A Double-Blind, Randomized, Placebo-Controlled Study of Levosimendan in Pulmonary Hypertension Patients With Heart Failure With Preserved Left Ventricular Ejection Fraction (PH-HFpEF)
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 44
- 试验地点
- 16
- 主要终点
- Change From Baseline Pulmonary Capillary Wedge Pressure (PCWP) With Bicycle Exercise
研究概览
简要总结
Phase 2 study to evaluate the efficacy and safety of intermittent levosimendan compared with placebo in hemodynamic improvement with exercise in PH-HFpEF subjects
详细描述
Levosimendan and its prolonged active metabolite, OR-1896, have been shown to have favorable hemodynamic effects in subjects with pulmonary hypertension and right heart failure. Clinical studies that have been conducted in subjects with right heart failure and pulmonary hypertension suggest levosimendan may be an effective therapy in treatment of subjects with PH-HFpEF. This study will provide demonstration of levosimendan/OR-1896's effectiveness in critical measures of hemodynamic response in weekly administration of levosimendan and the concomitant response as measured by exercise capacity, subject quality of life, and changes in functional capacity. These data will support and guide the Phase 3 development of levosimendan in PH-HFpEF subjects.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Criteria to enter Open-label, Lead-in Dose Phase:
- •Diagnosis of World Health Organization (WHO) Group 2 Pulmonary Hypertension (PH) with Heart Failure with Preserved Ejection Fraction (HFpEF) confirmed at the time of the diagnosis of pulmonary hypertension.
- •Baseline Pulmonary Arterial Pressure (PAP) ≥35, Pulmonary Capillary Wedge Pressure (PCWP) ≥20, New York Heart Association (NYHA) Class IIb/III, Left Ventricular Ejection Fraction (LVEF) ≥40%
- •Ability to walk at least 50 meters, but not more than 550 meters in a six-minute walk test.
- •Stable oxygen treatment (if applicable), and medications for heart failure, hypertension, and respiratory condition
- •Criterion for Randomization to Double-blind Phase:
- •Response to Open-label, Lead-in Levosimendan: Patients who demonstrate a ≥4mmHg reduction in PCWP from baseline measured at bicycle exercise (25 watts) with no more than a 10% decrease from baseline in cardiac index
排除标准
- •Subject has a primary diagnosis of PH other than Group 2 PH-HFpEF
- •Previous Percutaneous Coronary Intervention (PCI) or cardiac surgery (CABG), unless they have a negative stress test in the last 12 months)
- •Congenital heart disease
- •Clinically significant lung disease
- •Planned heart or lung surgery
- •Cardiac Index >4.0 L/min/m2
- •Concomitant administration of pulmonary vasodilator therapy or taken within 14 days
- •Dialysis or Glomerular Filtration Rate (GFR) <30 mL/min/1.73 m2
- •Liver dysfunction with Child-Pugh Class B or C
- •Evidence of systemic infection
- •Weight > 150kg
- •Symptomatic systolic blood pressure (SBP) cannot be managed to ensure SBP >100 mmHg
- •Heart rate >= 100 bpm with the study drug, symptomatic and persistent for at least 10 minutes
- •Hemoglobin < 80 g/L
- •Serum potassium < 3.0 mmol/L or > 5.5 mmol/L at baseline
- •Patients having severely compromised immune function
- •Pregnant, suspected to be pregnant, or breast-feeding
研究组 & 干预措施
Levosimendan 2.5mg/mL Injectable Solution
0.075 - 0.1µg/kg/min for 24 hrs (weekly)
干预措施: Levosimendan (Drug)
Matching Placebo
0.075 - 0.1µg/kg/min for 24 hrs (weekly)
干预措施: Matching Placebo (Drug)
结局指标
主要结局
Change From Baseline Pulmonary Capillary Wedge Pressure (PCWP) With Bicycle Exercise
时间窗: Baseline, Week 6
Change from baseline Pulmonary Capillary Wedge Pressure (PCWP) with bicycle exercise at Week 6
次要结局
- Change in Cardiac Index (CI) at Rest and With Exercise.(Baseline, Week 6)
- Patient Global Assessment(Baseline, Week 6)
- Exercise Duration Via 6 Minute Walk Test(Baseline, Week 6)
- Change in Pulmonary Vascular Resistance (PVR) Effect at Rest and With Exercise(Baseline, Week 6)
- Change in PCWP When Supine and Legs Elevated(Baseline, Week 6)
- Physician's Assessment of Functional Class(Baseline, Week 6)
- Number of Participants With Composite Events of Death or Hospitalization(Baseline, Week 6)