Rivastigmine Tartrate

Launched ZUNVEYL (benzgalantamine) to US market on March 17, 2025 Secured business development licensing revenues of $2.6M for partnership with CMS Pharma Cash and cash equivalents of $45.5 million as of March 31, 2025, compared to $48.6 million as of December 31, 2024. At current cash utilization rates, the Company expects a cash runway of approximately two years. Vancouver, BC — (BUSINESS WIRE) — May 15th, 2025 — Alpha Cognition Inc. (Nasdaq: ACOG) (“Alpha Cognition”, or the “Company”) today announced its financial results for the first quarter ended March 31, 2025. “We closed the quarter on a strong note, launching ZUNVEYL® to the long-term care market,” said Michael McFadden, Chief Executive Officer. “We feel that the company is operating at a high level and are on schedule and within budget on all of our launch plans. Early market feedback on ZUNVEYL utilization reinforces our belief that ZUNVEYL can be a disruptive product for the Alzheimer’s segment. The team is reporting successful patient stories that fuel our passion to tell more health care providers about ZUNVEYL.” Recent Business and Operational Highlights: Commercial Readiness: Alpha Cognition launched ZUNVEYL to long term care market on time and within budget. Early clinician feedback underscores ZUNVEYL’s positive impact on cognitive function, established safety profile, and convenient administration. Medicare reimbursement secured shortly after launch, expanding access for long-term care patients. Robust initial demand reflected in broad ordering activity and early product replenishment by wholesalers. Order momentum is building, with many accounts already submitting reorders. Field team actively engaging the majority of high-priority long-term care targets nationwide. Strengthened Intellectual Property Portfolio: The Company secured a new composition of matter patent in the U.S., covering the tablet formulation of benzgalantamine. This patent extends ZUNVEYL’s U.S. protection through 2044 and global protection through 2041, enhancing Alpha Cognition’s long-term competitive position. The Company received notice from FDA regarding an extension of a method of use patent. The final extension date is expected to be provided by the agency in Q3 2025. First Quarter 2025 Financial Results: Zunveyl net product revenues of $347 thousand for the quarter ended March 31, 2025. Licensing revenue of $2.6M for the quarter ended March 31, 2025. Research and development expenses for the three months ended March 31, 2025 were $408 thousand compared to $917 thousand for the same period in 2024. Selling, general and administrative expenses for the three months ended March 31, 2025 were $5.4 million compared to $3.5 million for the same period in 2024, driven primarily by commercial-readiness activities. Net loss for the for the three months ended March 31, 2025 were $2.0 million compared to $5.0 million for the same period in 2024 Cash and cash equivalents of $45.5 million as of March 31, 2025 compared to $48.6 million as of December 31, 2024. At current cash utilization rates, the Company expects a cash runway of approximately two years. About Alpha Cognition Inc. Alpha Cognition Inc. is a commercial stage, biopharmaceutical company dedicated to developing treatments for patients suffering from neurodegenerative diseases, such as Alzheimer’s disease and Cognitive Impairment with mild Traumatic Brain Injury (“mTBI”), for which there are currently no approved treatment options. ZUNVEYL is a patented drug approved as a new generation acetylcholinesterase inhibitor for the treatment of Alzheimer’s disease, with expected minimal gastrointestinal side effects. ZUNVEYL’s active metabolite is differentiated from donepezil and rivastigmine in that it binds neuronal nicotinic receptors, most notably the alpha-7 subtype, which is known to have a positive effect on cognition. ALPHA-1062 is also being developed in combination with memantine to treat moderate to severe Alzheimer’s dementia, and as an intranasal formulation for Cognitive Impairment with mTBI. For further information: Investor Relations IR@alphacognition.com https://www.alphacognition.com/ INDICATION AND USAGE ZUNVEYL is a cholinesterase inhibitor indicated for the treatment of mild to moderate dementia of the Alzheimer’s type in adults. IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS ZUNVEYL is contraindicated in patients with known hypersensitivity to benzgalantamine, galantamine, or to any inactive ingredients in ZUNVEYL. Serious skin reactions have occurred. WARNINGS AND PRECAUTIONS Serious Skin Reactions: Serious skin reactions (Stevens-Johnson syndrome and acute generalized exanthematous pustulosis) have been reported in patients receiving galantamine (the active metabolite of ZUNVEYL tablets). If signs or symptoms suggest a serious skin reaction, use of this drug should not be resumed, and alternative therapy should be considered. Anesthesia: See Drug Interactions Section Cardiovascular Conditions: Cholinesterase inhibitors, including ZUNVEYL, have vagotonic effects on the sinoatrial and atrioventricular nodes, leading to bradycardia and AV block. Bradycardia and all types of heart block have been reported in patients taking cholinesterase inhibitors, both with and without known underlying cardiac conduction abnormalities. Therefore, all patients should be considered at risk for adverse effects on cardiac conduction. Patients treated with galantamine up to 24 mg/day using the recommended dosing schedule showed a dose-related increase in risk of syncope. Gastrointestinal Conditions: Cholinesterase inhibitors, including ZUNVEYL, may increase gastric acid secretion. Patients should be monitored closely for active or occult gastrointestinal bleeding, especially those with a history of ulcer disease or those receiving concurrent nonsteroidal anti-inflammatory drugs (NSAIDs). Clinical studies of galantamine have shown no increase, relative to placebo, in the incidence of either peptic ulcer disease or gastrointestinal bleeding. Galantamine has been shown to produce nausea, vomiting, diarrhea, anorexia, and weight loss. Monitor the patient's weight during therapy with ZUNVEYL. Genitourinary Conditions: Although this was not observed in clinical trials with galantamine, cholinesterase inhibitors, including ZUNVEYL, may cause bladder outflow obstruction. Neurological Conditions: Cholinesterase inhibitors are believed to have some potential to cause generalized convulsions. Seizure activity may also be a manifestation of Alzheimer's disease. Patients with Alzheimer's disease should be monitored closely for seizures while taking ZUNVEYL. Pulmonary Conditions: Cholinesterase inhibitors, including ZUNVEYL, should be prescribed with care to patients with a history of severe asthma or obstructive pulmonary disease. Monitor for respiratory adverse reactions. ADVERSE REACTIONS The most common adverse reactions with galantamine tablets (≥5%) were nausea, vomiting, diarrhea, dizziness, headache, and decreased appetite. DRUG INTERACTIONS Use with Anticholinergics: Galantamine has the potential to interfere with the activity of anticholinergic medications. Use with Cholinomimetics and Other Cholinesterase Inhibitors: A synergistic effect is expected when cholinesterase inhibitors are given concurrently with succinylcholine, other cholinesterase inhibitors, similar neuromuscular blocking agents or cholinergic agonists such as bethanechol. USE IN SPECIFIC POPULATIONS Pregnancy: Based on animal data may cause fetal harm. Hepatic Impairment: In patients with moderate hepatic impairment, a decrease in clearance of galantamine was observed; therefore, a dosage adjustment is recommended. Use of ZUNVEYL in patients with severe hepatic impairment is not recommended. Renal Impairment: In patients with a creatinine clearance of 9 to 59 mL/min, an increase in exposure of galantamine was observed; therefore, a dosage adjustment is recommended. Use of ZUNVEYL in patients with creatinine clearance less than 9 mL/min is not recommended. These are not all of the possible side effects of ZUNVEYL. You can report side effects to the FDA. Visit www.fda.gov/MedWatch or call 1‑800‑FDA‑1088. Please click here for Full Prescribing Information. Forward-looking Statements This news release includes forward-looking statements within the meaning of applicable securities laws. Except for statements of historical fact, any information contained in this news release may be a forward‐looking statement that reflects the Company’s current views about future events and are subject to known and unknown risks, uncertainties, assumptions and other factors that may cause the actual results, levels of activity, performance or achievements to be materially different from the information expressed or implied by these forward-looking statements. In some cases, you can identify forward‐looking statements by the words “may,” “might,” “will,” “could,” “would,” “should,” “expect,” “intend,” “plan,” “objective,” “anticipate,” “believe,” “estimate,” “predict,” “project,” “potential,” “target,” “seek,” “contemplate,” “continue” and “ongoing,” or the negative of these terms, or other comparable terminology intended to identify statements about the future. Forward‐looking statements may include statements regarding the potential benefits of the licensing agreement for the development and commercialization of ZUNVEYL in Asia (excluding Japan), Australia and New Zealand, the Company’s timing and planned activities to launch ZUNVEYL in the U.S. and China, the timing for the Company’s planned corporate update call, the potential timing for the availability of ZUNVEYL in the U.S. and China, the potential future developments of ZUNVEYL in China, the potential market size for ZUNVEYL in China, the Company’s business strategy for the launch of ZUNVEYL in China, the market size and demand for ZUNVEYL in China, the Company’s potential growth opportunities in China, the timing and results of the Company’s milestone payments for China, the Company’s regulatory submissions in China, and the potential regulatory approval and commercialization of the Company’s products in China. Although the Company believes to have a reasonable basis for each forward-looking statement, we caution you that these statements are based on a combination of facts and factors currently known by us and our expectations of the future, about which we cannot be certain. The Company cannot assure that the actual results will be consistent with these forward-looking statements. These forward-looking statements are subject to certain risks, including risks regarding our ability to raise sufficient capital to implement our plans to commercialize ZUNVEYL, risks regarding the efficacy and tolerability of ZUNVEYL, risks related to ongoing regulatory oversight on the safety of ZUNVEYL, risk related to market adoption of ZUNVEYL, risks related to the Company’s intellectual property in relation to ZUNVEYL, risks related to the commercial manufacturing, distribution, marketing and sale of ZUNVEYL, risks related to product liability and other risks as described in the Company’s filings with Canadian securities regulatory authorities and available at www.sedar.com and the Company’s filings with the United States Securities and Exchange Commission (the “SEC”), including those risk factors under the heading “Risk Factors” in the Company’s Form S-1/A registration statement as filed with the SEC on November 6, 2024 and available at www.sec.gov. These forward‐looking statements speak only as of the date of this news release and the Company undertakes no obligation to revise or update any forward‐looking statements for any reason, even if new information becomes available in the future, except as required by law.

-01-引言阿尔茨海默病（Alzheimer′s disease，AD）是发生于老年期和老年前期的神经系统退行性疾病，起病隐袭且病程呈进行性发展，临床表现以获得性认知功能损害为核心症状，涉及记忆、学习、定向、理解、判断、计算、语言和视空间等认知域，不同程度地影响日常生活能力及社会职业功能，最终进展为全面性痴呆。根据GBD数据，2019年全球AD及相关痴呆的患病人数达到5162万，总体患病率为 667.2/10万，年龄标化患病率为 682.5/10万。同年，我国 AD 及相关痴呆总人数为1314 万， 大约占全球AD患者总人数的25.5%，我国AD及相关痴呆总体患病率为924.1/10万，年龄标化患病率为788.3/ 10万。目前我国国家药品监督管理局批准用于治疗 AD的一线药物包括胆碱酯酶抑制剂，如多奈哌齐、 卡巴拉汀等 ，以及N‑甲 基‑D‑门冬氨酸（NMDA）受体拮抗剂美金刚。2019年国家药品监督管理局有条件批准了甘露特钠胶囊上市注册申请，用于治疗轻度至中度AD。2024 年 1 月仑卡奈单抗（lecanemab）注射液获国家药品监督管理局批准上市，用于治疗由 AD引起的 MCI和轻度痴呆。然而，这些方法多半是对症治疗，近一半的患者对现有药物治疗的效果不满，其次是药物价格贵。因此，亟须针对这些问题和痛点进一步改善我国AD患者的治疗现状。主动免疫疗法，即疫苗接种，是针对淀粉样β（Aβ）的阿尔茨海默病（AD）研究最彻底的治疗方法之一。在20多年前， AN1792疫苗在临床进行了研究，虽然因为毒性问题没有继续开发，然而人们也从中看到了疫苗预防AD的潜力。AD的疫苗预防可能改变阿尔茨海默症目前的困境。-02-一、AD的发病机制目前，AD研究的主流观点认为，AD的发病机制是Aβ与Tau蛋白的协同作用结果：Aβ的毒性级联反应Aβ由淀粉样前体蛋白（APP）裂解产生，其可溶性寡聚体（AβOs）是神经毒性的“真凶”。它们攻击突触功能，触发炎症，并诱导Tau蛋白过度磷酸化，形成NFTs。研究表明，可溶性AβOs比斑块与认知衰退的相关性更强。Tau蛋白的雪崩效应Tau蛋白过度磷酸化后脱离微管，形成NFTs，破坏神经元运输系统。这种病理过程存在“交叉播种效应”：AβOs加速Tau病变扩散，而NFTs恶化神经元死亡。炎症与免疫失衡小胶质细胞和星形胶质细胞的慢性炎症反应进一步破坏脑内稳态，形成“病理恶性循环”。-03- 二、疫苗：AD预防的免疫堡垒传统药物治疗聚焦症状缓解，疫苗则直击疾病上游，提供“治未病”的可能。其核心策略包括：1. 精准打击Aβ毒性寡聚体AD疫苗通过诱导抗体中和AβOs，阻止其破坏突触并触发炎症。动物模型显示，靶向AβOs的疫苗可显著延缓认知衰退。2. Th2极化理想疫苗需诱导抗炎性Th2免疫反应，避免促炎性Th1反应加重脑损伤。佐剂选择是关键：传统铝佐剂（Alum）可能引发炎症副作用，而新型Th2偏向佐剂（如TLR9激动剂）可能解决上述问题。3. 被动免疫的局限性单克隆抗体（如Lecanemab、Donanemab和Aducanumab）虽可快速清除Aβ，但需频繁注射且成本高昂。主动免疫疫苗通过激发自身免疫记忆，提供长期保护，更适合预防性应用。-04-三、AD疫苗的开发现状AN-1792是第一个人类Aβ主动免疫疗法，由合成全长人类Aβ42和佐剂QS-21组成。AN-1792的1期临床研究包括372名轻度至中度AD患者。第1阶段试验的结果表明，该疫苗可诱导对Aβ42的抗体反应，并可清除大脑中的斑块。然而，在II期试验中，由于患者发展为脑膜炎，临床试验暂停。尽管AN-1792临床试验有副作用，但该研究的结果鼓励开发新的主动抗Aβ免疫治疗方法。 CAD106疫苗由诺华公司研发，通过诱导抗体产生来减少β淀粉样斑块。该疫苗由截短的β-淀粉样蛋白片段（Aβ1-6）组成，以避免T细胞活化。在第一阶段试验的52周内没有出现脑膜炎的迹象。然而由于缺乏疗效，目前已停止开发。ABvac40疫苗由Araclon Biotech开发，其结构针对Aβ40的C末端，包含与KLH偶联的Aβ33–40。ABvac40 2023年公布了II期临床结果，达到了主要终点，与安慰剂相比，ABvac40治疗可将疾病进展的速度减慢38%。ACI-24疫苗由AC Immune开发，包含Aβ1-15表位，不包括T细胞表位，以避免T细胞反应。ACI‐24的 II期临床试验由于低免疫原性撤回，正在继续优化；新分子ACI-24.060被武田以里程碑总价22亿美元引进。UB-311疫苗由United Biomedical开发，含有Aβ1-14表位，并与辅助T细胞肽表位融合，利用CpG作为佐剂。肽混合物将诱导B细胞反应，同时避免T细胞的炎症反应。2023年发表的2期研究结果显示，UB-311治疗达到了主要终点，该疗法具有良好安全性、耐受性，并产生稳健的免疫应答。-05-四、AD疫苗研发开发的挑战虽然AD疫苗展现出缓解AD进展的前景，但AD疫苗研发仍面临多重“拦路虎”：1. 免疫衰老（Immunosenescence）:老年人群免疫应答低下，疫苗需克服T细胞功能衰退和慢性炎症背景。2. 血脑屏障（BBB）阻碍98%的大分子抗体无法穿透BBB，新型的递送技术是破局方向。3. 患者异质性：AD亚型复杂，需基于生物标志物（如Aβ-PET、脑脊液pTau）细分人群，实现精准免疫。4. 临床试验设计困境：AD进程缓慢，需超长随访（10年以上）和替代终点（如Aβ清除率）加速验证。5. 安全性红线：避免诱发自身免疫性脑膜炎（如AN1792）或微出血，是疫苗设计的核心原则。-06-五、未来方向：多靶点联合与技术创新1. 靶向“Aβ-Tau轴”复合疫苗：同时激活针对AβOs和异常Tau的免疫应答，阻断病理级联。2. 新型递送系统：鼻内疫苗、DC细胞疫苗或外泌体载体可能增强脑内抗体渗透。3. 佐剂革命：开发纯Th2极化佐剂，平衡免疫激活与安全性。4. 人工智能助力设计：AI预测抗原表位和抗体结合构象，缩短疫苗开发周期。-07-结语AD是一种严重影响人类健康的多因素异质性神经退行性疾病，目前还没有能够治愈的药物，已获得批准的药物也只能减缓疾病的进展。因此，AD最好在发生严重认知障碍之前进行早期干预，AD预防有潜力可能实现延迟或预防AD痴呆的治疗目标。AD疫苗研发虽荆棘密布，但随着对病理机制的解码和技术迭代，未来十年或有革命性疫苗问世。“疫苗或许不能逆转时光，但能让我们优雅地老去。”愿未来AD将不再成为困扰我们的严重疾病。参考资料：1. The Importance of Vaccines in Preventing Impending Alzheimer's Epidemic. Rev Recent Clin Trials.2025 Apr 14.2. The informed road map to prevention of Alzheimer Disease: A call to arms. Mol Neurodegener.2021 Jul 21;16(1):49.公众号内回复“ADC”或扫描下方图片中的二维码免费下载《抗体偶联药物：从基础到临床》的PDF格式电子书！公众号已建立“小药说药专业交流群”微信行业交流群以及读者交流群，扫描下方小编二维码加入，入行业群请主动告知姓名、工作单位和职务。