Cognition Therapeutics, Inc. · NASDAQ:CGTX
Cognition Therapeutics — Investor Presentation (March 2026)
31 slides from Cognition Therapeutics's investor presentation, Mar 26, 2026
Slide 1: Zervimesine: a Once-daily Oral Therapeutic Advancing Toward Phase 3
March 2026 Zervimesine: a Once-daily Oral Therapeutic Advancing Toward Phase 3
Slide 2: Forward-Looking Statements
2 FORWARD-LOOKING STATEMENTS This presentation contains forward-looking statements within the meaning of The Private Securities Litigation Reform Act of 1995. All statements contained in this presentation, other than statements of historical facts or statements that relate to present facts or curren
Slide 3: Presentation Roadmap
3 • Executive summary • Zervimesine MoA • Clinical programs • Phase 2 results • Comparison to published results Presentation Roadmap Financials Geographic Atrophy • Phase 2 results • Neuropsychiatric signals with no motor impairment • FDA discussion • Phase 2 results in mild-mod AD • p-tau217 Releva
Slide 4: Over $170M in grants from NIH & others substantially funded development through Phase 2
4 Over $170M in grants from NIH & others substantially funded development through Phase 2 • Potential first-to-market for DLB psychosis - Majority of DLB patients experience psychosis - Psychotic symptoms result in higher HC costs and institutionalization - No drugs approved; off label use limited b
Slide 5: Zervimesine (CT1812) – Lead Product Candidate
5 • Zervimesine binds to TMEM97 (sigma-2) receptor • Oral, once-daily dosing • Favorable safety profile consistent through multiple clinical trials • Potential first-to-market for neuropsychiatric symptoms of dementia with Lewy bodies (DLB) • Fast Track granted for Alzheimer’s disease Zervimesine (C
Slide 6: Findings from Completed Studies Support Phase Plans
6 Findings from Completed Studies Support Phase 3 Plans Treatment period Patient Population Program Ongoing Studies 18 months Alzheimer’s disease MCI and Early 12 months Dementia with Lewy bodies Mild-to-moderate Completed Studies Alzheimer’s disease 6 months Mild-to-moderate Dementia with Lewy bodi
Slide 7: Prioritizing DLB Psychosis Following Regulatory Feedback
7 Completed: AD End-of-Phase 2 Meeting • Aligned with FDA on following: - Disease stage: mild-to-moderate AD - Enrichment: p-tau217 at screening ≤ 1.0pg/mL - Treatment period: 6 months - Randomization: 1:1 zervimesine (100mg) vs pbo - Endpoints: composite cognitive and functional - Open-label extens
Slide 8: Dementia with Lewy Bodies (DLB) Psychosis
Addressing unmet need of majority of DLB patients Dementia with Lewy Bodies (DLB) Psychosis
Slide 9: Four Core Domains + Functional Impairment Drive DLB Burden
9 Four Core Domains + Functional Impairment Drive DLB Burden DLB is “a multifactorial disease with a buffet of symptoms” James E. Galvin, MD, MPH, Univ Miami Miller School of Medicine Diminished ability to bathe, shop, prepare meals Difficulty standing, maintaining balance Fluctuations Impaired memo
Slide 10: Complex Symptomology Requires Array of Assessments
10 Complex Symptomology Requires Array of Assessments All assessments are standardized and have been used in clinical trials and drug approvals Assessment tools measure a variety of symptoms ADCS-Activities of Daily Living (ADL) MDS-Unified PD Rating Scale Part III (UPDRS III) Clinician Assessment o
Slide 11: Phase 2 Study in Dementia with Lewy Bodies
11 Phase 2 Study in Dementia with Lewy Bodies Funded by $30M NIA grant (R01AG071643) Program Objectives Assessments Treatment Period 6 months Enrollment Criteria Identify efficacy signal(s) Confirm safety and tolerability profile Identify dose(s) for Phase 3 Explore impact on behavioral symptoms and
Slide 12: Up to 91% Percent Slowing on Assessments
12 Up to 91% Percent Slowing on Assessments Strong clinical signals across major DLB symptoms relative to placebo 86% 114% 86% 91% 52% 60% 62% ADCS-Activities of Daily Living (ADL) MDS-Unified PD Rating Scale Part III (UPDRS III) Clinician Assessment of Fluctuation (CAF) Cognitive Drug Research (CDR
Slide 13: Zervimesine-Dramatic 86% Impact on Neuropsychiatric Measures
13 Zervimesine-Dramatic 86% Impact on Neuropsychiatric Measures NPI captures broad number of patient disturbances, including hallucinations, anxiety, and delusions NPI: Neuropsychiatric inventory NPI favor Treatment with Zervimesine LS Mean Difference from Placebo 95% CI Favors zervimesine 0.745 0.2
Slide 14: Caregivers Reported Less Distress
14 -1.5 -1 -0.5 0 0.5 1 1.5 Apathy Elation/Euphoria Aberrant Motor Disinhibitions Irritability Appetite Sleep Behaviour Depression Agitation/Aggresssion Hallucinations Delusions Anxiety Favors zervimesine Because Participants Improved in Hallucinations, Delusions & Anxiety, Caregivers Reported Less
Slide 15: Zervimesine Stabilizes Psychotic and Behavioral Symptoms
15 • The NPI-4 assesses the core psychosis symptoms of hallucinations and delusions plus behavioral symptoms including anxiety and agitation/aggression • A post-hoc analysis shows a stabilization of psychotic symptoms in zervimesine-treated participants in Phase 2 relative to placebo (102% slowing o
Slide 16: DLB Expanded Access Program (COG1202)
17 DLB Expanded Access Program (COG1202) Funded by an anonymous donation from SHIMMER family Program Objectives Program Period 12 months Enrollment Criteria Long-term safety Continued access to medication ‐ Age 50-85 ‐ DLB diagnosis ‐ MRI ‐ MMSE: 18-27 Zervimesine 100 mg Oral QD Administration Open
Slide 17: Zervimesine Making an Impact for DLB Patients
18 Zervimesine Making an Impact for DLB Patients Participant from Phase 2 and EAP comments on his experience with zervimesine in SHIMMER In the mornings he would stand there and forget what to do. Now he gets out of bed and knows exactly what he needs to do. Our lives are absolutely more enriched.”
Slide 18: Regulatory Next Steps
19 • Meeting mid-May 2026; minutes June 2026 • Finalized registrational plan to follow • Randomization 1:1 zervimesine (100mg) : placebo • Endpoints are validated and have previously supported FDA approvals • Open-label extension planned following randomized treatment period for all participants Reg
Slide 19: Alzheimer's Disease
95% slowing of cognitive decline in lower-p-tau217 'SHINE' participants Alzheimer’s Disease
Slide 20: AD and DLB: Two Diseases with Overlapping Pathology
21 α-synuclein Amyloid beta (Aβ) • Aβ: associated with Alzheimer’s pathogenesis • α-synuclein: associated with Lewy body dementias • Co-pathology is common - Up to 80% of DLB patients have BOTH α-synuclein and Amyloid beta (Aβ)1 - Appx 50% of Alzheimer’s patients have BOTH Aβ and α-synuclein2 • Zerv
Slide 21: Phase 2 PoC in Mild-to-Moderate Alzheimer's Disease
22 • Characteristics well-balanced between all 3 arms • Mean MMSE score upon entry: 21.37 • ~60% of patients carry the ApoE4 gene • Majority female (60%), Caucasian (96%), ~ 72 yo Phase 2 PoC in Mild-to-Moderate Alzheimer’s Disease Well-executed, over-enrolled study, supports advancing clinical deve
Slide 22: Up to 108% Slowing on Assessments in Lower p-Tau Population
23 ADAS-Cog 11 ADAS-Cog 13 MMSE ADCS-ADL ADCS-CGIC 95% 103% 108% 68% 61% median p-tau217 Up to 108% Slowing on Assessments in Lower p-Tau Population Cognition Function Endpoints measured 100/300mg zervimesine pooled vs placebo Response of 100 and 300 mg dose groups are similar
Slide 23: Plasma p-Tau217: a Predictive Biomarker of Treatment Response
24 • Individuals with lower levels of plasma p-tau217 at baseline have lower AD pathology. They show a greater response to amyloid-based therapies: - Donanemab TRAILBLAZER 21 - Lecanemab CLARITY AD tau sub study2 • Given zervimesine’s MoA of displacing Aβ oligomers, we hypothesized that larger treat
Slide 24: Participants with Below Median p-Tau217 Experienced Profound Treatment Effect
26 Participants with Below Median p-Tau217 Experienced Profound Treatment Effect Successful end-of-Phase 2 meeting was based on these results † Median plasma p-tau217 level is 1.0pg/mL at baseline ADAS-Cog 11* mITT population (n=150) Below median p-tau217 (n=69) Population selected for Phase 3
Slide 25: Consistent Treatment Impact Across Baseline MMSE Scores
27 Consistent Treatment Impact in Participants with Lower p-Tau217 Across Baseline MMSE scores Confirmed enrichment strategy and severity range at end-of-Phase 2 FDA meeting Zervimesine-treated Mild (MMSE 22-26) Participants Zervimesine-treated Moderate (MMSE 18-21) Participants
Slide 26: Consistent Safety Profile Across Completed Phase 2 Studies
28 • Average age was ~75 years • Adverse events (AEs) were well balanced between treatment and placebo arms - Serious AEs occurred at comparable or higher rates in placebo- compared to zervimesine-treated arms - Three participants in 100mg dose group had LFT elevations greater than 3x ULN (6.8%) • E
Slide 27: Phase 2 MCI and Early Alzheimer's Study
29 Phase 2 MCI and Early Alzheimer’s Study First study to allow approved mAbs as background therapy in combination with zervimesine START COG0203 study (NCT05531656) partially funded by $81M NIA grant R01AG065248 Program Objectives Assessments Treatment Period 18 months Enrollment Criteria Identify
Slide 28: START Study Completed Enrollment 4Q 2025
30 • Enrollment complete (n=545) - First participant enrolled February 2024 - Last participant enrolled in December 2025 • Cognitive and functional testing: CDR-SB, ADAS-Cog 13, ADCS-ADL-MCI • Trial duration: 18 months • Topline results anticipated 2H 2027 • 15-20% of participants enrolled on lecane
Slide 29: Major Diseases Addressed with Once-Daily Oral Pill
31 3 Major Diseases Addressed with Once-Daily Oral Pill Collective Phase 2 results support advancing zervimesine (CT1812) to registrational studies Dementia with Lewy Bodies Marked slowing of progression across multiple domains Geographic Atrophy Slowing of GA growth rate and area Alzheimer’s Diseas
Slide 30: Current Financial Position
32 Current Financial Position Cash runway through 2Q 2027 Cash, cash equivalents, and restricted cash equivalents $ 37 M Grant funding for zervimesine studies Preclinical through Phase 2 ~$171 M Approximate funding used ($135 M) Remaining grant funding $36 M As of December 31, 2025
Slide 31: Thank You
Thank You Lisa Ricciardi President & CEO info@cogrx.com
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