0000950170-23-021821 | 10-Q | XBRL Viewer | Eloxx Pharmaceuticals INC

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Prepaid Expenses and Other Current Assets - Schedule of Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Deferred Costs Capitalized Prepaid And Other Assets Disclosure [Abstract]
Research and development	$ 307	$ 366
Insurance	672	93
Other	259	202
Total	$ 1,238	$ 661

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Cash flows from operating activities:
Net loss	$ (6,230)	$ (11,620)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation	597	922
Depreciation	15	21
Amortization of operating lease right-of-use asset	171	177
Amortization of debt discount	120	124
Change in fair value of derivative liabilities	13	270
Loss on extinguishment of debt	406	0
Changes in operating assets and liabilities:
Prepaid expenses and other assets	(577)	(1,169)
Accounts payable	(586)	1,525
Accrued expenses	(569)	434
Operating lease liabilities	(174)	(175)
Net cash used in operating activities	(6,814)	(9,491)
Cash flows from investing activities:
Proceeds from sale of property and equipment	11	0
Purchases of property and equipment	0	(11)
Net cash (used in) provided by investing activities	11	(11)
Cash flows from financing activities:
Repayment of term loan principal	(7,500)	0
Proceeds from advances from collaboration partners	0	7,000
Net cash (used in) provided by financing activities	(7,500)	7,000
Decrease in cash, cash equivalents and restricted cash	(14,303)	(2,502)
Cash, cash equivalents and restricted cash at the beginning of the period	19,468	42,567
Cash, cash equivalents and restricted cash at the end of the period	5,165	40,065
Reconciliation of cash, cash equivalents and restricted cash to condensed consolidated balance sheets:
Cash and cash equivalents	4,904	39,768
Restricted cash	261	297
Total cash, cash equivalents and restricted cash	5,165	40,065
Supplemental disclosure of cash flow activities:
Cash paid for interest	$ 430	$ 297

Accrued Expenses (Tables)

3 Months Ended

Mar. 31, 2023

Payables And Accruals [Abstract]

Accrued expenses

Accrued expenses consisted of the following (in thousands):


	March 31, 2023		December 31, 2022
Research and development expenses	$	1,576	$	1,544
Payroll and other employee-related expenses		144		750
Professional services		215		225
Interest on debt		81		146
Other		214		134
Total	$	2,230	$	2,799

Debt (Tables)

3 Months Ended

Mar. 31, 2023

Debt Disclosure [Abstract]

Schedule of Future Principal Payments for Long-Term Debt


	At March 31,
	2023
Principal payments
2023	$	906
2024		2,988
2025		1,106
Total future principal payments		5,000
Less unamortized discount		(256	)
Carrying value of long-term debt		4,744
Less current portion of long-term debt		(1,536	)
Final fee due at maturity in 2025		819
Long-term portion	$	4,027

Property and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Property Plant And Equipment [Abstract]
Depreciation expenses	$ 15	$ 21
Property and equipment sold	$ 11

Advances From Collaboration Partners, Legal and Other Contingencies - Additional Information (Detail) $ in Thousands	1 Months Ended		3 Months Ended
	Mar. 31, 2022 USD ($)	May 31, 2021 USD ($)	Mar. 31, 2023 USD ($) Time	Dec. 31, 2022 USD ($)
Advances from collaboration partners			$ 12,535	$ 12,535
Royalties percentage of net sales based on actual amount of funding			6.00%
Maximum [Member]
Related party transaction percentage of expenses			5.00%
Two Thousand Nineteen Cystic Fibrosis Foundation Award [Member]
Advances from collaboration partners			$ 11,900	11,900
Two Thousand Nineteen Cystic Fibrosis Foundation Award [Member] \| Maximum [Member]
Funding award amount received			$ 3,600
Two Thousand Twenty Two Cystic Fibrosis Foundation Agreement [Member]
Number of times amount of funds received \| Time			3
Two Thousand Twenty Two Cystic Fibrosis Foundation Agreement [Member] \| Elox - Liabilities [Member]
Advances from collaboration partners			$ 58	45
Embedded derivative, gain (loss) on embedded derivative, net			$ 13
Two Thousand Twenty Two Cystic Fibrosis Foundation Agreement [Member] \| Elox - Cystic Fibrosis Foundation [Member]
Percentage Of Consideration Received For Disposition Event			10.00%
Two Thousand Twenty Two Cystic Fibrosis Foundation Agreement [Member] \| Elox - Cystic Fibrosis Foundation [Member] \| Elox - Phase Two Clinical Development [Member]
Remaining amount of award payable upon achievement certain clinical development milestones			$ 7,400
Two Thousand Twenty Two Cystic Fibrosis Foundation Agreement [Member] \| Elox - Cystic Fibrosis Foundation [Member] \| Elox - Phase Two Clinical Development [Member] \| Maximum [Member]
Award to fund development milestones	$ 15,900
Two Thousand Twenty One Cystic Fibrosis Foundation Award [Member]
Advances from collaboration partners			$ 600	$ 600
Two Thousand Twenty One Cystic Fibrosis Foundation Award [Member] \| Maximum [Member]
Funding award amount received		$ 2,600
Two Thousand Twenty One Cystic Fibrosis Foundation Award [Member] \| Elox - Cystic Fibrosis Foundation [Member]
Percentage Of Consideration Received For Disposition Event			20.00%
Percentage of sale or license event			10.00%

Debt - Schedule of Future Principal Payments for Long-Term Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
2023	$ 906
2024	2,988
2025	1,106
Total future principal payments	5,000
Less unamortized discount	(256)
Carrying value of long-term debt	4,744
Less current portion of long-term debt	(1,536)	$ (3,980)
Final fee due at maturity in 2023	819
Long-term portion	$ 4,027	$ 8,557

Other Expense, Net (Tables)

3 Months Ended

Mar. 31, 2023

Other Income And Expenses [Abstract]

Schedule of Other expense (income), net

Other expense, net consisted of the following (in thousands):


	Three Months Ended March 31,
	2023			2022
Interest and other expense	$	485		$	404
Interest and other income		(168	)		(14	)
Loss on debt extinguishment		406			—
Foreign currency exchange losses		11			7
Change in fair value of derivative liabilities		13			270
Total other expense, net	$	747		$	667

Property and Equipment - Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 331	$ 349
Less accumulated depreciation and amortization	(188)	(180)
Property and equipment, net	143	169
Computers and software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	26	26
Office furniture and equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	15	15
Laboratory equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	233	251
Leasehold improvement [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment, at cost	$ 57	$ 57

Net Loss Per Share - Schedule of Net Loss and Weighted Average Number of Shares Used in Computing Basic and Diluted Net Loss Per Share (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Numerator:
Net loss	$ (6,230)	$ (11,620)
Denominator:
Weighted average number of shares of common stock used in computing net loss per share, basic	2,166,356	2,166,275
Weighted average number of shares of common stock used in computing net loss per share, diluted	2,166,356	2,166,275
Net loss per share, basic	$ (2.88)	$ (5.36)
Net loss per share, diluted	$ (2.88)	$ (5.36)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

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+ Details

Stock-based Compensation - Summary of Allocated Stock-based Compensation Expense (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 597	$ 922
Research and Development Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	288	360
General and Administrative Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 309	$ 562

Basis of Presentation and Significant Accounting Policies (Policies)

3 Months Ended

Mar. 31, 2023

Accounting Policies [Abstract]

Recent Accounting Pronouncements

Although the FASB has issued several ASUs for which adoption dates are pending, the Company does not expect any to have any impacts on its consolidated financial statements.

UNAUDITED CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 4,904	$ 19,207
Restricted cash	261	261
Prepaid expenses and other current assets	1,238	661
Total current assets	6,403	20,129
Property and equipment, net	143	169
Operating lease right-of-use asset	654	825
Total assets	7,200	21,123
Current liabilities:
Accounts payable	2,434	3,020
Accrued expenses	2,230	2,799
Current portion of long-term debt	1,536	3,980
Advances from collaboration partners	12,535	12,535
Current portion of operating lease liability	667	712
Derivative liabilities	58	45
Total current liabilities	19,460	23,091
Long-term debt, net of current portion	4,027	8,557
Operating lease liability	6	135
Total liabilities	23,493	31,783
Commitments and contingencies
Stockholders' deficit:
Preferred stock, $0.01 par value per share, 5,000,000 shares authorized, no shares issued or outstanding as of March 31, 2023 and December 31, 2022	0	0
Common stock, $0.01 par value per share, 500,000,000 shares authorized,2,166,356 shares issued and outstanding as of March 31, 2023 and December 31, 2022	22	22
Additional paid-in capital	264,303	263,706
Accumulated deficit	(280,618)	(274,388)
Total stockholders' (deficit) equity	(16,293)	(10,660)
Total liabilities and stockholders' deficit	$ 7,200	$ 21,123

Nature of the Business - Additional Information (Detail) - USD ($) $ in Thousands	May 31, 2023	Mar. 07, 2023	Mar. 31, 2023	Dec. 31, 2022	Sep. 30, 2021
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Accumulated deficit			$ 280,618	$ 274,388
Aggregate principal amount of initial loan advance			4,744
Hercules Term Loan Agreement [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Additional cash and cash equivalent and available for sale debt securities			$ 4,900
Principal amount		$ 7,500
Minimum qualified cash balance		2,250
Hercules Term Loan Agreement [Member] \| Forecast [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Minimum qualified cash balance	$ 0
Raised from equity investment	$ 20,000
Hercules Term Loan Agreement [Member] \| Tranche 1 Advance [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Aggregate principal amount of initial loan advance				12,500	$ 12,500
Hercules Term Loan Agreement [Member] \| Maximum [Member]
Organization Consolidation And Presentation Of Financial Statements Disclosure [Line Items]
Minimum qualified cash balance		$ 10,000
Aggregate principal amount of initial loan advance				$ 30,000	$ 30,000

UNAUDITED CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' (DEFICIT) EQUITY - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Treasury stock [Member]	Accumulated deficit [Member]
Balance at Dec. 31, 2021	$ 22,384	$ 22	$ 262,875	$ (2,190)	$ (238,323)
Balance, shares at Dec. 31, 2021		2,166,248		(10,535)
Vesting of restricted stock units, shares		78
Stock-based compensation expense	922		922
Net loss	(11,620)				(11,620)
Balance at Mar. 31, 2022	11,686	$ 22	263,797	$ (2,190)	(249,943)
Balance, shares at Mar. 31, 2022		2,166,326		(10,535)
Balance at Dec. 31, 2022	$ (10,660)	$ 22	263,706		(274,388)
Balance, shares at Dec. 31, 2022	2,166,356	2,166,356
Stock-based compensation expense	$ 597		597
Net loss	(6,230)				(6,230)
Balance at Mar. 31, 2023	$ (16,293)	$ 22	$ 264,303		$ (280,618)
Balance, shares at Mar. 31, 2023	2,166,356	2,166,356

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

+ References

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-URI https://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

+ Details

Property and Equipment

3 Months Ended

Mar. 31, 2023

Property Plant And Equipment [Abstract]

Property and Equipment

4. Property and Equipment

Property and equipment, net consisted of the following (in thousands):


	March 31, 2023			December 31, 2022
Computers and software	$	26		$	26
Office furniture and equipment		15			15
Laboratory equipment		233			251
Leasehold improvements		57			57
		331			349
Less accumulated depreciation and amortization		(188	)		(180	)
Property and equipment, net	$	143		$	169

Depreciation expense was $15 thousand and $21 thousand for the three months ended March 31, 2023 and 2022, respectively. During the three months ended March 31, 2023, the Company sold property and equipment for $11 thousand and recognized an immaterial gain on sale of assets.

Recurring Fair Value Measurements - Schedule of Assets and liabilities measured at fair value on a recurring basis (Details) - Fair Value, Recurring [Member] - USD ($) $ in Thousands	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Embedded derivatives	$ 58	$ 45
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Embedded derivatives	58	45
Money Market Funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds included in cash and cash equivalents	4,512	18,737
Money Market Funds [Member] \| Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Money market funds included in cash and cash equivalents	$ 4,512	$ 18,737

Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2023	May 10, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Mar. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Entity Registrant Name	ELOXX PHARMACEUTICALS, INC.
Entity Central Index Key	0001035354
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity File Number	001-31326
Entity Tax Identification Number	84-1368850
Entity Address, Address Line One	480 Arsenal Way
Entity Address, City or Town	Watertown
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	02472
City Area Code	781
Local Phone Number	577-5300
Entity Incorporation, State or Country Code	DE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, $0.01 par value per share
Trading Symbol	ELOX
Security Exchange Name	NASDAQ
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		2,166,356

Recurring Fair Value Measurements

3 Months Ended

Mar. 31, 2023

Fair Value Disclosures [Abstract]

Recurring Fair Value Measurements

10. Recurring Fair Value Measurements

The following tables summarizes the Company's fair value hierarchy for its financial assets and liabilities measured at fair value on a recurring basis (in thousands):


As of March 31, 2023	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Assets
Money market funds included in cash and cash equivalents	$	4,512	$	4,512	$	—	$	—
Liabilities
Embedded derivatives	$	58	$	—	$	—	$	58


As of December 31, 2022	Total		Quoted Prices in Active Markets for Identical Assets (Level 1)		Significant Other Observable Inputs (Level 2)		Significant Unobservable Inputs (Level 3)
Assets
Money market funds included in cash and cash equivalents	$	18,737	$	18,737	$	—	$	—
Liabilities
Embedded derivatives	$	45	$	—	$	—	$	45

The Company is party to certain funding awards with the Cystic Fibrosis Foundation, which contain embedded derivatives (refer to Note 7). As of the balance sheet date, the Company has determined the fair value of these embedded derivatives using a Monte Carlo simulation of the occurrence of a disposition event. The Company has used observable input assumptions such as the amount of funding, the Royalty Cap, as well as unobservable assumptions such as the time to occurrence of 3 years, as well as the probability of occurrence of a disposition event. The table below provides a summary of the fair value of the embedded derivatives, a Level 3 fair value estimate (in thousands), for the three months ended March 31, 2023 and 2022:


	Three Months Ended March 31,		Three Months Ended March 31,
	2023		2022
Fair value of embedded derivatives, beginning of period	$	45	$	-
Change in fair value of derivative liabilities		13		270
Fair value of embedded derivatives, end of period	$	58	$	270

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Other Expense, Net

3 Months Ended

Mar. 31, 2023

Other Income And Expenses [Abstract]

Other Expense, Net

11. Other Expense, Net

Other expense, net consisted of the following (in thousands):


	Three Months Ended March 31,
	2023			2022
Interest and other expense	$	485		$	404
Interest and other income		(168	)		(14	)
Loss on debt extinguishment		406			—
Foreign currency exchange losses		11			7
Change in fair value of derivative liabilities		13			270
Total other expense, net	$	747		$	667

UNAUDITED CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
Statement Of Financial Position [Abstract]
Preferred stock, par value	$ 0.01	$ 0.01
Preferred Stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred Stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	500,000,000	500,000,000
Common stock, shares issued	2,166,356	2,166,356
Common stock, shares outstanding	2,166,356	2,166,356

Debt

3 Months Ended

Mar. 31, 2023

Debt Disclosure [Abstract]

Debt

6. Debt

Hercules Term Loan

On September 30, 2021, the Company entered into a Loan and Security Agreement, dated as of September 30, 2021 (the “Hercules Loan Agreement”) with Hercules Capital, Inc. (“Hercules” or the “Lender”).

The Hercules Term Loan Agreement provided for term loans in an aggregate principal amount of up to $30.0 million, comprised of (i) a tranche 1 advance of $12.5 million (the “Tranche 1 Advance”), (ii) a tranche 2 advance of $7.5 million (the “Tranche 2 Advance”) and (iii) a tranche 3 advance of $10.0 million (the “Tranche 3 Advance”) (collectively, the “Term

Loan Advances”). The Tranche 1 Advance under the Hercules Term Loan Agreement was funded on September 30, 2021. The Tranche 2 Advance was to be available at the Company’s election until August 15, 2022, subject to the Company's achievement of certain milestone events relating to data from the clinical trials. The Company did not meet the requirements for the Tranche 2 Advance and such funding will, therefore, not be available to the Company. The Tranche 3 Advance is available subject to approval by the Lenders’ investment committee in its sole discretion up to April 1, 2023, and, provided that if the Company receives net cash proceeds of equity investment of at least $35.0 million prior to June 30, 2023, such date shall be extended to October 1, 2023.

As security for its obligations, the Company granted Hercules a continuing security interest in substantially all of the assets of the Company, subject to certain customary exceptions, including for intellectual property.

Any outstanding principal on the Term Loan Advances will accrue interest at a floating rate equal to the greater of (i) 9.50% per annum and (ii) the sum of 6.25% plus the prime rate, as published in The Wall Street Journal. As of March 31, 2023 and December 31, 2022, the interest rate was 14.25% and 13.75%, respectively.

On March 7, 2023, the Company entered into an amendment (the "Hercules Amendment") to repay $7.5 million of the outstanding principal of the Hercules Term Loan, extend the interest only period until September 1, 2023, canceled the prepayment penalty for the March principal repayment and any future early principal repayments, and reduced the qualified cash balance from $10.0 million to $2.25 million effective as of March 7, 2023. The qualified cash balance may be further reduced to $0 if the Company has raised $20.0 million in equity investments prior to May 31, 2023. In accordance with the Hercules Loan Amendment, the Company will be required to make principal payments on the outstanding balance of the Term Loan Advances beginning on September 1, 2023, in 31 equal monthly installments, plus interest. Any amounts outstanding under the Term Loan Advances, if not repaid sooner, are due and payable on April 1, 2025 (the “Maturity Date”). On any date that the Company partially repays the outstanding obligations, the Company shall pay the Lenders a charge equal to 6.55% of the original principal amount. The Hercules Amendment removed this prepayment premium for both the March 7, 2023 principal repayment and for any future early prepayments of principal. The Hercules Amendment was accounted for as debt modification under ASC 470-50, Debt: Modifications and Extinguishments, with a partial debt extinguishment. The Company recognized a loss on debt extinguishment of $0.4 million related to the remaining unamortized debt discount as of the effective date of the Hercules Amendment during the three months ended March 31, 2023.

The Hercules Loan Agreement contains customary affirmative and negative covenants which, among other things, requires the Company to maintain at all times a minimum qualified cash balance plus qualified accounts payable (as defined) and limits the Company’s ability to (i) incur additional indebtedness, (ii) pay dividends or make certain distributions, (iii) dispose of its assets, grant liens or encumber its assets or (iv) fundamentally alter the nature of its business. These covenants are subject to a number of exceptions and qualifications. The Company was in compliance with all debt covenants at March 31, 2023.

The Hercules Loan Agreement also contains customary events of default, including the Company’s failure to make any principal or interest payments when due, the occurrence of certain bankruptcy or insolvency events or a breach of the covenants. Upon the occurrence of an event of default, Hercules may, among other things, accelerate the Company’s obligations under the Hercules Loan Agreement.

As of March 31, 2023, the carrying value of the outstanding loan consists of $5.0 million in principal less an unamortized debt discount of $0.3 million. The debt issuance costs and the final maturity payment of $0.8 million, have been recorded as a debt discount, which are being accreted to interest expense through the maturity date of the loan. Interest expense relating to the loan for the three months ended March 31, 2023 and 2022 was $0.5 million and $0.4 million, respectively. Interest expense is calculated using the effective interest method and is inclusive of non-cash amortization of the debt discount. As of March 31, 2023, the effective interest rate was 18.9%.

The Company’s scheduled future principal payments for the long-term debt are as follows (in thousands):


	At March 31,
	2023
Principal payments
2023	$	906
2024		2,988
2025		1,106
Total future principal payments		5,000
Less unamortized discount		(256	)
Carrying value of long-term debt		4,744
Less current portion of long-term debt		(1,536	)
Final fee due at maturity in 2025		819
Long-term portion	$	4,027

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
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+ Details

Stock-based Compensation

3 Months Ended

Mar. 31, 2023

Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]

Stock-based Compensation

9. Stock-Based Compensation

Summary of Stock Option Activity

Transactions related to stock options awarded to employees and directors during the three months ended March 31, 2023 were as follows:


	Shares			Weighted average exercise price		Weighted average remaining contractual life (years)		Aggregate intrinsic value
Options outstanding at December 31, 2022		249,403		$	105.87		8.12	$	3
Granted		195,895			4.27
Forfeited		(15,638	)		22.41
Options outstanding at March 31, 2023		429,660		$	62.59		6.77	$	10
Options exercisable at March 31, 2023		109,601		$	171.38		7.26	$	10

The aggregate intrinsic value represents the total intrinsic value (the difference between the fair value of the common stock as of March 31, 2023 and the exercise price, multiplied by the number of in-the-money options) that would have been received by the option holders had all option holders exercised their options on March 31, 2023. This amount is impacted by changes in the fair value of the common stock.

Stock-Based Compensation

Stock-based compensation relates to non-employee directors and non-employees, time-based stock options and restricted stock units granted. Total stock-based compensation expense related to all of the Company’s stock-based awards was recognized as follows (in thousands):


	Three Months Ended March 31,
	2023		2022
Research and development	$	288	$	360
General and administrative		309		562
Total stock-based compensation expense	$	597	$	922

Stock-based Compensation - Transactions Related to Stock Options Awarded to Employees and Directors (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Amount
Options outstanding at December 31, 2022	249,403
Granted	195,895
Forfeited	(15,638)
Options outstanding at March 31, 2023	429,660	249,403
Options exercisable at March 31, 2023	109,601
Weighted average exercise price
Options outstanding at December 31, 2022	$ 105.87
Granted	4.27
Forfeited	22.41
Options outstanding at March 31, 2023	62.59	$ 105.87
Options exercisable at March 31, 2023	$ 171.38
Weighted average remaining contractual life
Options outstanding	6 years 9 months 7 days	8 years 1 month 13 days
Options exercisable	7 years 3 months 3 days
Aggregate intrinsic value
Options outstanding	$ 10	$ 3
Options exercisable	$ 10

Nature of the Business

3 Months Ended

Mar. 31, 2023

Organization Consolidation And Presentation Of Financial Statements [Abstract]

Nature of the Business

1. Nature of the Business

Eloxx Pharmaceuticals, Inc., together with its subsidiaries (collectively “Eloxx” or the “Company”), is a clinical-stage biopharmaceutical company engaged in the science of ribosomal modulation. The Company is developing novel small molecule drug candidates from its library of unique Ribosome Modulating Agents (“RMAs”) and Eukaryotic Ribosomal Selective Glycosides (“ERSGs”), for the treatment of a subset of rare and ultra-rare diseases and cancers characterized by genetic mutations that cause defects in protein translation. Specifically, the Company is targeting restoration of functional proteins in patients with premature stop codon mutations and ribosomal mutations. Premature stop codons are point mutations that disrupt the stability of the impacted messenger RNA (mRNA) and the protein synthesis from that mRNA. Additionally, certain mutations of the ribosome disrupt normal protein translation and are drivers of a subset of cancers. On April 1, 2021, the Company acquired Zikani Therapeutics, Inc. (“Zikani”), a preclinical stage biopharmaceutical company engaged in the science of ribosome modulation, leveraging its innovative TURBO-ZMTM chemistry technology platform to develop novel ribosome modulating agents (“RMAs”). The TURBO-ZMTM platform is designed to enable rapid synthesis of novel macrolides that can be optimized to modulate the human, bacterial or viral ribosomes to treat rare diseases and cancers with certain ribonucleic acid (“RNA”) and ribosomal mutations.

The Company is headquartered in Watertown, Massachusetts, with additional operations in Israel and Australia.

Liquidity and Going Concern

The Company has a history of net losses and negative cash flows from operating activities since inception and, as of March 31, 2023, had an accumulated deficit of $280.6 million. The Company expects to continue to incur net losses and negative cash flows from its operations for the foreseeable future. The Company has not generated revenue from the sale of any product or service and does not expect to generate significant revenue unless it obtains marketing approval for and commercializes one or more of its product candidates currently in development. Successful transition to profitable operations is dependent upon achieving a level of revenue adequate to support the Company’s cost structure.

The Company has financed its operations primarily from the sale of equity securities and to a lesser extent, loans and grants. The Company may never achieve profitability, and unless and until it does, the Company will continue to need to raise additional capital to fund its operations. In addition, as disclosed in Note 6, in September 2021, the Company entered into the Hercules Term Loan (as defined below) for an aggregate principal amount of up to $30.0 million of which $12.5 million had been funded as of December 31, 2022 and effective March 7, 2023, the Company and Hercules agreed to amend the terms of the agreement, and the Company repaid $7.5 million of principal. The Hercules Term Loan Agreement contains customary affirmative and negative covenants, which among others further described in Note 6, require the Company to maintain at all times a minimum qualified cash balance net of qualified accounts payable (as defined in the Hercules Term Loan Agreement). On March 7, 2023, the minimum qualified cash balance debt covenant was decreased from $10.0 million to $2.25 million as of March 7, 2023, and may be further reduced to $0 if the Company has raised $20.0 million in equity investments prior to May 31, 2023.

As of March 31, 2023, the Company was in compliance with all debt covenants. However, the inherent uncertainties described above may impact the Company’s ability to remain in compliance with these covenants over the next 12 months. If the Company breaches its financial covenants and fails to secure a waiver or forbearance from the third-party lender, such breach or failure could accelerate the repayment of the outstanding borrowings under the Hercules Term Loan Agreement or the exercise of other rights or remedies the third-party lender may have under applicable law. No assurance can be provided a waiver or forbearance will be granted or the outstanding borrowings under the Hercules Term Loan Agreement, will be successfully refinanced on terms that are acceptable to the Company.

The Company believes that its cash and cash equivalents of $4.9 million at March 31, 2023 will not be sufficient to maintain its current and planned operations for at least the next 12 months following the filing of this Quarterly Report on Form 10-Q. The accompanying condensed consolidated financial statements have been prepared assuming that the Company will continue as a going concern, which contemplates the realization of assets and settlement of liabilities in the normal course of business. However, based on the Company’s current working capital, anticipated operating expenses and net losses and the uncertainties surrounding its ability to raise additional capital as needed, as discussed below, the Company believes that these conditions, in aggregate, raise substantial doubt about its ability to continue as a going concern for one year after the date these condensed consolidated financial statements are issued.

Management intends to fund future operations through private or public debt or equity financing transactions and may seek additional capital through arrangements with strategic partners or from other sources. The availability of sufficient

funding to alleviate the conditions that raise substantial doubt are not within management’s control and cannot be assessed as being probable of occurring. If the Company is unable to obtain adequate financing, it will evaluate options, which may include reducing or deferring operating expenses, which may have a material adverse effect on the Company’s operations and future prospects.

Other expense, Net - Schedule of Other Expense, Net (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Other Income And Expenses [Abstract]
Interest and other expense	$ 485	$ 404
Interest and other income	(168)	(14)
Loss on debt extinguishment	406	0
Foreign currency exchange losses	11	7
Change in fair value of derivative liabilities	13	270
Total other expense, net	$ 747	$ 667

Stockholders' Equity

3 Months Ended

Mar. 31, 2023

Equity [Abstract]

Stockholders' Equity

8. Stockholders’ Deficit

ATM Program

On September 30, 2021, we entered into a Sales Agreement with SVB Leerink, LLC (“SVB Leerink”) pursuant to which the Company may offer and sell up to $50.0 million of shares of its common stock (the “ATM Shares”) from time to time, through an “at the market offering” program (the “ATM Program”), under which SVB Leerink will act as sales agent. Pursuant to the Sales Agreement, the Company will set the parameters for the sale of ATM Shares, including the number of ATM Shares to be issued, the time period during which sales are requested to be made, limitations on the number of ATM Shares that may be sold in any one trading day and any minimum price below which sales may not be made. The Company is not obligated to make any sales of Shares under the ATM Program and has not sold any shares as of March 31, 2023.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Net Loss Per Share (Tables)

3 Months Ended

Mar. 31, 2023

Earnings Per Share [Abstract]

Schedule of Net Loss and Weighted Average Number of Shares Used in Computing Basic and Diluted Net Loss Per Share

The net loss and the weighted average number of shares used in computing basic and diluted net loss per share for the periods, are as follows (amounts in thousands, except share and per share data):


	Three Months Ended March 31,
	2023			2022
Numerator:
Net loss	$	(6,230	)	$	(11,620	)
Denominator:
Weighted average number of shares of common stock used in computing net loss per share, basic and diluted		2,166,356			2,166,275
Net loss per share, basic and diluted	$	(2.88	)	$	(5.36	)

Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding

The following potentially dilutive securities have been excluded from the computation of diluted weighted average shares outstanding as their effect would be anti-dilutive:


	Three Months Ended March 31,
	2023		2022
Options to purchase common stock		429,660		303,270
Restricted stock units		—		78
Warrants		1,021		8,097