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AZD8601 Study in CABG Patients

Primary Purpose

Heart Failure

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AZD8601
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Failure

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

For inclusion in the study patients should fulfil the following criteria at Visit 1 and/or 2:

1. Provision of signed and dated informed consent prior to any study specific procedures

Males and females:

  1. Males must be surgically sterile or using an acceptable method of contraception
  2. Females must be of non-childbearing potential confirmed at screening by fulfilling one of the following criteria a) postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of all exogenous hormonal treatments and follicle-stimulating hormone (FSH) levels in the postmenopausal range, b) documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation 3. Age >18 years 4. Indication for elective CABG surgery enrolled at least 15 days before the planned surgery 5. Moderately reduced global LVEF at rest (30% ≤ LVEF ≤ 50%) from medical records 6. If patient is on statin, ACE inhibitor/ARB, and/or beta-blocker, the dose should be stable at least 2 weeks prior to Visit 1 7. Patients who are blood donors should not donate blood during the study and for 3 months following their last dose of AZD8601.

Exclusion Criteria:

Patients should not enter the study if any of the following exclusion criteria are fulfilled:

1. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site) 2. Previous randomisation in the present study 3. Participation in another clinical study with an investigational product during the last 3 months 4. BMI > 35 kg/m2 OR poor image window for echocardiography 5. Need for CABG emergency operation. (Emergency operation is defined as significant symptom status worsening in CAD, such as crescendo angina, unstable angina or ACS requiring rescheduling the revascularization. CAD should be stable at least 3 months prior to Visit 3.) 6. History of ventricular arrhythmia (≥ Lown III) without Implantable Cardiac Defibrillator (ICD) History of any clinically significant disease or disorder which, in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study 8. Severe co-morbidities that can interfere with the execution of the study, interpretation of study results or affect the safety of the patient, in judgement of the investigator 9. eGFR ≤ 30 mL/min (derived from creatinine clearance, calculated by local lab) 10. For CFVR (Visit 1) and sMBF (Visit 2) measurement:

  • Known severe adverse reactions to adenosine
  • Known elevated intracranial pressure
  • AV block ≥ second degree and/or sick sinus syndrome in patient without pacemaker
  • Heart rate < 40 bpm (ECG verified)
  • Systolic blood pressure < 90 mmHg
  • Asthma or COPD with strong reactive component in judgement of investigator
  • Treatment with dipyridamole (e.g. Persantin or Asasantin), theophyllamine or fluvoxamine that cannot be paused 11. Inability to comply with the protocol 12. History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity to drugs with a similar chemical structure or class as study drugs 13. Patients unable to give their consent or communicate reliably with the investigator or vulnerable patients e.g., kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order 14. Positive hepatitis C antibody hepatitis B virus surface antigen or hepatitis B virus core antibody or human immunodeficiency virus, at Visit 1 15. Known history of drug or alcohol abuse 16. Any concomitant medications that are known to be associated with Torsades de Pointes 17. History of QT prolongation associated with other medications that required discontinuation of that medication 18. Congenital long QT syndrome 19. History of arrhythmia (multifocal premature ventricular contractions, bigeminy, trigeminy, ventricular tachycardia), which is symptomatic or requires treatment (CTCAE Grade 3).

    20. Current atrial fibrillation as well as paroxysmal atrial fibrillation.

Sites / Locations

  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Low dose AZD8601 (3 mg)

High dose AZD8601 (30 mg)

Placebo

Arm Description

8 patients will be randomised to receive 3 mg AZD8601

8 patients will be randomised to receive 30 mg AZD8601

8 patients will be randomised to receive placebo injections

Outcomes

Primary Outcome Measures

Serious Adverse Events
To assess safety and tolerability of AZD8601 given as epicardial injections
Adverse event
To assess safety and tolerability of AZD8601 given as epicardial injections
Electrocardiogram (ECG, number of patients with ECG results exceeding ICH reference ranges)
To assess safety and tolerability of AZD8601 given as epicardial injections
Left ventricular ejection fraction (LVEF) change from baseline (%)
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in physical examination (number of abnormal findings in physical examination)
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in vital signs - blood pressure (mmHg)
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in vital signs - pulse (bpm)
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in laboratory values - hematology
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in laboratory values - clinical chemistry
To assess safety and tolerability of AZD8601 given as epicardial injections
Changes in laboratory values - urinalysis
To assess safety and tolerability of AZD8601 given as epicardial injections

Secondary Outcome Measures

Full Information

First Posted
November 16, 2017
Last Updated
August 4, 2021
Sponsor
AstraZeneca
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1. Study Identification

Unique Protocol Identification Number
NCT03370887
Brief Title
AZD8601 Study in CABG Patients
Official Title
A Randomized, Double-blind, Placebo-controlled, Multi-centre, Sequential Design, Phase IIa Study to Evaluate Safety and Tolerability of Epicardial Injections of AZD8601 During Coronary Artery Bypass Grafting Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Completed
Study Start Date
February 5, 2018 (Actual)
Primary Completion Date
June 30, 2021 (Actual)
Study Completion Date
June 30, 2021 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This is a randomized, double-blind, placebo-controlled, sequential design, multicentre study in patients with moderately impaired systolic function undergoing CABG surgery. Twenty four (24) patients scheduled for elective bypass surgery will be randomized (up to approximately 33 patients if replacements are needed). The objective is to investigate safety and tolerability of AZD8601 following epicardial injection in patients undergoing Coronary Artery Bypass Grafting (CABG) surgery with moderately impaired systolic function. At Visit 3 patients will receive either AZD8601 or placebo as epicardial injections and will then be followed up at 14 days (telephone visit) and 1, 3 and 6 months (on-site) post-surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low dose AZD8601 (3 mg)
Arm Type
Experimental
Arm Description
8 patients will be randomised to receive 3 mg AZD8601
Arm Title
High dose AZD8601 (30 mg)
Arm Type
Experimental
Arm Description
8 patients will be randomised to receive 30 mg AZD8601
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
8 patients will be randomised to receive placebo injections
Intervention Type
Drug
Intervention Name(s)
AZD8601
Intervention Description
AZD8601 solution for injection, 0,5 mg/mL and 5 mg/mL will be given as 30 injections of 0.1 mg (3 mg per patient), or 1 mg (30 mg per patient) respectively on a single occasion
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo for AZ8601 injection for solution will be given as 30 injections per patient on a single occasion
Primary Outcome Measure Information:
Title
Serious Adverse Events
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from signing of ICF at Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Adverse event
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
6 months, from receiving IP at Visit 3 until 6 months after receiving IP.
Title
Electrocardiogram (ECG, number of patients with ECG results exceeding ICH reference ranges)
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Left ventricular ejection fraction (LVEF) change from baseline (%)
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in physical examination (number of abnormal findings in physical examination)
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in vital signs - blood pressure (mmHg)
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in vital signs - pulse (bpm)
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in laboratory values - hematology
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in laboratory values - clinical chemistry
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.
Title
Changes in laboratory values - urinalysis
Description
To assess safety and tolerability of AZD8601 given as epicardial injections
Time Frame
Up to 9 months; from Visit 1, maximum 90 days before investigational product (IP) administration, until 6 months after receiving IP.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: For inclusion in the study patients should fulfil the following criteria at Visit 1 and/or 2: 1. Provision of signed and dated informed consent prior to any study specific procedures Males and females: Males must be surgically sterile or using an acceptable method of contraception Females must be of non-childbearing potential confirmed at screening by fulfilling one of the following criteria a) postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of all exogenous hormonal treatments and follicle-stimulating hormone (FSH) levels in the postmenopausal range, b) documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation 3. Age >18 years 4. Indication for elective CABG surgery enrolled at least 15 days before the planned surgery 5. Moderately reduced global LVEF at rest (30% ≤ LVEF ≤ 50%) from medical records 6. If patient is on statin, ACE inhibitor/ARB, and/or beta-blocker, the dose should be stable at least 2 weeks prior to Visit 1 7. Patients who are blood donors should not donate blood during the study and for 3 months following their last dose of AZD8601. Exclusion Criteria: Patients should not enter the study if any of the following exclusion criteria are fulfilled: 1. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site) 2. Previous randomisation in the present study 3. Participation in another clinical study with an investigational product during the last 3 months 4. BMI > 35 kg/m2 OR poor image window for echocardiography 5. Need for CABG emergency operation. (Emergency operation is defined as significant symptom status worsening in CAD, such as crescendo angina, unstable angina or ACS requiring rescheduling the revascularization. CAD should be stable at least 3 months prior to Visit 3.) 6. History of ventricular arrhythmia (≥ Lown III) without Implantable Cardiac Defibrillator (ICD) History of any clinically significant disease or disorder which, in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study 8. Severe co-morbidities that can interfere with the execution of the study, interpretation of study results or affect the safety of the patient, in judgement of the investigator 9. eGFR ≤ 30 mL/min (derived from creatinine clearance, calculated by local lab) 10. For CFVR (Visit 1) and sMBF (Visit 2) measurement: Known severe adverse reactions to adenosine Known elevated intracranial pressure AV block ≥ second degree and/or sick sinus syndrome in patient without pacemaker Heart rate < 40 bpm (ECG verified) Systolic blood pressure < 90 mmHg Asthma or COPD with strong reactive component in judgement of investigator Treatment with dipyridamole (e.g. Persantin or Asasantin), theophyllamine or fluvoxamine that cannot be paused 11. Inability to comply with the protocol 12. History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity to drugs with a similar chemical structure or class as study drugs 13. Patients unable to give their consent or communicate reliably with the investigator or vulnerable patients e.g., kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order 14. Positive hepatitis C antibody hepatitis B virus surface antigen or hepatitis B virus core antibody or human immunodeficiency virus, at Visit 1 15. Known history of drug or alcohol abuse 16. Any concomitant medications that are known to be associated with Torsades de Pointes 17. History of QT prolongation associated with other medications that required discontinuation of that medication 18. Congenital long QT syndrome 19. History of arrhythmia (multifocal premature ventricular contractions, bigeminy, trigeminy, ventricular tachycardia), which is symptomatic or requires treatment (CTCAE Grade 3). 20. Current atrial fibrillation as well as paroxysmal atrial fibrillation.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vesa Anttila, MD, PhD
Organizational Affiliation
Heart Center, Turku University, Finland
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Kuopio
ZIP/Postal Code
70210
Country
Finland
Facility Name
Research Site
City
Tampere
ZIP/Postal Code
33520
Country
Finland
Facility Name
Research Site
City
Turku
ZIP/Postal Code
20520
Country
Finland
Facility Name
Research Site
City
München
ZIP/Postal Code
80363
Country
Germany
Facility Name
Research Site
City
München
ZIP/Postal Code
81675
Country
Germany
Facility Name
Research Site
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
IPD Sharing Time Frame
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing Access Criteria
When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing URL
https://astrazenecagroup-dt.pharmacm.com/DT/Home
Citations:
PubMed Identifier
32728595
Citation
Anttila V, Saraste A, Knuuti J, Jaakkola P, Hedman M, Svedlund S, Lagerstrom-Fermer M, Kjaer M, Jeppsson A, Gan LM. Synthetic mRNA Encoding VEGF-A in Patients Undergoing Coronary Artery Bypass Grafting: Design of a Phase 2a Clinical Trial. Mol Ther Methods Clin Dev. 2020 Jun 1;18:464-472. doi: 10.1016/j.omtm.2020.05.030. eCollection 2020 Sep 11.
Results Reference
derived

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AZD8601 Study in CABG Patients

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