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ESC 2026 | Comparing treatment strategies for ATTR-CM across clinical outcomes: insights from a meta-analysis
Adolfo Calderón Fernández, MD, National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), Mexico City, Mexico, shares insights from a network meta-analysis of treatment strategies for transthyretin amyloid cardiomyopathy (ATTR-CM), highlighting that therapy effectiveness depends on phenotype. Dr Calderón Fernández notes that certain medicines are better suited to reduce mortality, while others, such as vutrisiran, may be more effective in improving clinical and functional outcomes. This interview took place during the 2026 European Society of Cardiology (ESC) Congress in Munich, Germany.
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Transcript
Okay, well, in this network meta-analysis, we have to have a kind of a creation, because we don’t have the stabilizer or the silence stabilizer, because we are evaluating every pharmaco, everyone, and it’s not between classes, it’s just between every medicine okay so the main posture or the difference between that is that we found that this medicine these therapies about TTR are phenotype dependent okay we are talking about that we have some medicine that will help us to reduce the mortality, or maybe we have to reduce the anti-BMP, or maybe to reduce the functional capacity, talking about six-minute walk distance...
Okay, well, in this network meta-analysis, we have to have a kind of a creation, because we don’t have the stabilizer or the silence stabilizer, because we are evaluating every pharmaco, everyone, and it’s not between classes, it’s just between every medicine okay so the main posture or the difference between that is that we found that this medicine these therapies about TTR are phenotype dependent okay we are talking about that we have some medicine that will help us to reduce the mortality, or maybe we have to reduce the anti-BMP, or maybe to reduce the functional capacity, talking about six-minute walk distance. Yeah, in this case, the family is the best one to reduce the mortality and in the other side but with Iran having better clinical and functional improvements like the six-minute walk distance and the NT pro BMP in the other side the families improve the Kansas City questionnaire okay well I think the main the main outcome that we have and that we found in this network meta-analysis is that, I said the last question, that the families improve better than other medicine, the all-cause mortality. But we have to say that we are comparing trials with the families against placebo, participant against placebo, we don’t have a head-to-head between the medicines, so the main outcome is that one, the mortality, but if we have a patient that is younger and not have a kind of risk of, high risk of mortality, but have a kind of worse quality of life. We can use the vutrisiran because he improved the NT and the functional capacity like six minutes walk distance.
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