**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.**
Frederick M. Lang
Clinical Cardiovascular Research Laboratory for the Elderly, NewYork-Presbyterian/Columbia University Irving Medical Center
New York, NY 10032

**Main Body of the Abstract**
Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have transformed heart failure management but have not been well-studied in patients with amyloid light-chain cardiomyopathy (AL-CM). We conducted a retrospective study evaluating SGLT2i in AL-CM.
Methods: We queried our institutional registry and identified 27 patients prescribed SGLT2i. The safety analysis included all patients (n=27). To decrease confounding, only patients who were on stable anti-plasma cell therapy for ≥2 months prior to baseline and achieved at least a hematologic Very Good Partial Response (n=17) were included in the efficacy analysis comparing disease marker changes with a contemporaneous untreated control cohort (n=21).
Results: The mean age of the overall population (n=48) at baseline was 68.6±9.4 years. Sixteen (36.4%), 10 (22.7%), 16 (36.4%), and 2 (4.6%) patients demonstrated Mayo Stages I, II, III, and IV. In the safety analysis (median follow-up time: 10.9±7.2 months), 2 (7.4%) patients discontinued SGLT2i due to hypovolemia and genital irritation. Nine hospitalizations, all considered unrelated to SGLT2i by the study investigators, and no deaths occurred. In the efficacy analysis, SGLT2i-treated patients had more severe disease at baseline than controls, demonstrating significantly higher median troponin-T and loop diuretic dose (P<0.05). Compared with controls, SGLT2i treatment was associated with significantly greater reductions in loop diuretic dose at all timepoints, NTproBNP at 3 and 12 months, and mean arterial pressure at 12 months (P<0.05). No significant differences were observed on changes in weight, eGFR, troponin-T, and proteinuria.
Conclusions: SGLT2i treatment was well-tolerated in AL-CM and may aid diuresis. Long-term assessment of clinical outcomes is warranted.



**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.**
Frederick M. Lang
Clinical Cardiovascular Research Laboratory for the Elderly, NewYork-Presbyterian/Columbia University Irving Medical Center
New York, NY 10032

**Main Body of the Abstract**
**Background:** Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have transformed heart failure management but have not been well-studied in patients with amyloid light-chain cardiomyopathy (AL-CM). We conducted a retrospective study evaluating SGLT2i in AL-CM.
**Methods:** We queried our institutional registry and identified 27 patients prescribed SGLT2i. The safety analysis included all patients (n=27). To decrease confounding, only patients who were on stable anti-plasma cell therapy for ≥2 months prior to baseline and achieved at least a hematologic Very Good Partial Response (n=17) were included in the efficacy analysis comparing disease marker changes with a contemporaneous untreated control cohort (n=21).
**Results:** The mean age of the overall population (n=48) at baseline was 68.6±9.4 years. Sixteen (36.4%), 10 (22.7%), 16 (36.4%), and 2 (4.6%) patients demonstrated Mayo Stages I, II, III, and IV. In the safety analysis (median follow-up time: 10.9±7.2 months), 2 (7.4%) patients discontinued SGLT2i due to hypovolemia and genital irritation. Nine hospitalizations, all considered unrelated to SGLT2i by the study investigators, and no deaths occurred. In the efficacy analysis, SGLT2i-treated patients had more severe disease at baseline than controls, demonstrating significantly higher median troponin-T and loop diuretic dose (P<0.05). Compared with controls, SGLT2i treatment was associated with significantly greater reductions in loop diuretic dose at all timepoints, NTproBNP at 3 and 12 months, and mean arterial pressure at 12 months (P<0.05). No significant differences were observed on changes in weight, eGFR, troponin-T, and proteinuria.
**Conclusions:** SGLT2i treatment was well-tolerated in AL-CM and may aid diuresis. Long-term assessment of clinical outcomes is warranted.



Safety and Efficacy of SGLT2 Inhibitors for Amyloid Light-Chain Cardiomyopathy: An Early Experience PA148 (#163)

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.