Spruce Biosciences (SPRB) AI Stock Analysis

• Market Cap: $82.40M
• Dividend Yield: N/A
• Average Volume (3M): 988.68K
• Price to Earnings (P/E): ―
• Beta (1Y): -10.61
• Revenue Growth: -90.18%
• EPS Growth: -17.93%
• Country: US
• Employees: 20
• Sector: Healthcare
• Sector Strength: 45
• Industry: Biotechnology
• EPS (TTM): -8.73
• Shares Outstanding: 1,372,043
• 10 Day Avg. Volume: 2,922,716
• 30 Day Avg. Volume: 988,676
• PEG Ratio: 0.04
• Price to Book (P/B): 1.57
• Price to Sales (P/S): 0.00
• P/FCF Ratio: -2.00
• Enterprise Value/Market Cap: -0.16
• Enterprise Value/Revenue: N/A
• Enterprise Value/Gross Profit: 2.66K
• Enterprise Value/Ebitda: 0.36
• 1Y Price Target: $217.67
• Price Target Upside: 262.42% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 3
• EPS Forecast (FY): -32.34
• Revenue Forecast (FY): N/A

• Rating: 42 Neutral
• Price Target: $60.00 ▼(-0.10% Downside)
• Action: Reiterated Date: 03/10/26
• Date: Action: Reiterated 03/10/26

The score is primarily constrained by weak financial performance: zero recent revenue, ongoing large losses, and persistent negative cash flow (even with 2025 improvement), alongside shrinking equity/asset base. Technicals are neutral-to-mixed and do not offset the fundamental pressure. Valuation inputs (P/E of 0.000 and no dividend yield) provide no support based on the provided data.

Positive Factors

Durable clinical efficacy (TA-ERT)

Long-term data show TA-ERT normalized a key CSF biomarker and stabilized cognitive, motor, and organ outcomes up to six years in treated patients versus natural history. Durable, disease-modifying effects in an untreatable ultra-rare disorder strengthen first-in-class positioning and long-term commercial and clinical value if approved.

Regulatory engagement enabling accelerated pathway

Constructive Type B FDA interactions that endorse use of existing clinical and natural history data for an accelerated approval pathway materially reduce regulatory timeline uncertainty. This clarity can shorten time-to-market and de-risk late-stage development, benefiting long-term commercial planning and capital efficiency.

Extended runway and commercial readiness

Combination of a milestone-linked $50M facility, existing cash and a new ATM provides multi-channel financing flexibility and extends runway into early 2027. Appointment of an experienced rare-disease CCO bolsters launch planning, making the company better positioned to commercialize a first-in-class therapy if approval is achieved.

Negative Factors

No product revenue; persistent cash burn

The company reported zero product revenue in 2025 and multi-year operating and free cash flow deficits. Lack of recurring commercial sales means ongoing R&D and operating needs must be met via external financing, increasing dilution and execution risk if capital markets contract or milestones slip.

Eroding balance sheet capacity

Material decline in equity and total assets over several years signals value erosion from sustained losses and reduces the company’s ability to absorb setbacks or fund strategic initiatives internally. A thinner balance sheet limits flexibility and heightens sensitivity to adverse clinical or regulatory outcomes.

Secured, milestone-linked loan with dilution risk

Milestone tranches, asset security, warrants and conversion features create potential for dilution and place key assets at risk if covenants are breached. Such financing improves near-term runway but can constrain strategic optionality and worsen long-term shareholder economics if execution or regulatory timelines slip.

Spruce Biosciences Business Overview & Revenue Model

Company Description

Spruce Biosciences, Inc., a biopharmaceutical company, focuses on developing and commercializing novel therapies for rare endocrine disorders. The company engages in developing tildacerfont, a non-steroidal therapy to enhance disease control and reduce steroid burden for adult patients suffering from congenital adrenal hyperplasia (CAH), which is in Phase 2b clinical trial; and to evaluate glucocorticoid reduction and clinical consequences in adult patients with classic CAH that is Phase 2b clinical trial. It is also developing tildacerfont for the treatment of pediatric classic congenital adrenal hyperplasia in children that is in Phase 2 clinical trial; and for females with polycystic ovary syndrome, which is in Phase 2 clinical trial. The company has a license agreement with Eli Lilly and Company to research, develop, and commercialize compounds for various pharmaceutical uses. Spruce Biosciences, Inc. was incorporated in 2014 and is headquartered in Daly City, California.

How the Company Makes Money

Spruce Biosciences primarily makes money through the development and commercialization of its pharmaceutical products. The company's revenue model is centered around advancing its lead product candidate, tildacerfont, through clinical trials and ultimately obtaining regulatory approval and commercializing the drug. Revenue streams may include sales of the approved drug, milestone payments, and royalties from partnerships or licensing agreements with larger pharmaceutical companies. Significant partnerships with research institutions or other biotech firms can also contribute to its revenue through collaborative research and potential co-development agreements.

Spruce Biosciences Financial Statement Overview

Summary

Operating profile remains weak with revenue collapsing to $0 (2025) and persistent large losses alongside ongoing cash burn (despite improvement in 2025 vs. 2024). Balance sheet leverage is low, but equity and assets have materially declined over time, signaling ongoing value erosion and continued dependence on external funding.

Income Statement

Revenue has been inconsistent and recently collapsed to $0 in 2025 (annual), after declining from ~$10.1M (2023) to ~$4.9M (2024). Profitability remains very weak: operating losses are large and persistent (EBIT roughly -$36.5M to -$56.2M across recent years), and 2024 posted a sizable net loss (~-$53.0M). The main positive is that losses narrowed in 2025 versus 2024, but the lack of revenue and ongoing heavy operating burn keep the income statement profile pressured.

Balance Sheet

Leverage is low, with debt-to-equity staying modest (roughly ~0.01 to ~0.10), which reduces financial risk and provides flexibility. However, the equity base has fallen sharply over time (about ~$149.4M in 2020 down to ~$42.5M in 2025), signaling ongoing value erosion from sustained losses. Assets have also trended down (about ~$162.9M in 2020 to ~$53.0M in 2025). Overall: a relatively clean capital structure, but weakening balance sheet capacity.

Cash Flow

Cash generation is consistently negative, with operating cash flow and free cash flow deeply in the red every year. 2025 improved versus 2024 (operating/free cash flow around -$33.3M vs. about -$56.0M in 2024), but the multi-year pattern shows continued cash burn with no self-funding operations. Free cash flow volatility is also notable (including a materially worse year in 2024), keeping funding risk elevated if capital markets tighten.

Breakdown	Dec 2025	Dec 2024	Dec 2023	Dec 2022	Dec 2021
Income Statement
Total Revenue	0.00	4.91M	10.09M	0.00	0.00
Gross Profit	-21.00K	4.91M	10.09M	0.00	0.00
EBITDA	-36.51M	-52.68M	-47.37M	-45.69M	-41.88M
Net Income	-38.97M	-53.04M	-47.92M	-46.18M	-42.29M
Balance Sheet
Total Assets	53.02M	45.21M	103.95M	85.65M	126.49M
Cash, Cash Equivalents and Short-Term Investments	48.91M	38.75M	96.34M	79.08M	88.97M
Total Debt	419.00K	2.77M	4.61M	6.32M	6.53M
Total Liabilities	10.51M	16.39M	27.44M	17.16M	15.12M
Stockholders Equity	42.52M	28.82M	76.51M	68.49M	111.37M
Cash Flow
Free Cash Flow	-33.33M	-55.96M	-33.28M	-41.69M	-35.97M
Operating Cash Flow	-33.33M	-55.96M	-33.27M	-41.68M	-35.88M
Investing Cash Flow	0.00	0.00	55.78M	23.69M	-79.17M
Financing Cash Flow	43.48M	-1.62M	49.14M	-241.00K	643.00K

Spruce Biosciences Technical Analysis

• Technical Analysis Sentiment: Neutral
• Last Price: 60.06
• 50DMA: Negative
• 100DMA: Negative
• 200DMA: Positive
• MACD: Negative
• RSI: Neutral
• STOCH: Neutral

Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For SPRB, the sentiment is Neutral. The current price of 60.06 is above the 20-day moving average (MA) of 57.53, below the 50-day MA of 70.89, and above the 200-day MA of 54.83, indicating a neutral trend. The MACD of -3.13 indicates Negative momentum. The RSI at 45.77 is Neutral, neither overbought nor oversold. The STOCH value of 59.77 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for SPRB.

Spruce Biosciences Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
FBIO	54 Neutral	$96.22M	4.31	11.02%	―	-0.32%	94.05%
DTIL	53 Neutral	$140.20M	―	-95.12%	―	-99.07%	-10347.56%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
IMUX	47 Neutral	$152.64M	―	-1197.81%	―	―	30.16%
CLNN	45 Neutral	$67.37M	-2.21	240.83%	―	-49.17%	23.37%
SPRB	42 Neutral	$82.40M	-1.71	-305.39%	―	-90.18%	-17.93%
IMA	42 Neutral	$66.10M	―	-33.05%	―	-100.00%	45.48%

Spruce Biosciences Corporate Events

Spruce Biosciences Updates ATM Agreement, Strengthens Leadership Team

On March 9, 2026, Spruce Biosciences entered a new open market sale agreement with Jefferies to allow at-the-market issuances of common stock under an existing shelf registration, replacing a prior 2022 sales agreement and providing additional financial flexibility without obligating the company to sell shares. The company also reported 2025 results showing a narrowed net loss of $39.0 million on sharply reduced R&D spending, secured up to $50 million in growth capital from Avenue Capital in January 2026, and said its year-end 2025 cash of $48.9 million plus the new facility should fund operations into early 2027.

Operationally, Spruce highlighted positive February 2026 Type B meetings with the FDA indicating that existing TA-ERT clinical and natural history data may support an accelerated approval strategy, reinforcing its plan to file a biologics license application in the fourth quarter of 2026 for MPS IIIB, which currently has no approved therapies. To support a potential launch, the company appointed veteran rare disease commercial executive Dale (Corwin) Hooks as chief commercial officer effective March 9, 2026, expanded its regulatory and clinical leadership team, presented encouraging long-term TA-ERT data at WORLDSymposium, and noted that recent reauthorization of the U.S. Rare Pediatric Disease Priority Review Voucher program could enhance the asset’s strategic value if approved.

The most recent analyst rating on (SPRB) stock is a Buy with a $200.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Highlights Promising Long-Term Tralesinidase Data

On February 5, 2026, Spruce Biosciences reported long-term clinical data presented at the 22nd Annual WORLDSymposium showing that its investigational tralesinidase alfa enzyme replacement therapy (TA-ERT) produced rapid and durable reductions in heparan sulfate levels and preserved cognitive and non-cognitive functions in patients with Sanfilippo Syndrome Type B (MPS IIIB) compared with untreated natural history patients over a follow-up period of up to six years. Across 22 treated patients, weekly TA-ERT normalized a key cerebrospinal fluid biomarker (HS-NRE), stabilized cognitive performance, cortical gray matter volume, and liver and spleen size, and maintained receptive and expressive communication and fine and gross motor skills as measured by validated developmental and adaptive behavior scales, while exhibiting a safety profile consistent with intracerebroventricular administration over roughly 6,000 doses. A case study comparing two siblings with severe MPS IIIB, one treated with TA-ERT and one untreated, highlighted a marked divergence in language, self-care, and motor abilities in favor of the treated child, underscoring the potential for TA-ERT to alter the course of this fatal, currently untreatable disease and reinforcing Spruce’s positioning as a developer of first-in-class, disease-modifying therapies in the ultra-rare neurology space.

The most recent analyst rating on (SPRB) stock is a Hold with a $86.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Secures $50 Million Term Loan Facility

On January 7, 2026, Spruce Biosciences entered into a loan facility of up to $50 million with Avenue Venture Opportunities Fund II, L.P., featuring an initial $15 million tranche to be funded around January 9, 2026 and additional milestone-based tranches tied to regulatory and commercial progress for TA-ERT, as well as warrants and a potential conversion feature for the lender. The growth capital, secured against substantially all of the company’s assets and structured with a maturity date of July 1, 2029, is expected to extend Spruce’s cash runway into 2027, support its planned biologics license application filing and pre-launch commercial activities for TA-ERT, and potentially position the therapy as the first disease-modifying treatment for MPS IIIB in a market that currently lacks FDA-approved options, while the company reported preliminary cash and cash equivalents of approximately $48.9 million as of December 31, 2025.

The most recent analyst rating on (SPRB) stock is a Hold with a $82.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Appoints Keli Walbert as Director

On December 11, 2025, Spruce Biosciences, Inc. appointed Keli Walbert as a Class I Director, with her term expiring at the 2027 Annual Meeting of Stockholders. She was also appointed to the Compensation Committee and will receive stock options and a cash retainer as part of her compensation. This appointment is expected to enhance the company’s governance structure, with no related person transactions disclosed between Ms. Walbert and the company.

The most recent analyst rating on (SPRB) stock is a Buy with a $160.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.

Spruce Biosciences Announces Board Resignation and Stock Repricing

Spruce Biosciences announced that on December 11, 2025, Tiba Aynechi, Ph.D. resigned from its board of directors and as Chair of the Compensation Committee, with her departure not stemming from any disagreements with the company. On the same day, the board approved a stock option repricing to reduce the exercise price of certain stock options to $104.13 per share, aiming to retain and motivate employees and directors without causing stock dilution or significant cash expenditures.

The most recent analyst rating on (SPRB) stock is a Buy with a $160.00 price target. To see the full list of analyst forecasts on Spruce Biosciences stock, see the SPRB Stock Forecast page.