**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Abdirahman Wardhere
Cardiac Amyloidosis Program, Department of Cardiology, Columbia University Irving Medical, New York City, NY, USA

**Main Body of the Abstract**
Background: Transthyretin amyloidosis is currently treated with either stabilizers or silencers but given their different mechanism of action, there is interest in whether combination therapy has a role.
Aim: To compare the effects of combination therapy (tafamidis plus silencer) versus tafamidis monotherapy in transthyretin cardiac amyloid (ATTR-CM) patients.
Methods: A retrospective single-center cohort study of 155 patients (18 on combination therapy and 137 on tafamidis monotherapy) was conducted. Baseline biomarkers were measured at the start of the second medication for the combination therapy group and at tafamidis initiation for the monotherapy group. Death, cardiovascular-related hospitalizations (CVRH), composite death and CVRH, and all-cause hospitalizations, were compared and analyzed using Kaplan-Meier and Cox proportional hazard ratio models.
Results: At baseline, patients on combination therapy were younger (73 vs. 79 years), had a higher prevalence of variant type (44% vs. 16%), less symptom severity by NYHA scoring (5.6% in stages 3 or 4 vs. 40%), and slightly better eGFR (62 mL/min/1/0.73m2vs. 58 mL/min/1/0.73m2) than those on tafamidis monotherapy. There were no significant differences in outcomes [MM1] between the two treatment groups as shown by Kaplan Meier graphs (Figure 1). Furthermore, the multivariate Cox proportional hazard ratio, adjusted for the Columbia score, did not indicate any significant differences either.
Conclusions: This single center study comparing combination therapy and tafamidis monotherapy, suggests that combination therapy was not associated with benefits over tafamidis monotherapy in terms of mortality and cardiovascular hospitalization. Randomized trials are needed to determine the efficacy of combination therapy over monotherapy for ATTR-CM.



Comparison of Combination Therapy (Tafamidis Plus Silencer) vs. Tafamidis Monotherapy in Transthyretin Amyloid Cardiomyopathy: Single Center Retrospective Cohort Study PC97 (#42)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.