We welcome final guidance published by the National Institute for Health and Care Excellence (NICE) on 14th January 2026, which recommends acoramidis (brand name Beyonttra, from Bayer) as an option to treat adults with wild-type or hereditary (variant) transthyretin amyloidosis with cardiomyopathy (ATTR-CM).
ATTR-CM is a rare, progressive and life-limiting condition. It occurs when a protein produced by the body, called transthyretin (TTR), becomes unstable and breaks apart, leading to the accumulation of amyloid (abnormal protein deposits) in the heart muscle. Over time, these deposits can cause the heart to become stiffer and less able to fill and pump properly, leading to symptoms such as breathlessness, tiredness, swelling, and a reduced ability to exercise.
Acoramidis is a type of medicine known as a TTR stabiliser. Put simply, it is designed to stabilise the TTR protein – helping to keep it “held together” – so it is less likely to fall apart and contribute to amyloid build-up. This is different from some other approaches that aim to reduce how much TTR the body makes in the first place.
NICE notes that the usual treatment for ATTR-CM is tafamidis, and that acoramidis works in a similar way and would be offered to the same population. NICE also notes that where more than one treatment is suitable (including acoramidis and tafamidis), the specialist team will discuss the options with a patient and recommend the most appropriate treatment. The NHS also considers overall costs and commercial arrangements when choosing between suitable options.
For patients and families, the key question is what happens next. NICE is clear that when a treatment is recommended “as an option”, it should be made available within the required implementation timeframes if the clinician responsible for someone’s care believes it is the right treatment for them. In England, because acoramidis was recommended through a cost-comparison process, NHS England and integrated care boards have agreed to provide funding so it can be implemented 30 days after publication. In Wales, NICE notes that the NHS must usually provide funding and resources within 60 days of the first publication of the final draft guidance, in line with Welsh directions.
How this compares with vutrisiran
You may have seen recent news about vutrisiran for ATTR-CM. Both vutrisiran and acoramidis aim to slow the disease process, but they do it in different ways:
- Acoramidis is a TTR stabiliser: it helps keep the TTR protein stable, reducing the chance of it breaking apart and contributing to amyloid build-up.
- Vutrisiran is an RNA interference (siRNA) medicine: it works in the liver to reduce production of TTR by breaking down the messenger RNA (the “instruction message”) used to make TTR.
They also differ in how they are taken: acoramidis is taken orally (tablets), while vutrisiran is given by subcutaneous injection every three months (as described in product information).
The most appropriate treatment option will depend on individual clinical factors and specialist assessment, including the stage and characteristics of the disease and a person’s overall health.
Cardiomyopathy UK provided charity input to the NICE appraisal process, reflecting what we hear from people with ATTR-CM about the impact of the condition and highlighting the need for improved and equitable access to treatment options. We welcome progress that can widen treatment options, while recognising that real benefit for patients depends on earlier diagnosis, clear referral pathways, and consistent access to medicines across regions.
If you have ATTR-CM, are being tested for possible ATTR-CM, or have questions about what this guidance means for you, our support services can provide information and signposting. For advice specific to your situation, please speak with your specialist clinical team.
Reference: National Institute for Health and Care Excellence (NICE). Acoramidis for treating transthyretin amyloidosis with cardiomyopathy (TA1121). Technology appraisal guidance. Published: 14th January 2026.