Aperture

Cardiology · Rare-to-common · teaser

ATTR cardiomyopathy

Updated August 2026 · TTR (wild-type + hereditary)

Teaser case. Selected price and peak-sales fields are held for a paid Brief — the rest is the method.

Algorithm

Diagnose

Bone-avid tracer scan + rule-out AL. Genotype every patient.

Stabilizer

Tafamidis incumbent; acoramidis for complete stabilization / access.

Silencer

Vutrisiran now in CM. Mixed phenotype favours a silencer with neuro data.

Stabilizer, first-line incumbent

Vyndaqel / Vyndamax

tafamidis · Pfizer

List / typical annual

$268k

US WAC range; net lower. LoE ~2028

Eligible
ATTR-CM wild-type and hereditary
Route
Oral daily
Endpoint that matters
All-cause mortality + CV hosp; 6MWT
Curative?
Disease-modifying
Efficacy
ATTR-ACT: reduced all-cause mortality and CV hospitalisations vs placebo. The standard.
Safety
Well tolerated. The product problem is price and, soon, LoE.
Residual unmet need
Does not silence production. Late disease still progresses.