Non-interventional Study of Patients With Transthyretin (ATTR) Amyloidosis

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-130
SponsorAstraZeneca

About this trial

The MaesTTRo study aims to enroll a global cohort of patients with transthyretin (ATTR) amyloidosis to longitudinally observe the natural course of the disease and describe real-world treatment patterns and outcomes. In addition, information on the effectiveness of ATTR amyloidosis treatments, including eplontersen, which is a ligand-conjugated antisense oligonucleotide gene silencing treatment targeting activity against both the mutant and wild-type TTR protein, will be collected.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patient willing and able to provide written informed consent to participate in the study

Confirmed diagnosis of amyloid transthyretin (ATTR) amyloidosis

Aged ≥18 years at the time of signing the informed consent

Patient willing and able to participate in collection of electronic patient reported outcomes (PROs)

Disqualifiers

Concurrent participation in any interventional trial for ATTR amyloidosis

Involvement in the planning and/or conduct of the current study

Patients with evidence of primary or light chain amyloidosis (AL) or serum protein A amyloidosis (AA)

Asymptomatic patients with ATTR amyloidosis and asymptomatic ATTR mutation carriers

Trial population

Patients with a diagnosis of amyloid transthyretin (ATTR) amyloidosis

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

  • Treatment of transthyretin (ATTR) amyloidosis in observational study setting

    Drug

    Data will be collected on patients with ATTR amyloidosis in a real-world setting

Treatment groups

1,850 Participants
are divided into 3 treatment groups
Group A: ATTR cardiomyopathy (ATTR-CM)1 intervention
Group B: Hereditary polyneuropathy (ATTRv-PN)1 intervention
Group C: ATTR-Mixed1 intervention

Trial outcomes

Primary outcomes

1

Demographic characteristics (overall and in patients initiating a treatment with eplontersen)

* Age * Sex as determined by the investigator (male/female) * Race and ethnicity, where allowed

Time frame
From time of enrollment for up to 7 years
2

Treatment patterns (overall and in patients initiating a treatment with eplontersen)

In order to address this objective, the following treatments will be assessed: * ATTR amyloidosis treatment: Tafamidis, Diflunisal, Acoramidis, Vutrisiran, Patisiran, Inotersen, Eplontersen, Doxycycline and taurodesoxycholic acid, Liver transplant * Heart failure/arrhythmia-related treatment: Diuretics, Angiotensin converting enzyme inhibitor, Angiotensin receptor blocker, Angiotensin receptor-neprilysin inhibitor, Anticoagulation, Beta-blockers, Sodium-glucose co-transporter-2 inhibitor, Mineralocorticoid receptor antagonist, Digoxin, Pacemaker use, Implantable cardioverter-defibrillator, Left ventricular assist device, Cardiac transplant, Transcatheter aortic valve replacement, Surgical aortic valve replacement * Polyneuropathy-related treatment: Antiepileptics (gabapentin, pregabalin, carbamazepine, phenytoin), Antidepressants, Topical pain treatments, Opioids, Tetrahydrocannabinol * Other: Medications for gastrointestinal symptoms, Vitamin A supplementation, Dialysis

Time frame
From time of enrollment for up to 7 years
3

Clinical characteristics (overall and in patients initiating a treatment with eplontersen)

In order to address this objective, the following clinical characteristics will be assessed: * Modified body mass index (mBMI) * Medical history * TTR genetic test results * Family history of ATTR * Time period between the first symptoms to date of diagnosis of ATTR * Time since diagnosis of ATTR

Time frame
From time of enrollment for up to 7 years
4

Findings from biopsy (overall and in patients initiating a treatment with eplontersen)

In order to address this objective, the following biopsy information will be collected: * Type of biopsy * Amyloid identification result (Positive, Negative, Inconclusive for amyloid) * Method of amyloid typing * Result of the biopsy (Normal/Abnormal) * Reason for considering the biopsy result abnormal

Time frame
From time of enrollment for up to 7 years

Secondary outcomes

1

Comparison of demographic and clinical characteristics of patients prescribed eplontersen at any time during the observation period to patients on other ATTR treatments

The following outcomes will be compared between patients treated with eplontersen and patients on other ATTR treatments: * Demographics * mBMI * Medical history * Family history of ATTR amyloidosis * Time period between the first symptoms to date of diagnosis of ATTR amyloidosis * Time since diagnosis of ATTR amyloidosis

Time frame
Up to 7 years
2

Comparison of findings from biopsy in patients prescribed eplontersen at any time during the observation period to patients on other ATTR treatments

The following outcomes will be compared between patients treated with eplontersen and patients on other ATTR treatments: * Type of biopsy * Amyloid identification result (Positive, Negative, Inconclusive for amyloid) * Method of amyloid typing * Result of the biopsy (Normal/Abnormal) * Reason for considering the biopsy result abnormal

Time frame
Up to 7 years
3

Comparison of findings from Cardiovascular magnetic resonance imaging (CMR) in patients prescribed eplontersen at any time during the observation period to patients on other ATTR treatments

The following outcomes will be compared between patients treated with eplontersen and patients on other ATTR treatments: extracellular volume (ECV), contrast use, left ventricular (LV) end-diastolic volume, LV end-systolic volume, LV ejection fraction, LV Mass Index, interventricular wall thickness, right ventricular Free Wall Thickness, LV Free Wall Thickness, left Atrial Volume Index, native T1 mapping, CMR result (Normal/Abnormal), reason for considering the result abnormal.

Time frame
Up to 7 years
4

Comparison of findings from Echocardiography in patients prescribed eplontersen at any time during the observation period to patients on other ATTR treatments

The following outcomes will be compared between patients treated with eplontersen and patients on other ATTR treatments: LV ejection fraction, LV End Diastolic Volume, LV End Systolic Volume LV End Diastolic Dimension, LV End Systolic Dimension, Interventricular Septal, Thickness Diastole, Posterial Wall Thickness Diastole, Left Ventricular Mass Index, Left Atrial Volume, Left Atrial Volume Index, Mitral valve regurgitation, Aortic valve regurgitation, Tricuspid valve regurgitation, Pulmonic valve regurgitation, LV Outflow Gradient, Stroke Volume, Lateral early diastolic myocardial velocity (e' lateral), Medial early diastolic myocardial velocity (e' medial), Mitral E/e' Ratio, Early diastolic mitral inflow velocity (E), Late diastolic mitral inflow velocity (A), Mitral Peak E/A Ratio, Global LV longitudinal strain, Pulmonary artery systolic pressure, RV Free Wall Thickness Severity of Aortic stenosis, Severity of Mitral stenosis.

Time frame
Up to 7 years

Other outcomes

1

Risk factors for worsening ATTR progression

Factors associated with changes in clinical manifestations of ATTR amyloidosis, NYHA classification, NAC ATTR staging or Mayo staging, FAP (Coutinho) staging, PND score, LVEF, CCI and CCI components, and other comorbidities of interest will be identified.

Time frame
up to 7 years
2

Healthcare costs in patients with ATTR amyloidosis

Average annual costs will be calculated based on available data in the different countries.

Time frame
Up to 7 years
3

Serious adverse events in patients treated with ATTR amyloidosis treatments

Serious adverse events in patients treated with ATTR amyloidosis treatments will be measured

Time frame
Up to 7 years

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

AstraZeneca

Lead sponsor

ICON plc

Collaborator