Publications

The material below is provided to support scientific exchange. Any content about investigational therapeutics or investigational uses of locally approved products does not establish the safety or efficacy of these therapeutics or uses, and there is no guarantee of local regulatory approval.

For questions beyond a product’s authorized indications or for information not available here, please contact Alnylam Medical Information.

Treatment response and neurofilament light chain levels with long-term patisiran in hereditary transthyretin-mediated amyloidosis with polyneuropathy: 24-month results of an open-label extension study

Publication Details

Amyloid

July 2023

Access Here

Author(s)

Simina Ticau¹, Emre Aldinc¹, Michael Polydefkis², David Adams³, Teresa Coelho⁴, Mitsuharu Ueda⁵, Cecilia Hale¹, John Vest¹, Paul Nioi¹; Patisiran Global OLE Collaborators

Affiliations

¹Alnylam Pharmaceuticals, Cambridge, MA, USA; ²Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; ³Neurology Department, AP-HP, CHU Bicêtre, Université Paris-Saclay, Paris-Saclay, France; ⁴Centro Hospitalar Universitário Santo António, European Reference Network - EUroNMD, Porto, Portugal; 5Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

Abstract

Background:

Longitudinal changes in neurofilament light chain (NfL) levels were evaluated alongside prespecified clinical assessments 24 months into the patisiran Global open-label extension (OLE) study in patients with ATTRv amyloidosis with polyneuropathy.

Methods:

All patients enrolled in the Global OLE, from phase III APOLLO and phase II OLE parent studies, received patisiran. Assessments included measures of polyneuropathy (modified Neuropathy Impairment Score+7 (mNIS+7)), quality of life (QOL; Norfolk QOL-Diabetic Neuropathy questionnaire (Norfolk QOL-DN)), and plasma NfL.

Results:

Patients receiving patisiran in the parent study (APOLLO-patisiran, n = 137; phase II OLE-patisiran, n = 25) demonstrated sustained improvements in mNIS+7 (mean change from parent study baseline (95% confidence interval): APOLLO-patisiran −4.8 (−8.9, −0.6); phase II OLE-patisiran −5.8 (−10.5, −1.2)) and Norfolk QOL-DN (APOLLO-patisiran −2.4 (−7.2, 2.3)), and maintained reduced NfL levels at Global OLE 24 months. After initiating patisiran in the Global OLE, APOLLO-placebo patients (n = 49) demonstrated stabilized mNIS+7, improved Norfolk QOL-DN, and significantly reduced NfL levels. Patisiran continued to demonstrate an acceptable safety profile. Earlier patisiran initiation was associated with a lower exposure-adjusted mortality rate.

Conclusions:

Long-term patisiran treatment led to sustained improvements in neuropathy and QOL, with NfL demonstrating potential as a biomarker for disease progression and treatment response in ATTRv amyloidosis with polyneuropathy.