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Developing clinical stage small molecule therapeutics to treat hormonal and reproductive system disorders.

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Presentation on theme: "Developing clinical stage small molecule therapeutics to treat hormonal and reproductive system disorders."— Presentation transcript:

1 Developing clinical stage small molecule therapeutics to treat hormonal and reproductive system disorders

2 Forward-Looking Statements This presentation contains forward-looking statements and information regarding the future performance and actions of Repros Therapeutics Inc. (RPRX) that involve risks and uncertainties that could cause actual results and actions to differ materially. These risks include those discussed in this presentation and others that can be found in Repros’ Form 10-K for the year ended December 31, 2007 and in the subsequently filed Form 10-Q’s, which contain additional important risk factors that could cause actual results to differ from its current expectations and from the forward-looking statements made in this presentation. RPRX is providing this information as of this date 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. The results of initial clinical trials do not necessarily predict the results of later-stage clinical trials. RPRX cannot guarantee that data collected from clinical trials of any product candidate will be sufficient to support FDA or other regulatory approval.

3 Repros Strategy Focus on small molecule therapeutics for hormonal and reproductive system disorders that exhibit significant market potential and that are currently underserved Late stage development of highly differentiated drugs –Proellex for the treatment of female reproductive system disorders Acute anemia associated with uterine fibroids Chronic relief of uterine fibroid symptoms Chronic relief of the symptoms associated with endometriosis –Androxal for the treatment of endocrine disorders Treatment of Type II Diabetes in men with hypogonadotropic hypogonadism Fertility preservation/improvement in treatment of 2º hypogonadism Proven track record of efficient and rapid clinical development

4 Repros Market Opportunity Proellex Uterine fibroid anemia$140 million/year Uterine fibroid symptoms$1.75 billion/year Endometriosis symptoms$1.70 billion/year Androxal Fertility preservation$250 million/year Type II Diabetes$>1 billion/year 2º hypogonadism ex-US$100 million/year Total Potential Market~$5.0 billion/year

5 Repros Pipeline

6 Proellex ®

7 Proellex Overview New class of selective progesterone receptor modulator (SPRM) –Suitable for chronic and acute indications Potential significant advantages over existing GnRHa standard of care –No loss of bone mineral density in clinical trials –No chronic drug treatments available Excellent, long-term IP protection –US issued composition of matter patent to 2017 –Eligible for Hatch-Waxman extension –Potential use applications with life to 2027 Worldwide exclusive rights –In-licensed from NIH –Includes 43 additional compounds

8 Uterine Fibroids Large Underserved Market Most common tumor of the female reproductive tract –Heavy bleeding / anemia –Abdominal pressure / pain / urinary frequency Conservative Estimate, 15% of women of reproductive age with symptomatic uterine fibroids –Potentially 26,000,000 women in US, Japan, France, Germany, Italy, Spain, & UK with symptomatic fibroids –Estimated 700,000 severe cases currently requiring surgery or radical treatment in large market countries –Mean age of women seeking UF treatment, 39 –Potential years on therapy, 10 Uterine Fibroids regress when a woman reaches menopause If only 25% of severe population use drug option $1,750,000,000/yr Market ($140 million for anemia)

9 Key Symptom Driving Women to Seek Therapy for Uterine Fibroids Excessive Menstrual Bleeding US Phase IIb (n=127) P<0.0001 Menorrhagia=PBAC>80 Basis for Commencement of US Phase III Studies Proellex stops bleeding

10 Basis for Anemia IND and Ongoing Phase III Studies Change in Hemoglobin Levels in Anemic Patients (<10.5g/dl) Placebo n=8 25 mg Proellex n=11 Comparison of Means p=0.00000055 Mean Std. Dev. Roughly 40% of women seeking therapy for fibroids are anemic and therefore surgical risks 1 g increase = ~1 pint of blood

11 Phase 2 Uterine Fibroid Trial UFSQOL (Co-primary endpoint in Phase III) UFSQOL Uterine Fibroid Symptom Survey High score > severity Month 3 significance values v.s. placebo; 25 mg p <0.0001 Spies et al, Obstetrics & Gynecology, vol. 99, No. 2, February 2002

12 Endometriosis Epithelial & stromal endometrial cells outside the uterine cavity –Pelvic and back pain –Infertility –Pain during sex –Severe menstrual cramps 5% of reproductive-age women – more that are undiagnosed –71-87% of women with chronic pelvic pain –25-40% (2-4 million) infertility cases could be due to endometriosis –53% of teenagers with cramps Unmet medical need – chronic condition, poor treatment options –Lupron, OCs, Danazol, laparoscopic procedures High recurrence rates after treatment

13 US Phase 2 Endometriosis study MESSS Questionnaire US Phase II Endpoint

14 US Results for End of Phase II Meeting Modified Endometriosis Symptom Survey Total MESS Score Max.=15 (Last Observation Carried Forward) Total possible score = 15 15 patients in placebo group and 14 each in 25 & 50 mg No statistical difference between 25 & 50 mg After week 4 all p values < 0.01

15 US Results for End of Phase II Meeting Modified Endometriosis Symptom Survey Patient Reported Outcomes Total Scores (Last Observation Carried Forward) Total possible score =9 15 patients in placebo group and 28 in 25 & 50 mg combined No statistical difference between 25 & 50 mg P=0.007 P<0.0001

16 US Results for End of Phase II Meeting Modified Endometriosis Symptom Survey Dysmenorrhea (Painful Menses) (Last Observation Carried Forward) Total possible score =3 15 patients in placebo group and 28 in 25 & 50 mg combined No statistical difference between 25 & 50 mg P=0.0002 P<0.0001

17 US Results for End of Phase II Meeting Modified Endometriosis Symptom Survey Deep Dyspareunia (Painful Sex) (Last Observation Carried Forward) Total possible score =3 15 patients in placebo group and 28 in 25 & 50 mg combined No statistical difference between 25 & 50 mg P=NS P=0.0056 P=0.0005 P=0.004

18 US Phase II Results Modified Endometriosis Symptom Survey Non Menstrual Pelvic Pain (Last Observation Carried Forward) Total possible score =3 15 patients in placebo group and 28 in 25 & 50 mg combined No statistical difference between 25 & 50 mg P=NS P=0.014 P=0.003

19 US Phase 2 Endometriosis study Analgesic Use (narcotic & non narcotic) Analysis based on Patients last observation carried forward p=.0025 50 vs Pbo p=.0078 25 vs Pbo

20 Study Dropouts 50 mg (5 patients) –2-Lost to follow up –2-Non compliance with study protocol –1-Found to be Osteopenic on day of first dose 25 mg (7 patients) –2-elected hysterectomy upon completion of study –1-osteopenic, should not have been randomized –1-preexisting condition of auto immune disorder, should not have been randomized –1-endometrial stripe not measureable –1-exacerbation of depression and anxiety (never dosed) –1-non compliance, patient stopped taking drug Placebo (14 patients) –9-lost to follow up –1-no diagnosis of endometriosis –1-adverse event (burning throat when taking drug) –2-lack of relief –1-osteopenic, should not have been randomized.

21 US Phase II Endometriosis Study 25 mg Patients Electing Hysterectomy Situations Leading to Election of Hysterectomy Open Label Study not available for dosing until March/April ’09. Patients completed double blind study in Nov. 2008. Hysterectomy to treat severe endometriosis is relatively common option (120,000 procedures in the US annually) –Subject 1 was informed about the extension study (not yet dosing), but reported that due to her long history of endometriosis and severity of her condition she proceeded with the hysterectomy. This subject is now 36 years old. –Subject 2 was informed about the extension study but withdrew after completing Visit 7. She did not have worsening symptoms, only that she did not want to go without medications. The subject recently obtained insurance, which enabled her to have the procedure. This subject is now 43 years old.

22 Proellex Safety Experience Well tolerated at all doses No observed QT effects at up to 4X maximum clinical dose Potential for break through vaginal bleeding significantly reduced by incorporating “off-drug” intervals Open-label extension study confirming positive impact of “off-drug” interval

23 “Off Drug Interval” Treatment Strategy 4 Month Dosing Cycle Off Drug Interval to allow for: Menses Refresh the endometrium Experience to date suggests menses returns in 25-35 days Return of symptoms Continue as needed Concept has been accepted by the FDA as noted in End of Phase II meeting minutes

24 Proellex Summary of FDA meetings FDA will entertain multiple label indications –First NDA: Preoperative treatment of Anemia –2 nd NDA: Chronic treatment of symptoms associated with fibroids –3 rd NDA: Chronic treatment of symptoms of endometriosis Initial Phase III programs – anemia and fibroids –Initiated Two 65-patient trials – Anemia prior to surgery for fibroids –Initiated Two 75-patient trials – Symptoms associated with uterine fibroids Ongoing Phase II endometriosis study (n=75) –Interim results reported Open label extension studies as required to satisfy safety data base –Initiated 400 patient 2-cycle study with holiday until symptoms return (25mg or 50mg Proellex ) –Initiated 400 patient 3-cycle study with holiday until menses returns to satisfy FDA need for 200 patients for one year of dosing –Protocols submitted to FDA for input Total pooled safety data base ( 1,500 patients) Phase I-III trials as part of submission

25 Proellex Market Opportunity Uterine fibroid anemia Uterine fibroid symptoms Endometriosis symptoms +$3.5 Billion/Year Market

26 Androxal

27 Trans isomer of clomiphene citrate –Cis isomer opposes action and has increased side effect risk Antiestrogen that normalizes pituitary responsiveness in 2º hypogonadal men Highly statistically significant results in 6 month Phase III study showing restoration of pituitary responsiveness resulting in normalization of testicular function and testosterone levels Multiple patents and patent applications including pure isomer composition

28 Androxal Regulatory Strategy & Development Status Ongoing Phase II incorporating FDA comments –Preservation of fertility and testicular function and normalization of testosterone in hypogonadal men of reproductive age Based on FDA correspondence –Submission of IND for Type II Diabetes

29 Impact of Androxal on Male Fertility Basis for Ongoing US Phase II Comparison of Means p=0.011 Comparison of Median p=0.0045 Estimated 1/3 of current T market ($750 million) are men of reproductive age 32% of men in Repros study under age of 50 Exogenous testosterone suppresses pituitary secretion of FSH FSH required for stimulation of sertoli cell spermatogenesis Suppressed FSH suppresses spermatogenesis as evidenced by reduction in testicular size

30 Ongoing Androxal Phase II Impact on sperm function and testosterone levels Three arm (n=24) open label study with active comparator (Testim) in hypogoandal men previously treated with testosterone –8 men with 3 week washout followed by 25 mg Androxal for 6 months –8 men with 3 month washout followed by 25 mg Androxal for 6 months –8 men with 3 week washout followed by Testim for 6 months Endpoints –Change in sperm function from baseline to months 3 & 6 –Change in pituitary hormones and testosterone from baseline to months 3 & 6

31 Impact of Hypogonadism on Insulin Sensitivity and Metabolic Syndrome American Heart Association definition of Metabolic Syndrome –Elevated waist circumference, ≥ 40“ –Triglycerides, ≥ 150 mg/dl –Reduced HDL, < 40 mg/dl –Elevated Blood Pressure, ≥ 130/85 –Elevated Fasting Glucose, ≥ 100 mg/dl P<0.05 T<280 90% Metabolic Syndrome T>280 29% Metabolic Syndrome Pitteloud et al, Journal of Clinical Endocrinology & Metabolism 90(5):2636-2641 “In men, low T levels predisposes to central obesity and predicts the development of both the metabolic syndrome and DM2.”

32 Change in Serum Glucose Subset of Men BMI>26, Glucose >99 (+50% patients studied) No significant change in Placebo or Androgel arms Significant mean change in Androxal arm p<0.01 0123

33 Recent and Upcoming Milestones & Goals  2Q07 Reported top-line Proellex Phase 2b fibroid data  3Q07 Commenced US Proellex Phase 2 endometriosis trial  3Q07 Reported non-pivotal Phase 3 Androxal data  1Q08 Submitted Anemia IND  1Q08 Commence Phase 3 registration trials for Anemia  1Q08 Report data from ongoing Proellex open-label fibroid trial  1Q08 Commence Phase 3 registration trials for fibroid symptoms  3Q08 Report interim Proellex Phase 2 endometriosis data  3Q08 Commence Phase 2b Androxal fertility preservation trial  2Q09 Request endometriosis end of Phase 2 meeting with FDA  H209 Report Phase 3 Anemia registration trial top-line data  H209 Report Phase 3 Fibroid registration trial top-line data  H209 Commence Phase 3 registration trials for Endometriosis  H209 Report Androxal Phase 2b fertility preservation trial  H209 Submit Proellex Anemia indication NDA  H210 Submit Proellex Chronic Fibroid indication NDA

34 Repros Fundamentals Shares Outstanding –15,174,904 (all common, no warrants) No Debt 2006 Net Loss –$14,195,000 2007 Net Loss –$13,700,000 2008 Net Loss (through 9/08) –$19,300,000 Unaudited Cash on 12/31/08 : approximately $19.4 million

35 Thank you


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