PALO ALTO, Calif., July 2, 2026
BridgeBio Pharma, Inc. announced new post-hoc analyses published in Circulation: Heart Failure showing that Attruby® (acoramidis) demonstrated the first reported early and sustained direct kidney-protective effects in patients with transthyretin amyloid cardiomyopathy (ATTR-CM). The findings, based on data from the Phase 2 trial and the Phase 3 ATTRibute-CM study, revealed that treatment with acoramidis produced an early, reversible decline in estimated glomerular filtration rate (eGFR) accompanied by a 15.5% placebo-corrected reduction in urinary albumin-to-creatinine ratio (UACR) by Day 28, with no kidney-related adverse events reported. Researchers said the response resembles the hemodynamic kidney effects observed with established therapies such as ACE inhibitors, ARBs, and SGLT2 inhibitors, suggesting acoramidis may provide direct renal protection independent of transthyretin (TTR) stabilization, while also supporting improved cardiovascular outcomes in patients with ATTR-CM.
Early Kidney Response Linked to Better Cardiovascular Outcomes
The analyses demonstrated that acoramidis initiation resulted in an early and reversible eGFR dip of 8.5 mL/min/1.73 m², accompanied by a significant reduction in UACR, indicating an immediate favorable effect on kidney function. Investigators noted that this pattern is consistent with therapies known to directly improve renal hemodynamics and may explain the early separation in cardiovascular outcomes previously observed between acoramidis and placebo during the first months of treatment. Importantly, participants who experienced larger early eGFR reductions achieved a 58% lower risk of death or cardiovascular hospitalization and a 66% lower risk of cardiovascular hospitalization alone during the first year, whereas similar eGFR declines in the placebo group were associated with worse clinical outcomes. These findings strengthen the evidence that the initial kidney response reflects a beneficial physiological mechanism rather than treatment-related renal injury.
Long-Term Improvements Support Durable Cardiorenal Protection
Beyond the early response, acoramidis demonstrated sustained kidney protection through Month 30, with an improved chronic eGFR slope of +2.47 mL/min/1.73 m² per year (p<0.001) and a 13.7% sustained reduction in UACR (p=0.026). Researchers concluded that the long-term renal profile closely mirrors drugs that directly target kidney function, an effect not previously reported with other approved ATTR-CM therapies. Because kidney dysfunction is a major predictor of mortality in patients with ATTR-CM and heart failure, preserving renal function alongside cardiovascular health could provide meaningful long-term clinical benefits. The publication suggests that the dual cardiorenal effects of acoramidis may contribute to improved survival and fewer cardiovascular hospitalizations while offering a potential mechanism beyond near-complete TTR stabilization.
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Approved Therapy Expands Clinical Evidence in ATTR-CM
Attruby® (acoramidis) is an orally administered, selective small-molecule TTR stabilizer approved in the United States for reducing cardiovascular death and cardiovascular-related hospitalization in adults with wild-type or variant ATTR-CM. The therapy is also approved as BEYONTTRA® in multiple international markets, including Europe, Japan, Switzerland, the United Kingdom, and Brazil. According to BridgeBio Pharma, the newly published analyses further strengthen the clinical profile of acoramidis by demonstrating potential direct kidney-protective activity in addition to its established cardiovascular benefits. The company believes these findings represent an important advancement for patients with ATTR-CM, particularly as improved survival increases the importance of preserving long-term organ function in this progressive and life-threatening genetic disease.
Source: BridgeBio Pharma press release
