Acoramidis
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Pronunciation | ə-corAM-i-dis |
Trade names | Attruby |
Other names | AG10 |
AHFS/Drugs.com | Attruby |
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Routes of administration | By mouth |
Drug class | Amyloidogenesis suppressant |
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Formula | C15H17FN2O3 |
Molar mass | 292.310 g·mol−1 |
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Acoramidis, sold under the brand name Attruby, is a medication used for the treatment of cardiomyopathy.[1] It is a near-complete (>90%) transthyretin stabilizer, developed to mimic the protective properties of the naturally-occurring T119M mutation,[2][3] to treat transthyretin amyloid cardiomyopathy. It is taken by mouth.[1]
The most common adverse reactions include diarrhea and upper abdominal pain.[4]
Acoramidis was approved for medical use in the United States in November 2024.[4][5]
Medical uses
[edit]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.[1][4][6]
ATTR-CM is a rare and serious disease that affects the heart muscle.[4] In people with ATTR-CM, there is a build-up of protein deposits in the heart, causing the walls of the heart to become stiff, and making the left ventricle unable to properly relax and fill with blood (called cardiomyopathy).[4] As the condition progresses, the heart can become unable to pump blood out adequately, causing heart failure.[4] There are two types of ATTR-CM, hereditary ATTR-CM (hATTR-CM) and wild-type ATTR-CM (wATTR-CM).[4] In hATTR-CM, which can run in families, there's a variant in the transthyretin gene, which results in protein deposits in the heart. In wATTR-CM, there is no variant in the transthyretin gene.[4]
Side effects
[edit]The most common side effects are diarrhea and abdominal pain.[7]
History
[edit]The efficacy and safety of acoramidis were evaluated in a multicenter, international, randomized, double-blind, placebo-controlled study in 611 adult participants with wild-type or hereditary (variant) ATTR-CM (NCT03860935).[4]
Clinical trials
[edit]Phase I data indicated acoramidis achieved near-complete (>90%) TTR stabilization across the entire dosing interval at steady state.[8]
Phase II and the Open-Label Extension (OLE) data indicated after a median of 38 months, long-term treatment with acoramidis was generally well tolerated and resulted in a median decline in NT-proBNP levels, normalization of serum TTR, and sustained stabilization of TTR in individuals with ATTR-CM. [9]
Phase III data from ATTRibute-CM indicated acoramidis resulted in a significantly better four-step primary hierarchical outcome containing components of mortality, morbidity, and function than placebo at 30 months in participants with ATTR-CM. Adverse events were similar in the two groups.[10]
Other analyses from ATTRibute-CM indicated a 50% reduction in cumulative cardiovascular hospitalizations (CVH), a 42% reduction in all-cause mortality (ACM) and recurrent CVH, and a 3-month time-to-separation of the Kaplan Meier curves for ACM or CVH. No other treatment has demonstrated this degree of treatment effect this quickly in participants with ATTR-CM.[11][12][13][14]
In vitro data indicated acoramidis exhibits near-complete (>90%) TTR stabilization at therapeutic trough concentrations, and its TTR stabilization exceeds that of tafamidis' across a range of destabilizing TTR mutations.[15]
Society and culture
[edit]Legal status
[edit]Acoramidis was approved for medical use in the United States in November 2024.[4][16][17] The approval was granted to BridgeBio Pharma.[6]
Names
[edit]During development, acoramidis was known as AG10 (the Alhamadsheh-Graef molecule 10).[18]
Acoramidis is the international nonproprietary name (INN).[19]
References
[edit]- ^ a b c d "Attruby- acoramidis hydrochloride tablet, film coated". DailyMed. 26 November 2024. Retrieved 28 November 2024.
- ^ Penchala S, Connelly S, Wang Y, Park M, Zhao L, Baranczak A, et al. (28 May 2013). "AG10 inhibits amyloidogenesis and cellular toxicity of the familial amyloid cardiomyopathy-associated V122I transthyretin". Proceedings of the National Academy of Sciences. 110 (24): 9992–9997. doi:10.1073/pnas.1300761110. PMC 3683741. PMID 23716704.
- ^ Miller M, Pal A, Albusairi W, Joo H, Pappas B, Haque Tuhin MT, et al. (13 September 2018). "Enthalpy-Driven Stabilization of Transthyretin by AG10 Mimics a Naturally Occurring Genetic Variant That Protects from Transthyretin Amyloidosis". Journal of Medicinal Chemistry. 61 (17): 7862–7876. doi:10.1021/acs.jmedchem.8b00817. ISSN 0022-2623. PMC 6276790. PMID 30133284.
- ^ a b c d e f g h i j "FDA approves drug for heart disorder caused by transthyretin-mediated". U.S. Food and Drug Administration. 1 October 2024. Retrieved 27 November 2024. This article incorporates text from this source, which is in the public domain.
- ^ "FDA approves BridgeBio Pharma's Attruby to treat rare heart disease ATTR-CM". PMLiVE. 25 November 2024. Retrieved 25 November 2024.
- ^ a b PhD JL (25 November 2024). "Bridgebio's Attruby, to Treat Heart Condition ATTR-CM, Receives FDA Approval". Genetic Engineering and Biotechnology News. Retrieved 25 November 2024.
- ^ gullapalli (25 November 2024). "FDA approves BridgeBio's Attruby for ATTR-CM treatment". Pharmaceutical Technology. Retrieved 25 November 2024.
- ^ Fox JC, Hellawell JL, Rao S, O'Reilly T, Lumpkin R, Jernelius J, et al. (January 2020). "First-in-Human Study of AG10, a Novel, Oral, Specific, Selective, and Potent Transthyretin Stabilizer for the Treatment of Transthyretin Amyloidosis: A Phase 1 Safety, Tolerability, Pharmacokinetic, and Pharmacodynamic Study in Healthy Adult Volunteers". Clinical Pharmacology in Drug Development. 9 (1): 115–129. doi:10.1002/cpdd.700. ISSN 2160-763X. PMC 7003869. PMID 31172685.
- ^ Masri A, Aras M, Falk RH, Grogan M, Jacoby D, Judge DP, et al. (March 2022). "Long-Term Safety and Tolerability of Acoramidis (Ag10) in Symptomatic Transthyretin Amyloid Cardiomyopathy: Updated Analysis from an Ongoing Phase 2 Open-Label Extension Study". Journal of the American College of Cardiology. 79 (9): 227. doi:10.1016/S0735-1097(22)01218-9.
- ^ Gillmore JD, Judge DP, Cappelli F, Fontana M, Garcia-Pavia P, Gibbs S, et al. (11 January 2024). "Efficacy and Safety of Acoramidis in Transthyretin Amyloid Cardiomyopathy". New England Journal of Medicine. 390 (2): 132–142. doi:10.1056/NEJMoa2305434. ISSN 0028-4793. PMID 38197816.
- ^ "Program Planner". www.abstractsonline.com. Archived from the original on 6 February 2021. Retrieved 19 October 2024.
- ^ Alexander K, Judge D, Cappelli F, Fontana M, Garcia-Pavia P, Grogan M, et al. (6 May 2024). Acoramidis Achieves Early Reduction in Cardiovascular Death or Hospitalization in Transthyretin Amyloid Cardiomyopathy (ATTR-CM): Results from the ATTRibute-CM Clinical Trial OC7 (#281) (Report). doi:10.26226/m.65f9bf8ae6f73964e1d4f069.
- ^ Cheng R, Grodin J, Gordon R, Schmedtje J, Lecumberri R, berk j, et al. (3 May 2024). Treatment-related Early Increase in Serum TTR is Associated With Lower Cardiovascular Hospitalization in ATTR-CM: Insights From ATTRibute-CM OC10 (#282) (Report). doi:10.26226/m.65f9bf8ae6f73964e1d4f06f.
- ^ "BridgeBio Shares Recurrent Event Analysis of ATTRibute-CM, Demonstrating a 42% Reduction by Acoramidis on the Composite Endpoint of All-Cause Mortality and Recurrent Cardiovascular-related Hospitalization Events". HFSA. Retrieved 19 October 2024.
- ^ Ji A, Wong P, Judge DP, Graef IA, Fox J, Sinha U (November 2023). "Acoramidis produces near-complete TTR stabilization in blood samples from patients with variant transthyretin amyloidosis that is greater than that achieved with tafamidis". European Heart Journal. 44 (Supplement_2). doi:10.1093/eurheartj/ehad655.989. ISSN 0195-668X.
- ^ "Novel Drug Approvals for 2024". U.S. Food and Drug Administration (FDA). 1 October 2024. Retrieved 29 November 2024.
- ^ "Attruby (acoramidis), a Near Complete TTR Stabilizer (≥90%), approved by FDA to Reduce Cardiovascular Death and Cardiovascular-related Hospitalization in ATTR-CM Patients" (Press release). BridgeBio Pharma. 23 November 2024. Archived from the original on 25 November 2024. Retrieved 28 November 2024 – via GlobeNewswire.
- ^ "FDA approves Stanford Medicine-developed drug that treats rare heart disease". Stanford. 27 November 2024. Retrieved 29 November 2024.
- ^ World Health Organization (2024). "International nonproprietary names for pharmaceutical substances (INN): recommended INN: list 83". WHO Drug Information. 38 (1). hdl:10665/378096.
Further reading
[edit]- Penchala SC, Connelly S, Wang Y, Park MS, Zhao L, Baranczak A, et al. (June 2013). "AG10 inhibits amyloidogenesis and cellular toxicity of the familial amyloid cardiomyopathy-associated V122I transthyretin". Proceedings of the National Academy of Sciences of the United States of America. 110 (24): 9992–7. doi:10.1073/pnas.1300761110. PMC 3683741. PMID 23716704.
External links
[edit]- Clinical trial number NCT03860935 for "Efficacy and Safety of AG10 in Subjects With Transthyretin Amyloid Cardiomyopathy (ATTRibute-CM)" at ClinicalTrials.gov