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  • If MD/DO
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  • 1. Vutrisiran has been associated with improvements in all of the following outcomes compared to placebo, EXCEPT:*
  • Answer: D – Declines in hepatic function. Thankfully, the liver is not typically affected by ATTR-CM. Vutrisiran has been associated with improvements in outcome vs. placebo in all of the other parameters, as well as cardiovascular events, 6-minute walk distance, NYHA Class, and cardiac biomarkers.

  • 2. All of these agents work by lowering circulating TTR levels EXCEPT:*
  • Answer: B – Tafamidis. Tafamidis is a ‘stabilizer’, meaning it stabilizes the normal circulating form of TTR, thus making deposition as amyloid fibrils less likely. Vutrisiran, Nex-z, and nucresiran all work by lowering the liver’s production of TTR, though to date the only one approved for ATTR-CM (and ATTR-PN) is vutrisiran.

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