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SNPMiner SNPMiner Trials (Home Page)


Report for Mutation V122I

Developed by Shray Alag, 2020-2021.
SNP Clinical Trial Gene

There are 3 clinical trials

Clinical Trials


1 The Effects Of Fx-1006A On Transthyretin Stabilization And Clinical Outcome Measures In Patients With V122I Or Wild-Type TTR Amyloid Cardiomyopathy

Open-label, multicenter, international, single-treatment study designed to determine TTR stabilization as well as Fx-1006A safety and tolerability, and its effects on clinical outcomes in patients with V122I or wild-type TTR amyloid cardiomyopathy. The study will be conducted in two parts. Part 1 will include a six-week dosing period during which all enrolled patients will self-administer oral Fx-1006A 20 mg soft gelatin capsules once daily for six weeks. At Week 6, blood samples will be collected from each patient to determine TTR stabilization. Patients who complete the Week 6 visit will continue taking daily oral Fx 1006A 20 mg for up to a total of 12 months during Part 2 of this study. If it is determined that a patient is not stabilized at Week 6 (based on TTR stabilization data), the patient will be discontinued from the study. Safety and clinical outcomes will be evaluated during Part 2 of this study. Two whole blood samples for pharmacodynamic assessments (TTR stabilization) and pharmacokinetic assessments (Fx-1006A concentrations as well as calculated steady-state parameters) will be collected at Baseline and Week 6. At Months 6 and 12, two whole blood samples will be collected for pharmacodynamic assessments, and four whole blood samples (two samples per time point) will be collected for pharmacokinetic assessments to be utilized in population pharmacokinetic modeling. Echocardiography, chest x-ray, cardiac MRI, and 24-hour Holter monitoring will be conducted at Baseline, and Months 6 and 12. Six-minute walk test and quality of life utilizing the Patient Global Assessment, KCCQ, and SF-36 will be assessed at Baseline, and Months 3, 6, and 12. NYHA Classification will be assessed at Baseline, Week 6, and Months 3, 6, and 12. Serum markers of troponin I and T, and NT-pro-BNP levels will be assessed at each study visit. Safety and tolerability will be assessed throughout the study. Vital signs, 12-lead ECG, blood and urine samples for clinical laboratory tests (serum chemistry, hematology, coagulation panel, and urinalysis), AEs, and concomitant medications (including diuretic usage) will be assessed at each study visit. Abbreviated physical examinations will be conducted at Baseline, Weeks 2 and 6, and Months 3 and 6, and a complete physical examination will be conducted at Month 12. Clinic visits will be conducted during Screening (Days -30 to -1) and Baseline (Day 0); procedures scheduled for the Baseline visit may be conducted over a period of one week to accommodate patient scheduling. All Baseline procedures must be completed prior to the first self-administered dose on Day 1. Day 1 will be defined as administration of the first dose of study medication, which patients will self-administer at home. During treatment, clinic visits will be conducted at Week 2 (± 2 days), Week 6 (± 1 week), Month 3 (± 1 week), Month 6 (± 2 weeks), and Month 12 (± 2 weeks). Procedures scheduled for the Month 6 and 12 visits may occur over one week during the visit window to accommodate patient scheduling. Monthly telephone contacts (± 1 week of the scheduled date) will be made during months in which no clinical site visits are scheduled (Months 4, 5, 7, 8, 9, 10, and 11) for assessment of AEs and concomitant medications. A final telephone contact to assess AEs and concomitant medication usage will be made 30 days after the last dose of study medication for each patient. Patients who discontinue from the study at any time will have a final visit performed, including all safety assessments, at the time of discontinuation. Any patient discontinuing after the Month 6 visit will also have all exploratory assessments performed.

NCT00694161
Conditions
  1. Cardiomyopathy
Interventions
  1. Drug: Fx-1006A
MeSH:Cardiomyopathies
HPO:Cardiomyopathy

The Effects Of Fx-1006A On Transthyretin Stabilization And Clinical Outcome Measures In Patients With V122I Or Wild-Type TTR Amyloid Cardiomyopathy. --- V122I ---

The Effects Of Fx-1006A On Transthyretin Stabilization And Clinical Outcome Measures In Patients With V122I Or Wild-Type TTR Amyloid Cardiomyopathy Open-label, multicenter, international, single-treatment study designed to determine TTR stabilization as well as Fx-1006A safety and tolerability, and its effects on clinical outcomes in patients with V122I or wild-type TTR amyloid cardiomyopathy. --- V122I ---

The Effects Of Fx-1006A On Transthyretin Stabilization And Clinical Outcome Measures In Patients With V122I Or Wild-Type TTR Amyloid Cardiomyopathy Open-label, multicenter, international, single-treatment study designed to determine TTR stabilization as well as Fx-1006A safety and tolerability, and its effects on clinical outcomes in patients with V122I or wild-type TTR amyloid cardiomyopathy. --- V122I --- --- V122I ---

TTR amyloid cardiomyopathy is defined as: 1. Variant TTR amyloid cardiomyopathy as defined as: V122I genotype and presence of amyloid in cardiac biopsy tissue (as determined by congo red stain, alcin blue stain, or immunohistochemical TTR analysis), or 2. Variant TTR amyloid cardiomyopathy as defined as: V122I genotype, evidence of cardiac involvement by echocardiography with left ventricle wall thickness > 12 mm and presence of amyloid in non-cardiac biopsy tissue (as determined by congo red stain, alcin blue stain, or immunohistochemical TTR analysis), or 3. Wild-type TTR amyloid cardiomyopathy as defined as: normal TTR genotype and presence of TTR amyloid deposits in cardiac biopsy tissue (as determined by congo red stain and immunohistochemical TTR analysis), or 4. Wild-type TTR amyloid cardiomyopathy as defined as: normal TTR genotype, evidence of cardiac involvement by echocardiography with left ventricle wall thickness > 12 mm and presence of TTR amyloid deposits in non-cardiac biopsy tissue (as determined by congo red stain and immunohistochemical TTR analysis). --- V122I ---

TTR amyloid cardiomyopathy is defined as: 1. Variant TTR amyloid cardiomyopathy as defined as: V122I genotype and presence of amyloid in cardiac biopsy tissue (as determined by congo red stain, alcin blue stain, or immunohistochemical TTR analysis), or 2. Variant TTR amyloid cardiomyopathy as defined as: V122I genotype, evidence of cardiac involvement by echocardiography with left ventricle wall thickness > 12 mm and presence of amyloid in non-cardiac biopsy tissue (as determined by congo red stain, alcin blue stain, or immunohistochemical TTR analysis), or 3. Wild-type TTR amyloid cardiomyopathy as defined as: normal TTR genotype and presence of TTR amyloid deposits in cardiac biopsy tissue (as determined by congo red stain and immunohistochemical TTR analysis), or 4. Wild-type TTR amyloid cardiomyopathy as defined as: normal TTR genotype, evidence of cardiac involvement by echocardiography with left ventricle wall thickness > 12 mm and presence of TTR amyloid deposits in non-cardiac biopsy tissue (as determined by congo red stain and immunohistochemical TTR analysis). --- V122I --- --- V122I ---

2. Patient has a TTR mutation other than V122I. --- V122I ---

Primary Outcomes

Description: TTR tetramer was assessed using a validated immunoturbidimetric assay. The Fraction of Initial (FOI) is the ratio of the measured TTR tetramer concentration after denaturation to the measured TTR tetramer concentration before denaturation. TTR tetramer stabilization is based on the difference between the on-treatment FOI and the baseline FOI expressed as a percentage of the baseline FOI.

Measure: Percentage of Participants With Stabilized Transthyretin (TTR Tetramer) at Week 6

Time: Week 6

Secondary Outcomes

Description: TTR tetramer was assessed using a validated immunoturbidimetric assay. The Fraction of Initial (FOI) is the ratio of the measured TTR tetramer concentration after denaturation to the measured TTR tetramer concentration before denaturation. TTR tetramer stabilization is based on the difference between the on-treatment FOI and the baseline FOI expressed as a percentage of the baseline FOI.

Measure: Percentage of Participants With Stabilized Transthyretin (TTR Tetramer) at Month 6 and 12

Time: Month 6, Month 12

Other Outcomes

Description: An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Treatment-emergent are events between first dose of study drug and up to 30 days after last dose that were absent before treatment or that worsened relative to pretreatment state.

Measure: Number of Participants With Treatment-Emergent Adverse Events (AEs)

Time: Baseline up to 30 days after the last dose

Description: An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Treatment-emergent are events between first dose of study drug and up to 30 days after last dose that were absent before treatment or that worsened relative to pretreatment state. On the basis of intensity, grade 3 was referred as severe, grade 4 as life-threatening and grade 5 as death.

Measure: Number of Participants With Greater Than or Equal to (>=) Grade 3 Treatment-Emergent AEs

Time: Baseline up to 30 days after the last dose

Description: ECHO:investigator assessed test to assess cardiac function.ECHO abnormality criteria:any/valvular abnormality,pericardial effusion,abnormal regional wall motion,inferior vena cava respiratory variation,posterior left ventricular wall/septal thickness>=13 millimeter(mm),right ventricular thickness>=7mm,ejection fraction <50%, ratio of early (E) diastolic transmitral flow and atrial(A) contraction velocity (E/A)>=2, ratio of 'E'to lateral/septal mitral annular velocity (e') (E/e'prime lateral>15, E/e'prime septal>15), E deceleration time<=150 millisecond(msec),Isovolumic relaxation time<=70msec.

Measure: Number of Participants With Clinically Significant Treatment-Emergent Echocardiography (ECHO) Findings

Time: Baseline up to Month 12

Measure: Number of Participants Discontinuing From The Study Due to Clinically Significant Clinical or Laboratory Adverse Events (AEs)

Time: Baseline up to Month 12

Description: Echocardiography was used to measure interventricular septal thickness (IVST), posterior left ventricular wall thickness (PLVWT), right ventricular wall thickness (RVWT), left atrial diameter (LAD): anterior-posterior (ant-post), medio-lateral, superior-inferior (sup-inf) and left ventricular end diastolic diameter (LVEDD).

Measure: Change From Baseline in Echocardiographic (ECHO) Parameters at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: LVM was defined as increase in the mass of left ventricle, estimated by echocardiography. Increased LVM was associated with cardiovascular morbidity and mortality.

Measure: Change From Baseline in Left Ventricular Mass (LVM) at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Left ventricular ejection fraction (LVEF) was the fraction of the end-diastolic volume (EDV) that is ejected out of left ventricle with each contraction, estimated by echocardiography. EDV is the volume of blood within a ventricle immediately before a contraction.

Measure: Change From Baseline in Left Ventricular Ejection Fraction at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Doppler echocardiography was a procedure which used ultrasound technology to examine the heart. Ratio of early (E) diastolic transmitral flow velocity and atrial (A) contraction velocity (E/A) and ratio of the early (E) diastolic transmitral flow velocity to the mitral annular velocity (e') (E/e') were estimated.

Measure: Change From Baseline in Doppler Data: E/A and E/e' Ratio at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Doppler echocardiography was a procedure which used ultrasound technology to examine the heart. The mitral deceleration time was the time taken from the maximum E wave to baseline. E wave arises due to early diastolic filling.

Measure: Change From Baseline in Doppler Data: Mitral Deceleration Time at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Tissue Doppler used doppler principles to measure the annular velocities at the lateral and septal areas of the mitral annulus. s': systolic velocity during ejection, e': early diastolic mitral annular velocity, a': late diastolic mitral annular velocity.

Measure: Change From Baseline in Tissue Doppler- Septal and Lateral Velocity at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Pericardial effusion was the presence of an abnormal amount of fluid in the pericardial cavity, as determined by echocardiography.

Measure: Change From Baseline in Pericardial Effusion at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Valvular abnormalities were those abnormalities (thickening or regurgitation) that involved one or more valves of the heart, determined by echocardiography.

Measure: Number of Participants With Change From Baseline in Valvular Abnormalities at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac Magnetic Resonance Imaging (MRI) was done to measure the thickness of left ventricular anteroseptal (LVAS) wall, left ventricular inferolateral (LVIL) wall and right ventricular end diastolic free (RVEDF) wall.

Measure: Change From Baseline in Left Ventricular Anteroseptal, Left Ventricular Inferolateral Wall Thickness and Right Ventricular End Diastolic Free Wall Thickness at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure LVM, mass of left ventricular (LV) myocardium with amyloidosis, mass of LV myocardium with fibrosis/scar and right ventricular end diastolic mass (RVEDM).

Measure: Change From Baseline in Left Ventricular Mass, Mass of Left Ventricular Myocardium With Amyloidosis, Mass of Left Ventricular Myocardium With Fibrosis/Scar and Right Ventricular End Diastolic Mass at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure left ventricle end diastolic volume (LVEDV), left ventricle end systolic volume (LVESV), left ventricle stroke volume (LVSV), right ventricle end diastolic volume (RVEDV), right ventricle end systolic volume (RVESV) and right ventricle stroke volume (RVSV).

Measure: Change From Baseline in Left Ventricle End Diastolic Volume, Left Ventricle End Systolic Volume, Left Ventricle Stroke Volume, Right Ventricle End Diastolic Volume, Right Ventricle End Systolic Volume, Right Ventricle Stroke Volume at Month 6 and 12.

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure: left ventricular ejection fraction (LVEF) was the fraction of the EDV that is ejected out of left ventricle with each contraction and right ventricular ejection fraction (RVEF) was the fraction of the EDV that is ejected out of right ventricle with each contraction. EDV is the volume of blood within a ventricle immediately before a contraction.

Measure: Change From Baseline in Left Ventricular Ejection Fraction and Right Ventricular Ejection Fraction at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure cardiac output, which was the volume of blood being pumped by the heart, in particular by the left or right ventricle in the time interval of one minute.

Measure: Change From Baseline in Left Ventricular Cardiac Output and Right Ventricular Cardiac Output at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure percentage of LV myocardial mass with amyloidosis and LV myocardial mass with fibrosis/scar. LV myocardial mass with amyloidosis or fibrosis/scar was calculated from the product of the myocardial volume and specific gravity of heart muscle, in participants with amyloidosis or fibrosis/scar, respectively.

Measure: Change From Baseline in Percentage of Left Ventricular Myocardial Mass With Amyloidosis and Left Ventricular Myocardial Mass With Fibrosis/Scar at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure interatrial septal thickness in the 4 chamber view.

Measure: Change From Baseline in 4 Chamber Interatrial Septal Thickness at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Cardiac MRI was done to measure the left and right atrial dimensions which have diagnostic and prognostic significance in cardiology, in the 4 chamber view.

Measure: Change From Baseline in 4 Chamber Left Atrial Dimension and 4 Chamber Right Atrial Dimension at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Holter monitor was a machine that recorded the heart rhythms. Holter monitoring abnormalities of atrial fibrillation/flutter (rapid, irregular heart rhythm), atrial tachycardia (rapid cardiac rate), non-sustained ventricular tachycardia (NSVT)<30 beats, sustained ventricular tachycardia (SVT) >=30 beats and sinus pause (transient interruption in the sinus rhythm) were recorded.

Measure: Number of Participants With Atrial Fibrillation/Flutter, Atrial Tachycardia, Non-Sustained Ventricular Tachycardia (NSVT) Beats), Sustained Ventricular Tachycardia (SVT), Sinus Pause at Month 6 and 12

Time: Baseline, Month 6, Month 12

Description: Holter monitor was a machine that recorded the heart rhythms. 24-hour average heart rate and maximium/minimum heart rate was recorded using Holter monitoring.

Measure: 24-Hour Average Heart Rate and Maximium/Minimum Heart Rate

Time: Baseline, Month 6, Month 12

Description: Complete heart block is the third-degree atrioventricular block in which the impulse generated in the sinoatrial node in the atrium does not propagate to the ventricles.

Measure: Number of Participants With Complete Heart Block

Time: Baseline, Month 6, Month 12

Description: Holter monitor was a machine that recorded the heart rhythms. HRV time-domain indices were summarized for root-mean-square of successive differences [RMS SD] of the R-R intervals (R-R is the interval between successive Rs in the ECG wave) between normal beats (NN), magid standard deviation (Magid SD) of normal to normal R-R intervals and Kleiger standard deviation of normal to normal R-R intervals (Kleiger SD). The term 'NN' is used in place of 'R-R' when the processed beats are normal beats.

Measure: Heart Rate Variability (HRV)- Standard Deviation (SD) Parameters

Time: Baseline, Month 6, Month 12

Description: Holter monitor was a machine that recorded the heart rhythms. The term 'NN' was used in place of 'R-R' when the processed beats are normal beats. The percentage of successive R-R intervals with greater than 50 msec difference between normal beats was derived by dividing NN50 by the total number of NN intervals (pNN50), where NN50 was the number of interval differences of successive NN intervals greater than 50 msec.

Measure: Heart Rate Variability- Percentage of Successive R-R Intervals With Greater Than 50 Msec Difference Between Normal Beats (pNN50)

Time: Baseline, Month 6, Month 12

Description: NYHA: classified as 'class I' (participants with cardiac disease but without resulting limitations of physical activity), 'class II' (participants with cardiac disease resulting in slight limitation of physical activity), 'class III' (participants with cardiac disease resulting in marked limitation of physical activity), 'class IV' (participants with cardiac disease resulting in inability to carry on any physical activity without discomfort). Participants with change from baseline were classified as 'improved' (positive change), 'no change' or 'worsened' (negative change).

Measure: Number of Participants With Change From Baseline in New York Heart Association (NYHA) Classification at Week 6, Month 3, 6 and 12

Time: Baseline, Week 6, Month 3, Month 6, Month 12

Description: Cardiothoracic ratio was defined as the transverse diameter of the heart, compared with that of the thoracic cage, used to help determine enlargement of the heart.

Measure: Cardiothoracic (CT) Ratio

Time: Baseline, Month 6, Month 12

Description: Chest x-ray was done to record the presence of increased interstitial markings (a large number of interstitial markings was indicative of abnormality in the lung) and pleural effusion, which was defined as accumulation of fluid between the layers of tissue that line the lungs and chest cavity.

Measure: Number of Participants With Increased Interstitial Markings and Pleural Effusions

Time: Baseline, Month 6, Month 12

Description: Participant's overall quality of life was measured by the PtGA. At baseline participants answered to question: "in general, how do you feel today?" - on a 5-point scale from '1' (excellent) to '5' (poor). At each follow-up visit, participant's answered to question: "How do you feel today as compared to when we talked with you at your last clinic visit for this study?" on a 7-point scale- '1' markedly improved, '2' moderately improved, '3' mildly improved, '4' unchanged, '5' mildly worsened, '6' moderately worsened, '7' markedly worsened.

Measure: Number of Participants With Change in Patient Global Assessment (PtGA) at Month 3, 6 and 12

Time: Baseline, Month 3, Month 6, Month 12

Description: KCCQ was a 23-item heart failure specific questionnaire quantified in to following 10 summary scores: physical limitation, symptom frequency, symptom severity, and symptom stability, total symptoms, quality of life, social interference, self-efficacy, overall summary and clinical summary. Total score ranged from 0 to 100, where higher scores indicated better functioning, fewer symptoms, and better disease specific quality of life. Summary scores were scaled to range from 0 to 100, with higher scores representing greater disability.

Measure: Change From Baseline in Kansas City Cardiomyopathy Questionnaire (KCCQ) Score at Month 3, 6 and 12

Time: Baseline, Month 3, Month 6, Month 12

Description: SF-36 was standardized survey evaluating 8 aspects of functional health and well being: physical and social functioning, physical and emotional role limitations, bodily pain, general health, vitality, mental health. Scores for the 8 domains range from 0-100, where higher scores were better (100=highest level of functioning) and reported as 2 summary scores; Mental Component Score (MCS) and Physical Component Score (PCS). The score for a section was an average of the individual question scores, which were scaled 0-100, where higher scores were better.

Measure: Change From Baseline in the Short Form 36 (SF-36) at Month 3, 6 and 12

Time: Baseline, Month 3, Month 6, Month 12

Description: Troponin I and troponin T were the cardiac markers. Troponin I and troponin T were part of the troponin complex, where troponin I was bound to actin in thin myofilaments and troponin T was bound to tropomyosin. Higher level of these markers was indicative of heart damage.

Measure: Change From Baseline in Troponin I and Troponin T at Week 2, 6, Month 3, 6 and 12

Time: Baseline, Week 2, Week 6, Month 3, Month 6, Month 12

Description: NT-proBNP was a cardiac marker which had the prognostic value for participants with heart failure or left ventricular dysfunction. Higher level of the marker was indicative of heart damage.

Measure: Change From Baseline in N-Terminal Prohormone Brain Natriuretic Peptide(NT-proBNP) Levels at Week 2, 6, Month 3, 6 and 12

Time: Baseline, Week 2, Week 6, Month 3, Month 6, Month 12

Description: 6MWT was used to assess the distance that a participant could walk in 6 minutes. Participants were asked to perform the test at a pace that was comfortable to them, with as many breaks as they needed. Continuous pulse oximetry was conducted during the test for safety.. The distance walked in 6 minutes was categorized as: Level 1: <300 meter, Level 2: 300-374.9 meter, Level 3: 375-449.9 meter, Level 4: >=450 meter.

Measure: Change From Baseline in 6-Minute Walk Test (6MWT) at Month 3, 6 and 12

Time: Baseline, Month 3, Month 6, Month 12

2 A Phase 4 Multicenter Observational Study to Evaluate the Effectiveness of Patisiran in Patients With Polyneuropathy of Hereditary Transthyretin-Mediated (ATTRv) Amyloidosis With a V122I or T60A Mutation

To evaluate the effectiveness of patisiran in patients with ATTRv amyloidosis with polyneuropathy who have a V122I or T60A mutation.

NCT04201418
Conditions
  1. Hereditary Transthyretin-mediated (ATTRv) Amyloidosis
  2. Polyneuropathy
Interventions
  1. Drug: Patisiran
MeSH:Polyneuropathies Amyloidosis
HPO:Amyloidosis Motor polyneuropathy Polyneuropathy

A Phase 4 Multicenter Observational Study to Evaluate the Effectiveness of Patisiran in Patients With Polyneuropathy of Hereditary Transthyretin-Mediated (ATTRv) Amyloidosis With a V122I or T60A Mutation. --- V122I ---

A Multicenter Observational Study to Evaluate the Effectiveness of Patisiran in Patients With Polyneuropathy of ATTRv Amyloidosis With a V122I or T60A Mutation To evaluate the effectiveness of patisiran in patients with ATTRv amyloidosis with polyneuropathy who have a V122I or T60A mutation. --- V122I ---

A Multicenter Observational Study to Evaluate the Effectiveness of Patisiran in Patients With Polyneuropathy of ATTRv Amyloidosis With a V122I or T60A Mutation To evaluate the effectiveness of patisiran in patients with ATTRv amyloidosis with polyneuropathy who have a V122I or T60A mutation. --- V122I --- --- T60A --- --- V122I ---

PND Scores: Stage 0=No symptoms, Stage 1=Sensory disturbances but preserved walking capability, Stage 2=Impaired walking capacity, but ability to walk without a stick or crutches, Stage 3A/B=Walking with the help of 1 or 2 sticks or crutches, Stage 4=confined to wheel chair or bedridden.. Inclusion Criteria: - Diagnosed with ATTRv amyloidosis with polyneuropathy, with a documented V122I or T60A mutation - PND score of I-IIIB at baseline. --- V122I ---

Exclusion Criteria: - New York Heart Association (NYHA) heart failure classification ≥3 - Karnofsky Performance Status (KPS) <60% - Unstable congestive heart failure (CHF) - Known primary amyloidosis (AL) or leptomeningeal amyloidosis - Prior major organ transplant - Previously received patisiran - Previous treatment with a TTR silencing therapy Inclusion Criteria: - Diagnosed with ATTRv amyloidosis with polyneuropathy, with a documented V122I or T60A mutation - PND score of I-IIIB at baseline. --- V122I ---

Primary Outcomes

Description: PND Scores: Stage 0=No symptoms, Stage 1=Sensory disturbances but preserved walking capability, Stage 2=Impaired walking capacity, but ability to walk without a stick or crutches, Stage 3A/B=Walking with the help of 1 or 2 sticks or crutches, Stage 4=confined to wheel chair or bedridden.

Measure: Percentage of Participants with Stable or Improved Polyneuropathy Disability (PND) Score at 12 Months Relative to Baseline

Time: Baseline, Month 12

3 Screening for Cardiac Amyloidosis Using Nuclear Cardiology for Minority Populations

In this study, the investigators will recruit a cohort of elderly Black and Hispanic patients with heart failure to define the number of patients who have cardiac amyloidosis by utilizing highly sensitive heart imaging and blood tests. The investigators will also explore differences in genetics and sex as they relate to heart failure disease progression in cardiac amyloidosis.

NCT03812172
Conditions
  1. Amyloid Cardiomyopathy, Transthyretin-Related
Interventions
  1. Drug: 99mTc-PYP
MeSH:Cardiomyopathies Amyloidosis
HPO:Amyloidosis Cardiomyopathy

Among subjects with ATTR-CA we will determine the prevalence of ATTRwt and ATTRm from the Val122Ile mutation in Blacks and Caribbean Hispanics. --- Val122Ile ---

For hATTR, a substitution of isoleucine for valine (Val122Ile) is the most frequent TTR mutation in the US, observed exclusively in Black Americans with an allele frequency of 3.4%. --- Val122Ile ---

Primary Outcomes

Description: The prevalence of ATTR CA will be defined by the number of cases with significant myocardial retention of Tc-99 PYP including both ATTRwt and ATTRm CA as a percentage of total enrollment.

Measure: Prevalence of Transthyretin Cardiac Amyloidosis in Caribbean Hispanics and Blacks with heart failure (HF)

Time: 5 years

Secondary Outcomes

Description: Among subjects with ATTR-CA we will determine the prevalence of ATTRwt and ATTRm from the Val122Ile mutation in Blacks and Caribbean Hispanics

Measure: Prevalence of ATTRwt and ATTRm in Blacks and Caribbean Hispanics

Time: 5 years

Description: The prevalence of ATTR cardiac amyloidosis will be calculated among men and women enrolled in this study

Measure: Sex distribution of ATTR cardiac amyloidosis

Time: 5 years

Description: In the ATTR CA group alone, a composite time-to-first-event endpoint at 1-year of death, heart failure hospitalization, or 30% decline in 6-minute hall walk will be compared between ATTRwt and ATTRm subjects.

Measure: Disease progression in ATTRwt compared to ATTRm

Time: 5 years

Description: Retinol binding protein 4 (RBB4) will be measured in urine.

Measure: RBP4 in Urine

Time: 5 years


HPO Nodes


HP:0001638: Cardiomyopathy
Genes 753
DSP UBR1 TRNK DSP PET100 ND6 CSRP3 TOP3A PEX3 NDUFS4 PEX6 COL7A1 TREX1 ACTN2 BAG3 PSEN1 ACADS LMNA NDUFAF4 AHCY MYBPC3 WARS2 GTF2IRD1 EPG5 DOLK GSN INSR ERCC6 POMGNT1 TTN COL7A1 SDHA CAVIN1 D2HGDH SLC25A4 ATP6V1A LAMA3 FANCM FKRP DSG2 ND1 ITPA BMP2 DSG2 TTR NBAS NDUFA2 HADHA GAA POLG TMEM43 LMNA ACTA1 LMNA PRKAG2 MYL3 SYNE1 ABCC9 PPCS RAD51C FKRP FHL1 GNPTAB CLIP2 COA5 JUP LAMA4 TAZ ANKRD11 SDHA TPM1 TARS1 NF1 RAF1 BAG3 SLC25A4 BRIP1 MYOZ2 DES TKFC PMM2 CRYAB NRAS TPM2 BRAF EMD COX1 SCO2 TXNRD2 FIG4 ELN DSG2 HJV SLC19A2 TCAP TWNK EYA4 ARSB FANCG NDUFV2 NDUFAF5 HFE DLD TERT GNS SLC40A1 SURF1 USP9X SHOC2 ND4 POLG SLC25A20 NDUFS8 MLYCD CHKB TTR TPM2 SPEG LAMP2 SDHAF1 MYH6 TXNRD2 SHOC2 KRAS XYLT1 HAMP SUFU TRNW NEB ADCY5 MRAP PIGT FHL1 PTPN11 POMT2 PSEN2 BCS1L TPM2 MRPS22 NDUFB11 PCCA RNU4ATAC GLA CLN3 RAF1 HSD17B10 TNNT2 GNE MYBPC3 MTO1 ATP5F1D FANCD2 GATA5 FKTN MAP2K2 AGL JUP GPC4 MYOCD H19-ICR TRNV NAGA RMND1 TMEM70 NDUFAF6 FAH MEFV ACAD8 PYGM NDUFB10 MAP3K20 POMT1 FKTN NF1 CSRP3 ERCC8 GYS1 FANCL KRAS MAP2K2 NDUFB11 SLC25A4 ENPP1 NDUFA11 NDUFS3 GSN MYOT HJV ACADVL HRAS CAP2 MRPL3 COX10 TAPT1 EPB42 VPS33A VPS13A LDB3 NAGA XYLT2 MYH6 COX15 NDUFA12 HRAS XK TTN SLC25A20 TRNS1 TRNH PTPN11 SDHA TPM1 AGPAT2 TREX1 SCO2 LMNA AIP STAR ND2 ND5 IFIH1 DES FHL1 USP8 LMNA FANCF ND1 ACADVL BRCC3 ND4 LAMA4 LDB3 TKFC FOXRED1 MICOS13 PCCB KIF20A GTPBP3 TMEM126A UQCRFS1 GPR101 PPARG MYH7 TRNQ ATP5MK ATP6 PLN PCCA TCAP KCNH1 TRNN SLC19A3 MYLK2 PEX13 NDUFB11 FLAD1 RBCK1 HNRNPA2B1 MYL2 RNASEH2B TRNE FIG4 XRCC4 COA6 NDUFAF8 AHCY ATPAF2 ND3 ACAD9 TRNK LAMA2 SLC4A1 PDHA1 GUSB ADCY5 FBXL4 MMACHC BRAF HADHB DES FANCI NUP107 SLC22A5 NDUFS2 GMPPB HACD1 HBB HADH MYBPC3 NEXN TTN SELENON ABCC6 TAZ TNNT2 MRPS14 TRNF LMNA ALMS1 VCP CDKN1C ECHS1 IDUA KANSL1 NDUFV1 HMGCL MIB1 LAMP2 ABCC9 GPC3 DTNA NDUFS2 PEX14 RNASEH2A TRNS2 SPTB TIMMDC1 AGPAT2 RBM20 SGCB NDUFA13 LMNA NDUFA4 TGFB3 ND1 FANCA DLD IDUA GATAD1 VCL PTPN11 MYH7 RMRP TTN TNNC1 NNT NPPA PEX7 ABHD5 NDUFAF3 MYPN KCNQ1OT1 MGME1 EPG5 TNNI3 ATP5F1E NDUFS4 SLC25A3 TACO1 DSP ANK1 ANKRD1 SYNE2 PPP1CB MMUT POLG2 POLG JPH2 PEX7 ACTA1 NDUFS3 PHYH LIPT1 PHYH FASTKD2 MYSM1 TRNL1 IDS MYH7 PLN MC2R BSCL2 ATAD3A LIMS2 CRYAB ACTC1 TNNT2 JUP CAV1 BRAF SGCD RTL1 FXN SCN5A NDUFA11 TSFM INSR TNNT2 NDUFB9 WFS1 NDUFA10 ND2 PEX7 PMM2 PPA2 CDH23 TTPA EYA4 KAT6B DPM3 CRYAB YARS2 SLC2A10 NDUFS8 NDUFB8 SMC1A TNNC1 SLC30A10 CPT2 NDUFS7 NDUFS6 PALB2 TRNK POMT1 GMPPB IL12B FKTN VCL COQ4 TBL2 PIGT RRM2B SYNE2 FLNC NDUFS8 FANCE SDHD PDGFRA HCCS HCCS TGFB1 DCAF8 PNPLA2 POMT1 LMNA NDUFAF5 NDUFB11 MPLKIP PLN RFC2 GYG1 LAMC2 SDHB RNASEH1 NDUFS1 GATA4 RNASEH2C MYH6 LMNA KLHL41 FANCC PYGL RRM2B LMNA LIMK1 DMD NDUFA10 FLNC DSP SDHAF1 MYO18B GTPBP3 NEB POMK TPM3 SDHA TWNK TRNT SURF1 NDUFAF1 ATAD3A RIT1 BRCA1 NDUFA6 TANGO2 GATC MYH6 SGCD ACTC1 TMPO NDUFS2 FKTN SPTA1 MLX VAC14 DMD ND3 HAND2 KLF1 TAZ ANKS6 BRCA2 FOXRED1 TPM3 NUP107 IDS MYOT RNF113A BRAF RAF1 FKRP TNNI3K PEX16 FXN TRNS1 TNNT2 FOXRED1 TRIP4 DNAJC19 MAP2K1 CISD2 CPT2 PRDM16 POLG PRKAG2 FLNC NDUFS7 MRPL44 MYPN NDUFA1 ITGA7 NUBPL ERCC2 TAF1A RAB3GAP2 TK2 BSCL2 PPCS COX15 COX2 COQ2 NDUFA2 TNNI3 HADHA NF1 DES ACTN2 ACTA1 TNNC1 DSP NDUFB3 COX3 PEX12 TNNI3 TMEM126B GPC3 AGK HADH NDUFV2 GATAD1 ACAD9 GNPTAB IDUA ACTA1 HBB GBE1 RERE TFR2 POLG HADHB TPM1 MAD2L2 PRDM16 LTBP4 NEU1 SKI AIP NDUFAF3 NDUFAF2 TNNI3 RBM20 FANCB MYH7 TRNW PEX2 PEX10 MTFMT SDHD SLX4 SLC25A4 BAG3 GLB1 ALMS1 KRAS PGM1 COX7B ANO5 PARS2 TNNI3 DPM3 BBS2 FHL2 GABRD LMNA SOS1 HAMP NDUFAF2 DMPK PEX26 MYH7 CRYAB PNPLA2 SURF1 RYR2 SGCA NDUFS1 SAMHD1 C1QBP HPS1 NDUFV1 KBTBD13 TREX1 RAF1 MGME1 ABCC6 UBE2T CENPE GTF2I WARS2 MYH7 DMD COG7 TWNK HGSNAT LAMB3 DSC2 KCNQ1 TMEM126B KANSL1 GTF2H5 NEK8 FHL1 FTO CLPB LDB3 OPA1 NDUFB10 ALG1 PRKAG2 TWNK RYR1 DNAJC19 PSEN2 HADHA COX14 HADHA MAP2K1 RNU4ATAC HFE AIP NDUFS2 ELAC2 CPT1A MAP2K1 TMEM70 SELENON PCCB NDUFAF4 NEXN ERCC4 ERBB3 VCL NEXN RAD51 ATAD3A AARS2 TRNT1 QRSL1 NDUFA9 MMUT HSD17B10 SCN5A XRCC2 MYH7 PEX19 NAGLU TRNL1 ACTC1 PEX5 ADA2 DOLK HNRNPA1 TPM3 CPT2 MYPN ADAR DMD SLC25A3 MYL2 MEN1 RFWD3 NDUFV2 ND5 HSD17B10 GPC4 SARDH COX6B1 ND6 FOS HLA-B MMP1 BOLA3 TNNI3 GMPPB MEG3 NDUFS4 PRDM16 AGK KCNJ8 IDH2 DLK1 PEX11B TPI1 LIAS PPARG NAXD PSEN1 WFS1 GTF2E2 ACAD8 PKP2 SGSH MYPN ABCC9 MYPN IGF2 BAZ1B VHL JUP ALG1 NDUFAF1 POMT1 RAF1 MIPEP PEX1 COX7B CPT2 ATP6 NEBL LDB3 ERCC3 COA8 CAV3 CSRP3 DMD SGCB KCNAB2 TMEM43 VPS33A POMT2 GJA5 TRNL1 SDHA