Efmody® distribution and marketing agreement signed with EffRx for Switzerland

25th April 2022

Extends Company’s existing agreement with EffRx for Alkindi® in Switzerland

EffRx to submit Market Authorisation Application for Efmody® to Swissmedic in H2 2022

Diurnal Group plc (AIM: DNL), the specialty pharmaceutical company targeting patient needs in chronic endocrine (hormonal) diseases, announces that it has extended its distribution and marketing agreement with EffRx Pharmaceuticals (“EffRx”) in Switzerland to now include Efmody® (hydrocortisone modified-release hard capsules). Under the agreement signed in October 2020, EffRx already holds the exclusive rights to market and distribute Alkindi® (hydrocortisone granules in capsules for opening) in Switzerland. Alkindi® was approved by Swissmedic in November 2021.

EffRx intends to submit a Market Authorisation Application (MAA) to Swissmedic for the registration of Efmody® as treatment for adolescent and adult patients (12 years and older) with the rare condition congenital adrenal hyperplasia (CAH) in Switzerland during the second half of 2022. The MAA submission to Swissmedic for Efmody® will be based on the European regulatory dossier and published clinical trial data, with EffRx expecting potential market launch in Switzerland in 2024. Under the terms of the agreement, EffRx will receive the exclusive rights to market and sell Efmody® in Switzerland once registered. According to the Company’s estimates, there are approximately 450 patients in Switzerland suffering from CAH.

Efmody® is a modified-release preparation of hydrocortisone that has been specifically designed for the treatment of patients with CAH, a rare condition caused by a genetic deficiency of adrenal enzymes. In May 2021, Efmody® was granted marketing authorisation in the European Union and was subsequently launched by the Company in Germany, Austria and the UK in September 2021.

On successful approval in Switzerland, Diurnal will provide Efmody ® to EffRx for sale from its established European supply chain.

Richard Bungay, Interim Chief Executive Officer of Diurnal, commented:

“We are pleased to deepen our relationship with EffRx to include the distribution and marketing of Efmody® in Switzerland. We have been impressed by the progress EffRx has made with the regulatory approval and reimbursement of Alkindi® and look forward to continuing to work with them as they prepare to submit an MAA to Swissmedic for Efmody®.”

Lorenzo Bosisio, Chief Executive Officer of EffRx, commented:

“We are excited to sign this additional agreement with Diurnal, enabling us to build on the momentum we have achieved with Alkindi ® in Switzerland following approval from Swissmedic in November 2021. We believe the unique release profile of Efmody ®, that mimics the body’s natural cortisol circadian rhythm, could have a genuine impact on CAH patients’ symptoms. We are aligned with Diurnal’s strategy to address the unmet medical need in patients suffering from diseases of cortisol deficiency and look forward to working with the Diurnal team to bring Efmody® to patients suffering from CAH in Switzerland.”

This is a business press release containing financial information and/or data for the benefit of shareholders and potential investors. Data are included to allow informed investment decisions.

This announcement contains inside information for the purposes of Article 7 of Regulation (EU) 596/2014 (MAR).

For further information, please visit www.diurnal.co.uk or contact:

Diurnal Group plc

+44 (0)20 3727 1000

Richard Bungay, Interim Chief Executive Officer and Chief Financial Officer

Panmure Gordon (UK) Limited (Nominated Adviser and Joint Corporate Broker)

+44 (0)20 7886 2500

Corporate Finance: Freddy Crossley, Emma Earl

Corporate Broking: Rupert Dearden

Stifel Nicolaus Europe Limited (Joint Corporate Broker)

+44 (0) 20 7710 7600

Healthcare Investment Banking: Nicholas Moore, Samira Essebiyea, William Palmer-Brown

Corporate Broking: Nick Adams, Nick Harland

FTI Consulting (Media and Investor Relations)

+44 (0)20 3727 1000

Simon Conway

Victoria Foster Mitchell

Alex Davis

Notes to Editors

About congenital adrenal hyperplasia

Congenital adrenal hyperplasia (CAH) is an orphan condition caused by deficiency of adrenal enzymes, most commonly 21-hydroxylase. This enzyme is required to produce the adrenal steroid hormone, cortisol. The block in the cortisol production pathway causes the over-production of male steroid hormones (androgens), which are precursors to cortisol. The condition is congenital (inherited at birth) and affects both sexes. The cortisol deficiency and over-production of male sex hormones can lead to increased mortality, infertility and issues during sexual development including ambiguous genitalia, premature (precocious) sexual development and short stature. Sufferers, even if treated, remain at risk of death through an adrenal crisis.

Current therapy for CAH uses a variety of generic glucocorticoid (steroid) preparations including hydrocortisone, dexamethasone, prednisolone and prednisone in the US, with no standard treatment regimen. Approximately two-thirds of CAH patients are estimated to have poor disease control, leading to elevated androgen levels. The condition is estimated to affect a total of approximately 16,000 patients in the US, with over 400,000 in the rest of the world.

About Efmody® (hydrocortisone modified-release hard capsules)

Efmody® is a preparation of hydrocortisone that has been specifically designed to mimic the circadian rhythm of cortisol when given in a twice-a-day "toothbrush" regimen (administered last thing at night before sleep and first thing in the morning on waking) to control androgen excess and chronic fatigue in patients with diseases of cortisol deficiency. The first indication for Efmody® is congenital adrenal hyperplasia (CAH) in adults and adolescents (children older than 12 years of age). Efmody® has been extensively studied in 239 human subjects including 138 CAH patients who have taken part in clinical trials in Europe and the US.

The MHRA and European Commission marketing authorisation approval of Efmody ® was based on a Phase 3 study conducted in a total of 122 patients enrolled across 11 clinical sites, including sites in Great Britain, the largest ever interventional clinical trial completed in CAH. The Phase 3 data was supported by detailed analysis of data from an open-label safety extension study for patients completing treatment in the Phase 3 study, which is assessing the impact of treatment with Efmody ® over an extended period, with a number of patients on this trial having been treated for over five years. Summary of Product Characteristics (SmPC) for UK (Northern Ireland) can be found here .

About Diurnal Group plc

Diurnal Group plc is a European, UK-headquartered, specialty pharmaceutical company dedicated to developing hormone therapeutics to aid lifelong treatment for rare and chronic endocrine conditions, including congenital adrenal hyperplasia, adrenal insufficiency, hypogonadism and hypothyroidism. Its expertise and innovative research activities focus on circadian-based endocrinology to yield novel product candidates in the rare and chronic endocrine disease arena.

For further information about Diurnal, please visit www.diurnal.com

About EffRx Pharmaceuticals

EffRx Pharmaceuticals is a commercial-stage pharmaceutical company focused on the late-stage development and commercialisation of prescription medications for niche and orphan indications. The business model is centred around providing superior clinical and commercial value propositions for physicians, payers and patients. EffRx pro-actively seeks in-licensing opportunities for Europe in niche therapeutic areas, with a primary interest for rare diseases, where EffRx has received an orphan drug designation (ODD) from the US Food and Drug Administration (FDA).

For further information about EffRx Pharmaceuticals, please visit www.effrx.com

Date of Preparation: April 2022 Code: CORP-EU-0034

Diurnal Limited (Company Number: 05237326) is registered in England & Wales. Registered office: Cardiff Medicentre, Heath Park, Cardiff CF14 4UJ, UK.