Acoramidis

关注并星标CPHI制药在线制药领域是一个花无百日红的场所，不仅是因为“江山代有才人出”，也因为“风流总被雨打风吹去”。一款曾经“一览众山小”的重磅药物，在专利到期之后面对的通常会是“故国不堪回首月明中”的落寞。药品专利，这个起初旨在维护制药公司利益的保护伞，在逐渐走向专利悬崖的后期，却成为这些公司如芒在背的威胁。       专利悬崖对大型制药公司，尤其是对那些依赖几款超级重磅炸弹药物的制药公司构成非常严重的威胁。当这些药物的专利到期后，仿制药制造商迅速进入市场，推出价格远低于原研药的替代品。这将直接导致原研药销售额的骤降，并削弱了这些开发商的盈利能力。由于超级重磅炸弹药物通常占公司总收入的相当大部分，一旦失去专利保护，公司可能难以在短期内通过新药研发或收购来弥补收入缺口。因此专利悬崖不仅威胁到公司的财务稳定，还可能影响其研发投入和市场竞争力。放眼大时代，2026-2030 年，生物制药行业将进入动荡时期，众多超重磅药物将在这一时期失去美国市场独占权。几乎所有大型制药公司都将或多或少受到头顶的这把专利到期达摩克利斯之剑的影响，但受威胁程度疾徐不一。诺和诺德、赛诺菲、吉利德、礼来和拜耳可能是2030年前“受灾”程度最小的五家制药巨头（表1，图1-2）。根据 Evaluate Pharma 的数据和Scrip的分析，预计从2026年至2030年，这五家制药商因专利到期遭受的损失将不超过各自2025年美国市场预测收入的15% 。在诺和等五家制药公司“事大如天醉亦休”地置身其外的同时，感受“日长似岁”般煎熬的制药巨头将面临渡劫。这些公司可能会因 2026 年至 2030 年美国专利到期药物而损失50% 以上的收入，其中葛兰素史克、百时美施贵宝和默沙东将面临最大危局。葛兰素史克的 Tivicay（多替拉韦）和 Dovato（拉米夫定）、百时美施贵宝的 Eliquis（阿哌沙班）和 Opdivo（纳武利尤单抗）以及默沙东的药王 Keytruda（帕博利珠单抗）等超级重磅药物可能将在这个时间段面临仿制药或生物类似药的竞争。表1. 全球大型制药公司2026-2030年受专利悬崖影响数据（数据来源：Evaluate Pharma）图1. 2025年预计美国市场收入中遭受2026-2030年间市场独占权丧失威胁的比例。（数据来源：Evaluate Pharma)图2. 大型制药公司2025年预计收入中面临2026-2030年间市场独占权丧失威胁的绝 对数额。（数据来源：Evaluate Pharma）A.安全榜1.诺和诺德（2% 风险）诺和诺德的支柱性产品无疑是其Semaglutide产品组合，尤其是Ozempic和Wegovy。虽然诺和诺德将在GLP-1市场遭遇礼来和众多后来者的严峻挑战，以及Medicare价格谈判的潜在影响，但从专利悬崖的角度来看，诺和面临的压力要比默沙东小得多。Semaglutide在美国市场的核心专利保护预计将延续到2031年，这将赋予诺和诺德宝贵的开发新产品的黄金时间，在享受semaglutide巨大红利的同时，将利润投入到新一代产品的开发中，例如GLP-1/胰淀素类似物联合疗法CagriSema。2.赛诺菲（9% 风险）赛诺菲CEO Paul Hudson在今年1月召开的摩根大通医疗保健大会的演讲中就曾信誓旦旦地表态，“就独占权丧失而言，赛诺菲是业内最低的”。赛诺菲的当家花魁Dupixent (dupilumab) 仍处在生命周期的黄金时代，被批准用于从牛皮癣到哮喘等多种炎症疾病，最近还获得了慢性阻塞性肺病 (COPD)的批准，进一步夯实了这款超重磅药物的盈利能力。Dupixent 的专利保护期将持续到 2030 年代初。其活性成分专利将于 2031 年到期，其他专利有效时间则更长。Evaluate Pharma 的数据显示，赛诺菲预计的2025 年美国收入中只有 9% 会因 2026 年至 2030 年期间的市场独占丧失而损失，但这些损失多数来自“帐中副将”，例如乙型血友病药物Alprolix（重组凝血因子IX-Fc融合蛋白）和慢性移植物抗宿主病药物Rezurock（belumosudil），预计它们将分别在 2028 年和 2029 年失去独占权。3.吉利德（9%风险）吉利德追求的目标之一是在其核心 HIV 业务之外成功实现更多多元化，这个志向是建立在其HIV 业务一直在实现增长的基础之上的。吉利德最畅销的联合疗法的专利目前还一眼望不到底，2033 年底之前可保无虞。Biktarvy 在 2024 年的销售额为 134 亿美元，占吉利德总收入的将近48%。吉利德表示，在Biktarvy收入曲线进入下行阶段之前，他们将有能力推出新一代长效HIV药物。吉利德2025 年美国收入中只有9%将遭受到2026-2030年市场独占权丧失的影响，包括2027 年到期的CD19 靶向CAR-T疗法，而考虑到 CAR-T 疗法制造的复杂性，Tecartus未必在市场独占期到来之后立即面临生物类似药的竞争。4.拜耳（风险 13%）处在多事之秋的拜耳，其重磅产品血液稀释剂 Xarelto（rivaroxaban）市场独占期在2024年4月已经到来，令拜耳更加感受到压力重重。但遭受亏损的拜耳有望在2027年实现业务增长。拜耳CEO Bill Anderson 认为，用于治疗与 2 型糖尿病相关的慢性肾病的盐皮质激素受体拮抗剂 Kerendia（finerenone）和前列腺癌药物 Nubeqa（darolutamide）等新药将有助于推动拜耳回春。此外，BridgeBio 的 acoramidis 在欧洲将由拜耳负责商业化（欧洲商品名Beyonttra），针对转甲状腺素蛋白淀粉样心肌病 (ATTR-CM)。拜耳的elinzanetant针对更年期相关的中度至重度血管舒缩症状的申请正在等待FDA的监管审批。5.礼来（风险 15%）礼来的旗舰产品Mounjaro和Zepbound相对于其直接竞争对手，诺和诺德的Ozempic和Wegovy更加年轻。其活性成分tirzepatide的专利至少要到2036年才到期，这位礼来长期盈利提供了关键保障。礼来公司在 2026-2030 年期间也将面临一些畅销药物的专利损失，包括预计在 2027 年失去市场独占的糖尿病重磅药物 Trulicity（dulaglutide），其2024 年为礼来创造了 52.5 亿美元的收入；以及在 2030 年失去专利保护的牛皮癣药物 Taltz（ixekizumab），其2024 年销售额达到36 亿美元。B.风险榜1.默沙东（78%）Keytruda，默沙东的这款支柱产品免疫检查点抑制剂肿瘤学产品2024年销售额高达295亿美元，而默沙东全年销售额为642亿美元。也就是说，Keytruda以一己之力贡献了默沙东全部销售额的46%，这是一个非常卓越的成就，但同样也包藏祸机，因为Keytruda在美国的关键专利将在2028年到期，Keytruda专利悬崖危机成为默沙东目前的头号挑战。随着 Keytruda、Sitagliptin/Metformin和 Letermovir 的专利即将到期，默沙东未来五年将面临严峻挑战。另一个主要收入来源 HPV 疫苗 Gardasil 9 因中国市场饱和而表现不佳，导致默沙东于 2024 年 2 月暂停发货以清理库存，在 2025 年可能会恢复增长。为了保持增长，默沙东抗体药物偶联物 (ADC) 方面投入了大量资金，包括与科伦生物科技和第一三共的合作。2.GSK（62%）葛兰素史克的dolutegravir一直是其HIV 药物组合的主要产品，是葛兰素史克四个最畅销的 HIV 品牌 Tivicay（13.5亿英镑）、Triumeq（13.3亿英镑）、Juluca（6.85亿英镑） 和 Dovato （22.4亿英镑）中的成分。但其关键专利可能将于2027年到期。3.BMS (55%)百时美施贵宝的Eliquis (Apixaban) 和 Opdivo 正面临专利悬崖危机，2024 年这两款药物的营收为 234 亿美元，占公司总营收的近一半。Eliquis面临即将到来的仿制药竞争，Eliquis是BMS与辉瑞共同商业化的产品，是一种用于预防成人血栓的小分子药物，2012年获得FDA批准，2023年实现全球122亿美元的销售额。其专利已于2022年到期，但得益于补充保护证书（Supplementary Protection Certificate）的荫护，其保护期已延长到2026年。实际上，Eliquis仿制药已经获得了FDA的临时批准，但BMS与仿制药商已经达成和解，仿制药不会在2027年之前上市。作为回应，BMS 实施了积极的成本削减措施，包括 2024 年 4 月的 15 亿美元成本削减计划和 2025 年 2 月的额外 20 亿美元削减计划，包含削减产品线和裁员。BMS 还将重点转向神经科学，以 140 亿美元收购了 Karuna Therapeutics，并投资了精神分裂症药物 Cobenfy。C.2025-2031年间失去市场独占权的重要药物2025年• Entresto (sacubitril/valsartan，诺华，2015年获批，2024年全球销售额：78.2亿美元，下同)• Farxiga (Dapagliflozin，诺华，2014年获批，2型糖尿病，38.4亿美元)• Prolia (denosumab，安进，2010年获批，骨质疏松症，43.7亿美元)• Xgeva (denosumab，安进，2010年获批，肿瘤，22.3亿美元)      2026年• Eliquis (apixaban，BMS/辉瑞，2012年获批，血栓，122亿美元)• Revlimid (lenalidomide，BMS，2005年获批，骨髓增生异常综合征、多发性骨髓瘤、淋巴瘤、滤泡性淋巴瘤等，57.7亿美元)       2027年• Trulicity (dulaglutide，礼来，2014年获批，2型糖尿病，52.5亿美元)• Ocrevus (ocrelizumab ，罗氏，2017年获批，多发性硬化症，67亿美元)• Ibrance (Palbociclib，辉瑞，2015年获批，乳腺癌，43.7亿美元)• Xtandi (enzalutamide，安斯泰来/辉瑞，2012年获批，前列腺癌，63亿美元)• Imbruvica (ibrutinib，艾伯维/强生，2013年获批，慢性淋巴细胞白血病等，49亿美元)• Dolutegravir药物组合 (GSK，2013年获批，HIV，56亿英镑)       2028年• Keytruda (pembrolizumab，默沙东，2014年获批，肿瘤，295亿美元)• Opdivo (nivolumab，BMS，2014年获批，肿瘤，93亿美元)• Gardasil 9 (human papillomavirus 9-valent vaccine ，2014年获批，默沙东，86亿美元)       2029年• Darzalex (daratumumab，强生/Genmab，2015年获批，多发性骨髓瘤，117亿美元)• Cosentyx (secukinumab，诺华，2015年获批，斑块性银屑病等，61.4亿美元)• Enbrel (etanercept，安进，1998年获批，类风湿性关节炎等，33.2亿美元)       2031年• Dupixent (dupilumab，赛诺菲/再生元，2017年获批，特应性皮炎、哮喘、慢性阻塞性肺病等，131亿欧元)Ref.      1、Merck Announces Fourth-Quarter and Full-Year 2024 Financial Results. Merck Press Release. 04. 02. 2025.       2、Merrill, J. et al. Five Companies Heading Toward 2030 With Wind At Their Back. Scrip. 26. 02. 2025.       3、2024 Financial report of various pharmaceuticals.       4、Pharma patent cliff. LinkedIn: Joanna-sadowska-phdEND【企业推荐】智药研习社直播预告来源：CPHI制药在线声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。投稿邮箱：Kelly.Xiao@imsinoexpo.com▼更多制药资讯，请关注CPHI制药在线▼点击阅读原文，进入智药研习社~

- In a post-hoc analysis of ATTRibute-CM, acoramidis reduced the annual frequency of CVH due to AF/AFL by 43% compared to placebo and reduced the incidence of new-onset AF/AFL by 17% in the subgroup with no prior history of AF compared to placebo - In the ATTRibute-CM study, acoramidis demonstrated the most rapid benefit seen in any Phase 3 study of ATTR-CM to date in both ATTRv-CM and ATTRwt-CM patients: - In as few as 3 months, the time to first event (ACM or CVH) durably separated relative to placebo- A 42% reduction in composite ACM and recurrent CVH events relative to placebo at Month 30- A 50% reduction in the cumulative frequency of CVH events relative to placebo at Month 30 - Acoramidis is approved as Attruby™ by the U.S. FDA and is approved as BEYONTTRA® by the European Commission, Japanese Pharmaceuticals and Medical Devices Agency and UK Medicines and Healthcare Products Regulatory Agency PALO ALTO, Calif., May 20, 2025 (GLOBE NEWSWIRE) -- BridgeBio Pharma, Inc. (Nasdaq: BBIO) (“BridgeBio” or the “Company”), a new type of biopharmaceutical company focused on genetic diseases, presented data from ATTRibute-CM, highlighting the reduced incidence of atrial fibrillation (AF) events in the overall ATTR-CM population. These data were presented in a moderated ePoster at the Annual Congress of the Heart Failure Association of the ESC (Heart Failure 2025), taking place in Belgrade, Serbia from May 17 - 20, 2025. Acoramidis is a selective small molecule, orally administered, near-complete (≥90%) transthyretin (TTR) stabilizer. “The reduction in new-onset atrial fibrillation and AF-related hospitalizations represents an important finding for the ATTR-CM community. I am encouraged by the growing body of data from the ATTRibute-CM study, which adds to the understanding of acoramidis and its potential impact on clinical outcomes for patients. Furthermore, the observed reductions in hospitalizations and mortality, along with improvements in functional capacity and quality of life, suggest that acoramidis may offer benefit to both variant and wild-type ATTR-CM patients who have limited treatment options,” said Kevin Alexander, M.D. of Stanford University School of Medicine, USA. “These data support further consideration of acoramidis as a promising front-line therapy for ATTR-CM, particularly for patients with the hereditary form of the disease, who often face rapid and severe progression.” Details from the post-hoc analysis on incidence of AF in ATTRibute-CM included: Acoramidis Treatment Is Associated with a Lower Incidence of Atrial Fibrillation-related Events in Patients with ATTR-CM: A Post-hoc Analysis of the ATTRibute-CM Trial, presented by Dr. Alexander AF is a common complication of ATTR-CM, observed in up to 70% of patients, and the onset of AF is associated with an increased risk of cardiovascular-related hospitalizations (CVH)In ATTRibute-CM, a 43% relative risk reduction in the annual frequency of CVH due to AF/atrial flutter (AFL) was observed with acoramidis relative to placebo. In the subgroup who had no prior history of AF, a 17% lower incidence of new-onset AF/AFL was reported with acoramidis compared to placeboThese findings show the potential of acoramidis to reduce both disease progression, as indicated by a lower incidence of new-onset AF/AFL, and CVH morbidity caused by AF/AFL, in patients with ATTR-CM In addition to the moderated ePoster, three analyses were shared on the strong clinical outcomes in ATTRv-CM versus placebo. ATTRv-CM is associated with early age of disease onset with more advanced heart failure symptoms, which often leads to a poorer prognosis than those with wild-type ATTR-CM (ATTRwt-CM). These findings included: Acoramidis Improves Serum TTR Levels in Patients with Wild-type or Variant Transthyretin Amyloid Cardiomyopathy: Results from ATTRibute-CM, presented by Anique Ducharme, M.D. of Université de Montréal, CAN In both subgroups of ATTRv-CM and ATTRwt-CM, acoramidis treatment induced a rapid increase in serum TTR levels, a measure of TTR stability, by Day 28, with comparable serum TTR levels achieved in both subgroups from Day 28 through Month 30. Relative increases in serum TTR concentrations resulting from greater TTR stability have been associated with reduced risk of all-cause and cardiovascular mortality in the general population in recent literature1 Effect of Acoramidis on Functional Capacity and Quality of Life in Patients with Variant ATTR-CM: Results from ATTRibute-CM, presented by Marianna Fontana, M.D. of University College London, UK Data from ATTRibute-CM showed that when acoramidis was administered for 30 months, participants with ATTRv-CM had a clinically significant slower decline in functional capacity and quality of life compared with placebo, consistent with the overall results in both ATTRv-CM and ATTRwt-CMAt Month 30, the mean difference between acoramidis and placebo treatment groups in the change from baseline in 6-minute walk distance was 86.7 meters (p = 0.0048) in favor of acoramidis and in the change from baseline in KCCQ-OS at Month 30, was 20.3 points (p = 0.0019) in favor of acoramidis, in patients with ATTRv-CM Effect of Acoramidis on All-cause Mortality, Cardiovascular Hospitalization and NT-proBNP in Variant ATTR-CM: Results from ATTRibute-CM, presented by Marianna Fontana, M.D. of University College London, UK In ATTRibute-CM, acoramidis treatment administered for 30 months led to a substantial reduction (>50%) in the composite of all-cause mortality (ACM)/CVH, ACM and CVH in participants with ATTRv-CM compared to placebo. This improvement was accompanied by favorable effects on N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels “Based on the findings from ATTRibute-CM, we believe that acoramidis has the potential to enable patients with both variant and wild-type ATTR-CM to live longer, healthier lives, especially for those with variant ATTR-CM who typically have a poorer prognosis. We observed both a striking reduction in the frequency of cardiovascular hospitalizations (which included clinic or emergency department visits for urgent heart failure management) and a clinically important and statistically significant reduction in all-cause mortality in the important subgroup. These clinical outcomes were further mirrored in robust improvements in functional capacity, quality of life, and biomarkers of heart failure severity,” said Jonathan Fox, M.D., Ph.D., President and Chief Medical Officer of BridgeBio Cardiorenal. “Given these compelling results, acoramidis should be considered as first-line treatment for newly diagnosed patients, and those currently on other therapies could be switched to acoramidis to maximize their potential to achieve such benefits.” Additional acoramidis moderated ePosters at Heart Failure 2025 included: Disease Progression Among Patients Receiving Tafamidis for ATTR-CM in a Real-world Setting, presented by Daniel P. Judge, M.D. of Medical University of South Carolina, USA This analysis suggests disease progression despite treatment with tafamidis in ATTR-CM. CVH was frequent, with approximately 1 in 5 tafamidis-treated patients hospitalized in the first six months of therapy. As more therapeutic options become available, measuring the clinical effectiveness of therapies in a real-world setting will be important to help inform physicians and patients when making treatment decisions Cause of Death in Patients with Transthyretin Amyloid Cardiomyopathy (ATTR-CM): Findings from the ATTRibute-CM Study, presented by Laura Obici, M.D. of University of Pavia, ESP In the ATTRibute-CM study, total deaths were numerically lower with acoramidis compared with placebo. The relative risk reduction of 30% in cardiovascular-related mortality by Month 30 was driven predominantly by a reduction in heart failure-related deaths Time from First Recorded Clinical Manifestation to Diagnosis of Transthyretin Amyloid Cardiomyopathy: A Retrospective Cohort Study Using U.S. Claims Data, presented by Joshua Mitchell, M.D., Washington University School of Medicine in St. Louis, USA The median time from the first documented clinical manifestation to ATTR-CM diagnosis was almost 5 years, and over 2 years from the first heart failure diagnosis. This demonstrates that the patient journey to an ATTR-CM diagnosis can be prolonged and challenging, which potentially leads to more severe disease at diagnosis. Understanding the factors contributing to diagnostic delays is important to improving diagnostic pathways and patient outcomes Acoramidis is approved as Attruby by the U.S. FDA and is approved as BEYONTTRA by the European Commission, Japanese Pharmaceuticals and Medical Devices Agency, and the UK Medicines and Healthcare Products Regulatory Agency with all labels specifying near-complete stabilization of TTR. More data on the benefit of Attruby for ATTR-CM patients is planned for future medical meetings. 1Christoffersen M et al. Transthyretin Tetramer Destabilization and Increased Mortality in the General Population. JAMA Cardiol. 2024 Dec 4:e244102. About Attruby™ (acoramidis) INDICATION Attruby is a transthyretin stabilizer indicated for the treatment of the cardiomyopathy of wild-type or variant transthyretin-mediated amyloidosis (ATTR-CM) in adults to reduce cardiovascular death and cardiovascular-related hospitalization. IMPORTANT SAFETY INFORMATION Adverse Reactions Diarrhea (11.6% vs 7.6%) and upper abdominal pain (5.5% vs 1.4%) were reported in patients treated with Attruby versus placebo, respectively. The majority of these adverse reactions were mild and resolved without drug discontinuation. Discontinuation rates due to adverse events were similar between patients treated with Attruby versus placebo (9.3% and 8.5%, respectively). About BridgeBioBridgeBio Pharma (BridgeBio; NASDAQ:BBIO) is a new type of biopharmaceutical company founded to discover, create, test, and deliver transformative medicines to treat patients who suffer from genetic diseases. BridgeBio’s pipeline of development programs ranges from early science to advanced clinical trials. BridgeBio was founded in 2015 and its team of experienced drug discoverers, developers and innovators are committed to applying advances in genetic medicine to help patients as quickly as possible. For more information visit bridgebio.com and follow us on LinkedIn, Twitter, Facebook, and YouTube. BridgeBio Forward-Looking Statements This press release contains forward-looking statements. Statements in this press release may include statements that are not historical facts and are considered forward-looking within the meaning of Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), which are usually identified by the use of words such as “anticipates,” “believes,” “continues,” “could,” “estimates,” “expects,” “hopes,” “intends,” “may,” “plans,” “projects,” “potential,” “seeks,” “should,” “will,” and variations of such words or similar expressions. BridgeBio intends these forward-looking statements to be covered by the safe harbor provisions for forward-looking statements contained in Section 27A of the Securities Act and Section 21E of the Exchange Act. These forward-looking statements, including statements regarding the potential impact of acoramidis on clinical outcomes for patients, the possibility that acoramidis may offer benefit to both variant and wild-type ATTR-CM patients, the consideration of acoramidis as a promising front-line therapy for ATTR-CM, the potential of acoramidis to reduce disease progression and cardiovascular hospitalization morbidity caused by AF/AFL, BridgeBio’s belief that acoramidis could help patients live longer, healthier lives—especially those with variant ATTR-CM—and the view that acoramidis should be considered as a first-line treatment or as a replacement for current therapies to maximize patient benefit, reflect BridgeBio’s current views about its plans, intentions, expectations, and strategies, which are based on the information currently available to BridgeBio and on assumptions it has made. Although BridgeBio believes that its plans, intentions, expectations, and strategies as reflected in or suggested by these forward-looking statements are reasonable, it can give no assurance that such plans, intentions, expectations, or strategies will be attained or achieved. Furthermore, actual results may differ materially from those described in the forward-looking statements and will be affected by a number of risks, uncertainties, and assumptions, including, but not limited to: the risks associated with BridgeBio’s dependence on third parties for development; regulatory authorities requiring additional studies or data to support the continued or expanded commercialization of acoramidis; whether data and results meet regulatory requirements or are sufficient for continued development, review, or approval; and whether other regulatory agencies agree with BridgeBio’s strategies or data interpretations. These risks also include impacts from global health emergencies, such as delays in regulatory reviews and other activities, manufacturing and supply chain interruptions, adverse effects on healthcare systems, and disruption of the global economy; and the impacts of macroeconomic and geopolitical events, including changing conditions from hostilities in Ukraine and in Israel and the Gaza Strip, increasing inflation rates, and fluctuating interest rates on BridgeBio’s operations and expectations. Additional risks are described in the Risk Factors section of BridgeBio’s most recent Annual Report on Form 10-K, Quarterly Report on Form 10-Q, and other filings with the U.S. Securities and Exchange Commission. Moreover, BridgeBio operates in a very competitive and rapidly changing environment in which new risks emerge from time to time. These forward-looking statements are based upon the current expectations and beliefs of BridgeBio’s management as of the date of this press release and are subject to certain risks and uncertainties that could cause actual results to differ materially from those described in these statements. Except as required by applicable law, BridgeBio assumes no obligation to publicly update any forward-looking statements, whether as a result of new information, future events, or otherwise. BridgeBio Media Contact:Bubba Murarka, EVP Communicationscontact@bridgebio.com (650)-789-8220 BridgeBio Investor Contact:Chinmay Shukla, VP Strategic Financeir@bridgebio.com