Iodine-124 evuzamitide PET imaging may identify cardiac involvement in transthyretin amyloid cardiomyopathy despite inconclusive conventional testing, according to data reviewed at the Heart Failure Society of America meeting.
PET Imaging and Systemic Burden in REVEAL
Data from the REVEAL trial indicate that iodine-124 evuzamitide PET scans may identify cardiac involvement when conventional testing is inconclusive. The imaging technique also provides an assessment of systemic burden in transthyretin amyloid cardiomyopathy (ATTR-CM) patients. Nitasha Sarswat, MD, reviewed these findings.
Acoramidis Outcomes and Renal Function in ATTRibute-CM
Post hoc analyses from the ATTRibute-CM trial associated acoramidis with more time outside the hospital and improved health status, supporting patient-centered care. According to Dr. Sarswat, when an initial drop in estimated glomerular filtration rate is followed by a leveling off, this early shift in renal function on its own should not be a reason to stop therapy.
Clinical Consideration: When managing ATTR-CM, clinicians should recognize that if an initial reduction in estimated glomerular filtration rate is followed by stabilization, that early renal fluctuation by itself ought not to trigger the discontinuation of treatment.
HELIOS-B Trial Supports Reductions in Cardiovascular Events
Extension findings from the HELIOS-B trial support reductions in cardiovascular events and hospitalizations with vutrisiran. However, Dr. Sarswat does not identify evidence establishing one medication’s superiority over another. Meanwhile, the CARDIO-TTRansform trial did not meet its primary endpoint with eplontersen. Despite this, patients without baseline stabilizer therapy showed a benefit.
Researchers Initiated ASCEND-ATTR to Clarify Structural and Functional Changes
Favorable health-status and biomarker findings are encouraging, yet Dr. Sarswat has doubts regarding the exact function of eplontersen in ATTR-CM, specifically questioning whether supplementing a stabilizer with a silencer yields better clinical results. To address these questions, researchers initiated ASCEND-ATTR, a prospective cardiac MRI study intended to clarify structural and functional changes during acoramidis treatment.
Frequently Asked Questions About ATTR-CM Therapies
What did the REVEAL trial reveal about iodine-124 evuzamitide PET imaging?
Data reviewed at the HFSA meeting show that iodine-124 evuzamitide PET imaging may identify cardiac involvement in ATTR-CM despite inconclusive conventional testing and provide an assessment of systemic burden.
How should clinicians interpret an early decline in estimated glomerular filtration rate during acoramidis treatment?
Evaluations following the ATTRibute-CM study demonstrate that if an initial drop in estimated glomerular filtration rate eventually stabilizes, that early shift in renal function should not automatically lead clinicians to halt treatment.
Did the CARDIO-TTRansform trial meet its primary endpoint?
The primary endpoint with eplontersen was not achieved in the CARDIO-TTRansform trial, though individuals who were not on baseline stabilizer therapy still experienced positive effects.
Related reading