Forum Topics PAR PAR Initial Thesis (6/5/26)

Pinned straw:

Added 2 months ago

Paradigm's Phase 3 global study of repurposed injectable Pentosan Polysulfate Sodium (iPPS) for knee osteoarthritis is approaching a pivotal interim dataset (Day 112), with results expected in August. At 18c, the stock is trading below the 19c raise recently conducted to fund the company through that milestone. Strong interim results could trigger a material re-rating and/or catalyse a partnership to progress the NDA and commercialisation.

I have taken a small initial position with the intention of adding at attractive prices following the interim data release if the opportunity arises. The current sizing also reflects the possibility that an entry point does not materialise post-release, in which case I retain some exposure to any upside.

The modest initial weighting reflects the binary nature of this investment. While there are several adjacent indications available should the knee OA program fall short, pursuing them would require substantial additional capital, likely raised at materially lower prices, which would catastrophically dilute existing shareholders.

My read of the efficacy data to date is cautiously positive, though I acknowledge the results are difficult to interpret without specialist expertise. The outcome is not uniform across patients, and the Phase 3 study will be the true test of statistical significance. The use of a subjective scale assessment is entirely appropriate for this indication, but does introduce an element of ambiguity in evaluating the results.

The repurposed nature of the drug is a meaningful positive from a safety standpoint, even given the change in administration route (subcutaneous injection). However, it introduces commercial risk around the durability of patent protection and the timeline before generic competition emerges. In theory, "Method of Use" patent protection extends to 2040 for the treatment of OA with bone marrow edema, but the underlying molecule PPS is off-patent. The company also holds a 25-year exclusive supply agreement with bene pharmaChem (the only FDA-approved PPS manufacturer), though the enforceability of this arrangement and the feasibility of a competitor obtaining FDA manufacturing approval remain open questions.

If approved and successfully commercialised, this treatment has genuine blockbuster potential. It is well-positioned as a non-steroidal, non-opioid, non-addictive therapy for chronic pain in a large and underserved market of approximately 30 million patients in the US alone, with an annual revenue opportunity in excess of US$2,000 per patient. The company is also actively broadening its PPS pipeline, including the 2025 acquisition of Proteobioactives and its oral PPS and COX-2 inhibitor combination therapy, which provides longer-term optionality.

Despite being a mid-Phase 3 asset with substantial commercial potential, a sub-A$100m valuation is not surprising given the risk factors outlined above. Were this company listed in the US with stronger patent protection, it would likely command 5–10x the current valuation at this stage and potentially another order of magnitude beyond that if it successfully navigates the NDA process.

Thank you to the many in the SM community over a long period who have followed and written on PAR to bring it to my attention and provide great insights.  Credit to @GazD 's endurance on this one and thanks to @mikebrisy for a clear perspective on possible value.

High risk, high reward. Small position sizing warranted.

Disc: I own RL

mikebrisy
Added 2 months ago

@Tom73 nice initial thesis.

There are two other aspects of $PAR and iPPS that stand out for me: i) the multiple phase 2 trials conducted to date and ii) the range of potential outcomes.

1) Phase 2 Studies

There were multiple Phase 2 studies (5) conducted, including 4 that were placebo controlled. Now, of course, they had low numbers being Phase 2, but in aggregate across the series, there was a consistent positive effect - albeit variable, due to differences in the design of each trial and highly uncertain due to the wide confidence intervals, likely due to small sample size as well as inter-trial variablity.

In dosing, screening criteria, and endpoint specification $PAR have taken somewhat more care than is usually the case. Albeit, I recognise that has been at the expense of considerable pain for long term shareholders. (Hence my preference to hop on during Phase 3 and preferrably, late Phase 3 as a general rule).

Of course, the placebo-effect in pain treatments can be significant, so we won't know how it scales into Phase 3. But it does seem pretty clear to me that there is a positive signal there, at a meaningful level - although this is a gut feel only - I can't put a p-value on it, if pressed. So perhaps - therefore - "pretty clear" is overstating things!

2) Potential Outcomes

The interim milestone is, of course, not the end of the game. However, I think that August is pivotal for the company.

In the Bear Case, the results are muddy, and there is no basis to continue the trial. All the options are well and truly out of the money, and we'll see a raise again before long. I don't know what the investment case is in that scenario, and I will probably exit to recover anyhting I can, given that anything is better than nothing! We could easily see the SP collapse to a few cents pretty quickly.

In the Bull Case, with the Interim Endpoint met, meaning drug has shown a large enough and statistically strong enough treatment effect at the halfway point to support an early efficacy conclusion. It would materially de-risk the programme, validate the Phase 2 signal, and likely shift investor focus to regulatory pathway, full safety package, NDA preparation and commercial value. On re-risked fundamentals, the shares become worth a lot more than they are today, and - of course - that might well attract the usual hype flows in addition.

There is of course quite a bit of ground in between, where the Interim 112 Day Endpoint is questionable, between the thresholds of "futility" (i.e., abandonment) and "significant efficacy". I haven't figured out what that does to the SP, although I guess that depends where on the "futility" to "significant efficacy" continuum the result actually lies and the SP on the day. I plan to do some further work on this over the next couple of months, because there is a real possibility of the market mispricing a result that is in the "grey zone". My hunch on this is that on a risked basis the shares are currently undervalued, and so if the IA Endpoint indicates that the trial remains live, then arguably, the SP should re-rate upwards, closer to fair value on a risked basis.

So that can offers an important decision point. For example, the market response to an indeterminate Day 112 result could be quite negative, which could push the shares significantly below fair value on a Risked Basis, in which case there is a decision to make on whether to stay, go, lighten or load up.

Finally, in all outcomes, there will also potentially be further information on safety - a potential further complication.

My Conclusions

The deeper I have gotten into this one, the more I've realised that it is far from binary, at least in the short term. Yes, there is a possibility that the "futility" threshold fails to be passed, in which case the thesis is broken and iPPS is likely abandoned. But on the strength of all the Phase 2 results, I guesstimate the likelihood of that is only 20-30%,

To simplify, I see the potential outcome probabilities as follows (more based on "gut feel" that rigorous analysis!!)

  • "Trial is futile": 20% - 30%. Trial abandoned. SP crashes.
  • "Keep Going": 50% - 70%. IA Result not strong enough to warrant early trial completion, but also not weak enough to abandon, so the trial continues to final analysis
  • "Stops Early For Efficacy": 10% - 20%,


I imagine "Keep Going" will generate a potentially strong SP response, because the positive potential of this outcome will be communicated strongly. The nature of the market response to this scenario governs whether an investor can - should they wish to - increase their position size in a way that makes sense as valuable decision on a risked-basis. In thinking this through, the penny dropped that this is possibly why they have structured the capital raising, and Option Pricing in the way they have. It makes sense to me when viewed in this way.

Which leads me to my position size. I have to have enough so that the "Stops Early For Efficacy" yields a meaningful prize, because from where we are today $PAR would easly 5x to 10x in short order, while equally being able to live with my position essentially going to zero in the "Trial is Futile" scenario.

My work on valuation has to help me decide at what SP I should not buy more, in the case we get a "Keep Going" result. "Trial is Futile" speaks for itself, in terms of investment implications!

Anyway, I'm just thinking out loud here, but that's how I'm currently thinking about this one. For sure, shareholders of $PAR live in interesting times, indeed.

Disc: Held (0.6% RL for now - weighing up some more)

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Tom73
Added 2 months ago

I think you have yet again hit the key issues @mikebrisy, how de-risking were the P2 studies and how to structure an investment for the P3 interim dataset release base on possible outcomes.

P2 Studies

The results of the P2 studies seemed ok to me (as a non-expert), showing improvements on placebo, but it was hard to tell how meaningful these improvements were. The variances had some validity statistically (cavate on the small sample size), but we are talking about pain which is subjectively measured (PGIC). There were clear clinical outcomes in terms of biomarkers (COMP and CTX-II change), so it’s doing something Vs placebo for sure, but is it doing enough consistently enough to be both approved and have commercial success.

This is where I am unsure and the P3 should settle most of this, the odds of success of which I would put at the statistical average rates of success as you have done on your valuation at around 50% for a P3 asset to get through NDA. 

Below covers the P2 results I am talking to:

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P3 interim dataset outcomes

Your discussion on outcomes is very much where my thinking is at, so I will just say “dito” on it. I will add that my decision to buy now is with the “Stops Early For Efficacy” outcome in mind as I totally see the structure of the Option pricing for the last round aiming to lock in next capital raises to get through to NDA. I like the structure and thinks it shows thoughtful planning and rewards all shareholders willing to stump up cash pre P3 with additional opportunities post P3.

Assuming a good initial dataset result I think a partnership deal will likely land, the value and structure of which will probably look something like what Neuren had with Arcadia. Paradigm have a larger market opportunity than Neuren did in that deal but Neuren has much stronger commercial protections (aka patents), so balancing factors.

I expect the deal would just be for iPPS use to treat knee OA, allowing independent development for other indications by Paradigm (like Neuren has done with NNZ-2591). US$50-100m upfront and up to US$1b in regulatory and commercial milestones payments plus 10-15% royalties. Which would probably push PAR’s market cap to A$1-2b rapidly (all options will be well in the money and provide additional capital to advance the rest of the portfolio).

Like you my position is light ~1% which isn’t going to hurt much if the worst happens (~50% chance fails to get an NDA) but will still provide a notable impact to my portfolio if the investment gods bless it with a 10x or better outcome.

Disc: I own RL

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mikebrisy
Added 2 months ago

@Tom73 sounds like we are like-minded on this.

I’ve decided to get a little more via the SPP to take me up to 1% in total, partly because I like that options turbocharge the upside in the Bull Case.

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