DGAP-News: Centogene NV / Key word(s): Agreement 
CENTOGENE and Alnylam Pharmaceuticals Launch a New Clinical Program Aimed at 
Revolutionizing the Diagnosis of Hereditary Transthyretin-Related 
Amyloidosis ('ATTRv') 
 
2020-12-08 / 12:30 
The issuer is solely responsible for the content of this announcement. 
 
*CENTOGENE and Alnylam Pharmaceuticals Launch a New Clinical Program Aimed 
at Revolutionizing the Diagnosis of Hereditary Transthyretin-Related 
Amyloidosis ("ATTRv")* 
 
*CAMBRIDGE, Mass. and ROSTOCK, Germany, and BERLIN and MUNICH, Germany, 
December 08, 2020* - Centogene N.V. (Nasdaq: CNTG), a commercial-stage 
company focused on rare diseases that transforms real-world clinical and 
genetic data into actionable information for patients, physicians and 
pharmaceutical companies, and Alnylam Pharmaceuticals, Inc. ("*Alnylam*"), 
the leading RNAi therapeutics company, announced today the launch of a new 
joint clinical screening program: the genetic screening of the at-risk 
population for hereditary *T*ransthy*R*etin-related *AM*yloidosis and 
longitudinal *moni*toring of *TTR*positive subjects (the "TRAMmoni_TTR_ 
Study"). 
 
The new TRAMmoni_TTR_ Study is a follow-up to the preceding epidemiological 
analysis for hereditary *T*ransthy*R*etin-related *AM*yloidosis (the "*TRAM* 
*Study*" (NCT03237494)). Since 2017, 5,000 participants from Germany, 
Austria and Switzerland with polyneuropathy and/or cardiomyopathy of no 
obvious etiology have been screened for ATTRv as part of the TRAM Study. 
More than 1% of participants were eventually diagnosed with ATTRv, 
clinically characterized and regionally mapped. 
 
The follow-up TRAMmoni_TTR _Study will include both symptomatic and 
asymptomatic _TTR_ positive participants, who will be invited to take part 
in the longitudinal phase to monitor their clinical status. Using 
CENTOGENE's metabolomics profiling platform, the Company has discovered and 
now characterizes novel ATTRv biomarkers. Such molecules are crucial to 
accelerate ATTRv diagnostics and treatment personalization. The monitoring 
of these biomarkers in _TTR_ positive participants will support the 
validation process. 
 
Prof. Peter Bauer, Chief Genomic Officer of CENTOGENE, said, "This is the 
first study where both symptomatic and asymptomatic _TTR _positive 
participants will be monitored for two years. This will allow us to validate 
our ATTRv biomarkers and later utilize them for treatment 
individualization." 
 
Dr. Volha Skrahina, Director of Clinical Studies at CENTOGENE, added, 
"Within the initialTRAM Study, we were able to deliver truly valuable 
insights. More than 50 participants suffering from the known and treatable 
disease received the diagnosis. We will now proceed with the screening in 
TRAMmoni_TTR_ in order to accelerate the diagnosis for those suffering and 
awaiting answers. This is crucial due to the progressive nature of the 
disease." 
 
"We are excited about expanding our collaboration with CENTOGENE in its 
epidemiology and biomarker work through the initiation of a new clinical 
program (TRAMmoni_TTR_) focused on Hereditary Transthyretin-Related 
Amyloidosis," said Dr. Bernhard Kaumanns, VP Medical Affairs CEMEA (Canada, 
Europe, Middle East & Africa) at Alnylam. "This program will help to better 
understand diagnostic pathways and identify possible biomarkers to 
accelerate the diagnosis of this devastating disease. Equally important is 
the patient follow-up that this program provides; long term evidence-based 
data will be generated to improve the understanding of this disease under 
conditions of daily clinical practice." 
 
*About Hereditary Transthyretin-Related Amyloidosis ("ATTRv")* 
ATTRv is an autosomal dominant condition caused by a pathogenic variant in 
the _TTR_ gene (Plante-Bordeneuve _et al._ 2011). The _TTR _gene is coding 
for transthyretin, formerly known as prealbumin. Transthyretin ("*Ttr*") is 
found primarily in the serum (secreted by the liver) and the cerebrospinal 
fluid (secreted by the choroid plexus), and functions as a carrier for the 
hormone thyroxine (T4) and retinol-binding protein (bound to retinol or 
vitamin A). The destabilization of the Ttr protein and the formation of 
misfolded Ttr proteins results in the transthyretin amyloidosis diseases. 
There are more than 150 _TTR _pathogenic variants described; the disease 
phenotype is _TTR_ variant dependent (Ando _et al_. 2013, Rowczenio _et al_. 
2014, Rowczenio _et al_. 2015). 
 
On average, the diagnosis is delayed by 4-5 years, especially in non-endemic 
areas. Also, there is potential for misdiagnosis due to ATTRv's clinical 
heterogeneity (Adams _et al_., 2016). The common misdiagnosis of ATTRv with 
polyneuropathy includes chronic inflammatory demyelinating 
polyradiculoneuropathy, idiopathic axonal polyneuropathy, lumbar spinal 
stenosis and, more rarely, diabetic neuropathy and AL amyloidosis (Koike _et 
al_., 2011; Adams _et al_., 2019). 
 
In order to facilitate an early diagnosis, treatment choice and 
individualization, ATTRv biomarkers are critical. 
 
*About CENTOGENE * 
 
CENTOGENE engages in diagnosis and research around rare diseases 
transforming real-world clinical and genetic data into actionable 
information for patients, physicians and pharmaceutical companies. Our goal 
is to bring rationality to treatment decisions and to accelerate the 
development of new orphan drugs by using our extensive rare disease 
knowledge, including epidemiological and clinical data, as well as 
innovative biomarkers. CENTOGENE has developed a global proprietary rare 
disease platform based on our real-world data repository with over 3.6 
billion weighted data points from approximately 570,000 patients 
representing over 120 different countries as of August 31, 2020. 
 
The Company's platform includes epidemiologic, phenotypic and genetic data 
that reflects a global population, and also a biobank of these patients' 
blood samples. CENTOGENE believes this represents the only platform that 
comprehensively analyzes multi-level data to improve the understanding of 
rare hereditary diseases, which can aid in the identification of patients 
and improve our pharmaceutical partners' ability to bring orphan drugs to 
the market. As of August 31, 2020, the Company collaborated with over 40 
pharmaceutical partners covering over 45 different rare diseases. 
 
*About Alnylam Pharmaceuticals* 
 
Alnylam (Nasdaq: ALNY) is leading the translation of RNA interference 
("*RNAi*") into a whole new class of innovative medicines with the potential 
to transform the lives of people afflicted with rare genetic, 
cardio-metabolic, hepatic infectious, and central nervous system/ocular 
diseases. Based on Nobel Prize-winning science, RNAi therapeutics represent 
a powerful, clinically validated approach for the treatment of a wide range 
of severe and debilitating diseases. Founded in 2002, Alnylam is delivering 
on a bold vision to turn scientific possibility into reality, with a robust 
RNAi therapeutics platform. Alnylam's commercial RNAi therapeutic products 
are ONPATTRO(R) (patisiran), approved in the U.S., EU, Canada, Japan, Brazil 
and Switzerland, and GIVLAARI(R) (givosiran), approved in the U.S., EU, 
Brazil and Canada, and OXLUMO(TM) (lumasiran) approved in the U.S. and the 
EU. Alnylam has a deep pipeline of investigational medicines, including six 
product candidates that are in late-stage development. Alnylam is 
headquartered in Cambridge, MA. 
 
*Important Notice and Disclaimer* 
 
This press release contains statements that constitute "forward looking 
statements" as that term is defined in the United States Private Securities 
Litigation Reform Act of 1995, including statements that express the 
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projections regarding future events or future results, in contrast with 
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or "expect," "may," "will," "would," "could" or "should," the negative of 
these terms or similar expressions. Forward looking statements are based on 
management's current beliefs and assumptions and on information currently 
available to the Company. However, these forward-looking statements are not 
a guarantee of our performance, and you should not place undue reliance on 
such statements. Forward-looking statements are subject to many risks, 
uncertainties and other variable circumstances, such as negative worldwide 
economic conditions and ongoing instability and volatility in the worldwide 
financial markets, the effects of the COVID-19 pandemic on our business and 
results of operations, possible changes in current and proposed legislation, 
regulations and govern-mental policies, pressures from increasing 
competition and consolidation in our industry, the expense and uncertainty 
of regulatory approval, including from the U.S. Food and Drug 
Administration, our reliance on third parties and collaboration partners, 
including our ability to manage growth and enter into new client 
relationships, our dependency on the rare disease industry, our ability to 
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forward-looking statements included in this press release are made only as 
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declines, any obligation to update any such statements or to publicly 

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