Enbrel for CHF relief
Enbrel for CHF relief
The genetically engineered protein etanercept (Immunex’s Enbrel) may help patients in the later stages (NYHA class III) of congestive heart failure (CHF), according to a small trial reported in late June.1
The drug has passed the safety and efficacy phase of testing for the treatment of CHF. Researchers have speculated that tumor necrosis factor (TNF), a substance that is produced by the body in response to cell damage, promoting inflammation, may contribute to worsening heart failure because of its direct toxic effects on the heart. TNF antagonist etanercept binds to TNF and renders it harmless, so it may help to prevent heart failure patients from deteriorating.
In the recent early-phase clinical testing, investigators at Baylor College of Medicine in Houston tested various doses of etanercept in 12 CHF patients and compared the outcome with that of six in the same stage of heart failure who did not receive the drug. A single dose led to reduced TNF activity and a significant improvement in signs and symptoms of heart failure with no serious side effects. The drug achieved about a 40% improvement in quality of life among patients on the highest doses and a 10% improvement in the heart’s pumping ability.
"TNF levels are seven to eight times higher in people with congestive heart failure than in those with normal hearts. . . . Etanercept acts like a decoy and diverts TNF away from the heart," wrote Douglas L. Mann, MD, one of the study’s authors. However, he went on to say that TNF is only one of the factors that play a role in heart failure, and the drug cannot be seen as a panacea for heart failure.
Etanercept recently received approval for the treatment of rheumatoid arthritis, and large trials of the drug as a treatment for heart failure are under way in the United States and Europe.
Reference
1. Deswal A, Bozkurt B, Seta Y, et al. Safety and efficacy of a soluble P75 tumor necrosis factor receptor (Enbrel, etanercept) in patients with advanced heart failure. Circulation 1999; 99:3,224-3,226.
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