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RADIANT Phase 2 Topline Results Conference Call SEPTEMBER 24, 2026 Evaluating Remlifanserin for the treatment of Alzheimer’s Disease Psychosis
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Call Agenda 2 Welcome Opening Remarks RADIANT Phase 2 Topline Results Closing Remarks Q&A Catherine Owen Adams | Chief Executive Officer Elizabeth H.Z. Thompson | Executive Vice President, Head of Research and Development Catherine Owen Adams | Chief Executive Officer Al Kildani | Senior Vice President, Investor Relations and Corporate Communications
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Forward-Looking Statements 3 This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements other than statements of historical fact and can be identified by terms such as “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “projects,” “predicts,” “outlook,” “potential,” "milestone," "guidance" and similar expressions (including the negative thereof) intended to identify forward-looking statements. Forward-looking statements contained in this presentation, include, but are not limited to, statements about: (i) the continued development of remlifanserin in Alzheimer's disease psychosis (ADP) and Lewy body dementia psychosis, as well as our other product candidates; (ii) our plans to implement amendments to Phase 3 studies of remlifanserin in ADP and our expectations for favorable results in the Phase 3 program as a result of those amendments; (iii) the safety profile of remlifanserin; (iv) our business strategy, objectives and opportunities; (v) plans for, including timing, development and progress of commercialization or regulatory timelines for our products and our product candidates; (vi) benefits to be derived from and efficacy of our products and product candidates, including the potential advantages of our products; and (vii) estimates regarding the prevalence of the diseases targeted by our products and product candidates; (viii) our estimates regarding our future financial performance, cash position, profitability or capital requirements; and (ix) the interpretation of topline results from our Phase 2 RADIANT study, including post-hoc and enriched subgroup analyses. Forward-looking statements are subject to known and unknown risks, uncertainties, assumptions and other factors that may cause our actual results, performance or achievements to differ materially and adversely from those anticipated or implied by our forward-looking statements. Such risks, uncertainties and other factors include, but are not limited to: our dependency on the continued successful commercialization of our products and our ability to maintain or increase sales of our products; the costs of our commercialization plans and development programs, and the financial impact or revenues from any commercialization we undertake; our ability to obtain necessary regulatory approvals for our product candidates and, if and when approved, market acceptance of our products; our dependence on third- party collaborators, the fact that topline, post-hoc and subgroup analyses from clinical trials, including enriched population analyses, are based on preliminary or limited data and may not be predictive of results in ongoing or future studies, including our Phase 3 program; risks that future clinical trial results may not be consistent with interim, initial, preliminary or topline results or results from prior preclinical studies or clinical trials; clinical research organizations, manufacturers, suppliers and distributors; the impact of competitive products and therapies; our ability to generate or obtain the necessary capital to fund our operations; our ability to grow, equip and train our specialized sales forces; our ability to manage the growth and complexity of our organization; our ability to maintain, protect and enhance our intellectual property; our ability to meet our financial guidance; and our ability to continue to stay in compliance with applicable laws and regulations. Given the risks and uncertainties, you should not place undue reliance on these forward-looking statements. For a discussion of these and other risks, uncertainties and other factors that may cause our actual results, performance or achievements to differ, please refer to our annual report on Form 10-Q for the period ended June 30, 2026 as well as our subsequent filings with the Securities and Exchange Commission from time to time. The forward-looking statements contained herein are made as of the date hereof, and we undertake no obligation to update them after this date, except as required by law.
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Opening Remarks Catherine Owen Adams Chief Executive Officer
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Data support the continued development of remlifanserin in ADP with the two Phase 3 trials currently underway RADIANT: Phase 2 Remlifanserin Alzheimer’s Disease Psychosis (ADP) Data Are Enabling for Phase 3 Program Meaningful and consistent efficacy trends across endpoints Narrowly missed primary endpoint (SAPS H+D) for remlifanserin 60 mg Significance (nominal) on key secondary endpoint of CGI-S Safety and tolerability profile in the study was favorable No new safety signals Phase 3 EnablingSafety & TolerabilityEfficacy 5
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RADIANT Phase 2 Topline Results Elizabeth H.Z. Thompson, Ph.D. Executive Vice President, Head of Research and Development
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PHASE 2 N=363, double-blind, randomized 1:1:1 Remlifanserin (60 mg QD) Remlifanserin (30 mg QD) Placebo 6 WEEKS PRIMARY ENDPOINT SAPS-H+D total score change from baseline to Week 6 KEY SECONDARY ENDPOINT CGI-S-ADP change from baseline to Week 6 Remlifanserin: RADIANT Phase 2 Trial in ADP Modified Full Analysis Set (mFAS) includes all randomized subjects who received at least one dose of study drug and who have a baseline SAPS-H+D total score ≥10 and at least one post-baseline value for SAPS-H+D total score. Subjects were analyzed based on their planned randomized treatment. ADP = Alzheimer’s Disease Psychosis; QD = once daily; SAPS-H+D = Scale for Assessment of Positive Symptoms - Hallucinations + Delusions; CGI-S-ADP = Clinical Global Impression–Severity in ADP 126 Randomized → 109 mFAS 121 Randomized → 110 mFAS 116 Randomized → 107 mFAS 7
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Demographics and Baseline Disease Characteristics (mFAS) Placebo n (%) N=107 Remlifanserin 30 mg n (%) N=110 Remlifanserin 60 mg n (%) N=109 Remlifanserin Overall n (%) N=219 Sex, n (%) Female 68 (64) 69 (63) 75 (69) 144 (66) Male 39 (36) 41 (37) 34 (31) 75 (34) Age at Randomization (years) Mean (SD) 76.3 (6.26) 76.9 (5.51) 75.7 (6.25) 76.3 (5.91) Median (Min, Max) 76.0 (60, 88) 77.0 (61, 89) 76.0 (60, 95) 76.0 (60, 95) Primary Race, n (%) White 96 (89.7) 89 (80.9) 93 (85.3) 182 (83.1) Black or African American 4 (3.7) 3 (2.7) 2 (1.8) 5 (2.3) Asian 4 (3.7) 11 (10.0) 5 (4.6) 16 (7.3) American Indian or Alaska Native 1 (0.9) 3 (2.7) 4 (3.7) 7 (3.2) Other (includes unknown, not reported, multiple) 2 (1.9) 4 (3.6) 5 (4.6) 9 (4.1) SAPS-H+D Total Score Mean (SD) 24.5 (10.25) 24.6 (10.39) 25.5 (12.81) 25.1 (11.64) Median (Min, Max) 24.0 (10, 80) 23.0 (10, 68) 22.0 (10, 87) 23.0 (10, 87) CGI-S-ADP Score Mean (SD) 4.8 (0.70) 4.8 (0.65) 4.7 (0.69) 4.7 (0.67) Median (Min, Max) 5.0 (4, 6) 5.0 (4, 6) 5.0 (4, 7) 5.0 (4, 7) 8
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Remlifanserin Narrowly Missed Primary Endpoint. Nominally Significant Key Secondary Placebo (N=107) Remlifanserin 30 mg (N=110) Remlifanserin 60 mg (N=109) Change from Baseline (LSM) Change from Baseline (LSM) Standardized Effect Size P-value Change from Baseline (LSM) Standardized Effect Size P-value Primary Endpoint: Change from Baseline in the SAPS- H+D total score at Week 6 -10.4 -10.9 0.05 0.6890 -12.6 0.26 0.0603 Key Secondary Endpoint: Change from Baseline in the CGI-S- ADP score at Week 6 -0.9 -1.0 0.11 0.4085 -1.3 0.37 0.0077 9 mFAS population was the pre-specified analysis population for efficacy CGI-S-ADP = Clinical Global Impression of Severity for Alzheimer's Disease Psychosis; LSM = least squares mean; SAPS H+D = Scale for the Assessment of Positive Symptoms, Hallucinations and Delusions domains
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10 Consistent Improvement Across Primary and Key Secondary Endpoint with Increasing Separation Through Week 6 Primary Endpoint: SAPS-H+D Total Score Key Secondary: CGI-S-ADP Score LS Mean Change from Baseline (SE)-15 -13 -11 -9 -7 -5 -3 -1 0 1 2 3 4 5 6 Placebo Remlifanserin 30 mg Remlifanserin 60 mg -1.6 -1.4 -1.2 -1 -0.8 -0.6 -0.4 -0.2 0 0 1 2 3 4 5 6 Placebo Remlifanserin 30 mg Remlifanserin 60 mg Study Week mFAS population was the pre-specified analysis population for efficacy CGI-S-ADP = Clinical Global Impression – Severity in Alzheimer's Disease Psychosis; ES = effect size; LSM = least squares mean; MMRM = mixed model repeated measures; SAPS-H+D = Scale for the Assessment of Positive Symptoms-Hallucinations and Delusions Subscales; SE = standard error. *nominal p-value < 0.05 * *
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11 Subgroup of Modestly Higher Baseline Psychosis (80% of Trial Population) Improves Separation Throughout Treatment Period Primary Endpoint: SAPS-H+D Total Score Key Secondary: CGI-S-ADP Score LS Mean Change from Baseline (SE)-15 -13 -11 -9 -7 -5 -3 -1 0 1 2 3 4 5 6 Placebo (Subgroup) Remlifanserin 60 mg (Subgroup) -1.6 -1.4 -1.2 -1 -0.8 -0.6 -0.4 -0.2 0 0 1 2 3 4 5 6 Placebo (Subgroup) Remlifanserin 60 mg (Subgroup) Study Week ES=0.33 ES=0.43 CGI-S-ADP = Clinical Global Impression – Severity in Alzheimer's Disease Psychosis; ES = effect size; LSM = least squares mean; MMRM = mixed model repeated measures; SAPS-H+D = Scale for the Assessment of Positive Symptoms-Hallucinations and Delusions Subscales; SE = standard error. At baseline, n of 86 in placebo and 86 in Remlifanserin 60 mg for subgroup of mFAS population
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Phase 2 Safety Profile Supports Continued Phase 3 Development • No signal of QT prolongation vs placebo • Low rates of serious adverse events and discontinuations due to adverse events • No AE was seen in more than 5% of patients receiving 60 mg remlifanserin • Only somnolence (3.2%) and nausea (2.4%) were seen in more than 2% of patients on 60 mg remlifanserin and were numerically higher than placebo • Data to date suggest no negative impact on motor symptoms or cognition Placebo (N=115) n (%) Remlifanserin 30 mg (N=120) n (%) Remlifanserin 60 mg (N=125) n (%) Any TEAE 48 (41.7) 46 (38.3) 46 (36.8) Any TEAE Leading to Discontinuation from Study Drug 3 (2.6) 1 (0.8) 3 (2.4) Any TEAE with an Outcome of Death 2 (1.7) 0 0 12 Safety analysis set Includes all patients receiving at least 1 dose of investigational product
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Next Steps 13 • Detailed safety and efficacy results to be shared at Clinical Trials on Alzheimer's Disease (CTAD) November 16-19, 2026 in Boston • Phase 3 enrollment continues while we implement amendments to the program, including removing the 30 mg dosage arm
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Closing Remarks Catherine Owen Adams Chief Executive Officer
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1. Cummings J, et al. J Prev Alzheimers Dis. 2018;5(4):253-258. ADP is a condition in which a person with Alzheimer's disease experiences hallucinations or delusions There are no approved treatments for hallucinations and delusions associated with ADP Alzheimer's Disease Psychosis (ADP) is Common in Alzheimer’s Disease and Represents a Substantial Unmet Need ~7M Patients in the U.S. with Alzheimer’s disease Approximately 30% of patients with Alzheimer’s disease experience psychosis commonly consisting of hallucinations and delusions1 15
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1. Simuni T, Chahine LM, Poston K, et al. A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research. Lancet Neurol. 2024 Feb;23(2):178-190. doi: 10.1016/S1474-4422(23)00405-2. PMID: 38267190. 2. https://www.alzheimers.gov/alzheimers-dementias/lewy-body-dementia or https://www.lbda.org/wp-content/uploads/2021/03/lewy-body- dementia-booklet.pdf 3. Lewy Body Dementia Association (LBDA), Treatment of Lewy Body Dementia https://www.lbda.org/treatment/ 4. NINDS https://www.ninds.nih.gov/current-research/focus-disorders/alzheimers-disease-and-related-dementias/focus-lewy-body-dementia-lbd- research. 5. Cummings J, et al. J Prev Alzheimers Dis. 2018;5(4):253-258. . 6. Based on IQVIA data and Acadia internal estimates. >1M Patients in the U.S. may be living with LBD4 Overview of Lewy Body Dementia (LBD) A progressive brain disorder that affects thinking, movement, mood, and behavior that is associated with abnormal deposits of alpha- synuclein in the brain1,2 No therapies are approved for LBD with psychosis (LBDP); and some traditional antipsychotics that are commonly used in other diseases can be harmful3 50%-75% of people with LBD experience psychosis5 ▪ Approximately 200,000 patients living with LBDP are being treated with antipsychotics6 16
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~$1.7B Projected FY 2028 Global Net Sales NUPLAZID: ~$1B DAYBUE:~$700M ~$11B Full Global Peak Sales Potential (Unadjusted) ~$4B Remlifanserin peak sales for both ADP and LBDP Internal Acadia estimates for full potential peak sales for pipeline molecules as of September 24, 2026, assuming all successfully approved and commercialized. Note: Peak sales used for calculations do not all occur within the same fiscal year. ACP-711 ACP-211 ACP-271 17 Potential Growth Outlook
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Ongoing Today 2026 2027 Trofinetide Rett Syndrome | Japan Remlifanserin ADP + LBDP ACP-211 Major Depressive Disorder ACP-711 Healthy Volunteers ACP-271 Healthy Volunteers Advancing a Robust Pipeline with Multiple Value-Driving Milestones 18 Ph 2 | LBDP Ph 3s | ADP Ph 2 | MDD Ph 1 | First in Human Ph 2 | Readout RADIANT Ph 2 | Readout Regulatory SubmissionPh 3 | Readout Studies ongoing today Three Ph 2 or Ph 3 study readouts expected1 1Fourth readout is undisclosed at this time. Ph 1 | First in Human Ph 2 | Essential Tremor Planned initiation Ph 3 | Rett Syndrome
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Q&A Session 19