DMAC DiaMedica Therapeutics Inc.
$8.79
DiaMedica Therapeutics Inc. Q3 F2026 Earnings Call Transcript
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Conference Call Operator
Good morning, ladies and gentlemen, and welcome to Diametica Therapeutics' third quarter 2026 earnings conference call. An audio recording of today's webcast will be available following the call on Diametica's website, diametica.com, in the investor relations section. Before we begin, please note that management will be making forward-looking statements. These statements are subject to risks and uncertainty, that could cause actual results to differ materially from those expressed or implied. Additional information about these risks appears in the cautionary statement in the company's earnings press release issued yesterday and in Diomedica's filings with the Security and Exchange Commission, including its most recent Form 10-K and Form 10-Q. Statements on this call speak only as of today, November 13th, 2026. Following prepared remarks, we will open the call for questions. I would now like to introduce Rick Pauls, Diomedica's President and Chief Executive Officer. Rick, please go ahead.
Rick Pauls
President and Chief Executive Officer
Thank you, Operator, and good morning, everyone. Thank you for joining our third quarter earnings call. With me today are Dr. Julie Krop, our Chief Medical Officer, and Scott Kellen, our Chief Financial Officer. Since our last earnings call, we achieved two major clinical milestones. First, enrollment was completed, and the first two cohorts of the investigator-sponsored Phase II early onset fetal growth restriction study. Second, in October, we enrolled the 200th participant in Remedy 2, our pivotal Phase II-III trial in acute ischemic stroke. With this, we attained the pre-specified enrollment threshold required for the Remedy 2 interim analysis. Together, these milestones bring us closer to important clinical readouts that could help define the next stage of development for DM-19 in fetal growth restriction, preeclampsia, and acute ischemic stroke. We also continue to prepare for additional studies in preeclampsia, including our company-sponsored Phase II trial and made progress addressing FDA feedback on the non-clinical package needed for U.S. investigational new drug applications for preeclampsia. I will walk through the major updates Julie will discuss the clinical objectives in more detail, and Scott will review our financial results. As a reminder, DM-1A9, generic name rinbacalinase alpha, is a recombinant form of human tissue calocrine 1, or KLK1. Through activation of the bradykinin-2 receptor pathway, we believe DM-1A9 has the potential to improve vascular health and function, ultimately improving blood flow. This is a completely novel mechanism of action and provides a common therapeutic rationale across preeclampsia, fetal growth restriction, acute ischemic stroke, and other diseases, even though the clinical objectives and endpoints differ across these indications. Let me begin with Early-Onset Fetal Growth Restriction Program, or FGR. Professor Kluver has now completed enrollment in the first two cohorts of the Phase II study being conducted at Tiger Bird Hospital in Cape Town, South Africa. Together, these cohorts include 12 participants with six treated at 5 micrograms per kg and six treated at 10 micrograms per kg. This is the first clinical evaluation of D-109 in women with early onset fetal growth restriction. Early onset FGR is a pregnancy disorder associated with significant risks to the fetus frequently resulting from placental insufficiency, creating impaired blood flow that restricts the supply of oxygen and nutrients to the baby. Currently, no therapy is approved to treat FGR. The only option today for physicians is to closely monitor both mother and baby, balancing the risk of stillbirth and fetal complications from worsening placental insufficiency against the serious neonatal risk of delivering very prematurely. In pregnancies complicated by preeclampsia, maternal risk also includes severe hypertension and organ injury. The current early onset SGR study is evaluating repeated subcutaneous dosing of DM-19 with the objective of assessing whether DM-19 can safely prolong pregnancy while minimizing risk to the mother and baby. Assessments include maternal and fetal safety, measures of utero placental vascular resistance, birth weight, centile, and duration of pregnancy. The dose for the third cohort will be selected based on the findings from the first two cohorts. On Tuesday, November 24th at 8 a.m. Eastern Time, we will host a virtual Key Opinion Leader event focusing on fetal growth restriction, featuring preliminary results from both completed cohorts. Professor Kluver will be joined by Professor Stephen Tong and Professor Susan Walker, both from the University of Melbourne, and Professor Andrew Shannon from King's College London. The panel will discuss the treatment landscape and unmet need, The Clinical Rationale for DM-19 and Preliminary Safety and Clinical Observations in the Context of Current Maternal Fetal Medicine Best Practices. Within the investigation response for trial, two additional preeclampsia studies are expected to begin enrollment by the end of 2026. One comprised of up to 30 women with early onset preeclampsia receiving repeated subcutaneous dosing of DM-19 until delivery. This is referred to as our part two of the study. The second study will include up to 30 women with late onset or late stage preeclampsia who are acutely hypertensive with delivery expected within 72 hours, referred to as Part 1B. In the second study, patients will receive DME9 via continuous intravenous infusion, which may provide insight into whether IV dosing of DME9 can help control severe hypertension. We believe every day matters for mom and baby. Switching to IV DM-19 may enable further prolongation of pregnancy for these women beyond sub-Q dosing. We're also advancing our company-sponsored Phase 2 program in early-onset preeclampsia. Health Canada authorized a protocol amendment to the open-label Phase 2 dose-finding study in September, and preparations continue to initiate enrollment at Canadian sites. We also plan to expand the study into the United Kingdom, subject to regulatory authorization. In October, the study received conditional authorization from the European Medicines Agency, or EMA, with consideration for full approval after country-specific ethical insight requirements, creating an opportunity for future European expansion. This trial is designed to evaluate approximately 30 patients with early-onset preeclampsia across three dose levels, drawing on the Part Ia preeclampsia experience and emerging FGR observations. Together, both of these studies will provide further information on dosing and pharmacologic activity in different clinical settings, allowing us to develop the dosing plan for use in larger preeclampsia trials. In the United States, our focus remains on addressing FDA's feedback regarding the non-clinical reproductive toxicology data to support an investigational new drug application, or IND, to study DM-109 in preeclampsia in the United States. Last quarter, we discussed FDA feedback indicating that our completed rat reproductive toxicology studies may be acceptable to support an IND application. FDA's acceptance would depend on our ability to demonstrate that DM-19 exposure and enzymatic activity were maintained at adequate levels throughout those studies and that DM-19 produces a sufficient pharmacologic effect in rats to justify their use as a toxicology species. We initiated an additional rat study during the third quarter to generate this data and please report that the in-life portion of the study has been complete and DM-19 was well tolerated by the animals. We expect the pharmacokinetics and pharmacologic results in the coming weeks, and once the report is complete, we plan to submit to the FDA. Our other major recent clinical milestone was an acute ischemic stroke, where Remedy 2 reached the enrollment threshold for its pre-specified interim analysis. Acute ischemic stroke, when a blood clot blocks blood flow to the brain, can cause profound lasting disability or death. Current reperfusion treatments, including thrombolytic drugs, which attempt to dissolve the clot, and mechanical thrombectomy, which attempts to physically remove the clot, can be highly effective for certain eligible patients, but their use is limited by clinical eligibility, treatment time window, and the location of the clot. Most stroke patients either cannot receive these treatments were still experiencing significant disability despite treatment. This is why stroke also remains a significant unmet medical need and additional approaches to preserve at-risk brain tissue and improve function recovery are urgently needed. Following the required 90-day follow-up of the 200th participant, the Independent Data Safety Monitoring Board, or DSMB, will examine the primary efficacy endpoints. The proportion of participants with a modified rank and Dr. Kahn. As part of the trial's prespecified adaptive design, the DSMB will use its efficacy data to determine whether the study should continue, and if so, whether the final sample size should be adjusted. If the trial continues, the final enrollment target will range from 300 to 728 participants under the prespecified statistical plan. Diomedica will remain blinded to the treatment effect data reviewed by the DSMB. If successful, Remedy 2 has the potential to serve as a pivotal trial supporting a future new drug application or NDA for use of D-1-9 in acute ischemic stroke. Patient recruitment continues during the completion of the follow-up period and data preparations for interim review. We expect the DSMB to complete its analysis in the first quarter of 2027. With that, I will turn the call over to Julie to discuss the clinical program in more detail. Julie?
Dr. Julie Krop
Chief Medical Officer
Thank you, Rick, and good morning, everyone. I would like to expand on two aspects of our pregnancy-related development strategy. First, what are we seeking to learn from the FGR cohorts? And second, how the initial preeclampsia findings are informing the next studies. Severe early onset fetal growth restriction presents a substantial challenge because impaired placental function can severely limit the fetus's ability to grow and develop. As Rick noted, clinical management requires balancing the potential benefit of prolonging gestation against the maternal and fetal risk of continuing the pregnancy. We are evaluating whether and to what degree DM-199 can favorably affect vascular physiology to improve vascular health and blood flow and ultimately support improved outcomes for both the mother and the baby. The ongoing phase two FGR IST trial is evaluating repeated subcutaneous dosing of DM-199 in women with early onset disease. Key assessments include safety and tolerability and umbilical artery Doppler indices that reflect the degree of resistance to blood flow from the fetus to the placenta. Abnormal Doppler findings, particularly absent or reversed end diastolic flow, help guide the timing of delivery in pregnancies complicated by fetal growth restriction. Changes in these physiologic parameters will provide important information about the pharmacologic activity of DM-199 and help inform further development. At the November 24th KOL event, We will review preliminary observations from the two six-participant cohorts tested at DM-199 subcutaneous dose levels 5 and 10 micrograms per kilogram, respectively. Although this is an early open-label study involving a small number of patients, the findings will provide an initial opportunity to assess DM-199 safety, pharmacologic activity, and potential clinical effects in women with early-onset FGR and importantly, the experts will help put the open label data into context by providing benchmarking data on outcomes in patients receiving current standard of care treatment. In part 1A of the investigator-sponsored trial, patients with late onset preeclampsia were studied. If you recall, that data showed rapid and sustained reductions in maternal systolic and diastolic blood pressure following DM-199 treatment. We also observed pharmacodynamic effects, including trends suggesting reduction in the uterine artery pulsatility index, a measure of resistance, and an indirect measure of uteroplacental blood flow. Together, these observations support dose selection and provide a strong rationale for conducting additional studies to determine whether DM-199 can deliver meaningful clinical benefits, particularly in early-onset disease. I would also like to highlight the clinical rationale for DM-199 in acute ischemic stroke. Unlike thrombolytic therapies, which dissolve blood clots, or mechanical thrombectomy, which physically remove them, DM-199 is designed to improve collateral blood flow within the ischemic penumbra, the surrounding brain tissues that are adversely impacted by the clot and that remain viable for a period of time, are at risk of irreversible injury if adequate blood flow is not restored. By improving oxygen delivery to the threatened tissue, we believe DM-199 may help preserve neurologic function, which ultimately may lead to improved recovery following stroke. Remedy 2 is a randomized double-blind placebo-controlled study evaluating DM-199 in patients with acute ischemic stroke who begin treatment The study focuses on patients who are not candidates for mechanical thrombectomy, a population with substantial unmet medical need. Across these programs, our goal is to determine whether DM-199's effect on vascular function and blood flow can translate into meaningful clinical benefits for patients with these serious conditions. Rick, back to you.
Rick Pauls
President and Chief Executive Officer
Thanks, Julie. I will now ask Scott to review our third quarter financial results.
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Unidentified speaker / transcript attribution artifact
Scott?
Scott Kellen
Chief Financial Officer
Thanks, Rick, and good morning, everyone. As of September 30, 2026, We had $34.9 million in cash, cash equivalents, and short-term investments, compared with $59.9 million at December 31, 2025. Current liabilities were $7.5 million, and working capital was $28 million at quarter-end, compared with $5.1 million and $55.5 million, respectively, at year-end 2025. Based upon our current plans, we expect our cash, cash equivalents, and short-term investments to fund our planned clinical studies and corporate operations into the fourth quarter of 2027. Net cash used in operating activities for the first nine months of 2026 was 26 million, compared with 21.3 million for the first nine months of 2025. This increase primarily reflected the higher net loss partially offset by changes in operating assets and liabilities. Turning to the income statements, our research and development expense was $9.2 million for the third quarter and $25.4 million for the first nine months of 2026, compared with $6.4 million and $17.9 million for the corresponding periods of 2025. These increases were driven primarily by the expansion of our clinical team, ongoing Remedy 2 activities, including the trial's global expansion, Startup Activities for our Phase 2 Preeclampsia Study in Canada and the United Kingdom, additional reproductive toxicity testing supporting our planned U.S. preeclampsia program, increased manufacturing development activity, and higher non-cash share-based compensation charges. We expect that research and development expenses will increase moderately relative to recent prior periods as enrollment continues in Remedy 2 and Startup Activities Progress in their Global Phase 2 Preeclampsia Study. General and administrative expense was $2.4 million for the third quarter and $7.2 million for the first nine months of 2026, compared with $2.6 million and $7.3 million, respectively, for the same periods in 2025. The modest reductions primarily reflected lower professional fees, partially offset by increased non-cash share-based compensation in the current quarter, and increased personnel costs over the nine-month period. We expect general and administrative expense to remain relatively steady compared with recent prior periods. Our net loss for the third quarter was 11.3 million or 21 cents per share compared with 8.6 million or 17 cents per share in the third quarter of 2025. For the nine months ended September 30, our net loss was 31.5 million or 58 cents per share compared with 24 million or 53 cents per share for the same period in the prior year.
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With that, operator, please open the call for questions.
Operator
Conference Call Operator
We will now begin the question and answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, press star one again. And your first question comes from the line of Thomas Flayton with Lake Street Capital Markets. Please go ahead.
Thomas Flaten
Analyst, Lake Street Capital Markets
Hey, good morning. I appreciate you taking the questions. Just two for me. Rick, assuming that current pacing is maintained, do you have a projection on how many patients will be enrolled in the stroke study by the time the interim analysis reads out?
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Thanks, Thomas.
Rick Pauls
President and Chief Executive Officer
We haven't provided specific updates, but Hopefully, we'll be getting closer to the 300th patient in total. So, if 300 patients is the final amount, we'd hopefully only need a few more months to complete enrollment. Got it.
Thomas Flaten
Analyst, Lake Street Capital Markets
And then, this is a bit of in the weeds question, and I don't want to get ahead of the event in a week and a half, but you mentioned in your prepared remarks that birth weight was going to be measured in the FGR cohorts. I'm just curious what your benchmarking birth weight percentile is. against, is it a projection at the time they start treatment? Can you just help me think that one through?
Rick Pauls
President and Chief Executive Officer
Yeah, if you could hang tight here, we'll have that here in a week and a half, and we really look forward to sharing the full results at the conference, at the event.
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Got it. Appreciate it. Thank you.
Operator
Conference Call Operator
Your next question comes from the line of Stacy Koo with TD Cowan. Please go ahead.
Stacy Koo
Analyst, TD Cowen
Thanks so much for taking your questions, and we are looking forward to the KOL event in two weeks. So we're also going to try to get a couple of, I would say, heads up for the FGR data as we await kind of the detailed discussion points. A few things, we can talk through your current thinking on the potential differences in dosing as we think about hypotension and the patient population. and then two, as we think about the patient population that you're enrolling, you've seen the path, they're gonna be very severe. So you're planning to disclose what percent have concomitant preeclampsia or are they gonna be FGR patients kind of purely? And then Julie, a question on kind of the recordings for vascular resistance. How frequently are we recording the updates for a possibility index? So just trying to understand when we get the data, how we kind of put it all together. And then last question, Rick, if you're willing to comment, as we get the early proof of concept for fetal growth restriction, what kind of read-through would you expect as we think about the early onset preeclampsia opportunity? Those might be questions. Thank you so much.
Rick Pauls
President and Chief Executive Officer
All right. Thanks, Stacey. Yeah, for the FTR data, I mean, we're going to be sharing results from the cohorts 1 and 2, so 5 and 10 micrograms per kg. and then based upon that we'll share our plans in terms of the next dose that will likely looking at going at a higher level while we also do believe there's a potential to in the future measure at a lower levels as well. In terms of severity, so these are very severe patients so the severity, the pulsatility index is in the, the fetal weight is in the third percentile or less whereas the official definition for fetal growth is a tenth percentile. So these are very small, very severe severity. And then in terms of read-through with regards to the preeclampsia, many preeclampsia patients also have fetal growth restriction, but one of the main differences though is that preeclampsia patients, in particular early onset, have typically more severe endothelial dysfunction. that often results in hypertension, high blood pressure. And so one of the things that we feel very clearly that our drug does is control blood pressure. So if we control positive effects in this FGR, which is focusing more on blood flow to the placenta and extending gestational days, I think that will have us feeling even more excited about the prospects for preeclampsia where we think we can also address the more severe endothelial dysfunction and from past studies, about half of pre-eclampsia patients, the reason they have to deliver is high blood pressure, which we think we can also address. So again, I think this should, assuming we share some positive results, this should be very encouraging in terms of the read-through. And then Julie?
Dr. Julie Krop
Chief Medical Officer
Yeah, hi Stacey, thanks for the question. So early on, they're checked more often, and then if they stabilize every three days is typically when we would measure them in the study.
Unknown
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Super helpful.
Stacy Koo
Analyst, TD Cowen
Thank you so much. Looking forward to it.
Operator
Conference Call Operator
Your next question comes from the line of Matthew Caulfield with HC Wainwright. Please go ahead.
Matthew Caulfield
Analyst, HC Wainwright
Hi. Good morning. Thank you, guys. Looking towards the Phase 2 FGR interim data, what could be key signals or any initial thresholds for pregnancy elongation and observations for the uterine and umbilical artery Doppler measurements? Any additional thoughts there on what success could look like? Thanks.
Rick Pauls
President and Chief Executive Officer
Yeah, thanks, Matt. So what we'll be sharing during the call is the prolongation days, and we will compare that to historical controls. and so it will also depend on severity. So if we're targeting the more severe patients, there'll be less prolongation expected from historical, whereas they're less severe, they'll be longer. And so we'll share some historical data that I think will help to support a difference in terms of outcomes with what we're seeing thus far.
Matthew Caulfield
Analyst, HC Wainwright
And then any thoughts on the Doppler measurements?
Rick Pauls
President and Chief Executive Officer
Yeah, historically, you're looking at seeing more, you know, these patients typically only worsen So what we believe is that even a stabilization would be good, whereas if we can see an absolute reduction, that would be great. Again, compared to historical controls, they're typically more stable to worsening, which would be increasing.
Dr. Julie Krop
Chief Medical Officer
So, and I guess in terms of the Doppler findings, you know, if you start to, obviously, you know, sustained reversed blood flow would be a signal for immediate delivery. and so we're looking at those signals as well and looking at absence, we're looking at reversal, we're looking at forward flow and all those things contribute along with the pulsatility index and how the baby is doing too when delivery is needed. So as Rick mentioned, there are benchmarks about how those parameters affect when to end gestation and deliver the baby.
Unknown
Unidentified speaker / transcript attribution artifact
Excellent. Thank you, guys. Looking forward to it.
Operator
Conference Call Operator
Your next question comes from the line of Chase Knickerbocker with Craig Hellam. Please go ahead.
Chase Knickerbocker
Analyst, Craig-Hallum
Good morning. Thanks for taking the questions. Rick, I know we've talked about this in the past, but I wanted to get your thoughts, you know, again, as we approach the interim resampling and stroke. Can you just give us a sense for how you're thinking about decision tree around the trial and resample size. So, you know, really asking, is there a threshold of resample size at the high end of the range or continuing? You know, does it make practical sense in your mind or a threshold at which there's a go, no-go decision? Just trying to get your thoughts on there ahead of that. Thanks.
Rick Pauls
President and Chief Executive Officer
Sure. Yeah, so right now, so the interim analysis, if we're not seeing a drug effect, you know, we will stop the study for futility. Otherwise, if we see a drug effect, a lot of it depends on the statistical analysis plan, but if we see a drug effect that's comparable to what we saw in our Phase 2, we'd be looking at closer to 300 patients. If we see a drug effect closer to 6%, we'd be looking at the high end of 728. So I think that'll give us a very good indication in terms of where the drug effect is coming in.
Unknown
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Got it.
Chase Knickerbocker
Analyst, Craig-Hallum
Maybe just on the company-sponsored phase two, I think you previously expected that first enrollment in Q4. Can you just give us a little bit of a sense or a little bit more detail just on the kind of status there, what might be causing some delays? And then you also noted that it's going to be informed by preliminary FGF results. So can you just give us your kind of thoughts there on kind of what that means for that company-sponsored phase two? Thanks.
Rick Pauls
President and Chief Executive Officer
Yeah, so we're doing everything we can to expedite the process. So we've been providing customized contracts and budgets to simplify the process with the sites. Ultimately, you know, we're subject to some of the constraints of the administration and process at each site. So we would still like to see enrollment this year, but worst case, you know, it should be early in 2027. That study will be quite comparable to the phase two early onsets in South Africa. So also looking at three different dose levels. We're looking at six patients per dose level, and then we'll select one of those three doses and have an additional 12 patients. So it'll be very comparable, again, to the South African study. That should be starting here in the next few weeks.
Chase Knickerbocker
Analyst, Craig-Hallum
And then just last for me, if we think about potential IND approval in the US, assuming satisfactory data here shortly, Should we think about it as expanding enrollment from that current company-sponsored phase two, or is there other program plans in the U.S.? Just your thoughts there. Interesting questions.
Rick Pauls
President and Chief Executive Officer
Yep. Yep, that's the current plan, is that it would be an expansion of the existing study that will be starting off in Canada and the U.K., and we're also already looking at what that next larger clinical trial will look like for early-onset preeclampsia.
Unknown
Unidentified speaker / transcript attribution artifact
Thanks, Rick.
Operator
Conference Call Operator
That concludes today's question and answer session. I will turn the call back to Rick Pauls for closing remarks.
Rick Pauls
President and Chief Executive Officer
All right. Thank you, operator, and thank you, everyone, for joining us this morning. Looking ahead, our next major milestones are for the November 24th Feudal Growth Restriction, KOL, event and the expected completion of the revenue to Data Safety Monitoring Board interim analysis in the first quarter of 2027. At the same time, we're preparing to initiate our additional preeclampsia studies and advancing our U.S. regulatory efforts. Together, these activities will help inform the next stages of DM-19's clinical development. Thank you for all your continued interest in Diet Medica. We look forward to updating you as these programs progress. Operator, you may now conclude the call.
Operator
Conference Call Operator
This concludes today's Diet Medical Therapeutics Earnings Conference Call. Thank you for participating. You may now disconnect.