Delivery 7–10 daysAttruby (acoramidis) 356 mg tablets
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Description
💊 Prescription transthyretin stabiliser for transthyretin amyloid cardiomyopathy in adults, both the hereditary and the age-related form.
▪︎ Acoramidis 356 mg film-coated tablets, 120 per bottle; the dose is two tablets twice daily (712 mg twice a day)
▪︎ Manufacturer: BridgeBio Pharma
▪︎ FDA approval: November 2024
🔬 How it works: transthyretin normally exists as a tetramer — four identical parts locked together. With age or an inherited mutation that lock weakens, the structure falls apart and the loose parts clump into amyloid fibrils that stiffen the heart muscle. Acoramidis was designed after the natural T119M variant, whose carriers have unusually stable transthyretin and do not develop amyloidosis: it binds the four parts and holds them together. 📊 Evidence: ATTRibute-CM (NEJM 2024) in 632 patients over 30 months — the hierarchical primary outcome favoured acoramidis (p<0.001) with a win ratio of 1.8 (95% CI 1.4–2.2); more than half of that came from death from any cause and cardiovascular hospitalisation. Adverse events matched placebo (98.1% versus 97.6%) and serious ones were fewer (54.6% versus 64.9%).
⚠️ Prescription-only, prescribed by a cardiologist after the diagnosis is confirmed by scintigraphy and light-chain amyloidosis is excluded — that is a different disease with different treatment. The drug slows the formation of new amyloid but does not dissolve what is already deposited, so earlier treatment protects more muscle. It has never been compared head-to-head with tafamidis.
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