Slide 1: Pioneering Precision Peptides for Endocrine and Metabolic Diseases
June 12, 2026 Pioneering Precision Peptides for Endocrine and Metabolic Diseases ENDO 2026
Slide 2: Introduction
Kent Hawryluk MBX President & CEO Introduction 2
Slide 3: Disclaimer
Disclaimer This presentation includes forward looking statements. All statements other than statements of historical facts contained in this presentation, including statements regarding our product candidates, preclinical study and/or clinical trial timelines, including projected data announcements,
Slide 4: Our Mission
Our Mission Transforming the Lives of People Impacted by Endocrine and Metabolic Diseases through Precision Peptides 4
Slide 5: MBX ENDO 2026 Canvuparatide 12-week Avail & OLE Update
MBX ENDO 2026 Canvuparatide 12-week Avail & OLE Update 1 2 3 Welcome/Introductions MBX Canvuparatide Market Landscape & Kent Hawryluk, MBX Overview Opportunity President & CEO Richard DiMarchi, Ph.D., Michael T. Collins, M.D. Distinguished Professor of Endocrinologist Chemistry at Indiana Special Vo
Slide 6: MBX Proprietary PEP Platform
Richard DiMarchi, PhD MBX Scientific Co-Founder Distinguished Professor of MBX Proprietary Chemistry and Gill Chair in PEP Platform Biomolecular Sciences at Indiana University 6
Slide 7: MBX: Building on a Century of Progress in Peptide-Based Drugs
MBX: Building on a Century of Progress in Peptide-Based Drugs Eli Lilly First oral GLP-1 produces treatment for type 2 the first diabetes insulin First cancer- focused peptide therapeutics approved First rDNA-derived human 1982 parathyroid hormone for treatment of osteoporosis1 1985 The Next Frontie
Slide 8: Clinically Validated Precision Endocrine Peptide (PEP) Platform
Clinically Validated Precision Endocrine Peptide (PEP ) Platform Created by MBX and Scientific Co-Founder Richard DiMarchi, PhD INNOVATIVE PROGRAMMABLE FATTY PEPTIDE DESIGN PRODRUG ACYLATION With a goal to optimize: Designed to provide: With a goal to optimize: • Multiple mechanisms of • Gradual, co
Slide 9: Canvuparatide: Prodrug Chemically Converts to Active Drug
Canvuparatide: Prodrug Chemically Converts to Active Drug at a Precisely Controlled Rate Under Physiologic Conditions PTH Receptor CANVUPARATIDE (MBX 2109) Active drug binds to and activates PRODRUG the PTH receptor C Fatty acids (FA) facilitate A binding to albumin ACTIVE DRUG Biologically active p
Slide 10: Hypoparathyroidism Market Landscape
Michael T. Collins, M.D. Endocrinologist Special Volunteer and Senior Hypoparathyroidism Clinical Advisor at the National Market Landscape Institutes of Health 10
Slide 11: Hypoparathyroidism (HP) is a Serious Chronic Condition
Hypoparathyroidism (HP) is a Serious Chronic Condition Symptoms Hypocalcemia, cramping, paresthesia, tetany, seizures, arrhythmias, and kidney disease, neurocognitive deficits (“brain fog”), depression, Presentation increase in major adverse cardiac events Hypoparathyroidism Typical Onset Main cause
Slide 12: Chronic HP Affects Thousands of Patients Worldwide
Chronic HP Affects Thousands of Patients Worldwide + Majority (~75%) of patients are Prevalence Annual Incidence post-surgical Majority post- >250K >7K surgical patients in US and EU1 in US and EU2,3 diagnosed within months of surgery Large population with increased healthcare utilization in need of
Slide 13: Patients with Chronic HP have a Significant Disease Burden
Patients with Chronic HP have a Significant Disease Burden Symptoms Can Be Debilitating “If I go without my meds, I will be dead Pill Burden in days. If I skip/miss calcium, I will be Taking Daily in the ED in 12 hours.” - Chronic HP Patient (conventional therapy) Supplements • 10-30+ pills a day Is
Slide 14: Yorvipath Uptake Validates Need; Significant Gaps Remain
Yorvipath® Uptake Validates Need and Acceptance of Injectable PTH Replacement Therapy; But Significant Gaps Remain Daily Anxiety About Continued Injection Fatigue Missing Daily Dose Symptoms Daily injections lead to Patients worry about Many patients continue to injection fatigue and the risk disrup
Slide 15: Canvuparatide Demonstrated Positive Results in Phase 2
Canvuparatide Demonstrated Positive Results in Phase 2 Phase 3 Initiating in Q3’26 Phase 2 Phase 3 Clear registrational path with endpoints that matter to physicians and payers Demonstrated compelling efficacy across Normalization of serum calcium, and comorbidities related to PTH deficiency indepen
Slide 16: Once-Weekly Canvuparatide Potential New Standard of Care
Once-Weekly Canvuparatide has the Potential to be the New Standard of Care for Patients with Chronic HP In market research… Canvuparatide Potential (to be proven in Ph3 study) PTH-Naïve PTH-Treated Patients Patients First once-weekly PTH replacement therapy HCPs would make HCPs would HCPs canvuparat
Slide 17: In Summary
In Summary…. 1 Chronic HP is a damaging disease affecting >250K patients across US and EU 2 Yorvipath® uptake validates need/acceptance of PTH replacement; significant gaps remain 3 Once-weekly canvuparatide has the potential to set a new standard for treating chronic HP 4 The majority of HCPs and p
Slide 18: Canvuparatide One-Year OLE Results
Sam Azoulay, M.D. MBX Chief Medical Officer Canvuparatide One-Year OLE Results 18
Slide 19: Phase 2 and OLE Study: Trial Design and Endpoints
Phase 2 and OLE Study: Trial Design and Endpoints 12-Week Trial and 2-Year Open-Label Extension Study Design Screening & Optimization Treatment Period: 12 weeks Open-Label Extension (Ongoing): 2 years Period 4- Week Fixed Dose 8-Week Dose Treatment Period Adjustment Period 400 μg QW (n=16) Titrate C
Slide 20: Baseline Characteristics: Representative of HP Population
Baseline Characteristics: Representative of HP Population and Well Balanced Canvuparatide Placebo Canvuparatide Placebo Characteristics (n = 48) (n = 16) Characteristics (n = 48) (n = 16) Age, years, median (range) 49.0 (23–72) 44.5 (19–63) Etiology of HP, n (%) Female, n (%) 41 (85.4) 15 (93.8) Pos
Slide 21: Patient Disposition
Patient Disposition Canvuparatide Canvuparatide Canvuparatide Placebo 400 μg QW 600 μg QW 800 μg QW n = 16 n = 16 n = 16 n = 16 Avail (Parent Study) Completed Parent 100% of patients completed the Study Avail 12-week study n = 64 Enrolled in OLE Study 94% of patients continued into the OLE N = 60 OL
Slide 22: Primary Composite Endpoint and Components at 1 Year (OLE)
Primary Composite Endpoint and Components at 1 Year (OLE) 12-Week Study 1 Year (OLE) Canvuparatide Canvuparatide1 Parameter, n (%) (n = 48) (n = 54) Proportion of Patients Meeting Response Criteria 30 (63%)2,3 31 (57%)3 (Responders) (CI: 44-71%) Proportion of patients meeting each component of respo
Slide 23: Once-Weekly Canvuparatide Demonstrated Competitive Responder Rates
Once-Weekly Canvuparatide Demonstrated Competitive Responder Rates in the Phase 2 Avail Trial and OLE Once-Weekly Canvuparatide Once-Daily Yorvipath® Phase 2 Responder Rates Phase 2 Responder Rates1, 2 1/week 7/week 79% 63% 71% 63% 57% 50% 12 Week Tx 6 Month Tx 1 Year Tx 4 Week Tx 6 Month Tx 1 Year
Slide 24: Pharmacokinetics and Serum Calcium Profile Support Once-Weekly Dosing
Pharmacokinetics and Serum Calcium Profile Continue to Support Once-Weekly Dosing Phase 2 Phase 2 Pharmacodynamics Pharmacokinetics (Serum AdjCa Over Time*) (Drug Exposure) PK in chronic HP patients demonstrated consistent concentration of canvuparatide active drug with a Tmax of 2-3 days, minimal f
Slide 25: Once-Weekly Canvuparatide Reduced 24h Urine Calcium Through 1 Year
Once-Weekly Canvuparatide Reduced 24h Urine Calcium While Maintaining Stable Serum Calcium Through 1 Year Mean 24-Hour Urine Calcium Mean Serum Calcium Over Time 350 12.0 Avail Study OLE Avail Study OLE Avail Study OLE 300 11.0 ULN Mean (SE) Serum AdjCa Mean (SE) 24-Hour Urine 250 Calcium Levels, mg
Slide 26: Urine Calcium Continued to Decrease in Elevated Baseline Patients
In Patients With Elevated Baseline Urine Calcium, Urine Calcium Continued to Decrease Through 1 Year Mean 24-Hour Urine Calcium 500 Avail Study OLE Avail Study OLE 450 400 Mean (SE) 24-Hour Urine Calcium Levels, mg/day 350 300 ULN 250 200 426 367 150 255 229 100 188 50 106 0 n= 19 19 16 6 6 5 Baseli
Slide 27: Once-Weekly Canvuparatide Demonstrated Expected Effects of PTH in the Kidney
Once-Weekly Canvuparatide Demonstrated Expected Effects of PTH in the Kidney Change from Baseline at 1 Year (OLE)a Canvuparatide Parameter, Mean (SE) (n = 54) Phosphate, mg/dL –0.4 (0.1) Calcium-phosphate product, mg2/dL2 –5.9 (0.8)b 1,25-Dihydroxyvitamin D3, ng/L 3.5 (3.6) Estimated glomerular filt
Slide 28: Canvuparatide Restored Bone Metabolism
Canvuparatide Restored Bone Metabolism C-Terminal Telopeptide of Type 1 Collagen (CTx) Procollagen Type 1 N-Terminal Propeptide (P1NP) Avail OLE Study Avail OLE Study 1600 300 Mean (SE) P1NP Levels, μg/L Study Study Mean (SE) CTx Levels, ng/L 1400 250 1200 200 1000 800 150 600 100 400 50 200 0 0 W0
Slide 29: BMD Changes Consistent with Restored Bone Metabolism
BMD Changes Were Consistent with Restored Bone Metabolism and Remained Within the Normal Range Lumbar Spine Femoral Neck Avail Study OLE Study Avail Study OLE Study 4 4 Mean (SE) BMD Mean (SE) BMD 2 2 Z-Scores Z-Scores 0 0 -2 -2 -4 -4 Total Hip Radius (Forearm 1/3) Avail Study OLE Study Avail Study
Slide 30: Immunogenicity to Canvuparatide Was Minimal
Immunogenicity to Canvuparatide Was Minimal Canvuparatide Patients With Treatment-Induced ADAs, n (%) ADA to Canvuparatide ADA to Active Peptide Week 12 (Avail parent trial) 0 0 Week 60 (OLE week 48) 1/59 (1.7)* 0 ADA: anti-drug antibodies 30 * Low titer.
Slide 31: OLE: Treatment Emergent Adverse Events and AESI
OLE: Treatment Emergent Adverse Events and Adverse Events of Special Interest TEAE, n (%) Canvuparatide (n = 60) TEAE 48 (80.0) Mild 22 (36.7) Moderate 23 (38.3) Severe 3 (5.0) Treatment-related TEAE 23 (38.3) SAE 5 (8.3) Treatment-related SAEs 0 TEAE leading to discontinuation 3 (5.0) Deaths 0 AESI
Slide 32: One-Year Data Demonstrate Sustained Benefit of Once-Weekly Canvuparatide
One-Year Data Demonstrate Sustained Benefit of Once-Weekly Canvuparatide as a Potential PTH Replacement Therapy in Chronic HP • Results consistent with restoration of systemic PTH activity through serum calcium normalization, reduction of urine calcium excretion, restoration of bone metabolism and i
Slide 33: Phase 3 Trial Design and Endpoints for Once-Weekly Canvuparatide
Phase 3 Trial Design and Endpoints for Once-Weekly Canvuparatide 26-Week Double-blind Placebo-Controlled Trial followed by a 78-Week Open-Label Extension Treatment Period: 26 weeks Open-Label Extension: 78 weeks 4- Week Fixed Dose 18-Week Dose 4-Week Dose Treatment Period Adjustment Period Maintenan
Slide 34: Conclusion
Kent Hawryluk MBX President & CEO Conclusion 34
Slide 35: Once-Weekly Canvuparatide: Paving the Way for a Potential New Standard of Care
Once-Weekly Canvuparatide: Paving the Way for a Potential New Standard of Care in Chronic HP • One-year OLE data support canvuparatide as a once-weekly PTH replacement therapy • Market research indicates majority of HCPs and patients would choose once weekly first • Phase 3 trial preparations underw
Slide 36: MBX: Catalyst-Rich Year
MBX: Catalyst-Rich Year Anticipated Program Milestone Timing End-of-Phase 2 FDA Meeting Canvuparatide (MBX 2109) Avail Phase 2 presentation and one-year OLE data ENDO 2026 Phase 3: Initiation Q3 2026 MBX 4291 (GLP-1/GIP) Phase 1: 12-week MAD results Q4 2026 MBX 5765 (amycretin) Nominate development
Slide 37: Our Mission
Our Mission Transforming the Lives of People Impacted by Endocrine and Metabolic Diseases through Precision Peptides 37