EX-99.2 3 d376137dex992.htm EX-99.2 EX-99.2

Exhibit 99.2 Presentation #590 Oral Menin Inhibitor, BMF-219, displays a significant and durable reduction in HbA1c in a Type 2 Diabetes Rat Model Priyanka Somanath, Sanchita Mourya, Weiqun Li, Tenley Archer, Brian Law, Daniel Lu, Tripta Rughwani, Lekha Kumar, Taisei Kinoshita, Mini Balakrishnan, Thomas Butler EASD Annual Meeting 2022 September 20, 2022 1


Menin: A novel target for beta-cell homeostasis Potential Mechanism of Menin in Diabetes BMF-219: A selective covalent menin inhibitor ▪ Menin is an epigenetic protein that plays a key role in regulating NPM1 beta-cell proliferation and function. BMF-219 covalent binding to menin disrupts menin MYC ▪ Menin inhibition has previously been shown to improve glycemic complexes, resulting in global change of function control in high fat induced diabetic mice (Ma et al., 2021). Menin ▪ Inhibition of menin/JunD complex reduces the expression of Cyclin Dependent Kinase Inhibitors (CDKIs), allowing CDKs to MLL drive beta-cell proliferation. JunD Menin inhibition by BMF-219 allows for beta-cell Menin regulates beta-cell quiescence restoration and glucose homeostasis CDK inhibition results in beta-cell quiescence 2 Figure adapted from Issa et al. Leukemia 35, 2482–2495 (2021).


Study Design: Zucker Diabetic Fatty (ZDF) rat model of T2DM Treatment Scheme of ZDF Rat Model THE ZDF RAT Day: 0 8 15 21 28 43 56 Daily oral dosing (QD) Drug wash out Group 1 dose study last dose increased from 40 to termination 200 mg/day Treatment groups (n=10/group): 1. Vehicle Rats monitored through dosing Image Source: Charles River Laboratories, 2001. 2. BMF-219 40 mg/kg days 1-16, 200 mg/kg days 17-28 (QD, PO) and washout phases: 3. BMF-219 85 mg/kg (QD, PO) Fasting blood glucose, insulin, 4. BMF-219 170 mg/kg (QD, PO) OGTT, HbA1c, body weight, blood • The ZDF rat is a model of pancreatic 5. Liraglutide 0.2 mg/kg (BID, SC) lipemic levels exhaustion and insulin resistance, thus mimicking some aspects of human diabetes. Study Objective • The ZDF rat is a translatable model for studying the development of T2D. Measure the ability of BMF-219 in restoring glycemic control in Zucker Diabetic Fatty (ZDF) Rat over a 4-week dosing study. 3


BMF-219 substantially controls blood glucose levels in a 4-week dosing study in ZDF rats * p<0.05 ** p<0.001 4hr Fasting Blood Glucose **** p<0.0001 4 hr Fasting Blood Glucose Vehicle 800 600 ✱ BMF-219 40 mg/kg (Day 1-16), ✱✱ ✱✱✱ ✱✱✱✱ 200mg/kg (Day 17-28) PO ✱✱ ✱ 600 500 Liraglutide 0.2 mg/kg BID 400 400 200 300 Day 21 Day 29 0 Day 1 Day 8 Day 15 Day 21 Day 29 4hr Fasting Insulin 10 9 8 7 6 5 4 3 2 1 0 Day 1 Day 8 Day 15 Day 21 Day 29 Vehicle 0mg/kg BMF-219 40 mg/kg PO (days 1-16), 200 mg/kg PO (day 17-28) BMF-219 170mg/kg PO Liraglutide 0.2 mg/kg BID 4 Blood glucosse (mg/dL) Mean± SEM Insunin (ng/mL), Mean± SEM Blood Glucose (mg/dL)


BMF-219 substantially controls blood glucose levels in a 4-week dosing study in ZDF rats * p<0.05 ** p<0.001 4hr Fasting Blood Glucose **** p<0.0001 4 hr Fasting Blood Glucose Vehicle 800 600 ✱ BMF-219 40 mg/kg (Day 1-16), ✱✱ ✱✱✱ ✱✱✱✱ 200mg/kg (Day 17-28) PO ✱✱ ✱ 600 500 Liraglutide 0.2 mg/kg BID 400 400 200 300 Day 21 Day 29 0 Day 1 Day 8 Day 15 Day 21 Day 29 OGTT- Day 25 9 0 0 4hr Fasting Insulin 10 Vehicle 0mg/kg 8 0 0 9 BMF-219 200mg/kg PO 8 7 0 0 7 BMF-219 170mg/kg PO 6 6 0 0 5 Liraglutide 0.2 mg/kg BID 4 5 0 0 3 2 4 0 0 1 0 Day 1 Day 8 Day 15 Day 21 Day 29 3 0 0 0 15 30 60 90 120 Vehicle 0mg/kg BMF-219 40 mg/kg PO (days 1-16), 200 mg/kg PO (day 17-28) T i m e ( m i n ) BMF-219 170mg/kg PO Liraglutide 0.2 mg/kg BID 5 Blood glucosse (mg/dL) Mean± SEM Insunin (ng/mL), Mean± SEM Blood Glucose (mg/dL) Blood Glucose (mg/dL) Mean± SEM


BMF-219 restores beta-cell function over 4 weeks of treatment 4 hr Fasting HOMA-B (Day 21) 4 hr Fasting HOMA-B (Day 29) BMF-219 restores and maintains HOMA-B index to Last day of treatment normal state (>201) over 4 weeks of treatment 400 400 HOMA-B (4 hr Fasting) 300 300 250 200 200 200 BMF-219 (170 mg/kg) 100 100 Liraglutide (0.2 mg/kg) 150 0 0 Vehicle 100 Vehicle Liraglutide (0.2 mg/kg) BMF-219 (170 mg/kg) 50 0 Day 21 Day 29 Severity Grading Assessment for HOMA-B Index Pancreatic Beta-Cell Function Adequate (normal state) ≥ 201.00 Mild deficiency 134.00 to 200.99 Moderate deficiency 67.00 to 133.99 Severe deficiency 0.00 to 66.99 Table Source: Fasipe JO et al. 2020. Can J Diabetes 44 (2020) 663e669. 6 HOMA-B Score


BMF-219 significantly reduces HbA1c (-3.5%) during treatment and maintains lowering effect during 2 weeks of drug washout Hemoglobin A1c (%) * p<0.05 ** p<0.01 ****p<0.0001 * BMF-219 Day 29: ✱✱✱✱ ✱✱✱✱ 15 3.5% HbA1c reduction ✱✱✱✱ ✱✱✱✱ Vehicle 0mg/kg * 10 BMF-219 40mg/kg (days 1-16), 200mg/kg (days 17-28) PO 5 BMF-219 170mg/kg PO Liraglutide 0.2 mg/kg BID 0 Day 1 Day 21 Day 29 Day 43 HbA1c reduction in BMF-219 Day: 0 15 21 28 43 56 8 treated groups maintained through washout period Daily oral dosing (QD) Drug wash out 7 HbA1c (%), Mean± SEM


BMF-219 treated groups display body weight and cholesterol reduction BMF-219 200 mg/kg group reduces body weight during BMF-219 reduces blood lipemic levels measured treatment in ZDF rats on Day 29 Total Cholesterol Triglycerides Body weight 425 *** p<0.0005 ✱✱✱✱ ****p<0.0001 400 ✱✱✱ 250 1000 375 200 800 150 600 350 100 400 325 50 200 13% body weight reduction on Day 29 0 0 300 1 3 5 8 10 12 15 17 19 21 22 25 28 29 31 Days Vehicle 0mg/kg BMF-219 170mg/kg PO Liraglutide 0.2mg/kg BID BMF-219 40mg/kg (days 1-16), 200mg/kg (days 17-28) PO 8 Vehicle 0mg/kg BMF-219 200mg/kg PO BMF-219 170mg/kg PO Liraglutide 0.2 mg/kg BID Vehicle 0mg/kg BMF-219 200mg/kg PO BMF-219 170mg/kg PO Liraglutide 0.2 mg/kg BID Body weight (g) Mean± SEM TC (mg/dL) Mean± SEM TG (mg/dL) Mean± SEM


Summary and Conclusions ➢ BMF-219 displays significant glycemic control in ZDF rats, outperforming liraglutide in reduction of fasting blood glucose by Day 29 and by OGTT on day 25. ➢ BMF-219 significantly reduces HbA1c levels (-3.5%) during treatment and drug washout. ➢ BMF-219 treatment restores HOMA-B scores to normal state indicating restored beta-cell function. ➢ BMF-219 treated groups have significant reductions in body weight (13% at 4 weeks of treatment) and reduced blood lipemic levels. Collectively, these data demonstrate the novel long-acting potential of BMF-219 as an orally administered short-term treatment in achieving and maintaining glycemic control in T2DM. 9


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