SIGNIFICANTLY
REDUCED ATTACKS
IN ADULTS WITH AHP1
In the 6-month double-blind period of the ENVISION study, patients with AHP receiving GIVLAARI experienced1:
In the 24-month interim analysis of the ENVISION open-label extension (OLE)2:

![[99%] of patients have confirmed access icon](/sites/default/files/inline-images/1.0_Home_SustainedAttack_1.png)
Attack rate ratio: GIVLAARI vs placebo 0.3 (95% CI: 0.2, 0.4; P<0.0001)1
In the OLE, patients who crossed over from placebo to GIVLAARI had reductions in attacks similar to GIVLAARI patients in the double-blind period.2
- Endpoints in the ENVISION OLE are exploratory3
In the 6-month double-blind period of the ENVISION study, patients with AHP receiving GIVLAARI experienced1:

Attack rate ratio: GIVLAARI vs placebo 0.3 (95% CI: 0.2, 0.4; P<0.0001)1
In the 24-month interim analysis of the ENVISION open-label extension (OLE)2:

In the OLE, patients who crossed over from placebo to GIVLAARI had reductions in attacks similar to GIVLAARI patients in the double-blind period.2
- Endpoints in the ENVISION OLE are exploratory3
Attacks were defined as those requiring hospitalization, urgent healthcare visit, or intravenous (IV) hemin administration at home.1
GIVLAARI targets and causes degradation of ALAS1 mRNA, reducing the production of neurotoxic intermediates ALA and PBG1
ALA and PBG are factors associated with attacks and other disease manifestations of AHP
CI=confidence interval; ALA=aminolevulinic acid; ALAS1=aminolevulinic acid synthase 1; mRNA=messenger RNA; PBG=porphobilinogen.
References: 1. GIVLAARI [prescribing information]. Cambridge, MA: Alnylam Pharmaceuticals, Inc. 2. Ventura P, Bonkovsky HL, Gouya L, et al. Liver Int. 2021;00:1-12. 3. Balwani M, Sardh E, Ventura P, et al. Protocol. Phase 3 trial of RNAi therapeutic givosiran for acute inter-mittent porphyria. N Engl J Med. 2020;382:2289-301.
Exceptional insurance access
![[98%] of patients have confirmed access icon](/sites/default/files/inline-images/1.0_Home_PrcntAccess_2.png)
*Coverage may vary for individual and plan. Data as of August 2022.