"PATHWAY-RCT: Preventing Admission To Hospital With ATTR Cardiomyopathy

  • Research type

    Research Study

  • Full title

    PATHWAY-RCT: Preventing Admission To Hospital with Attr cardiomyopathy using Remote Cardiac Telemonitoring

  • IRAS ID

    305840

  • Contact name

    Dominic Pimenta

  • Contact email

    grants@richmondresearchinstitute.org

  • Sponsor organisation

    Richmond Research Institute

  • Duration of Study in the UK

    3 years, 5 months, 1 days

  • Research summary

    Cardiac amyloidosis is a condition where the heart muscle, amongst other tissues, is infiltrated by the abnormal build-up of a protein called amyloid. This stiffens and thickens the heart muscle over time, which makes it less efficient, and puts further stress and strain on the other chambers of the heart - leading to heart failure. The commonest form, that affects predominantly the elderly, is called 'wild-type' ATTR amyloid, (TTR is the protein that accumulates). In this condition a patient has a 60% chance of admission to hospital, each year after diagnosis. There is no current treatment for ATTR amyloid other than using water tablets to reduce excess fluid and prevent more serious fluid build up in lungs and other tissues. Increasing body weight is the most clinical sign of fluid build up.
    Telemonitoring is the practice of monitoring patients from a distance, and has been shown to reduce heart failure admissions and death in patients with heart failure from any cause. We propose to monitor the weight patients with cardiac amyloidosis at home and intervene where we see a build of fluid by telephone discussion with a doctor. Our early pilot data in patients already on clinical trials for a cardiac amyloid drug has seen reductions in hospitalisations of over 80% already, and reduced deaths by 67%. We hope to evaluate this effect in a formal clinical trial in the community.
    We will make sure the effect is fair by comparing telemonitoring with usual care in patients attending cardiac amyloidosis outpatients already.

  • REC name

    South West - Frenchay Research Ethics Committee

  • REC reference

    21/SW/0161

  • Date of REC Opinion

    8 Feb 2022

  • REC opinion

    Further Information Favourable Opinion