title: Safety and efficacy of SITAgliptin plus GRanulocyte-colony-stimulating factor in patients suffering from Acute Myocardial Infarction (SITAGRAMI-Trial)--rationale, design and first interim analysis.
abstract: OBJECTIVE
  Our pre-clinical studies demonstrated that G-CSF based stem cell mobilization in combination with genetic or pharmaceutical CD26/DPP-IV inhibition after acute myocardial infarction leads to improved cardiac homing of stem cells, enhanced heart function and increased survival. Thereupon, we initiated a phase III, multi-centre, randomised, placebo-controlled efficacy and safety study (n=100) analyzing the effect of combined application of G-CSF and Sitagliptin, which is a clinically admitted, anti-diabetic DPP-IV-inhibitor, after acute myocardial infarction ("SITAGRAMI-Trial"; EudraCT Number: 2007-003941-34).
  
  
  METHODS
  The primary objective of the study is to assess myocardial regeneration by improved myocardial homing of mobilized stem cells, as measured by cardiac function using MRI analysis. In this paper, we report on the study design and a planned first interim-analysis on safety issues without unblinding.
  
  
  RESULTS
  During the first 6 weeks of follow-up, only two major adverse cardiac events occurred (one de novo stenosis and one instent-restenosis) in the first 36 patients. Presumably, they were not related to any study medication. No other side effects like headache, bone pain, hypoglycaemias etc. were observed. Furthermore, no myocardial infarction or death occurred in any patient. Thus, the rate of serious adverse events lay within the expected range.
  
  
  CONCLUSIONS
  Our data demonstrate that the combined application of Sitagliptin and G-CSF seems to be safe on the short term and feasible after acute myocardial infarction and may represent a new therapeutic option in future.
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Hans D
authors.initials: HD
authors.lastname: Theiss
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Brenner
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Markus G
authors.initials: MG
authors.lastname: Engelmann
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Marc-Michael
authors.initials: MM
authors.lastname: Zaruba
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Huber
authors.affiliation: Institute for medical Informatics, Biometry und Epidemiology, Germany.
authors.forename: Volkmar
authors.initials: V
authors.lastname: Henschel
authors.affiliation: Institute for medical Informatics, Biometry und Epidemiology, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mansmann
authors.affiliation: Institute of Radiology, all Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Wintersperger
authors.affiliation: Institute of Radiology, all Klinikum Grosshadern, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.affiliation: Medical Department I - Cardiology, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.affiliation: Medical Department I - Cardiology, Germany. Electronic address: wolfgang.franz@med.uni-muenchen.de.
authors.forename: Wolfgang-M
authors.initials: WM
authors.lastname: Franz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D011719:Pyrazines / Q000008:administration & dosage* / Q000009:adverse effects*; D000068900:Sitagliptin Phosphate; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D011719:Pyrazines; D014230:Triazoles; D016179:Granulocyte Colony-Stimulating Factor; D000068900:Sitagliptin Phosphate