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A multicenter, randomized trial evaluating the efficacy and safety of Ad5FGF-4 gene therapy in patients with angina not responsive to traditional revascularization options. Presented at ACC 2005.
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AGENT-3 Trial A Multicenter, Prospective, Randomized Trial of Intracoronary Administration of Ad5FGF-4 in Patients With No Revascularization Options (AGENT-3) Trial Presented at The American College of Cardiology Scientific Sessions 2005 Presented by Dr. Timothy Henry
AGENT-3 Trial 415 patients with CCS Class 2-4 angina despite optimal medical treatment not in need of immediate traditional revascularizationstrategies, able to walk between 3 & 10 minutes with inducible ST depression of at least 1 mm and variability between successive exercise tests of 20% or less, at least 1 proximal vessel with <70% stenosis Placebo controlled, randomized, blinded, mean follow-up 5 years (data reported for 1 year) Amino Acid Protein Ad5FGF-4 1*109 virus particles n=150 Amino Acid Protein Ad5FGF-4 1*1010 virus particles n=150 Control n=150 Primary Endpoint:Change in exercise tolerance test (ETT) time from baseline to 12 weeks and the proportion of patients with 30% greater increase in treadmill exercise duration in 12 weeks. Secondary Endpoint:Time to a number of patients with coronary events (non-fatal MI, unplanned hospitalization or revascularization for myocardial ischemia), death at 12 months, time to ST depression, angina, and quality of life parameters. Presented at ACC2005
AGENT-3 Trial: Primary Endpoint Primary endpoint of change in ETT duration • The primary endpoint of change in ETT duration at 12 weeks was not significant. There was also no change in exercise duration at 6 months. • In a pre-specified analysis, older patients (>55 years) with more severe angina (CCS Class 3 or 4) had a significantly greater increase in ETT at 12 weeks (p=0.02 high-dose, p=0.08 low-dose) and 6 months (p=0.08 high-dose, p=0.07 low-dose). • Similarly, older patients (>55years) with exercise time 300 seconds or less had a significantly greater increase in ETT time at 12 weeks (p=0.03 high-dose, p=0.06 low-dose) and 6 months (p=0.017 high-dose, p=0.03 low-dose). Presented at ACC 2005
AGENT-3 Trial: Subgroup Analysis p=NS • The combined endpoint of coronary events or death at 1 year in patients completing 12 month follow-up did not differ significantly among the three groups. % Presented at ACC 2005
AGENT-3 Trial: Summary • This study is the largest randomized gene therapy trial for myocardial angiogenesis. • Ad5FGF-4 was not associated with increased exercise time compared to placebo • The favorable safety profile of this drug seen in this trial makes further evaluation using higher doses possible. • The beneficial effect demonstrated in the pre-specified subgroup analysis of higher risk patients warrants further study. Presented at ACC 2005