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Path to Alnylam 2020
R&D Day 2015
John Maraganore, Ph.D., Chief Executive Officer
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What we’re about: RNAi Therapeutics
• Harness natural pathway
◦ Catalytic mechanism
◦ Mediated by small interfering RNA
or “siRNA”
• Therapeutic gene silencing
◦ Any gene in genome
◦ Distinct mechanism of action vs. other
drug classes
◦ Unique opportunities for innovative
medicines
• Clinically validated platform
◦ Human POC in multiple programs
– Papers in NEJM and Lancet
A New Class of Innovative Medicines
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RNAi therapeutics as genetic medicines
• In 2011: 5 Key products in clinical
development through 2015
• Expect to greatly exceed 2011 guidance ◦ 8 in Clinic
◦ 2 in Phase 3
◦ 6-7 with Human POCs
Product characteristics
Genetically defined target/disease
Existing Alnylam delivery platform
Phase 1 proof of concept
Clear and rapid development
Significant commercial opportunity
Focused Product Development Pipeline for Genetic Medicines
Where we were: Alnylam 5x15TM
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Where we’re going…
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>10 Clinical
Read-outs
in 2016
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>5 Programs in
Phase 3 in
2017
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1st Phase 3 data read out
in 2017
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How do we get there?
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#1: Capital
Strong Cash Position
• Q3 ’15 cash ~$1.34B
• Year-end cash guidance >$1.2B
Alnylam-Genzyme Genetic
Medicine Alliance
• Valued at well over $1B
◦ Equity
◦ R&D funding
◦ Milestones
◦ Royalties
Financial Resources to Drive Pipeline Forward
CAMBRIDGE, MA
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#2: Reproducible and Modular Platform Risk-Mitigating Development Strategy Applied Across Programs
1
Genetically
validated, liver-
expressed target
gene
• Liver-expressed targets involved in
disease with high unmet need and
validated through human genetics
• Delivery with GalNAc conjugate
platform
2 Biomarker for POC
in Phase 1
• Blood- or urine-based biomarkers
with strong disease correlation
• Establish dose/regimen for late-
stage development
3 Definable path to
approval and
market
• Clinical development plans with
focused trial size and established
endpoints
• Definable value for payers
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#2: Reproducible and Modular Platform Rapid Path from Idea to Human POC with 100% Success to Date
IDEA DEVELOPMENT
CANDIDATE
CTA/IND HUMAN POC
6 months 12-18 months 6-9 months
Success Rate at
each stage to date: 100% 100% 100%
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#2: Reproducible and Modular Platform Fundamentally New Approach to Drug Development
0
100
100 % Mean KD in NHP
% M
en
KD
in
hu
man
Excellent
Translation
Select
Dose/Regimen
Increased POS
due to Genetically
Validated Targets Phase 3
Data
100
80
60
40
20
0
0 1 2 3 4
Months
% M
ean
KD
Start of
Phase 3
Human
POC
Pre-
clinical
POC
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#3: Competitive and Differentiated Profiles Robust Human Experience to Date*
Number of Programs 7
Number of Clinical Studies 16
Total Patients or Volunteers
Dosed >300
Longest Duration of Exposure >24 months
Total siRNA Doses Administered >4,500
*Numbers are approximate as many studies are ongoing
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#3: Competitive and Differentiated Profiles Potent and Durable Knockdown of Target Proteins
Mean
(S
EM
) %
AL
A R
ed
ucti
on
-100
-75
-50
-25
0
25
50
0 5 10 15 20 25 30 35 40 45
Time (Days)
Placebo
0.035 mg/kg
0.1 mg/kg
0.35 mg/kg
1.0 mg/kg
ALN-AS1
Mean
(S
EM
) %
AT
Lo
weri
ng
Time (Days)
0
25
50
75
100
125
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160
225 mcg/kg
450 mg/kg
900 mcg/kg
1800 mcg/kg
Fitusiran
Mean
(S
EM
) %
C5 K
no
ckd
ow
n
Time (Days)
100
80
60
40
20
0
-20
0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190
50 mg 200 mg 400 mg
600 mg 900 mg
Placebo
ALN-CC5
Mean
(S
EM
) P
CS
K9 K
no
ckd
ow
n
100
80
60
40
20
0
-20
-40
-60
Time (Months) 0 1 2 3 4 5 6
Placebo
25 mg
100 mg
300 mg
500 mg
800 mg
ALN-PCSsc
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#3: Competitive and Differentiated Profiles RNAi vs. Monoclonal Antibody (MAb)
mRNA
Protein Synthesis
Nucleus
RNAi siRNA durably blocks protein
synthesis in catalytic process
26 doses/year
2 doses/year
MAbs Transiently block protein in
stoichiometric process, consumed
by ongoing protein synthesis
Clamped effect
Saw-tooth effect
GalNAc
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#3: Competitive and Differentiated Profiles RNAi vs. Monoclonal Antibody (MAb)
mRNA
Protein Synthesis
Nucleus
RNAi siRNA durably blocks protein
synthesis in catalytic process Clamped effect
26 doses/year
2 doses/year
MAbs Transiently block protein in
stoichiometric process, consumed
by ongoing protein synthesis
Potential resurgence of
disease symptoms
Sustained suppression
of disease symptoms
GalNAc
Saw-tooth effect
Clamped effect
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#3: Competitive and Differentiated Profiles
2nd Gen ESC-
GalNAc siRNA
ESC-GalNAc siRNA vs. ASO Dosing
Gen 2.0/2.5 ASO &
1st Gen STC-GalNAc
siRNA
GalNAc-ASO aka
“LICA”
52 DOSES PER YEAR 2 12 DOSES PER YEAR DOSES PER YEAR
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#4 Large Number of Opportunities Liver Targets across 3 Strategic Therapeutic Areas (STArs)
Cardio-Metabolic Disease
Genetically validated liver
targets for dyslipidemia,
NASH, type 2 diabetes,
and hypertension
Development path in
genetically defined,
high unmet need
subpopulations
o Access to larger
populations thereafter
Emerging genetics
qM, qQ, or potentially
bi-annual SC dosing
Partnership opportunities
Hepatic Infectious Disease
Liver pathogen and/or
host targets
Sub-acute duration of
treatment (~12 mo)
Multiple siRNAs possible,
if needed
Defined opportunities with
very large markets
qM or qQ SC dosing
Partnership opportunities
Genetic Medicines
• Genetically validated
liver targets for rare
orphan diseases
• High unmet needs in
focused markets
• SC dosing
• Alnylam direct
commercial in NA and
EU
• Genzyme alliance for
ROW commercial
◦ Through end-2019