Company Wins Back Promising Eye Disease Drug and Eyes Two Product Launches by 2028
Research Report

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Disclosures for H.C. Wainwright & Co., MeiraGTx Holdings Plc., April 20, 2026

This material is confidential and intended for use by Institutional Accounts as defined in FINRA Rule 4512(c). It may also be privileged or otherwise protected by work product immunity or other legal rules. If you have received it by mistake, please let us know by e-mail reply to unsubscribe@hcwresearch.com and delete it from your system; you may not copy this message or disclose its contents to anyone. The integrity and security of this message cannot be guaranteed on the Internet. H.C. WAINWRIGHT & CO, LLC RATING SYSTEM: H.C. Wainwright employs a three tier rating system for evaluating both the potential return and risk associated with owning common equity shares of rated firms. The expected return of any given equity is measured on a RELATIVE basis of other companies in the same sector. The price objective is calculated to estimate the potential movements in price that a given equity could reach provided certain targets are met over a defined time horizon. Price objectives are subject to external factors including industry events and market volatility. RETURN ASSESSMENT Market Outperform (Buy): The common stock of the company is expected to outperform a passive index comprised of all the common stock of companies within the same sector. Market Perform (Neutral): The common stock of the company is expected to mimic the performance of a passive index comprised of all the common stock of companies within the same sector. Market Underperform (Sell): The common stock of the company is expected to underperform a passive index comprised of all the common stock of companies within the same sector. Rating and Price Target History for: MeiraGTx Holdings plc (MGTX-US) as of 04-17-2026 12 10 8 6 4 2 Q1 Q2 Q3 2024 Q1 Q2 Q3 2025 Q1 Q2 Q3 2026 Q1 Q2 I:BUY:$20.00 11/24/25 Investment Banking Services include, but are not limited to, acting as a manager/co-manager in the underwriting or placement of securities, acting as financial advisor, and/or providing corporate finance or capital markets-related services to a company or one of its affiliates or subsidiaries within the past 12 months. Distribution of Ratings Table as of April 17, 2026 IB Service/Past 12 Months Ratings Count Percent Count Percent Buy 556 83.61% 163 29.32% Neutral 62 9.32% 10 16.13% Sell 2 0.30% 0 0.00% Under Review 45 6.77% 15 33.33% H.C. Wainwright & Co, LLC (the “Firm”) is a member of FINRA and SIPC and a registered U.S. Broker-Dealer. I, Mitchell S. Kapoor, Yi Chen, Ph.D. CFA and Raghuram Selvaraju, Ph.D. , certify that 1) all of the views expressed in this report accurately reflect my personal views about any and all subject securities or issuers discussed; and 2) no part of my compensation was, is, or will be directly or indirectly related to the specific recommendation or views expressed in this research report; and 3) neither myself nor any members of my household is an officer, director or advisory board member of these companies. None of the research analysts or the research analyst’s household has a financial interest in the securities of MeiraGTx Holdings plc (including, without limitation, any option, right, warrant, future, long or short position). As of March 31, 2026 neither the Firm nor its affiliates beneficially own 1% or more of any class of common equity securities of MeiraGTx Holdings plc. Neither the research analyst nor the Firm knows or has reason to know of any other material conflict of interest at the time of publication of this research report.

The research analyst principally responsible for preparation of the report does not receive compensation that is based upon any specific investment banking services or transaction but is compensated based on factors including total revenue and profitability of the Firm, a substantial portion of which is derived from investment banking services. The Firm or its affiliates did not receive compensation from MeiraGTx Holdings plc for investment banking services within twelve months before, but will seek compensation from the companies mentioned in this report for investment banking services within three months following publication of the research report. The Firm does not make a market in MeiraGTx Holdings plc as of the date of this research report. The securities of the company discussed in this report may be unsuitable for investors depending on their specific investment objectives and financial position. Past performance is no guarantee of future results. This report is offered for informational purposes only, and does not constitute an offer or solicitation to buy or sell any securities discussed herein in any jurisdiction where such would be prohibited. This research report is not intended to provide tax advice or to be used to provide tax advice to any person. Electronic versions of H.C. Wainwright & Co., LLC research reports are made available to all clients simultaneously. No part of this report may be reproduced in any form without the expressed permission of H.C. Wainwright & Co., LLC. Additional information available upon request. H.C. Wainwright & Co., LLC does not provide individually tailored investment advice in research reports. This research report is not intended to provide personal investment advice and it does not take into account the specific investment objectives, financial situation and the particular needs of any specific person. Investors should seek financial advice regarding the appropriateness of investing in financial instruments and implementing investment strategies discussed or recommended in this research report. H.C. Wainwright & Co., LLC’s and its affiliates’ salespeople, traders, and other professionals may provide oral or written market commentary or trading strategies that reflect opinions that are contrary to the opinions expressed in this research report. H.C. Wainwright & Co., LLC and its affiliates, officers, directors, and employees, excluding its analysts, will from time to time have long or short positions in, act as principal in, and buy or sell, the securities or derivatives (including options and warrants) thereof of covered companies referred to in this research report. The information contained herein is based on sources which we believe to be reliable but is not guaranteed by us as being accurate and does not purport to be a complete statement or summary of the available data on the company, industry or security discussed in the report. All opinions and estimates included in this report constitute the analyst’s judgment as of the date of this report and are subject to change without notice. Securities and other financial instruments discussed in this research report: may lose value; are not insured by the Federal Deposit Insurance Corporation; and are subject to investment risks, including possible loss of the principal amount invested.

In a research note published on April 20, 2026, Mitchell S. Kapoor, Raghuram Selvaraju, Ph.D., and Yi Chen, Ph.D., CFA of H.C. Wainwright & Co. reiterated a Buy rating and 12-month price target of US$20.00 on MeiraGTx Holdings Plc (MGTX:NASDAQ), representing a potential return of approximately 98% from the April 17, 2026 share price of US$10.12. The analysts cite two near-term product launches coming into view — AAV-hAQP1 for radiation-induced xerostomia and bota-vec for X-linked Retinitis Pigmentosa — along with a recent financing that extends the company's runway into the expected launch window as the basis for their conviction.

AAV-hAQP1 Durability Data

The 36-month AQUAx update demonstrated that the AAV-hAQP1 Phase 1 signal held at both the cohort and individual patient level. The bilateral cohort's approximately 21-point mean Xerostomia Questionnaire (XQ) improvement at 12 months was essentially maintained at 36 months, and Unstimulated Whole Saliva Flow Rate improvement was similarly sustained through three years. Biopsy samples collected 12 to 30 months post-treatment showed vector DNA in 6 of 7 patients, with AQP1 protein expression detected in one patient with sufficient tissue. The analysts note that the FDA's Breakthrough Therapy designation was supported by the Phase 1 dataset, including the three-year follow-up data.

Management described improved physician and payer engagement following incorporation of the three-year data into commercial discussions, with modeled pricing of approximately US$150K, gross-to-net of 15%–20%, and approximately 90% access, supporting management's view of US$2.0B U.S. peak annual sales and approximately US$3.7B in global peak annual sales. The analysts note that more than 60% of U.S. radiation-induced xerostomia patients are located within three hours of 15 metro areas, keeping the launch footprint concentrated.

AQUAx2, a 276-patient, double-blind, placebo-controlled study across the U.S., U.K., and Canada, is the next major value inflection. The FDA has provided written alignment that the study can support a Biologics License Application (BLA), with success defined as any one active arm beating the pooled placebo on XQ. A data readout and potential BLA filing are targeted for 2Q27, with a U.S. launch slated for early 2028. The analysts also note Sjögren's syndrome and PSMA-radioligand xerostomia as the clearest expansion opportunities beyond radiation-induced xerostomia.

Bota-vec Reacquisition

MeiraGTx regained full control of bota-vec, a filing-ready asset for X-linked Retinitis Pigmentosa (XLRP), from Johnson & Johnson (JNJ-NYSE; not rated). The company will pay US$25M upfront, a US$50M milestone only if both U.S. approval is achieved and cumulative U.S. net sales exceed US$250M, and mid-teens royalties on net sales beginning July 1, 2029. MeiraGTx is also assuming UCL obligations and sharing certain sub-license economics. The company had previously monetized the RPGR asset for up to US$415M and had received US$125M under that framework; the reacquisition brings it back in-house with completed Process Performance Qualification (PPQ) batches in place. Regulatory submissions are intended to begin promptly in the U.S., EU, and Japan, with a potential 2027 launch target.

The analysts acknowledge that the LUMEOS pivotal trial missed its novel Visual Mobility Assessment (VMA) primary endpoint, though they note that treated patients were directionally 2.4x more likely to respond, that Low Luminance Questionnaire (LLQ) and Interleaved Visual Integration Assessment (IVI-A) showed functional benefit, that retinal sensitivity endpoints were statistically positive, and that investigators highlighted 10- and 15-letter gains in low-luminance visual acuity. The analysts assign bota-vec a 65% probability of approval.

Financing and Catalyst Calendar

MeiraGTx priced 11.1 million shares at US$9.00 per share for approximately US$100M in gross proceeds.

The company stated that net proceeds, together with existing cash of US$226.0M, should fund operating expenses and capital expenditures — including potential launches of bota-vec and AAV-hAQP1 if approved — into the second half of 2028. Beyond the two lead programs, AAV-GAD Phase 3 initiation under the Hologen JV and trigeminal neuralgia's entry into the clinic are both expected in 2026, and Ribo-leptin remains a candidate for a near-term IND submission pending FDA alignment. Milestone optionality from EEli Lilly and Co. (LLY:NYSE), including US$135M in nearer-term milestones within a total package of more than US$400M, is characterized as incremental to the core commercial setup.

Model Updates and Valuation

The analysts updated their model to account for the April 16 financing and bota-vec reacquisition, increasing the diluted share count for the 11.1 million-share offering and incorporating acquisition economics. In radiation-induced xerostomia, the probability of approval was raised to 75% from 45%, the U.S. list price assumption was lowered to US$150K with a 15% gross-to-net rate, and peak market penetration was raised to 30% from 10% to reflect improved access dynamics at lower pricing.

Despite these changes, the analysts characterize their US$1B U.S. peak sales estimate for AAV-hAQP1 as conservative relative to management's approximately US$2B U.S. peak view. The net effect of higher share count, the addition of bota-vec, and updated pricing and penetration assumptions was neutral to the price target. Using a 12% discount rate and 1% terminal growth rate, the DCF-based analysis yields an estimated enterprise value of approximately US$1.985B and a 12-month price target of US$20, assuming 109 million fully diluted shares outstanding and an estimated end-2Q27 cash position of approximately US$309M.

Risks

The analysts identify the following material risks: delays in advancing pipeline candidates into and through clinical trials; failure to obtain positive clinical data from ongoing programs; and possible long-term equity dilution risk.

Outlook

H.C. Wainwright reiterates its Buy rating and US$20 price target on MeiraGTx Holdings plc (MGTX:NASDAQ).

At the April 17, 2026, share price of US$10.12, the stock trades at approximately a 49% discount to the 12-month price target, implying a potential return of approximately 98%.