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Kiora Pharmaceuticals IncHealth Care · Pharmaceutical Preparations · CIK 1372514 · FY ends Dec 31
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KPRX · 10-K · period ended 2020-12-31

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10-K

1

tm211090d1_10k.htm

FORM 10-K

UNITED

STATES

SECURITIES

AND EXCHANGE COMMISSION

Washington,

D.C. 20549

FORM 10-K

For

the fiscal year ended December 31, 2020

or

For

the transition period from to

Commission

File Number 001-36672

EYEGATE

PHARMACEUTICALS, INC.

(Exact

Name of Registrant as Specified in Its Charter)

271

Waverley Oaks Road

Suite

108

Waltham,

MA 02452

(Address

of Principal Executive Offices, including zip code)

(781)

788-8869

(Registrant’s

telephone number, including area code)

Securities

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

Title of each class Trading symbol(s) Name of each exchange on which registered

Common Stock, $0.01 par value EYEG The Nasdaq Capital Market

Securities

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

Indicate

by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. YES

☐ NO ☒

Indicate

by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the

Act. YES ☐ NO ☒

Indicate

by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the

Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required

to file such reports), and (2) has been subject to such filing requirements for the past 90 days. YES

☒ NO ☐

Indicate

by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant

to Rule 405 of Regulation S-T 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 ☐

Indicate

by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act). YES

☐ NO ☒

The

aggregate market value of the voting and non-voting common equity held by non-affiliates of the registrant, computed by reference

to the price at which the common equity was last sold, or the average bid and asked price of such common equity, as of June 30,

2020 was approximately $16,289,960. Shares of the registrant’s common stock held by each officer and director and each person

known to the registrant to own 10% or more of the outstanding voting power of the registrant have been excluded in that such persons

may be deemed affiliates. This determination of affiliate status is not a determination for other purposes.

At

March 23, 2021, there were 7,097,912 shares of the registrant’s common stock

issued and outstanding.

EYEGATE

PHARMACEUTICALS, INC.

Table

of Contents

ANNUAL

REPORT ON FORM 10-K

For

the Year Ended December 31, 2020

INDEX

Page

PART I

Item 1. Business 2

Item 1A. Risk Factors 24

Item 1B. Unresolved Staff Comments 52

Item 2. Properties 52

Item 3. Legal Proceedings 52

Item 4. Mine Safety Disclosures 52

PART II

Item 6. Selected Financial Data 53

Item 7A. Quantitative and Qualitative Disclosures About Market Risk 65

Item 8. Financial Statements and Supplementary Data 65

Item 9A. Controls and Procedures 66

Item 9B. Other Information 67

PART III

Item 10. Directors, Executive Officers and Corporate Governance 67

Item 11. Executive Compensation 67

Item 14. Principal Accounting Fees and Services 67

PART IV

Item 15. Exhibits, Financial Statement Schedules 68

Index to Consolidated Financial Statements F-1

Signatures 70

FORWARD-LOOKING

STATEMENTS

This

Annual Report on Form 10-K contains statements that are not statements of historical fact and are forward-looking statements within

the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act

of 1934, as amended (the “Exchange Act”), each as amended. The forward-looking statements are principally, but not

exclusively, contained in “Item 1: Business” and “Item 7: Management’s Discussion and Analysis of Financial

Condition and Results of Operations.” These statements involve known and unknown risks, uncertainties and other factors

that may cause our actual results, performance or achievements to be materially different from any future results, performance

or achievements expressed or implied by the forward-looking statements. Forward-looking statements include, but are not limited

to, statements about management’s confidence or expectations, and our plans, objectives, expectations and intentions that

are not historical facts. In some cases, you can identify forward-looking statements by terms such as “may,” “will,”

“should,” “could,” “would,” “expects,” “plans,” “anticipates,”

“believes,” “goals,” “sees,” “estimates,” “projects,” “predicts,”

“intends,” “think,” “potential,” “objectives,” “optimistic,” “strategy,”

and similar expressions intended to identify forward-looking statements. Forward looking statements include, but are not limited

to, statements about:

• the rate and degree of market acceptance of any of our product candidates;

• our expectations regarding competition;

• our anticipated growth strategies;

• our ability to attract or retain key personnel;

• our ability to establish and maintain development partnerships;

• our expectations regarding federal, state and foreign regulatory requirements;

• regulatory developments in the U.S. and foreign countries;

• the impact of the evolving COVID-19 pandemic and the global response thereto.

These

statements reflect our current views with respect to future events and are based on assumptions and subject to risks and uncertainties.

Given these uncertainties, you should not place undue reliance on these forward-looking statements. We discuss many of these risks

in detail under the heading “Item 1A. Risk Factors” beginning on page 24 of this Annual Report on Form 10-K. You should

carefully review all of these factors, as well as other risks described in our public filings, and you should be aware that there

may be other factors, including factors of which we are not currently aware, that could cause these differences. Also, these forward-looking

statements represent our estimates and assumptions only as of the date of this report. We may not update these forward-looking

statements, even though our situation may change in the future, unless we have obligations under the federal securities laws to

update and disclose material developments related to previously disclosed information.

EyeGate

Pharmaceuticals, Inc. is referred to herein as “we,” “our,” “us,” and “the Company.”

1

PART I

Item 1. Business.

Overview

We

are a clinical-stage pharmaceutical company developing and commercializing products for treating inflammatory and immune diseases

with a focus on the eye and nervous system.

In

the fourth quarter of 2020, we acquired Panoptes Ges.m.b.H. (“Panoptes”), transforming our pipeline with the addition

of PP-001, a clinical stage Dihydroorotate Dehydrogenase (“DHODH”) inhibitor. PP-001, is a next-generation, non-steroidal,

immuno-modulatory and small-molecule inhibitor of DHODH with what we believe to be best-in-class picomolar potency and a validated

immune modulating mechanism designed to overcome the off-target side effects and safety issues typically associated with DHODH

inhibitors. PP-001 has been developed in two clinical-stage ophthalmic formulations: PaniJect, an intravitreal injection for inflammatory

diseases of the eye including posterior uveitis, and PaniDrop, a novel nano carrier technology eye drop for ocular surface diseases

such as conjunctivitis, dry eye disease and others. Other administration routes are also in development and Investigational New

Drug (“IND”) enabling studies are underway for conditions outside the ocular space.

In

addition, we are developing Ocular Bandage Gel (“OBG”), a modified form of the natural polymer hyaluronic acid, designed

to protect the ocular surface to permit re-epithelialization of the cornea and improve ocular surface integrity. OBG, with unique

properties that help hydrate and protect the ocular surface, is in clinical evaluation for patients undergoing photorefractive

keratectomy (“PRK”) surgery for corneal wound repair after refractive surgery and patients with punctate epitheliopathies

(“PE”) as a result of dry eye. We are currently developing OBG as a device, but are evaluating the potential to reclassify

OBG as a drug. We attended a type-B meeting with the U.S. Food and Drug Administration’s (“FDA”) Center for

Drug Evaluation and Research (“CDER”) division during the first quarter of 2021 to discuss OBG’s path forward

as a drug and will continue to evaluate the feedback received as we move towards reaching a decision on the reclassification.

2

Our

Strategy

Our

goal is to continue developing products for treating disorders of the eye and to expand development to indications outside of

ophthalmology. The key elements of this strategy are to:

Market

Opportunity

PP-001

Overview

PP-001

is a third-generation small molecule DHODH inhibitor. DHODH is extensively exploited as potential drug targets for immunological

disorders, oncology, and infectious diseases. DHODH is a key enzyme in the de novo pyrimidine synthesis pathway. This enzyme is

located in the mitochondria and catalyzes the conversion of dihydroorotate (“DHO”) to orotate as the fourth step in

the de novo synthesis of pyrimidines that are ultimately used in the production of nucleotides.

Nucleotides

are required for cell growth and replication. Nucleotides are the activated precursors of nucleic acids and are necessary for

the replication of the genome and the transcription of the genetic information into RNA. Nucleotides also serve as an energy source

for a more select group of biological processes (ATP and GTP). They also play a role in the formation of glycogen, signal-transduction

pathways, and as components of co-enzymes (NAD and FAD). An ample supply of nucleotides in the cell is essential for all cellular

processes.

There

are two pathways for the biosynthesis of nucleotides: salvage and de novo. The main difference is where the nucleotide bases come

from. In the salvage pathway, the bases are recovered (salvaged) from RNA and DNA degradation. In the de novo pathway, the bases

are assembled from simple precursor molecules (made from scratch).

One

critical requirement of fast-growing or proliferating cells, such as the expansion of activated B and T-cells, cancer cells, and

pathogen infected host cells, is the requirement of an abundance of nucleotide bases. These metabolic activities will predominately

utilize the de novo pathway for nucleotide biosynthesis. A key advantage of DHODH inhibition is the selectivity towards metabolically

activated cells (with a high need for RNA and DNA production), which should mitigate any negative impact on normal cells. Depletion

of cellular pyrimidine pools through the selective inhibition of DHODH has been shown to be a successful approach for therapeutic

development.

Currently,

two first generation DHODH inhibitors have been approved in the U.S. and abroad and are marketed by Sanofi as leflunomide (Arava®)

and the active metabolite teriflunomide (Aubagio®). These oral tablets are approved for the treatment of rheumatoid and psoriatic

arthritis and multiple sclerosis (“MS”), respectively. Both diseases are autoimmune disorders. One potential explanation

for the therapeutic effects of Arava® in arthritis is the reduction in the numbers or reactivity of activated T-cells, which

are involved in the pathogenesis of arthritis. The generally accepted view of human MS pathogenesis implicates peripheral activation

of myelin-specific autoreactive T-cells that lead to inflammatory disease in the central nervous system (“CNS”). By

blocking the de novo pyrimidine synthesis pathway via DHODH inhibition, it is suggested that Aubagio® reduces T-cell proliferation

in the periphery. Arava® and Aubagio® are formulated as oral drugs and it is established that leflunomide will be metabolized

in the liver to the active metabolite teriflunomide. Hepatotoxicity was reported as a major side effect after oral administration,

possibly as a result of extensive liver metabolization. Moreover, it was shown that apart from DHOHD, a series of protein kinases

are inhibited by Arava® and Aubagio®.

3

PP-001

was identified as a promising novel third generation DHODH inhibitor, with a half-maximal inhibitory concentration IC50-value

of 0.3 nM. Based on internal work completed, we believe that this is more than 1,000-fold more potent than teriflunomide (IC50

DHODH 415 nM). Furthermore, PP-001 represses the expression of key pro-inflammatory cytokines such as IL-17, IFN-g,VEGF

and others, potentially as a consequence of inhibiting DHODH. IL-17 and IFN-g are the hallmark cytokines expressed by Th1 and

Th17 T-cells, respectively, and play a crucial role in initiating the inflammatory processes in several ocular diseases, including

non-noninfectious uveitis and dry eye disease. PP-001 is structurally and mechanistically different from Arava®. The IC50

of PP-001 on selected tyrosine kinases, such as PI3K, AKT and JAK, is more than 10,000-fold above the IC50 of

PP-001 for DHODH. In general, side effects are not expected and have not been observed to date in animal and human studies after

PP-001 administration.

Despite

the fact that the DHODH protein is ubiquitously expressed in most cells, malignant cells seem to be more metabolically dependent

on de novo pyrimidine production, forming the potential basis of a therapeutic window. Inhibiting DHODH alone or in combination

with standard-of-care has been shown to be very active in a series of different in vivo cancer models for AML, breast,

lung, and others.

Additionally,

viral replication and viral cell metabolism is dependent on a large nucleotide pool. Therefore, PP-001 demonstrates antiviral

efficacy, which is likely due to pyrimidine depletion caused by DHODH inhibition. The postulated DHODH directed mode of action

of PP-001 is underlined by reversibility of the antiviral activity by co-application of uridine or other pyrimidine precursors.

The

postulated mode of action of PP-001 is depicted below.

4

OBG

Overview

OBG

is a synthetic modified hyaluronic acid (“HA”) capable of coating the ocular surface and designed to resist degradation

under conditions present in the eye. This prolongs residence time of the bandage on the ocular surface, thereby addressing the

limitations of current non-cross-linked hyaluronic acid formulations. Additionally, cross-linking allows the product’s viscosity

to be modified to meet optimum ocular needs. The increased viscosity and non-covalent muco-adhesive interfacial forces improve

residence time in the tear film, thus providing a coating that aids and promotes re-epithelization of the ocular surface via physical

protection. If OBG is approved by the FDA, we expect that it will be the only prescription eye drop available in the U.S. based

on HA.

OBG

exhibits significant shear thinning properties. This feature allows the modified HA to act as a more concentrated, viscous barrier

at low shear rates in a resting tear film, but also as a lower resistance fluid (therefore thinned) during high shear events such

as blinking. This property enables better residence time and a more favorable ocular surface coating with less optical blur. We

have demonstrated in animal studies that OBG remains on the ocular surface for up to two hours and further demonstrated in a human

clinical study that OBG does not cause blurriness while on the ocular surface. This enhances ocular surface protection and patient

comfort.

OBG

has been shown to provide a mechanical barrier that aids in the management of corneal epithelial defects and re-epithelization

in both preclinical studies and in clinical ophthalmic veterinary use. As such, PRK surgery was chosen as the subject population

which is best suited to demonstrate this effect. PRK is an efficacious alternative to patients seeking surgical correction of

refractive errors who are not suitable candidates for laser in situ keratomileusis (“LASIK”) due to inadequate corneal

thickness, larger pupil size, history of keratoconjunctivitis sicca (“KCS”), or anterior basement membrane disease.

OBG has demonstrated statistical significance in a pivotal clinical study for its ability to accelerate wound healing against

the current standard-of-care, a bandage contact lens.

We

believe that OBG can be used for the management of a variety of large and small corneal epithelial defects including PE, which

also includes dry eye. PE is an early sign of epithelial compromise and is associated with a variety of pathologic ocular inflammatory

conditions including ocular causes, as well as systemic diseases. This ocular surface condition is common and may represent areas

of epithelial cell damage and loss and therefore stain positively with fluorescein. Causes can include dry eye, acute and chronic

bacterial and viral conjunctivitis, trauma, contact lens wear (tight lens syndrome), chemical irritation and burns, diabetic and

infectious neuropathies, chemotherapy, and corneal abrasion. OBG demonstrated its ability to reduce corneal staining, which occurs

when the compromised corneal epithelial defects heal, in a pilot study in dry eye patients when compared against Refresh®

lubricating eye drops.

5

Potential

Targeted Indications

We

are undergoing an assessment of routes of administration for PP-001 and which diseases to focus our resources on. This will include

a review of existing routes of delivery, specifically PaniJect and PaniDrop, and may determine that it is not in our best interest

to continue with both ophthalmic routes of administration.

PaniJect

PaniJect

is being considered for multiple diseases that affect the posterior region of the eye (the retina), including Non-Infectious Posterior

Uveitis (“NIPU”) and Diabetic Macular Edema (“DME”).

PaniDrop

PaniDrop

is being considered for multiple diseases that affect the ocular surface and anterior region of the eye, including Allergic Conjunctivitis,

Viral Conjunctivitis and Dry Eye Disease (“DED”).

OBG

Punctate

Epitheliopathies due to Dry Eye

PE

is an early sign of epithelial compromise and is associated with a variety of pathologic ocular inflammatory conditions including

ocular causes, as well as systemic diseases. This ocular surface condition is common and may represent areas of epithelial cell

damage and loss and therefore stain positively with fluorescein. PE is characterized by a breakdown or damage of the epithelium

of the cornea in a pinpoint pattern, which can be seen by examination with a slit lamp. Patients may present with non-specific

symptoms such as red eye, tearing, foreign body sensation, photophobia, and burning. Causes can include dry eye, acute and chronic

bacterial and viral conjunctivitis, trauma, contact lens wear (tight lens syndrome), chemical irritation and burns, diabetic and

infectious neuropathies, chemotherapy, and corneal abrasion.

Standard-of-care

treatments are aimed at attempting to heal these punctate micro defects and/or epitheliopathies and can include increasing humidity,

artificial tears, lubricants, and ointments and in severe cases can even utilize bandage contact lens, antibiotics and amniotic

membrane graphs, as well as treating the underlying cause with topical anti-inflammatory and T-cell modulators. Often these current

treatments fall short, as they are ineffective in protecting and enabling corneal re-epithelization. The artificial tears have

limited residence time and often do nothing to mechanically protect the cornea and create an environment that can manage corneal

re-epithelization. Furthermore, many of the ointments and gels, although offering better residence time, are thicker and blur

vision, thus making them less attractive for daytime use.

OBG,

once applied to the eye, forms a thin layer that protects and lubricates the eye to promote re-epithelization in the management

of a variety of large and small corneal epithelial defects including PE.

Corneal

Wound Repair

OBG

has been shown to provide a mechanical barrier that aids in the management of corneal epithelial defects and re-epithelization

in both preclinical studies and in clinical ophthalmic veterinary use. PRK surgery was chosen as the subject population that is

best suited to demonstrate this effect. PRK is an efficacious alternative to patients seeking surgical correction of refractive

errors who are not suitable candidates for LASIK due to inadequate corneal thickness, larger pupil size, history of KCS, or anterior

basement membrane disease. PRK involves controlled mechanical removal of corneal epithelium with subsequent excimer laser photoablation

of the underlying Bowman’s layer and anterior stroma, including the subepithelial nerve plexus.

The

military prefers PRK as a refractive surgery due to the stability of the PRK incision and the absence of risk for flap dislocation

during military active duty. Although this procedure yields desirable visual acuity results, common complications of the procedure

include post-operative pain secondary to the epithelial defects, risk of corneal infection prior to re-epithelization of the large

epithelial defect, corneal haze formation, decreased contrast sensitivity, and slower visual recovery.

OBG

provides a thin coating to the surface of the eye, serving as a protectant and lubricant to facilitate and manage corneal re-epithelization.

6

Clinical

Trial Results

PaniJect:

Non-Infectious Posterior Uveitis

Phase

1a/2b Safety Study

A

first in human clinical study to evaluate the safety of intravitreally applied PP-001 in patients with chronic, non-infectious

uveitis has been completed. PP-001 was applied as a single, intravitreal injection of 300, 600 and 1,200 ng per eye. The primary

objective of the study was to assess the safety and tolerability of ascending doses of PP-001 in patients. The secondary objectives

were to assess improvement of intraocular inflammation and to evaluate the pharmacokinetics of PP-001 in patients. For this study,

PP-001 was formulated as a sterile, aqueous solution for intravitreal injection.

The

purpose of this study was to assess safety, pharmacokinetic (“PK”), and efficacy data of 12 treated patients.

PP-001 showed an excellent safety profile and promising efficacy signals in improvement of inflammatory parameters and visual

acuity in uveitis patients.

Assessment

of the evaluated efficacy parameters shows a clear dose dependent treatment effect in improvement of visual acuity at day 14 post

dosing. Figure 1 shows the mean change in letters read from baseline for patients treated in cohorts 1, 2, and 3 (300, 600, and

1,200 ng per eye).

Figure

1: Improvement of visual acuity in cohorts 1, 2, and 3 at day 14 post dose

7

Analyzing

only the highest dose group (1200 ng per eye, cohort 3), a fundamental mean improvement of visual acuity is seen in the patients,

which started within the first week post injection (day 7) and lasted beyond the last study visit (day 28). Figure 2 shows the

mean letters read change from baseline to study days 7, 14, and 28 for patients treated in cohort 3.

Figure

2: Improvement of visual acuity in cohort 3 on study days 7, 14, and 28

Apart

from improved visual acuity, improvements in vitreous haze and reduction in macular edema were observed in the patients treated

with PP-001.

PaniDrop:

Healthy Volunteers

Phase

1 Safety Study:

A

Phase I safety and tolerability study of PP-001 eye drops in healthy adult volunteers was completed. In this study, healthy volunteers

were repeatedly treated with ascending doses of PP-001 and placebo eyedrops. 0.05 and 0.15% eyedrops showed excellent tolerability.

Both doses can be used for future studies in patients having an infection or inflammation on the ocular surface.

8

OBG:

Corneal Wound Repair

Pivotal

Study:

In

the fourth quarter of 2019, we reported positive topline results from our corneal wound repair pivotal clinical trial of OBG for

the corneal re-epithelialization in patients having undergone PRK surgery. The prospective, controlled study randomized 234 patients

undergoing bilateral PRK surgery and was designed to assess safety and efficacy by comparing EyeGate’s OBG to the current

standard- of-care, a bandage contact lens (“BCL”). The primary endpoint was the proportion of study eyes achieving

complete wound closure on Day 3 (and remaining closed). This assessment was evaluated by an independent masked reading center,

using digital slit-lamp photographs of fluorescein staining in all treated eyes, and a protocol-driven method to quantify the

outcomes.

The

enrolled patients were randomized into one of two study groups, with patients receiving the same treatment in both eyes:

• Arm 1 (n=117) was comprised of OBG QID for two weeks after surgery.

• Arm 2 (n=117) was comprised of BCL administered four times daily.

OBG

demonstrated superiority for the primary endpoint with a p-value of 0.0203. The statistical significance measurement was based

on the number of patients in each arm that achieved complete corneal defect closure three days post refractive surgery. At Day

3, 80.2% of eyes receiving the OBG treatment regimen were completely healed, compared with 67.0% for BCL. Additionally, at Day

2, the average wound size for all eyes treated with OBG was 3.61 mm2, compared to 6.66 mm2 for eyes treated

with BCL, which is 46% smaller than the standard-of-care.

9

OBG:

Punctate Epitheliopathies with a Focus on Dry Eye

Follow-On

Pilot Study:

In

the first quarter of 2020, we reported positive topline results from the follow-on clinical trial of OBG evaluating the potential

to help clinicians better manage patients with dry eye. This positive controlled, investigator masked study enrolled 20 patients,

or 40 eyes, with dry eye. This study confirmed the ability of OBG eye drops to demonstrate improvement of the ocular surface for

several important ophthalmic endpoints. OBG eye drops showed an improvement in central corneal region staining, high order ocular

aberrations (“HOA”) and best corrected visual acuity (“BCVA”), outperforming the positive control, Allergan’s

Refresh Plus Preservative-Free (“Refresh Plus”) lubricant eye drop.

Prior

to randomization there was a one-week run in period where all patients took Refresh eye drops only in both eyes. Patients with

a corneal staining score of ≥4, using the NEI scale, and a tear film break-up time (“TFBUT”) of ≤7 seconds at

Day 0, or at the end of the 7-day run-in period, then entered the 14-day treatment phase. To be randomized at Day 0, both eyes

had to qualify and have similar scores for staining and TFBUT. The patient acted as their own control and one eye was treated

with Refresh Plus eye drops and the other eye was treated with OBG eye drops.

The

twenty enrolled patients had one eye randomized to the OBG treatment group and the other eye randomized to the Refresh Plus treatment

group, for a total of 40 eyes randomized:

• Arm 1 (n=20 eyes) received OBG eye drops four times daily for four weeks.

The

primary endpoint was based on corneal epithelial healing as measured by fluorescein staining. Punctates are a sign of epithelial

compromise (corneal barrier disruption) which is characterized by a breakdown of the epithelium of the cornea and an increased

permeability to fluorescein dye. Thus, fluorescein dye is used to clinically evaluate the severity of corneal barrier disruption.

The National Eye Institutes (“NEI”) scale was used, which divides the cornea into five different regions. Each region

was scored on a scale from 0 to 3 for a total maximum score of 15 (a higher score represented a more severe disruption of the

corneal barrier). To be randomized into the study, each eye had to have a minimum total score of 4.

At

all visits, all corneal regions were assessed, but of particular interest due to vision quality involvement and corneal sensitivity,

is the central region of the cornea. All 20 patients randomized had a minimum scoring for the whole cornea (i.e., all 5 regions)

of at least 4 (maximum score = 15) in both eyes, and 16 of these patients also had a minimum score of at least 1 (maximum score

= 3) in the central region of the cornea in both eyes. OBG demonstrated a positive treatment effect as compared to Refresh Plus

at both Day 7 and Day 14. The overall improvement (i.e., reduction in staining) at Day 14 was approximately 27% from baseline

versus only approximately 9% for the positive control, Refresh Plus eye drops. OBG also showed improvement more quickly than Refresh

Plus eye drops with an approximately 10% reduction in staining versus an increase in staining of approximately 7% for the Refresh

Plus treatment group.

10

The

uniqueness of OBG is the combination of the high viscosity profile with a high shear rate. This means that with blinking or other

sources of shearing or energy that the viscosity of OBG temporarily drops. Thus, this clinical study was also used to confirm

that OBG does not result in blurriness of vision while on the eye. After all endpoint assessments were completed, one drop of

OBG and one drop of Refresh Plus was instilled onto each eye. This was completed in a masked fashion based on randomization of

each eye per drop. BCVA measurements were taken at 30 and 60 minutes to determine if instillation of either OBG or Refresh Plus

caused blurriness or a change in vision. At all assessment time points there was essentially no change in BCVA for OBG or Refresh

Plus, but OBG did perform better than Refresh Plus. At 30 minutes post instillation, OBG saw a negative change of 0.4% versus

a negative change of 1.0% for Refresh Plus. At 60 minutes, OBG had a positive effect of 0.2% versus a negative effect of 0.3%

for Refresh Plus.

11

Clinical

Development Plan

PP-001

The

clinical development plan for all PP-001 routes of delivery is under assessment.

OBG

We

are currently developing OBG as a device but are evaluating the potential to reclassify OBG as a drug. We attended a type-B meeting

with the FDA’s CDER division during the first quarter of 2021 to discuss OBG’s path forward as a drug and will continue

to evaluate the feedback received as we move towards reaching a decision on the reclassification.

12

Intellectual

Property and Proprietary Rights

Overview

We

are building an intellectual property portfolio for our PP-001 and modified HA platforms and any other product candidates that

we may develop, as well as other devices and product candidates for treatment of ocular indications in the U.S. and abroad. We

currently seek, and intend to continue to seek, patent protection in the U.S. and internationally for our product candidates,

methods of use, and processes for manufacture, and for other technologies, where appropriate. Our current policy is to actively

seek to protect our proprietary position by, among other things, filing patent applications in the U.S. and abroad relating to

proprietary technologies that are important to the development of our business. We also rely on, and will continue to rely on,

trade secrets, know-how, continuing technological innovation and in-licensing opportunities to develop and maintain our proprietary

position. We cannot be sure that patents will be granted with respect to any of our pending patent applications or with respect

to any patent applications filed by us in the future, nor can we be sure that any of our existing patents or any patents that

may be granted to us in the future will be commercially useful in protecting our technology.

Our

success will depend significantly on our ability to obtain and maintain patent and other proprietary protection for the technologies

that we consider important to our business, our ability to defend our patents, and our ability to preserve the confidentiality

of our trade secrets and operate our business without infringing the patents and proprietary rights of third parties.

Patent

Portfolio

Our

patent portfolio includes drug delivery device patents directed to PP-001 as composition-of-matter, formulations thereof and its

therapeutic uses in the treatment of viral and ocular disorders and diseases. In addition, further patent applications are directed

to the modified HA platform in combination with active therapeutics to treat ocular diseases. These issued patents will expire

between 2021 and 2036. 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. In the future, we intend to apply for restorations of patent term for some of our currently owned or licensed

patents to add patent life beyond their current expiration date, depending on the expected length of clinical trials and other

factors involved in the submission of the relevant new drug application or NDA. See “Government Regulation—Patent

Term Restoration and Marketing Exclusivity” below.

We

and our subsidiaries have been developing drug compositions and drug delivery systems for non-invasive treatment on the eye for

several years. These delivery systems include various patented and patent pending drug delivery devices, active therapeutics and

combination device/therapeutic to treat components of the eye, such as the cornea, sclera, and combinations thereof. These devices

and therapeutics have been further improved to provide better patient comfort levels, patient compliance and recovery times. We

hold 11 U.S. patents and 43 international patents.

13

License

Agreements

We

are a party to four license agreements as described below. These license agreements require us to pay or receive royalties or

fees to or from the licensor based on revenue or milestones related to the licensed technology.

On

July 2, 2013, we (through our Panoptes subsidiary) entered into a patent and know-how assignment agreement with 4SC Discovery

GmbH (“4SC”) transferring to us all patent rights and know-how to the compound PP-001. We are responsible for paying

royalties based on a specified percentage of net sales of PP-001.

On

July 2, 2013, we (through our Panoptes subsidiary) entered into an out-license agreement with 4SC Discovery GmbH (“4SC”)

granting 4SC the exclusive worldwide right to commercialize the compound PP-001 for rheumatoid arthritis and inflammatory bowel

disease, including Crohn’s Disease and Ulcerative Colitis. We are eligible to receive milestone payments totaling up to

155 million euros, upon and subject to the achievement of certain specified developmental and commercial milestones. In addition,

we are eligible to receive royalties based on a specified percentage of net sales of PP-001.

On

September 12, 2013, we (through our subsidiary, Jade Therapeutics, Inc.) entered into an agreement with BioTime, Inc. granting

to it the exclusive worldwide right to commercialize modified HA for ophthalmic treatments in humans. The agreement calls for

a license issue fee paid to BioTime of $50,000 and requires us to pay an annual fee of $30,000 and royalties to BioTime based

on revenue relating to any product incorporating the modified HA technology. The agreement expires when patent protection for

the modified HA technology lapses.

On

September 26, 2018, we entered into an intellectual property licensing agreement (the “SentrX Agreement”) with SentrX,

a veterinary medical device company that develops and manufactures veterinary wound care products. Under the SentrX Agreement,

we will in-license the rights to trade secrets and know-how related to the manufacturing of OBG. The SentrX Agreement will enable

us to pursue a different vendor with a larger capacity for manufacturing and an FDA-inspected facility for commercialization of

a product for human use. Under the SentrX Agreement, we paid SentrX an upfront payment of $250,000. SentrX is eligible to

receive milestone payments totaling up to $4.75 million, upon and subject to the achievement of certain specified developmental

and commercial milestones.

We

were previously a party to an exclusive worldwide license agreement with the University of Miami School of Medicine to license

technology relating to our former EyeGate® II Delivery System. This agreement, which was amended in December 2005, required

us to pay to the University of Miami an annual license fee of $12,500. This license also required payments to the University of

Miami upon our achievement of certain milestones. On July 9, 2020, we provided written notice to terminate this agreement effective

90 days from the written notice. Effective October 7, 2020, the Company’s agreement with the University of Miami School

of Medicine terminated.

We

were previously a party to an exclusive worldwide license agreement with the University of Utah Research Foundation to further

the commercial development of the NASH technology, together with alkylated HA. The agreement called for payments due to the University

of Utah, consisting of a license grant fee of $15,000 due within 30 days of signing, and minimum royalty payments, initially $5,000,

and escalating ratably up to $20,000 in 2021. On October 8, 2019, we provided written notice to terminate this agreement effective

120 days from the written notice. Effective February 5, 2020, the Company’s agreement with the University of Utah Research

Foundation terminated.

On

July 9, 2015, we entered into an exclusive worldwide licensing agreement with a subsidiary of Bausch Health Companies, Inc. (“BHC”),

through which we granted BHC exclusive, worldwide commercial and manufacturing rights to our EGP-437 Combination Product in the

field of anterior uveitis, as well as a right of last negotiation to license the EGP-437 Combination Product for other indications.

Under the agreement, BHC paid us an upfront payment of $1.0 million. We were eligible to receive milestone payments totaling up

to $32.5 million, upon and subject to the achievement of certain specified developmental and commercial milestones. In addition,

we were eligible to receive royalties based on a specified percentage of net sales of the EGP-437 Combination Product throughout

the world, subject to adjustment in certain circumstances. BHC voluntarily terminated this license agreement effective March 14,

2019.

On

February 21, 2017, we entered into an exclusive, worldwide licensing agreement with a subsidiary of BHC (the “New BHC Agreement”),

through which we granted BHC exclusive, worldwide commercial and manufacturing rights to our EGP-437 Combination Product in the

field of ocular iontophoretic treatment for post-operative ocular inflammation and pain in ocular surgery patients (the “New

Field”). Under the New BHC Agreement, BHC paid us an initial upfront payment of $4.0 million, and we were eligible to receive

milestone payments totaling up to approximately $99.0 million, upon and subject to the achievement of certain specified developmental

and commercial progress of the EGP-437 Combination Product for the New Field. In addition, we were eligible under the New BHC

Agreement to receive royalties based on a specified percentage of net sales of the EGP-437 Combination Product for the New Field

throughout the world, subject to adjustment in certain circumstances. BHC voluntarily terminated this license agreement effective

March 14, 2019.

14

Confidential

Information and Inventions Assignment Agreements

We

currently require and will continue to require each of our employees and consultants to execute confidentiality agreements upon

the commencement of such individual’s employment, consulting, or collaborative relationships with us. These agreements provide

that all confidential information developed or made known during the course of the relationship with us be kept confidential and

not disclosed to third parties except in specific circumstances.

In

the case of employees, the agreements provide that all inventions resulting from such individual’s work performed for us,

utilizing our property, or relating to our business and conceived or completed by the individual during employment shall be our

exclusive property to the extent permitted by applicable law. Our consulting agreements also provide for assignment to us of any

intellectual property resulting from services performed by a consultant for us.

Sales

and Marketing

If

PP-001 or OBG is approved by the FDA for commercial sale, we may enter into agreements with third parties to sell PP-001 or OBG,

or we may choose to market these directly to physicians in the United States or globally through our own sales and marketing force

and related internal commercialization infrastructure. If we market PP-001 or OBG directly, we will need to incur significant

additional expenses and commit significant additional management resources to establish and train an internal sales and marketing

force to market and sell PP-001 or OBG.

Manufacturing

We

currently do not have an in-house manufacturing capability for our products and as a result, we will depend heavily on third-party

contract manufacturers to produce and package our products. We currently do not have any contractual relationships with third-party

manufacturers. We intend to rely on third-party suppliers that we have used in the past for the manufacturing of various components

that comprise our PP-001, OBG and other contemplated clinical trials.

Competition

The

biotechnology and pharmaceutical industries are characterized by rapidly advancing technologies, intense competition, and a strong

emphasis on proprietary products. While we believe that our technologies, knowledge, experience, and scientific resources provide

us with competitive advantages, we face potential competition from many different sources, including major pharmaceutical, specialty

pharmaceutical and biotechnology companies, academic institutions and governmental agencies and public and private research institutions.

Any product candidates that we successfully develop and commercialize will compete with existing therapies and new therapies that

may become available in the future.

Our

potential competitors include large pharmaceutical and biotechnology companies, and specialty pharmaceutical and generic drug

companies. Many of our competitors have significantly greater financial resources and expertise in research and development, manufacturing,

preclinical testing, conducting clinical trials, obtaining regulatory approvals, and marketing approved products than we do. These

competitors also compete with us in recruiting and retaining qualified scientific and management personnel and establishing clinical

trial sites and patient registration for clinical trials, as well as in acquiring technologies complementary to, or necessary

for, our programs. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative

arrangements with large and established companies.

The

key competitive factors affecting the success of each of our product candidates, if approved for marketing, are likely to be its

efficacy, safety, method of administration, convenience, price, the level of generic competition and the availability of coverage

and adequate reimbursement from government and other third-party payors.

Source: SEC EDGAR (public domain) · 10-K for the period ended 2020-12-31, filed 2021-03-25 · accession 0001104659-21-041515

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