Category: Cardiometabolic

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Evidence-first notes on bioscience and medical affairs, at the edge of the clinic and the market. Information only — not investment advice, not medical advice. The 30-second version What. Part 1 identified the largest gap in the US CKM standard as the absence of the liver. The European/global axis attacks exactly that gap: the EAS…

The ATTR-CM commercial map — revenue and narrative are decoupled: stabilizers own the market, siRNA becomes a blockbuster, and the real bottlenecks are the add-on outcome threshold and the price-value gap

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. All revenue, prescription, pricing and reduction figures are attributed to the company’s own results (press release / SEC), to the ICER report, or to market-analysis reporting. The acoramidis-versus-tafamidis real-world comparison…

Hard outcomes in ATTR-CM — mortality and CV events are settled within each trial, but “which modality is better” is undeterminable because there is not a single head-to-head RCT

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. Every hard-outcome figure is attributed to its own trial’s primary paper or press release; the eplontersen miss and monotherapy signal are attributed to the AstraZeneca/Ionis press release of 2026-07-09 (press-release…

The TTR silencers — siRNA vutrisiran succeeded, ASO eplontersen missed, but the deciding variable was the trial population, not the modality

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. All knockdown, hazard-ratio and subgroup figures are attributed to the sponsoring trial, journal or company; several eplontersen numbers are a company press release rather than peer-reviewed data (noted inline), with…

Stabilizers in ATTR-CM — tafamidis and acoramidis built the first hard-outcome standard of care, but the “next-generation” increment is not proven mortality superiority

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. All efficacy figures are attributed to the sponsoring trial or company (ATTR-ACT to Pfizer/NEJM 2018; ATTRibute-CM to BridgeBio/NEJM 2024). Cross-trial comparisons are not head-to-head. The “near-complete (≥90%) stabilization” claim is…

The ATTR cardiomyopathy landscape — four modalities target one protein, but the siRNA-success/ASO-miss split is cross-trial, not head-to-head

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. All reduction and outcome figures are attributed to the sponsoring trial or company; some are company press releases rather than peer-reviewed data (noted inline). The eplontersen result below is a…

Finerenone and the CKM “third pillar” — complementarity is a division of outcomes, and the anti-fibrotic expansion is preclinical-thick but human-empty

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, not medical advice. The 30-second version What. Finerenone completes the cardio-kidney-metabolic (CKM) “three-pillar” standard of care alongside SGLT2 inhibitors and GLP-1 agonists through a non-overlapping anti-inflammatory / anti-fibrotic axis. But the real substance…

The clinical cost behind the finerenone headline — hyperkalemia, modest absolute benefit, and the real-world monitoring gap, by evidence tier

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment advice, and not medical advice. The 30-second version What. Behind finerenone’s headline hazard ratios sits a clinical cost that is not dramatic harm but friction. Across RCTs, hyperkalemia occurs at roughly 2× the placebo…

Finerenone’s commercial moat (Part 3): “the only nonsteroidal MRA with hard-outcome trials” — a real but time-limited advantage boxed in on three sides

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Evidence-first notes on bioscience and deep tech, at the edge of the lab and the market. Information only — not investment or medical advice. The 30-second version What. Finerenone (Bayer’s Kerendia) is currently the only nonsteroidal MRA (nsMRA) with hard-outcome RCT evidence. That single fact is its commercial moat: every competitor is on a surrogate…

The three-pillar combination in CKM — where the finerenone + SGLT2i + GLP-1 case is proven, and where it is still an assumption

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