ReviewThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2025
Efficacy and safety of diflunisal therapy in patients with transthyretin cardiac amyloidosis (ATTR-CA): a systematic review and meta-analysis.
Review in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Specific treatment of ATTR-CM in Germany-expert consensus of the German Society of Amyloid Diseases (DGAK) and German Cardiac Society (DGK).Clinical research in cardiology : official journal of the German Cardiac Society · 2026Review
- Multimodal Imaging for Monitoring of Disease Progression in Cardiac Amyloidosis: Advances and Gaps in Evidence.Journal of cardiovascular development and disease · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTransthyretin cardiac amyloidosis (ATTR-CA) is a progressive cause of diastolic heart failure associated with poor prognosis. Currently available treatment, tafamidis, a TTR stabilizer, is highly effective and tolerable but is not cost-effective. Hence, we aim to evaluate the efficacy and safety of a mechanistically similar but more affordable TTR stabilizer, diflunisal, in patients with ATTR-CA.
methodsSystematic searching until June 2024 was done on 3 databases to include patients with ATTR-CA of any type (hereditary or wild-type). Efficacy and safety of diflunisal are assessed by baseline to follow-up mean difference of specific clinical parameters and mortality risk reduction comparing intervention to the control group is evaluated by the generic inverse variance model. The proportion of discontinuation rate and adverse effects are evaluated with a single-arm inverse variance model. Statistical analyses are done with a random effect model conducted on RevMan and R software.
resultsTwelve studies comprising 539 ATTR-CA patients with a mean of 70 years old are included. The majority of them are male with NYHA I-II severity and are being followed up for approximately 12 months. For diflunisal efficacy outcomes, we found no statistically significant changes in BNP, troponin I, LVEF, GLS, IVSD, PWD, and E wave from baseline to diflunisal posttreatment, however, we found a statistically significant posttreatment increase of transthyretin level (MD 9.34 mg/dL; CI 1.54-17.14; I
conclusionDiflunisal therapy is beneficial in treating ATTR-CA patients but is associated with adverse effects that require therapy discontinuation. Hence, careful monitoring during diflunisal therapy is necessary.
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