Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2: Double-blind, randomized, controlled clinical trial

Michael Simons, Brian H. Annex, Roger J. Laham, Neal Kleiman, Timothy Henry, Harold Dauerman, James E. Udelson, Ernesto V. Gervino, Marilyn Pike, M. J. Whitehouse, Thomas Moon, Nicolas A. Chronos

Research output: Contribution to journalArticle

Abstract

Background - Single-bolus intracoronary administration of fibroblast growth factor-2 (FGF2) improved symptoms and myocardial function in a phase I, open-label trial in patients with coronary artery disease. We conducted the FGF Initiating RevaScularization Trial (FIRST) to evaluate further the efficacy and safety of recombinant FGF2 (rFGF2). Methods and Results - FIRST is a multicenter, randomized, double-blind, placebo-controlled trial of a single intracoronary infusion of rFGF2 at 0, 0.3, 3, or 30 μg/kg (n=337 patients). Efficacy was evaluated at 90 and 180 days by exercise tolerance test, myocardial nuclear perfusion imaging, Seattle Angina Questionnaire, and Short-Form 36 questionnaire. Exercise tolerance was increased at 90 days in all groups and was not significantly different between placebo and FGF-treated groups. rFGF2 reduced angina symptoms as measured by the angina frequency score of the Seattle Angina Questionnaire (overall P=0.035) and the physical component summary scale of the Short-Form 36 (pairwise P=0.033, all FGF groups versus placebo). These differences were more pronounced in highly symptomatic patients (baseline angina frequency score ≤40 or Canadian Cardiovascular Society score of III or IV). None of the differences were significant at 180 days because of continued improvement in the placebo group. Adverse events were similar across all groups, except for hypotension, which occurred with higher frequency in the 30-μg/kg rFGF2 group. Conclusions - A single intracoronary infusion of rFGF2 does not improve exercise tolerance or myocardial perfusion but does show trends toward symptomatic improvement at 90 (but not 180) days.

Original languageEnglish (US)
Pages (from-to)788-793
Number of pages6
JournalCirculation
Volume105
Issue number7
DOIs
StatePublished - Feb 19 2002
Externally publishedYes

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Fibroblast Growth Factor 2
Coronary Artery Disease
Randomized Controlled Trials
Pharmacology
Exercise Tolerance
Placebos
Therapeutics
Myocardial Perfusion Imaging
Exercise Test
Hypotension
Perfusion
Safety
Surveys and Questionnaires

Keywords

  • Angina
  • Angiogenesis
  • Coronary disease
  • Revascularization
  • Trials

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2 : Double-blind, randomized, controlled clinical trial. / Simons, Michael; Annex, Brian H.; Laham, Roger J.; Kleiman, Neal; Henry, Timothy; Dauerman, Harold; Udelson, James E.; Gervino, Ernesto V.; Pike, Marilyn; Whitehouse, M. J.; Moon, Thomas; Chronos, Nicolas A.

In: Circulation, Vol. 105, No. 7, 19.02.2002, p. 788-793.

Research output: Contribution to journalArticle

Simons, M, Annex, BH, Laham, RJ, Kleiman, N, Henry, T, Dauerman, H, Udelson, JE, Gervino, EV, Pike, M, Whitehouse, MJ, Moon, T & Chronos, NA 2002, 'Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2: Double-blind, randomized, controlled clinical trial', Circulation, vol. 105, no. 7, pp. 788-793. https://doi.org/10.1161/hc0802.104407
Simons, Michael ; Annex, Brian H. ; Laham, Roger J. ; Kleiman, Neal ; Henry, Timothy ; Dauerman, Harold ; Udelson, James E. ; Gervino, Ernesto V. ; Pike, Marilyn ; Whitehouse, M. J. ; Moon, Thomas ; Chronos, Nicolas A. / Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2 : Double-blind, randomized, controlled clinical trial. In: Circulation. 2002 ; Vol. 105, No. 7. pp. 788-793.
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abstract = "Background - Single-bolus intracoronary administration of fibroblast growth factor-2 (FGF2) improved symptoms and myocardial function in a phase I, open-label trial in patients with coronary artery disease. We conducted the FGF Initiating RevaScularization Trial (FIRST) to evaluate further the efficacy and safety of recombinant FGF2 (rFGF2). Methods and Results - FIRST is a multicenter, randomized, double-blind, placebo-controlled trial of a single intracoronary infusion of rFGF2 at 0, 0.3, 3, or 30 μg/kg (n=337 patients). Efficacy was evaluated at 90 and 180 days by exercise tolerance test, myocardial nuclear perfusion imaging, Seattle Angina Questionnaire, and Short-Form 36 questionnaire. Exercise tolerance was increased at 90 days in all groups and was not significantly different between placebo and FGF-treated groups. rFGF2 reduced angina symptoms as measured by the angina frequency score of the Seattle Angina Questionnaire (overall P=0.035) and the physical component summary scale of the Short-Form 36 (pairwise P=0.033, all FGF groups versus placebo). These differences were more pronounced in highly symptomatic patients (baseline angina frequency score ≤40 or Canadian Cardiovascular Society score of III or IV). None of the differences were significant at 180 days because of continued improvement in the placebo group. Adverse events were similar across all groups, except for hypotension, which occurred with higher frequency in the 30-μg/kg rFGF2 group. Conclusions - A single intracoronary infusion of rFGF2 does not improve exercise tolerance or myocardial perfusion but does show trends toward symptomatic improvement at 90 (but not 180) days.",
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AU - Simons, Michael

AU - Annex, Brian H.

AU - Laham, Roger J.

AU - Kleiman, Neal

AU - Henry, Timothy

AU - Dauerman, Harold

AU - Udelson, James E.

AU - Gervino, Ernesto V.

AU - Pike, Marilyn

AU - Whitehouse, M. J.

AU - Moon, Thomas

AU - Chronos, Nicolas A.

PY - 2002/2/19

Y1 - 2002/2/19

N2 - Background - Single-bolus intracoronary administration of fibroblast growth factor-2 (FGF2) improved symptoms and myocardial function in a phase I, open-label trial in patients with coronary artery disease. We conducted the FGF Initiating RevaScularization Trial (FIRST) to evaluate further the efficacy and safety of recombinant FGF2 (rFGF2). Methods and Results - FIRST is a multicenter, randomized, double-blind, placebo-controlled trial of a single intracoronary infusion of rFGF2 at 0, 0.3, 3, or 30 μg/kg (n=337 patients). Efficacy was evaluated at 90 and 180 days by exercise tolerance test, myocardial nuclear perfusion imaging, Seattle Angina Questionnaire, and Short-Form 36 questionnaire. Exercise tolerance was increased at 90 days in all groups and was not significantly different between placebo and FGF-treated groups. rFGF2 reduced angina symptoms as measured by the angina frequency score of the Seattle Angina Questionnaire (overall P=0.035) and the physical component summary scale of the Short-Form 36 (pairwise P=0.033, all FGF groups versus placebo). These differences were more pronounced in highly symptomatic patients (baseline angina frequency score ≤40 or Canadian Cardiovascular Society score of III or IV). None of the differences were significant at 180 days because of continued improvement in the placebo group. Adverse events were similar across all groups, except for hypotension, which occurred with higher frequency in the 30-μg/kg rFGF2 group. Conclusions - A single intracoronary infusion of rFGF2 does not improve exercise tolerance or myocardial perfusion but does show trends toward symptomatic improvement at 90 (but not 180) days.

AB - Background - Single-bolus intracoronary administration of fibroblast growth factor-2 (FGF2) improved symptoms and myocardial function in a phase I, open-label trial in patients with coronary artery disease. We conducted the FGF Initiating RevaScularization Trial (FIRST) to evaluate further the efficacy and safety of recombinant FGF2 (rFGF2). Methods and Results - FIRST is a multicenter, randomized, double-blind, placebo-controlled trial of a single intracoronary infusion of rFGF2 at 0, 0.3, 3, or 30 μg/kg (n=337 patients). Efficacy was evaluated at 90 and 180 days by exercise tolerance test, myocardial nuclear perfusion imaging, Seattle Angina Questionnaire, and Short-Form 36 questionnaire. Exercise tolerance was increased at 90 days in all groups and was not significantly different between placebo and FGF-treated groups. rFGF2 reduced angina symptoms as measured by the angina frequency score of the Seattle Angina Questionnaire (overall P=0.035) and the physical component summary scale of the Short-Form 36 (pairwise P=0.033, all FGF groups versus placebo). These differences were more pronounced in highly symptomatic patients (baseline angina frequency score ≤40 or Canadian Cardiovascular Society score of III or IV). None of the differences were significant at 180 days because of continued improvement in the placebo group. Adverse events were similar across all groups, except for hypotension, which occurred with higher frequency in the 30-μg/kg rFGF2 group. Conclusions - A single intracoronary infusion of rFGF2 does not improve exercise tolerance or myocardial perfusion but does show trends toward symptomatic improvement at 90 (but not 180) days.

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KW - Angiogenesis

KW - Coronary disease

KW - Revascularization

KW - Trials

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