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转甲状腺素蛋白淀粉样变心肌病患者的真实世界特征与治疗模式:一项多国疾病登记研究方案

Real-World Characteristics and Treatment Patterns of Patients With Transthyretin Amyloid Cardiomyopathy: Protocol for a Multicountry Disease Registry Study.

作者信息

Lin Yen-Hung, Chou Hsu-Wen, Tsai Sarah, Gomez Roy

机构信息

Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

JMIR Res Protoc. 2025 Jun 6;14:e71314. doi: 10.2196/71314.

Abstract

BACKGROUND

Transthyretin amyloid cardiomyopathy (ATTR-CM) is a systemic amyloidosis disorder with early clinical manifestations similar to other heart conditions, which complicates its diagnosis and management. The disease's insidious nature and its progression to heart failure emphasize the critical need for enhanced recognition and understanding of its clinical landscape.

OBJECTIVE

This study aimed to understand the natural history and current treatment patterns for managing ATTR-CM in a diverse Asian cohort from Taiwan, Hong Kong, and Malaysia.

METHODS

This study is a multicenter, noninterventional disease registry that plans to enroll patients diagnosed with ATTR-CM across approximately 17 sites in Taiwan, Hong Kong, and Malaysia. Almost 350 patients with a documented diagnosis of ATTR‑CM after June 1, 2019, will be enrolled in the study. Deceased patients will be enrolled without the need for consent in accordance with applicable regulations. Their data will be gathered retrospectively through a 1-time review of their medical records, where permissible. Data related to clinical characteristics, treatment, and outcomes will be collected for each patient during the routine clinical practice while adhering to local standards of care. The end of data collection is planned for at least 12 months after the end of the enrollment period.

RESULTS

As of March 16, 2025, ethical approvals for this study have been obtained or are under review at multiple sites across Taiwan, Hong Kong, and Malaysia. The study commenced on October 1, 2024, with the first participant's first visit and so far, 59 patients have been recruited: 35 from National Taiwan University Hospital (Taiwan), 13 from Taipei Veterans General Hospital (Taiwan), 2 from China Medical University Hospital (Taiwan), 2 from Sarawak Heart Center (Malaysia), and 7 from Queen Mary Hospital (Hong Kong). An interim report is scheduled for completion by December 31, 2025. The end of data collection, marked by the last participant's visit, is planned for October 1, 2027, and the final study report is expected to be finalized by June 1, 2028. Once established, the database will serve as a comprehensive resource for analyzing baseline characteristics, treatment patterns, and outcomes in patients with ATTR-CM from diverse health care systems.

CONCLUSIONS

This research will aid in understanding the demographic, clinical, and therapeutic patterns of ATTR-CM in Taiwan, Hong Kong, and Malaysia. This registry may influence advancements in early detection, diagnosis, and tailored treatment strategies in ATTR-CM.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06651073; https://clinicaltrials.gov/study/NCT06651073.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/71314.

摘要

背景

转甲状腺素蛋白淀粉样变心肌病(ATTR-CM)是一种全身性淀粉样变性疾病,其早期临床表现与其他心脏疾病相似,这使其诊断和管理变得复杂。该疾病隐匿的性质及其向心力衰竭的进展凸显了加强对其临床情况的识别和理解的迫切需求。

目的

本研究旨在了解台湾、香港和马来西亚不同亚洲队列中ATTR-CM的自然病史和当前治疗模式。

方法

本研究是一项多中心、非干预性疾病登记研究,计划在台湾、香港和马来西亚的约17个地点招募被诊断为ATTR-CM的患者。2019年6月1日之后有ATTR-CM确诊记录的近350名患者将被纳入研究。根据适用法规,已故患者将在无需同意的情况下被纳入。在允许的情况下,将通过一次性查阅他们的病历对其数据进行回顾性收集。在遵循当地护理标准的同时,在常规临床实践中为每位患者收集与临床特征、治疗和结局相关的数据。数据收集计划在入组期结束后至少12个月结束。

结果

截至2025年3月16日,本研究已在台湾、香港和马来西亚的多个地点获得伦理批准或正在接受审查。该研究于2024年10月1日开始,第一名参与者进行了首次就诊,到目前为止,已招募了59名患者:35名来自台湾大学附属医院(台湾),13名来自台北荣民总医院(台湾),2名来自中国医药大学附设医院(台湾),2名来自砂拉越心脏中心(马来西亚),7名来自玛丽医院(香港)。中期报告计划于2025年12月31日前完成。以最后一名参与者就诊为标志的数据收集结束时间计划为2027年10月1日,最终研究报告预计于2028年6月1日前完成。一旦建立,该数据库将作为一个综合资源,用于分析来自不同医疗保健系统的ATTR-CM患者的基线特征、治疗模式和结局。

结论

本研究将有助于了解台湾、香港和马来西亚ATTR-CM的人口统计学、临床和治疗模式。该登记研究可能会影响ATTR-CM早期检测、诊断和个性化治疗策略的进展。

试验注册

ClinicalTrials.gov NCT06651073;https://clinicaltrials.gov/study/NCT06651073。

国际注册报告识别码(IRRID):DERR1-10.2196/71314。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00b1/12181751/e44a56cbb2a4/resprot_v14i1e71314_fig1.jpg

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