Zealand Pharma A/S

Zealand Pharma announced that results from its Phase 2 ZUPREME-1 trial of investigational petrelintide have been published in The Lancet Diabetes & Endocrinology, with additional data to be presented at EASD 2026 on September 30 at 3:30pm CEST. In the randomized, double-blind, placebo-controlled, dose-finding trial, 485 adults with a mean age of 47 years and a BMI of 36.7 kg/m² were assigned 5:1 to once-weekly subcutaneous petrelintide at 1.0 mg, 2.5 mg, 5.0 mg, 7.0 mg or 9.0 mg, or placebo, for 42 weeks including dose escalation. Petrelintide led to mean body weight reductions from baseline to week 42 of up to 10.7% versus 1.7% for placebo on the efficacy estimand, and up to 10.2% versus 1.4% on the treatment policy estimand. Gastrointestinal adverse events were generally mild and occurred at rates similar to placebo, with no cases of vomiting and no treatment discontinuations due to gastrointestinal adverse events at the maximally effective dose. Treatment was also associated with reductions in waist circumference of up to 10.8 cm versus 4.3 cm with placebo, up to 41% reductions in high-sensitivity C-reactive protein versus 6% with placebo, triglyceride reductions of up to 21% versus 9%, and a mean pulse rate reduction of up to 2.9 beats per minute versus a mean increase of 0.3 bpm with placebo. Petrelintide is being evaluated for chronic weight management in three global Phase 3 registrational trials, and a Phase 2 trial of petrelintide in combination with enicepatide is planned for initiation in the second half of 2026.

Royalty Pharma has agreed to pay Zealand Pharma $100 million for the rights to future royalties on rusfertide, an experimental treatment for the rare blood disorder polycythemia vera, with the deal announced on August 12. The payment is split into two $50 million installments, one at closing and one on the first anniversary, in exchange for a 1% royalty on global sales plus regulatory and commercial milestones. Rusfertide, a once-weekly self-injected therapy, has an FDA goal date in the third quarter of 2026, with Takeda handling commercialization. This is Royalty Pharma's second collaboration with Zealand, and the company's broader portfolio showed strength, with Royalty Receipts up 14% to $768 million in the second quarter of 2026 and full-year guidance raised to $3.4 billion to $3.5 billion. However, the royalty structure caps Royalty Pharma's share at 0.75% once global sales exceed $1.5 billion, and the second payment is committed before the FDA decision, adding risk to a balance sheet with $9.2 billion in debt principal and $812 million in cash as of June 30, 2026.