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Ethos Technologies Inc.

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FY2023 Annual Report · Ethos Technologies 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, 2023
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: 001-37378

ATYR PHARMA, INC.

(Exact name of registrant as specified in its charter)

Delaware
(State or other jurisdiction of 
incorporation or organization)

10240 Sorrento Valley Road, Suite 300, San Diego, CA
(Address of principal executive offices)

20-3435077
(I.R.S. Employer 
Identification No.)

92121
(Zip Code)

Registrant’s telephone number, including area code: (858) 731-8389
Securities registered pursuant to Section 12(b) of the Act:

Title of each class
Common Stock, par value $0.001 per share

Trading Symbol
LIFE

Name of each exchange on which registered
The Nasdaq Capital Market

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 or Section 15(d) of the Act.    Yes      No  ☒

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

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or Section 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  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 whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an 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    Accelerated filer    Non-accelerated filer  ☒  Smaller reporting company  ☒  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 has filed a report on and attestation to its management’s assessment of the effectiveness of its internal control over financial 

reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued its audit report.  

If securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant included in the filing reflect the 

correction of an error to previously issued financial statements.  ☐

Indicate by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation received by any of the 

registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b).  ☐

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act).  Yes    No  ☒

The aggregate market value of the registrant’s voting and non-voting common equity held by non-affiliates of the registrant was approximately $120,774,416 based on the 
closing price of the registrant’s common stock on the Nasdaq Capital Market of $2.16 per share on June 30, 2023, the last business day of the registrant’s most recently completed 
second fiscal quarter. Shares of common stock held by each executive officer and director have been excluded from this calculation. This determination of affiliate status may not be
conclusive for other purposes.

The number of outstanding shares of the registrant’s common stock, par value $0.001 per share, as of March 13, 2024 was 67,750,024.

Portions of the registrant’s definitive proxy statement to be filed with the Securities and Exchange Commission (SEC), pursuant to Regulation 14A in connection with the 
registrant’s 2024 Annual Meeting of Stockholders, which will be filed subsequent to the date hereof, are incorporated by reference into Part III of this Annual Report on Form 10-K. 
Such proxy statement will be filed with the SEC not later than 120 days following the end of the registrant’s fiscal year ended December 31, 2023.

DOCUMENTS INCORPORATED BY REFERENCE

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ATYR PHARMA, INC.

ANNUAL REPORT ON FORM 10-K

For the Fiscal Year Ended December 31, 2023

Table of Contents

Forward-Looking Statements
Summary of Risks Associated with Our Business

PART I
Item 1
Item 1A
Item 1B
Item 1C
Item 2
Item 3
Item 4

PART II
Item 5

Item 6
Item 7
Item 7A
Item 8
Item 9
Item 9A
Item 9B
Item 9C

PART III 
Item 10
Item 11
Item 12
Item 13
Item 14

PART IV
Item 15
Item 16

Signatures 

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

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 
Securities
[Reserved]
Management’s Discussion and Analysis of Financial Condition and Results of Operations
Quantitative and Qualitative Disclosures About Market Risk 
Financial Statements and Supplementary Data
Changes in and Disagreements With Accountants on Accounting and Financial Disclosure
Controls and Procedures
Other Information
Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

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

Exhibit and Financial Statement Schedules
Form 10-K Summary

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In this Annual Report on Form 10-K (Annual Report), unless the context requires otherwise, “aTyr Pharma,” “aTyr,” “Company,” “we,” “our,” 

and “us” means aTyr Pharma, Inc. and our subsidiary, Pangu BioPharma Limited. 

The market data and certain other statistical information used in this Annual Report are based on independent industry publications, governmental 
publications, reports by market research firms or other independent sources. Some data are also based on our good faith estimates. Information that is based 
on estimates, forecasts, projections, market research or similar methodologies is inherently subject to uncertainties and actual events or circumstances may 
differ materially from events and circumstances reflected in this information.

We  own  various  U.S.  federal  trademark  applications  and  unregistered  trademarks,  including  our  company  name.  All  other  trademarks  or  trade 
names referred to in this Annual Report are the property of their respective owners. Solely for convenience, the trademarks and trade names in this Annual 
Report are referred to without the symbols  ®  and  ™,  but  such  references  should  not  be  construed  as  any  indicator  that  their  respective  owners  will  not 
assert, to the fullest extent under applicable law, their rights thereto.

Forward-Looking Statements

In addition to historical information, this Annual Report and the information incorporated herein by reference contains forward-looking statements 
within the meaning of Section 27A of the Securities Act of 1933, as amended (Securities Act) and Section 21E of the Securities Exchange Act of 1934, as 
amended (Exchange Act) including statements regarding our business, our financial position, the research and development of biopharmaceutical products, 
the  timing  of  clinical  trial  activities  and  other  statements  describing  our  goals,  expectations,  intentions  or  beliefs.  These  statements  include  but  are  not 
limited to statements under the captions “Business” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations”, as 
well  as  other  sections  in  this  Annual  Report.  Such  statements  reflect  our  current  views  and  assumptions  and  are  subject  to  risks  and  uncertainties, 
particularly those inherent in the process of developing and commercializing biopharmaceutical products. Actual results could differ materially from those 
discussed in this Annual Report. Factors that could cause or contribute to such differences include, but are not limited to, those identified in Part I, Item 1A 
“Risk Factors”, as well as those discussed in our other filings with the Securities and Exchange Commission (SEC). As a result, you are cautioned not to 
unduly rely on these forward-looking statements. We disclaim any duty to update any forward-looking statement to reflect events or circumstances that 
occur after the date on which such statement is made, except at required by law.

Risk Factors Summary 

Below is a summary of the principal factors that make an investment in our securities speculative or risky. This summary does not address all of the 
risks that we face. Additional discussion of the risks summarized in this risk factors summary, and other risks that we face, can be found in Part I, Item 1A 
“Risk Factors” and should be carefully considered, together with other information in this Annual Report and our other filings with the SEC before making 
investment decisions regarding our securities.

Investing in our securities involves substantial risk. The risks described under Part I, Item 1A “Risk Factors” of this Annual Report may cause us to 
not realize the full benefits of our strengths or may cause us to be unable to successfully execute all or part of our strategy. Some of the more significant 
risks we face include the following: 

•

•

•

•

•

•

We may encounter substantial delays and other challenges in our ongoing or planned clinical trials or we may fail to demonstrate safety and 
efficacy to the satisfaction of applicable regulatory authorities;

If  we  are  unable  to  successfully  complete  or  otherwise  advance  clinical  development,  obtain  regulatory  or  marketing  approval  for,  or 
successfully  commercialize  our  therapeutic  product  candidates,  including  efzofitimod,  or  experience  significant  delays  in  doing  so,  our 
business will be materially harmed;

There  is  no  established  FDA  regulatory  pathway  for  approval  of  a  drug  in  pulmonary  sarcoidosis.  As  a  result,  our  Phase  3  randomized, 
double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of efzofitimod in patients with pulmonary sarcoidosis (the 
EFZO-FIT  study),  even  if  successful,  may  not  be  sufficient  to  support  FDA  approval,  which  would  materially  and  adversely  harm  our 
business;

Our  current  product  candidates  and  any  other  product  candidates  that  we  may  develop  from  our  discovery  platform  represent  novel 
therapeutic approaches, which may cause significant delays or may not result in any commercially viable drugs;

Our therapeutic product candidates may cause undesirable side effects or have other properties that could delay or prevent their regulatory 
approval, limit the commercial profile of an approved label, or result in significant negative consequences following marketing approval, if 
any;

We will need to raise additional capital or enter into strategic partnering relationships to fund our operations;

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•

•

•

•

•

•

We  are  a  pre-commercial  biotherapeutics  company  and  have  incurred  significant  losses  since  our  inception  and  anticipate  that  we  will 
continue to incur significant losses for the foreseeable future;

We  depend  on  our  existing  collaborations  and  may  depend  on  collaborations  with  additional  third  parties  for  the  development  and 
commercialization  of  certain  of  our  product  candidates.  If  our  collaborations  are  not  successful,  we  may  not  be  able  to  capitalize  on  the 
market potential of these product candidates;

If we are unable to obtain, maintain or protect intellectual property rights related to our product candidates, or if the scope of such intellectual 
property protection is not sufficiently broad, we may not be able to compete effectively in our markets;

Our future success depends on our ability to retain key employees, consultants and advisors and to attract, retain and motivate qualified 
personnel;

Unfavorable macroeconomic conditions could adversely affect our business, financial condition or results of operations; and

The market price of our common stock historically has been highly volatile and is likely to continue to be volatile, and you could lose all or 
part of your investment.

Item 1. Business. 

PART I

We are a clinical stage biotechnology company leveraging evolutionary intelligence to translate tRNA synthetase biology into new therapies for 
fibrosis and inflammation. tRNA synthetases are ancient, essential proteins that have evolved novel domains that regulate diverse pathways extracellularly 
in  humans.  Our  discovery  platform  is  focused  on  unlocking  hidden  therapeutic  intervention  points  by  uncovering  signaling  pathways  driven  by  our 
proprietary library of domains derived from all 20 tRNA synthetases.

Efzofitimod 

Our  lead  therapeutic  candidate  is  efzofitimod,  a  first-in-class  biologic  immunomodulator  in  clinical  development  for  the  treatment  of  interstitial 
lung  disease  (ILD),  a  group  of  immune-mediated  disorders  that  can  cause  inflammation  and  fibrosis,  or  scarring,  of  the  lungs.  Efzofitimod  is  a  tRNA 
synthetase  derived  therapy  that  selectively  modulates  activated  myeloid  cells  through  neuropilin-2  (NRP2)  to  resolve  aberrant  inflammation  without 
immune  suppression  and  potentially  prevent  the  progression  of  fibrosis.  ILDs  are  predominantly  immune-mediated  disorders  that  are  characterized  by 
chronic  inflammation,  which  can  lead  to  progressive  fibrosis  of  the  lung.  There  are  limited  treatment  options  for  ILD  and  there  remains  a  high  unmet 
medical need. Sarcoidosis and systemic sclerosis (SSc, also known as scleroderma)-associated ILD (SSc-ILD) are two major forms of ILD. The U.S. Food 
and Drug Administration (FDA) has granted efzofitimod orphan drug designations for the treatment of sarcoidosis and for the treatment of SSc, and Fast 
Track designations for the treatment of pulmonary sarcoidosis and for the treatment of SSc-ILD. The European Commission (EC) has granted efzofitimod 
orphan drug designations for the treatment of sarcoidosis and for the treatment of SSc, based on the opinion of the European Medicines Agency (EMA) 
Committee for Orphan Medicinal Products (COMP). 

In September 2021, we announced positive results and clinical proof-of-concept from a double-blind, placebo-controlled Phase 1b/2a clinical trial 
in 37 patients with pulmonary sarcoidosis. The study was designed to evaluate the safety, tolerability, immunogenicity and preliminary efficacy of three 
doses of intravenous (IV) efzofitimod, 1.0, 3.0 and 5.0 mg/kg, in the context of a forced steroid taper. Efzofitimod was safe and well-tolerated at all doses 
administered with no serious drug-related adverse events or signal of immunogenicity. Additionally, the study demonstrated consistent dose response for 
efzofitimod  on  key  efficacy  endpoints  and  improvements  compared  to  placebo,  including  measures  of  steroid  reduction,  lung  function,  pulmonary 
sarcoidosis  symptom  measures  and  inflammatory  biomarkers.  These  data  were  subsequently  presented  at  the  American  Thoracic  Society  (ATS) 
International Conference and published in the peer-reviewed journal CHEST during 2022. 

In  February  2022,  we  met  with  the  FDA  in  an  end-of-Phase  2  meeting  to  discuss  our  plans  for  subsequent  clinical  development  and  path  to 
registration for efzofitimod for pulmonary sarcoidosis. Subsequently, we initiated a global pivotal Phase 3 randomized, double-blind, placebo-controlled 
clinical trial to evaluate the efficacy and safety of efzofitimod in patients with pulmonary sarcoidosis (the EFZO-FIT study). The EFZO-FIT study is a 52-
week study consisting of three parallel cohorts randomized equally to either 3.0 mg/kg or 5.0 mg/kg of efzofitimod or placebo dosed intravenously once a 
month for a total of 12 doses. The study is currently enrolling and intends to enroll up to 264 subjects with pulmonary sarcoidosis at multiple centers in the 
United States, Europe, Brazil, and Japan. The study design incorporates a forced steroid taper. The objective of the study is to evaluate the efficacy and 
safety of efzofitimod in patients with pulmonary sarcoidosis. The primary endpoint of the study is steroid reduction. Secondary endpoints include measures 
of lung function assessed by forced vital capacity (FVC) and health-related quality of life assessments and questionnaires (KSQ lung score). In September 
2022, we dosed the first patient in this study. Additionally, during 2023, we had a data and safety monitoring board 

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(DSMB) review of our EFZO-FIT study. The DSMB concluded that the study could continue unmodified. We expect to complete enrollment in the study in 
the second quarter of 2024. 

In February 2024, we announced an Individual Patient Expanded Access Program (EAP). The Individual Patient EAP has been initiated based on 
blinded  EFZO-FIT  study  investigator  and  patient  participant  feedback.  The  program  is  designed  to  allow  access  for  patients  who  complete  the  Phase  3 
EFZO-FIT study and wish to receive treatment with efzofitimod outside of the clinical trial. The administration of efzofitimod as part of the Individual 
Patient EAP will occur independent of the EFZO-FIT study protocol, and we, principal investigators and patients will remain blinded to the treatment that 
occurred as part of the EFZO-FIT study. As this  Individual Patient EAP will occur independent of the EFZO-FIT study, this program is not an open-label 
extension (OLE) and no long-term data will be collected by us.

Based  on  the  results  of  the  Phase  1b/2a  clinical  trial,  we  believe  efzofitimod  has  potential  applications  in  the  treatment  of  other  ILDs,  such  as 
chronic hypersensitivity pneumonitis (CHP) and connective tissue disease related ILD (CTD-ILD), including SSc-ILD and rheumatoid arthritis-associated 
ILD. As such, we designed a focused Phase 2 proof-of-concept clinical trial of efzofitimod (the EFZO-CONNECT study) in patients with SSc-ILD. The 
EFZO-CONNECT  study  is  a  randomized,  double-blind  placebo-controlled  proof-of-concept  study  to  evaluate  the  efficacy,  safety  and  tolerability  of 
efzofitimod in patients with SSc-ILD. This is a 28-week study with three parallel cohorts randomized 2:2:1 to either 270 mg or 450 mg of efzofitimod or 
placebo dosed intravenously monthly for a total of six doses. The study intends to enroll up to 25 patients at multiple centers in the United States. The 
objective of the study is to evaluate the efficacy of multiple doses of IV efzofitimod on pulmonary, cutaneous and systemic manifestations in patients with 
SSc-ILD.  The  primary  endpoint  is  reduction  in  FVC.  Secondary  endpoints  include  certain  measures  regarding  safety  and  tolerability.  The  study  was 
initiated in the third quarter of 2023, and in October 2023, we dosed the first patient in this study. 

In January 2020, we entered into a collaboration and license agreement (Kyorin Agreement) with Kyorin Pharmaceutical Co., Ltd. (Kyorin) for the 
development and commercialization of efzofitimod for the treatment of ILD in Japan. Under the Kyorin Agreement, Kyorin received an exclusive right to 
develop  and  commercialize  efzofitimod  in  Japan  for  all  forms  of  ILD,  and  is  obligated  to  fund  all  research,  development,  regulatory,  marketing  and 
commercialization activities in Japan. In 2020, Kyorin conducted and funded a Phase 1 clinical trial of efzofitimod (known as KRP-R120 in Japan). The 
Phase 1 clinical trial was a placebo-controlled clinical trial to evaluate the safety, pharmacokinetics (PK) and immunogenicity of efzofitimod in 32 healthy 
Japanese  male  volunteers.  Efzofitimod  was  observed  to  be  generally  well-tolerated  with  no  drug-related  serious  adverse  events,  and  PK  findings  were 
consistent with previous studies of efzofitimod. Kyorin is also participating in the EFZO-FIT study as the local sponsor in Japan. In February 2023, Kyorin 
dosed  the  first  patient  in  Japan  in  the  EFZO-FIT  study  which  triggered  a  $10.0  million  milestone  payment  to  us.  To  date,  the  Kyorin  Agreement  has 
generated $20.0 million in upfront and milestone payments to us and we are eligible to receive up to an additional $155.0 million in the aggregate upon 
achievement of certain development, regulatory and sales milestones, as well as tiered royalties on any net sales in Japan. 

Discovery Platform 

Using efzofitimod as a model, we have developed a process to advance novel tRNA synthetase domains from a concept to therapeutic candidate. 
This process leverages our early discovery work as well as current scientific understanding of tRNA synthetase evolution, protein structure, gene splicing 
and tissue-specific regulation to identify potentially active protein domains. Screening approaches are employed to identify target cells and extracellular 
receptors for these tRNA synthetase-derived proteins. These cellular systems can then be used in mechanism-of-action studies to elucidate the role these 
proteins play in cellular responses and their potential therapeutic utility. We are working to identify new tRNA synthetase based drug candidates through 
our internal discovery efforts and external collaboration efforts.  

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Therapeutic Candidate Pipeline

Strategy

Key elements of our strategy include the following:

Advance efzofitimod toward regulatory approval in pulmonary sarcoidosis. Based on the positive results and clinical proof-of-concept from our 
efzofitimod  Phase  1b/2a  clinical  trial  in  September  2021,  we  believe  we  can  expedite  development  of  efzofitimod  for  pulmonary  sarcoidosis  toward 
regulatory  approval.  During  the  third  quarter  of  2022,  we  initiated  the  EFZO-FIT  study,  a  global  pivotal  Phase  3  randomized,  double-blind,  placebo-
controlled  clinical  trial  to  evaluate  the  efficacy  and  safety  of  efzofitimod  in  patients  with  pulmonary  sarcoidosis.  Our  strategy  for  the  advancement  of 
efzofitimod includes completing the EFZO-FIT study which we expect will serve as the basis for regulatory approval.

Develop efzofitimod to address unmet medical needs in other ILDs. In addition, we believe the positive results from our efzofitimod Phase 1b/2a 
clinical trial, as well as data from numerous preclinical studies we have conducted to date, will give us the opportunity to potentially launch additional 
Phase 2 clinical trials of efzofitimod in other forms of ILD. As part of this strategy, we initiated the EFZO-CONNECT study of efzofitimod in patients with 
SSc-ILD and dosed the first patient in this study in October 2023.  

Build  a  diverse  pipeline  of  biologics  product  candidates  based  on  our  understanding  of  extracellular  tRNA  synthetase  biology.  Utilizing our 
unique  drug  discovery  approach  through  internal  research  efforts  and  external  collaboration  efforts,  we  intend  to  continue  to  advance  novel  tRNA 
synthetase  domains  from  concept  to  product  candidates  in  the  areas  of  fibrosis  and  inflammation.  We  have  advanced  two  additional  tRNA  synthetase 
programs,  ATYR0101  and  ATYR0750,  into  preclinical  development.  We  plan  to  further  elucidate  the  therapeutic  potential  of  these  candidates  through 
mechanistic investigations, including in vitro and in vivo preclinical studies.

Efzofitimod

Background and Mechanism of Action 

Efzofitimod  is  a  novel  immunomodulatory  Fc  fusion  protein  in  development  for  the  treatment  of  ILD.  Efzofitimod  is  a  selective  modulator  of 
NRP2  that  downregulates  innate  immune  responses  at  a  cellular  level  in  uncontrolled  inflammatory  disease  states  to  resolve  chronic  inflammation  and 
prevent subsequent fibrosis.

Efzofitimod is a novel molecular entity comprised of a human 59 amino acid protein fused to the Fc region of human immunoglobulin 1 (IgG1). It 
acts  as  an  extracellular  immunomodulator.  The  amino  acid  sequence  of  the  active  moiety  corresponds  identically  to  the  extracellularly  active 
immunomodulatory domain of histidyl-tRNA synthetase (HARS) amino acids 2 to 60 (HARS 2-60).

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The  gene  for  HARS  gives  rise  to  a  number  of  splice  variants,  and  though  most  of  these  have  lost  their  catalytic  activity,  they  all  retain  the  N-
terminal domain (HARS amino acids 1-60). This N-terminal domain, non-essential for the enzyme’s protein synthesis activity that is required in all living 
organisms,  was  appended  to  HARS  during  the  evolutionary  development  of  multicellular  organisms  and  retained  with  high  sequence  identity  across 
mammalian species, but is not found in lower organisms. One splice variant (SV9), which encodes only the N-terminal domain of the protein, is enriched in 
human lung tissue. Expression of this HARS splice variant is increased following inflammatory cytokine stimulation (interferon gamma (IFN-g) and TNF 
alpha (TNF-a), two key players in the initiation of lung inflammation and fibrosis) followed by subsequent secretion, indicating it is being regulated in 
response  to  local  inflammation.  Furthermore,  HARS,  specifically  the  N-terminal  domain,  is  targeted  by  autoantibodies  in  a  rare  autoimmune  disorder 
(known as anti-Jo-1 syndrome). Anti-Jo-1 syndrome is characterized by extensive activation and migration of immune cells into lung and muscle and is 
classically  associated  with  the  triad  of  ILD,  myositis,  and  arthritis.  It  is  hypothesized  that  the  sequestration  of  HARS  may  play  a  causal  role  through 
disruption of its homeostatic immune-regulatory effects. 

NRP2 was identified as the sole binding partner for efzofitimod through screening via a cell microarray system in which over 4,500 cell surface 
proteins  are  represented.  This  screening  approach  identified  two  NRP2  isoforms  (Neuropilin  2A  and  2B)  as  the  only  convincing  and  specific  binding 
partners of efzofitimod. The binding site was confirmed to be within the “turn” of the helix-turn-helix structure of the HARS N-terminal domain comprised 
within efzofitimod. Binding of efzofitimod is specific to NRP2 with no observable cross-reactivity to NRP1, which is the most closely related cell surface 
receptor in both protein sequence and structure. A domain that is structurally similar (but divergent in protein sequence) to the HARS N-terminal domain 
(termed the WHEP domain) is found in other amino-acyl tRNA synthetases, yet these domains do not exhibit binding to NRP2, indicating this is a highly 
specific interaction. Interestingly, binding of efzofitimod occurs in a manner distinct from the more well-characterized ligands of NRP2 including VEGF 
and semaphorin 3F (SEMA3F), and does not interfere with NRP2 dimerization with their co-receptors. Thus, the HARS N-terminus appears to be a newly 
discovered ligand for NRP2, as opposed to an antagonist. The discovery of the HARS N-terminus/NRP2 signaling axis represents a previously unknown 
mechanism of biological regulation, in which this novel ligand of NRP2 may act as a homeostatic regulator of aberrant immune responses.

NRP2  is  a  cell  surface  receptor  that  is  present  on  multiple  immune  cell  types,  including  certain  myeloid  cells  and  subsets  of  T-cells.  NRP2 
expression  is  often  upregulated  upon  inflammatory  insult  or  stimulation.  Growing  evidence  indicates  that  NRP2  predominantly  influences  myeloid  cell 
biology such as activation and recruitment to inflammatory sites. For instance, NRP2 expression on alveolar macrophages regulates airway inflammatory 
responses to inhaled lipopolysaccharide. In sarcoidosis, NRP2 expression has been shown to be localized within the sarcoid granulomas, highly expressed 
in Langhans giant cells which are myeloid in nature.

Efzofitimod  has  been  shown  to  significantly  reduce  lung  inflammation  and  fibrosis,  reduce  immune  cell  trafficking  to  the  lung  and  improve 
respiratory function parameters in multiple animal models of lung fibrosis. Furthermore, efzofitimod has demonstrated consistent downregulatory effects 
on  inflammatory  and  pro-fibrotic  cytokines  and  chemokines  in  both  animal  disease  models  and  human  clinical  trials.  Efzofitimod  appears  to  primarily 
impact interleukin-6 (IL-6), TNF-(cid:0), IFN-(cid:0), MCP-1 and IP-10, markers that have been implicated in the pathology of ILD.

Preclinical Development

Our  preclinical  estate  of  translational  animal  models  was  selected  to  help  inform  and  de-risk  clinical  development  of  efzofitimod.  We  have 
evaluated the biological activity and safety of efzofitimod across a diverse set of experimental fibrotic lung disease models, representative of the four major 
forms  of  ILD  (sarcoidosis,  CHP,  CTD-ILD  and  idiopathic  pulmonary  fibrosis  (IPF)),  as  well  as  in  normal  animals,  looking  for  signals  of  activity  and 
potential biomarkers, while confirming tolerability and a favorable safety profile.

In  these  models,  efzofitimod  has  significantly  reduced  histological  lung  fibrosis  and  inflammation,  restored  normal  lung  function,  reduced  lung 
protein levels of several inflammation and fibrosis-related cytokines and chemokines (e.g. IFN-γ, MCP-1/CCL2, IL-6) and reduced counts of immune cells 
in bronchoalveolar lavage (BAL) central to ILD pathology (e.g., neutrophils). These data have been presented in posters at key respiratory conferences over 
the past several years (e.g. the ATS International Congress) and are available for review on our website.

Efzofitimod and NRP2 receptor 

NRP2 is known to be expressed on a number of different immune cell types that play a key role in regulating inflammatory responses. Efzofitimod 
is  a  fusion  protein  combining  a  novel  immunomodulatory  domain  from  HARS  and  a  human  IgG1  Fc.  Efzofitimod  inhibits  cytokines  and  chemokines 
involved  in  the  regulation  of  inflammatory  and  fibrotic  responses  and  reduces  inflammation  and  fibrosis  in  animal  models  of  ILD.  Efzofitimod  has 
previously  demonstrated  potent  immunomodulatory  activity  in  vitro  and  in  vivo.  We  sought  to  characterize  the  molecular  basis  for  efzofitimod’s 
immunomodulatory properties and demonstrated that efzofitimod specifically and selectively binds to NRP2 on the cell surface. These  findings  indicate 
that modulation of the NRP2 signaling pathway with efzofitimod could be a novel therapeutic approach to immune-mediated and fibrotic diseases such as 
pulmonary sarcoidosis.

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Sarcoidosis is characterized by the formulation of granulomas, clumps of inflammatory cells found in one or more organs of the body and denoted 
by  the  presence  of  Langhans  giant  cells  which  are  myeloid  in  nature.  NRP2  was  shown  to  be  expressed  in  samples  obtained  from  lung  and  skin  of 
sarcoidosis patients with high NRP2 expression detected on key immune cells known to play an important role in inflammation and granuloma formation, 
including  the  Langhans  giant  cells.  In  work  carried  out  in  collaboration  with  Dr.  Elliot  Crouser’s  laboratory  at  The  Ohio  State  University  utilizing  an 
established ex  vivo  assay  of  granuloma  formation,  it  was  demonstrated  that  an  efzofitimod  analog  containing  the  identical  immunomodulatory  HARS 
domain exhibited statistically significant reduction of granuloma formation generated from sarcoid peripheral blood mononuclear cells (PBMCs). Given 
the  importance  of  granulomas  in  the  pathology  and  progression  of  pulmonary  sarcoidosis  and  the  known  ability  of  efzofitimod  to  disrupt  inflammatory 
responses, we hypothesize that efzofitimod may play a role in regulating sarcoid granuloma formation. These findings highlight the potential of efzofitimod 
to exert its effect on various immune cells directly related to the pathology of the target patient population. These data were presented in posters at the ATS 
International  Virtual  Meeting  in  2020  and  the  European  Society  International  Congress  in  2021.  As  an  extension  of  this  work,  a  highly  selective  and 
sensitive antibody was developed for immunohistochemical detection of the target receptor for efzofitimod, NRP2, in patient tissue samples. Development 
and characterization of the antibody, as well as detection of NRP2 on key immune cells in granulomas of sarcoidosis patient lung and skin biopsy samples 
was highlighted in a poster presentation at the European Respiratory Society (ERS) International Congress 2022 in Barcelona, Spain. 

SSc-ILD  is  an  autoimmune  disease  characterized  by  chronic  inflammation  and  fibrosis  with  common  involvement  of  the  skin  and  lungs.  As  in 
sarcoidosis, myeloid cells are centrally involved in driving this cycle of chronic inflammation and fibrosis in SSc-ILD. One aspect of this is the production 
by these cells of inflammatory cytokines, including IL-6.

Based on our translational biology program, which demonstrated activity across distinct experimental animal models either driven by direct lung 
injury or systemic pathology, along with our understanding of efzofitimod’s mechanism of action, we decided to move the program forward into patient 
clinical trials in ILD.

ILD and the Role of Immunology 

The current primary target population for efzofitimod is ILD, a group of predominantly immune-mediated disorders which can cause progressive 
fibrosis of the lung. There are over 200 different types of ILD, of which the four major forms are: pulmonary sarcoidosis, CHP, CTD-ILD, and IPF. These 
four types comprise roughly 80% of the total ILD population. We have focused our development efforts on progressive, immune-mediated forms of ILD, 
with  limited  therapeutic  options,  where  we  believe  efzofitimod  can  have  disease  modifying  effects.  These  lung  conditions  are  recognized  as  having  a 
measurable  immune-mediated  pathology,  involving  both  innate  and  adaptive  immune  mechanisms  that  contribute  to  pathogenesis,  and  can  result  in 
progressive disease leading to fibrosis and death.

Pulmonary Sarcoidosis

Sarcoidosis is an inflammatory disease of unknown cause, characterized by the formation of granulomas, clumps of inflammatory cells in one or 
more organs in the body. Sarcoidosis affects people of all ages, with the incidence peaking at 20 to 39 years of age. The disorder usually begins in the 
lungs, skin or lymph nodes, but can affect almost any organ. Sarcoidosis in the lungs is called pulmonary sarcoidosis and occurs in over 90% of sarcoidosis 
patients. Approximately 200,000 Americans are currently living with pulmonary sarcoidosis. The prognosis for patients with pulmonary sarcoidosis ranges 
from benign and self-limiting to chronic, debilitating fibrotic disease and death. 

The  immunopathogenesis  of  sarcoidosis  is  not  yet  well  understood,  but  a  hallmark  of  the  disease  is  the  presence  of  granulomas,  or  clumps  of 
immune cells. Granulomas consist of epithelioid cells, lymphocytes (both T and B cells) and myeloid cells, with macrophages and multinucleated giant 
cells  (formed  by  fusion  of  macrophages),  both  of  myeloid  origin,  playing  a  central  role  in  their  formation  and  persistence.  A  leading  hypothesis  is  that 
granuloma  formation  involves  the  interplay  between  antigen,  human  leukocyte  antigen  class  II  molecules,  and  T-cell  receptors:  a  presumptive  sarcoid 
antigen is engulfed by circulating antigen-presenting cells (APCs; macrophages, dendritic cells) and the subsequent interplay between APCs and CD4+ T-
cells initiates granuloma formation. This process is accompanied by the release of inflammatory cytokines such as IFN-g and TNF-a from myeloid cells.

For patients with pulmonary sarcoidosis, the primary goal of treatment is to improve quality of life and avoid damage to organs. Efzofitimod may 
provide a therapeutic benefit in pulmonary sarcoidosis by resolving chronic inflammation, alleviating symptoms such as cough and shortness of breath and 
preventing disease progression towards fibrosis and permanent organ damage. Efzofitimod may also improve patient quality of life by allowing patients to 
reduce or completely avoid the need for oral corticosteroids (OCS), which are associated with debilitating side effects when used chronically. Efzofitimod 
targets  the  immune  cells,  primarily  of  myeloid  lineage  (monocytes,  macrophages  and  dendritic  cells),  that  drive  the  cellular  pathology  observed  in 
pulmonary  sarcoidosis.  In  preclinical  studies,  efzofitimod  has  been  observed  to  inhibit  cytokines  involved  in  regulation  of  inflammatory  and  immune 
responses,  modulating  the  reaction  of  myeloid  cells  at  the  sites  of  inflammation  and  attenuating  T-cell  activation.  We  have  also  discovered  that 
efzofitimod’s 

8

 
 
receptor  target  NRP2  is  up-regulated  during  differentiation  and  activation  of  myeloid  cells  including  macrophages,  dendritic  cells  and  neutrophils. 
Furthermore,  efzofitimod  has  been  observed  to  significantly  reduce  lung  inflammation  and  fibrosis  and  improve  respiratory  function  parameters  in 
bleomycin-induced animal models of ILD. We believe that by inhibiting the chronic inflammatory response in these patients, efzofitimod may be able to 
restore immune balance and prevent progressive fibrosis, without toxicity associated with current treatment options, thereby providing a safer, potentially 
more  effective  alternative  to  OCS  and  other  immunosuppressive  therapies  that  currently  comprise  the  standard  of  care  for  patients  with  symptomatic 
pulmonary sarcoidosis.

Systemic Sclerosis

Systemic sclerosis (SSc, or scleroderma) is a chronic, progressive, autoimmune disease characterized by inflammation and fibrosis of connective 
tissues throughout the body, including the skin and other internal organs. SSc that occurs in the lungs is called SSc-ILD. It is estimated that approximately 
100,000  people  in  the  U.S.  are  affected  by  SSc  and  up  to  80%  may  develop  ILD.  SSc-ILD  is  caused  by  chronic  inflammation  in  the  lungs  and,  if  left 
untreated, can result in scarring, or fibrosis, that causes permanent loss of lung function. ILD is the primary cause of death in patients with SSc. Current 
treatment options are limited. They mainly focus on slowing lung function decline, do not improve patient symptoms and are associated with significant 
toxicity. New treatments are needed that can stabilize or improve lung function and improve patient quality of life. 

Efzofitimod has been shown to reduce lung and skin fibrosis in an animal model of SSc. Certain cytokines central to the immune pathology of SSc-
ILD, including IL-6, were also downregulated in both animal models of ILD and in humans in an adjacent ILD, pulmonary sarcoidosis, in our Phase 1b/2a 
study. Furthermore, NRP2 is expressed in the skin of patients with SSc. This data in both animal and human systems, along with our current understanding 
of  the  role  of  efzofitimod’s  target  receptor  NRP2  and  the  manner  with  which  this  novel  ligand  can  modulate  the  immune  response  at  the  sites  of 
inflammation, suggest it is a promising therapeutic candidate for SSc-ILD.

Clinical Development

Efzofitimod Phase 3 Clinical Trial – Pulmonary Sarcoidosis

We are conducting the EFZO-FIT study, which is a global Phase 3, multicenter, randomized, double-blind, placebo-controlled study to evaluate the 
efficacy and safety of IV efzofitimod 3.0 mg/kg and 5.0 mg/kg versus placebo in patients with symptomatic pulmonary sarcoidosis. It is a 52-week study 
with patients receiving either efzofitimod or placebo once a month for a total of 12 doses. The study is currently enrolling and intends to enroll adults with 
histologically  confirmed  pulmonary  sarcoidosis  receiving  stable  treatment  with  OCS,  with  or  without  immunosuppressant  therapy.  The  study  intends  to 
enroll up to 264 patients at centers throughout the United States, Europe, Brazil and Japan. The study incorporates a forced steroid taper. The objective of 
the  study  is  to  evaluate  the  efficacy  and  safety  of  efzofitimod  in  patients  with  pulmonary  sarcoidosis.  The  primary  endpoint  of  the  study  is  steroid 
reduction. Secondary endpoints include measures of lung function assessed by FVC and health-related quality of life assessments and questionnaires (KSQ 
lung score).

This study consists of three periods: a screening period, a 48-week placebo-controlled treatment period with the primary endpoint being measured 
at week 48, and a four-week follow-up period. Within the study, up to 264 patients will be randomized 1:1:1 to efzofitimod 3.0 mg/kg (N=88), efzofitimod 
5.0 mg/kg (N=88) or placebo (N=88). Study drug is administered via IV infusion every four weeks for a total of 12 doses (48 weeks of treatment). Starting
on  Day  15  patients  begin  a  taper  (reduction)  in  OCS  according  to  specific  guidelines  from  their  starting  dose  of  7.5-25  mg/day  of  prednisone  (or 
equivalent) to a target dose of 0.0 mg/day. Patients will be followed for the remainder of the study to determine their ability to remain off of OCS. Patients 
who require an increase in OCS dose at any time in the study will continue to receive blinded study drug and be followed through to the end of the study.

In September 2022, we dosed the first patient in this study. Additionally, during 2023, we had a DSMB review of our EFZO-FIT study. The DSMB 

concluded that the study could continue unmodified. We expect to complete enrollment in the study in the second quarter of 2024.

In  February  2024,  we  announced  an  Individual  Patient  EAP. The  Individual  Patient  EAP  has  been  initiated  based  on  blinded  EFZO-FIT  study 
investigator and patient participant feedback. The program is designed to allow access for patients who complete the Phase 3 EFZO-FIT study and wish to 
receive  treatment  with  efzofitimod  outside  of  the  clinical  trial.  The  administration  of  efzofitimod  as  part  of  the  Individual  Patient  EAP  will  occur 
independent of the EFZO-FIT study protocol, and we, principal investigators and patients will remain blinded to the treatment that occurred as part of the 
EFZO-FIT study. As this Individual Patient EAP will occur independent of the EFZO-FIT study, this program is not an open-label extension (OLE) and no 
long-term data will be collected by us.

Efzofitimod Phase 1b/2a Clinical Trial –Pulmonary Sarcoidosis

We designed a proof-of-concept Phase 1b/2a clinical trial for efzofitimod in patients with pulmonary sarcoidosis. The Phase 1b/2a clinical trial was 

a randomized, double-blind, placebo-controlled multiple-ascending dose, first-in-patient study with IV 

9

 
efzofitimod in 37 patients. The study was conducted in patients with pulmonary sarcoidosis undergoing an OCS tapering regimen, in three cohorts of 12 
patients each, at dose levels of 1.0 mg/kg, 3.0 mg/kg and 5.0 mg/kg. 

The  primary  objective  of  the  study  was  to  evaluate  safety  and  tolerability  of  multiple  ascending  doses  of  efzofitimod.  Secondary  objectives 
included  assessment  of  the  potential  steroid-sparing  effects  of  efzofitimod.  In  addition,  efzofitimod’s  PK  and  immunogenicity  following  multiple  dose 
administration  were  evaluated.  Additional  endpoints  of  interest  included  the  exploratory  assessment  of  the  efficacy  of  efzofitimod  for  the  treatment  of 
pulmonary sarcoidosis by evaluating changes over time in: lung function assessed by forced vital capacity (FVC) and diffusing capacity of the lungs for 
carbon monoxide (DLCO); health-related quality of life assessments and questionnaires; and serum biomarkers of interest.

This  study  consisted  of  three  staggered  dose  cohorts.  Each  cohort  consisted  of  three  periods:  a  screening  period,  a  20-week  placebo-controlled 
treatment period, and a four-week follow-up period ending with final study assessments at Week 24. Within each cohort, 12 patients were randomized 2:1 
to efzofitimod (N=8) or placebo (N=4). Study drug was administered via IV infusion every four weeks for a total of six doses (20 weeks of treatment). The 
efzofitimod doses levels being evaluated were 1 mg/kg, 3 mg/kg and 5 mg/kg. Starting on Day 15 patients began a taper (reduction) in OCS according to 
specific guidelines from their starting dose of 10-25 mg/day of prednisone (or equivalent) to a target dose of 5.0 mg/day, to be completed on or before Day 
50. The OCS dose was tapered through Week 24 and patients were followed for the remainder of the study to determine their ability to maintain on this 5 
mg dose. Optionally, further reductions in the OCS dose to below 5.0 mg/day may be attempted after the Week 16 visit, if determined by the investigator to 
be feasible. Patients who required an increase in OCS dose at any time in the study were to continue to receive blinded study drug and be followed through 
to the end of the study.

In September 2021, we announced positive results and clinical proof-of-concept from the Phase 1b/2a clinical trial in 37 patients with pulmonary 
sarcoidosis.  These  data  were  subsequently  presented  at  the  ATS  International  Conference  and  published  in  the  peer  reviewed  journal  CHEST  in  2022. 
Efzofitimod  was  safe  and  well-tolerated  at  all  doses  with  no  drug-related  serious  adverse  events  or  signal  of  immunogenicity.  Additionally,  the  study 
demonstrated consistent dose response for efzofitimod on key efficacy endpoints and improvements compared to placebo, including measures of steroid 
reduction, lung function, sarcoidosis symptom measures and inflammatory biomarkers. Key safety and clinical efficacy findings for efzofitimod from the 
study include:

• Safe and well-tolerated at all doses:

•

•

•

No dose-relationship with most common adverse events associated with underlying disease;

No drug-related serious adverse events; and

No signal of immunogenicity.

• Dose response and consistent positive findings across key efficacy endpoints:

•

•

•

•

•

•

Steroid reduction of 58% overall from baseline and 22% relative reduction compared to placebo in steroid usage post taper in the 5.0 
mg/kg treatment group;

Complete steroid taper to 0 mg achieved and maintained for 33% of patients in the 5.0 mg/kg treatment group compared to no patients 
in any other group;

Absolute  improvement  in  FVC  as  a  measure  of  lung  function  at  week  24  of  3.3%  in  the  5.0  mg/kg  treatment  group  compared  to 
placebo, with an improvement in FVC of > 2.5%, considered clinically meaningful;

Clinically  meaningful  improvement  over  placebo  observed  for  dyspnea  (shortness  of  breath),  cough,  fatigue  and  the  King’s 
Sarcoidosis Scores for Lung and General Health in 5.0 mg/kg treatment group;

Dose dependent trends of improvement in key inflammatory biomarkers compared to placebo including IL-6, MCP-1, IFN-γ, IP-10 
and TNF-(cid:0)  as  well  as  key  sarcoidosis  markers  including  ACE,  IL-2Ra  and  SAA  with  tightest  control  in  the  5.0  mg/kg  treatment 
group; and

FDG-PET-CT was not evaluable due to incomplete data primarily caused by operational issues related to the COVID-19 pandemic.

In 2023, we published additional analyses of data from this study. This included a positive exposure response demonstrated for efzofitimod across 
multiple clinically relevant endpoints published in the peer-reviewed journal Frontiers in Pharmacology and a post-hoc analysis demonstrating statistically 
significant  improvement  in  time  to  relapse,  FVC  and  patient  reported  outcomes  for  efzofitimod  presented  at  the  European  Respiratory  Society  (ERS) 
International Congress.

Efzofitimod Phase 2 Clinical Trial – SSc-ILD

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During 2023, we initiated the EFZO-CONNECT study, a Phase 2 study of efzofitimod in patients with SSc-ILD. The EFZO-CONNECT study is a 
Phase 2 randomized, double-blind placebo-controlled proof-of-concept study to evaluate the efficacy, safety and tolerability of efzofitimod in patients with 
SSc-ILD.  The  study  is  a  28-week  study  with  three  parallel  cohorts  randomized  2:2:1  to  either  270  mg  or  450  mg  of  efzofitimod  or  placebo  dosed  IV 
monthly  for  a  total  of  six  doses.  The  study  intends  to  enroll  up  to  25  patients  at  multiple  centers  in  the  United  States.  The  objective  of  the  study  is  to 
evaluate  the  efficacy  of  multiple  doses  of  IV  efzofitimod  on  pulmonary,  cutaneous  and  systemic  manifestations  in  patients  with  SSc-ILD.  The  primary 
endpoint is reduction of FVC. Secondary endpoints include certain measures regarding safety and tolerability. The study was initiated in the third quarter of 
2023, and in October 2023, we dosed the first patient in this study. 

Efzofitimod Phase 2 Clinical Trial – COVID-19 with Severe Respiratory Complications

In response to the COVID-19 pandemic, we conducted a Phase 2 clinical trial of efzofitimod in patients with COVID-19 related severe respiratory 
complications. The study was designed to evaluate the safety and preliminary efficacy of efzofitimod compared to placebo through the assessment of key 
clinical outcome measures. In early 2021, we reported positive data which showed that the trial met its primary endpoint of safety, demonstrating that a 
single, IV dose of efzofitimod was observed to be generally safe and well-tolerated in both the 1.0 and 3.0 mg/kg treatment groups. The study also showed 
a signal of activity in the 3.0 mg/kg cohort. In addition, patients treated with efzofitimod demonstrated a trend of overall improvement in key biomarkers 
analyzed compared to placebo. We are leveraging these data for our mechanistic understanding of efzofitimod and for its application in ILD. 

Efzofitimod Phase 1 Clinical Trial – Healthy Volunteers

In June 2018, we announced results of our first-in-human Phase 1 clinical trial of efzofitimod conducted in Australia. This randomized, double-
blind, placebo-controlled study evaluated the safety, tolerability, immunogenicity, and PK of IV efzofitimod in healthy volunteers. The Phase 1 clinical trial 
enrolled  36  healthy  volunteers  who  were  randomized  to  one  of  six  sequential  cohorts  and  received  a  single  infusion  of  IV  efzofitimod  or  placebo. 
Ascending efzofitimod doses by cohort ranged from 0.03 mg/kg to 5.0 mg/kg. The results indicate that the drug was observed to be generally well-tolerated 
at all dose levels tested, with no significant adverse events or induction of anti-drug antibodies observed following efzofitimod dosing or throughout the 
one-month  follow-up  period.  The  PK  profile  of  efzofitimod  following  single-dose  administration  was  linear  across  the  evaluated  dose  range.  Higher 
efzofitimod  doses  yielded  sustained  serum  concentrations  through  the  end  of  the  one-month  follow-up  period  that  were  above  the  predicted  therapeutic 
threshold, supporting the potential for a once-monthly dosing regimen.

Kyorin Agreement

In  January  2020,  we  entered  into  the  Kyorin  Agreement  for  the  development  and  commercialization  of  efzofitimod  for  the  treatment  of  ILD  in 
Japan. Under the terms of the Kyorin Agreement, Kyorin received exclusive rights to develop and commercialize efzofitimod in Japan for all forms of ILD 
and is obligated to fund all research, development, regulatory, marketing and commercialization activities in Japan. We are responsible for supplying all 
drug  product  for  Japan,  as  well  as  supporting  development  activities  for  efzofitimod.  In  2020,  Kyorin  conducted  and  funded  a  Phase  1  clinical  trial  of 
efzofitimod  (known  as  KRP-R120  in  Japan).  The  Phase  1  trial  was  a  placebo-controlled  study  to  evaluate  the  safety,  PK  and  immunogenicity  of 
efzofitimod in 32 healthy Japanese male volunteers. Efzofitimod was observed to be generally well-tolerated with no drug-related serious adverse events, 
and PK findings were consistent with previous studies of efzofitimod. Kyorin is also participating in the EFZO-FIT study as the local sponsor in Japan. In 
February 2023, Kyorin dosed the first patient in Japan in the EFZO-FIT study which triggered a $10.0 million milestone payment to us. To date, the Kyorin 
Agreement has generated $20.0 million in upfront and milestone payments to us and we are eligible to receive up to an additional $155.0 million in the 
aggregate upon achievement of certain development, regulatory and sales milestones, as well as tiered royalties on any net sales in Japan. 

Unless earlier terminated, the term of the Kyorin Agreement continues until the expiration of the royalty obligations. Either party may terminate the 
Kyorin  Agreement  in  the  event  that  the  other  party  breaches  the  agreement  and  fails  to  cure  the  breach,  becomes  insolvent  or  challenges  certain  of  the 
intellectual property rights licensed under the agreement.

Our Discovery Platform

tRNA Synthetase Biology 

Extracellular tRNA synthetase biology represents a novel set of potential physiological modulators and therapeutic targets.

Using efzofitimod as a model, we have developed a process to advance novel tRNA synthetase domains from a concept to therapeutic candidate. 
This process leverages our early discovery work as well as current scientific understanding of tRNA synthetase evolution, protein structure, gene splicing 
and tissue-specific regulation to identify potentially active protein domains. Screening approaches are employed to identify target cells and extracellular 
receptors for these tRNA synthetase-derived proteins. These cellular systems can then be used in mechanism-of-action studies to elucidate the role these 
proteins play in cellular responses and their potential 

11

 
therapeutic  utility.  We  are  working  to  identify  new  tRNA  synthetase  based  drug  candidates  through  our  internal  discovery  efforts  and  other  external 
collaboration efforts, including our collaboration with Dualsystems Biotech AG (Dualsystems). Dualsystems has agreed to utilize their proprietary receptor 
screening technology and research expertise to attempt to identify and validate new target receptors for tRNA synthetases. Through our internal research 
efforts, the Dualsystems collaboration and other external collaboration efforts, we intend to continue to advance our product development efforts within our 
tRNA synthetase biology platform.

tRNA Synthetase Candidates

Utilizing  our  novel  approach,  we  have  identified  target  receptors  for  domains  of  two  additional  tRNA  synthetases,  gaining  insights  into  their 
potential biological activity in immunology and fibrosis. These fragments form the basis of our additional pipeline candidates. We plan to further elucidate 
the therapeutic potential of these candidates through mechanistic investigations, including in vitro and in vivo preclinical studies.

ATYR0101

ATYR0101  is  a  fusion  protein  derived  from  a  domain  of  aspartyl-tRNA  synthetase  (DARS).  ATYR0101  binds  directly  to  latent-transforming 
growth factor beta-binding protein 1 (LTBP1), which regulates transforming growth factor beta (TGFβ), which is at the apex of fibrotic signaling. Derived 
from a naturally occurring tRNA synthetase, ATYR0101 interacts with LTBP1 in a unique way that presents a differentiated approach to targeting fibrosis. 
Early data suggest ATYR0101 exerts its antifibrotic effects by inducing apoptosis of myofibroblasts in a TGFβ dependent manner. We believe ATYR0101 
may have broad therapeutic applications in multiple fibrotic diseases, such as pulmonary fibrosis, SSc, liver fibrosis and kidney fibrosis.

ATYR0750

ATYR0750 is a fusion protein derived from a domain of alanyl-tRNA synthetase (AARS). ATYR0750 is a novel ligand to fibroblast growth factor 
receptor 4 (FGFR4), which is involved in many cellular processes, including cell proliferation, differentiation, and tissue repair. FGFR4 is known to play a 
role in diseases related to inflammation and fibrosis, particularly in the liver. As a novel ligand, ATYR0750 interacts with FGFR4 in a differentiated way to 
other approaches targeting the receptor, which may lead to improved therapeutic benefit. 

Impact of Geopolitical and Macroeconomic Conditions

Global  economic  and  business  activities  continue  to  face  widespread  macroeconomic  uncertainties,  including  global  geopolitical  tension,  armed 
conflicts, potential future health pandemics, labor shortages, inflation and monetary supply shifts, liquidity concerns at, and failures of, banks and other 
financial  institutions  or  other  disruptions  in  the  banking  system  or  financing  markets,  higher  interest  rates  and  financial  and  credit  market  fluctuations, 
volatility  in  the  capital  markets  and  recession  risks,  disruptions  to  trade,  commerce,  pricing  stability,  credit  availability  and  supply  chain  continuity 
globally. The ultimate long-term impact of these evolving geopolitical and macroeconomic conditions on our business is uncertain, although we continue to 
actively monitor the impact of these factors on our results of operations, financial condition and cash flows. The extent of the impact of these factors on our 
operational and financial performance, including our ability to execute our business strategies and initiatives in the expected timeframe, will depend on 
future  developments,  which  are  uncertain  and  cannot  be  predicted;  however,  any  continued  or  renewed  disruption  resulting  from  these  factors  could 
negatively impact our business.

Competition 

The biotechnology and pharmaceutical industries are intensely competitive. We will face competition with respect to our current product candidates 
and any other therapeutics we may develop or commercialize in the future, from pharmaceutical companies, biotechnology companies, universities and 
other research institutions. Our competitors may have substantially greater financial, technical and other resources, such as larger research and development 
staff  and  established  marketing,  sales  and  manufacturing  organizations.  Additional  mergers  and  acquisitions  in  the  biotechnology  and  pharmaceutical 
industries  may  result  in  even  more  resources  being  concentrated  in  our  competitors.  Competition  may  increase  further  as  a  result  of  advances  in  the 
commercial applicability of technologies and greater availability of capital for investment in these industries. Our competitors may succeed in developing, 
acquiring or licensing on an exclusive basis, drug products that are more effective, safer or less costly than any product candidate that we may develop.

Although  we  believe  we  are  the  only  company  engaged  in  the  discovery  and  development  of  therapeutics  based  on  novel  functions  of  tRNA 

synthetases, we are aware of other companies that could compete with our product candidates as described below.

Efzofitimod 

Our lead indication for efzofitimod is pulmonary sarcoidosis. For patients with pulmonary sarcoidosis, the primary goal of treatment is to improve 

the patient’s quality of life and avoid danger to organs, such as development of scarring or fibrosis caused by 

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chronic  inflammation.  Currently,  the  only  FDA-approved  therapies  for  the  treatment  of  sarcoidosis  are  glucocorticoids  approved  by  FDA  in  the  1950s, 
prior  to  current  regulatory  standards.  The  consensus  standard  of  care  for  pulmonary  sarcoidosis  is  immunomodulatory  therapy.  First  line  treatment  is 
typically with OCS that act mainly by suppressing inflammatory genes. OCS therapy has been shown to stabilize or improve disease symptoms in some 
patients, although relapse commonly occurs once OCS therapy is tapered or discontinued. Long-term OCS use is associated with significant side effects 
including substantial weight gain, development of insulin resistance, osteoporosis, and risk of infection. Alternatives, such as cytotoxic immunosuppressive 
agents (e.g., methotrexate) have been used as steroid-sparing agents, however, these therapies can also have significant side effects and toxicities, including 
serious infections and liver toxicity. Patients who have progressive disease despite OCS or other immunosuppressive therapy are sometimes given biologic 
immunomodulators, such as the tumor necrosis factor (TNF) inhibitors infliximab or adalimumab. These therapies are not approved by the FDA or other 
regulatory agencies for the treatment of sarcoidosis, and are also associated with serious potential side effects, including malignancy. The efficacy of these 
agents  has  not  been  well  established  clinically.  Given  the  known  toxicities  of  long-term  OCS,  immunosuppressive  and  immunomodulatory  biologic 
therapeutic regimens, treatment of patients with sarcoidosis is limited to those who are symptomatic and whose disease is considered active. The presence 
of  granulomas  from  sarcoidosis  define  the  disease  as  active,  and  granulomatous  inflammation  is  the  major  cause  of  fibrosis  in  pulmonary  sarcoidosis. 
Studies  to  date  have  not  clearly  demonstrated  that  OCS  or  other  immunomodulatory  therapies  prevent  disease  progression  or  formation  of  fibrosis.  We 
believe there remains a substantial unmet need for safer, more effective therapies for sarcoidosis that could reduce or replace the requirement for long-term 
OCS or other immunosuppressive therapy. To our knowledge, efzofitimod is the most advanced drug candidate currently in development for the treatment 
pulmonary sarcoidosis. 

Our  second  indication  for  efzofitimod  is  SSc-ILD.  SSc-ILD  is  very  difficult  to  treat,  with  limited  options.  Few  randomized  studies  have  been 
conducted, and first line standard of care remains off-label immunosuppressive agents, whose impact is modest and associated with significant side effects 
including  malignancies.  Despite  not  being  approved  for  SSc-ILD,  the  immunosuppressants  mycophenolate  mofetil  and  cyclophosphamide  are  typically 
used  as  first-line  treatment.  Two  products  were  recently  approved  for  the  treatment  of  SSc-ILD.  Ofev®  (nintedanib)  marketed  globally  by  Boehringer 
Ingelheim International GmbH, received FDA approval in 2019 for slowing the rate of decline in pulmonary function in patients with SSc-ILD. In 2020, 
the approval was further expanded to include patients with chronic fibrosing ILD with a progressive phenotype. Actemra® (tocilizumab) marketed globally 
by  F.  Hoffmann-La  Roche  Ltd.  and  Chugai  Pharmaceutical  Co  Ltd.,  was  approved  by  the  FDA  in  2021  for  slowing  the  rate  of  decline  in  pulmonary 
function in adult patients with SSc-ILD. These therapies have demonstrated the ability to slow decline in lung function as measured by FVC in controlled 
clinical  studies  but  are  associated  with  significant  side  effects,  continued  symptoms,  and  progressive  disease  in  the  majority  of  patients.  Rituximab,  a 
biologic immunosuppressant targeting B-cells, is also used, but there is little clinical evidence supporting its efficacy in this indication.

If efzofitimod is successful for the treatment of pulmonary sarcoidosis and SSc-ILD, we believe it may have applications in other ILD indications 
and potentially in other severe immune disorders. Based on an analysis from an independent consultant that we engaged during 2022, we estimate that there 
is a $2-3 billion dollar global market opportunity in pulmonary sarcoidosis and Ssc-ILD and our own modeling.

There  are  a  number  of  companies  engaged  in  the  clinical  development  of  potential  new  treatments  for  ILD,  including  Boehringer  Ingelheim 

International GmbH, F. Hoffman-La Roche Ltd., Merck & Co., Sanofi-Aventis LLC, Amgen Inc., GSK plc, and Kinevant Sciences GmbH, among others. 

Sales and Marketing 

We  intend,  where  strategically  appropriate,  to  build  the  commercial  infrastructure  necessary  to  effectively  support  the  commercialization  of  our 
product  candidates,  if  and  when  we  believe  a  regulatory  approval  of  the  first  of  such  product  candidates  in  a  particular  geographic  market  appears 
imminent. We may elect to utilize strategic partners, distributors, or contract sales forces to assist in the commercialization of our product candidates in 
selected geographic locations or for particular indications. For example, we have licensed the rights to Kyorin to develop and commercialize efzofitimod in 
Japan.

Additional capabilities important to the marketing of therapeutics include the management of key stakeholders such as managed care organizations, 
group-purchasing  organizations,  specialty  pharmacies,  and  government  accounts.  To  develop  the  appropriate  commercial  infrastructure,  we  will  have  to 
invest  significant  amounts  of  financial  and  management  resources,  some  of  which  will  be  committed  prior  to  any  confirmation  that  any  of  our  product 
candidates will be approved.

Manufacturing 

We currently contract with third parties for the manufacturing and testing of our product candidates, including efzofitimod, to support preclinical 
studies and clinical trials, and we intend to do so in the future. We do not own or operate manufacturing or testing facilities for the clinical or commercial 
production of our product candidates. We currently have no plans to build our own clinical or commercial scale manufacturing capabilities. The use of 
contracted development and manufacturing organizations (CDMOs) is 

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cost-efficient and has eliminated the need for our direct investment in manufacturing facilities and additional resources early in development. Although we 
rely on CDMOs, we employ personnel with extensive biologics development and manufacturing experience to oversee such CDMOs.

Efzofitimod is a fusion protein that is expressed in recombinant E.coli. We have worked with CDMOs in the United States and internationally on 
the development and manufacture of products using current Good Manufacturing Practices (cGMP) to produce drug substance and drug product to support 
preclinical and clinical development. We have also contracted with CDMOs to conduct the labeling, storage and distribution of our drug product candidates 
to clinical sites.

To date, our CDMOs have met our manufacturing and testing requirements for clinical development and we expect that our current supply chain is 
capable  of  providing  sufficient  quantities  of  our  product  candidates  to  meet  our  anticipated  clinical  development  needs.  Currently  we  have  sufficient 
efzofitimod  on  hand  to  meet  our  projected  needs  for  the  EFZO-FIT  (and  related   Individual Patient EAP)  and  EFZO-CONNECT  studies.  Additionally, 
during 2023, the CDMO that we engaged during late 2021 completed its first and second full, commercial-scale bulk drug substance GMP runs. Quality 
release testing has been completed and all release specifications were met, supporting the CDMO's ability to produce bulk drug substance of efzofitimod 
for  commercial  purposes  if  we  receive  regulatory  approval  for  efzofitimod.  We  will  need  to  demonstrate  that  the  drug  substance  manufactured  by  this 
CDMO  is  comparable  in  quality,  safety  and  potency  to  the  drug  substance  manufactured  by  our  previous  CDMO,  which  is  currently  being  used  in  the 
EFZO-FIT and EFZO-CONNECT studies. 

Patents and Proprietary Rights 

We strive to protect the proprietary technologies that we believe are important to our business, including seeking and maintaining patent protection 
intended to cover the composition of matter of our product candidates, their methods of use, related technology and other inventions that are important to 
our business. We own, or have exclusive licenses to, over 300 issued patents or allowed patent applications with predicted expiration dates ranging from 
2026 to 2034. In addition to patent protection, we also rely on trade secrets and careful monitoring of our proprietary information to protect aspects of our 
business that are not amenable to, or that we do not consider appropriate for, patent protection.

Our  success  will  depend  significantly  on  our  ability  to  obtain  and  maintain  patent  and  other  proprietary  protection  for  commercially  important 
technology, inventions and know-how related to our business, defend and enforce our patents, maintain our licenses to use intellectual property owned by 
third parties, preserve the confidentiality of our trade secrets and operate without infringing the valid and enforceable patents and other proprietary rights of 
third  parties.  We  also  rely  on  know-how,  continuing  technological  innovation  and  in-licensing  opportunities  to  develop,  strengthen,  and  maintain  our 
proprietary  position  in  the  field  of  extracellular  tRNA  synthetase  biology,  their  receptors  and  associated  signaling  pathways,  including,  for  example, 
antibody diagnostics and therapeutics to NRP2.

A third party may hold intellectual property, including patent rights, which is important or necessary to the development of our products. It may be 
necessary for us to use the patented or proprietary technology of third parties to commercialize our products, in which case we would be required to obtain 
a license from these third parties on commercially reasonable terms, or our business could be harmed, possibly materially.

We plan to continue to expand our intellectual property estate by filing patent applications directed to new methods of treatment, therapeutics and 
additional new product forms thereof with new therapeutic or pharmacokinetic properties. Specifically, we seek patent protection in the United States and 
internationally  for  novel  compositions  of  matter  covering  our  protein  therapeutics,  antibody  therapeutics,  next  generation  product  forms  and  the  use  of 
these compositions in a variety of therapies.

The patent positions of biopharmaceutical companies like us are generally uncertain and involve complex legal, scientific and factual questions. In 
addition,  the  coverage  claimed  in  a  patent  application  can  be  significantly  reduced  before  the  patent  is  issued,  and  its  scope  can  be  reinterpreted  after 
issuance. Consequently, we do not know whether any of our product candidates will be protectable or remain protected by enforceable patents. We cannot 
predict whether the patent applications we are currently pursuing will issue as patents in any particular jurisdiction or whether the claims of any issued 
patents will provide sufficient proprietary protection from competitors. Any patents that we hold may be challenged, circumvented or invalidated by third 
parties.

Because patent applications in the United States and certain other jurisdictions are maintained in secrecy for 18 months, 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  United  States  Patent  and  Trademark  Office 
(USPTO), or a foreign patent office to determine priority of invention or in post-grant challenge proceedings, such as oppositions, that challenge priority of 
invention or other features of patentability. Such proceedings could result in us incurring substantial costs, even if the eventual outcome is favorable to us.

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Efzofitimod 

Our  efzofitimod  patent  portfolio  is  comprised  of  a  number  of  patent  families  related  to  derivatives  of  HARS,  including  the  HARS  amino  1-60, 
related  splice  variants,  combinations  with  other  therapeutics,  and  next-generation  product  forms  with  modified  therapeutic  activity  or  pharmacokinetic 
characteristics. Our efzofitimod patent portfolio includes a patent family that is jointly owned by us and our 98% owned subsidiary, Pangu BioPharma, and 
includes issued patents in the United States, Australia, Canada, China, Europe, Hong Kong and Japan, and pending patent applications in the United States. 
The  U.S.  patents  are  expected  to  expire  between  2030  and  2031,  absent  any  patent  term  extension  for  regulatory  delays,  and  the  ex-U.S.  patents,  and 
patents that issue from these patent applications, if any, are expected to expire in 2030, absent any patent term extension. 

The  efzofitimod  patent  portfolio  includes  another  patent  family  jointly  owned  by  us  and  Pangu  BioPharma,  which  includes  patent  applications 
directed to related splice variants of HARS. This patent family includes issued patents in the United States, Australia, Canada, China, Europe, Hong Kong, 
Japan and New Zealand. The issued patents are expected to expire in 2031, absent any patent term extension. 

Also  included  within  the  efzofitimod  patent  portfolio  are  issued  patents  and  pending  patent  applications  directed  to  specific  product  forms  of 
efzofitimod,  and  other  HARS  splice  variants,  including  patent  families  directed  to  Fc  fusion  proteins,  and  combinations  for  treating  lung  inflammation, 
among  other  indications.  One  family  directed  to  specific  Fc  fusion  proteins  includes  issued  or  allowed  patents  in  the  United  States,  Australia,  Canada, 
Europe, Hong Kong, India and Japan, and pending patent applications in the United States and Japan. A patent family directed to combination therapies 
includes an issued patent in the United States, and pending patent applications in the United States, Australia, Canada, China, Europe, Hong Kong and 
Japan. If issued, the patents that derive from the patent applications are predicted to expire between 2034 and 2038, absent any patent term extensions.

tRNA Synthetases

Our pipeline of extracellular tRNA synthetase proteins is covered by a series of patent families, which are directed to all 20 human cytosolic tRNA 
synthetases.  Numerous  patents  are  issued  in  the  United  States  and  elsewhere,  including  issued  U.S.  patents  directed  to  specific  therapeutic  protein 
compositions, the corresponding protein polynucleotide sequences, and certain antibody compositions to specific splice variants. These cases are jointly 
owned by us and Pangu BioPharma, and include issued patents and/or pending applications in the United States, Australia, Canada, Europe, China and 
Japan.  Patents  that  issue  from  these  applications,  if  any,  would  be  expected  to  expire  in  2031,  absent  any  patent  term  extension.  Additional  patent 
applications  have  also  been  separately  filed  (or  are  in  preparation)  on  the  splice  variants,  and  optimized  sequences  derived  from  GARS  (Glycyl-tRNA 
synthetase), DARS, YARS (tyrosyl-tRNA synthetase), and other tRNA synthetases, and any patents issuing from these patent applications are expected to 
expire between 2026 and 2030, absent any patent term extension. 

The term of individual patents depends upon the legal term of the patents in the countries in which they are obtained. In most countries in which we 

file, the patent term is generally 20 years from the earliest date of filing the non-provisional patent application from which the patent issued.

In the United States, the patent term of a patent that covers a drug approved by the FDA, may also be eligible for patent term extension, which 
permits  patent  term  restoration  as  compensation  for  the  patent  term  lost  during  the  FDA  regulatory  review  process.  The  Hatch-Waxman  Act  permits  a 
patent term extension of up to five years beyond the expiration of the patent. The length of the patent term extension is related to the length of time the drug 
is under regulatory review. Patent extension cannot extend the remaining term of a patent beyond a total of 14 years from the date of product approval and 
only one patent applicable to an approved drug may be extended. Similar provisions are available in Europe and other non-United States jurisdictions to 
extend the term of a patent that covers an approved drug. In the future, if and when our pharmaceutical products receive FDA approval, we expect to apply 
for patent term extensions on patents covering those products. We intend to seek patent term extensions to any of our issued patents in any jurisdiction 
where  these  are  available,  however  there  is  no  guarantee  that  the  applicable  authorities,  including  the  FDA  in  the  United  States,  will  agree  with  our 
assessment of whether such extensions should be granted, and even if granted, the length of such extensions.

We  also  rely  on  trade  secret  protection  for  our  confidential  and  proprietary  information.  Although  we  take  steps  to  protect  our  proprietary 
information  and  trade  secrets,  including  through  contractual  means  with  our  employees  and  consultants,  third  parties  may  independently  develop 
substantially equivalent proprietary information and techniques or otherwise gain access to our trade secrets or disclose our technology. Thus, we may not 
be  able  to  meaningfully  protect  our  trade  secrets.  It  is  our  policy  to  require  our  employees,  consultants,  outside  scientific  collaborators,  sponsored 
researchers and other advisors to execute confidentiality agreements upon the commencement of employment or consulting relationships with us. These 
agreements  provide  that  all  confidential  information  concerning  our  business  or  financial  affairs  developed  or  made  known  to  the  individual  during  the 
course of the individual’s relationship with us is to be kept confidential and not disclosed to third parties except in specific circumstances. In the case of 
employees, the agreements provide that all inventions conceived by the individual, and which are related to our current or planned business or research 

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and development or made during normal working hours, on our premises or using our equipment or proprietary information, are our exclusive property.

Government Regulation 

Government authorities in the United States, including federal, state, and local authorities, and in other countries, extensively regulate, among other 
things,  the  manufacturing,  research  and  clinical  development,  marketing,  labeling  and  packaging,  storage,  distribution,  post-approval  monitoring  and 
reporting,  advertising  and  promotion,  and  export  and  import  of  biological  products,  such  as  those  we  are  developing.  Pricing  of  such  products  is  also 
subject to regulation in many countries. The process of obtaining regulatory approvals and the subsequent compliance with appropriate federal, state, local, 
and foreign statutes and regulations require the expenditure of substantial time and financial resources.

U.S. Government Regulation 

In the United States, the FDA regulates biologics under the Federal Food, Drug, and Cosmetic Act and the Public Health Service Act and their 
implementing regulations. FDA approval is required before any new unapproved biologic or dosage form, including a new use of a previously approved 
biologic, can be marketed in the United States. Biologics are also subject to other federal, state, and local statutes and regulations. If we fail to comply with 
applicable FDA or other requirements at any time during the product development process, clinical testing, approval process or after approval, we may 
become subject to administrative or judicial sanctions. These sanctions could include the FDA’s refusal to approve pending applications, license suspension 
or revocation, untitled or warning letters, product recalls, product seizures, total or partial suspension of production or distribution, injunctions, fines, civil 
penalties or criminal prosecution. Any FDA enforcement action could have a material adverse effect on us.

The process required by the FDA before product candidates may be marketed in the United States generally involves the following:

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•

•

•

•

•

•

completion  of  extensive  preclinical  laboratory  tests  and  preclinical  animal  studies,  performed  in  accordance  with  the  good  laboratory 
practice regulations, where applicable;

submission to the FDA of an IND which must become effective before human clinical trials may begin and must be updated annually;

approval by an independent institutional review board (IRB) or ethics committee representing each clinical site before each clinical trial 
may be initiated;

performance of adequate and well-controlled human clinical trials to establish the safety and efficacy of the product candidate for each 
proposed indication and conducted in accordance with good clinical practice (GCP) requirements;

preparation of and submission to the FDA of a biologics license application (BLA) after completion of all pivotal clinical trials;

potential review of the product application by an FDA advisory committee, where appropriate and if applicable;

a determination by the FDA within 60 days of its receipt of a BLA to file the application for review;

satisfactory  completion  of  an  FDA  pre-approval  inspection  of  the  manufacturing  facilities  where  the  proposed  product  is  produced  to 
assess compliance with cGMP;

potential FDA audit of the clinical trial sites that generated the data in support of the BLA; and

FDA review and approval of a BLA prior to any commercial marketing or sale of the product in the United States.

The preclinical and clinical testing and approval process requires substantial time, effort, and financial resources, and we cannot be certain that any 

approvals for our product candidates will be granted on a timely basis, if at all.

An IND is a request for authorization from the FDA to administer an investigational new drug or biologic product to humans in clinical trials. The 
IND  submission  includes  the  general  investigational  plan  and  the  protocol(s)  for  human  trials.  The  IND  also  includes  results  of  preclinical  testing, 
including  animal  and  in  vitro  studies,  to  assess  the  toxicology,  PK,  pharmacology,  and  pharmacodynamic  characteristics  of  the  product;  chemistry, 
manufacturing,  and  controls  information;  and  any  available  human  data  or  literature  to  support  the  use  of  the  investigational  new  drug.  An  IND  must 
become effective before human clinical trials may begin. An IND will automatically become effective 30 days after receipt by the FDA, unless before that 
time  the  FDA  raises  concerns  or  questions  related  to  the  proposed  clinical  trials.  In  such  a  case,  the  IND  may  be  placed  on  clinical  hold  and  the  IND 
sponsor and the FDA must resolve any outstanding concerns or questions before clinical trials can begin. Accordingly, submission of an IND may or may 
not result in the FDA allowing clinical trials to commence. The FDA may impose a clinical hold at any time during a clinical trial and may impose a 

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partial clinical hold that would apply certain limits to the trial, for example, imposing dosage limitations or restricting the timeframe of the trial.

Clinical Trials

Clinical  trials  involve  the  administration  of  the  investigational  new  drug  to  human  subjects  under  the  supervision  of  qualified  investigators  in 
accordance with GCPs which include the requirement that all research subjects provide their informed consent for their participation in any clinical trial. 
Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the parameters to be used in monitoring safety, and 
the efficacy criteria to be evaluated. A protocol for each clinical trial and any subsequent protocol amendments must be submitted to the FDA as part of the 
IND. Additionally, approval must also be obtained from each clinical trial site’s IRB before the clinical trials may be initiated, and the IRB must monitor 
the trial until it is completed. There are also requirements governing the reporting of ongoing clinical trials and clinical trial results to public registries.

The clinical investigation of a drug is generally divided into three phases. Although the phases are usually conducted sequentially, they may overlap 

or be combined.

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•

•

Phase 1. The drug is initially introduced into a relatively small number of healthy human subjects or patients with the target disease or 
condition.  These  studies  are  designed  to  evaluate  the  safety,  dosage  tolerance,  metabolism  and  pharmacologic  actions  of  the 
investigational  new  drug  in  humans,  the  side  effects  associated  with  increasing  doses,  and  if  possible,  to  gain  early  evidence  on
effectiveness.

Phase  2.  The  drug  is  administered  to  a  limited  patient  population  to  evaluate  dosage  tolerance  and  optimal  dosage,  identify  possible 
adverse side effects and safety risks, and preliminarily evaluate efficacy. Multiple Phase 2 clinical trials may be conducted by the sponsor 
to obtain information prior to beginning larger and more costly Phase 3 clinical trials.

Phase 3. The drug is administered to an expanded patient population, generally at geographically dispersed clinical trial sites to generate 
enough data to evaluate dosage, clinical effectiveness and safety, and establish the overall benefit-risk relationship of the investigational 
new drug product. A well-controlled, statistically robust Phase 3 trial may be designed to deliver the data that regulatory authorities will 
use  to  decide  whether  or  not  to  approve,  and,  if  approved,  how  to  appropriately  label  a  drug:  such  Phase  3  studies  are  referred  to  as 
“pivotal.”

In some cases, the FDA may condition approval of a BLA for a product candidate on the sponsor’s agreement to conduct additional clinical trials 
after approval. In other cases, a sponsor may voluntarily conduct additional clinical trials after approval to gain more information about the drug. Such 
post-approval studies are typically referred to as Phase 4 clinical trials. Failure to exhibit due diligence with regard to conducting Phase 4 clinical trials that 
the FDA requires as a condition of approval could result in FDA withdrawing approval for the product.

A clinical trial sponsor must submit written IND safety reports to the FDA and the investigators for serious and unexpected adverse reactions, any 
clinically important increase in the rate of a serious suspected adverse reaction over that listed in the protocol or investigator’s brochure, or any findings 
from other studies or animal or in vitro testing that suggest a significant risk in humans exposed to the product candidate within 15 calendar days after the 
sponsor determines that the information qualifies for reporting. The sponsor also must notify the FDA of any unexpected fatal or life-threatening suspected 
adverse  reaction  within  seven  calendar  days  after  the  sponsor’s  initial  receipt  of  the  information.  The  FDA,  the  IRB,  or  the  clinical  trial  sponsor  may 
suspend or terminate a clinical trial at any time on various grounds, including a finding that the research subjects are being exposed to an unacceptable 
health risk. Additionally, some clinical trials are overseen by an independent group of qualified experts organized by the clinical trial sponsor, known as a 
data safety monitoring board or committee. This group provides authorization for whether or not a trial may move forward at designated check points based 
on access to certain data from the trial. We may also suspend or terminate a clinical trial based on evolving business objectives or competitive climate.

BLA Submission

Assuming successful completion of all required testing in accordance with all applicable regulatory requirements, detailed information about the 
investigational  biologic  product  is  submitted  to  the  FDA  in  the  form  of  a  BLA  requesting  approval  to  market  the  product  for  one  or  more  indications. 
Efzofitimod and our other potential product candidates are proteins that will be regulated as biological products subject to the BLA marketing pathway. 
Under federal law, the submission of most BLAs is subject to an application user fee, and the sponsor of an approved BLA is also subject to an annual 
prescription drug product program fee. These fees typically increase annually. Applications for orphan drug products are exempted from the BLA user fees, 
unless the application includes an indication for other than a rare disease or condition.

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A BLA must include all relevant data available from pertinent preclinical studies and clinical trials, including negative or ambiguous results as well 
as positive findings, together with detailed information relating to the product’s chemistry, manufacturing, controls, and proposed labeling, among other 
things.  To  support  marketing  approval,  the  data  submitted  must  be  sufficient  in  quality  and  quantity  to  establish  the  safety  and  effectiveness  of  the 
investigational new drug product to the satisfaction of the FDA. FDA approval of a BLA must be obtained before a biologic may be marketed in the United 
States.

Before approving a BLA, the FDA typically will conduct a pre-approval inspection of the facility or facilities where the product is manufactured. 
The FDA will not approve an application unless it determines that the manufacturing processes and facilities are in compliance with cGMP requirements 
and adequate to assure consistent production of the product within required specifications. Additionally, before approving a BLA, the FDA will typically 
inspect one or more clinical sites to assure compliance with GCP.

Additionally, the FDA may refer any NDA or BLA, including applications for novel biologic candidates which present difficult questions of safety 
or efficacy, to an advisory committee. Typically, an advisory committee is a panel of independent experts, including clinicians and other scientific experts, 
that reviews, evaluates and provides a recommendation as to whether the application should be approved and under what conditions. The FDA is not bound 
by the recommendations of an advisory committee, but it considers such recommendations carefully when making decisions.

The FDA’s Decision on a BLA 

The  FDA  evaluates  a  BLA  to  determine  whether  the  data  demonstrate  that  the  biologic  is  safe,  pure,  and  potent,  or  effective.  After  the  FDA 
evaluates the BLA and conducts inspections of manufacturing facilities where the product will be produced, it may issue an approval letter or a Complete 
Response Letter (CRL). An approval letter authorizes commercial marketing of the drug with specific prescribing information for specific indications. A 
CRL indicates that the review cycle of the application is complete and the application is not ready for approval. A CRL generally outlines the deficiencies 
in  the  submission  and  may  require  substantial  additional  testing  or  information  in  order  for  the  FDA  to  reconsider  the  application.  A  CRL  may  require 
additional clinical data or an additional pivotal Phase 3 clinical trial(s), or other significant, expensive and time-consuming requirements related to clinical 
trials, preclinical studies or manufacturing. Even with the submission of this additional information, however, the FDA may ultimately decide that the BLA 
does not satisfy the criteria for approval and issue a denial.

The FDA could also approve the BLA with a Risk Evaluation and Mitigation Strategy plan to mitigate risks associated with the product, which 
could include medication guides, physician communication plans, or elements to assure safe use, such as restricted distribution methods, patient registries 
and other risk minimization tools. The FDA may also condition approval on, among other things, changes to proposed labeling, development of adequate 
controls and specifications, or a commitment to conduct one or more post-market studies or clinical trials. Such post-market testing may include Phase 4 
clinical  trials  and  surveillance  to  further  assess  and  monitor  the  product’s  safety  and  effectiveness  after  commercialization.  Also,  new  government 
requirements,  including  those  resulting  from  new  legislation,  may  be  established,  or  the  FDA’s  policies  may  change,  which  could  delay  or  prevent 
regulatory approval of our products under development.

Expedited Review and Accelerated Approval Programs

A sponsor may seek approval of its product candidate under programs designed to accelerate FDA’s review and approval of NDAs and BLAs. For 
example, Fast Track designation may be granted to a drug or biologic intended for treatment of a serious or life-threatening disease or condition that has 
potential to address unmet medical needs for the disease or condition by providing a therapy where none exists or a therapy that may be potentially superior 
to  existing  therapy  based  on  efficacy  or  safety  factors.  The  key  benefits  of  Fast  Track  designation  are  more  frequent  interactions  with  the  FDA  during 
development and testing and eligibility for priority review. The FDA may also review sections of the NDA or BLA for a Fast Track product on a rolling 
basis before the complete application is submitted, if the sponsor and the FDA agree on a schedule for the submission of the application sections, and the 
sponsor pays any required user fees upon submission of the first section of the application. Based on results of the Phase 3 clinical trial(s) submitted in a 
BLA, the FDA may grant the BLA a priority review designation, which sets the target date for FDA action on the application at six months after the FDA 
accepts the application for filing. Priority review is granted where there is evidence that the proposed product would be a significant improvement in the 
safety or effectiveness of the treatment, diagnosis, or prevention of a serious condition. If criteria are not met for priority review, the application is subject 
to  the  standard  FDA  review  period  of  ten  months  after  FDA  accepts  the  application  for  filing.  Priority  review  designation  does  not  change  the 
scientific/medical standard for approval or the quality of evidence necessary to support approval. Fast Track designation may be withdrawn by the sponsor 
or rescinded by the FDA if the designation is no longer supported by data emerging in the clinical trial process.

Under  the  accelerated  approval  program,  the  FDA  may  approve  a  BLA  on  the  basis  of  either  a  surrogate  endpoint  that  is  reasonably  likely  to 
predict clinical benefit or, on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably likely to predict an 
effect  on  irreversible  morbidity  or  mortality  or  other  clinical  benefit,  taking  into  account  the  severity,  rarity,  or  prevalence  of  the  condition  and  the 
availability or lack of alternative treatments. Drugs and biologics granted 

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accelerated  approval  must  meet  the  same  statutory  standards  for  safety  and  effectiveness  as  those  granted  traditional  approval.  Post-marketing  trials  or 
completion of ongoing trials after marketing approval are generally required to verify the drug’s clinical benefit in relationship to the surrogate endpoint or 
ultimate outcome in relationship to the clinical benefit. In addition, a sponsor may seek FDA designation of its product candidate as a breakthrough therapy 
if the drug is intended, alone or in combination with one or more other drugs, to treat a serious or life-threatening disease or condition and preliminary 
clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies on one or more clinically significant endpoints, 
such as substantial treatment effects observed early in clinical development. If so designated, the FDA shall act to expedite the development and review of 
the product’s marketing application, including by meeting with the sponsor throughout the product’s development, providing timely advice to the sponsor 
to  ensure  that  the  development  program  to  gather  preclinical  and  clinical  data  is  as  efficient  as  practicable,  involving  senior  managers  and  experienced 
review staff in a cross-disciplinary review, and assigning a cross-disciplinary project lead for the FDA review team to facilitate an efficient review of the 
development program and to serve as a scientific liaison between the review team and the sponsor. 

Post-Approval Requirements

Drugs manufactured or distributed pursuant to FDA approvals are subject to pervasive and continuing regulation by the FDA, including, among 
other  things,  requirements  relating  to  recordkeeping,  periodic  reporting,  product  sampling  and  distribution,  advertising  and  promotion  and  reporting  of 
adverse experiences with the product. After approval, most changes to the approved product, such as adding new indications or other labeling claims or 
some changes to the manufacturing process, are subject to prior FDA review and approval. 

Drug manufacturers are subject to periodic unannounced inspections by the FDA and state agencies for compliance with cGMP requirements. 

We rely, and expect to continue to rely, on third parties for the production of clinical quantities of our product candidates, and expect to rely in the 
future on third parties for the production of commercial quantities. Future FDA and state inspections may identify compliance issues at our facilities or at 
the facilities of our contract manufacturers that may disrupt production or distribution, or require substantial resources to correct. In addition, discovery of 
previously unknown problems with a product or the failure to comply with applicable requirements may result in restrictions on a product, manufacturer or 
holder of an approved BLA, including withdrawal or recall of the product from the market or other voluntary, FDA-initiated or judicial action that could 
delay or prohibit further marketing, or result in the imposition of post-market studies or trials to assess new safety risks.

The FDA strictly regulates marketing, labeling, advertising, and promotion of products that are placed on the market. Drugs may be promoted only 
for  the  approved  indications  and  in  accordance  with  the  provisions  of  the  approved  label.  The  FDA  and  other  agencies  actively  enforce  the  laws  and 
regulations  prohibiting  the  promotion  of  off-label  uses,  and  a  company  that  is  found  to  have  improperly  promoted  off-label  uses  may  be  subject  to 
significant liability.

Orphan Designation and Exclusivity 

The FDA may grant orphan drug designation to drugs intended to treat a rare disease or condition that affects fewer than 200,000 individuals in the 
United States, or if it affects more than 200,000 individuals in the United States and for which there is no reasonable expectation that the cost of developing 
and making a drug for this type of disease or condition will be recovered from sales in the United States. Orphan drug designation must be requested before 
submitting an NDA or BLA. After the FDA grants orphan drug designation, the identity of the therapeutic agent and its potential orphan use are disclosed 
publicly by the FDA.

Orphan drug designation does not convey any advantage in or shorten the duration of the regulatory review and approval process, but it entitles a 
party  to  financial  incentives  such  as  opportunities  for  grant  funding  towards  clinical  trial  costs,  tax  advantages,  and  user-fee  waivers.  In  addition,  if  a 
product is the first to receive FDA approval for the indication for which it has orphan designation, the product is entitled to orphan drug exclusivity, which 
means  the  FDA  may  not  approve  any  other  application  to  market  the  same  drug  for  the  same  indication  for  a  period  of  seven  years,  except  in  limited 
circumstances, such as a showing of clinical superiority over the product with orphan exclusivity. Orphan drug exclusivity, however, also could block the 
approval  of  one  of  our  products  for  seven  years  if  a  competitor  obtains  approval  of  the  same  drug  as  defined  by  the  FDA  for  treatment  of  the  same 
indication or disease.

Pediatric Trials and Exclusivity

Under the Pediatric Research Equity Act of 2003, as amended, BLAs or supplement to a BLA must contain data that are adequate to assess the 
safety and effectiveness of an investigational drug or biologic product for the claimed indications in all relevant pediatric populations and to support dosing 
and administration for each pediatric subpopulation for which the drug is safe and effective. A sponsor who is planning to submit a marketing application 
for a drug product that includes a new active ingredient, new indication, new dosage form, new dosing regimen or new route of administration must submit 
an initial Pediatric Study Plan (PSP) within sixty days of an 

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end-of-phase 2 meeting or, if there is no such meeting, as early as practicable before the initiation of the Phase 3 or Phase 2/3 clinical trial. The initial PSP 
must  include  an  outline  of  the  pediatric  study  or  studies  that  the  sponsor  plans  to  conduct,  including  study  objectives  and  design,  age  groups,  relevant 
endpoints and statistical approach, or a justification for not including such detailed information, and any request for a deferral of pediatric assessments or a 
full or partial waiver of the requirement to provide data from pediatric studies along with supporting information. The FDA may, on its own initiative or at 
the request of the applicant, grant deferrals for submission of some or all pediatric data until after approval of the product for use in adults or full or partial 
waivers if certain criteria are met. The FDA and the sponsor must reach agreement on the PSP. A sponsor can submit amendments to an agreed-upon initial 
PSP at any time if changes to the pediatric plan need to be considered based on data collected from preclinical studies, early phase clinical trials, and/or 
other  clinical  development  programs.  The  requirements  for  pediatric  data  do  not  apply  to  any  drug  or  biologic  for  an  indication  for  which  orphan 
designation has been granted, except under certain circumstances.

Pediatric exclusivity is another type of non-patent exclusivity in the United States and, if granted, provides for the attachment of an additional six 
months of marketing protection to the term of any existing regulatory exclusivity, including orphan exclusivity. This six-month exclusivity may be granted 
if a BLA sponsor submits pediatric data that fairly respond to a written request from the FDA for such data. 

Rest of World Government Regulation 

In addition to regulations in the United States, we will be subject to a variety of regulations in other jurisdictions governing, among other things, 
clinical trials and any commercial sales and distribution of our products. The cost of establishing a regulatory compliance system for numerous varying 
jurisdictions can be very significant. Although many of the issues discussed above with respect to the United States apply similarly in the context of the 
European Union and in other jurisdictions, the approval process varies between countries and jurisdictions and can involve additional product testing and 
additional administrative review periods. The time required to obtain approval in other countries and jurisdictions might differ from and be longer than that 
required to obtain FDA approval. Regulatory approval in one country or jurisdiction does not ensure regulatory approval in another, but a failure or delay in 
obtaining regulatory approval in one country or jurisdiction may negatively impact the regulatory process in others.

Whether or not we obtain FDA approval for a product, we must obtain the requisite approvals from regulatory authorities in foreign countries prior 
to the commencement of clinical trials or marketing of the product in those countries. Certain countries outside of the United States have a similar process 
that requires the submission of a clinical trial application much like the IND prior to the commencement of human clinical trials. In the EU, for example, a 
clinical trial authorization application (CTA) must be submitted for each clinical protocol to each country’s national health authority and an independent 
ethics committee, much like the FDA and IRB, respectively. Once the CTA is accepted in accordance with a country’s requirements, the clinical trial may 
proceed.

The requirements and process governing the conduct of clinical trials vary from country to country. In all cases, the clinical trials are conducted in 

accordance with GCP the applicable regulatory requirements, and the ethical principles that have their origin in the Declaration of Helsinki.

Pharmaceutical Coverage, Pricing and Reimbursement 

Significant uncertainty exists as to the coverage and reimbursement status of any products for which we obtain regulatory approval. In the United 
States and in other countries, sales of any products for which we receive regulatory approval for commercial sale will depend in part on the availability of 
coverage and reimbursement from third-party payors. Third-party payors include government authorities, managed care providers, private health insurers 
and other organizations. Private payors often follow Centers for Medicare & Medicaid Services (CMS’s) determinations relating to Medicare and Medicaid 
with respect to coverage policy and payment limitations in setting their own reimbursement policies. The process for determining whether a payor will 
provide coverage for a product may be separate from the process for setting the reimbursement rate that the payor will pay for the product. Third-party 
payors may limit coverage to specific products on an approved list, or formulary, which might not include all of the FDA-approved products for a particular 
indication.  Moreover,  a  payor’s  decision  to  provide  coverage  for  a  drug  product  does  not  imply  that  an  adequate  reimbursement  rate  will  be  approved. 
Adequate third-party reimbursement may not be available or sufficient to enable us to maintain price levels sufficient to realize an appropriate return on our 
investment in product development.

Third-party  payors  are  increasingly  challenging  the  price  and  examining  the  medical  necessity  and  cost-effectiveness  of  medical  products  and 
services, in addition to their safety and efficacy. In order to obtain coverage and reimbursement for any product that might be approved for sale, we may 
need to conduct expensive pharmacoeconomic studies in order to demonstrate the medical necessity and cost-effectiveness of our products, in addition to 
the costs required to obtain regulatory approvals. Our product candidates may not be considered medically necessary or cost-effective. If third-party payors 
do not consider a product to be cost-effective compared to other available therapies, they may not cover the product after approval as a benefit under their 
plans or, if they do, the level of payment may not be sufficient to allow a company to sell its products at a profit.

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The U.S. government, state legislatures and foreign governments have shown significant interest in implementing cost containment programs to 
limit the growth of government-paid health care costs, including price controls, restrictions on reimbursement and requirements for substitution of generic 
products for branded prescription drugs. By way of example, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education 
Reconciliation Act of 2010 (collectively, the ACA) contains provisions that may reduce the profitability of drug products, including, for example, increased 
rebates for drugs sold to Medicaid programs, extension of Medicaid rebates to Medicaid managed care plans, mandatory discounts for certain Medicare 
Part D beneficiaries and annual fees based on pharmaceutical companies’ share of sales to federal health care programs. There have been executive, judicial 
and Congressional challenges to certain aspects of the ACA. For example, legislation enacted in 2017, informally titled the Tax Cuts and Jobs Act of 2017, 
included a provision which repealed, effective January 1, 2019, the tax-based shared responsibility payment imposed by the ACA on certain individuals 
who fail to maintain qualifying health coverage for all or part of a year that is commonly referred to as the “individual mandate.” On June 17, 2021, the 
Supreme Court dismissed a challenge on procedural grounds that argued the ACA is unconstitutional in its entirety because the “individual mandate” was 
repealed by Congress. Further, on August 16, 2022, President Biden signed the Inflation Reduction Act of 2022 (IRA) into law, which among other things, 
extends enhanced subsidies for individuals purchasing health insurance coverage in ACA marketplaces through plan year 2025. The IRA also eliminates 
the “donut hole” under the Medicare Part D program beginning in 2025 by significantly lowering the beneficiary maximum out-of-pocket cost and creating 
a new manufacturer discount program. It is possible that the ACA will be subject to judicial or Congressional challenges in the future. It is unclear how any 
such challenges and the healthcare reform measures of the Biden administration will impact the ACA and our business. 

Prior  to  the  Supreme  Court  ruling,  on  January  28,  2021,  President  Biden  issued  an  executive  order  to  initiate  a  special  enrollment  period  for 
purposes  of  obtaining  health  insurance  coverage  through  the  ACA  marketplace.  The  executive  order  also  instructed  certain  governmental  agencies  to 
review  and  reconsider  their  existing  policies  and  rules  that  limit  access  to  healthcare,  including  among  others,  reexamining  Medicaid  demonstration 
projects and waiver programs that include work requirements, and policies that create unnecessary barriers to obtaining access to health insurance coverage 
through Medicaid or the ACA. It is possible that the ACA will be subject to judicial or Congressional challenges in the future. It is unclear how any such 
challenges and the healthcare reform measures of the Biden administration will impact the ACA and our business.

In addition, there has been heightened governmental scrutiny in the United States of pharmaceutical pricing practices in light of the rising cost of 
prescription drugs and biologics. Such scrutiny has resulted in several recent congressional inquiries and proposed and enacted federal and state legislation 
designed to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer patient programs, 
and reform government program reimbursement methodologies for products. For example, in July 2021, the Biden administration released an executive 
order, “Promoting Competition in the American Economy,” with multiple provisions aimed at prescription drugs. In response to Biden’s executive order, on 
September 9, 2021, the Department of Health and Human Services (HHS) released a Comprehensive Plan for Addressing High Drug Prices that outlines 
principles  for  drug  pricing  reform  and  sets  out  a  variety  of  potential  legislative  policies  that  Congress  could  pursue  as  well  as  potential  administrative 
actions  HHS  can  take  to  advance  these  principles.  In  addition,  the  IRA,  among  other  things  (i)  directs  HHS  to  negotiate  the  price  of  certain  high-
expenditure, single-source drugs and biologics covered under Medicare and (ii) imposes rebates under Medicare Part B and Medicare Part D to penalize 
price increases that outpace inflation. These provisions take effect progressively starting in fiscal year 2023. On August 29, 2023, HHS announced the list 
of the first ten drugs that will be subject to price negotiations, although the Medicare drug price negotiation program is currently subject to legal challenges. 
In  response  to  the  Biden  administration’s  October  2022  executive  order,  on  February  14,  2023,  HHS  released  a  report  outlining  three  new  models  for 
testing by the CMS Innovation Center which will be evaluated on their ability to lower the cost of drugs, promote accessibility, and improve quality of care. 
It  is  unclear  whether  the  models  will  be  utilized  in  any  health  reform  measures  in  the  future.  Further,  on  December  7,  2023,  the  Biden  administration 
announced an initiative to control the price of prescription drugs through the use of march-in rights under the Bayh-Dole Act. On December 8, 2023, the 
National Institute of Standards and Technology published for comment a Draft Interagency Guidance Framework for Considering the Exercise of March-In 
Rights which for the first time includes the price of a product as one factor an agency can use when deciding to exercise march-in rights. While march-in 
rights have not previously been exercised, it is uncertain if that will continue under the new framework. At the state level, legislatures have increasingly 
passed legislation and implemented regulations designed to control pharmaceutical and biological product pricing, including price or patient reimbursement 
constraints,  discounts,  restrictions  on  certain  product  access  and  marketing  cost  disclosure  and  transparency  measures,  and,  in  some  cases,  designed  to 
encourage importation from other countries and bulk purchasing. Additional state and federal healthcare reform measures may be adopted in the future. 

In  the  European  Community,  governments  influence  the  price  of  pharmaceutical  products  through  their  pricing  and  reimbursement  rules  and 
control of national health care systems that fund a large part of the cost of those products to consumers. Some jurisdictions operate positive and negative 
list systems under which products may only be marketed once a reimbursement price has been agreed to by the government. To obtain reimbursement or 
pricing approval, some of these countries may require the completion of clinical trials that compare the cost-effectiveness of a particular product candidate 
to currently available therapies. Other member states allow companies to fix their own prices for medicines, but monitor and control company profits. The 
downward pressure on health care costs in general, particularly prescription drugs, has become very intense. As a result, increasingly higher barriers are 
being erected to 

21

 
the entry of new products. In addition, in some countries, cross-border imports from low-priced markets exert a commercial pressure on pricing within a 
country.

The  marketability  of  any  products  for  which  we  receive  regulatory  approval  for  commercial  sale  may  suffer  if  the  government  and  third-party 
payors fail to provide adequate coverage and reimbursement. In addition, an increasing emphasis on cost containment measures in the United States and 
other  countries  has  increased  and  we  expect  will  continue  to  increase  the  pressure  on  pharmaceutical  pricing.  Coverage  policies  and  third-party 
reimbursement  rates  may  change  at  any  time.  Even  if  favorable  coverage  and  reimbursement  status  is  attained  for  one  or  more  products  for  which  we 
receive regulatory approval, less favorable coverage policies and reimbursement rates may be implemented in the future.

Other Healthcare Laws and Compliance Requirements 

If we obtain regulatory approval for any of our product candidates, we may be subject to various federal and state laws targeting fraud and abuse in 
the healthcare industry. These laws may impact, among other things, our proposed sales, marketing and education programs. In addition, we may be subject 
to  patient  privacy  regulation  by  both  the  federal  government  and  the  states  in  which  we  conduct  our  business.  The  laws  that  may  affect  our  ability  to 
operate include:

•

•

•

•

•

•

the  federal  Anti-Kickback  Statute,  which  prohibits,  among  other  things,  persons  and  entities  from  knowingly  and  willfully  soliciting, 
receiving, offering or paying remuneration, directly or indirectly, to induce, or in return for, the purchase or recommendation of an item or 
service reimbursable under a federal healthcare program, such as the Medicare and Medicaid programs;

federal civil and criminal false claims laws and civil monetary penalty laws, including the civil False Claims Act, which prohibit, among 
other things, individuals or entities from knowingly presenting, or causing to be presented, claims for payment from Medicare, Medicaid, 
or other third-party payors that are false or fraudulent;

the  federal  Health  Insurance  Portability  and  Accountability  Act  of  1996  (HIPAA),  which  created  new  federal  criminal  statutes  that 
prohibit executing a scheme to defraud any healthcare benefit program and making false statements relating to healthcare matters;

the  federal  transparency  laws,  including  the  provision  of  the  ACA  referred  to  as  the  federal  Physician  Payments  Sunshine  Act,  that 
requires  certain  drug  and  biologics  manufacturers  to  disclose  payments  and  other  transfers  of  value  provided  to  physicians  (defined  to 
include doctors, dentists, optometrists, podiatrists, and chiropractors), certain other healthcare professionals (such as physician assistants 
and nurse practitioners), and teaching hospitals and ownership interests of physicians and their immediate family members;

HIPAA,  as  amended  by  the  Health  Information  Technology  for  Economic  and  Clinical  Health  Act  and  its  implementing  regulations, 
which imposes certain requirements on HIPAA covered entities, their business associates and their covered subcontractors relating to the 
privacy, security and transmission of individually identifiable health information; and

state law equivalents of each of the above federal laws, such as anti-kickback and false claims laws that may apply to items or services 
reimbursed by any third-party payor, including commercial insurers, and state laws governing transparency, marketing and drug pricing 
reporting, and the privacy and security of health information in certain circumstances, many of which differ from each other in significant 
ways and may not have the same effect, thus complicating compliance efforts.

The ACA broadened the reach of the fraud and abuse laws by, among other things, amending the intent requirement of the federal Anti-Kickback 
Statute  and  certain  other  criminal  healthcare  fraud  statutes.  Pursuant  to  the  statutory  amendment,  a  person  or  entity  no  longer  needs  to  have  actual 
knowledge of this statute or specific intent to violate it in order to have committed a violation. In addition, the ACA provides that the government may 
assert that a claim including items or services resulting from a violation of the federal Anti-Kickback Statute constitutes a false or fraudulent claim for 
purposes of the civil False Claims Act or the civil monetary penalties statute. Many states have adopted laws similar to the federal Anti-Kickback Statute, 
some of which apply to the referral of patients for healthcare items or services reimbursed by any source, not only the Medicare and Medicaid programs.

We  are  also  subject  to  the  U.S.  Foreign  Corrupt  Practices  Act  (FCPA),  which  prohibits  improper  payments  or  offers  of  payments  to  foreign 
governments and their officials for the purpose of obtaining or retaining business. Safeguards we implement to discourage improper payments or offers of 
payments by our employees, consultants, and others may be ineffective, and violations of the FCPA and similar laws may result in severe criminal or civil 
sanctions,  or  other  liabilities  or  proceedings  against  us,  any  of  which  would  likely  harm  our  reputation,  business,  financial  condition  and  result  of 
operations. 

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If our operations are found to be in violation of any of the laws described above or any other governmental regulations that apply to us, we may be 
subject to penalties, including significant administrative, civil and criminal penalties, exclusion from participation in government healthcare programs, such 
as Medicare and Medicaid and imprisonment, disgorgement, damages, fines, additional reporting requirements and regulatory oversight and the curtailment 
or restructuring of our operations, any of which could adversely affect our ability to operate our business and our results of operations.

Employees and Human Capital Resources

As of December 31, 2023, we had 59 employees, 56 of which were full-time employees. Of our full-time employees, 36 serve in roles related to 
research and development, clinical, manufacturing and regulatory affairs, and 20 serve in general and administrative capacities. As of December 31, 2023, 
all of our employees were based in the United States. We also engage temporary consultants and contractors. All of our employees are “at–will,” which 
means that each employee can terminate his or her relationship with us and we can terminate our relationship with him or her, at any time. None of our 
employees are represented by a labor union or covered by collective bargaining agreements. We consider our relationship with our employees to be good.

We compete in the highly competitive biotechnology industry. Attracting, developing and retaining talented employees is crucial to executing our 
strategy and our ability to compete effectively. Our ability to recruit and retain such talent depends on several factors, including compensation and benefits, 
talent development and career opportunities, and work environment. To that end, we invest in our employees to be an employer of choice.

Our Code of Business Conduct and Ethics (Code of Conduct) ensures that our core values of respect, integrity, collaboration, innovation, trust, and 
excellence are applied throughout our operations. Our Code of Conduct serves as a critical tool to help all of us recognize and report unethical conduct, 
while preserving and nurturing our culture of honesty and accountability. 

The physical health, financial wellbeing, work-life balance and mental health of our employees is vital to our success. Our environmental, health 
and safety team stays abreast of local, regional and global concerns and trends and ensures safety procedures are in place to mitigate workplace injuries and 
safety risks. Our employees are required to complete training in various safety procedures for the laboratories and manufacturing facilities and specialized 
safety training based on particular job duties. Our Designated Safety Officers and response teams oversee safety-related initiatives and a safety committee 
that  provides  input  on  safety  procedures,  practices,  and  policies.  Our  employees  are  required  to  wear  personal  protective  equipment  relevant  for  their 
particular  job  duties.  Occupational  injuries  at  our  facilities  are  extremely  low  and  are  always  investigated  to  determine  if  any  environmental  or  other 
changes need to be implemented.

Financial Information about Segments

We operate in a single accounting segment. Refer to Note 1 to our consolidated financial statements included elsewhere in this Annual Report.

 Corporate Information 

We  were  incorporated  under  the  laws  of  the  State  of  Delaware  in  September  2005.  Our  principal  executive  office  is  located  at  10240  Sorrento 

Valley Road, Suite 300, San Diego, California 92121, and our telephone number is (858) 731-8389. Our website address is www.atyrpharma.com. 

You  are  advised  to  read  this  Annual  Report  in  conjunction  with  other  reports  and  documents  that  we  file  from  time  to  time  with  the  SEC.  Our 
Annual  Reports  on  Form  10-K,  Quarterly  Reports  on  Form  10-Q,  Current  Reports  on  Form  8-K,  and  amendments  to  these  reports  filed  or  furnished 
pursuant to Section 13(a) or 15(d) of the Exchange Act, are available free of charge on our website as soon as reasonably practicable after such reports and 
amendments are electronically filed with, or furnished to, the SEC. You may obtain copies of these reports directly from us or from the SEC. In addition, 
the SEC maintains information for electronic filers (including aTyr Pharma, Inc.) at its website at www.sec.gov. We also make available copies of our news 
releases and other financial information and updates with respect to our business on our website. We do not incorporate the information on or accessible 
through our website into this Annual Report, and you should not consider any information on, or that can be accessed through, our website as part of this 
Annual Report.

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Item 1A. Risk Factors

You should carefully consider the following risk factors, as well as the other information in this Annual Report on Form 10-K (Annual Report) and 
in our other public filings with the SEC. The occurrence of any of these risks could harm our business, financial condition, results of operations and/or 
growth prospects or cause our actual results to differ materially from those contained in forward-looking statements we have made in this Annual Report 
and those we may make from time to time. You should consider all of the risk factors described in our public filings when evaluating our business.

Risks related to the discovery, development and regulation of our product candidates

We may encounter substantial delays and other challenges in our ongoing or planned clinical trials or we may fail to demonstrate safety and efficacy to 
the satisfaction of applicable regulatory authorities.

Before obtaining marketing approval from regulatory authorities for the sale of our product candidates, we must conduct extensive clinical trials to 
demonstrate the safety and efficacy of the product candidates in humans. Clinical trials are expensive, time-consuming, often delayed and uncertain as to 
outcome. We cannot guarantee that our ongoing or planned clinical trials will be initiated or conducted as planned or completed on schedule, if at all. We 
cannot assure you that our product candidates will not be subject to new clinical holds or significant delay in the future. For example, we may experience 
delays in site initiation and patient enrollment, failures to comply with study protocols, delays in the manufacture of study drug for clinical testing and 
other  difficulties  in  starting  or  completing  our  Phase  3  randomized,  double-blind,  placebo-controlled  clinical  trial  to  evaluate  the  efficacy  and  safety  of 
efzofitimod in patients with pulmonary sarcoidosis (the EFZO-FIT study) and our Phase 2 study in systemic sclerosis (SSc also known as scleroderma) 
associated-ILD  (SSc-ILD)  (the  EFZO-CONNECT  study)  or  future  clinical  trials.  Any  inability  to  initiate  or  complete  clinical  trials  of  our  product
candidates in the United States, as a result of clinical holds or otherwise, would delay our clinical development plans, may require us to incur additional 
clinical development costs and could impair our ability to obtain U.S. regulatory approval for such product candidates.

A  failure  of  one  or  more  clinical  trials  can  occur  at  any  stage  of  testing,  and  our  clinical  trials  may  not  be  successful.  Events  that  may  prevent 

successful or timely completion of clinical development include, but are not limited to:

•

•

•

•

•

•

•

•

•

•

•

•

•

our inability to generate sufficient preclinical, toxicology, or other in vivo or in vitro data to support the initiation of human clinical trials, 
including clinical trials of certain dosages;

delays  in  reaching  consensus  with  regulatory  agencies  on  trial  design,  including  the  endpoints  for  our  global  pivotal  Phase  3  study  of 
efzofitimod  in  patients  with  pulmonary  sarcoidosis  (the  EFZO-FIT  study),  and  prioritization  of  outcome  measurements  that  would  best 
support the evaluation of efzofitimod’s efficacy;

delays  in  reaching  agreement  on  acceptable  terms  with  prospective  clinical  contract  research  organizations  (CROs)  and  clinical  trial  sites, 
including any delays resulting from changes in CROs;

delays in obtaining required institutional review board or Ethics Committee approval at each clinical trial site;

delays  in  recruiting  suitable  patients  to  participate  in  our  clinical  trials,  or  delays  that  may  result  if  the  number  of  patients  required  for  a 
clinical trial is larger than we anticipate;

imposition  of  a  clinical  hold  by  regulatory  agencies,  which  may  occur  at  any  time  before  or  during  a  clinical  trial,  including  after  our 
submission of data to these agencies or an inspection of our clinical trial operations or trial sites;

failure by our CROs, investigators, other third parties or us to adhere to clinical trial requirements;

failure  to  perform  in  accordance  with  the  good  clinical  practices  (GCPs)  of  the  U.S.  Food  and  Drug  Administration  (FDA)  or  applicable 
regulatory requirements in other countries;

delays in the testing, validation, manufacturing and delivery of our product candidates to the clinical sites; 

delays in having patients complete participation in a trial or return for post-treatment follow-up;

disagreements with regulators regarding our interpretation of data from preclinical studies or clinical trials;

occurrence of adverse events associated with a product candidate that are viewed to outweigh its potential benefits; or

changes in regulatory requirements and guidance that require amending or submitting new clinical protocols.

Any delay in or inability to successfully complete preclinical and clinical development (including any delays resulting from any changes in a CRO) 
could  result  in  additional  costs  to  us  and  impair  our  ability  to  generate  revenue.  In  addition,  if  we  make  manufacturing  or  formulation  changes  to  our 
product candidates (including our technology transfer to another contract development manufacturing organization (CDMO) for bulk drug substance and 
production capacity changes for efzofitimod), we will need to conduct additional 

24

 
 
comparability studies to bridge our modified product candidates to earlier versions, and the data generated from these comparability studies will need to be 
reviewed and accepted by the FDA or other regulatory authorities. 

If the results of our clinical trials are perceived to be negative or inconclusive, or if there are safety concerns or adverse events associated with our 
product  candidates,  we  may  be  required  to  perform  additional  clinical  trials  to  support  approval  or  be  subject  to  additional  post-marketing  testing 
requirements; be delayed in obtaining marketing approval for our product candidates, if at all; obtain approval for indications or patient populations that are 
not as broad as intended or desired; obtain approval with labeling that includes significant use or distribution restrictions or safety warnings; be subject to 
changes in the way the product is manufactured or administered; have regulatory authorities withdraw their approval of the product or impose restrictions 
on its distribution in the form of a modified risk evaluation and mitigation strategy; be subject to litigation; or experience damage to our reputation.

To  date,  the  safety  and  efficacy  of  efzofitimod  has  only  been  studied  in  a  limited  number  of  humans.  Accordingly,  efzofitimod  and  any  future 
product candidates could potentially cause unexpected adverse events. In addition, the inclusion of critically ill patients in our clinical trials may result in 
deaths or other adverse medical events due to the natural progression of the disease. 

Further,  if  patients  drop  out  of  our  ongoing  or  future  clinical  trials,  miss  scheduled  doses  or  follow-up  visits  or  otherwise  fail  to  follow  trial 
protocols,  or  if  our  clinical  trials  are  otherwise  disrupted  due  to  global  geopolitical  tension,  armed  conflicts,  potential  future  health  pandemics  or  other 
adverse macroeconomic and geopolitical events, the integrity of data from our clinical trials may be compromised or not accepted by the FDA or other 
regulatory authorities, which would represent a significant setback for the applicable program. In addition, the COVID-19 pandemic previously impacted 
clinical trials broadly, including our completed efzofitimod Phase 1b/2a trial in patients with pulmonary sarcoidosis, where many sites stopped enrollment 
and patients chose not to enroll or continue participating in the trial due to the impact of COVID-19. While we completed the clinical trial, the availability 
of results from the Phase 1b/2a clinical trial was delayed until September 2021. 

If  we  are  unable  to  successfully  complete  or  otherwise  advance  clinical  development,  obtain  regulatory  or  marketing  approval  for,  or  successfully 
commercialize our therapeutic product candidates, including efzofitimod, or experience significant delays in doing so, our business will be materially 
harmed. 

To date, we have expended significant time, resources and effort on the discovery and development of product candidates related to the extracellular 
proteins derived from the histidyl tRNA synthetase (HARS) family, including conducting preclinical studies and clinical trials. We have not yet completed 
any evaluation of our product candidates in human clinical trials designed to demonstrate efficacy to the satisfaction of the FDA. Before we can market or 
sell our therapeutic candidates in the United States or foreign jurisdictions, we will need to commence and complete additional clinical trials (including our 
EFZO-CONNECT study) and larger, pivotal trials (like the EFZO-FIT study), manage clinical and manufacturing activities, obtain necessary regulatory 
approvals  from  the  FDA  in  the  United  States  and  from  similar  regulatory  authorities  in  other  jurisdictions,  obtain  adequate  clinical  and  commercial 
manufacturing  supplies,  build  commercial  capabilities,  which  may  include  entering  into  a  marketing  collaboration  with  a  third  party,  and  in  some 
jurisdictions, obtain reimbursement authorization, among other things. We cannot assure you that we will be able to successfully complete the necessary 
clinical trials, obtain regulatory approvals, secure an adequate commercial supply for, or otherwise successfully commercialize our therapeutic candidates. 
If we do not receive regulatory approvals for our product candidates, and even if we do obtain regulatory approvals, we may never generate significant 
revenues,  if  any,  from  commercial  sales.  If  we  fail  to  successfully  commercialize  our  therapeutic  candidates,  we  may  be  unable  to  generate  sufficient 
revenues to sustain and grow our company, and our business, prospects, financial condition and results of operations will be adversely affected.

There is no established FDA regulatory pathway for approval of a drug in pulmonary sarcoidosis. As a result, the EFZO-FIT study, even if successful, 
may not be sufficient to support FDA approval, which would materially and adversely harm our business.

During  the  third  quarter  of  2022,  we  initiated  the  EFZO-FIT  study.  The  only  FDA-approved  therapies  for  the  treatment  of  sarcoidosis  are 
glucocorticoids which were approved by the FDA in the 1950s, prior to current regulatory standards. As such, the most appropriate efficacy endpoints to 
demonstrate clinically meaningful treatment effects have not been established. In this instance, without regulatory precedent for established endpoints, the 
FDA has not endorsed a specific means for measurement of steroid reduction. Therefore, we are measuring steroid reduction in multiple ways in an effort 
to  support  an  approval.  Our  rationale  for  selecting  endpoints  for  the  EFZO-FIT  study  is  based  on  the  anticipated  effects  of  efzofitimod  in  pulmonary 
sarcoidosis consistent with the results of our completed Phase 1b/2a study in patients with pulmonary sarcoidosis. The FDA has highlighted the risk of 
proceeding with a larger study of longer duration based on our limited Phase 1b/2a data, and our inability to replicate the findings in our Phase 1b/2a study 
would not support FDA approval and will adversely affect our business, prospects, financial condition and results of operations. 

In  addition,  the  FDA  has  substantial  discretion  in  the  approval  process  and  may  refuse  to  accept  any  application  or  decide  that  our  data  are 
insufficient for approval and require additional preclinical, clinical or other trials, which would be costly and significantly delay the potential for regulatory 
approval. In particular, even if we were to receive positive data from the EFZO-FIT study, the FDA may determine that the data is not compelling enough 
for approval. The FDA may also require a panel of experts, referred to as an 

25

 
Advisory Committee, to deliberate on the adequacy of the safety and efficacy data to support approval. The opinion of the Advisory Committee, although 
not binding, may have a significant impact on our ability to obtain approval of efzofitimod based on the completed clinical trials. 

Interim, top-line and preliminary data from our clinical trials that we announce or publish from time to time may change as more patient data become 
available and are subject to audit and verification procedures that could result in material changes in the final data.

From time to time, we may publicly disclose preliminary or top-line data from our clinical studies, which are based on a preliminary analysis of 
then-available data, and the results and related findings and conclusions are subject to change following a more comprehensive review of the data related to 
the particular study or trial. We also make assumptions, estimations, calculations and conclusions as part of our analyses of data, and we may not have 
received or had the opportunity to fully and carefully evaluate all data. As a result, the top-line results that we report may differ from future results of the 
same studies, or different conclusions or considerations may qualify such results, once additional data have been received and fully evaluated. Top-line data 
also remain subject to audit and verification procedures that may result in the final data being materially different from the preliminary data we previously 
published. As a result, top-line data should be viewed with caution until the final data are available. From time to time, we may also disclose interim data 
from our clinical studies.

In  addition,  we  may  report  interim  analyses  of  only  certain  endpoints  rather  than  all  endpoints.  Interim  data  from  clinical  trials  that  we  may 
complete are subject to the risk that one or more of the clinical outcomes may materially change as patient enrollment continues and more patient data 
become  available.  Adverse  differences  between  preliminary  or  interim  data  and  final  data  could  significantly  harm  our  business  prospects.  Further, 
disclosure of interim data by us or by our competitors could result in volatility in the price of our common stock.

Further, others, including regulatory agencies, may not accept or agree with our assumptions, estimates, calculations, conclusions or analyses or 
may interpret or weigh the importance of data differently, which could impact the value of the particular program, the approvability or commercialization 
of a particular product candidate or product and our company in general. In addition, the information we choose to publicly disclose regarding a particular 
study or clinical trial is based on what is typically extensive information, and you or others may not agree with what we determine is material or otherwise 
appropriate information to include in our disclosure, and any information we determine not to disclose may ultimately be deemed significant with respect to 
future decisions, conclusions, views, activities or otherwise regarding a particular product, product candidate or our business. If the top-line data that we 
report differ from actual results, or if others, including regulatory authorities, disagree with the conclusions reached, our ability to obtain approval for, and 
commercialize, our product candidates may be harmed, which could harm our business, operating results, prospects or financial condition.

We have encountered and may continue to encounter delays and difficulties enrolling patients in our clinical trials for a variety of reasons, including 
the  limited  number  of  patients  who  have  the  diseases  for  which  certain  of  our  product  candidates  are  being  studied,  which  could  delay  or  halt  the 
clinical development of our product candidates.

Identifying and qualifying patients to participate in clinical trials for our product candidates is critical to our success. Certain of the conditions for 

which we may elect to evaluate our product candidates may be rare diseases with limited patient pools from which to draw for clinical trials. 

For example, we are conducting the EFZO-FIT study in patients with pulmonary sarcoidosis. While estimates of pulmonary sarcoidosis prevalence 
vary,  we  estimate  that  pulmonary  sarcoidosis  affects  an  estimated  200,000  patients  in  the  United  States.  Of  that  population,  however,  we  estimate  that 
approximately 70% experience symptomatic disease such that our targeted population is smaller. The eligibility criteria for any of our clinical trials may 
further limit the pool of available participants in our clinical trials. For example, if patients have been previously prescribed certain other medications to 
treat pulmonary sarcoidosis or if they have not been on steroids for a certain period of time, they may not be eligible to participate in the EFZO-FIT study, 
thus further reducing our patient pool. We may be unable to identify and enroll a sufficient number of patients with the disease in question and who meet 
the eligibility criteria for, and are willing to participate in, the clinical trials. Once enrolled, patients may decide or be required to discontinue from the 
clinical trial due to inconvenience, burden of trial requirements, adverse events associated with efzofitimod, limitations required by trial protocols or other 
reasons. Additionally, we are conducting the EFZO-CONNECT study in patients with SSc-ILD. It is estimated that approximately 100,000 people in the 
United States are affected by SSc and up to 80% may develop interstitial lung disease (ILD). 

Our  ability  to  identify,  recruit,  enroll  and  maintain  a  sufficient  number  of  patients,  or  those  with  required  or  desired  characteristics  to  achieve 

diversity in our clinical trials in a timely manner may also be affected by other factors, including, but not limited to:

•

•

proximity and availability of clinical trial sites for patients;

severity of the disease under investigation;

26

 
•

•

•

•

•

•

design of the study protocol and the burdens to patients of compliance with our study protocol;

perceived risks and benefits of the product candidate under study;

availability of competing therapies and clinical trials for the patient populations and indications under study;

efforts to facilitate timely enrollment in clinical trials;

patient referral practices of physicians; and

ability to monitor patients adequately during and after treatment.

We  plan  to  seek  initial  marketing  approval  in  the  United  States.  We  may  not  be  able  to  initiate  or  continue  clinical  trials  if  we  cannot  enroll  a 
sufficient  number  of  eligible  patients  to  participate  in  the  clinical  trials  required  by  the  FDA  or  other  regulatory  agencies.  Our  ability  to  successfully 
initiate,  enroll  and  complete  a  clinical  trial  in  any  foreign  country  is  subject  to  numerous  risks  unique  to  conducting  business  in  foreign  countries, 
including, but not limited to: 

•

•

•

•

difficulty in establishing or managing relationships with or changes in CROs and physicians; 

different requirements and standards for the conduct of clinical trials; 

our inability to locate qualified local consultants, physicians and partners; and 

the potential burden of complying with a variety of foreign laws, medical standards and regulatory requirements, including the regulation of 
biotechnology products and treatment.

Additionally, if patients are unwilling to participate in our clinical trials because of negative publicity from adverse events in our clinical trials or in 
the biotechnology or protein therapeutics industries or for other reasons, including competitive clinical trials for similar patient populations, the timeline for 
recruiting patients, conducting studies and obtaining regulatory approval of potential products may be delayed. These delays could result in increased costs, 
delays in advancing our product development or termination of our clinical trials altogether. If we have difficulty enrolling and maintaining a sufficient 
number of patients to conduct our clinical trials as planned for any reason, we may need to delay, limit or terminate clinical trials, any of which would have 
an adverse effect on our business, prospects, financial condition and results of operations.

Furthermore,  clinical  trial  delays  could  also  shorten  any  periods  during  which  we  may  have  the  exclusive  right  to  commercialize  our  product 
candidates or allow our competitors to bring products to market before we do, which could impair our ability to obtain orphan exclusivity and successfully 
commercialize our product candidates and may have an adverse effect on our business, financial condition and results of operations.

Our  current  product  candidates  and  any  other  product  candidates  that  we  may  develop  from  our  discovery  platform  represent  novel  therapeutic 
approaches, which may cause significant delays or may not result in any commercially viable drugs.

We have concentrated the bulk of our research and development efforts to date on studying extracellular functions of tRNA synthetase biology, a 
newly discovered area of biology. Our future success is highly dependent on the successful development of product candidates based on this new area of 
biology,  including  efzofitimod,  and  additional  product  candidates  arising  from  proteins  derived  from  tRNA  synthetases,  including  aspartyl-tRNA 
synthetase  (DARS)  and  aminoacyl-tRNA  synthetase  (AARS).  ATYR0101,  a  fusion  protein  derived  from  a  domain  of  DARS,  and  ATYR0750,  a  fusion 
protein  derived  from  a  domain  of  AARS,  are  product  candidates  from  our  tRNA  synthetase  biology  program  that  we  are  continuing  to  advance  in 
preclinical studies. Extracellular tRNA synthetase-based biology represents a novel approach to drug discovery and development, and to our knowledge, no 
drugs  have  been  developed  using,  or  based  upon,  this  approach.  Despite  the  successful  development  of  other  naturally  occurring  proteins,  such  as 
erythropoietin and insulin, as therapeutics, proteins derived from HARS, AARS or DARS families and from other tRNA synthetase pathways represent a 
novel class of protein therapeutics, and our development of these therapeutics is based on our new understanding of human physiology. In particular, the 
mechanism  of  action  of  tRNA  synthetases  has  not  been  studied  extensively,  nor  has  the  safety  of  this  class  of  protein  therapeutics  been  evaluated 
extensively in humans. The therapeutic product candidates that we elect to develop may not have the physiological functions that we currently ascribe to 
them, may have limited or no therapeutic applications, or may present safety problems of which we are not yet aware. We cannot be sure that our discovery 
platform will yield therapeutic product candidates that are safe, effective, approvable by regulatory authorities, manufacturable, scalable, or profitable.

Because our work represents a new therapeutic approach, developing and commercializing our product candidates, including efzofitimod, subjects 

us to a number of challenges, including:

•

defining  indications  within  our  targeted  diseases  and  clinical  endpoints  within  each  indication  that  are  appropriate  to  support  regulatory 
approval, including with respect to the EFZO-FIT study and the EFZO-CONNECT study, and prioritization of outcome measurements that 
would best support the evaluation of efzofitimod’s efficacy;

27

 
•

•

•

•

•

•

•

•

obtaining  regulatory  approval  from  the  FDA  and  other  regulatory  authorities  that  have  little  or  no  experience  with  the  development  of 
extracellular tRNA synthetase-based therapeutics;

educating  medical  personnel  regarding  the  potential  side  effect  profile  of  each  of  our  product  candidates,  such  as  the  potential  for  the 
development of antibodies against our purified protein therapeutics;

developing processes for the safe administration of these product candidates, including long-term follow-up for all patients who receive our 
product candidates;

sourcing clinical and, if approved, commercial supplies for the materials used to manufacture and process our product candidates;

developing a manufacturing process and distribution network that ensures consistent manufacture of our product candidates in compliance 
with  current  good  manufacturing  practices  (cGMPs)  and  related  requirements,  with  a  cost  of  goods  that  allows  for  an  attractive  return  on 
investment;

obtaining and maintaining third-party coverage and adequate reimbursement of our product candidates;

establishing sales and marketing capabilities after obtaining any regulatory approval to gain market acceptance; and

developing therapeutics for diseases or indications beyond those addressed by our current product candidates.

Moreover, public perception of safety issues, including adoption of new therapeutics or novel approaches to treatment, may adversely influence the 
willingness  of  subjects  to  participate  in  clinical  trials,  or  if  approved,  of  physicians  to  adopt  and  prescribe  novel  therapeutics.  Physicians,  hospitals  and 
third-party  payors  often  are  slow  to  adopt  new  products,  technologies  and  treatment  practices.  Physicians  may  decide  the  therapy  is  too  complex  or 
unproven to adopt and may choose not to administer the therapy. Based on these and other factors, healthcare providers and payors may decide that the 
benefits of any therapeutic candidates for which we receive regulatory approval do not or will not outweigh its costs. Any inability to successfully develop 
commercially viable drugs would have an adverse impact on our business, prospects, financial condition and results of operations.

Data generated in our preclinical studies and patient sample data relating to the immunomodulatory domain of HARS, including efzofitimod, may not 
be predictive or indicative of the immunomodulatory activity or therapeutic effects, if any, of our product candidates in patients. 

Our  scientists  discovered  the  activity  of  the  immunomodulatory  domain  of  HARS,  including  efzofitimod,  using  in  vitro  and  in  vivo  screening 
systems  designed  to  test  potential  immunomodulatory  activity  in  animal  models  of  immune  activity  or  inflammation.  Translational  medicine,  or  the 
application of basic scientific findings to develop therapeutics that promote human health, is subject to a number of inherent risks. In particular, scientific 
hypotheses  formed  from  preclinical  observations  may  prove  to  be  incorrect,  and  the  data  generated  in  animal  models  or  observed  in  limited  patient 
populations  may  be  of  limited  value,  and  may  not  be  applicable  in  clinical  trials  conducted  under  the  controlled  conditions  required  by  applicable 
regulatory requirements and our protocols. For example, we have not extensively studied the activity of efzofitimod in patients with ILD. 

Our classification of diseases based on the existence of excessive immune cell activation or lack thereof and our hypothesis that these represent 
potential indications for our product candidates may not prove to be therapeutically relevant. Accordingly, the conclusions that we have drawn from animal 
studies and patient sample data regarding the potential immunomodulatory activity of efzofitimod may not be substantiated in other animal models or in 
clinical trials. Further, based on the discovery of the involvement of NRP2 in the mechanism of action of efzofitimod, we are still expanding our knowledge 
of the role of the NRP2 pathway in regulating immune responses. Although we were able to establish clinical proof-of-concept for efzofitimod in our Phase 
1b/2a clinical trial in patients with pulmonary sarcoidosis, this may not be validated in other clinical trials. Any failure to demonstrate in controlled clinical 
trials the requisite safety and efficacy of our product candidates will adversely affect our business, prospects, financial condition and results of operations.

We have previously conducted and we or our third party collaborators may conduct additional clinical trials of efzofitimod outside of the United States. 
The  FDA,  however,  may  not  accept  data  from  such  trials,  in  which  case  our  development  plans  will  be  delayed,  which  could  materially  harm  our 
business.

In  June  2018,  we  completed  a  Phase  1  clinical  trial  of  efzofitimod  in  healthy  subjects  in  Australia.  This  randomized,  double-blind,  placebo-
controlled study investigated the safety, tolerability, immunogenicity, and pharmacokinetics (PK) of intravenous efzofitimod in 36 healthy volunteers. In 
addition, we or our third party collaborators may choose to conduct additional clinical trials for efzofitimod in countries outside the United States, subject 
to  applicable  regulatory  approval.  For  example,  our  partner,  Kyorin  Pharmaceutical  Co.,  Ltd.  (Kyorin),  conducted  and  funded  an  efzofitimod  Phase  1 
clinical trial in 32 healthy Japanese male volunteers 

28

 
and is participating in the EZFO-FIT study. We are enrolling subjects in the EZFO-FIT study in centers in the United States, Europe and Brazil and Kyorin 
is enrolling subjects in the EZFO-FIT study in centers in Japan.

Although the FDA may accept data from clinical trials conducted outside the United States, acceptance of such study data is generally subject to 
certain conditions. For example, in cases where data from foreign clinical trials are intended to serve as the basis for marketing approval in the United 
States, the FDA will generally not approve the application on the basis of foreign data alone unless (i) the data are applicable in the U.S. population and 
U.S.  medical  practice;  and  (ii)  the  clinical  trials  were  performed  by  clinical  investigators  of  recognized  competence  and  pursuant  to  GCP  regulations. 
Additionally, the FDA’s clinical trial requirements, including sufficient size of patient populations and statistical powering, must be met. In addition, when 
studies are conducted only at sites outside of the United States, the FDA generally does not provide advance comment on the clinical protocols for the 
studies, and therefore there is an additional risk that the FDA could determine that the study design or protocol for a non-U.S. clinical trial was inadequate, 
which would likely require us to conduct additional clinical trials, in which case our development plans will be delayed, which could materially harm our 
business. 

Conducting clinical trials outside the United States also exposes us to additional risks, including risks associated with:

•

•

•

•

•

•

additional foreign regulatory requirements;

foreign exchange fluctuations; 

compliance with foreign manufacturing, customs, shipment and storage requirements; 

cultural differences in medical practice and clinical research; 

evolving global geopolitical tension, armed conflicts and macroeconomic developments, ; and

diminished protection of intellectual property in some countries.

Further, the integrity of data from any clinical trials conducted outside of the United States may not be acceptable to the FDA.

Our therapeutic product candidates may cause undesirable side effects or have other properties that could delay or prevent their regulatory approval, 
limit the commercial profile of an approved label, or result in significant negative consequences following marketing approval, if any.

Undesirable side effects caused by our product candidates, or safety, tolerability or toxicity issues that may occur in our preclinical studies, clinical 
trials or in the future, could cause us or regulatory authorities to interrupt, restrict, delay, or halt clinical trials and could result in a more restrictive label or 
the delay or denial of regulatory approval by the FDA or other comparable foreign authorities. 

Generalized infusion related reactions (IRRs) and other complications or side effects could harm further development and/or commercialization of 
our product candidates, including efzofitimod. Additionally, our product candidates are designed to be administered by intravenous injection, which may 
cause side effects, including acute immune responses and injection site reactions. The risk of adverse immune responses remains a significant concern for 
protein therapeutics, and we cannot assure you that these or other risks will not occur in any of our clinical trials our product candidates. There is also a risk 
of delayed adverse events as a result of long-term exposure to protein therapeutics that must be administered repeatedly for the management of chronic 
conditions, such as the development of antibodies, which may occur over time. If any such adverse events occur, which may include the development of a 
negative autoimmune response from antibodies or the occurrence of IRRs associated with antibodies, further advancement of our clinical trials could be 
halted or delayed, which would have a material adverse effect on our business, prospects, financial condition and results of operations.

If  one  or  more  of  our  product  candidates  receives  marketing  approval,  and  we  or  others  later  identify  undesirable  side  effects  or  other  safety 

concerns caused by such products, a number of potentially significant negative consequences could result.

Any of these events could prevent us from achieving or maintaining market acceptance of the particular product candidate, if approved, and could 

significantly harm our business, prospects, financial condition and results of operations.

We may not be successful in our efforts to identify or discover additional product candidates.

A key element of our strategy is to expand applications of efzofitimod to additional immune-mediated diseases and leverage our discovery platform 
to identify the therapeutic potential of extracellular proteins derived from tRNA synthetases to help identify or discover additional product candidates. A 
significant portion of the research that we are conducting involves new compounds and drug discovery methods, including our proprietary technology. Our 
drug discovery activities using our proprietary technology may not be 

29

 
successful in identifying product candidates that are useful in treating diseases. Our research programs may initially show promise in identifying potential 
product candidates, yet fail to yield product candidates for clinical development for a number of reasons, including: 

•

•

the research methodology used may not be successful in identifying appropriate potential product candidates; or 

potential product candidates may, on further study, be shown to have harmful side effects or other characteristics that indicate that they are 
unlikely to be product candidates that will receive marketing approval and achieve market acceptance.

Research programs to identify new product candidates require substantial technical, financial and human resources. We may choose to focus our 
efforts and resources on a potential product candidate that ultimately proves to be unsuccessful. If we are unable to identify suitable product candidates for 
preclinical and clinical development and regulatory approval, we will not be able to generate product revenues, which would have an adverse impact on our 
business, prospects, financial condition and results of operations.

We may face manufacturing stoppages and other challenges associated with the clinical or commercial manufacture of our product candidates.

All  entities  involved  in  the  preparation  of  therapeutics  for  clinical  trials  or  commercial  sale,  including  our  existing  CDMOs  for  our  product 
candidates,  are  subject  to  extensive  regulation.  Components  of  a  finished  therapeutic  product  approved  for  commercial  sale  or  use  in  late-stage  clinical 
trials must be manufactured in accordance with cGMPs. These regulations govern manufacturing processes and procedures (including record keeping) and 
the  implementation  and  operation  of  quality  systems  to  control  and  assure  the  quality  of  investigational  products  and  products  approved  for  sale.  Poor 
control  of  production  processes  can  lead  to  the  introduction  of  contaminants  or  to  inadvertent  changes  in  the  properties  or  stability  of  our  product 
candidates that may not be detectable in final product testing. We or our CDMOs must supply all necessary documentation in support of a biologics license 
application  (BLA)  on  a  timely  basis  and  must  adhere  to  the  FDA’s  Good  Laboratory  Practices  and  cGMP  regulations  enforced  by  the  FDA  through  its 
facilities inspection program. The facilities and quality systems of our CDMOs and other CROs must pass a pre-approval inspection for compliance with 
applicable regulations as a condition of regulatory approval of our product candidates. If these facilities do not pass a pre-approval plant inspection, FDA 
approval of the products will not be granted. If anything were to prevent the FDA or other regulatory authorities from conducting their regular inspections, 
it could impact the ability of our CDMOs to provide us with product for clinical trials.

The regulatory authorities also may, at any time following approval of a product for sale, audit the facilities in which the product is manufactured. If 
any such inspection or audit of our facilities or those of our CDMOs and CROs identifies a failure to comply with applicable regulations or if a violation of
our product specifications or applicable regulations occurs independently of such an inspection or audit, we or the relevant regulatory authority may require 
remedial measures that may be costly or time-consuming for us or a third party to implement and that may include the temporary or permanent suspension 
of a clinical trial or commercial sales or the temporary or permanent closure of a facility. Any such remedial measures imposed upon us or third parties 
with whom we contract could materially harm our business.

If we or any of our CDMOs and CROs fail to maintain regulatory compliance, the FDA can impose regulatory sanctions including, among other 
things,  refusal  to  approve  a  pending  application  for  a  new  biologic  product,  or  revocation  of  a  pre-existing  approval.  Additionally,  if  supply  from  one 
approved manufacturer is interrupted, there could be a significant disruption in clinical or commercial supply. An alternative manufacturer would need to 
be  qualified  through  a  BLA  supplement  which  could  result  in  further  delay.  The  regulatory  agencies  may  also  require  additional  studies  if  a  new 
manufacturer  is  relied  upon  for  commercial  production.  Switching  manufacturers  may  involve  substantial  costs  and  is  likely  to  result  in  a  delay  in  our 
desired clinical and commercial timelines.

In addition, the manufacture of our product candidates presents challenges associated with biologics production, including the inherent instability of 
larger, more complex molecules and the need to ensure uniformity of the drug substance produced in different facilities or across different batches. The 
process of manufacturing biologics is extremely susceptible to product loss due to contamination, equipment failure or improper installation or operation of 
equipment, or vendor or operator error. Even minor deviations from normal manufacturing and distribution processes for any of our product candidates 
could  result  in  reduced  production  yields,  product  defects,  and  other  supply  disruptions.  Furthermore,  although  tRNA  synthetases  represent  a  class  of 
proteins that may share immunomodulatory properties in various physiological pathways, each tRNA synthetase has a different structure and may have 
unique manufacturing requirements that are not applicable across the entire class. For example, fusion proteins, such as efzofitimod, include an additional 
antibody domain to improve PK characteristics, and may therefore require a more complex and time-consuming manufacturing process than other tRNA 
synthetase-based  therapeutic  candidates.  Currently,  we  are  producing  our  efzofitimod  molecule  in  E.coli.  The  manufacturing  processes  for  one  of  our 
product  candidates  may  not  be  readily  adaptable  to  other  product  candidates  that  we  develop,  and  we  may  need  to  engage  multiple  third-party 
manufacturers to produce our product candidates. For example, we engaged an additional CDMO to manufacture efzofitimod and completed a technology 
transfer  and  validation  process  before  the  new  CDMO  was  able  to  produce  additional  bulk  drug  substance.  Any  adverse  developments  affecting 
manufacturing  operations  for  our  product  candidates  may  result  in  shipment  delays,  inventory  shortages,  lot  failures,  withdrawals  or  recalls  or  other 
interruptions in the supply of 

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our drug substance and drug product which could delay the development of our product candidates. We may also have to write off inventory, incur other 
charges  and  expenses  for  supply  of  drug  product  that  fails  to  meet  specifications  or  expires,  undertake  costly  remediation  efforts,  or  seek  more  costly 
manufacturing alternatives. Any manufacturing stoppage or delay, or any inability to consistently manufacture adequate supplies of our product candidates 
for our clinical trials or on a commercial scale will harm our business, prospects, financial condition and results of operations.

Even  if  we  complete  the  necessary  preclinical  studies  and  clinical  trials,  we  cannot  predict  when  or  if  we  will  obtain  regulatory  approval  to 
commercialize a product candidate, and the scope of any approval may be narrower than we expect.

We  cannot  commercialize  a  product  until  the  appropriate  regulatory  authorities  have  reviewed  and  approved  the  product  candidate.  Even  if  our 
product candidates demonstrate safety and efficacy in clinical trials, the regulatory agencies may not complete their review processes in a timely manner, or 
we may not be able to obtain regulatory approval. 

Additional  delays  may  result  if  an  FDA  advisory  committee  or  regulatory  authority  recommends  non-approval  or  restrictions  on  approval.  In 
addition, we may experience delays or rejections based upon additional government regulation from future legislation or administrative action, or changes
in  regulatory  agency  policy  during  the  period  of  product  development,  clinical  trials  and  the  review  process.  Regulatory  agencies  also  may  approve  a 
product  candidate  for  fewer  or  more  limited  indications  than  requested,  may  impose  restrictions  on  dosing  or  may  grant  approval  subject  to  the 
performance  of  post-marketing  studies.  In  addition,  regulatory  agencies  may  not  approve  the  labeling  claims  that  are  necessary  or  desirable  for  the 
successful commercialization of our product candidates.

Although we have obtained orphan drug designation for efzofitimod for the treatment of sarcoidosis and systemic sclerosis in the United States and for 
the treatment of sarcoidosis in the European Union (EU) we may not receive orphan drug designation for efzofitimod in other jurisdictions or for other 
indications that we may pursue, or for any other product candidates we may develop under any new applications for orphan drug designation that we 
may  submit,  and  any  orphan  drug  designations  that  we  have  received  or  may  receive  may  not  confer  marketing  exclusivity  or  other  expected 
commercial benefits.

The FDA granted orphan drug designation to efzofitimod for the treatment of sarcoidosis in January 2022 and SSc in April 2022. The European 
Commission, on the basis of the opinion of the European Medicines Agency (EMA) Committee for Orphan Medicinal Products (COMP) granted orphan 
drug designation to efzofitimod for the treatment of sarcoidosis in January 2023 and for the treatment of SSc in June 2023. We may apply for orphan drug 
designation for efzofitimod for other indications and product candidates in the United States and the EU. 

Under  the  Orphan  Drug  Act,  the  FDA  may  designate  a  drug  or  biologic  product  as  an  orphan  drug  if  it  is  intended  to  treat  a  rare  disease  or 
condition,  defined  as  a  patient  population  of  fewer  than  200,000  in  the  United  States,  or  a  patient  population  greater  than  200,000  in  the  United  States
where  there  is  no  reasonable  expectation  that  the  cost  of  developing  the  drug  will  be  recovered  from  sales  in  the  United  States.  In  the  EU,  the  EMA’s 
COMP  grants  orphan  drug  designation  to  promote  the  development  of  products  that  are  intended  for  the  diagnosis,  prevention,  or  treatment  of  a  life-
threatening or chronically debilitating condition affecting not more than five in 10,000 persons in the EU. Additionally, designation is granted for products 
intended for the diagnosis, prevention, or treatment of a life-threatening, seriously debilitating or serious and chronic condition when, without incentives, it 
is unlikely that sales of the drug in the EU would be sufficient to justify the necessary investment in developing the drug or biological product or where 
there  is  no  satisfactory  method  of  diagnosis,  prevention,  or  treatment,  or,  if  such  a  method  exists,  the  medicine  must  be  of  significant  benefit  to  those 
affected by the condition.

Orphan drug status confers up to ten years of marketing exclusivity in Europe, and up to seven years of marketing exclusivity in the United States, 
for a particular product in a specified indication. Obtaining an orphan drug designation can be difficult and we cannot assure you that we will be able to 
obtain orphan drug designation in other jurisdictions or for other indications, or rely on orphan drug or similar designations to exclude other companies 
from manufacturing or selling products using the same principal mechanisms of action for the same indications that we pursue beyond these timeframes. 
Furthermore, marketing exclusivity in Europe can be reduced from ten years to six years if the initial designation criteria have significantly changed since 
the  market  authorization  of  the  orphan  product.  Even  if  we  are  the  first  to  obtain  marketing  authorization  for  an  orphan  drug  indication,  there  are 
circumstances under which a competing product may be approved for the same indication during the period of marketing exclusivity, such as if the later 
product  is  shown  to  be  clinically  superior  to  the  orphan  product,  or  if  the  later  product  is  deemed  a  different  product  than  ours.  Further,  the  marketing 
exclusivity would not prevent competitors from obtaining approval of the same product candidate as ours for indications other than those in which we have 
been granted orphan drug designation, or for the use of other types of products in the same indications as our orphan product.

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 A breakthrough therapy or Fast Track designation by the FDA, including the Fast Track designation we received for efzofitimod, may not lead to 
expedited development or regulatory review or approval.

In 2022, the FDA granted Fast Track designation to efzofitimod for the treatment of pulmonary sarcoidosis and for the treatment of SSc-ILD. We 
may  seek,  from  time  to  time,  breakthrough  therapy  or  Fast  Track  designation  for  our  product  candidates.  A  breakthrough  therapy  designation  is  for  a 
product  candidate  intended  to  treat  a  serious  or  life-threatening  condition,  and  preliminary  clinical  evidence  indicates  that  the  product  candidate  may 
demonstrate substantial improvement on a clinically significant endpoint(s) over available therapies. A Fast Track designation is for a product candidate 
that treats a serious or life-threatening condition, and preclinical or clinical data demonstrate the potential to address an unmet medical need. The FDA has 
broad  discretion  whether  or  not  to  grant  these  designations.  Accordingly,  even  if  we  believe  a  particular  product  candidate  is  eligible  for  breakthrough 
therapy or Fast Track designation, we cannot assure you that the FDA would decide to grant it. Even if we receive breakthrough therapy or Fast Track 
designation, we may not experience a faster development process, review or approval compared to conventional FDA procedures. The FDA may withdraw 
breakthrough therapy or Fast Track designation if it believes that the product no longer meets the qualifying criteria. In addition, the breakthrough therapy 
program is a relatively new program. As a result, we cannot be certain whether any of our product candidates can or will qualify for breakthrough therapy 
designation. Our business may be harmed if we are unable to avail ourselves of these or any other expedited development and regulatory pathways.

Disruptions at the FDA and other government agencies caused by funding shortages or global health concerns could negatively impact our business.

The ability of the FDA to review and approve proposed clinical trials or new products can be affected by a variety of factors, including government 
budget and funding levels, statutory, regulatory, and policy changes, the FDA’s ability to hire and retain key personnel and accept the payment of user fees, 
and other events that may otherwise affect the FDA’s ability to perform routine functions. Average review times at the agency have fluctuated in recent 
years as a result. In addition, government funding of other government agencies that fund research and development activities is subject to the political 
process,  which  is  inherently  fluid  and  unpredictable.  Disruptions  at  the  FDA  and  other  agencies  may  also  slow  the  time  necessary  for  new  product 
candidates  to  be  reviewed  and/or  approved  by  necessary  government  agencies,  which  would  adversely  affect  our  business.  For  example,  over  the  last 
several years, including for 35 days beginning on December 22, 2018, the U.S. government has shut down several times and certain regulatory agencies, 
such as the FDA, have had to furlough critical FDA employees and stop critical activities.

Even if we obtain regulatory approval for a product candidate, our products will remain subject to regulatory scrutiny.

Even if we obtain regulatory approval for a product candidate, such product will be subject to ongoing regulatory requirements for manufacturing, 
labeling, packaging, storage, advertising, promotion, sampling, record-keeping, conduct of post-marketing studies, adverse event reporting and submission 
of safety, efficacy, and other post-market information, including both federal and state requirements in the United States and requirements of comparable 
foreign regulatory authorities.

We and our CDMOs will be subject to continual review and inspections to assess compliance with cGMPs and adherence to commitments made in 
any BLA or marketing authorization application (MAA). Accordingly, we and others with whom we work will need to continue to expend time, money, 
and effort in all areas of regulatory compliance, including manufacturing, production, and quality control.

Any regulatory approvals that we receive for our product candidates may be subject to limitations on the approved indicated uses for which the 
product may be marketed or to the conditions of approval, or contain requirements for potentially costly post-marketing testing, including Phase 4 clinical 
trials, and surveillance to monitor the safety and efficacy of the product candidate. If new safety issues emerge, we may be required to change our labeling. 
Any new legislation addressing drug safety or efficacy issues could result in delays in product development or commercialization, or increased costs to 
assure compliance.

We  will  have  to  comply  with  requirements  concerning  advertising  and  promotion  for  our  products.  Violations,  including  actual  or  alleged 
promotion  of  our  products  for  unapproved,  or  off-label,  uses  are  subject  to  enforcement  letters,  inquiries  and  investigations,  and  civil  and  criminal 
sanctions. Any actual or alleged failure to comply with labeling and promotion requirements may have a negative impact on our business. In the United 
States, engaging in impermissible promotion of our products for off-label uses can also subject us to false claims litigation under federal and state statutes, 
which can lead to civil and criminal penalties and fines, agreements that would materially restrict the manner in which we promote or distribute our drug 
products  and  exclusion  from  Medicare,  Medicaid  and  other  federal  and  state  healthcare  programs.  These  false  claims  statutes  include  the  federal  False 
Claims Act, which allows any individual to bring a lawsuit against a pharmaceutical company on behalf of the federal government alleging submission of 
false or fraudulent claims, or causing to present such false or fraudulent claims, for payment by a federal program such as Medicare or Medicaid. If the 
government prevails in the lawsuit, the individual will share in any fines or settlement funds. If we do not lawfully promote our approved products, we may 
become subject to such litigation and, if we are not successful in defending against such actions, those actions could compromise our ability to become 
profitable.

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The holder of an approved BLA or MAA must submit new or supplemental applications and obtain approval for certain changes to the approved 
product, product labeling, or manufacturing process. We could also be asked to conduct post-marketing clinical trials to verify the safety and efficacy of our 
products  in  general  or  in  specific  patient  subsets.  If  original  marketing  approval  were  obtained  through  an  accelerated  approval  pathway,  we  could  be 
required to conduct a successful post-marketing clinical trial to confirm clinical benefit for our products. An unsuccessful post-marketing study or failure to 
complete such a trial could result in the withdrawal of marketing approval.

If a regulatory agency discovers previously unknown problems with a product, such as adverse events of unanticipated severity or frequency, or 
problems with the facility where the product is manufactured, or disagrees with the promotion, marketing or labeling of a product, such regulatory agency 
may  impose  restrictions  on  that  product  or  us,  including  requiring  withdrawal  of  the  product  from  the  market.  If  we  fail  to  comply  with  applicable 
regulatory requirements, a regulatory agency or enforcement authority may, among other things:

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issue untitled or warning letters;

impose civil or criminal penalties;

suspend or withdraw regulatory approval;

suspend any of our ongoing clinical trials;

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

impose restrictions on our operations, including closing our CDMOs’ facilities; or

seize or detain products, or require or request a product recall.

Any government investigation of alleged violations of law could require us to expend significant time and resources in response, and could generate 
negative publicity. Any failure to comply with ongoing regulatory requirements may significantly and adversely affect our ability to commercialize and 
generate revenue from our products. If regulatory sanctions are applied or if regulatory approval is withdrawn, the value of our company and our operating 
results will be adversely affected.

Risks related to our financial condition and need for additional capital 

We will need to raise additional capital or enter into strategic partnering relationships to fund our operations.

The  development  of  therapeutic  product  candidates  is  expensive,  and  we  expect  our  research  and  development  expenses  to  fluctuate.  As  of 
December 31, 2023, our cash, cash equivalents, restricted cash and available-for-sale investments were approximately $101.7 million. We believe that our 
current  cash,  cash  equivalents,  restricted  cash  and  available-for-sale  investments,  will  be  sufficient  to  meet  our  material  cash  requirements  for  known 
contractual and other obligations for a period of at least one year from the date of this Annual Report. However, our operating plans may change as a result 
of many factors currently unknown to us, and we may need to seek additional funds sooner than planned, through equity or debt offerings, grant funding, 
collaborations,  strategic  partnerships  and/or  licensing  arrangements.  Our  future  funding  requirements  are  difficult  to  forecast  and  will  depend  on  many 
factors, including but not limited to:

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the type, number, scope progress, expansions, results, costs and timing of, our clinical trials and preclinical studies for our product candidates 
or other potential product candidates or indications which we are pursuing or may choose to pursue in the future, including changes in our 
CROs or CDMOs;

the costs, timing and outcome of regulatory review of our product candidates;

potential delays of our planned clinical trials of efzofitimod;

cost  increases  related  to  the  manufacturing  of  preclinical  study  and  clinical  trial  materials,  including  cost  increases  related  to  technology 
transfers to additional CDMOs and any delays in the manufacturing of study drug; 

cost increases as a result of global geopolitical tension, armed conflicts, potential future health pandemics, liquidity concerns at, and failures 
of, banks and other financial institutions or other disruptions in the banking system or financing markets, higher interest rates and financial 
and  credit  market  fluctuations,  volatility  in  the  capital  markets,  labor  shortages,  economic  slowdowns,  recessions  or  market  corrections, 
inflation and monetary supply shifts and tightening of credit markets;

the number and characteristics of product candidates that we pursue;

the scope, progress, results and costs of preclinical development, and clinical trials for other product candidates;

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•

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our ability to maintain existing and enter into new collaboration and licensing arrangements and the timing of any payments we may receive 
under such arrangements;

the costs and timing of preparing, filing and prosecuting patent applications, maintaining and enforcing our intellectual property rights and 
defending any intellectual property-related claims; and

the costs and timing of future commercialization activities, including product manufacturing, marketing, sales and distribution, for any of our 
product candidates for which we receive marketing approval.

In any event, we will require additional capital to complete additional clinical trials, to obtain regulatory approval for, and to commercialize, our 

product candidates, such as efzofitimod. 

Raising funds in the current and future economic environment may present additional challenges. Even if we believe we have sufficient funds for 
our current or future operating plans, we may seek additional capital if market conditions are favorable or if we have specific strategic considerations. If we 
are unable to obtain funding on a timely basis, we may be required to significantly curtail, delay or discontinue one or more of our research or development 
programs  or  the  commercialization  of  any  product  candidates,  or  we  may  be  unable  to  expand  our  operations,  maintain  our  current  organization  and 
employee base or otherwise capitalize on our business opportunities, as desired, which could materially affect our business, financial condition and results 
of operations.

The terms of any financing may adversely affect the holdings or the rights of our stockholders and the issuance of additional securities by us, or the 
possibility of such issuance, may cause the market price of our shares to decline. The sale of additional equity or convertible securities would cause dilution 
to  all  of  our  stockholders.  The  incurrence  of  indebtedness  would  result  in  fixed  payment  obligations  and  may  require  us  to  agree  to  certain  restrictive 
covenants, such as limitations on our ability to incur debt, limitations on our ability to acquire, sell or license intellectual property rights and other operating 
restrictions  that  could  adversely  impact  our  ability  to  conduct  our  business.  As  a  result  of  global  geopolitical  and  macroeconomic  conditions,  liquidity 
concerns at, and failures of, banks and other financial institutions or other disruptions in the banking system or financing markets, higher interest rates and 
financial and credit market fluctuations, volatility in the capital markets, the global credit and financial markets have experienced volatility and disruptions, 
including severely diminished liquidity and credit availability, declines in consumer confidence, declines in economic growth, volatility in unemployment 
rates, inflation, higher interest rates and uncertainty about economic stability. If the equity and credit markets deteriorate, it may make any necessary debt 
or equity financing more difficult, more costly and more dilutive. In addition, any fundraising efforts may divert our management from their day-to-day 
activities, which may adversely affect our ability to develop and commercialize our product candidates.

Additionally, financial markets around the world experienced volatility following the invasion of Ukraine by Russia in February 2022. In response 
to the invasion, the United States, United Kingdom and European Union (EU), along with others, imposed significant new sanctions and export controls 
against Russia, Russian banks and certain Russian individuals and may implement additional sanctions or take further punitive actions in the future. The 
full economic and social impact of the sanctions imposed on Russia (as well as possible future punitive measures that may be implemented), as well as the 
counter measures imposed by Russia, in addition to the ongoing Ukraine-Russian conflict, which could conceivably expand into the surrounding region, 
remains uncertain; however, both the conflict and related sanctions have resulted and could continue to result in disruptions to trade, commerce, pricing 
stability, credit availability and/or supply chain continuity in both Europe and globally, and has introduced significant uncertainty into global markets. In 
particular, the ongoing Ukraine-Russia conflict has contributed to rapidly rising costs of living (driven largely by higher energy prices) in Europe and other 
advanced economies. Similarly, the conflict in the Middle East has resulted, and may continue to result, in disruptions to trade and supply chain continuity, 
and  has  increased  supply  chain  costs,  the  full  effects  of  which  remains  uncertain.  Further,  a  weak  or  declining  economy  could  strain  our  suppliers  and 
manufacturers, possibly resulting in additional supply disruption for the production of efzofitimod. As a result, our business and results of operations may 
be  adversely  affected  by  the  ongoing  Ukraine-Russia  conflict,  particularly  to  the  extent  it  escalates  to  involve  additional  countries,  further  economic 
sanctions or wider military conflict.

In addition, global economic and business activities continue to face widespread macroeconomic uncertainties, including liquidity concerns at, and 
failures of, banks and other financial institutions or other disruptions in the banking system or financing markets, higher interest rates and financial and 
credit market fluctuations, volatility in the capital markets, labor shortages, inflation and monetary supply shifts, and recession risks, which has resulted in 
further volatility in the U.S. and global financial markets and which has led to, and may continue to lead to, additional disruptions to trade, commerce, 
pricing stability, credit availability and supply chain continuity globally. The ultimate long-term impact of the ongoing Ukraine-Russia conflict, the conflict 
in the Middle East, and other evolving geopolitical and macroeconomic conditions on our business is uncertain, although we continue to actively monitor 
the impact of these factors on our results of operations, financial condition and cash flows. The extent of the impact of these factors on our operational and 
financial  performance,  including  our  ability  to  execute  our  business  strategies  and  initiatives  in  the  expected  time  frame,  will  depend  on  future 
developments, which are uncertain and cannot be predicted; however, any continued or renewed disruption resulting from these factors could negatively 
impact our business.

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We  are  a  pre-commercial  biotherapeutics  company  and  have  incurred  significant  losses  since  our  inception  and  anticipate  that  we  will  continue  to 
incur significant losses for the foreseeable future.

We are a pre-commercial biotherapeutics company, and we have not yet generated any revenues from product sales. We have incurred net losses in 
each year since our inception in 2005, including consolidated net losses of $50.4 million for the year ended December 31, 2023. As of December 31, 2023, 
we had an accumulated deficit of $468.0 million.

We  have  devoted  most  of  our  financial  resources  to  research  and  development,  including  our  clinical  and  preclinical  development  activities.  To 
date, we have financed our operations primarily through the sale of equity securities and convertible debt and through venture debt, term loans and license 
and collaboration agreement revenues. The amount of our future net losses will depend, in part, on the rate of our future expenditures and our ability to 
obtain  funding  through  equity  offerings,  grant  funding,  collaborations,  strategic  partnerships  and/or  licensing  arrangements.  We  have  not  completed 
registrational  clinical  trials  for  any  product  candidate  to  date  and  it  will  be  several  years,  if  ever,  before  we  have  a  product  candidate  ready  for 
commercialization. Even if we obtain regulatory approval to market a product candidate, our future revenues will depend, in part, upon the size of any 
markets in which our product candidates have received approval, and our ability to achieve sufficient market acceptance, reimbursement from third-party 
payors and adequate market share for our product candidates in those markets. 

We expect to continue to incur significant expenses and operating losses for the foreseeable future. We anticipate that our expenses will fluctuate in 
connection with our ongoing activities as we: continue our research and preclinical and clinical development of efzofitimod or any other product candidates 
that we may develop; obtain clinical trial materials and further develop the manufacturing process for our product candidates; seek regulatory approvals for 
our product candidates that successfully complete clinical trials; ultimately establish a sales, marketing and distribution infrastructure to commercialize any 
products  for  which  we  may  obtain  marketing  approval;  seek  to  identify  and  validate  additional  product  candidates;  maintain,  protect  and  expand  our 
intellectual property portfolio; acquire or in-license other product candidates and technologies; attract and retain skilled personnel; and create additional 
infrastructure to support our operations as a public company and our product development and planned future commercialization efforts.

Our  revenues,  expenses  and  income  or  losses  may  fluctuate  significantly  from  quarter  to  quarter  and  year  to  year,  such  that  a  period-to-period 
comparison of our results of operations may not be a good indication of our future performance. In any particular quarter or quarters, our operating results 
could be below the expectations of securities analysts or investors, which could cause our stock price to decline.

We have never generated any revenue from product sales and may never be profitable.

Our  ability  to  generate  revenue  and  achieve  profitability  depends  on  our  ability,  alone  or  with  strategic  collaboration  partners,  to  successfully 
complete  the  development  of,  and  obtain  the  regulatory  approvals  necessary  to  commercialize  our  product  candidates.  We  do  not  anticipate  generating 
revenues from product sales for the foreseeable future, if ever. Our ability to generate future revenues from product sales depends heavily on our success in:

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completing research, preclinical development and clinical development of our product candidates, potentially with a strategic partner;

seeking and obtaining regulatory approvals for product candidates for which we complete clinical trials;

developing a sustainable, scalable, reproducible, and transferable manufacturing process for our product candidates and establishing supply 
and manufacturing relationships with third parties;

launching  and  commercializing  product  candidates  for  which  we  obtain  regulatory  approval,  either  by  collaborating  with  a  partner  or,  if 
launched independently, by establishing a sales force, marketing and distribution infrastructure;

maintaining, protecting and expanding our intellectual property portfolio;

obtaining market acceptance of our product candidates as viable treatment options for our target indications;

identifying and validating new therapeutic product candidates;

attracting, hiring and retaining qualified personnel; and

negotiating favorable terms in any licensing, collaboration or other arrangements into which we may enter.

Even if one of our product candidates is approved for commercial sale, we anticipate incurring significant costs associated with commercializing 
any  such  approved  product  candidate.  Our  expenses  could  increase  beyond  expectations  if  we  are  required  by  the  FDA  or  other  regulatory  agencies, 
domestic or foreign, to perform clinical trials and other studies in addition to those that we currently anticipate. Even if we are able to generate revenues 
from the sale of any approved products, we may not become profitable and may need to obtain additional funding to continue operations.

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Risks related to our reliance on third parties

We depend on our existing collaborations and may depend on collaborations with additional third parties for the development and commercialization of 
certain of our product candidates. If our collaborations are not successful, we may not be able to capitalize on the market potential of these product 
candidates.

We have entered into, and may continue to enter into, research collaborations for the research and development of specified product candidates. Our
sole source of revenue depends upon the performance by these collaborators of their responsibilities under these arrangements. For example, while we are 
eligible to receive up to an additional $155.0 million in milestone payments under the Kyorin Agreement, as well as tiered royalties ranging from the mid-
single  digits  to  mid-teens  on  any  net  sales  in  Japan,  whether  and  when  we  receive  these  payments  will  depend  on  Kyorin’s  development  and 
commercialization of efzofitimod in Japan, over which we have limited control. The development efforts of our collaborators are subject to the same risks 
and uncertainties described above with respect to our independently developed product candidates. 

Some collaborators may not succeed in their product development efforts. It is possible that our collaborators may be unable to obtain regulatory 
approval of our product candidates or successfully market and commercialize any such products for which regulatory approval is obtained. For example, 
while  we  have  received  $20.0  million  in  upfront  and  milestone  payments  from  Kyorin  to  date,  if  Kyorin’s  operations  are  limited  as  a  result  of  global 
geopolitical and macroeconomic conditions or other reasons, the development of efzofitimod in Japan may be significantly delayed and adversely affected, 
which may in turn delay or limit our receipt of any additional payments under the Kyorin Agreement. Other collaborators may not devote sufficient time or 
resources to the programs covered by these arrangements, and we may have limited or no control over the time or resources allocated by these collaborators 
to these programs. The occurrence of any of these events may cause us to derive little or no revenue from these arrangements, lose opportunities to validate 
our product candidates, or force us to curtail or cease our development efforts in these areas.

Our  collaborators  may  breach  or  terminate  their  agreements  with  us,  including  termination  without  cause,  subject  to  certain  prior  written  notice 
requirements, and we may be unsuccessful in entering into and maintaining other collaborative arrangements for the development of product candidates. 
For example, Kyorin has the right to terminate the agreement for any reason upon 90 days advance written notice to us. In addition, if we are unable to 
maintain existing collaboration arrangements or enter into new ones, our ability to generate licensing, milestone or royalty revenues would be materially 
impaired. 

We  may  decide  to  enter  into  additional  strategic  partnerships,  including  collaborations  with  pharmaceutical  and  biotechnology  companies,  to 
enhance and accelerate the development and potential commercialization of our product candidates. We face significant competition in seeking appropriate 
partners, and the negotiation process is time-consuming and complex. Moreover, we may not be successful in our efforts to establish any new strategic 
partnership or other collaborative arrangement for any of our product candidates and programs for a variety of reasons, including strategic fit with partners 
and differences in analysis of commercial value and regulatory risk. We may not be able to negotiate strategic partnerships on a timely basis, on acceptable 
terms or at all. We are unable to predict when, if ever, we will enter into any new strategic partnership because of the numerous risks and uncertainties 
associated with establishing strategic partnerships. Even if we are successful in our efforts to establish new strategic partnerships, the terms that we agree 
upon may not be favorable to us and we may not be able to maintain such strategic partnerships if, for example, we encounter unfavorable results or delays 
during development or approval of a product candidate or sales of an approved product are lower than expectations. 

We rely, and expect to continue to rely, on third parties to conduct some or all aspects of our product manufacturing, protocol development, research 
and preclinical and clinical testing, and these third parties may not perform satisfactorily.

We currently rely, and expect to continue to rely, on third parties to conduct some or all aspects of product manufacturing, protocol development, 
research and preclinical and clinical testing with respect to our product candidates. Any of these third parties may terminate their engagements with us at 
any  time.  If  we  need  to  enter  into  alternative  arrangements,  it  could  delay  our  product  development  activities.  Our  reliance  on  these  third  parties  for 
research  and  development  activities  reduces  our  control  over  these  activities  but  does  not  relieve  us  of  our  responsibility  to  ensure  compliance  with  all 
required  regulations  and  study  protocols.  For  example,  for  any  product  candidates  that  we  develop  and  commercialize  on  our  own,  we  will  remain 
responsible for ensuring that each of our clinical trials is conducted in accordance with the applicable study plan and protocols and GCPs so long as we 
continue to develop and commercialize on our own.

If  these  third  parties  do  not  successfully  carry  out  their  contractual  duties,  meet  expected  deadlines  or  conduct  our  research  and  development 
activities, including clinical trials, in accordance with regulatory requirements or our stated study plans and protocols, we will not be able to complete, or 
may  be  delayed  in  completing,  the  preclinical  studies  and  clinical  trials  required  to  support  future  BLA  submissions  and  approval  of  our  product 
candidates.

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We rely and intend to rely on third parties to produce preclinical, clinical and commercial supplies of our product candidates. 

Other  than  some  internal  capacity  to  support  preclinical  activities,  we  do  not  have,  nor  do  we  plan  to  acquire,  the  infrastructure  or  capability 
internally to manufacture our preclinical and clinical quantities of our product candidates, and we lack the internal resources and capability to manufacture 
any of our product candidates on a clinical or commercial scale. Reliance on CDMOs entails risks to which we would not be subject if we manufactured the 
product candidates ourselves, including:

•

•

•

•

the inability to negotiate manufacturing agreements with third parties under commercially reasonable terms;

reduced control as a result of using third-party CDMOs for all aspects of manufacturing activities;

termination or nonrenewal of manufacturing agreements with third parties in a manner or at a time that is costly or damaging to us; and

disruptions  to  the  operations  of  our  CDMOs  or  suppliers  caused  by  conditions  unrelated  to  our  business  or  operations,  including  the 
insolvency or bankruptcy of the CDMOs or suppliers.

Any of these events could lead to clinical trial delays or failure to obtain regulatory approval, or impact our ability to successfully commercialize 

future products. Some of these events could be the basis for FDA action, including injunction, recall, seizure or total or partial suspension of production.

Additionally,  each  CDMO  may  require  licenses  to  manufacture  our  product  candidates  or  components  thereof  if  the  applicable  manufacturing 
processes are not owned by the CDMO or in the public domain, and we may be unable to transfer or sublicense the intellectual property rights we may have 
with  respect  to  such  activities.  These  factors  could  cause  the  delay  of  clinical  development,  regulatory  submissions,  required  approvals  or 
commercialization of our product candidates, cause us to incur higher costs and prevent us from commercializing our products successfully. 

We do not have long-term contracts with our CDMOs, and our CDMOs may terminate their agreements with us for a variety of reasons including 
technical issues or our material breach of our obligations under the applicable agreement. Furthermore, our CDMOs may reallocate resources away from 
the  production  of  our  product  candidates  if  we  delay  manufacturing  under  certain  circumstances,  and  the  manufacturing  facilities  in  which  our  product 
candidates are made could be adversely affected by earthquakes and other natural disasters, labor shortages, power failures, economic slowdowns, higher 
interest rates, inflation and monetary supply shifts, evolving global geopolitical tension and numerous other factors. If our CDMOs fail to meet contractual 
requirements,  and  we  are  unable  to  secure  one  or  more  replacement  CDMOs  capable  of  production  at  a  substantially  equivalent  cost,  our  clinical 
development activities may be delayed, or we could lose potential revenue. Manufacturing biologic drugs is complicated and tightly regulated by the FDA 
and comparable regulatory authorities around the world, and although alternative CDMOs with the necessary manufacturing and regulatory expertise and 
facilities exist, it could be expensive and take a significant amount of time to arrange for alternative CDMOs, transfer manufacturing procedures to these 
alternative CDMOs, and demonstrate comparability of material produced by such new CDMOs. New CDMOs of any product would be required to comply
with applicable regulatory requirements. These CDMOs may not be able to manufacture our product candidates at costs, or in quantities, or in a timely 
manner necessary to complete the clinical development of our product candidates or make commercially successful products.

We previously relied on a single CDMO for process development and scale-up of efzofitimod, including the manufacture of bulk drug substance for our 
projected  needs  for  planned  clinical  trials.  We  have  entered  into  an  agreement  with  another  CDMO  for  the  transfer  of  the  process,  scale-up  and 
manufacturing of bulk drug substance. If we want to eventually utilize product manufactured by the new CDMO for commercial purposes, the FDA 
will require us to demonstrate that the product manufactured by the new CDMO is comparable in quality, safety and efficacy to the product that is 
being used in the EFZO-FIT and EFZO-CONNECT studies. 

The  current  supply  of  efzofitimod  being  used  in  the  EFZO-FIT  and  EFZO-CONNECT  studies  was  produced  by  a  prior  CDMO.  We  have 
transitioned to a new CDMO that completed its first two commercial-scale cGMP runs during 2023. Full quality release testing has been completed and all 
release specifications were met, supporting the new CDMO's ability to produce bulk drug substance of efzofitimod for commercial purposes if we receive 
regulatory approval for efzofitimod. Because the change in CDMO has been introduced at an advanced stage of development of efzofitimod, the FDA will 
require  a  comparability  assessment,  including  additional  nonclinical  or  clinical  studies  utilizing  the  product  manufactured  by  the  new  CDMO.  These 
requirements  could  result  in  substantial  delays  and  additional  costs  for  clinical  development,  and  commercialization  of  efzofitimod,  or  our  inability  to 
obtain approval for efzofitimod. 

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We rely, and expect to continue to rely, on third parties to conduct, supervise and monitor our clinical trials, and if these third parties perform in an 
unsatisfactory manner, it may harm our business.

We  have  relied,  and  expect  to  continue  to  rely,  on  third-party  CROs,  clinical  investigators  and  clinical  trial  sites  to  ensure  our  clinical  trials  are 
conducted properly and on time. While we have and will continue to enter into agreements governing their activities, we will have limited influence over 
their actual performance. We will control only certain aspects of our CROs’ activities. Nevertheless, we will be responsible for ensuring that each of our 
clinical trials is conducted in accordance with the applicable protocol, legal and regulatory requirements, and scientific standards, and our reliance on the 
CROs does not relieve us of our regulatory responsibilities.

We and our investigators and CROs are required to comply with GCPs for conducting, recording and reporting the results of clinical trials to assure 
that the data and reported results are credible and accurate and that the rights, integrity and confidentiality of clinical trial participants are protected. The 
FDA enforces GCPs through periodic inspections of study sponsors, principal investigators and clinical trial sites. If we or our investigators and CROs fail 
to comply with applicable GCPs, the clinical data generated in our future clinical trials may be deemed unreliable and the FDA may require us to perform 
additional unanticipated clinical trials before approving any marketing applications. Upon inspection, the FDA may determine that our clinical trials did not 
comply with GCPs. In addition, our future clinical trials will require a sufficient number of test subjects to evaluate the safety and effectiveness of our 
product candidates. Accordingly, if our investigators and CROs fail to comply with these regulations or fail to recruit a sufficient number of patients, we 
may be required to repeat such clinical trials, which would delay the regulatory approval process.

Our investigators and CROs are not our employees, and we are therefore unable to directly monitor whether or not they devote sufficient time and 
resources to our clinical and preclinical programs. They may also have relationships with other commercial entities, including our competitors, for whom 
they may also be conducting clinical trials or other drug development activities that could harm our competitive position. If our investigators or CROs do 
not successfully carry out their contractual duties or obligations, fail to meet expected deadlines, or if the quality or accuracy of the clinical data they obtain 
is  compromised  due  to  the  failure  to  adhere  to  our  clinical  protocols  or  regulatory  requirements,  or  for  any  other  reasons,  our  clinical  trials  may  be 
extended, delayed or terminated, and we may not be able to obtain regulatory approval for, or successfully commercialize our product candidates. As a 
result, enrollment and data integrity from monitoring of the trial may suffer, our financial results could be harmed, our costs could increase, our ability to 
generate revenues could be delayed and the commercial prospects for our product candidates could be adversely affected. 

Our reliance on third parties requires us to share our trade secrets, which increases the possibility that a competitor will discover them or that our trade 
secrets will be misappropriated or disclosed.

We  rely  on  third  parties  to  manufacture  our  product  candidates,  and  we  collaborate  with  both  industry  and  various  academic  institutions  in  the 
development of our discovery platform for therapeutic applications based on tRNA synthetase biology. In connection with these activities, we are required, 
at  times,  to  share  trade  secrets  with  them.  We  seek  to  protect  our  proprietary  technology  in  part  by  entering  into  confidentiality  agreements  and,  if 
applicable,  material  transfer  agreements,  collaborative  research  agreements,  consulting  agreements  or  other  similar  agreements  with  our  collaborators, 
advisors, employees and consultants prior to beginning research or disclosing proprietary information. These agreements typically limit the rights of the 
third parties to use or disclose our confidential information, such as trade secrets. Despite the contractual provisions employed when working with third 
parties, the need to share trade secrets and other confidential information increases the risk that such trade secrets become known by our competitors, are 
inadvertently incorporated into the technology of others, or are disclosed or used in violation of these agreements. Given that our proprietary position is 
based, in part, on our know-how and trade secrets, a competitor’s discovery of our trade secrets or other unauthorized use or disclosure would impair our 
competitive position and may have a material adverse effect on our business, prospects, financial condition and results of operations.

In  addition,  these  agreements  typically  restrict  the  ability  of  our  collaborators,  advisors,  employees  and  consultants  to  publish  data  potentially 
relating  to  our  trade  secrets.  Our  academic  collaborators  typically  have  rights  to  publish  data,  provided  that  we  are  notified  in  advance  and  may  delay 
publication  for  a  specified  time  in  order  to  secure  intellectual  property  rights  to  which  we  are  entitled  arising  from  the  collaboration.  In  other  cases, 
publication rights are controlled exclusively by us, although in some cases we may share these rights with other parties. We also conduct joint research and 
development  programs  that  may  require  us  to  share  trade  secrets  under  the  terms  of  our  research  and  development  partnerships  or  similar  agreements. 
Despite  our  efforts  to  protect  our  trade  secrets,  our  competitors  may  discover  our  trade  secrets,  either  through  breach  of  these  agreements,  independent 
development or publication of information including our trade secrets in cases where we do not have proprietary or otherwise protected rights at the time of 
publication. A competitor’s discovery of our trade secrets would impair our competitive position and have an adverse impact on our business, prospects, 
financial condition and results of operations.

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Risks related to our intellectual property

If we are unable to obtain, maintain or protect intellectual property rights related to our product candidates, or if the scope of such intellectual property 
protection is not sufficiently broad, we may not be able to compete effectively in our markets.

We  rely  upon  a  combination  of  patents,  trade  secret  protection  and  confidentiality  agreements  to  protect  the  intellectual  property  related  to  our 
technologies  and  product  candidates.  Our  success  depends  in  large  part  on  our  and  our  licensors’  abilities  to  obtain  and  maintain  patent  and  other 
intellectual property protection in the United States and in other countries for our proprietary technology and product candidates.

We have sought to protect our proprietary position by filing patent applications in the United States and abroad related to our novel technologies 
and product candidates that are important to our business. This process is expensive and time consuming, and we may not be able to file and prosecute all 
necessary or desirable patent applications at a reasonable cost or in a timely manner. It is also possible that we will fail to identify patentable aspects of our 
research and development output before it is too late to obtain patent protection.

The  patentability  of  inventions,  and  the  validity,  enforceability  and  scope  of  patents  in  the  biotechnology  and  pharmaceutical  fields  involves 
complex legal and scientific questions and can be uncertain. As a result, patent applications that we own or in-license may not issue as patents with claims 
that cover our product candidates, or at all, in the United States or in foreign countries for many reasons. For example, there is no assurance that we were 
the first to invent or the first to file patent applications in respect of the inventions claimed in our patent applications or that our patent applications claim 
patentable subject matter. We may also be unaware of potentially relevant prior art relating to our patents and patent applications, and this prior art, if any, 
may be used by third parties as grounds to seek to invalidate a patent or to prevent a patent from issuing from a pending patent application. Even if patents 
do successfully issue and even if such patents disclose aspects of our product candidates, third parties may challenge their validity, enforceability or scope, 
which may result in such patents being narrowed or invalidated. Furthermore, even if they are unchallenged, our patents and patent applications may not 
adequately  protect  our  intellectual  property,  provide  exclusivity  for  our  product  candidates  or  prevent  others  from  designing  around  our  claims.  If  the 
breadth  or  strength  of  protection  provided  by  the  patents  and  patent  applications  we  hold,  license  or  pursue  with  respect  to  our  product  candidates  is 
threatened, it could threaten our ability to commercialize our product candidates. Further, if we encounter delays in our clinical trials, the period of time 
during  which  we  could  market  any  of  our  product  candidates  under  patent  protection,  if  approved,  would  be  reduced.  Since  patent  applications  in  the 
United  States  and  most  other  countries  are  confidential  for  a  period  of  time  after  filing,  we  cannot  be  certain  that  we  were  the  first  to  file  any  patent 
application related to our product candidates. Changes to the patent laws in the United States and other jurisdictions could also diminish the value of our 
patents and patent applications or narrow the scope of our patent protection. Any of these outcomes could impair our ability to prevent competition from 
third parties, which may have an adverse effect on our business.

If the patent applications we own or have in-licensed that relate to our programs or product candidates do not issue as patents, if their breadth or 
strength of protection is threatened, or if they fail to provide exclusivity for our product candidates, it could dissuade companies from collaborating with us 
to develop product candidates, and threaten our ability to commercialize future products. We cannot offer any assurances about which, if any, patents will 
issue, the breadth of any such patents or whether any issued patents will be found invalid and unenforceable or will be threatened by third parties. Any 
successful  opposition  to  these  patents  or  any  other  patents  owned  by  or  licensed  to  us  could  deprive  us  of  rights  necessary  for  the  successful 
commercialization of any product candidates that we may develop. In addition, patents have a limited term. In the United States, the natural expiration of a 
patent is generally 20 years after it is filed. Although various extensions may be available, the life of a patent, and the protection it affords, is limited. Even 
if a patent does issue for any of our pending patent applications, possible delays in regulatory approvals could mean that the period of time during which 
we  could  market  a  product  candidate  under  patent  protection  could  be  reduced  from  what  we  generally  would  expect.  Since  patent  applications  in  the 
United States and most other countries are confidential for a period of time after filing, and some remain so until issued, we cannot be certain that we were 
the  first  to  file  any  patent  application  related  to  a  product  candidate.  Furthermore,  if  third  parties  have  filed  such  patent  applications,  an  interference 
proceeding in the United States can be initiated by a third party to determine who was the first to invent any of the subject matter covered by the patent 
claims of our applications. Even if patents covering aspects of our product candidates are obtained, once the patent life has expired for a product, we may 
be open to competition from generic medications.

In addition to the protection afforded by patents, we rely on trade secret protection and confidentiality agreements to protect proprietary know-how 
that is not patentable or that we elect not to patent, processes for which patents are difficult to enforce and any other elements of our product candidate 
discovery and development processes that involve proprietary know-how, information or technology that is not covered by patents. However, trade secrets 
can  be  difficult  to  protect.  We  seek  to  protect  our  proprietary  technology  and  processes,  in  part,  by  entering  into  confidentiality  agreements  with  our 
employees,  consultants,  scientific  advisors  and  contractors.  We  also  seek  to  preserve  the  integrity  and  confidentiality  of  our  data  and  trade  secrets  by 
maintaining  physical  security  of  our  premises  and  physical  and  electronic  security  of  our  information  technology  systems,  but  it  is  possible  that  these 
security measures could be breached. Although we expect all of our employees and consultants to assign their inventions to us, and all of our employees, 

39

 
consultants,  advisors  and  any  third  parties  who  have  access  to  our  proprietary  know-how,  information  or  technology  to  enter  into  confidentiality 
agreements, we cannot provide any assurances that all such agreements have been duly executed or that our trade secrets and other confidential proprietary 
information will not be disclosed or that competitors will not otherwise gain access to our trade secrets or independently develop substantially equivalent 
information  and  techniques.  For  example,  any  of  these  parties  may  breach  the  agreements  and  disclose  our  proprietary  information,  including  our  trade 
secrets,  and  we  may  not  be  able  to  obtain  adequate  remedies  for  such  breaches.  Misappropriation  or  unauthorized  disclosure  of  our  trade  secrets  could 
impair our competitive position and may have a material adverse effect on our business. Additionally, if the steps we take to maintain the confidentiality of 
our trade secrets are inadequate, we may have insufficient recourse against third parties for misappropriating our proprietary information and processes. In 
addition, others may independently discover our trade secrets and proprietary information. For example, the FDA, as part of its Transparency Initiative, is 
currently considering whether to make additional information publicly available on a routine basis, including information that we may consider to be trade 
secrets or other proprietary information, and it is not clear at the present time how the FDA’s disclosure policies may change in the future, if at all.

If due to the effects on our operations of general political and economic conditions, including global geopolitical tension, armed conflicts, potential 
future health pandemics, labor shortages, economic slowdowns, recessions or market corrections, inflation and monetary supply shifts, higher interest rates 
and  tightening  of  credit  markets,  or  another  cause,  we  are  unable  to  generate  new  animal,  or  in  vitro  data,  in  time  to  support  new,  or  updated  patent 
application filings, or prior to patent conversion deadlines, it could materially impact the enforceability or scope of those patent filings.

If we are unable to prevent material disclosure of the non-patented intellectual property related to our technologies to third parties, and there is no 
guarantee  that  we  will  have  any  such  enforceable  trade  secret  protection,  we  may  not  be  able  to  establish  or  maintain  a  competitive  advantage  in  our 
market, which could materially adversely affect our business, results of operations and financial condition.

Further, the laws of some foreign countries do not protect proprietary rights to the same extent or in the same manner as the laws of the United 
States. As a result, we may encounter significant problems in preventing third parties from practicing our inventions in countries outside the United States, 
or from selling or importing products made using our inventions in and into the United States or other jurisdictions.

Claims that our product candidates or the manufacture, sale or use of our future products infringe the patent or other intellectual property rights of 
third parties could result in costly litigation or could require substantial time and money to resolve, even if litigation is avoided.

Our commercial success depends in part on our avoiding infringement of the patents and proprietary rights of third parties. There is a substantial 
amount  of  litigation,  both  within  and  outside  the  United  States,  involving  patent  and  other  intellectual  property  rights  in  the  biotechnology  and 
pharmaceutical industries, including patent infringement lawsuits, interferences, oppositions and inter partes reexamination proceedings before the United 
States  Patent  and  Trademark  Office  (USPTO)  and  corresponding  foreign  patent  offices.  Numerous  U.S.  and  foreign  issued  patents  and  pending  patent 
applications,  which  are  owned  by  third  parties,  exist  in  the  fields  in  which  we  are  pursuing  development  candidates.  As  the  biotechnology  and 
pharmaceutical industries expand and more patents are issued, the risk increases that our product candidates may be subject to claims of infringement of the 
patent rights of third parties.

Third  parties  may  assert  that  we  are  employing  their  proprietary  technology  without  authorization.  There  may  be  third-party  patents  or  patent 
applications  with  claims  to  materials,  formulations,  methods  of  manufacture  or  methods  for  treatment  related  to  the  use  or  manufacture  of  our  product 
candidates. Because patent applications can take many years to issue, there may be currently pending patent applications which may later result in issued 
patents that our product candidates may infringe. In addition, third parties may obtain patents in the future and claim that use of our technologies infringes 
upon these patents. If any third-party patents were held by a court of competent jurisdiction to cover the formulations for, or the manufacturing process or 
methods of use of, any of our product candidates, any molecules formed during the manufacturing process or any final product itself, the holders of any 
such  patents  may  be  able  to  block  our  ability  to  develop  and  commercialize  such  product  candidate  unless  we  obtained  a  license  under  the  applicable 
patents, or until such patents expire. In either case, such a license may not be available on commercially reasonable terms or at all.

Parties making claims against us may obtain injunctive or other equitable relief, which could effectively block our ability to further develop and 
commercialize one or more of our product candidates. Defense of these claims, regardless of their merit, would involve substantial litigation expense and 
would be a substantial diversion of employee resources from our business. In the event of a successful claim of infringement against us, we may have to 
pay substantial damages, including treble damages and attorneys’ fees for willful infringement, pay royalties, redesign our infringing products or obtain one 
or  more  licenses  from  third  parties,  which  may  not  be  able  to  be  obtained  on  reasonable  commercial  terms  or  at  all,  or  require  substantial  time  and 
monetary expenditure.

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Patent terms may be inadequate to protect our competitive position on our product candidates for an adequate amount of time.

Patents have a limited lifespan. In the United States, if all maintenance fees are timely paid, the natural expiration of a patent is generally 20 years 
from its earliest U.S. non-provisional filing date. Various extensions may be available, but the life of a patent, and the protection it affords, is limited. Even 
if  patents  covering  our  product  candidates  are  obtained,  once  the  patent  life  has  expired,  we  may  be  open  to  competition  from  competitive  products, 
including generics or biosimilars. Given the amount of time required for the development, testing and regulatory review of new product candidates, patents 
protecting such candidates might expire before or shortly after such candidates are commercialized. As a result, our owned and licensed patent portfolio 
may not provide us with sufficient rights to exclude others from commercializing products similar or identical to ours.

We  may  not  be  successful  in  obtaining  or  maintaining  necessary  rights  to  our  therapeutic  product  candidates  and  processes  for  our  development 
pipeline through acquisitions and in-licenses.

We believe that we have rights to intellectual property, through licenses from third parties and under patents that we own, that is necessary or useful 
to develop our product candidates. Because our programs may involve additional product candidates that may require the use of proprietary rights held by 
third  parties,  the  growth  of  our  business  will  likely  depend  in  part  on  our  ability  to  acquire,  in-license  or  use  these  proprietary  rights.  In  addition,  our 
product  candidates  may  require  specific  formulations  to  work  effectively  and  efficiently  and  these  rights  may  be  held  by  others.  We  may  be  unable  to 
acquire  or  in-license  any  compositions,  methods  of  use,  processes  or  other  third-party  intellectual  property  rights  from  third  parties  that  we  identify  on 
reasonable commercial terms or at all. The licensing and acquisition of third-party intellectual property rights is a competitive area, and a number of more 
established  companies  are  also  pursuing  strategies  to  license  or  acquire  third-party  intellectual  property  rights  that  we  may  consider  attractive.  These
established companies may have a competitive advantage over us due to their size, cash resources and greater clinical development and commercialization 
capabilities.

We  sometimes  collaborate  with  U.S.  and  foreign  academic  institutions  to  accelerate  our  preclinical  research  or  development  under  written 
agreements with these institutions. These institutions may provide us with an option to negotiate a license to the institution’s rights in technology resulting 
from  the  collaboration.  Regardless  of  any  such  right  of  first  negotiation  for  intellectual  property,  we  may  be  unable  to  negotiate  a  license  within  the 
specified timeframe or under terms that are acceptable to us. If we are unable to do so, the institution may offer the intellectual property rights to other 
parties, potentially blocking our ability to pursue our program.

In addition, companies that perceive us to be a competitor may be unwilling to assign or license rights to us. We also may be unable to license or 
acquire  third-party  intellectual  property  rights  on  terms  that  would  allow  us  to  make  an  appropriate  return  on  our  investment.  If  we  are  unable  to 
successfully obtain rights to required third-party intellectual property rights, our business, financial condition and prospects for growth could suffer.

If  we  fail  to  comply  with  our  obligations  in  the  agreements  under  which  we  license  intellectual  property  rights  from  third  parties  or  otherwise 
experience disruptions to our business relationships with our licensors, we could lose license rights that are important to our business.

We are a party to a number of intellectual property license agreements that are important to our business and expect to enter into additional license 
agreements in the future. Our existing license agreements impose, and we expect that future license agreements will impose, various diligence, milestone 
payment,  royalty  and  other  obligations  on  us.  If  we  fail  to  comply  with  our  obligations  under  these  agreements,  or  we  are  subject  to  a  bankruptcy,  the 
licensor may have the right to terminate the license, in which event we would not be able to market products covered by the license. 

We may need to obtain licenses from third parties to advance our research or allow commercialization of our product candidates, and we have done 
so from time to time. We may fail to obtain any of these licenses at a reasonable cost or on reasonable commercial terms, if at all. In that event, we may be 
required to expend significant time and resources to develop or license replacement technology. If we are unable to do so, we may be unable to develop or 
commercialize the affected product candidates, which could harm our business significantly.

In some cases, patent prosecution of our licensed technology is controlled by the licensor. If our licensors fail to obtain and maintain patent or other 
protection for the proprietary intellectual property we license from them, we could lose our rights to the intellectual property or our exclusivity with respect 
to those rights, and our competitors could market competing products using such intellectual property. In certain cases, we may control the prosecution of 
patents resulting from licensed technology. In the event we breach any of our obligations related to such prosecution, we may incur significant liability to 
our licensors. Licensing of intellectual property is of critical importance to our business and involves complex legal, business and scientific issues and is 
complicated  by  the  rapid  pace  of  scientific  discovery  in  our  industry.  Disputes  may  arise  regarding  intellectual  property  subject  to  a  license  agreement, 
including:

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•

•

•

•

•

the scope of rights granted under the license agreement and other interpretation-related issues;

the extent to which our technology and processes infringe on intellectual property of the licensor that is not subject to the license agreement;

the sublicensing of patent and other rights under our collaborative development relationships;

our diligence obligations under the license agreement and what activities satisfy those diligence obligations;

the ownership of inventions and know-how resulting from the joint creation or use of intellectual property by our licensors and us and our 
sublicensees or partners, if any; and

the priority of invention of patented technology.

If  disputes  over  intellectual  property  that  we  have  licensed  prevent  or  impair  our  ability  to  maintain  our  current  licensing  arrangements  on 

acceptable terms, we may be unable to successfully develop and commercialize the affected product candidates.

We may become involved in lawsuits to protect or enforce our patents or the patents of our licensors, which could be expensive, time-consuming and 
unsuccessful.

Competitors  may  infringe  or  otherwise  violate  our  patents,  the  patents  of  our  licensors  or  our  other  intellectual  property  rights.  To  counter 
infringement or unauthorized use, we may be required to file infringement claims, which can be expensive and time-consuming. Any claims that we assert 
against perceived infringers could also provoke these parties to assert counterclaims against us alleging that we infringe their intellectual property rights. In 
addition, in an infringement proceeding, a court may decide that a patent of ours or our licensors is not valid, is unenforceable or is not infringed, or may 
refuse to stop the other party from using the technology at issue on the grounds that our patents do not cover the technology in question. An adverse result 
in any litigation or defense proceedings could put one or more of our patents at risk of being invalidated or interpreted narrowly and could put our patent 
applications at risk of not issuing.

Interference or derivation proceedings provoked by third parties or brought by us may be necessary to determine the priority of inventions or other 
matters of inventorship with respect to our patents or patent applications or those of our licensors. We may also become involved in other proceedings, such 
as re-examination or opposition proceedings, before the USPTO or its foreign counterparts relating to our intellectual property or the intellectual property 
rights of others. An unfavorable outcome in any such proceedings could require us to cease using the related technology or to attempt to license rights to it 
from the prevailing party, or could cause us to lose valuable intellectual property rights. Our business could be harmed if the prevailing party does not offer 
us a license on commercially reasonable terms, if any license is offered at all. Our defense of litigation or interference proceedings may fail and, even if 
successful, may result in substantial costs and distract our management and other employees. We may not be able to prevent, alone or with our licensors, 
misappropriation of our intellectual property rights, particularly in countries where the laws may not protect those rights as fully as in the United States. In 
addition, the uncertainties associated with litigation could have a material adverse effect on our ability to raise the funds necessary to continue our clinical 
trials, continue our research programs, license necessary technology from third parties, or enter into development partnerships that would help us bring our 
product candidates to market. We may also become involved in disputes with others regarding the ownership of intellectual property rights. For example, 
we  jointly  develop  intellectual  property  with  certain  parties,  and  disagreements  may  therefore  arise  as  to  the  ownership  of  the  intellectual  property 
developed pursuant to these relationships. If we are unable to resolve these disputes, we could lose valuable intellectual property rights.

Furthermore, because of the substantial amount of discovery required in connection with intellectual property litigation, there is a risk that some of 
our confidential information could be compromised by disclosure during this type of litigation. There could also be public announcements of the results of 
hearings, motions or other interim proceedings or developments. If securities analysts or investors perceive these results to be negative, it could have a 
material adverse effect on the price of our common stock.

We may be subject to claims that our employees, consultants or independent contractors have wrongfully used or disclosed confidential information of 
third parties or that our employees have wrongfully used or disclosed alleged trade secrets of their former employers.

We  employ  individuals  who  were  previously  employed  at  universities  or  other  biotechnology  or  pharmaceutical  companies,  including  our 
competitors  or  potential  competitors.  Although  we  try  to  ensure  that  our  employees,  consultants  and  independent  contractors  do  not  use  the  proprietary 
information or know-how of others in their work for us, we may be subject to claims that we or our employees, consultants or independent contractors have 
inadvertently or otherwise used or disclosed intellectual property, including trade secrets or other proprietary information, of any of our employee’s former 
employer or other third parties. Litigation may be necessary to defend against these claims. If we fail in defending any such claims, in addition to paying 
monetary damages, we may lose valuable intellectual property rights or personnel, which could adversely impact our business. Even if we are successful in 
defending against such claims, litigation could result in substantial costs and be a distraction to management and other employees.

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We may be subject to claims challenging the inventorship or ownership of our patents and other intellectual property.

We  may  be  subject  to  claims  that  former  employees,  collaborators  or  other  third  parties  have  an  ownership  interest  in  our  patents  or  other 
intellectual  property.  For  example,  we  may  have  inventorship  disputes  arise  from  conflicting  obligations  of  consultants  or  others  who  are  involved  in 
developing our product candidates. Litigation may be necessary to defend against these and other claims challenging inventorship or ownership, or we may 
enter into agreements to clarify the scope of our rights in such intellectual property. If we fail in defending any such claims, in addition to paying monetary 
damages, we may lose valuable intellectual property rights, such as exclusive ownership of, or right to use, valuable intellectual property. Such an outcome 
could have a material adverse effect on our business. Even if we are successful in defending against such claims, litigation could result in substantial costs 
and be a distraction to management and other employees.

Obtaining  and  maintaining  our  patent  protection  depends  on  compliance  with  various  procedural,  document  submission,  fee  payment  and  other 
requirements  imposed  by  governmental  patent  agencies,  and  our  patent  protection  could  be  reduced  or  eliminated  for  non-compliance  with  these 
requirements.

Periodic maintenance fees, renewal fees, annuity fees and various other governmental fees on patents or applications will be due to be paid to the 
USPTO and various governmental patent agencies outside of the United States in several stages over the lifetime of the patents or applications. We have 
systems in place to remind us to pay these fees, and we employ an outside firm and rely on our outside counsel to pay these fees due to non-U.S. patent 
agencies. The USPTO and various non-U.S. governmental patent agencies require compliance with a number of procedural, documentary, fee payment and 
other  similar  provisions  during  the  patent  application  process.  We  employ  law  firms  and  other  professionals  to  help  us  comply,  and  in  many  cases,  an 
inadvertent lapse can be cured by payment of a late fee or by other means in accordance with the applicable rules. However, there are situations in which 
non-compliance can result in abandonment or lapse of the patent or patent application, resulting in partial or complete loss of patent rights in the relevant 
jurisdiction. In such an event, our competitors might be able to enter the market and this circumstance would have a material adverse effect on our business.

Issued patents covering our product candidates could be found invalid or unenforceable if challenged in court.

If  we  or  one  of  our  licensors  initiated  legal  proceedings  against  a  third  party  to  enforce  a  patent  covering  one  of  our  product  candidates,  the 
defendant could counterclaim that the patent covering our product candidate is invalid or unenforceable. In patent litigation in the United States, defendant 
counterclaims alleging invalidity or unenforceability are commonplace. Grounds for a validity challenge could be an alleged failure to meet any of several 
statutory requirements, including lack of novelty, obviousness or non-enablement. Grounds for an unenforceability assertion could be an allegation that 
someone connected with prosecution of the patent withheld relevant information from the USPTO, or made a misleading statement, during prosecution. 
Third  parties  may  also  raise  similar  claims  before  administrative  bodies  in  the  United  States  or  abroad,  even  outside  the  context  of  litigation.  Such 
mechanisms include re-examination, post grant review, and equivalent proceedings in foreign jurisdictions (e.g., opposition proceedings). Such proceedings 
could  result  in  revocation  or  amendment  to  our  patents  in  such  a  way  that  they  no  longer  cover  our  product  candidates.  The  outcome  following  legal 
assertions  of  invalidity  and  unenforceability  is  unpredictable.  With  respect  to  the  validity  question,  for  example,  we  cannot  be  certain  that  there  is  no 
invalidating  prior  art,  of  which  we  and  the  patent  examiner  were  unaware  during  prosecution.  If  a  defendant  were  to  prevail  on  a  legal  assertion  of 
invalidity  or  unenforceability,  we  would  lose  at  least  part,  and  perhaps  all,  of  the  patent  protection  on  our  product  candidates.  Such  a  loss  of  patent 
protection would have a material adverse effect on our business.

Changes in patent law could diminish the value of patents in general, thereby impairing our ability to protect our products.

As is the case with many other biotechnology companies, our success is heavily dependent on intellectual property, particularly patents. Obtaining 
and enforcing patents in the biotechnology industry involve both technological and legal complexity, and therefore obtaining, maintaining and enforcing 
biotechnology patents is costly, time-consuming and inherently uncertain. In addition, recent legislative and judicial developments in the United States and
elsewhere  have  in  some  cases  removed  the  protection  afforded  to  patent  owners,  made  patents  more  difficult  to  obtain,  or  increased  the  uncertainty 
regarding the ability to obtain, maintain and enforce patents. For example, Congress has recently passed, and the United States is currently implementing, 
wide-ranging patent reform legislation, and may pass further patent reform legislation in the future. Recent U.S. Supreme Court rulings have narrowed the 
scope of patent protection available in certain circumstances and weakened the rights of patent owners in certain situations. For example, in Association for 
Molecular  Pathology  v.  Myriad  Genetics,  Inc.,  the  U.S.  Supreme  Court  held  that  certain  claims  to  naturally  occurring  substances  are  not  patentable. 
Although we do not believe that any of the patents owned or licensed by us will be found invalid based on this decision, we cannot predict how future 
decisions by the courts, Congress, or the USPTO may impact the value of our patents. In addition to increasing uncertainty with regard to our ability to 
obtain patents in the future, this combination of events has created uncertainty with respect to the value of patents generally, once obtained. Depending on 
decisions  and  actions  by  Congress,  the  federal  courts,  the  USPTO  and  their  respective  foreign  counterparts,  the  laws  and  regulations  governing  patents 
could change in unpredictable ways that would weaken our ability to obtain new patents or to maintain and enforce our existing patents and patents that we 
might obtain in the future.

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Patent reform legislation could increase the uncertainties and costs surrounding the prosecution of our patent applications and the validity or defense 
of our issued patents.

On  September  16,  2011,  the  Leahy-Smith  America  Invents  Act  (the  Leahy-Smith  Act)  was  signed  into  law.  The  Leahy-Smith  Act  includes  a 
number of significant changes to U.S. patent law, including provisions that affect the way patent applications will be prosecuted and may also affect patent 
litigation. The USPTO is developing regulations and procedures to govern administration of the Leahy-Smith Act, and many of the substantive changes to 
patent law associated with the Leahy-Smith Act, and in particular, the first to file provisions, were enacted March 16, 2013. Although it is not clear what, if 
any, impact the Leahy-Smith Act will have on the operation of our business, the Leahy-Smith Act and its implementation could increase the uncertainties 
and costs surrounding the prosecution of our patent applications and the enforcement or defense of our issued patents, all of which could have a material 
adverse effect on our business and financial condition.

We may not be able to protect our intellectual property rights throughout the world.

Filing, prosecuting and defending patents on product candidates in all countries throughout the world would be prohibitively expensive, and our 
intellectual property rights in some countries outside the United States can be less extensive than those in the United States. In addition, the laws of some 
foreign countries do not protect intellectual property rights to the same extent as federal and state laws in the United States. Consequently, we may not be 
able to prevent third parties from practicing our inventions in all countries outside the United States, or from selling or importing products made using our 
inventions in and into the United States or other jurisdictions. Competitors may use our technologies in jurisdictions where we have not obtained patent 
protection  to  develop  their  own  products  and  further,  may  export  otherwise  infringing  products  to  territories  where  we  have  patent  protection,  but 
enforcement is not as strong as that in the United States. These products may compete with our products and our patents or other intellectual property rights 
may not be effective or sufficient to prevent them from competing.

Many companies have encountered significant problems in protecting and defending intellectual property rights in foreign jurisdictions. The legal 
systems of certain countries, particularly certain developing countries, do not favor the enforcement of patents, trade secrets and other intellectual property 
protection, particularly those relating to biotechnology products, which could make it difficult for us to stop the infringement of our patents or marketing of 
competing  products  in  violation  of  our  proprietary  rights  generally.  Proceedings  to  enforce  our  patent  rights  in  foreign  jurisdictions  could  result  in 
substantial costs and divert our efforts and attention from other aspects of our business, could put our patents at risk of being invalidated or interpreted 
narrowly and our patent applications at risk of not issuing and could provoke third parties to assert claims against us. We may not prevail in any lawsuits 
that  we  initiate  and  the  damages  or  other  remedies  awarded,  if  any,  may  not  be  commercially  meaningful.  Accordingly,  our  efforts  to  enforce  our 
intellectual property rights around the world may be inadequate to obtain a significant commercial advantage from the intellectual property that we develop 
or license.

Risks related to our business operations

We may use our financial and human resources to pursue a particular business strategy, research program or product candidate and fail to capitalize 
on strategies, programs or product candidates that may be more profitable or for which there is a greater likelihood of success.

Because  we  have  limited  resources,  we  may  forego  or  delay  pursuit  of  certain  strategic  opportunities  or  opportunities  with  certain  programs, 
product candidates or indications that later prove to have greater commercial potential. We may focus on or pursue one indication over another potential 
indication and such development efforts may not be successful, which would cause us to delay the clinical development and approval of efzofitimod and 
other  product  candidates.  In  addition,  our  decisions  as  to  which  of  our  discovery  programs  to  advance  into  preclinical  and  clinical  development  could 
preclude us from advancing others. Our resource allocation decisions may cause us to fail to capitalize on viable commercial products or profitable market 
opportunities. For example, based on analysis from an independent consultant that we engaged during 2022, we estimate that there is a $2-3 billion dollar 
market  opportunity  in  pulmonary  sarcoidosis  and  SSc-ILD  in  our  own  modeling.  Depending  on  the  accuracy  of  this  estimate,  we  may  not  be  most 
efficiently allocating resources toward the advancement of efzofitimod versus the advancement of other development efforts. In addition, we may elect to 
pursue a research, clinical or commercial strategy that ultimately does not yield the results that we desire. Our spending on current and future research and 
development  programs  for  product  candidates  may  not  result  in  any  commercially  viable  products.  If  we  do  not  accurately  evaluate  the  commercial 
potential or target market for a particular product candidate, we may relinquish valuable rights to that product candidate through strategic collaboration, 
licensing or other royalty arrangements in cases in which it would have been more advantageous for us to retain sole development and commercialization 
rights to such product candidate, or we may allocate internal resources to a product candidate in a therapeutic area or market in which it would have been 
more advantageous to enter into a partnering arrangement. Any failure to allocate resources or capitalize on strategies in a successful manner will have an 
adverse impact on our business.

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Our future success depends on our ability to retain key employees, consultants and advisors and to attract, retain and motivate qualified personnel.

We are highly dependent on principal members of our executive team, the loss of whose services may adversely impact the achievement of our 
objectives. While we have entered into employment agreements with each of our executive officers, any of them could leave our employment at any time, 
as all of our employees are “at will” employees. Recruiting and retaining other qualified employees, consultants and advisors for our business, including 
scientific and technical personnel, will also be critical to our success.

 In response to competition, higher rates of inflation and labor shortages, we may need to adjust employee cash compensation, which would affect 
our operating costs and our margins, or equity compensation, which would affect our outstanding share count and cause dilution to existing stockholders. 
We  may  not  be  able  to  attract  and  retain  personnel  on  acceptable  terms  given  the  competition  among  numerous  pharmaceutical  and  biotechnology 
companies for individuals with similar skill sets. In addition, the available pool of skilled employees may be further reduced if immigration laws change in 
a  manner  that  increases  restrictions  on  immigration.  Further,  failure  to  succeed  in  preclinical  studies  or  clinical  trials  may  make  it  more  challenging  to 
recruit and retain qualified personnel. The inability to recruit or loss of the services of any executive, key employee, consultant or advisor may impede the 
progress of our research, development and commercialization objectives. 

We  may  undertake  internal  restructuring  activities  in  the  future  that  could  result  in  disruptions  to  our  business  or  otherwise  materially  harm  our 
results of operations or financial condition. 

From  time  to  time  we  may  undertake  internal  restructuring  activities  as  we  continue  to  evaluate  and  attempt  to  optimize  our  cost  and  operating 
structure  in  light  of  developments  in  our  business  strategy  and  long-term  operating  plans.  For  example,  we  implemented  a  corporate  and  program 
prioritization plan in May 2018 that included a reduction in our workforce. Any such restructuring activities may result in write-offs or other restructuring 
charges.  There  can  be  no  assurance  that  any  restructuring  activities  that  we  have  undertaken  or  undertake  in  the  future  will  achieve  the  cost  savings, 
operating efficiencies or other benefits that we may initially expect. Restructuring activities may also result in a loss of continuity, accumulated knowledge 
and  inefficiency  during  transitional  periods  and  thereafter.  In  addition,  internal  restructurings  can  require  a  significant  amount  of  time  and  focus  from 
management and other employees, which may divert attention from commercial operations. If any internal restructuring activities we have undertaken or 
undertake in the future fail to achieve some or all of the expected benefits therefrom, our business, results of operations and financial condition could be 
materially and adversely affected. 

We are subject to a variety of risks associated with international operations that could materially adversely affect our business.

We  currently  conduct  research  activities  through  Pangu  BioPharma  Limited,  in  collaboration  with  the  Hong  Kong  University  of  Science  and 
Technology. Additionally, we have conducted clinical trials in the EU and in Australia and may conduct future clinical trials internationally. Our partner, 
Kyorin, conducted and funded an efzofitimod Phase 1 clinical trial in healthy volunteers in Japan, and has joined the EFZO-FIT study, a global Phase 3 
clinical  trial  designed  to  enroll  up  to  264  subjects  at  multiple  centers  in  United  States,  Europe,  Brazil  and  Japan.  If  any  of  our  product  candidates  are 
approved for commercialization outside of the United States, we expect to either use our own sales organization or selectively enter into agreements with 
third parties to market our products on a worldwide basis or in more limited geographical regions, as with Kyorin and efzofitimod in Japan. We are, and we 
expect that we will continue to be, subject to a variety of risks related to international operations, including, but not limited to: liquidity concerns at, and 
failures  of,  banks  and  other  financial  institutions  or  other  disruptions  in  the  banking  system  or  financing  markets,  different  regulatory  requirements  for 
approval of drugs and biologics in foreign countries; reduced or uncertain protection for intellectual property; unexpected changes in tariffs, trade barriers 
and regulatory requirements; economic weakness, including labor shortages, economic slowdowns, recessions, inflation and monetary supply shifts, higher 
interest rates and tightening of credit markets, or political instability in particular foreign economies and markets, including global geopolitical tension and 
armed conflicts; compliance with tax, employment, immigration and labor laws for employees living or traveling abroad; foreign currency fluctuations, 
which  could  result  in  reduced  revenues,  and  other  obligations  incident  to  doing  business  in  another  country;  and  the  global  impacts  of  potential  future 
health pandemics.

Any failure to continue our international operations or to commercialize our product candidates outside of the United States may impair our ability 

to generate revenues and harm our business, prospects and results of operations.

Our employees, principal investigators, consultants and commercial partners may engage in misconduct or other improper activities, including non-
compliance with regulatory standards and requirements and insider trading.

We  are  exposed  to  the  risk  of  fraud  or  other  misconduct  by  our  employees,  principal  investigators,  consultants  and  commercial  partners. 
Misconduct  by  these  parties  could  include  intentional  failures  to  comply  with  the  regulations  of  the  FDA  and  non-U.S.  regulators,  provide  accurate 
information  to  the  FDA  and  non-U.S.  regulators,  comply  with  healthcare  fraud  and  abuse  laws  and  regulations  in  the  United  States  and  abroad,  report 
financial information or data accurately or disclose unauthorized activities to us. In particular, sales, marketing and business arrangements in the healthcare 
industry are subject to extensive laws and regulations intended to prevent fraud, misconduct, kickbacks, self-dealing and other abusive practices. These 
laws and regulations may restrict or prohibit a 

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wide  range  of  pricing,  discounting,  marketing  and  promotion,  sales  commission,  customer  incentive  programs  and  other  business  arrangements.  Such 
misconduct  could  also  involve  the  improper  use  of  information  obtained  in  the  course  of  clinical  trials,  which  could  result  in  significant  regulatory 
sanctions and cause serious harm to our reputation. We have adopted a code of business conduct and ethics applicable to all of our employees, but it is not 
always  possible  to  identify  and  deter  employee  misconduct,  and  the  precautions  we  take  to  detect  and  prevent  this  activity  may  not  be  effective  in 
controlling  unknown  or  unmanaged  risks  or  losses  or  in  protecting  us  from  governmental  investigations  or  other  actions  or  lawsuits  stemming  from  a 
failure to comply with these laws or regulations. If any such actions are instituted against us, and we are not successful in defending ourselves or asserting 
our rights, those actions could have a significant impact on our business, including the imposition of significant fines or other sanctions.

We  face  potential  product  liability,  and,  if  successful  claims  are  brought  against  us,  we  may  incur  substantial  liability  and  costs.  If  the  use  of  our 
product  candidates  harm  patients,  or  is  perceived  to  harm  patients  even  when  such  harm  is  unrelated  to  our  product  candidates,  our  regulatory 
approvals could be revoked or otherwise negatively impacted and we could be subject to costly and damaging product liability claims.

The use of our product candidates in clinical trials and the sale of any products for which we obtain marketing approval exposes us to the risk of 
product liability claims. Product liability claims might be brought against us by patients, healthcare providers, pharmaceutical companies or others selling 
or otherwise coming into contact with our products. There is a risk that our product candidates may induce adverse events. If we cannot successfully defend 
against product liability claims, we could incur substantial liability and costs. In addition, regardless of merit or eventual outcome, product liability claims 
may result in:

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impairment of our business reputation;

withdrawal of clinical trial participants;

costs due to related litigation;

distraction of management’s attention from our primary business;

substantial monetary awards to patients or other claimants;

the inability to commercialize our product candidates; and

decreased demand for our product candidates, if approved for commercial sale.

We carry product liability insurance for our clinical trials covering $10.0 million per occurrence and up to $10.0 million in the aggregate, subject to 
certain deductibles and exclusions. Although we believe the amount of our insurance coverage is typical for companies similar to us in our industry, we 
may not have adequate insurance coverage or be able to maintain insurance coverage at a reasonable cost or in sufficient amounts to protect us against 
losses due to liability. If and when we obtain marketing approval for product candidates, we intend to expand our insurance coverage to include the sale of 
commercial  products;  however,  we  may  be  unable  to  obtain  product  liability  insurance  on  commercially  reasonable  terms  or  in  adequate  amounts.  On 
occasion,  large  judgments  have  been  awarded  in  class  action  lawsuits  based  on  drugs  or  medical  treatments  that  had  unanticipated  adverse  effects.  A 
successful product liability claim or series of claims brought against us could cause our stock price to decline and adversely affect our reputation and, if 
judgments exceed our insurance coverage, could adversely affect our results of operations and business.

Patients with the diseases targeted by our product candidates are often already in severe and advanced stages of disease and may have both known 
and  unknown  significant  pre-existing  and  potentially  life-threatening  health  risks.  During  the  course  of  treatment,  patients  may  suffer  adverse  events, 
including death, for reasons that may be related to our product candidates. Such events could subject us to costly litigation, require us to pay substantial
amounts of money to injured patients, delay, negatively impact or end our opportunity to receive or maintain regulatory approval to market our products, or 
require us to suspend or abandon our commercialization efforts. Even in a circumstance in which we do not believe that an adverse event is related to our 
products, the investigation into the circumstance may be time-consuming or inconclusive. These investigations may interrupt our sales efforts, delay our 
regulatory approval process in other countries, or impact and limit the type of regulatory approvals our product candidates receive or maintain. As a result 
of these factors, a product liability claim, even if successfully defended, could have a material adverse effect on our business, financial condition or results 
of operations.

We are, or may become, subject to stringent and evolving U.S. and foreign laws, regulations, rules, policies, contractual obligations, industry standards, 
and  other  obligations  related  to  data  privacy  and  security.  Our  actual  or  perceived  failure  to  comply  with  such  obligations  could  have  a  material 
adverse  effect  on  our  business  and  financial  condition,  including  a  disruption  of  clinical  trials  or  commercialization  of  products;  regulatory 
investigations or actions; litigation (including class claims) and mass arbitration demands; fines and penalties; reputational harm; loss of revenue or 
profits; and other adverse business consequences. 

We  collect,  receive,  store,  process,  use,  generate,  transfer,  disclose,  make  accessible,  protect,  secure,  dispose  of,  transmit  and  share  (Process  or 

Processing) personal data and other sensitive information, including information we or our third party partners (such 

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as CROs and clinical trial sites) collect about patients and healthcare providers in connection with clinical trials necessary to operate our business.

Therefore, our data Processing activities subject us to numerous data privacy and security laws, regulations, rules, guidance, and industry standards 
as well as external and internal data privacy and security policies, contractual requirements and other obligations that apply to the Processing of personal 
(and  other  sensitive)  data  both  by  us  and  on  our  behalf  (collectively,  Data  Protection  Requirements).  The  number  and  scope  of  the  Data  Protection 
Requirements  are  changing,  becoming  increasingly  stringent,  creating  uncertainty,  subject  to  differing  applications  and  interpretations,  and  may  be 
inconsistent between jurisdictions. These Data Protection Requirements may require us to change our business model. New Data Protection Requirements 
may  be  proposed  or  enacted.  Additionally,  given  the  breadth  and  evolving  nature  of  Data  Protection  Requirements  (and  consumers’  data  privacy 
expectations),  preparing  for  and  complying  with  these  requirements  is  rigorous,  time-intensive  and  requires  significant  resources  and  a  review  of  our 
technologies, systems and practices, as well as those of any third-party collaborators, service providers, contractors or consultants that Process personal 
data on our behalf. We may at times fail (or be perceived to have failed) in our efforts to comply with our Data Protection Requirements. Moreover, despite 
our  efforts,  our  personnel  or  third  parties  upon  whom  we  rely  may  fail  to  comply  with  such  obligations,  which  could  negatively  impact  our  business 
operations and compliance posture. 

If we or the third parties upon which we rely fail, or are perceived to have failed, to address or comply with Data Protection Requirements, this 
could result in government enforcement actions against us that could include investigations, fines, penalties, audits and inspections, additional reporting 
requirements  and/or  oversight,  temporary  or  permanent  bans  on  all  or  some  Processing  of  personal  data,  or  orders  to  destroy  or  not  use  personal  data. 
Further, individuals or other relevant stakeholders could bring a variety of claims (including class claims and mass arbitration demands) against us for our 
actual  or  perceived  failure  to  comply  with  the  Data  Protection  Requirements.  In  particular,  plaintiffs  have  become  increasingly  more  active  in  bringing 
privacy-related claims against companies, including class claims and mass arbitration demands. Some of these claims allow for the recovery of statutory 
damages on a per violation basis, and, if viable, carry the potential for monumental statutory damages, depending on the volume of data and the number of 
violations. Any of these events could have a material adverse effect on our reputation, business, or financial condition, and could lead to a loss of actual or 
prospective customers, collaborators or partners; interrupt or stop our clinical trials; result in an inability to Process personal data or to operate in certain 
jurisdictions;  limit  our  ability  to  develop  or  commercialize  our  products;  require  us  to  revise,  restructure  or  substantially  change  our  operations;  or 
otherwise materially adversely affect our operations (each, a Material Adverse Impact). 

In the United States, federal, state and local governments have enacted numerous data privacy and security laws, including data breach notification 
laws, personal data privacy laws, consumer protection laws (e.g., Section 5 of the Federal Trade Commission Act). and other similar laws (e.g. wiretapping 
laws). For example, the California Consumer Privacy Act of 2018, as amended by the California Privacy Rights Act of 2020 (CPRA), (collectively, CCPA) 
applies to personal data of consumers, business representatives, and employees who are California residents, and requires businesses to provide specific 
disclosures in privacy notices and honor requests of California residents to exercise certain privacy rights, such as those noted below. The CCPA provides 
for fines of up to $7,500 per intentional violation and allows private litigants affected by certain data breaches to recover significant statutory damages. 
Although the CCPA exempts some data Processed in the context of clinical trials, the CCPA may increase compliance costs and potential liability with 
respect to other personal data maintained about California residents. In addition, the CPRA expanded the CCPA’s requirements and established a regulatory 
agency to implement and enforce the law. Other states have also passed or are considering comprehensive privacy laws, with actions also being considered 
at the federal and local levels. These state laws and the CCPA provide individuals with certain rights concerning their personal data, including the right to 
access,  correct,  or  delete  certain  personal  data,  and  opt-out  of  certain  data  Processing  activities,  such  as  targeted  advertising,  profiling,  and  automated 
decision-making. The exercise of these rights may impact our business and ability to provide our products and services. While these states, like the CCPA, 
also exempt some data Processed in the context of clinical trials, these developments may further complicate compliance efforts, and may increase legal 
risk and compliance costs for us and the third parties upon whom we rely. 

Outside the United States, an increasing number of laws, regulations, and industry standards may govern data privacy and security. For example, 
the European Union’s General Data Protection Regulation (EU GDPR), the United Kingdom’s GDPR (UK GDPR), Brazil’s General Data Protection Law 
(Lei  Geral  de  Proteção  de  Dados  Pessoais,  or  LGPD)  (Law  No.  13,709/2018)  and  China's  Personal  Information  Protection  Law  (“PIPL”)  impose  strict 
requirements  for  Processing  personal  data.  We  may  become  subject  to  an  increasing  number  of  foreign  privacy  laws,  particularly  as  we  have  begun  to 
sponsor clinical trials in foreign jurisdictions, including in Europe. For example, failure to comply with the requirements of the EU and UK GDPR may 
result in warning letters, litigation, orders banning the Processing of personal data, mandatory audits and financial penalties, including fines of up to 4% of 
the total worldwide annual turnover, or €20,000,000 under the EU GDPR (17,500,000 British Pounds under the UK GDPR), in either case, whichever is 
greater; or private litigation related to Processing of personal data brought by classes of data subjects or consumer protection organizations authorized at 
law to represent their interests. Kyorin has also enrolled clinical trial patients in Japan and may be subject to local laws and regulations regarding data 
privacy, including Japan’s Act on the Protection of Personal Information. As another 

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example, the LGPD broadly regulates Processing personal data of individuals in Brazil and imposes compliance obligations and penalties comparable to 
those of the EU GDPR.

In  the  ordinary  course  of  business,  we  may  transfer  personal  data  from  Europe  and  other  jurisdictions  to  the  United  States  or  other  countries. 
Europe and other jurisdictions have enacted laws requiring data to be localized or limiting the transfer of personal data to other countries. In particular, the 
EEA and the UK have significantly restricted the transfer of personal data to the United States and other countries whose privacy laws it generally believes 
are  inadequate.  Other  jurisdictions  may  adopt  similarly  stringent  interpretations  of  their  data  localization  and  cross-border  data  transfer  laws.  Although 
there are currently various mechanisms that may be used to transfer personal data from the EEA and UK to the United States in compliance with law, such 
as  the  EEA  and  UK’s  standard  contractual  clauses,  the  UK’s  International  Data  Transfer  Agreement  /  Addendum,  and  the  EU-U.S.  Data  Privacy 
Framework and the UK extension thereto (which allows for transfers for relevant U.S.-based organizations who self-certify compliance and participate in 
the  Framework),  these  mechanisms  are  subject  to  legal  challenges,  and  there  is  no  assurance  that  we  can  satisfy  or  rely  on  these  measures  to  lawfully 
transfer personal data to the United States. If there is no lawful manner for us to transfer personal data from the EEA, the UK, or other jurisdictions to the 
United  States,  or  if  the  requirements  for  a  legally-compliant  transfer  are  too  onerous,  we  could  face  significant  adverse  consequences,  including  the 
interruption or degradation of our operations, the need to relocate part of or all of our business or data processing activities to other jurisdictions (such as 
Europe)  at  significant  expense,  increased  exposure  to  regulatory  actions,  substantial  fines  and  penalties,  the  inability  to  transfer  data  and  work  with 
partners,  vendors  and  other  third  parties,  and  injunctions  against  our  processing  or  transferring  of  personal  data  necessary  to  operate  our  business. 
Additionally, companies that transfer personal data out of the EEA and UK to other jurisdictions, particularly to the United States, are subject to increased 
scrutiny from regulators, individual litigants, and activities groups. Some European regulators have ordered certain companies to suspend or permanently 
cease certain transfers of personal data out of Europe for allegedly violating the EU and UK GDPR’s cross-border data transfer limitations. 

Our employees and personnel use generative artificial intelligence (AI) technologies to perform their work, and the disclosure and use of personal 
data  in  generative  AI  technologies  is  subject  to  various  privacy  laws  and  other  privacy  obligations.  Governments  have  passed  and  are  likely  to  pass 
additional laws regulating generative AI. Our use of this technology could result in additional compliance costs, regulatory investigations and actions, and 
lawsuits. If we are unable to use generative AI, it could make our business less efficient and result in competitive disadvantages.

In addition to data privacy and security laws, we are contractually subject to industry standards adopted by industry groups and, we are, or may 
become  subject  to  such  obligations  in  the  future.  We  are  also  bound  by  contractual  obligations  related  to  data  privacy  and  security,  and  our  efforts  to 
comply with such obligations may not be successful. For example, certain privacy laws, such as the EU and UK GDPR and the CCPA, may require our 
customers to impose specific contractual restrictions on their service providers. We also publish privacy policies, marketing materials and other statements, 
such  as  compliance  with  certain  certifications,  regarding  data  privacy  and  security.  If  these  policies,  materials  or  statements  are  found  to  be  deficient, 
lacking in transparency, deceptive, unfair, or misrepresentative of our practices, we may be subject to investigation, enforcement actions by regulators or 
other adverse consequences.

Unfavorable macroeconomic conditions could adversely affect our business, financial condition or results of operations. 

Our results of operations could be adversely affected by general conditions in the global economy and in the global financial markets. For example, 
the global financial crisis caused volatility and disruptions in the capital and credit markets. In addition, due to general political and economic conditions, 
including global geopolitical tension, armed conflicts, liquidity concerns at, and failures of, banks and other financial institutions or other disruptions in the
banking system or financing markets, higher interest rates and financial and credit market fluctuations, volatility in the capital markets, the global credit 
and  financial  markets  have  experienced  extreme  volatility  and  disruptions,  including  diminished  liquidity  and  credit  availability,  declines  in  consumer 
confidence,  declines  in  economic  growth,  volatility  in  unemployment  rates,  inflation  and  uncertainty  about  economic  stability.  A  severe  or  prolonged 
economic downturn, such as the global financial crisis, could result in a variety of risks to our business, including inability to raise additional capital when 
needed on acceptable terms, if at all. A weak or declining economy could also strain our CDMOs and CROs, possibly resulting in supply disruption. Any 
of the foregoing could harm our business and we cannot anticipate all of the ways in which the current economic climate and financial market conditions 
could adversely impact our business.

We or the third parties upon whom we depend may be adversely affected by earthquakes, droughts, floods, fires, hurricanes or other natural disasters
and our business continuity and disaster recovery plans may not adequately protect us from a serious disaster.

We are located in San Diego, California and our manufacturing activities are conducted by CDMOs and our clinical trials are conducted at various 
locations in the United States and abroad. Some of these geographic locations have in the past experienced natural disasters, including severe earthquakes. 
Earthquakes,  droughts,  floods,  fires,  hurricanes,  disease  epidemics  or  other  natural  disasters  could  severely  disrupt  our  operations,  and  have  a  material 
adverse  effect  on  our  business,  results  of  operations,  financial  condition  and  prospects.  If  a  natural  disaster,  power  outage  or  other  event  occurred  that 
prevented us from using all or a significant portion of our facilities, that damaged critical infrastructure, such as the manufacturing facilities of our CDMOs 
and clinical sites utilized by our CROs, or that otherwise disrupted operations, it may be difficult or, in certain cases, impossible for us to continue our 
business for a substantial 

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period of time. The disaster recovery and business continuity plans we have in place currently are limited and are unlikely to prove adequate in the event of 
a  serious  disaster  or  similar  event.  We  may  incur  substantial  expenses  as  a  result  of  the  limited  nature  of  our  disaster  recovery  and  business  continuity 
plans, as well as limits on our insurance coverage, which could have a material adverse effect on our business, prospects, financial condition and results of 
operations.

Risks related to the commercialization of our product candidates

If we are unable to establish sales, marketing and distribution capabilities or enter into agreements with third parties to market and sell our product 
candidates, we may be unable to generate any revenues.

We do not currently have any infrastructure for the sales, marketing and distribution of pharmaceutical products. In order to market our product 
candidates,  if  approved  by  the  FDA  or  any  other  regulatory  body,  we  must  build  our  sales,  marketing,  distribution,  managerial  and  other  non-technical 
capabilities or make arrangements with third parties to perform these services. There are risks involved with both establishing our own sales and marketing 
capabilities and entering into arrangements with third parties to perform these services. For example, recruiting and training a sales force is expensive and 
time  consuming  and  could  delay  any  product  launch.  If  the  commercial  launch  of  a  product  candidate  for  which  we  recruit  a  sales  force  and  establish 
marketing capabilities is delayed or does not occur for any reason, we would have prematurely or unnecessarily incurred these commercialization expenses. 
This may be costly, and our investment would be lost if we cannot retain or reposition our sales and marketing personnel.

If we enter into arrangements or collaborations with third parties to perform sales, marketing and distribution services, our product revenues or the 
profitability of these product revenues to us are likely to be lower than if we were to market, sell or distribute any medicines that we develop ourselves. In 
addition, we may not be successful in entering into arrangements with third parties to sell and market our product candidates or may be unable to do so on 
terms that are favorable to us. We likely will have little control over such third parties, and any of them may fail to devote the necessary resources and 
attention  to  sell  and  market  our  medicines  effectively.  If  we  do  not  establish  sales  and  marketing  capabilities  successfully,  either  on  our  own  or  in 
collaboration with third parties, we will not be successful in commercializing our product candidates.

We rely on third-party manufacturers to produce our product candidates, but we have not entered into agreements with any such manufacturers to 
support commercialization.

We  have  not  yet  secured  manufacturing  capabilities  for  commercial  quantities  of  any  of  our  product  candidates.  Although  we  intend  to  rely  on 
third-party manufacturers for commercialization, we have not yet entered into a long-term commercial supply agreement to support full scale commercial 
production,  and  we  or  our  CDMOs  may  be  unable  to  process  validation  activities  necessary  to  enter  into  commercial  supply  agreements  or  otherwise 
negotiate agreements with the manufacturers to support our commercialization activities at commercially reasonable terms.

We may run into technical or scientific issues related to development or manufacturing that we may be unable to resolve in a timely manner or with 
available funds. For example, we engaged an additional CDMO to manufacture efzofitimod bulk drug substance. If the new CDMO experiences delays in 
validating  the  manufacturing  process,  particularly  delays  in  producing  efzofitimod  in  compliance  with  cGMP  regulations,  we  could  be  forced  to  delay 
future  clinical  trials  or  the  submission  of  regulatory  approval  applications  to  the  FDA.  In  addition,  due  to  the  fact  that  all  prior  cGMP  batches  of 
efzofitimod, including those that we intend to use in the EFZO-FIT study, have been produced by our existing CDMO, we will be required to complete 
comparability  studies  prior  to  using  efzofitimod  produced  at  the  new  CDMO’s  facilities  in  subsequent  clinical  trials  or  submitting  regulatory  approval 
applications to the FDA. If we are unable to demonstrate such comparability to the satisfaction of the FDA, it may result in delays to future clinical trials or 
a deficiency in future regulatory applications. If we or our CDMOs are unable to scale the manufacturing process to produce commercial quantities of our 
product candidates, or our CDMOs do not pass required regulatory pre-approval inspections, our commercialization efforts will be harmed.

In  addition,  any  significant  disruption  in  our  relationships  with  our  CDMOs  could  harm  our  business.  There  are  a  relatively  small  number  of 
potential manufacturers for our product candidates, and such manufacturers may not be able to supply our drug products at the times we need them or on 
commercially reasonable terms. Any disruption to our relationship with our current CDMOs and any manufacturers that we contract with in the future will
result in delays in our ability to complete the clinical development of, or to commercialize, our product candidates, and may require us to incur additional 
costs.

We face intense competition and rapid technological change and the possibility that our competitors may develop therapies that are more advanced or 
effective than ours, which may adversely affect our financial condition and our ability to successfully commercialize our product candidates. 

The  biotechnology  and  pharmaceutical  industries  are  intensely  competitive  and  subject  to  rapid  and  significant  technological  change.  We  have 
competitors  both  in  the  United  States  and  internationally,  including  major  multi-national  pharmaceutical  companies,  biotechnology  companies  and 
universities and other research institutions. Although we believe we are the only company engaged in the 

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discovery and development of therapeutics based on novel functions of tRNA synthetases, we are aware of other companies that could compete with our 
product candidates in their target therapeutic indications, such as our lead candidate, efzofitimod, for the treatment of pulmonary sarcoidosis, SSc-ILD and 
other ILD. 

Many  of  our  competitors  have  substantially  greater  financial,  technical  and  other  resources,  such  as  larger  research  and  development  staff  and 
experienced  marketing  and  manufacturing  organizations.  Competition  may  increase  further  as  a  result  of  advances  in  the  commercial  applicability  of 
technologies and greater availability of capital for investment in these industries. Our competitors may succeed in developing, acquiring or licensing on an 
exclusive basis, products that are more effective, safer, more convenient or less costly than any product candidate that we may develop, or achieve earlier 
patent protection, regulatory approval, product commercialization and market penetration than us. Additionally, technologies developed by our competitors 
may  render  our  potential  product  candidates  uneconomical  or  obsolete,  and  we  may  not  be  successful  in  marketing  our  product  candidates  against 
competitors.

The  commercial  success  of  any  current  product  candidate  or  future  product  candidates  will  depend  upon  the  degree  of  market  acceptance  by 
physicians, patients, third-party payors and others in the medical community.

Even with the requisite approval from the FDA and comparable foreign regulatory authorities, the commercial success of our product candidates 
will depend in part on the medical community, patients, and third-party payors accepting our product candidates as medically useful, cost-effective, and 
safe.  Any  product  that  we  bring  to  the  market  may  not  gain  market  acceptance  by  physicians,  patients,  third-party  payors  and  others  in  the  medical 
community.  If  these  products  do  not  achieve  an  adequate  level  of  acceptance,  we  may  not  generate  significant  product  revenue  and  may  not  become 
profitable. 

Even if a potential product displays a favorable efficacy and safety profile in preclinical studies and clinical trials, market acceptance of the product 
will not be known until after it is launched. Our efforts to educate the medical community and third-party payors on the benefits of the product candidates 
may require significant resources and may never be successful. Such efforts to educate the marketplace may require more resources than are required by the 
conventional technologies marketed by our competitors, and our competitors may have substantially greater resources or brand recognition to effectively 
market their products. If our product candidates are approved but fail to achieve an adequate level of acceptance by physicians, patients, third-party payors, 
and others in the medical community, we will not be able to generate sufficient revenue to become or remain profitable.

The  insurance  coverage  and  reimbursement  status  of  newly-approved  products  is  uncertain.  Failure  to  obtain  or  maintain  adequate  coverage  and 
reimbursement for new or current products could limit our ability to market those products and decrease our ability to generate revenue.

The availability and extent of coverage and adequate reimbursement by third-party payors, including government health administration authorities, 
private  health  coverage  insurers,  managed  care  organizations  and  other  third-party  payors  is  essential  for  most  patients  to  be  able  to  afford  expensive 
treatments. Sales of any of our product candidates that receive marketing approval will depend substantially, both in the United States and internationally, 
on the extent to which the costs of such product candidates will be covered and reimbursed by third-party payors. If reimbursement is not available, or is 
available  only  to  limited  levels,  we  may  not  be  able  to  successfully  commercialize  our  product  candidates.  Even  if  coverage  is  provided,  the  approved 
reimbursement amount may not be high enough to allow us to establish or maintain pricing sufficient to realize an adequate return on our investment.

There is significant uncertainty related to the insurance coverage and reimbursement of newly approved products. In the United States, the principal 
decisions about reimbursement for new medicines are typically made by the Centers for Medicare & Medicaid Services (CMS), as CMS decides whether 
and to what extent a new medicine will be covered and reimbursed under Medicare. Private payors often follow CMS with respect to coverage policy and 
payment  limitations  in  setting  their  own  reimbursement  policies.  It  is  difficult  to  predict  what  CMS  will  decide  with  respect  to  reimbursement  for 
fundamentally  novel  products  such  as  ours,  as  there  is  no  body  of  established  practices  and  precedents  for  these  new  products.  One  third-party  payor’s 
determination to provide coverage for a product candidate does not assure that other payors will also provide coverage for the product candidate. Further, 
no  uniform  policy  for  coverage  and  reimbursement  exists  in  the  United  States,  and  coverage  and  reimbursement  can  differ  significantly  from  payor  to 
payor. As a result, the coverage determination process is often time-consuming and costly. This process will require us to provide scientific and clinical 
support  for  the  use  of  our  products  to  each  third-party  payor  separately,  with  no  assurance  that  coverage  and  adequate  reimbursement  will  be  applied 
consistently or obtained in the first instance. Reimbursement agencies in Europe may be more conservative than third-party payors in the United States. For 
example, a number of cancer drugs have been approved for reimbursement in the United States, but have not been approved for reimbursement in certain 
European  countries.  There  may  be  significant  delays  in  obtaining  reimbursement  for  newly  approved  medicines,  and  our  inability  to  promptly  obtain 
coverage and profitable payment rates from third-party payors for any approved medicines could have a material adverse effect on our business, prospects, 
financial condition and results of operations.

Outside the United States, international sales are generally subject to extensive governmental price controls and other market regulations, and we 

believe the increasing emphasis on cost-containment initiatives in Europe, Canada, and other countries has and will 

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continue to put pressure on the pricing and usage of our product candidates. In many countries, the prices of medical products are subject to varying price 
control mechanisms as part of national health systems. In general, the prices of medicines under such systems are substantially lower than in the United 
States. Other countries allow companies to fix their own prices for medicines, but monitor and control company profits. Additional foreign price controls or 
other changes in pricing regulation could restrict the amount that we are able to charge for our product candidates. Accordingly, in markets outside the 
United  States,  the  reimbursement  for  our  products  may  be  reduced  compared  with  the  United  States  and  may  be  insufficient  to  generate  commercially 
reasonable revenues and profits. Net prices for medicines may be reduced by mandatory discounts or rebates required by government healthcare programs 
or private payors and by any future relaxation of laws that currently restrict imports of medicines from countries where they may be sold at lower prices 
than in the United States.

Moreover, increasing efforts by governmental and third-party payors, in the United States and abroad, to cap or reduce healthcare costs may cause 
such organizations to limit both coverage and level of reimbursement for new products and, as a result, they may not cover or provide adequate payment 
for our product candidates. For example, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act 
of 2010 (collectively, the ACA) was passed in March 2010, and substantially changed the way healthcare is financed by both governmental and private 
insurers. There have been executive, judicial and congressional challenges to certain aspects of the ACA. While Congress has not passed comprehensive 
repeal legislation, it has enacted laws that modified certain provisions of the ACA such as removing penalties, starting January 1, 2019, for not complying 
with the ACA’s individual mandate to carry health insurance. On June 17, 2021 the U.S. Supreme Court dismissed a challenge on procedural grounds that 
argued the ACA is unconstitutional in its entirety because the “individual mandate” was repealed by Congress. On August 16, 2022, President Biden signed 
the  Inflation  Reduction  Act  of  2022  (IRA)  into  law,  which  among  other  things,  extends  enhanced  subsidies  for  individuals  purchasing  health  insurance 
coverage in ACA marketplaces through plan year 2025. The IRA also eliminates the “donut hole” under the Medicare Part D program beginning in 2025 
by significantly lowering the beneficiary maximum out-of-pocket cost and through a newly established manufacturer discount program. It is possible that 
the ACA will be subject to judicial or Congressional challenges in the future. It is unclear how any such challenges and the healthcare reform measures of 
the Biden administration will impact the ACA and our business. 

In addition, there has been heightened governmental scrutiny in the United States of pharmaceutical pricing practices in light of the rising cost of 
prescription  drugs  and  biologics.  Such  scrutiny  has  resulted  in  several  recent  presidential  executive  orders,  congressional  inquiries  and  proposed  and 
enacted federal and state legislation designed to, among other things, bring more transparency to product pricing, review the relationship between pricing 
and  manufacturer  patient  programs,  and  reform  government  program  reimbursement  methodologies  for  products.  For  example,  in  July  2021,  the  Biden 
administration released an executive order, “Promoting Competition in the American Economy,” with multiple provisions aimed at prescription drugs. In 
response to Biden’s executive order, on September 9, 2021, the U.S. Department of Health and Human Services (HHS) released a Comprehensive Plan for 
Addressing  High  Drug  Prices  that  outlines  principles  for  drug  pricing  reform  and  sets  out  a  variety  of  potential  legislative  policies  that  Congress  could 
pursue as well as potential administrative actions HHS can take to advance these principles. Further, the IRA, among other things, (1) directs the HHS to 
negotiate the price of certain single-source drugs and biologics covered under Medicare and (2) imposes rebates under Medicare Part B and Medicare Part 
D  to  penalize  price  increases  that  outpace  inflation.  These  provisions  take  effect  progressively  starting  in  fiscal  year  2023.  On  August  29,  2023,  HHS 
announced the list of the first ten drugs that will be subject to price negotiations, although the Medicare drug price negotiation program is currently subject 
to legal challenges. HHS has and will continue to issue and update guidance as these programs are implemented. It is currently unclear how the IRA will be 
implemented but is likely to have a significant impact on the pharmaceutical industry. In addition, in response to the Biden administration's October 2022 
executive order, on February 14, 2023, HHS released a report outlining three new models for testing by the Center for Medicare and Medicaid Innovation 
which will be evaluated on their ability to lower the cost of drugs, promote accessibility, and improve quality of care. It is unclear whether the models will 
be utilized in any health reform measures in the future. Further, on December 7, 2023, the Biden administration announced an initiative to control the price 
of  prescription  drugs  through  the  use  of  march-in  rights  under  the  Bayh-Dole  Act.  On  December  8,  2023,  the  National  Institute  of  Standards  and 
Technology  published  for  comment  a  Draft  Interagency  Guidance  Framework  for  Considering  the  Exercise  of  March-In  Rights  which  for  the  first  time 
includes the price of a product as one factor an agency can use when deciding to exercise march-in rights. While march-in rights have not previously been 
exercised, it is uncertain if that will continue under the new framework. We expect to experience pricing pressures in connection with the sale of any of our 
product candidates, due to the trend toward managed healthcare, the increasing influence of health maintenance organizations and additional health reform 
measures. The downward pressure on healthcare costs in general, particularly prescription drugs and surgical procedures and other treatments, has become 
very intense. As a result, increasingly higher barriers are being erected to the entry of new products.

In addition, drug prices are under significant scrutiny in the markets in which our products may be sold. Drug pricing and other health care costs 
continues  to  be  subject  to  intense  political  and  societal  pressures  which  we  anticipate  will  continue  and  escalate  on  a  global  basis.  If  coverage  and 
reimbursement is available only to limited levels, we may not be able to successfully commercialize our product candidates for which we obtain marketing 
approval. As a result, we may have difficulty raising capital and our results of operations may be adversely impacted.

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Our  business  operations  and  current  and  future  relationships  with  investigators,  healthcare  professionals,  consultants,  third-party  payors  and 
customers  may  be  subject,  directly  or  indirectly,  to  federal  and  state  healthcare  fraud  and  abuse  laws,  false  claims  laws,  transparency  laws,  health 
information privacy and security laws and other healthcare laws and regulations. If we are unable to comply, or have not fully complied, with such 
laws, we could face substantial penalties. 

Although  we  do  not  currently  have  any  products  on  the  market,  our  current  and  future  operations  may  be,  directly  or  indirectly  through  our 
prescribers, customers and third-party payors, subject to various federal and state healthcare laws and regulations. The laws that may affect our ability to 
operate include: 

•

•

•

•

•

•

the federal Anti-Kickback Statute, which prohibits, among other things, persons or entities from knowingly and willfully soliciting, offering, 
receiving or paying any remuneration (including any kickback, bribe or certain rebates), directly or indirectly, overtly or covertly, in cash or 
in kind, to induce or reward either the referral of an individual for, or the purchase, lease, order or recommendation of, any good, facility, 
item  or  service,  for  which  payment  may  be  made,  in  whole  or  in  part,  under  federal  and  state  healthcare  programs  such  as  Medicare  and 
Medicaid. A person or entity does not need to have actual knowledge of the statute or specific intent to violate it in order to have committed a 
violation; 

the  U.S.  federal  false  claims,  including  the  False  Claims  Act,  which  can  be  enforced  through  whistleblower  actions,  and  civil  monetary 
penalties laws, which, among other things, impose criminal and civil penalties against individuals or entities for knowingly presenting, or 
causing to be presented, to the U.S. federal government, claims for payment or approval that are false or fraudulent, knowingly making, using 
or causing to be made or used, a false record or statement material to a false or fraudulent claim, or from knowingly making a false statement 
to  avoid,  decrease  or  conceal  an  obligation  to  pay  money  to  the  federal  government.  In  addition,  the  government  may  assert  that  a  claim 
including  items  and  services  resulting  from  a  violation  of  the  federal  Anti-Kickback  Statute  constitutes  a  false  or  fraudulent  claim  for 
purposes of the False Claims Act; 

the federal Health Insurance Portability and Accountability Act (HIPAA), which imposes criminal and civil liability for, among other things, 
knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, or knowingly and willfully 
falsifying, concealing or covering up a material fact or making any materially false statement, in connection with the delivery of, or payment 
for, healthcare benefits, items or services; similar to the U.S. federal Anti-Kickback Statute, a person or entity does not need to have actual 
knowledge of the statute or specific intent to violate it in order to have committed a violation; 

HIPAA,  as  amended  by  the  Health  Information  Technology  for  Economic  and  Clinical  Health  Act  (HITECH),  which  imposes  certain 
obligations,  including  mandatory  contractual  terms,  with  respect  to  safeguarding  the  privacy,  security  and  transmission  of  individually 
identifiable health information without appropriate authorization by covered entities, i.e. health plans, healthcare clearinghouses and certain 
healthcare  providers,  as  well  as  their  business  associates  and  covered  subcontractors  that  perform  certain  services  for  or  on  their  behalf 
involving the use or disclosure of individually identifiable health information;

the U.S. federal legislation commonly referred to as Physician Payments Sunshine Act, enacted as part of the ACA, and its implementing 
regulations, which requires certain manufacturers of drugs, devices, biologics and medical supplies that are reimbursable under Medicare, 
Medicaid  or  the  Children’s  Health  Insurance  Program  to  report  annually  to  the  CMS  information  related  to  certain  payments  and  other 
transfers  of  value  to  physicians  (defined  to  include  doctors,  dentists,  optometrists,  podiatrists  and  chiropractors),  certain  other  healthcare 
professionals (such as physician assistants and nurse practitioners), and teaching hospitals, as well as ownership and investment interests held 
by the physicians described above and their immediate family members; and

analogous state and foreign laws and regulations. 

If our operations are found to be in violation of any of the laws described above or any other governmental laws and regulations that may apply to 
us, we may be subject to significant penalties, including civil, criminal and administrative penalties, damages, fines, exclusion from government funded 
healthcare  programs,  such  as  Medicare  and  Medicaid,  or  similar  programs  in  other  countries  or  jurisdictions,  disgorgement,  imprisonment,  contractual 
damages, reputational harm, diminished profits, additional reporting requirements and oversight if we become subject to a corporate integrity agreement or 
similar agreement to resolve allegations of non-compliance with these laws and the delay, reduction, termination or restructuring of our operations. 

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Risks related to the ownership of our common stock

The market price of our common stock historically has been highly volatile and is likely to continue to be volatile, and you could lose all or part of your 
investment.

The market price of our common stock has been volatile and could be subject to wide fluctuations in response to various factors, some of which are 

beyond our control. In addition to the factors discussed in this “Risk Factors” section and elsewhere in this Annual Report, these factors include:

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adverse results or delays in preclinical studies or clinical trials;

manufacturing sufficient quantities of product candidates for use in clinical trials;

the imposition of a clinical hold on our product candidates or our inability to cause the clinical hold to be lifted;

any delay in filing an investigational new drug application (IND) or BLA for any of our product candidates and any adverse development or 
perceived adverse development with respect to the FDA’s review of that IND or BLA;

failure of our strategic partners to perform under our collaborations or early termination of collaborations;

failure to successfully develop and commercialize our product candidates;

limited market sizes and pricing for our product candidates;

failure by us or our licensors to prosecute, maintain or enforce intellectual property rights covering our product candidates and processes;

changes in laws or regulations applicable to current or future products;

inability to obtain adequate product supply for our product candidates or the inability to do so at acceptable prices;

adverse regulatory decisions;

introduction of new products, services or technologies by our competitors;

inability to obtain additional capital;

failure to meet or exceed financial or operational projections we may provide to the public;

failure to meet or exceed the financial or operational projections of the investment community;

the perception of the biopharmaceutical industry by the public, politicians, legislatures, regulators and the investment community;

significant acquisitions, strategic partnerships, joint ventures or capital commitments by us or our competitors;

disputes or other developments relating to proprietary rights, including patents, litigation matters and our ability to obtain patent protection 
for our technologies;

additions or departures of key scientific or management personnel;

significant lawsuits, including patent or stockholder litigation;

if securities or industry analysts issue an adverse or misleading opinion regarding our common stock;

changes in the market valuations of similar companies;

changes in the structure of healthcare payment systems;

sales of our common stock by us or our stockholders in the future; 

a potential additional reverse stock split if we are unable to maintain a stock price above $1.00 per share of common stock;

trading volume of our common stock; and

general  political  and  macroeconomic  conditions,  including  global  geopolitical  tension,  armed  conflicts,  potential  future  health  pandemics, 
liquidity concerns at, and failures of, banks and other financial institutions or other disruptions in the banking system or financing markets, 
rising interest rates and financial and credit market fluctuations, volatility in the capital markets, and other geopolitical and macroeconomic 
conditions,  including  labor  shortages,  economic  slowdowns,  recessions,  inflation  and  monetary  supply  shifts,  rising  interest  rates  and 
tightening of credit markets, and the resulting impacts on our business operations or financial condition.

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In addition, companies trading in the stock market in general, and on the Nasdaq Capital Market and biotechnology companies in particular, have 
experienced  extreme  price  and  volume  fluctuations,  and  we  have  in  the  past  experienced  volatility  that  has  been  unrelated  or  disproportionate  to  our 
operating performance. From January 1, 2023 through March 8, 2024 the closing price of our common stock has ranged between $1.11 and $2.57 per share. 
Broad market and industry factors may negatively affect the market price of our common stock, regardless of our actual operating performance.

Our executive officers, directors, 5% holders and their affiliates currently own a significant percentage of our stock and will be able to exert significant 
control over matters submitted to stockholders for approval.

As of March 8, 2024, based on the latest information available to us, our executive officers, directors, holders known by us to own 5% of our voting 
stock and their affiliates own approximately 38.5% of our voting stock. Therefore, our executive officers, directors, holders known by us to own 5% of our
voting stock and their affiliates will have the ability to influence us through their ownership positions and may be able to determine all matters requiring 
stockholder approval. For example, these stockholders, acting together, may be able to control elections of directors, amendments of our organizational 
documents, or approval of any merger, sale of assets, or other major corporate transaction. This may prevent or discourage unsolicited acquisition proposals 
or offers for our common stock that you may believe are in your best interest as one of our stockholders.

Future sales and issuances of equity securities could result in dilution to our stockholders, impose restrictions or limitations on our business and could 
cause our stock price to fall.

We  will  need  additional  capital  in  the  future  to  continue  our  planned  operations,  and  we  may  seek  additional  funding  through  a  combination  of 

equity offerings, debt, grant funding, collaborations, strategic partnerships and/or licensing arrangements. 

In  February  2023,  we  completed  an  underwritten  follow-on  public  offering  of  23,125,000  shares  of  our  common  stock,  including  the  partial 
exercise of the underwriters’ option to purchase additional shares, at a price to the public of $2.25 per share. The total net proceeds from the offering were 
approximately $48.1 million, after deducting underwriting discounts, commissions and offering expenses payable by us.

In  April  2022,  we  entered  into  an  Open  Market  Sale  AgreementSM  with  Jefferies  LLC  (Jefferies)  implementing  an  “at-the-market”  offering 
program, (the Jefferies ATM Offering Program) pursuant to which we may offer and sell, from time to time and at our option, up to an aggregate of $65.0 
million of shares of our common stock through Jefferies, acting as sales agent. Jefferies is entitled to a fixed commission rate of up to 3.0% of the gross 
sales proceeds of shares sold under the Jefferies ATM Offering Program. During 2022, we sold an aggregate of 1,421,627 shares of common stock at a 
weighted-average  price  of  $3.09  per  share  for  net  proceeds  of  approximately  $4.0  million  under  the  Jefferies  ATM  Offering  Program.  During  the  year 
ended December 31, 2023, we sold an aggregate of 10,530,795 shares of common stock at a weighted-average price of $1.82 per share for net proceeds of 
approximately $18.4 million under the Jefferies ATM Offering Program.

These financing activities may have an adverse effect on our stockholders’ rights, the market price of our common stock and on our operations, and 
may require us to relinquish rights to some of our technologies, intellectual property or product candidates, issue additional equity or debt securities, or 
otherwise agree to terms unfavorable to us.

In addition, sales of a substantial number of shares of our common stock by our existing stockholders in the public market or the perception that 
these sales might occur, could depress the market price of our common stock and could impair our ability to raise capital through the sale of additional 
equity securities. Any sales of securities by these stockholders could have a material adverse effect on the trading price of our common stock, even if there 
is no relationship between such sales and the performance of our business.

We have also registered or plan to register all common stock that we may issue under our employee benefits plans as well as shares of common 
stock underlying options to purchase shares of our common stock that were granted as inducement grants. As a result, once registered, these shares can be 
freely  sold  in  the  public  market  upon  issuance,  subject  to  restrictions  under  the  securities  laws.  In  addition,  our  directors  and  executive  officers  may 
establish programmed selling plans under Rule 10b5-1 of the Securities Exchange Act of 1934 (Exchange Act) for the purpose of effecting sales of our 
common stock. If any of these events cause a large number of our shares to be sold in the public market, the sales could reduce the trading price of our 
common stock and impede our ability to raise future capital.

Our ability to use our net operating losses to offset future taxable income may be subject to certain limitations.

We  have  incurred  substantial  losses  during  our  history,  we  do  not  expect  to  become  profitable  in  the  near  future  and  we  may  never  achieve 
profitability.  Net  operating  loss  carryforwards  (NOLs)  that  expire  unused  will  be  unavailable  to  offset  future  income  tax  liabilities.  Under  current  law, 
federal  net  operating  losses  incurred  in  tax  years  beginning  after  December  31,  2017,  may  be  carried  forward  indefinitely,  but  the  deductibility  of  such 
federal NOLs is limited to 80% of taxable income.

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In addition, under Section 382 of the Internal Revenue Code of 1986, as amended (Code) a corporation that undergoes an “ownership change” (as 
defined under Section 382 of the Code and applicable Treasury Regulations) is subject to limitations on its ability to utilize its pre-change NOLs to offset 
post-change taxable income. We have experienced ownership changes in the past, and may experience future ownership changes, under Section 382 of the 
Code that could affect our ability to utilize our NOLs to offset our income. Furthermore, our ability to utilize NOLs of companies that we may acquire in 
the future may be subject to limitations. There is also a risk that due to regulatory changes, such as suspensions on the use of NOLs or other unforeseen 
reasons, portions of our existing NOLs could expire or otherwise be unavailable to reduce future income tax liabilities, including for state tax purposes. For 
these reasons, we may not be able to utilize a material portion of our NOLs, even if we attain profitability, which could potentially result in increased future 
tax liability to us and could adversely affect our operating results and financial condition.

Uncertainties in the interpretation and application of existing, new and proposed tax laws and regulations could materially affect our tax obligations 
and effective tax rate.

The  tax  regimes  to  which  we  are  subject  or  under  which  we  operate  are  unsettled  and  may  be  subject  to  significant  change.  The  issuance  of 
additional guidance related to existing or future tax laws, or changes to tax laws or regulations proposed or implemented by the current or a future U.S. 
presidential administration, Congress, or taxing authorities in other jurisdictions, including jurisdictions outside of the United States, could materially affect 
our tax obligations and effective tax rate. To the extent that such changes have a negative impact on us, including as a result of related uncertainty, these 
changes may adversely impact our business, financial condition, results of operations, and cash flows.

The  amount  of  taxes  we  pay  in  different  jurisdictions  depends  on  the  application  of  the  tax  laws  of  various  jurisdictions,  including  the  United 
States, to our international business activities, tax rates, new or revised tax laws, or interpretations of tax laws and policies, and our ability to operate our 
business in a manner consistent with our corporate structure and intercompany arrangements. The taxing authorities of the jurisdictions in which we operate 
may challenge our methodologies for pricing intercompany transactions pursuant to our intercompany arrangements or disagree with our determinations as 
to the income and expenses attributable to specific jurisdictions. If such a challenge or disagreement were to occur, and our position was not sustained, we 
could be required to pay additional taxes, interest, and penalties, which could result in one-time tax charges, higher effective tax rates, reduced cash flows, 
and lower overall profitability of our operations. Our financial statements could fail to reflect adequate reserves to cover such a contingency. Similarly, a 
taxing authority could assert that we are subject to tax in a jurisdiction where we believe we have not established a taxable connection, often referred to as a 
“permanent establishment” under international tax treaties, and such an assertion, if successful, could increase our expected tax liability in one or more 
jurisdictions.

We do not intend to pay dividends on our common stock, and therefore any returns will be limited to the value of our stock.

We have never declared or paid any cash dividends on our common stock. We anticipate that we will retain future earnings for the development, 
operation and expansion of our business and do not anticipate declaring or paying any cash dividends for the foreseeable future. Any return to stockholders 
will therefore be limited to the appreciation of their stock.

In addition, future debt instruments may materially restrict our ability to pay dividends on our common stock. Any future determination related to 
dividend  policy  will  be  made  at  the  discretion  of  our  board  of  directors  and  will  depend  upon,  among  other  factors,  our  results  of  operations,  financial 
condition, capital requirements, tax considerations, legal or contractual restrictions, business prospects, the requirements of current or then-existing debt 
instruments, general economic conditions and other factors our board of directors may deem relevant.

Provisions in our amended and restated certificate of incorporation and amended and restated bylaws, as well as provisions of Delaware law, could 
make it more difficult for a third party to remove our current management, acquire us or increase the cost of acquiring us, even if doing so would 
benefit our stockholders.

Our amended and restated certificate of incorporation, amended and restated bylaws and Delaware law contain provisions that may have the effect 
of delaying or preventing a change in control of us or changes in our management. Our amended and restated certificate of incorporation and amended and 
restated bylaws include provisions that:

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authorize  “blank  check”  preferred  stock,  which  could  be  issued  by  our  board  of  directors  without  stockholder  approval  and  may  contain 
voting, liquidation, dividend and other rights superior to our common stock;

create a classified board of directors whose members serve staggered three-year terms;

specify that special meetings of our stockholders can be called only by our board of directors, the chairperson of our board of directors, our 
chief executive officer or our president;

prohibit stockholder action by written consent;

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establish  an  advance  notice  procedure  for  stockholder  approvals  to  be  brought  before  an  annual  meeting  of  our  stockholders,  including 
proposed nominations of persons for election to our board of directors;

provide that our directors may be removed only for cause;

provide that vacancies on our board of directors may be filled only by a majority of directors then in office, even though less than a quorum;

specify that no stockholder is permitted to cumulate votes at any election of directors;

expressly authorize our board of directors to modify, alter or repeal our amended and restated bylaws; and

require  supermajority  votes  of  the  holders  of  our  common  stock  to  amend  specified  provisions  of  our  amended  and  restated  certificate  of 
incorporation and amended and restated bylaws.

These provisions, alone or together, could delay or prevent hostile takeovers and changes in control or changes in our management.

In addition, because we are incorporated in Delaware, we are governed by the provisions of Section 203 of the Delaware General Corporation Law, 

which limits the ability of stockholders owning in excess of 15% of our outstanding voting stock to merge or combine with us.

Any  provision  of  our  amended  and  restated  certificate  of  incorporation  or  amended  and  restated  bylaws  or  Delaware  law  that  has  the  effect  of 
delaying or deterring a change in control could limit the opportunity for our stockholders to receive a premium for their shares of our common stock, and 
could also affect the price that some investors are willing to pay for our common stock.

Our amended and restated bylaws provide that the Court of Chancery of the State of Delaware is the exclusive forum for certain disputes between us 
and our stockholders, which could limit our stockholders’ ability to obtain a favorable judicial forum for disputes with us or our directors, officers or 
employees.

Our amended and restated bylaws provide that the Court of Chancery of the State of Delaware will be the sole and exclusive forum for (i) any 
derivative action or proceeding brought on our behalf, (ii) any action asserting a claim of breach of a fiduciary duty owed by any of our directors, officers 
or employees to our company or our stockholders, (iii) any action asserting a claim against our company arising pursuant to any provision of the Delaware 
General  Corporation  Law  or  our  amended  and  restated  certificate  of  incorporation  or  bylaws,  or  (iv)  any  action  asserting  a  claim  against  our  company 
governed  by  the  internal  affairs  doctrine.  This  choice  of  forum  provision  does  not  apply  to  suits  brought  to  enforce  a  duty  or  liability  created  by  the 
Securities Act of 1933, as amended (Securities Act) or the Exchange Act, or any other claim for which the federal courts have exclusive jurisdiction.

This choice of forum provision may limit a stockholder’s ability to bring certain claims in a judicial forum that it finds favorable for disputes with 
us or any of our directors, officers, other employees or stockholders, which may discourage lawsuits with respect to such claims, although our stockholders 
will not be deemed to have waived our compliance with federal securities laws and the rules and regulations thereunder. If a court were to find this choice 
of  forum  provision  to  be  inapplicable  or  unenforceable  in  an  action,  we  may  incur  additional  costs  associated  with  resolving  such  action  in  other 
jurisdictions, which could adversely affect our business and financial condition.

General Risk Factors

If we fail to comply with environmental, health and safety laws and regulations, we could become subject to fines or penalties or incur costs that could 
have a material adverse effect on the success of our business.

We  are  subject  to  numerous  environmental,  health  and  safety  laws  and  regulations,  including  those  governing  laboratory  procedures  and  the 
handling, use, storage, treatment and disposal of hazardous materials and wastes. Our operations involve the use of hazardous and flammable materials, 
including  chemicals  and  biological  materials.  Our  operations  also  produce  hazardous  waste  products.  We  generally  contract  with  third  parties  for  the 
disposal of these materials and wastes. We cannot eliminate the risk of contamination or injury from these materials. In the event of contamination or injury 
resulting from our use of hazardous materials, we could be held liable for any resulting damages, and any liability could exceed our resources. We also 
could incur significant costs associated with civil or criminal fines and penalties.

Although we maintain workers’ compensation insurance to cover us for costs and expenses we may incur due to injuries to our employees resulting 
from  the  use  of  hazardous  materials  or  other  work-related  injuries,  this  insurance  may  not  provide  adequate  coverage  against  potential  liabilities.  In 
addition, we may incur substantial costs in order to comply with current or future environmental, health 

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and  safety  laws  and  regulations.  These  current  or  future  laws  and  regulations  may  impair  our  research,  development  or  production  efforts.  Failure  to 
comply with these laws and regulations also may result in substantial fines, penalties or other sanctions.

If our information technology systems or data, or those maintained on our behalf, are or were compromised, this could result in a Material Adverse 
Impact. 

In  the  ordinary  course  of  our  business,  we  and  the  third-parties  upon  which  we  rely  Process  (as  defined  above)  proprietary,  confidential  and
sensitive  information,  including  personal  data  (including  key-coded  data,  health  information  and  other  special  categories  of  personal  data),  intellectual 
property, trade secrets, and proprietary business information owned or controlled by ourselves or other third parties (collectively, Sensitive Information). 

We and our third-party service providers utilize information technology systems to Process Sensitive Information in connection with our business 

activities, and we face a variety of evolving threats that could cause security incidents. 

Cyber-attacks,  malicious  internet-based  activity,  online  and  offline  fraud,  and  other  similar  activities  threaten  the  confidentiality,  integrity  and 
availability of our Sensitive Information and information technology systems, and those of the third parties upon which we rely. Such threats are prevalent, 
continue  to  rise,  are  increasingly  difficult  to  detect  and  come  from  a  variety  of  sources,  including  traditional  computer  “hackers,”  threat  actors, 
“hacktivists,” organized criminal threat actors, personnel (such as through theft or misuse), sophisticated nation states, and nation state supported actors. 
Some actors now engage and are expected to continue to engage in cyber-attacks, including without limitation nation state actors for geopolitical reasons 
and in conjunction with military conflicts and defense activities. During times of war and other major conflicts, we and the third parties upon which we rely 
may be vulnerable to a heightened risk of these attacks, including retaliatory cyber-attacks, that could materially disrupt our systems and operations, supply 
chain, and ability to conduct our business. 

We and the third parties upon which we rely are subject to a variety of evolving threats, including but not limited to software bugs; malicious code 
(such  as  viruses  and  worms);  denial-of-service  attacks;  credential  stuffing;  credential  harvesting;  malware  (including  as  a  result  of  advanced  persistent 
threat  intrusions;  natural  disasters;  terrorism;  war;  telecommunication  and  electrical  failures;  ransomware  attacks;  social-engineering  attacks  (including 
through deep fakes, which may be increasingly more difficult to identify as fake, and phishing attacks); server malfunctions; software or hardware failures; 
supply-chain attacks; loss of data or other computer assets; attacks enhanced or facilitated by AI; and other similar issues. Particularly, severe ransomware 
attacks are becoming increasingly prevalent and can lead to significant interruptions, delays, or outages in our operations, disruption of clinical trials, loss 
of  data  (including  data  related  to  clinical  trials),  and  other  Material  Adverse  Impacts  (as  defined  above).  To  alleviate  the  financial,  operational  and 
reputational impact of a ransomware attack, it may be preferable to make extortion payments, but we may be unwilling or unable to do so (including, for 
example, if applicable laws or regulations prohibit such payments). 

Additionally,  remote  work  has  become  more  common  and  has  increased  the  risk  to  our  information  technology  assets  and  data,  as  more  of  our 
employees  utilize  network  connections,  computers  and  devices  outside  of  our  premises  and  networks,  including  working  at  home,  while  in  transit  and 
public locations. Additionally, future or past business transactions (such as acquisitions or integrations) could expose us to additional cybersecurity risks 
and  vulnerabilities,  as  our  systems  could  be  negatively  affected  by  vulnerabilities  present  in  acquired  or  integrated  entities’  systems  and  technologies. 
Furthermore, we may discover security issues that were not found during due diligence of such acquired or integrated entities, and it may be difficult to 
integrate companies into our information technology environment and security program.

We use third-party service providers and subprocessors to help us operate our business and engage in Processing on our behalf or otherwise share 
Sensitive Information with our partners or other third parties in conjunction with our business. These third party service providers and technologies operate 
critical  business  systems  to  Process  Sensitive  Information  in  a  variety  of  contexts,  including,  without  limitation,  cloud-based  infrastructure,  data  center 
facilities, encryption and authentication technology, employee email, and other functions. Our ability to monitor these third parties’ information security 
practices is limited, and these third parties may not have adequate information security measures in place. If our third-party service providers experience a 
security  incident  or  other  interruption,  we  could  experience  Material  Adverse  Impacts.  While  we  may  be  entitled  to  damages  if  our  third-party  service 
providers fail to satisfy their privacy or security-related obligations to us, any award may be insufficient to cover our damages, or we may be unable to 
recover such award. Similarly, supply chain attacks have increased in frequency and severity, and we cannot guarantee that third parties’ infrastructure in 
our supply chain or our third-party partners’ supply chains have not been compromised.

Any of the previously identified or similar threats could cause a security incident or other interruption that could result in unauthorized, unlawful, 
or  accidental  acquisition,  modification,  destruction,  loss,  alteration,  encryption,  disclosure  of,  or  access  to  our  Sensitive  Information  or  our  information 
technology systems, or those of the third parties upon whom we rely. A security incident or other interruption could disrupt our ability (and that of third 
parties upon whom we rely) to provide our services.

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We may expend significant resources, fundamentally change our business activities and practices, or modify our operations, including our clinical 
trial  activities,  or  information  technology  in  an  effort  to  protect  against  security  incidents  and  to  mitigate,  detect,  and  remediate  actual  and  potential 
vulnerabilities.  Applicable  Data  Protection  Requirements  (as  defined  above)  may  require  us  to  implement  specific  security  measures  or  use  industry-
standard or reasonable measures to protect against security incidents.

While we have implemented security measures designed to protect against security incidents, there can be no assurance that we, or any third-party 
partner,  will  be  successful  in  preventing  a  security  incident  or  mitigating  their  effects.  We  take  steps  designed  to  detect,  mitigate  and  remediate 
vulnerabilities in our information technology systems, but we may not be able to detect and remediate all vulnerabilities because the threats and techniques 
used to exploit the vulnerability change frequently and are often sophisticated in nature. Therefore, such vulnerabilities could be exploited but may not be 
detected until after a security incident has occurred. Unremediated high risk or critical vulnerabilities pose material risk to our business. Further, we may 
experience delays in developing and deploying remedial measures designed to address any such identified vulnerabilities. 

Furthermore,  applicable  Data  Protection  Requirements  may  require  us  to  notify  relevant  stakeholders  of  security  incidents.  Such  disclosures  are 

costly, and the disclosures or the failure to comply with such requirements could lead to Material Adverse Impacts.

If we or the third parties upon which we rely experience or in the future experience (or are perceived to have experienced) any security incident(s), 
we could suffer reputational harm, face litigation or adverse regulatory actions, fines, other penalties, audits, inspections, additional reporting requirements 
and/or oversight, restrictions on Processing Sensitive Information, indemnification obligations, negative publicity, business interruptions, and diversion of 
funds. For example, the loss of data from completed clinical trials for our product candidates could result in delays in our regulatory approval efforts and 
significantly increase our costs. As a result, we could experience Material Adverse Impacts.

Our contracts may not contain limitations of liability, and even where they do, there can be no assurance that limitations of liability in our contracts 
are sufficient to protect us from liabilities, damages, or claims related to our data privacy and security obligations. Furthermore, we cannot be sure that our 
insurance  coverage,  will  be  adequate  or  otherwise  protect  us  from  or  adequately  mitigate  liabilities  or  damages  with  respect  to  claims,  costs,  expenses,
litigation, fines, penalties, business loss, data loss, regulatory actions or Material Adverse Impacts arising out of our Processing operations, data privacy 
and security practices, or security incidents we may experience. The successful assertion of one or more large claims against us that exceeds our available 
insurance  coverage,  or  results  in  changes  to  our  insurance  policies  (including  premium  increases  or  the  imposition  of  large  excess  or  deductible  or  co-
insurance requirements), could have a Material Adverse Impact.

In addition to experiencing a security incident, third parties may gather, collect, or infer Sensitive Information about us from public sources, data 
brokers, or other means that reveals competitively sensitive details about our organization and could be used to undermine our competitive advantage or 
market  position.  Additionally,  Sensitive  Information  of  the  Company  could  be  leaked,  disclosed,  or  revealed  as  a  result  of  or  in  connection  with  our 
employees’, personnel’s, or vendors’ use of generative AI technologies.

We are subject to anti-corruption laws in the jurisdictions in which we operate.

We are subject to a number of anti-corruption laws, including the Foreign Corrupt Practices Act of 1977, as amended (FCPA), and various other 
anti-corruption laws. The FCPA generally prohibits companies and their intermediaries from making improper payments to foreign officials for the purpose 
of obtaining or keeping business and/or other benefits. Our business relies on approvals and licenses from government and regulatory entities, and as a 
result, we are subject to certain elevated risks associated with interactions with these entities. Although we have adopted a code of business conduct and 
ethics that includes provisions governing the interactions of employees with government entities to mitigate these risks, there can be no assurance that this 
will  be  successful  in  preventing  violations  of  anti-corruption  laws.  If  we  are  not  in  compliance  with  anti-corruption  laws  and  other  laws  governing  the 
conduct of business with government entities (including local laws), we may be subject to criminal and civil penalties and other remedial measures, which 
could harm our reputation and have a material adverse effect on our business, financial condition, results of operations and prospects. Any investigation of
any actual or alleged violations of such laws could also harm our reputation or have an adverse impact on our business, prospects, financial condition and 
results of operations.

We have incurred and will continue to incur significant costs as a result of operating as a public company, and our management will be required to 
devote substantial time to new compliance initiatives.

As a public company, we have incurred and will continue to incur legal, accounting and other expenses. In addition, the Sarbanes-Oxley Act of 
2002 as well as rules subsequently implemented by the SEC and The Nasdaq Stock Market have imposed various requirements on public companies. In 
July  2010,  the  Dodd-Frank  Wall  Street  Reform  and  Consumer  Protection  Act  (the  Dodd-Frank  Act)  was  enacted.  There  are  significant  corporate 
governance and executive compensation related provisions in the Dodd-Frank Act that require the SEC to adopt additional rules and regulations in these 
areas such as “say on pay” and proxy access. Stockholder activism, the current political environment and the current high level of government intervention 
and regulatory reform may lead to substantial 

58

 
new regulations and disclosure obligations, which may lead to additional compliance costs and impact the manner in which we operate our business in 
ways we cannot currently anticipate. Our management and other personnel devote a substantial amount of time to these compliance initiatives. Moreover, 
these rules and regulations increase our legal and financial compliance costs and make some activities more time-consuming and costly. For example, these 
rules and regulations make it more difficult and more expensive for us to maintain director and officer liability insurance and we have been required to 
incur substantial costs to maintain our current levels of such coverage.

If securities analysts do not publish research or reports about our business or if they publish negative evaluations of our stock, the price of our stock 
could decline.

The  trading  market  for  our  common  stock  relies  in  part  on  the  research  and  reports  that  industry  or  financial  analysts  publish  about  us  or  our 
business. If no or few analysts commence coverage or continue coverage of us, the trading price of our stock would likely decrease. If one or more of the 
analysts covering our business downgrade their evaluations of our stock, the price of our stock could decline. If one or more of these analysts cease to cover
our stock, we could lose visibility in the market for our stock, which in turn could cause our stock price to decline. 

We could be subject to securities class action litigation.

In the past, securities class action litigation has often been brought against companies following a decline in the market price of their securities. 
This risk is especially relevant for us because pharmaceutical companies have experienced significant stock price volatility. If we face such litigation, it 
could  result  in  substantial  costs  and  a  diversion  of  management’s  attention  and  resources,  which  could  harm  our  business  and  cause  our  stock  price  to 
decline.

We have broad discretion in the use of our cash, cash equivalents, restricted cash and available-for-sale investments and are exposed to risks related to 
the marketable securities we may purchase.

We  have  considerable  discretion  in  the  application  of  our  existing  cash,  cash  equivalents,  restricted  cash  and  available-for-sale  investments.  We 
expect to use our existing cash to fund research and development activities and for working capital and general corporate purposes, including funding the 
costs of operating as a public company. In addition, pending their use, we may invest our existing cash in certain short-term investments, including but not 
limited to investment-grade, interest-bearing securities. Historically, investment in these securities has been highly liquid and has experienced only very 
limited defaults. However, volatility in the financial markets in recent years has created additional uncertainty regarding the liquidity and safety of these 
investments.  Additionally,  we  may  use  this  cash,  cash  equivalents,  restricted  cash  and  available-for-sale  investments  for  purposes  that  do  not  yield  a 
significant return or any return at all for our stockholders.

Item 1B. Unresolved Staff Comments.

Not applicable.

Item 1C. Cybersecurity. 

Risk management and strategy

We  have  implemented  and  maintain  various  information  security  processes  designed  to  identify,  assess  and  manage  material  risks  from 
cybersecurity threats to our critical computer networks, third party hosted services, communications systems, hardware and software, and our critical data, 
including intellectual property, data associated with our clinical trials or manufacturing campaigns, and other confidential information that is proprietary, 
strategic or competitive in nature. We perform periodic assessments of our information security processes, and the results of these assessments are reported 
to the audit committee of the board of directors (Audit Committee) as part of a cybersecurity update report conducted at least annually. 

We also engage vendors from time to time to assist with enterprise managed detection and response, security information and event management, 
and  enterprise  vulnerability  management.  These  vendors  also  assist  us  from  time  to  time  in  identifying,  assessing  and  managing  material  risks  from 
cybersecurity  threats.  The  vendors  include  threat  intelligence  service  providers,  cybersecurity  software  providers  and  managed  cybersecurity  service 
providers. 

We have adopted an Incident Response Management Procedure (Procedure) designed to help us respond to cybersecurity incidents and mitigate our 
risks and impacts. An incident response team is responsible for carrying out the Procedure and is led by our Information & Technology (IT) department, 
and  includes  members  from  our  legal  and  compliance,  finance,  and  human  resource  departments  (Security  Management  Team).  We  also  manage  and 
maintain  business  continuity  and  disaster  recovery  capabilities  to  help  ensure  the  availability  of  business-critical  technology  resources  during  adverse 
conditions.

59

 
 
Our assessment and management of material risks from cybersecurity threats are integrated into our overall risk management process. In addition, 
we have implemented a cybersecurity third party risk management process designed to assess the cybersecurity practices and monitor certain critical third 
parties, and to assist the business in making risk-informed technology services decisions. Our practice is to perform due diligence on certain third parties 
who maintain Sensitive Information, including CROs that manage and administer our clinical trials, and our CDMOs that manufacture our drug product to 
be used in clinical trials. Additionally, we monitor these third parties through frequent program management meetings as well as joint steering committee 
meetings in certain cases. 

For a description of the risks from cybersecurity threats that may materially affect us and how those threats may do so, see our risk factors under 
Part 1. Item 1A. “Risk Factors - If our information technology systems or data, or those maintained on our behalf, are or were compromised, this could 
result in a Material Adverse Impact.”

Governance 

Our board of directors addresses our cybersecurity risk management as part of its general oversight function. The Audit Committee is responsible 
for reviewing, assessing and considering the overall risk management policies and procedures, including our cybersecurity risk management processes, and 
oversight of mitigation of risks from cybersecurity threats. 

Our Security Management Team is responsible for day-to-day management of cybersecurity risk, including hiring appropriate personnel, helping to 
integrate  cybersecurity  risk  considerations  into  our  overall  risk  management  strategy,  communicating  key  priorities  to  relevant  personnel,  approving 
budgets,  helping  prepare  for  cybersecurity  incidents,  approving  cybersecurity  processes,  and  reviewing  security  assessments  and  other  security-related 
reports. Our cybersecurity risk assessment and management processes are implemented and maintained by the Security Management Team. Our Security 
Management Team includes our CFO who has more than 15 years of experience in managing IT departments, and certain members of our IT department 
who have over 25 years of experience in cybersecurity, information security, data protection, privacy, regulatory compliance and risk management.

Our cybersecurity incident response and vulnerability management policies are designed to escalate certain cybersecurity incidents to members of 
management depending on the circumstances, including our CFO, CEO and other members of our executive leadership team (ELT). Our CFO, CEO and 
ELT  work  with  our  Security  Management  Team  to  help  us  mitigate  and  remediate  cybersecurity  incidents  of  which  they  are  notified.  In  addition,  our 
incident response and vulnerability management policies include reporting to the Audit Committee for certain cybersecurity incidents.

The Audit Committee receives annual reports from the Security Management Team concerning our significant cybersecurity threats and risk and 
the  processes  we  have  implemented  to  address  them.  The  Audit  Committee  also  receives  various  reports,  summaries  or  presentations  related  to 
cybersecurity threats, risk and mitigation.

Item 2. Properties. 

In May 2022, we entered into a lease (the Lease) with San Diego Creekside, LLC (Landlord), as lessor, pursuant to which we agreed to lease from 
Landlord approximately 23,696 rentable square feet (subject to increase pursuant to the terms of the Lease) of office and laboratory space located at 10240 
Sorrento Valley Road, Suite #300, San Diego, California. The Lease expires in July 2033 (subject to extension pursuant to the terms of the Lease). This 
facility serves as our corporate headquarters. We believe that this facility is sufficient to meet our needs and that suitable additional space will be available 
as and when needed.

Item 3. Legal Proceedings. 

We are not a party to any material legal proceedings at this time. From time to time, we may be subject to various legal proceedings and claims that 
arise in the ordinary course of our business activities. Although the results of litigation and claims cannot be predicted with certainty, we do not believe we 
are party to any claim or litigation the outcome of which, if determined adversely to us, would individually or in the aggregate be reasonably expected to 
have a material adverse effect on our results of operations or financial condition. Regardless of the outcome, litigation can have an adverse effect on us 
because of defense and settlement costs, diversion of management resources and other factors.

Item 4. Mine Safety Disclosures.

Not applicable.

60

 
 
PART II

Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities.

Market Information

Our common stock is traded on the Nasdaq Capital Market under the symbol “LIFE.”

Holders of Record

As of March 8, 2024, there were approximately 31 holders of record of our common stock. The approximate number of holders is based upon the
actual number of holders registered in our records at such date and excludes holders in “street name” or persons, partnerships, associations, corporations, or 
other entities identified in security positions listings maintained by depository trust companies.

Dividend Policy

We have never declared or paid any cash dividends on our common stock. We currently intend to retain all available funds and any future earnings 
to support our operations and finance the growth and development of our business. We do not intend to pay cash dividends on our common stock for the 
foreseeable future. Any future determination related to our dividend policy will be made at the discretion of our board of directors and will depend upon, 
among  other  factors,  our  results  of  operations,  financial  condition,  capital  requirements,  tax  considerations,  legal  or  contractual  restrictions,  business 
prospects, the requirements of current or then-existing debt instruments, general economic conditions and other factors our board of directors may deem 
relevant.

Securities Authorized for Issuance Under Equity Compensation Plans

Information  about  our  equity  compensation  plans  is  incorporated  herein  by  reference  to  Part  III,  Item  12,  under  the  section  entitled  “Security 

Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters.”

Recent Sales of Unregistered Securities 

During the year ended December 31, 2023, we did not issue or sell any unregistered securities not previously disclosed in a Quarterly Report on 

Form 10-Q or in a Current Report on Form 8-K. 

Issuer Purchases of Equity Securities

We did not repurchase any securities during the three months ended December 31, 2023.

Item 6. [Reserved]

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

You should read the following discussion and analysis together with the consolidated financial statements and related notes included elsewhere in 
this Annual Report on Form 10-K (Annual Report). The following discussion contains forward-looking statements that involve risks and uncertainties. Our 
actual results could differ materially from those expressed or implied in any forward-looking statements as a result of various factors, including those set 
forth under the caption “Part I, Item 1A. Risk Factors.”

Overview 

We are a clinical stage biotechnology company leveraging evolutionary intelligence to translate tRNA synthetase biology into new therapies for 
fibrosis and inflammation. tRNA synthetases are ancient, essential proteins that have evolved novel domains that regulate diverse pathways extracellularly 
in  humans.  Our  discovery  platform  is  focused  on  unlocking  hidden  therapeutic  intervention  points  by  uncovering  signaling  pathways  driven  by  our 
proprietary library of domains derived from all 20 tRNA synthetases.

Efzofitimod 

Our  lead  therapeutic  candidate  is  efzofitimod,  a  first-in-class  biologic  immunomodulator  in  clinical  development  for  the  treatment  of  interstitial 
lung  disease  (ILD),  a  group  of  immune-mediated  disorders  that  can  cause  inflammation  and  fibrosis,  or  scarring,  of  the  lungs.  Efzofitimod  is  a  tRNA 
synthetase  derived  therapy  that  selectively  modulates  activated  myeloid  cells  through  neuropilin-2  (NRP2)  to  resolve  aberrant  inflammation  without 
immune  suppression  and  potentially  prevent  the  progression  of  fibrosis.  ILDs  are  predominantly  immune-mediated  disorders  that  are  characterized  by 
chronic  inflammation,  which  can  lead  to  progressive  fibrosis  of  the  lung.  There  are  limited  treatment  options  for  ILD  and  there  remains  a  high  unmet 
medical need. Sarcoidosis and systemic sclerosis (SSc, also known as scleroderma)-associated ILD (SSc-ILD) are two major forms of ILD. The U.S. Food 
and Drug Administration (FDA) has 

61

 
granted efzofitimod orphan drug designations for the treatment of sarcoidosis and for the treatment of SSc, and Fast Track designations for the treatment of 
pulmonary  sarcoidosis  and  for  the  treatment  of  SSc-ILD.  The  European  Commission  (EC)  has  granted  efzofitimod  orphan  drug  designations  for  the 
treatment of sarcoidosis and for the treatment of SSc, based on the opinion of the European Medicines Agency (EMA) Committee for Orphan Medicinal 
Products (COMP). 

In September 2021, we announced positive results and clinical proof-of-concept from a double-blind, placebo-controlled Phase 1b/2a clinical trial 
in 37 patients with pulmonary sarcoidosis. The study was designed to evaluate the safety, tolerability, immunogenicity and preliminary efficacy of three 
doses of intravenous (IV) efzofitimod, 1.0, 3.0 and 5.0 mg/kg, in the context of a forced steroid taper. Efzofitimod was safe and well-tolerated at all doses 
administered with no serious drug-related adverse events or signal of immunogenicity. Additionally, the study demonstrated consistent dose response for 
efzofitimod  on  key  efficacy  endpoints  and  improvements  compared  to  placebo,  including  measures  of  steroid  reduction,  lung  function,  pulmonary 
sarcoidosis  symptom  measures  and  inflammatory  biomarkers.  These  data  were  subsequently  presented  at  the  American  Thoracic  Society  (ATS) 
International Conference and published in the peer-reviewed journal CHEST during 2022. 

In  February  2022,  we  met  with  the  FDA  in  an  end-of-Phase  2  meeting  to  discuss  our  plans  for  subsequent  clinical  development  and  path  to 
registration for efzofitimod for pulmonary sarcoidosis. Subsequently, we initiated a global pivotal Phase 3 randomized, double-blind, placebo-controlled 
clinical trial to evaluate the efficacy and safety of efzofitimod in patients with pulmonary sarcoidosis (the EFZO-FIT study). The EFZO-FIT study is a 52-
week study consisting of three parallel cohorts randomized equally to either 3.0 mg/kg or 5.0 mg/kg of efzofitimod or placebo dosed intravenously once a 
month for a total of 12 doses. The study is currently enrolling and intends to enroll up to 264 subjects with pulmonary sarcoidosis at multiple centers in the 
United States, Europe, Brazil, and Japan. The study design incorporates a forced steroid taper. The objective of the study is to evaluate the efficacy and 
safety of efzofitimod in patients with pulmonary sarcoidosis. The primary endpoint of the study is steroid reduction. Secondary endpoints include measures 
of lung function assessed by forced vital capacity (FVC) and health-related quality of life assessments and questionnaires (KSQ lung score). In September 
2022, we dosed the first patient in this study. Additionally, during 2023, we had a data and safety monitoring board (DSMB) review of our EFZO-FIT 
study. The DSMB concluded that the study could continue unmodified. We expect to complete enrollment in the study in the second quarter of 2024.

In February 2024, we announced an Individual Patient Expanded Access Program (EAP). The Individual Patient EAP has been initiated based on 
blinded EFZO-FIT™ study investigator and patient participant feedback. The program is designed to allow access for patients who complete the Phase 3 
EFZO-FIT™ study and wish to receive treatment with efzofitimod outside of the clinical trial. The administration of efzofitimod as part of the Individual 
Patient EAP will occur independent of the EFZO-FIT study protocol, and we, principal investigators and patients will remain blinded to the treatment that 
occurred as part of the EFZO-FIT study. As this  Individual Patient EAP will occur independent of the EFZO-FIT study, this program is not an open-label 
extension (OLE) and no long-term data will be collected by us.

Based  on  the  results  of  the  Phase  1b/2a  clinical  trial,  we  believe  efzofitimod  has  potential  applications  in  the  treatment  of  other  ILDs,  such  as 
chronic hypersensitivity pneumonitis (CHP) and connective tissue disease related ILD (CTD-ILD), including SSc-ILD and rheumatoid arthritis-associated 
ILD. As such, we designed a focused Phase 2 proof-of-concept clinical trial of efzofitimod (the EFZO-CONNECT study) in patients with SSc-ILD. The 
EFZO-CONNECT  study  is  a  randomized,  double-blind  placebo-controlled  proof-of-concept  study  to  evaluate  the  efficacy,  safety  and  tolerability  of 
efzofitimod in patients with SSc-ILD. This is a 28-week study with three parallel cohorts randomized 2:2:1 to either 270 mg or 450 mg of efzofitimod or 
placebo dosed intravenously monthly for a total of six doses. The study intends to enroll up to 25 patients at multiple centers in the United States. The 
objective of the study is to evaluate the efficacy of multiple doses of IV efzofitimod on pulmonary, cutaneous and systemic manifestations in patients with 
SSc-ILD.  The  primary  endpoint  is  reduction  in  FVC.  Secondary  endpoints  include  certain  measures  regarding  safety  and  tolerability.  The  study  was 
initiated in the third quarter of 2023, and in October 2023, we dosed the first patient in this study.

In January 2020, we entered into a collaboration and license agreement (Kyorin Agreement) with Kyorin Pharmaceutical Co., Ltd. (Kyorin) for the 
development and commercialization of efzofitimod for the treatment of ILD in Japan. Under the Kyorin Agreement, Kyorin received an exclusive right to 
develop  and  commercialize  efzofitimod  in  Japan  for  all  forms  of  ILD,  and  is  obligated  to  fund  all  research,  development,  regulatory,  marketing  and 
commercialization activities in Japan. In 2020, Kyorin conducted and funded a Phase 1 clinical trial of efzofitimod (known as KRP-R120 in Japan). The 
Phase 1 clinical trial was a placebo-controlled clinical trial to evaluate the safety, pharmacokinetics (PK) and immunogenicity of efzofitimod in 32 healthy 
Japanese  male  volunteers.  Efzofitimod  was  observed  to  be  generally  well-tolerated  with  no  drug-related  serious  adverse  events,  and  PK  findings  were 
consistent with previous studies of efzofitimod. Kyorin is also participating in the EFZO-FIT study as the local sponsor in Japan. In February 2023, Kyorin 
dosed  the  first  patient  in  Japan  in  the  EFZO-FIT  study  which  triggered  a  $10.0  million  milestone  payment  to  us.  To  date,  the  Kyorin  Agreement  has 
generated $20.0 million in upfront and milestone payments to us and we are eligible to receive up to an additional $155.0 million in the aggregate upon 
achievement of certain development, regulatory and sales milestones, as well as tiered royalties on any net sales in Japan. 

Discovery Platform 

62

 
Using efzofitimod as a model, we have developed a process to advance novel tRNA synthetase domains from a concept to therapeutic candidate. 
This process leverages our early discovery work as well as current scientific understanding of tRNA synthetase evolution, protein structure, gene splicing 
and tissue-specific regulation to identify potentially active protein domains. Screening approaches are employed to identify target cells and extracellular 
receptors for these tRNA synthetase-derived proteins. These cellular systems can then be used in mechanism-of-action studies to elucidate the role these 
proteins play in cellular responses and their potential therapeutic utility. We are working to identify new tRNA synthetase based drug candidates through 
our internal discovery efforts and external collaboration efforts.

Impact of Geopolitical and Macroeconomic Conditions

Global  economic  and  business  activities  continue  to  face  widespread  macroeconomic  uncertainties,  including  global  geopolitical  tension,  armed 
conflicts,  labor  shortages,  inflation  and  monetary  supply  shifts,  liquidity  concerns  at,  and  failures  of,  banks  and  other  financial  institutions  or  other 
disruptions in the banking system or financing markets, higher interest rates and financial and credit market fluctuations, volatility in the capital markets 
and  recession  risks,  which  has  resulted  in  further  volatility  in  the  U.S.  and  global  financial  markets  and  which  has  led  to,  and  may  continue  to  lead  to, 
additional disruptions to trade, commerce, pricing stability, credit availability and supply chain continuity globally. The ultimate long-term impact of these 
evolving geopolitical and macroeconomic conditions on our business is uncertain, although we continue to actively monitor the impact of these factors on 
our  results  of  operations,  financial  condition  and  cash  flows.  The  extent  of  the  impact  of  these  factors  on  our  operational  and  financial  performance, 
including our ability to execute our business strategies and initiatives in the expected timeframe, will depend on future developments, which are uncertain 
and cannot be predicted; however, any continued or renewed disruption resulting from these factors could negatively impact our business.

Liquidity and Capital Resources 

We have incurred losses and negative cash flows from operations since our inception. As of December 31, 2023, we had an accumulated deficit of 
$468.0 million, and we expect to continue to incur net losses for the foreseeable future. As of December 31, 2023, we had cash, cash equivalents, restricted 
cash  and  available-for-sale  investments  of  $101.7  million.  We  believe  that  our  current  cash,  cash  equivalents,  restricted  cash  and  available-for-sale 
investments, will be sufficient to meet our material cash requirements from known contractual and other obligations for a period of at least one year from 
the  date  of  this  Annual  Report.  In  addition  to  the  factors  discussed  under  “Material  Cash  Requirements,”  our  ability  to  fund  our  longer-term  operating 
needs will depend on our ability to raise additional funding through equity or debt offerings, grant funding, collaborations, strategic partnerships and/or 
licensing arrangements, and other factors, including those discussed in Part I, Item 1A. “Risk Factors - Risks related to our financial condition and need for 
additional capital—We will need to raise additional capital or enter into strategic partnering relationships to fund our operations.” 

Sources of Cash

From our inception through December 31, 2023, we have financed our operations primarily through the sale of equity securities and convertible 

debt, venture debt, term loans and through license and collaboration agreement revenues.

Public Offerings

In  February  2023,  we  completed  an  underwritten  follow-on  public  offering  of  23,125,000  shares  of  our  common  stock,  including  the  partial 
exercise of the underwriters’ option to purchase additional shares, at a price to the public of $2.25 per share. The total net proceeds from the offering were 
approximately $48.1 million, after deducting underwriting discounts, commissions and offering expenses payable by us.

In September 2021, we completed an underwritten follow-on public offering of 10,781,250 shares of our common stock, including the full exercise 
of  the  underwriters’  option  to  purchase  additional  shares,  at  a  price  to  the  public  of  $8.00  per  share.  The  total  net  proceeds  from  the  offering  were 
approximately $80.6 million, after deducting underwriting discounts, commissions and offering expenses payable by us.

At-the-Market Offering Programs

In April 2022, we entered into an Open Market Sale AgreementSM with Jefferies LLC (Jefferies) (the Jefferies ATM Offering Program), pursuant to 
which we may offer and sell, from time to time and at our option, up to an aggregate of $65.0 million of shares of our common stock through Jefferies, 
acting  as  sales  agent.  Jefferies  is  entitled  to  a  fixed  commission  rate  of  up  to  3.0%  of  the  gross  sales  proceeds  of  shares  sold  under  the  Jefferies  ATM 
Offering Program. During the year ended December 31, 2023, we sold an aggregate of 10,530,795 shares of common stock at a weighted-average price of 
$1.82 per share for net proceeds of approximately $18.4 million under the Jefferies ATM Offering Program. Additionally, from January 1, 2024 through 
March  13,  2024,  we  sold  an  aggregate  of  4,441,509  shares  of  common  stock  at  a  weighted-average  price  of  $1.75  per  share  for  net  proceeds  of 
approximately $7.6 million under the Jefferies ATM Offering Program.

63

 
In May 2019, we entered into a sales agreement with H.C. Wainwright & Co., LLC (Wainwright) for an ATM Offering Program (the Wainwright 
ATM Offering Program) under which we could offer and sell shares of our common stock having an aggregate offering price of up to $10.0 million. In 
November 2020, we amended our sales agreement with Wainwright to increase the amount of the ATM Offering Program to $20.0 million. Wainwright was 
entitled  to  a  commission  at  a  fixed  commission  rate  equal  to  3%  of  the  gross  proceeds.  In  March  2021,  the  ATM  Offering  Program  with  Wainwright 
automatically terminated upon the issuance and sale of all of the shares having an aggregate offering price of $20.0 million. Prior to the termination of the 
sales  agreement  with  Wainwright,  in  2021,  we  sold  an  aggregate  of  1,988,254  shares  of  common  stock  at  an  average  price  of  $4.99  per  share  for  net 
proceeds of $9.6 million.

Purchase Agreement

In  September  2020,  we  entered  into  a  common  stock  purchase  agreement  (the  Purchase  Agreement)  with  Aspire  Capital  Fund,  LLC  (Aspire
Capital), which provided that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital was committed to purchase up to 
an aggregate of $20.0 million of shares of our common stock at our request from time to time during the 30 month term of the Purchase Agreement. In 
2021, we sold an aggregate of 3,000,000 shares of common stock at a weighted-average price of $5.09 per share for net proceeds of $15.2 million under the 
Purchase Agreement. There were no issuances or sales under the Purchase Agreement during the years ended December 31, 2023 and December 31, 2022, 
respectively, and this agreement was terminated on March 11, 2023.

Kyorin Agreement Milestone Payments

On February 6, 2023, we announced that our partner Kyorin dosed the first patient in Japan in the EFZO-FIT study, which triggered a $10.0 million 
milestone  payment  by  Kyorin  to  us  pursuant  to  the  Kyorin  Agreement.  We  recorded  this  $10.0  million  milestone  as  revenue  in  December  2022  and 
received the cash in February 2023. Kyorin is our partner for the development and commercialization of efzofitimod for ILD in Japan. Under the Kyorin 
Agreement, we have generated $20.0 million in upfront and milestone payments to date and are eligible to receive up to an additional $155.0 million in the 
aggregate upon the achievement of certain development, regulatory and sales milestones, as well as tiered royalties on any net sales in Japan. Kyorin has 
the exclusive rights to develop and commercialize efzofitimod in Japan for all forms of ILD. 

Cash Flows

The following table sets forth a summary of the net cash flow activity for each of the periods indicated (in thousands): 

Net cash provided by (used in):

Operating activities
Investing activities
Financing activities

Net change in cash, cash equivalents and restricted cash

2023

Years Ended December 31,
2022

2021

  $

  $

(33,221 )   $
(20,127 )  
66,230    
12,882     $

(41,886 )   $
47,245    
5,451  
10,810     $

(33,075 )
(91,566 )
110,025  
(14,616 )

Operating activities. Net cash used in operating activities was $33.2 million, $41.9 million and $33.1 million for the years ended December 31, 
2023, 2022 and 2021, respectively. The net cash used in each period is primarily due to the advancement of efzofitimod into later stage clinical trials and 
additional manufacturing campaigns to support those trials and potential future clinical trials. Net cash used in operating activities decreased during the 
year ended December 31, 2023 as we received a $10.0 million milestone payment from the Kyorin Agreement. We expect cash used in operating activities 
to increase as we advance our clinical and manufacturing efforts toward possible commercialization of efzofitimod. 

Investing activities. Net cash (used in) provided by investing activities for the years ended December 31, 2023, 2022 and 2021 was $(20.1) million, 
$47.2 million and $(91.6) million, respectively. The fluctuation in net cash provided by or used in investing activities resulted primarily from the timing 
differences in investment purchases, sales and maturities, and the fluctuation of our portfolio mix between cash equivalents and investment holdings. The 
average term to maturity in our investment portfolio as of December 31, 2023 was less than two years. Net cash used for December 31, 2023 included $4.2 
million purchases of property and equipment primarily for tenant improvements associated with our corporate headquarters facility lease.

64

 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
   
 
Financing activities. Net cash provided by financing activities for the year ended December 31, 2023 was $66.2 million and consisted primarily of 
$48.1  million  in  proceeds  from  an  underwritten  follow-on  public  offering,  net  of  offering  costs,  and  $18.4  million  proceeds  from  our  Jefferies  ATM 
Offering  Program,  net  of  issuance  costs.  Net  cash  provided  by  financing  activities  for  the  year  ended  December  31,  2022  was  primarily  due  to  cash 
proceeds from our ATM offering programs, net of issuance costs. Net cash provided by financing activities for the year ended December 31, 2021 was 
$110.0 million and consisted primarily of $80.6 million in proceeds from an underwritten follow-on public offering, net of offering costs, $15.2 million in 
proceeds  from  the  issuance  of  common  stock  through  a  common  stock  purchase  agreement,  net  of  offering  costs,  and  $14.1  million  proceeds  from  our 
ATM offering programs, net of issuance costs. 

Material Cash Requirements

To date, we have not generated any revenues from product sales. We expect our expenses to increase in connection with our ongoing activities, 
particularly as we continue to advance efzofitimod in clinical development, manufacturing and technology transfer activities, continue our research and 
development activities with respect to other potential therapies based on tRNA synthetase biology and seek marketing approval for product candidates that 
we may develop. In addition, if we obtain marketing approval for any of our product candidates, we expect to incur significant commercialization expenses 
related to product sales, marketing, manufacturing and distribution. We currently have no sales or marketing capabilities and would need to expand our 
organization to support these activities. Accordingly, we will need to obtain substantial additional funding in connection with our continuing operations. 
Our forecast of the period of time through which our financial resources will be adequate to support our operations is a forward-looking statement that 
involves risks and uncertainties, and actual results could vary materially.

Our future capital requirements are difficult to forecast and will depend on many factors. Refer to Part I, Item 1A, "Risk Factors - Risks related to 
our financial condition and need for additional capital—We will need to raise additional capital or enter into strategic partnering relationships to fund our 
operations.” for a discussion of these factors. 

Until  such  time,  if  ever,  as  we  can  generate  substantial  product  revenues,  we  expect  to  finance  our  cash  needs  through  a  combination  of  equity 
offerings, grant funding, collaborations, strategic partnerships and/or licensing arrangements, and when we are closer to commercialization of our product 
candidates  potentially  through  debt  financings.  To  the  extent  we  raise  additional  capital  through  the  sale  of  equity,  the  ownership  interest  of  our 
stockholders will be diluted, and the terms of these securities may include liquidation or other preferences that adversely affect the rights of our common 
stockholders.  If  we  raise  additional  funds  through  collaborations,  strategic  partnerships  or  licensing  arrangements  with  third  parties,  we  may  have  to 
relinquish valuable rights to our product candidates, our other technologies, future revenue streams or research programs or grant licenses on terms that 
may not be favorable to us. The incurrence of additional indebtedness would increase our fixed payment obligations and may require us to agree to certain 
restrictive covenants, such as limitations on our ability to incur additional debt, limitations on our ability to acquire, sell or license intellectual property 
rights  and  other  operating  restrictions  that  could  adversely  impact  our  ability  to  conduct  our  business.  We  may  be  unable  to  raise  additional  funds  on
acceptable terms or at all. If the equity and credit markets deteriorate, it may make any necessary debt or equity financing more difficult, more costly and 
more  dilutive.  If  we  are  unable  to  raise  additional  funds,  we  may  be  required  to  delay,  limit,  reduce  or  terminate  our  product  development  or  future 
commercialization  efforts  or  grant  rights  to  develop  and  market  our  product  candidates  even  if  we  would  otherwise  prefer  to  develop  and  market  such 
product candidates ourselves.

As of December 31, 2023, our material cash requirements from known contractual and other obligations consisted primarily of (i) operating leases 
for our corporate headquarters and laboratory space, and (ii) our master financing lease agreement for various research and development and informational 
technology equipment.

Corporate Headquarters Facility Lease

In May 2022, we entered into a lease (Lease) with San Diego Creekside, LLC (Landlord), as lessor, pursuant to which we agreed to lease from 
Landlord approximately 23,696 rentable square feet (subject to increase pursuant to the terms of the Lease) of office and laboratory space. The term of the 
lease (the Lease Term) commenced on March 20, 2023 (the Lease Commencement Date) and will continue for 124 months from the Lease Commencement 
Date. We also have one option to extend the Lease Term for five years. Base rent during such extension period would be at the fair market rent for the 
Premises (as that term is defined in the Lease). Under the terms of the Lease, the base rent during the first 12 months of the Lease Term will be $5.75 per 
square foot of rentable area per month, subject to certain upward adjustments of approximately 3.0% annually. We are entitled to an allowance of up to $5.3 
million  for  tenant  improvements  of  which  as  of  December  31,  2023,  we  received  $5.0  million  from  the  Landlord,  and  we  received  the  remaining  $0.3 
million in February 2024. We provided a $0.7 million security deposit in the form of a letter of credit which is included in restricted cash as of December 
31,  2023.  During  the  second  quarter  of  2023,  additional  common  area  amenities  were  completed  by  the  Landlord  which  provided  us  with  access  to 
approximately 1,500 additional rentable square feet. As a result, our base rent increased for this additional rentable square feet at the same monthly base 
rent per rentable square foot as contemplated in the Lease.

65

 
Financing Lease

In April 2022, we entered into a financing lease to lease various research and development and information technology equipment over a 48-month 
term.  Financing  lease  liabilities  total  $1.9  million  as  of  December  31,  2023.  Additionally,  we  provided  $2.7  million  in  cash  collateral  for  the  financing 
lease, and this amount is included in restricted cash as of December 31, 2023. 

We did not have any off-balance sheet arrangements as of December 31, 2023.

Financial Operations Overview

Organization and Business; Principles of Consolidation 

We  conduct  substantially  all  of  our  activities  through  aTyr  Pharma,  Inc.,  a  Delaware  corporation,  at  our  facility  in  San  Diego,  California.  aTyr
Pharma,  Inc.  was  incorporated  in  the  State  of  Delaware  in  September  2005.  The  consolidated  financial  statements  include  our  accounts  and  our  98% 
majority-owned  subsidiary  in  Hong  Kong,  Pangu  BioPharma,  as  of  December  31,  2023.  All  intercompany  transactions  and  balances  are  eliminated  in 
consolidation.

Revenue Recognition

In January 2020, we entered into the Kyorin Agreement with Kyorin for the development and commercialization of efzofitimod for the treatment of 
ILD in Japan. Under the Kyorin Agreement, Kyorin received an exclusive right to develop and commercialize efzofitimod in Japan for all forms of ILD, 
and Kyorin is obligated to fund all research, development, regulatory, marketing and commercialization activities in Japan. The Phase 1 clinical trial, which 
was conducted and funded by Kyorin, was a placebo-controlled clinical trial to evaluate the safety, PK and immunogenicity of efzofitimod in 32 healthy 
Japanese  male  volunteers.  Efzofitimod  was  observed  to  be  generally  well-tolerated  with  no  drug-related  serious  adverse  events  and  PK  findings  were 
consistent with previous studies of efzofitimod. Kyorin is also participating in the EFZO-FIT study as the local sponsor in Japan. In February 2023, Kyorin 
dosed  the  first  patient  in  Japan  in  the  EFZO-FIT  study.  This  achievement  triggered  a  $10.0  million  milestone  payment  by  Kyorin  to  us  pursuant  to  the 
Kyorin  Agreement.  This  milestone  was  recorded  as  revenue  during  the  year  ended  December  31,  2022,  and  the  payment  was  received  during  the  year 
ended December 31, 2023. Under the Kyorin Agreement, we have generated $20.0 million in upfront and milestone payments to date and are eligible to 
receive up to an additional $155.0 million in the aggregate upon the achievement of certain development, regulatory and sales milestones, as well as tiered 
royalties on any net sales in Japan. During the year ended December 31, 2023, we recognized $0.4 million in collaboration revenue from Kyorin for drug 
product material sold to Kyorin for the Japan portion of the EFZO-FIT study.

Research and Development Expenses

To date, our research and development expenses have been related primarily to the development of, and clinical trials for, our product candidates, 
and to research efforts targeting the potential therapeutic application of other tRNA synthetase-based immunomodulators. These expenses consist primarily 
of:

•

•

•

•

•

•

salaries  and  employee-related  expenses,  including  stock-based  compensation  and  benefits  for  personnel  in  research  and  product 
development functions;

costs associated with conducting our preclinical, development and regulatory activities, including fees paid to third-party professional 
consultants, service providers and our scientific, therapeutic and clinical advisory board;

costs to acquire, develop and manufacture preclinical study and clinical trial materials;

costs incurred under clinical trial agreements with CROs and investigative sites;

costs for laboratory supplies; and

allocated facilities, depreciation and other allocable expenses.

Product  candidates  in  later  stages  of  clinical  development  generally  have  higher  development  costs  than  those  in  earlier  stages  of  clinical 
development,  primarily  due  to  the  increased  size  and  duration  of  later-stage  clinical  trials.  We  expect  that  the  levels  of  our  research  and  development 
expenses will continue to increase in future years and will consist primarily of costs related to our clinical development and manufacturing of efzofitimod 
for patients with pulmonary sarcoidosis and SSc-ILD, and other potential therapeutics based on tRNA synthetase biology.

At this time, due to the inherently unpredictable nature of preclinical and clinical development and given the early stage of our programs, we are 
unable  to  estimate  with  any  certainty  the  costs  we  will  incur  or  the  timelines  we  will  require  in  the  continued  development  of  our  product  candidates. 
Clinical and preclinical development timelines, the probability of success and development 

66

 
costs  can  differ  materially  from  expectations.  We  anticipate  that  we  will  make  determinations  as  to  which  product  candidates  to  pursue  and  how  much 
funding  to  direct  to  each  product  candidate  on  an  ongoing  basis  in  response  to  the  results  of  ongoing  and  future  preclinical  studies  and  clinical  trials, 
regulatory developments and our ongoing assessments as to each product candidate’s commercial potential. In addition, we cannot forecast which programs 
or product candidates may be subject to future collaborations, when such arrangements will be secured, if at all, and to what degree such arrangements 
would affect our development plans and capital requirements.

General and Administrative Expenses

General  and  administrative  expenses  consist  primarily  of  salaries  and  related  costs  for  employees  in  executive,  finance  and  administration, 
corporate  development  and  administrative  support  functions,  including  stock-based  compensation  expenses  and  benefits.  Other  significant  general  and 
administrative  expenses  include  accounting,  legal  services,  expenses  associated  with  applying  for  and  maintaining  patents,  cost  of  insurance,  cost  of 
various consultants, occupancy costs, information systems costs and depreciation.

Critical Accounting Policies and Significant Judgments and Estimates

Our management’s discussion and analysis of financial condition and results of operations is based on our consolidated financial statements, which 
have  been  prepared  in  accordance  with  accounting  principles  generally  accepted  in  the  United  States.  The  preparation  of  these  consolidated  financial 
statements requires us to make estimates and assumptions that affect the reported amounts of assets and liabilities and the disclosure of contingent assets 
and liabilities as of the date of the consolidated financial statements, as well as the reported expenses during the reporting periods. We monitor and analyze 
these  items  for  changes  in  facts  and  circumstances,  and  material  changes  in  these  estimates  could  occur  in  the  future.  We  base  our  estimates  on  our 
historical  experience  and  on  various  other  factors  we  believe  to  be  reasonable  under  the  circumstances,  the  results  of  which  form  the  basis  for  making 
judgments about the carrying value of assets and liabilities that are not readily apparent from other sources. Changes in estimates are reflected in reported 
results for the period in which they become known. Actual results may differ materially from these estimates under different assumptions or conditions. 

We  discuss  our  accounting  policies  and  assumptions  that  involve  a  higher  degree  of  judgment  and  complexity  within  Note  2  to  our  audited 
consolidated financial statements appearing elsewhere in this Annual Report. We believe that our accounting policies related to research and development 
expense accruals involve the most significant estimation and judgment in accounting for our reported consolidated financial results. 

Research and Development Expense Accruals

As part of the process of preparing our consolidated financial statements, we are required to estimate our accrued expenses. This process involves 
reviewing  open  contracts  and  purchase  orders,  communicating  with  our  personnel  to  identify  services  that  have  been  performed  on  our  behalf  and 
estimating the level of service performed and the associated cost incurred for the service when we have not yet been invoiced or otherwise notified of the 
actual cost. The majority of our service providers invoice us monthly in arrears for services performed or when contractual milestones are met. We make 
estimates of our accrued expenses as of each balance sheet date in our consolidated financial statements based on facts and circumstances known to us at 
that  time.  We  periodically  confirm  the  accuracy  of  our  estimates  with  the  service  providers  and  make  adjustments  if  necessary.  Examples  of  estimated 
accrued  research  and  development  expenses  include  fees  paid  to  investigative  sites  and  CROs  in  connection  with  clinical  trials;  service  providers  in 
connection  with  preclinical  development  activities;  and  service  providers  related  to  product  manufacturing,  development  and  distribution  of  clinical 
supplies.

We currently rely on third parties for the clinical development of our product candidates and the manufacture of our product candidates to support 
our ongoing and future clinical trials. We pay these third parties, including consultants, CROs, CDMOs and other service providers, pursuant to contractual 
arrangements, which may include provisions for time and materials-based payments, project-based fees and milestone payments. We base our accrual for 
these  expenses  on  our  estimates  of  the  services  received  and  efforts  expended  pursuant  to  our  contractual  arrangements.  The  financial  terms  of  these 
agreements are subject to negotiation, vary from contract to contract and may result in uneven payment flows. There may be instances in which payments 
made to our service providers will exceed the level of services provided and result in a prepayment of the clinical expense. Payments under some of these 
contracts depend on factors such as the successful enrollment of patients and the completion of clinical milestones. In accruing service fees, we estimate the 
time period over which services will be performed and the level of effort to be expended in each period. If the actual timing of the performance of services 
or the level of effort varies from our estimate, we adjust our accrual or prepaid expenses accordingly.

Although  we  do  not  expect  our  estimates  to  be  materially  different  from  amounts  actually  incurred,  if  our  estimates  of  the  status  and  timing  of 
services performed differs from the actual status and timing of services performed, we may report amounts that are too high or too low in any particular 
period. To date, there have been no material differences between our estimates and the amounts actually incurred.

67

 
Results of Operations 

Comparison of the Years Ended December 31, 2023 and 2022 

In this section, we discuss the results of our operations for the year ended December 31, 2023, compared to the year ended December 31, 2022. For 
a discussion of the year ended December 31, 2022 compared to the year ended December 31, 2021, please refer to our Annual Report on Form 10-K filed 
with the Securities and Exchange Commission on March 14, 2023. 

The following table summarizes our results of operations for the years ended December 31, 2023 and 2022 (in thousands):

License and collaboration agreement revenues
Research and development expenses
General and administrative expenses
Other income (expense), net

  $

353     $

42,293    
12,979    
4,522    

10,386     $
42,808    
13,982    
1,061    

(10,033 )
(515 )
(1,003 )
3,461  

Years Ended December 31,
2022
2023

Increase /
(Decrease)

License and collaboration agreement revenues. Revenues of $0.4 million for the year ended December 31, 2023 consisted of drug product material 
sold to Kyorin for the Japan portion of the EFZO-FIT study while revenues of $10.4 million for the year ended December 31, 2022 consisted primarily of 
the $10.0 million development milestone earned under the Kyorin Agreement as Kyorin dosed the first patient in the Japan portion of the EFZO-FIT study.

Research and development expenses. Research and development expenses were $42.3 million and $42.8 million for the years ended December 31, 
2023 and 2022, respectively. The decrease of $0.5 million was due primarily to a decrease of $3.8 million in manufacturing costs due to the timing of the 
associated manufacturing activities conducted, a reduction of $1.9 million in earlier stage discovery research and development costs as well a reduction of 
$0.7 million in personnel costs. The reduction in personnel related expenses was primarily due to the recognition of the ERC benefit made available under 
the  CARES  Act  as  discussed  under  Note  2  -  “Summary  of  Significant  Accounting  Policies”  of  our  consolidated  financial  statements  included  in  this 
Annual Report. These decreases were partially offset by an increase of $5.9 million in clinical trial costs for the EFZO-FIT and EFZO-CONNECT studies 
as those studies progressed during the year ended December 31, 2023. We expect research and development expenses to increase as we advance our clinical 
and manufacturing efforts toward possible commercialization of efzofitimod. 

General and administrative expenses. General and administrative expenses were $13.0 million and $14.0 million for the years ended December 31, 
2023 and 2022, respectively. The decrease of $1.0 million was due primarily to a decrease of $0.8 million in personnel related expense. The reduction in
personnel  related  expenses  was  primarily  due  to  the  recognition  of  the  ERC  benefit  made  available  under  the  CARES  Act  as  discussed  under  Note  2  - 
“Summary of Significant Accounting Policies” of our consolidated financial statements included in this Annual Report.

Other  income  (expense),  net.  Other  income  (expense),  net  was  $4.5  million  and  $1.1  million  for  years  ended  December  31,  2023  and  2022, 
respectively.  The  increase  was  primarily  a  result  of  interest  earned  on  higher  cash,  cash  equivalents,  restricted  cash  and  available-for-sale  investments 
balances during the year ended December 31, 2023 as compared to the prior year, and increased interest rates.

Recent Accounting Pronouncements

For discussion of recently issued accounting pronouncements, refer to the Section titled “Recent Accounting Pronouncements” within Note 2 of our 

consolidated financial statements included in this Annual Report. 

Item 7A. Quantitative and Qualitative Disclosures About Market Risk.

Not Applicable.

68

 
 
 
 
   
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 8. Financial Statements and Supplementary Data.

Report of Independent Registered Public Accounting Firm

To the Stockholders and Board of Directors of aTyr Pharma, Inc.

Opinion on the Financial Statements

We  have  audited  the  accompanying  consolidated  balance  sheets  of  aTyr  Pharma,  Inc.  (the  Company)  as  of  December  31,  2023  and  2022,  the  related 
consolidated statements of operations, comprehensive loss, stockholders’ equity and cash flows for each of the three years in the period ended December 
31, 2023, and the related notes (collectively referred to as the “consolidated financial statements”). In our opinion, the consolidated financial statements 
present fairly, in all material respects, the financial position of the Company at December 31, 2023 and 2022, and the results of its operations and its cash 
flows for each of the three years in the period ended December 31, 2023, in conformity with U.S. generally accepted accounting principles.

Basis for Opinion

These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial 
statements  based  on  our  audits.  We  are  a  public  accounting  firm  registered  with  the  Public  Company  Accounting  Oversight  Board  (United  States) 
(PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and 
regulations of the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable 
assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor 
were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of 
internal  control  over  financial  reporting  but  not  for  the  purpose  of  expressing  an  opinion  on  the  effectiveness  of  the  Company’s  internal  control  over 
financial reporting. Accordingly, we express no such opinion. 

Our  audits  included  performing  procedures  to  assess  the  risks  of  material  misstatement  of  the  financial  statements,  whether  due  to  error  or  fraud,  and 
performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in 
the  financial  statements.  Our  audits  also  included  evaluating  the  accounting  principles  used  and  significant  estimates  made  by  management,  as  well  as 
evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.

Critical Audit Matter

The  critical  audit  matter  communicated  below  is  a  matter  arising  from  the  current  period  audit  of  the  financial  statements  that  was  communicated  or 
required to be communicated to the audit committee and that: (1) relates to accounts or disclosures that are material to the financial statements and (2) 
involved our especially challenging, subjective or complex judgments. The communication of the critical audit matter does not alter in any way our opinion 
on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion 
on the critical audit matter or on the accounts or disclosures to which it relates. 

69

 
 
 
 
Accrued clinical and manufacturing costs 

Description of the 
Matter

As  of  December  31,  2023,  the  Company  had  $7.8  million  of  clinical  and  manufacturing  costs  recorded  as  an  accrual.  A 
substantial  portion  of  the  Company’s  ongoing  research  and  development  activities  are  conducted  by  third-party  service 
providers,  including  clinical  research  organizations  and  contracted  development  and  manufacturing  organizations.  As 
described  in  Note  2  to  the  consolidated  financial  statements,  external  costs  for  clinical  and  manufacturing  to  be  paid  are 
accrued and expensed based upon work completed in accordance with contractual arrangements.

Auditing  management’s  accounting  for  accrued  clinical  and  manufacturing  costs  is  especially  challenging  because  it  is 
dependent on data from third parties and involves judgments applied by management to determine the commencement and 
completion date of vendor tasks as well as the extent of work performed during the reporting period, which may not match the 
pattern of bills received or payments made to third-party service providers. The testing of accrued clinical and manufacturing 
costs  is  dependent  upon  a  high-volume  of  data  and  input  exchanged  between  clinical  personnel  and  third-party  service 
providers, which includes the total clinical trial management costs, number of sites activated, number of patients enrolled, and 
number of patient visits, which is tracked in spreadsheets and other end user computing programs.

How We Addressed 
the Matter in Our 
Audit

Our substantive testing procedures over the completeness of the Company’s accrued clinical and manufacturing costs include 
obtaining from third-parties confirmation of total costs billed and work completed as of December 31, 2023, for significant 
clinical  trial  and  manufacturing  activities.  We  obtained  an  understanding  of  the  status  of  significant  clinical  trial  and 
manufacturing activities from accounting personnel and the clinical project managers to understand the status of significant 
clinical trial and manufacturing activities. To assess the appropriate measurement of accrued clinical and manufacturing costs, 
we inspected key terms, timelines of completion, activities and costs for a sample of vendor contracts, including amendments, 
and  compared  these  to  management’s  analyses  used  in  tracking  the  progress  of  service  agreements.  We  also  inspected  a 
sample of subsequent payments, obtained invoice support and tested the expense was recorded to the appropriate period.

/s/ Ernst & Young LLP

We have served as the Company’s auditor since 2008.

San Diego, California 

March 14, 2024

70

 
 
 
 
 
 
 
 
 
 
 
aTyr Pharma, Inc.
Consolidated Balance Sheets
(in thousands, except share and per share data)

December 31,
2023

December 31,
2022

Assets
Current assets:

Cash and cash equivalents
Available-for-sale investments
Other receivables
Prepaid expenses
Total current assets
Restricted cash
Property and equipment, net
Operating lease, right-of-use assets
Financing lease, right-of-use assets
Other assets

Total assets
Liabilities and Stockholders’ Equity
Current liabilities:

Accounts payable
Accrued expenses
Current portion of operating lease liability
Current portion of financing lease liability

Total current liabilities
Long-term operating lease liability, net of current portion
Long-term financing lease liability, net of current portion
Commitments and contingencies (Note 6)
Stockholders’ equity:

Preferred stock, $0.001 par value per share; 5,000,000 undesignated authorized shares as of 
December 31, 2023 and 2022, respectively; no shares issued or outstanding as of December 31, 2023 
and 2022, respectively
Common stock, $0.001 par value per share; 170,000,000 and 85,000,000 authorized shares as of 
December 31, 2023 and 2022, respectively; issued and outstanding shares – 63,286,404 and 
29,498,488 as of December 31, 2023 and 2022, respectively
Additional paid-in capital
Accumulated other comprehensive loss
Accumulated deficit

Total aTyr Pharma, Inc. stockholders’ equity

Noncontrolling interest in Pangu BioPharma Limited

Total stockholders’ equity

Total liabilities and stockholders’ equity

See accompanying notes.

71

  $

  $

  $

  $

22,544     $
75,622    
2,436    
2,390    
102,992    
3,484    
5,531    
6,727    
1,788    
131    
120,653     $

3,529     $
11,559    
831    
497    
16,416    
12,339    
1,428    

9,981  
56,165  
11,775  
2,950  
80,871  
3,165  
3,059  
7,250  
1,248  
193  
95,786  

3,106  
9,862  
630  
264  
13,862  
9,633  
1,007  

—    

—  

63    
558,692    
(74 )  
(468,023 )  
90,658    
(188 )  
90,470    
120,653     $

29  
489,502  
(433 )
(417,634 )
71,464  
(180 )
71,284  
95,786  

 
 
 
 
   
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
   
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
aTyr Pharma, Inc.
Consolidated Statements of Operations
(in thousands, except share and per share data)

Years Ended December 31,
2022

2023

2021

Revenues:

License and collaboration agreement revenues

Total revenues
Operating expenses:

Research and development
General and administrative

Total operating expenses
Loss from operations

Total other income (expense), net

Consolidated net loss

Net loss attributable to noncontrolling interest in Pangu BioPharma Limited

  $

  $

353  
353  

  $

10,386  
10,386  

42,293    
12,979    
55,272    
(54,919 )  
4,522    
(50,397 )  
8    

42,808    
13,982    
56,790    
(46,404 )  
1,061    
(45,343 )  
5    

Net loss attributable to aTyr Pharma, Inc.

Net loss per share, basic and diluted

  $
  $

(50,389 )   $
(0.94 )   $

(45,338 )   $
(1.60 )   $

—  
—  

23,264  
10,751  
34,015  
(34,015 )
238  
(33,777 )
9  
(33,768 )

(1.77 )

Shares used in computing net loss per share, basic and diluted

53,606,488    

28,419,569    

19,080,878  

See accompanying notes.

72

 
 
 
 
 
 
 
   
   
 
 
 
 
   
 
   
 
 
 
 
   
 
   
 
 
 
 
   
   
 
 
   
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
aTyr Pharma, Inc.
Consolidated Statements of Comprehensive Loss
(in thousands)

Years Ended December 31,
2022

2023

2021

  $

(50,397 )   $

(45,343 )   $

(33,777 )

Consolidated net loss
Other comprehensive loss:

Change in unrealized gain (loss) on available-for-sale investments, net of tax

Comprehensive loss

Comprehensive loss attributable to noncontrolling interest in Pangu BioPharma 
Limited

359    
(50,038 )  

(170 )  
(45,513 )  

8    

5    

Comprehensive loss attributable to aTyr Pharma, Inc. common stockholders

  $

(50,030 )   $

(45,508 )   $

(220 )
(33,997 )

9  
(33,988 )

See accompanying notes.

73

 
 
 
 
 
 
 
 
 
   
 
 
 
 
   
     
   
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
aTyr Pharma, Inc.
Consolidated Statements of Stockholders’ Equity
(in thousands, except share data)

Common Stock

Additional

Paid-In  

Other
Comprehensi
ve

Shares

  Amount   Capital

  Gain/(Loss)

Balance as of December 31, 2020

  11,018,954   $

Issuance of common stock upon release of restricted stock units
Issuance of common stock upon exercise of stock options
Issuance of common stock pursuant to employee stock purchase plan
Issuance of common stock from at-the-market offerings, net of offering costs
Issuance of common stock from committed purchase agreement, net of offering 
costs
Issuance of common stock from underwritten follow-on offering, net of offering 
costs
Stock-based compensation
Net unrealized loss on investments, net of tax
Net loss

Balance as of December 31, 2021

Issuance of common stock upon release of restricted stock units
Issuance of common stock upon exercise of stock options
Issuance of common stock pursuant to employee stock purchase plan
Issuance of common stock from at-the-market offerings, net of offering costs
Stock-based compensation
Net unrealized loss on investments, net of tax
Net loss

Balance as of December 31, 2022

Issuance of common stock upon release of restricted stock units
Issuance of common stock pursuant to employee stock purchase plan
Issuance of common stock from at-the-market offerings, net of offering costs
Issuance of common stock from underwritten follow-on offering, net of offering 
costs
Stock-based compensation
Net unrealized gain on investments, net of tax
Net loss

4,177  
10,751  
3,382  
2,974,521  

3,000,000  

  10,781,250  
—  
—  
—  
  27,793,035  
2,500  
259  
20,612  
1,682,082  
—  
—  
—  
  29,498,488  
58,111  
74,010  
  10,530,795  

  23,125,000  
—  
—  
—  

Balance as of December 31, 2023

  63,286,404   $

11   $ 370,210   $
—  
—  
—  
3  

—  
62  
11  
14,067  

3  

11  
—  
—  
—  
28  
—  
—  
—  
1  
—  
—  
—  
29  
—  
—  
11  

15,233  

80,635  
1,614  
—  
—  
481,832  
—  
1  
44  
5,471  
2,154  
—  
—  
489,502  
—  
105  
18,435  

48,050  
2,600  
—  
—  

23  
—  
—  
—  
63   $ 558,692   $

See accompanying notes.

74

Accumulate
d
Deficit
(338,528 ) $

Noncontrolli
ng
Interest

Total
Stockholders’  
Equity

(43 ) $
—  
—  
—  
—  

—  

—  
—  
(220 )  
—  
(263 )  
—  
—  
—  
—  
—  
(170 )  
—  
(433 )  
—  
—  
—  

—  
—  
359  
—  
(74 ) $

—  
—  
—  
—  

—  

—  
—  
—  

(33,768 )  
(372,296 )  

—  
—  
—  
—  
—  
—  

(45,338 )  
(417,634 )  

—  
—  
—  

—  
—  
—  

(50,389 )  
(468,023 ) $

(166 ) $
—  
—  
—  
—  

31,484  
—  
62  
11  
14,070  

—  

15,236  

—  
—  
—  
(9 )  
(175 )  
—  
—  
—  
—  
—  
—  
(5 )  
(180 )  
—  
—  
—  

—  
—  
—  
(8 )  
(188 ) $

80,646  
1,614  
(220 )
(33,777 )
109,126  
—  
1  
44  
5,472  
2,154  
(170 )
(45,343 )
71,284  
—  
105  
18,446  

48,073  
2,600  
359  
(50,397 )
90,470  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
aTyr Pharma, Inc.
Consolidated Statements of Cash Flows
(in thousands)

Cash flows from operating activities:
Consolidated net loss
Adjustments to reconcile net loss to net cash used in operating activities:

Depreciation and amortization
Stock-based compensation
(Accretion) amortization of (discount) premium of available-for-sale investment 
securities
Amortization of right-of-use assets
(Gain) loss on disposal of property and equipment
Changes in operating assets and liabilities:

Other receivables
Prepaid expenses and other assets
Accounts payable and accrued expenses
Operating lease liability

Net cash used in operating activities
Cash flows from investing activities:
Purchases of property and equipment
Purchases of available-for-sale investment securities
Maturities of available-for-sale investment securities
Proceeds from sale of property and equipment

Net cash (used in) provided by investing activities

Cash flows from financing activities:
Proceeds from issuance of common stock through option exercises
Proceeds from issuance of common stock through employee stock purchase plan
Proceeds from issuance of common stock from at-the-market offerings, net of offering 
costs
Proceeds from issuance of common stock from committed purchase agreement, net of 
offering costs
Proceeds from issuance of common stock from underwritten follow-on public 
offering, net of offering costs
Principal paid on finance lease liabilities

Net cash provided by financing activities

Net change in cash, cash equivalents and restricted cash
Cash, cash equivalents and restricted cash at beginning of period

Cash, cash equivalents and restricted cash at the end of period

Cash and cash equivalents at the end of period
Restricted cash at the end of period

Cash, cash equivalents and restricted cash at the end of period

Supplemental disclosure of cash flow information:

Interest paid

Purchases of property and equipment in accounts payable

Right-of-use assets obtained in exchange for lease obligation

See accompanying notes.

75

Years Ended December 31,
2022

2023

2021

$

(50,397 )   $

(45,343 )   $

(33,777 )

592    
2,600    

(3,171 )  
2,149    
(6 )  

9,054    
622    
3,262    
2,074    
(33,221 )  

(4,215 )  
(106,977 )  
91,050    
15    
(20,127 )  

—    
105    

232    
2,154    

533    
1,463    
(92 )  

(11,923 )  
2,238    
6,741    
2,111    
(41,886 )  

(1,641 )  
(42,118 )  
90,825    
179    
47,245    

1    
44    

475  
1,614  

366  
829  
6  

1,604  
(3,378 )
47  
(861 )
(33,075 )

(192 )
(126,506 )
35,082  
50  
(91,566 )

62  
11  

18,446    

5,472    

14,070  

—    

—    

15,236  

48,073    
(394 )  
66,230    
12,882    
13,146    
26,028     $

22,544     $
3,484    
26,028     $

172     $
51     $
1,854     $

—    
(66 )  
5,451    
10,810    
2,336    
13,146     $

9,981     $
3,165    
13,146     $

54     $
1,194     $
8,695     $

80,646  
—  
110,025  
(14,616 )
16,952  
2,336  

2,336  
—  
2,336  

—  

—  

—  

$

$

$

$

$

$

 
 
 
 
 
 
 
 
 
   
 
 
 
   
   
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
     
   
 
 
 
 
 
 
 
  
     
   
 
   
 
     
     
   
 
 
 
 
 
aTyr Pharma, Inc.

Notes to Consolidated Financial Statements

1. Organization, Business and Basis of Presentation 

Organization and Business

We  were  incorporated  in  the  state  of  Delaware  on  September  8,  2005.  We  are  a  clinical  stage  biotechnology  company  leveraging  evolutionary 
intelligence to translate tRNA synthetase biology into new therapies for fibrosis and inflammation. tRNA synthetases are ancient, essential proteins that 
have evolved novel domains that regulate diverse pathways extracellularly in humans. Our discovery platform is focused on unlocking hidden therapeutic 
intervention points by uncovering signaling pathways driven by our proprietary library of domains derived from all 20 tRNA synthetases.

Principles of Consolidation

Our  consolidated  financial  statements  include  our  accounts  and  our  98%  majority-owned  subsidiary  in  Hong  Kong,  Pangu  BioPharma  Limited 

(Pangu BioPharma). All intercompany transactions and balances are eliminated in consolidation.

Liquidity and Financial Condition

We have incurred losses and negative cash flows from operations since our inception. As of December 31, 2023, we had an accumulated deficit of 
$468.0 million and we expect to continue to incur net losses for the foreseeable future. As of December 31, 2023, our cash, cash equivalents, available-for-
sale investments and restricted cash were $101.7 million. We currently have an “at-the-market” offering program (the Jefferies ATM Offering Program) 
through an Open Market Sale AgreementSM with Jefferies LLC (Jefferies). During the year ended December 31, 2023, we sold an aggregate of 10,530,795 
shares of common stock at a weighted-average price of $1.82 per share for net proceeds of approximately $18.4 million under the Jefferies ATM Offering 
Program. Additionally, from January 1, 2024 through March 13, 2024, we sold an aggregate of 4,441,509 shares of common stock at a weighted-average 
price of $1.75 per share for net proceeds of approximately $7.6 million under the Jefferies ATM Offering Program. We believe that our current cash, cash 
equivalents, available-for-sale investments and restricted cash, will be sufficient to meet our anticipated cash requirements for a period of at least one year 
from the date of this Annual Report.

We  do  not  expect  to  generate  any  revenues  from  product  sales  unless  and  until  we  successfully  complete  development  and  obtain  regulatory 
approval for one or more of our product candidates, which we expect will take a number of years at a minimum. If we obtain regulatory approval for any of 
our  product  candidates,  we  expect  to  incur  significant  commercialization  expenses  related  to  product  sales,  marketing,  manufacturing  and  distribution. 
Accordingly, we will need to raise substantial additional capital to fund our operations. The amount and timing of our future funding requirements will 
depend  on  many  factors,  including  the  pace  and  results  of  our  preclinical  and  clinical  development  efforts  and  the  timing  and  nature  of  the  regulatory 
approval process for our product candidates. We anticipate that we will seek to fund our operations through equity offerings, grant funding, collaborations, 
strategic  partnerships  and/or  licensing  arrangements,  and  when  we  are  closer  to  commercialization  of  our  product  candidates  potentially  through  debt 
financings. However, we may be unable to raise additional capital or enter into such arrangements when needed on favorable terms or at all. Our failure to 
raise  capital  or  enter  into  such  arrangements  when  needed  would  have  a  negative  impact  on  our  financial  condition  and  ability  to  develop  our  product 
candidates.

Restricted Cash

As of December 31, 2023, restricted cash was approximately $3.5 million, which was held as a security deposit in conjunction with our corporate 

headquarter facility lease and financing leases as discussed further in Note 6 - Commitments and Contingencies. 

Use of Estimates

Our consolidated financial statements are prepared in accordance with generally accepted accounting principles (GAAP). The preparation of our 
consolidated financial statements requires us to make estimates and assumptions that impact the reported amounts of assets, liabilities and expenses and the 
disclosure for these items in our consolidated financial statements and accompanying notes. The most significant estimates in our consolidated financial 
statements relate to the fair value of equity issuances and awards, and clinical trial and research and development expenses. Although these estimates are 
based on our knowledge of current events and actions we may undertake in the future, actual results may ultimately differ materially from these estimates 
and assumptions.

76

 
Segment Reporting

Operating segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by 
the chief operating decision-maker in making decisions regarding resource allocation and assessing performance. We view our operations and manage our 
business in one operating segment

2. Summary of Significant Accounting Policies

Cash and Cash Equivalents and Restricted Cash

Cash, cash equivalents and restricted cash consist of checking, money market and highly liquid investments that are readily convertible to cash and 
that have an original maturity of three months or less from date of purchase. The carrying amounts approximate fair value due to the short maturities of 
these instruments. 

Employee Retention Credit

On March 27, 2020, the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed into law providing numerous tax incentives 
and  other  stimulus  measures,  including  an  employee  retention  credit  (ERC),  which  is  a  refundable  tax  credit  against  certain  employment  taxes.  The 
Taxpayer Certainty and Disaster Tax Relief Act of 2020 and the American Rescue Plan Act of 2021 extended and expanded the availability of the ERC.

As a result of the foregoing legislation, we determined that we are eligible to claim an ERC benefit equal to 50% of qualified wages that we paid to 
our employees between March 17, 2020 and December 31, 2020, and 70% of the qualified wages that we paid to our employees between January 1, 2021 
and September 30, 2021. Qualified wages are limited to $10,000 per employee for March 17, 2020 through December 31, 2020, and $10,000 per employee 
per calendar quarter from January 1, 2021 through September 30, 2021. Our credit was primarily derived from qualified wages during January 1, 2021 
through  September  30,  2021.  To  determine  eligibility  for  January  1,  2021  through  September  30,  2021,  we  compared  gross  receipts  for  each  calendar 
quarter in 2021 to the corresponding calendar quarter in 2019 and determined that we had met the requirement for a decline in gross receipts. 

Accounting Standards Codification (ASC) Topic 105, Generally Accepted Accounting Principles describes the decision-making framework when 
no  guidance  exists  in  U.S.  GAAP  for  a  particular  transaction.  Specifically,  ASC  105-10-05-2  instructs  companies  to  look  for  guidance  for  a  similar 
transaction within U.S. GAAP and apply that guidance by analogy. We accounted for the ERC by analogy to International Accounting Standards (IAS) 20, 
Accounting for Government Grants and Disclosure of Government Assistance, of International Financial Reporting Standards (IFRS). Under an IAS 20 
analogy, a business entity would recognize the credit on a systematic basis over the periods in which the entity recognizes the payroll expenses for which 
the ERC is intended to compensate when there is reasonable assurance that the entity will comply with any conditions attached to the ERC and the ERC 
will be received. 

During the year ended December 31, 2023, we amended certain payroll tax filings and applied for a refund of $1.2 million of ERC benefits. The 
refund was recorded within the other receivables in our consolidated balance sheet, and as a $0.8 million reduction of research and development expenses 
and a $0.4 million reduction of general and administrative expenses in our consolidated statements of operations for the year ended December 31, 2023.

Allowance of Credit Losses

For available-for-sale securities in an unrealized loss position, we first assess whether we intend to sell, or if it is more likely than not that we will 
be  required  to  sell,  the  security  before  recovery  of  its  amortized  cost  basis.  If  either  of  the  criteria  regarding  intent  or  requirement  to  sell  is  met,  the 
security’s amortized cost basis is written down to fair value through earnings. For available-for-sale securities that do not meet the aforementioned criteria, 
we evaluate whether the decline in fair value has resulted from credit losses or other factors. In making this assessment, we consider the severity of the 
impairment, any changes in interest rates, market conditions, changes to the underlying credit ratings and forecasted recovery, among other factors. The 
credit-related  portion  of  unrealized  losses,  and  any  subsequent  improvements,  are  recorded  in  interest  income  through  an  allowance  account.  Any 
impairment  that  has  not  been  recorded  through  an  allowance  for  credit  losses  is  included  in  other  comprehensive  income  (loss)  on  the  consolidated 
statements of operations and comprehensive loss. 

We elected the practical expedient to exclude the applicable accrued interest from both the fair value and amortized costs basis of our available-for-
sale securities for purposes of identifying and measuring an impairment. Accrued interest receivable on available-for-sale securities is recorded within other 
receivables on our consolidated balance sheets. Our accounting policy is to not measure an allowance for credit loss for accrued interest receivable and to 
write-off any uncollectible accrued interest receivable as a reversal of interest income in a timely manner, which we consider to be in the period in which 
we determine the accrued interest will not be collected by us.

77

 
Concentration of Credit Risk

Financial instruments that potentially subject us to significant concentration of credit risk consist primarily of cash, cash equivalents, restricted cash 
and  investment  securities.  We  have  established  guidelines  regarding  diversification  of  investments  and  their  maturities,  which  are  designed  to  maintain 
principal  and  maximize  liquidity.  We  maintain  deposits  in  federally  insured  financial  institutions  in  excess  of  federally  insured  limits.  We  have  not 
experienced any losses in such accounts and we believe that we are not exposed to significant credit risk due to the financial position of the depository 
institutions in which those deposits are held.

Property and Equipment

Property and equipment are stated at cost and depreciated on a straight-line basis over the estimated useful life of the related assets (generally three 
to seven years). Leasehold improvements are stated at cost and amortized on a straight-line basis over the lesser of the remaining term of the related lease 
or the estimated useful life of the leasehold improvements. Repairs and maintenance costs are charged to expense as incurred.

Impairment of Long-Lived Assets

Long-lived assets consist primarily of property and equipment and right-of-use assets (ROU) associated with our operating and financing leases. An 
impairment loss is recorded if and when events and circumstances indicate that assets might be impaired and the undiscounted cash flows estimated to be 
generated by those assets are less than the carrying amount of those assets. While our current and historical operating losses are indicators of impairment, 
we believe that future cash flows to be received support the carrying value of our long-lived assets and, accordingly, have not recognized any impairment 
losses since inception.

Accrued Expenses

Accrued  expenses  include  salaries,  wages,  benefits  costs,  consulting  fees,  legal  and  research  and  development  costs.  We  have  entered  into 
contractual  arrangements  related  to  our  clinical  studies  with  clinical  research  organizations  (CROs)  and  contracted  development  and  manufacturing 
organizations  (CDMOs)  and  recognize  expense  based  on  work  completed  and  efforts  expended  pursuant  to  our  contractual  arrangements.  We  make 
estimates of our accrued CRO costs as of each balance sheet date based on facts and circumstances known at the time and include total trial management 
costs, sites activated, patients enrolled and number of patient visits. We estimate the time period over which services will be performed and the level of 
effort  to  be  expended  in  each  period.  There  may  be  instances  in  which  payments  made  to  our  service  providers  including  CROs  and  CDMOs,  will 
temporarily exceed the level of services provided and result in a prepayment of the expense. If the actual timing of the performance of services or the level 
of  effort  varies  from  our  estimate,  we  adjust  the  accrual  or  prepaid  expense  balance  accordingly.  Historically,  our  estimated  accrued  liabilities  have 
materially approximated actual expenses incurred.

Leases

We determine if an arrangement is a lease at inception. Short-term leases with an initial term of 12 months or less are not recorded on our balance 
sheet. For long-term leases with an initial term of greater than 12 months, we recognize a right-of-use asset (ROU) and a lease liability based on the present 
value  of  future  lease  payments  using  an  estimated  rate  of  interest  that  we  would  pay  to  borrow  equivalent  funds  on  a  collateralized  basis  at  the  lease 
commencement  date.  We  determine  the  lease  term  at  the  commencement  date  by  considering  whether  renewal  options  and  termination  options  are 
reasonably assured of exercise. Rent expense for operating leases is recognized on a straight-line basis over the lease term and is included in operating 
expenses in our consolidated statements of operations. For financing leases, interest expense and amortization of the ROU is included in operating expenses 
in our consolidated statements of operations and variable lease payments are recorded as incurred.

If  a  lease  is  modified,  the  modified  contract  is  evaluated  to  determine  whether  it  is  or  contains  a  lease.  If  a  lease  continues  to  exist,  the  lease 
modification is determined to be a separate contract when the modification grants the lessee an additional ROU that is not included in the original lease and 
the lease payments increase commensurate with the standalone price for the additional ROU. A lease modification that results in a separate contract will be 
accounted for in the same manner as a new lease. For a modification that is not a separate contract, we reassess the lease classification using the modified 
terms and conditions and the facts and circumstances as of the effective date of the modification and recognize the amount of the remeasurement of the 
lease liability for the modified lease as an adjustment to the corresponding lease ROU asset.

Our ROU assets consist of non-cancelable operating leases and financing leases. Non-cancelable operating leases consist of leases for our corporate 
headquarters  and  additional  laboratory  space.  Financing  leases  consist  of  leases  for  various  research  and  development  and  information  technology 
equipment.

We do not separate lease and non-lease components for our long-term leases.

78

 
Revenue Recognition

We evaluate our agreements under ASC Topic 606, Revenue from Contracts with Customers and ASC Topic 808, Collaborative Arrangements. We 
recognize revenue when we transfer promised goods or services to customers in an amount that reflects the consideration to which we expect to be entitled 
in  exchange  for  those  goods  or  services.  In  determining  the  appropriate  amount  of  revenue  to  be  recognized  as  we  fulfill  our  obligations  under  our 
agreement, we perform the following steps: (i) identification of the promised goods or services in the contract; (ii) determination of whether the promised 
goods or services are performance obligations including whether they are distinct in the context of the contract; (iii) measurement of the transaction price, 
including the constraint on variable consideration; (iv) allocation of the transaction price to the performance obligations; and (v) recognition of revenue 
when (or as) we satisfy each performance obligation. As part of the accounting for these arrangements, we must develop assumptions that require judgment 
to determine the stand-alone selling price for each performance obligation identified in the contract. We use key assumptions to determine the stand-alone 
selling price, which may include forecasted revenues, development timelines, reimbursement rates for personnel costs, discount rates and probabilities of 
technical and regulatory success.

We  recognize  revenue  in  one  of  two  ways,  over  time  or  at  a  point  in  time.  We  recognize  revenue  over  time  when  we  are  executing  on  our 
performance obligation over time and our partner receives benefit over time. For example, we recognize revenue over time when we provide research and 
development services. We recognize revenue at a point in time when we transfer control of a distinct performance obligation to our partner. For example, if 
a  license  to  our  intellectual  property  is  determined  to  be  distinct  from  the  other  performance  obligations  identified  in  the  arrangement,  we  recognize 
revenues from non-refundable, up-front fees allocated to the license when the license is transferred to the licensee and the licensee is able to use and benefit 
from the license.

Research and Development Costs

Research  and  development  costs  are  expensed  as  incurred.  Research  and  development  costs  include:  salaries  and  employee-related  expenses, 
including  stock-based  compensation  and  benefits  for  personnel  in  research  and  product  development  functions;  costs  associated  with  conducting  our 
preclinical,  development  and  regulatory  activities,  including  fees  paid  to  third-party  professional  consultants,  service  providers  and  our  scientific,
therapeutic and clinical advisors; costs to acquire, develop and manufacture preclinical study and clinical trial materials; costs incurred under clinical trial 
agreements with CROs and investigative sites; costs for laboratory supplies; payments related to licensed products and technologies; allocated facilities and 
information technology costs; and depreciation.

Patent Costs

Costs  related  to  filing  and  pursuing  patent  applications  are  recorded  as  general  and  administrative  expense  and  expensed  as  incurred  since 

recoverability of such expenditures is uncertain.

Stock-Based Compensation

We evaluate our stock-based compensation arrangements under ASC Topic 718, Compensation – Stock Compensation. Stock-based compensation 
expense  represents  the  grant  date  fair  value  of  employee  stock  option  and  restricted  stock  unit  grants  recognized  as  expense  over  the  requisite  service 
period  of  the  awards  (usually  the  vesting  period)  on  a  straight-line  basis.  We  estimate  fair  value  of  stock  option  grants  using  the  Black-Scholes  option 
pricing  model.  We  estimate  the  fair  value  using  assumptions,  including  the  risk-free  interest  rate,  the  expected  volatility  of  a  peer  group  of  similar 
companies,  the  expected  term  of  the  awards  and  the  expected  dividend  yield.  These  estimates  involve  inherent  uncertainties  and  the  application  of 
management’s judgment. If factors change and different assumptions are used, our stock-based compensation expense could be materially different in the 
future. 

Income Taxes 

We  account  for  income  taxes  under  the  asset  and  liability  method,  which  requires  the  recognition  of  deferred  tax  assets  and  liabilities  for  the 
expected future tax consequences of events that have been included in the consolidated financial statements. Under this method, deferred tax assets and 
liabilities are determined on the basis of the differences between the consolidated financial statements and tax basis of assets and liabilities using enacted 
tax rates in effect for the year in which the differences are expected to reverse. The effect of a change in tax rates on deferred tax assets and liabilities is 
recognized as income in the period that includes the enactment date.

We  recognize  net  deferred  tax  assets  to  the  extent  that  we  believe  these  assets  are  more  likely  than  not  to  be  realized.  In  making  such  a 
determination,  we  consider  all  available  positive  and  negative  evidence,  including  future  reversals  of  existing  taxable  temporary  differences,  projected 
future taxable income, tax-planning strategies and results of recent operations. If we determine that we would be able to realize the deferred tax assets in 
the future in excess of their net recorded amount, we would make an adjustment to the deferred tax asset valuation allowance, which would reduce the 
provision for income taxes.

79

 
We  record  uncertain  tax  positions  on  the  basis  of  a  two-step  process  whereby  (1)  we  determine  whether  it  is  more  likely  than  not  that  the  tax 
positions will be sustained on the basis of the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition 
threshold, we recognize the largest amount of tax benefit that is more than 50% likely to be realized upon ultimate settlement with the related tax authority. 
We recognize interest and penalties related to unrecognized tax benefits within income tax expense. Any accrued interest and penalties are included within 
the related tax liability.

Net Loss Per Share

Basic net loss per share is calculated by dividing the net loss attributable to common stockholders by the weighted average number of common 
shares outstanding for the period, without consideration for common stock equivalents. Diluted net loss per share attributable to common stockholders is 
calculated by dividing the net loss attributable to common stockholders by the weighted average number of common stock and common stock equivalents 
outstanding for the period determined using the treasury-stock method. Dilutive common stock equivalents are comprised of convertible preferred stock, 
warrants for common stock, options and restricted stock units outstanding under our stock option plans and inducement grants and estimated shares to be 
purchased under our 2015 Employee Stock Purchase Plan (the 2015 ESPP). For all periods presented, there is no difference in the number of shares used to 
calculate basic and diluted shares outstanding due to our net loss position.

Potentially dilutive securities not included in the calculation of diluted net loss per share because to do so would be anti-dilutive are as follows (in 

common share equivalents):

Common stock warrants
Common stock options and restricted stock units
Employee stock purchase plan

Total

2023

Years Ended December 31,
2022

2021

5,864      
4,020,154      
41,862      
4,067,880      

13,760      
3,077,608      
34,588      
3,125,956      

13,760  
1,420,050  
2,045  
1,435,855  

The following table summarizes our net loss per share (in thousands, except per share data):

Numerator:

Net loss attributable to aTyr Pharma, Inc.

Denominator:

Years Ended December 31,
2022

2023

2021

  $

(50,389 )   $

(45,338 )   $

(33,768 )

Shares used in computing net loss per share, basic and diluted

53,606,488    

28,419,569      

19,080,878  

Net loss per share - basic and diluted

  $

(0.94 )   $

(1.60 )   $

(1.77 )

Recent Accounting Pronouncements

In June 2016, the Financial Accounting Standards Board issued Accounting Standards Update (ASU) No. 2016-13, Financial Instruments – Credit 
Losses (Topic 326), to provide financial statement users with more decision-useful information about the expected credit losses on financial instruments 
and other commitments to extend credit held by a reporting entity at each reporting date. To achieve this objective, the amendments in Topic 326 replace 
the incurred loss impairment methodology in current U.S. GAAP with a methodology that reflects expected credit losses and requires consideration of a 
broader range of reasonable and supportable information to inform credit loss estimates. Topic 326 is effective for fiscal years beginning after December 
15, 2022, including interim periods within those fiscal years for smaller reporting companies. We adopted Topic 326 on January 1, 2023. The adoption did 
not have a material impact on our consolidated financial statements. 

In December 2023, the FASB, issued ASU 2023-09, Improvements to Income Tax Disclosures,  which  requires  entities  to  disclose  disaggregated 
information about their effective tax rate reconciliation as well as expanded information on income taxes paid by jurisdiction. The disclosure requirements 
will be applied on a prospective basis, with the option to apply them retrospectively. The standard is effective for fiscal years beginning after December 15, 
2024, with early adoption permitted. We are currently evaluating the disclosure requirements related to the new standard.

80

 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
     
     
   
 
 
     
     
   
 
     
     
   
 
 
 
 
 
     
     
   
 
 
 
3. Fair Value Measurements

The carrying amounts of cash equivalents, prepaid and other assets, accounts payable and accrued liabilities are considered to be representative of 

their respective fair values because of the short-term nature of those instruments. Investment securities are recorded at fair value.

The  accounting  guidance  defines  fair  value,  establishes  a  consistent  framework  for  measuring  fair  value  and  expands  disclosure  for  each  major 
asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is defined as an exit price, representing the amount 
that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-
based  measurement  that  should  be  determined  based  on  assumptions  that  market  participants  would  use  in  pricing  an  asset  or  liability.  As  a  basis  for 
considering such assumptions, the accounting guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value 
as follows:

Level 1: Observable inputs such as quoted prices in active markets.

Level 2: Inputs, other than the quoted prices in active markets that are observable either directly or indirectly.

Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Financial assets measured at fair value on a recurring basis consist of investment securities. Investment securities are recorded at fair value, defined 
as the exit price in the principal market in which we would transact, representing the amount that would be received to sell an asset or paid to transfer a 
liability in an orderly transaction between market participants. Level 2 securities are valued using quoted market prices for similar instruments, non-binding 
market  prices  that  are  corroborated  by  observable  market  data,  or  discounted  cash  flow  techniques  and  include  our  investments  in  commercial  paper, 
corporate  debt  securities  and  U.S.  government  agencies.  We  have  no  financial  liabilities  measured  at  fair  value  on  a  recurring  basis.  None  of  our  non-
financial assets and liabilities are recorded at fair value on a non-recurring basis. No transfers between levels have occurred during the periods presented.

Assets measured at fair value on a recurring basis are as follows (in thousands): 

As of December 31, 2023
Assets:

Current:
Cash equivalents
Available-for-sale investments:

Commercial paper
Corporate debt securities
U.S. government agencies

Total available-for-sale investments

Total assets measured at fair value

Fair Value Measurements Using

Quoted Prices 
in
 Active 
Markets
for Identical
Assets
(Level 1)

Total

Significant
Other
Observable
Inputs
(Level 2)

Significant
Unobservable
Inputs
(Level 3)

  $

21,626     $

21,626     $

—     $

31,198    
27,578    
16,846    
75,622    
97,248     $

—    
—    
—    
—    
21,626     $

31,198    
27,578    
16,846    
75,622    
75,622     $

  $

81

—  

—  
—  
—  
—  
—  

 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
 
   
 
 
 
 
 
     
     
     
   
 
     
     
     
   
 
     
     
     
   
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2022
Assets:

Current:
Cash equivalents
Available-for-sale investments:

Commercial paper
Corporate debt securities
Municipal bonds

Total available-for-sale investments

Total assets measured at fair value

Fair Value Measurements Using

Quoted Prices 
in
Active 
Markets
for Identical
Assets
(Level 1)

Total

Significant
Other
Observable
Inputs
(Level 2)

Significant
Unobservable
Inputs
(Level 3)

  $

8,585     $

8,585     $

—     $

28,074    
26,094    
1,997    
56,165    
64,750     $

—    
—    
—    
—    
8,585     $

28,074    
26,094    
1,997    
56,165    
56,165     $

  $

—  

—  
—  
—  
—  
—  

As of December 31, 2023 and 2022, available-for-sale investments are detailed as follows (in thousands): 

Contractual 
Maturity

Gross
Amortized
Cost

December 31, 2023

Gross
Unrealized
Gains

Gross
Unrealized
Losses

Available-for-sale investments:

Commercial paper
Corporate debt securities
U.S. government agencies

  Within 1 year
  Within 2 years
  Within 1 year

  $

  $

31,198     $
27,607    
16,841    
75,646     $

14     $
12    
26    
52     $

    Market Value

(14 )   $
(41 )  
(21 )  
(76 )   $

31,198  
27,578  
16,846  
75,622  

Available-for-sale investments:

Commercial paper
Corporate debt securities
Municipal bonds

Contractual 
Maturity

Gross
Amortized
Cost

December 31, 2022

Gross
Unrealized
Gains

Gross
Unrealized
Losses

    Market Value

  Within 1 year
  Within 2 years
  Within 1 year

  $

  $

28,121     $
26,401    
2,026    
56,548     $

—     $
—    
—    
—     $

(47 )   $
(307 )  
(29 )  
(383 )   $

28,074  
26,094  
1,997  
56,165  

We evaluate our available-for-sale debt securities for credit losses when the amortized cost basis exceeds fair value. The credit-related portion of 
unrealized losses, and any subsequent improvements, are recorded in interest income through an allowance account. Unrealized gains and losses that are 
not credit-related are included in accumulated other comprehensive income (loss). When evaluating an investment for impairment, we review factors such 
as the severity of the impairment, changes in underlying credit ratings, our intent to sell or the likelihood that we would be required to sell the investment 
before its anticipated recovery in market value and the probability that the scheduled cash payments will continue to be made. Based on our evaluation, we 
did not record allowance for credit losses in the consolidated statement of operations during the year ended December 31, 2023.

As of December 31, 2023, all available-for-sale investments had a variety of effective maturity dates of less than two years. As of December 31, 
2023, $74.6 million of our short-term investments had maturities less than one year and $1.0 million had maturities greater than one year. As of December 
31, 2023, 19 out of 25  available-for-sale  investments  were  in  a  gross  unrealized  loss  position  of  which  one  available-for-sale  investment  with  a  market 
value of $2.0 million was in such position for greater than 12 months. 

As of December 31, 2023 and 2022, accrued interest receivable on available-for-sale securities was $0.3 million and $0.2 million, respectively. 

82

 
 
 
 
   
 
 
 
   
   
   
 
 
     
     
     
   
 
     
     
     
   
 
     
     
     
   
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
   
 
 
 
 
 
 
     
     
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
4. License, Collaboration and Other Agreements

Kyorin Pharmaceutical Co., Ltd.

In January 2020, we entered into a collaboration and license agreement (Kyorin Agreement) with Kyorin Pharmaceutical Co., Ltd. (Kyorin) for the 
development  and  commercialization  of  efzofitimod  for  the  treatment  of  interstitial  lung  disease  (ILD)  in  Japan.  Under  the  Kyorin  Agreement,  Kyorin 
received an exclusive right to develop and commercialize efzofitimod in Japan for all forms of ILD, and is obligated to fund all research, development, 
regulatory, marketing and commercialization activities in Japan. In 2020, Kyorin conducted and funded a Phase 1 clinical trial of efzofitimod (known as 
KRP-R120 in Japan). The Phase 1 clinical trial was a placebo-controlled clinical trial to evaluate the safety, pharmacokinetics (PK) and immunogenicity of 
efzofitimod in 32 healthy Japanese male volunteers. Efzofitimod was observed to be generally well-tolerated with no drug-related serious adverse events, 
and PK findings were consistent with previous studies of efzofitimod. Kyorin is also participating in the EFZO-FIT study as the local sponsor in Japan. In 
February 2023, Kyorin dosed the first patient in Japan in the EFZO-FIT study which triggered a $10.0 million milestone payment to us. To date, the Kyorin 
Agreement has generated $20.0 million in upfront and milestone payments to us and we are eligible to receive up to an additional $155.0 million in the 
aggregate upon achievement of certain development, regulatory and sales milestones, as well as tiered royalties on any net sales in Japan. 

Either party may terminate the Kyorin Agreement in the event that the other party breaches the agreement and fails to cure the breach, becomes 

insolvent or challenges certain of the intellectual property rights licensed under the agreement.

We assessed our license and collaboration with Kyorin in accordance with Topic 606 and concluded that Kyorin is a customer. We identified the 
following  performance  obligations  under  the  Kyorin  Agreement:  1)  the  license  of  efzofitimod  for  ILD  in  Japan;  and  2)  free  clinical  trial  material  for 
Kyorin’s  Phase  1  clinical  trial.  Kyorin  is  participating  in  the  EFZO-FIT  study  and  received  approval  from  the  Pharmaceuticals  and  Medical  Devices 
Agency (PMDA) to commence the EFZO-FIT study in Japan in December 2022. Additionally, in February 2023, Kyorin dosed the first patient in Japan in 
the EFZO-FIT study which triggered a $10.0 million milestone payment to us. We recognized this $10.0 million milestone payment as revenue during the 
year  ended  December  2022,  as  we  determined  the  milestone  became  probable  of  achievement  with  Kyorin  having  scheduled  site  visits  for  patient 
screenings by that time. We received this $10.0 million milestone payment in February 2023. During the year ended December 31, 2023, we recognized 
$0.4 million in collaboration revenue from Kyorin for drug product material sold to Kyorin for the Japan portion of the EFZO-FIT study. 

The remaining milestones and royalty payments under the Kyorin Agreement are variable consideration. Since the milestone payments are binary
in nature, we will use the “most-likely” method to evaluate whether the milestones should be included as revenue. We will constrain these amounts until 
they become probable of being achieved. The royalties are dependent on future sales by Kyorin which are at the full discretion of Kyorin. Accordingly, we 
will apply a constraint to these amounts until the future sale sales have occurred. 

5. Balance Sheet Details 

Prepaid expenses consist of the following (in thousands):

Prepaid clinical and research expense
Prepaid manufacturing expenses
Other prepaid expenses

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

Computer and office equipment
Scientific and laboratory equipment
Tenant improvements

Less accumulated depreciation and amortization

December 31,

2023

2022

1,475     $
125      
790      
2,390     $

334  
2,049  
567  
2,950  

December 31,

2023

2022

448     $
4,051      
5,653      
10,152      
(4,621 )    
5,531     $

620  
4,379  
4,414  
9,413  
(6,354 )
3,059  

  $

  $

  $

  $

During the years ended December 31, 2023, 2022 and 2021, depreciation expense was $0.6 million, $0.2 million and $0.5 million, respectively.

83

 
 
 
 
 
 
 
   
 
   
   
 
 
 
 
 
 
 
   
 
   
   
 
   
   
 
 
Accrued expenses consist of the following (in thousands):

Accrued salaries, wages and benefits
Accrued clinical and manufacturing
Other accrued expenses

6. Commitments and Contingencies 

Operating Leases

Corporate Headquarters Facility Lease

December 31,

2023

2022

  $

  $

2,706     $
7,753    
1,100    
11,559     $

2,781  
5,151  
1,930  
9,862  

In May 2022, we entered into a lease (the Lease) with San Diego Creekside, LLC (Landlord), as lessor, pursuant to which we agreed to lease from 
Landlord approximately 23,696 rentable square feet (subject to increase pursuant to the terms of the Lease) of office and laboratory space. The term of the 
lease (the Lease Term) commenced on March 20, 2023 (the Lease Commencement Date) and will continue for 124 months from the Lease Commencement 
Date. We also have one option to extend the Lease Term for five years. Base rent during such extension period would be at the fair market rent for the 
Premises (as that term is defined in the Lease). Under the terms of the Lease, the base rent during the first 12 months of the Lease Term will be $5.75 per 
square foot of rentable area per month, subject to certain upward adjustments of approximately 3.0% annually. We are entitled to an allowance of up to $5.3 
million for tenant improvements of which as of December 31, 2023 we had received $5.0 million, and we received the remaining $0.3 million in February 
2024. We provided a $0.7 million security deposit in the form of a letter of credit which is included in restricted cash as of December 31, 2023. During the 
second  quarter  of  2023,  additional  common  area  amenities  were  completed  by  the  Landlord  which  provided  us  with  access  to  approximately  1,500 
additional rentable square feet. As a result, our base rent increased for this additional rentable square feet at the same monthly base rent per rentable square 
foot as contemplated in the Lease. 

Previous Corporate Headquarters Facility Lease

Our operating lease for our previous corporate headquarters was subject to base lease payments, additional charges for common area maintenance 

and other costs and it expired in May 2023. 

Future minimum payments under the facility lease and reconciliation to the operating lease liability as of December 31, 2023 were as follows (in 

thousands):

2024
2025
2026
2027
2028 and thereafter
Less: Amount representing interest
Present value of lease payments
Less: Current portion of operating lease liability

Less: Tenant improvement allowance not yet received

Long-term operating lease liability, net of current portion

Operating Leases

1,949  
1,975  
1,923  
1,942  
11,968  
(6,289 )
13,468  
(831 )
(298 )
12,339  

  $

  $

Operating lease expense was $1.9 million, $1.5 million and $1.0 million for the years ended December 31, 2023, 2022 and 2021, respectively. As 
of December 31, 2023 and 2022, the weighted average remaining lease term was 9.4 years and 9.9 years, respectively. As of December 31, 2023 and 2022, 
the weighted average discount rate for each period was 8.8%.

84

 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Financing Leases

In  April  2022,  we  entered  into  a  master  financing  lease  agreement  to  lease  various  research  and  development  and  information  technology 
equipment over a 48-month term. Future minimum payments under the financing lease and reconciliation to the financing lease liability as of December 31, 
2023 were as follows (in thousands): 

2024
2025
2026
2027
Less: Amount representing interest
Present value of lease payments
Less: Current portion of financing lease liability

Long-term financing lease liability, net of current portion

Financing Leases

634  
634  
676  
264  
(283 )
1,925  
(497 )
1,428  

  $

  $

As of December 31, 2023 and 2022, the weighted-average remaining lease term was 3.0 years and 3.7 years, respectively and the weighted-average 
discount rate was 8.3% and 7.9%, respectively. We provided a $2.7 million deposit to be held as collateral for the leased equipment, and this deposit is 
included in restricted cash as of December 31, 2023. 

7. Stockholders’ Equity 

Underwritten Follow-On Public Offerings

In  February  2023,  we  completed  an  underwritten  follow-on  public  offering  of  23,125,000  shares  of  our  common  stock,  including  the  partial 
exercise of the underwriters’ option to purchase additional shares, at a price to the public of $2.25 per share. The total net proceeds from the offering were 
approximately $48.1 million, after deducting underwriting discounts, commissions and offering expenses payable by us.

In September 2021, we completed an underwritten follow-on public offering of 10,781,250 shares of our common stock, including the full exercise 
of  the  underwriters’  option  to  purchase  additional  shares,  at  a  price  to  the  public  of  $8.00  per  share.  The  total  net  proceeds  from  the  offering  were 
approximately $80.6 million, after deducting underwriting discounts, commissions and offering expenses payable by us.

At-the-Market Offering Programs

In April 2022, we entered into an Open Market Sale AgreementSM with Jefferies implementing the Jefferies ATM Offering Program, pursuant to 
which we may offer and sell, from time to time and at our option, up to an aggregate of $65.0 million of shares of our common stock through Jefferies, 
acting  as  sales  agent.  Jefferies  is  entitled  to  a  fixed  commission  rate  of  up  to  3.0%  of  the  gross  sales  proceeds  of  shares  sold  under  the  Jefferies  ATM 
Offering Program. During the year ended December 31, 2022, we sold an aggregate of 1,421,627 shares of common stock at a weighted-average price of 
$3.09 per share for net proceeds of approximately $4.0 million under the Jefferies ATM Offering Program. During the year ended December 31, 2023, we 
sold an aggregate of 10,530,795 shares of common stock at a weighted-average price of $1.82 per share for net proceeds of approximately $18.4 million 
under the Jefferies ATM Offering Program.

In March 2021, we entered into a Capital on DemandTM Sales Agreement with JonesTrading Institutional Services LLC (JonesTrading) for an at-
the-market offering program (the JonesTrading ATM Offering Program), pursuant to which we were entitled to sell from time to time, at our option, up to 
an aggregate of $25.0 million of shares of our common stock through JonesTrading, as sales agent or principal. JonesTrading was entitled to a commission 
at a fixed rate of up to 3.0% of the gross proceeds. During 2021, we sold an aggregate of 986,267 shares of common stock at a weighted-average price of 
$4.75  per  share  for  net  proceeds  of  $4.4  million  under  the  JonesTrading  ATM  Offering  Program.  In  April  2022,  we  terminated  the  JonesTrading  ATM 
Offering Program. During 2022 and prior to termination in April 2022, we sold an aggregate of 260,455 shares of common stock at a weighted-average 
price of $6.07 per share for net proceeds of approximately $1.5 million under the JonesTrading ATM Offering Program. 

In May 2019, we entered into a sales agreement with H.C. Wainwright & Co., LLC (Wainwright) for an ATM Offering Program (the Wainwright 
ATM Offering Program) under which we could offer and sell shares of our common stock having an aggregate offering price of up to $10.0 million. In 
November 2020, we amended our sales agreement with Wainwright to increase the amount of the ATM Offering Program to $20.0 million. Wainwright was 
entitled  to  a  commission  at  a  fixed  commission  rate  equal  to  3%  of  the  gross  proceeds.  In  March  2021,  the  ATM  Offering  Program  with  Wainwright 
automatically terminated upon the issuance and sale of all of the shares having an aggregate offering price of $20.0 million. Prior to the termination of the
sales  agreement  with  Wainwright,  in  2021,  we  sold  an  aggregate  of  1,988,254  shares  of  common  stock  at  an  average  price  of  $4.99  per  share  for  net 
proceeds of $9.6 million.

85

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Purchase Agreement

In  September  2020,  we  entered  into  a  common  stock  purchase  agreement  (the  Purchase  Agreement)  with  Aspire  Capital  Fund,  LLC  (Aspire
Capital), which provided that, upon the terms and subject to the conditions and limitations set forth therein, Aspire Capital was committed to purchase up to 
an aggregate of $20.0 million of shares of our common stock at our request from time to time during the 30 month term of the Purchase Agreement. In 
2021, we sold an aggregate of 3,000,000 shares of common stock at a weighted-average price of $5.09 per share for net proceeds of $15.2 million under the 
Purchase Agreement. There were no issuances or sales under the Purchase Agreement during the years ended December 31, 2023 and December 31, 2022, 
respectively, and this agreement was terminated on March 11, 2023.

2014 Stock Plan

We adopted a stock option plan in 2007 (the 2007 Plan), which was subsequently amended, restated and renamed in July 2014 (the 2014 Plan) to 
provide  for  the  incentive  stock  options,  nonstatutory  stock  options,  stock  and  rights  to  purchase  restricted  stock  to  eligible  recipients.  Recipients  of 
incentive stock options are eligible to purchase shares of our common stock at an exercise price equal to no less than the estimated fair market value of 
such stock on the date of grant. The maximum term of options under the 2014 Plan is ten years. Options granted generally vest over four years. We ceased 
granting under the 2014 Plan after our IPO in May 2015. Shares underlying any awards under the 2014 Plan that are forfeited, canceled, reacquired by us 
prior to vesting, satisfied without the issuance of stock or otherwise terminated (other than by exercise) will be added to shares available for issuance under 
our 2015 Stock Option and Incentive Plan (the 2015 Stock Plan), which became effective in May 2015.

2015 Stock Plan

Total shares available for issuance under the 2015 Stock Plan as of December 31, 2023 were 3,964,555. Shares underlying any awards under the 
2015 Stock Plan that are forfeited, canceled, reacquired by us prior to vesting, satisfied without the issuance of stock or otherwise terminated (other than by 
exercise) will be added to shares available for issuance under the 2015 Stock Plan.

The maximum term of options granted under 2015 Stock Plan is ten years. For an initial grant to an employee, 25% of the options generally vest on 
the first anniversary of the original vesting date, with the balance vesting monthly over the remaining three years. For subsequent grants to an employee, 
the options generally vest monthly over a four-year term.

Inducement Plan

In  March  2022,  our  board  of  directors  approved  and  adopted  our  2022  Inducement  Plan  (our  Inducement  Plan).  Awards  granted  under  our 
Inducement Plan are in accordance with Nasdaq Listing Rule 5635(c)(4). A total of 300,000 shares of our common stock were initially reserved for the 
issuance under our Inducement Plan. 

The  maximum  term  of  options  granted  under  our  Inducement  Plan  is  ten years.  Each  option  vests  over  a  period  of  four years,  with  25%  of  the 
shares vesting on the one-year anniversary of the applicable vesting commencement date and the remaining 75% vesting in equal monthly installments over 
three years, thereafter, subject to continuous employment. 

During the year ended December 31, 2023, we granted nonstatutory stock options under our Inducement Plan to purchase an aggregate of 23,400 

shares of our common stock, with a weighted-average exercise price of $2.26 per share as inducement awards to new employees.

2015 Employee Stock Purchase Plan

As of December 31, 2023, total shares reserved for issuance under the 2015 ESPP were 727,311.

Stock-based Compensation

Stock Options

Stock option activity is summarized as follows: 

Outstanding as of December 31, 2022

Granted
Canceled/forfeited/expired

Outstanding as of December 31, 2023

Number of
Outstanding
Stock Options

Weighted-
Average
Exercise Price

Weighted
Remaining 

Aggregate 

Contractual Term    

Intrinsic Value  

2,956,170  
1,112,885  
(112,228 )
3,956,827  

  $
  $
  $

  $

86

7.45  
2.21  
6.42  

6.00  

7.94     $

—  

 
 
 
 
 
 
   
   
 
     
   
   
 
     
   
   
 
     
   
   
   
 
The assumptions used in the Black-Scholes option pricing model to determine the fair value of the employee stock option grants were as follows:

Expected term (in years)
Risk-free interest rate
Expected volatility
Expected dividend yield

2023

Years Ended December 31,
2022

5.51 – 6.09    
3.58% – 4.5%    
81.5% – 83.0%    

0.0 %   

5.98 – 6.08    
1.7% – 4.2%    
84.2% – 86.5%    
0.0 % 

2021

5.50 – 6.08  
0.6% – 1.3%  
86.3% – 104.8%  
0.0 %

The assumptions used in the Black-Scholes option pricing model to determine the fair value of the ESPP offering were as follows:

Expected term (in years)
Risk-free interest rate
Expected volatility
Expected dividend yield

2023

Years Ended December 31,
2022

2021

0.50    
4.54% – 5.38%    
40.9% – 58.5%    
0.0 % 

0.50      

0.06% – 4.54%    
51.9% – 95.9%    

0.0 %   

0.50  
0.04% – 0.12%  
89.7% – 108.12%  
0.0 %

Expected term.  The  expected  term  represents  the  period  of  time  that  options  are  expected  to  be  outstanding.  Because  we  do  not  have  sufficient 
history of exercise behavior, we determine the expected life assumption using the simplified method, which is an average of the contractual term of the 
option and its vesting period.

Risk-free  interest  rate.  We  base  the  risk-free  interest  rate  assumption  on  the  U.S.  Treasury’s  rates  for  U.S.  Treasury  zero-coupon  bonds  with 

maturities similar to those of the expected term of the award being valued.

Expected  volatility.  The  expected  volatility  assumption  is  based  on  our  historical  volatility  as  well  as  the  volatilities  of  a  peer  group  of  similar 

companies whose share prices are publicly available. The peer group was developed based on companies in the biotechnology industry. 

Expected dividend yield. We base the expected dividend yield assumption on the fact that we have never paid cash dividends and have no present 

intention to pay cash dividends.

Restricted Stock Units

Occasionally, we grant restricted stock units to employees. The fair value of restricted stock is determined by the closing price of our common stock 

reported on the Nasdaq Capital Market on the date of grant. Restricted stock unit activity is summarized as follows:

Balance as of December 31, 2022

Released

Balance as of December 31, 2023

Number of Outstanding
Restricted Stock Units

Weighted-Average
Grant Date
Fair Value

121,438    
(58,111 )  
63,327    

$
$

$

5.09  
4.69  

5.45  

The allocation of stock-based compensation for all options, including performance options with market condition and restricted stock units is as 

follows (in thousands): 

Research and development
General and administrative

Total stock-based compensation expense

2023

Years Ended December 31,
2022

2021

600     $

2,000    
2,600     $

528     $

1,626    
2,154     $

295  
1,319  
1,614  

  $

  $

87

 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The weighted-average grant date fair value per share of stock options granted by us, during the years ended December 31, 2023, 2022 and 2021 
was $1.59, $2.49 and $3.82, respectively. The total grant date fair value of restricted stock units granted by us during the years ended December 31, 2023, 
2022, and 2021 was approximately $0, $597,000 and $16,000, respectively. The aggregate intrinsic value of stock options exercised during the years ended 
December 31, 2023, 2022 and 2021 was approximately $0, $1,000 and $80,000, respectively. The fair value of restricted stock units released during the 
years  ended  December  31,  2023,  2022  and  2021  was  approximately  $123,875,  $6,000  and  $31,000,  respectively.  As  of  December  31,  2023,  total 
unrecognized  share-based  compensation  expense  related  to  unvested  stock  options  and  restricted  stock  units  was  approximately  $4.6  million  and  $0.2 
million, respectively. As of December 31, 2023, these unrecognized costs for options and restricted stock units are expected to be recognized ratably over a 
weighted-average period of approximately 2.3 years and 2.0 years, respectively.

Warrants

Warrants outstanding for the purchase of common stock as of December 31, 2023 were as follows:

Number
Outstanding

Exercise Price
Per Share

2,978  
2,886  
5,864    

  $
  $

50.37  
51.98  

Expiration
Date
June 2024
December 2024

Common Stock Reserved for Future Issuance

Common stock reserved for future issuance was as follows: 

Common stock warrants
Common stock options and restricted stock units
Shares available under the 2015 equity incentive plan
Shares available under the 2022 inducement plan
Shares available under the employee stock purchase plan

December 31, 2023

5,864  
4,020,154  
3,964,555  
95,367  
727,311  
8,813,251  

8. Income Tax

Pretax losses were generated by both domestic and foreign operations as follows (in thousands):

United States
Foreign

Worldwide pre-tax loss

Years Ended December 31,
2022

2023

2021

  $

  $

(49,967 )   $
(428 )    
(50,395 )   $

(45,086 )   $
(254 )    
(45,340 )   $

(33,316 )
(458 )
(33,774 )

For the years ended December 31, 2023, 2022, and 2021, we did not record a provision for income taxes due to a full valuation allowance against 
our deferred taxes. A reconciliation of the expected statutory federal income tax provision to the actual income tax provision is summarized as follows (in 
thousands):

Expected income taxes benefit at federal statutory rate
State income taxes, net of federal benefit
Permanent items and other
Stock compensation
Research credits
Unrecognized tax benefits
Foreign rate differential
Change in tax rate
Change in valuation allowance

Income tax (benefit) expense

88

Years Ended December 31,
2022

2023

2021

  $

  $

(10,583 )   $
(2,171 )  
172    
91    
(5,336 )  
5,209    
19    
(5 )  
12,604    

—     $

(9,521 )   $
(380 )    
438      
44      
(4,415 )    
2,454      
11      
34      
11,335      
—     $

(7,093 )
(2,313 )
592  
90  
(1,253 )
500  
21  
52  
9,404  
—  

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
   
 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Deferred  income  taxes  are  provided  for  temporary  differences  in  recognizing  certain  income  and  expense  items  for  financial  and  tax  reporting 
purposes. The deferred tax assets consisted primarily of the income tax benefits from net operating loss (NOL) carryforwards, research and development 
credits  and  capitalized  research  and  development  expenses,  along  with  other  accruals  and  reserves.  Valuation  allowances  of  $108.0 million  and  $95.5 
million as of December 31, 2023 and 2022, respectively, have been recorded to offset deferred tax assets as realization of such assets does not meet the 
more-likely-than-not threshold under ASC 740, Accounting for Income Taxes.

Significant components of our deferred tax assets are summarized as follows (in thousands):

Deferred tax assets:

Net operating loss carryforwards
Capitalized research and development expenses
Research credits and other state credits
Intangible assets
Reserve and accruals
Share-based compensation expense
Lease liability

Total tax assets

Valuation allowance
Total deferred tax assets
Deferred tax liabilities:

Right of use lease assets
Total deferred tax liabilities

Net deferred tax assets

December 31,

2023

2022

  $

  $

  $

60,090     $
25,922    
18,246    
1,093    
522    
1,821    
1,709    
109,403    
(107,989 )  

1,414     $

(1,414 )  
(1,414 )  

—     $

52,752  
22,576  
16,021  
1,278  
596  
1,628  
2,157  
97,008  
(95,484 )
1,524  

(1,524 )
(1,524 )
—  

The Tax Cuts and Jobs Act of 2017 requires taxpayers to capitalize and amortize research and development (R&D) expenditures under section 174 
for  tax  years  beginning  after  December  31,  2021.  This  rule  was  effective  at  the  beginning  of  2022  which  resulted  in  a  capitalization  of  R&D  costs  of 
approximately $44.2 million and $38.8 million during the years ended December 31, 2023 and 2022, respectively. We will amortize these costs for tax 
purposes over 5 years if the R&D was performed in the U.S. and over 15 years if the R&D was performed outside the U.S.

As  of  December  31,  2023,  we  had  federal  NOL  carryforwards  of  approximately  $257.4  million,  with  $144.9  million  of  NOLs  generated  after 
December 31, 2017 carrying forward indefinitely and $112.5 million of NOLs that will begin to expire in 2025. NOL carryforwards generated after January 
1,  2018  are  subject  to  an  80%  of  taxable  income  limitation  in  accordance  with  the  Tax  Cuts  and  Jobs  Act  of  2017.  We  had  state  net  operating  loss 
carryforwards of approximately $225.3 million, and foreign net operating loss carryforwards of $9.4 million. The state net operating losses began to expire 
in 2025. The foreign net operating losses carry over indefinitely. 

As of December 31, 2023, we had federal and state research and development credit carryforwards of approximately $9.3 million and $5.8 million, 
respectively, which begin to expire in 2026 for both federal and state purposes. We had $18.4 million of federal Orphan Drug Credits as of December 31, 
2023, which will begin to expire in 2035. 

  Utilization  of  the  domestic  NOL  and  research  and  development  credit  carryforwards  may  be  subject  to  a  substantial  annual  limitation  due  to 
ownership change limitations that may have occurred or that could occur in the future, as required by Sections 382 and 383 of the Internal Revenue Code of 
1986, as amended (the Code), as well as similar state and foreign provisions. These ownership changes may limit the amount of NOL and research and 
development credit carryforwards that can be utilized annually to offset future taxable income and tax, respectively. In general, an “ownership change” as 
defined by Section 382 of the Code results from a transaction or series of transactions over a three-year period resulting in an ownership change of more 
than 50 percentage points of the outstanding stock of a company by certain stockholders. Since the Company’s formation, we raised capital through the 
issuance of capital stock on several occasions which on its own or combined with the purchasing stockholders’ subsequent disposition of those shares, has 
resulted in such an ownership change, and could result in an ownership change in the future.

Upon  the  occurrence  of  an  ownership  change  under  Section  382  as  outlined  above,  utilization  of  the  NOL  and  research  and  development  credit 
carryforwards become subject to an annual limitation under Section 382 of the Code, which is determined by first multiplying the value of our stock at the 
time of the ownership change by the applicable long-term, tax-exempt rate, which could be subject to additional adjustments. Any limitation may result in 
expiration of a portion of our NOL or research and development credit carryforwards before utilization. Due to the existence of the valuation allowance, 
any impact to the NOL and research and development 

89

 
 
 
 
 
 
 
   
 
 
     
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
tax  credit  carryforwards  from  Section  382  analysis  will  be  offset  by  a  corresponding  adjustment  to  valuation  allowance,  resulting  in  no  tax  provision 
impact. 

We  recognize  a  tax  benefit  from  an  uncertain  tax  position  when  it  is  more  likely  than  not  that  the  position  will  be  sustained  upon  examination, 
including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more-likely-than-not 
recognition threshold to be recognized.

Our practice is to recognize interest and penalties related to income tax matters in income tax expense. We had no accrual for interest and penalties 
on our balance sheet and had not recognized interest or penalties in the consolidated statements of operations for the years ended December 31, 2023, 2022 
and 2021.

Due to the existence of the valuation allowance, future changes in unrecognized tax benefits will not impact our effective tax rate.

Uncertain tax positions are evaluated based upon the facts and circumstances that exist at each reporting period. Subsequent changes in judgment 
based upon new information may lead to changes in recognition, derecognition, and measurement. Adjustments may result, for example, upon resolution of 
an issue with the taxing authorities, or expiration of a statute of limitations barring an assessment for an issue.

The activity related to our unrecognized tax benefits is summarized as follows (in thousands):

Balance as of beginning of year
Increase (decrease) related to prior year tax positions
Increase related to current year tax positions

Balance as of end of year

2023

December 31,
2022

  $

  $

25,145     $
(483 )  
5,416    
30,078     $

22,232     $
(48 )    
2,961      
25,145     $

2021

21,707  
(9 )
534  
22,232  

We do not anticipate that the amount of unrecognized tax benefits as of December 31, 2023 will change within the next twelve months. 

We are subject to taxation in the United States, Hong Kong and state jurisdictions. Our tax years from inception are subject to examination by the 

United States, Hong Kong and various state authorities due to carry forward of unutilized NOLs and research and development credits. 

9. Employee Benefits 

401(k) Plan

We maintain a defined contribution 401(k) plan available to eligible employees. Employee contributions are voluntary and are determined on an 
individual  basis,  limited  to  the  maximum  amount  allowable  under  federal  tax  regulations.  In  April  2015,  our  board  of  directors  approved  a  policy, 
beginning on June 1, 2015, to match employee contributions equal to 50% of the participant’s contribution of up to a maximum of 6% of the participant’s 
annual salary. We made discretionary contributions totaling $0.2 million during each of the years ended December 31, 2023, 2022 and 2021.

10. Subsequent Events 

Sales of Common Stock through the Jefferies ATM Offering Program

From January 1, 2024 through March 13, 2024, we sold an aggregate of 4,441,509 shares of common stock at a weighted-average price of $1.75 

per share through the Jefferies ATM Offering Program for net proceeds of $7.6 million.

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

None

90

 
 
 
 
 
 
 
   
   
 
 
 
 
 
 
 
 
 
 
Item 9A. Controls and Procedures.

Evaluation of Disclosure Controls and Procedures 

We maintain disclosure controls and procedures, as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act that are designed to ensure 
that information required to be disclosed in our periodic and current reports that we file with the SEC is recorded, processed, summarized and reported 
within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including 
our Principal Executive Officer and Principal Financial Officer, as appropriate, to allow timely decisions regarding required disclosure. In designing and 
evaluating the disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, 
can  provide  only  reasonable  and  not  absolute  assurance  of  achieving  the  desired  control  objectives.  In  reaching  a  reasonable  level  of  assurance, 
management necessarily is required to apply its judgment in evaluating the cost-benefit relationship of possible controls and procedures. In addition, the 
design of any system of controls also is based in part upon certain assumptions about the likelihood of future events, and there can be no assurance that any 
design will succeed in achieving its stated goals under all potential future conditions; over time, control may become inadequate because of changes in 
conditions, or the degree of compliance with policies or procedures may deteriorate. Because of the inherent limitations in a cost-effective control system, 
misstatements due to error or fraud may occur and not be detected.

We carried out an evaluation, under the supervision and with the participation of our management, including our Principal Executive Officer and 
Principal Financial Officer, of the effectiveness of the design and operation of our disclosure controls and procedures, as defined in Rules 13a-15(e) and 
15d-15(e) under the Exchange Act. Based on this evaluation, our Principal Executive Officer and Principal Financial Officer concluded that our disclosure 
controls and procedures were effective at the reasonable assurance level as of December 31, 2023.

Management’s Report on Internal Control Over Financial Reporting 

Our management is responsible for establishing and maintaining adequate internal control over financial reporting as such term is defined in Rules 
13a-15(f) and 15d-15(f) of the Exchange Act. Internal control over financial reporting is a process designed by, or under the supervision of, our Principal 
Executive Officer and Principal Financial Officer, and effected by our board of directors, management and other personnel, to provide reasonable assurance 
regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with accounting principles 
generally accepted in the United States of America.

As of December 31, 2023, our management assessed the effectiveness of our internal control over financial reporting using the criteria set forth by 
the Committee of Sponsoring Organizations of the Treadway Commission in Internal Control – 2013 Integrated Framework (2013 Framework). Based on 
this assessment, our management concluded that our internal control over financial reporting was effective as of December 31, 2023.

This Annual Report does not include an attestation report of our registered public accounting firm under Section 404(b) of the Sarbanes-Oxley Act (15 

U.S.C. 7262(b)).

Changes in Internal Control Over Financial Reporting 

During the quarter ended December 31, 2023, there have been no changes in our internal control over financial reporting, as such term is defined in 
Rules 13a-15(f) and 15d-15(f) promulgated under the Exchange Act, that have materially affected, or are reasonably likely to materially affect, our internal
control over financial reporting.

Item 9B. Other Information. 

None.

Item 9C. Disclosure Regarding Foreign Jurisdictions that Prevent Inspections. 

Not applicable.

91

 
  
 
Item 10. Directors, Executive Officers and Corporate Governance. 

PART III

Except as set forth below, the information required by this item will be contained in our Definitive Proxy Statement to be filed with the SEC in 
connection with our 2024 Annual Meeting of Stockholders within 120 days after the end of the fiscal year ended December 31, 2023, under the sections 
headed “Proposal 1 – Election of Directors,” “Executive Officers” and “Delinquent Section 16(a) Reports,” if any, and is incorporated herein by reference.

We have adopted a written code of ethics for directors, officers (including our principal executive officer, principal financial officer and principal 
accounting officer or controller, or persons performing similar functions) and employees, known as the Code of Business Conduct and Ethics. The Code of 
Business  Conduct  and  Ethics  is  available  on  our  website  at  http://www.atyrpharma.com  under  the  Corporate  Governance  section  of  our  Investors  and 
Media page. If we make any amendments to, or grant any waivers from, the Code of Business Conduct and Ethics for any officer or director, we intend to 
satisfy our disclosure obligations, if any, with respect to such amendment or waiver by posting such information on our website or in a Current Report on 
Form  8-K.  Information  contained  in,  or  that  can  be  accessed  through,  our  website  is  not  incorporated  by  reference  herein,  and  you  should  not  consider 
information on our website to be part of this Annual Report.

Item 11. Executive Compensation. 

The information required by this item will be contained in our Definitive Proxy Statement under the section headed “Executive Officers,” and is 

incorporated herein by reference.

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

The information required by this item will be contained in our Definitive Proxy Statement, under the sections headed “Equity Compensation Plan 
Information  and  “Security  Ownership  of  Certain  Beneficial  Owners  and  Management  and  Related  Stockholder  Matters,”  and  is  incorporated  herein  by 
reference.

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

The information required by this item will be contained in our Definitive Proxy Statement, under the sections headed “Proposal 1 – Election of 

Directors” and “Certain Relationships and Related Transactions,” and is incorporated herein by reference.

Item 14. Principal Accountant Fees and Services.

The information required by this item will be contained in our Definitive Proxy Statement, under the section headed “Proposal 2 – Ratification of 

the Independent Registered Public Accounting Firm,” and is incorporated herein by reference.

PART IV

Item 15. Exhibit and Financial Statement Schedules.

(a) The following documents are filed as part of this Annual Report.

1. Index list to Financial Statements: 

Report of Independent Registered Public Accounting Firm (PCAOB ID: 42)
Consolidated Balance Sheets
Consolidated Statements of Operations
Consolidated Statements of Comprehensive Loss
Consolidated Statements of Stockholders’ Equity
Consolidated Statements of Cash Flows
Notes to Consolidated Financial Statements

2. Financial Statement Schedules.

  Page

69
71
72
73
74
75
76

Schedules have been omitted as all required information has been disclosed in the consolidated financial statements and related footnotes. 

3. Exhibits.

The Exhibits listed in the Exhibit Index are filed as a part of this Annual Report.

92

 
 
 
 
 
 
 
 
 
 
 
EXHIBIT INDEX

Incorporated by Reference

Exhibit
Number
3.1

Restated Certificate of Incorporation of the Registrant

Exhibit Title

3.2

3.3

3.4

3.5

3.6

Certificate  of  Amendment  to  Restated  Certificate  of  Incorporation  of  the 
Registrant

Certificate  of  Amendment  to  Restated  Certificate  of  Incorporation  of  the 
Registrant

Certificate  of  Amendment  to  Restated  Certificate  of  Incorporation  of  the 
Registrant

Certificate  of  Amendment  to  Restated  Certificate  of  Incorporation  of  the 
Registrant

Certificate of Amendment to Restated Certificate of Incorporation of the 
Registrant

3.7

Amended and Restated Bylaws of the Registrant

4.1

Specimen Common Stock Certificate

4.2

Warrant to Purchase Stock issued to Silicon Valley Bank on June 30, 2017

4.3

Warrant to Purchase Stock issued to Solar Capital Ltd on June 30, 2017

4.4

Warrant  to  Purchase  Stock  issued  to  Silicon  Valley  Bank  on  December  22, 
2017

Form
10-Q

8-K

10-Q

8-K

8-K

8-K

10-Q

S-1/A

10-Q

10-Q

10-K

4.5

Warrant to Purchase Stock issued to Solar Capital Ltd on December 22, 2017

10-K

—

S-1/A

8-K

S-1/A

S-1/A

4.6

Description of Common Stock of the Registrant 

10.1*

2014 Stock Plan and forms of agreements thereunder

10.2*

2015 Stock Option and Incentive Plan, as amended

10.3*

Forms of agreement under 2015 Stock Option and Incentive Plan

10.4

10.5

Form  of  Indemnification  Agreement  entered  into  between  the  Registrant  and 
its directors

Form  of  Indemnification  Agreement  entered  into  between  the  Registrant  and 
its officers

S-1/A

10.6*

Senior Executive Cash Incentive Bonus Plan

10.7*

Executive Severance and Change in Control Policy

10.8*

10.9*

Registrant’s Non-Qualified Stock Option Agreement for Non-Plan Inducement 
Grant

Employment  Agreement,  dated  November  1,  2017,  by  and  between  the 
Registrant and Sanjay S. Shukla, M.D., M.S.

8-K

10-K

10-Q

10-Q

10.10* Employment  Offer  Letter  by  and  between  the  Registrant  and  Jill  M. 

8-K

Broadfoot, dated July 16, 2018

93

File No.
001-
37378

001-
37378

001-
37378

001-
37378

001-
37378

001-
37378

333-
203272

333-
203272
001-
37378
001-
37378
001-
37378

001-
37378
—

333-
203272
001-
37378
333-
203272
333-
203272

333-
203272

001-
37378
001-
37378

001-
37378

001-
37378

001-
37378

Exhibit
3.1

Filing Date

November 14, 2022

3.1

3.3

3.1

3.1

3.1

3.6

4.1

4.7

4.8

4.8

4.9

—

10.1

10.1

10.2

10.12

10.13

10.1

10.16

10.1

10.4

10.1

June 28, 2019

May 12, 2020

May 4, 2021

April 29, 2022

May 19, 2023

November 14, 2022

April 27, 2015

August 14, 2017

August 14, 2017

March 20, 2018

March 20, 2018

Filed herewith

April 27, 2015

May 19, 2023

April 27, 2015

April 27, 2015

April 27, 2015

January 29, 2016

March 30, 2016

November 14, 2016

November 14, 2017

August 1, 2018

 
 
 
 
 
 
 
 
 
 
 
 
 
Exhibit
Number
10.11* Employment  Offer  Letter  by  and  between  the  Registrant  and  Ms.  Nancy 

Exhibit Title

Form
10-Q

Krueger, Esq., dated October 7, 2014

10.12† Collaboration  and  License  Agreement  by  and  between  the  Registrant  and 

S-1/A

Kyorin Pharmaceutical Co., Ltd., dated January 6, 2020

10.13*

First Amendment to Employment Agreement dated February 5, 2021, by and 
the between the Registrant and Sanjay S. Shukla, M.D., M.S.

10.14*

aTyr Pharma, Inc. 2015 Employee Stock Purchase Plan, as amended

10.15*

aTyr Pharma, Inc. 2022 Inducement Plan

10.16*

Forms of Grant Notice and Stock Option Agreement under aTyr Pharma, Inc. 
2022 Inducement Plan

10.17 Open  Market  Sale  Agreement

  dated  April  22,  2022  by  and  between  the 

SM

Registrant and Jefferies LLC

10.18

Lease  dated  May  12,  2022,  by  and  between  the  Registrant  and  San  Diego 
Creekside, LLC

10.19* Non-Employee Director Compensation Policy

21.1

Subsidiaries of the Registrant

23.1

24.1

97.1

31.1

31.2

32.1#

32.2#

Consent of Independent Registered Public Accounting Firm

Power of Attorney (included on signature page to this Annual Report)

aTyr Pharma, Inc. Incentive Compensation Recoupment Policy

Certification  of  Principal  Executive  Officer  required  by  Rule  13a-14(a)  or 
Rule 15d-14(a) of the Securities Exchange Act of 1934, as adopted pursuant to 
Section 302 of the Sarbanes-Oxley Act of 2002 

Certification of Principal Financial Officer required by Rule 13a-14(a) or Rule 
15d-14(a)  of  the  Securities  Exchange  Act  of  1934,  as  adopted  pursuant  to 
Section 302 of the Sarbanes-Oxley Act of 2002 

Certification  of  Principal  Executive  Officer  pursuant  to  18  U.S.C.  Section 
1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 

Certification  of  Principal  Financial  Officer  pursuant  to  18  U.S.C.  Section 
1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002 

101.INS Inline XBRL Instance Document

101.SCH Inline  XBRL  Taxonomy  Extension  Schema  With  Embedded  Linkbases 

Document

104

Cover  Page  Interactive  Data  File  (embedded  within  the  Inline  XBRL  and 
contained in Exhibits 101)

10-K

8-K

10-Q

10-Q

8-K

8-K

—

S-1

—

—

—

—

—

—

—

—

—

—

Incorporated by Reference

File No.
001-
37378

333-
235951

001-
37378

001-
37378

001-
37378

001-
37378

001-
37378

001-
37378

—

333-
203272

—

—

—

—

—

—

—

—

—

—

Exhibit
10.2

10.21

10.19

10.2

10.3

10.4

1.1

10.1

—

21.1

—

—

—

—

—

—

—

—

—

—

Filing Date

May 14, 2019

February 3, 2020

March 24, 2021

April 29, 2022

May 10, 2022

May 10, 2022

April 22, 2022

May 16, 2022

Filed herewith

April 6, 2015

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Filed herewith

Indicates a management contract or compensatory plan, contract or arrangement.

* 
†  Certain portions have been omitted because the Registrant has determined that the information is not material and is the type that the Registrant treats as private or  

# 

confidential.
The information in Exhibits 32.1 and 32.2 shall not be deemed “filed” for purposes of Section 18 of the Exchange Act, or otherwise subject to the liabilities of that 
section, nor shall it be deemed incorporated by reference in any filing under the Securities Act or the Exchange Act (including this Annual Report on Form 10-K), 
unless the Registrant specifically incorporates the foregoing information into those documents by reference.

Item 16. Form 10-K Summary.

None.

94

 
 
 
 
 
 
 
 
 
Pursuant to the requirements of Section 13 or 15(d) of 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

Date: March 14, 2024

aTyr Pharma, Inc.

By  /s/ Sanjay S. Shukla

Sanjay S. Shukla, M.D., M.S.
President, Chief Executive Officer and Director
(Principal Executive Officer)

POWER OF ATTORNEY

KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature appears below constitutes and appoints Sanjay S. Shukla, M.D., 
M.S. and Jill M. Broadfoot, jointly and severally, and each of them, his or her true and lawful attorneys-in-fact, each with full power of substitution, for him 
or  her  in  any  and  all  capacities,  to  sign  any  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, hereby ratifying and confirming all that each of said attorneys-in-fact or 
their substitute or substitutes may 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 below by the following persons on behalf of the 

registrant and in the capacities and on the dates indicated.

Signature

Title

/s/ Sanjay S. Shukla
Sanjay S. Shukla, M.D., M.S.

  President, Chief Executive Officer and Director 
   (Principal Executive Officer)

/s/ Jill M. Broadfoot
Jill M. Broadfoot

/s/ Timothy P. Coughlin
Timothy P. Coughlin

John K. Clarke

/s/ Jane A. Gross
Jane A. Gross, Ph.D.

/s/ Svetlana Lucas
Svetlana Lucas, Ph.D.

/s/ Paul Schimmel
Paul Schimmel, Ph.D.

/s/ Sara L. Zaknoen
Sara L. Zaknoen

  Chief Financial Officer
  (Principal Financial and Accounting Officer)

  Chairman of the Board 

  Director

  Director

  Director

  Director

  Director

95

Date

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

March 14, 2024

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
 
 
 
 
   
 
 
 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
 
 
 
   
   
 
   
   
 
DESCRIPTION OF COMMON STOCK

Exhibit 4.6

The following summary description of the common stock of aTyr Pharma, Inc. (we, our or us) is based on the provisions of our 
amended and restated certificate of incorporation, as well as our amended and restated bylaws, and the applicable provisions of the Delaware 
General  Corporation  Law  (DGCL).  This  information  is  qualified  entirely  by  reference  to  the  applicable  provisions  of  our  amended  and 
restated certificate of incorporation, amended and restated bylaws, and the DGCL. Our amended and restated certificate of incorporation and 
amended and restated bylaws have previously been filed as exhibits with the Securities and Exchange Commission (SEC). 

Common Stock 

The holders of our common stock are entitled to one vote for each share held on all matters submitted to a vote of the stockholders. 
The holders of our common stock do not have any cumulative voting rights. Holders of our common stock are entitled to receive ratably any 
dividends declared by our Board of Directors out of funds legally available for that purpose, subject to any preferential dividend rights of any 
outstanding  preferred  stock.  Our  common  stock  has  no  preemptive  rights,  conversion  rights  or  other  subscription  rights  or  redemption  or 
sinking fund provisions. 

In the event of our liquidation, dissolution or winding up, holders of our common stock will be entitled to share ratably in all assets 

remaining after payment of all debts and other liabilities and any liquidation preference of any outstanding preferred stock. 

Preferred Stock 

The rights of holders of our common stock described above, are and will be subject to, and may be adversely affected by, the rights of 
currently authorized and outstanding preferred stock and any preferred stock that we may designate and issue in the future. Our Board of 
Directors is authorized to issue up to 5,000,000  shares of undesignated preferred stock in one or more series without stockholder approval. 
Our Board of Directors may determine the rights, preferences, privileges and restrictions, including voting rights, dividend rights, conversion 
rights, redemption privileges and liquidation preferences, of each series of preferred stock, any or all of which may be more favorable than 
the rights of our common stock. The issuance of shares of undesignated preferred stock could decrease the amount of earnings and assets 
available  for  distribution  to  holders  of  shares  of  common  stock.  The  issuance  may  also  adversely  affect  the  rights  and  powers,  including 
voting  rights,  of  these  holders  and  may  have  the  effect  of  delaying,  deterring  or  preventing  a  change  in  control  of  us.  The  existence  of 
authorized but unissued shares of undesignated preferred stock may enable our Board of Directors to render more difficult or to discourage an
attempt  to  obtain  control  of  us  by  means  of  a  merger,  tender  offer,  proxy  contest  or  otherwise.  For  example,  if  in  the  due  exercise  of  its 
fiduciary obligations, our Board of Directors were to determine that a takeover proposal is not in the best interests of us or our stockholders, 
our Board of Directors could cause shares of preferred stock to be issued without stockholder approval in one or more private offerings or 
other transactions that might dilute the voting or other rights of the proposed acquirer, stockholder or stockholder group. 

Provisions  of  our  Amended  and  Restated  Certificate  of  Incorporation  and  Amended  and  Restated  Bylaws  and  Delaware  Anti-
Takeover Law 

Certain provisions of the DGCL and of our amended and restated certificate of incorporation and amended and restated bylaws could 
have the effect of delaying, deferring or discouraging another party from acquiring control of us. These provisions, which are summarized 
below, are expected to discourage 

1

 
 
 
 
 
 
 
 
 
 
 
 
certain  types  of  coercive  takeover  practices  and  inadequate  takeover  bids  and,  as  a  consequence,  they  might  also  inhibit  temporary 
fluctuations in the market price of our common stock that often result from actual or rumored hostile takeover attempts. These provisions are 
also designed in part to encourage anyone seeking to acquire control of us to first negotiate with our Board of Directors. These provisions 
might  also  have  the  effect  of  preventing  changes  in  our  management.  It  is  possible  that  these  provisions  could  make  it  more  difficult  to 
accomplish transactions that stockholders might otherwise deem to be in their best interests. However, we believe that the advantages gained 
by  protecting  our  ability  to  negotiate  with  any  unsolicited  and  potentially  unfriendly  acquirer  outweigh  the  disadvantages  of  discouraging 
such  proposals,  including  those  priced  above  the  then-current  market  value  of  our  common  stock,  because,  among  other  reasons,  the 
negotiation of such proposals could improve their terms.  

Board  Composition  and  Filling  Vacancies.  Our  amended  and  restated  certificate  of  incorporation  provides  for  the  division  of  our 
Board of Directors into three classes serving staggered three-year terms, with one class being elected each year. Our amended and restated 
certificate of incorporation also provides that directors may be removed only for cause and then only by the affirmative vote of the holders of 
75% or more of the shares then entitled to vote at an election of directors. Furthermore, any vacancy on our Board of Directors, however 
occurring, including a vacancy resulting from an increase in the size of our board, may only be filled by the affirmative vote of a majority of 
our directors then in office even if less than a quorum. 

No Written Consent of Stockholders. Our amended and restated certificate of incorporation provides that all stockholder actions are 
required to be taken by a vote of the stockholders at an annual or special meeting, and that stockholders may not take any action by written 
consent in lieu of a meeting. 

Meetings of Stockholders. Our amended and restated certificate of incorporation and amended and restated bylaws provide that only a 
majority of the members of our Board of Directors then in office may call special meetings of stockholders and only those matters set forth in 
the notice of the special meeting may be considered or acted upon at a special meeting of stockholders. Our amended and restated bylaws 
limit the business that may be conducted at an annual meeting of stockholders to those matters properly brought before the meeting. 

Advance  Notice  Requirements.  Our  amended  and  restated  bylaws  establish  advance  notice  procedures  with  regard  to  stockholder 
proposals relating to the nomination of candidates for election as directors or new business to be brought before meetings of our stockholders. 
These procedures provide that notice of stockholder proposals must be timely given in writing to our corporate secretary prior to the meeting 
at which the action is to be taken. 

Amendment to Amended and Restated Certificate of Incorporation and Amended and Restated Bylaws. As required by the DGCL, 
any amendment of our amended and restated certificate of incorporation must first be approved by a majority of our Board of Directors, and 
if  required  by  law  or  our  amended  and  restated  certificate  of  incorporation,  must  thereafter  be  approved  by  a  majority  of  the  outstanding 
shares entitled to vote on the amendment and a majority of the outstanding shares of each class entitled to vote thereon as a class, except that 
the  amendment  of  the  provisions  relating  to  stockholder  action,  board  composition,  limitation  of  liability  and  the  amendment  of  our 
certificate of incorporation must be approved by not less than 75% of the outstanding shares entitled to vote on the amendment, and not less 
than 75% of the outstanding shares of each class entitled to vote thereon as a class. Our amended and restated bylaws may be amended by the 
affirmative vote of a majority of the directors then in office, subject to any limitations set forth in the amended and restated bylaws; and may 
also  be  amended  by  the  affirmative  vote  of  at  least  75%  of  the  outstanding  shares  entitled  to  vote  on  the  amendment,  or,  if  our  Board  of 
Directors recommends that the stockholders approve the amendment, by the affirmative vote of the majority of the outstanding shares entitled 
to vote on the amendment, in each case voting together as a single class. 

2

 
 
 
 
 
 
 
Delaware  Anti-Takeover  Law.  We  are  subject  to  the  provisions  of  Section  203  of  the  DGCL.  In  general,  Section  203  prohibits  a 
publicly  held  Delaware  corporation  from  engaging  in  a  “business  combination”  with  an  “interested  stockholder”  for  a  three-year  period 
following  the  time  that  this  stockholder  becomes  an  interested  stockholder,  unless  the  business  combination  is  approved  in  a  prescribed 
manner. Under Section 203, a business combination between a corporation and an interested stockholder is prohibited unless it satisfies one 
of the following conditions: 

•

•

•

•

•

•

•

•

before the stockholder became interested, the board of directors approved either the business combination or the transaction which 
resulted in the stockholder becoming an interested stockholder;

upon  consummation  of  the  transaction  which  resulted  in  the  stockholder  becoming  an  interested  stockholder,  the  interested 
stockholder owned at least 85% of the voting stock of the corporation outstanding at the time the transaction commenced, excluding 
for  purposes  of  determining  the  voting  stock  outstanding,  shares  owned  by  persons  who  are  directors  and  also  officers,  and 
employee stock plans, in some instances; or

at  or  after  the  time  the  stockholder  became  interested,  the  business  combination  was  approved  by  the  board  of  directors  of  the 
corporation and authorized at an annual or special meeting of the stockholders by the affirmative vote of at least two-thirds of the 
outstanding voting stock which is not owned by the interested stockholder.

Section 203 defines a business combination to include: 

any merger or consolidation involving the corporation and the interested stockholder;

any  sale,  transfer,  lease,  pledge  or  other  disposition  involving  the  interested  stockholder  of  10%  or  more  of  the  assets  of  the 
corporation;

subject to exceptions, any transaction that results in the issuance or transfer by the corporation of any stock of the corporation to the 
interested stockholder;

subject to exceptions, any transaction involving the corporation that has the effect of increasing the proportionate share of the stock 
of any class or series of the corporation beneficially owned by the interested stockholder; and

the  receipt  by  the  interested  stockholder  of  the  benefit  of  any  loans,  advances,  guarantees,  pledges  or  other  financial  benefits 
provided by or through the corporation.

In general, Section 203 defines an interested stockholder as any entity or person beneficially owning or having owned in the past three 
years 15% or more of the outstanding voting stock of the corporation and any entity or person affiliated with or controlling or controlled by 
the entity or person. 

Exclusive  Jurisdiction  of  Certain  Actions.  Our  amended  and  restated  bylaws  provide  that,  unless  we  consent  in  writing  to  the 
selection of an alternative forum, the Court of Chancery of the State of Delaware shall be the sole and exclusive forum for (i) any derivative 
action  or  proceeding  brought  on  our  behalf,  (ii)  any  action  asserting  a  claim  of  breach  of  a  fiduciary  duty  owed  by  any  of  our  directors, 
officers or other employees to us or our stockholders, (iii) any action asserting a claim arising pursuant to any provision of the DGCL, our 
amended and restated certificate of incorporation or our amended and restated bylaws, or 

3

 
 
 
 
 
 
 
 
 
 
 
 
 
 
(iv)  any  action  asserting  a  claim  against  us  governed  by  the  internal  affairs  doctrine.  Although  we  believe  this  provision  benefits  us  by 
providing increased consistency in the application of Delaware law in the types of lawsuits to which it applies, the provision may have the 
effect of discouraging lawsuits against our directors and officers. This choice of forum provision does not apply to suits brought to enforce a 
duty or liability created by the Securities Act of 1933, as amended, or the Exchange Act, or any other claim for which the federal courts have 
exclusive jurisdiction.

This choice of forum provision may limit a stockholder’s ability to bring certain claims in a judicial forum that it finds favorable for 
disputes  with  us  or  any  of  our  directors,  officers,  other  employees  or  stockholders,  which  may  discourage  lawsuits  with  respect  to  such 
claims,  although  our  stockholders  will  not  be  deemed  to  have  waived  our  compliance  with  federal  securities  laws  and  the  rules  and 
regulations thereunder. If a court were to find this choice of forum provision to be inapplicable or unenforceable in an action, we may incur 
additional  costs  associated  with  resolving  such  action  in  other  jurisdictions,  which  could  adversely  affect  our  business  and  financial 
condition.

4

 
 
 
 
 
ATYR PHARMA, INC.

NON-EMPLOYEE DIRECTOR COMPENSATION POLICY

EXHIBIT 10.19

The  purpose  of  this  Non-Employee  Director  Compensation  Policy  (the  “Policy”)  of  aTyr  Pharma,  Inc.,  a  Delaware 
corporation (the “Company”), is to provide a total compensation package that enables the Company to attract and retain, on a 
long-term  basis,  high-caliber  directors  who  are  not  employees  or  officers  of  the  Company.    In  furtherance  of  this  purpose, 
effective  as  of  the  effective  time  of  the  registration  statement  for  the  Company’s  initial  firm  commitment  underwritten  public 
offering of equity securities (the “Effective Date”), all non-employee directors shall be paid compensation for services provided 
to the Company as set forth below:

Cash Retainers

Annual Retainer for Board Membership:  $40,000.00 for general availability and participation in meetings and conference calls 
of our Board of Directors (the “Board”).  No additional compensation for attending individual Board meetings.  

Additional Annual Retainers for Committee Membership and Service as Chairperson:

Board Chairperson: $35,000.00

Audit Committee Chairperson: 

$25,000.00

Audit Committee member:  $8,000.00

Compensation Committee Chairperson: 

$12,000.00

Compensation Committee member: 

$6,000.00

Nominating and Corporate Governance Committee Chairperson: 

$8,000.00

Nominating and Corporate Governance Committee member: 

$4,000.00

No additional compensation for attending individual committee meetings.

All cash retainers will be paid quarterly, in arrears, or upon the earlier resignation or removal of the non-employee director.  Cash
retainers owing to non-employee directors shall be annualized, meaning that with respect to non-employee directors who join the 
Board during the calendar year, and with respect to all non-employee directors for 2015, such amounts shall be pro-rated based 
on the number of calendar days served by such director. 

Equity Retainers

Initial  Equity  Grant:  One-time  option  grant  to  each  new  non-employee  director  upon  his/her  election  to  the  Board  after  the 
Effective Date to purchase 48,000 shares of the Company’s common 

 
 
stock, par value $0.001 per share (“Common Stock”).  Such initial equity grant shall vest in equal monthly installments during 
the 36 months following the grant date, subject to the director’s continued service on the Board.

On the date of each Annual Meeting of Stockholders:  Annual option grant to each non-employee director serving on the Board 
immediately  following  the  Company’s  annual  meeting  of  stockholders  to  purchase  24,000  shares  of  Common  Stock.    Such 
annual equity grant shall vest on the earlier of the one-year anniversary of the grant date and the Company’s next annual meeting 
of stockholders, subject to the director’s continued service on the Board.

Additional Equity Grants: In addition to the foregoing, non-employee directors may also be granted such additional stock options 
in such amounts and on such dates as the Board may recommend.

The  form  of  option  agreement  will  give  directors  up  to  one  year  following  cessation  of  service  as  a  director  to  exercise  the 
options (to the extent vested at the date of such cessation), provided that the director has not been removed for cause.

All of the foregoing option grants will have an exercise price equal to the fair market value of a share of Common Stock on the 
date of grant.

Expenses

The Company shall reimburse all reasonable out-of-pocket expenses incurred by non-employee directors in attending Board and 
committee meetings.

2

 
 
 
Exhibit 23.1

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We consent to the incorporation by reference in the following Registration Statements:

(1) Registration Statement (Form S-1 No. 333-248905) of aTyr Pharma, Inc.,

(2) Registration Statements (Form S-3 Nos. 333-220463, 333-263585 and 333-275455) of aTyr Pharma, Inc., 

(3) Registration Statement (Form S-8 No. 333-203955) pertaining to the ATYR PHARMA, INC. 2014 STOCK PLAN, 
ATYR PHARMA, INC. 2015 STOCK OPTION AND INCENTIVE PLAN, and the ATYR PHARMA, INC. 2015 
EMPLOYEE STOCK PURCHASE PLAN, 

(4) Registration Statements (Form S-8 Nos. 333-210543 and 333-223865) pertaining to the ATYR PHARMA, INC. 2015 

STOCK OPTION AND INCENTIVE PLAN, and the ATYR PHARMA, INC. 2015 EMPLOYEE STOCK PURCHASE 
PLAN, 

(5) Registration Statement (Form S-8 No. 333-216880) pertaining to the ATYR PHARMA, INC. 2015 STOCK OPTION 
AND INCENTIVE PLAN, ATYR PHARMA, INC. 2015 EMPLOYEE STOCK PURCHASE PLAN, and the NON-
QUALIFIED STOCK OPTION INDUCEMENT AWARD, 

(6) Registration Statement (Form S-8 No. 333-231594) pertaining to the ATYR PHARMA, INC. 2015 STOCK OPTION 
AND INCENTIVE PLAN, AS AMENDED, ATYR PHARMA, INC. 2015 EMPLOYEE STOCK PURCHASE PLAN, and 
the NON-QUALIFIED STOCK OPTION AGREEMENT FOR NON-PLAN INDUCEMENT GRANT, 

(7) Registration Statements (Form S-8 Nos. 333-248090, 333-256145 and 333-273876) pertaining to the ATYR 

PHARMA, INC. 2015 STOCK OPTION AND INCENTIVE PLAN, AS AMENDED, and

(8) Registration Statement (Form S-8 No. 333-264866) pertaining to the ATYR PHARMA, INC. 2015 STOCK OPTION 
AND INCENTIVE PLAN, AS AMENDED, ATYR PHARMA, INC. 2015 EMPLOYEE STOCK PURCHASE PLAN, AS 
AMENDED, ATYR PHARMA, INC NON-QUALIFIED STOCK OPTION AGREEMENT FOR NON-PLAN 
INDUCEMENT GRANTS, and the ATYR PHARMA, INC. 2022 INDUCEMENT PLAN;

of our report dated March 14, 2024, with respect to the consolidated financial statements of aTyr Pharma, Inc. included in this 
Annual Report (Form 10-K) of aTyr Pharma, Inc. for the year ended December 31, 2023.

/s/ Ernst & Young LLP

San Diego, California

March 14, 2024

 
 
 
 
 
 
 
 
 
CERTIFICATION PURSUANT TO 
RULE 13a-14(a) AND 15d-14(a) OF THE SECURITIES EXCHANGE ACT OF 1934, 
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.1

I, Sanjay S. Shukla, certify that:

1. I have reviewed this Annual Report on Form 10-K of aTyr Pharma, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 
financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for 
the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 

ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, 
particularly during the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes 
in accordance with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent 
fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, 
the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the 
registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably 

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control 

over financial reporting.

Date: March 14, 2024

/s/ Sanjay S. Shukla
Sanjay S. Shukla, M.D., M.S.
President, Chief Executive Officer and Director
(Principal Executive Officer)

 
 
 
 
 
CERTIFICATION PURSUANT TO 
RULE 13a-14(a) AND 15d-14(a) OF THE SECURITIES EXCHANGE ACT OF 1934, 
AS ADOPTED PURSUANT TO SECTION 302 OF THE SARBANES-OXLEY ACT OF 2002

Exhibit 31.2

I, Jill M. Broadfoot, certify that:

1. I have reviewed this Annual Report on Form 10-K of aTyr Pharma, Inc.;

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the 
statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the 
financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer(s) and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in 
Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for 
the registrant and have:

a) Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to 

ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, 
particularly during the period in which this report is being prepared;

b) Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our 
supervision, to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes 
in accordance with generally accepted accounting principles;

c) Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the 

effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

d) Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent 
fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, 
the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer(s) and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to 

the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

a) All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably 

likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

b) Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control 

over financial reporting.

Date: March 14, 2024

/s/ Jill M. Broadfoot
Jill M. Broadfoot
Chief Financial Officer
(Principal Financial and Accounting Officer)

 
 
 
 
 
CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT 
TO SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Annual Report on Form 10-K of aTyr Pharma, Inc. (the “Company”) for the year ended December 31, 2023, as filed with the 
Securities and Exchange Commission on the date hereof (the “Report”), I, Sanjay S. Shukla, President and Chief Executive Officer of the Company, certify, 
pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

1. The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended (the “Exchange 

Act”); and

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Exhibit 32.1

Date:  March 14, 2024

/s/ Sanjay S. Shukla

Sanjay S. Shukla, M.D., M.S.
President, Chief Executive Officer and Director
(Principal Executive Officer)

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. Section 1350, is not being filed for purposes of 
Section 18 of the Securities Exchange Act of 1934, and is not to be incorporated by reference into any filing of the Company, whether made before or after 
the date hereof, regardless of any general incorporation language in such filing. 

 
 
 
 
 
 
CERTIFICATION PURSUANT TO 18 U.S.C. SECTION 1350, AS ADOPTED PURSUANT TO
SECTION 906 OF THE SARBANES-OXLEY ACT OF 2002

In connection with the Annual Report on Form 10-K of aTyr Pharma, Inc. (the “Company”) for the year ended December 31, 2023, as filed with the 

Securities and Exchange Commission on the date hereof (the “Report”), I, Jill M. Broadfoot, Chief Financial Officer of the Company, certify, pursuant to 
18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that:

1. The Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934, as amended (the “Exchange 

Act”); and

2. The information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Exhibit 32.2

Date: March 14, 2024

/s/ Jill M. Broadfoot
Jill M. Broadfoot
Chief Financial Officer
(Principal Financial and Accounting Officer)

The foregoing certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. Section 1350, and is not being filed for 
purposes of Section 18 of the Securities Exchange Act of 1934, and is not to be incorporated by reference into any filing of the Company, whether made 
before or after the date hereof, regardless of any general incorporation language in such filing.

 
 
 
 
 
 
ATYR PHARMA, INC.

INCENTIVE COMPENSATION RECOUPMENT POLICY

EXHIBIT 97.1

1.

INTRODUCTION

The Board of Directors (the “Board”) of aTyr Pharma, Inc., a Delaware corporation (the “Company”), has determined that it is in 
the best interests of the Company and its stockholders to adopt this Incentive Compensation Recoupment Policy (this “Policy”) providing for 
the  Company’s  recoupment  of  Recoverable  Incentive  Compensation  that  is  received  by  Covered  Officers  of  the  Company  under  certain 
circumstances. Certain capitalized terms used in this Policy have the meanings given to such terms in Section 3 below.

This Policy is designed to comply with, and shall be interpreted to be consistent with, Section 10D of the Exchange Act, Rule 10D-

1 promulgated thereunder (“Rule 10D-1”) and Nasdaq Listing Rule 5608 (the “Listing Standards”).

2.

EFFECTIVE DATE

This  Policy  shall  apply  to  all  Incentive  Compensation  that  is  received  by  a  Covered  Officer  on  or  after  October  2,  2023  (the 
“Effective Date”). Incentive Compensation is deemed “received” in the Company’s fiscal period in which the Financial Reporting Measure 
specified in the Incentive Compensation award is attained, even if the payment or grant of such Incentive Compensation occurs after the end 
of that period.

3.

DEFINITIONS

“Accounting  Restatement”  means  an  accounting  restatement  that  the  Company  is  required  to  prepare  due  to  the  material 
noncompliance  of  the  Company  with  any  financial  reporting  requirement  under  the  securities  laws,  including  any  required  accounting 
restatement to correct an error in previously issued financial statements that is material to the previously issued financial statements, or that 
would result in a material misstatement if the error were corrected in the current period or left uncorrected in the current period.

“Accounting Restatement Date” means the earlier to occur of (a) the date that the Board, a committee of the Board authorized to 
take  such  action,  or  the  officer  or  officers  of  the  Company  authorized  to  take  such  action  if  Board  action  is  not  required,  concludes,  or 
reasonably should have concluded, that the Company is required to prepare an Accounting Restatement, or (b) the date that a court, regulator 
or other legally authorized body directs the Company to prepare an Accounting Restatement.

“Administrator” means the Compensation Committee or, in the absence of such committee, the Board.

“Code” means the U.S. Internal Revenue Code of 1986, as amended, and the regulations promulgated thereunder.

“Compensation Committee” means the Compensation Committee of the Board.

“Covered Officer” means each current and former Executive Officer.

“Exchange” means the Nasdaq Stock Market.

 
 
“Exchange Act” means the U.S. Securities Exchange Act of 1934, as amended.

“Executive Officer” means the Company’s president, principal financial officer, principal accounting officer (or if there is no such 
accounting officer, the controller), any vice-president of the Company in charge of a principal business unit, division, or function (such as 
sales, administration, or finance), any other officer who performs a policy-making function, or any other person who performs similar policy-
making  functions  for  the  Company.  Executive  officers  of  the  Company’s  parent(s)  or  subsidiaries  are  deemed  executive  officers  of  the 
Company if they perform such policy-making functions for the Company. Policy-making function is not intended to include policy-making 
functions  that  are  not  significant.  Identification  of  an  executive  officer  for  purposes  of  this  Policy  would  include  at  a  minimum  executive 
officers identified pursuant to Item 401(b) of Regulation S-K promulgated under the Exchange Act.

“Financial Reporting Measures” means measures that are determined and presented in accordance with the accounting principles 
used in preparing the Company’s financial statements, and any measures derived wholly or in part from such measures, including Company 
stock price and total stockholder return (“TSR”). A measure need not be presented in the Company’s financial statements or included in a 
filing with the SEC in order to be a Financial Reporting Measure.

“Incentive Compensation” means any compensation that is granted, earned or vested based wholly or in part upon the attainment of 

a Financial Reporting Measure. 

“Lookback Period” means the three completed fiscal years immediately preceding the Accounting Restatement Date, as well as any 
transition period (resulting from a change in the Company’s fiscal year) within or immediately following those three completed fiscal years 
(except that a transition period of at least nine months shall count as a completed fiscal year). Notwithstanding the foregoing, the Lookback 
Period shall not include fiscal years completed prior to the Effective Date. 

“Recoverable Incentive Compensation” means Incentive Compensation received by a Covered Officer during the Lookback Period 
that  exceeds  the  amount  of  Incentive  Compensation  that  would  have  been  received  had  such  amount  been  determined  based  on  the 
Accounting  Restatement,  computed  without  regard  to  any  taxes  paid  (i.e.,  on  a  gross  basis  without  regard  to  tax  withholdings  and  other 
deductions). For any compensation plans or programs that take into account Incentive Compensation, the amount of Recoverable Incentive 
Compensation  for  purposes  of  this  Policy  shall  include,  without  limitation,  the  amount  contributed  to  any  notional  account  based  on 
Recoverable  Incentive  Compensation  and  any  earnings  to  date  on  that  notional  amount.  For  any  Incentive  Compensation  that  is  based  on 
stock price or TSR, where the Recoverable Incentive Compensation is not subject to mathematical recalculation directly from the information 
in an Accounting Restatement, the Administrator will determine the amount of Recoverable Incentive Compensation based on a reasonable 
estimate of the effect of the Accounting Restatement on the stock price or TSR upon which the Incentive Compensation was received. The 
Company shall maintain documentation of the determination of that reasonable estimate and provide such documentation to the Exchange in 
accordance with the Listing Standards.

“SEC” means the U.S. Securities and Exchange Commission.

4.

RECOUPMENT

(a) Applicability  of  Policy.  This  Policy  applies  to  Incentive  Compensation  received  by  a  Covered  Officer  (i)  after  beginning 
services  as  an  Executive  Officer,  (ii)  who  served  as  an  Executive  Officer  at  any  time  during  the  performance  period  for  such  Incentive 
Compensation, (iii) while the Company had a class of securities listed on a national securities exchange or a national securities association, 
and (iv) 

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during the Lookback Period. 

(b) Recoupment Generally.  Pursuant to the provisions of this Policy, if there is an Accounting Restatement, the Company must 
reasonably promptly recoup the full amount of the Recoverable Incentive Compensation, unless the conditions of one or more subsections of 
Section 4(c) of this Policy are met and the Compensation Committee, or, if such committee does not consist solely of independent directors, a 
majority of the independent directors serving on the Board, has made a determination that recoupment would be impracticable. Recoupment 
is required regardless of whether the Covered Officer engaged in any misconduct and regardless of fault, and the Company’s obligation to 
recoup Recoverable Incentive Compensation is not dependent on whether or when any restated financial statements are filed.  

(c) Impracticability of Recovery. Recoupment may be determined to be impracticable if, and only if:

(i)

the direct expense paid to a third party to assist in enforcing this Policy would exceed the amount of the applicable 
Recoverable  Incentive  Compensation;  provided  that,  before  concluding  that  it  would  be  impracticable  to  recover  any  amount  of 
Recoverable Incentive Compensation based on expense of enforcement, the Company shall make a reasonable attempt to recover 
such Recoverable Incentive Compensation, document such reasonable attempt(s) to recover, and provide that documentation to the 
Exchange in accordance with the Listing Standards; or

(ii)

recoupment of the applicable Recoverable Incentive Compensation would likely cause an otherwise tax-qualified 
retirement plan, under which benefits are broadly available to employees of the Company, to fail to meet the requirements of Code 
Section 401(a)(13) or Code Section 411(a) and regulations thereunder.

(d) Sources of Recoupment.  To the extent permitted by applicable law, the Administrator shall, in its sole discretion, determine the 
timing and method for recouping Recoverable Incentive Compensation hereunder, provided that such recoupment is undertaken reasonably 
promptly.  The  Administrator  may,  in  its  discretion,  seek  recoupment  from  a  Covered  Officer  from  any  of  the  following  sources  or  a 
combination thereof, whether the applicable compensation was approved, awarded, granted, payable or paid to the Covered Officer prior to, 
on  or  after  the  Effective  Date:  (i)  direct  repayment  of  Recoverable  Incentive  Compensation  previously  paid  to  the  Covered  Officer;  (ii) 
cancelling prior cash or equity-based awards (whether vested or unvested and whether paid or unpaid); (iii) cancelling or offsetting against 
any planned future cash or equity-based awards; (iv) forfeiture of deferred compensation, subject to compliance with Code Section 409A; 
and (v) any other method authorized by applicable law or contract. Subject to compliance with any applicable law, the Administrator may 
effectuate  recoupment  under  this  Policy  from  any  amount  otherwise  payable  to  the  Covered  Officer,  including  amounts  payable  to  such 
individual under any otherwise applicable Company plan or program, e.g., base salary, bonuses or commissions and compensation previously 
deferred by the Covered Officer. The Administrator need not utilize the same method of recovery for all Covered Officers or with respect to 
all types of Recoverable Incentive Compensation.

(e) No Indemnification of Covered Officers. Notwithstanding any indemnification agreement, applicable insurance policy or any 
other agreement or provision of the Company’s certificate of incorporation or bylaws to the contrary, no Covered Officer shall be entitled to 
indemnification  or  advancement  of  expenses  in  connection  with  any  enforcement  of  this  Policy  by  the  Company,  including  paying  or 
reimbursing such Covered Officer for insurance premiums to cover potential obligations to the Company under this Policy.

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(f) Indemnification of Administrator. Any members of the Administrator, and any other members of the Board who assist in the 
administration of this Policy, shall not be personally liable for any action, determination or interpretation made with respect to this Policy and 
shall  be  indemnified  by  the  Company  to  the  fullest  extent  under  applicable  law  and  Company  policy  with  respect  to  any  such  action, 
determination or interpretation. The foregoing sentence shall not limit any other rights to indemnification of the members of the Board under 
applicable law or Company policy.

(g) No “Good Reason” for Covered Officers.  Any action by the Company to recoup or any recoupment of Recoverable Incentive 
Compensation under this Policy from a Covered Officer shall not be deemed (i) “good reason” for resignation or to serve as a basis for a 
claim of constructive termination under any benefits or compensation arrangement applicable to such Covered Officer, or (ii) to constitute a 
breach of a contract or other arrangement to which such Covered Officer is party.

5.

ADMINISTRATION

Except as specifically set forth herein, this Policy shall be administered by the Administrator. The Administrator shall have full and 
final authority to make any and all determinations required under this Policy.  Any determination by the Administrator with respect to this 
Policy shall be final, conclusive and binding on all interested parties and need not be uniform with respect to each individual covered by this 
Policy. In carrying out the administration of this Policy, the Administrator is authorized and directed to consult with the full Board or such 
other committees of the Board as may be necessary or appropriate as to matters within the scope of such other committee’s responsibility and 
authority. Subject to applicable law, the Administrator may authorize and empower any officer or employee of the Company to take any and 
all  actions  that  the  Administrator,  in  its  sole  discretion,  deems  necessary  or  appropriate  to  carry  out  the  purpose  and  intent  of  this  Policy 
(other than with respect to any recovery under this Policy involving such officer or employee).

6.

SEVERABILITY

If  any  provision  of  this  Policy  or  the  application  of  any  such  provision  to  a  Covered  Officer  shall  be  adjudicated  to  be  invalid, 
illegal or unenforceable in any respect, such invalidity, illegality or unenforceability shall not affect any other provisions of this Policy, and 
the invalid, illegal or unenforceable provisions shall be deemed amended to the minimum extent necessary to render any such provision or 
application enforceable.

7.

NO IMPAIRMENT OF OTHER REMEDIES

Nothing contained in this Policy, and no recoupment or recovery as contemplated herein, shall limit any claims, damages or other 
legal  remedies  the  Company  or  any  of  its  affiliates  may  have  against  a  Covered  Officer  arising  out  of  or  resulting  from  any  actions  or 
omissions by the Covered Officer. This Policy does not preclude the Company from taking any other action to enforce a Covered Officer’s 
obligations to the Company, including, without limitation, termination of employment and/or institution of civil proceedings. This Policy is in 
addition  to  the  requirements  of  Section  304  of  the  Sarbanes-Oxley  Act  of  2002  (“SOX 304”)  that  are  applicable  to  the  Company’s  Chief 
Executive  Officer  and  Chief  Financial  Officer  and  to  any  other  compensation  recoupment  policy  and/or  similar  provisions  in  any 
employment, equity plan, equity award, or other individual agreement, to which the Company is a party or which the Company has adopted 
or may adopt and maintain from time to time; provided, however, that compensation recouped pursuant to this Policy shall not be duplicative 
of  compensation  recouped  pursuant  to  SOX  304  or  any  such  compensation  recoupment  policy  and/or  similar  provisions  in  any  such 
employment, equity plan, equity award, or other individual agreement except as may be required by law.

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8.

AMENDMENT; TERMINATION

The Administrator may amend, terminate or replace this Policy or any portion of this Policy at any time and from time to time in its 

sole discretion. The Administrator shall amend this Policy as it deems necessary to comply with applicable law or any Listing Standard.

9.

SUCCESSORS

This  Policy  shall  be  binding  and  enforceable  against  all  Covered  Officers  and,  to  the  extent  required  by  Rule  10D-1  and/or  the 

applicable Listing Standards, their beneficiaries, heirs, executors, administrators or other legal representatives.

10. REQUIRED FILINGS

The Company shall make any disclosures and filings with respect to this Policy that are required by law, including as required by the 

SEC.

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ATYR PHARMA, INC. 

INCENTIVE COMPENSATION RECOUPMENT POLICY

FORM OF EXECUTIVE ACKNOWLEDGMENT

I, the undersigned, agree and acknowledge that I am bound by, and subject to, the aTyr Pharma, Inc. Incentive Compensation Recoupment 
Policy, as may be amended, restated, supplemented or otherwise modified from time to time (the “Policy”). In the event of any inconsistency 
between  the  Policy  and  the  terms  of  any  employment  agreement,  offer  letter  or  other  individual  agreement  with  aTyr  Pharma,  Inc.  (the 
“Company”) to which I am a party, or the terms of any compensation plan, program or agreement, whether or not written, under which any 
compensation has been granted, awarded, earned or paid to me, the terms of the Policy shall govern.

In the event that the Administrator (as defined in the Policy) determines that any compensation granted, awarded, earned or paid to me must 
be  forfeited  or  reimbursed  to  the  Company  pursuant  to  the  Policy,  I  will  promptly  take  any  action  necessary  to  effectuate  such  forfeiture 
and/or reimbursement. I further agree and acknowledge that I am not entitled to indemnification, and hereby waive any right to advancement 
of expenses, in connection with any enforcement of the Policy by the Company.

Agreed and Acknowledged:

Name:  

Title:  

Date: