Pfizer bv, Capelle a/d IJssel, The Netherlands.
EVERSANA, 204-3228 S Service Rd, Burlington, ON, L7N 3H8, Canada.
Am J Cardiovasc Drugs. 2022 Jul;22(4):445-450. doi: 10.1007/s40256-022-00526-9. Epub 2022 Mar 30.
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.
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.
Data from ATTR-ACT were used to calculate the total burden of CV-related hospitalization (days) by treatment arm in this post hoc analysis.
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.
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.
NCT01994889.
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。
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。
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）。
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。
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。
NCT01994889。
