Interest Form: Bitopertin Expanded Access Program

Disc Medicine has shared with UPA that it is planning an Expanded Access Program, or EAP, for bitopertin in the United States for people with EPP or XLP ages 12 and older. An EAP is a way some patients may be able to receive an investigational treatment outside of a clinical trial. Patients will need to meet specific criteria to be considered.

This program is not open yet.

Because the program is not yet open, information is still limited. To help us understand interest and share updates as more details (such as study sites, inclusion criteria, etc.) become available, we invite you to fill out this interest form.

Please note that completing the form does not mean you are enrolled in the program or guaranteed access to bitopertin.

Bitopertin is an investigational medicine. It is not approved by any regulatory authority, and its safety and effectiveness have not been established.

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have you been formally diagnosed with EPP or XLP?

Age

Are you currently participating in a clinical trial and/or taking any study drug(s)?

Are you currently taking any medication(s) for porphyria?

Which medication(s) are you currently taking for your porphyria

Other

Have you ever taken Bitopertin?

Other