When AKTS insiders can sell

…ally all of our outstanding capital stock have entered into lock-up agreements with the underwriters or otherwise agreed, among other things and subject to certain exceptions, not to sell or transfer any common stock or securities convertible into, exchangeable for, exercisable for, or repayable with common stock, for 180 days after the date of this prospectus without first obtaining the written consent of J.P. Morgan Securities LLC, BofA Securities, Inc., Leerink Partners LLC and TD Securities (USA) LLC. Upon the expiration of the lock-up period, substantially all of the shares subject to such lock-up restrictions will become eligible for sale, subject to the limitations discussed above. For a further description of these lock-up agreements, please see the section titled "Underwriting." 234 Table of Contents After the date of the initial public filing of the prospect…

Upon expiration of the lock-up period, we estimate that approximately 34,872,279 shares, including shares of common stock issued upon conversion of shares of Class A common stock, of our common stock will be available for sale in the public market, subject in some cases to applicable volume limitations under Rule 144. Lock-up agreements We and each of our directors and executive officers and the holders of substantially all of our outstanding capital stock have entered into lock-up agreements with the underwriters or otherwise agreed, among other things and subject to certain exceptions, not to sell or transf…

Rule 10b5-1 plans Our directors, officers and key employees may adopt written plans, known as Rule 10b5-1 plans, in which they will contract with a broker to buy or sell shares of our common stock on a periodic basis. Under a Rule 10b5-1 plan, a broker executes trades under parameters established by the director or officer when entering into the plan, without further direction from them. The director or officer may amend a Rule 10b5-1 plan in some circumstances and may terminate a plan at any time.

…ck-up parties do not apply, subject in certain cases to various conditions, to certain transactions, including (a) transfers, distributions or the causing of the disposition of or surrender of lock-up securities: (i) as bona fide gifts, or for bona fide estate planning purposes, or as a charitable contribution, (ii) by will, other testamentary document or intestacy, (iii) to any (A) immediate family member of the lock-up party or (B) trust for the direct or indirect benefit of the lock-up party or any immediate family member, or in the case of a trust, to a trustor or beneficiary of the trust or to the estate of a beneficiary of suc…

…and chiropractors), certain other healthcare professionals (such as physician assistants and nurse practitioners), and teaching hospitals, as well as ownership and investment interests held by such physicians and their immediate family members; analogous U.S. state laws and regulations, including: state anti-kickback and false claims laws, which may apply to our business practices, including but not limited to, research, distribution, sales and marketing 47 Table of Contents arrangements, and claims involving healthcare items or services reimbursed by any third-party payor, including private insurers; state laws that require pharmaceutical companies to comply with the pharmaceutical industry's voluntary compliance guidelines and the relevant compliance guidance promulgated by the U.S.

The number of shares of our common stock to be outstanding after this offering excludes: 5,394,964 shares of our common stock issuable upon the exercise of stock options outstanding as of September 30, 2025 pursuant to our 2020 Equity Incentive Plan, or the 2020 Plan, with a weighted-average exercise price of $5.26 per share; 417,702 shares of our common stock reserved for future issuance under the 2020 Plan as of September 30, 2025, which shares will cease to be available for issuance at the time our 2026 Equity Incentive Plan, or the 2026 Plan, becomes eff…