The Pathway study is based on pioneering work during the pandemic between clinicians at Richmond Pharmacology and the National Amyloidosis Centre and aims to help patients with the complex disease ATTR amyloidosis avoid A&E and be monitored and treated remotely using a tele-health approach.
The purpose of PATHWAY-RCT is to offer patients that are unable to join interventional trials (such as the Intellia CRISPR-Cas9 gene editing study), due to their disease being too advanced or their own personal commitments, to still have access to a better standard of care than currently available.
The study works by providing ‘smart’ scales for patients to weigh themselves daily. If they forget, they are contacted with a reminder. The smart scales then send the weight to a data centre that tracks any changes. A sudden increase in body weight triggers an alert for a clinician to contact the patient to make any short-term changes to their medication so the excess fluid can be removed before the patient progresses to needing hospitalisation.
ATTR patients have a 1 in 3 chance of fatality with every A&E admission due to a decompensating heart failure episode and they have an average of two admissions per year. It is hoped this study will demonstrate that by using the ‘smart’ scales, hospital admissions are significantly reduced with an overall benefit to patients in quality and length of life. A reduction in hospital admissions would also produce savings for the NHS and allow bed space to be repurposed to help other patients.
Consultant Nephrologist at the NAC, Dr Tamer Rezk says: “With this study, we hope to show that remote weight monitoring, a low-cost patient centric home-based approach can be just as important as more complex disease modifying therapies, focusing on patients’ symptoms and quality of life. With a fresh approach and the use of digital innovation, which is now readily available, we hope to make a big impact on patients’ lives.”
The first patient was enrolled in January 2025 with target of 160 patients being supported and followed over three years. The study registration number is NCT05098665.
Authored by Georg Ferber, PhD, Dilshat Djumanov, PhD, Ulrike Lorch, MD, FFPM, Edward Jackson, BSc, MSc, PhD, MBChB, Joao Almeida Melo, James Rickard, MPharm, and Jorg Taubel, MD, FFPM, FESC.
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