Astria Therapeutics, a company striving to carve a niche for itself in the world of rare allergic and immunological diseases, recently released its Q3 2023 earnings transcript. While much of the attention centered on their lead program, STAR-0215 for Hereditary Angioedema (HAE), a closer look reveals a fascinating, potentially overlooked detail about their second program, STAR-0310, targeting atopic dermatitis.

Throughout the transcript, Astria emphasizes the concept of "first-choice" products. This signifies treatments that stand out due to superior efficacy, minimal treatment burden, and a favorable safety profile. While this concept is primarily associated with STAR-0215 in the context of HAE, there's a subtle shift when discussing STAR-0310. The language subtly changes from aiming for a "best-in-class" OX40 inhibitor to aspirations of becoming the "first-choice" treatment for atopic dermatitis.

This seemingly minor shift in terminology could signal a far greater ambition. It suggests that Astria isn't simply aiming to improve upon existing OX40 inhibitors, but rather to leapfrog the current market leader, Dupixent, and establish STAR-0310 as the preferred starting point for atopic dermatitis treatment.

Several factors fuel this hypothesis. Firstly, Astria directly compares the trajectory of targeted therapies in psoriasis to the potential of atopic dermatitis. They highlight the explosive growth in the psoriasis market, from $1 billion in 2010 to a staggering $17 billion in 2022. This growth coincided with a surge in approved therapies, expanding from two drug classes to four, covering 15 different treatments.

In contrast, atopic dermatitis currently has only two approved drug classes for biologic therapies. Astria strategically uses this comparison to underscore the immense potential of the atopic dermatitis market, estimating it could reach $26 billion by 2030. This bold prediction, coupled with their internal assumption of OX40 treatments initially being positioned *after* Dupixent, sets the stage for a potential disruption.

Atopic Dermatitis Market Potential

The following chart illustrates Astria's projection for the atopic dermatitis market, compared to the historical growth of the psoriasis market.

The transcript further reveals Astria's confidence in STAR-0310's potential to upend the current treatment paradigm. They emphasize the drug's ability to target multiple T-cell pathways involved in atopic dermatitis, offering a broader therapeutic impact compared to existing biologics that solely focus on the Type 2 pathway. This multi-pronged approach, they argue, could lead to higher clinical response rates and potential disease modification.

Furthermore, Astria projects a compelling dosing regimen for STAR-0310, aiming for administration every four to six months. This starkly contrasts with the anticipated 12-times-per-year dosing for competitor OX40 inhibitors, Amlitelimab and Rocatinlimab. Coupled with a subcutaneous delivery method and a potentially best-in-class safety profile due to its T-cell preserving nature, STAR-0310 starts to resemble a formidable challenger, not just a contender.

STAR-0310 vs. Competitor OX40 Inhibitors

Reference: Astria Therapeutics Q3 2023 Earnings Transcript - https://seekingalpha.com/symbol/ATXS

Intriguingly, the projected patent term extension for STAR-0310 stretches through 2044, further hinting at Astria's long-term aspirations for this program. This lengthy protection window aligns with their vision of establishing a dominant, enduring presence in the atopic dermatitis market.

The transcript, however, lacks specific numerical data to directly support this hypothesis. While market research data for STAR-0215 is presented, no comparable figures are provided for STAR-0310. This information gap creates both intrigue and uncertainty.

Astria's strategic silence on STAR-0310 market research could be deliberate, perhaps to maintain a competitive edge or to avoid revealing their hand prematurely. It's crucial to monitor future disclosures and presentations for concrete data points that could validate or refute this hypothesis.

Could Astria be quietly harboring a potential blockbuster treatment for atopic dermatitis? The Q3 2023 transcript provides tantalizing hints, but the definitive answer remains shrouded in strategic ambiguity. One thing is certain: Astria's subtle shift in language and their bold projections for the atopic dermatitis market warrant close attention from investors and industry observers alike.

"Fun Fact: The term "atopic" comes from the Greek word "atopos," meaning "out of place." It refers to the tendency of individuals with atopic dermatitis to have an exaggerated immune response to common environmental allergens."