Acoramidis Associated With Health Status Recovery After CV Hospitalization in ATTR-CM: Post Hoc ATTRibute-CM Analysis
Key Highlights
- The abstract authors share that Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) scores declined in both treatment groups during the 12 months before a first cardiovascular-related hospitalization.
- During the 12 months after hospitalization, scores recovered in the acoramidis group but continued to decline in the placebo group (P<.05).
- At least one cardiovascular-related hospitalization occurred in 26.7% of acoramidis recipients and 42.6% of placebo recipients during the trial.
Acoramidis was associated with recovery in patient-reported heart failure health status after cardiovascular-related hospitalization (CVH), compared with continued deterioration with placebo, in a post hoc analysis of the phase 3 ATTRibute-CM trial. These findings were presented as an abstract at the Heart Failure Society of America 2026 Annual Scientific Meeting.
ATTRibute-CM randomized participants with transthyretin amyloid cardiomyopathy (ATTR-CM) 2:1 to acoramidis HCl 800 mg or placebo twice daily for 30 months. This analysis used the modified intention-to-treat population of 409 acoramidis recipients and 202 placebo recipients. Researchers assessed heart failure-related health status with the Kansas City Cardiomyopathy Questionnaire Overall Summary score (KCCQ-OS), for which higher scores indicate better health status.
The investigators first compared KCCQ-OS scores across pooled treatment groups according to whether participants experienced at least one CVH; those who died without a CVH were excluded from that comparison. They then modeled KCCQ-OS trajectories by treatment group during the 12 months before and after a first CVH event. The model accounted for treatment, time relative to hospitalization, treatment-by-time interactions, the number of CVH events, and randomization stratification factors.
Study Findings
Across treatment groups, participants who experienced at least one CVH had higher N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and lower KCCQ-OS scores at baseline. The 195 participants who experienced a CVH had lower KCCQ-OS scores throughout the study than the 361 participants who did not.
At least one CVH occurred in 109 of 409 acoramidis recipients (26.7%) and 86 of 202 placebo recipients (42.6%). During the 12 months preceding a first CVH, mean KCCQ-OS scores declined in both treatment groups. Over the following 12 months, scores recovered among acoramidis recipients but continued to decline among placebo recipients (P<.05).
Clinical Implications
According to the authors, worsening KCCQ-OS before a CVH may serve as an early indicator of an increased risk of an adverse outcome in patients with ATTR-CM. They suggest that the different trajectories after CVH merit attention when evaluating health status during acoramidis treatment.
Expert Commentary
“Following a CVH event, acoramidis was associated with recovery of health status versus continued decline observed with placebo, suggesting a beneficial effect on post-CVH health status trajectory,” the researchers concluded.
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