Alpha-1 antitrypsin deficiency (AATD) affects 1 in 3,500, causing liver/lung damage. Current treatment, augmentation therapy, doesn't reverse damage. Multiple companies develop candidates to prevent/reverse damage, with RNAi, RNA-editing, and base editing therapies showing promise. Vertex's AATD candidates failed, while Arrowhead, Sanofi, Beam Therapeutics, Wave Life Sciences, and Korro Bio advance their treatments. Augmentation therapy may become obsolete within 5-10 years.