Apic Bio, Inc.

10月7日，2024年诺贝尔生理学或医学奖颁布给了Victor Ambros和Gary Ruvkun两位科学家，以表彰其发现了microRNA（简称miRNA）及其在转录后基因调控中的作用，并阐明了控制基因活动的基本原则。 图片来源：诺贝尔生理学或医学奖委员会  虽然，在此之前，大众对诺贝尔医学奖的猜测大多集中于glp-1等产业应用较广泛的领域，但其实miRNA无论是学术意义，还是现阶段的产业落地速度，都并不逊色于前者，而诺贝尔官方将医学奖颁给miRNA或许某种程度上也不失为对未来作为创新疗法的潜力认可。  那么，miRNA究竟是何方神圣，目前全球产业界的布局又推进至何种程度了呢？  获奖实至名归 miRNA参与人类1/3的基因调节  其实，在过去很长一段时间里，人们一直遵循的都是由佛朗西斯·克里克1958年提出的中心法则，即遗传信息必须从DNA传递给RNA，再从RNA传递给蛋白质，再由蛋白质执行各种生命功能。  而随着科学家对人类基因的探索愈发深入，人们却逐渐意识到RNA原来可以分为两种：一种是参与编码蛋白质的编码RNA，仅占全部RNA的2%左右；另一种则是不参与编码蛋白质的非编码RNA，占全部RNA的98%，而miRNA正是“非编码RNA”的主要代表之一。  miRNA在翻译过程中的作用不同于大多数同类，其主要执行的是监督、调节编码RNA与效应蛋白的作用，可以将其想象成工地里的“施工员”，几乎参与了所有的生物学功能，以至于人类近1/3的基因均由miRNA进行调节。  而也正是因此，miRNA在近20年里一直都是科学界的研究热点，期间全球各大期刊发布了不低于18万篇相关的科学研究文章，仅就连国内与之相关的研究论文也多达2万余篇，充分彰显了这个“新大陆”的辽阔与前景。  堪比siRNA miRNA趋势性同样明显  众所周知，在新药蓬勃发展的今天，小核酸药物被认为是将带来“除小分子药和抗体药之外的第三次制药浪潮”的关键，而对于目前的小核酸药物开发，目前主要的思路有三种：  可以针对细胞内的mRNA、非编码RNA（ncRNA）等，沉默抑制该基因的表达，以影响最终蛋白的表达，即RNA干扰疗法。 对于由蛋白缺乏导致的疾病，也可引入上调目标基因的表达，通过saRNA实现。 直接引入mRNA表达新的所需的蛋白，比如大家熟悉mRNA疫苗（所以说是子集） 。 其中，RNA干扰疗法是目前小核酸领域最受关注的存在，而其中除了熟知的siRNA外，miRNA也是该疗法中的主要构成之一。  只不过siRNA的研究进度更为靠前，其在抑制效率已足够优秀的情况下，miRNA就显得没那么亮眼了。但其实，miRNA与siRNA两者在很多方面均存在着较明显的差异点： 表1. siRNA与miRNA的主要区别点 分类 siRNA miRNA 体内作用 RNA干扰 RNA干扰 序列长度 21-23nt 19-25nt 结构 双链RNA 单链RNA 互补程度 完全互补 部分互补 来源 人工体外合成 内源 Dicer酶加工过程 对称加工 不对称加工 作用位置 任何部位 靶标基因3′-UTR区 作用方式 下调 上调+下调 靶标RNA数量 一对一 一对多 数据来源：公开数据来源 其中，miRNA对比siRNA在功能上的特定优势主要有三点，分别是：  可同时靶向多个基因，miRNA对序列的匹配要求不高，不需要像siRNA那样完全与目标基因匹配，因此原则上可以结合并抑制多种靶mRNA，以此形成庞大而复杂的调控网络。 靶点选择广泛，miRNA非编码RNA的特性导致其在靶点选择比ASO等疗法范围更广，理论上可治疗的疾病也更多。 多样化的调节方式，与单纯降低基因表达的siRNA不同，miRNA既可以下调也可以上调mRNA的表达水平。 因此，miRNA在原理上的成药空间并不低，只是受限于相关研究的不足，以及产业界对miRNA的认知不足，其领域内的发展速度较siRNA更为缓慢，但随着miRNA的基础研究水平上升，其与多种疾病的关联性被确定，未来其在肿瘤、心血管疾病、代谢性疾病（如糖尿病等）、免疫疾病、神经类疾病、传染病等领域，都有着极大的应用空间。  甚至已有不少创新Biotech企业开始布局。  三足鼎立 miRNA海外格局初成  虽然，原则上miRNA的发现时间不长，目前也并无任何一款相关新药上市，但其产业化落地速度却是极快，尤其是海外领域。  其中，基于miRNA的诊断方法应用最广泛，比如将miRNA用于肿瘤转移、肿瘤恶性程度，或肿瘤的早期诊断就是目前miRNA最被看重的板块，此外，循环miRNA也可以用于心血管疾病、肾病和神经退行性疾病的诊断等等。  排除miRNA在疾病诊断方面的广泛应用，如肿瘤转移、肿瘤恶性程度与肿瘤的早期诊断等，在miRNA作为药物治疗靶点方面，目前已有不少突破性进展，如利用基因编辑技术针对 miRNA 治疗疾病，目前已有多种经过临床试验的 miRNA 分子靶向药物面世。  统计miRNA领域全球在研新药，目前共有92项miRNA疗法在研，虽其中绝大部分管线尚处于临床前阶段，但仍有7款创新疗法率先进入临床，且初步展现出一定的临床优势，其中：  Causeway针对肱骨外上髁炎的CWT-001研究进展最快，已推进至临床II期。 Apic Bio的APB-102、UniQure的AMT-260与AMT-130目前已进入临床I/II期。 InteRNA针对实体瘤的INT-1B3处于临床I期。 JBT-miR2与APB-101处于临床申请阶段。 表2. 全球部分临床阶段的“miRNA”疗法（点击查看大图） 数据来源：公开数据来源  而其中，Causeway、Apic Bio与UniQure作为现阶段miRNA领域的技术三巨头，几乎占据了该领域绝大多数的技术推进力，未来也大概率将是MNC推进相关产业合作的首选。  miRNA先驱：UniQure UniQure于1998年在荷兰成立，其致力于治愈性基因疗法在肝脏代谢、中枢神经系统和心血管领域的开发应用，是基因治疗领域的先行者，同样也是miRNA领域的技术龙头之一。  目前，该企业全球员工超400人，经历多轮融资之后，已于美国纳斯达克成功上市，并且在资金与人才的双重助力之下，成功建立了独有的两大技术核心平台。  其中miQURETM技术是UniQure专有的下一代基因沉默平台，旨在降解致病基因，而不产生脱靶毒性，并通过继发性外泌体介导的递送诱导整个靶器官的沉默。  使用该技术设计的基因治疗候选药物结合了专有的治疗性miRNA，并通过AAV递送，能够提供持久的活性。在临床上展现出众多优势，如组织特异性的增强、细胞核基因的改善、未产生与miRNA或mRNA相关的不良影响等。  目前，UniQure共有5条miRNA相关管线，其中AMT-260与AMT-130的临床推进最为迅速，目前已进入了临床Ⅰ/Ⅱ期，是UniQure最核心的临床管线之一。  表3. UniQure共有5条miRNA相关管线 药品成分 研发机构 全球最高状态 全球适应症在研状态 疾病领域 项目最新进展时间 项目最新进展 AMT-260 UniQure biopharma，Corlieve Therapeutics 临床I/II期 临床I/II期: 颞叶癫痫发作 神经系统疾病 2023年11月15日 NCT06063850开始招募 AMT-130 UniQure biopharma 临床I/II期 临床I/II期: 亨廷顿舞蹈病 神经系统疾病，罕见病 2024年10月3日 NCT04120493招募完成 AMT-240 UniQure biopharma 临床前 临床前: 阿尔兹海默病 神经系统疾病，精神障碍疾病 2021年12月21日 阿尔兹海默病临床前 (进行中) AMT-161 UniQure biopharma 临床前 临床前: 肌萎缩侧索硬化症 罕见病，骨骼肌肉系统疾病，神经系统疾病 2023年5月18日 肌萎缩侧索硬化症 AMT 150 UniQure biopharma 临床前 临床前: 脊髓小脑性共济失调 神经系统疾病，罕见病 2021年12月21日 脊髓小脑性共济失调临床前 (进行中) 数据来源：公开数据来源  AMT-260，是2016年UniQure收购Corlieve所获得的项目资产。作为一种拟用于治疗颞叶癫痫的AAV基因疗法，其采用了miRNA沉默技术来靶向抑制颞叶癫痫（TLE）患者海马体中异常表达的kainate受体，能有效地减少了皮质神经元中GluK2的表达。  在临床前数据显示，AMT-260能有效降低癫痫样活性和过度扩张，阻断患者异常放电。目前其关于内侧颞叶癫痫适应症的II期试验正在进行，计划将于2026年完成主要临床数据的收集。  AMT-130，是UniQure利用了其专有的miQURETM沉默技术设计的，由microRNA和载体AAV5组成，递送入脑后能够抑制突变亨廷顿蛋白的产生。  在一项AMT-130治疗亨廷顿舞蹈症I/II期临床试验低剂量队列中，AMT-130耐受性良好，未发生与AMT-130相关的严重不良事件，且MRI成像未显示任何具有临床意义的安全性信号。后续12月随访中，接受AMT-130治疗的患者在12个月时脑脊液中的神经丝轻链（NfL）接近基线，相较于对照组有较好改善。  miRNA黑马：Causeway 从数据上看，Causeway是现阶段全球领域miRNA疗法研究推进最快的企业之一，作为一家2017才成立的biotech企业，其致力于开发新型microRNA疗法，专注于常见的肌肉骨骼和年龄相关疾病，并始终相信miRNA疗法几乎有无限的治愈潜力。  其认为，递送是miRNA靶向技术用于治疗的主要障碍。虽然，肝脏是寡核苷酸疗法能够可靠递送的唯一器官。然而，一个值得注意的例外是局部递送，其拥有用药量小、有限的系统吸收、更高安全性与更低的商业化成本等诸多优势，这也是为何Causeway会选择肌肉骨骼和年龄相关疾病的根本原因。  目前，该公司管线进展最快的是CWT-001（临床Ⅱ期），是一种化学合成的microRNA-29a（miR29a）模拟物，针对肌腱病，在之前一项针对网球肘患者进行的1b期临床试验中，替诺米似乎安全且耐受性良好；一项具有疗效终点（肘关节功能、疼痛和肌腱再生）的多中心2期研究已于2023年夏季开始招募。 图片来源：Causeway官网  另外，据其公司官网数据显示，其miRNA管线中还有针对骨关节炎、皮肤老化的OsteoMiR与DermaMiR，有望继CWT-001之后，迅速进入临床阶段。  miRNA大拿：Apic Bio Apic Bio是一家创新型基因治疗公司，致力于推动罕见病的基因疗法发展。2017年由麻省大学医学院（UMMS）衍生而来，并于之后几年连续获得多次融资。  Apic Bio主打方向为腺相关病毒（AAV）基因疗法，核心管线主要有APB-102与APB-101等多款创新疗法，而在miRNA领域，现阶段Apic共有四款创新疗法涉及，其中APB-102推进最快，目前已处于临床Ⅰ/Ⅱ期，APB-101正处于临床申请阶段，CNS disease与APB-105则尚处于临床前阶段。 表4.  腺相关病毒（AAV）基因疗法 药品成分 研发机构 全球最高状态 全球适应症在研状态 疾病领域 项目最新进展时间 项目最新进展 APB-102 Apic Bio，UniQure biopharma 临床I/II期 临床I/II期: 肌萎缩侧索硬化症 罕见病，骨骼肌肉系统疾病，神经系统疾病 2024年08月1日 NCT06100276首例入组 APB-101 Apic Bio，UMass Chan Medical School（大学） 申请临床 申请临床: α-1抗胰蛋白酶缺乏症 消化系统疾病，呼吸系统疾病，罕见病 2021年12月2日 α-1抗胰蛋白酶缺乏症临床研究 (申请中) CNS disease(Apic Bio) Apic Bio 临床前 临床前: 中枢神经系统疾病 神经系统疾病 2021年12月2日 中枢神经系统疾病临床前 (进行中) APB-105 Apic Bio 临床前 临床前: 肌萎缩侧索硬化症 罕见病，骨骼肌肉系统疾病，神经系统疾病 2021年12月2日 肌萎缩侧索硬化症临床前 (进行中) 数据来源：公开数据来源  作为Apic的 主打产品，APB-102是一款针对遗传性肌萎缩侧索硬化症（SOD1-ALS）的基因疗法，由重组AAVrh10载体表达组成，该载体表达微核糖核酸（miRNA），miRNA旨在敲低SOD1的表达，减缓或逆转有SOD1突变的患者的ALS进展。临床前概念性研究已经证明APB-102可抑制突变SOD1基因活性。  在SOD1-ALS小鼠模型的临床前研究表明，APB-102大大提高了患病小鼠的生存率。在啮齿类动物和非人灵长类动物中，在建议的临床剂量下，脊髓运动神经元的SOD1也有相关减少。APB-102已于2021年4月获批临床，并先后获得 FDA 的孤儿药和快速通道指定，Apic Bio预计将在今年下半年启动相关临床Ⅰ/Ⅱ期试验。  2023年1月23日，Apic Bio与UniQure达成合作，后者引进了Apic的APB-102，并成功获得了该药的开发和商业化权利。  继续观望 国内miRNA落地尚需时日  相较于国外，国内miRNA赛道发展相对更慢，布局企业主要的方向还主要集中于诊断方向，如觅瑞集团致力于miRNA及其他非编码RNA作为生物标志物的诊断产品创新及临床转化等。  至于miRNA治疗领域方面，国内现阶段相关管线基本尚处于临床前阶段，且绝大多数相关疗法均为国内大学、研究机构发起的研究，企业对该领域的兴趣存在较大的缺失，导致国内相关临床管线推进相对缓慢。  而如此差异的根本原因，主要是海内外新药研究的格局不同所致，就目前而言，国内新药产业仍多以fast follow为主，对于miRNA之类在海外没有明确临床数据验证的情况下，国内短期内的兴趣不会有所提升，也很难看到新玩家的加入。 表5.国内部分“miRNA疗法”涉及管线 药品成分 靶点 研发机构 全球最高状态 全球适应症在研状态 T-155 (云海生物) miR-155 成都云海四面体生物科技有限公司，四川大学（大学） 临床前 临床前: 脉络膜新生血管,免疫系统疾病 miR-22 (云海生物) miR-22 成都云海四面体生物科技有限公司，四川大学（大学） 临床前 临床前: 视神经疾病 miR-200c (复旦) HSPA9 复旦大学（大学） 临床前 临床前: 卵巢上皮癌 miR-708 NRAS 国立清华大学（大学） 临床前 临床前: 肿瘤 ARVN601 - 极目生物有限公司 临床前 临床前: 青光眼 AAV9-hSMN1-dual-amiR(纽欧申) SOD1 纽欧申医药（上海）有限公司 临床前 临床前: 肌萎缩侧索硬化症 AAV therapy to treat C9orf72 HRE-caused ALS(纽欧申) C9orf72 纽欧申医药（上海）有限公司 临床前 临床前: 肌萎缩侧索硬化症 T-155 (云海生物) miR-155 成都云海四面体生物科技有限公司，四川大学（大学） 临床前 临床前: 脉络膜新生血管,免疫系统疾病 miR-22 (云海生物) miR-22 成都云海四面体生物科技有限公司，四川大学（大学） 临床前 临床前: 视神经疾病 miR-200c (复旦) HSPA9 复旦大学（大学） 临床前 临床前: 卵巢上皮癌 miR-708 NRAS 国立清华大学（大学） 临床前 临床前: 肿瘤 ARVN601 - 极目生物有限公司 临床前 临床前: 青光眼 AAV9-hSMN1-dual-amiR(纽欧申) SOD1 纽欧申医药（上海）有限公司 临床前 临床前: 肌萎缩侧索硬化症 AAV therapy to treat C9orf72 HRE-caused ALS(纽欧申) C9orf72 纽欧申医药（上海）有限公司 临床前 临床前: 肌萎缩侧索硬化症 数据来源：公开数据来源  或许，在大多数国内企业看来，现阶段入局miRNA风险过大，无论是成药性，还是商业化可能都还存在较大的局限性，短期内很难看到较为明显的投资回报，与其不断试错，不如继续观望来得更稳健一点。  小结  显而易见，miRNA虽有诺奖加持，且也基本符合核酸药物引领产业变革的大势，但就目前而言，我们对其的了解仍相对早期，miRNA要成功走向产业化，仍有诸多研究与开发上的挑战。  在研究层面，疾病机制的突破、关键工艺合成技术、递送技术的革新、序列设计与优化、工艺工程放大等问题仍需全球各界一同努力。 在商业化层面，要想将该疗法推进至全球，单纯靠创新biotech企业明显不现实，过程中一定需要MNC与全球各地本土企业的加入。  只有兼顾成药性与商业化趋势之后，miRNA才算是迈出了成功的第一步。在不久的将来才有希望成为精准医疗领域的后起之秀，在小核酸领域绽放光芒，为医药产业带来一场全新的革命。 来源 | 博药（药智网获取授权转载） 撰稿 | 弎 责任编辑 | 八角 声明：本文系药智网转载内容，图片、文字版权归原作者所有，转载目的在于传递更多信息，并不代表本平台观点。如涉及作品内容、版权和其它问题，请在本平台留言，我们将在第一时间删除。 商务合作 | 王存星 19922864877（同微信）  阅读原文，是受欢迎的文章哦

▎Armstrong 2024年10月7日，诺贝尔生理学或医学奖被授予给microRNA（miRNA）域做出突破性贡献的Victor Ambros教授和Gary Ruvkun教授，这两位学者发现了microRNA及其在转录后基因调控中的作用。 核酸药物领域，mRNA、siRNA、ASO等都已经成药并受到业界广泛关注，miRNA似乎还相对小众，那么这个赛道都有哪些主要的Biotech呢？ 截至目前，约有十几款miRNA药物（部分为靶向并抑制miRNA，另一部分则为miRNA类似物）进入临床阶段，适应症覆盖实体瘤、亨廷顿病、NASH、心衰、丙肝等， 递送系统也是miRNA药物开发的关键环节之一。 Abivax  Abivax为纳斯达克上市公司，目前市值为6亿美元。Abivax核心管线Obefazimod，可以选择性上调miR-124，用于治疗炎症性肠病。 Regulus Therapeutics Regulus Therapeutics为纳斯达克上市公司，目前市值1亿美元，首付管线为RGLS8429，靶向并抑制miR-17，用于治疗常染色体显性多囊肾（ADPKD），目前处于1b期临床阶段，正在筹备2/3期临床。 EnGeneIC EnGeneIC聚焦开发EDV技术，来递送siRNA或miRNA。 Cardior Pharmaceuticals Cardior Pharmaceuticals的核心管线CDR132L为一款阻断miR-132的基于寡核苷酸的ncRNA抑制剂，1b期临床中表现出心脏功能改善的效果，目前在进行HFrEF的二期临床。2024年3月，诺和诺德以11亿美元的价格收购Cardior Pharmaceuticals。 Transcode Therapeutics Transcode Therapeutics的首发管线为靶向miR-10b的TTX-MC138，用于治疗肿瘤，今年9月完成首例患者给药。 miRagen 原本以miRNA诊断为主，后被Viridian借壳上市。 miRNA Therapeutics miRNA Therapeutics的核心管线MRX-34为miR-34类似物，用于治疗肿瘤，因安全性问题终止开发。 此外，还有Arthex Biotech、Apic Bio、InteRNA Technologies，被韩国Nexturn Biosciences收购的RosVivo Therapeutics等。 总结 国内方面，觅瑞集团专注开发基于miRNA的液体活检，今年5月递交港股IPO申请。觅瑞集团于2023年7月完成5000万美元D轮融资，投后估值6亿美元。江苏命码生物聚焦开发miRNA诊断或治疗药物，并于2021年与金斯瑞合作开发KRAS为靶标基因的RNAi治疗药物和以miR-214为靶标基因的适应于多种抗肿瘤细胞逃逸的RNAi治疗药物。命码生物的创始人为南京大学张辰宇教授，一直致力于细胞外miRNA的研究。2021年，张辰宇又创立了艾玛生物，但管线以外泌体递送siRNA为主。 Armstrong技术全梳理系列 GPRC5D靶点全梳理； CD40靶点全梳理； CD47靶点全梳理； 补体靶向药物技术全梳理； 补体药物：眼科治疗的重要方向； Claudin 6靶点全梳理； Claudin 18.2靶点全梳理； 靶点冷暖，行业自知； 中国大分子新药研发格局； 被炮轰的“me too”； 佐剂百年史； 胰岛素百年传奇； CUSBEA：风雨四十载； 中国新药研发的焦虑； 中国生物医药企业的研发竞争； 中国双抗竞争格局； 中国ADC竞争格局； 中国双抗技术全梳理； 中国ADC技术全梳理； Ambrx技术全梳理； Vir Biotech技术全梳理； Immune-Onc技术全梳理； 亘喜生物技术全梳理； 康哲药业技术全梳理； 科济药业技术全梳理； 恺佧生物技术全梳理； 同宜医药技术全梳理； 百奥赛图技术全梳理； 腾盛博药技术全梳理； 创胜集团技术全梳理； 永泰生物技术全梳理； 中国抗体技术全梳理； 德琪医药技术全梳理； 德琪医药技术全梳理2.0； 和铂医药技术全梳理； 荣昌生物技术全梳理； 再鼎医药技术全梳理； 药明生物技术全梳理； 恒瑞医药技术全梳理； 豪森药业技术全梳理； 正大天晴技术全梳理； 吉凯基因技术全梳理； 基石药业技术全梳理； 百济神州技术全梳理； 百济神州技术全梳理第2版； 信达生物技术全梳理； 信达生物技术全梳理第2版； 中山康方技术全梳理； 复宏汉霖技术全梳理； 先声药业技术全梳理； 君实生物技术全梳理； 嘉和生物技术全梳理； 志道生物技术全梳理； 道尔生物技术全梳理； 尚健生物技术全梳理； 康宁杰瑞技术全梳理； 科望医药技术全梳理； 科望医药技术全梳理2.0； 岸迈生物技术全梳理； 礼进生物技术全梳理； 康桥资本技术全梳理； 余国良的抗体药布局； 荃信生物技术全梳理； 安源医药技术全梳理； 三生国健技术全梳理； 仁会生物技术全梳理； 乐普生物技术全梳理； 同润生物技术全梳理； 宜明昂科技术全梳理； 派格生物技术全梳理； 迈威生物技术全梳理； Momenta技术全梳理； NGM技术全梳理； 普米斯生物技术全梳理； 普米斯生物技术全梳理2.0； 三叶草生物技术全梳理； 贝达药业抗体药全梳理； 泽璟制药抗体药全梳理； 恒瑞医药抗体药全梳理； 齐鲁制药抗体药全梳理； 石药集团抗体药全梳理； 豪森药业抗体药全梳理； 华海药业抗体药全梳理； 科伦药业抗体药全梳理； 百奥泰技术全梳理； 凡恩世技术全梳理。

~ On track to initiate FDA interaction regarding AMT-130 in second quarter of 2024 and provide a clinical update from the Phase I/II trials in mid-2024 ~ ~ Clinical trial initiation for Fabry disease on track to begin in second quarter of 2024, followed by refractory mesial temporal lobe epilepsy and SOD1-ALS in third quarter of 2024 ~ ~ Comprehensive review of operations and options to reduce expenses underway and expected to be completed in mid-2024 ~ LEXINGTON, Mass. and AMSTERDAM, May 07, 2024 (GLOBE NEWSWIRE) -- uniQure N.V. (NASDAQ: QURE), a leading gene therapy company advancing transformative therapies for patients with severe medical needs, today reported its financial results for the first quarter of 2024 and highlighted recent progress across its business. “In the first quarter, we made solid progress across three key business priorities – clarifying the road ahead for AMT-130 in Huntington’s disease, initiating three new Phase I/II clinical trials, and prudently conserving our capital,” stated Matt Kapusta, chief executive officer of uniQure. “We are on track to initiate FDA interactions on AMT-130 this quarter and look forward to presenting longer-term follow-up data from our Phase I/II trials mid-year, which will include up to three years of patient follow-up on 29 treated patients. We have also made significant progress towards the initiation of new Phase I/II studies. We have obtained IRB approvals for initial sites, which are poised for imminent activation, and have also identified prospective patients. Enrollment for the Fabry disease study is on track to begin in the second quarter of 2024, with the SOD1-ALS and MTLE studies expected to begin in third quarter.” “In addition, we are actively engaged in a comprehensive review of uniQure’s operations and options to reduce expenses and increase shareholder value,” he added. “We believe deeply in the significant value of our assets, as well as the need to achieve a focused and sustainable level of investment in order to maximize this potential. We expect to complete this evaluation mid-2024.” Recent Updates Advancing AMT-130 for the treatment of Huntington’s disease The Company is on track to initiate interactions with the U.S. Food and Drug Administration in the second quarter of 2024 with the goal of defining the future clinical and regulatory pathway for AMT-130. These interactions, which are expected to continue throughout the year, are expected to include discussions of the interim data from the ongoing Phase I/II clinical trials and the potential to leverage natural history comparators alongside our long-term Phase I/II clinical data. The Company expects to provide an update on its regulatory plans as part of the next clinical update on AMT-130 mid-year and have greater clarity regarding a potential approval pathway for AMT-130 before the end of the year.In mid-2024, the Company expects to provide an update from its ongoing Phase I/II clinical trials of AMT-130. The data will include up to three years of follow-up data on 29 treated patients in both the low- and higher-dose cohorts, of which 21 patients will have a minimum of two years of follow-up.Patient dosing is ongoing in a third cohort of up to 12 patients to further evaluate both doses of AMT-130 in combination with perioperative immunosuppression, with a focus on evaluating near-term safety and tolerability. Enrollment in this third cohort is expected to be completed in the second half of 2024. Initiating new Phase I/II clinical studies AMT-191 for the treatment of Fabry disease - Patient enrollment in a Phase I/IIa clinical trial is expected to begin in the second quarter of 2024. The Phase I/IIa clinical trial will be a U.S.-based, multi-center, open-label trial consisting of two cohorts enrolling up to six adult male patients each. The study is designed to evaluate safety, tolerability, and early signs of efficacy. AMT-162 for the treatment of SOD1 amyotrophic lateral sclerosis (ALS) – Patient enrollment in a Phase I/II clinical trial is expected to begin in the third quarter of 2024. The Phase I/II clinical trial will be a U.S.-based, multi-center, open-label trial consisting of three cohorts with up to four patients each receiving a one-time intrathecal infusion with immunosuppression. The study is designed to evaluate safety, tolerability, and early signs of efficacy. AMT-260 for the treatment of refractory mesial temporal lobe epilepsy (MTLE) – Patient enrollment in a Phase I/IIa clinical trial is expected to begin in third quarter of 2024. The Phase I/II will be a U.S.-based consisting of two parts. The first part is a multicenter, open-label trial with two dosing cohorts of six patients each to assess safety, tolerability, and first signs for efficacy of AMT-260 in patients with refractory MTLE. The second part is expected to be a randomized, controlled trial to generate proof of concept (POC) data. Upcoming Investor Events RBC Capital Markets 2024 Global Healthcare Conference, May 15th – New York, NY Financial Highlights Cash position: As of March 31, 2024, the Company held cash and cash equivalents and investment securities of $555.7 million, compared to $617.9 million as of December 31, 2023. The Company expects cash, cash equivalents and investment securities will fund operations into the second quarter of 2027. Revenues: Revenue for the three months ended March 31, 2024 was $8.5 million, compared to $5.3 million in the same period in 2023. The net increase of $3.2 million in revenue resulted from an increase of $2.9 million from collaboration revenue and an increase of $1.2 million in license revenue partially offset by a decrease of $0.9 million from contract manufacturing of HEMGENIX® for CSL. Cost of contract manufacturing revenues: Cost of contract manufacturing revenues were $9.1 million for the three months ended March 31, 2024, compared to $2.4 million for the same period in 2023. The increase primarily relates to expensing costs previously capitalized as inventory. R&D expenses: Research and development expenses were $40.7 million for the three months ended March 31, 2024, compared to $60.8 million during the same period in 2023. The $20.1 million decrease was primarily related to an $8.1 million decrease in external spend for the ALS SOD1 program, as prior year costs included a $10.0 million one-time cost for the acquisition of the program from Apic Bio. Additionally, there was a $7.0 million decrease in preclinical and other program spend, a $2.0 million decrease in costs incurred related to preclinical supplies and a $2.7 million decrease in employee related expenses. SG&A expenses: Selling, general and administrative expenses were $13.9 million for the three months ended March 31, 2024, compared to $17.8 million during the same period in 2023. The $3.9 million decrease was primarily related to a $1.7 million decrease in professional and intellectual property fees, as well as a reduction of expenses for information technology. Other non-operating items, net: Other non-operating items, net was an expense of $10.7 million for the three months ended March 31, 2024, compared to $4.3 million for the same period in 2023. The $6.5 million increase in other non-operating items, net was primarily related to an increase in non-cash interest expense of $12.5 million related to the royalty agreement that the Company entered into in May 2023, which partially was offset by an increase of $4.8 million in interest income earned on investment securities and cash on hand. Net loss:The net loss for the three months ended March 31, 2024, was $65.6 million, or $1.36 basic and diluted loss per ordinary share, compared to $77.2 million net loss for the same period in 2023, or $1.63 basic and diluted loss per ordinary share. About uniQure uniQure’s mission is to reimagine the future of medicine by delivering innovative cures that transform lives. The recent approvals of our gene therapy for hemophilia B – a historic achievement based on more than a decade of research and clinical development – represent a major milestone in the field of genomic medicine and ushers in a new treatment approach for patients living with hemophilia. We are now leveraging our modular and validated technology and manufacturing platform to advance a pipeline of proprietary gene therapies for the treatment of patients with Huntington's disease, refractory mesial temporal lobe epilepsy, amyotrophic lateral sclerosis (ALS), Fabry disease, and other severe diseases. www.uniQure.com uniQure Forward-Looking Statements This press release contains forward-looking statements. All statements other than statements of historical fact are forward-looking statements, which are often indicated by terms such as "anticipate," "believe," "could," “establish,” "estimate," "expect," "goal," "intend," "look forward to", "may," "plan," "potential," "predict," "project," “seek,” "should," "will," "would" and similar expressions. Forward-looking statements are based on management's beliefs and assumptions and on information available to management only as of the date of this press release. Examples of these forward-looking statements include, but are not limited to, statements concerning the Company’s cash runway and its ability to fund its operations into the second quarter of 2027; the Company’s ongoing review of its operations and options to reduce expenses, the Company’s expectations that such review will lead to a strategy that, if effectively executed, will reduce operating expenses and increase shareholder value, and the expected timing of the completion of such review; the Company’s plans to announce additional follow-up data from its ongoing U.S. and European Phase I/II clinical studies of AMT-130; the Company’s plans to initiate interactions with the FDA regarding the further development of AMT-130, the timing of such interactions and expectations regarding regulatory clarity from such interactions; the Company’s plans regarding the third cohort in its AMT-130 clinical trial and the timing of enrollment for such cohort; and the Company’s plans to initiate patient enrollment for AMT-191 in the second quarter of 2024, and to initiate patient enrollment for AMT-260 and AMT-162 in the third quarter of 2024. The Company’s actual results could differ materially from those anticipated in these forward-looking statements for many reasons. These risks and uncertainties include, among others: risks associated with the clinical results and the development and timing of the Company’s programs; the Company’s interactions with regulatory authorities, which may affect the initiation, timing and progress of clinical trials and pathways to approval; the Company’s ability to continue to build and maintain the company infrastructure and personnel needed to achieve its goals; the Company’s effectiveness in managing current and future clinical trials and regulatory processes; the continued development and acceptance of gene therapies; the Company’s ability to demonstrate the therapeutic benefits of its gene therapy candidates in clinical trials; the Company’s ability to obtain, maintain and protect intellectual property; the Company’s ability to fund its operations and to raise additional capital as needed; and the impact of global economic uncertainty, rising inflation, rising interest rates or market disruptions on its business. These risks and uncertainties are more fully described under the heading "Risk Factors" in the Company’s periodic filings with the U.S. Securities & Exchange Commission (“SEC”), including its Annual Report on Form 10-K filed February 28, 2024 and in other filings that the Company makes with the SEC from time to time. Given these risks, uncertainties and other factors, you should not place undue reliance on these forward-looking statements, and the Company assumes no obligation to update these forward-looking statements, even if new information becomes available in the future. uniQure Contacts: FOR INVESTORS: FOR MEDIA: Maria E. CantorDirect: 339-970-7536Mobile: 617-680-9452m.cantor@uniQure.comChiara RussoDirect: 617-306-9137Mobile: 617-306-9137c.russo@uniQure.comTom MaloneDirect: 339-970-7558Mobile:339-223-8541t.malone@uniQure.com uniQure N.V.UNAUDITED CONSOLIDATED BALANCE SHEETS March 31, December 31, 2024 2023 (in thousands, except share and per share amounts)Current assets Cash and cash equivalents$243,062 $241,360Current investment securities 312,621 376,532Accounts receivable and contract asset 10,717 4,193Inventories 7,672 12,024Prepaid expenses 18,839 15,089Other current assets and receivables 3,092 2,655Total current assets 596,003 651,853Non-current assets Property, plant and equipment, net 44,554 46,548Operating lease right-of-use assets 27,695 28,789Intangible assets, net 59,111 60,481Goodwill 25,795 26,379Deferred tax assets, net 11,594 12,276Other non-current assets 5,298 5,363Total non-current assets 174,047 179,836Total assets$ 770,050 $ 831,689Current liabilities Accounts payable$5,231 $6,586Accrued expenses and other current liabilities 22,658 30,534Current portion of contingent consideration 27,587 28,211Current portion of operating lease liabilities 7,997 8,344Total current liabilities 63,473 73,675Non-current liabilities Long-term debt 102,120 101,749Liability from royalty financing agreement 405,398 394,241Operating lease liabilities, net of current portion 26,983 28,316Contingent consideration, net of current portion 14,625 14,795Deferred tax liability, net 7,376 7,543Other non-current liabilities 3,321 3,700Total non-current liabilities 559,823 550,344Total liabilities 623,296 624,019Shareholders' equity Total shareholders' equity 146,754 207,670Total liabilities and shareholders' equity$ 770,050 $ 831,689 uniQure N.V.UNAUDITED CONSOLIDATED STATEMENTS OF OPERATIONS Three months ended March 31, 2024 2023 (in thousands, except share and per share amounts)Total revenues$ 8,485 $ 5,325 Operating expenses: Cost of license revenues (150) — Cost of contract manufacturing revenues (9,076) (2,435)Research and development expenses (40,692) (60,809)Selling, general and administrative expenses (13,937) (17,848)Total operating expenses (63,855) (81,092)Other income 1,376 1,811 Other expense (234) (216)Loss from operations (54,228) (74,172)Non-operating items, net (10,734) (4,262)Loss before income tax (expense) / benefit$ (64,962) $ (78,434)Income tax (expense) / benefit (656) 1,207 Net loss$ (65,618) $ (77,227) Basic and diluted net loss per ordinary share$(1.36) $(1.63)Weighted average shares used in computing basic and diluted net loss per ordinary share 48,384,510 47,436,335