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Transthyretin Amyloidosis (ATTR) With CardiomyopathyPhase 3NCT03997383

APOLLO-B: A Study to Evaluate Patisiran in Participants With Transthyretin Amyloidosis With Cardiomyopathy (ATTR Amyloidosis With Cardiomyopathy)

A Phase 3 study testing Patisiran in people with Transthyretin Amyloidosis (ATTR) With Cardiomyopathy, run by Alnylam Pharmaceuticals at 90 sites in 22 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this study is to evaluate the efficacy and safety of patisiran in participants with ATTR amyloidosis with cardiomyopathy. Read more about this study

Who is it for?
Ages 18 to 85 years
What is being tested?
Patisiran
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
360 participants
Where
90 sitesin 22 countries
Study dates
4 Sep 2019to 24 Dec 2025
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Documented diagnosis of ATTR amyloidosis with cardiomyopathy, classified as either hereditary ATTR amyloidosis with cardiomyopathy or wild-type ATTR amyloidosis with cardiomyopathy
  • Medical history of heart failure with at least 1 prior hospitalization for heart failure, or current clinical evidence (signs and symptoms of heart failure)
  • Clinically stable with no cardiovascular related hospitalizations within 6 weeks of study start
  • Has never taken tafamidis before (tafamidis naïve) or currently on tafamidis for ≥6 months with evidence of disease progression while on tafamidis treatment
  • Able to complete ≥150 m on the 6-minute walk test
  • Screening N-terminal pro B-type natriuretic peptide (NT-proBNP), a blood marker of heart failure severity, >300 ng/L and <8500 ng/L; in participants with permanent or persistent atrial fibrillation, screening NT-proBNP> 600 ng/L and <8500 ng/L

Who cannot join

  • Known primary amyloidosis (AL) or leptomeningeal amyloidosis.
  • Received prior TTR lowering treatment
  • New York Heart Association heart failure classification of III and at high risk
  • New York Heart Association heart failure classification of IV
  • Neuropathy requiring cane or stick to walk, or is wheelchair bound
  • Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73m^2
Show all 11Show fewer
  • Abnormal liver function
  • Has hepatitis B, hepatitis C or human immunodeficiency virus (HIV) infection
  • Has non-amyloid disease that significantly affects ability to walk (e.g., severe chronic obstructive pulmonary disease, severe arthritis, or peripheral vascular disease affecting ambulation)
  • Prior or planned heart, liver, or other organ transplant
  • Other cardiomyopathy not related to ATTR amyloidosis

Trial locations and contacts

90 sites in 22 countries.

90 sites in 22 countries

United States19 sites
  • Clinical Trial Site

    Baltimore, Maryland, 21224

  • Clinical Trial Site

    Boston, Massachusetts, 02118

  • Clinical Trial Site

    Burlington, Massachusetts, 10805

  • Clinical Trial Site

    Chicago, Illinois, 60637

  • Clinical Trial Site

    Cleveland, Ohio, 44195

  • Clinical Trial Site

    Dallas, Texas, 75246

  • Clinical Trial Site

    Iowa City, Iowa, 52242

  • Clinical Trial Site

    Kansas City, Kansas, 66160

  • Clinical Trial Site

    Los Angeles, California, 90048

  • Clinical Trial Site

    Nashville, Tennessee, 37232

  • Clinical Trial Site

    New York, New York, 10029

  • Clinical Trial Site

    New York, New York, 10032

  • Clinical Trial Site

    Norfolk, Virginia, 23507

  • Clinical Trial Site

    Philadelphia, Pennsylvania, 19104

  • Clinical Trial Site

    Philadelphia, Pennsylvania, 19140

  • Clinical Trial Site

    Pittsburgh, Pennsylvania, 15212

  • Clinical Trial Site

    Rochester, Minnesota, 55905

  • Clinical Trial Site

    Skokie, Illinois, 60076

  • Clinical Trial Site

    St Louis, Missouri, 63110

Other trials in United States

Argentina8 sites
  • Clinical Trial Site

    Buenos Aires, C1039AAO

  • Clinical Trial Site

    Buenos Aires, C1428AQK

  • Clinical Trial Site

    Córdoba, X5000KEH

  • Clinical Trial Site

    Rosario, S2000DSR

  • Clinical Trial Site

    Rosario, S2000DTC

  • Clinical Trial Site

    Rosario, S2000PBJ

  • Clinical Trial Site

    San Juan Bautista, B1888AAE

  • Clinical Trial Site

    Santa Fe, S3000FWO

Other trials in Argentina

Japan7 sites
  • Clinical Trial Site

    Bunkyō City, 113-8655

  • Clinical Trial Site

    Fukuoka, 812-8582

  • Clinical Trial Site

    Kumamoto, 860-8556

  • Clinical Trial Site

    Kurume, 830-0011

  • Clinical Trial Site

    Matsumoto, 390-8621

  • Clinical Trial Site

    Nagoya, 466-8560

  • Clinical Trial Site

    Suita, 565-8565

Other trials in Japan

United Kingdom7 sites
  • Clinical Trial Site

    Bellshill, ML4 3NJ

  • Clinical Trial Site

    Birmingham, B15 2SQ

  • Clinical Trial Site

    Cardiff, CF15 9SS

  • Clinical Trial Site

    Hexham, NE46 1QJ

  • Clinical Trial Site

    London, NW3 2PF

  • Clinical Trial Site

    London, SE1 1YR

  • Clinical Trial Site

    Manchester, M15 6SE

Other trials in United Kingdom

Brazil6 sites
  • Clinical Trial Site

    Porto Alegre, 90035-030

  • Clinical Trial Site

    Ribeirão Preto, 14026-900

  • Clinical Trial Site

    Ribeirão Preto, 14048-900

  • Clinical Trial Site

    Rio de Janeiro, 22280-000

  • Clinical Trial Site

    São Paulo, 04012-909

  • Clinical Trial Site

    São Paulo, 05403-000

Other trials in Brazil

Poland5 sites
  • Clinical Trial Site

    Gdansk, 80-382

  • Clinical Trial Site

    Katowice, 40-635

  • Clinical Trial Site

    Lódz, 90-127

  • Clinical Trial Site

    Warsaw, 01-192

  • Clinical Trial Site

    Warsaw, 04-628

Other trials in Poland

Belgium4 sites
  • Clinical Trial Site

    Aalst, 9300

  • Clinical Trial Site

    Hasselt, 3500

  • Clinical Trial Site

    Liège, 4000

  • Clinical Trial Site

    Roeselare, 8800

Other trials in Belgium

Czechia4 sites
  • Clinical Trial Site

    Brno, 656 91

  • Clinical Trial Site

    Prague, 120 00

  • Clinical Trial Site

    Prague, 128 08

  • Clinical Trial Site

    Prague, 140 21

Other trials in Czechia

France4 sites
  • Clinical Trial Site

    Clichy, 92110

  • Clinical Trial Site

    Créteil, 94010

  • Clinical Trial Site

    Rennes, 35033

  • Clinical Trial Site

    Toulouse, 31059

Other trials in France

Italy4 sites
  • Clinical Trial Site

    Bologna, 40138

  • Clinical Trial Site

    Florence, 50134

  • Clinical Trial Site

    Messina, 98125

  • Clinical Trial Site

    Pavia, 27100

Other trials in Italy

Australia3 sites
  • Clinical Trial Site

    Box Hill, 3128

  • Clinical Trial Site

    Westmead, 2145

  • Clinical Trial Site

    Woolloongabba, 4021

Other trials in Australia

Bulgaria3 sites
  • Clinical Trial Site

    Sofia, 1680

  • Clinical Trial Site

    Sofia, 1784

  • Clinical Trial Site

    Stara Zagora, 6000

Other trials in Bulgaria

Denmark3 sites
  • Clinical Trial Site

    Aarhus N, 8200

  • Clinical Trial Site

    Copenhagen, 2100

  • Clinical Trial Site

    Odense C, 5000

Other trials in Denmark

Portugal3 sites
  • Clinical Trial Site

    Porto, 4099-001

  • Clinical Trial Site

    Senhora da Hora, 4464-513

  • Clinical Trial Site

    Viseu, 3504-509

Other trials in Portugal

Netherlands2 sites
  • Clinical Trial Site

    Groningen, 9713 GZ

  • Clinical Trial Site

    Maastricht, 6229 HX

Other trials in Netherlands

New Zealand2 sites
  • Clinical Trial Site

    Christchurch, 8011

  • Clinical Trial Site

    Hamilton, 3204

Other trials in New Zealand

Chile1 site
  • Clinical Trial Site

    Providencia/ Santiago, 7500587

Other trials in Chile

Hong Kong1 site
  • Clinical Trial Site

    Lai Chi Kok, 999077

Other trials in Hong Kong

Mexico1 site
  • Clinical Trial Site

    Mexico City, 14080

Other trials in Mexico

South Korea1 site
  • Clinical Trial Site

    Seoul, 3080

Other trials in South Korea

Sweden1 site
  • Clinical Trial Site

    Stockholm, 17164

Other trials in Sweden

Taiwan1 site
  • Clinical Trial Site

    Taipei, 11217

Other trials in Taiwan

About this study

Official title: APOLLO-B: A Phase 3, Randomized, Double-blind, Placebo-controlled Multicenter Study to Evaluate the Efficacy and Safety of Patisiran in Patients With Transthyretin Amyloidosis With Cardiomyopathy (ATTR Amyloidosis With Cardiomyopathy)

The purpose of this study is to evaluate the efficacy and safety of patisiran in participants with ATTR amyloidosis with cardiomyopathy.

Being tested
Placebo, Patisiran
Keywords
RNAi therapeutic, Transthyretin, TTR, Amyloidosis, Cardiomyopathy, ATTR
Medical subject headings
Amyloidosis, Hereditary, Transthyretin-Related, Amyloidosis, Cardiomyopathies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PlaceboDrug

    Normal saline (0.9% NaCl) matching volume of patisiran doses will be administered intravenously.

  • PatisiranDrug

    Also called ALN-TTR02, patisiran-lipid nanoparticle (LNP)

    Patisiran will be administered by intravenous (IV) infusion.

Study groups in NCT03997383
Study groupRoleWhat they receive
PatisiranExperimentalParticipants will be administered multiple doses of patisiran in the double-blind and open-label extension period.
Receives: Drug: Patisiran
PlaceboPlacebo comparatorParticipants will be administered multiple doses of placebo in the double-blind period. In the open-label extension period, participants will be administered multiple doses of patisiran.
Receives: Drug: Placebo; Drug: Patisiran

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline at Month 12 in Six-Minute Walk Test (6-MWT)

    Distance in meters walked in 6 minutes, longer distances indicate greater functional capacity. Missing 6MWT values due to non-COVID-19 death or inability to walk due to ATTR disease progression were imputed using the worst 10th percentile change observed in the DB period. Missing 6-MWT values due to other reasons are multiply imputed to create 100 complete datasets. The change from baseline is averaged across the 100 complete datasets.

    Measured: Baseline, Month 12

Secondary outcomes (4)
  1. Change From Baseline at Month 12 in Kansas City Cardiomyopathy Questionnaire Overall Summary (KCCQ-OS) Score

    The KCCQ is a 23-item self-administered questionnaire quantifying 6 domains (symptoms, physical function, quality of life, social limitation, self-efficacy, and symptom stability) and 2 summary scores (clinical and overall summary [OS]). Scores are transformed to a range of 0-100, in which higher scores reflect better health status.

    Measured: Baseline, Month 12

  2. Composite Endpoint of All-Cause Mortality, Frequency of Cardiovascular (CV) Events (CV Hospitalizations and Urgent Heart Failure [HF] Visits) and Change From Baseline in 6-MWT Analyzed by Win Ratio

    The composite endpoint was analyzed using the stratified win ratio method, stratified by baseline tafamidis use. This method combines all-cause mortality, frequency of CV events (CV hospitalizations and HF visits) and change from baseline in 6-MWT in a hierarchical fashion. This method makes within-stratum pairwise comparisons for all patisiran-placebo participant pairs in a sequential manner (first mortality, then CV events, then 6-MWT), with later steps evaluated only in the case of a tie on the prior step. Within each stratum, the win ratio is the total number of 'winners' divided by the total number of 'losers' in the active group. A win ratio >1 represents a favorable outcome for patisiran.

    Measured: Up to Month 12

  3. Composite Endpoint of All-Cause Mortality and Frequency of All-Cause Hospitalizations and Urgent HF Visits in Participants Not on Tafamidis at Baseline

    The hazard rate of all-cause mortality and all-cause hospitalizations and urgent HF visits will be compared between treatment groups using an Andersen-Gill model. A hazard ratio <1 represents a favorable outcome for patisiran.

    Measured: Up to Month 12

  4. Composite Endpoint of All-cause Mortality and Frequency of All-cause Hospitalizations and Urgent HF Visits in All Participants

    The hazard rate of all-cause mortality and all-cause hospitalizations and urgent HF visits was compared between treatment groups using a modified Andersen-Gill model. A hazard ratio <1 represents a favorable outcome for patisiran.

    Measured: Up to Month 12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jun 2019
  2. Study start4 Sep 2019
  3. Primary completion20 Jun 2022
  4. Study completion24 Dec 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
360 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03997383
Sponsor's protocol ID
ALN-TTR02-011
Other IDs
2019-001458-24, 2019
Status last verified
Mar 2026
First submitted
24 Jun 2019
Last updated
20 Apr 2026
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Access to Anonymized individual participant data that support these results is made available 12 months after study completion and not less than 12 months after the product and indication have been approved in the US and/or the EU. Access to data may be declined where there is likelihood a patient could be identified or other feasibility issue, where there is a potential conflict of interest, a planned business activities or an actual or potential competitive risk. Data will be provided contingent upon the approval of a research proposal and the execution of a data sharing agreement. Timeframes for data access may vary and can take up to 6 months or more. Requests for access to data can be submitted via the website www.vivli.org. Questions can also be directed to datasharing@alnylam.com.

Publications

  • Mesquita CT, Schwartzmann P, Correia EB, Simoes MV, Biolo A, Duque DR, Jay PY, Fernandes F. Patisiran Treatment in the Brazilian Subpopulation of the Phase 3 APOLLO-B Study in Transthyretin Amyloidosis with Cardiomyopathy: Post Hoc Analysis. Arq Bras Cardiol. 2025 Mar;122(4):e20240568. doi: 10.36660/abc.20240568. English, Portuguese.

    PubMed 40243852
  • Maurer MS, Kale P, Fontana M, Berk JL, Grogan M, Gustafsson F, Hung RR, Gottlieb RL, Damy T, Gonzalez-Duarte A, Sarswat N, Sekijima Y, Tahara N, Taylor MS, Kubanek M, Donal E, Palecek T, Tsujita K, Tang WHW, Yu WC, Obici L, Simoes M, Fernandes F, Poulsen SH, Diemberger I, Perfetto F, Solomon SD, Di Carli M, Badri P, White MT, Chen J, Yureneva E, Sweetser MT, Jay PY, Garg PP, Vest J, Gillmore JD; APOLLO-B Trial Investigators. Patisiran Treatment in Patients with Transthyretin Cardiac Amyloidosis. N Engl J Med. 2023 Oct 26;389(17):1553-1565. doi: 10.1056/NEJMoa2300757.

    PubMed 37888916

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Patisiran in people with Transthyretin Amyloidosis (ATTR) With Cardiomyopathy, run by Alnylam Pharmaceuticals at 90 sites in 22 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 90 sites in United States, Argentina, Japan, United Kingdom, Brazil and 17 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Oct 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline at Month 12 in Six-Minute Walk Test (6-MWT) (time frame: Baseline, Month 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03997383, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Apr 2026.

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