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Sponsored by: |
University of Maryland |
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Information provided by: | University of Maryland |
ClinicalTrials.gov Identifier: | NCT00806390 |
The primary objective of this study is to investigate whether giving prophylactic metoprolol prior to and during anthracycline therapy will decrease the incidence of anthracycline-induced cardiomyopathy. Patients are randomized to receive metoprolol or no treatment prior to anthracycline treatment. The ejection fraction, as measured by nuclear ventriculography is measured before and after treatment.
Condition | Intervention | Phase |
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Cardiomyopathy |
Drug: Metoprolol |
Phase IV |
Study Type: | Interventional |
Study Design: | Prevention, Randomized, Open Label, Single Group Assignment, Efficacy Study |
Official Title: | GCC0766: Prevention of Anthracycline Induced Cardiomyopathy by Metoprolol |
Estimated Enrollment: | 58 |
Study Start Date: | July 2008 |
Estimated Primary Completion Date: | June 2010 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Metoprolol: Active Comparator
Receiving metoprolol
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Drug: Metoprolol
Metroprolol tartrate titrated up
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Control: No Intervention
Not receiving metoprolol
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This is a randomized, controlled exploration. Consent will be obtained from patients receiving care for cancer with anthracycline regimen at the University Of Maryland Greenebaum Cancer Center prior to initiation of anthracycline treatment during the initial oncology visit.
Patients will be evaluated in the initial consultation in the oncology clinic during which time consent will be obtained, and any patient with bradycardia (HR less than 50) or other contraindication will be excluded from the study. The patients will be randomly assigned to metoprolol vs. control groups during this initial visit. Individuals in the control group will not receive any study drug where as those in the metoprolol group will be given prophylactic metoprolol prior to initiation of anthracycline treatment. Metoprolol tartrate will be provided to each patient randomized to the metoprolol group.
Also at the time of the initial consultation, a baseline MUGA will be obtained for evaluation of left ventricular ejection fraction. Additionally, a post-treatment MUGA will be obtained after the final course of chemotherapy. Lastly, also at the initial visit, one vial of blood will be obtained from each patient to test for genetic polymorphisms, as described in the background section, which may contribute to the response to beta blockade in the prevention of anthracyline induced cardiomyopathy.
Each participant in the metoprolol group will be started on 25 mg of metoprolol tartrate twice a day prior to initiation of the anthracycline. After one week, this dose will be increased to 50 mg twice daily, if tolerated. Prior to increasing the dose, the patients will be seen in the cardiology research clinic by the study doctor and evaluated for side effects. After another week the dose will again be increased to 100 mg twice daily. The dose can be decreased at any time if side effects occur such as bradycardia with HR less than 50 or hypotension with SBP less than 90. The beta blocker will be held for two days prior to the post-treatment MUGA so as not to acutely affect heart rate, as a decrease in heart rate would be expected to increase EF14. Abrupt cessation of metoprolol tartrate will not lead to withdrawal of beta-blockade. This study will end with the post-treatment MUGA. The primary end point of this study will be the change in EF before and after anthracycline treatment. A pill diary will be maintained to document compliance of study medication.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Stephen S Gottlieb, MD | 4103288788 | sgottlie@medicine.umaryland.edu |
United States, Maryland | |
University of Maryland | Recruiting |
Baltimore, Maryland, United States, 21201 | |
Principal Investigator: Stephen S Gottlieb, MD | |
Sub-Investigator: Jennifer Brown, MD |
Principal Investigator: | Stephen S Gottlieb, MD | University of Maryland |
Responsible Party: | University of MD ( Stephen Gottlieb ) |
Study ID Numbers: | H-29426 |
Study First Received: | December 8, 2008 |
Last Updated: | December 9, 2008 |
ClinicalTrials.gov Identifier: | NCT00806390 |
Health Authority: | United States: Institutional Review Board |
ejection fraction anthracyclines beta-adrenergic blockade Patients receiving anthracyclines |
Heart Diseases Metoprolol succinate Metoprolol Cardiomyopathies |
Neurotransmitter Agents Sympatholytics Adrenergic Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Cardiovascular Agents Antihypertensive Agents Pharmacologic Actions |
Autonomic Agents Therapeutic Uses Adrenergic beta-Antagonists Cardiovascular Diseases Adrenergic Antagonists Peripheral Nervous System Agents Anti-Arrhythmia Agents |