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A Multiple Dose Titration Study of MK-8892 in Participants With Pulmonary Hypertension and Left Heart Disease (MK-8892-007)

Primary Purpose

Pulmonary Hypertension, Left Heart Disease

Status
Terminated
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
MK-8892
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Hypertension

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Pulmonary hypertension (out of proportion, PHOOP) and heart failure with reduced left ventricular ejection fraction (PHOOP/rEF)
  • If female, cannot be pregnant or breastfeeding. Females of reproductive potential must agree to agree to use (and/or have their partner use) two (2) acceptable methods of birth control throughout the study and until 2 weeks after the last dose of study drug is administered
  • Body mass index (BMI) <=35 kg/m^2 and and <=18 kg/m^2
  • Has World Health Organization (WHO) Group 2 pulmonary hypertension (PAH)
  • Stable heart failure on optimal medical therapy with no hospitalizations for congestion due to heart failure within the previous 3 months

Exclusion Criteria:

  • Primary pulmonary arterial hypertension or veno-occlusive disease (WHO Group 1), or pulmonary hypertension secondary to other causes (WHO Groups 3 -5) including but not limited to autoimmune disease, connective tissue disease, and Eisenmenger syndrome
  • Currently treatment with or anticipates use of nitrate, phosphodiesterase type 5 (PDE5) inhibitor, or medications known to induce or inhibit cytochrome P450 3A4 (CYP3A4) metabolism, and cannot be transitioned off of this therapy for >=7 days prior to dosing and through completion of this study
  • Symptoms of coronary artery disease requiring therapy with nitrates, within the past 3 months
  • Severe aortic or mitral stenosis, or severe aortic, mitral, or tricuspid insufficiency.
  • Significant carotid artery disease
  • Restrictive, infiltrative (e.g., amyloidosis) or hypertrophic cardiomyopathy
  • Mentally or legally institutionalized or incapacitated, has significant emotional problems at the time of pre study (screening) visit or expected during the conduct of the study or has a history of a clinically significant psychiatric disorder over the last 5 years. Subjects who have had situational depression may be enrolled in the study at the discretion of the investigator.
  • History of stroke, chronic seizures, or major neurological disorder
  • History of clinically significant endocrine (not including diabetes mellitus), gastrointestinal, hematological, hepatic (not including chronic Hepatitis C), immunological (not including chronic human immunodeficiency virus [HIV]), respiratory, or genitourinary abnormalities or diseases. Participants with a history of childhood asthma may be enrolled in the study at the discretion of the investigator. Participants with controlled hypertension are allowed to be enrolled.
  • Unable to refrain from or anticipates the use of any medication, including prescription and non-prescription drugs or herbal remedies (such as St. John's Wort [hypericum perforatum]) beginning approximately 2 weeks (or 5 half-lives) prior to administration of the dose of study drug, throughout the study (including washout intervals between treatment periods), until the post study visit. There may be certain medications that will be permitted.
  • Consumes excessive amounts of alcohol, defined as greater than 5 glasses of alcoholic beverages (1 glass is approximately equivalent to: beer [284 mL/10 ounces], wine [125 mL/4 ounces], or distilled spirits [25 mL/1 ounce]) per day
  • Major surgery or donated blood within 8 weeks prior to the pre study (screening) visit
  • Participated in another investigational study within 4 weeks prior to the pre study (screening) visit
  • History of significant multiple and/or severe allergies (including latex allergy), or has had an anaphylactic reaction or significant intolerability to prescription or nonprescription drugs or food
  • Uses illicit drugs or has a history of drug (including alcohol) abuse within the past 6 months

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    MK-8892

    Arm Description

    Starting dose of 1 mg daily (oral); the dose may be titrated up on the 8th, 15th, and 22nd day of treatment to 2 mg, 3 mg, or 4 mg, respectively, for the duration of the study (28 days) as tolerated. For participants who reach one or more of the down-dosing criteria, there is an opportunity to decrease the dose back to a previously well-tolerated dose level, or to ½ of the starting dose.

    Outcomes

    Primary Outcome Measures

    Percentage Change From Baseline in Pulmonary Vascular Resistance (PVR)
    Pulmonary vascular resistance (PVR) is the general pressure which the right ventricle must counteract to pump blood through the lungs. PVR was measured by right heart catheterization performed prior to dosing at baseline (Day 1) and 4 hours postdose on Day 28. Percentage change in PVR from baseline at Day 28 was calculated as [(Baseline-Day 28)/Baseline]. Standard deviation is reported as a percentage.
    Number of Participants Who Experienced an Adverse Event
    An adverse event was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or disease temporally associated with the use of the study drug or a study procedure, whether or not considered related to the study drug or study procedure. Any worsening of a preexisting condition which is temporally associated with the use of the study drug is also an adverse event.
    Number of Participants Who Discontinued Study Drug Due to an Adverse Event
    An adverse event was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or disease temporally associated with the use of the study drug or a study procedure, whether or not considered related to the study drug or study procedure. Any worsening of a preexisting condition which is temporally associated with the use of the study drug is also an adverse event.

    Secondary Outcome Measures

    Full Information

    First Posted
    March 3, 2014
    Last Updated
    March 29, 2018
    Sponsor
    Merck Sharp & Dohme LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02078557
    Brief Title
    A Multiple Dose Titration Study of MK-8892 in Participants With Pulmonary Hypertension and Left Heart Disease (MK-8892-007)
    Official Title
    A Multiple Dose Titration Trial to Study the Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of MK-8892 in Patients With Pulmonary Hypertension and Left Heart Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2018
    Overall Recruitment Status
    Terminated
    Study Start Date
    May 9, 2014 (Actual)
    Primary Completion Date
    August 15, 2014 (Actual)
    Study Completion Date
    September 10, 2014 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Merck Sharp & Dohme LLC

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This study will assess multiple doses of MK-8892 administered to participants with pulmonary hypertension "out of proportion" (PHOOP) and heart failure with reduced left ventricular ejection fraction (rEF). It is hypothesized that generally safe and well tolerated multiple doses of MK-8892 will achieve a true reduction from baseline in pulmonary vascular resistance (PVR) greater than 12%. Sixteen participants with PHOOP/rEF were to receive multiple doses of MK-8892 titrated to the highest tolerated dose for each participant (up to 4 mg daily), and to undergo evaluation for safety and systemic hemodynamics and cardiac function. Only 4 participants were enrolled and completed the study due to a strategic business decision by the sponsor to terminate the clinical conduct of all MK-8892 ongoing trials including this trial.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Pulmonary Hypertension, Left Heart Disease

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    4 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    MK-8892
    Arm Type
    Experimental
    Arm Description
    Starting dose of 1 mg daily (oral); the dose may be titrated up on the 8th, 15th, and 22nd day of treatment to 2 mg, 3 mg, or 4 mg, respectively, for the duration of the study (28 days) as tolerated. For participants who reach one or more of the down-dosing criteria, there is an opportunity to decrease the dose back to a previously well-tolerated dose level, or to ½ of the starting dose.
    Intervention Type
    Drug
    Intervention Name(s)
    MK-8892
    Primary Outcome Measure Information:
    Title
    Percentage Change From Baseline in Pulmonary Vascular Resistance (PVR)
    Description
    Pulmonary vascular resistance (PVR) is the general pressure which the right ventricle must counteract to pump blood through the lungs. PVR was measured by right heart catheterization performed prior to dosing at baseline (Day 1) and 4 hours postdose on Day 28. Percentage change in PVR from baseline at Day 28 was calculated as [(Baseline-Day 28)/Baseline]. Standard deviation is reported as a percentage.
    Time Frame
    Baseline and Day 28
    Title
    Number of Participants Who Experienced an Adverse Event
    Description
    An adverse event was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or disease temporally associated with the use of the study drug or a study procedure, whether or not considered related to the study drug or study procedure. Any worsening of a preexisting condition which is temporally associated with the use of the study drug is also an adverse event.
    Time Frame
    Up to 42 days
    Title
    Number of Participants Who Discontinued Study Drug Due to an Adverse Event
    Description
    An adverse event was defined as any untoward medical occurrence in the form of signs, symptoms, abnormal laboratory findings, or disease temporally associated with the use of the study drug or a study procedure, whether or not considered related to the study drug or study procedure. Any worsening of a preexisting condition which is temporally associated with the use of the study drug is also an adverse event.
    Time Frame
    Up to 28 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Pulmonary hypertension (out of proportion, PHOOP) and heart failure with reduced left ventricular ejection fraction (PHOOP/rEF) If female, cannot be pregnant or breastfeeding. Females of reproductive potential must agree to agree to use (and/or have their partner use) two (2) acceptable methods of birth control throughout the study and until 2 weeks after the last dose of study drug is administered Body mass index (BMI) <=35 kg/m^2 and and <=18 kg/m^2 Has World Health Organization (WHO) Group 2 pulmonary hypertension (PAH) Stable heart failure on optimal medical therapy with no hospitalizations for congestion due to heart failure within the previous 3 months Exclusion Criteria: Primary pulmonary arterial hypertension or veno-occlusive disease (WHO Group 1), or pulmonary hypertension secondary to other causes (WHO Groups 3 -5) including but not limited to autoimmune disease, connective tissue disease, and Eisenmenger syndrome Currently treatment with or anticipates use of nitrate, phosphodiesterase type 5 (PDE5) inhibitor, or medications known to induce or inhibit cytochrome P450 3A4 (CYP3A4) metabolism, and cannot be transitioned off of this therapy for >=7 days prior to dosing and through completion of this study Symptoms of coronary artery disease requiring therapy with nitrates, within the past 3 months Severe aortic or mitral stenosis, or severe aortic, mitral, or tricuspid insufficiency. Significant carotid artery disease Restrictive, infiltrative (e.g., amyloidosis) or hypertrophic cardiomyopathy Mentally or legally institutionalized or incapacitated, has significant emotional problems at the time of pre study (screening) visit or expected during the conduct of the study or has a history of a clinically significant psychiatric disorder over the last 5 years. Subjects who have had situational depression may be enrolled in the study at the discretion of the investigator. History of stroke, chronic seizures, or major neurological disorder History of clinically significant endocrine (not including diabetes mellitus), gastrointestinal, hematological, hepatic (not including chronic Hepatitis C), immunological (not including chronic human immunodeficiency virus [HIV]), respiratory, or genitourinary abnormalities or diseases. Participants with a history of childhood asthma may be enrolled in the study at the discretion of the investigator. Participants with controlled hypertension are allowed to be enrolled. Unable to refrain from or anticipates the use of any medication, including prescription and non-prescription drugs or herbal remedies (such as St. John's Wort [hypericum perforatum]) beginning approximately 2 weeks (or 5 half-lives) prior to administration of the dose of study drug, throughout the study (including washout intervals between treatment periods), until the post study visit. There may be certain medications that will be permitted. Consumes excessive amounts of alcohol, defined as greater than 5 glasses of alcoholic beverages (1 glass is approximately equivalent to: beer [284 mL/10 ounces], wine [125 mL/4 ounces], or distilled spirits [25 mL/1 ounce]) per day Major surgery or donated blood within 8 weeks prior to the pre study (screening) visit Participated in another investigational study within 4 weeks prior to the pre study (screening) visit History of significant multiple and/or severe allergies (including latex allergy), or has had an anaphylactic reaction or significant intolerability to prescription or nonprescription drugs or food Uses illicit drugs or has a history of drug (including alcohol) abuse within the past 6 months
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Medical Director
    Organizational Affiliation
    Merck Sharp & Dohme LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    A Multiple Dose Titration Study of MK-8892 in Participants With Pulmonary Hypertension and Left Heart Disease (MK-8892-007)

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