Spruce Biosciences (SPRB) boosts cash with $69M raise, funds TA‑ERT into 2027

Rhea-AI Filing Summary

Spruce Biosciences reported a first quarter 2026 net loss of $12.3 million, or $(8.94) per share, improving from a $14.0 million loss a year earlier as total operating expenses fell to $12.0 million from $14.5 million on lower R&D spending.

Cash and cash equivalents were $54.1 million as of March 31, 2026 and approximately $107.3 million as of April 30, 2026, supported by a $69.0 million underwritten equity offering and a term loan facility of up to $50.0 million. The company expects this liquidity, together with the April financing, to fund planned operations and debt obligations into the second half of 2027 as it advances its lead therapy TA‑ERT toward a planned BLA submission in the fourth quarter of 2026.

Positive

• Strengthened balance sheet and runway: Cash and cash equivalents increased from $54.1 million at March 31, 2026 to approximately $107.3 million at April 30, 2026, supported by a $69.0 million equity offering and a term loan facility of up to $50.0 million, funding operations into the second half of 2027.

Negative

• None.

Insights

Biopharma earnings and capital markets analyst

Spruce bolstered cash through equity and debt to fund TA‑ERT into 2027.

Spruce remains loss‑making, with a Q1 2026 net loss of $12.3M, but tightened expenses as total operating costs declined to $12.0M from $14.5M year over year. R&D dropped mainly due to prior one‑time costs and discontinued programs.

Liquidity is the standout: cash rose from $54.1M at March 31, 2026 to about $107.3M at April 30, 2026, helped by a $69.0M underwritten offering and a term loan facility of up to $50.0M. Management states this should fund planned operations and debt into the second half of 2027.

On the pipeline side, TA‑ERT generated long‑term data in MPS IIIB and is being prepared for a planned BLA submission in Q4 2026. New commercial and development leadership hires are intended to support potential FDA review and a possible U.S. launch if approved. Subsequent filings may detail progress toward the confirmatory study and expanded access program.

8-K Event Classification

2 items: 2.02, 9.01

2 items

Item 2.02 Results of Operations and Financial Condition Financial

Disclosure of earnings results, typically an earnings press release or preliminary financials.

Item 9.01 Financial Statements and Exhibits Exhibits

Financial statements, pro forma financial information, and exhibit attachments filed with this report.

Key Figures

Cash and cash equivalents: $54.1M Preliminary cash and cash equivalents: $107.3M Underwritten public offering gross proceeds: $69.0M +5 more

8 metrics

Cash and cash equivalents $54.1M As of March 31, 2026

Preliminary cash and cash equivalents $107.3M As of April 30, 2026, unaudited estimate

Underwritten public offering gross proceeds $69.0M April 22, 2026 equity and pre-funded warrant offering

Term loan facility size $50.0M Avenue Capital Loan and Security Agreement across four tranches

Q1 2026 R&D expenses $7.6M Three months ended March 31, 2026; down from $10.8M in 2025

Q1 2026 net loss $12.3M Three months ended March 31, 2026; vs. $14.0M in 2025

ATM capacity $75.0M Aggregate offering price available under Jefferies Sales Agreement

Weighted-average shares outstanding 1,372,084 shares Basic and diluted, three months ended March 31, 2026

Key Terms

Biologics license application, Breakthrough Therapy Designation, Orphan Drug Designation, Underwritten public offering, +2 more

6 terms

Biologics license application regulatory

"advancing TA-ERT toward our planned biologics license application submission in the fourth quarter of 2026"

A biologics license application is a formal request submitted to regulatory authorities seeking approval to market a new biological medicine, such as vaccines or treatments made from living organisms. It is a comprehensive review process that evaluates the safety, effectiveness, and manufacturing quality of the product. For investors, receiving approval signals that a biological therapy can be sold to the public, potentially leading to revenue growth and market success.

Breakthrough Therapy Designation regulatory

"TA-ERT has received Breakthrough Therapy Designation, Rare Pediatric Disease Designation, Fast Track Designation and Orphan Drug Designation"

A breakthrough therapy designation is a regulatory fast-track given to a drug or treatment that shows early signs of providing a major improvement over existing options for a serious condition. Think of it as a VIP lane that can speed up development and more intensive guidance from regulators, which matters to investors because it can shorten time to market, reduce development risk and potentially increase a company’s value — though it does not guarantee approval.

Orphan Drug Designation regulatory

"Orphan Drug Designation from the FDA, as well as Orphan Drug Designation in the European Union"

Orphan drug designation is a special status given to medicines developed to treat rare diseases affecting only a small number of people. This status often provides benefits like faster approval processes and financial incentives, making it more attractive for companies to develop these drugs. For investors, it signals potential for exclusive market rights and reduced competition, which can impact the drug’s profitability.

Underwritten public offering financial

"closed its previously announced underwritten public offering of 1,150,000 shares of common stock"

An underwritten public offering is when a company sells new shares of its stock to the public with the help of a financial firm, called an underwriter. The underwriter agrees to buy all the shares upfront, reducing the company's risk, and then sells them to investors. This process helps companies raise money quickly and confidently from a wide range of buyers.

At-the-market Sales Agreement financial

"entered into an Open Market Sales Agreement℠ (Sales Agreement) with Jefferies"

An at-the-market sales agreement lets a company raise cash by selling newly issued shares directly into the open market at whatever price buyers are paying that day, using a broker to place the trades over time. Investors should watch these deals because they can dilute existing ownership and put downward pressure on the stock price while giving the company flexible, on-demand funding—like a store gradually listing extra items on an online marketplace at current prices.

Expanded access program medical

"plans for a confirmatory study in patients with MPS IIIB and expanded access program"

A program that allows patients with serious or life‑threatening conditions to receive an experimental drug or therapy before it is fully approved by regulators, when they cannot join clinical trials. Investors care because expanded access can change a treatment’s market perception, create early real‑world safety or demand signals, and affect regulatory timelines and potential revenue — like a pre‑order system that also reveals how the product performs outside controlled testing.

Earnings Snapshot

Net loss: $12.3M · Guidance included

Q1 2026

Net loss $12.3M

R&D expenses $7.6M

G&A expenses $4.4M

Cash and cash equivalents $54.1M

Guidance

Spruce believes its March 31, 2026 cash plus April 2026 offering proceeds will fund planned operations and debt obligations into the second half of 2027.

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Understanding 8-K Material Events →

0001683553false00016835532026-05-132026-05-13

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549

FORM 8-K

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934

Date of Report (Date of earliest event reported): May 13, 2026

Spruce Biosciences, Inc.

(Exact name of Registrant as Specified in Its Charter)

Delaware			001-39594	81-2154263
(State or Other Jurisdiction of Incorporation)			(Commission File Number)	(IRS Employer Identification No.)
611 Gateway Boulevard, Suite 740
South San Francisco, California				94080
(Address of Principal Executive Offices)				(Zip Code)

Registrant’s Telephone Number, Including Area Code: 415-343-5986

Not Applicable

(Former Name or Former Address, if Changed Since Last Report)

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:

☐	Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
☐	Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
☐	Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
☐	Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:

Title of each class		Trading Symbol(s)		Name of each exchange on which registered
Common Stock, par value $0.0001 per share		SPRB		Nasdaq Capital Market

Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (§ 230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (§ 240.12b-2 of this chapter).

Emerging growth company ☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐

Item 2.02 Results of Operations and Financial Condition.

On May 13, 2026, Spruce Biosciences, Inc. (the "Company") issued a press release announcing its financial results for the first quarter ended March 31, 2026 and providing corporate updates. The full text of the press release is furnished as Exhibit 99.1 to this Current Report on Form 8-K and is incorporated herein by reference.

The Company also reported cash and cash equivalents of $107.3 million as of April 30, 2026. This estimate is preliminary, has not been audited and is subject to change upon completion of the Company’s financial statement closing procedures. Additional information and disclosure would be required for a more complete understanding of the Company’s financial position and results of operations as of April 30, 2026. Accordingly, the unaudited preliminary cash and cash equivalents balance set forth above reflects the Company’s preliminary estimate with respect to such information, based on information currently available to management, and may vary from its actual financial position as of April 30, 2026. The information presented herein should not be considered a substitute for the financial information the Company files with the U.S. Securities and Exchange Commission. The Company has no intention or obligation to update preliminary estimates of its cash and cash equivalents set forth above.

All of the information furnished in this Item 2.02 and Item 9.01 (including Exhibit 99.1) shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and shall not be incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such a filing.

Item 9.01 Financial Statements and Exhibits.

(d) Exhibits.

Exhibit Number		Exhibit Description
99.1		Press Release of Spruce Biosciences, Inc., dated May 13, 2026.
104		Cover Page Interactive Data File (formatted as inline XBRL).

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

				Spruce Biosciences, Inc.
Date: May 13, 2026				By:		/s/ Samir Gharib
						Samir Gharib
						President and Chief Financial Officer

Exhibit 99.1

Spruce Biosciences Reports First Quarter 2026 Financial Results and Provides Corporate Updates

Long-Term TA-ERT Data Presented at the 22nd Annual WORLDSymposium™ Highlight Rapid and Durable Reduction of Heparan Sulfate and Stabilization of Cognitive Function in Patients with MPS IIIB

Strengthened Leadership Team Across Commercial, Clinical Development, and Regulatory Functions to Support BLA Submission and Pre-Launch Readiness

Closed Underwritten Public Offering for $69.0 Million in Gross Proceeds, Extending Cash Runway into the Second Half of 2027 and Beyond Anticipated Potential FDA Approval of TA-ERT

Entered into Loan and Security Agreement with Avenue Capital for up to $50.0 Million in Term Loans to Strengthen Financial Flexibility Ahead of Potential U.S. Commercial Launch

South San Francisco, Calif. — May 13, 2026 — Spruce Biosciences, Inc. (Nasdaq: SPRB), a late-stage biopharmaceutical company focused on developing and commercializing novel therapies for neurological disorders with significant unmet medical need, today reported financial results for the first quarter ended March 31, 2026 and provided corporate updates.

“We are very pleased with the meaningful progress we continue to make in advancing TA-ERT toward our planned biologics license application submission in the fourth quarter of 2026. This would mark a transformative milestone for Spruce and, more importantly, for the children living with MPS IIIB,” said Javier Szwarcberg, M.D., M.P.H., Chief Executive Officer of Spruce Biosciences. “In April, our balance sheet was meaningfully strengthened with the closing of our $69.0 million underwritten public offering, which was in addition to our $50.0 million term loan facility signed with Avenue Capital in January, and we are now well positioned to support TA-ERT through key regulatory milestones and to prepare for a potential commercial launch in the United States next year. I want to thank our entire team at Spruce for their tremendous efforts and am also grateful for the continued support from our Board, shareholders, and, most importantly, from the families and patients living with MPS IIIB. We look forward to making a meaningful difference in patients’ lives.”

TA-ERT Program Updates

•Continued progress toward BLA submission for TA-ERT for the treatment of MPS IIIB: Spruce continues to advance manufacturing readiness, regulatory interactions, and commercial planning to support an anticipated BLA submission in the fourth quarter of 2026. There is currently no FDA-approved therapy for the treatment of MPS IIIB, and disease management consists of limited palliative care.

•Long-term TA-ERT data presented at the 22nd Annual WORLDSymposium™: At the February 2026 22nd Annual WORLDSymposium™, Spruce shared long-term clinical data supporting TA-ERT as a potential first disease-modifying treatment option for patients with MPS IIIB.

In a platform presentation on February 5, 2026, titled “Long-term administration of tralesinidase alfa enzyme replacement therapy (TA-ERT) results in profound and durable reduction of heparan sulfate (HS) and stabilization of cognitive function and cortical gray matter volume (CGMV) in patients with Sanfilippo Syndrome Type B (MPS IIIB),” Nicole Muschol, M.D., of the International Center for Lysosomal Disorders at the University Medical Center Hamburg-Eppendorf, presented data demonstrating that long-term administration of TA-ERT resulted in rapid and durable reductions in cerebrospinal fluid heparan sulfate, with stabilization of cognitive function and cortical gray matter volume relative to natural history.

•Confirmatory study and expanded access: Spruce continues to advance plans for a confirmatory study in patients with MPS IIIB and expanded access program to support continued patient access prior to and following potential approval.

Building Out Commercial Leadership Team and Capabilities

To prepare for a potential U.S. commercial launch of TA-ERT, if approved, Spruce continued to build out its rare disease commercial organization with three senior appointments:

•Dale Hooks, Chief Commercial Officer: Mr. Hooks joined Spruce as Chief Commercial Officer in March 2026, bringing nearly 35 years of pharmaceutical marketing and sales experience and commercial leadership across 21 new product launches. He previously served as Chief Commercial Officer of Applied Therapeutics, and earlier as Vice President, Global Commercial Operations at Reata Pharmaceuticals, where he helped lead one of the most successful rare disease launches in U.S. history.

•Brian Walls, Vice President, Market Access: Mr. Walls brings more than 20 years of biopharmaceutical commercial leadership experience and has contributed to more than 18 product launches across rare, ultra-rare, oncology, neurology, and metabolic disease indications. Most recently, he served as Vice President, Market Access at Applied Therapeutics, where he architected the U.S. commercialization access platform for ultra-rare neurology assets.

•Darren Johnson, Vice President, Commercial Operations: Mr. Johnson brings nearly two decades of biopharmaceutical commercial leadership experience in market planning, analytics, and operations, with expertise in rare disease launch readiness. He previously served as Senior Director, Global Commercial Analytics at BioMarin Pharmaceutical, where he led commercial analytics and operations for a global rare disease business with product sales in 72 countries. Earlier in his career, he held positions of increasing responsibility at Genentech, most recently as Group Manager, Forecasting & Business Analysis.

Strengthening Clinical Development Capabilities

In February 2026, Spruce expanded its leadership team with two senior appointments to deepen the company’s clinical development, regulatory, and quality capabilities in support of the planned TA-ERT BLA submission and potential FDA approval:

•Bruno Gagnon, B.Pharm., M.Sc., Senior Vice President, Clinical Development Operations: Mr. Gagnon brings more than 30 years of experience leading clinical operations for global drug development programs. He most recently served as Senior Vice President, Global Clinical Operations at Opthea, where he oversaw clinical execution for a Phase 3 wet age-related macular degeneration program, and previously led development operations at Eidos Therapeutics, a BridgeBio Pharma affiliate, where he played a key role in advancing acoramidis (ATTRUBY®) for the treatment of TTR amyloidosis toward regulatory approval. Earlier, Mr. Gagnon served as Vice President of Clinical Operations at BioMarin Pharmaceutical, directing rare disease clinical programs and global trial execution across multiple development-stage compounds.

•Daven Mody, Pharm.D., Senior Vice President, Regulatory and Quality: Dr. Mody brings more than 25 years of regulatory affairs experience guiding global development programs across multiple therapeutic areas, including rare diseases. He most recently held senior regulatory affairs and quality leadership roles at Lassen Therapeutics, Ocelot Bio, and Blade Therapeutics, where he led investigational programs across ophthalmologic, hepatic, pulmonary, and oncology indications and helped secure multiple orphan drug and fast track designations. Earlier in his career, Dr. Mody served as Head of Regulatory Affairs at Theravance Biopharma and Impax Laboratories, where he led efforts in the first-round U.S. and E.U. approvals of YUPELRI® for COPD and RYTARY® for Parkinson’s Disease.

Other Corporate Updates

•Closed Underwritten Public Offering: On April 22, 2026, Spruce closed its previously announced underwritten public offering of 1,150,000 shares of common stock at a public offering price of $50.00 per share and pre-funded warrants to purchase up to 50,000 shares of common stock at a public offering price of $49.99 per pre-funded warrant. The underwriters’ 30-day option to purchase up to 180,000 additional shares of common stock was exercised in full. Aggregate gross proceeds to Spruce from the offering were approximately $69.0 million, before deducting underwriting discounts and commissions and estimated offering expenses payable by the company.

•Term Loan Facility with Avenue Capital: On January 7, 2026, Spruce entered into a Loan and Security Agreement with Avenue Capital Management II, L.P., providing for term loans of up to $50.0 million across four tranches. Tranche 1 of $15.0 million was funded shortly after closing, and the remaining tranches are

subject to the achievement of specified regulatory and commercial milestones related to TA-ERT, among other conditions. The Avenue facility does not contain any minimum cash requirement or other financial covenants.

•At-the-Market Sales Agreement: In March 2026, Spruce entered into an Open Market Sales Agreement℠ (Sales Agreement) with Jefferies, pursuant to which the company may issue and sell, from time to time, shares of common stock having an aggregate offering price of up to $75.0 million under its effective shelf registration statement. As of March 31, 2026, no shares of common stock had been issued under the Sales Agreement.

First Quarter 2026 Financial Results

•Cash and Cash Equivalents: Cash and cash equivalents as of March 31, 2026 were $54.1 million, compared to $48.9 million as of December 31, 2025. Spruce believes that its cash and cash equivalents as of March 31, 2026, together with the net proceeds from its April 2026 underwritten public offering of common stock and pre-funded warrants, will be sufficient to fund its planned operations and debt obligations into the second half of 2027.

•Research and Development (R&D) Expenses: R&D expenses for the three months ended March 31, 2026 were $7.6 million, compared to $10.8 million for the same period in 2025. The decrease was primarily attributable to one-time product acquisition costs of $5.7 million related to SPR202 and the discontinuation of the tildacerfont congenital adrenal hyperplasia development program of $1.9 million, partially offset by increased expenses to advance TA-ERT.

•General and Administrative (G&A) Expenses: G&A expenses for the three months ended March 31, 2026 were $4.4 million, compared to $3.7 million for the same period in 2025. The increase was primarily attributable to higher professional fees and personnel-related costs.

•Total Operating Expenses: Total operating expenses for the three months ended March 31, 2026 were $12.0 million, compared to $14.5 million for the same period in 2025. Operating expenses include non-cash stock-based compensation expense of $0.7 million and $0.5 million for the three months ended March 31, 2026 and 2025, respectively.

•Net Loss: Net loss for the three months ended March 31, 2026 was $12.3 million, or $(8.94) per basic and diluted share, compared to a net loss of $14.0 million, or $(23.95) per basic and diluted share, for the same period in 2025.

April 30, 2026 Financial Update

Spruce also reported cash and cash equivalents were approximately $107.3 million as of April 30, 2026.

This estimate of the company’s cash and cash equivalents as of April 30, 2026 is preliminary, has not been audited and is subject to change upon completion of the company’s financial statement closing procedures. Additional information and disclosure would be required for a more complete understanding of the company’s financial position and results of operations as of April 30, 2026. Accordingly, the unaudited preliminary cash and cash equivalents balance set forth above reflects Spruce’s preliminary estimate with respect to such information, based on information currently available to management, and may vary from its actual financial position as of April 30, 2026. The information presented herein should not be considered a substitute for the financial information the company files with the U.S. Securities and Exchange Commission. The company has no intention or obligation to update preliminary estimates of its cash and cash equivalents set forth above.

About Spruce Biosciences

Spruce Biosciences is a late-stage biopharmaceutical company focused on developing and commercializing novel therapies for neurological disorders with significant unmet medical need. Spruce’s lead product candidate, tralesinidase alfa enzyme replacement therapy (TA-ERT), is in late-stage development for the treatment of mucopolysaccharidoses type IIIB (MPS IIIB), or Sanfilippo Syndrome Type B, a devastating pediatric neurodegenerative disorder for which there are no FDA-approved therapies. TA-ERT has received

Breakthrough Therapy Designation, Rare Pediatric Disease Designation, Fast Track Designation and Orphan Drug Designation from the FDA, as well as Orphan Drug Designation in the European Union. To learn more, visit www.sprucebio.com and follow Spruce on LinkedIn, Facebook and YouTube.

Forward-Looking Statements

Statements contained in this press release regarding matters that are not historical facts are “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements include statements regarding, among other things, the design, results, conduct, progress and timing of Spruce’s clinical and preclinical development of TA-ERT and other product candidates, including plans for a confirmatory study and expanded access program; Spruce’s expectations regarding the timing of a planned BLA submission for TA-ERT for the treatment of MPS IIIB, including manufacturing readiness activities in support thereof; Spruce’s preliminary estimate of its cash and cash equivalents as of April 30, 2026; Spruce’s expectations regarding the sufficiency of its cash and cash equivalents and the net proceeds from its April 2026 underwritten public offering and its term loan facility with Avenue Capital to fund its planned operations and debt obligations; Spruce’s plans to advance TA-ERT through potential FDA approval and commercialization, if approved; the contributions and impact of recently appointed members of Spruce’s leadership team; the potential receipt of additional tranches under its term loan facility with Avenue Capital; potential issuances under Spruce’s at-the-market Sales Agreement with Jefferies; and Spruce’s product candidate, strategy and regulatory matters. Because such statements are subject to risks and uncertainties, actual results may differ materially from those expressed or implied by such forward-looking statements. Words such as “anticipate,” “could,” “will,” “potential,” “suggest,” “plan,” “expect,” “believe,” “prepare,” “look forward” and similar expressions are intended to identify forward-looking statements. These forward-looking statements are based upon Spruce’s current expectations and involve assumptions that may never materialize or may prove to be incorrect. Actual results could differ materially from those anticipated in such forward-looking statements as a result of various risks and uncertainties, which include, without limitation, risks and uncertainties associated with Spruce’s business in general, the impact of geopolitical and macroeconomic events, and the other risks described in Spruce’s filings with the U.S. Securities and Exchange Commission. All forward-looking statements contained in this press release speak only as of the date on which they were made and are based on management’s assumptions and estimates as of such date. Spruce undertakes no obligation to update such statements to reflect events that occur or circumstances that exist after the date on which they were made, except as required by law.

SPRUCE BIOSCIENCES, INC.

CONDENSED BALANCE SHEETS

(unaudited)

(in thousands, except share and per share amounts)

		March 31,				December 31,
		2026				2025
ASSETS
Current assets:
Cash and cash equivalents		$	54,080			$	48,906
Prepaid expenses			864				353
Other current assets			88				2,853
Total current assets			55,032				52,112
Right-of-use assets			595				666
Other assets			539				243
Total assets		$	56,166			$	53,021
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable		$	2,683			$	943
Accrued expenses and other current liabilities			8,101				9,143
Debt, current portion			1,000				—
Total current liabilities			11,784				10,086
Lease liabilities, net of current portion			332				419
Debt, net of current portion			5,464				—
Warrant liability			3,938				—
Total liabilities			21,518				10,505
Commitments and contingencies
Stockholders’ equity:
Preferred stock, $0.0001 par value; 10,000,000 shares authorized and    no shares issued or outstanding as of March 31, 2026 and December    31, 2025			—				—
Common stock, $0.0001 par value; 200,000,000 shares authorized as of    March 31, 2026 and December 31, 2025; 1,372,278 and 1,372,043    shares issued and outstanding as of March 31, 2026 and December 31,    2025, respectively			—				—
Additional paid-in capital			336,148				331,750
Accumulated deficit			(301,500	)			(289,234	)
Total stockholders’ equity			34,648				42,516
Total liabilities and stockholders’ equity		$	56,166			$	53,021

SPRUCE BIOSCIENCES, INC.

CONDENSED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS

(unaudited)

(in thousands, except share and per share amounts)

		Three Months Ended March 31,
		2026				2025
Operating expenses:
Research and development		$	7,575			$	10,837
General and administrative			4,412				3,655
Total operating expenses			11,987				14,492
Loss from operations			(11,987	)			(14,492	)
Interest expense			(674	)			(36	)
Interest and other income, net			486				329
Change in fair value of warrant and conversion option liabilities			(91	)			158
Net loss and comprehensive loss			(12,266	)			(14,041	)
Net loss per share, basic and diluted		$	(8.94	)		$	(23.95	)
Weighted-average shares of common stock outstanding,    basic and diluted			1,372,084				586,142

Media

Carolyn Hawley
Inizio Evoke Comms
Carolyn.Hawley@inizioevoke.com
media@sprucebio.com

Investors

Monique Kosse
Gilmartin Group
Monique@GilmartinIR.com
investors@sprucebio.com

FAQ

How did Spruce Biosciences (SPRB) perform financially in Q1 2026?

Spruce Biosciences reported a Q1 2026 net loss of $12.3 million, or $(8.94) per share, compared with a $14.0 million loss in 2025. Total operating expenses declined to $12.0 million from $14.5 million, mainly due to lower research and development costs.

What is Spruce Biosciences’ current cash position and runway?

Spruce Biosciences had $54.1 million in cash and cash equivalents at March 31, 2026 and approximately $107.3 million at April 30, 2026. The company believes this, plus April 2026 financing proceeds, will fund planned operations and debt obligations into the second half of 2027.

What capital-raising transactions did Spruce Biosciences (SPRB) complete in 2026?

Spruce completed a $69.0 million underwritten public offering in April 2026, selling common stock and pre-funded warrants. It also entered a Loan and Security Agreement with Avenue Capital for up to $50.0 million in term loans, with $15.0 million funded shortly after closing.

What are the latest developments for Spruce’s TA-ERT program for MPS IIIB?

Spruce continues preparing a planned Q4 2026 BLA submission for TA‑ERT in MPS IIIB. Long‑term data presented at the 22nd Annual WORLDSymposium™ showed rapid, durable reductions in heparan sulfate and stabilization of cognitive function and cortical gray matter volume relative to natural history.

How is Spruce Biosciences building its commercial and development leadership?

To support a potential U.S. launch of TA‑ERT, Spruce appointed a Chief Commercial Officer and senior leaders for market access and commercial operations. It also added senior vice presidents for clinical development operations and for regulatory and quality to strengthen late‑stage development and regulatory execution.

What debt and at-the-market facilities does Spruce Biosciences (SPRB) have?

Spruce’s Avenue Capital term loan facility provides up to $50.0 million across four tranches, with remaining tranches tied to TA‑ERT milestones and no minimum cash covenants. An at-the-market Sales Agreement with Jefferies allows issuance of up to $75.0 million in common stock; none was sold by March 31, 2026.

Filing Exhibits & Attachments

2 documents

Press Releases

• EX-99.1 EX-99.1 184.5 KB

Other Documents

• EX-101 XBRL TAXONOMY EXTENSION SCHEMA WITH EMBEDDED LINKBASES DOCUMENT 31.2 KB