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塔非酰胺在转甲状腺素蛋白家族性淀粉样多神经病中延缓疾病进展达2年的积极疗效:来自转甲状腺素蛋白淀粉样变性结果调查(THAOS)的分析

Positive Effectiveness of Tafamidis in Delaying Disease Progression in Transthyretin Familial Amyloid Polyneuropathy up to 2 Years: An Analysis from the Transthyretin Amyloidosis Outcomes Survey (THAOS).

作者信息

Mundayat Rajiv, Stewart Michelle, Alvir Jose, Short Sarah, Ong Moh-Lim, Keohane Denis, Rill Denise, Sultan Marla B

机构信息

Pfizer, New York, NY, USA.

Pfizer, Groton, CT, USA.

出版信息

Neurol Ther. 2018 Jun;7(1):87-101. doi: 10.1007/s40120-018-0097-9. Epub 2018 Apr 9.

Abstract

INTRODUCTION

The effectiveness of tafamidis for the treatment of transthyretin familial amyloid polyneuropathy (TTR-FAP) was evaluated using data from the Transthyretin Amyloidosis Outcomes Survey (THAOS) registry.

METHODS

Subjects receiving tafamidis (n = 252) were compared with untreated subjects in a non-randomized, matched cohort analysis. Subjects were matched with up to four untreated controls by genetic mutation, region of birth, and mean treatment propensity score.

RESULTS

The matched, treated sample consisted predominantly of subjects with the Val30Met genotype (92.5%), from Portugal, and with a mean age of 40.4 years. Over the course of the 2-year follow-up period, subjects treated with tafamidis showed significantly less deterioration on the Neuropathy Impairment Score for Lower Limbs (p < 0.001) and its subscales (p < 0.023) compared with untreated subjects. There was significantly less deterioration among tafamidis-treated subjects compared with untreated subjects on the Norfolk Quality of Life scale (p < 0.001). There were no significant differences observed in functional (assessed by Karnofsky Performance Status Scale score) or nutritional (assessed by modified body mass index) status between the treated and untreated groups. The primary model which examined survival from baseline using the matched cohort was not able to yield estimates of the hazard ratio, as there were no deaths in the tafamidis-treated subjects.

CONCLUSION

These findings support the results from clinical trials and strengthen evidence of the effectiveness of tafamidis beyond conventional clinical trials.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT00628745 FUNDING: Pfizer.

摘要

引言

使用转甲状腺素蛋白淀粉样变疾病结局调查(THAOS)登记处的数据评估了他法米地斯治疗转甲状腺素蛋白家族性淀粉样多神经病(TTR-FAP)的有效性。

方法

在一项非随机的匹配队列分析中,将接受他法米地斯治疗的受试者(n = 252)与未治疗的受试者进行比较。根据基因突变、出生地区和平均治疗倾向评分,将受试者与多达四名未治疗的对照进行匹配。

结果

匹配的治疗样本主要由携带Val30Met基因型(92.5%)、来自葡萄牙且平均年龄为40.4岁的受试者组成。在2年的随访期内,与未治疗的受试者相比,接受他法米地斯治疗的受试者在下肢神经病变损害评分(p < 0.001)及其子量表(p < 0.023)上的恶化明显更少。在诺福克生活质量量表上,与未治疗的受试者相比,接受他法米地斯治疗的受试者的恶化明显更少(p < 0.001)。在治疗组和未治疗组之间,在功能(通过卡诺夫斯基表现状态量表评分评估)或营养(通过改良体重指数评估)状态方面未观察到显著差异。使用匹配队列从基线检查生存率的主要模型无法得出风险比的估计值,因为接受他法米地斯治疗的受试者中没有死亡病例。

结论

这些发现支持了临床试验的结果,并加强了他法米地斯在传统临床试验之外有效性的证据。

试验注册

ClinicalTrials.gov:NCT00628745 资助:辉瑞公司

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a8b/5990502/43df779d8c30/40120_2018_97_Fig1_HTML.jpg

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