Table 1

Reducing the supply of fibril precursors in systemic amyloidosis

Disease Aim of treatment Example of treatment
AA amyloidosisSuppress acute phase response (Monitor serum amyloid A protein)Immunosuppression in rheumatoid arthritis, juvenile rheumatoid arthritis (for example, chlorambucil). Colchicine for familial Mediterranean fever. Surgery for resistant osteomyelitis, and rare cytokine producing tumours
AL amyloidosisSuppress production of monoclonal immunoglobulin light chainsChemotherapy for myeloma and monoclonal gammopathy
Hereditary amyloidosisEliminate source of genetically variant proteinOrthotopic liver transplantation for variant transthyretin associated familial amyloid polyneuropathy
Haemodialysis amyloidosisReduce plasma concentration of β2MRenal transplantation