Company announcement - No. 9 / 2024

Zealand Pharma Announces Financial Results for the Full Year 2023

Significant progress delivered across our obesity and rare disease assets while building a solid financial position

Positive results achieved for petrelintide in 6-week Phase 1 trial and clinical advancement of dapiglutide and petrelintide towards obesity data readouts in 2024
Positive results announced in Boehringer Ingelheim Phase 2 clinical trials for survodutide in obesity and global Phase 3 clinical program in obesity initiated
NDA submissions for dasiglucagon in congenital hyperinsulinism and glepaglutide in short bowel syndrome expected to support regulatory decisions for rare diseases in 2024
Private placement of shares to institutional investors, European Investment Bank loan facility, undrawn committed RCF and milestone payments from existing partners contribute to strengthened financial position

Events after the reporting period

Positive results announced in Boehringer Ingelheim Phase 2 clinical trial for survodutide in MASH and private placement of shares to institutional investors contribute to extended cash runway into 2027

Copenhagen, Denmark, February 27, 2024 – Zealand Pharma A/S (NASDAQ:ZEAL) (CVR-no. 20045078), a biotechnology company focused on the discovery and development of innovative peptide-based medicines, today announced the annual report for the year ended December 31, 2023, and provided a corporate update.

Building momentum in 2024

"2023 was an extraordinary year for Zealand and I am proud of our team's performance to progress our business," said Adam Steensberg, President and Chief Executive Officer at Zealand Pharma. "With the promising results for our long-acting amylin analog, petrelintide, and the advancement of our dual GLP-1/GLP-2 receptor agonist, dapiglutide, in obesity, Zealand is well positioned to achieve significant milestones in 2024. We look forward to important clinical results for petrelintide and dapiglutide in obesity that we believe will support advancing both compounds into subsequent Phase 2b trials, and to progressing our rare disease product candidates through the regulatory phase to patients who need them."

Key financial results for FY 2023

DKK million	FY 2023	FY 2022
Revenue	342.8	104.0
Net operating expenses¹	-895.9	-941.1
Net operating result	-572.2	-837.2
Net financial items	-136.6	-134.9
Cash position²	1,633.1	1,177.8
Cash position including undrawn committed RCF³, EIB⁴ loan facility (Tranche A, B and C) and January 2024 private placement⁵	4,104.0	1,177.8
Notes: Net operating expenses consist of R&D, S&M, G&A and other operating items. Cash position includes cash, cash equivalents and marketable securities. RCF = Revolving Credit Facility of DKK 350 million provided by Danske Bank. EIB = European Investment Bank. The conditions for Tranche A (EUR 50 million) have been met. Pay-out expected in Q1 2024. Tranche B (EUR 20 million) and Tranche C (EUR 20 million) are subject to predefined milestones being met. In January 2024, Zealand received gross proceeds of DKK 1.45 billion in connection with a private placement of new shares.

Maintaining a strong financial position.

Revenue in 2023 of DKK 343 million was mainly driven by a EUR 30 million milestone payment from Boehringer Ingelheim associated with survodutide and USD 10 million from a milestone payment from Sanofi associated with lixisenatide.
Cash position is DKK 4.1 billion including the undrawn committed RCF, the EIB loan facility (tranche A, B and C) and the January 2024 private placement of DKK 1.45 billion. Cash, cash equivalents and marketable securities as of December 31, 2023, was DKK 1.6 billion, including gross proceeds of DKK 1.5 billion from a directed issue and private placement in April 2023.
Under the current assumptions Zealand projects its existing financial resources will be sufficient to fund operations into 2027.

Financial guidance for 2024

The solid financial situation enables Zealand to expand its investments in the company's wholly owned obesity assets and continue investing in progressing the rare disease product candidates through the regulatory phase while engaging in partnership discussions.

DKK million	2024 Guidance	2023 Actual
Revenue anticipated from existing and new license and partnership agreements	No guidance due to uncertain size and timing	343
Net operating expenses⁵	1,100-1,200	896
Notes: 5. Financial guidance based on foreign exchange rates as of February 26, 2024.

Recent R&D highlights and key events anticipated in 2024

Obesity – advancing the portfolio

Petrelintide, a long-acting amylin analog. At Obesity Week in November 2023, Zealand presented results from Part 1 of the Phase 1b MAD trial (NCT05613387), in which low doses of up to 1.2 mg petrelintide administered once weekly for six weeks led to reductions in body weight of up to 5.3% in healthy lean and overweight participants (mean body weight of 82 kg and BMI of 25.4). Petrelintide was well tolerated in the trial with a mostly mild adverse event profile. In the first half of 2024, Zealand expects to report topline results from Part 2 of the MAD trial designed to evaluate higher doses of petrelintide administered for 16 weeks in participants with overweight or obesity (eligible BMI 27.0–39.9). In parallel, Zealand is planning a Phase 2b trial of petrelintide planned for initiation in the second half of 2024.
Dapiglutide, a first-in-class GLP-1/GLP-2 receptor dual agonist: In the first half of 2024, Zealand anticipates topline results from the Phase 2a investigator-led DREAM trial (NCT05788601) designed to evaluate the potential for weight loss following 12 weeks of treatment with dapiglutide and gain key mechanistic insights into effects on inflammatory markers. In the second half of 2024, Zealand expects topline results from the Phase 1b 13-week dose titration trial (NCT06000891) designed to evaluate dapiglutide in otherwise healthy participants with overweight or obesity (eligible BMI 27.0–39.9). In this trial, higher maximum maintenance doses are planned than were used in the prior 4-week MAD trial and ongoing DREAM trial.
Survodutide, a glucagon/GLP-1 receptor dual agonist. In February 2024, Boehringer Ingelheim and Zealand Pharma announced positive results from the Phase 2 trial of survodutide in metabolic dysfunction-associated steatohepatitis (MASH), previously known as nonalcoholic steatohepatitis (NASH). The topline results showed that up to 83.0% of adults treated with survodutide achieved a biopsy-proven improvement in MASH (stages F1, F2 and F3) after 48 weeks, versus 18.2% with placebo [response difference: 64.8% (CI 51.1% - 78.6%), p-value (p<0.0001)]. Boehringer expects to present these results at a scientific congress in the first half of 2024. In a Phase 2 trial in people living with overweight or obesity, survodutide achieved up to 18.7% mean weight loss from baseline after 46 weeks. The full data were presented at the 2023 American Diabetes Association's (ADA) 83rd Scientific Sessions. Boehringer is currently evaluating survodutide in Phase 3 clinical trials, including SYNCHRONIZE™-1 and SYNCHRONIZE™-2, enrolling people living with overweight or obesity without and with type 2 diabetes, respectively, and SYNCHRONIZE™-CVOT, a long-term cardiovascular safety trial in people living with overweight or obesity with cardiovascular disease, chronic kidney disease or with risk factors for cardiovascular disease.

Rare diseases – progressing towards patients

Dasiglucagon in congenital hyperinsulinism (CHI). In the first half of 2024, Zealand expects to resubmit the New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for the prevention and treatment of hypoglycemia in pediatric patients seven days of age and older with CHI for up to three weeks of dosing. The resubmission is in response to a Complete Response Letter issued by the FDA in December 2023 related to deficiencies identified at a third-party manufacturing facility that are not specific to dasiglucagon. Also in the first half of 2024, to support use of dasiglucagon beyond three weeks, the company plans to submit additional analyses, requested by the FDA, from existing continuous glucose monitoring (CGM) datasets that were included as a secondary outcome measure in the Phase 3 program. Zealand plans to make dasiglucagon available to healthcare professionals and patients upon regulatory approval and expects to identify a partner for future commercialization.
Glepaglutide in short bowel syndrome (SBS). In December 2023, Zealand submitted an NDA to the U.S. FDA for the treatment of adult patients with SBS dependent on parenteral support. The company expects to receive notification of a PDUFA date in the coming weeks following acceptance of the filing. Zealand anticipates identifying a partner for future commercialization of glepaglutide.

Chronic inflammation – initiating first-in-human trials

ZP10068, Complement Inhibitor. As part of the discovery and development collaboration with Alexion, Zealand has completed pre-clinical and CMC activities for the investigational long-acting complement inhibitor. Subsequent regulatory, clinical and development efforts will be led and conducted by Alexion.
ZP9830, Kv1.3 Ion Channel Blocker. Zealand expects to initiate first-in-human clinical trials in 2024.

Conference call today at 2 PM CET / 8 AM ET

Zealand's management will host a conference call today at 2:00 PM CET / 8:00 AM ET to present results for the full year 2023 followed by a Q&A session. Participating in the call will be Chief Executive Officer, Adam Steensberg; Chief Financial Officer, Henriette Wennicke; and Chief Medical Officer, David Kendall. The conference call will be conducted in English.

The live listen-only audio webcast of the call and accompanying slide presentation will be accessible at https://edge.media-server.com/mmc/p/6jgd3v24. To receive telephone dial-in information and a unique personal access PIN, please register at https://register.vevent.com/register/BI7cc2120bbf334442986b5bd9d320475a. Participants are advised to register for the call or webcast approximately 10 minutes before the start. A recording of the event will be available following the call on the Investor section of Zealand's website at https://www.zealandpharma.com/events/.

About Zealand Pharma A/S

Zealand Pharma A/S (NASDAQ:ZEAL) ("Zealand") is a biotechnology company focused on the discovery and development of peptide-based medicines. More than 10 drug candidates invented by Zealand have advanced into clinical development, of which two have reached the market and three candidates are in late-stage development. The company has development partnerships with a number of pharma companies as well as commercial partnerships for its marketed products.

Zealand was founded in 1998 and is headquartered in Copenhagen, Denmark, with a presence in the U.S. For more information about Zealand's business and activities, please visit www.zealandpharma.com.

Forward-Looking Statements

This company announcement and associated annual report contain "forward-looking statements", as that term is defined in the Private Securities Litigation Reform Act of 1995 in the United States, as amended, even though no longer listed in the United States this is used as a definition to provide Zealand Pharma's expectations or forecasts of future events regarding the research, development and commercialization of pharmaceutical products, the timing of the company's pre-clinical and clinical trials and the reporting of data therefrom and the company's Key Events Anticipated and Financial Guidance for 2024. These forward-looking statements may be identified by words such as "aim," "anticipate," "believe," "could," "estimate," "expect," "forecast," "goal," "intend," "may," "plan," "possible," "potential," "will," "would" and other words and terms of similar meaning. You should not place undue reliance on these statements, or the scientific data presented. The reader is cautioned not to rely on these forward-looking statements. Such forward-looking statements are subject to risks, uncertainties and inaccurate assumptions, which may cause actual results to differ materially from expectations set forth herein and may cause any or all of such forward-looking statements to be incorrect, and which include, but are not limited to, unexpected costs or delays in clinical trials and other development activities due to adverse safety events, patient recruitment or otherwise; unexpected concerns that may arise from additional data, analysis or results obtained during clinical trials; our ability to successfully market both new and existing products; changes in reimbursement rules and governmental laws and related interpretation thereof; government-mandated or market-driven price decreases for our products; introduction of competing products; production problems at third party manufacturers; dependency on third parties, for instance contract research or development organizations; unexpected growth in costs and expenses; our ability to effect the strategic reorganization of our businesses in the manner planned; failure to protect and enforce our data, intellectual property and other proprietary rights and uncertainties relating to intellectual property claims and challenges; regulatory authorities may require additional information or further studies, or may reject, fail to approve or may delay approval of our drug candidates or expansion of product labeling; failure to obtain regulatory approvals in other jurisdictions; exposure to product liability and other claims; interest rate and currency exchange rate fluctuations; unexpected contract breaches or terminations; inflationary pressures on the global economy; and political uncertainty, including the ongoing military conflict in Ukraine and the uncertainty surrounding upcoming elections in the US. If any or all of such forward-looking statements prove to be incorrect, our actual results could differ materially and adversely from those anticipated or implied by such statements. The foregoing sets forth many, but not all, of the factors that could cause actual results to differ from our expectations in any forward-looking statement. All such forward-looking statements speak only as of the date of this company announcement and are based on information available to Zealand Pharma as of the date of this announcement. We do not undertake to update any of these forward-looking statements to reflect events or circumstances that occur after the date hereof. Information concerning pharmaceuticals (including compounds under development) contained within this material is not intended as advertising or medical advice.

Contacts:

Adam Lange

Investor Relations Officer

Zealand Pharma

Email: ALange@zealandpharma.com

Anna Krassowska, PhD

Vice President, Investor Relations & Corporate Communications

Zealand Pharma

Email: AKrassowska@zealandpharma.com

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