Beyonttra (acoramidis) 356 mg is reimbursed in Belgium from January 1, 2026, for the treatment of wild-type or hereditary transthyretin amyloidosis in adults with cardiac ATTR cardiomyopathy who meet the reimbursement criteria.
Acoramidis is a potent, nearly complete transthyretin (TTR) stabilizer (≥ 90% TTR stabilization) and thus prevents further deposition of TTR monomers in the myocardium.
In the ATTRibute-CM study, acoramidis demonstrated significant benefits on cardiovascular endpoints compared with placebo from 3 months of treatment (Judge DP, et al. JACC 2025 Mar, 85 (10) 1003–101).
Acoramidis is now the second reimbursed treatment for cardiac ATTR amyloidosis, alongside tafamidis (Vyndaqel). No studies have been conducted that directly compared tafamidis and acoramidis. Furthermore, the studies of both medications differ in terms of study design, the included population, and the statistical analysis used. The choice of either product must be made by the treating cardiologist.
The recommended dose is 2 times 2 tablets per day (i.e., 2 tablets in the morning and 2 tablets in the evening). Dose reduction is usually not necessary based on weight, renal function, or other factors. Taking a lower dose will reduce the positive impact on the prognosis. Physicians should monitor and encourage good adherence to the recommended dose. However, limited data are available in patients with severe renal impairment with a creatinine clearance <30 ml/min. The use of acoramidis is not recommended in patients with renal dialysis and hepatic impairment, as acoramidis has not been studied in these populations.
The reimbursement criteria for acoramidis are the same as for tafamidis:
- To be requested by a cardiologist.
- Criteria:
- No or few symptoms of dyspnea, NYHA-class I or II.
- Abnormal bone scintigraphy (Perugini score 2 or 3) or proven cardiac ATTR amyloidosis on a myocardial biopsy.
- No evidence of an underlying gammopathy and therefore AL amyloidosis (based on blood and urine tests).
- Genetic testing of the TTR gene, after the patient's informed consent, to identify a genetic variant that can be passed on to family members.
- If the patient is ≥ 85 years of age, a geriatric evaluation must be performed to estimate life expectancy. This therapy may only be initiated if the life expectancy is estimated at ≥ 2 years.
- Medication must be collected from the hospital pharmacy.
Read more about cardiac amyloidosis: Specific cardiomyopathies
