BioXcel Therapeutics Reports First Quarter 2025 Financial Results and Provides Business Update

Rhea-AI Summary

BioXcel Therapeutics (NASDAQ: BTAI) has announced the completion of enrollment in its SERENITY At-Home Phase 3 safety trial for BXCL501, testing acute treatment of agitation in bipolar disorders or schizophrenia patients. The trial has enrolled 200 patients, with over 165 patients dosed and 115 receiving multiple doses over 12 weeks. Topline data is expected in H2 2025. For Q1 2025, BTAI reported IGALMI® revenue of $168,000, down from $582,000 in Q1 2024. The company's net loss improved to $7.3 million from $26.8 million year-over-year, with R&D expenses decreasing to $4.6 million from $11.4 million. Cash position stands at $31 million as of March 31, 2025, with $12 million used in Q1 operations.

Positive

• Net loss significantly improved to $7.3M from $26.8M YoY
• Successful completion of SERENITY At-Home Phase 3 trial enrollment with 200 patients
• Reduced operating expenses with R&D costs down to $4.6M from $11.4M and SG&A down to $5.7M from $13.3M

Negative

• IGALMI® revenue declined 71% to $168,000 from $582,000 YoY
• Significant cash burn with $12M used in Q1 2025 operations
• Limited cash position of $31M as of March 31, 2025

Insights

Biotech Clinical Analyst

BioXcel reports complete enrollment in pivotal SERENITY At-Home trial with data expected H2 2025, while Q1 revenue declined amid financial improvements.

The completion of enrollment in the SERENITY At-Home pivotal Phase 3 safety trial represents a significant clinical milestone for BioXcel's BXCL501 program. This study is designed to assess the safety of BXCL501 (120 mcg) in the at-home treatment setting for agitation associated with bipolar disorders or schizophrenia—a substantial untapped market with an estimated 23 million annual episodes and no FDA-approved treatments.

The enrollment metrics are noteworthy: over 165 patients dosed and more than 115 patients receiving multiple doses throughout the 12-week period. This robust dataset should provide comprehensive safety information needed for regulatory consideration. The upcoming Data Safety Monitoring Board meeting in mid-May will offer an important interim assessment of the safety profile before the expected topline data release in H2 2025.

IGALMI® (dexmedetomidine) is currently approved for acute treatment of agitation in healthcare facilities, but the at-home indication would substantially expand its market potential. A successful trial could lead to a supplemental New Drug Application (sNDA) for IGALMI®, potentially transforming the treatment paradigm for home-based agitation management.

Meanwhile, the TRANQUILITY program for Alzheimer's-related agitation remains part of BioXcel's pipeline, though appears to be advancing more slowly. This suggests the company is strategically prioritizing the SERENITY program, likely due to its nearer-term commercial potential and clearer regulatory pathway.

BioXcel's disciplined approach to resource allocation is evident in their substantially reduced R&D ($4.6 million vs $11.4 million) and SG&A expenses ($5.7 million vs $13.3 million), which has significantly improved their bottom line despite declining IGALMI® revenue ($168,000 vs $582,000). This operational efficiency has slowed their cash burn, though their $31 million cash position may still necessitate additional financing before potential SERENITY approval and commercialization.

Financial Analyst

BioXcel's significant cost reductions and narrowed losses offset declining IGALMI sales, while successful trial advancement may expand future revenue opportunities.

BioXcel's Q1 2025 financial results reveal both challenges and improvements in their financial position. Revenue from IGALMI® dropped substantially to $168,000, representing a 71% decline compared to the $582,000 reported in Q1 2024. This concerning revenue trend suggests continued commercial challenges for their FDA-approved product, despite the company's efforts to maintain market presence with "minimal commercial resources."

However, the company has made impressive progress in cost containment. R&D expenses decreased by 60% to $4.6 million from $11.4 million year-over-year, while SG&A expenses fell by 57% to $5.7 million from $13.3 million. These significant reductions reflect the company's strategic reprioritization efforts implemented in 2024.

This disciplined expense management has dramatically improved BioXcel's bottom line. Net losses decreased by 73% to $7.3 million from $26.8 million in the prior-year period. The company used $12.0 million in operating cash during Q1, and ended the quarter with $31 million in cash and equivalents.

The current cash position gives BioXcel runway into late 2025, which should be sufficient to reach the critical SERENITY At-Home trial readout expected in H2 2025. However, without significant revenue growth or additional financing, the company may face cash constraints for any potential commercial launch of the expanded indication.

Looking forward, the fully enrolled SERENITY At-Home trial represents a significant potential value driver. Success here could substantially expand IGALMI's addressable market by enabling at-home use for the estimated 23 million annual episodes of bipolar or schizophrenia-related agitation. This represents a crucial opportunity to transform BioXcel's commercial outlook and financial trajectory through access to a much larger patient population than the current in-facility approval allows.

Enrollment complete in SERENITY At-Home pivotal Phase 3 safety trial for acute treatment of agitation associated with bipolar disorders or schizophrenia

Topline data expected in second half of 2025 intended to support potential sNDA submission for label expansion of IGALMI^® in the at-home setting

NEW HAVEN, Conn., May 12, 2025 (GLOBE NEWSWIRE) -- BioXcel Therapeutics, Inc. (Nasdaq: BTAI), a biopharmaceutical company utilizing artificial intelligence to develop transformative medicines in neuroscience, today reported its financial results for the first quarter of 2025 and announced that its SERENITY At-Home pivotal Phase 3 safety trial for acute treatment of agitation associated with bipolar disorders or schizophrenia is fully enrolled.

“We are pleased to have achieved this major milestone in our first trial of BXCL501 in the at-home setting,” said Vimal Mehta, Ph.D., CEO of BioXcel Therapeutics. “An estimated 23 million episodes of bipolar or schizophrenia-related agitation occur annually^1-3 at home, yet there are no FDA-approved acute treatment options for patients in this setting. We look forward to a data readout expected in the second half of this year and are excited by the opportunity to expand the market potential of IGALMI^® and bring this drug to millions of additional patients.”

BXCL501 Late-Stage Clinical Programs

SERENITY Program

• SERENITY At-Home Phase 3 Trial: designed as a double-blind, placebo-controlled study to evaluate the safety of a 120 mcg dose of BXCL501 in 200 patients for acute treatment of agitation associated with bipolar disorders or schizophrenia in the at-home setting.
  • Trial enrollment is complete:
    • More than 165 patients have been dosed.
    • More than 115 patients have received multiple doses for agitation over the 12-week trial period.

• A Data Safety Monitoring Board (DSMB) meeting is scheduled for mid-May.
• Topline data is expected in the second half of 2025.

TRANQUILITY Program

• TRANQUILITY In-Care Phase 3 Trial: designed as a double-blind, placebo-controlled study to evaluate the efficacy and safety of a 60 mcg dose of BXCL501 for acute treatment of agitation associated with Alzheimer’s dementia in the care setting.
  • The program remains part of the Company’s broader development strategy.
  • The Company is advancing plans for trial initiation.
    

Corporate Updates

IGALMI^® Market Presence

• The Company is continuing to supply IGALMI^® to patients and providers, and build brand awareness, with minimal commercial resources.
  

First Quarter 2025 Financial Results

Net revenue from IGALMI^® was $168,000 for the first quarter of 2025, compared to $582,000 for the same period in 2024.

Cost of Goods Sold for the first quarter of 2025 was $14,000, compared to $80,000 for the same period in 2024. Cost of goods sold is related to the costs to produce, package, and deliver IGALMI^® to customers, as well as costs related to excess or obsolete inventory. There were no charges for reserves for excess or obsolete inventory in the three months ended March 31, 2025.

Research and Development (R&D) expenses were $4.6 million for the first quarter of 2025, compared to $11.4 million for the same period in 2024. The decreased expenses were primarily attributable to a decrease in clinical trial activity associated with previously completed Phase 3 studies and a decrease in personnel related to the company’s reprioritization.

Selling, General and Administrative (SG&A) expenses were $5.7 million for the first quarter of 2025, compared to $13.3 million for the same period in 2024. The decreased expenses were attributable to a decrease in personnel and related costs, lower professional fees, and lower commercial and marketing costs resulting from reprioritization actions taken in 2024.

Net Loss: BioXcel Therapeutics had a net loss of $7.3 million for the first quarter of 2025, compared to a net loss of $26.8 million for the same period in 2024. The Company used $12.0 million in operating cash during the first quarter of 2025.

Cash and cash equivalents totaled $31 million as of March 31, 2025. 

About BXCL501
Outside of its approved indication by the U.S. Food and Drug Administration as IGALMI^® (dexmedetomidine) sublingual film, BXCL501 is an investigational proprietary, orally dissolving film formulation of dexmedetomidine, a selective alpha-2 adrenergic receptor agonist. BXCL501 is under investigation by BioXcel Therapeutics for the acute treatment of agitation associated with Alzheimer’s dementia and for the acute treatment of agitation associated with bipolar I or II disorder or schizophrenia in the at-home setting. The safety and efficacy of BXCL501 for these investigational uses have not been established. BXCL501 has been granted Breakthrough Therapy designation by the FDA for the acute treatment of agitation associated with dementia and Fast Track designation for the acute treatment of agitation associated with schizophrenia, bipolar disorders, and dementia.

About the SERENITY At-Home Phase 3 Trial
The SERENITY At-Home Phase 3 trial is a double-blind, placebo-controlled study designed to evaluate the safety of a 120 mcg dose of BXCL501 for the acute treatment of agitation associated with bipolar disorders or schizophrenia in the at-home setting. The trial is designed to evaluate 200 patients with a history of agitation episodes residing at home either alone or with caregivers/informants. Patients are self-administering 120 mcg of BXCL501 or placebo when agitation episodes occur over the 12-week trial period, with safety data (adverse events) collected during the trial. In addition, patients or caregivers/informants will complete a modified global impression of severity (mCGIs) and a clinical global impression of change (mCGI-C) two hours after dosing as an exploratory endpoint to evaluate use in the outpatient setting.

About the TRANQUILITY In-Care Phase 3 Trial
The TRANQUILITY In-Care trial is designed as a double-blind, placebo-controlled study to evaluate the efficacy and safety of a 60 mcg dose of BXCL501 over a 12-week period for agitation associated with Alzheimer’s dementia in the care setting. The trial is expected to enroll approximately 150 patients 55 years and older who have mild, moderate, or severe dementia with mini-mental state examination scores of 0 to 25 and who reside in skilled nursing facilities, memory care units, or assisted living facilities. Patients will self-administer 60 mcg of BXCL501 or placebo when episodic agitation episodes occur over the trial period. The primary endpoint is expected to be a change from baseline in the Positive and Negative Syndrome Scale-Excitatory Component (PEC) total score at two hours post-first dose. Additional PEC and Clinical Global Impressions – Improvement Scale measurements will also be obtained during the trial.

About IGALMI^® (dexmedetomidine) sublingual film  
  
INDICATION 

IGALMI^® (dexmedetomidine) sublingual film is a prescription medicine, administered under the supervision of a health care provider, that is placed under the tongue or behind the lower lip and is used for the acute treatment of agitation associated with schizophrenia and bipolar disorder I or II in adults. The safety and effectiveness of IGALMI has not been studied beyond 24 hours from the first dose. It is not known if IGALMI is safe and effective in children. 

IMPORTANT SAFETY INFORMATION 

IGALMI can cause serious side effects, including: 

• Decreased blood pressure, low blood pressure upon standing, and slower than normal heart rate, which may be more likely in patients with low blood volume, diabetes, chronic high blood pressure, and older patients. IGALMI is taken under the supervision of a healthcare provider who will monitor vital signs (like blood pressure and heart rate) and alertness after IGALMI is administered to help prevent falling or fainting. Patients should be adequately hydrated and sit or lie down after taking IGALMI and instructed to tell their healthcare provider if they feel dizzy, lightheaded, or faint. 
• Heart rhythm changes (QT interval prolongation). IGALMI should not be given to patients with an abnormal heart rhythm, a history of an irregular heartbeat, slow heart rate, low potassium, low magnesium, or taking other drugs that could affect heart rhythm. Taking IGALMI with a history of abnormal heart rhythm can increase the risk of torsades de pointes and sudden death. Patients should be instructed to tell their healthcare provider immediately if they feel faint or have heart palpitations. 
• Sleepiness/drowsiness. Patients should not perform activities requiring mental alertness, such as driving or operating hazardous machinery, for at least 8 hours after taking IGALMI. 
• Withdrawal reactions, tolerance, and decreased response/efficacy. IGALMI was not studied for longer than 24 hours after the first dose. Physical dependence, withdrawal symptoms (e.g., nausea, vomiting, agitation), and decreased response to IGALMI may occur if IGALMI is used longer than 24 hours. 

The most common side effects of IGALMI in clinical studies were sleepiness or drowsiness, a prickling or tingling sensation or numbness of the mouth, dizziness, dry mouth, low blood pressure, and low blood pressure upon standing. 

These are not all the possible side effects of IGALMI. Patients should speak with their healthcare provider for medical advice about side effects. 

Patients should tell their healthcare provider about their medical history, including if they suffer from any known heart problems, low potassium, low magnesium, low blood pressure, low heart rate, diabetes, high blood pressure, history of fainting, or liver impairment. They should also tell their healthcare provider if they are pregnant or breastfeeding or take any medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Patients should especially tell their healthcare provider if they take any drugs that lower blood pressure, change heart rate, or take anesthetics, sedatives, hypnotics, and opioids. 

Everyone is encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. You can also contact BioXcel Therapeutics, Inc. at 1-833-201- 1088 or medinfo@bioxceltherapeutics.com. 

Please see full prescribing information at Igalmi.com.

About BioXcel Therapeutics, Inc.
BioXcel Therapeutics, Inc. (Nasdaq: BTAI) is a biopharmaceutical company utilizing artificial intelligence to develop transformative medicines in neuroscience. Its wholly owned subsidiary, OnkosXcel Therapeutics, is focused on the development of medicines in immuno-oncology. The Company’s drug re-innovation approach leverages existing approved drugs and/or clinically validated product candidates together with big data and proprietary machine learning algorithms to identify new therapeutic indications. For more information, please visit bioxceltherapeutics.com.

Forward-Looking Statements
This press release includes “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. We intend such forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act of 1933, as amended and Section 21E of the Securities Exchange Act of 1934, as amended. All statements contained in this press release other than statements of historical fact should be considered forward-looking statements, including, without limitation, statements related to: the Company’s planned advancement of its TRANQUILITY and SERENITY trials and the trial designs thereof; potential market opportunity for BXCL501; completing enrollment and release of topline data from the ongoing SERENITY trial; the DSMB meeting for the ongoing SERENITY trial; the supply of IGALMI through existing distribution channels; the potential for the results from the Company’s completed, ongoing and proposed clinical trials to support regulatory approvals for its product candidates. When used herein, words including “anticipate,” “believe,” “can,” “continue,” “could,” “designed,” “estimate,” “expect,” “forecast,” “goal,” “intend,” “may,” “might,” “plan,” “possible,” “potential,” “predict,” “project,” “should,” “target,” “will,” “would” and similar expressions are intended to identify forward-looking statements, though not all forward-looking statements use these words or expressions. In addition, any statements or information that refer to expectations, beliefs, plans, projections, objectives, performance or other characterizations of future events or circumstances, including any underlying assumptions, are forward-looking. All forward-looking statements are based upon the Company’s current expectations and various assumptions. The Company believes there is a reasonable basis for its expectations and beliefs, but they are inherently uncertain. The Company may not realize its expectations, and its beliefs may not prove correct. Actual results could differ materially from those described or implied by such forward-looking statements as a result of various important factors, including, without limitation: its limited operating history; its incurrence of significant losses; its need for substantial additional funding and ability to raise capital when needed; the impact of the reprioritization; its significant indebtedness, ability to comply with covenant obligations and potential payment obligations related to such indebtedness and other contractual obligations; the Company has identified conditions and events that raise substantial doubt about its ability to continue as a going concern; its limited experience in drug discovery and drug development; risks related to the TRANQUILITY program; its dependence on the success and commercialization of IGALMI^®, BXCL501, BXCL502, BXCL701 and BXCL702 and other product candidates; the number of episodes of agitation and the size of the Company’s total addressable market may be overestimated, and approval that the Company may obtain may be based on a narrower definition of the patient population; its lack of experience in marketing and selling drug products; the risk that IGALMI or the Company’s product candidates may not be accepted by physicians or the medical community in general; the Company still faces extensive and ongoing regulatory requirements and obligations for IGALMI; the failure of preliminary data from its clinical studies to predict final study results; failure of its early clinical studies or preclinical studies to predict future clinical studies; its ability to receive regulatory approval for its product candidates; its ability to enroll patients in its clinical trials; undesirable side effects caused by the Company’s product candidates; its novel approach to the discovery and development of product candidates based on EvolverAI; the significant influence of and dependence on BioXcel LLC; its exposure to patent infringement lawsuits; its reliance on third parties; its ability to comply with the extensive regulations applicable to it; impacts from data breaches or cyber-attacks, if any; risks associated with the increased scrutiny relating to environmental, social and governance (ESG) matters; risks associated with federal, state or foreign health care “fraud and abuse” laws; and its ability to commercialize its product candidates, as well as the important factors discussed under the caption “Risk Factors” in its Annual Report on Form 10-K for the fiscal year ended December 31, 2024, as such factors may be updated from time to time in its other filings with the SEC, which are accessible on the SEC’s website at www.sec.gov and the Investors section of the Company’s website at www.bioxceltherapeutics.com. These and other important factors could cause actual results to differ materially from those indicated by the forward-looking statements made in this press release. Any such forward-looking statements represent management’s estimates as of the date of this press release. While the Company may elect to update such forward-looking statements at some point in the future, except as required by law, it disclaims any obligation to do so, even if subsequent events cause our views to change. These forward-looking statements should not be relied upon as representing the Company’s views as of any date subsequent to the date of this press release.

Contact Information

Corporate/Investors
BioXcel Therapeutics
Erik Kopp
1.203.494.7062

Media
Russo Partners
David Schull
1.858.717.2310

Source: BioXcel Therapeutics, Inc.
IGALMI^® is a registered trademark of BioXcel Therapeutics, Inc.

References

• Data on file relating to agitation episodes associated with schizophrenia or bipolar I or II disorder. BioXcel Therapeutics, Inc. New Haven, CT December 2020. Episode estimations may not reflect potential treatable episodes, and actual addressable market may be smaller.
  
  
• Data from Wu EQ, Shi L, Birnbaum H, et al. Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach. Psychol Med. 2006;36(11):1535-1540. Estimates based on whether indications are approved for at-home use for the intended patient population and such patients are treatable. Episode estimations may not reflect potential treatable episodes, and actual addressable market may be smaller.
  
  
• National Institute of Mental Health. Prevalence of bipolar disorder in adults. November 2017. Accessed December 16, 2022. https://www.nimh.nih.gov/health/statistics/bipolar-disorder. Episode estimations may not reflect potential treatable episodes, and actual addressable market may be smaller.
  

BioXcel Therapeutics, Inc.
Statements of Operations
(Unaudited, in thousands, except per share amounts)
		Three months ended March 31,
			2025				2024
Revenues
Product revenues		$	168			$	582
Operating expenses
Cost of goods sold			14				80
Research and development			4,554				11,401
Selling, general and administrative			5,699				13,264
Total operating expenses			10,267				24,745
Loss from operations			(10,099	)			(24,163	)
Other (income) expense
Interest expense, net			3,993				3,607
Interest income			(279	)			(947	)
Other (income) expense, net			(6,559	)			(32	)
Net loss and comprehensive loss		$	(7,254	)		$	(26,791	)
Net loss per share - basic and diluted		$	(1.50	)		$	(13.89	)
Weighted average shares outstanding - basic and diluted			4,834				1,929
Condensed Balance Sheets
(Unaudited, in thousands)
		March 31,				December 31,
			2025				2024
Cash and cash equivalents		$	31,013			$	29,854
Total assets		$	38,566			$	38,338
Total liabilities		$	128,738			$	131,439
Total stockholders' equity (deficit)		$	(90,172	)		$	(93,101	)

FAQ

What were BioXcel Therapeutics (BTAI) Q1 2025 earnings results?

BTAI reported Q1 2025 net loss of $7.3M (improved from $26.8M YoY), IGALMI® revenue of $168,000, R&D expenses of $4.6M, and SG&A expenses of $5.7M. Cash position was $31M as of March 31, 2025.

What is the status of BTAI's SERENITY At-Home Phase 3 trial?

The SERENITY At-Home Phase 3 safety trial has completed enrollment with 200 patients, over 165 patients dosed, and 115 receiving multiple doses over 12 weeks. Topline data is expected in H2 2025.

How much did BTAI's IGALMI® sales decline in Q1 2025?

IGALMI® sales declined 71% to $168,000 in Q1 2025 from $582,000 in Q1 2024.

What is BTAI's cash position and burn rate as of Q1 2025?

BTAI had $31M in cash and cash equivalents as of March 31, 2025, with $12M used in operating cash during Q1 2025.

What is the market potential for BXCL501 in the at-home setting?

According to the company, there are an estimated 23 million episodes of bipolar or schizophrenia-related agitation occurring annually at home, with no FDA-approved acute treatment options currently available.