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Novel drug therapy tackles third 'pathway' causing congestive heart failure

he immune system and healthy individuals generally have low levels of TNF in their blood. In people with heart failure, TNF is produced by the heart itself.

Twelve of the patients in the study received varying amounts of etanercept, given in a one-time intravenous injection, and six received an inert compound called a placebo. The patients were all similar in age, severity of heart failure, and in the types and dosage levels of heart failure medications they were taking.

In those receiving the higher doses of etanercept, circulating blood levels of TNF decreased within a two-week period. Improvements were also seen in physical function, as assessed by a six-minute walk test and in ejection fraction -- the heart's ability to pump blood. Additionally, the patients perceived that their 'quality of life' improved (based on the patient's assessment of his/her feeling of well being). None of the patients in the study experienced any adverse side effects from the drug.

Congestive heart failure occurs when the heart fails to function as efficiently as it should and can't pump enough blood to meet the body's needs. It can be the result of a heart attack, high blood pressure, a congenital defect in the heart, or an infection or defect in a heart valve. Symptoms, which include shortness of breath, fluid retention and fatigue, can severely hamper an individual's quality of life. In advanced cases of heart failure, a heart transplant is often the only option.

In an accompanying editorial, Gary S. Francis, M.D., of the Cleveland Clinic says that while the results of the study are encouraging, additional studies are needed because of the small number of patients and the short duration of the clinical trial. "The results indicate no significant side effects, a decrease in biologically active levels of TNF, and an increase in quality of life scores, six-minute walk distance and ejection fraction. The study offers further proof of principle and suggests a g
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
28-Jun-1999


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