**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.**
Dimitrios Bampatsias, Columbia University Irving Medical Center, New York, USA

**Main Body of the Abstract**
Background: Tafamidis is the only currently approved treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). Recently, acoramidis, was shown to reduce cardiovascular-related hospitalizations (CVRH) compared to placebo. However, there are no evidence directly comparing the two stabilizers.
Aim: To compare the long-term effect of tafamidis vs acoramidis in patients with ATTR-CM.
Methods: This a retrospective cohort study including 10 patients receiving acoramidis treatment for a median of 60 (range 38-64) months and compared to patients taking tafamidis (n=137). Acoramidis treated patients (n=10) were matched 1:3 to tafamidis treated subjects (n=30) on age, gender, race, genotype, and disease severity based on Columbia score. We compared outcomes by Kaplan Meier analysis and by a hierarchical endpoint of all-cause mortality followed by CVRH using the win ratio.
Results: Among the entire cohort, there was a trend for better survival (log-rank test=0.13, Figure A) with acoramidis. Hierarchical analysis in the total cohort, resulted in a win ratio of 2.6 (1.31-5.16) favoring acoramidis (p=0.006, Figure B). Among the matched cohort, all-cause mortality did not differ between the two-groups (log-rank test=0.42, Figure C). Hierarchical analysis in the matched cohort revealed a win ratio of 1.88 (0.74 - 4.77) in favor of acoramidis (p=0.18, Figure D).
Conclusions: The present study, limited by a small sample size, showed for the first time that long term treatment with acoramidis compares favorably to tafamidis in terms of survival and CVRH.



**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.**
Dimitrios Bampatsias, Columbia University Irving Medical Center, New York, USA

**Main Body of the Abstract**
**Background:** Tafamidis is the only currently approved treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). Recently, acoramidis, was shown to reduce cardiovascular-related hospitalizations (CVRH) compared to placebo. However, there are no evidence directly comparing the two stabilizers.
**Aim:** To compare the long-term effect of tafamidis vs acoramidis in patients with ATTR-CM.
**Methods:** This a retrospective cohort study including 10 patients receiving acoramidis treatment for a median of 60 (range 38-64) months and compared to patients taking tafamidis (n=137). Acoramidis treated patients (n=10) were matched 1:3 to tafamidis treated subjects (n=30) on age, gender, race, genotype, and disease severity based on Columbia score. We compared outcomes by Kaplan Meier analysis and by a hierarchical endpoint of all-cause mortality followed by CVRH using the win ratio.
**Results:** Among the entire cohort, there was a trend for better survival (log-rank test=0.13, Figure A) with acoramidis. Hierarchical analysis in the total cohort, resulted in a win ratio of 2.6 (1.31-5.16) favoring acoramidis (p=0.006, Figure B). Among the matched cohort, all-cause mortality did not differ between the two-groups (log-rank test=0.42, Figure C). Hierarchical analysis in the matched cohort revealed a win ratio of 1.88 (0.74 - 4.77) in favor of acoramidis (p=0.18, Figure D).
**Conclusions:** The present study, limited by a small sample size, showed for the first time that long term treatment with acoramidis compares favorably to tafamidis in terms of survival and CVRH.



Single Center Study of Long-Term Outcomes in ATTR-CM Patients treated with Tafamidis vs Acoramidis: Early findings at the dawn of a new era. PC101 (#118)

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.