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ArticleCardiology and therapy2026

Functional Stability Measured by Changes in the 6-min Walk Test in Patients Treated with Tafamidis Versus Placebo: Post hoc Analysis from ATTR-ACT.

Ronald Witteles, Mazen A Hanna, Martha Grogan, Perry Elliott, Ronnie Wang, Pablo Garcia-Pavia

Registry-linked trialAbstract read
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In one paragraph

Article in Cardiology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01994889 (A MULTICENTER, INTERNATIONAL, PHASE 3, DOUBLE-BLIND, PLACEBO-CONTROLLED, RANDOMIZED STUDY TO EVALUATE THE EFFICACY, SAFETY, AND TOLERABILITY OF DAILY ORAL DOSING OF TAFAMIDIS MEGLUMINE), which is not on this map. Not yet cited in PubMed.

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1 · What the graph read from it

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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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01994889 phase3completednot on this map

A multicenter, international, phase 3, double-blind, placebo-controlled, randomized study to evaluate the efficacy, safety, and tolerability of daily oral dosing of tafamidis meglumine (pf-06291826) 20 mg or 80 mg in comparison to placebo in subjects diagnosed with transthyretin cardiomyopathy (ttr-cm)

TypeinterventionalSponsorPfizerRan2013 to 2018Enrolled441ConditionsTransthyretin (TTR) Amyloid CardiomyopathyArmsTafamidis, Placebo
3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Ronald WittelesStanford Amyloid Center, Division of Cardiovascular Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Lane #154, Stanford, CA, USA. witteles@stanford.edu.ORCID http://orcid.org/0000-0002-3043-1472
Mazen A HannaDepartment of Cardiology, Cleveland Clinic, Cleveland, OH, USA.ORCID http://orcid.org/0000-0002-7251-3003
Martha GroganMayo Clinic, Rochester, MN, USA.ORCID http://orcid.org/0000-0002-2541-4440
Perry ElliottDepartment of Cardiology, UCL Institute of Cardiovascular Science, London, UK.ORCID http://orcid.org/0000-0003-3383-3984
Ronnie WangPfizer, Groton, CT, USA.
Pablo Garcia-PaviaHospital Universitario Puerta de Hierro Majadahonda, IDIPHISA, CIBERCV, and Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.ORCID http://orcid.org/0000-0002-5470-2257

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTafamidis, a transthyretin stabilizer for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM), significantly reduced the decline in 6-min walk test (6MWT) distance, a marker of functional stability, compared with placebo in the pivotal study ATTR-ACT. In this post hoc analysis, functional stability was assessed at month 12, and the subsequent impact of treatment on all-cause mortality (ACM) and cardiovascular-related hospitalization (CVH) was examined.

methodsPatients alive at month 12 who received tafamidis meglumine 80 mg (n = 149) or placebo (n = 149) were categorized by month 12 changes in 6MWT distance: stability (≤ 35-m decline from baseline) or progression (> 35-m decline from baseline). ACM and CVH rates during months 12-30 were evaluated using Cox proportional hazard and Poisson regression models, respectively.

resultsA greater proportion of patients treated with tafamidis had 6MWT stability at month 12 (64%) vs. placebo (53%). Month 30 ACM incidence was 12% and 34% with 6MWT stability and progression, respectively, in the tafamidis group and 28% and 43%, respectively, in the placebo group. Among patients with 6MWT stability, tafamidis resulted in a 65% hazard reduction for ACM vs. placebo (hazard ratio 0.347 [95% CI 0.166-0.724]; p = 0.0048). Model-adjusted annual CVH rates with tafamidis were numerically lower vs. placebo (6MWT stability: 0.65 vs. 0.96; 6MWT progression: 1.19 vs. 1.59). A 32% reduction in CVH risk was observed with tafamidis vs. placebo (risk ratio 0.677 [0.500-0.916]; p = 0.0115) with 6MWT stability.

conclusionsTafamidis resulted in a larger proportion of patients with functional stability after 12 months of treatment, with a significantly lower risk of ACM and CVH in patients with 6MWT stability during the subsequent 18 months. This post hoc analysis suggests treatment with tafamidis plays an important role in maintaining functional stability and improving outcomes for patients with ATTR-CM. Graphical abstract available for this article. 

trial registrationClinicaltrials.gov ID NCT01994889.

Indexed as

6-min walk testFunctional stabilityTafamidisTransthyretin amyloid cardiomyopathy

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