The ENERGIZE-T study reported a 30.4% transfusion reduction response (TRR) in the mitapivat arm versus 12.6% in the placebo group. How impactful is this level of reduction in transfusion burden for managing long-term health outcomes in thalassemia patients?

The study highlighted statistically significant results in transfusion reduction over extended periods, including 24 weeks and beyond. How critical is the durability of response in defining mitapivat’s potential as a transformative therapy for transfusion-dependent thalassemia?

Results showed consistent efficacy across subgroups such as genotype and baseline transfusion burden. How does this uniformity enhance the potential for mitapivat to address diverse patient populations with thalassemia?

9.9% of patients in the mitapivat arm achieved transfusion independence for at least eight consecutive weeks. How significant is this finding, and what does it suggest about the potential for mitapivat to modify disease progression?

With similar overall adverse event rates between mitapivat and placebo, and 90.1% experiencing treatment-emergent adverse events on mitapivat, how do these findings align with the safety expectations for a long-term disease-modifying therapy?

Thalassemia management often involves secondary complications from transfusions, such as iron overload and organ damage. How might mitapivat’s ability to reduce transfusion requirements alleviate these downstream health risks?

Agios has filed for regulatory approval in multiple regions, including the U.S. and EU. What challenges and opportunities might arise in securing approval for mitapivat, given the current landscape of thalassemia treatment?

The ENERGIZE and ENERGIZE-T trials demonstrated promising results for transfusion- and non-transfusion-dependent thalassemia. What future clinical data or real-world evidence will be most critical to establishing mitapivat as a standard of care in thalassemia?

The recent FDA update on PYRUKYND® now includes a warning about liver injury at higher doses in patients with another condition. How might this update impact the perception of mitapivat's safety profile, especially for transfusion-dependent thalassemia patients?

The updated USPI advises monthly liver tests for the first six months of treatment. How feasible is this monitoring requirement in clinical practice, and could it influence treatment adherence or physician prescribing patterns?

Since the liver injury was observed at doses higher than those recommended for PK deficiency, how relevant is this risk to thalassemia patients receiving standard dosing protocols in the ENERGIZE-T trial?

Given the risk of hepatic injury noted in the updated USPI, how should the benefit-risk balance of mitapivat be communicated to both patients and healthcare providers managing transfusion-dependent thalassemia?

 The FDA update specifies that liver injury resolved after treatment discontinuation. How should this finding influence ongoing monitoring protocols and the approach to reinitiating therapy after discontinuation?

For a new thalassemia patient, what factors would make you choose mitapivat over luspatercept or transfusions? 

Are there specific patient populations (e.g, those with co-existing liver disease or higher risk for hepatoxicity ) for whom you would avoid mitapivat entirely?