You should read the following discussion and analysis of our financial condition
and results of operations together with and our financial statements and the
related notes appearing elsewhere in this Quarterly Report on Form 10-Q. In
addition to historical information, this discussion and analysis contains
forward-looking statements that involve risks, uncertainties and assumptions.
Our actual results may differ materially from those discussed below. Factors
that could cause or contribute to such differences include, but are not limited
to, those identified below, and those discussed in the section titled "Risk
Factors" included in our Annual Report on Form 10-K for the fiscal year ended
December 31, 2019. All amounts in this report are in U.S. dollars, unless
otherwise noted.
Overview
We are a clinical-stage biopharmaceutical company incorporated in May 2017
focused on developing new generation therapies for dermatological disorders. We
believe that our pipeline has the potential to improve the quality of life for
patients suffering from indications including atopic dermatitis (also known as
eczema), chronic wounds, psoriasis, asthma and acne.
Our primary asset is a sublicense agreement with Chelexa Biosciences, Inc.
("Chelexa") which we entered into on May 26, 2017, as amended on August 22, 2018
and August 29, 2018, pursuant to which Chelexa has granted us an exclusive
sublicense to make, use, have made, import, offer for sale, and sell products
based upon or involving the use of (i) topical compositions comprising a zinc
chelator and gentamicin and (ii) zinc chelators to inhibit biofilm formation
(the "BioLexa Platform" or "BioLexa"), which rights were originally granted to
Chelexa pursuant to an exclusive license agreement with the University of
Cincinnati. The license enables us to develop the platform for any indications
in humans. Our initial focus will be on the treatment of eczema through the
application of a topical cream. Although our initial focus will be on the
treatment of eczema, we intend to develop a second topical cream which, upon
application, is intended to reduce post-procedure infections, accelerate healing
and improve clinical outcomes for patients undergoing aesthetic dermatology
procedures. In addition, we conducted an initial pilot study on the efficacy of
BioLexa to accelerate diabetic wound healing and intend to conduct additional
studies with respect to the regenerative effects of the BioLexa Platform in the
context of chronic diabetic ulcers, with and without substantial bacterial
burden. The BioLexa Platform combines a U.S. Food and Drug Administration
("FDA") approved zinc chelator with one or more approved antibiotics in a
topical dosage form to address unchecked eczema flare-ups by preventing the
formation of infectious biofilms and the resulting clogging of sweat ducts which
trigger symptoms. It is the first product candidate intended to prevent the
symptom triggering flare-ups rather than simply treating symptoms when they
occur.
We intend to initially use the BioLexa Platform to develop two different topical
cream products: (i) a product to treat eczema and (ii) a product that reduces
post-procedure infections, accelerates healing and improves clinical outcomes
for patients undergoing aesthetic dermatology procedures. Eczema is a disease
that results in inflammation of the skin and is characterized by rash, red skin,
and itchiness. Eczema is also referred to as atopic dermatitis. We are
concentrating our effort and resources to develop the BioLexa Platform,
utilizing our novel formulation and approach for these two markets.
The BioLexa Platform has achieved positive results in its initial pre-clinical
studies conducted at the University of Miami. BioLexa's formulation is a new
topical dosage form "repurposing" the antibiotic, enabling it to be developed
for use in patients following a special regulatory pathway codified in Section
505(b)(2) of the FDA rules. Section 505(b)(2) of the Federal Food, Drug and
Cosmetic Act was enacted to enable sponsors to seek New Drug Application ("NDA")
approval for novel repurposed drugs without the need for such sponsors to
undertake time consuming and expensive pre-clinical safety studies and Phase 1
safety studies. Proceeding under this regulatory pathway, we will be able to
rely upon all of the publicly available safety and toxicology data with respect
to gentamicin and zinc chelator in our FDA submissions. We will be required to
conduct a Phase 2 study to show the safety of the combination in humans and
after such Phase 2 study will be required to proceed to Phase 3 pivotal clinical
trials. We believe that this path will dramatically reduce the required clinical
development effort, costs and risks as compared to what would be required of us
if we were required to conduct pre-clinical safety, toxicology and animal
studies together with Phase 1 human safety trials required for new chemical
entities which are not eligible to be reviewed pursuant to the Section 505(b)(2)
regulatory pathway. We estimate that by using the Section 505(b)(2) regulatory
pathway, that the clinical development process may be five to six years shorter
than is required for a new chemical entity, and the FDA approval process may be
six to nine months shorter than the typical eighteen month period, which we
believe may result in lower development costs and shorter development time. As
of the date hereof, we have not submitted an NDA to the FDA. In September 2018,
we attended the first of a planned series of meetings with the FDA to review the
requirements for submission and activation of an investigational new drug
application ("IND") with respect to the BioLexa Platform for use in eczema. In
preparation for such pre-IND meeting, we prepared and presented to the FDA our
proposed Phase 2 clinical trial plan for the treatment of eczema in patients
over the age of one year old. As part of our pre-IND meeting, the FDA provided
us with general guidance with respect to specific animal studies, dosing
schedules and suggested human safety studies before we commence clinical trials
in pediatric or adult patients. We are currently investigating multiple
potential venues for conducting such trial both in and outside of the U.S. We
have engaged Camargo Pharmaceutical Services, LLC ("Camargo") to assist us with
the FDA process required for Section 505(b)(2) applications and with the
evaluation of potential clinical trial venues for the proof of concept study
should we determine to undertake such study. Specifically, Camargo has provided
and will continue to provide advice and guidance relative to the IND preparation
phase for the BioLexa Platform. Camargo will assist us with the refinement of
our non-clinical, clinical, clinical pharmacology and biopharmaceutics strategy
incorporating the preliminary feedback we received from the FDA during our
pre-IND meeting.
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We believe that the key elements for our market success with respect to BioLexa
include:
? the proprietary formulation of two FDA-approved drugs to treat bacterial
proliferation reduces development time and costs by giving us the ability to
rely on safety and efficacy data from the two approved drugs;
? our proprietary formulation is not a topical corticosteroid, and may not be
subject to the same FDA black box warning issues as most commonly prescribed
treatments currently in use; and
? a recent peer-reviewed publication titled "Staphylococcal Bacteria May Cause
Eczema, Study Reveals", published by Dr. Herbert B. Allen, highlights that
staph-induced biofilms are the root cause of flare-ups in eczema. Our BioLexa
product candidate has been demonstrated to prevent the formation of these
biofilms with the promise of delaying or completely arresting flare-ups,
rather than merely treating symptoms of a flare-up already underway.
In addition to our sublicense agreement with Chelexa, we entered into the
following agreements:
? an exclusive license agreement with the University of Cincinnati for a
patented, novel genetic marker for food allergies. The genetic marker licensed
by us from the University of Cincinnati may be used to (i) identify at risk
infants in predicting food allergies, including peanut and milk allergies,
(ii) identify a person's predisposition to an allergic reaction, thereby
avoiding such reaction and (iii) determine an individual's propensity to
develop AD, such as eczema. We intend to utilize the genetic marker for
purposes of determining an individual's propensity to develop eczema as well
as to identify and treat allergies in at-risk infants.
? an exclusive sublicense agreement (the "Sublicense Agreement") with Zylö
Therapeutics, Inc. ("Zylö") pursuant to which Zylö granted us an exclusive
sublicense to the Licensed Patent Rights (as defined in the Sublicense
Agreement) and the Licensed Technology (as defined in the Sublicense
Agreement) to, among other things, develop, make and sell the Licensed
Products (as defined in the Sublicense Agreement) and to practice the Licensed
Technology in the United States and Canada for any and all therapeutic uses
related to lupus in human beings, subject to the Field Expansion Rights (as
defined in the Sublicense Agreement).
? a license agreement with North Carolina State University ("NCSU") pursuant to
which NCSU granted us an exclusive license to, among other things, develop,
make, use, offer and sell certain licensed products throughout the world with
respect to NCSU's exon skipping approach for treating allergic diseases.
? a patent license agreement with The George Washington University ("GWU")
pursuant to which GWU granted us a license to certain patent rights to, among
other things, make, use, offer and sell certain licensed products throughout
the world with respect to aprepitant as used in treating side effects from
drugs used for the treatment of cancer.
In order to generate revenue from our product candidates, we will need to sell
our product candidates either through distribution partnerships or through our
own sales efforts. Prior to selling our product candidates, we will need to
receive FDA approval of our NDA for each indication that we intend to treat. The
first indication we are seeking approval for is the BioLexa Platform for
treating eczema. We intend to submit our NDA for such indication by the end of
2021 with approval of such NDA anticipated to be in 2022; however, no assurances
can be given that we will receive approval of the NDA in a timely manner, if at
all.
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Recent Developments
The outbreak of the novel Coronavirus (COVID-19) has evolved into a global
pandemic, and the Coronavirus has spread to many regions of the world. The
extent to which the Coronavirus impacts our business and operating results will
depend on future developments that are highly uncertain and cannot be accurately
predicted, including new information that may emerge concerning the Coronavirus
and the actions to contain the Coronavirus or treat its impact, among others.
As a result of the continuing spread of the Coronavirus, certain aspects of our
business operations have been delayed, and we may be subject to additional
delays or interruptions. Specifically, as a result of the
shelter-in-place orders and other mandated local travel restrictions, among
other things, the research and development activities of certain of our partners
have been affected, resulting in delays to our clinical trials, and we can
provide no assurance as to when such trials will resume at this time.
Results of Operations
Comparison of the Three Months Ended March 31, 2020 and 2019
Operating Costs and Expenses
Research and Development Expenses
For the three months ended March 31, 2020, research and development expenses
were approximately $0.7 million, of which approximately $40,000 was related to
license acquired and approximately $0.6 million was related to other research
and development expenses.
For the three months ended March 31, 2019, research and development expenses
were approximately $0.1 million, of which $10,000 was related to license
acquired and approximately $0.1 million was related to other research and
development expenses.
We expect our research and development activities to increase as we develop our
existing product candidate and potentially acquire new product candidates,
reflecting increasing costs associated with the following:
? employee-related expenses, which include salaries and benefits, and rent
expenses;
? license fees and milestone payments related to in-licensed products and
technology;
? expenses incurred under agreements with contract research organizations,
investigative sites and consultants that conduct our clinical trials and a
substantial portion of our preclinical activities;
? the cost of acquiring and manufacturing clinical trial materials; and
? costs associated with non-clinical activities, and regulatory approvals.
Compensation, Professional Fees, Rent and Other ("General and Administrative
Expenses")
For the three months ended March 31, 2020, General and Administrative Expenses
were approximately $1.1 million, which primarily consisted of approximately $0.2
million related to payroll expenses and stock-based compensation, approximately
$0.8 million for professional fees and approximately $0.2 million for other
expenses.
For the three months ended March 31, 2019, General and Administrative Expenses
were approximately $0.7 million, which primarily consisted of approximately $0.3
million related to payroll expenses and stock-based compensation, and
approximately $0.3 million for professional fees.
We anticipate that our General and Administrative Expenses will increase in
future periods, reflecting continued and increasing costs associated with:
? support of our research and development activities;
? stock compensation granted to key employees and non-employees;
? support of business development activities; and
? increased professional fees and other costs associated with the regulatory
requirements.
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Liquidity and Capital Resources
We have incurred substantial operating losses since inception, and expect to
continue to incur significant operating losses for the foreseeable future and
may never become profitable. As of March 31, 2020, we had cash of approximately
$4.3 million, marketable securities of approximately $0.5 million, working
capital of approximately $4.4 million and an accumulated deficit of
approximately $14.0 million.
Cash Flows from Operating Activities
For the three months ended March 31, 2020, net cash used in operations was
approximately $1.6 million, which primarily resulted from a net loss of
approximately $1.8 million, partially offset by changes in operating assets and
liabilities of approximately $0.2 million.
For the three months ended March 31, 2019, net cash used in operations was $0.8
million, which primarily resulted from a net loss of approximately $0.8 million.
Cash Flows from Investing Activities
For the three months ended March 31, 2020, net cash provided by investing
activities was approximately $10,000, which was related to the sale of
marketable securities of $300,000, partially offset by the purchase of research
and development licenses of approximately $40,000 and the purchase of investment
of $250,000.
For the three months ended March 31, 2019, net cash used in investing activities
was $10,000, which was related to the purchase of research and development
licenses.
Cash Flows from Financing Activities
For the three months ended March 31, 2020, net cash provided by financing
activities was approximately $4.2 million. The cash provided by financing
activities primarily resulted from approximately $4.2 million in net proceeds
from the issuance of common stock and warrants.
For the three months ended March 31, 2019, net cash provided by financing
activities was $5.9 million, including $0.2 million restricted cash, from the
net proceeds in our initial public offering ("IPO"). The $0.2 million restricted
cash has been deposited into a third-party escrow account in order to provide a
source of funding for certain indemnification obligations we have pursuant to
our Qualified Independent Underwriter Engagement Agreement.
On February 20, 2019, we closed the IPO pursuant to which we issued 1,250,000
shares of our common stock for net proceeds of approximately $5.8 million, after
deducting underwriting discounts and commissions and offering expenses.
Off-Balance Sheet Arrangements; Commitments and Contractual Obligations
As of March 31, 2020, we did not have any off-balance sheet arrangements as
defined in Item 303(a)(4)(ii) of Regulation S-K and did not have any commitments
or contractual obligations.
JOBS Act
On April 5, 2012, the Jumpstart Our Business Startups Act of 2012 (the "JOBS
Act") was enacted. Section 107 of the JOBS Act provides that an "emerging growth
company" can take advantage of the extended transition period provided in
Section 7(a)(2)(B) of the Securities Act for complying with new or revised
accounting standards. In other words, an "emerging growth company" can delay the
adoption of certain accounting standards until those standards would otherwise
apply to private companies.
We have chosen to take advantage of the extended transition periods available to
emerging growth companies under the JOBS Act for complying with new or revised
accounting standards until those standards would otherwise apply to private
companies provided under the JOBS Act. As a result, our financial statements may
not be comparable to those of companies that comply with public company
effective dates for complying with new or revised accounting standards.
Subject to certain conditions set forth in the JOBS Act, as an "emerging growth
company," we intend to rely on certain of these exemptions, including, without
limitation, (i) providing an auditor's attestation report on our system of
internal controls over financial reporting pursuant to Section 404(b) of the
Sarbanes-Oxley Act and (ii) complying with any requirement that may be adopted
by the Public Company Accounting Oversight Board regarding mandatory audit firm
rotation or a supplement to the auditor's report providing additional
information about the audit and the financial statements, known as the auditor
discussion and analysis. We will remain an "emerging growth company" until the
earliest of (i) the last day of the fiscal year in which we have total annual
gross revenues of $1.07 billion or more; (ii) the last day of our fiscal year
following the fifth anniversary of the date of the IPO; (iii) the date on which
we have issued more than $1 billion in nonconvertible debt during the previous
three years; or (iv) the date on which we are deemed to be a large accelerated
filer under the rules of the SEC.
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