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)

• Published in: Neurology and therapy Vol. 7; no. 1; pp. 87 - 101
• Main Authors: Mundayat, Rajiv, Stewart, Michelle, Alvir, Jose, Short, Sarah, Ong, Moh-Lim, Keohane, Denis, Rill, Denise, Sultan, Marla B.
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.06.2018; Springer Nature B.V
• Subjects: Amyloidosis; Clinical trials; Cohort analysis; Internal Medicine; Medicine; Medicine & Public Health; Neurology; Original Research; Matched cohort analysis; Tafamidis; Familial amyloid polyneuropathy; Transthyretin
• ISSN: 2193-8253; 2193-6536
• DOI: 10.1007/s40120-018-0097-9

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.