{
  "schema_version": "1.0",
  "type": "article",
  "title": "Alnylam’s Next Test: Winning the First Prescription",
  "url": "https://drugnews.com.tw/articles/2026-10-16-attr-rnai-first-prescription-en.html",
  "markdown_url": "https://drugnews.com.tw/articles/2026-10-16-attr-rnai-first-prescription-en.md",
  "lang": "en",
  "date": "2026-10-16",
  "publish_at": "2026-10-16T08:00:00+08:00",
  "updated_at": "2026-10-16",
  "category": "商業分析系列",
  "topic": "商業分析系列",
  "tags": [
    "RNA therapeutics",
    "Alnylam",
    "BridgeBio",
    "ATTR cardiomyopathy",
    "Amvuttra",
    "Attruby"
  ],
  "summary": "Amvuttra sold $1 billion in a quarter, yet Alnylam cut its full-year TTR revenue forecast as the initial wave of patients switching treatment was largely exhausted. BridgeBio is using medical-record evidence to win new patients from Pfizer’s tafamidis. In the ATTR heart-drug battle, the first prescription decides who wins.",
  "key_points": [],
  "facts": [],
  "sections": [
    "01｜One Disease, Three Companies, Three Approaches",
    "02｜Alnylam’s First Wave Came After Other Treatments Fell Short",
    "03｜BridgeBio Goes After Pfizer’s Patients Before Taking On RNA Drugs",
    "04｜Alnylam’s Countermove: Add On Instead of Displace",
    "05｜Read the Earnings Reports for Where Patients Come From",
    "Conclusion｜The Next Revenue Starts With the First Prescription",
    "References"
  ],
  "references": [
    {
      "title": "BridgeBio／Acoramidis Associated with Significantly Improved Clinical Outcomes Versus Tafamidis in ATTR-CM in an Independent, Real-World Study of U.S. Electronic Health Records／2026-10-11／",
      "source": "",
      "date": "",
      "url": "https://investor.bridgebio.com/news/news-details/2026/Acoramidis-Associated-with-Significantly-Improved-Clinical-Outcomes-Versus-Tafamidis-in-ATTR-CM-in-an-Independent-Real-World-Study-of-U-S--Electronic-Health-Records/default.aspx"
    },
    {
      "title": "Alnylam／Alnylam Pharmaceuticals Reports Second Quarter 2026 Financial Results and Highlights Recent Period Progress／2026-07-30／",
      "source": "",
      "date": "",
      "url": "https://investors.alnylam.com/press-release?id=ddc78e15-7847-4066-8fdb-3562023a60f4"
    },
    {
      "title": "FDA／AMVUTTRA Prescribing Information／Revised March 2025／",
      "source": "",
      "date": "",
      "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215515s006lbl.pdf"
    },
    {
      "title": "FDA／ATTRUBY Prescribing Information／Revised November 2024／",
      "source": "",
      "date": "",
      "url": "https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/216540s000lbl.pdf"
    },
    {
      "title": "Wright et al., Cardiology and Therapy／Comparative Effectiveness of TTR Stabilizers for the Treatment of ATTR-CM Using Real-World Evidence／2026-09-23／",
      "source": "",
      "date": "",
      "url": "https://link.springer.com/article/10.1007/s40119-026-00476-2"
    },
    {
      "title": "BridgeBio／BridgeBio Reports Second Quarter 2026 Financial Results and Corporate Updates／2026-08-10／",
      "source": "",
      "date": "",
      "url": "https://investor.bridgebio.com/news/news-details/2026/BridgeBio-Reports-Second-Quarter-2026-Financial-Results-and-Corporate-Updates/default.aspx"
    },
    {
      "title": "Hamatani et al., JACC／Effect of Vutrisiran According to Baseline Tafamidis Use in Transthyretin Amyloidosis With Cardiomyopathy: Insights From HELIOS-B／Published online August 30, 2026／",
      "source": "",
      "date": "",
      "url": "https://www.jacc.org/doi/10.1016/j.jacc.2026.07.022"
    },
    {
      "title": "Alnylam／Alnylam Presents New Data at ESC Congress 2026 Reinforcing Strength in RNAi-Powered TTR Silencing Across ATTR-CM Patient Populations and Treatment Settings／2026-08-30／",
      "source": "",
      "date": "",
      "url": "https://investors.alnylam.com/press-release?id=9c44884f-61bb-4f2e-85d5-09f4659cfc7c"
    },
    {
      "title": "FDA／Drug Trials Snapshot: ATTRUBY／Approved November 22, 2024／",
      "source": "",
      "date": "",
      "url": "https://www.fda.gov/drugs/drug-trials-snapshots/drug-trials-snapshot-attruby"
    },
    {
      "title": "FDA／Search Orphan Drug Designations and Approvals: vutrisiran／Approved March 20, 2025／",
      "source": "",
      "date": "",
      "url": "https://www.accessdata.fda.gov/scripts/opdlisting/oopd/detailedIndex.cfm?cfgridkey=637618"
    },
    {
      "title": "Pfizer／VYNDAQEL and VYNDAMAX Prescribing Information／Revised October 2023／",
      "source": "",
      "date": "",
      "url": "https://labeling.pfizer.com/ShowLabeling.aspx?id=11685"
    }
  ],
  "images": [
    {
      "alt": "Figure 1｜RNA silencing and oral stabilizers intervene at different points in the TTR disease process",
      "url": "https://drugnews.com.tw/assets/articles/attr-rnai-first-prescription-en/figure-01.png"
    },
    {
      "alt": "Figure 2｜Both companies seek treatment-naïve patients, but their new evidence answers different questions",
      "url": "https://drugnews.com.tw/assets/articles/attr-rnai-first-prescription-en/figure-02.png"
    },
    {
      "alt": "Figure 3｜After launch, both companies continue to build evidence on treatment sequencing",
      "url": "https://drugnews.com.tw/assets/articles/attr-rnai-first-prescription-en/figure-03.png"
    },
    {
      "alt": "Figure 4｜The composite endpoint and death alone must be read separately within the same medical-record study",
      "url": "https://drugnews.com.tw/assets/articles/attr-rnai-first-prescription-en/figure-04.png"
    }
  ],
  "cover_image": "https://drugnews.com.tw/assets/articles/attr-rnai-first-prescription-en/cover.png",
  "publisher": {
    "name": "Drugnews｜藥時事",
    "url": "https://drugnews.com.tw/",
    "profile": "https://drugnews.com.tw/brand-profile.json"
  },
  "citation": "Drugnews｜藥時事（2026-10-16）。Alnylam’s Next Test: Winning the First Prescription。https://drugnews.com.tw/articles/2026-10-16-attr-rnai-first-prescription-en.html",
  "disclaimer": "This article is intended for industry research and knowledge sharing only. It does not constitute investment, medical, fundraising, or individual stock advice.",
  "translations": {
    "zh-Hant": "attr-rnai-first-prescription"
  }
}