Acumen (ABOS) Q1 2026 Earnings Transcript

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Date

May 12, 2026, 8:00 a.m. ET

Call participants

• Chief Executive Officer — Daniel O'Connell
• Chief Financial Officer — Matt Zuga
• Chief Development Officer — James Doherty
• Chief Medical Officer — Eric Siemers

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Takeaways

• Cash and Marketable Securities -- $128.4 million as of March 31, supporting operations into early 2027.
• Private Placement Proceeds -- $35.75 million grossed in March, attributed to advancing the enhanced brand delivery (EBD) program.
• R&D Expenses -- $16.5 million, with lower manufacturing, materials, and CRO costs following completion of ALTITUDE-AD enrollment in March 2025.
• G&A Expenses -- $4.7 million, reflecting reduced legal, accounting, consulting, and insurance outlays.
• Operating Loss -- $21.1 million and net loss of $20.7 million, both recorded for the quarter.
• ALTITUDE-AD Phase II Progress -- Study remains on schedule with high transition rates into its 12-month open-label extension, and top-line results expected late in the year.
• Dosing Details -- Phase II ALTITUDE-AD evaluates sabirnetug at 35 mg/kg and 50 mg/kg, anchored to the pharmacodynamic exposure range identified in previous Phase I work.
• Key Clinical Endpoints -- Primary endpoint is change on the iADRS after 18 months; secondary endpoints include clinical dementia rating sum of boxes, adverse event rates including ARIA, and fluid/imaging biomarkers.
• Operational Metrics -- Enrollment for ALTITUDE-AD reached 542 subjects in 10 months; protocol and study execution reportedly met design assumptions.
• Screening Innovation -- Use of plasma p-tau217 in screening reduced negative PET scan rates from roughly 60% to under 20%, improving trial efficiency.
• EBD Program Milestone -- Management plans to exercise options to license two compounds from JCR Pharma in the second quarter, with IND filing targeted for mid-2027.
• Preclinical EBD Data -- Exposure in primate studies demonstrated 15-fold to 40-fold higher brain penetration for candidate antibodies, assessed across multiple brain regions.
• Regulatory Strategy -- Concurrent regulatory engagement ongoing across the U.S. Canada, and Europe for both sabirnetug and EBD programs.
• Physician and KOL Interest -- Field interviews and medical meetings indicate high anticipation for ALTITUDE-AD data and differentiated approach versus approved agents.
• Subcutaneous Formulation Plans -- Decision to pursue subcutaneous arm in Phase III will be informed by ALTITUDE-AD's active dose data.

Summary

Acumen Pharmaceuticals (NASDAQ:ABOS) delivered a data-rich update as it advanced its core Alzheimer's clinical program and pipeline. The ALTITUDE-AD Phase II trial is progressing toward a late-year top-line readout, with management emphasizing robust operational execution and patient retention through its open-label extension. Financial discipline was highlighted by reduced R&D and G&A costs, and a substantial private placement extended the cash runway into 2027. The EBD platform is set for near-term candidate license activation and demonstrated a substantial increase in brain penetration in preclinical models. Discussions with regulators and physicians suggest the company's differentiated oligomer-targeted approach is under close observation within the Alzheimer's treatment landscape.

• CEO O'Connell said, "ALTITUDE is designed as a well-powered study to detect a statistically significant difference after 18 months on our primary clinical efficacy end point, the amount of slowing as measured by the iADRS."
• O'Connell stated that "we anticipate exercising our option for 2 candidates in the second quarter and remain confident that we will be filing an IND mid-2027" for the EBD program.
• Chief Development Officer Doherty cited feedback from study sites on plasma biomarker screening, stating, "We heard feedback from the sites that they really like that approach. I think that's something that could be used in clinical practice."
• The management team noted that any dose selection for Phase III and introduction of a subcutaneous arm will be guided by both efficacy and safety differentiation observed in ongoing Phase II data, specifically regarding ARIA incidence and cognitive endpoints.

Industry glossary

• Sabirnetug: Acumen’s investigational monoclonal antibody targeting soluble amyloid-beta oligomers in Alzheimer's disease.
• ALTITUDE-AD: Company’s ongoing Phase II clinical trial evaluating sabirnetug in early Alzheimer’s patients.
• iADRS: Integrated Alzheimer's Disease Rating Scale, a composite clinical endpoint measuring changes in cognition and function.
• ARIA: Amyloid-related imaging abnormalities, adverse events including brain swelling or bleeding observed in some anti-amyloid therapies.
• EBD (Enhanced Brand Delivery): Acumen’s blood-brain barrier platform leveraging receptor-mediated transcytosis to increase antibody brain penetration.
• JCR Pharma: Japanese biotechnology company supplying carrier technology for Acumen's EBD program.
• Phase III: Late-stage clinical trial phase used to confirm safety and efficacy prior to regulatory approval.
• PK (Pharmacokinetics): Study of drug absorption, distribution, metabolism, and excretion in organisms.
• CRO (Contract Research Organization): External service provider managing elements of the clinical trial process for biopharmaceutical sponsors.
• KOL (Key Opinion Leader): Influential medical professionals and researchers whose perspectives can impact drug development adoption.

Full Conference Call Transcript

Daniel O'Connell: Great. Thanks, Alex. Good morning, everyone, and thanks for joining us today. I ended last quarter's call by emphasizing the progress we've achieved with sabirnetug and our next-generation blood-brain barrier EVD candidates and highlighted the important work and upcoming milestones that lay ahead. That message has not changed. In the first quarter, we continued to advance sabirnetug through our Phase II ALTITUDE-AD trial, building on the clinical momentum established over the past year. The study remains a critical proving ground for our central scientific thesis that selectively targeting synaptotoxic a-beta oligomers rather than amyloid plaques may constitute a more effective and/or safer path forward in Alzheimer's.

Execution has stayed on track, participants have been transitioning smoothly into the 12-month open-label extension study and the conversion rate remains high. We see this disciplined progress is bringing us closer to a potentially differentiated treatment option with people living with Alzheimer's. We expect our top line results for ALTITUDE-AD late this year. As we've described, ALTITUDE is designed as a well-powered study to detect a statistically significant difference after 18 months on our primary clinical efficacy end point, the amount of slowing as measured by the iADRS.

We expect to also report on key secondary endpoints in the top line results, such as the clinical dementia rating score some boxes, certain safety measures such as adverse event rates, including ARIA rates and key fluid and imaging biomarkers. The study is designed to evaluate safety and efficacy of 2 dose levels, 35 and 50 milligrams per kilogram compared to placebo. Both of the active doses are within the range of exposures shown to have exhibited pharmacodynamic target engagement in our INTERCEPT-AD Phase I trial. Our enhanced brand delivery EBD program is also advancing nicely. We are conducting additional preclinical work to fully establish candidate profiles and are very pleased with the output.

We intend to submit a notice to exercise our option to license 2 compounds developed as part of our collaboration with JCR Pharma in the second quarter of 2026. So this development is imminent. We expect to discuss those candidate profiles in greater detail at a future medical meeting and continue to anticipate an IND filing in mid-'27. We view EBD as a way to enhance our antibodies, enabling the potential to develop treatments with increased penetration and distribution in the brain while maintaining a favorable safety profile and allowing for patient-friendly subcutaneous dosing. We recognize there is competition in this space. However, none with an a-beta oligomer targeted therapeutic cargo.

This is where we see the potential to push the therapeutic index even further, attaining efficacy by engaging the soluble toxic species of a-beta throughout the brain. Also, JCR, our collaborator on our ABD program has clinically validated transparent targeting blood brain barrier receptor-mediated transcytosis technology. JCR has an approved therapy in Japan, which incorporates their technology and has exhibited little to no anemia. This anemia safety profile offers us further potential for differentiation with our carriers plus cargo EBD product strategy. Taken all together, our EBD program adds optionality to our pipeline as an additional oligomer-targeted therapeutic strategy.

While not currently contemplated in our immediate clinical development plans and anti a-beta oligomer EBD therapeutic could also potentially be studied in preclinical Alzheimer's. A population earlier in the disease course that could benefit greatly from a next-generation oligomer-directed approach. The progress we've made with sabirnetug and our next-generation EBD candidates reflect the strength of our science and ability to execute and sets a solid foundation for an exciting remainder of the year. I look forward to updating you on the imminent candidate selections in our EBD program and on our ALTITUDE-AD Phase II results in late '26. And with that, I'll turn the call over to Matt.

Matt Zuga: Thank you, Dan. As a reminder, our first quarter 2026 financial results are available in the press release we issued this morning and in our 10-Q we will file later today. We ended 2025 with -- we ended March 31 with $128.4 million in cash and marketable securities on the balance sheet, which is expected to support our current clinical and operational activities into early 2027. This increase over the prior quarter is due to the private placement we completed in support of our EBD program that grossed $35.75 million, in which we announced in March of this year. R&D expenses were $16.5 million in the first quarter.

The decrease over the prior year was primarily due to a reduction in manufacturing and material costs as well as a reduction in CRO costs associated with our ALTITUDE-AD clinical trial, which completed enrollment in March 2025. G&A expenses were $4.7 million in the first quarter, the decrease primarily due to reductions in legal fees as well as reductions in accounting, consulting and insurance expenses. This led to a loss from operations of $21.1 million and a net loss of $20.7 million in the first quarter. We are confident in our scientific innovation and strong track record of execution as we work toward our Phase II ALTITUDE-AD readout later this year and advance our EBD program.

We remain dedicated to building value with our portfolio of a-beta oligomer-targeted antibodies for Alzheimer's patients, caregivers and stakeholders. And with that, we can open the call for Q&A. Operator?

Operator: [Operator Instructions] And our first question comes from Pete Stavropoulos of Cantor Fitzgerald.

Pete Stavropoulos: Congratulations on the continued execution of ALTITUDE. A question sort of about ALTITUDE. ALTITUDE is looking at Alzheimer's disease, similar to the approved amyloid beta antibodies. However, there are ongoing studies for preclinical Alzheimer's with a Phase III readout starting in 2027, assuming that ALTITUDE is positive and you move forward with sabirnetug. Could you just give us your current thoughts on which populations or patient types you would target in Phase III studies, what would trigger you to expand the preclinical Alzheimer's?

Daniel O'Connell: Thanks Pete, I can address that real quickly. In terms of our focus, we remain focused on the early AD population such as we've enrolled in ALTITUDE-AD see that as the path forward for sabirnetug in a future registration study. I think our interest in the preclinical population remains quite high. And as I mentioned, potentially part of the future opportunities ahead for -- principally for a EBD candidate. So that's not an immediate part of our plans. But certainly, I think the science and mechanism neutralizing toxic oligomers in the early course of the pathogenesis of disease is something that is promising on the horizon.

Pete Stavropoulos: And another question, please, on the EBD program. You do have different versions of 193 and 234. They have different PK profiles at least which we've shown to date. What are sort of the key properties and preclinical data that will drive you or drive the decision on candidate selection. And with an IND targeted, I believe, mid-2027, could you just walk us through how you're thinking about development plans and trial designs?

Daniel O'Connell: Sure. That's a lot, Pete. So I think, as you know, we've explored a lot of diversity in the EBD program, both from a carrier and cargo perspective, and we like sort of the -- having the ability to evaluate a series of candidates. We are down to the short list. And as I mentioned, we anticipate exercising our option for 2 candidates in the second quarter and remain confident that we will be filing an IND mid-2027. I don't know that we can go into the details of specific PK properties.

But as we have characterized, I mean, the advantages of EBD you really have to do with broad brain distribution, potentially a wider safety margin and the subcutaneous dosing convenience. So those are elements of what we are using as part of the filter for prioritizing candidates in that program. Jim Doherty, who's on the call. I don't know, Jim, if you want to add some additional color to comment on Pete's question.

James Doherty: Yes. No, I think that sounded great, Dan. I guess, Pete, the only other thing I would add, you asked about clinical program. I mean it's early days. So we're still thinking about what the early phase clinical program is going to look like. But I think we have a huge benefit in having conducted the INTERCEPT study with sabirnetug, it really gave us quite a lot of data, not only the safety and tolerability and PK data you typically get in the Phase I study. But since we were looking at Alzheimer's patients in the mad phase, we're able to collect data on PET imaging for a-beta, for biochemical biomarkers for a number of different things.

And that's really helped us with the sabirnetug program. And so we're actively discussing how to incorporate that kind of thinking into the early clinical studies for the EBD program. So more to come, but we're modeling what we've done on the sabirnetug program as a way to go forward.

Operator: And our next question comes from Geoff Meacham of Citi.

Mary Kate Davis: This is Mary Kate Davis on for Geoff. Just was wondering, could you please walk us through the early physician interest and feedback of sabirnetug, especially given the unmet need in early Alzheimer's and mechanism of the treatment. And then as a follow-up, could you just walk us through the ongoing regulatory interactions in anticipated discussions for the late-stage development of the program?

Daniel O'Connell: Thanks, Mary kate. Actually, Jim, why don't you take that. Jim and Eric, I think on the feedback we've received, we've done a lot of work at meetings and visited with a number of KOLs and other clinicians that have provided a broad set of feedback on the sabirnetug program in particular.

James Doherty: Yes, happy to do that, Mary Kate. And as Dan says, we've spoken to quite a number of KOLs about the sabirnetug program. And I think there's a lot of interest, obviously. I mean, we're testing a hypothesis that is slightly different than what's been tested so far with the approved therapeutics. And I think we can talk about both what those therapies have been able to do in treating patients and where there's opportunity. And we do think that the sabirnetug approach offers a differentiated opportunity from what's been done to date. And I think that's generally understood by KOL.

So I think everyone is very much looking forward to seeing the data as we release the results for the ALTITUDE trial in late 2026. But I think at this point, there's a level of anticipation to see that potential for a differentiated response.

Eric Siemers: Yes. And I might just add, we have spent a lot of time thinking about the differentiation of sabirnetug. And I think to sum it -- well, obviously, we don't have the data right now. We're in a blinded trial. But when we get the data one of the things that we'll look at, number one, would be efficacy because, again, we target oligomers which is different than the 2 approved drugs. And then the second thing is we'll look to see if we can differentiate on safety because our antibody is an IgG2, the 2 approved antibodies or IgG1s, igG1s have more effector function the potential for more ARIA.

And so we're going to look at the safety data very carefully when those become available.

Daniel O'Connell: Yes. And other question Yes, go ahead.

James Doherty: Yes. And to your question around regulatory interactions, the ALTITUDE study, of course, is running in multiple countries across multiple jurisdictions. So we're obviously speaking to regulatory agencies in the U.S. and Canada and in Europe as part of all that. And then thinking strategically about the program we're, of course, engaging with regulators about the overall progress of both of our programs, both the sabirnetug program as well as our EBD programs. And so that's something we'll continue to do. Obviously, it's quite important to stay in contact and to keep them apprised of progress. And so that's just the fundamental thing that we're always doing.

Operator: And our next question comes from Paul Matteis of Stifel.

Unknown Analyst: This is Emily on for Paul. I wanted to say congrats on the quarter and just 2 quick questions from us. As it relates to the upcoming Phase II readout, what do you think would be a clear win that would prove out to sabirnetug to be a unique alternative to donanemab and lecanemab. And do you see kind of different scenarios at the different doses? And then as a follow-up to that, assuming success in Phase II, would you be able to incorporate a subcutaneous arm in a Phase III program? And maybe any color on the subcutaneous timelines would be helpful, too.

Daniel O'Connell: Thanks, Emily. So I think in terms of a clear win in ALTITUDE-AD would be an efficacy signal. At least a 30% of flow, which is sort of the maximum or the upper end of the boundary, I think, for the current approved agents. So we are hopeful and anticipating that by targeting toxic species in a directed fashion, selective fashion that it will unlock greater efficacy. I think the safety profile, I think there's now a real world evidence to sort of suggest what the overall rates of ARIA. And of course, those rates of ARIA differ by genotype. And so those are some of the other elements of what we'll be looking to establish in terms of ARIA.

So it's -- I think it will be the totality of the ALTITUDE data and really this sort of the risk-benefit profile sabirnetug with the combination of efficacy and work safety is positioned as the primary means of differentiation relative to the current approved agents. And in terms of subcu, I think we've previously guided that we will be looking at the Phase II data, particularly in respect of the 2 active doses that are being investigated in ALTITUDE to inform precisely where and how we would advance the ongoing work in subcu as part of the Phase III program.

James Doherty: And I might add, Emily, I think you asked an interesting question as well around doses. As you know, there are 2 different doses included in the ALTITUDE study. And those doses were chosen to sort of bracket the range of oligomer clearance as measured by our target engagement assay in Phase I. So we think we've got an interesting range of doses chosen. And it will be -- I'll be very curious to see how that impacts the results both from a point of view of efficacy and safety, as Dan said. And so that's an interesting feature of the ATTITUDE study is that we've got both of those doses to investigate.

Eric Siemers: Yes. And just one other point about the ARIA. I think one of the concepts that's across the field now that's being better appreciated is that it's really symptomatic ARIA that you're really concerned about. And even if the symptomatic ARIA it's serious adverse events that you really worry about. So those are nearly as common, but obviously, they have a bigger impact. And so that's one of the things that will be benchmarking pretty carefully when we do get our data.

Operator: Our next question comes from Jason Zemansky of Bank of America.

Jason Zemansky: Congrats on the great progress. I wanted to ask a question maybe from a different perspective here. But over the last several weeks, we've seen both the Cochrane report questioning the value of the anti-amyloid class. And I guess, a few days ago, there was an article that detailed that use of the current commercially available anti-amyloid antibodies has been slower than expected.

So -- as we kind of take a step back and think about both the overall unmet need and sort of the overall sort of view of the classic itself, what do you think is necessary from ALTITUDE and any sort of Phase III you do to really demonstrate that there's a level of differentiation here as well as overall efficacy to the point that it sort of turns back some of the skeptism.

Daniel O'Connell: Jason -- so I think in terms of the Cochrane report, I think there's been a good bit of follow-up in terms of the methodology there. And I think there's your question about kind of the merits of the approach from a methodology standpoint. I do think that I'm familiar with the stat article as well. And I think it speaks to sort of 2 things, the unmet need and the demand for better options and the fact that there is -- the clinical infrastructure is now -- has been established and continues to adopt and progress the make available these first couple of agents and build out essentially the marketplace.

I think what the market is looking for is a more clear value proposition in terms of the risk-benefit profile. And that's really where reading out ALTITUDE and validating the oligomer hypothesis. I think Acumen and sabirnetug stand at really attractive position from a timing perspective sort of reenergized the space and position next-generation treatment options. I think the field has progressed over a number of years to develop better insights into clinical trial design, which patients to treat underlying aspects of the pathophysiology of the disease. And so we view sabirnetug as sort of that next position advancing the field forward on the basis of positive data.

Eric Siemers: And I might just add, I was recently at the American Academy of Neurology meeting in Chicago. And these are practicing neurologists for the most part. There was a great deal of interest and enthusiasm for information concerning the 2 approved drugs, lecanemab and donanemab. So even though there have been these relatively negative analysis, and again, as Dan mentioned, the Cochrane report was pretty flawed and a lot of people's opinions in terms of how they did the analysis. I think if you actually talk to neurologists, they understand that the infrastructure has been rate-limiting but that infrastructure is going to continue to improve. And so there is a lot of interest from neurologists at the AAN meeting.

Operator: And our next question comes from Tom Shrader of BTIG.

Jimmy Kim: This is Jimmy Kim on for Tom Shrader. At ALTITUDE-AD approaches the late 2026 top line readout, could you give us some additional color on the blinded operational metrics are tracking things like protocol deviation rate, site level dropout patterns or any shifts in enrolled patient population profile relative to your original assumptions. More broadly, what distinguishes the quality of this data set relative to prior anti-amyloid trial?

Daniel O'Connell: Thanks, Jim. Jim, Do you want to lead out on that and Eric provide some color?

James Doherty: Yes. Jenny, I'll give you a first pass and then ask Eric to weigh in. I think probably the best thing to say is that we, at this point, have been very pleased with the progress of the ATTITUDE study. Any of these studies is a 542 subject study. There's a lot of data and a lot of information flowing in the study. But we've been relatively pleased with the conduct of the study. It's a great team that is working extremely hard across multiple geographies to deliver the data. And I think to date, we have been tracking to the assumptions that we built into our study design.

So we are -- we have confidence in our study design as well. And I'll turn it over to Eric to give you any specific commentary.

Eric Siemers: Yes. So thanks for the question. The study is progressing quite well. I think as you know, we completed enrollment in a very short period of time in 10 months. One of the things that we did in our study, which is being done in other studies, that is quite innovative, I think, was to use this plasma p-tau217 test as part of the screening procedure. So in other words, when we did our Phase I study to get into the study, you had to have a positive PET scan and it turned out that about 60% of the time, the PET scans were negative.

When we added this blood test, simple blood test as a screening step before you got to PET scans, the rate of negative PET scans drop from, again, around 60% to under 20%. So it made the screening process much better. We heard feedback from the sites that they really like that approach. I think that's something that could be used in clinical practice. And actually at the American Academy of Neurology meeting, there was a lot of discussion about how you would use these plasma biomarkers as part of your screening process for patients. So we were really very pleased how that worked out in our trial, and we're looking forward to seeing that utilized in clinical practice.

Operator: Our next question comes from Dev Prasad of Lucid Capital Markets.

Dev Prasad: Congrats on the progress. Just following up on the previous question regarding Phase II doses how much separation between 35 mg and 50 mg do you expect? And what would you need to see to select a Phase III dose? Also on EBD program. Can you provide more detail on 14 to 40x higher brain exposure that you observed in the primates. What differentiated those exposures such as dose, route, brain, distribution, et cetera?

Daniel O'Connell: Thanks, Dev. Jim I'm going to direct those straight to you.

James Doherty: Yes, Dev, so happy to take those questions. So when we think about dosing for the ALTITUDE study first. The doses are 35 mg per kg and 50 mg per kg. And I was mentioning earlier, the doses were sort of chosen with the idea in mind that, that is what looks to be a key part of the dynamic range and exposure of soluble oligmers, which, of course, is our key primary target. And I think there's the opportunity to see effects differential effects of the 2 doses in a couple of different ways. I mean we'll have to wait and see what the data actually show. But one possibility is differences in efficacy.

You might expect to see dose-related differences in efficacy. Although I think part of what we're testing there is what the role of the soluble oligmers is and how that's different from what you've seen to date with more plaque targeting antibodies. So in some ways, the lower dose may give more of an oligmer-specific signal. Although we do expect some contribution from other species of a-beta even at that dose. And then certainly, as you go to a higher dose, you would expect some additional effects on larger species as we've seen in the INTERCEPT study in Phase I. And I think also, one might expect there could be some differences in tolerability, right?

I mean that would be again, consistent with the Phase I data. So very excited to see the study at the end of the year, and we'll be looking at all of these things for differential effects at multiple doses. And then I think your other question around the EBD programs. So of course, what we're trying to achieve is both an improvement in brain penetration, but also the brain distribution of our oligmer targeting antibodies by coupling with the carrier technology from JCR. And so what we've done is we've investigated multiple candidates is we've been able to vary both sides of that equation.

So looking at the changes to the carrier choices from JCR as well as modifications on the cargo side. And really, the quick way to summarize it is what you're seeing is a range of substantial improvements in brand exposure. And that's in both rodent studies using humanized [ tranferrin ] receptor. And then also in primate studies. And so we're looking at multiple brain regions and so in the primate study. And so we're seeing really substantial improvements and you quoted the range between 15-fold and 40-fold improvements in exposure. And so we're seeing both that improved brain penetration as well as distribution.

And we really think it's both properties that are part of what makes this technology so exciting for the treatment of Alzheimer's and specifically for soluble oligomer approach. So that's what I can say to date. We are keeping a close eye on which are the best candidates to give us the broadest distribution in multiple brain regions.

Operator: Thank you, this concludes our question-and-answer session and also today's conference call. Thank you for participating, and you may now disconnect.

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