Immune Therapy May Help Some Heart Failure Patients

By Amanda Gardner
HealthDay Reporter
Thursday, January 17, 2008; 8:00 PM

Copyright © 2008 ScoutNews, LLC. All rights reserved.

THURSDAY, Jan. 17 (HealthDay News -- Some patients with heart failure may stand to benefit from therapy which modifies the body's immune response.

A study in the Jan. 19 issue of The Lancet found that patients with no history of heart attacks, as well as those in a milder stage of heart failure, had a reduced rate of death and of subsequent hospitalizations with such a treatment.

But the novel therapy is far from hitting hospitals or doctors' offices any time soon, experts said.

"It had absolutely no improvement [in the general study population]," noted Dr. Norbert Moskovits, director of the Heart Failure Program at Maimonides Medical Center in New York City. "The subgroup analysis is more or less a way to come up with a new study. If they show improvements in certain subgroups then next time they can look at that in a larger trial. You cannot draw any conclusions from this, really. It was a very good trial and it still showed nothing."

According to the American Heart Association, some five million Americans have heart failure. "There are half a million new cases each year. It is the number one discharge diagnosis for Medicare patients," Moskovits said. "It's a huge problem, and that's why everyone is looking for a new angle."

Heart failure is commonly treated with drugs, including ACE inhibitors, beta blockers and diuretics. "Most improve patient survival, symptoms and lifestyle," Moskovits said.

Some experts believe that inflammation plays a role in chronic heart failure. Logic would dictate, then, that interfering with the immune system and related inflammatory processes could impact the course of the disease.

But interventions that have targeted specific inflammatory cytokines (signaling chemicals central to the immune system) have not met with much success.

This has led scientists to hypothesize that affecting the immune system more generally might have a benefit.

This study involved more than 2,400 heart failure patients who were randomly assigned to receive non-specific immunomodulation therapy (IMT) or a placebo. They also had left ventricular systolic dysfunction and had undergone hospitalization for heart failure or IV drug therapy in an outpatient setting within the past 12 months.