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September 25, 2013Circulation Research

Long-Term Effects of AAV1/SERCA2a Gene Transfer in Patients With Severe Heart Failure

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Key result

High-dose AAV1/SERCA2a gene transfer reduced the risk of recurrent cardiovascular events by 82% compared to placebo over 3 years in patients with advanced heart failure (P=0.048).

Why the study?

Does intracoronary infusion of AAV1/SERCA2a reduce recurrent cardiovascular and terminal events in patients with advanced heart failure?

Population

39 patients with advanced heart failure on stable, optimal heart failure therapy

Comparison

Single intracoronary infusion of AAV1/SERCA2a in… vs Placebo

Design

RCT, randomized

Follow-up

3 years

Authors

KZKrisztina M. ZseboHeart Failure / CardiomyopathyAYAlex YaroshinskyVital ResearchJRJ RudySarepta Therapeutics (United States)

Discussion

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Implication

Opens a new treatment axis for advanced HF; extends AAV1/SERCA2a gene transfer to randomized long-term event reduction.

Study Design

Type

RCT (n=39)

Structured PICO

Does intracoronary infusion of AAV1/SERCA2a reduce recurrent cardiovascular and terminal events in patients with advanced heart failure?

P
Population
39 patients with advanced heart failure on stable, optimal heart failure therapy
I
Intervention
Single intracoronary infusion of AAV1/SERCA2a in 1 of 3 doses (low-dose, 6×10^11 DNase-resistant particles; mid-dose, 3×10^12 DNase-resistant particles; and high-dose, 1×10^13 DNase-resistant particles)
C
Comparator
Placebo
O
Outcome
Recurrent cardiovascular and terminal events (myocardial infarction, worsening heart failure, heart failure-related hospitalization, ventricular assist device placement, cardiac transplantation, and death) at 3 yearscomposite

Main Result

Effect estimate: 82% risk reduction

p-value: p=0.048

A single intracoronary infusion of high-dose AAV1/SERCA2a gene therapy significantly reduced recurrent cardiovascular events over 3 years in patients with advanced heart failure without safety concerns.

Cite This Study

Zsebo et al. (2013) conducted an RCT in advanced heart failure (n=39). AAV1/SERCA2a vs. placebo was evaluated on recurrent cardiovascular and terminal events (myocardial infarction, worsening heart failure, heart failure-related hospitalization, ventricular assist device placement, cardiac transplantation, and death) (82% risk reduction, p=0.048). High-dose AAV1/SERCA2a gene transfer reduced the risk of recurrent cardiovascular events by 82% compared to placebo over 3 years in patients with advanced heart failure (P=0.048).

synapsesocial.com/papers/6a178acc8d470cd9925361b0https://doi.org/10.1161/circresaha.113.302421

Topics

Heart failureHFrEF treatment
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Improvement in Survival and Cardiac Metabolism After Gene Transfer of Sarcoplasmic Reticulum Ca 2+ -ATPase in a Rat Model of Heart Failure2001 · 386 citations
  2. 2Recombinant Adeno-Associated Virus Serotype 9 Leads to Preferential Cardiac Transduction In Vivo2006 · 407 citations
  3. 3Targeted Sarcoplasmic Reticulum Ca 2+ ATPase 2a Gene Delivery to Restore Electrical Stability in the Failing Heart2012 · 104 citations
  4. 4Gene Delivery of Sarcoplasmic Reticulum Calcium ATPase Inhibits Ventricular Remodeling in Ischemic Mitral Regurgitation2010 · 69 citations
  5. 5Rescuing the Failing Heart by Targeted Gene Transfer2011 · 67 citations