Interferon beta-1b therapy in chronic viral dilated cardiomyopathy--is there a role for specific therapy?
BACKGROUND
Myocardial biopsy can be used for the detection of viral genome in dilated cardiomyopathy (DCM). Pilot studies have previously reported beneficial effects on clinical outcome and safety of an antiviral therapy using interferon beta-1b in chronic viral DCM.


RESULTS
Myocardial biopsies were taken from patients with DCM. Using polymerase chain reaction and Southern Blot analysis, viral genome could be detected in 49% of patients. In 42 patients with viral infection, off-label use with interferon beta-1b was initiated. A further 68 patients formed the control group. The outcome was evaluated after follow-up with echocardiography, exercise electrocardiogram, and New York Heart Association class. A total of 81 men and 29 women with a median left ventricular ejection fraction of 34% were included. The follow-up period was 36 months. In 33 (79%) patients with interferon beta-1b treatment, minor adverse reactions occurred, but no major adverse events were reported. No significant benefit for interferon beta-1b treatment on clinical outcome could be detected during follow-up.


CONCLUSIONS
Off-label use with interferon beta-1b in patients with viral DCM is feasible and safe under routine clinical practice. Concerning the herein evaluated clinical outcome parameters, promising results from pilot studies could not be confirmed. High prevalence of parvovirus B19 (92%) might influence the results.
Zimmermann
Oliver
O
Department of Internal Medicine II - Cardiology, University of Ulm, Ulm, Germany. oliver.zimmermann@uniklinik-ulm.de
Rodewald
Christoph
C
Radermacher
Michael
M
Vetter
Martin
M
Wiehe
Juliane M
JM
Bienek-Ziolkowski
Magdalena
M
Hombach
Vinzenz
V
Torzewski
Jan
J
D000328:Adult; D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000235:genetics / Q000821:virology*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D016679:Genome, Viral / Q000235:genetics; D006801:Humans; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000502:physiology* / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000639:trends; D012189:Retrospective Studies; D014777:Virus Diseases / Q000188:drug therapy* / Q000235:genetics / Q000821:virology*; D055815:Young Adult
D000068576:Interferon beta-1b; D016899:Interferon-beta