{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:58:34Z","timestamp":1791395914281,"version":"4.3.3"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Region V\u00e4sterbotten","award":["RV-9652052021-06-20"],"award-info":[{"award-number":["RV-9652052021-06-20"]}]},{"name":"Norrl\u00e4ndska Hj\u00e4rtfonden","award":["NA"],"award-info":[{"award-number":["NA"]}]},{"name":"Agreement on Medical Education and Research (ALF) funds"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The role of guideline-directed medical therapy for heart failure (HF) is unclear in transthyretin amyloid cardiomyopathy (ATTR-CM). Dapagliflozin has demonstrated beneficial effects across HF phenotypes, and retrospective studies suggest potential benefit in ATTR-CM; however, prospective data are lacking. This pilot study evaluated the effect and tolerability of dapagliflozin in patients with ATTR-CM to inform the design of a larger randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants were followed for 30 weeks over three study periods: 8 weeks baseline without study medication, 12 weeks intervention with dapagliflozin 10 mg once daily, and 10 weeks withdrawal without study medication. The study was open-label and nonrandomized. Vital signs and NT-proBNP were assessed every second week, while Kansas City Cardiomyopathy Questionnaire total symptom score (KCCQ-TSS) and 6-minute walking test (6MWT) were assessed every 4 weeks. Results were analyzed using linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven of ten enrolled patients completed the trial. One participant discontinued because of genitourinary adverse effects, and two withdrew for reasons unrelated to the intervention. The estimated intervention-versus-baseline difference was \u2212142 pg\/mL (95% CI \u2212324\u201341) for NT-proBNP, 24.3 m (95% CI \u22122.8 to 51.5) for 6MWT distance, and 0.4 points (95% CI \u22124.0 to 4.8) for KCCQ-TSS. Sitting SBP was 8.8 mmHg lower during intervention than during baseline (95% CI \u221213.2 to \u22124.4). No increase in hypotensive symptoms or cardiovascular adverse events was detected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dapagliflozin was generally well tolerated in this pilot study of patients with ATTR-CM. The estimated differences in NT-proBNP, 6MWT distance, and KCCQ-TSS were imprecise and did not provide conclusive evidence of treatment effects. SBP was lower during treatment, without a detected increase in hypotensive symptoms. These exploratory findings support further evaluation in an adequately powered randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      This study was registered with clinical trial number EudraCT no\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/2021-003674-32\" xlink:type=\"simple\">2021-003674-32<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346065","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:28:06Z","timestamp":1791394086000},"page":"e0346065","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using dapagliflozin to reduce symptoms in transthyretin cardiac amyloidosis: An n-of-1 trial series pilot study"],"prefix":"10.1371","volume":"21","author":[{"given":"Erik","family":"H\u00e5kansson","sequence":"first","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"],"department":["Department of Public Health and Clinical Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Intissar","family":"Anan","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"],"department":["Department of Public Health and Clinical Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Brunstr\u00f6m","sequence":"additional","affiliation":[{"name":"Ume\u00e5 University","place":["Ume\u00e5, Sweden"],"department":["Department of Public Health and Clinical 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