Document Detail


Design of a phase 1/2 trial of intracoronary administration of AAV1/SERCA2a in patients with heart failure.
MedLine Citation:
PMID:  18514926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heart failure (HF) remains a major cause of morbidity and mortality in North America. With an aging population and an unmet clinical need by current pharmacologic and device-related therapeutic strategies, novel treatment options for HF are being explored. One such promising strategy is gene therapy to target underlying molecular anomalies in the dysfunctional cardiomyocyte. Prior animal and human studies have documented decreased expression of SERCA2a, a major cardiac calcium cycling protein, as a major defect found in HF. METHODS AND RESULTS: We hypothesize that increasing the activity of SERCA2a in patients with moderate to severe HF will improve their cardiac function, disease status, and quality of life. Gene transfer of SERCA2a will be performed via an adeno-associated viral (AAV) vector, derived from a nonpathogenic virus with long-term transgene expression as well as a clinically established favorable safety profile. CONCLUSIONS: We describe the design of a phase 1 clinical trial of antegrade epicardial coronary artery infusion (AECAI) administration of AAVI/SERCA2a (MYDICAR) to subjects with HF divided into 2 stages: in Stage 1, subjects will be assigned open-label MYDICAR in one of up to 4 sequential dose escalation cohorts; in Stage 2, subjects will be randomized in parallel to 2 or 3 doses of MYDICAR or placebo in a double-blinded manner.
Authors:
Roger J Hajjar; Krisztina Zsebo; Lawrence Deckelbaum; Craig Thompson; Jeff Rudy; Alex Yaroshinsky; Hung Ly; Yoshiaki Kawase; Kim Wagner; Kenneth Borow; Brian Jaski; Barry London; Barry Greenberg; Daniel F Pauly; Richard Patten; Randall Starling; Donna Mancini; Mariell Jessup
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2008-05-27
Journal Detail:
Title:  Journal of cardiac failure     Volume:  14     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-02     Completed Date:  2008-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-67     Citation Subset:  IM    
Affiliation:
Mount Sinai School of Medicine, New York, New York 10029, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenergic beta-Antagonists / therapeutic use
Adult
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Combined Modality Therapy
Coronary Vessels
Dependovirus*
Diuretics / therapeutic use
Double-Blind Method
Drug Therapy, Combination
Female
Gene Therapy*
Genetic Vectors*
Green Fluorescent Proteins
Heart Failure / drug therapy,  enzymology,  genetics,  therapy*
Humans
Male
Middle Aged
Receptors, Angiotensin / agonists
Sarcoplasmic Reticulum Calcium-Transporting ATPases / administration & dosage,  genetics*,  metabolism
Transduction, Genetic / methods*
Transgenes
Grant Support
ID/Acronym/Agency:
HL071763/HL/NHLBI NIH HHS; HL080498/HL/NHLBI NIH HHS; HL083156/HL/NHLBI NIH HHS; R01 HL078691/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Diuretics; 0/Receptors, Angiotensin; 147336-22-9/Green Fluorescent Proteins; EC 3.6.3.8/Sarcoplasmic Reticulum Calcium-Transporting ATPases

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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