- acoramidis (Attruby)
- tafamidis (Vyndamax, Vyndaqel)
- vutrisiran (Amvuttra)
“All three have shown tremendous efficacy in greatly slowing disease progression,” Dr. Witteles says.
Acoramidis and tafamidis, both oral medications, are TTR protein stabilizers, which keep the TTR from breaking down into deposits. Vutrisiran is an injected TTR protein silencer, which halts production of the TTR protein altogether.
While silencers lower TTR production to a greater degree, stabilizers are typically prescribed first, particularly in early stages of ATTR-CM.
Some other medications are not FDA-approved for ATTR-CM but are still prescribed off-label. These include inotersen (Tegsedi) and patisiran (Onpattro), which slow down the liver’s production of defective amyloid proteins. Your doctor may consider these drugs if you have hereditary ATTR with polyneuropathy, or peripheral nerve damage, alongside heart issues or if other approved treatments aren’t sufficient to treat the disease.
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