Kiniksa Q1 2026 Earnings Call - ARCALYST Revenue Surges as Pipeline Milestones Loom

Jonathan, Call Moderator, Kinikska Pharmaceuticals: Good morning, everyone, and thank you for joining Kiniksa’s call to discuss our 1st quarter 2026 financial results and recent portfolio execution. A press release highlighting these results can be found on our website under the investors section. As for the agenda, our Chief Executive Officer, Sanj K. Patel, will start with an introduction. From there, Ross Moat, our Chief Operating Officer, will provide an update on ARCALYST commercial execution. Kiniksa’s Chief Medical Officer, Dr. John Paolini, will review our KPL-387 development program and the ongoing phase II/III clinical trial in recurrent pericarditis. Mark Ragusa, our Chief Financial Officer, will review our 1st quarter 2026 financial results. Sanj will share closing remarks and kick off the Q&A session, for which Evan Tasari, our Chief Strategy Officer, will also be on the line.

Before getting started, please note that we will be making forward-looking statements today that are subject to risks and uncertainties that may cause actual results to differ materially from such statements. A review of these statements and risk factors can be found on this slide, as well as under the caption Risk Factors contained in our SEC filings. These statements speak only as the date of this presentation, and we undertake no obligation to update such statements except as required by law. With that, I’ll turn it over to Sanj.

David Niedergarten, Analyst, Wedbush Securities2: Thanks, Jonathan. Good day everyone. Kiniksa continues to build strength across the business, which is driven by both our commercial progress with ARCALYST and the advancement of our pipeline programs, including KPL-387 and KPL-1161. On the commercial side, the end of the 1st quarter marks the 5th anniversary of the FDA approval for ARCALYST in recurrent pericarditis. Through our consistent and effective execution over those past 5 years, we’ve established and developed the market for this debilitating disease. This has enabled a fundamental shift in the treatment paradigm for patients and led to significant growth for the ARCALYST franchise. Within our clinical portfolio, we continue to advance the KPL-387 phase II/phase III study in recurrent pericarditis. Data from the phase II dose focusing portion of the study are on track for the 2nd half of this year.

We also expect to start the phase III portion of the program by the end of this year. We are advancing KPL-1161 closer to the clinic. This is our Fc-modified IL-1 alpha and beta inhibitor with a target profile of quarterly dosing. As we’ve previously shared, we plan to start a phase I study by the end of this year. Our robust financial position, together with profitable ARCALYST revenue growth, gives us the ability to invest in value creation across the business. Commercially, ARCALYST continues to be on a robust trajectory five years from launch, and we intend to capture the additional opportunity that remains across the recurrent pericarditis market. Adoption of long-term IL-1 alpha and beta inhibition with ARCALYST is expanding in the approximately 40,000 patients each year in the United States who experience recurrent pericarditis flares.

In the first quarter of this year, this expanding adoption contributed to ARCALYST sales growing to $214.3 million. Looking to the rest of the year, the marked increase in both the breadth and depth of prescribing we observed in the first quarter provide momentum going forward. As a result, we’ve now raised our full year 2026 revenue guidance to $930 million-$945 million from our previous guidance of $900 million-$920 million. In summary, Kiniksa is a well-capitalized, growth-orientated company that is well-positioned to maximize the substantial ARCALYST commercial opportunity that is available to us. The company’s portfolio programs have numerous milestones throughout the rest of the year that also have the potential to create meaningful value. And now, Ross Moat.

David Niedergarten, Analyst, Wedbush Securities1: Thank you, Sanj. Our continued commercial execution has driven strong revenue growth in Q1, leading to an ARCALYST net revenue of $214.3 million, which represents an increase of more than $76 million compared to the first quarter 2025, and approximately $12 million over Q4 of last year. This revenue growth was driven by strong underlying commercial metrics, which outpaced the Q1 industry-wide headwinds related to co-pay resets and changes in insurance plans. In particular, growth was achieved by 2 key commercial dynamics. Firstly, we saw an acceleration in the growth of new prescribers through the quarter, which resulted in the highest quarterly increase in new patient enrollments since launch.

This bodes particularly well for the rest of the year as the new larger prescriber base, along with the durability of average duration of therapy, has enabled us to increase our full year revenue guidance from between $900 million and $920 million to between $930 million and $945 million. In Q1, our gross-to-net increased compared to the prior quarter as expected. However, it was lower than Q1 of 2025. This was mainly driven by changes to our co-pay support program, where we made enhancements to our assistance program design, which reduced the average co-pay payout per patient relative to prior Q1s.

With the momentum created early in the year, combined with our strong underlying commercial foundation, we believe we are well-positioned to continue driving ARCALYST growth through the rest of the year and believe there is substantial opportunity ahead to support many more recurrent pericarditis patients. In Q1, thanks to the strong execution from our team, approximately 400 new prescribers wrote ARCALYST for the first time, representing the highest quarter-on-quarter increase launch to date. This brings the total number of prescribers to more than 4,550. As a reminder, with more than 25,000 healthcare professionals seeing recurrent pericarditis patients in a given year, there is substantial opportunity ahead. We also saw growth in the number of healthcare professionals who became repeat prescribers during Q1, resulting in approximately 1,320 prescribers in total who have now prescribed ARCALYST multiple times.

The acceleration we’ve seen in both the breadth and the depth of prescribing reflects our continued commercial execution, as well as the growing understanding and adoption of interleukin-1 alpha and beta inhibition as the treatment choice following the prior use of NSAIDs and colchicine, as recommended in the 2025 ACC Concise Clinical Guidance. Earlier this month, we announced the initiation of our highly targeted direct-to-consumer campaign, Heart’s Home. This campaign is designed to identify and target patients who may be suffering with recurrent pericarditis and not currently taking ARCALYST, with the aim of empowering them to discuss ARCALYST with their healthcare provider. Through digital innovation, including the use of AI, we are able to deploy DTC in a way that’s cost-effective, highly targeted, and ultimately applicable for a rare disease market.

We have focused on utilizing our existing patient database and added search optimization and machine learning models informed by de-identified claims, demographics, and consumer market data to define an enriched population of potential recurrent pericarditis patients to deliver tailored content, opposed to a traditional DTC approach of broad-scale and high-cost marketing. The centerpiece of our campaign is a connected TV commercial that is directed to potential patients through their individual streaming accounts on platforms such as YouTube and Hulu, as well as across social media channels. This campaign is informed by our market research, which demonstrated that when a recurrent pericarditis patient inquires about ARCALYST to their provider, the healthcare professional is receptive to the inquiry, and it results in ARCALYST being prescribed in around 80% of cases. As previously mentioned, our ARCALYST franchise is growing, is profitable, and has significant opportunity ahead.

This has allowed us to make disciplined investment decisions to expand our reach to capture the opportunity and help more patients. With that, I’ll turn the call over to John to cover our KPL-387 development program.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Thank you, Ross. As a brief refresher, we leveraged our extensive clinical experience with the IL-1 signaling pathway when designing the integrated development program for KPL-387, shown here, broken down by phase of development. The core component of the program is the phase III placebo-controlled event-driven randomized withdrawal study. Just as in RHAPSODY, the pivotal study which supported ARCALYST approval in recurrent pericarditis, the primary efficacy endpoint for phase III will measure the reduction in risk of pericarditis recurrence as the primary demonstration of KPL-387 efficacy for the label. We believe from our regulatory interactions that this study will be sufficient to support registration as a single pivotal study.

As a reminder, to maximize operational efficiency, we combined the phase II dose focusing trial and the phase III pivotal trial into a single integrated phase II/III protocol so that phase III could initiate independently of phase II execution, and we added long-term extensions to all trial activities. We previously guided that we expect data from the dose focusing study outlined here in red in the second half of this year, and today we guided that we expect to initiate the phase III portion of the study by the end of this year. The phase II dose focusing study builds on insights from previous clinical trials with rilonacept, and it is designed to define the KPL-387 PK/PD relationship, as well as to support the data-driven approach for affirming the dose level for the phase III pivotal trial.

Looking at the rilonacept phase II precedent in the left panels, the single active arm study demonstrated that IL-1 pathway inhibition with once-weekly rilonacept resulted in rapid and sustained reductions in reported pain and inflammation in patients with active recurrent pericarditis and elevated C-reactive protein over the initial 6-week treatment period, as well as the subsequent long-term extension through 24 weeks. Now, looking forward, the KPL-387 phase II dose focusing study, which is assessing 4 dose levels in up to 20 patients per arm, mirrors the rilonacept phase II study in terms of study population, number of patients per arm, and the primary endpoint, which is time to treatment response. The study framework has been adjusted for the specific attributes of the long-acting pharmacokinetics of KPL-387.

Thus, development stage appropriate data, which are expected in the second half of this year, are designed to provide useful information on the cadence and magnitude of initial response, as well as the duration of action of KPL-387 dose levels, affirming the dose level for phase III and informing phase III outcomes measures. I will now turn it over to our Chief Financial Officer. Mark?

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: Thanks, John. This morning, I will cover our first quarter 2026 financial performance. Always, you can find our detailed financial information in today’s press release. In the first quarter of 2026, we continued to build strong momentum across the business, advancing ARCALYST, progressing our clinical portfolio, and maintaining a strong financial position. Starting on the left-hand side of this slide with our income statement. As you’ve heard from Sanj and Ross, ARCALYST revenue grew 56% year over year to $214.3 million in the first quarter. This growth was driven by strong expansion in new prescribers and new patient enrollments, which more than offset the impact of industry-wide seasonal headwinds. Operating expense growth year over year was driven by several factors. Higher cost of goods sold due to ARCALYST revenue growth.

Increased collaboration expenses aligned with higher ARCALYST revenue and collaboration profit. Higher R&D, primarily due to increased clinical and manufacturing costs associated with the development of KPL-387. An additional SG&A, primarily driven by investment associated with the commercialization of ARCALYST, including personnel and leveraging new technologies to enhance our targeting strategy and reach additional patients and HCPs. As a result of the strong revenue growth against more moderate expense growth, net income increased significantly to $22.6 million in the first quarter of 2026, compared to $8.5 million in the first quarter of 2025. Turning to the right-hand side of this slide, you’ll find the calculation for ARCALYST collaboration profit, which drives total collaboration expenses.

In the first quarter of 2026, ARCALYST collaboration profit continued to grow faster than sales on a year-over-year basis, up 73% to $151.2 million. Finally, at the bottom of this slide, we ended the first quarter with a $468.1 million cash balance, representing $54 million of net cash generation for the period. We expect to remain cash flow positive on an annual basis under our current operating plan, enabling us to continuing to help patients while creating additional value in both the near and long term. With that, I will turn the call back to Sanj for closing remarks.

David Niedergarten, Analyst, Wedbush Securities2: Thanks, Mark. As you’ve heard, Kiniksa is well-positioned to build significant future value as we grow our IL-1 alpha and beta inhibition franchise. We are dedicated to helping as many patients as possible with ARCALYST and to advancing the development of our clinical portfolio in order to bring additional therapies to patients suffering from debilitating diseases. With that, I’ll now turn the call back to the operator for questions. Operator?

Operator: Our first question comes from Nick Larosa with TD Cowen. Your line is open.

Nick Larosa, Analyst, TD Cowen: Great. Thanks very much for taking our question, and congrats on the strong quarter. Can you discuss what you have seen in terms of increased demand from the early days of the DTC campaign, acknowledging that it is still pretty early on? What other plans do you have to accelerate demand in future, either via patients or prescriber targeting? Thanks very much.

David Niedergarten, Analyst, Wedbush Securities1: Yeah. Hi, Nick. This is Ross. I’ll take a pass on that. Thank you very much. Yeah, as you said, it’s early on for the DTC campaign. We just announced it pretty recently that we’re focusing on DTC in a very targeted way in order to go and try and reach patients who we believe are recurrent pericarditis patients, and in order to kind of inform them and educate them in how to go and speak with their healthcare providers about the potential of ARCALYST and recurrent pericarditis. It’s early days. One thing that I share with you is that, you know, while we also understand that when patients go in and speak to their healthcare professionals proactively about ARCALYST, it gets, you know, prescribed.

The patients get prescribed ARCALYST in around 80% of the cases. It’s also true that there’s only around 14% of recurrent pericarditis patients who are actually unaided, aware of ARCALYST. We know that there’s a big awareness gap out there with patients. We know patients are very widely dispersed across the country. This is our approach of ours of going out, trying to identify those patients and serve up appropriate, very targeted, very tailored messages that can help appropriate patients to be empowered to go and speak to their healthcare professionals about ARCALYST. We’re excited about the campaign, as you said, it’s early days. We are focused on many different initiatives to accelerate the growth.

As a reminder, last announced, we were around 18% penetrated into the 14,000 patient population, not accounting for patients that are even in their first recurrence. As you know, we’ve seen, you know, a strong growth in patients on their first recurrence as well over time. So the opportunity is very significant. We’re focused on continuing to execute incredibly well across our commercial organization. We’re focused obviously on digital marketing, of which the DTC campaign is a part of that, a much broader umbrella of digital marketing. We’re also focused on peer-to-peer education and growing, you know, this new wave of how to treat recurrent pericarditis patients, which has been, you know, really transforming over the last 5 years of the availability of ARCALYST on the market. We’re very excited about the future.

We have a multifaceted approach to how we’re gonna continue to grow the breadth and the depth of prescribing and help more and more patients.

David Niedergarten, Analyst, Wedbush Securities: Very helpful. Thank you very much.

Operator: One moment for our next question. Our next question comes from Anupam Rama with JPMorgan. Your line is open.

Anupam Rama, Analyst, JPMorgan: Hey, guys. Thanks so much for taking the question, congrats on a strong quarter here. For KPL-387 and the second half dose focus update, John, I was wondering if you could comment a little bit as when you look at the totality of the range of endpoints and assessments that you’re gonna be looking at in phase II, how do you think about which ones are most important in sort of the ultimate dose selection moving to phase III? Thanks so much.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Sure. Good morning, Anupam, and thank you for that question. Yes. With regard to the phase II trial, which is currently ongoing, the value I think of slide 13 is that it shows you what kind of data we had generated in the past in the phase II program with rilonacept in terms of 3 critical elements, which is of course the what we call the cadence and magnitude, which is basically the time of onset of action and the degree of suppression of pain and the inflammation with C-reactive protein, and then the additional element of durability of response. That’s what we showed previously with rilonacept, and so carrying that forward to the KPL-387 program.

Again, with that initial dose of KPL-387, what we’ve shown in our models, regardless of the dose level selected, we expect to see high drug levels, which, you know, would be modeled to have a rapid cadence in terms of onset of action and magnitude of effect in suppressing the initial inflammatory response. The additional scientific question that we intend to glean by looking at the different dose levels is that duration of action of the four different dose levels that we take forward, that we look at in the trial. From that, we integrate all three of those elements to build the PK/PD relationship and affirm what we believe to be the therapeutic concentration as well as the dose level that we would carry forward into phase III.

It’s really the integration of those three critical elements.

Anupam Rama, Analyst, JPMorgan: Thanks so much for taking the question.

Operator: One moment for our next question. Our next question comes from David Niedergarten with Wedbush Securities. Your line is open.

David Niedergarten, Analyst, Wedbush Securities: Hey, thanks for taking the question. Just a couple quick ones from me. First off, on the DTC ad, is it fair to, you know, model in the incremental spend year-over-year on marketing as the DTC, you know, component? Or is there, you know, some additional sales guys or other folks that you hired or other expenses going in there? The second one on 387. On the transition study, the treatment duration 16 weeks, you know, which is different than the 12 or 24 weeks, you know, that you’ve looked at in the phase I or phase II. Is there any reason you picked 16 weeks versus, you know, having a little bit more apples-to-apples duration comparison, at least for patients who are moving from ARCALYST to 387?

Thanks.

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: Maybe David, on the, on the first one, I mean, I think as you heard us talk about on the call, you know, SG&A did go up as a result of sort of personnel related expenses as well as sales and marketing initiatives, which Ross has sort of covered. I mean, I think we continue to invest responsibly in the commercialization of ARCALYST, as shown by collaboration profit continuing to grow faster than revenue. I think as we, you know, we haven’t really guided to spend, but I think it’s worth sort of noting that on a percentage of sales basis, SG&A has been fairly consistent over the last year.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: With regard to your question, David, you know, thank you for that question about the transition to KPL-387 monotherapy dosing and administration study. Yes, the 16-week treatment duration for the posology portion of the study is in fact appropriate for this type of study. This study is really designed to look at well-controlled patients as they move from their prior therapies to KPL-387. In this study, patients are transitioning from regimens of NSAIDs and colchicine from corticosteroids and IL-1 pathway inhibitors, including anakinra and rilonacept. What we had seen previously with regard to rilonacept was a time to monotherapy of under 8 weeks in the RHAPSODY program.

You know, this program is designed to basically move patients off of those other therapies onto KPL-387 and achieve monotherapy within that time window. Of course, there are additional doses that are administered to achieve steady state by the week 16 time point. Importantly, patients transition to a long-term extension where they can continue to receive KPL-387 for up to 2 total years. It’s a well-designed study to inform that element of, you know, the label, if you will, clinical practice for transitioning patients to KPL-387.

David Niedergarten, Analyst, Wedbush Securities: Maybe a quick follow-up. Is there a... Obviously, you look at the patients by prior treatment to determine, you know, if anyone has a new attack of pericarditis that, you know, of course you’ll know which prior treatment they’re on and you’ll stratify accordingly or, you know, how are you thinking about the differences in prior treatments for, you know, the transition?

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: That’s a very reasonable statement. If you look at, for example, the ARCALYST label, it covers all of the different therapies that patients can transition from. It talks about NSAIDs and colchicine, it talks about corticosteroids. We didn’t do this study specifically for recurrent pericarditis for anakinra, because that had already been done for DIRA. You know, what we reported in that trial was, you know, how patients responded across the different treatments, and the time to monotherapy. Similarly in this trial, of course, you would look at each one of those different types of dosing regimens that patients came from, and then look to make sure that the transition to KPL-387 is robust. It’s important to point out that the onset.

The duration of action of KPL-387 with our anticipated phase III dose level is once monthly dosing, which covers, you know, most of that initial transition period, depending on the therapy.

David Niedergarten, Analyst, Wedbush Securities: Got it. Thanks.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Mm-hmm.

Operator: One moment for our next question. Our next question comes from Edward Nash with Canaccord Genuity. Your line is open.

Edward Nash, Analyst, Canaccord Genuity: Hi. Good morning, guys, and great quarter. Congratulations. Wanted to ask, I know obviously the DTC program is relatively new, and I just wanted to kind of understand with regards to what’s driving the biggest change in new patient starts. You said that on awareness, the awareness gap has shrunk and that you’ve seen increasing physician adoption. What effect has reimbursement or referral patterns had into this new patient starts?

David Niedergarten, Analyst, Wedbush Securities1: Thanks, Ed. Appreciate your question. Yeah, there are lots of different things, you know, driving the increases that we’ve seen, not just in Q1, but, you know, over time as well. Of note, you know, Q1 was the highest ever quarter-on-quarter growth that we’ve had in terms of new prescribers. It was also the highest ever since the time of our launch, so 5 years ago, the highest ever number of new patient enrollments or new prescriptions coming in for ARCALYST. Clearly, you know, we’re at a stage, 5 years out from our launch where we’re growing very nicely with a substantial opportunity ahead.

The reimbursement continues to be very strong across all the different payer mixes, and that’s both for new patients coming on as well as the revalidation of the script, usually after a 1-year time period. That continues to really be very positive. In terms of referrals, I think, you know, certainly there are some centers out there, around 18 centers that are centers of excellence, if you like, or whole pericardial disease-specific clinics, and they’re acknowledged partially under one program, which is the AHA’s Addressing Recurrent Pericarditis, of which, you know, we are a sponsor of. And that’s, you know, that’s been a helpful initiative, I think, to grow the expertise and share expertise in how to diagnose and treat recurrent pericarditis over time among those 18 groups.

It also remains the case that recurrent pericarditis patients are, you know, broadly dispersed across the country. We have to touch, you know, many touchpoints across the country in order to educate physicians. We focus on peer-to-peer education to do that, as well as, of course, our sales team and the digital marketing initiatives such as the new DTC campaign, which we’re excited about.

As I mentioned earlier, you know, with only around 14% of patients that suffer recurrent pericarditis having an unaided awareness of ARCALYST, clearly putting the power in the hands of the patient and the knowledge in the hands of the patient of their disease, acknowledging that, you know, many patients go through multiple physicians and, you know, multiple misdiagnoses before they get the recurrent pericarditis diagnosis, we think can play a substantial role in helping the awareness and empowering patients to go and ask their physicians about recurrent pericarditis, about ARCALYST, and ultimately, you know, one of the roles amongst many things that we’re doing in continuing to seize the opportunity that we have ahead.

Edward Nash, Analyst, Canaccord Genuity: That’s very helpful. Thank you.

David Niedergarten, Analyst, Wedbush Securities1: Thank you.

Operator: One moment for our next question. Our next question comes from Paul Choi with Goldman Sachs. Your line is open.

David Niedergarten, Analyst, Wedbush Securities0: Hi. Thank you. Good morning, and congratulations on the strong quarterly results. I was wondering first if you could maybe elaborate a little bit more on the copayment commentary for the quarter. Is this going to be something just specific to this particular quarter or could it be more potentially structurally favorable to gross-to-net over the long term? My second question is on KPL-387. Just with regard to the transition, the switch study that’s ongoing, can you comment if the implication here is that you have a fairly confident view on the dose going forward for the phase III, or are you still testing multiple doses there? Thank you very much.

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: I take the first-

David Niedergarten, Analyst, Wedbush Securities1: Yes.

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: -on the gross to net.

David Niedergarten, Analyst, Wedbush Securities1: Yep.

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: you know, I think, Paul, you know, we haven’t provided specific guidance on gross-to-net. We still do not expect major fluctuations relative to 2025, but we do anticipate now that copay support will, you know, be favorable to gross-to-net on an annual basis, with the majority of the impact having taken place in the first quarter.

I think as we, you know, sort of take a look at gross-to-net over the course of the year, you know, I’ll kind of say what we’ve said before here, but we do expect to return to our historical pattern where, you know, absent any sort of prior period reserve adjustments, you know, we do expect gross-to-net to be highest in the first quarter, to work lower in the second and the third quarter, then begin to shift higher again in the fourth quarter due to industry dynamics as they begin to play a factor again. I don’t know if there’s components to the copay that you wanna discuss further than that, but at least that’s the impact on gross-to-net.

David Niedergarten, Analyst, Wedbush Securities1: That’s why I made Mark. Thank you for that. I just maybe add a little bit more flavor onto the copay dynamics, Paul. You know, we did make enhancements to our copay assistance program at the beginning of this year, which ultimately reduced the average copay payment per patient, and subsequently, you know, had the knock-on effect to the more favorable Gross-to-Net versus Q1 of last year, albeit higher than Q4 of last year. That’s driven by a couple of things. Firstly, reducing the maximum amount of copay payments that we make per patient.

Secondly, we also implemented a machine learning solution to proactively identify patients who are on non-traditional payment plans such as maximizer plans, in order to kinda pick up those patients, which, you know, you may know a lot of these plans are designed to take the cost to the manufacturers all the way until funds are exhausted before the insurance companies pick up on it. By lowering that copay amount for those non-traditional plans, it reduced the maximum amount that we paid per patient before the patients got full coverage under their insurer. That had the knock-on effect into the gross to net. Thank you for the question, Paul.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Good morning, Paul. Thank you for your question about the transition to monotherapy study. The details of the study design that we’ve shared so far can be found in clinicaltrials.gov. What you will see there is the overall architecture of the study, but the disclosure does not include specific information of the dose level or dose levels that would be studied. We will have more to say at a later date about the design of the study.

David Niedergarten, Analyst, Wedbush Securities0: Okay, great. Thank you.

Operator: One moment for our next question. The next question comes from Geoff Meacham with Citi. Your line is open.

Geoff Meacham, Analyst, Citi: Hey, guys. Good morning. Thanks for the question. Just had two quick ones. Ross, on the commercial side, you know, is there a tipping point for adding more patients to the, to the first recurrent segment? I wasn’t sure maybe if you wanted to wait a little bit longer on the awareness and DTC visibility, or do you feel like you have to navigate maybe reimbursement hurdles in that, you know, more, more upstream segment? The second one for Sanj. With the positive cash flow, you got consistent profitability. Yeah, how do you, how do you think about maximizing value from here? Would you want to be, you know, in the phase III for KPL-387 before you take another look at BD? I wasn’t sure you’re thinking about it. Thank you.

David Niedergarten, Analyst, Wedbush Securities1: Thanks very much, Geoff. I appreciate the question. As mentioned earlier, you know, we were around 18% penetrated into the 2-plus recurrence group. About 20% of prescriptions that we have, you know, now are in the first recurrence group. That’s grown over time. We think the 2025 ACC Concise Clinical Guidance is also helpful towards that as it places the use of IL-1 inhibition prior to the use of corticosteroids. Moving ARCALYST further, you know, upstream if you like, early on in the disease. We think those things are all important and acknowledging that, you know, ARCALYST really has a very broad label, which is agnostic to the number of flares that a patient has suffered.

We have broad patient coverage really across the labeled indication for the majority of plans. We’re in a pretty good situation there, which is why we, you know, we feel that the opportunity that we have ahead is still very significant when you take those metrics around the two-plus recurrences and the first recurrence group.

David Niedergarten, Analyst, Wedbush Securities2: Geoff, this is Sanj. Thanks for the question as well. As you know, for many years, this team’s very much focused on creating value. We also know how to execute. To your point on 387, clearly there’s a lot of focus.

On getting through this phase II study, you know, how you get through the second half of this year and starting that phase III study this year, which I think is very exciting. You know, clearly we’re very much focused on capturing further growth with ARCALYST. Very important continued effort for us. As we’ve said, KPL-1161 also should enter the clinic this year. A number of milestones for us. You know, we balance all that consistently looking at how there are other ways to create value. As you said, we continually look at BD opportunities. We have a very, very high bar, though. We try to stay as pragmatic as possible, looking at all the value both internal creators with, you know, via creation from internal value drivers, but also looking at business development.

We’ll continue to do that. Capital allocation is very important to us. Being efficient is very important to us. You know, we’ve done that very nicely, I think, through this digital DTC effort and looking at AI ways to really do it very efficiently. Trust us when we say that we’ll continue to think about value creation over time and balance it well going forward.

Geoff Meacham, Analyst, Citi: Okay. Thank you.

Operator: One moment for our next question. Our next question comes from Roger Song with Jefferies. Your line is open.

David Niedergarten, Analyst, Wedbush Securities3: Hi, good morning, team. This is Fiona on for Roger. Congrats on the strong quarter, and thanks for taking our question. Maybe just a quick one on KPL-387. Any meaningful difference in terms of formulation versus ARCALYST, and do you plan to use an autoinjector? Maybe just down the line, if 387 gets approved, how do you plan your commercial strategy around incorporating to potentially transitioning to 387? Thank you.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Yes. No, thanks for that question. I’ll handle some of the biophysical characteristics of the molecules to maybe lay a little bit of groundwork and then turn it over to Sanj with regard to next steps. Yeah, there is a difference with regard to KPL-387 in that it is a liquid formulation. That liquid formulation, you know, allows for the total dose, if you will, of KPL-387 to be delivered in a single syringe subcutaneously. We anticipate that with the extended pharmacokinetics, which we’ve shown previously in phase I, that that would support once-monthly dosing. Once you have that profile, it then does set up a situation, if you will, that is quite favorable for the development of an auto-injector.

We have not discussed that in detail at this time. I’ll turn it over to Sanj.

David Niedergarten, Analyst, Wedbush Securities2: Yeah. Fiona, nothing really to add. Obviously, we’ll continue to execute on the ongoing clinical trials. We talked about those today, phase II, phase III study, starting the phase III this year, obviously entering more KPL-1161. Nothing else to add other than that we plan to do them as fast as humanly possible and as well as humanly possible.

Operator: Thank you. One moment for our next question. Our next question comes from Eva Fortea-Verdejo with Wells Fargo. Your line is open.

Eva Fortea-Verdejo, Analyst, Wells Fargo: Hey, good morning. Congrats on the quarter, and thanks for taking our questions. Two quick ones from us. First, how should we be thinking about R&D expense for the rest of the year and into 2027 as KPL-387, phase III and KPL-1161, phase I are initiated? The second question is, you’ve guided to initiating the phase III pivotal portion for KPL-387 by year-end 2026. Are there any key steps or milestones you need to clear to initiate the study, or is it just a matter of seeing the phase II data before moving forward? Thanks.

Mark Ragusa, Chief Financial Officer, Kinikska Pharmaceuticals: Thanks, Eva, for the question. Maybe just to touch upon the R&D question first here. You know, similarly to an earlier question, we haven’t provided explicit guidance. You know, that being said, you know, I think on a percentage of sales basis, R&D has been fairly consistent over the last year. Really with R&D, it’s timing of our clinical trials and manufacturing of clinical supply that are the key variables. We’ve disclosed several ongoing investments that we plan to further advance in 2026, including the development of KPL-387 into phase III and KPL-1161 into phase I. You know, obviously the longer trials go on, they tend to get a little bit more expensive.

I think keeping in the context of where sales growth has been, and where we’ve been fairly consistent on R&D to sales over the last year is an important metric to keep in mind.

Dr. John Paolini, Chief Medical Officer, Kinikska Pharmaceuticals: Eva Fortea-Verdejo, thank you for your question, with regard to the phase II/III transition. With phase II data expected in the second half of 2026, we’re on track for receiving dose level confirmation data, you know, in that time framework. Because the phase II dose focusing portion and the phase III pivotal portion have been integrated into a single phase II/III protocol, the phase III pivotal trial can begin independently of phase II execution.

Eva Fortea-Verdejo, Analyst, Wells Fargo: Got it. Thanks.

Operator: I’m not showing any further questions at this time. I turn the call back over to Sanj for any further remarks.

David Niedergarten, Analyst, Wedbush Securities2: Thanks, operator. Thank you for all the questions and joining the call today. We look forward to the remainder of the year and look forward to providing additional updates in the future. Thank you. It is great.

Operator: Thank you, ladies and gentlemen. This does conclude today’s presentation. We thank you for your participation. You may now disconnect and have a wonderful day.