2 Key Catalysts Ahead for Developer of Psych Drugs
Research Report

1. As of the date of this article, officers, contractors, shareholders, and/or employees of Streetwise Reports LLC (including members of their household) own securities of Alto Neuroscience Inc.
2. Doresa Banning wrote this article for Streetwise Reports LLC and provides services to Streetwise Reports as an independent contractor.
3.  This article does not constitute investment advice and is not a solicitation for any investment. Streetwise Reports does not render general or specific investment advice and the information on Streetwise Reports should not be considered a recommendation to buy or sell any security. Each reader is encouraged to consult with his or her personal financial adviser and perform their own comprehensive investment research. By opening this page, each reader accepts and agrees to Streetwise Reports' terms of use and full legal disclaimer. Streetwise Reports does not endorse or recommend the business, products, services or securities of any company. 
4. This article does not constitute medical advice. Officers, employees and contributors to Streetwise Reports are not licensed medical professionals. Readers should always contact their healthcare professionals for medical advice.

For additional disclosures, please click here.

Disclosures for H.C. Wainwright & Co., Alto Neuroscience Inc., September 15, 2025

This material is confidential and intended for use by Institutional Accounts as defined in FINRA Rule 4512(c). It may also be privileged or otherwise protected by work product immunity or other legal rules. If you have received it by mistake, please let us know by e-mail reply to [email protected] and delete it from your system; you may not copy this message or disclose its contents to anyone. The integrity and security of this message cannot be guaranteed on the Internet. H.C. WAINWRIGHT & CO, LLC RATING SYSTEM: H.C. Wainwright employs a three tier rating system for evaluating both the potential return and risk associated with owning common equity shares of rated firms. The expected return of any given equity is measured on a RELATIVE basis of other companies in the same sector. The price objective is calculated to estimate the potential movements in price that a given equity could reach provided certain targets are met over a defined time horizon. Price objectives are subject to external factors including industry events and market volatility. RETURN ASSESSMENT Market Outperform (Buy): The common stock of the company is expected to outperform a passive index comprised of all the common stock of companies within the same sector. Market Perform (Neutral): The common stock of the company is expected to mimic the performance of a passive index comprised of all the common stock of companies within the same sector. Market Underperform (Sell): The common stock of the company is expected to underperform a passive index comprised of all the common stock of companies within the same sector. Rating and Price Target History for: Alto Neuroscience, Inc. (ANRO-US) as of 09-12-2025 25 20 15 10 5 0 Q2 Q3 2023 Q1 Q2 Q3 2024 Q1 Q2 Q3 2025 Q1 Q2 Q3 I:BUY:$10.00 04/07/25 Investment Banking Services include, but are not limited to, acting as a manager/co-manager in the underwriting or placement of securities, acting as financial advisor, and/or providing corporate finance or capital markets-related services to a company or one of its affiliates or subsidiaries within the past 12 months. Distribution of Ratings Table as of September 12, 2025 IB Service/Past 12 Months Ratings Count Percent Count Percent Buy 564 83.43% 112 19.86% Neutral 76 11.24% 12 15.79% Sell 2 0.30% 0 0.00% Under Review 34 5.03% 9 26.47% H.C. Wainwright & Co, LLC (the “Firm”) is a member of FINRA and SIPC and a registered U.S. Broker-Dealer. I, Patrick R. Trucchio, CFA , certify that 1) all of the views expressed in this report accurately reflect my personal views about any and all subject securities or issuers discussed; and 2) no part of my compensation was, is, or will be directly or indirectly related to the specific recommendation or views expressed in this research report; and 3) neither myself nor any members of my household is an officer, director or advisory board member of these companies. None of the research analysts or the research analyst’s household has a financial interest in the securities of Alto Neuroscience, Inc. (including, without limitation, any option, right, warrant, future, long or short position). As of August 31, 2025 neither the Firm nor its affiliates beneficially own 1% or more of any class of common equity securities of Alto Neuroscience, Inc.. Neither the research analyst nor the Firm knows or has reason to know of any other material conflict of interest at the time of publication of this research report.

The research analyst principally responsible for preparation of the report does not receive compensation that is based upon any specific investment banking services or transaction but is compensated based on factors including total revenue and profitability of the Firm, a substantial portion of which is derived from investment banking services. The firm or its affiliates received compensation from Alto Neuroscience, Inc. for non-investment banking services in the previous 12 months. The Firm or its affiliates did not receive compensation from Alto Neuroscience, Inc. for investment banking services within twelve months before, but will seek compensation from the companies mentioned in this report for investment banking services within three months following publication of the research report. The Firm does not make a market in Alto Neuroscience, Inc. as of the date of this research report. The securities of the company discussed in this report may be unsuitable for investors depending on their specific investment objectives and financial position. Past performance is no guarantee of future results. This report is offered for informational purposes only, and does not constitute an offer or solicitation to buy or sell any securities discussed herein in any jurisdiction where such would be prohibited. This research report is not intended to provide tax advice or to be used to provide tax advice to any person. Electronic versions of H.C. Wainwright & Co., LLC research reports are made available to all clients simultaneously. No part of this report may be reproduced in any form without the expressed permission of H.C. Wainwright & Co., LLC. Additional information available upon request. H.C. Wainwright & Co., LLC does not provide individually tailored investment advice in research reports. This research report is not intended to provide personal investment advice and it does not take into account the specific investment objectives, financial situation and the particular needs of any specific person. Investors should seek financial advice regarding the appropriateness of investing in financial instruments and implementing investment strategies discussed or recommended in this research report. H.C. Wainwright & Co., LLC’s and its affiliates’ salespeople, traders, and other professionals may provide oral or written market commentary or trading strategies that reflect opinions that are contrary to the opinions expressed in this research report. H.C. Wainwright & Co., LLC and its affiliates, officers, directors, and employees, excluding its analysts, will from time to time have long or short positions in, act as principal in, and buy or sell, the securities or derivatives (including options and warrants) thereof of covered companies referred to in this research report. The information contained herein is based on sources which we believe to be reliable but is not guaranteed by us as being accurate and does not purport to be a complete statement or summary of the available data on the company, industry or security discussed in the report. All opinions and estimates included in this report constitute the analyst’s judgment as of the date of this report and are subject to change without notice. Securities and other financial instruments discussed in this research report: may lose value; are not insured by the Federal Deposit Insurance Corporation; and are subject to investment risks, including possible loss of the principal amount invested.

Alto Neuroscience Inc.'s (ANRO:NYSE) management discussed its next two major catalysts at H.C. Wainwright & Co.'s 27th Annual Global Investment Conference on September 9, according to Analyst Patrick Trucchio in a September 15 research note.

"We reiterate our Buy rating and US$10 price target on ANRO," Trucchio wrote.

157% Return Implied

Compared to the US$10 per share target, the California-based biotech firm was trading at the time of Trucchio's report at about US$3.89 per share, the analyst noted. From this price, the return to target is 157%.

Alto has 27.1 million shares outstanding, a market cap of US$105 million, and a 52-week range of US$1.60–US$15.04 per share.

Precision Psychiatry Focus

Trucchio reported that Alto Neuroscience develops precision psychiatric treatments via a platform that analyzes neurobiological biomarkers, like electroencephalogram (EEG) activity, cognitive test results, and data from wearables, "to enrich trial populations and measure target engagement," the company's management team told H.C. Wainwright (HCW).

"This framework is designed to address high placebo response rates and improve trial efficiency," Trucchio explained.

Upcoming catalysts, which management discussed at the recent HCW conference, are linked to two of Alto's investigative new drugs, ALTO-101 and ALTO-207. Also, the Alto team stated the company has sufficient funds to see it through 2028, including four clinical trial readouts.

Catalyst No. 1: Trial Readout

In the current half-year, topline data are expected from Alto's Phase 2 proof-of-concept trial of ALTO-101 in cognitive impairment associated with schizophrenia (CIAS), Trucchio reported. This investigative drug is a transdermal brain-penetrant phosphodiesterase-4 (PDE4) inhibitor.

Management emphasized that the 10-day crossover trial is designed to show biomarker engagement versus short-interval cognitive change. Management pointed out that the primary EEG biomarker in the trial, independent replication of theta intertrial coherence, that it reported on Sept. 9, bolsters its confidence in the results ahead of the data readout.

"While expectations remain pragmatic given the challenges in CIAS, we believe a clear biomarker signal would mark important progress in a field with no approved treatments," Trucchio wrote.

Catalyst No. 2: Start of Trial

In mid-2026, Alto is expected to initiate a Phase 2b clinical trial of ALTO-207 in broad treatment-resistant depression (TRD), reported Trucchio. ALTO-207 is a combination of Pramipexole, a dopamine D2/D3 agonist, and Ondansetron, 5-HT3 receptor antagonist. The company is advancing this program under the 505(b)(2) regulatory pathway.

The study will include predefined biomarkers for efficacy and tolerability, "allowing for potential enrichment in later studies while still aiming for broad TRD labeling," the analyst noted. The benchmark, a three-point separation on the Montgomery-Asberg Depression Rating Scale, is credible, the analyst wrote.

If this Phase 2b trial demonstrates a statistically significant benefit, then the program could move to a single Phase 3. For the upcoming Phase 2b, however, Alto has yet to finalize patient enrollment numbers and drug dosing, which it will do after meeting with the U.S. Food and Drug Administration.

"Commercially, management expects ALTO-207 to be positioned early in the TRD treatment pathway as a simpler, more scalable option relative to procedure-based therapies," Trucchio wrote.