BridgeBio's Attruby Outperforms Expectations in ATTR-CM Market, Challenging Pfizer's Dominance

BridgeBio Pharma's Attruby has made a striking debut in the transthyretin amyloid cardiomyopathy (ATTR-CM) market, surpassing analysts' projections and positioning itself as a formidable competitor to Pfizer's established Vyndaqel franchise. The drug's strong performance signals a potential shift in the treatment landscape for this rare but serious heart condition.

Attruby's Remarkable Launch Performance

In its first full quarter on the market since its November FDA approval and December launch, Attruby generated $36.7 million in revenue, nearly tripling the consensus expectation of $12.6 million. As of April 25, 2025, a total of 2,072 prescriptions have been written by 756 unique healthcare providers, demonstrating rapid adoption and growing physician confidence in the treatment.

BridgeBio CEO and founder Neil Kumar, Ph.D., attributed this success to Attruby's "stellar clinical efficacy, safety profile, and the access work we have done to ensure patients in need can get our drug." The company's Chief Commercial Officer, Matt Outten, expressed optimism about Attruby's potential to become "the global first line therapy of choice for ATTR-CM."

Global Expansion and Market Competition

Attruby's success extends beyond U.S. borders, with recent approvals in Europe, Japan, and the United Kingdom. Branded as Beyonttra outside the U.S., the drug's global commercialization involves strategic partnerships. Bayer acquired European rights in a $310 million deal, while AstraZeneca's Alexion unit will market the drug in Japan.

Despite Attruby's impressive start, Pfizer's Vyndaqel franchise continues to show strong growth, with global sales increasing 31% to $1.5 billion in the first quarter of 2025. Both Attruby and Vyndaqel are TTR stabilizers, working to reduce the misfolding of TTR proteins that can lead to harmful buildups and heart failure. However, BridgeBio contends that Attruby stabilizes TTR more completely than its Pfizer counterpart.

The ATTR-CM market is further evolving with Alnylam's recent entry. Their RNA interference drug, Amvuttra, received approval for ATTR-CM in March, adding to its existing indication for hereditary transthyretin-mediated amyloidosis (hATTR-PN).

Financial Implications and Analyst Perspectives

Attruby's strong performance has caught the attention of financial analysts. Evercore ISI analyst Cory Kasimov noted that the drug "blew past even the most bullish of Street expectations," while Mizuho's Salim Syed projected that 2025 consensus sales expectations for Attruby could rise from about $150 million to around $200 million.

As BridgeBio continues to make waves in the ATTR-CM market, the company is also advancing other pipeline candidates. Key phase 3 trial readouts are expected this year for treatments targeting limb-girdle muscular dystrophy and autosomal dominant hypocalcemia, potentially expanding BridgeBio's impact across multiple rare disease areas.