UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549


 

FORM 10-Q

(Mark one)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

 

For the quarterly period ended SeptemberJune 30, 20202021

 

or

 

TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934‐‐

 

For the transition period from ________________ to __________________.

 

Commission File Number: 001-36291

____________________


 

DIAMEDICA THERAPEUTICS INC.

(Exact name of registrant as specified in its charter)

 

British Columbia

(State or other jurisdiction of incorporation or organization)

Not Applicable

(I.R.S. Employer Identification No.)

 

Two Carlson Parkway, Suite 260

Minneapolis, Minnesota 55447

(Address of principal executive offices) (Zip code)

 

(763) 312-6755312-6755

(Registrant’s telephone number, including area code)

 

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

 

Title of each class

Trading Symbol

Name of each exchange on which registered

Voting common shares, no par value per share

DMAC

The Nasdaq Stock Market LLC

 

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. YESYesNONo

 

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). YESYesNONo

 

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

 

Large accelerated filer ☐

Accelerated filer ☐

Non-accelerated filer ☒

Smaller reporting company ☒

Emerging growth company ☒

 

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☒

 

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

 

As of November 2, 2020,August 9, 2021, there were 18,739,07418,786,157 voting common shares of the registrant outstanding.



 

 

 

 

DiaMedica Therapeutics Inc.

FORM 10-Q

SeptemberJune 30, 20202021

 

TABLE OF CONTENTS

 

Description

Page
  

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

1
   

PART I.

FINANCIAL INFORMATION

2
   

Item 1.

Financial Statements

2

Item 2.

Management’s Discussion and Analysis of Financial Condition and Results of Operations

14

Item 3.

Quantitative and Qualitative Disclosures about Market Risk

21

20

Item 4.

Controls and Procedures

21

20

   

PART II.

OTHER INFORMATION

 

Item 1.

Legal Proceedings

21

Item 1.1A.

Legal Proceedings

Risk Factors

22

21

Item 1A.Risk Factors 22

Item 2.

Unregistered Sales of Equity Securities and Use of Proceeds

24

21

Item 3.

Defaults Upon Senior Securities

25

22

Item 4.

Mine Safety Disclosures

25

22

Item 5.

Other Information

25

22

Item 6.

Exhibits

25

22

   
SIGNATURE PAGE2623

_________________


 

This quarterly report on Form 10-Q contains certain forward-looking statements within the meaning of Section 27A of the United States Securities Act of 1933, as amended, and Section 21E of the United States Securities Exchange Act of 1934, as amended, that are subject to the safe harbor created by those sections. For more information, see Cautionary Note Regarding Forward-Looking Statements.

 

As used in this report, references to “DiaMedica,DiaMedica, the “Company,Company, “we,we, “our”our or “us,us, unless the context otherwise requires, refer to DiaMedica Therapeutics Inc. and its subsidiaries, all of which are consolidated in DiaMedica’s DiaMedicas condensed consolidated financial statements. References in this report to “common shares”common shares mean our voting common shares, no par value per share.

 

We own various unregistered trademarks and service marks, including our corporate logo. Solely for convenience, the trademarks and trade names in this report are referred to without the ® and symbols, but such references should not be construed as any indicator that the owner of such trademarks and trade names will not assert, to the fullest extent under applicable law, their rights thereto. We do not intend the use or display of other companies’companies trademarks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies.

 

 

 

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

 

Statements in this report that are not descriptions of historical facts are forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995 that are based on management’s current expectations and are subject to risks and uncertainties that could negatively affect our business, operating results, financial condition and share price. We have attempted to identify forward-looking statements by terminology including “anticipates,” “believes,” “can,” “continue,” “could,” “estimates,” “expects,” “intends,” “may,” “plans,” “potential,” “predicts,” “should,” “will,” “would,” the negative of these terms or other comparable terminology, and the use of future dates.

 

The forward-looking statements in this report include, among other things, statements about:

 

 

our plans to develop, obtain regulatory approval for and commercialize our DM199 product candidate for the treatment of acute ischemic stroke (AIS) and chronic kidney disease (CKD) and acute ischemic stroke (AIS) andour expectations regarding the benefits of our expectations regarding the benefits of our DM199 product candidate;

 

our ability to conduct successful clinical testing of our DM199 product candidate for AIS and CKD and AIS;certain anticipated dates with respect to our pending and anticipated clinical studies;

 

our ability to obtain required regulatory approvals of our DM199 product candidate for CKDAIS and AIS;CKD;

 

the perceived benefits of our DM199 product candidate over existing treatment options for CKDAIS and AIS;CKD;

 

the potential size of the markets for our DM199 product candidate and our ability to serve those markets;

the potential size of the markets for our DM199 product candidate and our ability to serve those markets;

 

the rate and degree of market acceptance, both in the United States and internationally, of our DM199 product candidate for CKDAIS and AIS;CKD;

 

our ability to partner with and generate revenue from biopharmaceutical or pharmaceutical partners to develop, obtain regulatory approval for and commercialize our DM199 product candidate for CKDAIS and AIS;CKD;

 

the success, cost and timing of planned clinical trials,studies, as well as our reliance on collaboration with third parties to conduct our clinical trials;studies;

 

our expectations regarding the impact of the novel strain of coronavirus, or COVID-19, pandemic on our business, including in particular the conduct of our clinical trialsstudies and the timing thereof;

our commercialization, marketing and the timing thereof;manufacturing capabilities and strategy;

our commercialization, marketing and manufacturing capabilities and strategy;

 

expectations regarding federal, state, and foreign regulatory requirements and developments, such as potential United States Food and Drug Administration (FDA) regulation of our DM199 product candidate for CKDAIS and AIS;CKD;

 

expectations regarding competition and our ability to obtain data exclusivity for our DM199 product candidate for CKDAIS and AIS;CKD;

 

our ability to obtain funding for our operations, including funding necessary to complete planned clinical trialsstudies and obtain regulatory approvals for our DM199 product candidate for CKDAIS and AIS;CKD;

 

our estimates regarding expenses, future revenue, capital requirements and needs for additional financing;

our estimates regarding expenses, future revenue, capital requirements and needs for additional financing;

 

our expectations regarding our ability to obtain and maintain intellectual property protection for our DM199 product candidate; and

our expectations regarding outcomes in our litigation with PRA Netherlands in the United States District Court; and

 

our anticipated use of the net proceeds from our underwritten public offerings.

 

These forward-looking statements are subject to a number of risks, uncertainties and assumptions, including those described under Part I. Item 1A. Risk Factors in our annual report on Form 10-K for the fiscal year ended December 31, 20192020 and “Part II. Item 1A. Risk Factors”those described above and elsewhere in this report. Moreover, we operate in a very competitive and rapidly-changing environment. New risks emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed in this report may not occur and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. YouForward-looking statements should not relybe relied upon forward-looking statements as predictions of future events. Although we believe that the expectations reflected in the forward-looking statements are reasonable, we cannot guarantee that the future results, levels of activity, performance or events and circumstances reflected in the forward-looking statements will be achieved or occur. Except as required by law, including the securities laws of the United States, we do not intend to update any forward-looking statements to conform these statements to actual results or to changes in our expectations.

 

1


 

PART I -

PART I - FINANCIAL INFORMATION

 

ITEM 1.

ITEM 1.FINANCIAL STATEMENTS

FINANCIAL STATEMENTS

 

DiaMedica Therapeutics Inc.

Condensed Consolidated Balance Sheets

(In thousands, except share amounts)

 

 

September 30, 2020

  

December 31, 2019

  

June 30, 2021

  

December 31, 2020

 
 

(unaudited)

      

(unaudited)

   

ASSETS

            

Current assets:

         

Cash and cash equivalents

 $9,797  $3,883  $2,228  $7,409 

Marketable securities

  20,826   3,995  19,067  20,098 

Amounts receivable

  335   823  16  340 

Prepaid expenses and other assets

  138   47   318   74 

Deposits

  10   88 

Total current assets

  31,106   8,836   21,629   27,921 
         

Non-current assets:

         

Operating lease right-of-use asset

  114   153  72  100 

Property and equipment, net

  50   64   73   74 

Total non-current assets

  164   217   145   174 
           

Total assets

 $31,270  $9,053  $21,774  $28,095 
         

LIABILITIES AND EQUITY

            

Current liabilities:

         

Accounts payable

 $720  $182  $239  $1,099 

Accrued liabilities

  658   1,076  1,132  864 

Finance lease obligation

  6   6  5  6 

Operating lease obligation

  59   54   64   59 

Total current liabilities

  1,443   1,318   1,440   2,028 
         

Non-current liabilities:

         

Finance lease obligation, non-current

  8   13  5  7 

Operating lease obligation, non-current

  61   105   11   46 

Total non-current liabilities

  69   118   16   53 
         

Shareholders’ equity:

         

Common shares, no par value; unlimited authorized; 18,739,074 and 12,006,874 shares issued and outstanding, as of September 30, 2020 and December 31, 2019, respectively

      

Common shares, no par value; unlimited authorized; 18,786,157 and 18,746,157 shares issued and outstanding, as of June 30, 2021 and December 31, 2020, respectively

 0  0 

Paid-in capital

  94,457   64,232  96,126  94,925 

Accumulated other comprehensive income

  10   2 

Accumulated other comprehensive loss

 (3) (2)

Accumulated deficit

  (64,709)  (56,617)  (75,805)  (68,909)

Total shareholders’ equity

  29,758   7,617   20,318   26,014 

Total liabilities and shareholders’ equity

 $31,270  $9,053  $21,774  $28,095 

 

See accompanying notes to the condensed consolidated financial statements.

 

2

 

DiaMedica Therapeutics Inc.

Condensed Consolidated Statements of Operations and Comprehensive Loss

(In thousands, except share and per share amounts)

(Unaudited)

 

 

Three Months Ended

September 30,

  

Nine Months Ended

September 30,

  

Three Months Ended

June 30,

  

Six Months Ended

June 30,

 
 

2020

  

2019

  

2020

  

2019

  

2021

  

2020

  

2021

  

2020

 

Operating expenses:

                 

Research and development

 $2,180  $1,617  $5,190  $6,098  $2,156  $1,600  $4,562  $2,949 

General and administrative

  1,139   1,044   3,241   2,725   1,209   1,108   2,422   2,163 

Operating loss

  (3,319

)

  (2,661

)

  (8,431

)

  (8,823

)

 (3,365

)

 (2,708

)

 (6,984

)

 (5,112

)

                 

Other (income) expense:

                

Other income:

 

Governmental assistance - research incentives

  (25

)

  (263

)

  (205

)

  (663

)

 0  (65

)

 0  (180

)

Other (income) expense, net

  (103

)

  38   (154

)

  (20

)

Other income, net

  (98

)

  (178

)

  (102

)

  (51

)

Total other income

  (128

)

  (225

)

  (359

)

  (683

)

 (98

)

 (243

)

 (102

)

 (231

)

                         

Loss before income tax expense

  (3,191

)

  (2,436

)

  (8,072

)

  (8,140

)

 (3,267

)

 (2,465

)

 (6,882

)

 (4,881

)

                 

Income tax expense

  2   12   20   29  7  9  14  18 
                         

Net loss

  (3,193

)

  (2,448

)

  (8,092

)

  (8,169

)

 (3,274

)

 (2,474

)

 (6,896

)

 (4,899

)

                 

Other comprehensive income

                

Other comprehensive income (loss)

 

Unrealized gain (loss) on marketable securities

  (19

)

  (5

)

  8   6    (13) 1  27 
                         

Net loss and comprehensive loss

 $(3,212

)

 $(2,453

)

 $(8,084

)

 $(8,163

)

 $(3,274

)

 $(2,487

)

 $(6,895

)

 $(4,872

)

                 

Basic and diluted net loss per share

 $(0.19

)

 $(0.20

)

 $(0.55

)

 $(0.68

)

 $(0.17

)

 $(0.17

)

 $(0.37

)

 $(0.36

)

Weighted average shares outstanding – basic and diluted

  16,689,074   12,006,874   14,652,749   11,981,233   18,786,157   14,139,074   18,776,461   13,623,400 

 

See accompanying notes to the condensed consolidated financial statements.

 

3

 

DiaMedica Therapeutics Inc.

Condensed Consolidated Statements of Shareholders’Shareholders Equity

For the NineSix Months Ended SeptemberJune 30, 20202021 and 20192020

(In thousands, except share and per share amounts)

(Unaudited)

 

 

Common
Shares

  

Paid-In
Capital

  

Accumulated Other
Comprehensive
Income

  

Accumulated
Deficit

  

Total
Shareholders’
Equity

  

Common

Shares

  

Paid-In

Capital

  

Accumulated Other Comprehensive

Income (Loss)

  

Accumulated

Deficit

  

Total

Shareholders

Equity

 

Balances at December 31, 2019

  12,006,874  $64,232  $2  $(56,617) $7,617 

Issuance of common shares net of offering costs of $819

  2,125,000   7,682         7,682 

Balances at December 31, 2020

 18,746,157  $94,925  $(2) $(68,909) $26,014 

Exercise of common stock options

  7,200   16         16  40,000  244      244 

Share-based compensation expense

   511      511 

Unrealized loss on marketable securities

     (2)   (2)

Net loss

            (3,622)  (3,622)

Balances at March 31, 2021

  18,786,157  $95,680  $(4) $(72,531) $23,145 

Share-based compensation expense

     393         393    446      446 

Unrealized gain on marketable securities

        40      40      1    1 

Net loss

           (2,425)  (2,425)           (3,274)  (3,274)

Balances at March 31, 2020

  14,139,074  $72,323  $42  $(59,042) $13,323 

Share-based compensation expense

     436         436 

Unrealized loss on marketable securities

        (13)     (13)

Net loss

           (2,474)  (2,474)

Balances at June 30, 2020

  14,139,074  $72,759  $29  $(61,516) $11,272 

Issuance of common shares net of offering costs of $1.8 million

  4,600,000   21,190         21,190 

Share-based compensation expense

     508         508 

Unrealized loss on marketable securities

        (19)     (19)

Net loss

           (3,193)  (3,193)

Balances at September 30, 2020

  18,739,074  $94,457  $10  $(64,709) $29,758 

Balances at June 30, 2021

  18,786,157  $96,126  $(3) $(75,805) $20,318 

 

 

Common
Shares

  

Paid-In
Capital

  

Accumulated Other
Comprehensive
Income

  

Accumulated
Deficit

  

Total
Shareholders’
Equity

  

Common

Shares

  

Paid-In

Capital

  

Accumulated Other Comprehensive

Income (Loss)

  

Accumulated

Deficit

  

Total

Shareholders

Equity

 

Balances at December 31, 2018

  11,956,874  $62,993  $  $(45,968) $17,025 

Share-based compensation expense

     130         130 

Unrealized gain on marketable securities

        3      3 

Net loss

           (3,252)  (3,252)

Balances at March 31, 2019

  11,956,874  $63,123  $3  $(49,220) $13,906 

Balances at December 31, 2019

 12,006,874  $64,232  $2  $(56,617) $7,617 

Issuance of common shares net of offering costs of $819

 2,125,000  7,682      7,682 

Exercise of common stock options

  50,000   75         75  7,200  16      16 

Share-based compensation expense

     182         182    393  0  0  393 

Unrealized gain on marketable securities

        8      8      40    40 

Net loss

           (2,469)  (2,469)           (2,425)  (2,425)

Balances at June 30, 2019

  12,006,874  $63,380  $11  $(51,689) $11,702 

Balances at March 31, 2020

  14,139,074  $72,323  $42  $(59,042) $13,323 

Share-based compensation expense

     451         451    436  0  0  436 

Unrealized loss on marketable securities

        (5)     (5)     (13)   (13)

Net loss

           (2,448)  (2,448)           (2,474)  (2,474)

Balances at September 30, 2019

  12,006,874  $63,831  $6  $(54,137) $9,700 

Balances at June 30, 2020

  14,139,074  $72,759  $29  $(61,516) $11,272 

 

See accompanying notes to the condensed consolidated financial statements.

 

4

 

DiaMedica Therapeutics Inc.

Condensed Consolidated Statements of Cash Flows

(In thousands)

(Unaudited)

 

 

Nine Months Ended September 30,

  

Six Months Ended June 30,

 
 

2020

  

2019

  

2021

  

2020

 

Cash flows from operating activities:

            

Net loss

 $(8,092

)

 $(8,169

)

 $(6,896

)

 $(4,899

)

Adjustments to reconcile net loss to net cash used in operating activities:

         

Share-based compensation

  1,337   763  957  829 

Amortization of discount on marketable securities

  (24

)

  (68

)

Amortization of premium (discount) on marketable securities

 38  (23

)

Non-cash lease expense

  39   36  28  26 

Depreciation

  16   16  12  11 

Changes in operating assets and liabilities:

         

Amounts receivable

  488   116  324  504 

Prepaid expenses

  (91

)

  280 

Deposits

  78   (39

)

Prepaid expenses and other assets

 (244

)

 (146

)

Accounts payable

  538   (171

)

 (860

)

 370 

Accrued liabilities

  (458

)

  (1

)

  239   (494

)

Net cash used in operating activities

  (6,169

)

  (7,237

)

 (6,402

)

 (3,822

)

         

Cash flows from investing activities:

            

Purchase of marketable securities

  (25,048

)

  (10,928

)

 (25,244

)

 (8,799

)

Maturities of marketable securities

  8,249   6,000  26,235  6,000 

Purchase of property and equipment

  (2

)

   

Disposition of property and equipment, net

     12 

Net cash used in investing activities

  (16,801

)

  (4,916

)

Purchases of property and equipment

 (13

)

 (2

)

Proceeds from disposition of property and equipment

  2   0 

Net cash provided by (used in) investing activities

 980  (2,801

)

         

Cash flows from financing activities:

            

Proceeds from issuance of common shares, net of offering costs

  28,872     0  7,682 

Proceeds from the exercise of stock options

  16   75  244  16 

Principal payments on finance lease obligations

  (4

)

  (4

)

  (3

)

  (3

)

Net cash provided by financing activities

  28,884   71  241  7,695 
         

Net increase (decrease) in cash and cash equivalents

  5,914   (12,082

)

 (5,181

)

 1,072 

Cash and cash equivalents at beginning of period

  3,883   16,823   7,409   3,883 

Cash and cash equivalents at end of period

 $9,797  $4,741  $2,228  $4,955 

 

See accompanying notes to the condensed consolidated financial statements.

 

5


 

DiaMedica Therapeutics Inc.

Notes to the Condensed Consolidated Financial Statements

(Unaudited)

 

 

1.

Business

 

DiaMedica Therapeutics Inc. and its wholly-owned subsidiaries, DiaMedica USA, Inc. and DiaMedica Australia Pty Ltd. (collectively we, us, our, DiaMedica and the Company), existare focused on developing novel treatments for theneurological disorders and kidney diseases. Currently, our primary purpose of advancing the clinical and commercial development offocus is on developing DM 199, a proprietary recombinant or synthetic,human tissue Kallikrein-1kallikrein-1 (KLK1) protein (KLK1) for the treatment of kidneyacute ischemic stroke (AIS) and neurological diseases with our primary focus on chronic kidney disease (CKD) and acute ischemic stroke (AIS). Our parent company is governed under the British Columbia Business Corporations Act, and our common shares are publicly traded on The Nasdaq Capital Market under the symbol “DMAC.”

 

 

2.

Risks, Uncertainties and UncertaintiesGoing Concern

 

DiaMedica operates in a highly regulated and competitive environment. The development, manufacturing and marketing of pharmaceutical products require approval from, and are subject to ongoing oversight by, the FDAFood and Drug Administration (FDA) in the United States, the European Medicines Agency (EMA) in the European Union and comparable agencies in other countries. We are in the clinical stage of development of our initial product candidate, DM199, for the treatment of CKDAIS and AIS.CKD. The Company has not completed the development of any product candidate and, accordingly, has not begun to commercialize any product candidate or generate any revenues from the commercial sale of any product candidate. DM199 requires significant additional clinical testing and investment prior to seeking marketing approval and is not expected to be commercially available for at least three to five years, if at all.

Additionally, clinical testing is currently being adversely impacted by the novel strain of the coronavirus (COVID-19) pandemic. We are experiencing slower than expected enrollment in the REDUX clinical trial due to the reduction or suspension of activities at our clinical study sites as they address staff and patient safety concerns and patient concerns related to visiting clinical study sites. We anticipate that the COVID-19 pandemic will likely continue to adversely affect our ability to recruit or enroll subjects and we cannot provide any assurance as to when sites will be able to resume enrollment at a normal rate.

The Company’s future success is dependent upon the success of its development efforts, its ability to demonstrate clinical progress for its DM199 product candidate in the United States or other markets, its ability to obtain required governmental approvals of its product candidate, its ability to license or market and sell its DM199 product candidate and its ability to obtain additional financing to fund these efforts.

 

As of SeptemberJune 30, 2020, 2021, we have incurred losses of $64.7$75.8 million since our inception in 2000. For the ninesix months ended SeptemberJune 30, 2020, 2021, we incurred a net loss of $8.1$6.9 million and negative cash flows from operating activities of $6.2$6.4 million. We expect to continue to incur operating losses until such time as any future product sales, royalty payments, licensing fees, and/or milestone payments generate revenue sufficient to fund our continuing operations. For the foreseeable future, we expect to incur significant operating losses as we continue the development and clinical trialsstudies of, and to seek regulatory approval for, our DM199 product candidate. As of SeptemberJune 30, 2020, 2021, DiaMedica had cash and cash equivalents of $9.8$2.2 million, marketable securities of $20.8$19.1 million, working capital of $29.7$20.2 million and shareholders’ equity of $29.8$20.3 million. Our principal source of cash has been net proceeds from the issuance of equity securities. Although the Company has previously been successful in obtaining financing through equity securities offerings, there is no assurance that we will be able to do so in the future. This is particularly true if our clinical data is not positive or economic and market conditions deteriorate.

 

We expect that we will need substantial additional capital to further our research and development activities, complete the required clinical trialsstudies and regulatory activities and otherwise develop our product candidate, DM199, or any future product candidates, to a point where they may be commercially sold. We expect our current cash, resources willcash equivalents and marketable securities, to be sufficient to allow us to complete all three cohorts in our REDUXcurrently ongoing Phase II2 study in patients with CKD and to otherwise fund our currently planned operations forinto the third quarter of 2022, but not at least the next twelve months from the date of issuance of these condensed consolidated financial statements. However, theThe amount and timing of our future funding requirements will depend on many factors, including the timing and results of ongoing development efforts, the potential expansion of current development programs, potential new development programs and related general and administrative support. We may require significant additional funds earlier than we currently expect and there is no assurance that we will not need or seek additional funding prior to such time. We may elect to raise additional funds even before we need themtime, especially if market conditions for raising additional capital are favorable.

The accompanying interim condensed consolidated financial statements have been prepared assuming that we will continue as a going concern which contemplates the realization of assets and liquidation of liabilities in the normal course of business and do not include any adjustments relating to the recoverability or classification of assets or the amounts of liabilities that might result from the outcome of these uncertainties. Our ability to continue as a going concern, realize the carrying value of our assets and discharge our liabilities in the ordinary course of business is dependent upon a number of factors, including our ability to obtain additional financing, the success of our development efforts, our ability to obtain marketing approval for our initial product candidate, DM199, in the United States, the European Union or other markets, and ultimately our ability to license and/or market and sell our initial product candidate. These factors, among others, raise substantial doubt about our ability to continue operations as a going concern. See Note 3 titled “Liquidity and Management Plans.”

 

6

 

 

3.

Summary of Significant Accounting PoliciesLiquidity and Management Plans

 

As of December 31, 2020 and June 30, 2021, the Company had an accumulated deficit of $68.9 million and $75.8 million, respectively, and the Company has not generated positive cash flow from operations since its inception.

Additional funding will be required to continue the Company’s research and development and other operating activities. In the next 12 months, we will likely seek to raise additional funds through various sources, such as equity or debt financings, or through strategic collaborations and license agreements. We can give no assurances that we will be able to secure additional sources of funds to support our operations, or if such funds are available to us, that such additional financing will be on terms acceptable to us or sufficient to meet our needs. This risk would increase if our clinical data is not positive or economic and market conditions deteriorate.

There can be no assurances that we will be able to obtain additional financing on commercially reasonable terms, or at all. To the extent we raise additional capital through the sale of equity or convertible debt securities, the ownership interests of our shareholders will be diluted. Debt financing, if available, may involve agreements that include conversion discounts or covenants limiting or restricting our ability to take specific actions, such as incurring additional debt or making capital expenditures. If we raise additional funds through government or other third-party funding, marketing and distribution arrangements or other collaborations, or strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates or grant licenses on terms that may not be favorable to us. The availability of financing may be affected by our clinical data and other results of scientific and clinical research; our ability to obtain regulatory approvals; market acceptance of our product candidates; the state of the capital markets generally with particular reference to pharmaceutical and biotechnology companies; the status of any then strategic alliance agreements; and other relevant commercial considerations.

If adequate funding is not available when needed, we may be required to scale back our operations by taking actions that may include, among other things, implementing cost reduction strategies, such as reducing use of outside professional service providers, reducing the number of our employees or employee compensation, modifying or delaying the development of our DM199 product candidate; licensing to third parties the rights to commercialize our DM199 product candidate for AIS, CKD or other indications that we would otherwise seek to pursue, or otherwise relinquishing significant rights to our technologies, future revenue streams, research programs or product candidates or granting licenses on terms that may not be favorable to us; and/or divesting assets or ceasing operations through a merger, sale, or liquidation of our company.

4.

Summary of Significant Accounting Policies

Interim financial statements

 

We have prepared the accompanying condensed consolidated financial statements in accordance with accounting principles generally accepted in the United States (US GAAP) for interim financial information and with the instructions to Form 10-Q10-Q and Regulation S-XS-X of the Securities and Exchange Commission (SEC). Accordingly, they do not include all of the information and footnotes required by US GAAP for complete financial statements. These condensed consolidated financial statements reflect all adjustments consisting of normal recurring accruals which, in the opinion of management, are necessary to present fairly our consolidated financial position, consolidated results of operations, consolidated statement of shareholders’ equity and consolidated cash flows for the periods and as of the dates presented. Our fiscal year ends on December 31. The condensed consolidated balance sheet as of December 31, 2019 2020 was derived from our audited consolidated financial statements. Certain prior year amounts have been reclassified to conform to the current year presentation. These condensed consolidated financial statements should be read in conjunction with our annual consolidated financial statements and the notes thereto. The nature of our business is such that the results of any interim period may not be indicative of the results to be expected for the entire year.

 

7

Cash and cash equivalentsequivalents

 

The Company considers all bank deposits, including money market funds, and other investments, purchased with an original maturity to the Company of three months or less, to be cash and cash equivalents. The carrying amount of our cash equivalents approximates fair value due to the short maturity of the investments.

 

Concentration of credit risk

 

Financial instruments that potentially expose the Company to concentration of credit risk consist primarily of cash, cash equivalents and marketable securities. The Company maintains its cash balances primarily with twoone financial institutions.institution. These balances generally exceed federally insured limits. The Company has not experienced any losses in such accounts and believes it is not exposed to any significant credit risk in cash and cash equivalents. The Company believes that the credit risk related to marketable securities is limited due to the adherence to an investment policy focused on the preservation of principal.

 

Marketable securities

 

The Company’s marketable securities typically consist of obligations of the United States government and its agencies, investment grade corporate obligations and bank certificates of deposit, which are classified as available-for-sale and included in current assets as they are intended to fund current operations. Securities are valued based on market prices for similar assets using third party certified pricing sources. Available-for-sale securities are carried at fair value with unrealized gains and losses reported as a component of shareholders’ equity in accumulated other comprehensive income (loss). The amortized cost of debt securities is adjusted for amortization of premiums and accretion of discounts to maturity. Such amortization or accretion is included in interest income. Realized gains and losses, if any, are calculated on the specific identification method and are included in other income in the condensed consolidated statements of operations.

 

Available-for-sale securities are reviewed for possible impairment at least quarterly, or more frequently if circumstances arise that may indicate impairment. When the fair value of the securities declines below the amortized cost basis, impairment is indicated and it must be determined whether it is other than temporary. Impairment is considered to be other than temporary if the Company: (i) intends to sell the security, (ii) will more likely than not be forced to sell the security before recovering its cost, or (iii) does not expect to recover the security’s amortized cost basis. If the decline in fair value is considered other than temporary, the cost basis of the security is adjusted to its fair market value and the realized loss is reported in earnings. Subsequent increases or decreases in fair value are reported as a component of shareholders’ equity in accumulated other comprehensive income (loss). There were no other-than-temporary unrealized losses as of SeptemberJune 30, 2020.2021.

 

7

Fair value measurements

 

Under the authoritative guidance for fair value measurements, fair value is defined as the exit price, or the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants as of the measurement date. The authoritative guidance also establishes a hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability developed based upon the best information available in the circumstances. The categorization of financial assets and financial liabilities within the valuation hierarchy is based upon the lowest level of input that is significant to the fair value measurement.

 

8

The hierarchy is broken down into three levels defined as follows:

 

Level 1 Inputs — quoted prices in active markets for identical assets and liabilities

Level 2 Inputs — observable inputs other than quoted prices in active markets for identical assets and liabilities

Level 3 Inputs — unobservable inputs

 

As of SeptemberJune 30, 2020, 2021, the Company believes that the carrying amounts of its other financial instruments, including amounts receivable, accounts payable and accrued liabilities, approximate their fair value due to the short-term maturities of these instruments. See Note 4, titled “Marketable Securities” for additional information.

Patent costs

Costs associated with applying for, prosecuting and maintaining patents are expensed as incurred given the uncertainty of patent approval and, if approved, the resulting probable future economic benefit to the Company. Patent-related costs, consisting primarily of legal expenses and filing/maintenance fees, are included in general and administrative costs and were $68,000 and $60,000 for the six months ended June 30, 2021 and 2020, respectively.

 

 

4.5.

Marketable Securities

 

The available-for-sale marketable securities are primarily comprised of investments in commercial paper, corporate bonds and government securities and consist of the following, measured at fair value on a recurring basis (in thousands):

 

 

Fair Value Measurements Using Inputs Considered as of:

  

Fair Value Measurements Using Inputs Considered as of:

 
 

September 30, 2020

  

December 31, 2019

  

June 30, 2021

 

December 31, 2020

 
 

Total

  

Level 1

  

Level 2

  

Level 3

  

Total

  

Level 1

  

Level 2

  

Level 3

  

Total

  

Level 1

  

Level 2

  

Level 3

  

Total

  

Level 1

  

Level 2

  

Level 3

 

Government securities

 $12,827  $  $12,827  $  $1,998  $  $1,998  $  $4,247  $0  $4,247  $0  $8,924  $0  $8,924  $0 

Bank certificates of deposit

  1,748      1,748                 0  0  0  0  496  0  496  0 

Commercial paper and corporate bonds

  6,251      6,251      1,997      1,997      14,820   0   14,820   0   10,678   0   10,678   0 

Total

 $20,826  $  $20,826  $  $3,995  $  $3,995  $  $19,067  $0  $19,067  $0  $20,098  $0  $20,098  $0 

 

Accrued interest receivable on available-for-sale securities is included in amounts receivable and was $38,000$9,000 and $25,000$34,000 as of SeptemberJune 30, 2020 2021 and December 31, 2019, 2020, respectively.

 

There were no transfers of assets between Level 1 and Level 2 of the fair value measurement hierarchy during the ninesix months ended SeptemberJune 30, 2020.2021.

 

Under the terms of the Company’s investment policy, purchases of marketable securities are limited to investment grade governmental and corporate obligations and bank certificates of deposit with a primary objective of principal preservation. Maturities of individual securities are less than one year and the amortized cost of all securities approximated fair value as of SeptemberJune 30, 2020 2021 and December 31, 2019.2020.

8

 

 

5.6.

Amounts Receivable

 

Amounts receivable consisted of the following (in thousands):

 

  

September 30, 2020

  

December 31, 2019

 

Research and development incentives

 $289  $793 

Accrued interest

  38   17 

Sales-based taxes receivable

     13 

Other

  8    

Total amounts receivable

 $335  $823 

6.

Deposits

Deposits consisted of the following (in thousands):

  

June 30, 2021

  

December 31, 2020

 

Research and development incentives

 $0  $289 

Sales-based taxes receivable

  0   2 

Other

  16   49 

Total amounts receivable

 $16  $340 

 

  

September 30, 2020

  

December 31, 2019

 

Advances to vendors - current

 $10  $88 
9

We periodically advance funds to vendors engaged to support the performance of our clinical trials and supporting activities. The funds advanced are held, interest free, for varying periods of time and may be recovered by DiaMedica through partial reductions of ongoing invoices, application against final study/project invoices or refunded upon completion of services to be provided. Deposits are classified as current or non-current based upon their expected recovery time.


 

 

7.

Property and Equipment

 

Property and equipment consisted of the following (in thousands):

 

 

September 30, 2020

  

December 31, 2019

  

June 30, 2021

  

December 31, 2020

 

Furniture and equipment

 $51  $51  $64  $69 

Computer equipment

  58   56   63   62 
  109   107  127  131 

Less accumulated depreciation

  (59)  (43)  (54)  (57)

Property and equipment, net

 $50  $64  $73  $74 

 

 

8.

Accrued Liabilities

 

Accrued liabilities consisted of the following (in thousands):

 

 

September 30, 2020

  

December 31, 2019

  

June 30, 2021

  

December 31, 2020

 

Accrued compensation

 $340  $419 

Accrued clinical study costs

  211   433  $638  $13 

Accrued research and other professional fees

  94   172  296  360 

Accrued compensation

 191  483 

Accrued taxes and other liabilities

  13   52   7   8 

Total accrued liabilities

 $658  $1,076  $1,132  $864 

 

 

9.

Operating Lease

 

We lease certain office space under a non-cancelable operating lease. This lease does not have significant rent escalation holidays, concessions, leasehold improvement incentives or other build-out clauses. Further this lease does not contain contingent rent provisions. This lease terminates on August 31, 2022 and we do not have an option to renew. This lease does include both lease (e.g., fixed rent) and non-lease components (e.g., common-area and other maintenance costs). The non-lease components are deemed to be executory costs and are therefore excluded from the minimum lease payments used to determine the present value of the operating lease obligation and related right-of-use asset.

 

This lease does not provide an implicit rate and, due to the lack of a commercially salable product, we are generally considered unable to obtain commercial credit. Therefore, we estimated our incremental borrowing rate to be 9%, considering the quoted rates for the lowest investment-grade debt and the interest rates implicit in recent financing leases. We used our estimated incremental borrowing rate and other information available at the lease commencement date in determining the present value of the lease payments.

9

Our operating lease cost and variable lease costs were $49,000$34,000 and $40,000,$28,000, respectively, for the ninesix months ended SeptemberJune 30, 2020. 2021. Variable lease costs consist primarily of common area maintenance costs, insurance and taxes which are paid based upon actual costs incurred by the lessor.

 

Maturities of our operating lease obligation are as follows as of SeptemberJune 30, 2020 (in2021 (in thousands):

 

2020

 $17 

2021

  68  33 

2022

  46   46 

Total lease payments

 $131  $79 

Less interest portion

  (11)  (4)

Present value of lease obligation

 $120  $75 

 

 

10.10.

Shareholders’Shareholders Equity

 

Authorized capital stock

 

The Company has authorized share capital of an unlimited number of voting common shares and the shares do not have a stated par value.

 

Common shareholders are entitled to receive dividends as declared by the Company, if any, and are entitled to one vote per share at the Company's annual general meeting and any special meeting.

 

10

Equity issued during the six months ended June 30, 2021

During the six months ended June 30, 2021, 40,000 common shares were issued upon the exercise of options for gross proceeds of $244,000 with an aggregate intrinsic value of $132,000 and no warrants were exercised.

Equity issued during the ninesix months endedSeptemberJune 30, 2020

 

On August 10, 2020, we issued and sold an aggregate 4,600,000 common shares in a public, underwritten offering at a public offering price of $5.00 per share. As a result of the offering, we received gross proceeds of $23.0 million, which resulted in net proceeds to us of approximately $21.2 million, after deducting the underwriting discount and offering expenses.

On February 13, 2020, we issued and sold an aggregate of 2,125,000 common shares in a public, underwritten offering at a public offering price of $4.00 per share. As a result of the offering, we received gross proceeds of $8.5 million, which resulted in net proceeds to us of approximately $7.7 million, after deducting the underwriting discount and offering expenses.

 

On September 11, 2020, we issued a warrant to purchase up to 10,000 common shares at an exercise price equal to $4.00 per share to Craig-Hallum Capital Group LLC in consideration for certain strategic advisory services. The warrant is exercisable until October 1, 2024, unless terminated earlier pursuant to the terms thereof.

During the ninesix months ended SeptemberJune 30, 2020, 7,200 common shares were issued onupon the exercise of options for gross proceeds of $16,000 and no0 warrants were exercised.

Equity issued during the nine months endedSeptember 30, 2019

During the nine months ended September 30, 2019, 50,000 common shares were issued on the exercise of options for gross proceeds of $75,000 and no warrants were exercised.

10

 

Shares reserved

 

Common shares reserved for future issuance are as follows:

 

  

SeptemberJune 30, 20202021

 

Stock options outstanding

  1,395,3991,421,092 

Deferred share units outstanding

  47,23772,142 

Shares available for grant under the DiaMedica Therapeutics Inc. Omnibus Incentive Plan

  1,107,431995,026 

Common shares issuable under common share purchase warrants

  265,000 

Total

  2,815,0672,753,260

 

 

11.11.

Net Loss Per Share

 

We compute net loss per share by dividing our net loss (the numerator) by the weighted-average number of common shares outstanding (the denominator) during the period. Shares issued during the period and shares reacquired during the period, if any, are weighted for the portion of the period that they were outstanding. The computation of diluted earnings per share, or EPS, is similar to the computation of basic EPS except that the denominator is increased to include the number of additional common shares that would have been outstanding if the dilutive potential common shares had been issued. Our diluted EPS is the same as basic EPS due to common equivalent shares being excluded from the calculation, as their effect is anti-dilutive.

 

The following table summarizes our calculation of net loss per common share for the periods (in thousands, except share and per share data):

 

 

Three Months Ended

September 30,

  

Nine Months Ended

September 30,

  

Three Months Ended

June 30,

  

Six Months Ended

June 30,

 
 

2020

  

2019

  

2020

  

2019

  

2021

  

2020

  

2021

  

2020

 

Net loss

 $(3,193

)

 $(2,448

)

 $(8,092

)

 $(8,169

)

 $(3,274

)

 $(2,474

)

 $(6,896

)

 $(4,899

)

Weighted average shares outstanding—basic and diluted

  16,689,074   12,006,874   14,652,749   11,981,233   18,786,157   14,139,074   18,776,461   13,623,400 

Basic and diluted net loss per share

 $(0.19

)

 $(0.20

)

 $(0.55

)

 $(0.68

)

 $(0.17

)

 $(0.17

)

 $(0.37

)

 $(0.36

)

 

The following outstanding potential common shares were not included in the diluted net loss per share calculations as their effects were not dilutive:

 

  

Three Months Ended

June 30,

  

Six Months Ended

June 30,

 
  

2021

  

2020

  

2021

  

2020

 

Employee and non-employee stock options

  1,421,092   1,413,988   1,421,092   1,413,988 

Common shares issuable under common share purchase warrants

  265,000   255,000   265,000   255,000 

Common shares issuable under deferred unit plan

  72,142   47,237   72,142   47,237 

  

Three Months Ended

September 30,

  

Nine Months Ended

September 30,

 
  

2020

  

2019

  

2020

  

2019

 

Employee and non-employee stock options

  1,395,399   1,251,893   1,395,399   1,251,893 

Common shares issuable under common share purchase warrants

  265,000   807,563   265,000   807,563 

Common shares issuable under deferred unit awards

  47,237   21,183   47,237   21,183 
11

 

 

12.

Share-Based Compensation

 

2019 Omnibus Incentive Plan

 

The DiaMedica Therapeutics Inc. 2019 Omnibus Incentive Plan (2019(2019 Plan) was adopted by the Board of Directors in March 2019 and approved by our shareholders at our annual general and special meeting of shareholders held on May 22, 2019. The 2019 Plan permits the Board, or a committee or subcommittee thereof, to grant to the Company’s eligible employees, non-employee directors and consultants non-statutory and incentive stock options, stock appreciation rights, restricted stock awards, restricted stock units, deferred stock units, performance awards, non-employee director awards and other stock-based awards. We grant options to purchase common shares under the 2019 Plan at no less than the fair market value of the underlying common shares as of the date of grant. Options granted to employees and non-employee directors have a maximum term of ten years and generally vest in approximately equal quarterly installments over one to three years. Options granted to non-employees have a maximum term of five years and generally vest in approximately equal quarterly installments over one year. Subject to adjustment as provided in the 2019 Plan, the maximum number of the Company’s common shares authorized for issuance under the 2019 Plan is 2,000,000 shares. As of SeptemberJune 30, 2020, 2021, options to purchase 866,515930,682 common shares were outstanding and there were 26,05450,959 common shares were reserved for issuance upon settlement of deferred stockshare units (DSUs) outstanding under the 2019 Plan.

11

 

Prior stock option plan

 

The DiaMedica Therapeutics Inc. Stock Option Plan, Amended and Restated November 6, 2018 (Prior(Prior Plan), was terminated by the Board of Directors in conjunction with the shareholder approval of the 2019 Plan. Awards outstanding under the Prior Plan remain outstanding in accordance with and pursuant to the terms thereof. Options granted under the Prior Plan have terms similar to those used under the 2019 Plan. As of SeptemberJune 30, 2020, 2021, options to purchase 528,884490,410 common shares were outstanding under the Prior Plan.

As the TSX Venture Exchange was the principal trading market for the Company’s common shares, all options granted prior to December 31, 2018 were priced in Canadian dollars. Options granted after December 31, 2018 have been priced in United States dollars.

 

Prior deferred share unit plan

 

The DiaMedica Therapeutics Inc. Amended and Restated Deferred Share Unit Plan (DSU Plan) was terminated by the Board of Directors in conjunction with the shareholder approval of the 2019 Plan. Awards outstanding under the DSU Plan remain outstanding in accordance with and pursuant to the terms thereof. As of SeptemberJune 30, 2020, 2021, there were 21,183 common shares reserved for DSUs outstanding under the DSU Plan.

The aggregate number of common shares reserved for issuance for awards granted under the 2019 Plan, the Prior Plan and the DSU Plan as of September 30, 2020 was 1,442,636.outstanding.

 

Share-based compensation expense for each of the periods presented is as follows (in thousands):

 

 

Three Months Ended

September 30

  

Nine Months Ended

September 30

  

Three Months Ended

June 30

  

Six Months Ended

June 30

 
 

2020

  

2019

  

2020

  

2019

  

2021

  

2020

  

2021

  

2020

 

Research and development

 $141  $151  $379  $276  $140  $131  $271  $238 

General and administrative

  367   300   958   487   306   305   686   591 

Total share-based compensation

 $508  $451  $1,337  $763  $446  $436  $957  $829 

 

We recognize share-based compensation based on the fair value of each award as estimated using the Black-Scholes option valuation model. Ultimately, the actual expense recognized over the vesting period will only be for those shares that actually vest.

 

12

A summary of option activity is as follows (in thousands except share and per share amounts):

 

  

Shares

Underlying

Options
Outstanding

  

Weighted

Average Exercise

Price Per Share

  

Aggregate

Intrinsic Value

 

Balances at December 31, 2019

  1,220,359  $5.32  $ 

Granted

  282,332   4.77     

Exercised

  (7,200)  2.25     

Expired/cancelled

  (78,147)  5.10     

Forfeited

  (21,945)       

Balances at September 30, 2020

  1,395,399  $5.24  $301 

12

  

Shares

Underlying

Options

Outstanding

  

Weighted

Average Exercise

Price Per Share

  

Aggregate

Intrinsic Value

 

Balances at December 31, 2020

  1,389,568  $5.38  $7,109 

Granted

  85,000   9.69     

Exercised

  (40,000)  6.11   132 

Expired/cancelled

  (13,476)  6.54     

Balances at June 30, 2021

  1,421,092  $5.63  $0 

 

Information about stock options outstanding, vested and expected to vest as of SeptemberJune 30, 2020, 2021, is as follows:

 

   

Outstanding, Vested and Expected to Vest

  

Options Vested and Exercisable

    

Outstanding, Vested and Expected to Vest

  

Options Vested and Exercisable

 

Per Share Exercise Price

Per Share Exercise Price

 

Shares

  

Weighted Average
Remaining
Contractual Life
(Years)

  

Weighted Average
Exercise Price

  

Options
Exercisable

  

Weighted Average
Remaining

Contractual Life

(Years)

 

Per Share Exercise

Price

 

Shares

  

Weighted Average Remaining

Contractual Life

(Years)

  

Weighted Average

Exercise Price

  

Options

Exercisable

  

Weighted Average Remaining

Contractual Life

(Years)

 

$2.00

-$2.99   125,700   5.3  $2.28   125,700   5.2 -

$2.99

 120,500  4.5  $2.44  120,500  4.5 

$3.00

-$3.99   97,905   6.2   3.88   97,905   6.2 -

$3.99

 2,500  5.8  3.06  2,500  5.8 

$4.00

-$4.99   932,744   8.7   4.56   483,716   8.4 -

$4.99

 953,567  7.9  4.51  792,526  7.7 

$5.00

-$10.00   188,900   7.0   7.84   130,280   7.2 -

$9.99

 274,525  7.1  8.10  216,088  6.5 

$10.01

-$34.00   50,150   2.1   18.16   50,150   2.1 
$10.00-

$27.06

  70,000   3.7   16.80   51,667   1.6 
    1,395,399   7.8  $5.24   887,751   7.2     1,421,092   7.2  $5.63   1,183,281   6.9 

 

 

13.

Related Party Transaction

 

During 2020,2021, we have engaged a consulting firm owned by our Vice President of Regulatory Affairs to perform certain tasks supporting our quality and regulatory activities. The work is performed as required by us and all services are invoiced on an hourly basis with no minimum commitment. Total charges invoiced were approximately $90,000 and $137,000 for$149,000 during the three and nine-monthssix-months ended SeptemberJune 30, 2020, 2021, and are recorded as research and development expenses, of which $11,000 isapproximately $8,500 was outstanding and included in accounts payable as of SeptemberJune 30, 2020.2021.


 

 

14.

Commitments and Contingencies

Litigation funding agreement

On December 27, 2019, we entered into a litigation funding agreement with LEGALIST FUND II, L.P. (the Funder) for the purpose of funding our currently pending lawsuit against Pharmaceutical Research Associates Group B.V. Under the terms of the litigation funding agreement, the Funder agreed to pay up to an aggregate of $1.0 million to fund reasonable legal fees, court costs, and other expenses incurred by us in connection with the litigation. These payments, however, were conditioned upon the transfer of venue of the litigation from Delaware to Minnesota; and if the venue was not transferred, we were not entitled to receive any payments under the agreement. On September 21, 2020, the United States District Court, District of Delaware, issued a ruling denying our motion to transfer the litigation indicating that we had not met the required standards to support a venue transfer. As a result of this ruling, the litigation funding agreement is terminated.

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ITEM 2.

MANAGEMENT’SMANAGEMENTS DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS

 

The following Management’s Discussion and Analysis of Financial Condition and Results of Operations is based upon accounting principles generally accepted in the United States of America and discusses the financial condition and results of operations for DiaMedica Therapeutics Inc. and its subsidiaries for the three and ninesix months ended SeptemberJune 30, 20202021 and 2019.2020.

 

This discussion should be read in conjunction with our condensed consolidated financial statements and related notes included elsewhere in this report and our Annual Report on Form 10-K for the year ended December 31, 2019,2020, which includes additional information about our critical accounting policies and practices and risk factors. The following discussion contains forward-looking statements that involve numerous risks and uncertainties. Our actual results could differ materially from the forward-looking statements as a result of these risks and uncertainties. See “Cautionary Note Regarding Forward-Looking Statements” for additional cautionary information.

 

Business Overview

 

We are a clinical stage biopharmaceutical company primarily focused on developing novel treatments for neurological disorders and kidney diseases. Currently, our primary focus is on developing DM199, a proprietary recombinant KLK1 protein for the developmenttreatment of novel recombinant, or synthetic, proteins.acute ischemic stroke (AIS) and chronic kidney disease (CKD). Our goal is to use our patented and licensed technologies to establish our Company as a leader in the development and commercialization of therapeutic treatments from novel recombinant proteins. Our current focus is on the treatment of chronic kidney disease (CKD) and acute ischemic stroke (AIS). We plan to advance DM199, our lead drug candidate, through required clinical trialsstudies to create shareholder value by establishing its clinical and commercial potential as a therapy for CKDAIS and AIS.CKD.

 

DM199 is a recombinant form of human tissue kallikrein-1 (KLK1). KLK1 is a serine protease (protein), produced primarily in the kidneys, pancreas and salivary glands, whichthat plays a critical role in the regulation of local blood flow and vasodilation (the widening of blood vessels which decreases blood pressure) in the body, as well as an important role in inflammation and oxidative stress (an imbalance between potentially damaging reactive oxygen species, or free radicals, and antioxidants in the body). We believe DM199 has the potential to treat a variety of diseases where healthy functioning requires sufficient activity of KLK1 and its system, the kallikrein-kinin system.

 

Our DM199 product candidate is in clinical development as follows:

 

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AIS Phase 2/3 ReMEDy2 Study

In December 2020, we received written responses from the FDA following a Type B Pre-IND meeting request that we submitted in October 2020 regarding our development plan for DM199 in the treatment of AIS. In the FDA’s written responses to the questions we provided, the FDA agreed with our proposals regarding key elements of a pivotal Phase 2/3 study for DM199 in patients with AIS, including plans for an adaptive study design with a primary endpoint based upon the modified Rankin Scale at day 90 and acknowledged that, provided the study results qualify, a single study may support a Biologics License Application submission.

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In April 2021, we submitted an Investigational New Drug (IND) application to the FDA detailing a proposed protocol for this clinical study. The FDA accepted our IND in May 2021, allowing us to proceed with this pivotal Phase 2/3 study which we have named ReMEDy2. This clinical study follows our Phase 2 study in AIS patients that demonstrated an improvement in stroke outcomes and reduction in severe stroke recurrence. The upcoming pivotal ReMEDy2 study will evaluate whether DM199, a recombinant investigational agent, can improve three-month outcomes in AIS patients who have no treatment option other than supportive care. Initial preparations are underway and initiation of the study is expected later this summer.

 

REDUX Clinical TrialStudy

 

In October 2019, the U.S. Food and Drug Administration (FDA) accepted our Phase II2 clinical trialstudy protocol for the treatment of CKD caused by rare or significant unmet diseases. The trialstudy named REDUX, Latin for restore, is a multi-center, open-label investigation targeting enrollment of approximately 90 participants with mild or moderate CKD (Stage II or III) and albuminuria, who are being enrolled in three cohorts (30 participants per cohort).equal cohorts. The study is being conducted in the United States at 1413 sites and is focused on participants with CKD: Cohort I is focused on non-diabetic, hypertensive African Americans (AA) with Stage II or III CKD. African Americans are at greater risk for CKD than Caucasians, and those African Americans who have the APOL1 gene mutation are at an even higher risk. The study is designed to captureevaluate the APOL1 gene mutation as an exploratory biomarker in this cohort. Cohort II is focused on participants with IgA Nephropathy (IgAN). Cohort III, which was added after the completion of our August 2020 public offering, is focused on diabetic kidney disease (DKD) participants with Type II2 diabetes mellitus with CKD, hypertension and albuminuria. The study will evaluate two dose levels of DM199 within each cohort. Study participants will receive DM199 by subcutaneous injection twice weekly for 95 days. The primary study endpoints include safety, tolerability, blood pressure, albuminuria and kidney function, which will be evaluated by changes from baseline in estimated glomerular filtration rate (eGFR) and albuminuria, as measured by the urinary albumin to creatinine ratio. Participant enrollment and dosing for this study commenced in December 2019.

 

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In June 2021, we announced interim results indicating that DM199 is demonstrating clinically meaningful improvements in kidney function in Cohorts I and II, as measured by simultaneously stabilizing estimated glomerular filtration rate (eGFR) and decreasing urine albumin-to-creatinine ratio (UACR). In participants who were hypertensive (Cohorts I and III), DM199 also reduced blood pressure by clinically significant levels and importantly, there was no effect on participants who were not hypertensive (Cohort II). We reported the following preliminary data:

AA: Decrease in UACR -27% in moderate to severe albuminuria (baseline UACR >500) (n=6), Increase in eGFR +2 ml/min (n=12) and decrease in blood pressure -8/-3 mmHg;

IgAN: UACR decreased by -33% (P=0.002) (baseline UACR>500) (n=11) and eGFR and blood pressure were stable (n=16); and

DKD: eGFR and UACR levels were stable and blood pressure decreased significantly by -5/1 mmHg (n=28)

DM199 was safe and well tolerated across all cohorts, with no DM199 related severe adverse events (SAEs) or discontinuations due to drug-related adverse events (AEs). AEs were generally mild to moderate in severity, with the most common being local injection site irritation that resolved.

 

As of October 30, 2020,July 31, 2021, we had enrolled 4975 subjects, including 1120 African American subjects into Cohort I, 1322 subjects with IgAN into Cohort II and 25completed enrollment with 33 subjects with Type II2 diabetes, hypertension and albuminuria into Cohort III of the REDUX study. Due to actions implemented at our clinical study sites to combat the COVID-19 pandemic, weIII. We have continued to experience slower than expected enrollment in the first two cohorts of the REDUX trial.study. We believe this is due to the reduction or suspensioncontinued concerns of activities at our clinicalpotential study sites as they address staff and patient safety concerns and patient concernssubjects related to visiting clinical study sites in lightsites. We are evaluating the effects of the recent surge in COVID-19 pandemic. We have added two additional study sites to increase the enrollment rates in these cohorts. The enrollment rate for Cohort III has been much more rapid, which is likely dueinfections  related to the large population of potential subjects. We anticipate that the COVID-19 pandemic will likely continue to adversely affect our ability to recruit or enroll subjects,Delta variant and we cannotwill provide any assurance as toan update on the anticipated completion of  Cohort I and Cohort II when clinical sites will bewe are able to resume enrollment in Cohorts I and II at a normal rate or any guidance at this time as to when we will complete enrollment in the study. DiaMedica expects enrollment in Cohort III to complete by the end of the year with topline results available in the first half of 2021.reasonably estimate.

 

ReMEDy Clinical Trial

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Enrollment in the ReMEDy study began in February 2018 and concluded in October 2019. We enrolled 92 participants to assess DM199 in the treatment of participants who experienced an AIS. The study drug (DM199 or placebo) was administered as an intravenous (IV) infusion within 24 hours of stroke symptom onset, followed by subcutaneous injections later that day and once every 3 days for 21 days. The study was designed to measure safety and tolerability along with multiple tests designed to investigate DM199’s therapeutic potential including plasma-based biomarkers and standard functional stroke measures assessed at 90 days post-stroke. Standard functional stroke measurements include the Modified Rankin Scale, National Institutes of Health Stroke Scale, the Barthel Index and C-reactive protein, a measure of inflammation. Positive top-line results, including the achievement of primary safety and tolerability endpoints and no DM199-related serious adverse events, were announced on May 13, 2020. In addition, there was also a demonstrated therapeutic effect in participants that received tissue plasminogen activator (tPA) prior to enrollment but not in participants receiving mechanical thrombectomy prior to enrollment according to top-line phase II results.

On October 5, 2020, we submitted a pre-IND meeting request to the FDA. We have requested an initial meeting with the FDA to review our proposed strategy and plan for conducting the safety/toxicology studies and human clinical trials required for approval of DM199 for the treatment of AIS.

From a strategic perspective, we continue to believe that strategic alternatives with respect to our DM199 product candidate, including licenses and business collaborations, with other regional and global pharmaceutical and biotechnology companies can be important in advancing the clinical development of DM199. Therefore, as a matter of course and from time to time, we engage in discussions with third parties regarding these matters.

Financial Overview

 

We have not generated any revenues from product sales. Since our inception, we have financed our operations from public and private sales of equity, the exercise of warrants and stock options, interest income on funds available for investment and government grants. We have incurred losses in each year since our inception. Our net losses were $8.1$6.9 million and $8.2$4.9 million for the ninesix months ended September 30,June, 2021 and 2020, and 2019, respectively. As of SeptemberJune 30, 2020,2021, we had an accumulated deficit of $64.7$75.8 million. Substantially all of our operating losses resulted from expenses incurred in connection with the development of our DM199 product candidate, our primary research and development (R&D) activities, and general and administrative (G&A) support costs associated with our operations.

 

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On August 10, 2020, we issued and sold an aggregate of 4,600,000 common shares in a public underwritten offering at a public offering price of $5.00 per share, receiving gross proceeds of $23.0 million and net proceeds of approximately $21.2 million, after deducting the underwriting discount and offering expenses.

We expect to continue to incur significant expenses and continuingincreased operating losses in 2020, which we believe will be up slightly from 2019. Our expenses will increase further if we progress to advanced stages of clinical development overfor at least the next several years. In the near term, we anticipate that our expenses will increase as we:

 

 

advance thecomplete our ongoing clinical developmentREDUX Phase 2 study of DM199;DM199 for CKD;

 

provide G&A supportinitiate and complete our pivotal ReMEDy2 Phase 2/3 study of DM199 for our operations; andAIS;

 

complete manufacturing process development to support applications for commercial approval of DM199;

complete preliminary development of a second proprietary recombinant protein named DM300;

provide G&A support for our operations; and

maintain, expand and protect our intellectual property portfolio.

 

While we expect our rate of future negative cash flow per month will vary due to the timing of expenses incurred, we expect our current cash and marketable securities resources will be sufficient to allow us to complete all threethe remaining two cohorts in our REDUX Phase II2 study in patients with CKD, initiate our pending Phase 2/3 study in patients with AIS and to otherwise fund our currently planned operations forinto the third quarter of 2022, but not at least the next twelve months from the date of issuance of these condensed consolidated financial statements. However, the amount and timing of future funding requirements will depend on many factors, including the timing and results of our ongoing development efforts, including enrollment in our clinical trials,studies, the potential expansion of our current development programs, potential new development programs, related G&A support and the effects of the COVID-19 pandemic. We may require significant additional funds earlier than we currently expect and there is no assurance that we will not need or seek additional funding prior to such time. We may elect to raise additional funds even before we need them if market conditions for raising additional capital are favorable.

 

Overview of Expense Components

 

Research and Development Expenses

 

R&D expenses consist primarily of fees paid to external service providers such as contract research organizations; contractual obligations for clinical development including clinical sites, outside nursing services and laboratory testing, and preclinical trials;studies; development of manufacturing processes, costs for production runs of DM199; salaries, benefits, and share-based compensation and other personnel costs.

 

At this time, due to the risks inherent in the clinical development process and the clinical stage of our product development programs, we are unable to estimate with any certainty the costs we will incur in the continued development of DM199 or any of our preclinical development programs. WeAlthough as previously discussed, we have experienced a delay and expect to continue to expectexperience a delay in the timing of costs incurred in the REDUX trialstudy as a result of the COVID-19 pandemic. Wepandemic, we do not however, expect to experience a significant overall increase in costs. We intend to continue to assess the effect of the pandemic on our REDUX trialstudy and our future studies by monitoring the continued spread of the COVID-19 virus, and the actions implemented to combat the virus.virus, the availability and effectiveness of vaccines and the number of people vaccinated. Our R&D expenses have increased beginning with the second quarter of 2021 as compared to prior year periods as we commenced preparation for our ReMEDy2 clinical study. We expect that our R&D expenses will continue to increase in the future as we initiate the ReMEDy2 clinical study and if we are successful in advancing DM199, or any of our preclinical programs, into advanced stages of clinical development. The process of conducting clinical trialsstudies necessary to obtain regulatory approval and manufacturing scale-up to support expanded development and potential future commercialization is costly and time consuming. Any failure by us or delay in completing clinical trials,studies, manufacturing scale-up or in obtaining regulatory approvals could lead to increased R&D expenses and, in turn, have a material adverse effect on our results of operations.

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General and Administrative Expenses

 

G&A expenses consist primarily of salaries and related benefits, including share-based compensation related to our executive, finance, business development and support functions. Other G&A expenses also include insurance, rent and utilities, travel expenses, patent costs and professional fees for auditing, tax and legal services. We expect our G&A expenses will continue to increase in the future as we expand our development and operating activities.

 

We have instituted a number of procedural changes related to protecting the health and safety of our employees in response to the COVID-19 pandemic. Duringpandemic.Our office was closed in the thirdsecond quarter of 2020 our officeand remained closed during the first quarter of 2021 and our employees worked remotely. In addition, all non-essentialthe second quarter of 2021, we opened our office and allowed, but did not require, employees to work in the office two days of each week. Non-essential travel remainedcontinues to be on hold. We have encouragedhold and we encourage our employees to interact with each other and vendors through audio and video conferencing. We did not incur significant additional G&A expenses during the third quarter of 2020three and six months ended June 30, 2021 related to these changes, or the COVID-19 pandemic, nor do we expect to incur significant additional G&A expenses related to the COVID-19 pandemic going forward. WeProvided conditions related to COVID-19 do not deteriorate, we expect to continue to work remotelyon a modified in-person/remote schedule and restrict non-essential travel for the foreseeable future.

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Other (Income) Expense

 

Other (income) expense consists primarily of governmental assistance – research incentives, interest income and foreign currency exchange gains and losses.

Related Party Transactions

For In past years, governmental assistance – research incentives, which were associated with the ReMEDy Phase 2 stroke study, were a discussionsignificant component of related party transactions, see Note 13 to the Company’s condensed consolidated financial statements included herein.this line item.

 

Results of Operations

 

Comparison of the ThreeThree and NineSix Months endedSeptember June 30, 20202021 and 20192020

 

The following table summarizes our unaudited results of operations for the three and ninesix months ended SeptemberJune 30, 20202021 and 20192020 (in thousands):

 

 

Three Months Ended September 30,

  

Nine Months Ended September 30,

  

Three Months Ended June 30,

  

Six Months Ended June 30,

 
 

2020

  

2019

  

2020

  

2019

  

2021

  

2020

  

2021

  

2020

 

Operating expenses:

                 

Research and development

 $2,180  $1,617  $5,190  $6,098  $2,156  $1,600  $4,562  $2,949 

General and administrative

  1,139   1,044   3,241   2,725  1,209  1,108  2,422  2,163 

Total other income, net

  128   225   359   683  98  243  102  231 

 

Research and Development Expenses

 

R&D expenses increased to $2.2 million for the three months ended SeptemberJune 30, 2020,2021, up from $1.6 million for the three months ended SeptemberJune 30, 2019,2020, an increase of $0.6 million, due primarily to costs incurred in connection with the REDUX Phase II CKD trial, including the launching of the third Cohort.million. R&D expenses decreasedincreased to $5.2$4.6 million for the ninesix months ended SeptemberJune 30, 2020,2021, compared to $6.1$2.9 million for the ninesix months ended SeptemberJune 30, 2019, a decrease2020, an increase of $0.9$1.7 million. The decreaseincrease for the nine-monthsix month comparison was primarily due to non-recurring costsa number of approximately $1.3 million incurred for a new production run of the DM199 drug substance during the nine months ended September 30, 2019 and a net decrease in year-over-year clinical study costs. The decrease in clinical study costs was due to a combination of the decrease infactors including costs incurred for theour pivotal ReMEDy2 clinical study, increased year-over-year costs related to manufacturing process development and our REDUX Phase 2 CKD study, as well as increased personnel costs associated with additional staff added to support R&D operations. These increases were partially offset by decreased costs incurred for our ReMEDy Phase 2 stroke study as it wound down and non-recurring costs of the Phase 1b CKD study which was started and completed in the prior year period. These decreases were partially offset by costs incurred for the REDUX Phase II CKD study initiated late in 2019, increased manufacturing development costs and increased non-cash share-based compensation costs.year.

 

General and Administrative Expenses

 

G&A expenses were $1.2 million for the three months ended June 30, 2021, up from $1.1 million for the three months ended SeptemberJune 30, 2020, up from $1.0 million for the three months ended September 30, 2019.2020. G&A expenses increased to $3.2$2.4 million for the ninesix months ended SeptemberJune 30, 2020,2021, up $0.5$0.2 million from $2.7$2.2 million for the ninesix months ended SeptemberJune 30, 2019.2020. The increase for the nine-monthsix-month comparison was primarily due to increased non-cash share-based compensationprofessional services costs and increased professional service costs.personnel costs to support our expanding clinical programs.

 

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Total Other (Income) Expense

Total other income decreased to $128,000 for the three months ended September 30, 2020, down from $225,000 for the prior year period. Total other income decreased to $359,000 for the nine months ended September 30, 2020, compared to $683,000 for the nine months ended September 30, 2019. The decrease for the nine-month comparison is primarily related to reduced R&D incentives associated with decreased ReMEDy stroke study costs during the nine months ended September 30, 2020, partially offset by foreign currency transaction gains recognized in the current year.

 

Liquidity and Capital Resources

 

The following tables summarize our liquidity and capital resources as of SeptemberJune 30, 20202021 and December 31, 2019,2020, and our sources and uses of cash for each of the ninesix month periods ended SeptemberJune 30, 20202021 and 2019,2020, and is intended to supplement the more detailed discussion that follows (in thousands):

 

Liquidity and Capital Resources

 

September 30, 2020

  

December 31, 2019

  

June 30, 2021

 

December 31, 2020

 

Cash, cash equivalents and marketable securities

 $30,623  $7,878  $21,295  $27,507 

Total assets

  31,270   9,053  21,774  28,095 

Total current liabilities

  1,443   1,318  1,440  2,028 

Total shareholders’ equity

  29,758   7,617  20,318  26,014 

Working capital

  29,663   7,518  20,189  25,893 

 

 

Nine Months Ended September 30,

  

Six Months Ended June 30,

 

Cash Flow Data

 

2020

  

2019

  

2021

 

2020

 

Cash flow provided by (used in):

         

Operating activities

 $(6,169) $(7,237) $(6,402) $(3,822)

Investing activities

  (16,801)  (4,916) 980  (2,801)

Financing activities

  28,884   71   241  7,695 

Net increase (decrease) in cash and cash equivalents

 $5,914  $(12,082) $(5,181) $1,072 

 

Working Capital

 

We had cash and cash equivalents of $9.8$2.2 million, marketable securities of $20.8$19.1 million, current liabilities of $1.4 million and working capital of $29.7$20.2 million as of SeptemberJune 30, 2020,2021, compared to $3.9$7.4 million in cash and cash equivalents, marketable securities of $4.0$20.1 million, $1.3$2.0 million in current liabilities and $7.5$25.9 million in working capital as of December 31, 2019.2020. The increasesdecreases in our combined cash, cash equivalents and marketable securities and in our working capital are due primarily to our Februaryincreased clinical study costs associated with preparing for our ReMEDy2 Phase 2/3 stroke study, costs related to our REDUX Phase 2 CKD study and August 2020 public offerings.

On December 27, 2019, we entered into a litigation funding agreement with LEGALIST FUND II, L.P. (the Funder) for the purpose of funding our currently pending lawsuit against Pharmaceutical Research Associates Group B.V., which lawsuit is described in more detail under “Part II. Other Information – Item 1. Legal Proceedings.” Under the terms of the litigation funding agreement, the Funder agreed to pay up to an aggregate of $1.0 million to fund reasonable legal fees, courtincreased costs and other expenses incurred by us in connection with the litigation. These payments, however, were conditioned upon the transfer of venue of the litigation from Delaware to Minnesota; and if the venue was not transferred, we were not entitled to receive any payments under the agreement. As described in more detail under “Part II. Other Information – Item 1. Legal Proceedings” of this report, on September 21, 2020, the United States District Court, District of Delaware, issued a ruling denying our motion to transfer the litigation indicating that we had not met the required standards to support a venue transfer. As a result of this ruling, the litigation funding agreement is terminated.related manufacturing development.

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Cash Flows

 

Operating Activities

 

Net cash used in operating activities for the ninesix months ended SeptemberJune 30, 20202021 was $6.2$6.4 million compared to $7.2$3.8 million for the ninesix months ended SeptemberJune 30, 2019.2020. This decreaseincrease relates primarily to the combination of the decreaseincrease in the net loss, and increase inpartially offset by non-cash share-based compensation.compensation and the effects of the changes in operating assets and liabilities.

 

Investing Activities

 

Investing activities consist primarily of purchases and maturities of marketable securities and property and equipment duringsecurities. Net cash provided by investing activities was $1.0 million for the respective periods. Netsix months ended June 30, 2021 compared to net cash used in investing activities was $16.8of $2.8 million for the ninesix months ended SeptemberJune 30, 2020 compared to $4.9 million for the nine months ended September 30, 2019. This increase was due to the investment of a portion of the net proceeds received in the August 2020 public offering, partially offset by an increase in the maturities of marketable securities during the current year period.2020.

 

Financing Activities

 

Financing activities consist primarily of net proceeds from the exercise of stock options and in the prior year period from the sale of common shares in the current year period.our February 2020 underwritten public offering. Net cash provided by financing activities was $28.9$0.2 million for the ninesix months ended SeptemberJune 30, 20202021 compared to $71,000$7.7 million for the ninesix months ended SeptemberJune 30, 2019. This increase was due to our February and August 2020 public offerings.2020.

 

On February 13, 2020, we issued and sold an aggregate of 2,125,000 common shares in a public, underwritten offering at a public offering price of $4.00 per share, resulting in net proceeds to us of approximately $7.7 million, after deducting the underwriting discount and offering expenses.

On August 10, 2020, we issued and sold an aggregate of 4,600,000 common shares in a public underwritten offering at a public offering price of $5.00 per share, receiving gross proceeds of $23.0 million and net proceeds of approximately $21.2 million, after deducting the underwriting discount and offering expenses.

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Capital Requirements

 

Since our inception, we have incurred losses while advancing the developmentR&D of our DM199 product candidates.candidate. We have not generated any revenues from product sales and do not expect to do so for a number ofat least three to five years. We do not know when, or if, we will be able to license and/or market and sellgenerate any revenues from product sales of our DM199 product candidate or any future product candidates.candidate. We do not expect to generate any revenue from product sales unless and until we obtain regulatory approval. We expect the development work required to obtain regulatory approval may take at least an additional three to five years. We will likely continue to incur substantial operating losses until such time as any future product sales, royalty payments, licensing fees and/or milestone payments are sufficient to generate revenues to fund our continuing operations. We expect our operating losses to continueincrease in the near term and increase ifas we progress to advanced stages of clinicalcontinue the research, development and weclinical studies of, and seek regulatory approval for, our DM199 product candidate. However, with the effects of the COVID-19 pandemic slowing the enrollment in our REDUX trial we expect our operating expenses for the year ended December 31, 2020 to be comparable to or slightly less than our operating expenses for the year ended December 31, 2019. In the long-term, subject to obtaining regulatory approval of our DM199 product candidate or any other future product candidates,candidate and in the absence of the assistance of a strategic partner, we expect to incur significant commercialization expenses for product sales, marketing, manufacturing and distribution.

 

We have experienced a delay and expect to continue to experience a delay in the timing of costs incurred in the REDUX trial as a result of the COVID-19 pandemic. We do not, however, expect to experience a significant overall increase in costs. We intend to continue to assess the effect of the pandemic on our REDUX trial by monitoring the spread of the COVID-19 virus and the actions implemented to combat the virus.

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Accordingly, despite the completion of our recent public offerings, we expect we will need substantial additional capital to further our R&D activities, planned clinical trials,studies, regulatory activities and otherwise develop our product candidate, DM199, or any future product candidates, to a point where they may be commercially sold. WhileAlthough we are striving to achieve these plans, there is no assurance that these and other strategies will be achieved or that additional funding will be obtained on favorable terms or at all. While our rate of future negative cash flow per month will vary due to the timing of expenses incurred, we expect our current cash resources will be sufficient to allow us to complete all threethe remaining two cohorts in our REDUX Phase II2 study in patients with CKD, initiate our pending Phase 2/3 study in patients with AIS and to otherwise fund our currently planned operations forinto the third quarter of 2022, but not at least the next twelve months from the date of issuance of these condensed consolidated financial statements. However, the amount and timing of future funding requirements will depend on many factors, including the timing and results of our ongoing development efforts, including enrollment in our clinical trials,studies, the potential expansion of our current development programs, potential new development programs and related G&A support. We may require significant additional funds earlier than we currently expect and there is no assurance that we will not need or seek additional funding prior to such time. We may elect to raise additional funds even before we need themtime, especially if market conditions for raising additional capital are favorable.

 

Since our inception, we have financed our operations from public and private sales of equity, the exercise of warrants and stock options, interest income on funds available for investment, and government incentive grants, and we expect to continue this practice for the foreseeable future. We do not have any existing credit facilities under which we could borrow funds. We may seek to raise additional funds through various sources, such as equity or debt financings, or through strategic collaborations and license agreements. We can give no assurances that we will be able to secure additional sources of funds to support our operations, or if such funds are available to us, that such additional financing will be sufficient to meet our needs or on terms acceptable to us. This is particularly true if our clinical data is not positive or economic and market conditions deteriorate.

 

To the extent we raise additional capital through the sale of equity or convertible debt securities, the ownership interests of our shareholders will be diluted. Debt financing, if available, may involve agreements that include conversion discounts or covenants limiting or restricting our ability to take specific actions, such as incurring additional debt, making capital expenditures or declaring dividends. If we raise additional funds through government or other third-party funding, marketing and distribution arrangements or other collaborations, or strategic alliances or licensing arrangements with third parties, we may have to relinquish valuable rights to our technologies, future revenue streams, research programs or product candidates or grant licenses on terms that may not be favorable to us. The availability of financing will be affected by our clinical data and other results of scientific and clinical research; the ability to attain regulatory approvals; market acceptance of our product candidates; the state of the capital markets generally with particular reference to pharmaceutical, biotechnology and medical companies; the status of strategic alliance agreements; and other relevant commercial considerations.

 

If adequate funding is not available when needed, we may be required to scale back our operations by taking actions that may include, among other things, implementing cost reduction strategies, such as reducing use of outside professional service providers, reducing the number of our employees or employee compensation, modifying or implementing other cost reduction strategies; significantly modify or delaydelaying the development of our DM199 product candidate; licenselicensing to third parties the rights to commercialize our DM199 product candidate for AIS, CKD AIS or other indications that we would otherwise seek to pursue, or otherwise relinquishrelinquishing significant rights to our technologies, future revenue streams, research programs or product candidates or grantgranting licenses on terms that may not be favorable to us; and/or divestdivesting assets or ceaseceasing operations through a merger, sale, or liquidation of our company.

 

Off-Balance Sheet Arrangements

 

We have no off-balance sheet arrangements (as defined by applicable SEC regulations) that could have a current material effect or that are reasonably likely to have a current or future material effect on our financial condition, results of operations, liquidity, capital expenditures or capital resources.

 

Critical Accounting Policies and Estimates

 

There have been no material changes to our critical accounting policies and estimates from the information provided in “Part II. Item 7, Management’sManagements Discussion and Analysis of Financial Condition and Results of Operations—OperationsCritical Accounting Policies,” included in our annual report on Form 10-K for the fiscal year ended December 31, 2019.2020.

 

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ITEM 3.

QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

 

As a smaller reporting company, we are not required to provide disclosure pursuant to this item.

 

ITEM 4.

CONTROLS AND PROCEDURES

 

Evaluation of Disclosure Controls and Procedures

 

We maintain disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e) under the United States Securities Exchange Act of 1934, as amended (Exchange Act)) that are designed to provide reasonable assurance that information required to be disclosed by us in the reports we file or submit under the Exchange Act, is recorded, processed, summarized and reported, within the time periods specified in the SEC’s rules and forms and that such information is accumulated and communicated to our management, including our principal executive officer and principal financial officer, or persons performing similar functions, as appropriate to allow timely decisions regarding required disclosure. Our management evaluated, with the participation of our Chief Executive Officer and Chief Financial Officer, the effectiveness of the design and operation of our disclosure controls and procedures as of the end of the period covered in this report. Based on that evaluation, our Chief Executive Officer and Chief Financial Officer concluded that our disclosure controls and procedures were effective as of the end of such period to provide reasonable assurance that information required to be disclosed in the reports that we file or submit under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to our management, including our Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.

 

Changes in Internal Control over Financial Reporting

 

Despite most employees working remotely due to the COVID-19 pandemic, thereThere was no change in our internal control over financial reporting that occurred during the three months ended SeptemberJune 30, 20202021 that has materially affected or is reasonably likely to materially affect our internal control over financial reporting.

 

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PART II -

OTHER INFORMATION

 

ITEM 1.

LEGAL PROCEEDINGS

 

In March 2013, we entered into a clinical research agreement with Pharmaceutical Research Associates Group B.V. (PRA Netherlands)PRA Netherlands to perform a double-blinded, placebo-controlled, single-dose and multiple-dose study to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and proof of concept of DM199 in healthy subjects and in patients with Type 2 diabetes mellitus. In one arm of this study, we enrolled 36 patients with Type 2 diabetes who were treated with two subcutaneous dose levels of DM199 over a 28-day period. This study achieved its primary endpoint and demonstrated that DM199 was well-tolerated. The secondary endpoints for this study, however, were not met. The secondary efficacy endpoints were confounded due to what we believe were significant execution errors caused by protocol deviations occurring at the clinical trialstudy site that were unable to be reconciled. To date, we have been unable to obtain the complete study records from PRA Netherlands and generate a final study report. On November 14, 2017, we initiated litigation with PRA Netherlands in the United States District Court, Southern District of New York, to compel PRA Netherlands to comply with the terms of the clinical research agreement, including providing full study records and to recover damages. After PRA Netherlands objected to personal jurisdiction and venue, on August 24, 2018, we re-filed our complaint against both PRA Netherlands and its U.S. parent, PRA Health Sciences, Inc. (“PRA USA”(PRA USA and collectively with PRA Netherlands, PRA), in the United States District Court, District of Delaware. PRA again objected to the venue and personal jurisdiction. The complaint alleges, among other things, that PRA failed to conduct the study in accordance with the study protocol and with generally accepted standards for conducting such clinical trialsstudies and that PRA further refused to provide us with all data, records and documentation, and/or access thereto, related to the study in accordance with the clinical trial study agreement. The complaint seekssought to compel PRA to comply with the terms of the clinical trial study agreement, including providing full study records and to recover damages. On November 19, 2018, PRA Netherlands and PRA USA filed motions to dismiss the lawsuit. On February 20, 2019, we filed a motion seeking to transfer the Delaware action to the United States District Court, District of Minnesota. PRA Netherlands and PRA USA filed an opposition to our motion. On September 21, 2020, the District Court judge issued a ruling denying our motion to transfer indicating that DiaMedica had not met the required standards to support a venue transfer. We believe that, based upon the rationale utilized in the opinion, that the case will likely be dismissed for lack of personal jurisdiction over PRA Netherlands. On November 2, 2020, a final dismissal order was issued by the District Court judge. Due to the uncertainty inherent in appealing this ruling, we have chosen to cease action in the United States and file our claims against PRA Netherlands directly in a Dutch Court. On November 13, 2020, PRA Netherlands was served with our complaint. PRA Netherlands and PRA USA filed their initial appearances with the Dutch Court on February 24, 2021, and are due to submit their defense, bringing forward all procedural and substances defenses. We have filed a motion to move the case to the Netherlands Commercial Court (NCC), which specializes in handling international commercial disputes and provides more flexibility to accommodate the specific needs of an individual case and PRA has agreed to move to the NCC. We are workingcurrently waiting for the NCC to obtainassign judges to this matter, after which they will evaluate the adequacy of the documentation submitted in support of our claims and PRA’s response in order to determine the activities or additional information required and determine a final appealable judgment and are evaluating alternatives for appealing the decision at an appropriate time.schedule accordingly.

 

From time to time, we may be subject to other various ongoing or threatened legal actions and proceedings, including those that arise in the ordinary course of business, which may include employment matters and breach of contract disputes. Such matters are subject to many uncertainties and to outcomes that are not predictable with assurance and that may not be known for extended periods of time. Other than the PRA matter noted above, we are not currently engaged in or aware of any threatened legal actions.

 

ITEM 1A.

RISK FACTORS

 

Although this Item 1A is inapplicable to us asAs a smaller reporting company, we hereby disclose the following additional and revised risk factors, which were updated in a Current Report on Form 8-K that we filed with the SEC on August 5, 2020 in connection with our August 2020 public offering:are not required to provide disclosure pursuant to this item.

 

The COVID-19 pandemic has resulted in a delay in enrollment in our REDUX trial and will likely continue to result in enrollment delays and could also significantly disrupt in other ways our REDUX trial or other clinical trials which could delay or prevent our receipt of necessary regulatory approvals.

The COVID-19 pandemic is having a severe effect on the clinical trials of many drug candidates. Some trials have been merely delayed, while others have been cancelled. Due to actions implemented at our clinical study sites to combat the COVID-19 pandemic, we have experienced slower than expected enrollment in the first two cohorts of the REDUX clinical trial. We believe this is due to the reduction or suspension of activities at our clinical study sites as they address staff and patient safety concerns and patient concerns related to visiting clinical study sites in light of the COVID-19 pandemic. We have added two additional study sites to increase the enrollment rates in these cohorts, although no assurance can be provided that the addition of these sites will help increase enrollment. Although the enrollment rate for Cohort III has been much more rapid, which is likely due to the large population of potential subjects, no assurance can be provided that the pandemic will not also adversely affect the enrollment rate for Cohort III. We anticipate that the COVID-19 pandemic will likely continue to adversely affect our ability to recruit or enroll subjects, and we cannot provide any assurance as to when clinical sites will be able to resume enrollment in Cohorts I and II at a normal rate or any guidance at this time as to when we will complete enrollment in the study.

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The extent to which the COVID-19 pandemic may impact our ongoing and planned clinical trials will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as the duration and geographic reach of the outbreak, the severity of COVID-19, and the effectiveness of actions to contain and treat COVID-19. To date, the COVID-19 pandemic has caused significant delays in the enrollment of participants. The continued spread of COVID-19 could cause us to experience additional disruptions that could severely impact our business and clinical trials, including:

additional delays or difficulties in enrolling and/or retaining participants in our clinical trials;

delays or difficulties in the initiation of additional clinical sites in the event that the current clinical sites are unable to recruit sufficient participants or at an acceptable rate;

delays in clinical sites receiving the supplies and materials needed to conduct our clinical trials, including interruption in shipping that may affect the transport of clinical trial materials;

changes in local regulations as part of a response to the COVID-19 pandemic, which may require us to change the ways in which our clinical trials are conducted, which may result in unexpected costs, or to discontinue the clinical trials altogether;

inability of participants to comply with clinical trial protocols, impede participant movement or interrupt healthcare services;

interruption of key clinical trial activities, such as clinical trial site monitoring, due to limitations on travel imposed or recommended by federal or state governments, employers and others, or interruption of clinical trial subject visits and study procedures, the occurrence of which could affect the integrity of clinical trial data;

risk that participants enrolled in our clinical trials will contract COVID-19 while the clinical trial is ongoing, which could result in participants dropping out of the trial, missing scheduled doses or follow-up visits or failing to follow protocol or otherwise impact the results of the clinical trial, including by increasing the number of observed adverse events;

delays in receiving authorizations from local regulatory authorities to initiate our planned clinical trials;

delays in necessary interactions with local regulatory authorities, ethics committees, and other important agencies and contractors due to limitations in employee resources or forced furlough of government employees; and

limitations in employee resources that would otherwise be focused on the conduct of our clinical trials, including because of sickness of employees or their families or the desire of employees to avoid contact with large groups of people.

As a result, the expected timeline for data readouts of our clinical trials and certain regulatory filings may be negatively impacted, which would adversely affect our ability to initiate required phase III studies, obtain regulatory approval for and to commercialize our product candidates, increase our operating expenses and have a material adverse effect on our financial results.

We have conducted and may in the future conduct clinical trials for our product candidate outside the United States, and the FDA may not accept data from such trials.

We have conducted and may in the future conduct clinical trials for our product candidate outside the United States. For example, we conducted our ReMEDy Phase II clinical trial in Australia. Although the FDA may accept data from clinical trials conducted outside the United States, acceptance of such study data by the FDA is subject to certain conditions, and there can be no assurance that the FDA will accept data from the clinical trial we conducted in Australia or clinical trials we may conduct outside the United States in the future. For example, the clinical trial must be conducted in accordance with good clinical practices (GCP) requirements, and the FDA must be able to validate the data from the clinical trial through an onsite inspection if it deems such inspection necessary. In addition, when studies are conducted only at sites outside the United States, the FDA generally does not provide advance comment on the clinical protocols for the studies, and therefore there is an additional potential risk that the FDA could determine that the study design or protocol for a non-U.S. clinical trial was inadequate, which would likely require us to conduct additional clinical trials.

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If the FDA does not accept data from the clinical trial we conducted in Australia, it would likely result in the need for additional clinical trials, which would be costly and time-consuming and delay aspects of our business plan, including the development and commercial launch of our DM199 product candidate. In addition, the conduct of clinical trials outside the United States also exposes us to additional risks, including risks associated with the following:

foreign regulatory requirements that could burden or limit our ability to conduct our clinical trials;

administrative burdens of conducting clinical trials under multiple foreign regulatory schemes;

foreign exchange fluctuations;

compliance with foreign manufacturing, customs, shipment, and storage requirements;

cultural differences in medical practice and clinical research; and

diminished protection of intellectual property in some countries.

ITEM 2.

UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS

 

Recent Sales of Unregistered Equity Securities

On September 11, 2020, we issued a warrant to purchase up to 10,000 common shares at an exercise price equal to $4.00 per share to Craig-Hallum Capital Group LLC (Craig-Hallum) in consideration for certain strategic advisory services. The warrant is exercisable until October 1, 2021, unless terminated earlier pursuant to the terms thereof. The warrant includes a cashless exercise provision entitling Craig-Hallum to surrender a portion of the underlying common shares that has a value equal to the aggregate exercise price in lieu of paying cash upon exercise. The warrant was issued to Craig-Hallum in reliance on the exemption from registration provided by Section 4(a)(2) of the Securities Act since the issuance did not involve a public offering, the recipient took the securities for investment and not resale, and we took appropriate measures to restrict transfer.

We did not sell any other unregistered equity securities of our company during the quarter ended September 30, 2020.

Purchases of Equity Securities by the Company

We did not purchase any common shares or other equity securities of our company during the quarter ended September 30, 2020.

Use of Proceeds from Initial Public Offering

On December 11, 2018, the SEC declared effective our registration statement on Form S-1 (File No. 333-228313), as amended, filed in connection with our initial public offering in the United States. Pursuant to the registration statement, we issued and sold an aggregate of 4,100,000 common shares in the initial public offering at a price to the public of $4.00 per share. As a result of the offering, we received gross proceeds of approximately $16.4 million, resulting in net proceeds to us of approximately $14.7 million, after deduction of underwriters’ discounts and commissions and offering expenses. None of the expenses associated with the initial public offering were paid to directors, officers, persons owning ten percent or more of any class of equity securities, or to their associates, or to our affiliates. Craig-Hallum Capital Group LLC acted as the sole managing underwriter for the offering.

As of September 30, 2020, we have used all of the proceeds from our initial public offering to fund clinical development of DM199, to conduct research activities and for working capital and general corporate purposes. No payments were made by us to directors, officers or persons owning ten percent or more of our common shares or to their associates, or to our affiliates, other than payments in the ordinary course of business to officers for salaries and bonuses and to non-employee directors as compensation for board and board committee service. There has been no material change in the planned use of proceeds from our initial public offering from that described in the final prospectus, dated December 6, 2018, filed with the SEC on December 10, 2018 pursuant to Rule 424(b)(4) under the Securities Act of 1933, as amended.Not applicable

 

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ITEM 3.

DEFAULTS UPON SENIOR SECURITIES

 

None.Not applicable.

 

ITEM 4.

MINE SAFETY DISCLOSURES

 

Not applicable.

 

ITEM 5.

OTHER INFORMATION

 

On December 27, 2019, we entered into a litigation funding agreement with LEGALIST FUND II, L.P. for the purpose of funding our currently pending lawsuit against Pharmaceutical Research Associates Group B.V., which lawsuit is described in more detail under “Part II. Other Information – Item 1. Legal Proceedings.” Under the terms of the litigation funding agreement, the Funder agreed to pay up to an aggregate of $1.0 million to fund reasonable legal fees, court costs, and other expenses incurred by us in connection with the litigation. These payments, however, were conditioned upon the transfer of venue of the litigation from Delaware to Minnesota; and if the venue was not transferred, we were not entitled to receive any payments under the agreement. As described in more detail under “Part II. Other Information – Item 1. Legal Proceedings” of this report, on September 21, 2020, the United States District Court, District of Delaware, issued a ruling denying our motion to transfer the litigation indicating that we had not met the required standards to support a venue transfer. As a result of this ruling, the litigation funding agreement is terminated.Not applicable.

 

ITEM 6.

EXHIBITS

 

The following exhibits are being filed or furnished with this quarterly report on Form 10-Q:

 

Exhibit

No.

 

Description

 

Manner of Filing

3.1

 

Notice of Articles of DiaMedica Therapeutics Inc. dated May 31, 2019

 

Incorporated by reference to Exhibit 3.1 to DiaMedica’s Current Report on Form 8-K as filed with the Securities and Exchange Commission on June 4, 2019 (File No. 001-36291)

3.2

 

Articles of DiaMedica Therapeutics Inc. dated May 31, 2019

 

Incorporated by reference to Exhibit 3.2 to DiaMedica’s Current Report on Form 8-K as filed with the Securities and Exchange Commission on June 4, 2019 (File No. 001-36291)

4.1

 

Warrant dated September 11, 2020 issued by DiaMedica Therapeutics Inc. to Craig-Hallum Capital Group LLC

 

Filed herewith

31.1

 

Certification of Chief Executive Officer Pursuant to Exchange Act Rules 13a-14(a)/15d-14(a), as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

 

Filed herewith

31.2

 

Certification of Chief Financial Officer Pursuant to Exchange Act Rules 13a-14(a)/15d-14(a), as Adopted Pursuant to Section 302 of the Sarbanes-Oxley Act of 2002

 

Filed herewith

32.1

 

Certification of Chief Executive Officer Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

 

Furnished herewith

32.2

 

Certification of Chief Financial Officer Pursuant to 18 U.S.C. Section 1350, as Adopted Pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

 

Furnished herewith

101

 

Financial statements from the quarterly report on Form 10-Q of DiaMedica Therapeutics Inc. for the quarter ended SeptemberJune 30, 2020,2021, formatted in Inline XBRL: (i) the Condensed Consolidated Balance Sheets, (ii) Condensed Consolidated Statements of Operations and Comprehensive Loss, (iii) Condensed Consolidated Statements of Shareholders’ Equity, (iv) Condensed Consolidated Statements of Cash Flows, and (v)  Notes to the Condensed Consolidated Financial Statements.

 

Filed herewith

104

Cover Page Interactive Data File (formatted as Inline XBRL and contained in Exhibit 101)

Embedded within the Inline XBRL document

 

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SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

 

 

DIAMEDICA THERAPEUTICS INC.

  

Date: November 4, 2020August 11, 2021

/s/ Rick Pauls

 

Rick Pauls

President and Chief Executive Officer

 

(Principal Executive Officer)

  

Date: November 4, 2020August 11, 2021

/s/ Scott Kellen

Scott Kellen

Chief Financial Officer

 

Scott Kellen

Chief Financial Officer

(Principal Financial Officer and Principal Accounting Officer)

 

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