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Alto Neuroscience (ANRO) FY Conference Transcript

Summary of Alto Neuroscience (ANRO) FY Conference - June 17, 2025 Company Overview - Company: Alto Neuroscience - Industry: Clinical stage biopharmaceutical company focused on precision psychiatry through biomarker-guided drug development - Pipeline: Five phase two programs targeting depression, bipolar disorder, and schizophrenia using a proprietary platform that integrates EEG, cognitive assessments, and wearable data to optimize patient treatment matching [2][8] Core Points and Arguments Challenges in Psychiatry - Traditional psychiatric treatments often lack data-driven selection, relying on historical responses from patients or family members [3][9] - There is a significant gap in understanding which treatments work for specific patients and the underlying reasons [3][9] Precision Psychiatry Approach - Alto Neuroscience aims to address these challenges by utilizing biomarkers to understand drug effects on brain functions related to psychiatric disorders [4][10] - The company employs biomarkers to determine drug efficacy and predict patient responses, thereby reducing risks in drug development [5][12] Clinical Programs and Prioritization - Alto has five clinical stage programs, with a focus on late-stage trials that leverage existing data to inform patient selection and drug efficacy [13][14] - The company is broadening its representation of psychopathology, including various forms of depression and cognitive impairment in schizophrenia [14][15] FDA Guidance and Digital Biomarkers - Alto aligns its strategies with evolving FDA guidance on enrichment strategies in psychiatry trials, particularly regarding digital biomarkers [17][19] - The company has engaged with the FDA to ensure its biomarker strategies are scientifically sound and regulatory compliant [19] Alto 207 - Dopamine Agonist for Treatment-Resistant Depression (TRD) - Alto 207 is positioned as a next-generation dopamine agonist, differentiating itself from existing treatments by directly stimulating the dopamine system [20][21] - The combination of pramipexole (a D3-preferring dopamine agonist) with ondansetron (an antiemetic) aims to mitigate side effects like nausea and vomiting, allowing for faster and higher dosing [22][23] - The program is set to enter a late-stage phase 2b trial, with promising preliminary data indicating significant antidepressant efficacy [23][26] Upcoming Trials and Expectations - The phase 2b trial for Alto 207 is designed to support registration, with expectations for interactions with the FDA to clarify pivotal design [30][31] - The company anticipates a broad TRD label, with biomarkers serving as adjuncts to enhance clinical decision-making [27][28] Other Pipeline Developments - Alto 203: An early-stage program using an H3 inverse agonist strategy, focusing on subjective response and cognition [36][37] - Alto 101: Targets cognitive impairment associated with schizophrenia, utilizing a transdermal formulation to improve tolerability [41][43] - Alto 300: An approved antidepressant in Europe, being developed in the US with a focus on biomarker-defined patient populations [46][48] Market Positioning - Alto 207 is expected to compete favorably against existing treatments like SPRAVATO, with advantages in efficacy, safety profile, and ease of use [34][35] - The company aims to address a significant unmet need in the TRD population, estimated at three million patients in the US annually [32][33] Important but Overlooked Content - The company emphasizes the importance of rigorous patient selection and compliance monitoring to ensure trial integrity and data quality [56][58] - Alto is implementing advanced AI tools to enhance patient profiling and trial execution, aiming to mitigate risks associated with noncompliance and professional patients [58] This summary encapsulates the key insights from the conference, highlighting Alto Neuroscience's innovative approach to psychiatric treatment and its strategic positioning within the biopharmaceutical industry.