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A Study of CK-1827452 Infusion in Stable Heart Failure

Primary Purpose

Heart Failure

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CK-1827452
CK-1827452
CK-1827452
CK-1827452
CK-1827452
CK-1827452
CK-1827452
CK-1827452
Placebo
Placebo
CK-1827452
Placebo
CK-1827452
CK-1827452
CK-1827452
CK-1827452
Sponsored by
Cytokinetics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Failure

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Patient is male, or female of non-childbearing potential (two years post-menopausal or surgically sterilized)
  2. Female patients must have a negative urine pregnancy test prior to entry into the study
  3. Patient is 18 years old or greater
  4. Patient has given signed informed consent
  5. Patient is considered to be in suitable health in the opinion of the investigator, as determined by:

    • A pre-study physical examination with no clinical abnormalities which in the opinion of the investigator would preclude participation in the study other than physical symptoms or signs consistent with stable heart failure
    • An electrocardiogram (ECG) with no abnormalities in the opinion of the investigator that would impair assessment of stopping criteria
  6. Patient has pre-study clinical laboratory findings that are within normal range, or if outside of the normal range, should not preclude participation in the study in the opinion of the investigator (see Exclusion Criteria, below, for exceptions)
  7. Patient has a documented diagnosis of heart failure with an ejection fraction of less than 40%
  8. Patient has been on a stable dose of a beta blocker and an ACE (angiotensin-converting enzyme) inhibitor or an ARB (angiotensin II receptor blocker) for at least 4 weeks. If prescribed, diuretics must have been administered according to a consistent regimen for at least 4 weeks
  9. Patient is currently in sinus rhythm
  10. Patient has interpretable echocardiographic images on a screening echocardiogram

Exclusion Criteria

  1. Patient has been hospitalized for heart failure, myocardial infarction, coronary revascularization, or another cardiac indication within the last 6 weeks
  2. Patient has a current history of alcohol use which in the opinion of the investigator would preclude participation in the study
  3. Patient has a current history of drug abuse
  4. Patient has donated blood or blood products within 30 days prior to screening
  5. Patient has Canadian Cardiovascular Society (CCS) Class III or IV angina
  6. Patient has significant obstructive valvular disease or significant congenital heart disease
  7. Patient has had a valve replacement
  8. Patient is pacemaker dependent
  9. Patient is on chronic anti-arrhythmic therapy, with the exception of amiodarone
  10. Patient is currently taking, or has taken in the last 7 days, a CYP3A4 inhibitor or inducer medication
  11. Patient has a history of hypertrophic obstructive cardiomyopathy
  12. Patient weighs > 120 kg
  13. Patient has a supine resting systolic blood pressure < 95 mmHg after 3 minutes rest
  14. Patient has a supine resting heart rate ≥ 100 beats per minute after 3 minutes rest
  15. Patient has an Modification of Diet in Renal Disease (MDRD) estimate of Glomerular Filtration Rate (GFR) ≤ 35 ml/min/1.73 m2
  16. Patient has a potassium < 3.5 mEq/L or > 5.5 mEq/L
  17. Patient has a sodium ≤ 133 mEq/L
  18. Patient has a urea > 15 mmole/L
  19. Patient has a troponin I or T at screening that is detectable at the investigative site's clinical laboratory
  20. Patient has a hemoglobin < 11 gm/dL in males or < 10 gm/dL in females
  21. Patient has an alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALKP) or total bilirubin (TBILI) > 3 times the upper limit of normal
  22. Patient is, in the opinion of the investigator, not suitable to participate in the study
  23. Patient has participated in any clinical study with an investigational drug within three months prior to the first day of dosing with the exception of coronary stent studies Patient has ever received CK-1827452

Sites / Locations

  • University of California, San Diego Medical Center
  • Christiana Care Health Services, Inc.
  • Diagnostic Services Clinic
  • Russian Cardiological Research and Production Complex
  • Dzhanelidze Research Institute for Emergency Medical Care
  • Almazov Federal Heart, Blood and Endocrinology Center
  • St. Petersburg State Medical University
  • Castle Hill Hospital, University of Hull
  • King's College Hospital
  • St. George's Hospital
  • St. Mary's Hospital & Imperial College
  • Manchester Heart Centre, Manchester Royal Infirmary
  • ICON Development Solutions
  • Wythenshawe Hospital
  • Northwick Park Hospital
  • Ninewells Hospital and Medical School
  • BHF Cardiovascular Centre

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Arm Label

Cohort 1

Cohort 2

Cohort 3

Cohort 4

Cohort 5

Arm Description

4 treatment periods with a 2 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.

4 treatment periods with a 2 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.

4 treatment periods with a 24 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.

4 treatment periods with a 24 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.

2 treatment periods with a 72 hour infusion. The 2 treatment periods are randomly assigned and consist of 1 dose level of CK-1827452 (with dose de-escalation possible depending on tolerability) and 1 placebo treatment. Treatment period 2 occurs at least 7 days after the conclusion of period 1.

Outcomes

Primary Outcome Measures

Change From Baseline of Systolic Ejection Time at Various CK-1827452 Plasma Concentrations
Pooled analysis of the echocardiographic measure systolic ejection time from echocardiograms taken at all timepoints. The systolic ejection time is the period during which the aortic valve is open and blood is flowing across the valve. Echocardiograms from cohorts 1,2,3,4 and 5 (564 echocardiograms) were binned into either placebo group or 1 of 6 groups based on plasma concentration of CK-1827452.
Change From Baseline of Fractional Shortening at Various CK-1827452 Plasma Concentrations
Pooled analysis of the echocardiographic measure fractional shortening from echocardiograms taken at all timepoints. Fractional shortening is the percentage of change from baseline in the left ventricular cavity dimension with systole. Echocardiograms from cohorts 1,2,3,4 and 5 (564 echocardiograms) were binned into either placebo group or 1 of 6 groups based on plasma concentration of CK-1827452.

Secondary Outcome Measures

CK-1827452 Maximum Observed Plasma Concentration (Cmax)
Determined by evaluation of plasma concentrations from blood samples collected prior to dosing and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 12, 24 and 48 hours after initiation of study drug infusion
CK-1827452 Area Under the Plasma Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Plasma Concentration (AUClast)
Determined by evaluation of plasma concentrations from blood samples collected prior to dosing and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 12, 24 and 48 hours after initiation of study drug infusion

Full Information

First Posted
December 21, 2007
Last Updated
April 20, 2021
Sponsor
Cytokinetics
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1. Study Identification

Unique Protocol Identification Number
NCT00624442
Brief Title
A Study of CK-1827452 Infusion in Stable Heart Failure
Official Title
A Phase II, Multi Center, Double-Blind, Randomized, Placebo Controlled, Dose-Escalation, Pharmacokinetic (PK) and Pharmacodynamic (PD) Study of CK-1827452 in Patients With Stable Heart Failure
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
April 2007 (undefined)
Primary Completion Date
February 2009 (Actual)
Study Completion Date
February 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cytokinetics

4. Oversight

5. Study Description

Brief Summary
This study will assess the safety, tolerability, and pharmacodynamics of CK-1827452 infusion in patients with stable heart failure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1
Arm Type
Experimental
Arm Description
4 treatment periods with a 2 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.
Arm Title
Cohort 2
Arm Type
Experimental
Arm Description
4 treatment periods with a 2 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.
Arm Title
Cohort 3
Arm Type
Experimental
Arm Description
4 treatment periods with a 24 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.
Arm Title
Cohort 4
Arm Type
Experimental
Arm Description
4 treatment periods with a 24 hour infusion. The 4 treatment periods consist of 3 escalating dose levels of CK-1827452 and 1 placebo treatment randomized into the dose escalation sequence. Treatment periods occur at least 7 days apart.
Arm Title
Cohort 5
Arm Type
Experimental
Arm Description
2 treatment periods with a 72 hour infusion. The 2 treatment periods are randomly assigned and consist of 1 dose level of CK-1827452 (with dose de-escalation possible depending on tolerability) and 1 placebo treatment. Treatment period 2 occurs at least 7 days after the conclusion of period 1.
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.125 mg/kg/h followed by 1 hour at 0.0625 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.25 mg/kg/h followed by 1 hour at 0.125 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.5 mg/kg/h followed by 1 hour at 0.25 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.75 mg/kg/h followed by 1 hour at 0.375 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 1.0 mg/kg/h followed by 1 hour at 0.5 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.25 mg/kg/h followed by 1 hour at 0.125 mg/kg/h followed by 22 hours at 0.025 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.5 mg/kg/h followed by 1 hour at 0.25 mg/kg/h followed by 22 hours at 0.05 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 1.0 mg/kg/h followed by 1 hour at 0.5 mg/kg/h followed by 22 hours at 0.1 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
IV infusion for 2 hours
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
IV infusion for 24 hours
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 1.0 mg/kg/h followed 1 hour at 0.5 mg/kg/h followed by 70 hours at 0.1 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
IV infusion for 72 hours
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.75 mg/kg/h followed 1 hour at 0.5 mg/kg/h followed by 70 hours at 0.1 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.25 mg/kg/h followed by 23 hours at 0.025 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 0.5 mg/kg/h followed by 23 hours at 0.05 mg/kg/h
Intervention Type
Drug
Intervention Name(s)
CK-1827452
Intervention Description
IV infusion for 1 hour at 1.0 mg/kg/h followed by 23 hours at 0.1 mg/kg/h
Primary Outcome Measure Information:
Title
Change From Baseline of Systolic Ejection Time at Various CK-1827452 Plasma Concentrations
Description
Pooled analysis of the echocardiographic measure systolic ejection time from echocardiograms taken at all timepoints. The systolic ejection time is the period during which the aortic valve is open and blood is flowing across the valve. Echocardiograms from cohorts 1,2,3,4 and 5 (564 echocardiograms) were binned into either placebo group or 1 of 6 groups based on plasma concentration of CK-1827452.
Time Frame
4 days
Title
Change From Baseline of Fractional Shortening at Various CK-1827452 Plasma Concentrations
Description
Pooled analysis of the echocardiographic measure fractional shortening from echocardiograms taken at all timepoints. Fractional shortening is the percentage of change from baseline in the left ventricular cavity dimension with systole. Echocardiograms from cohorts 1,2,3,4 and 5 (564 echocardiograms) were binned into either placebo group or 1 of 6 groups based on plasma concentration of CK-1827452.
Time Frame
4 days
Secondary Outcome Measure Information:
Title
CK-1827452 Maximum Observed Plasma Concentration (Cmax)
Description
Determined by evaluation of plasma concentrations from blood samples collected prior to dosing and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 12, 24 and 48 hours after initiation of study drug infusion
Time Frame
2 days
Title
CK-1827452 Area Under the Plasma Concentration-time Curve From Time Zero to the Time of the Last Quantifiable Plasma Concentration (AUClast)
Description
Determined by evaluation of plasma concentrations from blood samples collected prior to dosing and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 12, 24 and 48 hours after initiation of study drug infusion
Time Frame
2 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Patient is male, or female of non-childbearing potential (two years post-menopausal or surgically sterilized) Female patients must have a negative urine pregnancy test prior to entry into the study Patient is 18 years old or greater Patient has given signed informed consent Patient is considered to be in suitable health in the opinion of the investigator, as determined by: A pre-study physical examination with no clinical abnormalities which in the opinion of the investigator would preclude participation in the study other than physical symptoms or signs consistent with stable heart failure An electrocardiogram (ECG) with no abnormalities in the opinion of the investigator that would impair assessment of stopping criteria Patient has pre-study clinical laboratory findings that are within normal range, or if outside of the normal range, should not preclude participation in the study in the opinion of the investigator (see Exclusion Criteria, below, for exceptions) Patient has a documented diagnosis of heart failure with an ejection fraction of less than 40% Patient has been on a stable dose of a beta blocker and an ACE (angiotensin-converting enzyme) inhibitor or an ARB (angiotensin II receptor blocker) for at least 4 weeks. If prescribed, diuretics must have been administered according to a consistent regimen for at least 4 weeks Patient is currently in sinus rhythm Patient has interpretable echocardiographic images on a screening echocardiogram Exclusion Criteria Patient has been hospitalized for heart failure, myocardial infarction, coronary revascularization, or another cardiac indication within the last 6 weeks Patient has a current history of alcohol use which in the opinion of the investigator would preclude participation in the study Patient has a current history of drug abuse Patient has donated blood or blood products within 30 days prior to screening Patient has Canadian Cardiovascular Society (CCS) Class III or IV angina Patient has significant obstructive valvular disease or significant congenital heart disease Patient has had a valve replacement Patient is pacemaker dependent Patient is on chronic anti-arrhythmic therapy, with the exception of amiodarone Patient is currently taking, or has taken in the last 7 days, a CYP3A4 inhibitor or inducer medication Patient has a history of hypertrophic obstructive cardiomyopathy Patient weighs > 120 kg Patient has a supine resting systolic blood pressure < 95 mmHg after 3 minutes rest Patient has a supine resting heart rate ≥ 100 beats per minute after 3 minutes rest Patient has an Modification of Diet in Renal Disease (MDRD) estimate of Glomerular Filtration Rate (GFR) ≤ 35 ml/min/1.73 m2 Patient has a potassium < 3.5 mEq/L or > 5.5 mEq/L Patient has a sodium ≤ 133 mEq/L Patient has a urea > 15 mmole/L Patient has a troponin I or T at screening that is detectable at the investigative site's clinical laboratory Patient has a hemoglobin < 11 gm/dL in males or < 10 gm/dL in females Patient has an alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALKP) or total bilirubin (TBILI) > 3 times the upper limit of normal Patient is, in the opinion of the investigator, not suitable to participate in the study Patient has participated in any clinical study with an investigational drug within three months prior to the first day of dosing with the exception of coronary stent studies Patient has ever received CK-1827452
Facility Information:
Facility Name
University of California, San Diego Medical Center
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Christiana Care Health Services, Inc.
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Facility Name
Diagnostic Services Clinic
City
Tbilisi
Country
Georgia
Facility Name
Russian Cardiological Research and Production Complex
City
Moscow
ZIP/Postal Code
121552
Country
Russian Federation
Facility Name
Dzhanelidze Research Institute for Emergency Medical Care
City
St. Petersburg
ZIP/Postal Code
192242
Country
Russian Federation
Facility Name
Almazov Federal Heart, Blood and Endocrinology Center
City
St. Petersburg
ZIP/Postal Code
194156
Country
Russian Federation
Facility Name
St. Petersburg State Medical University
City
St. Petersburg
ZIP/Postal Code
197089
Country
Russian Federation
Facility Name
Castle Hill Hospital, University of Hull
City
Hull
State/Province
England
ZIP/Postal Code
HU16 5JQ
Country
United Kingdom
Facility Name
King's College Hospital
City
London
State/Province
England
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
St. George's Hospital
City
London
State/Province
England
ZIP/Postal Code
SW17 ORE
Country
United Kingdom
Facility Name
St. Mary's Hospital & Imperial College
City
London
State/Province
England
ZIP/Postal Code
W2 1LA
Country
United Kingdom
Facility Name
Manchester Heart Centre, Manchester Royal Infirmary
City
Manchester
State/Province
England
ZIP/Postal Code
M13 9WL
Country
United Kingdom
Facility Name
ICON Development Solutions
City
Manchester
State/Province
England
ZIP/Postal Code
M15 6SH
Country
United Kingdom
Facility Name
Wythenshawe Hospital
City
Manchester
State/Province
England
ZIP/Postal Code
M23 9LT
Country
United Kingdom
Facility Name
Northwick Park Hospital
City
Middlesex
State/Province
England
ZIP/Postal Code
HA1 3UJ
Country
United Kingdom
Facility Name
Ninewells Hospital and Medical School
City
Dundee
State/Province
Scotland
ZIP/Postal Code
DD1 9SY
Country
United Kingdom
Facility Name
BHF Cardiovascular Centre
City
Glasgow
State/Province
Scotland
ZIP/Postal Code
G12 8TA
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
25951506
Citation
Vu T, Ma P, Xiao JJ, Wang YM, Malik FI, Chow AT. Population pharmacokinetic-pharmacodynamic modeling of omecamtiv mecarbil, a cardiac myosin activator, in healthy volunteers and patients with stable heart failure. J Clin Pharmacol. 2015 Nov;55(11):1236-47. doi: 10.1002/jcph.538. Epub 2015 Jul 14.
Results Reference
derived
PubMed Identifier
21856481
Citation
Cleland JG, Teerlink JR, Senior R, Nifontov EM, Mc Murray JJ, Lang CC, Tsyrlin VA, Greenberg BH, Mayet J, Francis DP, Shaburishvili T, Monaghan M, Saltzberg M, Neyses L, Wasserman SM, Lee JH, Saikali KG, Clarke CP, Goldman JH, Wolff AA, Malik FI. The effects of the cardiac myosin activator, omecamtiv mecarbil, on cardiac function in systolic heart failure: a double-blind, placebo-controlled, crossover, dose-ranging phase 2 trial. Lancet. 2011 Aug 20;378(9792):676-83. doi: 10.1016/S0140-6736(11)61126-4.
Results Reference
derived

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A Study of CK-1827452 Infusion in Stable Heart Failure

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