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Combating Neurodegeneration Via Treg Directed Combination Therapy Investor Overview March 2026
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Cautionary Note of Forward-Looking Statements and Disclaimers in this Presentation This presentation and the accompanying oral presentation contain “forward -looking” statements that are based on our management’s beliefs and assumptions and on information currently available to management. Forward-looking statements include all statements other than statements of historical fact contained in this presentation, inclu ding information concerning our current and future financial performance, business plans and objectives, current and future clinical and preclinical development activities, timing and success of our ongoing a nd planned clinical trials and related data, the timing of announcements, updates and results of our clinical trials and related data, our ability to obtain and maintain regulatory approval, the potential therap eutic benefits and economic value of our product candidates, competitive position, industry environment and potential market opportunities. The words “believe,” “may,” “will, ” “estimate,” “continue,” “anticipate,” “intend,” “expect,” and similar expressions are intended to identify forward -looking statements. Forward-looking statements are subject to known and unknown risks, uncertainties, assumptions and other factors including, but n ot limited to, those related to risks associated with the success, cost and timing of our product candidate development activities and ongoing and planned clinical trials; our plans to develop and commercialize targeted therapeutics; the progress of patient enrollment and dosing in our preclinical or clinical trials; the ability of our product candidates to achieve applicable endpoints in the clinical trials; the safety pro file of our product candidates; the potential for data from our clinical trials to support a marketing application, as well as the timing of these events; our ability to obtain funding for our opera tions; development and commercialization of our product candidates; the timing of and our ability to obtain and maintain regulatory approvals; the rate and degree of market acceptance and clinical utility of our pro duct candidates; the size and growth potential of the markets for our product candidates, and our ability to serve those markets; our commercialization, marketing and manufacturing capabilities and strategy; future agre ements with third parties in connection with the commercialization of our product candidates; our expectations regarding our ability to obtain and maintain intellectual property protection; our dependence on third party manufacturers; the success of competing therapies or products that are or may become available; our ability to attract and retain key scientific or managem ent personnel; our ability to identify additional product candidates with significant commercial potential consistent with our commercial objectives; and our estimates regarding expenses, future revenue, capital requirements and needs for additional financing. We have based these forward-looking statements largely on our current expectations and projections about future events and trend s that we believe may affect our financial condition, results of operations, business strategy, short-term and long-term business operations and objectives, and financial needs. Moreover, we operate in a very compe titive and rapidly changing environment, and new risks may 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 herein may not occur and actual results could differ materially and adversely from those a nticipated or implied in the forward -looking statements. Although our management believes that the expectations reflected in our forward -looking statements are reasonable, we cannot guarantee that the future r esults, levels of activity, performance or events and circumstances described in the forward-looking statements will be achieved or will occur. We undertake no obligation to publicly update any forward -looking statements, whether written or oral, that may be made from time to time, whether as a result of new information, future developments or otherwise. The distribution of this presentation may also be restricted by law and persons into whose possession this presentation comes should inform themselves about and observe any such restrictions. The recipient acknowledges that it is (a) aware that the U.S. securities laws prohibit any person who has material, non -public information concerning a company from purchasing or selling securities of such company or from communicating such information to any other person under circumstances in which it is reasonably foreseeable that such person is likely to purchase or sell such securities, and (b) familiar with the Securities Exchange Act of 1934, as amended, and the rules and regulations promulgated thereunder (collectively, the “Exchange Act”), an d that the recipient will neither use, nor cause any third party to use, this presentation or any information contained herein in contravention of the Exchange Act, including , without limitation, Rule 10b-5 thereunder.
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Coya Therapeutics (COYA): Investment Highlights Indications With High Unmet Need • ALS, Frontotemporal Dementia (FTD), Alzheimer's Disease (AD) • De-risked approach with regulatory flexibility Clinical Programs Ongoing • COYA 302: ALSTARS Phase 2 study in ALS ongoing • COYA 302: Phase 2 in FTD to commence in 2026 Novel Combination Therapies • COYA 302 (ALS, FTD) and COYA 303 (AD) have differentiated approach targeting Treg dysfunction via combination therapies Value Creation - Compelling Market Opportunity • COYA 302: Pipeline within a product > $10B Potential • COYA 303- Potential to add value for existing GLP-1 RA's Strong Partnership and Cash Position • 2H 2027 estimated runway: ~$47 million as of Dec. 31, 2025 • Dr. Reddy’s partnership: royalties + up to ~$700M in potential milestones • $10 million strategic investment from Dr. Reddy's (Jan. 2026)
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Coya's Late Stage Neurodegenerative Pipeline Product IND-Enabling Phase 1 Phase 2 Phase 3 Partner COYA 302 Low Dose IL-2 + CTLA4-Ig Dr. Reddy’s Labs (worldwide, excl. Japan & LatAm) Coya retains worldwide rights COYA 303 Low Dose IL-2 + GLP-1 RA Coya retains worldwide rights COYA 201 Allogeneic Treg Derived Exosomes Coya retains worldwide rights COYA 206 Antigen-Directed Treg Exosomes Coya retains worldwide rights ALS (Amyotrophic Lateral Sclerosis) FTD (Frontotemporal Dementia) Alzheimer's Disease Undisclosed Undisclosed
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COYA 302 in ALS: ALSTARS (Phase 2) • Complete enrollment: expected 2H 2026 • Top-line data: expected 1Q 2027 • Management to provide periodic updates COYA 302 in FTD: • Acceptance of IND: accepted 1Q 2026 • initiate Phase 2a study: expected 2H 2026 Translational Datasets • Present further translational and clinical datasets across Coya programs Including biomarker, proteomics, and single-cell data • Further elucidate role of Tregs in neuroinflammation and neurodegeneration • Provide additional insight into target engagement, pathway modulation, and patient-level biology: COYA 303 in Alzheimer's • Evaluate path forward: mid-2026 • Evaluate emerging clinical data EVOKE/EVOKE+ to inform R&D strategy Key Catalysts and Milestones
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Neurodegeneraive Indications with High Unmet Medical Need Parkinson’s Disease ALS FTD Alzheimer’s Disease COYA 303: Alzheimer’s Disease • One of the most common neurodegenerative diseases • High unmet need despite approved therapies • > $5Bn market Pipeline > $10B Opportunity in ALS, FTD, AD & PD COYA 302: ALS and FTD • High unmet need • Orphan indications • Flexible & fast path to market • > $5Bn market
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• Nobel Prize–Recognized for discovery & role of Treg Biology(1) • Well-established association between Treg Dysfunction and ALS/FTD(2) • Independent scientific support of Coya's approach in ALS(3) • Combination therapy restores and maintains Treg function • Stabilization of disease progression in ALS & FTD • Potential for combo therapies to alter disease trajectory ➢ ALS IIT: no ALSFR-S decline at 6 months, minimal decline at 1 year ➢ FTD IIT: cognitive stability at 6 months • Combination therapy increase likelihood of success • Endorsed by external thought leaders (KOLs, ADDF, CTAD) • Well-established therapeutics (low-dose IL-2 & Abatacept) • Low-dose IL-2 used at ~50x lower doses vs standard IL-2 dosing • CTLA4-Ig's safety and efficacy established in millions of patients Validated Science Differentiated Combination- based Therapeutic Approach Early Clinical Validation The neurodegeneration field increasingly recognizes combination-based therapeutic strategies such as Coya's as a viable path forward for diseases driven by complex, multifactorial biology LD IL-2 Combination Therapy: 3 Pillars For Success 1. Bluestone, The 2025 Nobel Prize in Physiology or Medicine — a bridge to peripheral immune tolerance, Journal of Clinical Investigation, 2025 2. Appel et al, ALS patients' regulatory T lymphocytes are dysfunctional, and correlate with disease progression rate and severity, JCI Insight, 2027 3. Sette et al, Autoimmune response to C9orf 72 protein in amyotrophic lateral sclerosis, Nature, November 2025
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Tregs (Regulatory T Cells) • Specialized immune cells that help maintain a balanced immune system • Restrain chronic inflammation • Limit pathways that drive neuroinflammation Treg Dysfunction & Disease lead to: • Immune activation and chronic inflammation • Chronic inflammation leads to autoimmune pathology • Autoimmune pathology leads to neuro- degenerative disease Coya combinations treat neuro- degenerative disease: • COYA 302 & COYA 303 target immune pathways that drive neuro-degeneration • Enhancing Tregs restores immune balance and blocks the pro-inflammatory mechanisms that impair Tregs • This can potentially treat underlying neurodegeneration Healthy Treg cells keep pro-inflammatory cells in check Dysfunctional Tregs exacerbate chronic inflammatory signaling Treg Focused Pipeline: Critical Role in Inflammation By helping functional regulatory T cells (Tregs) maintain immune balance, Coya combinations restrain chronic inflammation and limit pathways that drive inflammation, thereby potentially treating neuro-degeneration Healthy Tregs Dysfunctional Tregs Pro-inflammatory cells Pro-inflammatory cells
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Treg Imbalance Leads to Neuroinflammation… … And neuroinflammation leads to neurodegeneration, which drives disease progression Loss of selective population of neurons Healthy Tregs Pro-Inflammatory Cells Healthy Neuron Sick Neuron Dead Neuron
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Rebalancing Treg Leads to Improved Clinical Outcomes Coya combination therapies: • Restore and enhance Tregs function, numbers, and survival • Mechanistically reduces chronic neuroinflammation due to immune dysregulation • Drive improved disease outcomes in neurodegenerative and autoimmune disease Restoring and enhancing Tregs re- establishes immune balance and improves disease outcomes Healthy Tregs Pro-inflammatory Cells Healthy NeuronSick Neuron
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COYA 302 in ALS & FTD Proprietary, Recombinant Human Low Dose Interleukin-2 (LD rhIL-2) and CTLA4-Ig
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COYA 302 in ALS and FTD ALS and Frontotemporal Dementia • High unmet need • Relatively short life expectancy from time of diagnosis • Significant loss of QoL • Orphan diseases • Flexible and fast paths to regulatory approval • ALS: ~33,000 patients in U.S. (NIH) • FTD: 50,000-60,000 patients in U.S. (Alzheimer's Association) COYA 302 • Proprietary combination (co-administered) • Recombinant Human Low Dose Interleukin-2 (LD rhIL-2) and CTLA4-Ig • Strong IP through 2040's ADDF Partnership • $5M Investment to support Phase 2 trial in FTD Dr. Reddy Partnership • Global rights to ALS in U.S. and Europe excluding Japan & LATAM • Up to ~$700 million in R&D, regulatory, and sales milestones, mid-digits royalties • $10 million strategic investment (Jan. 2026)
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COYA 302: Combo Therapies Enhance Treg Function Low-dose IL-2 + CTLA4 Ig Restoring Immune Regulation via Combination Therapy • Inflammation creates a dysfunctional immuno- regulatory environment o Tregs are dysregulated and dysfunctional • CTLA-4 Ig + low-dose IL-2 combination acts synergistically to expand dysfunctional Tregs and shift them to functional state • The combination restores immune suppressive function and shifts myeloid cells toward an anti- inflammatory phenotype • The result is re-balanced immune homeostasis, which leads to neuro-protection against neuro- degenerative disease Dysfunctional immuno-regulatory environment due to inflammation Functional and re-balanced immuno-regulatory environment Anti-inflammatory macrophages CD80 pro-inflammatory macrophages Functional Tregs Dysfunctional Tregs
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COYA 302 in ALS
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1. The PRO-ACT database is the largest ALS data repository (Atassi et al, 2014) 2. Relyvrio US Prescribing Information (9/2022) 3. Radicava US Prescribing Information (5/2022) ALS patients average rate of decline is ~1 point/month in ALSFRS-R score1 Current ALS Therapies aim to slow disease progression Weeks Baseline 4 8 12 16 20 24 PRO-ACT ALS Database Mean (SD) Documented Decline (ALSFRS-R) Many companies have garnered significant value by demonstrating a limited` benefit of slowing the rate of ALS progression 2 3
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Participant 1: +4 points Participant 2: +3 points Participant 3: Stable Participant 4: -6 points (declined at month 1 and remained stable thereafter ) Thonhoff et al. A Phase 1 Proof-of-Concept Study Evaluating Safety, Tolerability, and Biological Marker Responses with combination therapy of CTLA4-Ig and Interleukin-2 in Amyotrophic Lateral Sclerosis. Frontiers in Neurology, 2024. In press. LD IL-2 + CTLA4-Ig IIT: Signal in Mild-to-Moderate ALS ALSFRS-R improved or stabilized over 6 months CTLA-4 Ig + LD IL-2 ameliorates progression in a 48 week IST in ALS Patients 33.5 33.75 32 30 0 4 8 12 16 20 24 28 32 36 40 44 48 B 4 8 12 16 20 24 28 32 36 40 44 48 52 56 ALSFRS-R Score Mean (±SD) ALSFRS-R Score (N=4) 48-Week Treatment Follow-Up • 4 mild-to-moderate ALS patients • Low-dose IL-2 + CTLA4 Ig led to stable or improved ALSFRS-R Scores • Ameliorate ALS progression over 48 weeks • Well tolerated over 48 weeks (the most common AE mild was ISR) • All patients completed the study • No deaths or serious AEs (SAEs) Investigator Initiated Trial with LD IL-2 and CTLA4 Ig
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n.s. n.s.: not significant (paired t test) *p <0.05 ** p <0.01 (paired t test) LD IL-2+CTLA4 Ig: Restored Treg Suppressive Function ** ** ** * * * ** LD IL-2 + CTLA4 Ig combination is synergistic and effective LD IL-2 + CTLA4-Ig • Significantly expanded Treg suppressive function as early as week 4 • Maintained a significantly increased Treg function • Increased Treg numbers as early as week 4 • Maintained higher number of Tregs over the course of treatment • Enhanced suppression of macrophage-mediated oxidative stress and proinflammatory cytokine biomarkers over 48 weeks
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Change in disease severity over time measured by ALSFRS-R total score from baseline to Week 24 vs. placebo Primary Endpoint 1. Efficacy 2. Safety and Tolerability 3. Biological Activity 4. Biomarker levels Study Objectives COYA 302 Regimen 1 (N=40) Randomized, Double-Blind, Placebo-Controlled Phase 2 Study with Blinded Active Extension 4 wk. Screening 24 wk. Double Blind Treatment Phase 24 wk. Blinded Active Extension Phase Placebo Group B (N=40) COYA 302 Regimen 2 (N=40) COYA 302 Regimen 1 (N=60) COYA 302 Regimen 2 (N=60) COYA 302: ALSTARS Phase 2 Study in ALS Ongoing • Trial is active and enrolling patients • Complete enrollment: expected 2H 2026 • Top-line data: expected 1Q 2027 • Diagnosis of sporadic or familial ALS • ALSFR-R score ≥ 35 at Screening • Slow vital capacity (SVC) ≥ 70% of predicted capacity for age, height, and gender at Screening • Documented disease progression between -0.5 and -1.5 points per month on ALSFR-R total score Key Inclusion Criteria
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COYA 302 in FTD
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LD IL-2 & CTLA-4 Ig: Signal in Mild-to-Moderate FTD Encouraging clinical data in FTD in Investigator Sponsored Study • Treg suppressive function and percentage: o Increased after first treatment o Remained elevated across 22-week treatment period *<0.05 **<0.01 ***<0.001 ****<0.0001 Increased Treg Suppressive Function Expansion of Treg Percentage (% of CD4+ T cells)
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Cognitive Stability in 22-Week Investigator Sponsored Study • CDR‐FTLD, MoCA, PASS cognitive tests exhibited no cognitive decline at end of study compared with baseline LD IL-2 & CTLA-4 Ig: Signal in FTD – cont. Moca Scores Remains Unchanged Compared to Baseline SC W22 0 2 4 6 8 10 12 14 16 18 20 22 MOCA Score CDR-FTLD Scores Remains Unchanged Compared to Baseline SC W22 0 1 2 3 4 5 6 7 8CDR-FTLD (% of CD4+ T cells)
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COYA-302 in FTD: Phase 2a Expected 2Q 2026 Start COYA 302 (N=32) Randomized, Double-Blind, Placebo-Controlled Phase 2a Study with Open Label Extension 4 wk. Screening 24 wk. Double Blind Treatment Phase 24 week Open Label Extension Phase Placebo (N=16) COYA 302 • Study initiation: expected 2Q 2026 * CDR® Dementia Staging Instrument PLUS National Alzheimer’s Coordinating Center (NACC) Behavior and Language Domains for FTLD - sum of boxes • Non-Fluent Primary Progressive Aphasia Subtype • Global Clinical Dementia Rating - Frontotemporal Lobar Degeneration (CDR® plus NACC FTLD) score of 0.5, 1 or 2 Key Inclusion Criteria • Safety and tolerability Primary Endpoint • CDR+NACC- FTLD-SB* • Neuropsychologic al tests Clinical Efficacy Endpoints • Plasma Glial Fibrillary Acidic Protein (GFAP) • Inflammatory cytokines • NfL Biomarkers
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COYA 301 Proprietary Low Dose Recombinant Human IL-2
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LD IL-2 monotherapy works in Alzheimer's • Enhanced Treg function and numbers • Stabilized cognitive decline LD IL-2 Monotherapy in AD: Exciting Phase I POC Combination with GLP-1 receptor agonist offers: • Enhanced clinical benefit • Synergistic advantage over monotherapy • Validation of low-dose IL-2 therapy as backbone therapy Improved Treg Function *<0.05 **<0.01 ***<0.001 Pre-dose Post-dose Enhances Treg Suppressive Function Improved Cognition MMSE Score (n=8)
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COYA 303 in Alzheimer's Proprietary, Recombinant Human Low Dose Interleukin-2 (LD rhIL-2) and GLP-1 RA
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COYA 303 in Alzheimer's Disease Alzheimer's Disease • High unmet need • Significant loss in QoL • >7 million patients in U.S. COYA 303 • Proprietary combination (co-administered) • Recombinant Human Low Dose Interleukin-2 (LD rhIL-2) and GLP-1 receptor agonist • IP through 2040's Strong scientific rationale • Proof-of-concept in neuro-degenerative diseases • Combinations increase efficacy, durability, stable disease; lower individual doses, and improve tolerability & safety • Preclinical POC in-vitro and LPS mouse model Competitive landscape • Combinations expand efficacy, safety, indications of existing and developmental products • Expands IP exclusivity
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COYA 303 in Alzheimer's: Compelling Preclinical Signal Encouraging in-vitro and in LPS mouse model • Lipopolysaccharide (LPS) mouse model is well-characterized of systemic and neuro-inflammation • COYA 303 decreased both periphery inflammation and in neuro-inflammation • Mechanistic synergy: complementary effects on Treg enhancement and myeloid-driven inflammation • Pre-IND meeting with FDA mid-2026 COYA-303: • Reduced peripheral pro- inflammatory cell expansion • Enhanced Treg function • Attenuated CNS inflammation • Shifted macrophages to an anti-inflammatory phenotype • Decreased neuroinflammation Systemic Tregs NeuroinflammationSystemic inflammation Improved Treg function Reduced Inflammation
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Leadership • Management • Scientific Advisory Board • Board of Directors
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Management • Bristol Myers Squibb • Actinium • Covance • Alteogen • Lynkogen Arun Swaminathan, Ph.D. Chief Executive Officer • Johnson-Johnson • Sunovion • Bristol Myers Squibb • Mesoblast • Eli Lilly • Glenmark Fred Grossman, D.O., FAPA President & Chief Medical Officer • DisperSol Technologies • Exicure • Cellular Dynamics International • Roche NimbleGen David Snyder Chief Financial Officer & Chief Operating Officer
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Experienced Development Team • Revance Therapeutics • CytomX • FDA • Coherus BioSciences Michelle Frazier, Ph.D. Senior Vice President of Regulatory Affairs • Recursion • MacroGenics • Supernus • Shire • MedImmune Karen King, MS Management and Clinical Operations • End The Legacy: Genetic ALS & FTD • I AM ALS • Morgan Stanley Daniel Barvin, M.B.A Vice President of Operations & Patient Advocacy
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Scientific Advisors Board • Nobel Prize for discovery & role of Treg Biology • Distinguished Professor at the World Premier International Research Institute - Immunology Frontier Research Center at Osaka University Shimon Sakaguchi, M.D., Ph.D. Member of the National Academy of Sciences • Professor in Residence at UCLA • Consulting Professor at Stanford University • Renowned expert on stem cell biology and regenerative therapeutic approaches Clive Svendsen, Ph.D. Director, Cedars-Sinai Regenerative Medicine Institute • For more than 50 years, Dr. Appel has devoted his life to finding solutions for people living with ALS • Pioneered role of Tregs in Neurodegeneration Stanley Appel, M.D. Co-Director, Houston Methodist Neurological Institute • Professor, Baylor College of Medicine • Dedicated career to the field of stem cell transplantation through the therapeutic use of T cell immunologic approaches Malcolm Brenner, M.D., Ph.D. Director, Center for Cell and Gene Therapy
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Board of Directors Howard Berman, Ph.D. Executive Chairman of the Board Ann Lee, Ph.D. Chief Technical Officer Prime Medicine Dov Goldstein, M.D., MBA Chief Financial Officer BioAge Labs Wilbur Ross Former U.S. Secretary of Commerce Anabella Villalobos, Ph.D. Former Head of Biotherapeutics and Medicinal Sciences, Biogen Dieter Weinand Former Chairman and CEO Bayer Pharma, AG
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Appendix
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IL-2 is Essential in Treg Biology Romano et al., Frontiers in Neurology, 31 January 2019 doi: 10.3389/fimmu.2019.00043 IL-2
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LD IL-2 + CTLA4-Ig Investigator Initiated Trial Open-Label, Single-Arm PoC Clinical Study in ALS Patients (N=4) Follow-Up Treatment Period Screening 20 weeks LD IL-2 + CTLA4-Ig was administered via subcutaneous injection over 48 weeks 8 weeks Post-Treatment Assessments ✔ Safety and Tolerability ✔ Treg Function & Numbers ✔ Serum Biomarkers ✔ ALSFRS-R Score Screening Assessments ✔ Clinical Labs ✔ ALSFRS-R Score ✔ Electrocardiogram (ECG) ✔ Physical & Neurological Exam Treatment Period Assessments ✔ Safety and Tolerability ✔ Treg Function and Numbers ✔ Serum Biomarkers ✔ ALSFRS-R Score Study patients had well- documented disease progression prior to treatment (-1.1 points/month prior to treatment with COYA 302) Safety and tolerability assessments included reported adverse events, periodic physical and neurological exams, clinical labs, and ECGs * Conducted using commercially available products
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LD IL-2 + CTLA4-Ig Investigator Initiated Trial – cont. Baseline Characteristics Age (years) Sex Type Onset ALS Progression Prior to Baseline (ALSFRS-R score) Respiratory Status Respiratory Support Patient 1 47 Female Familial Limb -1.6 points / month No Respiratory Insufficiency None Patient 2 54 Male Sporadic Limb -1 points / month Respiratory Insufficiency Non-invasive Ventilation Patient 3 57 Female Sporadic Bulbar -1 point / month Respiratory Insufficiency Non-invasive Ventilation Patient 4 84 Female Sporadic Bulbar -0.7 points / month Respiratory Insufficiency None