In the past decade, treatment of transthyretin cardiomyopathy (ATTR-CM) has been revolutionized mainly due to the deepened understanding of the cellular biology of the disease. Intervening in TTR synthesis, by gene editing or RNA silencing, TTR tetramer stabilization and TTR amyloid removal from tissues could all serve as therapeutic targets. There are now three FDA approved disease modifying therapies for ATTR-CM. These therapies targeting different mechanisms in the pathophysiology of ATTR-CM provide new alternatives for treating the disease. This chapter will discuss available and investigational therapies, their mechanism of action, indications, evidence for their efficacy, and safety profile. Finally, this chapter will summarize all major completed and ongoing trials for the treatment of ATTR-CM.

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New Frontiers and Evolving Therapies in ATTR Cardiac Amyloidosis

  • Abdirahman Wardhere,
  • Dimitrios Bampatsias,
  • Mathew S. Maurer

摘要

In the past decade, treatment of transthyretin cardiomyopathy (ATTR-CM) has been revolutionized mainly due to the deepened understanding of the cellular biology of the disease. Intervening in TTR synthesis, by gene editing or RNA silencing, TTR tetramer stabilization and TTR amyloid removal from tissues could all serve as therapeutic targets. There are now three FDA approved disease modifying therapies for ATTR-CM. These therapies targeting different mechanisms in the pathophysiology of ATTR-CM provide new alternatives for treating the disease. This chapter will discuss available and investigational therapies, their mechanism of action, indications, evidence for their efficacy, and safety profile. Finally, this chapter will summarize all major completed and ongoing trials for the treatment of ATTR-CM.