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    Amendment: SEC Form SCHEDULE 13G/A filed by Milestone Pharmaceuticals Inc.

    2/14/25 9:00:06 AM ET
    $MIST
    Biotechnology: Pharmaceutical Preparations
    Health Care
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    SECURITIES AND EXCHANGE COMMISSION
    Washington, D.C. 20549


    SCHEDULE 13G


    UNDER THE SECURITIES EXCHANGE ACT OF 1934
    (Amendment No. 5)


    Milestone Pharmaceuticals Inc.

    (Name of Issuer)


    Common Shares, no par value per share

    (Title of Class of Securities)


    59935V107

    (CUSIP Number)


    12/31/2024

    (Date of Event Which Requires Filing of this Statement)


    Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
    Checkbox checked   Rule 13d-1(b)
    Checkbox not checked   Rule 13d-1(c)
    Checkbox not checked   Rule 13d-1(d)






    SCHEDULE 13G

    CUSIP No.
    59935V107


    1Names of Reporting Persons

    RTW Investments, LP
    2Check the appropriate box if a member of a Group (see instructions)

    Checkbox not checked  (a)
    Checkbox not checked  (b)
    3Sec Use Only
    4Citizenship or Place of Organization

    DELAWARE
    Number of Shares Beneficially Owned by Each Reporting Person With:
    5Sole Voting Power

    0.00
    6Shared Voting Power

    5,640,593.00
    7Sole Dispositive Power

    0.00
    8Shared Dispositive Power

    5,640,593.00
    9Aggregate Amount Beneficially Owned by Each Reporting Person

    5,640,593.00
    10Check box if the aggregate amount in row (9) excludes certain shares (See Instructions)

    Checkbox not checked
    11Percent of class represented by amount in row (9)

    9.99 %
    12Type of Reporting Person (See Instructions)

    PN, IA


    SCHEDULE 13G

    CUSIP No.
    59935V107


    1Names of Reporting Persons

    Roderick Wong, M.D.
    2Check the appropriate box if a member of a Group (see instructions)

    Checkbox not checked  (a)
    Checkbox not checked  (b)
    3Sec Use Only
    4Citizenship or Place of Organization

    UNITED STATES
    Number of Shares Beneficially Owned by Each Reporting Person With:
    5Sole Voting Power

    0.00
    6Shared Voting Power

    5,640,593.00
    7Sole Dispositive Power

    0.00
    8Shared Dispositive Power

    5,640,593.00
    9Aggregate Amount Beneficially Owned by Each Reporting Person

    5,640,593.00
    10Check box if the aggregate amount in row (9) excludes certain shares (See Instructions)

    Checkbox not checked
    11Percent of class represented by amount in row (9)

    9.99 %
    12Type of Reporting Person (See Instructions)

    IN, HC


    SCHEDULE 13G

    Item 1. 
    (a)Name of issuer:

    Milestone Pharmaceuticals Inc.
    (b)Address of issuer's principal executive offices:

    1111 Dr. Frederik-Philips Boulevard, Suite 420, Montreal, Quebec, CA H4M 2X6
    Item 2. 
    (a)Name of person filing:

    This statement is filed by: (i) RTW Investments, LP ("RTW Investments"), a Delaware limited partnership and the investment adviser to certain funds (the "RTW Funds"), with respect to shares of Common Shares, no par value (the "Shares") of Milestone Pharmaceuticals Inc. (the "Company") directly held by the RTW Funds; and (ii) Roderick Wong, M.D. ("Dr. Wong"), the Managing Partner and Chief Investment Officer of RTW Investments, with respect to the Shares directly held by the RTW Funds. The foregoing persons are hereinafter sometimes collectively referred to as the "Reporting Persons." The filing of this statement should not be construed as an admission that any of the foregoing persons or any Reporting Person is, for the purposes of Section 13 of the Securities Exchange Act of 1934, as amended, the beneficial owner of the Shares reported herein.
    (b)Address or principal business office or, if none, residence:

    The address of the business office of each of the Reporting Persons is 40 10th Avenue, Floor 7, New York, New York 10014.
    (c)Citizenship:

    RTW Investments is a Delaware limited partnership. Dr. Wong is a citizen of the United States.
    (d)Title of class of securities:

    Common Shares, no par value per share
    (e)CUSIP No.:

    59935V107
    Item 3.If this statement is filed pursuant to §§ 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:
    (a)Checkbox not checked   Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o);
    (b)Checkbox not checked   Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c);
    (c)Checkbox not checked   Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c);
    (d)Checkbox not checked   Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8);
    (e)Checkbox checked   An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E);
    (f)Checkbox not checked   An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F);
    (g)Checkbox checked   A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);
    (h)Checkbox not checked   A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
    (i)Checkbox not checked   A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);
    (j)Checkbox not checked   A non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J). If filing as a non-U.S. institution in accordance with § 240.13d-1(b)(1)(ii)(J),
           please specify the type of institution:
    (k)Checkbox not checked   Group, in accordance with Rule 240.13d-1(b)(1)(ii)(K).
     
    Item 4.Ownership
    (a)Amount beneficially owned:

    The information required by Item 4(a) is set forth in Rows 5 - 9 of the cover page for each of the Reporting Persons and is incorporated herein by reference. The amounts reported herein assume the exercise of warrants held by the Reporting Persons to purchase 3,134,491 Shares (the "Warrants"), the maximum amount that may be exercised given the current number of outstanding shares and the shares held by the Reporting Persons. Pursuant to the terms of the Warrants, the Reporting Persons cannot exercise any of the Warrants to the extent the Reporting Persons would beneficially own, after any such exercise, more than 9.99% of the outstanding Shares. The percentages set forth in Row 11 of the cover pages are calculated based upon 53,327,908 Shares outstanding as of November 12, 2024 as reported in the Company's Quarterly Report on Form 10-Q filed with the Securities and Exchange Commission on November 12, 2024, and assume the exercise of Warrants held by the Reporting Persons to purchase 3,134,491 Shares.
    (b)Percent of class:

    RTW Investments: 9.99% Dr. Wong: 9.99
    (c)Number of shares as to which the person has:
     (i) Sole power to vote or to direct the vote:

    RTW Investments: 0 Dr. Wong: 0

     (ii) Shared power to vote or to direct the vote:

    RTW Investments: 5,640,593 Dr. Wong: 5,640,593

     (iii) Sole power to dispose or to direct the disposition of:

    RTW Investments: 0 Dr. Wong: 0

     (iv) Shared power to dispose or to direct the disposition of:

    RTW Investments: 5,640,593 Dr. Wong: 5,640,593

    Item 5.Ownership of 5 Percent or Less of a Class.
     
    Item 6.Ownership of more than 5 Percent on Behalf of Another Person.
     
    If any other person is known to have the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, such securities, a statement to that effect should be included in response to this item and, if such interest relates to more than 5 percent of the class, such person should be identified. A listing of the shareholders of an investment company registered under the Investment Company Act of 1940 or the beneficiaries of employee benefit plan, pension fund or endowment fund is not required.


    See Item 2. The RTW Funds have the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, the Shares reported herein. Each of RTW Master Fund Ltd. and RTW Innovation Master Fund Ltd., each an RTW Fund, has the right to receive or the power to direct the receipt of dividends or the proceeds from the sale of more than 5% of the Shares.
    Item 7.Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person.
     
    Not Applicable
    Item 8.Identification and Classification of Members of the Group.
     
    Not Applicable
    Item 9.Notice of Dissolution of Group.
     
    Not Applicable

    Item 10.Certifications:
     
    By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect, other than activities solely in connection with a nomination under ?? 240.14a-11.

        SIGNATURE 
     
    After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

     
    RTW Investments, LP
     
    Signature:/s/ Roderick Wong, M.D.
    Name/Title:Roderick Wong, M.D., Managing Partner
    Date:02/14/2025
     
    Roderick Wong, M.D.
     
    Signature:/s/ Roderick Wong, M.D.
    Name/Title:Managing Partner
    Date:02/14/2025
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