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Evaluation of Patiromer in Heart Failure Patients (PEARL-HF)

Primary Purpose

Hyperkalemia, Heart Failure

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
patiromer
placebo
Sponsored by
Relypsa, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Hyperkalemia focused on measuring HF, Heart failure, hyperkalemia, chronic kidney disease, prevention of hyperkalemia in heart failure participants

Eligibility Criteria

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

Inclusion Criteria:

  • Participants with chronic heart failure clinically indicated to receive spironolactone therapy, aged 18 years or older with serum potassium level of 4.3 - 5.1 mEq/L at screening and baseline, AND (1) chronic kidney disease (GFR < 60 mL/min) OR (2) documented history of hyperkalemia within the last 6 months
  • Females of child-bearing potential must be non-lactating, must have a negative serum pregnancy test at screening, and must have used a highly effective form of contraception for at least 3 months before study drug administration, during the study, and for one month after study completion
  • Male participants and/or their female partners of child-bearing potential must use a highly effective form of contraception during the study and for 3 months after study completion
  • Must sign informed consent document

Exclusion Criteria:

  • History of bowel obstruction, swallowing disorders, severe gastrointestinal disorders or major gastrointestinal surgery
  • Uncorrected hemodynamically significant primary valvular disease, known obstructive or restrictive cardiomyopathy, uncontrolled or hemodynamically unstable arrhythmia
  • Coronary-artery bypass graft, percutaneous intervention (e.g. cardiac, cerebrovascular, aortic), or major surgery including thoracic and cardiac, within 3 months prior to baseline or anticipated need during study participation
  • Heart transplant recipient, or anticipated need for transplant during study participation
  • Any of the following events having occurred within 3 months prior to baseline: unstable angina as judged by the Investigator, unresolved acute coronary syndrome, transient ischemic attack or stroke
  • Current dialysis participant, or anticipated need for dialysis during study participation
  • Prior kidney transplant, or anticipated need for transplant during study participation
  • Metastatic, late-stage or end-stage cancer with < 12 months life expectancy
  • History of alcoholism or drug/chemical abuse within 1 year
  • QTcB interval > 500 msec (Bazett's correction formula)
  • Sustained systolic blood pressure > 170 or < 90 mmHg
  • Liver enzymes (ALT, AST) > 3 times upper limit of normal
  • Use of oral cardiac medications (including loop and thiazide diuretics) that have not been stable for at least 21 days prior to baseline and are not anticipated to remain stable during study participation
  • Use of any IV cardiac medications within 21 days prior to baseline, or their anticipated need during study participation.
  • Current use of polymer-based drugs (e.g. Renagel, Kayexalate, Welchol, Colestid), other phosphate binders or potassium binders, calcium supplements, antacids (eg TUMS, Maalox), or their anticipated need during study participation
  • Use of aldosterone antagonist in the last 30 days prior to baseline, unless was discontinued due to hyperkalemia
  • Use of potassium sparing medication and/or potassium supplements in the last 30 days prior to baseline
  • Use of any investigational medication, 30 days or 5 half-lives whichever is longer, prior to baseline
  • Participants who have taken investigational product in this study, or a previous patiromer study
  • Inability to consume the study medication, or, in the opinion of the Investigator, inability to comply with the protocol
  • In the opinion of the Investigator, any medical condition, uncontrolled systemic disease, serious intercurrent illness, or extenuating circumstance occurring or persisting, within 30 days prior to baseline, that would significantly decrease study compliance or jeopardize the safety of the participant or affect the validity of the trial results

Sites / Locations

  • Investigator Site 029
  • Investigator Site 031
  • Investigator Site 009
  • Investigator Site 018
  • Investigator Site 020
  • Investigator Site 005
  • Investigator Site 022
  • Investigator Site 001
  • Investigator Site 019
  • Investigator Site 102
  • Investigator Site 104
  • Investigator Site 103
  • Investigator Site 605
  • Investigator Site 602
  • Investigator Site 604
  • Investigator Site 603
  • Investigator Site 201
  • Investigator Site 202
  • Investigator Site 305
  • Investigator Site 409
  • Investigator Site 407
  • Investigator Site 406
  • Investigator Site 402
  • Investigator Site 403
  • Investigator Site 404
  • Investigator Site 412
  • Investigator Site 405
  • Investigator Site 507
  • Investigator Site 502
  • Investigator Site 509
  • Investigator Site 504
  • Investigator Site 506
  • Investigator Site 501

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

patiromer

placebo

Arm Description

Outcomes

Primary Outcome Measures

Change From Baseline in Serum Potassium to the End of the 28-day Treatment Period.

Secondary Outcome Measures

Proportion of Participants With a Serum Potassium Level During the 28-day Treatment Period That Was > 5.5 mEq/L.
Analysis based on central laboratory data.
Proportion of Participants Discontinuing the Study Due to Serum Potassium Elevation (Serum K+ > 5.5 mEq/L).
Analysis based on local laboratory data.
Proportion of Participants Whose Spironolactone Dose Was Increased.
Proportion of Participants With an Increase in Serum Potassium Level From Baseline to the End of the 28-day Treatment Period That Was ≥ 0.5 mEq/L
Time to First Elevated Serum K+ > 5.5 mEq/L.

Full Information

First Posted
March 23, 2009
Last Updated
May 10, 2021
Sponsor
Relypsa, Inc.
Collaborators
Medpace, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00868439
Brief Title
Evaluation of Patiromer in Heart Failure Patients
Acronym
PEARL-HF
Official Title
A Multicenter, Randomized, Double-blind, Placebo-Controlled, Parallel-Group, Multiple-Dose Study to Evaluate the Effects of Patiromer in Heart Failure Patients
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
April 2009 (undefined)
Primary Completion Date
November 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Relypsa, Inc.
Collaborators
Medpace, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study was to assess the effects of patiromer on serum potassium participants with heart failure. This study also assessed the safety and tolerability of patiromer in participants with heart failure.
Detailed Description
This was a double-blind, randomized, placebo-controlled, parallel-group, multiple-dose study in congestive heart failure participants. Depending on the outcome from the initial cohort of 100 participants (Part 1), a second cohort of 170 participants could have been enrolled (Part 2). Based on the results of Part 1 of the study, Part 2 was not conducted. Participants were randomly assigned to and received patiromer (30 g/day) or placebo for up to 28 days. All participants also received spironolactone; the initial spironolactone dose was 25 mg daily and was increased to 50 mg daily for participants who had a serum potassium ≤ 5.1 mEq/L on treatment Day 14. Study visits occurred on treatment Days 3, 7, 14, 17, 21 and 28. A safety follow-up contact was made 7 days after administration of last dose of study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hyperkalemia, Heart Failure
Keywords
HF, Heart failure, hyperkalemia, chronic kidney disease, prevention of hyperkalemia in heart failure participants

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
patiromer
Arm Type
Active Comparator
Arm Title
placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
patiromer
Other Intervention Name(s)
RLY5016, Veltassa
Intervention Description
Active investigational drug
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
placebo
Primary Outcome Measure Information:
Title
Change From Baseline in Serum Potassium to the End of the 28-day Treatment Period.
Time Frame
Baseline and Day 28
Secondary Outcome Measure Information:
Title
Proportion of Participants With a Serum Potassium Level During the 28-day Treatment Period That Was > 5.5 mEq/L.
Description
Analysis based on central laboratory data.
Time Frame
28 Days
Title
Proportion of Participants Discontinuing the Study Due to Serum Potassium Elevation (Serum K+ > 5.5 mEq/L).
Description
Analysis based on local laboratory data.
Time Frame
28 Days
Title
Proportion of Participants Whose Spironolactone Dose Was Increased.
Time Frame
28 Days
Title
Proportion of Participants With an Increase in Serum Potassium Level From Baseline to the End of the 28-day Treatment Period That Was ≥ 0.5 mEq/L
Time Frame
Baseline and Day 28
Title
Time to First Elevated Serum K+ > 5.5 mEq/L.
Time Frame
28 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants with chronic heart failure clinically indicated to receive spironolactone therapy, aged 18 years or older with serum potassium level of 4.3 - 5.1 mEq/L at screening and baseline, AND (1) chronic kidney disease (GFR < 60 mL/min) OR (2) documented history of hyperkalemia within the last 6 months Females of child-bearing potential must be non-lactating, must have a negative serum pregnancy test at screening, and must have used a highly effective form of contraception for at least 3 months before study drug administration, during the study, and for one month after study completion Male participants and/or their female partners of child-bearing potential must use a highly effective form of contraception during the study and for 3 months after study completion Must sign informed consent document Exclusion Criteria: History of bowel obstruction, swallowing disorders, severe gastrointestinal disorders or major gastrointestinal surgery Uncorrected hemodynamically significant primary valvular disease, known obstructive or restrictive cardiomyopathy, uncontrolled or hemodynamically unstable arrhythmia Coronary-artery bypass graft, percutaneous intervention (e.g. cardiac, cerebrovascular, aortic), or major surgery including thoracic and cardiac, within 3 months prior to baseline or anticipated need during study participation Heart transplant recipient, or anticipated need for transplant during study participation Any of the following events having occurred within 3 months prior to baseline: unstable angina as judged by the Investigator, unresolved acute coronary syndrome, transient ischemic attack or stroke Current dialysis participant, or anticipated need for dialysis during study participation Prior kidney transplant, or anticipated need for transplant during study participation Metastatic, late-stage or end-stage cancer with < 12 months life expectancy History of alcoholism or drug/chemical abuse within 1 year QTcB interval > 500 msec (Bazett's correction formula) Sustained systolic blood pressure > 170 or < 90 mmHg Liver enzymes (ALT, AST) > 3 times upper limit of normal Use of oral cardiac medications (including loop and thiazide diuretics) that have not been stable for at least 21 days prior to baseline and are not anticipated to remain stable during study participation Use of any IV cardiac medications within 21 days prior to baseline, or their anticipated need during study participation. Current use of polymer-based drugs (e.g. Renagel, Kayexalate, Welchol, Colestid), other phosphate binders or potassium binders, calcium supplements, antacids (eg TUMS, Maalox), or their anticipated need during study participation Use of aldosterone antagonist in the last 30 days prior to baseline, unless was discontinued due to hyperkalemia Use of potassium sparing medication and/or potassium supplements in the last 30 days prior to baseline Use of any investigational medication, 30 days or 5 half-lives whichever is longer, prior to baseline Participants who have taken investigational product in this study, or a previous patiromer study Inability to consume the study medication, or, in the opinion of the Investigator, inability to comply with the protocol In the opinion of the Investigator, any medical condition, uncontrolled systemic disease, serious intercurrent illness, or extenuating circumstance occurring or persisting, within 30 days prior to baseline, that would significantly decrease study compliance or jeopardize the safety of the participant or affect the validity of the trial results
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Director Clinical Operations
Organizational Affiliation
Relypsa, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Investigator Site 029
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Investigator Site 031
City
Port Charlotte
State/Province
Florida
ZIP/Postal Code
33952
Country
United States
Facility Name
Investigator Site 009
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61606
Country
United States
Facility Name
Investigator Site 018
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55417
Country
United States
Facility Name
Investigator Site 020
City
Buffalo
State/Province
New York
ZIP/Postal Code
14215
Country
United States
Facility Name
Investigator Site 005
City
Northport
State/Province
New York
ZIP/Postal Code
11768
Country
United States
Facility Name
Investigator Site 022
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Facility Name
Investigator Site 001
City
Dallas
State/Province
Texas
ZIP/Postal Code
75216
Country
United States
Facility Name
Investigator Site 019
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States
Facility Name
Investigator Site 102
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Name
Investigator Site 104
City
Prague
ZIP/Postal Code
12008
Country
Czechia
Facility Name
Investigator Site 103
City
Prague
ZIP/Postal Code
14021
Country
Czechia
Facility Name
Investigator Site 605
City
Tbilisi
ZIP/Postal Code
0102
Country
Georgia
Facility Name
Investigator Site 602
City
Tbilisi
ZIP/Postal Code
0159
Country
Georgia
Facility Name
Investigator Site 604
City
Tbilisi
ZIP/Postal Code
0164
Country
Georgia
Facility Name
Investigator Site 603
City
Tbilisi
ZIP/Postal Code
0179
Country
Georgia
Facility Name
Investigator Site 201
City
Gottingen
ZIP/Postal Code
37075
Country
Germany
Facility Name
Investigator Site 202
City
Heidelberg
ZIP/Postal Code
69120
Country
Germany
Facility Name
Investigator Site 305
City
Warsaw
ZIP/Postal Code
02637
Country
Poland
Facility Name
Investigator Site 409
City
Barnaul
ZIP/Postal Code
656099
Country
Russian Federation
Facility Name
Investigator Site 407
City
Kemerovo
ZIP/Postal Code
650002
Country
Russian Federation
Facility Name
Investigator Site 406
City
Moscow
ZIP/Postal Code
111020
Country
Russian Federation
Facility Name
Investigator Site 402
City
Moscow
ZIP/Postal Code
111539
Country
Russian Federation
Facility Name
Investigator Site 403
City
Moscow
ZIP/Postal Code
129301
Country
Russian Federation
Facility Name
Investigator Site 404
City
St Petersburg
ZIP/Postal Code
197341
Country
Russian Federation
Facility Name
Investigator Site 412
City
St Petersburg
ZIP/Postal Code
198205
Country
Russian Federation
Facility Name
Investigator Site 405
City
St Petersburg
ZIP/Postal Code
199106
Country
Russian Federation
Facility Name
Investigator Site 507
City
Dnipropetrovsk
ZIP/Postal Code
49023
Country
Ukraine
Facility Name
Investigator Site 502
City
Kharkiv
ZIP/Postal Code
61018
Country
Ukraine
Facility Name
Investigator Site 509
City
Kharkiv
ZIP/Postal Code
61176
Country
Ukraine
Facility Name
Investigator Site 504
City
Kiev
ZIP/Postal Code
03680
Country
Ukraine
Facility Name
Investigator Site 506
City
Kiev
ZIP/Postal Code
03680
Country
Ukraine
Facility Name
Investigator Site 501
City
Kiev
ZIP/Postal Code
04114
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
21208974
Citation
Pitt B, Anker SD, Bushinsky DA, Kitzman DW, Zannad F, Huang IZ; PEARL-HF Investigators. Evaluation of the efficacy and safety of RLY5016, a polymeric potassium binder, in a double-blind, placebo-controlled study in patients with chronic heart failure (the PEARL-HF) trial. Eur Heart J. 2011 Apr;32(7):820-8. doi: 10.1093/eurheartj/ehq502. Epub 2011 Jan 5.
Results Reference
result
PubMed Identifier
32588430
Citation
Natale P, Palmer SC, Ruospo M, Saglimbene VM, Strippoli GF. Potassium binders for chronic hyperkalaemia in people with chronic kidney disease. Cochrane Database Syst Rev. 2020 Jun 26;6(6):CD013165. doi: 10.1002/14651858.CD013165.pub2.
Results Reference
derived
Links:
URL
http://www.relypsa.com
Description
Relypsa company website

Learn more about this trial

Evaluation of Patiromer in Heart Failure Patients

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