Quarterlytics / Healthcare / Biotechnology / AEterna Zentaris Inc.

AEterna Zentaris Inc.

aezs · TSX Healthcare
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Ticker aezs
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Industry Biotechnology
Employees 11-50
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FY2023 Annual Report · AEterna Zentaris Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 20-F

☐☐  Registration Statement Pursuant to Section 12(b) or 12(g) of The Securities Exchange Act of 1934

OR

X Annual Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934 for the fiscal year ended December 31, 2023

☐☐  Transition Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934

OR

OR

☐☐  Shell Company Report Pursuant to Section 13 or 15(d) of The Securities Exchange Act of 1934

Commission file number 001-38064

AETERNA ZENTARIS INC.
(Exact Name of Registrant as Specified in its Charter)

Not Applicable
(Translation of Registrant’s Name into English)

Canada
(Jurisdiction of Incorporation)

c/o Norton Rose Fulbright Canada, LLP, 222 Bay Street, Suite 3000, PO Box 53, Toronto ON M5K 1E7
(Address of Principal Executive Offices)

Klaus Paulini
Telephone: +49-69-426020
E-mail: KPaulini@aezsinc.com
Weismüllerstr. 50
Frankfurt am Main, Germany
D-60314
(Name, Telephone, E-mail and Address of Company Contact Person)

Securities registered or to be registered pursuant to Section 12(b) of the Act:

Title of Each Class
Common Shares

Trading Symbol(s)
AEZS

Name of Each Exchange on Which Registered
NASDAQ Capital Market
Toronto Stock Exchange

Securities registered or to be registered pursuant to Section 12(g) of the Act: NONE

Securities for which there is a reporting obligation pursuant to Section 15(d) of the ACT: NONE

Indicate the number of outstanding shares of each of the issuer’s classes of capital or common stock as at the close of the period covered by the annual report: 4,855,876 Common
Shares as at December 31, 2023.

Indicate by check mark whether the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No : X

If this report is an annual or transition report, indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Securities Exchange Act of
1934. Yes ☐ No X

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12
months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes X No ☐

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T
(§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files). Yes X No ☐

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or an emerging growth company. See definitions of "accelerated
filer,” "large accelerated filer,” and "emerging growth company” in Rule 12b-2 of the Exchange Act. (Check one):

Large accelerated filer ☐ Accelerated filer ☐ Non-accelerated filer X Emerging growth company ☐

If an emerging growth company that prepares its financial statements in accordance with U.S. GAAP, 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. ☐

† The term "new or revised financial accounting standard” refers to any update issued by the Financial Accounting Standards Board to its Accounting Standards Codification
after April 5, 2012.

Indicate by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial
reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report. ☐

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the correction
of an error to previously issued financial statements. ☐

Indicate  by  check  mark  whether  any  of  those  error  corrections  are  restatements  that  required  a  recovery  analysis  of  incentive-based  compensation  received  by  any  of  the
registrant’s executive officers during the relevant recovery period pursuant to § 240.10D-1(b). ☐

Indicate by check mark which basis of accounting the registrant has used to prepare the financial statements included in this filing:

US GAAP ☐ International Financial Reporting Standards as issued by the Other ☐

International Accounting Standards Board X

If "other” has been checked in response to the previous question, indicate by check mark which financial statement item the registrant has elected to follow. Item 17 ☐ Item 18 ☐

If this is an annual report, indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). Yes ☐ No X

Basis of Presentation

General

Except where the context otherwise requires, all references in this Annual Report on Form 20-F to the "Company”, "Aeterna Zentaris”, "Aeterna”, "we”, "us”, "our” or similar
words or phrases are to Aeterna Zentaris Inc. and its subsidiaries, taken together. In this Annual Report on Form 20-F, references to "$” and "U.S.$” are to United States (" U.S.”)
dollars, references to "CAN$” are to Canadian dollars and references to "EUR” and "€” are to euros, and references to "£” are to British Pounds. Unless otherwise indicated, all
information contained in this Annual Report on Form 20-F are presented as of December 31, 2023.

This Annual  Report  on  Form  20-F  also  contains  certain  information  regarding  products  or  product  candidates  that  may  potentially  compete  with  our  products  and  product
candidates, and such information has been primarily derived from information made publicly available by the companies developing such potentially competing products and
product candidates and has not been independently verified by Aeterna Zentaris.

Special Note on Forward-Looking Statements

This Annual Report on Form 20-F and the documents incorporated herein by reference contain "forward-looking information” as defined in Canadian securities laws and "forward-
looking statements” made pursuant to the safe-harbor provision of the U.S. Private Securities Litigation Reform Act of 1995, which reflect our current expectations regarding future
events. All statements other than statements of historical facts included in or incorporated by reference into this Annual Report on Form 20-F, under the caption "Key Information
—Risk Factors” filed with the relevant Canadian securities regulatory authorities and with the U.S. Securities and Exchange Commission ("SEC”) that address activities, events or
developments that we expect, believe or anticipate will or may occur in the future are forward-looking statements. Our forward-looking statements may relate to the Company’s
future outlook and anticipated events or results, and may include statements regarding the financial position, business strategy, growth strategy, budgets, operations, financial
results, taxes, dividends, plans and objectives of the Company. Particularly, statements regarding future results, performance, achievements, prospects or opportunities of the
Company are forward-looking statements. In some cases, forward-looking statements can be identified by the use of forward-looking terminology such as "plans”, "expects” or
"does not expect”, "is expected”, "budget”, "scheduled”, "estimates”, "forecasts”, "intends”, "anticipates” or "does not anticipate” or "believes”, or variations of such words and
phrases or state that certain actions, events or results "may”, "could”, "would”, "might”, "will” or "will be taken”, "occur” or "be achieved” or the negative of these words or other
words and terms of similar meaning.

Certain forward-looking statements contained herein about prospective results of operations, financial position or cash flows may constitute a financial outlook. Such statements
are based on assumptions about future events, are given as at the date hereof and are based on economic conditions, proposed courses of action and management’s assessment
of the relevant information currently available. Management of the Company has approved the financial outlook as of the date hereof. Readers are cautioned that such financial
outlook information contained herein should not be used for purposes other than for which it is disclosed herein.

Forward-looking statements are based on the opinions and estimates of the Company as of the date of this Annual Report, and they are subject to known and unknown risks,
uncertainties, assumptions and other factors that may cause the actual results, level of activity, performance or achievements to be materially different from those expressed or
implied by such forward-looking statements, including but not limited to the factors described in "Risk Factors” and those relating to: Aeterna’s expectations with respect to the
DETECT-trial (including regarding the enrollment of subjects in the DETECT-trial, the application of the macimorelin growth hormone stimulation tests and the completion of the
DETECT-trial); Aeterna’s expectations regarding conducting pre-clinical research to identify and characterize an AIM Biologicals-based development candidate for the treatment
of NMOSD as well as Parkinson’s disease, and developing a manufacturing process for selected candidates; Aeterna’s expectations regarding conducting assessments in relevant
Parkinson’s disease models; The University of Queensland undertaking a subsequent investigator initiated clinical trial evaluating macimorelin as a potential therapeutic for the
treatment of ALS and Aeterna formulating a pre-clinical development plan for same; the commencement of Aeterna’s formal pre-clinical development of AEZS-150 in preparation
for a potential IND filing for conducting the first in-human clinical study of AEZS-150; the impacts associated with the termination of the license agreement with Novo Nordisk
Healthcare AG; the expected outcomes and benefits of the Arrangement (as defined herein); the ability of Aeterna and Ceapro Inc. ("Ceapro”) to complete the Arrangement on the
terms described herein, or at all; the anticipated timeline for the completion of the Arrangement; and receipt of regulatory and stock exchange approvals (including approval of the
continued listing of Aeterna’s common shares on the Nasdaq and the TSX).

2

Forward-looking statements involve known and unknown risks and uncertainties, and other factors which may cause the actual results, performance or achievements stated herein
to be materially different from any future results, performance or achievements expressed or implied by the forward-looking information.  Such risks and uncertainties include,
among others: Aeterna’s and Ceapro’s present and future business strategies; operations performance within expected ranges; anticipated future cash flows; local and global
economic conditions and the environment in which the combined operations will operate in the future; anticipated capital and operating costs; and the availability and timing of
required stock exchange, regulatory and other approvals for the completion of the Arrangement; our reliance on the success of the pediatric clinical trial in the European Union and
U.S. for Macrilen™ (macimorelin); the commencement of the DETECT-trial may be delayed or we may not obtain regulatory approval to initiate that study; we may be unable to
enroll the expected number of subjects in the DETECT-trial and the result of the DETECT-trial may not support receipt of regulatory approval in CGHD; results from ongoing or
planned pre-clinical studies of macimorelin by the University of Queensland or for our other products under development may not be successful or may not support advancing the
product to human clinical trials; our ability to raise capital and obtain financing to continue our currently planned operations; our now heavy dependence on the success of
Macrilen™ (macimorelin) and related out-licensing arrangements and the continued availability of funds and resources to successfully commercialize the product; our ability to
enter into a new license agreement or similar arrangement following the termination of the license agreement with Novo Nordisk AG; the long-term changes to markets due to the
global pandemic of COVID-19, including increases in materials costs and supply chain difficulties and the corresponding impacts on consumer behavior and the potential effects
on our planned operations; our ability to enter into out-licensing, development, manufacturing, marketing and distribution agreements with other pharmaceutical companies and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
keep such agreements in effect; and our ability to continue to list our common shares on the NASDAQ Capital Market ("NASDAQ”) or the Toronto Stock Exchange ("TSX”).

These risk factors are not intended to represent a complete list of the risk factors that could affect the Company. These factors and assumptions, however, should be considered
carefully. More detailed information about these and other factors is included under "Risk Factors” in this Annual Report on Form 20-F and in other documents incorporated herein
by reference.

However, we advise you to review any further disclosures we make on related subjects in our reports on Form 6-K filed or furnished to the SEC and in our other public disclosure
filed under our profile on SEDAR+ at www.sedarplus.com.

Although the Company has attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there
may be other factors that cause results not to be as anticipated, estimated or intended. Many of these factors are beyond our control. There can be no assurance that such
statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements, particularly in light of the ongoing and
developing lingering effects of the COVID-19 pandemic and its resulting impacts on the global economy and its uncertain impact on the Company’s business. Accordingly, readers
should not place undue reliance on forward-looking statements. The Company does not undertake to update any forward-looking statements contained herein, except as required
by applicable securities laws. New factors emerge from time to time, and it is not possible for the Company to predict all of these factors, or to assess in advance the impact of each
such factor on the Company’s 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 statement.

3

TABLE OF CONTENTS

GENERAL INFORMATION

PART I
Item 1.

Item 2.

Item 3.

Item 4.

Item 4A.
Item 5.

Item 6.

Item 7.

Item 8.

Item 9.

Identity of Directors, Senior Management and Advisers
A. Directors and senior management
B. Advisers
C. Auditors
Offer Statistics and Expected Timetable
A. Offer statistics
B. Method and expected timetable
Key Information
A. [Reserved]
B. Capitalization and indebtedness
C. Reasons for the offer and use of proceeds
D. Risk factors
Information on the Company
A. History and development of the Company
B. Business overview
C. Organizational structure
D. Property and equipment
Unresolved Staff Comments
Operating and Financial Review and Prospects
A. Operating results
B. Liquidity, cash flows and capital resources
C. Research and development, patents and licenses, etc.
D. Trend information
E. Critical Accounting Estimates
Directors, Senior Management and Employees
A. Directors and senior management
B. Compensation
C. Board practices
D. Employees
E. Share ownership
Major Shareholders and Related Party Transactions
A. Major shareholders
B. Related party transactions
C. Interests of experts and counsel
Financial Information
A. Consolidated statements and other financial information
B. Significant changes
The Offer and Listing
A. Offer and listing details
B. Plan of distribution
C. Markets
D. Selling shareholders
E. Dilution
F. Expenses of the issue

Item 10.

Additional Information
A. Share capital
B. Memorandum and articles of association
C. Material contracts
D. Exchange controls
E. Taxation

4

Page
Responsibility

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Item 11.
Item 12.

F. Dividends and paying agents
G. Statement by experts
H. Documents on display
I. Subsidiary information
Quantitative and Qualitative Disclosures About Market Risk
Description of Securities Other than Equity Securities
A. Debt securities
B. Warrants and rights
C. Other securities
D. American depositary shares

PART II
Defaults, Dividend Arrearages and Delinquencies
Item 13.
Material Modifications to the Rights of Security Holders and Use of Proceeds
Item 14.
Controls and Procedures
Item 15.
Audit Committee Financial Expert
Item 16A.
Code of Ethics
Item 16B.
Principal Accountant Fees and Services
Item 16C.
Exemptions from the Listing Standards for Audit Committees
Item 16D.
Purchases of Equity Securities by the Issuer and Affiliated Purchasers
Item 16E.
Change in Registrant’s Certifying Accountant
Item 16F.
Item 16G.
Corporate Governance
Item 16H. Mine Safety Disclosure
Item 16I.
Item 16J.
Item 16K.

Disclosure Regarding Foreign Jurisdictions That Prevent Inspections
Insider Trading Policy
Cybersecurity

PART III
Item 17.
Item 18.
Item 19.

Financial Statements
Financial Statements
Exhibits

5

PART I

Item 1.

Identity of Directors, Senior Management and Advisers

A.

Directors and senior management

Not applicable.

B.

Advisers

Not applicable.

C.

Auditors

Not applicable.

Item 2.

Offer Statistics and Expected Timetable

A.

Offer statistics

Not applicable.

B.

Method and expected timetable

Not applicable.

Item 3.

Key Information

A.

B.

(Reserved)

Capitalization and indebtedness

Not applicable.

C.

Reasons for the offer and use of proceeds

Not applicable.

D.

Risk factors

An investment in our securities involves a high degree of risk. You should carefully consider the risks described below, together with all of the other information included in
this Annual Report, before making an investment decision. If any of the following risks actually occur, our business, prospects, financial condition or results of operations
could be materially, adversely affected by any of these risks. Additional risks not presently known to us or that we currently deem immaterial may also impair our business
operations. The trading price of our securities could decline due to any of these risks, and you may lose all or part of your investment. This Annual Report also contains
forward-looking statements that involve risks and uncertainties. Our actual results could differ materially from those anticipated in these forward-looking statements as a
result of certain factors, including the risks mentioned below. Forward-looking statements included in this Annual Report are based on information available to us on the date
hereof, and all forward-looking statements in the documents incorporated by reference are based on information available to us as of the date of each such document. We
undertake no obligation to update or revise any forward-looking statements whether as a result of new information, future events or otherwise, other than as required by

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
applicable law.

Risks Relating to Us and Our Business

Summary of Risk Factors

6

The following is a summary of the risk factors our business faces. The list below is not exhaustive and investors should read this "Risk Factors” section in full. Some of the risks
we face include:

● the delisting of our Common Shares from the NASDAQ or the TSX, or a failure to satisfy such exchanges’ listing requirements in relation to the Plan of Arrangement,

could impact their market price and liquidity;

● we may be a passive foreign investment company, which could result in adverse tax consequences;

● our net operating losses may be limited under U.S. tax laws;

● our Rights Plan may prevent changes of control of the Company;

● the economic effects of a public health crisis may impact the market price of our Common Shares;

● investments in biopharmaceutical companies are generally considered to be speculative;

● risks relating to the failure to commercialize or out-license Macrilen™ (macimorelin);

● our revenues and expenses may fluctuate significantly and we may fail to meet financial expectations;

● the failure to complete the pediatric clinical trial program for Macrilen™ (macimorelin) could impact our operations;

● our dependence on strategic third-party relationships regarding Macrilen™ (macimorelin);

● we may be unsuccessful in completing further out-licensing arrangement for Macrilen™ (macimorelin);

● we have initiated significant early-stage pre-clinical programs;

● we may require significant additional financing, and we may not have access to sufficient capital;

● we are and will be subject to ongoing government regulation for our products and marketing approval for Macrilen™ (macimorelin) could be subject to restrictions or

withdrawals;

● healthcare reforms could hinder the commercial success of a product and affect our business;

● we may be subject to civil or criminal penalties if we interact with healthcare practitioners in a way that violates healthcare fraud or abuse laws;

● we may be unable to generate significant revenues if  Macrilen™ (macimorelin) does not gain market acceptance or if we fail to obtain acceptable prices or adequate

reimbursement for Macrilen™ (macimorelin);

● we may expend our limited resources to pursue a particular product or indication and fail to capitalize on other products or indications for which there may be a greater

likelihood of success;

● we may not achieve our projected development goals in the time-frames we announce and expect;

● competition in  our  targeted  markets  is  intense,  and  development  by  other  companies  could  render  Macrilen™  (macimorelin),  or  any  of  our future  products,  non-

competitive;

● we may not obtain adequate protection for Macrilen™ (macimorelin) through our intellectual property;

● we may infringe the intellectual property rights of others, resulting in costly and time-consuming litigation, which may subject us to liabilities;

● we may not obtain trademark registrations for our current or future products;

● any difficulties or delays in our clinical trials could result in increased costs to us, delay or limit our ability to generate revenue and adversely affect our commercial

prospects;

● the FDA and other foreign equivalents may not accept data from clinical trials outside the United States, in which case our development plans will be delayed, which

could materially harm our business;

7

● we are dependent on a stable and consistent supply of ingredients and raw materials for our operations;

● we rely on third parties to conduct, supervise and monitor our clinical trials, and those third parties may not perform satisfactorily;

● the failure to perform satisfactorily by third parties upon which we expect to rely to manufacture and supply products may lead to supply shortfalls;

● we are subject to intense competition for our skilled personnel, and the loss of key personnel or the inability to attract additional personnel could impair our ability to

conduct our operations;

● we may be subject to litigation in the future;

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● we are subject to the risk of product liability claims for which we may not have adequate insurance coverage;

● claims of creditors of our subsidiaries will generally have priority as to the assets of such subsidiaries over our claims and those of our creditors and shareholders;

● it may be difficult for U.S. investors to obtain and enforce judgments against us because of our Canadian incorporation and German presence;

● we can provide no assurance that we will, at all times in the future, be able to report that our internal controls over financial reporting are effective;

● we may have material weaknesses in our internal controls over financial reporting which could have a material adverse effect on the price of our Common Shares

● we are subject to environmental laws and may be subject to environmental remediation obligations that may have a material adverse effect on our business;

● we may incur losses associated with foreign currency fluctuations;

● legislative actions, new accounting pronouncements and higher insurance costs may adversely impact our future financial position or results of operations;

● data security breaches and other cyber security risks may disrupt our operations and adversely affect our operating results;

● our systems, procedures and controls may not be adequate to support the expansion of operations and associated increased costs and complexity following and resulting

from the Plan of Arrangement with Ceapro.

● we may be unable to successfully integrate our businesses with Ceapro’s and realize the anticipated benefits of the Plan of Arrangement.

● failure by  us  or  Ceapro  to  comply  with  applicable  Laws  prior  to  the  Plan  of  Arrangement  could  subject  the  combined  company  to  penalties  and other  adverse

consequences following completion of the Plan of Arrangement

● our share price is volatile, which may result from factors outside of our control;

● we do not intend to pay dividends in the near future;

● future issuances of securities and hedging activities may depress the trading price of our Common Shares;

● in the event we were to lose our foreign private issuer status as of June 30 of a given financial year, we would be required to comply with the Securities Exchange Act of

1934 domestic reporting regime, which could cause us to incur additional legal, accounting and other expenses;

● our articles of incorporation contain "blank check” preferred share provisions, which could delay or impede an acquisition of our company; and

● our business could be negatively affected as a result of the actions of activist shareholders.

8

Our Common Shares may be delisted from the NASDAQ or the TSX, which could affect their market price and liquidity. If our Common Shares were to be delisted, investors
may have difficulty in disposing their Common Shares.

Our Common Shares are currently listed on both the NASDAQ and the TSX under the symbol "AEZS”. We must meet continuing listing requirements to maintain the listing of our
Common Shares on the NASDAQ and the TSX. For continued listing, the NASDAQ requires, among other things, that listed securities maintain a minimum closing bid price of not
less than $1.00 per share, as set forth in Nasdaq Listing Rule 5450(a)(1) (the "Bid Price Rule”). Although we are in compliance with the Bid Price Rule as of the date of this Annual
Report, we have previously fallen out of compliance and there is no guarantee that we will be able to maintain it going forward.

If we were to fall out of compliance with the Bid Price Rule or Nasdaq’s other continued listing requirements, we would consider all options to remain in compliance with the
Nasdaq’s continued listing requirements, including a consolidation of our Common Shares.

In the event that we fail to satisfy any of the listing requirements of Nasdaq, including the Bid Price Rule, Nasdaq may reject our application to list on Nasdaq.

The  Common  Shares  are  currently  listed  on  both  the  Nasdaq  and  the  TSX  under  the  symbol  "AEZS”,  however,  under  applicable  Nasdaq  rules  and  regulations,  the  Plan  of
Arrangement will be considered to be change of control requiring a new listing and, in such a circumstance, we will be required to make a new application to list the Common
Shares on Nasdaq following the completion of the Plan of Arrangement. To meet the Nasdaq’s initial listing requirements, the Nasdaq requires, among other things, that listed
securities have a minimum bid price of US$4.00 per share or a minimum closing price of US$2.00 to US$3.00 per share, with the specific requisite price based on the satisfaction of
certain financial and liquidity requirements set forth in Nasdaq Listing Rules 5505(a) and (b) in accordance with the Bid Price Rule.

We are considering all options to satisfy the Nasdaq’s initial listing requirements in connection with the Plan of Arrangement, including a consolidation of our Common Shares
(the "Consolidation”). Pursuant to the Consolidation, all issued and outstanding Common Shares will be consolidated on the basis of one post-Consolidation Common Share for
every three to four pre-Consolidation Common Shares. Reducing the number of issued and outstanding Common Shares through the Consolidation is intended, absent other
factors, to increase the per share market price of the Common Shares. However, the market price of the Common Shares will also be affected by the Company’s financial and
operational results, its financial position, including its liquidity and capital resources, the development of its reserves and resources, industry conditions, the market’s perception
of the Company’s business and other factors, which are unrelated to the number of Common Shares outstanding.

Having regard to these other factors, there can be no assurance that the market price of the Common Shares will increase following the implementation of the Consolidation to the
extent sufficient to ensure compliance with the initial listing requirements to allow for a listing of the Common Shares on the Nasdaq following the completion of the Plan of
Arrangement, or that the market price of the Common Shares will not decrease in the future and result in noncompliance with the continuous listing Bid Price Rule. There can also
be no assurance that the implementation of the Consolidation will, in and of itself, guarantee the initial or continued listing of the Common Shares on the Nasdaq or that the
Common Shares will not be delisted from the Nasdaq because the Company fails to meet other Nasdaq listing requirements.

The market price of the Common Shares immediately following the implementation of the Consolidation is expected to be approximately equal to the market price of the Common
Shares prior to the implementation of the Consolidation multiplied by the Consolidation Ratio but there is no assurance that the anticipated market price immediately following the
implementation of the Consolidation will be realized or, if realized, will be sustained or will increase. There is a risk that the total market capitalization of the Common Shares (the
market price of the Common Shares multiplied by the number of Common Shares outstanding) after the implementation of the Consolidation may be lower than the total market
capitalization of the Common Shares prior to the implementation of the Consolidation.

9

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Although the Company believes that establishing a higher market price for the Common Shares could increase investment interest for the Common Shares in equity capital markets
by potentially broadening the pool of investors that may consider investing in the Company, including investors whose internal investment policies prohibit or discourage them
from purchasing stocks trading below a certain minimum price, there is no assurance that implementing the Consolidation will achieve this result.

If the Consolidation is implemented and the market price of the Common Shares (adjusted to reflect the Consolidation Ratio) declines, the percentage decline as an absolute number
and as a percentage of the Company’s overall market capitalization may be greater than would have occurred if the Consolidation had not been implemented. Both the total market
capitalization  of  a  company  and  the  adjusted  market  price  of  such  company’s  shares  following  a  consolidation  or  reverse  split  may  be  lower  than  they  were  before  the
consolidation or reverse split took effect. The reduced number of Common Shares that would be outstanding after the Consolidation is implemented could adversely affect the
liquidity of the Common Shares.

The Consolidation may result in some Shareholders owning "odd lots” of fewer than 100 Common Shares on a post-Common Consolidation basis. Odd lot Common Shares may be
more difficult to sell, or may attract greater transaction costs per Share to sell, and brokerage commissions and other costs of transactions in odd lots may be higher than the costs
of transactions in "round lots” of even multiples of 100 Common Shares.

In addition to the Bid Price Rule, if the Plan of Arrangement is treated as a new listing, Nasdaq requires us to have, depending on the applicable listing standard: (i) stockholders’
equity of at least US$5 million, a market value of unrestricted publicly held shares of US$15 million, an operating history of 2 years, at least 1 million unrestricted publicly held
shares outstanding, at least 300 unrestricted round lot shareholders, and at least 3 market makers; (ii) stockholders’ equity of at least US$4 million, a market value of unrestricted
publicly held shares of US$15 million, a market value of listed securities of at least US$50 million, at least 1 million unrestricted publicly held shares outstanding, at least 300
unrestricted round lot shareholders, and at least 3 market makers; or (iii) stockholders’ equity of at least US$4 million, a market value of unrestricted publicly held shares of US$5
million, net income from continuing operations (in the latest fiscal year or in two of the last three fiscal years) of at least US$750,000, at least 1 million unrestricted publicly held
shares outstanding, at least 300 unrestricted round lot shareholders, and at least 3 market makers, in each case in addition to the Nasdaq’s corporate governance requirements.

It is possible that we may be a passive foreign investment company, which could result in adverse tax consequences to U.S. investors.

Adverse U.S. federal income tax rules apply to "U.S. Holders” who directly or indirectly hold stock of a passive foreign investment company ("PFIC”). We would be classified as a
PFIC for U.S. federal income tax purposes for a taxable year if (i) at least 75% of our gross income is "passive income” or (ii) at least 50% of the average value of our assets,
including goodwill (based on annual quarterly average), is attributable to assets which produce passive income or are held for the production of passive income.

The determination of whether we are, or will be, a PFIC for a taxable year depends, in part, on the application of complex U.S. federal income tax rules, which are subject to various
interpretations. Although the matter is not free from doubt, we believe that we were not a PFIC during our 2023 taxable year and will not likely be a PFIC during our 2024 taxable
year. Because PFIC status is based on our income, assets and activities for the entire taxable year, and our market capitalization, it is not possible to determine whether we will be
characterized as a PFIC for the 2024 taxable year until after the close of the taxable year. The tests for determining PFIC status are subject to a number of uncertainties. These tests
are applied annually, and it is difficult to accurately predict future income, assets and activities relevant to this determination. In addition, because the market price of our Common
Shares is likely to fluctuate, the market price may affect the determination of whether we will be considered a PFIC. There can be no assurance that we will not be considered a PFIC
for any taxable year (including our 2024 taxable year).

If we are a PFIC for any taxable year during which a U.S. Holder holds Common Shares, we generally would continue to be treated as a PFIC with respect to that U.S. Holder for all
succeeding years during which the U.S. Holder holds such Common Shares, even if we ceased to meet the threshold requirements for PFIC status. Accordingly, no assurance can
be given that we will not constitute a PFIC in the current (or any future) tax year or that the Internal Revenue Service (the "IRS”) will not challenge any determination made by us
concerning our PFIC status. PFIC characterization could result in adverse U.S. federal income tax consequences to U.S. Holders. In particular, absent certain elections, a U.S.
Holder would generally be subject to U.S. federal income tax at ordinary income tax rates, plus a possible interest charge, in respect of a gain derived from a disposition of our
Common Shares, as well as certain distributions by us. If we are treated as a PFIC for any taxable year, a U.S. Holder may be able to make an election to "mark-to-market” Common
Shares each taxable year and recognize ordinary income pursuant to such election based upon increases in the value of the Common Shares.

10

In addition, U.S. Holders may mitigate the adverse tax consequences of the PFIC rules by making a "qualified electing fund” ("QEF”) election; however, there can be no assurance
that we will satisfy the record keeping requirements applicable to a QEF or that we will provide the information regarding our income that would be necessary for a U.S. Holder to
make a QEF election.

If the Company is a PFIC, U.S. Holders will generally be required to file an annual information return with the IRS (on IRS Form 8621 Information Return by a Shareholder of a
Passive Foreign Investment Company or Qualified Electing Fund, which PFIC shareholders will be required to file with their U.S. federal income tax or information returns) relating
to their ownership of Common Shares. This filing requirement is in addition to any pre-existing reporting requirements that apply to a U.S. Holder’s interest in a PFIC (which this
requirement does not affect).

Our net operating losses may be limited for U.S. federal income tax purposes under Section 382 of the Internal Revenue Code.

If a corporation with net operating losses ("NOLs”) undergoes an "ownership change” within the meaning of Section 382 of the United States Internal Revenue Code of 1986, as
amended (the "Code”), then such corporation’s use of such "pre-change” NOLs to offset income incurred following such ownership change may be limited. Such limitation also
may apply to certain losses or deductions that are "built-in” (i.e., attributable to periods prior to the ownership change, but not yet taken into account for tax purposes) as of the
date of the ownership change that are subsequently recognized. An ownership change generally occurs when there is either (i) a shift in ownership involving one or more "5%
shareholders,” or (ii) an "equity structure shift” and, as a result, the percentage of stock of the corporation owned by one or more 5% shareholders (based on value) has increased
by more than 50 percentage points over the lowest percentage of stock of the corporation owned by such shareholders during the "testing period” (generally the 3 years preceding
the testing date).  In general, if such change occurs, the corporation’s ability to utilize its  NOL carry-forwards and certain other tax attributes would be subject to an annual
limitation, as described below. The unused portion of any such NOL carry-forwards or tax attributes each year is carried forward, subject to the same limitation in future years. The
impact  of  an  ownership  change  on  state  NOL  carry  forwards  may  vary  from  state  to  state.  Due  to  previous  ownership  changes,  or  if  we  undergo  an  ownership  change  in
connection with or after this offering, our ability to use our NOLs could be limited by Section 382 of the Code. Future changes to our stock ownership, some of which are outside of
our control, could result in an ownership change under Section 382 of the Code. Recent legislation added several limitations to the ability to claim deductions for NOLs in future
years, particularly for tax years beginning after December 31, 2021, including a deduction limit equal to 80% of taxable income and a restriction on NOL carryback deductions. For
these reasons, we may not be able to use a material portion of the NOLs, even if we attain profitability.

Our Rights Plan May Prevent Transactions Resulting in a Change of Control of the Company

Effective June 21, 2022, the shareholders re-approved our Rights Plan that provides the Board and the Company’s shareholders with additional time to assess any unsolicited take-
over bid for the Company and, where appropriate, to pursue other alternatives for maximizing shareholder value. Under the Rights Plan, one right has been issued for each currently
issued Common Share, and one right will be issued with each additional Common Share that may be issued from time to time. The Rights Plan may have a significant anti-takeover
effect. The Rights Plan has the potential to significantly dilute the ownership interests of an acquiror of our shares, and therefore may have the effect of delaying, deterring or
preventing a change in control of the Company.

11

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The economic effects of a pandemic, epidemic or outbreak of an infectious disease or other public health crisis could adversely affect our operations or the market price of
our Common Shares.

Public health crises such as pandemics, epidemics or similar outbreaks, including the novel strain of coronavirus known as "COVID-19”, could adversely impact our operations or
the  market  price  of  our  Common  Shares.  The  extent  to  which  such  pandemics  may  impact  our  operations  or  the  market  price  of  our  Common  Shares  will  depend  on  future
developments, which are highly uncertain and cannot be predicted  with  confidence,  either  internationally  or  within  the  U.S.,  Canada  or  Germany,  including  the  duration  and
severity of such an outbreak and the actions taken in response to contain the outbreak or treat its impact, among others.

The spread of a pandemic may impact our operations, including the potential interruption of our clinical trial activities and our supply chain. For example, the rise in the Omicron
variant in the COVID-19 pandemic caused delays in site initiation and patient enrollment in our Phase 3 DETECT clinical trial for diagnostic use in childhood-onset growth hormone
deficiency. As  well,  sales  activities  for  Macrilen™  in  the  US  by  Novo  Nordisk  may  be  impacted  due  to  delays  of  diagnostic  activities  on  adult  growth  hormone  deficiency
("AGHD”) in the U.S. In addition, the COVID-19 pandemic may also have caused some patients to be unwilling to enroll in our trials or be unable to comply with clinical trial
protocols if quarantines impeded patient movement or interrupted healthcare services, which would have delayed our ability to conduct clinical trials or release clinical trial results
on a timely basis and could have delayed our ability to obtain regulatory approval and commercialize our product candidates. The spread of an infectious disease, such as COVID-
19, may also result in the inability of our suppliers to deliver components or raw materials on a timely basis or at all. In addition, hospitals may reduce staffing and reduce or
postpone certain treatments in response to the spread of an infectious disease. Such events may result in a period of business disruption and, in reduced operations, doctors or
medical providers may be unwilling to participate in our clinical trials, any of which could materially affect our business, financial condition or results of operations. Although we
believe we are in a recovery period, the significant spread of COVID-19 within the U.S., Canada or Germany resulted in a widespread health crisis and had an adverse effect on the
national economies generally, the markets that we serve, our operations and the market price of our Common Shares.

Investments in biopharmaceutical companies are generally considered to be speculative in nature.

The  prospects  for  companies  operating  in  the  biopharmaceutical  industry  are  uncertain,  given  the  very  nature  of  the  industry,  in  which  companies  often  experience  lengthy
development time, extensive capital requirements, rapid technological developments and a high degree of competition based primarily on scientific and technological factors. These
factors include the availability to obtain patent and other protection for technology and products, the ability to commercialize technological developments and the ability to obtain
government approval for testing, manufacturing and marketing. Accordingly, investments in biopharmaceutical companies should be considered to be speculative assets.

If we are unable to successfully commercialize or out-license Macrilen™ (macimorelin), or if we experience significant delays in doing so, our business would be materially
harmed, and the future and viability of the Company could be imperiled.

Our lead product, Macrilen™ (macimorelin), is the first and only U.S. Food and Drug Administration and European Commission approved oral test indicated for the diagnosis of
patients with AGHD and we currently do not have any other products. We are focused on opportunistically utilizing our network with universities in Europe and the U.S., which
we believe will provide vital access to innovative development candidates in different indications, with a focus on rare or orphan indications and potential for pediatric use. To
date, we have signed agreements to establish this growing pipeline across a number of indications, including neuromyelitis optica spectrum disorder ("NMOSD”) and Parkinson’s
disease ("PD”), primary hypoparathyroidism and amyotrophic lateral sclerosis ("ALS”, or Lou Gehrig’s disease).

We are a party to license agreements to carry out development, manufacturing, registration and commercialization of Macrilen™ (macimorelin) in the European Economic Area, the
United Kingdom, and the Republic of Korea. We are party to a distribution agreement for the commercialization of Macrilen™ (macimorelin) in Israel and the Palestinian Authority,
Turkey and some non-European Union Balkan countries. We continue to explore licensing and distribution opportunities worldwide.

On August  26,  2022,  the  Company  announced  that  it  would  regain  full  rights  to  Macrilen™  in  the  U.S.  and  Canada,  following  Novo’s  termination  of  the  development  and
commercialization license agreement, which triggered a 270-day notice period. Although the Company is actively engaged in exploring all options for Macrilen™ in the U.S. and
Canada, there can be no assurance that the Company will be able to enter into a similar agreement or any agreement with respect to the rights to Macrilen™ in the U.S. and Canada.

12

The commercial success of Macrilen™ (macimorelin) depends on several factors, including, but not limited to, the following:

● receipt of approvals from foreign regulatory authorities;

● successfully negotiating pricing and reimbursement in key markets in the EU for Macrilen™ (macimorelin);

● successfully contracting with qualified third-party suppliers to manufacture Macrilen™ (macimorelin);

● developing appropriate distribution and marketing infrastructure and arrangements for our product;

● launching and growing commercial sales of the product;

● out-licensing Macrilen™ (macimorelin) to third parties; and

● acceptance of the product in the medical community, among patients and with third-party payers.

If we are unable to successfully achieve any of these factors, our business, financial condition and results of operations may be materially, adversely affected.

Our revenues and expenses may fluctuate significantly, and any failure to meet financial expectations may disappoint securities analysts or investors and result in a decline
in the price or the value of our Common Shares or other securities.

We have a history of operating losses. Our revenues and expenses have fluctuated in the past and may continue to do so in the future. These fluctuations could cause our share
price of Common Shares or the value of our other securities to decline. Some of the factors that could cause our revenues and expenses to fluctuate include, but are not limited to,
the following:

● the timing and willingness of any current or future collaborators to invest the resources necessary to commercialize Macrilen™ (macimorelin);

● not obtaining  necessary  regulatory  approvals  from  the  United  States  Food  &  Drug  Administration  ("FDA”),  the  European Medicines  Agency  ("EMA”),  the
European Commission ("EC”) or other agencies that may delay or prevent us from obtaining approval of a pediatric indication for Macrilen™ (macimorelin), which
may affect the share price of our Common Shares;

● the timing of regulatory submissions and approvals;

● the nature and timing of licensing fee revenues;

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● the outcome of future litigation;

● foreign currency fluctuations;

● the effects of COVID-19, including the effects of intensified efforts to contain the spread of the virus, which included, among other things, quarantines and travel

restrictions;

● the timing of the achievement and the receipt of milestone payments from current or future licensing partners; and

● failure to enter into new or the expiration or termination of current agreements with suppliers who manufacture Macrilen™ (macimorelin).

Due  to  fluctuations  in  our  revenues  and  expenses,  we  believe  that  period-to-period  comparisons  of  our  results  of  operations  are  not  necessarily  indicative  of  our  future
performance. It is possible that in some future periods, our revenues and expenses will be above or below the expectations of securities analysts or investors. In this case, the
share price of our Common Shares and the value of our other securities could fluctuate significantly or decline.

13

If we are unable to successfully complete the pediatric clinical trial program for Macrilen™ (macimorelin), or if such clinical trial takes longer to complete than we project,
our ability to execute any related business strategy will be adversely affected.

If we experience delays in identifying and contracting with sites and/or in-patient enrollment in our pediatric clinical trial program for  Macrilen™ (macimorelin), we may incur
additional costs and delays in our development programs and may not be able to complete our clinical trials on a cost-effective or timely basis. In addition, conducting multi-
national studies adds another level of complexity and risk as we are subject to events affecting countries other than the U.S. and Canada. Moreover, negative or inconclusive
results from the clinical trials we conduct or adverse medical events could cause us to have to repeat or terminate the clinical trials. Furthermore, children have different metabolic
issues than adults. Accordingly, we may not be able to complete the pediatric clinical trial within an acceptable time-frame, if at all. If we or our Contract Research Organizations
("CRO”) have difficulty enrolling a sufficient number of patients to conduct our clinical trials as planned, we may need to delay or terminate ongoing clinical trials.

Clinical trials are subject to continuing oversight by governmental regulatory authorities and institutional review boards and must, among other requirements:

● meet the requirements of these authorities from multiple countries and jurisdictions and their related statutes, regulations and guidance;

● meet the requirements for informed consent;

● meet the requirements for institutional review boards; and

● meet the requirements for good clinical practices

We are currently dependent on certain strategic relationships with third parties for the development, manufacturing and licensing of Macrilen™ (macimorelin) and we may
enter into future collaborations for the development, manufacturing and licensing of Macrilen™ (macimorelin).

Our arrangements with third parties may not provide us with the benefits we expect and may expose us to a number of risks.

Currently, we are dependent on various partners to commercialize macimorelin in the U.K. and EU and the Republic of Korea. As set out above, the Company has regained full
rights to Macrilen™ following the termination of the license agreement with Novo Nordisk. Most of our potential revenue consists of contingent payments, including milestones
and royalties on the sale of Macrilen™ (macimorelin). The milestone and royalty revenue that we may receive under this collaboration will depend upon these parties’ ability to
successfully introduce, market and sell Macrilen™ (macimorelin). If they do not devote sufficient time and resources to their respective collaboration arrangements with us, we may
not realize the potential commercial benefits of the arrangement, and our results of operations may be materially, adversely affected.

Our reliance on these relationships and other potential third parties poses a number of risks. We may not realize the contemplated benefits of such agreements nor can we be
certain that any of these parties will fulfill their obligations in a manner which maximizes our revenue. These arrangements may also require us to transfer certain material rights to
third  parties.  These  agreements  create  certain  additional  risks.  The  occurrence  of  any  of  the  following  or  other  events  may  delay  or  impair  commercialization  of  Macrilen™
(macimorelin):

● in certain circumstances, third parties may assign their rights and obligations under these agreements to other third parties without our consent or approval;

● the third parties may cease to conduct business for financial or other reasons;

● we may not be able to renew such agreements;

● the third parties may not properly maintain or defend certain intellectual property rights that may be important to the commercialization of Macrilen™ (macimorelin);

● the third parties may encounter conflicts of interest, changes in business strategy or other issues which could adversely affect their willingness or ability to fulfill
their obligations to us (for example, pharmaceutical companies historically have re-evaluated their priorities following mergers and consolidations, which have been
common in this industry);

14

● delays in, or failures to achieve, scale-up to commercial quantities, or changes to current raw material suppliers or product manufacturers (whether the change is

attributable to us or the supplier or manufacturer) could delay clinical studies, regulatory submissions and commercialization of Macrilen™ (macimorelin); and

● disputes may  arise  between  us  and  the  third  parties  that  could  result  in  the  delay  or  termination of  the  manufacturing  or  commercialization  of  Macrilen™
(macimorelin), resulting in litigation or arbitration that could be time-consuming and expensive, or causing the third parties to act in their own self-interest and not in
our interest or those of our shareholders.

In addition, the third parties can terminate our agreements with them for a number of reasons based on the terms of the individual agreements that we have entered into with them.
If one or more of these agreements were to be terminated, we would be required to devote additional resources to manufacturing and commercializing Macrilen™ (macimorelin).

We may be unsuccessful in consummating further out-licensing arrangements for MacrilenTM (macimorelin) on favorable terms and conditions, or we may be significantly
delayed in doing so.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As part of our product development and commercialization strategy, we are evaluating out-licensing opportunities for Macrilen™ (macimorelin) in addition to existing License
Agreements and commercialization agreements signed with Pharmanovia, MegaPharm Ltd. and ER Kim Pharmaceuticals Bulgaria Eood and NK MEDITECH Ltd. If we elect to
collaborate with third parties in respect of macimorelin, we may not be able to negotiate a collaborative arrangement for macimorelin on favorable terms and conditions, if at all.
Should any partner fail to successfully commercialize macimorelin, our business, financial condition and results of operations may be adversely affected.

We have initiated significant early-stage pre-clinical programs.

Over the course of 2021, we in-licensed four new pre-clinical development programs related to potential therapeutics, all of which were added to our development pipeline based on
their potential to represent significant individual market opportunities. These pre-clinical development programs are at an early stage of development and none of these potential
products  has  obtained  regulatory  approval  for  commercial  use  and  sale  in  any  country  and,  as  such,  no  revenues  have  resulted  from  product  sales.  Significant  additional
investment will be necessary to complete the development of any of our product candidates. Pre-clinical and clinical trial work must be completed before our potential products
could be ready for use within the markets that we have identified. We may fail to develop any products, obtain regulatory approvals, enter clinical trials or commercialize any
products.  We  do  not  know  whether  any  of  our  potential  product  development  efforts  will  prove  to  be  effective,  meet  applicable  regulatory  standards,  obtain  the  requisite
regulatory approvals, be capable of being manufactured at a reasonable cost or be accepted in the marketplace. We also do not know whether sales, license fees or related royalties
will allow us to recoup any investment we make in the commercialization of our products. The product candidates we are currently developing are not expected to be commercially
viable for at least the next several years and we may encounter unforeseen difficulties or delays in commercializing our product candidates. In addition, our potential products may
not be effective or may cause undesirable side effects.

Our product candidates require significant funding to reach regulatory approval assuming positive clinical results. Such funding for our product candidates may be difficult, or
impossible to raise in the public or private markets or through partnerships. If funding or partnerships are not readily attainable, the development of our product candidates may be
significantly delayed or stopped altogether. The announcement of a delay or discontinuation of development would likely have a negative impact on our share price.

We may require significant additional financing, and we may not have access to sufficient capital.

We may require significant additional capital to fund our commercialization efforts and may require additional capital to pursue planned clinical trials and regulatory approvals.
Although we believe that our existing cash on hand will be sufficient to fund our anticipated operating and capital expenditure requirements for the next 12 months, we do not
anticipate generating significant revenues from operations in the near future. Moreover, we currently have no committed sources of capital.

15

We may attempt to raise additional funds through public or private financings, collaborations with other pharmaceutical companies or from other sources, including, without
limitation, through at-the-market offerings and issuances of securities. Additional funding may not be available on terms that are acceptable to us. If adequate funding is not
available to us on reasonable terms, we may need to delay, reduce or eliminate our product development programs or obtain funds on terms less favorable than we would otherwise
accept. To the extent that additional capital is raised through the sale of equity securities or securities convertible into or exchangeable or exercisable for equity securities, the
issuance of those securities would result in dilution to our shareholders. Moreover, the incurrence of debt financing or the issuance of dividend-paying preferred shares, could
result in a substantial portion of our future operating cash flow, if any, being dedicated to the payment of principal and interest on such indebtedness or the payment of dividends
on such preferred shares and could impose restrictions on our operations and on our ability to make certain expenditures and/or to incur additional indebtedness, which could
render us more vulnerable to competitive pressures and economic downturns.

Our future capital requirements are substantial and may increase beyond our current expectations depending on many factors, including, but not limited to, the following:

● the duration of changes to and results of our clinical trials for any future products going forward;

● unexpected delays or developments in seeking regulatory approvals;

● the time and cost involved in preparing, filing, prosecuting, maintaining and enforcing patent claims;

● unexpected developments encountered in implementing our business development and commercialization strategies;

● the potential addition of commercialized products to our portfolio;

● the outcome of future litigation; and

● further arrangements, if any, with collaborators.

In addition, global economic and market conditions, as well as future developments in the credit and capital markets, may make it even more difficult for us to raise additional
financing in the future.

We are and will be subject to stringent ongoing government regulation for our products and our product candidates, even if we obtain regulatory approvals for the latter.

The manufacturing, marketing and sale of  Macrilen™ (macimorelin) and our product candidates are and will be subject to strict and ongoing regulation, even with marketing
approval by the FDA and the EC for Macrilen™ (macimorelin). Compliance with such regulation will be expensive and consume substantial financial and management resources.
For example, the EC approval for macimorelin was conditioned on our agreement to conduct post-marketing follow-up studies to monitor the safety or efficacy of the product. In
addition, as clinical experience with a drug expands after approval because the drug is used by a greater number and more diverse group of patients than during clinical trials, side
effects or other problems may be observed after approval that were not observed or anticipated during pre-approval clinical trials. In such a case, a regulatory authority could
restrict the indications for which the product may be sold or revoke the product’s regulatory approval.

We and our contract manufacturers will be required to comply with applicable current Good Manufacturing Practice (" GMP”) regulations for the manufacture of our current or
future products and other regulations. These regulations include requirements relating to quality assurance, as well as the corresponding maintenance of rigorous records and
documentation. Manufacturing facilities must be approved before we can use them in the commercial manufacturing of a product and are subject to subsequent periodic inspection
by regulatory authorities. In addition, material changes in the methods of manufacturing or changes in the suppliers of raw materials are subject to further regulatory review and
approval.

16

If we, or if any future marketing collaborators or contract manufacturers, fail to comply with applicable regulatory requirements, we may be subject to sanctions including fines,
product  recalls  or  seizures  and  related  publicity  requirements,  injunctions,  total  or  partial  suspension  of  production,  civil  penalties,  suspension  or  withdrawals  of  previously
granted  regulatory  approvals,  warning  or  untitled  letters,  refusal  to  approve  pending  applications  for  marketing  approval  of  new  products  or  of  supplements  to  approved
applications, complete withdrawal of a marketing application, exclusion from government healthcare programs, import or export bans or restrictions, and/or criminal prosecution and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
penalties. Any of these penalties could delay or prevent the promotion, marketing or sale of a product.

Even with marketing approval for MacrilenTM (macimorelin), such product approval could be subject to restrictions or withdrawals. Regulatory requirements are subject to
change.

On December 20, 2017, the FDA granted marketing approval in the U.S. for Macrilen™ (macimorelin) to be used in the diagnosis of patients with AGHD, and on January 16, 2019,
the  EC  granted  marketing  approval  in  Europe  for  macimorelin  for  the  diagnosis  of AGHD.  Regulatory  authorities  generally  approve  products  for  specified  indications.  If  an
approval is for a limited indication, this limitation reduces the size of the potential market for that product. Product approvals, once granted, are subject to continual review and
periodic inspections by regulatory authorities. Our operations and practices are subject to regulation and scrutiny by the U.S. government, as well as governments of any other
countries in which we do business or conduct activities. Later discovery of previously unknown problems or safety issues and/or failure to comply with domestic or foreign laws,
knowingly or unknowingly, can result in various adverse consequences, including, among other things, a possible delay in the approval or refusal to approve a product, warning
or untitled letters, fines, injunctions, civil penalties, recalls or seizures of products and related publicity requirements, total or partial suspension of production, import or export
bans or restrictions, refusal of the government to renew marketing applications, complete withdrawal of a marketing application, criminal prosecution and penalties, suspension or
withdrawals  of  previously  granted  regulatory  approvals,  withdrawal  of  an  approved  product  from  the  market  and/or  exclusion  from  government  healthcare  programs.  Such
regulatory enforcement could have a direct and negative impact on the product for which approval is granted, but also could have a negative impact on the approval of any
pending applications for marketing approval of new drugs or supplements to approved applications.

Because we operate in a highly regulated industry, regulatory authorities could take enforcement action against us in connection with our licensees’ or collaborators’ businesses
or marketing activities for various reasons.

From time to time, new legislation is passed into law that could significantly change the statutory provisions governing the approval, manufacturing and marketing of products
regulated  by  the  FDA,  the  EC  and  other  health  authorities.  In  addition,  regulations  and  guidance  are  often  revised  or  reinterpreted  by  health  agencies  in  ways  that  may
significantly affect our business. It is impossible to predict whether further legislative changes will be enacted, or whether regulations, guidance, or interpretations will change, and
what the impact of such changes, if any, may be.

Healthcare reform measures could hinder or prevent the commercial success of a product and adversely affect our business.

The business prospects and financial condition of pharmaceutical and biotechnology companies are affected by the efforts of governmental and third-party payers to contain or
reduce the costs of healthcare. The U.S. government and other governments have shown significant interest in pursuing healthcare reform and reducing healthcare costs. Any
government-adopted reform measures could cause significant pressure on the pricing of healthcare products and services, including Macrilen™ (macimorelin), both in the U.S. and
internationally,  as  well  as  the  amount  of  reimbursement  available  from  governmental  agencies  and  other  third-party  payers.  If  reimbursement  for  Macrilen™  (macimorelin)  is
substantially less than we expect, our revenue prospects could be materially and adversely impacted.

In the  U.S. and in other jurisdictions there have been, and we expect that there will continue to be, a number of legislative and regulatory  proposals  aimed  at  changing  the
healthcare system, such as proposals relating to the pricing of healthcare products and services in the U.S. or internationally, the reimportation of drugs into the U.S. from other
countries (where they are then sold at a lower price), and the amount of reimbursement available from governmental agencies or other third-party payers. Furthermore, the pricing
of pharmaceutical products, in general, and specialty drugs, in particular, has been a topic of concern in the U.S. Congress, where hearings on the topic have been held, and has
been a topic of speeches given by political figures, including the President of the U.S. Additionally, in the U.S., individual states have also passed legislation and proposed bills
that are aimed at drug pricing transparency, which will likely impact drug pricing. There can be no assurance as to how this scrutiny on pricing of pharmaceutical products will
impact future pricing of Macrilen™ (macimorelin).

17

The Patient Protection and Affordable Care Act and the Healthcare and Education Affordability Reconciliation Act of 2010 (collectively, the " ACA”) has had far-reaching
consequences for most healthcare companies, including specialty biopharmaceutical companies like us. The future of the ACA is, however, uncertain as there have been executive,
judicial and congressional challenges to certain aspects of the ACA. In June 2021, the United States Supreme Court dismissed a challenge to the ACA on the grounds the plaintiffs
did  not  have  standing  to  attack  as  unconstitutional  the ACA’s  minimum  essential  coverage  provision  because  they  had  not  shown  they  had  suffered  damages  from  the
defendants’ conduct in enforcing the ACA. It is unclear how other such litigation and the healthcare reform efforts of the Biden administration will impact the ACA and our
business.

In addition, the Food and Drug Administration Amendments Act of 2007 gives the FDA enhanced post-market authority, including the authority to require post-marketing studies
and clinical trials, labeling changes based on new safety information, and compliance with risk evaluations and mitigation strategies approved by the FDA. The FDA’s exercise of
this authority may result in delays or increased costs during the period of product development, clinical trials and regulatory review and approval, which may also increase costs
related to complying with new post-approval regulatory requirements and increase potential FDA restrictions on the sale or distribution of approved products.

If we or our licensees market products or interact with health care practitioners in a manner that violates healthcare fraud or abuse laws, we or our licensees may be subject
to civil or criminal penalties, including exclusion from participation in government healthcare programs.

As a pharmaceutical company, even though we do not provide healthcare services or receive payments directly from or bill directly to Medicare, Medicaid or other national or
third-party payers for our current product, U.S. federal and state healthcare laws and regulations, as well as certain EU regulatory and government agencies, pertaining to fraud or
abuse are and will be applicable to our business. We, and our licensees, are subject to healthcare fraud and abuse regulation by EU regulatory and government agencies in the
countries where we may seek marketing access, and the U.S. federal government and the states in which we conduct our business.

The laws that may affect us or affect our licensee’s ability to operate include the federal healthcare program anti-kickback statute, which prohibits, among other things, knowingly
and willfully offering, paying, soliciting, or receiving remuneration to induce, or in return for, the purchase, lease or order, or arrangement for the purchase, lease or order of any
healthcare item or service reimbursable under Medicare, Medicaid or other federally financed healthcare programs. This statute applies to arrangements between pharmaceutical
manufacturers and prescribers, purchasers and formulary managers. Although there are a number of statutory exceptions and regulatory safe harbors protecting certain common
activities, the exceptions and safe harbors are drawn narrowly, and practices that involve remuneration intended to induce prescribing, purchases or recommendations may be
subject to scrutiny if they do not qualify for an exception or a safe harbor.

Federal false claims laws prohibit any person from knowingly presenting, or causing to be presented, a false claim for payment to the federal government, or knowingly making, or
causing to be made, a false statement to get a false claim paid. Pharmaceutical companies have been prosecuted under these laws for a variety of alleged promotional and marketing
activities, such as providing free product to customers with the expectation that the customers would bill federal programs for the product, reporting to pricing services inflated
average wholesale prices that were then used by federal programs to set reimbursement rates, engaging in off-label promotion that caused claims to be submitted to Medicaid for
non-covered off-label uses, and submitting inflated best price information to the Medicaid Drug Rebate Program.

The Health  Insurance  Portability and  Accountability  Act of 1996 also created prohibitions against healthcare fraud and false statements relating to healthcare matters.  The
healthcare fraud statute prohibits knowingly and willfully executing a scheme to defraud any healthcare benefit program, including private payers. The false statements statute
immediately noted above prohibits knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent statement in
connection with the delivery of or payment for healthcare benefits, items or services.

18

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In addition, there has been a recent trend of increased federal and state regulation of payments made to physicians. The ACA, through the Physician Payment Sunshine Act of
2010, imposed new requirements on manufacturers of drugs, devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s
Health  Insurance  Program (with certain exceptions) to report annually to the  Centers for  Medicare and  Medicaid  Services ("CMS”), information related to payments or other
"transfers of value” made to physicians (defined to include doctors, dentists, optometrists, podiatrists and chiropractors) and teaching hospitals, and applicable manufacturers and
group purchasing organizations to report annually to CMS ownership and investment interests held by physicians (as defined above) and their immediate family members and
payments or other "transfers of value” to such physician owners and their immediate family members. Manufacturers are required to report such data to the government by the
90th calendar day of each year.

The majority of states also have statutes or regulations similar to these federal laws, which apply to items and services reimbursed under Medicaid and other state programs, or, in
several states, apply regardless of the payer. In addition, some states have laws that require pharmaceutical companies to adopt comprehensive compliance programs. For example,
under California law, pharmaceutical companies must comply with both the April 2003 Office of Inspector General Compliance Program Guidance for Pharmaceutical Manufacturers
and  the  PhRMA  Code  on  Interactions  with  Healthcare  Professionals,  as  amended.  Certain  states  also  mandate  the  tracking  and  reporting  of  gifts,  compensation,  and  other
remuneration paid by us to physicians and other healthcare providers.

Although compliance programs can mitigate the risk of investigation and prosecution for violations of these laws, the risks cannot be entirely eliminated. Any action against us or
our licensees for violation of these laws, even if we successfully defend against it, could cause us to incur significant legal expenses, cause reputational harm and divert our
management’s attention from the operation of our business. Moreover, achieving and sustaining compliance with EU government and regulatory agencies and applicable U.S.
federal and state laws may prove costly.

Because of the breadth of these laws and the narrowness of the safe harbors, it is possible that some of our business activities could be subject to challenge under one or more of
such laws. The ACA also made several important changes to the federal anti-kickback statute, false claims laws and healthcare fraud statute by weakening the intent requirement
under the anti-kickback and healthcare fraud statutes that may make it easier for the government or whistleblowers to charge such fraud and abuse violations. A person or entity
no longer needs to have actual knowledge of this statute or specific intent to violate it. In addition, the ACA provides that the government may assert that a claim including items
or services resulting from a violation of the federal anti-kickback statute constitutes a false or fraudulent claim for purposes of the false claims statutes. In addition, the ACA
increases  penalties  for  fraud  and  abuse  violations.  If  our  past,  present  or  future  operations  are  found  to  be  in  violation  of  any  of  the  laws  described  above  or  other  similar
governmental  regulations  to  which  we  are  subject,  we  may  be  subject  to  significant  civil,  criminal  and  administrative  penalties,  damages,  fines,  imprisonment,  exclusion  from
government funded healthcare programs, such as Medicare and Medicaid, and the curtailment or restructuring of our operations, any of which could adversely affect our ability to
operate our business and negatively impact our financial results.

If Macrilen™ (macimorelin) does not gain market acceptance, we may be unable to generate significant revenues.

Market acceptance of Macrilen™ (macimorelin) depends on a number of factors, including, but not limited to, the following:

● demonstration of clinical efficacy and safety;

● the prevalence and severity of any adverse side effects;

● limitations or warnings contained in the product’s approved labeling;

● availability of alternative treatments or tests for the indications we target;

● the advantages and disadvantages of Macrilen™ (macimorelin) relative to current or alternative treatments and tests;

● the classification and description of MacrilenTM (macimorelin) in relevant guidelines;

● the availability of acceptable pricing and adequate third-party reimbursement; and

● the effectiveness of marketing and distribution methods for Macrilen™ (macimorelin).

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If Macrilen™ (macimorelin) does not gain market acceptance among physicians, patients, healthcare payers and others in the medical community, who may not accept or utilize
Macrilen™ (macimorelin), our ability to generate significant revenues from Macrilen™ (macimorelin) would be limited, and our financial condition could be materially, adversely
affected. In addition, if we fail to further penetrate our core markets and existing geographic markets or to successfully expand our business into new markets, the growth in sales of
Macrilen™ (macimorelin), along with our operating results, could be negatively impacted.

Our ability to further penetrate our core markets and existing geographic markets in which we compete or to successfully expand our business into additional countries in Europe,
Asia or elsewhere is subject to numerous factors, many of which are beyond our control. Macrilen™ (macimorelin), if successfully commercialized, may compete with a number of
drugs,  therapies,  products  and  tests  currently  manufactured  and  marketed  by  major  pharmaceutical  and  other  biotechnology  companies.  Macrilen™  (macimorelin)  may  also
compete with new products currently under development by others or with products which may be less expensive than Macrilen™ (macimorelin). There can be no assurance that
our efforts to increase market penetration in our core markets and existing geographic markets will be successful. Our failure to do so could have an adverse effect on our operating
results and would likely cause a drop in the share price of our Common Shares.

If we fail to obtain acceptable prices or adequate reimbursement for Macrilen™ (macimorelin), our ability to generate revenues will be diminished.

Our ability or that of our licensee(s) to successfully commercialize Macrilen™ (macimorelin) will depend significantly on our or their ability to obtain acceptable prices and the
availability of reimbursement to the patient from third-party payers, such as governmental and private insurance plans. These third-party payers frequently require companies to
provide  predetermined  discounts  from  list  prices,  and  they  are  increasingly  challenging  the  prices  charged  for  pharmaceuticals  and  other  medical  products.  Macrilen™
(macimorelin) may not be considered cost-effective, and reimbursement to the patient may not be available or sufficient to allow us or our licensee(s) to sell our products on a
competitive basis. It may not be possible to negotiate favorable reimbursement rates for Macrilen™ (macimorelin). Adverse pricing and reimbursement conditions would also likely
diminish our ability to induce third parties to in-license Macrilen™ (macimorelin).

In addition, the continuing efforts of third-party payers to contain or reduce the costs of healthcare through various means may limit our commercial opportunity and reduce any
associated revenue and profits. We expect that proposals to implement similar government controls will continue. The pricing of pharmaceutical products, in general, and specialty
drugs, in particular, has been a topic of concern in the U.S. Congress, where hearings on the topic have been held, and has been a topic of speeches given by political figures,
including the  President of the  U.S.  Specifically, there have been several recent  U.S.  Congressional inquiries and proposed bills designed to, among other things, bring more
transparency to drug pricing, review the relationship between pricing and manufacturer patient programs, and reform government program reimbursement methodologies for drugs.
Furthermore, there is drug pricing reform taking place at the state level in the U.S. that will impact how pharmaceutical companies can market and sell drug products and at what
price. Additionally, third-party payers are increasingly challenging the price, examining the medical necessity, and reviewing the cost-effectiveness of medical drug products and
medical services, in addition to questioning their safety and efficacy. There can be no assurance as to how this scrutiny on pricing of pharmaceutical products will impact future

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
pricing of a product or orphan drugs or pharmaceutical products generally. In addition, increasing emphasis on managed care will continue to put pressure on the pricing of
pharmaceutical and biopharmaceutical products. Cost control initiatives could decrease the price that we or any current or potential collaborators could receive a product and
could adversely affect our profitability.  In addition, in the  U.S.,  Canada and many other countries, pricing and/or profitability of some or all prescription pharmaceuticals and
biopharmaceuticals are subject to government control.

If  we  or  our  licensee(s)  fail  to  obtain  acceptable  prices  or  an  adequate  level  of  reimbursement  for  Macrilen™  (macimorelin),  the  sales  of  Macrilen™  (macimorelin)  would  be
adversely affected or there may be no commercially viable market for Macrilen™ (macimorelin).

20

We may expend our limited resources to pursue a particular product or indication and fail to capitalize on other products or indications for which there may be a greater
likelihood of success.

We are currently focusing our efforts on Macrilen™ (macimorelin) for specific indications and for our four pre-clinical programs. As a result, we may forego or delay pursuit of
opportunities for other potential indications for Macrilen™ (macimorelin), which there may be a greater likelihood of success or may prove to have greater commercial potential.
Research programs to identify new product candidates or pursue alternative indications for Macrilen™ (macimorelin) require substantial technical, financial and human resources.
These activities – if pursued – may initially show promise in identifying potential product candidates or indications yet fail to yield product candidates or indications for further
clinical development.

We may not achieve our projected development goals in the time-frames we announce and expect.

We may set goals and make public statements regarding the timing of the accomplishment of objectives material to our success, such as the commencement, enrollment and
anticipated completion of clinical trials, anticipated regulatory submission and approval dates and time of product launch. The actual timing of these events can vary dramatically
due to factors such as delays or failures in any clinical trials, the uncertainties inherent in the regulatory approval process and delays in achieving manufacturing or marketing
arrangements sufficient to commercialize any of our products or product candidates. There can be no assurance that we will make regulatory submissions or receive regulatory
approvals as planned or that we will be able to adhere to our schedule for launching of Macrilen™ (macimorelin) or any of our future product candidates. If we fail to achieve one
or more of these milestones as planned, the share price of our Common Shares may decline.

Competition in our targeted markets is intense, and development by other companies could render Macrilen™ (macimorelin), or any of our future products, non-competitive.

The  biopharmaceutical  field  is  highly  competitive.  New  products  developed  by  other  companies  in  the  industry  could  render  Macrilen™  (macimorelin)  or  any  of  our  future
products uncompetitive or significantly less competitive. Competitors are developing and testing products and technologies that would compete with Macrilen™ (macimorelin) or
any of our future products. Some of these competitive products may be more effective or have an entirely different approach or means of accomplishing the desired effect than
Macrilen™  (macimorelin)  or  any  of  our  future  products.  We  expect  competition  from  pharmaceutical  and  biopharmaceutical  companies  and  academic  research  institutions  to
continue to increase over time. Many of our competitors and potential competitors have substantially greater product development capabilities and financial, scientific, marketing
and human resources than we do.

We may not obtain adequate protection for Macrilen™ (macimorelin) through our intellectual property.

We  rely  heavily  on  our  proprietary  information  in  developing  and  manufacturing  Macrilen™  (macimorelin).  Our  success  depends,  in  large  part,  on  our  ability  to  protect  our
competitive position through patents, trade secrets, trademarks and other intellectual property rights. We have filed and are pursuing applications for patents and trademarks in
many  countries.  Pending  patent  applications  may  not  result  in  the  issuance  of  patents,  and  we  may  not  be  able  to  obtain  additional  issued  patents  relating  to  Macrilen™
(macimorelin).

The laws of some countries do not protect intellectual property rights to the same extent as the laws of the U.S. and Canada. Many companies have encountered significant
problems in protecting and defending such rights in foreign jurisdictions. Many countries, including certain countries in Europe, have compulsory licensing laws under which a
patent owner may be compelled to grant licenses to third parties.  In addition, many countries limit the enforceability of patents against government agencies or government
contractors.  In these countries, the patent owner may have limited remedies, which could materially diminish the value of the patent.  Moreover, the legal systems of certain
countries, particularly certain developing countries, do not favor the aggressive enforcement of patent and other intellectual property protection, which makes it difficult to stop
and prevent infringement.

Our patents may be challenged, narrowed, invalidated, held to be unenforceable or circumvented, which could limit our ability to stop competitors from marketing similar products
or limit the length of term of patent protection we may have for Macrilen™ (macimorelin). Changes in either patent laws or in interpretations of patent laws in the U.S. and other
countries may diminish the value of our intellectual property or narrow the scope of our patent protection for Macrilen™ (macimorelin). The patents issued or to be issued to us for
Macrilen™ (macimorelin) may not provide us with any competitive advantage or protect us against competitors with similar technology. In addition, it is possible that third parties
with products that are very similar to ours will circumvent our patents by means of alternate designs or processes. We may have to rely on method-of-use, methods of manufacture
and/or new-formulation protection for our compounds in development, and any resulting products, which may not confer the same protection as claims to compounds per se.

21

In addition, our patents may be challenged by third parties in patent litigation, which is becoming widespread in the biopharmaceutical industry. There may be prior art of which we
are not aware that may affect the validity or enforceability of a patent claim. There may also be prior art of which we are aware, but which we do not believe affects the validity or
enforceability of a claim, which may, nonetheless, ultimately be found to affect the validity or enforceability of a claim. No assurance can be given that our patents would, if
challenged, be held by a court to be valid or enforceable, or that a competitor’s technology or product would be found by a court to infringe our patents. Our granted patents could
also be challenged and revoked in U.S. post-grant proceedings as well as in opposition or nullity proceedings in certain countries outside the U.S. In addition, we may be required
to disclaim part of the term of certain patents. The costs of these proceedings could be substantial, and it is possible that our efforts could be unsuccessful, resulting in a loss of
our U.S. patent position.

We also rely on trade secrets and proprietary know-how to protect our intellectual property. If we are unable to protect the confidentiality of our proprietary information and know-
how, the value of our technology and products could be adversely affected.  We seek to protect our unpatented proprietary information in part by requiring our employees,
consultants, outside scientific collaborators, and sponsored researchers and other advisors to enter into confidentiality agreements. These agreements provide that all confidential
information developed or made known to the individual during the course of the individual’s relationship with us is to be kept confidential and not disclosed to third parties except
in specific circumstances. In the case of our employees, the agreements provide that all of the technology that is conceived by the individual during the course of employment is
our  exclusive  property.  These  agreements  may  not  provide  meaningful  protection  or  adequate  remedies  in  the  event  of  unauthorized  use  or  disclosure  of  our  proprietary
information. In addition, it is possible that third parties could independently develop proprietary information and techniques substantially similar to ours or otherwise gain access
to our trade secrets. If we are unable to protect the confidentiality of our proprietary information and know-how, competitors may be able to use this information to develop
products that compete with our products and technologies, which could adversely impact our business.

We currently have the right to use certain patents and technologies under license agreements with third parties. Our failure to comply with the requirements of one or more of our

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
license agreements could result in the termination of such agreements, which could cause us to terminate the related development program and cause a complete loss of our
investment in that program or given market. Inventions claimed in certain in-licensed patents may have been made with funding from the U.S. government and may be subject to
the rights of the U.S. government, and we may be subject to additional requirements in the event we seek to commercialize or manufacture product candidates incorporating such
in-licensed technology.

As a result of the foregoing factors, we may not be able to rely on our intellectual property to protect Macrilen™ (macimorelin) in the marketplace.

We may infringe the intellectual property rights of others.

Our commercial success depends significantly on our ability to operate without infringing the patents and other intellectual property rights of third parties. There could be issued
patents of which we are not aware that our products or methods may be found to infringe, or patents of which we are aware and believe we do not infringe, but which we may
ultimately be found to infringe. Moreover, patent applications and their underlying discoveries are in some cases maintained in secrecy until patents are issued. Because patents
can take many years to issue, there may be currently pending applications of which we are unaware that may later result in issued patents that our products or technologies are
found to infringe. Moreover, there may be published pending applications that do not currently include a claim covering our products or technologies, but, which nonetheless,
provide support for a later drafted claim that, if issued, our products or technologies could be found to infringe.

22

If we infringe or are alleged to infringe intellectual property rights of third parties, it will adversely affect our business. Third parties may own or control these patents or patent
applications in the U.S. and abroad. These third parties could bring claims against us or our collaborators that would cause us to incur substantial expenses and, if successful
against us, could cause us to pay substantial damages. Further, if a patent infringement suit were brought against us or our collaborators, we or they could be forced to stop or
delay research, development, manufacturing or sales of the product or product candidate that is the subject of the suit.

The biopharmaceutical industry has produced a proliferation of patents, and it is not always clear to industry participants, including us, which patents cover various types of
products. The coverage of patents is subject to interpretation by the courts, and the interpretation is not always uniform. In the event of infringement or violation of another
party’s patent or other intellectual property rights, we may not be able to enter into licensing arrangements or make other arrangements at a reasonable cost. Any inability to secure
licenses or alternative technology could result in delays in the introduction of our products or lead to prohibition of the manufacture or sale of products by us or our partners and
collaborators.

Patent litigation is costly and time consuming and may subject us to liabilities.

If we become involved in any patent litigation, interference, opposition, re-examination or other administrative proceedings, we will likely incur substantial expenses in connection
therewith, and the efforts of our technical and management personnel will be significantly diverted. In addition, an adverse determination in litigation could subject us to significant
liabilities.

We may not obtain trademark registrations for our current or future products.

We have filed applications for trademark registrations, including Macrilen™ (macimorelin), in various jurisdictions, including the U.S. We may file applications for other possible
trademarks for macimorelin. No assurance can be given that any of our trademarks will be registered elsewhere, or that the use of any registered or unregistered trademarks will
confer a competitive advantage in the marketplace.

Any difficulties or delays in the commencement or completion, or termination or suspension, of our ongoing or planned clinical trials could result in increased costs to us,
delay or limit our ability to generate revenue and adversely affect our commercial prospects.

Before we can initiate clinical trials for our product candidates, we must submit the results of preclinical studies to the FDA or comparable foreign regulatory authorities along with
other information, including information about product candidate chemistry, manufacturing and controls and our proposed clinical trial protocol, as part of an  IND or similar
regulatory filing required for authorization to proceed with clinical development.  The  FDA or comparable foreign regulatory authorities  may  require  us  to  conduct  additional
preclinical studies for any product candidate before it allows us to initiate clinical trials under any IND or similar regulatory filing, which may lead to delays and increase the costs
of our preclinical development programs. Any such delays in the commencement or completion of the DETECT-trial evaluating macimorelin for the diagnosis of CGHD, or any other
product candidate, could significantly affect our product development costs.

Further, conducting clinical trials in foreign countries, as in our ongoing DETECT-trial, presents additional risks that may delay completion of our clinical trials. These risks include
the  failure  of  enrolled  patients  in  foreign  countries  to  adhere  to  clinical  protocol  as  a  result  of  differences  in  healthcare  services  or  cultural  customs,  managing  additional
administrative burdens associated with foreign regulatory schemes, as well as political and economic risks, including war, relevant to such foreign countries. For example, in 2022
our DETECT-trial activities in both Russia and Ukraine were halted due to the Russian invasion of Ukraine, which represented approximately 25 of the planned total patients in the
trial, resulting in a delay in the expected completion of the trial. To replace these countries and ensure the timely completion of the DETECT-trial, the Company engaged a second
CRO to establish testing sites in four new countries (Armenia, Slovakia, Greece, and Turkey). Clinical trial applications are ongoing, however, Russia’s invasion of Ukraine has
impacted our ability to conduct certain trials in the region and caused delays in the trial to date. This could hinder the completion of our clinical trials and/or analyses of clinical
results, which could materially harm our business.

23

We  are  conducting  our  DETECT-trial  of  macimorelin  globally  and  may  conduct  future  clinical  trials  outside  the  United  States.  However,  the  FDA  and  other  foreign
equivalents may not accept data from such trials, in which case our development plans will be delayed, which could materially harm our business.

In particular, we have engaged two CRO’s to conduct our DETECT-trial outside of the United States, including in Russia and Ukraine. As a result of Russia’s invasion of Ukraine
in  February  2022,  clinical  trial  sites  in  Ukraine  and  the  surrounding  region  were  halted.  Furthermore,  the  United  States  and  its  European  allies  have  imposed  significant  new
sanctions against Russia, including regional embargoes, full blocking sanctions, and other restrictions targeting major Russian financial institutions. Our ability to conduct clinical
trials in Russia, parts of Ukraine and elsewhere in the region were restricted under applicable sanctions laws, which required us to identify alternative trial sites, which increased
our development costs and delayed the clinical development of our product candidates. All of the foregoing could impede the execution of our clinical development plans, which
could materially harm our business.

In carrying out our operations, we are dependent on a stable and consistent supply of ingredients and raw materials.

There can be no assurance that we, our contract manufacturers or our licensees, will be able, in the future, to continue to purchase products from our current suppliers or any other
supplier on terms that are favorable or similar to current terms or at all. An interruption in the availability of certain raw materials or ingredients, or significant increases in the prices
we pay for them, could have a material adverse effect on our business, financial condition, liquidity and operating results.

We rely on third parties to conduct, supervise and monitor our clinical trials, and those third parties may not perform satisfactorily.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We rely on third parties such as CROs, medical institutions and clinical investigators to enroll qualified patients and to conduct, supervise and monitor our clinical trials. Our
reliance on these third parties for clinical development activities reduces our control over these activities. Our reliance on these third parties, however, does not relieve us of our
regulatory responsibilities, including ensuring that our clinical trials are conducted in accordance with GCP guidelines and the investigational plan and protocols contained in an
IND application to the FDA, or a comparable foreign regulatory submission. Furthermore, these third parties may also have relationships with other entities, some of which may be
our competitors. In addition, they may not complete activities on schedule, or may not conduct our preclinical studies or clinical trials in accordance with regulatory requirements
or our trial design. If these third parties do not successfully carry out their contractual duties or meet expected deadlines, our efforts to obtain regulatory approvals for, and to
commercialize, our products may be delayed or prevented.

We  are  dependent  on,  and  rely  upon,  third  parties  to  perform  various  functions  related  to  our  business,  including,  but  not  limited  to,  development  of  some  of  our  product
candidates. Our reliance on these relationships poses a number of risks.

The failure to perform satisfactorily by third parties upon which we expect to rely to manufacture and supply products may lead to supply shortfalls.

We rely on third parties to manufacture and supply Macrilen™ (macimorelin). We also have or may have certain supply obligations  vis-à-vis our existing and potential licensees,
who are or will be responsible for the marketing of  Macrilen™ (macimorelin).  To be successful,  Macrilen™ (macimorelin) has to be manufactured in commercial quantities in
compliance with quality controls and regulatory requirements. Even though it is our objective to minimize such risk by introducing alternative suppliers to ensure a constant
supply  at  all  times,  there  are  a  limited  number  of  contract  manufacturers  or  suppliers  that  are  capable  of  manufacturing  Macrilen™  (macimorelin)  or  the  materials  used  in  its
manufacture.  If we are unable to do so ourselves or to arrange for third-party manufacturing or supply of  Macrilen™ (macimorelin) or materials, or to do so on commercially
reasonable terms, we may not be able to commercialize Macrilen™ (macimorelin) through our licensees. Reliance on third-party manufacturers entails risks to which we would not
be subject if we manufactured products ourselves, including reliance on the third party for regulatory compliance, the possibility of breach of the manufacturing agreement by the
third party because of factors beyond our control, and the possibility of termination or non-renewal of the agreement by the third party, based on its own business priorities, at a
time that is costly or inconvenient for us.

24

We are subject to intense competition for our skilled personnel, and the loss of key personnel or the inability to attract additional personnel could impair our ability to
conduct our operations.

We  are  highly  dependent  on  our  management  and  our  clinical,  regulatory  and  scientific  staff,  the  loss  of  whose  services  might  adversely  impact  our  ability  to  achieve  our
objectives.  Recruiting  and  retaining  qualified  management  and  clinical,  scientific  and  regulatory  personnel  is  critical  to  our  success.  Reductions  in  our  staffing  levels  have
eliminated redundancies in key capabilities and skill sets among our full-time staff and required us to rely more heavily on outside consultants and third parties. We have been
unable to increase the compensation of our associates to the extent required to remain fully competitive for their services, which increased our employee retention risk.  The
competition for qualified personnel in the biopharmaceutical field is intense, and if we are not able to continue to retain qualified personnel and/or maintain positive relationships
with our outside consultants, we may not be able to achieve our strategic and operational objectives.

We may be subject to litigation in the future.

We may, from time to time, be a party to litigation in the normal course of business. Monitoring and defending against legal actions, whether meritorious, is time-consuming for our
management and detracts from our ability to fully focus our internal resources on our business activities.  In addition, legal fees and costs incurred in connection with such
activities may be significant and we could, in the future, be subject to judgments or enter into settlements of claims for significant monetary damages. A decision adverse to our
interests could result in the payment of substantial damages and could have a material adverse effect on our cash flow, results of operations and financial position.

With respect to any litigation, our insurance may not reimburse us, or may not be sufficient to reimburse us, for the expenses or losses we may suffer in contesting and concluding
such lawsuit. Substantial litigation costs, including the substantial self-insured retention that we are required to satisfy before any insurance applies to a claim, unreimbursed legal
fees or an adverse result in any litigation may adversely impact our business, operating results or financial condition.

We are subject to the risk of product liability claims, for which we may not have or may not be able to obtain adequate insurance coverage.

The sale and use of Macrilen™ (macimorelin) will involve the risk of product liability claims and associated adverse publicity. Product liability claims might be made against us
directly by patients, healthcare providers or pharmaceutical companies, or others selling, buying or using our products. We attempt to manage our liability risks by means of
insurance. We maintain insurance covering our liability for our preclinical and clinical studies as well as products liability insurance. However, we may not have or be able to obtain
or maintain sufficient and affordable insurance coverage, including coverage for potentially very significant legal expenses, and without sufficient coverage any claim brought
against us could have a materially adverse effect on our business, financial condition or results of operations.

We are a holding company, and claims of creditors of our subsidiaries will generally have priority as to the assets of such subsidiaries over our claims and those of our
creditors and shareholders. In addition, our principal operating subsidiary, AEZS Germany, may become subject to insolvency proceedings if it is illiquid or "over-indebted”
in accordance with German law.

Aeterna Zentaris is a holding company and a substantial portion of our non-cash assets is the share capital of our subsidiaries. AEZS Germany, our principal operating subsidiary,
based in  Frankfurt,  Germany, holds most of our intellectual property rights.  Because Aeterna  Zentaris is a holding company, our obligations to our creditors are structurally
subordinated to all existing and future liabilities of our subsidiaries, which may incur additional or other liabilities and/or obligations. As a result, our rights and the rights of our
creditors to participate in any distribution of the assets of any subsidiary in the event that such subsidiary were to be liquidated or reorganized or in the event of any bankruptcy
or insolvency proceeding relating to or involving such subsidiary, and, therefore, the rights of the holders of our securities to participate in those assets, are subject to the prior
claims of such subsidiary’s creditors. To the extent that we may be a creditor with recognized claims against any such subsidiary, our claims would still be subject to the prior
claims of our subsidiary’s creditors to the extent that they are secured or senior to those held by us.

25

Holders of our securities are not creditors of our subsidiaries. Claims to the assets of our subsidiaries will derive from our own ownership interest in those operating subsidiaries.
Claims of our subsidiaries’ creditors will generally have priority as to the assets of such subsidiaries over our own ownership interest claims and, therefore, will have priority over
the holders of our securities.  Our subsidiaries’ creditors may from time to time include general creditors, trade creditors, employees, secured creditors, taxing authorities and
creditors  holding  guarantees.  Accordingly,  in  the  event  of  any  foreclosure,  dissolution,  winding-up,  liquidation  or  reorganization,  or  a  bankruptcy,  insolvency  or  creditor
protection proceeding relating to us or our property, or any subsidiary, there can be no assurance as to the value, if any, that would be available to holders of our securities. In
addition, any distributions to us by our subsidiaries could be subject to monetary transfer restrictions in the jurisdictions in which our subsidiaries operate.

German  law,  which  governs  our  principal  operating  subsidiary AEZS  Germany,  imposes  an  obligation  on  the  managing  director(s)  of AEZS  Germany  to  institute  insolvency
proceedings  of  that  subsidiary  if  the  managing  director(s)  concludes  that AEZS  Germany  is  insolvent  because  it  is  either  illiquid  or  "over-indebted”  in  accordance  with  the
provisions of German law.

It may be difficult for U.S. investors to obtain and enforce judgments against us because of our Canadian incorporation and German presence.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We are a company existing under the laws of Canada. A number of our directors and officers are residents of Canada or otherwise reside outside the U.S., and all or a substantial
portion of their assets, and a substantial portion of our assets, are located outside the U.S. Consequently, although we have appointed an agent for service of process in the U.S.,
it may be difficult for investors in the U.S. to bring an action against such directors or officers or to enforce against those persons or us a judgment obtained in a U.S. court
predicated upon the civil liability provisions of federal securities laws or other laws of the U.S. Investors should not assume that foreign courts (i) would enforce judgments of U.S.
courts obtained in actions against us or such directors, officers or experts predicated upon the civil liability provisions of the U.S. federal securities laws or the securities or "blue
sky” laws of any state within the U.S. or (ii) would enforce, in original actions, liabilities against us or such directors, officers or experts predicated upon the U.S. federal securities
laws or any such state securities or "blue sky” laws.

We are subject to various internal control reporting requirements under applicable Canadian securities laws and the Sarbanes-Oxley Act in the U.S. We can provide no
assurance that we will, at all times in the future, be able to report that our internal controls over financial reporting are effective.

As a public company, we are required to comply with  Section 404 of the  U.S. Sarbanes-Oxley  Act of 2002 ("Section 404”)  and  National  Instrument  52-109  - Certification  of
Disclosure in Issuers’ Annual and Interim Filings of the Canadian securities administrators. In any given year, we cannot be certain as to the time of completion of our internal
control evaluation, testing and remediation actions or of their impact on our operations. Upon completion of this process, we may identify control deficiencies of varying degrees
of severity under applicable SEC and Public Company Accounting Oversight Board (U.S.) rules and regulations. As a public company, we are required to report, among other
things, control deficiencies that constitute material weaknesses or changes in internal controls that, or that are reasonably likely to, materially affect internal controls over financial
reporting. A "material weakness” is a deficiency, or a combination of deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a
material misstatement of our annual or interim consolidated financial statements will not be prevented or detected on a timely basis. If we fail to comply with the requirements of
Section 404 or similar Canadian requirements, or if we report a material weakness, we might be subject to regulatory sanction and investors may lose confidence in our consolidated
financial statements, which may be inaccurate if we fail to remedy such material weakness.

We may have material weaknesses in our internal controls over financial reporting which could have a material adverse effect on the price of our Common Shares

Internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial
statements for external purposes in accordance with generally accepted accounting principles. Disclosure controls and procedures are designed to ensure that information required
to be disclosed by a company in reports filed with securities regulatory agencies is recorded, processed, summarized and reported on a timely basis and is accumulated and
communicated to a company’s management, including its Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.
The Company has invested resources to document and analyze its system of disclosure controls and its internal control over financial reporting. A control system, no matter how
well designed and operated, can provide only reasonable, not absolute, assurance with respect to the reliability of financial reporting and financial statement preparation.

As previously disclosed in our annual report Item 15 – "Controls and Procedures” in our Annual Report on Form 20-F for the year ended December 31, 2022, our management
identified a material weakness in our control over financial reporting that resulted from a failure in the design and implementation of review controls over the accounting for license
and collaboration agreements under IFRS and the related revenue recognition. Due to remediation measures taken by us during 2022 to implement and subsequently test newly
established policies, procedures, and control activities designed to address the material weakness, management has concluded that this material weakness was remediated as of
December 31, 2022.

26

We are subject to a broad range of environmental laws and regulations and may be subject to environmental remediation obligations under such safety and related laws and
regulations. The impact of these obligations and the Company’s ability to respond effectively to them may have a material adverse effect on our business, financial condition,
cash flows and results of operations and could cause the market value of our Common Shares to decline.

We are subject to a broad range of federal, state, provincial and local environmental laws and regulations in the U.S., Canada and Germany concerning the environment, safety
matters, regulation of chemicals and product safety in the countries where we manufacture and sell our products or otherwise operate our business. These requirements include,
among other matters, regulation of the handling, manufacture, transportation, storage, use and disposal of materials, including the discharge of pollutants, hazardous substances
and waste into the environment. In the normal course of our business, such substances and waste may be released into the environment, which could cause environmental or
property damage or personal injuries, and which could subject us to remediation obligations regarding contaminated soil and groundwater, potential liability for damage claims or
to social or reputational harm and other similar adverse impacts. Under certain laws, we may be required to remediate contamination at certain of our properties regardless of
whether the contamination was caused by us or by previous occupants of the property, or by others and at third-party sites where we send waste.

In recent years, the operations of all companies have become subject to increasingly stringent legislation and regulation related to environmental protection. Such legislation and
regulations are complex and constantly changing. Future events, such as changes in existing laws or regulations or the enforcement thereof, or the discovery of contamination at
our facilities may, among other things, require us to install additional controls for certain of our emission sources, undertake changes in our manufacturing processes, remediate
soil or groundwater contamination at facilities where such cleanup is not currently required, or to take action to address social expectations or concerns arising from or relating to
such changes and our response to such changes. The cost of such additional compliance or remediation obligations or responding to such social expectations or concerns may be
significant and could have a material adverse effect on our business, financial condition, cash flows and results of operations and could cause the market value of our Common
Shares and/or debt securities to decline.

We may incur losses associated with foreign currency fluctuations.

Our operations are, in many instances, conducted in currencies other than our functional currency or the functional currencies of our subsidiaries. Fluctuations in the value of
currencies could cause us to incur currency exchange losses. We do not currently employ a hedging strategy against exchange rate risk. We cannot assert with any assurance that
we will not suffer losses as a result of unfavorable fluctuations in the exchange rates between the U.S. dollar, the euro, the Canadian dollar and other currencies.

Legislative actions, new accounting pronouncements and higher insurance costs may adversely impact our future financial position or results of operations.

Changes in financial accounting standards or implementation of accounting standards may cause adverse, unexpected revenue or expense fluctuations and affect our financial
position or results of operations. New pronouncements and varying interpretations of pronouncements have occurred with greater frequency and are expected to occur in the
future, and we may make or be required to make changes in our accounting policies in the future. Compliance with changing regulations of corporate governance and public
disclosure, notably with respect to internal controls over financial reporting, may result in additional expenses. Changing laws, regulations and standards relating to corporate
governance and public disclosure are creating uncertainty for companies such as ours, and insurance costs are increasing as a result of this uncertainty.

27

Data security breaches and other cyber security risks may disrupt our operations and adversely affect our operating results.

Attempts to gain unauthorized access to our information technology systems and that hosted by our third-party suppliers have become more sophisticated over time. These
attempts, which might be related to industrial or other espionage, include covertly introducing malware to our computers and networks and impersonating authorized users, among
others. Our network security and data recovery measures and those of third parties with which we contract, may not be adequate to protect against computer viruses, cyber-

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
attacks, breaches, and similar disruptions from unauthorized tampering with our computer systems. The misappropriation, theft, sabotage or any other type of security breach with
respect to any of our proprietary and confidential information that is electronically stored, including research or clinical data, could cause interruptions in our operations, could
result  in  a  material  disruption  of  our  clinical  activities  and  business  operations  and  could  expose  us  to  third-party  legal  claims.  Furthermore,  we  could  be  required  to  make
substantial expenditures of resources to remedy the cause of cyber-attacks or break-ins. This disruption could have a material adverse impact on our business, operating results
and financial condition. Additionally, any break-in or trespass of our facilities that results in the misappropriation, theft, sabotage or any other type of security breach with respect
to our proprietary and confidential information, including research or clinical data, or that results in damage to our research and development equipment and assets could have a
material adverse impact on our business, operating results and financial condition.

Our business processes personal information, both in connection with clinical activities and our employees. The use of this information is critical to our operations and innovation,
including  the  development  of  our  products,  as  well  as  management  of  our  employees.  New  and  evolving  regulations,  such  as  the  European  Union  General  Data  Protection
Regulation, could bring increased scrutiny of our data management in the future. Any cyber-attacks or other failure to protect critical and sensitive systems and information could
damage our reputation, prompt litigation or lead to regulatory sanctions, all of which could materially affect our financial condition and results of operation.

We seek to detect and investigate all security incidents and to prevent their recurrence, but in some cases, we might be unaware of an incident or its magnitude and effects. The
theft, unauthorized use, or publication of our intellectual property and/or confidential business information could harm our competitive position, reduce the value of our investment
in research and development and other strategic initiatives or otherwise adversely affect our business. In addition, the devotion of additional resources to the security of our
information technology systems in the future could significantly increase the cost of doing business or otherwise adversely impact our financial results.

We cannot provide any assurance that our systems, procedures and controls will be adequate to support the expansion of operations and associated increased costs and
complexity following and resulting from the Plan of Arrangement with Ceapro.

As a result of the pursuit and completion of the Plan of Arrangement with Ceapro, significant demands will be placed on our managerial, operational and financial personnel and
systems. We cannot provide any assurance that our systems, procedures and controls will be adequate to support the expansion of operations and associated increased costs and
complexity following and resulting from the Plan of Arrangement. The future operating results of the combined company will be affected by the ability of its officers and key
employees to manage changing business conditions, to integrate the acquisition of Ceapro, to implement a new business strategy and to improve its operational and financial
controls and reporting systems.

We may be unable to successfully integrate our businesses with Ceapro’s and realize the anticipated benefits of the Plan of Arrangement. The failure to successfully integrate
the businesses of Aeterna and Ceapro could have a material adverse effect on the market price of the Common Shares following completion of the Plan of Arrangement.

The integration requires the dedication of substantial effort, time and resources on the part of management which may divert management’s focus and resources from other
strategic opportunities and from operational matters during this process. In addition, the integration process could result in disruption of existing relationships with suppliers,
employees, customers and other constituencies of each Party. There can be no assurance that management will be able to integrate the operations of each of the businesses
successfully or achieve any of the synergies or other benefits that are anticipated as a result of the Plan of Arrangement. Most operational and strategic decisions and certain
staffing decisions with respect to integration have not yet been made. These decisions and the integration of the two parties will present challenges to management, including the
integration of systems and personnel of the two parties which may be geographically separated, unanticipated liabilities and unanticipated costs. It is possible that the integration
process could result in the loss of key employees, the disruption of the respective ongoing businesses or inconsistencies in standards, controls, procedures and policies that
adversely  affect  the  ability  of  management  to  maintain  relationships  with  operators  or  employees  or  to  achieve  the  anticipated  benefits  of  the  Plan  of  Arrangement.  The
performance of our operations after completion of the Plan of Arrangement could be adversely affected if we cannot retain key employees to assist in the integration and operation
of Aeterna and Ceapro.

28

The consummation of the Plan of Arrangement may pose special risks, including one-time write-offs, restructuring charges and unanticipated costs. Although Ceapro, Aeterna and
our respective advisors have conducted due diligence on the various operations, there can be no guarantee that we will be aware of any and all liabilities of Ceapro or the Plan of
Arrangement. As  a  result  of  these  factors,  it  is  possible  that  certain  benefits  expected  from  the  Plan  of Arrangement  may  not  be  realized. Any  inability  of  management  to
successfully integrate the operations could have an adverse effect on our business, financial condition and results of operations.

Failure  by  us  and/or  Ceapro  to  comply  with  applicable  Laws  prior  to  the  Plan  of  Arrangement  could  subject  the  combined  company  to  penalties  and  other  adverse
consequences following completion of the Plan of Arrangement.

We are subject to the United States Foreign Corrupt Practices Act and Aeterna Zentaris and Ceapro are subject to the Corruption of Foreign Public Officials Act (Canada). The
foregoing Laws prohibit companies and their intermediaries from making improper payments to officials for the purpose of obtaining or retaining business. In addition, such Laws
require the maintenance of records relating to transactions and an adequate system of internal controls over financial reporting. There can be no assurance that either Party’s
internal control policies and procedures, compliance mechanisms or monitoring programs will protect it from recklessness, fraudulent behavior, dishonesty or other inappropriate
acts or adequately prevent or detect possible violations under applicable anti-bribery and anti-corruption legislation. A failure by us or Ceapro to comply with anti-bribery and anti-
corruption  legislation  could  result  in  severe  criminal  or  civil  sanctions,  and  may  subject  us  to  other  liabilities,  including  fines,  prosecution,  potential  debarment  from  public
procurement and reputational damage, all of which could have a material adverse effect on our business, consolidated results of operations and consolidated financial condition.
Investigations by governmental authorities could have a material adverse effect on the business, consolidated results of operations and consolidated financial condition of the
combined company.

Aeterna and Ceapro are also subject to a wide variety of Laws relating to the environment, health and safety, intellectual property, taxes, employment, labor standards, money
laundering, terrorist financing and other matters in the jurisdictions in which they operate. A failure by either of Aeterna or Ceapro to comply with any such legislation prior to the
Plan of Arrangement could result in severe criminal or civil sanctions, and may subject us to other liabilities, including fines, prosecution and reputational damage, all of which
could  have  a  material  adverse  effect  on  the  business,  consolidated  results  of  operations  and  consolidated  financial  condition.  The  compliance  mechanisms  and  monitoring
programs adopted and implemented by either of Aeterna Zentaris or Ceapro prior to the Plan of Arrangement may not adequately prevent or detect possible violations of such
applicable  Laws.  Investigations  by  governmental  authorities  could  also  have  a  material  adverse  effect  on  our  business,  consolidated  results  of  operations  and  consolidated
financial condition.

Risks Relating to our Common Shares

Our share price is volatile, which may result from factors outside of our control.

Our valuation and share price since the beginning of trading after our initial listings, first in  Canada and then in the  U.S., have had no meaningful relationship to current or
historical financial results, asset values, book value or many other criteria based on conventional measures of the value of shares.

29

Between January 1, 2023 and December 31, 2023, the closing price of our Common Shares ranged from $1.42 to $3.89 per share on the NASDAQ and from C$1.391 to C$5.30 per
share on the TSX. As of March 26, 2024, the price of our Common Shares on the NASDAQ was $2.00 and C$2.77 on the TSX. Our share price may be affected by developments

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
directly affecting our business and by developments out of our control or unrelated to us. The stock market generally, and the biopharmaceutical sector in particular, are vulnerable
to abrupt changes in investor sentiment. Prices of shares and trading volume of companies in the biopharmaceutical industry can swing dramatically in ways unrelated to, or that
bear a disproportionate relationship to, operating performance. Our share price and trading volume may fluctuate based on a number of factors including, but not limited to, the
following:

● developments regarding current or future third-party suppliers and licensee(s);
● clinical trial and regulatory developments regarding Macrilen™ (macimorelin);
● delays in our anticipated clinical trial development or commercialization timelines;
● announcements by us regarding technological, regulatory or other matters;
● arrivals or departures of key personnel;
● governmental or regulatory action affecting our product candidates and our competitors’ products in the U.S., Canada and other countries;
● developments or disputes concerning patent or proprietary rights;
● actual or anticipated fluctuations in our revenues or expenses;
● general market conditions and fluctuations for the emerging growth and biopharmaceutical market sectors; and
● economic conditions in the U.S. or abroad, including the instability due to pandemics, armed conflicts or other events.

Our listing on both the NASDAQ and the TSX may increase price volatility due to various factors, including different ability to buy or sell our Common Shares, different market
conditions in different capital markets, and different trading volumes. In addition, low trading volume may increase the price volatility of our Common Shares. A thin trading market
could cause the share price of our Common Shares to fluctuate significantly more than the stock market as a whole.

We do not intend to pay dividends in the near future.

To date, we have not declared or paid any dividends on our Common Shares. As a result, the return on an investment in our Common Shares, or any of our other securities, will
depend upon any future appreciation in value. There is no guarantee that our Common Shares or any of our other securities will appreciate in value or even maintain the price at
which shareholders have purchased them.

Future issuances of securities and hedging activities may depress the trading price of our Common Shares.

Any additional or future issuance of securities or convertible securities, including the issuance of securities upon the exercise of stock options and upon the exercise of warrants
or other convertible securities or securities pursuant to which Common Shares are issuable, could dilute the interests of our existing shareholders, and could substantially decrease
the trading share price of our Common Shares.

We may issue equity securities in the future for a number of reasons, including to finance our operations and business strategy, to satisfy our obligations upon the exercise of
options or warrants, or for other reasons. Our stock option plans generally permit us to have outstanding, at any given time, stock options that are exercisable for a maximum
number of Common Shares equal to 11.4% of all then issued and outstanding Common Shares.

In addition, the share price of our Common Shares could also be affected by possible sales of securities by investors who view other investment vehicles as more attractive means
of equity participation in us and by hedging or arbitrage trading activity that may develop involving our securities. This hedging or arbitrage could, in turn, affect the trading share
price of our Common Shares.

30

In the event we were to lose our foreign private issuer status as of June 30 of a given financial year, we would be required to comply with the Securities Exchange Act of 1934
domestic reporting regime, which could cause us to incur additional legal, accounting and other expenses.

In order to maintain our current status as a foreign private issuer, either (1) a majority of our Common Shares must not be either directly or indirectly owned of record by residents
of the U.S. or (2) (a) a majority of our executive officers and of our directors must not be U.S. citizens or residents, (b) more than 50 percent of our assets cannot be located in the
U.S. and (c) our business must be administered principally outside the U.S.

In 2023, our management conducted its annual assessment of the various facts and circumstances underlying the determination of our status as a foreign private issuer and based
on the foregoing, our management has determined that, as of the date of such determination and as of June 30, 2023, we continued to be a foreign private issuer.

There can be no assurance, however, that we will remain a foreign private issuer either in 2024 or in future financial years.

If we were to lose our foreign private issuer status as of June 30 of any given financial year, we would be required to comply with the Securities Exchange Act of 1934 reporting and
other requirements applicable to U.S. domestic issuers, which are more detailed and extensive than the requirements for foreign private issuers. We may also be required to make
changes in our corporate governance practices in accordance with various SEC rules and the NASDAQ listing standards. The regulatory and compliance costs to us of complying
with the reporting requirements applicable to a U.S. domestic issuer under U.S. securities laws may be higher than the cost we have historically incurred as a foreign private issuer.
As  a  result,  we  would  expect  that  a  potential  loss  of  foreign  private  issuer  status  at  some  future  point  in  time  could  increase  our  legal,  financial  reporting  and  accounting
compliance costs, and it is difficult at this time to estimate by how much our legal, financial reporting and accounting compliance costs may increase in such eventuality.

Our articles of incorporation contain "blank check” preferred share provisions, which could delay or impede an acquisition of our company.

Our  articles  of  incorporation,  as  amended,  authorize  the  issuance  of  an  unlimited  number  of  "blank  check”  preferred  shares,  which  could  be  issued  by  our  Board  without
shareholder  approval  and  which  may  contain  liquidation,  dividend  and  other  rights  equivalent  or  superior  to  our  Common  Shares.  In  addition,  we  have  implemented  in  our
constating documents an advance notice procedure for shareholder approvals to be brought before an annual meeting of our shareholders, including proposed nominations of
persons for election to our Board. These provisions, among others, whether alone or together, could delay or impede hostile takeovers and changes in control or changes in our
management. Any provision of our constating documents that has the effect of delaying or deterring a change in control could limit the opportunity for our shareholders to receive
a premium for their Common Shares and could also affect the price that some investors are willing to pay for our Common Shares.

Our business could be negatively affected as a result of the actions of activist shareholders.

Proxy  contests  have  been  waged  against  many  companies  in  the  biopharmaceutical  industry  over  the  last  few  years.  If  faced  with  a  proxy  contest,  we  may  not  be  able  to
successfully respond to the contest, which would be disruptive to our business. Even if we are successful, our business could be adversely affected by a proxy contest because:

● responding to proxy contests and other actions by activist shareholders may be costly and time-consuming, and may disrupt our operations and divert the attention

of management and our employees;

● perceived uncertainties  as  to  the  potential  outcome  of  any  proxy  contest  may  result  in  our  inability to  consummate  potential  acquisitions,  collaborations  or  in-

licensing opportunities and may make it more difficult to attract and retain qualified personnel and business partners; and

● if individuals that have a specific agenda different from that of our management, or other members of our board of directors are elected to our Board as a result of any

proxy contest, such an election may adversely affect our ability to effectively and timely implement our strategic plan and to create value for our shareholders.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 4.

Information on the Company

A.

History and development of the Company

31

Aeterna Zentaris Inc. was incorporated on September 12, 1990 under the Canada Business Corporations Act (the "CBCA”) and continues to be governed by the CBCA. Our
registered address is located at 222 Bay St., Suite 3000, Toronto, Ontario, Canada M5K 1E7 c/o Norton Rose Fulbright Canada LLP and we operate another office located at 315
Sigma Drive, Summerville, South Carolina 29486; our telephone number is (843) 900-3223 and our website is www.zentaris.com.

In May 2004, we changed our name to Aeterna Zentaris Inc. On July 18, 2022, we completed a 25-for-1 share consolidation (reverse stock split) and previously, on November 17,
2015, we completed 100-to-1 share consolidation (reverse stock split). Our Common Shares commenced trading on a consolidated and adjusted basis on both the NASDAQ and the
TSX on November 20, 2015.

We currently have three wholly-owned direct and indirect subsidiaries: Aeterna Zentaris GmbH ("AEZS Germany”), based in Frankfurt am Main, Germany and incorporated under
the laws of Germany; Zentaris IVF GmbH, a direct wholly-owned subsidiary of AEZS Germany based in Frankfurt am Main, Germany and incorporated under the laws of Germany;
and Aeterna Zentaris, Inc., an entity incorporated in the State of Delaware with an office in the Charleston, South Carolina area in the U.S.

Our Common Shares are listed for trading on both the NASDAQ and the TSX under the trading symbol "AEZS”.

Our agent for service of process and SEC matters in the U.S. is our wholly-owned subsidiary, Aeterna Zentaris, Inc., located at 315 Sigma Drive, Summerville, South Carolina 29486.

Recent Developments

Please see "Item 4.B. – Business Overview” (below) for a complete description of the recent events and developments relevant to the Company.

B.

Business overview

Aeterna Zentaris ("Aeterna” or the "Company”) is a specialty biopharmaceutical company commercializing and developing therapeutics and diagnostic tests. The Company’s lead
product, Macrilen® (macimorelin), is the first and only U.S. Food and Drug Administration ("FDA”) and European Medicines Agency ("EMA”) approved oral test indicated for the
diagnosis of patients with adult growth hormone deficiency ("AGHD”). Macimorelin is currently marketed under the tradename Ghryvelin™ in the European Economic Area and
the United Kingdom through an exclusive licensing agreement with Pharmanovia. The Company’s several other license and commercialization partners are also seeking approval
for commercialization of macimorelin in Israel and the Palestinian Authority, the Republic of Korea, Turkey and several non-European Union Balkan countries. The Company is
actively pursuing business development opportunities for the commercialization of macimorelin in North America, Asia and the rest of the world.

32

The Company is also dedicated to the development of therapeutic assets and has taken steps to establish a pre-clinical pipeline to potentially address unmet medical needs across
several indications with a focus on rare or orphan indications.

Plan of Arrangement with Ceapro

On December 14, 2023, Aeterna Zentaris entered into an Arrangement Agreement with Ceapro, pursuant to which Aeterna Zentaris and Ceapro agreed that, subject to the terms
and conditions set forth in the Arrangement Agreement, including the receipt of the approval of the stockholders of Aeterna Zentaris and Ceapro on March 12. 2024, the final order
of the Court of King’s Bench of Alberta and certain regulatory and exchange approvals described below, on the Effective Date Aeterna Zentaris will acquire 100 percent of the
Ceapro Shares pursuant to a company-approved plan of arrangement under the Canada Business Corporations Act (the "CBCA”) such that Ceapro will become a wholly-owned
subsidiary of Aeterna Zentaris and Aeterna Zentaris will continue the operations of Aeterna Zentaris and Ceapro on a combined basis (the "Arrangement”). The terms of the
Arrangement Agreement were the result of arm’s length negotiation between Aeterna Zentaris and Ceapro and their respective advisors. On March 12, 2024, the stockholders of
Aeterna approved the Plan of Arrangement.

If completed, the Arrangement will be considered a reverse acquisition under the International Financial Reporting Standards as issued by the International Accounting Standards
Board ("IFRS”) and the historical financial statements following the Arrangement will be those of Ceapro.

On the Effective Date, immediately prior to the closing of the Plan of Arrangement, Aeterna Zentaris will distribute to each Aeterna Zentaris shareholder and each Aeterna Zentaris
warrant holder 0.47698 of a warrant that entitles the holder of such warrant to purchase from Aeterna Zentaris one Common Share at the Exercise Price of US$0.01 (each, a Aeterna
Zentaris  New  Warrant)  for  each  Common  Share  and Aeterna  Zentaris  warrant  held  by Aeterna  Shareholders  and Aeterna  Warrant  Holders,  respectively,  as  of  the  Warrant
Issuance Record Date, which will be a record date to be determined by the Aeterna Zentaris board of directors. All Aeterna Zentaris New Warrants must be exercised on cashless
basis and no fractional Common Shares will be issued upon the exercise of Aeterna Zentaris New Warrants.

On  the  Effective  Date  and  following  the  closing  of  the  Plan  of Arrangement,  the  existing Aeterna  Zentaris  Shareholders  and  former  Ceapro  Shareholders  would  each  own
approximately 50% of the outstanding Common Shares assuming the exercise of all of the Aeterna Zentaris New Warrants and based on the number of Common Shares and Ceapro
Shares issued and outstanding as of market close on December 13, 2023.

Aeterna Zentaris has applied to list all of its Common Shares issuable upon the exercise of the Aeterna Zentaris New Warrants on the TSX and has filed an initial listing application

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
with the Nasdaq as the exchange has determined that the Plan of Arrangement constitutes a "change of control” under its rules and regulations. The parties intend to rely upon the
exemption from the registration requirements of the U.S. Securities Act pursuant to Section 3(a)(10) thereof and applicable state securities laws with respect to the issuance of the
Consideration Shares and the Replacement Options pursuant to the Plan of Arrangement.

Following closing, Aeterna  Zentaris and  Ceapro have agreed to use their commercially reasonable efforts to delist the  Ceapro  Shares from the  TSXV promptly following the
Effective Date. Aeterna Zentaris and Ceapro also intend to apply for a decision for Ceapro to cease to be a reporting issuer under the Securities Laws of each jurisdiction of Canada
in which it is a reporting issuer, if permitted by applicable Laws.

The Arrangement Agreement contains customary representations and warranties and is subject to customary conditions to closing and other restrictive covenants, including, but
not limited to, the following:

● Directors and Officers: Upon the occurrence of the Plan of Arrangement, effective as of the Effective Date, certain directors of Aeterna  Zentaris will resign, the number of
director seats on the Aeterna Zentaris Board will be increased and nominees of Ceapro will be appointed to fill such vacancies on the Aeterna Zentaris Board, to the
extent permitted by law. Furthermore, Aeterna Zentaris will appoint a new Chief Executive Officer as of the Effective Date.

33

● Non-Solicitation: Subject to certain exceptions, neither party will solicit or assist in the initiation of proposals that could result in an Acquisition Proposal by a third-party.

● Notification of Proposals: A Party that receives an acquisition solicitation has to notify the other Party within 24 hours of its receipt of such solicitation and must provide

certain information and details relating to such acquisition solicitation.

● Superior Proposal: Notwithstanding other restrictions contained in the Plan of Arrangement, in the event a Party receives a superior proposal from a third-party, such
Party may, subject to compliance with the terms of the Plan of Arrangement, enter into a definitive agreement  with a party providing for an Acquisition Proposal so long
as such Acquisition Proposal constitutes a Superior Proposal.

● Termination of Arrangement Agreement :  The  parties  may  terminate  the Arrangement Agreement  upon  the  occurrence  of  certain  conditions,  and  in  any  event,  if  the

Effective Date has not occurred on or before June 14, 2024.

● Termination Fees: Upon the occurrence of certain termination events pursuant to the terms of the Arrangement Agreement, Aeterna Zentaris  shall be entitled to a fee of

US$0.5 million to be paid by Ceapro within the time(s) specified in the Arrangement Agreement in respect to each termination event.

For additional information with respect to the Arrangement and the representations and warranties, conditions to closing and other terms in the Plan of Arrangement, including the
risk factors related thereto, please refer to the section entitled "The Plan of Arrangement – Principal Terms of the Plan of Arrangement” in the Company’s Registration Statement
on Form F-1 filed with the SEC on February 15, 2024 and to the Arrangement Agreement incorporated by reference as Exhibit 2.1 to the Registration Statement on Form F-1.
Macrilen™ (macimorelin)

Macrilen™ (macimorelin) is a novel orally available peptidomimetic ghrelin receptor agonist that stimulates the secretion of growth hormone by binding to the ghrelin receptor
(GHSR-1a) and has potential uses in both endocrinology and oncology indications. Macrilen™ (macimorelin) was granted orphan-drug designation by the FDA for use in the
diagnosis of growth hormone deficiency ("GHD”).

Competitors for Macrilen™ (macimorelin) as a product for the diagnosis of AGHD are principally the diagnostic tests currently performed by endocrinologists, although none of
these tests are approved by the FDA for this purpose. The most commonly used diagnostic tests for GHD are:

● The Insulin  Tolerance  Test  ("ITT”),  which  has  historically  been  considered  the  gold standard  for  the  evaluation  of AGHD  because  of  its  high  sensitivity  and
specificity.  However,  the ITT is inconvenient to both patients and physicians, administered intravenously ("IV”), and contra-indicated in certain patients, such as
patients with coronary heart disease or seizure disorder, because it requires the patient to experience hypoglycemia to obtain an accurate result. Some physicians will
not induce full hypoglycemia, intentionally compromising accuracy to increase safety and comfort for the patient. Furthermore, administration of the ITT  includes
additional costs associated with the patient being closely monitored by a physician for the two- to four-hour duration of the test, and the test must be administered in
a  setting where emergency equipment is available and where the patient can be quickly hospitalized. The ITT is not used for patients with co-morbidities, such as
cardiovascular disease, seizure disorder or a history of brain cancer, or for patients who are elderly and frail, due to safety concerns.

● The Glucagon Stimulation Test ("GST”) is considered relatively safe by endocrinologists. The mechanism of action for this test is unclear. Also, this test takes up to
three to four hours. It produces side effects in up to one-third of the patients with the most common being nausea during and after the test. This test is administered
intramuscularly ("IM”).

● The growth hormone releasing hormone-arginine stimulation test ("GHRH + ARG”) is an easier test to perform in an office setting and has a good safety profile, but is
considered to be costly to administer compared to the ITT and the GST. GHRH + ARG has been proposed to be the best alternative to ITT, but GHRH + ARG is no
longer available in the U.S. This test is administered through an IV.

34

Oral administration of Macrilen™ (macimorelin) offers convenience and simplicity over the current GHD tests used, all of which require either IV or IM administration. Additionally,
Macrilen™ (macimorelin) may demonstrate a more favorable safety profile than existing diagnostic tests, some of which may be inappropriate for certain patient populations (e.g.
patients with diabetes mellitus or coronary heart disease) and have demonstrated a variety of side effects, which Macrilen™ (macimorelin) has not thus far. These factors may be
limiting  the  use  of  GHD  testing  and  may  potentially  enable  Macrilen™  (macimorelin)  to  become  the  product  of  choice  in  evaluating  AGHD.  We  believe  that  Macrilen™
(macimorelin) is well-positioned to displace the ITT as the preferred means by endocrinologists of evaluating AGHD for the following reasons:

● it is safer and more convenient than the ITT because it does not require the patient to become hypoglycemic;
● Macrilen™ (macimorelin) is administered orally, while the ITT requires an intravenous injection of insulin;
● Macrilen™ (macimorelin) is a more robust test than the ITT leading to evaluable test results;
● Macrilen™ (macimorelin) results are highly reproducible;
● the evaluation of AGHD using Macrilen™ (macimorelin) is less time-consuming and labor-intensive than the ITT; and
● the evaluation can be conducted in the physician’s office rather than in a hospital-like setting.

We believe that approximately 15,000 – 20,000 AGHD tests will be conducted annually, in the U.S., after full market introduction of Macrilen™ (macimorelin). In addition, based on
published information from the U.S. Centers for Disease Control and Prevention, different scientific publications, Huron, TVG and Navigant Research, we estimate that the total
potential U.S. market for AGHD evaluation is in the range of 28,000 to 43,000 tests per year, excluding the evaluation of patients who have suffered a traumatic brain injury (" TBI”).
In patients with a TBI, GHD is frequent and may contribute to cognitive sequelae and reduction in quality of life. GHD may develop in approximately 10% to 35% of TBI victims
according to published study results. These data support a large upside potential for GHD testing.

Macimorelin Development History

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following is a summary of the history of our development of Macrilen™ (macimorelin):

2017 – present

● On January 4, 2017, we announced that, based on an analysis of top-line data, the confirmatory Phase 3 clinical trial of Macrilen™ (macimorelin) failed to achieve one
of its co-primary endpoints. Under the study protocol, the evaluation of AGHD with Macrilen™ (macimorelin) would be considered successful, if the lower bound of
the two-sided 95% confidence interval for the primary efficacy variables was 75% or higher for "percent negative agreement” with the ITT, and 70% or higher for the
"percent positive agreement” with the ITT. While the estimated percent negative agreement met the success criteria, the estimated percent positive agreement did not
reach  the  criteria  for  a  successful  outcome.  Therefore, the  results  did  not  meet  the  pre-defined  equivalence  criteria  which  required  success  for both  the  percent
negative agreement and the percent positive agreement.

● On February 13, 2017, we announced that, after reviewing the raw data on which the top-line data were based, we had concluded that Macrilen™ (macimorelin) had
demonstrated performance supportive of achieving FDA registration and that we intended to pursue registration. The announcement set forth the facts on which our
conclusion was based. The Company met with the FDA at the end of March 2017 to discuss this position.

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● On March  7,  2017,  we  announced  that  the  Pediatric  Committee  ("PDCO”)  EMA  agreed to  the  Company’s  Pediatric  Investigation  Plan  ("PIP”)  for  Macrilen™
(macimorelin) and agreed that the  Company may defer conducting the  PIP until after it files a  Marketing Authorization Application ("MAA”) seeking marketing
authorization for the use of Macrilen™ (macimorelin) for the evaluation of AGHD.

● On July 18, 2017, we were provided a Prescription Drug User Fee Amendment date of December 30, 2017 by the FDA.
● On November 27, 2017, the EMA accepted our MAA submission for Macrilen™ (macimorelin).
● On December 20, 2017, the FDA approved the market authorization for Macrilen™ (macimorelin), to be used in the diagnosis of patients with AGHD.
● On January 16, 2018, the Company, through AEZS Germany, entered into a License Agreement to  carry out development, manufacturing, registration, regulatory and

supply chain services for the commercialization of Macrilen™ (macimorelin) in the U.S. and Canada as further described below.

● In the August 2018, Volume 103, Issue 8 edition of The Journal of Clinical Endocrinology and  Metabolism, the pivotal Phase 3 data from the Macrilen® (macimorelin)

confirmatory trial was published by Jose M. Garcia, MD, PhD, et al., titled ‘Macimorelin as a Diagnostic Test for Adult GH Deficiency’.

● On November 19, 2018, we announced the Committee for Medicinal Products for Human Use ("CHMP”) of the EMA adopted a positive opinion recommending a

marketing authorization for macimorelin.

● On January 16, 2019, we announced that the EC granted marketing authorization for macimorelin.
● On December 18, 2019, we announced that the American Association of Clinical Endocrinologists  ("AACE”) and the American College of Endocrinology ("ACE”)
published new "Guidelines for Management of Growth Hormone Deficiency in Adults and Patients Transitioning from Pediatric to Adult Care” ("Guidelines”). The
AACE/ACE 2019 Guidelines identify macimorelin as a "shorter and simpler alternative” compared to the traditionally available GHST.

● On January 28, 2020, we announced the successful completion of patient recruitment for the first pediatric study of macimorelin as a growth hormone stimulation test

for the evaluation of growth hormone deficiency (GHD) in children.

● On April 6, 2020, we announced positive results for the first pediatric study of macimorelin as a growth hormone stimulation test for the evaluation of child-onset

growth hormone deficiency (CGHD).

● On April 7, 2020, we announced the decision of the  European  Medicines Agency (EMA) to accept a modification request by AEZS of the  Company’s  Pediatric

Investigation Plan (PIP) for macimorelin.

● On June 25, 2020, we announced that we had entered into an exclusive distribution and related quality agreement with MegaPharm Ltd. for the commercialization of

Macrilen® in Israel and the Palestinian Authority.

● On July 22, 2020, we filed two patent applications in connection with macimorelin. Both patent applications relate to the invention of macimorelin as a method to

diagnose growth hormone deficiency in pediatric patients.

● On November 16, 2020, we announced that, through a wholly-owned subsidiary, we had entered into an amendment of its existing license agreement with Novo
Nordisk Biopharm Ltd. (NNBL) related to the development and commercialization of macimorelin. The amendment partly amended the original license agreement on
specific terms and conditions to, among others (i) reflect the updated supply agreement, (ii) grant  NNBL a joint ownership interest in patents rights, (iii) amend
responsibility for the pediatric clinical trial, and (iv) make a payment to AEZS.

● On December 7, 2020, we announced that we had entered into an exclusive licensing agreement with Consilient Health Ltd. for the commercialization in Europe and the

United Kingdom of macimorelin.

36

● On May 13, 2021, we announced the commencement of our pivotal Phase 3 safety and efficacy study AEZS-130-P02 (the DETECT-trial) evaluating macimorelin for the

diagnosis of childhood-onset growth hormone deficiency (CGHD).

● On January 31, 2022, our partner Er-Kim, a regional specialty pharmaceutical company, announced the signature of an exclusive agreement with Aeterna Zentaris for

the distribution and sales of Macrilen® in eight countries, including Turkey, Serbia, and Albania.

● On March 21, 2022, we provided an update for our ongoing pivotal Phase 3 safety and efficacy study AEZS-130-P02 (the DETECT-trial) and noted that site activation
and patient enrollment continued to be impacted by the COVID-19 pandemic. Additionally, clinical trial sites originally  planned in the Ukraine and Russia were halted
due to the Russian invasion.

● On April 19, 2022, we announced that European Patent Office had issued a patent providing intellectual property protection of macimorelin in 27 countries within the

European Union as well as additional European non-EU countries.

● On May 25, 2022, we announced that Ghryvelin™ (macimorelin) was now available to healthcare professionals across Europe (subject to reimbursement).
● Following a 270-day notice period, Aeterna regained full rights to Macrilen® in the U.S. and Canada on May 23, 2023, and the sales of Macrilen® are temporarily

discontinued in the U.S. commercial market for the diagnosis of AGHD, until an anticipated re-launch with an alternate commercialization partner.

● On May 9, 2023, the United States Patent and Trademark Office issued patent US11,644,474 to the Company protecting the use of macimorelin for the diagnosis of

GHD in pediatrics.

Macimorelin Commercialization Program

On  March  15,  2023,  with  the  Company’s  consent,  Consilient  Health  Limited  ("Consilient”  or  "CH”)  entered  into  an  assignment  agreement  with  Atnahs  Pharma  UK  Ltd.
(Pharmanovia) to transfer the current licensing agreement for the commercialization of macimorelin in the European Economic Area and the United Kingdom to Pharmanovia, as well
as the current supply agreement pursuant to which the Company agreed to provide the licensed product. Also on March 15, 2023, the Company and Pharmanovia entered into an
amendment agreement, pursuant to which the Company provided its acknowledgement and consent to the Assignment Agreement and agreed to certain amended terms which do
not materially differ from the previous license and supply agreement with CH. To date, we have received total pricing milestone payments from CH of $0.5 million (€0.5 million)
relating to Ghryvelin™/Macimorelin 60 mg approved list prices in the United Kingdom, Germany and Spain. We shipped initial batches of macimorelin (Ghryvelin™/Macimorelin 60
mg) to  Consilient in the first quarter of 2022.  Consilient launched the product meanwhile in the  United  Kingdom,  Sweden,  Denmark,  Finland,  Germany and Austria.  More  EU
countries will follow pending re-imbursement negotiations. On April 19, 2022, we announced that the European Patent Office had issued a patent providing intellectual property
protection of macimorelin in 27 countries within the European Union as well as additional European non-EU countries, such as the UK and Turkey, for macimorelin for use to
diagnose GHD in adults. In the meantime, the related PCT patent application has been granted in Canada, Japan, South Korea, Eurasia and New Zealand.

 
 
 
 
 
 
 
 
 
 
 
On May 9, 2023, the USPTO issued patent US11,644,474 to the Company protecting the use of macimorelin for the diagnosis of GHD in pediatrics.

Since  November  2020,  Novo  marketed  macimorelin  under  the  tradename  Macrilen®  through  a  license  agreement  and  an  amended  license  agreement  (collectively  the  "Novo
Amendment”) for the diagnosis of AGHD. On August 26, 2022, the Company announced that Novo had exercised its right to terminate the Novo Amendment. Following a 270-day
notice period, Aeterna regained full rights to Macrilen® in the U.S. and Canada on May 23, 2023, and the sales of Macrilen® are temporarily discontinued in the U.S. commercial
market for the diagnosis of AGHD, until an anticipated re-launch with an alternate commercialization partner. The Company continues to actively strategize and seek alternate
development and commercialization partners for Macrilen® in the U.S. and other territories. The decision to temporarily discontinue sales of Macrilen® in the United States does
not have any impact on the sales and commercialization efforts in the UK and European Economic Area.

37

On  June 25, 2020, we announced that we entered into an exclusive distribution and related quality agreement with  MegaPharm  Ltd., a leading  Israel-based biopharmaceutical
company, for the commercialization in Israel and in the Palestinian Authority of macimorelin, to be used in the diagnosis of patients with AGHD and in clinical development for the
diagnosis of CGHD. Under the terms of the agreement, MegaPharm Ltd. will be responsible for obtaining registration to market macimorelin in Israel and the Palestinian Authority,
while the Company will be responsible for manufacturing, product supply, quality assurance and control, regulatory support, and maintenance of the relevant intellectual property.
In June 2021, MegaPharm Ltd. filed an application to the Ministry of Health of Israel for regulatory approval of macimorelin in Israel, which received the Israeli license in November
2022 and final approval in February 2024.

We  entered  into  license  and  supply  agreements  with  NK  Meditech  Ltd.  ("NK”),  a  subsidiary  of  PharmBio  Korea,  effective  November  30,  2021,  and  a  distribution  and
commercialization agreement with ER Kim Pharmaceuticals Bulgaria Eood ("ER-Kim”), effective February 1, 2022. The agreements with NK are related to the development and
commercialization  of  macimorelin  for  the  diagnosis  of AGHD  and  CGHD  in  the  Republic  of  Korea,  while  the  agreement  with  ER-Kim  is  related  to  the  commercialization  of
macimorelin for the diagnosis of growth hormone deficiency in children and adults in  Turkey and some non-European  Union  Balkan countries.  The  South  Korean marketing
authorization was granted in September 2023.

Macimorelin Clinical Program

On January 28, 2020, we announced the successful completion of patient recruitment for the first pediatric study of macimorelin as a growth hormone stimulation test for the
evaluation of GHD in children. This study, AEZS-130-P01 ("Study P01”), was the first of two studies as agreed with the EMA in our Pediatric Investigation Plan (the "PIP”) for
macimorelin as a GHD diagnostic. Macimorelin, a ghrelin agonist, is an orally active small molecule that stimulates the secretion of growth hormone from the pituitary gland into the
circulatory system. The goal of Study P01 was to establish a dose that can both be safely administered to pediatric patients and cause a clear rise in growth hormone concentration
in subjects ultimately diagnosed as not having GHD. The recommended dose derived from Study P01 is being evaluated in the pivotal second study, Study P02, on diagnostic
efficacy and safety (the "DETECT-trial”). Study P01 was an international, multicenter study, which was conducted in Hungary, Poland, Ukraine, Serbia, Belarus and Russia. Study
P01 was an open label, group comparison, dose escalation trial designed to investigate the safety, tolerability, and pharmacokinetic/pharmacodynamic ("PK/PD”) of macimorelin
acetate after ascending single oral doses of macimorelin at 0.25, 0.5, and 1.0 milligram per kilogram body weight in pediatric patients from 2 to less than 18 years of age with
suspected CGHD. We enrolled a total of 24 pediatric patients across the three cohorts of the study. Per study protocol, all enrolled patients completed four study visits after
successful completion of the screening period. At Visit 1 and Visit 3, a provocative growth hormone stimulation test was conducted according to the study sites’ local practices.
At  Visit  2,  the  macimorelin  test  was  performed,  and  following  the  oral  administration  of  the  macimorelin  solution,  blood  samples  were  taken  at  predefined  times  for  PK/PD
assessment. Visit 4 was a safety follow-up visit at study end.

The final study results from Study P01 were published in the second quarter of 2020 indicating positive safety and tolerability data for use of macimorelin in CGHD, as well as
PK/PD data observed in a range as expected from the adult studies.

On April 7, 2020, we announced the decision of the EMA to accept our modification request of our PIP as originally approved in March 2017, which covered the conduct of two
pediatric studies and defined relevant key elements in the outline of these studies. We believe this EMA decision supports the development of one globally harmonized study
protocol for test validation, specifically Study P02, which we expect to be accepted both in Europe and the U.S.

In late 2020, we entered into the start-up phase for the clinical safety and efficacy study, AEZS-130-P02 ("DETECT-trial”), evaluating macimorelin for the diagnosis of CGHD. The
DETECT-trial is an open-label, single dose, multicenter and multinational study expected to enroll approximately 100 subjects worldwide (incl. sites in U.S: and EU), with at least 40
pre-pubertal and 40 pubertal subjects. The study design is expected to be suitable to support a claim for potential stand-alone testing, if successful. On April 22, 2021, the U.S.
FDA  Investigational  New  Drug Application  associated  with  this  clinical  trial  became  active,  (see: https://clinicaltrials.gov/ct2/show/NCT04786873),  and  on  May  13,  2021,  we
announced the opening of the first clinical site in the  U.S.  Under the  Novo Amendment, and following  Novo’s notice to terminate the  Novo Amendment,  Novo has funded
DETECT-trial costs up to $10.1 million (€9.4 million). Any additional trial costs incurred over $10.1 million (€9.4 million) will be paid by Aeterna.

38

On January 26, 2022, we announced that the DETECT-trial had experienced unavoidable delays in site initiation and patient enrollment due to the rise of the Omicron variant in the
COVID-19  pandemic.  Furthermore,  in  February  2022,  due  to  the  Russian  invasion  of  Ukraine,  the  clinical  trial  activities  planned  in  both  Russia  and  Ukraine  were  halted  and
consequently, no patients have been enrolled in either of these countries’ clinical sites to date. On January 17, 2023, we provided a business update, highlighting that bolstered
enrollment was expected by the engagement of an additional Clinical Research Organization (CRO) and the replacement of inactive countries and sites with three new countries
(Armenia, Slovakia, and Turkey) as well as additional sites in the U.S. In March 2023, we received approval for and activated our first site in Slovakia. Sites in Armenia and Turkey
were approved and activated in early 2024. With enrollment in the DETECT-trial now completed, we expect the conclusion of the active part of the trial in Q2 2024 and top-line
results in Q3 2024.

Pipeline Expansion Opportunities

AIM  Biologicals:  Targeted,  highly  specific  autoimmunity  modifying  therapeutics  for  the  potential  treatment  of  neuromyelitis  optica  spectrum  disorder  (NMOSD)  and
Parkinson’s disease

AIM Biologicals are based on a natural process during pregnancy, which induces immunogenic tolerance of the maternal immune system to the partially foreign fetal antigens.
Fetal proteins are processed and presented on certain immunosuppressive major histocompatibility complex class I molecules to induce this tolerance. In an autoimmune disease
the immune system is misdirected and targets the body’s own protein. With AIM Biologicals, we aim to restore the tolerance against such proteins to treat autoimmune diseases.
Our AIM Biologics program is focused on the rare and orphan indication NMOSD and on the second most common neurodegenerative disorder, Parkinson’s disease.

In January 2021, we entered into an exclusive patent license and research agreement with the University of Wuerzburg, Germany, for worldwide rights to develop, manufacture, and
commercialize AIM Biologicals for the potential treatment of NMOSD. Additionally, we have engaged Prof. Dr. Joerg Wischhusen from the University Hospital in Wuerzburg as
well as neuro-immunologist Dr. Michael Levy from the Massachusetts General Hospital in Boston as consultants for scientific support and advice in the field of inflammatory
central nervous system "CNS” disorders, autoimmune diseases of the nervous system, and NMOSD. In September 2021, we entered into an additional exclusive license with the
University of Wuerzburg for early pre-clinical development towards the potential treatment of Parkinson’s disease. On May 12, 2022, we announced positive pre-clinical results in
an innovative mouse model of Parkinson’s disease, where treatment with α-Synuclein specific AIM Biologicals showed a trend towards improved motoric function, as well as

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
significant  induction  of  regulatory  T  cells  and  rescue  of  substantia  nigra  neurons.  The  data  were  presented  at  IMMUNOLOGY2022™,  the  annual  event  of  the  American
Association of Immunologists, held on May 6-10, 2022, in Portland, Oregon. On June 13, 2022, we announced that we had achieved proof-of-concept for the treatment of NMOSD
in both in-vitro and in mouse models. These findings were presented at the 13th International Congress on Autoimmunity on June 10-13, 2022, in Athens, Greece. In October 2022,
we entered into a research and development agreement with Massachusetts General Hospital (MGH) in Boston and Dr. Michael Levy, to conduct pre-clinical  ex-vivo  and in-vivo
studies in NMOSD.

NMOSD is an autoimmune disease targeting the protein aquaporin 4, primarily found in optic nerves and the spinal cord. The disease leading to blindness and paralysis has a
prevalence of 0.7-10 in 100,000, more common in persons with Asian or African compared to European ancestors, and nine times more prevalent among women compared to men.
NMOSD progresses in often life-threatening relapses, which are aggressively treated with high-dose steroids and plasmapheresis. Current treatment options include treatment with
immunosuppressive monoclonal antibodies, which carries risk of serious infections. Our pre-clinical plans include expanding the already available proof-of-concept data for the
treatment  of  NMOSD  in  both in-vitro  and in-vivo  assessments  to  select  an AIM  Biologicals-based  development  candidate;  and  manufacturing  process  development  for  the
selected candidate.

Parkinson’s disease is a neurological disease commonly associated with motoric problems with a slow and fast progression form. It is the second most common neurodegenerative
disease affecting 10 million people worldwide. The hallmark of PD is the neuronal inclusion of mainly α-synuclein protein (αSyn) associated with the death of dopamine-producing
cells. Dopaminergic medication is the mainstay treatment of PD symptoms. Up to now there is no pharmacological therapy available to prevent or delay disease progression.
Alternate treatments, such as deep brain stimulation with short electric bursts, are being investigated for the treatment of symptoms. For the development of AIM Biologicals as
potential PD therapeutics, Aeterna utilizes, among others, an innovative animal model on neurodegeneration by α-synuclein-specific T cells in AAV-A53T-α-synuclein Parkinson’s
disease  mice,  which  has  recently  been  published  by  University  of  Wuerzburg  researchers.  We  are  continuing in-vitro  and in-vivo  testing  of  antigen-specific AIM  Biologics
candidate molecules for the potential treatment of Parkinson’s disease.

39

AEZS-150 - Delayed Clearance ("DC”) Parathyroid Hormone ("PTH”) ("DC-PTH”) Fusion Polypeptides: Potential treatment for chronic hypoparathyroidism

On  March  11,  2021,  we  entered  into  an  exclusive  license  agreement  with  The  University  of  Sheffield,  United  Kingdom,  for  the  intellectual  property  relating  to  PTH  fusion
polypeptides covering the field of human use, which will initially be studied by Aeterna for the potential therapeutic treatment of chronic hypoparathyroidism ("HypoPT”). Under
the  terms  of  the  exclusive  patent  and  know-how  license  agreement  entered  into  with  the  University  of  Sheffield,  we  obtained  worldwide  rights  to  develop,  manufacture  and
commercialize PTH fusion polypeptides covered by the licensed patent applications for all human uses for an up-front cash payment, and milestone payments to be paid upon the
achievement of certain development, regulatory and sales milestones, as well as low single digit royalty payments on net sales of those products and certain fees payable in
connection with sublicensing. We will be responsible for the further development, manufacturing, approval, and commercialization of the licensed products. We also engaged the
University of Sheffield under a research contract to conduct certain research activities to be funded by Aeterna, the results of which will be included within the scope of the license
granted to Aeterna.

The researchers at the University of Sheffield have developed a method to increase the serum clearance time of peptides, which the Company is applying to the development of a
treatment for HypoPT. HypoPT is an orphan disease where the PTH level is abnormally low or absent, with a prevalence per 100,000 of 37 in the U.S., 22 in Denmark, 9.4 in Norway,
and 5.3 to 27 in Italy. Standard treatment is calcium and vitamin D supplementation. In consultation with The University of Sheffield, Aeterna has selected AEZS-150 as the lead
candidate in its DC-PTH program. AEZS-150 is being developed to provide a weekly treatment option of chronic hypoparathyroidism in adults. Recent progress includes the
successful verification and reproduction of previous in-vivo data from the University of Sheffield, in a rat model of hypoparathyroidism, as well as ongoing development of the
manufacturing process for AEZS-150 with the Company’s contract development and manufacturing organization, establishment of a master cell bank for a cell line expressing
AEZS-150 and the development of a production process suitable for larger scale good manufacturing practices. Our next steps include working with The University of Sheffield to
continue with in depth characterization of development candidate (in-vitro and in-vivo); meeting with regulatory authorities to formalize the pre-clinical development of AEZS-150
in preparation for a potential IND filing for conducting the first in-human clinical study.

AEZS-130 - Macimorelin Pre-clinical Program

On January 13, 2021, we entered into a material transfer agreement with Queensland University to provide macimorelin for the conduct of preclinical and clinical studies evaluating
macimorelin as a therapeutic for the treatment of ALS. ALS is a rare progressive neurological disease primarily affecting the neurons controlling voluntary movement, leading to the
disability to control movements such as walking, talking, and chewing. Most people with ALS die from respiratory failure, usually between 3-5 years after diagnosis. Currently
there is no cure for ALS and no effective treatment to halt or reverse the progression of the disease. Ghrelin is a hormone with wide-ranging biological actions, most known for
stimulating growth hormone release, which is demonstrating emerging evidence as therapeutic for ALS. As a ghrelin agonist, macimorelin has the potential as a treatment for ALS,
which is evaluated in this research collaboration.

In July 2022, we entered a research and option to license agreement with UniQuest Pty Ltd., the commercialization company of The University of Queensland (UQ), Brisbane,
Australia, to advance the development of macimorelin as a potential therapeutic for the treatment of ALS. We have developed an alternative formulation suitable for use in ALS
patients and are accumulating data for positive effects of AEZS-130 treatment on survival of motor-neurons. We are continuing to evaluate AEZS-130 in transgenic mouse ALS
models as well as in human patient-derived neuron cultures to demonstrate the therapeutic potential of macimorelin in this indication. Our next steps include completion of the
ongoing toxicology and safety studies to support treatment over prolonged periods and following potential achievement of proof-of-concept, scientific advice with regulatory
authorities to discuss program development to support first in human studies.

40

Geographic Areas

A description of the principal geographic areas in which we compete, including a geographical and categorical breakdown of our revenues in the past three years, is presented in
note 25 (Segment information) to our consolidated financial statements included in this Annual Report on Form 20-F at Item 18.

Seasonality

As a specialty biopharmaceutical company, the Company does not consider any of its products or services to be seasonal.

Raw Materials

Raw  materials  and  supplies  are  generally  available  in  quantities  adequate  to  meet  the  needs  of  our  business.  We  will  be  dependent  on  third-party  manufacturers  for  the
pharmaceutical products that we or our licensees will market. An interruption in the availability of certain raw materials or ingredients, or significant increases in the prices paid by
us for them, could have a material adverse effect on our business, financial condition, liquidity and operating results.

Regulation of Drug Development

Generally. Governmental authorities in the U.S., Canada, Europe, and other countries extensively regulate the preclinical and clinical testing, manufacturing, labeling, storage,

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
record keeping, advertising, promotion, export, marketing, and distribution, among other things, of pharmaceuticals. Under the laws of the U.S., the countries of the EU, and other
countries, we are subject to obligations to ensure that our clinical trials are conducted in accordance with Good Clinical Practice ("GCP”) guidelines and the investigational plan
and protocols contained in an Investigational New Drug ("IND”) application, or comparable foreign regulatory submission. Set forth below is a brief summary of the material
governmental regulations affecting us in the major markets in which we intend to market our products and/or promote products that we acquire or in-license or to which we obtain
promotional rights.

The United States. In the U.S., the FDA’s Center for Drug Evaluation and Research (" CDER”) under the Federal Food, Drug and Cosmetic Act of 1938, as amended (the " FDCA”),
the Public Health Service Act and other federal statutes and regulations, subjects pharmaceutical products to rigorous review. In order to market and sell a new drug product in the
U.S., we must first test it and send CDER evidence from these tests to prove that the drug is safe and effective for its intended use. In most cases, these tests include extensive
preclinical, clinical, and laboratory tests. A team of  CDER physicians, statisticians, chemists, pharmacologists, and other scientists review the company’s data and proposed
labeling. If this independent and unbiased review establishes that a drug’s health benefits outweigh its known risks, the drug is approved for sale. CDER does not test the drug
itself, but it does conduct limited research in the areas of drug quality, safety, and effectiveness standards. Before approving a new drug or marketing application, the FDA may
conduct pre-approval inspections of the developer of the drug (the "sponsor”), its  CRO and/or its clinical trial sites to ensure that clinical, safety, quality control, and other
regulated  activities  are  compliant  with  GCP,  or  Good  Laboratory  Practices  (" GLP”),  for  specific  non-clinical  toxicology  studies.  The  manufacturing  process,  which  must  be
compliant with GMP, and the manufacturing facilities used to produce a product are also subject to ongoing inspection by the FDA. The FDA may also require confirmatory trials,
post-marketing testing, and/or extra surveillance to monitor the effects of approved products, or place conditions on any approvals that could restrict the commercial applications
of  a  product.  Once  approved,  the  labeling,  advertising,  promotion,  marketing,  and  distribution  of  a  drug  or  biologic  product  must  be  in  compliance  with  FDA  regulatory
requirements.

The first stage required for ultimate FDA approval of a new biologic or drug involves completion of preclinical studies whereby a sponsor must test new drugs on animals for
toxicity. Multiple species are used to gather basic information on the safety and efficacy of the compound being investigated and/or researched. The FDA regulates preclinical
studies under a series of regulations called the current GLP regulations as well as regulatory requirements found in Part 21 subchapter D of the Code of Federal Regulations. If the
sponsor violates these regulations, the FDA may require that the sponsor replicates those studies or can subject the sponsor to enforcement actions or penalties as described
further below. The sponsor then submits to the FDA an IND application based on the results from the initial testing that include the drug’s composition and manufacturing, along
with a plan for testing the drug on humans. The FDA reviews the IND to ensure that the proposed studies (clinical trials) do not place human subjects at unreasonable risk of harm.
FDA also verifies that there are adequate informed consent and human subject protections in place.

41

After a sponsor submits an IND application, it must wait thirty (30) days before starting a clinical trial to allow the FDA time to review the prospective study. If the FDA finds a
problem, it can order a clinical hold to delay an investigation, or interrupt a clinical trial if problems occur during the study. After the IND application is in effect, a sponsor may
commence human clinical trials. The sponsor typically conducts human clinical trials in three sequential phases, but the phases may overlap. In Phase 1 trials, the sponsor tests the
product in a small number of patients or healthy volunteers (typically 20-80 healthy volunteers), primarily for safety at one or more doses. The goal in this phase is to determine
what the drug’s most frequent side effects are and, often, how the drug is metabolized and excreted. Phase 2 studies begin if Phase 1 studies do not reveal unacceptable toxicity. In
Phase 2, in addition to safety, the sponsor evaluates the efficacy of the product in a patient population somewhat larger than Phase 1 trials. The number of subjects in Phase 2
studies typically ranges from a few dozen to about 300. This phase aims to obtain preliminary data on whether a drug works in people who have a certain disease or condition. At
the end of Phase 2, the FDA and sponsor try to come to an agreement on how large-scale studies in Phase 3 should be done.

Phase 3 studies begin if evidence of effectiveness is shown in Phase 2. Phase 3 trials typically involve additional testing for safety and clinical efficacy in an expanded population
(approx.  300-3,000  volunteers  who  have  the  disease  or  condition)  at  geographically  dispersed  test  sites.  The  sponsor  must  submit  to  the  FDA  a  clinical  plan,  or  "protocol”,
accompanied  by  the  approval  of  the  institutions  participating  in  the  trials,  prior  to  commencement  of  each  clinical  trial.  The  FDA  may  order  the  temporary  or  permanent
discontinuation of a clinical trial at any time.

In the case of product candidates for cancer, the initial human testing may be done in patients with the disease rather than in healthy volunteers. Because these patients are
already afflicted with the target disease, such studies may provide results traditionally obtained in Phase 2 studies. Accordingly, these studies are often referred to as "Phase 1/2”
studies as they combine two phases. Even if patients participate in initial human testing and a Phase 1/2 study is carried out, the sponsor is still responsible for obtaining all the
data usually obtained in both Phase 1 and Phase 2 studies.

The sponsor must submit to the FDA the results of the preclinical and clinical testing, together with, among other things, detailed information on the manufacture and composition
of the product, in the form of a New Drug Application (an " NDA”) or, in the case of a biologic, a Biologics License Applications (a " BLA”). In a process that can take a year or
more, the FDA reviews this application and, when and if it decides that adequate data are available to show that the new compound is both safe and effective for a particular
indication and that other applicable requirements have been met, approves the drug or biologic for marketing. The amount of time taken for this approval process is a function of a
number of variables, including the quality of the submission and studies presented and the potential contribution that the compound will make in improving the treatment of the
disease in question.

FDA  provides incentives, such as orphan drug designation or pediatric exclusivity. Orphan-drug designation is granted by the FDA Office of Orphan Drug Products to novel
drugs or biologics that are intended for the safe and effective treatment, diagnosis or prevention of rare diseases or disorders that affect fewer than 200,000 people in the U.S., or
that affect more than 200,000 people but are not expected to recover the costs of developing and marketing a treatment drug. The designation provides the sponsor with a seven-
year  period  of  U.S.  marketing  exclusivity  if  the  drug  is  the  first  of  its  type  approved  for  the  specified  indication,  or  if  it  demonstrates  superior  safety,  efficacy,  or  a  major
contribution to patient care versus another drug of its type that was previously granted the designation for the same indication. We have been granted orphan drug designations
for Macrilen™ (macimorelin) for the evaluation of GHD.

Under the Drug Price Competition and Patent Term Restoration Act of 1984 (the " Hatch-Waxman Act”), newly approved drugs and indications may benefit from a statutory period
of non-patent data exclusivity. The Hatch-Waxman Act provides five-year data exclusivity to the first applicant to gain approval of an NDA for a new chemical entity (" NCE”),
meaning that the FDA has not previously approved any other drug containing the same active pharmaceutical ingredient, or active moiety. Although protection under the Hatch-
Waxman Act will not prevent the submission or approval of another full  NDA, such an  NDA applicant would be required to conduct its own preclinical and adequate, well-
controlled clinical trials to demonstrate safety and effectiveness.

42

The Hatch-Waxman Act also provides three years of data exclusivity for the approval of new and supplemental NDAs, including Section 505(b)(2) applications, for, among other
things, new indications, dosage forms, routes of administration, or strengths of an existing drug, or for a new use, if new clinical investigations that were conducted or sponsored
by the sponsor are determined by the FDA to be essential to the approval of the application. This exclusivity, which is sometimes referred to as clinical investigation exclusivity,
would not prevent the approval of another application if the sponsor has conducted its own adequate, well-controlled clinical trials demonstrating safety and efficacy, nor would it
prevent approval of a generic product that did not incorporate the exclusivity-protected changes of the approved drug product.

The labeling, advertising, promotion, marketing, and distribution of a drug or biologic product must be in compliance with FDA regulatory requirements. Failure to comply with
applicable requirements can lead to the FDA demanding that production and shipment cease and, in some cases, that the manufacturer recall products, or to enforcement actions
that can include seizures, injunctions, and criminal prosecution. These failures can also lead to FDA withdrawal of approval to market a product. As long as the requirements are
fulfilled and the fees are paid to FDA the product can stay on the market, there is no renewal procedure.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Canada. In Canada, the Therapeutic Products Directorate of Health Canada is the Canadian federal authority that regulates pharmaceutical drugs and medical devices for human
use. Prior to being given market authorization, a sponsor must present substantive scientific evidence of a product’s safety, efficacy, and quality as required by the Food and
Drugs Act and other legislation and regulations. The requirements for the development and sale of pharmaceutical drugs in Canada are substantially similar to those in the U.S.,
which are described above.

The  European  Union. Medicines can be authorized in the  EU by using either the centralized authorization procedure (CP), or national authorization procedures.  The  EU has
implemented a centralized procedure coordinated by the EMA for the approval of human medicines, which results in a single marketing authorization issued by the EC that is valid
across the EU, as well as Iceland, Liechtenstein, and Norway. The centralized procedure is mandatory for human medicinal products containing a new active substance for the
treatment of HIV/AIDS, cancer, diabetes, neurodegenerative diseases, autoimmune diseases, other immune dysfunctions, viral diseases, or that are designated as orphan medicinal
products. In addition, the CP is required for product types derived, for example, from biotechnological processes or genetic engineering. For medicines that do not fall within these
categories, an applicant has the option of submitting an application for a centralized marketing authorization to the  EMA, as long as the medicine concerned is a significant
therapeutic, scientific or technical innovation, or if its authorization would be in the interest of public health.

There are two national routes to authorize medicinal products in several EU countries, which are available for investigational drug products that fall outside the scope of the
centralized procedure and result in a national marketing authorization:

● Decentralized procedure. Using the decentralized procedure, a sponsor may apply for simultaneous authorization in more than one EU country of medicinal products
that have not yet been authorized in any EU country and that do not fall within the mandatory scope of the centralized procedure. After mutual approval national
authorizations  will  be  granted  separately  by  each  member  state involved.  Mutual  recognition  procedure.  In  the  mutual  recognition  procedure,  a  medicine  is first
authorized in one EU Member State, in accordance with the national procedures of that country. Following this, further marketing authorizations can be sought from
other EU countries in a procedure whereby the countries concerned agree to recognize the validity of the original, national marketing authorization.

● National procedure.  If  approval  is  sought  independently  in  only  one  country,  the  application  for  marketing authorization is addressed directly to the competent

authority of the member state.

Similar to the U.S., the EMA provides incentives for the development of orphan drugs or for pediatrics. Orphan designation is granted for diseases affecting less than 5 in 10,000
people in the EU. With the designation, the sponsor benefits from prolonged market exclusivity (10 years) and fee reductions.

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The pediatric regulation grants pediatric development with a six-month extension of the supplementary protection certificate.

The EU marketing authorization is valid for five years and is renewable upon application by the MAH. After the renewal the approval is permanently valid.

Regulation of Commercial Operations

The marketing, promotional, and pricing practices of human pharmaceutical manufacturers, as well as the manner in which manufacturers interact with purchasers and prescribers,
are subject to various U.S. federal and state laws, including the federal anti-kickback statute and the False Claims Act, and state laws governing kickbacks, false claims, unfair trade
practices, and consumer protection, and to similar laws in other countries. In the U.S., these laws are administered by, among others, the Department of Justice (" DOJ”), the Office
of Inspector General of the Department of Health and Human Services, the Federal Trade Commission, the Office of Personnel Management, and state attorneys general. Over the
past several years, the FDA, the DOJ and many other agencies have increased their enforcement activities with respect to pharmaceutical companies and increased the inter-
agency coordination of enforcement activities.

In the U. S., biopharmaceutical and medical device manufacturers are required to record any transfers of value made to licensed physicians and teaching hospitals and to disclose
such data to the Department of Health and Human Services ("HHS”). In addition to civil penalties for failure to report transfers of value to physicians or teaching hospitals, there
will be criminal penalties if a manufacturer intentionally makes false statements or excludes information in such reports. The payment data across biopharmaceutical and medical
device companies is posted by the HHS on a publicly available website. Increased access to such data by fraud and abuse investigators, industry critics and media will draw
attention to our collaborations with reported entities and will importantly provide opportunities to underscore the critical nature of our collaborations for developing new medicines
and exchanging scientific information. This national payment transparency effort coupled with industry commitment to uphold voluntary codes of conduct (such as the PhRMA
Code on  Interactions with  Healthcare  Professionals and  PhRMA  Guiding  Principles  Direct to  Consumer Advertisements About  Prescription  Medicines) and rigorous internal
training and compliance efforts will complement existing laws and regulations to help ensure ethical collaboration and truthful product communications.

The Canadian Association of Research-Based Pharmaceutical Companies (" Rx & D”) has adopted "Guidelines for Transparency in Stakeholder Funding” that require member
companies to regularly disclose, by means of websites and annual reports, a list of all stakeholders to which they provide direct funding. The term "stakeholder” is defined in Rx &
D’s Code of Ethical Practices to include "Health Care Professionals”. In the EU, the disclosure code of transfers of value to healthcare professionals and organizations adopted by
the European Federation of Pharmaceutical Industries and Associations (" EFPIA”) requires all members of EFPIA to disclose transfers of value to healthcare professionals and
healthcare organizations beginning in 2016, covering the relevant transfers in 2015. Each member company will be required to document and disclose: (i) the names of healthcare
professionals and associations that have received payments or other transfers of value and (ii) the amounts or value transferred, and the type of relationship.

For more information about the regulatory risks associated with our business operations, see "Item 3D. Risk Factors”.

Intellectual Property - Patents

We seek to protect our compounds, manufacturing processes, compositions and methods of medical use for our lead drugs and drug candidates through a combination of patents,
trade secrets and know-how. Our patent portfolio consists of approximately six owned and in-licensed patent families (issued, granted or pending in the U.S., Europe and other
jurisdictions).  The  patent  positions  of  companies  in  the  biotechnology  and  pharmaceutical  industries  are  highly  uncertain  and  involve  complex  legal  and  factual  questions.
Therefore, we cannot predict the breadth of claims, if any, that may be allowed under any of our patent applications, or the enforceability of any of our allowed patents. See "Item
3.D. Risk Factors - We may not obtain adequate protection for our products through our intellectual property.”

44

Patents extend for varying periods according to the date of patent filing or grant and the legal term of patents in the various countries where patent protection is obtained. The
actual protection afforded by a patent, which can vary from country to country, depends on the type of patent, the scope of its coverage and the availability of legal remedies in
the country. In the U.S., the patent term of a patent that covers an FDA-approved drug may also be eligible for patent term extension, which permits patent term restoration as
compensation for the patent term lost during the FDA regulatory review process. The Hatch-Waxman Act permits a patent term extension of up to five years beyond the expiration
of the patent, in which the patentee may file an application for yearly interim extensions within five years if the patent will expire and the FDA has not yet approved the NDA. The
length of the patent term extension is related to the length of time the drug is under regulatory review. Patent extension cannot extend the remaining term of a patent beyond a total
of 14 years from the date of product approval and only one patent applicable to an approved drug may be extended.

Similar provisions are available in Europe and other foreign jurisdictions to extend the term of a patent that covers an approved drug. In these jurisdictions, however, no interim
extensions exist and the marketing approval must be granted before the patent expires. In the future, we expect to apply for patent term extensions on patents covering those
products, outside the U.S. While we anticipate that any such applications for patent term extensions will likely be granted, we cannot predict the precise length of time for which

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
such patent terms would be extended in the U.S., Europe or other jurisdictions. If we are not able to secure patent term extensions on patents covering our products for meaningful
periods of additional time, we may not achieve or sustain profitability, which would adversely affect our business.

In addition to patent protection, our products may benefit from the market-exclusivity provisions contained in the orphan-drug regulations or the pediatric-exclusivity provisions or
other provisions of the FDA Act, such as a NCE exclusivity or new formulation exclusivity. Orphan drug regulations provide incentives to pharmaceutical and biotechnology
companies to develop and manufacture drugs for the treatment of rare diseases, currently defined as diseases that exist in fewer than 200,000 individuals in the U.S., or diseases
that affect more than 200,000 individuals in the U.S. but that the sponsor does not realistically anticipate will generate a net profit. Under these provisions, a manufacturer of a
designated orphan drug can seek tax benefits, and the holder of the first FDA approval of a designated orphan product will be granted a seven-year period of marketing exclusivity
for such FDA-approved orphan product. In the U.S., the FDA has the authority to grant additional data protection for approved drugs where the sponsor conducts specified
testing in pediatric or adolescent populations. If granted, this pediatric exclusivity provides an additional six months which are added to the term of data protection as well as to the
term of any relevant patents, to the extent these protections have not already expired. We may also seek to utilize market exclusivities in other territories, such as in the EU. There
can be no assurance that any of our drug candidates will obtain such orphan drug designation, pediatric exclusivity, a NCE exclusivity or any other market exclusivity in the U.S.,
the  EU or any other territory, or that we will be the first to receive the regulatory approval in a given country or territory for such drugs so as to be eligible for any market
exclusivity protection.

Macrilen™ (macimorelin):

We hold the worldwide rights to macimorelin pursuant to an exclusive license agreement with the French Centre National de la Recherche Scientifique (CNRS), as licensor, and
AEZS Germany, as licensee. The obligation to pay royalties on net sales to CNRS expired in 2022. Macrilen™ is the approved trademark for macimorelin as licensed under the
License Agreement for commercialization in the U.S. and Canada.

The following patents and patent applications relate to macimorelin:

● U.S. patent  8,192,719  covers  a  method  of  assessing  pituitary-related  GHD  in  a  human  or  animal subject  comprising  an  oral  administration  of  the  compound
macimorelin and determination of the level of growth hormone in the sample and assessing whether the level of growth hormone in the sample is indicative of GHD.
This patent expires in October 2027.

● European patent 1,984,744 covers a method of assessing pituitary-related GHD by oral administration of macimorelin. This patent expires in February 2027.

45

● Japanese patent 4,852,728 covers a method of assessing pituitary-related GHD by oral administration of macimorelin. This patent expires in February 2027.
● Based on the European patent 1,289,951 a request for supplementary protection certificate (SPC) of 5 years has been granted for Germany, United Kingdom, France,

Italy, Spain, The Netherlands and Denmark.

An invention has been made by inventors of AEZS Germany to use a macimorelin containing composition for the assessment of GHD in adults.

● A related U.S. provisional patent applications Serial No. 62/607,866 was filed on December 19, 2017, and Serial No. 62/609,059 was filed on December 21, 2017. Both are
identical  and are directed to a method of assessing GHD comprising oral administration of a macimorelin containing composition and collecting one or two post-
administration samples.

● The non-provisional U.S. application 15/993,507 was filed on May 30, 2018 drawing the priority of both provisional applications. The related U.S. patent 10,288,629
was granted on May 14, 2019, and will expire on May 30, 2038. A Patent Cooperation Treaty ("PCT”) PCT/EP/2018/085622 application was filed December 18, 2018,
drawing the priority of both provisional U.S. applications. In addition to the method of assessing GHD comprising oral administration of a macimorelin containing
composition  and  collecting  one  or  two  post-administration  samples,  the  PCT  application also  covers  a  similar  method  of  assessing  GHD  using  three  post-
administration  samples.  On February  24,  2022,  following  examination  of  European  patent  application  18827044.1,  a  European patent  with  the  title  "Method  of
assessing growth hormone deficiency comprising oral administration of a macimorelin containing composition and collecting one or two post-administration samples”
has been granted. The patent will be published in European Patent Bulletin on March 23, 2022. The European patent covers the use of macimorelin according to the
label approved by EC to diagnose GHD in adults. The European patent is in the validation process in 12 European countries. In 29 European countries the patent has
been nationalized.

An invention has been made by inventors of AEZS Germany to use a macimorelin containing composition for the assessment of GHD in children. The invention is directed to a
method comprises providing at least one blood sample, taken from a subject within a range from about 15 to about 100 minutes following an administration of a sufficient amount of
macimorelin to induce growth hormone secretion, measuring the growth hormone level of each blood sample and compare the level with a single threshold value to carry out the
diagnosis GHD. The method of the invention is a stand-alone test.

● A related U.S. provisional application Serial No. 63/054,889 was filed July 22, 2020, for the use of macimorelin in assessing growth hormone deficiency in children.
● A non-provisional U.S. application named "Use of macimorelin in assessing growth hormone deficiency in children” with docket number 17/375,709 was filed on July

14, 2021, drawing the priority of the provisional application.

● An international PCT application with docket number PCT/EP2020/070691 was filed on July 22, 2020. Based on the PCT application several national applications have

been filed in due time.

Patent applications related to the pipeline expansion opportunities and covered by the individual Patent and License Agreements between AEZS Germany and licensors.

● Delayed Clearance Parathyroid Hormone (DC-PTH) Fusion Polypeptide for the treatment of hypoparathyroidism in adults
● A priority patent application with docket number GB 1706781.0 has been filed by our licensor The University of Sheffield on April 27, 2017. The patent application
provides  long-acting parathyroid  hormone  like  fusion  polypeptides  comprising  a  receptor  polypeptide  and  its  use in  the  treatment  of  hypoparathyroidism  and
osteoporosis. An international PCT application named "Parathyroid Hormone Fusion Polypeptide” with docket number PCT/GB2018/051120 was filed April 27, 2018.
A national U.S. application with docket number 16/608,611 has been filed on October 25, 2019, and was published as US 2020/0164033A1 on May 28, 2020. The related
U.S. patent US 11,344,607 has been granted on May 31, 2022.

46

AIM Biologicals: Targeted, highly specific autoimmunity modifying therapeutics.

● Our licensor the University of Wuerzburg has filed a priority patent application with docket number EP 17172444.6 on May 23, 2017. The invention relates to targeted
immunomodulatory effects  of  defined  peptides  in  combination  with  proteins  comprising  one  or  more  domains  of a  non-classical  MHC  class  1b  molecules  or  in
combination with molecules that interfere with the interaction of MHC class 1b molecules and their receptors. An international PCT application named "Combinations
of MHC class 1b molecules and peptides for targeted therapeutic immunomodulation” with docket number PCT/EP2018/063100 has been filed on May 18, 2018. The
application was published as WO 2018/215340 A1 on November 29, 2018. A national U.S.  application with docket number 16/615,188 has been filed on November 20,
2019, and was published as US 2020/0157175A1 on May 21, 2020.

● Our licensor the University of Wuerzburg has filed a priority patent application with docket number EP 22164161.6 on March 24, 2022. The patent application provides

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
therapeutic  proteins for  MHC  Ib-mediated  aquaporin  4  (AQP4)-specific  immunosuppression  as  a  novel  treatment  for neuromyelitis  optica  spectrum  disorder
(NMOSD).

● Our licensor  the  University  of  Wuerzburg  has  filed  a  priority  patent  application  with  docket number  EP  22164123.6  on  March  24,  2022.  The  invention  relates  to

therapeutic uses of MHC class Ib molecules in combination with peptide antigens for the treatment of Parkinson’s disease.

C.

Organizational structure

Our corporate structure, the jurisdiction of incorporation of our direct and indirect subsidiaries and the percentage of shares that we held in those subsidiaries as at December 31,
2023 is depicted in the chart set forth under the caption "Item 4.A. History and development of the Company”.

D.

Property and equipment

Our registered address is located in Toronto, Canada. Our largest office is located in Frankfurt, Germany and we have an additional office in Summerville, South Carolina. We do
not own any real property. Effective September 30, 2022, the Company and its landlord mutually agreed to a one-year plus 6 months’ notice extension to its existing building lease
agreement for its German subsidiary, continuing such terms until March 31, 2024.

The following table sets forth information with respect to our main facilities as at December 31, 2022.

Location

315 Sigma Drive, Summerville SC 29486
Weismüllerstr. 50
D-60314
Frankfurt-am-Main, Germany

Use of space

  Occupied for administration
  Occupied for management, R&D, business development and

administration

We believe that our current facilities are adequate to meet our ongoing needs.

47

Square Footage

168 
7,319 

Type of interest
Leasehold
Leasehold

Item 4A

Unresolved Staff Comments

Not required.

Item 5.

Operating and Financial Review and Prospects

Key Developments

A. Operating Results

Introduction

This Management’s Discussion and Analysis ("MD&A”) provides a review of the results of operations, financial condition and cash flows of Aeterna Zentaris Inc. for the year
ended December 31, 2023. In this MD&A, "Aeterna Zentaris”, "Aeterna”, the "Company”, "we”, "us” and "our” mean Aeterna Zentaris Inc. and its subsidiaries. This discussion
should be read in conjunction with the information contained in the Company’s audited consolidated financial statements and the notes thereto as of December 31, 2023 and 2022
and for the years ended December 31, 2023, 2022 and 2021. Our audited consolidated financial statements have been prepared in accordance with International Financial Reporting
Standards as issued by the International Accounting Standards Board ("IFRS”).

The Company’s common shares are listed on both The Nasdaq Capital Market ("Nasdaq”) and on the Toronto Stock Exchange ("TSX”) under the symbol "AEZS”.

All amounts in this MD&A are presented in thousands of United States ("U.S.”) dollars, except for share and per share data, or as otherwise noted. This MD&A was approved by
the Company’s Board of Directors (the "Board”) on March 26, 2024. This MD&A is dated March 26, 2024.

About Forward-Looking Statements

This document contains statements that may constitute forward-looking statements within the meaning of  U.S. and  Canadian securities legislation and regulations, and such
statements are made pursuant to the safe-harbor provision of the U.S. Private Securities Litigation Reform Act of 1995. In some cases, these forward-looking statements can be
identified by words or phrases such as "forecast”, "may”, "will”, "expect”, anticipate”, "estimate”, "intend”, "plan”, "indicate”, "believe”, "direct”, or "likely”, or the negative of
these terms, or other similar expressions intended to identify forward-looking statements. In addition, any statements that refer to expectations, intentions, projections and other
characterizations of future events or circumstances contain forward-looking information.

Forward-looking  statements  are  based  on  the  opinions  and  estimates  of  the  Company  as  of  the  date  of  this  MD&A,  and  they  are  subject  to  known  and  unknown  risks,
uncertainties, assumptions and other factors that may cause the actual results, level of activity, performance or achievements to be materially different from those expressed or
implied by such forward-looking statements, including but not limited to the factors described under Item 3, D. – "Risk factors” in this Annual Report on Form 20-F and those
relating to: Aeterna’s expectations with respect to the DETECT-trial (as defined below) (including the enrollment of subjects in the DETECT-trial, the application of the macimorelin
growth hormone stimulation tests and the completion of the DETECT-trial); Aeterna’s expectations regarding conducting pre-clinical research to identify and characterize an AIM
Biologicals-based  development  candidate  for  the  treatment  of  neuromyelitis  optica  spectrum  disorder  ("NMOSD”),  as  well  as  Parkinson’s  disease  ("PD”),  and  developing  a
manufacturing process for selected candidates; Aeterna’s expectations regarding conducting assessments in relevant PD models; the University of Queensland’s undertaking a
subsequent investigator initiated clinical trial evaluating macimorelin as a potential therapeutic for the treatment of amyotrophic lateral sclerosis ("ALS”), also known as  Lou
Gehrig’s disease, and Aeterna’s formulating a pre-clinical development plan for same; the commencement of Aeterna’s formal pre-clinical development of AEZS-150 (as a potential
therapeutic in chronic hypoparathyroidism as defined below) in preparation for a potential investigational new drug ("IND”) filing for conducting the first in-human clinical study
of AEZS-150; and the impacts associated with the termination of the license agreement with Novo Nordisk Healthcare AG ("Novo Nordisk” or "Novo”), as discussed below.

48

Forward-looking statements involve known and unknown risks and uncertainties and other factors which may cause the actual results, performance or achievements stated herein
to be materially different from any future results, performance or achievements expressed or implied by the forward-looking information.  Such risks and uncertainties include,
among others: our reliance on the success of the pediatric clinical trial in the European Union and U.S. for Macrilen® (macimorelin); potential delays associated with the completion
of the DETECT-trial; we may be unable to enroll the expected number of subjects in the DETECT-trial, and the result of the DETECT-trial may not support receipt of regulatory
approval in childhood-onset growth hormone deficiency ("CGHD”); results from ongoing or planned pre-clinical studies of macimorelin by the University of Queensland or for our
other products under development may not be successful or may not support advancing the product to human clinical trials; our ability to raise capital and obtain financing to
continue our currently planned operations; our dependence on the success of Macrilen® (macimorelin) and related out-licensing arrangements, including the continued availability

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
of  funds  and  resources  to  successfully  commercialize  the  product;  our  ability  to  enter  into  additional  out-licensing,  development,  manufacturing,  marketing  and  distribution
agreements with other pharmaceutical companies and to keep such agreements in effect; and our ability to continue to list our common shares on the Nasdaq or the TSX. These
risk factors are not intended to represent a complete list of the risk factors that could affect the Company. These factors and assumptions, however, should be considered carefully.
More detailed information about these and other factors is included under Item 3, D. – "Risk factors” in this Annual Report on Form 20-F.

Although the Company has attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there
may be other factors that cause results not to be as anticipated, estimated or intended. Many of these factors are beyond our control. There can be no assurance that such
statements will prove to be accurate, as actual results and future events could differ materially from those anticipated in such statements. Accordingly, readers should not place
undue reliance on forward-looking statements. The Company does not undertake to update any forward-looking statements contained herein, except as required by applicable
securities laws. New factors emerge from time to time, and it is not possible for the Company to predict all of these factors, or to assess in advance the impact of each such factor
on the Company’s 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
statement.

Certain forward-looking statements contained herein about prospective results of operations, financial position or cash flows may constitute a financial outlook. Such statements
are based on assumptions about future events, are given as of the date hereof and are based on economic conditions, proposed courses of action and management’s assessment
of currently available relevant information. The Company’s management has approved the financial outlook as of the date hereof. Readers are cautioned that such financial outlook
information contained herein should not be used for purposes other than for which it is disclosed herein.

About Material Information

This MD&A includes information that we believe to be material to investors after considering all circumstances. We consider information and disclosures to be material if they
result in, or would reasonably be expected to result in, a significant change in the market price or value of our securities, or where it is likely that a reasonable investor would
consider the information and disclosures to be important in making an investment decision.

We are a reporting issuer under the securities legislation of all of the provinces of Canada, and our securities are registered with the U.S. Securities and Exchange Commission
("SEC”). We are therefore required to file or furnish continuous disclosure information, such as interim and annual financial statements, management’s discussion and analysis,
proxy or information circulars, annual reports on Form 20-F, material change reports and press releases with the appropriate securities regulatory authorities. Additional information
about the Company and copies of these documents may be obtained free of charge upon request from our Corporate Secretary or on the Internet at the following addresses:
www.zentaris.com, www.sedarplus.ca and www.sec.gov.

49

Company Overview

Aeterna  Zentaris  is  a  specialty  biopharmaceutical  company  commercializing  and  developing  therapeutics  and  diagnostic  tests.  The  Company’s  lead  product,  Macrilen®
(macimorelin), is the first and only U.S. Food and Drug Administration ("FDA”) and European Medicines Agency ("EMA”) approved oral test indicated for the diagnosis of
patients with adult growth hormone deficiency ("AGHD”). Macimorelin is currently marketed under the tradename Ghryvelin™ in the European Economic Area and under the
tradename "Macimorelin 60 mg granules for oral suspension in sachet” in the United Kingdom through an exclusive licensing agreement with Pharmanovia. The Company’s several
other  license  and  commercialization  partners  have  already  received  or  are  seeking  approval  for  commercialization  of  macimorelin  in  Israel  and  the  Palestinian Authority,  the
Republic of Korea, Turkey and several non-European Union Balkan countries. The Company is actively pursuing business development opportunities for the commercialization of
macimorelin in North America, Asia and the rest of the world. We are also leveraging the clinical success and compelling safety profile of macimorelin to develop the compound for
the diagnosis of CGHD, an area of significant unmet need.

The Company is also dedicated to the development of therapeutic assets and has established a pre-clinical development pipeline to potentially address unmet medical needs
across a number of indications, with a focus on rare and/or orphan indications, including, Neuromyelitis Optica Spectrum Disorder (NMOSD), Parkinson’s disease (PD), chronic
hypoparathyroidism (DC-PTH) and ALS (Lou Gehrig’s disease).

Plan of Arrangement with Ceapro

On December 14, 2023, Aeterna Zentaris entered into an arrangement agreement (the "Arrangement Agreement”) with Ceapro Inc. ("Ceapro”) which was subsequently amended on
January 16, 2024, pursuant to which Aeterna Zentaris and Ceapro agreed that, subject to the terms and conditions set forth in the Arrangement Agreement, including the receipt of
the approval of the securityholders of Aeterna Zentaris and Ceapro which was obtained on March 12 2024, the final order of the Court of King’s Bench of Alberta and certain
regulatory  and  exchange  approvals  described  below, Aeterna  Zentaris  will  acquire  100  percent  of  the  common  shares  of  Ceapro  (the  "Ceapro  Shares”)  pursuant  to  a  court-
approved plan of arrangement under the Canada Business Corporations Act such that Ceapro will become a wholly-owned subsidiary of Aeterna Zentaris and Aeterna Zentaris
will continue the operations of Aeterna Zentaris and Ceapro on a combined basis (the "Arrangement”). Additionally, as part of the Arrangement, Aeterna Zentaris will issue to its
shareholders immediately prior to the closing of the Arrangement, 0.47698 of a share purchase warrant ("Aeterna Zentaris New Warrant”) for each Aeterna Zentaris common share
held as of such date. The terms of the Arrangement Agreement were the result of arm’s length negotiation between Aeterna Zentaris and Ceapro and their respective advisors.

On the closing of the Arrangement, existing shareholders of Aeterna  Zentaris and former shareholders of  Ceapro would own approximately 50% of the outstanding Aeterna
Zentaris common shares assuming the exercise of all of the Aeterna Zentaris New Warrants and based on the number of Aeterna Zentaris common shares and Ceapro Shares
issued and outstanding as of market close on December 13, 2023. If completed, the Arrangement will be considered a reverse acquisition and the historical financial statements
following the business combination will be those of Ceapro.

Aeterna Zentaris has applied to list all of its common shares issuable upon the exercise of the Aeterna Zentaris New Warrants on the TSX and has filed an initial listing application
with the Nasdaq as the exchange has determined that the Arrangement constitutes a "change of control” under its rules and regulations. The parties intend to rely upon the
exemption from the registration requirements of the U.S. Securities Act pursuant to Section 3(a)(10) thereof and applicable state securities laws with respect to the issuance of the
Aeterna Zentaris common shares and the replacement options pursuant to the Arrangement.

Following closing, Aeterna Zentaris and Ceapro have agreed to use their commercially reasonable efforts to delist the Ceapro Shares from the TSXV. Aeterna Zentaris and Ceapro
also intend to apply for a decision for Ceapro to cease to be a reporting issuer under the securities laws of each jurisdiction of Canada in which Ceapro is a reporting issuer, if
permitted by applicable laws.

50

The Arrangement Agreement contains customary representations and warranties and is subject to customary conditions to closing and other restrictive covenants, including, but
not limited to, the following:

● Directors and Officers: Upon the closing of the Arrangement, certain directors of Aeterna Zentaris will resign, the number of director  seats on the Aeterna Zentaris Board
will be increased by four and Ronald W. Miller, Ulrich Kosciessa, Geneviève Foster and  William Li, each a nominee of Ceapro, will be appointed to fill such vacancies on
the Aeterna Zentaris board, to the extent permitted by law. The Chief Executive Officer of the combined company will be Gilles Gagnon, the current Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
of  Ceapro and a director of Aeterna Zentaris and the Chief Financial Officer of the combined company will be Giuliano La Fratta, the Chief Financial Officer of Aeterna
Zentaris.

● Non-Solicitation: Subject to certain exceptions, neither party will solicit or assist in the initiation of proposals that could result in an Acquisition Proposal (as defined in

the Arrangement Agreement) by a third-party.

● Notification of Proposals: A party that receives an acquisition solicitation has to notify the other party within 24 hours of its receipt of such solicitation and must provide

certain information and details relating to such acquisition solicitation.

● Superior Proposal: Notwithstanding other restrictions contained in the Arrangement Agreement, in the event a party receives a superior  proposal from a third-party, such
party may, subject to compliance with the terms of the Arrangement Agreement, enter into a definitive  agreement with a party providing for an Acquisition Proposal so
long as such Acquisition Proposal constitutes a Superior Proposal (as defined in the Arrangement Agreement).

● Termination of Arrangement Agreement :  The  parties  may  terminate  the Arrangement Agreement  upon  the  occurrence  of  certain  conditions,  and  in  any  event,  if  the

effective date has not occurred on or before June 14, 2024.

● Termination Fees: Upon the occurrence of certain termination events pursuant to the terms of the Arrangement Agreement, Aeterna Zentaris  shall be entitled to a fee of

US$0.5 million to be paid by Ceapro within the time(s) specified in the Arrangement Agreement in respect to each termination event.

For additional information with respect to the Arrangement and the representations and warranties, conditions to closing and other terms in the Arrangement Agreement please
refer to the section entitled "The Plan of Arrangement – Principal Terms of the Plan of Arrangement” in the Company’s Registration Statement on Form F-1 filed with the SEC on
February 15, 2024 and to the Arrangement Agreement incorporated by reference as Exhibit 2.1 to the Registration Statement on Form F-1. Further information is also available in the
management information circular dated February 9, 2024 which is available on the Company’s SEDAR+ profile at www.sedarplus.com.

51

Key Operational Developments

Macimorelin Commercialization Program

On  March  15,  2023,  with  the  Company’s  consent,  Consilient  Health  Limited  ("Consilient”  or  "CH”)  entered  into  an  assignment  agreement  with  Atnahs  Pharma  UK  Ltd.
(Pharmanovia) to transfer the current licensing agreement for the commercialization of macimorelin in the European Economic Area and the United Kingdom to Pharmanovia, as well
as the current supply agreement pursuant to which the Company agreed to provide the licensed product. Also on March 15, 2023, the Company and Pharmanovia entered into an
amendment agreement, pursuant to which the Company provided its acknowledgement and consent to the Assignment Agreement and agreed to certain amended terms which do
not materially differ from the previous license and supply agreement with CH. To date, we have received total pricing milestone payments from CH of $0.5 million (€0.5 million)
relating to Ghryvelin™/Macimorelin 60 mg approved list prices in the United Kingdom, Germany and Spain. We shipped initial batches of macimorelin (Ghryvelin™/Macimorelin 60
mg) to  Consilient in the first quarter of 2022.  Consilient launched the product meanwhile in the  United  Kingdom,  Sweden,  Denmark,  Finland,  Germany and Austria.  More  EU
countries will follow pending re-imbursement negotiations. On April 19, 2022, we announced that the European Patent Office had issued a patent providing intellectual property
protection of macimorelin in 27 countries within the European Union as well as additional European non-EU countries, such as the UK and Turkey, for macimorelin for use to
diagnose GHD in adults. In the meantime, the related PCT patent application has been granted in Canada, Japan, South Korea, Eurasia and New Zealand.

On May 9, 2023, the USPTO issued patent US11,644,474 to the Company protecting the use of macimorelin for the diagnosis of GHD in pediatrics.

Since  November  2020,  Novo  marketed  macimorelin  under  the  tradename  Macrilen®  through  a  license  agreement  and  an  amended  license  agreement  (collectively  the  "Novo
Amendment”) for the diagnosis of AGHD. On August 26, 2022, the Company announced that Novo had exercised its right to terminate the Novo Amendment. Following a 270-day
notice period, Aeterna regained full rights to Macrilen® in the U.S. and Canada on May 23, 2023, and the sales of Macrilen® are temporarily discontinued in the U.S. commercial
market for the diagnosis of AGHD, until an anticipated re-launch with an alternate commercialization partner. The Company continues to actively strategize and seek alternate
development and commercialization partners for Macrilen® in the U.S. and other territories. The decision to temporarily discontinue sales of Macrilen® in the United States does
not have any impact on the sales and commercialization efforts in the UK and European Economic Area.

52

On  June 25, 2020, we announced that we entered into an exclusive distribution and related quality agreement with  MegaPharm  Ltd., a leading  Israel-based biopharmaceutical
company, for the commercialization in Israel and in the Palestinian Authority of macimorelin, to be used in the diagnosis of patients with AGHD and in clinical development for the
diagnosis of CGHD. Under the terms of the agreement, MegaPharm Ltd. will be responsible for obtaining registration to market macimorelin in Israel and the Palestinian Authority,
while the Company will be responsible for manufacturing, product supply, quality assurance and control, regulatory support, and maintenance of the relevant intellectual property.
In June 2021, MegaPharm Ltd. filed an application to the Ministry of Health of Israel for regulatory approval of macimorelin in Israel, which received the Israeli license in November
2022 and final approval in February 2024.

We  entered  into  license  and  supply  agreements  with  NK  Meditech  Ltd.  ("NK”),  a  subsidiary  of  PharmBio  Korea,  effective  November  30,  2021,  and  a  distribution  and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
commercialization agreement with ER Kim Pharmaceuticals Bulgaria Eood ("ER-Kim”), effective February 1, 2022. The agreements with NK are related to the development and
commercialization  of  macimorelin  for  the  diagnosis  of AGHD  and  CGHD  in  the  Republic  of  Korea,  while  the  agreement  with  ER-Kim  is  related  to  the  commercialization  of
macimorelin for the diagnosis of growth hormone deficiency in children and adults in  Turkey and some non-European  Union  Balkan countries.  The  South  Korean marketing
authorization was granted in September 2023.

Macimorelin Clinical Program

On January 28, 2020, we announced the successful completion of patient recruitment for the first pediatric study of macimorelin as a growth hormone stimulation test for the
evaluation of GHD in children. This study, AEZS-130-P01 ("Study P01”), was the first of two studies as agreed with the EMA in our Pediatric Investigation Plan (the "PIP”) for
macimorelin as a GHD diagnostic. Macimorelin, a ghrelin agonist, is an orally active small molecule that stimulates the secretion of growth hormone from the pituitary gland into the
circulatory system. The goal of Study P01 was to establish a dose that can both be safely administered to pediatric patients and cause a clear rise in growth hormone concentration
in subjects ultimately diagnosed as not having GHD. The recommended dose derived from Study P01 is being evaluated in the pivotal second study, Study P02, on diagnostic
efficacy and safety (the "DETECT-trial”). Study P01 was an international, multicenter study, which was conducted in Hungary, Poland, Ukraine, Serbia, Belarus and Russia. Study
P01 was an open label, group comparison, dose escalation trial designed to investigate the safety, tolerability, and pharmacokinetic/pharmacodynamic ("PK/PD”) of macimorelin
acetate after ascending single oral doses of macimorelin at 0.25, 0.5, and 1.0 milligram per kilogram body weight in pediatric patients from 2 to less than 18 years of age with
suspected CGHD. We enrolled a total of 24 pediatric patients across the three cohorts of the study. Per study protocol, all enrolled patients completed four study visits after
successful completion of the screening period. At Visit 1 and Visit 3, a provocative growth hormone stimulation test was conducted according to the study sites’ local practices.
At  Visit  2,  the  macimorelin  test  was  performed,  and  following  the  oral  administration  of  the  macimorelin  solution,  blood  samples  were  taken  at  predefined  times  for  PK/PD
assessment. Visit 4 was a safety follow-up visit at study end.

The final study results from Study P01 were published in the second quarter of 2020 indicating positive safety and tolerability data for use of macimorelin in CGHD, as well as
PK/PD data observed in a range as expected from the adult studies.

On April 7, 2020, we announced the decision of the EMA to accept our modification request of our PIP as originally approved in March 2017, which covered the conduct of two
pediatric studies and defined relevant key elements in the outline of these studies. We believe this EMA decision supports the development of one globally harmonized study
protocol for test validation, specifically Study P02, which we expect to be accepted both in Europe and the U.S.

In late 2020, we entered into the start-up phase for the clinical safety and efficacy study, AEZS-130-P02 ("DETECT-trial”), evaluating macimorelin for the diagnosis of CGHD. The
DETECT-trial is an open-label, single dose, multicenter and multinational study expected to enroll approximately 100 subjects worldwide (incl. sites in U.S: and EU), with at least 40
pre-pubertal and 40 pubertal subjects. The study design is expected to be suitable to support a claim for potential stand-alone testing, if successful. On April 22, 2021, the U.S.
FDA  Investigational  New  Drug Application  associated  with  this  clinical  trial  became  active,  (see: https://clinicaltrials.gov/ct2/show/NCT04786873),  and  on  May  13,  2021,  we
announced the opening of the first clinical site in the  U.S.  Under the  Novo Amendment, and following  Novo’s notice to terminate the  Novo Amendment,  Novo has funded
DETECT-trial costs up to $10.1 million (€9.4 million). Any additional trial costs incurred over $10.1 million (€9.4 million) will be paid by Aeterna.

53

On January 26, 2022, we announced that the DETECT-trial had experienced unavoidable delays in site initiation and patient enrollment due to the rise of the Omicron variant in the
COVID-19  pandemic.  Furthermore,  in  February  2022,  due  to  the  Russian  invasion  of  Ukraine,  the  clinical  trial  activities  planned  in  both  Russia  and  Ukraine  were  halted  and
consequently, no patients have been enrolled in either of these countries’ clinical sites to date. On January 17, 2023, we provided a business update, highlighting that bolstered
enrollment was expected by the engagement of an additional Clinical Research Organization (CRO) and the replacement of inactive countries and sites with three new countries
(Armenia, Slovakia, and Turkey) as well as additional sites in the U.S. In March 2023, we received approval for and activated our first site in Slovakia. Sites in Armenia and Turkey
were approved and activated in early 2024. With enrollment in the DETECT-trial now completed, we expect the conclusion of the active part of the trial in Q2 2024 and top-line
results in Q3 2024.

Pipeline Expansion Opportunities

AIM  Biologicals:  Targeted,  highly  specific  autoimmunity  modifying  therapeutics  for  the  potential  treatment  of  neuromyelitis  optica  spectrum  disorder  (NMOSD)  and
Parkinson’s disease.

AIM Biologicals are based on a natural process during pregnancy, which induces immunogenic tolerance of the maternal immune system to the partially foreign fetal antigens.
Fetal proteins are processed and presented on certain immunosuppressive major histocompatibility complex class I molecules to induce this tolerance. In an autoimmune disease,
the immune system is misdirected and targets the body’s own protein. With AIM Biologicals, we aim to restore the tolerance against such proteins to treat autoimmune diseases.
Our AIM Biologics program is focused on the rare and orphan indication NMOSD and on the second most common neurodegenerative disorder, Parkinson’s disease.

54

In January 2021, we entered into an exclusive patent license and research agreement with the University of Wuerzburg, Germany, for worldwide rights to develop, manufacture, and

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
commercialize AIM Biologicals for the potential treatment of NMOSD. Additionally, we have engaged Prof. Dr. Joerg Wischhusen from the University Hospital in Wuerzburg as
well  as  neuro-immunologist  Dr.  Michael  Levy  from  the  Massachusetts  General  Hospital  ("MGH”)  in  Boston  as  consultants  for  scientific  support  and  advice  in  the  field  of
inflammatory central nervous system "CNS” disorders, autoimmune diseases of the nervous system, and NMOSD. In September 2021, we entered into an additional exclusive
license with the University of Wuerzburg for early pre-clinical development towards the potential treatment of Parkinson’s disease. On May 12, 2022 we announced positive pre-
clinical  results  in  an  innovative  mouse  model  of  Parkinson’s  disease,  where  treatment  with  α-Synuclein  specific AIM  Biologicals  showed  a  trend  towards  improved  motoric
function, as well as significant induction of regulatory T cells and rescue of substantia nigra neurons. The data were presented at IMMUNOLOGY2022™, the annual event of the
American Association of Immunologists, held on May 6-10, 2022, in Portland, Oregon. On June 13, 2022, we announced that we had achieved proof-of-concept for the treatment of
NMOSD in both in-vitro and in mouse models. These findings were presented at the 13th International Congress on Autoimmunity on June 10-13, 2022, in Athens, Greece. In
October 2022, we entered into a research and development agreement with MGH in Boston and Dr. Michael Levy, to conduct pre-clinical ex-vivo and in-vivo studies in NMOSD.

NMOSD is an autoimmune disease targeting the protein aquaporin 4, primarily found in optic nerves and the spinal cord. The disease leading to blindness and paralysis has a
prevalence of 0.7-10 in 100,000, more common in persons with Asian or African compared to European ancestors, and nine times more prevalent among women compared to men.
NMOSD progresses in often life-threatening relapses, which are aggressively treated with high-dose steroids and plasmapheresis. Current treatment options include treatment with
immunosuppressive monoclonal antibodies, which carries risk of serious infections. Our pre-clinical plans include expanding the already available proof-of-concept data for the
treatment  of  NMOSD  in  both in-vitro  and in-vivo  assessments  to  select  an AIM  Biologicals-based  development  candidate;  and  manufacturing  process  development  for  the
selected candidate.

Parkinson’s disease is a neurological disease commonly associated with motoric problems with a slow and fast progression form. It is the second most common neurodegenerative
disease affecting 10 million people worldwide. The hallmark of PD is the neuronal inclusion of mainly α-synuclein protein (αSyn) associated with the death of dopamine-producing
cells. Dopaminergic medication is the mainstay treatment of PD symptoms. Up to now there is no pharmacological therapy available to prevent or delay disease progression.
Alternate treatments, such as deep brain stimulation with short electric bursts, are being investigated for the treatment of symptoms. For the development of AIM Biologicals as
potential PD therapeutics, Aeterna utilizes, among others, an innovative animal model on neurodegeneration by α-synuclein-specific T cells in AAV-A53T-α-synuclein Parkinson’s
disease  mice,  which  has  recently  been  published  by  University  of  Wuerzburg  researchers.  We  are  continuing in-vitro  and in-vivo  testing  of  antigen-specific AIM  Biologics
candidate molecules for the potential treatment of Parkinson’s disease.

AEZS-150 - Delayed Clearance ("DC”) Parathyroid Hormone ("PTH”) ("DC-PTH”) Fusion Polypeptides: Potential treatment for chronic hypoparathyroidism

On  March  11,  2021,  we  entered  into  an  exclusive  license  agreement  with  The  University  of  Sheffield,  United  Kingdom,  for  the  intellectual  property  relating  to  PTH  fusion
polypeptides covering the field of human use, which will initially be studied by Aeterna for the potential therapeutic treatment of chronic hypoparathyroidism ("HypoPT”). Under
the  terms  of  the  exclusive  patent  and  know-how  license  agreement  entered  into  with  the  University  of  Sheffield,  we  obtained  worldwide  rights  to  develop,  manufacture  and
commercialize PTH fusion polypeptides covered by the licensed patent applications for all human uses for an up-front cash payment, and milestone payments to be paid upon the
achievement of certain development, regulatory and sales milestones, as well as low single digit royalty payments on net sales of those products and certain fees payable in
connection with sublicensing. We will be responsible for the further development, manufacturing, approval, and commercialization of the licensed products. We also engaged the
University of Sheffield under a research contract to conduct certain research activities to be funded by Aeterna, the results of which will be included within the scope of the license
granted to Aeterna.

55

The researchers at the University of Sheffield have developed a method to increase the serum clearance time of peptides, which the Company is applying to the development of a
treatment for HypoPT. HypoPT is an orphan disease where the PTH level is abnormally low or absent, with a prevalence per 100,000 of 37 in the U.S., 22 in Denmark, 9.4 in Norway,
and 5.3 to 27 in Italy. Standard treatment is calcium and vitamin D supplementation. In consultation with The University of Sheffield, Aeterna has selected AEZS-150 as the lead
candidate in its DC-PTH program. AEZS-150 is being developed to provide a weekly treatment option of chronic hypoparathyroidism in adults. Recent progress includes the
successful verification and reproduction of previous in-vivo data from the University of Sheffield, in a rat model of hypoparathyroidism, as well as ongoing development of the
manufacturing process for AEZS-150 with the Company’s contract development and manufacturing organization, establishment of a master cell bank for a cell line expressing
AEZS-150 and the development of a production process suitable for larger scale good manufacturing practices. Our next steps include working with The University of Sheffield to
continue with in depth characterization of development candidate (in-vitro and in-vivo); meeting with regulatory authorities to formalize the pre-clinical development of AEZS-150
in preparation for a potential IND filing for conducting the first in-human clinical study.

AEZS-130 - Macimorelin Pre-clinical Program

On January 13, 2021, we entered into a material transfer agreement with Queensland University to provide macimorelin for the conduct of preclinical and clinical studies evaluating
macimorelin as a therapeutic for the treatment of ALS. ALS is a rare progressive neurological disease primarily affecting the neurons controlling voluntary movement, leading to the
disability to control movements such as walking, talking, and chewing. Most people with ALS die from respiratory failure, usually between 3-5 years after diagnosis. Currently
there is no cure for ALS and no effective treatment to halt or reverse the progression of the disease. Ghrelin is a hormone with wide-ranging biological actions, most known for
stimulating growth hormone release, which is demonstrating emerging evidence as therapeutic for ALS. As a ghrelin agonist, macimorelin has the potential as a treatment for ALS,
which is evaluated in this research collaboration.

In July 2022, we entered a research and option to license agreement with UniQuest Pty Ltd., the commercialization company of The University of Queensland (UQ), Brisbane,
Australia, to advance the development of macimorelin as a potential therapeutic for the treatment of ALS. We have developed an alternative formulation suitable for use in ALS
patients and are accumulating data for positive effects of AEZS-130 treatment on survival of motor-neurons. We are continuing to evaluate AEZS-130 in transgenic mouse ALS
models as well as in human patient-derived neuron cultures to demonstrate the therapeutic potential of macimorelin in this indication. Our next steps include completion of the
ongoing toxicology and safety studies to support treatment over prolonged periods and following potential achievement of proof-of-concept, scientific advice with regulatory
authorities to discuss program development to support first in human studies.

56

Results of operations

The following is a discussion of our financial condition and results of operations for the years ended December 31, 2023, and 2022. This discussion should be read in conjunction
with the consolidated financial statements and related notes thereto. Comparisons between 2022 and 2021 have been omitted from this MD&A but can be found in "Operating and
Financial Review and Prospects” under Item 5 our Form 20-F for the year ended December 31, 2022, which was filed on March 23, 2023.

Consolidated Statements of Loss and Comprehensive Loss Information

Revenues

121   

2,485   

4,498   

5,640   

5,260 

Three months ended
December 31,
2022
$

2023
$

Twelve months ended
December 31,

2023
$

2022
$

2021
$

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
Expenses
Cost of sales
Research and development
Selling, general and administrative
Impairment of intangible assets
Impairment of goodwill
Impairment of other assets
Total expenses
Loss from operations

(Loss) gain due to changes in foreign currency exchange rates  
Gain on sale of intangible asset
Interest income
Net other costs
Net other income (costs)

Loss before income taxes

Income tax recovery
Net loss
Other comprehensive loss:
Items that may be reclassified subsequently to profit or loss:

Foreign currency translation adjustments

Items that will not be reclassified to profit or loss:

Actuarial gain on defined benefit plans

Comprehensive loss

Basic and diluted loss per share

Consolidated Statements of Financial Position Data

(in thousands)
Cash and cash equivalents
Trade and other receivables and other current assets
Inventory
Restricted cash equivalents
Property and equipment
Other non-current assets (1)
Total assets
Payables and accrued liabilities and income taxes payable
Current portion of provisions
Current portion of deferred revenues
Lease liabilities
Non-financial non-current liabilities (2)
Total liabilities
Shareholders’ equity
Total liabilities and shareholders’ equity

51   
4,425   
2,012   
584   
7,642   
124   
14,838   
(12,353)  

(98)  
-   
-   
-   
(98)  

(12,451)  

-   
(12,451)  

(263)  

(969)  
(13,683)  

(2.56)  

55   
3,868   
2,594   
-   
-   
-   
6,517   
(6,396)  

(162)  
549   
387   
(13)  
761   

(5,635)  

-   
(5,635)  

(367)  

(2,108)  
(8,110)  

(1.16)  

57

222   
13,560   
8,724   
-   
-   
-   
22,506   
(18,008)  

(206)  
549   
1,126   
(13)  
1,456   

(16,552)  

-   
(16,552)  

(211)  

(1,195)  
(17,958)  

(3.41)  

157   
12,506   
8,230   
584   
7,642   
124   
29,243   
(23,603)  

879   
-   
-   
(3)  
876   

(22,727)  

-   
(22,727)  

(289)  

5,262   
(17,754)  

(4.68)  

2023
$

December 31,
2022
$

2021
$

34,016   
2,285   
66   
332   
317   
-   
37,016   
3,733   
429   
218   
279   
14,161   
18,820   
18,196   
37,016   

50,611   
4,648   
229   
322   
216   
-   
56,026   
3,936   
45   
2,949   
179   
13,141   
20,250   
35,776   
56,026   

90 
6,574 
7,267 
- 
- 
- 
13,931 
(8,671)

215 
- 
- 
(21)
194 

(8,477)

109 
(8,368)

367 

(3,592)
(11,593)

(1.82)

65,300 
5,447 
73 
335 
192 
8,755 
80,102 
2,787 
34 
4,815 
161 
19,319 
27,116 
52,986 
80,102 

(1) Comprised of goodwill and intangible assets.
(2) Comprised mainly of employee future benefits, deferred gain, non-current portion of deferred revenues and provisions.

Critical Accounting Estimates and Judgments

Critical accounting estimates and judgements are described in Note 3 to our audited consolidated financial statements as of December 31, 2023, and 2022 and for the years ended
December 31, 2023, 2022 and 2021.

58

Recent Accounting Pronouncements

New standards and amendments

The Company applied for the first-time certain standards and amendments, which are effective for annual periods beginning on or after January 1, 2023 (unless otherwise stated).
The Company has not early adopted any other standard, interpretation or amendment that has been issued but is not yet effective.

Disclosure of Accounting Policies - Amendments to IAS 1 and IFRS Practice Statement 2

The  amendments  to  IAS  1  and  IFRS  Practice  Statement  2  Making  Materiality  Judgements  provide  guidance  and  examples  to  help  entities  apply  materiality  judgements  to
accounting policy disclosures. The amendments aim to help entities provide accounting policy disclosures that are more useful by replacing the requirement for entities to disclose
their ‘significant’ accounting policies with a requirement to disclose their ‘material’ accounting policies and adding guidance on how entities apply the concept of materiality in
making decisions about accounting policy disclosures. The amendments have had an impact on the Company’s disclosures of accounting policies, but not on the measurement,
recognition or presentation of any items in the Company’s financial statements.

 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
   
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Definition of Accounting Estimates - Amendments to IAS 8

The amendments to IAS 8 clarify the distinction between changes in accounting estimates, changes in accounting policies and the correction of errors. They also clarify how
entities use measurement techniques and inputs to develop accounting estimates. The amendments had no impact on the Company’s consolidated financial statements.

Deferred Tax related to Assets and Liabilities arising from a Single Transaction – Amendments to IAS 12

The amendments to  IAS 12  Income  Tax narrow the scope of the initial recognition exception, so that it no longer applies to transactions that give  rise  to  equal  taxable  and
deductible temporary differences such as leases and decommissioning liabilities. The amendments had no impact on the Company’s consolidated financial statements.

Financial Risk Factors and Other Instruments

The nature and extent of our exposure to risks arising from financial instruments, including credit risk, liquidity risk and market risk and how we manage those risks are described in
Note 23 to our audited consolidated financial statements as of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021.

59

Revenues

We generate revenue from license and collaboration agreements with customers (license fees, milestone revenue, royalties), the provision of development services, the sale of
certain active pharmaceutical ingredients ("API”), semi-finished goods and finished goods, and from certain supply chain activities, which are comprised largely of oversight or
supervisory support services related to stability studies or development activities carried out with respect to API batch production as specified in underlying contracts with
customers.

(in thousands)

License fees
Development services
Product sales
Royalty income
Supply chain
Total revenues

2023
$

Three months ended December 31,
Change
$

2022
$

Change
%

53   
-   
66   
2   
-   
121   

873   
1,526   
-   
44   
42   
2,485   

(820)  
(1,526)  
66   
(42)  
(42)  
(2,364)  

-94%
-100%
100%
-95%
-100%
-95%

Our total revenue for the three-month period ended December 31, 2023, was $0.1 million as compared to $2.5 million for the same period in 2022, representing a decrease of $2.4
million. This decrease is primarily due to a $2.5 million decrease due to the termination of the Company’s amended agreement with Novo Nordisk Healthcare in May 2023. This was
partially offset by an increase in product sales of $0.1 million to our UK and European partner, Pharmanovia.

(in thousands)

License fees
Development services
Product sales
Royalty income
Supply chain
Total revenues

2023
$

Twelve months ended December 31,
Change
$

2022
$

Change
%

1,607   
2,741   
66   
31   
53   
4,498   

1,704   
3,617   
57   
101   
161   
5,640   

(97)  
(876)  
9   
(70)  
(108)  
(1,142)  

-6%
-24%
16%
-69%
-67%
-20%

Our total revenue for the twelve-month period ended December 31, 2023, was $4.5 million as compared to $5.6 million for the same period in 2022, representing a decrease of $1.1
million, which is due primarily to the termination of the Company’s amended agreement with Novo Nordisk Healthcare in May 2023.

60

Research and development expenses

The following table summarizes our research and development expenses incurred during the periods indicated:

(in thousands)

Direct research and development expenses:

Macimorelin pediatric DETECT-trial
AEZS-130 – Macimorelin ALS
AEZS-150 – DC-PTH
Aim Biologics - Parkinson’s Disease
Aim Biologics - NMOSD
Bacterial Vaccine Platform - Covid-19
Bacterial Vaccine Platform - Chlamydia
Additional programs

Total direct research and development expenses
Employee-related expenses
Other
Total

2023
$

Three months ended December 31,
Change
$

2022
$

Change
%

1,216   
303   
973   
297   
425   
-   
-   
25   
3,239   
593   
36   
3,868   

1,297   
1,004   
697   
155   
320   
222   
295   
27   
4,017   
311   
97   
4,425   

(81)  
(701)  
276   
142   
105   
(222)  
(295)  
(2)  
(778)  
282   
(61)  
(557)  

-6%
-70%
40%
92%
33%
-100%
-100%
-7%
-19%
91%
-63%
-13%

Our total research and development expenses for the three-month period ended December 31, 2023, were $3.9 million as compared to $4.4 million for the same period in 2022, a
decrease of $0.5 million. Direct research and development expenses include expenses incurred under arrangements with third parties, such as contract research organizations,
contract manufacturers, and consultants.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The decrease in research and development expenses was primarily attributable to:

● a $0.7 million decrease in spending on the Company’s ALS trial driven by the timing of various pre-clinical activities associated with the project;
● a $0.5 million decrease in the Company’s Bacterial Vaccine platform projects as the Company  ceased development of both the COVID-19 and Chlamydia vaccine trials in

Q1, 2023; offset by

● a $0.5 million increase in costs related to the DETECT, DC-PTH and AIM Biologics projects due to the timing of various pre-clinical activities and the advancement of

these projects; and

● a net increase in the employee-related and other expenses of $0.2 million due primarily to an increase in the number of full-time employees.

61

The following table summarizes our research and development expenses incurred during the periods indicated:

(in thousands)

Direct research and development expenses:

Macimorelin pediatric DETECT-trial
AEZS-130 – Macimorelin ALS
AEZS-150 – DC-PTH
Aim Biologics - Parkinson’s Disease
Aim Biologics - NMOSD
Bacterial Vaccine Platform - Covid-19
Bacterial Vaccine Platform - Chlamydia
Additional programs

Total direct research and development expenses
Employee-related expenses
Other
Total

2023
$

Twelve months ended December 31,
Change
$

2022
$

Change
%

4,672   
2,270   
2,312   
816   
1,147   
113   
221   
188   
11,739   
1,546   
275   
13,560   

3,818   
2,514   
1,999   
657   
637   
527   
623   
262   
11,037   
1,199   
270   
12,506   

854   
(244)  
313   
159   
510   
(414)  
(402)  
(74)  
702   
347   
5   
1,054   

22%
-10%
16%
24%
80%
-79%
-65%
-28%
6%
29%
2%
8%

Our total research and development expenses for the twelve-month period ended December 31, 2023, were $13.6 million as compared to $12.5 million for the same period in 2022, an
increase of $1.1 million. The $1.1 million increase was primarily due to:

● a $0.9  million  increase  in  costs  for  the  DETECT-trial  as  the  Company  saw  an  increase  in  the number  of  testing  sites  opened  and  the  recruitment  of  patients  for  the

DETECT-trial leading to the increase in cost from the previous year;

● a $0.5 million and $0.1 million increase in the Company’s AIM Biologicals programs for  NMOSD and Parkinson’s disease respectively, driven by the timing of various pre-

clinical activities and the advancement of these projects;

● a net $0.1 million increase in spending on the Company’s ALS, DC-PTH and other programs due to timing of various pre-clinical activities; and
● a $0.3 million increase in employee-related expenses due to an increase in the number of full-time employees;
● offset by a $0.8 million decrease in the Company’s Bacterial Vaccine platform projects as  the Company ceases development of both the COVID-19 and Chlamydia vaccine

trials in Q1, 2023.

Selling, general, and administrative expenses

(in thousands)

Salaries & benefits
Insurance
Professional fees
Other

62

2023
$

Three months ended December 31,
Change
$

2022
$

Change
%

645   
250   
1,485   
214   
2,594   

882   
420   
311   
399   
2,012   

(237)  
(170)  
1,174   
(185)  
582   

-27%
-40%
377%
46%
29%

Our total Selling, general and administrative expenses for the three-month period ended December 31, 2023, were $2.6 million as compared to $2.0 million for the same period in 2022.
This increase of $0.6 million was primarily attributable to the following:

● a $1.2 million increase in professional fees due primarily to an increase in payments made to the Company’s legal and financial advisors to assist in strategic review and

the Plan of Arrangement, which is described above under "Plan of Arrangement with Ceapro”; offset by

● a $0.2 million decrease in salaries & benefits expenses primarily due to a decrease in the cost of the defined benefit pension;
● a $0.2 million decrease in other expenses primarily due to the reversal of a provision for future estimated patent costs upon the sale of Cetrotide trademarks to Merck; and
● a $0.2 million decrease in insurance expenses as the Company negotiated a lower premium for the current year.

(in thousands)

Salaries & benefits
Insurance
Professional fees
Other

2023
$

3,124   
1,176   
2,981   
1,443   
8,724   

Twelve months ended December 31,
Change
$

2022
$

Change
%

2,994   
1,678   
1,845   
1,713   
8,230   

130   
(502)  
1,136   
(270)  
494   

4%
-30%
62%
-16%
6%

Our total Selling, general and administrative expenses for the twelve-month period ended December 31, 2023, were $8.7 million as compared to $8.2 million for the same period in
2022. This increase of $0.5 million was primarily attributable to the following:

● a $1.1 million increase in professional fees due primarily to an increase in payments made to the Company’s legal and financial advisors to assist in strategic review and

the Plan of Arrangement, which is described above under "Plan of Arrangement with Ceapro”; and

 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● a $0.1 million increase in salaries & benefits expenses primarily due to an increase in the number of full time employees; offset by
● a $0.5 million decrease in insurance expenses as the Company negotiated a lower premium for the current year; and
● a $0.3 million decrease in other expenses primarily due to the reversal of a provision for future estimated patent costs upon the sale of Cetrotide trademarks to Merck.

63

Impairment of goodwill and intangible assets

In the prior year ended December 31, 2022, the Company ceased its development of both the COVID-19 and Chlamydia vaccine trials. The previously capitalized upfront payments
for licenses relating to these two trials of $212 was fully impaired. In addition, as part of the Company’s annual goodwill impairment assessment, the recoverable amount of the
group of cash generating units ("CGUs”) that goodwill was allocated to was determined based on a fair value less cost of disposal ("FVLCD”) model. FVLCD was determined
based on a market approach and also derived from market data including information from market participants regarding the price that the Company could receive in a sale of the
group of CGUs. Based on the Company’s assessment, the recoverable amount of the group of CGUs was lower than the carrying value and therefore an impairment charge was
recorded on its goodwill and intangible assets for an amount of $7,642 and $372 respectively, as discussed in note 11 of the Company’s audited consolidated financial statements.

Net other income (costs)

For the three-month period ended December 31, 2023, our net other income was $0.8 million as compared to a net other loss of $0.1 million for the three-month period ended
December 31, 2022, an increase of $0.9 million. This increase was primarily due to a $0.4 million increase in interest income and the gain on sale of intangible asset of $0.5 million.

Net other income for the twelve-month period ended December 31, 2023, was $1.5 million as compared to $0.9 million for the same period in 2022, an increase of $0.6 million. This
increase was primarily due to a $1.1 million increase in interest income and the gain on sale of intangible asset of $0.5 million, partially offset by an increase in loss due to changes
in foreign currency exchange rates of $1.0 million.

Net loss

For the three-month period ended December 31, 2023, we reported a consolidated net loss of $5.6 million, or $1.16 loss per common share (basic and diluted), as compared to a
consolidated net loss of $12.5 million, or $2.56 loss per common share (basic and diluted) for the three-month period ended December 31, 2022. The $6.9 million decrease in net loss
is primarily attributable to:

● a $8.3 million decrease in expense from the impairment of goodwill and intangible assets in 2022;
● a $0.6 million decrease in cost of sales and  R&D costs, offset by $0.6 million increase in  SG&A costs, primarily associated with the announced plan of arrangement

between the Company and Ceapro Inc

● a $0.4 million increase in interest revenue; and
● a $0.5 million gain on the sale of trademarks due to the sale of the Cetrotide trademarks to Merck;
● offset by a $2.3 million decrease in revenue as a result of the termination of the Novo Amended agreement in May 2023;

For the twelve-month period ended December 31, 2023, we reported a consolidated net loss of $16.6 million, or $3.41 loss per common share (basic and diluted), as compared to a
consolidated net loss of $22.7 million, or $4.68 loss per common share (basic and diluted), for the year ended December 31, 2022. The $6.1 million decrease in net loss is primarily
attributable to:

● a $8.3 million decrease in expense from the impairment of goodwill and intangible assets in 2022;
● a $0.5 million gain on the sale of trademarks due to the sale of the Cetrotide trademarks to Merck; and
● a $1.1 million increase in interest income;
● offset by a $1.1 million decrease in revenue as a result of the termination of the Novo Amended agreement in May 2023;
● a $1.1 million increase in R&D costs as previously described and a $0.5 million increase in SG&A costs primarily associated with the announced plan of arrangement

between the Company and Ceapro Inc; and

● a $1.1 million increase in loss due to changes in foreign currency exchange rates.

64

Selected quarterly financial data

(in thousands, except for per share data)

Revenues
Net loss
Net loss per share (basic and diluted)(1)

(in thousands, except for per share data)

Revenues
Net loss
Net loss per share (basic and diluted)(1)

Three months ended

Dec 31, 2023
$

Sept 30, 2023
$

Jun 30, 2023
$

Mar 31, 2023
$

121   
(5,635)  
(1.16)  

3   
(4,145)  
(0.85)  

2,246   
(2,518)  
(0.52)  

2,128 
(4,255)
(0.88)

Three months ended

Dec 31, 2022
$

Sept 30, 2022
$

Jun 30, 2022
$

Mar 31, 2022
$

2,485   
(12,451)  
(2.56)  

1,860   
(3,420)  
(0.70)  

(222)  
(4,216)  
(0.87)  

1,517 
(2,640)
(0.54)

(1) Net loss per share is based on the weighted average number of shares outstanding during each reporting period, which may differ on a quarter-to-quarter basis. As such, the

sum of the quarterly net loss per share amounts may not equal full-year net loss per share.

Historical quarterly results of operations and net loss cannot be taken as reflective of recurring revenue or expenditure patterns of predictable trends, largely given the non-
recurring nature of certain components of our revenues, unpredictable quarterly variations in net finance income and of foreign exchange gains and losses.

The decrease in revenue in Q3, 2023 and Q4, 2023 in contrast to the other quarterly periods presented, is due to the termination of the Company’s amended agreement with Novo
Nordisk Healthcare in May 2023 and as a result, no license fee or development services revenue was recognized in Q3 or Q4, 2023.

The increase in net loss for the three-month period ended December 31, 2022 in contrast to the other quarterly periods presented, was due to the recording of an impairment charge
on the Company’s goodwill and intangible assets for an amount of $7,642 and $372 respectively.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The decrease in revenue and increase in net loss for the three months ended June 30, 2022, was driven by the reversal of revenue of $0.4 million in license fees and $0.8 million in
development services which took place in Q2, 2022 as a result of a change in management’s best estimate of additional costs associated to the DETECT-trial.

65

Liquidity and capital resources

The Company’s objective in managing capital, consisting of shareholders’ equity, with cash and cash equivalents being its primary components, is to ensure sufficient liquidity to
fund research and development costs, selling, general and administrative expenses and working capital requirements. Over the past several years, we have raised capital via public
and  private  equity  offerings  and  issuances  and  have  entered  into  licensing  and  collaborative  arrangements,  consideration  from  which,  together  with  proceeds  from  equity
issuances, has been our primary source of liquidity. During the year, the Company’s total assets decreased primarily due to funding research and development and selling, general
and administrative expenses, while total liabilities decreased primarily due to the recognition of deferred revenue resulting from the termination of the Novo Amended agreement,
resulting in an overall reduction in the working capital available. The capital management objective of the Company remains the same as that in previous periods. The policy on
dividends  is  to  retain  cash  to  keep  funds  available  to  finance  the  activities  required  to  advance  the  Company’s  product  development  portfolio  and  to  pursue  appropriate
commercial opportunities as they may arise. The Company is not subject to any capital requirements imposed by any regulators or by any other external source.

Cash flows

The following table shows a summary of our consolidated cash flows for the periods indicated:

(in thousands)

Cash and cash equivalents - beginning of year
Cash used in operating activities
Cash flows (used in) provided by financing activities
Cash flows provided (used in) by investing activities
Effect of exchange rate changes on cash and cash equivalents
Cash and cash equivalents - end of year

Operating activities

2023
$

December 31,
2022
$

2021
$

50,611   
(17,118)  
(151)  
528   
146   
34,016   

65,300   
(13,680)  
(118)  
(12)  
(879)  
50,611   

24,271 
(8,581)
51,037 
(658)
(769)
65,300 

Cash used by operating activities totaled $17.1 million for the twelve-month period ended December 31, 2023, as compared to $13.7 million in the same period in 2022. This $3.4
million increase in operating cash outflows is attributed primarily to:

● a decrease in development services, product sales, royalty and supply chain revenues of $1.1 million;
● an increase in R&D and SG&A expenses of $1.6 million, as described above; and
● an increase in other operating cash and working capital outflows of $1.9 million, primarily related to the recognition of deferred revenue upon termination of the Novo

Amendment agreement; offset by

● an increase in interest received on cash deposits of $1.2 million.

Financing activities

Cash spent on financing activities totaled $0.2 million for the twelve months ended December 31, 2023, as compared to cash provided by financing activities of $0.1 million in the
same period in 2022 and primarily related to building and car lease payments for our German subsidiary.

Investing activities

Cash provided by investing activities totaled $0.5 million for the twelve months ended December 31, 2023, as compared to $0. million in the same period in 2022. The $0.5 million
increase is primarily related to the proceeds from the sale of an intangible asset.

66

Adequacy of financial resources

Since inception, the Company has incurred significant expenses in its efforts to develop and co-promote products. Our current business focus is to: investigate further therapeutic
uses  of  Macrilen™,  expand  pipeline  development  activities,  further  expand  the  commercialization  of  macimorelin  in  available  territories  and  fund  ongoing  clinical  trial  costs.
Consequently, the Company has incurred operating losses and has generated negative cash flow from operations and in each of the last several years except for the year ended
December 31, 2018 when the Company earned revenue from the sale of a license for the adult indication of Macrilen™ in the U.S. and Canada. The Company expects to incur
significant expenses and operating losses for the foreseeable future as it advances its product candidates through preclinical and clinical development, seeks regulatory approval
and pursues commercialization of any approved product candidates. We expect that our research and development costs will increase in connection with our planned research and
development activities.

As of December 31, 2023, the Company had an accumulated deficit of $369.8 million. The Company also had a net loss of $16.6 million and negative cash flows from operations of
$17.1  million  for  the  year  ended  December  31,  2023  We  believe  that  our  existing  cash  on  hand  will  be  sufficient  to  fund  our  anticipated  operating  and  capital  expenditure
requirements for the next 12 months. We plan to finance our future operations and capital expenditures primarily through cash on hand. We also believe that our existing cash on
hand will be sufficient to fund our anticipated operating and capital expenditure requirements beyond the next 12 months and through 2025. We have based this estimate on
assumptions that may prove to be wrong, and we could exhaust our capital resources sooner than we expect. We may also require additional capital to pursue in-licenses or
acquisitions of other product candidates.
Our  forecast  of  the  period  of  time  through  which  our  financial  resources  will  be  adequate  to  support  our  operations  is  a  forward-looking  statement  that  involves  risks  and
uncertainties, and actual results could vary materially as a result of a number of factors. Our future capital requirements are difficult to forecast and will depend on many factors,
including:

● the terms and timing of any other collaboration, licensing, and other arrangements that we may establish;

● the initiation, progress, timing, and completion of preclinical studies and clinical trials for our current and future potential product candidates;

● our alignment with the FDA on regulatory approval requirements;

 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● the number and characteristics of product candidates that we pursue;

● the outcome, timing, and cost of regulatory approvals;

● delays that may be caused by changing regulatory requirements;

● the cost and timing of hiring new employees to support our continued growth;

● the costs involved in filing and prosecuting patent applications and enforcing and defending patent claims;

● the costs of filing and prosecuting intellectual property rights and enforcing and defending any intellectual property-related claims;

● the costs of responding to and defending ourselves against complaints and potential litigation;

● the costs and timing of procuring clinical and commercial supplies for our product candidates; and

● the extent to which we acquire or in-license other product candidates and technologies.

67

Contractual obligations and commitments

The following is a summary of our contractual obligations as of December 31, 2023:

Less than 1 year
1 – 5 years

Amount
$

5,634 
71 
5,705 

In 2021, the Company executed various agreements including in-licensing and similar arrangements with development partners. Such agreements may require the Company to make
payments on achievement of stages of development, launch or revenue milestones, although the Company generally has the right to terminate these agreements at no penalty. The
Company may have to pay up to $39,373 upon achieving certain sales volumes, regulatory or other milestones related to specific products.

Contingencies

In the normal course of operations, the Company may become involved in various claims and legal proceedings related to, for example, contract terminations and employee-related
and other matters.

Related Party Transactions

Other than ordinary course employment agreements and indemnification agreements with our management, which are disclosed in Note 27 of our consolidated financial statements
for the years ending December 31, 2023, and 2022, there were no other related party transactions.

Off-Balance Sheet Arrangements

As of December 31, 2023, we did not have any interests in special purpose entities or any other off-balance sheet arrangements.

Risk Factors and Uncertainties

An investment in our securities involves a high degree of risk. In addition to the other information included in this MD&A and in the related consolidated financial statements,
investors are urged to carefully consider the risks described in our annual information form under the heading "Risk Factors” for a discussion of the various risks that may
materially affect our business. The risks and uncertainties not presently known to us or that we currently deem immaterial may also materially harm our business, operating results
and financial condition and could result in a complete loss of your investment.

68

B.

Liquidity, Cash Flows and Resources

Please see Item 5.A "Operating Results” for information regarding the Company’s liquidity and capital resources for the year ended December 31, 2023.

C.

Research and development, patents and licenses, etc.

For a description of our R&D policies for the last three years, see "Item 4.B. Business Overview” and "Key Developments” at the beginning of this Item 5. Over the past four years,
our research and development activities have encompassed:

● the 2018 initiation of pediatric indication P01 study for MacrilenTM (macimorelin) for which Novo paid 70% of the costs;
● the 2021 initiation of the DETECT-trial which Novo funded all costs up to $9.6 million (€9 million), and any additional costs incurred over $9.6 million (€9 million) up to

$10.5 million (€9.8 million) was shared equally between Novo and the Company until May 2023; and

● our pipeline activities which consist of pre-clinical work.

D.

Trend Information

Other than as disclosed below and elsewhere in this Annual Report, we are not aware of any trends, uncertainties, demands, commitments, or events that are reasonably likely to
have a material effect on our net revenue, income from continuing operations, profitability, liquidity, or capital resources, or that would cause reported financial information not
necessarily to be indicative of future operating results or financial condition.

Aeterna is currently conducting its pivotal Phase 3 safety and efficacy study AEZS-130-P02 (the " DETECT-trial”) evaluating macimorelin for the diagnosis of CGHD. Children and
adolescents from two to less than 18 years of age with suspected growth hormone deficiency are to be included. The study is expected to include approximately 100 subjects in
Europe and North America, with at least 40 subjects in pre-pubertal and 40 subjects in pubertal status. Macimorelin growth hormone stimulation test (" GHST”) will be performed

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
twice for repeatability data and two standard  GHSTs will be used as controls: arginine (IV) and clonidine (orally).  On April 22, 2021, the  U.S.  FDA  Investigational  New  Drug
Application associated with this clinical trial became active. On January 26, 2022, we announced that the DETECT-trial had experienced unavoidable delays in site initiation and
patient enrollment due to the rise of the  Omicron variant in the  COVID-19 pandemic.  Furthermore, in  February 2022, due to the  Russian invasion of  Ukraine, the clinical trial
activities planned in both Russia and Ukraine were halted and consequently, no patients have been enrolled in either of these countries’ clinical sites to date. On January 17, 2023,
we provided a business update, highlighting that bolstered enrollment was expected by the engagement of an additional CRO and the replacement of inactive countries and sites
with three new countries (Armenia, Slovakia, and Turkey) as well as additional sites in the U.S. In March 2023, we received approval for and activated our first site in Slovakia. Sites
in Armenia and Turkey were approved and activated in early 2024. We expect enrollment in our DETECT-trial to be completed in Q1 2024.

The Company continues to advance its ongoing business development discussions to secure commercialization partners for macimorelin in additional markets. In addition to its
previously established agreements, Aeterna recently entered into a license agreement with NK Meditech Ltd., for the development and commercialization of macimorelin in the
Republic of Korea, and a distribution agreement with Er-Kim Pharmaceuticals Bulgaria EOOD for the commercialization of macimorelin in Turkey and some Balkan countries.

For the development of AIM Biologicals as potential PD therapeutics, Aeterna plans to utilize, among others, an innovative animal model on neurodegeneration by α-synuclein-
specific T cells in AAV-A53T-α-synuclein Parkinson’s disease mice, which has recently been published by University of Wuerzburg researchers.

Next Steps – NMOSD

● Conduct in-vitro and in-vivo assessments to select an AIM Biologicals-based development candidate.
● Manufacturing process development for selected candidate.

Next Steps – Parkinson’s Disease

● Design and produce antigen-specific AIM Biologics molecules for the potential treatment of Parkinson’s disease.
● Conduct in-vitro and in-vivo assessments in relevant Parkinson’s disease models.

69

In consultation with the University of Sheffield, Aeterna has selected AEZS-150 as the lead candidate in its DC-PTH program. AEZS-150 is being developed with the goal of
providing a potential new treatment option of primary hypoparathyroidism in adults.

Next Steps DC-PTH

● Work with the University of Sheffield to conduct in depth characterization of development candidate (in-vitro and in-vivo).
● Develop manufacturing process.
● Formalize pre-clinical development of AEZS-150 in preparation for a potential IND filing for conducting the first in-human clinical study

Apart from already available pre-clinical and clinical data on macimorelin for the development as a diagnostic, Aeterna may utilize the established supply chain to support this
development. Alternative formulations are currently also under development, as a further option in addition to the existing oral solution already approved for the diagnostic use in
adult growth hormone deficiency (AGHD).

Next Steps – Macimorelin as a Potential Therapeutic (ALS)

● Work with the University of Queensland to conduct proof-of-concept studies with macimorelin in disease-specific animal models.
● Assess alternative formulations.
● Formalize pre-clinical development plan

The COVID-19 vaccine landscape has continued to evolve profoundly in the past two years. There are highly effective vaccines available, an increasing number of therapeutic
options are meanwhile approved or in later stage development and less lethal virus variants are spreading, all of which increase the financial risk associated with any early stage
COVID-19 vaccine program. In order to ensure we are prudent with the use of resources, given the early stage of the Company’s vaccine development programs and the changes in
the global situation, Aeterna had decided in Q1 2023 that it will not pursue further development of the vaccine platform for either COVID-19 or Chlamydia (which was based on the
same vaccine platform as used in the Company’s COVID-19 program). As a result, the Company has also elected to terminate its existing license agreements with the University of
Wuerzburg for that vaccine platform technology.

Financial Risk Factors and Other Instruments

The nature and extent of our exposure to risks arising from financial instruments, including credit risk, liquidity risk and market risk (share price risk) and how we manage those risks
are described in note 23 to the Company’s annual audited consolidated financial statements as of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and
2021.

The consolidated financial statements filed as part of this Annual Report on Form 20-F are presented under "Item 18. – Financial Statements”.

E.

Critical Accounting Estimates

See Item 5. A above "Operating Results”.

Item 6. Directors, Senior Management and Employees

A.

Directors and senior management

70

The following table sets forth information about our directors and our senior corporate officers as at December 31, 2023:

Name and Place of Residence

Position with Aeterna Zentaris

Ammer, Nicola
Hessen, Germany
Edwards, Peter G.
Ohio, United States
Egbert, Carolyn

Senior Vice President Clinical Development, Chief Medical Officer

  Director

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Texas, United States
Gagnon, Gilles
Quebec, Canada
Gerlach, Matthias
Hessen, Germany
Guenther, Eckhard (1)
Hessen, Germany
La Fratta, Giuliano
Quebec, Canada
Paulini, Klaus
Hessen, Germany
Turpin, Dennis
Quebec, Canada
Teifel, Michael
Hessen, Germany

  Director, Chair of the Board

  Director

Senior Vice President Manufacturing and Supply Chain

Senior Vice President Business Development & Alliance Management; Managing
Director AEZS Germany

Senior Vice President, Chief Financial Officer

President, Chief Executive Officer, Director; Managing Director AEZS Germany

  Director

Senior Vice President Non-Clinical Development, Chief Scientific Officer

(1) Dr. Guenther retired from his positions with Aeterna effective as of January 31, 2024. Dr. Matthias Gerlach succeeded Dr. Guenther in his role as Managing Director AEZS

Germany”

The following is a brief biography of each of our directors and executive officers.

Nicola Ammer was appointed as our Senior Vice President, Clinical Development and as Chief Medical Officer in January 2021. She serves as one of our executive officers. Dr.
Ammer, who is based in the Frankfurt, Germany office of AEZS Germany, began her career in the pharmaceutical medicine environment in the CRO business in 2002 and gained
experience in all aspects of clinical research & development  in  various  positions  with  increasing  responsibility,  including  a  Director  of  Clinical  Operations.  She  joined AEZS
Germany in March 2015 as Clinical Program Director and took over the role of the Head of Clinical Development in January 2016. She possesses numerous skills in the area of
pharmaceutical medicine and contributed significantly to the successful completion of the macimorelin clinical development program in the adult indication. Dr. Ammer obtained
the license to practice medicine in 1995 after completion of her academic studies at the University of Essen. She was awarded a doctorate diploma in medicine by the University of
Münster in 2004 and a Master of Science in Pharmaceutical Medicine by the University Duisburg-Essen in 2009.

Peter G. Edwards joined the Board on May 15, 2020 and is a member of the Audit Committee and of the Nominating, Governance and Compensation Committee. Mr. Edwards is
currently General Counsel of Aziyo Biologics. Mr. Edwards served as the Executive Vice President and General Counsel of Celanese Corporation from January 2017 to January
2019. Mr. Edwards previously was Executive Vice President and General Counsel of Baxalta Incorporated, the biopharmaceutical spin-off from Baxter, from June 2015 until its merger
with Shire plc in July 2016. Before that, he was Senior Vice President and General Counsel of the global specialty pharmaceuticals company Mallinckrodt plc from July 2013 to June
2015 and served as its Vice President and General Counsel from May 2010 to its spin-off from Covidien plc in June of 2013. He previously served as Executive Vice President and
General Counsel for Solvay Pharmaceuticals in Brussels, Belgium from June 2007 until April 2010 and as its Senior Vice President and General Counsel in the US from October 2005
to June 2007. Prior to that, he held in-house positions of increasing responsibility within Mettler-Toledo, Inc. and Eli Lilly and Company. Mr. Edwards began his career in 1990 as
an associate in the Kansas City, Missouri office of Shook, Hardy & Bacon L.L.P. Mr. Edwards received his J.D., cum laude, from Brigham Young University.

71

Carolyn Egbert has served as a director on our Board since August 2012 and as Chair of our Board since May 2016. She is also a member of the Nominating, Governance and
Compensation  Committee. After  enjoying  the  private  practice  of  law  as  a  defense  litigator  in  Michigan  and  Washington,  D.C.,  she  joined  Solvay America,  Inc.  (" Solvay”)  (a
chemical and pharmaceutical company) in  Houston,  Texas.  Over the course of a twenty-year career with  Solvay, she held the positions of  Vice  President,  Human  Resources,
President of Solvay Management Services, Global Head of Human Resources and Senior Executive Vice President of Global Ethics and Compliance. During her tenure with Solvay,
she served as a director on the board of directors of seven subsidiary companies and as Chair of one subsidiary board. After retiring in 2010, she established Creative Solutions for
Executives, a consulting business providing expertise in corporate governance, ethics and compliance, organizational development, executive compensation and strategic human
resources.  She  holds  a  Bachelor  of  Sciences  degree  in  Biological  Sciences  from  George  Washington  University,  Washington  D.C.  and  a  Juris  Doctor  degree  from  Seattle
University,  Seattle,  Washington.  She  also  was  a  Ph.D.  candidate  in  Pharmacology  at  both  Georgetown  University  Medical  School  at  Washington,  D.C.  and  Northwestern
University Medical School at Chicago, Illinois. She remains an active member of both the Michigan State Bar and the District of Columbia Bar, Washington, D.C.

Gilles  Gagnon joined the Board on January 1, 2020 and is a member of the Audit Committee and of the Nominating, Governance and Compensation Committee. Mr. Gagnon is
currently the President and Chief Executive Officer of Ceapro Inc., a biotechnology company. Prior to that, he was President and CEO of Aeterna Zentaris Inc. During the past 35
years,  Mr.  Gagnon  has  worked  at  several  management  levels  within  the  field  of  health,  especially  in  the  hospital  environment  and  pharmaceutical  industry.  Mr.  Gagnon  has
participated  in  several  international  committees  and  strategic  advisory  boards.  He  served  nine  years  on  the  board  of  directors  of  Canada’s  Research  Based  Pharmaceutical
Companies (Rx&D—now  Innovative  Medicine  Canada) where he represented members from the biopharmaceutical sector and pioneered the  Rx&D’s  Canadian  Bio partnering
initiative. He currently serves as the President and Chief Executive Officer of Ceapro Inc. He is a member of the CEO Council of Innovative Medicine Canada. He is a certified
corporate Director having completed the Directors Education Program at the Rotman School of Management at the University of Toronto, and he has served on several boards of
both private and publicly listed companies in the biopharmaceutical sector.

Matthias Gerlach was appointed as our Vice President, Manufacturing Operations in June 2014 and as Vice President, Manufacturing and Supply Chain in January 2018. He serves
as one of our executive officers. From December 2011 through May 2014, he was our Vice President, Medicinal Chemistry. Dr. Gerlach, who is based in the Frankfurt office of AEZS
Germany,  began  his  career  in  the  pharmaceutical  industry  in  1997.  He  joined  our  Company  in  January  2001,  assuming  roles  of  increasing  responsibility  in  areas  of  medicinal
chemistry  and  preclinical  development  through  product  commercialization  during  his  career.  He  possesses  numerous  scientific  and  business  skills  and  has  a  long  record  of
successful  innovation,  drug  development  and  management,  and  contributed  significantly  to  the  successful  U.S.-commercialization  of  macimorelin  in  the  adult  indication.  Dr.
Gerlach obtained a diploma in Chemistry from the Johann Wolfgang Goethe University in Frankfurt in 1994 and was awarded his doctorate diploma in synthetic organic chemistry
by the Johann Wolfgang Goethe University in 1997.

Eckhard Guenther was appointed as Managing Director of Aeterna Zentaris GmbH in January 2020 and Senior Vice President of Business Development & Alliance Management
in 2021. Dr. Guenther brings more than 25 years in the pharmaceutical industry, with profound knowledge and expertise in drug discovery and development in various indication
areas  like  oncology  and  endocrinology. Additionally,  over  the  course  of  his  career,  he  has  gained  extensive  experience  across  research  coordination,  project  management,
intellectual properties and business development. After receiving his Ph.D. in organic chemistry from the Martin-Luther University of Halle-Wittenberg (Germany), he started his
industrial career at Fahlberg-List Magdeburg in 1985. In 1990 he joined ASTA Medica AG in Frankfurt where he worked in the department of Medicinal Chemistry. During his time
at ASTA Medica, Dr. Guenther was significantly involved in the preparation and execution for the spin-off of the biotechnology company Zentaris from ASTA Medica. After the
founding  of Aeterna  Zentaris  in  2002  he  was  appointed  to  Vice  President  of  Drug  Discovery  and  Preclinical  Research.  In  2008  he  was  promoted  to  Vice  President Alliance
Management & Intellectual Property and in 2014 he became Vice President of Business Development at Aeterna Zentaris. Dr. Guenther was responsible for the initiation and
execution of several research and development and licensing deals with midsize and large international pharmaceutical companies, like Consilient Health, MegaPharm Ltd., Schering
Pharma, Solvay, Yakult Honsha, Hikma Pharmaceuticals and Sinopharm A-Think. Dr. Guenther is based in Frankfurt, Germany. Dr. Guenther retired from his positions with Aeterna
effective as of January 31, 2024. Dr. Matthias Gerlach succeeded Dr. Guenther in his role as Managing Director AEZS Germany.

72

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Giuliano La Fratta was appointed as our Senior Vice President, Chief Financial Officer in January 2022. He is a senior financial professional with over 20 years of professional
experience in the pharmaceutical, biopharma and financial services sector. During his career, he has served in both the public and private sectors where he has gained significant
experience in leading and managing broad financial activities, including M&A transactions, corporate development, auditing, accounting and administrative functions. Prior to
joining Aeterna Zentaris, Mr. La Fratta served as the Vice President of Finance at CellCarta (formerly Caprion Biosciences), a private equity-owned specialty Clinical Research and
Development Organization laboratory with global operations headquartered in Montreal, Canada. Prior to CellCarta, Mr. La Fratta served in various functions at IMS Canada Health
(now Iqvia) and Cato Research. He began his career at Deloitte Touche as a Senior Auditor for both Canadian and American companies across various industries, including the
pharmaceutical sector. Mr. La Fratta holds a bachelor’s degree in accounting from Concordia University and holds a CPA designation.

Dr.  Klaus  Paulini was  appointed  President  and  Chief  Executive  Officer  of  the  Company  in  October  2019  and  also  serves  as  a  director  on  our  Board.  Dr.  Paulini  is  based  in
Frankfurt, Germany at our subsidiary AEZS Germany, where he was appointed Managing Director in July 2019 and as Vice President Quality and Regulatory in February 2018. Dr.
Paulini began his career in the pharmaceutical industry at ASTA Medica AG in 1997. He had an active role when Zentaris was formed and spun out of ASTA Medica and served in
various roles with increasing responsibility at the company ever since, including project responsibility for Cetrotide®. As Head of Quality Assurance from 2010 and 2019, Dr.
Paulini successfully managed many of our clinical development projects – including Macrilen™/Macimorelin – in the research and development phase as group leader medicinal
chemistry. With his extensive experience and knowledge, he provided successful oversight and valuable input for our pharmaceutical and clinical development programs, ensuring
successful and compliant outcomes, ultimately leading to regulatory approvals by the U.S. FDA and the EMA. Dr. Paulini obtained his PhD (Dr. Ing.) in chemistry at the Technical
University Darmstadt (Germany) in 1993 and specialized in medicinal chemistry/drug discovery during subsequent postdoctoral fellowships at Strathclyde University (Glasgow,
Scotland) and J.W. Goethe University (Frankfurt, Germany) before joining ASTA Medica AG.

Dennis Turpin is a seasoned professional executive and chartered professional accountant (CPA) with significant experience in finance and capital markets transactions, business
development  and  mergers  and  acquisitions,  over  20  years  of  which  has  been  in  the  biopharmaceutical  industry.  He  is  currently  the  President  and  Chief  Executive  Officer  of
Endoceutics, Inc., a speciality biopharmaceutical company where he was previously the Vice President, Special Projects. Mr. Turpin was previously the Vice President and Chief
Financial Officer of the Quebec Port Authority from February 2016 to June 2018. From 2007 to 2015, Mr. Turpin was the Senior Vice President and Chief Financial Officer of Aeterna
Zentaris  and,  between  1996  and  2007  he  held  various  finance  roles  with Aeterna  Zentaris.  Prior  to  that,  he  was  a  Director  in  the  tax  department  at  Coopers  Lybrand,  now
PricewaterhouseCoopers, from 1988 to 1996 and worked as an auditor from 1985 to 1988. Mr. Turpin earned his Bachelor’s degree in Accounting from Laval University in Québec.
He obtained his license in accounting in 1985 and became a chartered professional accountant in 1987.

Michael Teifel is a leading industry executive with a career spanning over 20 years in various therapeutic areas, including endocrinology and oncology. He has deep experience in
translating research into clinical development.  Over the course of his career, he has gained particular expertise in the design and implementation of non-clinical development
programs for small molecule drugs, peptides, targeted therapies, and biologics, as well as in the continued non-clinical evaluation of drug candidates for global registration. Dr
Teifel joined Aeterna Zentaris having held various positions in industry with increasing responsibilities in pharmacology, pharmacokinetics, toxicology and translational sciences.
He began his career in industry at Roche Diagnostics in the area of delivery systems / non-viral gene therapy. In 1999, Dr. Teifel joined the biotech start-up, Munich Biotech in
Martinsried, Germany as a co-founder. As head of pharmacology & toxicology, he was responsible for the evaluation and non-clinical development of a novel vascular targeting
technology for the development of anti-tumor diagnostics and therapeutics. In 2004, Dr. Teifel started his first term at Aeterna Zentaris where he held several positions in the field
of preclinical development and translational research. In his capacity he was, among others, responsible for preparation of the non-clinical dossier for registration of macimorelin in
the U.S. and EU in the indication AGHD. In 2019, Dr. Teifel left Aeterna Zentaris to pursue his career in non-clinical research and development at Cleara Biotech in Utrecht, The
Netherlands. As head of translational sciences at Cleara Biotech, he was responsible for translating research on anti-senescent drugs into pre-clinical development in age-related
diseases and late-stage cancer. In May 2021 he re-joined Aeterna Zentaris as Senior Vice-President Non-Clinical Development and Chief Scientific officer. Dr. Teifel holds a degree
in biology and his Ph.D. from the Technical University of Darmstadt, Germany.

73

There are no family relationships between any of the persons named above and no arrangement with any customers, major shareholders, suppliers or others pursuant to which any
person above was selected as a director or executive officer. Each director holds office until the Company’s next annual general meeting or until a successor is duly elected or
appointed.

Board Diversity

The table below provides certain information regarding the diversity of our board of directors as of the date of this Annual Report on Form 20-F.

Board Diversity Matrix
Country of Principal Executive Offices:
Foreign Private Issuer
Disclosure Prohibited under Home Country Law
Total Number of Directors

Canada
Yes
No
5

As of March 26, 2024

As of March 23, 2023

Part I: Gender Identity
Directors

Female
1

  Male

4

Non-
Binary
—

Did Not
Disclose
Gender
—

  Female
1

  Male

4

Non-
Binary
—

Did Not
Disclose
Gender
—

Part II: Demographic Background
Underrepresented Individual in Home
Country Jurisdiction
LGBTQ+
Did Not Disclose Demographic
Background

Plan of Arrangement

—

—

5

—

—

5

Assuming the successful completion of the Plan of Arrangement, our board of directors will be reconstituted such that it will be comprised of Gilles Gagnon, Ronald W. Miller,
Ulrich Kosciessa, Geneviève Foster, William Li, Carolyn Egbert, Peter Edwards and Dennis Turpin. Mr. Gagnon is currently a director of Aeterna and chairman of the board of
Ceapro and Mssrs. Miller, Kosciessa and Li and Ms. Foster are also current members of the board of Ceapro. Please see the section of our Registration Statement on Form F-1 filed
with the SEC on February 15, 2024, entitled "The Plan of Arrangement – Covenants – Covenants of Aeterna Zentaris Regarding the Board and Management.”

B.

Compensation

Our directors and executive officers are generally paid in their home country currency. Unless otherwise indicated, all compensation information included in this document is
presented in U.S. dollars and, to the extent a director or officer has been paid in a currency other than U.S. dollars, the amounts have been converted from such person’s home
country currency to U.S. dollars based on the following annual average exchange rates: for the financial year ended December 31, 2023: €1.000 = U.S.$1.082 and CAN$1.000 =

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
U.S.$0.741; for the financial year ended December 31, 2022: €1.000 = U.S.$1.053 and CAN$1.000 = U.S.$0.759; for the financial year ended December 31, 2021: €1.000 = U.S.$1.182 and
CAN$1.000 = U.S.$0.797.

74

Compensation of Outside Directors

The compensation paid to members of our Board who are not our employees (our "Outside Directors”) is designed to (i) attract and retain the most qualified people to serve on
the  Board  and  its  committees,  (ii)  align  the  interests  of  the  Outside  Directors  with  those  of  our  shareholders,  and  (iii)  provide  appropriate  compensation  for  the  risks  and
responsibilities related to being an effective Outside Director. This compensation is recommended to the Board by the Nominating, Governance and Compensation Committee
("NGCC”). The NGCC is currently composed of three Outside Directors, each of whom is independent, namely Ms. Carolyn Egbert (Chair), Mr. Peter G. Edwards and Mr. Gilles
Gagnon.

The Board has adopted a formal mandate for the NGCC, which is available on our website at www.zentaris.com. The mandate of the NGCC provides that it is responsible for,
among  other  matters,  assisting  the  Board  in  developing  our  approach  to  corporate  governance  issues,  proposing  new  Board  nominees,  overseeing  the  assessment  of  the
effectiveness of the Board and its committees, their respective chairs and individual directors, making recommendations to the Board with respect to directors’ compensation and
generally serving in a leadership role for our corporate governance practices.

Retainers

Our Outside Directors are paid an annual retainer, the amount of which depends on the position held on the Board. Annual retainers are paid on a quarterly basis to our Outside
Directors. Each Outside Director is paid the equivalent value of the payment in his or her home currency, net of any withholdings or deductions required by applicable law.

Type of Compensation

Monthly Retainer for the year
2023

Annual Retainer for the year
2023

Chair of the Board Retainer
Board Member Retainer
Audit Committee Chair Retainer
Audit Committee Member Retainer
NGCC Chair Retainer
NGCC Member Retainer
BOD Strategic Committee

—   
—   
—   
—   
—   
—   
—   

80,000 
50,000 
30,000 
7,500 
15,000 
5,000 
78,000 

All Directors are reimbursed for travel and other out-of-pocket expenses incurred in attending Board or committee meetings. Retainers are prorated when an Outside Director joins
the Board during a financial year.

75

Outstanding Awards

The following table shows all awards outstanding to each Outside Director as at December 31, 2023:

Option-based Awards

Share-based Awards

Number of
Securities
Underlying
Unexercised
Options
(#)

Option
Exercise
Price
($)

Issuance
Date

Option
Expiration
Date

Issuance
Date

Market or
Payout
Value of
Share-
based
Awards
that have
not
vested(2)    
($)

Market or
payout value
of vested
share-based
awards not
paid out or
distributed(2)  
($)

Number
of Shares
or Units
of Shares
that have
vested    

(#)

—   
—   
—   
—   

08-15-

2017   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   

—   
—   
—   
—   

2,400   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   

—   
—   
—   
—   

51.25   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   

—   
—   
—   
—   

  05/15/2020   
  05/05/2021   
  08/03/2022   
  06/14/2023   

08-15-

2024   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   

—   
  05/08/2018   
  05/22/2019   
  05/15/2020   
  05/15/2021   
  08/03/2022   
  06/14/2023   
  05/15/2020   
  05/19/2021   
  08/03/2022   
  06/14/2023   
  05/19/2021   
  08/03/2022   
  06/14/2023   

1,200   
2,800   
20,000   
25,000   

—   
920   
1,200   
1,200   
2,800   
20,000   
25,000   
1,200   
2,800   
20,000   
25,000   
2,800   
20,000   
25,000   

—   
—   
—   
—   

—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   
—   

2,232 
5,208 
37,200 
46,500 

— 
1,711 
2,232 
2,232 
5,208 
37,200 
46,500 
2,232 
5,208 
37,200 
46,500 
5,208 
37,200 
46,500 

Edwards,
Peter

Egbert,
Carolyn

Gagnon,
Gilles

Turpin,
Dennis

(1) "Value of unexercised in-the-money options” at financial year-end is calculated based on the difference between the closing prices of the Common Shares on the NASDAQ on the last trading day of
the fiscal year (December 31, 2023) of $1.86 and the exercise price of the options, multiplied by the number of unexercised options.

(2) The Company used the closing price of its Common Shares on the NASDAQ as at the last trading day of the fiscal year (December 31, 2023) of $1.86.

See "Summary of the Stock Option Plan” for more details on the Company’s second amended and restated stock option plan adopted by the Board on March 29, 2016 and ratified

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
   
   
   
 
 
 
   
   
   
 
   
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
    
 
    
 
    
 
  
 
 
 
by the shareholders on May 10, 2016 ("Stock Option Plan”) and see "Summary of Long-Term Incentive Plan” for more details on the Company’s long-term incentive plan adopted
by the Board on March 27, 2018, and ratified by the shareholders on May 8, 2018 ("Long-Term Incentive Plan”).

Total Compensation of Outside Directors

The table below summarizes the total compensation paid to our Outside Directors during the financial year ended December 31, 2023 (all amounts are in U.S. dollars). Our Outside
Directors are generally paid in their home currency. Mr. Gagnon and Mr. Turpin were paid in Canadian dollars. Ms. Egbert and Mr. Edwards were paid in U.S. dollars.

Name
Edwards, Peter
Egbert, Carolyn
Gagnon, Gilles
Turpin, Dennis

Fees
earned(1)
($)

140,500   
173,000   
62,500   
158,000   

Share-
based
Awards(2)
($)

Option-
based
Awards
($)

Non-Equity
Incentive Plan
Compensation
($)

Pension
Value
($)

All Other
Compensation
($)

Total
($)

   —   
—   
—   
—   

   —   
—   
—   
—   

—   
—   
—   
—   

  —   
—   
—   
—   

211,500 
244,000 
133,500 
229,000 

71,000   
71,000   
71,000   
71,000   

76

(1)

In respect of our financial year ended December 31, 2023, we paid an aggregate amount of $534,000 in fees to all of our Outside Directors for services rendered in their capacity as directors,
excluding reimbursement of out-of-pocket expenses and the value of share-based and option-based awards granted in 2023.

(2) Amounts shown represent the value of the DSUs on the grant date ($2.84). The value of one DSU on the grant date is the closing price of one Common Share on the NASDAQ on the last

trading day preceding the date of grant.

Compensation of Executive Officers

The following is disclosure of information related to the compensation that we paid to our "Named Executive Officers” during 2023. For the 2023 year, our "Named Executive
Officers” were as follows:

● Dr. Klaus Paulini, who, since October 4, 2019, is serving as President and Chief Executive Officer, as well as Managing Director AEZS Germany since July 2019;
● Mr. Giuliano La Fratta, who, since January 24, 2022, is serving as Senior Vice President, Chief Financial Officer; and
● Dr. Matthias Gerlach, who serves as Senior Vice President Manufacturing & Managing Director, Aeterna Zentaris GmbH ; Mr. Eckhard Guenther, who serves as Vice
President Business Development & Alliance Management and Managing Director AEZS Germany; Ms. Nicola Ammer, who serves  as Chief Medical Officer and Senior
Vice President Clinical Development; and Mr. Michael Teifel who serves as Senior Vice President, Non-Clinical Development and Chief Scientific Officer, who were our
hour most highly compensated executive officers.

Compensation Discussion & Analysis

Compensation Philosophy and Objectives

Our Board, through the NGCC, establishes our executive compensation program that is market-based and at a competitive percentile grouping for both total cash and total direct
compensation.  The  NGCC  has  established  a  compensation  program  that  is  designed  to  attract,  motivate  and  retain  high-performing  senior  executives,  encourage  and  reward
superior performance and align the executives’ interests with those of our shareholders by:

● providing the opportunity for an executive to earn compensation that is competitive with the compensation received by executives serving in the same or measurably

similar positions within comparable companies;

● providing the opportunity for executives to participate in equity-based incentive compensation plans;
● aligning executive compensation with our corporate objectives; and
● attracting and retaining highly qualified individuals in key positions.

Compensation Elements

Our executive compensation is targeted at the 50th percentile for small cap biopharmaceutical companies within both the local and national markets and is comprised of both fixed
and variable components. The variable components include equity and non-equity incentive plans. Each compensation component is intended to serve a different function, but all
elements are intended to work in concert to maximize both corporate and individual performance by establishing specific, competitive operational and corporate goals and by
providing financial incentives to employees based on their level of attainment of these goals.

Our current executive compensation program is comprised of the following four basic components: (i) base salary; (ii) an annual bonus linked to both individual and corporate
performance; (iii) equity incentives, including stock options, previously granted under our second amended and restated stock option plan adopted by the Board on March 29,
2016 and ratified by the shareholders of Aeterna Zentaris on May 10, 2016 (the " Stock Option Plan”), and presently granted under the Corporation’s long-term incentive plan
adopted by the Board on March 27, 2018 and ratified by the shareholders of Aeterna Zentaris on May 8, 2018 (the " Long-Term Incentive Plan”), established for the benefit of our
directors, certain executive officers and other participants as may be designated from time to time by either the Board or the NGCC; and (iv) other elements of compensation,
consisting of benefits, perquisites and retirement benefits.

77

Base Salary. Base salaries are intended to provide a steady income to our executive officers regardless of share price. In determining individual base salaries, the NGCC takes into
consideration individual circumstances that may include the scope of an executive’s position, the executive’s relevant competencies or experience and retention risk. The NGCC
also takes into consideration the fulfillment of our corporate objectives, as well as the individual performance of the executive.

Short-Term,  Non-Equity  Incentive  Compensation. Our short-term, non-equity incentive compensation plan sets a target cash bonus for each executive officer, expressed as a
percentage of the executive officer’s base salary. The amount of cash bonus paid to an executive officer depends on the extent to which he or she contributed to the achievement
of the annual performance objectives established by the Board for the year. The annual performance objectives are specific operational, clinical, regulatory, financial, commercial
and  corporate  goals  that  are  intended  to  advance  our  product  pipeline,  to  promote  the  success  of  our  commercial  efforts  and  to  enhance  our  financial  position.  The  annual
performance objectives are set at the end of each financial year as part of the annual review of corporate strategies. The performance objectives are not established for individual
executive officers but rather by functional area(s), many of which are carried out by or fall within the responsibility of our President and Chief Executive Officer, Chief Financial
Officer (or principal financial officer) and our other executive officers, including our Named Executive Officers. The award of a cash bonus requires the approval of both the NGCC
and  the  Board  and  is  based  upon  an  assessment  of  each  individual’s  performance,  as  well  as  our  overall  performance  at  a  corporate  level.  The  determination  of  individual
performance does not involve quantitative measures using a mathematical calculation in which each individual performance objective is given a numerical weight. Instead, the
NGCC’s determination of individual performance is a subjective determination as to whether a particular executive officer substantially achieved the stated objectives or over-
performed or under-performed with respect to corporate objectives that were deemed to be important to our success.

 
 
 
 
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Long-Term Equity Compensation Plan of Executive Officers.  The long-term component of the compensation of our executive officers is based exclusively on the  Long-Term
Incentive Plan, which permits the issuance of a number of equity-based awards based on the contribution of the officers and their responsibilities. The Board adopted a policy
regarding stock option grants in December 2014, which provides that each Named Executive Officer is eligible to receive options to acquire our Common Shares having a value,
based on the Black-Scholes option pricing model, equal to a specified multiple of his or her salary. The specified multiple for the President and Chief Executive Officer is 1.5. The
specified multiple for each other Named Executive Officer is 0.75. To encourage retention and focus management on developing and successfully implementing our continuing
growth strategy, stock options vest over a period of three years, with the first third vesting on the first anniversary of the date of grant. Since the adoption of the Long-Term
Incentive Plan in 2018, we have broadened the types of equity-based awards which we may issue beyond stock options (to include, among other types, restricted stock units
("RSUs”), DSUs and others).

Other Forms of Compensation. Our executive employee benefits program also includes life, medical, dental and disability insurance to the same extent and in the same manner as all
other employees as either enrollment in the payroll system benefits program or by additional percentage compensation to self-enroll in private insurance policies. These benefits
and perquisites are designed to be competitive overall with equivalent positions in comparable North American organizations in the life sciences industry. We also contribute to
our North American employees’ retirement plans up to an annual maximum amount of $19,500 for employees in the United States and Canada. The contribution amounts for our
United States and Canadian employees are subject to limitations imposed by the United States Internal Revenue Service and the Canadian Revenue Agency respectively, on
contributions to our most highly compensated employees. Employees based in Frankfurt; Germany also benefit from certain employer contributions into the employees’ pension
funds. Our executive officers, including the Named Executive Officers, are eligible to participate in such employer-contribution plans to the same extent and in the same manner as
all other employees.

Positioning

The NGCC is authorized to engage its own independent consultant to advise it with respect to executive compensation matters. While the NGCC may rely on external information
and advice, all of the decisions with respect to executive compensation are made by the Board upon the recommendation of the NGCC and may reflect factors and considerations
other than, or that may differ from, the information and recommendations provided by any external compensation consultants that may be retained from time to time.

78

In 2022, the NGCC retained a compensation consultant to benchmark our director compensation plan in an effort to determine whether we were achieving our objective of providing
market competitive compensation opportunities. The compensation consultant gathered compensation data from companies that it concluded were of comparable size and/or stage
of development as us and from other companies with which we compete. Based, in part, on the recommendations of the compensation consultant, the NGCC recommended, and the
Board approved, certain changes to the board member retainer and committee chair compensation.

Risk Assessment of Executive Compensation Program

The Board, through the NGCC, oversees the implementation of compensation methods that tie a portion of executive compensation to our short-term and long-term performance
and that of each executive officer and that take into account the advantages and risks associated with such compensation methods. In addition, the Board oversees the creation of
compensation policies that are intended to reward the creation of shareholder value while reflecting a balance between our short-term and long-term performance and that of each
executive officer. The NGCC has considered in general terms the concept of risk as it relates to our executive compensation program.

Base salaries are fixed in amount to provide a steady income to the executive officers regardless of share price and thus do not encourage or reward risk-taking to the detriment of
other important business, operational, commercial or clinical metrics or milestones. The variable compensation elements (annual bonuses and equity-based awards) are designed to
reward  each  of  short-term,  mid-term  and  long-term  performance.  For  short-term  performance,  a  discretionary  annual  bonus  may  be  awarded  based  on  the  timing  and  level  of
attainment of specific operational and corporate goals that the NGCC believes to be challenging yet does not encourage unnecessary or excessive risk-taking. While our bonus
payments are generally based on annual performance, a maximum bonus payment is pre-fixed for each senior executive officer and represents only a portion of each individual’s
overall total compensation opportunities. In exceptional circumstances, a particular executive officer may be awarded a bonus that exceeds his or her maximum pre-fixed or target
bonus amount. Finally, a significant portion of executive compensation is provided in the form of equity-based awards, which is intended to further align the interests of executives
with those of shareholders. The NGCC believes that these awards do not encourage unnecessary or excessive risk-taking since the ultimate value of the awards is tied to our share
price, and in the case of grants under the long-term incentive compensation plan, are generally subject to mid-term and long-term vesting schedules to help ensure that executives
generally have significant value tied to long-term share price performance.

The  NGCC believes that the variable compensation elements (annual bonuses and equity-based awards) represent a percentage of  overall  compensation  that  is  sufficient  to
motivate our executive officers to produce superior short-term, mid-term and long-term corporate results, while the fixed compensation element (base salary) is also sufficient to
discourage executive officers from taking unnecessary or excessive risks. The NGCC and the Board also generally have the discretion to adjust annual bonuses and equity-based
awards  based  on  individual  performance  and  any  other  factors  they  may  determine  to  be  appropriate  in  the  circumstances.  Such  factors  may  include,  where  necessary  or
appropriate, the level of risk-taking a particular executive officer may have engaged in during the preceding year.

Based on the foregoing, the NGCC has not identified any specific risks associated with our executive compensation program that are reasonably likely to have a material adverse
effect on us. The NGCC believes that our executive compensation program does not encourage or reward any unnecessary or excessive risk-taking behavior.

Our directors, executive officers and employees are prohibited from purchasing, selling or otherwise trading in derivative securities relating to our Common Shares. Derivative
securities are securities whose value varies in relation to the price of our securities. Examples of derivative securities include warrants to purchase our Common Shares, and put or
call options written on our Common Shares, as well as individually arranged derivative transactions, such as financial instruments, including, for greater certainty, prepaid variable
forward contracts, equity swaps, collars, or units of exchange funds, which are designed to hedge or offset a decrease in market value of our equity securities granted as executive
compensation or directors’ remuneration. Options to acquire our Common Shares and other equity-based awards issued pursuant to the Stock Option Plan or Long-Term Incentive
Plan are not derivative securities for this purpose.

79

2023 Compensation

Base Salary. The primary element of our compensation program is base salary. Our view is that a competitive base salary is a necessary element for retaining qualified executive
officers. In determining individual base salaries, the NGCC takes into consideration individual circumstances that may include the scope of an executive’s position, the executive’s
relevant competencies or experience and retention risk. The NGCC also takes into consideration the fulfillment of our corporate objectives, as well as the individual performance of
the executive.

Short-Term, Non-Equity Incentive Compensation. The Board, based on the NGCC’s recommendation, adopted the following performance objectives for 2023:

Objective
Drive financial  performance  with  a  high  degree  of  disclosure  quality  and  receiving  clean
audited reports and reducing our close to 5-6 days instead of 10-14 days.

  Result
  Objective met: We received a clean audit opinion for the 2022 year end, reduced
our monthly close to 6 days and greatly improved the quality of our internal and
external  financial  reporting.  This  was  accomplished  by  implementing  additional

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Streamlining back-office  process  related  to  month  end  close;  further  improving  interaction
with operations to ensure accuracy by rolling out an R&D accrual process tool in  Q1 and
implementation a new reporting tools in Q1.

Identify at least $1M in additional savings or gains vs. budget by end of Q2.

processes, leveraging existing technology, utilizing new applications, and greater
collaboration across the finance team.

  Objective met:  We  have  streamlined  monthly  calls  with  operations  to  review
progress of projects and ensure accurate R&D accruals. We also completed our
initial  implementation  of  the  new  Insight  reporting  tool  in  Q1.  Through  Q2  the
team continues to refine the reporting tool and expect it to be fully operational at
the end of Q2.

  Objective met: As of April 30th, we are $2.6M in favorable cash savings versus

budget, and projections indicate that we will exceed this goal by June.

Transition from  Novo:  Ensure  in  Q2  the  $9.4M  are  received  together  with  all  other
deliverables (Product; API, equipment, documentation) at minimal cost.
Continue to prioritize operational strategies within our pipeline to ensure high quality of work
and success of hitting milestones:
1. Completion of the DETECT trial (l.p.l.v.) by end of 2023.
2. Securing NMOSD efficacy data from patient blood in Q1
3. Defining NMOSD development candidate in Q4
Ensure Go/No-Go decision for ALS project by end of Q1.
Enable evaluation of success probability of ALS vs. DC-PTH project before ASM meeting

  Objective met: All expected payments ($9.4M) received from Novo; API received

at no cost; NDA and documents transferred.

1. Objective not met: Completed in Q1, 2024.
2. Objective met: AIM efficacy data received (T cell effects in blood).
3. Objective on track: to define development candidates for AIMs.
  Objective met: Positive ALS data warrants continuation, a go decision.
  Objective met: ALS  and  DC-PTH  seem  feasible  and  we  are  looking  to  identify

Ensure timely  product  supplies  with  adequate  quality  oversight  to  prevent  any  re-calls
throughout 2023.
Meet or beat the YTD performance of the XBI index on Dec. 1st, 2023.

Revise IR strategy and planning from the restrained approach during H1 2023:
1. Constant review of retail investors chat rooms

2. More public appearances in person and virtually

3. Tailored outreach to our known (main) investors.

partners for both projects.
Objective met.

  Objective not met:  Due  to  delays  in  achieving  certain  business  and  operational

milestones.

1. Objective ongoing – Review of investor feedback from chat rooms is included

as a recurrent item for internal investor relations meetings.

2. Objective  ongoing – The company made appearances at two events, the JTC
Virtual  Investor  Summer  Spotlight  Series  (July  13)  and  the  H.C.Wainwright
25th Annual Global Investment Conference (Sept. 11-13).

3. Objective  ongoing – Regular outreach program to our known investors base

was implemented and is ongoing.

4. Increased outreach to potential institutional investors

4. Objective ongoing – The Company’s M&A process during the year resulted in

tailoring back outreach to selected activities.

MACRILEN partnering in US – Identify a new US and Canadian partner for Macrilen® by the
end of 2023.

  Objective ongoing

80

Long-Term Equity Compensation

For the financial year ended December 31, 2023, the Board approved did not approve any issuance of stock option awards to any of the Named Executives.

Summary of the Stock Option Plan

We established the  Stock  Option  Plan in order to attract and retain directors, officers, employees and suppliers of ongoing services, who will be motivated to work towards
ensuring  our  success.  The  Board  has  full  and  complete  authority  to  interpret  the  Stock  Option  Plan,  to  establish  applicable  rules  and  regulations  and  to  make  all  other
determinations it deems necessary or useful for the administration of the Stock Option Plan, provided that such interpretations, rules, regulations and determinations are consistent
with the rules of all stock exchanges and quotation systems on which our securities are then traded and with all relevant securities legislation.

There were 2,400 options outstanding under the Stock Option Plan representing approximately 0.0% of all issued and outstanding Common Shares as of December 31, 2023. The
proposed number of Common Shares issuable pursuant to the Long-Term Incentive Plan is fixed at 11.4% of the issued and outstanding Common Shares at any given time less the
number of Common Shares issuable pursuant to stock options granted at such time under the Stock Option Plan. See below for a complete description of the Long-Term Incentive
Plan. As of December 31, 2023, there were 237,656 Common Shares unallocated and available for future grants of options under the Stock Option Plan; however, the Corporation
does not intend on issuing any new stock options under the Stock Option Plan, and instead will issue any future stock options under the Long-Term Incentive Plan.

The burn rate for the Stock Option Plan for the most recently completed fiscal year is set out below:

Year End
December 31, 2023
December 31, 2022
December 31, 2021

Stock Option Plan

Options Granted

Weighted Average
Shares Outstanding

Burn Rate(1)

—   
—   
—   

4,855,766   
4,855,766   
4,596,980   

0%
0%
0%

(1) Annual burn rate is expressed as a percentage and is calculated by dividing the number of securities granted under the Stock Option Plan by the weighted average number of securities outstanding for

the applicable fiscal year

Under the Stock Option Plan, (i) the number of securities issuable to insiders, at any time, or issued within any one-year period, under all of our security-based compensation
arrangements, cannot exceed 10% of our issued and outstanding securities and (ii) no single person eligible to receive grants under the Stock Option Plan (each a "Participant”)
may hold options to purchase, from time to time, more than 5% of our issued and outstanding Common Shares. In addition: (i) the aggregate fair value of options granted under all
of our security-based compensation arrangements to any one of our Outside Directors entitled to receive a benefit under the Stock Option Plan, within any one-year period, cannot
exceed $100,000 valued on a Black-Scholes basis and as determined by the NGCC; and (ii) the aggregate number of securities issuable to all of our Outside Directors entitled to
receive  a  benefit  under  the  Stock  Option  Plan,  within  any  one-year  period,  under  all  of  our  security-based  compensation  arrangements,  cannot  exceed  1%  of  its  issued  and
outstanding securities.

Options granted under the Stock Option Plan may be exercised at any time within a maximum period of seven or ten years following the date of their grant (the "Outside Expiry
Date”), depending on the date of grant. The Board or the NGCC, as the case may be, designates, at its discretion, the specific Participants to whom stock options are granted under
the Stock Option Plan and determines the number of Common Shares covered by each of such option grants, the grant date, the exercise price of each option, the Outside Expiry
Date and any other matter relating thereto, in each case in accordance with the applicable rules and regulations of the regulatory authorities. The price at which the Common Shares
may be purchased may not be lower than the greater of the closing prices of the Common Shares on the NASDAQ on the last trading day preceding the date of grant of the option.
Options granted under the Stock Option Plan shall vest in equal tranches over a three-year period (one-third each year, starting on the first anniversary of the grant date) or as
otherwise determined by the Board or the NGCC, as the case may be. Participants may not assign their options (nor any interest therein) other than by will or in accordance with

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
the applicable laws of estates and succession.

81

Unless the Board or the NGCC decides otherwise, Participants cease to be entitled to exercise their options under the Stock Option Plan: (i) immediately, in the event a Participant
who is an officer or employee resigns or voluntarily leaves his or her employment or his or her employment is terminated with cause and, in the case of a Participant who is a non-
employee director of us or one of our subsidiaries, the date on which such Participant ceases to be a member of the relevant Board; (ii) six months following the date on which
employment is terminated as a result of the death of a Participant who is an officer or employee and, in the case of a Participant who is an Outside Director, six months following the
date on which such Participant ceases to be a member of the Board by reason of death; (iii) 90 days following the date on which a Participant’s employment is terminated for a
reason other than those mentioned in (i) or (ii) above including, without limitation, upon the disability, long-term illness, retirement or early retirement of the Participant; and (iv)
where the Participant is a service supplier, 30 days following the date on which such Participant ceases to act as such, for any cause or reason (each, an "Early Expiry Date”).

The Stock Option Plan also provides that, if the expiry date of one or more options (whether an Early Expiry Date or an Outside Expiry Date) occurs during a "blackout period” or
within the seven business days immediately after a blackout period imposed by us, the expiry date will be automatically extended to the date that is seven business days after the
last day of the blackout period. For the purposes of the foregoing, "blackout period” means the period during which trading in our securities is restricted in accordance with our
corporate policies.

If (i) we accept an offer to amalgamate, merge or consolidate with any other entity (other than one of our wholly-owned subsidiaries) or to sell or license all or substantially all of
our assets to any other entity (other than one of our wholly-owned subsidiaries); (ii) we sign a support agreement in customary form pursuant to which the Board agrees to
support a takeover bid and recommends that our shareholders tender their Common Shares to such takeover bid; or (iii) holders of more than 50% of our then outstanding Common
Shares tender all of their Common Shares to a takeover bid made to all of the holders of the Common Shares to purchase all of the then issued and outstanding Common Shares,
then, in each case, all of the outstanding options shall, without any further action required to be taken by us, immediately vest. Each Participant shall thereafter be entitled to
exercise all of such options at any time up to and including, but not after the close of business on that date which is ten days following the Closing Date (as defined below). Upon
the expiration of such ten-day period, all rights of the Participant to such options or to the exercise of same (to the extent not already exercised) shall automatically terminate and
have no further force or effect whatsoever. "Closing Date” is defined to mean (x) the closing date of the amalgamation, merger, consolidation, sale or license transaction in the case
of clause (i) above; (y) the first expiry date of the takeover bid on which each of the offeror’s conditions are either satisfied or waived in the case of clause (ii) above; or (z) the date
on which it is publicly announced that holders of greater than 50% of our then outstanding Common Shares have tendered their Common Shares to a takeover bid in the case of
clause (iii) above.

The Stock Option Plan provides that the following amendments may be made to the plan only upon approval of each of the Board and our shareholders as well as receipt of all
required regulatory approvals:

● any amendment to Section 3.2 of the Stock Option Plan (which sets forth the limit on the number of options that may be granted to insiders) that would have the effect of
permitting, without having to obtain shareholder approval on a "disinterested vote” at a duly convened shareholders’ meeting, the grant of any option(s) under the Stock
Option Plan otherwise prohibited by Section 3.2;

● any amendment  to  the  number  of  securities  issuable  under  the  Stock  Option  Plan  (except  for  certain permitted  adjustments,  such  as  in  the  case  of  stock  splits,

consolidations or reclassifications);

● any amendment that would permit any option granted under the Stock Option Plan to be transferable or assignable other than by will or in accordance with the applicable

laws of estates and succession;

82

● the addition of a cashless exercise feature, payable in cash or securities, which does not provide for a full deduction of the number of underlying securities from the Stock

Option Plan reserve;

● the addition of a deferred or restricted share unit component or any other provision that results in employees receiving securities while no cash consideration is received

by us;

● with respect to any Participant, whether or not such Participant is an "insider” and except in respect of certain permitted adjustments, such as in the case of stock splits,

consolidations or reclassifications:

● any reduction in the exercise price of any option after the option has been granted; or

● any cancellation of an option and the re-grant of that option under different terms;

● any extension to the term of an option beyond its Outside Expiry Date to a Participant who is an "insider” (except for extensions made in the context of a "blackout

period”);

● any amendment to the method of determining the exercise price of an option granted pursuant to the Stock Option Plan;

● the addition of any form of financial assistance or any amendment to a financial assistance provision which is more favorable to employees; and

● any amendment to the foregoing amending provisions requiring Board, shareholder and regulatory approvals.

The  Stock  Option  Plan  further  provides  that  the  following  amendments  may  be  made  to  the  Stock  Option  Plan  upon  approval  of  the  Board  and  upon  receipt  of  all  required
regulatory approvals, but without shareholder approval:

● amendments of a "housekeeping” or clerical nature or to clarify the provisions of the Stock Option Plan;

● amendments regarding any vesting period of an option;

● amendments regarding the extension of an option beyond an Early Expiry Date in respect of any Participant, or the extension of an option beyond the Outside Expiry Date

in respect of any Participant who is a "non-insider”;

● adjustments to the number of issuable Common Shares underlying, or the exercise price of, outstanding options resulting from a split or a consolidation of the Common
Shares, a reclassification, the payment of a stock dividend, the payment of a special cash or non-cash distribution to our shareholders on a pro rata basis provided such
distribution is approved by our shareholders in accordance with applicable law, a recapitalization, a reorganization or any other event which necessitates an equitable
adjustment to the outstanding options in proportion with corresponding adjustments made to all outstanding Common Shares;

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● discontinuing or terminating the Stock Option Plan; and any other amendment which does not require shareholder approval under the terms of the Stock Option Plan.

Summary of the Long-Term Incentive Plan

The purpose of the Long-Term Incentive Plan is to (i) promote our long-term financial interests and growth by attracting and retaining management and other personnel and key
service providers with the training, experience and ability to enable them to make a substantial contribution to the success of our business; (ii) motivate management personnel by
means of growth-related incentives to achieve long-range goals; and (iii) further the alignment of interests of participants with those of our shareholders through opportunities for
increased share ownership in the Corporation.

The NGCC is the administrator of the Long-Term Incentive Plan (the "Administrator”). At any time, the Board may serve as the Administrator of the Long-Term Incentive Plan, in
lieu of, or in addition, to the NGCC. Except as provided otherwise under the Long-Term Incentive Plan, the Administrator has plenary authority to grant awards pursuant to the
terms of the Long-Term Incentive Plan to eligible individuals, determine the types of awards and the number of shares to be covered by the awards, establish the terms and
conditions for awards, including the exercise price and term of awards, and take all other actions necessary or desirable to carry out the purpose and intent of the Long-Term
Incentive Plan.

83

Participation in the  Long-Term  Incentive  Plan is generally open to all officers, employees and other individuals, including  Outside  Directors.  However, any individual whose
services to the Corporation or any of its subsidiaries are limited to capital-raising transactions, or the promotion and maintenance of a market for the Corporation securities, are
ineligible  to  participate  in  the  Long-Term  Incentive  Plan.  Prospective  officers,  employees  and  other  service  providers  who  have  accepted  offers  to  provide  services  to  the
Corporation may also participate in the Long-Term Incentive Plan.

The  Long-Term  Incentive  Plan  enables  the  grant  of  stock  options,  stock  appreciation  rights  ("SARs”),  stock  awards,  stock  unit  awards,  performance  shares,  cash-based
performance units, deferred share units and other stock-based awards, each of which may be granted separately or in tandem with other awards.

The maximum number of Common Shares issuable under the Long-Term Incentive Plan is fixed at 11.4% of the issued and outstanding Common Shares at any given time, less the
number of Common Shares issuable pursuant to stock options granted at such time under the Stock Option Plan. There were 247,920 awards outstanding under the Long-Term
Incentive Plan representing approximately 2.8% of all issued and outstanding Common Shares as of December 31, 2023. As of December 31, 2023, there were 303,250 Common
Shares unallocated and available for future grants of awards that are settled in Common Shares under the Long-Term Incentive Plan. See above for a complete description of the
Stock Option Plan.

The burn rate for the LTIP for the most recently completed fiscal year is set out below:

Year End
December 31, 2023
December 31, 2022
December 31, 2021

LTIP

Awards Granted

Weighted Average
Shares Outstanding

Burn Rate(1)

114,000   
82,000   
34,400   

4,855,876   
4,855,876   
4,596,980   

2.3%
1.7%
0.7%

(1) Annual burn rate is expressed as a percentage and is calculated by dividing the number  of  securities granted under the  LTIP by the weighted average  number  of  securities  outstanding  for  the

applicable fiscal year.

The number of securities issuable to insiders, at any time, or issued within any one-year period, under all of our security-based compensation arrangements, cannot exceed 10% of
our issued and outstanding securities and no single participant may hold options to purchase, from time to time, more than 5% of our issued and outstanding Common Shares.

The aggregate fair value of options granted under all of our security-based compensation arrangements to any one of our Outside Directors entitled to receive a benefit under the
Long-Term Incentive Plan, within any one-year period, cannot exceed $100,000 valued on a Black-Scholes basis and as determined by the NGCC; and the aggregate number of
securities issuable to all of our Outside Directors entitled to receive a benefit under the Long-Term Incentive Plan, within any one-year period, under all of our security-based
compensation arrangements, cannot exceed 1% of its issued and outstanding securities.

Except as provided below or within an award agreement, each award granted under the Long-Term Incentive Plan (other than a performance unit that cannot be paid in shares) will
be subject to a minimum vesting period or minimum restriction period as follows: (i) each stock option or SAR will be subject to a minimum vesting period of 12 months from the
date of grant, (ii) each award of stock, stock units, performance shares, performance units payable in shares and other stock- based awards ("Full Value Awards”) granted to non-
employee directors will be subject to a minimum restriction period of 12 months from the date of grant, and (iii) each Full Value Award granted to a participant other than a non-
employee director will be subject to a minimum restriction period of 12 months from the date of grant if vesting of or lapse of restrictions on such award is based on the satisfaction
of performance goals and a minimum restriction period of 36 months from the date of grant, applied in either pro rata installments or a single installment, if vesting of or lapse of
restrictions on such award is based solely on the participant’s satisfaction of specified service requirements with us (provided that no such Full Value Awards will vest or have its
restrictions lapse during the first 12 months following the date of grant). If the grant of a performance award is conditioned on satisfaction of performance goals, the performance
period must not be less than 12 months’ duration, but no additional minimum restriction period need apply to such award. The minimum vesting period or minimum restriction
period will not apply in the case of death or disability of a participant or in the event of a change in control. Awards that result in the issuance of an aggregate of up to 5% of the
share pool under the Long-Term Incentive Plan may be granted without regard to such minimum vesting period or minimum restriction period.

84

A SAR is the right to receive a payment equal to the excess of the Fair Market Value (as defined below) of a specified number of shares on the date the SAR is exercised over the
base price per share specified in the award agreement. The base price for each SAR cannot be less than 100% of the Fair Market Value of Common Shares on the grant date and the
term of a SAR cannot be more than 10 years from the grant date, unless required otherwise by applicable law. At the discretion of the Administrator, the payment upon a SAR
exercise may be in cash, shares or a combination of the two. The "Fair Market Value” means the official closing price per Common Share for the regular market session on the day
of determination.

Awards granted under the Long-Term Incentive Plan shall not be subject in any manner to alienation, anticipation, sale, transfer, assignment, pledge, or encumbrance, except as
otherwise determined by the Administrator; provided, however, that this restriction shall not apply to the Common Shares received in connection with an award after the date that
the restrictions on transferability of such shares set forth in the applicable award agreement have lapsed.

Except as provided in the applicable award agreement or otherwise determined by the Administrator, and subject to the minimum vesting period or minimum restriction period
described above, upon termination of service (as defined in the Long-Term Incentive Plan):

● Stock options or stock appreciation rights shall be forfeited, to the extent stock options or stock appreciation rights are not vested and exercisable;
● During the applicable restriction period, restricted stock and any accrued but unpaid dividends that are at that time subject to restrictions shall be forfeited; and

 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● During the applicable deferral period or portion thereof to which forfeiture conditions apply, or upon failure to satisfy any other conditions precedent to the delivery of
Common Shares or cash to which RSUs, performance shares or performance units relate, all performance shares, performance units and RSUs and any other accrued but
unpaid dividend equivalents with respect to such RSUs that are then subject to deferral or restriction shall be forfeited.

In the event of a change in control (as defined in the Long-Term Incentive Plan) of the Corporation, outstanding awards will terminate upon the effective time of the change in
control unless provision is made for the continuation, assumption or substitution of awards by the surviving or successor entity or its parent. Unless an award agreement says
otherwise, the following will occur with respect to awards that terminate in connection with a change in control of the Corporation:

● stock options and SARs, whether vested or unvested, will become fully exercisable and holders of these awards will be permitted immediately before the change in control

to exercise them;

● restricted stock and  RSUs with time-based vesting (i.e., not subject to achievement of performance goals) will become fully vested immediately before the change in

control, and RSUs will be settled as promptly as is practicable in accordance with applicable law; and

● restricted stock, RSUs, performance shares, and performance units that vest based on the achievement of performance goals will become fully vested and earned based on
the  target  performance level  as  to  the  performance  goals,  such  that  100%  of  the  target  award  is  earned  as  of  the date  of  the  change  of  control;  and  the  RSUs  and
performance units will be settled as promptly as is practicable in accordance with applicable law. The Long-Term Incentive Plan will terminate on the earlier of (i) the
earliest date as of which all awards granted under the Long-Term Incentive Plan have been satisfied in full or terminated and no shares approved for issuance under the
Long-Term Incentive Plan remain available to be granted under new awards, or (ii) the tenth anniversary of date the Long-Term Incentive Plan, as amended and restated, is
approved by our shareholders.

85

The Administrator may amend, alter or discontinue the Long-Term Incentive Plan, but no amendment, alteration or discontinuation will be made that would materially impair the
rights of a participant with respect to a previously granted award without his or her consent, except such an amendment made to comply with applicable law or rule of any
securities exchange or market on which our Common Shares are listed or admitted for trading or to prevent adverse tax or accounting consequences to the Corporation or the
participant. In no event, however, will an amendment be made without the approval of our shareholders to the extent such amendment would (i) materially increase the benefits
accruing to participants under the Long-Term Incentive Plan, (ii) increase the number of shares that may be issued under the Long-Term Incentive Plan or to a participant, (iii)
materially expand the eligibility for participation in the Long-Term Incentive Plan, (iv) eliminate or modify the prohibition on repricing of stock options and SARs, (v) lengthen the
maximum term or lower the minimum exercise price or base price permitted for stock options and SARs, (vi) modify the prohibition on the issuance of reload or replenishment
options, (vii) amend the amendment provisions in the Long-Term Incentive Plan, or (viii) amend the Long-Term Incentive Plan to remove or exceed the 10% insider participation
limit.

Outstanding Option-Based Awards and Share-Based Awards

The following table shows all awards outstanding to our Named Executive Officers as of December 31, 2023:

Option-based Awards

Share-based Awards

Name
Paulini, Klaus

Giuliano La
Fratta
Gerlach,
Matthias

Guenther,
Eckhard

Ammer, Nicola  

Issuance Date
(mm/dd/yyyy)  
08/15/2019
11/11/2019
12/14/2020
12/17/2021

1/10/2022

12/04/2019
12/14/2020
12/17/2021

12/04/2019
12/14/2020
12/17/2021

12/04/2019
12/14/2020
12/17/2021

Teifel, Michael  

12/17/2021

Number of
Securities
Underlying
Unexercised
Options(1)
(#)

1,000   
1,400   
1,400   
4,000   

2,000   

800   
1,000   
2,000   

1,000   
1,000   
2,000   

1,000   
1,000   
2,000   

2,000   

Option
Exercise
Price
($)

53.75   
25.75   
9.15   
10.51   

Option
Expiration
Date
(mm/dd/yyyy)  
08/15/2026 
11/11/2026 
12/14/2027 
12/17/2028 

8.88   

01/10/2029 

21.75   
9.15   
10.51   

21.75   
9.15   
10.51   

21.75   
9.15   
10.51   

12/04/2026 
12/14/2027 
12/17/2028 

12/04/2026 
12/14/2027 
12/17/2028 

12/04/2026 
12/14/2027 
12/17/2028 

10.51   

12/17/2028 

Value of
Unexercised
In-the-
money
Options(2)
($)

Issuance
Date

Number of
Shares or
Units of
shares
that have
Not Vested
(#)

—   
—   
—   
—   

—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   

—   
—   
—   
—   

—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   

—   
—   
—   
—   

—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   

Market or
Payout
Value of
Share-
based
Awards that
have Not
Vested ($)    
—   
—   
—   
—   

—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   

Market or
payout value
of vested
share-based
awards not
paid out or
distributed
($)

— 
— 
— 
— 

— 

— 
— 
— 

— 
— 
— 

— 
— 
— 

— 

(1) The number of securities underlying unexercised options represents all awards outstanding as at December 31, 2023.
(2) "Value of unexercised in-the-money options” at financial year-end is calculated based on the difference between the closing price of the Common Shares on the NASDAQ on the last trading

day of the fiscal year (December 31, 2023) of $1.86 and the exercise price of the options, multiplied by the number of unexercised options.

86

For the financial year ended December 31, 2023, the Board approved did not approve any issuance of stock option awards to any of the Named Executives.

Incentive Plan Awards - Value Vested or Earned During the Year

The following table shows the incentive plan awards value vested or earned for each Named Executive Officer for the financial year ended December 31, 2023:

Option-based awards —

Share-based awards —
Value

Non-equity incentive plan

 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
  
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
  
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
  
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
  
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Paulini, Klaus
La Fratta, Giuliano
Gerlach, Matthias
Guenther, Eckhard
Ammer, Nicola
Teifel, Michael

Value vested during
the year(1)
$

vested during
the year
$

compensation — Value
earned during the year(2)  
$

—   
—   
—   
—   
—   
—   

—   
—   
—   
—   
—   
—   

46,543 
37,045 
24,895 
19,483 
23,813 
23,813 

(1) Represents the aggregate dollar value that would have been realized if the options had been exercised on the vesting date, based on the difference between the closing price of the Common
Shares on the NASDAQ and the exercise price on such vesting date. If closing price of the Common Shares on the NASDAQ on the vesting date was lower than the exercise price, then $nil was
considered realized.

(2) During 2023, each of Dr. Paulini, Dr. Gerlach, Dr. Guenther and Dr. Ammer were paid bonuses granted  in 2023 for activities related to 2022 and will be paid in 2024 bonuses granted in 2024

for activities related to 2023.

Summary Compensation Table

The Summary Compensation Table set forth below shows compensation information for each of the Named Executive Officers for services rendered in all capacities during each of
the financial years ended December 31, 2023, 2022 and 2021. All amounts in the table below are in U.S. dollars. Ms. Auld’s and Mr. La Fratta’s cash payments were made in
Canadian dollars. All cash amounts paid to Dr. Paulini, Dr. Guenther, Dr. Gerlach, Dr Teifel and Dr. Ammer were made in Euros.

87

SUMMARY COMPENSATION TABLE

Non-equity incentive
plan compensation(1)    

Name and principal position

  Years    

Share
based
awards
($)

Option
based
awards
($)

Annual
incentive
plan
($)

Salary
($)

Long-
term
incentive
plans
($)

Pension
Value
($)(2)

Contributions
to Registered
Retirement
Saving Plan /
401K account
($)

Total
compensation
($)

Paulini, Klaus(3) 
President and Chief Executive
Officer; Managing
Director AEZS Germany
Giuliano La Fratta 
Senior  Vice  President,  Chief  Financial
Officer

Guenther, Eckhard 
Senior Vice President Business
Development and Alliance
Management; Managing
Director AEZS Germany
Gerlach, Matthias 
Senior Vice
President Manufacturing
and Supply Chain
Ammer, Nicola 
Chief Medical Officer and
Senior Vice President
Clinical Development
Teifel, Michael 
Chief Science Officer and 
Senior Vice President

2023   
2022   
2021   

  324,097   
  319,614   
  374,496   

—   
—   
—   

—   
—   
  35,298   

46,543   
45,561   
  162,530   

—   
—   
—   

  593,905   
  218,798   
  213,700   

2023   
2022   
2021   

  206,805   
  208,262   
—   

2023   
2022   
2021   

2023   
2022   
2021   

2023   
2022   
2021   

  232,716   
  223,359   
  238,737   

  188,532   
  200,316   
  203,276   

  173,993   
  173,724   
  182,787   

2023   
2022   
2021   

  188,757   
  153,558   
  157,510   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

  14,944   
—   

—   
—   
  17,649   

—   
—   
  17,649   

—   
—   
  17,649   

—   
—   
—   

37,045   
31,192   
—   

19,483   
19,072   
67,021   

24,895   
24,370   
55,319   

28,813   
23,310   
53,191   

23,813   
23,310   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

85,366   
  (146,455)  
5,019   

49,683   
  (247,820)  
16,314   

9,746   
(29,047)  
2,400   

—   
—   
—   

35,672   
  (139,729)  
1,007   

—   
—   
—   

10,340   
12,921   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

—   
—   
—   

964,545 
583,972 
786,024 

254,190 
267,319 
— 

337,565 
95,976 
328,426 

263,110 
(23,135)
292,558 

207,552 
167,987 
256,027 

248,242 
37,138 
158,517 

(1) Non-equity incentive plan compensation includes cash bonuses. During 2023, each of Dr. Paulini, Dr. Gerlach, Dr. Guenther and Dr. Ammer were paid for bonuses granted in 2022 for activities
related to 2022 and will be paid in 2024 bonuses granted in 2023 for activities related to 2023.

(2) Dr. Paulini and Dr. Guenther participate in the DUPK (as defined below), a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. that was introduced for employees who
began their employment with AEZS Germany (or its predecessors) prior to December 31, 1999. The DUPK includes indirect obligations through a funded multi-employer contribution plan as well as
direct unfunded defined benefit plans obligations. Dr. Gerlach participates in RUK 1 (as defined below), a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Dr. Ammer
participates in RUK 2 (as defined below), a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. The pension value represents the change in the pension liability between
December 31, 2022 and 2023 for each Named Executive Officer. In 2023 there was a decrease in the discount rate actuarial assumption from 3.75% in 2022 to 3.30% in 2023, that is used to estimate
the Pension Benefit Plan obligation. For several of the named Executive Officers, this has resulted in an increase in the their Pension Value and is reflected in the above table.

(3) Dr. Paulini did not receive any compensation in his role as a managing director of GmbH or as an executive director.

88

The value of option-based awards set out in the table above represents the closing price of the Common Shares on the NASDAQ on the last trading day preceding the date of
grant multiplied by the Black-Scholes factor as at such date and the number of stock options granted on such date. For 2023, the Black-Scholes valuation model values the options
based on the following assumptions: a 5.45-year expected life, 104.46% expected volatility, risk-free annual interest rate of 3.56% per annum and an expected dividend yield of 0%.
See the consolidated financial statements for the Corporation for the years ended December 31, 2022, 2021 and 2020 and for the years ended December 31, 2021, 2020 and 2019 for
the assumptions applied to the Black-Scholes option pricing model in previous years. The Corporation used the Black-Scholes valuation model as it most accurately captured the
fair value of such options. The following table sets forth the value of the option-based awards and the corresponding Black-Scholes factor:

 
 
   
   
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
   
 
   
 
   
 
   
 
   
 
 
   
   
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
August 15, 2017
August 15, 2019
November 11, 2019
December 4, 2019
December 14, 2020
December 17, 2021
January 10, 2022
January 17, 2023

Compensation of the Chief Executive Officer

Date of Grant

Value of Grant

Black-Scholes Factor

$
$
$
$
$
$
$
$

51.25   
53.75   
26.25   
21.75   
9.15   
10.50   
8.88   
3.75   

79%
79%
67%
68%
74%
84%
84%
80%

The compensation of our President and Chief Executive Officer is governed by our executive compensation policy described in the section titled "Compensation of Executive
Officers”, and the President and Chief Executive Officer participates, together with the other Named Executive Officers, in all our incentive plans.

Dr. Paulini’s total earnings during the financial year ended December 31, 2023 was $964,545, including an incentive bonus in the amount of $46,543.

For the financial year ended December 31, 2023, the Board did not approve an award of stock options to Dr. Paulini in accordance with the Long-Term Incentive Plan.

See "Long-Term Equity Compensation Plan of Executive Officers - Summary of the Stock Option Plan”, for a complete description of the Stock Option Plan. See "Long-Term Equity
Compensation Plan of Executive Officers - Summary of the Long-Term Incentive Plan”, for a complete description of the Long-Term Incentive Plan.

Pension, retirement or similar benefits

Each of our Named Executive Officers who are employed with AEZS Germany participate in defined-contribution pension plans. The terms of these pension plans are described
below.

Degussa Pensionskasse ("DUPK”)

Dr. Paulini and Dr. Guenther participate in the DUPK, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. that was introduced for employees
who began their employment with AEZS Germany (or its predecessors) prior to December 31, 1999. The DUPK includes indirect obligations through a funded multi-employer
contribution plan as well as direct unfunded defined benefit plans obligations.

Under the funded multi-employer contribution portion of the DUPK, the contributions by AEZS Germany and the employee are calculated based on the employee’s total salary
during the prior year. The employee contributes 2% of his or her monthly average salary and AEZS Germany contributes an amount of 1.784 times the employee’s contribution.
The contributions are limited to the social security contribution  assessment  ceiling.  In  2023,  the  social  security  contribution  assessment  ceiling  is  $7,906  (€7,300)  per  month.
Accordingly, the employee will contribute at most $158.12 (€146.00) monthly and AEZS Germany will contribute at most $282.08 (€260.46) monthly.

89

Under the unfunded defined benefit portion of the DUPK, the employee earns additional claims for future pension payments for the part of the employee’s salary that exceeds the
social security contribution assessment ceiling ("Supplementary Pensions”) that are unfunded and are presented as a pensions benefit obligation on the balance sheet of the
Company. The Supplementary Pensions amount to 1.25% annually of a fictional salary peak, which is a percentage of the social security contribution assessment ceiling. Further,
the employee is entitled to annual Christmas benefits ("Christmas Benefits”), which amount to 1.4% of the last pensionable monthly income for each year of service, limited by the
social security contribution assessment ceiling. The employee’s contribution and AEZS Germany’s contribution are transferred monthly to the pension fund, and AEZS Germany’s
contribution is calculated with the salary payments and treated as provision for pension payment. We are liable to the employees for the pension benefits that have been promised
if the private pension provider does not, or cannot, pay the promised pension payments. Employees will receive a pension payment based on the contributions that were made
during their employment, and will also receive the Supplementary Pensions and Christmas Benefits, after they have reached the statutory retirement age, independent of whether
they work with AEZS Germany until such age. All direct pension obligations as well as pension obligations from deferred compensation are included and have been included in the
pensions benefit obligation of the Company.

Rückgedeckte Unterstützungskasse 1 ("RUK 1”)

Dr. Gerlach participates in RUK 1, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Under RUK 1, AEZS Germany contributes 2.4% of Dr.
Gerlach’s monthly gross salary and Dr. Gerlach contributes 2% of his monthly gross salary. The contributions are limited to the social security contribution assessment ceiling.
However, AEZS Germany provides an additional contribution of 18% of his monthly pensionable salary for the part of his salary that exceeds the social security contribution
assessment  ceiling.  In  2023,  the  social  security  contribution  assessment  ceiling  is  $7,905  (€7,300)  per  month. Accordingly, AEZS  Germany  will  contribute  at  most  $1,596.23
(€1,473.90) (which includes the additional contribution of 18%) monthly and Dr. Gerlach will contribute at most $158.12 (€146.00) monthly. Both contributions are calculated with the
monthly salary accounting and transferred to the relief fund monthly. We are liable to Dr. Gerlach for the pension benefits that have been promised if the private pension provider
does not, or cannot, pay the promised pension payments. Dr. Gerlach will receive a pension payment based on the contributions that were made during his employment after he
has reached the statutory retirement age, independent of whether he works with AEZS Germany until such age.

Dr. Ammer participates in RUK 1, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Under RUK 1, AEZS Germany contributes 2.4% of Dr.
Ammer’s monthly gross salary and Dr. Ammer contributes 3% of her monthly gross salary. The contributions are limited to the social security contribution assessment ceiling. In
2023, the social security contribution assessment ceiling is $7,905 (€7,300) per month. Accordingly, AEZS Germany will contribute at most $189.74 (€175.20) monthly and Dr. Ammer
will contribute at most $237.18 (€219.00) monthly. Both contributions are calculated with the monthly salary accounting and transferred to the relief fund monthly. We are liable to
Dr. Ammer for the pension benefits that have been promised if the private pension provider does not, or cannot, pay the promised pension payments. Dr. Ammer will receive a
pension payment based on the contributions that were made during her employment after she has reached the statutory retirement age, independent of whether she works with
AEZS Germany until such age.

Rückgedeckte Unterstützungskasse 2 ("RUK 2”)

Dr. Teifel participates in RUK 2, a defined-contribution pension plan maintained by Unterstützungskasse Degussa e.V. Under RUK 2, AEZS Germany contributes 2.4% of Dr.
Teifel’s monthly gross salary and Dr. Teifel contributes 3% of his monthly gross salary. The contributions are limited to the social security contribution assessment ceiling. In
2023, the social security contribution assessment ceiling is $7,905 (€7,300) per month. Accordingly, AEZS Germany will contribute at most $189.74 (€175.20) monthly and Dr. Teifel
will contribute at most $237.18 (€219.00) monthly. Both contributions are calculated with the monthly salary accounting and transferred to the relief fund monthly. We are liable to
Dr. Teifel for the pension benefits that have been promised if the private pension provider does not, or cannot, pay the promised pension payments. Dr. Teifel will receive a
pension payment based on the contributions that were made during her employment after he has reached the statutory retirement age, independent of whether he works with AEZS
Germany until such age.

● The table below includes the following information about each Named Executive Officer participating in the pension, retirement or similar plans of the Company:, years of

 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
credited service as at December 31, 2023;

● estimated annual benefit accrued, or earned, for service to December 31, 2023 and to the normal retirement age of 65; and
● a reconciliation of the accrued obligation from December 31, 2023 to December 31, 2022.

90

Number
of years    
credited
service
(#)(1)

26   
33   
23   
19   
9   

Annual benefits 
payable ($)(2)

At year
end
74,388   
37,901   
12,797   
14,570   
2,447   

    At age 65    
88,986   
37,901   
20,651   
15,518   
4,744   

Name

Paulini, Klaus
Guenther, Eckhard
Gerlach, Matthias
Teifel, Michael
Ammer, Nicola

Opening
present
value of
defined     Compensatory   
benefit
obligation
($)(3)
  1,353,345   
946,298   
168,102   
210,532   
29,089   

526,625   
38,322   
41,326   
25,205   
8,299   

change
($)(4)

Closing
present
value of
defined  
benefit
obligation
($)(3)
  1,947,250 
  1,031,663 
217,785 
246,204 
38,835 

Non-
compensatory
change
($)(5)

67,280   
47,044   
8,357   
10,466   
1,446   

(1) The number of years of credited service as at December 31, 2023 corresponds to the actual years of service with AEZS Germany.

(2) For each Named Executive Officer, the amount of annual benefits payable at December 31, 2023 is the pension the Named Executive Officer would be entitled to starting at age 65 based on
termination of employment at December 31, 2023. For each Named Executive Officer, the annual benefits payable at age 65 is the annual benefits payable at December 31, 2023 increased to reflect
estimated credited service at age 65.

(3) The present value is the estimated value of the pension obligation to the date indicated using the actuarial assumptions and methods that are consistent with those used in determining pension
liabilities as disclosed in the Company’s consolidated financial statements. In the past, certain Pension Benefit Plans were accounted for as defined contribution plans as sufficient information was not
available for the Company to account for its proportionate share of the defined benefit obligation, plan assets and cost associated with such Pension Benefit Plans. In 2021, additional information
became available to the Company, which began to account for its proportionate share of the defined benefit obligation and plan assets. The opening present value of defined benefit obligation for each
named Executive Officer was adjusted to reflect the revised accounting treatment.

(4) Compensatory change represents the change in the pension liability between December 31, 2022, and 2023 for each Named Executive Officer.

(5) The calculations of reported amounts use the same actuarial assumptions and methods that are used for calculating accrued benefit obligations and annual expenses, as disclosed in the Company’s
2023 and 2022 consolidated financial statements in Note 15, and as prescribed by IFRS. The methods and assumptions used to determine estimated amounts will not be identical to the methods and
assumptions used by other issuers so, as a result, the figures may not be directly comparable across issuers. All amounts shown above are based on assumptions and represent contractual entitlements that
may change over time.

C.

Board practices

Our Articles provide that our Board shall be composed of a minimum of five (5) and a maximum of fifteen (15) directors. Directors are elected annually by our shareholders, but the
directors may from time to time appoint one or more directors, provided that the total number of directors so appointed does not exceed one-third of the number of directors elected
at the last annual meeting of shareholders. Each elected director will remain in office until termination of the next annual meeting of the shareholders or until his or her successor is
duly elected or appointed, unless his or her post is vacated earlier. We do not have service agreements with our independent directors.

See Item 6A. for information about the period of service of each of our directors and senior corporate officers.

Standing Committees of the Board of Directors

Our Board has established an Audit Committee and a NGCC.

91

Audit Committee

The Audit Committee assists the Board in fulfilling its oversight responsibilities. The Audit Committee reviews the financial reporting process, the system of internal control, the
audit process, and our process for monitoring compliance with laws and regulations and with our Code of Ethical Conduct. In performing its duties, the Audit Committee will
maintain effective working relationships with the  Board, management, and the external auditors.  To effectively perform his or her role, each committee member will obtain an
understanding of the detailed responsibilities of committee membership as well as our business, operations and risks.

The function of the Audit Committee is oversight and while it has the responsibilities and powers set forth in its charter (incorporated by reference to Exhibit 11.3 to this Annual
Report on Form 20-F), it is neither the duty of the committee to plan or to conduct audits or to determine that our financial statements are complete, accurate and in accordance with
generally accepted accounting principles, nor to maintain internal controls and procedures.

The current members of the Audit Committee are Dennis Turpin (Chair), Peter G. Edwards, and Gilles Gagnon. In accordance with Nasdaq rules applicable to foreign private issuers,
all members of the Audit Committee satisfy the independence standards under Rule 10A-3 of the Securities Exchange Act of 1934, as amended. Our Board has determined that Mr.
Turpin is the financial expert (as defined in paragraph (b) of Item 16A to Form 20-F).

NGCC

The compensation of executive officers of the Corporation and its subsidiaries is recommended to the Board by the NGCC. The NGCC is responsible for, among other matters, (i)
assisting the Board in developing our approach to corporate governance issues, (ii) proposing new Board nominees, (iii) overseeing the assessment of the effectiveness of the
Board and its committees, their respective chairs and individual directors and (iv) making recommendations to the Board with respect to board member nominees and directors’
compensation, as well as serving in a leadership role for our corporate governance practices. It is also responsible for taking all reasonable actions to ensure that appropriate
human resources policies, procedures and systems, e.g., recruitment and retention policies, competency and performance metrics and measurements, training and development
programs, and market-based, competitive compensation and benefits structures, are in place so that we can attract, motivate and retain the quality of personnel required to achieve
our business objectives. The NGCC also assists the Board in discharging its responsibilities relating to the recruitment, retention, development, assessment, compensation and
succession planning for our executive and senior management members.

Thus, the  NGCC recommends the appointment of senior officers, including the terms and conditions of their appointment and termination, and reviews the evaluation of the
performance of our senior officers, including recommending their compensation and overseeing risk identification and management in relation to executive compensation policies
and practices. The Board, which includes the members of the NGCC, reviews the Chief Executive Officer’s corporate strategy, goals and performance objectives and evaluates and

 
 
 
 
 
   
   
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
measures his or her performance and compensation against the achievement of such goals and objectives.

The  NGCC  recognizes  that  the  industry,  regulatory  and  competitive  environment  in  which  we  operate  requires  a  balanced  level  of  risk-taking  to  promote  and  achieve  the
performance expectations of executives of a specialty biopharmaceutical company. The NGCC is of the view that our executive compensation program should not encourage senior
executives to take inappropriate or unreasonable risk. In this regard, the NGCC recommends the implementation of compensation methods that appropriately connect a portion of
senior executive compensation with our short-term and longer-term performance, as well as that of each individual executive officer and that take into account the advantages and
risks associated with such compensation methods. The NGCC is also responsible for establishing compensation policies that are intended to reward the creation of shareholder
value while reflecting a balance between our short-term and longer-term performance and that of each executive officer.

The NGCC is currently composed of Ms. Carolyn Egbert (Chair), Mr. Peter G. Edwards and Mr. Gilles Gagnon, each of whom is independent. The Board believes that the members
of the NGCC collectively have the knowledge, experience and background required to fulfill its mandate.

92

D.

Employees

As at December 31, 2023, we had a total of 21 active employees, of which 17 are based in Frankfurt, Germany. In addition, there was one employee based in the U.S. and 3 other
active employees each based in Quebec, New Brunswick and Ontario, Canada.

Our current employees are engaged in the following activities: (i) six are engaged in research and development, regulatory affairs and quality assurance; (ii) six are involved in
commercial operations and business development; and (iii) nine are involved in various administrative functions, including finance and accounting. We do not employ any sales
representatives. As at December 31, 2022, we had a total of 21 active employees, of which 17 were based in Frankfurt, Germany. In addition, there was one employee based in the
U.S. and 3 other active employees each based in Quebec, New Brunswick and Ontario, Canada.

We have agreements with our employees covering confidentiality, loyalty, non-competition and assignment of all intellectual property rights developed during the employment
period.

E.

Share ownership

The table below sets forth information as of March 26, 2024 provided to us by our directors and named executive officers as of December 31, 2023 concerning their ownership of
Common Shares and stock options of the Company:

Name

No. of Common
Shares owned or
held

Percent(1)

—   
1,876   
—   
—   
—   
—   
4,200   
1,280   
—   
—   
10,297   

No. of stock
options held(2)    
4,000   
2,400   
—   
—   
3,800   
4,000   
7,800   
—   
2,000   
2,000   
26,000   

—   
*   
—   
—   
—   
—   
*   
*   
—   
—   
—   

Ammer, Nicola
Egbert, Carolyn
Edwards, Peter G.
Gagnon, Gilles
Gerlach, Matthias
Guenther, Eckhard
Paulini, Klaus
Turpin, Dennis
Teifel, Michael
La Fratta, Giuliano
Total

* Less than 1%

No. of currently
exercisable
options

    No. of DSUs Held 
— 
51,120 
49,000 
49,000 
— 
— 
— 
47,800 
— 
— 
196,920 

3,334   
2,400   
—   
—   
3,134   
3,334   
6,467   
—   
1,334   
667   
20,670   

(1) Based on 4,855,876 Common Shares outstanding as at March 26, 2024
(2) For information regarding option expiration dates and exercise price refer to the tables included under the caption "Outstanding Option-Based Awards and Share-Based Awards”.

Item 7.

Major Shareholders and Related Party Transactions

A.

Major shareholders

We are not directly or indirectly owned or controlled by another corporation or by any foreign government. Based on filings with the SEC and the Canadian securities regulatory
authorities, as at March 26, 2024, no individual or entity, other than as set out below, beneficially owned, directly or indirectly, or exercised control or direction over our Common
Shares carrying more than 5% of the voting rights attached to all our Common Shares (to whom we refer as our major shareholders).

93

Changes in Percentage Ownership by Major Shareholders

On February 18, 2020, Armistice Capital Master Fund, LTD became a major shareholder of the Company due to the acquisition of over 5% of our outstanding Common Shares, but
as of December 31, 2020 ceased to beneficially own more than 5% of our Common Shares, based solely on a Schedule 13G filed with the SEC on February 16, 2021. On July 1, 2020,
Intracoastal Capital LLC became a major shareholder due to the acquisition of over 5% of our outstanding Common Shares, but as of December 31, 2021 ceased to beneficially own
more than 5% of our Common Shares, based solely on a Schedule 13G filed with the SEC on February 11, 2022. On July 2, 2020, Lind Global Macro Fund, LP became a major
shareholder due to the acquisition of over 5% of our outstanding Common Shares, but as of December 31, 2021 ceased to beneficially own more than 5% of our Common Shares,
based solely on a Schedule 13G filed with the SEC on February 11, 2022. We have no major shareholders as of March 26, 2024.

United States Shareholders

Based on a review of the information provide to us by our transfer agent, as at March 26, 2024, there were 14 holders of record of our Common Shares, of which two were registered
with an address in the U.S., holding in the aggregate approximately 99% of our outstanding Common Shares. We believe that the number of beneficial owners of our Common
Shares is substantially greater than the number of record holders, because the overwhelming majority of our Common Shares are held in broker "street names”.

B.

Related party transactions

For  a  description  of  the  interests  of  our  directors  and  executive  officers  and  other  related  party  considerations  in  the  Plan  of Arrangement,  please  see  the  sections  in  our

 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
preliminary prospectus dated February 15, 2024, filed with the SEC on Form F-1 entitled "Interest of Directors and Executive Officers in the Plan of Arrangement” and "Certain
Relationships and Related Party Transactions,” which information is incorporated by reference in this annual report.
Other  than  the  foregoing  discussion  and  certain  employment  agreements  and  indemnification  agreements  with  our  management  as  described  under  "Item  10.  – Additional
Information,” there are no related party transactions.

C.

Interests of experts and counsel

Not required.

Item 8.

Financial Information

A.

Consolidated statements and other financial information

The consolidated financial statements filed as part of this Annual Report on Form 20-F are presented under "Item 18. – Financial Statements”.

B.

Significant changes

Except for the Plan of Arrangement discussed in Item 4.B. of this Annual Report, no significant changes occurred since the date of our annual consolidated financial statements
included elsewhere in this Annual Report on Form 20-F.

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Item 9.

The Offer and Listing

A.

Offer and listing details

Not applicable, except for Item 9A(4). Our Common Shares are listed on both the NASDAQ and the TSX under the symbol "AEZS”. The following table indicates, for the relevant
periods, the high and low closing prices of our Common Shares on the NASDAQ and on the TSX as of December 31, 2023:

2023

Fourth quarter
Third quarter
Second quarter
First quarter

2022

Fourth quarter
Third quarter
Second quarter
First quarter

2021

Fourth quarter
Third quarter
Second quarter
First quarter

B.

Plan of distribution

Not applicable.

C.

Markets

NASDAQ (US$)

TSX (CAN$)

High

Low

High

Low

3.89   
2.46   
3.19   
3.23   
3.89   
10.50   
4.34   
6.00   
9.25   
10.50   
83.50   
19.25   
22.00   
28.50   
83.50   

1.42   
1.42   
2.44   
2.45   
2.61   
3.02   
3.02   
3.69   
4.25   
8.25   
9.00   
9.00   
14.75   
20.75   
12.75   

5.30   
3.36   
4.21   
4.38   
5.30   
12.75   
5.84   
7.50   
11.75   
12.75   
106.25   
24.00   
27.50   
35.50   
106.25   

1.91 
1.91 
3.25 
3.34 
3.36 
4.05 
4.05 
5.07 
5.50 
10.25 
16.00 
11.38 
19.00 
25.50 
16.00 

Our Common Shares are listed and posted for trading on both the NASDAQ and the TSX under the symbol "AEZS”.

D.

Selling shareholders

Not applicable.

E.

Dilution

Not applicable.

F.

Expenses of the issue

Not applicable.

Item 10.

Additional Information

A.

Share capital

Not required.

B.

Memorandum and articles of association

We  are  governed  by  our  restated  articles  of  incorporation  (the  " Restated Articles of  Incorporation”)  under  the  CBCA  and  by  articles  of  amendment  dated  October  2,  2012,
November 17, 2015, May 9, 2019 and July 18, 2022 (together with the Restated Articles of Incorporation, the " Articles”) and by our bylaws, as amended and restated on March 21,
2013 (the "bylaws”). Our Articles are on file with Corporations Canada under Corporation Number 264271-9. The Articles do not include a stated purpose and do not place any
restrictions on the business that we may carry on. In connection with and assuming the successful closing of the Plan of Arrangement, we will be amending our Articles to reflect a
share consolidation.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Inspection Rights of Shareholders

Under the CBCA, shareholders are entitled to be provided with a copy of the list of our registered shareholders. In order to obtain the shareholder list, a shareholder must provide
to us an affidavit including, among other things, a statement that the list will only be used for the purposes permitted by the CBCA. These permitted purposes include an effort to
influence the voting of our shareholders, an offer to acquire our securities and any other matter relating to our affairs. We are entitled to charge a reasonable fee for the provision
of the shareholder list and must deliver that list no more than ten days after receipt of the affidavit described above.

95

Under the CBCA, shareholders have the right to inspect certain corporate records, including our Articles and bylaws and minutes of meetings and resolutions of the shareholders.
Shareholders have no statutory right to inspect minutes of meetings and resolutions of our directors. Our shareholders have the right to certain financial information respecting us.
In addition to the annual and quarterly financial statements required to be filed under applicable securities laws, we are required by the CBCA to place before every annual meeting
of shareholders our audited comparative annual financial statements. In addition, shareholders have the right to examine the financial statements of each of our subsidiaries and
any other corporate entity whose accounts are consolidated in our financial statements.

Directors

The minimum number of directors we must have is five (5) and the maximum number is fifteen (15). In accordance with the CBCA, at least 25% of our directors must be residents of
Canada. In order to serve as a director, a person must be a natural person at least 18 years of age, of sound mind, not bankrupt, and must not be prohibited by any court from
holding the office of director. None of the Articles, the bylaws and the CBCA impose any mandatory retirement requirements for directors.

The directors are elected by a majority of the votes cast at the annual meeting at which an election of directors is required, to hold office until the election of their successors,
except in the case of resignations or if their offices become vacant by death or otherwise. Subject to the provisions of our bylaws, all directors may, if still qualified to serve as
directors, stand for re-election. The Board is not replaced at staggered intervals but is elected annually.

There is no provision in our bylaws or Articles that requires that a director must be a shareholder.

The directors are entitled to remuneration as shall from time to time be determined by the Board or by a committee to which the Board may delegate the power to do so. Under the
mandate  of  the  NGCC,  such  committee,  comprised  of  at  least  a  majority  of  independent  directors,  is  tasked  with  making  recommendations  to  the  Board  concerning  director
remuneration. The directors are allowed to vote on and approve their own remuneration in the absence of an independent quorum of directors.

The CBCA provides that a director who is a party to, or who is a director or officer of, or has a material interest in, any person who is a party to a material contract or transaction or
proposed material contract or transaction with us must disclose to us the nature and extent of his or her interest at the time and in the manner provided by the CBCA, or request
that same be entered in the minutes of the meetings of the Board, even if such contract, in connection with our normal business activity, does not require the approval of either the
directors or the shareholders. At the request of the president or any director, the director placed in a situation of conflict of interest must leave the meeting while the Board
discusses the matter. The CBCA prohibits such a director from voting on any resolution to approve the contract or transaction unless the contract or transaction:

● relates primarily to his or her remuneration as our director, officer, employee or agent or as a director, officer, employee or agent of an affiliate of us;
● is for indemnity or insurance for director’s liability as permitted by the CBCA; or
● is with our affiliate.

The CBCA provides that the Board may, on our behalf and without authorization of our shareholders:

● borrow money upon our credit;
● issue, reissue, sell or pledge our debt obligations;
● give a guarantee on our behalf to secure performance of an obligation of any person; and
● mortgage, hypothecate, pledge or otherwise create a security interest in all or any of our property, owned or subsequently acquired, to secure any of our obligations.

96

The shareholders have the ability to restrict such powers through our Articles or bylaws (or through a unanimous shareholder agreement), but no such restrictions are in place.

The CBCA prohibits the giving of a guarantee to any of our shareholders, directors, officers or employees or of an affiliated corporation or to an associate of any such person for
any purpose or to any person for the purpose of or in connection with a purchase of a share issued or to be issued by us or our affiliates, where there are reasonable grounds for
believing that we are or, after giving the guarantee, would be unable to pay our liabilities as they become due, or the realizable value of our assets in the form of assets pledged or
encumbered to secure a guarantee, after giving the guarantee, would be less than the aggregate of our liabilities and stated capital of all classes. These borrowing powers may be
varied by our bylaws or Articles. However, our bylaws and Articles do not contain any restrictions on or variations of these borrowing powers.

Pursuant to the CBCA, our directors manage and administer our business and affairs and exercise all such powers and authority as we are authorized to exercise pursuant to the
CBCA, the Articles and the bylaws. The general duties of our directors and officers under the CBCA are to act honestly and in good faith with a view to our best interests and to
exercise the care, diligence and skill that a reasonably prudent person would exercise in comparable circumstances. Any breach of these duties may lead to liability to us and our
shareholders for breach of fiduciary duty. In addition, a breach of certain provisions of the CBCA, including the improper payment of dividends or the improper purchase or
redemption of shares, will render the directors who authorized such action liable to account to us for any amounts improperly paid or distributed.

Our bylaws provide that the Board may, from time to time, appoint from amongst their number committees of the Board, and delegate to any such committee any of the powers of
the Board except those which pursuant to the CBCA a committee of the Board has no authority to exercise. As such, the Board has two standing committees: the Audit Committee
and the Nominating, Governance and Compensation Committee, or the NGCC.

Subject to the limitations provided by the CBCA, our bylaws provide that we shall, to the full extent provided by law, indemnify a director or an officer, a former director or officer
or  a  person  who  acts  or  acted  at  our  request  as  a  director  or  officer  of  a  body  corporate  of  which  we  are  or  were  a  shareholder  or  creditor,  and  his  or  her  heirs  and  legal
representatives, against all costs, losses, charges and expenses, including an amount paid to settle an action or satisfy a judgment, reasonably incurred by him or her in respect of
any civil, criminal or administrative action or proceeding to which he or she is made a party by reason of having been our director or officer or such body corporate, provided: (a)
he or she acted in good faith in our best interests and (b) in the case of a criminal or an administrative action or proceeding that is enforced by a monetary penalty, he or she had
reasonable grounds to believe that his or her conduct was lawful.

Our directors are authorized to indemnify from time to time any director or other person who has assumed or is about to assume in the normal course of business any liability for us
or for any corporation controlled by us and to secure such director or other person against any loss by the pledge of all or part of our movable or immovable property through the
creation of a hypothec or any other real right in all or part of such property or in any other manner.

We have also agreed to indemnify and save harmless our directors and senior corporate officers as well as the managing directors of our German subsidiary pursuant to various
Director  and  Officer  Indemnification Agreements  against  certain  charges,  damages,  awards,  settlements,  liabilities,  interest,  judgments,  fines,  penalties,  statutory  obligations,

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
professional  fees  and  retainers  and  other  expenses  of  whatever  nature  or  kind,  provided  that  any  such  costs,  charges,  professional  fees  and  other  expenses  are  reasonable
(collectively, "Expenses”) and from and against all Expenses sustained or incurred by the indemnified party as a result of serving as a director, officer or employee of the Company
(or its subsidiary) in respect of any act, matter, deed or thing whatsoever made, done, committed, permitted, omitted or acquiesced in by the indemnified party as a director, officer
or employee of the Company (or its subsidiary).

Share Capitalization

Our authorized share capital structure consists of an unlimited number of shares of the following classes (all classes are without nominal or par value): Common Shares; and first
preferred  shares  (the  "First  Preferred  Shares”)  and  second  preferred  shares  (the  "Second  Preferred  Shares”  and,  together  with  the  First  Preferred  Shares,  the  "Preferred
Shares”), both issuable in series. As at March 26, 2024, there were approximately 4,855,876 Common Shares outstanding. No Preferred Shares have been issued to date. We have
also issued warrants to acquire Common Shares in connection with certain equity financings.

97

Common Shares

The holders of the Common Shares are entitled to one vote for each Common Share held by them at all meetings of shareholders, except meetings at which only shareholders of a
specified class of shares are entitled to vote. In addition, the holders are entitled to receive dividends if, as and when declared by our Board on the Common Shares. Finally, the
holders of the Common Shares are entitled to receive our remaining property upon any liquidation, dissolution or winding-up of our affairs, whether voluntary or involuntary.
Shareholders have no liability to further capital calls as all shares issued and outstanding are fully paid and non-assessable.

Preferred Shares

The First and Second Preferred Shares are issuable in series with rights and privileges specific to each class. The holders of Preferred Shares are generally not entitled to receive
notice of or to attend or vote at meetings of shareholders. The holders of First Preferred Shares are entitled to preference and priority to any participation of holders of Second
Preferred Shares, Common Shares or shares of any other class of shares of our share capital ranking junior to the First Preferred Shares with respect to dividends and, in the event
of our liquidation, the distribution of our property upon our dissolution or winding-up, or the distribution of all or part of our assets among the shareholders, to an amount equal to
the value of the consideration paid in respect of such shares outstanding, as credited to our issued and paid-up share capital, on an equal basis, in proportion to the amount of
their respective claims in regard to such shares held by them. The holders of Second Preferred Shares are entitled to preference and priority to any participation of holders of
Common  Shares or shares of any other class of shares of our share capital ranking junior to the  Second  Preferred  Shares with respect to dividends and, in the event of our
liquidation, the distribution of our property upon our dissolution or winding-up, or the distribution of all or part of our assets among the shareholders, to an amount equal to the
value of the consideration paid in respect of such shares outstanding, as credited to our issued and paid-up share capital, on an equal basis, in proportion to the amount of their
respective claims in regard to such shares held by them.

Our Board may, from time to time, provide for additional series of Preferred Shares to be created and issued, but the issuance of any Preferred Shares is subject to the general duties
of the directors under the CBCA to act honestly and in good faith with a view to our best interests and to exercise the care, diligence and skill that a reasonably prudent person
would exercise in comparable circumstances.

Warrants

For a description of our Warrants, see note 16 – share capital, warrants and other capital, to the audited consolidated financial statements included in Item 18 of this Annual Report
on Form 20-F.

Shareholder Actions

The CBCA provides that our shareholders may, with leave of a court, bring an action in our name and on our behalf for the purpose of prosecuting, defending or discontinuing an
action on our behalf. In order to grant leave to permit such an action, the CBCA provides that the court must be satisfied that our directors were given adequate notice of the
application, the shareholder is acting in good faith and that it appears to be in our best interests that the action be brought.

98

Shareholder Rights Plan

The Board of the Company approved an amended and restated shareholder rights plan of the Company on March 29, 2019, which was approved, ratified and confirmed by the
shareholders at the annual and special meeting of shareholders of the Company on May 8, 2019 (the "Rights Plan”). Shareholders of the Company reconfirmed the Rights Plan on
June 21, 2022. The Rights Plan was originally implemented in 2016 and was implemented to ensure, to the extent possible, that all shareholders of the Company are treated fairly in
connection with any take-over offer or other acquisition of control of the Company.

Objectives and Background of the Rights Plan

The fundamental objectives of the Rights Plan are to provide adequate time for our Board and shareholders to assess an unsolicited take-over bid for us, to provide the Board with
sufficient time to explore and develop alternatives for maximizing shareholder value if a take-over bid is made, and to provide shareholders with an equal opportunity to participate
in a take-over bid.

The Rights Plan encourages a potential acquiror who makes a take-over bid to proceed either by way of a "Permitted Bid”, as described below, which requires a take-over bid to
satisfy certain minimum standards designed to promote fairness, or with the concurrence of our Board. If a take-over bid fails to meet these minimum standards and the Rights Plan
is not waived by the Board, the Rights Plan provides that holders of Common Shares, other than the acquiror, will be able to purchase additional Common Shares at a significant
discount to market, thus exposing the person acquiring Common Shares to substantial dilution of its holdings.

Summary of the Rights Plan

The following is a summary of the principal terms of the Rights Plan, which summary is qualified in its entirety by reference to the terms thereof. Capitalized terms not otherwise
defined in this summary shall have the meaning ascribed to such terms in the Rights Plan. A draft of the Rights Plan is available at the following websites: www.zenataris.com,
www.sedarplus.ca and www.sec.gov.

For the purposes of this summary and as set out in the Rights Plan, the term "NI 62-104” refers to National Instrument 62-104-Take-Over Bids and Issuer Bids adopted by the
Canadian securities regulatory authorities, as now in effect or as the same may from time to time be amended, re-enacted or replaced and including for greater certainty any
successor instrument thereto.

Operation of the Rights Plan

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pursuant to the terms of the Rights Plan, one right was issued in respect of each common share outstanding at 5:01 p.m. on March 29, 2016 (the "Record Time”). In addition, we
will issue one right for each additional Common Share issued after the Record Time and prior to the earlier of the Separation Time (as defined below) and the Expiration Time (as
defined below). The rights have an initial exercise price equal to the Market Price (as defined below) of the Common Shares as determined at the Separation Time, multiplied by five,
subject to certain anti-dilution adjustments (the "Exercise Price”), and they are not exercisable until the Separation Time. Upon the occurrence of a Flip-in Event (as defined
below), each right will entitle the holder thereof, other than an Acquiring Person or any other person whose rights are or become void pursuant to the provisions of the Rights
Plan, to purchase from us, effective at the close of business on the eighth trading day after the Stock Acquisition Date (as defined below), upon payment to us of the Exercise
Price, Common Shares having an aggregate Market Price equal to twice the Exercise Price on the date of consummation or occurrence of such Flip-in Event, subject to certain anti-
dilution adjustments.

Definition of Market Price

Market Price is generally defined in the Rights Plan, on any given day on which a determination must be made, as the volume weighted average trading price of the Common Shares
for the 20 consecutive trading days (i.e. days on which the  TSX or another stock exchange or national securities quotation system on which the  Common  Shares are traded
(including for greater certainty, each of the Nasdaq Global Select Market, the Nasdaq Global Market and the Nasdaq Capital Market) is open for the transaction of business,
subject to certain exceptions), through and including the trading day immediately preceding such date of determination, subject to certain exceptions.

99

Trading of Rights

Until the Separation Time (or the earlier termination or expiration of the rights), the rights trade together with the Common Shares and are represented by the same share certificates
as the Common Shares or an entry in our securities register in respect of any outstanding Common Shares. From and after the Separation Time and prior to the Expiration Time, the
rights are evidenced by rights certificates and trade separately from the Common Shares. The rights do not carry any of the rights attaching to the Common Shares such as voting
or dividend rights.

Separation Time

The rights will separate from the Common Shares to which they are attached and become exercisable at the time (the "Separation Time”) of the close of business on the eighth
business day after the earliest to occur of:

(1)

the first date (the "Stock Acquisition Date”) of a public announcement of facts indicating that a person has become an Acquiring Person; and

(2)

the date of the commencement of, or first public announcement of the intention of any person (other than us or any of our subsidiaries) to commence a take-over bid or a
share exchange bid for more than 20% of our outstanding Common Shares other than a Permitted Bid or a Competing Permitted Bid (as defined below), so long as such
take-over bid continues to satisfy the requirements of a Permitted Bid or a Competing Permitted Bid, as the case may be.

The Separation Time can also be such later time as may from time to time be determined by the Board, provided that if any such take-over bid expires, or is canceled, terminated or
otherwise withdrawn prior to the Separation Time, without securities deposited thereunder being taken up and paid for, it shall be deemed never to have been made and if the
Board determines to waive the application of the Rights Plan to a particular Flip-in Event, the Separation Time in respect of such Flip-in Event shall be deemed never to have
occurred.

From and after the Separation Time and prior to the Expiration Time, each right entitles the holder thereof to purchase one Common Share upon payment of the Exercise Price to us.

Flip-in Event

The acquisition by a person (an "Acquiring Person”), including others acting jointly or in concert with such person, of more than 20% of the outstanding Common Shares, other
than by way of a Permitted Bid, a Competing Permitted Bid or in certain other limited circumstances described in the Rights Plan, is referred to as a "Flip-in Event”.

In the event that, prior to the Expiration Time, a Flip-in Event that has not been waived occurs (see "Waiver and Redemption” below), each right (other than those held by or
deemed to be held by the Acquiring Person) will thereafter entitle the holder thereof, effective as at the close of business on the eighth trading day after the Stock Acquisition
Date, to purchase from us, upon payment of the Exercise Price and otherwise exercising such right in accordance with the terms of the Rights Plan, that number of Common Shares
having an aggregate Market Price on the date of consummation or occurrence of the Flip-in Event equal to twice the Exercise Price, for an amount in cash equal to the Exercise Price
(subject to certain anti-dilution adjustments described in the Rights Plan).

A bidder may enter into Permitted Lock-up Agreements with our shareholders (" Locked-up Persons”) who are not affiliates or associates of the bidder and who are not, other than
by virtue of entering into such agreement, acting jointly or in concert with the bidder, whereby such shareholders agree to tender their Common Shares to the take-over bid (the
"Lock-up Bid”) without the bidder being deemed to beneficially own the Common Shares deposited pursuant to the Lock-up Bid. Any such agreement must include a provision
that  permits  the  Locked-up  Person  to  withdraw  the  Common  Shares  to  tender  to  another  take-over  bid  or  to  support  another  transaction  that  will  either  provide  greater
consideration to the shareholder than the Lock-up Bid or provide for a right to sell a greater number of shares than the Lock-up Bid contemplates (provided that the Permitted
Lock-up Agreement may require that such greater number exceed the number of shares under the Locked-up Bid by a specified percentage not to exceed 7%).

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A  Permitted  Lock-up Agreement may require that the consideration under the other transaction exceed the consideration under the  Lock-up  Bid by a specified amount.  The
specified amount may not be greater than 7%. For greater certainty, a Permitted Lock-up Agreement may contain a right of first refusal or require a period of delay (or other similar
limitation) to give a bidder an opportunity to match a higher price in another transaction as long as the limitation does not preclude the exercise by the Locked-up Person of the
right to withdraw the Common Shares during the period of the other take-over bid or transaction.

The Rights Plan requires that any Permitted Lock-up Agreement be made available to us and the public. The definition of Permitted Lock-up Agreement also provides that under a
Permitted Lock-up Agreement, no "break up” fees, "topping” fees, penalties, expenses or other amounts that exceed in aggregate the greater of (i) 2.5% of the price or value of the
aggregate consideration payable under the Lock-up Bid, and (ii) 50% of the amount by which the price or value of the consideration received by a Locked-up Person under another
take-over bid or transaction exceeds what such Locked-up Person would have received under the Lock-up Bid, can be payable by such Locked-up Person if the Locked-up Person
fails to deposit or tender Common Shares to the Lock-up Bid or withdraws Common Shares previously tendered thereto in order to deposit such Common Shares to another take-
over bid or support another transaction.

Permitted Bid Requirements

The requirements of a Permitted Bid include the following:

1.
2.

the take-over bid must be made by means of a take-over bid circular;
the take-over bid must be made to all holders of Common Shares wherever resident, on identical terms and conditions, other than the bidder;

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3.

the take-over bid must not permit Common Shares tendered pursuant to the bid to be taken up or paid for:

a)

b)

prior to the close of business on a date that is not less than 105 days following the date of the relevant take-over bid or such shorter minimum period that a take-over
bid (that is not exempt from any of the requirements of  Division 5 (Bid  Mechanics of  NI 62-104)) must remain open for deposits of securities thereunder, in the
applicable circumstances at such time, pursuant to NI 62-104;
then only if at the close of business on the date Common Shares (and/or "Convertible Securities”, as defined in the Rights Plan) are first taken up or paid for under
such take-over bid, outstanding Common Shares and Convertible Securities held by shareholders other than any other Acquiring Person, the bidder, the bidder’s
affiliates or associates, persons acting jointly or in concert with the bidder and any employee benefit plan, deferred profit-sharing plan, stock participation plan or
trust  for  the  benefit  of our employees or the employees of any of our subsidiaries, unless the beneficiaries of such plan or trust direct the manner in which the
Common Shares are to be voted or direct whether the Common Shares are to be tendered to a take-over bid (collectively, "Independent Shareholders”) that represent
more than 50% of the aggregate of (I) then outstanding Common Shares and (II) Common Shares issuable upon the exercise of Convertible Securities, have been
deposited or tendered pursuant to the take-over bid and not withdrawn

4.

5.
6.

the take-over bid must allow Common Shares and/or Convertible Securities to be deposited or tendered pursuant to such take-over bid, unless such take-over bid is
withdrawn, at any time prior to the close of business on the date Common Shares and/or Convertible Securities are first taken up or paid for under the take-over bid;
the take-over bid must allow Common Shares and/or Convertible Securities to be withdrawn until taken up and paid for; and
in the event the requirement set forth in clause 3.b) above is satisfied, the bidder must make a public announcement of that fact and the take-over bid must remain open for
deposits and tenders of Common Shares for not less than ten days from the date of such public announcement.

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A Permitted Bid need not be a bid for all outstanding Common Shares not held by the bidder, i.e., a Permitted Bid may be a partial bid. The Rights Plan also allows a competing
Permitted Bid (a "Competing Permitted Bid”) to be made while a Permitted Bid is in existence. A Competing Permitted Bid must satisfy all the requirements of a Permitted Bid other
than the requirement set out in clause 3.a) above and must not permit Common Shares tendered or deposited pursuant to the bid to be taken up or paid for prior to the close of
business on the last day of the minimum initial deposit period that such take-over bid must remain open for deposits of securities thereunder pursuant to NI 62-104 after the date of
the take-over bid constituting the Competing Permitted Bid; provided, however, that a take-over bid that has qualified as a Competing Permitted Bid shall cease to be a Competing
Permitted Bid at any time and as soon as such time as when such take-over bid ceases to meet any or all of the foregoing provisions of the definition of "Competing Permitted Bid”
and any acquisition of Common Shares and/or Convertible Securities made pursuant to such take-over bid that qualified as a Competing Permitted Bid, including any acquisition of
Common Shares and/or Convertible Securities made before such take-over bid ceased to be a Competing Permitted Bid, will not be a "Permitted Bid Acquisition” (as defined in the
Rights Plan).

Waiver and Redemption

The Board may, prior to the occurrence of a Flip-in Event, waive the dilutive effects of the Rights Plan in respect of, among other things, a particular Flip-in Event resulting from a
take-over bid made by way of a take-over bid circular to all holders of our Common Shares. In such an event, such waiver shall also be deemed to be a waiver in respect of any
other Flip-in Event occurring under a take-over bid made by way of a take-over bid circular to all holders of Common Shares prior to the expiry of the first mentioned take-over bid.

The  Board may, with the approval of a majority of  Independent  Shareholders (or, after the  Separation  Time has occurred, holders of rights, other than rights which are void
pursuant to the provisions of the Rights Plan or which, prior to the Separation Time, are held otherwise than by Independent Shareholders), at any time prior to the occurrence of a
Flip-in  Event which has not been waived, elect to redeem all, but not less than all, of the then outstanding rights at a price of  CAN$0.00001 each, appropriately adjusted as
provided in the Rights Plan (the "Redemption Price”).

Where  a  take-over  bid  that  is  not  a  Permitted  Bid  or  Competing  Permitted  Bid  is  withdrawn  or  otherwise  terminated  after  the  Separation  Time  has  occurred  and  prior  to  the
occurrence of a Flip-in Event, the Board may elect to redeem all the outstanding rights at the Redemption Price without the consent of the holders of the Common Shares or the
rights and reissue rights under the Rights Plan to holders of record of Common Shares immediately following such redemption. Upon the rights being so redeemed and reissued, all
the provisions of the Rights Plan will continue to apply as if the Separation Time had not occurred, and the Separation Time will be deemed not to have occurred and we shall be
deemed to have issued replacement rights to the holders of its then outstanding Common Shares.

Amendment to the Rights Plan

The Rights Plan may be amended to correct any clerical or typographical error or to make such changes as are required to maintain the validity of the Rights Plan as a result of any
change in any applicable legislation, regulations or rules thereunder, without the approval of the holders of the Common Shares or rights. Prior to the Separation Time, we may,
with the prior consent of the holders of Common Shares, amend, vary or delete any of the provisions of the Rights Plan in order to effect any changes which the Board, acting in
good faith, considers necessary or desirable. We may, with the prior consent of the holders of rights, at any time after the Separation Time and before the Expiration Time, amend,
vary or delete any of the provisions of the Rights Plan.

Protection Against Dilution

The Exercise Price, the number and nature of securities which may be purchased upon the exercise of rights and the number of rights outstanding are subject to adjustment from
time to time to prevent dilution in the event of stock dividends, subdivisions, consolidations, reclassifications or other changes in the outstanding  Common  Shares, pro rata
distributions to holders of Common Shares and other circumstances where adjustments are required to appropriately protect the interests of the holders of rights.

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Fiduciary Duty of Board

The Rights Plan will not detract from or lessen the duty of the Board to act honestly and in good faith with a view to our best interests and the best interests of our shareholders.
The Board will continue to have the duty and power to take such actions and make such recommendations to our shareholders as are considered appropriate.

Exemptions for Investment Advisors

Fund managers, investment advisors (for fully-managed accounts), trust companies (acting in their capacities as trustees and administrators), statutory bodies whose business
includes the management of funds, and administrators of registered pension plans are exempt from triggering a Flip-in Event, provided that they are not making, or are not part of a
group making, a take-over bid.

Term

The Rights Plan will expire on the earlier of (i) the Termination Time; and (ii) the Close of Business on the date on which the annual meeting of the Company to be held in 2025 and
at every third annual meeting of the Company thereafter (each such annual meeting being a "Reconfirmation Meeting”) occurs and at which the Rights Plan is not reconfirmed or
presented for reconfirmation as contemplated in the Rights Plan (the "Expiration Time”).

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Action Necessary to Change Rights of Shareholders

In order to change the rights of our shareholders, we would need to amend our Articles to effect the change. Such an amendment would require the approval of holders of two-
thirds of the issued and outstanding shares cast at a duly called special meeting. For certain amendments, a shareholder is entitled under the CBCA to dissent in respect of such a
resolution amending the Articles and, if the resolution is adopted and we implement such changes, demand payment of the fair value of its shares.

Disclosure of Share Ownership

In general, under applicable securities regulation in Canada, a person or company who beneficially owns, or who directly or indirectly exercises control or direction over voting
securities of a reporting issuer, voting securities of an issuer or a combination of both, carrying more than ten percent of the voting rights attached to all the issuer’s outstanding
voting securities is an insider and must, within ten days of becoming an insider, file a report in the required form effective the date on which the person became an insider,
disclosing any direct or indirect beneficial ownership of, or control or direction over, securities of the reporting issuer.

Additionally, securities regulation in Canada provides for the filing of a report by an insider of a reporting issuer whose holdings change, which report must be filed within five
days from the day on which the change takes place.

Section 13 of the Exchange Act imposes reporting requirements on persons who acquire beneficial ownership (as such term is defined in the Rule 13d-3 under the Exchange Act) of
more than five percent of a class of an equity security registered under Section 12 of the Exchange Act. Our Common Shares are so registered. In general, such persons must file,
within ten days after such acquisition, a report of beneficial ownership with the SEC containing the information prescribed by the regulations under Section 13 of the Exchange
Act. This information is also required to be sent to the issuer of the securities and to each exchange where the securities are traded.

The bylaws of the Company do not require disclosure of share ownership.

Meeting of Shareholders

An annual meeting of shareholders is held each year for the purpose of considering the financial statements and reports, electing directors, appointing auditors and fixing or
authorizing the Board to fix their remuneration and for the transaction of other business as may properly come before a meeting of shareholders. Any annual meeting may also
constitute a special meeting to take cognizance and dispose of any matter of which a special meeting may take cognizance and dispose. Under the bylaws, our Chief Executive
Officer or our President has the power to call a meeting of shareholders.

103

The CBCA provides that the holders of not less than 5% of our outstanding voting shares may requisition our directors to call a meeting of shareholders for the purpose stated in
the requisition. Except in limited circumstances, including where a meeting of shareholders has already been called and a notice of meeting already given or where it is clear that the
primary purpose of the requisition is to redress a personal grievance against us or our directors, officers or shareholders, our directors, on receipt of such requisition, must call a
meeting of shareholders. If the directors fail to call a meeting of shareholders within twenty-one days after receiving the requisition, any shareholder who signed the requisition
may call the meeting of shareholders and, unless the shareholders resolve otherwise at the meeting, we shall reimburse the shareholders for the expenses reasonably incurred by
them in requisitioning, calling and holding the meeting of shareholders.

The  CBCA  also  provides  that,  except  in  limited  circumstances,  a  resolution  in  writing  signed  by  all  of  the  shareholders  entitled  to  vote  on  that  resolution  at  a  meeting  of
shareholders is as valid as if it had been passed at a meeting of shareholders.

A quorum of shareholders is present at an annual or special meeting of shareholders, regardless of the number of persons present in person at the meeting, if the holder(s) of
shares representing at least 10% of the outstanding voting shares at such meeting are present in person or represented in accordance with our bylaws. In the case where the
CBCA, our Articles or our bylaws require or permit the vote by class of holders of a given class of shares of our share capital, the quorum at any meeting will be one or more
persons representing 10% of the outstanding shares of such class.

Notice of the time and place of each annual or special meeting of shareholders must be given not less than 21 days, nor more than 50 days, before the date of each meeting to each
director, to the auditor and to each shareholder entitled to vote thereat. If the address of any shareholder, director or auditor does not appear in our books, the notice may be sent
to such address as the person sending the notice may consider to be most likely to reach such shareholder, director or auditor promptly. Every person who, by operation of the
CBCA, transfers or by any other means whatsoever, becomes entitled to any share, shall be bound by every notice given in respect of such share which, prior to the entry of his or
her name and address on our register, is given to the person whose name appears on the register at the time such notice is sent. Notice of meeting of shareholders called for any
other purpose other than consideration of the financial statements and auditor’s report, election of directors and reappointment of the incumbent auditor, must state the nature of
the business in sufficient detail to permit the shareholder to form a reasoned judgment on and must state the text of any special resolution or bylaw to be submitted to the meeting.

Our bylaws include an advance notice provision (the "Advance Notice Requirement”). The Advance Notice Requirement applies in certain circumstances where nominations of
persons for election to the Board are made by our shareholders other than pursuant to: (a) a requisition of a meeting made pursuant to the provisions of the CBCA; or (b) a
shareholder proposal made pursuant to the provisions of the CBCA.

Among other things, the Advance Notice Requirement fixes a deadline by which shareholders must submit a notice of director nominations to us prior to any annual or special
meeting of shareholders where directors are to be elected and sets forth the information that a shareholder must include in the notice for it to be valid. In the case of an annual
meeting of shareholders, we must be given not less than 30 nor more than 65 days’ notice prior to the date of the annual meeting; provided, however, that in the event that the
annual meeting is to be held on a date that is less than 50 days after the date on which the first public announcement of the date of the annual meeting was made, notice may be
made not later than the close of business on the 10th day following such public announcement. In the case of a special meeting of shareholders (which is not also an annual
meeting), we must be given notice not later than the close of business on the 15th day following the day on which the first public announcement of the date of the special meeting
was made.

The Board may, in its sole discretion, waive any requirement of the Advance Notice Requirement.

104

Limitations on Right to Own Securities

Neither Canadian law nor our Articles or bylaws limit the right of a non-resident to hold or vote our Common Shares, other than as provided in the Investment Canada Act (the
"Investment Act”).

The Investment Act requires any person that is a "non-Canadian” (as defined in the Investment Act) who acquires "control” (as defined in the Investment Act) of an existing
Canadian business to file either a pre-closing application for review or a post-closing notification with Innovation, Science and Economic Development Canada.

As of the date hereof, the threshold for review of a direct acquisition of control of a non-cultural Canadian business by a World Trade Organization member country investor that

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
is not a state-owned enterprise is an enterprise value of assets that exceeds CAN$1.326 billion. For "trade agreement investors” that are not state-owned enterprises (as defined in
the Investment Act), the threshold for review of a direct acquisition of control of a non-cultural Canadian business is an enterprise value of assets that exceeds CAN$1.989 billion.
The enterprise value review thresholds for both World Trade Organization member countries and trade agreement investors are indexed to annual GDP growth and are adjusted
accordingly each year. For purposes of a publicly traded company, the "enterprise value” of the assets of the Canadian business is equal to the market capitalization of the entity,
plus its liabilities (excluding its operating liabilities), minus its cash and cash equivalents.

As such, under the Investment Act, the acquisition of control of us (either through the acquisition of our Common Shares or all or substantially all our assets) by a non-Canadian
who is a World Trade Organization member country investor or a trade agreement investor, including a U.S. investor, would be reviewable only if the enterprise value of our assets
exceeds the specified threshold for review.

Where the acquisition of control is a reviewable transaction, the Investment Act generally prohibits the implementation of the reviewable transaction unless, after review, the
relevant Minister is satisfied or deemed to be satisfied that the acquisition is likely to be of net benefit to Canada.

The acquisition of a majority of the voting interests of an entity is deemed to be acquisition of "control” of that entity. The acquisition of less than a majority but one-third or more
of the total number of votes attached to all of the voting shares of a corporation or of an equivalent undivided ownership interest in the total number of votes attached to all of the
voting shares of the corporation is presumed to be an acquisition of control of that corporation unless it can be established that, on the acquisition, the corporation is not
controlled in fact by the acquiror through the ownership of voting shares. The acquisition of less than one-third of the total number of votes attached to all of the voting shares of
a corporation is deemed not to be acquisition of control of that corporation subject to certain discretionary rights relative to investments involving state-owned enterprises. Other
than in connection with a "national security” review, discussed below, certain transactions in relation to our Common Shares would be exempt from the Investment Act including:

● the acquisition of our Common Shares by a person in the ordinary course of that person’s business as a trader or dealer in securities;
● the acquisition or control of us in connection with the realization of security granted for a loan or other financial assistance and not for any purpose related to the
provisions of the Investment Act, if the acquisition is subject to approval under the Bank Act,  the Cooperative Credit Associations Act, the Insurance Companies Act or
the Trust and Loan Companies Act; and

● the acquisition or control of us by reason of an amalgamation, merger, consolidation or corporate reorganization following which the ultimate direct or indirect control in

fact of us, through the ownership of our voting interests, remains unchanged.

Under the national security regime in the Investment Act, review on a discretionary basis may also be undertaken by the federal government in respect of a much broader range of
investments by a non-Canadian to "acquire, in whole or in part, or to establish an entity carrying on all or any part of its operations in Canada”. The relevant test is whether such
an investment by a non-Canadian could be "injurious to national security”. The Minister of Innovation, Science and Economic Development has broad discretion to determine
whether an investor is a non-Canadian and therefore may be subject to national security review. Review on national security grounds is at the discretion of the federal government
and may occur on a pre- or post-closing basis.

There is no law, governmental decree or regulation in Canada that restricts the export or import of capital, or which would affect the remittance of dividends or other payments by
us to non-resident holders of our Common Shares, other than withholding tax requirements.

105

C.

Material contracts

The following are the only material agreements of the  Company that are in effect as of the date hereof (other than certain agreements entered into in the ordinary course of
business):

● the Arrangement Agreement (as described below);
● the Lock-Up Agreements (as described below); and
● the Licensing Agreement with Consilient Health (as described below).

Arrangement Agreement

On December 14, 2023, Aeterna Zentaris entered into an Arrangement Agreement with Ceapro, pursuant to which we and Ceapro agreed that, subject to the terms and conditions
set forth in the Arrangement Agreement, including the receipt of the approval of the stockholders of Aeterna Zentaris and Ceapro the final order of the Court of King’s Bench of
Alberta and certain regulatory and exchange approvals described below, on the Effective Date (as defined in the Arrangement Agreement) we will acquire 100 percent of the
Ceapro Shares pursuant to a company-approved plan of arrangement under the Canada Business Corporations Act such that Ceapro will become a wholly-owned subsidiary of
Aeterna  Zentaris  and Aeterna  Zentaris  will  continue  the  operations  of Aeterna  Zentaris  and  Ceapro  on  a  combined  basis.  On  March  12,  2024,  the  stockholders  of Aeterna
approved the Plan of Arrangement.

For additional information with respect to the representations and warranties, conditions to closing and other terms in the Plan of Arrangement please refer to the section entitled
"The Plan of Arrangement” and to the Arrangement Agreement incorporated by reference as Exhibit 2.1 to our Registration Statement on Form F-1 filed with the SEC on February
15, 2024, which is incorporated herein by reference.

Lock-Up Agreements

On December 14, 2023 and prior to entering into the Arrangement Agreement, each of the directors and officers of Ceapro have entered into Aeterna Zentaris Lock-Up Agreements
pursuant  to  which,  among  other  things,  they  have  agreed  in  favour  of Aeterna  Zentaris  to  vote  in  favour  of  the Arrangement  Resolution  (as  defined  in  the Arrangement
Agreement) on the terms and subject to the conditions set forth in the Aeterna Zentaris Lock-Up Agreements. As of January 12, 2024, the record date for the determination of
shareholders and option holders of Ceapro entitled to receive notice of and vote at Ceapro’s special meeting of shareholders and option holders held on March 12, 2024, the
directors  and  officers  of  Ceapro  subject  to  the  Aeterna  Zentaris  Lock-Up  Agreements  held  or  exercised  control  or  direction  over  1,990,468  Ceapro  Shares,  representing
approximately 2.54% of the issued and outstanding  Ceapro  Shares, and 1,985,000  Ceapro  Options (as defined in the Arrangement Agreement), for a total of 3,975,468  Ceapro
securities, representing 4.90% of the total issued and outstanding Ceapro securities.

European Economic Area and United Kingdom License Agreement

On December 7, 2020, the Company entered into an exclusive licensing agreement with Consilient Health Limited ("CH”) for the commercialization of macimorelin (the "Licensed
Product”) in the European Economic Area and the United Kingdom (the "CH License Agreement”). On March 15, 2023, with the Company’s consent, Consilient Health ("CH”)
entered into an assignment agreement with Pharmanovia to transfer the current licensing agreement for the commercialization of macimorelin in the European Economic Area and
the United Kingdom to Pharmanovia, as well as the current supply agreement pursuant to which the Company agreed to provide the licensed product (together, the "Assignment
Agreement”). Also on March 15, 2023, the Company and Pharmanovia entered into an amendment agreement, pursuant to which the Company provided its acknowledgement and
consent to the Assignment Agreement and agreed to certain amended terms which do not materially differ from the previous license and supply agreement with CH.

106

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Under the terms of the Agreement, CH agreed to make a non-refundable, non-creditable upfront payment to the Company of $1,209 (€1.0 million), which the Company received in
January 2021. The Company also is eligible to receive additional consideration, including regulatory milestones related to agreed-upon pricing and reimbursement parameters; net
sales milestones; and royalties, ranging from 10%-20% of net sales of macimorelin, subject to reduction in certain cases, or sublicense income recorded by Pharmanovia.

As consideration for the right to commercialize the licensed product, Pharmanovia has agreed to pay certain milestones and royalty payments as summarized below:

Paediatric Use Regulatory payment (non-refundable and non-creditable)

● Grant of first marketing authorization from the European Commission for Paediatric Use of Euro 500,000.

Regulatory payments (non-refundable and non-creditable)

● Upon receipt of pricing and reimbursement approval in France, Germany, Italy, Spain and the United Kingdom upon price per test of:
● Above Euro 300: Euro 200,000 per country;
● Euro 250 to Euro 300: Euro 100,000 per country; and
● Achievement of a mean average reimbursement price of above Euro 300 in France, Germany, Italy, Spain and UK of Euro 500,000.

Commercial milestones (non-refundable and non-creditable)

● Annual net sales reaching Euro 4 million for payment of Euro 250,000;
● Annual net sales reaching Euro 6 million for payment of Euro 400,000;
● Annual net sales reaching Euro 8 million for payment of Euro 600,000; and
● Annual net sales reaching Euro 10 million for payment of Euro 1,000,000.

Royalties

● 10.0% for up to Euro 2 million annual net sales;
● 12.5% between Euro 2 million and Euro 3 million net sales;
● 15.0% between Euro 3 million and Euro 4 million net sales; and
● 20.0% for above Euro 4 million net sales.

Sublicense Income Royalty

● 10.0% on any form of consideration other than running royalties on net sales

The license remains in full force and effect (i) as long as the licensed product is covered by a valid claim in any country covered by the licensing agreement; (ii) the expiration of
any regulatory marketing exclusivity period or other statutory designation that provides similar exclusivity for the commercialization of the licensed product in any country covered
by the licensing agreement; or (iii) on a country by country of the covered territory, and licensed product by licensed product basis, for a period of ten (10) years after the first
commercial sale date in the respective country, whichever term is longer, subject to renewal. The licensee has the right to terminate the license in certain circumstances.

107

Employment and Service Agreements

We, or one of our subsidiaries, had entered into an employment agreement and, in some cases, a change of control agreement with each of our Named Executive Officers.

Klaus Paulini

We entered into an employment agreement with Dr. Klaus Paulini, effective as of October 4, 2019 (the " Employment Agreement”) for his position as Chief Executive Officer of the
Corporation. The Corporation, through AEZS Germany, also entered into a service agreement with Dr. Klaus Paulini effective as of July 26, 2019 (the "Services Agreement”) for his
position as Managing Director of AEZS Germany. The Employment Agreement provides that we will pay Dr. Paulini (the " Executive”) an initial base salary of €260,000 per annum,
which includes payment for his service as Managing Director of AEZS Germany. Additionally, pursuant to the Employment Agreement, we provided the Executive with an initial
grant of 35,000 stock options in November 2019. Under the terms of the Services Agreement, the Executive may receive subsequent grants of stock options at the discretion of the
Board of Directors or the NGCC, an annual bonus subject to the determination and approval of the NGCC and participation in an employer sponsored pension scheme.

If there is a termination of the Executive’s employment by us without "Cause”, then the Executive will be entitled to receive a severance payment in the amount equal to €300,000.

The Employment Agreement contains customary confidentiality, intellectual property and non-disparagement covenants.

For the purposes of the Employment Agreement, termination of employment for "Cause” includes (but is not limited to) (i) if the Executive commits any fraud, theft, embezzlement
or other criminal act of a similar nature, and (ii) if the Executive has committed serious misconduct or willful negligence in the performance of his duties.

Giuliano La Fratta

AEZS Inc entered into an employment agreement in January 20022 with Giuliano La Fratta, Senior Vice President, Finance and Chief Financial Officer ("CFO”). In accordance with
the terms of his employment agreement, Mr. La Fratta will receive a RRSP Contribution equal to 5% of his Base Salary.

If there is a termination of the Executive’s employment by us without "Cause”, then the Executive will be entitled to receive a severance payment depending on the length of his
service. At the end of December 31, 2023 the Executive will be entitled to receive a severance payment in the amount equal to $603,389 CAD.

AEZS entered into an amended change of control agreement with Mr. La Fratta on November 10, 2023. In the event of a "Change of Control” (as defined in the change of control
agreement) occurring within a 24 month period of the date of the amended agreement, Mr. La Fratta will be entitled to receive:

● all accrued obligations under his employment agreement;
● a severance payment equal to 18 months of his base salary;
● an amount equal to his annual bonus for the year in which the Change of Control occurs;
● an amount equal to 1.5 times the annual bonus based on the target annual bonus for the year in which the Change of Control occurs;
● a cash amount equal to 1.5 times the annual premium cost to the Corporation of providing his insured health benefits; and

all outstanding options will automatically vest upon the Change of Control.

Matthias Gerlach

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
AEZS Germany entered into an employment agreement in January 2001 with Dr. Gerlach, Vice President Manufacturing and Supply Chain. In accordance with the terms of his
employment agreement, Dr. Gerlach will receive a pension payment after he has reached the statutory retirement age, independent of whether he works with AEZS Germany until
such age, in an amount to be based on the contributions that were made during his employment with AEZS Germany.

108

Eckhard Guenther

AEZS Germany entered into an employment agreement in 1990 with Dr. Guenther, Vice President Business Development & Alliance Management. In accordance with the terms of
his employment agreement, Dr. Guenther will receive a pension payment after he has reached the statutory retirement age, independent of whether he works with AEZS Germany
until such age, in an amount to be based on the contributions that were made during his employment with AEZS Germany. Dr. Guenther retired from his positions with Aeterna
effective as of January 31, 2024. Dr. Klaus Paulini succeeded Dr. Guenther in his role as Managing Director AEZS Germany

Nicola Ammer

AEZS Germany entered into an employment agreement in April 2015 with Dr. Ammer, Chief Medical Officer and Senior Vice President Clinical Development. In accordance with the
terms of her employment agreement, Dr. Ammer will receive a pension payment after she has reached the statutory retirement age, independent of whether she works with AEZS
Germany until such age, in an amount to be based on the contributions that were made during her employment with AEZS Germany.

Ammer, Nicola
La Fratta, Giuliano
Gerlach, Matthias
Guenther, Eckhard
Paulini, Klaus

Name

Termination Provisions
Value ($)(1) (2)

— 
456,077 
— 
— 
324,690 

(1) The termination values assume that the triggering event took place on the last business day of our financial year-end (December 31, 2023).
(2) Value of  earned/unused  vacation,  if  applicable,  and  amounts  owing  for  expense  reimbursement  are not  included  as  they  are  not  considered  as  "incremental”  payments  made  in  connection with

termination of employment.

D.

Exchange controls

Canada has no system of exchange controls. There are no exchange restrictions on borrowing from foreign countries or on the remittance of dividends, interest, royalties and
similar payments, management fees, loan repayments, settlement of trade debts or the repatriation of capital.

E.

Taxation

THE FOLLOWING SUMMARY IS OF A GENERAL NATURE ONLY AND IS NOT INTENDED TO BE, NOR SHOULD IT BE CONSTRUED TO BE, LEGAL OR TAX ADVICE TO
ANY PARTICULAR HOLDER. CONSEQUENTLY, HOLDERS ARE URGED TO CONSULT THEIR OWN TAX ADVISORS FOR ADVICE AS TO THE TAX CONSEQUENCES OF
AN INVESTMENT IN THE COMMON SHARES HAVING REGARD TO THEIR PARTICULAR CIRCUMSTANCES.

Material Canadian Income Tax Considerations

The following summary describes the principal Canadian federal income tax considerations applicable to a holder of Common Shares and who, for the purposes of the Canadian
federal Income Tax Act, R.S.C. 1985, as amended (the " Tax Act ”), and at all relevant times, deals at arm’s length with, and is not affiliated with, the Company and holds their
Common Shares as capital property (a "holder”). Common Shares will generally be considered to be capital property to a holder for purposes of the Tax Act unless either the holder
holds such Common Shares in the course of carrying on a business of trading or dealing in securities, or the holder has held or acquired such Common Shares in a transaction or
transactions considered to be an adventure in the nature of trade.

This summary is not applicable to a holder (i) that is a "financial institution”, as defined in the Tax Act for purposes of the mark-to- market rules, (ii) that is a "specified financial
institution”, as defined in the Tax Act, (iii) an interest in which would be a "tax shelter investment” as defined in the Tax Act, (iv) that has made a functional currency reporting
election for purposes of the Tax Act, (v) that has entered or will enter into a "derivative forward agreement”, as defined in the Tax Act, in respect of Common Shares, or (vi) that
receives dividends on Common Shares under or as part of a dividend rental arrangement as defined in the Tax Act. Such holders should consult their own tax advisors.

109

Additional considerations, not discussed herein, may be applicable to a holder that is a corporation resident in Canada, and is, or becomes, or does not deal at arm’s length for
purposes of the Tax Act with a corporation resident in Canada that is or becomes, as part of a transaction or series of transactions or events that includes the acquisition of the
Common Shares, controlled by a non-resident person or a group of non-resident persons not dealing with each other at arm’s length for the purposes of the "foreign affiliate
dumping” rules in section 212.3 of the Tax Act. Such holders should consult their tax advisors with respect to the consequences of acquiring Common Shares.

This summary is based upon the current provisions of the Tax Act and the regulations promulgated thereunder (the " Regulations”) and the Company’s understanding of the
current published administrative policies and assessing practices of the Canada Revenue Agency (" CRA”). It also takes into account all proposed amendments to the Tax Act and
the Regulations publicly released by the Minister of Finance (Canada) prior to the date hereof ("Tax Proposals ”), and assumes that all such Tax Proposals will be enacted as
currently proposed. No assurance can be given that the Tax Proposals will be enacted in the form proposed or at all. This summary does not otherwise take into account or
anticipate any changes in law or administrative or assessing practice or policy of the CRA, whether by legislative, regulatory, judicial or administrative action or interpretation, nor
does it address any provincial, local, territorial or foreign tax considerations.

For purposes of the  Tax Act, all amounts, including dividends, adjusted cost base and proceeds of disposition, must generally be determined in  Canadian dollars. Amounts
denominated in a foreign currency must be converted to Canadian currency using exchange rates determined in accordance with the Tax Act. The amount of any capital gain or
any capital loss to a holder with respect to the Common Shares may be affected by fluctuations in Canadian dollar exchange rates.

Holders Not Resident in Canada

The following discussion applies to a holder who, at all relevant times, for purposes of the Tax Act, is neither resident nor deemed to be resident in Canada and does not, and is not
deemed to, use or hold Common Shares in carrying on a business or part of a business in Canada (a "Non-Resident holder”). In addition, this discussion does not apply to an
insurer who carries or is deemed to carry on, an insurance business in Canada and elsewhere.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Disposition of Common Shares

A Non-Resident holder generally will not be subject to tax under the Tax Act in respect of any capital gain realized by such Non- Resident holder on a disposition or deemed
disposition of Common Shares unless such shares constitute "taxable Canadian property” (as defined in the Tax Act) of the Non-Resident holder at the time of disposition and the
gain is not exempt from tax pursuant to the terms of an applicable income tax treaty or convention. As long as the Common Shares are listed on a designated stock exchange (which
currently includes the NASDAQ and the TSX) at the time of their disposition, the Common Shares generally will not constitute taxable Canadian property of a Non-Resident
holder, unless (a) at any time during the 60-month period immediately preceding the disposition (i) one or any combination of (A) the Non-Resident holder, (B) persons with whom
the Non-Resident holder did not deal at arm’s length, and (C) partnerships in which the Non-Resident holder or a person described in (B) holds a membership interest directly or
indirectly through one or more partnerships, owned 25% or more of the issued shares of any class or series of shares of the Company; and (ii) more than 50% of the fair market
value  of  the  shares  of  the  Company  was  derived  directly  or  indirectly  from  one  or  any  combination  of  real  or  immovable  property  situated  in  Canada,  "Canadian  resource
properties” (as defined in the Tax Act), "timber resource properties” (as defined in the Tax Act) or options in respect of, or interests in, or for civil law rights in, any such property
whether or not such property exists or (b) the Common Shares are otherwise deemed to be taxable Canadian property to the Non-Resident holder.

110

A Non-Resident holder’s capital gain (or capital loss) in respect of Common Shares that constitute or are deemed to constitute taxable Canadian property (and are not "treaty-
protected property” as defined in the Tax Act) will generally be computed in the manner described below under the heading "Holders Resident in Canada - Disposition of Common
Shares”. If the Common Shares were to cease being listed on the NASDAQ, the TSX or another "recognized stock exchange” (as defined in the Tax Act), a Non-Resident holder
who disposes of Common Shares that are taxable Canadian property may be required to fulfill the requirements of section 116 of the Tax Act, unless the Common Shares are
"treaty-protected property” (as defined in the Tax Act) of the disposing Non-Resident holder.

Non-Resident holders whose Common Shares are taxable Canadian property should consult their own tax advisors.

Taxation of Dividends on Common Shares

Dividends paid or credited or deemed to be paid or credited to a Non-Resident holder by the Company are subject to Canadian withholding tax at the rate of 25% unless reduced by
the terms of an applicable tax treaty or convention.  Under the  Canada -  United  States  Tax  Convention (1980) (the "Convention”)  as  amended,  the  rate  of  withholding  tax  on
dividends paid or credited to a Non-Resident holder who is the beneficial owner of the dividends, is resident in the U.S. for purposes of the Convention and entitled to the benefits
of the Convention (a "U.S. holder”) is generally limited to 15% of the gross amount of the dividend (or 5% in the case of a U.S. holder that is a company beneficially owning at least
10% of the Company’s voting shares). Non-Resident holders should consult their own tax advisors.

Holders Resident in Canada

The following discussion applies to a holder of Common Shares who, at all relevant times, for purposes of the Tax Act, is or is deemed to be resident in Canada (a " Canadian
holder”). Certain Canadian holders whose Common Shares might not otherwise qualify as capital property may, in certain circumstances, treat the Common Shares and every other
"Canadian security” (as defined in the Tax Act) owned by the Canadian holder as capital property by making an irrevocable election provided by subsection 39(4) of the Tax Act.
Canadian holders should consult their own tax advisors for advice as to whether an election under subsection 39(4) of the Tax Act is available and/or advisable in their particular
circumstances.

Taxation of Dividends on Common Shares

Dividends received or deemed to have been received on the Common Shares will be included in a Canadian holder’s income for purposes of the Tax Act. Such dividends received
or deemed to have been received by a Canadian holder that is an individual (other than certain trusts) will be subject to the gross-up and dividend tax credit rules generally
applicable under the Tax Act in respect of dividends received on shares of taxable Canadian corporations. Generally, a dividend will be eligible for the enhanced gross-up and
dividend tax credit if the Company designates the dividend as an "eligible dividend” (within the meaning of the Tax Act) in accordance with the provisions of the Tax Act. There
may be limitations on the ability of the Company to designate dividends as eligible dividends. A Canadian holder that is a corporation will be required to include such dividends in
computing its income and will generally be entitled to deduct the amount of such dividends in computing its taxable income. In certain circumstances, subsection 55(2) of the Tax
Act may treat a taxable dividend received by a Canadian holder that is a corporation as proceeds of disposition or a capital gain. A Canadian holder that is a "private corporation”
or a "subject corporation” (as such terms are defined in the Tax Act), may be liable under Part IV of the Tax Act to pay a refundable tax on dividends received or deemed to have
been received on the Common Shares to the extent such dividends are deductible in computing the holder’s taxable income.

Disposition of Common Shares

A disposition, or a deemed disposition, of a Common Share by a Canadian holder will generally give rise to a capital gain (or a capital loss) equal to the amount by which the
proceeds of disposition of the share, net of any reasonable costs of disposition, exceed (or are less than) the adjusted cost base of the share to the holder. Such capital gain (or
capital loss) will be subject to the treatment described below under "Taxation of Capital Gains and Capital Losses”.

Additional Refundable Tax

A  Canadian  holder  that  is  a  "Canadian-controlled  private  corporation”  (as  such  term  is  defined  in  the  Tax Act)  may  be  liable  to  pay  an  additional  refundable  tax  on  certain
investment income including amounts in respect of "Taxable Capital Gains”, as defined below.

111

Taxation of Capital Gains and Capital Losses

In general, one half of any capital gain (a "Taxable Capital Gain”) realized by a Canadian holder in a taxation year will be included in the holder’s income in the year. Subject to and
in accordance with the provisions of the Tax Act, one half of any capital loss (an " Allowable Capital Loss”) realized by a Canadian holder in a taxation year must be deducted from
Taxable Capital Gains realized by the holder in the year and Allowable Capital Losses in excess of Taxable Capital Gains may be carried back and deducted in any of the three
preceding taxation years or carried forward and deducted in any subsequent taxation year against net Taxable Capital Gains realized in such years. The amount of any capital loss
realized by a Canadian holder that is a corporation on the disposition or deemed disposition of a Common Share may be reduced by the amount of dividends received or deemed to
have been received by it on such Common Share (or on a share for which the Common Share has been substituted) to the extent and under the circumstances prescribed by the Tax
Act. Similar rules may apply where a corporation is a member of a partnership or a beneficiary of a trust that owns Common Shares, directly or indirectly, through a partnership or a
trust.
Alternative Minimum Tax

A Taxable Capital Gain realized and taxable dividends received or deemed to have been received by a Canadian holder who is an individual (including a trust, other than certain
specified trusts) may give rise to liability for alternative minimum tax.

Material U.S. Federal Income Tax Considerations

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following discussion is a summary of the material U.S. federal income tax consequences applicable to the purchase, ownership and disposition of Common Shares by a U.S.
Holder (as defined below), but does not purport to be a complete analysis of all potential U.S. federal income tax effects. This summary is based on the Internal Revenue Code of
1986, as amended (the "Code”), U.S. Treasury regulations promulgated thereunder, IRS rulings and judicial decisions in effect on the date hereof. All of these are subject to change,
possibly with retroactive effect, or different interpretations. This summary does not discuss the potential effects, whether adverse or beneficial, of any proposed legislation that, if
enacted, could be applied on a retroactive basis. This summary is not binding on the IRS, and the IRS is not precluded from taking a position that is different from, and contrary to,
the positions taken in this summary.

This summary does not address all aspects of U.S. federal income taxation that may be relevant to particular U.S. Holders in light of their specific circumstances (for example, U.S.
Holders subject to the alternative minimum tax or the Medicare contribution tax on net investment income under the Code) or to holders that may be subject to special rules under
U.S. federal income tax law, including:

● dealers in stocks, securities or currencies;
● securities traders that use a mark-to-market accounting method;
● banks and financial institutions;
● insurance companies;
● regulated investment companies;
● real estate investment trusts;
● tax-exempt organizations;
● retirement plans, individual plans, individual retirement accounts and tax-deferred accounts;
● partnerships or other pass-through entities for U.S. federal income tax purposes and their partners or members;
● persons holding Common Shares as part of a hedging or conversion transaction straddle or other integrated or risk reduction transaction;
● persons who or that are, or may become, subject to the expatriation provisions of the Code;
● persons whose functional currency is not the U.S. dollar; and
● direct, indirect or constructive owners of 10% or more of the total combined voting power of all classes of our voting stock or 10% or more of the total value of shares

of all classes of our stock.

This summary also does not address the tax consequences of holding, exercising or disposing of warrants in the Company. If the Company is a PFIC, as described below, U.S.
Holders of its warrants will be subject to adverse tax rules and will not be able to make the mark-to-market or the QEF election described below with respect to such warrants. U.S.
Holders of warrants should consult their tax advisors with regard to the U.S. federal income tax consequences of holding, exercising or disposing of warrants in the Company,
including in the situation in which the Company is classified as a PFIC.

112

This summary also does not discuss any aspect of state, local or foreign law, or estate or gift tax law as applicable to U.S. Holders. In addition, this discussion is limited to U.S.
Holders holding Common Shares as capital assets. For purposes of this summary, "U.S. Holder” means a beneficial holder of Common Shares who or that for U.S. federal income
tax purposes is:

● an individual citizen or resident of the U.S.;
● a corporation or other entity classified as a corporation for U.S. federal income tax purposes created or organized in or under the laws of the U.S., any state thereof or the

District of Columbia;

● an estate, the income of which is subject to U.S. federal income taxation regardless of its source; or
● a trust, if (a) a court within the U.S. is able to exercise primary supervision over the administration of such trust and one or more "U.S. persons” (within the meaning of the
Code) have the authority to control all substantial decisions of the trust, or (b) a valid election is in effect to be treated as a U.S. person for U.S. federal income tax
purposes.

If a partnership or other entity or arrangement classified as a partnership for U.S. federal income tax purposes holds Common Shares, the U.S. federal income tax treatment of a
partner generally will depend on the status of the partner and the activities of the partnership. This summary does not address the tax consequences to any such partner. Such a
partner should consult its own tax advisor as to the tax consequences of the partnership purchasing, owning and disposing of Common Shares.

U.S. HOLDERS SHOULD CONSULT THEIR OWN TAX ADVISORS WITH REGARD TO THE APPLICATION OF THE TAX CONSEQUENCES DESCRIBED BELOW TO THEIR
PARTICULAR SITUATIONS AS WELL AS THE APPLICATION OF ANY STATE, LOCAL, FOREIGN OR OTHER TAX LAWS, INCLUDING GIFT AND ESTATE TAX LAWS.

For a summary of the U.S. federal income tax consequences to U.S. Holders of the receipt and exercise (or expiration) of the new warrants to be issued in connection with the Plan
of Arrangement and the ownership and disposition of Common Shares received upon exercise of such warrants, please refer to the section entitled " U.S.  Federal  Income  Tax
Considerations for U.S. Holders” of our Registration Statement on Form F-1 filed with the SEC on February 15, 2024, which is incorporated herein by reference.

Tax Consequences if we are a Passive Foreign Investment Company ("PFIC”)

A foreign corporation will be classified as a PFIC for any taxable year in which, after taking into account the income and assets of the corporation and certain subsidiaries pursuant
to applicable "look-through rules”, either (i) at least 75% of its gross income is "passive income” or (ii) at least 50% of the average quarterly value of its assets is attributable to
assets which produce passive income or are held for the production of passive income. Passive income generally includes dividends, interest, rents and royalties (other than
certain rents and royalties derived in the active conduct of a trade or business), annuities and gains from assets that produce passive income. If a non-U.S. corporation owns at
least 25% by value of the stock of another corporation, the non-U.S. corporation is treated for purposes of the PFIC tests as owning its proportionate share of the assets of the
other corporation and as receiving directly its proportionate share of the other corporation’s income.

113

The Company believes it was a PFIC for the 2015 taxable year, but not for the taxable years 2016 through 2023. However, the fair market value of the Company’s assets may be
determined in large part by the market price of the Common Shares, which is likely to fluctuate, and the composition of the Company’s income and assets will be affected by how,
and how quickly, the Company spends any cash that is raised in any financing transaction. Thus, no assurance can be provided that the Company will not be classified as a PFIC
for the 2023 taxable year or any future taxable year. U.S. Holders should consult their tax advisors regarding the Company’s PFIC status.

If the Company is classified as a PFIC for any taxable year during which a U.S. Holder owns Common Shares, the U.S. Holder, absent certain elections (including the mark-to-market
and QEF elections described below), will generally be subject to adverse rules (regardless of whether the Company continues to be classified as a PFIC) with respect to (i) any
"excess  distributions”  (generally,  any  distributions  received  by  the  U.S.  Holder  on  the  Common  Shares  in  a  taxable  year  that  are  greater  than  125%  of  the  average  annual
distributions received by the U.S. Holder in the three preceding taxable years or, if shorter, the U.S. Holder’s holding period for the Common Shares) and (ii) any gain realized on
the sale or other disposition of the Common Shares.

Under these adverse rules (a) the excess distribution or gain will be allocated ratably over the U.S. Holder’s holding period, (b) the amount allocated to the current taxable year and
any taxable year prior to the first taxable year in which the Company is classified as a PFIC will be taxed as ordinary income and (c) the amount allocated to each of the other taxable

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
years during which the Company was classified as a PFIC will be subject to tax at the highest rate of tax in effect for the applicable category of taxpayer for that year and an interest
charge will be imposed with respect to the resulting tax attributable to each such other taxable year. A U.S. Holder that is not a corporation will be required to treat any such
interest paid as "personal interest”, which is not deductible.

U.S. Holders can avoid the adverse rules described above in part by making a mark-to-market election with respect to the Common Shares, provided that the Common Shares are
"marketable”.  The  Common  Shares will be marketable if they are "regularly traded” on a "qualified exchange” or other market within the meaning of applicable  U.S.  Treasury
regulations. For this purpose, the Common Shares generally will be considered to be regularly traded during any calendar year during which they are traded, other than in de
minimis quantities, on at least 15 days during each calendar quarter. The Common Shares are currently listed on the NASDAQ, which constitutes a qualified exchange; however,
there can be no assurance that the Common Shares will be treated as regularly traded for purposes of the mark-to-market election on a qualified exchange. If the Common Shares
were not regularly traded on the NASDAQ or were delisted from the NASDAQ and were not traded on another qualified exchange for the requisite time period described above, the
mark-to-market election would not be available.

A U.S. Holder that makes a mark-to-market election must include in gross income, as ordinary income, for each taxable year an amount equal to the excess, if any, of the fair market
value of the U.S. Holder’s Common Shares at the close of the taxable year over the U.S. Holder’s adjusted tax basis in the Common Shares. An electing U.S. Holder may also claim
an ordinary loss deduction for the excess, if any, of the U.S. Holder’s adjusted tax basis in the Common Shares over the fair market value of the Common Shares at the close of the
taxable year, but this deduction is allowable only to the extent of any net mark-to-market gains previously included in income. A U.S. Holder that makes a mark-to-market election
generally will adjust such U.S. Holder’s tax basis in the Common Shares to reflect the amount included in gross income or allowed as a deduction because of such mark-to-market
election. Gains from an actual sale or other disposition of the Common Shares will be treated as ordinary income, and any losses incurred on a sale or other disposition of the
Common Shares will be treated as ordinary losses to the extent of any net mark-to-market gains previously included in income.

If the Company is classified as a PFIC for any taxable year in which a U.S. Holder owns Common Shares but before a mark-to-market election is made, the adverse PFIC rules
described above will apply to any mark-to-market gain recognized in the year the election is made. Otherwise, a mark-to-market election will be effective for the taxable year for
which the election is made and all subsequent taxable years. The election cannot be revoked without the consent of the IRS unless the Common Shares cease to be marketable, in
which case the election is automatically terminated.

If the Company is classified as a PFIC, a U.S. Holder of Common Shares will generally be treated as owning stock owned by the Company in any direct or indirect subsidiaries that
are also PFICs and will be subject to similar adverse rules with respect to distributions to the Company by, and dispositions by the Company of, the stock of such subsidiaries. A
mark-to-market election is not permitted for the shares of any subsidiary of the Company that is also classified as a PFIC. U.S. Holders should consult their tax advisors regarding
the availability of, and procedure for making, a mark-to-market election.

114

In some cases, a shareholder of a PFIC can avoid the interest charge and the other adverse PFIC consequences described above by making a QEF election to be taxed currently on
its share of the PFIC’s undistributed income. We will endeavor to satisfy the record keeping requirements that apply to a QEF and to supply requesting U.S. Holders with the
information that such U.S. Holders are required to report under the QEF rules. However, there can be no assurance that the Company will satisfy the record keeping requirements or
provide the information required to be reported by U.S. Holders.

A U.S. Holder that makes a timely and effective QEF election for the first tax year in which its holding period of its Common Shares begins generally will not be subject to the
adverse PFIC consequences described above with respect to its Common Shares. Rather, a U.S. Holder that makes a timely and effective QEF election will be subject to U.S. federal
income tax on such U.S. Holder’s pro rata share of (a) the Company’s net capital gain, which will be taxed as long-term capital gain to such U.S. Holder, and (b) the Company’s
ordinary earnings, which will be taxed as ordinary income to such U.S. Holder, in each case regardless of which such amounts are actually distributed to the U.S. Holder by the
Company. Generally, "net capital gain” is the excess of (i) net long-term capital gain over (ii) net short-term capital loss, and "ordinary earnings” are the excess of (A) "earnings and
profits” over (B) net capital gain.

A  U.S.  Holder  that  makes  a  timely  and  effective  QEF  election  with  respect  to  the  Company  generally  (a)  may  receive  a  tax-free  distribution  from  us  to  the  extent  that  such
distribution represents "earnings and profits” that were previously included in income by the U.S. Holder because of such QEF election and (b) will adjust such U.S. Holder’s tax
basis in the Common Shares to reflect the amount included in income or allowed as a tax-free distribution because of such QEF election. In addition, a U.S. Holder that makes a QEF
election generally will recognize capital gain or loss on the sale or other taxable disposition of Common Shares.

The QEF election is made on a shareholder-by-shareholder basis. Once made, a QEF election will apply to the tax year for which the QEF election is made and to all subsequent tax
years, unless the QEF election is invalidated or terminated or the IRS consents to revocation of the QEF election. In addition, if a U.S. Holder makes a QEF election, the QEF
election will remain in effect (although it will not be applicable) during those tax years in which the Company is not a PFIC.

If the Company is classified as a PFIC and then ceases to be so classified, a U.S. Holder may make an election (a "deemed sale election”) to be treated for U.S. federal income tax
purposes as having sold such U.S. Holder’s Common Shares on the last day of the taxable year of the Company during which it was a PFIC. A U.S. Holder that made a deemed sale
election would then cease to be treated as owning stock in a PFIC by reason of ownership of Common Shares in the Company. However, gain recognized as a result of making the
deemed sale election would be subject to the adverse rules described above and loss would not be recognized.

If the Company is a PFIC in any year with respect to a U.S. Holder, the U.S. Holder will be required to file an annual information return on IRS Form 8621 regarding distributions
received on Common Shares and any gain realized on the disposition of Common Shares.

In addition, if the Company is a PFIC, U.S. Holders will generally be required to file an annual information return with the IRS (also on IRS Form 8621, which PFIC shareholders are
required to file with their U.S. federal income tax or information returns) relating to their ownership of Common Shares.

U.S. Holders should consult their tax advisors regarding the potential application of the PFIC regime and any reporting obligations to which they may be subject under that regime.

Dividends

Subject to the PFIC rules discussed above, any distributions paid by the Company out of current or accumulated earnings and profits (as determined for U.S. federal income tax
purposes), before reduction for any Canadian withholding tax paid with respect thereto, will generally be taxable to a U.S. Holder as foreign source dividend income, and generally
will not be eligible for the dividends received deduction generally allowed to corporations.

115

Distributions in excess of current and accumulated earnings and profits will be treated as a non-taxable return of capital to the extent of the U.S. Holder’s adjusted tax basis in the
Common Shares and thereafter as capital gain. The Company does not, however, intend to calculate its earnings and profits under U.S. federal income tax principles. Therefore, U.S.
Holders should expect that any distribution from the Company generally will be treated for U.S. federal income tax purposes as a dividend. U.S. Holders should consult their own
tax advisors with respect to the appropriate U.S. federal income tax treatment of any distribution received from the Company.

Dividends paid to non-corporate U.S. Holders by the Company in a taxable year in which it is treated as a PFIC, or in the immediately following taxable year, will not be eligible for
the special reduced rates normally applicable to long-term capital gains. In all other taxable years, dividends paid by the Company should be taxable to a non-corporate U.S. Holder

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
at the special reduced rates normally applicable to long-term capital gains, provided that certain conditions are satisfied. (including a minimum holding period requirement). The
Company believes it was not a PFIC for the 2023 taxable year. However, no assurance can be provided that the Company will not be classified as a PFIC for 2024 and, therefore, no
assurance can be provided that a U.S. Holder will be able to claim a reduced rate for dividends paid in 2023 or 2024 (if any). Please see the subsection above entitled "Material U.S.
Federal Income Tax Considerations—’Tax Consequences if we are a Passive Foreign Investment Company’” for a more detailed discussion.

Under current law, payments of dividends by the  Company to non-Canadian investors are generally subject to a 25%  Canadian withholding tax.  The rate of withholding tax
applicable to U.S. Holders that are eligible for benefits under the Canada-United States Tax Convention (the "Convention”) is reduced to a maximum of 15% (or 5% in the case of a
U.S. holder that is a company beneficially owning at least 10% of the Company’s voting shares). This reduced rate of withholding will not apply if the dividends received by a U.S.
Holder are effectively connected with a permanent establishment of the U.S. Holder in Canada. For U.S. federal income tax purposes, U.S. Holders will be treated as having received
the amount of Canadian taxes withheld by the Company, and as then having paid over the withheld taxes to the Canadian taxing authorities. As a result of this rule, the amount of
dividend income included in gross income for U.S. federal income tax purposes by a U.S. Holder with respect to a payment of dividends may be greater than the amount of cash
actually received (or receivable) by the U.S. Holder from the Company with respect to the payment.

Subject to certain limitations, a U.S. Holder will generally be entitled, at the election of the U.S. Holder, to a credit against its U.S. federal income tax liability, or a deduction in
computing its U.S. federal taxable income, for Canadian income taxes withheld by the Company. This election is made on a year-by-year basis and applies to all foreign taxes paid
(whether directly or through withholding) by a U.S. Holder during a year. For purposes of the foreign tax credit limitation, dividends paid by the Company generally will constitute
foreign  source  income  in  the  "passive  category  income”  basket.  The  foreign  tax  credit  rules  are  complex  and  U.S.  Holders  should  consult  their  tax  advisors  concerning  the
availability of the foreign tax credit in their particular circumstances.

Dividends paid in Canadian dollars will be included in the gross income of a U.S. Holder in a U.S. dollar amount calculated by reference to the exchange rate in effect on the date
the U.S. Holder (actually or constructively) receives the dividend, regardless of whether such Canadian dollars are actually converted into U.S. dollars at that time. If the Canadian
dollars received are not converted into U.S. dollars on the date of receipt, a U.S. Holder will have a tax basis in the Canadian dollars equal to their U.S. dollar value on the date of
receipt. Gain or loss, if any, realized on a sale or other disposition of the Canadian dollars will generally be U.S. source ordinary income or loss to a U.S. Holder.

The Company generally does not pay any dividends and does not anticipate paying any dividends in the foreseeable future.

Sale, Exchange or Other Taxable Disposition of Common Shares

Subject to the PFIC rules discussed above, upon a sale, exchange or other taxable disposition of Common Shares, a U.S. Holder generally will recognize capital gain or loss for U.S.
federal income tax purposes equal to the difference, if any, between the amount realized on the sale, exchange or other taxable disposition and the U.S. Holder’s adjusted tax basis
in the Common Shares.

This capital gain or loss will be long-term capital gain or loss if the U.S. Holder’s holding period in the Common Shares exceeds one year. The deductibility of capital losses is
subject to limitations. Any gain or loss will generally be U.S. source for U.S. foreign tax credit purposes.

116

Information Reporting and Backup Withholding

Payments made within the U.S., or by a U.S. payor or U.S. middleman, of dividends on, and proceeds arising from sales or other dispositions of Common Shares, generally will be
reported to the IRS and to the U.S. Holder as required under applicable regulations. Backup withholding tax may apply to these payments if the U.S. Holder fails to timely provide in
the appropriate manner an accurate taxpayer identification number or otherwise fails to comply with, or establish an exemption from, such backup withholding tax requirements.
Certain U.S. Holders are not subject to the information reporting or backup withholding tax requirements described herein. U.S. Holders should consult their tax advisors as to their
qualification for exemption from backup withholding tax and the procedure for establishing an exemption.

Backup withholding tax is not an additional tax. U.S. Holders generally will be allowed a refund or credit against their U.S. federal income tax liability for amounts withheld, provided
the required information is timely furnished to the IRS. The company assumes responsibility for the withholding of tax at the source.

Subject to certain exceptions and future guidance, a U.S. Holder that is a "specified individual” or a "specified domestic entity” (as defined in the instructions to IRS Form 8938)
must report annually to the IRS on IRS Form 8938 such U.S. Holder’s interests in stock or securities issued by a non-U.S. person (such as the Company). U.S. Holders should
consult their tax advisors regarding the information reporting obligations that may arise from their acquisition, ownership or disposition of Common Shares.

F.

Dividends and paying agents

We have never declared nor paid dividends on our securities and do not have paying agents therefor. We currently expect to retain future earnings, if any, for use in the operation
and expansion of our business and do not anticipate paying any cash dividends in the foreseeable future. Any future determination to pay dividends on our securities is subject to
the discretion of our Board of Directors and will depend upon various factors, including, without limitation, our results of operations and financial condition.

G.

Statement by experts

Not required.

H.

Documents on display

117

In addition to placing our audited consolidated annual financial statements before every annual meeting of shareholders as described above, we are subject to the information
requirements of the Securities Exchange Act of 1934, as amended. In accordance with these requirements, we file and furnish reports and other information with the SEC. These
materials, including this Annual Report on Form 20-F and the exhibits hereto, may be inspected and copied at the SEC’s Public Reference Room at 100 F Street, N.E., Room 1580,
Washington, D.C. 20549. The public may obtain information on the operation of the SEC’s Public Reference Room by calling the SEC in the U.S. at 1-800-SEC-0330. The SEC also
maintains a website at www.sec.gov that contains reports, proxy statements and other information regarding registrants that file electronically with the SEC. Our annual reports and
some  of  the  other  information  we  submitted  to  the  SEC  may  be  accessed  through  this  website.  In  addition,  material  we  filed  can  be  inspected  on  the  Canadian  Securities
Administrators’ electronic filing system, SEDAR+, accessible at the website www.sedarplus.ca. This material includes our Management Information Circular for our annual meeting
of shareholders to be held in 2024 to be furnished to the SEC on Form 6-K, which provides information including directors’ and officers’ remuneration and indebtedness and
principal holders of securities. Additional financial information is provided in our audited annual financial statements for the year ended December 31, 2023 and our MD&A relating
to these statements included elsewhere in this Annual Report on Form 20-F. These documents are also accessible on SEDAR+ (www.sedarplus.ca) and on EDGAR (www.sec.gov).

I.

Subsidiary information

Not required.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 11.

Quantitative and Qualitative Disclosures About Market Risk

Fair value

The Company classifies its financial instruments in the following categories: "Financial assets at amortized cost”; and "Financial liabilities at amortized cost”.

● The Company’s financial assets at amortized cost are comprised of cash and cash equivalents, trade and other receivables and restricted cash equivalents.
● Financial liabilities at amortized cost include payables and accrued liabilities, and lease liability.

The carrying values of all of the aforementioned financial instruments approximate their fair values due to their short-term maturity or to the prevailing interest rates of these
instruments which are comparable to those of the market.

The Black-Scholes valuation methodology uses inputs in calculating fair value, as defined in IFRS 13, which establishes a hierarchy that prioritizes the inputs used to measure fair
value. The hierarchy gives the highest priority to unadjusted quoted prices in active markets for identical assets or liabilities (Level 1 measurement) and the lowest priority to
unobservable inputs (Level 3 measurement).

Financial risk factors

The following provides disclosures relating to the nature and extent of the Company’s exposure to risks arising from financial instruments, including credit risk, liquidity risk and
foreign exchange risk and how the Company manages those risks.

(a)

Credit risk

Credit risk is the risk of an unexpected loss if a customer or counterparty to a financial instrument fails to meet its contractual obligations. The Company regularly monitors credit
risk exposure and takes steps to mitigate the likelihood of this exposure resulting in losses. The Company’s exposure to credit risk currently relates to the financial assets at
amortized cost in the table above. The Company holds its available cash in amounts that are readily convertible to known amounts of cash and deposits its cash balances with
financial institutions that have an investment grade rating of at least "P-2” or the equivalent. This information is supplied by independent rating agencies where available and, if
not available, the  Company uses publicly available financial information to ensure that it invests its cash in creditworthy and reputable financial institutions.  Once there are
indicators that there is no reasonable expectation of recovery, such financial assets are written off but are still subject to enforcement activity.

118

As of December 31, 2023, three counterparties included in trade accounts receivable comprised a total receivable of approximately $67 (2022 - three counterparties for $403) of
which $nil (2022 - $nil) was past due, considered to be impaired and fully provided for.

Generally,  the  Company  does  not  require  collateral  or  other  security  from  customers  for  trade  accounts  receivable;  however,  credit  is  extended  following  an  evaluation  of
creditworthiness. In addition, the Company performs ongoing credit reviews of all of its customers and determines expected credit losses. On this basis, as of December 31, 2023,
the Company has provided for all outstanding and unpaid amounts relating to its operations.

The maximum exposure to credit risk approximates the amount recognized in the Company’s consolidated statement of financial position.

(b)

Liquidity risk

Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they become due. The Company manages this risk through the management of its
capital structure by monitoring rolling forecasts of the Company’s cash and cash equivalents on the basis of expected cash flows.

Management concluded that the Company has sufficient cash on hand to meet its obligations as they become due for the next 12 months, considering the Company’s planned
research and development activities, selling expenses, general and administrative expenses and working capital requirements. The Company has the ability to scale its research and
development activities, and will do so as necessary, based on cash availability. While the Company has $34,016 in cash and cash equivalents at December 31, 2023, it continues to
have an ongoing need for additional capital resources to research and develop, commercialize and manufacture its products and technologies.

All of the Company’s financial liabilities except lease liabilities are current liabilities with expected settlement dates within one year.

(c)

Foreign exchange risk

Entities using the Euro as their functional currency

The Company is exposed to foreign exchange risk due to its investments in foreign operations whose functional currency is the Euro. As of December 31, 2023, if the US dollar had
increased or decreased by 10% against the  Euro, with all other variables held constant, net loss for the year ended  December 31, 2023 would have been lower or higher by
approximately $1,055 (2022 - $823 and 2021 - $300).

Item 12.

Description of Securities Other than Equity Securities

A.

Debt securities

Not required.

B.

Warrants and rights

Not required.

C.

Other securities

Not required.

D.

American depositary shares

Not applicable.

119

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 13.

Defaults, Dividend Arrearages and Delinquencies

None.

Item 14.

Material Modifications to the Rights of Security Holders and Use of Proceeds

PART II

None.

Item 15.

Controls and Procedures

Under the supervision and with the participation of our management, including the Chief Executive Officer and the Chief Financial Officer, we have evaluated the effectiveness of
our disclosure controls and procedures as of December 31, 2023. Our disclosure controls and procedures are designed to ensure that information required to be disclosed in the
reports  we  file  or  submit  under  the  Securities  Exchange Act  of  1934  is  recorded,  processed,  summarized  and  reported  within  the  time  periods  specified  in  the  Securities  and
Exchange Commission’s rules and forms, and that such information is accumulated and communicated to our management, including the Chief Executive Officer and the Chief
Financial Officer, to allow timely decisions regarding required disclosures.

Any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objective and management
necessarily applies its judgment in evaluating the cost-benefit relationship of possible controls and procedures. Based on this evaluation, the Chief Executive Officer and Chief
Financial Officer have concluded that these disclosure controls and procedures were effective as of December 31, 2023.

Management’s Annual Report on Internal Control over Financial Reporting

Our  management  is  responsible  for  establishing  and  maintaining  adequate  internal  control  over  financial  reporting.  Our  internal  control  over  financial  reporting  is  a  process
designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with IFRS.

Our internal control over financial reporting includes those policies and procedures that: (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly
reflect the transactions and dispositions of the assets of Aeterna Zentaris; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of
financial statements in accordance with IFRS, and that receipts and expenditures of the Company are being made only in accordance with authorizations of Company management;
and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use or disposition of Company assets that could have a material effect
on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future
periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may
deteriorate.

120

Remediation of Previously Reported Material Weakness

As previously disclosed in our annual report Item 15 – "Controls and Procedures” in our Annual Report on Form 20-F for the year ended December 31, 2021, our management
identified a material weakness in our control over financial reporting that resulted from a failure in the design and implementation of review controls over the accounting for license
and collaboration agreements under IFRS and the related revenue recognition. Due to remediation measures taken by us during 2022 to implement and subsequently test newly
established policies, procedures, and control activities designed to address the material weakness, management has concluded that this material weakness was remediated as of
December 31, 2022.

Our management assessed our internal control over financial reporting as of December 31, 2023. Management based its assessment on criteria established in "Internal Control—
Integrated Framework (2013)” issued by the Committee of Sponsoring Organizations of the Treadway Commission. Based on management’s assessment of our internal control over
financial reporting, management concluded that, as of December 31, 2023, our internal control over financial reporting was effective.

Changes in Internal Controls over Financial Reporting

There were no changes in our internal control over financial reporting during the year ended December 31, 2023, that materially affected, or are reasonably likely to materially affect,
our internal control over financial reporting.

Item 16A. Audit Committee Financial Expert

Our Board has determined that we have at least one audit committee financial expert (as defined in paragraph (b) of Item 16A to Form 20-F). The name of the audit committee
financial expert is Mr. Dennis Turpin, the Audit Committee’s Chairman. In accordance with Item 16A, paragraph (d) of Form 20-F, the designation of Mr. Turpin as our audit
committee financial expert does not: (i) make Mr. Turpin an "expert” for any purpose, including without limitation for purposes of Section 11 of the Securities Act of 1933, as
amended, as a result of this designation; (ii) impose any duties, obligations or liability on  Mr.  Turpin that are greater than those imposed on him as a member of the Audit
Committee and the Board in the absence of such designation; or (iii) affect the duties, obligations or liability of any other member of the Audit Committee or the Board. The other
current members of the Audit Committee are Peter G. Edwards and Gilles Gagnon each of whom, along with Dennis Turpin (Chair), is independent, as that term is defined in the
NASDAQ listing standards and Rule 10A-3 under the Securities Exchange Act of 1934, as amended. For a description of their respective education and experience, please refer to
"Item 6. – Directors, Senior Management and Employees”.

Item 16B. Code of Ethics

On February 2, 2023, we adopted a Code of Ethics for all directors, officers and employees that complies with the Nasdaq rules and the definition of a "code of ethics” set forth in
Section 406(c) of the Sarbanes-Oxley Act of 2002, as amended. We have filed our Code of Ethics as Exhibit 11.1 to this Annual Report on Form 20-F. A copy of our Code of Ethics
is posted on the "Corporate Governance – Governance Documents” page of our website at https://www.zentaris.com/governance-docs. We expect that any amendment to our
Code of Ethics, or any waivers of its requirements, will be disclosed on our website. We will also provide a copy of our Code of Ethics without charge to any person or company
upon request to our Corporate Secretary, at our principal executive offices at c/o Norton Rose Fulbright Canada, LLP, 222 Bay Street, Suite 3000, PO Box 53, Toronto ON M5K 1E7.

Item 16C.

Principal Accountant Fees and Services

(All amounts are in U.S. dollars)

The current auditors of the Company are Deloitte LLP. Deloitte LLP was appointed as the Company’s auditor on June 14, 2023 and Ernst & Young LLP resigned as the Company’s

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
auditor on March 25, 2023.

(a)

Audit Fees

During the financial year ended December 31, 2023, the Company’s principal accountant, Deloitte LLP, billed $394,345 for the audit of the Company’s annual consolidated financial
statements and for services rendered in connection with statutory and regulatory filings and the Company’s previous principal accountant, Ernst & Young LLP billed $31,526.  for
the review of the Company’s quarterly consolidated financial statements. During the financial year ended December 31, 2022, the Company’s principal accountant, Ernst & Young
LLP, billed $348,498, for the audit of the Company’s annual consolidated financial statements and for services rendered in connection with statutory and regulatory filings.

121

(b)

Audit-related Fees

During the financial year ended  December 31, 2023, the  Company’s principal accountant,  Deloitte  LLP, billed $58,639.  During the financial year ended  December 31, 2022, the
Company’s principal accountant, Ernst & Young LLP, billed $nil.

(c)

Tax Fees

During the financial year ended December 31, 2023, the Company’s principal accountants, Deloitte LLP, billed $nil, for services related to tax compliance, tax planning and tax
advice. During the financial year ended December 31, 2022, the Company’s principal accountants, Ernst & Young LLP, billed $15,646, for services related to tax compliance, tax
planning and tax advice.

(d)

All Other Fees

During the financial year ended December 31, 2023, the Company’s principal accountant, Deloitte LLP, billed us $5,198 for services not included in audit fees, audit-related fees and
tax fees. During the financial year ended December 31, 2022, the Company’s principal accountant, Ernst & Young LLP, billed us $nil for services not included in audit fees, audit-
related fees and tax fees.

(e)

Audit Committee Pre-Approval Policies and Procedures

Under applicable Canadian securities regulations, we are required to disclose whether our Audit Committee has adopted specific policies and procedures for the engagement of
non-audit services and to prepare a summary of these policies and procedures. The Audit Committee Charter (incorporated by reference as Exhibit 11.3 to this Annual Report on
Form 20-F) provides that it is such committee’s responsibility to approve all audit engagement fees and terms as well as reviewing policies for the provision of non-audit services
by the external auditors and, when required, the framework for pre-approval of such services. The Audit Committee delegates to its Chairman the pre-approval of such non-audit
fees. The pre-approval by the Chairman is then presented to the Audit Committee at its first scheduled meeting following such pre-approval.

For the year ended December 31, 2023 the Company’s principal accountant, Deloitte LLP, billed us $58,639 for non-audit services that were approved by the Audit Committee. For
the year ended December 31, 2022, there were no non-audit services provided by our external auditor that required the approval from the Audit Committee.

Item 16D.

Exemptions from the Listing Standards for Audit Committees

None.

Item 16E.

Purchases of Equity Securities by the Issuer and Affiliated Purchasers

None.

Item 16F.

Change in Registrant’s Certifying Accountant

On March 25, 2023 its auditor, Ernst & Young LLP ("E&Y”), advised the Company that it has declined to stand for reappointment to conduct the audit of the Company’s financial
statements for the fiscal year ending December 31, 2023. E&Y completed the audit for the financial fiscal year ended December 31, 2022. Following a comprehensive review of the
Company’s external audit services, the Audit Committee sought proposals to provide audit services for the financial year ending on December 31, 2023. After careful review of the
proposals received and due consideration of all relevant factors, the Audit Committee recommended to the Board that Deloitte LLP be proposed for appointment as auditors of the
Company for the financial year ending on December 31, 2023. Deloitte LLP was appointed as the Company’s auditor effective June 14, 2023.

122

Ernst & Young LLP’s audit reports on the Company’s consolidated financial statements as of and for the fiscal years ended December 31, 2022 and 2021 did not contain any
adverse opinion or a disclaimer of opinion and were not qualified or modified as to uncertainty, audit scope or accounting principles. Additionally, during the two fiscal years
ended December 31, 2022 and 2021, there were no (1) disagreements (as described under Item 16F(a)(1)(iv) of Form 20-F and the related instructions thereto) with Ernst & Young
LLP on any matter of accounting principles or practices, financial statement disclosure, or auditing scope or procedures, which if not resolved to the satisfaction of Ernst & Young
LLP would have caused Ernst & Young LLP to make reference to the subject matter of the disagreement in their report or (2) "reportable events” (within the meaning of Item 16F(a)
(1)(v) of Form 20-F and the related instructions thereto) except that, in connection with the preparation of the Company’s consolidated financial statements as of December 31,
2021, Ernst & Young LLP and management identified a material weakness in the Company’s internal controls as described in the Company’s Annual Report on Form 20-F for the
year ended December 31, 2021, which was remediated as of December 31, 2022 or (3) reportable events, disagreements or unresolved issues (as such terms are defined in Canadian
securities legislation).

The text above is substantially the same as that which was included in our report on Form 6-K furnished to the SEC on March 31, 2023, which was provided to Ernst & Young LLP
and on which we requested and received from Ernst & Young LLP a letter addressed to the SEC stating whether or not Ernst & Young LLP agrees with the statements therein. A
copy of Ernst & Young LLP’s letter, dated March 31, 2023, is hereby incorporated by reference as Exhibit 16.1 to this annual report.

In the past two years the independent auditor’s reports have not contained an adverse opinion or a disclaimer of opinion, or was qualified or modified as to uncertainty, audit
scope,  or  accounting  principles.  Further,  there  have  been  no  disagreements  with  a  former  independent  auditor  on  any  matter  of  accounting  principles  or  practices,  financial
statement disclosure, or auditing scope or procedure, which disagreement, if not resolved to the satisfaction of the former accountant, would have caused it to make reference to
the subject matter of the disagreement in connection with its report.

Item 16G. Corporate Governance

We are generally in compliance with the corporate governance requirements of the NASDAQ except as described below and in the risk factor entitled "Our Common Shares may be
delisted from the NASDAQ or the TSX, which could affect their market price and liquidity. If our Common Shares were to be delisted, investors may have difficulty in disposing

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
their Common Shares” in Item 3.D above. We are not in compliance with the NASDAQ requirement that a quorum for a meeting of the holders of our Common Shares be no less
than 33 1/3% of such outstanding shares. Our bylaws provide that a quorum for purposes of any meeting of our shareholders consists of at least 10% of the outstanding voting
shares. We benefit from an exemption from the NASDAQ from this quorum requirement because the quorum provided for in our bylaws complies with the requirements of the
CBCA, our governing corporate statute, and with the rules of the TSX, the home country exchange on which our voting shares are traded. In accordance with applicable current
NASDAQ requirements, we have in the past, and upon request, provided to the NASDAQ letters from outside counsel certifying that these practices are not prohibited by our
home country law.

Item 16H. Mine Safety Disclosure

None.

Item 16I.

Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

Not applicable.

Item 16J.

Insider Trading Policies

Not applicable.

Item 16K. Cybersecurity

123

We recognize the critical importance of maintaining the trust and confidence of all of our stakeholders. Our business depends on the efficient and uninterrupted operation of our
information technology systems and those of our third-party vendors. Our board of directors is actively involved in oversight of our risk management program, and cybersecurity
represents an important component of our risk management and compliance program.

Our cybersecurity policies, standards, processes and practices are fully integrated into the Company’s enterprise-wide risk management and compliance program and overseen by
the Audit Committee and our CFO. In general, we seek to address cybersecurity risks through a comprehensive, cross-functional approach that is focused on preserving the
confidentiality, security and availability of the information that we collect and store by identifying, preventing and mitigating cybersecurity threats and effectively responding to
cybersecurity incidents when they occur.

Risk Management and Strategy

As one of the critical elements of the Company’s overall risk management and compliance approach, the Company’s cybersecurity program is focused on the following key areas:

Governance:  The  Board’s  oversight  of  cybersecurity  risk  management  is  led  by  the Audit  Committee  of  the  Board,  which  regularly  interacts  with  our  CFO,  our  Information
technology partners and other members of management.

Collaborative Approach: We have implemented a comprehensive, cross-functional approach to identifying, preventing and mitigating cybersecurity threats and incidents, while
also implementing controls and procedures that provide for the prompt escalation of certain cybersecurity incidents so that decisions regarding the public disclosure and reporting
of such incidents can be made by management in a timely manner.

Technical Safeguards: We deploy technical safeguards that are designed to protect our information systems from cybersecurity threats, including firewalls, intrusion prevention
and detection systems, Security Information and Event Management systems, Extended Detection and Response with 24/7 Security Operations Center, anti-malware functionality
and access controls, which are evaluated and improved through vulnerability assessments and cybersecurity threat intelligence.

Incident Response and Recovery Planning: We have established and maintain comprehensive incident response and recovery plans to address our response to a cybersecurity
incident, and such plans are tested and evaluated on a regular basis.

Third-Party  Risk  Management:  We  maintain  a  risk-based  approach  to  identifying  and  overseeing  cybersecurity  risks  presented  by  third  parties,  including  vendors,  service
providers and other external users of our systems, as well as the systems of third parties that could adversely impact our business in the event of a cybersecurity incident affecting
those third-party systems.

Education  and Awareness :  We  provide  regular  training  for  personnel  regarding  cybersecurity  threats  as  a  means  to  equip  our  employees  with  effective  tools  to  address
cybersecurity threats, and to communicate our evolving information security policies, standards, processes and practices.

PART III

Item 17

Financial Statements

Not applicable.

Item 18.

Financial Statements

The financial statements and related notes required by this Item 18 are included in this Annual Report beginning on page F-1.

124

Aeterna Zentaris Inc.

Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021

Report of Independent Registered Public Accounting Firm (PCAOB ID:1208)
Report of Predecessor Independent Registered Public Accounting Firm (PCAOB ID:1263)
Consolidated Statements of Financial Position
Consolidated Statements of Changes in Shareholders’ Equity
Consolidated Statements of Loss and Comprehensive Loss
Consolidated Statements of Cash Flows

F-2
F-3
F-4
F-5
F-6
F-7

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements

F-8

F-1

Report of Independent Registered Public Accounting Firm

To the Shareholders and the Board of Directors of
Aeterna Zentaris Inc.

Opinion on the Financial Statements

We have audited the accompanying consolidated statement of financial position of Aeterna Zentaris Inc. and subsidiaries (the "Company”) as of December 31, 2023, the related
consolidated  statements  of  changes  in  shareholders’  equity,  loss  and  comprehensive  loss,  and  cash  flows,  for  the  year  ended  December  31,  2023,  and  the  related  notes
(collectively referred to as the "financial statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of
December 31, 2023, and its financial performance and its cash flows for the year ended December 31, 2023, in accordance with International Financial Reporting Standards as issued
by the International Accounting Standards Board.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our
audit. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect
to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about
whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of
its internal control over financial reporting. As part of our audit, we are required to obtain an understanding of internal control over financial reporting but not for the purpose of
expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audit included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that
respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audit also included
evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe
that our audit provides a reasonable basis for our opinion.

Critical Audit Matter

The critical audit matter communicated below is a matter arising from the current-period audit of the financial statements that was communicated or required to be communicated to
the audit committee and that (1) relates to accounts or disclosures that are material to the financial statements and (2) involved our especially challenging, subjective, or complex
judgments. The communication of critical audit matters does not alter in any way our opinion on the financial statements, taken as a whole, and we are not, by communicating the
critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates.

Research and development ("R&D”) accruals – Refer to Notes 3, 8 and 12 of the financial statements

Critical Audit Matter Description

The Company carries out R&D activities including contracts with clinical research organizations and contract manufacturing organizations. Management applies judgment when
reviewing  open  contracts  and  purchase  orders,  communicating  with  the  Company’s  personnel  to  identify  services  that  have  been  performed  on  the  Company’s  behalf  and
estimating the level of service performed and the associated cost incurred for the service when the Company has not yet been invoiced or otherwise notified of the actual cost. The
Company adjusts the accrued or prepaid expense balance accordingly.

We identified the estimation of R&D accruals as a critical audit matter due to the judgment made by management. This resulted in an increased extent of audit effort.

How the Critical Audit Matter Was Addressed in the Audit

Our audit procedures related to the evaluation of R&D accruals included the following, among others:

● For a sample of open contracts and purchase orders:

-

Assessed the Company’s estimates of the activities completed to date by (i) inspecting original contract terms, change orders and the expected timeline for the related
study, (ii) obtaining third party reports detailing progress of the study, and (iii) discussing the status of the study with certain members of management and project teams;

● For a sample of subsequent disbursements related to R&D expenses:

-

Assessed whether the related purchase orders were properly accrued for as at year-end;

● Inspecting (i) publicly available information (such as press releases and investor presentations) and (ii) board of directors’ materials, as available, regarding the status of the

studies and assess any contradictory evidence over the advancement of the studies.

/s/ Deloitte LLP
Chartered Professional Accountants
Montreal, Canada
March 26, 2024
We have served as the Company’s auditor since 2023.

To the Shareholders and the Board of Directors of
Aeterna Zentaris Inc.

F-2

Report of Independent Registered Public Accounting Firm

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Opinion on the Financial Statements

We  have  audited  the  accompanying  consolidated  statement  of  financial  position  of Aeterna  Zentaris  Inc.  (the  Company)  as  of  December  31,  2022,  the  related  consolidated
statements of changes in shareholders’ equity, loss and comprehensive loss, and cash flows, for each of the two years in the period ended December 31, 2022, and the related
notes (collectively referred to as the "consolidated financial statements”). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial
position of the Company as of December 31, 2022, and its financial performance and its cash flows for each of the two years in the period ended December 31, 2022, in conformity
with International Financial Reporting Standards (IFRSs) as issued by the International Accounting Standards Board.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our
audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect
to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about
whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of
its internal control over financial reporting. As part of our audits, we are required to obtain an understanding of internal control over financial reporting but not for the purpose of
expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.

Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that
respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the financial statements. Our audits also included
evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements.
We believe that our audits provide a reasonable basis for our opinion.

/s/ Ernst & Young LLP

We served as the Company’s auditor from 2021 to 2023.

Montreal, Canada
March 22, 2023

F-3

Aeterna Zentaris Inc.
Consolidated Statements of Financial Position
As of December 31, 2023 and 2022
(in thousands of US dollars)

ASSETS
Current assets
Cash and cash equivalents (note 6)
Trade and other receivables (note 7)
Inventory
Income taxes receivable
Prepaid expenses and other current assets (note 8)
Total current assets

Non-current assets
Restricted cash equivalents (note 6)
Property and equipment (note 9)
Total non-current assets
Total assets

LIABILITIES
Current liabilities
Payables and accrued liabilities (note 12)
Provisions (note 13)
Income taxes payable
Deferred revenues (note 5)
Lease liabilities (note 14)
Total current liabilities
Non-current liabilities
Deferred revenues (note 5)
Deferred gain
Lease liabilities (note 14)
Employee future benefits (note 15)
Provisions
Total non-current liabilities
Total liabilities

Shareholders’ equity
Share capital (note 16)
Warrants (note 17)
Contributed surplus (note 18)
Deficit
Accumulated other comprehensive loss
Total Shareholders’ equity
Total liabilities and shareholders’ equity

2023
$

2022
$

34,016   
222   
66   
121   
1,942   
36,367   

332   
317   
649   
37,016   

3,622   
429   
111   
218   
160   
4,540   

1,544   
-   
119   
12,617   
-   
14,280   
18,820   

293,410   
5,085   
90,710   
(369,831)  
(1,178)  
18,196   
37,016   

50,611 
732 
229 
1,428 
2,488 
55,488 

322 
216 
538 
56,026 

3,828 
45 
108 
2,949 
114 
7,044 

1,684 
110 
65 
11,159 
188 
13,206 
20,250 

293,410 
5,085 
90,332 
(352,084)
(967)
35,776 
56,026 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Commitments (note 26)
Subsequent event (note 28)

The accompanying notes are an integral part of these consolidated financial statements.

Approved by the Board of Directors

/s/ Carolyn Egbert
Carolyn Egbert, Chair of the Board

Aeterna Zentaris Inc.
Consolidated Statements of Changes in Shareholders’ Equity
For the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars)

/s/ Dennis Turpin
  Dennis Turpin, Director

F-4

Share
capital
$

    Warrants    

Balance - January 1, 2021
Net loss
Other comprehensive loss:

Foreign currency translation adjustments
Actuarial loss on defined benefit plans and remeasurement of the
net defined benefit liability

Comprehensive loss
Issuance of common shares and warrants, net of transaction costs
(note 16)
Exercise of warrants (note 17)
Transfer of warrant issuance costs on exercise of warrants (note 17)  
Exercise of deferred share units
Share-based compensation costs
Balance - December 31, 2021
Net loss
Other comprehensive loss:

Foreign currency translation adjustments
Actuarial gain on defined benefit plans and remeasurement of the
net defined benefit liability (note 15)

Comprehensive loss
Share-based compensation costs
Balance – December 31, 2022
Net loss
Other comprehensive loss:

Foreign currency translation adjustments
Actuarial loss on defined benefit plans and remeasurement of the
net defined benefit liability (note 15)

Comprehensive loss
Share-based compensation costs
Balance – December 31, 2023

235,008   
-   

-   

-   
-   

29,082   
29,833   
(532)  
19   
-   
293,410   
-   

-   

-   
-   
-   
293,410   
-   

-   

-   
-   
-   
293,410   

The accompanying notes are an integral part of these consolidated financial statements.

F-5

Aeterna Zentaris Inc.
Consolidated Statements of Loss and Comprehensive Loss
For the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data)

Contributed
Surplus
$
89,505   
-   

-   

-   
-   

-   
-   
-   
(28)  
311   
89,788   
-   

Deficit
$

(322,659)  
(8,368)  

-   

(3,592)  
(11,960)  

-   
-   
-   
-   
-   
(334,619)  
(22,727)  

-   

-   

-   
-   
544   
90,332   
-   

5,262   
(17,465)  
-   
(352,084)  
(16,552)  

-   

-   

-   
-   
378   
90,710   

(1,195)  
(17,747)  
-   
(369,831)  

Accumulated
other
comprehensive
income (loss)    

$

(1,045)  
-   

367   

-   
367   

-   
-   
-   
-   
-   
(678)  
-   

(289)  

-   
(289)  
-   
(967)  
-   

(211)  

-   
(211)  
-   
(1,178)  

$
12,402   
-   

-   

-   
-   

1,897   
(9,746)  
532   
-   
-   
5,085   
-   

-   

-   
-   
-   
5,085   
-   

-   

-   
-   
-   
5,085   

Revenues (note 5)

Expenses
Cost of sales
Research and development
Selling, general and administrative
Impairment of intangible assets (note 10)
Impairment of goodwill (note 11)
Impairment of other assets (note 7)
Total expenses
Loss from operations

2023

Years ended December 31,
2022

2021

 $   
4,498   

222   
13,560   
8,724   
-   
-   
-   
22,506   
(18,008)  

$   
5,640   

157   
12,506   
8,230   
584   
7,642   
124   
29,243   
(23,603)  

Total
$
13,211 
(8,368)

367 

(3,592)
(11,593)

30,979 
20,087 
- 
(9)
311 
52,986 
(22,727)

(289)

5,262 
(17,754)
544 
35,776 
(16,552)

(211)

(1,195)
(17,958)
378 
18,196 

$ 
5,260 

90 
6,574 
7,267 
- 
- 
- 
13,931 
(8,671)

 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(Loss) gain due to changes in foreign currency exchange rates
Gain on sale of intangible asset (note 10)
Interest income
Net other costs
Net other income (costs)

Loss before income taxes

Income tax recovery
Net loss
Other comprehensive loss:
Items that may be reclassified subsequently to profit or loss:
Foreign currency translation adjustments
Items that will not be reclassified to profit or loss:
Actuarial (loss) gain on defined benefit plans (note 15)
Comprehensive loss

Basic and diluted loss per share (note 25)

The accompanying notes are an integral part of these consolidated financial statement

F-6

(206)  
549   
1,126   
(13)  
1,456   

(16,552)  

-   
(16,552)  

(211)  

(1,195)  
(17,958)  

(3.41)  

879   
-   
-   
(3)  
876   

(22,727)  

-   
(22,727)  

(289)  

5,262   
(17,754)  

(4.68)  

Aeterna Zentaris Inc.
Consolidated Statements of Cash Flows
For the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars)

Cash flows from operating activities
Net loss
Items not affecting cash and cash equivalents:

Amortization of deferred revenues
Share-based compensation costs
Movement in provisions
Depreciation and amortization
Employee future benefits
Gain on disposal of property and equipment
Gain on sale of intangible asset (note 10)
Interest accretion on lease liabilities
Net foreign exchange differences
Impairment of intangible assets (note 10)
Impairment of goodwill (note 11)
Impairment of other assets
Other non-cash items

Refund (payment) of income taxes
Changes in operating assets and liabilities (note 20)
Net cash (used in) provided by operating activities

Cash flows from financing activities
Proceeds from issuances of common shares and warrants (note 16)
Transaction costs
Proceeds from exercise of warrants
Proceeds on deferred gain
Payments on lease liabilities
Net cash (used in) provided by financing activities

Cash flows from investing activities
Purchase of intangible assets
Purchase of property and equipment
Proceeds from disposals of property and equipment
Proceeds from sale of intangible asset (note 10)
Decrease in restricted cash equivalents
Net cash provided by (used in) investing activities

Effect of exchange rate changes on cash and cash equivalents

Net change in cash and cash equivalents
Cash and cash equivalents – beginning of year
Cash and cash equivalents – end of year

The accompanying notes are an integral part of these consolidated financial statements.

F-7

2023
$

Years ended December 31,
2022
$

2021
$

(16,552)  

(1,607)  
378   
224   
169   
520   
-   
(549)  
13   
(7)  
-   
-   
-   
-   
1,329   
(1,036)  
(17,118)  

-   
-   
-   
-   
(151)  
(151)  

-   
(19)  
-   
549   
(2)  
528   

146   

(16,595)  
50,611   
34,016   

(22,727)  

(1,704)  
544   
(28)  
135   
295   
-   
-   
4   
16   
584   
7,642   
124   
-   
831   
604   
(13,680)  

-   
-   
-   
16   
(134)  
(118)  

-   
(11)  
-   
-   
(1)  
(12)  

(879)  

(14,689)  
65,300   
50,611   

215 
- 
- 
(21)
194 

(8,477)

109 
(8,368)

367 

(3,592)
(11,593)

(1.82)

(8,368)

(1,670)
311 
23 
145 
161 
(1)
- 
7 
(179)
- 
- 
- 
95 
(1,605)
2,500 
(8,581)

34,200 
(3,221)
20,087 
98 
(127)
51,037 

(609)
(30)
1 
- 
(20)
(658)

(769)

41,029 
24,271 
65,300 

 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
   
 
   
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

1. Business overview

Summary of business

Aeterna Zentaris ("Aeterna” or the "Company”) is a specialty biopharmaceutical company commercializing and developing therapeutics and diagnostic tests. The Company’s
lead product,  Macrilen® (macimorelin), is the first and only  U.S.  Food and  Drug Administration ("FDA”) and  European  Medicines Agency  ("EMA”)  approved  oral  test
indicated for the diagnosis of patients with adult growth hormone deficiency ("AGHD”). Macimorelin is currently marketed under the tradename Ghryvelin™ in the European
Economic Area and the United Kingdom through an exclusive licensing agreement with Pharmanovia. The Company’s several other license and commercialization partners are
also seeking approval for commercialization of macimorelin in Israel and the Palestinian Authority, the Republic of Korea, Turkey and several non-European Union Balkan
countries. The Company is actively pursuing business development opportunities for the commercialization of macimorelin in North America, Asia and the rest of the world.

The Company is also dedicated to the development of therapeutic assets and has taken steps to establish a pre-clinical pipeline to potentially address unmet medical needs
across several indications with a focus on rare or orphan indications.

Reporting entity

The accompanying consolidated financial statements include the accounts of Aeterna Zentaris Inc., an entity incorporated under the Canada Business Corporations Act, and
its wholly owned subsidiaries (the "Group”). Aeterna Zentaris Inc. is the ultimate parent company of the Group. The Company currently has three wholly owned direct and
indirect subsidiaries, Aeterna Zentaris GmbH ("AEZS Germany”), based in Frankfurt, Germany, Zentaris IVF GmbH, a wholly owned subsidiary of AEZS Germany, based in
Frankfurt, Germany, and Aeterna Zentaris, Inc., an entity incorporated in the state of Delaware and with offices in Summerville, South Carolina, in the US.

The registered office of the Company is located at 222 Bay Street, Suite 3000, P.O. Box 53, Toronto, Ontario M5K 1E7, Canada.

The Company’s common shares are listed on both the Toronto Stock Exchange and on the NASDAQ Capital Market.

Basis of presentation

(a) Statement of compliance

These consolidated financial statements as of December 31, 2023, and 2022 and for the years ended December 31, 2023, 2022 and 2021 have been prepared in accordance with
International Financial Reporting Standards as issued by the International Accounting Standards Board ("IFRS”).

These consolidated financial statements were approved by the Company’s Board of Directors on March 26, 2024.

The  preparation  of  financial  statements  in  accordance  with  IFRS  requires  the  use  of  certain  critical  accounting  estimates  and  the  exercise  of  management’s  judgment  in
applying the Company’s accounting policies. Areas involving a high degree of judgment or complexity and areas where assumptions and estimates are significant to the
Company’s consolidated financial statements are discussed in note 3 - Critical accounting estimates and judgments.

F-8

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

(b) Basis of measurement

The consolidated financial statements have been prepared under a historical cost convention.

(c) Principles of consolidation

These consolidated financial statements include any entity for which the Company has power over, through existing rights providing the current ability to direct the relevant
activities. The Company controls an entity when the Company is exposed to, or has rights to, variable returns from its involvement with the entity and has the ability to affect
those returns through its power over the entity. An entity is included in the consolidation from the date that control is transferred to the Company, while any entities that are
sold are excluded from the consolidation from the date that control ceases. All inter-company balances and transactions are eliminated on consolidation.

(d) Foreign currency

The  consolidated  financial  statements  are  presented  in  United  States  Dollars.  Items  included  in  the  financial  statements  of  the  Group’s  entities  are  measured  using  the
currency of the primary economic environment in which the entities operate (the "functional currency”), which is the US dollar for the Company and its US subsidiary, Aeterna
Zentaris, Inc., and the Euro ("EUR” or "€”) for its German subsidiaries.

Assets and liabilities of the German subsidiaries are translated from EUR balances at the period-end exchange rates, and the results of operations are translated from EUR
amounts at average rates of exchange for the period. The resulting translation adjustments are included in accumulated other comprehensive loss within shareholders’ equity.

Foreign currency transactions are translated into the functional currency using the exchange rates prevailing at the dates of the underlying transaction. Foreign exchange
gains and losses resulting from the settlement of such transactions and from the translation of monetary assets and liabilities not denominated in the functional currency are
recognized in the consolidated statements of loss and comprehensive loss.

2. Summary of material accounting policies

The accounting policies set out below have been applied consistently to all years presented in these consolidated financial statements and have been applied consistently by
all Group entities.

Cash and cash equivalents

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Cash and cash equivalents consist of unrestricted cash on hand and balances with banks, as well as short-term interest-bearing deposits, such as money market accounts, that
are  readily  convertible  to  known  amounts  of  cash  and  are  subject  to  an  insignificant  risk  of  changes  in  value,  with  a  maturity  of  three  months  or  less  from  the  date  of
acquisition.

Goodwill

Goodwill is recognized as the fair value of the consideration transferred, in a business combination, including the recognized amount of any non-controlling interest in the
acquiree, less the fair value of the net identifiable assets acquired, and liabilities assumed, as of the acquisition date. Subsequent to initial recognition, goodwill is measured at
cost less accumulated impairment losses. Goodwill acquired in business combinations is allocated to groups of cash generating units ("CGU”) that are expected to benefit from
the synergies of the combination.

F-9

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Impairment of long-lived assets

Items of property and equipment and identifiable intangible assets with finite lives that are subject to depreciation or amortization, respectively, are reviewed for impairment
whenever events or changes in circumstances indicate that the carrying amounts of the assets may not be recoverable. Intangible assets that are not subject to amortization
are tested when there are indications that their carrying value may not be recoverable, or, at a minimum, annually.

Goodwill is not subject to amortization, but instead is tested for impairment annually or more often if there is an indication that the group of CGUs to which the goodwill has
been allocated may be impaired.  Impairment is determined for goodwill by assessing whether the carrying value of the group of  CGUs, including the allocated goodwill,
exceeds the group of CGU’s recoverable amount, which is the higher of fair value less costs of disposal and the group of CGU’s value in use. Fair value less costs of disposal
is determined based on a market approach and also derived from market data, including, information from market participants regarding the price that the Company could
receive in a sale of the group of CGUs. Value in use is determined based on cash flow projections from financial budgets approved by senior management covering a five-year
period. The estimated future cash flows are discounted to their present value using a pre-tax discount rate that reflects current market assessments of the time value of money
and the risks specific to the group of CGUs. In the event that the carrying amount of the group of CGU’s, including the allocated goodwill exceeds its recoverable amount, an
impairment  loss  is  recognized  in  an  amount  equal  to  the  excess.  Impairment  losses  related  to  goodwill,  which  are  recorded  in  the  consolidated  statement  of  loss  and
comprehensive loss, are not subsequently reversed.

Post-employment benefits

The Company has partially funded and unfunded defined benefit multi-employer pension plans, namely the DUPK pension plan and the RUK 1990 and 2006 pension plans,
(the "Pension Benefit Plans”) and unfunded post-employment benefit plans in Germany. Provisions for pension obligations are established for benefits payable in the form of
retirement, disability and surviving dependent pensions. The Company also provides defined contribution plans to some of its employees.

For defined benefit pension plans and other post-employment benefits, net periodic pension expense is actuarially determined on a quarterly basis using the projected unit
credit method. The cost of pension and other benefits earned by employees is determined by applying certain assumptions, including discount rates, rate of pension benefit
increases, the projected age of employees upon retirement and the expected rate of future compensation.

The employee future benefits liability is recognized at its present value, which is determined by discounting the estimated future cash outflows using interest rates of high-
quality corporate bonds that are denominated in the currency in which the benefits will be paid and that have terms to maturity approximating the terms of the related future
benefit liability. Actuarial gains and losses that arise in calculating the present value of the defined benefit obligation are recognized in other comprehensive loss, net of tax,
and simultaneously reclassified in the deficit in the consolidated statement of financial position in the year in which the actuarial gains and losses arise and without recycling
to the consolidated statement of loss and comprehensive loss in subsequent periods.

Share-based compensation costs

The Company operates an equity-settled share-based compensation plan under which the Company receives services from directors, senior executives, employees and other
collaborators as consideration for equity instruments of the Company.

F-10

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company grants deferred share units ("DSUs”) to members of its Board of Directors who are not employees or officers of the Company. DSUs cannot be redeemed until
the holder is no longer a director of the Company and are considered equity-settled instruments. Under the terms of the DSU agreement, the DSUs vest immediately upon
grant. The value attributable to the DSUs is based on the market value of the share price at the time of grant and share based compensation expense is recognized in general
and administrative expenses in the consolidated statement of loss and comprehensive loss. At the time of redemption, each DSU may be exchanged for one common share of
the Company, net of applicable holding taxes. Any consideration received by the Company in connection with the exercise of DSUs is credited to share capital. Any other
capital component of the share-based compensation is transferred to share capital upon the issuance of shares.

Revenue recognition

The Company generates revenue from license and collaboration agreements with customers (license fees, milestone revenue, royalties), the provision of development services,
the sale of certain active pharmaceutical ingredients ("API”), semi-finished goods and finished goods, and from certain supply chain activities, which are comprised largely of
oversight or supervisory support services related to stability studies or development activities carried out with respect to API batch production as specified in underlying
contracts with customers.

IFRS 15 prescribes a five-step framework through which revenue is recognized when control of promised goods or services is transferred to a customer at an amount that
reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Goods and services that are determined not to be distinct are
combined with other promised goods or services until a distinct bundle is identified. The Company allocates the transaction price (the amount of consideration to which the

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Company expects to be entitled in exchange for the promised goods or services) to each performance obligation and recognizes the associated revenue when (or as) each
performance obligation is satisfied. The Company’s estimate of the transaction price for each contract includes all variable consideration to which the Company expects to be
entitled, and that estimate is reassessed at the end of each reporting period. When two or more contracts are entered into with the same customer at or near the same time, the
Company evaluates the contracts to determine whether the contracts should be accounted for as a single arrangement.

The transaction price is allocated among the performance obligations on a relative standalone selling price basis, and the applicable revenue recognition criteria are applied to
each of the separate performance obligations. Standalone selling prices may be estimated via methods that include, but are not limited to, an adjusted market assessment
approach, an expected cost-plus-margin approach or a residual approach. Determining the standalone selling price for performance obligations requires significant judgment.

The Company records deferred revenues when payments are received or due in advance of its performance. Deferred revenues are primarily from the Company’s services
arrangements and are recognized as revenues over the periods when services are performed.

The Company applies judgment in determining whether a combined performance obligation is satisfied at a point in time or over time, and, for performance obligations satisfied
over time, in concluding upon the appropriate method of measuring progress to be applied for purposes of recognizing revenue. The Company evaluates the measure of
progress each reporting period and, as estimates related to the measure of progress change, related revenue recognition is adjusted accordingly. Changes in the Company’s
estimated measure of progress are accounted for on a cumulative catch-up basis as a change in accounting estimate and are recorded in the consolidated statement of loss and
comprehensive loss in the period of adjustment.

F-11

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

License fees

If  the  license  to  the  Company’s  intellectual  property  is  determined  to  be  distinct  from  the  other  promises  or  performance  obligations  identified  in  the  arrangement,  the
Company recognizes revenue from non-refundable, upfront fees allocated to the license when the license is transferred to the customer and the customer is able to use and
benefit from the license. In assessing whether a license is distinct from the other promises, the Company considers whether the collaboration partner can benefit from the
license for its intended purpose without the receipt of the remaining promises, whether the value of the license is dependent on the unsatisfied promises, whether there are
other vendors that could provide the remaining promises and whether it is separately identifiable from the remaining promises. For licenses that are combined with other
promises,  the  Company  utilizes  judgment  to  assess  the  nature  of  the  combined  performance  obligation  and  whether  the  license  is  the  predominant  promise  within  the
combined performance obligation to determine whether the combined performance obligation is satisfied over time or at a point in time and, if over time, the appropriate method
of measuring progress for purposes of recognizing revenue.

Development services

Arrangements that include a promise for the Company to provide development services are assessed to determine whether the services are capable of being distinct, are not
highly interdependent or do not significantly modify one another, and if so, the services are accounted for as a separate performance obligation as the services are provided to
the customer. Otherwise, when development services are determined not to be capable of being distinct, such services are added to the performance obligation that includes
the underlying license. For development services that are combined with other promises, the Company applies judgment to assess the nature of the combined performance
obligation to determine whether the combined performance obligation is satisfied over time or at a point in time. The Company utilizes judgment to determine the appropriate
method of measuring progress for purposes of recognizing revenue, which is generally an input measure such as costs incurred.

Milestone payments

At the inception of any contracts with a customer that includes milestone payments, which are oftentimes payable upon the successful achievement of development or
regulatory events, the Company evaluates whether the milestones are considered probable of being reached and estimates the amount to be included in the transaction price
using the most likely amount method. If the Company concludes it is highly probable that a significant revenue reversal will not occur, the associated milestone payment is
included  in  the  transaction  price.  Milestone  payments  that  are  not  within  the  control  of  the  Company  or  the  licensee,  such  as  regulatory  approvals,  are  generally  not
considered probable of being achieved until those approvals are received. The transaction price is then allocated to each performance obligation on a relative stand-alone
selling price basis, for which the Company recognizes revenue when (or as) the performance obligations under the contract are satisfied. At the end of each subsequent
reporting period, the Company reassesses the probability of achievement of milestones and any related constraints, and, if necessary, adjusts the estimate of the overall
transaction price on a cumulative catch-up basis.

Royalty payments

For arrangements that include sales-based royalties, including milestone payments based on the level of sales, and when the license is deemed to be the predominant item to
which the royalties relate, the Company recognizes revenue at the later of (a) when the related sales occur, or (b) when the performance obligation to which some or all of the
royalty has been allocated has been satisfied or partially satisfied.

Product sales

The Company recognizes revenue from the sale of certain API and semi-finished goods, including MacrilenTM, upon delivery of such items to its customer.

Supply chain revenue

Supply chain services are contracted with fixed fees and are provided over a period of time. The Company recognizes revenue on a straight-line basis over time as it best
represents the pattern of performance of the services.

F-12

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Research and development expenses

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Research costs are expensed as incurred. Development costs are expensed as incurred, except for those that meet the criteria for deferral, in which case the costs are capitalized
and amortized to operations over the estimated period of benefit. No development costs have been capitalized during any of the periods presented.

Net loss per share

Basic net loss per share is calculated using the weighted average number of common shares outstanding during the year.

Diluted net loss per share is calculated based on the weighted average number of common shares outstanding during the year, plus the effects of dilutive common share
equivalents, such as stock options, warrants and similar instruments. The number of shares included with respect to options, warrants and similar instruments is computed
using the treasury stock method. Diluted net loss per share is equal to the basic net loss per share as the Company is in a loss position and all securities, comprised of options
and warrants, would be anti-dilutive.

3. Critical accounting estimates and judgments

The preparation of consolidated financial statements in accordance with IFRS requires management to make judgments, estimates and assumptions that affect the reported
amounts  of  the  Company’s  assets,  liabilities,  revenues,  expenses  and  related  disclosures.  Judgments,  estimates  and  assumptions  are  based  on  historical  experience,
expectations, current trends and other factors that management believes to be relevant at the time at which the Company’s consolidated financial statements are prepared.

Management  reviews,  on  a  regular  basis,  the  Company’s  accounting  policies,  assumptions,  estimates  and  judgments  in  order  to  ensure  that  the  consolidated  financial
statements are presented fairly and in accordance with IFRS. Revisions to accounting estimates are recognized in the period in which the estimates are revised and in any
future periods affected.

Critical accounting estimates and assumptions are those that have a significant risk of causing material adjustment and are often applied to matters or outcomes that are
inherently uncertain and subject to change. As such, management cautions that future events often vary from forecasts and expectations and that estimates routinely require
adjustment.

The following discusses the most significant accounting estimates and assumptions that the Company has made in the preparation of the consolidated financial statements.

Accounting for contract modification

The Novo notice of termination of the Novo Amendment received on August 26, 2022, as defined and discussed in note 5, was determined to be a contract modification
pursuant to the provisions of IFRS 15, requiring management to apply significant judgments, including the assessment of any changes to the scope of the license agreement
and  assessment  of  whether  the  remaining  goods  or  services  are  distinct  from  goods  or  services  transferred  before  the  modification. Any  changes  in  the  judgments  or
assumptions applied to account for this agreement could have a significant impact on the Company’s revenue and deferred revenue.

F-13

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

License and collaboration arrangements with multiple elements

The Company enters into licensing and supply agreements related to the licensing, development, supply and distribution for macimorelin in various territories. Each agreement
may contain specific terms or clauses that require careful analysis by management under IFRS 15 in order to ensure the appropriate accounting treatment is reached. The
agreements may include non-refundable upfront payments and licensing fees, the provision of development services, pre- and post-commercialization milestone payments,
royalties on future product sales derived from such license agreements, and supply arrangements. Management analyzes each agreement and applies significant judgment to
determine whether contracts entered into at or near the same time should be accounted for as a single arrangement, whether all parts of the contract are scoped into IFRS 15, to
identify all performance obligations, determine whether a performance obligation is distinct or should be combined with other promised goods and services, determine and
allocate the transaction price on a relative stand-alone selling price basis, determine whether a combined performance obligation is satisfied at a point in time or over time, and,
for performance obligations satisfied over time, in concluding upon the appropriate method of measuring progress to be applied for purposes of recognizing revenue. Any
changes in the judgments or assumptions applied can give rise to a significant impact on the Company’s revenues and deferred revenues.

Impairment of goodwill

The annual impairment assessment related to goodwill requires management to estimate the recoverable amount, which is the higher of an asset’s fair value less costs of
disposal and value in use. Management has determined that using fair value less cost of disposal results in the higher estimated recoverable value. The carrying amount of its
consolidated net assets is compared to the fair value less cost of disposal. Based on this calculation, management determined that goodwill was impaired in the year ended
December 31, 2022, see note 11.

Employee future benefits

The  determination  of  expenses,  obligations  and  the  Company’s  share  of  the  multi-employer  plan  assets  associated  with  employee  future  benefits  requires  the  use  of
assumptions, such as the discount rate to measure obligations, rate of pension benefit increases, the projected age of employees upon retirement and the expected rate of
future compensation. Because the determination of the costs, obligations and the Company’s share of the multi-employer plan assets associated with employee future benefits
requires the use of various assumptions, there is measurement uncertainty inherent in the actuarial valuation process. Actual results will differ from results that are estimated
based on the aforementioned assumptions. Additional information is included in note 15 - Employee future benefits.

Research and development accruals

As part of the process of preparing our financial statements, management is required to estimate accrued expenses including those pertaining to the Company’s research and
development expenses. This process involves reviewing open contracts and purchase orders, communicating with our personnel to identify services that have been performed
on the Company’s behalf and estimating the level of service performed and the associated cost incurred for the service when the Company has not yet been invoiced or
otherwise notified of the actual cost. If the actual timing of the performance of services or the level of effort varies from management’s estimate, the Company adjusts the
accrued or prepaid expense balance accordingly. Although the Company does not expect estimates to be materially different from amounts actually incurred, if those estimates
of the status and timing of services performed differ from the actual status and timing of services performed, the Company may report amounts that are too high or too low in
any particular period.

F-14

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

4. Recent accounting pronouncements

New standards and amendments

The Company applied for the first-time certain standards and amendments, which are effective for annual periods beginning on or after January 1, 2023 (unless otherwise
stated). The Company has not early adopted any other standard, interpretation or amendment that has been issued but is not yet effective.

Disclosure of Accounting Policies - Amendments to IAS 1 and IFRS Practice Statement 2

The amendments to IAS 1 and IFRS Practice Statement 2 Making Materiality Judgements provide guidance and examples to help entities apply materiality judgements to
accounting policy disclosures. The amendments aim to help entities provide accounting policy disclosures that are more useful by replacing the requirement for entities to
disclose their ‘significant’ accounting policies with a requirement to disclose their ‘material’ accounting policies and adding guidance on how entities apply the concept of
materiality in making decisions about accounting policy disclosures. The amendments have had an impact on the Company’s disclosures of accounting policies, but not on
the measurement, recognition or presentation of any items in the Company’s financial statements.

Definition of Accounting Estimates - Amendments to IAS 8

The amendments to IAS 8 clarify the distinction between changes in accounting estimates, changes in accounting policies and the correction of errors. They also clarify how
entities use measurement techniques and inputs to develop accounting estimates. The amendments had no impact on the Company’s consolidated financial statements.

Deferred Tax related to Assets and Liabilities arising from a Single Transaction – Amendments to IAS 12

The amendments to IAS 12 Income Tax narrow the scope of the initial recognition exception, so that it no longer applies to transactions that give rise to equal taxable and
deductible temporary differences such as leases and decommissioning liabilities. The amendments had no impact on the Company’s consolidated financial statements.

New standards and interpretations not yet adopted

Certain amendments to accounting standards have been published that are not mandatory for December 31, 2023 reporting periods and have not been early adopted by the
Company. These amendments are not expected to have a material impact on the Company in future reporting periods and on foreseeable future transactions.

F-15

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

5. Revenue

Disaggregation of revenue

The Company derives revenue from the transfer of goods and services over time and at a point in time in the following categories:

License fees
Development services
Product sales
Royalties
Supply chain

2023
$

Years ended December 31,
2022
$

2021
$

1,607   
2,741   
66   
31   
53   
4,498   

1,704   
3,617   
57   
101   
161   
5,640   

1,670 
3,337 
- 
68 
185 
5,260 

Revenues of approximately $4,328 (2022 – $5,555 and 2021 - $5,260) are derived from Novo Nordisk.

The Company recorded revenue for the transfer of services over time for the year ended December 31, 2023 of $4,401 (2022 – $5,482 and 2021 - $5,192). Revenue recorded at a
point in time for the year ended December 31, 2023, was $97 (2022 – $158 and 2021 - $68).

License, supply and distribution arrangements

Novo Nordisk Health Care AG ("Novo”) - Macrilen™ - United States and Canada

In January 2018, the Company entered into a License Agreement with Novo for the development and commercialization of macimorelin in the U.S. and Canada, which provided
for, among others; a right to use license relating to the adult indication; a license for a future FDA-approved pediatric indication; and the licensee to fund costs of a pediatric
clinical trial (the "DETECT-trial”) to be run by the Company with oversight from a joint steering committee. The Company was also entitled to receive a milestone payment of
$5,000 upon FDA approval of the pediatric indication.

On November 16, 2020, the Company entered into an amendment (the "Novo Amendment”) of its existing License Agreement with Novo related to the development and
commercialization of macimorelin. Under the Novo Amendment, Aeterna continued to retain all rights to macimorelin outside of the U.S. and Canada and Novo agreed to make
an additional upfront payment to Aeterna of $6,109 (€5,000), which the Company received in December 2020. The royalty payment Aeterna received on sales of macimorelin in
the U.S. and Canada was reduced from 15%  to 8.5% for annual net sales up to $40,000 and returned to 15% for annual net sales over $40,000. Additionally, the milestone
payment to be received upon FDA approval of the pediatric indication was waived. Novo and Aeterna agreed that solely Aeterna will conduct the pivotal DETECT-trial in
partnership with a contract research organization ("CRO”) and that  Novo was required to reimburse Aeterna for 100% of costs up to €9,000  (approximately  $9,600). Any
additional external DETECT-trial costs incurred over €9,000 that were jointly approved were shared equally between Novo and Aeterna.

Novo was also granted co-ownership of the U.S. and Canadian patents and trademarks owned by Aeterna on macimorelin but will be required to transfer co-ownership in
those patents back to Aeterna on the occurrence of certain termination events. The Novo Amendment also confirmed that Aeterna has the right to use the results from the

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DETECT-trial, if successful, to support Aeterna seeking regulatory approval and ongoing efforts to seek partnering opportunities for macimorelin in other regions outside of
the two countries licensed to Novo, the U.S. and Canada.

The Company allocated $550 (€470) of the additional upfront payment received to the adult indication which was recognized in revenues for the year ended December 31, 2020.
The remaining $5,559 (€4,530) was deferred and allocated to the combined performance obligation consisting of the license for the pediatric indication and the development
services for the DETECT-trial. The modified transaction price amounted to $5,754 (€4.7 million), which comprised of an unamortized pre-Novo Amendment balance of $195 (€0.2
million)  and  $5,559  (€4.5  million)  which  was  allocated  for  the  Novo Amendment.  Revenue  associated  with  the  combined  pediatric  indication  performance  obligation  was
recognized as pediatric development services are incurred using a cost-to-cost measure of progress method based on the cost of the DETECT-trial. The transfer of control to
Novo occurred over time, and as such, in management’s judgment, this input method is the best measure of progress towards satisfying the performance obligation and
reflects a faithful depiction of the transfer of goods and services.

F-16

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Notice of termination

On August 26, 2022,  Novo provided the  Company with a notice of termination of the  Novo Amendment.  Under the terms of the  Novo Amendment, the termination was
effective May 23, 2023 upon the completion of a 270 day notice period ("notice period”). Upon termination, the rights and licenses granted by the Company to Novo under the
Novo Amendment were returned to the Company, and the Company regained full rights to continue the clinical development and future commercialization of Macrilen™.
Following the notice of termination and throughout the 270-day notice period, as per the terms of the Novo Amendment, Novo continued to fund all DETECT-trial costs up to
$9.6 million (€9 million), and any additional DETECT-trial costs incurred over $9.6 million (€9 million) up to $10.5 million (€9.8 million) were shared equally between Novo and
the Company.

The Company concluded that the notice of termination represents a contract modification for accounting purposes. The Company further concluded that upon receipt of the
notice of termination, the remaining goods and services to be performed during the notice period are considered distinct goods and services and therefore, the contract
modification is to be accounted for prospectively. As of the date of receipt of the notice of termination from Novo, the Company had recognized total license fees associated
with the pediatric indication of $1,615 (€1,880) and total development services revenue of $3,865 (€4,448). Subsequent to the receipt of the notice of termination, management
estimated the combined transaction price of the remaining services to be performed as $7,937 (€7,776), comprised of pediatric indication license fees of $2,872 (€2,814)  and
development services revenue of $5,065 (€4,962).  Revenue associated with this combined performance obligation was recognized as pediatric development services were
incurred during the notice period, until the date of termination on May 23, 2023, using the cost-to-cost method.

Pharmanovia and Consilient Health Limited

On  December  7,  2020,  the  Company  entered  into  an  exclusive  licensing  agreement  with  Consilient  Health  Limited  ("CH”)  for  the  commercialization  of  macimorelin  (the
"Licensed Product”) in the European Economic Area and the United Kingdom (the "CH License Agreement”).

Under the terms of the  CH  License Agreement,  CH agreed to make a non-refundable, non-creditable upfront payment to the  Company of $1,209 (€1.0  million),  which  the
Company received in  January 2021.  The  Company also is eligible to receive additional consideration, including regulatory milestones related to agreed-upon pricing and
reimbursement parameters; net sales milestones; and royalties, ranging from 10%-20% of net sales of macimorelin, subject to reduction in certain cases, or sublicense income
recorded by CH. Also on December 7, 2020, the Company and CH entered into an exclusive supply agreement, pursuant to which the Company agreed to provide the Licensed
Product to CH, with such Licensed Product to be manufactured by third-party manufacturers for a period of ten years, subject to renewal (the "CH Supply Agreement”).

The total transaction price associated with the CH Agreement is $1,209 (€1.0 million), which consists of the non-refundable, non-creditable upfront payment, discussed above.
At  the  inception  of  the  contract,  all  other  contractual  consideration  to  which  the  Company  may  be  entitled  represents  variable  consideration,  including  the  regulatory
milestones, which were determined to be zero, based on management’s estimate of the most likely amount, given that the achievement of the underlying milestones is uncertain
and highly susceptible to factors outside of the Company’s control.

F-17

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company allocated the transaction price to the combined performance obligation of the license agreement and the supply agreement for the adult and pediatric indication,
using  the  application  of  an  adjusted  market  assessment  approach.  Revenue  will  be  recognized  over  time  using  an  outputs  method  based  on  units  of  Licensed  Product
supplied. The total units that the Company expects to supply pursuant to the CH Agreement is an estimate, based on current projections and anticipated market demand, and
therefore will be a significant judgment that will be relied upon when using the outputs method to recognize revenue.

During the year ended December 31, 2021, the Company has received a milestone payment of $226 (€0.2 million) relating to a list price in the United Kingdom. During the year
ended December 31, 2022, the Company received aggregate milestone payments of $319 (€0.3 million) relating to list price approvals in Germany and Spain. All payments were
allocated to the Adult license performance obligation and deferred to the consolidated statement of financial position.

On  March  15,  2023,  with  the  Company’s  consent,  CH  entered  into  an  assignment  agreement  with  Pharmanovia  to  transfer  the  current  licensing  agreement  for  the
commercialization of macimorelin in the European Economic Area and the United Kingdom to Pharmanovia, as well as the current supply agreement pursuant to which the
Company  agreed  to  provide  the  licensed  product  (together,  the  "Assignment  Agreement”).  Also  on  March  15,  2023,  the  Company  and  Pharmanovia  entered  into  an
amendment agreement, pursuant to which the Company provided its acknowledgement and consent to the Assignment Agreement and agreed to certain amended terms which
do not materially differ from the previous license and supply agreement with CH.

The aggregate amount of the transaction price allocated to the Company’s unsatisfied or partially unsatisfied performance obligations under the Pharmanovia Agreement as of
December 31, 2023 was $1,629 (2022 - $1,591). The Company expects to recognize the balance of the relevant deferred revenue over the remaining period of nine years, subject
to extension based on the outcome of the ongoing clinical development related to the Pediatric Indication and related patent application initiatives.

For the year ended December 31, 2023, the Company recognized $52 (2022 - $18, 2021 - $nil) as license fee revenue associated with the Pharmanovia Agreement.

Liabilities related to contracts with customers

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Company has recognized the following deferred revenue balances related to contracts with customers:

Novo Nordisk Health Care
Pharmanovia
NK Meditech Limited

Novo Nordisk Health Care
Consilient Healthcare Limited
NK Meditech Limited

Current
$

Current
$

-   
209   
9   
218   

2,914   
35   
-   
2,949   

December 31, 2023
Non-Current
$

-   
1,420   
124   
1,544   

December 31, 2022
Non-Current
$

-   
1,556   
128   
1,684   

Total
$

Total
$

- 
1,629 
133 
1,762 

2,914 
1,591 
128 
4,633 

F-18

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

6. Cash and cash equivalents

Cash on hand and balances with banks

December 31,

2023
$

34,016   
34,016   

2022
$

50,611 
50,611 

The Company had restricted cash equivalents amounting to $332 at December 31, 2023 (2022 - $322). These balances consist of certificates of deposit that are used as collateral
for corporate credit cards and leases.

7. Trade and other receivables

Trade accounts receivable
Value added tax
Other receivables

During the year ended December 31, 2023, the Company recorded a write-down within other receivables of $nil (2022 - $124).

8. Prepaid expenses and other current assets

Prepaid insurance
Prepaid research and development
Other

F-19

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

9. Property and equipment

Components of the Company’s property and equipment are summarized below.

December 31,

2023
$

2022
$

67   
103   
52   
222   

December 31,

2023
$

2022
$

250   
1,633   
59   
1,942   

403 
275 
54 
732 

428 
1,998 
62 
2,488 

At January 1, 2022
Additions

Equipment
$

Computer
Equipment
$

Cost
Right of use
building
$

Right of use
vehicles
$

199   
-   

268   
11   

623   
-   

87   
38   

Total
$

1,177 
49 

 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
Remeasurement
Disposals
Impact of foreign exchange rate changes
At December 31, 2022
Additions
Remeasurement
Disposals
Impact of foreign exchange rate changes
At December 31, 2023

At January 1, 2022
Disposals
Depreciation
Impact of foreign exchange rate changes
At December 31, 2022
Disposals
Depreciation
Impact of foreign exchange rate changes
At December 31, 2023

At December 31, 2022
At December 31, 2023

-   
-   
(11)  
188   
6   
-   
(1)  
6   
199   

-   
(1)  
(13)  
265   
14   
-   
-   
7   
286   

98   
(10)  
(26)  
685   
-   
103   
-   
22   
810   

18   
-   
(7)  
136   
134   
6   
(94)  
4   
186   

Equipment
$

Computer
Equipment
$

Accumulated Depreciation
Right of use
building
$

Right of use
vehicles
$

Total
$

181   
-   
2   
(10)  
173   
-   
3   
5   
181   

244   
(1)  
9   
(12)  
240   
-   
13   
7   
260   

493   
(10)  
94   
(21)  
556   
-   
103   
17   
676   

67   
-   
25   
(3)  
89   
(94)  
50   
2   
47   

116 
(11)
(57)
1,274 
154 
109 
(95)
39 
1,481 

985 
(11)
130 
(46)
1,058 
(94)
169 
31 
1,164 

Equipment
$

Computer
Equipment
$

Carrying amount
Right of use
building
$

Right of use
vehicles
$

15   
18   

25   
26   

129   
134   

47   
139   

Total
$

216 
317 

On September 30, 2023, the Company and its landlord mutually agreed to a one-year plus 6 months’ notice extension to its existing building lease agreement for its German
subsidiary, continuing such terms until March 31, 2025, resulting in a remeasurement of the building right of use asset in the amount of $103 (2022 - $98).

F-20

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

10. Intangible assets

Sale of Cetrotide trademarks to Merck

On August 10, 2021, the Company entered into a trademark maintenance and assignment option agreement with ARES Trading SA, a subsidiary of Merck KGaA ("Merck”),
with respect to the trademarks owned by the Company on Cetrotide® (cetrorelix acetate for injection). As consideration for having been granted the option, Merck agreed to
pay the Company a total of $549 (€0.5 million). During the year ended December 31, 2023, Merck exercised the option agreement, and the Company accordingly transferred all
trademarks to Merck, after which the Company no longer has any ownership in or obligations related to the Cetrotide trademarks.

Impairment of intangible assets

In 2022, the Company ceased its development of both the COVID-19 and Chlamydia vaccine trials. The previously capitalized upfront payments for licenses relating to these
two trials of $212 was fully impaired. Furthermore, as part of the Company’s annual goodwill and intangible asset impairment assessment, the Company identified the need for
an additional impairment of $372 to intangible assets, as discussed in note 11.

11. Goodwill

Balance – Beginning of year
Impairment of goodwill
Impact of foreign exchange rate changes
Balance – End of year

December 31,

2023
$

2022
$

-   
-   
-   
-   

8,130 
(7,642)
(488)
- 

As of December 31, 2022, the market capitalization of the Company was below the carrying value of its shareholders’ equity, indicating a potential impairment of goodwill and
impairment of the assets of the group of CGUs. The recoverable amount of the group of CGUs was determined based on a fair value less cost of disposal ("FVLCD”) model.
FVLCD was determined based on a market approach and also derived from market data, including, information from market participants regarding the price that the Company
could  receive  in  a  sale  of  the  group  of  CGUs.  The  fair  value  measurement  is  categorized  as  a  level  2  fair  value  based  on  the  inputs  in  the  valuation  techniques  used.
Management determined that value-in-use resulted in a lower estimated recoverable value than FVLCD. Based on the Company’s assessment, the recoverable amount of the
group of CGUs was lower than the carrying value and therefore an impairment charge was recorded on its goodwill and intangible assets for an amount of $7,642 and $372
respectively.

F-21

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
 
 
 
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

12. Payables and accrued liabilities

Trade accounts payable
Accrued research and development costs
Accrued employee benefits
Payroll tax and other statutory liabilities
Other accrued liabilities

13. Provisions

Balance – Beginning of year
Provision recognized
Utilization of provision
Change in the provision
Unwinding of discount and impact of foreign exchange rate changes
Balances – End of the year
Current liabilities
Non-current liabilities

December 31,

2023
$

2022
$

1,866   
804   
343   
78   
531   
3,622   

December 31,

2023
$

2022
$

233   
404   
(40)  
(174)  
6   
429   
429   
-   

2,038 
751 
325 
74 
640 
3,828 

277 
- 
(28)
- 
(16)
233 
45 
188 

In 2023, the Company recognized a provision of $404 related to estimated exit costs for certain contracts with suppliers. It is anticipated that these costs will be incurred in the
next financial year.

F-22

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

14. Lease liabilities

Balance – Beginning of year
Additions
Interest paid as charged to net loss as other finance costs
Payment against lease liabilities
Modification of lease liability
Impact of foreign exchange rate changes
Balances – End of the year
Current lease liabilities
Non-current lease liabilities

December 31,

2023
$

2022
$

179   
134   
(13)  
(151)  
108   
22   
279   
160   
119   

161 
38 
(4)
(134)
114 
4 
179 
114 
65 

The Company and its landlord mutually agreed to a one-year plus 6 months’ notice extension to its existing building lease agreement for its German subsidiary, continuing
such terms until March 31, 2025, resulting in a remeasurement of the lease liability in the amount of $103 (2022 - $98).

Future lease payments as of December 31, 2023, are as follows:

Less than 1 year
1 – 3 years
4 – 5 years

15. Employee future benefits

Amount
$

160 
102 
17 
279 

The Company has partially funded and unfunded defined benefit multi-employer pension plans and unfunded post-employment benefit plans in Germany. The plans are final
salary pension plans, which provide benefits to members (or to their surviving dependents) in the form of a guaranteed level of pension payable for life. The level of benefits
provided depends on the members’ length of service and their salary in the final years leading up to retirement.

These plans are governed by the employment laws of  Germany, which generally require final salary payments of each plan to be adjusted every third year for either an
inflationary increase or a set 1% increase per annum. The form of increase varies for each plan and was an election made by each plan when it was initially established.

Since the pension liability is adjusted for either an increase in inflation or a set 1% increase per annum, the pension plan is exposed to the Company’s inflation, interest rate
risks and changes in the life expectancy for pensioners. As the plan assets include significant investments in listed equity shares of entities and real estate, the Company is
also exposed to equity market and property market risk. A decrease in corporate bond yields will also increase plan liabilities, although this will be partially offset by an
increase in the value of the plans’ bond holdings.

 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
F-23

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The change in the Company’s accrued benefit obligations associated with the employee future benefit obligation is summarized for the years ended:

Pension
benefit plans
$

December 31,

2023
Other
benefit plans
$

Total
$

2022

Total
$

Change in plan liabilities
Balances – Beginning of the year
Current service cost (residual value)
Interest cost
Actuarial loss (gain) arising from changes in financial
assumptions
Benefits paid
Impact of foreign exchange rate changes
Balances – End of the year
Change in plan assets
Balances – Beginning of the year
Interest income from plan assets
Employer contributions
Employee contributions
Benefits paid
Remeasurement of plan assets
Impact of foreign exchange rate changes
Balances – End of the year

Net liability of the unfunded plans
Net liability of the funded plans
Net amount recognized as Employee future benefits
Amounts recognized:
In net loss
Actuarial gain (loss) on defined benefit plans and
remeasurement of the net defined benefit liability in other
comprehensive (gain) loss

21,657   
123   
803   

1,210   
(814)  
643   
23,622   

10,591   
396   
36   
13   
(266)  
15   
318   
11,103   

11,584   
935   
12,519   

517   

(1,195)  

F-24

93   
(3)  
4   

3   
(1)  
2   
98   

-   
-   
-   
-   
-   
-   
-   
-   

98   
-   
98   

3   

-   

21,750   
120   
807   

1,213   
(815)  
645   
23,720   

10,591   
396   
36   
13   
(266)  
15   
318   
11,103   

11,682   
935   
12,617   

520   

(1,195)  

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The fair values of each major class of the Company’s proportionate share of the multi-employer pension plan assets are as follows:

Cash and cash equivalents (level 1)
Debt instruments (level 1)
Equity instruments (level 1)
Real estate (level 3)
Other (level 3)

December 31,

2023
$

2022
$

225   
6,357   
1,219   
2,692   
610   
11,103   

29,412 
142 
295 

(5,915)
(752)
(1,432)
21,750 

11,927 
120 
45 
10 
(247)
(641)
(623)
10,591 

10,787 
372 
11,159 

295 

5,262 

46 
6,302 
846 
2,079 
1,318 
10,591 

The significant actuarial assumptions applied to determine the Company’s accrued benefit obligations are as follows:

Actuarial assumptions

Discount rate
Pension benefits increase
Rate of compensation increase

Pension Benefit Plans
Years ended December 31,
2022
%

2023
%

3.30   
2.00   
2.50   

3.75   
2.00   
2.50   

2021
%    
1.10   
0.50   
2.50   

Other benefit plans
Years ended December 31,
2022
%    
3.75   
2.00   
2.50   

2023
%    
3.30   
2.00   
2.50   

2021
%  
1.10 
0.50 
2.50 

Assumptions regarding future mortality are set based on actuarial advice in accordance with published statistics and experience in Germany. These assumptions translate into
an average remaining life expectancy in years for a pensioner retiring at age 65:

2023

December 31,
2022

2021

 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
   
 
 
 
 
   
   
   
 
 
 
   
   
   
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
   
   
   
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
Retiring at the end of the reporting period:

Male
Female

Years

Years

Years

21   
24   

21   
24   

21 
24 

F-25

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

In accordance with the assumptions used as of December 31, 2023, undiscounted defined pension benefits expected to be paid are as follows:

2024
2025
2026
2027
2028
Thereafter

Amount
$

871 
881 
923 
1,098 
1,123 
36,144 
41,040 

The weighted average duration of the defined benefit obligation is 14.5 years (2022 – 14.4 years).

If variations in the following assumptions had occurred during 2023, the impact on the Company’s pension benefit obligation of $23,622 as of December 31, 2023, would have
been as follows:

Assumption

Change in discount rate of 0.25%
Change in salary rate of 0.25%
Change in pension rate assumption by 0.25%
Change mortality by one year

Increase

Decrease

(809)    
17     
506     
1,160     

855 
(16)
(485)
(1,160)

Total expenses for the defined benefit plan that the Company accounts for as a defined contribution plan amounted to approximately $18 for the year ended December 31, 2023
(2022 - $20 and 2021 - $45).

16. Share Capital

Authorized

The Company has unlimited number of common shares (being voting and participating shares) with no par value, as well as an unlimited number of preferred, first and second
ranking shares, issuable in series, with rights and privileges specific to each class, with no par value.

Shareholder rights plan

Effective  May 8, 2019, the shareholders re-approved the  Company’s shareholder rights plan (the "Rights  Plan”) that provides the board of directors and the  Company’s
shareholders with additional time to assess any unsolicited take-over bid for the Company and, where appropriate, to pursue other alternatives for maximizing shareholder
value. Under the Rights Plan, one right has been issued for each currently issued common share, and one right will be issued with each additional common share that may be
issued from time to time.

F-26

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Issued and outstanding

Balance – December 31, 2020

Issuance of common shares, net of transaction costs
Exercise of warrants, net of issuance costs upon exercise
Exercise of deferred share units
Balance – December 31, 2021

Balance – December 31, 2022

Balance – December 31, 2023

Common shares
#

Amount
$

2,507,145   

943,448   
1,404,443   
840   
4,855,876   
-   
4,855,876   
-   
4,855,876   

235,008 

29,082 
29,301 
19 
293,410 
- 
293,410 
- 
293,410 

On  July  15,  2022,  the  Company’s  shareholders  and  board  of  directors  approved  an  amendment  to  the  Company’s  articles  of  incorporation  to  effect  a  1-for-25  share
consolidation (reverse split) of the Company’s common shares. The Company’s outstanding stock options, DSUs and warrants were also adjusted to reflect the  1-for-25 share
consolidation (reverse split) of the Company’s common shares. Accordingly, all common shares, DSU, warrants, stock options and per share amounts in these consolidated
financial statements have been retroactively adjusted for all years presented to give effect to the share consolidation (reverse split). Outstanding warrant and stock options
were proportionately reduced and the respective exercise prices, if applicable, were proportionately increased. The share consolidation (reverse split) was affected on July 21,

 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
    
  
   
   
   
   
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2022.

2021

On February 19, 2021, the Company completed an underwritten public offering of 820,390 common shares at $36.25 per common share, resulting in aggregate gross proceeds of
$29,739,  less  underwriting  discounts,  commissions  and  offering  expenses  of  $2,837  (the  "February  2021  Financing”).  The  Company  also  granted  to  the  underwriter  and
placement  agent  (the  "Underwriter”),  a  30-day  over-allotment  option  to  purchase  up  to 123,058  additional  common  shares  at  a  price  of  $36.25  per  common  share  (the
"Underwriter Option”). Additionally, the Company issued warrants underlying  57,427 common shares to the Underwriter, with each warrant bearing an exercise price of $45.31
(the "February 2021 Placement Agent Warrants”). The February 2021 Placement Agent Warrants expire on February 17, 2026.

On February 22, 2021, the Underwriter exercised the Underwriter Option and received 123,058 common shares in exchange for gross proceeds to the Company of $4,461. Upon
exercise  of  the  Underwriter  Option,  the  Underwriter  also  received  an  additional 8,614  February  2021  Placement Agent  Warrants. Aggregate  gross  proceeds  received  in
connection with the February 2021 Financing totaled $34,200, less cash transaction costs of $3,221 and non-cash transaction costs, which represent the issue-date fair value of
the February 2021 Placement Agent Warrants, of $1,897.

F-27

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

17. Warrants

Warrant activity for the years ended December 31, 2023, 2022 and 2021, was as follows:

December 31, 2020
Granted
Exercised
Allocation of transaction costs to share capital
December 31, 2021

December 31, 2022

December 31, 2023

Number
#

Weighted average
exercise price
$

Amount
$

1,796,050   
66,041   
(1,404,443)  
-   
457,648   
-   
457,648   
-   
457,648   

17.79   
45.31   
14.31   
-   
21.76   
-   
21.76   
-   
21.76   

12,402 
1,897 
(9,746)
532 
5,085 
- 
5,085 
- 
5,085 

The fair values of warrants are estimated using the Black-Scholes option pricing model. The weighted average assumptions used in the Black-Scholes valuation model for the
year presented were as follows:

Expected dividend yield
Expected volatility
Risk-free annual interest rate
Expected life (years)
Weighted average share price
Weighted average exercise price

December 31,
2021

- 

119.18%
0.59%
4.99 
37.00 
45.31 

$
$

The expected volatility of these warrants was determined using historical volatility rates and the expected life was determined based on time to expiry from the issuance date.

At December 31, 2023, the following warrants were outstanding:

Warrant issuance

September 2019
February 2020
July 2020
August 2020
February 2021

Number
#

Weighted average
remaining contractual
life
years

Weighted average
exercise price
$

53,000   
44,521   
224,845   
69,241   
66,041   
457,648   

0.73   
1.64   
1.51   
2.10   
2.14   
1.61   

41.25 
32.28 
11.25 
11.75 
45.31 
21.76 

F-28

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

18. Contributed Surplus

At the 2018 annual and special meeting of shareholders, the Company’s shareholders approved the adoption of the 2018 long-term incentive plan (the "LTIP”), which allows
the Board of Directors to issue up to 11.4% of the total issued and outstanding common shares at any given time to eligible individuals at an exercise price to be determined by
the Board of Directors at the time of the grant, subject to a ceiling, as stock options, stock appreciation rights, stock awards, deferred stock units ("DSUs”), performance
shares, performance units, and other stock-based awards. This LTIP replaces the stock option plan (the "Stock Option Plan”) for its directors, senior executives, employees

 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
and other collaborators who provide services to the Company. Options granted under the LTIP expire after seven years following the date of grant, vest over three years,
beginning one year after date of grant. The Company’s Board of Directors amended the Stock Option Plan on March 20, 2014 and the Company’s Shareholders approved,
ratified and confirmed the Stock Option Plan on May 10, 2016. Options granted under the Stock Option Plan prior to the 2014 amendment expire after a maximum period of 10
years following the date of grant. Options granted after the 2014 amendment expire after a maximum period of seven years following the date of grant.

Stock options

The Company settles stock options exercised through the issuance of new common shares as opposed to purchasing common shares on the market to settle stock option
exercises.

The compensation expense for the year end December 31, 2023, was $94 (2022 – $142 and 2021 – $107) recognized over the vesting period. Option activity for the years ended
December 31, 2023, 2022 and 2021, was as follows:

December 31, 2020
Granted
Expired
December 31, 2021
Granted
Canceled/Forfeited
Expired
December 31, 2022
Granted
Expired
December 31, 2023

Number
#

Weighted average
exercise price
$

20,256   
23,200   
(1)  
43,455   
2,000   
(2,900)  
(525)  
42,030   
14,000   
(2,630)  
53,400   

36.43 
10.51 
14,000.00 
21.95 
8.88 
14.49 
165.08 
20.05 
3.75 
86.37 
12.51 

On January 17, 2023, the Company granted 14,000 stock options under the LTIP. The stock options will be exercisable at $3.75 per share, have a term of seven years  and vest
over a period of three years.

F-29

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The table below shows the assumptions, or weighted average parameters, applied to the Black-Scholes option pricing model in order to determine share-based compensation
costs over the life of the awards.

Expected dividend yield
Expected volatility
Risk-free annual interest rate
Expected life (years)
Weighted average share price
Weighted average exercise price
Weighted average grant date fair value

2023

December 31,
2022

2021

- 

104.46%  
3.56%  
5.45 
3.75 
3.75 
2.99 

$
$
$

$
$
$

- 

115.75% 
1.59% 
5.72 
8.88 
8.88 
7.47 

$
$
$

- 

115.80%
1.23%
5.71 
10.51 
10.51 
8.82 

The expected volatility of these stock options was determined using historical volatility rates and the expected life was determined using the weighted average life of past
options issued.

At December 31, 2023, the following options were outstanding:

Range of stock option exercise prices

3.75 to 8.87
8.88 to 10.00
10.01 to 20.00
20.01 to 30.00
30.01 to 53.75

Deferred share units

Options outstanding
Weighted
average
remaining
contractual
life
years

Options exercisable
Weighted
average
remaining
contractual
life
years

Number    

#

Weighted
average
exercise
price
$

Weighted
average
exercise
price
$

6.05   
4.20   
4.96   
2.91   
1.21   
4.65   

3.75   
9.09   
10.51   
22.68   
51.99   
12.51   

-   
7,467   
14,141   
6,000   
3,400   
31,008   

4.05   
4.96   
2.91   
1.21   
3.94   

9.13 
10.51 
22.68 
51.99 
17.08 

Number    

#
14,000   
8,800   
21,200   
6,000   
3,400   
53,400   

The compensation expense for the year end December 31, 2023, was $284 (2022 – $402 and 2021 – $204) and is presented in selling, general and administrative expenses. DSU
activity for the years ended December 31 are:

Balance – Beginning of the year
Granted

2023
#

December 31,
2022
#

2021
#

96,920   
100,000   

16,920   
80,000   

6,920 
11,200 

 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
   
   
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
Exercised
Balance – End of the year

-   
196,920   

-   
96,920   

(1,200)
16,920 

F-30

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

19. Expenses by nature

Inventory expensed during the year
Provision for obsolete inventory
Third-party research and development
Salaries, wages and benefits
Professional and consulting fees
Insurance
Stock-based compensation
Software and IT services
Depreciation and amortization
Marketing, communications and investor relations
Travel, meals and entertainment
Office, rent and telecommunications
License fees
Other
Impairment of goodwill
Impairment of other assets
Impairment of intangible assets

20. Supplemental disclosure of cash flow information

Changes in operating assets and liabilities:
Trade and other receivables
Inventory
Prepaid expenses and other current assets
Payables and accrued liabilities
Income taxes payable
Deferred revenues
Deferred gain
Provisions
Employee future benefits

2023
$

December 31,
2022
$

2021
$

45   
133   
11,664   
4,260   
3,504   
1,184   
378   
523   
170   
274   
276   
171   
10   
(86)  
-   
-   
-   
22,506   

54   
32   
11,244   
3,563   
2,475   
1,687   
544   
386   
135   
317   
225   
120   
19   
92   
7,642   
124   
584   
29,243   

2023
$

December 31,
2022
$

2021
$

147   
162   
589   
76   
-   
(1,313)  
(110)  
(14)  
(573)  
(1,036)  

592   
(161)  
(783)  
1,076   
-   
441   
-   
(2)  
(559)  
604   

- 
- 
5,534 
3,037 
2,570 
1,077 
311 
387 
144 
289 
111 
162 
139 
170 
- 
- 
- 
13,931 

120 
(56)
(750)
634 
(109)
3,010 
- 
- 
(349)
2,500 

F-31

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

21. Income taxes

Significant components of the current and deferred income tax recovery for the years ended December 31, 2023, 2022 and 2021 are as follows:

Current income tax recovery
Deferred tax:
Origination and reversal of temporary differences
Change in unrecognized tax assets
Total income tax recovery

2023
$

December 31,
2022
$

2021
$

-   

3,706   
(3,706)  
-   

-   

2,885   
(2,885)  
-   

109 

1,291 
(1,291)
109 

From time to time, the Company is subject to tax audits. While the Company believes that its filing positions are appropriate and supportable, periodically, certain matters are
challenged by tax authorities. Although the Company believes its tax provisions are adequate, the final determination of tax audits and any related disputes could be materially
different from historical income tax provisions and accruals. In 2019, AEZS Germany underwent a tax audit regarding the taxation years 2013 to 2016. As of December 31, 2023
and 2022, the tax authorities concluded the audit for those years. The subsequent years remain unaudited, and the Company has accrued $108 as an uncertain tax provision for

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
those years.

The reconciliation of the combined Canadian federal and provincial corporate income tax rate to the income tax expense for the years ended December 31, 2023, 2022 and 2021
is provided below:

2023

December 31,
2022

2021

Combined Canadian federal and provincial statutory income tax rate

26.50%  

26.50% 

26.50%

Income tax recovery based on combined statutory income tax rate
Change in unrecognized tax assets
Share issuance costs
Permanent difference attributable to impairment of goodwill
Impact of expiring investment tax credits
Provision to filed return adjustments
Share-based compensation costs
Difference in statutory income tax rate of foreign subsidiaries
Other

2023
$

December 31,
2022
$

2021
$

4,273   
(3,706)  
-   
-   
(1,156)  
-   
(100)  
521   
168   
-   

6,023   
(2,885)  
-   
(2,407)  
(1,559)  
106   
(144)  
902   
(36)  
-   

F-32

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Loss before income taxes is attributable to the Company’s tax jurisdictions for the years ended December 31, 2023, 2022 and 2021. as follows:

Germany
Canada
United States

Significant components of deferred tax assets and liabilities are as follows:

2023
$

(10,935)  
(5,371)  
(246)  
(16,552)  

December 31,
2022
$

(16,756)  
(5,679)  
(292)  
(22,727)  

Deferred tax assets
Operating losses carried forward

Deferred tax liabilities
Payables and accrued liabilities
Property and equipment
Other

Deferred tax assets (liabilities), net

Significant components of unrecognized deferred tax assets and losses are as follows:

December 31,

2023
$

143   
143   

-   
86   
57   
143   
-   

2021
$

2022
$

Deferred revenues and other provisions
Operating losses carried forward
Capital losses carried forward
SR&ED Pool
Unused tax credits
Employee future benefits
Property and equipment
Intangible assets
Share issuance expenses
Other

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements

December 31,

2023
$

2022
$

53   
96,866   
210   
9,138   
1,788   
1,784   
524   
104   
453   
388   
111,768   

F-33

2,246 
(1,291)
367 
- 
(1,724)
151 
(82)
226 
216 
109 

(4,383)
(3,860)
(234)
(8,477)

582 
582 

450 
55 
77 
582 
- 

1,475 
87,445 
210 
9,138 
1,559 
1,317 
524 
95 
781 
294 
102,838 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
    
 
  
 
 
 
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

Deferred income tax assets are recognized to the extent that the realization of the related tax benefit through reversal of temporary differences and future taxable profits is
probable. Based on the current forecasted future taxable profits and reversal of temporary differences, the company does not believe it will have sufficient future earnings to
offset the deferred tax assets and has an unrecognized deferred tax asset balance of $111,768.

As of December 31, 2023, the Company has a total accumulated non-capital losses of $90,436 federally and $89,114 provincially, which may be carried forward for twenty years
and used to reduce taxable income in future years. The Company has not recognized deferred tax assets on any of the non-capital losses, due to the uncertainty that there will
be sufficient taxable income or that the taxable temporary differences will be reversing in the same reporting period and jurisdiction. The losses will be expiring as follows:

2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043

Canada
Federal
$

Canada Provincial
$

8,054   
4,791   
4,104   
1,753   
4,250   
3,721   
4,153   
10,418   
10,592   
7,343   
6,557   
3,501   
3,808   
4,822   
6,367   
6,202   
90,436   

6,668 
4,773 
4,089 
1,737 
4,250 
3,721 
4,153 
10,452 
10,592 
7,343 
6,557 
3,501 
3,808 
4,822 
6,367 
6,202 
89,114 

F-34

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

The Company has non-refundable R&D investment tax credits of approximately $1,778 which can be carried forward to reduce Canadian federal income taxes payable and
which expire at dates ranging from 2023 to 2035. Furthermore, the Company has unrecognized tax assets in respect of operating losses to be carried forward in Germany and in
the US. The federal tax losses amount to approximately $225,296 in Germany (€ 203,833) for which there is no expiry date, and to $5,342 in the US. The losses in the US will be
expiring as follows:

2028
2029
2034
2035
2036
2037
Indefinite
indefinite
indefinite
indefinite
Indefinite
indefinite

United States
$

369 
178 
151 
447 
195 
709 
1,224 
771 
516 
244 
292 
246 
5,342 

The operating loss carryforwards and the tax credits claimed are subject to review, and potential adjustment, by tax authorities. Other deductible temporary differences for
which tax assets have not been booked are not subject to a time limit, except for share issuance expenses which are amortizable over five years.

22. Capital management

The  Company’s  objective  in  managing  capital,  consisting  of  shareholders’  equity,  with  cash  and  cash  equivalents  and  restricted  cash  equivalents  being  its  primary
components, is to ensure sufficient liquidity to fund R&D costs, selling expenses, general and administrative expenses and working capital requirements. Historically, the
Company has raised capital via public and private equity offerings and issuances as its primary source of liquidity, as discussed in note 23. The capital management objective
of the Company remains the same as that in previous periods. The policy on dividends is to retain cash to keep funds available to finance the activities required to advance the
Company’s product development portfolio and to pursue appropriate commercial opportunities as they may arise.

The Company is not subject to any capital requirements imposed by any regulators or by any other external source.

F-35

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
23. Financial instruments and financial risk management

Financial assets and liabilities as of December 31, 2023, and 2022 are presented below.

December 31, 2023

Cash and cash equivalents
Trade and other receivables
Restricted cash equivalents
Payables and accrued liabilities
Lease liability

December 31, 2022

Cash and cash equivalents
Trade and other receivables
Restricted cash equivalents
Payables and accrued liabilities
Lease liability

Financial assets at
amortized cost
$

Financial liabilities at
amortized cost
$

34,016   
67   
332   
-   
-   
34,415   

- 
- 
- 
3,544 
160 
3,704 

Financial assets at
amortized cost
$

Financial liabilities at
amortized cost
$

50,611   
457   
322   
-   
-   
51,390   

- 
- 
- 
3,752 
179 
3,931 

The Company assessed that the fair values of cash and cash equivalents, trade receivables and other receivables, restricted cash equivalents, payables and accrued liabilities
and lease liability approximate their carrying amounts largely due to the short-term maturities of these instruments.

Assets and liabilities, such as value added taxes, that are not contractual and that arise as a result of statutory requirements imposed by governments, do not meet the
definition of financial assets or financial liabilities and are, therefore, excluded from trade and other receivables and payables and accrued liabilities.

Financial risk factors

The following provides disclosures relating to the nature and extent of the Company’s exposure to risks arising from financial instruments, including credit risk, liquidity risk
and foreign exchange risk and how the Company manages those risks.

(a) Credit risk

Credit risk is the risk of an unexpected loss if a customer or counterparty to a financial instrument fails to meet its contractual obligations. The Company regularly monitors
credit risk exposure and takes steps to mitigate the likelihood of this exposure resulting in losses. The Company’s exposure to credit risk currently relates to the financial
assets at amortized cost in the table above. The Company holds its available cash in amounts that are readily convertible to known amounts of cash and deposits its cash
balances with financial institutions that have an investment grade rating of at least "P-2” or the equivalent. This information is supplied by independent rating agencies where
available and, if not available, the Company uses publicly available financial information to ensure that it invests its cash in creditworthy and reputable financial institutions.
Once there are indicators that there is no reasonable expectation of recovery, such financial assets are written off but are still subject to enforcement activity.

F-36

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

As of December 31, 2023, two counterparties included in trade accounts receivable comprised a total receivable of approximately $67 (2022 - three counterparties for $403) of
which $nil (2022 - $nil) was past due, considered to be impaired and fully provided for.

Generally, the Company does not require collateral or other security from customers for trade accounts receivable; however, credit is extended following an evaluation of
creditworthiness. In addition, the Company performs ongoing credit reviews of all of its customers and determines expected credit losses. On this basis, as of December 31,
2023, the Company has provided for all outstanding and unpaid amounts relating to its operations.

The maximum exposure to credit risk approximates the amount recognized in the Company’s consolidated statement of financial position.

(b) Liquidity risk

Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they become due. The Company manages this risk through the management of its
capital structure by monitoring rolling forecasts of the Company’s cash and cash equivalents on the basis of expected cash flows.

Management concluded that the Company has sufficient cash on hand to meet its obligations as they become due for the next 12 months, considering the Company’s planned
research and development activities, selling, general and administrative expenses and working capital requirements. The Company has the ability to scale its research and
development  activities,  and  will  do  so  as  necessary,  based  on  cash  availability.  While  the  Company  has  $34,016  in  cash  and  cash  equivalents  at  December  31,  2023,  it
continues to have an ongoing need for additional capital resources to research and develop, commercialize and manufacture its products and technologies.

All of the Company’s financial liabilities except lease liabilities are current liabilities with expected settlement dates within one year. The maturity analysis for lease liabilities is
disclosed in note 14.

(c) Foreign exchange risk

Entities using the Euro as their functional currency

The Company is exposed to foreign exchange risk due to its investments in foreign operations whose functional currency is the Euro. As of December 31, 2023, if the US dollar
had increased or decreased by 10% against the Euro, with all other variables held constant, net loss for the year ended December 31, 2023, would have been lower or higher by
approximately $1,055 (2022 - $823 and 2021 - $300).

 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
F-37

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

24. Segment information

The Company operates in a single operating segment, being the biopharmaceutical segment.

Geographical information

Revenues by geographical area have been allocated to geographic regions based on the country of residence of the  Company’s external customers or licensees and are
detailed as follows:

Switzerland
Ireland
Denmark
Other

2023
$

Years ended December 31,
2022
$

4,317   
122   
11   
48   
4,498   

5,395   
82   
160   
3   
5,640   

Non-current assets include restricted cash equivalents and property and equipment, and are detailed by geographical area as follows:

December 31,

2023
$

575   
3   
71   
649   

Germany
Canada
United States

F-38

Aeterna Zentaris Inc.
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

25. Net loss per share

2021
$

2022
$

5,075 
- 
185 
- 
5,260 

463 
4 
71 
538 

The following table sets forth pertinent data relating to the computation of basic and diluted net loss per share attributable to common shareholders.

2023
$

Years ended December 31,
2022
$

2021
$

Net loss
Basic and diluted weighted-average number of shares outstanding

Basic and diluted loss per share
Items excluded from the calculation of diluted net loss per share due to their
anti-dilutive effect:
Stock options and DSUs
Share purchase warrants

26. Commitments

(16,552)  
4,855,876   

(3.41)  

250,320   
457,648   

(22,727)  
4,855,876   

(4.68)  

138,950   
457,648   

Significant expenditure contracted for at the end of the reporting period but not recognized as liabilities is as follows:

Less than 1 year
1 – 5 years

(8,368)
4,596,980 

(1.82)

60,375 
457,648 

Amount
$

5,634 
71 
5,705 

In 2021, the Company executed various agreements including in-licensing and similar arrangements with development partners. Such agreements may require the Company to
make payments on achievement of stages of development, launch or revenue milestones, although the Company generally has the right to terminate these agreements at no
penalty. The Company may have to pay up to $39,373 upon achieving certain sales volumes, regulatory or other milestones related to specific products.

F-39

Aeterna Zentaris Inc.

 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
    
 
    
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements
As of December 31, 2023 and 2022 and for the years ended December 31, 2023, 2022 and 2021
(in thousands of US dollars, except share and per share data and where otherwise noted)

27. Related party disclosures

Compensation of key management

Key management includes the Company’s Directors, Chief Executive Officer, Chief Financial Officer, Chief Scientific Officer and Chief Medical Officer. Compensation awarded
to key management is summarized as follows: 

Salaries and short-term benefits
Consultant’s fees
Post-retirement benefits
Stock-based compensation

2023
$

December 31,
2022
$

2021
$

2,025   
-   
37   
284   
2,346   

1,848   
17   
63   
460   
2,388   

1,646 
163 
70 
295 
2,174 

Most of the employment agreements entered into between the Company and its executive officers include termination provisions, whereby the executive officers would be
entitled to receive benefits that would be payable if the Company were to terminate the executive officers’ employment without cause or if their employment is terminated
following a change of control. Separation benefits generally are calculated based on an agreed-upon multiple of applicable base salary and incentive compensation and, in
certain cases, other benefit amounts.

28. Subsequent event

On December 14, 2023, the Company and Ceapro Inc. ("Ceapro”) jointly announced the signing of a definitive agreement to combine their operations in an all-stock merger of
equals.  Pursuant to the agreement, the transaction will be effected by way of a plan of arrangement under the  Canada  Business  Corporations Act pursuant to which, at
closing, each outstanding Ceapro common share will be exchanged for 0.09439 of an Aeterna common share with the result that Ceapro will become a wholly-owned subsidiary
of  Aeterna  (the  "Transaction”).  If  completed,  the  Transaction  will  be  considered  a  reverse  acquisition  and  the  historical  financial  statements  following  the  business
combination will be those of Ceapro. Additionally, as part of the Transaction, Aeterna will issue to its shareholders immediately prior to the closing of the transaction,  0.47698
of a share purchase warrant ("Transaction Warrants”) for each Aeterna common share held as of such date. Holders of Aeterna’s currently outstanding warrants will also be
issued transaction warrants in accordance with the anti-dilution provisions of such warrants. Each whole transaction warrant will be exercisable to purchase one common
share of Aeterna at a nominal exercise price of $0.01. The transaction also provides the outstanding options to acquire Ceapro common shares to be replaced by options
allowing current holders to acquire common shares of Aeterna on similar terms, as adjusted by the exchange ratio in the transaction. Following the closing of the Transaction,
the former shareholders of  Ceapro will own 50% of Aeterna and the pre-transaction securityholders of Aeterna will own the remaining 50%, assuming the exercise of all
Transaction Warrants. The transaction required the approval of shareholders of both Companies, which was obtained on March 12, 2024, and is subject to closing conditions
customary for transactions of this nature, including Alberta court approval and applicable stock exchange approvals. It is anticipated that the transaction will close in the
second quarter of 2024, subject to the satisfaction of the conditions of the agreement.

F-40

Item 19. Exhibits

Exhibit Index

1.1

  Restated Certificate of Incorporation and Restated Articles of Incorporation of the Registrant (incorporated by reference to Exhibit 99.2 to the Registrant’s report on

Form 6-K furnished to the Commission on May 25, 2011)

1.2

  Certificate of Amendment and Articles of Amendment of the Registrant (incorporated by reference to Exhibit 99.2 to the Registrant’s report on Form 6-K furnished to the

Commission on October 3, 2012)

1.3

  Certificate of Amendment and Articles of Amendment of the Registrant (incorporated by reference to Exhibit 99.1 to the Registrant’s report on Form 6-K furnished to the

Commission on November 17, 2015)

1.4**   Certificate of Amendment and Articles of Amendment of the Registrant
1.5

  Amended and Restated By-Law One of the Registrant (incorporated by reference to Exhibit 1.3 of the Registrant’s Annual Report on Form 20-F for the financial year

ended December 31, 2012 filed with the Commission on March 22, 2013)

2.1

  Amended and Restated Shareholder Rights Plan Agreement between the Registrant and Computershare Trust Company of Canada, as Rights Agent, dated as of May 8,

2.2
4.1

4.2
4.3

2019 (incorporated by reference to Exhibit 99.2 to the Registrant’s report on Form 6-K furnished to the Commission on May 9. 2019)

  Description of Securities Registered Under Section 12 of The Exchange
  Second Amended and Restated Stock Option Plan of the Registrant (incorporated by reference to Exhibit 4.1 of the Registrant’s Annual Report on Form 20-F for the

financial year ended December 31, 2013 filed with the Commission on March 21, 2014)

  2018 Long-Term Incentive Plan of the Registrant (incorporated by reference to Exhibit 4.7 of the Registrant’s Form S-8 filed with the Commission on May 8, 2018)
  License and Assignment Agreement, dated January 16, 2018 by and between Aeterna Zentaris GmbH and Strongbridge Ireland Limited (incorporated by reference to

Exhibit 99.2 of the Registrant’s report on Form 6-K furnished to the Commission on January 19, 2018)

4.4

  Amendment Agreement dated November 16, 2020, by and between Aeterna Zentaris GmbH and Novo Nordisk Biopharm Limited. (incorporated by reference to Exhibit

99.1 of the Registrant’s report on Form 6-K furnished to the Commission on November 16, 2020)

4.5

  License Agreement effective December 7, 2020, by and between Aeterna Zentaris GmbH and Consilient Health Ltd. (incorporated by reference to Exhibit 99.1 of the

Registrant’s report on Form 6-K furnished to the Commission on December 7, 2020)

4.6
4.7
8.1

  Amendment Agreement between Aeterna Zentaris GmbH and Atnahs Pharma UK Limited ("Pharmanovia”) dated as of March 15, 2023
  Novo Nordisk Early - Termination of Amendment Agreement ("Agreement”) dated as of 16 November 2020
  Subsidiaries of the Registrant

11.1**   Code of Conduct and Business Ethics of the Registrant
11.2   Code of Business Conduct and Ethics for Members of the Board of Directors (incorporated by reference to Exhibit 11.2 of the Registrant’s Annual Report on Form 20-F

for the financial year ended December 31, 2014 filed with the Commission on March 17, 2015)

11.3   Audit  Committee  Charter  of  the  Registrant  (incorporated  by  reference  to  Exhibit  11.3  of  the  Registrant’s Annual  Report  on  Form  20-F  for  the  financial  year  ended

December 31, 2014 filed with the Commission on March 17, 2015)

12.1**   Certification of the Principal Executive Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002
12.2**   Certification of the Principal Financial Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002
13.1**   Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002
13.2**   Certification of the Principal Financial Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

 
 
 
 
 
 
 
 
 
   
   
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
15.1**   Consent of Deloitte LLP
15.2**   Consent of Ernst &Young LLP
16.1*   Letter of Ernst & Young LLP dated March 31, 2023 (incorporated by reference to Exhibit 99.1 of the Registrant’s report on Form 6-K furnished to the Commission on

March 31, 2023)

97.1**   Aeterna Zentaris Executive Compensation Clawback Policy

*
**

  Incorporated by reference.
  Filed with this annual report on Form 20-F.

Exhibit Index

101. INS XBRL Instance Document

101. SCH XBRL Taxonomy Extension Schema

101. CAL XBRL Taxonomy Extension Schema Calculation Linkbase

101. DEF XBRL Taxonomy Extension Schema Definition Linkbase

101. LAB XBRL Taxonomy Extension Schema Label Linkbase

101. PRE XBRL Taxonomy Extension Schema Presentation Linkbase

125

SIGNATURES

The registrant hereby certifies that it meets all of the requirements for filing on Form 20-F and that it has duly caused and authorized the undersigned to sign this annual report on
its behalf.

Date: March 26, 2024

AETERNA ZENTARIS INC.

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

126

 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 1.4

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 2.2

DESCRIPTION OF SECURITIES REGISTERED UNDER SECTION 12 OF THE EXCHANGE ACT

As of the date of the Annual Report on Form 20-F of which this Exhibit 2.2 is a part, Aeterna Zentaris Inc. (the “ Company”) had the following securities registered pursuant to
Section 12(b) of the Securities Exchange Act of 1934 (the “Exchange Act”):

Title of each class

Common Shares

Trading Symbol(s)

AEZS

Name of each exchange on which registered
NASDAQ Capital Market
Toronto Stock Exchange

Common Shares:

The following description of our Common Shares is a summary and does not purport to be complete. It is subject to and qualified in its entirety by reference to our articles (the
“Articles”), as amended, which are filed as an exhibit to the Annual Report on Form 20-F of which this Exhibit 2.2 is a part.

We have 4,855,876 Common Shares issued and outstanding as of March 26, 2024, and we are authorized to issue an unlimited number of Common Shares, without par value.

Basic Rights of our Common Shares

The holders of Common Shares are entitled to one vote per share on all matters voted on by shareholders, including the election of directors. All our Common Shares rank equally
as to dividends (as may be declared from time to time by our board of directors from funds available for distribution to holders), voting power and participation in assets. Upon
liquidation, dissolution or winding up of the Company, holders of our Common Shares are entitled to receive pro rata the assets of the Company, if any, remaining after payments
of all debts and liabilities.

Our Common Shares are not subject to liability to further capital calls by the Company. There are no provisions in our Articles discriminating against any existing or prospective
shareholder as a result of such shareholder owning a substantial number of our Common Shares, and non-resident or foreign holders of our Common Shares are not limited in
having, holding or exercising the voting rights associated with Common Shares. Also, no provision or rights exist in our Articles regarding our Common Shares in connection with
exchange, redemption, retraction, purchase for cancellation, surrender or sinking or purchase funds.

Pre-emptive Rights

Our Common Shares do not contain any pre-emptive purchase rights to any of our securities.

Transferability of Common Shares

Our Articles do not impose restrictions on the transfer of Common Shares by a shareholder. We will not, however, register a transfer of Common Shares until: (1) we receive a duly
signed instrument in respect of the transfer of Common Shares; (2) a share certificate, if any, representing the transferred Common Shares has been surrendered to us; and (3) if a
non-transferable  written  acknowledgment  of  the  shareholder’s  right  to  obtain  a  share  certificate  has  been  issued  by  the  Company  in  respect  of  the  Common  Shares  to  be
transferred, that acknowledgement has been surrendered to us.

Action(s) to change Rights attaching to our Common Shares

Provisions as to the modification, amendment or variation of shareholder rights for holders of our Common Shares are contained in the British Columbia Business Corporation Act
(“BCBCA”).  The  BCBCA  requires  a  “special  resolution”  of  shareholders  for  specific  corporate  actions,  including  certain  alterations  of  our  share  capital,  with  such  “special
resolution” requiring an affirmative two-thirds vote of shareholders (rather than a simple majority) for passage. No right or special right attached to any of our issued shares may be
prejudiced or interfered with unless the shareholders holding shares of such class or series of shares to which the right or special right is attached consent by a separate “special
resolution” of those shareholders.

Change of Control restrictions for our Common Shares

Our Articles do not contain provisions that would have an effect of delaying, deferring or preventing a change in control of the Company which would operate with respect to a
merger, acquisition or corporate restructuring involving the Company or any of its subsidiaries.

Ownership disclosure threshold for our Common Shares

Our Articles  do  not  have  any  specific  threshold  requiring  disclosure  of  ownership  by  holders  of  our  Common  Shares.  However,  Canadian  securities  regulators  do  require
disclosure of shareholder ownership by any shareholder owning more than 10% of our outstanding Common Shares.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 4.6

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 4.7

 
 
 
 
SUBSIDIARIES OF THE REGISTRANT

AETERNA ZENTARIS INC.

Exhibit 8.1

 
 
 
 
 
 
 
 
 
Exhibit 11.1

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002 Certification

Exhibit 12.1

I, Klaus Paulini, certify that:

1.

2.

3.

4.

I have reviewed this annual report on Form 20-F of Aeterna Zentaris Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,
results of operations and cash flows of the company as of, and for, the periods presented in this report;

The company’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-
15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the company and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the company, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the
period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally
accepted accounting principles;

Evaluated the effectiveness of the company’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the company’s internal control over financial reporting that occurred during the period covered by the annual report that
has materially affected, or is reasonably likely to materially affect, the company’s internal control over financial reporting; and

5.

The company’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the company’s auditors
and the audit committee of the company’s board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the company’s ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the company’s internal control over financial
reporting.

Date: March 26, 2024

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit 12.2

Certification of the Principal Financial Officer pursuant to §302 of the Sarbanes-Oxley Act of 2002 Certification

I, Giuliano La Fratta, certify that:

1.

2.

3.

4.

I have reviewed this annual report on Form 20-F of Aeterna Zentaris Inc.;

Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light
of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition,
results of operations and cash flows of the company as of, and for, the periods presented in this report;

The company’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-
15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the company and have:

(a)

(b)

(c)

(d)

Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that
material information relating to the company, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the
period in which this report is being prepared;

Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, to provide
reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally
accepted accounting principles;

Evaluated the effectiveness of the company’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the
disclosure controls and procedures, as for the end of the period covered by this report based on such evaluation; and

Disclosed in this report any change in the company’s internal control over financial reporting that occurred during the period covered by the annual report that
has materially affected, or is reasonably likely to materially affect, the company’s internal control over financial reporting; and

5.

The company’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the company’s auditors
and the audit committee of the company’s board of directors (or persons performing the equivalent functions):

(a)

(b)

All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely
affect the company’s ability to record, process, summarize and report financial information; and

Any fraud, whether or not material, that involves management or other employees who have a significant role in the company’s internal control over financial
reporting.

Date: March 26, 2024

/s/ Giuliano La Fratta
Giuliano La Fratta
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

Exhibit 13.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the annual report of Aeterna Zentaris Inc. (the “Company”) on Form 20-F for the year ended December 31, 2021 as filed with the Securities and Exchange
Commission on the date hereof (the “Report”), I, Klaus Paulini, President and Chief Executive Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to
§ 906 of the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Dated: March 26, 2024

/s/ Klaus Paulini
Klaus Paulini
President and Chief Executive Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Certification of the Principal Executive Officer pursuant to 18 U.S.C. Section 1350 as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

Exhibit 13.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350,

AS ADOPTED PURSUANT TO

SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the annual report of Aeterna Zentaris Inc. (the “Company”) on Form 20-F for the year ended December 31, 2021 as filed with the Securities and Exchange
Commission on the date hereof (the “Report”), I, Giuliano La Fratta, Chief Financial Officer of the Company, certify, pursuant to 18 U.S.C. § 1350, as adopted pursuant to § 906 of
the Sarbanes-Oxley Act of 2002, that:

(1)

(2)

The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Dated: March 26, 2024

/s/ Giuliano La Fratta
Giuliano La Fratta
Chief Financial Officer

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We consent to the incorporation by reference in Registration Statement Nos. 333-224737, 333-210561 and 333-200834 on Form S-8 and Registration No. 333-254680 on Form F-3 of
our report dated March 26, 2024, relating to the financial statements of Aeterna Zentaris Inc. appearing in this Annual Report on Form 20-F for the year ended December 31, 2023.

Exhibit 15.1

/s/ Deloitte LLP

Chartered Professional Accountants

Montreal, Canada
March 26, 2024

 
 
 
 
 
 
 
 
 
 
Consent of Independent Registered Public Accounting Firm

Exhibit 15.2

We consent to the incorporation by reference in the Registration Statements on Form S-8 (No. 333-224737, No. 333-210561 and No. 333-200834) and Form F-3 (No. 333-254680) of
Aeterna Zentaris Inc. of our report dated March 22, 2023 with respect to the consolidated financial statements of Aeterna Zentaris Inc. as of December 31, 2022 and for each of the
two years in the period ended December 31, 2022, included in this Annual Report on Form 20-F.

/s/ Ernst & Young LLP

Montreal, Canada
March 26, 2024

 
 
 
 
 
 
 
 
AETERNA ZENTARIS INC.

EXECUTIVE COMPENSATION CLAWBACK POLICY

Exhibit 97.1

Introduction

The Board of Directors (the “Board”) of Aeterna Zentaris Inc. (the “Company”) believes that it is in the best interests of the Company and its shareholders to create and maintain a
culture that emphasizes integrity and accountability and that reinforces the  Company’s pay-for-performance compensation philosophy.  The  Board has therefore adopted this
policy  which  provides  for  the  recoupment  of  certain  executive  compensation  in  the  event  of  an  accounting  restatement  resulting  from  material  noncompliance  with  financial
reporting requirements under the federal securities laws (the “Policy”). This Policy is designed to comply with Section 10D of the Securities Exchange Act of 1934 (the “Exchange
Act”), Rule 10D-1 promulgated under the Exchange Act and Listing Rule 5608 of the Nasdaq Stock Market (the “Listing Standards”).

Administration

The Board has delegated administration of this Policy to the Nominating, Governance & Compensation Committee of the Board (the “Committee”). Any determinations made by
the Committee shall be final and binding on all affected individuals.

Covered Executives

This Policy applies to the Company’s current and former executive officers, as determined by the Committee in accordance with Section 10D of the Exchange Act and the Listing
Standards, and such other senior executives or employees who may from time to time be deemed subject to the Policy by the Committee (“Covered Executives”). The following are
examples of persons who may be deemed executive officers:

● Chief Executive Officer;

● President;

● Chief Financial Officer or principal financial officer;

● Principal accounting officer or controller;

● Any vice president in charge of a principal business unit, division or function, such as sales administration or finance;

● Any other officer who performs a policy-making function; and

● Any other person (such as an executive officer of a subsidiary or parent entity) who performs similar policy-making functions for the company.

Recoupment; Accounting Restatement

In the event the Company is required to prepare an accounting restatement of its financial statements due to the Company’s material noncompliance with any financial reporting
requirement under the securities laws, the Committee will require reimbursement or forfeiture of any excess Incentive Compensation received by any Covered Executive during the
three completed fiscal years immediately preceding the date on which the Company is required to prepare an accounting restatement. However, no reimbursement or forfeiture will
apply to Incentive Compensation received by a Covered Executive before such Covered Executive began providing services as a Covered Executive.

Incentive Compensation

For purposes of this Policy, “Incentive Compensation” means any compensation that is granted, earned or vested based wholly or in part upon the attainment of a Financial
Reporting Measure. Incentive Compensation is “received” for purposes of this Policy in the Company’s fiscal period during which the Financial Reporting Measure specified in
the Incentive Compensation award is attained, even if the payment or grant of such Incentive Compensation occurs after the end of that period. The following are examples of
Incentive Compensation that may be based on a Financial Reporting Measure:

● Annual bonuses and other short- and long-term cash incentives.

● Stock options.

● Stock appreciation rights.

● Restricted stock.

● Restricted stock units.

● Performance shares.

● Performance units.

A “Financial Reporting Measure” is any measure that is determined and presented in accordance with the accounting principles used in preparing the  Company’s financial
statements, and any measure that is derived wholly or in part from such measure. A Financial Reporting Measure need not be presented within the Company’s financial statements
or included in a filing with the Securities Exchange Commission. Examples of Financial Reporting Measures may include:

● Company stock price;

● Total shareholder return;

● Revenues;

● Net income;

● Earnings before interest, taxes, depreciation, and amortization (EBITDA);

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
● Funds from operations;

● Liquidity measures such as working capital or operating cash flow;

● Return measures such as return on invested capital or return on assets; or

● Earnings measures such as earnings per share.

Excess Incentive Compensation: Amount Subject to Recovery

The amount to be recovered will be the excess of the Incentive Compensation paid to the Covered Executive based on the erroneous data over the Incentive Compensation that
would have been paid to the Covered Executive had it been based on the restated results, as determined by the Committee.

If the Committee cannot determine the amount of excess Incentive Compensation received by the Covered Executive directly from the information in the accounting restatement,
then it will make its determination based on a reasonable estimate of the effect of the accounting restatement.

Method of Recoupment

The Committee will determine, in its sole discretion, the method for recouping Incentive Compensation hereunder which may include, without limitation:

● requiring reimbursement of cash Incentive Compensation previously paid;

● seeking recovery of any gain realized on the vesting, exercise, settlement, sale, transfer, or other disposition of any equity-based awards;

● offsetting the recouped amount from any compensation otherwise owed by the Company to the Covered Executive;

2

● cancelling outstanding vested or unvested equity awards; and

● taking any other remedial and recovery action permitted by law, as determined by the Committee.

No Indemnification

The Company shall not indemnify any Covered Executives against the loss of any incorrectly awarded Incentive Compensation.

Interpretation

The Committee is authorized to interpret and construe this Policy and to make all determinations necessary, appropriate, or advisable for the administration of this Policy. It is
intended that this Policy be interpreted in a manner that is consistent with the requirements of Section 10D of the Exchange Act and any applicable rules or standards adopted by
the Securities and Exchange Commission or any national securities exchange on which the Company’s securities are listed.

Effective Date

This Policy has been adopted by the Committee effective as of December 1, 2023 (the “Effective Date”) and shall apply to Incentive Compensation that is approved, awarded or
granted to Covered Executives on or after that date.

Amendment; Termination

The Committee may amend this Policy from time to time in its discretion and shall amend this Policy as it deems necessary to reflect further regulations adopted by the Securities
and Exchange Commission under Section 10D of the Exchange Act or rules or interpretations promulgated thereunder and to comply with any Listing Standards. The Committee
may terminate this Policy at any time.

Other Recoupment Rights

The Committee intends that this Policy will be applied to the fullest extent of the law. The Committee may require that any employment agreement, equity award agreement, or
similar agreement entered into on or after the Effective Date shall, as a condition to the grant of any benefit thereunder, require a Covered Executive to agree to abide by the terms
of this Policy. Any right of recoupment under this Policy is in addition to, and not in lieu of, any other remedies or rights of recoupment that may be available to the Company
pursuant to the terms of any similar policy in any employment agreement, equity award agreement, or similar agreement and any other legal remedies available to the Company.

Impracticability

The Committee shall recover any excess Incentive Compensation in accordance with this Policy unless such recovery would be impracticable, as determined by the Committee in
accordance with Rule 10D-1 of the Exchange Act and the Listing Standards.

Successors

This Policy shall be binding and enforceable against all Covered Executives and their beneficiaries, heirs, executors, administrators or other legal representatives.

Exhibit Filing Requirement

A copy of this Policy and any amendments thereto shall be posted on the Company’s website and filed as an exhibit to the Company’s annual report on Form 20-F.

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