title: DITPA (3,5-Diiodothyropropionic Acid), a thyroid hormone analog to treat heart failure: phase II trial veterans affairs cooperative study.
abstract: 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.
authors.affiliation: Cardiology Section (1-111C), Southern Arizona VA Health Care System, 3601 S 6th Ave, Tucson, AZ 85723, USA. steven.goldman@va.gov
authors.forename: Steven
authors.initials: S
authors.lastname: Goldman
authors.forename: Madeline
authors.initials: M
authors.lastname: McCarren
authors.forename: Eugene
authors.initials: E
authors.lastname: Morkin
authors.forename: Paul W
authors.initials: PW
authors.lastname: Ladenson
authors.forename: Robert
authors.initials: R
authors.lastname: Edson
authors.forename: Stuart
authors.initials: S
authors.lastname: Warren
authors.forename: Janet
authors.initials: J
authors.lastname: Ohm
authors.forename: Hoang
authors.initials: H
authors.lastname: Thai
authors.forename: Lori
authors.initials: L
authors.lastname: Churby
authors.forename: Jamie
authors.initials: J
authors.lastname: Barnhill
authors.forename: Terrence
authors.initials: T
authors.lastname: O'Brien
authors.forename: Inder
authors.initials: I
authors.lastname: Anand
authors.forename: Alberta
authors.initials: A
authors.lastname: Warner
authors.forename: Brack
authors.initials: B
authors.lastname: Hattler
authors.forename: Mark
authors.initials: M
authors.lastname: Dunlap
authors.forename: John
authors.initials: J
authors.lastname: Erikson
authors.forename: Mei-Chiung
authors.initials: MC
authors.lastname: Shih
authors.forename: Phil
authors.initials: P
authors.lastname: Lavori
mesh_terms: 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
chemical_list: D004104:Diiodothyronines; D008077:Lipoproteins, LDL; D011422:Propionates; D013963:Thyroid Hormones; C082182:3,5-diiodothyropropionic acid; D002784:Cholesterol