Spruce Biosciences ($SPRB) is a late-stage biotech tackling rare endocrine disorders, led by its flagship candidate tildacerfont, an oral therapy designed to reduce steroid dependence in congenital adrenal hyperplasia (CAH). In this episode, we explore Spruce’s focused approach, the promise of steroid-sparing treatments, and the high-stakes nature of a single-asset pipeline. With validation from competitors like Neurocrine and growing physician awareness, Spruce’s science is on solid ground—but so are the risks. Financing needs, trial outcomes, and regulatory hurdles will determine whether Spruce transitions from research hopeful to commercial player. Is this a calculated bet on rare-disease innovation, or another small-cap biotech walking a tightrope between breakthrough and burnout?
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