Core Insights - BridgeBio Pharma reported a total revenue of $120.7 million for Q3 2025, driven primarily by $108.1 million in U.S. Attruby net product revenue, alongside $4.3 million from royalty revenue and $8.3 million in license and services revenue [1][3][10] - The company has seen significant commercial progress, with 5,259 unique patient prescriptions written by 1,355 unique prescribers as of October 25, 2025, indicating strong adoption of Attruby since its FDA approval in November 2024 [1][2][4] - BridgeBio plans to file New Drug Applications (NDAs) for BBP-418 and encaleret in the first half of 2026, aiming for full approval of these therapies [1][5][8] Commercial Performance - Attruby's launch has been characterized by strong physician adoption and continued growth across all market segments, reflecting its differentiated clinical profile [4][6] - The company reported a significant increase in total revenues, with a $118 million rise compared to the same period last year, primarily due to the commercial success of Attruby [10][11] Pipeline Developments - Positive interim analysis results from the FORTIFY Phase 3 study of BBP-418 showed a 1.8x increase in glycosylated αDG from baseline at 3 months, with sustained improvements at 12 months [1][8] - The CALIBRATE Phase 3 study of encaleret for ADH1 met its primary endpoint, with 76% of participants achieving target calcium levels at Week 24 [1][8] - The PROPEL 3 study of infigratinib for achondroplasia is fully enrolled, with topline results expected in early 2026 [1][8] Financial Overview - As of September 30, 2025, the company had $645.9 million in cash, cash equivalents, and marketable securities, positioning it well to support the commercialization of Attruby and advance its late-stage pipeline [1][9] - Operating costs for Q3 2025 were $265.9 million, reflecting increased investments in support of Attruby's commercial launch [14][15] Key Metrics - The net loss attributable to common stockholders for Q3 2025 was $182.7 million, compared to $162.0 million for the same period in the prior year, with a net loss per share of $0.95 [22][23] - Total revenues for the nine months ended September 30, 2025, were $347.9 million, up from $216.0 million in the prior year [11][12]

Summary of BridgeBio Pharma's Conference Call on ADH1 Calibrate Phase 3 Results Company and Industry Context - **Company**: BridgeBio Pharma - **Industry**: Biotechnology, specifically focusing on rare genetic conditions and therapies Key Points and Arguments 1. **Positive Phase 3 Data**: The Calibrate clinical trial for autosomal dominant hypocalcemia type 1 (ADH1) showed positive results, marking a significant advancement for patients suffering from this condition [2][8][22] 2. **Therapeutic Impact**: Encaleret, the investigational drug, demonstrated the ability to normalize calcium and parathyroid hormone (PTH) levels in a majority of patients, addressing the root cause of ADH1 [5][11][22] 3. **Study Results**: - 76% of participants achieved target serum and urine calcium levels within 24 weeks of treatment with encaleret [8][17] - 91% of participants showed a positive response in PTH levels [18] - Encaleret was well tolerated, with no discontinuations due to adverse effects [9][21] 4. **Prevalence of ADH1**: The estimated prevalence of ADH1 is approximately 1 in 25,000, translating to about 12,000 individuals in the U.S. [9][10] 5. **Mechanism of Action**: Encaleret acts as a calcilytic, targeting the calcium-sensing receptor (CASR) to restore mineral homeostasis, which is disrupted in ADH1 patients [10][11] 6. **Future Studies**: Plans to initiate a phase 2/3 study in pediatric patients and a phase 3 study in chronic hypoparathyroidism are underway [24][26] Additional Important Information 1. **Commercial Strategy**: BridgeBio Pharma is preparing for a potential blockbuster launch of encaleret, leveraging its existing commercial infrastructure from previous product launches [26][29] 2. **Market Dynamics**: The ADH1 market is underrecognized, presenting a significant opportunity for diagnosis and treatment expansion [27][66] 3. **Regulatory Engagement**: The company plans to engage with the FDA for a New Drug Application (NDA) submission in the first half of 2026 [24] 4. **Patient Identification**: Increased awareness and new ICD-10 codes are expected to facilitate the identification of ADH1 patients, enhancing market access [45][66] 5. **Safety Profile**: The safety profile of encaleret appears favorable, with manageable adverse events primarily related to the drug's mechanism of action [21][94] This summary encapsulates the critical insights from the conference call, highlighting the advancements in treatment for ADH1 and the strategic direction of BridgeBio Pharma.

- The CALIBRATE study of encaleret for patients with ADH1 met all pre-specified primary and key secondary efficacy endpoints  - The primary endpoint was met with 76% of participants administered encaleret achieving both serum and urine calcium within the respective target ranges at Week 24 compared to 4% when on conventional therapy at Week 4 (p<0.0001) - In a key secondary analysis, 91% of participants administered encaleret achieved intact PTH above the lower limit of the reference range at Week 24 compar ...

Core Insights - The presentation focuses on encaleret, a small molecule being developed for autosomal dominant hypocalcemia type 1 (ADH1) [2][3] - The webinar includes insights from key figures in the field, including Dr. Rachel Gafni and Dr. Scott Adler, who will discuss the clinical development program for encaleret [3] Market Opportunity - The company aims to highlight the market potential for ADH1 and the patient experience associated with the condition [4]

Core Insights - The presentation focuses on encaleret, a small molecule being developed for autosomal dominant hypocalcemia type 1 (ADH1) [2][3] - The webinar includes insights from key figures in the development of encaleret, including Dr. Rachel Gafni and Dr. Scott Adler [3] Market Opportunity - The company aims to discuss the market potential for ADH1 and the implications of encaleret in addressing this condition [4]

Core Insights - Encaleret demonstrated significant efficacy in normalizing blood and urine calcium levels in post-surgical hypoparathyroidism patients, with 80% achieving normal levels within 5 days of treatment initiation compared to 0% on conventional therapy at baseline [1][6] - The treatment was well-tolerated, with no serious adverse events reported during the study [1] - BridgeBio plans to initiate a registrational clinical study for encaleret in chronic hypoparathyroidism in 2026 based on the promising Phase 2 results [1][3] Company Overview - BridgeBio Pharma, Inc. is focused on developing transformative medicines for genetic diseases, with a pipeline that includes early science to advanced clinical trials [5] - The company was founded in 2015 and aims to leverage advances in genetic medicine to expedite patient care [5] Study Details - The Phase 2 proof-of-concept study evaluated the PTH-independent effects of encaleret on renal calcium handling in ten participants with post-surgical hypoparathyroidism, administered at 162 mg twice daily for up to 5 days [2] - Calcitriol was stopped one day prior to the first dose, and calcium levels were titrated based on blood calcium after starting encaleret [2] Additional Findings - Encaleret treatment resulted in a rapid and sustained reduction in fractional excretion of calcium in nine participants, supporting its potential as an orally-administered treatment option for chronic hypoparathyroidism [6] - Data from preclinical studies of infigratinib were also presented, showing significant improvements in bone growth and skull development in relevant mouse models, indicating broad potential for treating skeletal conditions [4]

Summary of BridgeBio Pharma (BBIO) 2025 Conference Call Company Overview - **Company**: BridgeBio Pharma - **Key Products**: Acoramidis, Encaleret - **Focus Areas**: Limb-girdle muscular dystrophy, autosomal dominant hypocalcemia type 1 (ADH1) Key Points Acoramidis Launch and Performance - The launch of acoramidis is described as having a strong start, with increasing momentum in both treatment naive and switch settings [2][3] - Acoramidis is noted for its superior clinical profile, being the only near-complete stabilizer on the market [2] - Key clinical outcomes include: - 50% reduction in hospitalization at 30 months - 40% reduction in all-cause mortality (ACM) and hospitalization at 30 months [3] - Metrics such as gross-to-net revenue have stabilized in the 30% to 40% range, with compliance around 80% [3][5] - New patient additions have accelerated, with 3,751 patients reported by Q2, up from 2,072 in Q1, indicating a growth rate of approximately 90 to 100 patients per week [8][9] Market Dynamics and Competitive Landscape - The discontinuation of Pfizer's Vyndaqel in 2026 is seen as an opportunity for BridgeBio to capture patients who would have been prescribed Vyndaqel, as these physicians are already predisposed to using stabilizers [12] - The polymorph patent covering both Vyndaqel and Vyndamax is expected to protect acoramidis from generic competition, raising the bar for any potential generic manufacturers [13][14] Encaleret Development - Encaleret is being developed for ADH1, with a prevalence rate of about 1 in 25,000, translating to approximately 12,000 individuals in the U.S. [22] - The diagnosis rates for ADH1 are lagging behind prevalence due to the lack of indicated treatments [22][23] - Phase two results showed that 70% of patients normalized both blood and urine calcium levels, which is a significant improvement over conventional therapies [34][35] - The phase three study is designed to evaluate the concurrent normalization of blood and urine calcium over six months, informed by phase two results [35] Limb-Girdle Muscular Dystrophy Insights - Ribitol is crucial for muscle function as it is used by FKRP to glycosylate alpha-dystroglycan, a stabilizing protein in muscle fibers [45] - Phase two results indicated an approximate doubling of glycosylated alpha-dystroglycan levels in patients, with a significant reduction in creatine kinase (CK) levels [52][53] - The study aims for a 5% absolute change in glycosylated alpha-dystroglycan and a 40% reduction in CK for potential accelerated approval [56][57] Competitive Landscape for Hypoparathyroidism - Encaleret is positioned against Yorvipath, with potential advantages such as being an oral medication and offering a urine calcium benefit [43][44] - The treatment goals focus on normalization of blood calcium, urine calcium, and phosphate, rather than complete independence from conventional therapy [41] Future Outlook - The company is optimistic about the continued growth of acoramidis and the potential for encaleret to address unmet needs in hypoparathyroidism and ADH1 [14][44] - Upcoming data presentations and interim analyses are expected to provide further insights into the efficacy and market positioning of both acoramidis and encaleret [56][57] Additional Important Insights - The company emphasizes the importance of genetic testing for undiagnosed patients with ADH1, suggesting that many patients with hypoparathyroidism are not genotyped [28][23] - The phase three trial for encaleret is designed to be powered for success based on the promising phase two results, indicating a strong confidence in the product's potential [35][40]

Financial Data and Key Metrics Changes - The company announced a significant increase in the number of treatment-naive patients on acoramidis, indicating positive commercial execution [47][48] - The gross-to-net ratio is expected to stabilize in the range of 30% to 40%, reflecting a more representative payer mix [56][57] Business Line Data and Key Metrics Changes - The ADH-1 program is transitioning from a single-center phase two study to a global phase three study with over 25 sites, which may lead to a more heterogeneous patient population [3][4] - In the phase two study of ADH-1, 70% of patients responded to encaleret, and the company aims to replicate this success in phase three [15][38] Market Data and Key Metrics Changes - The prevalence of ADH-1 was estimated at 1 in 25,000 based on data from multiple biobanks, indicating a consistent finding across different cohorts [18][19] - The company is learning that many patients diagnosed with hypoparathyroidism may actually have ADH-1, which highlights the need for better disease education and genetic testing [19] Company Strategy and Development Direction - The company is focused on driving disease education and increasing the utilization of genetic testing to improve diagnosis rates for ADH-1 [19] - The strategy includes leveraging compelling clinical data and new treatment guidelines to enhance awareness and diagnosis of the condition [12][13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the launch of acoramidis, noting that the share of treatment-naive patients has been increasing month over month [47][48] - The company believes that any treatment that stops or slows the progressive loss of function will be well-received by patients, given the lack of current options [43] Other Important Information - The company plans to present full phase two data for chronic hypoparathyroidism at an upcoming medical meeting, which may address skepticism regarding efficacy [26] - The phase three study for 418 is designed to show trends in clinical measures rather than statistically significant benefits, aligning with FDA requirements for accelerated approval [38][40] Q&A Session Summary Question: What are the risks in translating phase two findings to phase three for ADH-1? - The main difference is the number of sites and patients, with phase three being a global study involving over 25 sites [3] Question: How does the company view the use of PTH replacement therapy in ADH-1 patients? - Management indicated that PTH replacement is not ideal for these patients due to the intact parathyroid glands and the need for a more biologically appropriate treatment [9][10] Question: What factors will drive physicians to pursue genetic testing for ADH-1? - Compelling clinical data, new treatment guidelines recommending genetic testing, and the implementation of a new ICD-10 code for ADH-1 are key drivers [12][13] Question: How does the company plan to differentiate encaleret in the market? - The company aims to demonstrate urine calcium benefits and long-term safety, which are not currently addressed by other treatments [27] Question: What is the expected impact of competition on the market? - The company believes that its strategy of parity access and best-in-class hospitalization data will maintain its market position despite competition [60][61] Question: What is the company's stance on the potential for generic competition for tafamidis? - Management expressed confidence that the existing patents provide strong protection against generics entering the market [62][63]

Financial Data and Key Metrics Changes - The company reported a significant increase in the number of treatment-naive patients on acoramidis, indicating a positive trend in commercial execution [47][53] - The gross-to-net ratio is expected to stabilize in the range of 30% to 40%, reflecting a more representative payer mix as of Q2 [55][56] Business Line Data and Key Metrics Changes - The ADH-1 program is transitioning from a single-center phase two study to a global phase three study with over 25 sites, which may lead to a more heterogeneous patient population [3][4] - In the phase two study of ADH-1, approximately 70% of patients responded to encaleret, and the company aims to replicate this success in phase three [16][38] Market Data and Key Metrics Changes - The prevalence of ADH-1 has been estimated at about 1 in 25,000 based on data from multiple biobanks, indicating a consistent finding across different cohorts [18][19] - The company is comparing the patient identification and market development strategies for ADH-1 to those used in the ATTR field, which has seen significant improvements in diagnosis rates [22] Company Strategy and Development Direction - The company is focused on driving disease education and the utilization of genetic testing to improve diagnosis rates for ADH-1 [19] - The strategy for encaleret includes differentiating the product through urine calcium reduction and long-term safety, aiming to establish it as a standard of care [27][28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the launch of acoramidis, noting that the share of treatment-naive patients continues to increase, which is a positive indicator for long-term success [47][48] - The company is optimistic about the upcoming data presentations that may address skepticism regarding the efficacy of encaleret in chronic hypoparathyroidism [25][26] Other Important Information - The company is preparing for a webinar to provide more details on the ADH-1 program, indicating a commitment to transparency and stakeholder engagement [3] - Management highlighted the importance of compelling clinical data and new treatment guidelines in driving diagnosis rates for ADH-1 [13][14] Q&A Session Summary Question: What are the risks in translating phase two findings to phase three for ADH-1? - The main difference is the number of sites and patients, with phase three being a global study involving over 25 sites [3] Question: Why is PTH replacement therapy not optimal for ADH-1 patients? - PTH replacement does not address the root cause of the condition, and urine calcium levels remain high even with treatment [10][11] Question: How is the company addressing patient identification for ADH-1? - The company is focusing on compelling clinical data, new treatment guidelines recommending genetic testing, and increased awareness through ICD-10 coding [13][14][18] Question: What is the expected impact of competition on acoramidis? - The company has not seen significant pressure from competitors and maintains a strategy of parity access without needing to offer larger rebates [57][59] Question: What is the confidence level regarding the safety profile of infigratinib? - The phase two data provided confidence in a clean safety profile, and the company expects to continue monitoring safety closely in phase three [65][66]

Financial Data and Key Metrics Changes - The company reported a significant increase in the number of treatment-naive patients on acoramidis, indicating a positive trend in commercial execution [47][53] - The gross-to-net ratio is expected to stabilize in the range of 30% to 40%, reflecting a more representative payer mix as of Q2 [55][56] Business Line Data and Key Metrics Changes - The ADH-1 program is transitioning from a single-center phase two study to a global phase three study with over 25 sites, which may lead to a more heterogeneous patient population [3][4] - In the phase two study of ADH-1, approximately 70% of patients responded to encaleret, and the company aims to replicate this success in phase three [16][38] Market Data and Key Metrics Changes - The prevalence of ADH-1 has been estimated at about 1 in 25,000, consistent across multiple biobanks, indicating a stable understanding of the patient population [18][19] - The company is comparing its market potential to that of ATTR and X-linked hypophosphatemia, suggesting a similar trajectory in patient identification and market development [22][23] Company Strategy and Development Direction - The company is focused on driving disease education and the utilization of genetic testing to improve diagnosis rates for ADH-1 [19] - The strategy includes leveraging compelling clinical data and new treatment guidelines to enhance awareness and diagnosis of the condition [13][14] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the launch of acoramidis, noting that the share of treatment-naive patients continues to increase, which is a positive indicator for long-term success [47][52] - The company is optimistic about the upcoming data presentations that may address skepticism regarding the efficacy of encaleret in chronic hypoparathyroidism [25][66] Other Important Information - The company is preparing for a webinar to provide more details on the ADH-1 program, indicating a commitment to transparency and stakeholder engagement [3] - Management highlighted the importance of long-term safety and efficacy data for encaleret, particularly in relation to urine calcium reduction, which could differentiate it in the market [27][66] Q&A Session Summary Question: What are the risks in translating phase two findings to phase three for ADH-1? - The main difference is the number of sites and patients, with phase three being a global study involving over 25 sites [3] Question: Why is PTH replacement therapy not optimal for ADH-1 patients? - PTH replacement does not address the root cause of the condition, and urine calcium levels remain high even with treatment [10][11] Question: How is the company addressing patient identification for ADH-1? - The company is focusing on compelling clinical data, new treatment guidelines recommending genetic testing, and increased awareness through ICD-10 coding [13][14][18] Question: What is the expected impact of competition on acoramidis? - The company has not seen significant pressure from competitors and maintains a strategy of parity access without needing to offer larger rebates [57][58] Question: How does the company view the potential for generic competition for tafamidis? - The company believes that the existing patents provide strong protection against generics, and the discontinuation of Vyndaqel complicates entry for potential competitors [60][61]