Transthyretin amyloid cardiomyopathy is a progressive disease that requires both disease-modifying treatment and symptom-directed management.

In the past 6 months, the number of therapies approved by the United States Food and Drug Administration (FDA) for transthyretin amyloid cardiomyopathy has tripled. Tafamidis was approved in 2019, followed by acoramidis in November 2024 and vutrisiran in March 2025. Additional therapies targeting transthyretin silencing, amyloid clearance, and gene editing are in development.

This review focuses on current and emerging therapies for transthyretin amyloid cardiomyopathy and the practical challenges clinicians face in initiating, monitoring, and adjusting treatment as options continue to expand.