Unicycive Therapeutics Provides Regulatory Update on Lanthanum Dioxycarbonate Program

Therapeutics Provides Regulatory Update on Lanthanum Dioxycarbonate Program

ALTOS, California, June 29, 2023 -- Unicycive Therapeutics, Inc. (Nasdaq: UNCY),

a clinical-stage biotechnology company developing therapies for patients with kidney disease (the "Company or "Unicycive"),

today provided an update based on recent interactions with the U.S. Food and Drug Administration (FDA or Agency) concerning the Company's

New Drug Application (NDA) for lanthanum dioxycarbonate (LDC), previously known as Renazorb. LDC is an investigational new drug being

developed for the treatment of hyperphosphatemia in chronic kidney disease patients on dialysis.

preparation for its anticipated NDA filing for LDC, the Company requested a pre-NDA meeting with the FDA to align on the contents of

the NDA. As previously noted, the Agency had requested a 6-month toxicity study in mice comparing LDC and lanthanum carbonate (LC), the

drug substance in Fosrenol , the Reference Listed Drug for the 505(b)(2) regulatory pathway. The study report was submitted to the

Agency as part of the pre-NDA meeting package showing that there was no evidence of any gastrointestinal (GI) neoplasms for either LC-

or LDC-dosed mice. However, upon review of the study report, the Agency pointed out that although the GI adverse findings observed with

LDC are qualitatively similar to lanthanum carbonate, there were quantitative differences.

on the review of this information, the FDA has asked the Company to provide additional information, including risk assessment and clinical

data, to evaluate the tolerability of LDC in patients with chronic kidney disease on dialysis. The Company requested a follow-up meeting

with the FDA to discuss its additional requests.

will work diligently to gain alignment with the FDA on the additional data requirements and plan to provide further updates regarding

the program in the third quarter of this year," stated Shalabh Gupta, MD, CEO of Unicycive. "We remain undeterred in our

enthusiasm for the potential best-in-class profile of LDC and are dedicated to bringing this important new treatment option to patients

as soon as possible."

is seeking FDA approval of LDC via the 505(b)(2) regulatory pathway. As part of the clinical development program, two clinical studies

were conducted in over 100 healthy volunteers. The first study was a dose-ranging Phase I study to determine safety and tolerability.

The second study was a randomized, open-label, two-way crossover bioequivalence study to establish pharmacodynamic bioequivalence between

LDC and Fosrenol. Based on the topline results of the bioequivalence study, pharmacodynamic (PD) bioequivalence of lanthanum dioxycarbonate

to Fosrenol was established.

is a serious medical condition that occurs in nearly all patients with End Stage Renal Disease (ESRD). If left untreated, hyperphosphatemia

leads to secondary hyperparathyroidism (SHPT), which then results in renal osteodystrophy (a condition similar to osteoporosis and associated

with significant bone disease, fractures and bone pain); cardiovascular disease with associated hardening of arteries and atherosclerosis

(due to deposition of excess calcium-phosphorus complexes in soft tissue). Importantly, hyperphosphatemia is independently associated

with increased mortality for patients with chronic kidney disease on dialysis. Based on available clinical data to date, over 80% of

patients show signs of cardiovascular calcification by the time they become dependent on dialysis.

patients are already at an increased risk for cardiovascular disease (because of underlying diseases such as diabetes and hypertension),

and hyperphosphatemia further exacerbates this. Treatment of hyperphosphatemia is aimed at lowering serum phosphate levels via two means:

(1) restricting dietary phosphorus intake; and (2) using, on a daily basis, and with each meal, oral phosphate binding drugs that facilitate

fecal elimination of dietary phosphate rather than its absorption from the gastrointestinal tract into the bloodstream.

Lanthanum Dioxycarbonate (LDC)

dioxycarbonate is a next-generation lanthanum-based phosphate binding agent utilizing proprietary nanoparticle technology being

developed for the treatment of hyperphosphatemia in patients with chronic kidney disease (CKD). LDC has over forty issued and

granted patents globally. Its potential best-in-class profile may have meaningful patient adherence benefits over currently

available treatment options as it requires a lower pill burden for patients in terms of number and size of pills per does that are

swallowed instead of chewed. Based on a survey conducted in 2022, Nephrologists stated that the greatest unmet need in the treatment

of hyperphosphatemia with phosphate binders is a lower pill burden and better patient compliance.1 The global market

opportunity for treating hyperphosphatemia is projected to be in excess of $2.5 billion in 2023, with the United States accounting

for more than $1 billion of that total. Despite the availability of several FDA-cleared medications, 75 percent of U.S. dialysis

patients fail to achieve the target phosphorus levels recommended by published medical guidelines.

Therapeutics is a biotechnology company developing novel treatments for kidney diseases. Unicycive's lead drug candidate, lanthanum

dioxycarbonate (LDC), is a novel investigational phosphate binding agent being developed for the treatment of hyperphosphatemia in chronic

kidney disease patients on dialysis. UNI-494 is a patent-protected new chemical entity in late preclinical development for the treatment

of acute kidney injury. For more information, please visit www.unicycive.com.

is a registered trademark of Shire International Licensing BV.

statements in this press release are forward-looking within the meaning of the Private Securities Litigation Reform Act of 1995. These

statements may be identified using words such as "anticipate," "believe," "forecast," "estimated"

and "intend" or other similar terms or expressions that concern Unicycive's expectations, strategy, plans or intentions.

These forward-looking statements are based on Unicycive's current expectations and actual results could differ materially. There

are several factors that could cause actual events to differ materially from those indicated by such forward-looking statements. These

factors include, but are not limited to, clinical trials involve a lengthy and expensive process with an uncertain outcome, and results

of earlier studies and trials may not be predictive of future trial results; our clinical trials may be suspended or discontinued due

to unexpected side effects or other safety risks that could preclude approval of our product candidates; risks related to business interruptions,

which could seriously harm our financial condition and increase our costs and expenses; dependence on key personnel; substantial competition;

uncertainties of patent protection and litigation; dependence upon third parties; and risks related to failure to obtain FDA clearances

or approvals and noncompliance with FDA regulations. Actual results may differ materially from those indicated by such forward-looking

statements as a result of various important factors, including: the uncertainties related to market conditions and other factors described

more fully in the section entitled Risk Factors' in Unicycive's Annual Report on Form 10-K for the year ended December

31, 2022, and other periodic reports filed with the Securities and Exchange Commission. Any forward-looking statements contained in this

press release speak only as of the date hereof, and Unicycive specifically disclaims any obligation to update any forward-looking statement,

whether as a result of new information, future events or otherwise.

Unicycive Therapeutics, Inc.