A Phase 2 Open-label Pilot Study Evaluating MYK-461 in Subjects With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction (PIONEER-HCM)
Primary Purpose
Cardiomyopathy, Hypertrophic Obstructive, Left Ventricular Outflow Tract Obstruction
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MYK-461
Sponsored by
About this trial
This is an interventional treatment trial for Cardiomyopathy, Hypertrophic Obstructive
Eligibility Criteria
Key Inclusion Criteria:
- Diagnosed with HCM (hypertrophied and non-dilated left ventricle in absence of systemic or other known cause), with LV wall thickness ≥ 15 mm at time of initial diagnosis or ≥ 13 mm with a positive family history of HCM.
- Age 18-70
- BMI 18-37kg/m2
- Documented LVEF ≥ 55% at the Screening visit as determined by the investigator and the investigational site's echocardiography laboratory.
- Resting LVOT gradient ≥ 30 mg Hg and post-exercise peak LVOT gradient ≥ 50 mm Hg
- NYHA functional class II or higher
Key Exclusion Criteria:
- History of sustained ventricular tachyarrhythmia.
- History of syncope with exercise within past 6 months.
- Active infection.
- Persistent atrial fibrillation or atrial fibrillation at Screening or history of paroxysmal atrial fibrillation with resting rate document > 100bpm within 1 year of screening.
- Has QTc Fridericia (QTcF) > 500 ms, or any other ECG abnormality considered by the investigator to pose a risk to subject safety (e.g. second degree atrioventricular block type II).
- Aortic stenosis or fixed subaortic obstruction.
- History of LV systolic dysfunction (LVEF < 45%) at any time during their clinical course.
- History of obstructive coronary artery disease.
- History or evidence of any other clinically significant disorder, condition, or disease that, in the opinion of the investigator or MyoKardia physician, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion.
- Part A: Ongoing therapy with beta blockers, calcium channel blockers, or disopyramide. Subjects on any of these medications who, in the opinion of the investigator, can safely be withdrawn are eligible as long as medication is discontinued at least 14 days prior to the Screening visit.
- Part B: Ongoing therapy with calcium channel blockers or disopyramide. Subjects on any of these medications who, in the opinion of the investigator, can safely be withdrawn are eligible as long as medication is discontinued at least 14 days prior to the Screening visit.
- Prior treatment with cardiotoxic agents such as doxorubicin or similar, or current treatment with antiarrhythmic drugs that have negative inotropic activity, e.g. flecainide or propafenone.
Sites / Locations
- Mayo Clinic Arizona
- Yale New Haven Hospital
- Tufts Medical Center
- Washington University St. Louis
- Duke Health Center at Southpoint
- Oregon Health and Science University
- Hospital of the University of Pennsylvania (Penn Heart and Vascular Center)
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Open Label
Arm Description
MYK-461
Outcomes
Primary Outcome Measures
Change in Post-exercise Peak LVOT Gradient From Baseline to Week 12
Post-exercise peak LVOT gradients are assessed after a treadmill stress test by echocardiography.
Secondary Outcome Measures
Number of Participants Achieving a Post-exercise Peak LVOT Gradient Response of < 30 mmHg. Gradient < 30 mmHg
LVOT gradients are assessed after a treadmill stress test by echocardiography.
Change in Dyspnea Symptom Score From Baseline to Week 12
The scale name is Dyspnea Numeric Rating Scale (NRS). It is intended to measure how much shortness of breath you have had in the past week. 0 = no shortness of breath and 10 = shortness of breath as the worst possible.
Change in Peak VO2 From Baseline to Week 12
Peak VO2 is assessed using a cardiopulmonary exercise test.
Change in VE/VCO2 From Baseline to Week 12
VE/VCO2 is assessed from cardiopulmonary exercise testing results.
Change in Resting LVEF From Baseline to Week 12
LVEF is assessed by echocardiography.
Change in LV Fractional Shortening (LVFS) From Baseline to Week 12
LVFS is assessed using echocardiography measures.
Change in Global Longitudinal Strain (GLS) From Baseline to Week 12
GLS is assessed using echocardiography measures.
Change in Post-exercise Peak LVOT Gradient From Week 12 to Week 16
Post-exercise peak LVOT gradients are assessed after a treadmill stress test by echocardiography.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02842242
Brief Title
A Phase 2 Open-label Pilot Study Evaluating MYK-461 in Subjects With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction
Acronym
PIONEER-HCM
Official Title
A Phase 2 Open-label Pilot Study to Evaluate Efficacy, Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of MYK-461 in Subjects With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction
Study Type
Interventional
2. Study Status
Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
August 2016 (Actual)
Primary Completion Date
November 2017 (Actual)
Study Completion Date
November 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MyoKardia, Inc.
4. Oversight
5. Study Description
Brief Summary
The purpose of this phase 2 open-label pilot study is to evaluate the efficacy, pharmacokinetics (PK), pharmacodynamics (PD), safety, and tolerability of MYK-461 in subjects with symptomatic HCM and LVOT obstruction aged 18-70 years.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cardiomyopathy, Hypertrophic Obstructive, Left Ventricular Outflow Tract Obstruction
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Open Label
Arm Type
Experimental
Arm Description
MYK-461
Intervention Type
Drug
Intervention Name(s)
MYK-461
Primary Outcome Measure Information:
Title
Change in Post-exercise Peak LVOT Gradient From Baseline to Week 12
Description
Post-exercise peak LVOT gradients are assessed after a treadmill stress test by echocardiography.
Time Frame
Baseline and Week 12
Secondary Outcome Measure Information:
Title
Number of Participants Achieving a Post-exercise Peak LVOT Gradient Response of < 30 mmHg. Gradient < 30 mmHg
Description
LVOT gradients are assessed after a treadmill stress test by echocardiography.
Time Frame
Baseline and Week 12
Title
Change in Dyspnea Symptom Score From Baseline to Week 12
Description
The scale name is Dyspnea Numeric Rating Scale (NRS). It is intended to measure how much shortness of breath you have had in the past week. 0 = no shortness of breath and 10 = shortness of breath as the worst possible.
Time Frame
Baseline and Week 12
Title
Change in Peak VO2 From Baseline to Week 12
Description
Peak VO2 is assessed using a cardiopulmonary exercise test.
Time Frame
Baseline and Week 12
Title
Change in VE/VCO2 From Baseline to Week 12
Description
VE/VCO2 is assessed from cardiopulmonary exercise testing results.
Time Frame
Baseline and Week 12
Title
Change in Resting LVEF From Baseline to Week 12
Description
LVEF is assessed by echocardiography.
Time Frame
Baseline and Week 12
Title
Change in LV Fractional Shortening (LVFS) From Baseline to Week 12
Description
LVFS is assessed using echocardiography measures.
Time Frame
Baseline and Week 12
Title
Change in Global Longitudinal Strain (GLS) From Baseline to Week 12
Description
GLS is assessed using echocardiography measures.
Time Frame
Baseline and Week 12
Title
Change in Post-exercise Peak LVOT Gradient From Week 12 to Week 16
Description
Post-exercise peak LVOT gradients are assessed after a treadmill stress test by echocardiography.
Time Frame
Weeks 12 and 16
Other Pre-specified Outcome Measures:
Title
Change in NYHA Functional Class From Baseline to Week 12
Time Frame
Baseline and Week 12
Title
Change in KCCQ OSS From Baseline to Week 12
Time Frame
Baseline and Week 12
Title
Change in NT-proBNP From Baseline to Week 12
Time Frame
12 weeks
Title
Number of Subjects Achieving an LVOT Gradient Response of Post-exercise Peak Gradient < 10 mmHg at Week 12
Description
Post-exercise peak LVOT gradients are assessed after a treadmill stress test by echocardiography.
Time Frame
Baseline and Week 12
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria:
Diagnosed with HCM (hypertrophied and non-dilated left ventricle in absence of systemic or other known cause), with LV wall thickness ≥ 15 mm at time of initial diagnosis or ≥ 13 mm with a positive family history of HCM.
Age 18-70
BMI 18-37kg/m2
Documented LVEF ≥ 55% at the Screening visit as determined by the investigator and the investigational site's echocardiography laboratory.
Resting LVOT gradient ≥ 30 mg Hg and post-exercise peak LVOT gradient ≥ 50 mm Hg
NYHA functional class II or higher
Key Exclusion Criteria:
History of sustained ventricular tachyarrhythmia.
History of syncope with exercise within past 6 months.
Active infection.
Persistent atrial fibrillation or atrial fibrillation at Screening or history of paroxysmal atrial fibrillation with resting rate document > 100bpm within 1 year of screening.
Has QTc Fridericia (QTcF) > 500 ms, or any other ECG abnormality considered by the investigator to pose a risk to subject safety (e.g. second degree atrioventricular block type II).
Aortic stenosis or fixed subaortic obstruction.
History of LV systolic dysfunction (LVEF < 45%) at any time during their clinical course.
History of obstructive coronary artery disease.
History or evidence of any other clinically significant disorder, condition, or disease that, in the opinion of the investigator or MyoKardia physician, would pose a risk to subject safety or interfere with the study evaluation, procedures, or completion.
Part A: Ongoing therapy with beta blockers, calcium channel blockers, or disopyramide. Subjects on any of these medications who, in the opinion of the investigator, can safely be withdrawn are eligible as long as medication is discontinued at least 14 days prior to the Screening visit.
Part B: Ongoing therapy with calcium channel blockers or disopyramide. Subjects on any of these medications who, in the opinion of the investigator, can safely be withdrawn are eligible as long as medication is discontinued at least 14 days prior to the Screening visit.
Prior treatment with cardiotoxic agents such as doxorubicin or similar, or current treatment with antiarrhythmic drugs that have negative inotropic activity, e.g. flecainide or propafenone.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amy Sehnert, MD
Organizational Affiliation
MyoKardia, Inc.
Official's Role
Study Chair
Facility Information:
Facility Name
Mayo Clinic Arizona
City
Scottsdale
State/Province
Arizona
Country
United States
Facility Name
Yale New Haven Hospital
City
New Haven
State/Province
Connecticut
Country
United States
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
Country
United States
Facility Name
Washington University St. Louis
City
Saint Louis
State/Province
Missouri
Country
United States
Facility Name
Duke Health Center at Southpoint
City
Durham
State/Province
North Carolina
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
Country
United States
Facility Name
Hospital of the University of Pennsylvania (Penn Heart and Vascular Center)
City
Philadelphia
State/Province
Pennsylvania
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
31035291
Citation
Heitner SB, Jacoby D, Lester SJ, Owens A, Wang A, Zhang D, Lambing J, Lee J, Semigran M, Sehnert AJ. Mavacamten Treatment for Obstructive Hypertrophic Cardiomyopathy: A Clinical Trial. Ann Intern Med. 2019 Jun 4;170(11):741-748. doi: 10.7326/M18-3016. Epub 2019 Apr 30.
Results Reference
derived
Learn more about this trial
A Phase 2 Open-label Pilot Study Evaluating MYK-461 in Subjects With Symptomatic Hypertrophic Cardiomyopathy and Left Ventricular Outflow Tract Obstruction
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