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Stabilizing TTR
Stabilizing the TTR tetramer has become
an important therapeutic target for
slowing ATTR-CM progression1
TTR, or prealbumin, is essential
for everyday health and function2,3
TTR is a key transport protein that binds to and transports vitamin A and thyroxine
throughout the body, and it performs its function when it's present and stable.
ATTR-CM is a disease of destabilization4-6
In ATTR-CM, aging or genetic variants can cause TTR to destabilize and
break apart into monomers, which misfold and accumulate as toxic
amyloid fibrils throughout the body, including in the myocardium.
ATTR-CM is a disease of destabilization4-6
In ATTR-CM, aging or genetic variants can cause TTR to destabilize and
break apart into monomers, which misfold and accumulate as toxic
amyloid fibrils throughout the body, including in the myocardium.
Watch TTR
destabilization unfold
Stabilizing the
TTR tetramer is key1
By preserving TTR structure and slowing toxic amyloid fibril formation, TTR stabilizers may
help alter the natural course of the disease.7
been associated with
worsening outcomes8,9*
*Based on a retrospective analysis of multivariate predictors of shorter overall survival in 116 patients with biopsy-proven ATTRwt-CM.9
The level of TTR stabilization can help
make a difference10,11
That's why Attruby is intentionally designed
for >90% stabilization.12,13
ATTR-CM=transthyretin amyloid cardiomyopathy; ATTRwt=wild-type transthyretin amyloidosis; TTR=transthyretin.
References: 1. Morfino P, Aimo A, Vergaro G, et al. Transthyretin stabilizers and seeding inhibitors as therapies for amyloid transthyretin cardiomyopathy. Pharmaceutics. 2023;15(4):1129. doi:10.3390/pharmaceutics15041129
2. 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
3. Vieira M, Saraiva MJ. Transthyretin: a multifaceted protein. Biomol Concepts. 2014;5(1):45-54. doi:10.1515/bmc-2013-0038
4. 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
5. 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
6. 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
7. 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
8. Greve AM, Christoffersen M, Frikke-Schmidt R, Nordestgaard BG, Tybjærg-Hansen A. Association of low plasma transthyretin concentration with risk of heart failure in the general population. JAMA Cardiol. 2021;6(3):258-266. doi:10.1001/jamacardio.2020.5969
9. Hanson JLS, Arvanitis M, Koch CM, et al. Use of serum transthyretin as a prognostic indicator and predictor of outcome in cardiac amyloid disease associated with wild-type transthyretin. Circ Heart Fail. 2018;11(2):e004000. doi:10.1161/CIRCHEARTFAILURE.117.004000
10. Angueira A, Abramowitz SA, Levin MG. Unfolding the link between transthyretin stability and survival. JAMA Cardiol. Published online December 4, 2024. doi:10.1001/jamacardio.2024.4112
11. 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. Published online December 4, 2024. doi:10.1001/jamacardio.2024.4102
12. 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
13. Attruby. Prescribing information. BridgeBio, Inc.; 2024.
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.