Vutrisiran reduced mortality and cardiovascular events in patients with transthyretin amyloid cardiomyopathy (ATTR-CM) across all age groups-including those 80 years and older-while maintaining functional capacity and quality of life, according to a prespecified age-based analysis of the phase 3 HELIOS-B trial (NCT04153149).ATTR-CM is a progressive, infiltrative cardiomyopathy caused by misfolded transthyretin protein deposits in the heart and other organs.2 It primarily affects older adults,who face high risks of
Vutrisiran demonstrated consistent benefits across all age groups in patients with transthyretin amyloid cardiomyopathy (ATTR-CM), according to results from the NCT03860935 studies.the authors noted the mean age of the overall population was 75 years.
Across all age categories, vutrisiran consistently reduced the primary composite outcome of all-cause mortality and recurrent cardiovascular events compared with placebo (pinteraction = .56), with no meaningful interaction between treatment effect and age (pinteraction = .50). Benefits were also seen for the individual components of the composite end point, including fewer recurrent cardiovascular events and lower all-cause mortality through 42 months of follow-up.
Importantly, patients 80 years and older-who had more advanced disease at baseline, higher cardiac biomarkers, and lower functional capacity-experienced similar relative risk reductions to younger participants.Continuous age modeling confirmed that treatment efficacy remained stable across the full age spectrum, suggesting no reduction in benefit among older adults.
Older participants were more likely to have wild-type ATTR-CM and advanced disease stage, which reflects real-world epidemiology, the authors noted.They also had higher levels of NT-proBNP and troponin, which are markers associated with worse prognosis, underscoring the clinical meaning of achieving consistent benefits in this group.
Beyond clinical events, vutrisiran preserved physical function and health-related quality of life across all age groups.Patients receiving vutrisiran showed improvements in 6-minute walk distance and Kansas City Cardiomyopathy Questionnaire overall summary scores compared with placebo, with no evidence that age influenced these functional outcomes.
Rates of serious adverse events and treatment discontinuation were also comparable between vutrisiran and placebo across age categories, and older patients did not experience higher safety risks.
“There is a historical undertreatment of elderly patients with heart failure,likely due to several factors,including co
