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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 OR 15(d)
of The Securities Exchange Act of 1934
Date of Report (Date of earliest event reported): October 29, 2024
Coya Therapeutics, Inc.
(Exact name of registrant as specified in its charter)
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Delaware |
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001-41583 |
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85-4017781 |
(State or other jurisdiction of incorporation) |
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(Commission File Number) |
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(IRS Employer Identification No.) |
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5850 San Felipe St., Suite 500 |
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Houston, Texas |
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77057 |
(Address of principal executive offices) |
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(Zip Code) |
Registrant’s telephone number, including area code: (800) 587-8170
N/A
(Former name or former address, if changed since last report.)
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
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Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425) |
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Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12) |
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Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b)) |
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Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c)) |
Securities registered pursuant to Section 12(b) of the Act:
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Title of each class |
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Trading Symbol(s) |
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Name of each exchange on which registered |
Common Stock, par value $0.0001 per share |
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COYA |
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The Nasdaq Stock Market LLC |
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§240.12b-2 of this chapter).
Emerging growth company ☒
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Item 7.01 |
Regulation FD Disclosure. |
On October 29, 2024, Coya Therapeutics, Inc. (the “Company”) issued a press release announced that results from the placebo-controlled Phase 2 clinical trial of LD IL-2 in patients with mild to moderate Alzheimer’s Disease (the “Clinical Data”) were announced at the 17th Clinical Trials on Alzheimer’s Disease Conference (CTAD24) in Madrid, Spain. A copy of the press release is furnished as Exhibit 99.1 and incorporated by reference.
On October 29, 2024, the Company provided a presentation of the Clinical Data. A copy of the presentation is furnished as Exhibit 99.2 and incorporated by reference.
The information in this Current Report on Form 8-K under Item 7.01, including the information contained in Exhibits 99.1 and 99.2, is being furnished to the Securities and Exchange Commission, and shall not be deemed to be “filed” for the purposes of Section 18 of the Exchange Act, or otherwise subject to the liabilities of that section, and shall not be deemed to be incorporated by reference into any filing under the Securities Act or the Exchange Act, except as shall be expressly set forth by a specific reference in such filing.
Item 9.01 |
Financial Statements and Exhibits. |
(d) Exhibits.
SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
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COYA THERAPEUTICS, INC. |
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Date: October 29, 2024 |
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By: |
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/s/ Howard Berman |
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Howard Berman Chief Executive Officer |
Exhibit 99.1
Coya Therapeutics Announces Positive Results of a Double-Blind Study of Subcutaneous Low-Dose Interleukin-2 (LD IL-2) in Alzheimers Disease (AD) Presented at the Clinical Trials on Alzheimers Disease Conference (CTAD24) in Madrid (Spain)
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Study met Primary and Secondary Endpoints for Safety and Regulatory T cell (Treg) Cell Population Enhancement,
respectively, with no off-target effects on T effector lymphocytes, providing further evidence of target engagement |
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Exploratory Endpoints demonstrated cognitive stabilization on treatment vs. cognitive declines on placebo for
LD IL-2 dosing every 4 weeks (LD IL-2 q4wks), which was associated with significant improvement in cerebrospinal fluid (CSF) soluble Aß42 levels and stabilized CSF
Neurofilament Light Chain (NfL) |
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Study supports and increases confidence in Treg modulation strategies in neurodegenerative conditions and in
advancing LD IL-2 q4wks and LD IL-2 q4wks combination strategies (i.e. COYA 302) in AD and other related diseases |
HOUSTON, TX, October 29, 2024 Coya Therapeutics, Inc. (NASDAQ: COYA) (Coya or the Company), a clinical-stage
biotechnology company developing biologics intended to enhance regulatory T cell (Treg) function, announces that results from the placebo-controlled Phase 2 clinical trial of LD IL-2 in patients with mild to
moderate Alzheimers Disease were announced today at the 17th Clinical Trials on Alzheimers Disease Conference (CTAD24) in Madrid, Spain. The study was led by Dr. Alireza Faridar and Dr. Stanley Appel from the Houston Methodist
Research Institute. Dr. Appel is a member of Coyas Scientific Advisory Board. The study received funding from the Alzheimers Association, the Gates Foundation, and the National Institute on Aging, with additional support from Coya.
The presentation summarizing the clinical results is available for viewing here.
We want to express our gratitude to the investigators
for this study. We believe this trial strongly supports and adds further validation of Coyas approach in modulating Treg function as a platform to address neurodegenerative diseases said Arun Swaminathan, Ph.D., incoming CEO of Coya.
These monotherapy treatment results increase our confidence that combinations of COYA 301, our proprietary LD- IL-2, with other drug targets have strong potential
in treating Alzheimers Disease. In addition, this data on LD IL-2 alone provides additional confidence in COYA 302, our proprietary combination of LD-IL-2 and cytotoxic T lymphocyte-associated antigen 4 immunoglobulin fusion protein (CTLA4-Ig) in amyotrophic lateral sclerosis (ALS) and frontotemporal dementia
(FTD) based on increased and more durable Treg suppressive function observed with the combination in patients with ALS.
Study Design:
The investigator-initiated, randomized, double-blind, placebo-controlled Phase 2 trial evaluated two dosing regimens of subcutaneous low-dose interleukin-2 in 38 participants with Alzheimers disease that were between the ages of 50 to 86 and had Mini-Mental State Examination (MMSE) scores ranging from
12 to 26.
Of the 38 total participants, 22 were randomized in a 1:1 ratio to receive either 5 days of LD IL-2 (106 IU/day) (LD IL-2 q4wks) or placebo every 4 weeks for 21 weeks. An additional 16 participants were randomized in a 2:1 ratio to receive
5-day cycles of LD IL-2 every 2 weeks (LD IL-2 q2wks) or placebo for the same 21-week
duration. All participants were monitored for 9 weeks post-treatment, resulting in a total study period of 30 weeks. Demographics and baseline disease characteristics were comparable among the treatment groups.
The primary endpoint was the incidence and severity of adverse events (AEs), with the secondary endpoint evaluating changes in Tregs. Exploratory endpoints
assessed changes in cerebrospinal fluid (CSF), AD-related biomarkers, and cognitive status.
Study Results:
The study successfully met its primary and secondary endpoints, demonstrating that treatment with low-dose interleukin-2 is safe and well-tolerated in patients with Alzheimers disease. Notably, LD IL-2 showed targeted biological activity, evidenced by a significant expansion
of regulatory T cell populations in the LD IL-2 q4wks group without any off-target effects on other peripheral lymphocytes. Additionally, the q4wks regimen led to
significant improvements (defined by increased levels) in cerebrospinal fluid (CSF)-soluble Aß42 levels, an indicator of amyloid pathology, and showed a promising trend in stabilizing cognitive function, with a clinically meaningful 4.93-point improvement1 in the ADAS-Cog14 score compared to placebo.
In contrast, the q2wks group, representing the higher total dose cohort, did not exhibit benefits in exploratory endpoints, underscoring the importance of
appropriate IL-2 dosing for maintaining Treg functionality and its associated effects on CSF biomarkers and cognitive outcomes. LD IL-2 q2wks dosing also resulted in a
reduction of Foxp3 expression, a critical marker of Treg functionality (a lower level or loss of Foxp3 expression is associated with unstable/dysfunctional Tregs). While these unstable Tregs continue to show suppressive immune response in vitro,
they may lose their immunomodulatory functions in vivo, potentially explaining the dose impact on Treg populations and associated exploratory endpoints. As a result of these data, the Company will likely advance LD
IL-2 q4wks.
Primary Endpoint (Safety and Tolerability): All patients completed the 21-week treatment phase. The proportion of patients experiencing adverse events (AEs) was similar between the LD IL-2 treatment groups and the placebo group, with no serious
AEs or deaths reported. The most common AEs in the LD IL-2 groups included mild erythema at the injection site and a slight increase in eosinophil counts.
Secondary Endpoint (Treg Cell Populations): There was a significant increase (p < 0.05) in the percentage of CD4+ FOXP3+CD25 high Tregs, mean
fluorescence intensity (MFI) of Foxp3, Treg CD25 MFI, and Treg suppression of T responders following both dosing regimens of LD IL-2 treatment compared to placebo. Notably, the LD IL-2 q4wks treatment group showed greater enhancement in both Treg numbers and Foxp3 MFI compared to the q2wks group. The loss of Foxp3 expression in the q2wks group (back to baseline levels equivalent to placebo)
indicated that higher IL-2 dosing may compromise Treg functionality. Repeated stimulation of Tregs without sufficient rest periods has been reported to result in exhausted and unstable Treg populations2. Published studies also suggest an inverse relationship between IL-2 dose and Treg functionality3,4.
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For patients with mild AD, a change of +3 on the ADAS-Cog has been
described as clinically meaningful to assess worsening (Muir et al., Alzheimers Dement 2024; 20:33523363). |
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Hoffmann, et al. Loss of FOXP3 expression in natural human CD4+CD25+ regulatory T cells upon repetitive in
vitro stimulation. Eur J Immunol 2009; 39 (4): 1088-1097. |
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Gao et al., Dynamically modeling the effective range of IL-2 dosage in
the treatment of systemic lupus erythematosus. iScience 2022; 25: 104911 |
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Moon B-I., et al., Functional Modulation of Regulatory T Cells by IL-2. PLoS ONE 2015; 10(11) |
Exploratory Endpoint (Cognitive Function & Cerebrospinal Fluid (CSF) Biomarkers):
Although not powered for significance, the analyses of exploratory endpoints also showed encouraging results.
Cognitive Function: The Alzheimers Disease Assessment ScaleCognitive Subscale (ADAS-Cog14) scores on day 148 showed a slight improvement
following LD IL-2 q4wks administration (change from baseline: -0.450), vs. placebo, which worsened 4.480 from baseline, demonstrating a clinically meaningful difference
of 4.93 points (P=0.061). This cognitive effect was not observed in the LD IL-2 q2wks administration, which demonstrated a similar decline as placebo.
Stabilization of ADCS-CGIC (Alzheimers Disease Assessment Scale Cognitive Subscale) scores was observed in both the IL-2 q4wks and IL-2 q2wks groups on day 148 compared to the placebo arm, which declined from baseline.
The change from baseline in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) on Day 148 was 1.401 in the LD IL-2 q4wks group, 1.976 in the LD IL-2 q2wks group, and 1.893 in the placebo group, suggesting a 27% slower decline in CDR-SOB scores
following LD IL-2 q4wks treatment compared to the placebo group. These findings suggest that LD IL-2 q4wks may be an optimal dose for cognitive effects in mild to
moderate AD, which was the dose associated with a robust and sustained increase in Treg populations along with enhanced expression of the IL-2 receptor, CD25, and the Treg transcription factor, FoxP3.
Furthermore, the cognitive effect of this dose was associated with significant improvements in AD pathology in the CSF and stabilization of CSF inflammatory markers.
CSF Aß42: Low CSF Aß42 is universally associated with AD, and higher CSF Aß42 levels are independently associated with slowing
cognitive impairment and clinical decline. Increases in Aß42 may represent a mechanism of potential benefit of intervention. LD IL-2 q4wks treatment significantly improved CSF Aß42 levels after the
21-week treatment, compared to the placebo group (p = 0.045). LD IL-2 q2wks treatment did not significantly modify CSF Aß42 levels. These data further suggest the
dose-dependent effect of LD IL-2 on Treg cell populations (i.e. FOXP3) is associated with effects on CSF Aß42.
CSF Neurofilament Light Chain (NfL): NfL is increasingly recognized as a promising biomarker for neurodegeneration (neuronal/axonal degeneration) in
AD. Residing predominantly within myelinated axons, NfL is a cytoskeletal protein that plays a role in maintaining neuronal structural integrity and axonal caliber. Neuronal damage in neurodegenerative diseases releases NfL into the extracellular
space and eventually into the CSF, resulting in higher CSF NfL levels in AD.
CSF NfL levels remained stable following LD
IL-2 q4wks administration and almost reached statistical significance vs. placebo (which increased by 217.3pg/mL) (p=0.060). CSF NfL increased by 148.0 pg/mL in the LD
IL-2 q2wks arm. These data suggest the dose-dependent effect of LD IL-2 on Treg cell populations (i.e. FOXP3) is associated with effects on CSF NfL.
CSF Glial Fibrillary Acidic Protein (GFAP): GFAP is an astrocytic cytoskeleton intermediate filament
protein. GFAP is a marker of astrogliosis, which is the abnormal activation and proliferation of astrocytes. Astrogliosis is associated with Aß plaques in the prodromal stages of AD.
CSF GFAP levels showed a slight improvement following LD IL-2 q4wks administration (change from baseline: -214.1 pg/mL) and remained almost stable in the LD IL-2 q2wks group (change from baseline: 17.4 pg/mL), but increased by 1548.99 pg/mL in the placebo group.
About Alzheimers Disease
Alzheimers disease
is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimers disease accounts for up to 80% of dementia cases, affecting an estimated
5.7 million Americans. In more than 90% of people with Alzheimers, symptoms do not appear until after age 60. The incidence of the disease increases with age and doubles every 5 years beyond age 65. Alzheimers is a progressive
disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimers, individuals lose the ability to carry on a conversation and respond to their environment. It is
the sixth leading cause of death among all adults and the fifth leading cause for those aged 65 or older. On average, a person with Alzheimers lives 4 to 8 years after diagnosis but can live as long as 20 years, depending on other factors. 1,2
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Alzheimers Association (www.alz.org) |
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Centers for Disease Control and Prevention (www.cdc.gov) |
About COYA 301
COYA 301 is the companys
proprietary investigational low-dose interleukin-2 (IL-2) intended to enhance the anti-inflammatory function of regulatory T
cells (Tregs) and is designed for subcutaneous administration. COYA 301 is an investigational product not yet approved by the FDA or any other regulatory agency.
About COYA 302
COYA 302 is an investigational and
proprietary biologic combination therapy with a dual immunomodulatory mechanism of action intended to enhance the anti-inflammatory function of regulatory T cells (Tregs) and suppress the inflammation produced by activated monocytes and macrophages.
COYA 302 is comprised of proprietary low dose interleukin-2 (LD IL-2) and cytotoxic T lymphocyte-associated antigen 4 immunoglobulin fusion protein (CTLA-4 Ig) and is being developed for subcutaneous administration for the treatment of patients with ALS, FTD, and Parkinsons Diseases (PD). These mechanisms may have additive or synergistic effects.
In February of 2023, Coya announced results from a proof-of-concept,
open-label clinical study evaluating commercially available LD IL-2 and CTLA-4 Ig in a small cohort of patients with ALS conducted at the Houston Methodist Research
Institute (Houston, Texas) by Stanley Appel, M.D., Jason Thonhoff, M.D., Ph.D., and David Beers, Ph.D. This study was the
first-of-its-kind to
evaluate this dual-mechanism immunotherapy for the treatment of ALS. Patients in the study received investigational treatment for 48 consecutive weeks and were evaluated for safety and
tolerability, Treg function, serum biomarkers of oxidative stress and inflammation, and clinical functioning as measured by the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) scale.
During the 48-week treatment period, the therapy was well tolerated. The most common adverse event was mild
injection-site reactions. No patient discontinued the study, and no deaths or other serious adverse events were reported.
Patients disease
progression was measured using the ALSFRS-R scale, a validated rating tool for monitoring the progression of disability in patients with ALS. The mean (±SD)
ALSFRS-R scores at week 24 (33.75 ±3.3) and week 48 (32 ±7.8) after initiation of treatment were not statistically different compared to the ALSFRS-R score
at baseline (33.5 ±5.9), suggesting significant amelioration in the progression of the disease over the 48-week treatment period.
Treg suppressive function, expressed as a percentage of inhibition of proinflammatory T cell proliferation, showed a statistically significant increase over
the course of the treatment period and was significantly reduced at the end of the 8-week washout post-treatment period. Treg suppressive function at 24 weeks (79.9 ±9.6) and 48 weeks (89.5 ±4.1)
were significantly higher compared to baseline (62.1 ±8.1) (p<0.01), suggesting enhanced and durable Treg suppressive function over the course of treatment. In contrast, Treg suppressive function (mean ±SD) was significantly
decreased at the end of the 8-week washout period compared to end-of-treatment at week 48 (70.3 ±8.1 vs. 89.5 ±4.1,
p <0.05).
The study also evaluated serum biomarkers of inflammation, oxidative stress, and lipid peroxides. The available data up to 16 weeks after
initiation of treatment suggest a decrease in these biomarker levels, which is consistent with the observed enhancement of Treg function. The evaluation of the full biomarker data is ongoing.
COYA 302 is an investigational product not yet approved by the FDA or any other regulatory agency.
About Coya Therapeutics, Inc.
Headquartered in Houston,
TX, Coya Therapeutics, Inc. (Nasdaq: COYA) is a clinical-stage biotechnology company developing proprietary treatments focused on the biology and potential therapeutic advantages of regulatory T cells (Tregs) to target systemic
inflammation and neuroinflammation. Dysfunctional Tregs underlie numerous conditions, including neurodegenerative, metabolic, and autoimmune diseases, and this cellular dysfunction may lead to sustained inflammation and oxidative stress resulting in
a lack of homeostasis of the immune system.
Coyas investigational product candidate pipeline leverages multiple therapeutic modalities aimed at
restoring the anti-inflammatory and immunomodulatory functions of Tregs. Coyas therapeutic platforms include Treg-enhancing biologics, Treg-derived exosomes, and autologous Treg cell therapy.
COYA 302 the Companys lead biologic investigational product or Pipeline in a Product is a proprietary combination of COYA 301
(Coyas proprietary LD IL-2) and CTLA4-Ig for subcutaneous administration with a unique dual mechanism of action that is now being developed for the treatment of
Amyotrophic Lateral Sclerosis, Frontotemporal Dementia, Parkinsons Disease, and Alzheimers Disease. Its multi-targeted approach enhances the number and anti-inflammatory function of Tregs and simultaneously lowers the expression of
activated microglia and the secretion of pro-inflammatory mediators. This synergistic mechanism may lead to the re-establishment of immune balance and amelioration
of inflammation in a sustained and durable manner that may not be achieved by either low-dose IL-2 or CTLA4-Ig alone.
For more information about Coya, please visit www.coyatherapeutics.com
Forward-Looking Statements
This press release contains
forward-looking statements that are based on our managements beliefs and assumptions and on information currently available to management. Forward-looking statements include all statements other than statements of historical fact
contained in this presentation, including information concerning our current and future financial performance, business plans and objectives, current and future clinical and preclinical development activities, timing and success of our ongoing and
planned clinical trials and related data, the timing of announcements, updates and results of our clinical trials and related data, our ability to obtain and maintain regulatory approval, the potential therapeutic benefits and economic value of our
product candidates, competitive position, industry environment and potential market opportunities. The words believe, may, will, estimate, continue, anticipate,
intend, expect, and similar expressions are intended to identify forward-looking statements.
Forward-looking statements are
subject to known and unknown risks, uncertainties, assumptions and other factors including, but not limited to, those related to risks associated with the impact of COVID-19; the success, cost and timing of
our product candidate development activities and ongoing and planned clinical trials; our plans to develop and commercialize targeted therapeutics; the progress of patient enrollment and dosing in our preclinical or clinical trials; the ability of
our product candidates to achieve applicable endpoints in the clinical trials; the safety profile of our product candidates; the potential for data from our clinical trials to support a marketing application, as well as the timing of these events;
our ability to obtain funding for our operations; development and commercialization of our product candidates; the timing of and our ability to obtain and maintain regulatory approvals; the rate and degree of market acceptance and clinical utility
of our product candidates; the size and growth potential of the markets for our product candidates, and our ability to serve those markets; our commercialization, marketing and manufacturing capabilities and strategy; future agreements with third
parties in connection with the commercialization of our product candidates; our expectations regarding our ability to obtain and maintain intellectual property protection; our dependence on third party manufacturers; the success of competing
therapies or products that are or may become available; our ability to attract and retain key scientific or management personnel; our ability to identify additional product
candidates with significant commercial potential consistent with our commercial objectives; ; and our estimates regarding expenses, future revenue, capital requirements and needs for additional
financing.
We have based these forward-looking statements largely on our current expectations and projections about future events and trends that we
believe may affect our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. Moreover, we operate in a very competitive and rapidly changing environment, and
new risks may emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to
differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed herein may not occur and actual results could differ
materially and adversely from those anticipated or implied in the forward-looking statements. Although our management believes that the expectations reflected in our forward-looking statements are reasonable, we cannot guarantee that the future
results, levels of activity, performance or events and circumstances described in the forward-looking statements will be achieved or occur. We undertake no obligation to publicly update any forward-looking statements, whether written or oral, that
may be made from time to time, whether as a result of new information, future developments or otherwise.
Investor Contact
David Snyder, CFO
david@coyatherapeutics.com
CORE IR
Bret Shapiro
brets@coreir.com
561-479-8566
Media Contacts
For Coya Therapeutics:
Kati Waldenburg
media@coyatherapeutics.com
212-655-0924
*Trial funded by Alzheimer’s
Association, Gates Foundation, NIA with support by Coya Therapeutics Low Dose Interleukin-2 (LD IL-2) in Patients with Mild to Moderate Alzheimer’s Disease: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial An Investigator
Initiated Trial Led by Dr. Alireza Faridar at Houston Methodist Hospital* Exhibit 99.2
Cautionary Note of Forward-Looking
Statements and Disclaimers This presentation and the accompanying oral presentation contain “forward-looking” statements that are based on our management’s beliefs and assumptions and on information currently available to
management. Forward-looking statements include all statements other than statements of historical fact contained in this presentation, including information concerning our current and future financial performance, business plans and objectives,
current and future clinical and preclinical development activities, timing and success of our ongoing and planned clinical trials and related data, the timing of announcements, updates and results of our clinical trials and related data, our ability
to obtain and maintain regulatory approval, the potential therapeutic benefits and economic value of our product candidates, competitive position, industry environment and potential market opportunities. The words “believe,”
“may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” and similar expressions are intended to identify forward-looking statements. Forward-looking
statements are subject to known and unknown risks, uncertainties, assumptions and other factors including, but not limited to, those related to risks associated with the success, cost and timing of our product candidate development activities and
ongoing and planned clinical trials; our plans to develop and commercialize targeted therapeutics; the progress of patient enrollment and dosing in our preclinical or clinical trials; the ability of our product candidates to achieve applicable
endpoints in the clinical trials; the safety profile of our product candidates; the potential for data from our clinical trials to support a marketing application, as well as the timing of these events; our ability to obtain funding for our
operations; development and commercialization of our product candidates; the timing of and our ability to obtain and maintain regulatory approvals; the rate and degree of market acceptance and clinical utility of our product candidates; the size and
growth potential of the markets for our product candidates, and our ability to serve those markets; our commercialization, marketing and manufacturing capabilities and strategy; future agreements with third parties in connection with the
commercialization of our product candidates; our expectations regarding our ability to obtain and maintain intellectual property protection; our dependence on third party manufacturers; the success of competing therapies or products that are or may
become available; our ability to attract and retain key scientific or management personnel; our ability to identify additional product candidates with significant commercial potential consistent with our commercial objectives; and our estimates
regarding expenses, future revenue, capital requirements and needs for additional financing. We have based these forward-looking statements largely on our current expectations and projections about future events and trends that we believe may affect
our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. Moreover, we operate in a very competitive and rapidly changing environment, and new risks may
emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ
materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed herein may not occur and actual results could differ
materially and adversely from those anticipated or implied in the forward-looking statements. Although our management believes that the expectations reflected in our forward-looking statements are reasonable, we cannot guarantee that the future
results, levels of activity, performance or events and circumstances described in the forward-looking statements will be achieved or will occur. We undertake no obligation to publicly update any forward-looking statements, whether written or oral,
that may be made from time to time, whether as a result of new information, future developments or otherwise. The distribution of this presentation may also be restricted by law and persons into whose possession this presentation comes should inform
themselves about and observe any such restrictions. The recipient acknowledges that it is (a) aware that the U.S. securities laws prohibit any person who has material, non-public information concerning a company from purchasing or selling securities
of such company or from communicating such information to any other person under circumstances in which it is reasonably foreseeable that such person is likely to purchase or sell such securities, and (b) familiar with the Securities Exchange Act of
1934, as amended, and the rules and regulations promulgated thereunder (collectively, the “Exchange Act”), and that the recipient will neither use, nor cause any third party to use, this presentation or any information contained herein
in contravention of the Exchange Act, including, without limitation, Rule 10b-5 thereunder.
LD IL-2 Meets Primary and Secondary
Endpoints for Potential Treatment of Alzheimer’s Disease (AD) Cognition Stabilization (Exploratory Endpoint) Throughout Drug Treatment vs. Placebo: 2 out of 3 scales showed cognitive stabilization (ADAS-Cog14 and ADCS-CGIC)* for the
Administering 5-day LD IL-2 cycles every 4 weeks (LD IL-2 q4wk) regimen. On day 148, ADAS-Cog14 scores indicated a slight improvement of -0.450 points from baseline for the LD IL-2 administered every four weeks, compared to a worsening of 4.480
points from baseline in the placebo group. The 4.93 point ∆ suggests a clinically meaningful treatment effect. For patients with mild AD, a change of +3 on the ADAS-Cog has been described as clinically meaningful to assess worsening (Muir et
al., Alzheimer’s Dement. 2024;20:3352–3363). Safety (Primary Endpoint) and Regulatory T cell (Treg) Enhancement (Secondary Endpoint) Validated: Both dosing frequencies regimens of LD IL-2 studied (q4wk & q2wk) were safe and
well-tolerated. Administering LD IL-2 q4wk effectively, sustainably, and significantly expanded Treg numbers and function vs. placebo without off-target effects on other peripheral lymphocytes. Significant Improvement in central nervous system (CNS)
Amyloid Beta Pathology vs. Placebo: LD IL-2 q4wk significantly improved CSF Soluble Aβ42 levels (an index of amyloid pathology) vs. placebo. LD IL-2 among the first double-blind human trials to document subcutaneous Treg-enhancing therapy that
modifies beta-amyloid. Cerebral Spinal Fluid (CSF) Biomarker and Cognitive Effects Were Associated with Boosted Treg Function and Numbers vs. Placebo *The Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) was developed
in the 1980s to assess the level of cognitive dysfunction in Alzheimer’s disease. Clinical Global Impression of Change (CGIC) scales have been used as primary outcomes in phase 2 and 3 clinical trials for Alzheimer disease, mild cognitive
impairment, and for cognitive enhancers. A CGIC score is intended to be used as a measure of clinically meaningful change, as distinct from an instrument’s ability to assess any change.
LD IL-2 Study Results
The trial was designed to detect
significant differences in primary and secondary endpoints: LD IL-2 in Mild to Moderate Alzheimer’s Disease Overall Study Endpoints Primary Endpoint: Safety and Tolerability Secondary Endpoint: Treg Cell Populations No Serious Treatment
Related Adverse Events Reported All Patients Completed Trial Drug was Well Tolerated Significant change in Treg population following two different dosing frequency regimens of LD IL-2 treatment, compared to placebo Exploratory Endpoints: CSF
Biomarkers and Clinical Scales Clinical scales, including the ADAS-Cog Score Significant improvement in cerebrospinal (CSF) AD-related biomarker Soluble AB42 Assessment of peripheral/central inflammatory responses will be reported in the near
future) : 21 week or 148 day on-treatment period
LD IL-2 Overview of Study Design
Randomized, Double-Blind, Placebo-Controlled Trial (N=38) Treatment Groups LD IL-2 Q4wk: (n=9) LD IL-2 Q2wk: (n=10) Placebo: (n=19)
LD IL-2 Baseline Characteristics
Consistent Across Groups Characteristics of the participants at baseline Characteristics IL-2 q 4 wks (n=9) IL-2 q 2 wks (n=10) Placebo (n=19) Age-yr (MEAN±SD) 68.67±6.96 75.9±6.54 68.68±7.63 Sex- no. (%)
Female 6 (66%) 6 (60%) 11 (58%) Male 3 (33%) 4 (40%) 8 (42%) Race/ Ethnicity White/non-Hispanic 9 (100%) 9 (90%) 16 (85%) White/ Hispanic 0 (0%) 1 (10%) 2 (10%) Black 0 (0%) 0 (0%) 1 (5%) Education High school 0 (0%) 2
(20%) 2 (11%) College 6 (66%) 6 (60%) 12 (63%) Post-grad 3 (33%) 2 (20%) 5 (26%) APOE ε4 status — no. (%) Noncarrier 3 (33%) 2(22%) 6 (32%) Carrier-Heterozygotes 4 (44%) 6 (66%) 5 (26%) Carrier-Homozygotes 2 (22%) 2 (22%) 8 (42%)
Cognitive scales (MEAN±SD) MMSE score 18.78±2.95 18.50±2.84 17.37±3.47 CDR-SB score 4.72±3.19 4.30±2.35 4.84±3.04 ADAS-Cog score 31.24±12.84 30.75±8.54 36.04±15.39
All Patients Completed the Trial and
the Drug Was Well-Tolerated No Serious Adverse Events Were Reported LD IL-2 Primary Endpoint Safety & Tolerability
Secondary Endpoint Effective,
Sustainable, and Significant Expansion of Treg Populations LD IL-2 q4wks resulted in effective and sustainable expansion of Tregs without off-target effects : 21 week or 148 day on-treatment period
Exploratory Endpoints CSF
Modifications of Disease Pathology LD IL-2 q4wks resulted in stabilized or improved key CSF biomarkers related to AD Treg Percentage : 21 week or 148 day on-treatment period
Cognition Stabilized (LD IL2 Q4w)
Exploratory Endpoint Clinical Scales Demonstrating Cognitive Stabilization LD IL-2 q4wks resulted in slight improvement of ADAS-Cog Score, with stabilization or decreased rate of decline in key clinical scales for AD : 21 week or 148 day
on-treatment period Treg Percentage 0.45 Point Improvement (LD IL2 Q4w) ∆ of 4.93 points 27% Slower Decline (LD IL2 Q4w) No Change (LD IL2 Q4w)
LD IL-2 Study in Support of COYA
301 & 302 COYA 301 and 302 are investigational products, not yet approved by the US Food and Drug Administration
What’s Next? Reporting of
additional data from the LD IL-2 study documenting the effect of LD IL-2 treatment vs. placebo on systemic and CNS inflammatory markers (including peripheral blood cytokines and chemokines, and PET brain imaging) Discussions ongoing to advance other
combination strategies with COYA 301 (proprietary LD rh IL-2*) in larger cohorts of Alzheimer’s Disease patients, as well as for COYA 302 (proprietary LD rh IL-2 & CTLA-4 Ig Fusion Protein**) Planned clinical trials for COYA 302 in
Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD) *LD rh IL-2: low-dose recombinant human IL-2 / **CTLA-4 Ig: cytotoxic T lymphocyte-associated antigen-4-Ig
Pro-inflammatory Macrophages CD80
CTLA-4 Ig Dysfunctional Tregs FoxP3 FoxP3 LD IL-2 Tregs Increased Numbers and Suppressive Function Anti-Inflammatory Macrophages CD80 CTLA4-Ig LD IL-2 FoxP3 FoxP3 Functional Tregs + anti-inflammatory macrophages provide synergistic neuroprotection
Adaptive and Innate Immune-Mediated Neuroinflammation + CTLA-4 Ig COYA 302 Proprietary LD rh IL-2 + CTLA-4 Ig LD IL-2 Trial Tested Single Component of COYA 302 (proprietary LD rh IL-2 + CTLA-4 Ig) LD rh IL-2
COYA 302: Dual Immunomodulatory
Activity Against Inflammation LD IL-2 COYA 302 (Proprietary LD rh IL-2 + CTLA-4 Ig) The synergistic dual mechanism of COYA 302 increases Treg numbers and function, and suppresses pro-inflammatory myeloid cells (monocytes, macrophages) (Blood Brain
Barrier)
Takeaways We believe LD IL-2 study
results further validate the hypothesis that restoring the numbers and function of Tregs with systemic LD IL-2 alone targets neuroinflammation. We believe LD IL-2 study results indicate that systemically administered LD IL-2 directly mediates
significant disease-modifying pathology in the CNS. LD IL-2 study results increase our confidence in COYA 302 (proprietary LD rh IL-2 + CTLA-4 Ig Fusion Protein) outcomes in neurodegenerative diseases (including ALS and FTD). LD IL-2 study results
increase our confidence in the opportunity to combine COYA 301 (proprietary rh LD IL-2) with other complementary modalities targeting AD (Amyloid, Tau targeting agents). LD IL-2 study results increase our confidence to pursue additional
value-creating strategic partnership opportunities for COYA 301.
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