This is how it is not "entirely de-risked" at this

This is how it is not "entirely de-risked" at this point:
They need to use 50 - 60 million of those shares in the next 5 months to retire the current Fife obligations under the current terms (if the share price remains around $1.25).
They will need to use another 50 million to fund operations for the next 6 months. At least. So, after those 110 million shares, they would be right where they are now. No cash on hand. They can use the other 90 million to fund themselves on a month to month basis. And, who knows how many of those 90 million will be utilized in the short term for compensation and recruiting purposes.

As Ohm surmised, one of the reason for slow trial enrollment in Brazil is/was lack of funding. With the new shares, they will accelerate activity, which is good, but also causes a need for more shares.

All of these new shares keep a lid on the price. Especially because they are being issued at 15% to 25% discounts to sophisticated investors who utilize various strategies, including shorting the stock, to hedge their positions while selling shares (and waiting for them to be registered).

The company has yet to demonstrate it can satisfy FDA submission requirements.

None of the above is insurmountable. But, it all introduces risk.