Gene therapy for refractory angina

Refractory angina is a chronic disorder, which accompanies coronary artery disease. Patients experience lower physical activity and require support of physicians from multiple disciplines. Currently, there is no treatment for refractory angina.

To date, two genetic trials aimed to lighten the life of refractory angina patients. Today, the third trial was entered into the clinical registry.

New gene therapy (NCT04125732) will begin in January 2020. 29 patients will receive adenovirus carrying VEGF gene. The dose of single administration will be evaluated in the first 12 participants divided to four groups. Then, the most efficient dose will be tested in the following 17 individuals. Primary goal, as always in early clinical trials, will be safety assessment. Secondary goals include various measures of physical activity and severity of angina.

Viral vectors are expected to reach epicardial tissue and establish expression of the VEGF gene. VEGF is known for induction of angiogenesis – formation of new blood vessels, which should help to ease refractory angina.

This is the third gene therapy for this disorder, after a trial of adenovirus with FGF-4 in 2016 (NCT02928094) and a trial of adenovirus with VEGF in 2017 (NCT03039751). Both studies are still described as “not yet recruiting”.

Photo: Christopher V. Carman and Roberta Martinelli, Harvard Medical School, Boston, Mass.