DITPA (3,5-Diiodothyropropionic Acid), a thyroid hormone analog to treat heart failure: phase II trial veterans affairs cooperative study.
BACKGROUND
In animal studies and a pilot trial in patients with congestive heart failure, the thyroid hormone analog 3,5 diiodothyropropionic acid (DITPA) had beneficial hemodynamic effects.


RESULTS
This was a phase II multicenter, randomized, placebo-controlled, double-blind trial of New York Heart Association class II to IV congestive heart failure patients randomized (2:1) to DITPA or placebo and treated for 6 months. The study enrolled 86 patients (n=57 to DITPA, n=29 to placebo). The primary objective was to assess the effect of DITPA on a composite congestive heart failure end point that classifies patients as improved, worsened, or unchanged based on symptom changes and morbidity/mortality. DITPA was poorly tolerated, which obscured the interpretation of congestive heart failure-specific effects. Fatigue and gastrointestinal complaints, in particular, were more frequent in the DITPA group. DITPA increased cardiac index (by 18%) and decreased systemic vascular resistance (by 11%), serum cholesterol (-20%), low-density lipoprotein cholesterol (-30%), and body weight (-11 lb). Thyroid-stimulating hormone was suppressed in patients given DITPA, which reflects its thyromimetic effect; however, no symptoms or signs of potential hypothyroidism or thyrotoxicosis were seen.


CONCLUSIONS
DITPA improved some hemodynamic and metabolic parameters, but there was no evidence for symptomatic benefit in congestive heart failure.
Goldman
Steven
S
Cardiology Section (1-111C), Southern Arizona VA Health Care System, 3601 S 6th Ave, Tucson, AZ 85723, USA. steven.goldman@va.gov
McCarren
Madeline
M
Morkin
Eugene
E
Ladenson
Paul W
PW
Edson
Robert
R
Warren
Stuart
S
Ohm
Janet
J
Thai
Hoang
H
Churby
Lori
L
Barnhill
Jamie
J
O'Brien
Terrence
T
Anand
Inder
I
Warner
Alberta
A
Hattler
Brack
B
Dunlap
Mark
M
Erikson
John
J
Shih
Mei-Chiung
MC
Lavori
Phil
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D002784:Cholesterol / Q000097:blood; D004104:Diiodothyronines / Q000008:administration & dosage* / Q000009:adverse effects*; D004311:Double-Blind Method; D005221:Fatigue / Q000097:blood / Q000139:chemically induced; D005260:Female; D005767:Gastrointestinal Diseases / Q000097:blood / Q000139:chemically induced; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D011422:Propionates / Q000008:administration & dosage* / Q000009:adverse effects*; D013963:Thyroid Hormones; D014481:United States; D014493:United States Department of Veterans Affairs; D014655:Vascular Resistance / Q000187:drug effects
D004104:Diiodothyronines; D008077:Lipoproteins, LDL; D011422:Propionates; D013963:Thyroid Hormones; C082182:3,5-diiodothyropropionic acid; D002784:Cholesterol