**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.**
Richa Manwani, AstraZeneca, London, United Kingdom

**Main Body of the Abstract**
Background
AL amyloidosis (AL) with renal involvement confers significant morbidity. We characterised renal outcomes in these patients using U.S. EMR TriNetX database.

Methods
Adults with renal involvement receiving bortezomib or daratumumab at index (between July 2016-June 2023) were included. Exclusion criteria included prior AL treatment, myeloma, baseline end-stage renal disease (ESRD), dialysis or renal transplant. Palladini Renal Stages I, II and III were defined as none, one or both, respectively, of eGFR<50ml/min and proteinuria >5g/day. Graded renal response criteria (without ≥25% eGFR decrease) were: renal complete response (renCR, proteinuria≤200mg/day), renal very good partial response (renVGPR, >60% proteinuria reduction), renal partial response (renPR, 31-60% reduction) and renal non-response (renNR, ≤30% reduction).

Results
265 patients with Palladini Renal Stage I (29.4%), II (51.3%) and III (19.3%) were treated with bortezomib-based (60%), daratumumab-based (8.3%) or bortezomib plus daratumumab-based regimens (31.7%). Of the bortezomib-based group (n=159), 7.5% and 32.1% subsequently received daratumumab in addition to/instead of bortezomib, respectively.
17% of all patients had ≥25% 1-year eGFR reduction. 2-year progression to ESRD was 10% (Palladini Stage III at greatest risk (p<0.001), Figure), and 2-year overall survival (OS ) was 77%. There was no difference in OS by treatment or renal stage.
Among 180 patients with serial proteinuria data, best renal responses within 1 year were: renCR 1.7%, renVGPR 43.3%, renPR 8.9%, renNR 46.1%. There was no significant difference in renal response by treatment group.

Conclusion
Only half of patients were renal-responders and few achieved renCR, highlighting considerable unmet need in AL patients with renal involvement.



**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.**
Richa Manwani, AstraZeneca, London, United Kingdom

**Main Body of the Abstract**
**Background**
AL amyloidosis (AL) with renal involvement confers significant morbidity. We characterised renal outcomes in these patients using U.S. EMR TriNetX database.

**Methods**
Adults with renal involvement receiving bortezomib or daratumumab at index (between July 2016-June 2023) were included. Exclusion criteria included prior AL treatment, myeloma, baseline end-stage renal disease (ESRD), dialysis or renal transplant. Palladini Renal Stages I, II and III were defined as none, one or both, respectively, of eGFR<50ml/min and proteinuria >5g/day. Graded renal response criteria (without ≥25% eGFR decrease) were: renal complete response (renCR, proteinuria≤200mg/day), renal very good partial response (renVGPR, >60% proteinuria reduction), renal partial response (renPR, 31-60% reduction) and renal non-response (renNR, ≤30% reduction).

**Results**
265 patients with Palladini Renal Stage I (29.4%), II (51.3%) and III (19.3%) were treated with bortezomib-based (60%), daratumumab-based (8.3%) or bortezomib plus daratumumab-based regimens (31.7%). Of the bortezomib-based group (n=159), 7.5% and 32.1% subsequently received daratumumab in addition to/instead of bortezomib, respectively.
17% of all patients had ≥25% 1-year eGFR reduction. 2-year progression to ESRD was 10% (Palladini Stage III at greatest risk (p<0.001), Figure), and 2-year overall survival (OS ) was 77%. There was no difference in OS by treatment or renal stage.
Among 180 patients with serial proteinuria data, best renal responses within 1 year were: renCR 1.7%, renVGPR 43.3%, renPR 8.9%, renNR 46.1%. There was no significant difference in renal response by treatment group.

**Conclusion**
Only half of patients were renal-responders and few achieved renCR, highlighting considerable unmet need in AL patients with renal involvement.



Outcomes in Patients with AL Amyloidosis with Renal Involvement: Findings from the TriNetX Database PA144 (#113)

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.