Late Stage, Novel Antibiotics



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Late Stage, Novel Antibiotics November, 2015 11/18/2015 1

Third-party information included herein has been obtained from sources believed to be reliable, but the accuracy or completeness of such information is not guaranteed by, and should not be construed as a representation by, Paratek Pharmaceuticals, Inc. ( Paratek ). The information contained in this presentation is accurate only as of the date hereof. Paratek and the Paratek logo are trademarks and service marks of Paratek. All other trademarks, service marks, trade names, logos and brand names identified in this presentation are the property of their respective owners. Forward-Looking Statements / Risk Factors This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements include, but are not limited to, statements about our strategy, future operations, future financial position, future revenue, clinical development plans and timing, projected costs, prospects, plans, objectives of management, potential use and effectiveness of our product candidates, expected market growth, the market opportunity for and the market acceptance of our product candidates, and the strength of, and protection offered by, our intellectual property position. Examples of such statements include, but are not limited to, statements relating to the potential clinical risks and efficacy of, and market opportunities for, our product candidates, including Omadacycline and Sarecycline, the timing of clinical development of, and regulatory approval for, our product candidates, and the nature and timing of our collaboration agreements with respect to our product candidates. The words anticipate, estimate, expect, potential, believe, will and similar terms and phrases are used to identify forward-looking statements. These statements are based on current information and belief and are not guarantees of future performance. Our ability to predict results, financial or otherwise, or the actual effect of future plans or strategies, is inherently uncertain and actual results may differ from those predicted depending on a variety of factors. Our operations involve risks and uncertainties, many of which are outside our control, and any one of which, or a combination of which, could materially affect our results of operations or whether the forward-looking statements ultimately prove to be correct. We undertake no obligation to publicly update forward-looking statements, whether as a result of new information, future events or otherwise. Among the risks and uncertainties that could cause actual results to differ materially from those indicated by such forwardlooking statements include: delays in clinical trials or unexpected results; the failure of collaborators to perform obligations under our collaboration agreements; our failure to obtain regulatory approval for our product candidates; delays in undertaking or completing clinical trials; our products not gaining the anticipated acceptance in the marketplace or acceptance being delayed; our products not receiving reimbursement from healthcare payors; the effects of competition; our inability to protect our intellectual property and proprietary technology through patents and other means; and the risks described in the Risk Factors section of our Quarterly Report Form 10-Q for the quarter ended June 30, 2015, and our other periodic reports filed with the SEC. 11/18/2015 2

Paratek Investment Highlights Developing novel tetracycline antibiotics to address unmet medical needs Omadacycline : Oral/IV antibiotic addressing bacterial resistance Enrolling two pivotal trials ABSSSI and CABP Developing for UTI Potential additional indications - Sinusitis Worldwide commercial rights retained Sarecycline : Antimicrobial and anti-inflammatory tetracycline for treating acne Partnered with Allergan in U.S. Ex-U.S. commercial rights retained Proven management team Strong IP position 11/18/2015 3

Proven Management Team Commercialized Major Antibiotics/Built Leading Companies Michael F. Bigham Chairman & CEO Doug Pagan Chief Financial Officer Evan Tzanis VP, Clinical Development Evan Loh, MD President & CMO Led Tygacil Development Adam Woodrow Chief Commercial Officer Led Tygacil Commercialization Steve Villano, MD VP, Clinical and Medical Affairs Randy Brenner SVP, Regulatory & Quality Susan Perkins VP, Intellectual Property William Haskel SVP, General Counsel & Corporate Secretary Sean M. Johnston, PhD VP, Manufacturing Yulii Bogatyrenko SVP, Business Development Jeanne Jew VP, Business Development 11/18/2015 4 S. Ken Tanaka, PhD VP, Research and Development Developed clarithromycin, temafloxacin

Developing Novel Tetracycline Antibiotics Addressing Unmet Medical Needs Research Preclinical Phase 1 Phase 2 Phase 3 Commercial Rights ABSSSI (Oral & IV) QIDP Status SPA Omadacycline (1) CABP (Oral & IV) QIDP Status UTI (Oral & IV) QIDP Stauts (2) SPA TM Acute Sinusitis (Oral) Sarecycline (3) (WC 3035) Acne Safety/Efficacy X2 (Oral) Acne Long Term Safety Follow up (Oral) (1) Paratek owns Worldwide Commercial Rights (2) UTI program in development + QIDP for cuti (3) Paratek owns Ex-U.S. Commercial Rights 11/18/2015 5

Critical Need for New Antibiotics Bacterial resistance renders generic products obsolete over time Bacterial resistance costs society billions $USD > $20 billion USD/year in excess health care costs ~ $35 billion USD societal costs in 2000 > 8 million additional patient days (1) (2) REPORT TO THE PRESIDENT ON COMBATING ANTIBIOTIC RESISTANCE Executive Office of the President President s Council of Advisors on Science and Technology September 2014 (1) Roberts RR, Hota B, Ahmad I, Scott RD 2nd, Foster SD, Abbasi F, Schabowski S, Kampe LM, Ciavarella GG, Supino M, Naples J, Cordell R, Levy SB, Weinstein RA. Clin Infect Dis. 2009 Oct 15;49(8):1175-84. doi: 10.1086/605630 11/18/2015 6

11/18/2015 7 Scarcity of New Antibiotics in Development

Legislative Initiatives to Drive Antibiotic Development 2012 2013 2014 GAIN ACT (1) ADAPT ACT (2) DISARM ACT (3) Five years additional data exclusivity & priority review Passed Accelerated development pathway New Reimbursement framework to enable premium pricing (1) Provisions signed into law on July 9, 2012 as part of the Food and Drug Administration Safety and Innovation Act (FDASIA) (2) S. 2582 (113 th ): ADAPT Act, Introduced Jul 10, 2014 (3) H.R.512 - DISARM Act of 2015, Introduced Jan 22, 2015 11/18/2015 8

Developing Novel Tetracycline Antibiotics that Overcome Bacterial Resistance Efflux Pump Ribosomal Protection 11/18/2015 9

Aminomethylcyclines A New Generation Tetracycline Antibiotic 7-Position Modification: Overcomes Efflux Pump R1 R2 N R3 OH O H H O H O H N O OH NH 2 O 9-Position Modification: Overcomes Ribosomal Protection 11/18/2015 10

Omadacycline Overcoming Bacterial Resistance The Next Levofloxacin? Well Tolerated Once-Daily IV & Oral Potentially optimizes patient compliance No Drug-Drug Interactions Anticipated Reduces potential safety concerns Potentially Replaces Quinolones MRSA in ABSSSI PRSP/MRSA in CABP ESBL+ E. coli in UTI 11/18/2015 11

Omadacycline Vancomycin (Vancocin) Linezolid (Zyvox) Levofloxacin (Levaquin) Ceftriaxone (Rocephin) Amox-Clav (Augmentin) Azithromycin (Zithromax) Omadacycline Potent Against Key Resistant ABSSSI Pathogens (1) In-Vitro MIC90 (µg/ml) Organism (# Isolates) MRSA (111) 0.25 1 4 >8 >64 >8 >8 MSSA (52) 0.25 1 2 2 4 1 >8 S.pyogenes (104) 0.25 0.5 2 1 0.03 0.015 >4 (1) CMI 2007 report to Paratek 11/18/2015 12

Omadacycline: Demonstrated Clinical Efficacy in Complicated Skin, Skin Structure Infections in both Phase 2 and a Truncated Phase 3 (1) (2) Clinical Success Rate (3) Phase 2 Population Omadacycline Linezolid Intent-to-Treat (ITT) 88.3% (98/111) 75.9% (82/108) Clinically Evaluable (CE) 98.0% (98/100) 93.2% (82/88) Phase 3 Population (2) Clinical Success Rate (3) Omadacycline Linezolid Intent-to-Treat (ITT) 85.3% (58/68) 88.9% (64/72) Clinically Evaluable (CE) 96.7% (58/60) 95.5% (64/67) (1) Data from PRTK s Phase 2 and truncated Phase 3 csssi trials (2) An Intent-to-Treat, or ITT, population refers to all enrolled subjects, as defined in the protocol, who received at least one dose of study drug. A Clinically Evaluable, or CE, population refers to all ITT subjects who had a qualifying infection, as defined in the protocol. (3) Clinical success refers to resolution of the infection such that no additional antibiotics were needed in the ITT or CE populations, assessed by the clinical investigator 10 to 17 days after the last dose of study drug. 11/18/2015 13

Omadacycline Levofloxacin (Levaquin) Azithromycin (Zithromax) Ceftriaxone (Rocephin) Amox-Clav (Augmentin) Vancomycin (Vancocin) Omadacycline Potent Against Key Resistant CABP Pathogens (1) In-Vitro MIC90 (µg/ml) Organism (# Isolates) MRSA (111) 0.25 >8 >8 >64 >8 1 PRSP (51) 0.12 1 >4 2 8 1 H. influenzae (105) 1 0.03 4 0.008 1 Legionella (25) 0.25 0.03 (2) 0.5 Not Active Not Active Not Active Not Active (1) CMI 2007 report to Paratek (2) Indicates data is from moxifloxacin; J. Dubois et al. 2006 11/18/2015 14

Omadacycline SPA Approved Phase 3 Trial Designs (1) ABSSSI 650 patients Omadacycline IV Linezolid IV Omadacycline Oral Linezolid Oral d1 d2-3 Early Response Up to d14 End of Treatment d16-20 Post Treatment Evaluation, Test of Cure (2) CABP 750 patients Omadacycline IV Moxifloxacin IV Omadacycline Oral Moxifloxacin Oral (1) FDA approved 1 + 1 strategy (2) TOC endpoint = Primary endpoint confirmed through EMA scientific advice 11/18/2015 15 d1 d3-5 Early Response Up to d14 End of Treatment d16-20 Post Treatment Evaluation, Test of Cure (2)

Omadacycline Addressing Resistant E. coli in an Oral Form 97.1% of surveyed physicians believe that their patients with resistant E. coli could benefit from a new antibiotic (1) Omadacycline: UTI Profile Activity against most prevalent UTI pathogen E.coli (2) >40% Renal clearance Once-daily oral dose; plus an IV formulation Safety and tolerability profile: anticipated to match community-based needs Clinical development plans being finalized (1) Medacorp survey 1Q 2013 (2) CMI 2007 report to Paratek 11/18/2015 16

Omadacycline Amox-Clav (Augmentin) Ceftriaxone (Rocephin) Linezolid (Zyvox) Levofloxacin (Levaquin) Omadacycline Potent Against Key Resistant UTI Pathogens (1) In-Vitro MIC90 (µg/ml) Organism (# Isolates) E. coli ESBL+ (102) 4 16 128 Not Active >16 E. faecium, VS (56) 0.12 >8 >64 4 >8 E. faecium, VRE* (100) 0.12 >8 >64 2 >8 E. faecalis, VS (107) 0.5 1 >64 2 >8 E. faecalis, VNS* (47) 0.25 1 >64 2 >8 (1) CMI 2007 report to Paratek,; *VNS=Vancomycin MIC 16 µg/ml; VRE=Vancomycin MIC 32 µg/ml 11/18/2015 17

Omadacycline Levofloxacin (Levaquin) Azithromycin (Zithromax) Amox-Clav (Augmentin) Omadacycline Potent Against Key Resistant Sinusitis Pathogens (1) In-Vitro MIC90 (µg/ml) Organism (# Isolates) S. pneumonia (104) 0.12 1 >4 8 PRSP (51) 0.12 1 >4 8 H. influenzae (105) 1 0.03 4 1 M. catarrhalis (105) 0.25 0.06 0.06 0.25 11/18/2015 18 (1) CMI 2007 report to Paratek

Omadacycline Favorable Safety and Tolerability Profile ~700 individuals treated to-date No known metabolites No CYP interactions identified No DDI effects anticipated No anticipated monitoring No herg channel effects: TQTc (1) study completed No effects on heart rate (HR) in patients Modest transient vagolytic HR effect in healthy volunteers (1) Thorough QTc study 11/18/2015 19

Omadacycline Commercial-Scale Formulations and Process Established Both Oral tablet and IV manufactured at commercial-scale Stability >3 years at room temp for both oral and IV Oral tablets are bioequivalent to the IV Cost effective 3 step manufacturing process 11/18/2015 20

Omadacycline Power of Oral and IV Dosing for the Big 3 Indications (1) Antibiotic Class Oral Frequency Big 3 Indications (2) 2010 Sales (3,4) Levofloxacin Quinolone Once Daily 3 $3.4B Co-Amoxy clav B-Lactam Twice Daily 3 $2.8B Azithromycin Macrolide Once Daily 2 (2) $1.8B Ciprofloxacin Quinolone Twice Daily 3 $1.4B Clarithromycin Macrolide Twice Daily 2 (2) $1.4B Oral Use ~Two-thirds of Total Sales (1) Skin, Respiratory, UTI (2) Both Azithromycin and Clarithromycin did not have UTI claim (3) IMS global sales data in 2010 (4) Major patents had expired for all products by 2010 except Levofloxacin 11/18/2015 21

Significant at risk patient population in U.S. hospitals and community (1) ABSSSI, CABP, UTI ~38M by 2028 Total Patients (2) Non-elevated risk 66% Elevated risk(3) 34% ~13M Elevated- Risk Patients (1) No suspected drug resistant pathogens (DRP) 8M or 62% Suspected or confirmed DRP 5M or 38% ~5M patients with suspected or confirmed DRP (1) Community 3.5M Hospital 1.5M (1) Paratek Research and Analysis, September 2015 (2) Projected Total Patient Popultaion in the U.S. with Omadacycline potential indications of ABSSSI, CABP and UTI both hospital and community in 2028 (3) Elevated risk defined as Elderly, Immuno-compromised, Co-morbidity e.g, diabetes, history of treatment failure, recent hospitalization, resident of a nursing home, suspected or confirmed drug-resistant pathogen 11/18/2015 22

Omadacycline Value Proposition Aligns Well with Current and Future Patient Needs (1) Unmet Need Lack of Bio- equivalent IV-to-oral step-down therapies Hospital Formulary Acceptance: In the hospital setting for ABSSSI and CABP, the IV and oral formulations of omadacycline allow for IV-oral stepdown therapy in hospital, greatly facilitating patient discharge (1.5M patients with known or suspected drug resistant pathogens DRP) Need for oral therapies covering drug-resistant pathogens (DRP) Hospital & Community Adoption Opportunity: The broad spectrum of activity with coverage against drug resistant pathogens (MRSA, Penicillin and macrolideresistant S. pneumonia & MDR E. coli), and an oral formulation, make Omadacycline especially suited for elevated risk patients with confirmed or suspected DRP (1.5M Hospital + 3.5M Community Patients) Improved safety, tolerability & Once-daily dosing Expansion Opportunity: A lack of drug-drug interactions, overall tolerability profile and once-daily oral dosing makes Omadacycline suitable for all elevated risk patients with or without DRP (8M patients) (1 Paratek Research and Analysis September 2015 11/18/2015 23

Omadacycline Potential Broad Range of Major Indications Scarcity of Late-Stage IV/Oral Antibiotics in Development Late-Stage IV & Oral Omadacycline Hospital Community cuti ABSSSI CABP CABP ABSSSI UTI Other Sinusitis Delafloxacin Finafloxacin Lefamulin Solithromycin Neisseria 11/18/2015 24

Omadacycline Strong IP Through 2028 U.S. Base Composition of Matter plus anticipated patent term extension into 2028 And U.S. Hatch Waxman plus GAIN Act extension totaling 10 yrs. EU: 10 yrs. of market exclusivity expected 11/18/2015 25

Sarecycline: Narrow-spectrum Tetracycline Antibiotic Specifically Designed for Inflammatory Acne Novel, narrow-spectrum antibiotic Demonstrated anti-inflammatory activity Does not cross Blood-Brain Barrier Favorable GI tolerability Once-daily Oral formulation Composition of Matter IP protection U.S. Base Composition of Matter: 2031 EU: 10 years of market exclusivity expected 11/18/2015 26

Sarecycline Late-Stage Development Progressing as Planned U.S. commercial rights: Allergan Ex-U.S. commercial rights: Paratek Phase 2 Trials met primary endpoints for efficacy and safety (1) Phase 3 Trials in U.S. underway; Data expected in 2016 Milestones and royalties to Paratek Allergan estimates $250-500M peak U.S. revenue (1) Solodyn analogue supports sales potential Peak sales >$750M (reformulated minocycline) (2) (1) Allergan plc, Investor Day 2015, p. 142 (February 18, 2015) (2) IMS Sales data 2011 11/18/2015 27

Phase 3 & NDA Filing Milestones for Omadacycline and Sarecycline Omadacycline Events Estimated Timing ABSSSI Phase 3 Study Initiated enrollment 2015 CABP Phase 3 Study Initiation Late 2015 ABSSSI Phase 3 Data 2H 2016 CABP Phase 3 Data 2H 2017 Omadacycline Filing 2018 Sarecycline Events (1) Estimated Timing Sarecycline Phase 3 Efficacy Data (2 trials) 2016 Sarecycline Phase 3 long term safety study Data 2016 Sarecycline Filing 2017 (1) Allergan owns U.S. development & commercial rights 11/18/2015 28

Key Financial Information Total Cash (1) (2) $146.4 Total Debt, Net of Issuance Costs Key Metrics (1) (2) $19.5 million million Basic Shares Outstanding (1) 17,608,615 Stock Options, Restricted Stock, and Warrants Outstanding (1) 2,412,813 Cash balance expected to fund operations through 2H 2017 Potential BD opportunities Sarecycline: Ex-U.S. development and commercialization rights Monetize potential U.S. royalties Omadacycline: Ex-U.S. partnerships (e.g., Asia) (1) As of September 30, 2015 (2) Note: On September 30, 2015, Company drew $20 million of $40 million debt line 11/18/2015 29

Paratek Investment Highlights Developing novel tetracyclines to address unmet medical needs Omadacycline: Oral/IV antibiotic addressing bacterial resistance Enrolling two pivotal trials ABSSSI and CABP Developing for UTI Potential additional indications - Sinusitis Worldwide commercial rights retained Sarecycline: Antimicrobial and anti-inflammatory tetracycline for treating acne Partnered with Allergan in U.S. Ex-U.S. commercial rights retained Proven management team Strong IP position 11/18/2015 30

11/18/2015 31 Back Up Slides

Omadacycline: Data supports Potential CABP Indication Tygacil Omadacycline Animal Pneumonia Model Efficacy Yes Yes AUC:MIC PK Target 12.8 (human) (1) 4.3-8.9 (mouse) AUC (human; µg-hr/ml) (2) ~ 4.7 ~ 10 MIC 90 (µg/ml; S. pneumoniae) 0.06 (3) 0.12 AUC:MIC (human) Achieved ~ 80 ~ 80 Efficacy for CABP Approved Phase 3 11/18/2015 32 (1) Rubino et al. 2012. Pharmacokinetics-Pharmacodynamics of Tigecycline in Patients with Community-Acquired Pneumonia. AAC56:130-136.; (2) Tygacil AUC: Tygacil Product Label; Omadacycline AUC: Sun, H. et al. 2012. A single dose study to evaluate the pharmacokinetics, safety and tolerability of multiple formulations of PTK 0796 in healthy subjects. ECCMID 2012, Poster P1423. (3) Tomic and Dowzicky. 2014. Regional and Global Susceptibility among isolates of Streptococcus pneumoniae and Haemophilus influenzae collected as part of the Tigecycline Evaluation and Surveillance Trial (Table S1). Ann Clin Micro Antimicrob. 13:52.;