The Study of an Investigational Drug, Patisiran (ALN-TTR02), for the Treatment of Transthyretin (TTR)-Mediated Amyloidosis in Participants Who Have Already Been Treated With ALN-TTR02 (Patisiran)

Change From Baseline in the Norfolk Quality of Life-Diabetic Neuropathy (QoL-DN) Questionnaire Total Score at Year 5

The Norfolk QoL-DN questionnaire is a standardized 47-item patient-reported outcomes measure, sensitive to the perception of the effects of diabetic neuropathy by the participant. The scores range from -4 (best possible QOL) to 136 (worst possible QOL). A negative change from baseline represents improved QOL.

Time frame: Baseline, Year 5

Change From Baseline in the EuroQOL-5 Dimensions-5 Levels (EQ-5D-5L) Index Score at Year 5

The EQ-5D-5L is a patient-reported measure of QoL based on 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The overall score is rated on a scale from 0 (worst) to 1 (no impairment). Higher scores indicate a higher QoL. A negative change from baseline indicates worsening of QoL.

Time frame: Baseline, Year 5

Change From Baseline in the EuroQoL Visual Analogue Scale (EQ-VAS) Score at Year 5

EQ-VAS measures the participant's self-rated health on a vertical scale evaluated on a scale of 0 ("worst health you can imagine") to 100 ("best health you can imagine"). Higher scores indicate a higher QOL. A negative change from baseline indicates worsening of QoL.

Time frame: Baseline, Year 5

Change From Baseline in the Composite Autonomic Symptom Score (COMPASS 31) Total Score at Week 52

COMPASS 31 questionnaire measures autonomic symptoms in participants with neuropathy. The questionnaire consists of 31 clinically selected questions evaluating 6 autonomic domains (orthostatic intolerance, secretomotor, gastrointestinal, bladder, and pupillomotor). COMPASS 31 is measured on a scale from 0 to 100, with 100 representing maximum impairment.

Time frame: Baseline, Week 52

Change From Baseline in the Modified Body Mass Index (mBMI) at Year 5

Nutritional status of participants was evaluated using the mBMI, calculated as BMI (kilograms per square meter \[kg/m\^2\]) multiplied by the concentration of serum albumin (grams per liter \[g/L\]). A positive change from baseline indicates improvement in nutritional status.

Time frame: Baseline, Year 5

Change From Baseline in the Rasch-built Overall Disability Scale (R-ODS) at Year 5

The R-ODS is a 24-item patient-reported questionnaire that specifically captures activity and social participation limitations. It measures the level of disability on a scale of 0 (worst) to 48 (best, no limitations), higher score indicates a better outcome. A negative change from baseline indicates worsening of disability.

Time frame: Baseline, Year 5

Change From Baseline in the NIS+7 Component: NIS-Weakness (NIS-W) Score at Year 5

The NIS+7 provides additional, objective measures of nerve fiber function and autonomic nerve function in participants with diabetic neuropathy. The NIS+7 includes the full NIS (NIS-W, NIS-R, NIS-S), sum of 5 nerve conduction studies (NCS) (Sural SNAP, tibial motor nerve distal latency, peroneal CMAP, motor nerve conduction velocity, motor nerve distal latency), vibration detection threshold, and pulse rate response to deep breathing. NIS-W is a measure of motor strength, comprised of cranial nerve and both upper and lower limb motor assessments. The score ranges from 0 to 192. A higher score indicates greater severity of disease.

Time frame: Baseline, Year 5

Change From Baseline in the 10-meter Walk Test (10-MWT) Speed at Year 5

10-MWT is a measure of ambulatory ability and walk speed. It measures the speed (in meters per second \[m/s\]) of a participant to walk 10 meters. A negative change from baseline represents decreased ambulatory ability.

Time frame: Baseline, Year 5

Change From Baseline in the Hand Grip Strength at Week 52

Hand grip strength was measured by dynamometer. Grip strength in the dominant arm is a measure of motor function, with a higher grip strength indicating better motor function. The mean change from baseline in the hand grip strength was reported.

Time frame: Baseline, Week 52

Number of Participants With Change From Baseline in the Polyneuropathy Disability (PND) Stage

PND measures changes in the ambulatory ability including the need of walking aids on the following stages: 0 (no symptoms), I (sensory disturbances but preserved walking capability), II (impaired walking capability but ability to walk without a stick or crutches), IIIA (walking with help of 1 stick/crutch), IIIB (with help of 2 sticks/crutches), and IV (confined to wheelchair or bedridden). Lower scores indicate greater ambulatory function. The number of participants with change in the stage from baseline was reported as: Improved or worsened.

Time frame: Baseline, Year 5

Number of Participants With Change From Baseline in the Familial Amyloidotic Polyneuropathy (FAP) Stage

FAP measures changes in the ambulatory ability including the need of walking aids on the following stages: 0 (no symptoms), I (unimpaired ambulation; mostly mild sensory, motor, and autonomic neuropathy in the lower limbs), II (assistance with ambulation required; moderate impairment of the lower limbs, upper limbs, and trunk), and III (wheelchair-bound or bedridden; severe sensory, motor, and autonomic involvement of all limbs). Lower scores indicate greater ambulatory function. The number of participants with change in the stage from baseline was reported as: Improved or worsened.

Time frame: Baseline, Year 5

Number of Participants With Change From Baseline in the New York Heart Association (NYHA) Classification

NYHA classification grades the severity of heart failure symptoms into the following stages: I (no symptoms; ordinary physical activity such as walking and climbing stairs does not cause fatigue or dyspnea), II (symptoms with ordinary physical activity; walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, in cold weather, in wind or when under emotional stress causes undue fatigue or dyspnea), III (symptoms with less than ordinary physical activity; walking 1 to 2 blocks on the level and climbing more than 1 flight of stairs in normal conditions causes undue fatigue or dyspnea), IV (symptoms at rest; inability to carry on any physical activity without fatigue or dyspnea). The number of participants with change in the stage from baseline was reported as: Improved or worsened.

Time frame: Baseline, Year 5

Change From Baseline in the Intraepidermal Nerve Fiber Density (IENFD) at Year 5

IENFD (fibers/millimeter \[mm\]) is a measure for the pathologic evaluation of sensory and autonomic innervation. It is obtained by tandem 3 mm skin punch biopsies: one set of biopsies taken from the distal thigh and one set from the distal lower leg. An increase in nerve fiber density suggests improvement, while a decrease in nerve fiber density suggests worsening.

Time frame: Baseline, Year 5

Change From Baseline in the Sweat Gland Nerve Fiber Density (SGNFD) at Year 5

SGNFD (meter/cubic millimeter \[m/mm\^3\]) is a measure for the pathologic evaluation of sensory and autonomic innervation. It is obtained by tandem 3 mm skin punch biopsies: one set of biopsies taken from the distal thigh and one set from the distal lower leg. An increase in nerve fiber density suggests improvement, while a decrease in nerve fiber density suggests worsening.

Time frame: Baseline, Year 5

Change From Baseline in the Dermal Amyloid Burden at Year 5

Dermal Amyloid Burden is a measure for the pathologic evaluation of sensory and autonomic innervation and reported as % congo red stain. It is obtained by tandem 3 mm skin punch biopsies: one set of biopsies taken from the distal thigh and one set from the distal lower leg.

Time frame: Baseline, Year 5

Change From Baseline in the Cardiac Biomarker: Serum Troponin I at Year 5

Manifestations of cardiac amyloid involvement were assessed through measurement of serum levels of the cardiac biomarker: troponin (micrograms per liter \[µg/L\]). The troponin I values \<0.1 μg/L were imputed to 0.1 thus the actual changes cannot be calculated for values \<0.1 μg/L.

Time frame: Baseline, Year 5

Change From Baseline in the Cardiac Biomarker: N-terminal Prohormone of B-type Natriuretic Peptide (NT-proBNP) at Year 5

Manifestations of cardiac amyloid involvement were assessed through measurement of serum levels of the cardiac biomarker: NT-proBNP (nanograms per liter \[ng/L\]).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: Average Peak Longitudinal Strain at Year 5

The echocardiogram parameters analyzed included measures of systolic function: Average peak longitudinal strain (percentage \[%\]).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: Left Ventricular (LV) Mass at Year 5

The echocardiogram parameters analyzed included measures of cardiac structure: LV mass (grams \[g\]).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: LV End-diastolic Volume at Year 5

The echocardiogram parameters analyzed included measures of diastolic function: LV end-diastolic volume (milliliters \[mL\]).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: LV Relative Wall Thickness at Year 5

The echocardiogram parameters analyzed included measures of cardiac structure: LV relative wall thickness (ratio).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: Mean LV Wall Thickness at Year 5

The echocardiogram parameters analyzed included measures of cardiac structure: Mean LV wall thickness (centimeters \[cm\]).

Time frame: Baseline, Year 5

Change From Baseline in the Echocardiogram Parameter: Cardiac Output at Year 5

The echocardiogram parameters analyzed included measures of systolic function: Cardiac output (liters per minute \[L/min\]).

Time frame: Baseline, Year 5

Percent Change From Baseline in Serum TTR Levels at Year 5

Serum TTR was assessed using enzyme linked immunosorbent assay (ELISA).

Time frame: Baseline, Year 5