BridgeBio Pharma, Inc. (BBIO)
NASDAQ: BBIO · Real-Time Price · USD
69.71
-4.81 (-6.45%)
At close: Apr 28, 2026, 4:00 PM EDT
69.98
+0.27 (0.39%)
After-hours: Apr 28, 2026, 7:25 PM EDT
← View all transcripts

JPMorgan Healthcare Conference

Jan 9, 2023

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

All right. All right, let's go ahead and get started. This is Monday afternoon of the 41st annual J.P. Morgan Healthcare Conference. My name's Anupam Rama. I'm one of the senior biotech analysts here at J.P. Morgan. I'm joined by Malcolm Kuno and Priyanka Grover from the team. Our next presenting company is BridgeBio, and presenting on behalf of the company, we have CEO Neil Kumar. Neil?

Neil Kumar
Founder and CEO, BridgeBio

Thanks, Anupam, thanks to Phil and the J.P. Morgan team for having us back to present here. Thanks everyone here for braving the tough weather and for those listening in. I'm gonna spend the next 20 minutes or so talking about BridgeBio Pharma, a company that aspires to be a leader in the area of genetic medicine. We arrive here at the beginning of 2023, once again, at the doorstep of profound advancement, both for the patients that we serve as well as for our investors, most notably due to two key readouts we have upcoming in the first half of this year, the first in achondroplasia and the second in ATTR cardiomyopathy. We arrive at this doorstep having learned some tough and difficult lessons last year in 2022.

We are a leaner, more focused, well-capitalized, and more advanced company than we ever have been before. Over the course of the first five minutes in my talk, I'll talk about what all that gives us in terms of a five-year vision, and then I'll spend the remainder of my time focusing in on those two key readouts. The first part of the talk will answer why BridgeBio? The second half of the talk, hopefully, why BridgeBio now. Just as a reminder, BridgeBio is an engine that sits atop the profound advances that are occurring every year in human clinical genetics. We seek to translate those advances into, first, preclinical programs, then clinical programs, and ultimately into commercial products over time. Employing this engine over seven years allows us to articulate what we call our R3 five-year vision.

It's a bold vision that we think, if we're able to hew to, will establish us as the next leading genetic medicines player that is product-focused. The first R and the most important R is revenue. Revenue, we think, is a good proxy for the number and quality of meaningful medicines that we can deliver to the marketplace over time. Here our aspiration is an annualized run rate of $2 billion of revenue within five years. The second R, which underpins revenue, is readouts and, most importantly, phase III readouts. Our expectation based on the already assembled pipeline that we have is eight phase III readouts over the coming five years, five of those readouts occurring in markets that are $1 billion or more in size. The final R, which really enlivens our company and has from the get-go, is research.

Our aspiration here is the provision of one to two INDs per year, as always, cutting across therapeutic areas, modalities, and approaches, but always with an eye toward establishing best or first-in-class molecules in genetic medicine markets. The reason that we can aspire to this vision is because of the team I'm very privileged to be working with, just a subset of them listed on this slide here. Two things stand out to me. The first is the quality of drugs that this team has created, both at BridgeBio and before in their careers. We are a team that's really focused on meaningful impact as described by drugs that are approved. The second is the persistence of this team. As many of you know, I've been presenting here for some six years, and the faces on this slide hasn't changed much over that course of time.

The second key ingredient associated with our five year vision is our late-stage product pipeline. This is an already assembled pipeline here of five key value drivers. I won't go through each of them. I don't have time today. What you can see is on a risk-adjusted basis, by 2030, we expect to provide over $2 billion of revenue. That's not even to mention potential M&A that we might engage in, which would obviously be focused on the late stages or on commercial products. Luckily, we don't have to wait till 2030 to see significant value inflection for the firm. In fact, 2023, as I mentioned at the outset, is gonna be a very important year for the company.

I won't have time to get into the entirety of the 12-month catalyst map as listed here. The two key catalyst readouts will be our ATTR-CM program as well as our achondroplasia program, the latter of which we expect in the first week of March, the former of which we expect early July. As a reminder, we're well capitalized to get through the entirety of this catalyst map and into mid to late 2024, some $550 million + on the balance sheet right now. With the exception of the Japanese geography associated with acoramidis, whole ownership of those five value-driving assets, allowing for flexibility in financing, potentially either through royalties or pharma partnerships.

That's the vision, I wanna now get into the first and probably most prominent of our catalysts for the year, which is that against our ATTR cardiomyopathy program, a phase III, again, that we expect to read out sometime in early July. I wanna touch on three simple themes today. The first is that this is a large, growing, and durable marketplace in which there's room for many winners. The second is that within this large, growing, and durable marketplace, we expect to provide a best-in-class stabilizer that both pre-clinically and clinically has established itself as a two times more potent molecule than the existing stabilizer in the marketplace, tafamidis. Finally, I wanna talk a little bit about our ongoing phase III trial's fidelity and what the expectation set should be based on an updated standard of care and our advantage molecule.

What should we expect in early July? As a reminder, and I think many of you know this, the ATTR cardiomyopathy market is already $3.1 billion large, growing at above a 65% CAGR. Many of the tailwinds would be familiar to most people in this room. It's a very, very large marketplace. Some couple hundred thousand patients alone in the U.S. are hiding within the heart failure with preserved ejection fraction community. Diagnosis is quite easy, and awareness has been spreading. I think the aspect of the market that is less well appreciated in terms of growth is likely access. Tafamidis said trending toward $3 billion-plus alone is still not available in some of the larger marketplaces across the world, including the United Kingdom, for instance.

Furthermore, within the United States, 25%-50% of scripts associated with tafamidis don't get filled because it's a Medi-D medicine and the copay is about $13,800. That goes away with the Inflation Reduction Act over the course of the next two years. That copay moving from $13,800 to something like $2,100, we believe could double the market alone in the U.S. over the coming 24 months. Overall, we believe this market is a $10 billion-$15 billion market. Within that marketplace, our desire is to create a potential best-in-class medicine. To do so, we really hewed to two design principles, the first of which was to maximize TTR stabilization. There are several strains of evidence that suggest why one should do this.

Probably the most profound is the ATTRACT trial itself, where 80 mg tafamidis, which is about a 50% stabilizer, outperformed 20 mg tafamidis, which is about a 35% stabilizer or so. The second is, all other things being equal, to preserve circulating tetramer of transthyretin. No human that we know of is haploinsufficient or null for this protein, and it's kept around in the human body and all species' bodies at a high metabolic cost. Over the course of the last five years or so, we've demonstrated both pre-clinically and clinically the higher degree of potency associated with our stabilizer. Here you can see several different assays that assert that we're about a 100% or twofold better stabilizer. Acoramidis has been shown to be a better stabilizer, both in our hands and indeed in labs affiliated with Pfizer Inc.'s hands.

There's no publication out there that includes albumin that shows that we're not a superior stabilizer. Most importantly, the reason for that advanced stability has been well articulated. It's threefold. One, we see more target because we're less albumin-bound. Two, we bind more target, primarily that second binding site of the tetramer. Third, upon binding, utilizing the enthalpic binding mode, we do a better job of pulling the tetramer together. We've shown this material advantage clinically as well. You can't measure the actual toxic monomer production in the clinic, but what you can measure are serum TTR levels, some 30%-50% advantages over what's been measured with tafamidis in the clinic to date with serum TTR. You can see that advantage extend to probably the most important univariate predictor of mortality in this space, which is NT-proBNP.

Here you can see measurements of NT-proBNP, NT-proBNP at 30 months in our Phase II OLE, which is a very sick patient population, actually maybe a little bit more sick than the ATTRACT population itself, with some 68% of patients actually deriving improvement against this key predictive biomarker. A recent publication just about a week ago showed that tafamidis at that 30-month time point in ATTRACT provided that to only 24% of their patients. Across the diaspora of measurements that we can make related to stability against TTR, we can see outperformance for our molecule. All right, how are we interrogating this potentially best-in-class molecule in a phase III?

Just as a reminder, we have an ongoing clinical trial against which we have two key endpoints, the first of which we read out at the end of last year, six-minute walk distance, the second of which is gonna read out in early July, which is a hierarchical composite of mortality and cardiovascular hospitalization. As a reminder, we didn't achieve our primary endpoint at the end of last year against the six-minute walk distance because we saw no material decrease in six-minute walk for the placebo population. Wherever there was a decrease, importantly, we saw statistically significant impacts of the drug. That started with stabilization, moved to NT-proBNP. We saw it in serum TTR. We saw it in quality of life. We saw it importantly wherever we saw a decline in subpopulations for six-minute walk distance, like the variant subpopulation.

Intriguingly, we saw a 27% reduction in AE-driven death as well. All signs were that this drug was safe, biochemically active, and doing what we want it to do, but there was no material decline in the placebo. Over time, we've asked ourselves as to why that might have occurred and how we might update our expectations against what we expect to see coming out of part B when we look at mortality and hospitalization. This slide speaks to how the standard of care has changed for patients over the course of the decades since we ran the ATTRACT trial. I think the first two panels have been well described and are gonna be familiar to many of you in the room.

There's no question that we're picking up patients earlier, and we're doing it with greater ease as we've moved from an invasive to a non-invasive diagnostic algorithm. I think most important is the third panel here, which suggests that given heavier use of diuretics and the fact that we're not putting patients on medicines that are actually contraindicated, like rhythm control medicines, because we're identifying them as ATTR cardiomyopathy patients and not just run-of-the-mill heart failure patients. A patient with the exact same baseline today will die less and go to the hospital less over the course of time. Therefore, the standard of care has fundamentally shifted over the course of the last decade. This is not surprising for those of you that have seen cardiovascular markets evolve over time, but I think it's well worth keeping in mind.

Another way to think about it is that the bar for demonstrating efficacy, and you can see this from ATTRibute-CM part A, you can also see this from APOLLO-B, and several of the observational studies that have been run over the last 12 months, has effectively increased. That the patient populations have been left shifted in time. Meaning at any given time, let's say at 30 months, tafamidis would have had the amount in the ATTRACT trial, a certain amount of decrease in six-minute walk distance or a certain amount of decrease in terms of number of people alive. We're gonna see something that's fundamentally less than that or left shifted in time.

The implications of this are that we believe our drug still has a great chance of showing efficacy against the endpoint of mortality and CV hospitalization, that we're gonna need to look at an overall survival where patients live longer and an overall hospitalization rate where patients access the hospital less. The reason that we think we're gonna be able to see that is partly listed on this slide here, where the ongoing fidelity of our trial continues to be very strong. We're seeing low discontinuation rates, extremely low tafamidis drop-in rates, and ultimately, our over-enrollment going from 510 to about 632 patients provides us with adequate power, and we believe to resolve the effect of acoramidis against the totality of evidence at the end.

What does that totality of evidence look like in terms of what are our expectations? First and foremost, we need to outperform tafamidis and all competitors on the win ratio. This is the primary endpoint, and it is the constellation of endpoints going from mortality to morbidity that we'll be measuring at 30 months. Secondly, we believe that survival needs to come in at 80% or more over 30 months. We've never seen that before in the TTR space, either on tafamidis, as far as we know, or in observational trials. We believe that could be possible with a highly potent stabilizer like ours. We believe that there's room to improve the hospitalization risk reduction that was demonstrated by tafamidis.

Ultimately, we need to provide a favorable and safe profile in terms of our drug as well as ease of access. A reminder that in a $10 billion-$15 billion market, there's room for many different players to succeed. Our feeling is with a highly potent stabilizer that demonstrates this constellation of data that we would be able to pick up between 30% and 50% share, and with a highly advantaged hazard ratio, even more. That is what our market research suggests. That's ATTR cardiomyopathy, and maybe I'll spend the remaining five minutes or so on the first of our value inflection points here associated with achondroplasia. I'll hit on thee key themes here as well. Something similar in terms of the first theme, which is this is a large and growing market.

I think one of the things people don't appreciate as much about this market are the immediate adjacencies in hypochondroplasia that are perhaps just as large as achondroplasia. Touch on that in a moment. I'll remind everyone that we have designed what we believe is a best-in-class profile, both in terms of efficacy and in terms of ROA. Our route of administration is a single daily oral medicine, which stands in contrast to the single daily injections that are currently being provided by BioMarin. Finally, I'll just review how we measure efficacy in this space and what our expectations are from our fifth cohort in our proof of concept trial. That should read out again, first week of March or within two weeks, either earlier or later than that.

Starting with the total addressable market, I think many of folks in the room understand that achondroplasia itself is about a two and a half billion dollar market. I'll remind everyone of the Voxzogo launch on the next slide. A large market affecting some 55,000 folks with about 7,000-10,000 treatable children being affected by this condition. Hypochondroplasia, or what was historically called idiopathic short stature, is another disease that's also FGFR3-driven. It's driven by a different point mutation that activates FGFR3, but nevertheless, another very large opportunity with several thousand people affected and about a $2 billion total addressable market there that both BioMarin and ourselves are exploring. There are some more severe skeletal dysplasias that are FGFR-driven, accounting for a total addressable market of some $5+ billion.

Another very, very large genetic disease market. Within that context, you can see the Voxzogo or vosoritide launch going very well to date. Obviously, it's just been a few quarters, but consensus analysts really have growth eventually peaking out at around $2.5 billion or a little bit over that within the achondroplastic condition alone. There seems to be a great deal of enthusiasm and awareness, both amongst peds endos and geneticists, for new treatment algorithms here. Within this space, our goals were two fold, really. Number one was to maximize efficacy. The way we thought about maximizing efficacy was doing what we always do with every disease, which is to target the disease at its source. The existing competing therapies only tamp down one of two effector pathways that are turned on when you have a gain-of-function mutation in this space.

I'll walk through just exactly what that looks like. Our goal was to inhibit all necessary effector pathways to normalize their action, therefore providing best-in-class efficacy. The second piece was to avoid injections. As I mentioned, the ROA for our competition today is a once-daily injection. When we actually go out and do market research, even if we provided equivalent efficacy, almost 70% of skip preference would go towards a single daily oral versus a single daily injection. Recall that these are chronic administrative medicines that you have to actually get a use from treatment all the way until your growth plate closes. A reminder of the pathomechanism of disease here. This is one of the most monogenic of all monogenic diseases, meaning the same point mutation G380R is at play in almost 90% of achondroplasia patients.

It turns up two effector pathways, the MAPK signaling pathway, as well as the JAK-STAT pathway, that in turn affect chondrocyte differentiation and proliferation. What we're doing, again, is targeting this disease at its source, taking that upregulated signaling and normalizing it. We believe this stands in contrast to our competitors who are using CNPs to basically tap down the MAPK signaling pathway alone. In preclinical studies, we've shown that not only can we affect both of those effector pathways and normalize them, but that translates into better phenotypic resolution in the context of a preclinical mouse model that's been shown to be faithful. In the achondroplasia condition alone, we can see four to five times elevated bone growth as well as impact on femur length in L4, L6.

Hearteningly suggesting that we may have impact if we're able to dose early enough on the constellation of symptomatology that many of these children and families care about, like spinal stenosis, proportionality, and the like. We've been evaluating this compound in the context of our PROPEL study. We started at extremely low doses to ensure that this drug was safe, and in our fourth cohort started to approach AUC levels whereby we thought we would start to be able to see some efficacy. We are currently in a fifth cohort, which is double the dose of our fourth cohort, where we expect to see differential efficacy against what BioMarin was able to put up in the past. That, again, is the cohort that we'll be reading out in March 2023 with between 10 and 15 patients.

A reminder of what we saw alone in the fourth cohort, which was against baseline, an elevation in AHV of 1.52 cm per year. That compares to 1.35 or so of what BioMarin delivered in their phase III clinical trial. A 64% responder rate since AHV can be sensitive to outliers. A responder rate is defined as people who are growing at 25% or more effectively coming off of one growth quartile and moving to the next of about 68%. That compares favorably to about 50% in what BioMarin was able to deliver in their phase III. Well-tolerated with no hyperphos whatsoever observed in cohort four and none observed to date in cohort five. A statistically significant increase in the key biomarker here of bone turnover, which is Collagen X.

What are we looking for in the fifth cohort, as it reads out? Well, first and foremost, we're looking for a continued development in AHV. Our goal, even though AHV is quite variable, is that we could provide something around 1.52 or better, again suggesting potential best-in-class efficacy within this space and meaningful improvements for patients. We'll be looking at efficacy across at least three measures, the responder rate that I mentioned, the change from baseline. Finally, our hope is, although we haven't been able to demonstrate it to date in the fourth cohort, nor has any of our competitors been able to demonstrate this, the ability to move children into a normal growth range. The 99th percentile or so of growth for achondroplastic children is about 6.5 cm per year.

If we can get into that seven to nine range, we would be heartened, and the hope for a catch-up growth would be upon us. Those are the goals for our fifth cohort, and again, we look forward to announcing that data sometime toward the end of this quarter. I'll end by just a little bit of market research alluding to what I was talking to earlier, which is even if we put up similar efficacy numbers to BioMarin, we would expect that we would get a lot of script preference just based on the ROA, as long as we were safe with a single daily oral that could be mixed in with children's food versus a single daily injection.

I can see that I've run over time, so maybe I'll just quickly stop on the remainder of the pipeline that I don't have time to address today. These are the other programs that we have ongoing in our late-stage pipeline. We have a AAV program for congenital adrenal hyperplasia, where we expect to announce phase II data mid this year. We have an ADH1 program where we recently announced FPI in our phase III. We expect that phase III to read out late this year or early next year. We have a program for limb-girdle muscular dystrophy type 2I that will begin its phase III mid this year as well. On top of all of the activity that I have listed here, two major milestones for the company this year, well-capitalized to get through it.

With that, I'll take any questions.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Thanks, Neil. There will be microphone runners. If you wanna ask a question, just raise your hand. If you want to submit a question via the digital portal, you can do that as well, and I'm happy to ask on your behalf. We have actually got a bunch of questions in the, in the portal, so let me ask them here. Can you provide us with an update on the death rates in ATTRibute-CM and how that's currently tracking for Acoramidis relative to your expectations?

Neil Kumar
Founder and CEO, BridgeBio

Yeah, good question. what's that? the question... Should I repeat the question?

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

No.

Neil Kumar
Founder and CEO, BridgeBio

Oh, you got it.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

I got it.

Neil Kumar
Founder and CEO, BridgeBio

The death rates so far, with about three and a half months to go on a blinded basis, are around 20% in our trial. The expectation from what we've seen in observed cohorts with updated standards of care is between 25%-30% death rates in the context of wild type patients. We think this is tracking to the type of death that you are seeing with the updated standard of care, but certainly well below the death rates that one would see a decade ago in the ATTRACT trial, which as you recall, at least on placebo, was around 40% and on drug was 30%. I think that is enough in our eyes, enough of a diminution for the drug to show signal.

certainly is gonna be a higher bar, as I mentioned, or left shifted in time as compared to ATTRACT.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

When as a follow-up question, is it basically that you're tracking all deaths or just the ones that are deemed treatment emergent? If a patient comes off therapy and dies later, would they be counted as part of the death rate that you've been reporting?

Neil Kumar
Founder and CEO, BridgeBio

Yeah, they would. Yeah, it's a good question. I mean, we're only tracking what we get... we have measured to date. There's obviously, you know, these things can change in terms of people who discontinue, and then at the end of the trial you go back and you try to find everyone who's discontinued and ascertain whether or not they have passed. So we have some fraction of those patients within that blind degree, but not the entirety. It's not just AE-driven death, though. I think maybe is that what the question's referring to?

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Yeah.

Neil Kumar
Founder and CEO, BridgeBio

It's not just AE-driven death, no. Because the, you know, that was obviously all we could see in an unblinded fashion on a blinded basis, we could see more.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Questions from the audience? One more from the portal, which is, given that Pfizer's well entrenched in the ATTR market with a once daily, how do you differentiate yourself and maximize your market opportunity?

Neil Kumar
Founder and CEO, BridgeBio

Yeah, it's a great question, and, you know, I'd go back to that market research slide. I think, first and foremost, it starts with the win ratio. I think we need to do at or better than Pfizer in terms of the constellation of impact we have on mortality and morbidity as measured by CV hospitalization. I think secondly, the absolute amount of survival that we see on drug needs to be superior. Physicians ultimately are concerned here with people living longer and going to the hospital less, so I think we need to show that, on a treatment basis. I think, you know, the third, which I just alluded to is hospitalization. I don't think the once daily versus twice daily is gonna be a big deal.

Many of these patients are already on, twice daily therapy, so ROA, I don't think will be a massive differentiator here. I think ultimately it'll be if the story holds together, meaning we see differential impact on stabilization, serum TTR, NT-proBNP, hospitalization, and ultimately people are dying less, out at 30 months on the drug.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Neil, you talked about, you know, the expenses here in the U.S. for tafamidis and the out-of-pocket payment and things like that, but I was wondering if you could expand on that maybe globally. Does tafamidis have some of the same issues globally as per under-penetration because of access?

Neil Kumar
Founder and CEO, BridgeBio

It does in the sense that it's not accessible right now in some of the main markets. It doesn't in the sense that no other marketplace that I know of has such a high barrier to treatment in terms of copay. For instance, Germany, France, Spain, when it does get on in the U.K., there won't be a barrier associated with high copay as you see in the States. Again, that barrier is likely to go away over the course of the next. Not likely, it will go away because of the Inflation Reduction Act. You know, I think that there are other dynamics at play in the U.S. that aren't at play internationally that many of you are familiar with.

You know, for instance, the 340B pricing that would be associated with some of our competitors and the specialty pharmacy ownership of some of the academic medical centers changes the economics for each script within the U.S. in a way that you wouldn't see, say, in the U.K., French, or German system. There are vagaries that will affect relative share. But yeah, I mean, there's no European system I know of that has $14,000 copays for a drug like this.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Maybe switching gears a little bit to achondroplasia. On the cohort five update, you know, you've outlined and some of the physicians we've talked to are looking for a dose response. What gives you confidence in that given, I think, cohorts one through three didn't show any type of dose response?

Neil Kumar
Founder and CEO, BridgeBio

Yeah. I mean, I think cohorts one through three were subtherapeutic. We started at a very low dose because we were worried about safety. If you look at the AUCs associated with those cohorts, we weren't really in the therapeutic range as measured by what we saw pre-clinically. Cohort four is really where we started to tickle the bottom of where we would expect to see reasonable efficacy. That's why I was suspecting cohort five, that we see a continued rise of AHV, and obviously concomitant, you know, response rate. I think that, you know, BioMarin obviously in their last two doses of their phase II did not see a dose response. There is a chance that there's a thresholding effect occurring.

Our suspicion is that there's more growth to be had, in this condition and hopefully our drug can provide it.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Questions from the audience? Another question from the portal here. When you report a treatment emergent death rate in... They're talking about ATTRibute-CM.

Neil Kumar
Founder and CEO, BridgeBio

Yeah, right.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

4.5% and 6.2% at 12-month data. Was that the blended all-cause death rate at that point? Is that safe to assume that that's 10% in aggregate?

Neil Kumar
Founder and CEO, BridgeBio

That was just the AE-driven death because we can't unblind ourselves to death obviously as a, you know, part of the primary endpoint in Part B.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Got it. One of the programs that I think we were supposed to get an update on kind of early this year was the CAH gene therapy program.

Neil Kumar
Founder and CEO, BridgeBio

Yeah.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

I saw in the slide that, you know, that update's in the back half of this year. You have noted that the first I think four patients or so, safety hasn't been an issue.

Neil Kumar
Founder and CEO, BridgeBio

Yeah.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Maybe talk to us about the decision to give us the data in the back half of the year now, as well as did we see any changes on some of the biomarkers?

Neil Kumar
Founder and CEO, BridgeBio

I would say the first three patients thus far have been safe. The fourth patient got dosed later than we had hoped, so that's why we don't have the full two patients in the second cohort. I think, yeah, it continues to be well-tolerated. We're not seeing, you know, a monster effect on endogenous cortisol levels, but we are seeing all biomarkers move in the right direction. You know, our learning from cohort four in achondroplasia is let's wait for, you know, the full package. I think mid this year we'll have one patient at the high dose and then four other patients, so we should have a total of five patients. Hopefully that'll be a more meaningful update than releasing any data today.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Got it. Questions from the audience?Maybe on Encaleret. Just maybe talk to us a little bit about where you are on site activation, how you're thinking about that enrollment curve. I believe that data is scheduled to be in the back half of the year as well, right?

Neil Kumar
Founder and CEO, BridgeBio

Yeah. I think we're guiding here to end of the year, beginning of next year, depend on how that ramps. I mean, yeah, like with any clinical trial, it's hard to exactly know how quickly it'll ramp. There's a lot of excitement around the trial, there's no other competing agents in the space. If you look at our PSSVs and things of that nature, it could enroll very quickly. The other thing that's heartening is we've had a look at the nonsurgical hypopara community and done some work with Invitae. We'll have to transition that over to another company going forward. Just looking at how many patients within that population are actually CASR mutation positive for hyperactivating mutations, it looks like something like 20%.

That might be another pool in which we can fish in terms of, you know, we have had already identified 26 patients within that pool that could potentially be part of our clinical trial. It could ramp very quickly, but, yeah, too early to tell, to be honest.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Questions from the audience? Maybe, final one from me, just in terms of, you know, which programs are on the table basically for partnering and bringing in non-dilutive capital versus keeping wholly owned? I guess in particular, maybe talk about the oncology assets.

Neil Kumar
Founder and CEO, BridgeBio

Yeah. I mean, just as a reminder, we have one of two, I believe, potentially three, but two that I've seen data on, GTP-bound G12C inhibitors, for KRAS. We have a first in class PI3K breaker that breaks the interaction between PI3K and RAS that could be useful for G12D as well as for helical mutations in the context of breast cancer. For those two assets, the first is headed into the clinic in about eight months. The latter would head into the clinic at about 12 months. You know, I think our aspiration ultimately would be to do or at least on the table to do a partnership there, because we wouldn't want to seek to commercialize in the oncology space.

Whether we do that today or whether we do that, you know, after we generate some clinical data, will be dependent on finding the right partner. The second area that we've approached in terms of partnerships is the gene therapy area. We have quite a few, you know, ongoing programs, and manufacturing can be quite expensive, especially pre-IND. Just given the state that we're in today, thinking about a broad gene therapy partnership is something that's been on the table. I'm thinking you shouldn't be surprised if we execute one or both of those types of partnerships over the course of the next few months.

Anupam Rama
Managing Director and Senior Equity Research Analyst, JP Morgan

Okay. Thank you, everyone. Thank you, Neil.

Neil Kumar
Founder and CEO, BridgeBio

Thanks.

Powered by