ATTR amyloidosis is a protein-misfolding disorder of the transthyretin (TTR) protein1

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THE SOURCE OF THE DISEASE IS PRODUCED IN THE LIVER3,4

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Liver

(where 90% of TTR is produced)

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Transthyretin tetramer destabilizes
Transthyretin
tetramer destabilizes
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Tetramer dissociates into monomers
Tetramer dissociates
into monomers
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Monomers Misfold And Aggregate Into Amyloid Fibrils
Monomers misfold
and
aggregate into
amyloid fibrils
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Amyloid deposits throughout the body
Amyloid deposits
throughout the body

WATCH THIS VIDEO TO LEARN MORE ABOUT THE MECHANISM OF DISEASE FOR ATTR

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The disease is classified as hereditary or wild type4

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Hereditary ATTR (hATTR): Instability of TTR is due to mutations in the TTR gene1,4

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Wild-type ATTR (ATTRwt): Instability of TTR may be due to unknown environmental and age-related factors4

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hATTR CAN PROGRESS RAPIDLY

hATTR-PN5,6

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Stage 1: Walking Without Assistance
Walking without assistance
STAGE 1
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Stage 2: Walking With Assistance
Walking with assistance
STAGE 2
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Stage 3: Confined To A Wheelchair Or Bed
Confined to a wheelchair or bed
STAGE 3
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MORTALITY

LIFE EXPECTANCY IS 5 TO 15 YEARS FROM DIAGNOSIS7

ATTR-CM8

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Early Clinical HF And Arrhythmias
Early clinical HF
Arrhythmias
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Restrictive HF and HF Hospitalizations
Restrictive CM
HF hospitalizations
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End Stage HF
End-stage HF
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MORTALITY

LIFE EXPECTANCY IS 2.6 TO 6 YEARS FROM DIAGNOSIS9

Configure Accordion Item: - See how hATTR-PN progresses to mortality as soon as 5 years from diagnosis7
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Configure Accordion Item: - See how hATTR-PN progresses to mortality as soon as 5 years from diagnosis7

hATTR-PN5,6

Stage 1: Walking Without Assistance
Walking without assistance
STAGE 1
Stage 2: Walking With Assistance
Walking with assistance
STAGE 2
Stage 3: Confined To A Wheelchair Or Bed
Confined to a wheelchair or bed
STAGE 3

MORTALITY

LIFE EXPECTANCY IS 5 TO 15 YEARS FROM DIAGNOSIS7

Configure Accordion Item: - See how ATTR-CM progresses to mortality as soon as 2.6 years from diagnosis9
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Configure Accordion Item: - See how ATTR-CM progresses to mortality as soon as 2.6 years from diagnosis9

ATTR-CM8

Early Clinical HF And Arrhythmias
Early clinical HF
Arrhythmias
Restrictive HF and HF Hospitalizations
Restrictive CM
HF hospitalizations
End Stage HF
End-stage HF

MORTALITY

LIFE EXPECTANCY IS 2.6 TO 6 YEARS FROM DIAGNOSIS9

Increased clinical suspicion of hATTR is important for your patients

Low clinical suspicion and nonspecific symptoms result in underdiagnosis, misdiagnosis, and/or delayed treatment.1,10

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Patients with hATTR may face
a diagnostic delay of

>

3

YEARS5

50% of patients saw

≥

3

PHYSICIANS

before receiving the correct diagnosis of hATTR11

See the symptoms
of hATTR

ATTR-CM, cardiomyopathy of transthyretin-mediated amyloidosis; ATTRwt, wild-type transthyretin-mediated amyloidosis; CM, cardiomyopathy; hATTR, hereditary transthyretin-mediated amyloidosis; hATTR-PN, polyneuropathy of hereditary transthyretin-mediated amyloidosis; HF, heart failure.

References: 1. Nativi‑Nicolau JN, Karam C, Khella S, Maurer MS. Screening for ATTR amyloidosis in the clinic: overlapping disorders, misdiagnosis, and multiorgan awareness. Heart Fail Rev. 2022;27(3):785-793. 2. Gertz M, Adams D, Ando Y, et al. Avoiding misdiagnosis: expert consensus recommendations for the suspicion and diagnosis of transthyretin amyloidosis for the general practitioner. BMC Fam Pract. 2020;21(1):198. 3. Tschöpe C, Elsanhoury A. Treatment of transthyretin amyloid cardiomyopathy: the current options, the future, and the challenges. J Clin Med. 2022;11(8):2148. 4. Ioannou A, Fontana M, Gillmore JD. RNA targeting and gene editing strategies for transthyretin amyloidosis. BioDrugs. 2023;37(2):127-142. 5. Adams D, Ando Y, Beirão JM, et al. Expert consensus recommendations to improve diagnosis of ATTR amyloidosis with polyneuropathy. J Neurol. 2021;268(6):2109-2122. 6. Ando Y, Coelho T, Berk JL, et al. Guideline of transthyretin-related hereditary amyloidosis for clinicians. Orphanet J Rare Dis. 2013;8:31. 7. Hawkins PN, Ando Y, Dispenzeri A, Gonzalez-Duarte A, Adams D, Suhr OB. Evolving landscape in the management of transthyretin amyloidosis. Ann Med. 2015;47(8):625-638. 8. Griffin JM, Rosenthal JL, Grodin JL, Maurer MS, Grogan M, Cheng RK. ATTR amyloidosis: current and emerging management strategies: JACC: CardioOncology state-of-the-art review. JACC CardioOncol. 2021;3(4):488-505. 9. Kittleson MM, Ruberg FL, Ambardekar AV, et al; Writing Committee. 2023 ACC Expert Consensus Decision Pathway on comprehensive multidisciplinary care for the patient with cardiac amyloidosis: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2023;81(11):1076-1126. 10. Gertz MA. Hereditary ATTR amyloidosis: burden of illness and diagnostic challenges. Am J Manag Care. 2017;23(7 Suppl):S107-S112. 11. Lousada I, Maurer MS, Warner M, et al. Amyloidosis Research Consortium Cardiac Amyloidosis Survey: results from patients with AL and ATTR amyloidosis and their caregivers. Presented at the 23rd annual Heart Failure Society of America; September 13-16, 2019; Philadelphia, PA.

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