US Biotechnology: ALNY / BBIO | Readthrough Takes from CARDIO-TTransform’s Disappointment

Research evidence excerpt

US Biotechnology: ALNY / BBIO | Readthrough Takes from CARDIO-TTransform’s Disappointment

Flash |

09 Jul 2026 11:59:58 ET │ 11 pages

US Biotechnology

ALNY / BBIO | Readthrough Takes from CARDIO-TTRansform’s

Disappointment

CITI'S TAKE

In a surprising twist to the TTR Wars saga, phase 3 CARDIO-TTRansform

(eplontersen (Wainua) for ATTR cardiomyopathy) failed to meet its primary

endpoint of composite CV mortality and recurrent CV events in the overall Eric Joseph, PhDAC

study population and showed no treatment effect in patients on stabilizer +1-212-816-8697

at baseline. Beyond the directly negative implications for covered IONS eric.joseph@citi.com

(discussed here), we see the Wainua setback shifting the outlook for those

with commercial ATTR-CM incumbents – namely Alnylam (Buy/HR) and

BridgeBio (Neutral/HR) – by varying degree. In our view, this morning’s

upside reactions by both (ALNY +7%, BBIO +15%) look appropriate in

reflecting retained ATTR-CM share opportunities with a large pharma

competitor no longer likely to enter the field. That said, with CARDIO-

TTRansform notable for being conducted in a large contemporary ATTR-

CM population, we suspect the presentation of full study results and

meta-analyses at ESC could impact treatment choice and, in-turn,

broader Street model assumptions.

ALNY | CARDIO-TTRansform’s failure effectively grants Amvuttra/Alnylam’s TTR

franchise sole ownership of the TTR silencer category, and we view today’s upside

reflecting some degree of conversion of 2028-2031 Wainua CM forecasts to

Amvuttra. That said, we’d been attracted by CARDIO-TTRansform’s potential to

bolster the clinical and commercial profile the TTR silencer class overall, and

minimally concerned about direct competition or the convenience of Wainua’s self-