EX-99.2 3 d821192dex992.htm EX-99.2 EX-99.2

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*Trial funded by Alzheimer’s Association, Gates Foundation, NIA with support by Coya Therapeutics Low Dose Interleukin-2 (LD IL-2) in Patients with Mild to Moderate Alzheimer’s Disease: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial An Investigator Initiated Trial Led by Dr. Alireza Faridar at Houston Methodist Hospital* Exhibit 99.2


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Cautionary Note of Forward-Looking Statements and Disclaimers This presentation and the accompanying oral presentation contain “forward-looking” statements that are based on our management’s beliefs and assumptions and on information currently available to management. Forward-looking statements include all statements other than statements of historical fact contained in this presentation, including information concerning our current and future financial performance, business plans and objectives, current and future clinical and preclinical development activities, timing and success of our ongoing and planned clinical trials and related data, the timing of announcements, updates and results of our clinical trials and related data, our ability to obtain and maintain regulatory approval, the potential therapeutic benefits and economic value of our product candidates, competitive position, industry environment and potential market opportunities. The words “believe,” “may,” “will,” “estimate,” “continue,” “anticipate,” “intend,” “expect,” and similar expressions are intended to identify forward-looking statements. Forward-looking statements are subject to known and unknown risks, uncertainties, assumptions and other factors including, but not limited to, those related to risks associated with the success, cost and timing of our product candidate development activities and ongoing and planned clinical trials; our plans to develop and commercialize targeted therapeutics; the progress of patient enrollment and dosing in our preclinical or clinical trials; the ability of our product candidates to achieve applicable endpoints in the clinical trials; the safety profile of our product candidates; the potential for data from our clinical trials to support a marketing application, as well as the timing of these events; our ability to obtain funding for our operations; development and commercialization of our product candidates; the timing of and our ability to obtain and maintain regulatory approvals; the rate and degree of market acceptance and clinical utility of our product candidates; the size and growth potential of the markets for our product candidates, and our ability to serve those markets; our commercialization, marketing and manufacturing capabilities and strategy; future agreements with third parties in connection with the commercialization of our product candidates; our expectations regarding our ability to obtain and maintain intellectual property protection; our dependence on third party manufacturers; the success of competing therapies or products that are or may become available; our ability to attract and retain key scientific or management personnel; our ability to identify additional product candidates with significant commercial potential consistent with our commercial objectives; and our estimates regarding expenses, future revenue, capital requirements and needs for additional financing. We have based these forward-looking statements largely on our current expectations and projections about future events and trends that we believe may affect our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. Moreover, we operate in a very competitive and rapidly changing environment, and new risks may emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed herein may not occur and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. 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LD IL-2 Meets Primary and Secondary Endpoints for Potential Treatment of Alzheimer’s Disease (AD) Cognition Stabilization (Exploratory Endpoint) Throughout Drug Treatment vs. Placebo: 2 out of 3 scales showed cognitive stabilization (ADAS-Cog14 and ADCS-CGIC)* for the Administering 5-day LD IL-2 cycles every 4 weeks (LD IL-2 q4wk) regimen. On day 148, ADAS-Cog14 scores indicated a slight improvement of -0.450 points from baseline for the LD IL-2 administered every four weeks, compared to a worsening of 4.480 points from baseline in the placebo group. The 4.93 point ∆ suggests a clinically meaningful treatment effect. For patients with mild AD, a change of +3 on the ADAS-Cog has been described as clinically meaningful to assess worsening (Muir et al., Alzheimer’s Dement. 2024;20:3352–3363). Safety (Primary Endpoint) and Regulatory T cell (Treg) Enhancement (Secondary Endpoint) Validated: Both dosing frequencies regimens of LD IL-2 studied (q4wk & q2wk) were safe and well-tolerated. Administering LD IL-2 q4wk effectively, sustainably, and significantly expanded Treg numbers and function vs. placebo without off-target effects on other peripheral lymphocytes. Significant Improvement in central nervous system (CNS) Amyloid Beta Pathology vs. Placebo: LD IL-2 q4wk significantly improved CSF Soluble Aβ42 levels (an index of amyloid pathology) vs. placebo. LD IL-2 among the first double-blind human trials to document subcutaneous Treg-enhancing therapy that modifies beta-amyloid. Cerebral Spinal Fluid (CSF) Biomarker and Cognitive Effects Were Associated with Boosted Treg Function and Numbers vs. Placebo *The Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) was developed in the 1980s to assess the level of cognitive dysfunction in Alzheimer’s disease. Clinical Global Impression of Change (CGIC) scales have been used as primary outcomes in phase 2 and 3 clinical trials for Alzheimer disease, mild cognitive impairment, and for cognitive enhancers. A CGIC score is intended to be used as a measure of clinically meaningful change, as distinct from an instrument’s ability to assess any change.


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LD IL-2 Study Results


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The trial was designed to detect significant differences in primary and secondary endpoints: LD IL-2 in Mild to Moderate Alzheimer’s Disease Overall Study Endpoints Primary Endpoint: Safety and Tolerability Secondary Endpoint: Treg Cell Populations No Serious Treatment Related Adverse Events Reported All Patients Completed Trial Drug was Well Tolerated Significant change in Treg population following two different dosing frequency regimens of LD IL-2 treatment, compared to placebo Exploratory Endpoints: CSF Biomarkers and Clinical Scales Clinical scales, including the ADAS-Cog Score Significant improvement in cerebrospinal (CSF) AD-related biomarker Soluble AB42 Assessment of peripheral/central inflammatory responses will be reported in the near future) : 21 week or 148 day on-treatment period


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LD IL-2 Overview of Study Design Randomized, Double-Blind, Placebo-Controlled Trial (N=38) Treatment Groups LD IL-2 Q4wk: (n=9) LD IL-2 Q2wk: (n=10) Placebo: (n=19)


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LD IL-2 Baseline Characteristics Consistent Across Groups  Characteristics of the participants at baseline Characteristics IL-2 q 4 wks (n=9) IL-2 q 2 wks (n=10) Placebo (n=19) Age-yr (MEAN±SD) 68.67±6.96 75.9±6.54 68.68±7.63 Sex- no. (%)       Female 6 (66%) 6 (60%) 11 (58%) Male 3 (33%) 4 (40%) 8 (42%) Race/ Ethnicity       White/non-Hispanic 9 (100%) 9 (90%) 16 (85%) White/ Hispanic 0 (0%) 1 (10%) 2 (10%) Black 0 (0%) 0 (0%) 1 (5%) Education High school 0 (0%) 2 (20%) 2 (11%) College 6 (66%) 6 (60%) 12 (63%) Post-grad 3 (33%) 2 (20%) 5 (26%) APOE ε4 status — no. (%) Noncarrier 3 (33%) 2(22%) 6 (32%) Carrier-Heterozygotes 4 (44%) 6 (66%) 5 (26%) Carrier-Homozygotes 2 (22%) 2 (22%) 8 (42%) Cognitive scales (MEAN±SD)       MMSE score 18.78±2.95 18.50±2.84 17.37±3.47 CDR-SB score 4.72±3.19 4.30±2.35 4.84±3.04 ADAS-Cog score 31.24±12.84 30.75±8.54 36.04±15.39


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All Patients Completed the Trial and the Drug Was Well-Tolerated No Serious Adverse Events Were Reported LD IL-2 Primary Endpoint Safety & Tolerability


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Secondary Endpoint Effective, Sustainable, and Significant Expansion of Treg Populations LD IL-2 q4wks resulted in effective and sustainable expansion of Tregs without off-target effects : 21 week or 148 day on-treatment period


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Exploratory Endpoints CSF Modifications of Disease Pathology LD IL-2 q4wks resulted in stabilized or improved key CSF biomarkers related to AD Treg Percentage : 21 week or 148 day on-treatment period


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Cognition Stabilized (LD IL2 Q4w) Exploratory Endpoint Clinical Scales Demonstrating Cognitive Stabilization LD IL-2 q4wks resulted in slight improvement of ADAS-Cog Score, with stabilization or decreased rate of decline in key clinical scales for AD : 21 week or 148 day on-treatment period Treg Percentage 0.45 Point Improvement (LD IL2 Q4w) ∆ of 4.93 points 27% Slower Decline (LD IL2 Q4w) No Change (LD IL2 Q4w)


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LD IL-2 Study in Support of COYA 301 & 302 COYA 301 and 302 are investigational products, not yet approved by the US Food and Drug Administration


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What’s Next? Reporting of additional data from the LD IL-2 study documenting the effect of LD IL-2 treatment vs. placebo on systemic and CNS inflammatory markers (including peripheral blood cytokines and chemokines, and PET brain imaging) Discussions ongoing to advance other combination strategies with COYA 301 (proprietary LD rh IL-2*) in larger cohorts of Alzheimer’s Disease patients, as well as for COYA 302 (proprietary LD rh IL-2 & CTLA-4 Ig Fusion Protein**) Planned clinical trials for COYA 302 in Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD) *LD rh IL-2: low-dose recombinant human IL-2 / **CTLA-4 Ig: cytotoxic T lymphocyte-associated antigen-4-Ig


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Pro-inflammatory Macrophages CD80 CTLA-4 Ig Dysfunctional Tregs FoxP3 FoxP3 LD IL-2 Tregs Increased Numbers and Suppressive Function Anti-Inflammatory Macrophages CD80 CTLA4-Ig LD IL-2 FoxP3 FoxP3 Functional Tregs + anti-inflammatory macrophages provide synergistic neuroprotection Adaptive and Innate Immune-Mediated Neuroinflammation + CTLA-4 Ig COYA 302 Proprietary LD rh IL-2 + CTLA-4 Ig LD IL-2 Trial Tested Single Component of COYA 302 (proprietary LD rh IL-2 + CTLA-4 Ig) LD rh IL-2


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COYA 302: Dual Immunomodulatory Activity Against Inflammation LD IL-2 COYA 302 (Proprietary LD rh IL-2 + CTLA-4 Ig) The synergistic dual mechanism of COYA 302 increases Treg numbers and function, and suppresses pro-inflammatory myeloid cells (monocytes, macrophages) (Blood Brain Barrier)


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Takeaways We believe LD IL-2 study results further validate the hypothesis that restoring the numbers and function of Tregs with systemic LD IL-2 alone targets neuroinflammation. We believe LD IL-2 study results indicate that systemically administered LD IL-2 directly mediates significant disease-modifying pathology in the CNS. LD IL-2 study results increase our confidence in COYA 302 (proprietary LD rh IL-2 + CTLA-4 Ig Fusion Protein) outcomes in neurodegenerative diseases (including ALS and FTD). LD IL-2 study results increase our confidence in the opportunity to combine COYA 301 (proprietary rh LD IL-2) with other complementary modalities targeting AD (Amyloid, Tau targeting agents). LD IL-2 study results increase our confidence to pursue additional value-creating strategic partnership opportunities for COYA 301.