Spruce Biosciences : Corporate Presentation

Focused on developing and commercializing novel therapies for rare endocrine disorders with significant unmet medical need

Corporate Presentation

January 9, 2023

FORWARD-LOOKING STATEMENTS

This presentation contains forward-looking statements about Spruce Biosciences, Inc. ("we," "Spruce" or the "Company"). All statements other than statements of historical facts contained in this presentation are forward-looking statements, including statements about our strategy, our expectations regarding the timing and achievement of our product candidate's development activities and ongoing and planned clinical trials, and plans and expectations for future operations.

These forward-looking statements are subject to a number of risks, uncertainties and assumptions, including, but not limited to: the effects of the evolving and ongoing COVID-19 pandemic; our limited operating history; net losses; our expectation that we will incur net losses for the foreseeable future, and that we may never be profitable; our need for additional funding and related risks for our business, product development programs and future commercialization activities; the timing and success of clinical trials we conduct; the ability to obtain and maintain regulatory approval of our product candidate; the ability to commercialize our product candidate; our ability to compete in the marketplace; risks regarding our license agreement; our ability to obtain and maintain intellectual property protection for our product candidate; and our ability to manage our growth. We operate in a very competitive and rapidly changing environment. New risks emerge from time to time. It is not possible for our management to predict all risks, nor can we assess the impact of all factors on our business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements we may make. In light of these risks, uncertainties and assumptions, the forward-looking events and circumstances discussed in this presentation may not occur and actual results could differ materially and adversely from those anticipated or implied in the forward-looking statements. Except as required by law, neither we nor any other person assumes responsibility for the accuracy and completeness of the forward-looking statements. We undertake no obligation to update publicly any forward-looking statements for any reason after the date of this presentation to conform these statements to actual results or to changes in our expectations.

Certain information contained in this presentation and statements made orally during this presentation relate to or are based on studies, publications, surveys and other data obtained from third-party sources and Spruce's own internal estimates and research. While Spruce believes these third-party studies, publications, surveys and other data to be reliable as of the date of this presentation, it has not independently verified, and makes no representations as to the adequacy, fairness, accuracy or completeness of, any information obtained from third-party sources. In addition, no independent source has evaluated the reasonableness or accuracy of Spruce's internal estimates or research and no reliance should be made on any information or statements made in this presentation relating to or based on such internal estimates and research.

This presentation discusses a product candidate that is under clinical study and which has not yet been approved for marketing by the U.S. Food and Drug Administration. No representation is made as to the safety or effectiveness of this product candidate for the use for which it is being studied.

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SPRUCE AT-A-GLANCE

Large Orphan Market Primed for Innovation

Transformative Treatment Paradigm in CAH

Robust Clinical Data in Adult CAH

Potentially Registrational Studies Ongoing

Multiple Expansion Opportunities

Strong IP Protection

~$3B+ market opportunity in CAH with high unmet need, low competitive intensity, and no new therapeutic options in ~50 years

Tildacerfont is a second generation CRF-1 receptor antagonist with clear MOA, designed to reduce disease and steroid burden

Two positive Phase 2a studies demonstrating ~80% reduction in biomarkers; 235 subjects dosed across eight studies to date

Data from two studies in Adult-CAH patients expected in 2H-2023 (CAHmelia-203) and 2H-2024 (CAHmelia-204)

Topline results from P2 P.O.W.E.R. in PCOS in 1H-2023; Topline data in adolescents from P2 CAHptain in Pediatric-CAH in 2H-2023

Comprehensive IP portfolio with exclusivity to 2038 combined with Orphan Drug Designation in U.S. and E.U.

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OVERVIEW OF SPRUCE'S ONGOING TRIALS AND CATALYSTS

2022			2023		2024
H1	H2	H1	H2	H1	H2
			CAHmelia-2031
Adrenal androgen reduction study in patients with classic CAH and highly elevated adrenal androgens at baseline
Adult CAH			Topline Results
			CAHmelia-2041
Glucocorticoid steroid reduction study in patients with classic CAH and supraphysiologic daily glucocorticoids at baseline
Tildacerfont					Topline Results
	Phase 2 CAHptain
Pediatric CAH
			Topline Data in Adolescents
PCOS	Phase 2 P.O.W.E.R.
			Topline Results

4Q22 Projected Cash and	Cash Runway Into 1H 2024
Investments Balance:
~$79mm2
Note: CAH is congenital adrenal hyperplasia, PCOS is polycystic ovary syndrome.		4
1. Topline data from these trials along with an open label extension study will form the basis for an NDA filing. 2. This amount is unaudited and preliminary and is subject to completion of financial closing procedures.

Classic CAH Overview