantage Grew Over Time Early muscle strength improvement maintained & increased through full 26-week study (p=0.001) ANX005 30mg/kg (n=79) 10-point improvement Placebo (n=81) over placebo p=0.0351 * 1 45.5 days p<0.0001 1 35 days *** Gain in time to recovery maintained throughout study 1 28 days Nominal p‐ values Modified Intent‐ to‐ Treat (N=241) 1 Approximate Time difference 12 Topline Results Subject to Change


ANX005 75 mg/kg Did Not Meet the Primary Endpoint with Inhibition Beyond Active Disease Process 75mg/kg did improve muscle strength similar to 30 mg/kg at early timepoints to week 4 Grotta Bar of GBS-DS at Week 8 Change from Baseline MRC Score ANX005 30mg/kg (n=79) ANX005 75mg/kg (n=81) ANX005 Placebo (n=81) 75mg/kg N=81 Placebo N=81 OR 1.20, p=0.5548 Modified Intent‐ to‐ Treat (N=241) Nominal p‐ values 13 Topline Results Subject to Change


Getting Better Sooner: ANX005 30 mg/kg Showed Significant Early * Improvement in Motor Disability vs. Placebo on the ONLS Scale Maintains ability to perform daily tasks through 26 weeks p=0.0063 2.1-point improvement over placebo, p<0.0001 *** Gain in time to recovery maintained throughout study * 1 20 days 1 18 days ***Week 1: p <0.0001 1 Week 8: p=0.0965 35 days Nominal p‐ values *Overall Neuropathy Limitation Scale 1 Approximate Time difference 14 Topline Results Subject to Change


Getting Better Sooner: ANX005 30 mg/kg Consistently Showed Faster Recovery Across Clinically Important Measures Relative to Placebo Helping patients achieve their independence sooner 56 Days ANX005 30mg/kg: N=79 Walking Earlier 87 Days 31 days earlier, p=0.0211 Placebo N=81 20 Days ANX005 Off Ventilation Earlier 30mg/kg: N=15 48 Days 28 days earlier, p=0.0356 Placebo N=15 Nominal p‐ values 15 Topline Results Subject to Change


Through Week 26, ANX005 30mg/kg-Treated Patients had Better Outcomes Relative to Placebo ANX005 treatment demonstrated better outcomes than placebo at all time points in the study GBS-DS: 1.49x more likely of being better Be in a better state of health p=0.012 Through Week 26, Patients Treated with MRC: 5.4 mean point improvement Have more muscle strength p=0.0010 ANX005 30mg/kg Were More Likely to: ONLS: 1.1 mean point improvement Perform daily tasks better p=0.0063 Nominal p‐ values 16 16 Topline Results Subject to Change


GBS Phase 3 Results are Highly Relevant to Western Populations ANX005 30 mg/kg treatment effect more pronounced in Western World-type patients Western patients tend to have less severe disease ANX005 30 mg/kg impact on patients and an AIDP neurotype with these characteristics Disease Severity US/Europe Severe Disease 3.03x more likely to be in a better state (MRC 0‐ 20) 80% of US/European 20% of health at Week 8 patients have baseline p=0.0102 MRC of >20 points (47% of patients had milder disease) 80% Mild/Mod Disease (MRC 21‐ 60) Neurotype 5.31x more likely to be in a better state of health at Week 8 60% of US/European 40% AMAN + Other 60% patients have AIDP p=0.0130 (21% of patients had AIDP) AIDP Nominal p‐ values 17 Topline Results Subject to Change


ANX005 Generally Safe and Well-Tolerated Placebo ANX005 30mg/kg ANX005 75mg/kg Majority of AEs were mild (Grade 1) to N=81 N=79 N=81 moderate (Grade 2) • Most common related events were All Grades Grade ≥ 3 All Grades Grade ≥ 3 All Grades Grade ≥ 3 infusion related reactions Number of Subjects 79 35 79 33 80 36 § Majority were mild transient rashes Reporting TEAEs, n (%) (97.5) (43.2) (100.0) (41.8) (98.8) (44.4) • No autoimmune related adverse events Number of Subjects with reported 4 (4.9) 1 (1.2) 24 (30.4) 4 (5.1) 32 (39.5) 7 (8.6) Infusion Related Reaction • Infection rates were comparable across dose groups and consistent with typical Rash (most common 2 (2.5) 0 20 (25.3) 1 (1.3) 25 (30.9) 2 (2.5) hospital acquired infections with IRR) • 3 patients had treatment Most Common TEAEs (non-IRR), n (%) discontinuations 44 (55.7) 14 (17.7) 35 (43.2) 12 (14.8) Blood CPK Increased 46 (56.8) 16 (19.8) § 1 in each dose group Deaths Musculoskeletal Pain 35 (43.2) 0 36 (45.6) 0 26 (32.1) 1 (1.2) • No difference observed in incidence of 21 (26.6) 2 (2.5) 23 (28.4) 6 (7.4) ALT Increased 23 (28.4) 6 (7.4) all-cause mortality - 3 deaths in each dose group Urinary Tract Infection 18 (22.2) 6 (7.4) 19 (24.1) 5 (6.3) 18 (22.2) 1 (1.2) • Mortality rate of 3.7% was consistent Hypokalemia 24 (29.6) 8 (9.9) 16 (20.3) 4 (5.1) 11 (13.6) 3 (3.7) with rates seen in US and EU Constipation 10 (12.3) 0 15 (19.0) 0 17 (21.0) 0 • Deaths occurred in older and more severe subjects 11(13.9) 1 (1.3) 17 (21.0) 3 (3.7) AST Increased 16 (19.8) 3 (3.7) 18 PROPRIETARY & CONFIDENTIAL Topline Results Subject to Change


GBS Pathophysiology and the Targeted MOA of ANX005 19


GBS is a Neurological Emergency Requiring Urgent Intervention Limited time window to stop the active disease process and achieve a therapeutic effect ACUTE ACTIVE PHASE RECOVERY PHASE ACUTE ACTIVE PHASE Active Disease Process • Rapidly progressive bilateral muscle weakness peaking by 1 – 2 weeks in most cases • Paralysis in legs, arms and potentially Paralysis breathing muscles • Extended periods of ventilation in ICU, and intensive supportive care RECOVERY PHASE Range of functional • Gradual muscle strength and functional recovery improvement over months to years as nerve Autoantibodies regeneration takes place • ~20% unable to walk or dead at 1 year and Infection additional 20% continue to experience symptoms ‐ 4 0 2 4 8 12+ Time from onset of weakness (weeks) 20 Adapted from van den Berg, et al. (2014) Nat Rev Neurol 10, 469–482


GBS Time Course: Autoimmune Complement-Mediated Nerve Damage Followed by Normal Complement-Facilitated Repair Complement-mediated Complement-facilitated nerve nerve damage repair (debris clearance) IDENTIFY MOST EFFECTIVE Active Disease Process TREATMENT WINDOW Paralysis BLOCK AUTOIMMUNE COMPLEMENT- MEDIATED NERVE DAMAGE DURING Shorter duration of inhibition ACTIVE DISEASE Longer duration of inhibition Range of functional recovery Autoantibodies ALLOW NORMAL COMPLEMENT FACILITATED NERVE REPAIR DURING Infection RECOVERY PHASE ‐ 4 0 2 4 8 12+ Time from onset of weakness (weeks) 21 Adapted from van den Berg, et al. (2014) Nat Rev Neurol 10, 469–482


ANX005: Expected Pharmacokinetic and Dynamic Response for Both Doses Duration of complement inhibition defines active treatment window • Rapid C1q engagement and functional inhibition (CH50 assay) § 30 mg/kg provided: ~1 week duration of inhibition § 75 mg/kg provided: 2‐ 3 weeks duration of inhibition ANX005 75 mg/kg ANX005 30 mg/kg C1q inhibition ~ 1 week C1q inhibition 2-3 weeks Active Disease Phase Recovery Phase Active Disease Phase Recovery Phase C1q Function C1q Function ANX005 ANX005 22 Topline Results Subject to Change


ANX005 Rapidly Shuts Down Activation of the ENTIRE Classical Complement Cascade on the Nerve to Prevent Acute Injury Classical Complement Drives Harmful Inflammation and Tissue Destruction STOPPING AT THE START C1q • Blocks upstream and downstream inflammation & tissue damage • Before downstream bypass mechanisms (breakthrough) and Immune C4b C4 C4a pathway amplification cell attack • Differentiated functional outcomes C2 Immune cell shown in GBS, GA, HD and ALS recruitment DOWNSTREAM APPROACHES (C3/C5) • Do not block ongoing inflammatory pressure of upstream classical pathway C3a C3 C3b • More susceptible to complement bypass mechanisms / inflammatory breakthrough Membrane C5a C5b-9 C5 damage 23 23 GBS: Guillain‐ Barré Syndrome; GA: geographic atrophy; HD: Huntington’s Disease; ALS: amyotrophic lateral sclerosis


ANX005 GBS Phase 3 Trial Summary and Path Forward Douglas Love, President & CEO Annexon Biosciences 24


Real-World Evidence to Support Planned Regulatory Submission Interim RWE Data Support Comparability & Relevance of Phase 3 Findings to the West • FDA agreed that a single pivotal study would be Annexon + IGOS RWE sufficient for BLA assuming it demonstrates: Comparability Study § Substantial evidence of ANX005’s treatment effect vs. placebo § Comparability between Ph3 population & Western patients Global GBS Real-World Evidence Cohort • Annexon has developed a real-world evidence (RWE) comparability protocol with IGOS (ANX005-GBS-04) • IGOS data supports ongoing comparability study, including: Annexon Phase 3 Study § ~50% of all Western IGOS patients met the entry criteria for GBS Ph3 § Robust ANX005 impact on ‘Western World’ type Phase 3 patients § Preparing matched cohort for comparison with IVIg 25 Topline Results Subject to Change


GBS is an Untapped Commercial Opportunity and Annexon is Pursuing a Tailored Approach Significant commercial opportunity for ANX005 achieved through focused commercial footprint ANX005 First-line, 22,000 monotherapy people in US treatment for & Europe GBS hospitalized with GBS ANX005 helped GBS patients Get Better Sooner every year ü Single infusion ü Faster recovery / independence 90% of GBS patients treated with off-label IVIg in US ü Potential for significant cost reductions for health care system ‐ Daily infusions over 5 days Robust HEOR plan to demonstrate reduced cost of care ‐ Non-specific approach to treating GBS Focused and targeted commercial launch plan >$2B annual cost burden on patients, caregivers, 1 Commercial manufacturing partnership with Lonza hospitals, and payers GBS a beachhead for mechanistically-related neuro and Majority of patients treated in major metro areas 2 and large community hospitals autoimmune indications 1 2 Frenzen, PD (2008) Neurology 71:21‐ 27 7, ClearView Health market research 26 26 Topline Results Subject to Change


ANX005 GBS Phase 3 Summary of Key Results A profound moment for the GBS community – first targeted therapy to demonstrate positive outcomes Phase 3 Met Primary Endpoint, confirming earlier study 1 GBS-DS at Week 8: Patients treated with ANX005 were 2.4 times more likely to be in a better state of health compared to placebo, p=0.0058 ANX005 Helped Patients with GBS Get Better Sooner 2 Early, robust, and clinically meaningful benefit on multiple outcome measures by week 8 including ability to walk earlier and less nerve damage vs. placebo Durable Treatment Effects Across Full Course of 26-Week Study Maintained improvement over placebo at all timepoints across multiple measures including less time on 3 ventilation and less overall disability Generally Safe and Well Tolerated 4 Safety profile similar to placebo – no increased rate of infections, convenient single dose Clear Path to BLA Submission and Launch 5 Preparing to engage FDA later this year to support BLA submission 1H25 On-track to complete RWE study by 1H25 to support BLA timelines Preparing clear launch strategy with focused commercial team 27 27 Topline Results Subject to Change


To the patients, families, caregivers, physicians and medical teams who participated in our trial, we are eternally grateful for your support and contributions! To our employees, collaborators and advisors, thank you for your WARRIOR SPIRIT AND ALL FOR ONE COMMITMENT! 28


Thank You! Q&A Annexon Biosciences sincerely thanks all the patients, families, and study staff who are helping make the ANX005 Ph3 GBS study possible. 29


Appendix 30


ANX005 30 mg/kg Demonstrated Significant Early Reduction in Prespecified Analysis of Neurofilament Light Chain (NfL) Assessment of reduction of neuronal damage Change in Serum NfL Weeks 2 - 4 p=0.03 Key Takeaways p=0.027 Placebo (n=77) 30 mg/kg (n=76) • Prespecified assessment of NfL reduction 75 mg/kg (n=77) during weeks 2‐ 4 consistent with Ph1b • Captures transition from acute progressive to recovery phase of disease • ANX005 30 mg/kg achieved significant early reduction in NfL between weeks 2 – 4 vs. pbo 1 (31.3% vs. 20.1%, p=0.03 ) Weeks 1 Nominal p‐ value 31 Topline Results Subject to Change if found Serum NfL (ng/ml) ± 1 SEM


Y Complement is Pivotal Force in Driving Nerve Damage in GBS ANX005 is a Targeted Immunotherapy which Rapidly Blocks Complement • C1q binds to autoantibodies on nerve surface • One dose of ANX005 rapidly blocks C1q • Activates classical complement pathway • Stops activation of entire classical pathway GBS ANX005 • Blocks nerve fiber damage during the active • Results in neuroinflammation, nerve disease phase damage, tissue debris and paralysis Peripheral Nerve Fiber Peripheral Nerve Fiber Under Attack in GBS in GBS with ANX005 • Classical complement activation C1q C1q Blocked ANX005 • Nerve fiber damage • Tissue debris Nerve fiber intact Pathogenic autoantibodies Hafer‐ Macko C et al., (1996) Ann Neurol 39 & 40 32


Phase 3 Comparison of Eculizumab vs. ANX005 Eculizumab Ph3 GBS Trial ANX005 GBS Ph3 Trial Targets downstream complement (C5) Blocks entire classical complement MOA ‐ misses important upstream cascade complement drivers of nerve damage Mean time from onset of >7 days < 7 days* weakness to treatment N 57 241 Stratification by prognostic Not stratified leading to imbalance Stratified factors *Stratified for days since onset of weakness (<7 days, ≥7 days) 33


ANX005 Has Demonstrated Characteristics Required to Combat GBS Directly targets mechanism driving extensive nerve damage and paralysis • Complement is an established target in GBS • C1q binds to autoantibodies on nerve components initiating local activation of complement leading to inflammation, recruitment of immune cells, and damage to nerves Rapid onset of action • ANX005 has demonstrated rapid target engagement in blood & CSF across multiple central and peripheral neurological disorders • A single dose of ANX005 inhibits classical complement pathway on day 1 • Prevents acute and ongoing nerve damage to promote nerve repair Provides clinical benefit across entire disease spectrum • Complement-mediated nerve destruction present in all neurotypes of GBS • ANX005 mechanism of action is agnostic to neurotype or disease severity • Early improvement in MRC seen across disease spectrum Minimal side-effects • ANX005 has been safely administered in > 250 patients with GBS • Generally well-tolerated • No drug-related deaths & no serious infections observed 34


The Phase 3 Study Embodies Key Characteristics of a Smart, Data- Driven, & Patient-Centric Design HOW I WOULD DESIGN A PH3 GBS STUDY HOW ANNEXON DESIGNED THE PHASE 3 PIVOTAL STUDY ü Data-driven by Ph1b, IGOS, and multiple external IVIg/PE datasets Use all available global data and ü Routinely engaged with leading experts in GBS routinely seek expert input ü Proportional odds uses full GBS-DS scale, includes all patients, increases power Measures all meaningful outcomes ü Efficacy assessments cover all GBS symptoms & signs at all important timepoints through all phases of disease ü Patients stratified by baseline MRC and days since onset of GBS symptoms Control for disease heterogeneity ü Using MRC, time of onset of weakness, baseline NfL and age as covariates ü Streamlined time from onset to treatment increasing likelihood of better outcomes Rigorous execution ü Conducted at sites with internationally recognized GBS clinical experience 35