Sunday, March 05, 2000

Patients first to try new therapy


Light-activated drug zaps clogs in arteries

BY TIM BONFIELD
The Cincinnati Enquirer

        Jerry Lowe and Dan Nader can look at the world in a new light after becoming a part of medical history.

        The two men have become the first patients worldwide to receive an experimental treatment that uses a light-activated drug to zap clogged coronary arteries. The treatments were done Feb. 25 at Christ Hospital as part of a study run by the Lindner Clinical Trial Center.

        Mr. Lowe, 49, of Hillsboro, said it was “kind of a surprise” to learn he was the first patient.

        “I feel great,” Mr. Lowe said. “And from what I've been told, it's been a success.”

        Phototherapy has emerged in recent years as a way to guide medications so they attack disease without harming healthy tissue. Light-activated drugs have been tested for certain kinds of throat cancer and to treat blocked blood vessels in the legs. Now, researchers are looking at the concept for treating heart disease.

        “I think you're going to see a whole new wave of (drug therapies) as we understand more about the role inflammation plays in vascular disease,” said Dr. Dean Kereiakes, medical director of the Lindner Center and principal investigator in the cardiac phototherapy trial.

        The Lindner Center is testing a drug called Antrin, made by California-based Pharmacyclics Inc. When triggered by light, the drug destroys plaque, a tissuelike substance that builds up inside blood vessels.

        In the next several months, 70 to 75 patients will be tested at Christ Hospital in Cincinnati, at Brigham and Women's Hospital in Boston, and at St. Joseph Medical Center in Ann Arbor, Mich.

        In addition, Dr. Kereiakes said he's aware of at least two drug companies developing their versions of light-activated heart drugs that will soon be ready for human testing.

        For Antrin, the two-step treatment begins with patients taking an IV dose of the drug a day before the procedure. The drug courses through the body, but is designed to concentrate primarily in plaque cells. Without exposure to light, the drug does nothing and gets processed out of the body within days.

        To “turn on” the drug, doctors insert a catheter at the groin, then snake a fiber-optic cable up through large blood vessels to the blocked area near the heart. A laser then makes a 30-millimeter section of the cable glow red for about 12 minutes.

        The patient goes home the day after treatment, but the drug keeps working for several days. In tests involving leg vessels, the drug stopped plaque growth. Sometimes it also helped shrink the plaque, Dr. Kereiakes said.

        Both Tristate men had their blocked arteries propped open with stents, in addition to the light treatment. The stents were needed because doctors considered it too risky for patients to wait several days for the drug to act.

        For now, the idea is to use Antrin as a way to prevent blockages from the inflammation and scarring that often occurs after placing a stent. Such an approach would be similar to using radioactive fibers to prevent scarring, which also have been recently tested through the Lindner Center.

        “You could look at Antrin as a competing type of technology with radiation,” Dr. Kereiakes said.

        If Antrin lives up to hopes, the light therapy might be useful all by itself as a treatment before blockages reach serious levels. High-risk patients, people with diabetes or a family history of heart disease, “might get something like this every couple of years as a (preventive) treatment,” Dr. Kereiakes said.

        Daniel Nader, 76, of Price Hill, said it felt “fantastic” to be the second patient in the study. Not only has the treatment made him feel better, he said, but the information might help other people.

        Mr. Nader has volunteered for several years at a Catholic church-run food pantry and at church bingo games. Getting into the study might have been God's way of paying him back for those efforts, he said.

        “I feel like I just got my reward. I feel like I can continue to do what I want to do,” Mr. Nader said.

       



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