Treatment with acoramidis appears to significantly decrease the rate of death and cardiovascular hospitalization in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), according to a recently published study in the Journal of the American College of Cardiology.
The study’s authors aimed to perform a post hoc analysis on the ATTRibute-CM trial, that is, to use data from the study to confirm hypotheses different from those analyzed in the original work. The original trial showed that acoramidis effectively reduces cardiac biomarkers (substances released into the bloodstream when the heart is damaged), such as N-terminal pro-brain natriuretic peptide (NT-proBNP), and improves the functional capacity of patients with ATTR-CM.
In this post hoc analysis, researchers aimed to determine the long-term outcome of disease progression. The analysis used a combined primary endpoint consisting of all-cause mortality, cardiovascular hospitalization, NT-proBNP and six-minute walking distance (6MWD).
The results showed that during the first three months after treatment initiation patients receiving a placebo and acoramidis progressed similarly. However, after the third month, both groups began to increasingly diverge, with patients in the acoramidis group exhibiting a 36% risk reduction for the combined endpoint.
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After 30 months, 19% of patients receiving acoramidis had died, compared to 25% of patients on a placebo. Close to 80% of the deaths were due to cardiovascular causes. Cardiovascular hospitalization events were reported in 26% of patients receiving treatment and 42% of patients on placebo, representing a yearly hospitalization rate of 0.22 vs 0.45.
Regarding side effects, the authors observed no significant difference in the incidence of side effects between patients on acoramidis and placebo.
The 36% reduction in composite risk is comparable with the 20% median risk reduction associated with sodium-glucose co-transporter-2 (SGLT2) inhibitors, the current standard of care for heart failure.
“The internal consistency of the ATTRibute-CM study results shows the robustness of the efficacy of acoramidis treatment to improve clinical outcomes in a contemporary ATTR-CM patient population,” the authors wrote. “Further studies, including the currently ongoing open-label extension of ATTRibute-CM (NCT04988386), will provide further insights into the long-term efficacy and safety of acoramidis,”
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