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1
The Future of Anti-Infectives
November 14, 2012
2012 Credit Suisse Healthcare Conference
2
Forward looking statements
Statements made in this presentation regarding matters that
are not historical facts are “forward-looking statements”
within the meaning of the Private Securities Litigation Reform Act of 1995. Because such statements
are subject to risks and uncertainties, actual results may differ materially from those expressed or
implied by such forward-looking statements. Such statements include, but are not limited to,
statements regarding Trius’ ability to successfully complete its ongoing clinical trials and
development programs, the expected timing for reporting of top-line data for the TR701-113 study,
Trius’ ability to obtain regulatory approval for tedizolid, market penetration and acceptance of
tedizolid and the initiation of clinical studies for Trius’ Gyrase B program. Risks that contribute to the
uncertain nature of the forward-looking statements include: Trius’ future preclinical studies and
clinical trials may not be successful; changes in regulatory requirements in the United States and
foreign countries may prevent or significantly delay regulatory approval of Trius’ products; Trius may
change its plans to develop and commercialize its product candidates; the FDA may not agree with
Trius’ interpretation of the data from recently-completed clinical trials of tedizolid; Trius may
decide, or the FDA may require Trius, to conduct additional clinical trials or to modify Trius’ ongoing
clinical trials; Trius may experience delays in the commencement, enrollment, completion or analysis
of clinical testing for its product candidates, or significant issues regarding the adequacy of its
clinical trial designs or the execution of its clinical trials, which could result in increased costs and
delays, or limit Trius’ ability to obtain regulatory approval; the third parties with whom Trius has
partnered with for the development of tedizolid and upon whom Trius relies to conduct its clinical
trials and manufacture its product candidates may not perform as expected; tedizolid may not
receive regulatory approval or be successfully commercialized; unexpected adverse side effects or
inadequate therapeutic efficacy of tedizolid could delay or prevent regulatory approval or
commercialization; Trius’ may be unable to obtain and maintain intellectual property protection for
its product candidates; the loss of key scientific or management personnel; Trius’ ability to obtain
additional financing; and the accuracy of Trius’ estimates regarding expenses, future revenues and
capital requirements. These and other risks and uncertainties are described more fully in Trius’ most
recent Form 10-K, Forms 10-Q and other documents filed with the United States Securities and
Exchange Commission, including those factors discussed under the caption “Risk Factors” in such
filings. All forward-looking statements contained in this press release speak only as of the date on
which they were made. Trius undertakes no obligation to update such statements to reflect events
that occur or circumstances that exist after the date on which they were made.
3
Investment highlights
• Focus on novel antibacterial compounds for serious infections
• Tedizolid completing confirmatory ESTABLISH-2 Phase 3 trial
– ESTABLISH-1 trial met all primary and secondary endpoints
– De-risked asset with high efficacy & superior safety
• Bayer collaboration to generate additional clinical data
• Broad spectrum gyrase program entering clinic in 2013
• Significant potential near-term catalysts
4
Pre-clinicalPre-clinical Phase 1Phase 1 Phase 2Phase 2 Phase 3Phase 3
Tedizolid Phosphate
Oral
IV/Oral
HAP/VAP IV
Bacteremia IV/Oral
GyrB/ParE
Gram- Infections IV
ABSSSI
Trius pipeline
5
Strong growth in MRSA* treatment days
Source: AMR (United States market) *methicillin-resistant Staphylococcus aureus
Total hospital treatment days in US
(Vancomycin, Linezolid and Daptomycin)
2005 2006 2007 2008 2009 2010
16.7M
21.1M 21.0M 22.2M
24.0M 25.8M
6
Increasing resistance to vancomycin
Resistance of MRSA against Vancomycin
Source: Theravance Company Report, April 2010 & AMR (United States market).
AMR - Hospital Insight Series, US Data, August 2011
2.8% 3.3%
3.8%
9.2%
11.1%
2005 2006 2007 2008 2009
7
Physician attitude on vancomycin is changing
Source: AMR - Hospital Insight Series, US Data, August 2011
51% 39%
9%
6% 8%
48%
CubicinZyvoxVancomycin
Percent of physicians reporting decreased or increased prescriptions
Less
M
ore
8
Tedizolid: highly differentiated oxazolidinone
Tedizolid Linezolid (Zyvox)
Week 1 Week 2 Week 1 Week 2
9
Strong product profile
Attribute Linezolid Vancomycin Daptomycin Tedizolid
IV/Oral
In-Vivo Bactericidal
Active in Lung
Infections
Once Daily
Treatment
Short Course of
Therapy
Generic
X
X
X
X
X
X X
X
X
10
Tedizolid Attributes Align Well With Market Need
Source: Datamonitor.
Key unmet needs for antibacterials
Activity against Gram-
negative pathogens
Activity against
resistant pathogens
Shorter treatment
courses
Lower cost of
therapy
Improved safety and
tolerability profile
Oral/IV switch
Incre
asin
g l
evel
of
imp
ort
an
ce
Tedizolid
11
29%
38%
9%11%
5% 6%3%
-12pp
-3pp
-10pp
-2pp -2pp 0pp
-25%
50%
Tedizolid Vancomycin Cubicin Zyvox Teflaro Tygacil Other
% P
ati
en
ts P
res
cri
be
d
Future Usage
Change from Current
Tedizolid Profile Shifts Share From Both Vancomycin and Zyvox
D13: Now, please think about your prescribing for these same patients if Product X were also available, considering the fact that trials would be
ongoing for hospital-acquired pneumonia at the time Product X becomes available.
Original
Allocation 50% 12% 21% 7% 8% 3%
Allocation of Common Agents for Treatment of MRSA Overall (n=165)
Trius Quantitative Study, 2012
12
Generic Linezolid Has a Modest Impact on Tedizolid
29%
40%
7%
11%
5% 5%3%
23%
14%
38%
7% 6%5% 5% 2%
0%
50%
Tedizolid GenericLinezolid Vancomycin Cubicin Zyvox Tefla
r
o Tygacil Other
% P
hys
icia
ns
Impact of Generic Linezolid on Treatment of MRSA ABSSSI (n=165)
BrandedZyvox:TedizolidCostperDayofTherapySameasZyvox
GenericLinezolid:TedizolidCostperDayofTherapySameasZyvox
C2: Now, please think about your prescribing for these same patients if Product X were also available, using your previous answers as a
reference.
E3: How would the availability of generic linezolid impact your use of Product X in your next 20 MRSA ABSSSI patients at that point? Please
assume that the price of Product X would be the same as branded Zyvox (linezolid) per day. Trius Quantitative Study, 2012
13
Phase 3 trial design: ESTABLISH-1 (oral), ESTABLISH-2 (IV/PO)
2o
EMA
1o
EMA
Tedizolid
Linezolid
1x 200mg
2x 600mg
n=667
1o
FDA
2o
FDA
Placebo
Post-Treatment Evaluations
END-POINTS FOR GLOBAL REGISTRATION
Safety Analysis
Non-inferiority trail design vs Linezolid
14
1o endpoint achieved: current & expected guidance
Lesion Criteria (Area)
No increase from baseline
Fever Criteria (Temperature)
Measurements required
Lesion Criteria (Area)
≥20% reduction from baseline
Fever Criteria (Temperature)
Excluded*
79.5%
78.0%
79.4%
76.1%
Current Guidelines* Expected Guidelines**
Tedizolid
Linezolid
* Primary endpoint as agreed to under Study 112 and 113 SPA
** FNIH recommendations to FDA: ABSSSI Docket ID: FDA-2010-D-0433
15
Significantly lower impact on platelets
2.3% 4.9%
9.2%*
14.9%*
TedizolidLinezolid
75% - 100% LLN (112-150K/μL)
<75% LLN (<112K/μL)
* Statistically significant difference
16
Phase 3: lower rates of adverse events
TEAE = Treatment Emergent Adverse Event
Gastrointestinal AEs incl. diarrhea, nausea, vomiting & dyspepsia
* Statistically significant difference: p = 0.004
43.3%
31.0%
25.4%
40.8%
24.2%
16.3%*
Any TEAE Drug-Related TEAE GI Disorder
Linezolid Tedizolid
17
Clinical studies show DDI advantage over linezolid
Phase 1 - Tyramine:
• Tedizolid similar to placebo. No dietary restrictions necessary
• Linezolid induces 5-fold increase in tyramine sensitivity
Phase 1 - Noradrenergic:
• Tedizolid similar to placebo. No increase in mean blood pressure
• Linezolid induces 113% increase in mean blood pressure
No monoamine oxidase mediated interactions
18
Tedizolid showed no interactions with SSRIs
Mouse Head Twitch Study
13 Tedizolid Placebo
13
(30X human exposure)
Linezolid
69
(1X human exposure)
19
Differences between ESTABLISH-1 and 2
• IV to oral switch: minimum 1-day of IV dosing
– Slightly higher exposure for tedizolid IV (~8%)
– No differences expected in efficacy or safety
• Patient demographics
– ESTABLISH-1: 80% US; ESTABLISH-2: 50% US
• X-US patients have statistically larger lesions (ESTABLISH-1)
• Tedizolid response rate vs linezolid enhanced in larger lesions
20
Rapid efficacy in severe cellulitis
0 cm2 0 cm2 337cm2
Screen Day 3 Day 10
21
High cellulitis efficacy at both FDA + EMA endpoints*
*Clinical cure at days 17-21
98%
82%
91%
78%
EMA EndpointFDA Endpoint
Tedizolid
Linezolid
Difficult to treat deep tissue infections
22
Tedizolid on track toward market
* With Priority Review afforded by the GAIN Act
• ESTABLISH-2 enrollment completion: Q4 2012
• ESTABLISH-2 top line data: H1 2013
• ABSSSI NDA filing: H2 2013
• Potential NDA approval: mid 2014*
23
Gyrase: broad spectrum antibacterial program
• Potent activity against gram negative and gram positive pathogens
• Novel chemical class, broad IP rights
• Funded through Phase 1 from 5-year $28M NIAID contract
• Expected to enter clinic 2013
• First data roll out at ICAAC (9/12): 14 posters, 1 oral presentation
24
Strong balance sheet
Cash and Marketable Securities (9/30/12) $71M
Long-term Debt (9/30/12) $0M
Shares Outstanding (11/1/12) 39.4M
25
Investment highlights
• Focus on novel antibacterial compounds for serious infections
• Tedizolid completing confirmatory ESTABLISH-2 Phase 3 trial
– ESTABLISH-1 trial met all primary and secondary endpoints
– De-risked asset with high efficacy & superior safety
• Bayer collaboration to generate additional clinical data
• Broad spectrum gyrase program entering clinic in 2013
• Significant potential near-term catalysts
26
The Future of Anti-Infectives
November 14, 2012
2012 Credit Suisse Healthcare Conference
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