Acoramidis Benefit Persists Across Early eGFR Dip Subgroups in ATTR-CM

Acoramidis was associated with a lower risk of all-cause mortality or recurrent cardiovascular-related hospitalization than placebo through Month 30 in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), regardless of the size of an early decline in estimated glomerular filtration rate (eGFR). The post hoc analysis was presented October 11 at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026 in Phoenix, Arizona.

The phase 3 ATTRibute-CM trial randomized 421 participants to acoramidis and 211 to placebo. This analysis included those with an evaluable eGFR measurement at Day 28—378 in the acoramidis arm and 193 in the placebo arm. Investigators divided participants within each treatment arm according to whether their change in eGFR from baseline to Day 28 was above or at or below that arm’s median. They compared the risk of recurrent cardiovascular-related hospitalization or all-cause mortality through Month 30 using an analysis beginning at Day 28 that accounted for baseline eGFR, NT-proBNP, and variant or wild-type ATTR-CM status.

The median Day 28 eGFR decline was 7.62 mL/min/1.73 m² with acoramidis and 0.99 mL/min/1.73 m² with placebo. Among participants with an above-median decline in their respective treatment arms, the composite outcome was less frequent with acoramidis than with placebo (hazard ratio [HR], 0.51; 95% CI, 0.31–0.85; P = .004). That comparison included 189 acoramidis recipients and 96 placebo recipients.

The treatment comparison also favored acoramidis among participants with an eGFR decline at or below their arm’s median (HR, 0.54; 95% CI, 0.32–0.94; P = .012). Each group included 189 acoramidis recipients and 97 placebo recipients. The presentation did not report a direct comparison between the larger- and smaller-eGFR-dip groups within the acoramidis arm.

Investigators also examined changes through Day 28 in potassium, sodium, blood urea nitrogen, and blood pressure. They reported no clinically concerning changes in either eGFR subgroup. Blood pressure data were missing for some participants, leaving 181, 186, 92, and 92 participants in the four respective subgroup analyses.

Reference

Masri A, Bergemann T, Castaño A, et al. Early eGFR dip following acoramidis initiation is associated with reduced risk of mortality and recurrent cardiovascular-related hospitalizations in ATTR-CM. Presented at: Heart Failure Society of America Annual Scientific Meeting 2026; October 11, 2026; Phoenix, AZ.