Zealand Pharma A/S : Q1 Financial Results / Interim Report First Quarter 2026

About this update from Zealand Pharma A/s

Q1 2026 Presentation • Zealand Pharma May 7, 2026 Agenda Q&A Opening remarks R&D pipeline Financials Adam Steensberg Chief Executive Officer David Kendall Chief Medical Officer Henriette Wennicke Chief Financial Officer 3 Executing on the commitments we made in December Opening remarks Significant advancements delivered since start of 2026 Petrelintide Positive ZUPREME-1 topline results, demonstrating double-digit weight loss and placebo-like tolerability profile Confirmed advancement into Phase 3 registrational trials in H2 2026 Early pipeline Positive Phase 1a SAD topline results with Kv1.3 inhibitor (ZP9830) Announced establishment of new research hub in Cambridge and entered agreement with DCAI to access a leading AI supercomputer Survodutide Positive SYNCHRONIZE TM -1 results delivering competitive weight loss and potential for sustained improvements in metabolic health Capital allocation Initiated USD 200 million share buy-back program Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally 5 Petrelintide has potential to redefine the weight management experience Potential first choice treatment option setting a new standard for what to expect from a weight management journey Petrelintide/enicepatide (CT-388) (GLP-1/GIP) for people who need greater weight loss and/or better glycemic control 50/50 profit sharing on both monotherapy and combination USD 700m in milestone payments expected in 2026 a USD 575m of the total USD 1,225m in development milestones USD 125m of the total USD 250m in anniversary payments a Zealand Pharma will pay Roche USD 350 million in four installments throughout 2026-2027 for the contribution of CT-388 in the first combination product arising from the collaboration. 6 x Equal partnership with co-development and co-commercialization Opening remarks Executing on our strategy to establish leadership in obesity and metabolic health Redefining the near-term future of weight management Expanding capabilities to enhance our pipeline METABOLIC FRONTIER 2030 Two mid- to late-stage candidates Leading programs backed by strong partners Leverage internal metabolic health expertise Partnerships for external innovation Petrelintide a Survodutide b Cambridge, MA. research hub Danish Centre for AI Innovation 5 launches +10 clinical programs #1 in cycle times from idea to clinic a Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. b Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. 7 Opening remarks Significant pipeline progress and several Phase 2/3 clinical readouts remaining in 2026 Building the pipeline of the future ZP9830 (Kv1.3) Results from Ph1a SAD and MAD, and clinical advancement Progress pre-clinical programs at accelerated speed Establish Boston research site Partnerships to evolve and fuel platform Survodutide b (GCGR/GLP-1R) Results from Ph3 obesity program SYNCHRONIZE TM -1 SYNCHRONIZE TM -2 SYNCHRONIZE TM -CVOT SYNCHRONIZE TM -MASLD Petrelintide a (amylin analog) Results from Ph2 ZUPREME-1 Results from Ph2 ZUPREME-2 Initiation of Phase 3a program Initiation of Ph2 with petrelintide/CT-388 NON-EXHAUSTIVE Executing on rare disease programs Dasiglucagon for CHI: U.S. regulatory submission Glepaglutide for SBS: Progression of Ph3 EASE-5 trial a Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. b Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. CGCR=glucagon receptor; GLP-1R=glucagon-like peptide-1 receptor; CVOT=cardiovascular outcomes trial; MASLD=metabolic dysfunction-associated steatotic liver disease; SAD=single ascending dose; MAD=multiple ascending dose; CHI=congenital hyperinsulinism; SBS=short bowel syndrome. 8 R&D pipeline Clinical pipeline: Five launches by 2030 INDICATION PRODUCT CANDIDATE a PRE-CLINICAL PHASE 1 PHASE 2 PHASE 3 REGISTRATION Obesity +/- T2D Petrelintide b amylin analog H2 2026 Obesity +/- T2D Petrelintide/enicepatide b amylin/GLP-1/GIP H1 2026 Obesity +/- T2D Survodutide c GCGR/GLP-1R dual agonist MASH (F2/F3 + F4) Survodutide c GCGR/GLP-1R dual agonist Obesity Dapiglutide GLP-1R/GLP-2R dual agonist paused Obesity ZP6590 GIP receptor agonist 2026 Congenital hyperinsulinism Dasiglucagon SC continuous glucagon infusion H2 2026 Short bowel syndrome Glepaglutide GLP-2 analog Inflammation ZP9830 Kv.1.3 ion channel blocker a Investigational compounds whose safety and efficacy have not been evaluated or approved by the U.S. Food and Drug Administration (FDA) or any other regulatory authority. b Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. c Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. GCGR=glucagon receptor; GIP=gastric inhibitory polypeptide; GLP-1R=glucagon-like peptide-1 receptor; GLP-2R=glucagon-like peptide-2 receptor; MASH=metabolic dysfunction-associated steatohepatitis; SC=subcutaneous; T2D=type 2 diabetes. 9 R&D pipeline Phase 3 trials with petrelintide to initiate this year Phase 2 results showed double-digit weight loss with placebo-like tolerability Phase 2 ZUPREME-1 results (Petrelintide DG3) Double-digit weight loss at 42 weeks 98% of participants escalated to targeted maintenance dose No participant discontinued treatment due to GI AEs ~70% of participants did not report any GI AE Advancing to Phase 3 registrational trials in H2 2026 Pbo-adj. % of participants 80% of events were mild 16.7% Additional ZUPREME-1 data at ADA <0.0% 1.0% 2.3% Nausea Vomiting Diarrhea Constipation Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Source: Data on file. 10 R&D pipeline In Phase 3 trial, survodutide delivered competitive weight loss and meaningful metabolic improvements Survodutide holds potential as a differentiated therapy for people living with obesity or overweight, delivering competitive weight loss with the potential to directly support liver function SYNCHRONIZE TM -1: Overweight/obesity without T2D 2 Baseline characteristics 3 : Female: 59%, Body weight:109 kg, BMI: 38 kg/m 2 Survodutide 6.0 mg QW Survodutide 3.6 mg QW Up to 16.6% weight loss after 76 weeks of treatment with survodutide (vs. 3.2% in placebo arm) a Initial analyses indicate that body weight reduction predominantly driven by loss of fat tissue Delivered statistically significant reduction in waist circumference - clinical marker closely linked to visceral fat and cardiometabolic risk Week Placebo QW 0 Dose escalation 24 76 Follow 79 up GI AEs were the most commonly reported side effects with no new safety concerns observed outside of what is expected for GLP-1 class Primary endpoints: Body weight change (%) at week 76, Body weight reduction ≥5% from baseline to week 76 Full SYNCHRONIZE TM -1 data at ADA in June Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. a Using the efficacy estimand, the estimated treatment effect assuming patients remained on treatment for the entire study duration. Sources: 1 Zealand Pharma Company Announcement No. 10/2026, April 28, 2026; 2 Wharton et. al, Obesity Silver Spring 2024;33(1):67-77 (adapted with permission from Wiley); 3 Le Roux et al. Diabetes Obes Metab 2025; doi: 10.1111/dom.70196 11 R&D pipeline Results from the Phase 3 SYNCHRONIZE TM program may pave the way for regulatory submissions in 2026 Large, global Phase 3 program in obesity SYNCHRONIZE TM -1 1 : Overweight/obesity w/o T2D (N=725) SYNCHRONIZE TM -2 2 : Overweight/obesity with T2D (N=~750) SYNCHRONIZE TM -CVOT 3 : Long-term CV safety in patients with ADA - June 7, 2026 obesity and established CVD/CKD or risk factors for CVD (N=~5,500) SYNCHRONIZE TM -MASLD 4 : Overweight/obesity with confirmed or We expect Phase 3 data from key trials in the SYNCHRONIZE program to be presumed MASH (N=~250) ADA - June 7, 2026 reported and presented in detail at scientific meetings throughout 2026 SYNCHRONIZE TM -JP 5 : In Japanese participants (N=~270) SYNCHRONIZE TM -CN 6 : In Chinese participants (N=~300) Boehringer Ingelheim could be the third company to market in the U.S. and Europe in this new era of therapies for chronic weight management - with a first-in-class glucagon/GLP-1 receptor dual agonist Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. Sources: 1 ClinicalTrials.gov (NCT06066515); 2 ClinicalTrials.gov (NCT06066528); 3 ClinicalTrials.gov (NCT06077864); 4 ClinicalTrials.gov (NCT06309992); 5 ClinicalTrials.gov (NCT06176365); 6 ClinicalTrials.gov (NCT06214741). CKD=chronic kidney disease; CV=cardiovascular; CVD=cardiovascular disease; GLP-1=glucagon-like peptide-1; MASLD=metabolic dysfunction-associated liver disease; MASH=metabolic dysfunction-associated steatohepatitis; T2D=type 2 diabetes. 12 Financials Q1 2026 Profit & Loss Q1 2026 OPEX composition a DKK million P&L reflecting strategic investments in differentiated R&D assets and organization 82 (14%) 22 (4%) 469 (82%) Research and Development Sales and Marketing General and Administrative DKK million Q1 2026 Q1 2025 Revenue 34 8 Gross profit 34 8 Research and development expenses -469 -291 Sales and marketing expenses -22 -37 General and administrative expenses -82 -65 Other operating items - -22 a Net operating expenses -573 -415 Operating result -539 -407 Net financial items 145 70 Result before tax -394 -337 Tax - 1 Net result for the period -394 336 a Other operating items of DKK 22 million in Q1 2025 consist of transaction-related costs associated with the Roche partnership agreement. 13 Financials Financial muscle to deliver on Metabolic Frontier 2030 strategy 16000 14000 15,109 -672 31 14,468 Total milestones of USD 700 million from Roche in 2026 c Cash position (DKK million) a 12000 10000 8000 6000 4000 2000 1,633 9,022 Executing on key strategic priorities and more: Maximize the value of petrelintide Invest significantly in early-stage research pipeline Inorganic investments to enhance R&D capabilities USD 200 million share buy-back program 0 2023 2024 b 2025 b CF from operations Other cash adjustments March 31, 2026 a Cash position includes cash, cash equivalents and marketable securities; b EIB loan Tranches B and C (EUR 20 million each) are excluded from this chart. The two tranches are subject to pre-specified milestones being met; c Milestone payments expected in 2026 include USD 575 million linked to the initiation of Phase 3 trials with petrelintide monotherapy, and an anniversary payment of USD 125 million. Zealand Pharma will pay Roche USD 350 million in four installments throughout 2026-2027 for the contribution of CT-388 in the first combination product arising from the collaboration. 14 Financials 2026 financial outlook DKK billion 2026 Guidance as of May 7, 2026 2026 Guidance as of February 19, 2026 2025 Actuals Collaboration revenue 4.5 b No guidance 9.2 Net operating expenses excl. OOI a 2.7-3.3 2.7-3.3 2.1 a Net operating expenses consist of R&D, S&M, and G&A; b Includes a development milestone payment of USD 575 million from Roche that is linked to Phase 3 initiation with petrelintide monotherapy and an anniversary payment of USD 125 million. Financial guidance based on foreign exchange rates as of May 6, 2026. 15 Concluding remarks 2026 transformational milestones shaping long-term value creation H1 2026 H2 2026 NON-EXHAUSTIVE Petrelintide/enicepatide (CT-388) Initiation of Phase 2 Petrelintide Topline results from Phase 2 ZUPREME-2 Petrelintide ZUPREME-1 data at ADA Petrelintide Initiation of Phase 3 program Survodutide Topline results from SYNCHRONIZE TM -2 and SYNCHRONIZE TM -CVOT Survodutide Full data from SYNCHRONIZE TM -1 and -MASLD at ADA ZP9830 (Kv1.3 ion channel blocker) Topline results from Phase 1a trial (MAD) ZP9830 (Kv1.3 ion channel blocker) Initiation of Phase 1b/2a trial Dasiglucagon for CHI U.S. regulatory submission Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally. ADA=American Diabetes Association; CVOT=cardiovascular outcomes trial; MASLD=metabolic dysfunction-associated steatotic liver disease; MAD=multiple ascending dose; SAD=single ascending dose; CHI=congenital hyperinsulinism. 16 Q&A Zealand Pharma upcoming investor conferences Berenberg Healthcare Conference, New York, May 19 Jefferies Global Healthcare Conference, New York, June 3 Goldman Sachs 47 th Annual Global Healthcare Conference, June 9 SEB Summer Seminar, Copenhagen, June 17 J.P. Morgan European Healthcare Forum, London, June 18 17 Attention : This is an excerpt of the original content. To continue reading it, access the original document here .

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