Bilal Hussain MD , Sanchit Duhan MBBS , Bansari Patel MD , Yu-Chun Chang MS3 PhD , Mohammad Hamza MD , Maria Najam MD , Mustafa Sajjad Cheema MD , Mubashar Karamat MD , Junaid Mir MD , Bijeta Keisham MD , M. Chadi Alraies MD , Yasar Sattar MD
{"title":"Tafamidis:促甲状腺素型心肌病的游戏规则改变者?安全性和有效性的系统评价和荟萃分析。","authors":"Bilal Hussain MD , Sanchit Duhan MBBS , Bansari Patel MD , Yu-Chun Chang MS3 PhD , Mohammad Hamza MD , Maria Najam MD , Mustafa Sajjad Cheema MD , Mubashar Karamat MD , Junaid Mir MD , Bijeta Keisham MD , M. Chadi Alraies MD , Yasar Sattar MD","doi":"10.1016/j.cpcardiol.2025.103129","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Tafamidis was FDA-approved for Transthyretin cardiomyopathy (ATTR-CM) due to its demonstrated reduction in mortality and hospitalizations.</div></div><div><h3>Methods</h3><div>976 studies from PubMed and Embase were screened. Seven studies were included that compared tafamidis treatment with no tafamidis for ATTR-CM. The mantel-Haenszel method was used for binary outcomes, and Hedges’ g was used for continuous outcomes.</div></div><div><h3>Results</h3><div>Tafamidis was associated with decreased odds of mortality (OR 0.55, 95 % CI 0.42-0.73, I<sup>2</sup>=41 %, p<0.0001) and reduced CHF exacerbations (OR 0.71, 95 % CI 0.51-0.99, I<sup>2</sup>= 0 %, p= 0.04). While, CHF related hospitalizations (OR 0.35, 95 % CI 0.07-1.67, I2= 87 %, p= 0.19), atrial arrhythmias (OR 0.98, 95 % CI 0.67-1.42, I<sup>2</sup>= 0 %, p= 0.9), change in left ventricular ejection fraction (SMD 0.87, 95 % CI -0.37-2.11, I<sup>2</sup>=98 %, p= 0.17), left ventricular end-diastolic diameter from baseline (SMD -0.12, 95 % CI -0.41-0.18, I<sup>2</sup>= 0 %, p= 0.4), interventricular septal thickness from baseline (SMD -0.7, 95 % CI -1.57-0.17, I<sup>2</sup>= 96 %, p= 0.11) were not statistically different for tafamidis compared to no tafamidis for ATTR-CM.</div></div><div><h3>Conclusion</h3><div>Tafamidis treatment in ATTR-CM is associated with reduced all-cause mortality and a lower incidence of CHF exacerbations. These observations are consistent with the ATTRACT trial, which supports the efficacy of tafamidis in treating ATTR-CM.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 9","pages":"Article 103129"},"PeriodicalIF":3.3000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tafamidis: A game changer in transthyretin cardiomyopathy? A systematic review and meta-analysis of safety and efficacy\",\"authors\":\"Bilal Hussain MD , Sanchit Duhan MBBS , Bansari Patel MD , Yu-Chun Chang MS3 PhD , Mohammad Hamza MD , Maria Najam MD , Mustafa Sajjad Cheema MD , Mubashar Karamat MD , Junaid Mir MD , Bijeta Keisham MD , M. Chadi Alraies MD , Yasar Sattar MD\",\"doi\":\"10.1016/j.cpcardiol.2025.103129\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>Tafamidis was FDA-approved for Transthyretin cardiomyopathy (ATTR-CM) due to its demonstrated reduction in mortality and hospitalizations.</div></div><div><h3>Methods</h3><div>976 studies from PubMed and Embase were screened. Seven studies were included that compared tafamidis treatment with no tafamidis for ATTR-CM. The mantel-Haenszel method was used for binary outcomes, and Hedges’ g was used for continuous outcomes.</div></div><div><h3>Results</h3><div>Tafamidis was associated with decreased odds of mortality (OR 0.55, 95 % CI 0.42-0.73, I<sup>2</sup>=41 %, p<0.0001) and reduced CHF exacerbations (OR 0.71, 95 % CI 0.51-0.99, I<sup>2</sup>= 0 %, p= 0.04). While, CHF related hospitalizations (OR 0.35, 95 % CI 0.07-1.67, I2= 87 %, p= 0.19), atrial arrhythmias (OR 0.98, 95 % CI 0.67-1.42, I<sup>2</sup>= 0 %, p= 0.9), change in left ventricular ejection fraction (SMD 0.87, 95 % CI -0.37-2.11, I<sup>2</sup>=98 %, p= 0.17), left ventricular end-diastolic diameter from baseline (SMD -0.12, 95 % CI -0.41-0.18, I<sup>2</sup>= 0 %, p= 0.4), interventricular septal thickness from baseline (SMD -0.7, 95 % CI -1.57-0.17, I<sup>2</sup>= 96 %, p= 0.11) were not statistically different for tafamidis compared to no tafamidis for ATTR-CM.</div></div><div><h3>Conclusion</h3><div>Tafamidis treatment in ATTR-CM is associated with reduced all-cause mortality and a lower incidence of CHF exacerbations. 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引用次数: 0
摘要
目的:Tafamidis被fda批准用于治疗甲状腺素型心肌病(atr - cm),因为它可以降低死亡率和住院率。方法:从PubMed和Embase中筛选976项研究。纳入了7项研究,比较了治疗atr - cm的他法米迪与未治疗他法米迪。二元结果采用mantel-Haenszel方法,连续结果采用Hedges’g方法。结果:他法非底斯与死亡率降低相关(OR 0.55, 95% CI 0.42-0.73, I2=41%, p2= 0%, p= 0.04)。与此同时,CHF相关的住院(OR 0.35, 95% CI 0.07-1.67, I2= 87%, p= 0.19)、心房心律不整(OR 0.98, 95% CI 0.67-1.42, I2= 0%, p= 0.9)、左室射血分数变化(SMD 0.87, 95% CI -0.37-2.11, I2=98%, p= 0.17)、左室舒张末期直径较基线变化(SMD -0.12, 95% CI -0.41-0.18, I2= 0%, p= 0.4)、室间隔厚度较基线变化(SMD -0.7, 95% CI -1.57-0.17, I2= 96%,p= 0.11),在atr - cm中,使用他法肌纤维组与不使用他法肌纤维组比较,差异无统计学意义。结论:他法非地治疗atr - cm与全因死亡率降低和CHF加重发生率降低相关。这些观察结果与attraction试验一致,该试验支持他法非地治疗atr - cm的疗效。
Tafamidis: A game changer in transthyretin cardiomyopathy? A systematic review and meta-analysis of safety and efficacy
Purpose
Tafamidis was FDA-approved for Transthyretin cardiomyopathy (ATTR-CM) due to its demonstrated reduction in mortality and hospitalizations.
Methods
976 studies from PubMed and Embase were screened. Seven studies were included that compared tafamidis treatment with no tafamidis for ATTR-CM. The mantel-Haenszel method was used for binary outcomes, and Hedges’ g was used for continuous outcomes.
Results
Tafamidis was associated with decreased odds of mortality (OR 0.55, 95 % CI 0.42-0.73, I2=41 %, p<0.0001) and reduced CHF exacerbations (OR 0.71, 95 % CI 0.51-0.99, I2= 0 %, p= 0.04). While, CHF related hospitalizations (OR 0.35, 95 % CI 0.07-1.67, I2= 87 %, p= 0.19), atrial arrhythmias (OR 0.98, 95 % CI 0.67-1.42, I2= 0 %, p= 0.9), change in left ventricular ejection fraction (SMD 0.87, 95 % CI -0.37-2.11, I2=98 %, p= 0.17), left ventricular end-diastolic diameter from baseline (SMD -0.12, 95 % CI -0.41-0.18, I2= 0 %, p= 0.4), interventricular septal thickness from baseline (SMD -0.7, 95 % CI -1.57-0.17, I2= 96 %, p= 0.11) were not statistically different for tafamidis compared to no tafamidis for ATTR-CM.
Conclusion
Tafamidis treatment in ATTR-CM is associated with reduced all-cause mortality and a lower incidence of CHF exacerbations. These observations are consistent with the ATTRACT trial, which supports the efficacy of tafamidis in treating ATTR-CM.
期刊介绍:
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.