11/13/2023

speaker
Tara
Conference Call Moderator

Good morning and welcome to the Astria therapeutics quarter 3, 2023 corporate update at this time. All attendees are in a listen only mode. A question and answer session will follow the formal presentations. If you'd like to submit a question, you may do so by using the Q and a text box at the bottom of the webcast player, or by emailing your questions to questions at lifestyle advisors dot com. As a reminder, this call is being recorded and a repo will be made available on the ASHRAE website following the conclusion of the event. I'd now like to turn the call over to Liz Higgins, Director of Communications and Investor Relations at ASHRAE Therapeutics. Please go ahead, Liz.

speaker
Liz Higgins
Director of Communications and Investor Relations

Thank you, Tara. Welcome to today's ASHRAE Therapeutics Q3 2023 conference call. With me today are Jill Milne, Chief Executive Officer, Christopher Morabito, Chief Medical Officer, Andrew Pomiani, Chief Commercial Officer, Andrew Matthews, Chief Business Officer and Noah Klauser, Chief Financial Officer. We issued a press release this morning summarizing our corporate update and third quarter financial results, which we will reference on today's call and is available on our website. We are also using slides during today's call that are available within the events and presentation section in the investors part of our website. I would like to note during today's event, as mentioned on slide two, we will be making forward-looking statements related to our business based on current and future expectations. Actual results may differ materially from those indicated by these statements as a result of a variety of risks and uncertainties, including those discussed in our most recent Form 10-K and our subsequent SEC violence. Such statements may represent our judgment as of today, and we undertake no obligation to publicly update any forward-looking statements except as required by law. I will now pass the call over to Jill Mill, Chief Executive Officer. Jill.

speaker
Jill Milne
Chief Executive Officer

Good morning, and thank you for joining our earnings call. We've had an exciting few months at Astraea and are in a strong position to close out the year. Just a few days ago at ACAAI annual meeting, we shared positive phase 1A data for STAR-0215, our lead program, that supports our vision for STAR-215 to be the first choice preventative treatment for hereditary angioedema, or HAE. The data confirmed the potential for STAR-215 to prevent HAE attacks with dosing two or four times per year. We aim to provide patients the option to choose a dosing regimen that works best for their lives, which we will review more on the coming slides. Last month, we also announced the expansion of our pipeline with STAR 310. We plan to present a preclinical profile for this program next year with a planned IND submission by the end of 2024 and Phase 1A initiation expected in Q1 2025. Our focus for Astrea is to develop first choice products that improve the health outcomes of patients with allergic and immunological diseases. First choice to us means patients and treating physicians would choose our products because of their strong competitive efficacy, low treatment burden, and favorable safety and tolerability profile. Our initial pipeline is focused on well-established mechanisms, mechanisms that are clinically validated where we believe we can advance ultimately best-in-class programs. Very much in line with this strategy is our STAR-215 program. We think that STAR-215 is very well positioned to be the first choice preventative treatment to help stabilize the lives of patients living with HAE, a rare, life-changing, and at times, life-threatening disease. STAR-310 is an anti-Ox40 antibody also aligned with this strategy that we plan to develop as a potential best-in-class therapeutic for atopic dermatitis and potentially other indications. The next slide is an overview of our expected milestones for the integrated pipeline with both programs. We just shared additional Phase Ia results at ACAAI this weekend, which further supports STAR215's best-in-class PK profile and the options for Q3 and Q6 month dosing as a potential HAE preventative therapy with robust attack suppression and low treatment burden. Our AlphaStar trial in HAE patients is progressing very well. We are now planning to share meaningful initial proof of concept results in Q1 of 2024. Assuming positive results from this trial, we plan to initiate a pivotal phase three trial In Q1 of 2025 and are looking at ways to accelerate this timeline we're actively working on the design of our phase three trial. With star 310 we expect to submit 90 by year end 2024 and to share the preclinical profile in 2024 at a scientific conference. We anticipate early proof of concept results from a phase one a trial in Q3 of 2025. which we believe will be an important milestone for the program. Next, assuming positive results in the phase 1A trial, we anticipate initiating a phase 1B clinical trial in atopic dermatitis patients in the second half of 2025. I will now turn it over to Chris Morabito, our chief medical officer, who will review the new data we have seen for STAR215. Chris.

speaker
Christopher Morabito
Chief Medical Officer

Thanks, Jill. STAR-215 is a potential first choice treatment for the prevention of attacks in hereditary angioedema. HAE is a rare, life-threatening, and life-changing disease characterized by severe, unpredictable, painful, and sometimes life-threatening edema in the skin, abdomen, and airway. Patients with HAE live in fear of having an attack that could be immensely painful or leave them disfigured could be fatal. For most patients, it's caused by a deficiency in a protein called C1 inhibitor, which is an important component of the body's complement system. Deficient C1 inhibitor may lead to runaway plasmid calocrine activity, producing bradykinin that causes the painful swelling attacks that characterize HAE. Star 215 inhibits plasmid caligrene in order to prevent bradykinin release and subsequent swelling, the same mechanism as market leader Taxairo. We believe that 215 has the potential to differentiate from currently available therapies, and our goal is to reduce the disease and treatment burden for people living with HAE and help to normalize their lives. Star 215 is a YTE-modified extended half-life monoclonal antibody, which is a trusted modality in HAE. Star 215 has the potential to support dosing every three and every six months, and we have formulated it to be high concentration and citrate-free for self-administration that may be less painful. As Jill mentioned, we have now shared the results of our Phase 1 Healthy Subject Trial up through day 224 days, and these data support our vision for the program. I will now review them in more detail in the coming slides. The Phase 1A Trial of 215 is a randomized, double-blind, placebo-controlled trial conducted in 41 healthy subjects. Shown here are the five single-dose cohorts. The results I will share over the next few slides include safety, tolerability, PK, and PD data through the full follow-up period for cohorts one through three and the initial results for cohorts four and five. Ultimately, we are very pleased to see that these results support both every three and every six month dosing strategies for a potential HAE preventative therapy with robust attack suppression and low treatment burden. On slide 8, we turn to the pharmacokinetic results. In the graph, you can see the rapid and sustained increases in 215. In the 600 milligram dose, for example, concentrations above 12 micrograms per mil, the threshold we believe is associated with clinical benefit, were achieved at about 11 hours after the dose was administered. For all of the doses above 100 milligrams, concentrations remained above the threshold for clinical benefit for more than 84 days or three months. Based on these data, we estimate the half-life of 215 to be up to 127 days. We also saw favorable safety and tolerability with 215 and no serious adverse events or discontinuations due to an adverse event. The most common treatment immersion adverse events observed were associated with injection site reactions of erythema, pruritus, and swelling. Here we see our modeling for potential three and six month dosing regimens updated with these newest data. As you see, these results confirm our approach to evaluate administration of 215 every three and every six months. On the left side, we have a simulated three month dosing regimen that begins with a 600 milligram loading dose on day zero, and then follows it up with a 300 milligram dose given then every three months. We are pleased to see that this dosing regimen can maintain C trough levels at about 25 micrograms per mil well above the 12 microgram per mil threshold associated with prevention of HAE attacks. On the graph on the right, we have a simulated six month dosing regimen, which begins with a 600 milligram loading dose and then 600 milligrams every six months, starting 28 days later. Again, we see C trough levels that stay well above the 12 microgram per mil threshold, this time at 27 micrograms per mil. Based on these results, we believe that both of these regimens could be successful in preventing HAE attacks. and we will talk more about our dosing strategy on upcoming slides. On slide 10, we turn to the pharmacodynamic results. The graph shows the reporter substrate assay in healthy subjects and includes STAR-215 data, as well as lanodilumab data, acknowledging that these are data from two different healthy subjects, single-dose clinical trials. With 215, we saw statistically significant inhibition of plasmic caliphene activity observed through day 140 after single doses of 300 and 600 milligrams and through day 224 after single doses of 1200 milligrams sub-q. The percent inhibition of plasmicaloquine is maintained through day 84 after single doses at levels greater than or similar to those achieved by lanodilumab at peak. Given the promising healthy subject results, we are excited to be studying STAR 215 in HAE patients. Here is an outline of our AlphaStar trial, which is currently evaluating STAR 215 in HAE patients. We are pleased to share that this trial is progressing well, and we are currently enrolling into the third cohort. We are now planning to share initial proof of concept results in HAE patients in the first quarter of 2024. Assuming positive results from this trial, we expect to initiate pivotal phase three trial in Q1 2025, and we are looking at strategies to accelerate this timeline. The alpha solar long term open label trial is open. Now, there are data accruing of participants who have received multiple doses of start 215. I will now turn it over to enter community or our chief commercial officer who will review the results of some new market research Andrew. Thank you Chris.

speaker
Andrew Pomiani
Chief Commercial Officer

And good morning. Everyone. Our vision for stars 0215 is to develop a treatment option that can help normalize the lives of patients with. As Chris mentioned, we've recently completed or conducted some additional market research with both patients and physicians to get a better understanding of the level of interest. And enthusiasm around every 3 and every 6 month dosing options for star 0215. We presented star 0215's profile with both three and six month dosing options to 92 HAE patients and caregivers and 60 HAE treatment providers. On the left graph, you can see that 90% of patients are likely to ask their HCPs about a product with star 0215's profile with every three month dosing and 97% of HCPs are likely to prescribe it. On the right, you see that 76% of patients are likely to ask their prescribers about the profile with every 6 month dosing. And 93% of prescribers are likely to prescribe. While the patients and caregivers indicated a slightly higher preference for a 3 month dosing regimen. Both options indicated a high level of interest from both patients and from prescribers. Given the faster development timeline for a three-month dosing regimen, we intend to prioritize clinical development for every three-month administration, followed by a six-month dosing option, enabling patients to choose a regimen that works best for them. So, in summary, we're excited about the potential of STAR-0215 becoming a first-choice preventative treatment for HAE patients for the following reasons. As Chris shared earlier, we have compelling data from our 1A trial that supports its potential best-in-class profile. Two, STAR-0215's mechanism of action and modality are proven safe and effective in HAE as demonstrated by the current market leader. Three, STAR-0215 has the potential to provide rapid and durable protection against HAE attacks. STAR-0215's citric acid-free formulation is expected to reduce injection site pain associated with formulations that contain citrate buffers. Finally, we plan to develop STAR-0215 in options that support patient choice by prioritizing development on a three-month dose option first, followed by a six-month dosing regimen. We see a very bright future for STAR-0215 as the potential first choice preventative HA therapy, and we look forward to providing you additional updates on our progress next quarter. I'll now turn it over to Andrea Matthews, our Chief Business Officer, who will introduce our STAR-0 310 program. Andrea?

speaker
Andrew Matthews
Chief Business Officer

Thanks, Andrew. Let's turn to our second program, STAR-310, in atopic dermatitis. A topic dermatitis is an immune disorder associated with loss of skin barrier function and itching. It is driven by diverse mechanisms which span the spectrum of T cell driven pathology and it affects approximately 5% of the US population half of these cases are reported to be moderate to severe. The burden experienced by moderate to severe atopic dermatitis patients can be significant and can include intense itch inflamed skin sleep disruption depression and infections. Here you see psoriasis demonstrates precedent for growth for market growth and evolution for targeted therapies and dermatology. U.S. sales for targeted therapies for psoriasis were approximately a billion dollars in 2010, and that's when there were two drug classes approved compared to more than 17 million in 2022, with 15 approved therapies across four major drug classes. In atopic dermatitis, there are currently only two approved drug classes for biologic therapies. Given the higher prevalence of atopic dermatitis than psoriasis, we and others see that the atopic dermatitis market has even greater potential. We think that the moderate to severe atopic dermatitis treatment market could reach 26 billion by 2030. Currently, Dupixent is the market leader for targeted atopic dermatitis treatments. And our base case assumption is that OX40 treatments will be after Dupixent in the treatment regimen for atopic dermatitis. However, there's good rationale for this to evolve prior to the potential launch of our program. In both scenarios, we believe that there is substantial opportunity for STAR-310. I'll now hand the presentation over to Chris, who will review the disease pathology of atopic dermatitis and also our vision for STAR-310. Chris? Thank you, Andrea.

speaker
Christopher Morabito
Chief Medical Officer

Here you can see the immune dysregulation in atopic dermatitis can be complex. Current approved biologics and other late-stage non-Ox40 biologics target only the type 2 pathway, hitting downstream cytokines from Th2 cells. But AD is more complicated than this. Type 1 and type 3 pathways also contribute to this disease. STAR310 is an OX40 inhibitor which targets multiple effector T cell pathways. It aims to reduce the activity of a broader group of TH cells that are known to contribute to the disease and has the potential to induce higher rates of clinical responses in more patients than currently available biologics and maybe disease modify. Here we do a deeper dive on the AUX40 pathway programs. There are three programs that have achieved a clinical proof of concept. Amletelamab from Sanofi, which targets AUX40 ligand, ropatilamab from Amgen, and telazolamab, which is the parent program for STAR310, both of which target AUX40 on activated T cells. All three of these programs have seen promising clinical efficacy results through Phase IIb in atopic dermatitis. And the telomab targets OX40 ligand, which is expressed in a wider array of cell types, which could lead to increased risk for respiratory and vascular adverse events. Roptatinumab is an efflucosylated anti-OX40, which is selective for T cells, but depletes T cells via enhanced ADCC. T cell depletion leads to cytokine release and potential increased risk of infection. 310 is the next generation of telis or the MAP. 310 is designed to have higher affinity, greater potency, and YTE half-life extension technology. We believe that 310 has the potential to be the first choice OX40 for moderate to severe atopic dermatitis. As mentioned on the previous slide, it is designed for high affinity with selective potency, and we believe that it can match or beat the efficacy seen in other OX40 programs. The half-life of 310 is extended with YTE technology with the goal of reducing the time between doses, and we also believe that we have the potential to administer 310 with subcutaneous delivery. And given that 310 is designed to be T-cell preserving with low ADCC, we think it has the potential to have the best-in-class safety profile. We have filed a provisional patent application for STAR 310 that, if converted, granted, and nationalized, would provide patent term extension through 2044 before taking into consideration any potential patent term extensions. As noted, we believe that 310 could be a best-in-class and first-choice treatment for atopic dermatitis. Starting first with common factors for OX40 pathway monoclonal antibodies, targeting this pathway has the ability to have disease-modifying impacts. The OX40 pathway has potential for effectiveness across AD driven by multiple effector T cell types, not just Th2. sustained responses across a broad range of AD. We also believe that due to the YTE modification, long acting 310 has the potential to be administered four to six times per year compared to the anticipated 12 times per year for amitilumab and rocatilumab. We believe the safety profile of 310 will differentiate from both amlatilumab and amlatilumab, as 310 has the potential for reduced T cell depletion due to ADCC and limited potential for AEs due to off-target binding. Beyond atopic dermatitis, we believe that targeting the OX40 has strong potential in a broad range of additional indications. Noah Clouser, our Chief Financial Officer, will now review our financial information and upcoming milestones. Noah? Thank you, Chris.

speaker
Noah Klauser
Chief Financial Officer

On this slide, I'll provide a brief summary of important financial information. As of September 30, 2023, we had $188.8 million in cash, cash equivalents, and short-term investments. In October 2023, we closed a $64 million underwritten offering. Following the October financing, we expect our cash to support our current operating plan into 2026. Our current operating plan includes the development of Star 215 and Star 310, including for Star 215, support for all program activities up to the initiation of the planned pivotal Phase 3 trial, and for Star 310, the anticipated submission of an IND, the planned Phase 1A clinical trial on healthy subjects, and any related anticipated milestone payments. Also illustrated here is a summary of our outstanding equity. In addition to our 36.3 million outstanding common shares, we now have 1.6 million pre-funded warrants and 5.2 million as-converted preferred shares. So in total, we have 43.1 million outstanding common equivalent shares. For additional financial information, please see our earnings press release issued earlier this morning and our 10K, which we plan to file with the SEC after market today. I will now touch on upcoming milestones and then we will open up for questions. On this slide, you can see the cadence of anticipated milestones as well as our future development goals for our combined pipeline with at least one clinical milestone each year in the coming years. Next year is a big year, as we expect to report proof of concept results for STAR 215 in patients in Q1 and for STAR 310. We plan to submit an IND by year end. Our ultimate goal is to bring first choice therapies to patients, and we are looking forward to executing on that goal in the years to come. I will now ask the operator to open up the line for questions. Thank you.

speaker
Tara
Conference Call Moderator

Great. At this time, we'll be conducting a question and answer session with our speakers. Please hold for a brief moment while we pull for questions. So our first question comes from Oon Yang from Jefferies. Please go ahead, Oon. Oon, you might be on mute.

speaker
Oon Yang
Analyst, Jefferies

Oh, yes. Can you hear me okay? Yes, we can. Okay, great. Thank you very much. So can you talk about, so phase 1b data in HAE patients have been accelerated. Can you talk about what has caused the accelerated timeline for the data readout? And second question is on phase 3. I think June mentioned that It's going to start in first quarter 2025, but you are looking to expedite the timeline. So, phase three, do you think the design would be similar to ASO targeting Brichelli crime from Ionis, or do you think that you may add an active competitor, such as Texira, for the efficacy comparison? Thank you.

speaker
Operator
Conference Call Operator

Great. Thanks, Yoon. And Chris will address those questions.

speaker
Christopher Morabito
Chief Medical Officer

Yeah, thanks, Yoon. Yeah, we're very excited about the ability to demonstrate some initial proof of concept data in patients and even more excited that the timeline for that has been accelerated now to Q1. And the reason for that is because we've now achieved target enrollment in cohorts one and two and are enrolling into cohort three. and anticipate that we will achieve a planned interim analysis trigger earlier than anticipated. So the data that we plan to share in Q1 will be based on the interim analysis that will trigger in Q1, and as mentioned during the call, aim to provide meaningful POC data demonstrating that whether STAR-0215 may be effective when given every three months and every six months to patients. The 2nd question about the phase 3 design. Yes, we are anticipating that the phase 3 is in Q1, but we're looking at every opportunity to potentially accelerate that. We've been doing a lot of work thinking about the design of the phase 3 study. Our current assumption is that it will be a placebo controlled trial that we will not be versus an active comparator. We also assumed that we would have a similar treatment period as other phase three trials, which specifically is about six months of treatment period, and that the primary endpoint would be similar to what's been used also in phase three studies, which is essentially change from baseline versus placebo and monthly attack rates.

speaker
Tara
Conference Call Moderator

Thank you.

speaker
Noah Klauser
Chief Financial Officer

Sure.

speaker
Tara
Conference Call Moderator

Thanks for the questions, Eun. Our next question comes from Sam Slutsky at LifeSci Capital. Please go ahead, Sam.

speaker
Sam Slutsky
Analyst, LifeSci Capital

Hey, good morning, everyone. Thanks for the questions and congrats on the updates. Just two for me. I guess for the upcoming AlphaStar interim analysis, given that there's no placebo arm, just what data are you looking for that you would consider when before moving to phase three as you think about the different dosing regimens that you might take forward?

speaker
Christopher Morabito
Chief Medical Officer

Yeah, Chris? Yeah, sure. Hi, Sam. So, right, we don't have a placebo, but we've built into this a robust running period in which we collect important baseline information on all of our participants. The planned efficacy analysis is changed from baseline on various efficacy parameters to inform the effectiveness of this drug in HEE, specifically whether a dose can prevent for three months and a dose can prevent for six months.

speaker
Sam Slutsky
Analyst, LifeSci Capital

Okay. And then just as you think about the quicker enrollment you saw in AlphaStar and read through to Phase 3, anything that stands out, whether it be certain sites you may reuse or just patient feedback in terms of your regimens, et cetera, as we think about timelines for Phase 3?

speaker
Christopher Morabito
Chief Medical Officer

Sure. So I think two key things have contributed to the accelerated timelines here. One is the profile. I think that when we talk with physicians, the community, the patients, Working with our advocacy organizations, we get a lot of, frankly, positive feedback that the profile is something that is meaningful to patients with this disease. Specifically, the ability to administer in such a way that has the potential to potentially normalize the lives of people living with this disease appears to be very attractive. And there is interest among sites and potential participants in joining our development program. And the second is the trial design. I think we found a lot of, we put a lot of effort into thinking about a clinical trial that would provide meaningful data in a timely fashion. And you pointed out one in question one, which is the lack of a placebo group, which for many is a detriment. So eliminating the placebo group and thinking about dosing regimens that could provide important data with limited resource utilization, i.e. sample size, again, appears to be attractive to SICE and also to patients.

speaker
Sam Slutsky
Analyst, LifeSci Capital

Awesome. Thank you.

speaker
Tara
Conference Call Moderator

Thanks for the question, Sam. Our next question comes from Seema Shorin from Evercore. Please go ahead, Seema. Hi.

speaker
Seema Shorin
Analyst, Evercore

Thank you for taking my questions. My first question is on the proof of concept data that is coming in first quarter. Like, I know this study is small, but what do you think is a win in terms of reduction in HAE attack rates for this upcoming data readout? And I will follow up.

speaker
Christopher Morabito
Chief Medical Officer

Right, so the traditional way of looking at efficacy here is by looking at essentially the monthly attack rates over time. And what has been done in other phase 1B and 2 trials is looking at this endpoint and there's been between 75 to 100% reductions with small sample sizes. At various dose levels, another way of looking at this is by looking at the proportion of people who are attack free for defined periods of time for us. That could be. After a single dose, looking at a proportion of people who are attacked for 3 months, looking at people who are tech free at 6 months. And that hasn't been previously reported in any significantly meaningful way. So that's something that I think would differentiate us in terms of this drug's ability to impact meaningfully the lives of people with this disease. So we'll be looking for a high proportion of people that are attack-free for those predefined periods of time.

speaker
Seema Shorin
Analyst, Evercore

That's helpful, thank you. And also just curious, why there's less interest from docs and patients for six months dosing than three months?

speaker
Andrew Pomiani
Chief Commercial Officer

This is Andrew. A couple of comments there as we look through the data. First of all, there potentially could be some perception as happens with dosing intervals with other products that you might be able to, you might be losing some levels of efficacy as you extend the dose. We don't intend that to happen. We understand that efficacy is an important element of treatment. our intention is to develop a highly effective treatment for both a three and a six month dose. So we believe that that might be an issue. The second issue is that the patients that had the six month dosing option had obviously two injections. And what quite a few patients, especially with TexIRO experience, is injection site pain associated with the citrate buffer. We obviously, or we're going to be developing a citrate free buffer, and we expect to have that level of pain be significantly reduced. So. You know, the numbers are relatively small in terms of the difference. I think the good news for us is that both physicians and patients are very excited about both dosing options. But again, I think if we can. Demonstrate high efficacy at both doses and have a formulation that reduces injection site pain. I think that those differences could be addressed.

speaker
Seema Shorin
Analyst, Evercore

That's very helpful. Thank you. My last question is on the ADARx data that was presented at ACAI. If you can speak about the read-through from that data for your program. And thank you.

speaker
Jill Milne
Chief Executive Officer

Yeah, so with regards to, yes, so ADARx had presented this weekend at ACAI as well as we have, I think, you know, based on the data that we saw presented by ADARx, we do believe that we have a better chance of technical and regulatory success with STAR 215 and that we are more advanced. I think what we learned over the weekend about their program is that, from what we understood, they're currently limited on which dose they can take forward based on safety concerns and the two-meg-per-kig dose that they are advancing first to patients does not appear that it'll get them through every six-month dosing. And so, obviously, you know, lots more information to come from them.

speaker
Seema Shorin
Analyst, Evercore

That sounds good. Thank you for taking my questions.

speaker
Tara
Conference Call Moderator

Thanks for the question, Seema. Our next question comes from Hartaj Singh from Oppenheimer. Please go ahead, Hartaj.

speaker
Hartaj Singh
Analyst, Oppenheimer

Great. Thank you for a couple of questions and then really nice presentation. We had done a survey with 25 high prescribing physicians and a lot of, Andrew, what you've been saying was we saw concordance in our survey. But I had just a couple of questions extending from the survey that we did. One was just what are you hearing from PEARS? This is a very competitive area. There's a lot of different options. you know the pair dynamic and the competitiveness is also i imagine a thing so one what are you hearing from pairs or you know if if you haven't uh you know gone there yet you know what what's the work you're thinking of doing there uh preparing uh secondly you know there still seem to be somewhat of a lack of awareness um you know there was a core group of our 25 physicians that seemed to really know two and five very well and others that seem to be sort of you know kind of aware of it How are you gonna tackle that? And then lastly, for Chris, just on biomarkers, Chris, the biomarkers you've been showing us from preclinical and phase one, could those in any way help in the phase three trial in coming up with a design that could be fostered? Thank you for the questions.

speaker
Andrew Pomiani
Chief Commercial Officer

Sure. So we did a payer landscape assessment earlier this year. And what we learned is that at least right now, Ultimately, patients can get the product that physicians will prescribe. In a, but over the class is going to continue to be managed. So, you know, I think, like, in other rare diseases. There might be some work associated with getting patients onto the treatment that they want. But generally, um, you can get there, but again, um. The class will continue to be managed more actively as more treatments become available. The other thing that we heard is, is that efficacy continues to be a very important element of what the payers are looking for. So, again, given the profile that we're looking to develop, we're looking to develop a treatment that. Hopefully can provide comparable efficacy in terms of attack rate reduction. There's an opportunity for us to keep even more patients attack free, but then also combine that with a product that patients obviously would be more compliant with. So, so that's what we're learning from the payers in the US. I would say that from an awareness perspective, obviously we're generating additional data that we're going to continue to share at conferences. We are creating a medical affairs function. We started that process earlier this year. We're looking to grow that. So, you know, I think that our awareness amongst the Top one KOLs is very high. I think our awareness within the HAE community continues to grow. But, you know, I do believe that we'll continue to publish hopefully very impressive, encouraging data that both physicians and patients will be interested in. And as we continue to grow our organization, hopefully we can increase that share of voice within the community.

speaker
Christopher Morabito
Chief Medical Officer

And regarding biomarkers, the biomarkers that we and others use in this space are useful for targeting engagement, but don't, I think, get up to the level of surrogacy. So I think we'll be able to use PD to inform the potential data set that we'll bring to regulators, but not rely on it. As I mentioned before in other meetings that we've had, I think PK is, meetings that we've had here in investor settings, the PK itself I think is a stronger supporter of potential effectiveness. We target 12 micrograms per mil as a threshold we believe confers the potential for effectiveness. So we've been looking very closely at that. We will be looking obviously at PK in patients in our phase three trial. So, PK and PD will support, but I don't think replace the data set we'll be able to use for Phase III.

speaker
Hartaj Singh
Analyst, Oppenheimer

Great. Thank you for all the questions.

speaker
Tara
Conference Call Moderator

Thanks for the questions, Haritaj. Our next question comes from Joe Pangenis from HC Wainwright. Please go ahead, Joe. Jo, are you there? Okay, we'll go to the next analyst until Jo is able to connect. So our next question comes from Ingrid Reitermeier from Wedbush. Please go ahead, Ingrid. Ingrid, you might be on mute. Ingrid, are you on mute? The audience, please give us a second. So our next question comes from Farhana Sackloff from Lattenburg. Please unmute your line. Unmute your line.

speaker
Farhana Sackloff
Analyst (on behalf of Michael) – Lattenburg

Hi, good morning. This is Farhana on behalf of Michael. First, three congrats on the quarter. As most of our questions have been asked, we will just follow up on one. You guys said that the Phase 2, I mean, sorry, the Phase 1B was enrolling faster because there was no placebo arm. For the Phase 3, if I heard correctly, for the design, there is going to be a placebo arm. So do you see that there will be an impact on enrollment?

speaker
Christopher Morabito
Chief Medical Officer

I do think that there will be an impact on enrollment, but I think that we'll be able to mitigate it with a variety of factors, including ideally strong proof of concept data that will continue to support the profile and raise awareness among sites. We have intentions of making this a global trial as well, which will increase the opportunity for patients around the world to experience 215 and also to contribute to our data set. And we've been working very closely with the community in not just talking about the profile, but also in the development of this medicine. And I think we all already have strong support from the community demonstrated by the enrollment that we've talked about with 215. And ideally, that support will translate into support for phase three and enrollment into the trial in phase three.

speaker
Tara
Conference Call Moderator

Thank you. Thanks for the questions, Farhana. Our next question comes from Joe Pangenis from HC Wainwright. Please go ahead, Joe.

speaker
Joe Pangenis
Analyst, HC Wainwright

Hey, everybody. Sorry about that. That was Murphy's law of connectivity issue timing. But appreciate the getting back in. So my question is also on the phase three. I guess I'll ask it this way. Your goal is to accelerate the timing that you talked about. what do you consider the rate limiting steps i mean there's a lot going on over the next several months you do need to be able to get to you know more solar ole data you know additional follow-up across the board you know what kind of logistics you know design uh regulatory discussions and cmc i basically listed a lot there but what do you think are the rate limiting steps

speaker
Christopher Morabito
Chief Medical Officer

Until you answer the question yourself, I think you've outlined all of the things that we have to think about as we think about the plan for the start of the phase 3 and without knowing the data. It's difficult for me to identify what factor could be contributing as a critical path or rate limiting. Just to repeat what you said, after we get the data, we need to analyze them, understand them, and finalize the approach for phase three. We need to get regulatory input from not just the U.S., but around the world. As I mentioned, we plan to make this a global trial. Obviously, we're making drug thinking that we're going to continue dosing people with this disease, so hopefully CMC doesn't impact timelines too much, but we'll have to do some work on dose selection, which can impact the timing for for the start of the phase three. So we're going to be looking very deeply at all of those steps. And as mentioned before, look for opportunities to accelerate. And when we share the updates with the Q1 data, we anticipate being able to share a more robust timeline to phase three, as well as the phase three trial itself.

speaker
Joe Pangenis
Analyst, HC Wainwright

Appreciate the color, thanks.

speaker
Tara
Conference Call Moderator

Thanks for the questions, Joe. Our final question comes from Ingrid Reitermeier from Wedbush. Please go ahead, Ingrid.

speaker
Ingrid Reitermeier
Analyst, Wedbush

This is Ingrid on for Laura Chico. Just any color on the baseline characteristics you can share at this time of the patients you have enrolled in the AlphaStar trial. Just trying to get a sense of demographics, if you can share that. Thank you.

speaker
Christopher Morabito
Chief Medical Officer

Yeah, I can't share the specifics about the demographics at this point, but I can tell you that the inclusion and exclusion criteria of our trial are very similar to what's been done in other diseases in the space. In fact, we designed ours based on other trials, so we would anticipate a similar set of baseline demographics in terms of the severity of the disease and background or history of medication use has been demonstrated with other trials. I can tell you that we've been up, as you well know from clinicaltrials.gov, we've been up in the U.S. and Canada, so the data will be limited to patients from U.S. and Canada.

speaker
Tara
Conference Call Moderator

Thank you. Thanks for the questions, Ingrid. This concludes today's Q&A session. I'll now turn the call back over to Jill.

speaker
Jill Milne
Chief Executive Officer

Thank you, Operator. And thank you all for joining our call this morning and for your continued support of Astria. We'll keep you updated as we execute on our Star 215 program, the Alpha Star trial, and share other areas of progress at the company, including our Star 310 program. We look forward to speaking with you again soon. Liz?

speaker
Liz Higgins
Director of Communications and Investor Relations

That concludes today's call. A webcast replay will be available for 90 days via the investor relations page on our website at www.astriatx.com. Thank you.

Disclaimer

This conference call transcript was computer generated and almost certianly contains errors. This transcript is provided for information purposes only.EarningsCall, LLC makes no representation about the accuracy of the aforementioned transcript, and you are cautioned not to place undue reliance on the information provided by the transcript.

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