What is the Purpose of this Study?
The purpose of this study is to determine whether tafamidis, an oral medication used to delay disease progression in adults with certain forms of transthyretin amyloidosis (ATTR), is effective in treating patients with heart transplants that also have ATTR, including managing non-cardiac manifestations such as neuropathy. Neuropathy may include symptoms like numbness, tingling, imbalance, constipation, diarrhea, or low blood pressure. Participants will undergo screening that includes a blood draw, physical exam, medical history review, and completion of quality-of-life surveys. Once screening is complete, participants will begin taking tafamidis daily for 12 months. Tafamidis has been approved by the U.S. Food and Drug Administration (FDA) to treat cardiac ATTR, but its use in this study is considered investigational.
Eligibility
- * Has received orthotopic heart transplantation for end-stage ATTRv or ATTRwt ≥12 months prior to screening. Concomitant hepatic and renal transplantation with adequate allograft function are included.
- * Has a stable immunosuppressive regimen and ≤ 10 mg of prednisone (or equivalent) at time of enrollment.
- * Has a Karnofsky performance status ≥ 70%
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Inclusion Criteria:
- * Has received orthotopic heart transplantation for end-stage ATTRv or ATTRwt ≥12 months prior to screening. Concomitant hepatic and renal transplantation with adequate allograft function are included.
- * Has a stable immunosuppressive regimen and ≤ 10 mg of prednisone (or equivalent) at time of enrollment.
- * Has a Karnofsky performance status ≥ 70%
Exclusion Criteria:
- * Has previously received inotersen within the past 180 days, patisiran within the past 90 days, tafamidis within the past 14 days, or diflunisal in the past 14 days.
- * Participating in a clinical trial for ATTR targeted therapies.
- * Has an estimated glomerular filtration rate (eGFR) ≤ 15 ml/min/1.73 m2
- * Has known leptomeningeal or AL amyloidosis
- * Has active post-transplant lymphoproliferative disease
- * Excluding non-melanomatous skin cancers, has an active malignancy.
- * Has active infection with hepatitis B, hepatitis C, human immunodeficiency virus, or cytomegalovirus (CMV). For CMV, donor/ recipient exposure status and prior treated CMV disease on stable doses of antiviral therapies are not excluded.
- * Has cardiac allograft dysfunction defined by left ventricular ejection fraction (LVEF) \<50% by echocardiogram within the past 3 months
- * Has been treated for acute cellular or antibody mediated rejection in the past 3 months
- * Has criteria to meet International Society for Heart and Lung Transplantation standardized nomenclature for severe coronary allograft vasculopathy ("ISHLT CAV3")
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Where can I participate?
Beverly
More about this Clinical Trial
What is the full name of this clinical trial?
Safety, Efficacy, and Pharmacokinetics of Tafamidis in Patients With Transthyretin-mediated Amyloidosis Post Orthotopic Heart Transplantation