Crescendo's initial tests are for rheumatoid arthritis (RA) patients. Future products may address other autoimmune diseases in rheumatology such as systemic lupus erythematosus, psoriatic arthritis, and ankylosing spondylitis.

Rheumatoid Arthritis

RA is a debilitating, highly variable, chronic disease affecting approximately 1.5 million Americans and more than 2 million people in Europe. The primary symptoms of RA are joint inflammation, pain, and fatigue, with the disease often resulting in joint damage and disability. RA is a systemic disease and can significantly damage other parts of the body as well, resulting in infection, osteoporosis and cardiovascular disease, a leading cause of death for RA patients. Early and accurate detection of RA, followed with frequent monitoring and responsive therapeutic adjustments, is critical to improving clinical outcomes.

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Clinicians assess RA based on three factors: disease activity (clinical signs and symptoms), structural damage such as erosions, and functional status (including pain). The goal is to manage patients to achieve both clinical remission and structural damage remission, which leads to improved functional status. To aid the assessment of RA on these first two dimensions, Crescendo's first two tests are:

• Vectra™ DA (Disease Activity Test): a multi-protein biomarker test that aids in the assessment and monitoring of disease activity in RA
• Structural Damage Test: a multi-protein biomarker test that will aid in the assessment and monitoring of the rate of joint damage associated with RA

Clinical studies have shown that frequent measurement, with resulting changes in patient management, leads to better RA outcomes. Our goal is to provide tests of quantitative biology to optimize measurement of both disease activity and structural damage. To this end, we have identified multiple key protein biomarkers involved in the clinical pathways of the disease and developed algorithms that condense this biology into usable, actionable tests to help rheumatologists easily and effectively track and monitor their patients. The goal of the Vectra DA and Structural Damage tests is to provide objective, accurate information that reflects clinically meaningful changes in the disease in a timely manner.

Crescendo is also pursuing numerous additional opportunities in RA to fill unmet needs in diagnosis, prognosis, treatment selection, and monitoring.