Cognition Therapeutics: Navigating the Complexities of Alzheimer's and DLB Trials

Cognition Therapeutics Inc (CGTX) reported its Q4 2024 earnings on March 20, 2025, revealing a net loss of $34 million, or $0.86 per share, compared to a net loss of $25.8 million in 2023. The company's financial performance reflects the high costs associated with advancing its clinical trials for Alzheimer's disease and dementia with Lewy bodies (DLB). Despite the financial setbacks, Cognition Therapeutics has made significant strides in its research and development, particularly with its lead product candidate, Zervimesine (CT1812).

The company's focus on advancing its clinical trials for Alzheimer's disease and DLB has led to increased research and development expenses, which rose to $41.7 million in 2024 from $37.2 million in 2023. This increase is primarily due to the costs associated with completing two Phase 2 trials. The Phase 2 SHIMMER study in DLB showed strong clinical results, including a 91% slowing in cognitive decline compared to placebo. Similarly, the SHINE study in Alzheimer's disease demonstrated near-total preservation of cognition in patients with lower p-tau217 levels. These results underscore the potential of Zervimesine as a treatment for neurodegenerative diseases, a critical area of need in the biotechnology industry.



The company's strategic decision to conclude the Phase 2 dry AMD study has several implications for its financial health and future research priorities. This decision allows Cognition Therapeutics to prioritize resources towards its Alzheimer's and DLB programs, which are seen as having significant market potential. As Lisa Ricciardi, Cognition’s president and CEO, stated, "The Company reprioritized its clinical focus in 2025, concluding enrollment in the Phase 2 dry AMD clinical study in order to devote resources to support the planned registrational programs for Alzheimer’s and DLB, and extend the cash runway into the fourth quarter of 2025." This reprioritization is expected to result in cost savings, which will extend the company’s cash runway. As of December 31, 2024, Cognition Therapeutics held approximately $25.0 million in cash and cash equivalents, with total obligated grant funds remaining from the NIA amounting to $50.0 million. This financial position, combined with the cost savings from concluding the dry AMD study, provides the company with the necessary runway to advance its Phase 3 readiness for Zervimesine. Additionally, the company is actively evaluating options to fund its clinical trials, including potential partnering opportunities with pharmaceutical companies. This strategic shift not only enhances the company's financial health but also aligns its research priorities with areas of high unmet medical need, such as Alzheimer's and DLB, where Zervimesine has shown promising results in Phase 2 trials.

The company's ability to secure funding and partnerships will be crucial as it advances its clinical programs. Cognition Therapeutics is actively evaluating options to fund its clinical trials, including potential partnering opportunities with pharmaceutical companies. This strategic shift not only enhances the company's financial health but also aligns its research priorities with areas of high unmet medical need, such as Alzheimer's and DLB, where Zervimesine has shown promising results in Phase 2 trials. The company's focus on developing Zervimesine for sizable markets in Alzheimer's and DLB, aiming for separate studies for each, is a testament to its commitment to addressing these critical areas of need.