Item 2. Management’s Discussion and Analysis
ITEM
2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The
following discussion of our financial condition and results of operations should be read in conjunction with our unaudited condensed
consolidated financial statements and the related notes thereto and other financial information included elsewhere in this report. For
additional context with which to understand our financial condition and results of operations, see management’s discussion and
analysis of financial condition and results of operations included in our annual report on Form 10-K for the year ended December 31,
2025, filed with the SEC on March 10, 2026 (the “2025 Form 10-K”), our first quarter report on Form 10-Q filed with the SEC
on May 7, 2026, as well as the financial statements and related notes contained therein.
As
used in the discussion below, “we,” “our,” and “us” refers to Lipocine.
Forward-Looking
Statements
This
section and other parts of this report contain forward-looking statements within the meaning of Section 27A of the Securities Act of
1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange
Act”), that involve risks and uncertainties. Forward-looking statements provide current expectations of future events based on
certain assumptions and include any statement that does not directly relate to any historical or current fact. Forward-looking statements
may refer to such matters as products, product benefits, pre-clinical and clinical development timelines, clinical and regulatory expectations
and plans, expected responses to regulatory actions, anticipated financial performance, future revenues or earnings, business prospects,
projected ventures, new products and services, anticipated market performance, expected research and development and other expenses,
future expectations for liquidity and capital resources needs and similar matters. Such words as “may,” “will,”
“expect,” “continue,” “estimate,” “project,” and “intend” and similar terms
and expressions are intended to identify forward-looking statements. Forward-looking statements are not guarantees of future performance
and our actual results may differ significantly from the results discussed in the forward-looking statements. Factors that might cause
such differences include, but are not limited to, those discussed in Part I, Item 1A (Risk Factors) of our 2025 Form 10-K and Item 1A
of our Form 10-Q for the quarter ended March 31, 2026 filed with the SEC on May 7, 2026. Except as required by applicable law, we assume
no obligation to revise or update any forward-looking statements for any reason.
Overview
of Our Business
We
are a biopharmaceutical company focused on leveraging our proprietary technology platform to develop innovative products with effective
oral delivery of previously difficult to deliver molecules. Our proprietary delivery technologies are designed to improve patient compliance
and safety through orally available treatment options. Our primary development programs are based on oral delivery solutions for poorly
bioavailable drugs. We have a portfolio of differentiated innovative product candidates that target high unmet needs for neurological
and psychiatric CNS disorders, liver disease, and hormone supplementation.
On
January 12, 2024, we entered into the Verity License Agreement with Verity, pursuant to which we granted to Verity an exclusive, royalty-bearing,
sublicensable right and license to develop and commercialize the TLANDO product for TRT in the Licensed Verity Territory. Any FDA post-marketing
studies required will also be the responsibility of our licensee, Verity.
In
September 2024, we entered into the SPC License Agreement (the “SPC License Agreement”) for the development and commercialization
of TLANDO with SPC Korea Limited (“SPC”), pursuant to which the Company granted to SPC a non-transferable, exclusive, royalty-bearing
license to commercialize our TLANDO product for TRT in the SPC Territory. In October 2024, we entered into the Pharmalink Distribution
Agreement with Pharmalink, granting a non-transferable, exclusive, license to commercialize our TLANDO product specific to the Gulf Cooperation
Council (“GCC”), including Saudi Arabia, Kuwait, UAE, Qatar, Bahrain, and Oman (the “Pharmalink Territory”).
On July 8, 2026, Pharmalink received product marketing authorization approval for TESTYRA ® (TLANDO) in the UAE. In April
2025, we entered into a License and Supply Agreement (the “Aché License Agreement”) with Aché Laboratórios
Farmacêuticos S.A. (“Aché”) pursuant to which we granted to Aché an exclusive license to commercialize
our TLANDO product with respect to the Field, specific to Brazil (the “Aché Territory”). Under the agreement, we are
entitled to receive fees upon the achievement of certain regulatory milestones, royalties on net sales and will supply TLANDO to Aché
at an agreed transfer price.
Additional
clinical development pipeline candidates include: LPCN 1154 for postpartum depression (“PPD”); LPCN 2201 for major depressive
disorder (“MDD”); LPCN 2203 for essential tremor; LPCN 2101 for epilepsy; LPCN 2401 for improved body composition in obesity
management. In addition to our clinical development product candidates, we have assets for which we expect to seek partnerships to enable
further development including TLANDO for territories outside of the United States, South Korea, the GCC and Brazil, LPCN 1148 comprising
a novel prodrug of testosterone and testosterone laurate (“TL”) for the management of decompensated cirrhosis; and LPCN 1107,
potentially the first oral hydroxy progesterone caproate (“HPC”) product indicated for the prevention of recurrent preterm
birth (“PTB”), which has completed a dose finding clinical study in pregnant women and has been granted orphan drug designation
by the FDA.
21
The
following chart summarizes the status of our product candidate development programs:
Corporate
Strategy
Our
goal is to become a leading biopharmaceutical company focused on leveraging our proprietary drug delivery technology platform to develop
differentiated products through oral delivery of previously difficult to deliver molecules. The key components of our corporate strategy
are to:
Advance
LPCN 1154 and other CNS product candidates. We intend to focus on the development of endogenous neuroactive steroids (“NASs”)
which have broad applicability in treating various CNS conditions where we can leverage our technology platform to develop highly differentiated
oral therapeutics. Our priority is on the development of LPCN 1154, a potential fast-acting oral antidepressant for PPD with potential
for outpatient use.
Support
our Licensees, Verity, SPC, Pharmalink and Aché, in commercialization of our licensed oral TRT product. We believe the TRT
market needs a differentiated, convenient oral option. We have exclusively licensed rights to TLANDO to Verity for commercialization
of TLANDO in the U.S. and Canada (the “Licensed Verity Territory”), to SPC for commercialization in South Korea, to Pharmalink
in the GCC and to Aché in Brazil (together, the “Currently Licensed TLANDO Territories”). We plan to support Verity’s,
SPC’s, Pharmalink’s, and Aché’s efforts to effectively enable the availability of TLANDO to patients in a timely
manner, in addition to receiving milestone, royalty payments and/or payments for product sales associated with TLANDO commercialization
as agreed to in the Verity License Agreement, the SPC License Agreement, the Pharmalink Distribution Agreement and the Aché License
Agreement.
Develop
partnership(s) to continue the advancement of pipeline assets . We continuously strive to prioritize our resources in seeking partnerships
of our pipeline assets. We are currently exploring partnerships for our liver program LPCN 1148 for the management of decompensated cirrhosis
including prevention of the recurrence of overt hepatic encephalopathy (“OHE”); LPCN 2401 for improved body composition as
adjunct therapy to incretin mimetics use in obesity management; and LPCN 1107, our candidate for prevention of pre-term birth. We are
also exploring the possibility of licensing LPCN 1021 (known as TLANDO in the United States) to third parties outside of the Currently
Licensed TLANDO Territories although no additional licensing agreements have been entered into by the Company in any other territories.
22
Our
Pipeline Product Candidates
Our
pipeline of clinical development candidates includes LPCN 1154 for PPD, LPCN 2201 for MDD, LPCN 2203 for essential tremor, and LPCN 2101
for epilepsy. We will continue to explore other product development candidates targeting CNS indications with a significant unmet need.
We will also continue efforts to enter into partnership arrangements for the continued development and/or marketing of LPCN 1148, LPCN
2401, and LPCN 1107 as well as for the TRT assets outside of the Currently Licensed TLANDO Territories. We continually evaluate our pipeline
product candidates and all strategic options available to us, which options may include, but are not limited to, continued development
of LPCN 1154, including the potential submission of a validation study protocol, development of other product candidates, strategic transactions,
partnerships, and other opportunities.
Our
products are based on our proprietary drug delivery technology platform. TLANDO was approved by the FDA in March 2022. Our patented technology
is based on lipidic compositions which form an optimal dispersed phase in the gastrointestinal environment for improved absorption of
insoluble drugs. The drug loaded dispersed phase presents the solubilized drug efficiently at the absorption site (gastrointestinal tract
membrane) thus improving the absorption process and making the drug less dependent on physiological variables such as dilution, gastrointestinal
pH and food effects for absorption. Our formulation enables improved solubilization and higher drug-loading capacity, which can lead
to improved bioavailability, reduced dose, faster and more consistent absorption, reduced variability, reduced sensitivity to food effects,
improved patient compliance, and targeted lymphatic delivery where appropriate.
TRT
Franchise – TLANDO and LPCN 1111 (TLANDO XR)
TLANDO:
An Oral Product for Testosterone Replacement Therapy
Under
the Verity License Agreement, in January 2024, we granted to Verity an exclusive, royalty-bearing, sublicensable right and license to
develop and commercialize TLANDO, our product for TRT, in the U.S. and Canada effective February 1, 2024. TLANDO received FDA approval
on March 28, 2022. Any FDA requirement to conduct certain post-marketing studies will be the responsibility of Verity. In addition, in
September 2024, we granted SPC an exclusive, royalty-bearing license to commercialize TLANDO in South Korea, in October 2024 we granted
Pharmalink an exclusive license to commercialize TLANDO in the GCC countries and in April 2025, we granted Aché an exclusive license
to commercialize and supply TLANDO in Brazil.
Proof-of-concept
for TLANDO was initially established in 2006, and TLANDO was subsequently licensed in 2009 to Solvay Pharmaceuticals, Inc., which was
then acquired by Abbott Products, Inc. (“Abbott”). Following a portfolio review associated with the spin-off of AbbVie Inc.
by Abbott in 2011, we re-acquired the rights to TLANDO. All obligations under the prior license agreement have been completed except
that Lipocine will owe Abbott a perpetual 1% royalty on net sales of TLANDO. Such royalties are limited to $1 million in the first two
calendar years following product launch, after which period there is no cap on royalties and no maximum aggregate amount. If generic
versions of any such product are introduced, then royalties will be reduced by 50%. TLANDO was commercially launched on June 7, 2022.
During the three months ended June 30, 2026 and 2025, we incurred royalty expense of approximately $16,000 and $10,000, respectively,
and during the six months ended June 30, 2026 and 2025, we incurred royalty expense of approximately $26,000 and $18,000, respectively.
Since
TLANDO received full FDA approval, under the terms of the Verity License Agreement, Verity will need to assess the safety and effectiveness
of TLANDO in pediatric patients, as required by the Pediatric Research Equity Act. The FDA may also require certain post-marketing studies
to be conducted which will also be the responsibility of Verity. Similarly, SPC, Pharmalink, and Aché are responsible for obtaining
any regulatory/marketing approvals for TLANDO required for the SPC Territory, the Pharmalink Territory, and the Aché Territory,
respectively.
Upon
execution of the Verity License Agreement, Verity Pharma paid us an initial payment of $2.5 million which was received on signing of
the License Agreement and $5 million which was received on February 1, 2024. Verity Pharma also paid an additional payment of $2.5 million
to us on December 30, 2024, and we received an additional payment of $1 million on January 5, 2026. We are also eligible to receive milestone
payments of up to $259 million in the aggregate, depending on the achievement of certain sales milestones in a single calendar year and/or
development milestones with respect to products licensed by Verity Pharma under the Verity License Agreement. In addition, we will receive
tiered royalty payments at rates ranging from 12% up to 18% of net sales of all products licensed under the Verity License Agreement
in the Licensed Verity Territory.
SPC
paid us a non-refundable, non-creditable upfront fee in October 2024. We also received additional payments including a non-refundable
payment in consideration for TLANDO product inventory, and we are eligible to receive additional payments for marketing authorization
and sales milestones, and we will supply TLANDO to SPC and receive a supply price. In addition, we will receive royalties on net sales
in South Korea under the SPC License Agreement.
23
Upon
execution of the Pharmalink License Agreement, Pharmalink paid us a non-refundable, non-creditable upfront fee in October 2024. Under
the Pharmalink License Agreement, we could receive additional payments in regulatory authorization milestones and we will supply TLANDO
to Pharmalink at an agreed transfer price. On July 8, 2026, Pharmalink received product marketing authorization approval for TESTYRA ®
(TLANDO) in the UAE.
Upon
execution of the Aché License Agreement, Aché paid us a non-refundable, non-creditable upfront fee in May 2025. Under the
Aché License Agreement, we may receive additional payments in regulatory authorization milestones, royalties on net sales and
will supply TLANDO to Aché at an agreed transfer price.
We
are exploring the possibility of licensing LPCN 1021 (known as TLANDO in the United States) to third parties outside the Currently Licensed
TLANDO Territories, although no licensing agreement has been entered into by the Company in any other territories. If and when an agreement
is made with a partner, such arrangement would likely be partially contingent upon obtaining local regulatory approval. No assurance
can be given that any license agreement will be completed or, if an agreement is completed, that such an agreement would be on terms
favorable to us.
Oral
Programs for CNS Disorders
Some
preferred endogenous or naturally occurring NAS present in the central nervous system act as positive allosteric modulators (“PAMs”)
of the GABA A receptor, the major biological target of the inhibitory neurotransmitter γ-aminobutyric acid (“GABA A” ).
In
October 2024, we announced positive data from our qEEG study of our oral brexanolone with results indicating robust central nervous system
activity of oral brexanolone, with concentration- and time-dependent post-dose changes in qEEG as follows:
● Quantitative
Electroencephalogram (“qEEG”) in healthy subjects administered single doses of
oral brexanolone, a neuroactive steroid, confirmed GABA A modulation
● Rapid
and durable CNS target engagement confirms effective oral delivery of bioidentical brexanolone
● Promising
results support continued development of oral brexanolone for the treatment of neuropsychiatric
disorders
We
believe through utilization of our proprietary technology we may have the ability to enable effective oral delivery of endogenous GABA A
receptor PAMs which historically had been deemed to be not orally bioavailable. As a novel drug class, NASs have received considerable
attention because of their potential to treat various neuropsychiatric conditions including depression, movement disorders, epilepsy,
anxiety, and neurodegenerative diseases. We have conducted Phase 1 pharmacokinetic (“PK”) studies for each of our three lead
NAS candidates which have demonstrated promising PK results, safety, and tolerability and we are evaluating additional undisclosed CNS-focused
candidates.
LPCN
1154: Product Candidate for PPD
Our
most advanced NAS candidate is LPCN 1154, a rapid onset, oral formulation of the neuroactive steroid brexanolone which we are developing
for the treatment of PPD. We have completed clinical oral PK studies including a pilot food effect study and a pilot PK bridge study.
In addition, as a prelude to a LPCN 1154 Phase 3 study, a multi-dose study was done confirming the dosing regimen for the PK bridge study
using the scaled up “to be marketed” formulation required for New Drug Application (“NDA”) filing. In June 2024,
we announced results from a dosing regimen confirmation study which demonstrated LPCN 1154 meets bioequivalence with comparator, IV brexanolone,
meeting standard bioequivalence criteria and C trough criteria. LPCN 1154 treatment was well-tolerated with no sedation nor
somnolence events observed in the dosing regimen confirmation study.
After
completing PK studies and labeling studies such as a food effect study and PK profiling in women with PPD, we met with the FDA in the
first quarter of 2025. In the meeting, we were advised that the FDA believed, in addition to the previously completed PK dosing regimen
confirmation data, an efficacy and safety study of oral LPCN 1154 in the target population would be required for 505(b)(2) NDA submission.
Based on observed comparable exposure of LPCN 1154 and IV brexanolone in the dosing confirmation study, we have confirmed the target
dosing regimen and we completed a Phase 3 safety and efficacy study.
In
April 2026, we released the topline results from our Phase 3 placebo-controlled trial for post-partum depression. LPCN 1154 did not show
a statistically significant reduction from baseline in HAM-D total score compared to placebo at hour 60 in the full analysis set and
the primary endpoint was not met. The results showed LPCN 1154 to be well tolerated and the treatment demonstrated a favorable safety
profile to support outpatient administration without the need for healthcare provider monitoring. No treatment-related severe or serious
adverse events (SAEs) were reported; no cases of excessive sedation or loss of consciousness were observed; and no treatment-related
discontinuations were reported.
24
Although
the primary endpoint in the study was not met, in a post hoc analysis of the data, numerous anomalies at one high-enrolling site raise
substantive questions about the validity of the data from that site. First, about 40% of participants at this site had no evidence of
study drug in the blood sample collected at Hour 60. Second, there were high rates of ‘de novo PPD’ – that is, PPD
being the participants first and only psychiatric diagnosis as per the MINI. Finally, placebo participants at this site had extremely
high response and remission rates, about 90 and 80%, respectively. Together, these findings suggest that this site may have enrolled
a patient population distinct from the intended severe PPD population.
We
believe that exclusion of the data from this outlier site signals LPCN 1154’s treatment effect – a rapid, sustained, and
clinically meaningful improvement in depression symptoms - not only based on HAM-D findings, but also other scales such as MADRS and
HAM-A. The results with the exclusion of this outlier site align with the known antidepressant profile of IV brexanolone, indicating
a potential development path for LPCN 1154.
Timepoint
Overall
Population N=90
Nonoutlier
Sites N=60
Placebo-Adjusted
Difference
Statistical
Significance
Placebo-Adjusted
Difference
Statistical
Significance
Hour 12
-3.9
P < 0.01
-7.1
P < 0.0001
Hour 36
-1.7
NSS
-5.3
P < 0.05
Hour 60
-1.3
NSS
-5.8
P < 0.05
Day 7
-1.2
NSS
-5.2
P < 0.05
Day 30
-2.3
NSS
-6.6
P < 0.01
NSS,
not statistically significant. Data are least-squares means placebo-adjusted difference from mixed model for repeated measures using
all timepoints. P-values are nominal.
Based
on a post hoc analysis of exclusion of data from participants from the outlier site, we plan to further evaluate these findings. We
have requested a guidance meeting with the FDA and the meeting is scheduled for the third quarter of 2026. We have initiated a new placebo controlled clinical
trial for PPD to complement the existing LPCN 1154 clinical database, and to further characterize the efficacy and safety of LPCN
1154.
We
continue to explore business partnerships around the development, approval, and commercialization of Brlizio TM (LPCN
1154) for PPD . No assurance can be given that any partnering agreement
will be completed, or, if an agreement is completed, that such an agreement would be on terms favorable to us.
PPD
PPD,
a type of major depressive disorder with onset either during pregnancy or within four weeks of delivery, refers to depression persisting
up to 12 months after childbirth. PPD can be clinically segmented by the severity of symptoms and presence of a comorbidity, including
epilepsy. PPD is a life-threatening condition with few existing treatment options. Maternal depression and suicide can have far-reaching
consequences for child development, family functioning, and the nation’s economy. Approximately 600,000 women are affected by PPD
annually with approximately 240,000 women diagnosed with PPD, and approximately 144,000 of those diagnosed patients are treated with
prescription medication. We believe that PPD is a significant and growing market opportunity, and increased awareness of PPD and effective
therapies is expected to increase diagnosis for symptomatic women with PPD.
25
Disease
Overview - PPD
● PPD
is distinct from the “baby blues,” a condition that up to 70% of all new mothers
experience; “baby blues” tend to be short-lived emotional conditions that do
not interfere with daily activities.
● Symptoms
of PPD include hallmarks of major depression, including, but not limited to, sadness, depressed
mood, loss of interest, change in appetite, insomnia, sleeping too much, fatigue, difficulty
thinking/concentrating, excessive crying, fear of harming the baby/oneself, and/or thoughts
of death or suicide.
● During
pregnancy, levels of endogenous NASs increase considerably along with levels of progesterone;
however, they drop sharply postpartum. It has been hypothesized that the rapid perinatal
decrease in circulating levels of endogenous NASs may be involved in the development of PPD.
The first approved treatment option for PPD was an injectable containing endogenous NASs.
● Depression
may persist long after child delivery. Additionally, approximately 40% of women relapse in
subsequent pregnancies or on other occasions.
● Psychiatric
comorbidities are common in patients with epilepsy. Patients with epilepsy are at high risk
for major depressive disorders and PPD. Reported PPD rates are higher among women with epilepsy
than the general population.
Associated
Risk Factors
● Genetic:
family history and/or previous experience of depression or other mood disorders.
● Physiological:
rapid changes in sex hormones, stress hormones, and thyroid hormone levels during and after
delivery.
● Environmental:
stressful life events, changes in relationships at home and at work, and/or lack of familial
support.
Unmet
Medical Need
We
believe there is considerable unmet need within women with PPD due to a lack of convenient and fast-acting oral therapies with good tolerability,
especially with respect to CNS depressant effects. Selective Serotonin Reuptake Inhibitors (“SSRIs”) have been the traditional
first-line choice for women with severe PPD and require weeks for onset of efficacy; therefore, a need for an oral treatment option with
a faster onset of action, short treatment duration, and improved tolerability remains a significant unmet need in treating PPD, especially
in mothers with moderate to severe depression prone to harmful actions.
Injectable
brexanolone (Zulresso™, SAGE Therapeutics (“SAGE”)) became the first FDA-approved treatment for postpartum depression.
However, numerous factors limited the utilization of injectable brexanolone such as method of administration, cost, and safety concerns
and SAGE discontinued Zulresso in October 2024. In addition to Zulresso, SAGE received FDA approval for zuranolone (brand name ZURZUVAE™)
in August 2023 and ZURZUVAE was launched commercially in December 2023. Zuranolone, a synthetic neuroactive steroid derivative, is an
oral, once daily 14-day treatment for postpartum depression and is the first oral medication approved by the FDA for the treatment of
postpartum depression. Per label, besides a long terminal half-life of approximately 19.7 to 24.6 hours and dosage modifications needed
for concomitant use with CYP3A4 modulators, warnings and precautions include CNS depressant effects, impaired ability to drive or engage
in other potentially hazardous activities and embryo-fetal toxicity. In June 2025, Sage announced the acquisition of Sage by Supernus
Pharmaceuticals (“Supernus”) and Supernus’ intention to strengthen their leading presence in neuropsychiatric conditions
with Sage’s innovative commercial product, ZURZUVAE. The transaction closed in the third quarter of 2025.
We
believe LPCN 1154 has the potential to target the current unmet need for robust, rapid relief of PPD symptoms with 48-hour dosing duration
through a convenient oral therapy candidate comprising bioidentical NASs with improved tolerability. If approved, we believe that LPCN
1154 has the potential to be a first-line therapy option in treating PPD, providing the following advantages over current treatment options:
○ Rapid
relief : faster management of depression, reduced risk of suicidal thoughts and behaviors,
fewer hospitalizations, positive outcomes in terms of mother and family relationships, and
reduced financial burden.
○ Short
treatment duration : better compliance, scheduling flexibility (e.g. weekend) with minimal
family disruption, more amenable to discreet treatment, and a quick return to normal daily
activities, including breast feeding and driving.
○ Improved
tolerability : fewer CNS depressant effects, better adherence to dosing regimen, more
quality time for baby care, and less dependence on caregiver support.
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LPCN
2201: NAS for Major Depressive Disorders (“MDD”)
In the aforementioned post hoc analysis of the Phase 3 PPD study, oral brexanolone also demonstrated that participants with a history
of psychiatric conditions showed statistically significant and clinically meaningful reductions in HAM-D scores versus placebo, observed
as early as hour 12 and sustained through day 30. We
plan to advance LPCN 2201, a unique oral brexanolone formulation, as a novel, rapid relief oral treatment option for MDD with the goal
of improving outcomes without the limitations of existing therapies. LPCN 2201 is chemically identical to the endogenous human hormone
allopregnanolone, a positive allosteric modulator of y-aminobutyric acid (GABAA) receptor. Post planned clinical assessment of unique
formulations, we plan to submit a protocol for a Phase 2 study to the FDA, and we may initiate a study to evaluate LPCN 2201 for MDD,
subject to resource prioritization.
Disease
Overview – MDD
MDD
affects approximately 21 million adults in the U.S., representing 8.4% of the population. While 12.8 million individuals receive treatment,
nearly 3.8 million patients continue to struggle with treatment-resistant depression (“TRD”), a condition where symptoms
persist despite multiple antidepressant therapies. These patients experience persistent, debilitating symptoms, reduced quality of life,
higher comorbidities, and significant social and occupational impairment. In 2018, the total annual burden of medication-treated MDD
in the U.S. was approximately $92.7 billion, with $43.8 billion (47%) attributable to TRD.
Unmet
Medical Need
Current
treatment options for MDD pose significant challenges. Most available antidepressants such as SSRIs and SNRIs require 4-6 weeks to show
meaningful effects and often fail to deliver adequate relief. Additionally, SSRIs and SNRIs can lead to metabolic issues, sexual dysfunction,
and heightened risk of cerebrovascular events in vulnerable populations. Even newer therapies that can be used for fast depression symptom
relief like Spravato ® (esketamine) come with serious safety concerns, including black box warnings for sedation, dissociation,
cognitive impairment, and increased blood pressure. Beyond safety, access remains a major hurdle – esketamine, for example, requires
intranasal administration in a clinical setting under a restricted program, limiting convenience and scalability.
Patients
and providers urgently need a convenient, well-tolerated, at-home rapid relief option for MDD. Ideal solutions should offer ease of use
without monitoring requirements, enabling treatment in outpatient or home settings. Improved treatments should deliver effective antidepressant
action with high and sustained remission rates, while maintaining a wide therapeutic index for safety and tolerability. Improved compliance,
better management of comorbid conditions such as anxiety, and enhanced patient experience are critical to addressing the gaps left by
current therapies.
We
believe LPCN 2201 has the potential to be a convenient, fastest time to action treatment through its fast-acting mechanism promoting
acute stabilization of symptoms with the freedom of at home dosing while presenting no significant risk of adverse reactions from exposure
to bioidentical brexanolone. LPCN 2201 could be an appealing option for patients for whom rapid improvement is a priority for the treatment
of moderate or severe MDD with suicidal ideation.
LPCN
2203: Oral Product for Management of Essential Tremor
LPCN
2203 is an oral candidate for management of essential tremor (“ET”) comprising a bioidentical GABA A modulating
NAS. We have successfully completed oral pharmacokinetics with bioidentical GABA A and are planning to submit a protocol for
a proof-of-concept Phase 2 study for ET to the FDA.
Disease
Overview - Essential Tremor
Essential
Tremor is one of the most common movement disorders affecting an estimated 7 million in the U.S. For ET patients,
uncontrollable shaking of the hands, head, voice, or legs creates difficulty eating, dressing, writing, and pursuing other day-to-day
tasks. The etiology of ET is largely unknown, but reduced GABA A receptor levels and decreased GABAergic activity have been
observed in ET.
While
ET is often associated with aging populations, ET can begin much earlier in life, with a progressive disease course that can eventually
necessitate a care partner. Social anxiety and depressive symptoms can manifest in patients with ET as tremor severity increases and
may negatively impact a patient’s ability to work and engage in hobbies. In an interview study of ET patients and care partners,
the most common impacts on activities of daily living are pouring liquids and writing/typing (100%) and grooming/hygiene, drinking, dressing,
eating, and reading (80-85%). Overall, 90% of participants noted the emotional impact of ET, with 75% reporting tremor-related worry
or anxiety.
27
The
only FDA approved pharmacological treatment for ET was approved more than 50 years ago, and the majority of patients with ET experience
a sub-optimal response with standard-of-care treatments, highlighting numerous and compelling unmet needs in care such as daytime efficacy
and improved tolerability, a PRN (pro re nata) or “as needed” option, and a superior benefit-to-risk profile. (1) (2)
(1)
Ref: Louis ED, Ottman R. Tremor Other Kyperkinet Mov (NY). 2014;4:259.
(2)
Ref: Gerbasi et.al. Patient experiences in essential tremor: Mapping functional impacts to existing measures using qualitative research.
MDS 2023.
LPCN
2101: NAS for Epilepsy
We
are currently evaluating an additional NAS candidate, LPCN 2101, for Drug Resistant Epilepsy (“DRE”) and women with epilepsy
(“WWE”). We have completed pre-clinical and Phase 1 studies for LPCN 2101 which demonstrated promising PK results, safety
and tolerability. In July 2022 our IND was accepted by the FDA for LPCN 2101 for adults with epilepsy and we may initiate a Phase 2 proof-of-concept
study to evaluate the safety, tolerability, and efficacy of LPCN 2101, subject to resource prioritization.
Disease
Overview – Epilepsy
Epilepsy
is one of the most common neurological disorders characterized by recurrent, unprovoked seizures caused by abnormal electrical activity
in the brain. Epilepsy is defined by the 1) occurrence of at least two unprovoked seizures more than 24 hours apart, 2) occurrence of
one unprovoked seizure and a probability of further seizures occurring over the next 10 years, and/or 3) diagnosis of an epilepsy syndrome.
Patients with epilepsy have increased risk of mortality due to direct effects of seizures (e.g., status epilepticus, car accidents) and
indirect effects of seizures (e.g., suicide, cardiovascular effects).
Epilepsy
is a disorder of the brain that causes seizures, affecting the physical, mental, and social well-being of persons, and is associated
with a 2 to 3 times greater mortality rate compared with the general population. About 60-65% of epilepsy is idiopathic and about 30%
of patients are refractory or have “DRE” (i.e., epilepsy not well managed with currently available Anti-Seizure Medications
(“ASMs”)).
DRE:
There are about 2.9 million adults and 456,000 children with active epilepsy, meaning they are either taking medication or have had a
seizure in the past year, with approximately 150,000 new diagnoses annually. Approximately 38% of adults with epilepsy report having
a disability and the unemployment rate among adults with epilepsy is approximately 29%. DRE is a significant clinical challenge in epilepsy
care, with high social and occupational limitations. DRE affects 30-40% of epilepsy patients in the U.S. and DRE contributes heavily
to the $24.5 billion annual epilepsy-related healthcare costs and DRE poses significant treatment challenges due to limited success with
medications, and need for early identification.
Unmet
needs in DRE: Many patients with DRE cycle through multiple ASMs with limited success. Seizures may cause physical injuries,
and a minority may last long (status epilepticus) or recur in clusters and can be life-threatening. Rescue treatments (primarily benzodiazepines)
do not prevent future seizures, they only stop the current episode. DRE patients are at high risk of seizure recurrence within hours
or days after a cluster. There is a lack of post-rescue medications, especially for patients who experience recurrent seizure clusters
or drug-resistant epilepsy and a need to transition effectively to maintenance therapy and sustain seizure control after acute treatment
prevents status epilepticus and to prevent patients from requiring emergency room treatment for seizure management. There remains an
unmet need for medications with novel mechanism of action and minimal cognitive, mood, or systemic side effects, especially for patients
who experience recurrent seizure clusters or DRE.
WWE :
It is estimated that approximately 1,000,000 childbearing (“CB”) aged women suffer from active epilepsy in the U.S. Women
of CB age with epilepsy face many additional challenges due to hormonal influences on seizure activity and endocrine function throughout
the different phases of their reproductive cycles. Elevated estrogen or decreased progesterone levels can exacerbate seizure frequency.
Often, these women experience hormonal and endogenous NAS imbalances, coupled with fluctuations in the blood levels of ASMs that impact
control of seizures, efficacy of oral contraceptives, any coexisting anxiety and/or depression and any associated sleep impairment. Epileptic
patients are 5-20 times more likely to develop depression.
Women
with epilepsy were once counseled to avoid pregnancy, but epilepsy is no longer considered a contraindication to pregnancy. Caregivers
for WWE in the preconception phase either intending to start a family (planning pregnancy) or using contraception to prevent an unplanned
pregnancy face significant challenges to balance seizure control efficacy with the selection and dosage of ASMs and ASM-related risks
such as, among other risks, fetal-neonatal toxicity, contraception failure, and psychiatric side effects.
28
Several
ASMs are known to have teratogenic effects on the developing fetus (converging evidence from registry studies indicates that teratogenic
risks are highest with valproate, followed by carbamazepine and topiramate). Other commonly prescribed ASMs, including older generation
agents, such as phenobarbital and phenytoin, have been associated with higher risks as compared with lamotrigine, levetiracetam, clonazepam
and gabapentin (Vajda et al., 2014; Voinescu and Pennell, 2015). Moreover, risks associated with ASMs are considerable early in pregnancy;
therefore, it is necessary that WWE of CB age undergo counseling, monitoring, and adjustment to the most appropriate ASM prior to becoming
pregnant. It is preferable that WWE of CB age discuss seizure control with their doctor for at least 6 months before conception and,
if possible, cease ASM therapy or use the lowest effective dose of a single anticonvulsant according to the type of epilepsy and the
fetal toxicity of the ASM. Anxiety, depression, lack of adherence to ASM, and/or contraception failure may be experienced by women who
are worried about unplanned pregnancy or are late in confirming pregnancy, planned or unplanned. ASMs can reduce the efficacy of oral
contraceptives, compounding this problem.
Complex,
multidirectional interactions between female hormones, seizures, and ASMs exist. Most hormones act as NASs and can thus modulate brain
excitability. Any changes in endogenous or exogenous hormone levels can affect the occurrence of seizures, either directly or via PK
interactions that modify the plasma levels of ASMs (Harden, 2008). The PK interactions between oral contraceptives and ASMs are bidirectional
(Johnston and Crawford, 2014). The efficacy of hormonal contraception may be diminished for women taking CYP-P450 enzyme inducing ASMs.
Epilepsy is not a medical condition in which contraceptives are contraindicated. Contraceptive failure, possibly related to ASMs, may
be responsible for up to 1 in 4 unplanned pregnancies in WWE (~12.5% of all WWE pregnancies), versus a rate of 1% in healthy women.
Unmet
need to treat WWE in CB age
Approximately
30% of patients with epilepsy cannot efficiently control their condition with available ASMs, making consideration of newer pharmacological
treatment development options important, and managing uncontrolled seizures in WWE of CB age is the primary aim during preconception,
pregnancy, and postpartum phases. Therefore, uncompromised ASM efficacy with acceptable variability and less or no drug-drug interactions
achieved with lowest possible monotherapy dose to address fetal toxicity concerns remain highly unmet needs. Moreover, control of seizures
including prevention of breakthrough seizures is critical when planning for pregnancy and also during pregnancy, as it can also lead
to undesired falls or auto-accidents and compromise freedom to drive.
Select
ASMs have the potential to induce contraception failures, reproductive hormone imbalance, anxiety, and depression. There remains an unmet
need for an ASM without the aforementioned downsides, with no to low fetal-neonatal toxicity and without breast-feeding concerns, as
well as the potential to treat associated comorbidities.
While
over 30 molecules have been approved for the treatment of epilepsy in the U.S., no epilepsy drug has been specifically approved for WWE
of CB age. We believe our endogenous NASs as GABA A PAMs, while targeting the goal of seizure control, also have the potential
for additional benefits in psychiatric disorders comorbidities (e.g., anxiety and/or depression) and sleep impairment. Moreover, these
oral endogenous NASs could potentially address some of the fetal toxicity concerns related to unplanned or planned pregnancy in WWE.
(1)
(1) Ref:
S.Bangar et al. Functional Neurology 2016; 31(3): 127-134; Reimers et al. Seizure. 2015 May;
28: 66-70.
Other
Pipeline Candidates
We
continue to pursue opportunities for partnering and/or development arrangements for the continued development of LPCN 2401, LPCN 1148,
and LPCN 1107. We do not currently anticipate conducting any further significant development activities with respect to these products
and product candidates without the participation of a partner. There can be no guarantee that we will be able to identify or enter into
partnering arrangements on terms that are beneficial to us or at all. Even if we do enter into partnering arrangements, such arrangements
may not be sufficient to successfully develop and commercialize these products.
LPCN
2401: Obesity Management
LPCN
2401 is targeted to be a once daily oral formulation comprising a proprietary anabolic androgen receptor agonist. LPCN 2401 is expected
to have a favorable benefit to risk profile as a non-invasive option for use as an adjunct to GLP-1 chronic weight management therapies
for quality weight loss and/or as a monotherapy post cessation of GLP-1 chronic weight management therapies for weight and glycemic status
maintenance with demonstrated benefits to the liver.
29
LPCN
2401 has potential for use as an adjunct to incretin mimetics (GLP-1/GIP agonists) including amplification of GLP-1 insulinotropic actions
which is supported by studies demonstrating the role of androgen receptor agonist in regulation of GLP-1 through:
● Enhancement
of GLP-1-mediated insulin release from β cells through genomic- and non-genomic mechanisms
● Increase
in GLP-1 Receptor Expression in diabetics and non-diabetics
● Promoting
proliferation of β cells and improving insulin sensitivity
Target
benefits of LPCN 2401 in combination with GLP-1 agonists include inducing quality weight loss by attenuation of functionality and activities
of daily life while lessening lean mass loss, a serious unmet need, especially for elderly and sarcopenic adult GLP-1 agonist users who
are most vulnerable to accelerated lean mass loss and functional decline. In a recent study with 16 weeks of GLP-1 agonist use for weight
management in elderly (60 yr and above) patients, a rapid loss of lean mass was observed with a median percentage of total body weight
loss that is due to lean mass of 32% in 16 weeks. In addition, 43% of GLP-1 users lost ≥10% Stair Climb Power from baseline; the equivalent
of almost eight years of expected age-related stair climb power loss was observed in just 4 months of GLP-1 use.
Moreover,
as an adjunct to incretin mimetics, LPCN 2401 may help maintain or increase weight loss, particularly in diabetics, through increased
expression activity of GLP1R and increased effectiveness of GIP1 therapies secondary to actions at GLP1R (glucose lowering). LPCN 2401
could also be potentially used as monotherapy post discontinuation of GLP-1 agonist to manage weight/fat regain and durability of diabetes
remission.
Data
from preclinical and clinical studies support the potential of LPCN 2401 and LPCN 2401+E in improving body composition. In April 2024,
Lipocine announced results from a multi-center prospective, blinded Phase 2 study, which demonstrated increases in lean mass of 4.4%,
decreases in fat mass of 6.7%, reduction in android fat of 4.1% and increased bone mineral content of 2.8% in a population consistent
with GLP-1 use for weight management. LPCN 2401 was well tolerated with minimal GI or androgenic adverse events and no reports of muscle
spasms. :
Per
FDA Guidance (2025), for efficacy claims related to changes in body composition, trial design should include appropriate choice of population
and selection of endpoints that measure how a patient feels, functions, or survives, to potentially support such a claim. We may initiate
a proof-of-concept study evaluating LPCN 2401 as an adjunct to GLP-1 agonist after we obtain regulatory clarity with respect to development
path and acceptable end points for improved body composition in obesity management pending available resources. We may explore the possibility
of partnering LPCN 2401 with a third party, although no partnering agreement has been entered into by us. No assurance can be given that
any license agreement will be completed, or, if an agreement is completed, that such an agreement would be on terms favorable to us.
Disease
and Market Overview – Obesity Management
Approximately
74% of U.S. adults aged 20 and older are either obese or overweight, and an estimated 30% of the U.S. adult population has a BMI ≥
30 kg/m 2 . Elderly and sarcopenic GLP-1 agonist users are the population of GLP-1 users who are most vulnerable to accelerated
lean mass loss and functional decline. Obesity is a chronic, relapsing health risk defined by excess body fat. Excess body fat increases
the risk of death and major comorbidities such as type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, osteoarthritis
of the knee, sleep apnea, and some cancers 1 . About 30% of overweight (BMI ≥ 25 kg/m 2) adults 2 have
type 2 diabetes, 50% 3 have dyslipidemia, and 67% 4 have hypertension. In the U.S. alone, ~34M older adults aged
60+ years are obese (BMI at or above 30.0) and ~31M older adults aged 60+ years are overweight (BMI between 25.0 to 30).
It
is estimated that the total GLP-1 users in the U.S. may reach 30 million (around 9% of the overall population) by 2030 5 .
Reportedly, ~24M 6 obese elderly are most vulnerable to losing muscle mass. The rapid weight loss observed with the currently
approved chronic weight management GLP-1 receptor agonist medications includes unwanted lean mass loss, up to 40% of the patient’s
total weight lost. Moreover, discontinuation of these therapies frequently results in a rapid regain in weight. Loss of lean mass has
multiple negative health implications including weakness/fatigue, lowered metabolism which can cause a regain in fat mass, declines in
neuromuscular function, potential effects on emotion and psychological states, and increased risk of injury.
Several
recent studies showed that body composition, especially lean body mass (muscle) may play an independent role in survival of patients
with diseases such as cancer and cardiovascular diseases (DH Lee and EL Giovannucci, Exp Biol Med. 2018). Therefore, a focus on body
composition in obesity management to sustainably lose fat mass while maintaining lean mass should be an essential goal.
30
There
is a significant unmet need for an oral, efficacious, muscle preserving/gaining option for chronic obesity/weight management that ameliorates
the loss of lean mass associated with GLP-1/GIP agonist treatment, resulting in a higher quality weight loss. Moreover, there is a need
for a chronic long-term pharmacotherapy option to maintain weight upon cessation of incretin mimetic therapy, prevent fat/weight rebound
“overshoot” and minimize lag in muscle recovery to prevent collateral fattening as well as improve the durability of any
achieved diabetes remission while on GLP-1.
(1) Ref:
Caterson and Hubbard et al. 2004; Calle and Thun et al. 1999
(2) https://news.harvard.edu/gazette/story/2012/03/the-big-setup/
(3) https://www.ncbi.nlm.nih.gov/books/NBK305895/
(4) https://pmc.ncbi.nlm.nih.gov/articles/PMC6316192/#sec3-nutrients-10-01976
(5) https://www.jpmorgan.com/insights/global-research/current-events/obesity-drugs
(6) Ref:
Flynn et al. Morgan Stanley, February 27, 2024
LPCN
1148: Oral Product Candidate for the Management of Decompensated Cirrhosis
We
are currently evaluating LPCN 1148 comprising testosterone laurate (“TL”) for the management of decompensated cirrhosis.
We believe LPCN 1148 targets unmet needs for patients with cirrhosis, including improvement in the quality of life of patients while
on the liver transplant waiting list, prevention or reduction in the occurrence of new decompensation events such as OHE, and improvement
in post liver transplant survival, including outcomes and costs. We are exploring the possibility of partnering with a third party for
the development and/or marketing of LPCN 1148, although no partnering agreement has been entered into by the Company. No assurance can
be given that any partnering agreement will be completed, or, if an agreement is completed, that such an agreement would be on terms
favorable to us.
We
conducted a Phase 2 proof of concept (“POC”) study (NCT04874350) in male subjects with cirrhosis to evaluate the therapeutic
potential of LPCN 1148 for the management of sarcopenia. The Phase 2 POC study was a prospective, multi-center, randomized, placebo-controlled
study in male sarcopenic patients with cirrhosis. Subjects were initially randomized 1:1 to 1 of 2 arms. The treatment arm was an oral
dose of LPCN 1148, and the second arm was a matching placebo. There were no restrictions on patients with respect to background therapies,
including current standard of care, diet or exercise. The primary endpoint was a change in skeletal muscle index at week 24 with key
secondary endpoints including change in liver frailty index, rates of breakthrough OHE, and number of waitlist events, including all-cause
mortality. Total treatment was 52 weeks, with 24-week placebo-controlled treatment subjects receiving LPCN 1148 in the 28-week open-label
extension (“OLE”) phase of the study for the duration of the study through week 52.
In
July 2023 we announced that the Phase 2 study met its primary endpoint, increased skeletal muscle index (L3-SMI) relative to placebo
(P<.01), in patients with cirrhosis. The study also demonstrated improvements in clinical outcomes such as prevention of new decompensation
events including OHE, rates of hospitalizations, and patient reported outcomes (“PROs”). LPCN 1148 was well-tolerated, with
adverse event (“AE”) rates and severities similar to placebo and no mortality was noted in the LPCN 1148 treatment group,
nor were there any cases of drug-induced liver injury.
In
March 2024 we announced that 24-week L3-SMI increases were maintained through 52 weeks of LPCN 1148 intervention and that placebo patients
who switched to LPCN 1148 in the open label extension period of the study had increases in L3-SMI. Furthermore, fewer OHE events were
observed in LPCN 1148 treated patients and time to first recurrent OHE event was longer for treated patients. LPCN 1148 was well-tolerated,
with AE rates and severities similar to placebo and fewer participants experienced serious or severe adverse events when switched from
placebo to LPCN 1148 and patients on therapy were hospitalized for fewer days. We had a Type D meeting with the FDA to discuss the clinical
development plan for LPCN 1148 for OHE, and we plan to continue discussions with the FDA seeking clarity on the Phase 3 study design
and endpoint.
Disease
Overview – Cirrhosis
Annually,
cirrhosis has caused more than 1 million deaths, and there are over 500,000 people living with decompensated cirrhosis in the U.S. Non-alcoholic
fatty liver disease is the most rapidly increasing indication for liver transplant. 62% of those on the liver transplant (“LT”)
waitlist are male and the economic burden (approximately $812,500/transplant) is high and continues to increase. Each year about half
of the approximately 17,000 people in the U.S. on the LT waitlist undergo transplant, while nearly 3,000 patients either die or are removed
from the list because they were “too sick to transplant.”
Liver
cirrhosis is defined as the histological development of regenerative nodules surrounded by fibrous bands. Patients with cirrhosis typically
have a year-long silent, asymptomatic phase (compensated cirrhosis) until decreasing liver function and increasing portal pressure move
the patient into the symptomatic phase (decompensated cirrhosis). Transition to decompensated cirrhosis is marked by clinical events
including ascites, encephalopathy, jaundice, and/or variceal hemorrhage. Decompensated subjects survive on average less than 2 years.
Common causes of liver cirrhosis include alcoholic liver disease, non-alcoholic fatty liver disease (“NAFLD”), chronic hepatitis
B and C, primary biliary cirrhosis, and primary sclerosing cholangitis and some patients have liver disease of unknown cause (cryptogenic).
Common
complications in patients with cirrhosis may include: compromised liver function, portal hypertension, varices in GI tract with internal
bleeding, edema, ascites, hepatic encephalopathy (“HE”), compromised immunity with post-transplant acute rejection risk,
high sodium levels, increased bilirubin, low albumin level, insulin resistance with impaired peripheral uptake of glucose, depression,
accelerated muscle disorder in the form of sarcopenia, myosteatosis, and frailty with compromised energetics, bone diseases (e.g., osteoporosis),
high alkaline phosphatase, cachexia, malnutrition, weight loss (>5%), symptoms of hypogonadism such as abnormal hair distribution,
anemia, sexual dysfunction, testicular atrophy, muscle wasting, fatigue, osteoporosis, gynecomastia, inflammation with elevated cytokines,
and infection risk leading to hospital admissions and possibly death.
31
HE,
a significant decompensation event in patients with cirrhosis, is a brain dysfunction caused by liver insufficiency and/or portal systemic
shunting. Because the damaged liver cannot function normally (as in cirrhosis), neurotoxins such as ammonia are inadequately removed
from systemic circulation and travel to the brain, where they affect neurotransmission. This can cause episodes of HE, which may present
as alterations in consciousness, cognition, and behavior that range from minimal to severe. Overt HE occurs in 30% to 40% of patients
with cirrhosis at some point during the clinical course of their disease. As the burden of chronic liver disease and cirrhosis is increasing,
the frequency of HE is also increasing.
LPCN
1107: An Oral Product Candidate for the Prevention of Preterm Birth (“PTB”)
We
are exploring the possibility of partnering with a third party for the development and/or marketing of LPCN 1107, although no partnering
agreement has been entered into by us. No assurance can be given that any partnering agreement will be completed, or, if an agreement
is completed, that such an agreement would be on terms favorable to us.
We
believe LPCN 1107 has the potential to become the first oral hydroxyprogesterone caproate (“HPC”) product indicated for the
reduction of risk of PTB (delivery less than 37 weeks) in women with singleton pregnancy who have a history of singleton spontaneous
PTB. Prevention of PTB is a significant unmet need as approximately 11% of all U.S. pregnancies result in PTB, a leading cause of neonatal
mortality and morbidity.
Current
Status
We
have completed a multi-dose PK dose selection study in pregnant women. The objective of the multi-dose PK selection study was to assess
HPC blood levels in order to identify the appropriate LPCN 1107 Phase 3 dose. The multi-dose PK dose selection study was an open-label,
4-period, 4-treatment, randomized, single and multiple dose PK study in pregnant women with 3 dose levels of LPCN 1107 and the IM HPC
(Makena®). The study enrolled 12 healthy pregnant women (average age of 27 years) with a gestational age of approximately 16 to 19
weeks. Subjects received three dose levels of LPCN 1107 (400 mg BID, 600 mg BID, or 800 mg BID) in a randomized, crossover manner during
the first 3 treatment periods and then received 5 weekly injections of HPC during the fourth treatment period. During each of the LPCN
1107 treatment periods, subjects received a single dose of LPCN 1107 on Day 1 followed by twice daily administration from Day 2 to Day
8. Following completion of the 3 LPCN 1107 treatment periods and a washout period, all subjects received 5 weekly injections of HPC.
Results from this study demonstrated that average steady state HPC levels (Cavg0-24) were comparable or higher for all 3 LPCN 1107 doses
than for injectable HPC. Additionally, HPC levels as a function of daily dose were linear for the 3 LPCN 1107 doses. Also, unlike the
injectable HPC, steady state exposure was achieved for all 3 LPCN 1107 doses within 7 days.
A
traditional PK/PD based Phase 2 clinical study in the intended patient population is not expected to be required prior to entering into
Phase 3. Therefore, based on the results of our multi-dose PK study we had an End-of-Phase 2 meeting and subsequent guidance meetings
with the FDA to define a pivotal Phase 2b/3 development plan for LPCN 1107. We have completed a food effect study to characterize the
dosing regimen for the pivotal study and we have submitted a pivotal clinical study protocol to the FDA.
The
FDA has granted orphan drug designation to LPCN 1107 based on a major contribution to patient care. Orphan designation qualifies Lipocine
for various development incentives, including tax credits for qualified clinical testing, and a waiver of the prescription drug user
fee when we file our NDA.
Financial
Operations Overview
Revenue
To
date, we have not generated any revenues from product sales and do not expect to do so until our FDA approved product receives regulatory
approval outside the U.S. and Canada or until one of our product candidates receives approval from the FDA. Revenues to date have been
generated substantially from license fees, royalty and milestone payments and research support from our licensees. Since our inception
through June 30, 2026, we have generated $55.4 million in revenue under our various license and collaboration arrangements and from government
grants. We have entered into the Verity License Agreement, the SPC License Agreement, the Pharmalink Distribution Agreement and the Aché
License Agreement with the potential for revenue from future milestones, royalties and/or product sales, but we may never generate revenues
from any of our clinical or preclinical development programs or licensed products as we may never succeed in obtaining regulatory approval
or commercializing any of these product candidates.
32
Research
and Development Expenses
Research
and development expenses consist primarily of salaries, benefits, stock-based compensation and related personnel costs, fees paid to
external service providers such as contract research organizations and contract manufacturing organizations, contractual obligations
for clinical development, clinical sites, manufacturing and scale-up for late stage clinical trials, formulation of clinical drug supplies,
and expenses associated with regulatory submissions. Research and development expenses also include an allocation of indirect costs,
such as those for facilities, office expense, and depreciation of equipment based on the ratio of direct labor hours for research and
development personnel to total direct labor hours for all personnel. We expense research and development expenses as incurred. Since
our inception, we have spent approximately $168.0 million in research and development expenses through June 30, 2026.
We
expect to continue to incur significant costs as we develop our other product candidates, including our CNS product candidates, as well
as the development of any future pipeline product candidates.
In
general, the cost of clinical trials may vary significantly over the life of a project as a result of uncertainties in clinical development,
including, among others:
● the
number of sites included in the trials;
● the
length of time required to enroll suitable subjects;
● the
duration of subject follow-ups;
● the
length of time required to collect, analyze and report trial results;
● the
cost, timing and outcome of regulatory review; and
● potential
changes by the FDA in clinical trial and NDA filing requirements.
Future
research and development expenditures are subject to numerous uncertainties regarding timing and cost to completion, including, among
others:
● the
timing and outcome of regulatory filings and FDA reviews and actions for product candidates;
● our
dependence on third-party manufacturers for the production of satisfactory finished products
for registration and launch should regulatory approval be obtained on any of our product
candidates;
● the
potential for future license or co-promote arrangements for our product candidates, when
such arrangements will be secured, if at all, and to what degree such arrangements would
affect our future plans and capital requirements; and
● the
effect on our product development activities of actions taken by the FDA or other regulatory
authorities.
A
change of outcome for any of these variables with respect to the development of our product development candidates could mean a substantial
change in the costs and timing associated with these efforts, could require us to raise additional capital, and may require us to reduce
operations.
Given
the stage of clinical development and the significant risks and uncertainties inherent in the clinical development, manufacturing, and
regulatory approval process, we are unable to estimate with any certainty the time or cost to complete the development of LPCN 1154,
LPCN 2201, LPCN 2203, LPCN 2101, LPCN 2401, LPCN 1148, LPCN 1107 and other product candidates. Clinical development timelines, the probability
of success, and development costs can differ materially from expectations and results from our clinical trials may not be favorable.
If we are successful in progressing LPCN 1154, LPCN 2201, LPCN 2203, LPCN 2101, or other future product candidates into later stage development,
we will require additional capital. The amount and timing of our future research and development expenses for these product candidates
will depend on the pre-clinical and clinical success of both our current development activities and potential development of new product
candidates, as well as ongoing assessments of the commercial potential of such activities. We will continue efforts to enter into partnership
arrangements for the continued development and/or marketing of LPCN 1154, LPCN 2401, LPCN 1148, LPCN 1107, and for the development and
commercialization of TLANDO outside of the United States, Canada, South Korea, the GCC countries and Brazil.
33
We
expect to continue to incur significant research and development expenses in the future as we complete on-going clinical studies,
including studies for our CNS product candidates, including a possible additional study for LPCN 1154, and as we conduct future
clinical studies, when and if we conduct Phase 2 clinical studies with LPCN 2201, LPCN 2203, LPCN 2101, LPCN 2401, and/or
development product candidates and when and if we conduct Phase 3 clinical studies with LPCN 1148 or LPCN 1107. We are also
exploring the possibility of licensing all of our product candidates, although we have not entered into a licensing agreement and no
assurance can be given that any license agreement will be completed, or, if an agreement is completed, that such agreement would be
on terms favorable to us. If we are unable to raise additional capital or obtain non-dilutive financing, we may need to reduce
research and development expenses in order to extend our ability to continue as a going concern.
General
and Administrative Expenses
General
and administrative expenses consist primarily of salaries and related benefits, including stock-based compensation, and outside consulting
services related to our executive, finance, business development and administrative support functions. Other general and administrative
expenses include rent and utilities, travel expenses, and professional fees for auditing, tax, legal, and various other services.
General
and administrative expenses also include expenses for the cost of preparing, filing and prosecuting patent applications and maintaining,
enforcing and defending intellectual property-related claims.
We
expect that general and administrative expenses will increase in the future as we continue as a public company. These fees include legal
and consulting fees, accounting and audit fees, director fees, directors’ and officers’ insurance premiums, fees for investor
relations services and enhanced business and accounting systems, litigation costs, professional fees and other costs. However, if we
are unable to raise additional capital, we may need to reduce general and administrative expenses in order to extend our ability to continue
as a going concern.
Other
Income and Expense
Other
income and expense consists primarily of interest income earned on our cash, cash equivalents and marketable investment securities.
Results
of Operations
Comparison
of the Three Months Ended June 30, 2026 and 2025
The
following table summarizes our results of operations for the three months ended June 30, 2026 and 2025:
Three
Months Ended June 30,
2026
2025
Variance
Revenue
$ 190,099
$ 622,849
$ (432,750 )
Research and development expenses
2,041,389
2,136,769
(95,380 )
General and administrative expenses
990,956
890,433
100,523
Interest and investment income
219,851
198,637
21,214
Income tax expense
200
-
200
Revenue
We
recognized revenue of $190,000 and $623,000 during the three months ended June 30, 2026 and 2025, respectively, which consists of royalty
revenue from TLANDO sales of $190,000 during the three months ended June 30, 2026, compared to licensing revenue of $500,000 and royalty
revenue of $123,000 recognized during the three months ended June 30, 2025.
Research
and Development Expenses
The
decrease in research and development expenses during the three months ended June 30, 2026, as compared to the three months ended June
30, 2025 consists of a decrease of approximately $96,000 in various research and development costs, with minimal change during the three
months ended June 30, 2026 in expenses related to LPCN 1154 compared to the three months ended June 30, 2025, with the completion of
our Phase 3 study in 2026 compared and startup costs of the same study during the three months ended June 30, 2025.
34
General
and Administrative Expenses
The
increase in general and administrative expenses during the three months ended June 30, 2026 as compared to the three months ended June
30, 2025 primarily consists of a $58,000 increase in consulting and professional fees, a $34,000 increase in various general and administrative
fees and a $8,000 increase in personnel expense.
Interest
and Investment Income
The
increase in interest and investment income during the three months ended June 30, 2026 compared to interest and investment income during
the three months ended June 30, 2025 was primarily due to higher cash balances available to invest as a result of sales of our common
stock under our ATM in 2026 as compared to cash balances during the second quarter of 2025.
Comparison
of the Six Months Ended June 30, 2026 and 2025
The
following table summarizes our results of operations for the six months ended June 30, 2026 and 2025:
Six
Months Ended June 30,
2026
2025
Variance
Revenue
$ 309,496
$ 716,713
$ (407,217 )
Research and development expenses
4,805,782
3,198,341
1,607,441
General and administrative expenses
2,195,425
2,012,910
182,515
Interest and investment income
397,422
424,149
(26,727 )
Income tax expense
200
200
-
Revenue
We
recognized revenue of $309,000 and $717,000 during the six months ended June 30, 2026 and 2025, respectively, which consists of royalty
revenue from TLANDO sales of $309,000 during the six months ended June 30, 2026, compared to licensing revenue of $500,000 and royalty
revenue of $217,000 recognized during the six months ended June 30, 2025.
Research
and Development Expenses
The
increase in research and development expenses during the six months ended June 30, 2026, as compared to the six months ended June 30,
2025 consists of an increase of approximately $1.7 million resulting from our LPCN 1154 study in 2026 and a $27,000 increase in personnel
expense, offset by a $168,000 decrease in various research and development costs.
General
and Administrative Expenses
The
increase in general and administrative expenses during the six months ended June 30, 2026 as compared to the six months ended June 30,
2025 primarily consists of a $97,000 increase in consulting and professional fees, a $51,000 increase in personnel expense, and a $34,000
increase in various general and administrative fees.
Interest
and Investment Income
The
increase in interest and investment income during the six months ended June 30, 2026 compared to interest and investment income during
the six months ended June 30, 2025 was primarily due to higher cash balances available to invest as a result of the sales of our common
stock under our ATM in 2026 as compared to cash balances during the six months ended June 30, 2025.
Liquidity
and Capital Resources
Since
our inception, our operations have been primarily financed through sales of our equity securities, issuances of debt and payments received
under our license and collaboration arrangements. We have devoted our resources to funding research and development programs, including
discovery research, and preclinical and clinical development activities. We have incurred operating losses in most years since our inception
and we expect to continue to incur operating losses into the foreseeable future as we advance the clinical development of LPCN 1154,
LPCN 2201, LPCN 2203, LPCN 2101, and any other future product candidates, including continued research efforts.
35
As
of June 30, 2026, we had $23.3 million of unrestricted cash, cash equivalents and marketable investment securities compared to $14.9
million at December 31, 2025.
In
April 2025, we entered into the Aché License and Supply Agreement with Aché pursuant to which we granted to Aché
an exclusive license to commercialize our TLANDO® product with respect to the Field, specific to Brazil. Under the agreement, we
are entitled to receive fees upon the achievement of certain regulatory milestones, royalties on net sales and will supply TLANDO to
Aché at an agreed transfer price. Our ability to realize benefits from the Aché License Agreement, including milestone,
product sale and royalty payments, is subject to a number of risks. We may not realize milestone, product sale, or royalty payments in
anticipated amounts, or at all.
In
October 2024, we entered into the Pharmalink Distribution Agreement with Pharmalink, pursuant to which we granted to Pharmalink a non-transferable,
exclusive license to commercialize our TLANDO product in the Pharmalink Territory. Pharmalink paid us a one-time non-refundable, non-creditable
upfront fee. We are eligible to receive additional payments in regulatory authorization milestones related to the marketing approval
in countries in the Pharmalink Territory under the Pharmalink Distribution Agreement and we have agreed to supply TLANDO to Pharmalink
at a specified transfer price. Our ability to realize benefits from the Pharmalink Distribution Agreement, including milestone, product
sale and royalty payments, is subject to a number of risks. We may not realize milestone, product sale, or royalty payments in anticipated
amounts, or at all.
In
September 2024, we entered into the SPC License Agreement with SPC, pursuant to which we granted to SPC a non-transferable, royalty-bearing
license to develop and commercialize our TLANDO product with respect to TRT in South Korea. Under the terms of the SPC License Agreement,
SPC paid us a non-refundable, non-creditable upfront fee in October 2024. We also received a non-refundable payment in consideration
for certain TLANDO product inventory, and are eligible to receive additional payments upon the receipt of marketing authorization and
achievement of sales milestones, and we will supply TLANDO to SPC at a specified supply price. In addition, we will receive royalties
on net sales in the SPC Territory under the SPC License Agreement. Our ability to realize benefits from the SPC License Agreement, including
milestone, product sale and royalty payments, is subject to a number of risks. We may not realize milestone, product sale, or royalty
payments in anticipated amounts, or at all.
On
January 12, 2024, we entered into the Verity License Agreement with Verity Pharma, pursuant to which we granted to Verity Pharma an exclusive,
royalty-bearing, sublicensable right and license to develop and commercialize our TLANDO product with respect to TRT in the Licensed
Verity Territory. Upon execution of the Verity License Agreement in January 2024 and upon transition of the commercialization of TLANDO
from Antares to Verity Pharma in February 2024, Verity Pharma paid us initial payments of $2.5 million and $5 million, respectively.
Verity Pharma also paid us $2.5 million on December 30, 2024, and we received payment for the final portion of the initial license of
$1.0 million on January 5, 2026. The Verity License Agreement also provides Verity Pharma with a license to develop and commercialize
TLANDO XR (LPCN 1111), our potential next generation, once daily oral product candidate for testosterone replacement therapy comprised
of TT in the U.S. and Canada. Under the Verity License Agreement, we are eligible to receive milestone payments of up to $259 million
in the aggregate, depending on the achievement of certain development milestones and sales milestones in a single calendar year with
respect to all products licensed by Verity Pharma under the Verity License Agreement. In addition, we receive tiered royalty payments
at rates ranging from 12% up to 18% of net sales of all products licensed to Verity Pharma in the Licensed Verity Territory. Our ability
to realize benefits from the Verity License Agreement, including milestone and royalty payments, is subject to a number of risks. We
may not realize milestone or royalty payments in anticipated amounts, or at all.
On
April 26, 2024, we entered into a sales agreement (the “A.G.P. Sales Agreement”) with A.G.P./Alliance Global Partners (“A.G.P.”)
pursuant to which we can issue and sell, from time to time, shares of our common stock having an aggregate offering price of up to the
amount we registered on an effective registration statement pursuant to which the offering is being made. As of February 26, 2026, we
have registered up to $50,000,000 of common shares for sale under the A.G.P. Sales Agreement, pursuant to the Registration Statement
on Form S-3, as amended (File No. 333-275716) (the “Form S-3”), through A.G.P. as sales agent. A.G.P. may sell our common
stock by any method permitted by law deemed to be an “at the market offering” as defined in Rule 415(a)(4) of the Securities
Act, including sales made directly on or through the Nasdaq Capital Market or any other existing trade market for our common stock, in
negotiated transactions at market prices prevailing at the time of sale or at prices related to prevailing market prices, or any other
method permitted by law. A.G.P. will use its commercially reasonable efforts consistent with its normal trading and sales practices and
applicable law and regulations to sell shares under the A.G.P. Sales Agreement. We will pay A.G.P. 3.0% of the aggregate gross proceeds
from each sale of shares under the A.G.P. Sales Agreement. In addition, we have also provided A.G.P. with customary indemnification rights.
Our shares of common stock to be sold under the A.G.P. Sales Agreement will be sold and issued pursuant to the Form S-3, as amended,
which was previously declared effective by the SEC, and the related prospectus and one or more prospectus supplements. We are not obligated
to make any sales of our common stock under the A.G.P. Sales Agreement. The offering of common stock pursuant to the A.G.P. Sales Agreement
will terminate upon the termination of the A.G.P. Sales Agreement as permitted therein. We and A.G.P. may each terminate the A.G.P. Sales
Agreement at any time upon ten days’ prior notice. During the six months ended June 30, 2026, we sold 2,083,276 shares of our common
stock for gross proceeds of approximately $13.9 million and net proceeds of $13.5 million under the A.G.P. Sales Agreement.
36
We
believe that our existing capital resources, together with interest thereon, will be sufficient to meet our projected operating requirements
through at least August 4, 2027, which include research and development activities and compliance with regulatory requirements. We have
based this estimate on assumptions that may prove to be wrong, and we could utilize our available capital resources sooner than we currently
expect if additional activities are performed by us including new clinical studies for LPCN 1154, LPCN 2201, LPCN 2203, LPCN 2101, LPCN
2401, LPCN 1148, and/or LPCN 1107. While we believe we have sufficient liquidity and capital resources to fund our projected operating
requirements through at least August 4, 2027, we will need to raise additional capital at some point through the equity or debt markets
or through additional out-licensing activities after August 4, 2027 to support our operations. If we are unsuccessful
in raising additional capital as necessary, our ability to continue as a going concern will be limited. Further, our operating plan may
change, and we may need additional funds to meet operational needs and capital requirements for product development, regulatory compliance
and clinical trial activities sooner than planned. In addition, our capital resources may be consumed more rapidly if we pursue additional
clinical studies for LPCN 1154, LPCN 2201, LPCN 2203, LPCN 2101, LPCN 2401, LPCN 1148, and/or LPCN 1107. Conversely, our capital resources
could last longer if we reduce expenses, reduce the number of activities currently contemplated under our operating plan or if we terminate,
modify or suspend on-going clinical studies. We can raise capital pursuant to the A.G.P. Sales Agreement but may choose not to issue
common stock if our market price is too low to justify such sales in our discretion. There are numerous risks and uncertainties associated
with the development and, subject to approval by the FDA, commercialization of our product candidates. There are numerous risks and uncertainties
impacting our ability to enter into collaborations with third parties to participate in the development and potential commercialization
of our product candidates. We are unable to precisely estimate the amounts of increased capital outlays and operating expenditures associated
with our anticipated or unanticipated clinical studies and ongoing development efforts. All of these factors affect our need for additional
capital resources. To fund future operations, we will need to ultimately raise additional capital and our requirements will depend on
many factors, including the following:
● the
scope, rate of progress, results and cost of our clinical studies, pre-clinical testing and
other related activities for all of our product candidates, including LPCN 1154, LPCN 2201,
LPCN 2203, LPCN 2101, LPCN 2401, LPCN 1148, and LPCN 1107;
● the
cost of manufacturing clinical supplies and establishing commercial supplies, of our product
candidates and any products that we may develop;
● the
cost and timing of establishing sales, marketing and distribution capabilities, if any;
● the
terms and timing of any collaborative, licensing, settlement and other arrangements that
we may establish;
● the
number and characteristics of product candidates that we pursue;
● the
cost, timing and outcomes of regulatory approvals;
● the
timing, receipt and amount of sales, profit sharing, milestones or royalties, if any, from
our potential products;
● the
cost of preparing, filing, prosecuting, defending and enforcing any patent claims and other
intellectual property rights;
● the
extent to which we acquire or invest in businesses, products or technologies, although we
currently have no commitments or agreements relating to any of these types of transactions;
and
● the
extent to which we grow significantly in the number of employees or the scope of our operations.
Funding
may not be available to us on favorable terms, or at all. Also, market conditions may prevent us from accessing the debt and equity capital
markets, including sales of our common stock through the A.G.P. Sales Agreement. If we are unable to obtain adequate financing when needed,
we may have to delay, reduce the scope of or suspend one or more of our clinical studies, research and development programs or, if any
of our product candidates receive approval from the FDA, commercialization efforts. We may seek to raise any necessary additional capital
through a combination of public or private equity offerings, including the Sales Agreement, debt financings, collaborations, strategic
alliances, licensing arrangements and other marketing and distribution arrangements. These arrangements may not be available to us or
available on terms favorable to us. To the extent that we raise additional capital through marketing and distribution arrangements, other
collaborations, strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our product
candidates, future revenue streams, research programs or product candidates or grant licenses on terms that may not be favorable to us.
If we do raise additional capital through public or private equity offerings, the ownership interest of our existing stockholders will
be diluted, and the terms of these securities may include liquidation or other preferences, warrants or other terms that adversely affect
our stockholders’ rights or further complicate raising additional capital in the future. If we raise additional capital through
debt financing, we may be subject to covenants limiting or restricting our ability to take specific actions, such as incurring additional
debt, making capital expenditures or declaring dividends. If we are unable, for any reason, to raise needed capital, we will have to
reduce costs, delay research and development programs, liquidate assets, dispose of rights, commercialize products or product candidates
earlier than planned or on less favorable terms than desired or reduce or cease operations.
37
Sources
and Uses of Cash
The
following table provides a summary of our cash flows for the six months ended June 30, 2026 and 2025:
Six
Months Ended June 30,
2026
2025
Cash used in operating activities
$ (5,285,564 )
$ (3,855,491 )
Cash provided by (used in) investing activities
(8,419,628 )
3,617,927
Cash provided by financing activities
13,478,780
75,618
Net
Cash from Operating Activities
During
the six months ended June 30, 2026 and 2025, net cash used in operating activities was $5.3 million and $3.9 million, respectively.
Net
cash used in operating activities during the six months ended June 30, 2026, was primarily attributable to cash required to support our
LPCN 1154 clinical trial activities and our ongoing operations. Net cash used in operating activities during the six months ended June
30, 2025, was primarily attributable to cash required to support ongoing operations.
Net
Cash from Investing Activities
During
the six months ended June 30, 2026 and 2025, net cash used in investing activities was $8.4 million and net cash provided by investing
activities was $3.6 million, respectively.
Net
cash used in investing activities during the six months ended June 30, 2026 was primarily the result of the purchases of marketable investment
securities, net. Net cash provided by investing activities during the six months ended June 30, 2025 was primarily the result of the
maturities of marketable investment securities, net. There were no capital expenditures during the six months ended June 30, 2026 or
2025.
Net
Cash from Financing Activities
During
the six months ended June 30, 2026 and 2025, net cash provided by financing activities was approximately $13.5 million and $76,000, respectively.
Net
cash provided by financing activities during the six months ended June 30, 2026 was primarily related to the sale of 2,083,276 shares
of common stock for net proceeds of approximately $13.5 million under the A.G.P. Sales Agreement at a weighted average price of $6.67
per share pursuant to the A.G.P. Sales Agreement. Net cash provided by financing activities during the six months ended June 30, 2025
was related to the sale of 23,739 shares of common stock at a weighted average price of $3.29 per share pursuant to the A.G.P. Sales
Agreement.
Contractual
Commitments and Contingencies
Purchase
Obligations
We
enter into contracts and issue purchase orders in the normal course of business with clinical research organizations for clinical trials
and clinical and commercial supply manufacturing and with vendors for pre-clinical research studies, research supplies and other services
and products for operating purposes. These contracts generally provide for termination on notice and are cancellable obligations.
Operating
Leases
In
August 2004, we entered into an agreement to lease our facility in Salt Lake City, Utah consisting of office and laboratory space which
serves as our corporate headquarters. On December 12, 2025, we modified and extended the lease through February 28, 2027.
38
Critical
Accounting Policies and Significant Judgments and Estimates
Our
management’s discussion and analysis of our financial condition and results of operations is based on our financial statements
which we have prepared in accordance with U.S. GAAP. In preparing our financial statements, we are required to make estimates and assumptions
that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the financial
statements and the reported amounts of revenues and expenses during the reporting periods. Our estimates are based on our historical
experience and on various other factors that we believe are 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. Actual results
may differ from these estimates under different assumptions or conditions. We concluded that licensing revenue recognized in conjunction
with the Verity License Agreement met the requirements under ASC 606, Revenue from Contracts with Customers. We evaluate the measure
of progress each reporting period and, if necessary, adjust the measure of performance and related revenue recognition. License revenue
from payments to be received in the future will be recognized when it is probable that we will receive license payments under the terms
of the Verity License Agreement, the SPC License Agreement, the Pharmalink Distribution Agreement and the Aché License Agreement
(see Footnote 7 – Contractual Agreements for disclosure regarding the SPC License Agreement, the Pharmalink Distribution Agreement,
and the Aché License Agreement).
There
have been no significant and material changes in our critical accounting policies during the six months ended June 30, 2026, as compared
to those disclosed in “Management’s Discussion and Analysis of Financial Condition and Results of Operations-Critical Accounting
Policies and Significant Judgments and Estimates” in our 2025 Form 10-K.
ITEM
3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
As
a “smaller reporting company,” this item is not required.
Text extracted from the filing as submitted to EDGAR. Formatting, tables and exhibits are simplified for reading; the original document is authoritative for anything you rely on.