Chronic, Low Dose Erythropoetin Beta in Ischemic Cardiomyopathy (EPOHeart)
Pilot Study to Assess the Effect of Low Dose Epoetin Beta Administered for Six Month in Patients With Ischemic Heart Failure Subjected to Percutaneous Coronary Intervention (PCI)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Several effects known to be exerted by erythropoetin (EPO) directly in the heart independent of hemoglobin levels could be of value immediately after revascularization procedures in ischemic cardiac remodeling: the generation of new capillaries is enhanced by the mobilization of endothelial progenitor cells from the bone marrow. EPO is neuron- and cardio-protective after ischemia/reperfusion. Administration of EPO enhances neuronal progenitors to differentiate into functional neurons; this observation may also be valid for the cardiac compartment. The concept of organ-specific effects of EPO independent of hemoglobin levels is supported by the analysis of EPO analogues lacking hematopoietic activity. In humans, currently this concept can only be tested by the use of EPO-doses that do not affect hemoglobin levels. The concept is valid as clinical trials have been performed showing that doses as low as 5000 I.U. EPO once weekly increase the levels of endothelial progenitor cells in blood. On the other hand, recent clinical trials have also shown neutral or even deleterious effects of high dose EPO treatment raising hemoglobin levels to above 12mg/dl in pre-dialysis patients concerning cardiovascular endpoints. Therefore, the chronic, hemoglobin-neutral administration of low doses of EPO might be a successful approach concerning ischemic cardiomyopathy.
Study outline:
This investigator initiated, double-blind, placebo-controlled study is testing the hypothesis, that low doses of erythropoietin beta (35 I.U./kg body weight) started within 14 days after a successful percutaneous coronary intervention enhance left ventricular remodeling as determined by comparison of two cardiac MRI´s over a course of 6 months. Secondary endpoints include changes in diastolic dysfunction as measured by echocardiography, VO2 measured by spiroergometry and serum brain natriuretic peptide levels.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Berlin, Germany, 13353
- Charite Campus Virchow
-
Berlin, Germany, 13125
- Charite Campus Buch
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- successful coronary intervention < 14 days
- regional contraction deficit of the left ventricle as detected either by echocardiography or cardiacMRI
- globally reduced ejection fraction (cardiac MRI or echocardiography: < 60%)
- willing and able to cooperate
- voluntary participation
Exclusion Criteria:
- contraindication for cardiac MRI (i.e. pacemaker, ICD current or within the next 6 months, other metal implants)
- cardiogenic shock at time of inclusion
- uncontrolled hypertension (systolic blood pressure > 180mmHg)
- hemoglobin > 16mg/dl
- thrombocytosis
- malignant tumor
- missing informed consent
- renal failure (creatinine > 300 mg/dl)
- liver failure
- other prognosis limiting, severe diseases (i.e. dementia)
- indication for open label erythropoietin treatment
- allergy towards solvents of the EPO preparation
- woman of childbearing potential
- other clinical study within the preceding 30days
- known alcohol or drug abuse
- neurologic or psychiatry disorders
- previous organ transplantation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: 1
35 I.E.
erythropoetin beta given by subcutaneous injection once per week for 6 months.
The drug is self-administered.
|
35 I.E.
kg body weight subcutaneous once per week for 6 months
Other Names:
|
|
Placebo Comparator: 2
Placebo to erythropoetin beta.
|
35 I.E.
kg body weight placebo to erythropoetin beta
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Change in global left ventricular ejection fraction between initial examination at study entry and the 6 months follow up examination employing cardiac MRI
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The application of 35 I.E./kg body weight erythropoetin beta s.c. once per week for 6 months is well tolerated and safe in patients after PCI.
Time Frame: 6 months
|
6 months
|
|
35 I.E. kg/KG erythropoetin beta s.c. once per week for 6 months improves left ventricular regional wall motion as assessed by cardiac MRI.
Time Frame: 6 months
|
6 months
|
|
35 I.E. kg/KG erythropoetin beta s.c. once per week for 6 months reduces serum levels of brain natriuretic peptide as a measure of heart failure.
Time Frame: 6 months
|
6 months
|
|
35 I.E. kg/KG erythropoetin beta s.c. once per week for 6 months improves peak VO2 as measured by spiroergometry
Time Frame: 6 months
|
6 months
|
|
35 I.E. kg/KG erythropoetin beta s.c. once per week for 6 months improves measures or cardiac diastolic dysfunction as assessed by echocardiography
Time Frame: 6 months
|
6 months
|
|
35 I.E. kg/KG erythropoetin beta s.c. once per week for 6 months improves cardiac tissue texture aqs assessed by contrast-enhanced cardiac MRI
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Martin W Bergmann, MD, Charité Camous Buch, University Medicine Berlin, Germany
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 8514077463
- EudraCT number 2004-002646-35
- EK 6 EA 3/015/05
- KP-3910-4030711
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