Lupus Erythematosus, Discoid

下一个吸金靶点已经浮现水面。3月初，以TYK2管线为核心的Biotech公司Alumis宣布了2.59亿美元的C轮融资，据Fierce Biotech的统计，这是2024年迄今为止初创Biotech公司获得的最大融资金额。在此之前，Alumis分别在2021年5月、2022年1月迅速完成了7000万美元A轮融资、2亿美元B轮融资，迄今已经累计融资超5.2亿美元。Alumis的核心产品为ESK-001，一种高选择性且有Best-in-Class潜力的TYK2抑制剂，即将开始用于治疗中重度斑块状银屑病的3期试验，并支持正在进行的两项治疗系统性红斑狼疮和非传染性葡萄膜炎的2期临床试验；以及第二代TYK2抑制剂A-005，一项First-in-Class针对多发性硬化等神经炎症性疾病的临床前项目。同时，由于ESK-001最先来自于海思科下属子公司FT集团的授权，今年下半年ESK-001的3期临床启动后，海思科预计将收到约1280万美元的里程碑付款。Alumis也并不是今年唯一获得大额融资的TYK2公司。Sudo Biosciences宣布于2024年1月完成了第二次B轮融资，并在2月额外筹集了3000万美元，使这家TYK2开发公司的B轮融资额达到了1.47亿美元。另一家TYK2公司Myrobalan Therapeutics也在1月得到了2400万美元的A轮融资。TYK2是JAK激酶家族的一个分支，但由于发现时间较早，没有按照JAK激酶的命名方式，所以TYK2抑制剂也属于广义上的JAK抑制剂之一。目前已上市的TYK2抑制剂仅有一款，为FDA在2022年9月批准的BMS的Sotyktu（Deucravacitinib，氘可来昔替尼），用于治疗中至重度银屑病。Sotyktu是市场上唯一一款用于治疗慢性炎性疾病且没有黑框的JAK，这归功于TYK2靶点作用的专一以及药物对TYK2本身的高选择性（通过变构抑制实现），几乎不会产生脱靶毒性。Sotyktu在2023年获得了1.7亿美元收入，BMS预计到2030年销售额将超过40亿美元。而TYK2领域中最著名的一笔交易，是2022年底武田与Nimbus Therapeutics围绕TAK-279（此前名为NDI-034858）的总金额60亿美元的合作，其中首付款为40亿美元。TAK-279的开发参考了BMS的Deucravacitinib，具有更高的体外选择性。具有戏剧意义的是，在去年底的美国风湿病学会（ACR）上，武田的一张海报被人窃走，海报上展示的正是TAK-279的2b期临床数据，这也侧面印证了TAK-279以及TYK2的火热程度。自免江湖轮动之时，TYK2的蓝海已经展现。TYK2欲戴王冠JAK-Stat通路在炎症、代谢、肿瘤中发挥重要作用，全球目前已经获批11款JAK抑制剂，除去用于骨髓纤维化治疗的JAK2抑制剂，其它大多用于自免领域。药王修美乐逐渐失势当下，JAK抑制剂被赋予下一任自免药王的重任。相对生物制剂，小分子抑制剂的生产、运输、储藏更加方便，监管机制也比较成熟，价格优势突出。因为采用口服给药方式，病人依从性高。相较于生物制剂，新上市的类似小分子JAK抑制剂在临床上展现了较生物制剂更优的的疗效，同时起效也较快。然而，由于JAK家族成员可以介导多种细胞因子的信号通路，目前已获批的JAK抑制剂就不可避免地带来一些副作用，这也就很大程度上限制了它们的临床应用范围，而这也是为什么阿布昔替尼、乌帕替尼的疗效强于达必妥（度普利尤单抗），却无法在临床上代替达必妥的原因。达必妥2023年销售额达到115.7亿美元，同比增长34%相比之下，TYK2主要通过抑制JH2假激酶结构域发挥作用，而JAK抑制剂是抑制JH1激酶结构域。通过与TYK2的JH2结构域结合，可以保持对其他JAK家族成员及整个激酶家族的高选择性。TYK2抑制剂通过选择性阻断TYK2介导的IL-23、IL-12、I型IFN等少数炎症信号通路，在发挥治疗作用的同时，对其他JAK家族成员和细胞因子通路的影响较小。这种高度选择性有助于在疗效和安全性之间取得更好平衡，降低毒副作用的风险。因此，TYK2抑制剂被认为是JAK家族最耀眼的希望。第一款TYK2抑制剂、Sotyktu的数据显示，与其他JAK抑制剂相比，Sotyktu在斑块状银屑病治疗中展现出相对优越的疗效，在感染、心血管事件等方面的风险可能较低，没有报告过严重副作用，不良事件以轻度或中度为主，最常见的是上呼吸道感染和鼻咽炎。中位复发时间可与二代生物制剂媲美。武田重金引进的TAK-279，被GlobalData预测为将是第二款获得批准的TYK2抑制剂。去年TAK-279治疗活动性银屑病关节炎的2b期研究达到主要终点，临床数据展现出了其良好的疗效，随着剂量增加疗效递增，瘙痒症状有明显改善，且各剂量组相比安慰剂没有明显增加不良事件发生率。占据First-in-Class先机的BMS还在大举扩张Sotyktu适应症范围，根据BMS官网显示，除了银屑病适应症，干燥综合征、银屑病关节炎、系统性红斑狼疮、斑秃、盘状红斑狼疮均已到后期临床阶段。BMS公司也在临床试验中探索Sotyktu用于克罗恩病等的潜力。这些布局虽然还存在不确定性，但若取得突破将极大拓展Sotyktu的市场空间。TYK2的世界才刚刚被打开。预计到2028年，全球银屑病药物市场将进一步扩容至约400亿美元，如果TYK2能继续通过大规模临床试验证明有效性和长期安全性，以及长期获益，已有的银屑病领域就足够让TYK2有跻身黄金靶点的潜力。  同类最佳TYK2，会来自中国吗？值得注意的是，目前的在研TYK2管线中，中国公司占据了重要位置。尽管中国企业在JAK抑制剂市场起步较晚，2017年一代JAK抑制剂才上市，但在TYK2抑制剂研发上，国内药企并不逊色。例如Alumis的核心管线ESK-001，是海思科早前立项于2018年的项目，在BMS的TYK2抑制剂（BMS-986165）还处于3期临床时，海思科发表了基于BMS-986165发现新的临床1期候选药物的文章，呈现了一个成功的Me-too药物研发案例。2021年3月，海思科下属子公司FT集团以首付6000万美元，潜在交易1.2亿美元里程碑，将旗下在研TYK2抑制剂所属专利和权益转让给Alumis的前身公司。转让之时，其在全球的研发进展处于第三，仅次于BMS和武田。经过三年的临床研究，ESK-001展现了争夺Best-in-Class的潜力。前不久的AAD大会上，Alumis公布了2期积极数据，所有测试的5个剂量PASI75指标都达到了主要终点。最高剂量组（每天两次，40mg）中，64.1%的患者达到了这一水平的改善，而安慰剂组只有0%的患者达到了这一水平，并表现出良好的总体耐受性。国产第一梯队中，诺诚健华进度最快。依靠肿瘤起家，诺诚健华虽然仍有亏损，但手中的现金和现金等价物却高达85.8亿元。相对雄厚的资金实力，是开发自免药物的重要优势。两款TYK2产品中，ICP-332是目前临床数据最佳的中重度特应性皮炎药物之一，也是副作用最小的JAK药物之一，主要是由于ICP-332对TYK2具有强效抑制活性，对JAK2的选择性高达约400倍。ICP-488这款TYK2变构抑制剂，则是和BMS Sotyktu正面交锋，选择性结合JH2假激酶结构域，对JAK1-3无抑制活性，开发用于银屑病、银屑病关节炎、系统性红斑狼疮等。在临床1期健康受试者试验中，ICP-488已完成单剂量爬坡和多剂量爬坡研究，显示了良好的安全性和耐受性，目前已经快速推进至临床2期。不过，针对自免疾病的TYK2药物赛道已日渐拥挤。TYK2的另外探索方向，是在包括阿尔茨海默病（AD）和多发性硬化症（MS）在内的介导神经退行性疾病所涉及的潜在炎症过程中的作用。尽管MS和AD的病因和临床表现不同，但TYK2信号通路可能是一个共同的治疗靶点。抑制TYK2在MS中可阻断IL-12/IL-23介导的炎症反应，在AD中可减少Aβ诱导的神经元死亡。目前在MS和AD中有所布局的不多，但同样有国内Biotech做先锋。高光制药的TLL-041，是首个具有穿透血脑屏障能力的高选择性TYK2/JAK1抑制剂，潜在适应症包括帕金森病、阿尔茨海默病和多发性硬化症等，已在去年3月对外授权给Biohaven。高光制药获得2000万美元首付款和潜在的9.5亿美元里程碑款及销售分成，双方在全球协作进行临床开发。TLL-041预计在今年进入临床2期。能够在TYK2竞争中挖掘到CNS渗透性TYK2/JAK1，足以说明高光制药的实力。国内在研TYK2管线，整理自公开数据总体来说，国内药企在TYK2跟进迅速，第一梯队品种正在快速临床进程中，但目前国内TYK2靶点药物研发仍处于早期阶段，创新式的结构优化、差异化的结构设计来取得更优秀的TYK2抑制剂，或许能让国内玩家有同类最佳的竞争机会。BMS Sotyktu的初步商业成功，武田的重金押注，都让TYK2充满“钱景”。但还需要关注的是，TYK2的竞争对手不止是自己，既包括达必妥等成熟商业化的药物，还有其他靶点机制的强力候选药物，如强生的IL-23R拮抗多肽JNJ-2113，礼来的IL-17抑制剂DC-806等。*封面图片来源：123rf文|张珏微信|13240321829添加时请注明：姓名-公司-职位网站、公众号等转载请联系授权：Rekkiiie近期推荐声明：动脉网所刊载内容之知识产权为动脉网及相关权利人专属所有或持有。未经许可，禁止进行转载、摘编、复制及建立镜像等任何使用。动脉网，未来医疗服务平台

CHARLOTTESVILLE, Va., March 27, 2024 /PRNewswire/ -- AMPEL BioSolutions announces a breakthrough in personalized precision medicine that will revolutionize the way doctors manage the autoimmune disease Lupus. Revealed in the peer-reviewed journal Genome Medicine and being made available to patients through a US follow-on study, the LuGENE® blood test forecasts patient flares and drug targets from gene expression utilizing predictive AI. The LuGENE® lab test is now launching at several Lupus practices around the country including those in medical centers, concierge practices and healthcare systems as a practical decision support biomarker test that could greatly impact day-to-day healthcare for patients with Lupus. The blood test predicts flares before they happen and provides specific information about a patient's disease abnormalities leading to symptoms, allowing physicians to make evidence-based decisions regarding therapy including whether a patient is stable on their current therapeutic regimen. There are a million and a half lupus patients in the US that could benefit from LuGENE® by preventing unexpected flares and shortening the time to disease-controlling therapy. From RNA gene expression in cells circulating in the blood, LuGENE® identifies real-time abnormalities leading to inflammation and immune system dysfunction that are targetable by medication. Some abnormalities are well-known and others are novel. Until now, therapeutic intervention is a trial-and-error endeavor that often takes years until a patient is stabilized without further threat of organ-damaging flares. LuGENE® clarifies that there are eight subgroups that make up the universe of Lupus patients, the reason why getting the right drug to the right patient at the right time has been so challenging, as until now physicians did not have a tool to know what drug targets are abnormal in their patient. AMPEL's approach pinpoints the patient subgroup(s) that express the target of one or both of the FDA-approved drugs for lupus, Benlysta and Anifrolumab, providing decision support for physicians to potentially shorten the time to effective therapy and potentially improve quality of life. Diversity across ancestries is a hallmark of Lupus and the AMPEL R&D team included patients from all ethnicities to ensure that LuGENE® is predictive for all patients in the United States living with Lupus. This is especially important as Lupus emerges earlier and with greater severity in African-American, Asian, Native-American and Hispanic/Latinx communities shortening life-span. Lupus has been called the "cruel mystery" because until now doctors have few objective metrics to assess whether their patient is stable with low risk of flare. Patients with Lupus experience inflammation and pain from their immune system attacking their own organs and tissues with the same vigor as fighting off an infection. Ninety-five percent of Lupus patients have experienced a flare in the last year. Symptoms including extreme fatigue and "brain fog" that impact daily activities, including work and family life, has led to Lupus being referred to as an "invisible disability". A Lupus Foundation of America survey found that fifty-five percent of patients with Lupus reported a complete or partial loss of their income because they no longer are able to work full time due to complications of lupus; one in three have been temporarily disabled by the disease, and one in four currently receive disability payments. "AMPEL is an industry leader in lupus disease management, and we are excited to unveil our latest advancement in the field of precision medicine," said Dr. Amrie Grammer, Co-Founder and President/CSO of AMPEL BioSolutions. "With so many patients experiencing a flare every year, and a high percentage of those cases so severe that they are hospitalized, this is a crucial tool in our fight against Lupus. With LuGENE®, healthcare providers will be able to stabilize lupus patients faster than ever before, minimize the occurrence of disruptive flares and hopefully transform Lupus to a chronic condition with increased quality of life." "Currently, there is no way to predict flares or determine which treatment is most appropriate for each patient, and in many instances it can take many years for some patients to find the most effective one to manage their disease," said Dr. Peter Lipsky, Co-Founder and CEO/CMO of AMPEL BioSolutions. "Healthcare professionals can now know whether a flare in disease activity in imminent and if the disease is not controlled, LuGENE® can identify the specific targets of therapies that are more likely to provide relief. The LuGENE® blood test is a monitoring biomarker that provides essential information to support personalized management for each individual lupus patient." "As a clinician, I am tired of wasting my patients' valuable time and money by trying different therapies for their Lupus using the 'trial and error' methodology, which is our only option now," said Dr. Don Thomas, Rheumatologist at Arthritis & Pain Associates of Prince George's County in Maryland, author of the Lupus Encyclopedia & Former Chair Advisory council Lupus Foundation of America DC/MD/VA, "This approach to taking care of Lupus patients ends up causing so much misery as they deal with life-altering symptoms and complications when therapies do not work or cause them side effects. The dream of using personalized medicine to assist me in choosing therapies that have a greater chance of working, based on their endotype and actual immunologic abnormalities, is closer to becoming a reality with the LuGENE® blood test." "Lupus is a very complicated disease that is pleomorphic in nature and very difficult to treat," said Dr. Daniel Wallace, author of Dubois SLE and The Lupus Book & Rheumatologist at Cedars-Sinai, UCLA, Wallace-Lee Center and BoD member of the Lupus Research Alliance affiliate Lupus Therapeutics and LupusLA, "The LuGENE® blood test is a novel and innovative approach that has the potential to revolutionize the way heterogenous Lupus patients are managed by identifying their genomic biomarker fingerprint and predict if the disease is stable (or not) and what drug targets are abnormal indicating therapeutic options to consider." "I want to express my excitement to be one of the first practices to utilize the LuGENE® genomic biomarker test for Lupus," Dr. John Tesser, Arizona Arthritis and Rheumatology Associates, "to potentially manage patients more specifically by being informed if a patient is stable on their current medication or if particular drug targets are abnormal. AMPEL's Genomic Platform with RNA analytics and machine learning is highly unique and is poised to provide true personalized medicine for patients living with Lupus. I am most enthusiastic to participate in the LuGENE® study called ReLATE that will examine the relationship between standard clinical & lab parameters with prediction of flare & abnormal drug targets." "The LuGENE® blood test is incredibly exciting as it represents an important advance towards achieving personalized medicine for Lupus patients by using novel technology of explainable predictive AI and analytics that group all known gene expression by drug target," Dr. Cindy Aranow, Feinstein Institute at Northwell Health. "A key part of the AMPEL Genomic approach is subsetting/endotyping patients by their RNA biomarker fingerprint that predict a patient's disease status and potential to flare. I am delighted to be one of practices that is launching LuGENE® through the ReLATE study." "I am excited about the publication describing LuGENE® as a blood test that offers rheumatologists clinically relevant information in real-time predicted by AMPEL's explainable-AI powered RNA analytic platform, that should be highly informative about an individual lupus patient's status," Dr. Orrin Troum, The Doctors of Saint John's Medical Center, Providence Healthcare "This approach could provide a real advance in personalized medicine for Lupus patients. Additionally, I am thrilled to be one of the first practices participating in the LuGENE® study called ReLATE, whose clinical report I anticipate will help me tailor Lupus management." During the interview with Scripps News Network, Dr. Grammer explains how there is currently no way to predict flares or determine which is the most appropriate treatment for an individual lupus patient. Identifying a therapeutic regimen that stabilizes a patient's disease course often takes several years of trial and error. LuGENE® is currently available through the ReLATE study at Cedars-Sinai in LA and Arthritis & Osteoporosis Consultants of the Carolinas (AOCC) in Charlotte NC. The study is expanding to sites across the US including Arizona Arthritis & Rheumatology, Feinstein at Northwell Health, Mayo Clinic, Providence Healthcare, Rush in Chicago, Hospital for Special Surgery, Cleveland Clinic, Univ of Maryland, Yale, MetroHealth at Case Western Reserve, U Mass, Duke and others. Physicians and patients enrolled at these centers will experience how the LuGENE® blood test informs lupus patient management. Kathleen Arntsen, Lupus and Allied Diseases Association (LADA) President & CEO, "For people struggling daily to live with complex autoimmune diseases like Lupus, what motivates us to face another day is the promise and progress of research that will improve our quality of life. Our community has eagerly awaited the development of more effective therapeutic approaches that can be tailored to each individual. This groundbreaking LuGENE® blood test has the potential to achieve this goal and transform patient care not only for lupus but for other autoimmune conditions." Emmitt Thompson III, Male Lupus Warriors, "Being able to predict a flare before it happens and get on stabilizing medications for my Lupus is a game changer! As patient who ends up in the ER frequently with organ damaging autoimmunity, I am encouraged by the possibility of getting ahead of Lupus inflammation by monitoring with the LuGENE® blood test." Deidre Gee Baptista and Kirsten Gee Maeda, GEE Twins for Lupus and Lupus Foundation of Northern California Board Members: "With two decades of experiencing the ups and downs of chronic Lupus, we are thrilled for a truly more personalized approach to managing and treating this chronic autoimmune disease. The LuGENE® blood test provides a much needed, personalized approach to reducing inflammation, pain and what are now 'unpredictable flares'. Families navigating their lupus journeys look forward to getting ahead of autoimmune organ damage by getting to an effective treatment more quickly, helping patient's lead productive lives." Jay Remley, Inaugural Google Cloud Global Dir & Vice-Chair Lupus Foundation NC, "Lupus is a complex autoimmune disease that is often mis-treated for years, causing pain and anxiety for people living with this lifelong condition. The LuGENE® blood test may address this critical care need. One of the most challenging times for a Lupus warrior is the time to establish an initial therapy. The second most difficult time is the 24x7 anxiety that a patient endures waiting for the inevitable next flare to arrive. LuGENE® will provide decision support to physicians re whether a patient is stable on the current drug regimen and specifics about what drug targets are abnormal right now, both of which are monumental breakthroughs for the Lupus community." McKenna Bowes, Molecular Biology Student, "As an undergraduate student in the Sawalha lab at the Univ. of Pittsburgh (BS, May 2025) and an aspiring medical student, understanding the science behind LuGENE® makes it even more exciting! Even after almost five years of living with lupus, I still find that managing symptoms and trying different medications can be a frustrating and lengthy process. The ability of the LuGENE® blood test to predict flares and identify different lupus endotypes with the LuGENE® score offers a more personalized and targeted approach to my lupus care, ultimately alleviating some of these challenges for patients overall . I believe that this test can significantly improve the lives of those living with lupus." Sobia Saleem MA LMFT, Psychotherapist and Lupus Advocate, "I am beyond thrilled at the launch of the LuGENE®. As a Lupus patient 10+ years, a blood test that can both predict flares and help my medical team prescribe me targeted therapies that work best with my body is an unprecedented leap. One of my greatest struggles is that Lupus is unpredictable and can rob you of important moments decreasing quality of life due to volatility in disease activity. To understand a flare is approaching in addition to what pathways are abnormal would be life-changing! I have wasted literal years of my life in pain because the current model of lupus treatment is a trial-and-error approach. The LuGENE® blood test solves two of the most unknown variables in a patient's journey," Estela & Juana Mata, Looms For Lupus, "As advocates for those living with lupus, and as people who live with lupus, we are thrilled about the LuGENE® blood test. Innovative approaches and precision medicine are crucial new ways to predict flares and manage care. More than exciting scientific advancements, personalized precision medicine is our hope for reducing irreversible damage and complications from unexpected flares. This LuGENE® personalized blood test represents a transformative impact on patient care, giving those living with lupus, and potentially others living with autoimmune conditions, the knowledge of what drug targets are abnormal so they can discuss early treatment opportunities with their doctors to potentially improve quality of life." Christine von Raesfeld, NIH All of Us Ambassador and People with Empathy Founder: "As a Lupus patient of mixed ancestry, I've experience long-term damage from standard treatments. I believe LuGENE® offers immense promise for our autoimmune community. By analyzing our gene expression profile, LuGENE® empowers patients to tailor their treatments, especially crucial for minority populations often underserved by current therapeutic approaches. Instead of "trial and error" prevalent in today's standard-of-care, LuGENE® provides a path to targeted treatment that minimizes flares and bridges the gap between science and personalized precision care." About AMPEL BioSolutions AMPEL is a Precision Medicine company commercializing a development pipeline of blood tests that measure dynamic RNA gene expression providing a real-time CLIA-certified report of inflammation status including drugs targets that are abnormal. Unlike DNA tests which only need to be done once, AMPEL's RNA blood or biopsy tests are utilized on demand with the goal of "treat to target" and optimal disease management for Lupus (LuGENE®) or Dermatology Conditions such as Psoriasis or Ezcema (DermaGENE®). For an otherwise healthy individual, AMPEL's prediction of inflammation with WellGENE® may be an early indicator of changes in the immune system that may be worth investigating further by a trained healthcare provider. In addition, AMPEL works with Pharma/Biotech customers for target identification, pre-clinical models, post-hoc analysis and real-time enrichment during clinical trial enrollment. The company's portfolio of tests are supported by the AMPEL Genomic Platform of RNA analytic tools and explainable predictive AI. SOURCE AMPEL BioSolutions

THOUSAND OAKS, Calif., Feb. 6, 2024 /PRNewswire/ -- Amgen (NASDAQ:AMGN) today announced financial results for the fourth quarter and full year 2023 versus comparable periods in 2022. "2023 was another year of performance and progress for our company," said Robert A. Bradway, chairman and chief executive officer. "Our marketed products are reaching many more patients around the world, and we anticipate more than a dozen significant pipeline milestones in 2024." Key results include: For the fourth quarter, total revenues increased 20% to $8.2 billion in comparison to the fourth quarter of 2022. Product sales grew 20%, driven by 23% volume growth, partially offset by 3% lower net selling price. Nine brands(1) achieved record sales in the quarter, and Repatha® (evolocumab), EVENITY® (romosozumab-aqqg), Prolia® (denosumab) and BLINCYTO® (blinatumomab) delivered double-digit volume growth globally. U.S. volume grew 26% and ex-U.S. volume grew 15%, including 46% volume growth in the Asia Pacific region. Our performance included $954 million of sales for the period of Oct. 6 - Dec. 31 from our recent Horizon Therapeutics (Horizon) acquisition, driven by several first-in-class, early-in-lifecycle medicines such as TEPEZZA® (teprotumumab-trbw), KRYSTEXXA® (pegloticase) and UPLIZNA® (inebilizumab-cdon). Excluding the impact of these sales from Horizon, our product sales grew 5%, driven by volume growth of 9%. For the full year, total revenues increased 7% to $28.2 billion, resulting from a 9% increase in product sales. Product sales growth was driven by 15% volume growth, partially offset by 3% lower net selling price, 1% unfavorable changes from estimated sales deductions and 1% negative impact from foreign exchange. GAAP earnings per share (EPS) decreased 53% from $3.00 to $1.42 in the fourth quarter, driven by acquisition-related expenses and incremental operating expenses from Horizon, partially offset by increased revenues. For the full year, GAAP EPS increased 3% from $12.11 to $12.49 driven by net gains on our BeiGene, Ltd equity investment in 2023 and higher revenues, partially offset by higher operating expenses, including acquisition-related expenses and incremental expenses from Horizon. For the fourth quarter, GAAP operating income decreased from $2.2 billion to $1.3 billion, and GAAP operating margin decreased 17.8 percentage points to 16.2%. For the full year, GAAP operating income decreased from $9.6 billion to $7.9 billion, and GAAP operating margin decreased 9.3 percentage points to 29.3%. Non-GAAP EPS increased 15% from $4.09 to $4.71 in the fourth quarter and increased 5% from $17.69 to $18.65 for the full year, driven by increased revenues, partially offset by higher operating expenses, including incremental expenses from Horizon. Fourth quarter non-GAAP EPS was also unfavorably impacted by higher interest expense. For the fourth quarter, non-GAAP operating income increased from $3.0 billion to $3.7 billion, and non-GAAP operating margin increased 0.8 percentage points to 46.7%. For the full year, non-GAAP operating income increased from $12.8 billion to $13.4 billion, and non-GAAP operating margin decreased 1.7 percentage points to 49.8%. The Company generated $7.4 billion of free cash flow for the full year versus $8.8 billion in 2022. The decrease in 2023 was primarily driven by transaction expenses related to the Horizon acquisition and higher repatriation tax payments. (1) Includes product sales for the full fourth quarter of 2023 from UPLIZNA and KRYSTEXXA in connection with Horizon acquisition. References in this release to "non-GAAP" measures, measures presented "on a non-GAAP basis," "free cash flow" (computed by subtracting capital expenditures from operating cash flow), "EBITDA, or earnings before interest, taxes, depreciation and amortization" (computed by adding interest expense, provision for income taxes, and depreciation and amortization expense to GAAP net income) and "debt leverage ratio" (calculated as the ratio of GAAP total debt to EBITDA) refer to non-GAAP financial measures. Adjustments to the most directly comparable GAAP financial measures and other items are presented on the attached reconciliations. Refer to Non-GAAP Financial Measures below for further discussion. Product Sales Performance Total product sales increased 20% for the fourth quarter of 2023 versus the fourth quarter of 2022. Volume grew 23%, partially offset by 3% lower net selling price. Full year product sales increased 9% versus 2022, driven by 15% volume growth, partially offset by 3% lower net selling price, 1% unfavorable changes from estimated sales deductions and 1% negative impact from foreign exchange. General Medicine Repatha® sales increased 25% year-over-year for the fourth quarter, driven by 35% volume growth, partially offset by lower net selling price. Full year sales increased 26%, driven by 37% volume growth, partially offset by lower net selling price. Repatha remains the global proprotein convertase subtilisin/kexin type 9 (PCSK9) segment leader, with over 2.5 million patients treated since launch. Prolia® sales increased 12% year-over-year, to a record $1.1 billion for the fourth quarter, and 12% for the full year, primarily driven by volume growth and higher net selling price. Volume grew 10% for the quarter and 9% for the full year. In 2023, over 7.5 million patients were treated with Prolia. EVENITY® sales increased 41% year-over-year to a record $318 million for the fourth quarter and 47% for the full year, driven by strong volume growth. U.S. volume grew 44% year-over-year and volume outside the U.S. grew 55% for the full year. Aimovig® (erenumab-aooe) sales decreased 32% year-over-year for the fourth quarter and 22% for the full year, driven by lower net selling price. Oncology BLINCYTO® sales increased 47% year-over-year to a record $241 million for the fourth quarter and 48% for the full year, driven by 55% and 49% volume growth, respectively. Volume growth was supported by broad prescribing across academic and community settings for patients with B-cell precursor acute lymphoblastic leukemia. Vectibix® (panitumumab) sales increased 5% year-over-year for the fourth quarter and 10% for the full year, driven by 5% and 10% volume growth, respectively. KYPROLIS® (carfilzomib) sales increased 8% year-over-year for the fourth quarter and 13% for the full year, driven by 8% and 12% volume growth, respectively. LUMAKRAS®/LUMYKRAS™ (sotorasib) sales increased 8% year-over-year for the fourth quarter, driven by 5% volume growth and higher net selling price. Full year sales decreased 2%, driven by unfavorable changes to estimated sales deductions, including changes related to ongoing reimbursement negotiations in France. Full year sales were also impacted by lower net selling price and lower inventory levels, partially offset by 16% volume growth. XGEVA® (denosumab) sales increased 9% year-over-year for the fourth quarter and 5% for the full year, primarily driven by higher net selling price. Nplate® (romiplostim) sales decreased 18% year-over-year for the fourth quarter, driven by volume decline related to timing of orders placed by the U.S. government, partially offset by volume growth across our U.S. and ex-U.S. regions. U.S. government orders were $207 million in Q4'22 compared to $62 million in Q4'23. Full year sales increased 13%, primarily driven by volume growth, including U.S. government orders. U.S. government orders were $207 million for FY'22 compared to $286 million for FY'23. Excluding these U.S. government orders, Nplate sales grew 23% year-over-year for the fourth quarter and 8% for the full year. MVASI® (bevacizumab-awwb) sales decreased 8% year-over-year for the fourth quarter, primarily driven by lower net selling price, partially offset by 12% volume growth. Full year sales decreased 11%, primarily driven by lower net selling price, partially offset by 13% volume growth. Going forward, we expect continued net selling price erosion driven by increased competition. KANJINTI® (trastuzumab-anns) sales decreased 33% year-over-year for the fourth quarter and 50% for the full year, driven by lower net selling price and volume decline. Inflammation TEZSPIRE® (tezepelumab-ekko) generated $177 million of sales in the fourth quarter. Quarter-over-quarter sales increased 10%, driven by 18% volume growth that benefited from the pre-filled, single-use pen, which was approved for self-administration by the U.S. Food and Drug Administration (FDA) in the first quarter. Healthcare providers recognize TEZSPIRE's unique, differentiated profile and its broad potential to treat the 2.5 million patients worldwide with severe asthma who are uncontrolled, without any phenotypic or biomarker limitation. Otezla® (apremilast) sales increased 2% year-over-year for the fourth quarter, driven by favorable changes to estimated sales deductions and 3% volume growth, partially offset by lower inventory levels and lower net selling price. Full year sales decreased 4%, driven by lower net selling price and lower inventory levels, partially offset by 2% volume growth. We expect future growth for Otezla to be driven by its established efficacy and safety profile, strong payer coverage with limited prior authorization requirements and ease of administration. Otezla remains the only approved oral systemic therapy with a broad indication and is well-positioned to help the 1.5 million U.S. patients with mild-to-moderate psoriasis who cannot be optimally addressed by a topical and can benefit from a systemic treatment like Otezla. Enbrel® (etanercept) sales decreased 8% year-over-year for the fourth quarter, driven by a 4% impact from unfavorable changes to estimated sales deductions and lower net selling price. Full year sales decreased 10%, driven by lower net selling price, lower inventory levels and a 3% impact from unfavorable changes to estimated sales deductions. Year-over-year volume remained flat, with U.S. volume growing 1% in the fourth quarter, supported by an increase in new patients starting treatment as a result of improved payer coverage. Going forward, we expect net selling price to continue to decline year-over-year, driven by higher rebates to maintain broad first-line payer coverage and changes in patient mix. We expect Otezla and Enbrel to follow the historical pattern of lower sales in the first quarter relative to subsequent quarters due to the impact of benefit plan changes, insurance reverification and increased co-pay expenses as U.S. patients work through deductibles. AMJEVITA®/AMGEVITA™ (adalimumab) sales increased 34% year-over-year for the fourth quarter and 36% for the full year, primarily driven by 35% and 46% volume growth, respectively. Ex-U.S. sales increased 9% for the full year, driven by 20% volume growth, partially offset by lower net selling price. U.S. sales increased 43% quarter-over-quarter, driven by higher inventory levels and higher net selling price, partially offset by volume decline. Rare Disease Excluding TAVNEOS®, the products listed below were acquired from our Horizon transaction on Oct. 6, 2023. Sales figures reflect only sales in the period from Oct. 6 2023 through the end of the year, and not the full quarter. TEPEZZA® (teprotumumab-trbw) generated $448 million of sales for the period. TEPEZZA is the first and only FDA-approved treatment for thyroid eye disease (TED). KRYSTEXXA® (pegloticase) generated $272 million of sales for the period. KRYSTEXXA is the first and only FDA-approved treatment for chronic refractory gout. UPLIZNA® (inebilizumab-cdon) generated $65 million of sales for the period. UPLIZNA is used to treat adults with neuromyelitis optica spectrum disorders (NMOSD). TAVNEOS® (avacopan) generated $44 million of sales in the fourth quarter. Quarter-over-quarter sales increased 19%, primarily driven by volume growth. U.S. volume grew 23% quarter-over-quarter. In the U.S., approximately 2,700 patients have now been treated with TAVNEOS. Ultra rare products, which consist of RAVICTI® (glycerol phenylbutyrate), PROCYSBI® (cysteamine bitartrate), ACTIMMUNE® (interferon gamma-1b), BUPHENYL® (sodium phenylbutyrate) and QUINSAIR® (levofloxacin) generated $164 million of sales for the period. Established Products Total sales of our established products, which consist of EPOGEN® (epoetin alfa), Aranesp® (darbepoetin alfa), Parsabiv® (etelcalcetide) and Neulasta® (pegfilgrastim), decreased 10% year-over-year for the fourth quarter, primarily driven by lower net selling price and volume declines, partially offset by favorable changes to estimated sales deductions. Full year sales decreased 19%, driven by lower net selling price and volume declines. In the aggregate, we expect the year-over-year net selling price and volume declines for this portfolio of products to continue. Product Sales Detail by Product and Geographic Region Operating Expense, Operating Margin and Tax Rate Analysis On a GAAP basis: Total Operating Expenses increased 50% year-over-year for the fourth quarter. For the full year, Total Operating Expenses increased 21%. Cost of Sales as a percentage of product sales increased 13.0 percentage points in the fourth quarter primarily driven by higher amortization expense from acquisition-related assets as well as higher profit share and royalties, partially offset by Puerto Rico excise tax, changes in product mix, and lower manufacturing cost. For the full year, cost of sales as a percentage of product sales increased 5.6 percentage points primarily driven by higher amortization expense from acquisition-related assets, higher profit share and royalties, and changes in product mix, partially offset by Puerto Rico excise tax. Research & Development (R&D) expenses increased 16% in the fourth quarter and increased 8% for the full year driven by higher spend in later-stage clinical programs and marketed products support, including spend from programs acquired from the Horizon acquisition. Selling, General & Administrative (SG&A) expenses increased 45% in the fourth quarter and increased 14% for the full year primarily driven by higher acquisition-related costs, in addition to commercial and general administrative expenses related to the Horizon acquisition. For the full year, this was partially offset by a decline in other marketed product spend. Other operating expenses for the full year consisted of net impairment charges for AMG 340 and Teneobio IPR&D assets in addition to expenses related to our restructuring plan initiated in the first quarter of 2023. Operating Margin as a percentage of product sales decreased 17.8 percentage points to 16.2% in the fourth quarter and decreased 9.3 percentage points for the full year to 29.3%. Tax Rate increased 2.4 percentage points in the fourth quarter and increased 3.7 percentage points for the full year, primarily driven by the 2022 Puerto Rico tax law change that replaced the excise tax with an income tax beginning in 2023. For the fourth quarter this was partially offset by the change in earnings mix. On a non-GAAP basis: Total Operating Expenses increased 18% for the fourth quarter and increased 9% for the full year. Cost of Sales as a percentage of product sales remained flat in the fourth quarter primarily driven by higher profit share and royalties, offset by Puerto Rico excise tax, changes in product mix, and lower manufacturing cost. For the full year, cost of sales as a percentage of product sales increased 1.1 percentage points primarily driven by higher profit share and royalties and changes in product mix, partially offset by Puerto Rico excise tax. R&D expenses increased 16% in the fourth quarter and increased 8% for the full year driven by higher spend in later-stage clinical programs and marketed products support, including spend from programs acquired from the Horizon acquisition. SG&A expenses increased 20% in the fourth quarter and increased 5% for the full year primarily driven by higher commercial and general administrative expenses related to the Horizon acquisition. For the full year, this was partially offset by a decline in other marketed product spend. Operating Margin as a percentage of product sales increased 0.8 pts. percentage points to 46.7% in the fourth quarter and decreased 1.7 percentage points for the full year to 49.8%. Tax Rate increased 2.5 percentage points in the fourth quarter and increased 2.7 percentage points for the full year primarily due to the 2022 Puerto Rico tax law change that replaced the excise tax with an income tax beginning in 2023. Cash Flow and Balance Sheet The Company generated $0.3 billion of free cash flow in the fourth quarter of 2023 versus $2.3 billion in the fourth quarter of 2022, primarily driven by timing of federal and repatriation tax payments. The Company generated $7.4 billion of free cash flow for the full year 2023 versus $8.8 billion in 2022. The Company's fourth quarter 2023 dividend of $2.13 per share was declared on October 24, 2023, and was paid on December 8, 2023, to all stockholders of record as of November 17, 2023, representing a 10% increase from 2022. During the fourth quarter, there were no repurchases of shares of common stock. Cash and investments totaled $10.9 billion and debt outstanding totaled $64.6 billion as of December 31, 2023. Debt leverage was approximately 4.4 times EBITDA as of December 31, 2023. 2024 Guidance For the full year 2024, the Company expects: Total revenues in the range of $32.4 billion to $33.8 billion. On a GAAP basis, EPS in the range of $8.42 to $9.87, and a tax rate in the range of 11.5% to 13.0%. On a non-GAAP basis, EPS in the range of $18.90 to $20.30, and a tax rate in the range of 16.0% to 17.0%. Capital expenditures to be approximately $1.1 billion. Share repurchases not to exceed $500 million. Fourth Quarter Product and Pipeline Update The Company provided the following updates on selected product and pipeline programs: General Medicine Maridebart cafraglutide (AMG 133) A Phase 2 study of maridebart cafraglutide, a multispecific molecule that inhibits the gastric inhibitory polypeptide receptor (GIPR) and activates the glucagon like peptide 1 (GLP-1) receptor, in overweight or obese adults with or without type 2 diabetes mellitus has completed enrollment, with topline data anticipated in late 2024. The Company recently added a Part 2 to this study which explores durable weight loss beyond 52 weeks. Planning for a comprehensive Phase 3 program across multiple indications remains on track. In February 2024, results of preclinical studies and the Phase 1 study of maridebart cafraglutide were published in Nature Metabolism. AMG 786 A Phase 1 study of AMG 786, a small molecule obesity program, is ongoing with initial data readout anticipated in H1 2024. This molecule has a different target than maridebart cafraglutide and is not an incretin-based therapy. Olpasiran (AMG 890) A Phase 3 cardiovascular outcomes study of olpasiran, a potentially best-in-class small interfering ribonucleic acid (siRNA) molecule that reduces lipoprotein(a) (Lp(a)) synthesis in the liver, in patients with atherosclerotic cardiovascular disease and elevated Lp(a) continues to enroll patients. To date, over 7,000 patients have been enrolled, with enrollment completion anticipated in H1 2024. Repatha EVOLVE-MI, a Phase 4 study of Repatha administered within 10 days of an acute myocardial infarction to reduce the risk of cardiovascular events, continues to enroll patients. A Phase 3 cardiovascular outcomes study (VESALIUS-CV) in patients at high cardiovascular risk without prior myocardial infarction or stroke is ongoing. Oncology Tarlatamab (AMG 757) The U.S. Food and Drug Administration (FDA) has granted Priority Review for the Company's Biologics License Application (BLA) for tarlatamab, a first-in-class investigational delta-like ligand 3 (DLL3) targeting BiTE® (bispecific T-cell engager) molecule. The BLA is based on the results from the Phase 2 DeLLphi-301 clinical trial, which demonstrated antitumor activity with a durable response and encouraging survival outcomes in previously treated small cell lung cancer (SCLC). The safety profile was consistent with the Phase 1 trial. Based on the Priority Review designation, the Prescription Drug User Fee Act (PDUFA) date for tarlatamab is June 12, 2024. DeLLphi-304, a Phase 3 study comparing tarlatamab with standard of care chemotherapy in second-line SCLC, continues to enroll patients. DeLLphi-306, a Phase 3 study comparing tarlatamab with placebo in limited-stage SCLC, was initiated. DeLLphi-305, a Phase 3 study comparing tarlatamab and durvalumab with durvalumab alone in first-line, extensive-stage SCLC, will be initiated in H1 2024. DeLLphi-300, a Phase 1 study of tarlatamab in relapsed/refractory SCLC, continues to enroll patients. DeLLphi-302, a Phase 1b study of tarlatamab in combination with AMG 404, an anti-programmed cell death protein 1 (PD1) monoclonal antibody, in second-line or later SCLC, is ongoing.   DeLLphi-303, a Phase 1b study of tarlatamab in combination with standard of care in first-line SCLC, continues to enroll patients. DeLLpro-300, a Phase 1b study of tarlatamab in de novo or treatment-emergent neuroendocrine prostate cancer, is ongoing. BLINCYTO The FDA granted Priority Review for the Company's supplemental BLA for BLINCYTO in early-stage, CD19-positive B-cell precursor acute lymphoblastic leukemia (B-ALL) based in part on the Phase 3 E1910 study conducted by the National Cancer Institute, the Eastern Cooperative Oncology Group and the American College of Radiology Imaging Network Cancer Research Group. Based on the Priority Review designation, the PDUFA date for BLINCYTO is June 21, 2024. Additional global regulatory authority submissions are underway. Golden Gate, a Phase 3 study of BLINCYTO alternating with low-intensity chemotherapy in older adults with newly diagnosed Philadelphia chromosome-negative (Ph-) B-ALL, continues to enroll patients. The Company is planning to amend the Golden Gate Phase 3 study to include an evaluation of blinatumomab subcutaneous administration with initiation anticipated in H2 2024. A Phase 1/2 study of subcutaneous blinatumomab in adults with relapsed or refractory Ph- B-ALL continues to enroll patients. Xaluritamig (AMG 509) A Phase 1b monotherapy and combination dose-escalation and -expansion study of xaluritamig, a first-in-class bispecific T-cell engager targeting six-transmembrane epithelial antigen of prostate 1 (STEAP1) in metastatic castrate resistant prostate cancer continues to enroll patients in the dose-expansion portion of the study, where enrollment is almost complete. A reduced monitoring cohort was also initiated. Two additional Phase 1 studies of xaluritamig to evaluate preliminary efficacy and safety in patients with early prostate cancer are planned. AMG 193 The Phase 1/1b/2 study of AMG 193, a first-in-class small molecule methylthioadenosine (MTA)-cooperative protein arginine methyltransferase 5 (PRMT5) inhibitor, continues to enroll patients with advanced methylthioadenosine phosphorylase (MTAP)-null solid tumors. To date, responses have been seen in nine patients across seven tumor types. Master protocols in thoracic and gastrointestinal malignancies exploring combinations with standard of care will be initiated in H1 2024. A Phase 1/2 study of AMG 193 in combination with IDE397, an investigational methionine adenosyltransferase 2A (MAT2A) inhibitor, is enrolling patients. Nplate A Phase 3 study of Nplate in chemotherapy-induced thrombocytopenia in gastrointestinal, pancreatic, or colorectal malignancies is fully enrolled. Data readout is anticipated in H2 2024. LUMAKRAS/LUMYKRAS A U.S. regulatory submission is planned for the Phase 3 CodeBreaK 300 trial in H1 2024. This study evaluated two doses of LUMAKRAS (960 mg or 240 mg) in combination with Vectibix in patients with chemorefractory KRAS G12C-mutated metastatic colorectal cancer (CRC). A Phase 3 study of LUMAKRAS in combination with Vectibix and FOLFIRI in first-line KRAS G12C-mutated CRC was initiated. A Phase 3 study of LUMAKRAS plus chemotherapy vs. pembrolizumab plus chemotherapy in first-line KRAS G12C-mutated and programmed cell death protein ligand-1 (PD-L1) negative advanced non-small cell lung cancer (NSCLC) is enrolling patients. Regulatory review by the European Medicines Agency (EMA) of the CodeBreaK 200 Phase 3 trial of adults with previously treated locally advanced or metastatic KRAS G12C-mutated NSCLC along with data from the Phase 2 dose-comparison substudy is ongoing. The FDA completed its review of the Company's supplemental New Drug Application seeking full approval of LUMAKRAS based on the CodeBreaK 200 trial results. The FDA issued a new postmarketing requirement for an additional confirmatory study to support full approval to be completed no later than February 2028, while also concluding that LUMAKRAS at 960 mg once-daily will remain the dose for patients with KRAS G12C-mutated NSCLC under accelerated approval. Bemarituzumab FORTITUDE-101, a Phase 3 study of bemarituzumab, a first-in-class fibroblast growth factor receptor 2b (FGFR2b) targeting monoclonal antibody, plus chemotherapy in first-line gastric cancer, continues to enroll patients. FORTITUDE-102, a Phase 1b/3 study of bemarituzumab plus chemotherapy and nivolumab in first-line gastric cancer, continues to enroll patients in the Phase 3 portion of the study. FORTITUDE-103, a Phase 1b/2 study of bemarituzumab plus oral chemotherapy regimens with or without nivolumab in first-line gastric cancer, continues to enroll patients. FORTITUDE-301, a Phase 1b/2 basket study of bemarituzumab monotherapy in solid tumors with FGFR2b overexpression, is ongoing. Inflammation TEZSPIRE In severe asthma, the WAYFINDER Phase 3b study is fully enrolled. The PASSAGE Phase 4 real-world effectiveness study and the SUNRISE Phase 3 study continue to enroll patients. A Phase 3 study of TEZSPIRE in chronic rhinosinusitis with nasal polyps is fully enrolled. Primary analysis is anticipated in H2 2024. A Phase 3 study of TEZSPIRE in eosinophilic esophagitis continues to enroll patients. A Phase 2 study of TEZSPIRE in chronic obstructive pulmonary disease is fully enrolled. Data readout is anticipated in H1 2024. Rocatinlimab (AMG 451/KHK4083) The ROCKET Phase 3 program, now composed of eight studies evaluating rocatinlimab, a first in class monoclonal antibody targeting OX40, in moderate to severe atopic dermatitis, continues to enroll adult and adolescent patients. To date, over 2,400 patients have been enrolled in the ROCKET program. The Phase 3 HORIZON study (part of the ROCKET program) evaluating rocatinlimab monotherapy vs. placebo in adults with moderate to severe atopic dermatitis is fully enrolled. Data readout is anticipated in H2 2024. A Phase 2 study of rocatinlimab in asthma will be initiated in H1 2024 and a Phase 3 study of rocatinlimab in prurigo nodularis will be initiated in H2 2024. Otezla In November 2023, data were presented from the MOSAIC and FOREMOST studies: In the MOSAIC Phase 4 study, primary and key secondary outcomes highlighted that Otezla led to better inflammatory disease control in psoriatic arthritis patients with moderate clinical disease activity than in patients with high disease activity. In the FOREMOST Phase 4 study, Otezla when added to standard of care, significantly improved disease activity in patients with early oligoarticular (few joints involved) psoriatic arthritis at 16 weeks compared to placebo. Efavaleukin alfa (AMG 592) A Phase 2b study of efavaleukin alfa, an interleukin 2 (IL 2) mutein Fc fusion protein, in ulcerative colitis continues to enroll patients. Ordesekimab (AMG 714/PRV-015) A Phase 2b study of AMG 714, a monoclonal antibody that binds interleukin-15, in nonresponsive celiac disease has completed enrollment. Rare Disease TAVNEOS In November 2023, data were presented from the Phase 3 ADVOCATE trial demonstrating that outcomes in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis favored TAVNEOS versus a prednisone taper across subgroups of patients 65 years and older, patients with kidney involvement and albuminuria, and patients with diffuse alveolar hemorrhage at baseline. TEPEZZA In December 2023, TEPEZZA received orphan drug designation in Japan for patients with moderate to severe active thyroid eye disease (TED). A New Drug Application was submitted for TEPEZZA in Japan based on the results from the OPTIC-J study evaluating TEPEZZA in patients with active TED. A Phase 3 study of TEPEZZA in Japan for chronic or low clinical activity score (CAS) TED continues to enroll patients. The Company plans to initiate a Phase 3 study evaluating the subcutaneous route of administration of TEPEZZA in patients with TED in H1 2024. UPLIZNA A Phase 3 study of UPLIZNA in myasthenia gravis is fully enrolled. Data readout is anticipated in H2 2024. A Phase 3 study of UPLIZNA for the prevention of flare in immunoglobulin G4- (IgG4) related disease is fully enrolled. Data readout is anticipated in H2 2024. Dazodalibep A Phase 3 study of dazodalibep, a cluster of differentiation 40 (CD40) ligand inhibitor fusion protein in Sjögren's syndrome is enrolling patients. Daxdilimab A Phase 2 study of daxdilimab, a fully human monoclonal antibody targeting immunoglobulin-like transcript 7 (ILT7), in moderate-to-severe active primary discoid lupus erythematosus refractory to standard of care is enrolling patients. A Phase 2 study of daxdilimab in dermatomyositis and antisynthetase inflammatory myositis is enrolling patients. Fipaxalparant (formerly AMG 670 / HZN 825) A Phase 2 study of fipaxalparant, a lysophosphatidic acid receptor 1 (LPAR1) antagonist, in idiopathic pulmonary fibrosis is enrolling patients. Data readout is anticipated in H2 2024. A Phase 2 study of fipaxalparant in diffuse cutaneous systemic sclerosis is enrolling patients. Biosimilars The clinical comparative study portion of a randomized, double-blind pivotal study evaluating pharmacokinetic (PK) similarity of ABP 206 compared with OPDIVO® (nivolumab) in resected stage III or stage IV melanoma patients in the adjuvant setting is enrolling patients. TEZSPIRE is being developed in collaboration with AstraZeneca. Rocatinlimab, formerly AMG 451/KHK4083, is being developed in collaboration with Kyowa Kirin. Ordesekimab, formerly AMG 714 and also known as PRV-015, is being developed in collaboration with Provention Bio, a Sanofi Company. For the purposes of the collaboration, Provention Bio conducts a clinical trial and leads certain development and regulatory activities for the program. Xaluritamig, formerly AMG 509, is being developed pursuant to a research collaboration with Xencor, Inc. IDE397 is an investigational MAT2A inhibitor from IDEAYA Biosciences. OPDIVO is a registered trademark of Bristol-Myers Squibb Company. Non-GAAP Financial Measures In this news release, management has presented its operating results for the fourth quarters and full years of 2023 and 2022, in accordance with U.S. Generally Accepted Accounting Principles (GAAP) and on a non-GAAP basis. In addition, management has presented its full year 2024 EPS and tax guidance in accordance with GAAP and on a non-GAAP basis. These non-GAAP financial measures are computed by excluding certain items related to acquisitions, divestitures, restructuring and certain other items from the related GAAP financial measures. Beginning January 1, 2022, following industry guidance from the U.S. Securities and Exchange Commission, the Company no longer excludes adjustments for upfront license fees, development milestones and in-process research and development (IPR&D) expenses of pre-approval programs related to licensing, collaboration and asset acquisition transactions from its non-GAAP financial measures. Management has presented Free Cash Flow (FCF), which is a non-GAAP financial measure, for the fourth quarters and full years of 2023 and 2022. FCF is computed by subtracting capital expenditures from operating cash flow, each as determined in accordance with GAAP. Management has also presented Earnings Before Interest, Taxes, Depreciation and Amortization (EBITDA) and debt leverage ratio for 2023, both of which are non-GAAP financial measures. EBITDA is computed by adding interest expense, provision for income taxes, and depreciation and amortization expense to GAAP net income. Debt leverage ratio is calculated as the ratio of GAAP total debt to EBITDA. The Company believes that its presentation of non-GAAP financial measures provides useful supplementary information to and facilitates additional analysis by investors. The Company uses certain non-GAAP financial measures to enhance an investor's overall understanding of the financial performance and prospects for the future of the Company's normal and recurring business activities by facilitating comparisons of results of normal and recurring business operations among current, past and future periods. The Company believes that FCF provides a further measure of the Company's liquidity. The Company believes its debt leverage ratio provides a supplemental operating metric for the full year period as it compares the amount of cash generated by our operations for the year. The Company uses the non-GAAP financial measures set forth in the news release in connection with its own budgeting and financial planning internally to evaluate the performance of the business, including to allocate resources and to evaluate results relative to incentive compensation targets. The non-GAAP financial measures are in addition to, not a substitute for, or superior to, measures of financial performance prepared in accordance with GAAP. About Amgen Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology. Amgen focuses on areas of high unmet medical need and leverages its expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be one of the world's leading independent biotechnology companies, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential. Amgen is one of the 30 companies that comprise the Dow Jones Industrial Average and is also part of the Nasdaq-100 index. In 2023, Amgen was named one of "America's Greatest Workplaces" by Newsweek, one of "America's Climate Leaders" by USA Today and one of the "World's Best Companies" by TIME. For more information, visit Amgen.com and follow us on X (formerly known as Twitter), LinkedIn, Instagram, TikTok, YouTube and Threads. Forward-Looking Statements This news release contains forward-looking statements that are based on the current expectations and beliefs of Amgen. All statements, other than statements of historical fact, are statements that could be deemed forward-looking statements, including any statements on the outcome, benefits and synergies of collaborations, or potential collaborations, with any other company (including BeiGene, Ltd. or Kyowa Kirin Co., Ltd.), the performance of Otezla® (apremilast) (including anticipated Otezla sales growth and the timing of non-GAAP EPS accretion), our acquisitions of Teneobio, Inc., ChemoCentryx, Inc., or Horizon (including the prospective performance and outlook of Horizon's business, performance and opportunities and any potential strategic benefits, synergies or opportunities expected as a result of such acquisition, and any projected impacts from the Horizon acquisition on our acquisition-related expenses going forward), as well as estimates of revenues, operating margins, capital expenditures, cash, other financial metrics, expected legal, arbitration, political, regulatory or clinical results or practices, customer and prescriber patterns or practices, reimbursement activities and outcomes, effects of pandemics or other widespread health problems on our business, outcomes, progress, and other such estimates and results. Forward-looking statements involve significant risks and uncertainties, including those discussed below and more fully described in the Securities and Exchange Commission reports filed by Amgen, including our most recent annual report on Form 10-K and any subsequent periodic reports on Form 10-Q and current reports on Form 8-K. Unless otherwise noted, Amgen is providing this information as of the date of this news release and does not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise. No forward-looking statement can be guaranteed and actual results may differ materially from those we project. Our results may be affected by our ability to successfully market both new and existing products domestically and internationally, clinical and regulatory developments involving current and future products, sales growth of recently launched products, competition from other products including biosimilars, difficulties or delays in manufacturing our products and global economic conditions. In addition, sales of our products are affected by pricing pressure, political and public scrutiny and reimbursement policies imposed by third-party payers, including governments, private insurance plans and managed care providers and may be affected by regulatory, clinical and guideline developments and domestic and international trends toward managed care and healthcare cost containment. Furthermore, our research, testing, pricing, marketing and other operations are subject to extensive regulation by domestic and foreign government regulatory authorities. We or others could identify safety, side effects or manufacturing problems with our products, including our devices, after they are on the market. Our business may be impacted by government investigations, litigation and product liability claims. In addition, our business may be impacted by the adoption of new tax legislation or exposure to additional tax liabilities. If we fail to meet the compliance obligations in the corporate integrity agreement between us and the U.S. government, we could become subject to significant sanctions. Further, while we routinely obtain patents for our products and technology, the protection offered by our patents and patent applications may be challenged, invalidated or circumvented by our competitors, or we may fail to prevail in present and future intellectual property litigation. We perform a substantial amount of our commercial manufacturing activities at a few key facilities, including in Puerto Rico, and also depend on third parties for a portion of our manufacturing activities, and limits on supply may constrain sales of certain of our current products and product candidate development. An outbreak of disease or similar public health threat, such as COVID-19, and the public and governmental effort to mitigate against the spread of such disease, could have a significant adverse effect on the supply of materials for our manufacturing activities, the distribution of our products, the commercialization of our product candidates, and our clinical trial operations, and any such events may have a material adverse effect on our product development, product sales, business and results of operations. We rely on collaborations with third parties for the development of some of our product candidates and for the commercialization and sales of some of our commercial products. In addition, we compete with other companies with respect to many of our marketed products as well as for the discovery and development of new products. Discovery or identification of new product candidates or development of new indications for existing products cannot be guaranteed and movement from concept to product is uncertain; consequently, there can be no guarantee that any particular product candidate or development of a new indication for an existing product will be successful and become a commercial product. Further, some raw materials, medical devices and component parts for our products are supplied by sole third-party suppliers. Certain of our distributors, customers and payers have substantial purchasing leverage in their dealings with us. The discovery of significant problems with a product similar to one of our products that implicate an entire class of products could have a material adverse effect on sales of the affected products and on our business and results of operations. Our efforts to collaborate with or acquire other companies, products or technology, and to integrate the operations of companies or to support the products or technology we have acquired, may not be successful. There can be no guarantee that we will be able to realize any of the strategic benefits, synergies or opportunities arising from the Horizon acquisition, and such benefits, synergies or opportunities may take longer to realize than expected. We may not be able to successfully integrate Horizon, and such integration may take longer, be more difficult or cost more than expected. A breakdown, cyberattack or information security breach of our information technology systems could compromise the confidentiality, integrity and availability of our systems and our data. Our stock price is volatile and may be affected by a number of events. Our business and operations may be negatively affected by the failure, or perceived failure, of achieving our environmental, social and governance objectives. The effects of global climate change and related natural disasters could negatively affect our business and operations. Global economic conditions may magnify certain risks that affect our business. Our business performance could affect or limit the ability of our Board of Directors to declare a dividend or our ability to pay a dividend or repurchase our common stock. We may not be able to access the capital and credit markets on terms that are favorable to us, or at all. ### CONTACT: Amgen, Thousand Oaks Jessica Akopyan, 805-440-5721 (media) Justin Claeys, 805-313-9775 (investors) * The known adjustments are presented net of their related tax impact, which amount to approximately $2.60 per share. (a) The adjustments include noncash amortization of intangible assets and fair value step-up of inventory acquired in business combinations. Our GAAP diluted EPS guidance does not include the effect of GAAP adjustments triggered by events that may occur subsequent to this press release such as acquisitions, asset impairments, litigation, changes in fair value of our contingent consideration obligations and changes in fair value of our equity investments. SOURCE Amgen