CytoSorbents Reports First Quarter 2025 Financial Results and Provides Business Update
- Operating loss improved by 17% to $3.9M from $4.7M in Q1 2024
- Net loss significantly reduced to $1.5M ($0.02/share) from $6.1M ($0.11/share) in Q1 2024
- Successfully raised $6.8M through Rights Offering and unlocked $5.0M restricted cash
- Cash position strengthened to $13.1M from $9.8M in December 2024
- Geographic expansion with new Dubai subsidiary opening
- Product revenue declined 3% to $8.7M compared to Q1 2024
- Gross margin decreased to 71% from 77% in Q1 2024
- FDA denied DrugSorb-ATR De Novo Request, requiring additional items to be addressed
- Temporary disruption in German direct sales due to commercial team reorganization
Insights
CytoSorbents shows mixed Q1 results with reduced losses despite revenue decline; FDA denial creates uncertainty for DrugSorb-ATR commercialization timeline.
CytoSorbents delivered a mixed Q1 2025 financial performance with product revenue declining 3% year-over-year to
While gross margin contracted to
The liquidity position improved substantially during the quarter, with cash rising to
The most concerning development is the FDA's April denial of their De Novo Request for DrugSorb-ATR, a potentially critical device for reducing bleeding in patients on blood thinners undergoing cardiac surgery. The company has opted to address the FDA's concerns through a formal appeal process rather than submitting a new application, believing this offers the fastest path to potential approval in 2025.
Meanwhile, their international expansion continues with a new sales subsidiary in Dubai and key executive appointments for North American marketing. Management maintains their goal of approaching breakeven on their core business this year while emphasizing the clinical effectiveness of their CytoSorb therapy when used early and aggressively.
FDA denial of DrugSorb-ATR creates significant regulatory hurdle despite company confidence in appeal process; clinical adoption continues internationally.
The FDA's denial of CytoSorbents' De Novo Request for DrugSorb-ATR represents a significant regulatory setback for the company's U.S. commercialization strategy. This blood purification device, which received FDA Breakthrough Device Designation, is designed to reduce life-threatening bleeding in patients on Brilinta® (ticagrelor) undergoing coronary artery bypass grafting (CABG). The FDA cited "outstanding items" that must be addressed before authorization, though specific deficiencies weren't detailed in the press release.
CytoSorbents has strategically chosen to pursue the formal FDA appeal process rather than submit a new application, believing this approach provides more direct engagement with FDA leadership and potentially faster resolution. While management remains confident these issues can be resolved in 2025, the denial introduces substantial uncertainty regarding the U.S. commercialization timeline.
Concurrent with these U.S. regulatory challenges, the company's application with Health Canada remains under review, though experiencing delays due to application backlogs. This creates a two-front regulatory challenge for North American market entry.
Meanwhile, the company continues emphasizing the clinical efficacy of their core CytoSorb product in critical care, particularly when used early and aggressively - similar to antibiotic treatment protocols. Management references "recent data" showing statistically significant survival improvements with this approach, though specific study details aren't provided.
For DrugSorb-ATR specifically, the company notes growing international adoption based on their STAR Registry data, suggesting real-world clinical validation despite the regulatory hurdles in North America. Their expanded Dubai sales office indicates commitment to geographic expansion while navigating these regulatory challenges.
First Quarter 2025 Financial Results
- Product revenue was
, a decrease of$8.7 million 3% , and flat on a constant currency basis, compared to in Q1 2024.$9.0 million - Gross margin was
71% compared to77% in Q1 2024. - Operating loss improved by
17% to compared to$3.9 million in Q1 2024, reflecting a$4.7 million 12% reduction in operating expenses. - Net loss was
or$1.5 million per share, compared to net loss of$0.02 or$6.1 million per share in Q1 2024.$0.11 - Adjusted net loss(1) was
or$3.7 million per share, compared to an adjusted net loss of$0.06 or$3.7 million per share in Q1 2024.$0.07 - Adjusted EBITDA(2) loss improved by
17% to compared to a loss of$2.7 million in Q1 2024.$3.3 million - Total cash, cash equivalents, and restricted cash of
at March 31, 2025, compared to$13.1 million as of December 31, 2024, reflecting proceeds from the Rights Offering of$9.8 million , net of fees, and net cash used in the quarter of approximately$6.8 million which includes disbursements unique to Q1 of approximately$3.7 million .$0.9 million - On April 21, the Company received
in cash proceeds from the sale of its 2023 and amended 2022 Net Operating Loss and R&D tax credits from the Technology Business Tax Certificate Transfer Program, sponsored by the New Jersey Economic Development Authority (NJEDA).$1.7 million
(1) | Adjusted net income is a non-GAAP financial measure. For a reconciliation of Adjusted net income to the most comparable GAAP measure, see the reconciliation included in the financial tables. All non-GAAP adjustments are presented pre-tax. |
(2) | Adjusted EBITDA is a non-GAAP financial measure. For a reconciliation of Adjusted EBITDA to the most comparable measure, see the reconciliation included in the financial tables. |
"Strong revenue growth in our distributor and other direct sales territories across the E.U. helped to substantially offset a temporary disruption in direct sales in
Dr. Chan continued, "Meanwhile, our message - Treating the right patient, at the right time, with the right dose of CytoSorb® - continues to resonate strongly with clinicians. The approach is much like using antibiotics: start early, treat aggressively, and complete the full course. When used this way, CytoSorb has been shown to disrupt the deadly cycle of inflammation, stabilize patients in shock, protect organ function, and ultimately improve clinical outcomes. Recent data confirm that early and aggressive use of CytoSorb leads to statistically significant improvements in survival and other key clinical indicators. We are now using this evidence to train our users and are confident our guidance will continue to drive broader adoption and more effective usage of this critical therapy."
Additional Business Highlights
- Completed Shareholder Rights Offering and raised total proceeds of
, net of fees, from the offering, and the exercise of the Series A Right Warrant. The raise also allowed for the release of$6.8 million of restricted cash on the Company's balance sheet, and combined, provided increased liquidity of$5.0 million .$11.8 million - Expanded our global footprint with the opening of our new regional sales subsidiary in
Dubai ,United Arab Emirates , providing a gateway into theMiddle East andAfrica . - Appointed Thomas Shannon as Vice President of Marketing for
North America to lead the marketing strategy and execution for DrugSorb™-ATR in theU.S. andCanada . - Appointed Melanie Grossman, CPA as Vice President and Corporate Controller.
The Company remains deeply committed to bringing DrugSorb™-ATR, an Investigational FDA Breakthrough Designated Device, to the large and important North American market, as a critical solution to address the serious, unmet need of reducing life-threatening bleeding in patients on Brilinta® undergoing coronary artery bypass grafting (CABG) surgery. Awareness of DrugSorb-ATR's potential to lessen bleeding severity in this high-risk population continues to grow. Compelling new real-world data from
On April 25, 2025, the
Dr. Efthymios N. Deliargyris, Chief Medical Officer of CytoSorbents stated, "We remain confident in the strength of our DrugSorb-ATR De Novo Request and believe the remaining issues can be successfully addressed. We are committed to working collaboratively with the FDA to secure marketing authorization for this FDA Breakthrough Designated Device, which has the potential to address a significant and routine challenge faced by cardiac surgery centers. We believe the formal appeals process offers the most efficient path forward to resolve the remaining issues and bring this important technology to patients in the U.S. Meanwhile real-world adoption continues to grow with an increasing number of heart centers around the world incorporating our technology as part of their standard care to reduce bleeding complications in patients on blood thinners undergoing cardiac surgery based on the growing evidence from our international STAR Registry showing that our device is a safe and effective strategy to address this major clinical need."
Finally, CytoSorbents' DrugSorb-ATR application with Health Canada remains under advanced review. While Health Canada has indicated that application reviews are currently delayed beyond their target Market Authorization Times (MAT) due to a backlog, Health Canada has confirmed its commitment to issuing a decision at the earliest opportunity. We remain confident in receiving a final regulatory decision in 2025.
First Quarter 2025 Earnings Conference Call
CytoSorbents' management will host a live conference call, presentation webcast, and a question-and-answer session with the following information:
Date: Wednesday, May 14, 2025
Time: 4:30 PM ET
North American toll-free: 1-800-836-8184
International toll: 1-646-357-8785
Live webcast link: https://app.webinar.net/Vbq3lbYwAy5
It is recommended that participants dial in approximately 10 minutes prior to the start of the call.
An archived recording of the conference call will be available under the Investor Relations section of the Company's website at https://ir.cytosorbents.com/
About Non-GAAP Financial Measures
To supplement our condensed consolidated financial statements, we use the non-GAAP financial measures of EBITDA, which measures earnings before interest, income taxes, depreciation and amortization, and Adjusted EBITDA which further excludes non-cash stock compensation expense, and gain or loss of foreign exchange translation. We also use the non-GAAP financial measures of Adjusted Net Income or Loss and Adjusted Net Income or Loss Per Common Share which excludes non-cash stock compensation expense and gain or loss of foreign exchange translation from Net Loss and Net Loss Per Common Share, respectively. These non-GAAP measures are not based on any comprehensive set of accounting rules or principles and should not be considered a substitute for, or superior to, financial measures calculated in accordance with GAAP and may be different from non-GAAP measures used by other companies. In addition, these non-GAAP measures should be read in conjunction with our financial statements prepared in accordance with GAAP. The reconciliations of the non-GAAP measures to the most directly comparable financial measures calculated and presented in accordance with GAAP should be carefully evaluated. We use these non-GAAP financial measures for financial and operational decision-making and as a means to evaluate period-to-period comparisons. We believe that these non-GAAP financial measures provide meaningful supplemental information regarding our performance and that both management and investors benefit from referring to these non-GAAP financial measures in assessing our performance and when planning, forecasting, and analyzing future periods. We believe these non-GAAP financial measures are useful to investors because (1) they allow for greater transparency with respect to key metrics used by management in its financial and operational decision-making and (2) they are used by investors and the analyst community to help them analyze the performance of our business, the Company's cash available for operations, and the Company's ability to meet future capital expenditure and working capital requirements.
About CytoSorbents Corporation (NASDAQ: CTSO)
CytoSorbents Corporation is a leader in the treatment of life-threatening conditions in the intensive care unit and cardiac surgery through blood purification. CytoSorbents' proprietary blood purification technologies are based on biocompatible, highly porous polymer beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface adsorption. Cartridges filled with these beads can be used with standard blood pumps already in the hospital (e.g. dialysis, continuous renal replacement therapy or CRRT, extracorporeal membrane oxygenation or ECMO, and heart-lung machines), where blood is repeatedly recirculated outside the body, through our cartridges where toxic substances are removed, and then back into the body. CytoSorbents' technologies are used in a number of broad applications. Specifically, two important applications are 1) the removal of blood thinners during and after cardiothoracic surgery to reduce the risk of severe bleeding, and 2) the removal of inflammatory agents and toxins in common critical illnesses that can lead to massive inflammation, organ failure and patient death. The breadth of these critical illnesses includes, for example, sepsis, burn injury, trauma, lung injury, liver failure, cytokine release syndrome, and pancreatitis as well as the removal of liver toxins that accumulate in acute liver dysfunction or failure the removal of myoglobin in severe rhabdomyolysis that can otherwise lead to renal failure. In these diseases, the risk of death can be extremely high, and there are few, if any, effective treatments.
CytoSorbents' lead product, CytoSorb®, is approved in the European Union and distributed in over 70 countries worldwide, with more than a quarter million devices used cumulatively to date. CytoSorb was originally launched in the European Union under CE mark as the first cytokine adsorber. Additional CE mark extensions were granted for bilirubin and myoglobin removal in clinical conditions such as liver disease and trauma, respectively, and for ticagrelor and rivaroxaban removal in cardiothoracic surgery procedures. CytoSorb has also received FDA Emergency Use Authorization in the United States for use in adult critically ill COVID-19 patients with impending or confirmed respiratory failure. CytoSorb is not yet approved or cleared in the United States.
In the
The Company has numerous marketed products and products under development based upon this unique blood purification technology protected by many issued U.S. and international patents and registered trademarks, and multiple patent applications pending, including ECOS-300CY®, CytoSorb-XL™, HemoDefend-RBC™, HemoDefend-BGA™, VetResQ®, K+ontrol™, DrugSorb™, ContrastSorb, and others. For more information, please visit the Company's website at https://ir.cytosorbents.com/ or follow us on Facebook and X.
Forward-Looking Statements
This press release includes forward-looking statements intended to qualify for the safe harbor from liability established by the Private Securities Litigation Reform Act of 1995. These forward-looking statements include, but are not limited to, statements about our plans, objectives, future targets and outlooks for our business, representations and contentions, and the outcome of our regulatory submissions, and are not historical facts and typically are identified by use of terms such as "may," "should," "could," "expect," "plan," "anticipate," "believe," "estimate," "predict," "potential," "continue" and similar words, although some forward-looking statements are expressed differently. You should be aware that the forward-looking statements in this press release represent management's current judgment and expectations, but our actual results, events and performance could differ materially from those in the forward-looking statements. Factors which could cause or contribute to such differences include, but are not limited to, our restructuring of our direct sales team and strategy in
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Peter J. Mariani, Chief Financial Officer
305 College Road East
pmariani@cytosorbents.com
Investor Relations Contact:
Aman Patel, CFA & Adanna G. Alexander, PhD
ICR Healthcare
ir@cytosorbents.com
CYTOSORBENTS CORPORATION CONDENSED CONSOLIDATED BALANCE SHEETS | ||||||
March 31, | December 31, | |||||
2025 | 2024 | |||||
(unaudited) | ||||||
ASSETS | ||||||
Current Assets: | ||||||
Cash and cash equivalents | $ | 11,587,275 | $ | 3,279,926 | ||
Restricted cash, current | — | 5,000,000 | ||||
Grants and accounts receivable, net of allowances of | 7,670,399 | 7,319,597 | ||||
Inventories | 3,018,524 | 2,732,907 | ||||
Prepaid expenses and other current assets | 3,136,706 | 3,270,812 | ||||
Total current assets | 25,412,904 | 21,603,242 | ||||
Property and equipment - net | 8,722,953 | 9,002,383 | ||||
Restricted cash | 1,522,458 | 1,483,958 | ||||
Right-of-use asset | 11,368,340 | 11,511,236 | ||||
Other assets | 3,755,029 | 3,770,681 | ||||
Total assets | $ | 50,781,684 | $ | 47,371,500 | ||
LIABILITIES AND STOCKHOLDERS' EQUITY | ||||||
Current Liabilities: | ||||||
Accounts payable | $ | 3,325,386 | $ | 3,339,885 | ||
Accrued expenses and other current liabilities | 5,936,791 | 6,031,670 | ||||
Lease liability – current portion | 473,889 | 452,688 | ||||
Total current liabilities | 9,736,066 | 9,824,243 | ||||
Lease liability, net of current portion | 12,316,119 | 12,443,971 | ||||
Long-term debt | 14,186,715 | 13,996,350 | ||||
Total liabilities | 36,238,900 | 36,264,564 | ||||
Commitments and Contingencies | ||||||
Stockholders' equity | ||||||
Preferred Stock, par value issued and outstanding as of March 31, 2025 and December 31, 2024 | — | — | ||||
Common Stock, par value March 31, 2025 and December 31, 2024; and 62,529,466 and 54,830,146 shares issued and outstanding as of March 31, 2025 and December 31, 2024, respectively | 62,529 | 54,830 | ||||
Additional paid-in capital | 318,451,572 | 310,808,711 | ||||
Accumulated other comprehensive income | 1,515,656 | 4,252,013 | ||||
Accumulated deficit | (305,486,973) | (304,008,618) | ||||
Total stockholders' equity | 14,542,784 | 11,106,936 | ||||
Total liabilities and stockholders' equity | $ | 50,781,684 | $ | 47,371,500 | ||
See accompanying notes to condensed consolidated financial statements. |
CYTOSORBENTS CORPORATION CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS | ||||||
Three Months Ended March 31, | ||||||
2025 | 2024 | |||||
Product revenue | $ | 8,727,238 | $ | 8,989,520 | ||
Cost of goods sold | 2,519,641 | 2,115,910 | ||||
Gross profit | 6,207,597 | 6,873,610 | ||||
Operating expenses | ||||||
Research and development, net of grant income | 1,662,925 | 2,246,911 | ||||
Selling, general and administrative | 8,431,877 | 9,283,067 | ||||
Total operating expenses | 10,094,802 | 11,529,978 | ||||
Loss from operations | (3,887,205) | (4,656,368) | ||||
Other income (expense) | ||||||
Interest expense, net | (605,134) | (6,653) | ||||
Gain (loss) on foreign currency transactions | 3,013,984 | (1,425,690) | ||||
Total other income (expense), net | 2,408,850 | (1,432,343) | ||||
Loss before benefit from income taxes | (1,478,355) | (6,088,711) | ||||
Benefit from income taxes | — | — | ||||
Net loss attributable to common stockholders | $ | (1,478,355) | $ | (6,088,711) | ||
Basic and diluted net loss per common share | $ | (0.02) | $ | (0.11) | ||
Weighted average number of shares of common stock outstanding | 60,731,929 | 54,434,609 | ||||
Comprehensive loss: | ||||||
Net loss attributable to common stockholders | $ | (1,478,355) | $ | (6,088,711) | ||
Other comprehensive income (loss): | ||||||
Foreign currency translation adjustment | (2,736,356) | 1,223,175 | ||||
Comprehensive loss | $ | (4,214,711) | $ | (4,865,536) | ||
See accompanying notes to condensed consolidated financial statements. |
CYTOSORBENTS CORPORATION CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY (UNAUDITED) | |||||||||||||||||
Accumulated | |||||||||||||||||
Additional | Other | ||||||||||||||||
Common Stock | Paid-In | Comprehensive | Accumulated | Stockholders' | |||||||||||||
Shares | Par value | Capital | Income (Loss) | Deficit | Equity | ||||||||||||
Balance as of December31, 2024 | 54,830,146 | $ | 54,830 | $ | 310,808,711 | $ | 4,252,013 | $ | (304,008,618) | $ | 11,106,936 | ||||||
Stock-based compensation | 32,321 | 32 | 818,394 | — | — | 818,426 | |||||||||||
Issuance of common stock from exercise of warrants | 1,417,208 | 1,417 | 1,438,411 | — | — | 1,439,828 | |||||||||||
Issuance of common stock and warrants from Rights Offering, net of fees incurred | 6,249,791 | 6,250 | 5, 386,056 | — | — | 5,392,306 | |||||||||||
Other comprehensive loss, foreign currency translation adjustment | — | — | — | (2,736,357) | — | (2,736,357) | |||||||||||
Net loss | — | — | — | — | (1,478,355) | (1,478,355) | |||||||||||
Balance as of March 31, 2025 | 62,529,466 | $ | 62,529 | $ | 318,451,572 | $ | 1,515,656 | $ | (305,486,973) | $ | 14,542,784 | ||||||
Accumulated | |||||||||||||||||
Additional | Other | ||||||||||||||||
Common Stock | Paid-In | Comprehensive | Accumulated | Stockholders' | |||||||||||||
Shares | Par value | Capital | Income (Loss) | Deficit | Equity | ||||||||||||
Balance as of December31, 2023 | 54,240,265 | $ | 54,240 | $ | 306,187,314 | $ | 529,321 | $ | (283,289,661) | $ | 23,481,214 | ||||||
Stock-based compensation | — | — | 959,465 | — | — | 959,465 | |||||||||||
Issuance of common stock offerings, net of fees incurred | 53,290 | 54 | 53,185 | — | — | 53,239 | |||||||||||
Other comprehensive income, foreign currency translation adjustment | — | — | — | 1,223,175 | — | 1,223,175 | |||||||||||
Net loss | — | — | — | — | (6,088,711) | (6,088,711) | |||||||||||
Balance as of March 31, 2024 | 54,293,555 | $ | 54,294 | $ | 307,199,964 | $ | 1,752,496 | $ | (289,378,372) | $ | 19,628,382 | ||||||
See accompanying notes to condensed consolidated financial statements. |
CYTOSORBENTS CORPORATION CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) | ||||||
Three | Three | |||||
Months Ended | Months Ended | |||||
March 31, | March 31, | |||||
2025 | 2024 | |||||
Cash flows from operating activities | ||||||
Net loss attributable to common stockholders | $ | (1,478,358) | $ | (6,088,711) | ||
Adjustments to reconcile net loss to net cash used in operating activities: | ||||||
Amortization of debt discount | 190,365 | — | ||||
Depreciation and amortization | 368,503 | 397,286 | ||||
Amortization of right-of-use asset | 36,245 | 45,927 | ||||
Bad debt expense | 1,890 | 29,240 | ||||
Impairment of patents | — | 64,296 | ||||
Foreign currency transaction (gains) losses | (3,013,984) | 1,425,690 | ||||
Debt costs | — | 10,713 | ||||
Stock-based compensation | 818,426 | 959,465 | ||||
Changes in operating assets and liabilities | ||||||
Grants and accounts receivable | (79,889) | (848,330) | ||||
Inventories | (198,802) | (429,869) | ||||
Prepaid expenses and other current assets | 257,931 | 886,258 | ||||
Accounts payable and accrued expenses | (367,282) | (1,281,724) | ||||
Net cash used in operating activities | (3,464,955) | (4,829,759) | ||||
Cash flows from investing activities | ||||||
Purchases of property and equipment | (2,121) | (45,191) | ||||
Patent costs | (45,121) | (81,827) | ||||
Net cash used in investing activities | (47,242) | (127,018) | ||||
Cash flows from financing activities | ||||||
Repayment of long-term debt | — | (625,000) | ||||
Proceeds from exercise of common stock warrants | 1,439,828 | 53,238 | ||||
Proceeds from rights offering, net of fees incurred | 5,392,306 | — | ||||
Net cash provided by (used in) financing activities | 6,832,134 | (571,762) | ||||
Effect of exchange rates on cash | 25,912 | 5,782 | ||||
Net change in cash, cash equivalents, and restricted cash | 3,345,849 | (5,522,757) | ||||
Cash, cash equivalents, and restricted cash at beginning of year | 9,763,884 | 15,615,095 | ||||
Cash, cash equivalents, and restricted cash – end of period | $ | 13,109,733 | $ | 10,092,338 | ||
Supplemental disclosure of cash flow information | ||||||
Cash paid for interest | $ | 506,250 | $ | 199,418 | ||
Supplemental disclosure of non-cash financing activities | ||||||
Fair value of common stock warrants issued in connection with the rights offering | $ | 555,988 | $ | — | ||
Offering fees included in accounts payable | $ | 252,783 | $ | — | ||
March 31, | ||||||
Reconciliation of cash, cash equivalents, and restricted cash to the condensed consolidated balance sheets | 2025 | 2024 | ||||
Cash and cash equivalents | $ | 11,587,275 | $ | 8,608,380 | ||
Restricted cash | 1,522,458 | 1,483,958 | ||||
Total cash, cash equivalents, and restricted cash | $ | 13,109,733 | $ | 10,092,338 |
Reconciliation of GAAP Financial Measures to Non-GAAP Financial Measures | |||
Quarter and Year to Date | |||
Mar 31, | Mar 31, | ||
2025 | 2024 | ||
(In thousands, except per share amounts) | |||
Net loss |
$ (1,478) |
$ (6,089) | |
Depreciation and amortization expense | 369 | 397 | |
Income tax expense (benefit) | -- | -- | |
Interest expense (income) | 605 | 7 | |
EBITDA - non GAAP | $ (5,685) | ||
Non cash stock-based compensation expense |
818 |
959 | |
(Gain)/Loss on foreign currency translation | (3,014) | 1,426 | |
Adjusted EBITDA - non GAAP | $ (2,700) | $ (3,300) | |
Net loss |
$ (1,478) |
$ (6,089) | |
Non cash stock-based compensation expense | 818 | 959 | |
(Gain)/Loss on foreign currency translation | (3,014) | 1,426 | |
Adjusted net income (loss) - non GAAP | $ (3,703) | ||
Weighted average common shares outstanding basic and diluted |
60,731,929 |
54,262,790 | |
Loss per common share — basic and diluted |
$ (0.02) |
$ (0.11) | |
Non cash stock-based compensation expense | $ 0.01 | $ 0.02 | |
(Gain)/Loss on foreign currency translation | $ (0.05) | $ 0.03 | |
Adjusted net income (loss) per common share - basis and diluted - non GAAP | $ (0.06) | $ (0.07) |
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SOURCE Cytosorbents Corp