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The Purpose of This Study is to Evaluate the Efficacy and Safety of Aficamten (CK-3773274) Compared to Placebo in Adults With Symptomatic Non-obstructive Hypertrophic Cardiomyopathy (ACACIA-HCM)

Primary Purpose

Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy

Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Aficamten
Placebo
Sponsored by
Cytokinetics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy focused on measuring CK-3773274, CK-274, Aficamten, Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy, nHCM, ACACIA-HCM, ACACIA

Eligibility Criteria

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

Inclusion Criteria: Between 18-85 years of age Body mass index < 40 kg/m2 Diagnosed with nHCM and has a screening echocardiogram with the following: End-diastolic left ventricular (LV) wall thickness: ≥ 15 mm in one or more myocardial segments OR ≥ 13 mm in one or more wall segments and a known disease-causing gene mutation or positive family history of HCM AND Resting LVOT-G < 30 mmHg AND Valsalva LVOT-G < 50 mmHg AND LVEF ≥ 60% Participants with a history of intracavitary obstruction are eligible. NYHA class II or III Respiratory exchange ratio of ≥ 1.00 at screening by cardiopulmonary exercise testing (CPET) and predicted peak oxygen uptake (pVO2) ≤ 90% for age and sex KCCQ-CSS score of ≥ 30 and ≤ 85 NT-proBNP of: NT-pro BNP ≥ 300 pg/mL or NT-proBNP ≥ 900 pg/mL if in atrial fibrillation or atrial flutter OR For Black participants, an NT-pro BNP ≥ 225 pg/mL or NT-proBNP ≥ 675 pg/mL if in atrial fibrillation or atrial flutter Exclusion Criteria: Significant valvular heart disease (per Investigator judgment) Moderate or severe valvular aortic stenosis or fixed subaortic obstruction Moderate or severe mitral regurgitation Known or suspected infiltrative, genetic or storage disorder causing cardiac hypertrophy that mimics nHCM (eg, Noonan syndrome, Fabry disease, amyloidosis) Known current unrevascularized coronary artery stenosis of ≥ 70% or documented history of myocardial infarction. History of LV systolic dysfunction (LVEF < 45%) or stress cardiomyopathy Inability to exercise on a treadmill or bicycle (eg, orthopedic limitations) Documented room air oxygen saturation reading < 90% at screening or history of significant chronic obstructive pulmonary disease or severe/significant pulmonary hypertension History of syncope, symptomatic ventricular arrhythmia, or sustained ventricular tachyarrhythmia with exercise within 3 months prior to screening History of resistant hypertension (persistently elevated blood pressure despite maximal doses of 3 or more classes of medications for hypertension control) Screening diastolic blood pressure ≥ 100 mmHg Received prior treatment with aficamten Received treatment with mavacamten within 3 months prior to screening (must be discussed with the medical monitor prior to screening) Undergone septal reduction therapy < 6 months prior to screening Is being considered for or is likely to be considered for heart transplant listing or left ventricular assist device placement during the study period Paroxysmal or permanent atrial fibrillation is excluded only if: rhythm restoring treatment (e.g., direct-current cardioversion, atrial fibrillation ablation procedure, or antiarrhythmic therapy) has been required ≤ 3 months prior to screening rate control and anticoagulation have not been achieved for at least 3 months prior to screening.

Sites / Locations

  • Alaska Heart and Vascular InstituteRecruiting
  • Oregon Health & Science UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Aficamten

Placebo

Arm Description

Participants in this arm will receive a single daily oral dose of 5 mg, 10 mg, 15 mg, or 20 mg of aficamten with dose levels guided by echocardiography assessments, for up to 72 weeks.

Participants in this arm will receive placebo, for up to 72 weeks.

Outcomes

Primary Outcome Measures

Change in Kansas City Cardiomyopathy Questionnaire - Clinical Summary Score (KCCQ-CSS)
Effect of aficamten compared with placebo on participant health status

Secondary Outcome Measures

Change in composite of two Z-scores of CPET parameters (pVO2 and VE/VCO2 slope)
Effect of aficamten compared with placebo on global exercise capacity based on maximal and sub-maximal exercise performance
Proportion of participants with ≥ 1 class improvement in NYHA Functional Class
Effect of aficamten compared with placebo on NYHA Functional Classification
Change in NT-proBNP
Effect of aficamten compared with placebo on a biomarker of cardiac wall stress
Change in LAVI
Effect of aficamten compared with placebo on echocardiographic measures of structural remodeling
Time to first CV event (CV death; heart transplantation or left ventricular assist device; aborted sudden cardiac death; non-fatal stroke; heart failure hospitalization; or cardiac arrhythmia requiring treatment or hospitalization)
Effect of aficamten compared with placebo on cardiovascular events

Full Information

First Posted
August 31, 2023
Last Updated
October 12, 2023
Sponsor
Cytokinetics
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1. Study Identification

Unique Protocol Identification Number
NCT06081894
Brief Title
The Purpose of This Study is to Evaluate the Efficacy and Safety of Aficamten (CK-3773274) Compared to Placebo in Adults With Symptomatic Non-obstructive Hypertrophic Cardiomyopathy
Acronym
ACACIA-HCM
Official Title
A Phase 3, Multi-Center, Randomized, Double-Blind Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 30, 2023 (Actual)
Primary Completion Date
June 2026 (Anticipated)
Study Completion Date
September 2026 (Anticipated)

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 clinical trial will study the effects of aficamten (versus placebo) on the quality of life, exercise capacity, and clinical outcomes of patients with non-obstructive hypertrophic cardiomyopathy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy
Keywords
CK-3773274, CK-274, Aficamten, Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy, nHCM, ACACIA-HCM, ACACIA

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
420 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Aficamten
Arm Type
Experimental
Arm Description
Participants in this arm will receive a single daily oral dose of 5 mg, 10 mg, 15 mg, or 20 mg of aficamten with dose levels guided by echocardiography assessments, for up to 72 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants in this arm will receive placebo, for up to 72 weeks.
Intervention Type
Drug
Intervention Name(s)
Aficamten
Intervention Description
Oral Tablet
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Oral Tablet
Primary Outcome Measure Information:
Title
Change in Kansas City Cardiomyopathy Questionnaire - Clinical Summary Score (KCCQ-CSS)
Description
Effect of aficamten compared with placebo on participant health status
Time Frame
Baseline to Week 36
Secondary Outcome Measure Information:
Title
Change in composite of two Z-scores of CPET parameters (pVO2 and VE/VCO2 slope)
Description
Effect of aficamten compared with placebo on global exercise capacity based on maximal and sub-maximal exercise performance
Time Frame
Baseline to Week 36
Title
Proportion of participants with ≥ 1 class improvement in NYHA Functional Class
Description
Effect of aficamten compared with placebo on NYHA Functional Classification
Time Frame
Baseline to Week 36
Title
Change in NT-proBNP
Description
Effect of aficamten compared with placebo on a biomarker of cardiac wall stress
Time Frame
Baseline to Week 36
Title
Change in LAVI
Description
Effect of aficamten compared with placebo on echocardiographic measures of structural remodeling
Time Frame
Baseline to Week 36
Title
Time to first CV event (CV death; heart transplantation or left ventricular assist device; aborted sudden cardiac death; non-fatal stroke; heart failure hospitalization; or cardiac arrhythmia requiring treatment or hospitalization)
Description
Effect of aficamten compared with placebo on cardiovascular events
Time Frame
Baseline to End of Study, Week 72

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: Between 18-85 years of age Body mass index < 40 kg/m2 Diagnosed with nHCM and has a screening echocardiogram with the following: End-diastolic left ventricular (LV) wall thickness: ≥ 15 mm in one or more myocardial segments OR ≥ 13 mm in one or more wall segments and a known disease-causing gene mutation or positive family history of HCM AND Resting LVOT-G < 30 mmHg AND Valsalva LVOT-G < 50 mmHg AND LVEF ≥ 60% Participants with a history of intracavitary obstruction are eligible. NYHA class II or III Respiratory exchange ratio of ≥ 1.00 at screening by cardiopulmonary exercise testing (CPET) and predicted peak oxygen uptake (pVO2) ≤ 90% for age and sex KCCQ-CSS score of ≥ 30 and ≤ 85 NT-proBNP of: NT-pro BNP ≥ 300 pg/mL or NT-proBNP ≥ 900 pg/mL if in atrial fibrillation or atrial flutter OR For Black participants, an NT-pro BNP ≥ 225 pg/mL or NT-proBNP ≥ 675 pg/mL if in atrial fibrillation or atrial flutter Exclusion Criteria: Significant valvular heart disease (per Investigator judgment) Moderate or severe valvular aortic stenosis or fixed subaortic obstruction Moderate or severe mitral regurgitation Known or suspected infiltrative, genetic or storage disorder causing cardiac hypertrophy that mimics nHCM (eg, Noonan syndrome, Fabry disease, amyloidosis) Known current unrevascularized coronary artery stenosis of ≥ 70% or documented history of myocardial infarction. History of LV systolic dysfunction (LVEF < 45%) or stress cardiomyopathy Inability to exercise on a treadmill or bicycle (eg, orthopedic limitations) Documented room air oxygen saturation reading < 90% at screening or history of significant chronic obstructive pulmonary disease or severe/significant pulmonary hypertension History of syncope, symptomatic ventricular arrhythmia, or sustained ventricular tachyarrhythmia with exercise within 3 months prior to screening History of resistant hypertension (persistently elevated blood pressure despite maximal doses of 3 or more classes of medications for hypertension control) Screening diastolic blood pressure ≥ 100 mmHg Received prior treatment with aficamten Received treatment with mavacamten within 3 months prior to screening (must be discussed with the medical monitor prior to screening) Undergone septal reduction therapy < 6 months prior to screening Is being considered for or is likely to be considered for heart transplant listing or left ventricular assist device placement during the study period Paroxysmal or permanent atrial fibrillation is excluded only if: rhythm restoring treatment (e.g., direct-current cardioversion, atrial fibrillation ablation procedure, or antiarrhythmic therapy) has been required ≤ 3 months prior to screening rate control and anticoagulation have not been achieved for at least 3 months prior to screening.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Cytokinetics MD
Phone
650-624-2929
Email
medicalaffairs@cytokinetics.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Cytokinetics MD
Organizational Affiliation
Cytokinetics
Official's Role
Study Director
Facility Information:
Facility Name
Alaska Heart and Vascular Institute
City
Anchorage
State/Province
Alaska
ZIP/Postal Code
99508
Country
United States
Individual Site Status
Recruiting
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Purpose of This Study is to Evaluate the Efficacy and Safety of Aficamten (CK-3773274) Compared to Placebo in Adults With Symptomatic Non-obstructive Hypertrophic Cardiomyopathy

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