Rationale, design and organisation of an efficacy and safety study of oxypurinol added to standard therapy in patients with NYHA class III - IV congestive heart failure

Ronald S. Freudenberg, Richard P. Schwarz, Joanne Brown, Alan Moore, Douglas Mann, Michael M. Givertz, Wilson S. Colucci, Joshua M. Hare

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

Oxypurinol, the active metabolite of allopurinol and a potent xanthine oxidase inhibitor (XOI), is under evaluation as a novel agent for the treatment of congestive heart failure (HF). Several lines of evidence provide the rationale for the hypothesis that XOIs will improve clinical outcomes in patients with HF. First, XOIs have unique positive inotropic effects, improving myocardial contraction and performance while simultaneously improving myocardial energy metabolism. Second, XOIs ameliorate endothelial dysfunction in humans with HF. Finally, XO activity is upregulated in the heart and vasculature of subjects with HF, which may in turn contribute to oxidative stress and/or increased uric acid levels. Together these findings form the rationale for the Controlled Efficacy and Safety Study of Oxypurinol Added to Standard Therapy in Patients with New York Heart Association (NYHA) class III - IV Congestive Heart Failure (OPT-CHF) trial (Food and Drug Adminstration IND 65,125), a Phase II - III prospective, randomised, double-blind, placebo-controlled trial, which will include patients with stable symptomatic HF in NYHA class III - IV congestive HF who are deemed clinically stable on a standard and appropriately maximised heart failure therapy regimen. The efficacy end point for OPT-CHF is a composite that incorporates measures of patient outcome and well-being.

Original languageEnglish (US)
Pages (from-to)1509-1516
Number of pages8
JournalExpert opinion on investigational drugs
Volume13
Issue number11
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

Keywords

  • Clinical trial
  • Drug therapy
  • Heart failure
  • Oxidative stress
  • Xanthine oxidase

ASJC Scopus subject areas

  • Pharmacology

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