Juan C. Díaz, Servicio de Electrofisiología y Arritmias Cardíacas, Clínica Las Vegas, Grupo Quirón Salud, Universidad CES, Medellín, Colombia
Julián M. Aristizábal, Servicio de Electrofisiología y Arritmias Cardíacas, Hospital Universitario San Vicente Fundación, Universidad CES, Rionegro, Colombia
Oriana Bastidas, Servicio de Electrofisiología y Arritmias Cardíacas, Clínica Las Vegas, Grupo Quirón Salud, Universidad CES, Medellín, Colombia
Jorge E. Marín, Servicio de Electrofisiología y Arritmias Cardíacas, Clínica Las Américas, Universidad CES, Medellín, Colombia
César D. Niño, Servicio de Electrofisiología y Arritmias Cardíacas, Clínica SOMER, Universidad CES, Rionegro, Colombia
Mauricio Duque, Servicio de Electrofisiología y Arritmias Cardíacas, Hospital Universitario San Vicente Fundación, Universidad CES, Rionegro, Colombia
Introduction: Tafamidis has been approved for the treatment of cardiomyopathy associated with transthyretin amyloidosis (CM-ATTR). However, its high-cost warrants in-depth evaluation of its efficacy and cost-effectiveness. Objective: To review the efficacy (defined as the impact on mortality and morbidity due to heart failure) and cost-effectiveness of tafamidis for the management of CM-ATTR. Methods: Systematic review of the literature including studies that evaluated the use of tafamidis in CM-ATTR. The quality of the included studies was assessed independently by three authors. Results: A total of 16 studies were included. The use of tafamidis was associated with a significant reduction in mortality, and a statistically significant reduction in heart failure-related hospitalization. Follow-up imaging reveals that tafamidis delays, but does not stop or regress, the damage induced by CM-ATTR. Although the clinical impact of tafamidis on mortality is high, its elevated cost resulted in a lack of cost-effectiveness for both screening and treatment. Conclusion: The use of tafamidis has a significant impact on mortality associated with CM-ATTR; However, its high cost prevents both screening and treatment from being cost-effective.
Keywords: Myocardiopathy. Transthyretin amyloidosis. Mortality. Heart failure. Cost-effectiveness.
