Efficacy and safety of vutrisiran for patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy: A randomized clinical trial

Adams, David and Tournev, Ivailo L. and Taylor, Mark S. and Coelho, Teresa and Plante-Bordeneuve, Violaine and Berk, John L. and Gonzalez-Duarte, Alejandra and Gillmore, Julian D. and Low, Soon-Chai and Sekijima, Yoshiki and Obici, Laura and Chen, Chongshu and Badri, Prajakta and Arum, Seth M. and Vest, John and Polydefkis, Michael and Collaborators, HELIOS-A (2023) Efficacy and safety of vutrisiran for patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy: A randomized clinical trial. Amyloid, 30 (1). pp. 18-26. ISSN 13506129, DOI https://doi.org/10.1080/13506129.2022.2091985.

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Abstract

Background The study objective was to assess the effect of vutrisiran, an RNA interference therapeutic that reduces transthyretin (TTR) production, in patients with hereditary transthyretin (ATTRv) amyloidosis with polyneuropathy. Methods HELIOS-A was a phase 3, global, open-label study comparing the efficacy and safety of vutrisiran with an external placebo group (APOLLO study). Patients were randomized 3:1 to subcutaneous vutrisiran 25 mg every 3 months (Q3M) or intravenous patisiran 0.3 mg/kg every 3 weeks (Q3W) for 18 months. Results HELIOS-A enrolled 164 patients (vutrisiran, n = 122; patisiran reference group, n = 42); external placebo, n = 77. Vutrisiran met the primary endpoint of change from baseline in modified Neuropathy Impairment Score +7 (mNIS+7) at 9 months (p = 3.54 x 10(-12)), and all secondary efficacy endpoints; significant improvements versus external placebo were observed in Norfolk Quality of Life-Diabetic Neuropathy, 10-meter walk test (both at 9 and 18 months), mNIS+7, modified body-mass index, and Rasch-built Overall Disability Scale (all at 18 months). TTR reduction with vutrisiran Q3M was non-inferior to within-study patisiran Q3W. Most adverse events were mild or moderate in severity, and consistent with ATTRv amyloidosis natural history. There were no drug-related discontinuations or deaths. Conclusions Vutrisiran significantly improved multiple disease-relevant outcomes for ATTRv amyloidosis versus external placebo, with an acceptable safety profile. ClinicalTrials.gov NCT03759379

Item Type: Article
Funders: Alnylam, Ed Childs of Adelphi Communication Ltd, Eidos Therapeutics
Uncontrolled Keywords: ATTRv amyloidosis; hATTR amyloidosis; Patisiran; RNA interference; Vutrisiran
Subjects: R Medicine > RC Internal medicine
R Medicine > RD Surgery
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 24 Nov 2024 12:23
Last Modified: 24 Nov 2024 12:23
URI: http://eprints.um.edu.my/id/eprint/39503

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