April 22, 2025 | 5 min read | Nick Paul Taylor
Alnylam and BridgeBio are competing for people who are switching from Pfizer’s blockbuster ATTR amyloidosis drug tafamidis while all three companies are fighting for new patients.
A three-way tussle has emerged in the growing ATTR amyloidosis market as Alnylam and BridgeBio Pharma have secured FDA approvals to challenge Pfizer.
Tafamidis, which Pfizer sells as Vyndaqel, Vyndamax and Vynmac, had the ATTR amyloidosis with cardiomyopathy (ATTR-CM) market to itself for five years. But BridgeBio won approval for Attruby, a drug with the same mechanism of action as tafamidis, in November 2024. Then the oral transthyretin stabilizers were joined on the market by the first silencer, Alnylam’s Amvuttra, in March. Amvuttra was already approved in ATTR with polyneuropathy (ATTR-PN).
ATTR-CM causes stiffening of cardiac muscle and heart failure, leading to death in around 2.5 years if left untreated. Cardiac capacity cannot be regained once lost. BridgeBio estimates there are around 240,000 ATTR-CM patients in the U.S. and BMO Capital Markets analyst Kostas Biliouris said he believes the market is big enough to accommodate multiple assets. Even so, competition is inevitable and the stakes are high.
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