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ARCA biopharma, Inc.

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FY2018 Annual Report · ARCA biopharma, Inc.
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION 
Washington, D.C. 20549 

FORM 10-K 

(Mark One) 
 ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the fiscal year ended December 31, 2018 
or 

 TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 

For the transition period from                      to                     

Commission File Number: 000-22873 

ARCA BIOPHARMA, INC. 

(Exact Name of Registrant as Specified in Its Charter) 

Delaware
(State or Other Jurisdiction
of Incorporation or Organization)

11080 CirclePoint Road, Suite 140, Westminster, CO
(Address of Principal Executive Offices)

36-3855489
(I.R.S. Employer
Identification No.)

80020
(Zip Code)

(720) 940-2200 
(Registrant’s telephone number, including area code) 

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

Title of Each Class
Common Stock $0.001 par value

Name of Each Exchange on Which Registered
The Nasdaq Capital Market

Securities registered pursuant to Section 12(g) of the Exchange Act: None 

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in rule 405 of the Securities Act.    Yes      No   
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 and Section 15(d) of the Act.    Yes      No   
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      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 such files).    Yes      No   
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein, and will not be contained, to 
the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any 
amendment to this Form 10-K.     
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or 
emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth 
company” in Rule 12b-2 of the Exchange Act. 

  
   

Large accelerated filer
Non-accelerated filer



Emerging growth company     
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any 
new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.  
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).    Yes      No   

  Accelerated filer
  Smaller reporting company

The aggregate market value of the common stock held by non-affiliates of the Registrant on June 29, 2018, the last business day of the most recently 
completed second fiscal quarter, was $7,650,869 based on the last sale price of the common stock as reported on that day by the The Nasdaq Capital 
Market. 
As of February 22, 2019, the Registrant had 18,355,111 shares of common stock outstanding. 

DOCUMENTS INCORPORATED BY REFERENCE 

 
 
 
 
 
 
 
 
 
 
TABLE OF CONTENTS 

PART I

Item 1.
Item 1A.
Item 1B.
Item 2.
Item 3.
Item 4.

PART II

Item 5.
Item 6.
Item 7.
Item 7A.
Item 8.

Item 9.
Item 9A.
Item 9B.

PART III

Item 10.
Item 11.
Item 12.
Item 13.
Item 14.

PART IV

Item 15.

 Business ..........................................................................................................................................................................  
 Risk Factors ....................................................................................................................................................................  
 Unresolved Staff Comments...........................................................................................................................................
 Properties ........................................................................................................................................................................  
 Legal Proceedings...........................................................................................................................................................  
 Mine Safety Disclosures.................................................................................................................................................  

 Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities ....  
 Selected Financial Data ..................................................................................................................................................  
 Management’s Discussion and Analysis of Financial Condition and Results of Operations ........................................  
 Quantitative and Qualitative Disclosures About Market Risk .......................................................................................  
 Financial Statements and Supplementary Data ..............................................................................................................  
 REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM, KPMG LLP .................................  
 BALANCE SHEETS......................................................................................................................................................  
 STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS .......................................................................  
 STATEMENTS OF STOCKHOLDERS’ EQUITY ......................................................................................................  
 STATEMENTS OF CASH FLOWS..............................................................................................................................  
 NOTES TO FINANCIAL STATEMENTS ...................................................................................................................  
 Changes in and Disagreements with Accountants on Accounting and Financial Disclosure ........................................  
 Controls and Procedures.................................................................................................................................................  
 Other Information ...........................................................................................................................................................  

 Directors, Executive Officers and Corporate Governance .............................................................................................  
 Executive Compensation ................................................................................................................................................  
 Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters ......................  
 Certain Relationships and Related Transactions, and Director Independence ...............................................................  
 Principal Accountant Fees and Services.........................................................................................................................  

 Exhibits and Financial Statement Schedules ..................................................................................................................  

SIGNATURES  

.................................................................................................................................................................................  

1
19
40
40
41
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42
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47
48
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PART I 

Item 1. Business 

Some of the statements under “Business,” “Risk Factors,” “Management’s Discussion and Analysis of Financial Condition and 
Results of Operations” and elsewhere in this Annual Report constitute forward-looking statements. In some cases, you can identify 
forward-looking statements by the following words: “may,” “will,” “could,” “would,” “should,” “expect,” “intend,” “plan,” 
“anticipate,” “believe,” “estimate,” “predict,” “project,” “potential,” “continue,” “ongoing” or the negative of these terms or 
other comparable terminology, although not all forward-looking statements contain these words. Examples of these statements 
include, but are not limited to, statements regarding the following: potential future development plans for Gencaro, including the 
likelihood that any Phase 3 clinical trial results for Gencaro to satisfy the requirements of our Special Protocol Assessment 
agreement, the expected features and characteristics of Gencaro, including the potential for genetic variations to predict individual 
patient response to Gencaro or AB171, Gencaro’s potential to treat atrial fibrillation, or AF, future treatment options for patients 
with AF, the potential for Gencaro to be the first genetically-targeted AF prevention treatment, statements regarding potential 
Phase 3 development plans for Gencaro, including the timing and results thereof, the expected features and characteristics of AB171 
as a potential genetically-targeted treatment for peripheral arterial disease and for heart failure, or HF, the potential timeline for 
development of AB171, including any Investigational New Drug, or IND, application submission related thereto, and the ability of 
ARCA’s financial resources to support its operations through the third quarter of 2019, the sufficiency of our current capital to reach 
certain of our corporate objectives, our ability to obtain additional funding when needed or enter into a strategic or other transaction, 
including our ability to raise sufficient capital to fund any Phase 3 clinical trials for Gencaro and our other operations, the extent to 
which our issued and pending patents may protect our products and technology, the potential of such product candidates to lead to the 
development of safe or effective therapies, our ability to enter into collaborations, our ability to maintain listing of our common stock 
on a national exchange, our future operating expenses, our future losses, our future expenditures, and the sufficiency of our cash 
resources to maintain operations. These statements involve known and unknown risks, uncertainties and other factors that may cause 
our actual results, levels of activity, performance or achievements to be materially different from the information expressed or implied 
by these forward-looking statements. While we believe that we have a reasonable basis for each forward-looking statement contained 
in this Annual Report, we caution you that these statements are based on a combination of facts and factors currently known by us and 
our projections of the future, about which we cannot be certain. 

In addition, you should refer to the “Risk Factors” section of this Annual Report for a discussion of other important factors that may 
cause our actual results to differ materially from those expressed or implied by our forward-looking statements. As a result of these 
factors, we cannot assure you that the forward-looking statements in this Annual Report will prove to be accurate. Furthermore, if our 
forward-looking statements prove to be inaccurate, the inaccuracy may be material. In light of the significant uncertainties in these 
forward-looking statements, you should not regard these statements as a representation or warranty by us or any other person that we 
will achieve our objectives and plans in any specified time frame, or at all. 

We undertake no obligation to publicly update any forward-looking statements, whether as a result of new information, future events 
or otherwise. You are advised, however, to consult any further disclosures we make on related subjects in our Quarterly Reports on 
Form 10-Q, Current Reports on Form 8-K, and our website. 

The terms “ARCA,” “the Company,” “we,” “us,” “our” and similar terms refer to ARCA biopharma, Inc. 

Overview

We are a biopharmaceutical company applying a precision medicine approach to developing genetically-targeted therapies for 
cardiovascular diseases. Precision medicine refers to the tailoring of medical treatment to the individual characteristics of each patient 
through the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease, in the biology 
and/or prognosis of those diseases they may develop, or in their response to a specific treatment. Our lead product candidate, 
Gencaro™ (bucindolol hydrochloride), is an investigational, pharmacologically unique beta-blocker and mild vasodilator that we are 
developing to treat atrial fibrillation, or AF, in certain patients who also have heart failure, or HF.  

Gencaro has a mechanism of action that we believe is unique in the beta-blocker drug class and is modulated by a specific genotype. 
We estimate this genotype is present in about 50% of North American and European general populations. We believe that Gencaro’s 
potential efficacy is enhanced in treating patients who have this genotype and, if Gencaro is approved by the U.S. Food and Drug 
Administration, or the FDA, Gencaro could potentially be a safe and effective therapy for treating AF in patients who have HF. We 
also believe that Gencaro, if approved, will have market exclusivity based on patents and new chemical entity status, if approved in 
the United States, Europe or other markets.

1

In February 2018, we reported the results of our Phase 2B clinical trial, known as GENETIC-AF, in which we evaluated Gencaro for 
the prevention of AF recurrence in patients with HF and a left ventricular ejection fraction, or LVEF, < 0.50. This population included 
267 patients that had HF with reduced LVEF < 0.40, or HFrEF, or HF with mid-range LVEF ≥ 0.40 and < 0.50, or HFmrEF. 
GENETIC-AF compared Gencaro to TOPROL-XL (metoprolol succinate), a drug approved for treating HFrEF that is also prescribed, 
but not approved, for treating AF in patients with HFrEF. There are no approved or guideline recommended drug therapies for 
prevention of AF in HFmrEF patients, which constituted approximately one-half of the GENETIC-AF patients.  

In GENETIC-AF, Gencaro was observed to have a similar treatment effect to TOPROL-XL (metoprolol succinate) in the overall 
population for prevention of AF recurrence. However, additional analyses prespecified in the statistical analysis plan showed 
statistically significant treatment effects in favor of Gencaro in the majority of the Phase 2B population (N=196; HR=0.54; p = 0.011). 
Gencaro also showed statistically significant treatment effects compared to TOPROL-XL for the prevention of AF recurrence in a 
subset of these patients with HFmrEF (N=91; HR=0.42; p = 0.017). We plan to conduct a pivotal Phase 3 trial, known as 
PRECISION-AF, evaluating Gencaro in HFmrEF patients because of Gencaro’s observed potential treatment effect in these patients 
in GENETIC-AF. 

The prevalence of AF is higher in HFmrEF patients as compared with HF generally; it is estimated that 30%-60% of HFmrEF patients 
also have AF. For patients with HF, AF can contribute to the disease processes that lead to the progression of heart failure and 
worsening clinical outcomes including hospitalizations and death. This increased risk of illness and death when AF is present with 
heart failure is true across the spectrum of HF, including HFmrEF. Given these risks and the absence of HF or AF therapies 
specifically indicated for the HFmrEF population, we believe there is an unmet medical need for drug therapy with greater efficacy to 
prevent or delay the development of AF in these patients.

In February 2019, we received a Special Protocol Assessment agreement, or SPA, from the FDA for our planned Phase 3 clinical 
program. The FDA’s SPA process is designed to facilitate the FDA’s review and approval of drugs by allowing the FDA to evaluate 
the proposed design and size of certain clinical trials that are intended to form the primary basis for determining a drug product’s 
efficacy and safety. Upon specific request by a clinical trial sponsor, the FDA evaluates the protocol and responds to a sponsor’s 
questions regarding, among other things, primary efficacy endpoints, trial conduct and data analysis, within 45 days of receipt of the 
request. The FDA ultimately assesses whether the protocol design and planned analysis of the trial are acceptable to support regulatory 
approval of the product candidate for the indication studied. An SPA agreement can potentially reduce the regulatory risk of bringing 
a drug to market. 

Our SPA details a single adequate and well-controlled Phase 3 clinical trial (PRECISION-AF) designed as a double-blind, active-
controlled, multicenter, international, study comparing Gencaro with TOPROL-XL (metoprolol succinate) for the prevention of 
recurrent AF or all-cause mortality, or ACM, in HFmrEF patients. Eligible patients will have HFmrEF, a recent AF event and the 
genotype which we believe responds most favorably to Gencaro. The primary endpoint of the submitted trial will be time to first event 
of atrial fibrillation/atrial flutter or ACM during a 26-week follow-up period. Subject to securing significant additional financing, we 
anticipate initiating PRECISION-AF in the fourth quarter of 2019. 

We believe that Gencaro, if approved, could potentially be a safe and more effective therapy than currently available therapeutics for 
treating heart failure patients with AF. We believe Gencaro has the potential to be unique in several aspects, including:

•

•

•

The first genetically-targeted cardiovascular therapy;

The only drug therapy indicated for AF in patients with HFmrEF; and

The only therapy for AF approved against an active comparator.

The genotype that we believe enhances Gencaro’s efficacy can be detected by a genetic test that can be performed by a centralized 
laboratory or potentially at the point of care during the patient visit. We also believe that Gencaro, if approved, will have market 
exclusivity based on patents and new chemical entity status in the United States, Europe or other markets in which it may be approved.

The Proposed Gencaro Phase 3 Clinical Trial

Based on our GENETIC-AF trial results, as well as results of previous Phase 3 pharmacogenetic substudy data from the Phase 3 heart 
failure clinical trial of bucindolol, known as the BEST trial, we submitted an SPA to the FDA detailing our proposed Phase 3 clinical 
trial and potential approval path for Gencaro. In February 2019, we received an SPA agreement for PRECISION-AF, a Phase 3 
pivotal study comparing Gencaro against TOPROL-XL for the treatment of AF in HFmrEF patients with the beta-1 389 arginine 
homozygous genotype.

2

The PRECISION-AF Phase 3 clinical trial is designed as a double-blind, active-controlled, multicenter, international, adaptive study 
comparing Gencaro with TOPROL-XL for the prevention of recurrent AF/atrial flutter, or AF/AFL, or all-cause mortality, or ACM, in 
HFmrEF patients. The study will enroll approximately 400 patients at investigative sites in the United States, Europe and Australia. 
 40 and < 50%), a recent AF event and the beta-1 389 arginine homozygous genotype 
Eligible patients will have HFmrEF (LVEF 
which we believe responds most favorably to Gencaro. The planned trial will use standard significance criteria (p < 0.01 with 
adjustment for interim analysis) for the primary endpoint and will include an interim analysis after a portion of total patients have been 
enrolled. The interim analysis is designed to assess safety, validate initial study assumptions and maintain adequate statistical power 
for the primary endpoint. Subject to securing additional financing, we anticipate initiating PRECISION-AF in the fourth quarter of 
2019. Any future development of Gencaro, including initiating any Phase 3 clinical trial, is dependent on obtaining significant 
additional financing, even if we enter into a strategic collaboration around the development of Gencaro.

≥

GENETIC-AF and BEST Trial DNA Substudy

Our planned Phase 3 development program of Gencaro is based on the results from GENETIC-AF and a prospectively designed DNA 
substudy of adrenergic receptor polymorphisms in the BEST trial, a previous Phase 3 study of bucindolol in 2,708 HF patients. Based 
on data from the BEST trial, Gencaro showed potential evidence of enhanced efficacy in treating AF and in reducing mortality and 
hospitalizations in HF patients with the beta-1 389 arginine homozygous genotype.

GENETIC-AF enrolled 267 patients from the United States, Canada and Europe. The primary analysis was conducted to evaluate the 
evidence of safety and superior efficacy of Gencaro versus an active comparator, TOPROL-XL. The primary endpoint of the trial was 
time to recurrent AF/AFL or ACM. Eligible patients had LVEF < 50%, a history of paroxysmal AF (episodes lasting 7 days or less) or 
persistent AF (episodes lasting more than 7 days and less than 1 year) in the past 6 months, and the beta-1 389 arginine homozygous 
genotype that we believe responds most favorably to Gencaro. A subgroup of patients underwent continuous (24/7) heart rhythm 
monitoring via implanted loop recorders or other implanted therapeutic devices of Medtronic, Inc., or Medtronic, a global healthcare 
solutions company, to evaluate daily AF burden, or AFB. A prespecified time-to-first event analysis was conducted using a total AFB 
of at least 6 hours per day to define an event of AF recurrence.

Overall, Gencaro demonstrated a similar treatment benefit compared to the active comparator, TOPROL-XL (hazard ratio of 1.01 [95% 
confidence interval: 0.71, 1.42]). In the U.S. patient cohort of 127 patients (approximately 50% of all patients and events), a trend for 
benefit in favor of Gencaro over TOPROL-XL was observed (hazard ratio of 0.70, [95% confidence interval: 0.41, 1.19]). The 
GENETIC-AF results in the United States were consistent with what had been observed in the pharmacogenetic substudy of the BEST 
heart failure trial, taking into account that BEST was placebo controlled and GENETIC-AF was Gencaro versus an active comparator. 
However, our analysis also showed significant treatment effects in favor of Gencaro in a majority of patients in the trial, based on 
factors pre-specified in the statistical analysis plan.

We believe that the inclusion of a small number of patients in the trial (13.9% of overall population) with long-standing and heavily 
pretreated HF and AF led to attenuation of the treatment effect estimates for the primary endpoint of GENETIC-AF. Therefore, in 
accordance with procedures outlined in the Statistical Analysis Plan, post-hoc analyses were performed that excluded 37 patients with 
extraordinarily long durations of HF and AF (subjects who had been diagnosed with HF and/or AF for more than 12 years). In these 
analyses, we observed a trend for benefit in favor of Gencaro over TOPROL-XL by intermittent, clinic-based heart rhythm monitoring 
for the entire cohort (230 patients [N=115 for each treatment arm], hazard ratio of 0.68, [95% confidence interval: 0.45, 1.02]) and for 
the HFmrEF cohort (113 patients, hazard ratio of 0.61, [95% confidence interval: 0.34, 1.10]). The onset of AF relative to the 
development of HF was also identified in our post-hoc analyses to have a relationship to treatment effect. In these analyses, there was 
an attenuation of the treatment effect estimates for the primary endpoint in patients who had long-standing AF (i.e., more than 2 years) 
prior to developing HF. We believe this is due to differences in the underlying pathophysiology for AF patients who eventually 
develop HF compared to HF patients who subsequently develop AF. Therefore, a post-hoc analysis was performed in the above 
patient population (N=230) that excluded patients who had developed AF for more than 2 years prior to developing HF. In these 
analyses, a significant reduction in the GENETIC-AF primary endpoint was observed in the overall population (N=196; HR=0.54; 95% 
CI: 0.33, 0.87; p = 0.011) and in the HFmrEF cohort (N=91; HR=0.42; 95% CI: 0.21, 0.86; p = 0.017). Based upon our analysis of the 
GENETIC-AF data, we believe further clinical development of Gencaro can be successful using entry criteria to identify HFmrEF 
patients with the characteristics for disease duration and onset described above and outlined in the following table:

3

GENETIC-AF Subgroup Analysis: Time to First AF/AFL/ACM Event 

   Population
             Subpopulation

  All Patients 

            HF and AF for less than 12 years

                    AF not more than 2 years prior to HF 

                              HFmrEF

Time to AF/AFL/ACM

HR (95% CI)

1.01 (0.71, 1.42)

0.68 (0.45, 1.02)

0.54 (0.33, 0.87)

0.42 (0.21, 0.86)

P-value

0.961

0.064

0.011

0.017

N

267

230

196

91

Stratified Cox proportional hazards model with adjustment for: 1) HF etiology, 2) LVEF, 3) rhythm at randomization, 
4) device type, 5) previous Class 3 AA use (subpopulations only). 

Gencaro was generally safe and well-tolerated, with 84% of patients attaining their target dose compared to 72% of patients receiving 
TOPROL-XL. The most frequently reported adverse events were similar in both groups and consistent with the known safety profile 
of the beta-blocker class of drugs. Adverse events assessed as related to study drug by the investigator occurred in 23.8% of patients in 
the Gencaro group and in 30.1% of patients in the TOPROL-XL group. Of note, adverse events of bradycardia were less frequently 
reported in the Gencaro group (3.7%) compared to patients receiving TOPROL-XL (12.0%). During the 24-week efficacy follow-up 
period there were three deaths (ACM) in the TOPROL-XL group and none in the Gencaro group. Three patients died in the long-term 
treatment extension period after receiving Gencaro for more than a year. 

We believe data from the BEST trial indicate that Gencaro may have a genetically regulated effect in reducing or preventing AF in 
HFrEF patients. A retrospective analysis of data from the BEST trial shows that all patients in the trial treated with Gencaro had a 
41% reduction in the risk of new onset AF (time-to-event) compared to placebo (p = 0.0004). In a substudy in the trial, which 
considered only patients with the genotype believed to enhance Gencaro’s efficacy (known as the beta-1 389 arginine homozygous 
genotype), patients treated with Gencaro experienced a 74% (p = 0.0003) reduction in risk of AF, based on the same analysis. In 
addition, the BEST study, the beta-1 389 arginine homozygous genotype Gencaro demonstrated enhanced efficacy in reducing 
mortality, hospitalizations, and ventricular tachycardia /ventricular fibrillation, or VT/VF. Furthermore, patients with a beta-1 389 
arginine homozygous genotype who entered the trial in AF had statistically significant reductions in major cardiovascular or HF 
mortality/hospitalization composite endpoints, which we believe is the first and thus far only demonstration of effectiveness of a beta-
blocker in reducing major HF events in HFrEF patients with permanent AF. The beta-1 389 arginine homozygous genotype was 
present in about 50% of the patients screened and all enrolled patients in the GENETIC-AF trial and 47% of the patients in the BEST 
pharmacogenetic substudy, and we estimate it is present in about 50% of the North American and European general populations.

Our GENETIC-AF clinical trial of Gencaro required a companion diagnostic test to identify the patient’s receptor genotype. 
Laboratory Corporation of America, or LabCorp, developed the genetic test, obtained an Investigational Device Exemption, or IDE, 
from the FDA and provided the companion diagnostic test and services to support our GENETIC-AF trial. We retain all rights to the 
genetic test. Future clinical trials of Gencaro, if any, are expected to use a similar diagnostic test to identify the patient’s receptor 
genotype. 

Medtronic collaborated with us on the GENETIC-AF trial in supporting our AFB substudy. The collaboration was administered by a 
joint ARCA-Medtronic committee. Medtronic used its proprietary CareLink System to collect and analyze the cardiac rhythm data 
from the implanted Medtronic devices. In April 2018, Medtronic and ARCA agreed to extend the current U.S., Canadian and 
European Clinical Trial Collaboration Agreement for an additional year.  

We have been granted patents in the United States, Europe, and other jurisdictions for methods of treating AF and HF patients with 
Gencaro based on genetic testing. If Gencaro is approved, we believe our patent portfolio and new chemical entity exclusivity may 
provide market exclusivity for the indications of Gencaro that we may develop for up to 10 years after approval in the United States, 
Europe and other markets, depending on when the drug is approved.  

AB171

AB171 is a thiol-containing derivative of isosorbide mononitrate. Pre-clinical data from human endothelial cells indicate that 
compared to nitrates in clinical use, AB171 has a genotype specific enhancement of nitric oxide, or NO, release and produces less 
peroxynitrite, a biologically harmful product of nitrate action. AB171 also has potent anti-oxidant properties, and these effects may 
contribute to its favorable differentiation from other nitrates for prevention of myocardial remodeling, anti-atherosclerotic effects and 
the loss of effectiveness when used as a sustained therapy. We believe the unique pharmacology of AB171, coupled with targeting to 
genetically-identified enhanced response subpopulations, has the potential to translate to better long-term responses than currently 

4

available treatments. We have identified what we believe to be a pharmacogenetic target for AB171 we believe may enable 
genetically-targeted cardiovascular development programs in two cardiovascular indications: HF and peripheral arterial disease. The 
European Patent Office has issued to us a patent on methods of treating cardiovascular disease and conditions with a thiol-substituted 
isosorbide mononitrate based on genetic targeting. The European patent has been validated in ten countries: Denmark, France, 
Germany, Ireland, Italy, Netherlands, Spain, Sweden, Switzerland and the United Kingdom. We also have related patent applications 
pending in the United States Patent Office and Canadian Intellectual Property Office. 

We are currently designing the preclinical development plan for AB171 and initiated Investigational New Drug, or IND, enabling 
activities during 2018; subject to availability of capital, this work would be followed by nonclinical studies with AB171 to support 
future submission of an IND application, as a potential genetically-targeted treatment for peripheral arterial disease and for HF. 

Financial Resources 

To support the continued development of Gencaro, including the planned PRECISION-AF clinical trial, we will need additional 
financing to fund the Phase 3 trial and our general and administrative costs through its projected completion. Considering the 
substantial time and costs associated with the development of Gencaro and the risk that we may be unable to raise a significant amount 
of capital on acceptable terms, we may also pursue partnering and licensing opportunities, a strategic combination or other strategic 
transactions. If we are delayed in obtaining financing or are unable to complete a strategic transaction, we may discontinue our 
development activities on Gencaro or discontinue our operations.  

We believe our cash and cash equivalents balance as of December 31, 2018, together with the $2.4 million of net proceeds raised in 
2019 from sales of our common stock, will be sufficient to fund our operations, at our current cost structure, through the third quarter 
of 2019. However, changing circumstances may cause us to consume capital significantly faster or slower than we currently 
anticipate. We have based these estimates on assumptions that may prove to be wrong, and we could exhaust our available financial 
resources sooner than we currently anticipate.

In 2017, we entered into a sales agreement, as amended, with an agent to sell, from time to time, our common stock having an 
aggregate offering price of up to $10.2 million, in an “at the market offering.” In January 2019, we amended the amended sales 
agreement to increase the maximum aggregate value of shares which we may issue and sell from time to time under this sales 
agreement by approximately $2.5 million, from $10.2 million to $12.7 million. As of February 22, 2019, we have sold an aggregate of 
9,242,406 shares of our common stock pursuant to the terms of such sales agreement, as amended, for aggregate gross proceeds of 
approximately $12.6 million.  Net proceeds received in the period were approximately $11.9 million, after deducting initial expenses 
for executing the “at the market offering” and commissions paid to the placement agent. We have sold all shares available under the 
current prospectus. 

On October 18, 2018, we held a special meeting of our stockholders to approve a series of certificates of amendment to the 
Company’s restated certificate of incorporation, as amended, to effect a reverse split of the Company’s outstanding common stock, at 
a ratio of between 1-for-3 and 1-for-20, inclusive, and to authorize the Company’s board of directors to, for a period of up to one-year, 
select and file such a certificate of amendment to effect such a reverse split of the Company’s outstanding common stock, if, in the our 
board’s judgment, it is deemed necessary. Our board of directors has not selected a ratio for the reverse split.    

Our Strategy 

Our mission is to become a leading biopharmaceutical company developing cardiovascular therapies, using genetic targeting, where 
possible, to enhance therapeutic response. To achieve this goal, we are pursuing the following strategies: 

•

•

•

Advance the development of Gencaro. We intend to advance Phase 3 clinical development of Gencaro as a therapy for HF 
patients with AF. In PRECISION-AF, we plan to evaluate Gencaro as a therapy for patients with HFmrEF, for whom no 
approved drug therapy currently exists. We received an SPA agreement for PRECISION-AF that, if successful, could 
qualify as a single, pivotal trial and support the submission of an NDA for Gencaro. However, our execution of 
PRECISION-AF and other future Gencaro development is dependent upon our ability to finance those efforts through 
raising capital or a strategic partnership, or a combination thereof.   

Raise additional funding or complete a strategic transaction. To support our continued operations, we expect to seek 
additional funding through the sale of public or private equity or debt securities, the completion of a strategic transaction, or 
a combination thereof. 

Product lifecycle and indication expansion of Gencaro. We believe the treatment of AF in HFmrEF patients is an unmet 
medical need with a near-term and straightforward regulatory pathway. We believe there are product indication expansion 
opportunities for Gencaro for the entire spectrum of heart failure, including HFrEF and HFpEF patients with AF, other 
cardiac arrhythmias, and new formulation development. We are seeking the support of strategic partners to develop these 
opportunities.

5

•

•

Advance the development of AB171. During 2018, we initiated IND-enabling development activities with AB171, a thiol-
substituted isosorbide mononitrate, as a potential genetically-targeted treatment for HR and peripheral arterial disease. 
Further development of AB171 is dependent on additional financing. 

Build a cardiovascular pipeline. Our management and employees, including our chief executive officer, are experienced in 
cardiovascular research, molecular genetics and clinical development of cardiovascular therapies. We are seeking to 
leverage this expertise to identify, acquire and develop other cardiovascular products or candidates, particularly those with 
potential for pharmacogenetic based development, such as AB171. 

Our strategies are dependent upon our ability to obtain additional funding through the sale of public or private equity or debt 
securities, the completion of a strategic transaction, or a combination thereof. If we are unable to secure additional funding or 
complete a strategic transaction, we may not be able to continue development of Gencaro, notwithstanding our receipt of an SPA 
agreement from the FDA.  

Atrial Fibrillation in Heart Failure Market Background and Opportunity 

Heart failure is a chronic condition in which the heart is unable to pump enough blood to meet the body’s demands for oxygen. Heart 
failure has numerous serious consequences, including severe impacts on quality of life, increased hospitalizations, lost wages and 
productivity, and premature death. Heart failure is the leading cause of death in the developed world. According to the 2019 American 
Heart Association, or AHA, Heart Disease and Stroke Statistics, there were an estimated 6.2 million Americans aged 20 years or more 
with HF (based on data between 2013 and 2016). The spectrum of heart failure includes HF in which LVEF is 50% or more and is 
considered preserved ejection fraction, known as HFpEF, and heart failure in which the LVEF is less than 40%, considered reduced 
ejection fraction, or HFrEF and LVEF of at least 40%, but less than 50%, considered mid-range ejection fraction, known as HFmrEF. 
Together, HFrEF and HFmrEF comprise an estimated 64% of all HF patients in the United States. In 2012, the economic cost of HF in 
the United States was estimated to be nearly $31 billion, of which two-thirds, or over $20 billion, was attributable to direct medical 
costs. 

HFmrEF is a subgroup of HF patients with reduced LVEF for whom there are no approved AF drug therapies. The prevalence of AF 
is higher in HFmrEF patients as compared with HF generally; it is estimated that 30%-60% of HFmrEF patients also have AF. 
Approximately one-half of the trial population in GENETIC-AF Phase 2B study were HFmrEF patients. In patients with heart failure, 
atrial fibrillation contributes to the disease processes that lead to the progression of heart failure and worsening clinical outcomes 
including hospitalizations and death. This increased risk of illness and death when AF is present with heart failure is true across the 
spectrum of HF, including HFmrEF.

AF, the most common sustained cardiac arrhythmia, is a potentially serious disorder in which the normally regular and coordinated 
contraction pattern of the heart’s two small upper chambers, or the atria, becomes irregular, rapid and uncoordinated. AF can have 
significant quality of life impacts and potentially serious medical consequences, including increasing the risk of stroke and other 
cardiovascular problems. In individuals with heart failure, AF contributes to the disease processes that lead to the progression of heart 
failure and worsening clinical outcomes. AF is considered an epidemic cardiovascular disease and a major public health burden. The 
estimated number of individuals with AF globally in 2015 was 33.3 million. According to AHA Heart Disease and Stroke Statistics 
Reports from 2017 - 2019, the prevalence of AF in the United States was estimated to be 5.2 million people in 2015. In the European 
Union, the prevalence of AF was estimated to be 8.8 million (age 55 and over) in 2010. It is estimated that AF costs the U.S. economy 
about $6.0 billion annually.

AF and HF share many of the same risk factors and about 40% of people having either AF or HF will develop the other condition. 
Both AF and HF are related to dysfunction and remodeling of the myocardium, and as such share many pathophysiologic features 
including chamber dilatation, increased interstitial fibrosis and cardiac myocyte apoptosis. However, longstanding AF that eventually 
leads to left ventricular dysfunction and HF has a different pathophysiology compared to HF with AF developing secondarily. In 
longstanding AF, fibrosis and hypertrophy develop in both the atrium and ventricles, whereas in HF that precedes AF there is 
predominantly eccentric hypertrophy and contractile dysfunction in the ventricle and to a lesser extent in the atrium, with only minimal 
fibrosis in most cases.

Although AF increases stroke risk above an already increased risk in HF, this risk can be mitigated by administration of oral 
anticoagulants. Although stroke is the most feared complication of AF, it is the increased risk of mortality and hospitalization 
conferred by new onset AF in HF that is of major concern. AF in patients with HF may predispose to progression of the disease, 
including worsening of left ventricular dysfunction, increased hospitalization burden, and increased risk of death. This increased risk 
of morbidity and mortality with AF appears to be true across the spectrum of HF, including HFmrEF. 

6

Relationship of AF to Clinical Outcomes 

AF is an important cardiovascular, or CV, endpoint and it has an even greater impact in patients with HF. An important clinical 
consequence of AF in HF is an increase in the risk of embolic events including stroke, and for this reason alone it is preferable for a 
HF patient to be in sinus rhythm, or SR. In patients with established HF it is clear that new onset AF, including new AF events after 
conversion of persistent AF to SR, is associated with increased mortality and worsening HF risks. Framingham Heart Study data 
indicate there is a potential interrelationship between the development of AF and HF, with each condition developing as HF 
progresses and often (21% of the time) both presenting contemporaneously. In the Framingham study, when AF developed after HF 
there was a 1.6-fold (95% CI: 1.2, 2.1) increase in mortality after adjusting for potential modifiers, and when HF developed after AF 
the hazard ratio was 2.7 (95% CI: 1.9, 3.7). 

Additional supporting data is from the Women's Health Study, which is based on 1011 AF cases developed over a 15.4 year span. In 
this study, new onset AF was associated with a 2.1-fold (95% CI: 1.6, 2.8) increase in ACM and a 4.2-fold (95% CI: 2.7, 6.5) increase 
in CV mortality. Moreover, in women with new onset AF, the risk of developing HF increased by 14.7-fold (95% CI: 11.2, 19.2). New 
onset AF also worsens the prognosis in patients with established HF, a finding that was observed in the BEST trial as well.

Treatment of Atrial Fibrillation in Heart Failure 

Effective medical therapy for HF patients with AF must address both disease conditions. Patients with both HF and AF have a 
significantly worse prognosis, and therefore we believe effective therapies for these patients should be of paramount importance. 
However, the current drug therapy options for patients with both heart failure and atrial fibrillation are limited. Treatments that have 
been approved and are effective for HF or AF in isolation are now understood to have efficacy and/or safety limitations if used in 
patients in whom both conditions are present. Importantly, none of the beta blockers approved for heart failure, or other indications, 
have been studied exclusively in or approved for patients with HFmrEF, a substantial segment of the total HF population.  

In treating heart failure, several drugs classes have been shown to improve outcomes and ameliorate symptoms and are now 
considered standard of care, including in patients with co-morbid AF. Three drugs in the beta-blocker class are approved in the United 
States for the treatment of heart failure (metoprolol, carvedilol, and bisoprolol). These drugs have the highest level of recommendation 
in the United States and European Union heart failure guidelines and are prescribed for most patients with HFrEF who also have AF. 
They continue to be viewed as foundational therapy for these patients in part for their efficacy in controlling the high heart rate that is 
typically found with AF, rate control, and is believed to contribute to the pathological effects of AF in HF patients. However, the beta 
blockers approved for HF are only mildly effective at maintaining normal cardiac rhythm, or rhythm control, a characteristic 
recognized as increasingly important in treating AF. Furthermore, recent evidence indicates that the efficacy of these beta blockers is 
uncertain when AF is present and becomes permanent. Additionally, none of these beta blockers have been exclusively studied in 
patients with HFmrEF, thus there is limited evidence of efficacy in patients with HFmrEF, a substantial subgroup of the HF population 
and about one half of the study population in GENETIC-AF. Therefore, we believe there is a significant unmet medical need for a 
beta-blocker with greater efficacy in controlling AF and in providing better symptom relief and outcome benefits for these patients, 
including patients with HFmrEF.

The goals of current medical therapy for AF are to maintain sinus rhythm or to control ventricular rate in patients who cannot maintain 
sinus rhythm in order to minimize patient symptoms and avoid the risk of further complications and disease progression. Addressing 
the rhythm and rate abnormalities of AF is believed to be particularly important in HF patients because of the relationship between the 
presence of AF and worsening heart failure. However, the current treatment options for controlling AF in HF patients have significant 
limitations. Anti-arrhythmic drugs are a drug class that is often prescribed to control the irregular heartbeat of AF, and these drugs are 
frequently used in addition to beta-blockers in patients with both heart failure and atrial fibrillation to treat the AF arrhythmia. 
However, most anti-arrhythmic agents with AF indications are either contraindicated or have significant label warnings for use in HF 
patients due to an increased risk of mortality.

In the United States, anti-arrhythmic drug therapy is confined to the Class 3 anti-arrhythmic agents, amiodarone and dofetilide, and 
amiodarone is not approved for the treatment of AF. In addition, amiodarone has multiple toxicities, is pro-arrhythmic, and likely 
increases mortality in HFrEF. Although the pro-arrhythmia of dofetilide can be reduced by in-hospital monitoring on institution of 
therapy, this requirement of dofetilide use does not preclude the potential occurrence of drug induced arrhythmias that can result in 
death. Considering these safety concerns, physicians treating heart failure patients seek to limit the use of anti-arrhythmic drugs.  

Surgical techniques, such as ablation, are also used in some patients with heart failure to control the arrhythmia of atrial fibrillation. 
However, surgical methods are invasive and have other drawbacks, and are not a substitute for drug therapy to provide heart failure 
benefits, such as with beta-blockade, but rather are generally used in heart failure patients as an additive therapy. Anticoagulants are 
effective against the risk of stroke in AF patients and are widely prescribed, but these drugs do not address the pathological effects of 
the irregular and rapid heartbeat that is the hallmark of AF. 

7

Consequently, we believe there is an unmet medical need for new therapeutics that may provide better treatment for patients with HF 
and AF, which can safely treat the rhythm and rate disorders in these patients with greater efficacy, while improving their clinical 
outcomes and prognoses.

Gencaro 

Gencaro (bucindolol hydrochloride) is a nonselective beta-adrenergic receptor blocking agent with mild vasodilator properties. 
Gencaro is considered part of the beta-blocker class of compounds because of its property of blocking both beta-1 and beta-2, 
receptors in the heart. The blocking of these receptors prevents them from binding with other molecules, primarily the 
neurotransmitter norepinephrine, or NE, which activate these receptors. We believe Gencaro has two unique anti-adrenergic properties 
not possessed by other beta-blockers currently approved for the treatment of HF: (1) it is moderately sympatholytic, i.e., it lowers 
adrenergic drive to a level that can be detected on measurements of central or systemic venous norepinephrine levels, and, (2) through 
“inverse agonism” promotes inactivation of active-state human myocardial beta-1 receptors in a genotype specific manner. These 
properties, as described below, were observed to interact with receptor polymorphisms in such a way that we believe targeting specific 
genotypes of these variants could improve the therapeutic response of patients. We believe Gencaro’s efficacy is enhanced in patients 
with the beta-1 389 arginine homozygous genotype, which we estimate is present in about 50% of the North American and European 
general populations. 

Gencaro was the subject of the BEST trial, a Phase 3 HF mortality trial in 2,708 patients, mostly in the United States. The BEST trial 
included a DNA bank of over 1,000 patients, which was used to evaluate the effect of genetic variations in cardiac receptors on 
patients’ response to Gencaro. ARCA-affiliated scientists conducted genetic sub-studies with data from the BEST DNA bank that 
showed patients with certain variations in these receptors had substantially improved outcomes on primary and certain secondary 
clinical endpoints in the BEST trial, such as mortality, cardiovascular mortality, HF progression, hospitalization and prevention of 
arrhythmias, relative to the counterpart genotype groups and the general patient population of the trial. We believe that these 
genetically determined receptor variations, which are detectable using standard DNA testing technology, can serve as diagnostic 
markers for predicting enhanced therapeutic response to Gencaro, and potentially avoiding adverse events in individual patients. We 
have patented our methods for treating AF and HF patients with Gencaro in the United States, Europe and other markets based on 
genetic testing. 

Pharmacology and Pharmacogenetics 

Gencaro’s pharmacology appears to be different from other compounds in the beta-blocker class in several fundamental respects. 
First, under previous sponsors, studies in human myocardial preparations showed Gencaro, but not other tested beta-blockers 
approved to treat HF, predisposes to a shift in equilibrium of beta-1 389 arginine but not 389 glycine receptors from a constitutively 
active to an inactive state, a property known as inverse agonism. Second, other studies, including BEST, indicated that Gencaro lowers 
the systemic levels of the neurotransmitter norepinephrine, or NE, released by cardiac and other adrenergic nerves. The beta-1 389 
arginine receptor, 100% of the receptor population in patients with a 389 arginine homozygous genotype, has much higher affinity for 
binding to NE compared to 389 glycine receptors, and published data indicate that NE lowering from Gencaro is beneficial in patients 
who have only beta-1 389 arginine receptors. In contrast, patients with lower NE affinity beta-1 389 glycine genotypes may have 
blunting of efficacy from greater amounts of NE lowering. We believe that Gencaro's inverse agonist property contributes to the 
enhanced lowering of heart failure and arrhythmia event rates in patients who are beta-1 389 arginine homozygous genotype relative 
to individuals who are beta-1 389 Gly carriers or to the general population. In addition, we believe the unique NE lowering properties 
of Gencaro have a selectively beneficial effect in patients who have only beta-1 389 arginine receptors, because of the high affinity of 
these receptors for NE. As a result, the GENETIC-AF trial was targeted at patients with the beta-1 389 arginine homozygous 
genotype, which was present in approximately 50% of screened patients. We believe that these properties and their pharmacogenetic 
implications for modulating effectiveness are unique to Gencaro, and if the drug is approved, will be described in in the prescribing 
information. 

Gencaro Heart Failure Development and the DNA Substudy

Gencaro was the subject of a major heart failure study known as the BEST trial, a double-blind, placebo-controlled, multi-center study 
of bucindolol’s effect on reduction of mortality and morbidity in an advanced chronic HF population (LVEF less than 35%). The 
primary endpoint of the BEST trial was ACM, and the pre-specified main secondary endpoint was progression of HF, defined as death 
from HF, cardiac transplant, HF hospitalization, or an emergency room visit for the treatment of worsening HF not requiring 
hospitalization. The trial was planned to run four and one-half years, and enroll 2,800 patients. The trial enrolled a total of 2,708 
chronic, mostly U.S., HF patients. The trial was notable for including a major DNA bank, in which 1,040 of the BEST patients 
participated by providing blood for DNA analysis. The DNA bank provided the basis for the genetic substudies that discovered 
Gencaro’s modulation by genetic variations of the beta-1 cardiac receptor. 

The BEST trial was terminated early because, after positive mortality results from two other HF trials involving other beta-blockers 
had been reported, a substantial number of BEST trial investigators concluded that it was unethical to continue to give placebo to 

8

BEST trial participants. It was initially reported the trial had failed to reach its primary endpoint of ACM, showing a 10% risk 
reduction in mortality with a p-value of 0.10. Our reanalysis of the BEST results in accordance with the FDA approved, pre-specified 
statistical analysis plans (which had not been performed by the sponsors of BEST) demonstrated a 13% risk reduction on the primary 
endpoint of ACM in the BEST trial with a p-value of 0.053. 

The results of the genetic substudies that were conducted using the BEST DNA bank were not available until several years after the 
completion of the trial. Importantly, these substudies indicated a significant enhancement of response on the major heart failure 
clinical endpoints from the BEST trial in patients with the beta-1 389 arginine homozygous genotype. The risk reduction on HF 
clinical efficacy endpoints such as mortality and hospitalization ranged from 34% to 48% in this genotype. In addition, in arrhythmia 
endpoints of atrial fibrillation, or VT/VF, tracked by adverse events, or AEs, and surveillance electrocardiograms, or ECGs, the risk 
reduction by bucindolol in the beta-1 389 arginine homozygous genotype appeared to be even greater, with risk reductions of 74% for 
both endpoints. 

Shown below are certain of the primary and secondary endpoint data from the BEST HF DNA substudy results, by genotype: 

BEST Trial Clinical Responses† by Genotype Groups 

Endpoint (entire BEST DNA substudy, n = 1040 patients)   
All Cause Mortality (ACM), TTE..........................
Cardiovascular Mortality (CVM), TTE .................
ACM + transplantation...........................................
HF (HF) Progression ..............................................
HF Hosp days/patient .............................................
AF prevention (from AE and ECG db) ‡ ................
VT/VF prevention (from AE db) ...........................

Entered DNA substudy in AF, n = 111
ACM/HF Hosp, TTE...............................................
Cardiovascular (CV) mortality/CV Hosp ...............

{beta-1 389 Arg/
Arg + any  alpha-2C}
“Very Favorable”
Patient Type
(47%)
↓ 38%*
↓ 48%*
↓ 43%*
↓ 34%**
↓ 48%**
↓ 74%**
↓ 74%**
beta-1 Arg/Arg, 
any alpha-2C
↓ 77%*
↓ 72%*

{beta-1 389 Gly
carrier+ alpha-2C
Ins/Ins}  “Favorable”
Patient Type
(40%)

↓ 25%
↓ 40%*
↓ 24%
↓ 20%
↓ 17%
↓   6%
↓ 49%*

{beta-1 389 Gly
carrier + alpha-2C
Del  carrier}
“Unfavorable”
Patient Type
(13%)
↑   4%
↑ 11%
↑   4%
↓   1%
↑ 19%
↑ 33%
↓ 24%

beta-1 389 Gly C, any alpha-2C

↑ 52%
↑  7%

†

*

Covariate adjusted, transplant censored analysis with 1 – hazard ratio estimates presented; ‡in 925 patients who entered in SR  
p<0.05; **p £ 0.007; TTE: Time To Event 

Analysis of BEST trial for AF 

The BEST study data were further analyzed focusing on AF prevention, rate control in patients with established AF, and on clinical 
outcomes of patients with AF. Although there was no pre-determined AF endpoint, including reduction in risk of AF, in the BEST 
trial, according to our analysis of adverse events and surveillance ECG’s during the trial, 7.9% of patients developed new onset AF, 
with a greater incidence observed in the placebo group (9.7%) compared to the bucindolol group (6.2%). This corresponded to a 36% 
reduction in the incidence of new onset AF (based on crude event rates) for patients receiving bucindolol (p = 0.002). In a time to 
event analysis, the risk of new onset AF was reduced by 41% (p = 0.0004) with bucindolol treatment. Patients in the BEST study with 
the beta-1 389 Arg/Arg genotype who received Gencaro had a 74% reduction in the risk of developing new onset AF (p = 0.0003). 

Further published analyses of the data from BEST suggest that Gencaro may also have potential efficacy for other clinical endpoints 
and outcomes related to AF. A published analysis of the BEST data revealed that of the 303 patients in the BEST trial with established 
AF, 67% of those who received Gencaro achieved ventricular response rate control, defined as a resting heart rate of less than or equal 
to 80 beats per minute without symptomatic bradycardia (p < 0.005). In AF patients who achieved ventricular response rate control, 
Gencaro produced a 39% reduction (p = 0.025) in cardiovascular mortality/cardiovascular hospitalizations. In addition, Gencaro also 
improved cardiovascular clinical endpoints for those AF patients possessing the beta-1 389 arginine genotype that ARCA believes is 
most favorable for Gencaro response. In a substudy of 1,040 patients in BEST in which patient genotypes were analyzed, Gencaro was 
associated with a 72% decrease (p = 0.039) in cardiovascular mortality/cardiovascular hospitalizations in those 52 AF patients in the 
substudy with the beta-1 389 arginine homozygous genotype. 

9

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Analysis of the BEST Study data also shows that Gencaro has potential efficacy against the serious arrhythmias of VT/VF, which also 
appears to be genetically regulated. A published report demonstrated that patients in the BEST Trial who received Gencaro 
experienced a 58% reduction in the incidence of VT/VF (p = 0.00006), adjusted for the competing risk of mortality. In addition, the 
authors of this report determined that Gencaro reduced the incidence of VT/VF by 74% (p = 0.00005) in patients with the beta-1 389 
arginine homozygous genotype. 

Clinical and Regulatory Strategy

The regulatory strategy for Gencaro is to obtain an initial approval to treat atrial fibrillation in a genotype specific population with 
HFmrEF. We enrolled patients with the beta-1 389 arginine homozygous genotype in our GENETIC-AF Phase 2B clinical trial 
because our analysis of the BEST DNA substudy demonstrated a 74% reduction in AF events, in addition to reducing event rates for 
major clinical endpoints such as mortality and HF hospitalizations. 

In February 2018, we reported the results of GENETIC-AF, our Phase 2B clinical superiority trial, in which we evaluated Gencaro for 
the treatment and prevention of recurrent AF in patients with HF (LVEF less than 0.50). GENETIC-AF compared Gencaro to 
TOPROL-XL (metoprolol succinate), a drug approved for treating HFrEF that is considered a standard of care for treating AF in 
patients with HFrEF. The GENETIC-AF trial only enrolled patients with the beta-1 389 arginine homozygous genotype, the specific 
genotype that we believe enhances Gencaro’s potential therapeutic effects. Overall, Gencaro demonstrated a similar treatment benefit 
compared to the active comparator, metoprolol succinate. However, additional analyses prespecified in the statistical analysis plan 
also showed clinically meaningful treatment effects in favor of Gencaro in a large majority of the Phase 2 population. Gencaro also 
showed a significant treatment effect compared to Toprol XL in reducing AF recurrence in a subgroup of HF patients with HFmrEF. 
About one-half of the GENETIC-AF population were HFmrEF patients, a HF population for which there are no approved or 
guideline-recommended therapies. We plan to conduct a Phase 3 pivotal superiority trial, known as PRECISION-AF, evaluating 
Gencaro in this population because of Gencaro’s observed potential treatment effect in these patients in the GENETIC-AF trial, the 
unmet medical need for approved or guideline recommended drug therapies for prevention of AF in HFmrEF patients, and what we 
believe to be a near-term path to potential regulatory approval with this indication.

Based on our GENETIC-AF trial results, as well as results of previous Phase 3 pharmacogenetic substudy data from the Phase 3 heart 
failure clinical trial of bucindolol, known as the BEST trial, we submitted an SPA to the FDA detailing our proposed Phase 3 clinical 
trial and potential approval path for Gencaro. In February 2019, we received an SPA agreement for PRECISION-AF, a Phase 3 
pivotal study comparing Gencaro against TOPROL-XL for the treatment of AF in HFmrEF patients with the beta-1 389 arginine 
homozygous genotype. FDA also provided guidance on the possible development of Gencaro in HFrEF and HFpEF patients, which 
we feel are potential product life cycle opportunities for Gencaro.

The PRECISION-AF Phase 3 clinical trial is designed as a double-blind, active-controlled, multicenter, international, adaptive study 
comparing Gencaro with TOPROL-XL for the prevention of recurrent AF/AFL or ACM, in HFmrEF patients. The study will enroll 
approximately 400 patients at investigative sites in the United States, Europe and Australia. Eligible patients will have HFmrEF, a 
recent AF event and the genotype which responds most favorably to Gencaro. A substudy planned to include a smaller group of 
patients within the trial would utilize AFB as one method to determine AF recurrence, as measured by an implanted cardiac electronic 
device. The planned trial will use standard significance criteria (p < 0.01with adjustment for interim analysis) for the primary endpoint 
and will include an interim analysis after a portion of total patients have been enrolled. The interim analysis is designed to assess 
safety, validate initial study assumptions and maintain adequate statistical power for the primary endpoint. Subject to securing 
significant additional financing, we anticipate initiating PRECISION-AF in the fourth quarter of 2019. Any future development of 
Gencaro, including initiating the Phase 3 clinical trial, is dependent on obtaining additional financing, even if we enter into a strategic 
collaboration around the development of Gencaro.

In 2015, the FDA designated the investigation of Gencaro for the prevention of atrial fibrillation/atrial flutter in a genetically targeted 
heart failure population (heart failure patients with reduced LVEF) as a Fast Track development program.  

Fast Track drug development designation was included in the FDA Modernization Act of 1997, or FDAMA, as a formal process to 
enhance interactions with the FDA during drug development. A drug development program with Fast Track designation is eligible for 
consideration for some or all of the following programs for expediting development and review: scheduled meetings to seek FDA 
input into development plans, priority review of the NDA the option of submitting portions of an NDA for review prior to submission 
of the complete application and potential accelerated approval.

10

The Gencaro Test 

If approved, we believe that Gencaro will be the first cardiovascular drug to be integrated with a companion diagnostic to predict 
enhanced efficacy. We believe the drug label we will propose for Gencaro would identify the patient receptor genotype studied in the 
trial that can expect enhanced efficacy and, and that the label would recommend receptor genotype testing prior to initiation of 
therapy. Therefore, the commercialization of Gencaro may require that an FDA approved diagnostic test for this genotype be 
available. Such a test, or the Gencaro Test, could be performed by a variety of laboratory processes or platforms. We used one such 
platform for the GENETIC-AF trial, and retain all rights to it. We believe the Genaro Test could be developed and commercialized 
through a preferred diagnostic provider, by the company marketing Gencaro, or a combination of approaches. We also believe that 
point of care genetic tests, which could be performed during the patient’s visit to the physician, may be feasible as part of the 
commercialization strategy.

Our GENETIC-AF clinical trial of Gencaro required a companion diagnostic test to identify the patient’s receptor genotype. 
Laboratory Corporation of America, or LabCorp, developed the genetic test, obtained an IDE from the FDA and provided the 
companion diagnostic test and services to support our GENETIC-AF trial. We retain all rights to the genetic test. Future clinical trials 
of Gencaro, if any, are expected to use a similar diagnostic test to identify the patient’s receptor genotype.

Licensing and Royalty Obligations 

We have licensed worldwide rights to all preclinical and clinical data from development of bucindolol through the BEST trial from 
Cardiovascular Pharmacology and Engineering Consultants, LLC, or CPEC, who has licensed rights to this data from BMS. In 
addition, we have sublicensed CPEC’s rights from Bristol Meyers Squibb, or BMS. CPEC is a licensing entity which holds the rights 
of the biotechnology companies that were the commercial sponsors of the BEST trial. If the FDA grants marketing approval for 
Gencaro, the license agreements state that we are required to make a milestone payment of $8.0 million within six months after FDA 
approval. The license agreements also state that we are required to make milestone payments of up to $5.0 million in the aggregate 
upon regulatory marketing approval in Europe and Japan. The licenses state that our royalty obligations range from 12.5% to 25% of 
revenue from the related product based on achievement of specified product sales levels including a 5% royalty that CPEC is obligated 
to pay BMS. The agreements state that we have the right to buy down the royalties to a range of 12.5% to 17% by making a payment 
to CPEC within six months of regulatory approval. In October 2017, we entered into an agreement with CPEC’s minority owner, 
Aeolus Pharmaceuticals, Inc., or Aeolus, pursuant to which we acquired Aeolus’ minority membership interest in CPEC. The 
transaction effectively buys-out Aeolus’ royalty interest thereby reducing or eliminating the stated milestone and royalty obligations 
by 35% that could be payable by us, if Gencaro receives regulatory approval and is commercialized. In the transaction, we also 
acquired all of CPEC’s rights to milestones and royalties for Europe and certain other territories outside of the United States.

All of the patents that were the subject of the CPEC and BMS licenses have expired. Based on this and the terms of these licenses, we 
believe that the financial obligations stated in these agreements will be reduced or eliminated, if and when they become payable under 
their stated terms.

We also have licensed worldwide rights to intellectual property covering the pharmacogenetic response of Gencaro based on the 
cardiac receptor polymorphisms, which is owned by the University of Colorado. We have no material future financial obligations 
under this license. We also have licensed exclusive, worldwide rights to develop and commercialize diagnostics for these receptor 
polymorphisms, for the purpose of prescribing Gencaro.  

Development Pipeline 

Our development activities are substantially focused on our lead product candidate, Gencaro, for the potential treatment of HF patients 
with AF. The primary endpoint of the GENETIC-AF trial was the prevention of AF in these patients. We believe the treatment of AF 
in HFmrEF patients is an unmet medical need with a near term and straightforward regulatory pathway. We believe there are product 
indication expansion opportunities for Gencaro for the entire spectrum of heart failure, including HFrEF and HFpEF patients with AF, 
other cardiac arrhythmias, and new formulation development. We are seeking the support of strategic partners to develop these 
opportunities. Finally, we have developed and patented an isomer version of bucindolol, which appears to be substantially more potent 
than the current formulation. 

We do not expect to pursue development of Gencaro for HFmrEF patients with AF or other disease indications without obtaining 
additional funding or entering into a strategic partnership or collaboration. We believe Gencaro has potential to address these 
additional indications, and that the clinical response of patients with these diseases may be genetically influenced, based on the same 
genetic markers we have identified for our proposed treatment of AF with Gencaro. 

AB171 is a thiol-containing derivative of isosorbide mononitrate. Pre-clinical data indicate that AB171 may have anti-oxidant 
properties and may be favorably differentiated from other nitrates for prevention of myocardial remodeling, anti-atherosclerotic effects 
and the loss of effectiveness when used as a sustained therapy. We believe the unique pharmacology of AB171, coupled with targeting 
to genetically-identified enhanced response subpopulations, has the potential to translate to better long-term responses than currently 
available treatments. We have identified what we believe to be a pharmacogenetic target for AB171 that is the basis for our patents 
and which we believe may enable genetically-targeted cardiovascular development programs in two cardiovascular indications: HF 

11

and peripheral arterial disease. The European Patent Office has issued to us a patent on methods of treating cardiovascular disease and 
conditions with a thiol-substituted isosorbide mononitrate based on genetic targeting. The European patent has been validated in ten 
countries: Denmark, France, Germany, Ireland, Italy, Netherlands, Spain, Sweden, Switzerland and the United Kingdom. We also 
have related patent applications pending in the United States Patent Office and Canadian Intellectual Property Office. 

We are currently designing the preclinical development plan for AB171 and initiated IND enabling activities during 2018, and subject 
to availability of capital, to be followed by nonclinical studies with AB171 to support future submission of an IND application, as a 
potential genetically-targeted treatment for HF and peripheral arterial disease. 

We also have exclusive pharmacogenetic and other patent rights to drug candidates that have potential indications in cardiovascular 
disease, oncology and other therapeutic areas. We may seek partners to assist us in the development of these candidates or who may 
license them. We may also seek funds to advance the development of the compounds on our own.  

Competition 

Current HF treatments include three beta-blockers approved for heart failure in the Unites States. However, their efficacy in providing 
control of the arrhythmia caused by AF, or rhythm control, is only mild. It is also now acknowledged that evidence is lacking that the 
approved beta-blockers provide outcome benefits for patients who develop permanent AF. Furthermore, these drugs have not 
demonstrated efficacy for patients with HFmrEF, a population included in the Gencaro development program. Current AF treatments 
include pharmaceutical, procedural or device intervention. There are several antiarrhythmic drugs approved by the FDA for the 
treatment and/or prevention of recurrent AF. However, these drugs have safety and/or administration concerns and all but one have 
contraindications or label warnings regarding their prescription in patients with heart failure. 

Drugs that are currently approved or used for the treatment or prevention of AF in HF, including HFmrEF, either have not 
demonstrated efficacy in these patients, or have notable risks due to adverse side effects or lack sufficient efficacy. Therefore, in HF, 
and specifically in HFmrEF patients, we believe there is a substantial unmet medical need for AF therapies that are more effective and 
have fewer side effects than those currently available. We believe that Gencaro’s treatment of AF in HF patients could provide a more 
effective and safer pharmacotherapy than treatments currently used in these patients. 

The pharmaceutical industry is highly competitive. We face significant competition from pharmaceutical companies and 
biotechnology companies that are researching and selling products designed to treat cardiovascular conditions. Most of these 
companies have significantly greater financial, product development, manufacturing, and commercial resources than we have. 

If approved, the drugs which Gencaro would potentially compete with are largely generic in the United States. Gencaro would be 
priced at a premium compared to these therapies. In addition, our proposed prescribing information for Gencaro includes a 
recommendation for genetic testing, which will add additional procedures to the process of prescribing Gencaro, which, together with 
its premium price, could make it more difficult for us to compete against existing or future therapies. 

Manufacturing and Product Supply 

Gencaro is a small molecule drug with an established manufacturing history. Multiple manufacturers of both the active pharmaceutical 
ingredients, or API, and drug product have successfully produced Gencaro for use in clinical trials over the course of its clinical 
development. We outsource all manufacturing and analytical testing of the Gencaro API and drug product. We have selected third 
party contract manufacturing organizations on the basis of their technical and regulatory expertise. Our approach with our contract 
manufacturing partners has been to replicate the manufacturing processes that were used to support the prior pivotal clinical trial with 
Gencaro, and to minimize any changes from these baseline processes, thereby reducing technical and regulatory risk. We contracted 
with Groupe Novasep to complete the drug substance registration batches required for the Gencaro NDA. These batches were 
successful, and the resulting drug substance was used to supply the drug product registration campaign. Remaining inventory was 
placed in current Good Manufacturing Practice, or cGMP, storage to provide a backup supply for the GENETIC-AF trial, and for use 
as an initial source of drug substance to support eventual product launch, if approved. 

For drug product production, we have contracted with Patheon, Inc. to manufacture the Gencaro tablets. Gencaro is produced in a 
tablet form, utilizing standard solid oral dosage processing techniques. Six separate dosage strengths were manufactured, with the 
maximum recommended dose of 50mg twice daily for patients weighing 75kg or less and 100mg twice daily for patients weighing 
more than 75kg. Registration batches were successfully completed by Patheon, Inc. and tablets from these runs were placed in cGMP 
storage to supply the GENETIC-AF trial. In addition, we contracted with a separate service provider for packaging and distribution of 
our clinical trial materials.  

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Research and Development Expenses 

Our research and development expenses were $4.2 million for the year ended December 31, 2018 as compared to $14.1 million for 
2017, a decrease of approximately $9.8 million. Subject to securing significant additional financing, we anticipate initiating our 
PRECISION-AF clinical trial in the fourth quarter of 2019. R&D expense in 2019 is expected to be higher than 2018, if we initiate our 
PRECISION-AF clinical trial. If we are unable to initiate our PRECISION-AF clinical trial, then R&D expense is expected to be 
lower than 2018.

Government Regulation 

Governmental authorities in the United States at the federal, state, and local levels and foreign countries extensively regulate, among 
other things, the research, development, testing, manufacture, labeling, promotion, advertising, marketing, distribution, sampling, and 
import and export of pharmaceutical and medical device products. In the United States, the FDA regulates these activities at the 
federal level pursuant to the Federal Food Drug and Cosmetic Act, or the FDCA, and the regulations promulgated thereunder. In 
Canada, Health Canada regulates these activities. In Europe, the Competent Authorities and Ethics Committees of the respective 
countries regulate these activities. We anticipate that all of our product candidates will require regulatory approval by governmental 
agencies prior to commercialization. The process of obtaining approval and the subsequent process of maintaining compliance with 
appropriate federal, state, local and foreign statutes and regulations require the expenditure of substantial time and financial resources. 
In addition, these statutes, rules, regulations and policies may change and our products may be subject to new legislation or 
regulations. Both before and after approval or clearance, failure to comply with the requirements of the FDA and other state and 
federal statutes can lead to significant penalties or could disrupt our ability to manufacture and sell these products. In addition, the 
FDA could refuse to provide certificates needed to export our products if the agency determines that we are not in compliance. 

Premarket Approval of Drugs 

FDA approval is required for marketing of any new drug, dosage form, indication, or strength. The steps required before new human 
therapeutic drug products are marketed in the United States and foreign countries include rigorous preclinical and clinical testing and 
other approval requirements by regulatory agencies, such as the FDA and comparable agencies in foreign countries. There is no 
guarantee that products will be approved in a specific timeframe or at all. 

Preclinical Phase. Preclinical studies are generally conducted in the laboratory to identify potential drug candidates and to evaluate 
their potential efficacy and safety. These studies include laboratory evaluation of product chemistry, formulation and stability, as well 
as studies to evaluate short and long-term toxicity in animals. Preclinical studies are governed by numerous regulations, including but 
not limited to FDA’s Good Laboratory Practices. 

Clinical Phase. Before human clinical trials can commence, an Investigational New Drug, or IND, application, submitted to FDA 
must become effective. For an IND to become effective, the applicant must submit, among other things, information on design of the 
proposed investigation, reports necessary to assess the safety of the drug for use in clinical investigation, and information on the 
chemistry and manufacturing of the drug, controls available for the drug, and primary data tabulations from animal or human studies. 
The clinical phase of development involves the performance of human studies, including adequate and well-controlled human clinical 
trials to establish the safety and efficacy of the product candidate for each proposed indication. Typically, clinical evaluation involves 
three sequential phases, which may overlap. During Phase 1, clinical trials are conducted with a relatively small number of subjects or 
patients to determine the early safety profile of a product candidate, as well as dose tolerance, absorption, and the pattern of drug 
distribution and drug metabolism. Phase 2 trials are conducted with groups of patients afflicted by a specific target disease to 
determine preliminary efficacy, optimal dosages and dosage tolerance and to identify possible adverse effects and safety risks. In 
Phase 3, larger-scale, multi- center trials are conducted with patients afflicted with a specific target disease over a longer term to 
confirm Phase 2 results and provide reliable and conclusive data supporting efficacy and safety of a drug as required by regulatory 
agencies for drug approval. The conduct of clinical trials is subject to extensive regulation. FDA may delay or suspend clinical trials 
through clinical holds. 

NDA Submission. In the United States, the results of preclinical and clinical testing along with chemistry, manufacturing and controls 
information, are submitted to the FDA in the form of an NDA. Under the current Prescription Drug User Fee Act, or PDUFA, after 
submission of an NDA and payment, or waiver, of the required fee, the FDA’s goal is to review most standard NDAs within 10 
months from the time that a sponsor’s application is accepted as filed by the FDA, which can occur within a 60-day window following 
the initial submission of the application. At the end of the 10 months, the FDA’s goal is to issue a “complete response,” or approve the 
NDA. While FDA’s goal is to issue a complete response within 10 months, the process may take longer than 10 months, particularly if 
multiple review cycles are required. Gencaro has been granted Fast Track Designation which allows for a rolling review of a 
marketing application. A rolling review allows FDA to consider reviewing portions of an NDA before the sponsor submits the 
complete application.

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In responding to an NDA, the FDA may grant marketing approval or deny the application if the FDA determines that the application 
does not satisfy the statutory and regulatory approval criteria. A denial may include a request for additional information, including 
additional clinical data and/or an additional Phase 3 clinical trial. Data from clinical trials are not always conclusive and FDA may 
interpret data differently than we interpret data. Under the Food and Drug Modernization Act of 1997, the FDA is authorized to 
approve a drug based on a single adequate and well-controlled study if such study and other confirmatory data are sufficient to 
establish the drug’s effectiveness. However, it has long been the FDA’s general position that the standard of proof of a drug’s 
effectiveness generally requires at least two well-controlled and adequate Phase 3 clinical studies demonstrating statistically 
significant results as compared to a placebo or active control (with p-values of less than 0.05) with respect to the primary endpoint or 
endpoints of the trial. 

In addition, in accordance with current FDA law and regulations, the FDA may refer a drug to an advisory committee for review prior 
to approval. Most new compounds are referred to an FDA advisory committee, which could add additional time to the review process. 
There is no guarantee that the advisory committee will recommend approval of a drug candidate. In some cases, FDA may require 
completion, within a specified time period, of additional clinical studies after approval, referred to as Phase 4 clinical studies, to 
monitor the effect of a new product and may prevent or limit future marketing of the product based on the results of these post-
marketing programs. Furthermore, prior to granting approval, the FDA generally conducts an inspection of the facilities, including 
outsourced facilities that will be involved in the manufacture, production, packaging, testing and control of the drug substance and 
finished drug product for compliance with current Good Manufacturing Practice, or cGMP, requirements. 

If the FDA approves the NDA, the sponsor is authorized to begin commercialization of the drug in accordance with the approval. 
Even if the FDA approves the NDA, the FDA may decide later to suspend or withdraw product approval if compliance with regulatory 
standards is not maintained or if safety problems are recognized after the product reaches the market. In addition, the FDA requires 
surveillance programs to monitor approved products that have been commercialized, and the agency has the power to require 
additional clinical studies, to require changes in labeling or to prevent further marketing of a product based on the results of these 
post-marketing programs. The FDA also has authority to request implementation of a risk evaluation and mitigation strategy, or 
REMS, that could restrict distribution of Gencaro or require us to provide additional risk information to prescribers. Whether or not 
FDA approval has been obtained, approval of a product candidate by comparable foreign regulatory authorities is necessary prior to 
the commencement of marketing of a product candidate in those countries. The approval procedures vary among countries and can 
involve additional testing. The time required to obtain approval may differ from that required for FDA approval. 

Post-approval Compliance. If regulatory approval for a drug or medical device is obtained, the product and the facilities manufacturing 
the product are subject to periodic inspection and continued regulation by regulatory authorities, including compliance with cGMP, as 
well as labeling, advertising, promotion, recordkeeping, and reporting requirements, including the reporting of adverse events. In 
addition, the FDA closely regulates the post-approval marketing and promotion of drugs, including standards and regulations for labeling, 
promotion to health care professionals, direct-to-consumer advertising, off-label promotion, industry-sponsored scientific and educational 
activities and promotional activities involving the Internet. Drugs may be marketed only for the approved indications and in accordance 
with the provisions of the approved labeling. Companies are responsible for compliance with such requirements and would be responsible 
to ensure that all contract manufacturing organizations who perform work for them also comply with such requirements. Similarly, if a 
drug manufacturer hires contract sales representatives or consultants to promote its products, such organizations or individuals must 
comply with all of the same requirements applicable to the drug manufacturer. The FDA regularly inspects companies to determine 
compliance with cGMPs and other post-market requirements. Failure to comply with statutory requirements and the FDA’s regulations 
can result in a variety of administrative or enforcement actions, including but not limited to an FDA Form 483 (which is issued by the 
FDA at the conclusions of an inspection when an investigator has observed any conditions that may constitute violations), a public 
warning letter, suspension or withdrawal of regulatory approvals, product recalls, product detentions, refusal to provide export 
certificates, seizure of products and criminal prosecution. 

Drug Price Competition and Patent Term Restoration Act of 1984. Under the Drug Price Competition and Patent Term Restoration 
Act of 1984, also known as the Hatch-Waxman Act, Congress created an abbreviated FDA review process for generic versions of 
pioneer (brand name) drug products. The Hatch-Waxman Act also provides for patent term restoration and the award, in certain 
circumstances, of non-patent marketing exclusivities. 

14

Generic Drug Approval. The Hatch-Waxman Act established an abbreviated FDA review process for drugs that are shown to be 
equivalent to approved pioneer drugs. Approval for a generic drug is obtained by filing an abbreviated NDA, or ANDA. Generic drug 
applications are “abbreviated” because they generally do not include clinical data to demonstrate safety and effectiveness. Instead, an 
ANDA applicant must establish that its product is bioequivalent to an approved drug and that it is the same as the approved drug with 
respect to active ingredient(s), route of administration, dosage form, strength and recommended conditions of use (labeling). The FDA 
will approve the generic as suitable for an ANDA if it finds that the generic does not raise questions of safety and effectiveness as 
compared to the pioneer drug. A drug is not eligible for ANDA approval if the FDA determines that it is not equivalent to the pioneer 
drug or if it is intended for a different use. Any applicant who files an ANDA seeking approval of a generic version of an approved 
drug listed in FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations, or the Orange Book, must certify to the 
FDA that (i) no patent information on the drug has been listed in the Orange Book; (ii) that each patent listed in the Orange Book for 
that approved drug has expired; (iii) FDA should approve the product on the date on which a listed patent expires; or (iv) that such 
patent is invalid, unenforceable or will not be infringed by the manufacture, use or sale of the generic drug. If the ANDA applicant 
makes a certification pursuant to (iv) above, or a Paragraph IV certification, and the NDA holder files an infringement suit against the 
ANDA applicant within 45 days of receiving the Paragraph IV notification, the NDA owner is entitled to an automatic 30-month stay 
of FDA’s ability to approve the ANDA. This 30-month stay will end early upon any decision by a court that the patent is invalid, 
unenforceable or not infringed by the generic drug. 

Patent Term Extension. While the term of a U.S. patent is generally 20 years from the earliest priority date of a patent application 
(excluding a provisional patent application), a U.S. patent that covers subject matter requiring regulatory approval to market is eligible 
for an extension of that patent term. The Hatch-Waxman Act provides for the restoration of a portion of the patent term lost during 
product development and FDA review of an application. Patent Term Extension, or PTE, extends the term of an issued patent for 
generally (i) the length of the FDA approval process, i.e., the complete period of NDA review, and (ii) half of the time spent in clinical 
trials, i.e., the IND period. However, the maximum period of restoration cannot exceed five years, or restore the total remaining term 
of the patent to greater than 14 years from the date of FDA approval of the product. 

Under 35 U.S.C. § 156(a), a patent covering a method of using a product is eligible for PTE if the following conditions are met: 

1)

2)

3)

4)

5)

the patent has not yet expired; 

the patent was not previously extended; 

the patent owner submits an application for PTE that includes all necessary supporting information within 60 days of FDA 
approval; 

the product was subject to regulatory review before its commercial marketing or use; and 

the drug application is for the first permitted commercial marketing of the product. 

We have obtained four U.S. patents (U.S. Patent Nos. 7,678,824; 8,080,578; 8,093,286; 8,946,284). We believe that, if Gencaro is 
approved by the FDA, any one of the U.S. patents may be eligible for PTE, which could provide approximately 5 years of additional 
patent life based on our current clinical trial plans. 

A Supplementary Protection Certificate, or SPC, is a form of patent term extension that is available for pharmaceutical products 
approved for marketing in the European Union, or EU. We obtained a patent in Europe on methods for using Gencaro that is similar to 
US Patent 7,678,824 (EP 1802775); this EU patent is in force in certain countries in Europe, including the United Kingdom, France, 
Germany, Italy and Spain. We believe that this patent may be eligible for an SPC, if Gencaro is approved for marketing in any 
European country in which the patent is in force, which could provide up to five years of additional patent life. We believe that our 
patents in other jurisdictions may also be eligible for similar term extensions.

Non-Patent Marketing Exclusivities. Separate and apart from patent protection, the Hatch-Waxman Act entitles approved drugs to 
various periods of non-patent statutory protection, known as marketing exclusivity. The Hatch-Waxman Act provides five years of 
“new chemical entity” marketing exclusivity to the first applicant to gain approval of an NDA for a product that contains an active 
moiety not found in any other approved product. This exclusivity means that another manufacturer cannot submit an ANDA or 
505(b)(2) NDA until the marketing exclusivity period ends. This exclusivity protects the entire new chemical entity franchise, 
including all products containing the active ingredient for any use and in any strength or dosage form, but will not prevent the 
submission or approval of stand-alone NDAs where the applicants have conducted their own clinical studies to demonstrate safety and 
effectiveness. There is an exception, however, for a competitor that seeks to challenge a patent with a Paragraph IV certification. Four 
years into the five-year exclusivity period, a manufacturer who alleges that one or more of the patents listed with the NDA is invalid, 
unenforceable or not infringed may submit an ANDA or 505(b)(2) NDA for a generic or modified version of the product. 

15

The Hatch-Waxman Act also provides three years of “new use” marketing exclusivity for the approval of NDAs, and supplements, 
where those applications contain the results of new clinical investigations (other than bioavailability studies) essential to the FDA’s 
approval of the applications. Such applications may be submitted for new indications, dosage forms, strengths, or new conditions of 
use of approved products. So long as the studies are essential to the FDA’s approval or were conducted by or for the applicant, this 
three-year exclusivity prohibits the final approval of ANDAs or 505(b)(2) NDAs for products with the specific changes associated 
with those studies. It does not prohibit the FDA from approving ANDAs or 505(b)(2) NDAs for other products containing the same 
active ingredient, without those changes. 

Similar non-patent market exclusivity is provided for in the EU and other international jurisdictions. We believe that, if approved in 
the EU, Gencaro may be eligible for ten years of market exclusivity in the EU, measured from the date of approval there.

FDA Premarket Review of Medical Devices 

Unless an exemption applies, each medical device that a company wishes to market in the United States requires either approval of a 
premarket approval application, or PMA, or clearance of a premarket notification, commonly known as a “510(k)” from the FDA. The 
FDA classifies medical devices into one of three classes. Devices deemed to pose lower risks are placed in either class I or II, which 
may require the manufacturer to submit to the FDA a 510(k) requesting permission to commercially distribute the device. Clearance of 
a 510(k) usually requires between three months and one year from the time of submission of the 510(k), although the process may take 
longer. The FDA’s 510(k) clearance procedure is less rigorous than the PMA approval procedure, but is available only to companies 
who can establish that their device is substantially equivalent to a legally-marketed “predicate” device that was (i) on the market prior 
to the enactment of the Medical Device Amendments of 1976, (ii) reclassified from Class III to Class II, or (iii) has been cleared 
through the 510(k) procedure. 510(k)s must typically be supported by performance data, including preclinical data, bench testing, and 
in some cases, clinical data. Some low risk devices are exempted from this requirement. Devices deemed by the FDA to pose the 
greatest risks, or for which there is no predicate, are placed in class III, and require a PMA. 

PMA Pathway. Generally, a PMA must be supported by extensive data and valid scientific evidence, including, but not limited to, 
technical, preclinical, clinical trials, manufacturing and labeling to demonstrate to the FDA’s satisfaction a reasonable assurance of the 
safety and effectiveness of the device for its intended use. After a PMA is sufficiently complete, the FDA will accept the application 
and begin an in-depth review of the submitted information and will generally conduct a pre-approval inspection of the manufacturing 
facility or facilities to ensure compliance with FDA’s Quality System Regulations, or QSR. By statute, the FDA has 180 days to 
review the “accepted application”, although, generally, review of the application can take between one and three years, and it may take 
significantly longer. The PMA application process can be expensive, and there is a substantial “user fee” that must be paid to FDA in 
connection with the submission of a PMA application. If the FDA’s evaluation of the PMA application or the manufacturing facility is 
not favorable, the FDA may deny approval of the PMA application or issue a “not approvable” letter. The FDA may also require 
additional clinical trials, which can delay the PMA approval process by several years. In addition, if FDA discovers that an applicant 
has submitted false or misleading information, FDA may refuse to review submissions until certain requirements are met pursuant to 
its Application Integrity Policy, or AIP. If the FDA approves the PMA, it may place restrictions on the device. After the PMA is 
approved, if significant changes are made to a device, its manufacturing or labeling, a PMA supplement containing additional 
information must be filed for prior FDA approval. PMA supplements often must be approved by the FDA before the modification to 
the device, the labeling, or the manufacturing process may be implemented. Delays in receipt of or failure to receive such clearances 
or approvals, the loss of previously received clearances or approvals, or the failure to comply with existing or future regulatory 
requirements could have a material adverse effect on our business, financial condition and results of operations.

Clinical Trials. Clinical trials are generally required to support a PMA application and are sometimes required for 510(k) clearance. 
These trials generally require an Investigational Device Exemption, or IDE, application approved in advance by the FDA for a 
specified number of patients, unless the proposed study is deemed a non-significant risk study, which is eligible for an exemption from 
the IDE requirements. The IDE application must be supported by appropriate data, such as animal and laboratory testing results. 
Clinical trials may begin if the IDE application is approved by the FDA and the appropriate institutional review boards, or IRBs, at the 
clinical trial sites. Submission of an IDE application does not give assurance that the FDA will issue the IDE. If the IDE application is 
approved, there can be no assurance the FDA will determine that the data derived from the trials support the safety and effectiveness 
of the device or warrant the continuation of clinical trials. An IDE supplement must be submitted to and approved by the FDA before 
a sponsor or investigator may make a change to the investigational plan in such a way that may affect its scientific soundness, study 
indication or the rights, safety or welfare of human subjects. The trial must also comply with the FDA’s regulations, including the 
requirement that informed consent be obtained from each subject. Even if a trial is completed, the results of clinical testing may not 
adequately demonstrate the safety and efficacy of the device or may otherwise not be sufficient to obtain FDA clearance to market the 
product in the United States.

In Vitro Diagnostic Companion Diagnostic Devices. FDA has described IVD companion diagnostic devices as in vitro diagnostic 
devices that provide information that is essential for the safe and effective use of a corresponding therapeutic product. The use of an 
IVD companion diagnostic device with a particular therapeutic product is stipulated in the instructions for use in the labeling of both 
the diagnostic device and the corresponding therapeutic product, as well as in the labeling of any generic equivalents of the therapeutic 

16

product. An IVD companion diagnostic device could be used to (i) identify patients who are most likely to benefit from a particular 
therapeutic product; (ii) identify patients likely to be at increased risk for serious adverse reactions as a result of treatment with a 
particular therapeutic product; or (iii) monitor response to treatment for the purpose of adjusting treatment (e.g., schedule, dose, 
discontinuation) to achieve improved safety or effectiveness. Although FDA’s regulation of IVD companion diagnostic devices is 
evolving and implemented on a case-by-case basis, FDA’s stated policy for a novel therapeutic product is that an IVD companion 
diagnostic device should be developed and approved or cleared contemporaneously to support the therapeutic product’s safe and 
effective use. The clinical performance and clinical significance of the IVD companion diagnostic device is to be established using 
data from the clinical development program of the corresponding therapeutic product. FDA recognizes, however, that there may be 
cases where contemporaneous development may not be possible. With respect to the Gencaro Test, there is no assurance that we will 
be able to develop and obtain approval or clearance contemporaneously with Gencaro. Failure to develop the Gencaro Test or obtain 
clearance or approval could delay approval of Gencaro, if FDA regards the Gencaro Test as an IVD companion diagnostic test that is 
essential to the safe and effective use of Gencaro. 

Continuing Regulation. After a device is placed on the market, numerous regulatory requirements apply to the manufacturer, or holder 
of a PMA approval. Unless subject to an exemption, medical devices distributed in the United States must be manufactured in 
compliance with the FDA’s Quality System Regulations, or QSRs, and current good manufacturing practices. These regulations 
govern the manufacturing process, including design, manufacture, testing, release, packaging, distribution, documentation and 
purchasing, as well as complaint handling, corrective and preventative actions and internal auditing. In complying with the QSRs, 
manufacturers must expend significant time, money and effort. Companies are also subject to other post-market and general 
requirements, including but not limited to product listing and establishment registration, post-market surveillance requirements, 
limitations on promotion, and requirements for recordkeeping and reporting of certain adverse events, malfunctions, corrections and 
removals. As discussed above, FDA regularly inspects companies to assess compliance with the QSRs and other post-market 
requirements. Failure to comply with these requirements can result in, among other things, adverse publicity, warning letters, and 
potential civil and criminal penalties. As part of such arrangement, we will seek to have the diagnostic company take responsibility for 
compliance with the FDA’s device approval and on-going regulatory requirements. 

International Marketing Approvals. International sales of medical devices are subject to foreign government regulations, which vary 
substantially from country to country and are subject to change. The time required to obtain approval by a foreign country may be 
longer or shorter than that required for FDA clearance or approval, and the requirements may differ. 

Other Regulatory Requirements. We are also subject to various federal, state and local laws, regulations and recommendations relating 
to safe working conditions, laboratory and manufacturing practices, the experimental use of animals and the use and disposal of 
hazardous or potentially hazardous substances, including radioactive compounds and infectious disease agents, used in connection 
with our work. The extent and character of governmental regulation that might result from future legislation or administrative action 
cannot be accurately predicted. 

Medical Device Tax

In March 2010, the U.S. Congress adopted and President Obama signed into law comprehensive health care reform legislation. 
Among other initiatives, these laws impose significant new taxes on medical device makers in the form of a 2.3% excise tax on U.S. 
medical device sales, with certain exemptions, beginning on January 1, 2013. On January 22, 2018, legislation was enacted 
suspending the medical device tax in 2018 and 2019. It will be reinstated on January 1, 2020, unless a permanent repeal takes place 
before that date. The Gencaro Test is likely to be subject to this tax if this tax is reinstated in the future.

Intellectual Property 

The future success of our business will partly depend on our ability to maintain market exclusivity for Gencaro, if approved, in the 
United States and important international markets, and for other products or product candidates that we may acquire or develop. We 
will rely on statutory protection, patent protection, trade secrets, know-how, and in-licensing of technology rights to maintain 
protection for our products. 

We believe that both patent protection and data exclusivity statutes will give Gencaro, if approved, market exclusivity in the United 
States and in major international markets. If approved by the FDA or international regulatory agencies, Gencaro will qualify as a New 
Chemical Entity, or NCE, as it has never received regulatory approval in any jurisdiction. As an NCE, Gencaro, if approved, will 
enjoy market exclusivity in the United States and most international markets under data exclusivity statutes. These laws provide for an 
exclusivity period beginning from regulatory approval, during which any generic competitor is barred from submitting an application 
that relies on the data that has been submitted in connection with the approval of the NCE. In the United States, the Hatch-Waxman 
Act provides for an initial period of up to five years from approval of the NCE, during which a generic application attempting to rely 
on the data submitted for the NCE cannot be filed with the FDA. This period can be effectively extended to seven and one-half years 
from FDA approval because a provision of the Hatch-Waxman Act provides for an automatic 30-month extension of the exclusivity 

17

period if we promptly pursue litigation against a company attempting to enter the market with a generic for a drug that is covered by a 
composition of matter or method of use patent. 

Many international markets have data exclusivity statutes that are analogous to Hatch-Waxman and sometimes more protective. The 
analogous statute in the European Medicines Evaluation Agency will, in general, provide Gencaro with a minimum of ten years of 
protection from marketing approval before such a generic application may be approved. Protection under Hatch-Waxman and other 
data exclusivity statutes is sometimes considered superior to patent protection, as the generic cannot be marketed during the period of 
exclusivity, thus eliminating the need to initiate patent infringement litigation with its accompanying risks and costs. 

In addition to protection under data exclusivity statutes, we believe that Gencaro’s patent portfolio will also provide market 
exclusivity, if approved. We have been granted patents in the United States and Europe that claim the use of Gencaro in patients 
predicted to have a favorable response to the drug based on genetic polymorphisms in the genes encoding the beta-1 and/or alpha-2C 
receptors. We believe that this patent strategy may deter generic competition because of the threat of patent litigation or may exclude 
generic competition from the market until the patents expire if we are successful in litigation. Consequently, if our patent strategy is 
successful, we believe we may avoid generic competition with Gencaro in the United States or certain countries in Europe until at 
least the expiration of these patents, which would be no earlier than 2026 in the United States and into 2025 in Europe. In addition, we 
believe that if Gencaro is approved, any one of our U.S. patents may be entitled to an extension of its term and the European patent 
may be entitled to an extension through a supplemental protection certificate in one or more countries in Europe. The length of any 
such extension may vary by country. We cannot predict whether any such extensions will be granted, but if they are, they may provide 
market exclusivity for Gencaro into approximately 2031 in the United States and Europe. In addition, we were granted a patent on the 
S-isomer formulation of Gencaro, which we believe could be important in Gencaro’s future development and could extend market 
exclusivity of the S-isomer form in the United States to approximately 2034, assuming it is the first approved formulation. 

For AB171, the European Patent Office issued patent on methods of treating cardiovascular disease and conditions with a thiol-
substituted isosorbide mononitrate based on genetic targeting. The European patent, entitled “Methods and Compositions for 
Cardiovascular Diseases and Conditions,” provides protection for this novel approach to treating patients with cardiovascular disease 
and conditions. The European patent has been validated in ten countries: Denmark, France, Germany, Ireland, Italy, Netherlands, 
Spain, Sweden, Switzerland and the United Kingdom. We have related patent applications pending at the United States Patent Office 
and Canadian Intellectual Property Office.

We also have other patent rights in additional drug candidates having possible indications in cardiovascular disease, oncology, and 
other therapeutic areas; these are in both early and later stages of development. We may seek collaborators to assist us in the 
development of these candidates or we may seek to raise funds to advance the development of the compounds on our own.

Employees 

As of December 31, 2018, we had 15 full-time employees. None of our employees are represented by any collective bargaining unit. 
We believe that we maintain good relations with our employees. 

Corporate Information 

On January 27, 2009, we completed a business combination, or the Merger, between Nuvelo, Inc., or Nuvelo, a corporation originally 
incorporated in 1992, and its subsidiary, ARCA biopharma, Inc. Immediately following the Merger, we changed our name from 
Nuvelo, Inc. to ARCA biopharma, Inc. Our principal offices are located in Westminster, Colorado. 

We file our annual reports on Form 10-K, quarterly reports on Form 10-Q and current reports on Form 8-K pursuant to Section 13(a) 
or 15(d) of the Securities Exchange Act of 1934, as amended, or the Exchange Act, electronically with the U.S. Securities and 
Exchange Commission, or the SEC. The public may read or copy any materials that have been filed with the SEC at the SEC’s Public 
Reference Rooms at 100 F Street, N.E., Washington, D.C. 20549 on official business days during the hours of 10:00 a.m. and 
3:00 p.m. The public may obtain information on the operation of the Public Reference Room by calling the SEC at 1-800-SEC-0330. 
The SEC maintains an Internet site that contains reports, proxy and information statements, and other information regarding issuers 
that file electronically with the SEC. The address of that site is http://www.sec.gov. 

You may obtain a free copy of our annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and 
amendments to those reports on our website at http://www.arcabiopharma.com on the earliest practicable date following the filing 
with the SEC or by contacting the Investor Relations Department at our corporate office by calling (720) 940-2200. Information found 
on our website is not incorporated by reference into this report. 

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Item 1A. Risk Factors 

An investment in our securities involves certain risks, including those set forth below and elsewhere in this report. In addition to the 
risks set forth below and elsewhere in this report, other risks and uncertainties not known to us, that are beyond its control or that we 
deem to be immaterial may also materially adversely affect our business operations. You should carefully consider the risks described 
below as well as other information and data included in this report. 

Risks Related to Our Business and Financial Condition 

We will need to raise substantial additional funds through public or private equity transactions and/or complete one or more 
strategic transactions, to continue development of Gencaro or any of our other product candidates. If we are unable to raise such 
financing or complete such a transaction, we may not be able to continue operations. 

In light of the expected development timeline to potentially obtain FDA approval for Gencaro, if at all, the substantial additional costs 
associated with the development of Gencaro and our other product candidates, including the costs associated with clinical trials related 
thereto, and the substantial cost of commercializing Gencaro, if it is approved, we will need to raise substantial additional funding 
through public or private equity or debt transactions or a strategic combination or partnership. If we are delayed in obtaining funding 
or are unable to complete a strategic transaction, we may discontinue our development activities on Gencaro and our other product 
candidates or discontinue our operations. Even if we are able to fund continued development and Gencaro or any of our other product 
candidates is approved, we expect that we will need to complete a strategic transaction or raise substantial additional funding through 
public or private debt or equity securities to successfully commercialize Gencaro or any other product candidate.

We believe our cash and cash equivalents balance as of December 31, 2018, together with the $2.4 million of net proceeds raised in 
2019 from sales of our common stock, will be sufficient to fund our operations, at our projected cost structure, through the third 
quarter of 2019. In 2017, we entered into a sales agreement, as amended, with an agent to sell, from time to time, our common stock 
having an aggregate offering price of up to $10.2 million, in an “at the market offering.” In January 2019, we further amended our 
sales agreement to increase the maximum aggregate value of shares which we may issue and sell from time to time under this sales 
agreement by approximately $2.5 million, from $10.2 million to $12.7 million. As of February 22, 2019, we have sold an aggregate of 
9,242,406 shares of our common stock pursuant to the terms of such sales agreement, as amended, for aggregate gross proceeds of 
approximately $12.6 million.  Net proceeds received in the period were approximately $11.9 million, after deducting initial expenses 
for executing the “at the market offering” and commissions paid to the placement agent. We have sold all shares available under the 
current prospectus. Sales of our common stock dilute the ownership interest of our stockholders and may cause the price per share of 
our common stock to decrease. Changing circumstances may cause us to consume capital significantly faster or slower than we 
currently anticipate. We have based these estimates on assumptions that may prove to be wrong, and we could exhaust our available 
financial resources sooner than we currently anticipate. 

Our liquidity, and our ability to raise additional capital or complete any strategic transaction, depends on a number of factors, 
including, but not limited to, the following: 

•

•

•

•

•

•

•

the costs and timing for potential additional clinical trials in order to gain possible regulatory approval for Gencaro and 
our other product candidates; 

the market price of our stock and the availability and cost of additional equity capital from existing and potential new 
investors; 

our ability to retain the listing of our common stock on the Nasdaq Capital Market; 

general economic and industry conditions affecting the availability and cost of capital; 

our ability to control costs associated with our operations; 

the costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual property rights; and 

the terms and conditions of our existing collaborative and licensing agreements. 

The sale of additional equity or convertible debt securities would likely result in substantial dilution to our stockholders. If we raise 
additional funds through the incurrence of indebtedness, the obligations related to such indebtedness would be senior to rights of 
holders of our capital stock and could contain covenants that would restrict our operations. We also cannot predict what consideration 
might be available, if any, to us or our stockholders, in connection with any strategic transaction. Should strategic alternatives or 
additional capital not be available to us, or not be available on acceptable terms, we may be unable to realize value from our assets and 
discharge our liabilities in the normal course of business which may, among other alternatives, cause us to further delay, substantially 
reduce or discontinue operational activities to conserve our cash resources. 

19

Our management and our independent registered public accounting firm, in their report on our financial statements as of and for 
the fiscal year ended December 31, 2018, have concluded that due to our need for additional capital, and the uncertainties 
surrounding our ability to raise such funding, substantial doubt exists as to our ability to continue as a going concern. 

Our audited financial statements for the fiscal year ended December 31, 2018 were prepared assuming that we will continue as a going 
concern. The going concern basis of presentation assumes that we will continue in operation for the foreseeable future and will be able 
to realize our assets and discharge our liabilities and commitments in the normal course of business and do not include any 
adjustments to reflect the possible future effects on the recoverability and classification of assets or the amounts and classification of 
liabilities that may result from our inability to continue as a going concern. Our management and our independent registered public 
accounting firm concluded as of December 31, 2018 that due to our need for additional capital and the uncertainties surrounding our 
ability to raise such funding, substantial doubt exists as to our ability to continue as a going concern for a period from one year after 
our financial statements have been issued. We believe our cash and cash equivalents balance as of December 31, 2018, together with 
the $2.4 million of net proceeds raised in 2019 from sales of our common stock, will be sufficient to fund our operations, at our 
projected cost structure, through the third quarter of 2019. We cannot be certain that we will be able to make any other sale of our 
common stock in any future offering to cover our future capital needs, or at all. Changing circumstances may cause us to consume 
capital significantly faster or slower than we currently anticipate. If we are delayed in completing or are unable to complete additional 
funding and/or a strategic transaction, we may discontinue our development activities or operations, but there are no assurances that 
these reductions would be sufficient to allow us to continue to operate as a going concern. Therefore, even if we resolve this 
uncertainty, our independent registered public accountants and/or management could conclude that uncertainty as to our ability to 
continue as a going concern could exist at a future date.

We have based these estimates on assumptions that may prove to be wrong, and we could exhaust our available financial resources 
sooner than we currently anticipate. We may be forced to reduce our operating expenses and raise additional funds to meet our 
working capital needs, principally through the additional sales of our securities or debt financings. However, we cannot guarantee that 
will be able to obtain sufficient additional funds when needed or that such funds, if available, will be obtainable on terms satisfactory 
to us. If we are unable to raise sufficient additional capital or complete a strategic transaction, we may be unable to continue to fund 
our operations, develop Gencaro or our other product candidates, or realize value from our assets and discharge our liabilities in the 
normal course of business. If we cannot raise sufficient funds, we may have to liquidate our assets, and might realize significantly less 
than the values at which they are carried on our financial statements, and stockholders may lose all or part of their investment in our 
common stock.

If we are not able to successfully develop, obtain FDA approval for, and provide for the commercialization of Gencaro in a timely 
manner, we may not be able to continue our business operations. 

We currently have no products that have received regulatory approval for commercial sale. The process to develop, obtain regulatory 
approval for and commercialize potential product candidates is long, complex and costly. We began screening patients for our 
Phase 2B GENETIC-AF clinical trial in April 2014 and enrolled our first patient in June 2014. Enrollment was completed in August 
2017 having randomized 267 HFrEF patients with AF. The Phase 2B trial completed the patient treatment phase in December 2017 
and we reported top-line data in February 2018. We received guidance from the FDA following an End-of-Phase 2 meeting regarding 
the Phase 3 program for Gencaro as a potential genetically-targeted treatment for AF patients with HF with the beta-1 389 arginine 
homozygous genotype. In consultation with the FDA, we developed key elements of the Phase 3 clinical trial needed to support a 
potential NDA, details of which were confirmed via the FDA SPA process. Any future development of Gencaro, including initiating 
the Phase 3 clinical trial, is dependent on obtaining additional financing, even if we enter into a strategic collaboration.  

Failure to demonstrate that a product candidate, including Gencaro, is safe and effective, or significant delays in demonstrating such 
safety and efficacy, would adversely affect our business. For instance, in February 2018, we announced the top-line results of our 
Phase 2B GENETIC-AF clinical trial in which Gencaro demonstrated a similar treatment benefit compared to the active comparator, 
metoprolol succinate (TOPROL-XL). Failure to obtain marketing approval of Gencaro from appropriate regulatory authorities, or 
significant delays in obtaining such approval, would also adversely affect our business and could, among other things, preclude us 
from completing a strategic transaction or obtaining additional financing necessary to continue as a going concern. 

Even if approved for sale, a product candidate must be successfully commercialized to generate value. We do not currently have the 
capital resources or management expertise to commercialize Gencaro or any of our other product candidates and, as a result, will need 
to complete a strategic transaction, or, alternatively, raise substantial additional funds to enable commercialization of Gencaro or any 
of our other product candidates, if approved. Failure to successfully provide for the commercialization of Gencaro or any other 
product candidate, if approved, would damage our business. 

20

We have received an SPA agreement from the FDA relating to our planned Phase 3 program for Gencaro. This SPA agreement 
does not guarantee approval of Gencaro or any other particular outcome from regulatory review. 

Following our End-of-Phase 2 meeting with the FDA, we requested agreement from the FDA under a SPA for our planned Phase 3 
clinical trial of Gencaro, which we received in February 2019. The FDA’s SPA process is designed to facilitate the FDA’s review and 
approval of drugs by allowing the FDA to evaluate the proposed design and size of certain clinical trials that are intended to form the 
primary basis for determining a drug product’s efficacy. Upon specific request by a clinical trial sponsor, the FDA will evaluate the 
protocol and respond to a sponsor’s questions regarding, among other things, primary efficacy endpoints, trial conduct and data 
analysis, within 45 days of receipt of the request. The FDA ultimately assesses whether the protocol design and planned analysis of 
the trial are acceptable to support regulatory approval of the product candidate with respect to the effectiveness of the indication 
studied. All agreements and disagreements between the FDA and the sponsor regarding a SPA must be clearly documented in a SPA 
letter or the minutes of a meeting between the sponsor and the FDA.

However, a SPA agreement does not guarantee approval of a product candidate, even if the trial is conducted in accordance with the 
protocol. Moreover, the FDA may revoke or alter our SPA agreement in certain circumstances. In particular, a SPA agreement is not 
binding on the FDA if public health concerns emerge that were unrecognized at the time of the SPA agreement, other new scientific 
concerns regarding product safety or efficacy arise, we fail to comply with the agreed upon trial protocols, or the relevant data, 
assumptions or information provided by us in our request for the SPA change or are found to be false or omit relevant facts. In 
addition, even after an SPA agreement is finalized, the SPA agreement may be modified, and such modification will be deemed 
binding on the FDA review division, except under the circumstances described above, if the FDA and the sponsor agree in writing to 
modify the protocol and such modification is intended to improve the study. The FDA retains significant latitude and discretion in 
interpreting the terms of the SPA agreement and the data and results from any study that is the subject of the SPA agreement.

Even though we obtained an agreement on our SPA, we cannot assure you that our planned Phase 3 clinical trial will succeed, will be 
deemed binding by the FDA under our SPA agreement, or will result in any FDA approval for Gencaro. Moreover, if the FDA 
revokes or alters its agreement under our SPA, or interprets the data collected from the clinical trial differently than we do, the FDA 
may not deem the data sufficient to support an application for regulatory approval, which could materially adversely affect our 
business, financial condition and results of operations.

If we are not able to maintain the requirements for listing on the Nasdaq Capital Market, we could be delisted, which could have a 
material adverse effect on our ability to raise additional funds as well as the price and liquidity of our common stock. 

Our common stock is currently listed on the Nasdaq Capital Market. To maintain the listing of our common stock on the Nasdaq 
Capital Market we are required to meet certain listing requirements, including, among others, (i) a minimum closing bid price of $1.00 
per share, (ii) a market value of publicly held shares (excluding shares held by our executive officers, directors and 10% or more 
stockholders) of at least $1 million and (iii) either: (x) stockholders’ equity of at least $2.5 million; or (y) a total market value of listed 
securities of at least $35 million. 

We have received three potential delisting notices from Nasdaq since 2012. In 2012, 2015 and 2018, we received notification from 
Nasdaq of potential delisting of our shares from the Nasdaq Capital Market because the closing bid price of our common stock had not 
met the minimum closing bid price of $1.00 per share during the preceding 30 business days. We subsequently regained compliance 
with Nasdaq’s minimum closing bid price requirements related to the 2012 and 2015 notices, effecting a 1-for-6 reverse split of our 
common stock in March 2013 and a 1-for-7 reverse split of our common stock in September 2015. On April 11, 2018, we received 
notification from Nasdaq, or the Notice, of potential delisting of our shares from the Nasdaq Capital Market because the closing bid 
price of our common stock had not met the minimum closing bid price of $1.00 per share during the preceding 30 business days. On 
October 9, 2018, we received a written notification from NASDAQ granting an additional 180 calendar day period, until April 8, 
2019, to regain compliance with the minimum bid price requirement. The minimum bid price requirement will be met if our common 
stock has a closing bid of at least $1.00 per share for a minimum of 10 consecutive business days during the 180 day period. If our 
stock does not trade above these levels, we may seek to execute a reverse split of our common stock in order to regain compliance. 
This second 180 day period relates exclusively to the bid price deficiency and ARCA could be delisted during the 180 day period for 
failure to maintain compliance with any other listing requirements that occurs during the 180 day period. In October 2018, we held a 
special meeting of our stockholders, at which our stockholders approved a series of certificates of amendment to our restated 
certificate of incorporation, as amended, to effect a reverse split of our outstanding common stock, at a ratio of between 1-for-3 and 1-
for-20, inclusive, and to authorize our board of directors to, for a period of up to one-year, to select and file such a certificate of 
amendment to effect such a reverse split of our outstanding common stock, if, in the judgment of our board of directors, it is deemed 
necessary. However, our board of directors has yet to approve any such stock split, and, even if effected, the effect of a reverse stock 
split on the market price of our common stock cannot be predicted with any certainty, and the history of similar stock split 
combinations for companies in like circumstances is varied. It is possible that the per share price of our common stock after the 
reverse stock split will not rise in proportion to the reduction in the number of shares of common stock outstanding resulting from the 
reverse stock split, effectively reducing our market capitalization, and there can be no assurance that the market price per post-reverse 
split share will either exceed or remain in excess of the $1.00 minimum bid price for a sustained period of time. We cannot provide 
any assurance when or if the closing bid price of our common stock will again be greater than $1.00. The market price of our common 
stock may vary based on other factors that are unrelated to the number of shares outstanding, including our future performance.

21

The delisting of our common stock from a national exchange could impair the liquidity and market price of the common stock. It 
could also materially, adversely affect our access to the capital markets, and any limitation on market liquidity or reduction in the 
price of the common stock as a result of that delisting could adversely affect our ability to raise capital on terms acceptable to us, or at 
all. 

In future periods, if we do not meet the minimum stockholders’ equity, minimum closing bid price requirements, or any other listing 
requirements, we would be subject to delisting from the Nasdaq Capital Market. 

As of February 22, 2019, the closing price of our common stock was $0.46 per share, rounded to the nearest penny, and the total 
market value of our listed securities was approximately $8.4 million. As of December 31, 2018, we had stockholders’ equity of 
$6.0 million. 

If we encounter difficulties enrolling patients in any future clinical trials, our future trials could be delayed or otherwise adversely 
affected. 

If we have difficulty enrolling a sufficient number of patients in any future clinical trial, we may need to delay or terminate our trial, 
which would have a negative impact on our business. Delays in enrolling patients in any future clinical trials would also adversely 
affect our ability to generate any product, milestone and royalty revenues under collaboration agreements, if any, and could impose 
significant additional costs on us or on any future collaborators. 

The GENETIC-AF clinical trial required that we identify and enroll a large number of patients with the condition under investigation 
and the trial enrolled only those patients having a specific genotype, and certain patients who have or are willing to have a Medtronic 
device implanted for monitoring and recording AFB data. Because of the rigorous enrollment criteria, our clinical trial timelines were 
delayed from our original projections. We anticipate that any future Phase 3 clinical trial of Gencaro may have similar enrollment 
criteria, and we cannot guarantee that we will not have similar issues in any future clinical trials.

Our clinical trials for our product candidates may not yield results that will enable us to further develop our products and obtain 
regulatory approvals necessary to sell them.

We will receive regulatory approval for our product candidates only if we can demonstrate in carefully designed and conducted 
clinical trials that the product candidate is safe and effective. We do not know whether any current or future clinical trials for Gencaro 
or any other product candidate will demonstrate sufficient safety and efficacy to obtain the requisite regulatory approvals or will result 
in marketable products. 

For example, GENETIC-AF was designed as an adaptive trial. The DSMB conducted a pre-specified interim analysis of study 
endpoints for efficacy, safety and futility. Based on the efficacy and safety data of the interim analysis, the DSMB recommended 
completing the Phase 2B trial with no changes to the trial design, rather than transition GENETIC-AF to a Phase 3 trial. In 
February 2018, we announced top-line results of the Phase 2B trial, which indicated that Gencaro demonstrated a similar treatment 
benefit compared to the active comparator, metoprolol succinate (TOPROL-XL). We have not determined if these results of 
GENETIC-AF, and cannot predict if the results from a future Phase 3 clinical trial, even with a SPA agreement, would allow us to 
obtain regulatory approval for Gencaro. 

Clinical trials are lengthy, complex and expensive processes with uncertain results. We have spent, and expect to continue to spend, 
significant amounts of time and money in the clinical development of our product candidates. We have never conducted a Phase 3 
clinical trial and have limited staff with the requisite experience to do so. We therefore rely on contract research organizations, or 
CROs, to conduct certain aspects of our clinical trial. While certain of our employees have experience in designing and administering 
clinical trials, these employees have no such experience as employees of ARCA.

The results we obtain in preclinical testing and early clinical trials may not be predictive of results that are obtained in later studies. 
We may suffer significant setbacks in advanced clinical trials, even after seeing promising results in earlier studies. Based on results at 
any stage of clinical trials, we may decide to repeat or redesign a trial or discontinue development of one or more of our product 
candidates. If we fail to adequately demonstrate the safety and efficacy of our products under development, we will not be able to 
obtain the required regulatory approvals to commercialize our product candidates, and our business, results of operations and financial 
condition would be materially adversely affected. 

Administering our product candidates to humans may produce undesirable side effects. These side effects could interrupt, delay or halt 
clinical trials of our product candidates and could result in the FDA or other regulatory authorities denying approval of our product 
candidates for any or all targeted indications. 

If clinical trials for a product candidate are unsuccessful, we will be unable to commercialize the product candidate. If one or more of 
our clinical trials are delayed, we will be unable to meet our anticipated development timelines. Either circumstance could cause the 
market price of our common stock to decline. 

22

We will rely on contract research organizations to conduct substantial portions of our clinical trials, including any future clinical 
trial of Gencaro, and as a result, we will be unable to directly control the timing, conduct and expense of all aspects of our clinical 
trials. 

We do not currently have sufficient staff with the requisite experience to conduct our clinical trials and therefore will rely on third 
parties to conduct certain aspects of any future clinical trials. We previously contracted with a CRO to conduct components of our 
GENETIC-AF trial and anticipate contracting with a CRO to conduct components of any future clinical trial for Gencaro or any future 
clinical trials for our other product candidates. As a result, we will have less control over many details and steps of any trial, the 
timing and completion of any trial, the required reporting of adverse events and the management of data developed through any trial 
than would be the case if we were relying entirely upon our own staff. Communicating with outside parties can also be challenging, 
potentially leading to mistakes as well as difficulties in coordinating activities. Outside parties, such as CROs, may have staffing 
difficulties, may undergo changes in priorities or may become financially distressed, adversely affecting their willingness or ability to 
conduct our trial. We may experience unexpected cost increases that are beyond our control. Problems with the timeliness or quality of 
the work of a CRO may lead us to seek to terminate the relationship and use an alternative service provider. However, making any 
change may be costly and may delay ongoing trials, if any, and contractual restrictions may make such a change difficult or 
impossible. Additionally, it may be impossible to find a replacement organization that can conduct clinical trials in an acceptable 
manner and at an acceptable cost.  

Even though we anticipate relying on CROs in the future, we will likely have to devote substantial resources and rely on the expertise 
of our employees to manage the work being done by the CROs. 

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

We set goals for, and make public statements regarding, the timing of certain accomplishments, such as, the commencement and 
completion of clinical trials, particularly with respect to steps for commencing and continuing our clinical trials, the disclosure of trial 
results, the obtainment of regulatory approval and the sale of drug product, which we sometimes refer to as milestones. These 
milestones may not be achieved, and the actual timing of these events can vary dramatically due to a number of factors such as delays 
or failures in our clinical trials, disagreements with any collaborative partners, the uncertainties inherent in the regulatory approval 
process and manufacturing scale-up and delays in achieving manufacturing or marketing arrangements sufficient to commercialize our 
products. FDA approval of Gencaro or any other product candidate, if it occurs, is expected to require years of additional clinical 
development, including the completion of genetic trials. There can be no assurance that we will make regulatory submissions or 
receive regulatory approvals as planned. If we fail to achieve one or more of these milestones as planned, our business will be 
materially adversely affected. 

We expect to depend on existing and future collaborations with third parties for the development of some of our product 
candidates. If those collaborations are not successful, we may not be able to complete the development of these product candidates. 

We had a collaboration agreement with Medtronic that supported our GENETIC-AF clinical trial. If our arrangement with Medtronic, 
as amended, is continued as part of our future development of Gencaro, we will have limited control over the amount and timing of 
resources that they dedicate to the development of Gencaro. This is also likely to be true in any future collaboration with third parties 
and we may seek additional third party collaborators for the development of Gencaro or other product candidates. Our ability to 
benefit from these arrangements will depend on our collaborators’ abilities to successfully perform the functions assigned to them in 
these arrangements. 

Collaborations involving our product candidates pose the following risks to us: 

•

•

•

•

•

collaborators have significant discretion in determining the efforts and resources that they will apply to these 
collaborations; 

collaborators may not pursue development and commercialization of our product candidates or may elect not to continue 
or renew development or commercialization programs based on clinical trial results, changes in the collaborator’s strategic 
focus or available funding, or external factors such as an acquisition that diverts resources or creates competing priorities; 

collaborators may delay clinical trials, provide insufficient funding for a clinical trial program, stop a clinical trial or 
abandon a product candidate, repeat or conduct new clinical trials or require a new formulation of a product candidate for 
clinical testing; 

collaborators could independently develop, or develop with third parties, products that compete directly or indirectly with 
our product candidates if the collaborators believe that competitive products are more likely to be successfully developed 
or can be commercialized under terms that are more economically attractive than ours; 

collaborators may not properly maintain or defend our intellectual property rights or may use our proprietary information 
in such a way as to invite litigation that could jeopardize or invalidate our proprietary information or expose us to 
potential litigation; 

23

•

•

•

•

•

•

•

•

disputes may arise between the collaborators and us that result in the delay or termination of the research, development or 
commercialization of our product candidates or that result in costly litigation or arbitration that diverts management 
attention and resources; 

collaborations may be terminated and, if terminated, may result in a need for additional capital to pursue further 
development or commercialization of the applicable product candidates; 

collaborators may elect to take over manufacturing rather than retain us as manufacturers and may encounter problems in 
starting up or gaining approval for their manufacturing facility and so be unable to continue development of product 
candidates; 

we may be required to undertake the expenditure of substantial operational, financial and management resources in 
connection with any collaboration; 

we may be required to issue equity securities to collaborators that would dilute our existing stockholders’ percentage 
ownership; 

we may be required to assume substantial actual or contingent liabilities; 

collaborators may not commit adequate resources to the marketing and distribution of our product candidates, limiting our 
potential revenues from these products; and 

collaborators may experience financial difficulties. 

We face a number of challenges in seeking additional collaborations. Collaborations are complex and any potential discussions may 
not result in a definitive agreement for many reasons. For example, whether we reach a definitive agreement for a collaboration will 
depend, among other things, upon our assessment of the collaborator’s resources and expertise, the terms and conditions of the 
proposed collaboration, and the proposed collaborator’s evaluation of a number of factors, such as the design or results of our clinical 
trials, the potential market for our product candidates, the costs and complexities of manufacturing and delivering our product 
candidates to patients, the potential of competing products, the existence of uncertainty with respect to ownership or the coverage of 
our intellectual property, and industry and market conditions generally. If we were to determine that additional collaborations for our 
Gencaro development is necessary and were unable to enter into such collaborations on acceptable terms, we might elect to delay or 
scale back the development or commercialization of Gencaro in order to preserve our financial resources or to allow us adequate time 
to develop the required physical resources and systems and expertise ourselves. 

Collaboration agreements may not lead to development or commercialization of our product candidates in the most efficient manner, 
or at all. In addition, there have been a significant number of recent business combinations among large pharmaceutical companies 
that have resulted in a reduced number of potential future collaborators. If a present or future collaborator of ours were to be involved 
in a business combination, the continued pursuit and emphasis on our product development or commercialization program could be 
delayed, diminished or terminated. 

Any future clinical trial for Gencaro will require the use of a third-party diagnostic services provider to administer a genetic test 
needed to identify the patient receptor genotypes of clinical trial participants, and as a result, we will be unable to directly control 
the timing, conduct and expense of the genetic test. 

We anticipate that any future clinical trial of Gencaro, if any, will require a companion diagnostic test that identifies the patient’s 
receptor genotype. The trial would only enroll those patients with the receptor that has the potential for enhanced efficacy, the beta-1 
389 Arg receptor as detected by a beta-1 389 Arg/Arg genotype. Accordingly, we anticipate that any future clinical trial for Gencaro 
will require the use of a third-party diagnostic service to perform the genetic testing. There has been limited experience in our industry 
in prospective development of companion diagnostics required to perform the required molecular profiling. We entered into an 
agreement with LabCorp to provide the diagnostic services of the genetic test needed to support our GENETIC-AF trial. To provide 
those services, LabCorp obtained from the FDA an IDE for the companion diagnostic test being used in our GENETIC-AF clinical 
trial. We would expect a similar agreement and approval would be necessary for any companion diagnostic used in any future clinical 
trials for Gencaro.

24

The FDA and similar regulatory authorities outside the United States regulate companion diagnostics. Companion diagnostics require 
separate or coordinated regulatory approval prior to commercialization. Changes to regulatory advice could delay our development 
programs or delay or prevent eventual marketing approval for our product candidates that may otherwise be approvable. In July 2011, 
the FDA issued draft guidance that stated that if safe and effective use of a therapeutic depends on an in vitro diagnostic, the FDA 
generally will not approve the therapeutic unless the FDA approves or clears this “in vitro companion diagnostic device” at the same 
time that the FDA approves the therapeutic. The approval or clearance of the companion diagnostic would occur through the FDA’s 
Center for Devices and Radiological Health. In 2014, the FDA issued guidance on in vitro companion diagnostic devices. The 
guidance allows for flexibility by the FDA in the case of therapeutic products to treat serious conditions for which no alternative 
treatment exists and the benefits of using the companion diagnostic outweigh the risk, but it is unclear how this discretion may be 
applied by the agency with respect to the companion diagnostic test related to any Gencaro clinical trials. The FDA’s evolving 
position on the topic of companion diagnostics could affect our clinical development programs that utilize companion diagnostics. In 
particular, the FDA may limit our ability to use retrospective data, otherwise disagree with our approaches to trial design, biomarker 
qualification, clinical and analytical validity, and clinical utility, or make us repeat aspects of a trial or initiate new trials. 

Given our limited experience in developing diagnostics, we expect to rely primarily on third parties for the design and manufacture of 
the companion diagnostics for our product candidates. If we, or any third parties that we engage to assist us, are unable to successfully 
develop companion diagnostics for our product candidates that require such diagnostics, or experience delays in doing so, the 
development of our product candidates may be adversely affected, our product candidates may not receive marketing approval and we 
may not realize the full commercial potential of any products that receive marketing approval. As a result, our business could be 
materially harmed. 

We will need to establish a collaborative arrangement with a third-party diagnostics services provider to obtain marketing 
clearance or approval of the companion genetic test. There is no guarantee that the FDA will grant timely clearance or approval of 
the genetic test, if at all, and failure to obtain such timely clearance or approval would adversely affect our ability to market 
Gencaro. 

The drug label we intend to seek for Gencaro would identify the patient receptor genotype for which the drug is approved. 
Accordingly, we believe developing a genetic test that is simple to administer and widely available will be critical to the successful 
commercialization of Gencaro. The genetic test will be subject to regulation by the FDA and by comparable agencies in various 
foreign countries. The process of complying with the requirements of the FDA and comparable agencies is costly, time consuming and 
burdensome. 

Despite the time and expense expended, regulatory clearance or approval is never guaranteed. If regulatory clearance or approval is 
delayed, or if one or more third-party diagnostic services providers are unable to obtain FDA approval of the genetic test at all or in 
parallel with the approval of Gencaro, or are unable to commercialize the test successfully and in a manner that effectively supports 
the commercial efforts for Gencaro, or if the information concerning the differential response to Gencaro resulting from certain 
genetic variation is not included in the approval label for Gencaro, the commercial launch of Gencaro may be significantly and 
adversely affected. 

Regulatory approval is required for the genetic test to be used in our Gencaro clinical trials and to support the commercialization 
of the test, if approved. Delays or failures in obtaining such regulatory approval, including any required validation analyses may 
prevent a third-party diagnostics provider from commercializing such genetic test and will adversely affect our business, operating 
results and prospects. 

Before a genetic test can be used commercially, including in conjunction with Gencaro, if it is approved for marketing, the third-party 
diagnostics provider must obtain FDA Premarket Approval, or PMA, for such test. The FDA may require additional validation of the 
genetic test we used in GENETIC-AF prior to any approval of Gencaro or the genetic test or prior to the use of such test in any future 
clinical trials for Gencaro. We anticipate the genetic test will be required as a condition to prescribing Gencaro. There is no guarantee 
the FDA will approve the anticipated PMA submission for the genetic test. Even if the genetic test is eventually approved, performing 
additional validation work necessary to support the PMA, if required, for current or future genetic test products, including one 
associated with Gencaro, would require additional time and expense and the outcome would be uncertain. Moreover, such delays or 
increased costs or failures could adversely affect our business, operating results and prospects for commercializing the genetic test.

25

If a third-party diagnostics provider responsible for the genetic test or certain of its third-party suppliers fails to comply with 
ongoing FDA or other foreign regulatory authority requirements, or if there are unanticipated problems with the genetic test, these 
products could be subject to restrictions or withdrawal from use in a trial or from the market. 

Any diagnostic for which a third-party diagnostics provider obtains clearance or approval, and the manufacturing processes, reporting 
requirements, post-approval clinical data and promotional activities for such product, will be subject to continued regulatory review, 
oversight and periodic inspections by the FDA and other domestic and foreign regulatory bodies. With respect to the genetic test, to 
the extent applicable, any third-party diagnostics provider and certain of its suppliers will be required to comply with the FDA’s 
Quality System Regulation, or QSR, and International Standards Organization, or ISO, requirements which cover the methods and 
documentation of the design, testing, production, control, quality assurance, labeling, packaging, storage and shipping of any product 
for which clearance or approval is obtained. Regulatory bodies, such as the FDA, enforce the QSR and other regulations through 
periodic inspections. The failure by a third-party diagnostics provider, or certain of its third-party manufacturers or suppliers, as the 
case may be, to comply with applicable statutes and regulations administered by the FDA and other regulatory bodies, or the failure to 
timely and adequately respond to any adverse inspectional observations or product safety issues, could result in, among other things, 
enforcement actions. If any of these actions were to occur, it could harm our reputation and cause product sales and profitability of 
Gencaro, if approved, to suffer and may prevent us from generating revenue or utilizing the genetic test further in any clinical trial. 
Even if regulatory clearance or approval is granted, such clearance or approval may be subject to limitations on the intended uses for 
which the product may be marketed and reduce our potential to successfully commercialize the product and generate revenue from the 
product. 

Future sales of Gencaro may suffer if its marketplace acceptance is negatively affected by the genetic test. 

The genetic test is an important component of the commercial strategy for Gencaro in addition to being required for our clinical trials. 
We believe that the genetic test helps predict patient response to Gencaro, and that this aspect of the drug is important to its ability to 
compete effectively with current therapies. The genetic test adds an additional step in the prescribing process, an additional cost for 
the patient and payors, the risk that the test results may not be rapidly available and the possibility that it may not be available at all to 
hospitals and medical centers. Although we anticipate that Gencaro, if approved in a timely manner, would be the first genetically-
targeted cardiovascular drug, Gencaro will be one of a number of successful drugs in the beta-blocker class currently on the market. 
Prescribers may be more familiar with these other beta-blockers, and may be resistant to prescribing Gencaro as an AF therapy in 
patients with HF. For instance, the top-line results of our Phase 2B GENETIC-AF clinical trial indicated that Gencaro demonstrated a 
similar treatment benefit compared to the active comparator, metoprolol succinate (TOPROL-XL). If our future clinical trials in 
Gencaro do not show that Gencaro has a clear therapeutic benefit as compared to other drugs in the beta-blocker class currently on the 
market, then prescribers may be unlikely to prescribe Gencaro to patients, even if approved. Any one of these factors could affect 
prescriber behavior, which in turn may substantially impede market acceptance of the genetic test, which could cause significant harm 
to Gencaro’s ability to compete, and in turn harm our business. 

Our failure to raise substantial additional funding or enter into a strategic transaction may materially and adversely affect our 
business. 

Unless we are able to raise substantial additional funding for the development of Gencaro through other means, we will need to 
complete a strategic transaction to continue the development of Gencaro through its next phase of clinical development, the regulatory 
submission process, the commercialization phase, and to continue our other operations. The strategic transactions that we may 
consider include a potential combination or partnership. Our board of directors and management team have and will continue to 
devote substantial time and resources to obtaining additional capital or the consideration and implementation of any such strategic 
transaction. In addition, conditions in the financial markets may lead to an increased number of biotechnology companies that are also 
seeking to enter into strategic transactions, which may limit our ability to negotiate favorable terms for any such transaction. Further, 
our current employees do not have experience in the strategic transaction process, and our previous efforts to enter into a strategic 
transaction have not been successful. As a result of these and other factors, there is substantial risk that we may not be able to 
complete a strategic transaction on favorable terms, or at all. The failure to complete such a strategic transaction may materially and 
adversely affect our business. 

26

We may be limited in our ability to access sufficient funding through a public or private equity offering or convertible debt 
offering. 

Nasdaq rules impose restrictions on our ability to raise funds through a private offering of our common stock, convertible debt or 
similar instruments without obtaining stockholder approval. Under Nasdaq rules, an offering of more than 20% of our total shares 
outstanding at a price per share less than (i) the closing price of our common stock on the Nasdaq Capital Market immediately 
preceding the signing of the binding agreement, or (ii) the average closing price of our common stock on the Nasdaq Capital Market 
for the five trading days immediately preceding the signing of the binding agreement requires stockholder approval unless the offering 
qualifies as a “public offering” for purposes of the Nasdaq rules. As of December 31, 2018, we had approximately 13.9 million shares 
of common stock outstanding, 20% of which is approximately 2.8 million shares. SEC rules impose restrictions on our ability to raise 
funds through the registered offering of our securities pursuant to a “shelf” registration statement on Form S-3. Under SEC rules, we 
are prohibited from selling securities under such a registration statement if the aggregate market value of the securities sold thereunder 
in any twelve-month period exceeds one-third of the market value of our outstanding common stock held by non-affiliates. In 2017, 
we entered into a sales agreement, as amended, with an agent to sell, from time to time, our common stock having an aggregate 
offering price of up to $10.2 million, in one or more “at the market offerings.” In January 2019, we further amended our sales 
agreement to increase the maximum aggregate value of shares which we may issue and sell from time to time under this sales 
agreement by approximately $2.5 million, from $10.2 million to $12.7 million. As of February 22, 2019, we have sold an aggregate of 
9,242,406 shares of our common stock pursuant to the terms of such sales agreement, as amended, for aggregate gross proceeds of 
approximately $12.6 million.  Net proceeds received in the period were approximately $11.9 million, after deducting initial expenses 
for executing the “at the market offering” and commissions paid to the placement agent. We have sold all shares available under the 
current prospectus. Due to these sales, we may be limited in our ability to sell securities registered on Form S-3 over the next 12 
months, which may substantially limit our ability to effect future financings. In addition, we are currently subject to certain contractual 
rights of investors arising from our public and private equity financing transactions that limit the nature and price of future public and 
private financing transactions that we may effect. For example, in January 2013, we entered into separate subscription agreements 
with certain institutional investors in connection with a private investment in public equity, pursuant to which we sold shares of our 
common stock and warrants to purchase shares of our common stock to the investors. In connection with this transaction, we agreed 
that, subject to certain exceptions, we would not, while the warrants issued in such financing are outstanding, effect or enter into an 
agreement to effect any issuance of common stock or securities convertible into, exercisable for or exchangeable for common stock in 
a “variable rate transaction,” which means a transaction in which we issue or sell any convertible securities either (A) at a conversion 
price, exercise price or exchange rate or other price that is based upon and/or varies with the trading prices of, or quotations for, the 
shares of common stock at any time after the initial issuance of such convertible securities, or (B) with a conversion, exercise or 
exchange price that is subject to being reset at some future date after the initial issuance of the convertible securities or upon the 
occurrence of the specified or contingent events directly or indirectly related to our business or the market for our common stock. The 
restrictions imposed by the terms of our previous offerings, and that could be imposed in future offerings, may limit our access to 
capital on agreeable terms and delay or make impossible certain otherwise available equity financing opportunities and could severely 
restrict our access to the capital necessary to conduct our business.   

Unless we are able to generate sufficient product revenue, we will continue to incur losses from operations and will not achieve or 
maintain profitability. We are years away from commercializing a product and generating product revenue. 

Our historical losses have had and will continue to have an adverse effect on our stockholders’ equity and working capital, among 
other things. We are years away from commercializing a product and generating any product revenue. As a result, we expect to 
continue to incur significant operating losses for the foreseeable future. Even if we ultimately receive regulatory approval for Gencaro 
or our other product candidates, sales of such products may not generate sufficient revenue for it to achieve or maintain profitability. 
Because of the numerous risks and uncertainties associated with developing therapeutic drugs, we may experience larger than 
expected future losses and may never reach profitability. 

Our product candidates are subject to extensive regulation, which can be costly and time-consuming, and unsuccessful or delayed 
regulatory approvals could increase our future development costs or impair our future revenue. 

The preclinical and clinical development, testing, manufacture, safety, efficacy, labeling, storage, recordkeeping, and subsequent 
advertising, promotion, sale, marketing, and distribution, if approved, of our product candidates are subject to extensive regulation by 
the FDA and other regulatory authorities in the United States and elsewhere. These regulations also vary in important, meaningful 
ways from country to country. We are not permitted to market a potential drug in the United States until we receive approval of an 
NDA from the FDA for such drug. We have not received an NDA approval from the FDA for Gencaro or any of our other product 
candidates. There can be no guarantees with respect to our product candidates that clinical studies will adequately support an NDA, 
that the products will receive necessary regulatory approvals, or that they will prove to be commercially successful. 

27

To receive regulatory approval for the commercial sale of any product candidates, we must demonstrate safety and efficacy in humans 
to the satisfaction of regulatory authorities through preclinical studies and adequate and well-controlled clinical trials of the product 
candidates. This process is expensive and can take many years, and failure can occur at any stage of the testing. Our failure to 
adequately demonstrate the safety and efficacy of our product candidates will prevent regulatory approval and commercialization of 
such products. In 2008, we submitted and the FDA accepted our NDA filing for Gencaro for the treatment of chronic HF. In 2009, the 
FDA issued a Complete Response Letter, or CRL, in which the FDA stated that it could not approve the Gencaro NDA in its current 
form and specified actions required for approval of the NDA, including conducting an additional Phase 3 clinical trial of Gencaro in 
patients with HF. We completed a Phase 2B clinical study of Gencaro in HFrEF patients to assess its efficacy in reducing or 
preventing AF. We enrolled 267 HFrEF patients with AF in the Phase 2B trial. We reported top-line Phase 2B data in February 2018. 
In the third quarter of 2018, we submitted a SPA to the FDA for a Phase 3 clinical trial. In February 2019, the FDA has approved our 
SPA request. Even though the FDA approved our SPA, this product candidate will require years of additional clinical development. 
Even if we conduct additional studies in accordance with our SPA agreement or further FDA guidance and submit or file a new or 
amended NDA, the FDA may ultimately decide that the NDA does not satisfy the criteria for approval. 

In the event that we or our collaborators conduct preclinical studies that do not comply with Good Laboratory Practices, or GLP, or 
incorrectly design or carry out human clinical trials in accordance with Good Clinical Practices, or GCP, or those clinical trials fail to 
demonstrate clinical significance, it is unlikely that we will be able to obtain FDA approval for product development candidates. Our 
inability to successfully initiate and effectively complete clinical trials for any product candidate on schedule, or at all, will severely 
harm our business. Significant delays in clinical development could materially increase product development costs or allow our 
competitors to bring products to market before we do, impairing our ability to effectively commercialize any future product candidate. 
We do not know whether planned clinical trials will begin on time, will need to be redesigned or will be completed on schedule, if at 
all. Clinical trials can be delayed for a variety of reasons, including: 

•

•

•

•

•

•

•

•

•

•

•

•

  delays or failures in obtaining regulatory authorization to commence a trial because of safety concerns of regulators relating 

to our product candidates or similar product candidates of our competitors or failure to follow regulatory guidelines; 

  delays or failures in obtaining clinical materials and manufacturing sufficient quantities of the product candidates for use in 

trials; 

  delays or failures in reaching agreement on acceptable terms with prospective study sites; 

  delays or failures in obtaining approval of our clinical trial protocol from an IRB to conduct a clinical trial at a prospective 

study site; 

  delays in recruiting patients to participate in a clinical trial, which may be due to the size of the patient population, 

eligibility criteria, protocol design, perceived risks and benefits of the drug, availability of other approved and standard of 
care therapies or, availability of clinical trial sites; 

  other clinical trials seeking to enroll subjects with similar profile; 

  failure of our clinical trials and clinical investigators to be in compliance with GCP; 

  unforeseen safety issues, including negative results from ongoing preclinical studies; 

  inability to monitor patients adequately during or after treatment; 

  difficulty recruiting and monitoring multiple study sites;

  failure of our third-party contract research organizations, clinical site organizations and other clinical trial managers, to 

satisfy their contractual duties, comply with regulations or meet expected deadlines; and 

  an insufficient number of patients who have, or are willing to have, a Medtronic device implanted for monitoring and 

recording AF burden data.

In addition, any approvals we may obtain may not cover all of the clinical indications for which we seek approval or permit us to 
make claims of superiority over currently marketed competitive products. Also, an approval might contain significant limitations in 
the form of narrow indications, warnings, precautions or contraindications with respect to conditions of use. If the FDA determines 
that a risk evaluation and mitigation strategy, or REMS, is necessary to ensure that the benefits of the drug outweigh the risks, we may 
be required to include as part of the NDA a proposed REMS that may include a package insert directed to patients, a plan for 
communication with healthcare providers, restrictions on a drug’s distribution, or a Medication Guide, to provide better information to 
consumers about the drug’s risks and benefits. Finally, an approval could be conditioned on our commitment to conduct further 
clinical trials, which we may not have the resources to conduct or which may negatively impact our financial situation. 

The manufacture and tableting of Gencaro is done by third party suppliers, who must also meet cGMP requirements and pass a pre-
approval inspection of their facilities before we can obtain marketing approval. 

28

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
All of our product candidates are prone to the risks of failure inherent in drug development. The results from preclinical animal testing 
and early human clinical trials may not be predictive of results obtained in later human clinical trials. Further, although a new product 
may show promising results in preclinical or early human clinical trials, it may subsequently prove unfeasible or impossible to 
generate sufficient safety and efficacy data to obtain necessary regulatory approvals. The data obtained from preclinical and clinical 
studies are susceptible to varying interpretations that may delay, limit or prevent regulatory approval, and the FDA and other 
regulatory authorities in the United States and elsewhere exercise substantial discretion in the drug approval process. The numbers, 
size and design of preclinical studies and clinical trials that will be required for FDA or other regulatory approval will vary depending 
on the product candidate, the disease or condition for which the product candidate is intended to be used and the regulations and 
guidance documents applicable to any particular product candidate. The FDA or other regulators can delay, limit or deny approval of 
any product candidate for many reasons, including, but not limited to: 

•

•

•

•

•

  side effects; 

  safety and efficacy; 

  defects in the design of clinical trials; 

  the fact that the FDA or other regulatory officials may not approve our or our third party manufacturer’s processes or 

facilities; or 

  the fact that new regulations may be enacted by the FDA or other regulators may change their approval policies or adopt 
new regulations requiring new or different evidence of safety and efficacy for the intended use of a product candidate. 

In light of widely publicized events concerning the safety of certain drug products, regulatory authorities, members of Congress, the 
Government Accountability Office, medical professionals and the general public have raised concerns about potential drug safety 
issues. These events have resulted in the withdrawal of certain drug products, revisions to certain drug labeling that further limit use of 
the drug products and establishment of risk management programs that may, for instance, restrict distribution of drug products. The 
increased attention to drug safety issues may result in a more cautious approach by the FDA to clinical trials and approval. Data from 
clinical trials may receive greater scrutiny with respect to safety and the product’s risk/benefit profile, which may make the FDA or 
other regulatory authorities more likely to terminate clinical trials before completion, or require longer or additional clinical trials that 
may result in substantial additional expense, and a delay or failure in obtaining approval or approval for a more limited indication than 
originally sought. Aside from issues concerning the quality and sufficiency of submitted preclinical and clinical data, the FDA may be 
constrained by limited resources from reviewing and determining the approvability of the Gencaro NDA in a timely manner. 

In pursuing clinical development of Gencaro for an AF indication, we will be required to amend the Gencaro HF NDA or prepare a 
new NDA. The FDA could approve Gencaro, but without including some or all of the prescribing information that we have requested. 
For instance, the FDA could approve Gencaro for AF in a more limited patient population or include additional warnings in the drug’s 
label. This, in turn, could substantially and detrimentally impact our ability to successfully commercialize Gencaro and effectively 
protect our intellectual property rights in Gencaro. 

If our product candidates receive regulatory approval, we would be subject to ongoing regulatory obligations and restrictions, 
which may result in significant expenses and limit our ability to develop and commercialize other potential products. 

If a product candidate of ours is approved by the FDA or by another regulatory authority, we would be held to extensive regulatory 
requirements over product manufacturing, testing, distribution, labeling, packaging, adverse event reporting and other reporting to 
regulatory authorities, storage, advertising, marketing, promotion, distribution, and record keeping. Regulatory approvals may also be 
subject to significant limitations on the indicated uses or marketing of the product candidates. Potentially costly follow-up or post-
marketing clinical studies may be required as a condition of approval to further substantiate safety or efficacy, or to investigate 
specific issues of interest to the regulatory authority. Previously unknown problems with the product candidate, including adverse 
events of unanticipated severity or frequency, may result in additional regulatory controls or restrictions on the marketing or use of the 
product or the need for post marketing studies, and could include suspension or withdrawal of the products from the market. 

Furthermore, our third-party manufacturers and the manufacturing facilities that they use to make our product candidates are regulated 
by the FDA. Quality control and manufacturing procedures must continue to conform to cGMP after approval. Drug manufacturers 
and their subcontractors are required to register their facilities and products manufactured annually with the FDA and certain state 
agencies and are subject to periodic unannounced inspections by the FDA, state and/or other foreign authorities. Any subsequent 
discovery of problems with a product, or a manufacturing or laboratory facility used by us or our collaborators, may result in 
restrictions on the product, or on the manufacturing or laboratory facility, including a withdrawal of the drug from the market or 
suspension of manufacturing. Any changes to an approved product, including the way it is manufactured or promoted, often require 
FDA approval before the product, as modified, can be marketed. We and our third-party manufacturers will also be subject to ongoing 
FDA requirements for submission of safety and other post-market information. 

29

 
 
 
 
 
 
 
 
 
 
The marketing and advertising of our drug products by our collaborators or us will be regulated by the FDA, certain state agencies or 
foreign regulatory authorities. Violations of these laws and regulations, including promotion of our products for unapproved uses or 
failing to disclose risk information, are punishable by criminal and civil sanctions and may result in the issuance of enforcement letters 
or other enforcement action by the FDA, U.S. Department of Justice, state agencies, or foreign regulatory authorities that could 
jeopardize our ability to market the product. 

In addition to the FDA, state or foreign regulations, the marketing of our drug products by us or our collaborators will be regulated by 
federal, state or foreign laws pertaining to health care “fraud and abuse,” such as the federal anti-kickback law prohibiting bribes, 
kickbacks or other remuneration for the order or recommendation of items or services reimbursed by federal health care programs. 
Many states have similar laws applicable to items or services reimbursed by commercial insurers. Violations of these laws are 
punishable by criminal and civil sanctions, including, in some instances, imprisonment and exclusion from participation in federal and 
state health care programs, including the Medicare, Medicaid and Veterans Affairs healthcare programs. Because of the far-reaching 
nature of these laws, we may be required to discontinue one or more of our practices to be in compliance with these laws. Healthcare 
fraud and abuse regulations are complex, and even minor irregularities can potentially give rise to claims that a statute or prohibition 
has been violated. Any violations of these laws, or any action against us for violations of these laws, even if we successfully defend 
against it, could have a material adverse effect on our business, financial condition and results of operations. 

We could also become subject to false claims litigation under federal statutes, which can lead to civil money penalties, restitution, 
criminal fines and imprisonment, and exclusion from participation in Medicare, Medicaid and other federal and state health care 
programs. These false claims statutes include the False Claims Act, which allows any person to bring a suit on behalf of the federal 
government alleging submission of false or fraudulent claims, or causing to present such false or fraudulent claims, under federal 
programs or contracts claims or other violations of the statute and to share in any amounts paid by the entity to the government in fines 
or settlement. These suits against pharmaceutical companies have increased significantly in volume and breadth in recent years. Some 
of these suits have been brought on the basis of certain sales practices promoting drug products for unapproved uses. This new growth 
in litigation has increased the risk that a pharmaceutical company will have to defend a false claim action, pay fines or restitution, or 
be excluded from the Medicare, Medicaid, Veterans Affairs and other federal and state healthcare programs as a result of an 
investigation arising out of such action. We may become subject to such litigation and, if we are not successful in defending against 
such actions, those actions may have a material adverse effect on our business, financial condition and results of operations. We could 
also become subject to false claims litigation and consumer protection claims under state statutes, which also could lead to civil 
monetary penalties, restitution, criminal fines and imprisonment, and exclusion from participation in state health care programs. Of 
note, over the past few years there has been an increased focus on the sales and marketing practices of the pharmaceutical industry at 
both the federal and state level. Additionally, the law or regulatory policies governing pharmaceuticals may change. New statutory 
requirements may be enacted or additional regulations may be adopted that could prevent or delay regulatory approval of our product 
candidates or limit our ability to commercialize our products. We cannot predict the likelihood, nature or extent of adverse 
government regulation that may arise from future legislation or administrative action, either in the United States or elsewhere. 

If we, our collaborators or our third-party manufacturers fail to comply with applicable continuing regulatory requirements, our 
business could be seriously harmed because a regulatory agency may: 

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•

  issue untitled or warning letters; 

  suspend or withdraw our regulatory approval for approved products; 

  seize or detain products or recommend a product recall of a drug or medical device, or issue a mandatory recall of a medical 

device; 

  refuse to approve pending applications or supplements to approved applications filed by us; 

  suspend our ongoing clinical trials; 

  restrict our operations, including costly new manufacturing requirements, or restrict the sale, marketing and/or distribution 

of our products; 

  seek an injunction; 

  pursue criminal prosecutions; 

  close the facilities of our contract manufacturers; or 

  impose civil or criminal penalties. 

30

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Reliance on third parties to commercialize Gencaro or our other product candidates could negatively impact our business. If we 
are required to establish a direct sales force in the United States and are unable to do so, our business may be harmed. 

Commercialization of Gencaro or any other product candidate, if approved, particularly the establishment of a sales organization, will 
require substantial additional capital resources. We currently intend to pursue a strategic partnership alternative for the 
commercialization of Gencaro, if it is approved, and we have suspended our efforts to build internal sales, marketing and distribution 
capabilities. If we elect to rely on third parties to sell Gencaro and any other products, then we may receive less revenue than if we 
sold such products directly. In addition, we may have little or no control over the sales efforts of those third parties. If we are unable to 
complete a strategic transaction, we would be unable to commercialize Gencaro or any other product candidate without substantial 
additional capital. Even if such capital were secured, we would be required to build internal sales, marketing and distribution 
capabilities to market Gencaro in the United States. None of our current employees have experience in establishing and managing a 
sales force. 

In the event we are unable to sell Gencaro and other selected product candidates, either directly or through third parties via a strategic 
transaction, the commercialization of Gencaro, if it is approved, may be delayed indefinitely. 

We are dependent on our key personnel. 

The success of our business is highly dependent on the principal members of our board of directors and executive management, 
including our President and Chief Executive Officer, Michael R. Bristow. The loss of the services of any such individual might 
seriously harm our product development, partnering and financing efforts. Recruiting and training personnel with the requisite skills is 
challenging and we compete for talent with companies that are larger and have more financial resources. 

We have no manufacturing capacity which puts us at risk of lengthy and costly delays of bringing our products to market. 

We do not currently operate manufacturing facilities for clinical or commercial production of our product candidates, including their 
active pharmaceutical ingredients, or API. We have no experience in drug formulation or manufacturing, and we lack the resources 
and the capabilities to manufacture any of our product candidates on a clinical or commercial scale. We do not intend to develop 
facilities for the manufacture of product candidates for clinical trials or commercial purposes in the foreseeable future. We have 
contracted with Groupe Novasep to manufacture the API for Gencaro. For drug production, we have contracted with Patheon, Inc. to 
manufacture the Gencaro tablets. In addition, we have contracted with a separate service provider for packaging and distribution of 
our clinical trial materials. These contract manufacturers may not perform as agreed or may not remain in the contract manufacturing 
business for the time required to successfully produce, store and distribute our products. In addition, these manufacturers may have 
staffing difficulties, may not be able to manufacture our products on a timely basis or may become financially distressed. In the event 
of errors in forecasting production quantities required to meet demand, natural disaster, equipment malfunctions or failures, 
technology malfunctions, strikes, lock-outs or work stoppages, regional power outages, product tampering, war or terrorist activities, 
actions of regulatory authorities, business failure, strike or other difficulty, we may be unable to find an alternative third-party 
manufacturer in a timely manner and the production of our product candidates would be interrupted, resulting in delays and additional 
costs, which could impact our ability to commercialize and sell our product candidates. We or our contract manufacturers may also 
fail to achieve and maintain required manufacturing standards, which could result in patient injury or death, product recalls or 
withdrawals, an order by governmental authorities to halt production, delays or failures in product testing or delivery, stability testing 
failures, cost overruns or other problems that could seriously hurt our business. Contract manufacturers also often encounter 
difficulties involving production yields, quality control and quality assurance, as well as shortages of qualified personnel. In addition, 
our contract manufacturers are subject to ongoing inspections and regulation by the FDA, the U.S. Drug Enforcement Agency and 
corresponding foreign and state agencies and they may fail to meet these agencies’ acceptable standards of compliance. If our contract 
manufacturers fail to comply with applicable governmental regulations, such as quality control, quality assurance and the maintenance 
of records and documentation, we may not be able to continue production of the API or finished product. If the safety of any API or 
product supplied is compromised due to failure to adhere to applicable laws or for other reasons, this may jeopardize our regulatory 
approval for Gencaro and other product candidates, and we may be held liable for any injuries sustained as a result. Upon the 
occurrence of one of the aforementioned events, the ability to switch manufacturers may be difficult for a number of reasons, 
including: 

•

•

•

•

  the number of potential manufacturers is limited and we may not be able to negotiate agreements with alternative 

manufacturers on commercially reasonable terms, if at all; 

  long lead times are often needed to manufacture drugs; 

  the manufacturing process is complex and may require a significant learning curve; and 

  the FDA must approve any replacement prior to manufacturing, which requires new testing and compliance inspections. 

31

 
 
 
 
 
 
 
 
Transitioning from a clinical development stage company will require successful completion of a number of steps, many of which 
are outside of our control and, consequently, we can provide no assurance of our successful and timely transition from a clinical 
development stage company. 

We are a clinical development stage biopharmaceutical company with a limited operating history. To date we have not generated any 
product revenue and have historically funded our operations through investment capital. Our future growth depends on our ability to 
emerge from the clinical development stage and successfully commercialize or provide for the commercialization of Gencaro and our 
other product candidates which in turn, will depend, among other things, on our ability to: 

•

•

•

•

•

  conduct an additional clinical trial and develop and obtain regulatory approval for Gencaro or other product candidates; 

  successfully partner a companion genetic test with the commercial launch of Gencaro; 

  enter into a strategic transaction enabling the continued development and commercialization of Gencaro, or alternatively, 

raise significant additional capital to enable these activities; 

  pursue additional indications for Gencaro and develop other product candidates, including other cardiovascular therapies; 

and 

  obtain commercial quantities of Gencaro or other product candidates at acceptable cost levels. 

Any one of these factors or other factors discussed in this report could affect our ability to successfully commercialize Gencaro and 
other product candidates, which could impact our ability to earn sufficient revenues to transition from a clinical development stage 
company and continue our business. 

If approved by the FDA, Gencaro will be entering a competitive marketplace and may not succeed. 

Gencaro is a new type of beta-blocker and vasodilator being developed for AF. While we anticipate that this drug, if approved, would 
be the first genetically-targeted cardiovascular drug, and potentially the only beta-blocker approved for AF, Gencaro will be one of a 
number of accepted treatments for AF. In addition, our proposed prescribing information for Gencaro is expected to include a 
requirement for genetic testing of the patient to ascertain if they have the genotype that we believe responds most favorably to 
Gencaro. This additional step will add incremental cost and procedures to prescribing Gencaro, which could make it more difficult to 
compete against existing therapies. 

Our commercial opportunity may be reduced or eliminated if competitors develop and commercialize products that are safer, more 
effective, have fewer side effects, are more convenient or are less expensive than Gencaro. If products with any of these properties are 
developed, or any of the existing products are better marketed, then prescriptions of Gencaro by physicians and patient use of Gencaro 
could be significantly reduced or rendered obsolete and noncompetitive. Further, public announcements regarding the development of 
any such competing drugs could adversely affect the market price of our common stock and the value of our assets. 

Future sales of our products may suffer if they are not accepted in the marketplace by physicians, patients and the medical 
community. 

Gencaro or our other product candidates may not gain market acceptance among physicians, patients and the medical community. The 
degree of market acceptance of Gencaro or our other product candidates will depend on a number of factors, such as its effectiveness 
and tolerability, as compared with competitive drugs. For instance, the top-line results of our Phase 2B GENETIC-AF clinical trial 
indicated that Gencaro demonstrated a similar treatment benefit compared to the active comparator, metoprolol succinate 
(TOPROL-XL). If our future clinical trials in Gencaro do not show that Gencaro has a clear therapeutic benefit as compared to other 
drugs in the beta-blocker class currently on the market, then prescribers may be unlikely to prescribe Gencaro to patients, even if 
approved. Also, prevalence and severity of side-effects could negatively affect market acceptance of Gencaro or our other product 
candidates. Failure to achieve market acceptance of Gencaro would significantly harm our business. 

If we are unable to obtain acceptable prices or adequate reimbursement from third-party payors for Gencaro, or any other product 
candidates that we may seek to commercialize, then our revenues and prospects for profitability will suffer. 

Our or any strategic partner’s ability to commercialize Gencaro, or any other product candidates that we may seek to commercialize, is 
highly dependent on the extent to which coverage and reimbursement for these product candidates will be available from: 

•

•

•

  governmental payors, such as Medicare and Medicaid; 

  private health insurers, including managed-care organizations; and 

  other third-party payors. 

32

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Many patients will not be capable of paying for our potential products themselves and will rely on third-party payors to pay for their 
medical needs. A primary current trend in the U.S. health care industry is toward cost containment. Large private payors, managed-
care organizations, group purchasing organizations and similar organizations are exerting increasing influence on decisions regarding 
the use of, and reimbursement levels for, particular treatments. Such third-party payors, including Medicare, are challenging the prices 
charged for medical products and services, and many third-party payors limit reimbursement for newly approved health care products. 

Cost-control initiatives could decrease the price we might establish for products, which could result in product revenues lower than 
anticipated. If the prices for our product candidates decrease, or if governmental and other third-party payors do not provide adequate 
coverage and reimbursement levels, then our revenue and prospects for profitability will suffer. 

Health care reform measures could materially and adversely affect our business. 

The business and financial condition of pharmaceutical and biotechnology companies are affected by the efforts of governmental and 
third-party payors to contain or reduce the costs of health care. The U.S. Congress has enacted legislation to reform the health care 
system. While we anticipate that this legislation may, over time, increase the number of patients who have insurance coverage for 
pharmaceutical products, it also imposes cost containment measures that may adversely affect the amount of reimbursement for 
pharmaceutical products. These measures include increasing the minimum rebates for products covered by Medicaid programs and 
extending such rebates to drugs dispensed to Medicaid beneficiaries enrolled in Medicaid managed care organizations as well as 
expansion of the 340(B) Public Health Services drug discount program. In addition, such legislation contains a number of provisions 
designed to generate the revenues necessary to fund the coverage expansion, including new fees or taxes on certain health-related 
industries, including medical device manufacturers. Each medical device manufacturer has to pay an excise tax (or sales tax) in an 
amount equal to 2.3% of the price for which such manufacturer sells its medical devices. Such excise taxes may impact any potential 
sales of the genetic test if it is approved for marketing. On January 22, 2018, legislation was enacted suspending the medical device 
tax in 2018 and 2019. It will be reinstated on January 1, 2020, unless a permanent repeal takes place before that date. In foreign 
jurisdictions there have been, and we expect that there will continue to be, a number of legislative and regulatory proposals aimed at 
changing the health care system. For example, in some countries other than the United States, pricing of prescription drugs is subject 
to government control and we expect to see continued efforts to reduce healthcare costs in international markets. 

Some states are also considering legislation that would control the prices of drugs, and state Medicaid programs are increasingly 
requesting manufacturers to pay supplemental rebates and requiring prior authorization by the state program for use of any drug for 
which supplemental rebates are not being paid. Managed care organizations continue to seek price discounts and, in some cases, to 
impose restrictions on the coverage of particular drugs. Government efforts to reduce Medicaid expenses may lead to increased use of 
managed care organizations by Medicaid programs. This may result in managed care organizations influencing prescription decisions 
for a larger segment of the population and a corresponding constraint on prices and reimbursement for drugs. It is likely that federal 
and state legislatures and health agencies will continue to focus on additional health care reform in the future although we are unable 
to predict what additional legislation or regulation, if any, relating to the health care industry or third-party coverage and 
reimbursement may be enacted in the future or what effect such legislation or regulation would have on our business. We or any 
strategic partner’s ability to commercialize Gencaro, or any other product candidates that we may seek to commercialize, is highly 
dependent on the extent to which coverage and reimbursement for these product candidates will be available from government payors, 
such as Medicare and Medicaid, private health insurers, including managed care organizations, and other third-party payors, and any 
change in reimbursement levels could materially and adversely affect our business. Further, the pendency or approval of future 
proposals or reforms could result in a decrease in our stock price or limit our ability to raise capital or to obtain strategic partnerships 
or licenses. 

Our competitors may be better positioned in the marketplace and thereby may be more successful than us at developing, 
manufacturing and marketing approved products. 

Many of our competitors currently have significantly greater financial resources and expertise in conducting clinical trials, obtaining 
regulatory approvals, managing manufacturing and marketing approved products than us. Other early-stage companies may also prove 
to be significant competitors, particularly through collaborative arrangements with large and established companies. In addition, these 
third parties compete with us in recruiting and retaining qualified scientific and management personnel, establishing clinical trial sites 
and patient registration for clinical trials, as well as in acquiring therapies and therapy licenses complementary to our programs or 
advantageous to our business. We expect that our ability to compete effectively will depend upon our ability to: 

•

•

•

•

•

  successfully and rapidly complete clinical trials for any product candidates and obtain all requisite regulatory approvals in a 

cost-effective manner; 

  build an adequate sales and marketing infrastructure, raise additional funding, or enter into strategic transactions enabling 

the commercialization of our products; 

  develop competitive formulations of our product candidates; 

  attract and retain key personnel; and 

  identify and obtain other product candidates on commercially reasonable terms. 

33

 
 
 
 
 
 
 
 
 
 
If we fail to identify and license or acquire other products or product candidates, then we may be unable to expand our business, 
and the acquisition or licensing of other products or product candidates may put a strain on our operations and will likely require 
us to seek additional financing. 

One of our strategies is to license or acquire clinical-stage products or product candidates and further develop them for 
commercialization. The market for licensing and acquiring products and product candidates is intensely competitive and many of our 
competitors may have greater resources than we do. If we undertake any additional acquisitions, whether of product candidates or 
other biopharmaceutical companies, the process of integrating an acquired product candidate or complementary company into our 
business may put a strain on our operations, divert personnel, financial resources and management’s attention. In 2018, our research 
and development activities were dedicated to Gencaro and initiating IND-enabling development activities with AB171. We expect our 
research and development activities in 2019 will be focused on regulatory activities related to Gencaro, initiating the PRECISION-AF 
clinical trial, subject to obtaining additional financing, and continuing IND-enabling development activities with AB171. If we are not 
able to substantially expand our research and development efforts, or identify, or license or acquire other products or product 
candidates or complete future acquisitions, then we will likely be unable expand our pipeline of product candidates. In addition, any 
future acquisition would give rise to additional operating costs and will likely require us to seek additional financing. Future 
acquisitions could result in additional issuances of equity securities that would dilute the ownership of existing stockholders. Future 
acquisitions could also result in the incurrence of debt, contingent liabilities or the amortization of expenses related to other intangible 
assets, any of which could adversely affect our operating results. 

We would be subject to applicable regulatory approval requirements of the foreign countries in which we market our products, 
which are costly and may prevent or delay us from marketing our products in those countries. 

In addition to regulatory requirements in the United States, we would be subject to the regulatory approval requirements in each 
foreign country where we market our products. In addition, we might be required to identify one or more collaborators in these foreign 
countries to develop, seek approval for and manufacture our products and any companion genetic test for Gencaro. If we decide to 
pursue regulatory approvals and commercialization of our product candidates internationally, we may not be able to obtain the 
required foreign regulatory approvals on a timely basis, if at all, and any failure to do so may cause us to incur additional costs or 
prevent us from marketing our products in foreign countries, which may have a material adverse effect on our business, financial 
condition and results of operations. 

If our internal control over financial reporting is not considered effective, our business and stock price could be adversely affected. 

Section 404 of the Sarbanes-Oxley Act of 2002 requires us to evaluate the effectiveness of our internal control over financial reporting 
as of the end of each fiscal year, and to include a management report assessing the effectiveness of our internal control over financial 
reporting in our annual report on Form 10-K for that fiscal year. Our management, including our principal executive officer and 
principal financial officer, does not expect that our internal control over financial reporting will prevent all error and all fraud. We 
continue to operate with a small staff for financial reporting. Though the process and design of our internal controls over financial 
reporting have not been altered, the small number of staff involved in financial reporting may limit our ability to properly segregate 
internal control procedures which could result in deficiencies or material weaknesses in our internal controls in the future. A control 
system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the control system’s 
objectives will be met. Further, the design of a control system must reflect the fact that there are resource constraints, and the benefits 
of controls must be considered relative to their costs. Because of the inherent limitations in all control systems, no evaluation of 
controls can provide absolute assurance that all control issues and instances of fraud involving a company have been, or will be, 
detected. The design of any system of controls is based in part on certain assumptions about the likelihood of future events, and we 
cannot assure you that any design will succeed in achieving its stated goals under all potential future conditions. Over time, controls 
may become ineffective because of changes in conditions or deterioration in the degree of compliance with policies or procedures. 
Because of the inherent limitations in a cost-effective control system, misstatements due to error or fraud may occur and not be 
detected. We cannot assure you that we or our independent registered public accounting firm will not identify a material weakness in 
our internal control over financial reporting in the future. A material weakness in our internal control over financial reporting would 
require management to consider our internal control over financial reporting as ineffective. If our internal control over financial 
reporting is not considered effective, we may experience a loss of public confidence, which could have an adverse effect on our 
business and on the market price of our common stock. 

Comprehensive tax reform bills could adversely affect our business and financial condition.

On December 22, 2017, and effective January 1, 2018, the U.S. government enacted H.R. 1, “An Act to provide for reconciliation 
pursuant to titles II and V of the concurrent resolution on the budget for fiscal year 2018” (informally titled the Tax Cuts and Jobs Act) 
which includes significant changes to the taxation of business entities. The Tax Cuts and Jobs Act, among other things, contains 
significant changes to corporate taxation, including reduction of the corporate tax rate from a top marginal rate of 35% to a flat rate of 
21%, limitation of the tax deduction for interest expense to 30% of adjusted earnings (except for certain small businesses), limitation 
of the deduction for net operating losses to 80% of current year taxable income and elimination of net operating loss carrybacks, one 
time taxation of offshore earnings at reduced rates regardless of whether they are repatriated, elimination of U.S. tax on foreign 

34

earnings (subject to certain important exceptions), immediate deductions for certain new investments instead of deductions for 
depreciation expense over time, and modifying or repealing many business deductions and credits. Notwithstanding the reduction in 
the corporate income tax rate, the Tax Cuts and Jobs Act remains subject to interpretation and further guidance from U.S. taxing 
authorities and as a result, the overall impact of this tax reform is uncertain and may change due to interpretation changes, and our 
business and financial condition could be adversely affected. The impact of the Tax Cuts and Jobs Act on holders of our common 
stock is also uncertain and could be adverse. We are unable to predict what tax reform may be proposed or enacted in the future or 
what effect such changes would have on our business, but such changes, to the extent they are brought into tax legislation, regulations, 
policies or practices, could affect our effective tax rates in the future in countries where we have operations and have an adverse effect 
on our overall tax rate in the future, along with increasing the complexity, burden and cost of tax compliance. We urge our 
stockholders to consult with their legal and tax advisors with respect to the Tax Cuts and Jobs Act and the potential tax consequences 
of investing in or holding our common stock. 

Failure to comply with data protection laws and regulations could lead to government enforcement actions (which could include 
civil or criminal penalties), private litigation, and/or adverse publicity and could negatively affect our operating results and 
business.

We and our partners may be subject to federal, state, and foreign data protection laws and regulations (i.e., laws and regulations that 
address privacy and data security). In the United States, numerous federal and state laws and regulations, including state data breach 
notification laws, state health information privacy laws, and federal and state consumer protection laws (e.g., Section 5 of the FTC 
Act), that govern the collection, use, disclosure, and protection of health-related and other personal information could apply to our 
operations or the operations of our partners. In addition, we may obtain health information from third parties (including research 
institutions from which we obtain clinical trial data) that are subject to privacy and security requirements under the Health Insurance 
Portability and Accountability Act of 1996, as amended, or HIPAA. Depending on the facts and circumstances, we could be subject to 
criminal penalties if we knowingly obtain, use, or disclose individually identifiable health information maintained by a HIPAA-
covered entity in a manner that is not authorized or permitted by HIPAA.

International data protection laws, including, without limitation, the European Union Directive 95/46/EC, or the Directive, and the 
European Union’s General Data Protection Regulation, or the GDPR, that became effective in May 2018, and member state data 
protection legislation, may also apply to health-related and other personal information obtained outside of the United States. These 
laws impose strict obligations on the ability to process health-related and other personal information of data subjects in the European 
Union, including in relation to use, collection, analysis, and transfer of such personal information. These laws include several 
requirements relating to the consent of the individuals to whom the personal data relates, limitations on data processing, establishing a 
legal basis for processing, notification of data processing obligations or security incidents to appropriate data protection authorities or 
data subjects, the security and confidentiality of the personal data and various rights that data subjects may exercise.  

The Directive and the GDPR prohibits, without an appropriate legal basis, the transfer of personal data to countries outside of the 
European Economic Area, or EEA, such as the United States, which are not considered by the European Commission to provide an 
adequate level of data protection. Switzerland has adopted similar restrictions. Although there are legal mechanisms to allow for the 
transfer of personal data from the EEA and Switzerland to the United States, uncertainty about compliance with European Union data 
protection laws remains. For example, ongoing legal challenges in Europe to the mechanisms allowing companies to transfer personal 
data from the EEA to the United States could result in further limitations on the ability to transfer personal data across borders, 
particularly if governments are unable or unwilling to reach new or maintain existing agreements that support cross-border data 
transfers, such as the European Union-U.S. and Swiss-U.S. Privacy Shield framework. Additionally, other countries have passed or 
are considering passing laws requiring local data residency.

Under the GDPR, regulators may impose substantial fines and penalties for non-compliance. Companies that violate the GDPR can 
face fines of up to the greater of 20 million Euros or 4% of their worldwide annual turnover (revenue). The GDPR increases our 
responsibility and potential liability in relation to personal data that we process, and we may be required to put in place additional 
mechanisms to ensure compliance with the GDPR and other EU and international data protection rules.

Failure to comply with U.S. and international data protection laws and regulations could result in government enforcement actions 
(which could include civil or criminal penalties), private litigation, and/or adverse publicity and could negatively affect our operating 
results and business. Moreover, patients about whom we or our partners obtain information, as well as the providers who share this 
information with us, may contractually limit our ability to use and disclose the information. Claims that we have violated individuals’ 
privacy rights, failed to comply with data protection laws, or breached our contractual obligations, even if we are not found liable, 
could be expensive and time-consuming to defend and could result in adverse publicity that could harm our business.

35

Risks Related to Intellectual Property and Other Legal Matters 

If product liability lawsuits are successfully brought against us, then we will incur substantial liabilities and may be required to 
limit commercialization of Gencaro or other product candidates. 

We face product liability exposure related to the testing of our product candidates in human clinical trials, and may face exposure to 
claims by an even greater number of persons once we begin marketing and distributing our products commercially. If we cannot 
successfully defend against product liability claims, then we will incur substantial liabilities. 

Regardless of merit or eventual outcome, liability claims may result in: 

•

•

•

•

•

•

•

  decreased demand for our products and product candidates; 

  injury to our reputation; 

  withdrawal of clinical trial participants; 

  costs of related litigation; 

  substantial monetary awards to patients and others; 

  loss of revenues; and 

  the inability to commercialize our products and product candidates. 

We have obtained limited product liability insurance coverage. Such coverage, however, may not be adequate or may not continue to 
be available to us in sufficient amounts or at an acceptable cost, or at all. We may not be able to obtain commercially reasonable 
product liability insurance for any product candidate. 

Defending against claims relating to improper handling, storage or disposal of hazardous chemicals, radioactive or biological 
materials could be time consuming and expensive. 

Our research and development of product candidates may involve the controlled use of hazardous materials, including chemicals, 
radioactive and biological materials. We cannot eliminate the risk of accidental contamination or discharge and any resultant injury 
from the materials. Various laws and regulations govern the use, manufacture, storage, handling and disposal of hazardous materials. 
We may be sued or be required to pay fines for any injury or contamination that results from our use or the use by third parties of 
these materials. Compliance with environmental laws and regulations may be expensive, and current or future environmental 
regulations may impair our research, development and production efforts. 

The loss of any rights to market key products would significantly impair our operating results. 

We have licensed from CPEC, who has licensed rights to all preclinical and clinical data from development of bucindolol through the 
BEST trial from Bristol Meyers Squibb, or BMS, the exclusive rights to Gencaro for all therapeutic and diagnostic uses in any country 
until the later of (i) 10 years from the first commercial sale of Gencaro in such country, or (ii) the termination of our commercial 
exclusivity in such country. This license includes a sublicense to us from BMS. We are obligated to use commercially reasonable 
efforts to develop and commercialize Gencaro, including obtaining regulatory approvals. Our ability to develop and commercialize 
Gencaro is dependent on numerous factors, including some factors that are outside of our control. CPEC has the right to terminate our 
license if we materially breach our obligations under the license agreement and fail to cure any such breach within the terms of the 
license. In October 2017, we entered into an agreement with Aeolus pursuant to which we acquired Aeolus’ minority membership 
interest in CPEC. The transaction effectively buys-out Aeolus’ royalty interest thereby reducing or eliminating the stated milestone 
and royalty obligations that could be payable by us, if Gencaro receives regulatory approval and is commercialized. 

If our license agreement with CPEC is terminated for reasons related to non-payment of fees, or for any other breach, then we would 
have no further rights to develop and commercialize Gencaro for any indication. The termination of this license, or of any other 
agreement which enables us to market a key product or product candidate, could significantly and adversely affect our business.

Certain intellectual property licensed by us is the subject of additional licensing arrangements to which the party that has licensed 
rights to us is subject. If such parties were to breach the terms of such licenses or such licenses were otherwise to terminate, our and 
our partners’ rights to use such technology and develop and commercialize their products such as the genetic test may terminate and 
our business would be materially harmed. 

36

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Third parties may own or control patents or patent applications that we may be required to license to commercialize our product 
candidates or that could result in litigation that would be costly and time consuming. 

Our or any strategic partner’s ability to commercialize Gencaro and other product candidates depends upon our ability to develop, 
manufacture, market and sell these drugs without infringing the proprietary rights of third parties. A number of pharmaceutical and 
biotechnology companies, universities and research institutions have or may be granted patents that cover technologies similar to the 
technologies owned by or licensed to us. We may choose to seek, or be required to seek, licenses under third party patents, which 
would likely require the payment of license fees or royalties or both. We may also be unaware of existing patents that may be 
infringed by Gencaro, the genetic testing we intend to use in connection with Gencaro or our other product candidates. Because patent 
applications can take many years to issue, there may be other currently pending applications that may later result in issued patents that 
are infringed by Gencaro or our other product candidates. Moreover, a license may not be available to us on commercially reasonable 
terms, or at all. 

There is a substantial amount of litigation involving patent and other intellectual property rights in the biotechnology and 
biopharmaceutical industries generally. If a third party claims that we are infringing on its technology, then our business and results of 
operations could be harmed by a number of factors, including: 

•

•

•

•

  infringement and other intellectual property claims, even if without merit, are expensive and time-consuming to litigate and 

can divert management’s attention from our core business; 

  monetary damage awards for past infringement can be substantial; 

  a court may prohibit us from selling or licensing product candidates unless the patent holder chooses to license the patent to 

us; and 

  if a license is available from a patent holder, we may have to pay substantial royalties. 

We may also be forced to bring an infringement action if we believe that a competitor is infringing our protected intellectual property. 
Any such litigation will be costly, time-consuming and divert management’s attention, and the outcome of any such litigation may not 
be favorable to us. 

Our intellectual property rights may not preclude competitors from developing competing products and our business may suffer. 

Our competitive success will depend, in part, on our ability to obtain and maintain patent protection for our inventions, technologies 
and discoveries, including intellectual property that we license. The patent positions of biotechnology companies involve complex 
legal and factual questions, and we cannot be certain that our patents and licenses will successfully preclude others from using our 
technology. Consequently, we cannot be certain that any of our patents will provide significant market protection or will not be 
circumvented or challenged and found to be unenforceable or invalid. In some cases, patent applications in the United States and 
certain other jurisdictions are maintained in secrecy until patents issue, and since publication of discoveries in the scientific or patent 
literature often lags behind actual discoveries, we cannot be certain of the priority of inventions covered by pending patent 
applications. Moreover, we may have to participate in interference proceedings declared by the U.S. Patent and Trademark Office to 
determine priority of invention, in opposition proceedings in a foreign patent office, or in a post-grant challenge proceeding such as an 
ex parte reexamination or inter partes review at the U.S. Patent and Trademark Office, any of which could result in substantial cost to 
us, even if the eventual outcome is favorable. There can be no assurance that a court of competent jurisdiction would hold any claims 
in any issued patent to be valid. An adverse outcome could subject us to significant liabilities to third parties, require disputed rights to 
be licensed from third parties or require us to cease using such technology. Regardless of merit, the listing of patents in the FDA 
Orange Book for Gencaro may be challenged as being improperly listed. We may have to defend against such claims and possible 
associated antitrust issues. We could also incur substantial costs in seeking to enforce our proprietary rights against infringement. 

While the composition of matter patents on the compound that comprises Gencaro have expired, we hold the intellectual property 
concerning the interaction of Gencaro with the polymorphisms of the beta-1 and alpha-2C receptors. We have obtained patents that 
claim methods involving Gencaro after a patient’s receptor genotype has been determined. We anticipate that any NDA for Gencaro 
will request a label including a claim that efficacy varies based on receptor genotype and a recommendation in the prescribing 
information that prospective patients be tested for their receptor genotype. We believe that under applicable law, a generic bucindolol 
label would likely be required to include this recommendation as it pertains directly to the safe or efficacious use of the drug. Such a 
label may be considered as inducing infringement, carrying the same liability as direct infringement. If the label with the genotype 
information for Gencaro is not approved, or if generic labels are not required to copy the approved label, competitors could have an 
easier path to introduce competing products and our business may suffer. The approved label may not contain language covered by the 
patents, or we may be unsuccessful in enforcing them. 

We may not be able to effectively protect our intellectual property rights in some foreign countries, as our patents are limited by 
jurisdiction and many countries do not offer the same level of legal protection for intellectual property as the United States. 

37

 
 
 
 
 
 
 
 
We require our employees, consultants, business partners and members of our scientific advisory board to execute confidentiality 
agreements upon the commencement of employment, consulting or business relationships with us. These agreements provide that all 
confidential information developed or made known during the course of the relationship with us be kept confidential and not disclosed 
to third parties except in specific circumstances. In the case of employees, the agreements provide that all inventions resulting from 
work performed for us, utilizing the property or relating to our business and conceived or completed by the individual during 
employment shall be our exclusive property to the extent permitted by applicable law. 

Third parties may breach these and other agreements with us regarding our intellectual property and we may not have adequate 
remedies for the breach. Third parties could also fail to take necessary steps to protect our licensed intellectual property, which could 
seriously harm our intellectual property position. 

If we are not able to protect our proprietary technology, trade secrets and know-how, then our competitors may develop competing 
products. Any issued patent may not be sufficient to prevent others from competing with us. Further, we have trade secrets relating to 
Gencaro, and such trade secrets may become known or independently discovered. Our issued patents and those that may issue in the 
future, or those licensed to us, may be challenged, opposed, invalidated or circumvented, which could allow competitors to market 
similar products or limit the patent protection term of our product candidates. All of these factors may affect our competitive position. 

If the manufacture, use or sale of our products infringe on the intellectual property rights of others, we could face costly litigation, 
which could cause us to pay substantial damages or licensing fees and limit our ability to sell some or all of our products. 

Extensive litigation regarding patents and other intellectual property rights has been common in the biopharmaceutical industry. 
Litigation may be necessary to assert infringement claims, enforce patent rights, protect trade secrets or know-how and determine the 
enforceability, scope and validity of certain proprietary rights. Litigation may even be necessary to defend disputes of inventorship or 
ownership of proprietary rights. The defense and prosecution of intellectual property lawsuits, U.S. Patent and Trademark Office 
interference proceedings, and related legal and administrative proceedings (e.g., a reexamination, inter partes review, or post-grant 
review) in the United States and internationally involve complex legal and factual questions. As a result, such proceedings are costly 
and time-consuming to pursue, and their outcome is uncertain. 

Regardless of merit or outcome, our involvement in any litigation, interference or other administrative proceedings could cause us to 
incur substantial expense and could significantly divert the efforts of our technical and management personnel. Any public 
announcements related to litigation or interference proceedings initiated or threatened against us could cause our stock price to 
decline. Adverse outcomes in patent litigation may potentially subject us to antitrust litigation which, regardless of the outcome, 
would adversely affect our business. An adverse determination may subject us to the loss of our proprietary position or to significant 
liabilities, or require us to seek licenses that may include substantial cost and ongoing royalties. Licenses may not be available from 
third parties, or may not be obtainable on satisfactory terms. An adverse determination or a failure to obtain necessary licenses may 
restrict or prevent us from manufacturing and selling our products, if any. These outcomes could materially harm our business, 
financial condition and results of operations. 

Risks Related to Stock Price Volatility 

Our stock price is expected to be volatile. 

Our common stock could be subject to significant fluctuations. Market prices for securities of early-stage pharmaceutical, 
biotechnology and other life sciences companies have historically been particularly volatile. Some of the factors that may cause the 
market price of our common stock to fluctuate include: 

•

•

•

•

•

•

•

•

•

  the regulatory status of Gencaro and the genetic test, and whether and when they are approved for sale, if at all, and the 

labeling or other conditions of use imposed by the FDA; 

  our ability to secure additional funding or complete a strategic transaction or to complete development of and 

commercialize Gencaro; 

  progress of any future clinical trials for Gencaro or our other product candidate, including enrollment and any data that may 

become available;

  the results of our future clinical trials and any future NDAs of our current and future product candidates; 

  the entry into, or termination of, key agreements, including key strategic alliance agreements; 

  the results and timing of regulatory reviews relating to our product candidates; 

  failure of any of our product candidates, if approved, to achieve commercial success; 

  general and industry-specific economic conditions that may affect our research and development expenditures; 

  the results of clinical trials conducted by others on drugs that would compete with our product candidates; 

38

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
•

•

•

•

•

•

•

•

•

  issues in manufacturing our product candidates or any approved products; 

  the initiation of or material developments in or the conclusion of litigation to enforce or defend any of our intellectual 

property rights; 

  the loss of key employees; 

  the introduction of technological innovations or new commercial products by our competitors; 

  changes in estimates or recommendations by securities analysts, if any, who cover our common stock; 

  future sales of our common stock; 

  changes in the structure of health care payment systems; 

  period-to-period fluctuations in our financial results; and 

  our ability to retain the listing of our common stock on the Nasdaq Capital Market. 

Moreover, the stock markets in general have experienced substantial volatility that has often been unrelated to the operating 
performance of individual companies. These broad market fluctuations may also adversely affect the trading price of our common 
stock. In the past, following periods of volatility in the market price of a company’s securities, stockholders have often instituted class 
action securities litigation against those companies. Such litigation, if instituted, could result in substantial costs and diversion of 
management attention and resources, which could significantly harm our profitability and reputation. 

Future sales or the possibility of future sales of our common stock may depress the market price of our common stock. 

Sales in the public market of substantial amounts of our common stock could depress prevailing market prices of our common stock. 
As of December 31, 2018, approximately 13.9 million shares of common stock were outstanding, and all of these shares are freely 
transferable without restriction or further registration under the Securities Act, except for shares held by our directors, officers and 
other affiliates and unregistered shares held by non-affiliates. The sale of these additional shares, or the perception that such sales may 
occur, could depress the market price of our common stock. 

As of December 31, 2018, approximately 2.7 million shares of our common stock were issuable upon the exercise of outstanding 
warrants. Once a warrant is exercised, if the shares of our common stock issued upon the exercise of any such warrant are not 
available for sale in the open market without further registration under the Securities Act, then the holder can arrange for the resale of 
shares either by invoking any applicable registration rights, causing the shares to be registered under the Securities Act and thus freely 
transferable, or by relying on an exemption to the Securities Act. For instance, in July 2015, we filed a registration statement on 
Form S-3 which registered for resale an aggregate of 2.4 million shares of our common stock issuable upon exercise of outstanding 
warrants. If these registration rights, or similar registration rights that may apply to securities we may issue in the future, are exercised, 
it could result in additional sales of our common stock in the market, which may have an adverse effect on our stock price. 

As of December 31, 2018, there were approximately 604,000 shares of our common stock which may be issued upon the exercise of 
outstanding stock options, and we anticipate that we will continue to issue stock option and restricted stock unit awards to our 
employees and consultants in the fiscal year ended December 31, 2019 and thereafter. If and when these options are exercised and 
these restricted stock units are vested, such shares will be available for sale in the open market without further registration under the 
Securities Act. The existence of these outstanding options and restricted stock units may negatively affect our ability to complete 
future equity financings at acceptable prices and on acceptable terms. The exercise of those options and vesting of the restricted stock 
units, and the prompt resale of shares of our common stock received, may also result in downward pressure on the price of our 
common stock. 

In the absence of a significant strategic transaction, we will need to raise significant additional capital to finance the research, 
development and commercialization of Gencaro and our other product candidate. If future securities offerings occur, they would dilute 
our current stockholders’ equity interests and could reduce the market price of our common stock. 

We do not expect to pay cash dividends, and accordingly, stockholders must rely on stock appreciation for any return on their 
investment. 

We anticipate that we will retain our earnings, if any, for future growth and therefore do not anticipate paying cash dividends in the 
future. As a result, only appreciation of the price of our common stock will provide a return to stockholders. Investors seeking cash 
dividends should not invest in our common stock. 

39

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
We have implemented anti-takeover provisions that could discourage, prevent or delay a takeover, even if the acquisition would be 
beneficial to our stockholders. 

Provisions of our certificate of incorporation and bylaws, as well as provisions of Delaware law, could make it more difficult for a 
third party to acquire us, even if doing so would benefit our stockholders. These provisions: 

•

•

•

•

•

  establish a classified board of directors so that not all members of our board may be elected at one time; 

  authorize the issuance of up to approximately 5 million additional shares of preferred stock that could be issued by our 

board of directors to increase the number of outstanding shares and hinder a takeover attempt; 

  limit who may call a special meeting of stockholders; 

  prohibit stockholder action by written consent, thereby requiring all stockholder actions to be taken at a meeting of our 

stockholders; and 

  establish advance notice requirements for nominations for election to our board of directors or for proposing matters that 

can be acted upon at a stockholder meeting. 

Specifically, our certificate of incorporation provides that all stockholder action must be effected at a duly called meeting and not by a 
written consent. The bylaws provide, however, that our stockholders may call a special meeting of stockholders only upon a request of 
stockholders owning at least 50% of our outstanding common stock. These provisions of our certificate of incorporation and bylaws 
could discourage potential acquisition proposals and could delay or prevent a change in control. We designed these provisions to 
reduce our vulnerability to unsolicited acquisition proposals and to discourage certain tactics that may be used in proxy fights. These 
provisions, however, could also have the effect of discouraging others from making tender offers for our shares. As a consequence, 
they also may inhibit fluctuations in the market price of our shares that could result from actual or rumored takeover attempts. Such 
provisions also may have the effect of preventing changes in our management. 

We are permitted to issue shares of our preferred stock without stockholder approval upon such terms as our board of directors 
determines. Therefore, the rights of the holders of our common stock are subject to, and may be adversely affected by, the rights of the 
holders of our preferred stock that may be issued in the future. In addition, the issuance of preferred stock could have a dilutive effect 
on the holdings of our current stockholders. 

We are subject to the Delaware anti-takeover laws regulating corporate takeovers. These anti-takeover laws prevent a Delaware 
corporation from engaging in a merger or sale of more than 10% of its assets with any stockholder, including all affiliates and 
associates of the stockholder, who owns 15% or more of the corporation’s outstanding voting stock, for three years following the date 
that the stockholder acquired 15% or more of the corporation’s stock unless: 

•

•

  the board of directors approved the transaction where the stockholder acquired 15% or more of the corporation’s stock; 

  after the transaction in which the stockholder acquired 15% or more of the corporation’s stock, the stockholder owned at 

least 85% of the corporation’s outstanding voting stock, excluding shares owned by directors, officers and employee stock 
plans in which employee participants do not have the right to determine confidentially whether shares held under the plan 
will be tendered in a tender or exchange offer; or 

•

  on or after this date, the merger or sale is approved by the board of directors and the holders of at least two-thirds of the 

outstanding voting stock that is not owned by the stockholder. 

The provisions of our governing documents and current Delaware law may, collectively: 

•

•

•

  lengthen the time required for a person or entity to acquire control of us through a proxy contest for the election of a 

majority of our board of directors; 

  discourage bids for our common stock at a premium over market price; and 

  generally deter efforts to obtain control of us. 

Item 1B. Unresolved Staff Comments 

Not applicable. 

Item 2. Properties 

Our headquarters facility consists of approximately 5,300 square feet of office space in Westminster, Colorado, which is leased until 
November 2019. We believe that this facility is adequate to meet our current needs. 

40

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 3. Legal Proceedings 

Not applicable. 

Item 4. Mine Safety Disclosures 

Not applicable.

41

PART II 

Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities 
As of March 7, 2011, our common stock began trading on The Nasdaq Capital Market under the symbol “ABIO”, and was previously 
traded under the same symbol on The Nasdaq Global Market. Prior to completion of the merger with Nuvelo, Nuvelo’s common stock 
traded under the symbol “NUVO” on The Nasdaq Global Market from January 31, 2003 to January 27, 2009 (except for the period 
between June 19, 2003 and March 19, 2004, where it temporarily traded under the symbol “NUVOD”). Stockholders 

As of February 22, 2019, we had approximately 47 stockholders of record of our common stock, and the last sale price reported on 
The Nasdaq Capital Market for our common stock as of such date was $0.46 per share, rounded to the nearest penny. 

Dividend Policy 

The holders of our common stock are entitled to dividends in such amounts and at such times, if any, as may be declared by our Board 
of Directors out of legally available funds. We have not paid any dividends on our common stock and do not anticipate paying any 
cash dividends in the foreseeable future. 

Securities Authorized for Issuance Under Equity Compensation Plans 

Information relating to our equity compensation plans as of December 31, 2018, under which our equity securities were authorized for 
issuance, is included in Item 12 of Part III of this Annual Report. 

Unregistered Sales of Equity Securities and Use of Proceeds 

None.

Issuer Purchases of Equity Securities 

None. 

Item 6. Selected Financial Data 

Not applicable. 

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations 

We have included or incorporated by reference into this Management’s Discussion and Analysis of Financial Condition and Results of 
Operations and elsewhere in this Annual Report on Form 10-K, and from time to time our management may make, statements that 
constitute “forward-looking statements” within the meaning of Section 27A of the Securities Act and Section 21E of the Exchange 
Act. Forward-looking statements may be identified by words including “anticipate,” “plan,” “believe,” “intend,” “estimate,” “expect,” 
“should,” “may,” “potential” and similar expressions. These statements involve known and unknown risks, uncertainties and other 
factors that may cause our actual results, levels of activity, performance or achievements to be materially different from the 
information expressed or implied by these forward-looking statements. While we believe that we have a reasonable basis for each 
forward-looking statement contained in this Annual Report, we caution you that these statements are based on a combination of facts 
and factors currently known by us and our projections of the future, about which we cannot be certain. We undertake no obligation to 
publicly update any forward-looking statements, whether as a result of new information, future events or otherwise. You are advised, 
however, to consult any further disclosures we make on related subjects in our Quarterly Reports on Form 10-Q, Current Reports on 
Form 8-K, and our website. 

Overview

We are a biopharmaceutical company applying a precision medicine approach to developing genetically-targeted therapies for 
cardiovascular diseases. Precision medicine refers to the tailoring of medical treatment to the individual characteristics of each patient 
through the ability to classify individuals into subpopulations that differ in their susceptibility to a particular disease, in the biology 
and/or prognosis of those diseases they may develop, or in their response to a specific treatment. Our lead product candidate, 
Gencaro™ (bucindolol hydrochloride), is an investigational, pharmacologically unique beta-blocker and mild vasodilator that we are 
developing to treat atrial fibrillation, or AF, in certain patients who also have heart failure, or HF.  

42

Gencaro has a mechanism of action that we believe is unique in the beta-blocker drug class and is modulated by a specific genotype. 
We estimate this genotype is present in about 50% of North American and European general populations. We believe that Gencaro’s 
potential efficacy is enhanced in treating patients who have this genotype and, if Gencaro is approved by the U.S. Food and Drug 
Administration, or the FDA, Gencaro could potentially be a safe and effective therapy for treating AF in patients who have HF. We 
also believe that Gencaro, if approved, will have market exclusivity based on patents and new chemical entity status, if approved in 
the United States, Europe or other markets.

In February 2018, we reported the results of our Phase 2B clinical trial, known as GENETIC-AF, in which we evaluated Gencaro for 
the prevention of AF recurrence in patients with HF and a left ventricular ejection fraction, or LVEF, < 0.50. This population included 
267 patients that had HF with reduced LVEF < 0.40, or HFrEF, or HF with mid-range LVEF ≥ 0.40 and < 0.50, or HFmrEF. 
GENETIC-AF compared Gencaro to TOPROL-XL (metoprolol succinate), a drug approved for treating HFrEF that is also prescribed, 
but not approved, for treating AF in patients with HFrEF. There are no approved or guideline recommended drug therapies for 
prevention of AF in HFmrEF patients, which constituted approximately one-half of the GENETIC-AF patients.  

In GENETIC-AF, Gencaro was observed to have a similar treatment effect to TOPROL-XL (metoprolol succinate) in the overall 
population for prevention of AF recurrence. However, additional analyses prespecified in the statistical analysis plan showed 
statistically significant treatment effects in favor of Gencaro in the majority of the Phase 2B population (N=196; HR=0.54; p = 0.011). 
Gencaro also showed statistically significant treatment effects compared to TOPROL-XL for the prevention of AF recurrence in a 
subset of these patients with HFmrEF (N=91; HR=0.42; p = 0.017). We plan to conduct a pivotal Phase 3 trial, known as 
PRECISION-AF, evaluating Gencaro in HFmrEF patients because of Gencaro’s observed potential treatment effect in these patients 
in GENETIC-AF. 

In February 2019, we received a Special Protocol Assessment, or SPA, agreement with the FDA in support of our planned Phase 3 
clinical program. The FDA’s SPA process is designed to facilitate the FDA’s review and approval of drugs by allowing the FDA to 
evaluate the proposed design and size of certain clinical trials that are intended to form the primary basis for determining a drug 
product’s efficacy and safety. Upon specific request by a clinical trial sponsor, the FDA evaluates the protocol and responds to a 
sponsor’s questions regarding, among other things, primary efficacy endpoints, trial conduct and data analysis, within 45 days of 
receipt of the request. The FDA ultimately assesses whether the protocol design and planned analysis of the trial are acceptable to 
support regulatory approval of the product candidate for the indication studied. An SPA agreement can potentially reduce the 
regulatory risk of bringing a drug to market. 

To support the continued development of Gencaro, including the planned PRECISION-AF clinical trial, we will need additional 
financing to fund the Phase 3 trial and our general and administrative costs through its projected completion. Considering the 
substantial time and costs associated with the development of Gencaro and the risk that we may be unable to raise a significant amount 
of capital on acceptable terms, we may also pursue partnering and licensing opportunities, a strategic combination or other strategic 
transactions. If we are delayed in obtaining financing or are unable to complete a strategic transaction, we may discontinue our 
development activities on Gencaro or discontinue our operations.  

We believe our cash and cash equivalents balance as of December 31, 2018, together with the $2.4 million of net proceeds raised in 
2019 from sales of our common stock, will be sufficient to fund our operations, at our current cost structure, through the third quarter 
of 2019. However, changing circumstances may cause us to consume capital significantly faster or slower than we currently 
anticipate. We have based these estimates on assumptions that may prove to be wrong, and we could exhaust our available financial 
resources sooner than we currently anticipate.

In 2017, we entered into a sales agreement, as amended, with an agent to sell, from time to time, our common stock having an 
aggregate offering price of up to $10.2 million, in an “at the market offering.” In January 2019, we amended the amended sales 
agreement to increase the maximum aggregate value of shares which we may issue and sell from time to time under this sales 
agreement by approximately $2.5 million, from $10.2 million to $12.7 million. As of February 22, 2019, we have sold an aggregate of 
9,242,406 shares of our common stock pursuant to the terms of such sales agreement, as amended, for aggregate gross proceeds of 
approximately $12.6 million.  Net proceeds received in the period were approximately $11.9 million, after deducting initial expenses 
for executing the “at the market offering” and commissions paid to the placement agent. We have sold all shares available under the 
current prospectus. 

43

On October 18, 2018, we held a special meeting of our stockholders to approve a series of certificates of amendment to the 
Company’s restated certificate of incorporation, as amended, to effect a reverse split of the Company’s outstanding common stock, at 
a ratio of between 1-for-3 and 1-for-20, inclusive, and to authorize the Company’s board of directors to, for a period of up to one-year, 
select and file such a certificate of amendment to effect such a reverse split of the Company’s outstanding common stock, if, in the our 
board’s judgment, it is deemed necessary. Our board of directors has not selected a ratio for the reverse split.  

Results of Operations 

Research and Development Expenses 

Research and development, or R&D, expense is comprised primarily of clinical development, manufacturing process development, 
and regulatory activities and costs. Our R&D expense continues to be almost entirely generated by our activities relating to the 
development of Gencaro. 

Our research and development expenses were $4.2 million for the year ended December 31, 2018 as compared to $14.1 million for 
2017. The $9.8 million decrease in research and development expenses in 2018 as compared to 2017 was primarily related to our 
GENETIC-AF clinical trial that was completed in 2017. 

Clinical expense decreased approximately $7.5 million for the year ended December 31, 2018. The decrease was related to our 
GENETIC-AF clinical trial that was completed in 2017.  

Manufacturing process development costs decreased approximately $2.1 million for the year ended December 31, 2018 compared to 
2017. The decrease was a result of decreased production of clinical trial materials used in our GENETIC-AF clinical trial that was 
completed in 2017.

Subject to securing significant additional financing, we anticipate initiating our PRECISION-AF clinical trial in the fourth quarter of 
2019. R&D expense in 2019 is expected to be higher than 2018, if we initiate our PRECISION-AF clinical trial. If we are unable to 
initiate our PRECISION-AF clinical trial, then R&D expense is expected to be lower than 2018. 

General and Administrative Expenses 

General and administrative, or G&A, expenses primarily consist of personnel costs, consulting and professional fees, insurance, 
facilities and depreciation expenses, and various other administrative costs. 

G&A expenses were $3.9 million for the year ended December 31, 2018, compared to $4.6 million for 2017, a decrease of 
approximately $0.8 million. The decrease in expenses during 2018 was comprised primarily of decreased personnel costs, non-cash 
stock-based compensation expense, consulting costs, professional fees and travel costs in 2018, as compared to 2017.    

G&A expenses in 2019 are expected to be consistent with those in 2018 as we maintain administrative activities to support our 
ongoing operations. 

Interest and Other Income 

Interest and other income was $162,000 for the year ended December 31, 2018 as compared to $167,000 for 2017, resulting in a 
decrease of $5,000. This decrease was due lower marketable securities balances as we funded our operations. We expect interest 
income to be lower in 2019 than in 2018, as we continue to use our cash and cash equivalents to fund our operations. 

Interest Expense 

Interest expense was $8,000 for the year ended December 31, 2018 as compared to $6,000 for 2017. The amounts were nominal to our 
overall operations. Based on our current capital structure, interest expense is expected to be negligible in 2019. 

Income Tax Benefit 

Income tax benefit was $31,000 for the year ended December 31, 2018 as compared to $61,000 for 2017, related to the Protecting 
Americans from Tax Hikes Act of 2015, or PATH Act, which allows qualified small businesses to monetize up to $250,000 of 
research and experimentation tax credits through payroll tax refunds.     

44

Liquidity and Capital Resources 

Cash, Cash Equivalents and Marketable Securities

Cash and cash equivalents..................................$
Marketable securities, short-term ....................... 
Cash, cash equivalents and marketable 
securities.............................................................$

December 31,

2018

2017

(in thousands)
6,608   $
—    

8,702 
3,050 

6,608   $

11,752  

As of December 31, 2018, we had total cash, cash equivalents and marketable securities of approximately $6.6 million, as compared 
to $11.8 million as of December 31, 2017. The net decrease of $5.1 million during the year primarily reflects the approximately 
$8.2 million of cash used to fund operating activities during year ended December 31, 2018, partially offset by $3.4 million of cash 
proceeds from sales of our common stock.

On April 11, 2018, we received notification from Nasdaq of potential delisting of our shares from the Nasdaq Capital Market because 
the closing bid price of our common stock had not met the minimum closing bid price of $1.00 per share during the preceding 30 days. 
On October 9, 2018, we received a written notification from NASDAQ granting an additional 180 calendar day period, until April 8, 
2019, to regain compliance with the minimum bid price requirement. The minimum bid price requirement will be met if our common 
stock has a closing bid of at least $1.00 per share for a minimum of 10 consecutive business days during the 180 day period. This 
second 180 day period relates exclusively to the bid price deficiency and we could be delisted during the 180 day period for failure to 
maintain compliance with any other listing requirements that occurs during the 180 day period. If we are not able to regain compliance 
with the closing bid requirement in such period, we may be subject to delisting from the Nasdaq Capital Market. If delisted it could 
substantially impact our access to the capital markets, and any limitation on market liquidity or reduction in the price of the common 
stock as a result of that delisting could adversely affect our ability to raise capital on acceptable terms, or at all. 

On October 18, 2018, we held a special meeting of its stockholders, at which our stockholders approved a series of certificates of 
amendment to our restated certificate of incorporation, as amended, to effect a reverse split of our outstanding common stock, at a 
ratio of between 1-for-3 and 1-for-20, inclusive, and to authorize our board of directors to, for a period of up to one-year, to select and 
file such a certificate of amendment to effect such a reverse split of our outstanding common stock, if, in the judgment of our board of 
directors, it is deemed necessary. Our board of directors has not selected a ratio for the reverse split.

Cash Flows from Operating, Investing and Financing Activities

Years Ended December 31,

2018

2017

(in thousands)

Net cash provided by (used in):

Operating activities ................................................... $
Investing activities ....................................................  
Financing activities ...................................................  
Net (decrease) increase in cash and cash equivalents ....... $

(8,244)  $
3,046   
3,104   
(2,094)  $

(17,472)
12,926 
5,847 
1,301  

Net cash used in operating activities for the year ended December 31, 2018 decreased approximately $9.2 million compared with 
2017. This was primarily due to a lower net loss in 2018, as discussed in more detail above, offset by changes in operating assets and 
liabilities. 

Net cash provided by investing activities for the year ended December 31, 2018 was $3.0 million, consisting of $3.1 million of 
proceeds from the maturities of marketable securities, offset by $4,000 for the purchase of property and equipment. Net cash provided 
by investing activities for the year ended December 31, 2017 was $12.9 million, consisting of $18.4 million of proceeds from the 
maturities of marketable securities, offset by $5.5 million for the purchases of marketable securities and $3,000 for the purchase of 
property and equipment.

45

 
 
 
  
 
 
 
 
 
 
   
 
 
 
 
    
 
  
 
 
Net cash provided by financing activities was $3.1 million for the year ended December 31, 2018 representing $3.4 million of net 
proceeds from sales of our common stock pursuant to our sales agreement, less $0.3 million in payments on a vendor financing 
arrangement. Net cash provided by financing activities was $5.8 million for the year ended December 31, 2017 representing 
$6.1 million of net proceeds from sales of our common stock pursuant to our sales agreement, less $0.3 million in payments on a 
vendor financing arrangement.   

Sources and Uses of Capital 

Our primary sources of liquidity to date have been capital raised from issuances of shares of our preferred and common stock. The 
primary uses of our capital resources to date have been to fund operating activities, including research, clinical development and drug 
manufacturing expenses, license payments, and spending on capital items. 

In 2017, we entered into a sales agreement, as amended, with an agent to sell, from time to time, our common stock having an 
aggregate offering price of up to $10.2 million, in an “at the market offering.” In January 2019, we amended the amended sales 
agreement to increase the maximum aggregate value of shares which we may issue and sell from time to time under this sales 
agreement by approximately $2.5 million, from $10.2 million to $12.7 million. As of February 22, 2019, we have sold an aggregate of 
9,242,406 shares of our common stock pursuant to the terms of such sales agreement, as amended, for aggregate gross proceeds of 
approximately $12.6 million.  Net proceeds received in the period were approximately $11.9 million, after deducting initial expenses 
for executing the “at the market offering” and commissions paid to the placement agent. We have sold all shares available under the 
current prospectus.

Our liquidity and our ability to raise additional capital or complete any strategic transaction depends on a number of factors, including, 
but not limited to, the following: 

•

•

•

•

•

•

•

the costs and timing for the potential additional clinical trials, including PRECISION-AF, in order to gain possible 
regulatory approval for Gencaro or any other product candidate; 

the market price of our stock and the availability and cost of additional equity capital from existing and potential new 
investors;

our ability to retain the listing of our common stock on the Nasdaq Capital Market; 

our ability to control costs associated with its operations; 

general economic and industry conditions affecting the availability and cost of capital; 

the costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual property rights; and 

the terms and conditions of our existing collaborative and licensing agreements.  

We believe that our cash and cash equivalents as of December 31, 2018, together with the $2.4 million of net proceeds raised in 2019 
from sales of our common stock, will be sufficient to fund our operations, at our projected cost structure, through the third quarter of 
2019. However, our forecast of the period of time through which our financial resources will be adequate to support our current and 
forecasted operations could vary materially. We will need to raise additional capital to fund future operations and any additional 
development of Gencaro or any other product candidates. Such financing would likely result in dilution to our existing stockholders. If 
we raise additional funds through the incurrence of indebtedness, the obligations related to such indebtedness would be senior to rights 
of holders of our capital stock and could contain covenants that would restrict our operations. The significant uncertainties 
surrounding the clinical development timelines and costs and the ability to raise a significant amount of capital raises substantial doubt 
about our ability to continue as a going concern from one year after the Company’s financial statements have been issued.

Critical Accounting Policies and Estimates 

A critical accounting policy is one that is both important to the portrayal of our financial condition and results of operation and 
requires management’s most difficult, subjective or complex judgments, often as a result of the need to make estimates about the 
effect of matters that are inherently uncertain. While our significant accounting policies are described in Note 1 of “Notes to Financial 
Statements” included within Item 8 in this report, we believe the following critical accounting policy affected our most significant 
judgments, assumptions, and estimates used in the preparation of our financial statements and, therefore, is important in understanding 
our financial condition and results of operations. 

Accrued Outsourcing Expenses 

As part of the process of preparing our financial statements, we are required to estimate accrued outsourcing expenses. This process 
involves identifying services that third parties have performed on our behalf and estimating the level of service performed and the 
associated cost incurred for these services as of the balance sheet date. Examples of estimated accrued outsourcing expenses include 
contract service fees, such as fees payable to contract manufacturers in connection with the production of materials related to our drug 
product, and service fees from clinical research organizations. We develop estimates of liabilities using our judgment based upon the 
facts and circumstances known at the time. 

46

Off-Balance Sheet Arrangements 

We have not participated in any transactions with unconsolidated entities, such as special purpose entities, which would have been 
established for the purpose of facilitating off-balance sheet arrangements. 

Indemnifications 

In the ordinary course of business, we enter into contractual arrangements under which we may agree to indemnify certain parties 
from any losses incurred relating to the services they perform on our behalf or for losses arising from certain events as defined within 
the particular contract. Such indemnification obligations may not be subject to maximum loss clauses. We have entered into indemnity 
agreements with each of our directors, officers and certain employees. Such indemnity agreements contain provisions, which are in 
some respects broader than the specific indemnification provisions contained in Delaware law. We also maintain an insurance policy 
for our directors and executive officers insuring against certain liabilities arising in their capacities as such. 

Item 7A. Quantitative and Qualitative Disclosures About Market Risk 

Not applicable. 

47

Item 8. Financial Statements and Supplementary Data 

Report of Independent Registered Public Accounting Firm, KPMG LLP .................................................................................................

Balance Sheets as of December 31, 2018 and 2017....................................................................................................................................

Statements of Operations and Comprehensive Loss for the years ended December 31, 2018 and 2017 ...................................................

Statements of Stockholders’ Equity for the years ended December 31, 2018 and 2017  ...........................................................................

Statements of Cash Flows for the years ended December 31, 2018 and 2017 ...........................................................................................

Notes to Financial Statements .....................................................................................................................................................................

Page
   49

50

51

52

53

54

48

Report of Independent Registered Public Accounting Firm 

The Stockholders and Board of Directors 
ARCA biopharma, Inc.: 

Opinion on the Financial Statements

We have audited the accompanying balance sheets of ARCA biopharma, Inc. (the Company) as of December 31, 2018 and 2017, the 
related statements of operations and comprehensive loss, stockholders’ equity, and cash flows for the years then ended, and the related 
notes (collectively, 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, 2018 and 2017, and the results of its operations and its cash flows for the years 
then ended, in conformity with U.S. generally accepted accounting principles. 

Going Concern 

The accompanying financial statements have been prepared assuming that the Company will continue as a going concern. As 
discussed in note 1 to the financial statements, the Company has incurred recurring losses from operations and needs to raise capital to 
fund its clinical development programs. The Company’s ability to raise such capital is uncertain. As a result, there is substantial doubt 
about the Company’s ability to continue as a going concern. Management’s plans in regard to these matters are also described in 
note 1. The financial statements do not include any adjustments that might result from the outcome of this uncertainty.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on these 
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 financial statements. We believe 
that our audits provide a reasonable basis for our opinion.  

We have served as the Company’s auditor since 2006.

/s/ KPMG LLP 

Denver, Colorado 
February 27, 2019 

49

ARCA BIOPHARMA, INC. 

BALANCE SHEETS 

Current assets:

ASSETS

Cash and cash equivalents............................................................................................. $
Marketable securities.....................................................................................................  
Other current assets .......................................................................................................  
Total current assets ..................................................................................................  
Property and equipment, net ...............................................................................................  
Other assets.........................................................................................................................  
Total assets ............................................................................................................. $

LIABILITIES AND STOCKHOLDERS’ EQUITY

Current liabilities:

Accounts payable .......................................................................................................... $
Accrued compensation and employee benefits .............................................................  
Accrued expenses and other liabilities ..........................................................................  
Total current liabilities.............................................................................................  
Deferred rent, net of current portion...................................................................................  
Total liabilities........................................................................................................  

Commitments and contingencies
Stockholders’ equity:

Preferred stock, $0.001 par value; 5 million shares authorized;
   no shares issued or outstanding at December 31, 2018 and 2017..............................  
Common stock, $0.001 par value; 100 million shares authorized
   at December 31, 2018 and 2017; 13,924,058 and 11,775,062
   shares issued and outstanding at December 31, 2018 and
   2017, respectively ......................................................................................................  
Additional paid-in capital..............................................................................................  
Accumulated other comprehensive loss........................................................................  
Accumulated deficit ......................................................................................................  
Total stockholders’ equity.....................................................................................  
Total liabilities and stockholders’ equity............................................................. $

As of December 31,

2018

2017

(in thousands, except share
and per share amounts)

$

$

$

6,608   
—   
169   
6,777   
24   
24   
6,825   

230   
150   
413   
793   
—   
793   

8,702 
3,050 
547 
12,299 
42 
24 
12,365 

622 
757 
691 
2,070 
20 
2,090 

—   

— 

14   
144,952   
—   
(138,934)  
6,032   
6,825   

$

12 
141,266 
(2)
(131,001)
10,275 
12,365  

See accompanying Notes to Financial Statements 

50

 
 
 
   
 
 
 
 
 
   
 
  
   
   
 
  
 
 
 
 
 
 
 
    
 
  
 
    
 
  
 
    
 
  
 
 
 
 
 
 
    
 
  
 
    
 
  
 
 
 
 
 
 
ARCA BIOPHARMA, INC. 

STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS 

Costs and expenses:

Research and development .........................................................................................$
General and administrative......................................................................................... 
Total costs and expenses ................................................................................. 
Loss from operations ....................................................................................... 

Interest and other income................................................................................................. 
Interest expense................................................................................................................ 
Loss before income taxes ................................................................................ 
Income tax benefit............................................................................................................ 
Net loss ............................................................................................................$

Change in unrealized loss on marketable securities ........................................................ 
Comprehensive loss .........................................................................................................$

Years Ended December 31,
2017
2018

(in thousands, except share
and per share amounts)

4,239    $
3,879   
8,118   
(8,118)  

162   
(8)  
(7,964)  
31   
(7,933)   $

2   
(7,931)   $

14,076 
4,636 
18,712 
(18,712)

167 
(6)
(18,551)
61 
(18,490)

17 
(18,473)

Net loss per share:

Basic and diluted...................................................................................................$

(0.57)   $

(1.77)

Weighted average shares outstanding:

Basic and diluted................................................................................................... 

13,849,055   

10,431,391  

See accompanying Notes to Financial Statements 

51

 
 
 
 
 
 
 
 
   
   
   
 
 
 
 
 
   
   
   
 
 
 
 
 
 
   
   
   
 
 
 
   
   
   
 
   
   
   
 
   
   
   
 
 
ARCA BIOPHARMA, INC.

STATEMENTS OF STOCKHOLDERS’ EQUITY 

Stockholders’ Equity

Common stock

Shares

Amount

Additional
Paid-In
Capital

Accumulated 
Other

    Comprehensive    Accumulated    

Loss

Deficit

Total

(in thousands, except share and per share amounts)

Balance, December 31, 2016............................... 
Issuance of common stock for cash,
   net of offering costs............................................
Issuance of common stock upon vesting
   of Restricted Stock Units ...................................
Share-based compensation .................................... 
Change in unrealized loss on
   marketable securities..........................................
Net loss.................................................................. 
Balance, December 31, 2017............................... 
Issuance of common stock for cash,
   net of offering costs............................................
Issuance of common stock upon vesting
   of Restricted Stock Units ...................................
Share-based compensation .................................... 
Change in unrealized loss on
   marketable securities..........................................
Net loss.................................................................. 
Balance, December 31, 2018............................... 

9,082,366 

 $

2,677,525 

15,171 
— 

— 
— 
11,775,062 

2,133,828 

15,168 
— 

— 
— 
13,924,058 

  $

9 

3 

— 
— 

— 
— 
12 

2 

— 
— 

— 
— 
14 

 $

134,715 

 $

(19)

 $

(112,511)

 $

22,194 

6,093 

— 
458 

— 
— 
141,266 

3,413 

— 
273 

— 
— 
144,952 

  $

  $

— 

— 
— 

17 
— 
(2)

— 

— 
— 

2 
— 
— 

— 

— 
— 

— 
(18,490)
(131,001)

— 

— 
— 

— 
(7,933)
(138,934)

  $

  $

6,096 

— 
458 

17 
(18,490)
10,275 

3,415 

— 
273 

2 
(7,933)
6,032  

See accompanying Notes to Financial Statements

52

 
 
 
 
 
 
 
 
 
 
   
 
   
   
   
 
 
   
 
 
 
 
 
   
 
 
 
 
 
   
   
   
   
   
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
   
 
 
   
 
 
   
 
 
 
 
 
  
  
  
  
  
 
 
  
  
  
  
  
 
  
  
  
  
  
 
 
  
  
  
  
  
 
  
  
  
  
  
 
  
  
  
  
  
 
 
  
  
  
  
  
 
 
  
  
  
  
  
 
  
  
  
  
  
 
 
  
  
  
  
  
 
  
  
  
  
  
 
ARCA BIOPHARMA, INC.

STATEMENTS OF CASH FLOWS 

Cash flows from operating activities:

Net loss ........................................................................................................................$
Adjustments to reconcile net loss to net cash used
   in operating activities:

Depreciation ........................................................................................................... 
Amortization of other assets................................................................................... 
Amortization of premiums and discounts on marketable securities ...................... 
Share-based compensation ..................................................................................... 
Change in operating assets and liabilities:

Other current assets........................................................................................... 
Accounts payable.............................................................................................. 
Accrued compensation and employee benefits................................................. 
Accrued expenses and other liabilities ............................................................. 
Net cash used in operating activities................................................................... 

Cash flows from investing activities:

Purchase of property and equipment ........................................................................... 
Purchases of marketable securities .............................................................................. 
Proceeds from maturities of marketable securities...................................................... 
Net cash provided by investing activities ........................................................... 

Cash flows from financing activities:

Proceeds from the issuance of common stock............................................................. 
Common stock offering costs ...................................................................................... 
Repayment of principal on vendor finance agreement ................................................ 
Net cash provided by financing activities........................................................... 
Net (decrease) increase in cash and cash equivalents .................................................. 
Cash and cash equivalents, beginning of year .................................................................. 
Cash and cash equivalents, end of year.........................................................................$
Supplemental cash flow information:

Interest paid............................................................................................................$
Income tax refund received....................................................................................$

Supplemental disclosure of noncash investing and financing
   transactions:

Common stock offering costs accrued but not yet paid .........................................$
Change in unrealized loss on marketable securities...............................................$

See accompanying Notes to Financial Statements 

Years Ended December 31,
2017
2018

(in thousands)

(7,933)   $

(18,490)

22   
—   
2   
273   

689   
(392)  
(607)  
(298)  
(8,244)  

(4)  
—   
3,050   
3,046   

3,532   
(117)  
(311)  
3,104   
(2,094)  
8,702   
6,608    $

8    $
54    $

 $
— 
2    $

27 
329 
119 
458 

437 
(583)
38 
193 
(17,472)

(3)
(5,471)
18,400 
12,926 

6,551 
(448)
(256)
5,847 
1,301 
7,401 
8,702 

6 
38 

7 
17  

53

 
 
 
 
 
 
 
 
 
 
 
    
 
  
 
    
 
  
 
 
 
 
 
    
 
  
 
 
 
 
 
 
    
 
  
 
 
 
 
 
    
 
  
 
 
 
 
 
 
 
    
 
  
   
   
   
 
 
ARCA BIOPHARMA, INC. 

NOTES TO FINANCIAL STATEMENTS 

(1) The Company and Summary of Significant Accounting Policies 

Description of Business 

ARCA biopharma, Inc. (the Company or ARCA), a Delaware corporation, is headquartered in Westminster, Colorado. The Company 
is a biopharmaceutical company applying a precision medicine approach to developing genetically-targeted therapies for 
cardiovascular diseases. The Company’s lead product candidate, Gencaro™ (bucindolol hydrochloride), is an investigational, 
pharmacologically unique beta-blocker and mild vasodilator that ARCA is developing for the potential treatment of atrial fibrillation 
(AF) in certain patients who also have heart failure (HF).  

In February 2018, the Company completed its Phase 2B clinical superiority trial, known as GENETIC-AF, in which the Company 
evaluated Gencaro for the treatment of AF in patients with heart failure with reduced left ventricular ejection fraction (HFrEF) and 
mid-range left ventricle ejection fraction (HFmrEF) against an active comparator, the beta-blocker TOPROL-XL (metoprolol 
succinate), a drug indicated for treating HFrEF that is also prescribed, but not approved, for treating AF in patients with HFrEF.   
Enrollment in GENETIC-AF was limited to patients that possess the specific genotype that the Company believes enhances Gencaro’s 
potential therapeutic effects.  The planned development program of Gencaro is, in part, based on the results of the Company’s 
completed GENETIC-AF Phase 2B clinical trial and a prospectively designed DNA substudy of adrenergic receptor polymorphisms in 
the BEST trial, a previous Phase 3 study of HF patients. 

GENETIC-AF was a Phase 2B, multi-center, randomized, double-blind, clinical superiority trial comparing the safety and efficacy of 
Gencaro against TOPROL-XL, that enrolled 267 patients. The Company reported top-line Phase 2B trial data in February 2018. 
Overall, Gencaro demonstrated a similar treatment benefit compared to the active comparator, metoprolol succinate; however, trends 
for benefit in favor of bucindolol were observed in multiple subpopulations of patients in the trial. Based on these data, the Company 
believes further clinical development of Gencaro is warranted. Based on review of the Phase 2 GENETIC-AF trial results, as well as 
its alignment with previous Phase 3 pharmacogenetic substudy data from the BEST trial, the FDA stated that data from a single 
pivotal Phase 3 clinical trial may be sufficient to support approval of Gencaro for the treatment of AF in patients with HF.  The 
Company, in consultation with the FDA, developed key elements of the Phase 3 clinical trial needed to support a potential New Drug 
Application (NDA), details of which were submitted for evaluation and confirmed via the FDA’s Special Protocol Assessment (SPA) 
process in February 2019.  

During 2018, ARCA initiated Investigational New Drug enabling development activities with AB171, a thiol-substituted isosorbide 
mononitrate, as a potential genetically-targeted treatment for peripheral arterial disease and for HF.

The Company will need to raise additional capital to fund future operations and any additional development of Gencaro or AB171.  If 
the Company is unable to obtain additional funding or is unable to complete a strategic transaction, it may have to discontinue 
development activities on Gencaro or discontinue its operations. 

Liquidity and Going Concern

The Company devotes substantially all of its efforts towards obtaining regulatory approval and raising capital necessary to fund its 
operations and it is subject to a number of risks associated with clinical research and development, including dependence on key 
individuals, the development of and regulatory approval of commercially viable products, the need to raise adequate additional 
financing necessary to fund the development and commercialization of its products, and competition from larger companies. The 
Company has not generated revenue to date and has incurred substantial losses and negative cash flows from operations since its 
inception. The Company has historically funded its operations through issuances of common and preferred stock. 

The Company believes that its cash and cash equivalents as of December 31, 2018, together with the $2.4 million of net proceeds 
raised in 2019 from sales of its common stock, as discussed in Note 11, will be sufficient to fund its operations, at its projected cost 
structure, through the end of the third quarter of 2019.  In light of the significant uncertainties regarding clinical development 
timelines and costs for developing drugs such as Gencaro, the Company will need to raise additional capital to finance the Company’s 
future operations and any additional development of Gencaro or any other product candidates.  If the Company is delayed in 
completing or is unable to complete additional financing and/or a strategic transaction, the Company may discontinue its development 
activities or operations.

Due to the current status of the Gencaro development program, the current amount of cash and cash equivalents held, the anticipated 
costs to be incurred for existing operations as well as exploring other corporate strategic alternatives, and the uncertainty of the 

54

 
 
Company’s ability to raise a significant amount of capital, management has determined there is substantial doubt about the Company’s 
ability to continue as a going concern from one year after the Company’s financial statements have been issued.  The Company could 
delay or cancel certain planned expenditures related to its drug development programs and/or implement cost reduction measures to 
conserve its cash balances; however, there is no assurance that those measures would be adequate to allow the Company to continue as 
a going concern for a period beyond one year from the issuance of these financial statements.  These financial statements have been 
prepared with the assumption that the Company will continue as a going concern and will be able to realize its assets and discharge its 
liabilities in the normal course of business and do not include any adjustments to reflect the possible future effects on the 
recoverability and classification of assets or the amounts and classification of liabilities that may result from the inability of the 
Company to continue as a going concern. The Company may not be able to raise sufficient capital on acceptable terms, or at all, to 
continue development of Gencaro or to otherwise continue operations and may not be able to execute any strategic transaction.

The Company’s liquidity, and its ability to raise additional capital or complete any strategic transaction, depends on a number of 
factors, including, but not limited to, the following: 

•

•

•

•

•

•

•

the costs and timing for the potential additional clinical trials in order to gain possible regulatory approval for Gencaro or 
any other product candidate;

the market price of the Company’s stock and the availability and cost of additional equity capital from existing and 
potential new investors; 

the Company’s ability to retain the listing of its common stock on the Nasdaq Capital Market; 

general economic and industry conditions affecting the availability and cost of capital; 

the Company’s ability to control costs associated with its operations; 

the costs of filing, prosecuting, defending and enforcing any patent claims and other intellectual property rights; and 

the terms and conditions of the Company’s existing collaborative and licensing agreements. 

The sale of additional equity or convertible debt securities would likely result in substantial additional dilution to the Company’s 
stockholders. If the Company raises additional funds through the incurrence of indebtedness, the obligations related to such 
indebtedness would be senior to rights of holders of the Company’s capital stock and could contain covenants that would restrict the 
Company’s operations. The Company also cannot predict what consideration might be available, if any, to the Company or its 
stockholders, in connection with any strategic transaction. Should strategic alternatives or additional capital not be available to the 
Company, or not be available on acceptable terms, the Company may be unable to realize value from its assets and discharge its 
liabilities in the normal course of business which may, among other alternatives, cause the Company to further delay, substantially 
reduce or discontinue operational activities to conserve its cash resources.

On April 11, 2018, the Company received notification from Nasdaq of potential delisting of its shares from the Nasdaq Capital Market 
because the closing bid price of its common stock had not met the minimum closing bid price of $1.00 per share during the preceding 
30 days.  On October 9, 2018, ARCA received a written notification from NASDAQ granting an additional 180 calendar day period, 
until April 8, 2019, to regain compliance with the minimum bid price requirement.  The minimum bid price requirement will be met if 
the Common Stock has a closing bid of at least $1.00 per share for a minimum of 10 consecutive business days during the 180 day 
period. If the Company is not able to regain compliance with the closing bid requirement in such period, the Company may be subject 
to delisting from the Nasdaq Capital Market. If delisted, it could substantially impact the Company’s access to the capital markets, and 
any limitation on market liquidity or reduction in the price of the common stock as a result of that delisting could adversely affect the 
Company’s ability to raise capital on acceptable terms, or at all. 

On October 18, 2018, the Company held a special meeting of its stockholders, at which stockholders authorized the Company’s board 
of directors to amend the Company’s restated certificate of incorporation, as amended, to effect a reverse split of the Company’s 
outstanding common stock, if, in the judgment of the Company’s board of directors, it is deemed necessary to maintain NASDAQ 
compliance or for other reasons. The Company’s board of directors has not selected a ratio for the reverse split.

Basis of Presentation 

The accompanying financial statements have been prepared in accordance with U.S. generally accepted accounting principles (U.S. 
GAAP) and include all adjustments necessary for the fair presentation of our financial position, results of operations and cash flows 
for the periods presented.  Management has performed an evaluation of the Company’s activities through the date of filing of this 
Annual Report on Form 10-K, and the subsequent events are disclosed in Note 11.  

55

 
Recent Accounting Pronouncements 

In January 2016, Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) No. 2016-01, 
Recognition and Measurement of Financial Assets and Financial Liabilities (ASU 2016-01). ASU 2016-01 requires equity 
investments to be measured at fair value with changes in fair value recognized in net income; simplifies the impairment assessment of 
equity investments without readily determinable fair values by requiring a qualitative assessment to identify impairment; eliminates 
the requirement for public business entities to disclose the method(s) and significant assumptions used to estimate the fair value that is 
required to be disclosed for financial instruments measured at amortized cost on the balance sheet; requires public business entities to 
use the exit price notion when measuring the fair value of financial instruments for disclosure purposes; requires an entity to present 
separately in other comprehensive income the portion of the total change in the fair value of a liability resulting from a change in the 
instrument-specific credit risk when the entity has elected to measure the liability at fair value in accordance with the fair value option 
for financial instruments; requires separate presentation of financial assets and financial liabilities by measurement category and form 
of financial assets on the balance sheet or the accompanying notes to the financial statements and clarifies that an entity should 
evaluate the need for a valuation allowance on a deferred tax asset related to available-for-sale securities in combination with the 
entity’s other deferred tax assets. ASU 2016-01 is effective for financial statements issued for fiscal years beginning after 
December 15, 2017, and interim periods within those fiscal years. The adoption of ASU 2016-01 as of January 1, 2018, had no impact 
to the Company’s financial statements and related disclosures.

In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (ASU 2016-02), which requires lessees to recognize assets 
and liabilities for the rights and obligations created by most leases on their balance sheet. In July 2018, FASB issued 
ASU No. 2018-11, Topic 842 - Targeted Improvements. The update requires modified retrospective transition, with the option to 
initially apply the new standard at the adoption date and recognize a cumulative-effect adjustment and elect various practical 
expedients.  The guidance is effective for fiscal years beginning after December 15, 2018, including interim periods within those fiscal 
years. The Company plans to apply the practical expedients permitted within the guidance, which allows the Company to carryforward 
its historical lease classification, and to apply the transition option which does not require application of the guidance to comparative 
periods in the year of adoption.  The Company has completed preliminary calculations of the impact that ASU 2016-02 will have on 
its financial statements and related disclosures and it is expected that the operating lease commitment discussed in Note 6 will be 
recognized as operating lease liability, at its present value, and the corresponding right-of-use asset will be recognized. The Company 
does not expect this guidance will have a material impact on the financial statements.

In August 2018, the FASB issued ASU No. 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework—Changes to the 
Disclosure Requirements for Fair Value Measurement, which modifies the disclosure requirements on fair value measurements. The 
new guidance is effective for fiscal years, and interim periods within those fiscal years, beginning after December 15, 2019.  Upon the 
effective date, certain provisions are to be applied prospectively, while others are to be applied retrospectively to all periods presented. 
An entity is permitted to early adopt any removed or modified disclosures upon issuance of this ASU and delay adoption of the 
additional disclosures until their effective date. The Company is currently evaluating the impact of the amendments on the financial 
statement disclosures. Since the amendments impact only disclosure requirements, the Company does not expect the amendments to 
have a material impact on the financial statements.

The Company reviewed all other recently issued accounting pronouncements and concluded that they were either not applicable or not 
expected to have a significant impact to the financial statements.

Accounting Estimates in the Preparation of Financial Statements 

The preparation of financial statements in conformity with accounting principles generally accepted in the United States of America 
requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of 
contingent assets and liabilities at the date of the financial statements and the reported amounts of expenses during the reporting 
period. The Company bases estimates on various assumptions that are believed to be reasonable under the circumstances. The 
Company believes significant judgment was involved in estimating the clinical trial accruals, and in estimating other accrued 
liabilities, stock-based compensation, and income taxes. Management is continually evaluating and updating these estimates, and it is 
possible that these estimates will change in the future or that actual results may differ from these estimates. 

Cash Equivalents 

Cash equivalents generally consist of money market funds and debt securities with maturities of 90 days or less at the time of 
purchase. The Company invests its excess cash in securities with strong ratings and has established guidelines relative to 
diversification and maturity with the objective of maintaining safety of principal and liquidity. 

56

 
Marketable Securities

The Company has designated its marketable securities as available-for-sale securities and accounted for them at their respective fair 
values.  Marketable  securities  are  classified  as  short-term  or  long-term  based  on  the  nature  of  the  securities  and  their  availability  to 
meet  current  operating  requirements.  Marketable  securities  that  are  readily  available  for  use  in  current  operations  are  classified  as 
short-term  available-for-sale  securities  and  are  reported  as  current  marketable  securities  in  the  accompanying  balance  sheets. 
Marketable  securities  that  are  not  considered  available  for  use  in  current  operations  are  classified  as  long-term  available-for-sale 
securities and are reported as a component of long-term assets in the accompanying balance sheets.

Securities  that  are  classified  as  available-for-sale  are  measured  at  fair  value,  including  accrued  interest,  with  temporary  unrealized 
gains and losses reported as a component of stockholders' equity until their disposition. The Company reviews all available-for-sale 
securities at each period end to determine if they remain available-for-sale based on the Company’s then current intent and ability to 
sell the security if it is required to do so.

All  of  the  Company’s  marketable  securities  are  subject  to  a  periodic  impairment  review.  The  Company  recognizes  an  impairment 
charge when a decline in the fair value of its investments below the cost basis is judged to be other-than-temporary.

Concentrations of Credit Risk 

Financial instruments that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and 
cash equivalents and marketable securities. The Company has no off-balance-sheet concentrations of credit risk, such as foreign 
exchange contracts, option contracts, or foreign currency hedging arrangements.  The Company maintains cash and cash equivalent 
balances in the form of bank demand deposits and money market fund accounts with financial institutions that management believes 
are creditworthy. Such balances may at times exceed the insured amount. 

Property and Equipment 
Property and equipment are stated at cost less accumulated depreciation and amortization. Cost includes expenditures for equipment, 
leasehold improvements, replacements, and renewals. Maintenance and repairs are charged to expense as incurred. When assets are 
sold, retired, or otherwise disposed of, the cost and accumulated depreciation are removed from the accounts and any resulting gain or 
loss is reflected in operations. The cost of property and equipment is depreciated using the straight-line method over the estimated 
useful lives of the related assets. Leasehold improvements are amortized over the shorter of the life of the lease or the estimated useful 
life of the assets. 

Accrued Outsourcing Expenses 

As part of the process of preparing its financial statements, the Company is required to estimate accrued outsourcing expenses. This 
process involves identifying services that third parties have performed on the Company’s behalf and estimating the level of service 
performed and the associated cost incurred for these services as of the balance sheet date. Examples of estimated accrued outsourcing 
expenses include contract service fees, such as fees payable to contract manufacturers in connection with the production of materials 
related to the Company’s drug product, and service fees from clinical research organizations. The Company develops estimates of 
liabilities using its judgment based upon the facts and circumstances known at the time. 

Segments 

The Company operates in one segment. Management uses one measure of profitability and does not segment its business for internal 
reporting. 

Research and Development 

Research and development costs are expensed as incurred. These consist primarily of salaries, contract services, and supplies. 

Costs related to clinical trial and drug manufacturing activities are based upon estimates of the services received and related expenses 
incurred by contract research organizations (CROs), clinical study sites, drug manufacturers, collaboration partners, laboratories, 
consultants, or otherwise. Related contracts vary significantly in length, and could be for a fixed amount, a variable amount based on 
actual costs incurred, capped at a certain limit, or for a combination of these elements. Activity levels are monitored through 
communications with the vendors, including detailed invoices and task completion review, analysis of expenses against budgeted 
amounts, and pre-approval of any changes in scope of the services to be performed. Certain significant vendors may also provide an 
estimate of costs incurred but not invoiced on a periodic basis. Expenses related to the CROs and clinical studies, as well as contract 
drug manufacturers, are primarily based on progress made against specified milestones or targets in each period. 

In accordance with certain research and development agreements, we are obligated to make certain upfront payments upon execution 
of the agreement. We record these upfront payments as prepaid research and development expenses, which are included in Other 

57

 
current assets or Other assets in the accompanying Balance Sheets. Such payments are recorded to research and development expense 
as services are performed. We evaluate on a quarterly basis whether events and circumstances have occurred that may indicate 
impairment of remaining prepaid research and development expenses.

Stock-Based Compensation 

The Company’s stock-based compensation cost recognized is based on the estimated grant date fair value. The Company recognizes 
compensation costs for its stock-based awards on a straight-line basis over the requisite service period for the entire award, as adjusted 
for expected forfeitures.

Income Taxes 

The current benefit for income taxes represents actual or estimated amounts payable or refundable on tax returns filed or to be filed 
each year. Deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences 
between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases and operating loss and 
tax credit carryforwards. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in the period that 
includes the enactment date. The overall change in deferred tax assets and liabilities for the period measures the deferred tax expense 
or benefit for the period. The measurement of deferred tax assets may be reduced by a valuation allowance based on judgmental 
assessment of available evidence if deemed more likely than not that some or all of the deferred tax assets will not be realized. The 
Company has recorded a valuation allowance against all of its deferred tax assets, as management has concluded that it is more likely 
than not that the net deferred tax asset will not be realized through future taxable income, based primarily on the Company’s history of 
operating losses. The Company has not performed an Internal Revenue Code Section 382 limitation study. Depending on the outcome 
of such a study, the gross amount of net operating losses recognizable in future tax periods could be limited. 

(2) Net Loss Per Share 

The Company calculates basic loss per share by dividing net loss by the weighted average common shares outstanding during the 
period. Diluted loss per share is computed by dividing net loss by the weighted average number of common shares outstanding during 
the period increased to include, if dilutive, the number of additional common shares that would have been outstanding if the potential 
common shares had been issued. The Company’s potentially dilutive shares include stock options, restricted stock units and warrants 
for common stock. 

Because the Company reported a net loss for the years ended December 31, 2018 and 2017, all potentially dilutive shares of common 
stock have been excluded from the computation of the dilutive net loss per share for all periods presented.  Such potentially dilutive 
shares of common stock consist of the following:

Potentially dilutive securities, excluded:
Outstanding stock options .............................................. 
Unvested restricted stock units....................................... 
Warrants to purchase common stock ............................. 

Years Ended December 31,

2018

2017

604,003     
—     
2,669,855     
3,273,858     

611,975 
15,168 
3,633,008 
4,260,151  

58

 
 
 
 
 
   
 
 
      
  
 
 
(3) Marketable Securities and Fair Value Disclosures 

There were no marketable securities as of December 31, 2018.  Marketable securities consisted of the following as of 
December 31, 2017 (in thousands):

December 31, 2017
Gross
Gross
Amortized    Unrealized    Unrealized    
Gains

Losses

Cost

Fair
Value

Short-term available-for-sale 
securities:

Corporate bonds ..................$
Total..........................$

3,052 
3,052 

 $
 $

— 
— 

 $
 $

(2)
(2)

 $
 $

3,050 
3,050 

Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between 
market participants at the measurement date (exit price). Inputs used to measure fair value are classified into the following hierarchy: 

•

•

•

Level 1—Unadjusted quoted prices in active markets for identical assets or liabilities. The Company’s Level 1 assets 
consist of money market investments.  The Company does not have any Level 1 liabilities. 

Level 2—Unadjusted quoted prices in active markets for similar assets or liabilities; unadjusted quoted prices for identical 
or similar assets or liabilities in markets that are not active; or inputs other than quoted prices that are observable for the 
asset or liability.  The Company’s Level 2 assets consist of corporate bonds and commercial paper securities.  The 
Company does not have any Level 2 liabilities. 

Level 3—Unobservable inputs for the asset or liability.  The Company does not have any Level 3 assets or liabilities. 

The following table identifies the Company’s assets that were measured at fair value on a recurring basis (in thousands):

Balance   

Level 1   

Level 2   

Level 3  

December 31, 2018

Money market ......................$
Total ..........................$

6,529 
6,529 

 $
 $

6,529 
6,529 

 $
 $

— 
— 

 $
 $

December 31, 2017

Money market ......................$
Corporate bonds................... 
Total ..........................$

8,189 
3,725 
11,914 

 $

 $

8,189 
— 
8,189 

 $

 $

— 
3,725 
3,725 

 $

 $

— 
— 

— 
— 
— 

As of December 31, 2018 and 2017, the Company had $6.5 million and $8.9 million, respectively, of cash equivalents consisting of 
money market funds, and corporate bonds in 2017, with original maturities of 90 days or less. The Company has the ability to 
liquidate these investments without restriction.  The Company determines fair value for these money market funds and equity 
securities with Level 1 inputs through quoted market prices.  There were no transfers between any fair value hierarchy levels in 2018 
or 2017. 

Fair Value of Other Financial Instruments 

The carrying amount of other financial instruments, including accounts payable, approximated fair value due to their short maturities. 
As of December 31, 2018 and 2017, the Company did not have any debt outstanding. 

59

 
 
 
 
 
 
  
  
   
 
 
 
 
 
 
  
  
   
 
 
 
 
  
 
 
  
 
 
   
 
 
 
 
 
     
 
     
 
 
   
 
 
 
 
  
  
  
  
  
  
  
 
   
  
   
  
   
  
   
 
 
 
 
     
 
     
 
     
 
 
 
 
  
  
  
  
  
  
  
 
   
  
   
  
   
  
   
 
 
 
     
 
     
 
     
 
 
  
  
  
 
   
  
   
  
   
  
   
 
(4) Property and Equipment 

Property and equipment consist of the following (in thousands):

Computer equipment .............................................
Lab equipment .......................................................
Furniture and fixtures ............................................
Computer software ................................................

Leasehold improvements.......................................

Accumulated depreciation and amortization .........
Property and equipment, net..................................

  $

Estimated Life
3 years
5 years
5 years
3 years
Lesser of useful life 
or life of the lease  

December 31,
2018

December 31,
2017

65    $
142   
62   
70   

59   
398   
(374) 

74 
142 
83 
85 

59 
443 
(401)
42  

  $

24    $

For the years ended December 31, 2018 and 2017, depreciation and amortization expense was $22,000 and $27,000, respectively. 

(5) Related Party Arrangements 

Transactions with the Company’s President and Chief Executive Officer 

The Company has entered into unrestricted research grants with its President and Chief Executive Officer’s academic research 
laboratory at the University of Colorado. Funding of any unrestricted research grants is contingent upon the Company’s financial 
condition, and can be deferred or terminated at the Company’s discretion. Total expense under these arrangements for the years ended 
December 31, 2018 and 2017 was $325,000 and $418,000, respectively, of which $111,000 was unpaid and included in accrued 
expenses and other liabilities as of December 31, 2018.   

(6) Commitments and Contingencies 

The Company has or is subject to the following commitments and contingencies: 

Employment Agreements 

The Company maintains employment agreements with several key executive employees. The agreements may be terminated at any 
time by the Company with or without cause upon written notice to the employee, and entitle the employee to wages in lieu of notice 
for periods not exceeding one calendar year from date of termination without cause or by the employee for good reason. Certain of 
these agreements also provide for payments to be made under certain conditions related to a change in control of the Company. 

Operating Lease  

On August 1, 2013 the Company entered into a lease agreement for approximately 5,300 square feet of office facilities in 
Westminster, Colorado which has served as the Company’s primary business office since October 1, 2013.  Effective March 2, 2016, 
the lease was renewed for an additional 38 month term beginning October 1, 2016 and expiring on November 30, 2019.  

Below is a summary of the future minimum lease payments committed for the Company’s facility in Westminster, Colorado as of 
December 31, 2018 (in thousands):

2019 ...............................................................................$
Total future minimum lease payments ..........................$

83 
83  

Rent expense under these leases for the years ended December 31, 2018 and 2017 was $82,000 and $82,000, respectively.

Cardiovascular Pharmacology and Engineering Consultants, LLC 

ARCA has licensed worldwide rights to all preclinical and clinical data from development of bucindolol through the BEST trial from 
Cardiovascular Pharmacology and Engineering Consultants, LLC (CPEC), who has licensed rights to this data from Bristol Myers 
Squib (BMS). CPEC is a licensing subsidiary of Indevus Pharmaceuticals Inc. (a wholly owned subsidiary of Endo Pharmaceuticals), 
holding ownership rights to certain clinical trial data of Gencaro.  Under the terms of its license agreement with CPEC, the Company 
will incur milestone and royalty obligations upon the occurrence of certain events.  If the FDA grants marketing approval for Gencaro, 

60

 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
the license agreement states that the Company will owe CPEC a milestone payment of $8.0 million within six months after FDA 
approval. The license agreement states that a milestone payment of up to $5.0 million in the aggregate shall be paid upon regulatory 
marketing approval in Europe and Japan. The license agreement also states that the Company’s royalty obligation ranges from 12.5% 
to 25% of revenue from the related product based on achievement of specified product sales levels, including a 5% royalty that CPEC 
is obligated to pay under its original license agreement for Gencaro. The agreement states that the Company has the right to buy down 
the royalties to a range of 12.5% to 17% by making a payment to CPEC within six months of regulatory approval.

In October 2017, the Company entered into an agreement with CPEC’s minority owner, Aeolus Pharmaceuticals, Inc. (Aeolus) 
pursuant to which the Company acquired Aeolus’ minority membership interest in CPEC.  The transaction effectively buys-out 
Aeolus’ royalty interest thereby reducing or eliminating the stated milestone and royalty obligations that could be payable by the 
Company, if Gencaro receives regulatory approval and is commercialized.  As a result of this transaction, the Company, together with 
Endo Pharmaceuticals, Inc., indirectly hold the remaining licensee rights of CPEC to certain Gencaro clinical data, as discussed above.  
The acquisition cost of this interest did not have a material impact on the Company’s annual financial statements. 

(7) Equity Financings and Warrants 

2017 Equity Financing 

On January 11, 2017, the Company entered into a Capital on Demand TM Sales Agreement (the Sales Agreement) with JonesTrading 
Institutional Services LLC, as agent (JonesTrading), pursuant to which the Company may offer and sell, from time to time through 
JonesTrading, shares of the Company’s common stock, par value $0.001 per share (the Common Stock), having an aggregate offering 
price of up to $7.3 million.  On August 21, 2017 and January 25, 2019, the Company amended its Capital on Demand Sales 
Agreement. The amendments, among other things, increased the maximum aggregate offering value of shares of the Company’s 
common stock which the Company may issue and sell from time to time under the Sales Agreement from $7.3 million to $12.7 
million (the Shares). 

Under the amended Sales Agreement, JonesTrading may sell the Shares by any method permitted by law and deemed to be an “at the 
market offering” as defined in Rule 415 promulgated under the Securities Act of 1933, as amended, including sales made directly on 
or through The NASDAQ Capital Market, on any other existing trading market for the Common Stock or to or through a market 
maker. In addition, under the amended Sales Agreement, JonesTrading may sell the Shares by any other method permitted by law, 
including in negotiated transactions. The Company may instruct JonesTrading not to sell Shares if the sales cannot be effected at or 
above the price designated by the Company from time to time. 

The Company is not obligated to make any sales of the Shares under the amended Sales Agreement. The offering of Shares pursuant 
to the amended Sales Agreement will terminate upon the earlier of (a) the sale of all of the Shares subject to the amended Sales 
Agreement or (b) the termination of the amended Sales Agreement by JonesTrading or the Company, as permitted therein. 

The Company paid JonesTrading a commission rate equal to 3.0% of the aggregate gross proceeds from each sale of Shares and 
agreed to provide JonesTrading with customary indemnification and contribution rights. The Company will also reimburse 
JonesTrading for certain specified expenses in connection with entering into and amending the Sales Agreement. 

61

 
Under the amended Sales Agreement, the Company sold an aggregate of 2,133,828 and 2,677,525 shares of Common Stock pursuant 
to the terms of such Sales Agreement, as amended, for net proceeds of approximately $3.4 million and $6.1 million during the years 
ended December 31, 2018 and 2017, respectively, including initial expenses for executing the “at the market offering” and 
commissions to the placement agent.  

See Note 11 for subsequent sales under the Sales Agreement.

Warrants 

Warrants to purchase shares of common stock were granted as part of various financing and business agreements.  All outstanding 
warrants were recorded in additional paid-in capital at their estimated fair market value at the date of grant using a Black-Scholes 
option-pricing model.

As of December 31, 2018, these warrants, by year of expiration, are summarized below:

Year of Expiration  

Number
of Warrants

Weighted Average
Exercise Price

2019
2020
2022

224,323   
44,299   
2,401,233   
2,669,855   

$

$

15.73 
15.96 
6.10 
7.07  

(8) Share-based Compensation 

Stock Plans 

The Company’s equity incentive plan, the 2013 Equity Incentive Plan (the Equity Plan), was approved by stockholders on 
September 17, 2013, and amended in June 2016 to increase the reserve for issuance under this Equity Plan by 1,000,000 shares.  The 
maximum number of shares issuable under this plan is 1,321,428 shares.    

The Equity Plan provides for the granting of stock options (including indexed options), restricted stock units, stock appreciation rights, 
restricted stock purchase rights, restricted stock bonuses, performance shares, performance units and deferred stock units. Under the 
Equity Plan, awards may be granted to employees, directors and consultants of ARCA, except for incentive stock options, which may 
be granted only to employees. As of December 31, 2018, options and awards for 597,342 shares were outstanding under the Equity 
Plan, and 615,976 shares were reserved for future awards. 

In general, the Equity Plan authorizes the grant of stock options that vest at rates set by the Board of Directors or the Compensation 
Committee thereof. Generally, stock options granted by ARCA under the equity incentive plans become exercisable ratably for a 
period of three to four years from the date of grant and have a maximum term of ten years. The exercise prices of stock options under 
the equity incentive plan generally meet the following criteria: the exercise price of incentive stock options must be at least 100% of 
the fair market value on the grant date and exercise price of options granted to 10% (or greater) stockholders must be at least 110% of 
the fair market value on the grant date.   

62

 
   
 
 
 
 
 
 
 
 
 
 
 
 
In conjunction with the adoption of the Equity Plan, the Company discontinued grants under its previous plan, the Amended and 
Restated ARCA biopharma, Inc. 2004 Equity Incentive Plan (the 2004 Plan), effective September 17, 2013. The 2004 Plan expired in 
2014; however, options outstanding under the 2004 plan will continue to vest according to the original terms of each grant.  As of 
December 31, 2018, options to purchase 5,383 shares with a weighted average exercise price of $102.16 per share were outstanding 
under this plan. Other stock plans that were assumed by ARCA in the Merger still have options outstanding that will continue to vest 
according to the original terms of each grant, but no new options can be granted under these plans, as the plans have expired.  As of 
December 31, 2018, options to purchase 1,278 shares with a weighted average exercise price of $233.94 were outstanding under these 
plans.

The Company granted options for 40,000 and 469,600 shares of common stock in the years ended December 31, 2018 and 2017, 
respectively. The fair values of employee stock options granted in the years ended December 31, 2018 and 2017 were estimated at the 
date of grant using the Black-Scholes model with the following assumptions and had the following estimated weighted average grant 
date fair value per share:

  Years Ended December 31,

Expected term ............................................................... 
Expected volatility ........................................................   
Risk-free interest rate....................................................   
Expected dividend yield ...............................................   
Weighted-average grant date fair value per share ........  $

2018
5.3 years 

2017
5.8 years 

90%   
2.59%   
0%   
  $

0.52 

73%
1.99%
0%

1.60  

A summary of ARCA’s stock option activities for the years ended December 31, 2018 and 2017, and related information as of 
December 31, 2018, is as follows:

Options Outstanding

Number
of Options

Weighted 
Average
Exercise
Price

Weighted 
Average 
Remaining 
Contractual 
Term
(in years)

Aggregate 
Intrinsic Value
(in thousands)  

Options outstanding - December 31, 2016 .. 
Granted ........................................................ 
Exercised ..................................................... 
Forfeited and cancelled................................ 
Options outstanding - December 31, 2017 .. 
Granted ........................................................ 
Exercised ..................................................... 
Forfeited and cancelled................................ 
Options outstanding - December 31, 2018 .. 
Options exercisable - December 31, 2018... 
Options vested and expected to vest -
       December 31, 2018............................... 

629,629    $
469,600   
—   
(487,254)  
611,975    $
40,000   
—   
(47,972)  
604,003    $
486,420    $

6.30   
2.54   
—   
3.05   
6.00   
0.72   
—   
9.51   
5.37   
6.04   

8.14    $

— 

7.29    $
7.13    $

— 
— 

—  

603,842    $

5.38 

7.29 

$

The aggregate intrinsic value in the table above represents the total intrinsic value, based on our closing price as of December 31 of 
the respective year, which would have been received by the option holders had all the option holders with in-the-money options 
exercised as of that date.    As of December 31, 2018, the unrecognized compensation expense related to unvested options, excluding 
estimated forfeitures, was $186,000 which is expected to be recognized over a weighted average period of 1.1 years. The Company 
recognizes compensation costs for its share-based awards on a straight-line basis over the requisite service period for the entire award, 
as adjusted for expected forfeitures. 

Restricted Stock Units

The Company began granting restricted stock units (RSUs) to employees during 2013 in conjunction with the adoption of the Equity 
Plan.  The fair value of RSU awards is the closing price of the Company’s common stock on the date of grant and was recognized as 

63

 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
    
 
  
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
    
 
  
 
 
 
 
 
 
 
 
compensation expense on a straight-line basis over the respective vesting period. The stock awards granted had a requisite service 
period between three and four years with annual vesting on the grant anniversary date.

A summary of RSU activity for the years ended December 31, 2018 and 2017 is presented below:

Restricted Stock Units Outstanding
Weighted
Average
Grant Date
Fair Value

Number
of Shares

RSUs outstanding - December 31, 2016........................... 
Granted ............................................................................. 
Vested and released .......................................................... 
Forfeited and cancelled..................................................... 
RSUs outstanding - December 31, 2017........................... 
Granted ............................................................................. 
Vested and released .......................................................... 
Forfeited and cancelled..................................................... 
RSUs outstanding - December 31, 2018........................... 

30,739    $
—   
(15,171) 
(400) 
15,168    $
—   
(15,168) 
—   
—    $

7.91 
— 
7.94 
6.03 
7.94 
— 
7.94 
— 
—  

As of December 31, 2018, all compensation cost related to stock awards was recognized.  

Non-cash Stock-based Compensation 

For the years ended December 31, 2018 and 2017, the Company recognized the following non-cash, share-based compensation 
expense (in thousands):

Years Ended
December 31,

2018

2017

Research and development.................$
General and administrative................. 
Total ...................................................$

117   $
156    
273   $

169 
289 
458  

Stock-based compensation expense related to non-employees was negligible in 2018 and 2017.  ARCA did not recognize any tax 
benefit related to employee stock-based compensation cost as a result of the full valuation allowance on its net deferred tax assets. 

(9) Employee Benefit Plans 

The Company has a 401(k) plan and makes a matching contribution equal to 100% of the employee’s first 3% of the employee’s 
contributions and 50% of the employee’s next 2% of contributions. The Company adopted the plan in 2006 and contributed $115,000 
and $135,000 for the years ended December 31, 2018 and 2017, respectively. 

(10) Income Taxes 

Effective June 1, 2005, the Company changed from an S-Corporation to a C-Corporation. As an S-Corporation, the net operating loss 
carryforwards were distributed to the Company’s stockholders; such amounts were not significant. As of December 31, 2018, the 
Company has net operating loss carryforwards of approximately $165.2 million, and approximately $1.8 million of research and 
development credits that may be used to offset future taxable income. The Company’s net operating loss carryforwards through 
December 31, 2017 will expire beginning 2025 through 2037.  The net operating loss carryforwards beginning in 2018, have no 
expiration, but are limited to 80% of taxable income.  Utilization of net operating losses and tax credits, including those acquired as a 
result of the Merger, will be subject to an annual limitation due to ownership change limitations provided by Internal Revenue Code 
Section 382. The Company believes that an ownership change limitation as defined under Section 382 of the U.S. Internal Revenue 
Code occurred as a result of its various historical financing transactions, and its offering of common stock completed in June 2015. 
Future utilization of the federal net operating losses and tax credit carryforwards accumulated from June 2005 to the change in 
ownership date will be subject to annual limitations to offset future taxable income. The annual limitation may result in the expiration 

64

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
of the net operating losses and credits before utilization. As such, a portion of the Company’s net operating loss carryforwards may be 
limited. 

In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of 
the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future 
taxable income during the period in which those temporary differences become deductible. Management considers the scheduled 
reversal of deferred tax liabilities, projected future taxable income and tax planning strategies in making this assessment. Due 
primarily to the Company’s history of operating losses, management is unable to conclude that it is more likely than not that the 
Company will realize the benefits of these deductible differences, and accordingly has provided a valuation allowance against the 
entire net deferred tax asset of approximately $43.5 million at December 31, 2018, reflecting an increase of approximately 
$1.9 million from December 31, 2017.  During 2017, deferred tax assets decreased $20.1million related to the remeasurement of the 
deferred tax assets from 34% to the new 2018 U.S. Federal corporate income tax rate of 21%. The deferred tax assets are primarily 
comprised of net operating loss carryforwards and research and experimentation credit carryforwards. As of December 31, 2018, the 
Company has not performed an Internal Revenue Code Section 382 limitation study. Depending on the outcome of such a study, the 
gross amount of net operating losses recognizable in future tax periods could be limited. A limitation in the carryforwards would 
decrease the carrying amount of the gross amount of the net operating loss carryforwards, with a corresponding decrease in the 
valuation allowance recorded against these gross deferred tax assets. 

Income tax benefit for the years ended December 31, 2018 and 2017 were related to a federal research and experimentation income 
tax credits related to the Protecting Americans from Tax Hikes Act of 2015, or PATH Act, which allows qualified small businesses to 
monetize up to $250,000 of research and experimentation tax credits through payroll tax refunds.  Income tax benefit attributable to 
our loss from operations before income taxes differs from the amounts computed by applying the U.S. federal statutory income tax 
rate of 21% for 2018 and 34% for 2017, as a result of the following (in thousands):

U.S. federal income tax benefit at statutory rates..............................$
State income tax benefit, net of federal benefit ................................. 
Research and experimentation credits ............................................... 
Change in tax rate.............................................................................. 
Deferred tax asset adjustment............................................................ 
Other .................................................................................................. 
Change in valuation allowance.......................................................... 
Income tax benefit .............................................................................$

Years ended December 31,
2017
2018

(1,666)  $
(290) 
(144) 
—   
34   
134   
1,901   

(31)  $

(6,286)
(565)
(303)
20,085 
37 
122 
(13,151)
(61)

Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for 
financial reporting and the amounts used for income tax purposes, as well as operating loss and tax credit carryforwards. The income 
tax effects of temporary differences and carryforwards that give rise to significant portions of the Company’s net deferred tax assets 
consisted of the following (in thousands):

As of December 31,

2018

2017

Net operating loss carryforwards............................................$
Charitable contribution carryforwards.................................... 
Research and experimentation credits .................................... 
Capitalized intangibles............................................................ 
Stock-based compensation...................................................... 
Depreciation and amortization................................................ 
Accrued compensation............................................................ 
Other ....................................................................................... 
Total deferred tax assets....................................................... 
Valuation allowance ............................................................... 
     Net deferred tax assets.............................................................$

 $

40,742 
433 
1,796 
409 
127 
1 
20 
1 
43,529 
(43,529)

—    $

38,566 
455 
1,682 
608 
148 
1 
168 
— 
41,628 
(41,628)
—  

65

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
  
  
  
  
  
  
  
  
  
Since the Company is in a loss carryforward position, the Company is generally subject to U.S. federal and state income tax 
examinations by tax authorities for all years for which a loss carryforward is available. Thus, the Company’s open tax years extend 
back to 2009. The Company believes that its tax filing positions and deductions related to tax periods subject to examination will be 
sustained upon audit and does not anticipate any adjustment will result in a material adverse effect on the Company’s financial 
condition, result of operations, or cash flow. For the years ended December 31, 2018 and 2017, the Company has no reserve for 
uncertain tax positions. The Company does not expect that the total amounts of unrecognized tax benefits will significantly increase or 
decrease within the subsequent twelve months. In the event the Company concludes it is subject to interest or penalties arising from 
uncertain tax positions, the Company will record interest and penalties as a component of other income and expense. No interest or 
penalties were recognized in the financial statements for the years ended December 31, 2018 and 2017. 
.   

(11) Subsequent Event 

In January 2019, the Company amended the Sales Agreement to increase the maximum aggregate value of shares which it may issue 
and sell from time to time under the Sales Agreement by approximately $2.5 million, from $10.2 million to $12.7 million.  Subsequent 
to December 31, 2018, the Company sold an aggregate of 4,431,053 shares of its Common Stock pursuant to the terms of the Sales 
Agreement, as amended, for aggregate gross proceeds of approximately $2.5 million.  Net proceeds received in the period were 
approximately $2.4 million, after deducting initial expenses for executing the “at the market offering” and commissions paid to the 
placement agent. As of February 22, 2019, the Company has sold all shares available under its current prospectus to the Company’s 
registration statement on Form S-3 (No. 333-217450).       

66

 
 
  
Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure 

Not applicable.  

Item 9A. Controls and Procedures 

Evaluation of Disclosure Controls and Procedures 

Under the supervision and with the participation of management, including our Principal Executive Officer and our Principal Financial 
Officer, we have evaluated the effectiveness of the design and operation of our disclosure controls and procedures (as defined in 
Exchange Act Rule 13a-15(e) and 15d-15(e). Based on this evaluation, our Principal Executive Officer and Principal Financial Officer 
have concluded that our disclosure controls and procedures were effective as of the end of the period covered by this annual report. 

Management’s Report on Internal Control over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting (as defined in Rules 
13a-15(f) and 15(d)-15(f) under the Exchange Act). Our internal control system is designed to provide reasonable assurance to 
management and our board of directors regarding the preparation and fair presentation of published financial statements. 

Because of its inherent limitations, internal control over financial reporting may not prevent or detect all 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. 

Under the supervision and with the participation of management, including our Principal Executive Officer and Principal Financial 
Officer, we have assessed the effectiveness of our internal control over financial reporting as of December 31, 2018. In making our 
assessment of internal control over financial reporting, we used the criteria issued in the report Internal Control-Integrated Framework 
(2013) by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). We have concluded that our internal 
control over financial reporting was effective as of December 31, 2018 based on these criteria. 

This annual report does not include an attestation report of our independent registered public accounting firm regarding internal 
control over financial reporting. Management’s report was not subject to attestation by our independent registered public accounting 
firm pursuant to the exemption from Section 404(b) of the Sarbanes-Oxley Act for non-accelerated filers provided by the Dodd-Frank 
Wall Street Reform and Consumer Protection Act. 

Changes in Internal Control over Financial Reporting 

During the fourth quarter of 2018, there were no changes in our internal control over financial reporting that have materially affected, 
or are reasonably likely to materially affect, our internal control over financial reporting.

Limitations on the Effectiveness of Controls 

Our management, including our Principal Executive Officer and Principal Financial Officer, does not expect that our disclosure 
controls and procedures or our internal control over financial reporting will prevent all errors and all fraud. A control system, no 
matter how well designed and operated, can provide only reasonable, not absolute, assurance that the objectives of the control system 
are met. Because of the inherent limitations in all control systems, no evaluation of controls can provide absolute assurance that all 
control issues and instances of fraud, if any, within our company have been detected. 

Item 9B. Other Information 

None 

67

 
Item 10. Directors, Executive Officers and Corporate Governance 

PART III

Our directors, executive officers and key employees as of February 22, 2019 are as follows: 

Name

Age

Position

Dr. Michael R. Bristow .....................................................
Thomas A. Keuer...............................................................
Christopher D. Ozeroff .....................................................
Brian L. Selby....................................................................
Dr. Linda Grais (1) (2)*.....................................................
Dr. Raymond L. Woosley (2) (3)* ....................................
Mr. Robert E. Conway (1)* (2) .........................................
Mr. Dan J. Mitchell (1) (3) ................................................
Dr. Anders Hove (3) ..........................................................

74
60
60
57
62
76
65
61
53

President and Chief Executive Officer and Director
Chief Operating Officer
Secretary, Senior Vice President and General Counsel
Vice President, Finance and Chief Accounting Officer
Director
Director
Director
Director
Director

*     Committee Chairperson

(1)  Member of the Audit Committee

(2)  Member of the Compensation Committee

(3)  Member of the Nominating and Corporate Governance Committee

Michael R. Bristow, M.D., Ph.D. Dr. Bristow was one of the founders of ARCA in September 2004, and has served as a 
Director since that time.  Dr. Bristow has also served as the Company’s President and Chief Executive Officer since July 2009.  
Previously, Dr. Bristow served as the President and Chief Executive Officer of the Company from September 2004 to November 2006, 
and as the Company’s Chief Science and Medical Officer from November 2006 to July 2009. Dr. Bristow is a Professor of Medicine 
and the former Head of Cardiology at the University of Colorado Health Sciences Center, where he has been since October 1991.  Dr. 
Bristow was one of the founders of Myogen, Inc. and served as Myogen’s Chief Science and Medical Officer from October 1996 to 
February 2006 and as a Scientific Advisor to Myogen from February 2006 until the acquisition of Myogen by Gilead Sciences, Inc. in 
November 2006.  We believe Dr. Bristow is an appropriate member of the Company’s Board of Directors given his extensive 
experience and expertise as a cardiologist, medical researcher and drug developer in the field of cardiovascular medicine, and heart 
failure specifically, and his experience as a founder and manager of cardiovascular-focused, public pharmaceutical company.  Dr. 
Bristow also has extensive experience with, and knowledge of, ARCA’s business, as the founder and former Chief Science and 
Medical Officer of the Company, and the current President and Chief Executive Officer of ARCA, and as a member of the Board of 
Directors of ARCA since the founding of the Company. Dr. Bristow holds a M.D. and Ph.D. from the University of Illinois.

Thomas A. Keuer. Mr. Keuer has served as the Company’s Chief Operating Officer since December 2014. Mr. Keuer served 
as the Company’s Executive Vice President, Pharmaceutical Operations from 2006 to 2014. Prior to joining the Company, Mr. Keuer 
served as the SVP of Operations for Insmed, Inc. from 2004 to 2006.  Prior to Insmed, Mr. Keuer served as the VP of Engineering for 
Baxter Healthcare from 1998 to 2004. Prior to Baxter, Mr. Keuer served as the VP of Operations for Somatogen, Inc. Mr. Keuer 
received his M.S. in Biochemical Engineering from Rice University and received his B.S. in Chemical Engineering from the 
University of Texas, Austin.

Christopher D. Ozeroff.  Mr. Ozeroff is a co-founder of ARCA.  Mr. Ozeroff has served as the Company’s Senior Vice 

President, General Counsel and Secretary since 2009, has served as the Company’s General Counsel and Secretary since the 
Company’s founding, and has also served as Executive Vice President, Business Development from 2004 to 2009. Prior to joining the 
Company, Mr. Ozeroff was a partner with the law firm of Hogan & Hartson L.L.P., where he practiced in such areas as finance, 
acquisitions, public offerings, and licensing.  Mr. Ozeroff completed his undergraduate degree at Stanford University and his law 
degree at the University of Chicago Law School. 

Brian L. Selby.  Mr. Selby has served as the Company’s Vice President, Finance and Chief Accounting Officer since 

December 2014.  Previously, Mr. Selby served as the Company’s Controller from 2007 to 2014.  Prior to joining the Company, Mr. 
Selby served as the Controller for Myogen, Inc., a publicly traded pharmaceutical company subsequently acquired by Gilead, from 
2004 to 2007.  Prior to Myogen, Mr. Selby served as the Controller for several private and publicly traded companies and earlier in his 
career was an audit professional with Deloitte.  Mr. Selby received his M.S. in Accounting from the University of Colorado and 
received his B.S., in Business Administration and Finance from Colorado State University, and is a certified public accountant.

68

 
Linda Grais, M.D. Dr. Grais has served as a member of the Board of Directors since May 2007.  Dr. Grais has been a director 

of Ocera Therapeutics, Inc., a public biopharmaceutical company, since January 2008 and became President and Chief Executive 
Officer of Ocera in June 2012, and served in that role until Ocera’s acquisition by Mallinckrodt Pharmaceuticals in December 2017. 
Dr. Grais served as a Managing Member at InterWest Partners, a venture capital firm from May 2005 until February 2011. From July 
1998 to July 2003, Dr. Grais was a founder and executive vice president of SGX Pharmaceuticals Inc., a drug discovery company. 
Prior to that, she was a corporate attorney at Wilson Sonsini Goodrich & Rosati, where she practiced in such areas as venture 
financings, public offerings and strategic partnerships. Before practicing law, Dr. Grais worked as an assistant clinical professor of 
Internal Medicine and Critical Care at the University of California, San Francisco. Dr. Grais received a B.A. from Yale University, 
magna cum laude, and Phi Beta Kappa, an M.D. from Yale Medical School and a J.D. from Stanford Law School. Since September 
2015, Dr. Grais has served on the board of PRA Health Sciences, a public contract research organization. Dr. Grais also joined the 
boards of Corvus Pharmaceuticals and Zosano Pharma Corp., both publicly traded pharmaceutical companies, in January 2019. We 
believe Dr. Grais is an appropriate member of the Board of Directors because of her diverse training and experience as both a medical 
doctor and a lawyer, her experience as a founder and senior executive of a pharmaceutical company, and her experience as an investor 
in new life sciences companies. She also has extensive experience with and knowledge of the Company's business from her service on 
the Board of Directors of the Company since 2007.

Raymond L. Woosley, M.D., Ph.D. Dr. Woosley was appointed to the Board of Directors in July 2013. Since 2012, Dr. 

Woosley is the Director of the Arizona Center for Education and Research on Therapeutics (AzCERT), an independent, nonprofit 
research and education organization. Dr. Woosley is currently the President Emeritus of the Critical Path Institute (C-Path), a non-
profit, public-private partnership with the Federal Food and Drug Administration, of which he was a founder in November 2004, and 
where he served as President, Chief Executive Officer and Chairman of the board of directors from 2005 to 2011. Since 2012, Dr. 
Woosley has also been the Director of AzCERT, an independent, nonprofit research and education organization. Since 2001, Dr. 
Woosley has also been a Professor of Medicine and Pharmacology at The University of Arizona Health Sciences Center (UAHSC), 
and, since 2012, Professor Emeritus, where he was also Vice President for Health Sciences from 2001 to 2005, and Dean of the 
College of Medicine from 2001 to 2002. Since 2015, he has been Professor of Medicine in the University of Arizona, College of 
Medicine-Phoenix. From 1988 to 2001, Dr. Woosley was a professor of medicine at the Georgetown University School of Medicine, 
where he was also Director of the Institute of Cardiovascular Sciences from 1994 to 2000, and Division Chief, Clinical Pharmacology, 
in the Department of Medicine from 1988 to 1994. Dr. Woosley earned his Ph.D. in Pharmacology from the University of Louisville 
and his M.D. from the University of Miami. Dr. Woosley’s research has been published in over 312 peer-reviewed publications and 50 
book chapters. We believe Dr. Woosley is an appropriate member of the Board of Directors, given his expertise and experience in 
cardiovascular clinical pharmacology, anti-arrhythmic therapeutics, pharmacogenetic drug development and therapeutic regulatory 
approval.

Robert E. Conway  Mr. Conway was appointed to the Board of Directors in September 2013, and has served as the Chairman 

of our Board of Directors since 2014.  Mr. Conway served as the Chief Executive Officer and member of the board of directors of 
Array Biopharma, a publicly traded pharmaceutical company, from 1999 to 2012.  Prior to joining Array, Mr. Conway was the Chief 
Operating Officer and Executive Vice President of Hill Top Research, Inc., from 1996 to 1999.  From 1979 until 1996, Mr. Conway 
held various executive positions for Corning Inc. including Corporate Vice President and General Manager of Corning Hazleton, Inc., 
a contract research organization.  From 2004 to 2013, he served on the board of directors of PRA International, Inc., which was a 
public company for a portion of his tenure there, from 2012 to the present, he has served on the board of directors of eResearch 
Technology, Inc., a private company, and from 2015 to July 2017, he has served on the board of directors of Nivalis Therapeutics, Inc. 
a public, clinical stage pharmaceutical company.  In July 2017, Nivalis Therapeutics, Inc. combined with Alpine Immune 
Sciences, Inc., a public, clinical stage pharmaceutical company, and Mr. Conway continues to serve on the board of directors 
following such combination.   In addition, Mr. Conway is a member of the Strategic Advisory Committee of Genstar Capital, LLC and 
is a member of the board of directors of CRF Bracket, Inc. and ClinOne, Inc.  Mr. Conway received a B.S. in accounting from 
Marquette University in 1976.  We believe Mr. Conway is an appropriate member of the Board of Directors given his experience and 
expertise in the pharmaceutical industry, in pharmaceutical development and clinical trials, and in corporate finance, governance, 
accounting and public company compliance.

Dan J. Mitchell Mr. Mitchell was appointed to the Board of Directors in February 2014.  He founded, and is a manager of 

Sequel Venture Partners, L.L.C., a venture capital firm formed in January 1997.  Prior to founding Sequel Venture Partners, Mr. 
Mitchell was a founder of Capital Health Venture Partners, a health care focused venture capital firm, where he was a General Partner 
from October 1986 until 2006, and he was in the Venture Capital Division of the Trust Department of the First National Bank of 
Chicago from 1983 to 1985.  He currently serves on the board of directors of several private companies.  Mr. Mitchell holds a B.S. 
from the University of Illinois and an M.B.A. from the University of California at Berkeley. We believe Mr. Mitchell is an appropriate 
member of the Board of Directors given his expertise and experience in the pharmaceutical industry, pharmaceutical development, and 
in corporate finance and governance.

69

 
Anders Hove, M.D. Dr. Hove has served as a member of the Board of Directors since February 2017.  Dr. Hove owns Acorn 
Capital Advisors and is a partner at Amzak Health, a partnership focusing on long-term investments in biotech, specialty pharma and 
medical device companies. Dr. Hove was most recently a general partner of Venrock Associates, a venture capital firm, which he 
joined in January 2004 and remained at through December 2016. In 2008, Dr. Hove was a founder of Venrock Healthcare Capital 
Partners, Venrock’s public funds focused on small capitalization biotech companies and late-stage private companies. From 1996 to 
2004, Dr. Hove was a fund manager at BB Biotech Fund, an investment firm, and from 2002 to 2003 he also served as Chief 
Executive Officer of Bellevue Asset Management, LLC, an investment company. Dr. Hove previously held senior level positions in 
the medical, clinical and business operations of the pharmaceuticals division of Ciba-Geigy and Novartis.  Mr. Hove was a member of 
the boards of directors of Anacor Pharmaceuticals, a publicly traded pharmaceutical company, from 2005 until its acquisition by 
Pfizer in June 2016, and Edge Therapeutics, a publicly traded biotechnology company, from 2015 to 2016.  In addition, Dr. Hove is a 
member of the board of directors of MC2 Therapeutics. He received a M.Sc. in Biotechnology Engineering from the Technical 
University of Denmark, an M.D. from the University of Copenhagen and an M.B.A. from the Institut Européen d'Administration des 
Affaires (INSEAD).  We believe Dr. Hove is an appropriate member of the Company’s Board of Directors, given his extensive 
training and experience as a medical doctor and masters of business administration, an executive in the pharmaceutical industry, and 
as an investor in biotechnology companies.

ADDITIONAL INFORMATION REGARDING THE BOARD OF DIRECTORS AND CORPORATE GOVERNANCE 

Election of Board of Directors

Directors are elected by a plurality of the votes of the holders of shares present in person or represented by proxy and entitled to 

vote on the election of directors at our annual stockholders’ meetings. The Company’s Amended and Restated Certificate of 
Incorporation, as amended, provides that the Board of Directors is divided into three classes to provide for staggered terms and that 
each director will serve for a term of three years or less, depending on the class to which the Board of Directors has assigned a director 
not previously elected by the stockholders. There are currently two Class I directors whose terms expire at the annual stockholders’ 
meeting in 2019, two Class II directors whose terms expire at the annual meeting in 2020 and two Class III directors whose terms 
expire at the annual stockholders’ meeting in 2021.  The two Class I directors, Dr. Linda Grais and Dr. Anders Hove, are currently 
scheduled for re-election to the Board of Directors at the 2019 annual stockholders’ meeting, for a three-year term ending on the date 
of the annual meeting in 2022 or until their successors are duly elected and qualified or appointed. 

Our executive officers are appointed by and serve at the discretion of our Board. There are no family relationships between our 

directors and executive officers.

Section 16(a) Beneficial Ownership Reporting Compliance 

Section 16 of the Exchange Act requires the Company’s directors and executive officers, and persons who own more than 10% 

of its common stock, to file with the SEC initial reports of ownership and reports of changes in ownership of common stock of the 
Company. Such persons are required by SEC regulation to furnish us with copies of all Section 16(a) forms that they file. 

To the Company’s knowledge, based solely upon its review of the copies of such reports furnished to it and written 

representations that no other reports were required, during the fiscal year ended December 31, 2018, all Section 16(a) filing 
requirements applicable to its officers, directors and ten percent beneficial owners were complied with.

Code of Ethics 

The Company has adopted the ARCA biopharma, Inc. Code of Business Conduct and Ethics that applies to all officers, directors 

and employees. The Code of Business Conduct and Ethics is available on the Company’s website at www.arcabiopharma.com. If the 
Company makes any substantive amendments to the Code of Business Conduct and Ethics or grants any waiver from a provision of 
the Code of Business Conduct and Ethics to any executive officer or director, the Company will promptly disclose the nature of the 
amendment or waiver on its website and file any current report on Form 8-K required by applicable law or NASDAQ listing 
standards.

Audit Committee

The Audit Committee was established by the Board of Directors in accordance with Section 3(a)(58)(A) of the Exchange 

Act, to oversee the Company’s corporate accounting and financial reporting processes and audits of its financial statements.  For this 
purpose, the Audit Committee performs several functions.  The Audit Committee evaluates the performance of and assesses the 
qualifications of the independent registered public accounting firm; determines and approves the engagement of the independent 
registered public accounting firm; determines whether to retain or terminate the existing independent registered public accounting firm 
or to appoint and engage a new independent registered public accounting firm; reviews and approves the retention of the independent 
registered public accounting firm to perform any proposed permissible non-audit services; monitors the rotation of partners of the 

70

 
independent registered public accounting firm on the Company’s audit engagement team as required by law; reviews and approves or 
rejects transactions between the company and any related persons; confers with management and the independent registered public 
accounting firm regarding the effectiveness of internal controls over financial reporting; establishes procedures, as required under 
applicable law, for the receipt, retention and treatment of complaints received by the Company regarding accounting, internal 
accounting controls or auditing matters and the confidential and anonymous submission by employees of concerns regarding 
questionable accounting or auditing matters; and meets to review the Company’s annual audited financial statements and quarterly 
financial statements with management and the independent registered public accounting firm, including a review of the Company’s 
disclosures under the “Management’s Discussion and Analysis of Financial Condition and Results of Operations” discussion in its 
Annual Reports on Form 10-K and Quarterly Reports on Form 10-Q.  As of December 31, 2018, the Audit Committee was composed 
of three directors: Mr. Conway (chair), Mr. Mitchell and Dr. Grais.  The Audit Committee met four times during the fiscal year.  The 
Board of Directors has adopted a written charter of the Audit Committee that is available to stockholders on the Company’s website at 
www.arcabio.com.

The Board of Directors reviews the Nasdaq listing standards definition of independence for audit committee members on an 

annual basis and has determined that all members of the Audit Committee are independent (as independence is currently defined in 
Rule 5605(c)(2)(A)(i) and (ii) of the Nasdaq listing standards).  The Board of Directors has also determined that Mr. Conway qualifies 
as an “audit committee financial expert,” as defined in applicable SEC rules.  The Board of Directors made a qualitative assessment of 
Mr. Conway’s level of knowledge and experience based on several factors, including his prior experience, business acumen and 
independence.  

Report of the Audit Committee of the Board of Directors1

The Audit Committee has reviewed and discussed the audited financial statements for the fiscal year ended 

December 31, 2018, with management of the Company.  The Audit Committee has discussed with the independent registered public 
accounting firm the matters required to be discussed by Public Company Accounting Oversight Board (“PCAOB”) Auditing Standard 
No. 1301, Communications with Audit Committees.  The Audit Committee has also received the written disclosures and the letter 
from the independent registered public accounting firm required by applicable requirements of the PCAOB regarding the independent 
registered public accounting firm’s communications with the Audit Committee concerning independence, and has discussed with the 
independent registered public accounting firm the accounting firm’s independence.  Based on the foregoing, the Audit Committee has 
recommended to the Board of Directors that the audited financial statements be included in the Company’s Annual Report on Form 
10-K for the fiscal year ended December 31, 2018.

Mr. Robert Conway
Mr. Dan Mitchell
Dr. Linda Grais

Compensation Committee

The Compensation Committee is currently composed of three directors: Mr. Conway, Dr. Grais (chair) and Dr. Woosley. 

All members of the Compensation Committee are independent, as independence is currently defined in Rule 5605(a)(2) of the Nasdaq 
listing standards. The Compensation Committee met one time during the fiscal year. The Compensation Committee has adopted a 
written charter that is available to stockholders on the Company’s website at www.arcabio.com.

The Compensation Committee of the Board of Directors acts on behalf of the Board of Directors to review, adopt and 

oversee the Company’s compensation strategy, policies, plans and programs, including:

●   overseeing succession planning for senior management of the Company, including a review of the performance and 
advancement potential of current and future senior management and succession plans for each and recommending, 
as appropriate, the retention of potential succession candidates;

●   assessing the overall compensation structure of the Company and evaluating and recommending changes to the 

Company’s compensation philosophies and strategies;

●   reviewing and approving performance-based compensation plans or programs, including establishing goals and 

targets, applicable to the Chief Executive Officer and other members of the management team;

1  The material in this report is not “soliciting material,” is not deemed “filed” with the Commission and is not to be incorporated by 

reference in any filing of the Company under the Securities Act of 1933, as amended, or the Exchange Act, whether made before or 
after the date hereof and irrespective of any general incorporation language in any such filing.

71

 
 
 
 
 
 
 
●  administering, reviewing, and approving all executive compensation programs or plans, and all of the Company’s 
incentive compensation and stock plans and awards thereunder of the Company, including amendments to the 
programs, plans or awards made thereunder; and

 ● preparing and approving the Report of the Compensation Committee to be included as part of the Company’s 

annual meeting proxy statement, to the extent required.

Compensation Committee Processes and Procedures

Typically, the Compensation Committee meets on a regular basis as it deems appropriate. The agenda for each meeting is 
usually developed by the Chair of the Compensation Committee. The Compensation Committee meets regularly in executive session. 
However, from time to time, various members of management and other employees as well as outside advisors or consultants may be 
invited by the Compensation Committee to make presentations, to provide financial or other background information or advice or to 
otherwise participate in Compensation Committee meetings. The Chief Executive Officer may not participate in, or be present during, 
any deliberations or determinations of the Compensation Committee regarding his compensation or individual performance objectives. 
The Compensation Committee has the sole authority to retain compensation consultants to assist in its evaluation of executive and 
director compensation, including the authority to approve the consultant’s reasonable fees and other retention terms.

In June 2013, the Company’s Compensation Committee reviewed the Company’s executive compensation considering 

general market conditions in the life science industry. As part of this review process, the Compensation Committee identified a peer 
group of biotechnology companies that it viewed as having a similar profile to ARCA at that time.

In setting 2018 base salary and cash bonus award amounts for the Company’s named executive officers, the Compensation 

Committee considered peer group data and factors specific to the Company, and targeted cash compensation to be consistent with 
these metrics. The Compensation Committee recommended, and the Board of Directors approved, a base salary of $295,359 for Dr. 
Bristow, the Company’s President and Chief Executive Officer, a base salary of $294,170 for Mr. Keuer, the Company’s Chief 
Operating Officer, and a base salary of $288,683 for Mr. Ozeroff, the Company’s Senior Vice President and General Counsel, for the 
fiscal year ended December 31, 2016. In early 2017, the Compensation Committee recommended, and the Board of Directors 
approved cash bonuses based on previous performance for the Named Executive Officers (as defined below), and also approved 
increases to Named Executive Officer salaries for the fiscal year 2017 as described in below under “Executive Compensation.”  There 
were no changes to the Named Executive Officers’ salaries for 2018 and the Compensation Committee has yet to review or approve 
salaries for our Named Executive Officers in 2019.

Historically, the Compensation Committee has made most of the significant adjustments to annual compensation, 
determined bonus and equity awards and established new performance objectives at one or more meetings held during the first quarter 
of the year. However, the Compensation Committee also considers matters related to individual compensation, such as compensation 
for new executive hires, as well as high-level strategic issues, such as the efficacy of the Company’s compensation strategy, potential 
modifications to that strategy and new trends, plans or approaches to compensation, at various meetings throughout the year. 
Generally, the Compensation Committee’s process comprises two related elements: the determination of compensation levels and the 
establishment of performance objectives for the current year.

The Compensation Committee reviews and approves the compensation of the Chief Executive Officer and the other 

executive officers of the Company, including annual base salaries, annual and long-term incentive or bonus awards, employment 
agreements, and severance and change in control agreements/provisions, in each case as, when and if appropriate, and any special or 
supplemental benefits. For executives other than the Chief Executive Officer, the Compensation Committee solicits and considers 
evaluations and recommendations submitted to the Compensation Committee by the Chief Executive Officer. The Compensation 
Committee evaluates the performance of the Chief Executive Officer in light of Company and individual goals and objectives, and 
makes appropriate recommendations for improving performance. In performing the evaluation, the Chair of the Compensation 
Committee may solicit comments from the other non-employee members of the Board of Directors and lead the Board of Directors in 
an overall review of the Chief Executive Officer’s performance in an executive session of non-employee members of the Board of 
Directors. If the compensation for the Chief Executive Officer or any other executive officer is governed by an employment 
agreement, the Compensation Committee approves such employment agreement and any amendments thereto.

For all executives as part of its deliberations, the Compensation Committee may review and consider, as 

appropriate, materials such as financial reports and projections, operational data, tax and accounting information, tally sheets that set 
forth the total compensation that may become payable to executives in various hypothetical scenarios, executive and director stock 

72

 
 
 
ownership information, company stock performance data, analyses of historical executive compensation levels and current Company-
wide compensation levels.

The Compensation Committee also considers the results of any “say-on-pay” vote of the Company’s stockholders with 

regard to the compensation of the Company’s executive officers when making compensation decisions. At the 2016 annual meeting of 
stockholders, the Company’s stockholders approved, on an advisory basis, the compensation of the Company’s named executive 
officers as described in the proxy statement for such annual meeting. The Compensation Committee believes that this advisory vote 
supports that the Company’s current compensation practices are aligned with the best interests of stockholders and anticipates taking 
into account any subsequent advisory vote when making compensation decisions in the future.

Nominating and Corporate Governance Committee

The Nominating and Corporate Governance Committee is responsible for identifying, reviewing and evaluating candidates 

to serve as directors of the Company (consistent with criteria approved by the Board of Directors), reviewing and evaluating 
incumbent directors, recommending to the Board of Directors candidates for election to the Board of Directors, making 
recommendations to the Board of Directors regarding compensation for service on the Board of Directors and the committees thereof, 
making recommendations to the Board of Directors regarding the membership of the committees of the Board of Directors, assessing 
the performance of the Board of Directors and developing a set of corporate governance principles for the Company. As of 
December 31, 2018, the Nominating and Corporate Governance Committee was composed of three directors: Dr. Hove, Mr. Mitchell 
and Dr. Woosley (chair). All members of the Nominating and Corporate Governance Committee in 2018 were independent (as 
independence is currently defined in Rule 5605(a)(2) of the Nasdaq listing standards). The Nominating and Corporate Governance 
Committee met three times during the 2018 fiscal year. The Nominating and Corporate Governance Committee has adopted a written 
charter that is available to stockholders on the Company’s website at www.arcabio.com.

The Nominating and Corporate Governance Committee periodically reviews the compensation of non-employee Directors 
for service on the Board of Directors and committees thereof. In 2015, the Nominating and Corporate Governance Committee began a 
review of its Director compensation levels considering general market conditions in the life science industry, and in comparison to 
other clinical stage biopharmaceutical companies, and in early 2016, the Committee recommended, and the Board of Directors 
approved, revised compensation for non-employee Directors, discussed in “Director Compensation” below.

The Board of Directors has adopted a process for identifying and evaluating director nominees, including stockholder 

nominees. Before recommending an individual to the Board of Directors for membership on the Board of Directors, the Nominating 
and Corporate Governance Committee canvasses its members and the Company’s management team for potential candidates for the 
Board of Directors. The Nominating and Corporate Governance Committee also uses its network of contacts to identify potential 
candidates and, if it deems appropriate, may also engage a professional search firm. The Nominating and Corporate Governance 
Committee will consider stockholders’ recommendations for nominees to serve as director if notice is timely received by the Secretary 
of the Company. Candidates nominated by stockholders will be evaluated in the same manner as other candidates. The Nominating 
and Corporate Governance Committee keeps the Board of Directors apprised of its discussions with potential nominees, and the 
names of potential nominees received from its current directors, management, and stockholders, if the stockholder notice of 
nomination is timely made.

Although the Board of Directors has not adopted a fixed set of minimum qualifications for candidates for membership on 

the Board of Directors, the Nominating and Corporate Governance Committee generally considers several factors in its evaluation of a 
potential member, such as the candidate’s education, professional background and field of expertise including industry or academic 
experience in the pharmaceutical and biotechnology fields, experience in corporate governance and management, the reasonable 
availability of the potential member to devote time to the affairs of the Company, as well as any other criteria deemed relevant by the 
Board of Directors or the Nominating and Corporate Governance Committee. However, the Nominating and Corporate Governance 
Committee retains the right to modify these qualifications from time to time. Candidates for director nominees are reviewed in the 
context of the current composition of the Board of Directors, the operating requirements of the Company and the long-term interests 
of stockholders. In conducting this assessment, the Nominating and Corporate Governance Committee typically considers diversity, 
age, skills and such other factors as it deems appropriate given the current needs of the Board of Directors and the Company, to 
maintain a balance of knowledge, experience and capability. The Nominating and Corporate Governance Committee believes it is 
essential that Board of Directors members come from a variety of backgrounds and experiences.

In the case of incumbent directors whose terms of office are set to expire, the Nominating and Corporate Governance 

Committee reviews these directors’ overall contributions to the Company and the Board of Directors during their terms, including 
level of attendance, level of participation, quality of performance and contribution to the Board of Directors’ responsibilities and 
actions, and any relationships and transactions that might impair the directors’ independence. In the case of new director candidates, 
the Nominating and Corporate Governance Committee also determines whether the nominee is independent for Nasdaq and SEC 
purposes, which determination is based upon applicable Nasdaq listing standards, applicable SEC rules and regulations and the advice 
73

 
of counsel, if necessary. The Nominating and Corporate Governance Committee conducts any appropriate and necessary inquiries into 
the backgrounds and qualifications of possible candidates after considering the function and needs of the Board of Directors. The 
Nominating and Corporate Governance Committee meets to discuss and consider the candidates’ qualifications and then determines 
whether to recommend a nominee to the Board of Directors by majority vote.

Stockholders who wish to recommend individuals for consideration by the Nominating and Corporate Governance Committee 
to become nominees for election to the Board of Directors may do so by delivering a written recommendation to the Nominating and 
Corporate Governance Committee addressed to the Corporate Secretary, between 60 and 90 days before the one year anniversary date 
of ARCA’s last annual meeting of stockholders. Recommendations must include the full name of the proposed nominee, a description 
of the proposed nominee’s business experience for at least the previous five years, complete biographical information, a description of 
the proposed nominee’s qualifications as a director, and a representation that the recommending stockholder is a beneficial or record 
owner of ARCA’s stock. Any such submission must be accompanied by the written consent of the proposed nominee to be named as a 
nominee and to serve as a director if elected. To date, the Nominating and Corporate Governance Committee has not rejected a timely 
director nominee from a stockholder.

In 2018, the Nominating and Corporate Governance Committee did not pay any fees to assist in the process of identifying 

or evaluating director candidates.

Stockholder Communications with the Board of Directors

Stockholders who wish to communicate with the Board of Directors may do so by e-mail by using the following email 

address: directors@arcabio.com; or by mail by following the directions as set forth on ARCA’s website at www.arcabio.com, under 
the section titled “Corporate Governance” and the subsection titled “Governance Documents”.

Item 11. Executive Compensation 

Executive Compensation

The following table shows for the fiscal years ended December 31, 2018 and December 31, 2017, compensation awarded to, 

paid to, or earned by the Company’s principal executive officer and its two most highly compensated executive officers as of 
December 31, 2018, collectively, the Named Executive Officers:

SUMMARY COMPENSATION TABLE FOR FISCAL 2018 AND 2017

Name and Principal Position
Michael R. Bristow 
President and Chief Executive Officer .... 2018
2017

Year

Thomas A. Keuer
Chief Operating Officer ........................... 2018
2017

Christopher D. Ozeroff 
Secretary, Senior Vice President and 
General Counsel  ...................................... 2018
2017

Salary 
($)(1)

Option 
Awards 
($)(2)

Non-Equity 
Incentive Plan 
Awards ($)(3)

All Other 
Compensation ($)

Total ($)

304,219
302,856

—
137,281

303,000
301,642

—
80,428

—
91,300

—
54,500

16,271
16,256
23,786

20,597

297,343
296,011

—
76,654

—
53,500

12,914
12,110

320,490
547,693

326,786
457,167

310,257
438,275

(1)

(2)

The amounts reported under “Salary” in the above table represent the actual amounts paid during the calendar year.  Because the Company’s actual 
pay dates do not always coincide with the first and last days of the year, these amounts may differ from the base salary amounts authorized by the 
Company’s Board of Directors and described in the narrative that follows.  

The amounts reported under “Option Awards” in the above table reflect the grant date fair value of these awards as determined in accordance with 
Financial Accounting Standards Board Accounting Standards Codification Topic 718, Compensation – Stock Compensation, excluding the effects 
of estimated forfeitures.  The vesting schedule for options included in the above table are included in the table of “Outstanding Equity Awards at 
Fiscal Year End” below. The value of stock option awards was estimated using the Black-Scholes option-pricing model.  The valuation 
assumptions used in the valuation of option grants may be found in Note 8 to the Company’s financial statements included in this annual report on 
Form 10-K for the year ended December 31, 2018.

(3)

Represents cash bonuses earned under the 2017 Bonus Plan.  Cash bonuses earned and reported above in 2017 were paid in 2018.  No 2018 cash 
bonus plan was adopted for the 2018 fiscal year and, accordingly, the Company does not anticipate paying any bonuses for 2018 performance in 
2019.  See “Executive Compensation” for descriptions of the 2017 Bonus Plan.

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Narrative Disclosure to Summary Compensation Table

Employment Agreements or Arrangements 

Michael R. Bristow, M.D., Ph.D. Dr. Bristow serves as the Company’s President and Chief Executive Officer under an 
Employment and Retention Agreement dated as of June 4, 2008, as amended.  Pursuant to such employment agreement, Dr. Bristow is 
permitted to continue his academic work for the University of Colorado Health Sciences Center and for the Cardiovascular Institute, 
so long as it does not interfere with his duties as President and Chief Executive Officer of ARCA. 

On February 16, 2017, the Board of Directors approved a 2017 base salary of $304,219 for Dr. Bristow.

On March 1, 2018, the Board of Directors approved a cash bonus of $91,300 for Dr. Bristow.  The cash bonus was earned 

under the 2017 Bonus Plan for services rendered in 2017.  See “Non-Equity Incentive Plan Compensation” below for descriptions of 
the 2017 Bonus Plan. There were no changes to the Named Executive Officers’ salaries for 2018 and the Compensation Committee 
has yet to review or approve salaries for our Named Executive Officers in 2019. 

If the Company terminates Dr. Bristow’s employment without “cause,” or if Dr. Bristow terminates his employment with 
“good reason” (as these terms are defined in his employment agreement), the Company has agreed to pay Dr. Bristow a severance 
payment equivalent to (i) (a) 12 months of his base salary, if such termination occurs on the same day as or within 13 months after a 
change of control of the Company,  or (b) six months of his base salary if such termination does not occur on the same day as or 
within 13 months after a change of control of the Company, (ii) a pro rata portion of any bonus compensation under any employee 
bonus plan that has been approved by the Board of Directors payable to him for the fiscal year in which his employment terminated to 
be paid at the same time that such incentive bonus would have been paid had the termination not occurred, and (iii) reimbursement to 
cover out-of-pocket costs to continue group health insurance benefits under COBRA for 6 months, whether he elects or is eligible to 
receive COBRA (provided, that even if he does not elect or is not eligible to receive COBRA, he will receive the equivalent of such 
out-of-pocket expenses paid by him not to exceed the costs that the benefits would equal under COBRA if he were so eligible).  In 
addition, ARCA may elect in its sole discretion, to pay additional severance equal to up to 6 months of base salary, which additional 
payment would extend the covenants and obligations under Dr. Bristow’s Employee Intellectual Property, Confidentiality and Non-
Compete Agreement for such additional period.  The severance payment is conditioned on the execution by Dr. Bristow of a legal 
release in a form acceptable to the Company.  A termination for “cause” includes Dr. Bristow’s willful misconduct, gross negligence, 
theft, fraud, or other illegal or dishonest conduct, any of which are considered to be materially harmful to the Company; refusal, 
unwillingness, failure, or inability to perform his material job duties or habitual absenteeism; or violation of fiduciary duty, violation 
of any duty of loyalty, or material breach of any material term of his employment agreement or his Employee Intellectual Property, 
Confidentiality and Non-Compete Agreement, or any other agreement, with the Company.  “Good reason” includes a relocation by us 
of Dr. Bristow’s normal work location greater than 30 miles; a decrease in current base salary by more than 15%, with certain 
exceptions; and the Company’s unilateral decision to significantly and detrimentally reduce Dr. Bristow’s job responsibilities. 

Thomas A. Keuer. Mr. Keuer serves as the Company’s Chief Operating Officer under an Amended and Restated 

Employment Agreement that was effective as of January 1, 2015. 

Under his employment agreement, Mr. Keuer is entitled to receive an annual base salary of $280,000, subject to annual 

increases if approved by the Company’s Board of Directors or Compensation Committee and is eligible to receive an annual bonus as 
determined by the Board of Directors or Compensation Committee in its sole discretion.

On February 16, 2017, the Board of Directors approved a 2017 base salary of $303,000 for Mr. Keuer.

On March 1, 2018, the Board of Directors approved a cash bonus of $54,500 for Mr. Keuer.  The cash bonus was earned 

under the 2017 Bonus Plan for services rendered in 2017.  See “Non-Equity Incentive Plan Compensation” below for descriptions of 
the 2017 Bonus Plan. There were no changes to the Named Executive Officers’ salaries for 2018 and the Compensation Committee 
has yet to review or approve salaries for our Named Executive Officers in 2019. 

 If the Company terminates Mr. Keuer’s employment without “cause,” or if Mr. Keuer terminates his employment with 
“good reason” (as these terms are defined in his employment agreement), the Company has agreed to pay Mr. Keuer a severance 
payment equivalent to (i) (a) 12 months of his base salary, if such termination occurs on the same day as or within 13 months after a 
change of control of the Company,  or (b) six months of his base salary if such termination does not occur on the same day as or 
within 13 months after a change of control of the Company, (ii) a pro rata portion of any bonus compensation under any employee 

75

 
bonus plan that has been approved by the Board of Directors payable to him for the fiscal year in which his employment terminated to 
be paid at the same time that such incentive bonus would have been paid had the termination not occurred, and (iii) reimbursement to 
cover out-of-pocket costs to continue group health insurance benefits under COBRA for (x) 12 months, if such termination occurs on 
the same day as or within 13 months after a change of control of the Company,  or (y) six months if such termination does not occur 
on the same day as or within 13 months after a change of control of the Company, whether he elects or is eligible to receive COBRA 
(provided, in either event, that even if he does not elect or is not eligible to receive COBRA, he will receive the equivalent of such out-
of-pocket expenses paid by him not to exceed the costs that the benefits would equal under COBRA if he were so eligible). In 
addition, ARCA may elect in its sole discretion, to pay additional severance equal to up to 12 months of base salary, which additional 
payment would extend the covenants and obligations under Mr. Keuer’s Employee Intellectual Property, Confidentiality and Non-
Compete Agreement for such additional period. The severance payment is conditioned on the execution by Mr. Keuer of a legal 
release in a form acceptable to the Company. A termination for “cause” includes Mr. Keuer’s willful misconduct, gross negligence, 
theft, fraud, or other illegal or dishonest conduct, any of which are considered to be materially harmful to the Company; refusal, 
unwillingness, failure, or inability to perform his material job duties or habitual absenteeism; or violation of fiduciary duty, violation 
of any duty of loyalty, or material breach of any material term of his employment agreement or his Employee Intellectual Property, 
Confidentiality and Non-Compete Agreement, or any other agreement, with the Company. “Good reason” includes a relocation by us 
of Mr. Keuer’s normal work location greater than 30 miles; a decrease in current base salary by more than 15%, with certain 
exceptions; and the Company’s unilateral decision to significantly and detrimentally reduce Mr. Keuer’s job responsibilities.

Christopher D. Ozeroff. Mr. Ozeroff serves as the Company’s Senior Vice President and General Counsel under an 

Employment and Retention Agreement dated as of June 12, 2008, as amended.

Under his employment agreement, Mr. Ozeroff is entitled to receive an annual base salary of $259,000, subject to annual 

increases if approved by the Company’s Board of Directors or Compensation Committee and is eligible to receive an annual bonus as 
determined by the Board of Directors or Compensation Committee in its sole discretion.  

On February 16, 2017, the Board of Directors approved a 2017 base salary of $297,343 for Mr. Ozeroff. 

On March 1, 2018, the Board of Directors approved a cash bonus of $53,500 for Mr. Ozeroff.  The cash bonus was earned 

under the 2017 Bonus Plan for services rendered in 2017.  See “Non-Equity Incentive Plan Compensation” below for descriptions of 
the 2017 Bonus Plan. There were no changes to the Named Executive Officers’ salaries for 2018 and the Compensation Committee 
has yet to review or approve salaries for our Named Executive Officers in 2019. 

If the Company terminates Mr. Ozeroff’s employment without “cause,” or if Mr. Ozeroff terminates his employment with 
“good reason” (as these terms are defined in his employment agreement), the Company has agreed to pay Mr. Ozeroff a severance 
payment equivalent to (i) (a) 12 months of his base salary, if such termination occurs on the same day as or within 13 months after a 
change of control of the Company,  or (b) six months of his base salary if such termination does not occur on the same day as or 
within 13 months after a change of control of the Company, (ii) a pro rata portion of any bonus compensation under any employee 
bonus plan that has been approved by the Board of Directors payable to him for the fiscal year in which his employment terminated to 
be paid at the same time that such incentive bonus would have been paid had the termination not occurred, and (iii) reimbursement to 
cover out-of-pocket costs to continue group health insurance benefits under COBRA for 6 months, whether he elects or is eligible to 
receive COBRA (provided, that even if he does not elect or is not eligible to receive COBRA, he will receive the equivalent of such 
out-of-pocket expenses paid by him not to exceed the costs that the benefits would equal under COBRA if he were so eligible).  In 
addition, ARCA may elect in its sole discretion, to pay additional severance equal to up to 6 months of base salary, which additional 
payment would extend the covenants and obligations under Mr. Ozeroff’s Employee Intellectual Property, Confidentiality and Non-
Compete Agreement for such additional period.  The severance payment is conditioned on the execution by Mr. Ozeroff of a legal 
release in a form acceptable to the Company.  A termination for “cause” includes Mr. Ozeroff’s willful misconduct, gross negligence, 
theft, fraud, or other illegal or dishonest conduct, any of which are considered to be materially harmful to the Company; refusal, 
unwillingness, failure, or inability to perform his material job duties or habitual absenteeism; or violation of fiduciary duty, violation 
of any duty of loyalty, or material breach of any material term of his employment agreement or his Employee Intellectual Property, 
Confidentiality and Non-Compete Agreement, or any other agreement, with the Company.  “Good reason” includes a relocation by us 
of Mr. Ozeroff’s normal work location greater than 30 miles; a decrease in current base salary by more than 15%, with certain 
exceptions; and the Company’s unilateral decision to significantly and detrimentally reduce Mr. Ozeroff’s job responsibilities.

76

 
Non-Equity Incentive Plan Compensation

In February 2007, the Compensation Committee and the Board of Directors of ARCA established a bonus structure for its entire 

executive team.  The philosophy employed was to create incentives for the executive officers to achieve key corporate goals.  The 
Compensation Committee retained discretion to change the bonus structure and the bonus payment amounts as it considered 
appropriate. 

2017 Cash Bonus Plan

The Board of Directors has set corporate goals for 2017, or the 2017 Goals, which may be updated at the Board of Directors’ 

discretion during 2017. Attainment of the 2017 Goals is a prerequisite to the payment of any awards to employees under the 
Company’s 2017 Cash Bonus Plan, including executive officers.

The amount payable to each employee is set as a target percentage of each employee’s annual salary, or the target bonus 

percentage, or TBP, but employees, including executive officers, may receive more or less than 100% of their TBP, based upon 
corporate goal achievement, individual performance and the discretion of the Board of Directors.

To receive a cash bonus (if any), each individual employee must be actively employed by the Company, and in good standing, 
on December 31, 2017.  Employees hired after January 1, 2017, will have their cash bonus (if any) prorated based on the percentage of 
time the employee worked at ARCA in 2017. The 2017 Goals are based on (1) the GENETIC-AF Data and Safety Monitoring Board 
analysis and enrollment of GENETIC-AF; (2) financing goals; and (3) corporate transaction objectives.

2018 Cash Bonus Plan

The Compensation Committee and Board of Directors did not approve a bonus structure or goals for 2018. As such, the 

Company does not anticipate paying any cash bonuses to its Named Executive Officers in 2019 for performance in the 2018 fiscal 
year.

Other Elements of Executive Compensation Program 

The remaining elements of the Company’s executive compensation program, like its broader employee compensation 

programs, are intended to make the Company’s overall compensation program competitive with those of its peer companies, keeping 
in mind the constraints imposed by the Company’s reliance on capital markets as a primary source of cash.  The remaining elements 
of the Company’s executive compensation program, (401(k) Plan, Medical, Dental, and Vision Plans, Life and Disability Insurance) 
are available to all Company employees.

77

 
OUTSTANDING EQUITY AWARDS AT FISCAL YEAR END

The following table shows for the fiscal year ended December 31, 2018, certain information regarding outstanding equity 

awards at fiscal year end for the Named Executive Officers.

A description of the equity incentive plans we maintain is set forth in Note 8 to the Company’s financial statements included 

in this annual report on Form 10-K.

Option Awards

Name
Michael R. Bristow, President and Chief Executive Officer ...

Thomas A. Keuer, Chief Operating Officer.............................

Christopher Ozeroff, Secretary, Senior Vice President and 

General Counsel................................................................

Number of 
Securities 
Underlying 
Unexercised 
Options
(#) Exercisable
596
380
714
28,142
12,260
7,357
3,700
22,667
25,667
584
190
476
4,775
1,428
1,500
1,950
13,000
15,400
152
476
6,091
1,500
1,850
12,334
14,667

Number of 
Securities 
Underlying 
Unexercised 
Options
(#)Unexercisable
—
—
—
—
—
—
—

4,533(1)(3)
16,333(2)(3)

—
—
—
—
—
—
 —

  2,600 (1)(3)
9,800 (2)(3)

—
—
—
—
—

2,466 (1)(3)
9,333 (2)(3)

Option 
Exercise 
Price
      ($)

Option
Expiration
     Date

233.94
124.74
94.08
9.66
9.66
13.65
4.69
3.30
2.50
121.80
124.74
94.08
9.66
10.85
13.65
4.69
3.30
2.50
124.74
94.08
9.66
13.65
4.69
3.30
2.50

1/23/2019
2/18/2020
5/20/2021
9/16/2023
9/16/2023
2/26/2024
2/11/2025
6/8/2026
2/15/2027
6/25/2019
2/18/2020
5/20/2021
9/16/2023
10/14/2023
2/26/2024
2/11/2025
6/8/2026
2/15/2027
2/18/2020
5/20/2021
9/16/2023
2/26/2024
2/11/2025
6/8/2026
2/15/2027

(1) Options vest in 36 monthly installments measured from June 9, 2016.
(2) Options vest in 36 monthly installments measured from February 16, 2017.
(3) In the event of a change in control of the Company, 50% of the unvested shares subject to this award shall become fully and immediately vested upon the 

closing date of such change in control, provided, however, that on the earlier of (i) the one-year anniversary of the closing date or (ii) involuntary termination, 
any options that remain unvested on such earlier date shall become fully and immediately vested.

78

 
 
Option Exercises And Stock Vested 

The following table sets forth certain information regarding option exercises and restricted stock units that vested during the 

year ended December 31, 2018, with respect to the Named Executive Officers: 

Name 
Michael R. Bristow ........................
Thomas A.  Keuer ................................
Christopher Ozeroff ..................................

Option Awards 

Stock Awards 

Number of
Shares
Acquired on
Exercise
(#) 

Value
Realized
on Exercise
($)(1) 

Number of
Shares
Acquired on
Vesting
(#) 

— 
—
— 

— 
—
— 

4,316 
2,429
2,367

Value
Realized
on Vesting
($)(2) 

2,477 
1,403
1,371

(1) The value realized on exercise of the options equals the difference between the market price of the underlying stock at exercise 

and the exercise or base price of the options, multiplied by the number of shares acquired on exercise. 

(2) The value realized on vesting of restricted stock units equals the market value of the Company's Common Stock on the vesting 

date, multiplied by the number of shares that vested. 

79

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
DIRECTOR COMPENSATION 

The following table shows for the fiscal year ended December 31, 2018, certain information with respect to the compensation 

of all non-employee directors of the Company:

DIRECTOR COMPENSATION FOR FISCAL 2018 (1)

Linda Grais, M.D. (3) ............................
Raymond L. Woosley, M.D. (4)............
Robert E. Conway (5)............................
Dan J. Mitchell (6).................................
Anders Hove (7) ....................................

Fees Earned
or Paid in
Cash ($)
52,500
50,000
80,000
47,500
40,000

Option
Awards
($)(2)

4,640
4,640
4,640
4,640
4,640

Nonqualified
Deferred
Compensation
Earnings
($) 

All Other
Compensation
($)

—
—
—
—
—

—
—
—
—
—

Total ($)
57,140
54,640
84,640
52,140
44,640

(1)

(2)

(3)

(4)

(5)

(6)

(7)

Dr. Bristow, our President and Chief Executive Officer, was also a director during the year ended December 31, 2018, but did not receive any additional 
compensation for his service as a director.  Dr. Bristow’s compensation as an executive officer is set forth above under “Executive Compensation—Summary 
Compensation Table.”
The amounts reported under “Option Awards” in the above table reflect the aggregate grant date fair value of these awards as determined in accordance with 
Financial Accounting Standards Board Accounting Standards Codification Topic 718, Compensation – Stock Compensation, excluding the effects of estimated 
forfeitures.  The value of stock option awards was estimated using the Black-Scholes option-pricing model.  The valuation assumptions used in the valuation of 
option awards may be found in Note 8 to the Company’s financial statements included in this annual report on Form 10-K for the year ended 
December 31, 2018.
The aggregate number of shares issuable upon exercise of option awards outstanding at December 31, 2018, for Dr. Grais was 30,138, of which all shares were 
fully vested. 
The aggregate number of shares issuable upon exercise of option awards outstanding at December 31, 2018, for Dr. Woosley was 29,063, of which all shares 
were fully vested.
The aggregate number of shares issuable upon exercise of option awards outstanding at December 31, 2018, for Mr. Conway was 28,941, of which all shares 
were fully vested.
The aggregate number of shares issuable upon exercise of option awards outstanding at December 31, 2018, for Mr. Mitchell was 28,438, of which all shares 
were fully vested.
The aggregate number of shares issuable upon exercise of option awards outstanding at December 31, 2018, for Dr. Hove was 18,000, of which all shares were 
fully vested.

In 2016, the Company revised its compensation plan for non-employee directors to provide that non-employee directors will 

be compensated for their service on the Board of Directors, as follows:

•

Each non-employee director will receive an annual retainer fee of $35,000;

• As  additional  compensation  for  their  services,  each  non-employee  director  will  receive  (i),  upon  joining  the  Board  of 
Directors, an initial option grant to purchase 10,000 shares of the Company’s Common Stock under the Amended and 
Restated  ARCA  2013  Equity  Incentive  Plan,  as  amended,  or  the  Amended  2013  Plan  and  (ii),  on  an  annual  basis,  an 
annual option grant to purchase 8,000 shares of the Company’s Common Stock under the Amended 2013 Plan;

•

•

•

•

•

The Chairman of the Board of Directors will receive an additional annual retainer fee of $25,000;

The Audit Committee chair will receive an additional annual retainer fee of $15,000;

The chairs of the Compensation Committee and the Nominating and Corporate Governance Committee will each receive 
an additional annual retainer fee of $10,000;

Each non-chair member of the Audit Committee will receive an additional annual retainer fee of $7,500; and

Each  non-chair  member  of  the  Compensation  Committee  and  the  Nominating  and  Corporate  Governance  Committees 
will receive an additional annual retainer fee of $5,000.

At the March 1, 2018, meeting of the Board of Directors, the Board of Directors awarded annual stock option grants to the 
Company’s non-employee directors.  Mr. Mitchell, Dr. Grais, Dr. Woosley, Mr. Conway and Dr. Hove each were granted options to 
purchase 8,000 shares of Common Stock under the Amended 2013 Plan vesting over one year.  The purchase price for the options 
issued on March 1, 2018, was $0.72 per share, which was equal to the closing price of the Company’s Common Stock on Nasdaq on 
the date of the grant.  If the non-employee director’s service terminates in connection with or at any time following a change in 
control, then any unexpired options that remain unvested shall become fully vested.

80

 
Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters 

The following table sets forth information as of December 31, 2018, for all of our equity compensation plans:

EQUITY COMPENSATION PLAN INFORMATION

No. of Securities 
to be Issued Upon 
Exercise of 
Outstanding Options 
Units
(a)

Weighted Average 
Exercise 
Price of Outstanding 
Options
($)
(b)

Equity compensation plans approved by 

security holders ....................................
Equity compensation plans not approved 
by security holders ...............................

604,003

— 

Total...........................................

604,003

5.37

—

5.37

No. of Securities 
Remaining 
Available for 
Future Issuance Under 
Equity Compensation
Plans Excluding Securities 
Reflected in 
Column(a)
(c)

615,976

—

615,976

On September 17, 2013, our stockholders approved the ARCA biopharma, Inc. 2013 Equity Incentive Plan, or the 2013 Plan, 

at the Company’s 2013 annual meeting of stockholders.  The 2013 Plan is the successor to the Amended and Restated ARCA 
biopharma, Inc. 2004 Equity Incentive Plan, or the 2004 Plan.  On June 9, 2016, our stockholders approved the Amended 2013 Plan. 
A description of the 2013 Plan and the Amended 2013 Plan is set forth in Note 8 to the Company’s financial statements included in 
this annual report on Form 10-K.  

Compensation Risks 

We believe our approach to goal setting, setting of targets with payouts at multiple levels of performance, and evaluation of 
performance results assist in mitigating excessive risk-taking that could harm the value or reward poor judgment by our executives.  
We believe several features of our programs reflect sound risk management practices.  We believe we have allocated compensation 
among base salary and short and long-term compensation target opportunities in such a way as to not encourage excessive risk-taking.  
The multi-year vesting of equity awards properly accounts for the time horizon of risk.  Furthermore, the Compensation Committee 
assesses and monitors whether any of our compensation policies and programs has the potential to encourage excessive risk-taking on 
an annual basis.

Security Ownership of Certain Beneficial Owners

The following table sets forth certain information regarding the ownership of the Company’s Common Stock as of 
February 22, 2019, by: (i) each director and nominee for director, (ii) each of our named executive officers, (iii) all executive officers 
and directors of the Company as a group, and (iv) all those known by the Company to be beneficial owners of more than five percent 
of its Common Stock.  Unless otherwise noted below, the address of each beneficial owner listed on the table is c/o ARCA biopharma, 
Inc., 11080 CirclePoint Road, Suite 140, Westminster, Colorado, 80020.  

We have determined beneficial ownership in accordance with the rules of the SEC.  Except as indicated by the footnotes 

below, we believe, based on the information furnished to us, that the persons and entities named in the table below have sole voting 
and investment power with respect to all shares of Common Stock that they beneficially own, subject to applicable community 
property laws.  The table is based upon information supplied by officers, directors and principal stockholders and Schedules 13G or 
13D, Form 4s or other ownership reports filed with the SEC.  For purposes of this table, certain of our outstanding warrants that may 
be exercisable for fractional shares have been rounded down to the nearest whole number. 

81

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In computing the number of shares of Common Stock beneficially owned by a person and the percentage ownership of that 

person, we deemed outstanding shares of Common Stock subject to options, restricted stock units,  or warrants held by that person that 
are currently exercisable or exercisable within 60 days of February 22, 2019.  We did not deem these shares outstanding, however, for 
the purpose of computing the percentage ownership of any other person. 

The percentages below are based on 18,335,111 shares of our Common Stock outstanding as of February 22, 2019.

Beneficial Owner
Directors and Named Executive Officers
Michael R. Bristow, M.D., Ph.D. (1).......................................
Thomas A. Keuer (2) ...............................................................
Christopher D. Ozeroff (3).......................................................
Linda Grais, M.D. (4) ..............................................................
Robert E. Conway (5) ..............................................................
Raymond L. Woosley (6).........................................................
Dan J. Mitchell (7) ...................................................................
Anders Hove, M.D. (8) ............................................................
All current directors and executive officers as a group (9 
persons) (9).........................................................................

5% Stockholders
Tekla Life Sciences Investors  (10) .........................................
Renaissance Technologies LLC (11) .......................................

Shares 
Beneficially
Owned

Percentage of 
Shares
Beneficially 
Owned

212,997
56,990
58,898
30,138
63,941
29,063
39,438
18,000

1.15%
*
*
*
*
*
*
*

548,400

2.93%

1,135,718
818,533

6.08%
4.46%

*
(1)

Represents beneficial ownership of less than 1% of our Common Stock. 
Includes the following owned by (i) Investocor Trust: 19,986 shares, Dr. Bristow is the sole trustee of Investocor Trust; (ii) NFS 
as Custodian for Michael Bristow’s IRA: (a) 25,459 shares and (b) 17,821 shares issuable upon the exercise of warrants, which 
warrants are immediately exercisable; and (iii) options to purchase 108,576 shares that are exercisable within 60 days of 
February 22, 2019. 
Includes options to purchase 43,837 shares that are exercisable within 60 days of February 22, 2019.
Includes options to purchase 41,381 shares that are exercisable within 60 days of February 22, 2019.  
Includes options to purchase 30,138 shares that are exercisable within 60 days of February 22, 2019.
Includes options to purchase 28,941 shares that are exercisable within 60 days of February 22, 2019.
Includes options to purchase 29,063 shares that are exercisable within 60 days of February 22, 2019.
Includes options to purchase 28,438 shares that are exercisable within 60 days of February 22, 2019.
Includes options to purchase 18,000 shares that are exercisable within 60 days of February 22, 2019.  

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9) See Notes (1) through (8) above. Also, includes additional options to purchase 38,934 shares that are exercisable within 60 days 

of February 22, 2019 beneficially owned by our executive officers not listed by name in the table above.

(10) Based on a Schedule 13G/A filed with the SEC on February 12, 2019. Includes 324,491 shares issuable upon exercise of 

warrants, which warrants are immediately exercisable. Tekla Capital Management LLC (“TCM”), as an investment adviser to 
Tekla Life Sciences Investors (“HQL”), shares beneficial ownership over the shares held by HQL. Each of TCM and Daniel R. 
Omstead, through his control of TCM, has sole power to dispose of the shares beneficially owned by HQL. Neither TCM nor 
Daniel R. Omstead has the sole power to vote or direct the vote of the shares beneficially owned by HQL, which power resides 
in the fund’s Board of Trustees. TCM carries the voting of shares under written guidelines established by the funders Board of 
Trustees. The address for Tekla Life Sciences Investors is 100 Federal Street, 19th Floor, Boston, MA 02110.

(11) Based upon a Schedule 13G filed with the SEC on February 12, 2019. Renaissance Technologies Holdings Corporation is 

deemed to beneficially own the shares owned by Renaissance Technologies LLC, because of Renaissance Technologies 
Holdings Corporation’s majority ownership of Renaissance Technologies LLC. The address for Renaissance Technologies 
Holdings Corporation and Renaissance Technologies LLC is 800 Third Avenue, New York, NY 10022. 

82

 
Item 13. Certain Relationships and Related Transactions, and Director Independence 

Independence of the Board of Directors

As required under the Nasdaq listing standards, a majority of the members of a listed company’s board of directors must 

qualify as “independent,” as affirmatively determined by the board of directors.  Our Board of Directors consults with the Company’s 
counsel to ensure that the Board of Directors’ determinations are consistent with relevant securities and other laws and regulations 
regarding the definition of “independent,” including those set forth in pertinent listing standards of the Nasdaq, as in effect from time 
to time. 

Consistent with these considerations, after review of all relevant identified transactions or relationships between each 
director, or any of his or her family members, and the Company, its senior management and its independent registered public 
accounting firm, the Board of Directors has affirmatively determined that the following five directors are independent directors within 
the meaning of the applicable Nasdaq listing standards: Mr. Conway, Dr. Grais, Mr. Mitchell, Dr. Hove and Dr. Woosley.  In making 
this determination, the Board of Directors found that none of the directors or nominees for director had a material or other 
disqualifying relationship with the Company.  Dr. Bristow, the Company’s President and Chief Executive Officer is not an 
independent director by virtue of his employment relationship with the Company. 

Certain Transactions With or Involving Related Persons

The following is a summary of transactions since January 1, 2017, to which we have been a party in which the amount 

involved exceeded the lesser of $120,000 or one percent of the average of our total assets at fiscal year end for 2017 and 2018, and in 
which any of our executive officers, directors or holders of more than 5% of our capital stock, or any member of the immediate family 
of any of the foregoing persons, had or will have a direct or indirect material interest, other than compensation arrangements disclosed 
in “Item 11. Executive Compensation” of this Form 10-K.

Transactions With the Company’s President and Chief Executive Officer

The Company has entered into unrestricted research grants with the academic research laboratory of Dr. Bristow, the 

Company’s President and Chief Executive Officer, at the University of Colorado.  Funding of any unrestricted research grants is 
contingent upon the Company’s financial condition, and can be deferred or terminated at the Company’s discretion. Total expense 
under these arrangements for the years ended December 31, 2018 and 2017 was approximately $325,000 and $418,000, respectively, 
of which $111,000 was unpaid and included in Accrued expenses and other liabilities as of December 31, 2018.

Policies and Procedures for Related Party Transactions

Our Audit Committee reviews and approves all related party transactions.  This review covers any material transaction, 
arrangement or relationship, or any series of similar transactions, arrangements or relationships, in which we were or are to be a 
participant, and a related party had or will have a direct or indirect material interest, including, purchases of goods or services by or 
from the related party or entities in which the related party has a material interest, indebtedness, guarantees of indebtedness and 
employment by us of a related party. 

83

 
Item 14. Principal Accountant Fees and Services 

The following table represents aggregate fees billed, or expected to be billed, to us for the fiscal years ended 

December 31, 2018 and December 31, 2017, by KPMG LLP, our independent registered public accounting firm.

Fiscal Year 
Ended 2018

Fiscal Year 
Ended 2017

Audit Fees (1)....................................
Audit-related Fees .............................
Tax Fees ............................................
All Other Fees ...................................
All Other Fees ...................................
Total Fees  .........................................

$154,500
—
—
—

$154,500 

$193,500
—
—
—
-
$193,500

(1) Audit Fees include fees for the (i) audit of the financial statements included in our Form 10-K for 

our fiscal years ended December 31, 2018, and December 31, 2017, (ii) review of interim financial statements 
included on Forms 10-Q and (iii) attest, consent and review services normally provided by the accountant in 
connection with SEC filings. 

All fees described above were approved by the Audit Committee.

PRE-APPROVAL POLICIES AND PROCEDURES

The above services performed by the independent registered public accounting firm were pre-approved in accordance with 

the pre-approval policy and procedures adopted by the Audit Committee.  This policy describes the permitted audit, audit-related, tax, 
and other services that our independent registered public accounting firm may perform.  The policy also requires that our independent 
registered public accounting firm provide in writing:

•

•

•

an annual description of all relationships between the independent registered public accounting firm and the client that 
may reasonably be thought to bear on independence; 

confirm that, in the independent registered public accounting firm’s professional judgment, the independent registered 
public accounting firm is independent of the client under SEC requirements; 

discuss with the Audit Committee the independent registered public accounting firm’s independence and the potential 
effects on its independence of performing any non-audit related services. 

The services expected to be performed by our independent registered public accounting firm during the subsequent fiscal year 

are presented to the Audit Committee for pre-approval.  Any pre-approval must describe, in writing, the particular service or category 
of services. 

Requests for audit, audit-related, tax, and other services not contemplated by those pre-approved services must be submitted 

to the Audit Committee for specific pre-approval.  Generally, pre-approval is considered at the Audit Committee’s regularly scheduled 
meetings.  However, the authority to grant specific pre-approval between meetings, as necessary, has been delegated to the chairman 
of the Audit Committee.  If the chairman is not available, the other two Audit Committee members together have the authority to grant 
specific pre-approval between meetings.  The chairman or the other members must update the Audit Committee at the next regularly 
scheduled meeting of any services that were granted specific pre-approval. 

The Audit Committee pre-approved all audit related services rendered in 2018 and did not rely on the waiver of pre-approval 

requirement provided by paragraph (c)(7)(i)(C) of Rule 2-01 of Regulation S-X promulgated under the Exchange Act.

84

 
     
Item 15. Exhibits and Financial Statement Schedules 

(a)

The following documents are filed as part of this Report: 

PART IV 

1. Financial statements filed as part of this Report are listed under Part II, Item 8, page 49 of this Annual Report on Form 

10-K. 

2. No schedules are required because either the required information is not present or is not present in amounts sufficient to 

require submission of the schedule, or because the information required is included in the consolidated financial statements 
or the notes thereto. 

(b)

Exhibits 

A list of exhibits filed with this report or incorporated herein by reference is found in the Exhibit Index. 

85

 
EXHIBIT INDEX 

Description 

Form

Incorporated by Reference

Filing
Date

Number

Filed
Herewith 

Exhibit
No.

3.1

3.1(a)

3.1(b)

3.2

4.1

4.2

4.3

4.4

4.5

10.1§

10.2

10.4†

10.5†

10.6†

10.7†

10.8†

10.9†

10.10†

10.11†

Amended and Restated Certificate of Incorporation of the 
Registrant, as amended.

10-K  

3/27/2009

Certificate of Amendment to Restated Certificate of 
Incorporation.

8-K  

3/5/2013

Certificate of Amendment to Restated Certificate of 
Incorporation.

8-K

9/3/2015

Second Amended and Restated Bylaws of the Registrant, as 
amended.

10-Q  

11/16/2009

Form of Common Stock Certificate.

Form of Warrants to Purchase Shares of Common Stock.

Form of Warrant to Purchase shares of Common Stock.

Form of Warrant to Purchase shares of Common Stock.

Reference is made to Exhibits 3.1, 3.1(a), 3.1(b) and 3.2

8-K  

8-K  

8-K

8-K

1/28/2009

1/23/2013

6/11/2015

6/11/2015

License and Sublicense Agreement, dated October 28, 2003, 
by and between ARCA Discovery, Inc. and CPEC, L.L.C.

10-Q  

5/15/2009

Amendment  to  License  and  Sublicense  Agreement,  dated 
February 22,  2006,  by  and  between  ARCA  Discovery,  Inc. 
and CPEC L.L.C.

10-Q  

5/15/2009

8-K  

8-K  

1/28/2009

1/28/2009

Amendment No. 1 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

Amendment No. 2 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

8-K  

1/28/2009

Amendment No. 3 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

8-K  

1/28/2009

Amendment No. 4 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

8-K  

1/28/2009

Amendment No. 5 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

8-K

1/28/2009

Amendment No. 6 to the ARCA Discovery, Inc. 2004 Stock 
Incentive Plan.

8-K  

1/28/2009

ARCA biopharma, Inc. 2004 Stock Incentive Plan, Form of 
Executive Incentive Stock Option Agreement.

8-K  

1/28/2009

ARCA biopharma, Inc. 2004 Stock Incentive Plan, Form of 
Non-Executive Incentive Stock Option Agreement.

8-K  

1/28/2009

86

10.3†

ARCA Discovery, Inc. 2004 Stock Incentive Plan.

3.1

5.1

3.1

3.2

4.1

4.1

4.1

4.2

10.1

10.2

10.1

10.2

10.3

10.4

10.5

10.6

10.7

10.8

10.9

 
   
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
   
 
 
  
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
Exhibit
No.

10.12†

10.13†

10.14†

10.15†

10.16†

10.17†

10.18†

10.19

10.20†

10.21

10.22†

10.23†

10.24†

Description 

Form

Incorporated by Reference

Filing
Date

Number

Filed
Herewith 

ARCA biopharma, Inc. 2004 Stock Incentive Plan, Form of 
Nonqualified Stock Option Agreement.

8-K  

1/28/2009

10.10  

ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan  (f/k/a 
Nuvelo,  Inc.  2004  Equity  Incentive  Plan),  Form  of  Partial 
Acceleration Stock Option Agreement.

ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan  (f/k/a 
Nuvelo,  Inc.  2004  Equity  Incentive  Plan),  Form  of  No 
Acceleration Stock Option Agreement.

ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan  (f/k/a 
Nuvelo, Inc. 2004 Equity Incentive Plan), Form of Director 
Stock Option Agreement.

ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan  (f/k/a 
Nuvelo, Inc. 2004 Equity Incentive Plan), Form of Notice of 
Grant of Stock Option.

ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan  (f/k/a 
Nuvelo, Inc. 2004 Equity Incentive Plan), Form of Notice of 
Director Grant of Stock Option.

Amended  and  Restated  Employment  and  Retention 
Agreement,  dated  June 4,  2008,  by  and  between  ARCA 
biopharma, Inc. and Michael R. Bristow.

Assignment  and  Assumption  Agreement,  dated  January 26, 
2009,  by  and  between  ARCA  biopharma,  Inc.  and  ARCA 
biopharma Colorado, Inc.

Amended  and  Restated  Employment  Agreement,  dated 
June 12,  2008,  by  and  between  ARCA  biopharma,  Inc.  and 
Christopher D. Ozeroff.

Assignment  and  Assumption  Agreement,  dated  January 26, 
2009,  by  and  between  ARCA  biopharma,  Inc.  and  ARCA 
biopharma Colorado, Inc.

10-K  

3/27/2009

10.34  

10-K  

3/27/2009

10.35  

10-K  

3/27/2009

10.36  

10-K  

3/27/2009

10.37  

10-K  

3/27/2009

10.38  

10-K  

3/27/2009

10.43

10-K  

3/27/2009

10.46

10-K  

3/27/2009

10.45  

10-K  

3/27/2009

10.48  

Amended and Restated ARCA biopharma, Inc. 2004 Equity 
Incentive Plan.

  10-Q/A  

8/21/2009

Form of Option Amendment pursuant to ARCA biopharma, 
Inc. 2004 Equity Incentive Plan and ARCA biopharma, Inc. 
2004 Stock Option Plan (change of control).

Form  of  Option  Agreement  and  Grant  Notice  pursuant  to 
ARCA  biopharma,  Inc.  2004  Equity  Incentive  Plan 
(NDA/change of control acceleration).

10-Q  

8/10/2009

10-Q  

8/10/2009

10.1

10.5

10.6

10.25

Form  of  Indemnification  Agreement  between  ARCA 
biopharma, Inc. and its directors and officers.

10-K  

3/27/2009

10.52  

10.26

Form of Subscription Agreement.

10.27

Capital  on  DemandTM Sales  Agreement,  dated  January 11, 
2017,  by  and  between  ARCA  biopharma,  Inc.  and 
JonesTrading Institutional Services LLC.

8-K  

8-K  

4/18/2011

1/11/2017

10.1

10.1

87

 
   
 
 
 
 
  
 
 
   
 
  
 
 
   
 
  
 
 
   
 
  
 
 
   
 
  
 
 
   
 
  
 
 
   
 
  
 
   
  
 
 
   
 
 
  
 
 
   
 
  
 
 
   
 
  
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
  
 
 
   
 
 
  
 
 
   
 
 
Description 

Form

Incorporated by Reference

Filing
Date

8-K  

8/21/2017

Filed
Herewith 

Number

10.1

8-K  

1/25/2019

10.1

Exhibit
No.

10.28

10.29

10.30§

Amendment No. 1 to Capital on DemandTM Sales 
Agreement, dated August 21, 2017, by and between ARCA 
biopharma, Inc. and JonesTrading Institutional 
Services LLC.

Amendment No. 2 to Capital on DemandTM Sales 
Agreement, dated January 25, 2019, by and between ARCA 
biopharma, Inc. and JonesTrading Institutional 
Services LLC.

Amended and Restated Exclusive License Agreement, dated 
August 12,  2011,  by  and  between  the  Regents  of  the 
University of Colorado and ARCA biopharma, Inc.

10-Q  

8/15/2011

10.31

Form of Subscription Agreement.

10.32

Form of Registration Rights Agreement.

10.33

Form of Subscription Agreement.

10.34

Form  of  Subscription  Agreement  by  and  among  the 
Company  and  the  purchasers  identified  therein,  dated 
October 22, 2012.

10.35

Form of Registration Rights Agreement.

10.36

Form  of  Subscription  Agreement  by  and  among  the 
Company  and  the  purchasers  identified  therein,  dated 
December 18, 2012.

10.37

Form of Registration Rights Agreement.

10.38

10.39

Form of Amendment to the Registration Rights Agreement, 
dated December 18, 2012.

Form  of  Subscription  Agreement  by  and  among  the 
Company  and  the  purchasers  identified  therein,  dated 
January 22, 2013.

10.40

Form of Registration Rights Agreement.

10.41

Subscription Agreement.

Placement  Agency  Agreement  by  and  between  ARCA 
biopharma,  Inc.  and  Dawson  James  Securities,  Inc.,  dated 
January 21, 2014.

Amendment  No.  1  Placement  Agency  Agreement  by  and 
between  ARCA  biopharma,  Inc.  and  Dawson  James 
Securities, Inc., dated January 31, 2014.

8-K  

8-K  

8-K  

8-K  

8-K  

8-K  

8-K  

8-K  

12/22/2011

12/22/2011

8/3/2012

10/23/2012

10/23/2012

12/19/2012

12/19/2012

12/19/2012

8-K  

1/23/2013

8-K  

8-K  

8-K  

1/23/2013

2/1/2013

2/4/2014

8-K  

2/4/2014

Securities Purchase Agreement by and among the Company 
and the purchasers identified therein, dated June 10, 2015.

8-K  

6/11/2015

Office Lease Agreement by and between ARCA biopharma, 
Inc.  and  Circle  Point  Properties,  LLC,  effective  August  1, 
2013.

8-K  

8/6/2013

88

10.42

10.42(a)

10.43

10.44

10.5

10.1

10.2

10.1

10.1

10.2

10.1

10.2

10.3

10.1

10.2

10.1

1.1

1.2

10.1

10.1

 
   
 
 
 
 
  
 
 
   
  
 
 
   
  
 
 
   
 
 
  
 
 
   
 
 
  
 
   
  
 
 
   
 
 
  
 
 
   
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
  
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
Description 

Amendment to Office Lease Agreement by and between 
ARCA biopharma, Inc. and Circle Point Properties, LLC, 
effective March 2, 2016.

Incorporated by Reference

Filing
Date

Number

Filed
Herewith 

3/7/2016

10.1

Form

8-K

Exhibit
No.

10.45

10.46†

10.47†

10.49†

10.50†

10.51†

10.52†

10.53†

10.54†

10.55†

23.1

24.1

31.1

31.2

32.1

10.48†

ARCA biopharma, Inc. 2013 Equity Incentive Plan.

Amendment Agreement by and between ARCA biopharma, 
Inc. and Michael R. Bristow, effective as of June 13, 2013.

10-Q  

8/13/2013

Amendment Agreement by and between ARCA biopharma, 
Inc. and Christopher Ozeroff, effective as of June 13, 2013.

10-Q  

8/13/2013

8-K  

8-K  

9/23/2013

9/23/2013

Form of Stock Option Agreement and Option Grant Notice 
under 2013 Equity Incentive Plan (Standard).

Form of Stock Option Agreement and Option Grant Notice 
under 2013 Equity Incentive Plan (Officer).

8-K  

9/23/2013

Form of Stock Option Agreement and Option Grant Notice 
under 2013 Equity Incentive Plan (Director).

8-K  

9/23/2013

Form of Restricted Stock Unit Award Agreement and Notice 
of Grant Award under 2013 Equity Incentive Plan 
(Standard).

8-K  

9/23/2013

Form of Restricted Stock Unit Award Agreement and Notice 
of Grant Award under 2013 Equity Incentive Plan (Officer).

8-K  

9/23/2013

Employment Agreement, dated December 29, 2014, by and 
between ARCA biopharma, Inc. and Brian Selby.

  8-K/A  

12/30/2014

Amended and Restated Employment Agreement, dated 
December 29, 2014, by and between ARCA biopharma, Inc. 
and Thomas A. Keuer.

  8-K/A  

12/30/2014

Consent of KPMG LLP, Independent Registered Public 
Accounting Firm.

Power of Attorney (included in the signature page hereto).

Certification of Principal Executive Officer pursuant to Rule 
13a-14(a) or 15d-14(a) under the Securities Exchange Act of 
1934, as adopted pursuant to Section 302 of the Sarbanes-
Oxley Act of 2002.

Certification of Principal Financial Officer pursuant to Rule 
13a-14(a) or 15d-14(a) under the Securities Exchange Act of 
1934, as adopted pursuant to Section 302 of the Sarbanes-
Oxley Act of 2002.

Certification of Principal Executive Officer and Principal 
Financial Officer pursuant to 18 U.S.C. sec. 1350, as 
adopted pursuant to Section 906 of the Sarbanes-Oxley Act 
of 2002.

101.INS

XBRL Instance Document (filed electronically herewith)

101.SCH

XBRL Taxonomy Extension Schema Document (filed 
electronically herewith)

89

10.6

10.8

10.1

10.2

10.3

10.4

10.5

10.6

10.1

10.2

X

X

X

X

X

X

X

 
   
 
 
 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
   
  
 
   
 
 
  
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
   
 
 
  
 
 
 
 
   
 
 
Exhibit
No.

101.CAL

101.LAB

101.PRE

101.DEF

Description 

Form

Incorporated by Reference

Filing
Date

Number

Filed
Herewith 

XBRL Taxonomy Extension Calculation Linkbase 
Document (filed electronically herewith)

XBRL Taxonomy Extension Label Linkbase Document 
(filed electronically herewith)

XBRL Taxonomy Extension Presentation Linkbase 
Document (filed electronically herewith)

XBRL Taxonomy Extension Definition Linkbase Document 
(filed electronically herewith)

X

X

X

X

†

§

Indicates management contract or compensatory plan or arrangement required to be filed as an exhibit pursuant to Item 15(b) 
of Form 10-K. 

Confidential treatment has been requested for portions of this document, which are omitted and filed separately with the SEC. 
Omitted portions have been filed with the Securities and Exchange Commission pursuant to Rule 24b-2 of the Securities 
Exchange Act of 1934, as amended. 

90

 
   
 
 
 
 
  
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
  
 
 
 
 
 
   
 
 
 
Pursuant to the requirements of Section 13 or 15(d) the Securities Exchange Act of 1934, the Registrant has duly caused this report to 
be signed on its behalf by the undersigned, thereunto duly authorized. 

SIGNATURES 

ARCA biopharma, Inc.

By: 

/S/ BRIAN L. SELBY
Brian L. Selby
Vice President, Finance
(Principal Financial Officer and Principal Accounting Officer)

Date: February 27, 2019

POWER OF ATTORNEY 

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints 
Michael R. Bristow and Brian L. Selby, and each of them, as his true and lawful attorneys-in-fact and agents, with full power of 
substitution for him, and in his name in any and all capacities, to sign any and all amendments to this Annual Report on Form 10-K, 
and to file the same, with exhibits thereto and other documents in connection therewith, with the Securities and Exchange 
Commission, granting unto said attorneys-in-fact and agents, and each of them, full power and authority to do and perform each and 
every act and thing requisite and necessary to be done therewith, as fully to all intents and purposes as he might or could do in person, 
hereby ratifying and confirming all that said attorneys-in-fact and agents, and any of them or his or her substitute or substitutes, may 
lawfully do or cause to be done by virtue hereof. 

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed by the following persons on behalf of 
ARCA biopharma, Inc., in the capacities and on the dates indicated. 

Signature

/S/ Michael R. Bristow
Michael R. Bristow

/S/ Brian L. Selby
Brian L. Selby

/S/ Linda Grais
Linda Grais

/s/ Raymond Woosley
Raymond Woosley

/s/ Robert Conway
Robert Conway

/s/ Daniel Mitchell
Daniel Mitchell

/s/ Anders Hove
Anders Hove

Date

February 27, 2019

February 27, 2019

February 27, 2019

February 27, 2019

February 27, 2019

February 27, 2019

February 27, 2019

Title

President and Chief Executive
Officer and Director
 (Principal Executive Officer)

Vice President, Finance 

  (Principal Financial Officer and Principal Accounting Officer)  

Director

Director

Director

Director

Director

91