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REDWOOD-HCM: Randomized Evaluation of Dosing With CK-3773274 in HCM (REDWOOD-HCM)

Primary Purpose

Hypertrophic Cardiomyopathy (HCM)

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
CK-3773274 (5 - 15 mg)
CK-3773274 (10 - 30 mg)
Placebo for CK-3773274
Sponsored by
Cytokinetics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypertrophic Cardiomyopathy (HCM) focused on measuring CK-3773274, CK-274, obstructive hypertrophic cardiomyopathy, oHCM, REDWOOD-HCM, non-obstructive hypertrophic cardiomyopathy, nHCM, hypertrophic cardiomyopathy, HCM

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Males and females between 18 and 85 years of age at screening.
  • Body weight is ≥45 kg at screening.
  • Diagnosed with HCM per the following criteria:

    • Has left ventricular (LV) hypertrophy with non-dilated LV chamber in the absence of other cardiac disease.
    • Has minimal wall thickness ≥15 mm (minimal wall thickness ≥13 mm is acceptable with a positive family history of HCM or with a known disease-causing gene mutation).
  • Adequate acoustic windows for echocardiography.
  • For Cohorts 1, 2 and 3 has LVOT-G during screening as follows:

    • Resting gradient ≥50 mmHg OR
    • Resting gradient ≥30 mmHg and <50 mmHg with post-Valsalva LVOT-G ≥50 mmHg
  • For Cohort 4 has resting and post-Valsalva LVOT-G < 30 mmHg at the time of screening
  • For Cohort 4 has elevated NT-proBNP > 300 pg/mL at the time of screening
  • LVEF ≥60% at screening.
  • New York Heart Association (NYHA) Class II or III at screening.
  • Patients on beta-blockers, verapamil, diltiazem, or ranolazine should have been on stable doses for >4 weeks prior to randomization and anticipate remaining on the same medication regimen during the study.
  • For Cohort 3: Patients must be taking disopyramide. Patients should have been on stable disopyramide doses for >4 weeks prior to screening and anticipate remaining on the same medication regimen during the study.

Exclusion Criteria

  • Aortic stenosis or fixed subaortic obstruction.
  • Known infiltrative or storage disorder causing cardiac hypertrophy that mimics oHCM (eg, Noonan syndrome, Fabry disease, amyloidosis).
  • History of LV systolic dysfunction (LVEF <45%) at any time during their clinical course.
  • Documented history of current obstructive coronary artery disease (>70% stenosis in one or more epicardial coronary arteries) or documented history of myocardial infarction.
  • Has been treated with septal reduction therapy (surgical myectomy or percutaneous alcohol septal ablation) or has plans for either treatment during the study period (Cohorts 1, 2, and 3 only). Patients having undergone septal reduction therapy > 12 months prior to screening who remain symptomatic from nHCM, and who meet all other criteria for inclusion, may be enrolled in Cohort 4.
  • For Cohorts 1, 2 and 4: Has been treated with disopyramide or antiarrhythmic drugs that have negative inotropic activity within 4 weeks prior to screening. (For Cohort 3, use of disopyramide is required).
  • Has any ECG abnormality considered by the investigator to pose a risk to patient safety (eg, second degree atrioventricular block type II).
  • Paroxysmal atrial fibrillation or flutter documented during the screening period.
  • Paroxysmal or permanent atrial fibrillation requiring rhythm restoring treatment (eg, direct-current cardioversion, ablation procedure, or antiarrhythmic therapy) ≤6 months prior to screening. (This exclusion does not apply if atrial fibrillation has been treated with anticoagulation and adequately rate-controlled for >6 months).
  • History of syncope or sustained ventricular tachyarrhythmia with exercise within 6 months prior to screening.
  • Has received prior treatment with CK-3773274 or mavacamten.
  • For Cohort 4: has any documented history of LVOT-G ≥ 30 mmHg at rest, with Valsalva, or with exercise (for subjects who have had prior septal reduction therapy, this exclusion criteria only applies to gradients detected following septal reduction therapy).

Sites / Locations

  • Cedar-Sinai Medical Center
  • UCSF Medical Center
  • Northwestern University
  • Tufts Medical Center
  • Massachusetts General Hospital
  • Brigham and Women's Hospital
  • Michigan Medicine - University of Michigan
  • Washington University School of Medicine
  • New York University Langone Health Medical Center
  • Carolinas Medical Center
  • Duke Cardiology at Southpoint
  • Oregon Health and Science University
  • Hospital of the University of Pennsylvania (University of Pennsylvania School of Medicine)
  • UMPC Heart and Vascular Institute
  • UT Southwestern Medical Center
  • Houston Methodist Hospital
  • Intermountain Medical Center
  • University of Virginia Health System
  • Azienda Ospedaliero Universitaria Careggi
  • Erasmus University Medical Center (Erasmus MC)
  • Complejo Hospitalario Universitario A Coruña
  • Hospital Universitario Puerta de Hierro de Majadahonda

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

CK-3773274 - Cohort 1 (Obstructive HCM)

Placebo - Cohort 1 (Obstructive HCM)

CK-3773274 - Cohort 2 (Obstructive HCM)

Placebo - Cohort 2 (Obstructive HCM)

CK-3773274 & disopyramide - Cohort 3 (Obstructive HCM)

CK-3773274 - Cohort 4 (non-obstructive HCM)

Arm Description

Subjects will receive doses of 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks

Subjects will receive placebo for up to 10 weeks

Subjects will receive doses 10 - 30 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks

Subjects will receive placebo for up to 10 weeks

Subjects will receive doses 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks while taking disopyramide

Subjects will receive doses of 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks

Outcomes

Primary Outcome Measures

Incidence of adverse events observed during dosing of CK--3773274 in patients with HCM
Patient incidence of reported adverse events (AEs)

Secondary Outcome Measures

Incidence of left ventricular ejection fraction (LVEF) < 50% observed during dosing of CK-3773274 in patients with HCM
Patient incidence of left ventricular ejection fraction (LVEF) < 50%
Incidence of serious adverse events observed during dosing of CK-3773274 in patients with HCM
Patient incidence of reported serious adverse events (SAEs)
Concentration-response relationship of CK-3773274 on the resting left ventricular outflow tract gradient (LVOT-G) on echocardiogram over 10 weeks of treatment in patients with oHCM (Cohorts 1, 2, 3 only)
Slope of the relationship of the plasma concentration of CK-3773274 to the change from baseline in the resting LVOT-G
Concentration-response relationship of CK-3773274 on the post-Valsalva left ventricular outflow tract gradient (LVOT-G) on echocardiogram over 10 weeks of treatment in patients with oHCM (Cohorts 1, 2, 3 only)
Slope of the relationship of the plasma concentration of CK-3773274 to the change from baseline in the post-Valsalva LVOT-G
Dose response relationship on LVOT-G of CK-3773274 in patients with oHCM at rest (Cohorts 1, 2, 3 only)
Change from baseline in resting LVOT-G over time as a function of dose
Dose response relationship on LVOT-G of CK-3773274 in patients with oHCM post-Valsalva (Cohorts 1, 2, 3 only)
Change from baseline in post-Valsalva LVOT-G over time as a function of dose
Concentration-response relationship of CK-3773274 on left ventricular ejection fraction (LVEF) over 10 weeks of treatment in patients with HCM
Change from baseline in the resting LVEF

Full Information

First Posted
January 3, 2020
Last Updated
July 27, 2023
Sponsor
Cytokinetics
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1. Study Identification

Unique Protocol Identification Number
NCT04219826
Brief Title
REDWOOD-HCM: Randomized Evaluation of Dosing With CK-3773274 in HCM
Acronym
REDWOOD-HCM
Official Title
A Multi-Center, Randomized, Double-blind, Placebo-controlled, Dose-finding Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of CK-3773274 in Adults With Symptomatic Hypertrophic Cardiomyopathy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
January 10, 2020 (Actual)
Primary Completion Date
February 28, 2023 (Actual)
Study Completion Date
February 28, 2023 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is being performed to understand the effect of different doses of CK-3773274 on patients with hypertrophic cardiomyopathy (HCM).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypertrophic Cardiomyopathy (HCM)
Keywords
CK-3773274, CK-274, obstructive hypertrophic cardiomyopathy, oHCM, REDWOOD-HCM, non-obstructive hypertrophic cardiomyopathy, nHCM, hypertrophic cardiomyopathy, HCM

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
96 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CK-3773274 - Cohort 1 (Obstructive HCM)
Arm Type
Experimental
Arm Description
Subjects will receive doses of 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks
Arm Title
Placebo - Cohort 1 (Obstructive HCM)
Arm Type
Placebo Comparator
Arm Description
Subjects will receive placebo for up to 10 weeks
Arm Title
CK-3773274 - Cohort 2 (Obstructive HCM)
Arm Type
Experimental
Arm Description
Subjects will receive doses 10 - 30 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks
Arm Title
Placebo - Cohort 2 (Obstructive HCM)
Arm Type
Placebo Comparator
Arm Description
Subjects will receive placebo for up to 10 weeks
Arm Title
CK-3773274 & disopyramide - Cohort 3 (Obstructive HCM)
Arm Type
Experimental
Arm Description
Subjects will receive doses 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks while taking disopyramide
Arm Title
CK-3773274 - Cohort 4 (non-obstructive HCM)
Arm Type
Experimental
Arm Description
Subjects will receive doses of 5 - 15 mg of CK-3773274 with dose levels guided by echocardiography assessments for up to 10 weeks
Intervention Type
Drug
Intervention Name(s)
CK-3773274 (5 - 15 mg)
Intervention Description
CK-3773274 tablets administered orally
Intervention Type
Drug
Intervention Name(s)
CK-3773274 (10 - 30 mg)
Intervention Description
CK-3773274 tablets administered orally
Intervention Type
Drug
Intervention Name(s)
Placebo for CK-3773274
Intervention Description
Placebo administered orally
Primary Outcome Measure Information:
Title
Incidence of adverse events observed during dosing of CK--3773274 in patients with HCM
Description
Patient incidence of reported adverse events (AEs)
Time Frame
14 weeks
Secondary Outcome Measure Information:
Title
Incidence of left ventricular ejection fraction (LVEF) < 50% observed during dosing of CK-3773274 in patients with HCM
Description
Patient incidence of left ventricular ejection fraction (LVEF) < 50%
Time Frame
14 weeks
Title
Incidence of serious adverse events observed during dosing of CK-3773274 in patients with HCM
Description
Patient incidence of reported serious adverse events (SAEs)
Time Frame
14 weeks
Title
Concentration-response relationship of CK-3773274 on the resting left ventricular outflow tract gradient (LVOT-G) on echocardiogram over 10 weeks of treatment in patients with oHCM (Cohorts 1, 2, 3 only)
Description
Slope of the relationship of the plasma concentration of CK-3773274 to the change from baseline in the resting LVOT-G
Time Frame
10 weeks
Title
Concentration-response relationship of CK-3773274 on the post-Valsalva left ventricular outflow tract gradient (LVOT-G) on echocardiogram over 10 weeks of treatment in patients with oHCM (Cohorts 1, 2, 3 only)
Description
Slope of the relationship of the plasma concentration of CK-3773274 to the change from baseline in the post-Valsalva LVOT-G
Time Frame
10 weeks
Title
Dose response relationship on LVOT-G of CK-3773274 in patients with oHCM at rest (Cohorts 1, 2, 3 only)
Description
Change from baseline in resting LVOT-G over time as a function of dose
Time Frame
10 weeks
Title
Dose response relationship on LVOT-G of CK-3773274 in patients with oHCM post-Valsalva (Cohorts 1, 2, 3 only)
Description
Change from baseline in post-Valsalva LVOT-G over time as a function of dose
Time Frame
10 weeks
Title
Concentration-response relationship of CK-3773274 on left ventricular ejection fraction (LVEF) over 10 weeks of treatment in patients with HCM
Description
Change from baseline in the resting LVEF
Time Frame
Day 1 to End of Study (EOS) (Week 14)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Males and females between 18 and 85 years of age at screening. Body weight is ≥45 kg at screening. Diagnosed with HCM per the following criteria: Has left ventricular (LV) hypertrophy with non-dilated LV chamber in the absence of other cardiac disease. Has minimal wall thickness ≥15 mm (minimal wall thickness ≥13 mm is acceptable with a positive family history of HCM or with a known disease-causing gene mutation). Adequate acoustic windows for echocardiography. For Cohorts 1, 2 and 3 has LVOT-G during screening as follows: Resting gradient ≥50 mmHg OR Resting gradient ≥30 mmHg and <50 mmHg with post-Valsalva LVOT-G ≥50 mmHg For Cohort 4 has resting and post-Valsalva LVOT-G < 30 mmHg at the time of screening For Cohort 4 has elevated NT-proBNP > 300 pg/mL at the time of screening LVEF ≥60% at screening. New York Heart Association (NYHA) Class II or III at screening. Patients on beta-blockers, verapamil, diltiazem, or ranolazine should have been on stable doses for >4 weeks prior to randomization and anticipate remaining on the same medication regimen during the study. For Cohort 3: Patients must be taking disopyramide. Patients should have been on stable disopyramide doses for >4 weeks prior to screening and anticipate remaining on the same medication regimen during the study. Exclusion Criteria Aortic stenosis or fixed subaortic obstruction. Known infiltrative or storage disorder causing cardiac hypertrophy that mimics oHCM (eg, Noonan syndrome, Fabry disease, amyloidosis). History of LV systolic dysfunction (LVEF <45%) at any time during their clinical course. Documented history of current obstructive coronary artery disease (>70% stenosis in one or more epicardial coronary arteries) or documented history of myocardial infarction. Has been treated with septal reduction therapy (surgical myectomy or percutaneous alcohol septal ablation) or has plans for either treatment during the study period (Cohorts 1, 2, and 3 only). Patients having undergone septal reduction therapy > 12 months prior to screening who remain symptomatic from nHCM, and who meet all other criteria for inclusion, may be enrolled in Cohort 4. For Cohorts 1, 2 and 4: Has been treated with disopyramide or antiarrhythmic drugs that have negative inotropic activity within 4 weeks prior to screening. (For Cohort 3, use of disopyramide is required). Has any ECG abnormality considered by the investigator to pose a risk to patient safety (eg, second degree atrioventricular block type II). Paroxysmal atrial fibrillation or flutter documented during the screening period. Paroxysmal or permanent atrial fibrillation requiring rhythm restoring treatment (eg, direct-current cardioversion, ablation procedure, or antiarrhythmic therapy) ≤6 months prior to screening. (This exclusion does not apply if atrial fibrillation has been treated with anticoagulation and adequately rate-controlled for >6 months). History of syncope or sustained ventricular tachyarrhythmia with exercise within 6 months prior to screening. Has received prior treatment with CK-3773274 or mavacamten. For Cohort 4: has any documented history of LVOT-G ≥ 30 mmHg at rest, with Valsalva, or with exercise (for subjects who have had prior septal reduction therapy, this exclusion criteria only applies to gradients detected following septal reduction therapy).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cytokinetics, MD
Organizational Affiliation
Cytokinetics
Official's Role
Study Director
Facility Information:
Facility Name
Cedar-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
UCSF Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Facility Name
Northwestern University
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60208
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Michigan Medicine - University of Michigan
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
New York University Langone Health Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Carolinas Medical Center
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28203
Country
United States
Facility Name
Duke Cardiology at Southpoint
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27713
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Hospital of the University of Pennsylvania (University of Pennsylvania School of Medicine)
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
UMPC Heart and Vascular Institute
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Intermountain Medical Center
City
Murray
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Facility Name
University of Virginia Health System
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Facility Name
Azienda Ospedaliero Universitaria Careggi
City
Firenze
Country
Italy
Facility Name
Erasmus University Medical Center (Erasmus MC)
City
Rotterdam
Country
Netherlands
Facility Name
Complejo Hospitalario Universitario A Coruña
City
A Coruña
ZIP/Postal Code
15003
Country
Spain
Facility Name
Hospital Universitario Puerta de Hierro de Majadahonda
City
Madrid
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34081217
Citation
Zampieri M, Argiro A, Marchi A, Berteotti M, Targetti M, Fornaro A, Tomberli A, Stefano P, Marchionni N, Olivotto I. Mavacamten, a Novel Therapeutic Strategy for Obstructive Hypertrophic Cardiomyopathy. Curr Cardiol Rep. 2021 Jun 3;23(7):79. doi: 10.1007/s11886-021-01508-0.
Results Reference
derived

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REDWOOD-HCM: Randomized Evaluation of Dosing With CK-3773274 in HCM

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