Effects of eplontersen on symptoms of autonomic neuropathy in hereditary transthyretin-mediated amyloidosis: secondary analysis from the NEURO-TTRansform trial.

IF 5.2 2区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY
Jonas Wixner, John L Berk, David Adams, Michael Polydefkis, Isabel Conceição, Shahram Attarian, Julian D Gillmore, P James B Dyck, Folke Folkvaljon, Wunan Zhou, Jersey Chen, Nicholas J Viney, T Jesse Kwoh, Teresa Coelho, Márcia Waddington-Cruz
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引用次数: 0

Abstract

Background: The NEURO-TTRansform trial showed that after 66 weeks of treatment, eplontersen significantly reduced neuropathic impairment and improved quality of life (QoL) in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy (ATTRv-PN). In this secondary analysis from NEURO-TTRansform, autonomic impairment, and the impact of eplontersen on autonomic impairment progression was evaluated through 85 weeks in patients randomised to eplontersen (n = 144) versus external placebo (n = 60; through Week 66 from the NEURO-TTR trial).

Methods: Change from baseline in modified Neuropathy Impairment Score +7 (mNIS+7) composite score, Norfolk Quality of Life-Diabetic Neuropathy (Norfolk QoL-DN) total score, and the Neuropathy Symptoms and Change (NSC) total score was evaluated. Exploratory assessments were change in autonomic components of these instruments, Composite Autonomic Symptom Score-31 (COMPASS-31) total score, and nutritional status (modified body mass index [mBMI]).

Results: Patients reported profound autonomic dysfunction at baseline. Improvements with eplontersen versus placebo were observed up to Week 66 in autonomic components of mNIS+7, Norfolk QoL-DN, NSC, and mBMI; eplontersen results were sustained up to Week 85, including improvements in COMPASS-31 (Week 81).

Conclusions: Eplontersen demonstrated benefit across multiple measures of autonomic impairment known to progress rapidly and negatively impact QoL without treatment, without deterioration in nutritional status.

依普仑特生对遗传性转甲状腺素介导的淀粉样变性自主神经病变症状的影响:NEURO-TTRansform 试验的二次分析。
研究背景NEURO-TTRansform试验表明,经过66周的治疗后,依普仑特生可显著减轻遗传性转甲状腺素介导的淀粉样变性伴多发性神经病(ATTRv-PN)患者的神经病理性损害并改善其生活质量(QoL)。在这项NEURO-TTRansform的二次分析中,对随机接受易普乐生(n = 144)与外部安慰剂(n = 60;NEURO-TTR试验第66周)治疗的患者进行了为期85周的自律神经损伤评估,并评估了易普乐生对自律神经损伤进展的影响:方法:评估改良神经病变损害评分+7(mNIS+7)综合评分、诺福克生活质量-糖尿病神经病变(Norfolk QoL-DN)总分以及神经病变症状和变化(NSC)总分与基线相比的变化。探索性评估包括这些工具中自主神经部分的变化、综合自主神经症状评分-31(COMPASS-31)总分以及营养状况(修正体重指数[mBMI]):结果:患者在基线时报告了严重的自主神经功能障碍。与安慰剂相比,依普仑特生可改善mNIS+7、Norfolk QoL-DN、NSC和mBMI中的自律神经成分,改善效果可持续到第66周;依普仑特生的效果可持续到第85周,包括COMPASS-31(第81周)的改善效果:结论:易普隆特生对自律神经损伤的多种测量均有益处,众所周知,自律神经损伤进展迅速,不经治疗会对 QoL 产生负面影响,而营养状况不会恶化。
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来源期刊
Amyloid-Journal of Protein Folding Disorders
Amyloid-Journal of Protein Folding Disorders 生物-生化与分子生物学
CiteScore
10.60
自引率
10.90%
发文量
48
审稿时长
6-12 weeks
期刊介绍: Amyloid: the Journal of Protein Folding Disorders is dedicated to the study of all aspects of the protein groups and associated disorders that are classified as the amyloidoses as well as other disorders associated with abnormal protein folding. The journals major focus points are: etiology, pathogenesis, histopathology, chemical structure, nature of fibrillogenesis; whilst also publishing papers on the basic and chemical genetic aspects of many of these disorders. Amyloid is recognised as one of the leading publications on amyloid protein classifications and the associated disorders, as well as clinical studies on all aspects of amyloid related neurodegenerative diseases and major clinical studies on inherited amyloidosis, especially those related to transthyretin. The Journal also publishes book reviews, meeting reports, editorials, thesis abstracts, review articles and symposia in the various areas listed above.
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