Abstract 16556: Tafamidis: A Game Changer in Transthyretin Cardiomyopathy? A Systematic Review of Efficacy and Safety

Introduction: FDA approval of tafamidis as a treatment for Transthyretin cardiomyopathy (ATTR-CM) was preceded by demonstrating clinical efficacy and safety based on double-blind trials that showed reduction in mortality, and cardiovascular-related hospitalization. We conducted a systematic review to assess the safety and efficacy using present literature.

Methods: 7 studies were included in this meta-analysis from PubMed and Embase comparing tafamidis treatment to no tafamidis for ATTR-CM. Mantel-Haenszel method was used to calculate pooled log odds-ratio (OR) for binary outcomes and Hedges’ g using inverse-variance method for continuous outcomes.

Results: Tafamidis was associated with decreased odds of mortality (OR 0.55, 95% CI 0.42-0.73, I2=41%, p<0.0001) and reduced CHF exacerbations (OR 0.71, 95% CI 0.51-0.99, I2= 0%, p= 0.04). While, CHR related hospitalizations (OR 0.35, 95% CI 0.07-1.67, I2= 87%, p= 0.19), atrial arrythmias (OR 0.98, 95% CI 0.67-1.42, I2= 0%, p= 0.9), change in left ventricular ejection fraction (OR 0.78, 95% CI -0.32-1.87, I2= 91%, p= 0.16), left ventricular end-diastolic diameter (OR -0.12, 95% CI -0.41-0.18, I2= 0%, p= 0.4), interventricular septal thickness from baseline (OR -0.26, 95% CI 0.56-0.04, I2= 0%, p= 0.08) were not statistically different for tafamidis compared to no tafamidis for ATTR-CM.

Conclusion: Tafamidis treatment in ATTR-CM is associated with reduced all-cause mortality and CHF exacerbation. These observations are consistent with the ATTRACT trial supporting the efficacy of tafamidis in the treatment of ATTR-CM.