SPRB

• Net loss was $16.2 million ($6.68 per share) for Q2 2026 and $28.5 million ($14.96 per share) for the first six months of 2026.
• R&D expenses were $12.2 million in Q2 2026 and $19.7 million in the first half of 2026; G&A expenses were $4.3 million and $8.8 million, respectively.
• BLA submission for TA-ERT for MPS IIIB is anticipated in Q4 2026, with the TrAnsform confirmatory study expected to initiate in Q4 2026.
• Cure Sanfilippo Foundation and National MPS Society made a combined $5.5 million strategic investment to fund the TA-ERT Expanded Access Program.
• Adrian Quartel, M.D., was appointed Chief Medical Officer effective July 27, 2026, and Jessica Cohen Pfeffer, M.D., was appointed VP of Clinical Development effective August 3, 2026.

2.02 Results of Operations and Financial Condition · 9.01 Financial Statements and Exhibits

• On July 27, 2026, Spruce Biosciences appointed Adrian Quartel, M.D., FFPM, as Chief Medical Officer.
• Dr. Quartel replaces Dr. Kirk Ways, who had been serving as Interim Chief Medical Officer.
• Dr. Quartel has over 25 years of pharmaceutical industry experience, including as CMO of Zevra Therapeutics and Acer Therapeutics.
• He previously led global medical affairs at BioMarin, launching six rare disease treatments.

5.02 Departure of Directors or Certain Officers; Election of Directors; Appointment of Certain Officers; Compensatory Arrangements

• Stockholders elected Michael Grey, Camilla V. Simpson, and Javier Szwarcberg as Class III directors to serve until the 2029 annual meeting.
• Stockholders ratified BDO USA, P.C. as independent auditor for fiscal year 2026 (880,984 for, 16,851 against, 6,058 abstentions).
• Advisory say-on-pay vote passed with 187,027 for, 111,274 against, 1,573 abstentions.
• Stockholders preferred an annual advisory vote on executive compensation; company will hold such vote every year until at least 2032.

5.07 Submission of Matters to a Vote of Security Holders · 9.01 Financial Statements and Exhibits

• Cash and cash equivalents were $54.1 million as of March 31, 2026, and a preliminary $107.3 million as of April 30, 2026.
• R&D expenses decreased to $7.6 million in Q1 2026 from $10.8 million in Q1 2025, while G&A expenses increased to $4.4 million from $3.7 million.
• The company closed an underwritten public offering in April 2026 with gross proceeds of approximately $69.0 million.
• Spruce plans to submit a BLA for TA-ERT in Q4 2026 and expects cash to fund operations into the second half of 2027.
• The company entered into a loan and security agreement with Avenue Capital for up to $50.0 million in term loans.

2.02 Results of Operations and Financial Condition · 9.01 Financial Statements and Exhibits

• The underwriters exercised in full their option to purchase an additional 180,000 shares of common stock.
• Gross proceeds from the offering are expected to be approximately $69.0 million before deducting underwriting discounts and commissions and estimated offering expenses.
• The offering is expected to close on April 22, 2026, subject to customary closing conditions.
• Leerink Partners, Guggenheim Securities, and Oppenheimer & Co. are acting as joint book-running managers, with Jones and Craig-Hallum as co-managers.

1.01 Entry into a Material Definitive Agreement · 8.01 Other Events · 9.01 Financial Statements and Exhibits

• The Collaboration Agreement will terminate effective March 31, 2026, after which all licenses and rights granted to Kaken will end.
• Under the original agreement, Kaken had made a non-refundable upfront payment of $15.0 million in April 2023 and could have paid up to $65.0 million in milestones plus royalties.
• As of the Termination Date, Spruce will not be entitled to any previously disclosed unearned milestone payments or royalties from Kaken.
• The termination follows a comprehensive assessment of the tildacerfont program for CAH, and no early termination penalties are incurred by Spruce.

1.02 Termination of a Material Definitive Agreement

• The company reported a net loss of $39.0 million for 2025, with cash and equivalents of $48.9 million as of December 31, 2025.
• BLA submission for TA-ERT (Sanfilippo syndrome type B) is on track for Q4 2026 following positive FDA Type B meetings.
• Corwin Dale Hooks was appointed Chief Commercial Officer, effective March 9, 2026, with a base salary of $480,000 and an RSU award of 11,000 shares.
• The company secured a loan facility of up to $50 million from Avenue Capital Group, with an initial $15 million tranche funded in January 2026.

1.01 Entry into a Material Definitive Agreement · 1.02 Termination of a Material Definitive Agreement · 2.02 Results of Operations and Financial Condition · 5.02 Departure of Directors or Certain Officers; Election of Directors; Appointment of Certain Officers; Compensatory Arrangements · 9.01 Financial Statements and Exhibits

• An analysis of 22 patients followed up to six years showed TA-ERT stabilized cognitive function, cortical gray matter volume, and normalized liver and spleen volume, with approximately 6,000 doses administered.
• A new VABS-II analysis showed TA-ERT stabilized receptive and expressive communication and fine and gross motor skills compared to declines in untreated natural history patients.
• A case study of two siblings with severe MPS IIIB showed the treated sibling had higher cognitive, language, and motor functioning than the untreated sibling at similar ages.
• The company stated its intent to advance TA-ERT through a biologics license application submission and potential U.S. FDA approval.
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7.01 Regulation FD Disclosure · 8.01 Other Events · 9.01 Financial Statements and Exhibits