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用特氟米德治疗转甲状腺素淀粉样变心肌病患者可避免的每年心血管相关住院天数。

Annual Cardiovascular-Related Hospitalization Days Avoided with Tafamidis in Patients with Transthyretin Amyloid Cardiomyopathy.

机构信息

Pfizer bv, Capelle a/d IJssel, The Netherlands.

EVERSANA, 204-3228 S Service Rd, Burlington, ON, L7N 3H8, Canada.

出版信息

Am J Cardiovasc Drugs. 2022 Jul;22(4):445-450. doi: 10.1007/s40256-022-00526-9. Epub 2022 Mar 30.

Abstract

BACKGROUND

Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) experience infiltrative cardiomyopathy and heart failure symptoms requiring costly hospitalizations. The Transthyretin Amyloidosis Cardiomyopathy Clinical Trial (ATTR-ACT) demonstrated the efficacy of tafamidis on the frequency of cardiovascular (CV)-related hospitalizations in patients with ATTR-CM.

PURPOSE

As length of stay can affect the total hospitalization burden, our study aimed to better understand the impact of tafamidis on the number of CV-related hospital days avoided in the management of ATTR-CM patients.

METHODS

Data from ATTR-ACT were used to calculate the total burden of CV-related hospitalization (days) by treatment arm in this post hoc analysis.

RESULTS

In the total trial population, patients receiving tafamidis had significantly fewer CV-related hospitalizations per year (relative risk reduction [RRR] 0.68; 0.4750 vs. 0.7025, p < 0.0001) and a shorter mean length of stay per CV-related hospitalization event (8.6250 vs. 9.5625 days) than patients receiving placebo. Taken together, tafamidis prevented 2.62 CV-related hospitalization days per patient per year. A subgroup analysis showed that with earlier treatment initiation of tafamidis, the annual number of CV-related hospitalizations was significantly lowered by 52% compared with placebo (RRR 0.48; 0.3378 vs. 0.7091, p < 0.0001). With 1.14 fewer days per hospitalization, tafamidis reduced the annual number of CV-related hospitalization days by 3.96 days per New York Heart Association class I/II patient.

CONCLUSIONS

In patients with ATTR-CM, tafamidis was associated with a lower rate of CV-related hospitalizations and shorter length of hospital stay. Timely diagnosis and treatment with tafamidis could further decrease the total number of CV-related hospitalization days per year.

GOV IDENTIFIER

NCT01994889.

摘要

背景

转甲状腺素蛋白淀粉样心肌病(ATTR-CM)患者患有浸润性心肌病和心力衰竭症状,需要昂贵的住院治疗。转甲状腺素蛋白淀粉样变性心肌病临床试验(ATTR-ACT)表明,塔法米迪在 ATTR-CM 患者心血管(CV)相关住院治疗频率方面具有疗效。

目的

由于住院时间可能会影响总住院负担,我们的研究旨在更好地了解塔法米迪在避免 ATTR-CM 患者 CV 相关住院天数方面对治疗的影响。

方法

本事后分析使用 ATTR-ACT 数据按治疗臂计算 CV 相关住院治疗的总负担(天)。

结果

在总试验人群中,接受塔法米迪治疗的患者每年 CV 相关住院次数明显减少(相对风险降低 [RRR] 0.68;0.4750 比 0.7025,p<0.0001),每例 CV 相关住院事件的平均住院时间也较短(8.6250 比 9.5625 天)。总的来说,塔法米迪每年可预防每位患者 2.62 个 CV 相关住院日。亚组分析表明,与安慰剂相比,塔法米迪的早期治疗开始可使每年 CV 相关住院次数显著降低 52%(RRR 0.48;0.3378 比 0.7091,p<0.0001)。由于每次住院天数减少 1.14 天,塔法米迪使每年的 CV 相关住院天数减少了 3.96 天,每位纽约心脏协会 I/II 级患者。

结论

在 ATTR-CM 患者中,塔法米迪与较低的 CV 相关住院率和较短的住院时间相关。及时诊断和治疗塔法米迪可进一步减少每年 CV 相关住院天数。

政府标识符

NCT01994889。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ed8/9270297/f727477e50e2/40256_2022_526_Fig1_HTML.jpg

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