Unlocking the potential of tafamidis in treating transthyretin cardiac amyloidosis: A systematic review
Cardiac amyloidosis has gained increasing attention in recent years due to substantial advancements in diagnostic techniques and treatment options. Among the most notable developments in this field is the approval of tafamidis by the U.S. Food and Drug Administration in May 2019 for treating transthyretin amyloid cardiomyopathy (ATTR-CM). This marked a pivotal step forward in managing this complex condition. This systematic review aimed to comprehensively analyze the efficacy of tafamidis in treating ATTR-CM and determine its broader applications, with a focus on its impact on patient outcomes, optimal dosing strategies, and side effect profiles. We strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, ensuring that the methodology was transparent and rigorous. This review involved an extensive search of multiple databases, including PubMed and Google Scholar, for relevant articles published between January 1, 2014 and January 9, 2024. After a comprehensive screening and quality assessment process, 16 high-quality articles were identified and included in the final analysis. These articles provided abundant data on the clinical outcomes associated with tafamidis use in ATTR-CM. The findings of our review highlight the transformative role of tafamidis in the treatment of ATTR-CM. The drug not only improves the quality of life of patients by significantly alleviating symptoms but also markedly reduces hospitalization rates and all-cause mortality. Tafamidis showed an impressive safety profile across different dosage levels, representing a key therapeutic option. As the use of tafamidis continues to expand in clinical practice, its potential to improve short- and long-term outcomes in patients with ATTR-CM becomes increasingly evident.
- Gościniak P, Baron T, Milczarek S, Kostkiewicz M, Machaliński B. Updates for the diagnosis and management of cardiac amyloidosis. Adv Clin Exp Med. 2022;31(2):175-185. doi: 10.17219/acem/142252
- Raval M, Siddiq S, Sharma K, et al. A review of recent advances in the diagnosis of cardiac amyloidosis, treatment of its cardiac complications, and disease-modifying therapies. F1000Research. 2023;12:192. doi: 10.12688/f1000research.130285.1
- Kittleson MM, Maurer MS, Ambardekar AV, et al. Cardiac amyloidosis: Evolving diagnosis and management: A scientific statement from the American heart association. Circulation. 2020;142(1):E7-E22. doi: 10.1161/CIR.0000000000000792
- Damy T, Garcia-Pavia P, Hanna M, et al. Efficacy and safety of tafamidis doses in the tafamidis in transthyretin cardiomyopathy clinical trial (ATTR-ACT) and long-term extension study. Eur J Heart Fail. 2021l;23(2):277-285. doi: 10.1002/ejhf.2027
- Nuvolone M, Girelli M, Merlini G. Oral Therapy for the treatment of transthyretin-related amyloid cardiomyopathy. Int J Mol Sci. 2022;23(24):16145. doi: 10.3390/ijms232416145
- Griffin JM, Rosenblum H, Maurer MS. Pathophysiology and therapeutic approaches to cardiac amyloidosis. Circ Res. 2021;128(10):1554-1575. doi: 10.1161/CIRCRESAHA.121.318187
- Takashio S, Morioka M, Ishii M, et al. Clinical characteristics, outcome, and therapeutic effect of tafamidis in wild-type transthyretin amyloid cardiomyopathy. ESC Heart Fail. 2023;10(4):2319-2329. doi: 10.1002/ehf2.14380
- Porcari A, Fontana M, Gillmore JD. Transthyretin cardiac amyloidosis. Cardiovasc Res. 2022;118(18):3517-3535. doi: 10.1093/cvr/cvac119
- Ruberg FL, Grogan M, Hanna M, Kelly JW, Maurer MS. Transthyretin amyloid cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(22):2872-2891. doi: 10.1016/j.jacc.2019.04.003
- Wang J, Chen H, Tang Z, et al. Tafamidis treatment in patients with transthyretin amyloid cardiomyopathy: A systematic review and meta-analysis. EClinicalMedicine. 2023;63:102172. doi: 10.1016/j.eclinm.2023.102172
- Elliott P, Drachman BM, Gottlieb SS, et al. Long-term survival with tafamidis in patients with transthyretin amyloid cardiomyopathy. Circ Heart Fail. 2022;15(1):e008193. doi: 10.1161/CIRCHEARTFAILURE.120.008193
- Maurer MS, Schwartz JH, Gundapaneni B, et al. Tafamidis Treatment for patients with transthyretin amyloid cardiomyopathy. N Engl J Med. 2018;379(11):1007-1016. doi: 10.1056/NEJMoa1805689
- Elliott P, Gundapaneni B, Sultan MB, Ines M, Garcia-Pavia P. Improved long-term survival with tafamidis treatment in patients with transthyretin amyloid cardiomyopathy and severe heart failure symptoms. Eur J Heart Fail. 2023;25:2060-2064. doi: 10.1002/ejhf.2974
- Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: 10.1136/bmj.n71
- Baethge C, Goldbeck-Wood S, Mertens S. SANRA-a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019;4(1):5. doi: 10.1186/s41073-019-0064-8
- Halpern SH. Appendix: Jadad scale for reporting randomized controlled trials. In: Evidence‐based Obstetric Anesthesia. United States: Wiley; 2005. p. 237-238. doi: 10.1002/9780470988343.app1.
- Checklist for Case Reports Critical Appraisal tools for use in JBI Systematic Reviews. Available from: https://www. coursehero.com/file/215346388/checklist-for-case [Last accessed on 2024 Jul 15].
- Hartling L, Hamm M, Milne A, et al. Validity and Inter-rater Reliability Testing of Quality Assessment Instruments; 2012. Available: https://www.ahrq.gov [Last accessed on 2024 Jul 15].
- Rapezzi C, Elliott P, Damy T, et al. Efficacy of tafamidis in patients with hereditary and wild-type transthyretin amyloid cardiomyopathy: Further analyses from ATTR-ACT. JACC Heart Fail. 2021;9(2):115-123. doi: 10.1016/j.jchf.2020.09.011
- Yamamoto H, Yokochi T. Transthyretin cardiac amyloidosis: An update on diagnosis and treatment. ESC Heart Failure. 2019;6(6):1128-1139. doi: 10.1002/ehf2.12518
- Maurer MS, Grogan DR, Judge DP, et al. Tafamidis in transthyretin amyloid cardiomyopathy: Effects on transthyretin stabilization and clinical outcomes. Circ Heart Fail. 2015;8(3):519-526. doi: 10.1161/CIRCHEARTFAILURE.113.000890
- Stern LK, Patel J. Cardiac amyloidosis treatment. Methodist Debakey Cardiovasc J. 2022;18(2):59-72. doi: 10.14797/mdcvj.1050