• Cash and Equivalents: Ended the third quarter of 2024 with almost $136 million.
• Sales Strategy: Initial sales appear flat quarter over quarter due to product stocking during launch.
• Market Engagement: Engaged with all 3,400 targeted immunologists and hematologists for the first phase of the launch.
• Coverage: More than 150 million lives covered with favorable policy decisions.
• Phase Three Trial Enrollment: Expected full trial enrollment in mid-2025.

• Warning! GuruFocus has detected 5 Warning Signs with XFOR.

Release Date: November 13, 2024

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• X4 Pharmaceuticals Inc (NASDAQ:XFOR) received FDA approval for their first product, Maverick, for the treatment of WHIM syndrome, a rare primary immunodeficiency disease.
• The company successfully engaged with all 3,400 targeted immunologists and hematologists in the first phase of their launch, increasing awareness of WHIM syndrome among potential prescribers.
• Market research indicates that 80% of healthcare providers surveyed would consider prescribing Maverick for their WHIM patients.
• The company has made significant progress in their global pivotal phase three trial for chronic neutropenia, with health authority authorizations received in approximately 85% of the targeted countries.
• X4 Pharmaceuticals Inc (NASDAQ:XFOR) ended the third quarter of 2024 with cash and equivalents of almost $136 million, providing a financial runway into late 2025.

Negative Points

• Sales of Maverick appear to be flat quarter over quarter, partly due to initial product stocking.
• The only currently available therapy for chronic neutropenia, GCSF, has been associated with dose-dependent side effects and long-term cancer risks, highlighting the challenge of introducing a new therapy.
• The phase two study for Maverick had a small sample size, limiting the ability to draw broad conclusions about its efficacy across different patient subtypes.
• The company is not yet providing sales guidance for 2025, which may create uncertainty for investors.
• The phase two study was not designed to assess infection rates, making it difficult to directly correlate Maverick's efficacy with reduced infection risk.

Q & A Highlights

Q: What were the biggest criteria in the trial that made physicians comfortable to reduce and lower G CSF usage? Were there any early signals of reduced pain or better convenience benefits for patients? A: The choice to adjust G CSF dosing was left to the physicians and patients, based on the robust ANC responses due to the addition of Maverick. Physicians were comfortable with the level of ANC and the clinical manifestations, which drove most of those decisions. It's too early to assess reduced pain or convenience benefits, but the broad reduction in G CSF across 75% of patients is promising. - Unidentified Company Representative and Christophe Arbet, Chief Medical Officer

Q: Can you explain what lower G CSF usage means? Is it about the frequency or amount of G CSF administered? A: A 25% reduction in dose and/or frequency is considered clinically meaningful. The reduction is based on the patient's entry criteria, as each patient's response to G CSF is different. - Unidentified Company Representative

Q: Regarding the phase three trial, are you looking at benefits from G CSF reduction in terms of improved tolerability and safety? A: The phase three trial is designed as a registration approval trial per FDA requirements. We will look at those aspects in a follow-on study to the phase three trial. - Christophe Arbet, Chief Medical Officer

Q: Can you provide more detail about the new initiative for Zol Remy in terms of reaching out to patients? A: We have launched a new patient-directed campaign combining digital campaigns and hardcopy materials to educate patients and encourage discussions with their physicians about Whim syndrome. - Paula Ragan, President, CEO

Q: Was there any correlation between CN subtype and the rapidity and magnitude of GCSF dose reduction? A: The sample size in the phase two study is too small to draw conclusions about different CN subtypes. However, all types of patients included in the study chose to decrease G CSF voluntarily. The phase three trial will provide a bigger picture. - Christophe Arbet, Chief Medical Officer

Q: Will you provide any sales guidance numbers for Zol Remy moving into 2025? Was there any data collected on infections in the new phase two data? A: We are not yet providing sales guidance for 2025. The phase two study was not designed to assess infection rates, but ANC is proven to correlate with infection risk. We are pleased with the robust ANC increases and functional neutrophils, which are promising for the phase three trial. - Paula Ragan, President, CEO

For the complete transcript of the earnings call, please refer to the full earnings call transcript.