Gilead Sciences (GILD): Promising Oral A4B7 Data In UC

Gilead presented Phase 2 ulcerative colitis data for emvistegrast (oral alpha-4-beta-7) that appear very promising and help de-risk a potential multi-billion-dollar opportunity. At the highest dose, the product showed a placebo-adjusted clinical response of ~30% and placebo-adjusted endoscopic improvement of ~28% at week 12, versus our previewed bar of ~20-25% on clinical response and ~15-20% on endoscopic improvement based on Entyvio. Absolute clinical response was 66% and clinical remission 31%, broadly comparable to Entyvio's Phase 3 VARSITY results, and tolerability looked benign. An inconsistent dose response, with low efficacy in the 75mg middle-dose arm, may be a point of debate. We view emvistegrast as an attractive pipeline asset as monotherapy, with a potentially broader opportunity in combination with other oral mechanisms such as IL-23 in the $35bn+ IBD market. Gilead expects to start a Phase 3 monotherapy UC trial in 2027 and explore internal and external combinations. Mai