Everything You Should Know About Attruby™ (Acoramidis)

Introduction to Attruby

Attruby™ (acoramidis) is a prescription medication approved for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM), a progressive and potentially fatal heart condition. This comprehensive guide delves into various aspects of Attruby, including its medical uses, mechanism of action, dosage, side effects, interactions, and more.

What is Attruby?

Attruby is an oral medication indicated for adults with cardiomyopathy caused by wild-type or variant transthyretin-mediated amyloidosis (ATTR-CM). Its primary purpose is to reduce cardiovascular-related death and hospitalization. 

Understanding ATTR-CM

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a condition where misfolded transthyretin (TTR) proteins aggregate into amyloid fibrils, which deposit in the heart tissue. This leads to stiffening of the heart muscle, resulting in heart failure and other complications. ATTR-CM can occur as a hereditary condition (variant ATTR) or without genetic mutations (wild-type ATTR). 

How Does Attruby Work?

Attruby functions as a TTR stabilizer. By binding to the TTR protein, it stabilizes its structure, preventing it from misfolding and forming harmful amyloid fibrils. This action slows disease progression and helps reduce related cardiovascular events. 

Dosage and Administration

Attruby is administered orally, with the recommended dosage being two tablets taken twice daily. It's important to follow your healthcare provider's instructions regarding timing and adherence to ensure optimal therapeutic outcomes. 

Potential Side Effects

While Attruby is generally well-tolerated, some patients may experience side effects. Common adverse reactions include:

• Diarrhea

• Upper abdominal pain

Serious side effects are rare but can occur. If you experience any unusual symptoms or signs of an allergic reaction, seek medical attention promptly. 

Drug Interactions

Attruby may interact with other medications, particularly those metabolized by the CYP2C9 enzyme. Co-administration with CYP2C9 substrates can lead to increased drug concentrations, necessitating careful monitoring for potential toxicity. Always inform your healthcare provider about all medications and supplements you are taking. 

Use in Specific Populations

• Pregnancy and Breastfeeding: The effects of Attruby during pregnancy and breastfeeding are not well-studied. Consult your healthcare provider to weigh the potential benefits and risks before using this medication if you are pregnant or nursing.

• Pediatric Use: The safety and efficacy of Attruby in children have not been established. 

Clinical Trials and Efficacy

Clinical trials have demonstrated that Attruby significantly improves survival rates and reduces hospitalizations related to heart problems in patients with ATTR-CM. However, it did not achieve statistically significant results for all-cause mortality.

Comparison with Other Treatments

Attruby competes with other treatments like Pfizer's Vyndaqel (tafamidis) and Alnylam's Amvuttra. While Vyndaqel is a once-daily pill, Amvuttra is administered as a twice-yearly injection. Attruby offers a twice-daily oral regimen. Each medication has its own efficacy, safety profile, and administration considerations, making it essential to consult with a healthcare provider to determine the most appropriate treatment. 

Cost and Availability

Attruby is priced at approximately $18,759.12 for a 28-day supply, which is slightly less than its main competitor, Vyndaqel. Pricing and insurance coverage can vary, so it's advisable to discuss financial considerations with your healthcare provider and insurance company.

Patient Support Programs

BridgeBio Pharma offers patient support programs to assist with access, education, and financial assistance for those prescribed Attruby. These programs aim to ensure that patients can obtain their medication and adhere to their treatment regimen effectively. 

Conclusion: Should I Take Attruby?

Attruby represents a significant advancement in the treatment of transthyretin amyloid cardiomyopathy, offering patients a new option to manage this challenging condition. As with any medication, it's crucial to have thorough discussions with your healthcare provider to understand the benefits, potential risks, and to determine if Attruby is the right choice for your specific situation.