search
Back to results

Fontan Udenafil Exercise Longitudinal Assessment Trial - 2 (FUEL-2)

Primary Purpose

Single Ventricle Heart Disease

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Udenafil
Placebo
Sponsored by
Mezzion Pharma Co. Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Single Ventricle Heart Disease focused on measuring Fontan, Maximal Oxygen Consumption, Work Rate, VO2 at VAT, Ventilatory Efficiency

Eligibility Criteria

12 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males and females with Fontan physiology who are 12 to less than 19 years of age at enrollment. Participant consent or parental/guardian consent and participant assent. Participant fluency in primary language of country in which study is being conducted. Current antiplatelet or anticoagulant therapy. Exclusion Criteria: Height < 132 cm. Hospitalization for acute decompensated heart failure within the last 12 months. Current intravenous inotropic drugs. Undergoing evaluation for heart transplantation or listed for transplantation. Diagnosis of active protein losing enteropathy or plastic bronchitis within the last 3 years, or a history of liver cirrhosis. Known Fontan baffle obstruction, branch pulmonary artery stenosis, or pulmonary vein stenosis resulting in a mean gradient of > 4 mmHg between the regions proximal and distal to the obstruction as measured by either catheterization or echocardiography, obtained prior to screening for the trial. Single lung physiology with greater than 80% flow to one lung. Peak minute oxygen consumption (VO2) less than 45% or ≥ 80% of predicated for age and gender at enrollment. Severe ventricular dysfunction assessed qualitatively by clinical echocardiography within 6 months prior to enrollment. Severe valvar regurgitation, ventricular outflow obstruction, or severe aortic arch obstruction assessed by clinical echocardiography within six months prior to enrollment. History of significant renal (serum creatinine > 2.0), hepatic (serum AST and/or ALT > 3 times upper limit of normal), gastrointestinal or biliary disorders that could impair absorption, metabolism or excretion of orally administered medications. Inability to complete exercise testing at baseline screening. History of PDE-5 inhibitor use within 12 months prior to enrollment. History of any other medication for treatment of pulmonary hypertension within 3 months before study onset. Known intolerance to oral udenafil. Frequent use of medications or other substances that inhibit or induce CYP3A4. Current use of alpha-blockers or nitrates. Ongoing or planned participation in another research protocol that would either prevent successful completion of planned study testing or invalidate its results. Noncardiac medical, psychiatric, and/or social disorder that would prevent successful completion of planned study testing or would invalidate its results. Cardiac care, ongoing or planned, at a non-study center that would impede study completion. For females: Pregnancy at the time of screening, pregnancy planned before study completion, or refusal to use an acceptable method of contraception for study duration if sexually active. Unable to abstain or limit intake of grapefruit juice and grapefruit containing drinks during the duration of the trial. Refusal to provide written informed consent/assent. In the opinion of the investigator, the subject is likely to be non-compliant with the study protocol. History of clinically significant thromboembolic event, in the option of the site Principal Investigator, that may put the subject at increased risk of a subsequent event while participating in the study. Coronavirus disease 2019 (COVID-19) vaccination or symptoms of COVID-19 infection within 7 days of Visit 1. Not taking antiplatelet or anticoagulant therapy.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Drug

    Placebo

    Arm Description

    Approximately 218 subjects dosed with udenafil will be enrolled at approximately 30 sites.

    Approximately 218 subjects dosed with matching placebo will be enrolled at approximately 30 sites.

    Outcomes

    Primary Outcome Measures

    Change in Exercise Capacity
    The change in exercise capacity (as measured by maximal VO2 at maximum exercise effort) from baseline to 26 weeks (or study completion)

    Secondary Outcome Measures

    Change in VO2 at the ventilatory anaerobic threshold (VAT)
    Change in peak oxygen consumption (VO2) from baseline to Week 26 as measured by maximal central cardiopulmonary exercise test (CPET) reading laboratory.
    Change in Enhanced Liver Fibrosis (ELF) Score
    Change from baseline to Week 26 in the ELF Score calculated by the change in the following biomarkers: hyaluronic acid, amino-terminal propeptide of type III collagen, and tissue inhibitor of metalloproteinase-1.
    Work rate (watts) at ventilatory anaerobic threshold (VAT)
    Change from baseline to 26 weeks in work rate in watts at the ventilatory anaerobic threshold as measured by the central cardiopulmonary exercise test reading laboratory.
    Change in ventilatory efficiency (VE/VCO2) at ventilatory anaerobic threshold
    Change from baseline to Week 26 in ventilatory efficiency calculated by ventilatory efficiency divided by minute carbon dioxide production at the ventilatory anaerobic threshold (VE/VCO2 at VAT).

    Full Information

    First Posted
    June 15, 2023
    Last Updated
    June 15, 2023
    Sponsor
    Mezzion Pharma Co. Ltd
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT05918211
    Brief Title
    Fontan Udenafil Exercise Longitudinal Assessment Trial - 2
    Acronym
    FUEL-2
    Official Title
    Fontan Udenafil Exercise Longitudinal Assessment Trial (FUEL-2)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 20, 2023 (Anticipated)
    Primary Completion Date
    October 28, 2025 (Anticipated)
    Study Completion Date
    October 28, 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Mezzion Pharma Co. Ltd

    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 will evaluate the clinical efficacy and safety of udenafil, an orally administered, potent and selective inhibitor of PDE5, versus placebo for the treatment of adolescent who have had the Fontan procedure.
    Detailed Description
    This study is a 26 week, prospective, multicenter, randomized, double-blinded, placebo-controlled safety and efficacy study of udenafil vs. placebo in adolescent subjects who have had the Fontan procedure. The primary efficacy endpoint will be change from baseline at 26 weeks in peak minute oxygen consumption (VO2 mL/kg/min) as measured by maximal cardiopulmonary exercise test (CPET) reading laboratory who will be blinded to treatment allocation.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Single Ventricle Heart Disease
    Keywords
    Fontan, Maximal Oxygen Consumption, Work Rate, VO2 at VAT, Ventilatory Efficiency

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Model Description
    Randomized, double-blind, placebo-controlled safety and efficacy study of udenafil versus placebo of approximately 436 subjects enrolled equally between the two arms (udenafil and placebo)
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Masking Description
    Active and matching placebo tablets will be identical in appearance.
    Allocation
    Randomized
    Enrollment
    436 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Drug
    Arm Type
    Experimental
    Arm Description
    Approximately 218 subjects dosed with udenafil will be enrolled at approximately 30 sites.
    Arm Title
    Placebo
    Arm Type
    Experimental
    Arm Description
    Approximately 218 subjects dosed with matching placebo will be enrolled at approximately 30 sites.
    Intervention Type
    Drug
    Intervention Name(s)
    Udenafil
    Intervention Description
    Active drug
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Matching Placebo
    Primary Outcome Measure Information:
    Title
    Change in Exercise Capacity
    Description
    The change in exercise capacity (as measured by maximal VO2 at maximum exercise effort) from baseline to 26 weeks (or study completion)
    Time Frame
    Baseline to 26 Weeks
    Secondary Outcome Measure Information:
    Title
    Change in VO2 at the ventilatory anaerobic threshold (VAT)
    Description
    Change in peak oxygen consumption (VO2) from baseline to Week 26 as measured by maximal central cardiopulmonary exercise test (CPET) reading laboratory.
    Time Frame
    Baseline to 26 weeks
    Title
    Change in Enhanced Liver Fibrosis (ELF) Score
    Description
    Change from baseline to Week 26 in the ELF Score calculated by the change in the following biomarkers: hyaluronic acid, amino-terminal propeptide of type III collagen, and tissue inhibitor of metalloproteinase-1.
    Time Frame
    Baseline to 26 weeks
    Title
    Work rate (watts) at ventilatory anaerobic threshold (VAT)
    Description
    Change from baseline to 26 weeks in work rate in watts at the ventilatory anaerobic threshold as measured by the central cardiopulmonary exercise test reading laboratory.
    Time Frame
    Baseline to 26 weeks
    Title
    Change in ventilatory efficiency (VE/VCO2) at ventilatory anaerobic threshold
    Description
    Change from baseline to Week 26 in ventilatory efficiency calculated by ventilatory efficiency divided by minute carbon dioxide production at the ventilatory anaerobic threshold (VE/VCO2 at VAT).
    Time Frame
    Baseline to 26 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    12 Years
    Maximum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Males and females with Fontan physiology who are 12 to less than 19 years of age at enrollment. Participant consent or parental/guardian consent and participant assent. Participant fluency in primary language of country in which study is being conducted. Current antiplatelet or anticoagulant therapy. Exclusion Criteria: Height < 132 cm. Hospitalization for acute decompensated heart failure within the last 12 months. Current intravenous inotropic drugs. Undergoing evaluation for heart transplantation or listed for transplantation. Diagnosis of active protein losing enteropathy or plastic bronchitis within the last 3 years, or a history of liver cirrhosis. Known Fontan baffle obstruction, branch pulmonary artery stenosis, or pulmonary vein stenosis resulting in a mean gradient of > 4 mmHg between the regions proximal and distal to the obstruction as measured by either catheterization or echocardiography, obtained prior to screening for the trial. Single lung physiology with greater than 80% flow to one lung. Peak minute oxygen consumption (VO2) less than 45% or ≥ 80% of predicated for age and gender at enrollment. Severe ventricular dysfunction assessed qualitatively by clinical echocardiography within 6 months prior to enrollment. Severe valvar regurgitation, ventricular outflow obstruction, or severe aortic arch obstruction assessed by clinical echocardiography within six months prior to enrollment. History of significant renal (serum creatinine > 2.0), hepatic (serum AST and/or ALT > 3 times upper limit of normal), gastrointestinal or biliary disorders that could impair absorption, metabolism or excretion of orally administered medications. Inability to complete exercise testing at baseline screening. History of PDE-5 inhibitor use within 12 months prior to enrollment. History of any other medication for treatment of pulmonary hypertension within 3 months before study onset. Known intolerance to oral udenafil. Frequent use of medications or other substances that inhibit or induce CYP3A4. Current use of alpha-blockers or nitrates. Ongoing or planned participation in another research protocol that would either prevent successful completion of planned study testing or invalidate its results. Noncardiac medical, psychiatric, and/or social disorder that would prevent successful completion of planned study testing or would invalidate its results. Cardiac care, ongoing or planned, at a non-study center that would impede study completion. For females: Pregnancy at the time of screening, pregnancy planned before study completion, or refusal to use an acceptable method of contraception for study duration if sexually active. Unable to abstain or limit intake of grapefruit juice and grapefruit containing drinks during the duration of the trial. Refusal to provide written informed consent/assent. In the opinion of the investigator, the subject is likely to be non-compliant with the study protocol. History of clinically significant thromboembolic event, in the option of the site Principal Investigator, that may put the subject at increased risk of a subsequent event while participating in the study. Coronavirus disease 2019 (COVID-19) vaccination or symptoms of COVID-19 infection within 7 days of Visit 1. Not taking antiplatelet or anticoagulant therapy.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    James Yeager, PhD
    Phone
    847.212.2679
    Email
    james.yeager@mezzion.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Kelly R Williams, BS
    Phone
    573.434.2579
    Email
    kelly.williams@mezzion.com

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Fontan Udenafil Exercise Longitudinal Assessment Trial - 2

    We'll reach out to this number within 24 hrs