MORTALITY, DISEASE BURDEN AND HEALTHCARE RESOURCE USE IN PATIENTS WITH TRANSTHYRETIN AMYLOIDOSIS WITH CARDIAC INVOLVEMENT IN SPAIN: RESULTS FROM THE OVERTTURE GLOBAL STUDY
Author(s)
Pablo García, MD1, Lucia Galan, MD2, Margarita Capel Sanchez, MSc3, Marta Castro Gasch, MSc3, Alicia Eisman, MD4, Eric T. Wittbrodt, MPH5, Joaquín Sánchez-Covisa Hernández, MSc4.
1Cardiology Service, Hospital Universitario Puerta de Hierro, Majadahonda, Spain, 2Neurology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain, 3Corporate Affairs and Market Access Department, BioPharmaceuticals, AstraZeneca, Madrid, Spain, 4Medical and Regulatory Affairs Department, BioPharmaceuticals Medical, AstraZeneca, Madrid, Spain, 5Medical and Payer Evidence Strategy, Biopharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
1Cardiology Service, Hospital Universitario Puerta de Hierro, Majadahonda, Spain, 2Neurology Service, Hospital Universitario Clínico San Carlos, Madrid, Spain, 3Corporate Affairs and Market Access Department, BioPharmaceuticals, AstraZeneca, Madrid, Spain, 4Medical and Regulatory Affairs Department, BioPharmaceuticals Medical, AstraZeneca, Madrid, Spain, 5Medical and Payer Evidence Strategy, Biopharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
OBJECTIVES: Transthyretin amyloidosis with cardiac involvement, including cardiomyopathy (ATTR-CM) and mixed phenotypes, is a progressive condition associated with substantial morbidity and mortality. Real-world evidence on healthcare resource utilization (HCRU) and outcomes is limited. This analysis describes disease burden, HCRU, and mortality among Spanish patients with cardiac involvement included in the OverTTuRe study.
METHODS: Retrospective, observational medical chart review conducted in 11 Spanish hospitals across all transthyretin amyloidosis phenotypes. This subanalysis focused on adult patients with documented cardiac involvement (ATTR-CM or mixed phenotype). Demographic and clinical characteristics, HCRU and mortality were analyzed descriptively. Resource use during follow-up was expressed as the percentage of patients and events per patient-per-year (PPPY).
RESULTS: A total of 363 patients with cardiac involvement were included (213 ATTR-CM and 150 mixed phenotype). Mean age at diagnosis was 77.4 years (SD=10.9), and 23.1% were female. Hereditary ATTR accounted for 63.8% of patients with mixed phenotype and 8.1% of those with ATTR‑CM. Mean follow-up was 38.3 months (SD=31.1). Median time from first manifestation to diagnosis was 19.4 months (IQR 3.6-82.6). Overall mortality during follow-up was 35.5%. Mortality was 20.2% at 1 year (N=336) and 66.7% at 5 years (N=180) after diagnosis, based on available follow-up, and was higher in ATTR‑CM patients. During follow-up, 57.1% experienced at least 1 hospitalization (0.73 PPPY, SD=1.70), with a mean length of stay of 9.9 days (SD=14.6); 9.6% of these had at least 5 hospitalizations, Emergency Room (ER) visits occurred in 67.5% (1.45 PPPY, SD=2.34). Specialist visits were recorded in 91.0%, with 7.53 visits PPPY (SD=14.6).
CONCLUSIONS: Patients with transthyretin amyloidosis and cardiac involvement in Spain experience a high healthcare burden, marked by diagnostic delays, frequent hospitalizations, intensive resource use, and substantial early and long-term mortality. These findings highlight the need for earlier diagnosis, optimized multidisciplinary management, and timely access to optimal disease-modifying therapies.
METHODS: Retrospective, observational medical chart review conducted in 11 Spanish hospitals across all transthyretin amyloidosis phenotypes. This subanalysis focused on adult patients with documented cardiac involvement (ATTR-CM or mixed phenotype). Demographic and clinical characteristics, HCRU and mortality were analyzed descriptively. Resource use during follow-up was expressed as the percentage of patients and events per patient-per-year (PPPY).
RESULTS: A total of 363 patients with cardiac involvement were included (213 ATTR-CM and 150 mixed phenotype). Mean age at diagnosis was 77.4 years (SD=10.9), and 23.1% were female. Hereditary ATTR accounted for 63.8% of patients with mixed phenotype and 8.1% of those with ATTR‑CM. Mean follow-up was 38.3 months (SD=31.1). Median time from first manifestation to diagnosis was 19.4 months (IQR 3.6-82.6). Overall mortality during follow-up was 35.5%. Mortality was 20.2% at 1 year (N=336) and 66.7% at 5 years (N=180) after diagnosis, based on available follow-up, and was higher in ATTR‑CM patients. During follow-up, 57.1% experienced at least 1 hospitalization (0.73 PPPY, SD=1.70), with a mean length of stay of 9.9 days (SD=14.6); 9.6% of these had at least 5 hospitalizations, Emergency Room (ER) visits occurred in 67.5% (1.45 PPPY, SD=2.34). Specialist visits were recorded in 91.0%, with 7.53 visits PPPY (SD=14.6).
CONCLUSIONS: Patients with transthyretin amyloidosis and cardiac involvement in Spain experience a high healthcare burden, marked by diagnostic delays, frequent hospitalizations, intensive resource use, and substantial early and long-term mortality. These findings highlight the need for earlier diagnosis, optimized multidisciplinary management, and timely access to optimal disease-modifying therapies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HSD55
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Service Delivery & Process of Care
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas