Keros Therapeutics, Inc. · NASDAQ:KROS

Keros Therapeutics — Technical Presentation (November 2021)

14 slides from Keros Therapeutics's technical presentation, Nov 14, 2021

  1. Slide 1: KER-012 Attenuated Cardiac Pathology in a Pulmonary Arterial Banding Model

    KER-012, a Novel Modified ActRII Ligand Trap, Attenuated Cardiac Pathology in a Pulmonary Arterial Banding Model of Right Ventricle Overload Keith Babbs, Chris Materna, ffolliott Fisher, Jasbir Seehra, Jennifer Lachey Keros Therapeutics, Inc. Lexington, MA, USA 14 November 2021| CONFIDENTIAL

  2. Slide 2: Disclosures

    Disclosures Keith Babbs, Chris Materna, ffolliott Fisher, Jasbir Seehra, and Jennifer Lachey are employees and stockholders of Keros Therapeutics, Inc.

  3. Slide 3: Overview: Pulmonary Arterial Hypertension (PAH)

    Overview: Pulmonary Arterial Hypertension (PAH) • Debilitating disorder with an estimated prevalence of 10,000 to 20,000 cases in the U.S. (Prins 2016, Wijeratne 2018) • Driven by pulmonary endothelial dysfunction and vascular remodeling leading to increased wall thickening and resistance to blood f

  4. Slide 4: Overview: PAH and TGF-b signaling

    Overview: PAH and TGF-b signaling • In healthy vasculature, homeostasis is achieved by balanced signaling through SMAD1/5/9 and SMAD2/3, the canonical signaling proteins for the TGF-b superfamily. • PAH has been associated with dysregulated TGF-b signaling, favoring signaling through SMAD2/3 (Machad

  5. Slide 5: Rebalancing Signaling

    Rebalancing Signaling • Increasing SMAD1/5/9 signaling or decreasing SMAD2/3 signaling may restore homeostasis. • Promoting SMAD1/5/9 by administration of BMP9 reversed RV and pulmonary dysfunction in models of PAH (Long 2015). • Inhibition of TGF-b2 and 3 by administration of TGFbRII-Fc reduced PAH

  6. Slide 6: ActRII Ligand Traps Affect Bone, Vasculature, and Erythropoiesis

    ActRII Ligand Traps Affect Bone, Vasculature, and Erythropoiesis • Signaling through SMAD1/5/9 and SMAD2/3 are known to regulate multiple systems, including bone, vasculature and erythropoiesis (Zhang 2017, Itoh 2012, Blank 2011, Song 2009). • Acceleron has disclosed that Sotatercept (ActRIIA-Fc) ha

  7. Slide 7: Research Questions

    Research Questions • Are the effects on bone, RBC and vasculature dependent on one another (i.e., can you have a therapeutic with more selective biology)? KER-012 is an investigational, modified ActRIIB ligand trap designed to inhibit SMAD2/3. Keros has previously demonstrated in preclinical studies

  8. Slide 8: Pulmonary Arterial Banding (PAB)

    Pulmonary Arterial Banding (PAB) RKER-012, a research form of KER-012, was evaluated in the PAB model to evaluate its effect on dysfunction resulting from RV overload • PAB increases RV pressure by mechanically restricting blood flow through the pulmonary artery. • 8 w.o. male C57Bl/6 mice (n=14-16/

  9. Slide 9: PAB Increased PAP was confirmed in all PAB groups

    PAB Increased PAP was confirmed in all PAB groups, verifying pressure overload Initial Final Values depicted are mean + SEM. ****p<0.0001 vs. Sham Initial; ##p<0.01, ####p<0.0001 vs. Sham Final

  10. Slide 10: RKER-012 treatment resulted in improved cardiac dysfunction

    RKER-012 treatment resulted in improved cardiac dysfunction End Systolic Pressure- Myocardial Volume Relationship Performance Index PAB induced cardiac dysfunction: • Increased ESPVR • Increased MPI RKER-012 decreased ESPVR and MPI. Values depicted are mean + SEM. ***p<0.001; ****p<0.0001 vs. Sham;

  11. Slide 11: RKER-012 decreased cardiac remodeling

    RKER-012 decreased cardiac remodeling Fulton Index RV Free Wall Thickness SHAM PAB+VEH PAB+ RKER-012 PAB induced cardiac remodeling: • Increased Fulton Index • Increased RV free wall thickness RKER-012 decreased Fulton Index and RV free wall thickness. Values depicted are mean + SEM. ****p<0.0001 vs

  12. Slide 12: RKER-012 decreased cardiac fibrosis

    RKER-012 decreased cardiac fibrosis Cardiac Fibrosis SHAM PAB+VEH PAB + RKER-012 Fibrotic Tissue • PAB induced formation of fibrotic tissue. • RKER-012 decreased cardiac fibrotic tissue. Values depicted are mean + SEM. ****p<0.0001 vs. Sham; ##p<0.01 vs. PAB + Vehicle

  13. Slide 13: KER-012 Did Not Affect Hemoglobin or Red Blood Cells in Non-human Primates

    KER-012 Did Not Affect Hemoglobin (HGB) or Red Blood Cells (RBC) in Non-human Primates • As discussed earlier, ActRII ligand traps have also been demonstrated to have pro- erythropoietic effects in humans, an effect which could be dose limiting in non- erythropoiesis-related diseases • Ligand traps

  14. Slide 14: Summary/Conclusions

    Summary/Conclusions • KER-012 is an investigational modified ActRIIB ligand trap designed to inhibit ligands that signal through SMAD2/3 to promote restoration of vascular homeostasis. • In a PAB model of RV pressure overload, RKER-012 showed direct cardiac benefit by decreasing: • Cardiac dysfuncti

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