Long-term cardiac amyloidosis survival benefits seen in extension acoramidis trial
Long-term survival benefits were seen in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) using the drug acoramidis (Attruby) in new data presented at the American College of Cardiology (ACC) 2026 meeting extending out to 54 months from the original FDA pivotal trial.
Cardiovascular Business spoke with the late-breaking presenter Prem Soman, MD, director of the Cardiac Amyloidosis Center and nuclear cardiology, and associate chief of cardiology at the University of Pittsburgh Medical Center Heart and Vascular Institute, in the above video to get more details.
This open-label extension of the ATTRibute-CM trial showed that patients who started the transthyretin stabilizer acoramidis early and remained on continuous therapy had significantly better outcomes compared to those initially treated with placebo. There was a very noticeable, persistent disadvantage for delayed treatment in placebo patients, underscoring the progressive and irreversible nature of cardiac amyloidosis. Soman said once the damage to the heart occurs, there is no way to reverse it.
He said the data clearly show acoramidis reduces both all-cause mortality and cardiovascular hospitalizations, with durable effects over time. The findings also reinforce the importance of early diagnosis and prompt initiation of therapy.
Drugs to treat and image cardiac amyloidosis have revolutionized ATTR care
Soman also highlighted a major shift in the field over the past decade: Cardiac amyloidosis is now recognized as more common than previously thought and can be diagnosed noninvasively using widely available radionuclide imaging, eliminating the need for an invasive cardiac biopsy. Increased screening has been driven in part by the availability of effective treatments.
"We know that early therapy and continued therapy has a sustained and long-term durable benefit, so it's important to go out there and find these patients, diagnose them and treat them. It's been a remarkable transformation in a field that, less than 10 years ago, we thought it was a rare disease and we had no therapy. Now we know that it's a prevalent disease. If you look for it, you'll find it. We can diagnose it without a biopsy. And even for the common wild type of cardiac amyloidosis, we have three therapies that are approved. So you have the two stabilizers, tafamidis and acoramidis, and there is the gene silencer amvuttra, which is also approved for the therapy of these patients," Soman explained.
Clinicians are encouraged to suspect amyloidosis in heart failure patients with thickened ventricles, especially when accompanied by conditions such as bilateral carpal tunnel syndrome or spinal stenosis. Early identification is critical, as patients do not regain lost ground if treatment is delayed.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]