Amvuttra (vutrisiran)

A next-generation RNA interference therapy for ATTR amyloidosis. Unlike patisiran (which requires IV infusion), vutrisiran is a single injection under the skin given once every 3 months.

Vutrisiran sharply lowers how much TTR (transthyretin) protein your body makes. Like patisiran, it silences the genetic code for TTR. The key difference is that vutrisiran is chemically modified to be more stable in the body, so you need fewer doses: just 1 injection every 3 months instead of an IV infusion every 3 weeks.

Vutrisiran lowers vitamin A levels in the blood, so the label advises taking a vitamin A supplement at the recommended daily amount (not higher). Tell your doctor about eye problems such as trouble seeing at night, which can be a sign of low vitamin A. The most common side effects in studies were pain in the arms or legs, joint pain, shortness of breath, and low vitamin A levels. Injection site reactions can also occur.

Vutrisiran is given as a 25 mg injection under the skin (subcutaneous) once every 3 months. This is a major advantage over patisiran, which requires IV infusions every 3 weeks. It is not a self-injection: a healthcare professional gives it at a doctor's office or treatment center, or in some cases at home if your insurance covers it.

Yes, Vutrisiran (Amvuttra) is FDA approved (2022) for the treatment of ATTR Amyloidosis and Wild-Type ATTR Cardiac Amyloidosis.

Both are RNA interference therapies from Alnylam that silence TTR production, but vutrisiran has significant practical advantages. Vutrisiran is given as a subcutaneous injection once every 3 months, while patisiran requires an IV infusion every 3 weeks with premedication. Vutrisiran uses an enhanced stabilization chemistry (ESC) that makes the molecule more stable, allowing the longer dosing interval. Vutrisiran lowered blood TTR by about 83% in its nerve trial, similar to patisiran, but no study has formally compared the 2 drugs on nerve or heart outcomes.

Yes. Vutrisiran was originally approved in June 2022 for hereditary ATTR with polyneuropathy, and in March 2025 it received an expanded approval for ATTR amyloidosis with cardiomyopathy, covering both hereditary and wild-type forms. This makes Amvuttra the only RNAi therapy approved for both the nerve and heart manifestations of ATTR amyloidosis.

The HELIOS-B Phase 3 trial demonstrated that vutrisiran reduced the composite of all-cause mortality and recurrent cardiovascular events by 28% over 36 months in ATTR cardiomyopathy patients. On average, blood TTR levels fell by more than 80%, similar to the earlier nerve trial. These results led to the expanded FDA approval for ATTR cardiomyopathy in March 2025.

Yes. Many patients have transitioned from patisiran (IV every 3 weeks) to vutrisiran (subcutaneous every 3 months) for the convenience of less frequent dosing and no need for IV infusion. Your physician can guide the transition timing. Both drugs achieve similar levels of TTR suppression, so the switch is primarily about treatment convenience.

No. Because vutrisiran is given as a subcutaneous injection rather than an IV infusion, it does not require the corticosteroid and antihistamine premedication that patisiran does. This is another practical advantage of vutrisiran, as it simplifies the treatment process and reduces time spent at the clinic.

Vutrisiran and tafamidis take different approaches to treating ATTR cardiomyopathy. Tafamidis stabilizes the TTR protein to prevent misfolding, while vutrisiran lowers TTR production by about 80% through gene silencing. Both have shown cardiovascular benefits in Phase 3 trials. Tafamidis has a longer track record (approved 2019) and is taken as a daily pill. Vutrisiran is an injection given by a healthcare professional once every 3 months. Head-to-head trials have not been conducted.