Detailed narrative
Attruby Commercial Momentum and Clinical Differentiation
Attruby (acoramidis) continues to demonstrate strong commercial momentum, achieving $180.6 million in U.S. net product revenue this quarter, a 24% sequential growth and 392% year-over-year. The company believes Attruby is convincingly the second brand by volume in the ATTR-CM space, with total new patient starts in the category exceeding 6,100. Growth is driven by its position as a near-complete stabilizer, with data suggesting a tripling in combo use with various knockdowns. Real-world evidence studies, including one presented at SCAI by the Valley Health System of Nevada, show statistically significant outcome improvements compared to tafamidis, such as a 43% reduction in diabetic intensification and lower incidence of acute kidney injury. Long-term Phase III open-label extension data showed a 45% reduction in all-cause mortality and a 49% reduction in cardiovascular mortality at 54 months versus placebo.
Late-Stage Pipeline Progress and Launch Readiness
BridgeBio is preparing for three anticipated near-term launches: BBP-418 for LGMD2I, encaleret for ADH1, and infigratinib for achondroplasia. The NDA for BBP-418 was submitted in 155 days from top-line data, with commercial leadership and patient identification infrastructure in place. For ADH1, claims analysis has identified nearly 2,000 patients in the U.S., and a Phase III trial for chronic hypoparathyroidism will commence this summer. Infigratinib for achondroplasia demonstrated statistically significant improvement in body proportionality, not just height velocity, and is the only oral option, with early commercial research indicating over 40% unaided awareness among prescribing physicians. The full PROPEL 3 data set is expected to be presented at a medical conference in H2 2026.
Share Repurchase Program and Value Capture
The Board authorized a $500 million share repurchase program, effective immediately. This decision aims to address the perceived disconnect between the company's intrinsic value and its current share price, even with the revised entry of generic tafamidis from 2035 to mid-2031 or early 2032. Management views repurchases as additive and opportunistic, leveraging a strong balance sheet and ample liquidity, while preserving flexibility to fund critical programs and launches. This strategy aligns with BridgeBio's founding principles of long-term value creation and responsible capital deployment.
Competitive Landscape and Market Dynamics
In the ATTR-CM market, Attruby's major competition remains tafamidis (Poser). The company's share has grown, but still trails tafamidis in the front line. Management expects the market for new patient starts to continue growing, driven by improved diagnostic algorithms, genetic testing, and broad awareness campaigns. The potential impact of competitor Alnylam's Cardiopet trial for ATTR cardiomyopathy is acknowledged, with management expecting positive results given its powering, but believes Attruby's position as a first-line stabilizer and in combination will remain strong due to its biochemical advantages and access programs.
Encaleret for Chronic Hypoparathyroidism
Beyond ADH1, encaleret is being positioned for the broader chronic hypoparathyroidism market. Key advantages highlighted include its potential as the first oral option, its ability to normalize both blood and urine calcium (demonstrated in a Phase II trial with 80% of patients), and avoiding potential safety risks associated with parathyroid hormone replacement therapies. The market research indicates strong excitement for an oral option, especially for patients seeking freedom from injections and improved calcium normalization.