Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days. Yes x No ¨

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files). Yes x No ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer, “accelerated filer,” “smaller reporting company” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

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. ¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).

As of ~~August 3, 2020,~~May 4, 2021, the registrant had ~~19,440,346~~132,042,538 shares of common stock, $0.001 par value per share, outstanding.

This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). In particular, statements contained in this Quarterly Report on Form 10-Q, including but not limited to, statements regarding the timing of our clinical trials, the development and commercialization of our pipeline products, the sufficiency of our cash, our ability to finance our operations and business initiatives and obtain funding for such activities and the timing of any such financing, our future results of operations and financial position, business strategy and plan prospects, or costs and objectives of management for future research, development or operations, are forward-looking statements. These forward-looking statements relate to our future plans, objectives, expectations and intentions and may be identified by words such as “may,” “will,” “should,” “expects,” “plans,” “anticipates,” “intends,” “targets,” “projects,” “contemplates,” “believes,” “seeks,” “goals,” “estimates,” “predicts,” “potential” and “continue” or similar words. Readers are cautioned that these forward-looking statements are based on our current beliefs, expectations and assumptions and are subject to risks, uncertainties, and assumptions that are difficult to predict, including those identified below, under Part II, Item 1A. “Risk Factors” and elsewhere in this Quarterly Report on Form 10-Q, and those identified under Part I, Item 1A of our Annual Report on Form 10-K for the year ended December 31, ~~2019~~2020 (the ~~“2019~~“2020 Form 10-K”) filed with the Securities and Exchange Commission (the “SEC”) on ~~February 20, 2020.~~March 4, 2021. Therefore, actual results may differ materially and adversely from those expressed, projected or implied in any forward-looking statements. We undertake no obligation to revise or update any forward-looking statements for any reason.

Throughout this Quarterly Report on Form 10-Q, “Synthetic Biologics,” the “Company,” “we,” “us” and “our” refer to Synthetic Biologics, Inc.

All trademarks, trade names and service marks appearing in this Quarterly Report on Form 10-Q are the property of their respective owners.

See accompanying notes to unaudited condensed consolidated financial statements.

Synthetic Biologics, Inc. (the “Company” or “Synthetic Biologics”) is a diversified clinical-stage company ~~leveraging the microbiome to develop~~developing therapeutics designed to prevent and treat gastrointestinal (GI) diseases in areas of high unmet need. The Company’s lead clinical development candidates are: (1) SYN-004 (ribaxamase) which is designed to degrade certain commonly used intravenous (IV) beta-lactam antibiotics within the gastrointestinal (GI) tract to prevent (a) microbiome damage, (b) Clostridioides difficile infection (CDI), (c) overgrowth of pathogenic organisms, (d) the emergence of antimicrobial resistance (AMR) and (e) acute graft-versus-host-disease (aGVHD) in allogeneic hematopoietic cell transplant (HCT) recipients, and (2) SYN-010 which is intended to reduce the impact of methane-producing organisms in the gut microbiome to treat an underlying cause of irritable bowel syndrome with constipation (IBS-C). The Company is also advancing SYN-020, ana recombinant oral formulation of the enzyme intestinal alkaline phosphatase (IAP) produced under Current Good Manufacturing Practice (cGMP) conditions and intended to treat both local GI and systemic diseases.

The accompanying condensed consolidated financial statements have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission (“SEC”) for interim financial information. Accordingly, they do not include all of the information and notes required by Accounting Principles Generally Accepted in the United States of America (“U.S. GAAP”) for complete financial statements. The accompanying condensed consolidated financial statements include all adjustments, comprised of normal recurring adjustments, considered necessary by management to fairly state the Company’s results of operations, financial position and cash flows. The operating results for the interim periods are not necessarily indicative of results that may be expected for any other interim period or for the full year. These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and notes thereto included in the Company’s ~~2019~~2020 Form 10-K. The interim results for the three ~~and six~~ months ended ~~June 30, 2020~~March 31, 2021 are not necessarily indicative of results for the full year.

The condensed consolidated financial statements are prepared in conformity with U.S. GAAP, which requires the use of estimates, judgments and assumptions that affect the amounts of assets and liabilities at the reporting date and the amounts of revenue and expenses in the periods presented. The Company believes that the accounting estimates employed are appropriate and the resulting balances are reasonable; however, due to the inherent uncertainties in making estimates, actual results may differ from the original estimates, requiring adjustments to these balances in future periods.

~~On January 30,~~In August 2020, the ~~World Health Organization (WHO) announced a global health emergency because of a new strain of coronavirus originating~~Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2020-06 Debt – Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging – Contracts in ~~Wuhan, China (the COVID-19 outbreak)~~Entity’s Own Equity (subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity. This ASU amends the guidance on convertible instruments and the ~~risks to~~derivatives scope exception for contracts in an entity’s own equity and improves and amends the ~~international community as the virus spreads globally beyond its point of origin. In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase~~related earnings per share guidance for both Subtopics. The ASU will be effective for annual reporting periods after December 15, 2023 and interim periods within those annual periods and early adoption is permitted in ~~exposure globally.~~

On March 27, 2020, the Coronavirus Aid, Relief and Economic Security Act (CARES Act) was enacted. The CARES Act is an emergency economic stimulus package that includes spending and tax breaks to strengthen the United States’ economy and fund a nationwide effort to curtail the effect of COVID-19. While the CARES Act provides sweeping tax changes in response to the COVID-19 pandemic, some of the more significant provisions include removal of certain limitations on utilization of net operating losses, increasing the loss carryback period for certain losses to five years, and increasing the ability to deduct interest expense, as well as amending certain provisions of the previously enacted Tax Cuts and Jobs Act.annual reporting periods ending after December 15, 2020. The Company ~~has assessed~~is currently assessing the impact of ~~the CARES Act and based upon our initial assessment, we do not believe that it will have a significant effect~~ASU 2020-06 on ~~our~~its consolidated financial ~~position, results of operations or cash flows. The Company continues to evaluate its impact as new information becomes available.~~statements.

~~(Unaudited)~~1. Organization, Nature of Operations and Basis of Presentation – (continued)

Long-lived assets include property, equipment and right-of-use assets. In accordance with ~~Accounting Standards Codification (“ASC”)~~ASC 360, - Property, Plant and Equipment (“ASC 360”), management reviews the Company’s ~~recorded~~ long-lived assets for impairment annually or whenever events or changes in circumstances indicate that the carrying amount of an asset may not be fully recoverable. The Company determines the extent to which an asset may be impaired based upon its expectation of the asset’s future usability as well as whether there is reasonable assurance that the future cash flows associated with the asset will be in excess of its carrying amount. If the total of the expected undiscounted future cash flows is less than the carrying amount of the asset, a loss is recognized for the difference between the fair value and the carrying value of the asset. The Company identified COVID-19 as a triggering event and performed a qualitative assessment of the fair value of its long-lived assets. The results from this analysis determined that it is still more likely than not that the fair value of its long-lived assets remain higher than the carrying value of these assets. As a result, no impairment charges were recorded during the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020.

The accompanying consolidated financial statements have been prepared assuming the Company will continue as a going concern. The Company continues to incur losses and, as of June 30, 2020, the Company had an accumulated deficit of approximately $242.3 million. Since inception, the Company has financed its activities principally from the proceeds from the issuance of equity securities.

The Company’s ability to continue as a going concern is dependent upon the Company’s ability to raise additional debt and equity capital. There can be no assurance that such capital will be available in sufficient amounts or on terms acceptable to the Company. These factors raise substantial doubt about the Company’s ability to continue as a going concern. The accompanying consolidated financial statements do not include any adjustments relating to the recoverability of the recorded assets or the classification of liabilities that may be necessary should the Company be unable to continue as a going concern.

The Company does not have sufficient capital to fund its operations for the next twelve months following the issuance date of its Quarterly Report on Form 10-Q. In order to address its capital needs, including its planned clinical trials, the Company is actively pursuing additional equity or debt financing in the form of either a private placement or a public offering. The Company has been in ongoing discussions with strategic institutional investors and investment banks with respect to such possible offerings. Such additional financing opportunities might not be available to the Company when and if needed, on acceptable terms or at all. If the Company is unable to obtain additional financing in sufficient amounts or on acceptable terms under such circumstances, the Company’s operating results and prospects will be adversely affected.

In January 2020, the World Health Organization declared a global pandemic for the novel strain of coronavirus, COVID-19. Since then, the COVID-19 coronavirus has spread to multiple countries, including throughout the United States. As the COVID-19 coronavirus continues to spread around the globe, the Company has experienced disruptions that impact our business and clinical trials, including temporarily halting the enrollment of new patients in its SYN-010 Phase 2b clinical study and the postponement of clinical site initiation for its SYN-004 Phase 1b/2a clinical study. While the Company is experiencing limited financial impacts at this time, given the global economic slowdown, the overall disruption of global healthcare systems and the other risks and uncertainties associated with the pandemic, the Company’s business, financial condition, results of operations and growth prospects could be materially adversely affected. With the recent and rapidly evolving impact of COVID-19 on patient recruitment in clinical trials and considering patient safety and trial integrity, initiation of the Company’s Phase 1b/2a clinical study of SYN-004 to be conducted by Washington University in Allogeneic HCT Recipients has been postponed until Q1 2021, subject to COVID-19 global pandemic. Enrollment of new patients in the Company’s Phase 2b clinical study of SYN-010 was temporarily halted during the first and second quarter of 2020 due to the COVID-19 pandemic and has since recommenced. However, the ability to continue to recruit new patients into this clinical trial remains at the discretion of CSMC and contingent upon the COVID-19 global pandemic.

At June 30, 2020, the Company had cash and cash equivalents of approximately $8.1 million. As a result of the global COVID-19 pandemic, management has been able to extend its cash runway since its clinical development partners (Cedars-Sinai Medical Center (CSMC) and Washington University) continued to limit non-essential activities during the second quarter, which included the halting of enrollment in the ongoing Phase 2b clinical trial of SYN-010 and postponement of the planned Phase 1b/2a clinical trial of SYN-004 (ribaxamase). The Company anticipates its current cash will allow it to cover overhead costs, manufacturing costs for clinical supply, commercial scale up costs and limited research efforts, including completing its funding requirements for its ongoing Phase 2b investigator-sponsored clinical study of SYN-010 and its planned Phase 1b/2a clinical study of SYN-004 in allogeneic HCT recipients.

The Company does not anticipate any additional expense related to the Phase 1b/2a SYN-004 (ribaxamase) clinical trial until the trial is cleared for commencement by Washington University. Commencement of planned future Phase 3 clinical trials of SYN-004 and SYN-010 are subject to the Company’s successful pursuit of opportunities that will allow it to establish the clinical infrastructure and financial resources necessary to successfully initiate and complete its plan. The Company will be required to obtain additional funding in order to continue the development of its current product candidates beyond its Phase 2b investigator-sponsored clinical study of SYN-010 and its planned Phase 1b/2a clinical study of SYN-004 in allogeneic HCT recipients within the anticipated time periods, if at all, and to continue to fund operations at the current cash expenditure levels. Currently, the Company does not have commitments from any third parties to provide it with capital. If the Company fails to obtain additional funding for its clinical trials, whether through the sale of securities or a partner or collaborator, and otherwise when needed, it will not be able to fully execute its business plan as planned and will be forced to cease certain development activities until funding is received and its business will suffer, which would have a material adverse effect on its financial position, results of operations and cash flows. Potential sources of financing include strategic relationships, public or private sales of equity (including through the “at-the-market” Issuance Sales Agreement (the “FBR Sales Agreement”) that the Company entered into with FBR Capital Markets & Co. in August 2016) or debt and other sources. The Company cannot assure that it will meet the requirements for use of the FBR Sales Agreement or that additional funding will be available on favorable terms, or at all. Current cash is expected to cover overhead costs, manufacturing costs for clinical supply, commercial scale up costs and limited research efforts.

~~The actual amount of funds the Company will need to operate is subject to many factors, some of which are beyond its control. These factors include the following:~~

The Company has based its estimates of funding requirements on assumptions that may prove to be wrong. The Company may need to obtain additional funds sooner or in greater amounts than it currently anticipates.

If the Company raises funds by selling additional shares of Common Stock or other securities convertible into Common Stock, the ownership interest of the existing stockholders will be diluted. If the Company is not able to obtain financing when needed, it may be unable to carry out its business plan. As a result, the Company may have to significantly limit its operations and its business, financial condition and results of operations would be materially harmed.

~~ASC~~Accounting Standards Codification (“ASC”) Topic 820, Fair Value Measurement, defines fair value as the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is determined based upon assumptions that market participants would use in pricing an asset or liability. Fair value measurements are rated on a three-tier hierarchy as follows:

In many cases, a valuation technique used to measure fair value includes inputs from multiple levels of the fair value hierarchy described above. The lowest level of significant input determines the placement of the entire fair value measurement in the hierarchy.

The carrying amounts of the Company’s short-term financial instruments, including cash and cash equivalents, other current assets, accounts payable and accrued liabilities approximate fair value due to the relatively short period to maturity for these instruments.

~~Cash and cash equivalents include money market accounts of $114,000 as of June 30, 2020 and $98,000 as of December 31, 2019 that are measured using Level 1 inputs.~~

The Company uses Monte Carlo simulations to estimate the fair value of its stock warrants. In using this model, the fair value is determined by applying Level 3 inputs for which there is little or no observable market data, requiring the Company to develop its own assumptions. The assumptions used in calculating the estimated fair value of the warrants represent the Company’s best estimates; however, these estimates involve inherent uncertainties and the application of management judgment. As a result, if factors change and different assumptions are used, the warrant liability and the change in estimated fair value could be materially different. ~~In 2020~~

Synthetic Biologics, Inc. and ~~2019, the Monte Carlo simulations were not used as the value of the warrants were deemed~~Subsidiaries

Notes to ~~be minimal based on the historical fair value of the warrants and the Company’s current stock price.~~Condensed Consolidated Financial Statements

~~Amounts prepaid to~~Prepaid clinical research organizations (CROs) ~~are~~expense is classified as a current ~~assets.~~asset. The Company makes payments to the CROs based on agreed upon terms that include payments in advance of study services.

On March 20, 2007, the Company’s Board of Directors approved the 2007 Stock Incentive Plan (the “2007 Stock Plan”) for the issuance of up to 71,429 shares of ~~Common Stock~~common stock to be granted through incentive stock options, nonqualified stock options, stock appreciation rights, dividend equivalent rights, restricted stock, restricted stock units and other stock-based awards to officers, other employees, directors and consultants of the Company and its subsidiaries. This plan was approved by the stockholders on November 2, 2007. The exercise price of stock options under the 2007 Stock Plan iswas determined by the compensation committee of the Board of Directors and ~~may~~could be equal to or greater than the fair market value of the Company’s ~~Common Stock~~common stock on the date the option is granted. The total number of shares of stock with respect to which stock options and stock appreciation rights may be granted to any one employee of the Company or a subsidiary during any one-year period under the 2007 stock plan shall not exceed 7,143. Options become exercisable over various periods from the date of grant and generally expire ten years after the grant date. As of ~~June 30, 2020,~~March 31, 2021, there were ~~7,052~~5,145 options issued and outstanding under the 2007 Stock Plan.

On November 2, 2010, the Board of Directors and stockholders adopted the 2010 Stock Incentive Plan (“2010 Stock Plan”) for the issuance of up to 85,714 shares of ~~Common Stock~~common stock to be granted through incentive stock options, nonqualified stock options, stock appreciation rights, dividend equivalent rights, restricted stock, restricted stock units and other stock-based awards to officers, other employees, directors and consultants of the Company and its subsidiaries. On October 22, 2013, the stockholders approved and adopted an amendment to the Company’s 2010 Stock Plan to increase the number of shares of ~~the~~ Company’s ~~Common Stock~~common stock reserved for issuance under the Plan from 85,714 to ~~171,429.~~

On171,429; on May 15, 2015, ~~the stockholders approved and adopted an amendment to the Company’s 2010 Stock Plan to increase~~increased the number of shares ~~of the Company’s Common Stock reserved for issuance under the Plan~~ from 171,429 to ~~228,572. On~~228,572; on August 25, 2016, ~~the stockholders approved and adopted an amendment to the 2010 Stock Plan to increase~~increased the number of shares ~~of the Company’s Common Stock reserved for issuance under the 2010 Stock Plan~~ from 228,572 to ~~400,000. On~~400,000; on September 7, 2017, ~~the stockholders approved and adopted an amendment to the 2010 Stock Plan to increase~~increased the number of shares ~~of the Company’s Common Stock reserved for issuance under the 2010 Stock Plan~~ from 400,000 to ~~500,000. On~~500,000; on September 24, 2018 ~~the stockholders approved and adopted an amendment to the 2010 Stock Plan to increase~~increased the number of shares ~~of the Company’s Common Stock reserved for issuance under the 2010 Stock Plan~~ from 500,000 to ~~1,000,000. On~~1,000,000; and on September 5, 2019, ~~the stockholders approved and adopted an amendment to the 2010 Stock Plan to increase~~increased the number of shares ~~of the Common Stock reserved for issuance under the 2010 Stock Plan~~ from 1,000,000 to 4,000,000. The exercise price of stock options under the 2010 Stock Plan is determined by the compensation committee of the Board of Directors and may be equal to or greater than the fair market value of the Company’s ~~Common Stock~~common stock on the date the option is granted. Options become exercisable over various periods from the date of grant and expire between five and ten years after the grant date. As of ~~June 30, 2020,~~March 31, 2021, there were ~~2,465,310~~2,452,273 options issued and outstanding under the 2010 Stock Plan.

On September 17, 2020, the stockholders approved and adopted the 2020 Stock Incentive Plan (“2020 Stock Plan”) for the issuance of up to 4,000,000 shares of Common Stock to be granted through incentive stock options, nonqualified stock options, stock appreciation rights, dividend equivalent rights, restricted stock, restricted stock units and other stock-based awards to officers, other employees, directors and consultants of the Company and its subsidiaries. As of March 31, 2021, there were 1,540,000 options issued and outstanding under the 2010 Stock Plan.

In the event of an employee’s termination, the Company will cease to recognize compensation expense for that employee. Stock forfeitures are recognized as incurred. There is no deferred compensation recorded upon initial grant date. Instead, the fair value of the stock-based payment is recognized ~~as compensation expense~~ over the stated vesting period.

The Company has applied fair value accounting for all stock-based payment awards since inception. The fair value of each option granted is estimated on the date of grant using the Black-Scholes option pricing model. There were no options granted during the three ~~and six~~ months ended ~~June 30, 2020~~March 31, 2021 and ~~2019. The assumptions used for the awards during the year ended December 31, 2019 were as follows:~~2020.

Expected dividends —The Company has never declared or paid dividends on its ~~Common Stock~~common stock and has no plans to do so in the foreseeable future.

Expected volatility—Volatility is a measure of the amount by which a financial variable such as a share price has fluctuated (historical volatility) or is expected to fluctuate (expected volatility) during a period. The expected volatility assumption is derived from the historical volatility of the Company’s common stock over a period approximately equal to the expected term.

Risk-free interest rate—The assumed risk free rate used is a zero coupon U.S. Treasury security with a maturity that approximates the expected term of the option.

Expected life of the option—The period of time that the options granted are expected to remain unexercised. Options granted during ~~2019~~the year have a maximum term of seven years. The Company estimates the expected life of the option term based on the weighted average life between the dates that options become fully vested and the maximum life of options granted.

The Company records stock-based compensation based upon the stated vesting provisions in the related agreements. The vesting provisions for these agreements have various terms as follows:

A summary of stock option activity for the ~~six~~three months ended ~~June 30, 2020~~March 31, 2021 and the year ended December 31, ~~2019~~2020 is as follows:

Stock-based compensation expense included in general and administrative expenses ~~relating to stock options issued to employees for the three~~ and six months ended June 30, 2020 was $40,000 and $79,000, respectively, and $50,000 and $106,000 for the three and six months ended June 30, 2019, respectively. Stock-based compensation expense included in research and development expenses relating to stock options issued to employees for the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020 was ~~$15,000~~$49,000 and ~~$31,000, respectively, and $32,000 and $110,000 for the three and six months ended June 30, 2019,~~$55,000, respectively.

Stock-based compensation expense included in general and administrative expenses ~~relating to stock options issued to consultants for the three~~ and six months ended June 30, 2020 was $27,000 and $53,000, respectively, and $9,000 and $19,000 for the three and six months ended June 30, 2019, respectively. Stock-based compensation expense included in research and development expenses relating to stock options issued to consultants for the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020 ~~was $4,000~~were $52,000 and ~~$6,000, respectively, and $1,000 for the three and six months ended June 30, 2019.~~

As of ~~June 30, 2020,~~March 31, 2021, total unrecognized stock-based compensation expense related to stock options was ~~$498,000,~~$585,000, which is expected to be expensed through ~~July 2022.~~February 2023.

The FASB’s guidance for stock-based payments requires cash flows from excess tax benefits to be classified as a part of cash flows from operating activities. Excess tax benefits are realized tax benefits from tax deductions for exercised options in excess of the deferred tax asset attributable to stock compensation costs for such options. The Company did not record any excess tax benefits during the three ~~and six~~ months ended ~~June 30, 2020~~March 31, 2021 and ~~2019.~~ 2020.

On October 15, 2018, the Company closed its underwritten public offering pursuant to which it received gross proceeds of approximately $18.6 million before deducting underwriting discounts, commissions and other offering expenses payable by the Company and sold an aggregate of (i) 2,520,000 Class A Units (the “Class A Units”), with each Class A Unit consisting of one share of the Common Stock, and one five-year warrant to purchase one share of Common Stock at an initial exercise price of $1.38 per share, which subsequently was reduced to $0.69 per share (each a “Warrant” and collectively, the “Warrants”), with each Class A Unit to be offered to the public at a public offering price of $1.15, and (ii) 15,723 Class B Units (the “Class B Units”, and together with the Class A Units, the “Units”), with each Class B Unit offered to the public at a public offering price of $1,000 per Class B Unit and consisting of one share of the Company’s Series B Convertible Preferred Stock (the “Series B Preferred Stock”), with a stated value of $1,000 and convertible into shares of Common Stock at the stated value divided by a conversion price of $1.15 per share, with all shares of Series B Preferred Stock convertible into an aggregate of 13,672,173 shares of Common Stock, and issued with an aggregate of 13,672,173 Warrants. On November 16, 2020, the exercise price of the Warrants was reduced from $1.38 per Warrant per full share of the Company’s common stock, $0.001 par value per share (the “Common Stock”), to $0.69 per Warrant per full share of Common Stock in accordance with the anti-dilution terms of the Warrant. The reduction was the result of the issuance of shares of Common Stock by the Company through its “at the market offering” facility. The effect of the change in the exercise price of the warrants as a result of the triggering of the down round protection clause in the Warrants was recorded as a deemed dividend of $880,000, which reduces the income available to common stockholders. In addition, pursuant to the underwriting agreement that the Company had entered into with A.G.P./Alliance Global Partners (the “Underwriters”), as representative of the underwriters, the Company granted the Underwriters a 45 day option (the “Over-allotment Option”) to purchase up to an additional 2,428,825 shares of Common Stock and/or additional Warrants to purchase an additional 2,428,825 shares of Common Stock. The Underwriters partially exercised the Over-allotment Option by electing to purchase from the Company additional Warrants to purchase 1,807,826 shares of Common Stock.

The Warrants are immediately exercisable at a price of $1.38 ($0.69 effective November 16, 2020) per share of Common Stock (which iswas 120% of the public offering price of the Class A Units) and expire on October 15, 2023. If, at the time of exercise, there is no effective registration statement registering, or no current prospectus available for, the issuance of the shares of Common Stock to the holder, then the Warrants may only be exercised through a cashless exercise. No fractional shares of Common Stock will be issued in connection with the exercise of a Warrant. In lieu of fractional shares, the holder will receive an amount in cash equal to the fractional amount multiplied by the fair market value of any such fractional shares. The Company has concluded that the Warrants are required to be equity classified. The Warrants were valued on the date of grant using Monte Carlo simulations. During the three months ended March 31, 2021, 11,655,747 warrants were exercised for cash proceeds of $8.0 million.

On November 18, 2016, the Company completed a public offering of 714,286 shares of ~~Common Stock~~common stock in combination with accompanying warrants to purchase an aggregate of 1,428,571 shares of ~~Common Stock.~~the common stock. The stock and warrants were sold in combination, with two warrants for each share of ~~Common Stock~~common stock sold, a Series A warrant and a Series B warrant, each representing the right to purchase one share of ~~Common Stock.~~common stock. The purchase price for each share of common stock and accompanying warrants was $35.00. The shares of ~~Common Stock~~common stock were immediately separable from the warrants and were issued separately. The initial per share exercise price of the Series A warrants iswas $50.05 and the per share exercise price of the Series B warrants iswas $60.20, each subject to adjustment as specified in the warrant agreements. The Series A and Series B warrants ~~may~~could be exercised at any time on or after the date of issuance. The Series A warrants ~~are~~were exercisable until the four-year anniversary of the issuance date. The Series B warrants expired on December 31, 2017 and none were exercised prior to expiration. The Series A warrants ~~include~~expired November 18, 2020 and none were exercised prior to expiration. The warrants included a provision, that if the Company were to enter into a certain transaction, as defined in the agreement, the warrants would be purchased from the holder for cash. Accordingly, the Company recorded the warrants as a liability at their estimated fair value on the issuance date of $15.7 million and changes in estimated fair value ~~are being~~will be recorded as non-cash income or expense in the Company’s ~~Condensed Consolidated Statements~~Statement of Operations at each subsequent period. At ~~June 30, 2020 and June 30,~~December 31, 2019, the fair value of the warrant liability was $100. The warrants were valued on the date of ~~grant. In 2020~~grant and ~~2019, the Monte Carlo simulations were not used as the value of the warrants were deemed to be minimal based~~ on ~~the historical fair value of the warrants and the Company’s current stock price.~~each remeasurement period.

On October 10, 2014, the Company raised net proceeds of $19.1 million through the sale of 14,059,616 units at a price of $1.47 per unit to certain institutional investors in a registered direct offering. Each unit consisted of one share of the Company’s Common Stock and a warrant to purchase 0.50 shares of Common Stock. The warrants, exercisable for an aggregate of 200,852 shares of Common Stock, had an exercise price of $61.25 per share and a life of five years. The warrants vested immediately and expired on October 10, 2019.

The warrants issued in conjunction with the registered direct offering in October 2014 included a provision that if the Company were to enter into a certain transaction, as defined in the agreement, the warrants would be purchased from the holder at a premium. Accordingly, the Company recorded the warrants as a liability at their estimated fair value on the issuance date, which was $7.4 million, and changes in estimated fair value are being recorded as non-cash income or expense in the Company’s Consolidated Statements of Operations at each subsequent period. At June 30, 2020 and 2019, the fair value of the warrant liability was zero. The warrants were valued on the date of grant using the Black-Scholes option pricing model which approximates the value derived using Monte Carlo simulations. In 2020 and 2019, the Monte Carlo simulations were not used as the value of the warrants were deemed to be minimal based on the historical fair value of the warrants and the Company’s current stock price.

A summary of all warrant activity for the Company for the ~~six months~~quarter ended ~~June 30, 2020~~March 31, 2021 and the year ended December 31, ~~2019~~2020 is as follows:

On December 26, 2017, the Company entered into a consulting agreement for advisory services for a period of six months. As compensation for such services, the consultant was paid an upfront payment, was paid a monthly fee and on January 24, 2018 was issued a warrant exercisable for 714 shares of the Company’s ~~Common Stock~~common stock on the date of ~~issuance.~~issue. The warrant is equity classified and the fair value of the warrant approximated $9,000 ~~on the date of grant~~ and was measured using the Black-Scholes option pricing model. ~~This entire expense was recorded in the quarter ended March 31, 2018.~~

A summary of all outstanding and exercisable common stock warrants as of ~~June 30, 2020~~March 31, 2021 is as follows:

Basic net loss per share is computed by dividing net loss by the weighted average number of common shares outstanding. Diluted net loss per share is computed by dividing net loss by the weighted average number of common shares outstanding including the effect of common share equivalents. Diluted net loss per share assumes the issuance of potential dilutive common shares outstanding for the period and adjusts for any changes in income and the repurchase of common shares that would have occurred from the assumed issuance, unless such effect is anti-dilutive. Net loss attributable to common stockholders for the three ~~and six~~ months ended ~~June 30, 2020~~March 31, 2021 excludes net loss attributable to non-controlling interest of $0.1 million and includes the accretion of the Series B preferred discount of ~~$0.4~~$1.5 million ~~and $0.8 million, respectively, on~~as a result of converted shares and Series A preferred stock accrued dividends of $0.1 ~~million.~~million and the deemed dividend of $7.4 million resulting from the effect of the Series A preferred stock price adjustment during the first quarter of 2021. Net loss attributable to common stockholders for the three ~~and six~~ months ended ~~June 30, 2019~~March 31, 2020 excludes net loss attributable to non-controlling interest of $0.1 million, ~~and~~ includes the accretion of Series B preferred discount of ~~$0.1~~$0.4 million ~~and $0.5 million, respectively,~~ on converted shares and $0.1 million of Series A accrued dividends. There were no shares of common stock underlying Series B Preferred shares convertible to common stock that were excluded from the computations of net loss per common share for the three months ended March 31, 2021 since all remaining Series B preferred stock were converted to common stock. The number of shares of common stock underlying Series B Preferred shares convertible to common stock that were excluded from the computations of net loss per common share for the three ~~and six~~ months ended ~~June 30,~~March 31, 2020 ~~and 2019~~ were ~~4,804,348 and 6,802,608, respectively.~~5,708,696. The number of options and warrants for the purchase of common stock that were excluded from the computations of net loss per common share and for the three ~~and six~~ months ended ~~June 30, 2020~~March 31, 2021 were ~~2,472,362~~3,997,418 and ~~18,714,999,~~6,344,966, respectively and for the ~~six~~three months ended ~~June 30, 2019~~March 31, 2020 were ~~843,119~~2,502,012 and ~~18,915,851,~~18,714,999, respectively, because their effect is anti-dilutive.

The Company’s non-controlling interest is accounted for under ASC 810, Consolidation (“ASC 810”), and represents the minority shareholder’s ownership interest related to the Company’s subsidiary, Synthetic Biomics, Inc. (“SYN Biomics”). In accordance with ASC 810, the Company reports its non-controlling interest in subsidiaries as a separate component of equity in the Consolidated Balance Sheets and reports both net loss attributable to the non-controlling interest and net loss attributable to the Company’s common stockholders on the face of the Consolidated Statements of Operations. On September 5, 2018, the Company entered into an agreement with CSMC for an investigator-sponsored Phase 2b clinical study of SYN-010 to be co-funded by the Company and CSMC (the “Study”). The Study ~~will~~was to provide further evaluation of the efficacy and safety of SYN-010, the Company’s modified-release reformulation of lovastatin lactone, which iswas exclusively licensed to the Company by CSMC. SYN-010 is designed to reduce methane production by certain microorganisms (M. smithii) in the gut to treat an underlying cause of irritable bowel syndrome with constipation (IBS-C). After the 2018 transaction with CSMC, the Company’s equity interest in SYN Biomics is 83% and the non-controlling stockholder’s interest is 17%. As of ~~June 30,~~March 31, 2021 and 2020, the accumulated net loss attributable to the non-controlling interest is $2.8 million and $2.9 ~~million.~~million, respectively.

In consideration of the support provided by CSMC for the Study, the Company ~~will pay $441,000~~paid $328,000 to support the Study and the Company entered into a Stock Purchase Agreement with CSMC pursuant to which the Company, upon the approval of the Study protocol by the Institutional Review Board (IRB): (i) issued to CSMC fifty thousand (50,000) shares of common stock of the Company; and (ii) transferred to CSMC an additional two million four hundred twenty thousand (2,420,000) shares of common stock of its subsidiary SYN Biomics, Inc. (“Synbiomics”) owned by the Company, such that after such issuance CSMC owns an aggregate of seven million four hundred eighty thousand (7,480,000) shares of common stock of SYN Biomics, representing seventeen percent (17%) of the issued and outstanding shares of SYN Biomics’ common stock. The services rendered are recorded to research and development expense in proportion with the progress of the study and based overall on the fair value of the shares ($285,000) as determined at the date of IRB approval. During the three ~~and six~~ months ended ~~June 30,~~March 31, 2020, research and development expense recorded related to this transaction ~~approximated $25,000 and $92,000, respectively. During the three and six months ended June 30, 2019, research and development~~ approximated $67,000. There was no expense recorded related to this transaction ~~approximated~~ ~~$119,000 and $174,000, respectively.~~during the three months ended March 31, 2021.

The Agreement also ~~provides~~provided CSMC with a right, commencing on the six month anniversary of issuance of the stock under certain circumstances in the event that the shares of stock of SYN Biomics are not then freely tradeable, and subject to NYSE American, LLC approval, to exchange its SYN Biomics shares for unregistered shares of the Company’s common stock, with the rate of exchange based upon the relative contribution of the valuation of SYN Biomics to the public market valuation of the Company at the time of each exchange. The Stock Purchase Agreement also provides for tag-along rights in the event of the sale by the Company of its shares of SYN Biomics.

On September 30, 2020, CSMC MAST formally agreed to discontinue the ongoing Phase 2b investigator-sponsored clinical study of SYN-010 following the results of a planned interim futility analysis. Although it was concluded that SYN-010 was well tolerated, SYN-010 was unlikely to meet its primary endpoint by the time enrollment is completed.

On November 9, 2020, the Company and its subsidiary, Synthetic Biomics, Inc. and CSMC mutually agreed to terminate the exclusive license agreement dated December 5, 2013 and all amendments thereto and the clinical trial agreement relating to SYN-010. The determination to terminate the SYN-010 license agreement was agreed following the completion of a planned interim futility analysis of the Phase 2b investigator-sponsored clinical trial of SYN-010. On September 30, 2020, CSMC (the Company’s SYN-010 clinical development partner) informed the Company that it discontinued the ongoing Phase 2b investigator-sponsored clinical study of SYN-010 IBS-C patients.

In addition, pursuant to the Underwriting Agreement that the Company entered into with the Underwriters on October 10, 2018, the Company granted the Underwriters a 45 day option (the “Over-allotment Option”) to purchase up to an additional 2,428,825 shares of Common Stock and/or additional warrants to purchase an additional 2,428,825 shares of Common Stock. Each Warrant is exercisable for one share of common stock. The Underwriters partially exercised the Over-allotment Option by electing to purchase from the Company additional Warrants to purchase 1,807,826 shares of Common Stock.

The Units were offered by the Company pursuant to a registration statement on Form S-1 (File No. 333-227400), as amended, filed with the SEC, which was declared effective by the SEC on October 10, 2018.

The conversion price of the Series B Preferred Stock and exercise price of the October 2018 Warrants ~~are~~is subject to appropriate adjustment in the event of recapitalization events, stock dividends, stock splits, stock combinations, reclassifications, reorganizations or similar events affecting the Common Stock. The exercise price of the Warrants is subject to adjustment in the event of certain dilutive issuances.

~~During~~On November 16, 2020, the ~~three and six months ended June 30, 2020, 1,040 and 2,113 Series B shares, respectively, have been converted into~~exercise price of the Warrants was reduced from $1.38 per Warrant per full share of common stock ~~resulting~~to $0.69 per Warrant per full share of common stock. The reduction was the result of the issuance of shares of Common Stock by the Company through its “at the market offering” facility. The effect of the change in the ~~recognition~~exercise price of ~~$392,000 and $796,000, respectively,~~the warrants as a result of ~~unamortized discount from~~ the ~~conversion. During~~triggering of the ~~three and six months ended June 30, 2019, 302 and 1,338 Series B shares, respectively, have been converted into common stock resulting~~down round protection clause in the recognition of $117,000 and $515,000, respectively, of unamortized discount from the conversion. As of June 30, 2020, 10,198 shares have been converted resulting in the recognition of $3.8 million of unamortized discount. This isWarrants was recorded as a deemed dividend in accumulated ~~deficit.~~ deficit of $880,000, which reduces the income available to common stockholders for the year ended December 31, 2020.

The October 2018 Warrants are immediately exercisable at a price of $1.38 ($0.69 effective November 16, 2020) per share of common stock (which iswas 120% of the public offering price of the Class A Units) and will expire on October 15, 2023. If, at the time of exercise, there is no effective registration statement registering, or no current prospectus available for, the issuance of the shares of common stock to the holder, then the October 2018 warrants may only be exercised through a cashless exercise. No fractional shares of common stock will be issued in connection with the exercise of any October 2018 warrants. In lieu of fractional shares, the holder will receive an amount in cash equal to the fractional amount multiplied by the fair market value of any such fractional shares.

The Company may not effect, and the holder will not be entitled to, exercise any Warrants or conversion of the Series B Preferred Stock, which, upon giving effect to such exercise, would cause (i) the aggregate number of shares of Common Stock beneficially owned by the holder (together with its affiliates) to exceed 4.99% (or, at the election of the holder, 9.99%) of the number of shares of Common Stock outstanding immediately after giving effect to the exercise, or (ii) the combined voting power of the Company’s securities beneficially owned by the holder (together with its affiliates) to exceed 4.99% (or, at the election of the holder, 9.99%) of the combined voting power of all of the Company’s securities then outstanding immediately after giving effect to the exercise or conversion, as such percentage ownership is determined in accordance with the terms of the October 2018 Warrants or Series B Preferred Stock. However, any holder may increase or decrease such percentage to any other percentage not in excess of 9.99% upon at least 61 days’ prior notice from the holder to the Company. The holders of the Series B Preferred will participate, on an as-if-converted-to-common stock basis, in any dividends to the holders of common stock. Upon a defined Fundamental Transaction, the holders of the Series B Preferred Stock are entitled to the same consideration as are holders of Common Stock. The Series B Preferred Stock ranks junior to existing Series A Preferred Stock but on parity with common stock. Liquidation preference is equal to an amount pari passu with the common stock on an as converted basis (i.e., there is no preference to common stock).

Since the effective conversion price of the Series B Preferred Stock is less than the fair value of the underlying common stock at the date of issuance, there is a beneficial conversion feature (“BCF”) at the issuance date. Because the Series B Preferred Stock has no stated maturity or redemption date and is immediately convertible at the option of the holder, the discount created by the BCF is immediately charged to accumulated deficit as a “deemed dividend” and impacts earnings per share. During the ~~year~~three months ended ~~December~~March 31, ~~2018,~~2021 and 2020, 3,973 and 1,073, respectively, shares were converted resulting in the ~~Company recorded~~recognition of a ~~discount~~deemed dividends of ~~$9.1~~$1.5 million and ~~immediately amortized~~$404,000, respectively, for the amortization of the Series B Preferred Stock discount ~~to record the deemed dividend.~~upon conversion.

On September 11, 2017, the Company entered into a share purchase agreement (the “Purchase Agreement”) with an investor (the “Investor”), pursuant to which the Company offered and sold in a private placement 120,000 shares of its Series A Convertible Preferred Stock, par value $0.001 per share (the “Series A Preferred Stock”) for an aggregate purchase price of $12 million, or $100 per share.

The Series A Preferred Stock ranks senior to the shares of the Company’s common stock, and any other class or series of stock issued by the Company with respect to dividend rights, redemption rights and rights onto the distribution of assets ~~upon~~on any voluntary or involuntary liquidation, dissolution or winding up of the affairs of the Company. Holders of Series A Preferred Stock are entitled to a cumulative dividend at the rate of 2.0% per annum, payable quarterly in arrears, as set forth in the Certificate of Designation of Series A Preferred Stock classifying the Series A Preferred Stock. The Series A Preferred Stock is convertible at the option of the holders at any time into shares of common stock at an initial conversion price of ~~$18.90~~$0.54 per share which was increased to $18.90 after taking into account the 2018 reverse stock split, subject to certain customary anti-dilution ~~adjustments.~~adjustments and was decreased to $1.50 on January 27, 2021, see below.

Any conversion of Series A Preferred Stock may be settled by the Company in shares of common stock only.

The holder’s ability to convert the Series A Preferred Stock into common stock is subject to (i) a 19.99% blocker provision to comply with NYSE American Listing Rules, (ii) if so elected by the Investor, a 4.99% blocker provision that will prohibit beneficial ownership of more than 4.99% of the outstanding shares of the Company’s common stock or voting power at any time, and (iii) applicable regulatory restrictions.

In the event of any liquidation, dissolution or winding-up of the Company, holders of the Series A Preferred Stock are entitled to a preference on liquidation equal to the greater of (i) an amount per share equal to the stated value plus any accrued and unpaid dividends on such share of Series A Preferred Stock (the “Accreted Value”), and (ii) the amount such holders would receive in such liquidation if they converted their shares of Series A Preferred Stock (based on the Accreted Value and without regard to any conversion limitation) into shares of the common stock immediately prior to any such liquidation, dissolution or winding-up (the greater of (i) and (ii), is referred to as the “Liquidation Value”).

Except as otherwise required by law, the holders of Series A Preferred Stock have no voting rights, other than customary protections against adverse amendments and issuance of pari passu or senior preferred stock. Upon certain change of control events involving the Company, prior to the filing of the amendment to the Certificate of Designation for the Series A Preferred Stock described below, the Company will be required to repurchase all of the Series A Preferred Stock at a redemption price equal to the greater of (i) the Accreted Value and (ii) the amount that would be payable upon a change of control (as defined in the Certificate of Designation) in respect of common stock issuable upon conversion of such share of Series A Preferred Stock if all outstanding shares of Series A Preferred Stock were converted into common stock immediately prior to the change of control.

On or at any time after (i) the VWAP (as defined in the Certificate of Designation) for at least 20 trading days in any 30 trading day period is greater than $70.00, subject to adjustment in the case of stock split, stock dividends or the like the Company has the right, after providing notice not less than 6 months prior to the redemption date, to redeem, in whole or in part, on a pro rata basis from all holders thereof based on the number of shares of Series A Preferred Stock then held, the outstanding Series A Preferred Stock, for cash, at a redemption price per share of Series A Preferred Stock of ~~$7,875,~~$7,875.00, subject to appropriate adjustment in the event of any stock dividend, stock split, combination or other similar recapitalization with respect to the Series A Convertible Preferred Stock or (ii) the five year anniversary of the ~~issuance~~issue date, the Company ~~has~~shall have the right to redeem, in whole or in part, on a pro rata basis from all holders thereof

based on the number of shares of Series A Convertible Preferred Stock then held, the outstanding Series A Preferred Stock, for cash, at a redemption price per share equal to the Liquidation ~~Value (as defined in the Certificate of Designations).~~Value.

The Series A Preferred Stock is classified as temporary equity due to the shares being redeemable based on contingent events outside of the Company’s control. Since the effective conversion price of the Series A Preferred Stock is less than the fair value of the underlying common stock at the date of issuance, there is a beneficial conversion feature (“BCF”) at the issuance date. Because the Series A Preferred Stock has no stated maturity or redemption date and is immediately convertible at the option of the holder, the discount created by the BCF is immediately charged to accumulated deficit as a “deemed dividend” and impacts earnings per share. During the year ended December 31, 2017, the Company recorded a discount of $6.9 million. Because the Series A Preferred Stock is not currently redeemable, the discount arising from issuance costs was allocated to temporary equity and will not be accreted until such time that redemption becomes probable. The stated dividend rate of 2% per annum is cumulative and the Company accrues the dividend on a quarterly basis (in effect accreting the dividend regardless of declaration because the dividend is cumulative). During the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020, the Company accrued dividends of ~~$63,000~~$24,000 and ~~$125,000, respectively. During the three and six months ended June 30, 2019, the Company accrued dividends of $61,000 and $122,000,~~$62,000, respectively. Once the dividend is declared, the Company will reclassify the declared amount from temporary equity to a dividends payable liability. When the redemption of the Series A Preferred Stock becomes probable, the temporary equity will be accreted to redemption value as a deemed dividend.

~~Notes~~On January 27, 2021, the Company filed an amendment to ~~Consolidated Financial Statements~~

~~9. Common and~~the Certificate of Designation for the Series A Preferred Stock ~~– (continued)~~to (i) lower the stated Conversion Price through September 30, 2021 and (ii) remove their change in control put, as an inducement for the holder to fully convert its Series A Preferred Stock. The Amendment to the Certificate of Designation for its Series A Convertible Preferred Stock (the “Certificate of Amendment”) with the Secretary of State of the State of Nevada adjusted the conversion price from $18.90 per share to $1.50 per share and removed the redemption upon change of control. The Company received notice from the holder of the Series A Preferred Stock that it was increasing the Maximum Percentage as defined in the “Certificate of Designation” from 4.99% to 9.99%, such increase to be effective 61 days from the date hereof. During the three months ended March 31, 2021, all outstanding shares of Series A Convertible Preferred Stock were converted to approximately 9.0 million shares of the Company’s common stock. There are no remaining shares of the Series A Convertible Preferred stock outstanding after these conversions. During January and February 2021, the Company issued 8,996,768 shares of its common stock upon the conversion effected on such date by the holder of 120,000 shares of its Series A Convertible Preferred Stock. The fair value of the consideration issued to the holder to induce conversion is accounted for as a deemed dividend and increased net loss available to common shareholders for purposes of calculating loss per share. The Company estimated fair value of the inducement consideration of $7.4 million and as a result has recorded a corresponding deemed dividend of $7.4 million during the three months ended March 31, 2021.

On August 5, 2016, the Company entered into the B. Riley FBR Sales Agreement with FBR Capital Markets & Co. (now known as B. Riley ~~FBR, Inc.)~~Securities), which enables the Company to offer and sell shares of ~~the Company’s~~ common stock ~~with an aggregate sales price of up to $40.0 million~~ from time to time through B. Riley ~~FBR,~~Securities, Inc. as the Company’s sales agent. Sales of common stock under the B. Riley ~~FBR~~Securities Sales Agreement are made in sales deemed to be “at-the-market” equity offerings as defined in Rule 415 promulgated under the Securities Act. B. Riley ~~FBR,~~Securities, Inc. is entitled to receive a commission rate of up to 3.0% of gross sales in connection with the sale of the ~~Company’s common stock~~Common Stock sold on the Company’s behalf. The Company ~~has~~did not ~~sold~~sell any shares of common stock during the three months ended March 31, 2020 ~~and 2019~~ through the B. Riley ~~FBR~~Securities Sales Agreement.

~~10.~~On February 9, 2021, the Company entered into an amended and restated sales agreement with B. Riley Securities, Inc. (“B. Riley”) and A.G.P./Alliance Global Partners (“AGP”) in order to include AGP as an additional sales agent for the Company’s “at the market offering” program (the “Amended and Restated Sales Agreement”). The Sales Agreement amended and restated the At Market Issuance Sales Agreement, dated August 5, 2016, with B. Riley Securities, Inc. (formerly known as B. Riley FBR, Inc.), as amended by amendment no. 1, dated May 7, 2018, to the At Market Issuance Sales Agreement.

During the three months ended March 31, 2021, the Company sold through the At Market Issuance Sales Agreement and the Amended and Restated Sales Agreement approximately 78.7 million shares of the Company’s common stock and received net proceeds of approximately $66.0 million.

On September 5, 2018, the Company entered into an agreement with CSMC for an investigator-sponsored Phase 2b clinical study of SYN-010 to be co-funded by the Company and CSMC (the “Study”). The Study will provide further evaluation of the efficacy and safety of SYN-010, the Company’s modified-release reformulation of lovastatin lactone, which is exclusively licensed to the Company by CSMC. SYN-010 is designed to reduce methane production by certain microorganisms (M. smithii) in the gut to treat an underlying cause of irritable bowel syndrome with constipation (IBS-C).

In consideration of the support provided by CSMC for the Study, the Company entered into a Stock Purchase Agreement with CSMC pursuant to which the ~~Company, upon the approval of the Study protocol by the Institutional Review Board (IRB) to:~~Company: (i) issued to CSMC fifty thousand (50,000) shares of common stock of the Company; and (ii) transferred to CSMC an additional two million four hundred twenty thousand (2,420,000) shares of common stock of its subsidiary Synthetic Biomics, Inc. (“SYN Biomics”) owned by the Company, such that after such issuance CSMC ~~will own~~owns an aggregate of seven million four hundred eighty thousand (7,480,000) shares of common stock of SYN Biomics, representing seventeen percent (17%) of the issued and outstanding shares of SYN Biomics’ common stock.

In December 2013, through the Company’s subsidiary, Synthetic Biomics, Inc., the Company entered into a worldwide exclusive license agreement with CSMC and acquired the rights to develop products for therapeutic and prophylactic treatments of acute and chronic diseases, including the development of SYN-010 to target IBS-C. The Company licensed from CSMC a portfolio of intellectual property comprised of several U.S. and foreign patents and pending patent applications for various fields of use, including IBS-C, obesity and diabetes. An investigational team led by Mark Pimentel, M.D. at CSMC discovered that these products may reduce the production of methane gas by certain GI microorganisms. During the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020, ~~and 2019,~~ the Company did not owe and did not pay CSMC for milestone payments related to this license agreement.

All of the Company’s existing leases as of ~~June 30, 2020~~March 31, 2021 are classified as operating leases. As of ~~June 30, 2020,~~March 31, 2021, the Company has one material operating lease for facilities with a remaining term expiring in 2022. The existing lease has fair value renewal options, none of which are considered certain of being exercised or included in the minimum lease term. The discount rate used in the calculation of the lease liability was 9.9%. The rates implicit within the Company's leases are generally not determinable, therefore, the Company's incremental borrowing rate is used to determine the present value of lease payments. The determination of the Company’s incremental borrowing rate requires judgment. Because the Company currently has no outstanding debt, the incremental borrowing rate for each lease is primarily based on ~~publicly-available~~publicly available information for companies within the same industry and with similar credit profiles. The rate is then adjusted for the impact of collateralization, the lease term and other specific terms included in the Company’s lease arrangements. The incremental borrowing rate is determined at lease commencement, or as of January 1, 2019 for operating leases in existence upon adoption of ASC 842. The incremental borrowing rate is subsequently reassessed upon a modification to the lease arrangement. ROU assets are subsequently assessed for impairment in accordance with the Company’s accounting policy for long-lived assets. Operating lease costs are presented as part of general and administrative expenses in the condensed consolidated ~~statement~~statements of operations, and for the three ~~and six~~ months ended ~~June 30,~~March 31, 2021 and 2020 approximated $51,000 and $50,000, ~~and $101,000, respectively, and for three and six months ended June 30, 2019 approximated $50,000 and $101,000,~~ respectively. ~~For~~During the ~~three and six months ended June 30, 2020,~~same periods, operating cash flows used for operating leases approximated ~~$77,000~~$79,000 and ~~$154,000,~~$77,000, respectively, and ~~for three and six months ended June 30, 2019 approximated $75,000 and $149,000, respectively. The~~ right of use assets exchanged for operating lease obligations was $0. The day one non-cash addition of right of use assets due to adoption of ASC 842 was $538,000.

A maturity analysis of our operating leases as of ~~June 30, 2020~~March 31, 2021 is as follows (amounts in thousands of dollars):

On January 30, 2020, the World Health Organization ~~(WHO)~~(“WHO”) announced a global health emergency because of a new strain of coronavirus originating in Wuhan, China (the ~~COVID-19~~“COVID-19” outbreak) and the risks to the international community as the virus spreads globally beyond its point of origin. In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally.

As ~~the~~ COVID-19 ~~coronavirus continues~~continued to spread around the globe, the Company experienced disruptions that ~~impact~~impacted its business and clinical trials, including halting the ~~enrollment of new patients in the ongoing Phase 2b investigator-sponsored clinical trial of SYN-010 and~~ postponement of clinical site initiation of the Phase 1b/2a clinical trial of SYN-004. The extent to which the COVID-19 pandemic impacts the Company’s business, the clinical development of ~~SYN-010,~~ SYN-004 (ribaxamase) and SYN-020, the business of the Company’s suppliers and other commercial partners, the Company’s corporate development objectives and the value of and market for the Company’s common stock, will depend on future developments that are highly uncertain and cannot be predicted with confidence at this time, such as the ultimate duration of the pandemic, travel restrictions, quarantines, social distancing and business closure requirements in the United States, Europe and other countries, and the effectiveness of actions taken globally to contain and treat the disease. The global economic slowdown, the overall disruption of global healthcare systems and the other risks and uncertainties associated with the pandemic could have a material adverse effect on the Company’s business, financial condition, results of operations and growth prospects. In addition, to the extent the ongoing COVID-19 pandemic adversely affects the Company’s business and results of operations, it may also have the effect of heightening many of the other risks and uncertainties which the Company faces.

~~12. Subsequent Events~~

On June 30, 2020 the Company submitted an Investigational New Drug (IND) application with the FDA for SYN-020, an oral formulation of recombinant intestinal alkaline phosphatase (IAP). On July 30, 2020 the Company announced that it received a study-may-proceed letter from the U.S. Food and Drug Administration (FDA) to conduct a Phase 1 single ascending dose study in healthy volunteers designed to evaluate SYN-020 for safety, tolerability and pharmacokinetic parameters. The Phase 1 clinical program is intended to support the clinical development of SYN-020 in multiple indications, including the treatment of radiation enteropathy secondary to pelvic cancer therapy.

On January 7, 2020 the Company held a Type-C meeting with the FDA to discuss the clinical program requirements needed to evaluate safety, tolerability and potential absorption into the systemic circulation (if any) of SYN-004 (ribaxamase) in adult allogeneic HCT recipients. On July 30, 2020 the Company received written notification from the FDA informing it that they determined the Phase 1b/2a clinical program in adult allogeneic HCT recipients is safe to proceed per the submitted clinical program protocol.

ITEM 2. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS.

The following discussion should be read in conjunction with our unaudited condensed consolidated financial statements and notes thereto included in this Quarterly Report on Form 10-Q, and our audited consolidated financial statements and notes thereto for the year ended December 31, ~~2019~~2020 included in our ~~2019~~2020 Form 10-K. This discussion contains forward-looking statements reflecting our current expectations that involve risks and uncertainties. See “Note Regarding Forward-Looking Statements” for a discussion of the uncertainties, risks and assumptions associated with these statements. Our actual results and the timing of events could differ materially from those expressed or implied by the forward-looking statements due to important factors and risks including, but not limited to, those set forth below under “Risk Factors” and elsewhere herein, and those identified under Part I, Item 1A of our ~~2019~~2020 Form 10-K. All share and per share numbers set forth in this Management’s Discussion and Analysis of Financial Conditions and Results of Operations reflect the one-for-thirty five reverse stock split effected August 10, 2018.

Overview

We are a diversified clinical-stage company ~~leveraging the microbiome to develop~~developing therapeutics designed to treat gastrointestinal (GI) diseases in areas of high unmet need. Our lead clinical development candidates are: (1) SYN-004 (ribaxamase) which is designed to degrade certain commonly used intravenous (IV) beta-lactam antibiotics within the GI tract to prevent microbiome damage, Clostridioides difficile infection (CDI), overgrowth of pathogenic organisms, the emergence of antimicrobial resistance (AMR), and acute graft-versus-host-disease (aGVHD) in allogeneic hematopoietic cell transplant (HCT) recipients, and (2) SYN-010 which is intended to reduce the impact of methane-producing organisms in the gut microbiome to treat an underlying cause of irritable bowel syndrome with constipation (IBS-C). We are also advancing SYN-020, ~~an early-stage~~a recombinant oral formulation of the enzyme intestinal alkaline phosphatase (IAP) produced under cGMP conditions and intended to treat both local GI and systemic diseases.

We plan to explore and evaluate a range of strategic options, which may include: in-licensing opportunities; evaluation of potential acquisitions; or other potential strategic transactions. In the meantime, we remain focused on working with our clinical development partners to advance the planned Phase 1b/2a clinical trial of SYN-004 (ribaxamase) in allogeneic hematopoietic cell transplant (HCT) patients, and advancing the clinical development program for SYN-020 intestinal alkaline phosphatase (IAP) in multiple potential indications.

We are continuing to assess the potential impact of the COVID-19 pandemic. We are in close contact with our clinical ~~sites and are assessing~~development partners in order to assess the impact of COVID-19 on our studies and current timelines and costs. ~~With the recent and rapidly evolving impact of~~While we currently do not anticipate any interruptions in our operations due to COVID-19, on patient recruitment in clinical trials and considering patient safety and trial integrity, initiation of our Phase 1b/2a clinical study of SYN-004 to be conducted by Washington University in Allogeneic HCT Recipients has been postponed until Q1 2021, subject toit is possible that if the COVID-19 ~~global pandemic. Enrollment of new patients in our Phase 2b clinical study of SYN-010 was temporarily halted during the first and second quarter of 2020 due to the COVID-19~~ pandemic and has since recommenced. However, the ability to continue to recruit new patients into the Phase 2b clinical trial of SYN-010 remains at the discretion of CSMC and contingent upon the COVID-19 pandemic. If the COVID-19 pandemic continues and persists for an extended period of time, we could experience significant disruptions to our clinical development ~~timeline,~~timelines due to the COVID-19 pandemic, which would adversely affect our business, financial condition, results of operations and growth prospects.

In response to the spread of COVID-19 as well as public health directives and orders, we have implemented a number of measures designed to ensure employee safety and business continuity. We have limited access to our offices and are allowing our administrative employees to continue their work outside of our offices in order to support the community efforts to reduce the transmission of COVID-19 and protect employees, complying with guidance from federal, state and local government and health authorities. The full extent to which the COVID-19 outbreak will directly or indirectly impact our business, results of operations and financial condition will depend on future developments that are highly uncertain and cannot be accurately predicted. The effects of the governmental orders and our work-from-home policies may negatively impact productivity, disrupt our business and delay our clinical programs and timelines, the magnitude of which will depend, in part, on the length and severity of the restrictions and other limitations on our ability to conduct our business in the ordinary course.

Our Product Pipeline:

*Based on management’s current beliefs and expectations

~~AAD~~ ~~antibiotic associated diarrhea;~~ aGVHD acute graft-vs-host disease; allo-HCT allogeneic hematopoietic cell transplant patients; AMR antimicrobial resistance; CDIClostridioides difficile ~~infection;~~infection. ~~CIC~~ ~~chronic idiopathic constipation;~~ ~~CPI~~SAD ~~checkpoint inhibitor autoimmune enteropathy;~~ ~~CRE~~ ~~carbapenem resistant enterococci;~~ DR ~~delayed release;~~ ~~Est.~~ ~~estimated;~~ ~~HCT~~ ~~hematopoietic cell transplant patients;~~ ~~IAP~~ ~~intestinal alkaline phosphatase;~~ ~~IBS-C~~ ~~irritable bowel syndrome with constipation;~~ ~~VRE~~ ~~vancomycin resistant enterococci.~~single ascending dose

¹Additional products with preclinical proof-of-concept include SYN-006 (carbapenemase) to prevent aGVHD and infection by carbapenem resistant enterococci and SYN-007 (ribaxamase) DR to prevent antibiotic associated diarrhea with oral β-lactam antibiotics.

²Dependent on funding/partnership.

³Announced option-license agreement with Massachusetts General Hospital to develop SYN-020 in several potential indications related to inflammation and gut barrier dysfunction.

Additional pipeline products with preclinical proof-of-concept include SYN-006 (carbapenemase) being designed to prevent aGVHD, microbiome damage and infection bydue to treatment with carbapenem ~~resistant Enterobacteriaceae~~antibiotics, and SYN-007 (ribaxamase) DR being designed to prevent antibiotic associated diarrhea with oral β-lactam antibiotics. ~~²Dependent on funding/partnership.~~

*Based on management’s current beliefs and expectations.

Summary of Clinical and Preclinical Programs

Therapeutic Area	Product Candidate	Current Status

Prevention of microbiome damage, CDI, overgrowth of pathogenic organisms, AMR, and aGVHD in allogeneic HCT recipients (Degrade IV beta-lactam antibiotics)	SYN-004 (ribaxamase) (oral enzyme)	·      Announced outcomes from End of Phase 2 meeting, including ~~FDA-proposed~~Food and Drug Administration (FDA)-proposed criteria for Phase 3 clinical efficacy and safety which, if achieved, may support submission for marketing approval on the basis of a single Phase 3 clinical trial (Q4 2018) ·     ~~Anticipate initiation of the Phase 3 clinical program proposed by the FDA for the prevention of CDI only after securing additional potential funding via a strategic partnership~~ ·Clarified market/potential partner needs and identified potential additional indications in specialty patient populations such as allogeneic hematopoietic cell transplant (HCT) patients ·      Announced clinical trial agreement (CTA) with Washington University School of Medicine to conduct a Phase 1b/2a clinical trial to evaluate safety, tolerability and pharmacokinetics in up to 36 evaluable adult allogeneic HCT recipients (Q3 2019) ·      Received official meeting minutes from FDA Type-C meeting held on December 2, 2019 to discuss development in allogeneic HCT recipients who are administered IV beta-lactam antibiotics in response to fever (Q1 2020) ·     Received written notification from the FDA informing the Company that the FDA determined the Phase 1b/2a clinical program in adult allogeneic hematopoietic cell transplant (HCT) recipients may proceed per the submitted clinical program protocol (Q3 2020) · ~~Initiation~~      Washington University began enrollment and the first patient was dosed in the first of ~~proposed~~three antibiotic cohorts for the Phase 1b/2a clinical trial ~~to be conducted by Washington University~~of SYN-004 in adult ~~allogeneic~~ HCT recipients ~~temporarily postponed~~ ~~until Q1 2021, subject to COVID-19 global pandemic~~

~~Treatment of IBS-C~~	~~SYN-010~~ ~~(oral modified-release~~ ~~lovastatin lactone)~~	· ~~Confirmed key elements of Pivotal Phase 2b/3 clinical trial design pursuant to consultations with FDA (Q1 2017)~~(Q2 2021) · ~~Entered into agreement with CSMC for an investigator-sponsored Phase 2b clinical study of SYN-010 to evaluate SYN-010 dose response and inform Phase 3 clinical development (Q3 2018)~~ · ~~Enrollment in the Phase 2b investigator-sponsored clinical study of SYN-010 conducted by CSMC was temporarily halted in Q1 and Q2 2020 due to the COVID-19 global pandemic~~ · ~~Patient recruitment has recommenced and remains contingent upon CSMC’s ability to enroll new patients during the COVID-19 global pandemic (Q3 2020)~~

Preserve gut barrier, treat local GI inflammation, and restore gut microbiome

SYN-020
(oral IAP enzyme)

·      Generated high expressing manufacturing cell lines for intestinal alkaline phosphatase (IAP) (1H 2017)

·      Identified basic ~~drug supply~~Drug Supply manufacturing process and potential tablet ~~and capsule formulations~~formulation (2H 2017)

·      Identified potential clinical indications with unmet medical need including enterocolitis associated with radiation therapy for cancer (Q1 2019)

·      Completed pre-IND (Investigational New Drug) meeting with the FDA to clarify requirements for IND-enabling toxicology studies and manufacturing requirements (Q2 2019)

·      Entered into an agreement with Massachusetts General Hospital (“MGH”) granting the Company an option for an exclusive license to intellectual property and technology related to the use of IAP to maintain GI and microbiome health, diminish systemic inflammation, and treat age-related diseases (Q2 2020)

·     Submitted IND application with U.S. FDA supporting an initial indication for the treatment of radiation enteropathy secondary to pelvic cancer therapy (Q2 2020)

·      Received study-may-proceed letter from U.S. FDA to conduct a Phase 1 single ascending dose study in healthy volunteers, designed to evaluate SYN-020 for safety, tolerability, and pharmacokinetic parameters (Q3 2020)

·      Announced enrollment commenced and three out of a total of four cohorts have been dosed in a Phase 1a single-ascending-dose (SAD) study of SYN-020 (Q2 2021).

Prevention of CDI, overgrowth of pathogenic organisms and AMR (Degrade IV carbapenem antibiotics)

SYN-006

(oral enzyme)

·      Identified P2A as a potent carbapenemase that is stable in the GI tract

·      Manufactured a formulated research lot for oral delivery (2017)

·      Demonstrated microbiome protection in a pig model of ertapenem administration (Q1 2018)

·      Reported supporting data demonstrating SYN-006 attenuated emergence of antibiotic resistance ~~genes~~ in a pig model, including ~~those encoding~~encoded beta-lactamases and genes conferring resistance to a broad range of antibiotics such as aminoglycosides and macrolides (Q1 2019)

Prevention of ~~CDI,~~antibiotic-associated diarrhea (AAD), overgrowth of pathogenic organisms and AMR (Degrade oral beta-lactam antibiotics)

SYN-007
(oral enzyme)

·      Preclinical work ongoing to expand the utility of SYN-004 (ribaxamase) for use with oral beta-lactam antibiotics

·      Reported supportive data from a second canine animal model demonstrating that when co-administered with oral ~~amoxicillin~~Amoxicillin and oral Augmentin (combination amoxicillin/clavulanate), oral SYN-007 did not interfere with systemic absorption of antibiotics but did diminish microbiome damage associated with these antibiotics (Q2 2018)

·      Reported supportive data demonstrating SYN-007 mitigated antibiotic-mediated gut microbiome alterations and maintained gut microbiome integrity when co-administered with oral amoxicillin in a dose-response canine study (Q2 2019)

·      Reported supportive data demonstrating SYN-007 protected the gut microbiome of dogs from amoxicillin and the beta-lactam/beta-lactamase inhibitor ~~combination amoxicillin/clavulanate~~Augmentin and also reduced the emergence of antibiotic resistance in a canine study (Q1 2020)

Prevention and treatment of pertussis

SYN-005
(monoclonal antibody
therapies)

·      Reported supportive preclinical data demonstrating that an extended half-life version of hu1B7, a component of SYN-005, provided protection from pertussis for five weeks in a neonatal non-human primate study (Q4 2017)

·      Collaboration with UT Austin

Recent Developments

Our Gastrointestinal (GI) and Microbiome-Focused Pipeline

Our SYN-004 (ribaxamase) and ~~SYN-010~~SYN-020 clinical programs are focused on the gastrointestinal tract (GI) and the gut microbiome, which is home to billions of microbial species and composed of a natural balance of both “good” beneficial species and potentially “bad” pathogenic species. When the natural balance or normal function of these microbial species is disrupted, a person’s health can be compromised. All of our programs are supported by our growing intellectual property portfolio. We are maintaining and building our patent portfolio through: filing new patent applications; prosecuting existing applications; and licensing and acquiring new patents and patent applications.

~~Recent Developments~~

Clinical and Pre-Clinical Update

SYN-004 (ribaxamase) — Prevention of antibiotic-mediated microbiome damage, C. difficile infections (CDI), overgrowth of pathogenic organisms, the emergence of antimicrobial resistance (AMR) and acute graft-versus-host disease (aGVHD) in allogeneic HCT recipients

Phase 1b/2a Clinical Study in Allogeneic HCT Recipients

In August 2019, we entered into a Clinical Trial Agreement (CTA) with the Washington University School of Medicine (Washington University) to conduct a Phase 1b/2a clinical trial of SYN-004 (ribaxamase). Under the terms of this agreement, we will serve as the sponsor of the study and supply SYN-004 (ribaxamase). Dr. Erik R. Dubberke, Professor of Medicine and Clinical Director, Transplant Infectious Diseases at Washington University and a member of the SYN-004 (ribaxamase) steering committee will serve as the principal investigator of the clinical trial in collaboration with his Washington University colleague Dr. Mark A. Schroeder, Associate Professor of Medicine, Division of Oncology, Bone Marrow Transplantation and Leukemia.

On January 7, 2020, we announced the receipt of official meeting minutes from the FDA following a Type-C meeting held on December 2, 2019 at our request to discuss the development of SYN-004 (ribaxamase) for treatment of allogeneic HCT recipients who are administered IV beta-lactam antibiotics in response to fever. Based on the final meeting minutes, the Phase 1b/2a clinical trial ~~will comprise~~is a single center, randomized, double-blinded, placebo-controlled clinical trial of oral SYN-004 (ribaxamase) in up to 36 evaluable adult allogeneic HCT recipients. The goal of this study is to evaluate the safety, tolerability and potential absorption into the systemic circulation (if any) of 150 mg oral SYN-004 (ribaxamase) administered to allogeneic HCT recipients four times per day who receive an IV beta-lactam antibiotic to treat fever. Study participants ~~will be~~are being enrolled into three sequential cohorts administered a different study-assigned IV beta-lactam antibiotic. Eight participants in each cohort will receive SYN-004 (ribaxamase) and four will receive placebo. On July 30, 2020 we received written notification from the FDA informing us that they determined the Phase 1b/2a clinical program in adult allogeneic HCT recipients may proceed per the submitted clinical program protocol.

Safety and pharmacokinetic data for each cohort will be reviewed by an independent Data and Safety Monitoring Committee, ~~(DSMC),~~ which will make a recommendation on whether to proceed to the next IV beta-lactam antibiotic. The clinical trial will also evaluate potential protective effects of SYN-004 (ribaxamase) on the gut microbiome as well as generate preliminary information on potential therapeutic benefits and patient outcomes of SYN-004 (ribaxamase) in allogeneic HCT recipients. ~~Initiation of this~~

On July 30, 2020, we received written notification from the FDA informing us that they determined the Phase 1b/2a clinical ~~trial remains contingent upon~~program in adult allogeneic HCT recipients may proceed per the submitted clinical program protocol. On December 22, 2020, we announced we received approval offrom the ~~clinical study protocol by the Washington University School of Medicine’s~~ Institutional Review Board (IRB). at Washington University to commence the Phase 1b/2a clinical trial of SYN-004. On April 14, 2021 we announced that enrollment has commenced and the first patient of the first antibiotic cohort of this study had been dosed. If enrollment proceeds as planned, a data readout for the first cohort is anticipated in Q4 2021.

Due to the unique challenges posed by the global COVID-19 pandemic, Washington University continues to evaluate non-essential activities which may have a direct impact on planned and ongoing clinical trials. ~~We have been notified by Washington University that they could consider initiating planned clinical trials, including~~Continuation of the ~~SYN-004 (ribaxamase)~~ Phase 1b/2a clinical ~~program as early as September 2020. However, this~~trial including, but not limited to, the enrollment of new patients remains largely at ~~their~~the discretion of Washington University and is contingent upon ~~Washington University’s~~their ability to conduct this clinical program free from the impact of COVID-19, and approval from their IRB and the FDA. At this time, we have determined that postponing the initiation of the planned Phase 1b/2a clinical trial in allogeneic HCT recipients until at least the first quarter of 2021 remains the appropriate course of action in the current operating environment.COVID-19. We remain in close contact with Washington University and are actively monitoring the crisis caused by the spread of COVID-19 and its impact to the clinical development plans for our SYN-004 (ribaxamase) program.

~~SYN-010 — Treatment of Irritable Bowel Syndrome with Constipation (IBS-C)~~

On September 5, 2018, we entered into an agreement with CSMC for an investigator-sponsored Phase 2b clinical study of SYN-010 to be co-funded by us and CSMC. The Phase 2b study is being conducted out of the Medically Associated Science and Technology (MAST) Program at CSMC and is a 12-week, placebo-controlled, double-blind, randomized clinical trial to evaluate two dose strengths of oral SYN-010 21 mg and 42 mg in as many as 150 patients diagnosed with IBS-C using a breath methane screening level as a criterion for patient enrollment.

The primary objective for the study is to determine the efficacy of SYN-010, measured as an improvement from baseline in the weekly average number of complete spontaneous bowel movements (CSBMs) during the 12-week treatment period for SYN-010 21 mg and 42 mg daily doses relative to placebo. Secondary efficacy endpoints for both dose strengths of SYN-010 will measure changes from baseline in abdominal pain, bloating, stool frequency as well as the use of rescue medication relative to placebo. Exploratory outcomes include Adequate Relief and quality of life measures using the well-validated EQ-5D-5L and PAC-SYM patient questionnaires.

Importantly, this study will aim to generate a comprehensive and meaningful data set to provide additional insights and address specific queries into potential SYN-010 clinical efficacy, including dose response, length of treatment and microbiome effects, intended to be evaluated in the FDA-agreed Phase 2b/3 adaptive design clinical program. We believe outcomes from this clinical trial are important to solidifying existing clinical outcomes data, and potentially simplifying and reducing costs for future Phase 3 clinical development. Generating such a data set requires rigorous screening criteria in order to obtain reliable baseline parameters that includes foregoing current constipation interventions for a period of time prior to breath methane screening. This has proven challenging for a portion of prospective participants leading to higher than anticipated and inadvertent patient-related screen-fail rates for IBS-C patients who presented at screening with breath-methane levels below the protocol-required ten parts-per-million. During the first quarter of 2020, we met with the study investigators at CSMC and, following some discussion, we collectively determined that generating a meaningful data set may be possible with a smaller patient population than previously anticipated. We believe the successful completion of this study will allow us to re-engage with prospective partners, both domestically and abroad, who found the results from our previously completed Phase 2 studies compelling and have indicated their interest in reviewing a more robust and meaningful clinical data set.

Enrollment in this study commenced in January 2019 and was temporarily halted during the first and second quarter of 2020 due to the unique challenges posed by the global COVID-19 pandemic which required CSMC to temporarily limit all non-essential activities, directly impacting their ability to actively recruit and screen new patients. During this time, active study participants who did not complete the study prior to the decision to halt all non-essential activities were given the opportunity to complete the study as CSMC took steps to ensure data from this group was collected in accordance with the clinical trial protocol. The recruitment of new patients into this trial has since recommenced, however, the ability to continue to recruit new patients into this clinical trial remains at the discretion of CSMC and contingent upon the COVID-19 global pandemic. A data readout in the form of an interim futility analysis is anticipated during the third quarter of 2020 and topline data is anticipated during the first quarter of 2021, subject to COVID-19.

SYN-020 — Oral Intestinal Alkaline Phosphatase

SYN-020 is a quality-controlled, recombinant version of bovine Intestinal Alkaline Phosphatase (IAP) produced under cGMP conditions and formulated for oral delivery. The published literature indicates that IAP functions to diminish GI inflammation, tighten the gut barrier to diminish “leaky gut,” promote a healthy microbiome, and diminish GI and systemic inflammation. Based on these known mechanisms as well as our own supporting animal model data, we are initially developing SYN-020 to mitigate the intestinal damage caused by radiation therapy that is routinely used to treat pelvic cancers, including the treatment and prevention of radiation enteropathy secondary to cancer therapy. Despite its broad therapeutic potential, a key hurdle to commercialization has been the high cost of IAP manufacture which is commercially available for as much as $10,000 per gram. We believe we have developed technologies to traverse this hurdle and now have the ability to produce more than 3 grams per liter of SYN-020 for roughly a few hundred dollars per gram at commercial scale.

~~On June 30, 2020~~ Based on the known mechanisms as well as our own supporting animal model data, we ~~submitted an Investigational New Drug (IND) application~~intended to initially develop SYN-020 to mitigate the intestinal damage caused by radiation therapy that is routinely used to treat pelvic cancers. And, while we believe SYN-020 may play a pivotal role in addressing acute and long-term complications associated with radiation exposure to the ~~FDA~~GI tract, we have begun planning to develop SYN-020 in ~~support~~indications that may offer a more accelerated or streamlined pathway to registration while also addressing significant unmet medical needs. Such indications include celiac disease, non-alcoholic fatty liver disease (“NAFLD”), and indications to treat and prevent metabolic and inflammatory disorders associated with aging which are supported by our collaboration with Massachusetts General Hospital (“MGH”). Across the six major markets, the total prevalent cases of celiac disease are expected to increase from 5.8 million cases in 2013 to an ~~initial indication for~~expected 8.1 million cases in 2023, representing an annual growth rate of approximately 4%. During the ~~treatment of radiation enteropathy secondary~~same period, prevalent cases in the U.S. are expected to ~~pelvic cancer therapy. On July 30, 2020 we announced that we received~~increase from 2.8 million in 2013 to an expected 4.3 million in 2023, representing a study-may-proceed letter from the FDA to conduct a Phase 1 single ascending dose study in healthy volunteers designed to evaluate SYN-020 for safety, tolerability and pharmacokinetic parameters. The Phase 1 clinical program is intended to support the clinical development of SYN-020 for multiple indications.significant market opportunity.

During the second quarter of 2020, we ~~also~~ announced that we entered into an agreement with Massachusetts General Hospital ~~(“MGH”)~~ granting us an option for an exclusive license to intellectual property and technology related to the use of IAP to maintain GI and microbiome health, diminish systemic inflammation, and treat age-related diseases. Research published by a team of investigators led by Richard Hodin, MD, Chief of the Massachusetts General Hospital Division of General and Gastrointestinal Surgery and Professor of Surgery, Harvard Medical School, evaluated long-term oral supplementation of IAP, including SYN-020, in mice. Dr. Hodin’s research demonstrated that IAP administration, starting at 10 months of age, slowed the microbiome changes, gut-barrier dysfunction, and gastrointestinal and systemic inflammation that normally accompany aging. Additionally, the IAP administration resulted in improved metabolic profiles in the aged mice, diminished frailty, and extended lifespan. Under the terms of the agreement, we are granted exclusive rights to negotiate a worldwide license with MGH to commercially develop SYN-020 to treat and prevent metabolic and inflammatory diseases associated with aging. If executed, we plan to use this license in the advancement of an expanded clinical development program for SYN-020.

On June 30, 2020, we submitted an IND application to the FDA in support of an initial indication for the treatment of radiation enteropathy secondary to pelvic cancer therapy. On July 30, 2020, we announced that we received a study-may-proceed letter from the FDA to conduct a Phase 1a single-ascending-dose (“SAD”) study in healthy volunteers designed to evaluate SYN-020 for safety, tolerability and pharmacokinetic parameters. On April 1, 2021, we announced that enrollment had commenced and three out of a total of four cohorts have been dosed in the Phase 1a SAD clinical trial of SYN-020. In ~~addition, we continue to explore and evaluate potential future indications~~all, twenty-four healthy adult volunteers will be enrolled, all of which will receive oral SYN-020. A topline data announcement from this clinical trial is expected during the third quarter of 2021. Planning for ~~use~~a second Phase 1a study evaluating multiple-ascending doses (“MAD”) of SYN-020 ~~in chronic inflammatory diseases such as inflammatory bowel disease (IBD), Celiac disease, Crohn’s disease~~is also underway and ~~metabolic syndrome, where decreased IAP expression and impairment~~anticipated to commence during the third quarter of 2021. A topline data readout of the ~~intestinal barrier has been linked~~Phase 1a MAD clinical study is anticipated during the first quarter of 2022, pandemic conditions permitting. Following the completion of Phase 1 safety studies, we may consider conducting a placebo-controlled Phase 1b/2a gluten challenge study in as many as 40 celiac patients who present with predominantly GI symptoms followed by a ~~causative factor.~~Phase 2b proof-of-concept clinical trial in a similar patient population. We may also seek to initiate clinical trials of SYN-020 evaluating its potential therapeutic benefit in NAFLD patients.

Intellectual Property

All of our programs are supported by growing patent ~~estates that we either own or exclusively license. Each potential product has issued patents that provide protection.~~estates. In total, we have over ~~110~~80 U.S. and foreign patents and over ~~100~~65 U.S. and foreign patents pending. The SYN-004 (ribaxamase) program is supported by IP that is assigned to Synthetic Biologics, namely U.S. patents and foreign patents (in most major markets, e.g. Europe (including Germany, Great Britain and France), Japan, China and Canada, among others) and U.S. and foreign patents pending in most major markets, e.g. Europe (including Germany, Great Britain and France), Japan, China and Canada, among others). For instance, U.S. Patent Nos. 8,894,994 and 9,587,234, which include claims to compositions of matter and pharmaceutical compositions of beta-lactamases, including SYN-004 (ribaxamase), have patent terms to at least 2031. Further, U.S. Patent 9,301,995 and 9,301,996, both of which will expire in 2031, cover various uses of beta-lactamases, including SYN-004 (ribaxamase), in protecting the microbiome, and U.S. Patent Nos. 9,290,754, 9,376,673, 9,404,103, 9,464,280, and 9,695,409 which will expire in at least 2035, covers further beta-lactamase compositions of matter related to SYN-004 (ribaxamase).

The ~~SYN-010~~SYN-020 (oral intestinal alkaline phosphatase (IAP)) program is supported by IP that is ~~exclusively licensed~~assigned to ~~(and, in some cases co-owned by)~~ Synthetic Biologics, namely U.S. ~~patents~~ and foreign ~~patents~~patent applications (in ~~most~~many major markets, e.g. Europe, ~~(including Germany, Great Britain~~Canada, and ~~France),~~Australia). These patent applications, which cover various formulations, medical uses and Canada, among others) and U.S. and foreign patents pending in most major markets, e.g. Europe (including Germany, Great Britain and France), Japan, China and Canada, among others). For instance, U.S. Patent No. 9,192,618, which expires in at least 2023, includes claims that cover usemanufacture of statins, including SYN-010, for the treatment of IBS-C. U.S. Patent No. 9,289,418, which expires in at least 2033, includes claims that cover the use of a variety of compounds, including the active agent of SYN-010,SYN-020, are expected to treat constipation in certain screened patients. U.S. Patent No. 9,744,208 covers methods of use of the active agent of SYN-010 for the treatment of constipation until at least 2034. U.S. Patent No. 9,956,292 includes claims related to composition of matter of anti-methanogenic compositions that find use in treating IBS-C and will expire in ~~at least 2035. Further,~~ ~~U.S. Patent No. 10,328,151, covers the composition of matter of the SYN-010 clinical agent~~2038-2040, if granted, and ~~U.S. Patent~~ ~~10,519,515covers methods of treating IBS-C with a statin, inclusive of SYN-010, in a selected patient population.~~without taking potential patent term extensions or patent term adjustment into account.

Our goal is to (i) obtain, maintain, and enforce patent protection for our products, formulations, processes, methods, and other proprietary technologies, (ii) preserve our trade secrets, and (iii) operate without infringing on the proprietary rights of other parties worldwide. We seek, where appropriate, the broadest intellectual property protection for product candidates, proprietary information, and proprietary technology through a combination of contractual arrangements and patents.

Critical Accounting Policies

The condensed consolidated financial statements are prepared in conformity with U.S. GAAP, which requires the use of estimates, judgments and assumptions that affect the reported amounts of assets and liabilities, the disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements, and the reported amounts of revenues and expenses in the periods presented. We believe that the accounting estimates employed are appropriate and resulting balances are reasonable; however, due to inherent uncertainties in making estimates, actual results may differ from the original estimates, requiring adjustments to these balances in future periods. The critical accounting estimates that affect the condensed consolidated financial statements and the judgments and assumptions used are consistent with those described under Part II, Item 7 of our ~~2019~~2020 Form 10-K.

Results of Operations

Three Months Ended ~~June 30,~~March 31, 2021 and 2020 ~~and 2019~~

General and Administrative Expenses

General and administrative expenses increased by ~~23%~~2% to ~~$1.3~~approximately $1.42 million for the three months ended ~~June 30, 2020,~~March 31, 2021, from ~~$1.0~~approximately $1.39 million for the three months ended ~~June 30, 2019.~~March 31, 2020. This increase is primarily due to ~~increased~~higher insurance costs, audit fees, and legal costs offset by a reduction in patent related ~~to business development, patent execution~~legal fees, consulting fees and ~~employee contract matters, vacation expense, and insurance costs.~~travel expense. The charge related to stock-based compensation expense was ~~$67,000~~$82,000 for the three months ended ~~June 30, 2020,~~March 31, 2021, compared to ~~$59,000~~$65,000 the three months ended ~~June 30, 2019.~~March 31, 2020.

Research and Development Expenses

Research and development expenses decreased by ~~38%~~32% to approximately $1.1 million for the three months ended March 31, 2021, from approximately $1.6 million for the three months ended ~~June 30, 2020, from $2.6 million for the three months ended June 30, 2019.~~March 31, 2020. This decrease is primarily the result of lower indirect program costs for the ~~response to~~three months ended March 31, 2021, including salary and related expense reductions, a decrease in manufacturing costs for SYN-020 and market research. In addition, as a result of the global COVID-19 pandemic, by our clinical development ~~partners~~partner (Washington University) reduced their operating capacity during 2021 to include only essential activities as part of their pandemic response, which ~~has led~~delayed the start of our clinical trial, resulting in lower clinical trial expenses for the quarter. The research and development costs incurred during the quarter were primarily related to ~~the postponement~~our Phase 1a clinical trial of SYN-020 and the Phase 1b/2a clinical trial of SYN-004 (ribaxamase) in allogeneic HCT ~~recipients~~recipients. We anticipate research and ~~a temporary halt in new enrollment in the Phase 2b investigator sponsored~~development expense to increase as our ongoing clinical ~~trial of SYN-010.~~trials continue to enroll patients. The charge related to stock-based compensation expense was $19,000 for the three months ended ~~June 30, 2020,~~March 31, 2021, compared to ~~$31,000~~$18,000 related to stock-based compensation expense for the three months ended ~~June 30, 2019.~~March 31, 2020.

The following table sets forth our research and development expenses directly related to our therapeutic areas for the three months ended ~~June 30, 2020~~March 31, 2021 and ~~2019.~~2020. These direct expenses were external costs associated with preclinical studies and clinical trials. Indirect research and development expenses related to employee costs, facilities, stock-based compensation and research and development support services that are not directly allocated to specific drug candidates.

Therapeutic Areas	June 30, 2020		June 30, 2019		March 31, 2021		March 31, 2020
SYN-020					$	172	$	-
Ribaxamase						148		65
SYN-010	$	94	$	159		3		154
Ribaxamase		40		46
SYN-005		4		13		-		24

Total direct costs		138		218		323		243
Total indirect costs		1,465		2,376		794		1,392

Total Research and Development	$	1,603	$	2,594	$	1,117	$	1,635

Other Income/Expense

Other income was ~~$6,000~~$347 for the three months ended ~~June 30, 2020,~~March 31, 2021, compared to other income of ~~$80,000~~$38,000 for the three months ended ~~June 30, 2019.~~March 31, 2020. Other income for the three months ended ~~June 30,~~March 31, 2021 and 2020 ~~and 2019~~ is primarily comprised of interest income.

Net Loss Attributable to Common Stockholders

Our net loss attributable to common stockholders was ~~$3.3~~approximately $11.5 million, or ~~$0.18~~$0.13 per basic and dilutive common share for the three months ended ~~June 30, 2020,~~March 31, 2021, compared to a net loss of ~~$3.7~~approximately $3.4 million, or ~~$0.23~~$0.20 per basic common share and dilutive common share for the three months ended ~~June 30, 2019.~~March 31, 2020. Net loss attributable to common stockholders for the three months ended ~~June 30,~~March 31, 2021 excludes net loss attributable to non-controlling interest of $1,000 and includes the accretion of the Series B preferred discount of $1.5 million on converted shares, Series A Preferred Stock accrued dividends of $24,000 and the deemed dividend for the effect of the Series A preferred shares price adjustment of $7.4 million. Net loss attributable to common stockholders for the three months ended March 31, 2020 excludes net loss attributable to non-controlling interest of ~~$16,000~~$24,000 and includes the accretion of Series B preferred discount of ~~$392,000~~$404,000 on converted shares and Series A Preferred Stock accrued dividends of $63,000. Net loss attributable to common stockholders for the three months ended June 30, 2019 excludes net loss attributable to non-controlling interest of $27,000 and includes the accretion of Series B preferred discount of $117,000 on converted shares and $61,000 of Series A accrued dividends.$62,000.

~~Six Months Ended June 30, 2020 and 2019~~

~~General and Administrative Expenses~~

General and administrative expenses increased by 22% to $2.7 million for the six months ended June 30, 2020, from $2.2 million for the six months ended June 30, 2019. This increase is primarily due to increased legal costs related to business development, patent execution and employee contract matters, vacation expense, insurance costs and registration fees. The charge related to stock-based compensation expense was $132,000 for the six months ended June 30, 2020, compared to $125,000 for the six months ended June 30, 2019.

~~Research and Development Expenses~~

Research and development expenses decreased by 35% to $3.2 million for the six months ended June 30, 2020, from $5.0 million for the six months ended June 30, 2019. This decrease is primarily the result of the response to the global COVID-19 pandemic by our clinical development partners which has led to the postponement of the Phase 1b/2a clinical trial of SYN-004 (ribaxamase) in allogeneic HCT recipients and a temporary halt in new enrollment in the Phase 2b investigator sponsored clinical trial of SYN-010. Research and development expenses also include a charge relating to stock-based compensation expense of $37,000 for the six months ended June 30, 2020, compared to $30,000 for the six months ended June 30, 2019.

The following table sets forth our research and development expenses directly related to our therapeutic areas for the six months ended June 30, 2020 and 2019. These direct expenses were external costs associated with preclinical studies and clinical trials. Indirect research and development expenses related to employee costs, facilities, stock-based compensation and research and development support services that are not directly allocated to specific drug candidates.

Therapeutic Areas June 30, 2020 June 30, 2019
SYN-010 $ 248 $ 253
SYN-004 (ribaxamase) 105 112
Other therapeutic areas 28 16
Total direct costs 381 381
Total indirect costs 2,857 4,631

Total Research and Development Expenses $ 3,238 $ 5,012

~~Other Income~~

Other income was $44,000 for the six months ended June 30, 2020, compared to other income of $125,000 for the six months ended June 30, 2019. Other income for the six months ended June 30, 2020 and 2019 is primarily comprised of interest income.

~~Net Loss Attributable to Common Stockholders~~

Our net loss attributable to common stockholders was $6.8 million, or $0.38 per basic and dilutive common share for the six months ended June 30, 2020, compared to a net loss of $7.7 million, or $0.48 per basic common share and dilutive common share for the six months ended June 30, 2019. Net loss attributable to common stockholders for the six months ended June 30, 2020 excludes net loss attributable to non-controlling interest of $42,000 and includes the accretion of Series B preferred discount of $796,000 on converted shares and Series A Preferred Stock accrued dividends of $125,000. Net loss attributable to common stockholders for the six months ended June 30, 2019 excludes net loss attributable to non-controlling interest of $43,000 and includes the accretion of Series B preferred discount of $515,000 on converted shares and $122,000 of Series A accrued dividends.

Liquidity and Capital Resources

With the exception of the three months ended June 30, 2010 and the three months ended December 31, 2017, we have experienced significant losses since inception, incurred negative cash flows from operations, and have a significant accumulated deficit. We have incurred an accumulated deficit of ~~$242.3~~$259.6 million as of ~~June 30, 2020~~March 31, 2021 and expect to continue to incur losses in the foreseeable future. Our ability to continue as a going concern is dependent upon our ability to raise additional debt and equity capital. There can be no assurance that such capital will be available in sufficient amounts or on terms acceptable to us. These factors raise substantial doubt about our ability to continue as a going concern.

We do not have sufficient capital to fund our operations beyond the next twelve months. In order to address our capital needs, including our planned clinical trials, we are actively pursuing additional equity or debt financing in the form of either a private placement or a public offering. We have been in ongoing discussions with strategic institutional investors and investment banks with respect to such possible offerings. Such additional financing opportunities might not be available to us when and if needed, on acceptable terms or at all. If we are unable to obtain additional financing in sufficient amounts or on acceptable terms under such circumstances, our operating results and prospects will be adversely affected.

Our cash and cash equivalents totaled ~~$8.1~~$76.9 million as of ~~June 30, 2020, a decrease~~March 31, 2021, an increase of ~~$7.0~~$70.6 million from December 31, ~~2019.~~2020. During the three months ended ~~June 30, 2020,~~March 31, 2021, the primary use of cash was for working capital requirements and operating activities which resulted in a net loss of ~~$2.9~~$2.5 million for the three months ended ~~June 30, 2020. With~~March 31, 2021. During the three months ended March 31, 2021, we raised approximately $74.0 million from cash ~~available~~received via the exercise of approximately 65% of the 2018 Warrants and sales of our common stock in ~~early August 2020,~~“at the market offerings pursuant to the Sales Agreement that we had entered into in 2016 with FBR Capital Markets & Co. (now known as B. Riley Securities) (the “Original ATM Sales Agreement”) and the Amended and Restated ATM Sales Agreement. At March 31, 2021 our cash position was $76.9 million, which we believe ~~these resources~~ will be sufficient to fund our operations through at least the end of the first quarter of ~~2021.~~2023.

As a result of the global COVID-19 pandemic, ~~management has the ability to further extend its cash runway since its~~our clinical development ~~partners (Cedars-Sinai Medical Center (CSMC) and Washington~~partner (Washington University) reduced their operating capacity during ~~the second quarter of~~ 2020 and 2021 to include only essential activities as part of their pandemic response. These delays impacted the timelines for our clinical programs, which excluded all planned and ongoing clinical trials of SYN-004 and SYN-010. However, our planned clinical trial timelines will be adversely impacted. We anticipate reduced research and development costs through the endincluded delaying commencement of the ~~year, since we anticipate that our proposed~~ Phase 1b/2a clinical trial ~~to be~~of SYN-004 until the second quarter of 2021. These delays also resulted in a decrease in expenses as no clinical trials had yet commenced during that period. If enrollment in our ongoing Phase 1b/2a clinical trial being conducted by Washington University ~~will be postponed until 2021, subject~~is halted due to ~~further~~ COVID-19 developments, ~~and~~ we ~~anticipate slower~~may experience reduced expenses until such time as enrollment than anticipated in our Phase 2b investigator-sponsored clinical study of SYN-010 conducted by CSMC due to the pandemic. We anticipate our current cash will allow us to cover overhead costs, manufacturing costs for clinical supply, commercial scale up costs and limited research efforts, including completing our funding requirements for our ongoing Phase 2b investigator-sponsored clinical study of SYN-010, and the initiation of the Phase 1b/2a SYN-004 (ribaxamase) clinical trial. Due to the unique challenges posed by the global COVID-19 pandemic, we have determined that postponing the commencement of the planned Phase 1b/2a clinical study of SYN-004 (ribaxamase) in allogeneic HCT recipients until the first quarter of 2021 remains the appropriate response to the novel coronavirus pandemic. We do not anticipate any additional expense related to the Phase 1b/2a SYN-004 (ribaxamase) clinical trial until the trial is cleared for commencement by Washington University. Commencement of planned future Phase 3 clinical trials of SYN-004 and SYN-010 are subject to our successful pursuit of opportunities that will allow us to establish the clinical infrastructure and financial resources necessary to successfully initiate and complete our plan. We will be required to obtain additional funding in order to continue the development of our current product candidates beyond our Phase 2b investigator-sponsored clinical study of SYN-010 and our planned Phase 1b/2a clinical study of SYN-004 in allogeneic HCT recipients within the anticipated time periods, if at all, and to continue to fund operations at the current cash expenditure levels. Currently, we do not have commitments from any third parties to provide us with capital. If we fail to obtain additional funding for our clinical trials, whether through the sale of securities or a partner or collaborator, and otherwise when needed, we will not be able to fully execute our business plan as planned and we will be forced to cease certain development activities until funding is received and our business will suffer, which would have a material adverse effect on our financial position, results of operations and cash flows.resumes.

~~While~~Although we are experiencing limited, if any, adverse impact to our financial ~~impacts at this time, given~~stability stemming from the global economic slowdown, the overall disruption of global healthcare systems and ~~the~~ other risks and uncertainties associated with the COVID-19 pandemic, including uncertainty regarding our clinical timelines, our business, financial condition, results of operations and growth prospects could be materially adversely affected.

Historically, we have financed our operations primarily through public and private sales of our securities, and we expect to continue to seek toand obtain ~~our required~~additional capital in a similar manner. During the year ended December 31, ~~2019 and the six months ended June 30,~~ 2020, we did not engage in any financing activity as our financings conducted during the year ended December 31, 2018 were sufficient to satisfy our cash needs during 2019 and the six months ended June 30, 2020. During the year ended December 31, 2018, our only ~~sources~~source of ~~funding were~~financing was from ~~our underwritten public offering (the “Offering”) described below pursuant to which we received net proceeds of approximately $16.7 million and~~ sales of ~~3.5~~9.2 million shares of our ~~Common Stock in~~common stock utilizing our at-the-market offering program through the ~~FBR~~Original ATM Sales Agreement pursuant to which we received net proceeds of approximately ~~$12.2~~$3.4 million. During the three months ended March 31, 2021, we received proceeds of approximately $8.0 million from the cash exercise of approximately 11.6 million of our 2018 warrants and sold approximately 78.7 million shares of our common stock for net proceeds of approximately $66.0 million pursuant to the Original ATM Sales Agreement and the Amended and Restated ATM Sales Agreement.

The ~~FBR~~Amended and Restated ATM Sales Agreement enables us to offer and sell shares of our ~~Common Stock~~common stock from time to time through ~~FBR Capital Markets & Co.~~B Riley and AGP as our sales ~~agent, provided that we meet certain conditions.~~agents. Sales of ~~Common Stock~~common stock under the ~~FBR~~Amended and Restated ATM Sales Agreement are made in sales deemed to be ~~“at-the-market” equity offerings~~an “at the market offering” as defined in Rule 415 promulgated under the Securities Act. ~~FBR Capital Markets & Co. is~~B Riley and AGP are entitled to receive a commission rate of up to 3.0% of gross sales in connection with the sale of our ~~Common Stock~~common stock sold on our behalf.

On October 15, 2018, we closed the Offering pursuant to which we received gross proceeds of approximately $18.6 million before deducting underwriting discounts, commissions and other offering expenses payable by us and sold an aggregate of (i) 2,520,000 Class A Units (the “Class A Units”), with each Class A Unit consisting of one share of Common Stock, and one five-year warrant to purchase one share of Common Stock at an exercise price of $1.38 per share (the “October 2018 Warrants”), with each Class A Unit offered to the public at a public offering price of $1.15, and (ii) 15,723 Class B Units (the “Class B Units), with each Class B Unit offered to the public at a public offering price of $1,000 per Class B Unit and consisting of one share of our Series B Convertible Preferred Stock (the “Series B Preferred Stock”), with a stated value of $1,000 and convertible into shares of Common Stock at the stated value divided by a conversion price of $1.15 per share, with all shares of Series B Preferred Stock convertible into an aggregate of 13,672,173 shares of Common Stock, and issued with an aggregate of 13,672,173 October 2018 Warrants. A.G.P./Alliance Global Partners (the “Underwriters”) acted as sole book-running manager for the Offering. In addition, pursuant to the Underwriting Agreement that we entered into with the Underwriters on October 10, 2018, we granted the Underwriters a 45 day option (the “Over-allotment Option”) to purchase up to an additional 2,428,825 shares of Common Stock and/or additional October 2018 Warrants to purchase an additional 2,428,825 shares of Common Stock. The Underwriters partially exercised the Over-allotment Option by electing to purchase from us additional October 2018 Warrants to purchase 1,807,826 shares of Common Stock. The Units were offered by us pursuant to a registration statement on Form S-1 (File No. 333-227400), as amended, filed with the SEC, which was declared effective by the SEC on October 10, 2018. As of December 31, 2019, 8,085 shares of Series B Preferred Stock have been converted to Common Stock and 7,638 shares of Series B Preferred Stock remain outstanding.

We have spent, and expect to continue to spend, a substantial amount of funds in connection with implementing our business strategy, including our planned product development efforts, preparation for our planned clinical trials, performance of clinical trials and our research and discovery efforts. Based on our current plans, our cash and cash equivalents will not be sufficient to enable us to meet our long-term expected plans as it is anticipated that we will not have enough cash to continue our operations beyond the next twelve months. We will be required to obtain additional funding in order to continue the development of certain product candidates within the anticipated time periods, if at all, and to continue to fund operations at the current cash expenditure levels.

Our ability to continue as a going concern is dependent upon our ability to raise additional capital. Our cash and cash equivalents will not be sufficient to enable us to meet our long-term expected plans, including initiation or completion of future registrational studies for SYN-010, potential Phase 3 clinical programs of SYN-004 (ribaxamase) for prevention of CDI and/or the prevention of aGVHD in allogeneic HCT recipients, or later-stage clinical trials of SYN-020. Therefore, we do not intend to commence future registrational studies of SYN-010, Phase 3 clinical programs of SYN-004 (ribaxamase) for prevention of CDI and/or the prevention of aGVHD in allogeneic HCT recipients, or later-stage clinical trials of SYN-020 until we are confident that we have funding necessary to complete such trials. We are actively pursuing additional equity or debt financing, in the form of either a private placement or a public offering and have been in ongoing discussions with strategic institutional investors and investment banks with respect to such possible offerings. However, we do not currently have commitments from any third parties to provide us with capital. Potential sources of financing that we are pursuing include strategic relationships, public or private sales of our equity (including through the FBR Sales Agreement) or debt and other sources. Such additional financing opportunities might not be available to the Company when and if needed, on acceptable terms or at all. We cannot assure that we will meet the requirements for use of the FBR Sales Agreement especially in light of the fact that we are currently limited by rules of the SEC as to the number of shares of Common Stock that we can sell pursuant to the FBR Sales Agreement due to the market value of our Common Stock held by non-affiliates. Even if we meet the requirements for use of the FBR Sales Agreement, there There can be no assurance that we will be able to continue to raise funds through the sale of shares of ~~Common Stock~~common stock through the ~~FBR~~Amended and Restated ATM Sales Agreement. Additionally, we may seek to access the public or private equity markets when conditions are favorable due to our long-term capital requirements. If we are unable to obtain additional capital (which is not assured at this time), our long-term business plan may not be accomplished and we may be forced to cease certain development activities. More specifically, the completion of future Phase 3 and/or registrational clinical studies will require significant financing or a significant partnership. If we raise funds by selling additional shares of ~~Common Stock~~common stock or other securities convertible into ~~Common Stock,~~common stock, the ownership interest of our existing stockholders will be diluted. If we are not able to obtain funding for future clinical trials when needed, we will be unable to carry out our business plan and we will be forced to delay the initiation of future clinical trials until such time as we obtain adequate ~~financing~~financing.

We have committed, and expect to continue to commit, substantial capital in order to implement our business strategy, including our planned product development efforts, preparation for our planned clinical trials, and performance of clinical trials and our ~~operating results~~research and ~~prospects will be adversely affected.~~

~~Following~~discovery efforts. We believe our cash position of $76.9. million as of March 31, 2021 is sufficient to fund our operations through at least the ~~completion~~end of the first quarter of 2023, including continuation of our ongoing ~~Phase 2b clinical study of SYN-010, our planned~~ Phase 1b/2a clinical study of SYN-004 (ribaxamase) in allogeneic HCT recipients for the prevention of aGVHD, as well as our ongoing Phase 1 SAD study and planned ~~IND filing~~Phase 1 MAD study and Phase 2 clinical programs for SYN-020.

Following the anticipated completion of our ongoing Phase 1b/2a clinical study of SYN-004 (ribaxamase) in allogeneic HCT recipients, the ongoing Phase 1 SAD and planned MAD studies and planned Phase 2a clinical trial of SYN-020, we ~~will~~may need to obtain additional funds for future clinical ~~trials.~~trials, the amount of which will depend upon the trial size and number of clinical sites. We anticipate that our future clinical trials will be much larger in size and require larger cash expenditures than the ~~current investigator sponsored Phase 2b study of SYN-010 or the planned Phase 1b/2a~~aforementioned clinical ~~trial of SYN-004 (ribaxamase) to be conducted by Washington University.~~programs. We do not have any committed sources of financing for future clinical trials at this time, and it is uncertain whether additional funding will be available when we need it on terms that will be acceptable to us, or at all.

On January 30, 2020, the World Health Organization (WHO) announced a global health emergency because of a new strain of coronavirus originating in Wuhan, China (the COVID-19 outbreak) and the risks to the international community as the virus spreads globally beyond its point of origin. In March 2020, the WHO classified the COVID-19 outbreak as a pandemic, based on the rapid increase in exposure globally. As the COVID-19 coronavirus continues to spread around the globe, we have experienced disruptions that ~~impact~~impacted our business and clinical trials, including ~~halting the enrollment of new patients in our ongoing Phase 2b investigator-sponsored clinical trial of SYN-010 clinical study and~~ postponement of ~~clinical site initiation~~commencement of the now ongoing Phase 1b/2a clinical trial of SYN-004. The full impact of the COVID-19 outbreak continues to evolve as of the date of this report. As such, it is uncertain as to the full magnitude that the pandemic will have on our financial condition, liquidity, and future results of operations. We are actively monitoring the global situation and its potential impact on our financial condition, liquidity, operations, suppliers, industry, and workforce. Given the daily evolution of the COVID-19 outbreak and the global responses to curb its spread, we are not able to estimate the future effects of the COVID-19 outbreak on our results of operations, financial condition, or liquidity.

Off-Balance Sheet Arrangements

During the three ~~and six~~ months ended ~~June 30, 2020,~~March 31, 2021, we did not have, and we do not currently have, any off-balance sheet arrangements, as defined under SEC rules.

Contractual Obligations

Leases

At the inception of a contract we determine if the arrangement is, or contains, a lease. Right-of-use (“ROU”) assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. ROU assets and liabilities are recognized at the commencement date based on the present value of lease payments over the lease term.

We have made certain accounting policy elections whereby we (i) do not recognize ROU assets or lease liabilities for short-term leases (those with original terms of 12-months or less) and (ii) combine lease and non-lease elements of our operating leases. ROU assets are included in other noncurrent assets and lease liabilities are included in other current and non-current liabilities in our condensed consolidated balance sheets. As of ~~June 30, 2020,~~March 31, 2021, we did not have any material finance leases.

ITEM 3. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK.

The primary objective of our investment activities is to preserve our capital to fund operations. We also seek to maximize income from our investments without assuming significant risk. Our exposure to market risk is confined to our cash and cash equivalents. As of ~~June 30, 2020,~~March 31, 2021, our cash and cash equivalents consisted primarily of investments in treasury securities. We do not engage in any hedging activities against changes in interest rates. Due to the short-term duration of our investment portfolio and the low risk profile of our investments, we would not expect our operating results or cash flows to be affected to any significant degree by the effect of a sudden change in market interest rates or credit conditions on our securities portfolio. We may, however, require additional financing to fund future obligations and no assurance can be given that the terms of future sources of financing will not expose us to material market risk.

ITEM 4. CONTROLS AND PROCEDURES.

(a) Evaluation of Disclosure Controls and Procedures

The Company has adopted and maintains disclosure controls and procedures (as defined Rules 13a-15(e) and 15d-15(e) under the Exchange Act) that are designed to provide reasonable assurance that information required to be disclosed in the reports filed under the Exchange Act, such as this Quarterly Report on Form 10-Q, is collected, recorded, processed, summarized and reported within the time periods specified in the rules of the SEC. The Company’s disclosure controls and procedures are also designed to ensure that such information is accumulated and communicated to management to allow timely decisions regarding required disclosure. As required under Exchange Act Rule 13a-15, the Company’s management, including the Chief Executive Officer, who also serves as the Chief Financial Officer, after evaluating the effectiveness of our disclosure controls and procedures as of ~~June 30, 2020,~~March 31, 2021, the end of the period covered by this Quarterly Report on Form 10-Q, has concluded that based on such evaluation, the Company’s disclosure controls and procedures are effective as of ~~June 30, 2020~~March 31, 2021 to ensure that information required to be disclosed by the Company in the reports that the Company files or submits under the Exchange Act is recorded, processed, summarized and reported within the time periods specified in the SEC’s rules and forms, and that such information is accumulated and communicated to the Company’s management, including the Company’s Chief Executive Officer and Chief Financial Officer, as appropriate, to allow timely decisions regarding required disclosure.

(b) Changes in Internal Control over Financial Reporting

There have not been any changes in our internal controls over financial reporting during the three months ended ~~June 30, 2020~~March 31, 2021 that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

PART II–OTHER INFORMATION

ITEM 1. LEGAL PROCEEDINGS.

From time to time we may become involved in legal proceedings or be subject to claims arising in the ordinary course of our business. We are not presently a party to any legal proceedings that, if determined adversely to us, would individually or taken together have a material adverse effect on our business, operating results, financial condition or cash flows. Regardless of the outcome, litigation can have an adverse impact on us because of defense and settlement costs, diversion of management resources and other factors.

ITEM 1A. RISK FACTORS.

The following information updates, and should be read in conjunction with, the information disclosed in Part I, Item 1A, “Risk Factors,” contained in our ~~2019~~2020 Form 10-K. Except as disclosed below, there have been no material changes from the risk factors disclosed in our ~~2019~~2020 Form 10-K.

RISKS RELATING TO OUR BUSINESS

Our auditor’s report on our consolidated financial statements for the years ended December 31, 2019 and 2018 contains an explanatory paragraph regarding our ability to continue as a going concern and the notes to our financial statements for the quarter ended June 30, 2020 mention there being substantial doubt about our ability to continue as a going concern.

Our consolidated financial statements as of December 31, 2019 have been prepared under the assumption that we will continue as a going concern for the next twelve months. In addition, our independent registered public accounting firm has issued a report that includes an explanatory paragraph referring to our recurring losses from operations (anticipated continued losses in the future) and net capital deficiency that raise substantial doubt about our ability to continue as a going concern without additional capital becoming available. Our consolidated financial statements as of December 31, 2019 did not include any adjustments that might result from the outcome of this uncertainty.

The consolidated financial statements for the quarter ended June 30, 2020 have been prepared assuming we will continue as a going concern. We continue to incur losses and, as of June 30, 2020, we had an accumulated deficit of approximately $242.3 million. Our consolidated financial statements as of June 30, 2020 do not include any adjustments that might result from the outcome of this uncertainty.

Our ability to continue as a going concern is dependent upon our ability to raise additional debt and equity capital. There can be no assurance that such capital will be available in sufficient amounts or on terms acceptable to us. These factors raise substantial doubt about our ability to continue as a going concern.

We will need to raise additional capital to operate our business and our failure to obtain funding when needed may force us to delay, reduce or eliminate our development programs or commercialization efforts. In addition, potential capital raises and strategic opportunities may require the issuance of additional securities.

During the ~~six~~three months ended ~~June 30, 2020,~~March 31, 2021, our operating activities used net cash of approximately ~~$7.0~~$3.3 million and our cash and cash equivalents were ~~$8.1~~approximately $76.9 million as of ~~June 30, 2020.~~March 31, 2021. With the exception of the three months ended June 30, 2010 and the three months ended December 31, 2017, we have experienced significant losses since inception and have a significant accumulated deficit. As of ~~June 30, 2020,~~March 31, 2021, our accumulated deficit totaled approximately ~~$242.3~~$259.6 million on a consolidated basis. ~~We do not have sufficient capital to fund our operations beyond twelve months following the issuance date of this Quarterly Report on Form 10-Q.~~ We expect to incur additional operating losses in the future and therefore expect our cumulative losses to increase. With the exception of the quarter ended September 30, 2010, and limited laboratory revenues from Adeona Clinical Laboratory, which we sold in March 2012, we have generated very minimal revenues. We do not expect to derive revenue from any source in the near future until we or our potential partners successfully commercialize our ~~products.~~products, if ever. We expect our expenses to increase in connection with our anticipated activities, particularly as we continue research and development, initiate and conduct later stage clinical trials, ~~recommence clinical trials that have been on hold or postponed~~ and seek marketing approval for our product candidates. Until such time as we receive approval from the FDA and other regulatory authorities for our product candidates, we will not be permitted to sell our products and therefore we will not have product revenues from the sale of products. For the foreseeable future we will have to fund all of our operations and capital expenditures from equity and debt offerings, cash on hand, licensing and collaboration fees and grants, if any.

We will need to raise additional capital to fund our operations and meet our current timelines and we cannot be certain that funding will be available on acceptable terms on a timely basis, or at all. Any failure to raise additional capital as and when needed, as a result of insufficient authorized shares or otherwise, could have a negative impact on our financial condition and on our ability to pursue our business plans and strategies. Based on our current plans, our cash and cash equivalents will ~~not~~ be sufficient to complete our planned Phase 31a/2a clinical trial ~~for~~of SYN-004, or our planned Phase 31 single-ascending and multiple-ascending dose clinical trials of SYN-020, and a potential Phase 2a clinical trial of SYN-020 but, may not be sufficient for ~~SYN-010,~~post-Phase 2a future clinical programs for SYN-020 or additional trials of SYN-004, which are expected to require significant cash expenditures. In addition, based on the significant anticipated ~~significant~~ cost of a Phase 3 clinical program in a broad indication for SYN-004, we expect it will not be feasible for us to initiate and complete this trial at this time without a partner given the capital constraints tied to our current market cap and share price. In addition, based on the anticipated cost of our planned Phase 3 clinical trial for SYN-010, we expect that we may also reach the same determination regarding the feasibility of initiating and completing the trial without a partner given the capital constraints tied to our current market cap and share price at such time. To the extent that we raise additional funds by issuing equity securities, our stockholders may experience significant dilution. We may also issue shares of our common stock in connection with strategic opportunities. However, our remaining authorized and unissued shares of common stock available may be insufficient to complete potential future equity financing transactions and/or strategic transactions we may seek to undertake. Accordingly, we anticipate taking steps, when appropriate, to increase our number of available shares which may have the effect of facilitating such transactions. Any debt financing, if available, may involve restrictive covenants that may impact our ability to conduct our business and also have a dilutive effect on our stockholders. A failure otherwise to secure additional funds when needed in the future whether through an equity or debt financing or a sufficient amount of capital without a strategic partnership could result in us being unable to complete planned preclinical and clinical trials or obtain approval of our product candidates from the FDA and other regulatory authorities. In addition, we could be forced to delay, discontinue or curtail product development, forego sales and marketing efforts, and forego licensing in attractive business opportunities. Our ability to raise capital through the sale of securities is currently limited by the rules of the SEC and NYSE American that place limits on the number and dollar amount of securities that may be sold. There can be no assurances that we will be able to raise the funds needed, especially in light of the fact that our ability to sell securities registered on registration statement Form S-3 will be limited until such time the market value of our voting securities held by non-affiliates is $75 million or more. We also may be required to seek collaborators for our product candidates at an earlier stage than otherwise would be desirable and on terms that are less favorable than might otherwise be available.

The ~~COVID-19 global health crisis~~market price of our common stock has ~~impacted our planned operations, including our clinical studies~~been and may continue to be volatile and adversely affected by various factors.

Our stock price has fluctuated in the past, has recently been volatile and may be volatile in the future. By way of example, on February 8, 2021, the price of our common stock closed at $1.17 per share while on April 19, 2021, our stock price closed at $0.52 per share with no discernable announcements or developments by the company or third parties. On February 9, 2021, the intra-day sales price of our common stock fluctuated between a reported low sale price of $0.91 and a reported high sales price of $1.19. We may incur rapid and substantial decreases in our stock price in the foreseeable future that are unrelated to our operating performance or prospects. In ~~January 2020,~~addition, the ~~World Health Organization declared a global pandemic for~~recent outbreak of the novel strain of coronavirus ~~COVID-19. Since then,~~(COVID-19) has caused broad stock market and industry fluctuations. The stock market in general and the ~~COVID-19 coronavirus has spread to multiple countries, including throughout the United States. We~~market for biotechnology and pharmaceutical companies in particular have experienced ~~disruptions~~extreme volatility that ~~have impacted~~has often been unrelated to the operating performance of particular companies. As a result of this volatility, investors may experience losses on their investment in our ~~business~~common stock. The market price of our common stock could fluctuate significantly in response to various factors and ~~clinical trials and expect to experience additional disruptions as the pandemic continues,~~events, including:

~~halting enrollment of new patients into our SYN-010 clinical study during~~

	·	investor reaction to our business strategy;

	·	the success of competitive products or technologies;

	·	our continued compliance with the listing standards of the NYSE American;

	·	regulatory or legal developments in the United States and other countries, especially changes in laws or regulations applicable to our products;

	·	results of our clinical trials;

	·	actions taken by regulatory agencies with respect to our products, clinical studies, manufacturing process or sales and marketing terms;

	·	variations in our financial results or those of companies that are perceived to be similar to us;

	·	the success of our efforts to acquire or in-license additional products or product candidates;

	·	developments concerning our collaborations or partners;

	·	developments or disputes concerning patents or other proprietary rights, including patents, litigation matters and our ability to obtain patent protection for our products;

	·	our ability or inability to raise additional capital and the terms on which we raise it;

	·	declines in the market prices of stocks generally;

	·	trading volume of our common stock;

	·	sales of our common stock by us or our stockholders;

	·	general economic, industry and market conditions; and

	·	other events or factors, including those resulting from such events, or the prospect of such events, including war, terrorism and other international conflicts, public health issues including health epidemics or pandemics, such as the recent outbreak of the novel coronavirus (COVID-19), and natural disasters such as fire, hurricanes, earthquakes, tornados or other adverse weather and climate conditions, whether occurring in the United States or elsewhere, could disrupt our operations, disrupt the operations of our suppliers or result in political or economic instability.

These broad market and industry factors may seriously harm the ~~first and second quarter of 2020;~~

~~unwillingness of potential study participants to enroll in new clinical trials and/or visit healthcare facilities;~~

~~postponement in clinical site initiation for our SYN-004 clinical study;~~

~~diversion of healthcare resources away from the conduct of clinical trials, including the diversion of hospitals serving as our clinical trial sites and hospital staff supporting the conduct~~market price of our ~~clinical trials;~~

interruption of key clinical trial activities, such as clinical site visits by study participants and clinical trial site monitoring, due to limitations on travel imposed or recommended by federal or state governments, employers and others;

~~limitations in employee resources that would otherwise be focused on the conduct~~common stock, regardless of our ~~clinical trials, including because~~operating performance. Further, recent increases are significantly inconsistent with any improvements in actual or expected operating performance, financial condition or other indicators of ~~sickness~~value. Since the stock price of ~~employees or their families or~~our common stock has fluctuated in the ~~desire of employees to avoid contact with large groups of people;~~

~~delays~~past, has been recently volatile and may be volatile in ~~receiving approval from local regulatory authorities to initiate our planned clinical trials;~~

~~delays in clinical sites receiving~~ the ~~supplies and materials needed to conduct our clinical trials;~~

~~interruption in global shipping that may affect the transport of clinical trial materials, such as investigational drug product used~~future, investors in our ~~clinical trials;~~

~~changes in local regulations as part~~common stock could incur substantial losses. In the past, following periods of a response to the COVID-19 coronavirus outbreak which may require us to change the ways in which our clinical trials are conducted, which may result in unexpected costs, or to discontinue the clinical trials altogether;

delays in necessary interactions with local regulators, ethics committees and other important agencies and contractors due to limitations in employee resources or forced furlough of government employees;

~~delay~~volatility in the timing of interactions with the FDA due to absenteeism by federal employees or by the diversion of their efforts and attention to approval of other therapeutics or other activities related to COVID-19.

~~Our business and the business of the suppliers of our clinical product candidates~~market, securities class-action litigation has often been ~~and is expected to continue to be materially and adversely affected by the pandemic.~~instituted against companies. Such ~~events~~litigation, if instituted against us, could result in ~~the complete or partial closure~~substantial costs and diversion of ~~clinical trial sites, one or more manufacturing facilities~~management’s attention and resources, which could impact our supply of our clinical product candidates. In addition, it could impact economies and financial markets, resulting in an economic downturn that could impact our ability to raise capital or slow down potential partnering relationships.

In response to the spread of COVID-19 as well as public health directives and orders, we have implemented a number of measures designed to ensure employee safety and business continuity. We have limited access to our offices and are allowing our administrative employees to continue their work outside of our offices in order to support the community efforts to reduce the transmission of COVID-19 and protect employees, complying with guidance from federal, state and local government and health authorities. The effects of the governmental orders and our work-from-home policies may negatively impact productivity, disrupt our business and delay our clinical programs and timelines, the magnitude of which will depend, in part, on the length and severity of the restrictions and other limitations on our ability to conduct our business in the ordinary course.

In addition. the COVID-19 outbreak could disrupt our operations due to absenteeism by infected or ill members of management or other employees, or absenteeism by members of management and other employees who elect not to come to work due to the illness affecting others in our office, or due to quarantines. The COVID-19 illness could also impact members of our Board of Directors resulting in absenteeism from meetings of the directors or committees of directors, and making it more difficult to convene the quorums of the full Board of Directors or its committees needed to conduct meetings for the management of our affairs.

The global outbreak of the virus continues to rapidly evolve. The extent to which the virus may impact our business and clinical trials will depend on future developments, which are highly uncertain and cannot be predicted with confidence, such as the ultimate geographic spread of the disease, the duration of the outbreak, travel restrictions and social distancing in the United States, business closures or business disruptions and the effectiveness of actions taken in the United States and other countries to contain and treat the disease. We do not yet know the full extent of potential delays or impacts on our business, operations, or the global economy as a whole. While the spread of COVID-19 may eventually be contained or mitigated, there is no guarantee that a future outbreak of this or any other widespread epidemics will not occur, or that the global economy will recover, either of which could seriously harm our business.

~~Difficulties enrolling patients in our clinical trials or delays in enrollment are expected to result in our clinical development activities being delayed or otherwise adversely affected.~~

~~Delays in patient enrollment may result in increased cost or may adversely affect timing or outcome of planned clinical trials, which could prevent completion of these trials~~materially and adversely affect our ~~ability to advance the development~~business, financial condition, results of ~~our product candidates. In some cases, generating meaningful clinical data may require rigorous screening criteria which may result in unintended~~operations and higher than anticipated patient-related screen-fail rates, as has occurred with our current investigator-sponsored Phase 2b clinical study conducted by CSMC. This can lead to delays in completion of clinical trials as well as additional expense for recruitment of patients. In addition, the COVID-19 pandemic may result in fewer technicians being available to conduct clinical testing for patients currently enrolled in our clinical trial.

~~Delays in clinical testing could result in increased costs to us and delay our ability to generate revenue.~~

We recently have experienced delays in clinical testing of our product candidates due to COVID-19 and may in the future experience other delays. We do not know when the planned SYN-004 clinical trial will initiate or when the SYN-010 clinical trial will recommence enrollment. These delays may result in the need for trials to be redesigned and will impact whether they will be completed on schedule, if at all. Clinical trialsgrowth prospects. There can be delayed for a variety of reasons, including the COVID-19 pandemic, delays in obtaining regulatory approval to commence a clinical trial, in securing clinical trial agreements with prospective sites with acceptable terms, in obtaining institutional review board approval to conduct a clinical trial at a prospective site, in recruiting patients to participate in a clinical trial or in obtaining sufficient supplies of clinical trial materials. Manufacturing considerations for clinical development candidates may include an expected several month lead time following a decision to commence any clinical trial(s) and capacity considerations of our third-party contract manufacturers to provide clinical supply of our product candidates could cause delays in clinical trials. Many factors affect patient enrollment, including the size of the patient population, the proximity of patients to clinical sites, the eligibility criteria for the clinical trial, competing clinical trials and new drugs approved for the conditions we are investigating. Clinical investigators will need to decide whether to offer their patients enrollment in clinical trials of our product candidates versus treating these patients with commercially available drugsno guarantee that have established safety and efficacy profiles. Any delays in completing our clinical trials will increase our costs, slow down our product development and timeliness and approval process and delay our ability to generate revenue.

~~RISKS RELATING TO OUR SECURITIES~~

We cannot assure you that our Common Stock will be liquid or that it will remain listed on the NYSE American. A failure to regain compliance with the NYSE American stockholders’ equity listing requirements or failure to continue to meet the other listing requirements could result in a de-listing of our Common Stock.

Our Common Stock is listed on the NYSE American. The NYSE American’s listing standards generally mandate that we meet certain requirements relating to stockholders’ equity, stock price, market capitalization, aggregate market value of publicly held shares and distribution requirements. We cannot assure you that we will be able to maintain the continued listing standards of the NYSE American. The NYSE American requires companies to meet certain continued listing criteria including a minimum stockholders’ equity of $6.0 million if an issuer has sustained losses from continuing operations and/or net losses in its five most recent years, as outlined in the NYSE American Company Guide. At June 30, 2020, we had a stockholders’ deficit of $6.8 million. The NYSE American Company Guide also states that the NYSE normally will not consider removing from listing securities of an issuer with total value of market capitalization of at least $50.0 million and 1,100,000 shares publicly held, a market value of publicly held shares of at least $15.0 million and 400 round lot shareholders. Although we have more than 1,100,000 shares publicly held and 400 round lot shareholders, our stock price ~~is volatile~~will remain at current prices or that future sales of our common stock will not be at prices lower than those sold to investors.

Additionally, recently, securities of certain companies have experienced significant and ~~during~~extreme volatility in stock price due short to sellers of shares of common stock, known as a “short squeeze.” These short squeezes have caused extreme volatility in those companies and in the ~~first two quarters of 2018,~~market and have led to the price per share of ~~our Common Stock experienced~~those companies to trade at a ~~sustained decrease resulting in a period where our market capitalization fell below $50.0 million. Our market capitalization~~significantly inflated rate that is ~~currently below $50.0 million~~

~~On November 25, 2019, we announced that we received written communication~~disconnected from the NYSE American stating we were no longer in compliance with certain continued listing standards as set forth in the NYSE American Company Guide relating to stockholders’ equity as of September 30, 2019. Specifically, the Deficiency Letter stated that we were not in compliance with Section 1003(a)(iii) (requiring stockholders’ equity of $6.0 million or more if the Company has reported losses from continuing operations and/or net losses in its five most recent fiscal years). The Deficiency Letter noted that the Company had stockholders’ equity of $4.9 million as of September 30, 2019 and had reported net losses in its five most recent fiscal years. On December 20, 2019, we submitted a plan of compliance to the NYSE American outlining our plan to regain compliance with certain continued listing standards as set forth in Part 10, Section 1003(iii)underlying value of the ~~NYSE American Company Guide by November 25, 2020,~~company. Many investors who have purchased shares in those companies at an inflated price face the ~~conclusion~~risk of losing a significant portion of their original investment as the ~~compliance plan period. On February 7, 2020,~~price per share has declined steadily as interest in those stocks has abated. While we ~~received notice from~~have no reason to believe our shares would be the ~~NYSE American that it had accepted our plan and granted~~target of a plan period through November 25, 2020 to regain compliance. On July 30, 2020 we received written communication from NYSE American stating that in addition to Section 1003(iii), the Company is also not in compliance with Section 1003(i) and Section 1003(ii) of the NYSE American Company Guide since it reported a stockholders’ deficit of ($4.0) million as of March 31, 2020 and losses from continuing operations and/or net losses in its five most recent fiscal years ended December 31, 2019. As a result, the Company is now subject to the procedures and requirements set forth in Section 1009 of the Company Guide. The Company remains subject to the conditions set forth in the Exchange’s letter dated November 25, 2019 for the initial equity noncompliance. The NYSE Regulation staff will review our company periodically for compliance with the initiatives outlined in the plan. If we are not in compliance with the continued listing standards by November 25, 2020 or if we do not make progress consistent with the plan during the plan period, NYSE Regulation staff may initiate a delisting proceeding as appropriate.

~~There~~short squeeze, there can be no assurance that we can regain compliance with the listing standards of the NYSE American, or that the NYSE American will continue to list our Common Stock if we regain compliance, or if we continue to fail to maintain the minimum stockholders’ equity. In addition,won’t be in the future, and you may lose a significant portion or all of your investment if you purchase our shares at a price that is significantly disconnected from our underlying value.

We expect to seek to raise additional capital in the future, which may be dilutive to stockholders or impose operational restrictions.

We expect to seek to raise additional capital in the future to help fund development of our proposed products. If we raise additional capital through the issuance of equity or of debt securities, the percentage ownership of our current stockholders will be reduced. We may also enter into strategic transactions, issue equity as consideration for acquisitions or part of license issue fees to our licensors, compensate consultants or settle outstanding payables using equity that may be dilutive. We are authorized to issue 200,000,000 shares of common stock, of which 132,042,548 shares of common stock were issued and outstanding as of May 3, 2021. At May 3, 2021, we had reserved 10,342,384 shares of common stock for issuance upon exercise of our outstanding options and warrants. In addition, at such date, we had 2,460,000 shares of our common stock reserved for future issuance under our equity incentive plans. If all of these securities were to be exercised, the total number of shares of our common stock that we would be required to issue is 12,802,384, which in addition to the 132,042,548 shares issued and outstanding, would leave 55,155,068 authorized but unissued shares of common stock. As a result of our limited number of authorized and unissued shares of common stock, we may have insufficient shares of common stock available to issue in connection with any future equity financing transactions or strategic transactions we may seek to undertake. Accordingly, we anticipate taking steps, when appropriate, to increase our number of available shares which may have the effect of facilitating such transactions.

Our stockholders may experience additional dilution in net book value per share and any additional equity securities may have rights, preferences and privileges senior to those of the holders of our common stock.

In order to raise additional capital, we may in the future offer additional shares of our common stock or other securities convertible into or exchangeable for our common stock at prices that may not be ~~able~~the same as the price per share paid by existing stockholders, thereby subjecting such stockholders to ~~maintain such minimum stockholders’ equity and/~~dilution. We may sell shares or ~~issue additional equity~~other securities in ~~exchange for cash~~any other offering at a price per share that is less than the price per share paid by existing stockholders, and investors purchasing shares or other ~~assets, if available,~~securities in the future could have rights superior to ~~maintain certain minimum stockholders’ equity required by~~existing stockholders. In the ~~NYSE American. If~~event that we ~~are delisted from~~sell shares or other securities at prices below the NYSE American then our Common Stock will trade, if at all, only on the over-the-counter market, such as the OTC Bulletin Board securities market, and then only if one or more registered broker-dealer market makers comply with quotation requirements. If our Common Stock is delisted from the NYSE American due to our failure to regain compliance with the listing standards by the endexercise price of the ~~compliance period or for any other reason,~~warrants that we issued in our October 2018 offering, the price protection anti-dilution provisions of the warrant provide that the exercise price of the warrants sold in our October 2018 offering is to be reduced which may result in additional warrant exercises and additional dilution to stockholders as was the case in 2020 and during the first quarter of 2021 when we utilized our at-the-market facility and the ~~market value~~warrant exercise price was reduced. The price per share at which we sell additional shares of our ~~shares of Common Stock held~~common stock, or securities convertible or exchangeable into common stock, in future transactions may be higher or lower than the price per share paid by non-affiliates remains below $15 million, we will likely no longer be eligible to sell Common Stock pursuant to the B. Riley FBR Sales Agreement or otherwise utilize our shelf registration statement. In addition, delisting of our Common Stock could depress our stock price, substantially limit liquidity of our Common Stock and materially adversely affect our ability to raise capital on terms acceptable to us, or at all. Delisting from the NYSE American could also have other negative results, including the potential loss of confidence by suppliers and employees, the loss of institutional investor interest and fewer business development opportunities. We cannot assure you that our Common Stock will be liquid or that it will remain listed on the NYSE American. A failure to regain compliance with the NYSE American stockholders’ equity requirements or failure to continue to meet the other listing requirements could result in a de-listing of our Common Stock.existing stockholders.

ITEM 2. UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS.

We did not sell any equity securities during the ~~three and six months~~quarter ended ~~June 30, 2020~~March 31, 2021 in transactions that were not registered under the Securities ~~Act.~~Act with the exception of February 9, 2021, in which the Company issued 531,614 shares of its common stock upon the conversion effected on such date by the holder of 4,764 shares of its Series A Convertible Preferred Stock. As of the date hereof, there are no outstanding shares of Series A Convertible Preferred Stock.

ITEM 3. DEFAULTS UPON SENIOR SECURITIES.

Not applicable.

ITEM 4. MINE SAFETY DISCLOSURES.

Not applicable.

ITEM 5. OTHER INFORMATION.

Not applicable

ITEM 6. EXHIBITS

The exhibits filed or furnished as part of this Quarterly Report on Form 10-Q are set forth on the Exhibit Index, which Exhibit Index is incorporated herein by reference.

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.

	SYNTHETIC BIOLOGICS, INC.

	By:	/s/ Steven A. Shallcross
		Steven A. Shallcross
		Chief Executive Officer, Chief Financial Officer
		(Principal Executive Officer, Principal Financial Officer and Principal Accounting Officer)

		Date: ~~August 6, 2020~~May 5, 2021

EXHIBIT INDEX

Exhibit Number		Exhibit Title
1.1		Amended and Restated At Market Issuance Sales Agreement dated February 9, 2021 by and among Synthetic Biologics, Inc. and B. Riley Securities, Inc. and A.G.P./Alliance Global Partners (Incorporated by reference to Exhibit 1.1 of the Registrant’s Current Report on Form 8-K filed February 10, 2021, File No. 001-12584.)

3.1		Certificate of Incorporation, as amended (Incorporated by reference to (i) Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed October 16, 2008, File No. 001-12584, (ii) Exhibit 3.1 of the Registrant’s Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2001 filed August 14, 2001, File No. 001-12584; and (iii) Exhibits 3.1, 4.1 and 4.2 of the Registrant’s Quarterly Report on Form 10-Q for the quarterly period ended June 30, 1998 filed August 14, 1998, File No. 001-12584.)

3.2		Articles of Merger (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed October 19, 2009, File No. 001-12584.)

3.3		Certificate of Merger filed with the Secretary of State of Delaware (Incorporated by reference to Exhibit 3.2 of the Registrant’s Current Report on Form 8-K filed October 19, 2009, File No. 001-12584.)

3.4		Articles of Incorporation filed with the Nevada Secretary of State (Incorporated by reference to Exhibit 3.3 of the Registrant’s Current Report on Form 8-K filed October 19, 2009, File No. 001-12584.)

3.5		Amended and Restated Bylaws Adopted and Effective October 31, 2011 (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed November 2, 2011, File No. 001-12584.)

3.6		Certificate of Amendment to Articles of Incorporation (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed February 16, 2012, File No. 001-12584.)

3.7		Certificate of Amendment to Certificate of Incorporation. (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed May 18, 2015, File No. 001-12584.)

3.8		Certificate of Amendment to Certificate of Incorporation. (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed September 8, 2017, File No. 001-12584.)

3.9		Certificate of Designations for Series A Preferred Stock to Certificate of Incorporation (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed September 12, 2017, File No. 001-12584.)

3.10		Certificate of Change Pursuant to NRS 78. 209 (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed August 13, 2018, File No. 001-12584.)

3.11		Certificate of Amendment to Articles of Incorporation (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed September 26, 2018, File No. 001-12584.)

3.12		Certificate of Designations for Series B Preferred Stock to Certificate of Incorporation (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K filed October 15, 2018, File No. 001-12584.)

3.13		Certificate of Amendment to Certificate of Designations for Series B Preferred Stock to Certificate of Incorporation (Incorporated by reference to Exhibit 3.2 of the Registrant’s Current Report on Form 8-K filed October 15, 2018, File No. 001-12584.)

3.14		Certificate of Amendment to the Certificate of Designation for the Series A Convertible Preferred Stock (Incorporated by reference to Exhibit 3.1 of the Registrant’s Current Report on Form 8-K/A filed on February 1, 2021 File No. 001-12584.)

31.1		Certification of Principal Executive Officer and Principal Financial Officer pursuant to Rule 13a-14(a)/15d-14(a)*

32.1		Certification of Principal Executive Officer and Principal Financial Officer pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002*

101.INS		XBRL Instance Document*

101.SCH		XBRL Taxonomy Extension Schema*

101.CAL		XBRL Taxonomy Extension Calculation Linkbase*

101.DEF		XBRL Taxonomy Extension Definition Linkbase*

101.LAB		XBRL Taxonomy Extension Label Linkbase*

101.PRE		XBRL Taxonomy Extension Presentation Linkbase*

*Filed herewith.

Nevada	13-3808303
(State or Other Jurisdiction of Incorporation or Organization)	(I.R.S. Employer Identification No.)

9605 Medical Center Drive, Suite 270
Rockville, MD	20850
(Address of Principal Executive Offices)	(Zip Code)

		Page
	PART I. FINANCIAL INFORMATION		3

Item 1.	Financial Statements (Unaudited)		3

	Condensed Consolidated Balance Sheets as of ~~June 30, 2020~~March 31, 2021 and December 31, ~~2019~~2020		3
	Condensed Consolidated Statements of Operations for the Three ~~and Six~~ Months ended ~~June 30,~~March 31, 2021 and 2020 ~~and 2019~~		4
	Condensed Consolidated Statements of Stockholders’ Equity (Deficit) for the ~~Six~~Three Months ended ~~June 30,~~March 31, 2021 and 2020 ~~and 2019~~		5
	Condensed Consolidated Statements of Cash Flows for the ~~Six~~Three Months ended ~~June 30,~~March 31, 2021 and 2020 ~~and 2019~~		6
	Notes to Condensed Consolidated Financial Statements		7
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations		2322
Item 3.	Quantitative and Qualitative Disclosures About Market Risk		3530
Item 4.	Controls and Procedures		3530

	PART II. OTHER INFORMATION		3531

Item 1.	Legal Proceedings		3531
Item 1A.	Risk Factors		3531
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds		3833
Item 3.	Defaults Upon Senior Securities		3933
Item 4.	Mine Safety Disclosures		3933
Item 5.	Other Information		3933
Item 6.	Exhibits		3933

SIGNATURES		4034

	June 30, 2020			December 31, 2019			March 31, 2021			December 31, 2020
Assets

Current Assets
Cash and cash equivalents	$	8,059		$	15,045		$	76,887		$	6,227
Prepaid expenses and other current assets		897			1,381			1,749			1,707
Total Current Assets		8,956			16,426			78,636			7,934

Property and equipment, net		251			367			156			174

Right of use asset		352			419			239			279

Deposits and other assets		23			23			23			23

Total Assets	$	9,582		$	17,235		$	79,054		$	8,410

Liabilities and Stockholders' Deficit

Current Liabilities:
Accounts payable	$	1,025		$	2,315		$	621		$	886
Accrued expenses		1,209			1,776			854			925
Accrued employee benefits		927			935			350			868
Lease liability		268			249
Operating lease liability								297			287
Total Current Liabilities		3,429			5,275			2122			2,966
Lease liability - Long term								108			186
Total Liabilities								2,230			3,152

Lease liability - Long term		334			473
Commitments and Contingencies

Total Liabilities		3,763			5,748
Series A convertible preferred stock, $0.001 par value; 10,000,000 shares authorized; 120,000 issued and outstanding		12,669			12,544
Stockholders' Deficit:
Series B convertible preferred stock, $1,000 par value; 10,000,000 shares authorized, 5,525 issued and outstanding and 7,638 issued and outstanding		3,444			4,761
Common Stock, $0.001 par value; 200,000,000 shares authorized, 18,646,152 and 16,808,758 issued and 18,643,824 and 16,806,430 outstanding		19			17
Series A convertible preferred stock, $0.001 par value; 10,000,000 shares authorized; 0 and 120,000 issued and outstanding as of March 31, 2021 and December 31, 2020, respectively								-			12,798
Stockholders' Equity (Deficit):
Series B convertible preferred stock, $1,000 par value; 10,000,000 shares authorized, 0 issued and outstanding and 3,973 issued and outstanding as of March 31, 2021 and December 31, 2020, respectively								-			2,477
Common stock, $0.001 par value; 200,000,000 shares authorized, 132,044,866 issued and 132,042,538 outstanding at March 31, 2021 and 29,252,253 issued and 29,249,925 outstanding at December 31, 2020								132			29
Additional paid-in capital		234,860			232,580			339,019			240,821
Accumulated deficit		(242,289	)		(235,537	)		(259,553	)		(248,094	)
Total Synthetic Biologics, Inc. and Subsidiaries Deficit		(3,966	)		1,821
Total Synthetic Biologics, Inc. and Subsidiaries Equity (Deficit)								79,598			(4,767	)
Non-controlling interest		(2,884	)		(2,878	)		(2,774	)		(2,773	)
Total Stockholders' Deficit		(6,850	)		(1,057	)
Total Stockholders' Equity (Deficit)								76,824			(7,540	)

Total Liabilities and Stockholders' Deficit	$	9,582		$	17,235
Total Liabilities and Stockholders' Equity (Deficit)							$	79,054		$	8,410

	For the three months ended June,						For the six months ended June 30,						For the three months ended March 31,
	2020			2019			2020			2019			2021			2020
Operating Costs and Expenses:
General and administrative	$	1,286		$	1,044		$	2,679		$	2,199		$	1,419		$	1,393
Research and development		1,603			2,594			3,238			5,012			1,118			1,635
Total Operating Costs and Expenses		2,889			3,638			5,917			7,211			2,537			3,028

Loss from Operations		(2,889	)		(3,638	)		(5,917	)		(7,211	)		(2,537	)		(3,028	)

Other Income:
Interest income		6			80			44			125			-			38
Total Other Income		6			80			44			125			-			38

Net Loss		(2,883	)		(3,558	)		(5,873	)		(7,086	)		(2,537	)		(2,990	)

Net Loss Attributable to Non-controlling Interest		(16	)		(27	)		(42	)		(43	)		(1	)		(26	)

Net Loss Attributable to Synthetic Biologics, Inc. and Subsidiaries	$	(2,867	)	$	(3,531	)	$	(5,831	)	$	(7,043	)	$	(2,536	)	$	(2,964	)

Series A Preferred Stock Dividends		(63	)		(61	)		(125	)		(122	)		(24	)		(62	)
Effect of Series A Preferred Stock price adjustment														(7,402	)		-
Series B Preferred Stock Dividends		(392	)		(117	)		(796	)		(515	)		(1,497	)		(404	)

Net Loss Attributable to Common Stockholders	$	(3,322	)	$	(3,709	)	$	(6,752	)	$	(7,680	)	$	(11,459	)	$	(3,430	)

Net Loss Per Share - Basic and Dilutive	$	(0.18	)	$	(0.23	)	$	(0.38	)	$	(0.48	)	$	(0.13	)	$	(0.20	)

Weighted average number of shares outstanding during the period - Basic and Dilutive		18,405,884			16,465,314			17,748,688			16,063,283			90,807,693			17,093,920

Title of each class		Trading Symbol(s)		Name of each exchange on which registered
Common Stock		SYN		NYSE American

	Common Stock $0.001 Par Value				Series B Preferred
	Shares		Amount		Shares			Amount			APIC		Accumulated Deficit			Non- Controlling Interest			Total Stockholders' Equity
Balance at December 31, 2019		16,806,430	$	17		7,638		$	4,761		$	232,580	$	(235,537	)	$	(2,878	)	$	(1,057	)

Stock-based compensation		-		-		-			-			83		-			-			83
Series A Preferred Stock Dividends ($0.01 per share)		-		-		-			-			-		(62	)		-			(62	)
Issuance of SYN Biomics Stock		-		-		-			-					-			26			26
Conversion of Series B Preferred Stock to Common ($0.03 per share)		933,045		1		(1,073	)		(669	)		1,072		(404	)		-			-
Net loss		-		-		-			-			-		(2,964	)		-			(2,964	)
Non-controlling interest		-		-		-			-			-		-			(26	)		(26	)

Balance at March 31, 2020		17,739,475	$	18		6,565		$	4,092		$	233,735	$	(238,967	)	$	(2,878	)	$	(4,000	)

Stock-based compensation		-		-		-			-			86		-			-			86
Series A Preferred Stock Dividends ($0.01 per share)		-		-		-			-			-		(63	)		-			(63	)
Issuance of SYN Biomics Stock		-		-		-			-			-		-			10			10
Conversion of Series B Preferred Stock to Common ($0.03 per share)		904,349		1		(1,040	)		(648	)		1,039		(392	)		-			-
Net loss		-		-		-			-			-		(2,867	)		-			(2,867	)
Non-controlling interest		-		-		-			-			-		-			(16	)		(16	)

Balance at June 30, 2020		18,643,824	$	19		5,525		$	3,444		$	234,860	$	(242,289	)	$	(2,884	)	$	(6,850	)

	Common Stock $0.001 Par Value				Series B Preferred								Accumulated			Non-Controlling			Total Stockholders'
	Shares		Amount		Shares			Amount			APIC		Deficit			Interest			Deficit
Balance at December 31, 2020		29,249,925	$	29		3,973		$	2,477		$	240,821	$	(248,094	)	$	(2,773	)	$	(7,540	)

Stock-based compensation		-		-		-			-			101		-			-			101
Stock issued under "at-the-market" offering		78,685,315		79		-			-			65,881		-			-			65,960
Warrants Exercised		11,655,747		12		-			-			8,030		-			-			8,042
Series A Preferred Stock Dividends		-		-		-			-			-		(24	)		-			(24	)
Effect of Series A Preferred Stock price adjustment		-		-		-			-			7,402		(7,402	)		-			-
Conversion of Series A Preferred Stock to Common		8,996,768		9		-			-			12,813		-			-			12,822
Conversion of Series B Preferred Stock to Common		3,454,783		3		(3,973	)		(2,477	)		3,971		(1,497	)		-			-
Net loss		-		-		-			-			-		(2,536	)		-			(2,536	)
Non-controlling interest		-		-		-			-			-		-			(1	)		(1	)

Balance at March 31, 2021		132,042,538	$	132		-		$	-		$	339,019	$	(259,553	)	$	(2,774	)	$	76,824

	·	~~the number and scope of its research programs;~~

	·	~~the ability to recruit patients for clinical studies in a timely manner;~~

	June 30, 2020		December 31, 2019		March 31, 2021		December 31, 2020
Prepaid clinical research organizations	$	471	$	48	$	1,138	$	470
Prepaid insurances		241		549		442		639
Prepaid consulting, subscriptions and other expenses						169		90
Stock sales receivable						-		469
Prepaid manufacturing expenses		94		622		-		39
Prepaid consulting, subscriptions and other expenses		91		134
Prepaid conferences, travel		-		25
Other receivables		-		3

Total	$	897	$	1,381	$	1,749	$	1,707

Exercise price	$	0.42
Expected dividends		0	%
Expected volatility		84	%
Risk free interest rate		1.61	%
Expected life of option		4.5 years

	Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life		Aggregate Intrinsic Value		Options			Weighted Average Exercise Price		Weighted Average Remaining Contractual Life		Aggregate Intrinsic Value
Balance - December 31, 2018		938,982		$	15.18		6.19 years	$	-

Granted		1,725,000			0.42
Exercised		-			-
Expired		(94,738	)		58.25
Forfeited		(67,232	)		5.95
Balance - December 31, 2019		2,502,012		$	3.62		6.51 years	$	153,353		2,502,012		$	3.62		6.51 years	$	153,353

Granted		-			-						1,540,000			0.42
Exercised		-			-						-			-
Expired		-			-						(14,944	)		17.57
Forfeited		(29,650	)		0.55						(29,650	)		0.55
Balance - December 31, 2020											3,997,418			2.35		6.09 years		-

Balance – June 30, 2020 - outstanding		2,472,362		$	3.65		5.98 years	$	158,270
Granted											-			-
Exercised											-			-
Expired											-			-
Forfeited											-			-

Balance – June 30, 2020 - exercisable		628,408		$	12.89		5.16 years	$	15,129
Balance - March 31, 2021 - outstanding											3,997,418		$	2.35		5.53 years	$	856,227

Grant date fair value of options granted – six months ended June 30, 2020				$	-
Balance - March 31, 2021 - exercisable											1,645,161		$	5.10		4.52 years	$	268,034

Weighted average grant date fair value – six months ended June 30, 2020				$	-
Grant date fair value of options granted – three months ended March 31, 2021													$	-

Grant date fair value of options granted – year ended December 31, 2019				$	470,000
Weighted average grant date fair value – three months ended March 31, 2021													$	-

Weighted average grant date fair value – year ended December 31, 2019				$	0.27
Grant date fair value of options granted – year ended December 31, 2020													$	412,000

Weighted average grant date fair value – year ended December 31, 2020													$	0.27

	Number of Warrants			Weighted Average Exercise Price		Number of Warrants			Weighted Average Exercise Price
Balance at December 31, 2018		18,915,851		$	3.85
Granted		-			-
Exercised		-			-
Forfeited		(200,852	)		61.25
Balance at December 31, 2019		18,714,999			3.24		18,714,999			3.24
Granted		-			-		-			-
Exercised		-			-		-			-
Forfeited		-			-		(714,286	)		50.05
Balance at June 30, 2020		18,714,999		$	3.24
Balance at December 31, 2020							18,000,713		$	0.69
Granted							-			-
Exercised							11,655,747			.69
Forfeited							-			-
Balance at March 31, 2021							6,344,966		$	.69

Exercise Price	Exercise Price	Warrants Outstanding		Warrants Exercisable		Weighted Average Remaining Contractual Life		Exercise Price	Warrants Outstanding		Warrants Exercisable		Weighted Average Remaining Contractual Life
$	1.38		17,999,999		17,999,999		3.28 years	0.69		6,344,252		6,344,252		2.53 years
	18.20		714		714		2.49 years	18.20		714		714		1.74 years
	50.05		714,286		714,286		0.39 years
$	3.24		18,714,999		18,714,999		3.17 years	0.69		6,344,966		6,344,966		2.53 years

Future undiscounted cash flow for the years ending December 31:
2020	$	156
Future undiscounted cash flow for the years ending March 31:
2021		321		$	242
2022		192			192
Total	$	669		$	434

Discount factor	$	(67	)	$	(29	)
Lease liability	$	602		$	405
Amount due within 12 months	$	(268	)	$	(297	)
Lease liability – long term	$	334		$	108

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