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ATTR-CM Impact

ATTR-CM is a life-threatening progressive heart
condition
that negatively impacts patients1-3

Actor portrayals.

Without early detection, ATTR-CM—
a debilitating condition—can lead to1,4:

  • Earlier death
    Earlier death
  • significantly impaired QoL
    Significantly impaired
    quality of life
  • Significantly impaired functional ability
    Significantly impaired
    functional capacity
  • hospitalizations
    Increased CV-related
    hospitalizations

ATTR-CM can be challenging to recognize and diagnose5,6

Symptoms can mirror other serious conditions or appear unrelated to a heart condition.

  • Shortness of breath
  • Swelling in legs and feet

  • Gastrointestinal problems info

  • Tiredness or weakness
  • Irregular heartbeat
  • Carpal tunnel

High prevalence of ATTR-CM in patients with certain
comorbid conditions6,7

  • 16% aortic stenosis with value replacement
  • 13%-15% HFpEF

Many patients remain undiagnosed, so the total population remains unknown7,8

discover-signs-image

Better identify cardiac and extracardiac
signs of ATTR-CM

In an age-matched
population without
ATTR-CM,

  • survival rate
  • survival rate

Identify signs of
ATTR-CM12

The following checklist can help you better understand how ATTR-CM and its
symptoms present

Clinical Clues From Routine Cardiac Evaluation That Should Prompt
Additional Diagnostic Evaluation for ATTR-CM

Neurological Symptoms

Neurological Symptoms:

  • Sensorimotor polyneuropathy (paresthesias and weakness)
  • Autonomic dysfunction (orthostatic hypotension, postprandial diarrhea alternating with constipation, gastroparesis, urinary retention,
    and incontinence)
Orthopedic Symptoms

Orthopedic Symptoms:

  • Carpal tunnel syndrome
  • Lumbar spinal stenosis
  • Unprovoked biceps tendon rupture
  • Hip and knee arthroplasty
Neurological Symptoms

Hereditary Factors:

  • Family history of cardiomyopathy
  • Family history of polyneuropathy
  • Black race
Diagnostic Factors

Diagnostic Factors:

  • Persistent low-level elevation in
    serum troponin
  • Discordance between QRS voltage on an ECG and wall thickness on imaging
  • Unexplained atrioventricular block or prior pacemaker implantation
  • Unexplained left ventricular wall thickening, right ventricular thickening, or atrial wall thickening
  • Intolerance to antihypertensive or heart failure medications because of symptomatic hypotension or orthostasis

ATTR-CM=transthryretin amyloid cardiomyopathy; ECG=electrocardiogram.

Explore additional resources
to
learn more about ATTR-CM

See Resources

arrow right
arrow right Actor portrayals.

*Based on data from the Healthcare Cost and Utilization Project 2000-2015 National (Nationwide) Inpatient Sample.10

6MWD=6-minute walk distance; ACM=all-cause mortality; ATTRwt=wild-type transthyretin amyloidosis; ATTRv=hereditary transthyretin amyloidosis;
ATTR-CM=transthyretin amyloid cardiomyopathy; CFB=change from baseline; CV=cardiovascular; CVH=cardiovascular-related hospitalization;
F-S test=Finkelstein-Schoenfeld test; HFpEF=heart failure with preserved ejection fraction; KCCQ-OS=Kansas City Cardiomyopathy Questionnaire Overall Summary; RRR=relative risk reduction.

References: 1. Stewart M, Shaffer S, Murphy B, et al. Characterizing the high disease burden of transthyretin amyloidosis for patients and caregivers. Neurol Ther. 2018;7(2):349-364. doi:10.1007/s40120-018-0106-z 2. Gertz MA, Benson MD, Dyck PJ, et al. Diagnosis, prognosis, and therapy of transthyretin amyloidosis. J Am Coll Cardiol. 2015;66(21):2451-2466. doi:10.1016/j.jacc.2015.09.075 3. Lane T, Fontana M, Martinez-Naharro A, et al. Natural history, quality of life, and outcome in cardiac transthyretin amyloidosis. Circulation . 2019;140(1):16-26. doi:10.1161/CIRCULATIONAHA.118.038169 4. Lauppe R, Liseth Hansen J, Fornwall A, et al. Prevalence, characteristics, and mortality of patients with transthyretin amyloid cardiomyopathy in the Nordic countries. ESC Heart Fail. 2022;9(4):2528-2537. doi:10.1002/ ehf2.13961 5. Rozenbaum MH, Large S, Bhambri R, et al. Impact of delayed diagnosis and misdiagnosis for patients with transthyretin amyloid cardiomyopathy (ATTR-CM): a targeted literature review. Cardiol Ther. 2021;10(1):141-159. doi:10.1007/s40119-021-00219-5 6. Kittleson MM, Ruberg FL, Ambardekar AV, et al. 2023 ACC expert consensus decision pathway on comprehensive multidisciplinary care for the patient with cardiac amyloidosis: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81(11): 1076-1126. doi:10.1016/j.jacc.2022.11.022 7. Kim MM, Prasad M, Burton Y, et al.
Comparative outcomes of a transthyretin amyloid cardiomyopathy cohort versus patients with heart failure with preserved ejection fraction enrolled in the TOPCAT Trial. J Am Heart Assoc. 2023;12(15):e029705. doi:10.1161/JAHA.123.029705 8. Hafeez AS, Bavry AA. Diagnosis of transthyretin amyloid cardiomyopathy. Cardiol Ther. 2020;9(1):85-95. doi:10.1007/s40119-020-00169-4 9. Agency for Healthcare Research and Quality. Trends in hospital in patients stays by age and payer, 2000-2015. Statistical Brief #235. Accessed December 9, 2024. https://hcup-us.ahrq.gov/reports/statbriefs/sb235-Inpatient-Stays-Age-Payer-Trends.jsp 10. Enright PL, Duane SL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998;158(5):1384-1387. doi:10.1164/ajrccm.158.5.9710086 11. Wixner J, Mundayat R, Karayal ON, Anan I, Karling P, Suhr OB. THAOS: gastrointestinal manifestations of transthyretin amyloidosis - common complications of a rare disease. Orphanet J of Rare Dis. 2014;9(1):61. doi:10.1186/1750-1172-9-61 12. Kittleson MM, Maurer MS, Ambardekar AV, et al. Cardiac amyloidosis: evolving diagnosis and management: a scientific statement from the American Heart Association. Circulation. 2020;142(1):e7-e22. doi:10.1161/CIR.0000000000000792

Experienced by 15% of patients with ATTRwt and 63% of patients with ATTRv.11

INDICATION

Attruby™ (acoramidis) is indicated for the treatment of cardiomyopathy of wild-type or variant transthyretin-mediated amyloidosis (ATTR-CM) in adults to reduce cardiovascular death and cardiovascular-related hospitalization.

IMPORTANT SAFETY INFORMATION

Adverse Reactions
Diarrhea (11.6% vs 7.6%) and upper abdominal pain (5.5% vs 1.4%) were reported in patients treated with Attruby versus placebo, respectively. The majority of these adverse reactions were mild and resolved without drug discontinuation.

Discontinuation rates due to adverse events were similar between patients treated with Attruby versus placebo (9.3% and 8.5%, respectively).

Laboratory Tests
Mean increase in serum creatinine of 0.2 and 0.0 mg/dL and a mean decrease in eGFR of 8.2 and 0.7 mL/min/1.73 m2 was observed in the adults with ATTR-CM treated with Attruby versus placebo, respectively, at Day 28 and then stabilized. These changes were reversible after treatment discontinuation.

Use in Specific Populations

Pregnancy & Lactation: There are no data on the use of Attruby in pregnant women. Animal data have not shown developmental risk associated with the use of Attruby in pregnancy. There are no available data on the presence of Attruby in either human or animal milk or the effects of the drug on the breastfed infant or maternal milk production.

Please see Full Prescribing Information including Patient Information.

INDICATION AND IMPORTANT
SAFETY INFORMATION

INDICATION

Attruby™ (acoramidis) is indicated for the treatment of cardiomyopathy of wild-type or variant transthyretin-mediated amyloidosis (ATTR-CM) in adults to reduce cardiovascular death and cardiovascular-related hospitalization.

IMPORTANT SAFETY INFORMATION

Adverse Reactions
Diarrhea (11.6% vs 7.6%) and upper abdominal pain (5.5% vs 1.4%) were reported in patients treated with Attruby versus placebo, respectively. The majority of these adverse reactions were mild and resolved without drug discontinuation.

Discontinuation rates due to adverse events were similar between patients treated with Attruby versus placebo (9.3% and 8.5%, respectively).

Laboratory Tests
Mean increase in serum creatinine of 0.2 and 0.0 mg/dL and a mean decrease in eGFR of 8.2 and 0.7 mL/min/1.73 m2 was observed in the adults with ATTR-CM treated with Attruby versus placebo, respectively, at Day 28 and then stabilized. These changes were reversible after treatment discontinuation.

Use in Specific Populations

Pregnancy & Lactation: There are no data on the use of Attruby in pregnant women. Animal data have not shown developmental risk associated with the use of Attruby in pregnancy. There are no available data on the presence of Attruby in either human or animal milk or the effects of the drug on the breastfed infant or maternal milk production.

Please see Full Prescribing Information including Patient Information.