Zealand Pharma A/S (ZEAL) Earnings Call Transcript & Summary

Good day, and thank you for standing by. Welcome to the Zealand Pharma Interim Report H1 2026 Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Eric Rojas, Vice President and Head of Investor Relations. Please go ahead.

Thank you, Heidi, and thank you, everyone, for joining us today to discuss Zealand Pharma's results for the first half of 2026. The related company announcement is available on our website at zealandpharma.com. As outlined on the slide, I would like to remind listeners that during today's call, we will be making forward-looking statements that are subject to risks and uncertainties. Turning to today's agenda. Joining me on this call is Adam Steensberg, President and Chief Executive Officer; David Kendall, Chief Medical Officer; and Henriette Wennicke, Chief Financial Officer. All speakers will be available for the Q&A session. I'll now hand the call over to Adam.

Thank you, Eric, and welcome, everyone. In the first half of 2026, we delivered on the key objectives we set out at the start of the year and grew significant progress across our pipeline. I'm pleased to walk through those accomplishments today. Starting with Petrelintide, we reported positive ZUPREME-1 results, demonstrating double-digit weight loss with a tolerability profile consistent with placebo. On the back of that data, we confirmed advancement into Phase III registrational trials initiating in the second half of this year, so full speed ahead. On Survodutide, our partner, Boehringer Ingelheim, reported positive SYNCHRONIZE-1 and SYNCHRONIZE-MASLD results. Delivering comparative weight loss and targeted liver fat reduction, pointing to the potential for sustained improvements in metabolic health. What is compelling is that survodutide targets the fat that actually drives poor metabolic health. And I believe that, that is an increasingly important value proposition as this category matures. BI also solidified their commitment and excitement around survodutide by announcing an expansion of the development program with 4 new and additional Phase IIIb trials initiating in 2026. On the early pipeline, we have initiated a Phase Ib clinical trial in plaque psoriasis, with ZP9830 and a first-in-human clinical trial with our GIP agonist ZP6590. So real momentum in building out the next wave of innovation. In May, we initiated a USD 200 million share buyback program, a statement for our strong commitment to returning capital to shareholders when we have the flexibility to do so. And finally, as announced yesterday, we monetized our royalty rights to a nonstrategic asset through the USD 100 million agreement with Royalty Pharma for rusfertide, which will be redeployed back into our strategic priorities and long-term growth initiatives. This has been a very strong half year and execution across our business, and we remain focused on advancing our programs to get these medicines to patients as fast as we can. Before I hand over the call to David, I want to briefly mention what we witnessed at the American Diabetes Association meeting in June this year. The messages on key unmet medical needs in chronic weight management was clear: tolerability, treatment persistence and patient experience. ADA opened with a symposium on amylin that spoke directly to these gaps. And what struck me the most was not the data, it was the framing. The speakers or key opinion leaders in the obesity space laid out a hypothetical treatment paradigm for chronic weight management. This felt like a real shift in how the field is starting to think about treatment sequencing. And I think it maps closely to how we see the role of petrelintide. For the majority of patients, the proposal was to start with a long-acting amylin as a first-line therapy. The logic here is simple. Why start with a very cumbersome treatment when a more benign one can deliver the weight loss most patients are actually after. For the patients with higher BMI and/or complications at GLP-1 with established evidence or higher efficacy dual or triple agonist could be the option. Then if those paths fell short of the patient's needs, escalate to combination therapy or bariatric surgery. This narrative is now being proposed by the broader scientific community as a logical way to think about chronic weight management. What I find validating is that this is exactly the value proposition we have been building for petrelintide, a benign, highly tolerable therapy delivering double-digit weight loss for patients starting their weight loss journey with the option to add or escalate if need of more. With that, I will turn over the call to our Chief Medical Officer, David Kendall, to walk through the progress across our pipeline. David?

Thank you, Adam. I will start with an overview of our pipeline. The first half of 2026 has been incredibly exciting and was one of the busiest 6-month stretches in our company's history. We shared initial Phase I data for our novel Kv1.3 ion channel blocker, reported Phase II results for petrelintide and as Adam mentioned, presented these data at the American Diabetes Association's Scientific Sessions. And our partners at Boehringer Ingelheim presented results from 2 Phase III studies with survodutide. Beyond these readouts, we continue to advance our pipeline in other important ways. We confirm plans for initiation of a registrational Phase III program for petrelintide as monotherapy, and we will initiate the Phase II ZYNERGY trial evaluating the petrelintide and enicepatide combination. As Adam also mentioned, we advanced our early-stage portfolio, including both the novel Kv1.3 ion channel blocker and our GIP agonist. Furthermore, for our rare disease programs, the Phase III EASE -5 trial for glepaglutide in short bowel syndrome continues to progress well, and we successfully completed the EASE-2 and EASE-3 extension trials, which will support the long-term efficacy and safety of glepaglutide. We look forward to sharing these data at scientific congresses in 2027. We have delivered a remarkable string of clinical milestones in the past 6 months, a real testament to the incredibly committed and talented teams we have at Zealand Pharma. Let's now turn to our Phase II ZUPREME-1 results, which we firmly believe support the unique potential of petrelintide as a future first choice therapy for people living with obesity. Petrelintide delivered double-digit weight loss with no apparent plateau over 42 weeks of treatment in a study population that was generally balanced between women and men. What stands out in these data is not solely the clinically meaningful weight reduction, it is the tolerability profile observed. More than 3/4 of the gastrointestinal events reported with petrelintide were mild, were transient in nature and occurred predominantly during dose escalation. More importantly, up to 98% of participants successfully escalated to their target maintenance dose. When looking at the adverse event rates, in particular, the reports of diarrhea, constipation and vomiting, they are strikingly similar rates in those treated with petrelintide as compared to those receiving placebo treatment, supporting a GI tolerability profile that is comparable to placebo. Together, these data point to the potential of petrelintide to fill a critical gap in chronic weight management, namely a highly tolerable therapy that delivers the weight reduction that the majority of those seeking weight management desire with exceptional tolerability and the potential to support long-term adherence. With these data in hand, we and Roche have made the decision to advance petrelintide monotherapy into a Phase III registrational program on track to initiate later this year. We look forward to sharing more details around that program once those studies begin. We are also on track to report top line results for the Phase II ZUPREME-2 study with petrelintide in participants with overweight or obesity and coexisting type 2 diabetes in the second half of this year. ZUPREME-2 has enrolled approximately 200 adults with a balanced gender representation comparing 3 doses of petrelintide with placebo over 28 weeks of treatment. The primary endpoint is percentage change in body weight from baseline, while key secondary endpoints include change from baseline in hemoglobin A1c and changes in cardiovascular risk markers, including fasting lipids. We are also expanding our petrelintide franchise with the initiation of the Phase II ZYNERGY trial, evaluating petrelintide in combination with enicepatide. Roche's potential best-in-class GLP-1/GIP dual receptor dual agonist. ZYNERGY is a comprehensive dose-finding study designed to identify an optimized ratio of petrelintide and enicepatide. The study includes 6 arms, 3 different dose regimens of the petrelintide/enicepatide combination along with petrelintide monotherapy, enicepatide monotherapy and placebo treatment groups. Participants will receive petrelintide and enicepatide as separate injections, allowing us to explore multiple combinations before committing to a fixed dose single cartridge co-formulated combination in Phase III. This study will enroll adults with obesity or overweight and at least one weight-related comorbidity with the primary endpoint of percentage change in body weight from baseline to week 40. As we have seen in separate Phase II studies, petrelintide's impressive tolerability profile paired with enicepatide's strong efficacy makes this combination a compelling and natural next step in the development of our portfolio. We believe it has the potential to deliver both substantial weight loss and improvements in cardiovascular risk markers while maintaining a competitive tolerability profile for patients who will benefit from additional weight loss efficacy. Turning to survodutide. Our partner, Boehringer Ingelheim, reported detailed results from 2 Phase III trials at the American Diabetes Association Scientific Sessions this year, and I would like to spend a moment on these exciting results. The 76-week SYNCHRONIZE-1 trial in participants living with overweight or obesity met its primary endpoint with survodutide delivering up to 16.6% weight loss from baseline compared to 3.2% with placebo. What we would like to further highlight today is data from the prespecified MRI substudy that looks beyond the top line number and assesses body composition following weight loss, a view of specifically what kind of weight is actually being lost. Relative to baseline, survodutide achieved up to a 34% reduction in visceral fat, the metabolically harmful fat that sits around the organs and drives cardiometabolic risk alongside a 63% reduction in liver fat content. Lean mass loss accounted for no more than 11.3% of the total tissue mass change at the highest dose. This is a body composition profile we believe supports sustained meaningful improvements in metabolic health. This is a differentiation point we believe will become increasingly important as the field moves beyond weight loss alone as the benchmark and focuses on overall improvements in metabolic health status. The 48-week SYNCHRONIZE-MASLD trial in participants living with overweight or obesity and metabolic dysfunction-associated steatotic liver disease or MASLD with evidence of inflammation and/or fibrosis also met both of its primary endpoints. Liver fat normalization was achieved by 6 out of 10 participants treated with survodutide for 48 weeks with an associated mean weight loss of up to 12%. On tolerability, what we're seeing is broadly consistent with what is expected across GLP-1-based therapies. It is worth providing some additional context here as the SYNCHRONIZE program used a stricter titration protocol than is typical in clinical practice or in many other clinical trials with limited flexibility for slower up titration, dose adjustment or temporary interruption of study drug. In a number of cases, participants were required per protocol to discontinue rather than adjust treatment. We and our partner, Boehringer Ingelheim, believe this contributed to both the GI event and discontinuation rates observed. We were also particularly excited to see Boehringer Ingelheim expand the survodutide program with 4 Phase III studies, including ELEVATE-LIVER, assessing preservation of cardiac structure and function in people with MASLD or early MASH. The newer programs, including the LIVERAGE study, incorporate more flexible patient-centered titration strategies to better reflect real-world use and support tolerability. Altogether, this reflects the breadth of opportunity for survodutide across the cardiometabolic and liver disease spectrum, a focus beyond brute force weight loss and to overall metabolic health. Lastly, I want to mention that SYNCHRONIZE-2 and SYNCHRONIZE-CVOT, the long-term cardiovascular outcome trial represent key upcoming readouts, both expected this year. We look forward to those readouts as we continue to believe survodutide is well positioned as a highly differentiated option addressing obesity and its most serious metabolic consequences. Turning now to our early-stage immunology candidate, ZP9830, our novel Kv1.3 ion channel blocker. Kv1.3 is a potassium ion channel selectively upregulated on effector memory T cells, the cells that drive much of the tissue damage in autoimmune and inflammatory diseases through the release of pro-inflammatory cytokines. Blocking Kv1.3 may dampen specific pathogenic immune activity while preserving the protective function of the broader immune system. That selectivity is what makes ZP9830 a genuine pipeline and a product opportunity across a broad range of cell-mediated autoimmune diseases. Building on the positive Phase Ia single ascending dose results, we have now initiated a Phase Ib trial in approximately 30 participants with plaque psoriasis. This 8-week trial will evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and clinical efficacy of ZP9830 with treatment-emergent adverse events as the primary endpoint. We look forward to progressing this candidate through Phase Ib and to report top line results from the ongoing multiple ascending dose trial part of the Phase I trial later this year. The Zealand teams are both energized and excited with the clinical development progress we've made thus far in 2026, and I look forward to providing additional updates going forward. And with that, I'll turn the call over to our Chief Financial Officer, Henriette Wennicke, who will review our financial results for the first 6 months of 2026. Henriette?

Thanks, David, and hello, everyone. I'll start by focusing on the strength of our balance sheet. We ended the first 6 months of 2026 with a significant cash position of DKK 14.5 billion. As a reminder, while we have recognized the revenue from the Phase III initiation development milestone of DKK 3.7 billion, we will only receive the payment from us later this year when we actually start the study. We continue to focus on active balance sheet management. This is evidenced by the launch of the USD 200 million share buyback program in Q2 and the announcement yesterday of the USD 100 million royalty monetization of a noncore asset via the agreement with Royalty Pharma rusfertide. I'm very pleased with this agreement, which converts a future potential royalty stream into immediate capital. And we will continue to leverage our strong financial position to invest into future growth opportunities in line with our strategic priorities. Beyond our near-term commitment with the existing clinical pipeline, this means expanding our capabilities to build a leading pipeline for the long term, drawing on our deep expertise in metabolic health and peptide innovation and complementing this with external innovation through partnerships that allow us to expand into other modalities, just like the partnership with OTR Therapeutics on small molecules. Moving to the income statement for the first 6 months of the year. Revenue was DKK 4.5 billion, driven by recognition of the Phase III initiation development milestones of DKK 3.7 billion and the first anniversary payment of DKK 798 million from the collaboration and license agreement with Roche. Operating expenses totaled DKK 1.2 billion. The vast majority of that was dedicated to research and development, reflecting continued investment in the petrelintide franchise, including preparation for the Phase III program with petrelintide's monotherapy and the ZYNERGY Phase II combination trial that David described earlier on. Expenses also reflect increased investments into our research program, clinical advancements of early-stage assets as well as the ongoing Phase III with glepaglutide. Net financial items amounted to a positive DKK 292 million for the period, reflecting exchange rate adjustments on our USD-denominated holdings and interest income from our investments in marketable securities and cash equivalents. As a result, profit for the first 6 months of 2026 was DKK 3.5 billion. Now let's briefly move on to the outlook for the full year. There are no changes to our financial guidance of DKK 4.5 billion in collaboration revenue for 2026. And we continue to expect operating expenses in the range of DKK 2.7 billion to DKK 3.3 billion, mainly driven by R&D activities. And with respect to the royalty sale agreement with Royalty Pharma for rusfertide just announced yesterday, we will receive USD 50 million in cash in Q3 and the remaining USD 50 million at the first anniversary of closing of the agreement. I would like to highlight that the anniversary payment is not linked to anything else than time. And with that, I will turn the call back to Adam for concluding remarks.

Thank you, Henriette. Leveraging our momentum, we look forward to several important milestones and catalysts ahead in 2026. These include data from additional key trials in the SYNCHRONIZE program with survodutide, continued clinical advancement of petrelintide franchise and the progress across our early-stage programs. With that, thank you all for your attention. I will now turn over the call to the operator, and we'll be happy to address your questions.

[Operator Instructions] We will take our first question. The first question comes from Hakon Hemme Bro-Jorgensen from Danske Bank.

On the combination product of petrelintide and enicepatide can you clarify your dose-ranging approach? Is petrelintide held constant around its maximally effective dose, while enicepatide dose altercation varies or are both components varied? And secondly, on the Kv1.3 channel blocker, how should we expect the future progression of this molecule to unfold? Will you run multiple Phase I indications in parallel or wait for more data before deciding where to focus?

Thank you Hakon. On the combination study, which, of course, we are extremely excited to get going and progress as we understand how important this could be for the future patient care. As we have discussed a few times before, the profile of a combination between an amylin and GLP-1 GIP actually holds the potential to address several different patient segments, including those living with the highest degree of obesity could also be patients who live with both obesity and type 2 diabetes and other situations. And the specific combinations and which molecules we titrate and the specific titration ranges is something we will probably have to keep a little bit proprietary for some time as we build a very competitive profile for this combination product for the future. But as we have mentioned a few times, we could consider quite a number of different patient needs to be addressed by this combination product. And we're extremely excited about getting it going and progressing it together with Roche. On Kv1.3, it's very clear, as David also mentioned, it has this pipeline in a product potential because Kv1.3 in these T effector memory cells are so central to the immune reaction in autoimmune diseases, but actually also in certain inflammation seen in metabolic diseases, we would definitely envision a broader program as we get later into development, but it's too early to comment on which indications we specifically will pursue beyond psoriasis. Thank you, Hakon.

And the question comes from the line of Mohit Bansal from Wells Fargo Securities.

So I have a couple of questions, one on survo and then one on petrelintide . So on survo the key question when we talk to doctors is that glucagon agonism does have a benefit in like liver fat reduction and all that. However, the question is, would you be able to show a differentiation against the GLP-1 or GLP-GIP based on the traditional MASH endpoint because they are more histology-related endpoints. Or you may have to come up with some unique endpoints or an outcome trials like Lilly is doing something of that sort that you may have to do to prove that this is GLP/GIP plus kind of drug. Secondly, on petrelintide, so one key theme, especially looking at the data for obesity was that doctors love the fact that you could actually titrate only once and then you could get to a tirzepatide like weight loss. So for petre, given the safety profile is pretty good here, do you see a possibility on differentiation on the dose titration part, which would be very appealing to the primary care doctors.

Thank you for your question. And I will just touch upon the first -- the second question on petrelintide and then hand over to David on survodutide. But on petrelintide and titration, I think it's actually an important thing to think about that when we look into how petrelintide is being dosed, we actually see this more as dose escalation. We have just gotten so used to talk about dose titration when we think about the GLP-1s because they are so intolerable molecules, the GLP-1s that you have to carefully titrate them, you go up in dose, then you find out that patients can't tolerate it and you step down in dose, then you try again a few weeks later and so on and so forth. That's a very, very cumbersome journey to get to the effective doses that delivers the weight losses that people like to talk about. With petrelintide as David mentioned, people can follow the dose escalation, meaning that you don't need to titrate up and down. So it's a very simple stepwise approach as you see with many general medicine in other categories. And if you think about our Phase II study, you also saw quite significant weight loss at the lower doses. So I think as a field, when we start to talk about amylins, we need to get used to talk about dose escalation rather than titration. It's 2 very different situations between the amylins and the GLP-1s. So David, will you talk about survo and the glucagon component for MASH resolution.

Happy to, Adam, and thanks for the question. I think you hit on one of the key points, which is the glucagon agonism that's added to the survodutide molecule. Clearly, we have a belief and our Boehringer Ingelheim partners have a belief that the glucagon signal and its ability to alter specifically how free fatty acid is trafficked and metabolized in the liver is distinct from the pure incretin mechanism or GLP-1 agonism. I think one has to look no further than the Phase II data that were reported now 2 years ago at the liver meetings in Europe, where the improvements in fibrosis and resolution of MASH with survodutide, at least based on those Phase II data are what we would consider best-in-class in terms of potential. That does not mean that other mechanisms, GLP-1 agonism alone with semaglutide, GLP-1 GIP agonism with tirzepatide will have an effect, presumably much of that driven through reductions in body weight specifically. But we and our BI partners firmly believe that, that glucagon signal has a critically important role in what is the primary insult that is driving the trafficking of fat into the liver, in this case, modifying that through the glucagon signal. The preliminary results from SYNCHRONIZE-MASLD also showed that 6 and 10 have resolution of liver fat, albeit in a lower-risk population. So I think those are 2 very important data points that suggest that while weight reducing therapies alone are very effective, that adding this glucagon signal may carry very important additional effects at specifically targeting not just MASLD but MASH, the F2, F3 and ultimately F4 population. So obviously, more to come with the LIVERAGE program, but exciting data to date, we believe, supporting this unique mechanism.

Your next question comes from Alana Shamzi from Jefferies.

Firstly, on amylin therapies, interested to hear if you hear of any illegal or unapproved use of amylin, including petrelintide in the same way that's been seen for drugs such as retatrutide? And then secondly, on GIP, could you walk us through how you're thinking about the development strategy from here? Specifically, what do you see as the most attractive commercial positioning for GIP-based therapy? And what could combination trials look like?

Thank you for your questions. I'll just address the first one and then hand over the question on GIP to David. We have not heard specific illegal use of compounded or imported use of petrelintide. Of course, it's something we monitor closely as we have seen these things with other products. So it's something we have to monitor closely going forward. David, will you take.

Yes. Yes. Yes. Happy to, Adam. And as regards amylin, it's worth noting that pramlintide approved symlin has been available indicated as an adjunct to insulin therapy, but we do know of both data published with pramlintide in the weight-producing space and some use as an adjunct to weight management, not illegal use, just use of a licensed compound. Your question on GIP and its potential in the metabolic health space, I think there is much to learn about GIP agonism. We see reports each day on both agonist antagonist approaches. But clearly, GIP through its myriad effects on both beta cell function islet cell function, potentially on bone health and muscle mass clearly has with the dual agonist molecules shown great promise. What is less well understood is how can this be combined with other classes of therapies, in particular, nonincretin therapies such as petrelintide. So clearly, having an effective GIP agonist compound that is safe and well tolerated. That's what the Phase I trial will assess for us. That can and likely will be used in multiple combinations. This is another molecule as is the history of Zealand that we believe can be readily co-formulated and administered with a number of other metabolically active peptides, not limited to the incretin hormones, but as an adjunct to a number of peptide hormone therapies. So right now, this is step 1, just as others have developed on these stand-alone molecules that will allow some freedom in formulation and dose selection as opposed to being tied into a fixed dual agonist molecule. Much more to come, in future earnings calls and with data becoming available. Thanks.

Your next question comes from the line of Rajan Sharma from Goldman Sachs.

I've got a couple. So firstly, just on the petrelintide, enicepatide combination. Could you just outline your target product profile there? We've also seen some data for Lilly's eloralintide and tirzepatide combination in the EASD abstracts. Is that a level of efficacy that you think is achievable with petre combination? And could you maybe just talk about potential other areas of differentiation there? And then second question, just on the royalty agreement that you announced last night. Could you just maybe talk about the rationale for the timing there, looking at the balance sheet and your previous communication, it doesn't feel like there is an obvious need for capital immediately. So just wanted to understand what the rationale was for doing that deal and doing it now.

Thank you for your question, Rajan. I'll take the first one and hand over the second question to Henriette. On the petrelintide, enicepatide combination, I would say there are opportunities to address multiple patient needs with such a combination. And rather than just pursuing the weight loss olympics, which I think I've been calling a few times that we should stop to care about, we should think about what are the true future patient needs. If you think about a more mature chronic therapy market, most patients will likely start on a monotherapy and then only step into combination therapies if their needs are not solved by a monotherapy. The combination of an amylin and a GIP in our minds, looks to be fantastic for those patients who need more. So that could be a patient who started on enicepatide and wanted more and then you add a combination or it could be the other way around, as I explained and as many physicians discussed at ADA this year that you start on petrelintide, for instance, what we think is the most tolerable approach to achieve a weight loss. And if you then find out you need more, then you step up to a combination between the 2 products. Where the combination, of course, looks extremely attractive with the data that are available, broadly speaking, from amylin and GLP-1 GIP combinations is also in patients living with obesity and type 2 diabetes because it seems like we can address both the weight loss and the glycemic deficiencies in a strong way. So I would say -- when we think about how to develop combination therapies for the future and not the current market, it's extremely important to think about what is the profile needed and not just try to run for the highest number, in particular, not if you then achieve very high dropout rates or a lot of GI side effects when you achieve those numbers. So I think you need to have a more balanced view when you view these data readouts in the future, at least how we think about designing these studies is about what is the future patient needs, what are the profiles of such combination products that could make them highly successful in a future, more complex treatment world rather than just running after specific numbers. So I hope this addressed partly your question. And then I'll hand over to you, Henriette.

Thanks, Adam, and thanks for the question Rajan. So you can say this royalty stream, of course, very passive. I think rusfertide as a product and an asset in our pipeline was maybe forgotten a bit by some. This was a good opportunity, and we saw a good appetite to actually get this deal done at this time. I think it's an opportunity for us to take this cash and redeploy it into some other activities and opportunities we have in the pipeline. And of course, this was a very passive ownership we had on this product and other strategic assets that doesn't really fit, you can say, our future ambitions and the vision. So we will redeploy this cash and put it into future opportunities.

Your next question comes from Suzanne van Voorthuizen from Van Lanschot Kempen.

This is Anna on for Susan. So could you elaborate on your view on the wider landscape in weight loss with now or available on the anticipated launches of petrelintide and enicepatide how you expect the treatment paradigm to change with increasingly more options to the needs for efficacy and safety and convenience? And where do you believe that petrelintide will sit?

Thank you for those questions. I'll start and maybe David will add some color to some of my comments. On the segment and the GLP-1 -- all GLP-1s, of course, as we are seeing right now, they have opened up the market and at least according to the manufacturers of these medicines, they are very much getting new patients on board who have not been candidates for their injectable GLP-1s. What we still need to see is, of course, how people manage to stay on these therapies will it truly change how we have seen the GLP-1s being used, where we know after 3 months, we have 30% who have dropped off and after a year, only 20% are still on. And I really have to remind us all that obesity is a chronic disease, and it should be considered a chronic treatment. So this thing that we get on and get off is probably not the way we would address obesity for the future. And that's why we are so focused on developing medicines that can give patients the weight loss that the majority of patients are looking for, which is a double-digit number. If you ask patients, broadly speaking, 80% in our surveys at least suggest that they would be looking for weight loss below 20%. What is important is that we are only, I would say, 4 to 5 years into the treatment of what we consider the biggest health care challenge of our time, obesity and all the metabolic consequences of living with obesity. So it is a very dynamic market. And as we will see more tools and in particular, differentiated tools getting to the market, it will, of course, also be more complex treatment algorithms. One thing where we see -- I think we'll see a major shift is that instead of just looking at specific patients and saying this treatment is for that patient or this treatment is for that patient, we will start to consider treatment of obesity as a weight loss journey, meaning you start on one product and then you see where you get on that one. And if you don't achieve your goals or if you can't tolerate it, you get on another product and then you see where that gets you to or you get on combination products. That's how we treat other chronic diseases. And that's the complexity that we are trying to develop our portfolio for. And this is also coming back to why we are so excited about the profile of petrelintide because we think it's the logical starting point for most patients ultimately when they start a weight loss journey. And then only if they need more weight loss, you will start to consider other more cumbersome modalities or combination therapies. So a more mature market, you should view patients as being on a journey towards achieving their goals and not just as this product fits this patient forever. So it will be more complex. We think we have the pipeline to actually address key aspects of the need of the future, and it will be exciting. Thank you. David, do you have further?