Stabilizing TTR

Stabilizing the TTR tetramer has become
an important therapeutic target for
slowing ATTR-CM progression1

TTR is essential for everyday health and function2-6

TTR is a key transport protein that has been preserved by nature throughout evolution

TTR, also known as prealbumin, supports the transport of:

  • vitamin a

    Vitamin A (retinol): important for vision,
    immunity, and neurologic function

    Deficiency can lead to ocular symptoms such as night blindness (nyctalopia)

  • Thyroxine

    Thyroxine (T4): critical hormone in 
metabolic regulation

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Low levels of TTR can have broad consequences

Associated with worsening outcomes in the context of7-9:

  • Cardiac health icon

    Cardiac
    health

  • Metabolic health icon

    Metabolic health

  • Neurologic health icon

    Neurologic health

  • Rheumatologic health icon

    Rheumatologic health

In ATTR-CM, preservation of TTR structure is key

Loss of tetramer stability can lead to ATTR-CM

TTR is a naturally occurring protein that is synthesized in the liver10,11

It performs its function only
when present and stable.

Misfolded monomers aggregate
into toxic amyloid fibrils2,3,12

These fibrils accumulate
throughout the body, including
in the myocardium.

Loss of TTR stability is the
initial event in ATTR-CM2,3,12

Aging or genetic variation can
cause TTR to destabilize and
break apart into monomers.

STABILIZE TTR13

to preserve its natural structure

SLOW ATTR-CM13

and help avoid consequences of low TTR

TTR is a naturally occurring protein that is synthesized in
the liver10,11

It performs its function only when present and stable.

Misfolded monomers aggregate into toxic amyloid fibrils2,3,12

These fibrils accumulate throughout the body, including in the myocardium.

Loss of TTR stability is the
initial event in ATTR-CM2,3,12

Aging or genetic variation can cause TTR to destabilize and break apart into monomers.

STABILIZE TTR13

to preserve its natural structure

SLOW ATTR-CM13

and help avoid consequences of low TTR

Watch TTR destabilization unfold

Play
See How Attruby Works

The level of TTR stabilization can help
make a difference7,14

That's why Attruby is intentionally designed
to deliver near-complete (>90%) in vitro TTR stabilization.15,16

hospital

Learn how you can get your patients
started on Attruby

See Access & Support

ATTR-CM=transthyretin amyloid cardiomyopathy; TTR=transthyretin.

References: 1. 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 2. 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 3. Witteles RM, Bokhari S, Damy T, et al. Screening for transthyretin amyloid cardiomyopathy in everyday practice. JACC Heart Fail. 2019;7(8):709-716. doi:10.1016/j.jchf.2019.04.010 4. 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 5. Brito D, Albrecht FC, de Arenaza DP, et al. World Heart Federation consensus on transthyretin amyloidosis cardiomyopathy (ATTR-CM). Glob Heart. 2023;18(1):59. doi:10.5334/gh.1262 6. Hennebry SC, Wright HM, Likic VA, Richardson SJ. Structural and functional evolution of transthyretin and transthyretin-like proteins. Proteins. 2006;64(4):1024-1045. doi:10.1002/prot.21033 7. Christoffersen M, Greve AM, Hornstrup LS, Frikke-Schmidt R, Nordestgaard BG, Tybjærg-Hansen A. Transthyretin tetramer destabilization and increased mortality in the general population. JAMA Cardiol. 2025;10(2):155-163. doi:10.1001/jamacardio.2024.4102 8. Alemi M, Oliveira Â, Tavares SC, et al. Exploring the physiological role of transthyretin in glucose metabolism in the liver. Int J Mol Sci. 2021;22(11):6073. doi:10.3390/ijms22116073 9. Wieczorek E, Ożyhar A. Transthyretin: from structural stability to osteoarticular and cardiovascular diseases. Cells. 2021;10(7):1768. doi:10.3390/cells10071768 10. Liz MA, Coelho T, Bellotti V, Fernandez-Arias MI, Mallaina P, Obici L. A narrative review of the role of transthyretin in health and disease. Neurol Ther. 2020;9(2):395-402. doi:10.1007/s40120-020-00217-0 11. Vieira M, Saraiva MJ. Transthyretin: a multifaceted protein. Biomol Concepts. 2014;5(1):45-54. doi:10.1515/bmc-2013-0038 12. Ruberg FL, Grogan M, Hanna M, Kelly JW, Maurer MS. Transthyretin amyloid cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(22):2872-2891. doi:10.1016/j.jacc.2019.04.003 13. Griffin JM, Grodin JL, Ruberg FL, Masri A, Hanna M, Maurer MS. Current landscape of therapies for transthyretin amyloid cardiomyopathy. JACC Heart Fail. 2025;13(5):685-694. doi:10.1016/j.jchf.2025.03.017 14. Angueira A, Abramowitz SA, Levin MG. Unfolding the link between transthyretin stability and survival. JAMA Cardiol. 2025;10(2):112-113. doi:10.1001/jamacardio.2024.4112 15. Attruby. Prescribing information. BridgeBio Pharma, Inc.; 2024. 16. Judge DP, Heitner SB, Falk RH, et al. Transthyretin stabilization by AG10 in symptomatic transthyretin amyloid cardiomyopathy. J Am Coll Cardiol. 2019;74(3):285-295. doi:10.1016/j.jacc.2019.03.012

Indication and Important safety information

INDICATION

Attruby® (acoramidis) is indicated for the treatment of the 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 the 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.