Corporate Presentation - July 2021 - Investor Overview

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Corporate Presentation - July 2021 - Investor Overview
Corporate
Presentation
July 2021
Corporate Presentation - July 2021 - Investor Overview
Forward-Looking Statements

This presentation contains forward-looking statements about Equillium, Inc. (the    Actual results or events could differ materially from the plans, intentions and
“Company”). In some cases, you can identify forward-looking statements by           expectations disclosed or implied in the forward-looking statements the
the words “will,” “expect,” “intend,” “plan,” “objective,” “believe,” “estimate,”   Company makes due to the risks and uncertainties inherent in the Company’s
“potential,” “continue” and “ongoing,” or the negative of these terms, or other     business, including without limitation, risk described in the Company’s filings with
comparable terminology intended to identify statements about the future.            the Securities and Exchange Commission (“SEC”). You are cautioned not to
These statements are based on Company management’s current beliefs and              place undue reliance on these forward-looking statements, which represent
expectations. These statements include but are not limited to statements            the Company’s views as of the date of this presentation. The Company’s
regarding the Company’s business strategy, the Company’s plans to develop           anticipates that subsequent events and developments will cause the its views
and commercialize its product candidates, the safety and efficacy of the            to change. However, while the Company may elect to update these forward-
Company’s product candidates, the Company’s plans and expected timing               looking statements at some point in the future, the Company has no current
with respect to regulatory filings and approvals, size and growth potential of      intention of doing so except to the extent required by applicable law. These
the markets for the Company’s product candidates and cash runway. These             and other risks and uncertainties are described more fully under the caption
statements involve substantial known and unknown risks, uncertainties and           “Risk Factors” and elsewhere in the Company’s filings and reports, which may
other factors that may cause the Company’s actual results, levels of activity,      be accessed for free by visiting EDGAR on the SEC web site at
performance or achievements to be materially different from the information         http://www.sec.gov and on the Company’s website under the heading
expressed or implied by these forward-looking statements. The Company may           “Investors.” All forward-looking statements are qualified in their entirety by this
not actually achieve the plans, intentions or expectations disclosed in its         cautionary statement. This caution is made under the “safe harbor” provisions
forward-looking statements, and you should not place undue reliance on the          of Section 21E of the Private Securities Litigation Reform Act of 1995.
Company’s forward-looking statements.

                                                                                                                                                                           2
Corporate Presentation - July 2021 - Investor Overview
Equillium Snapshot

World Leaders                   Validated                                Strategic Partnership
in CD6 Biology                  Therapeutic                              with Biocon Limited
• Developing itolizumab,        • Highly differentiated MoA,             • Commercial rights to U.S., Canada,
  a first-in-class monoclonal     inhibiting both the activity and         Australia, & New Zealand
  antibody targeting the          trafficking of T effector cells        • Commercial-scale manufacturing
  CD6-ALCAM pathway                                                        and supply agreement

Strong Cash Balance             First-Line aGVHD                         Proof-of-Concept
• $104.1M 1Q 2021               • Pivotal Phase 3 study to support BLA   • PoC studies for SLE/LN and
• Well capitalized to reach     • Study initiation planned Q4 2021         uncontrolled asthma ongoing,
  near-term catalysts           • Potential to be first to market          data anticipated 2H 2021
                                  in aGVHD first-line treatment

                                                                                                                3
Corporate Presentation - July 2021 - Investor Overview
Accomplished Management Team

                                        Dolca Thomas, MD
             Bruce Steel, CFA           EVP RESEARCH & DEVELOPMENT                     Steve Connelly, PHD
             CHIEF EXECUTIVE OFFICER    CHIEF MEDICAL OFFICER                          CHIEF SCIENTIFIC OFFICER
             BioMed Ventures • Rincon   Principia • Roche • Pfizer                     BioMed Ventures • aTyr Pharma
             Anaphore • Ambit           Bristol Meyers Squibb                          The Scripps Research Institute

             Christine
             Zedelmayer                 Jason Keyes                                    Joel Rothman
             CHIEF OPERATING OFFICER    CHIEF FINANCIAL OFFICER                        CHIEF DEVELOPMENT OFFICER

             Amylin • Amgen • Ligand    Orexigen • Amylin                              Cytokinetics • Genentech
                                        Amgen • Baxter                                 Raptor • Jazz Pharmaceuticals

Extensive Industry Experience

                                                                     Rincon
                                                                     Pharmaceuticals

                                                                                                                        4
Corporate Presentation - July 2021 - Investor Overview
Itolizumab: Pipeline-in-a-Product

Indication Selection Strategy              T Cell Mediated Immuno-inflammatory Diseases
                                                                                            Acute Graft-Versus-
                                                                                Solid Organ    Host Disease
                                                                                 Rejection                            Chronic Graft-Versus-
                                                                                                                          Host Disease

 Strong scientific rationale                             Multiple Sclerosis                                                      Crohn's Disease

                                                        Neuromyelitis
                                                          Optica                                                                        Ulcerative Colitis

 Robust preclinical / translational data
                                            Uncontrolled Asthma                                                                             Lupus/Lupus Nephritis

                                                  Interstitial Lung
 High unmet medical need                             Diseases
                                                                                                                                             Vasculitis

                                                                                                                                           Scleroderma

                                                                                                                                       Behcet's Disease

 Compelling commercial opportunity                     Atopic Dermatitis
                                                                                                                                  Rheumatoid Arthritis

                                                                         Psoriasis                                           Psoriatic Arthritis

                                                                                                            Uveitis

                                                              Current clinical             Research Implicates CD6/ALCAM
                                                                                                                                  T cell mediated diseases
                                                              development programs         pathway in disease pathogenesis
                                                                                                                                                                    5
Corporate Presentation - July 2021 - Investor Overview
Itolizumab Development Overview

Indication       Delivery   Phase 1   Phase 2        Phase 3          Status, Designations & Catalysts

                                                                      • Pivotal Phase 3 study to support
acute graft-                                       Pivotal study        BLA filing
versus-host                                     initiation expected
disease                                                               • FDA Fast Track and Orphan
                                                      Q4 2021
                                                                        Drug Designations

systemic lupus                                                        • EQUALISE phase 1b study
erythematosus                                                           actively enrolling
(SLE) / lupus                                                         • FDA Fast Track Designation
nephritis (LN)                                                        • LN interim data expected 2H 2021

                                                                      • EQUIP phase 1b study
uncontrolled                                                            actively enrolling
asthma
                                                                      • Topline data expected 2H 2021

                                                                                                           6
Corporate Presentation - July 2021 - Investor Overview
Mechanism of Action

                      7
Corporate Presentation - July 2021 - Investor Overview
CD6-ALCAM Pathway is Central to Immuno-inflammation

                                                                                  APC / TISSUE
CD6 is a co-stimulatory receptor expressed on T cells, differentially
expressed on subsets of innate lymphoid (ILC) and natural killer
(NK) cells, but not on T regulatory cells (Treg)

Activated leukocyte cell adhesion molecule (ALCAM), is
expressed on both antigen-presenting cells and
endothelial/epithelial tissue including the blood-brain-barrier, skin,
gut, lung and kidney

The binding of CD6-ALCAM is important for:
     • Immune synapse formation
     • Optimal co-stimulation and activation
     • Trafficking into tissues

The CD6-ALCAM pathway modulates T cell activity and
trafficking and we believe is central to the pathogenesis of
multiple immuno-inflammatory diseases
                                                                         T CELL

                                                                                                 8
            Consuegra-Fernandez et al., Cell Mol Immunol 2018
Corporate Presentation - July 2021 - Investor Overview
CD6 Associated With the Amplification of the Auto-reactive Cascade

 Highest levels of CD6 are found on activated T effector cells (Teff) and associated
 with amplification of the auto-reactive cascade

                                    CD6high                      CD6low/-

             Teff        • High Proliferation           • Low proliferation
                                                                                            Treg
                         • Pathogenic Phenotypes        • Regulatory phenotype
                         • Pro-inflammatory cytokines   • Anti-inflammatory cytokines

         Autoreactive                                                             Immune Regulation
        “Autoimmunity”                                                                  “Tolerance”

                                                                                                      9
Corporate Presentation - July 2021 - Investor Overview
CD6-ALCAM Pathway is Central to Immuno-inflammation
                     ACTIVITY                    TRAFFICKING

                     Increased proinflammatory
                          cytokine secretion

 Optimal immune
synapse formation,                                    Increased
    activation                                      trafficking of
 and proliferation                                   Teff cells into
                                                    target tissues

                     Suppression of regulatory
                            pathways                                   10
Itolizumab Reduces Levels of Cell Surface CD6

                                                                                                      Levels of CD6 on itolizumab treated cells
                                                                                                        normalized to isotype treated cells*
                    Pathogenic
   CD6hi                                                                                      CD4 effector/memory                                                         CD8 effector/memory
                     Teff Cells

                                                                                                                                  (MFI normalized to Isotype)
                                                                                                                                                                1.5

                                                      (MFI normalized to Isotype)
                                                                                    1.5

                                                                                                                                   Surface CD6 Expression
                                                       Surface CD6 Expression
                                                                                    1.0                                                                         1.0

                    Antigenic
                                                                                                                                                                0.5
                    modulation
                                                                                    0.5

                                                                                    0.0                                                                         0.0
                                                                                          1     10      100      1000     10000                                       1     10      100      1000     10000
                                                                                              Incubation Time (Minutes)                                                   Incubation Time (Minutes)

  CD6lo         Non-pathogenic                                         • IgG binds to domain-1 of CD6
                   Teff Cells
                                                                       • Dose-dependent loss of CD6 resulting in hyporesponsive T cells
                                                                       • Pharmacodynamic marker can be monitored in patients

                                                                                                                                                                                                              11
           * 3 independent experiments on Donor 1041 (unstimulated PBMCs)
Unique Upstream, Disease Modifying
Immuno-inflammatory Mechanism

 Selectively targets auto-reactive effector T cells, while sparing regulatory
 T cells to promote immune tolerance and homeostasis, resulting in durable disease remission

    Synergistic inhibition of multiple                                        Inhibition of Teff   Restoration of immune regulation
       Teff cells and cytokines*                                            trafficking into key   without broad immunosuppression
                                                                               target organs

                                             Teff
                                                                                                        Treg                 Teff
     Teff                                              Teff                     Teff

                                             Teff

              Th1 / Th2 / Th17

                                                                                                                                      12
            * including but not limited to IFN-γ, TNF-α, IL-4, IL-5, IL-6, IL-13 and IL-17
Development
Programs

              13
aGVHD Overview
Multisystem complication of allogeneic
hematopoietic stem cell transplants (HSCTs)
attacking the recipient’s body                              10,000   Allogeneic HSCTs performed in
                                                                     2020, with incidence increasing

                    0-100 days post-transplant

                                                            30-70%   Allogeneic HSCT patients
                                                                     will develop aGVHD

         First-line                    Steroid-refractory            Reported 5 year survival rate for
                                                              53%    responders to first-line treatment
                                                                     with corticosteroids
          Itolizumab                         JAKAFI®
         Phase 1b/2                          Approved

           BMTCTN
                                                               5%    Survival rate for steroid non-
                                                                     responders

      Alpha-1 antitrypsin                   inolimomab
           Phase 3                           Phase 3
                                                                0    Number of approved treatments
                                                                     for first-line aGVHD

                                                                                                          14
EQUATE Study: First-line Treatment of High-Risk aGVHD
                                  Phase 1b open-label, 3x3, dose escalation study of itolizumab
                                  5 doses bi-weekly (days 1, 15, 29, 43 & 57)
                                  Subjects followed through Day 337

                                                                                                                      1.6 mg/kg
                                                                                                                          n=6               Primary Objectives
                                                                                         COHORT
                                                                                                                        33% on
                                                                                        EXPANSION                                           • Assess safety and tolerability
      Grade III-IV                                        1.6 mg/kg                                                   steroids ≤3
       patients                                               n=3                          Grade II                      days                 of IV dosing
                                                                                         (AA 2 or 3),                                       • Determine optimal IV dose
                                                                                      III & IV patients
    Concomitant
    within 72 hours                         0.8 mg/kg                                  Concomitant                                          Secondary Objectives
      of steroids                               n=3                                    within 7 days                  0.8 mg/kg             • Characterize drug
      (2 mg/kg)                                                                         of steroids                       n=4
                                                                                                                        50% on
                                                                                                                                              pharmacokinetics (PK) and
                                                                                        (2 mg/kg)
                              0.4 mg/kg                                                                               steroids ≤3             pharmacodynamics (PD)
                                  n=4                                                                                    days               • Assess the clinical activity of
                                                                                                                                              itolizumab: GVHD ORR, CR,
                                                                                                                                              NRM, cGVHD, durability
• Per protocol, 3 evaluable subjects expected in each dose cohort for safety assessment                                                       (one year follow-up)
• Evaluable subjects must receive ≥ 2 doses or receive ≥ 1 dose with a DLT in first 29 days
• Continuing to enroll patients; no further dose escalation is anticipated
             *Ann  Arbor Score: 1, MAP 0.290.
             DLT is defined as ≥Grade 3 infusion reaction or clinical finding associated with hypersensitivity or any ≥Grade 3 AE that is
             not related to underlying disease that is at least possibly related to study treatment as per the investigator.                                                    15
             Data with cut-off date of 30 Apr 2021, subject to change.
Efficacy: Responses by Day 15 & Maintained at Day 29
                                      Early Response:                                Response Endpoint:                                  Treatment Naïve Response:
                                           Day 15                                         Day 29                                                  Day 29
                                                                                                                                            Treatment ≤3 days on steroids

                                   CR                      ORR                   CR            ORR                                   N              CR                       ORR
                                                                           All Subjects, n (%)
 0.4 mg/kg (N=4)               2 (50.0)                  3 (75.0)                 2 (50.0)                  2 (50.0)                 4           2 (50.0)                 2 (50.0)
 0.8 mg/kg (N=7)               5 (71.4)                  5 (71.4)                 5 (71.4)                  5 (71.4)                 5           4 (80.0)                 4 (80.0)
 1.6 mg/kg (N=9)               4 (44.4)                  7 (77.8)                 4 (44.4)                  7 (77.8)                 5           3 (60.0)                 4 (80.0)
 TOTAL (N=20)                 11 (55.0)                 15 (75.0)                11 (55.0)                 14 (70.0)                14           9 (64.3)                10 (71.4)
                                                 Evaluable Subjects (received ≥ 2 doses), n (%)
 0.4 mg/kg (N=3)               2 (66.7)                  3 (100)                  2 (66.7)                  3 (100)                  3           2 (66.7)                 3 (100)
 0.8 mg/kg (N=5)               5 (100)                   5 (100)                  5 (100)                   5 (100)                  4           4 (100)                  4 (100)
 1.6 mg/kg (N=6)               3 (50.0)                  5 (83.3)                 3 (50.0)                  5 (83.3)                 5           3 (60.0)                 4 (80.0)
 TOTAL (N=14)                 10 (71.4)                 13 (92.9)                10 (71.4)                 13 (92.9)                12           9 (75.0)                10 (83.3)

• Six subjects received only one itolizumab dose and were not evaluable per protocol, of which 67% received systemic
  steroids for ≥4 days prior to itolizumab dosing
• Discontinuation of study drug after one itolizumab dose due to:
 • Requiring subsequent administration of alternate anti-GVHD therapy for progressive disease (n=4)
 • Adverse event unrelated to study drug (n=2)
           Evaluable subjects must receive ≥ 2 doses or receive ≥ 1 dose with a dose limiting toxicity in the first 29 days.
           Abbreviations: ORR=CR+VGPR+PR, overall response rate; CR, complete response; VGPR, very good partial response defined as achieving all the criteria for skin, liver, and
           gut involvement per Martin 2009 Consensus criteria without meeting the criteria for CR; PR, partial response.                                                              16
           Data with cut-off date of 30 Apr 2021, subject to change.
Itolizumab: Clinically Meaningful Complete Responses
            in First-line High-Risk* aGVHD
                          100%
                                                                                                                               Itolizumab showing improved response at Day 29
                                                                GRAVITAS-301                     (itolizumab
                                                                                                  + steroids)
Response Rate at Day 29

                              80%                                                                                                                            Treatment Naïve
                                                                             (itacitinib            71%                                                                                             All Subjects
                                                       (steroids alone)
                                                                             + steroids)            ORR                                                       (≤3 days on steroids)
                                                                                                                                                                    CR/ORR                            CR/ORR
                                                                               61%                  7%
                                      MacMillan             56%                ORR                                          0.4 mg/kg                              50%/50%                            50%/50%
                              60%                           ORR
                                      et al. 2015                                                                           0.8 mg/kg
                                    (steroids alone)                                                                                                               80%/80%                            71%/71%
                                         43%                                    19%                                         1.6 mg/kg                              60%/80%                            44%/78%
                                         ORR                21%                                                             TOTAL                                                                     55%/70%
                                                                                                                                                                   64%/71%
                              40%
                                         16%
                                                                                                  64%                   •    CR’s associated with improved long-term patient
                              20%                                              42%                                           outcomes
                                                           35%
                                        27%
                                                                                                                        •    Early responses allowed for rapid steroid tapering
                              0%
                          N                269                57                 57                  14                 •    Adverse events reported with the EQUATE trial have
 Treatment Naïve
                                          n/a                n/a              ≤ 2 days           ≤ 3 days                    been consistent with the safety profile previously
   (steroid dose)
                                                            partial response                                                 reported for itolizumab and those experienced in
                                                       very good partial response                                            high-risk aGVHD patients
                                                           complete response
                                     *EQUATE high-risk defined as Grade III-IV by MAGIC criteria; 80% of subjects also met Minnesota high-risk criteria used by MacMillan and GRAVITAS-301.
                                     Abbreviations: ORR=CR+VGPR+PR, overall response rate; CR, complete response; VGPR, very good partial response defined as achieving all the criteria for skin, liver, and gut
                                     involvement per Martin 2009 Consensus criteria without meeting the criteria for CR; PR, partial response.
                                                                                                                                                                                                                    17
                                     MacMillan et al. BBMT 2015; Zeiser et al. EHA Abstract Library 2020.
                                     Data with cut-off date of 30 Apr 2021, subject to change.
Itolizumab Associated with Dose Reduction in Systemic Steroid Use
      Evaluable Patients

                                   0
        % Change from Baseline

                                                                                                                               0.4 mg/kg (N=3)
                                  -20                                                                                          0.8 mg/kg (N=4)
                                                                                                                               1.6 mg/kg (N=6)
               in Dose

                                  -40

                                  -60

                                  -80

                                 -100
                                        1 15 29 43 57       85                                169
                                                                 Day

Most subjects maintained steroid reduction from Day 29 and/or continued tapering through Day 169

        Data presented as mean (SD); equivalent prednisone dose calculated for methylprednisolone and dexamethasone to determine systemic corticosteroid use at each visit.
        Evaluable subjects must receive ≥ 2 doses or receive ≥ 1 dose and have DLT in the first 29 days, who received 1-2 mg/kg prednisone or equivalent at baseline.         18
        Data with cut-off date of 30 Apr 2021, subject to change.
EQUATE Data: Dose Responsive Reduction of CD6
PD data suggests optimal dose range at 0.8 to 1.6 mg/kg
 • Itolizumab significantly reduces the surface levels of CD6 on T cells by 24 hours following first dose
 • At 0.4 mg/kg CD6 trends toward baseline by Day 15; higher doses demonstrate durable CD6 reduction (p
aGVHD Next Steps

     Phase 1b                       Meeting                            Pivotal study in                      Submit
       data                         with FDA                        first-line treatment                      BLA

     1H 2021                       Mid-2021                                Q4 2021
                                                             Goal of conducting a single pivotal trial
                                                            to support a biologics license application
                                                               (BLA) submission for the indication of
                                                                   first-line treatment of aGVHD

     Proposed protocol and timeline for site initiation and BLA submission contingent on regulatory review and study outcomes

                                                                                                                                20
Lupus Overview
Lupus nephritis: a heterogeneous disease that
is the most frequent and serious manifestation
of systemic lupus erythematosus (SLE)                                         10,000   Lupus nephritis patients in the U.S.

                                                Targeted      Complement
             T cell                 B cell

                                                                              50-75%
                                                Cytokines      Inhibition              Of patients do not respond
                                                                                       to frontline treatments
                                                               Complement

               Teff

                                                                                40%    Of severe, proliferative patients will
                                                                                       progress to end-stage renal disease
             Itolizumab             BENLYSTA®   COSENTYX ®      ULTOMIRIS ®
              Phase 1b              Approved     Phase 3          Phase 2

  LUPKYNIS ®      deucravacitinib   GAZYVA®     anifrolumab    narsoplimab
                                                                                  2    Approved treatments

  Approved           Phase 2        Phase 3       Phase 2        Phase 2

                                                                                       Product in development designed to

   Phase 2
                      BI 655064
                       Phase 2
                                     KZR-616
                                     Phase 2
                                                 TREMFYA ®
                                                  Phase 2
                                                                                  1    modulate both the activity and
                                                                                       trafficking of Teff cells - itolizumab

                                                                                                                                21
EQUALISE Study:
Systemic Lupus Erythematosus & Lupus Nephritis

                       Phase 1b open-label, dose escalation study

                                                 Type B                              Primary Objective
    Type A        Cohort 1: 0.4 mg/kg                                                Type A & B
                                              patients with                          • Assess the safety and tolerability of
 patients with                                active LN with                           itolizumab in subjects with SLE with and
   active or      Cohort 2: 0.8 mg/kg          inadequate      Cohort 1: 0.8 mg/kg
 inactive SLE                                   response to                            without active proliferative lupus nephritis
  without LN                                      existing                           • Determine optimal subcutaneous dose
                  Cohort 3: 1.6 mg/kg            therapies     Cohort 2: 1.6 mg/kg
                                                                                       level(s) of itolizumab
   2 doses,
  day 1 & 14,                                   13 doses,
subcutaneous      Cohort 4: 2.4 mg/kg           bi-weekly,     Cohort 3: 3.2 mg/kg   Secondary Objective
                                              subcutaneous                           Type A & B
    N = 30
                  Cohort 5: 3.2 mg/kg
                                                                                     • Characterize the pharmacokinetics (PK)
                                                 N = 18
                                                                                       and pharmacodynamics (PD) of itolizumab
                                                                                     • Understand changes in disease serologies,
                                                                                       urinary ALCAM and CD6, CD6 receptor
                                Type A Data Announced
                                    March 30, 2021
                                                                                       occupancy
                                                                                     Type B
                                                                                     • Assess the clinical activity of itolizumab
                 Type B interim data expected 2H 2021                                  (Proteinuria and SLEDAI-2K)

                                                                                                                                    22
EQUALISE Interim Data: Dose Responsive Reduction of CD6

 Reduction in surface levels of CD6 on CD4 cells

                                                Day 15                                                  Day 29
                                              Pre 2nd dose                                       14 days post-2nd dose

                                                        ✱✱                                                 ✱✱

                                                    ✱                                                ✱✱✱

                                     150       ✱✱                                          150                           ***p
EQUALISE / EQUATE: Comparison of Cell Surface CD6 Level

 Comparable potency between intravenous and subcutaneous administration

                                                                                            Cell Surface CD6 Level
                 fold change from baseline
                                             6                           5000

                                                 baseline

                                                                                 baseline
                                                                                                                          SLE 1.6 mpk
                                             5                           4000
                                                                                                                          GVHD 1.6 mpk

                                                            CD6 (gMFI)
                                                                         3000
                                             4
                                                                         2000
                                             3                           1000

                                             2                             0

                                                                                 0               10        20        30
                                             1
                                                                                                  Study Day

                                                 0                              10                    20        30
                Fluorescent detection of cell surface
                                          Study       CD6 on CD4 T cells as measured by flow cytometry.
                                                    Day
                        Fluorescence expressed as geometric mean fluorescent intensity (gMFI)

                                                                                                                                         24
Therapeutic Limitations: Approved Drugs Hitting a Critical Ceiling
Complete responses critical for renal survival
Survival (%)
100%

                                                                                                                                             60
 75%

 50%
                                                                                                                                                   %
 25%

  0%
                                                                                                                                          of lupus nephritis
       n CR n PR           n NR
                                        50                             100                            150                           200
                                                                                                                                          patients are not
Renal survival (censuring for nonrenal death) in patients with severe lupus nephritis based on remission status, NR, no remission
(P
ALCAM Shown to be a Predictive Biomarker in Active Lupus Nephritis

Unbiased screening of >1100 urinary proteins identified urinary ALCAM as a strong predictor of
disease activity in lupus nephritis patients

                                          Urinary ALCAM Elevated in Active                                            Urinary Biomarker Outperforms Standard Disease Biomarkers in
                                                   Lupus Nephritis                                                                          Lupus Nephritis*
                      250000
                        250000

                                                                                                                                     AUC
                                                   Distribution of ALCAM levels seen                                                                P value      Sensitivity   Specificity     PPV       NPV
                                                                                                                                   (95% CI)
                                    *              within race and disease severity
Urinary ALCAM pg/mg

                      200000
                        200000

                                                                                                                 Urinary             0.91
                                                                                                                                                   < 0.0001        0.91           0.82         0.88      0.86
                                                                                                                 ALCAM           (0.86 – 0.96)
                      150000
                        150000

                                                                                                              Positive anti-
                                                                   *statistical significance                                          NA                           0.38           0.57         0.57      0.38
                                                                                                                dsDNA
                      100000
                        100000

                                                                                                                 Low
                                                                                                                                      NA                           0.56           0.55         0.65      0.46
                      50000
                        50000                      *                                                          complement
                                                                   *
                                                                                    *
                                                                                                             *Performance of urinary protein markers in differentiating active lupus nephritis (N=89) from
                        0
                                                                                                             inactive lupus nephritis (N=60) in African American and Hispanic systemic lupus erythematosus
                             0

                                 Active         Active                          Healthy
                                               Non-Renal
                                                              Inactive SLE
                                                                                Control
                                                                                                             patients - UT Southwestern Medical Center, TX
                                  LN

                                                                                                                                                                                                                26
                                  Stanley et al., 2016. Comprehensive Aptamer-Based Screening of 1129 Proteins Reveals Novel Urinary Biomarkers of Lupus Nephritis. ACR/ARHP Annual Meeting.
Uncontrolled Asthma Overview
A heterogeneous disease characterized by different Teff cell
subtypes & other innate immune cells driving both allergic and
autoimmune mechanisms, leading to chronic airway inflammation
                                                 Reciprocally
                                                  regulated
                                                                                                           2.6M   Severe asthma patients
                                                                                                                  in the U.S.

                                                   Th2-Low
    Th2-High                                                                             Non-Th2

                                                                                                           1.3M
                                                Low Eosinophils                                                   Patients uncontrolled
      Eosinophils                                                                     Neutrophils                 by standard-of-care
           Response to steroids
         Current therapies target                     Current downstream therapies        No approved
         downstream signaling of                       ineffective in patients with        therapies              Of uncontrolled patients who
                                                                                                            50%
       Th2-associated inflammation                       low levels of eosinophils
                                                                                                                  don’t respond to existing
anti-IgE        anti-IL-5   anti-IL-4 / IL-13                anti-IL-33                  anti-CD6-ALCAM           biologics

 XOLAIR®       NUCALA®         DUPIXENT®           RG6149            REGN3500               Itolizumab

                                                                                                              0   Approved products covering
Marketed       Marketed        Marketed            Phase 2            Phase 2                Phase 1b
                                                        Inhaled PI3Kd                       anti-TSLP
                                                                                                                  full spectrum of disease
               CINQAIR®        Anticalin
                               /AZD1402
               Marketed                                      AZD8154                       Tezepelumab
                                Phase 1
                                                             Phase 1                          Phase 3
                                                                                           Inhaled JAK
               FASENRA®
               Marketed

                                                                                          JAK1 / AZD0449
                                                                                             Phase 1                                             27
Upregulation of CD6 & ALCAM in Severe Asthma Patients

 Examination of lung tissue demonstrates increased CD6,
 T cells and ALCAM in the lungs of severe asthma patients

                                                                                                                          CD6                ALCAM                 overlay
Fatal asthma patients –

                                                                                                Fatal asthma Non-asthma
lung tissue staining suggests:
• Increased numbers of CD6+ cells
• Upregulation of ALCAM in the lamina
  propria (mucosa)                                                                                                              epithelium

• Co-localization of CD6+ cells with ALCAM                                                                                      Lamina propria

  expressing tissue

                       Gene expression analysis suggests higher expression of CD6+ T cells
                        within the airway of patients who have died from severe asthma

         Study of the Mechanisms of Asthma (MAST; NCT00595153); Bronchoscopic Exploratory Research Study of Biomarkers in Corticosteroid-refractory Asthma (BOBCAT) study; Data   28
         courtesy of Reynold A. Panettieri, Jr., MD, Rutgers Institute for Translational Medicine and Science.
EQUIP Study Design: Uncontrolled Asthma

                   Phase 1b randomized, double-blind, placebo controlled study

                               Cohort 1: 0.4 mg/kg           Primary Objective
            Uncontrolled                                     Type A & B
            moderate to
           severe asthma                                     • Assess the safety and tolerability of
              patients         Cohort 2: 1.6 mg/kg
                                                               subcutaneous dosing of itolizumab in patients
                                                               with moderate to severe asthma
              5 doses,                                       • Determine optimal subcutaneous dose level(s)
             bi-weekly,                                        of itolizumab
           subcutaneous        Cohort 3: 2.4 mg/kg
                                                             Secondary Objective
              N = 32                                         • Characterize the pharmacokinetics (PK) and
                                Cohort 4: 3.2 mg/kg            pharmacodynamics (PD) of itolizumab
                                                             • Assess the clinical activity of itolizumab: FEV1,
                                                               ACQ, FeNO, Eos

Enrollment ongoing; topline data expected 2H 2021

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Corporate

            30
Strong Intellectual Property Portfolio / Regulatory Exclusivity
                                                                                                     Orphan Designation
                                                                                                              7 years

                                                                                                                Biologics Exclusivity
                                                                                                                    12 years in US

                                             Compositions / Methods - U.S. Patent No. 8,524,233
                                                               Patent term ~ 2028

                                                               Formulations - U.S. 16/197,228
                                                                       Patent term ~ 2030

                                                                     Method of Treating MS - U.S. Patent No. 10,189,899
                                                                                       Patent term ~ 2034

                                                                                    Method of Inhibiting CD6 - PCT WO 2018/073721
                                                                                                   Patent term ~ 2037

                                                                               Method of Treating Lupus – U.S. Application 16/343,127
                                                                                                   Patent term ~ 2037

                                                                                      Method of Treating Severe Asthma - PCT US2019/019872
     Biocon Filings                                                                                         Patent term ~ 2039

                                                                                        Lupus sCD6/sALCAM diagnostic - PCT US2020/019990
    Equillium Filings                                                                                       Patent term ~ 2039

   Assumptions:                                                                                                   New Filing
   - Listed applications will issue
   - Biologics Exclusivity will be granted and will begin at NDA approval
   - Potential patent term extensions not shown                                                                    New Filing

                      2006          2010            2014            2018             2022           2026             2030         2034       2038   2042
                                                                                                                                                           31
Equillium Financial Overview
Key Financial Metrics as of 1Q 2021

Total Cash and Investments                                   $104.1M
                                                                                Well capitalized to reach
                                                                                near-term catalysts
Year-to-Date Operating Cash Burn                                 $7.9M

                                                               $10.0M
                                                                                Lean operating model
Outstanding Debt
                                                                                and disciplined spending

Shares Outstanding                                              29.0M           Operating runway into
                                                             $163.8M            mid-2023
Market Cap (as of close 12 July, 2021)

Please refer to the Form 10-Q filed on 13 May 2021 for complete financials of
the company as of 31 March 2021

                                                                                                            32
Multiple Catalysts in 2021

                                   Catalysts & Milestones                              Timing

EQUALISE Phase 1b study: interim data from Type B patients (lupus nephritis)          2H 2021

EQUIP Phase 1b study: topline data in uncontrolled asthma                             2H 2021

Initiate pivotal study in first-line aGVHD                                            Q4 2021

                           Financed through completion of ongoing clinical trials
                 with funding in place to advance itolizumab into late-stage development

                                                                                                33
Thank you

Michael Moore
Vice President, Investor Relations & Corporate Communications
ir@equilliumbio.com
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