Spruce Biosciences Inc. is a late-stage biopharmaceutical company dedicated to developing and commercializing novel therapies for rare neurological and endocrine disorders with significant unmet medical needs. Its lead program, tralesinidase alfa enzyme replacement therapy (TA-ERT), targets Sanfilippo Syndrome Type B (MPS IIIB), an ultra-rare, progressive, and fatal genetic disorder lacking FDA-approved treatments. Clinical data demonstrate TA-ERT's ability to profoundly reduce cerebral spinal fluid heparan sulfate non-reducing end (CSF HS-NRE), stabilize cognition, and preserve cortical grey matter volume, with the U.S. FDA granting Breakthrough Therapy Designation and confirming CSF HS-NRE as a surrogate biomarker. The company is advancing toward a biologics license application submission. Spruce Biosciences Inc. also pursues tildacerfont, a non-steroidal therapy for congenital adrenal hyperplasia aimed at enhancing disease control and reducing steroid dependency, alongside explorations in major depressive disorder and polycystic ovary syndrome through collaborations. Founded in 2014 and headquartered in South San Francisco, California, Spruce Biosciences Inc. operates in the rare disease space, emphasizing innovative treatments for patients with limited options.