Trevi Therapeutics (NasdaqGM:TRVI) FY Conference Transcript

Summary of Trevi Therapeutics FY Conference Call Company Overview - Company: Trevi Therapeutics (NasdaqGM:TRVI) - Focus: Development of a single asset drug in the opioid category, specifically a mixed agonist-antagonist that provides efficacy and safety without addiction potential [2][30] Core Points and Arguments Drug Mechanism and Indications - The drug targets three indications related to cough: 1. Chronic cough in idiopathic pulmonary fibrosis (IPF) 2. Other interstitial lung diseases (ILDs) 3. Refractory chronic cough (RCC) [3][4] - IPF is a severe condition with a poor prognosis, where 85% of patients experience chronic cough [3] - The drug has shown strong data in IPF, and the company aims to position itself as best in class against competitors [4] Competitive Landscape - There are currently no approved therapies for chronic cough associated with IPF and ILDs, creating a significant market opportunity [8] - Existing antifibrotics do not alleviate cough symptoms, leaving a gap in treatment options [8] - The company believes its drug's broad mechanism of action provides a competitive advantage over other peripheral-only mechanisms that have failed in trials [8][9] Clinical Development Plans - The company is preparing for a phase 3 trial in IPF, with a focus on maintaining a rigorous study design to manage placebo responses [12][10] - The upcoming phase 2 study for non-IPF ILDs is expected to enroll quickly due to overlapping patient populations [24][18] - The company plans to conduct a responder analysis to ensure robust data for safety and efficacy [14] Market Opportunity - Approximately 150,000 patients in the U.S. have IPF, with about two-thirds experiencing uncontrolled chronic cough [18] - Non-IPF ILDs could double the patient population, with 225,000 patients and a similar prevalence of chronic cough [18] Financial Position and Strategy - Trevi has over $200 million in cash, sufficient to fund multiple trials through late 2028 or early 2029 [43] - The company aims to leverage its capital efficiency by focusing on one drug across three indications [43] Regulatory Considerations - The company is preparing for an end of phase 2 meeting with the FDA, which will be critical for advancing its IPF program [27] - There are ongoing discussions about merging the ILD indication into the IPF program if positive results are obtained [24] Pricing Strategy - Specialty pricing is anticipated to be between $60,000 to $85,000, with expectations of inelastic demand [39] - The company plans to maintain pricing strategies across indications, including RCC, while exploring potential lower dosing options [40] Intellectual Property - Trevi has secured patents for its drug's method of treatment, with coverage extending to both IPF and RCC [41][42] External Factors - The company does not perceive significant competitive threats from rising biotech innovation in China, as respiratory therapies are not a primary focus there [46] - Trevi is exploring the use of AI to enhance operational efficiency and decision-making as it approaches commercialization [48] Important but Overlooked Content - The company has a strong focus on maintaining a tight study design to control variability in clinical trials, particularly for refractory chronic cough [11][20] - Trevi's drug has been unscheduled by the DEA, indicating a lower risk of abuse compared to traditional opioids [30] - The company is actively monitoring regulatory changes and their potential impacts, particularly concerning the FDA's evolving landscape [51][52]