Transthyretin amyloidosis (ATTR) is a rare, life‐threatening disease resulting from aggregation and deposition of a defective type of protein called (‘amyloids’) in various tissues. These deposits damage the structure and function of the tissues and cause serious disease which is usually fatal if it affects major organs. Transthyretin amyloidosis cardiomyopathy (ATTR‐CM) primarily affects the heart, causing thickening and stiffening of the heart tissues. Symptoms usually start after age 60 years and include shortness of breath, sometimes after only mild exertion; palpitations and abnormal heart rhythms, most frequently atrial fibrillation or atrial flutter; ankle swelling (oedema); fatigue; fainting, and angina (chest pain). ATTR‐CM is progressive and ultimately leads to death. Current treatment focuses mainly on managing the symptoms although heart transplantation may be appropriate for some patients.
Tafamidis is an oral (taken by mouth) drug that has the potential to slow the formation of the amyloid deposits that can produce heart problems in people with ATTR‐CM. Tafamidis works by specifically interfering with the disease process that leads to the formation and deposition of the amyloids within the heart tissues. If approved, tafamidis will become the first medicinal treatment option specifically indicated for treating ATTR‐CM, in patients that currently have very limited options available and that mostly focus on symptom management.
Angiotensin II acetate is in clinical development for the treatment of catecholamine and/or vasopressin resistant hypotension due to distributive shock. Shock is a critical condition in which blood pressure drops so low that the brain, kidneys and other vital organs cannot receive enough blood flow to function properly. Distributive shock is the most common type of shock that is most commonly caused by bacterial or fungal infection (septic shock) or allergic reaction (anaphylactic shock). Severe shock is usually treated with drugs called catecholamines or vasopressin. Shock that does not respond to treatment with these drugs is resistant shock.