Amyloidosis: diagnosis and new therapies for a misunderstood and misdiagnosed disease

Neurodegener Dis Manag. 2019 Dec;9(6):289-299. doi: 10.2217/nmt-2019-0020. Epub 2019 Nov 5.

Abstract

Amyloidosis is a group of diseases characterized by extracellular deposition of amyloid fibril complexes. Fibril deposition results in organ dysfunction and possible failure. Amyloidosis is regarded as a rare disease, but in general is underdiagnosed. The two main types of systemic amyloidosis are immunoglobulin light chain and transthyretin amyloidosis. The increased availability of noninvasive cardiac imaging, genetic testing and improved laboratory assays and protein identification methods have led to increased diagnosis. However, in many cases, the diagnosis is not made until the patient develops organ impairment. Earlier diagnosis is required to prevent irreversible organ failure. Novel treatments for immunoglobulin light chain and transthyretin amyloidosis that halt disease progression, prolong and increase quality of life have recently become available.

Keywords: AL; ATTR; amyloidosis; inotersen; patisiran; primary amyloidosis; reactive amyloidosis; tafamadis; transthyretin amyloidosis.

Publication types

  • Review

MeSH terms

  • Amyloidosis / diagnosis*
  • Amyloidosis / drug therapy*
  • Amyloidosis / genetics
  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents / therapeutic use*
  • Bortezomib / therapeutic use
  • Diagnostic Errors / prevention & control*
  • Diagnostic Errors / trends
  • Early Diagnosis
  • Genetic Testing / methods
  • Genetic Testing / trends
  • Humans
  • Oligodeoxyribonucleotides, Antisense / therapeutic use
  • Oligonucleotides / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Oligodeoxyribonucleotides, Antisense
  • Oligonucleotides
  • Inotersen
  • Bortezomib