John L Berk, Ole B Suhr, Laura Obici, Yoshiki Sekijima, Steven R Zeldenrust, Taro Yamashita, Michael A Heneghan, Peter D Gorevic, William J Litchy, Janice F Wiesman, Erik Nordh, Manuel Corato, Alessandro Lozza, Andrea Cortese, Jessica Robinson-Papp, Theodore Colton, Denis V Rybin, Alice B Bisbee, Yukio Ando, Shu-ichi Ikeda, David C Seldin, Giampaolo Merlini, Martha Skinner, Jeffery W Kelly, Peter J Dyck
IMPORTANCE: Familial amyloid polyneuropathy, a lethal genetic disease caused by aggregation of variant transthyretin, induces progressive peripheral nerve deficits and disability. Diflunisal, a nonsteroidal anti-inflammatory agent, stabilizes transthyretin tetramers and prevents amyloid fibril formation in vitro. OBJECTIVE: To determine the effect of diflunisal on polyneuropathy progression in patients with familial amyloid polyneuropathy. DESIGN, SETTING, AND PARTICIPANTS: International randomized, double-blind, placebo-controlled study conducted among 130 patients with familial amyloid polyneuropathy exhibiting clinically detectable peripheral or autonomic neuropathy at amyloid centers in Sweden (Umeå), Italy (Pavia), Japan (Matsumoto and Kumamoto), England (London), and the United States (Boston, Massachusetts; New York, New York; and Rochester, Minnesota) from 2006 through 2012...
December 25, 2013: JAMA