PK and Tolerability of IV and Oral CK-1827452 in Patients With Ischemic Cardiomyopathy and Angina
Primary Purpose
Heart Failure, Myocardial Ischemia, Angina Pectoris
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CK-1827452 24mg and 6 mg iv infusion
CK-1827452 12.5mg capsule
CK-1827452 48 mg and 11 mg iv infusion
CK-1827452 25mg capsule
Placebo iv infusion
Placebo capsule
Sponsored by
About this trial
This is an interventional treatment trial for Heart Failure
Eligibility Criteria
Inclusion Criteria:
- The patient has signed an Informed Consent Form/Patient Information Sheet for this study approved by the governing Institutional Review Board (IRB) or Independent Ethics Committee (IEC).
- The patient is at least 18 years old.
The patient has ischemic heart disease documented by any one or more of the following:
- A history of myocardial infarction documented by elevated CPK-MB, troponin I or T, or the presence of electrocardiographic Q waves consistent with myocardial infarction.
- Coronary angiography demonstrating at least 1 major epicardial coronary artery (i.e., left main, left anterior descending, left circumflex, or right coronary artery) with a stenosis of at least 60% diameter or greater but excluding stenosis of the left main coronary artery unless revascularized by coronary artery bypass grafting.
- The patient has a history of ≥ 1 episode of exercise induced angina within 2 months prior to the initial screening visit.
- The patient has been taking a beta blocker and an ACE inhibitor (and/or an ARB) for at least 4 weeks. If prescribed, diuretics must have been administered for at least 4 weeks prior to the initial screening visit.
- The patient is NYHA Class II-III at the time of enrollment and has been so for ≥ 3 months prior to the initial screening visit.
- The patient has a history of a left ventricular ejection fraction (LVEF) ≤ 35%.
- The patient has a history of EITHER a left ventricular end-diastolic diameter ≥ 55 mm, OR a left ventricular end-diastolic diameter index ≥ 32 mm/m2.
- The patient can be expected to complete at least 4 minutes of a Modified Naughton ETT (see Appendix B).
- For female patients only: The patient is post-menopausal (≥ 1 year) or sterilized, or if she is of childbearing potential, she is not breastfeeding, her pregnancy test is negative, she has no intention to become pregnant during the course of the study, and she is using contraceptive drugs or devices.
Exclusion Criteria:
- The patient has acute myocarditis; clinically significant restrictive, constrictive, or hypertrophic obstructive cardiomyopathy; or clinically significant congenital heart disease.
- The patient has a SBP > 160 mmHg, documented on at least 3 separate occasions, at least 10 minutes apart.
- The patient has a DBP > 90 mmHg, documented on at least 3 separate occasions, at least 10 minutes apart.
- The patient has levels of troponin I or T, or CPK-MB > the upper limit of normal at any time from 6 weeks prior to the Initial Screening Visit (Visit 1) and up to randomization.
- The patient has severe aortic or mitral stenosis.
- The patient has had an acute coronary syndrome, transient ischemic attack, or revascularization procedure within 6 weeks of the Initial Screening Visit (Visit 1).
- The patient has significant co-morbid conditions (i.e., lung disease, arthritis, peripheral vascular disease) that may limit his or her treadmill exercise capacity.
- The patient has renal impairment defined by a calculated creatinine clearance < 30 cc/min or a need for renal replacement therapy.
- The patient has known hepatic impairment defined by a total bilirubin > 3 mg/dL, or an ALT or AST > 2 times the upper limit of normal.
- The patient has received an investigational drug or device within 30 days or 5 half-lives, whichever is greater, of randomization.
- The patient weighs > 120 kg.
- The patient has a body temperature > 38 ° C, confirmed by at least 2 successive measurements, at least 10 minutes apart.
- The patient has any laboratory abnormality which, in the opinion of the investigator, should preclude his or her participation in the study.
- The patient has had any prior treatment with CK-1827452.
Sites / Locations
- Tbilisi State Medical University Clinic #1
- Cardio-Reanimation Centre
- Cardiology Clinic
- National Center of Therapy
- Multiprofile Clinical Hospital of Tbilisi #2
- Diagnostic Services Clinic
- Altay Territory Cardiology Dispensary
- City Hospital #1
- City Clinical Hospital #59
- City Clinical Hospital #64
- Moscow Municipal Clinical Hospital #4
- Federal Center of Heart, Blood and Endocrinology n.a. Almazov
- Research Centre for Cardiology n.a. Almazov under Roszdrav
- Volgograd Regional Cardiology Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Mid Dose CK-1827452 or Placebo
High Dose CK-1827452 or Placebo
Arm Description
CK-1827452 I.V. infusion for 2 hours at 24mg/hr followed by 18 hours at 6mg/hr or placebo, followed by 6 days three times a day oral dose and a final single oral dose
CK-1827452 I.V. infusion for 2 hours at 48mg/hr followed by 18 hours at 11mg/hr or placebo, followed by 6 days three times a day oral dose and a final single oral dose
Outcomes
Primary Outcome Measures
Participants Stopping Exercise Treadmill Test 3 (ETT-3) for Angina at Stage Earlier Than Baseline Exercise Treadmill Test (ETT-B)
The Modified Naughton Exercise Treadmill Test was employed in this study. Exercise Treadmill Test 3 (ETT-3) was performed during the last 2 hours of the 20-hour infusion of study drug or placebo. Baseline Exercise Treadmill Test (ETT-B) was performed prior to dosing.
Secondary Outcome Measures
Participants Stopping ETT-3 for Any Reason at Stage Earlier Than ETT-B
The Modified Naughton Exercise Treadmill Test was employed in this study. Exercise Treadmill Test 3 (ETT-3) was performed during the last 2 hours of the 20-hour infusion of study drug or placebo. Baseline Exercise Treadmill Test (ETT-B) was performed prior to dosing.
Increase in Exercise Duration During ETT-3 vs. ETT-B
Participants Stopping ETT-3 for Angina at Any Stage
This Outcome Measure includes all participants who stopped ETT-3 for angina at any stage, not only those who stopped at a stage earlier than ETT-B.
Note: All 9 subjects who stopped ETT-3 for angina also stopped ETT-B for angina.
Participants With 1 mm ST Segment Depression During ETT-3
ST Segment Depression measured by Electrocardiography while performing ETT-3.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00682565
Brief Title
PK and Tolerability of IV and Oral CK-1827452 in Patients With Ischemic Cardiomyopathy and Angina
Official Title
Tolerability and CK-1827452 Plasma Concentrations During Intravenous and Immediate-Release Oral CK-1827452 in Patients With Ischemic Cardiomyopathy and Angina
Study Type
Interventional
2. Study Status
Record Verification Date
February 2010
Overall Recruitment Status
Completed
Study Start Date
April 2008 (undefined)
Primary Completion Date
November 2008 (Actual)
Study Completion Date
March 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 investigates whether symptom-limited exercise capacity in ischemic cardiomyopathy patients with angina is deleteriously affected by treatment with CK-1827452.
Detailed Description
The primary objective of this study is to assess the effect of intravenous (i.v.) CK-1827452 on symptom-limited exercise tolerance in patients with ischemic cardiomyopathy and angina. The secondary objectives are to assess the tolerability of CK-1827452 administered three times daily (tid) to steady state in an immediate-release (IR), blend-in-capsule oral formulation to outpatients with ischemic cardiomyopathy and angina and to assess CK-1827452 plasma concentrations at trough and 1 hour after dosing with CK-1827452 administered tid to steady state in an IR, blend-in-capsule oral formulation to outpatients with ischemic cardiomyopathy and angina.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure, Myocardial Ischemia, Angina Pectoris
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
94 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Mid Dose CK-1827452 or Placebo
Arm Type
Experimental
Arm Description
CK-1827452 I.V. infusion for 2 hours at 24mg/hr followed by 18 hours at 6mg/hr or placebo, followed by 6 days three times a day oral dose and a final single oral dose
Arm Title
High Dose CK-1827452 or Placebo
Arm Type
Experimental
Arm Description
CK-1827452 I.V. infusion for 2 hours at 48mg/hr followed by 18 hours at 11mg/hr or placebo, followed by 6 days three times a day oral dose and a final single oral dose
Intervention Type
Drug
Intervention Name(s)
CK-1827452 24mg and 6 mg iv infusion
Other Intervention Name(s)
omecamtiv mecarbil
Intervention Description
I.V. infusion for 2 hours at 24mg/hr followed by 18 hours at 6mg/hr
Intervention Type
Drug
Intervention Name(s)
CK-1827452 12.5mg capsule
Other Intervention Name(s)
omecamtiv mecarbil
Intervention Description
12.5mg oral immediate release capsule
Intervention Type
Drug
Intervention Name(s)
CK-1827452 48 mg and 11 mg iv infusion
Other Intervention Name(s)
omecamtiv mecarbil
Intervention Description
I.V. infusion for 2 hours at 48mg/hr followed by 18 hours at 11mg/hr
Intervention Type
Drug
Intervention Name(s)
CK-1827452 25mg capsule
Other Intervention Name(s)
omecamtiv mecarbil
Intervention Description
25mg oral immediate release capsule
Intervention Type
Drug
Intervention Name(s)
Placebo iv infusion
Intervention Description
Matching placebo iv infusion
Intervention Type
Drug
Intervention Name(s)
Placebo capsule
Intervention Description
Matching placebo oral immediate release capsule
Primary Outcome Measure Information:
Title
Participants Stopping Exercise Treadmill Test 3 (ETT-3) for Angina at Stage Earlier Than Baseline Exercise Treadmill Test (ETT-B)
Description
The Modified Naughton Exercise Treadmill Test was employed in this study. Exercise Treadmill Test 3 (ETT-3) was performed during the last 2 hours of the 20-hour infusion of study drug or placebo. Baseline Exercise Treadmill Test (ETT-B) was performed prior to dosing.
Time Frame
1 day
Secondary Outcome Measure Information:
Title
Participants Stopping ETT-3 for Any Reason at Stage Earlier Than ETT-B
Description
The Modified Naughton Exercise Treadmill Test was employed in this study. Exercise Treadmill Test 3 (ETT-3) was performed during the last 2 hours of the 20-hour infusion of study drug or placebo. Baseline Exercise Treadmill Test (ETT-B) was performed prior to dosing.
Time Frame
1 day
Title
Increase in Exercise Duration During ETT-3 vs. ETT-B
Time Frame
1 day
Title
Participants Stopping ETT-3 for Angina at Any Stage
Description
This Outcome Measure includes all participants who stopped ETT-3 for angina at any stage, not only those who stopped at a stage earlier than ETT-B.
Note: All 9 subjects who stopped ETT-3 for angina also stopped ETT-B for angina.
Time Frame
1 day
Title
Participants With 1 mm ST Segment Depression During ETT-3
Description
ST Segment Depression measured by Electrocardiography while performing ETT-3.
Time Frame
1 day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The patient has signed an Informed Consent Form/Patient Information Sheet for this study approved by the governing Institutional Review Board (IRB) or Independent Ethics Committee (IEC).
The patient is at least 18 years old.
The patient has ischemic heart disease documented by any one or more of the following:
A history of myocardial infarction documented by elevated CPK-MB, troponin I or T, or the presence of electrocardiographic Q waves consistent with myocardial infarction.
Coronary angiography demonstrating at least 1 major epicardial coronary artery (i.e., left main, left anterior descending, left circumflex, or right coronary artery) with a stenosis of at least 60% diameter or greater but excluding stenosis of the left main coronary artery unless revascularized by coronary artery bypass grafting.
The patient has a history of ≥ 1 episode of exercise induced angina within 2 months prior to the initial screening visit.
The patient has been taking a beta blocker and an ACE inhibitor (and/or an ARB) for at least 4 weeks. If prescribed, diuretics must have been administered for at least 4 weeks prior to the initial screening visit.
The patient is NYHA Class II-III at the time of enrollment and has been so for ≥ 3 months prior to the initial screening visit.
The patient has a history of a left ventricular ejection fraction (LVEF) ≤ 35%.
The patient has a history of EITHER a left ventricular end-diastolic diameter ≥ 55 mm, OR a left ventricular end-diastolic diameter index ≥ 32 mm/m2.
The patient can be expected to complete at least 4 minutes of a Modified Naughton ETT (see Appendix B).
For female patients only: The patient is post-menopausal (≥ 1 year) or sterilized, or if she is of childbearing potential, she is not breastfeeding, her pregnancy test is negative, she has no intention to become pregnant during the course of the study, and she is using contraceptive drugs or devices.
Exclusion Criteria:
The patient has acute myocarditis; clinically significant restrictive, constrictive, or hypertrophic obstructive cardiomyopathy; or clinically significant congenital heart disease.
The patient has a SBP > 160 mmHg, documented on at least 3 separate occasions, at least 10 minutes apart.
The patient has a DBP > 90 mmHg, documented on at least 3 separate occasions, at least 10 minutes apart.
The patient has levels of troponin I or T, or CPK-MB > the upper limit of normal at any time from 6 weeks prior to the Initial Screening Visit (Visit 1) and up to randomization.
The patient has severe aortic or mitral stenosis.
The patient has had an acute coronary syndrome, transient ischemic attack, or revascularization procedure within 6 weeks of the Initial Screening Visit (Visit 1).
The patient has significant co-morbid conditions (i.e., lung disease, arthritis, peripheral vascular disease) that may limit his or her treadmill exercise capacity.
The patient has renal impairment defined by a calculated creatinine clearance < 30 cc/min or a need for renal replacement therapy.
The patient has known hepatic impairment defined by a total bilirubin > 3 mg/dL, or an ALT or AST > 2 times the upper limit of normal.
The patient has received an investigational drug or device within 30 days or 5 half-lives, whichever is greater, of randomization.
The patient weighs > 120 kg.
The patient has a body temperature > 38 ° C, confirmed by at least 2 successive measurements, at least 10 minutes apart.
The patient has any laboratory abnormality which, in the opinion of the investigator, should preclude his or her participation in the study.
The patient has had any prior treatment with CK-1827452.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew A Wolff, MD, FACC
Organizational Affiliation
Cytokinetics, Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
Tbilisi State Medical University Clinic #1
City
Tbilisi
ZIP/Postal Code
0102
Country
Georgia
Facility Name
Cardio-Reanimation Centre
City
Tbilisi
ZIP/Postal Code
0141
Country
Georgia
Facility Name
Cardiology Clinic
City
Tbilisi
ZIP/Postal Code
0144
Country
Georgia
Facility Name
National Center of Therapy
City
Tbilisi
ZIP/Postal Code
0159
Country
Georgia
Facility Name
Multiprofile Clinical Hospital of Tbilisi #2
City
Tbilisi
ZIP/Postal Code
0164
Country
Georgia
Facility Name
Diagnostic Services Clinic
City
Tbilisi
ZIP/Postal Code
0179
Country
Georgia
Facility Name
Altay Territory Cardiology Dispensary
City
Barnaul
Country
Russian Federation
Facility Name
City Hospital #1
City
Barnaul
Country
Russian Federation
Facility Name
City Clinical Hospital #59
City
Moscow
Country
Russian Federation
Facility Name
City Clinical Hospital #64
City
Moscow
Country
Russian Federation
Facility Name
Moscow Municipal Clinical Hospital #4
City
Moscow
Country
Russian Federation
Facility Name
Federal Center of Heart, Blood and Endocrinology n.a. Almazov
City
St. Petersburg
Country
Russian Federation
Facility Name
Research Centre for Cardiology n.a. Almazov under Roszdrav
City
St. Petersburg
Country
Russian Federation
Facility Name
Volgograd Regional Cardiology Center
City
Volgograd
Country
Russian Federation
12. IPD Sharing Statement
Citations:
PubMed Identifier
25453536
Citation
Greenberg BH, Chou W, Saikali KG, Escandon R, Lee JH, Chen MM, Treshkur T, Megreladze I, Wasserman SM, Eisenberg P, Malik FI, Wolff AA, Shaburishvili T. Safety and tolerability of omecamtiv mecarbil during exercise in patients with ischemic cardiomyopathy and angina. JACC Heart Fail. 2015 Jan;3(1):22-29. doi: 10.1016/j.jchf.2014.07.009. Epub 2014 Nov 11. Erratum In: JACC Heart Fail. 2020 Aug;8(8):700.
Results Reference
derived
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PK and Tolerability of IV and Oral CK-1827452 in Patients With Ischemic Cardiomyopathy and Angina
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