Lumvoa: A Treatment for Thyroid Eye Disease

© 2026 Viridian Therapeutics, Inc. All Rights Reserved. Lumvoa™ (veligrotug-vvze), Viridian Therapeutics®, ViridianCares™ and related trademarks are owned by Viridian Therapeutics, Inc. All other trademarks are the property of their respective owners. US-VG-0219 06/26

INDICATION

Lumvoa is indicated for the treatment of Thyroid Eye Disease regardless of Thyroid Eye Disease activity or duration.

​

IMPORTANT SAFETY INFORMATION

Infusion Reactions: Lumvoa may cause infusion reactions. Infusion reactions have been reported in approximately 9% of patients treated with Lumvoa. Signs and symptoms of infusion-related reactions include transient increases in blood pressure, fever, chills, headache, and fatigue. Infusion reactions may occur during or soon after an infusion. Reported infusion reactions are usually mild or moderate in severity and can usually be successfully managed with corticosteroids, antihistamines, and antipyretics. In patients who experience an infusion reaction, consideration should be given to standard premedication and/or administering infusions at a slower infusion rate.

​

Please refer to the full safety information throughout the presentation.

Speaker introduction

2

Brian Thomas Fowler MD

The University of Tennessee Health Science Center, Hamilton Eye Institute

Disclaimers

This presentation is sponsored by Viridian Therapeutics, Inc. The speaker is being paid to present this information on behalf of Viridian Therapeutics, Inc. and the information being presented by the speaker is consistent with approved labeling.

​

This presentation is intended only for physicians and other healthcare providers.

3

Objectives

IGF-1R=insulin-like growth factor 1 receptor; TED=thyroid eye disease.

4

Introduce Lumvoa, a full IGF-1R antagonist for TED

Explore how Lumvoa may be integrated into TED care

Review the efficacy and safety profile of Lumvoa in active and chronic TED

Highlight the impact and treatment of TED

Thyroid eye disease (TED): a progressive autoimmune disease

TSHR=thyroid-stimulating hormone receptor.

1. Tamhankar MA et al. Front Ophthalmol (Lausanne). 2025;5:1565762. doi:10.3389/fopht.2025.1565762. 2. Yuan X, Li H, Wang F. Front Med (Lausanne). 2026;13:1758015. doi:10.3389/fmed.2026.1758015. �3. Vincent AB et al. Cleve Clin J Med. 2025;92(11):693-701. doi:10.3949/ccjm.92a.25043. 4. Barrio-Barrio J et al. J Ophthalmol. 2015;2015:249125. doi:10.1155/2015/249125. 5. Kulbay M et al. Int J Mol Sci. 2024;25(21):11628. doi:10.3390/ijms252111628. 6. Patel P et al. Ophthalmic Plast Reconstr Surg. 2015;31(6):445-448. doi:10.1097/IOP.0000000000000371.

5

Common symptoms of TED include proptosis, diplopia, dry eyes, redness and pain of the eyes, and eyelid retraction.^4,5�In severe cases, TED can lead to loss of vision.⁴

Evolving treatment landscape in TED

1. Moledina M, Damato EM, Lee V. Eye. 2024;38(8):1425-1437. doi:10.1038/s41433-024-02967-9. 2. Kossler AL, Douglas R, Dosiou C. J Clin Endocrinol Metab. 2022;107(Suppl_1):S36-S46. doi:10.1210/clinem/dgac168. 3. Amgen. Amgen announces positive topline phase 3 results for subcutaneous TEPEZZA in adults living with moderate-to-severe active thyroid eye disease. Updated April 6, 2026. Accessed April 29, 2026. https://www.amgen.com/newsroom/press-releases/2026/04/amgen-announces-positive-topline-phase-3-results-for-subcutaneous-tepezza-in-adults-living-with-moderate-to-severe-active-thyroid-eye-disease. 4. Xu Z et al. Front Endocrinol. 2025;16:1480195. doi:10.3389/fendo.2025.1480195. 5. Tepezza® (teprotumumab-trbw) prescribing information. Amgen Inc. November 2025. 6. Kim DW et al. JCI Insight. 2024;9(24):e182352. doi:10.1172/jci.insight.182352. 7. Ciulla TA, Ugradar S, Smith TJ. Expert Rev Ophthalmol. 2025;20(5):217-221. doi:10.1080/17469899.2025.2503790.

6

Limited pharmacologic options

Introduction of IGF-1R–targeted therapy

Understanding �of the IGF-1R pathway continues to progress

Approvals of new therapies expand available options for patients.^1,2

Prior to 2020^1-3

2020^4,5

Today^6,7

Introducing Lumvoa

Lumvoa: Important Safety Information

INDICATION

Lumvoa is indicated for the treatment of Thyroid Eye Disease regardless of Thyroid Eye Disease activity or duration.

​

IMPORTANT SAFETY INFORMATION

Infusion Reactions: Lumvoa may cause infusion reactions. Infusion reactions have been reported in approximately 9% of patients treated with Lumvoa. Signs and symptoms of infusion-related reactions include transient increases in blood pressure, fever, chills, headache, and fatigue. Infusion reactions may occur during or soon after an infusion. Reported infusion reactions are usually mild or moderate in severity and can usually be successfully managed with corticosteroids, antihistamines, and antipyretics. In patients who experience an infusion reaction, consideration should be given to standard premedication and/or administering infusions at a slower infusion rate.

8

Lumvoa: Important Safety Information (cont’d)

Inflammatory Bowel Disease: Lumvoa may cause an exacerbation of inflammatory bowel disease (IBD). IBD has been reported in some patients receiving insulin-like growth factor-1 receptor inhibitors without a prior diagnosis of IBD. Monitor patients for signs and symptoms of IBD, including patients without a history of IBD. If IBD is suspected, discontinue use of Lumvoa.

Hyperglycemia: Hyperglycemia or increased blood glucose may occur in patients treated with Lumvoa. In clinical trials, 12% of patients, of whom one-half had preexisting diabetes or impaired glucose tolerance, experienced hyperglycemia. Hyperglycemic events should be controlled with medications for glycemic control, if necessary. Assess patients for elevated blood glucose and symptoms of hyperglycemia prior to infusion and continue to monitor while on treatment with Lumvoa. Ensure patients with hyperglycemia or preexisting diabetes are under appropriate glycemic control before and while receiving Lumvoa. Continued monitoring after treatment is recommended for patients who experience hyperglycemia while on Lumvoa.

9

Lumvoa: Important Safety Information (cont’d)

Hearing Impairment Including Hearing Loss: Lumvoa may cause severe hearing impairment including hearing loss, which in some cases may be permanent. Assess patients’ hearing before, during, and after treatment with Lumvoa and consider the benefit-risk of treatment with patients.

Most Common Adverse Events: Most common adverse reactions (incidence of 5% or more) are muscle spasms, headache, hearing impairment, hyperglycemia, fatigue, diarrhea, ear discomfort, infusion-related reaction, nausea, nasopharyngitis, blood creatine phosphokinase increased, dry skin, and hypertension.

Females of Reproductive Potential: Appropriate forms of contraception should be implemented prior to initiation, during treatment, and for 6 months following the last dose �of Lumvoa.

​

Lumvoa (500 mg) is an injection for infusion.�

Please see accompanying Full Prescribing Information.

​

​

10

Lumvoa is a full IGF-1R antagonist for �near-complete signaling inhibition^1,2

IGF-1=insulin-like growth factor; TSH=thyroid stimulating hormone; TSHR=thyroid stimulating hormone receptor.

1. Kaplan R et al. mAbs. 2025;17(1):2585616. 2. Smith TJ, Janssen J. Endocr Rev. 2019;40(1):236-267.

11

Lumvoa’s mechanism of action in patients with thyroid eye disease has not been fully characterized and is based on preclinical data. �Additionally, head-to-head efficacy/safety clinical studies between IGF-1R antagonists have not been conducted. The clinical significance of any differences in pharmacological properties is not known.

Trial design of THRIVE and THRIVE-2

Phase 3 trials of Lumvoa in active and chronic TED

Lumvoa was studied in the largest and broadest population of TED patients to date^1-3*

*Based on completed Phase 3 trials in TED.

CAS=clinical activity score.

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Tepezza® (teprotumumab-trbw) prescribing information. Amgen Inc. November 2025. 3. Data on file. TED trial combined search results. Feb 18, 2026. Viridian Therapeutics, Inc; 2026. 4. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022. 5. Cockerham K et al. Poster presentation at AAO 2025. Poster PO005.

13

THRIVE (N=113)

Recent-onset active TED patients^1,4

Moderate-to-severe active TED�with ≥3 mm excess proptosis

CAS ≥3 in study eye

Recent onset of TED signs�and symptoms

THRIVE-2 (N=188)

Chronic TED patients^1,5

Moderate-to-severe chronic TED�with ≥3 mm excess proptosis

All CAS (0-7) in study eye

Chronic TED signs and symptoms

THRIVE Phase 3 trial design¹

*Additional secondary endpoints included CAS change from baseline and CAS reduction to 0 or 1.

1. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022. 2. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301). Viridian Therapeutics, Inc; 2025.

14

THRIVE

Active TED

N=113

2:1 randomization�Lumvoa�or placebo

Follow-up�through

Week 52

Week 15

Primary endpoint:

• Proptosis responder rate

​

Selected secondary�endpoints:^*

• Diplopia responder rate
• Diplopia resolution rate

​

Selected exploratory �endpoint:

• Quality of life

Lumvoa Q3W�5 IV infusions�over 12 weeks

Placebo Q3W�5 IV infusions�over 12 weeks

THRIVE-2 Phase 3 trial design^1,2

*Additional exploratory endpoints included CAS change from baseline and CAS reduction to 0 or 1 in patients with CAS ≤3.

1. Cockerham K et al. Poster presentation at NANOS 2025. 2. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022..

15

Lumvoa Q3W�5 IV infusions�over 12 weeks

Placebo Q3W�5 IV infusions�over 12 weeks

THRIVE-2

Chronic TED

N=188

2:1 randomization�Lumvoa�or placebo

Follow-up�through

Week 52

Week 15

Primary endpoint:

• Proptosis responder rate

​

Selected secondary�endpoints:

• Diplopia responder rate
• Diplopia resolution rate

​

Selected exploratory �endpoint:*

• Quality of life

Baseline patient characteristics in THRIVE and THRIVE-2^1,2

1. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022. 2. Cockerham K et al. Poster presentation at NANOS 2025.

16

THRIVE: Lumvoa in active TED

Treatment with Lumvoa produced rapid, strong, and durable reductions in proptosis^1,2

Lumvoa in active TED

*Proptosis responder rate at week 15 was defined as the percentage of patients with a ≥2-mm reduction in proptosis in the study eye from baseline, without deterioration in proptosis �(≥2-mm increase) in the non-study eye. ^{1 †}Change in proptosis of -2 mm or greater was considered a clinically meaningful change. ²

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

18

71% of Lumvoa patients who were proptosis responders at week 15 maintained their response at week 52¹

70% of patients had proptosis�response at week 15 ^*†

Treatment with Lumvoa produced rapid, strong, and durable reductions in proptosis (cont’d)¹

Lumvoa in active TED

^*Change in proptosis of -2 mm or greater was considered a clinically meaningful change. ²

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

19

Proptosis reduction of 2.90 mm at week 15^*

Proptosis changes from baseline (mm)

Weeks

P < 0.0001

at each time point

-0.51

-0.67

-0.71

-0.72

-0.48

-1.82

-2.39

-2.67

-2.77

-2.90

The majority of patients treated with Lumvoa had diplopia improvement, with nearly half having complete resolution

Lumvoa in active TED

Diplopia response in a patient was defined as having a diplopia score >0 at baseline and achieving a reduction of at least 1 point on the diplopia scale at Week 15. Diplopia resolution in a patient was defined as having a diplopia score >0 at baseline and a score of 0 at Week 15.¹

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

20

50% of Lumvoa patients who achieved diplopia resolution�at week 15 maintained resolution at week 52¹

59% of patients had improvement �in diplopia at week 15¹

49% had complete resolution of diplopia�4x more than placebo at week 15^1,2

Improvements in overall quality of life were reported in people who took Lumvoa

Lumvoa in active TED

Results from the Graves Ophthalmopathy Quality of Life (GO-QOL) questionnaire. Overall combined score of the two subscales (visual function and appearance).

Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

21

Overall quality of life is a composite of the results from the visual function and appearance subscales.

• This analysis was exploratory
• The minimally important change from baseline is 8 points, which was considered the threshold for a clinically meaningful outcome
• The GO-QOL questionnaire has not been validated specifically in patients with TED

Overall quality of life

Improvements across visual function and appearance quality of life were reported in people who took Lumvoa

Lumvoa in active TED

Results from the Graves Ophthalmopathy Quality of Life (GO-QOL) questionnaire. Analysis is exploratory and has not been adjusted for multiplicity. The minimal clinically important difference in quality of life has not been determined for these subscales.

1. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022 [supplementary appendix]. 2. Terwee CB et al. Br J Ophthalmol. 1998;82(7):773-779. 3. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

22

The appearance subscale addresses psycho-social parameters, such as social isolation and influence on friendships²

The visual function subscale assesses �daily activities, such as driving and reading²

Visual function subscale¹

Appearance subscale¹

THRIVE-2: �Lumvoa in chronic TED

Treatment with Lumvoa produced rapid, strong, and durable reductions in proptosis¹

Lumvoa in chronic TED

*Proptosis responder rate at week 15 was defined as the percentage of patients with a ≥2-mm reduction in proptosis in the study eye from baseline, without deterioration in proptosis �(≥2-mm increase) in the non-study eye.¹ Change in proptosis of -2 mm or greater was considered a clinically meaningful change.²

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301). Viridian Therapeutics, Inc; 2025.

24

57% of patients had proptosis�response at week 15*

57% of Lumvoa patients who were proptosis responders at week 15 maintained their response at week 52¹

7x

more

Treatment with Lumvoa produced rapid, strong, and durable reductions in proptosis (cont’d)¹

Lumvoa in chronic TED

^�*Change in proptosis of -2 mm or greater was considered a clinically meaningful change.²

^�1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301). Viridian Therapeutics, Inc; 2025.

25

-0.62

-0.72

-0.69

-0.75

-0.46

-1.06

-1.70

-2.04

-2.22

-2.35

Proptosis changes from baseline (mm)

P < 0.003

at each time point

Proptosis reduction of 2.35 mm at week 15^*

Weeks

The majority of patients treated with Lumvoa had diplopia improvement, with nearly �one-third having complete resolution

Lumvoa in chronic TED

Diplopia response in a patient was defined as having a diplopia score >0 at baseline and achieving a reduction of at least 1 point on the diplopia scale at week 15. Diplopia resolution in a patient was defined as having a diplopia score >0 at baseline and a score of 0 at week 15.¹

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Cockerham K et al. Poster presentation at NANOS 2025.

26

80% of Lumvoa patients who achieved diplopia resolution at week 15 maintained resolution at week 52¹

Improvements in overall quality of life were reported in people who took Lumvoa

Lumvoa in chronic TED

Results from the Graves Ophthalmopathy Quality of Life (GO-QOL) questionnaire. Overall combined score of the two subscales (visual function and appearance). ¹

1. Cockerham K et al. Poster presentation at AAO 2025. Poster PO005. 2. Terwee CB et al. Br J Ophthalmol. 1998;82(7):773-779.

27

Overall quality of life is a composite of the results from the visual function and appearance subscales.²

• This analysis was exploratory¹
• The minimally important change from baseline is 8 points, which was considered the threshold for a clinically meaningful outcome¹
• The GO-QOL questionnaire has not been validated specifically in patients with TED

Improvements across visual function and appearance quality of life were reported in people who took Lumvoa

Lumvoa in chronic TED

¹Results from the Graves Ophthalmopathy Quality of Life (GO-QOL) questionnaire. Analysis is exploratory and has not been adjusted for multiplicity. The minimal clinically important difference in quality of life has not been determined for these subscales.

1. Cockerham K et al. Poster presentation at AAO 2025. Poster PO005. 2. Terwee CB et al. Br J Ophthalmol. 1998;82(7):773-779.

28

The appearance subscale addresses psycho-social parameters, such as social isolation and influence on friendships²

The visual function subscale assesses �daily activities, such as driving and reading²

Lumvoa safety profile

Demonstrated safety and tolerability profiles in active and chronic TED patients¹

*Hearing impairment includes tinnitus, hypoacusis, deafness, and autophony.

^†Hyperglycemia includes blood glucose increased, glucose tolerance impaired, glycosylated hemoglobin increased, diabetes mellitus, glucose urine present, and impaired fasting glucose.

^‡Fatigue includes asthenia.

^§Ear discomfort includes ear feels clogged, ear plugging, sensation of ear pressure, and ear popping.

1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022. 3. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301). Viridian Therapeutics, Inc; 2025.

30

Adverse reactions occurring in 5% or more of patients with active or chronic TED¹

• 94% of Lumvoa patients and 99% �of placebo patients completed �5 infusions, reflecting the low discontinuation rate of Lumvoa¹
• Adverse reactions were mostly �mild and transient and generally resolved during or after treatment^2,3
• Menstrual disorders were reported in approximately 29% (24/82) of menstruating women treated with Lumvoa compared to 6% (2/33) of patients treated with placebo in �the clinical trials¹

Hearing impairment adverse events with Lumvoa*

*Percentages are based on patients (not events). Individual patients may report multiple hearing‑impairment AEs; categories may overlap. �^†Due to sensorineural deafness, preceded by otitis media and nasopharyngitis.

^‡Patient was lost to follow-up.

1. Yen MT et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022. 2. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301). Viridian Therapeutics, Inc; 2025. 3. Data on file. Clinical study report: THRIVE-2 (Protocol VRDN-001-301) [Supplementary Table 14.3.14.5]. Viridian Therapeutics, Inc; 2025.

31

Getting started with Lumvoa

Lumvoa treatment occurs over 12 weeks, with 5 IV infusions

Dosing information based on US Prescribing Information for each product. �IV=intravenous.�1. Lumvoa™ (veligrotug-vvze) prescribing information. Viridian Therapeutics, Inc. 2026. 2. Tepezza® (teprotumumab-trbw) prescribing information. Amgen Inc. November 2025.

33

Lumvoa IV administration¹

10 mg/kg every 3 weeks over the following durations:

• 45 minutes for the first infusion
• At least 30 minutes for subsequent infusions if the first was well tolerated, or 45 minutes otherwise

No head-to-head study comparing the safety and efficacy of the products has been conducted.�

Before and after treatment with Lumvoa: active TED

Results may vary; not all patients treated with Lumvoa showed this magnitude of reduction. Among the proptosis responders in the Lumvoa arm at week 15, mean reduction of proptosis was 3.7 mm.

Written consent for participant images provided to investigator (V.L.), courtesy of Imperial College Healthcare NHS Trust UK and Viridian Therapeutics, Inc.

Summarized details and upscaled imagery adapted under Public License from Yen MT, Cockerham K, Saeed P, et al. Ophthalmology 2026; doi:10.1016/j.ophtha.2026.04.022. Original article © 2026 American Academy of Ophthalmology, Inc and available at: https://www.aaojournal.org.

CAS=clinical activity score.

Yen MT, Cockerham K, Saeed P, et al. Ophthalmology. 2026. doi:10.1016/j.ophtha.2026.04.022.

34

Female with active TED

Hertel proptosis: 27 mm; CAS: 5; Gorman score: 1

Hertel proptosis: 22.5 mm; CAS: 0; Gorman score: 0

Pre-treatment

Post-treatment, week 15

ViridianCares helps your patients start and stay on treatment

35

• Personalized, one-on-one support to help your patients throughout�their treatment journey

• Assistance with benefits verification, prior authorization�requirements, reimbursement, and required documentation

• The ViridianCares Co-pay Program offers co-pay assistance�for eligible patients. Commercially insured patients may pay as�little as $0* for both medication and infusion-related expenses
• If your patients experience a change in coverage or have�affordability concerns, ViridianCares will work closely with�them to explore available financial assistance options

* Patients must be enrolled in ViridianCares and meet all eligibility�requirements. Terms and conditions will apply.

See terms and conditions.

Key considerations when selecting therapy for patients with TED^1-3

1. Barrio-Barrio J et al. J Ophthalmol. 2015;2015:249125. doi:10.1155/2015/249125. 2. Lei C et al. Ophthalmol Ther. 2026;15(3):985-999. doi:10.1007/s40123-026-01326-z. 3. Dhaliwal NK, Razzaq L. Cureus. 2025;17(6):e86483. doi:10.7759/cureus.86483.

36

Questions?

Please scan the QR code to complete a short survey