Encouraging Results Reported for Heart Transplant Drug

An experimental immunosuppressant drug, everolimus, appears to be significantly more effective than the current therapy, Imuran, in reducing the severity and incidence of serious complications in heart transplant patients, according to a report in the New England Journal of Medicine.

Researchers said that everolimus appears to prevent or significantly reduce a condition called chronic rejection syndrome, in which muscle cells in the blood vessel walls proliferate, narrowing the vessels and squeezing the supply of blood to the new heart.

The condition occurs in at least half of all heart transplant patients, and often results in death or rejection of the new organ.

In a study led by Dr. Howard J. Eisen of Temple University School of Medicine, researchers at 52 centers in the United States, South America, Canada and Europe gave 634 patients either Imuran (azathioprine), 1.5 milligrams a day of everolimus, or double that dose.

Thirty percent of those patients on the higher dose of the experimental drug developed thickened blood vessels compared to 53 percent of those on Imuran. And the average thickening was much smaller among patients on everolimus.

After one year, 53 percent of the patients on Imuran had died, needed a second new heart, or had episodes of rejection that impaired blood flow or needed extra treatment. That compared with only 32 percent on the higher dose of everolimus.

Researchers also reported that everolimus significantly reduced the incidence of cytomegalovirus (CMV) infection, a major problem after transplantation.

"The impressive ability of everolimus to decrease the incidence and severity of cardiac allograft vasculopathy could offer transplant patients a powerful tool to improve long-term survival -- one of the major challenges in transplantation," said Eisen.

Other Sources: New England Journal of Medicine