Annual Cardiovascular-related Hospitalization Days Avoided With Tafamidis Treatment In Patients With Transthyretin Amyloid Cardiomyopathy

Abstract

<h3>Background</h3> Patients with transthyretin amyloid cardiomyopathy (ATTR-CM) experience infiltrative cardiomyopathy and heart failure symptoms requiring costly hospitalizations. In the ATTR-ACT trial, tafamidis significantly lowered the frequency of cardiovascular (CV)-related hospitalizations in patients with ATTR-CM. <h3>Hypothesis</h3> As length of stay can affect the total hospitalization burden, it is important to understand the impact of tafamidis on the number of CV-related hospital days avoided in the daily clinical management of ATTR-CM patients. <h3>Methods</h3> Post hoc analyses were conducted using ATTR-ACT trial data to derive annual frequency of CV-related hospitalizations and the mean length of stay per event. These outcomes were used to calculate the total burden of CV-related hospitalization (days) by treatment arm. <h3>Results</h3> In the total population, tafamidis significantly reduced the rate of CV-related hospitalizations per year by 32.4% compared with placebo (0.475 vs. 0.7025, p<0.0001). Furthermore, patients receiving tafamidis had a shorter mean length of stay per CV-related hospitalization event (8.6 days for tafamidis vs. 9.6 for placebo). Taken together, tafamidis prevented 2.659 CV-related hospitalization days per patient per year (4.085 vs. 6.744 days). Assuming that the 8,500 real-life patients who received tafamidis in the US followed the trend of trial participants, tafamidis would reduce on average a total of ∼22,602 CV-related hospitalization days per year. A subgroup analysis showed that with treatment initiation in NYHA class I/II, the reduction in the annual number of CV-related hospitalizations was 52% compared with placebo (0.3378 vs. 0.7091, p<0.0001). With 1.1 fewer days per hospitalization, tafamidis reduced the annual number of CV-related hospitalization days by 3.936 days per patient (2.871 vs. 6.807 days) in NYHA class I/II patients. <h3>Conclusions</h3> Tafamidis was shown to prevent a significant number of CV-related hospitalization events and hospitalization days per year of treatment, supporting the benefit of treatment with tafamidis. Timely diagnosis and treatment with tafamidis could further decrease the total number of CV-related hospitalization days.