ANVS Annovis Bio Inc

Annovis Bio, Inc. (NYSE: ANVS), a late-stage clinical drug platform company developing transformative therapies to treat neurodegenerative diseases, including Alzheimer’s Disease (AD) and Parkinson’s Disease (PD) announced third quarter financial results for the period ended September 30, 2023, and reviewed recent accomplishments.

Third Quarter 2023 Highlights and New Developments

Clinical Updates

AD phase II/III study

Status of Phase II/III Alzheimer's Study
	Sept. 30	Nov. 8
Sites activated	50	54
Patients enrolled	210	305
Patients completed	44	115
Expected full enrollment	November 22

• This is a dose ranging trial of buntanetap (formerly known as posiphen or ANV401) in patients with mild to moderate Alzheimer’s Disease with a dosing treatment period of 12 weeks. 320 patients will be enrolled to receive either one of three doses of buntanetap or placebo. Its mechanism of action, favorable toxicology profile, and oral mode of administration distinguish buntanetap as superior to other AD drugs. Other drugs attempt to remove just one neurotoxic protein and, at best, have a minor effect. Buntanetap has been shown to normalize the synthesis of four neurotoxic proteins -Amyloid Beta, Tau, alpha Synuclein, and TDP43 - the culprits behind nerve cell degeneration and death. Buntanetap’s early trials have shown its ability to reverse the destructive effects that Alzheimer’s Disease has on thinking and memory.

• Annovis announced on October 12 the positive efficacy interim analysis and on October 30 the safety review by the Data and Safety Monitoring Board (DSMB). The efficacy and safety analysis reviewed by the DSMB recommended that Annovis continue the trial as originally designed. 

• The feedback from the DSMB about the AD trial was:
  • No drug-related SAEs (Serious Adverse Events)
  • Each AE (Adverse Event): less than 5 percent
  • Very low dropout rate: 4.7 percent

PD phase III study

Status of Phase III Parkinson's Study
	Sept. 30	Nov. 8
Sites activated	67	67
Patients enrolled	523	523
Patients completed	283	415
Full enrollment	June 7

• On June 3, Annovis announced it had reached full enrollment in the trial in a record nine months. Since the first patient was dosed in late August 2022, over 640 patients were screened and a total of 523 patients enrolled with 67 sites (43 in the United States and 24 in the European Union).  

• The phase III trial is a randomized, double-blind, placebo-controlled trial investigating the efficacy, safety, and tolerability of buntanetap for early PD patients on top of their standard of care. Patients are treated with 10 mg, 20 mg, or placebo for 6 months. By lowering levels of all the neurotoxic proteins, buntanetap improves axonal transport (the nerve cell’s information highway). Dysfunction of axonal transport has been shown to be the cause of nerve cell degeneration and, ultimately, death.

• The record enrollment and low drop-out rate in this trial are believed to be due to the drug’s benefits demonstrated in the phase I/II trial:
  • Improvements in both body and motor function
  • Improvements the speed of movements
  • Easy administration as a once daily pill
  • Safe and well-tolerated.

• The study is expected to conclude on December 1 with top-line assessment data at the end of January 2024.

• Annovis announced on June 20 the positive safety review by the Data and Safety Monitoring Board (DSMB) for its phase III trial of buntanetap for PD. The DSMB recommended that Annovis continue the trial as originally designed. 
• The feedback from the DSMB included:
  • No drug-related SAEs (serious adverse events) 
  • Each AE (adverse event) less than 2 percent
  • Dropout rate 6 percent – significantly below expectations
  • Patients enrolled well ahead of the expected timeline: 9 months to enroll 523 patients.

With planned enrollment completed and the DSMB endorsement, Annovis expects topline results at the end of January 2024.

Patents

• Annovis announced on June 27, 2023, the creation of a novel crystalline form of buntanetap (ANVS402) and the filing of a new composition of matter provisional patent with the U.S. Patent and Trademark Office (ANVS402 is covered by a composition of matter claim as well as multiple claims for chronic and acute neurodegenerative diseases and for neuropsychiatric indications).

• This novel composition of matter form, ANVS402, is essentially the same drug as the previous form but offers structural advantages, including better stability and higher purity.

• Annovis is in communication with the FDA about conducting a bridge study to allow further drug trial work to utilize the new, crystalline form, ANVS402.

• Approval of this patent will come with protection of ANVS402 and all its uses for a 20-year patent term. This significant time frame will enable Annovis to continue working on its robust pipeline, moving forward expeditiously toward developing novel drug therapies for many neurodegenerative diseases.

Financial Results (for the quarter ending September 30, 2023)

• Cash and cash equivalents were $6.4 million. Research and development expenses for the third quarter were $13.8 million, compared to $4.1 million for the same period in 2022. The increase was primarily the result of an increase of $10.0 million in clinical expenses, as Annovis incurred costs related to its phase III study in early Parkinson’s Disease (PD) and its phase II/III Alzheimer's Disease (AD) study.

• General and administrative expenses for the third quarter were $1.0 million, compared to $2.3 million for the same period in 2022. The decrease was primarily the result of a decrease of $1.2 million in stock-based compensation expenses, and a decrease in administrative expenses of $0.1 million.

• Annovis reported a net loss of $14.7 million for the quarter, compared to a net loss of $6.4 million for the same period in 2022.

Staff News

• Annovis was named one of the 20 PHL Inno 2023 Fire Awards Honorees. The awards recognize businesses, institutions and individuals driving the region’s innovation scene in the Philadelphia region forward. The honorees were featured in a special print edition of the Philadelphia Business Journal on August 11.
• Maria Maccecchini, Ph.D, Annovis founder, president, and CEO, has been named a 2023 Woman of Influence by the Philadelphia Business Journal. The award, which celebrates the impactful businesswomen shaping Greater Philadelphia, was awarded October 12, with a feature on the honorees the following day.

• Maria Maccecchini, Ph.D, Annovis founder, president, and CEO, presented at the ThinkEquity conference on October 20, 2023.

• Melissa Gaines has been promoted from vice president of clinical operations to senior vice president of clinical operations, responsible for leading all clinical project activities. Her extensive CNS experience spans from small phase I and II studies to large global phase III trials in Alzheimer’s disease, Parkinson’s disease, and other disorders. Gaines joined Annovis in 2022.

Annovis scientists spoke at events featuring novel approaches in neurodegenerative diseases with other leaders in the life sciences and pharmaceutical industries:

• Annovis presented three posters at the Alzheimer’s Association International Conference (AAIC) 2023 annual meeting held in Amsterdam, Netherlands, from July 16-20.
  • Dr. Fang presented two posters: “Do Mouse Data Lie? For Buntanetap, They Totally Predict Human Outcome,” and “Interim Analysis Results of Buntanetap in Phase III Clinical Studies in Alzheimer’s and Parkinson’s Disease.”
  • A third poster was presented by Don Elbert, Ph.D., associate professor of neurology, University of Washington School of Medicine, in collaboration with Annovis through the ongoing national Alzheimer’s Disease Cooperative Study (ADCS), titled “Stable Isotope Labelling Kinetics: Models and Methods to Evaluate APP Production Rates with Posiphen Treatment in the DISCOVER Clinical Trial.”
  • The posters’ combined findings tell the story of an exceptionally promising treatment for neurodegenerative diseases such as AD and PD.
    • First, in a mouse model of AD, buntanetap inhibits toxic proteins in the brain, improves axonal transport, lowers inflammation, and protects nerve cells from dying, all of which is associated with improved movement and cognition. 
    • Second, these findings are also replicated in all the human AD and PD phase I and II trials to date.
    • Third, in both mice and humans, there is also evidence of a dose-response relationship between the drug dose administered and the inhibition of the neurotoxic proteins - important in determining the optimal dosage in future phase II and III trials.

Message from Dr. Maria

It is tremendously rewarding and important that our drug is safe, well-tolerated, and easily administered as a once-a-day pill. The only two FDA-approved drugs for Alzheimer’s Disease require I.V. infusions and repeated brain imaging, and have well-documented, serious side effects that manifest as brain swelling or brain bleeding. As buntanetap continues to show significant progress through clinical trials, we remain on course and anticipate having topline data with good news to share on our PD study around the end of January 2024, and on our AD study in Q1 of 2024.

The positive momentum we’re building with this drug is reflected in the more than 800% annual growth rate of our company over the last two years. The crystalline form of buntanetap will allow us to have a new 20-year patent protection for Annovis Bio to continue to move forward. There’s growing interest and excitement in the scientific and investment communities about our drug’s very real potential to not just alleviate devastating neurodegenerative disease symptoms but ultimately change the course of the diseases themselves. –Maria L. Maccecchini, Ph.D., Annovis Founder, President, and CEO 

About BuntanetapBuntanetap (previously known as ANVS401 or posiphen) is an oral translational inhibitor of neurotoxic aggregating proteins (TINAPs), whose mode of action leads to a lower level of neurotoxic proteins and consequently less toxicity in the brain. In a phase I/II clinical trial in AD and PD patients, buntanetap was shown to be well-tolerated and its pharmacokinetics were found to be in line with levels measured earlier in humans, meeting both the primary and secondary endpoints. Additionally, exploratory endpoints were also met, as treatment with buntanetap resulted in statistically significant improvement in motor function in PD patients and cognition in AD patients. Presently buntanetap is being studied in a phase III study in early PD patients with study results expected in one to two months and in a phase II/III study in mild to moderate AD patients with study results expected in Q1 2024.

About Annovis Bio, Inc.Headquartered in Berwyn, Pennsylvania, Annovis Bio, Inc. is a clinical-stage, drug platform company addressing neurodegeneration, such as Alzheimer’s Disease (AD), Parkinson’s Disease (PD), and other chronic neurodegenerative diseases. It is believed to be the only company developing a drug for both AD and PD designed to inhibit more than one neurotoxic protein to restore axonal and synaptic activity. By improving brain function, the company’s goal is to treat memory loss and dementia associated with AD as well as body and brain dysfunction associated with PD. Annovis conducted two phase I/II studies: one in AD patients and one in both AD and PD patients. In the AD/PD study buntanetap showed improvements in cognition in AD as well as movement and function in PD patients. Annovis is nearing completion of their phase III PD study and phase II/III study in AD, with study results expected in the next one and three months, respectively. For more information on Annovis Bio, please visit the Company's website www.annovisbio.com and follow us on LinkedIn, Facebook, Twitter and Threads

Forward-Looking StatementsThis press release contains "forward-looking" statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements other than statements of historical fact are statements that could be deemed forward-looking statements. The Company advises caution in reliance on forward-looking statements. Forward-looking statements include, without limitation, the Company's plans related to clinical trials. These statements involve known and unknown risks, uncertainties and other factors that may cause actual results to differ materially from those implied by forward-looking statements, including regarding patient enrollment, the effectiveness of buntanetap and the timing, effectiveness, and anticipated results of the Company's clinical trials evaluating the efficacy, safety, and tolerability of buntanetap. See also additional risk factors set forth in the Company's periodic filings with the SEC, including, but not limited to, those risks and uncertainties listed in the section entitled "Risk Factors," in the Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed with the SEC. All forward-looking statements in this press release are based on information available to the Company as of the date of this filing. The Company expressly disclaims any obligation to update or alter its forward-looking statements, whether as a result of new information, future events or otherwise, except as required by applicable law.

Investor Contact:Maria L. Maccecchini, Ph. D.maccecchini@annovisbio.com

SOURCE: Annovis Bio