**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.**
Giorgia Canali, Pfizer, Paris, France
Giorgia.canali@pfizer.com

**Main Body of the Abstract**
Background: Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a rare, progressively debilitating, fatal disease with poor prognosis, often under-diagnosed. Since November 2018, the availability of tafamidis meglumine (and then tafamidis) in France for ATTR-CM patients offers a therapeutic option for these patients who previously had no disease-specific medicinal treatment available.
Objective: To describe care pathways leading to ATTR-CM diagnosis and time to tafamidis initiation.
Methods: SNDS claims data were used to identify ATTR-CM patients with a first code of cardiovascular condition and a subsequent code of amyloidosis. This second code represents the diagnosis date. Medical consultations in the four years before diagnosis and time to tafamidis initiation were described.
Results: Between 2011 and 2021, 13,737 patients were identified, including 4,662 with at least one delivery of tafamidis meglumine or tafamidis. Medical consultations increased in the years before diagnosis: 35% of patients were followed by a cardiologist 3 years before diagnosis, reaching 74% the year before diagnosis, with an average of 2.7 consultations per individual. Median delay between the first cardiovascular condition and tafamidis delivery was 27.5 months and decreased over time. The delay varied slightly by region of residence and with density of dwelling place (Table 1), what could be linked to heterogeneity in codage, diagnosis wandering or delay in tafamidis initiation.
Conclusion: ATTR-CM diagnosis requires several years and therefore the treatment is delayed. Medical consultations increase in the years preceding diagnosis, reflecting the worsening disease symptoms and the active search for a diagnosis.
Funding: This study was sponsored by Pfizer.



**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.**
**Giorgia Canali,** Pfizer, Paris, France
[Giorgia.canali@pfizer.com](mailto:Giorgia.canali@pfizer.com)

**Main Body of the Abstract**
**Background:** Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a rare, progressively debilitating, fatal disease with poor prognosis, often under-diagnosed. Since November 2018, the availability of tafamidis meglumine (and then tafamidis) in France for ATTR-CM patients offers a therapeutic option for these patients who previously had no disease-specific medicinal treatment available.
**Objective:** To describe care pathways leading to ATTR-CM diagnosis and time to tafamidis initiation.
**Methods:** SNDS claims data were used to identify ATTR-CM patients with a first code of cardiovascular condition and a subsequent code of amyloidosis. This second code represents the diagnosis date. Medical consultations in the four years before diagnosis and time to tafamidis initiation were described.
**Results:** Between 2011 and 2021, 13,737 patients were identified, including 4,662 with at least one delivery of tafamidis meglumine or tafamidis. Medical consultations increased in the years before diagnosis: 35% of patients were followed by a cardiologist 3 years before diagnosis, reaching 74% the year before diagnosis, with an average of 2.7 consultations per individual. Median delay between the first cardiovascular condition and tafamidis delivery was 27.5 months and decreased over time. The delay varied slightly by region of residence and with density of dwelling place (Table 1), what could be linked to heterogeneity in codage, diagnosis wandering or delay in tafamidis initiation.
**Conclusion:** ATTR-CM diagnosis requires several years and therefore the treatment is delayed. Medical consultations increase in the years preceding diagnosis, reflecting the worsening disease symptoms and the active search for a diagnosis.
**Funding:** This study was sponsored by Pfizer.



Care pathways of transthyretin amyloid cardiomyopathy from a French nationwide study of in- and out-patient databases PB8 (#172)

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.