[Treatments for amyloidosis beyond symptomatic care]

Amyloid syndromes are pathogenetically different, each of the various amyloid diseases requiring specific treatment. Unfortunately, those treatments are often preventive and symptomatic, some efficient therapies being limited to particular types of amyloidosis.

Colchicine is effective in the prevention of amyloidosis due to familial Mediterranean fever but is less or not effective in other situations. Cytotoxic agents are useful in the treatment of AL amyloidosis with or without hemopoietic stem cell transplantation. Liver transplantation is indicated for familial polyneuropathy and kidney transplantation for dialysis-related beta 2 microglobulin amyloidosis.

In vivo binding of serum amyloid P (SAP) (component shared by all amyloid deposits) to amyloid fibril, is a new avenue in the therapeutic approach. Development of radiolabeled SAP scintigraphy allows assessment of the disease outcome and evaluation of treatment-related effects. The various treatments that were assessed until now with the objective of curing the disease are reviewed.