Executive Summary / Key Takeaways

• NeuroSense Therapeutics ($NRSN) is a clinical-stage biotechnology company focused on developing multi-targeted therapies for debilitating neurodegenerative diseases like ALS and Alzheimer's, addressing significant unmet medical needs in a market projected to reach $85.40 billion by 2032.
• The company's lead asset, PrimeC, an oral fixed-dose combination, has demonstrated compelling efficacy in Phase 2b ALS trials, slowing disease progression by approximately 33% and improving survival rates by 58% in the 18-month study, with new data showing a 40% reduction in functional decline and 74% improved overall survival in the per-protocol population.
• NeuroSense is strategically advancing PrimeC towards a multinational Phase 3 study in ALS, with FDA alignment and planned initiation in the second half of 2025, alongside pursuing early commercialization in Canada with an estimated peak annual revenue opportunity of $100 million to $150 million.
• Despite historical net losses and reliance on external financing, recent private placements at a premium to market price have strengthened the balance sheet, and a binding term sheet with a global pharmaceutical partner for PrimeC's development and commercialization is expected to provide substantial upfront funding and future royalties.
• Key risks include the inherent uncertainties of clinical trials, regulatory approvals, and the need for continued funding, though the company's differentiated technology and strategic partnerships aim to mitigate these challenges.

A New Dawn in Neurodegenerative Disease Treatment

NeuroSense Therapeutics Ltd. ($NRSN), established in 2017, is a clinical-stage biotechnology company dedicated to addressing the profound unmet medical needs in neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS), Alzheimer's disease (AD), and Parkinson's disease. The company's foundational strategy centers on developing combined therapies that target multiple pathological pathways, a crucial approach given the inherent complexity of these devastating conditions. This multi-targeted strategy positions NeuroSense as an innovator in a global neurodegenerative drugs market that was valued at $54.22 billion in 2024 and is projected to expand significantly to $85.40 billion by 2032. North America alone is expected to hold 51.77% of this market in 2025, with the U.S. market growing from $34.2 billion in 2024 to $58.9 billion by 2033.

The industry faces considerable challenges, including high attrition rates in late-stage trials and the exorbitant costs associated with advanced therapies. However, a favorable regulatory environment, marked by the FDA's emphasis on accelerated approvals and a surge of private capital into brain health research, creates a fertile ground for companies like NeuroSense to thrive. The company's focused innovation and strategic approach are designed to capitalize on these dynamics, aiming to deliver meaningful therapeutic advances where current options offer only limited symptomatic relief.

PrimeC: A Technological Edge in ALS and Alzheimer's

At the heart of NeuroSense's pipeline is PrimeC, its lead drug candidate. This novel extended-release oral formulation combines two FDA-approved drugs, ciprofloxacin and celecoxib, in a fixed-dose combination. PrimeC is engineered to synergistically target several key mechanisms implicated in neurodegeneration, including motor neuron degeneration, inflammation, iron accumulation, and impaired ribonucleic acid (RNA) regulation. This multi-targeted approach is a significant technological differentiator, aiming to inhibit disease progression more comprehensively than single-target treatments.

The tangible benefits of PrimeC have been demonstrated in rigorous clinical trials. In the Phase 2b PARADIGM study for ALS, PrimeC achieved primary and secondary clinical endpoints. Data from the 18-month analysis showed that PrimeC slowed disease progression, as measured by the ALS Functional Rating Scale-Revised (ALSFRS-R), by approximately 33% (p=0.007) in participants who received the treatment from the start of the study compared to those initially on placebo. Furthermore, PrimeC reduced the likelihood of mortality, hospitalization, and respiratory support, resulting in an overall 58% improvement in survival rates. More recent analysis in the per-protocol population indicated a 40% reduction in functional decline and a 74% improvement in overall survival. The study also revealed that PrimeC significantly modulated the expression of specific microRNAs (miRNAs) known to be dysregulated in ALS, with these changes correlating with clinical improvements, underscoring PrimeC's biological activity and disease-modifying potential. A key U.S. patent for PrimeC's novel formulation extends its protection until 2042, providing a substantial competitive moat.

Beyond ALS, NeuroSense is also advancing PrimeC for Alzheimer's disease. Initial results from the ongoing RoAD Phase 2 clinical trial, conducted in collaboration with NeuroKaire, have shown improvements in brain-cell connectivity and health in patient-derived neurons, coupled with a favorable safety profile. NeuroKaire's proprietary AI-driven platform, Stemifai, leverages stem cell differentiation and machine learning to analyze patient-specific neuronal responses, guiding precision development in AD. This innovative collaboration highlights NeuroSense's commitment to integrating advanced technologies for more precise and effective drug development. The company's preclinical pipeline further includes StabiliC for Parkinson's disease and CogniC for Alzheimer's disease, demonstrating a broad commitment to neurodegenerative conditions.

Competitive Dynamics in a High-Stakes Arena

NeuroSense operates as a niche, early-stage challenger within the highly competitive biotechnology landscape for neurodegenerative diseases. Its direct competitors include established pharmaceutical giants and other innovative biotech firms such as Biogen Inc. (BIIB), Amylyx Pharmaceuticals Inc. (AMLX), Roche Holding AG (RHHBY), and Ionis Pharmaceuticals Inc. (IONS). While these larger players boast extensive R&D resources, global commercialization capabilities, and diversified revenue streams, NeuroSense distinguishes itself through its multi-targeted therapeutic strategy and the unique oral formulation of PrimeC.

NeuroSense's oral PrimeC formulation offers a potential advantage in patient convenience and accessibility compared to some of Biogen's more complex biologic therapies or Ionis's specialized antisense technologies. The company's focused innovation in addressing multiple disease pathways simultaneously could lead to differentiated efficacy, potentially appealing to patients seeking more comprehensive treatment options. However, NeuroSense lags its larger rivals in terms of financial performance, operational scale, and market penetration. Competitors like Biogen and Roche benefit from established revenue bases and greater capital efficiency, allowing for substantial R&D investments and broader commercial reach. NeuroSense's smaller scale can lead to higher relative costs and potentially lower margins, and its early-stage pipeline inherently carries longer timelines to market and greater clinical risks. The company's ability to secure strategic partnerships, particularly the binding term sheet with a global pharmaceutical company for PrimeC, is crucial for offsetting these disadvantages by providing necessary funding and commercial expertise.

Financial Trajectory and Strategic Funding

As a clinical-stage biotechnology company, NeuroSense currently generates no revenue, a common characteristic in this phase of development. The company reported a net loss of $10.21 million for the year ended December 31, 2024, a slight increase from $10.11 million in 2023. However, the company has demonstrated prudent expense management. Research and development (R&D) expenses decreased by 21.9% to $5.7 million in 2024 from $7.3 million in 2023, primarily due to reduced subcontractor and consultant expenses, and lower share-based payments. General and administrative (G&A) expenses also saw a 12.5% reduction, falling to $4.2 million in 2024 from $4.8 million in 2023, mainly due to decreased share-based compensation, insurance costs, and a reduction in employee numbers. This trend of expense reduction continued into the first half of 2025, with R&D expenses decreasing by 32.9% to $2.503 million, attributed to a decrease in clinical activity, and G&A expenses showing an immaterial 4.4% decrease to $2.189 million. Total operating expenses for the first half of 2025 were $4.7 million, down from $6 million in the first half of 2024.

Liquidity remains a critical focus for NeuroSense. The company ended 2024 with approximately $3.4 million in cash. In a testament to investor confidence and strategic financial management, NeuroSense completed a $500,000 private placement of ordinary shares in September 2025 at a purchase price of $1.50 per share, representing a 40% premium to the market price. This financing is intended for general corporate purposes and working capital, serving as a "short-term bridge" to upcoming milestones while minimizing shareholder dilution, as stated by CEO Alon Ben-Noon. Earlier in January 2025, the company regained compliance with Nasdaq's stockholders' equity requirement following a $5 million private placement in December 2024, which strengthened its balance sheet.

Outlook and Strategic Milestones

NeuroSense is poised for a pivotal period of growth driven by its clinical advancements and strategic partnerships. The company plans to initiate a multinational Phase 3 study of PrimeC in ALS in the second half of 2025, following positive regulatory feedback from the FDA. This is a crucial step towards bringing a potentially disease-modifying treatment to market. Concurrently, NeuroSense is exploring early commercialization opportunities for PrimeC in Canada, with plans to submit a new request for a Notice of Compliance with Conditions (NOC/c) and an estimated potential market opportunity of $100 million to $150 million in peak annual revenues, aiming for commercialization by mid-2026.

A significant de-risking event is the ongoing progression towards finalizing a licensing agreement with a global pharmaceutical partner, following the execution of a binding term sheet in the fourth quarter of 2024. This agreement is anticipated to include a substantial upfront payment, funding for the Phase 3 study, milestone payments, and double-digit royalties on annual net sales, which would significantly bolster NeuroSense's financial position and accelerate PrimeC's development and commercialization. For its Alzheimer's program, top-line data from the RoAD Phase 2 clinical trial for PrimeC is expected following study completion.

Analyst projections reflect optimism, with an average one-year price target of $10.75, ranging from $7.50 to $14.00, representing a substantial upside from the current price. Forecasted annual revenue for 2026 is $12 million, with a projected EBIT of -$8 million, indicating a path towards revenue generation while still investing heavily in R&D. The long-term outlook suggests significant earnings potential, with forecasted annual earnings of $12.46 per share by 2032.

Risks and Investment Considerations

Despite the promising clinical data and strategic initiatives, investing in NeuroSense Therapeutics carries inherent risks typical of a clinical-stage biotechnology company. Significant uncertainties remain regarding the successful completion of Phase 3 trials, the attainment of regulatory approvals, and the eventual commercialization of PrimeC. The complex nature of neurodegenerative diseases means that future trial readouts could still present challenges.

Funding constraints are a persistent concern, as the company currently lacks revenue streams and relies on external financing to support its operations and extensive R&D efforts. While recent private placements have provided a short-term bridge, continued capital raises or the successful execution of the anticipated licensing agreement are crucial for sustained development. The company's stock exhibits high volatility, with a beta of 1.57, indicating its price is 57% more volatile than the S&P 500. Furthermore, the current valuation metrics, such as a negative Price-to-Book ratio and negative earnings, reflect its early-stage status and lack of profitability. Investors must weigh the significant potential of PrimeC to address critical unmet medical needs against these substantial development and financial risks.

Conclusion

NeuroSense Therapeutics stands at a critical juncture, poised to potentially transform the treatment landscape for devastating neurodegenerative diseases. The company's multi-targeted therapeutic strategy, embodied by its lead candidate PrimeC, represents a compelling technological differentiation in a market desperate for effective solutions. With robust Phase 2b data in ALS demonstrating significant improvements in disease progression and survival, coupled with promising early signals in Alzheimer's, NeuroSense is building a strong foundation for its pipeline.

The planned initiation of a Phase 3 ALS study, coupled with strategic efforts for early commercialization in Canada and a significant licensing partnership, outlines a clear path toward future revenue generation and market presence. While the financial challenges inherent to a clinical-stage biotech are evident in its historical net losses and reliance on external funding, the company's ability to secure premium private placements and advance partnership discussions underscores a growing confidence in its long-term potential. For discerning investors, NeuroSense offers an opportunity to participate in a high-impact biotechnology story, where the potential for addressing profound medical needs, driven by innovative technology and strategic execution, could unlock substantial value, provided the company successfully navigates the remaining clinical and regulatory hurdles.