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A Study to Evaluate the Effects of 4 Weeks Treatment With Subcutaneous Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Preserved Ejection Fraction

Primary Purpose

Chronic Heart Failure

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
elamipretide
Placebo
Sponsored by
Stealth BioTherapeutics Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Heart Failure focused on measuring Heart Failure, HFpEF, elamipretide, MTP-131, Bendavia™

Eligibility Criteria

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

Inclusion Criteria:

  • Age ≥45 and <80 years.
  • Symptomatic heart failure (i.e. NYHA II or III) due to HFpEF for at least 6 months prior to study start
  • Evidence of HFpEF: LVEF ≥45% and E/e´>10 and NT-pro-BNP >220 pg/ml (sinus rhythm) / > 600 pg/mL (atrial fibrillation)
  • An exercise-induced increase in E/e' of at least 1.5 units during stress echocardiography assessment.
  • Heart failure is considered to be stable, in the judgment of the investigator, and no hospitalization for HFpEF or changes in dose regimen of pharmacologic treatment for HF has occurred within 1 month prior to the Screening Visit.
  • Treatment with appropriate pharmacologic therapy to manage underlying risk factors according to current guidelines.
  • Women of childbearing potential must agree to use 1 of the following methods of birth control from the date they sign the ICF until two months after the last dose of study medication:

    a) Abstinence, b) surgically sterilized male partner, or c) barrier method And hormonal contraception

  • Women of child-bearing potential must have a negative serum pregnancy test at baseline
  • Willing and able to provide signed informed consent form (ICF) prior to participation in any study-related procedures

Exclusion Criteria:

  • Probable alternative diagnoses that in the opinion of the investigator could account for the patient's symptoms e.g. severe pulmonary dysfunction or severe asthma
  • LVEF <45% (at the moment of enrollment or in medical history)
  • Coronary or peripheral revascularization procedures, valvular procedures, OR any major surgical procedure within 3 months prior to the Screening Visit.
  • Acute coronary syndrome (ACS), stroke or transient ischemic attack (TIA) within 3 months prior to the Screening Visit.
  • Uncontrolled hypertension defined as a systolic blood pressure (BP) >160 mm Hg or a diastolic BP >100 mm Hg on at least 2 consecutive readings that will require a change in anti-hypertensive treatment during the study period.
  • Active cancer or undergoing chemotherapy within previous 6 months
  • Total bilirubin >2x the upper limit of normal (ULN) in the absence of Gilbert's Syndrome (M. Meulengracht) and liver enzymes (alanine aminotransferase [ALT] and/or aspartate aminotransferase [AST] and/or alkaline phosphatase) elevation >3xULN
  • Estimated glomerular filtration rate <30 mL/min, by MDRD
  • Known active drug or alcohol abuse within 1 year of the Screening Visit.
  • Use of other investigational drugs at the time of enrolment, or within 30 days or 5 half-lives of enrolment
  • Treatment with spironolactone or eplerenone for less than 3 months at study start
  • Treatment with dabigatran
  • Treatment with valsartan/sacubitril
  • Female subjects who are pregnant, planning to become pregnant, or lactating.

Sites / Locations

  • Charite Universitatsmedizin Berlin, Campus Virchow-Klinikum
  • German Heart Center
  • Clinical Centre of Serbia, Clinic for Cardiology
  • Clinical Hospital Center "Dr Dragiša Mišović-Dedinje", Department of Cardiology
  • Clinical Hospital Center "Zvezdara", Department of Cardiology
  • Clinical Hospital Center "Bežanijska Kosa", Department of Cardiology
  • Clinical Hospital Center "Zemun", Department of Cardiology
  • Clinical Center Niš, Clinic for Cardiology
  • Institute for Cardiovascular Diseases Vojvodina, Clinic for Cardiology

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

40 mg elamipretide

Placebo

Arm Description

40 mg elamipretide once daily for 28 consecutive days

Placebo once daily for 28 consecutive days

Outcomes

Primary Outcome Measures

Compare the delta in E/e' at rest exercise measured with echocardiography between the elamipretide and placebo groups

Secondary Outcome Measures

Compare the change at rest and during submaximal stress in LV systolic global longitudinal strain (GLS) between the elamipretide and placebo groups at the end of the 4-week treatment period
Compare the change in 6-minute walking distance, between the elamipretide and placebo groups at the end of the 4-week treatment period
Compare the change in NT-proBNP, between the elamipretide and placebo groups at the end of the 4-week treatment period
Compare the percent of patients on elamipretide versus placebo presenting with TEAEs and SAEs, including changes in biomarkers of myocardial damage and changes in markers of renal function

Full Information

First Posted
June 8, 2016
Last Updated
September 6, 2017
Sponsor
Stealth BioTherapeutics Inc.
Collaborators
Charite University, Berlin, Germany, SCIRENT Clinical Research and Science d.o.o.
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1. Study Identification

Unique Protocol Identification Number
NCT02814097
Brief Title
A Study to Evaluate the Effects of 4 Weeks Treatment With Subcutaneous Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Preserved Ejection Fraction
Official Title
A Phase 2 Randomized, Double-Blinded, Placebo-Controlled Study to Evaluate the Effects of 4 Weeks Treatment With Subcutaneous Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Preserved Ejection Fraction
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
September 2, 2016 (Actual)
Primary Completion Date
May 4, 2017 (Actual)
Study Completion Date
June 2, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stealth BioTherapeutics Inc.
Collaborators
Charite University, Berlin, Germany, SCIRENT Clinical Research and Science d.o.o.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a multi-center, randomized, double-blind, placebo-controlled study in subjects with stable heart failure with preserved ejection fraction (HFpEF) to evaluate the effects of 4 weeks treatment with subcutaneous MTP-131 (elampretide) on left ventricular function.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Heart Failure
Keywords
Heart Failure, HFpEF, elamipretide, MTP-131, Bendavia™

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
40 mg elamipretide
Arm Type
Experimental
Arm Description
40 mg elamipretide once daily for 28 consecutive days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo once daily for 28 consecutive days
Intervention Type
Drug
Intervention Name(s)
elamipretide
Other Intervention Name(s)
MTP-131, Bendavia
Intervention Description
Subcutaneous injection of 40 mg elamipretide once daily for 28 consecutive days
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Subcutaneous injection of placebo administered once daily for 28 consecutive days
Primary Outcome Measure Information:
Title
Compare the delta in E/e' at rest exercise measured with echocardiography between the elamipretide and placebo groups
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Compare the change at rest and during submaximal stress in LV systolic global longitudinal strain (GLS) between the elamipretide and placebo groups at the end of the 4-week treatment period
Time Frame
4 weeks
Title
Compare the change in 6-minute walking distance, between the elamipretide and placebo groups at the end of the 4-week treatment period
Time Frame
4 weeks
Title
Compare the change in NT-proBNP, between the elamipretide and placebo groups at the end of the 4-week treatment period
Time Frame
4 weeks
Title
Compare the percent of patients on elamipretide versus placebo presenting with TEAEs and SAEs, including changes in biomarkers of myocardial damage and changes in markers of renal function
Time Frame
4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥45 and <80 years. Symptomatic heart failure (i.e. NYHA II or III) due to HFpEF for at least 6 months prior to study start Evidence of HFpEF: LVEF ≥45% and E/e´>10 and NT-pro-BNP >220 pg/ml (sinus rhythm) / > 600 pg/mL (atrial fibrillation) An exercise-induced increase in E/e' of at least 1.5 units during stress echocardiography assessment. Heart failure is considered to be stable, in the judgment of the investigator, and no hospitalization for HFpEF or changes in dose regimen of pharmacologic treatment for HF has occurred within 1 month prior to the Screening Visit. Treatment with appropriate pharmacologic therapy to manage underlying risk factors according to current guidelines. Women of childbearing potential must agree to use 1 of the following methods of birth control from the date they sign the ICF until two months after the last dose of study medication: a) Abstinence, b) surgically sterilized male partner, or c) barrier method And hormonal contraception Women of child-bearing potential must have a negative serum pregnancy test at baseline Willing and able to provide signed informed consent form (ICF) prior to participation in any study-related procedures Exclusion Criteria: Probable alternative diagnoses that in the opinion of the investigator could account for the patient's symptoms e.g. severe pulmonary dysfunction or severe asthma LVEF <45% (at the moment of enrollment or in medical history) Coronary or peripheral revascularization procedures, valvular procedures, OR any major surgical procedure within 3 months prior to the Screening Visit. Acute coronary syndrome (ACS), stroke or transient ischemic attack (TIA) within 3 months prior to the Screening Visit. Uncontrolled hypertension defined as a systolic blood pressure (BP) >160 mm Hg or a diastolic BP >100 mm Hg on at least 2 consecutive readings that will require a change in anti-hypertensive treatment during the study period. Active cancer or undergoing chemotherapy within previous 6 months Total bilirubin >2x the upper limit of normal (ULN) in the absence of Gilbert's Syndrome (M. Meulengracht) and liver enzymes (alanine aminotransferase [ALT] and/or aspartate aminotransferase [AST] and/or alkaline phosphatase) elevation >3xULN Estimated glomerular filtration rate <30 mL/min, by MDRD Known active drug or alcohol abuse within 1 year of the Screening Visit. Use of other investigational drugs at the time of enrolment, or within 30 days or 5 half-lives of enrolment Treatment with spironolactone or eplerenone for less than 3 months at study start Treatment with dabigatran Treatment with valsartan/sacubitril Female subjects who are pregnant, planning to become pregnant, or lactating.
Facility Information:
Facility Name
Charite Universitatsmedizin Berlin, Campus Virchow-Klinikum
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
German Heart Center
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Clinical Centre of Serbia, Clinic for Cardiology
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Clinical Hospital Center "Dr Dragiša Mišović-Dedinje", Department of Cardiology
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Clinical Hospital Center "Zvezdara", Department of Cardiology
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Clinical Hospital Center "Bežanijska Kosa", Department of Cardiology
City
Belgrade
ZIP/Postal Code
11080
Country
Serbia
Facility Name
Clinical Hospital Center "Zemun", Department of Cardiology
City
Belgrade
ZIP/Postal Code
11080
Country
Serbia
Facility Name
Clinical Center Niš, Clinic for Cardiology
City
Niš
ZIP/Postal Code
18000
Country
Serbia
Facility Name
Institute for Cardiovascular Diseases Vojvodina, Clinic for Cardiology
City
Sremska Kamenica
ZIP/Postal Code
21204
Country
Serbia

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Effects of 4 Weeks Treatment With Subcutaneous Elamipretide on Left Ventricular Function in Subjects With Stable Heart Failure With Preserved Ejection Fraction

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