Day. Thank you for standing by. Welcome to the Almirall First Quarter 2026 Results Conference Call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star one and one on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star one and one again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Pablo Divasson, Head of Investor Relations. Please go ahead.
Thank you very much, Magdalena. Good morning, everyone. Thank you for joining us for today's quarterly earnings update and review of Almirall first quarter financial results for 2026. As always, we are sharing the slides we are using today in the investor sections of almirall.com. Please move to slide number two. Let me remind you that the information presented in this call contains forward-looking statements which involve known and unknown risk, uncertainties, and other factors that may cause actual results to materially differ from what we are sharing today. Please move to slide three. Presenting today, we have Carlos Gallardo, Chairman and Chief Executive Officer, Jon Garay, Chief Financial Officer, and Karl Ziegelbauer, Chief Scientific Officer. Carlos will start with the business highlights of the first quarter, followed by an update on Biologics as the key growth drivers of our medical dermatology portfolio.
Karl will provide you with an update on the pipeline and R&D programs. Jon will then walk you through the financials before Carlos Gallardo concludes the presentation, and we open for questions. I will hand over to Carlos Gallardo, our Chairman and CEO. Please move to slide number five.
Thank you, Pablo, and good morning to everyone in the call. Almirall delivered steady performance in line with our expectations and market consensus in the first quarter of 2026. The results reflect the high comparative base in the first quarter of 2025, which was boosted by divestments alongside a minor revenue-facing effects across quarters. This was anticipated and flagged at the 2025 full-year results presentation. Excluding the different effects, growth remains in line with the guidance and with the recent trends, being last 12 months net sales growth of 9% as of Q1 2026, consistent with our 2020 sales guidance, which is why we remain comfortable reiterating our guidance with growth expected to be driven by our biologics as well as the strength in our core medical dermatology business.
Growth this quarter is underpinned by effective commercial and operational execution, led by solid biologics performance in medical dermatology across Europe. We also continue to advance innovation, broaden patient access, and support the physician community. Turning to products, Ilumetri delivered a steady double-digit growth, reaching EUR 62 million in sales and remains on track to peak sales of over EUR 300 million. With EUR 42 million in net sales, Ebglyss momentum picked up in the last quarter following completion of the rollout across key regions, with launches in key European markets continuing to scale. With 2026 now providing a clear reflection of the approach potential, this strong performance reinforces our confidence in its positioning and long-term growth prospects. Among other products, Wynzora continues to lead market share across key regions, while Klisyri delivered a stable sales growth overall.
We remain highly active within the medical dermatology community, continuing to strengthen our presence in the field. At the 2026 American Academy of Dermatology annual meeting, we presented more than 15 posters featuring new data across atopic dermatitis, actinic keratosis, and acne. Earlier in the year, Almirall hosted the 17th edition of Skin Academy, bringing together leading global experts in medical dermatology, focusing on the latest advances in atopic dermatitis and the importance of individualized treatment in psoriasis. We are encouraged by our pipeline developments, with three proof of concept studies currently in phase II and a further three more POC studies on track to begin phase II over the coming quarters. Most of these assets are either first or best in class.
Our bispecific antibody targeting atopic dermatitis has progressed into phase I, and we recently entered a new collaboration with Otsuka to advance the development of a monoclonal antibody with potential applications across multiple indications within medical dermatology. Karl will revisit our pipeline in greater detail. Please move on to the next slide for an update on our biologics portfolio. In the first quarter, Ilumetri net sales reached EUR 62 million, marking a steady 12% year-on-year increase. The two-year positive study results were presented at both the 2026 American Academy of Dermatology annual meeting and 2025 European Academy of Dermatology and Venereology Congress. The data continue to highlight Ilumetri's long-term value, demonstrating meaningful real-world benefits in patients' well-being and reinforcing the approach clinical and commercial relevance.
Ilumetri continues to demonstrate a solid position in the psoriasis market, maintaining market share in the leading anti-IL-23 class. Performance remains consistent. We therefore continue to be firmly on track to deliver over EUR 300 million in peak net sales, even as both the product and the class enter a more mature phase of the growth cycle. Please move to the next slide on Ebglyss highlights. Since its approval in Germany in December 2023, Ebglyss has rapidly scaled to become our second-largest product, underscoring one of the most successful atopic dermatitis launches in recent years. This outcome reflects a strong patient and physician adoption, supported by solid commercial and operational execution. At the same time, the advanced therapy segment in atopic dermatitis across the EU5 continues to expand at around 30% annually.
First quarter sales more than doubled to EUR 42 million from EUR 19 million a year earlier, driven by the successful European rollout and continued scaling across key markets. Ebglyss has already achieved double-digit market shares in several strategic regions, alongside encouraging early traction in new country launches. This underpins our confidence in Ebglyss as a major growth driver in the years ahead. We aim to become a first-line treatment and capture increasing market share. We are confident in the product's potential, targeting the IL-13 as it is the predominant interleukin in AD patients, and there is a broad number of clinical studies validating the product's good efficacy, which is a main factor in picking the most adequate treatment. Our clinical collaboration with Lilly continues to support Ebglyss positioning through a growing body of evidence.
At the 2026 American Academy of Dermatology annual meeting, Almirall presented extensive lebrikizumab data, including ADlong results showing durable disease control for up to 4 years. Prior to that, Lilly published their ADorable-1 pediatric study data, demonstrating significant skin clearance and improved disease severity in improved disease severity children with moderate to severe atopic dermatitis. Please turn over to the next section for Karl to explain our pipeline developments in more detail.
Thank you, Carlos, and good morning to everyone in the call from my side. This slide shows you the status of our early and mid-stage pipeline. Today, we have three proof-of-concept phase II studies ongoing, with three additional studies planned to start within this year. In 2025, we progressed our anti-IL-1RAP antibody into phase II for hidradenitis suppurativa in our IL-2 mutein Fc for alopecia areata. In addition, our partner, Syngene, initiated a phase II study on the IL-2 mutein Fc in atopic dermatitis. As a reminder, we retain global rights for this asset outside Greater China. Looking ahead, we plan to initiate one additional proof-of-concept study each for the IL-2 mutein Fc and the anti-IL-1RAP antibody in an inflammatory skin disease. For the anti-IL-21 antibody, we will start a proof-of-concept study in hidradenitis suppurativa in the coming weeks.
The phase I study of our bispecific antibody targeting IL-13 and OX40 ligand has just started. From those six proof-of-concept phase II studies, we anticipate data readouts over the next couple of years, starting end of 2026, beginning of 2027. While these programs remain at an early stage, they address well-defined biological pathways and represent a range of first or best-in-class opportunities. Next slide, please. In March this year, we inaugurated our business development office in Shanghai, China, to advance innovation in medical dermatology through partnerships. This team is dedicated to life science innovation with a focus on programs and technologies that are complementary to our in-house R&D activities. A good example of what we intend to do is our collaboration with Huaota. We announced recently for the development of a novel monoclonal antibody in medical dermatology.
For this collaboration, we proposed a target for an attractive skin disease, and Huaota will conduct early research and initial development to deliver clinical proof of concept. While Almirall holds global rights outside China and leads further global development and commercialization. Next slide, please. This slide gives an overview of our lifecycle management activity for products that are on the market, and I would like to highlight a few new developments. For tirbanibulin applied to a larger treatment area of 100 square centimeters, the regulatory process is ongoing, and we expect launch in Europe late 2026. Together with our partners, Sun Pharma and Eli Lilly, we continue advancing label extension opportunities and generate additional clinical data for Ilumetri and Ebglyss, respectively. Let me share some recent data on the next slide.
At the AAD 2026 in March this year, we presented clinical data that showed that lebrikizumab delivers long-term disease controls for up to four years in patients with moderate to severe atopic dermatitis. In the ADlong phase III study, 94% of patients maintained EASI-75, 75% maintained EASI-90, and 68% kept clear or almost clear skin, defined as an Investigator's Global Assessment score of 0 or 1, with up to four years of lebrikizumab treatment, reinforcing the sustained response achieved over time in patients with moderate to severe atopic dermatitis. Importantly, itch relief was also sustained over the long term, with 78% of patients achieving a four-point or greater improvement on the Pruritus Numeric Rating Scale, which measures itch intensity on a scale from 0 to 10.
Overall, these results further reinforce the long-term disease control potential of lebrikizumab in a chronic condition requiring sustained and consistent treatment. Next slide, please. The ADorable-1 phase III study met co-primary efficacy endpoints with 63% of pediatric patients achieving meaningful skin improvement, EASI-75. 44% of patients reached clear or almost clear skin, IGA 0 or 1, at week 16. ADorable-1 is a multicenter, randomized, double-blind, placebo-controlled phase III trial in 363 children and adolescents with moderate to severe atopic dermatitis that evaluates lebrikizumab versus placebo on top of standardized low to medium potency topical corticosteroids. Sorry. Given the substantial physical and emotional burden of atopic dermatitis, particularly when disease onset occurs early in childhood, these findings further strengthen the role of lebrikizumab across the full patient journey. Detailed data will be presented at an upcoming scientific meeting.
We plan to use these data together with the forthcoming results of the ADorable-2, which is the open label 52-week extension trial of ADorable-1, to file for an extension of the label of lebrikizumab to the pediatric population aged six months to 18 years. Finally, we initiated our phase III study to explore lebrikizumab in patients with nummular eczema. The readout is expected in 2029. With that, I will hand over to Jon for the financial review.
Thank you, Karl, for the exciting pipeline update, and good morning, everyone. Net sales increased by 2.2% year-over-year in the first quarter of 2026, reaching EUR 291 million, which is in line with our expectations and consensus. Last 12 months net sales growth of 9% as of Q1 2026 is equally consistent with our 2026 guidance. As Carlos mentioned earlier and anticipated in our full year 2025 earnings call, the first quarter of 2026 needs to be viewed against the divestment of Algidol and out-licensing of Sekisan in Q1 2025. In addition, we also had some minor phasing of sales amongst our tail products in Derma and non-Derma between quarters.
Excluding these effects, growth is in line with our expectations and provided guidance, allowing us to remain on track for the full year 2026 guidance. Performance remains solid, and European dermatology portfolio continued to deliver solid growth, further reinforcing Almirall's path towards leadership in medical dermatology. Gross margin landed at 64.2%, slightly above the performance that you may have seen in the prior quarters. There is still a minor recurrent pressure that you should take into account, primarily due to the higher royalty tiers associated with Ilumetri's net sales growth. EBITDA came in at EUR 67.5 million, reaching 23.2% of our net sales versus 21% ratio reported at year-end 2025. SG&A declined by 1% versus prior year and is expected to pick up in the coming quarters, driven by phasing of our marketing and promotional activities.
R&D investment reached 12% of net sales, driven by phasing of our R&D activities as our POC trials progress gradually. In this sense, 12.5% remains a good proxy for the full year. We closed March 2026 with a net debt-to-EBITDA ratio of 0.1 after successfully completing the issuance of a new high-yield bond at 3.75% interest rate back in December 2025. Overall, the results lead us to reiterate our 2026 guidance. Let's move to the details of our sales breakdown on the next slide. European dermatology portfolio continued to perform strongly, delivering 19.3% year-on-year net sales growth in the first quarter. We will go into more detail on this performance on the next slide.
The comparison impact was concentrated in Europe, where general medicine and OTC sales reflected a stronger prior year base. Due to the Aligidol divestment and out-licensing of Sekisan, alongside the mentioned facing effect from the smaller portfolio areas. Lower sales in legacy products such as CRESTOR, Sativex, and Eklira were largely offset by contributions from Ebastel and Airtal. In the U.S., performance declined year-on-year, which we will discuss on the following slide. In the rest of the world, overall sales were slightly higher with solid dermatology growth more than compensating for a modest decline in general medicine. Let me take you through dermatology performance in more detail on the next slide. Our European dermatology business continued to perform well in the first quarter. Ilumetri delivered sustained year-on-year growth, while Ebglyss further increased its contribution, now with launches across all key European countries being completed.
Ebglyss generated EUR 42 million in the first quarter, reflecting continued scaling and reinforcing our confidence in its long-term growth potential. We continue to work hard to unlock the full value of the franchise from both the commercial and the R&D side. Wynzora continued to build market share, gaining traction across core European countries. Klisyri demonstrated a stable growth in Europe year-on-year in spite of some facing in sales against prior quarter. Ciclopoli sales were slightly soft following a strong Q4 2025. In the U.S., overall performance declined, reflecting continued pressure on the legacy portfolio. Products such as CORDAN, TAZORAC, and Aczone remain impacted by ongoing genetic competition. Seysara saw lower sales amid intensifying competition and exchange rate evolution. In the case of Klisyri, the exchange rate evolution impacted growth negatively by 10 points in the quarter.
Our market strategy to broaden coverage and increase volume has put some year-on-year price pressure, expecting sequential quarterly improvement during the year. In the rest of the world, dermatology sales increased year-on-year, driven primarily by thin Juve demand in China. Overall, our dermatology franchise continues to show solid underlying performance. Let's briefly review the remaining elements of the P&L. Gross margin reached 64.2% in the first quarter. Last year, gross margin benefited from the already mentioned divestment and out-licensing. Aside from this impact, we see continued slight margin pressure, primarily from higher royalty fees associated with Ilumetri's continued growth. SG&A expenses accounted for 41.8% of net sales, compared to 43.1% for the same period last year, which is in line with our expectations and facing throughout the year.
As highlighted earlier, SG&A is expected to increase in the coming quarters, driven by phasing of our marketing and promotional activities. We continue to anticipate SG&A full year growth to be slower than sales growth, becoming an important contributor to our EBITDA margin expansion guidance. R&D investment represented short percent of net sales. A full year ratio of around 12.5% remains a good proxy with the normal quarterly variability expected. Financial expenses increased versus last year, driven by the valuation impact of the equity swap in 2026 following the share price evolution. Our effective tax rate came in at 34.6%, which represents an improvement of 5.1 percentage points year-on-year.
We continue delivering on this positive trend, driven by the strong increase in the group's overall profitability, which materially reduces the relative impact of our U.S. business at the consolidated level. Please move to the next slide to take a look at the balance sheet. Our balance sheet remained stable as of March 2026 compared to December 2025. Intangible assets grew in the quarter, driven mainly by Ebglyss-related lifecycle management activities. The development milestone payment to Simcere as IL-2 fusion mutant protein progresses into phase II and a small upfront access fee linked to the new Huaota collaboration Karl has just mentioned. This increase was more than offset by higher amortization, resulting in a modest decline in goodwill and intangible assets during the quarter.
The payment this quarter of the 2025 Ilumetri milestone is driving the reflected decrease in current liabilities. Our net debt ratio stood at 0.1, continuing to provide us with a strong financial flexibility. The increase in net debt primarily reflects higher cash outflows related to investing activities. Let's now turn to the cash flow statement. Cash flow from operating activities reached EUR 47.9 million, an increase for EUR 21 million compared to the first quarter of 2025, driven by working capital improvement. Cash flow from investing activities amounted to EUR 72 million-, an increase of EUR 52 million versus the same period last year. This increase largely reflects the payment of the 2025 $55 million Ilumetri sales milestone, which has leaked into the first quarter of 2026.
I would like to highlight that this is the highest milestone payment expected during the year in the absence of new transactions. Projected investment-related payments in the remaining quarters are marginal, and the total estimated outflow related to investing activities for the whole year remains within the usual limits. Cash flow from financing activities was EUR 3 million-, representing an improvement compared with the EUR 9 million- in the first quarter of last year. The year-on-year difference mainly reflects the change in the new bond structure issued at the end of last year. With that, I would like to hand the word over to Carlos for his closing remarks. Thanks a lot, everyone, for your attention.
Thank you, Jon. To reiterate, the business remains solid despite the optically lower growth first quarter figure. We also remain very confident in the 2026 outlooks and our ability to deliver on our targets. We know where consensus sits today, and we can confirm we are comfortable with these figures. Turning to the key drivers of the business. First, our biologics portfolio is giving us real momentum. We are operating in a dermatology market that continues to expand, and we are doing so with a portfolio that is both diversified and as well aligned with where unmet needs remain highest. This is reflected in a pipeline that spans immune-mediated skin diseases, rare dermatology, and non-melanoma skin cancers. From a development standpoint, we currently have three programs in proof of concept of phase II, with a further three expected to enter in the next 9 to 12 months.
Taken together, this provides a solid base to support sustainable growth over the coming years without concentration on any single asset. In parallel, we remain disciplined but active on capital deployment. We continue to assess selective bolt-on opportunities in commercialized assets while screening early-stage licensing opportunities where we see differentiated science and a clear strategic fit. Most importantly, execution remains the anchor. We are translating strategy into delivery, staying on track to achieve our midterm ambitions for double-digit net sales growth through 2030 and a circa 25% EBITDA margin by 2028. Ebglyss continues to scale across Europe, while Ilumetri is being managed pragmatically as it moves through a more mature phase of growth. Overall, this combination of pipeline depth, financial discipline and execution give us confidence as we continue to advance Almirall towards leadership in medical dermatology.
With that, we'll conclude the presentation and turn to Pablo for the Q&A.
Thank you very much, Carlos. Magdalena, back to you for the Q&A, please.
Thank you. To ask a question, you will need to press star one and one on your telephone and wait for your name to be announced. To withdraw your question, please press star one and one again. One moment for our first question. Our first question comes from the line of Shan Hama from Jefferies. Please go ahead.
Hello. Thank you for taking my questions. Just two from me, please. As we acknowledged, there's quite a notable acceleration in Ebglyss in one key versus the prior quarter. Is this the sort of level of growth we should be anticipating throughout 2026? That's my first question. My second is, which countries have really driven this acceleration, and where do you see a more pronounced prescribing behavior for Ebglyss? Thanks so much.
Thank you, Shan, for the question. Yes, Ebglyss showing a very strong momentum. When you look at the recently published ADlong studies, you realize it's not a surprise the product achieves near complete skin clearance and its relief in up to four years. That translates into what? That physicians and dermatologists are achieving treatment goals in most of the patients, and that's what's driving the success of Ebglyss. You know, the vast majority of dermatologists go to an IL-13 inhibitor to treat moderate to severe atopic dermatitis patients. Very pleased with the results as well, and we expect, so confident with the consensus, and we're very happy to confirm the guidance of exceeding more than EUR 450 million peak sales.
In terms of which countries are driving, of course, you know, we have launched in the vast majority of the countries where we wanted to launch. All countries are performing well. We have double-digit market share in most of them. Also, importantly, we have the recently launched countries, Italy and France, that now are contributing, so they are adding to the sales of Ebglyss. You know, the recent performance and the recent acceleration has been driven for the inclusion of these two new important markets to the countries where we have launched Ebglyss.
Thanks so much.
Thank you. Our next question comes from the line of Damien Choplain from Stifel. Please go ahead.
Yes, hello, congrats on the results. Thank you for taking my questions. First one on the IL-2 mutein Fc. What level of clinical efficacy and differentiation would you need to see in phase II to trigger a phase III program in that database? Would you plan to run and finance a global study or would you consider limiting it to Europe? This is my first question. Maybe a quick one on Ebglyss. Is the pediatric population included in your peak sales guidance? Thank you.
Thank you, Damien, for the questions. I will take the latter. Yes, the pediatric indication is included in our peak sales estimates. I will refer to Karl on our very exciting IL-2 program.
Yeah. Thanks a lot, Damien, for the question. As you know, the IL-2 mutein Fc targets regulatory T-cell, and with that, trying to restore immune homeostasis. We believe this mechanism has potential across different skin diseases, including alopecia areata as well as atopic dermatitis.
Now in terms of future strategy, we of course need to wait for the data and the readouts and how they look like. I see a lot of different options that we have given the mechanism. Also, in terms of more a global versus a European study, certainly our goal is to maximize the value of this asset. Once data are available, we will look at all different options.
Okay. Thank you very much.
Thank you. Our next question comes from the line of Jaime Escribano from Banco Santander. Please go ahead.
Hi. Good morning. My first question regarding Ebglyss positioning and performance, which is doing very good. We also see other peers doing very well, like NEMLUVIO, for example. My question would be, how do you see the competitive landscape? Is it that the overall market is expanding, and that's why all the peers seems to be doing good? This would be my first question. The second one regarding Ilumetri, which we saw a decline quarter on quarter, but it's true that in Q1 2025, we saw something similar. Maybe you can confirm how the product is doing, or what's the outlook in Q2. A final question, if I may, regarding SG&A. 2%- year on year in Q1, which looks quite content.
What should we expect in terms of SG&A? Should we extrapolate this or you expect the growth rate to be slightly higher? Because it is quite low. Thank you.
Thank you, Jaime, for the question. Let me take the first question about Ebglyss and competitive dynamics. And Jon, you will take the Ilumetri and the SG&A questions. Competitive dynamics in AD. I think it's important to remind what we've been saying in the last quarterly calls that this market remains severely under-penetrated. Only around 15%-20% of patients that are eligible for advanced therapeutics are prescribed an advanced therapeutic. We've always said that new classes will make more noise, of course, for promotion and will expand this penetration, and that's what's driving the growth of the market. On that regard, new entrants are beneficial towards this growth.
In terms of positioning, there is very strong consensus within the dermatology community that IL-30 is a key cytokine. Therefore, the go-to product is an IL-30 inhibitor. Why? Because they achieve the treatment goals, right? IL-31s, they are good at dealing with itch relief but not good at dealing with skin clearance. That's why We're seeing higher use in prurigo nodularis. In atopic dermatitis, they are used more as a second-line or third-line patients. As let me remind you that this is highly heterogeneous patient population. Not all the patients always respond to a first-line treatment. Ilumetri. Jon, can you take Ilumetri and SG&A, please?
Thanks a lot, Carlos . Thanks for the question, Jaime. If we start with Ilumetri. Yes, Ilumetri grew around 12% in the quarter, which is aligned with the full-year growth of 2025. It's true, as you mentioned, that in Q4 2025 isolated, Ilumetri grew a bit higher. So far, on a full-year basis, we think Ilumetri will be continuing solidly in the range of the double-digit. As we estimated and as we shared in February earnings call, at the moment we are quite comfortable with the lower part of the market consensus for Ilumetri, which is in the range of EUR 260 million. Ilumetri is competing in the IL-23 segment, which is the leading class for psoriasis, moderate to severe.
Basically, the product recently will launch the Ilumetri 200 presentation, milligram presentation that is performing well and is providing flexibility to the healthcare professional to individualize care. We think it's one of the strengths we are bringing to the market. Switching to the third question you raised, Jaime, which is SG&A. Yes, SG&A in the quarter declined 1% versus prior year, reaching around 21% of our net sales. It's mainly driven by the phasing of our marketing and promotional activities. It's true this year that in some of our jurisdictions, the main campaigns are going to take place in Q2, and this is the phasing you see. You may expect a certain pickup in the upcoming quarters.
On a full-year basis, as we disclosed in our full year 2025 earnings call in February, you can expect a lower growth of our SG&A than our net sales growth. This will become a key contributor to the margin expansion at the EBITDA level.
Thank you very much.
Thank you. Our next question comes from the line of Guilherme Sampaio from CaixaBank. Please go ahead.
Hello. Thank you for taking my question. The first one, if you could provide a bit more details regarding your changing strategy for Klisyri in the U.S. market. Second and third related to readouts from competition and your position in the market. The first, there was a specific readout on that three specific antibody from Pfizer in atopic dermatitis, tilrekimig this quarter. Just wanted to check how we're seeing this data. The second question on competition regarding your products in the Dupixent market. Considering the profile, how you are in the positioning, regarding competition. How are you seeing that? Thanks.
Thank you very much for the question, Guilherme. I will take the question on the U.S. Klisyri and Karl will take the questions on the readout of competitive products. In terms of Klisyri U.S., the U.S. represent 3% of our sales. In terms of And again, this quarter have been impacted by exchange rate, also something to take into consideration. In terms of the strategy for Klisyri, it has not changed. Of course, one of the things that we are trying to do is to broaden coverage to increase volume, right? This always comes at the expense of a little bit of a price reduction. What we're seeing here is first comes the price reduction and then comes the expanded coverage.
You should expect to see increased volumes in the next quarter if we are successful with this change or with this push in expanded coverage in the U.S. Karl, back to you.
Yes.
For the competition.
Thanks a lot for the question on the competition. I mean, first of all, what Pfizer calls a trispecific antibody covers IL-13 and IL-4, we all know that, you know, maybe the IL-13 component is the more important. We rather think of this of more a bispecific antibody. There are a number of bispecific antibody now in early development, this is due to the still high unmet medical need in AD and the heterogeneous nature of the disease, as Carlos mentioned. We have to see, you know, how these early data translate into later stage data. We remain very confident on our data that we see with Ebglyss.
Carlos mentioned, for example, the very strong maintenance of response for up to four year or the recent data that we have seen in the pediatric population. Finally, in our bispecific antibody where we combine the anti-IL-13 approach together with an anti-IL-4 ligand approach, two validated mode of actions in atopic dermatitis that are highly complementary. Your second question was about HS and the competitive environment. HS is a disease, again, of a very high unmet medical need, and the currently approved therapy, which are either anti-TNFs or anti-IL-17s, according to experts, only provide a limited benefit to patients, and we believe there is a lot of room for improvement.
Based on, again, discussions with experts, we have chosen approaches and targets that cover more than one pathomechanisms, as this is a very complex disease potentially driven by multiple and different pathomechanism. On the one side, the anti-IL-1RAP covers six different cytokines of the IL-1 superfamily, IL-1 alpha, beta, IL-33, and IL-36 alpha, beta, and gamma. Based on data that were achieved or shown with antibody target in ENSA, the anti-IL-1 beta or the IL-36 component, we remain confident in this mode of action. On the other side, the anti-IL-21, where we are about to start the POC study, is a mechanism that covers both B and T cell pathophysiology. Again, covering more than one pathomechanism.
With that, we remain very confident in the two assets and the mechanisms we have chosen.
Okay. Just to follow up. There's a similar, or at least also targeting, after an anti-IL-1RAP from Cantargia that was recently acquired by Otsuka. How is your positioning relative to this product?
Thank you. Yes, there is a number of assets targeting IL-1RAP, one from Sanofi and also one from Cantargia. Sanofi has started a Phase II, so we are not aware that Cantargia has already started. We will continue with our study. I believe with our Phase II-A to B seamless design, we will have a very good approach and will be able to be first with this mechanism in HS.
Thank you very much.
Thank you. We have one more question. This question comes from Natalia Webster from RBC. Please go ahead.
Hi there. Thanks for taking my questions. I have two, please. Firstly, on your pipeline, phase I to the anti-IL-13 OX40 bispecific. I appreciate it's early days, but are you able to talk more on the opportunity you see here, particularly following data from competitor OX40 programs and how you expect this program to sit relative to your current Ebglyss franchise? Secondly, just curious to hear a bit more on the scope of your collaboration with Huaota and the expected financial impact from this. Thank you.
Thank you, Natalia, for the questions. I think both of them are for you, Karl.
Yes. Thanks a lot for the question. Our bispecific antibody targeting IL-13 and the OX40 ligand combines two clinically validated mechanisms for the treatment of AD. For example, it is known that the innate immune system leads to IL-13 release that is not covered by the OX40 ligand pathway. On the other side, while TH2 cells that secrete IL-13 are the main driver of AD in a lot of patients, there is also other T-cell population involved that can be covered by the anti-OX40 ligand blockage. We believe this combination has a chance for a broader and deeper response in AD. As Carlos has mentioned that AD is still an underserved indication. Only 10%-15% of patients who are eligible to advanced therapy actually get them.
We believe there is a lot of room for novel therapy like this bispecific antibody.
Well, I think on Huaota, that is a collaboration where we, based on our activities here in Barcelona, came across a very interesting target and a novel approach for an important skin disease. We haven't disclosed details because of competitive reasons. We have identified Huaota as a partner with very significant experience in monoclonal antibody discovery and early development. Actually, the CEO of Huaota was one of the inventors of SKYRIZI, which, as you know, is a very big product in the dermatology market.
We haven't disclosed detailed financials, but as you can see in our press release, cumulative payments would sum up to $340 million, including upfront and milestone payment that are linked to the development and commercialization success, as well as tiered royalties.
Great. Thank you.
Thank you. We are going to take our next question. This question comes from the line of Jaime Escribano, Banco Santander. Please go ahead.
Hi. Yeah, just a follow-up question on the pipeline for Karl. Building on one of the products you just explained. UCB has acquired Candid Therapeutics, mainly a platform which is a bispecific antibody directed to B cells and CD3 on T cells. The first question is if you have a view on this approach. Second, does this is this similar or has something to do with the one you just explained that was targeting also B cells and T cells? Just a reflection for the management or for Carlos.
UCB is willing to pay EUR 2 billion, which is like two-thirds of the market cap of Almirall, while for a platform that is in phase I. While you have several products, what do you think is missing for the market to put a higher valuation on your pipeline, which look much more advanced to biotech like this one? Thank you.
Thank you, Jaime, for the question. Before I pass the word to Karl to discuss the program you have mentioned. Again, we are a specialty company focused on medical dermatology. We're probably the only company in the Western Hemisphere that has capabilities from early research to commercialization, and that's only thing that we do. Why? Because there's tremendous unmet need. When we look at it, we see plenty of places, plenty of opportunity in diseases that don't have adequate treatment. We have also the ability to come with plenty of novel scientific hypotheses and develop either programs internally or externally. So far, our strategy is working. You can see it in our pipeline.
We've been able to either secure through licensing or through generating internal hypotheses and doing our program from scratch, right? We do see other companies paying a lot of money for licensing opportunities, for acquisitions. I can only speculate about the reasons and the market prices. What I can confirm is that our strategy is working. We are being able to spot opportunities. We are being able to capture opportunities through licensing agreements or through generating of internal programs, and we are very comfortable with that strategy. Now back to you, Karl, with about the program that Jaime mentioned.
Yes. Thanks a lot, Jaime, for the question. You know, this program is a so-called T-cell engager that targets CD19, and so pathogenic T-cells. This kind of approach is targeting with CD19 is B-cell in either an oncology, so malignant B-cells or in an autoimmune setting. Pathogenic B cells, either through CAR T or T-cell engager have recently gained quite a lot of attention, and we are very closely following that space. Now, to explore such a space, and such an assay, this might be important and that might be a driver for UCB to go beyond dermatology. As you know, we are focusing on dermatology. That is one angle to that.
I think another angle to it is that a lot of indications are not only driven, but by pathogenic B cells, by pathogenic T cells as well. This is an approach that is potentially not universally applied across all of the dermatological diseases we remain interested in.
Thank you. Thank you very much.
Thank you. There are no further questions for today. I will now hand the call back to Pablo Divasson for closing remarks.
Thank you very much, Magdalena. If there are no further questions, ladies and gentlemen, this concludes our today's conference call. Thank you for your participation. You may now disconnect.