Navigating Therapeutic Pathways and Transforming Care in ATTR-CM - Episode 13
Clinical Considerations for Monotherapy vs Dual Therapy in ATTR-CM Management
The panel discusses decision-making around monotherapy versus dual therapy in ATTR-CM. They explain that while there is not definitive, statistically significant evidence supporting routine dual therapy for all patients, there is also no evidence of harm when stabilizers and silencers are used together. Because the two therapeutic classes work through different mechanisms, dual therapy is considered reasonable in selected patients, particularly when the goal is to slow progression as much as possible. The panel emphasizes that treatment decisions should be individualized, guided by disease stage, symptom burden, neurologic involvement, patient priorities, and access considerations. They stress that ATTR-CM is not a uniform disease, and two patients with the same diagnosis may have completely different clinical needs. Ultimately, the group agrees that the only clearly inappropriate choice is providing no disease-modifying therapy at all.
The panel discusses decision-making around monotherapy versus dual therapy in ATTR-CM. They explain that while there is not definitive, statistically significant evidence supporting routine dual therapy for all patients, there is also no evidence of harm when stabilizers and silencers are used together. Because the two therapeutic classes work through different mechanisms, dual therapy is considered reasonable in selected patients, particularly when the goal is to slow progression as much as possible.
The panel emphasizes that treatment decisions should be individualized, guided by disease stage, symptom burden, neurologic involvement, patient priorities, and access considerations. They stress that ATTR-CM is not a uniform disease, and two patients with the same diagnosis may have completely different clinical needs. Ultimately, the group agrees that the only clearly inappropriate choice is providing no disease-modifying therapy at all.
