Key Information
Source
Year
2024
summary/abstract
Background
Tafamidisexternal link, opens in a new tab was approved to treat patients with transthyretinexternal link, opens in a new tab amyloid cardiomyopathyexternal link, opens in a new tab (ATTR-CM) on the basis of findings from the phase 3 Tafamidisexternal link, opens in a new tab in Transthyretin Cardiomyopathy Clinical Trialexternal link, opens in a new tab (ATTR-ACT).
Objectives
This study was a post hoc analysisexternal link, opens in a new tab exploring tafamidis efficacy in octogenarian patients.
Methods
Analysis of patients aged <80 and ≥80 years in ATTR-ACT and its ongoing open-label long-term extension (LTE) study, where all patients receive tafamidis.
Results
After 30 months in ATTR-ACT, least squaresexternal link, opens in a new tab (LS) mean change from baseline in 6-minute walk test (6MWT) distance, N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration, and Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) score were smaller (all P < 0.05) in patients aged ≥80 years treated with tafamidis (n = 51) vs placebo (n = 37). At the LTE study interim analysis, patients aged ≥80 years treated continuously with tafamidis had a smaller decline in KCCQ-OS score (P < 0.05) and trended toward longer median survival (45 vs 27 months; all-cause mortality HR: 0.6828 [95% CI: 0.4048-1.1517]; P = 0.1526) than those initially treated with placebo in ATTR-ACT. Similar efficacy was observed in patients aged <80 years in ATTR-ACT, including smaller LS mean change from baseline in 6MWT distance, NT-proBNP concentration, and KCCQ-OS score, and lower rate of cardiovascular-related hospitalizations with tafamidis (n = 125) vs placebo (n = 140). In the LTE study, patients aged <80 years treated continuously with tafamidis had a longer median survival (80 vs 41 months; HR = 0.4513 [95% CI: 0.3176-0.6413]; P < 0.0001) and a smaller decline in KCCQ-OS score than those initially treated with placebo.
Conclusions
The findings demonstrate tafamidis efficacy for patients with ATTR-CM both in those aged <80 and those aged ≥80 years. (Tafamidis in Transthyretin Cardiomyopathy Clinical Trialexternal link, opens in a new tab [ATTR-ACT]; NCT01994889external link, opens in a new tab/Long-term Safety of Tafamidis in Subjects With Transthyretin Cardiomyopathy; NCT02791230external link, opens in a new tab)