Summary of Disc Medicine (IRON) FY Conference Call Company Overview - **Company**: Disc Medicine - **Focus**: Non-malignant hematology, specifically manipulating red blood cell biology - **Lead Program**: Vitapertin targeting erythropoietic protoporphyria (EPP) with a projected NDA filing in the second half of 2025 [4][12][26] Core Points and Arguments Erythropoietic Protoporphyria (EPP) - **Disease Description**: Genetic condition caused by mutations in the heme biosynthetic pathway leading to excessive buildup of protoporphyrin IX (PP9), which causes severe pain and potential liver failure [6][8] - **Patient Impact**: Patients experience excruciating pain from light exposure, leading to significant lifestyle restrictions [7][8] - **Current Treatment Landscape**: Many patients resort to ineffective opioid therapy [7] Clinical Trials and Data - **Phase II Studies**: Completed two studies (AURORA and BEACON) with approximately 100 patients showing a significant reduction in PP9 levels (50-60% at the 60 mg dose) [10][11] - **Clinical Significance**: Reduction in PP9 correlates with improved quality of life and reduced phototoxic reactions [10][11] - **FDA Interaction**: Positive discussions with the FDA regarding the use of PP9 as a surrogate endpoint for accelerated approval [13][16] Upcoming Trials - **APOLLO Trial**: Designed as a confirmatory trial to support full approval, incorporating learnings from Phase II studies [18][21] - **Endpoints**: Co-primary endpoints include PP9 reduction and clinically meaningful measures of light exposure [21][22] Market Opportunity - **Patient Population**: Approximately 14,000 diagnosed EPP patients in the U.S., with 6,000 engaged patients based on claims analysis [27][28] - **Commercial Potential**: High motivation among patients to improve quality of life, leading to expected rapid uptake of the drug [28][29] Payer and Reimbursement Landscape - **Initial Interactions with Payers**: Payers recognize the severe nature of EPP and the potential value of effective treatments [31] - **Pricing Context**: Existing treatments for related conditions priced at $300,000 to $575,000 annually, indicating a willingness to pay for effective therapies [32] Second Asset: Nine Seven Four - **Indication**: Treatment for anemia associated with myelofibrosis, addressing a significant unmet need as no approved therapies exist for this condition [37][38] - **Phase II Study**: Ongoing with initial data expected in the second half of 2025 [41] Third Asset: Nine Thousand Nine Hundred Fourteen - **Indication**: Anemia in non-dialysis dependent chronic kidney disease (CKD) patients, with a significant unmet need in this population [48][49] Future Outlook - **Pipeline Development**: Disc Medicine aims to remain capital efficient while exploring new opportunities for pipeline expansion [59][60] - **Exciting Year Ahead**: Anticipation of NDA filing for Vitapertin and further data releases from ongoing studies [62] Important but Overlooked Content - **Patient Engagement**: High patient motivation and engagement in clinical trials, which may facilitate faster enrollment and data collection [26][27] - **Regulatory Environment**: Positive momentum from the FDA regarding accelerated approval pathways for rare diseases, which may benefit Disc Medicine's programs [16][46]

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