Recent Progress in the Development and Clinical Application of New Drugs for Transthyretin Cardiac Amyloidosis

J Cardiovasc Pharmacol. 2023 Dec 1;82(6):427-437. doi: 10.1097/FJC.0000000000001478.

Abstract

Transthyretincardiac amyloidosis is a rare disease that has gained significant attention in recent years because of misfolding of transthyretin fibrils produced by the liver, leading to their deposition in the myocardium. The disease has an insidious onset, nonspecific clinical manifestations, and historically lacked effective drugs, making early diagnosis and treatment challenging. The survival time of patients largely depends on the extent of heart involvement at the time of diagnosis, and conventional treatments for cardiovascular disease do not provide significant benefits. Effective management of the disease requires treatment of its underlying cause. Orthotopic liver transplantation and combined hepato-heart transplantation have been clinically effective means of treating transthyretin cardiac amyloidosis mutants for many years. However, transplantation has many limitations in clinical practice. In recent years, the development of new drugs has brought new hope to patients. This review presents the latest advances in drug development and clinical application to provide a reference for clinicians managing transthyretin cardiac amyloidosis.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amyloidosis* / complications
  • Amyloidosis* / diagnosis
  • Amyloidosis* / therapy
  • Cardiomyopathies* / diagnosis
  • Cardiomyopathies* / drug therapy
  • Cardiomyopathies* / etiology
  • Humans
  • Myocardium
  • Myocytes, Cardiac
  • Prealbumin / genetics

Substances

  • Prealbumin