BridgeBio Pharma’s oral transthyretin stabilizer, acoramidis (Attruby), achieved a 69% reduction in all‑cause mortality among patients with the V142I variant of transthyretin amyloid cardiomyopathy (ATTR‑CM). The data, presented at the American Heart Association Scientific Sessions 2025 and simultaneously published in JAMA Cardiology on November 8, 2025, report a hazard ratio of 0.31 for all‑cause mortality in the V142I subpopulation, translating to a relative risk reduction of 69% through month 42 of the ATTRibute‑CM Phase 3 trial.
The V142I variant is the most common pathogenic mutation in ATTR‑CM, affecting roughly 3–4 % of the U.S. Black population. BridgeBio’s approval of Attruby in November 2024 positioned the drug as a potential first‑line therapy, but the new data provide the strongest evidence yet that the drug can dramatically improve survival in the population most at risk. The study also documented significant gains in functional capacity and quality‑of‑life scores, underscoring the clinical benefit beyond mortality.
Attruby’s mechanism—near‑complete (≥90 %) stabilization of transthyretin protein—appears to be the key driver of the observed mortality benefit. By preventing misfolding and amyloid deposition, the drug reduces cardiac stress and improves heart function. The magnitude of the benefit places Attruby ahead of existing therapies such as tafamidis and the recently approved vutrisiran, giving BridgeBio a competitive edge in a market that has historically been dominated by a single drug. The data also support stronger pricing and reimbursement arguments, as payers increasingly look for therapies that deliver clear survival advantages.
Dr. Kevin Alexander, the first author of the JAMA Cardiology manuscript, noted that “the 69 % mortality reduction in the V142I subpopulation confirms the clinical value of a near‑complete TTR stabilizer and validates BridgeBio’s ‘beautiful science’ approach.” BridgeBio’s leadership has emphasized that these results reinforce the company’s strategy of combining deep mechanistic insight with potent therapeutics to deliver high‑impact treatments for underserved patient groups.
The findings are expected to accelerate Attruby’s market penetration, particularly in the high‑risk African‑American population, and may influence clinical guidelines and payer coverage decisions. With a robust evidence base now in hand, BridgeBio is positioned to strengthen its commercial momentum and expand its footprint in the ATTR‑CM treatment landscape, potentially reshaping the competitive dynamics of the market.
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