"Made to measure" heart failure drugs

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M

Marge

This may be of interest to those of us who are on beta blockers.

When I first started on Coreg, I was told that it helped about one third of those taking it, didn't seem to have much effect on another one third, and might actually be harmful to another one third. There didn't seem to be much of a way to tell ahead of time who would be helped. The article seems to indicate that in the future it may be possible to predict how individuals will respond & thereby to individualize beta blocker treatment more.

<< 'Made to measure' heart drug hope

By Michelle Roberts
BBC News Health reporter, Washington DC

Scientists say they have discovered gene differences that reveal which patients will benefit from a common type of heart drug.

In the future, doctors could tailor treatments to suit the individual based on their genes, they hope.

Professor Steve Liggett of the University of Cincinnati found some patients with heart failure responded better to beta-blockers than others.

"Good" responders had a 38% reduced risk of death as a result.

Heart failure is a serious disease that carries a 50% mortality rate over five years.

Beta-blockers are prescribed along with other heart drugs to relieve the pressure on the heart and help it function more normally.

However, Professor Liggett says, in some patients, adding in a beta-blocker does little to help and may actually cause more problems through side effects, or though interfering with the other medications the individual is on.

In earlier laboratory research in mice and human tissue, he discovered genetic variations in the receptor that beta blockers act on in the body.

One version of the beta-1-adrenergic receptor, the Arg version, appeared to respond better to beta-blockers than the other version, Gly.

To test whether this might be important clinically he recruited 1,040 heart failure patients to take part in a trial.

Half of the patients were given a beta-blocker called bucindolol and the other half received a dummy drug.

He followed what happened to the patients over five years and compared the outcomes with each individual's receptor type.

The patients with the Arg receptor fared much better.

"It was only this one group that had any benefit from the beta-blocker," said Professor Liggett.

In addition to the 38% reduction in death rate, these patients had a 36% reduction in the number of times they had to be hospitalised for their condition.

He said it was likely that the same would be true with other beta-blockers more commonly used.

"I'm beginning to get the feeling that this is a class effect."

Other researchers have found a similar variation in response to beta-blocker treatment among people with high blood pressure in relation to the same Arg/Gly receptor.

Professor Liggett predicts that by 2010, it will be possible for doctors to tailor an individual patient's treatment according to their genes.

Speaking on this topic at the meeting of the American Association for the Advancement of Science, Kathleen Giacomini from the University of California said: "At the moment we have a situation where drugs that have very serious side effects are used to treat large numbers of people and are not personalised.

"In the future, we can hope to begin to solve these problems and develop safer medicines."

She said several teams across the US were looking at tailor-made drugs for asthma, cancer, cardiovascular disease and depression. >>
http://news.bbc.co.uk/2/hi/science/nature/4277597.stm
 
Thanks, Marge. This was very interesting. It begs two questions. Was the study done by a mfger of beta blockers? Second, will we live til 2010 to benefit from the measured dose? I notice nobody else has responded. Wonder why? It concerns many of us.
 
Hi Marge,

It was a very interesting article. As a group, I think we have experienced how different our experiences can be with certain drugs. I am no longer on a beta-blocker because I just could not tolerate the side effects. It would be nice to know in advance what drugs would most likely to be helpful in each individual but I really wonder what the cost of doing that would be.

Ann, 2010 isn't all that long away anymore. :)
 
Beta blockers

Beta blockers

Hi. My cardiologist put me on Beta blockers last fall (Toprol XL). I don't have heart failure. She said she wants to see if it will have an effect on extending the life of my bovine valve - AVR, 2000. She also indicated that she was starting a study on the efficacy. I would like to know what side effects some of you have had. I only notice that I'm more tired these last few months.

Thanks Renee
 
no problem here

no problem here

Rene, I have been on Toprol for 3+ years and have experienced no adverse side effects. As a matter of fact my Cardio doc just upped my dose to 150 mg a day. Tired might be for another reason? Take care and if I can answer any other questions I certainly will try to. Laurie
 

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